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COtiMoNweALTH"oP peNNSYLVANIA }
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COUNTY OPetHlltlIRl:ANlt tc,"N<'IIM rp.
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A/CH 3l6-0BN
Assistant Viae President of Mellan Bank, N,A.
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.ooordln9 111 law, d,polI' .nd "yt th.1 ~ she is EXeoutor
111 Ih. Elfel. 01 Br~dford Ya9:c;1Y
'I~I. ol..:..-9'arusle , Cymblll.nd Cl1ynty, Pa., duulld .nd Ihil Ih.
wlth'n II .11 '"v,nlory m.d. by ~. J., Wo~niski, , Asst. Vioe , Presiden~ Ih. laid ,I!lxeoutor
01 Ihl .nllr. tllah al uld dU,d.nl, oanlhlln9 01 all Ih. plllanal pro,PI/ly .nd rul 'Iftl" Illa.pt rul IIht. aullld.
thl Commanwullh af P.nnlylva"'., and Ihtf Ih. f19ur,lappalll. luh"lftm 01 Ihl Inv,nlory "prlllnt 11"'.1/ valy.
II 01 the dale 01 d.old,nt'. duth. , '
Mill LON BANKr, N)^,
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b.ln9 duly, sworn
IIJJroll
Oat. of Oe'lh
25
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October
MoMh
1997
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INSTRUCTIOHS
,. An 'nVlntory my" be III.d wllhln thr.. month. altar appolntm.nl al pl/lon.1 r'p"untetlv..
2. A lupplement Inv.nlory must b. /II.d wllhln thirty daYI 01 dhaav.ry ol'.di:lltlonal ""II.
~. Ad~tllanallhf,:.,kmay b. ~tt.oh.d II ta plrlonalfy 0/ rully ,
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SCHEDULE H
PUNERAL EXPENses &
ADMINISTRATIVE QOSTS
PI~a NUMBBR
21-1997-0941
Bo Idu ,
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No,
A, pUNeRAL llXPllNBB81
,1' Professional sell:Victls
OS80RIPTION
AMO NT
64.00
, ,8, ADMINI8TRATIVe 008TSI
1, ,PI,..nal Rlpll~ntIUvl'l OQlM1IlIlonl
N.",. 01 PIJ10nai Rlpieian"Uvl(a) MeUon BanJI; N .A.
Ilodlal B80UIhy Numbtir(I)/BIN No, 01 Plllonal Replalant.Uve(l)
BUlttAddrl" ro Box 7899 ~ #193-0224
OIlY l?~la~ip!ua '," Blale )?A
16,990.00
ZIp 191(l1.7899 I
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V,"(') OQmmllllon PoIdl
MornlV Pile Name I F1CAA'er MJrgentl'lal F1CAA'er ~
F'rnll,! l!JcampUOnl (If d80ld'nt'l addrl8l11 not lha '1/l1ll AI clalmant'i, anaoh aMplanaUon)
Olaimant
BUt\lIAddr...
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R'lallonehlp 01 Cllimenl to Oecedant
8,495,00
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4. Plob"l Pi.. 354 . 00
e, AcCOuntant'l Fill 0.00
e, T~'f\t1UrnPllplIl~1 F.., .,0.00
7 Register of Wills, short certificates 39.00
25 942'.00
1 CPAI1 Hrp 10111
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