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PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of "
Holen E. Evans
'I deceased,
To Richard E, Anderson, Rcgister of Wills for the County of Cumberlond,
in the Commonwcalth ot Pennsylvania,
11Ix
Petitioner(s) ore the execut or_s named in the Last Will and
Testament of _.!I~~(]~.E!.~~y;~~q.u ,., ._. doted 1\m::!J. . U.....l91,5
Decedant was 0 citizen of the United States and 0 resident of
iaiowl'lsbt~
~ar~isle ___________ Borough, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on _sLl.n.9.~ the _El!1..__ day oLiLMJ,liU:~___"
A. D. 19~, in the County of ___<::umbeXlall9-,_,_____, '_____, State of
Pennsylvania . at the age of ~_ years,
*105 X~llIll her
Decedent has not been married and has not hod children born to :bin
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
$25,000.00 and of real estate to the value of
$0.00
os near as can be ascertained; said real
estate situated os follows __,__________.
apply
Therefore, your petitioner(s) respectfully l1I~ies for the probate
of the said Lost Will and Testament and for Letters Testamentary thereon.
Dated February 5 I 1979
Nome and address
of Petitioner(s)
~a;~r:e~:'~~~d~~'h~l{~m\;h'" N
il:)~mpsonto~nl Pl'>. Q, ~. k--.fL. ._
O~~~'D ~., )M~~d~~IRdl'&N~e~hT
wvil,. PA.L ~' " ~I
... ...~t~(L.f" Lt.' ~\,
a~ e H. Menden al I Jr.
-Srl.iSle, :l'A.,
N~'o;{ar/ee 'fr'<I'i"13'aJK" 01", 'v
_li . iahurg I PII.
COMMONWEALTH OF PENNSYLVANIA f
ss
COUNTY OF CUMBERLAND
l~fll'Y T,oo Hr'lIdudw:ll ~l,\;,th, 1)''',1''1 fl. 1,'uthI011hnlJ 'IolnoIl,
\lnYllO 11. t-1"l1doIlIIL 1 J~~ "",I .L"li,-2.LL1t~~~J:!~!l~NLL_}'1nli._.__,_,_"__
d. b I' t' b' d I 11'lul'tl d' t law
nome In 0 ove app Ica lon, elng u y __.n.'_. __..,_.._,., accor II1g 0
say(s) that the statements set forth in this petition are true to the
f .'
best 0 __.,t:!.l':,L~_.
~ ();' \-1 p~
.. _ knowledge and belief,
, I
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ubscribed before ,,/.re,;..j_,./y,'c/.....L'..J.cL'..IC/ (c~"",tr
( Ll.)tJL\Lj__)I\)~G.;.~;jJv-,'~v ,)l: ,L, \)
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11,1;,./, ,".' -'il /,!hd.l--, I _ .. '
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Richard E, Andefson, Register
Filed: F('[Jrui\ry , ] 97')
I
^ttOI'lIC'V ,Tamas ^. 1I1sh, Esg.
Sho[\rar, Motte & Woodsido
P.D.Box 729, lI[\rdsbun
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LAST WILL AND TESTAMENT
or
HELEN E. EVlUlS
I, HELEN E. EVANS, of tho City of li~I'risbur.g, Dauphin
County, pennsylvania, do make, publish and declare this to be my
Last Will and Testament, hereby revoking all wHls and oodicils
by me at any time made.
ITEM II
I dir.ect that all i"heritance
and estate taxes becoming due by reason of my death, whether such
taxes may be payable by my estate or by an recipient of any
property, shall be paid by my Executors out of the property passing
under ITEM V of this Will, a~ an expense and cost of administration
of my estate. My Executors shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on
proceeds of insurance or otber property not passing under this Will.
I'l'EM II I
I direct my Executors to pay the
expenses of my last illness and funeral expenses from the proceeds
of the life insurance policies in effect at the time of my death.
If any portion of the proceeds of these insurance policies remain
after payment of the aforesaid expenses said proceeds shall pass in
aooordance with the provisions of ITEM V hereof. I further direct
that my funeral service be held by my Executors at the oonvenience
of my family, that there be no publio viewing, that the funeral
service be simple and that attendance be limited to members of my
immediate family and close friends. I direct my Executors to request
Sheridan Watson Bell, retired pastor of the Grace united Methodist
,'" 't,,,,
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Church, Harrisburg, pennsylvania to conduct th~ f~neral service.
It is my desire that flowers be limited to arrangements of yellow
roses and that my family and friends contribute to the Crippled
Children's Foundation and the Heart Association in lieu of flowers.
ITEM IIII
I make the following specific
bequests I
(a) I give to Rose M. DiPet~o, of H~rrisburg,
pennsylvania, my silver Girard perrugaux watch
with diamond setting, provided that if Rose M.
DiPetro does not survive me, this gift shall
lapse and pass in accordance with the provisions
of ITEM IV hereof.
ITEM IVI I give and bequeath absolutely
and in fee simple all of my household furniture and furniShings,
books, pictures, jewelry, silverware, automobiles, wearing apparel
and all other articles of household or personal use or adornment,
not disposed of in ITEM III hereof, in equal shares, to such of
my ni.eces, Mary Lee Mendenhall Smith, Thompsontown, Juniata County,
Pennsylvania, and Donna D. MendenhAll Nelson, Newville, Cumberland
County, pennsylvania, and my nephew, Wayne H. Mendenhall, Jr.,
Carlisle, Cumberland County, pennsylvania, living at the time of
my death, to be divided among them as they shall agree. Should there
be no agreement, such property shall be divided among them by my
corporate Executor in as nearly equal portions as is deemed practical
in the sole discretion of my corporate Executor, having due regard
to the personal preferences of such nieces and nephew.
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ITEM VI
I give, devise ~nd bequeath all the
rest, residue Ilnd remainder of my eotate, not Jisposed of in the
preceding portions of this will, to my nieces, Mary I,ee ~Iendenh!lll
Smith and Donna D. Mendenhall Nelson and my nephew, Wayne H.
Mendenhall, Jr. in equal shares. If eit.her of my said nieces or
nephew is not living at my death, his or hur ehare shall be paid
to the then living issue of such deceased niece or nephew, per
stirpes. In the event, such deceased niece or nephew has no then
living issue, such deceased niece I s or nephew I B share of this bequest
shall be divided equally between my other nieces or nephew, or if
deceased to their issue per stirpes.
ITEM VI:
In addition to powers given them
by law, my Executors and their successors shall have the following
powers, applicable to all property held by them, effective wit,hout
court order Ilnd until actual distribution:
(a) To retain any property received by them;
(b) To sell my property for any purpose, for
such prices and on such terms as they deem proper,
without liability on the purchasers to see to appli-
cation of the purchase moneys; provided that said
property shall be at public sale only if determined
absolutely necessary in the discretion of my
Executors,
(c) To compromise controversies,
(d) To distribute in cash or kind or both
at such valuations as they may fix, and
(e) To hold investment in the name of a
nominee.
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PI';NNSYf,VANIA IRS;
COUNTY Ol? CUMBEHLAND \
rl'his." ...,.........."" ..".~.~.~ '"'' "..........,.. '" ," ," t,." ,.." day of,..". ......... .~~.~~~,~~X,,""'" """ "'"",,, ...... A.I)" 19" ,,?~t
beforo me Hichnl'd 1<;, AnuerHon, Register for the Pl'Obate of WHIR Hnd grunting lettCl's of Administration
in Hnd for SHid County of Cumberland, in the CommonweulLh of Pennsylvania, personally came ..............
Robert J. Woodside and John !lavas
".....,.'.,......",...""".,........"..".",...,.......,.......,.,........".,."............"..........................."""..,....".",..,.......,..,.....t..,........
the subscribh1g witnesses to the foregoing instrument of writing plll'porting to be the lust Will and
Testament of . .....' ..,~J,~,~,~,~..,~,7....~,:::7,~~,.."........ .....,............,.., '''''' ...... ....".... Duted ...~P..~~,l....~,~.!,.. ,~,?~,?..""
I t, I' Carlisle C I' -1 de t P d d
a e 0 ".............,...""........."...".........."........."..."...""..."..."..".".".............. unl )t:ll an DUll Y . a., eceuse
who being duly ."........:?~~~,~..,..............., according to law, depo~e and say, that ..,....~!:,e.:r...~.~~.~.............
t d d h d h t t tr lJ{ H n 1 (, n 'fi'1 17' v ru':l
presen ,an saw an ear tees a.......~................."....., ......"".............".",,,....,,....................,,..................
sign, seal, publish, pronounce and declure the said instrument of writing as and for h...";l,~......... Testament
and Last Will, and at the time of so doing "......,..,......~,~!:..,........,...."..,....was of sound and disposing mind
memory and understElnding, to the best of .............~,~~.~,~........,,,.......,..,knowledge, obRervation and belief.
........~~~,~~....,....................... and tbs(:ribed before
....."...(j}7.~.:..,~~~~~,~;;g;L,...........,...,.
( !,-,:J(;f. /-4"h --YO?;' A
ff.,' F' '{:' ..'''' '.~' .,/ _' ,':. _/-" ___
......~~.:f'h-..t:.r.... ....~:'/.i(."!J.o';' ..j'. .-I'rt~.............................
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,...t:..;...;".,............:.-:,............-............."......,,..,.",.........,..
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AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss;
COUNTY OF CUMBERLAND \
................,...........,...,...... .....~ ~X.~~...~:. ,. ,~~::.~~.I:l.h~.~.~.~,. .~?:. ~"....... ~".".........." ...;.. \"..,.j.. ,j.. ~'.....,... ..being duly
............f!~~!i!!:....,................... says that as nearly as can be ascertained the said decedent ...,..,...................
.........., ,,,,,,,........,..,,,,.....,.....,.. ..~~.~.~n,..~.~.. .~X.~,r. ~"....".,..........,....,.."."..," ....... "",.." ,-."..,,,,....,.......,...... ,died on
..........,$.~.-t:\9.-~.:v.................",..., the ....,."..,~.+.tEi;l;.......H....day of ,.,.."..".Y.'~.t;l,H~.t.~.,...... ,:...."......... A,D" 19".?~,
at or about ....,..,..,.....7..:),9...........,...... o'clock,I?",M,
.........' ..~:-!,9. F,i1...".."...,...."...,.,.., .and subscri bed this
......................~;.~:!!..,.........,..,... y of ....,f.~!?,n!~,;::y.,
19,~.L.., before
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.J.l:~~i}\'l-J.!...Jl..1:::i:;.t,...).-4::f!.~.,.,...........,...
--..............
"............... ..........,",..,...................,..,~,
Richard [,~, Andlll'son, Rt'giRtt'l' '.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PJ':NNSYLV ANIA} ss:
COUNTY OF ClJMB1~HLANJ)
Before mil, the Register fOI' the Probat.e of Wills nnd grunting of Lottuf's of Admlnistl'HUon Inllnd lor
),)\O-'~~- Lr't' (h('\<\d'''''ht>_' I ~~)I-~l ,"., t..... , 0 {-<"IV~I,/ (~_ 0 f\-HL~l.tI\II(I(
th Co t of Cum Ie' land pOI'SOI1Ully came \\i, I'"" J L,;" " h. II "h,,,,I,, 'I' 'I ,J t '1 (>.j" J<<.""I
e J un y ) 1 I ",'"I";"..~,,, """"""~""""""""""""",.,.I,, .1., """"""""""0'""""
C (...~ " '4~. \ (;)'\ V\. \.c
who, being duly ......~,;;-:,;:,..:~..,...... do ......... depose Hnt! suy thut a8.....X.~~:h\.dr.'.\..i.....""..""".""""".."....
f tl I t W'll d T,t nt f /-\( I e IV c: f Vr\ ,l ~ cl' ' 'J
o le as 1 an es ame .0 .",..,.......".....,,,........,,,,,...,,,,.................,,.....,..,,,,,.......,...."..........,..., (;..ceasc(
'~~~:.~"l-......."" will well and truly administer the goods and chattels, J'ights and credits of said deceased
aceording to law. And also will diligently comply with the provisions of the law relating to Transfer
Inheritances. ..,:;...*-1,;:,':..':'>"...... and subscribed
. .
Richard ". Anderson, Register
...............",,>..
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.,.,.'I.....~d.'........ ...."..............,.,!"I...r..t~',,,.....,.,.,..
before me.
. D., 19..1~""..
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DECREE
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C It remem ere t at on t; a .........:..:........... dAY of ......."...".......-.."-......;"..."."...".", ' .., .9........, t.lere
was probated and recorded tho last Will and Tcstal11ent of "..;~:-?+.::::l."~':,'"}:.~/:;tl.~~.."".....,...".",,....,,............,
late of .............. ,G,!:.':.U;:':.~,:;..................... ,....."....' ""....., Cumberland County, Pennsylvania, Deceased, Letters
\~[U'Y f,OO l'iTon.Jdlil'ir1ll ,(",tld th
'Postnniontn!"v. t'd t ;'lO!lnrl P. f-,1cl1rlorlhol'l 'l!ilnOl"l
...,......"......~.............,.....,.."",,.. ..'l.., wero gran eo.,.. 'I'''':: '!'!""1"" '~}t.-".'...:r",' '.'T'~j-\ '1 '1...'.'.,.(\."....."u...-......., ,.,. '.......
_'Inyrtl~ .. ''(:It,lL11''''' _." ~Il'. .1'U,.
11 1 :L!lud (' (: Ill; p'1 1 Iih
Witness my hand and ollicinl seul the duy IInd yonr nforesaid.
.......".,.,......,..,..""..,,,......'.. ....."....""....,..,,,,
Hi('hnrd K And(.rson, Rq~iHtcr.
tH (-11 ,,'I'!II
COMMONWEALTH Of PENNSYL VANIA
DU'ARTMENl or REVENUE
IllJRFAlJ OF COUNTY COI.l.ECTIONS
APPLICATION FOR AND CONSFlIT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDnn
.
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYL.VANIA DEPARTMENT OF REVENUE:
Application is hereby mode lor ClXlSOl1t to the tronsfor of the lollawing securities of 0 Pennsylvania
Cotporation or 0 Notionol Banking Associolion locoted in Ponnsylvania: 4~% Cum.
(0)6_8har~8_ d(b)_ llallUl18m111 Paper Company (cl.. Preferred
(NOTE: In describing socurities enter in (0), "b '''e, either the number 01 shores of stock or the face amount 01
regislered bonds, In (b), the nome of the issuing comp"n)' "nd i" (d the ,I"" of sto"I< or tho stated interest rote
and moturity date of rogistered bonds,)
DATE Feb, 12, 1979
ISSUED ON_Oct~~.~193B., and having 0 TOTAL MAllKET VALUE OF $~;)9.QO
(Data) 1 .
os of the dClte 01 dealh 01 the decedent He en E. Evans on January 21, 1979
,. I ...... .._.._ .u..__ _ ____.... ._
(Nom~ of Dflclldllntl (Dafll of donfh)
who wos lata oL~.c:ar.1t()n Avenue I Carlisle, Pennsylvania 1]013.
(SHllflf and Numher)
(Post Offield
(Counfy)
(Stoffl)
The securitios ore~~istere 10110 Sit Holen E.Rvans,. ." I
I, 1 . ( , . ." . I I, f!' '1. ,
..~ . '. -..t!, ~:/IiLJ, (N,,,"o", n"",", ,,, ",h',h '"""'<0)0', '~~~"11r' Ii, Jr',! ( "Il' '.." I\, '.'
aye. n ennat'1;"Jr. Donna . e';rcfenllall1re:J.son-
=~(ff~~~ 't~m~~de~haii (~ndtl~ 1/, iI. . )ll!IllJW~(IIN. l~ GE.~.!TRAL BANK
-t{AM~ DF AI"PLlCANlBY Y'i\CI' J.>~" ,_/C~.2n "-L' r"~'
V1C . ~re8i ont and Trust Off1cer
COUNTY FILE NUMBER "'~' m.l~__N/m_ ADDRESS OF APPLICANT' 2 Market Street
Harr1sburg, Pennsylvan1a 17108
BUREAU FILE NUMBER. . ... SIGNATURE OF APPLICANT.
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION,
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES .
""..--...... .. u .... 0 TE ) l \,\, 1 '~'1 (l' ')1.
A.. r- ""7 1 (
I hereby tonsent to the transler 01 the above ser.urities now regislerod in the name 01 the aloresaid
Docecleot aod waive Ihe filing 01 0 certilicate certifying to tho payment of the Ironsler inheritance tax to which
tho property 01 saicl Docedent is made subject pursuant to the provisions of the Act 01 Juoo 20,1919, P,L. 521,
as amendod and the Act 01 June 15,1961, P,L. 373, as amendecl. This is nlso in accordance with the provisions
01 the Act of April 9, 1929, P.L. 343.
This Cons'lnl to Trnnsler the herein descrihorl proporty Op"lotes only In relerence to the estate of the
above.namod Decedent.
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,;:!", f~L~; (\
Sill,,,,,J ior tho Secrotary of Revenue
[jy~J\~ Llb~;~o;= . ("'>l b.~,.",..~.\l/IfI\.
IT illfJ)
(County)
Inventory of the real and perianal ..tate of
Helen E. Evans
decea..d.
----....-.-..-------- .-... ,,-----.-.----.- .-.... -~..-- ---
- ------.---_...,.--.-.... ---~._--._.__. ..-
1. Jewelry
2. Household furniture and furnishings
3. Coins
4. Statement Savings Account #61-98018641 with National Central
Bank
Accrued interest on item #4
5. Certificate of Depos it 1f6l- 99323421 with National Central Bank
Accrued interest on item #5
6. Certificate of Deposit #61-99323448 with National Central Bank
Accrued interest on item #6
7. Passbook Savings Account #45478 with Harris Savings Association
Accrued interest on item #7
8. Certificate of Deposit #1-09-131604 with Harris Savings
A!3sociation
Accrued interest on item #8
9.
10.
11.
Checking Acco\mt #61-348921 with National Central Bank
6 shares Hammermill Paper Co. , Pfd.
Proceeds under Prudential Insurance Co. Policy #M06554784i face
amount - $500 plus dividends of $483
Proceeds under Prudential Insurance Co. Policy #M08642338; face
amount - $500 plus dividends of $524
$25 U. S. Savings Bond, Series "E", dated March 1977, P.O.D. to I
Mrs. Donna M. Nelson
$25 U. S. Savings Bond, Series "E", dated March 1977, P.C.D. to
Mary Lee M. Smith
$25 U. S. Savings Bond, Series "E", dated March 1977, P.O.D. to
Wayne H. Mendenhall, Jr.
12.
13.
14.
15.
2 , 481. 27
341. 00
31.150
983.107
2.173
5,395.104
155.105
I
I 5,395.i04
155.i05
II ,
875.~2
I 2.152
I
5,425. 3
23.79
4,231. 6
339. 0
I
983.\00
,
1,024.100
20. 3
20. 3
20.43
27 905. 6
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~ DAUPllIN
II:
Mary Lee Mendenhall Smith, Donna D. Mendenhall Nelaon, Wayne H. Mendenhall, Jr.,
and Na tional Cen tr al Bank
being duly aworn . occordlng 10 low, dopo,.<<ond ..ylt Ihol t h. Y ...are.
Exocutors of Iho E,lat. 01 HelenlL__ EY.aWL.... .._.
1.1. of Carlisle ... ., Gymb.,lend CO.1'nty, Pe., d.c....d .o.nd IhAt the
Mary Lee Mendenhall Smith, Donna D. Mendenhall Nel~pn, ~XECuTO~S
within II en Inv.nlory modo liy Wayne H. Mendenhall Jr-,-- & National I'i!etffral" Bank n
of Ih. ontlro .,feto of ..Id decede~t, con',l,tlng 01 .11 tho p.rlbnel prop.rty and ro.1 ell.l., ..c.p r,.1 .if.lo ouhlde
the Camn,onw.elth 01 Penn.ylv.nla, aod Ihot Ihc figure I Uppol,lt. ..ch. Ijom.of thelnvenlory rop'J,ent II', fair velu.
01 of tho dole of decedent'. d..lh , /) It' ' If.5' ( , )/ \ , (,! ( f I ,. ",' ( ( ..
(~!IO(,I'{'~ () ,,) ,O~'l\)/ ,J
~~.. ,111'11 I ,.
) ev.eutor . K!Y.IaUt
NA~~L CENTRAjfJANK)
n~~ fr~ia~~~d ~:t~6'ffi;;r
222 &rk.et Street... Harriabur.g,PA 17108
Addr...
Sworn ..__..._.____ and lub,crlbed befot. me,
_..!j~~L.......l '7___..___........19 ..I9......,_
.. 0~~ry~j~..--------
P~IIL I /lilillP, W'IMI! P!'I,:IG
HAt-<(':;;';(!ir"j_ ;,\li'i-1!i '__,:U;I',
MY COMMISSION I,PIII,:; (Jle /I, 1982
Member. Pt'n/l~yJvarll.1 A5S(If'!allon 01 NNafles
D.t. of D.ath . Jan1Jar~_~l._..__._.___
O'Y
1979
Month
Vu,
INSTRUCTIONS
I. An Inventory mUlt b. flied within thr.e month, oft.r eppolntmont of pOrion. I r.prol8ntetlve.
2. A luppl.m.nt Invontory mUlt bo flied within thirty dOYI of dlscovory of addltlonel en.h.
3. Additional Iho." may b. o".chod .. to porlonolty or reelty
4. See Artlcl. IV, Flduclorlel Act of 1949.
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Of __ CUDlb<.n::"llUlL COUNTY
ANIl AOENT Of' THE COMMONWUL lIi
/
,,' c/ " I ,
~l'
I
,,'
()"I)UCTION~ ALl OW,,[, IN
\}'I r (,('
HW !)UM In- _. ". _,., ~ _".~...,. I.~ .
, 1/ I !I' !I' Ii
rr!! mrrr.[j.t~d J-. (-il-
I _!L\-"..I.\~LLcJn'":,,.).hj, '~. .-
i\:\,,' . '~,rll:(ll~tl'~ Of' WIl.L!i, 'IIl\l't; r
_....:...~..:G.l4j'_____'d_. ..... . .___..... _ ..
IUlv-ue ~6~''')
on ICE O~ THe
RHI\HR or WIl.L1
Sl'ATEME:NT OF DEBTS
AND Dr:DlJCTlONS
~~----<'_._-
m A H OF ._c.Ji.e 11m E. ..~.YJill~__,_ LA TE OF _....J:_~_r lis ~e ___..__........____.
DATF. OF FILING APf'RAISEMENl L1i.l-/.J-_:./Jj ~ DATE OF DEATH January, ~t.t.... 19}9
.... . .:_ _~.:m,:,:=~::::;:-----,-:-...::::;;=...:.::::::::..-==::.:.::.:=.:::.:::.:t~::::::;:=:'";'.:...._;...:::-=---:=---_.. ~.'U _..~... .,. ._~ __ ___
NO. OF
VOU':iIER
NAME OF PAYEE
REMARK~
A.MOlJNT
IIAlf
1'979
Fe.b.. ..6_
- '."-'--.,'- -.-----'-___._~._.._.______. .,.. _r'."'.,...._.__.~__.. ...__.____~_M..___._._~__.__._.."__.......~~.
..Re.giatex..M_JUlla.. .
'_d.,,_" Le,tter.s.....Teat "mArl tary ._
sJ:lQr.t._r&ill.f1..c.a.teJL_..~.
'-1-
33lDo.
.. ..610.0. .
I
12
- dCumb.e..r.1AruL.LIlW ..J.ournIlL..... Ad.ve.rtising,....Le1:.te:ca.__._._.
Ma:rLL" _~._
ht.riQt~.eYlll....c.o...____..
_._Tes tam~)) ta:t;y__..n_____.u__.__. ,...1.8 OiL
1. sin g ..l&1:t.er.a.. .___._____ n
--1'e s_~.!!.l!I_entary
_. .~5.2..6_
ThomaR .s~-EiU p ,Il..JLll~_n__ .ant"P r111P
.MGM th,grmllli_____._____..__.__..__ Balance due
Edwin"A. JuliulL...Fun!;!r-<U._ F 1:leJ.:A.L..s~.for Helen m..__
_-----PJ.J;:fLC;;.tor_______.__._____ ___L_j<;Y.allL_.____._~_._._...n.. .2,24.6 72._
__nf....l.1ills..___.__.__ ..__.. ._.. ..... _ .10.0.._
Belvedere Medical .Q9IP,L__. Balange due...._..,___._Z2..Q.0._
---..--.._ ... ,. n...2.a~D.O.-..
_____..__._._..__... u__', .1.5.5_2._
__._..____ ..l".}JJt. J]_
...._ ___..5.0.. .00._
PresEJ.:terJ:an.J!om.~InE.:.___ Balan~e due
.. ...__.2
_,,_,,~L .___.
Apr. 1L
..1"sl.ndis Je'dill.r.s...._lnc...___.
praisa1 .o.f..Jewe1ry
June.l.6 . ..
...E4 _Gran.it.e...--W=ks____.__.._..
_R~t1!!:.ned for..~.___'.__m__.
f:Jrt'Al"'.ing. M~m(\l"'i ~, ._.~_______
___95.. .UD...
.ShearllJ::....Me t t~_U9_Q.Q.l1J_lk..._ ___...._______________.
_'_m_ ..__~fl.9.~.. _.._. ._m.____._._._.___ P~~_f~!,l. s ~ona 1 servic_~.s___.____
. ~ a t ~911!!LS;~ntr.!!]... B,.gI\..~_.__
C9.: EXl'1.Q.1J..t9r B....fgJiL_.________.
1 39.0,0.0
--,...-...-,--.......-..-
.L.3.9.0 10.0...
.Amo.unLior:..filing.imleIl.t ..s.tat Ampn f....o.f rI P h t s...and....
.!!~,r.!uc u.Qn!l.~_UUJ1gfinal__ c.CQl.ID..t......stt.c......_._..________n"_ .LSQ. 0.0.._
______ ~ _...._____.. - .....,..,.....__.__.. .. _.._.n__ ....
.'" ."....__~___u.",,____..,.._____,...m__._
c.. .,,'=~ ,=",.".,"=."="..==="=-~==,~,",c.rR!~'!,,...,o', ".?. ~ .~15 .:6~. n .
COMMOMWE"L TH OP PENNSl'LVANI"
Dauphin I SS, Mary Lee Mendenhall Smith, Donna D. Mendenhall
COU"TY Of
N 1 ------.-.-H --d' h 11 Central Bank
We If .es.oI)L!i~.YILlL_,-,-. Mel~ en.I,L.., .J:t;,.L!!.nd_J~I~.tJol1aJ HEREBY CERTIFY, THAT TO HIF BEq Of
MV KNOWI.EDGE AND BELIEF, THE fOREGOING I~ A .lUll AND TRlIE ST~HMENT Of DEBTS, FIJNE~AL lXPEN$I:$ A'fD
EXPE' N~.riS or ADMINISTRATION SUBMI THo TO lHE ESTATE OF - '." '/"_ _.He..le.n....E..-.Evanl) '--. ..c....
lJECFA$FIl, AS DEDUCTIONS FOR INIIERllAl~CE lAX PURPOSE.S,. \, . '. i rl
~'."""'l"'i'
.. ^ r ", ' .,--rr:-j IL I \
. ~ ~.~ - '" --.... ,'j \.' ' "1 ...,-~......-... ..
SWORN Ai ~IJBSCHIBEO BEFORE ME THIS _....L...l~ DAY OF_ ,'.' -. ." I
.:o;-.,...~-1'C.,--._..~-- 19..LL National) Central )ian'k/}
. ,<h..... j""-'-~~r~~-;;-rubii'~""-__"----hh-BY: ./ {I/'! /. I i ~ 1"<"/./:'-:::-.. l (' ! (",~
PAl/I 1 :,I:I":!,''.i'I'r~,.W'" Vi~EV Pres~del1t and Trust
111\1;1;: .,Iiil; ,," '11,;'1'11 Of:tP.lcer
Ml' i 'i~.:Mi
MI'II,I'I'I,I'I"II" ':"'1,.,1 I'j;
,
.
,
( .~) /
/fl' / I;' I
'H:t:.~3 (4oHf
COMMON\\I'.\LIII 01' I'LNNSYL\'ANL\
11I':I'ARTMI':NI 01" HI'\'liNIII'
Illll{I':M: 01- ('O":>-In' ('0 I.! ,E('T10NS
'*
RESIDENT DECEDENT
COUNTY OF_. fU.!1lberl_a~c1..._
~_. _._ ,_Lo _._~ _,_
IMPORTANT: 1'1111; ftHtlflllllllNllw romJlil'lt~t1 ill dl'luJlulld fikd III duplil'IlIP, with IIllulluclied, wilh 1I11' Register Ill' \Villfi of the
('oUIII}' wllt'W d(\l'('dl'nl I('''idt'd, I~l.t\ltll is dill' withill nine II11JllIlls aflt'r dale of <kUIIl. t111I{~ss lln cl(\(',nsinn is granted
hy Iht' S('(:rc~ljH~' 01 1(1'\II'!llW. ISi'l'lHIll 7f1.l lit llw InlU'filul\l'C I1ml Lstutt\ TlIx Act of 1961,)
.r__ _~~~
Lotfl of _
. Cumberland.
.1'e!lnflylVa!lh
} AI'I'II'AVI'I OF
.~
IN TilE MATTEll (II' TIW FSTA" I' 01'
Helen E. Evans
l-'iT-"-TI~-rlliL- N A,MY(irrl-f~~'--;:-:D-I-'-tl 'II
Counfy
Stale of
1'"
D.
Mendenhall
EXCI~Ultlr S
Ca"n'y of .__ _Dall'phJll
Mary Lee Mendenhall Smith, Donna
~~WaY!l~H,):1el1cl~l1b-all, . Jr_'L!ll1d~Nj'\'t:i.o.DlI.L.Centr.al Bank
. (If tho IIItotO of tho obovo.nanll,cl docfldenl being duly swami depolD ond lay
nC~Cdl'1I1 dit'd January
IMOI\lTHI
Namo ond odd'flIlI of attornoy 01 }
other oulhnrlud roprollClntoHvo to whom.
till CCHrolpondenco ~hould ho nloilod,
21
( !JAYl
_' J97~_J 10110le loovlng 0 losl will, copy of which I. heroto oflached, )
IYEAf~l~
-Jame.s...A.._ULsh,-- .Esq~",..She.ar.e.r...--.Me.t.t:e... & WOO dside.._____.
..lROJ..-Natth...E:r.Ont...5r,..""r. H""'r..ishl11"g, PA 171 O?
That liS sllch______e..x,e...C.U.t..Q.r.s.~___deJl(lnCnl is fiill1ilillr with the affairs of said estate find the properly clInstituting
(1- :<.1; CU TO R- t,[)MfNI 5 1 f, I, TO RI
the asst~ts thnenr and II1l'ir fair murkL'1 valuc,
Thntnl the time nf death there was no safe deposit hox registcred in decedent's individual namc, or jointly with, or
as nglHlI or deputy of lllltltlwr, or in dcc.:cdcllt's individuulname, with right of ncceS!i by 1I11othcr as agent or deputy, with the
exceptitln or the following: -
~,,~-_._._-----._~----_._--- .---..-.- ---.-----------,-....----. --,- .-..
---.---,.--.-.---- "----', ---~--_.~-~.__. -
NAME M~D A01H-H-:SS QF flJ\N!~ OR OHlER fNSTITLJTfON THIS SAFE D!':POSIT BOX r~E:"NTED
IN W~iICH Df':CEDENT RENTf:D A s~rE DEPOSIT BOX IN NAME OR NAMES OF
ll.aii.OrulLc.e.n::t:raLB.ank....:=~_____ _Jie.1en E. Evana._.
...222._.Marke t S tre.e.L.~____._________
.1iar..r.iahur~l'enns yJ.:\T.a.nill.._____
RELATIONSHIP OF JOINT
HOLDERS TO DFCF.DENT
.--
Thnt the contents of said Slife deposit hox or hoxes arc itemized under Schedules~_of this return,
wi th the excepl ion of tlw following, for the reasons hcreinafter set forth:
Thut Schedule A attached hereto lIlId Illudc part herl\of sets forth fully and in dcta1 I a II the real property
in the Commol1wenlth of Pennsylvania of which decedent diL.d having un interest therein. It also sels forth the
mortgage cncumhroncl's upon CilL'h Illlrl'el of rL'1l1 propcrty [It the dute of dCllth, giving the amount still due lit
dcnth, namt~ of Illortgaget~, dnte, rute of interest, and book alltl page of rl'cord thorenI'. It nlso sets forth ill the
columns provided therefore Ihe llsscsscd vulualioll of cueh of sllid purcelfoi, the estimated market value thereof
as of dute of dellth of dt'(,l.:dl~nt.
That Schedule B lIltacJwd heretn und madc pUr! ht~n'of :';l'fs forth fully ,1I\d in detail all personal property
wheresover situuted owned hy the dccl\dcnt ut the tinH: of death: all Illtlncys left hy the decedent III the time of
delllh, whether in decedent's immediate possession, standing to decedt~tll's crL~dit in hunks of deposit, sllvJngs
hank:.;, trust (:ompanies, or other institutions, whL'ther individuully, ur in trust for uny other person or persons
giving also sl~paratcly the nCl.'fUl'd interest thereon, if any, down to the last interest tluy priur 10 decedcnCs
druth in the case of slIvings banks, IIlld to the date of dL'Cl'(!t-nt's death in all other CjlSCS; all honds, poslul
savings, trensury ccrtificates or nolcs and olher evidence of indehtedness of' the tJnjtl~d Stlltes to the dew
tedent: all obligations, whcther hy SlUtutL' llf HgrCl:IlIl:nl tlH..'y lire dcsigrHltcd as tax frL'l', of thl' United Sllltes,
or I\ny Stutl~l or political suhdivisioJl thnenf, or of llny foreign country. which lire owncd "I the timc of dcltlh;
1111 wearing lippard, jcwL'lry, silverware, picllllL'S, hooks, works of art, household furniture, horsefoij t:urrillgcsl
Iltltolllohilesj boats, untl any and nIl other pcrsllrwl chattl'lfoi of whi\tsocvL'r, kind or nature, left hy decedt~nt,
together with the fairly estimated mllrket vuluc thereuf; all honds lI11d mortgages held hy decedellt lInd of ull
claims due and owing deL:cdctll at thc timt' of death, and nil promissory notcs or other instruments in writing
for 11w payment of mOlley of whkh deL'cdt'111 dicd IHHisl'ssed, of whatsoever nature, with illterl~st thcr(~lIn, if
any, giving Ihe fnl:c YUille and estimated fail' murkct "ullle thereof, find if sllch estimntcd filiI' market vullle he
less Ollln the face vnlue, it sets forth briefly thL' reasons for Stich dcpreciation liS to ellch item; ull rnolll'YS
pllynhle to the estate from life insurance policies L'ilrricd by decedent; all annuity und endowment l:ontl'llcts
the procel't!s of which wcrL' pnynble upon lhe death of lhe deL'cdcnt; nil and thl' l'orporatc sloeks und di\'id~llds
due thereon and ullpllid ItS of the date of dl~ath, honds llnd i1ct.:rlll'd interL'st thncoll to the dllte uf dct'cd('IlI's
delllli and otlwr investment secUI'itics owned hy Ihe decedent nl IhL' time of dellth, wilh the Alarkel value IIH'H"
of lit sllch IiIllL',
,
,
~
III tile; I\IHW Ill' H{I\lIlrlttclK of' ulmw 1'1' fnllllly IlnrJlflrlll.loll-"lt l.ll(! YfdwlH t'~flortl)rl 1l!'(J os fill' IlR
1'11"'"1111" "lIhN(IlIiUtlll'11 11)' t'lltlill!lllll H!.'ltoUltlIlI.M or tho o{JI'I.lOrttt,il!lI~t showing tllo tlflHOt.S IIllll,lfnhtltUos
11Iut'f1n I' 'l~ ilf' t 11f~ II Ii! t1 uf iti'lI tilt t'iw HnlUllhl1 r! n 1 Hn ~o l.s f'(Jr' "II Ul\1 ill t.OJ'(Hi t ('I f' do(wrlOIl t /I t l.!lfj t.l me of'
ihH\t.1I III ftll~' H1i'-'l'hl'IIlIlNllltl\ ill' llllN I Ilf!lHI, 111111 IH NIIJlport IIf', till! vlllun of sHeil IlltOt'osl (1101'n IH llI111fJxu,1 to
~fttd "('11(111111", f'lfwllnlnl !4tlAtf11U1!fltN HlioWlnA th(lIlH~lfjtR HI\ll Ilnhlllt.IIIH {If' "1/1111 {10-pllI.tIWI'Hl1lp 01' IlllS111l'RS.
A ('lIp~' of thll I!ft'=IIIII'IIWPlil1tp 11I~1'1!P1llfl'd'l (If' 1I1'ltI, II Ht/ltell1flllt I<wtUng f'ot'lll (tIn Ilfttlll'o of' tllB /tgl'PI'IIIUl1t)
tll~,qlu,,' "1111 fi ;.IH!lIm!tl1 ~Hl11111g l'nf'lh 1I1H OhlU'IWl.oJ' of' Iho IIl1s11l11~IS. Its lOf'utloll, fllld, f-Illf'1l OUlOT' I'llots
11llf'lllllltll,l( In tlllI hHijl1li1tilol '\~ 11I11,\' hn 1lt!I'Unnnl In /l j'nll' IItlfl .IllS! npprnlf-iul of' 01/' rlfHHltlunL's 1tIlI1J'nst.
lIulI'fdtl tllWI! hI' "IlIhrnltfl1It. II Mhllllld idHn !iot f'ol't.h III Hn11111(!tl f'of'!n. t.opplllnr wi tli tho ('Ilil' I!lark,," VUlllO
iltllrnnt', lillY fllhclf' 11I'IIPlll'l,V OWIlf'I! or hHqlll1nllwtl h~' tllo tlUlHHIII II I III thn limp 01' dnHIlh
'1'1111 Sr/,('dlll,. (. flltllnhlid Illll'lIlo '<1111 lIH1dn pilI'/. IWI'IHd' HOt.H l'orlh It t.1'lfn IIIlHWOI' t.o oucll 111f1ujry
1!IIHllltluld t.hlll'liill 1lIHI'il1l.1m ('Il"fl ol',tl'lln~f'(!I'H (If'pl'opnt'ty. 1'lllII Ill' IlorHfHllIl, within two .YOItI'~ of' doondont.'H
Ihl/lfll. III IHltllumllllltlli1l of' lh11]1!C1('II1.' N dO/It,ll. Uf' int.ol}!l"d In l'1ko pfTn(.t In pOS~II'HHiloll or ~m.l(Jyment Ilt or
,""tAl' "lilith, Mllil' l'whfllJlllo flotH forth UIO 11111.111'(1 IltHI \'1\111(1 0(' ~llll!h pl'nJlnl't~'t 1-0 wllom trnllsf'prrHd~ UlO
l't1Itlll'JlI14htll of' thft tI'lUlf'lferoof;! to tho dneHfIt!fJl., Uw proportioll/I!.!! Hhllf'l' fnl'HtvlHlily oneh i.rIlTlst'(11'Oe nnd
Itll lIt hf'lr "nntH nf' /1 Ilflrtillont nutl/rl,l rnl~llrdilll-!; S/lid trllllH1'0 t's. III 1.110 {]IlSf> nr'II'lltl~f'nrH 11lt.fl!ldfH1. t.o
tnkll 111'1'(tllt Iii IHlHHllfilRJOfl or on,loYIl1I'"1. lit or Ilt'tfJl' (Inlll.h, Illnrn l~ nlHo IIUlwlll\rl 1.0 l,lin HnhNt\l!') 1\ (10HY
ot' 111f! ttllilli, 1-1'IlHt. l\~rUlHI10tlt. or Ot!H'I' Inst.rllmnllt. Orf\llt,IIl,~ tllf' I,rmlt.. Thorn Is nhw lint. {'ol'I.11 ill Slltll
81'1111\1111(1 fI, Ill-d. nf' nIl prnpfJrt,y. rotll /llIrl!lf'rsofllll, wlt.h ItH V(llIlo, wlllnll t"l~:'if'S III dnoollfllll.'r-{ dt'llth hy
vlt'lI'" uf' t1w O)(ONlhHl hy decedont, nithorlndJviflulll'ly. or,jnintl.v wlU, /llloth(q', 01' /lilY jlOWIJI' of' IiPflnint-
m01l1 \'1!lit.HlttntlnnorIAtlt, either 1ndividlllllly or Joint.ly, b,Vtlln WIll, df1ndl III' nUlfll' I!HiLI'lImnnt of' IInothnr,
wilt! II r'HIlY nf' Uw iflFitrllmont crentinp; Rl10h pownr ntt/whod to tllf' Hnl!nllilln.
Thnt Sch(ldljl~ D I\ttl\OhArl hel'ot(J and m!\do )lftl't IInroof Fjnts f'ol'lll tho IHlff!IlH l\rld nddrn.'HHH-i rd' II] 1
Illll'NUH" 1l<'lh1f'inialJy intt'rosterl In this est.hl.e nt. tllo ttlllo of' deendOIlt.'H r!OflUl, tllP Jlnt.llrt' of' Ulntl' I'OS'"
IIOoUVtl intoroHts, Uloii' relationship, if' llny, to tile llncndf.llll., tnp;nl-hrq' with tlw flgOR Ill. L1w tiltH! of'
(h"llie'out,'" rlollt.h of till minors" nnnultnnts /Hut helud'telarlos for 11"0 WI/lor dnoodOl1t'H WI.!l. It lllRn
I!OntlllnN ft Ht,lltement. showing whioh of 1.110 henefioillr1os Ilnrl10d in Ulf\ dr!('Oflont's Will, If' /lilY, rlind prior
10 dfl(wcloIlL, tl1e dntos of their oOfith, tlln1!' tssllO, Ill\d tlw l'olllttonslltp of HIIDII IflH1W t.o t.llf~ hOI1(tf'lpinry.
1'hltt. Schedlllf> E nttncherl herot.o hnrl 11llulo fl pllrt 1I0rno1' sots forth 1\11 proJlol't.YJ r01l1 111111 par-
Plnnnl, nwnod hy tho deemlent .folntly w1j,h I\nothor or 01.hfCI1'S, In(';ll1dltl,gtnt.nnp;:tblfl, fitllfHltnp;ffl t,lw llllmA
fll' tho rloofHhmt Illlrl nthers, plua the clute find pll\eo of roeord of instT'umonts nf'f'oeUnp; tho \flst1t.ure of
rMtJ flHtntl' 111111 the dl\t,{~ of ncquisition of persollnlt.y, plus tho rlltl11o, luMr(JR~';; find l'elntiollslllp, if any,
of' IHl-OWllf"'f1 f,1) the decedent.
Ttll1t Sc/ledllle F uttnr-hed hereto tinct mndf' n pnrt horenI' Hots fOI't.h f'llll,Y nllli ill lIntftil 1\11 rlf)hts
nlllt dndll(';t.10tIR c]tdmed for llnd on 1:rnhalf of Uds dAl!ortenl.'s estfito, ,including f'lIm~rlll exponses pllioj
f'lImlly nxnmllt,-lon, whol'e flllpJ!culJlol costs nt' IHlnllll'lst.rIlUoll of' th!fi f'stlll.n; eOllll~wl f'oos nnt! f'udlc1nr'~"s
onmmlHfllnllK pfdc1 or to he ll/\fd; cost. oXl1cnrlod for h\lrlnl tr'l1st~, tnmhfltollHH or gru'IlAm/lrkerfol, amI Nlli-
RJ(IIIH Kftrvlo6R, in oonseqllonce of' the dont.h of' t.hoL'l()cnd()T1I,l dohts Inlet cln1mH owtllP; Hn(l IInpllld Ht Ume of
filllllt.1I1 tAUHf lloflrllod chnrgolthlf\ fnr Jrl~r1or( prim' to tlOOfHlfJll1.' H d{'1ltli ((lX(~{lld th'o~o flllowl]r1 Ilndor Snotion
ntH of tlti, IllllorUlmoo uHd gstllto Tux ;\pt)j t.OgflUlfl1' with Il stfltnmollt. 0/' 001101J'ral ptndgoll 1'01' ohligll"
!-lnnK, If' UIIY. It. 1.5 ngreorl t.hnt thp fffluc1IlI',v 1'1'111 prosi'nt }l1'not' of' S1l1(1 ellllJlll'd oldigflUoHH upon 1'0-
lplfllt1., thnt. If' thn lImount I\ct.llully pldrl ill sottlolllont. of' !lilY f'po, (~oltlltrlss.llln OT' 111'111- Is '/pss t.hllll thi'
tttlUIIH'tfltl 11,"01l1lt. olll!udnp; Hurt nllo\'r'orJt t.hllt. tho samn wi'll ho l'opoI'I-I'<I 10 tllo Hng1!'1tnl' of' Wills, find thllt
IIll! Illnfllllll- nt' t/lX Ilsl'ioR~od OUII ll(l 1'{!Il~SI'Sflnrl in 1l1~1~(Jl'fttlllC',O thnrowlth.
ThIll
hllVlI
Ill" tot.IlIR or 1.110 I~JlJirIlJlrllltl' (1f)lumns In Sl'llnrtulfJs "A", "Il",
hmm rlll'l'joft fnrwllrrl flI\11 }1t'opol'ly 1'(l1~1:'ltnl'(lrl In t.ho Sl1nllllttr,x.
lie",
" Ij~ II ,
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Subscribed I\nd sworn to before me thi~
....L]"&(' day Clf}",,><e
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PM!l I fli:;rRIf, tIOTM(,( PllbliC
H^RfIISfl,Uf:ti, !1!dIPHliII:OUNIY
MY COMMIS$ION EXPIRES [lEC 27. 1982
Member, PAnns~IV1nla A%oCl!lllon 01 Notaries
NOTE: n~rnr(! H1./l:nln~ nf1'irlnv1t. 111111.:0 AUI'O Ill] hIllllk ,Spfll,'I.'~ In 11,1' 1ll't'lrlllVII /Iud Sl'llndlllpi'; Ill1lJ('xt~d IIr(!
f't 110ft 11\ wi tlt d{l till 1 s or t,ht~ WOl'ri II NOIIU", tllid 111 nitRO UIP IlSSP t f-. I 111'1 (11\1' 1'111'(' HIlIl 1111 I II..; I od ~f'(,\l f'1l1 {IS,
Aflourlt:1e" of' clORe or flltllily oorlmrllUollR or fill l.11f.f'I'I'St In IllIY ('fl.-PIlI'IIIPf'Slllt' or hllSIIll'SH, t111lt. tl]()
11Ittn Illlrl Rtfl.l,t!mentH requlrN-t llnc10r l.hn pl\l'ugrupil 11110\'(' "OIIlIIIlJ\ to St'III'dllll' nB" 111'1) 111t.I\C'hf'd. Also mllkf!
corlfltll UHtt nnl1U111l 111. JII tho "811118111t1'Y" hllR 11tH'll pt'(lJlnl'ly \.(lllIpl"t"d II'; ilhOVt\-dll'f'f'tl'd.
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NA~ ENT L B NK
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IE C1Ltor.~
BY: Jf!j4?:1 :l> U;>"",." P2:' u! ct:~-,,,,
f"\" ~ Ii Vice President
222 rket St" Harrisburg, PA
(City or Town and State) 171 01
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I tVI' I "\Iii I 1t1'('Olll11H, I1II1Ht. !In 1 tHtnc1, tlmlJiI!,{l Ow fuet t.hut thoy I1r(' IIn" of' tho Ilrtmitli~tul'Orl oHt.atll.
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fdlll'kHt IIIUl'tJl,IlI1.I!Ht 'UllllH1 t.uK~tIlHr witl. ,w(~rtl(ld IIlI.OJ'~Ht. or rlivtclunrlR, snlnrioH or wnp;os, insuranco PllY-
Itllll' f,n llltl I'Hl.Ht.1l rlT' f'lfh1l11ury In Huitl t1l1pllnH,V, pllrt.l\orHhtp Int.erosIA, tnt.eroRt, in anyunrltstrtbllt.erl
m,tnU' 01' or IIHHllllfl f'I'OI!l ItllY prllJlnrty linld 111 t.rllst. undo I' tho will or Ilsr;roomout of' another, \oW on thoup;h
IOlllttnd llllUdlh! of' t.Il(~ foItntll, Ill. t.hn tlmn nl' {lont.h, should hn ltstflfl in t.hts sl1hodllle,
1'f1':M
Lilli fllllt r1nHPI't\l(! l\tllj'
!IN I'f !'S'11 MATEIJ
VAWE MA/lK~'" VAWE
IJEI'A/lTMENT VAUJATION
(Do not wri te in
this Hpuce)
1.
'2..
Jewelry, see attached appraisal
Household furniture and furnishings, see
attached appraisal
Coins, see attached appraisal.
Statement Savings Account #61-98018641
with National Central Bank
Accrued interest on item 4
Certificate of Deposit #61-99323421 with
National Central Bank, balance
Accrued interest on item 5
Certificate of Deposit #61-99323448 with
National Central Bank, balance
Accrued interest on item 6
Passbook Savings Account #45478 with
Harris Savings Association, balance
Accrued interest on item 7
Certificate of Deposit #1-09-131604 with
Harris Savings Association, balance
Accn.ed interest on item 8
Checking Account #61-348921 with National
Central Bank, balance
6 shares Hammermi11 Paper Co., Pfd. 6.50
Proceeds under Prudential Insurance Co.
Policy #M06554784; face amount - $50.0
plus dividends of $483
Proceeds under Prudential Insurance Co.
Policy ffM08642338; face amount - $50.0
plus dividends of $524
$25 U. S. Savings Bond, Series "E", dated
March 1977, P.O.D. to Mrs. Donna M.
Nelson
$25 IJ. S. Savings Bond, Series "E", dated
March 1977, P.O.D. to Mary Lee M. Smith
$25 U. S. Savings Bond, Series "E", dated
March 1977, P.O.D. to Wayne H.
Mendenhall, Jr.
2,481.27_ ./
_./"-
341. 00.
31. 50
.../
983. O~
2.7J
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5,395.04-
155.05
.
//
5,395.0~,
155.05
...//
875.92-'"
2.52
.r..........
5,425.43'/
23.79
,/
,//
4,231. 26r
339.00
3.
4.
5.
6.
7.
8.
.../
983.00,
1,024.00,//
20.43-
/
20.43'
20.43
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737.4719
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pay fncomo to or l'nr Uw hHIIOf'ft of' e/lro of' trIlIlH('t'ror? (AIIHwor yos or no) no
(ti) Did clocnrlent., at Iltl~' timn, t.rl~I1Rf(1r J1r{)Jl('rt.~', thf' hnnnf'ic1nl f'lI.lnymout of' wh10h wns Ruh,tllct to ChHn~(!,
hCtlllllS0 of' It rmwr\'t~d powor to !II t41r, 1l1l}(Jlld, or rl'volw, or whfoll e01l1f1 rllv<<\rt. to (lflCll)llont \lTl(ll,r torms
of' trElIIRf'flr or hy o)ll!r/tt.loll Ill' lnw? (Answpl' yns Ill' no) _~e.s......_
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(AnKwor yes or fHl) _"yes__
NO'!'E t: Tho flnRwers to t.IlfH.O fjlwstlons should lw stlJlPorturl hy nfr1flnvlt. hy tho ntlfHul1ng phystciun nR
wo] 1 IHi fi copy of tho nont.1i (lHI"t.1 {,Iento.
NnT)~ 2: If' IUlRwr'r t.n llflY of' t.he tt!IllV(' qllNiUOflH 11'1 yns, set fort.h hnlQw Il t!OHcl'tption of the I'ropr!l'ty
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relattonship of l.rllllsfAr('(!R to flocodont, If' ItH~'. Suhmtt copy of' nllY !-rust flN,,1 or tnAtrument., If' trnn~-
f'er~ Ilre olnimnd to he lIon-tltxllhlo, nlso RllbmH {intultoll st.Ht~nlOlI!. of' fuets 01\ which Rntfl clfdm If; l)/lRort.
NOTE 3: LtAt nppltr-Ilh](> proJlnrt.~' t}(~low ill II\lllHl(H In which provideli ill Sr-hOf'ublS AI lit or E.
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1J1':SrH I I'T llIN
MAlUmT V A],lIE
(E8 Urnn tell)
IIE!'T. VAWATION
(nopt.. Only)
1.
Gold Key Account #61-97001567 with
National Central Bank, under name of
Helen E. Evans in Trust for Donna
Mendenhall Nelson
Accrued interest on item #1
106.03
.3
2. Gold Key Account #61-97001575 with
National Central Bank, under nmne of
Helen E. Evans in Trust for Mary Lee
Mendenhall Smith 106.03
Accrued interest on item #2 .31
3. Gold Key Account #61-97001583 with
National Central Bank, under name of
Helen E. Evans in Trust for Wayne H.
Mendenhall, Jr. 106.03
Accrued interest on item #3 .31
3 \ '\ . 0'2._
In'H~rt thfR t.ot./ll oppoRtio "TrllllRferRft, Sohedulo "e" tn t.ho
"AB ROflortAd" column nil tho tnRt J'IllP;O of t,htH ret.ufn.
319.02
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lJ~I'ARTMENT OF HEVENUE
BUIIEAU OF f'IHO OPEHAlIONS
1',0, flOX 2970
HAHnISBiJfW, rr:NNA. 1110fi
lC;OMlllmJilt:'\l.l den l'f!HJ';'fl.\/,\cJlil I (,,,(, _~~~E' ~.31..,..1979
HE:SIIJErJI 11'-IHEIlI ril:'JCI 1;\;( I ('(ll'N(Y _Cu:fl~el,',l.a.nd
N'i'I1^I'" Mnll 21-79-0101
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-- ----,._-- -...---.--.----.--,-.--->---..--.. ..
Whoroas, Hel\ln E,_Evans __"'__'.'_ 1;,to,,1' ..Carll.le "____.,,,,__.,.
in the County of CllmhArIAnrl_.."..._,__________,____ .........._*'<" (>.illlnl(lll','.JI.,,\11h Ill' P'''ll'I';\'I'.';I1;jd, :):"1 Iii !
the 21 s t dilY {-If ..,_J.an.wl.r.y_...,____.._... 19 JJL r ~,\I~i:'J~d and pu..',,-!:,';h1 (J! ,'i\
subject to Inhrwitanco Tax under the laws /)1 thu CC>ltJllIf'llW1Jill!l1 uf P('tlll..v!v,lni.l;
Thereforo, I, Sandra L. S~.2!l!'______...______. ,,)11 ,1PI"'Ii<,ur dill\' 'il-iJ"illk,1 "" i'!l' (,
havinq been designatod to make a fair Cind cLn~;('ioll:1tj!(! dpprJ\:,clllonllJ 'tho :':"lid (),q[:1'll1, ,ud 11'1 d';;E,,'.'; .,lIl!1 il,\ !il',' i
valuo Df all annuities and Iifo estatos (/Towing out of said estall'. heroby file tho followiulI i1ppl'<liSernolll:
In tl10 ovont tllllt ,UIY futuro !lItofo~lll1l1J!~ I'st.llll is 1r,H,~lo1rfiJ(11:1 Ilo~~f\~~IOll "I fllljO"'II'rtHlII',) (,rll,il':ll"llhli,; i;! 111,1 dl":H(I(:\\1 ,llhn 111i' ".:"",1\1' I
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lato fill Any ~Uf.1l futuro InterosL
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Have been duly sw~rn according to law. ! do horeby cortify thM tbo abovo appraisomanl b, mado in r::",l'nnnil\'
, h h I h' 1st I I' AUQustl<J 70
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