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share shall be bequeathed and devised to George Peters,
the husband of Agnes Peters, if living, otherwise as
provided in the hereafter paragraph.
In the event that one or more of the persons named
in this Article III predecease me, then 1 direct and
provide that the share or shares of any such deceased
shall be divided equally between the surviving persons
named in this Article Ill.
ARTICLE IV
I nominate and appoint the United states National
Bank of 1919 Douglas street, Omaha, Nebraska, as Executor
of this Will, and 1 give and grant to my Executor with
respect to my estate all powers, duties, and discretions
given and granted to Executors.
1 further direct that no bond be required of the
corporate Executor named herein.
IN WITNESS WHEREOF, I have subscribed this, my Last
Will and Testament, consis'ting of three typewritten pages,
including this page and each bearing my signature on this
,~day of February, 1971, A. D.
P/ ',/ I' /~
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This instrument was by Godfrey B. Johnson signed, publiShed,
and declared by him to be his Last Will and Testament, in our
presence. We, at his request and in his presence and in the
presence of each other, and believing him to be of sound mind
. and disposing memory, have hereunto subscribed our names as
witnesses.
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Witness
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OATH OF SUBSCRIBING WITNESS
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COMM()~I~AL'I'H 01" PI'JNNHYLVANIA I
COllNTY OI~'Ct~MIl~JRLAN[) I ss:
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'I'hiS....."........,....,....~"'......................,.... ......... day of .......,......',....;...............,.... .,..........,...,.... A.I)., I!).........
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bl'fore me Rkhard I~, Andor'iih~<<,gist(Jr fOl' Ow Probate of Wills /lnd gl' ting- Il,ttors of AdministrllUoll
in and for said County of Cllmb("fu~in the Commonwoalth of P~sylvania, plJrsonully camo ..............
......."........""."....".....",.".",."".,..".""".;.~."."..'..,....,""""""""""',.,"..""....,......"..""..,...",.",..."",...".,.",.,
tbe subscribing witnesses to the foregoin~rumont writing purporting to be till! 11Ist Will lInd
Testament of ,..........................................,...........,........ .............,.......,....,'.,.... Dnj,(,d .........................................
"-
lateof.................................................................... ............~............."..... Cumberland County Pn" dece/lsed
who being duly ......................................~cording to law~se and say, I,hat ........................................
present, and saw (.ud heard the tey<..........................." ........:::, .............................................................
sign, seal, publish, pronounc~ declare the said instrument of writing
and Last Will, and at the me ol'so doing .................................................was 0 ound and disposing mind
ding. te the best of ..............................................knowledge,
Richard E. Anderson, Register
',...."..,,,,,,.....................,..,,,..,,,..........,.......,,,,"',0"""""
.....................................;..............,.,~..............
....................................................................~.....
................,........,............................."....................~.,
................. ............................. and sllbserlbed before
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss;
COUNTY OF CUMBERLAND \
"""""'"'' .r.~~:.~. .~,.. .~:~~.~~l.~.. :~'~~~~:. .!: ~~~~. ~.~.:'.~ .t.~.~.. !!.~ ~~;~~~. ~. ,~:~".~.~.~.~.:.. .~.~~~...,.... ,....................,.. being duly
.................~'!!.~~:!...................... says that as nearly as can be ascertained the said decedent ..........................
....."..",..""..........,.,...." ~~~.~~~,~,. .~~ ",~,9.~!)..~.c.~~:..".".".."..., ......"..."""'..............,.,..""".,';.. t...,." Ii..'..' ....,..... .d.ied on
...............:l'lIH;lrll!Y.................... the ......~~~h...,..............day of ...JJml.lilr.y..................................... A.D., 19....7.7,
at or about ,....,..}..}?.....,.."...."""""" o'clock, ~.~.M,
.................3worn..........................and subscribed this
,'?S d f .1::,< 'i:'Y
........,..,.,.,.,t~t.,...."...".....,""',., flY 0 ..,t...........,.,.:.,.,
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.....-...,..".."""'..............;.,......;...;,..;...,".,,,..,....,.,...,,,,..
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19. ..U.... before
.......~,...
Richard K Andel'Roll. H"Idst.el'
OATH OF PERSONAL REPRESENTATIVE
COMMONWI';ALTII (W 1'1':NN~YI.V ANIA }
HS:
COUNTY (W CUMBlmLANI>
lldhl'll nw, lilt! Hllgish'I' fill' tlw PI'Ohutll or WillH und "I'lllltln" or LoUtll's of Administration in and for
h. (' {'(' I ,'I d .' II' . "c'ld. '1. '(bOdln, '!'I'llflt. O('!'Jt(J!' of'
I, c ,ounty 0 ,um ILl 11I1 . pUHona y IlIIm ""","""'''''''''1'''....''''''''''''.'1''''''''''1.''''''''''''',.,'"""""",.""."""",."
,f 10n,'11 I:Plltpl1 '''!'11U(
h I.. d I :\\-/'>"11 I I" I tl' r,;XUC" tOl'fl
W 0, lelllg u y """''''''''''''''''''''''. (0 """"" (IPOHI 11Ill BIlY 111. liS""",,,,,,,,,,,,,,,,,,,...,,,,,,.,,..,,,,""'"''''''''''''''
'. 11'-1,If'r(:,1 ,T--)h";'101i '
of the last Wlllllnd Tllstumllnt or ",.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1',,,,,,,',,..,,,,:,,',::,,,,,,,,,,,,,,,,,'''..'''.".''''..""....",deceased
".""":~.',\~:f.,,,,.., will weiland truly administllr the "oods Ilnd chnttds, rights nnd credits of said decellRed
according te law, And also will diligently comply with the provisions of the law relating to Transfer
Inheritances, ......"~::.':'.;:!,l""..,,, and subscribed
before me.
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.... ..11 .. ........... """.....""...",."
".j.....,.....................,......"...........................................
Richard
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DECREE
B'it b dth t th 7t,h d I' Pn!;l'unpv AD 197') th
e remem ere a on e "".".""""",,,.., ay 0 """"...""""""""".."..~".....,,..,. . " ,.1......, ere
was prob ted and eco ded th I ,t W'll nd 1'e t m t f ",,,,If]",,v ''1, ,Tohnson
a r, r, 0 8H 1 a A fl on 0 ,....."....."""H...".........,......."...............................,
I te f Fnst l'ennnbo,'o ~'O'.vrliJhip C 1,'1 dC' t fl. I'D,' dI'
a .0 """."""""."......"..,,,,,....,,...,,.,,,,..,,,,,,,,,,.,,....,,,,.., ,um leI an oun y, Bnnsy vnnHI, (,cellse , ,{,ttms
rpp,ll-m.....ont""\' t d 'll"L'~();I;ll (""I!.pc,'1 l~'-I"lj:
....... ........ ",..... ,.':;,.~:.. ;:,. .,. ,,;',.'..l/,. ,., ,. wero gTan n to .,.. "..., "'" .,.".;", ,.:..,:.." ;;-....,. ,',:. ,. ,'" ,;. ,. ,. ,... ,',., ~....,
Wit.nesH my hand and ol1kial seal t.he day and \,eal' uforesuid,
. . ,
HI..!"'1't1 t.:. Anderson, I{,. J.(i Hf....,
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Illvontory of tho reol ond po",,,,al .stat. of
(;OIlI'IUJY B. ,JOJlNSON
. docooud.
_u ___ __ ..__ ..~,..
__ .L_ .__.__."
1. Cash on Person
2. Balance National Central Bank Chocklng Account No. (,2-559349
3. Balance National Central Bank Statement Savings Account Ne. 62-98000456
Accrllod interost te 1/16/7!1
4. Balance National Central Bank Golll Key Savings Account No. 62.00003894
Accrued interest to 1/16/79
5. Balance National Central Bank Big Saver CertIficate of Doposl t
No. 62.99027900, llatod 1/25/74 in tho !ImOlUlt of $11,000.00, dlle
1/25/78, automatically renewable, 7. 25~", Jnterest added to princlpal
tulllua11y
Accrued interest to 1/16/79
6.
Balance National Central Bank Big Savor Cortifieate of Doposi t
No. 62.!)9083908, dated 7/7/76 in the amewlt of $8,000.00 due
1/7/79, a'ltomatically ronewable, 6.59, Into rest ndded te prindpal
annually
No Accrued interest
7.
Balance Fhst Federal Savings & Loan Association Special Sflvings Account
No. 2-6-61
Accrued interost to 1/16/79
8.
Balance First Federal Savings and Loan Association SlIvings Account 2-6589
Accrued interest to 1/16/79
9.
Balance First Fodel'lll Savings & Lean Association Savings Certificato No. 21
dated 7/10/75 in the amowlt of $13,000.00 dlle 1/10/78, automatically
renewable, 6 3/49, interest added to principal
Accrlled interest to 1/16/79
10.
First Federal Savings & ",oan Association Savings Certificate No. 218-900140,
dated August 28, 1973 in the amount ef $6,000.00, due 2/28/76, automaticall
renewable, 6 3/4'6 interest added to principal
Accrued interest te 1/16/79
11.
United States Fidelity & Guaranty Company - Group Life Insurance Benefit
Payment Policy I GM, Certificate No. 6576
12.
United States Fidelity & GUlIranty Company - Salary Checks
Period ending 12/22/78
Period ending 1/ 5/79
Period end~lg 1/ 8/79 to 1/16/79
$ 468.89
423.92
350.77
$ 184.40
8.00
199.20
13. Received from Fidelity & Guaranty Ufe Insurance Cempany
Reimbursement account medical e.xpenses incurred 1/.19/78
Reimbursemont accollnt medica.1 expenses incurred 6/23/78
Reimbursement accelUlt medicn] expenses incurred from
1/9/79 to ]/]6/79
14. 487 Shures UnJ ted States Fidelity & Guaranty Company Cemmon Stock @ 32.0625
Dividend en above at .50~ per share payable 1/31/79 te steckhelders of
rocerd ]2/15/78
]5. Proceeds Veterans Administration Natiena] Service Life Insurance
Policy Ne. V6143987
16. Proceeds sule ]964 Kennedy Half Dollar
17. Preceeds sale 1922 Silver Dollar
27. 00
]43. 61
586. 00
1. 22
11 ,022. B(,
24, 95
14,763. 0]
1,097. 28
I
9,435. 41
11 ,253. 52
26. 6]
6,214. 14
13. 4]
908937, I
16,440. 83
45. 65
8,606.
23.
91
90
58,000.
00
.1,243.
58
391. 60
]5,614. 44
243. 50
10,'720. 88
2. 40
4. 80
I.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
II:
I. I'liARL. S. 1U1E1i~1, TltuST ^IJ~llN1STRATOR OF NATIONAL. CENTRAL BANK
f>\~orn . according to law, dopo.es and say. Ihat he
Exe~utor of tho Estale of Godfrcy,JJ._.!ohnsou.
lato of 2 Mar~hull IJri vo. Cump lIill., Cumberlend County, Po.. deceased and thet the
within is an Invuntory mado by Natl.ollul Contr.ul Bank _, the .ald.~Jil$.g~ut.or
of tho ontiro ..teto oi seld dec.dont, coo.lsllng of ell tho p."onel prop.rly end roel ..Iete, eMc.pl roel ethle oolslde
tho Commonwoellh of P.nnsylvania, and thot th. flgur.. oppo.lle .ech ilom of tho Inventory r.pr.sonl It'. lelr velue
a. of tho doto of docodonl's dooth,
b.ing duly
n_.~e-:!~._._......._" ond .ub,crlbod boforo mo,
NATION/\l. CliNTJlAI, BANK .. Exol'utor Estate of
BY:'(;~lt-.[)jL .,(~~;:::~_~~~ ,Johnm
l'e[/rI!~, RhoOhm'or.. Uolli".,IW#~ITrust
_-,~"',' __.hU::_,~~___....._.....,,19 ..:7.L
__~d.._;L u~..._~_...____
PAIlI. T. ARTfW', NOIARY PlIOllC
HAIlRISOlJlliJ, I!Io!JPIIIN COUIHY
MY COMMISSION [Xl'lklS O[C 27. 1982
Member, Pennsylvan" Association 01 Notarios
222 1'1a:r~eJ St.rgeL..
lIarrisburg. Pennsy1 vania 17108
Add,...
Dol. of D..lh
16th
D.y
. __d J JlI1~arl._.__ ~.. ~.......__...J.nQ.__..~___ .__."..__
Month Y..r
INSTRUCTIONS
I. An invMlory must be flied wllhln thr.e monlhs alt.r appointment of pe"onal repl'esenlatlva.
2. A .uppiement Inventory musl be filod within thirty day. of dlscovory of additional a..els.
3. Additionalsh..Is may be attach.d as to p.rsonally or r.ally
4, S.. Articl. IV, Fiduciari.. Acl of 1949.
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COMMONWFALHI 01' I'rNNSYLvAtII^
{H:PAWIMf'NT Of' flEVfNlJE
BUREAU o.~ COUNTY COLLECTIONS
APPLICATION FOR CHARIT ABLE EXEMPTION
FROM HNNSYLVANIA TRANSFElllNHERITMICr TAX
(Act of Muy 11l, 19~J6, P L 1/~17, (jlld Act 01 ),,"1'1 15, llJ(,l,
PL J1J, U!O ullIC''IIdtt(1)
.........-
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AppllcCltioll i~ hlH\~hy flied for the approve I
of 011 C)(('l1lfltion from Pt'nn!lylvonlo Transfer
Inhcdtance' T{IX 011 tho transfor of the proporty
dc",I"cci ",",ow:
1. Bureau File .'1
2. Dote of Death
.'ullllary
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3. Doto 01 App,ova I
.!~me-"U2...cedon t
nOdC~I'Y il. Jollll~on
5, The Commonwealth'. appral.ed valuo of tho proporty far which an axomplian I. clalmod I. $ -llLO.!.l....-[!/).
(Nate: Where the property I. ather than a .poclfied amount of ca.h, the exemption cannot "e approved until the valuo of
tho proporty has "een e.tabli,hod by opprul.ol by tho Comlnonweallh, oxcept in Iho.e ca,o. where the amounl of the gift
or bequ65t ropresonts a litated fractional or percontage portion of the ontlre estate or tho enllro residue. In thou cales
enter such fractional or perclntage amount above).
6, Chock Ihe n,annor In which Iho Iron,f.r was effect.d and .ubmil 0 copy of tho document aUlhorltlng the transf.r, unl...
.uch material ho. b..n previou.ly fll.d,
WILL ;',:~
DEED [';
TRUST INDENTURE 2;
SURVIVORSHIP 17;
OTIlER 0;
(If other, explain)
7, Corr.cI Bu,lne.. Nomo and Arldr... of Chorltoblo Organization rocelvlng properly:
NAME __,_ ..___ M:i.c1,lYi.W.~J.\ti:lw.u~r_JJui.llJlXsi.4..A.tc.1:1.U1LJ1mul,1"t inn oi Hn'\lf"tO'I. ~1i ..Ill llWl.--
A DO R E SS ~_.__.__HQl.Il<ll" llil..,~.tii.cl1igWL!I.llfi.il__AtJ;lll_._l{UillllU...l'_ll" 1.,1" " .,..EJr.uc_-llir...
o See listing all reverse sid~ for additional choritahle organizations covered,
8. I r.l'Irtify thelt the information contained heroin Is, to the best of my knowledge and bellof, true and correct.
Signature of Appllcanl -fif(}.~~~.!:~t,;~~~~~~~l~:L::~~:~:c=.:
1'0111'1 S. Rhllom, Trust Adll1inistlrator - eXeCQtOr Estate
GOdfrey n. Jolm5on
Addre.. of Applicant ._........ll;!_H!!.r.lo1~t1'9.QL.lllU'.r.u!.>.l.ll:l>...l'.llliIl.ll.Yllania 171llR _.__..._
Official Title ___mlixllCUtox..
-~._~._.._ Dote ...-...........DWW'I'L---.--
This form must bo completed In trlpllcata anti oil throe coplcs delivored to tho Roglstor of Wills for tho County In which the decedent
reslJod, Of In which lottors wore luued for 0 non.resldent docu<lonl's (lslote, If the dllcodent wa!. CI non-resident of Pennsylvania Clnd
lottors woro not IssLJod by tJ Ponnsylvonlo Register of WIlls, dollvor 011 ,hreo copios 'CI tho Directof, Bureau uf County Collectl~ns,
Penno, Dopartmont of Rovenue, 26 S. 4th Stroot, Harrisburg, Po.
____m...__m____..'__u__.~,_,_D_o,.'!_~ t .v.:r.I!."_.b~I~~\V~i.'J I no -:.f.or_ Of!i~~ln.!.!!_'_o On I y
APPROVED: For tho Secretory of Revenuo REFERRED to Bureau Headquarters
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_._~- ----"""----"._-~ . ,
(Slgnotu,e of Regl.lor of Will,)
Approvad /]
For Socretary of Revenue
. (
Oenlod* 0
(Initial, of Regi.ter of Will.)
(Authorlred Slgnolu,e)
..-.._-_._-~-_._---- -.-_.__._--~._---_._--~-~-
(County)
P.!(T -n F
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(County)
(Title)
(Date of App,ovol)
(Dolo ef Roforral)
(Data of Action)
. Soo revor!'.(1 Sldo for reasons
~ - '}.. - lei
MUST BE FILED IN TRIPLICATE
COMMONWF'ALlH OF prNNSYI VAtllA
OrPAlHMI~NT or IlEV(t-lUr:
l'UREAU OF CDUHlY COLl.f:Cil0NS
API'LICA TlON f'01{ CllARIT AI1LE EXEMPTION
FllaM PENNIYLYAI{IA THAN$FEll INII[RITANCE TAX
(An of Muy ')H, 1956, I-I L ll'l?, ullfl ,\(:1 ,,{ )"11" 15, 19(, \,
P,l In, C1~ lll1ll'!lld,.d\
_n_,
- .-.-
---......
AppllcCltion i~ Iwrohy fll(lc! for tho opprovol
of Clll ox()t\1ption from P(!P1n':loylvcmlo Transfor
Inherltance Tax on tho trunsfer of 1ho property
dc-scrIbed bolow:
1. HUf<HIU Filo I.'
2, Doto 01 Dooth
,Iallullry lG. lU7U
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3, Doto 01 Approv" I
4, Nom" ~f Docodent . wili'rey...l\ .,"JfJhw;.Oll.. ..............-.-...._
5, The Commonwealth', epprol.ed voluo of the proporty for which on exomptlon i. c1<llmed i. $ _ll'(Q.<LJJ.}........~..__"
(Not.: Where tho property I. other th.n 0 .peclfled om.unt of cosh, tho exemption connot be approved until tho voluo of
the proporty ho. boon e.tobll.hod by appraisal by tho Commonwoolth, except in tho.o co.o. where the amount of the gift
or boquElst roprosonts a stat.,d fractional or percontage portion of tho entire ostntc or the entiro rosldue, In thoso cose,'
enter such fractional of percentago amount above).
6, Check the manner in which the tron.fer wos effected ond .ubmit 0 copy of tho document outhorlzlng the tron.fer, unle..
.uch moteriol ho. boen previou.ly filed,
WILL I.);;
DEED (};
TRUST INDENTUR E !i;
SURVIVORSHIP ii;
OTHER 1.7;
(If othor, explaln)...._____
7, Correct Bu.ine.. Nome and Addre.. of Chorltable Orgonlzotion reteiving property:
NAM E ......__!..liJ 0111I111 1m ....l'l<theX~L_.._._..._..___.."....,
ADDRESS.......X&..~.htlr E'U!;ene RIll:..~t...1'r.':!!s.1l!,,1'_........_ St~...Colurr.ll.I..l!;..Ll'lel)I.agka 68056
o See listing en reverse side for additional cht]titable organizations covered,
8. I certify that the Informotian contained he,ein I., 10 tho, be.t of my knowledge and bellof, true and torrect.
)IN 7\) ". Ui',.'.i\~. .C..~. 'I'M...,. L.. I'A"'.'.'.'.'
51 fA II /jv"} i I, /(/ .........
gnaturoo pp cant _..~,j( -,'_ i i';L~L.......L+,-_..._..l_Lc:,--__.!'-'--::~__~.._.._......~
rearl S. Hhoem. Trust Administn.tol' .. lixecutor Estate
Co"lf1\')' ll. ,,fO,'IlHolL
Addre" of Applic.nt,___.......~~A_..1,1!1rKlil.t_StreeL,JJllrr~..$R.m.1L_J'..!L. 171 08 ..--
Official Title ~_ ..__..__ JJxecutor.,.
__m" Dote,.. O&f?;&f~-~_.----_.
This form musl he comploted In trlpllcQle and oil threo coplo& dtlll~atod '0 tho Roglster of Wills lot tho County In which the-docedent
rosldod, (H In which I(lttofs woro luued lor a non.rotoldont dflr.odunt's 05'010, If tho docadentwas (I nonoresldentof Pennsylvania and
lollors woro not issued by aPonnsylvonla Roglstor of WIII~! dollvor all threo copins to the Director, Buroou of County Colloctions,
Ponno. DOp(Htmnnl of Rnvonuo, 26 S. 4th Stroet, Harrisburg, Po.
00 not write below thl. linn. For OHicial Use Onl
---"-"-~''''''"''-'-''''''''-''---'---L-~-'-'-' ..--...................-------....-.....".............,.....
_~~R~~-=~:'. ."... H..d..,"'"
(Signature of Register 01 Will.) (Initial. of Re9Ist'" of Wills) (Authorized Signoture)
Approved {7
For Socretaryof Rovenue
Denied'" 0
..-----.-.. .~._------.--~..~-_.._"_. ,-~_.~~-_._...._._-_....-._~~~.~--- --_._~~_._.._-~------~_.-
(County)
j1
(Cou nty)
(Title)
-~~-,--~~._.._._.~--_._-_._. .._.._---_._~~--_.._--_._-_._-
(Date 01 Approval)
(Dote 01 Rolnrrol)
(Dote of Action)
'" Soe reverse side for reasons
~-2~1(
MUIT BE FILED IN TRIf'LlCA TE
COMMONWfALlli OF prNNSYLVAtllA
DF:PAR'iMEtH OF 1~[VfNUr:
CURr:AlJ OF CQUtHY COLLECTIONS
APPLICATIOI~ FOR CHARIT,.Ol.l' EXEMPTION
FIWM PENN5YL V Mil A TflANSFEI11I<lH'IlIT Aller' lAX
(Art of MOlY 2B, 19~(J, I' I . 17~i7, <111(1 A{l (If lUll!' 1~1, lilt,!,
P,L, 373, <Iii 1I11)~lIdt'l.ll
.1
-;
.-.
.
Application j", I,l:'roby fll~d for thv opprovol
of an c)(cmption from Ppnn'ylvanlCJ Tranifof
InhoritoncQ Tax on thl' frClnifo, of tho propCJrty
do",lbod bolow:
1. BUfCllU File
2, Doto of Dooth
.hUlllnry '11, I
3. Doto of Approvo I
I (
,
,
I~'I\,
I)?
4~ Nom!!....~f Docodnnt
nndr'II'Y
---- ---.---
l~, , J (l Ill!.'; lJ II
.---------------.-
--~---------~_._~~---_..-.---
5, The Commonwoolth', oppral,od volue of the proporty fo, which on oxol11pllon I. clalmod I, $ ..1...Qr.,.1 Q~ (I.J:.,
(Nato: Whoro the property I, other than a .poclfled amount of co.h, tho o.omptlol1 COl1f1ot boapprovod ul1li1 the valuo of
tho proporty ha. boen o,tobll.hod by appral,al by tho Commonwoalth, oxcopt in thobo co.o, whoro tho omount of the gift
or boquost ropro~onts a Itated fractional (H porcontago portion of tho ontlro- ostato or tho ol1tl,o rel\ldult, In tholO casel
ontor such fftlctfonal or porcentage amount obove),
6, Chock tho mannor In which tho tran.for wab oflectod and bubmlt a copy of tho dacumont authorlling the tran.fe" unle..
ouch motorial has boon p,ovioubly filed,
WILL i';
DEED
TRUST INDENTURE d;
SURVIVORSHIP 2;
OTH ER iX;
(II athor, a.plaln).. . __J:i:.:~l .l"l.IJ.i..;.iltl.l ...ill>!. 'li.Ll_Ul"LT\J,""~ollt oL~"r.Jl.. JoIlMcm......
uul,l,;U ~la'J.'dl 7 f i;;i~j
7, Corroct Bu.lno.. Name and Addre.. of Charltablo Organllatlon rocolvlng praporty:
NAME "\!"'" 'e< I .
.. -.---..--.,- -Vf\U-l'H l-'-H:'7,...tHtt.-{.,ttOtt-l'l-rtr:-p ""rct--- -.-.-------
ADDR ESS -..,..~~:...-+*.;i~-""......:.,m(,'.ml',.....i.U,. l""m.~.\>..mi..-...~..._..-._..m'-m_.-'---........ ......----.-
o Soo listing on rovorso sido for additional charitoble org(lnilotions covered,
8. I cortily that tho information cantalnod horoln I., to tho be.t of my knowlodgo and boliof, truo and carroct,
..' 1I,.ciunal COll'LT,i,l !:wlk
Signature of Appll cant -"a't.,LLJ.-r.,_..J._..~../j1:'.,r{~.,. :,"..:.=::CC:==::_,__.__.._..~._~_..__...._..
l'oRTl :i. Hh<lem. Trust A,lmillistrUI.Ol' - bXtlcntul' Estu\.o
GoJiru)' IJ, ,-lohason
Addro.. of Applicant _._~.;;.;L~..i,~I..J:it..Q;,L:'. 1l",,"'ijj,Jll'~._i';L.j7lJ.!.L..____...._.__.__ ..._..___,.
Offl c 101 T Itla ~......_...lj'.,s:.<ltlO.L........_._..._.._~.._,.,...____... Date -......--.Df>./.2Jl/.!J!L.......--. --....
Thill form musI bo compkloclln Irl)1llc<lto ond all three copIes dollvorcl(l to tho Rt'{,lster of Will, for tho County In whIch thv docouont
resldod, or In which lollors were luuod for 0 non.resldont dClCtldflnt1, ostolo. If tho dec:odent wos a non.rol'lld~nt of Ponnl'lylvtlnla and
lettel'A WOlll nol luued by 0 Pennsylvonlo Register of WIlls, doll...ar all IhloC! coplos to the DlrltclOr, Buroau of County Collol::tlons,
Pen no. D(lpartment of Rovenuo, 26 S. 41h Stroet, Horrlsburg, Po.
_ :_'Oy~~;:::""": ::';;~:~_ ::':;:::;;:;'~J~~::;;:d:F'~'"::" .1 ,......
(Slgnaturo of Ragl.tor of Will.) (Initial, of Rogl.tor of Will,) (Authorllod Signaturo)
(County) (County) (TItlo)
._..__,_.__________ _. ---+---_-.2.-
(Dato of Approval)
(Dato of Roforral)
(Dolo of Action)
\ See> rf1vot~c c,id(' for roasons
(-Z,~1'
MUST BE FIL.ED IN TRIPLICATE
...J!>.I~...""c.ti!'-'!...\'Iill..~.. ,~p l!.t.cl..hJl.~ r....~.H~.o.~,qU<l.tt"L..~..nly...w.h..~..t!>...1l p'pl.l~ <It 1.~"J,,~,.~!,."!p.!i'!.!'Ja. b..o d..!' I.d , --
Oato! :....-~~_._"----"'_...:._.-
Th. appllcotlan lor .x.mplIO" cantalnod 00 the lac. .1 thl. lorm hu, b..o d.ol.d b.cau.. ..._--
__~..__._~n_-'.-.--,.-----.--..-,-~.~.--.---.-..-n-----~-----'
..--_-....--------__I~.,-
~__.-----'-.~-..........~~..........-......-~,---~---.--~~----~-'---..,-.-'~-~..............---n-+--
_..-.-.-.........--.-.......------"'-~
-~----<~.....----...~~---~-_.~~-_.~.--~---.....------'-"'~~----.----.,~
--
_______.__._____.......--------------.~~...----~..........---........--..-.....................-------~-o..-~--.-~~-----
N.,., Aoy party 10'loI.,..t, Including th. Commoow.olth, oggrl.v.d by thl. acllor, mOY within .Ixty (60) doy. ohor
the doto 01 thl. ootlco exercl.e th.lr rlgh" 01 Prote.t, Natlc., or App.ollo occardanc. wllh the provlllont 01 oppllcobl.
Pooo.ylvool. Inh.,ltanc. ood eltot. Tox Ac",
.,-,
'1/.2/17
Rc-C.H ,oI-7,1!
('OMMON\\F\1.111 01' I'I'.NNS\'I.\ ANI\
IlFI'\In\II;NT 01' RI':\'I'NIII';
Illlll!',\ll Iii' I OliNl\' ('oL),L('1I0NS
_tJLt_
~
RESIDENT DECEDENT
COUNTY OF
C lJ~1BE H LAN Il
-. .- -"-~-' .
...~,~,._, ",' --- -,-
Thi", fclUfllll1t!Ht IU' l~tllllplf~tod ill dt'IUi] a 11I1 filt'd ill Iluplli.'lIlt', wilh 1111111111,-1\1'11, wilh Ill!' HqU'ilt'l tlf Wills of lilt'
('oUIlI)' wlwrl' dN;ed(~llt rt',.;hkd, hl'lllrll j!oi tllll' wilhllllllllt' 1111)11111" ullt" dull' III dt'illl!, IInln:s UlI ('X!I'IH,jOIl is i(lllllltHI
hy tht' St~I'1f'IIH~' of UI'\lt'tlllt'. fSi'l'liol\ '!In 01 tlw lnht'lilllllt'l' IIlld Fslltll; Tux Act (.1 19111,)
IMPORTANT,
-..".--...--,"
---.-....
,
--~. - ~ -','
Late of
CUMBERLAND
} AI'HIlAI'II 01'
~~:~I~IUb\~
IN 'I'llI' MAT'I'FR 01' '1'111': ENTh'IT,OI'
GODFREY U. .JOHNSON
....~-.(iiT ^T't~-r:'UL.-l:r;A:i~f -(JF-[)-f~c'!:r)f~N T)
County
Stat. of _ Yf.LNNSnVAtHA
J."
Coun'y of _._CIJMlllillLAND
I' 1 S IU 'P Admi' . N ti 1 (' .t 1 Jl " "'''''IOto,
..-. .car .. ._ lOJlD4_...rusL 1l1str1l...0l'_.__ a ona -"en .ra ._ an'4,~,_.._.___' .
of Ill" e.lole of tho allovo.nomod docodent being duly .wotn, dopa.. and say I
Ih'c{'dt'llt d!I~t1 ._~D_..l!.~l2l
IMorHHI
Namo and oddutlli 01 ,,!lornoy 01 }
olher authorhed Hlprullnla!lV(l to ....hom
all correlpondllnc" .houltl he l1loJlo~,
16...L..- I 19..1L{'OI!a,O I(lovlng u 101' will, copy 01 which I. hereto affoch'.d, }
fUIIYI (YEARI 'I~
__1_._1'9J~~,L~t~.!!ffeI_________,_______..______.__________
Market Square Buildlng, Mechanlcsburg, I'a. 17055
, '1' Execlltor I ,., 1 I 'f" f I I I '
Inl! liS such._..___..___.____. .__..-.___ m__{ l'pOlll!nt IS lnlllllillr wit 1 11C ul ltlrS 1I sai,. CNllllc um IlC property COnslllLlling
{(',rl LUT{)H- . ,,~'" ",RI
the nssels lhcfl'uf and thdr fair lllnrkct value.
Thai ill tlw Ilnll! or (h~lllh there WflS no sul'e dcposll box regifitercd in decedent's indi\'idunllHllllc, or jointly with1 or
us agcnt or deputy III' another, or ill dl'ccdent' s individllalllul1l{'l with right of ueccss hy llllothcr as ngctll or deputy, with tlw
exceptiun (If the follOWing: -
==-=--::,-:=-,:::',:-=:~-:=-::',==:="-",,""-,,,=---..z;..-__=-'--='-"--<=-:" ,=. ''-==' '.-=-~~'-o'-'.=--=~=,,=.;:,,- ~"~-;----':'::;;-==='--"=",='-""='''-=,~--=-o===<;, .-
NAME AN!) ADllfIE!lS (If flM-JK OR OHI[R IN~'rIT\JTION HUr. SAFE Or-POSIT 80X RENTl:~[l
IN WHICH DECEf:Jf':NT RtrlTFO A ~;,Fl-: lJFf'05IT flax IN NM.1E OR NAMES OF
=-=~tion;;-CEMtNl-1l.ill1L____-==_~__=_ _:_ :GO dfrQY_.Ji....~ olmsQD.~__=-=
____!'roI)LlL Ed.w.f!.riUH:.rQetL_______h_____ _________________
____.Jjfi1.'It:;Qurg....l~llD~lliauilLJ.7J.lJL,._.. __ ______________,__
RELATIONSHIP OF JOINT
HOl,DEIHi TO IJECE.rJf,NT
,~-
==~~-
=-r-~==,
Thnt the conlents of !illld !-ollfc dCllosit hox or boxes Ilru Ilcmi1.l~d under Sehcdul'esB,. E of this return,
with thc cxceplionol' the following, for lhe rellfiOIlS hercinafter sct forth:
Thill Schedul. A IOttllched hereto IIl1d mllde part hereof sets forth folly IIl1d ill detail 1111 the real property
in the Cnmrnnl1w{~lllth of Pellll~ylvallill 01' which dt~ccdcnt died having IIn inlcr{'sllherl'tll, It I\lso sets forth the
mortgage cIlCllmhrl\nCl~S upon l:lll'il pnrel.:l of renl propl.:rty nl the dute of death, giving the nnlOullt slill due al
dellth, IlIUllC of' nHirlg(\gl~c, dnle, rlltc of interest, <lnd hook l\nd page of record thcreof. It rdsn !-octs forth in thc
columns provided tlwrefoH: thl.: ll'iSeSSl'd valllulinll of cHeh or said purccls, tlw cslil1lntl'd markct valuc thereof
liS of tlnk of dCllth of th~l'edl'llt,
Thai Schodulo B ulllu.:lwd hereto ulld llludl' pllrt hnt.:of sets forlh fully llnd in ddllilall pcr!<oollulllH,lpurly
wher~'s{J\-'l'r \iilllllted owned hv the dc~~cdL'l1t III the rime or death; nil moneys left by Ihe del:edcntllt the tilllt: of
denth, whether in decedcnt1s illllll~\dill(C pllSSC~d,ioll, stullding III decl:dl'1l1's crcdit ill hanks of dqlOsit, l\i~vings
hunks, trllsl t'omlHlnies, or lither inslitulillllS, \\lwtlll'1' individually, or in trust for any {)tIH~r person or pl'rSOI1~
giving also SCPllf!ttcly tlH~ lll'('flH'd inll~rl'sl lherl~on, if nny, dowll to the last intcrl'st dny priur 10 del:l'dcllt's
deuth in the l:llSe of savings hunks, and to I Ill' dllt~ of de('l'dcnt's dl'nlh in all otllL'r cllses; ull honds, !WSllll
sllvings, tr<.:llsury ccrtifit:atcs or noll'S Illld other eVldcnl.:l' of illdchl~~dness Ill' the United Slatl~s to the dc~
l:edenl; ull obligatiolls, whellll'f hy slalute or agn'cllll'lll lht'\' ,\I'l' i..k...ij.!IWlcd as lax frt.'c, of till' United Stllles,
01' !tny f'lnll', or political suhdivlsioll thereof, or of any forl'i~n clIuntry, which arc owned at the tillll' of dClllh;
1111 ,,'curing llPpllrd, Jewclry, sil\'L'n,'uft~, pictures, books, wnr~:; of nrl, IlIlllsl'hnld flll'l1illlre, hilrscs1 cllrriuges,
ltutolllohih's, bOllts, llud any and all other )lcrsollul chatlels of whals(ln'~'r, kind ur l111tllrc, Idt by del'{'(!t'l1t,
together with lite fllirly t~stilllllh~d mllrkel \'lIluc thcreof; all hllllds lInd ltlorlttagcs held hy deccdellt anti or all
c!nims (hll~ flud owing de~;e~h~nl ut the timc of death, nnd nil rrnmi~;sory Holes or other instrummlls in writing
for lhe pilyrn~l1t of ll1one~' of which d(~eedcI11 tiled possessed, of whlltsncvt~1' llnlure, with inlncsl lhereon, if
IIny. giving the fnt'e v"llIe 1I1ld estil1lllled filiI' I11nrkct vlllut' tht:rcof, und if s~Jl:h cstillllJlcd filiI' I11l1rkct vnluc he
less tlwn the flll'l~ \'Uhll', it S(~ts forlh hriefly lhe rel1.'ifll1!-o for sllch dl'preciation liS to cHeh item; nil nwncys
pllYllhlc 10 lhe {'Slute from life insllrlll\t:c policies <.'lIf1'icd by d(,cl'dl~nt; all llnnuily lInd l~ndnwmcnt contracts
the prorl'cds of whit-h wefl' pnyahlc upon Ihe dl~Ulh of thl' decedent; 1I1llllld till: ('llfJlOratc stol:ks und dividends
due Ihercon lInd L1llpLlid liS of 11ll' dall' of dl'lIlh, hnnds !lnd nccfllL'd intel'l'st thercon tn the date of dc<.'cdent's
dculh IIml tltlH~r il1\'l'I-iIIlH'Il! Hl'urilil's OWlll'd by th~' dl'c(',th~l,t lit llle limc of lIt'lIth, \I/ith lhe 11l1lfkcl vullle tlwre-
of lit sHch t illll',
In t.ho 1~IlNt1 CJf Honurtt,tnR Ill' (1IuHH or f'llndty ()Orlllll'llttoIlN, tile. VItIUfl/i rnpnltt.nd Ill't! /lK 1'111' II"
)loRHthln HuhMtnllt.tnt,nel h~' f'llIUI1('ltlll Ht,ntnlll41llhl (If tlln t'HHI1I11'11t.loIIH, Hllowln~ U\fi IIMNfl!.H /lnd IlnldJ1UflH
ttH'r~nf 11M nf' 11m IInt.ll nl' dl'llt.II, 1'110 HI'hflflulu n'I'HI ,;nt.A f'ol'I.1l tllll 11I1,{t,rllHI, lit' dnllllrllllll, Itt, tllIl 1,lml' (II'
d~ftt.h III "n~' rO"l'nt'tlwrRlllp {lr lJ1lfltllt1HfI, IlIHI 111 HlIJiJlfll't of t!lfl Vlllw\ of' ~\wh 111t.fll'IIHt t.llfll'u IH mllll'K!'!!1 to
POnlel Rnhl\clI11f1, f'IIIIII",lnl Mtlll.nffil'IlIH Rhuwlll/l; tl1f1n~H;otp, 111111 Illtldlltlm. ot' Hili" (>fl-plLl'UlHr!'ihlp 01' hli'iIlHlIHi.
^ I'nN' nl' till' ('n"l'lIrtllflrP,tdp ,'l,,~rOI'lltfHlt, (if' or'nJ, n Htllt.omllnl s(lltlng f'ol'tll Ihll 1I111111'f' of' IiiI' 11,~I'''''mlllll)
tow'lhf'r with It RIl\tf\11tN11 Rfll1lll~ 1'01'111 11ll! nhtt!"/\l'f.flr of' I.hn hll!oillll'''l'l, ''''-I Illl'f1lillll, 1111ft Hlll'h olhl1l' I'fll'(H
'WI'tllllltll~ 10 tlto hll~lInro""s 11M Ul/lr hn JlI'I'1 IlIl1nL 1,0 n f'IIII' HHd .111Hl- Ilppl'lIl~ftl "I' Ihl' dtlf'l'd\!IlI.I", I 1l1.11 1'1111 I
thl'I'nln Illlllilt 1)(1 suhmtt-t.roct, It !-Ill/lull! 111HO fwt "orth In Itor'II1.flf! form. 1 <<'A,'I,III,'I' with tllll f'lllr' I11I11'knl VIIII\I'
throrf1ol', /lilY ot.liflr {If'Opfll'tr OWIHIlI or lJoqlluulllllll lly tllP dt'/~l'dont /It Ihl' limn 01' dl'llllt.
Tile _\ChNlulfJ (' Iltt/H"11lfHt lI/'rl1l.o HllcI rnHel(l I'llrt. hPI'pof' Hills "(If'ill 1\ t.r'wI IIIlRWI,'I' t.o o/wll lllljlllry
cnnt nlnoel U1I"I'('ln nnd in t 1m ("1fIHr> of trnfl"'f'orH Of'pl'opf1rq', ro/tl or plH'~Hlnlll, wllld II two YPnrH or IllJ/Jndfllltl H
dl'ftth, ill contf'mplflUOll of' Itoondrout' R (Innth, 01' tl1(.l'lI(trod 1.0 1.1\I.:f' ol'fnnt 111 IHI'i~nH!llnl1 or 11l1.lnyrrll!nt lit or
/lft.er (lfOtlth, slltd F1cllmJuto HHt,R f'ort,1I t.IlH tlut.urll /llld \'/\tlll' of' Slll'lt pI'OllPrt,v, In WllllllJ tI"lUlNf'f'l'rt'fI, llin
re l",t 1onRh1 II of tho trnnR fnrofHI t.o tho t1o(wdon t., !.lIP flropol' t iOl\1l l,l' Rhnrf' l'f!('{11 vol! hy flllch t.rllIlH l'(!!'(!\! lUll!
/t11 othAr fnetR of' R p~rttr1fmt. fluturn rl'gnr(l1nj.!; R/lld t.rnnNf'el's. III till' CIlHfI nf' 1.I'HIIHl'nr"l 11l!.(,Tlllod to
tl\ke Arfect in pONAl:H:lFlioll or on.1(Jynlf~llt Ill, 01' 111't.or "nllt.h, UWr/1 Is IllHO ul.tHl'III'(1 to t.h(! HrhlH1uln II 1~IIIlY
of' tho fhHlrl, trlltit. l1.1!:rflomont or othnr IIlHl.rUlIltHlt. erontlllg IIIH 1."lIl'It. 'rln'I'!' Is nlso Hfll. f'ol'lll III HIIII!
sch(H1ule n ltst of ull prOpl!rty, rl'lIl /lnd pf:'rsollltl, willi Its VI\ 1 t1fl, which 1l/IHlf'H nt d/'(!(lclllllt's dl'f1th hy
virt.uo of UtA oxerc1so hy rlO(lOllHfIl" nlUwr tlldlvldunl1)', ol'.1oint.1y wIth I\Illlt.llf<r, nr I1n~' pnwlll' of' IlpJI()\llt-
monl, vt!st.od indpcedent., either tlHttvlchwlly or .Jointly, by Uli,l will, donll, 01' !IU\flr IIlHl,r\1U1\111t. of' /lllolhl'r,
with 11 copy of the inRt.rUl'Illmt nrent1llg Rlletl pnwnr nt.t.flehl'r1 to t!JP s('lIn(lulf'.
That Stlledule 0 nttncllt'fl llf!roto flnel mnnn pnrt. hPI'uot' SI'Ui fllrt,1t tlu' 11 HmNI filltl Hfhtrnssf's of' III t
porsollR lu'!ner1clally interfHitP,d In this estnt.n HI. t.ho ttrllH 01' dl'f'odontl s Ilunt,/l, tho !lHtllre Ill' tI,,'II' ('/\ti-.
'pectlvf! interests, their relllUollshlp, il'IIIlY, t,cl Ulf' cJf1CH1dnllt, 1.0).!:1'1,llor wlt.h thro Ilj.!;U~ III, till' t.Il1\ft of'
decedent's death of nU minorA, nr1Tlllttnnt,s 11IIlt hHIWfl0.1HrtoH rill' ltr'f' \l11flnr do(wrlont's Will. It nlsfI
contll,.\nR fl. Htat.emont, showlf1.'l; whtch of' tile hflnofi0.lllrir!!i Ilnltlt'c1 III tlln r11'ct1flIHlt1u w:I1J, If' IIf1Y, fUr'll prior
to deCl:lllent, thA ctatAs of t.hHir dnrlt.Il, t.I1pir IHRUn, 1I1l11 tllf' I'nlnt.lollRlllp fll' sIlI'1! iO:;SllO to l.hn bfHlJ'f'lcll\l'Y.
That St/1t"dule E /lttnetwd hflrflto nncl mudn II pnrt horoof Hots fort.h III I prop(Jrt.YI renl HIIlI pnr-
sonnl, r.wnerl by tht'! flctHHlont .lolnt.ly with HlIOUIN' or othors, 1tH'11J(1I11~~ 11It.flflp;1hln, stflllll1ng ill t.he I\nnll~
of the docf!rlent, ,mrl otht'rs, pIllS t.hf1 d/ltf1 flllel pllt{~f1 of' "f1(~nl'c1 of' III~t.I'llllltlllts of'f'{1('t.tlll1; t.ho ',;ostlt.l1rf' of'
real f!stl\te f1.nfl the /1A.l,o of ,wl(ultdtloll (It' Iwr'Hllluliy, plus t,hf' nllmo, IIdrll'flHfl /III/I rellll,lol\slllpt If /lilY,
of co-owners to the (IAoedtHlt.
Thnt S""fJdule F fl,ttnohlle! heJ'f't.o /lnd mluln 1\ J1<irt. herf!nf ~flt.5 forth f'llt ty Hud tn l1rot,111J 1111 dnhts
and deductiolls cJnimE'rl f'or 811fl 011 hnhnl f of thIs dn(!flj1ont's f'!'!tnto, IIH'JIIIIIIlJ,!; 1'lllwl'nl nX!l('llsf1S }1fltrtj
fllmtly Axemption, wlloro nl'Pl1e111J11'1 I'osts of' lilllltllllstT'flUllll of' 1I1lfi nstnl.n; ellllllspl t'1l(~H /lnd l'wl\cdlll'Y'S
commissions paid or t.o he puill: \~()Ht ('XllI'wlne) ,'or hl\r In] tl'IISt.H, t,Ol1lhSt.OIlIJR or ~rl\vromflrknl's, Illlrl rf!l t-
giouR services, in C0I1SElquenel1 of 1,1111 dHlIl.h 01' tho df1on{lf'IlL-~ debt"i /lud cl ntms owing fllHI nllpnlfl nt l.lmo of'
deathl taxes nccrued chnrgolth\n for portoll 1'1'101' to ctl1eodnllt.'H f)('fllh (w'<f'fl}ll UIOHf' nllowNl undl'r H(l("11,lnl1
fHH or the Inheritl\nco find Estl\ln TIIX ,\1'1): 10f'.I1UII'I' willi /I stnU'l1lont ilf' eolIlltl'l'nl li1Prl,l';IHI 1'01' olillgn-
tlons, tf uny. It iH IIp;renrt thllt. t.I1f~ f't(hwI11t'y will I'l'OSOl1t 11I'(Hlf' Ill' Hllld dlllllll!11 (\lllll~IlI.lollH llpon I'{'-
qllUst, thut if' t.ho nmO\lnt I\Clllllll~' plllll In ";ot.I.lomnnl. of' IlIlY f'Ofl, Pllmmlsslnn or dflbt If! If'SS UlIln t.ho
f'sttmlttnd Ilmollnt cdft1rnln~ /Inti ldloWf!rl, filII\. Ihtl Hanlt' will hI' l'f'llCll'\.P(\ to till' H..~:lstf'r of' Wills, IIlld (.II/It
tho Ilmount. of' t,flX nssn~Aofl enn ho rl'llssc>sspd 111 1H'I'OI'rlhIWO t.lll~r{'wl tho
Thld thf' totnlR lIf t.ho npproprlnl,l' I'tllumns III Hl'llilftllll'R "A", "W', ne", "I';", IITHI "10''' fiR dlrncf.(H\ t!lorl'ln,
hl1vf' bf'on ClfiJ'l'lerl. forwnrd /Inti pT'op(1l'l~' 1'(l~1Rtnr'fHI ill l.h'l HlIlllnlllT',V.
Subscribed and sworn to be foro roe this
.,,~LJ;:>t..t. day of Jt1~'(
/l~ ./. (t:G~,.
P/1Ul T MIi!ilf'. /iflll,lil f'(ilP,([;
HMWISIlIJHC 1I,\,!!!'Hi,'/ fc:)Will
MY (:tJMfy'rfS~:111IJ I l'f'/f,( i; '. ;',7, I J,l;'
M!'rnht'r, PI'llilWIVMll,1 ^o;~,hCI,j!l(Jn r.1 tht,"I(''i
NfJTI':: Uof'nrt; ~.t.u;\1II1~ nff'lctflvtt mllkn HurO nIt hlfillk fiplWUH ill thl] 111'1'11\/\\'11 11111\ !->t'!ll'c\ulns nrHlI'KIlIl 111'1'
I'll If'll in wtth dntfllla or tlln wONI "NOllll". IInd III ellAtJ thl:' IIHf;I'l-!i 1111'111110 1'/11'1' fllld 'lllIIAtl'!l !iI'Clllrlt,ll's,
"flf~urlttp.H nf' clnRfJ fir f'um1ly lJoI'poruf,tofls nt' 1111 1111nl'tlHt III Illl~' CO'K\!'lI'Ull'l',llhll' 01' hwdnf!stl, tl1nl. till!
(1/11,/1 IHlrI N t.ll tnmflll tN ro fill I rod IIIHltH Clip 111I1'Il~I'(\JlI1 .I11H'IV'1 I'l! III I J Jil~ I 0 ~l'Ill'dll It' If JI" II rf' II t, t.1Il'1I1111. ;\ 1 so 111111\('
f'I!l'11111l Owl, (~Cllllmn III 111 1.11" "HlImlllflry" h/I~,hOOIl prnpnrly l'OJnplld,pd lIS Il!,o\,p-dlrul't.t'll.
... 111".
N^TlON^\. CENTRAL BANK
/)
)/ 1)1
B /.'./ (i', ~ /( \ / /'/ .-1 { M_..'__"
y,..'.....iE;.;~;;t~;:mBUlfmjx~;I~ t,Aii.~t~i" uUt
{,{, ~.. . Ha.r1zct91r9Rt................ ...........~..rnl~~~~r11~~ r
(Street Number)
Iiardsbllrg., I'cnll~rlvania ] 7108
(City or Town and Swte)
lW:"N.,
("Il!l!ONWnl,'J'I! 010' I'I':NNSYI.V,\N I A
'I'II,\NSVI>:I\ INlllml'I'ANn: 'l'AX
11I':SII1I':N'I' IJI':('lml':N'I'
S('lIlmIILI': "H"
f>1';I\SON A I. 1'1I01'1':I\'I'Y
I NS1'11I1C'I'I{INS: '.I'lltFi l-kIIHltulf- m\llit. ftlseltHw ltll tHIII~.tlI1tl (uHI illtullp;lhlu IIlll'HollnI prop(\rt.y {Inllf'i! tlldlvlrlullll \-
---'-
h~' t!w "(1,~tHIt!lIt., u(~Ul(l l.imll of' IllH dOll!'ll, PI'f1PflT'ty oWllurl h~' Ulll dtll'('dtlllt ,lollllly with 1l1111lllfll' or ollll'I'S
mUM!. hi' ItHt,mt ll1l1hlr Hl'hndulo It!':". Illj,!tlll~lhlu Jlul"Htll1nl IIroJlBT'!'y, t.lt.Iod III t.lw tlfUlIt.1 of t.IlI' llHf!t'dnllt, hilt
pll)'/llll(\ at. fltHlth t.o nnOUll'I' or f1thllrMf tllcllllllllJ.( hilt. 1I0t. Itmltflfl t.o P.O.U. (J. H. HIlVlnJ2;H 1I011ds llnrl !,1'nt.lI-
t.lvl' 1,1'IIS'!. nll110llnt.H, I1IIlFlt ho ItHt.flIt, dllspttp Uln f'IlI't. t.llllt. l.lwy Ilrf' lIut of t.Iltl lulmtlltfit~lr(HI f1Htnt.t'.
TlltlJ.(lhlfl purson/ll prOII(lrt~' 1411011111 110 IhltlHt f'lrHt (n.~, .Inwfllry, wnllrtn~ t\JlpnrAl, IHlllHnhold
goolls, HIli! f'tlrlll fihJ IIJ.(M, l'onks, (lutllt I lI/1,H , nil l-nlnoht I HH, holt tK, ul-c.)
IlltllIlAi1Jlo Jl(lrHOIUlI jll'ollOI't.y, HIlOI1 HH hOIl(tH, trO(llHlry cortlf'lotl.toR, CttRt! Oil hand Rnd In halik,
st,(H~kHI mort.p;lIJJ;oH, IHlt.nR, tOlJ:utllor wtt.h 11l~I~rHO(1 illt.nroHt or (tivlftfmrtHt Rul/lrtoH or wnp;os, insurance (llty-
ubII' t.o tho olit.nto or f'l(hwlury III A/ltd t~'ql/Hllt.V, pllrt,l1orHhlp tTlt.uroHl.H, tntnroHt, In RTlyutldlstrthutnrt
Of;tllt,fl of' 01' IlIoomn {'rom ltll~' jll'opflrf-y hlll(1 in t,rwit, tlmlol' t.Iw will or n~rOUlllftflt of Another, flvnn thollp;h
)nel1lnd ollt.silto of' t.ho IHlttH, Ilt. Uw lil1lfl of' dent-h, Hllould l)f! Ilstlld in t.his sohedtlle.
I t.ern
No.
lTJo:M
LIHt liTHl (Inr;nr1ho 1'tll1y
IlNIT
VALIl~:
1.
2.
Cash on Person
Balance National Central Bank Chccking Accoullt
No. 62 -5593~9
Balance National Central Bank Statoment Savings
AccoWlt No. 62-98000456
Accrued interest to 1/16/79
Balance National Contral Bank Gold Key Savings
Account No. 62..00003894
Accrued lnterest to 1/16/79
Balance National Central Bank Big Saver Certifil;a e
of Deposit No. 62-99027900, dated 1/25/74 in th
amount of $11,000.00, dlle 1/25/78, automatica11
renewable, 7.25 interest added to principal ann ally
Accrued interest to 1/16/79
Balance National Central Bank Big Saver Certi fica e
of Deposit No. 62 -99083908, dated 7/7/76 in the amolmt
of $8,000.00 due 1/7/79, automatically renewab1
6.59; interest added to principal annually
No Accrued interest
Balance First Federal Savings ii Loan Association
Special Savings Account No. 2-6-61
Accrued intorest to 1/16/79
Balance First Federal Savings (, 1.0[\11 Association
Savings Account 2-6589
Accrued interest to 1/16/79
Balance First Federal Savings f, Loan Association
Savings Cortificate Ne. 218-908937, dated 7/10/ 5
in the amOlmt of $13,000.00 duo 1/10/78, nutoma ically
renewable, 6 3/ 4 ~" interest added to principal
Accrlled interest to 1/16/79
First Federal Savings ii Lean Association Savings
Certificate No. 218-900140, dated 8/28/73 in th.
amount of $6,000.00, due 2/28/76, automatically
renewable, 6 3/4~" interest added to principnl
Accrued interest to 1/16/79
Unitod States Fidelity Ii Gunranty Company - (,roup Life
Insurance Benefit Paymont Polley ) G~I, Cortifia ,to 657
United Stntcs Fidelity f, Guaranty Compnny .. Salnr Check
Period ending 12/22/78 $ 468.89
Period ending 1/ 5/79 423.92
Poriod ending 1/ 8/79 to 1/16/79 350.77
Recd ved from Fidelity f, GunrllJ1ty Life Insurane.e;ompUll)'
Roi mblll'seJ\\ent ncceunt metl.ical expenses
incurred 1/19/78 :~
6/23/78
1/ 9/79 to 1/16/79
487 Shares United States Fidelity f,
COIJUnon Stock c, 32.0(.25
Dividend on abovo at .50~ per share pnyable
1/31/79 to stockholders of record 12/15/78
(CONT"D IWa: 112.)
.3.
4.
5.
6.
7.
8.
9.
10.
11.
12
13,
14.
1811.4 n
8.00
199.20
Guaranty omp my
Imwrt. OIlH tot.nl OpJlOfollt.11 "Ptlrtwl\ltl Proporty"J Schodulo "U" 1n X X
tilt' "As Hnportnd" ('01111111l nn Ull~ InN!, pftl1;fl of' t.htH rottlrll.
1~8Tl MATlill
MAIUU,T VAUlE
nEP^,\TMF~NT VAl.lJATION
(1)0 not wrf to in
/' tlllFl tip/we)
- .
.-
\143.61,//
',- .
586.00,
, 1. 22/
/
\'1l..,022.86/
. 24.l15
"" /'
14,763.01
"'--1,097.28 r
"-
9,435.41'
/
~
\
11,253.52
- 26.61
"
6,214.14
" 13.41
,
16,440.83
__45.65
'-
8,606.91
',,- 23.96
,/
\
1,243.58
391. 60"
",
, 15,614.44-
'" 243.50
, {(~\
".....,...." ..,..... \. .. ,'"'
".<11...~..""~'" ., " ". ),1
\ ' , , '
:' -:-" ,..D .\-Jj
NATIONAL CENTRAL BANK
H."loburg, Punnr(lvanl. 17108
17171 238.1.81
Pearl tlheem
Tr~et Departme~t
National Central Bank
REI Eetate of Godfrey B. Johnson, Date of Death - January 16, 1979
Dear Miss Rheetnl
This letter will inform you that the following accounts are registered
to Godfrey B. John'lOn. Checking occmmt 1162-559349 with a balance of
$143.61 as of January 16, 1979. Statement Savings account 1162-98000456
with a balance of $586.00 and accrued interest of $1.22 to the date of
death. Gold Key Savings account 1/67-00003894 with a balance of
$11,022.86 and accrued interest of $24.95 to the date of death.
Certificate of Deposit 1162-99027900 with a balance of $14,763.01 with
accrued interest of $1,097. 28. Certific.ate of Deposit fI62..99083908
with a balance of $9,435.41; no interest was accrued on this certificate
since the due date, January 7, 1979, WIlS withIn ten days of the date of
death. All of these accounts a~e under the single ownershIp of Godfrey
B. Johnson.
If any further informatIon is necessary, please contact me.
Sincerely,
J/uJli;i }J(JWnI{JlV
(Mrs.) Sheri S. Bowman
Assistant Manager
Harrisburg Regional Office
March 1, 1979
SSB!j ta
... ~
o '
~ ~
~".( .
, 0
, ~a
.8 t: J!
8 - 0
.a ~ l>
..: S_
i. 8-
~14~
a; - Q
~ S e-
'- ~
Heal I'l'Opcrty
Per,onlll Property
Tl'Ilnsfers
Schedu~e "B" ,Jointly
SUMMAI\Y
(Seh, "A")
(Soh, "B")
(Seh, "C")
..owned.Pr~perty
Gross Tuxublc Estute
------
,
l: ]
z
Iil to.) !
~ - ""
....
~~ ""
'" ....'
.... g i1:l
;:J 0 ~' '~
t.. ~ ~
~ 0 ! .
"' <<: ~ ~ i'
p ...,
I<l r.. ~
Q :z:: ... ffi . 0 0' ~
0 0 "" ~ r.::;
;,.'; ~ ~
IJ.. >< ..... ~
-~ li1 0
0 ~ of!
0 ~ ~
c ~ ~
';:: I<l 8 WI
" ~ ..... ;:: Ill:
l:J 0 6
v, <<: ..... .i::'
'" ;;< 0 E
"" 'f! '" 5 "'
.3 15 0
;;"tl 0
...~ U U
(I)
(AsH('!1ol'lm!)
~O.
$
$ 1.83" i23, 97
$ ., " -0-
$ 142,.95
$
$
,.183. ~66, ~~
( 2)
(A,\ Di.t"rmlll"d)
$
$
$
$
$
$
Itee.",
RESIllLNT 1JE<'LIII':NT
SClIFlJllLE "E"
,JOINTLY OWNFIJ I'IWPEllT\'
*
, ,
COM~lONWEALTII OF PENNSYLVANIA
TRANSFER INIII'.IUTAN(,lc TAX
IN!{l'IU1(TIONS: Tills ..l>l\l'rlllI f.l milA I t1IHolllAiI lill }ll'ofmrt)', rool Ilwl l1fll'SOIWl, ~.~_U\(l ftoPoII,'IIf, ,Jolutly
~~,~.!!:.-;2.!!~~l IIlOlllfill1g tlltlln~jldnH, Htlilld111~ ill thu 1l1H1lt1 0" tllf! llnf)l'dllllt /11111 othilrR, .LiNt
1'1'<11 C'!-.Inlp first, 1I!i f!lltlrl'th~s, or Joint tt11lllnts, ~1VllIg brillf' df1!-Hll'jpt.\(I1l1 IlH !Tllllo/ltl'd \ill/hI I' fojclLodllln
11,\", itlur.. llH! fllllll IIlid l'Iftoil Oft'll{lOrd of 1UHLrlllf1t.'Ilt nf'f'uotlllJ:{ Vll~ltttII'O, hUI fin 1101. Int'1udu ont.lrfJtlofi
01' 0\1\ 0" ~t,'ttt' r/lld md,l1j.tJ VlllUtl III IJHtllt.O vnlWltlon t10lllnllh POI'fHlllHl PI'{IPOf'l,y shuuld tHI lht.ml IlN In
Krht'1l1l11' fiB", pll"l \Int.o of' ItoqUJHIl.toll, lItHI Uw IIElnlO, Ilddrf\~lH /lull rolnl.lolIshlp (if' 11IlY) ot' l'O"OW110rM to
tht\ 111'('1:'\1'1\1..
.... ---
IhHH'rlpllnn of l'rol'ort.y, Unt.o ofJ\cqllisiUon, Nnlllu
,\ddrmH~ ,ulll lllt.tnt1ollfltdp of Cn-Owllors, Il.!1d PIneo
of I\l'eorll of' Instrumunt, Wllfll'{' Ih~f.ll ll;~tnto.
IIIdt
Vulun
pnl'l1l'l\f,U~il
!'ihl1rn
l,;Ht.nt.fl
Vtlllllltlnn
......
D1a'AlITMI':NT VAlJIATION
CAtJTION-Do Ilot. WrHo
In Thtl'l S HtcO.
VnluR of
1')1 t. lro
Prope r t.y
Vnlue uf'
Ilocorhmt' A
Int~I'oAt,
u. S. Savings Bonds, Series "E", registored
"Mrs. Marie J. Mosher 01' Godfroy B. ,;ohnson"
$50.00 dated Sep 1943
Cert. No. L 235 861 730 E
$50.00 dated Jun 1944
Cert No. L 235 861 730 Ii
$143.23
$142.66
'2. '6 S 'i
$285.90
1/2
Taxable
~. \)J....
'</ ,-r
$142.95
-
Insert UriR tOtll) c,ppl)HH~ ""{)tnt1~' OWlleo Pro))ort,y", S(~h(Hlul[! ",F."
jn the ftAH Hoport.cd" column on t11fl lHst, ))1l,ll;H or th1r:; N!turn.
2e.S'l,)
fH'V.4!l.1 tn-'Inl
CmJlltYI Numuor ond NUtlIO_.,
rill' N'.lIflhor.
Z I-Cumuerland...
21-79-0105
January IG, 1979
Godfrey-
II1Ii"1 !llIt.ll)
SUMMARY
D\1I1' {If Donth_
t..trlll' NUnlo _ Johnson
(1.1\:' I !-l (.1.11)
B.
(HI! \ !At.1
COMM()I~W[AI.TH Of' f'ENNSYL VANIA
TRANSFER INHERITANCE TAX
IlESIDENT DECEDENT
REPORT OF INHERIT ANCF. TAX APPRAISER
I, Ih" undn<olgnnd duly apI,olnl"d I"horlt,>o<" Tn. Apprnl,or In nnd for Iho County of Cumberland ,
Ponll'yh"nlu, da ",.poctfully roport that I hnya approl,ad tl", rnal and poroonal proporty a. rnportod In tho farogolng rotul'll at
tlw vullle!. sot forth opposite oach itom In tho lost column to tho right In Schodlllo5 HA", liB", "(1', and lfE",
Do k,!:.. .. ....___~E!~"!.be ~J_Jj].L....-_
Vl~1 ! ,...; : _. / / ,// (f !,' ,I
,/ H'IHl-;HITI\NcF TAX ^ppr~I\I~f.r~
'---.'-~-"."--'----'---'---
.._-~--~_.._-.~--------~-_..._-_.
c
REPpRT OF THE REGISTER OF WILLS
1,111" undclSlo,,"d duly "Ioclod R"g',lor of Will, In and for ___'_ County, Pannsylvanla, do ra.pacl.
fully rvpnrt that I hove allowod doductlonr. In lho amountfi claimed by deponont, excop; as to tholo Items whero 0 greotor or
It'!;~.f't <<mount is let forth in thD last column to tho right In Schodulo 'If", which greater or lessor "mount reprosents tho sum
cd In.,.,-(ql Clli 11 deduction.
Dotod:
REOISTFk [)f' WILl,!;
-..-.--. ------.--.-.---.-.----- .
...------_.__.~~~._---_._.
INVENTOIW
VALLIE AS AI'PflAISW
ADJUSTMENTS
,ODE IHARIlISIIURG USE ONL VI
nl\ll i 'I '1:'UrIV WChOtllllH ^)
1'I'tWII.11 P111!d1rly (Sr.huclulo n)
,J,)lrll'~ 11)ld 1'lupMty ISohndulo f:J
.\ fiHldun; (SthllChrlll Cl
TOTi\!. OfWfiS MiSEl'S
Ltt5S Dill-Is nnel Dl1ductloll!l
ISCHLDULF FI
CLEAn V^,..lJl: OF ESTATE
$
OOt
lOt
20+
30+
REMAINDER APPRAISEMENT CODE
92+
_.J
40-
93-
VolutdiClll of IHf) /lstotos or ';"" Pf~INCIPLr:.
:~~:;~"~';~'~~~~'s':~~~'-;:" '----: --==:-=1=
"=t= -
Y..~
c
f.Q[!I,ISl':OF.!ig~!.~Te:R_ O~
Tox Oil :P
To'( on !,
Tox elll ~ ....~~__~__---...._q~__
Tu)( I'" ~,
TUl\ on :;,
EI<(lnII11101l1, . ".=-::n--=~__""_h=-'~;'..",:!"_
Tohll I:f,luli'
~
COMPUTAIION OF TAX
2'Y.1.___
n'XI ---_
Hi% ---
$
$
$
$
$
TOTAL TAX
$
(") A. evldQnced hy Charitable
Ellomptlon Certificates luued
by the Socretary of Rovenue,
~-=:"l
LIIG':l 1(1)( rrnvloltloly 1)(lId
BALANCE
l.n't!, ,)'\- r.i 101' jfpol(1 wlfhlr.
:3 I11cmtll';rlfkf donth
::=-=-.-~1=:
~;-' --
-I 01l.L TAX BALANCE
PA Ir,_________
$ -'-
$
$
$
!
$
BAl."'''':;: N INHeRITANCE TAX DUE
Add il'" f';~, I 01 Tolo of 6% frCltll
_ I(I,._.._~-..-
AMOU,ll OF I:>TATE TAX AS,f'SSED
I\AI.ANCE rIllE
Add i.,\.,(,. I III rid( ,1/ 6% from
,,,
:---------1-
,~. _.-
Es llll" ~['" prdcl
Suppl,',""n!,,' Coda.: (FOR USE IN HARRISBURG ONL Y)
4A-,^rlj~llOtf1l0nt
49 t-Adjuitrne-nt
!>{'.~f..nnllity
6O-Llfo E.lot"
92i-Ramalndar Approl.a!
93-R.malnd.. Doductlon
93C-Charlty
94-Ramalnd.r R..ldu.
96-Su<<...Iv.
Llf. Eliot.
.. -~-_. ..-..-.--.-.....-------.-.----.---
HII; IJSE Of REGISTER ONLY
ADJUSTMENTS
t~().1 E: Whew subsequont adj'ustmollts CHO modu to tllo cLove c;url1pll~'t\tlon l,>f tax by tho Roghtar of Will, for proper rOO$on,
!.CHI," should he not<H below1 wilh :;hnrr t~):pIClIl{>tHJ!,. f
.. ~
" LtJ 'tl
" ::!! ~ ...l
>< .
IJ,J . <
lZ) ~ ra
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Cl.< III '" 0..
w .;f, w 0 c: ,~ <
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0;; LtJ ~ LtJ '0 " Q
?:. ::c: f-< .., c '" ;1:
z. .....
f-< '" < ..... III '", <
0 f~ <<i ..... - III
I.l. "" .- l. '" f-<
~ 0 IJ,J ).. :I:: Q) '" ~
t1 OJ
0:: Q) " 0.. 0
0> l. :::J Cl.<
,~ LtJ <I- ~ '-
~ u 0 LtJ
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~ ;-. .:;
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's "
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""or. ,!l ~
c:
" " 8
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t.i <3
H[V.'l~; I (B-'III)
llEPARTMfNT OF RFVFNUI'
BUREAU OF FIf.LD (Jtlr;l~^TIONS
1',0. uox ~fl7(l
HAAHISBURCi, PIHJNA, l1Wtl
lOMMONWlAL'I H Of 1'1 NN~;YI VANIA I DATi
fH SIDFN'I INIO HII A~I('I 11\,'; I (,lIlIJlY
AI'I'II^I~;f MII\II 1111 NO.
'~~~_U'___~."-'-+-"""',""",__~ ~_ _ ~_ ,_~~ _.*~~_
Se P teolP!\L. L8,,~J.nL
Cumberland
.?J.:1~<:9J.O~u
Whore;lS, ___ Godfrey B. Jol.'..!l!'..2!L<___~<_<_ [."" (,I _,_g~mP HII L-_
in tho County of Cumberl Clnd..___.______.._ ""..,"'''''"'' CUllHWili','/(;;,lltlt of P,mI1:1ylvilnh, h
the 16th __ di\yof Janvary _. 1913..... '10120(1 and poss(<s,,' 1,,1
subject to Inheritance Tax undo!' tho laws of tht! CornnlOllwoillth {)f Pt:nnsytvdl'lld;
Thel'oforo, I, Sandra L. Stone ,an apPld,"er dilly appointed accord "/,
having boon designated l'.:l make i\ fall' and consclonabln ilpprillnurnunl or tl", said "nlilte, ilnd to assoss,ancl Ij'l Ilii" ,,::1\
valno of all annuities and life O!ltatoR ~/l'owinCJ alii of silid os!.ilto, hnroby filn tho f'ollowinq apprai~omenl:
In 111l! nViln\ Illilt "'IV f\ttlHf! InlufU'.llr\ illl~ USlill1! l~ trilllHilrrnd III P"~',;)';'.i"I\ (,' i'liiElYfi';;fI! iu QJihi01,;! 1\;"" "itho diJi1udulIl ;;1\,,, 'rd
r)f /Hly tl~t,ltu lot Ilro (If f(,r YOM$11t1ll COI111ll0llwnal!Il iHllil!Jy 1'l',llf'I"ly rn';('lVW, itlf! r;,,1;\ Ii-, IIPPI,I',,' '111<1 ;I,,;.;,,,, IIM.,/;,i illll'Jrilill1c(J ii\XP5 ,It ,'I', i;, '"',>1 "ILt\
riltu on llllY SUI;!! 1llllHO Inlnlost
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Havo boen duly Ilworn fg;~'dll1q to law! 1 00 hereby cortifv th;ll l!to [Jho\'(~ ilpprdisornnnt is mado in CC!__n!lll ill:I':
with the law on this t _ day of _ S':'/1;mber_-:--;~--rF- .' .. I') Z9.....
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Hf:V"4M OJ-78)
DE:DUCTlONS AU.OWrtJ HI
OFF ICE OF THE
IlEGIHP.R OF WI!.!.S
STATeMENT OF' DEBTS
AND DEDUCTIONS
TilE SUi' or __.
1\ i, .' '/1'
~ ' i
--- (-~-,,-,,--_._~.._...._---..;
OF __.....,,'__ ~ COUNTY
4ND 4GES' 01 HIE COMMONWE4!. TH
, ) J I \; " ;' 1\ ; i
!jT4:.7r~'T;, ,,:, I ., .
!..LL.ll..,,,_1....___1_____.J..._ ._.
, ~"_.~." ~.f-(IPITtll()rWILL9, Mdtn'
i\.-\ l ,'"'
, ~ ,; 1-..------..---.---
ESTATE Of _l~ey U. ,JolH)SOI!___ !.ATE OF Borou~h of CUIIlP 11111. CumborluIHU';.\UJIJ.tt...J'll,
,
==:.OA!E.?F FILING APPRAISEME~! ~/~.1jp!t O~TE O~ OEATH
NO. OF
VOUCHER
,I'~_l.U.......l!1.2!l. .
D4TP.
S4ME OF P4 YEf
RP.M4RKS
AMOllt-ll
'-1'0-70--'---' -0-.---"-- '--i:~tters '1ost;;;-nta-;:Y-$SiOo-
._....1!llL2.6, 1., __ .Richard .Ji.~1w.dIu:::i!lll..l{QgistilLJ\I: ls.......5...5iJ.ux.t-Gm:.t.Wc.a.tcs.,. __...s~Oo.. -5l!... .0.0-.._
, Ront for apartment 12K, 2 Murshn1
2 G:I~:_I:.!-.tnJck lJov~.l..o.pllle~.~. Co .__lli........ Cmu!> IIi 11.-1'a.-.lllOnth..Fo.bl97 ..275_. 00..
['1;'9 12
,3._.._ C.l.IIIlll.QIlaruL1wLJil.u.rual.________ '
i "hi "g .1llt.t.C:;cs..:l'c.>.tmucll.tl<q-..
-10_ 0.0.,..
_~..___ .Jun.:'~:-'-~llffingto~~.__._.___.___ Proving~J!.l!~ltll.re OJ!...Wi~& _Cod.1(; 1 15. 'Og._
5
S. A, Kauffman. ,Jr.
~Iy()rs -1I~1l Fllner.!!.!:J:lomo, Inc ~
P 'ovlnQ slQnnt\ll'o 9.ILl'I.iJ..LU2.!.!.i L_...,lS....QQ....
Feb 26 6
F~ra1 r~)(l'onsos
.~4n, 65
7
Pomero 's
Ba1n1we Duo
..._Jl.?.... ~~_..
_.,..L~
9
P.!illlla.._~QI.Jl.J.J.lili.L Co.
lle 1l Telephone Co.
11nC't't'i (' SOl"'v.j ('H
.. ,22- 13:),__..
21. 16
Fint,l Bill
10
American Express COlllpllny
Balance duo
122, 00
11
Landis .Jewelers, rnc.
ExamlnlltIon f, ^l'prals!.tl..'?!:..J~we1r. ..__...2.!.l..:.'QQ.._.~
12
IUchard E, Anderson Register Wi Is 3 Short Cortificilte~_..__._..._..
Penal ty for to!1l1inatlon of 1easo
en Pjj:nick lJevclopmw..J;.~ Y J;JJlQnt priUr...iO....tc.rmi.nati
dute
---.,.- o...-.w;~Ut-Y--dl'I>=1t-..--l:ll..S.,.().
1 mo's additional ront 275.0
flmpof~ (.tll'PQt.~in lil,U-l LJllc.nt 50;-{ __....w____. ..-.--
professional cleaning of
apa.l'{:men1: --~.n-'-'.-~__~"49t,.~
~630.0
---.-------- -..----.-----.-.-- ..-.-..-------
Socurity 011 Hand 215.0 415, 00
;;,. Qll
_J!<!.L.P_ _J...L...
Mar 8 ]4
--.--------.......---...,...-- Bolance ,Ille forpublis'ilt"llg--------'
g.,l!,IlI!~~~.!:an1l:~1"_1.~Ul1li!L__...._____. .!!~_t t E.!.'s TesJ!!!!\91l1.<lD'..._____..._.._._.
11. 0.0._...
Mar 15
...___1S...____. ,Ri.cluu:.d.JL ^nder.>.CllLRo.gis.tlll'_JI'i
l.~_.____ ~~.!I~~.: lJepl:EtlllCl:~._ of_..I~o~el!lle_,_
~_.....L):;hnl't -Co-rt1 fi (';lte.~L...~......~__.
Indlvidul1l lllcome Tuxes for
f.\!l.9.11l1ar...YQ.J!T 1nS ........_...
,.3_ ()D .._
.132. 8.2
.. .Mar.)6 n......_. flr!lol.!.!....."'illkQ_.JLlillYlm'..__.._____.._ t;.Qillill1 tilti.oll~il:.s...Q.f. .o.~tJlte~ .. ....__
,~_=" _.....1",,=_== At!.9.rl~~ls~,,=,==~oo~cooo=~===~~"'~~;t~~~~~e .~~~~~.i'W~~1_c...75, DP,=
on 1/19/79 (Cant td on pagc 2)
COMMOHWEA~ TH OP PENNSYLVANIA
DCluphjn
COUN1Y OF..~__________..._. Bank
I XOII rl..!!~~ho~!L...,~l~~L.~~lmln.L"_!.1.nt()IL.Nut it2!lliLI~nt:.rn I HEREBY CER TIFY, iliA 11 D THE I'" I Of
MY K~IOWLE'DGl ASD BELIEF, THE fOREGOING IS A JUST AND TRUE SpTFMENT OF DEBTS, FUNERAL EXPENSES 4ND
EX Pl HSE, OF ADMII~ISTRA TION ,IIBMI TTED TO TH~ ESTATE OF ___,"l,odfl:!:')~.Jl-,-...:!.ohIlS()I~. ......_._........ .. ... '"_'
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. NATTONAl CW'ITIV\1. BANI.: Executor Lst:llto
)".' (,' //' -1',... ..C:llllfl'c)' B, ~h~JlI1son
",./, --... I rJIsr-m1Tiltn-rrri'l\TOr~--"""-"--- ( ..1
'WO~4ND.SUBSCRIBED BEfORE ME THIS __l..~..:.,- DAY OF
'1 <-. 19 '-J .,'
...-;-,:1.l:~(.:.E~;Z:?}~~'===__,_._:~__.__.__...,_
PAtH 1 MllIllf'. r~'-",',((! l'i'[.'I:
\(.',id;I,I.;'!JI!; !',\,: j'.i ,'i r,: ,f,11
M\' !'n~M!')!IIHl ! ~!-';d" ;il'
55,
Mt'ml"" 1','1''''.,:.-'11 1 ,'.;
,'. I
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,
I-
i
I
r Date
I
I
i
1979
Mar 19,
STATEMUN'l' OF DBBTS
AND DEDUCTIONS
Estate of Godfrey B. Johnson
No. of
Voucher Name of Payoe
18 lnternal Revenlle Servico
19
20
21
22
23
Apr 2 24
Apr 9 25
Apr 25 26
Jun 6 27
28
29
30
31
Penna. Power & Light Co.
Pallas Publishing Comp~lY
Holy Spirit Hospital
Radiology Associates
Cowley Associates
Rolando A. Casal, M.D.
Holy Spirit Hospital
Richard E. Anderson
Register of Wills
Harry M. Wimer
Auctioneer
Harry M. Wimer
Auctioneer
Richard E. Anderson
Register of Wills
Richard E. Anderson
Register of Wills
J. Robert Stauffer,
Attorney
National Central B~lk
Services as Executor
Page #2.
Remarks
AmolU1t
Indi vidual Income Tax for
calendar year 1978
$
1 ,261.17
Pinal electric bill
10.99
Pllb1ishing Letters Testamentary
16.75
Balance due for professional
services
,29.00
Bulance due for professional
services
4E8.00
Professional Services
100.00
Balance dlle
355.61
Short Certificate
1.00
Services as Auctione.or
(35% of $2,071.25)
724.93
Servicos for sale of watch
(359, of $15.00)
5.25
Filing Inventory & Appraisement
Statement of Debts & Deductions
Roport & Appraisal
AccolU1t, etc.
100.00
Additional Probate Fee
10.00
Professional Services
4,500.00
Inventory It
Appraisement $183,723.97
at 5% 50,000.00 $2,500.00
$133,723.97 '
100,000.00 4,000.00
$ 33,723,97 1,011.72
7,511.72
nt 49,
at 3%
$ 18,927.79
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMFtH OF REVENUE
BUREAU OF EXAMINATION
OFfiCIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
DATE
COUNTY r ILL NO
ESTATE
~-
TO_.____~___.
-.',..._--_..__.~......,~_._.._---
FILE NO,
COUNTY
DATE OF DEATH
*'
---------.---.
-........-.......--..,----'---1
Appralsod Value of Estate: :
HOil) Estllle
$
+
+
, , ,
$
,. I
,
$ ,
Personal ProportY
JOllllly Hold rro,t)arty/lransfers
ToWI Gruss ESIHlo
Total Approved DoductlOns
CIOllr V<llllO of Estate
Loss: Approvod Charitable Exemptions
Cluar VallHl of Estato Subject to T8)(
~
Amollnt Taxablo @ 6% Rate
$
ISM: due
Amount To)(oole @ '16% Rate
tox due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE I'
* 1\: '/l 1l,' '/I * Aflvo percent discount totaling $
will ba grantad If tha Inharitance Ta. is paid by
Loss Credlls'
_~~.lL()iJ'A"y"~E NT
DISCOUNT
JNTEREST
TAX CREDIT
AMOUNT PAID
$
'+
"
$
$
,. $
+
~
+
"
InlOfost Accruos at the fate of six (6) parcent par annum
011 th~i, llnpllid bAlance of Inhorltnnco Tal( from ._.........-..~.,..___________~_.___~.._~
to dntrl of pllymonL Interest due II paid by__._.___.~.___._~____._.__..__.__ is ------....;..--.....-; .f
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $
I
Assessed by: ..___.~___.-----......._--.--_~
Soe InformAtion on H(I"or~f1 Sldo Agflnt for lheCommonwealltl
11' '."1 I
INSTRUCTIONS
To Insure proper credit to yeur account, Ihe nnme of the eslnta and file number should bo
clearly priated on the check or monoy order.
This determination and assessment is made In occordonce with Soctlon 421 ond Soction 732
of tho Inheritonce ond Estate Tox Act of 1961, 72 P.S. 2485--421, 732.
The estate tax imposed by Section 421 is dlle nt tho data of tho decedent's death but sholl
not become dellnqllent until the expiralion of eightOt'n (18) months of tel' decedent's death provided
that any ostote tax occoslonod by 0 finol ch(lngo In the Fedorol return or of the tax duo thoreon
sholl nol become delinquent until the expiration of ana (1) month after the person liable to pay
the tox receives final notice of the Increoso. Coleuloto interest from the dellnquont date shown
on the face of this form to the date of poymont using tho following Interest tab'e:
-------------------------------.---------------------------------------------.---.---
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 month s .040 11 months .055
3 man Ihs .315 6 months .030 9 months .045 12 months .060
..----...... ......, -------_......."...~--. .-........-
1 day .00017 11 dn y s .00186 21 days . UO 3S2
2 do y s .00034 12 days .00203 22 days .00369
3 do y s .00051 13 do y s .00220 23 doy s .00386
4 dnys " 00068 14 days .00237 24 days .00403
5 do y s .00085 15 day s .00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .00118 17 day s ,00284 27 days .00454
8 days .00135 18 days ,00301 28 days .00471
9 days .00152 19 days .00318 'l9 days .00488
10 day s .00169 20 days .00335 30 days .00500
.--.- -,---_.- --- ------------ -.---- ----- ---~_._--- --- -------..... ------ ---- -- ------ -- _.- -----.....
Any party In interest, Including the Commonwealth and the personal representative, not
satisfied with the assessment may object thereto within sixty (60) days after receipt of this
notice os provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S.
~ 2485-1001)
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed helow:
IN TH~ OOURT OF OOMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA.
ORPHANS' OOURT DIVISION NO. 21 R 79 R 10,
ESTATE OF GODFREY B. JOHNSON, LATE OF' THE TOWNSHIP OF WAST PENNSaORO,
OOUNTY OF OUMBERLAND AND STATE OF PENNSYLVANIA. DEOEASE;D. ___
- .
SOHEDULE OF PROPOS!j1D DISTHIBU'rION
Suggestion is made, that the balance in hands of Aooountant
for Distribution, to wit, the sum of $162,984.09, consisting entirely
of cash be made to the five (5) residuary legatees designated in
Artiole III of deoedent's Last Will and Testament, attention is
oaUed to the faot that three (3) oash bequests of $1,000.00 eaoh
to the Ohuroh of the Good Shepherd, Oamp Hill, Pa.; the Oolumbian
Fathers of Bellevue, Nebraska; and Miohigan Teohnology University
Alumni FoundaUon of Houghton, Miohigan, have already been paid and
deducted as a oredit agalns t prl.noipal in the within account, and
therefore, Distribution is proposed as follows:
In Cash, to Mrs. Marie Moeher, an aunt, of Dearborn
Heights, Miohigan.
In Oash, to Mrs. Ella Bruder, an aunt, of Dearborn
Heights, Miohigan.
In Oash, to Mrs. Agnes Peters, an aunt, of Dearborn
Heights, Miohigan.
In Oash, to Miss Maureen Norvell, a second cousin,
ot Detroit, Miohigan.
In Oash, tG Mark Norvell, a seoond oousin, of
Detroit, Miohigan.
$ 32,596.82
,32,596.82
,32,596.82
,32,596.82
32,59/';>.81
$ 162, 984,.Q2
Respeotfully submitted,
/l ,~
-r-
Trust Offio of Hamilton
Bank, Executor
lIl:ch Ll.l 1,,1., 1'\'18
"lR
!NVlj~I'MEN'!~~-B1lDm!MED (Cont I d)
1980
Jiii\10 , $ 16,000.00 U. S. Treasury lIills dlle 1/10/80 $ 1& ,534,89
Mal' 6, $ 1,000.00 U. S. Treasury lIi11s due 3/ 6/80 983.5Z
Mar 27, $ 10,000.00 U, S. Trellsut')' lIills due 3/27/80 9,705,00
Apr 10, $ 15,000.00 LJ. S. Treasllry Ilills due 4/10/80 14,588.56
May 29, $130,000.00 U. S. Treasut')' Bill s dlle 5/29/80 122,665.40
Jun 5, $ 1,000.00 U. S. Treasury Bill s duo 6/ 5/80 962 .71
Jllll 26, $ 10,000.00 LJ. S. Treasury lIills due 6/26/80 9,603.65
$ 15,000.00 \I. S. Treasury Bills due 6/26/80 14,502.71
Aug 28, $130,000.00 \I. S. Treasury Ilills dlle 8/28/80 127,535.42
Nov 20, $130,OOU.00 U. S. Treasury Bills due 11/20/80 127,057,67
Dee 4, $ 1,000.00 U. S. Treasury Bi 11 s due 12/ 4/80 961.83
Dee 26, $ 25,000.00 U. S. Treasury Bill s due 12/26/80 24,059.58
1981
Peb -19, $130,000.00 U. S. Treasllry Bill s due 2/lf)/8l 125,517.75
Mllr 5, $ 1,000.00 U. S. Treasury Bill s due 3/ 5/81 963.60
Mar 26, $ 25,000.00 U. ,So Treasury Bills due 3/26/81 24,103.13
TOTAL PRINCIPAL RliCEIPTS--------------------$ 190,570.43
PRINCIPAL - DISBURSliMENTS
The Accountant asks credi t for tho fOllowing:
Feb 12,
Administration Expenses:
Richard E. Anderson, Register Wills
Letters Testamentary
5 Short Certificates
Cumberland Law Journll1
Publishing Letters Testamentary
Cumberland County
$ 53.00
5.00$
58.00
10.00
1979
J an 26,
Feb 13, Jllne L. Buffington
Proving signature on Will and Codicil
15.00
S. A. Kauffman, Jr.
Proving signature on Will and Codicil
15.00
Feb 26, Landis Jewelers
Appraising jewelry
20.00
Feb 27, Richard Ii. Anderson, Register Wills Cumberland County
3 Short Certificates
3.00
Mar 8, Cumberland Law Journal
Balance due for Publishing Letters Testamentary
8.00
Richard E. Anderson, Register Wills C\unberalnd County
3 Short Certificates
3,00
LW[h Lll 1110' tG5
-6-
1980
Mar 20,
Jun 3,
1981
,Tan 21,
. !~~OME - IHSBUI(SIJM1JNT~
The AccoWltant asks credit for tho following:
Income Transferr~d to I~ve8ted Income Account
1979 - Dee 4,
1980 - Feb 22,
- JWl 5,
- JWI 30,
- Sep 17,
1981 - Feb 26,
Internal Ilevenue Service
Fiduciary Income Tax for period ending 12/31/79
Pennsylvania Department of Revenue
FIduciary Income Tax for period ending 12/31/79
Transfer Income to Principal to cover overdraft
Internal Revenue Service
FIduciary Income Tax .for period ending 12/31/80
Hamil ton Bank
Conunission on Income (5% of $35,063.42)
$ 11 ,000 .00
1,000.00
4,000.00
1,000.00
2,800.00
4,000.00 $ 23,800.00
$ 2,457.89
16.02
3,477.03
4,793.83
1,753.17
12,497.94
TOTAL INCOME DISBURSEMENTS------------------$ ,36,297.94
II f .'." tlIV, (<;,,..;.
t:" ,u
-13-
PRINCIPAL, - DISBURSllMBN'rS
~
The Accountllnt asks credit ofr the following:
1980
i\iii"r31, Transferred to Godfrey B. Johnson Rogulll r Acco\mt
Cash to cover overdraft due to payment Income Tax $ 2 ,338 ,47
INVBSTMENTS PURCHASBD
1979 -- --
Dee' 4, $2,000.00 U. S. Treasury Bills due 1/24/80 $ 1,968,55
Dee 5, $9,000.00 U. S. Treasury Bills due 2/18/80 8',754 .56
1980
,Jun24 , $2,000.00 U. S. Treasury Dills duo 4/24/80 1,938.58
Feb 25, $1,000.00 U. S. Troasury Dills due 5/29/80 964.88
Feb 28, $9,000.00 U. S. Treasury Bills due 5/29/80 8,688.32
ApI' 24, $2,000,00 U. S. Treasury Bills due 10/23/80 1,882,71
May 29, $7,000.00 U. S. Trellsury Bills due 8/28/80 6,867.29
.lun 30, $4,000.00 U, S. Treasury Bills due 9/ 4/80 3,940.27
Jul 8, $1,000.00 ll. S. Treasury Bills due 10/ 2/80 979. S8
J u1 11, $1,000.00 U. S. Treasury Bills due 11/20/80 981.49
Aug 28, $7,000.00 U. S. Treasury Bi 11 s due 11/20/80 6,841.57
Sep 4, $4,000.00 U. S. Treasury Bills due 8/28/80 3,905.97
Sep 25, $3,000.00 ll. S. Trellsury Bills due 3/26/81 2,839.68
Sep 30, $2,000.00 U. S. Treasury Bills due 1/ 2/81 1,942,76
Oet 23, $2,000.00 U. S. Treasury Bills due 1/22/81 1,943.38
Nov 18, $7,000.00 U, S. Treasury Bills due 2/19/81 6,758.65
Dee 3, $4,000.00 ll. S. Treasury Bills due 3/ 5/81 3,854.40
1981
Jan 2, $2,000.00 U. S. Treasury Bills due 4/ 2/81 1,932.00
Jan 21, $2,000.00 lI. S. Treasury Bills due 4/16/81 1,931,87
Feb 18, $'1,000.00 U. S. Treasury Bi 11 s due 8/20/81 6,499.60
Peb 25, $5,000.00 lI. S. Treasury Bills due 5/7/81 4,859.98
Mar 4, $4,000.00 U. S. Treasury Bills due 6/ 4/81 3,85'LQ
, '
TOTAL PRINCIPAL DISBURSEMENTS INVESTED INCOME, ACCOUNT $ 2,338.47
.
L1U~k L0 tilL, 1.'\ ,"J
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SUMMARY
--.....-.....---
PRINCIPAL
Pages
$ 190,570043
46,853,87
$143,716.56
3 ,000 .0.0
RECEIPTS 1 . 6
L13SS DISBURS13MENTS 6 . 9
BALANCE BEPORE DISTRIBUTION
LESS DISTRIBUTIONS TO 'BI3NEPICIARIES 10
$ 140,716.56
PRINCIPAL BALANCI3 RllMAINING
INCOME
$ 36,297.94
36,297.94
0.00
RllCEIPTS
LESS [JISBURSBMENTS
11.-12
. 13
INVESTED INCOME ACCOUNT
-- --
PRINCIPAL
$ 24,SOO,,00
2,338,47
RECEIPTS
LESS !HSBURSEMENTS
. 14
,;;-t;15
21,961.53
PRINCIPAL BALANCE REMAINING
INCOME
$ 1,70.7.10
1.401.10
RECEIPTS
LESS DISBURSEMENTS
. 16
. 16
306.00
INCOME BALANCE RBMAINING
BALANCE AVAILABLE FOR DISTRIBUTION........,............................_-_.--_.....$ 162,984.09
Consisti,ng of Cash
$ 162,984.09
MJH/1IDlI
4/7/1981
L\~~k t"J tl\~. b i....
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