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Z Iii ".. :" .,.f......,..'.":'":,;.. , h,. , , ,i;., . .".:, <, .~::. , ~;:.' " ':", ..., :', . ".:;':c ~, " ',.'!.;', ',~:', .,:f' ," ',',;: . , ,.,: -. ': '.. ',:, ":'. :", i;," ,.: ".' .' :..' ;;. ".(1\' 1~ ~.nj; :).t:'; ~ A n." 'j ;if,l " :...,:, :'{" ,,>. ,',:, "".", " :.'."..,.:" :- '. "..; " '.;, " :;C;;.,: .. :".; ".:~" ':';_'c'" ...:')>:~~} , '1 .... R~C:'03 1;'131 .. COMMONWEAL TH OF PENNSYL VANIA DEPARTMENT OF REYENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION INHERITANCE TAX RETURN F'OR INSOLVENT ESTATES ONLY OF' RESIDENT DECEDENTS '* .1/~/71 COUNTY OF CUMRF.RT.ANn Thl. ,.h,," must b. compl.t.d In delall and fll.d In duplicate, wllh Ih. Reglal.r of Will. In Ih. County Wh.f. .h. deced.nt r.lld.d wlrhln nine month. aft., date of death, unl... an ulan.lon I. granted by the Secretary of Revenue. -~ ...AdmA. No, 19_ I, Gl pn IL Pprry, ~r _ INAMI::I Mi.c ) '- _!- belns duly swurn DCCUrtJinlt In law, dCflllsCS ami SO)'S thai he is Ihe ..r Rou~ #2, Box 77, St. Thomas, IADDRESSI Pa. heir IExt:C., ADM., LEOATEE, ETC.I the Borough of SQippe~~p_~rg \(11,. DOROUGH, OR TO_N5HIP1- d.cca.cd, and Ihol Ihe whole or Ihe e.lole or soid decedenl, who died ..n_.__No.vember_,3 ,_l91.8 10ATEI con!lhiled IIf Ihc DHNet!i listcll below Dnd thlll ollu",ohlc debls Dnd deducliuns c\cccdcd Illc fair morkel value IIf Ihc assets Dnd IIf Ihc cAlole of Le ro.Y_t..!-.P..e,z:ry IDle or nn Pennsylvania TronHrcr Inhcritunec Tux ifl dUL', 19 79 ' ::::J'). ij , ~. )/J ~< t?4j;)1~/(, ..t:, lIeir of IS. NATUREI L tTITLE' . eroy L. Perry Type 0' AII.~ 01 7 R.al E.tat., P.f" P,ope,!y, Jaln,ly H.ld P'.p. .f Tran".,. -IILI" I- ., / ASSETS (A'tach addition. I .h..h I' n.ulla,y) Ducrlp,lon a' A,..t E,tlmo'.d Ma,h, Valu. D.par'....n' Volua'lon CAUTION (Do no' .,It. In thl.. co) Checking Acct., First Nat. Bank of Shbg. $~v~ngs Acct., Fir~t Nut. Bank of Shbg. Jo~nt1y with Glen R. Perry, son, Ba1 11/3/78 - $1411. 79, created 8/6/76 Certificate of Deposit #5344 in names of Leroy L. Perry or Donald L. Perry, dated 1/7/76 -$1000.00+ $20.96 earned into Certificate of Deposit #5462 in names of Leroy L. Perry or Glen R. Perry, dated 3/8/76 - $3500.00 + 32.12 earned into 455.77 705.90/i 510.48 1766.06 - TOTALS 3438.21 '3 Ll3 ~"2.1 REPORT 01' INHERITANCE TAX Al'l'lt,\lSElt I, Ihe undersigned duly OppoiDled Inherilonee To. Arrroiser in Dnd ror Ihe abovc Counly do respcclrully rcpoll Ihall hovc appmised Ihe rcal and rersonal prurerl)' os rerOlled in Ihe (n",going schedule ollhe values..el rollh orpnsil. each itcm in Ihe lasl col n In Ihe righl. ~ "', _ '..", C r ,,-.....::)~ DalctJ: ,- . lI':HE~ITAN~E T....~~)"PPRAISERJ Nom. 0' Pay.. OEBTS ANO OEOUCTlONS Natur. of Claim A moun' Claimed AmoUft' Approwod by R.g"'.' Foge1sanger Funeral Hare M. Esther K. Perry Register of Wills QuiriCXl R. Magbojos, M.D. M. Davison, N. P. McCrea & Davis Funeral 1\cwunt l~idow' s exenption Filing Insolvent Form ~ca1 Account Affidavit Attorney Oommission 1446.44 2000.00 3.00 372.00 1.00 200.00 TOTALS 4022.44 ItEl'lIIH OF TilE REGISTER OF WILLS I, Ihe undersigned duly elccled Regisler or Wills in Dod ror Ihe 3buvc CUllnl)', d.. resreclrull)' reroll IhOl1 hav. allowed tJctJuclinn~ in Ihe amounts set fmlh in Ihe nlmve sehetJulc us eluitned, cxccl1l where I have scl forth D Brcslcr or ICllcr amounl. in Ihe last eCllumn lu the righi, \\hich grculcr e1r lesser Ilmnunt rcrrc~ent~" nllo"ctJ a~ a tJc:du ion. nOle ur Arrruval: ~ ~, I q '77 .. t- Lt' r.. Plj ,~ /- , . / . , . / ,-,,,./,- l ; ... '- ~,.- l / I L .. I-< a .. u 15 .. >- .. c Cl .. u .. '" !! ~ ..J <C a- t/.. .. In 0 a- 0 '!j :c .. < .. l>= Z '" tLI > Q. '" >. .. tLI .. I-< Q. l!; is .. (.S .. <C 0 " " Cl gj u ,..-.. t/.. C. % 0 ... <C .2 a: .. I- tLI oS l>= " ~ i c " ~ l:l Q. "'-. .. ... iO w .. 'c ... .. l>= 's :::s .. ~ II = u !i ,- ... ;; e ~< .. 8 ..J IJ .. :l-.. ~ .J .! ., " . . . .. '1b: Pennsylvania Department of Revenue Bureau of OJunty OJllections FIan: First National Bank & Trust Calpany Center Square Waynesboro, Pa. RE: Estate of LERJY L. PERRY Deceased Date of Death: November 3, 1978 It is herel:r;{ certified that the above-named decedent turl, on the above date, the following accounts with us: A. cmx::J<IN:; J\CXXlUm'S 1\CCXlUnt No. Title of J\coount ~ Iq7~ fl.3tc Opened Balance B. SAVINGS lICIXlUNl'S Account No. Title of lIccount lh'1tc Opened Ilal. (Prill. b C. g,an'.Lr'ICA'reS OF DEPOSIT Nurrber Owners Date Face Value Earned Intel 115344 Rev, Leroy L Perry or to 11(3(78 Donald L. Perry J/T 1/,7/76 1,000,00 ~,..7('. - 115462 Rev. Leroy L. Perry or Glen R. Perry 3/8/76 3,500.00 !3~.~ Date: JAN 1 8 1979 FIRST NATIONAL BANK and TRUST cn-!PJINY By Vice Preoidcnt and Audlto~