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Home My WebLink About79-00188 I Il \1 ,,~ . ~ ci {J] &1 ~ {J] .~ .. ,. ~ ~ . {J] ~ 'II: {J] I . H I ~ to;! tj , 3 ~ . rz:l ,'. " '0 ~ ... ... ,a \D- o " " " U Z ' " ... ;' IIEGISmll OF WII.I.~ OF ..,ClllI1b.er,land...... COUNT\' NO, PETITION FOil 1'1I01lAn: OF WILL AND I.ETTEIIS OF AIJMINISTIIATION CUM TESTA~mNTO ANNEXO , 21.79 '*"0(") "l JI..i x NX ~ 'M~XlOOOOUXKNKXlX In Ihe ~:,Iale nf Elizabe.th,S,...,Davis..............,........, dect'a.ed, Pellllon,'r(.), ..~l;!,~,'il,..,K,..,..P./i\y.J.I?".....,..,............,..,.............,........,........,.........,...,.............................. IIl1eAe(.) Ihllt, I. x~ 1. l'eUUoner(.) IN1t """nly,olle )"'a" of "Ae or older III1tI "l'plle. for letters of IIdmln"trllUon ,C1JU..teat:amanto...anneW,;l........,.......,....,.......,.. In Ihe 1III1IV" ellpUllned ",Ial,', 2, Dect,denl dle,1 on ........Januar,y.....3,Q,.....19.1.9.........,....... III ..,...............M, In Ihe Connly of ~,~~~,~E!,~,~~............,..,. SllIle of ....,p.!?r.m,!!y.J.y.i!:n,~,!L.. ollhe oge of ,..,..~}..............., )'eors, hovlog :i'A'1r "&af'ci'~1 ~~I~~~ T<'.~me~r~,'d ~e ,,,2.3f~~ .gFi..;'...~g~......".........., A,D: 19..6lt.. Wherein ..,ana.., IIp'Mi~1 ..whham..t,...M),l~s,..,ana..,J.ames....W,..,Ilavis Illia[ ,O:l~Ex.ecutors \Vhlch E...,utors.., ~ ,ince ..renounced.........,........,..................."..,...."......,..............",.....,...........".....,.....,.., 011 On ................ day of ..............,......,......,..",........... 19......,.. I....llers of Adllllnl,lrnUolI were grnnted to .........,.....'.. ,........................................................................................................................................................................................."...... ~ ~, 3, 1",lIe" of Admlni'lnoUoo e,l.lI, ore need.d 1>.",au,. ..11aJ1led..co"executors..and..cbildren ,~~...!.~~,S~~............,..,.....,..............,...........,......., IInd peUlilll\('r~ ~=e. 10 ...her.......... Cllpoclly a. ,9/i\lI8I:It'il,l;:::ID::JJtw...............,.............,....................,.... , 4, Docedenl di,.d domiciled In l',eoIllly,ly.w,i!-...................,...., wllh hi, hlSt fllmlly or principal (sloto orctllllllry) re,ldence 01......6etbany....vi11age...,l.oYier..Allen..T~bip........................".......,........,.......,.......,..... WllS WllS 5, (Where d''Cedenl died te'llIle) Decedenl wo' nol mllrrled IInd 0 child w'" nol born to Dr odopled by decedent ofler e.eculion of Ihe will (IInd where IIpplll'llnt I, alleged spouse) nor wa, decedcnl divorced from applll'llnt afler eseeullon of willllnd at dealh, 6, The sllld decedenl wn, po""",'d of Good" Challe)" IIIghls and Credlls 10 Ihe e.limated value of $..100.,000.,00,.. and of lIenl E.lale, 10 the ,.,Umaled value of $.....~,Q.7...............,.... a. oear os eao be nscerlalned, TIlIlt Ihe .nld lIenl E.lnle 10 so far 'IS knowlI I. IllCllled In ,....X)Q)]!i!,..,.....,..,.......,........... .................................................................................................................................................................................................. 7. (Where decedeol died lole.tille II' to 1I0y POrliOIl of Ihl, ".tille), Pelllioller after n proper .enreh has oscerlaloed Ihal decedenl WII' .urvlv...1 hy Ih. followlog'"l1l11ed persoll. enlltl.d to d"trfbullon 1I0der Ihe Inle'llIle Act of 1947, Nome lIelllllollshlp lIesldence 1. ........................,..,...,........,..............,..,.................,..,....,............,......'...........,......'..............,.............,...........................'....... 2....,...............,..,....,....,....,..........,...........,..,........,..,......,.........................................,......,..............,.............,..,..,....,............'.... 3.......,....................,..........,....................,..,........,........"................,..........".....,..'........"........"....,......'".."......,....,.........,........ 4....,....,...........,..........,.................,..".........."......,...............,.......,......,........,.."........."",......",..............,.....,.......,..,............... 5..,......,.............................,...........,............,............"...",....,.................,......,..........................,.....,...............,........................., 6...............,..,..,..,........,....,...............,....,......",.........................,......",............,...............,..........,..,.......,.....................,.........,... .................................................................................................................................................................................................. lG!Qd!t TI.erefore. pelllloOl'r~ ""pe,'lflllly IIpl'Ue. for (pm\",'" of 1111' wlllpre,elll,'d herewllh and for) lellers of IIdmfnlslrnlloll ..,'~..t:.l:.(It:.iIDml;~l...1MID~,...,........"............,..,...."....,................,..,....,..,.......,.. Dilled: ..f..'ilp.~..,~7....J979 SIAlled:..;6,t5i2~'lIign..~ck~~e.........,..,...... 17055 ,\ddress, .."."....,.."........,..~Cllar.I~~I?~g...,~l\.., ................,...,....,..............................,..,................,....,..,.,...."..., ':~:~,~~~,~~~~~ll~~[~~~,~~~~~~~} ss ....,......Alice..K.....Davis..............,........,.......,..,..................",....."....,....,....,..........'......,..............., Ihe IlClllioller( s) in the nl)(wc npplimtioll. ht'll1l-t tluly ....~m.......... ul'l'onllug to l,lW !illY( s) that thL- stntcmcnts set (orth lu Ihl. pelllloo lire Irlll' 10 Ihe he,1 of ,......h~E..,..,.. klllllvh,dAe IIl1d h"Uef, ...S~rn............................. IInll !ill "(,".' F /" ...4)......i.....1-,.\.lO.'.....t.':.)......-........~..h.\...:".....".................. ........................................................................................ ........................................................................................ 11t.~lsh.r \fa/V FiI,.<I: Mnrch 19,. 1979 Attorm'fl Nllme oml Addfl'U D::u1n"L.,..Snyder,....EsquiJ;~................,.................. P.O. Box 3787, !~isburg, PA 17105 / , .................................................................................................. ('IVI'r) ..... " "1" , Estate NoJl::.7..9...............,~:'''' BOND Bond No. 26-0160-289-79 KNOW ^LL MEN BY TIIESE PRESENTS, That we. "Alice K., Ihvis""",,,,,,,,,,,,,,,,,,"""'''''''''''''' 1512 High Meadow Lane, Mechanicsbur~. Pennsylvania ' , .................................................................................................., .,.' ....,. '.,... "','...',.,.'...',.., ",."".......,..."..., pnnclpal........, and """'"I!,~,;,~,~~'''~~,~~,~f1,,,.F.,;~~~~~,y.,.,~n,~,, ~uaran,~~.. .~l:lnlP..Il,~y". ."".., ",,' .,,,,,,,,,,,,,,..,,.,,,,'" ."....""",.,..,..",."."".,,,,,.,,,,.,""""""'''''''. X~",Sur,ety ..,.....,.,.....................................................,...................,.,.,............., are held and firmly bound unto the Commonwealth of Pen",)''''aniJ, in the ,urn of ,'l\,1o"Hundred"lbousand" ,and"QO/IOO"",,,,,,,,,,,,,,,,,,,,,,,,,,,,''',,,,,,,,,,,,,-,,,,,,, Dollars ($20.0,.000..0.0",,,), to be pai,lto the said Commonwealth. her certain attorne)' or assign', to which pa)'ment, well and trul)' to he made, "'e do bind oursel\'es, jointl)' and sc\'crillly, and our and each of our heirs, exccutors, admini!ltrators, smccssors and assigns, firmly, hy thesc prC'Scnts. for and in the whole of the said ,um, SE^LED and dated the ..."",,,,,,,,,,,,,,,,27,th,,,,,,,,,,,,,,,,,da)' of ,February"""""""",,,,,,,,,,,,,,,,. 1!17,g.".. WHERE^S, the abo\'e named ,,,,,Alice,,K.,, Davis, .,...................,............,..,..,................ . .,.....................,.............,................,...".........,..,............................. ,...,..........,...,...,............................................ IIJ' lIIIldIxJr made, or i, ~ about to mJke, application to the Rl'gi'ter of Wills of CumberlJnd Count)', Penn,)'I\'ania. for the grant of !cum ,,,,of,,Administtation C.T.A.""""""" .........,............................... on the t~tate of ,,,Elizabeth, S.",Davis"",,,,,,.,,,,,,,, """". IJte of "l.ower" Allen"Township "'" Cumberland Count)', Penn,)'h'aniJ, dl'(eJsed: THE CONDITION 01' THIS OBLlG^TION i" that if the SJid personal representati\'e """""" or any of them ,hall well and Iml)' admini,ter the said estate accord ing to law. thi, obligation ,hall be void as to the personal representati\'e or representati\'es who ,hall '0 admini,ter th e said estate; but otherwise, it ,hall remain in force, \ I ' , SE^LEO and dd;.'ercd I~)he presence'of ''\ I' \ ,\ 1,-- ----.--t"-~.(. --7~-.'~-0"~-u;:" n____ ;,; ,/-- , , ,.__~ak.~_J:.,-jdr......._~---..--- (SEAL) ....----------------------------------------. --------------------------------------. (SEAL) .~____.~__~__.___________40___________~__.~. uunu______._U_h.. _..... __u___ u. (SEAL) QI)_i.~~_cL~~.!l,t!~_l!_y.~~~:g~J...l.-fl.1!~~!lRAl) Co. ~y_{ELLl_.\:':~_':.~l__ J...{_f.!-'< ~Lt.(g~~ l.) Francis T. Oliver, Jr., Attorney-in-fact " . .--~1E-:71.::fZ.::r~::~:.. u1;:"oNW"mH 0' ",'NN,,'",'N" COUNTY OF CUMBERLAND ss: ......."", .......n. in and far the count). Jnd Pl'r\onJII)' Jpr"'Jr...,1 befor... me', a. ~tJI.... aforc~J.id .... ...........,...,...............,....,..,...,",...,......,....,.....,.......,.......'......,..,..,...,.".....,....,...........,........... of", .."""...."",an,l, .........,............."....,................,.....,..."...,..............' ...............................,..".....,.. """"..""".,,,..,,,,,,,,,,..,,,,,,,,,..,'''''',,,.....,......',.....,' ",,,of,,, "..",,,,.....,,,,,,,,,,..,,,,....,,.....,,,........ ",,,..',,..,.....,..,'" ,uritie, on the ;111O"e l10nd who heing dul)' ,worn (affirmed) aICo"tin): to law. dcpo" and sa)' Ihal the)' each own Real ('stJIe "'orth the whole of the penJI ,um named in the al1O,'e l'Ol"t, over and abo"e their debt, and the dehtor', exemption, Sworn ;tnll ~uhs(ribcd lx-fore me lhis , (5<JI) " (SeJI) (Seal) (Seal) , ,1.1)' of ,.... 1 t I A,D, Ill.. ~, ( I' . .' : I direct that in the event that they arc survived bYll.ny child or children, that such child or children shall take their parent's share. AND LASTLY, I nominate, constitute and appoint WILLIAM S. DAVIS and JAMES W. DAVIS, to be the Executors of this my estate, and I direct that they shall not be required to aive bond in any jurisdiction wherein it may become necessary to adlllin is tor lilY said es to. te . '\' IN WI1'NI,SS WmmEOF, I havo herounto sot my hand and seal this 23 day of March , A. D., Ul64. .)1;.1 i,., V ; ','':-' i,:" f~J~LAJ1 ,. D~ (SEAL) sianed, sealed, published and declarod by the above named ELIZABE1.'U S. DAVIS, as and for her LAST WILL AHD TESTAM1-:NT, in the presence of \IS, who have hereunto subscribed our names at her request, as witnesses thereto, in the presence of the said TestatriX, and in the presence of each other. , Ji ~, ~ OF 2701 North Front Street. Hb~. Pa. c . 10' t~,.,j(/,\,.,,-<.,--, 'I' II II (JZe a? /t~twu~ (,;. t<~~ OF {~tL ~l,l.,e.... II II: II OF 46~ II OATH OF SUBSCRIBING WITNESS MMONWEAL'I'H OF PENNSYLVANIA t HH: CO N1'Y OF CUMDI~HLAND \ Th iH, ...,., "", ,...".."".,."",.,..,..," ,....."....,." .,.,..".",. dny of .,...,..,....".."..""...""..."...."..,...,',..".....". A.D,. I before me ichnrd g, Anderson. IWgiswr for the Probnte of Wills nnd grnnting letters of Admi Istrution in and for sUi\unty of Cumberlnnd. in the Commonweullh of Pennsylvuniu. pcrsonully c t'~~..~~~~~~;~;~.~'~S..~~~~~..:~..:~~..;~~~~~;~~..;~'~:~~'~.~~'~..~'~..~~'~;:;~~..~~~:.~~'i';:~..~~..;:~..,..;~ ";~~'~"~~'i';; ..;:~:; Testament of .,.....""\.....,.,.".,....,......,...,...."....""".,.....,,,..,.....,.".."....",.,..." Duled ..". ,.",.."",..,.."..".....,..,.. Inwof,........,....,........,....~ ......,......,......,..........,..,........,............,.......,........, Cumherln (l County Pn.. decensed who being duly..,........,....,.... ,........,........... uccording to Inw. depose nnd sny. l t ..,..............,........,............, present. and snw and heard lh testa,..,....,..........,........,..,. .......................... ................................................. sign. seal. publish. pronounce and eclure the said inslrument of writing s nnd for h................ Testament and Last Will. and at the time of s~oing ..,..,.........,..,..........,........,..,.. ....wus of sound and disposing mind \ m,m"" ,,' .""".,'1". tn'h, """\.................................... ......k"wloo"'. ,hm~l;" ,,' hoH,r. .::::::::::::::::.::::::...:.~:~,I::~ Richard E. Anderson, IWgiswr \ \ , \ \ , .. , ...... .......................................................................... . ............................................................................... .................................................................................. 71DAVIT OF DEAT.~. COMMONWEALTH OF PENNSYLVANIA t " COUNTY OF CUMBERLAND / \ ss: ! / // ........................,....,..,..............,..l..........,..,.......,..,..................,....,....,................::...,.............................,being duly ! . ..............,..,..,........,.............../ snys thllt as nearly as cnn be ascertnined the said decedent ...,........,......,..,... .. .............,..,..,.......,.......,....,:..............,.................,......,...............,..,..,..............,..,..,....,........,..........,........,.....died on / ,..................,..,....,....,..:............ the ..,....,.........."..,.........day of .....,........,..."........,..,............,...,.... A.D.. 19........ : at or about ......,...............,................... o'clock. ....M. .....................,.................,....,......,nnd subscribed this ......,...........,............................. dny of ..,........,............ .................................................................................. 19. .......,. before \ ..................................................................................... Richard E, Anderson, Regisler . 'J"lBI8ilH 'UOBJi>pUY '3 pJUlP!1I 'PIOSi>JOJO JIli>A pUll Allp i>41(Ili>B (IlPWO pUll pUIl4 AW BBi>UlIM ..........,.........,'......" S.lAu'Ci'....jj...9 ii ~ .i:'ii..'...'...,........ 01 Pi>lU IlJll i>Ji>Mo V' "J?':i r ii'o 't !j'ij:i!i'ii't ii'furp'V' 'Jo' BJ"llIYJ 'Pi>BIli>i)ilO 'Il!Ullh(ABUUi>d 'Aluno:J PUIl(Jil<jwn:J ............'....QFiiiiiM.O.L..'iiiil:'i:'\i..:ziiM.O~..'........... JO "lll( ..............................'ii~Aiia...~s...ii~.iiqB.:ii~l:.:'C. JO lUi>WlllSi>.L pUll IIlM lBIl( i>41 pi>pJOi)i>J puo P"loqwd BOM ilJil41.....'6L 61 "0 'Y ......................q.o..xiiw............... JO Allp ,.......ii~.6t....... il41 uo lD41 pilJil<jWilWOJ 1! i>U 331::1030 "l ~ Il> . t>:l ~ . ~, ::l In - ~ p.. . a. ~ S- !~ ,~ . 1t . i.j::'" 0 If;l ~ :- it : I 1~ :0- 1""'-1 :0) III 'H : III p.. :N r ,., i~ ~. !> =E :n ::l :UJ i::t :e !~ ,0 ~. - .. - i:s:: i...... - r tll fen , \ 8 :. r ~~J . ;.;' !t::l ,,~ flI: :> 0 :< :00 ;H " ~U1 tl! ;.... III : n. Ill: co ~l :-.1 j-D ~: , . ..~,...................................................................... , ..............,................................................................... ". ''', .'........." '........., .......... '....... J"lBlllilH 'UOBJilPUY '3 PJ04i)!H .................................................................................... ............61 'oa.v ........................................ ............. 'ilW OJoJaq paQIJi)/pUO ......,..................... 'Bili)UDlIJil4UI / .-' Ji>JSUOJ.L III llU!lO(i>J MOl i>41 JO SUO!BlhD i>41 411h\ A(dW~'^\lUi>ll!l!P Il!M OS(O Puy . MOl III llu!pJOi)i)O // pilSOili)i>p PI OS JO Sllpi>Ji) pUll Bl41l!J 'B("l104i) pUO B lla41 Ji>lS!U!WP" A(nJl pUll IIi>M IIlM ....,.................... pasOi>i)ilp....................,......................,..........,...::~...;;,...,............, ...............,.., JO lUi>WlllSi>.L pUll IIlM lBIl( i>41 JO ......,......,..,...................................,......::,..'im 1041 AilS pUll i>sodi>p ......,.. .-// ...,..,......,..,....,......, A(np llU!i>Q '04M .......,................,..,...............:::~............................,.........,..,........,.. aWIli) AIIIlUOSJ, 'PUIl(Ji>qwn:J JO Aluno:J i>41 JOJ pUll U! UO!lIlJ1S!UIWPY JO SJi>ll<YJ JO llu!lUIlJll pUll SIIlA\ JO i>lIIqOJd i>41 JOJ Jil1S!1l /' :ss { ONY1H3HWfl:J .'10 NflO:J YINVA1ASNN3d.oJO IU:IV3MNOWW 3^11V1N3S31::1d31::1 1VNOSI::I3d:f0 H1VO , . " . Invlntory of thl real and plnonal IItatl of Elizabeth S. Davis dlcla.ld. REAL PROPERTY NONE -0- PERSONAL PROPERTY Commonwealth National Bank - Checking Account No. 161 106123 3 2,54 .65 41 .28 2 .00 1,66 .00 18,26 .00 21,08 .00 6,20 .00 14,88 .00 Westab Basic & Contributory Retirement Plans Travelers Insurance 332 shares of Standing Stone Agency, Inc., Certificate No. 27 - $5.00 per share 332 shares of Huntington County Thrift Corporation, Certificate No. 491 - $55.00 per share Penn Central National Bank, Certificate No. 1296, 680 shares - $31.00 per share Penn Central National Bank, Certificate No. 519, 200 shares - $31.00 per share Penn Central National Bank, Certificate No. 78, 480 shares - $31.00 per share The Mead Corporation - 1966 preferred $69.50 per share: Certificates Nos. NVC 6366, NVC 6365, NVC 6367, NVC 6363, NVC 6362, NVC 6361, NVC 6360, NVC 6359, NVC 6358, NVC 6357, NVC 6356, NVC 6355, NVC 6354, and NVC 6353 - 100 shares each 97,30 .00 The Mead Corporation - 1968 preferred $67.75 per share: Certificate No. NV01854 - 62 shares 4,20 .50 Personal effects 50 .00 State Capital Savings and Loan Assoc. Savings Account No. 002-20-15354 $15,680.00 interest $85.49 Jointly held with Alice K. Davis, daughter-in-law, 1512 High Meadow Lane, Mechanicsburg, PA 17055 One-half taxable 7,88 .75 Joint Account of decedent and Alice K. Davis. Transferred September, 1977 to Alice K. Davis alone. Amount trans- ferred $10,454.03. One-half taxable 5,2 7.02 180,18 .20 , , . " COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } u: Alice K. Davis bolng duly Awn.,.n occordlng 10 low, dopo.o. ond SOY' Ihot Sho is the Administratrix, C. T .A. or tho esloto or F.1i ""h"th S. Davis 1010 or _Lower _A11en_,Township , Cumborlond Counly, Po., docoo.od ond thll tho within I. on Invonlory modo by _AU,-c~~_~avis, Iho .0ldAdministratrlx, C.T.A. or Iho onllro oslolo or sold docodonl, con.!slln9 or oil Iho por.onol pro"orly ond rool oslllo, oxcopt rool oslolo outsldo tho Commonwoollh or Ponn.ylvanlo, and thot Iho rrguro. oppo.lto ooch Itom of tho Invontory ropro.ont It'. folr voluo os or Iho dllo of do co do nt'. death. Sworn ton ond .ub.crlbod boforo mo, April .::! <,/ 19 79 -('"h. .; -<' ,:(J"": ,- JUlH.H.K. Adm'nhl'.IM , C :r . A. rix 7/1';"~' m, ;;{,.-/.M ,,~_,; N^NCY M, BUSCEMI, Notory Public lIarrlsburg, nDvj.hin Co.. Pa. My Commission Expires March 20. 1982 l512 High Meadow Lane Mechanicsburg, PA 17055 Add,... Dolo of Dooth 30th O.Y Janull]:Y Month 1979 VOIr INSTRUCTIONS I. An Invontory musl bo fIIod within Ihroo monlhs oflor oppolnlmonl or porsonol ropro.onlollvo. 2. A .upplomont Invontory musl bo Wod wllhln Ihlrty doy. or dlscovory or oddillonol o..oh. 3. Addillonol shooh moy bo o"ochod o. to porsonolty or roolly 4. Soo Arllclo IV, Fiduclorles Act of 1949. !:1. ...! ..c: UI ~ ~ ..,; w " . ~ I- .. w ~ III II "' l1. U 8 0 II> ...! s:: " " w w ~ QJ C '" ... :t ~ r-l l.; .. " l1. U. ooi Do 1-0 E Z I- oJ Q r-l u. oJ ;:5 0 ..: Do ~ QJ 0 W 0 -< . i- '1:l~ 'l > z ~ en 1-0 Z 0 C QJ c: s:: " - II> Z ..c: :J <3 en 0 ~ Z w -< ~ 0 ... l1. QJ ~ ... . ~ c: ~ .. - -.: N 0 .. 13 ...! ..0 ... ... r-l " E 0 ... " 0 ~ .. " it 0 Q oJ 0 III Rcc.n CO'UI COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT '* APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby mode lor cement 10 the tronsfer olthe lollawing securities 01 a Pennsylvania Corporotion or a Notional Bonking Assaciotion located in Pennsylvania: DATE April 2~ 1979 $2.80 series conv. (a) 362 shares(b) The Mead Corporation (c) nrefexr.Q9__ (NOTE: In describing securities enter In (a), ab Ole, either the number 01 shores 01 stock or the lace amount of registered bonds, In (b), Ihe nome 01 the Issuing company and in (c) the class 01 stock or the stated interest rate and maturity dote of registered bonds.) ISSUED ON 8/5/66 , ond having 0 TOTAL MARKET VALUE OF S 25,169.00 (Date) os 01 the dDte 01 death 01 the decedent, Elizabeth S. Davis (Harne af Decaden') ,onJanuary 30, 1979 (Date of death) who was late of Bethanv Villaqe, Lower Allen Township.~and (Street and Humber) (Past Office) (County) PA (Slale) The securities are registered as follows: Elizabeth S. Davis (Hame or names In which certlfleatu are roglstered) ADMINISTRA TORfC, T. A. Al icLIL-J2aY.ll.,-HiJ;JhJ1eadaw ~) (Nome) NAME OF APPLICANT COUNTY FILE NUMBER ,;:{J-'Qq -/~gI ADDRESS OF APPLlCANTP. BUREAU FILE NUMBER SIGNA TURE OF APPLICANT , k> NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, T> CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. Pn. DATE _ ~_5' f9?f I hereby cansenlta the transler olthe above securities now registered in the name of the 010 said COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES Decedent ond waive the filing 01 0 certificate certifying to the payment 01 the transfer inheritance tax to which Ihe property 01 said Decedent is mode subject pursuontta the provisions of the Act 01 June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, os amended. This is also in accordance with the provisions of the Act 01 April 9, 1929, P.L. 343. This Consent to Transler the herein described property operates only in reference to the estale olthe above-named Decedent. ~\.. ,,~~ '~~ Signed lor the Secretary 01 Revenue ~~~~~,)~:,~~IJ~ L.':;; u ..,.;3 ~-"'L "r -(ifii;,)~-..~-..~..~J-v.n:yc;~;;t;)-_. --- .._...~__ r-r__ __ __...... III RCC,.t11/781 COMMONWEALTH OF PENNSYLVANIA I NO'J003122 DEPARTMENT OF REVENUE a.' " OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX If 01 ; RECEIVED II e From, ~ A~~re" " II ~ r No, i Dote 01 Payment - . --- "'... ---................=:.... - -'*~ _________________Jr~RR THOUSAND DOT.r.A 'RA____ ---- --------------- ~lIo's repre~enting Penns.vlvanla Inherlloncft or es.tate Tox due Irom the following estate: (Alice K. Davis) Poet Office Box *-3187 2CA: To.. on s s lla1'Y'1I1bul'i,Pa. 171015 6,;{ lOll on s s 21-7Q-18B Dole of Oeo,.1-30-1979 15''\ Tax on s s Nome of Decedent v.1'.T?ARF.'I'lI S. DAvrs ~ Tolt on S Eslole To., Act of May 7, 1927 s ~ 1/ Apr11 ~5,1979 s County C'I'llberl"'ld TOTAL TAX CREDIT less five perccnlum of tOlC If paid wllhln three manlhs oller dale of death Plus. Interest at the rote of _ Ck from 10 s ]1] 51. 89 Remarks: PAID ON ACCOtmr. s 157.69 'TI'OO~l?[L~@&'TI'~ SEAL TOTAL AMOUNT PAID s s ~ IV\ , , NOTE: this TfipliCllte Receipt to be rlltllned lor ludlt purpo.... II Received by NOTE- In ocupling ,h. "01'1"" Inh.,uonc. to. an 'l.ltl.l" '1101'1. p,io, 10 Ih. dlolh 01 thl hll Ilnonl 0' I."onllo' ylorl. 01 ...idlf\Ced br thil f.c.ipl. il II l.lndlfllood Ihol Ihl Commc"'....lolth Iholl nol b. p,.dl.lded Of p'lunlld Irom h"lolll' ouening odd,l,onol inhllrilonu 10' at Ihll dlat" of Ihe lire Ilnonl 0' 'Inont lor yeorl _h.n....' II oppearl 'hal luck addlt.onal 10. mar bl l.oa1lr due Ql'ld collect,ble fOf al'lr '10101'1 _hollOl"". (Slgnalure) lchard E. ~80n Regll er ~I I lie ,.-,., _.. --, - -- -- -, - -. - _.- - - -- - - - - -- - ._-, -- ..- - --- -- --- ~- - - -- - - - - - - -.' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION ~. ~ OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT 'TO: R(ir- ~:, 0'111 i~) 15 12, ,-I, ('((. VI" "f.{.:~.t" ~i~,r e I\..\ erk (Ilw:d1"f'" ,7f1, /705::) . . I", FILE NO, UATE 6>~?-?? r/..'.,.,-4/I~-II1 ()ll/lj '2 I - 74 -() /Z'!' (v}-"II;'/ 6,,/ . I - 30 - 79 ESTATE OF Far County Inlorml.lon purpas" onlv COUNTY FILE NO: ,0 - '2 Z G -' ij 6i COUNTY OF \ DATE OF DEATH - Appralsld Vllue 01 Estlle: Reel Estell Person II PrOPlrtY Jolnllv Held ProplnylTransllr. S''l!.--79 ~. .. , . -' ~ - I f,"', (1~".--f3 5. '2.27 ~:~ 'i', lfliZ, ''{.:'- 1'1:0, (io, ;lC) -,( -- /0. H:'"1, ?j . /691 7:!,s>nj " , Total Gro.. ESIIII . ", " ' ';.: ... TOIII Approved Deductlonl '. Clelr Vllul 0' Estlte . LI": ~provld Charlllble Exlmpllons -0- , " -- 169 72--,>:1/:> , Clllr Value 01 ESllte Subject to Tox . Amount TI..bll @ 6% Rate . ... . 'J 10'1/ 72-," ,'/5 tex dUI LIO) . JV:3. 'n " Amounl Ta.able @ 15% Ratl .. I.. due , , TOTAL PENNSYLVANIA INHERITANCE TAX DUE . /0, / E:; , ~'3 ~. . Less Credll.: DATE OF PAYMENT DISCOUNT INTEREST TAX CREDIT AMOUNT PAID >J- :1:;-'71 .. · 1/s?, g'l + . 1..;7.';;'1 . 1<<....).(10 . .,. .. + c BALANCE OF PENNSVLVANIAINHERITANCE TAX DUE . '7 tJ2~~Gr . Interell will eeerue el the rate' ,01 sl. (6) percent per annum on the unpaid balance 01 Inherilonee ta. from to Ihe dale 01 pavmenl. I'C ','{b yI,\ J., c;"l./k,- p. 0, i:b'x :3 r) '87 H:Jrr'~.h.','; /}/ /710:) , , ' SEE REVERSE SIDE FOR INSTR:.::i10HS TO BE DELIVERED TO TAXPAYER ,. ":, " RESIDENT DECEDENT COUNTY OF -l/~/11 *,';J/-r;q-Ol Iff I ''1..- l..-.,.' ~t ~ CUMBERLAND ,. . . . "ce-n 14.7"31 cmlMO~\':E,\LTlI OF I'E:-i:'-:SYL\'t\Nlt\ lJEI't\RUIENT OF REVENUE IllJRE,\U OF COUNTY COLLECTIONS -- -- IMPORTANT, Thb Iclwn R1U.' hL: cO/lIplelcd In dclolllilld lIIed tn dUlIlll:UllO. \l,hh lllllltludll'd, "1111 Ihe RCl'i\lcr IIf Will" ue Ihe CuUnl)' w.hru' dt'crdrnl frNidlL'di Iftlurn b dm' "illlin nme IIIHtllh"" Ilfln d",,~ IIf drillh, unlt.u UII C'J.lcl1linn i. [ranled by Ihe Secrelar)' of Iht4cnuc. ISrl:llun 7n.t lIf Ihe Inhl'rllul1cc ,ukl b,IiUC Tax Act or JI~b1.) Lat. of Cumher~and Pennsylvania }="I' C ~~~ ADMINISTRATRIX, C.T.A. Dun')' IS Tim ',^TTEI! (II' TilE EST,\TE Ill' ELlZAllEl'JLS. DAVIS UT"TE "ULL NAMf_ 0' Olct;OE...." Stat. 0' ~} .., County of ~;.,,!f,,~ Alice K. Davis, Administratrix, C.T.A. ltXOOlDl1 of ~. .,tttl. t" ,.,,. ol1awCllof'IClI"l.ct cf.ud.nl b.1nv duly tworn, d.p... 5 and uy S UccctJCnl dicll January 30 t IIJ~J ~"'Ol. INvlng 0 lOll will, cop, of which II h.,.to auach.d. ) l....~NTt11 to^yl (YEARl ~nx Nom. and odd,... of otta,n., a' } Donn 1.. Sn)!der r a,h., aulhorh.d '.p,..."lollv. 10 whom 011 ca".lpondenu Ihould be m~IIClrt. P.O. Box 3787, ~ Administratrix That as such deponent is fumilhu with the l.Itf:.lirs of said estule and Ihe propcrly cunstitulinlt I (;XECU10lf<oAC....1NISTRA TORI the ossels Iherenf and thcir fair market value. That atlhe time nf dealll there was uo slife deposit bm, re~i!'llcrcd in dcccdcnt's ituJh'idual "nme, ur joinll)' with, fir as agent or dcput)' or anuther, or in lIcccdcnt's individual Ilallle, wilh riltht or ucecss b)' nnllthcr as agcnt or dcpul)'. wilh Ihc exccplion of thc rnllowing: - Esq. Hbg. , Pa. 17105 NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A 5 .F~ DEPOSIT OOIC THIS SA"'E OErOSIT BOX RENTED IN N,t.MF-: OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Nono That the conlenls of soi~ safe deposit box or hoxes arc ilemile~ uoder Sehe~ule. wilh the exceptioo'of Ihe follo\\'ing, for .he reasons hereinafter sel forth: of this rcturn, ThaI Sch.Ju/. A olloehe~ herelo aod O1o~e part hereof sets forth fully 1I0~ io ~elail all the real property in the Commonwealth of Jlcnns)'lvania of which decedent died having un intere~t Iherein. It olso scts rorth the morlgage eoeumbraoces upon each pllree! of relll prol'erl)' al Ihe dllle of delllh. givillg the IImOllnt still due 01 death, name or mortgagee, dote, rate or interest. nnd bunk ond page or record Ihcreof. It also sets forth in the columns provided therefore the asscssed valuation ur each of ~tlid parccls, the eSlimnted market volue thereof as of dole of death of dcec~eol, ThaI Sch.Ju/e B allache~ hereto alld nm~e part hereof sels fmth fulll' an~ in ~elail 1111 persooal prupert)' wheresover situated owned b)' the decedent al the time ur dCltlh: ull mnne)'!rt len b)' the deccdent at the time of death, whcther in decedent's immcdiate possession, !rtlunding tn decedenl's crcdit in hunks or depusil, sa\'ings banks, trust companies, or othcr institutinns, whcthcr individuall)'. or in lrust fur an)' other pcrsun ur persons giving also separately the accrued inlcrest thcrcun. if an)', ..Inwn In Ihe la~1 inleresl du)' prior tn decedcnt's death in the case of sa\'ings bunks, nnd 10 Ihe dutc of decedent's dCllth ill nil other cases; all honds, postlll savings, treasury certificates or notes nnd other c\'idenee or indebtedness ur Ihe United StOIC~ tu the de- cedent: all obligations. whether by stolulc or :.1J:rcement Ihey .lfe de~ign:lled lis la~ rrce, or thc United Stntcs, or any stute. or pnlllieal subdivision thereof, or (If any furcign cuuntry, which arc uwncd nt Ihc timc of dcalll: all wearing apparel, jewelry, sih'erwarc, piclurcs, hlJuk!rt. \wdi.!'l uf art. hnuschnhl furniture, horses. carriage!., automobiles, boats, and an)' IInd all other 11ersunnl dltlllcls or whahllt:\'er. tdnd ur nuturc, lefl by..leccdcnl, togelher with the rairl)' eSlimatcd market \'olue Ihereuf: 0111 hllnd~ ..nd murlgllgcs held h)' decedent omS nf all claims due Rnd owing decedcnt at Ihe lime tlf death. nnd all l,wl1IbMHl lIules IIr uther inslruments in writing ror the pa)'mcnl of mnne)' of which deeedenl died pn!'lse~~ed, nf whaIMJC\'cr IHllutc. with intercst thcrclIn, if any, gj\'ing the race \'"IIIC and estim3ted fair market \'llluc Iherellf, lIud if !rtuch cslimnled fair IOllrkcl \'olue he less than Ihe fnce \'nlue, il sets forth hriefl)' the rea!rtllns rur such depreciatiun us tn cach itcm; all moncys payable to the estale from life insurnncc pulicies curried by deecllcnl; all annuity and endowment co"lraels the proceeds of which wcre [1i1)'nhlc upon the denth uf Ihe dccedclII; all l.1nd Ihe curpuratc stocks and dividends due thereon ond unpaid liS of the date ur dealh. bnnd!'l und uccrucd irllcrcst Ihereon 10 the dUle of deccdelll's death and other in\'cSlment secul.lll.... ()\\ncd by Ihe decedent ill tht: tin1e uf dealh, with the nnuket \'olue there- of at such time. . " ... III till' r."'U~ nl' "oenrlttcR uf cluMr. or rllM.))' corpurnllonK. tho vftluf'M r"(lurtod nrH ilK f'ar ft8 I'UKhlbll' NuhKlltllltnt,'1. h)' f'luflnclnl HlnLplllUlIlK nl' thl' CurJluI'lIl1ol1H, Hhn"lng tho Il6"'.'I,,, 1I11f1 111111111110" th"I't'nl' "A III' tilt.' tlnttl 01' donth. Tho fwl11'dulo n180 ""tR rurt.h tho Intel'''"l or tlllell,h'nl III the tlm,.' or 11,"nlh III It,,~, C'u-I'"ruwr..hllt ur IIIINIIIOM". Iltul In IUlp)lort or tho vulllO or Hurh Int..'rl'''t thorn IN IlIlIlmmd to ",.tel ~t'hl'lhll... f'l1II1I1C~1,,1 Htnt"mmlls f1ho__II1R Umft""otfl ftrlll l1ftbl111108 01' "ntft cO"(lRrtnf!r"hlll or IHIKhunu" ,\ c'nll~' nl' thl1 cU-I'''rtllt~r"hIJl n/,tr"f1mt1nt, (II' or"l, " Rlftlnll'lflnt MAtthiA rorth tho nnturn or llin lI~r~I'JTlOnt) Illlt,'llll'" _1111 n Klnt"lIlf'111 N'!'" hlR I'nrt.h Itll! cllornctnr of tllA hlltiln'.H", ItA locfttlUfI, nnd KliCh nUwr f'ltch 1',-'rl."llIll1~ In till. hll~I'lf'RN "'" mil)' ho Ilt!rl.lnnnl I,CJ R fnlr ft,ut JIIHt "JlprnlJIII&I 0" tho ,Inc~f'lh,ilt'''' IlItornHt trlttl'l'llI fTlll!'ltll4'!'\ullmltt"II. It "hllllld "hlfl HAt furth In Hemlzml form, tnA'~thrr with the I'nlr murk"t \'nhlO lIll'r,'nf', flll}' uLtu-,r IJrnr14'rt)' IIwllofl tlr hOfl"oIlU,,'d h)' Ull~ d~c.ulullt 6t tho ttmn ul' ch~ftth. TIII~ Sc/ipdu/' C Illt"ChOlI horotn Itlul mndn Ilnrt 'wreol' Hots rorth II true "flRwor to IHlch lflllulry conlnhll!d thlJroln ftllCllntlll~ oORool'trftnl'll'nrsol'l'rollOrtYI rOAl or porrlOnftl, within two )'CnrK or df!cedont'R dpnth, In cnnleml'lotlun 01' decmtont's IloRth, ur IntHlllleel to t.llko of"oct In pn!l!llosAlnn or l'nJO)'mfmt lit or after donth, Ratti schrdllle sots forth tho nnturo nnrt VIII un of AIICh proI1f'rt)', to "hom trnh!'lrt'rred, tho relnt!onKhll' or the trn"!IIrereOH to tho decedent, tho prol'orttonllt,o MhRre recelvofl h)' ench trnllRrereo ftlld "II otllf~r fllcts of n IIf!rttnent. ntlturo rpJ:nrrlhllot Rltht trnnsfers. In tho CURe of trnl1Rfer1\ Intemled to tnke O"ff~ct In I'UK"flSMlon or "n,Io}'Jlumt nt or ftftp.r ,Ionth, thore is KIRO nttAchl~rl to tho Hclll'rtulp. II COllY of" thf' Ih!oll, trust oRrof'ment or othor InKtrumt'lnt crenllnJ; tho trllfllt. Thortl IN nlso "(Ilt fort.h In Hnld 6ehcHIllln n list nt' nIl JlruJwrt)', ronl 111111 11OrHonRl, wJth ItA Vllluo, which lltlhHUS nt decutlont's dunth hy vlrtuH ul' thp cxorclso hy "ocedfmt, olther hullvtduull)', orJotntl). wllh nnothor, or Oil)' pmmr nf' 8)1)1oint- ment \'e8toll tllllf!codf!flt, olther tnlltvlduol1y or Jointly, by the wll1, lIeOlI, or ot.hf!r Instrument. of' nnnUler, with II CUP)' HI' Iho IrHitrllmPfll. cro"lIlI~ Much "ower nUftched to the Helmdulo. Thllt Sr"ttdu/p 0 nttnclu'fl horoto and mnde port horr.of" Rots I'orth lito WimeR Ilflll ofhlroRNUR of" "11 persulIR hf'nnl'lclnll)' Int.ernstr.d In thh nNtnte lit tho limo of' II(OcOIhmt,'R Ilunth, the lIuturH ul' Ihelr rf'S- pecth'c' tnter..sts, thulr rollttloflRhlp, If IIny, to tho deeolleflt, tORot.her wtth tho liKeN lit the lime or decfHlent.'s fleath of' nil minors, nnnultnnt.K 8ml heneficlBrles f'or 111'0 1It1f1f~r ,Iecullent'R Will. It alao conlnhls II stl\tf!ment shuwtll':; which or the lumeflclarlea nMr." in tho flf!cf!clont'!II will, If ,ltIy, IlIed I'rior to t1flcf'lhml., UlP. dnles of' lhp.lr dP.Rth, I,hulr lasllo, luullhp r,~lnt.ton~hlp of such Issue to tho honef'lclnry. Thnt Scfo,.r/ul,. E attached horeto ,mil made B pnrt horeof sets forth 1111 proJlerty, ront lUul por- SOlutl, mUlCH! hy tile decedent jointly with anothor or othors, lnclwllng InlRn~lhle, Rt.nntlln~ In tho lI"mc of tho t1f!cofhmt tlflll oUlOrR, plus the dnte And plnce of rccorrl or lnRtrllJfIl!f1trl offccttn~ the \'p.st.1 ture or ronl f!~ t.llt,~ nllll t.1Il! 1111 tl~ of" nCflll1 slllon of porsonRI ty, phHt tho nnme, fuhlreRR nntl rol n ttnnrlhl lit I I' Rny, or CO-oWlIf!r!ll t.o the decedellt. Thnt St/ipdulp F attached heroto fInd mfllte II IJnrt hereof Rets forth ful1)' aud In dotnll "11 debts rand deductions clalmetl for mill 011 110hBI f or thla decedent.' s eRtnt.f~, Incl1ltlln~ fUflernl (!lC)lf!IISeA lJnlct; rAmlly eXl~ml't1oll, whurt:' "I'pllcnhlp.; costs or ndmlnlstrnl10n or this cstlltc; counsel ff!o!ll null f'wltclllry' 8 convnlsRlons pllld or t.o ho palel; CORt expended ror lmrlBl trusts, tomhst.onea or J;rnvemnrkors, RllIl rell- ~Ious sorvlcCfl, In consp.1llloncH 01' t,he clonth or tho llccedont; dehts and claims owlnR: nr1l1 IInpllhl lit ttlllO or doo.th; Lnxos ftccrlloll chflr~Qnh1t! for porlOfI prior to decedent's IIp-Ath (except thoHo ,,110""'11 IUltlor Suction Oil! nf' Ulf~ InllorltnncH nUll EHtntu Tux ,\ct); t.ogether wit.h u stntement of" collotornl IIICfI~ell for nhltgn- tlons, If un)'. It 1M n~reed thnt the f'lduclnr)' will l,resent proof or Ruld clnlm"11 ohllJ;Rtlon!'l IIpon ro- 111Il'St, thnt. If thf' nmount "ctuIl11)' pllld In Hottlomont or nny reo, commission or deht Is 10MR thlln tho estlmlllell nmullnt r.1"lmln~ nnll nllnwml, thllt tho !'tRmP. will he reportrcl tu tho lleRlstl!r of WlIIA, IInd thnt th.' "mount nl' tllX nS!ilHuwll clm 1Ir. r''''HKr.s81'11 In lIccorllnllco thl!rt'wltll. Thllt 1I1f~ tf1tn1~ ClI' th,t "I'I'roIJrlnt." columnrl In SchmtllloR """, "n", "e", "10:", ntHI "F" 8S fl1rl!ctlltl thorrlll, hn\'I' hot!ll enrrlf'fl f'orwllrfl "nd I'rf1110rl)' rrRlHtored In tho SunvnAr}'. Subscribed and sworn to before me this ,.._..,...;~,~.~Ir.' doy of . Apri 1 . ,... 19.:7,9,." ,..a.{.....c..~__d::: ::~d:h"~...",,,___ " ~~~ Administratrix _ lH2,J:ligL~e,adow._Lane,,__-f.. T. A. (Strcet Numbe1') . !'le~~~~,:i..C:,I!.I>..!I.~.&,,__.!'.,~___EQ?_L,_,_,__,_, (Citll 01' Town I1nd State) J7 ",' /cq.:J...."Y )J], I.~....(,.. ...' IlAUCY ,.'., PtfC!I'I, II,t"ry rubllc ltarrj~bl'r:7. OJl.'jihin (g" r.!, My Comml:lion up!r.. l.I.mh 20. 1902 ~OTE: IIt'fnr" ~1~fllnR 1tI'I'lft"" I I. mllkf~ Kur'~ 1111 hlnnk !'I11AC.'S tll lhr. "rf"ltlR.\'lt IIlul Kcherllllo!' 11l1l1eXml lire r'lll"fl In ..1111 Ih.l.ltlls ur the "orll "SOli"'" llrul III CIt!'lI~ tho flMM!tR Il1cllIIle rure fll111 IInllRlf!fl ~ecurltles, ~'H!lIrlt.ll.'~ ..I' ..lflSH nr I'lImll" l~nrllfJrlltlollN 'Ir "II Inlt~r'~~t In UII}' cn"I"Irtrll'rshlfl or hllslnr.!'IK, thnt the ,Iltt.. "11I1 6i1',I""II."I.H r.tlllllr"11 1Iwh'r I.he pnru~rnlth nho\'" r'~!"lIlI~ In SChf'lllIh~ "H" "rf~ IItloehp.fl. ,\Iso rntlkl! f~f!rt II I II t.hn' I!OlllflUl .; I Itl I.lle "SII/lflIllr)'" hn~ ImHtl prnJlp.rl)' compl etml ns nhove-,II r'~c lOll. " . Ree - 3~, rOllllilS'\V\J.TII Ill' I'ESS~YI.\',\SI.\ TIl,\S~FEII ISIIElIlT,ISrE T,\X ~rIlElJl'I.E HI''' 'I'll \S'lt'WI~ ~~~ 'f:~' (\ .,,~(.,..I ."j"~"""iL lIE~ JIlEST m-:n:I1FST (1) ll11t Ih1cmhll1t, wllhln two )'"ltrK ul'lh~lItll, I11l1kn nil)' trnIlN",'r fll' 1111)' nllutlrllll )lurt nt' IIIR fl"tul", ..Ithllllt rHen.vllll( " vnllllthlt. IIl1lt IUhlllUltln t!UIlNtllufllllulI lh"fl-'Ihr',' (,\flNliIlllf )".~ or nu)_Yes- (~) Olel lh~c(llhlnt., wi Ihhl Um )'OllfH ul' dUlllh, t.ruIINI'.'r "fHI"'fl.)' t'rum hlmHI~1 t' tu hltn"iHt 1'111111 lHlClthl'f ur nth"fK (1IIC1UlIlI1~ II "'llnlIK") 111 Julnl Ullilu.rKhIJl" (.\f1S1ilt1f )"'N fir IIU)-1io- (:1) It' tho IInKWOf tu (1) ur (:J) nlillV" hi III njll nl'l'l rlllll1-hl! Hl"t.~: (n) A1(n ul' d"cmlllnL ul lIm" flf' trnllHfnr (h) Ntntn nl' tll!cl!tlunt'K hftulth lit Umt. ut' mllkln~ Ih" trltl1sf','r. (Suln I), (c) CRUS" nl' ch~t~f'fh'f1l'H III'IIlh. (SlItn I), (.j) Dill decodont, In hiM ltrot.lmf~, mllkl' 1111)' trl"".f'l!r uf' ..rol"'rt)' wll.hllut rl'I!I!lvlrlJt n \'"ll111h1t~ or lultlllllnlll cnl1MlllornLlon thnrnf'or which WIIK tu t.llkn Itl'r,'et. In IIfINH"KKlun fir IllIjll)'ml!Ut ut ur "r'Lflr hl~ Ilf!llth" (An8wor yml or IIU) NO- (II) ,ljllS t.hore nny 11U851h1ltt)' Lhut till' prulll~rt.y IrllIlMf'l'rrl,,1 mlJtht return lo lron8t'nr,'r ur I1IH "stuto or hn HuhJect t.o hlR flUllll'r fll' tllsJtuslt.lun? (.\IIHlilI1r )'UR fir 110) (h) "'hilt WIIM t 110 trltnl'll't!ro'~' H II~U II t. t Imn ..I' dl~CI'llf'llt' 8 111'lIth? (0) IJld decolhmL In 1118 11 f'.~t1mo mllkn fillY trnll!'lf'ur wi t hnut rl'cf!h'It,~ " Vlllllllhl,' /lIlIl ''''flllllllto l~ulIsld"rIlUfll1 therefor mulnr which t.rnl1sf'nrur OXllrf!Asl)' ur Iml'll,'lIl)' rlJSflr\"IR fflr hiM Ill''' fir nil)' I",rlltil which 1I0(lS lIoL In f'nct 1'1111 "ol'urn hiM ,IcAUu (n) 1'hf~ IlOSHORRlfllI or f!ll.tO)'PHHll 01' ur LhH rlRhl In Incume ('rulQ 1.1".-' prlll"'rl)' trnnsl'errlotl" (.\nswnr )'lHi or flU) No- (II) Tho rl~hl. t.n dnHIKI1l1tn tho IIf,rMomi whn Hhnll )lIl!UWHR or fllljO)' t.hlt JlrO(lurt.y trral1sf'~rrl!11 or Illcnmfl t.hnrnf'rllm? (AIIAwor yns ur un) N (0) If' tho 8nswnr lu (r\) (II) "hovo Is In the "fl"lrmIlLl~t:(.~w-;,I1ftlhf'r tilt' rl~ht -us rosnry,'" In ,Ipcmlrnt Il) one or (J tilers (7) IUd decellent In his )If'oLlmn mllko II truflloll'or, U," f~()nsldf~rntlon f'ur which ""S lrnnsf'ereo' K promise lu I'll)' Income to or lilr lho IlImol'll 01' cllr'~ or trnn!'if"'rur? (.\I1HW('r )"'H or un) No (8) Ulll ctf!cedcnl, ilL nil)' Umo, truIIRI"'r Ilrollflrt)', I.hl~ hl!Jll~rlcl,,1 'HlJU)'IIlClll nl' .hlell WIlK ~i1Ih,ll!f~t to chtUlKO, hCCltURO or n rnMer\'OII I'uwer t.u ul tl!r. "1Ul!lIfl, ur rl'vokll, ur lIIhh!h cUlll1I r('VI'rt to Ih~Cl~llfln1 1IJIlI"r term.", or tr8nsl'er or h)' olH!rntlon nf lnw? (AIIRwl~r )'OS ur IIn) No (0) If tho nnflwor tu (H) "huv,! IR In lhl~ nl'f'lrnUlLl\'o, WUN Ihl! (")lilt'r t.u nlll'r, um"ull, or reYlIkl! the Inlor- est or the bCllnflctnr)' rCHOrVI!fl In tlln ch'cmll'lIt Eltone or llll' .IeclH'ollt ulIIl uthnrs? (Answor )'OS or no) NOm I: Tile nnMWorS to Lhesn flUf!stlnllH should 1m RlIIII'orto1t II)' nfl'lllnvl t h)' UIH llLtf1lllllu~ 1111)'81clul1 UM well lI8 R cOI'Y or lllo dnnth cer1.1 rlclll'~, SOTI-: 2: If III1Rwcr to Any or the nlKlvn llue8t1um~ 19 )'OH. Rf.t furth hnlnw II dnscrlJlLlnn nl" till! IIrollOrt)' trllnsforrml, It's fnlr mllrkct VlIllw lit flntl! of ctonlh, ,IIlt.l~S ul' lrllnRt'.!rM 111111 tu whum trnI1Hr4~rrf.II, wiLh relaLlonshlp of trnnsforees to ch'Cl'tlent, If nil)', 8uhmiL CflJlY flf' UII)' lrllst. Ih!f!ll or Instrument, It' lrRlIK- ferR nre claimed to he non-tllxnble, nlMo HII"",11 dl~tllll"fl Kt ntemunl, nl' l'netM on whl ell sU III cl n 1m Is hnsl'll. SOTfo: 3: J,18L nppllcahlo JlrnJlflrty holow III mllnlll~r In which prnvllloll In Sr.h(!l11l14~H A, II, ur E. In:ll III(SCIlII'TIfIS lI.1llhl(T V,If,UJ( (~:"lI'UllO,l) III~'T. VAI,I'o\T InS (11..,,1. On1)') . Jl.. ~ S,,-:~x..:~ c..:. 1:5 Joint Account of decedent and Alice K. Davis. Transferred September, 1977 to Alice K. Davis alone. Amount transferred $10,454.03. One-half taxable $ 5,227.02 N ,..b_~J~ \'V'o-? ~ .- \, C: ..,-: (...-;,. :t;..- ~ .-v- ,<",. o Insert this tot"l oPJlo!'liLn IIITrnnsrnrMIII, Sch.'.lul.' IIICIII In t.llt~ IIIAN Ih~Jlnrtod. cnlunIl nn tho InKt I'"~n or this return_ $ 5,227.02 C~"::12L-'\. L-" \= ..JL"-\. L, \-:- '5.'"2."'2..",)<- ( nCC-11 '(12-61) . ('mUIll~\\'I':.-\I.TII OF I'F:\:\SYYI.A:\IA TIlANSFI-:H 1~IIFIlIT,\:\l'F TAX IlESIIlENT IlFn:m::\T - SCIIEDl'I.E "n" t,~~ I~\i',;:lti:,\ ~~'~:1i.Q) 1l":\EFICI:\IIIES , h \It:NEFICIAllIr_~ ANI) AOIJlIESSt:S IlEI.ATIOSSIIII' I SUftVIVEIl I)A'1'E nr .tcp,chlldron or INTFftFST IlF Stille lull nUr.lf'R und ndtlrrRSl'!i of all .ho i1h~"iUrnnte childrrn m:ct:IlENT 01' IlENEFIL'lAft\' ll\'(' lln Intpn'6l, vush!d. contincent or other nre in\'ol\'cd. set 1 STAn: n:s IN t:STATI,: ..hII' tn estate\ rorlt. Ihi. r.cl.) Oft NO 11111'1'11 Will in~ (l I"nn Yes nLage one-third 1512 Hi"h Meadow Lane , I l1el'h"ni('sb'1~8 PA ,.,nee I . I , I .!am"" 1.1, nllvis son I Yes ! of age one-third 4 M<L1l.t;.erey Dri"" I ! I Princeton Junction New ! , Je"s"v nR~~n I Marv D. Aoo1ewhite daughter I Yes , of one-third I age , n M^_ -'- D. ...! I R. D. 3 I I I . I I DOlI''''' New JllrsllY ,.,.,on, I . I I I I I I I I I , I --.- 1"'puIII'I11. "arlhcr sn,"'s thnt. ul1 the uhovr.-nnmed hcnl:!rlelllrtcs nrt. Ilvln~ III this llmQ "'XCf~pt lH!low: NAm: DATE or DE,\TII Ilt:SIOENct: - .. o ' ii~" ~: t: 'c &I E 'e Ci.:! ..,c.8 < s, ~8'll --t: \PIs. c:!s" _ 0: (1) SUMMAIIY (A, 1I"J'f>rl,.(1) lIeul Properly"......""",.."",.."..""..",....,..", ,(Seh, "A") $".., ,-,0- '" Per,onul Properly ..".."....,..,....,..,..,......,......,..",.."....""..(Sch, "nO) $ "1tiI,,QIO. 4,3, Trun,fers ..,....,....,...............",'.... ..,..,..,.."..,...."......,....,..,(SCh, "e") $ ".."S,227 .,02 Jointly ,owneclpx-operty........,..",..,...." ,..c~c;n.,~',E" ',..,7,882 .,7S "'.. ",.."",..'..,..,.."..' ""....,..", ,......, ,.... $ ....",.."" ,.."""",,, Cross Tnxuhle E,lule .. ""'''' .."""..,,,..,,..,,,,,.. ..'...""..""",,,,,,, $J~,()J,~,~,O.2.0 j:l, -,-I: ~ .d J III .. t.l ~, .., ," ..l " :;; ~ :-- 0 <0( t.l Q ~' III III - - III C <0( -r. " a:; ~ .~ QJ 'tl '2 Cl: '" .-l C ... 0 " ... w '" ~ nl. .-l nl ~ <0( ~ -r. t.l !:I' ~, .-l .., t.l i= l- I-< '" Q i:: - .. ~ . I-< QJ = Z 0 t: " en QJ ~ !:: Z ~ '" < ~ .d ~ Ii --- 0 4.1 t-l U c c QJ 0 c a:; .c ... ,., t.l nl ;..: - j: N ~ " .t: 'r! " g Cl: " '2 ... .-l ~ .., :;; t.l c "5 ~ 'e ~ ,- - :; 8 8 ::::r. - , . (2) (As lJd,'rmhll'd) $, $ $ $ $ ',' $ " . . .. . ,,,. ,;. ~ T ~ ~ ~ .,./ - ij .z:: ..:I :>< .... III ~ ~ '" ~. - en, ~ re H' 0, ,!! ta. >: H, c l>< 0 0:1:: 1:::' 't:l !: 101 101 Q: d < j: < j: ~ at <1l ::. ~ -i .-I .-I .. Q c ci ~ i: .. 5 en' .-I 1-1 c ~ 0 0:1: QJ ~ z is. ta. 1-1 ~ ... r- -- 0 0 W' QJ .:; I:lI: c =: IXI' ~ U 0 0' 0:1: .3 1 l>< :c ~ N, ~ ~ H, ... I:lI: 0 .:a 1-1. c -< ... c 0 ,;" C ::. w' 0 E 'e .. = E :>"t:: 3 8 8 ...< RCC-1l10-UI COMMONWEAl.TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT '* APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby mode for c ellSent to the transfer of the following securities 010 Pennsylvania Corporation or 0 Notional Bonking Association located in Pennsylvania: DATE-.JDI79 $2.80 series conv. (0) 1100 share~b) The Head Corporation (c) preferred (NOTE: In describing securities enter in (0), ab Ole, either the number of shores 01 stock or the lace omaunt of registered bonds, in (b), the nome of the issuing company and in (c) the closs of stock or the stated interest rote and maturity dote of registered bonds.) ISSUEDON 8/5/66 (Dala) os of the dote of death of the decedent, , ond having 0 TOTAL MARKET VALUE OF S~_2.6-...4.5J)...J)O Elizabeth S, Davis , on Januarv 30. 1979 (Harne of Decedenl) (Dale of death) who was late of Bethany Village , Lower Allen Township--, Cumberland PA (Street and Humber) (Palt Office) (Count)') (Slate) The securities ore registered os follows: Elizabeth S. Davis (Harne or name. In which certlflcatn are regl.lered) ADMINISTRATOR) ~) C.T,A. Alice K. Davis, High Meadow NAME OF APPLICANT Lane, Mechanicsburg, (Addrou) Donn ~der PA (Name) COUNTY FILE NUMBER 21-79-188 ADDRESS OF APPLICANT P. sburg, PA BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APP I TIO. T CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATE-.-J - J - 11 I hereby consent to the transfer of the above securities now registered in the nome of the aforesaid Decedent and waive the filing of 0 certificate certifying to the payment of the transfer Inheritance tax to which the property of said Decedent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521, os amended and the Act of June 15, 1961, P.L. 373, os amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent 10 Transfer the herein described property operates only In reference to the estate of the above.named Decedent. \ Signed for :,\,e ~pf1ftory of ~evenue..., ~ ~ By (Slgna'u,e) Ili(!"~~ a f;t,;';,fi jj. r~','~~. :/'j !..., , , ITllle) (County) '.....;./;1: tV-Oil , APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT * I C~1,40NWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE i BUREAU OF COUNTY COLLECTIONS I , APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made for cement to the transfer of the following securities of 0 Pennsylvonlo Corporotion or 0 National Bonking Associalion locoted in Pennsylvanio: DATEOotQber S 11179 . .,. (0) )32 (b) Tlllnt-4ngilnn f'nnnty Thr4ft Cnrporl'ltion (c) common (NOTE: In describing securities enter in (0), ob O/e, either the number of shDres of stock or the loce omount 01 registered bonds, In (b), the nome 01 the Issuing compony ond in (c) the class 01 stock or the stoted interest rote ond moturlty date of registered bonds.) ISSUED ONApr i1 11. 1967 , ond hoving 0 TOTAL MARKET V HUE OF S $18,260.00 (Oat.) as of the dote of death of the decedent, lHillabetlll f:. Da'..is ,on.:ranllary ;jQ. 11l7l1 (Home of o.cedent) (Dot. of death) who was late of !Ie1;RlIIlY Villagll. (St,..t and Humb.r) ~"Qcban~('"sbl1"'J1 "'nmh~r1~nrl, t"I9n"9'l,1uS}ntiIJ (Pa" Of/lc.) (County) (Stol.) The securities are registered os follows: Elizabeth S. Davis (Ham. or nom.. In whIch certlflca'" or. regllterod) ADMINISTRATOR) C '1' 1> ~HS!if~ ).. .. ~life K. Da'lis, 1512 lIi911 !4eadOl,' Lalle, M9bh3nicolBbl.lrt. am. (Addr...) NAME OF APPLICANT COUNTY FILE NUMBER-1/-?Q - / s--r ADDRESS OF APPLICANT Pa. Box 741 BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS All I TlON, T WI CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATE~cI- . 9', /179 I hereby consent to Ihe tronsfer of the above securities now registered In the nome of the oloresaid Decedent ond waive the filing of 0 certificate certifying to the poyment of the tronsler inheritance tax to which the property of said Decedent is made subject pursuont to the provisions of the Act of June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, as amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transler the herein described property operates only in reference to the estote of the above,named Decedent. ( ( h'~~1 (0'11 (County) \ ~ '..'-"I.IW'''1I1 . APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT *~-~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application Is hereby made for censent to the transfer of the following securities of 0 Pennsylvanlo Corporotlon or a Natlanol Banking Association located In Pennsylvania: DATE O"LoL"L 5, 1979 {oJ, te~ {b)~n (c) commo~ {NO : In describing securities enter in (a ,a Ole, eil er t e number of shares of stack or t e face amount of registered bends, in (b), the name of the issuing company and In (c) the class of stack or the stated Interest rote and maturity dote of registered bands.) ISSUED ONJ~iy' '1, 1964 (Da..) as of the dDte of death of the decedent, , and having 0 TOTAL MARKET V HUE OF S 1, 660. 00 -- E1iBabeth S. Da~i8 (Nom. of Decedent) ,0nJanuary Ja, 1979 (Date of death) who was late of ll11tRaRY Village, MeGha~bu1'9, Cumber-:l:itnd, pennttylvania (SUee' and Number) (Put Office) (County) (Slole) The securities are registered os follows: , , n1~zabeth O. Dav~~ (Nom. or names In which cerllfleo'.. ore ragllt.r.d) ADMINISTRATOR) ~ )' C.'!'.."'. f;t.!.'jc K. Davia, 1512 lIi'Jh rleado(~.},o.~~e, r,lec;!'anlc:...bu~ NAME OF APPLICANT COUNTY FILE NUMBER.:.{ 1- IJlj -I ,tZ.... ADDRESS OF APPLICANT 212 PA BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS A ICATION, IT WIL CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES A 'I n III nq DATE l"\ I '{ 'f 'f I hereby consent to the transfer of the above securities now registered in the name of the of ores aid Decedent and waive the filing of a certificate certifying to the payment of the transfer Inheritonce tax to which the property of soid Decedent Is made subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, as amended. This Is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transfer the herein described property operates only In reference to the estate of the above-named Decedent. ~~ ~'i-,~~ '~. "- , ..J .,J~" . '<tlJ~ s,~neifor. th~ ~ecr.etor~, of Revenu~ ,^. , t 0, I I I... \~' ,;, ^ {(f\ Z , By .. l' l~..' 't., (/) (,,,,,; , iX',: U('I ~- .( J (SI."na~u'.1 " .. (' \ 'liL~)~l\4~~,K ~ ,J,J 7 t \'",-, ~(;,li <Jnd (Till.) I \ \ (Caun'y) \ '. ..'LoU. . COMMONWEALTH OF PENNSYLVANIA < DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Applicotlon Is hereby mode for coosent to the tronsfer of the following securities of 0 Pennsylvonlo Corporotlon or 0 Notionol Bonking Associotion locoted in Pennsylvonio: (o)~(b) Pen" Celltral "'atiollal Ilallk (c) gommon (NOTE: In describing securities enter in (0), ob Ole, either the number of shores of stock or the foce omount of registered boods, In (b), the nome of the issuing compony ond in (c) the closs of stock or the stoted interest rote ond moturity dote of registered bonds.) April 3, 1967 ISSUED ON Feb. 10. 1976 Feb~Dcl.,j 1967 os of the dote of deoth of the decedent, E1 i eabe th G. DIl'JiIl (Nome 0' Decedent) DATE O",lub,,. 5, ,19'19 $ 6,200.00 , ond hoving 0 TOTAL MARKET VAoLUE OF S S21,ORO_On $14,880.00 , on JAhUgr:i JD (Dote of deolh~ 1979 who wos lote of BethaRY ...illa~e, IlcchaRic3bul'g, Climber 1llnd, Fennlly1vlll.ib. (Str.et and Number) (PasIOfflce) (Counly) (SIal.) The securities ore registered os follows: J:;.Ll Z8fm.1i110,l;\4mJ.1ift,VJt;l\:h e.rtilleot.. or. r.gl.r.r.d) ~TOR~C.'f.A. _ tMJ..'ic K. [lav!'" ::'512 HhJI. ~Ie"~~db..n\'" Mech,,"!c5buL9Y"'PA NAME OF APPLICANT COUNTY FILE NUMBER .A../-7Q -- ( g k ADDRESS OF APPLICANT a2 O. Box 741 BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS A >\TI, IT CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE 8 CONSENT TO TRANSFER SECURITIES DATE _ d" 9 /? 1)7 I hereby consent to the tronsfer of the obove securities noW registered in the nome of the oforesoid Decedent ond woive the filing of 0 certlficote certifying to the poyment of the tronsfer inheritonce tox to which the property of soid Decedent Is mode subject pursuont to the provisions of the Act of June 20, 1919, P.L. 521, os om ended ond the Act of June 15, 1961, P.L. 373, os omended. This is olso in occordonce with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Tronsfer the herein described property operotes only in reference to the estote of the above.nomed Decedent, Signed for the Secreto!y of Re.venue 1\ -1 B;'1:1c~/.(\("P-~ ,hIC(;'{C\d c ~(iJ-Ltt\1 (51?~otur.) A 11 \, 7 ~ \..J 1-"1'1' I.~L , (' ^ ~ -,,~ I \. (TIII.~ \.\ (County) '\ ~. .' . , COMMONWEALTH OF PENNSYLVANIA COUNTY OF D ~ \J Y II , N ) SS: ) ..- I hereby certify that on this ~~ day of - (J dOh"''- 1979, before me, the subscriber, a Notary Public in and for the said State and County, personally appeared Alice K. Davis, who being duly sworn according to law, deposes and says that the facts stated in the foregoing schedule of Distribution are true and correct to the best of her knowledge and belief. ...- ' /('t, r; );, J)",r" Alice K. Davis, Administratrix, C.T.A. of the Estate of Elizabeth S. Davis, Deceased Expires: Ar'~ElJI It \lOlI\E. 'Iul\!ll "".i" H.\RmSCuRr, ~WjHIN COU!li1 MY COMMISSIOll miRES M~R, 29, loa2 M::nber. Pcnnsylvt.nla Auet-iaMn 01 Nol:lC;'C1 l,"'l" UJ. I ' .".J\U ~ 1'\ ,,",It "",l, U....':1 0 >:;j ~ ~ ,: " " 'C r; ,< - .~ - ~J ., 0 ~ - "~ . ::i :I: 0 tJ '- ,- '" . E-o Z ',j ~o<: ~ 0<: ::- .. az all':~ i' - ". Z O<:~ ~ E-o~ N::C ~ - tr ~ ., , G 1':'" HaalO<: ":" 0 ';: ~ 0 ::l ..:I..:I:!:H ~ \... 0 - ~ ::lZ . ~ . ,.. ~ ~ U>< ~UO<: -..;; ..:I . .... ~ k E-o ~a :> \, ::l ~I - Z o -..:I OZ OO::l ~"'>< ~a , za rilE-oHOO '...... :I:H :J . ~ \" O<:U E-oO<::I:Z "- UE-o . :I: O<:..:IOOZ Q OO::l C- . :-.. "'0 E-o ~~ al . I':Z 00 - '" OH :t , -. 00<: ~ooa 0 ~I': .... ..:I He-. ..~ OOE-o ~( rill': ril:> ><00 - 000 ,!: :I:ril :I:O<:ZE-oO<: , ... "'H . 'r' E-oal E-oO~Z~ 00 .', ,-..;; ',4 :i: ..:I::lU " I': Z::l Z ...:Ia~ Ji-) '" HU HOOO<:UO '. -. . .. , FIRST AND FINAL ACCOUNT OF ALICE K. DAVIS, ADMINISTRATRIX, C.T.A. OF THE ESTATE OF ELIZABETH S. DAVIS, DECEASED, LATE OF THE TOWNSHIP OF LOWER ALLEN, CUMBERLAND COUNTY, PENNSYLVANIA PRINCIPAL RECEIPTS The Accountant charges herself with the amount as shown on the Inventory and Appraisement as filed $ 180,180.20 PRINCIPAL DISBURSEMENTS 1979 Apr i1 14 Myers & Hall Funeral Home - funeral expenses $ 469.00 16 Register of Wills - Letters of Administration and Short Certificates 63.00 18 Husted Insurance Agency, Inc. - Administratrix Bond 688.00 25 Register of Wills - Pennsylvania Inheritance Tax 3,000.00 30 West Shore Times - Advertisement 16.75 June 21 Register of Wills - Pennsylvania Inheritance Tax 7,025.64 Sept. 13 Cumberland Law Journal - Advertisement 18.00 18 Internal Revenue Service - Federal Estate Tax 4,756.64 RESERVED FOR PAYMENT OF: Donn L. Snyder - Attorney's Fee 9,000.00 Register of Wills - Filing Account 200.00 TOTAL PRINCIPAL DISBURSEMENTS $ 25,237.03 1I3lR ~4 f,\hl 813 . 1979 Apr 11 Apr 11 April Apr 11 May June June July July July Sept. INCOME RECEIPTS Penn Central National Bank - Dividend Huntingdon County Thrift Corporation Dividend Meade Corporation - Pension Refund - subscription Internal Revenue Service - Refund 1978 Tax Meade Corporation - Dividend Meade Corporation - Dividend Penn Central National Bank - Dividend Huntingdon County Thrift Corporation Dividend Meade Corporation - Dividend Meade Corporation - Dividend ~OTAL INCOME RECEIPTS INCOME DISBURSEMENTS NONE TOTAL INCOME DISBURSEMENTS . . . $ $ 408.00 166.00 418.28 5.21 59.00 770.00 253.40 408.00 166.00 9.18 1,147.60 2,810.67 -0- SUMMARY TOTAL PRINCIPAL RECEIPTS $ 180,180.20 TOTAL PRINCIPAL DISBURSE- MENTS 25,237.03 $ 154,943.17 TOTAL INCOME RECEIPTS $ 3,810.67 TOTAL INCOME DISBURSEMENTS -0- 3,810.67 BALANCE FOR DISTRIBUTION $ 158,753.84 BALANCE CONSISTS OF THE FOLLOWING PRINCIPAL CASH INCOME CASH l;6i~ o.~ 1\" !.I',., "" J ,OJ.. 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(',! o to E .;, ~-' il~ ~ ;r) . . . J: "'" ... ,," ..:. PURPOSE OF NOTICE: To fulfill th. requlrem.nts of 5.cllon 1745 (bl of th. Inherit.nc. and Est.t. Tu Ac~ Act 255 of 1982 172 PI. C,S, S.ctlon 17451, PAYMENT: Det.ch th. top porllon of this Notic. .nd submit with your p.vm.nt to tho R.glster of Wills, --Address inform.tion is listed on page 13 of the booklet "Instructions for Inherlt.nce Tax Return lor I Resident Decedent" --M.k. ch.ck or mon.y order p.y.bl. to: REGISTER OF WILLS. AGENT. REFUND feR): A refund af I tlX credit. may be requested by completing .n "Application for Refund of Pennsylvania Inheritance and Estlte Tax" (Form REV-1313). Applications Ire Iv.il.ble It the or flee of the Register of Wills. Iny of the 24 Revenue DIstrict Offices. or from the Department's Forms Service Unit 24 hour Forms Ordering tel.phon. hn.s in Harrisburg - 17171 233-3443, In Phil.d.'phl. - 12151351-2065 or In Pittsburgh - (4121 565-3601. OBJECTIONS: Any party in interest not satisfied with the .ssessment 01 tax IS shown on this Notice may object within Sixly 1601 d.ys of r.c.ipl of thiS Notic. .s follows: --by wrltt.n protest 10 tho D.partm.nl of R.v.nu., 80ard of App..ls, P,O, Box 1874. Harrisburg, PA 17105 DR - -by election to hive the nutter determined at the audit of the account of the personal representJtive OR - -by .pp.al to tho Orph.ns' Court. ADMIN- 15TRA TIVE CORRECTIONS: Factual errors discovered on thiS .ssessment should be addressed In writing to: PA Department of Revenue, Bureau of Indlvidu.1 Tu.s. P,O, Box 8327. Harrisburg, PA 17105, ATTN: Post A.....m.nt R.vi.w Unit 17171 787-6505, See page 3 of the booklet "Instructions for Inheritance Tal( Return for a Resident Decedent" for an elCplaOltion of administratively correctable errors, INTEREST: PennsylvanIa Est.te Tax based on the Federal Estate TIX return becomes delinquent It the expIration of .,ghte.n 1181 monlhs from Ihe dale 01 d..th, Interest is calculated on I dailv baSIS at the follOWing rates: Delinquent Date Interest Rate Daily Interest Faclor 5/27/43 to .nd including 12/31/Bl 6'~ 1/1/82 to .nd Including 12/31/82 2010 1/1/83 to .nd Including 12/3 1/83 16" 1/1/B4 to .nd Including 12/31/84 11% 1/1/85 to .nd InCludIng 12/31/85 13" 1/1 /B6 to .nd includIng 12/31/86 10" --TalCes that became delinquent on or before December 31, 19B 1 delinquent balance IS paid in fu\l, --Taxes that became delinquent on or after Jaf1uarv " 1982 Ire sublect to I varllble Interest rate that changes each calendar year, --Interesl is calculated 1$ follows: ,000164 ,00054B ,00043B ,000301 ,000356 ,000274 will maintain a constant Interest rate until the INTEREST . BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Nollce issued after the tax becomes delinquent will reflect an Interest calculation to fifteen (15) days beyond the date of Ihe assessmenL It payment IS made after the Interest computation date shawn on the Notice. additional interest must be calculated,