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HomeMy WebLinkAbout79-00236 ,,' /,. ,. , } ~ " o Z,' J_, , ,I{, >_" ''-1_. 'I" \' , 'li'",-' ;. _It' ;, I"~ 1',- .' _,I" " " ,~ ',i',!l. m ~ . l,iI~ :1' ,. " , . " " ,. ~ CII :D~ Ji,' " .' , ,. fi" If " .,. -,, -"" " ; 1- 110 ; ~ " j, " ,. " " " , ': " j CI /. ,. ~ .. ,I . ~ ' . ,If' , .. ~ I .,. ,. 0 ~ . > t.l , ~I, ' . 1;. '. ,. ~ "", 0 '" , ,. 'j E- ,. ", , , .1. " , I' " " fl,' , ~ " ,. ,. "I' i " ,. ,-1- "i ,. ,,-' ,. , ,. , ,. ,. I' ~ ' - . . ...- I' ., I. " i. " ',,, . f ~ ' .. ~ : J '! f " ,j'- '1_ ,. ,. '';- ~ "I - ,I '~ ',,' n, I' ,. " -"I' ,. :j' 1"-"-- " '-" ': I - ~ ~ ',:". ,1- /" , ~ 0" '-"- /' i" ;'::1,1,;, ~t _"fft . ,. NO, 21w79. (.....1').,(.... ".... 'W'.It IN '1'Hl~ I~RTA'I'I~ OF "..,..".."..mf.~~~,..~~...~1v.\W...,,,,,.......,........... Richard E, Anderson ..ii.......II11'...'.IIH"'..'.""..''''''''.......''..''''.'''...,,'....."",,,,,,,.,,,,,,,,,..,....,.,,,,,,.,,,,,,",',.,, PETITION FOR LETTERS OF ADMINISTRATION I)I~('NAHBI), 1'0 Hoglfltol' of WillA rOl' tlw COlllI()' of Cllmlwl'illlld, III tlHl COll1ll1ollwOlllth of 1'0llnHyll'lllllil, 1'ho l'otl ticBl of ,...".. .9h~:f.~~~., ,~, "" ~'),~.~".,'" ,,,,,,.,,,,.......,,,,,,,,,,,,,,,,,,,..,',.,'"'' "..", It, It"" ...; '" 1I....It IHI i i ""'0111 I'" ..""H.il...I..'''......,,,,,.,,,,.....:...,,,"..,,,,,. l'OHp(]ctrlll1~' HhowtJl h t Ita t ":..,~~,t~.~~,, Ht~.;,~hH~",'j.j,,'i.\'ili,nllli..tol..\P.I;.."i II 'f Hnmp,d'm 'I'ownAhlp c' I 'I 1 (' (. "( ( ,'1' "1 WflK 1\ reR( onl< 0 ,;""""~.,.l.."T,"".......,.,,.,,"It..,,"",".""HHJV)OHIbc: ' ItlI\) >01 ntH ,oun.~ ,nn 0 0 . .onnal, .. VIlI1II1, I\nd II CItizen of Unltod StlltllA, Illld (\uplIl'tocl tlllA lIrll III(llH(lItu In. 1)w (1()lInt~' nt',:"",,"'"''''''''''i~:''' .....>>lAt";J..m9.t.ft,I,...'I, """" f\nd St.n t.o of ,'" '" ,M~.t.Y.~AJ;\.~.. .""""""," ,,," ,,,,,i, II"""" fl.!I;' '" ..I", ,.., """"."" lll/.ill.I'.',:h.III.,' , on tll'I.\~}H}~.~.Y.."ll..,'.."..," tho ...,",.tQ,~,l,'I!"",..,""I""'" ilny of ,,,,,,P.RR,',tJlRA~,...,,"''',,..,,,.II'',,'I'.AI.n;I'lO!i.7.,,~"i'l at the allu of""~~....",, ~'onl'R. T~nt tho snid ",,,,,,,,,M~~~.t.l:,.B,.,.-,,~,~~~,,,,,,,lil"..""..,,''''..''''..Il'' <loCUtl~Odl .'oft ~urvlvll1g tho following ",'mod widow 01' hUHllllnd,holl'H IInd next to kin, (n wl(: '''' "'1'."'" "!! II .,'".....~; "" ".,.""..Ii 1111" f;"""" CharJ.as, Y,.. Thorna Son Ro'illdonoo 2 CounHlldda Court ,,! .,." "1'~1."'.''''.'' '''1'' ,., "'!"'Ill'!t':~"" II "I'H,"" "1 .., ,~~n'~'II~~ t.;, t, I j ~ ~~,t;\~X,; Y,~J1~f;',,; 11""" 923 ~hoarnaker' Avanua, """"I"""iI'"H'.II"'''''IIIl,,",'''II'''"l1ill''''';'' Nnme Charl.aa J.. '.Snaw ",..""..".,.,,,,,,.,,,,,',,,,.....,,,,,,,,,,,...,,....,...;,, HollIUonRhl11 Husband ,1I...",jj.,oti""....ilj""...,q"...,,,,, .......,......"",.",.""'''.,'''........'!.'"'''.''.';Ij".., "''''I'j'''';I''';''''''''''''''''''''!!''; ,,,.;,,,,.;;,I..',I,,.,,,,.!..,.,,,!;;,,,'II ",,"'"H" u..,."".j ;\h~p';'", 1,,,";11 I~I'"'''''' ,,'UI', .,...II."IH""II'''lI,,,,,,,,,.il;lI'.II',, '/" .~~:~.~; ,:;~r.~!!'.~,~M,\".~~n~.~.t~X~~~~n' ,..",.,.,.....H'lj.,.",,,.,..,.,"I,,,,,,,,,,,,,,'i'I',.,.,;,.1 1il<1"''''''''I.1;,,,...,,,!,H.;,'''''''h' '1"'IIHiI'I"",.."""",,,"'lilHHII"'!l'"'''"il''''''' . ~ ""II"".....;;,.".;;.."j"I'I"".'.'.I'."!il'....'.,..." , ;.."j"....li"...."'''''.'''ill.q'''.''".. H"" ";"..,, h. 'I" I;. '; 'II i .111. I" I' ".','" If" 1+11.' ....,p n, ",....di..l; ;"""'! llll'''',' ,,';.',Ii'H 1-1I,'~i''''''''.'I' '"'' II ,.,I.,.!,,,,.'j,.lii!i,,;,,,,.,,..j'!II''';' .,.,;.,..",i.....,."';.".II.".'.'.""'II!I.;I.....1111,.HIlI'" , " '!", oj '"' H'; '"'' ,.... f.III!' ~ I'"'' H i"'jj,, ',111'"'"';''' 'II "..,,,;"..'.'lIli.."'jj.j.l\j.......""i """,,"i'iiolllill''''''H;Il'-j'''lI,'';IIH~,''lIjlll'''!''H' ."""..".II"..III.I!l!'.'jll"....1+..'.."I.;;'''.......'"' ,H,.I""'"';;"";';'"''''I'''''l''''''' .""JJU"lt",..,";;I-'I""",I''1i1'lI11,,,!.,.;,.ilil'''''''' .. Thl\t thoBo nhovo ,11111110d Inclu(lo 1\110( tho'.noxC of ~In, RO 1'1\1' Ufl' knoWn, Tho ~lIltl'.deood~nt wlla pOARoAao(\ OfllOI'~\1ll1\lpl'oPUI'ty'lotho llHthl1l1tod vnluq of$"",?,9.~,R.9",,,,,,,,;.,,:,,,, und of HOIII l~atuto, leAa Incumhl'l\nco, to tho lJ,Ht!II1U(o<l vulue of' $,,,~,,,7.~P,t.QQ.,,,,,..lO'''' lIa .-nlllll' IIfl .dlm be lIacol'talnod, Thut tho ARlel Ronl gRtt~to in HO fur nA tH knOWl) IH locntod ..Iii ""~~~~,~,~~R~'~1I9~i~~~r.",,,,,;,,,,,,P:''''" 10_ , . .,. ' "''''1 ~.9.1A hh.. ,9.~ 1iR.+.~nft"..... """";,,;. Ii t..;',,,,,,,,,,, l",j! II ~",,,.. 1 .".." ,." q. d';;.""..,..",; tl."." '. ;",,,,,,,,,,,,,, /1 '! '." I"" i" ,.,.i ,'"..".. 1 Ii,,;j' Thorofol'o, IIl1med 'OAtllto, YOl\!' potltlonol' (A) , .'oalloc(fllll)' IIpplY(loa) fOI' 1,0ttOI'fl of AclmlnIHtI'lltl~n In thellbovo Dntcd "II""",,,,,,,~p,;,t;\.,,;,~,I,:~d\;,,;,i;"'1 A'"1J,, In.;;7,~,, S,(gnature Ilnl! Adlll'UH" M ~ t'ot 1l/1)lIlll' (H)' " ''''11'111'''' 2 'Country aide Court, Camp Ri11, . ".,."."",,,,,,.,,,!.,,!,....,...,,.,,,,,I,.I""''''",."'.'1.'.........."""",.. ,.,',.~.".;" H"", ~ ilh;; '/"'" H' ,1'.......;, t ..11" I I" "';",, j j.t"~ '.'!""" Ill"" ".. Pan\1sy~vania l70n u "f.,"ii",;"Uljiii;"""""!I".H,j1'i'i"'''''"'1H,,,",.Hlli';"llf"ji"'"'' COMMONWIMLTH OT-' I'mNN1'\'I'lNANIA COUNTY OF CUM~mR1,AND 1 aa: """,9,1:\" t. ~.~,~".~.~" ,~,\lAW, '-', Ii". "'.,'..",,, '".",;,,,. h.....".;.. H oj,,,,,,,,,, ~;,' ,";' {/... j",,!!,.;j /, H' i"" '" U:': :.'" "',,,- I';; "~! !I""': ,. d, j.., Oi,..,,,; 1\ntflcrl III the IIbol'O IIppllcntton bolng dul)' ....,!jl'l!?,Ii,\1"""'''''''''''''''''''''J'''' 1I(19ol'lIllui'to hIli', ilIP'thu( tho fhc(a. aot forth In (ho IIbol'O IIppltcllllon 111'0 tl'1I0 to .tho IlfJR( of ,Jl~.~,~, '.kn \'10(\ 0.1(11 b sworn /\1111 "1111"C 1'1/)011 1 'L"',,,... '"',, '., '" ....~ """"....."....,,,,,,,,,...,,,,,...."1""'''''''''''' f'I f'I ..\ "',. .,\",/,,,.'H""'''''';';'''' before mo. .....' ",,,;;;,,.i<',,""'; ""'1" I ,14 ,,,,.; II'''' "" ",".. ,!f"; ,.., ",,;1'''; ';0 '''' 1 ~1.~"..., '"'' ,.-u...~" .."h;.""", ". Ii"" Hi"" '''' ,Ii (I'" ,.. li!'''!I' ,'." "''','''' Ii" ~... -.""" ......""."..,..,.",,,.........,,Hl;, ;,.,;"""""........."'.."iH....''''".,......"",.."it.",."..,,,..,,,'..,, ,,,..,, , / (~rl) HOI\'IH\OI' ...,. ~p..~~.~... ;I..g.!.......:!, ~.~~........"".. ,,,..,,.,,,,, 1\1101'110.\': . A.',Hm .....J, I." 9,C;>.l:\nH.:U...y. ,~,A,Ii.... I. ..~.~.!ll!.t,e \ '">, "\ \ <"" t~~ ,'-':)('\.1'. "'II (-, ,,") }W,\W,\"(",J\'./, ~"I\ \'({ CJ \ ," 1\ 1"110<1: (OV(!1') ". ., COMMONWEA~ TH OF PENNSY~ VANIA llEPARTMENT OF REVENUE BUREAU OF COUNTY CO~~ECTIONS INliERITANCE TAX DIVISION INHERITANCE TAX RETURN FOR INSOLVENT ESTATES ONLY OF RESIDENT DECEDENTS * qll/7? '. \ Rce-tO'!l \3-'73\ COUNTY OF CUMDlllll,AND - Thl_ rnturn mUlt b. completed In detail and fll.d 'n dupllcat'l with the Rogl'hlt of Will. In tho County where the d.udentr.'ld.d within nine month. aft.r date of doath. !,.Inl.., an Gktontlon I, granted by the Seet.torr of RfJvenuI, --.- Will Admll,Nn, 21"79-211{~__ I,.. . Churles J. Sha\'L._~____lIfllounttvaide Court, Camll1lill,"I'A IN M,1UI I AOO"f.881 MIHC, helllM dill)' H\\'llrIlOClll>rdhlM III lull', dOP"'OH nlldHnYH 111111 he 10 Ihu (If Iho oHlllle 'L.._..._._.._ll~len._D..Shaw. _..m.__......_...._.._~_ IlIte "f Admints trnto..t'...-_ (1:!)(IlC,! APM'! LEGAnU!, file,} Cnmp 1Iill l,cfIT;P'01fc)u OH7(fJfTOWNBHI pI ~ ----~--- dceOIlHod, IIl1d Ihllt Iho wh"lo "f Ih" o"UIO "f Huld deeedulII, whll dlollnn ...__1ll.tc.Qmb.Clr....l.O'....19J.B-.--.------ {OAHU . cnll.lolod nf Ihe aHHelH 1I0led helow ami I hili nllnwnhlo dehlN nnd doducllllllo o"eoo,led Ihe flllr murket valuo of the. u.oelH and 1111 l'ellllHylvnlllu TrllllHfor lllltorlllllloO 'I'll" IH lhle, Swom and lubtc:rlh.d b.for. me 'h.~~ day af.J!J.C!.ct.;hv- ,19.ll- (./1 !i ,oct (l\iI. i', It ,1 AFL') /"'2'~~" ,! ... '~]'d '-,'~/' / I .' / ~c. _ 4., ~ i ,.-' __ ~/ c"" . t>~ """"", . .. (aION U HI C1IARLUS J. SHAW /.' ~. ..~.;.....-" ~ v . ; .'_ .- ;;-::t..,t.-li.~ . c....: '.:...- I Tm,E' ADMINISTRATOR Ty'~ of AII"l Rnl a,tat., p,,,, Pfo~rty, Jointly H,ld Prop. CH Trflnaft,. ASSeTS (Attach Qddlllonal ,huh If ",unary) Ducrlptlon of A,..l B,tlmlUld /M,k., Val.. D'pcJrtmtnt Val~tlon CAUTleN (D* not writ. In ,hit' u Renl llstate Ptopstty located in Georgetown County, South Catolina, owned ns tenants i.n common Personal property Je\'lel,ty, ornaments of the person and miscel- lnneous household possessions {i I' $3,750.00' 50.00"-"" ;' TOTALS $3,800.00 ~~ ,(.(~, 0 (i ,c. l' RUf>ORT OF 1i'llUlRITANCU TA" APPRAlSUR I. (he elldorHlgllod duly appoll'('Ud Inho'rltancoTa" Apptulnor IlIlInd for the abovo County do reHpec(felly report thai I havo apprlllHod tho roal and porHonal proporty aM ropunod III Ihe fo[ellnlnM oeho~IUe at 11'0 vlIl,"es H~t'J,!rll) uppoHito oaoh itom 10 Iho luol colem,1\ to tho right. ..' 'TC "':" \. '.." , '. ,., DlIlod: '1- 12. ''1 c/, '. lINHERITANCE TA~'AePRA"ERI . .. , HQIll. of Pay.. DERTS AND DEDUCTIONS Hotur. 01 Claim Amount Claimed Amount A PPlCwfld by Rlol,t" Charles J. Shaw John J, Baloga, Jr., Funeral Director Charles J. Shaw Cumberland County Register of Wi.1ls Office Harrisburg Hospitsl John llopkinll 1Iospital Beane, Kost & Cole, "I'.C, Cardiovascular and Thorncic Associates, Ine. Herbert I, Soller, M.D. Samuel L. Jones, M.D. Harri.shurg X-ray Associates Surgery, Inc. Surviving spouse - Fam:LJ,y exemption Funeral expense $ 2,000.00 2,163.70 After funeral limeheon Lecters of AdmJ.nJ.stration 108.00 19.50 Doctor bill Doctor bill Medical bill MedJ.cal bill 7,223.00 15,794.00 165.00 50.00 467.00 19.00 303.00 292.00 TOTALS $28 604.20 ?- i: C. (III, ,'c, Hospital bill Hospital bill. Doctor bJ.ll Doc tor hill Rlll'OItT OF TilE RIlOISTlm OF WII_LS I. Iho undor,lgnod duly olecled R.~I'lcr'uf WIIIH 10 and fur Ihe obuvo CoulIly, do reo,"iotfully rOPIlrt thai I hllve allowod deduclluuo In Iho amllllul' Hcl furlh In Ih. uhuvo oehedlllu uo o,lul'"0d, e"oopt whore I hove Hol fonh n groalor or 10Hoer IImounl lu Iho 1001 cululllu In Iho rlMhl, which grolllor or le",er "muunt ropreHonl' Ihe SIlm allowed II' a deducliou, IlOlo ur AppruvlIl: . /'/ ~ (7" . (It, ,,(!{,[I ((C" (':,.....{;{~,.-l::.~ ,;>>" '(.--;.., ",r<-' ,f r