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OATH OF PERSONAL REPRESENTATIVE
COMMONWIDAIlI'H Ol,~ rlDNNSYLV ANIA }
COUN'rY Ol~ CUMBilllll,AND SS:
Boforo mo, tho Roglstol' fol' tho Pl'obnto (If Wll\s nnd gl'unLlng of'Lott~"H of'Admlhlsirhthm In\lnd ro.'.
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tho County of Curnborlnnd, pot'sonnl)y carnu, "I"""".ilrlHJ.lt"~"jJ~~~pg,li!.l;".II'/''''HI1''i'!'jdillliH'I~'I"i.l.{fj;IOII"i'HII
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h b I d I Rwnt:'r, d' OB', d I' . 'h t ' the' axecutr:l.x
W 0, 0 ng' u y. ,..""..\1 H'.. .II........, 0 .",...1'1 upoao une auy .,,0 nBI"H.lI-'''....lI..,.,.j.jj''"fI.I...hl~_'"j'HII!!li\l'H..I.'.
of tho taRt Will and Tostamont of t".."..1t~11~,llfU~Q".Q"";\\~~ng,Q:rt'Il",,...till"'i,j"'"i..,.;.H.,t""";,I,'il1i'..,.jq,,,dcconaod
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........J'll~.~......"... will woll and truly hdmlnistor tho goods and chllttel~, rlgh'tsllnd 91'edltaof anlddocell'sod
lIccordlng to, law. And a,lao wlll diligently comply with the provisions oftho,lnw relutlng t!l ~~ansl~1'
Inhorit,ances. .....~1'I.Q.r.n............ 'dnd,aubscrlbod
before me. .
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I'll" .. t I i I t II i' j I t t i fill ,'j I' t, II jj 111,11 t. i, t j I' ,'.', i" t I'll j, I j <.. i ~t fIt I' j',', IIII
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IIi!. ".liIH""'
Richard E. Anderaon, Register
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DEC~EE
Bo It teme~bered.that on tho ,....,:.~p.~.n....'i' day of ,:..,.....".ii,~~1i'.~.t"....".:.....,,,.,,;A,, D,;19~j?tl'lnt09ro
I' . .
was probated lInd recordotUhe IlIst Wm,lmd 'rQstllmont of .....,..RMI)m.\',fi\"~.",)~l,~n<<m;........."......"......,,....
late of ........UP~~,\~,A;l.;l.~n..:r.O'\'lnllh:l;p."...,," ','" ,..."""" Cumborlllnd ConNy, Ponhsylvllntll, Decollsod(Letters
,
t... ;.1111 :r.e.s;t~nUlen;t'a\'\~. jlltll 1'111'" ii',.: 'woru gl'll ntod to, it .il jJ:Q.la. ,Q'il IK;t..r1,';1g~~ll..t ,Ij; I' t< .111.." jj'I'i 11''-' '111;. I, I. IH" II ,,,,..
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Wlt,noss myhllnd IInd ollicin! s01l1 thodny nnclyOlll' nforosuid.
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Hieltnl'd g. Andlll'SOIl, HCHiHtol',
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INHEFUTANCE TAX RETURN
F'OR INSOLVENT ESTATES ONLY
OF' RESIDENT DECEDENTS
,,/..l1./17
*
<III
COMMo~weA~ TH OF pe~N5YI.VA~IA
OEPARTMEH'r OF REVEI'WE
BUREAU OF COUNTY COI.I.ECTIO~5
INHERITA~CE TAX DIV1510~
COU~TY OF __J:UNIl!;IilJlliIL~_____
Thl. return mUlt b. completadln detail and fllad In dupllenlo, with Iho RltUI.to~ of Will_ In lhe County whore tho docudont rculded withIn nino
montlu aft., date of doalh, unl... an OIllenllon I, grantod hy'lha Sac'rotarv of Rovnnuo.
Will . 5..Junipot' Dr.Ivo
A dmn. Nil. 21- 7 0- 2 {Kl,_ I. _.j,QJ{LJL_KlJUlml'~__~_.____._.. of .M1ll.lhw.1illB.bLWg.,._l'A~__lZQS5.~__. .-.--
INAMHI \ AIH)fWflfI}
MIHc. she
heln~ doll' Hl\'lIIl1l1cellrdlllg III IIII\'. delltlHeH 111111 HIlYH IhllllbK iH Iho ____~__.:....."'Exeoutr.J.x.."_""_,."..,, -'~," ....".."._.
i II~XEC., AlJM" 1.I~U^' IHt, HTe,}
Ill' ehe eHllllo IIL____.R:fClll!ll~tl.G, ,KLing!:!!',...."...." IUle III'...:.utlfl.e.r,,,Al.lmLT.QWnahJIl,r..,.,,.,,.....
relTY, UOIWUOllt Ol~ TOWNOrfll11
deeeu.ed. IIl1d Ihlll Ihe 1\'1".,le nl' Ihe e.lule Ill' .uld deeedell!, I\'hll died 1111 _ MQt'.Q1L20,,19,7,9.,
1I1A''''1
ClIn.i.led Ill' Ihe U.HelS 11.led heinli' ulld IIIUI ulllIwuhle dehl. ullIl dedllcllnll' (\~e"elled Ihe I'ulr 1Il1lrkel vull'" nl' Ihe IISHIlI. ulld
IIn l'ell'IHylvlIl1ll1 TrulIHl'er IlIherllllllee TlI~ i" ,hil"
s:o'n~on'~~ub.crlb.; b.'oro mo , 79, ~-L"A__,-~, '~, . ..~.___.~._.
~,it=. d:k~~ '~'1:A1I1XmNn~QIJ~IJM. NO'^RY puotte IHION^TUIl'
>4J~'M'_~'/ MLC;UAlllilSOUOO OOIlOUOII
....J;:X80Utr>,tX
1,1('I'Lal, '
TyP." of A...'I
Rial e"ah, PI,..
prOPl't' Jointly
Held rop, or
rro .f",
MY COMMISSION rXPIRrS 1111. iils~&W
(AUoch addltlo"~'.'~11 "Iuuary)
Oucrlpllqn of Au.'
e.tlm~t.d
Markol
Vollle
D'lfla,'mlllnl
.Y.'Il!!<!!!J>.n..
CAUTION
(Do nOI writ.
In ,hI.. CI
PI'll'sona1ty
liDO ahar.es, oommon, Gener.ul ~led:l.oa1
Cor.po!:jlltior @ 12.50 per. s.hare
$5; ~lOO. 00'
;1
TOT ALS
$5,000.00
5
IUlPOH'I' OJlINllIllUl'ANOE TAX i\l'l'ltAISER
I, the ullder"18ued duly uppnlllled luherltUllee Tux ApprnlHor ill 1I11d IfIt the uhnve Cnllllly dn re.peelfully repurt Ihnll hnl'(\
npprulHed Ih~ roal nnd persnllnl prnpertynH repllrted In Ihe l',ore8l1il1 .ehellule,' nllhe.l'lIll1e i ,el furlh' nlll'nHile elleh lIelll ill
the IIIHI " (u II Ii> theJ:~hl. (.... '9' . ~ l'Ld&t2... ",,-i:Jf.:1~\',..-.-.__.
llntcd:. li ~_ _1_ ' . (INtlfiRI'fANCfi TAX ^r'PRAIlJl-lHl '
peSTS ANO OeOUCTIONS Amount Am,oun' Approved
Nature of Claim 'Clahnod by RIO"''''
Reg:l.stet' of WHls
[.ala O. Kl:inger.
Nyers Funeral. Ilomo
RolLlllg Or.eon Nemoda1
OIlt't1ells
Mel~CY Catholic MeclJcal.
Stnte CapItal. SavIngs
and [.aan '^ssoc:latIon
Probate costs
Fam:l.ly exempt:lon
I'lUler.a1 expellsos
$ 16.00
2,000.00
2,1190.20
732.50
'I9J..00
Lot and marl~or
C nter Ilosp:l.tul. aocount
. ~ of outstand:I.1lg balQllee on mor.tgag
pt'Qpe\:oty ut 5 ,JunJpOt' nr:lve,
Mechalllosbul'p;, Po. I owned by tleoecleT t
and T.ala G. J(l.:Ingcl~, hls spollse. as
tenants by tho l11lt :I,t'eti.oB.
fo!'
12,611.09
TOT AI.S
$18,3110.79 '
, IWI'OllT OF TilE ItlWISTliI1 OF WII.LS
I, Ihe Undllr.lgned <lull' c1ee'lcd Itcgl'ler 111' WIIIH,II" lIud I'nr Ihe, ul\nve CnlllllY, <Ill rll'l'e<>ll'nlll' rel'lIrllhnll hlll',,'uIIIIII'<><I
dcdllt:tlollH llllho nmnllllls sot rol'lh 111 lhe IIho\'o schcdultl liS clnlllH.lIl, CXCt'tlt WhOHl I huvl! !H!II:fU.t1111 (tHlnlur fir l(lloiSl'r lt1ll1lllnl
in Ihe Ill" ,,"1111ll11 111 he rl~hl. II' ,leh grelll"r IIr le"l!f IIlllllllnl lepr"'''"I.)) "-:" II~I '1""II'!lll!,," ,~,"hrll.\"' I
IlllleIlI'Apl'fflvnl:" ~ 1~:1!J~ ( ~~---
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INSTRUCTIONS
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1 1110 nth ,005 4 month s .020 7 m,onths .035 10 months .050
2 months .010 5 month s .025 6 months .040 11 months .055
3 man ths .015 6 months .030 9 months .045 12 months .060
_.__.~--~ ----
1 day .00017 11 do y s .00186 21 days .00352
2 day s .00034 12 days .002U3 22 !lays .00369
3 day s .00051 13 days .00220 23 day s .00386
4 days .00066 14 daY s .00237 24 days .00403
5 do y s .00085 15 days ,00250 25 days .00420
6 days .00101 1,6 days .00267 26 day s .00437
7 days .00118 17 day S .00284 27 days .00454
8 do ys ' .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00316 '}fJ days .00488
10 day s .00169 20,llays .00335 30 days .00500
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,__ - --- --- --- -- -- --- -'--'!""-7"-- -- -'-- -- -----........- -~~ ~----- - - -- ---~ --- - - ....---.... -.... -- -- -- ----
,
Any party lnlnto(Dst, Including the SOl11l11onwoallh and tho por,sonalreprosontallvo, not
satisfied yllth thll auossmontmayUobloct thoroto within sixty (60) days aftor receipt of,Ihls
nol.lce aspr,Qvlded bySoctlon 1001 of tho Inhorltanco and Estatd Tax Act of 1.961 (72 p,S,
~ 2485-1001) " .
Makocheck,or mo~ey order payable 101
"Roglster of Wills, Agont"
Mall"to tho address IIstodBoloWI
INSTRUCTlm~s
To Insuru propor crodlt to your occount, tho namo of tho llatato an~ fllo numbor ahould bo
cloarly printed on tho chock or Inonoy ardor. "
This detormlnatlon ond assossmontla modo In accord"npo with Soctlon 421 andSoctlon732
of tho Inhorltanco and Estato Tax Act of 1961, 7~ P,S. 2485-421,732,
Tho ostato tax Impasod by Soctlon 421 Is duo at tho dato of tho docodont's doath but shall
not bocomo dollnquont until tho oxplratlonof olghtcon (18) 1I10ntha of tor docodont's dl'ath)rovldod
that any ostato tax occaslonod by a final chango In Iha Fodoral totllrn or of tho tnx d"o thoroon
shall not bocomo dollnquont until tho oxplratlon of ono (1) 1I10nlh aftor tho porsan Ilablo to ,pay
tho tax rocolvasflnal notlco of tho Incroaso. Colculato Intorost frOIl1 tho dollnquont data shown
on tho faco of this forn, to tho data of paymont using thofollawlno Intoros,t tab'ol
___________....__________ _"'"':___~ __ ___ .........___:-___...._ -r-----....----.---!-- ---- --- -...-- ~....- .....--....-
1 month ,DOS 4 months .020 7 months ,035 10, months .050 '
2 months .0lD 5 months .025 8 months .040 11 months ,.055
3 months .(1lS 6 months ,030 9 months ,045 12 months ,060
...-----~---------
1 day ,00017 11 days ,00186 21 days .(10352
2 day s .00034 12 days, .00203 2 2 do y s ,00369
3 day s ,00051 13day s ,00220 23 day s .00386
4 days .00068 14 ~ays .00237 24 days ,00403
5 days .00085 15 days ,00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .00118 ,]7, days .00284 27 days .00454
8 days ,00135 l,8~ays ,00301 28 days' .00471
9 days .00152 l,9dilys .00318 29, days .00488
10 days .00169 20 days .00335 30, days .00500
,___ ______ -.....-------'"'lr--;,...;-------- --- ------"""'\---------7'--... --- ---...------------ --.....- -----...
Any p~'ify In Intorosf,lncIJdln\1theCommonwaalth and tho porsonal roprosontajlve, not
satlsflod with the as~assmont may obi oct thoro,to within sixty (60) days oltorrocolpt of this
notlco asprovldodby'Soctlon 1001 of tho Inhorltanco and Estato Tax Act 01196.1 (7;2 P.S, '
~ 2485-1001) , '" ,
"
Make chock, or mOnoy ardor, payablo iol
"Ro~I;>tor of Wills, Ao?nt"
Mallfo tho addross Ilstod bolow!
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