HomeMy WebLinkAbout79-00367
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No 21-19
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PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of .______ ._1'1l1'J,'.!.!....n.!LJ3_or~INI\_,JOR.l?At>I_d.- _...._._____, deceased.
To Richard E, Anderson, Register of Willr. for the County of Cumberland,
in the Commonweolth of Pennsylvania.
IS
Petltioner~l41le< the execut..oJ::.___u_ ..,. named in the Last Will and
Testament of __.__,---M.!!UJ.9.!!. BqJJl1e~g.9r.~:1.l!..ll____..._ dated J1lli1ust 29. 191.3
Decedent was a citizen of the United States and a resident of
Township
~ Cumberland County, Commonwealth
Hampden
of Pennsylvania.
Decedent died on Friday
A. D. 19 79_, In the County of
_ the _~st
day of
June
.---------,
State of
New York t th f 60
a e age 0 ___ years.
"BS has her
Decedent has not been married and has not had children born to ~
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
undetermined and of real estate to the value of
none
as near as can be ascertained; said real
estate situated as follows ______..______
Ql~
Therefore, your petltloner(s) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon,
Dated June 12 , 1979
Name and address
of Petltioner(~)
) / )
A. if 1(,/ ."t[ (~Iult"-
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Richard E. Jordan
675 St. John's Drive
CamE-HUl, Pa, 17011
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
Richard E. Jordan
named in above application, being duly ___ sworn..__~_ according to low
say(s) that the statements set forth In this petition ara true to the
best of _-----11.1.IL________._ knowledge and belief. /) __ ,]
Sworn___ and subscribed before ___/\t~j~'L (>~/It.(k
me, ..._..gu_ne__l.~. ----------J..1 97~_L__ Richar~_~. "Jo~~an__
j / ! '
-Richard E: Anderso'~--Re-gi;t~~'
'0
0) Iii
Filed;
::l.. j- 7c;- j(., 7
June
13,
1979
Tom H. Bietsch, Esq.
At torncy: (Bietsch f< Morgenthal)
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rllnlllstatll mOl'tf,la,i!O~ or oth(.l1' aocl1rlt:los or In such othOl' roal Ol~
personal proporty us my EX(lcl1trir(s) 01~ Tru~too shall deem wlae,
wlthol\t belni! rostd(:tod to so-cuUlld "]ogullnvea'tmontH",
(c) In ardor to effect a division of tho principal of my
Estnie or n 1'rust or for any othor pm'poso, Including uny flnul
distribution of my E~tuto or any Trust, my Exocutor(a) or Tl'usteo
is authorized to make suld divisions or distrihutlons onhe
personalty und realty purtly or wholly In kind. If such division
or distribution is mado In kind, said l\~~et~ are roquired to be
divided 01' distributed at their respective. values on the date 01'
dates of their division or distribution.
"
(d) To solI oither at public 01' private sale and upon such
tOl'ms and conditions as my Executor(s) or '1'rustee may deem
o,dvantageouB to my Estate ai' TruBs, any or nll real or pers~l'\al
oS,tate .01' Interest therein owned by my Estato or Trusts severally
or in conjunction with other persons 01' acquired after my deuth by
my Executor(s) 01' Tru~tee, and to consummate said ~ale 01' ~ales by
Sl,Iiflcient deeds or other Instrumonts to the purchasor or purchaser~,
conveying a ioo ~Imple tltlo, freo and clear of all trll~t and without
obligation 01' liability of tho pllrcha~er or. purchasers to ~eo to the
application of the pUl'chaso monoy 01' to make inquiry into the
validity of said sale 01' salesi also, to make, execute, acknowledge
and delivor any and all deeda, assignments, options o~ othor
writings which may he necossary or desirable in carrying out any
Pa.ge 7 oi 10 pages.
tll110 ns 'rostntrlx, ot' In a oommon dlHllstol' W!tll hCH', 01' undt;ll' suoh olt'(\urrt-
stanoeo that It Is diffloult 0)' Imposslblo to dotorl111no who dim! fh'st, shall bo
doemod to havo predeooased hot'. Any porson (othor thnn 'l'ostatrlx) who shall
have \lIed nt tho samo tlmo ns any thon roclplont: of inool11o 01' In a common
dlsalltElr with lIuch bonoC!clnry, 01' undo)' such olroul11l1tanooll that It: Is dlfClcult
or Imposslblo to dotermlno who dlod flrst, shall bo doomod to havo prodecensed
such boneflclal')',
ITEM IX, If at nny tlmo any 1111nor chlld shall be entitled
to recelvo any assetll horeundor, DAUPHIN DEPOSIT TRUST COMPANY, Hal'rls-
burg, Ponnsylvanla, IIha11 nct as Guardian of t:Iw assotll payablo to 8uoh chUd.
Said Guardlnn may recolve and administer nll allHots authorized by law and shall
have full authorlt:y to UIIO such assets, both principal and Incol11o, In any manner
said Guardian shall doom advisable fa)' tho bost jntet'osts of such chlld, Including
college, unlvorlllty, POllt-,graduato 01' othor oducatlon, without lIecurlng court
order. Said Guardian IIha11 havo all the rights and prlvllegollall to the Guardlan-
shlp(s) and the assets theroof as aro heroin granted to my ElCecutor(s) and
Trustee as to my Estate and Trullts and the aSlletll therein.
ITEM XI If I predecease my hUllband, RICHARD E.
JORDAN, I heroby nomlnnto, conlltltuto and appoint him to bo my r~lCocutor. If
I do not Pl'edecoase my said husband, 1 hereby nomlnnto, constitute and appoint
my lion, RICHARD E. JORDAN, II, and the DAUPHIN DEPOSIT TRUST COM-
PANY, or tho lIurvlvor,to bo my ElCocutor(II). My ElCOCUtol'(sl, Trustee and
Guardian speclflcally are rellevod from the duty a)' obligation of flllng nny bond
or other lIecurlty.
IN WITNESS WHEREOF, 1 have set 'my J~and and sed to this my
Page 9 of 10 pagos.
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OATH OF SUBSCRIBING WITNESS
COMMONWgAL'l'H Ol~ PI':NNSYLV ANIA !
HH:
COUNTY 0)" CLJMBlmLAND
'PhlH..." It...' ....."t" ~ ~,~,~ It' "..""""" ,,,,.,.... jt' '"'',' ...., dny of..... "' ,"" II.." ,,,.,,"~~,~~.,...,,,,. "" ..:...",..". A-,ll., 19.7,~"",
hofOl'o 11I1' Hichlll'd 1':. Andlll'slln, HogIstm' I'llI' Lho P,'obnLtl llf Wills IInd grunting ltltLot'A of AdmlnlALl'lIUon
in IInd fhl' suld CounLy of Cumlml'lllnd, In tho CI)mmonwolIlLh llf I'llnnsylvllnill, )lol'sll/Hllly Cllmtl ,.............
,."..",." I r.~\l~" JJ...... Rl}.C?~~,fiI". ~.I;l,~, t ,~~ P. At,~1~" I~ "''''~ ~~.gn.",." t"".,...""""."",,""" ,..."",.",.",.."."".",..."",."... .,"
t.ho subscl'ihing wit.nossos Lo tho fhl'ogoing InsLl'Umont of wl'iting IlllI'pol.tlng Lo ho tho IlIst Will nnd
'I'ostumont of .... .1".1;1, t.,U,r;\~...~RJ.M).E;!. ..H.9.r.8,M..........,.,.,..... ,....,............... ..,.. DlluJd ?\~,<;lH.~.t "~'~""'''~ ~ .?}....,..
lute of .........I;I,ml'R.~!'!.~.., ?!.9.\'m.f!l.\1 ~R.I,..,.... ............ ........,........ ....,................... Cumhol'lllnd Count.y PII" docolIsod
who boing duly ...........,.....JiWR.+.O.............. IIccol'ding to IIIW, dIJ)lOSO IInd SIlY, thllt ..t;.\1!'1;y..,W~,t.!'1..................
prosont, und SIIW IInd hOlll'd tho testu.t.1i'J,lL..,......,.........., ...~.I;\,H+.~f.l...~!?H1:.~..:~.9.!;'~,~!'!.!..............,........
slJ{n, ROlli, publish, pronounco llnd doclul'o tho suid lnRtl'llll1onL ofwl'ltlng liS nnd fill' h..~;1;'.......... 'l'ostument
und LlIst Will, !lnd lit the timo of Sll dolnfl .....,....~!~.~....,............................w~\1\ of sound nnd dis\l(,sinJ{ mind
momol'Y und undol'Rtnnding, to tho bost of ............t!).<<il.~!;',......................knowlodfl(J, ohsol'vution und boliof'.
...............~."".,.,.........."...,,"" ""I( "b.,,'b'" b,furo """P~'~&~""'i.' "...r".......... ",/
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iii;.;..".': A.d,,;~., ..~;i.,.j:::::,....,.. ..":"."'.~.......
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA!
. 8S:
COUNTY OF CUMBERLAND ,
...,..........., '"''','' ".. 1"'" """""'" t.... II ..R~.Q.t\fth.c:\, ,}P, r". H.c?'h~.~n"",.,....,c,..,.,.,.,.; ...,: ,..." ,,', ,,,,,,...,, ,. II.." "'" .being duly
..."......"Il......lI+...~Wf?~nll.'n..'" Rays that as noarly us can bo usccrtulnod the Bald decodent ..,..".........0........
, ,.
... "............. ",....,...'.........'.Il j I"'" """",, .Mp,..~.~ .~.c?~" ,~.g ,~,~.n~., ,~~.;:~ ~.t:'.........,..",..... i..,. to"...,..,....,." ,.....,... .dio.d 01\
..,.."..!t.t.~,~'~.Y...t.......",...,..i..,tl. tho .,.....".,.,t~.~,~',....."".dny of tl".".,."..,.'.~~'~'~"'..'.'..'j",.+l.'.."". A.D" 1,9.7.~..,
at or about .....~Q't.~.Q,".....Il"....".."".. o'clock, ~..,M.
................ t t:?W~};.\\..,.. .... """""'" ,nndsuhAcrtbod th is
,) . . . ,~ . ,
tt(j{l.t/c.-t, '3d,Itv-,.
"'IIl,...,.,.,..."".,,,,,...'HH""," '.h."..."..".......""...........
Richard E. ~9
......,.........,.,'''~~.~h.."..,..''...,., day of .,.....,~.';1.n~"...., '
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19, 7.:L.~bOfOl'e ,I
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".....~i..,.., .., ,. ....c.~...~".""...."",,..,..,
Rich;~d E. Andol'son, Reglstor '
1;;9:;
OATH OF PERSONAL REPRESENTATIVE
COMMONWgAL'I'H ()f<'.PI'iNNHYLVANIA l
COlJN'I'Y (J)<' CUMBI<iHI.AND f HI-!:
Bofol'o 1ll0. tho Hl'uIHtol' Ihl' Ulll Pl'Ohnto of WIIIII nnd UI'untlnu or IA'Hol'H of AdmlnIHtl'lIt.lnn' In IInd 1'01'
tho County or Cumhol'llInd, pOI'Honully cunlll ,....JH.9.tl...!.r.p....\l1.......;J,!H.,~!W....,.,',..,....,.."......,",.......,.....,.....,....
who, holnu duly ..,.....fI.\~~h.r:\,........ do(jll..,.... dOPOH\1 und IIU.Y t1I/1t UH..........~~.'il.~!-!,tc;!!:........"..,...........,..,........
of tho 111111. Will und 'roRt/lmont of' ..,....,....l:1~.HM,~,..~.c;!~.~.~~...~~.I?,<;'!~.l,1.................,....,..........."".......decOIl!Kld
..........I:\I'!..,..".... will woll und tl'lIly IlllmlnlHtol' t1w UOOdH unci Chlltwlll, I'iUhtH /lnll cl'(ldttH of suld dOCOIlROd
according to I/lw. And IIIRO will dtllgontly cum ply wit.h thu Jll'UvlslonH uf t111l IlIw I'olntlng to 1'l'ansfol'
Inheritancos. ,..,.....$,WQX',O........ IInd suhscrlbod
beforo mo,
Richal'd E. Andorson, Register
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DECREE
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Be it remembered thnt on the .."......~.~.~~,..,.. day uf .......,............:=!.~~~..............,...., A. D.. 19,7.9..... t.hero
was probated and recorded the last Will and Testamont of .......~~~,.j..M,~...~.9.~.;.~~...'!.R.li'.~~!,l,..,................,
late of ..........ff,li\\1)l?c;'\~J:l...7:'R,\'o:n.~.Mr.....,..,.....".............., ClImborlnnd County. Pennsylvania. Deceased. Letters
.........:r.~fI.t~!\W.!\~,~~~'.......,.,,,...... wore grnnted to .,..~.~,~.~~.7.~,..~:..,.~~;t;.~~~.......,..........,............,...~'.. ..........
Witness my hand lmd official Sllal the day and .1'0111' IIful'osllld.
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Hichnrd 1<:, Anderson, Register.
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..;M:'"I_:7"'"'Ilq --. .-
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\1 'COMMONWBAl.TH OF PENN$VLVANlA
g;NO' J063298 OFFIOIAL RECEIPT . PE~~:~~~~~~~~~~~~~~NCE AND ESTATE TAX
II - ._n .. --,. .__~o,=c.=""~'~-","',~,,,. "
i RECEIVED ....~~~~~_~~_~~.~~~~_~~.~--=~~.~~_~~llIII'l'Y~.lX-
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,
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Il
'~ Fllo No,.__.Uooo1'~llDolo 01 DoUII~-l-:~?"?
Dolo 01 Poymonl "__~~U.!n.!1L.,1.9BO
...~--
- . -". -. ---
J .".,,_.~....
7'"
w:
r,orn R. I. Jol:ISlln
,.__-n.070._Rhoadi;"llnon ..
~J, n;L._~lCLJ1,._nTb1._.J:4_.m.\:
. 7a/l00~~~~~~~~~~~~~~~~~-
'VPfl1\llotlng Ponnloylvofll(1 Inherlloflcfl or
hlnlo Tox dllO from tho followIng ellulo:
__" dollnli
."-"- --_.--~--~.,.,---_.__..
Render. ot~' Atty..
? % Tm: Oil \
--~-_.- $--~._._----_.
__..~~rr.i.~~~.!..n..~....1710B
6(,4, lox on
~...._"'-------- $
I !)l,k In.: 011
$_____
$
t Nmllo of Doc.odonl
lIIIat.i14&_->>o11n.40dll\n
(It Tux 011 ~ $
[.Iole 10', Acl of
MoV 7, 1927 $
100AL ~ AX CREDIT $ '..72
LO$!i flv 0' porconlum 01 lox If
puid wllhln threo month. oller
dQlo of dculh $-
Plu. '"lore.1 01 Iho rUi. of
__%from______
10_______ $
10TAl AMOUNT PAID $ 96.72
(o"niy ________.~~~.____.______.._
Romorks:
M'AID OM ACCOUNTM
'ITl~ n [P [l.J] @ [iI rlTl~ 5 E A l
NOTE: Thl' "Iplllla'o Receipt to be rutalned 'ot Iud It purpo....
11j.. . , p '/
l.~ ( .~:~.no ~t~),~.6 t '-(4J
.-9~.t."~ ftf _111_
II.)
Received by
NOTE, III occlpllng ,.,. Itan,'" Inhefllanu lOK on fulur. ..101.., Ilrlor lolhe dllulh of the IIi.
Iflnon! ot l.no'11Ior venn, 01 1I'I'ldonud by Ihll ,,{olpl, II II l,"dflf'tood tho' Ihe ConwDnwlIollh 11'1011
nol bll p,educhd or prevented hom h.,ool'.r olll"lng oddltlon{11Inh.rllon~D In_ tit Ih. death 01 the
11111 'Inortl or lenunt for '1',0" when_ve, 11 appear. thut IU(1l oddlllllnul la~ may ~II hloolly dvo ond-
(01,.<111110 lor ony r8(UOII whottoev.',
~.- -.-_. ,-,_.. ---. ...--. .... . .---- -
... . '.___ .___ .___ __~ _,~~ _. .. _. _.. .._.~, ~_..~ .__u".. .__ __.. ..... ~.n
INSTRUCTIONS
To Insuro propor crodlt to your accou~t, tho name of tho ostato and file numbor should be
cloarly printed on tho chock or money order,
This dotermlnotlon and aasessment Is made In accordanco with Soctlan 421 and Soctlon 732
of tho Inhorltanco \lnd Estate Tax Act of 1961, 72 P.S. 2485-421, 732,
Tho ostato tax Imposod by Section 421 Is due at the dolo of tho docadont's death but shall
not bocomo dollnquent until tho expiration of olghtcon (18) months of tor c1ocedonl's doath proYlded
that any estate tax occaslonod by 0 final chango In Iho Fodoral roturn or of tho tax duo thoroon
shall not bocome dollnquont until tho oxplrotl\ln of one (1) monlh of tor tho parson lIablo to pay
tho tax rocolvos final notico lIf the Increaso, Calculato Interost from tho dollnquont dato shown
on the faco of this form to tho dato of payment using Iho fallowing Intorest lab'al
-----------------------------------------------------------------------------------
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months ,040 11 months ,055
3 mon ths .015 6 months .030 9 monl hs ,045 12 months .060
--_........._._._-_._~_._..-._--_...._._-
1 day .00017 11 doys ,00186 21 days .00352
2 days .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 dny s .00386
4 days .00068 14 days ,00237 24 do y s .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .00118 17 days ,00284 27 days .00454
8 do y s .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00318 'l!J days .00488
10 dop .00169 20 days .00335 30 days .00500
,--- ------ --- ---- ------------- --- -- ----,...--.... --- ------.... -.-- --.....- ------ ------ ----. ....----.....
Any party In Interost, Incluail\g the Coml11onwoalth and the porsonal representatlvo, not
satisfied with thll assossmant may obloct thoro to within sl"ty (60) days aftor rocolpt of this
notice as provided by Soctlon 1001 of tho Inhorltanco and Estato Tax Act of 1961 (72 P.S.
5 2485-1001) ,
Mako check ,or monoy ardor payable tOI
"Reglstor of Wills, Agont"
Moll to the oddross IIstod belowl
6/27/79
7/5/79
8/22/79
10/11/79
10/26/79
11/19/79
1/2/80
1/4/80
1/4/80
1/4/80
2/28/80
4/28/80
5/22/80
7/5/80
G/ll/80
6/20/79
2/28/80
" ',I
S'.I,^,l'R~I1,:N'l' OJ." 1\CCOUN'l' (JIo' Cl\Llll 1"UNDB Hl~Cf::[VEP
?lND 'IHBlll.1Hfllm BY rnc,'lI^ l~n ro:. ,IOnnl\N, l':xmCUTOR,
UNl)mJ:~ 'J'lII~ WH,T., OJ<' ~1^,,'.I1:,Il^ nOr,INJI: Jonlll\N
CASH RU:CEIPTS
-,
Haraao (Dividend)
Dauphin Deposit Corp. (Dividend)
Unrsco (Dividend)
I'lhite Consolo (Bond Int.)
Dauphin Deposit COrP. (Dividend)
IlCUBCO (Divi.dl;md)
\'1heeling-Pittsburgh (Dividend)
Dauphin Deposit Corp. (Dividend)
Dauphin Deposit Corp. (Dividend)
Dauphin Deposit Corp. (Dividend)
Ilarsao (Dividend)
\'1hite Consolo (Dond Tnt.)
Harsdo (Dividend)
Dauphin Deposit Corp. (Dividend)
Total Income
$ 259.G5
3.55.65
259.65
22.00
lG9.00
259.65
110.00
169.80
169.80
169.80
288.50
22.00
288.50
169.80,
$ 2,522.60
Received from Mutual Benefit Life
~nBUranoe Company, aD oash
'f3urr~nder value of POli~lY
No. 6206253, 3l..Ji33.78. "
TO'l'AL CASH 'HECEIPTS
CI\SH D1.flBURSEI1ENTS
~
Myers-Hall' Funeral Home
PennsYlv~n~a Inheritance Ta~
Rhoads, Sinon & Hendershot -
Counsel for Executor
'l'O',['1\L Cl\SH DISBURSI~141~NTS
CI\SHJ3l1LI\NCE
$34,156.38
$ 2,060.00
,4,911.23
2,OOO.0...Q,
9,772.03
. ,
'$24,384.35
",./) l(D "
._~..-"-t0..!L\,~~ ,I tl~....:';.i'f.~f{a.~.... ..__ '
'IUchl\l:q I~. d6r,(~~ I EXGlcutor, undClr
t:hl'l 'I'in of: t,luC:tJ.clCl Bolit,1e Jordan
. , " 2/25/('.0
011 - '7Cf- ~3(c.1
\i..~." ; 1-..I.;J.RJ7j,)
D IS C l.::iI ME It
TOI RICHARD E. JORDAN. Executor of the
Estate of Matilda Dollne Jordan
TOI ORPHANS' COURT DIVISION OF CUMBERLAND COUNTY,
PENNSYLVANIA
t, RICHARD E, JORDAN, of the Township of Hampden, Cumbel'.
land County, Pennsylvania, do hereby unequlvoca1ly, completelYI Irrevocably and
unqualifiedly disclaim and refuse to accept any ane1 a1l present and future vested
and contingent l'lghts to, ownership In, title to and Interest In any property, rell1,
personal and mixed, to which I am 01' may now, or hereaCter, have or be entitled
to under ITEM IV of the Last Will and Testament of my \Vlfe, Matilda Boline
Jordan, dated August 29, 1973, which ITEM IV statesl
".lTE M IV, If I predecea se my husband, RICHARD E.
JORDAN, I give, devise and bequeath unto him all of the rest,
resl<;lue and remainder of my property, real, personal and mlxed,
not disposed of in the preceding portions of this Will."
My said wife died on June 1, 1979.
It Is my intention that this instrument conform to the provisions of
Sections 2045 and 2518 of the Internal Revenue Code of 1954, as amended, and of
Chapter 62 of the Pennsylvania Probate, Fstates and Fiduciaries Code, as
amended. t, therefore I direct that this Instrument be Interpreted, construed and
enforced In accordance with said Intentlon.
IN WITNESS WHERFOF, I, Rlchal'd F. Jordan, have hereunto set
my hand'and seal, Intending to be legally bound, this )7ti day of February, 1980.
" ) I!.-r () .I
'~~l( ttl.1,d, c. ~i((/(.t.......
Richard 17~/Jordan
(SEAL)
RFClrtVF~D thlsJ1"<:' day of
February, 1980,
"lV If! '(' t.
:..i (Lttt ' ,~.:'(,.
RlchardF. Jo.r ani Executor of
the Estate of aHlda Boline Jo.rdan
RE CE IVE D thl s ...:- \" rla y of
February, 1980
~~,p.(.. ~R Q..<-
Clerk of the Orphans' C J't DI islo.
o.f Cumberland County, Pennsylvania
COMMONWUALTH OF PENNSYLVANIA
COUNTY OF ~BERL"Nb\'''''''i~\..~~-
Iqq.!ARP IC uT.Qtl.I)A N . .. .. "~m_"'m..,..+_,
b~lng duly . .SW01'n .. ~ccordlng to I~w, d(lp(l~"1 "n\1 I"y' thot hn., Rlchl\J..tl E..,.JQrdl\f~.
.:V;xocutor ... ._ ,.. ..'. '., , of tllu I1lhto of ,,,Matlld/.l..l301ltlo4oJJ,don-.......__,..........__
1~lu of 675 St. Johns Dl'lvo" Cf1mp 1-1111, ' ., CumburlMld County, Po., doooand and thollhu
within II M Invontnry modn by..., ,.lUcbllrd..E..,J,O.r.dllll,., ....__ ......._........_.._, tho lold......,EXttCutur,__,.~.._.
of II", \lnllro oltato 01 lold dooudont, cun~htln9 011111 tho po"onol prop,orly "nd ro/,I 0.1010, ""copt roal Ulhlo oulll<lo
Iho Communwo.lth 01 Pnnnlylvanla, Ilnd thaI 111/1 II<Jurol oppolllo ooeh Itom 01 tho Invontury ropronnt 1/'1 lair. ynluo
," <'If II", doto ~I ""codont'l d"lllh.
&II
'&. .....,,,.~- ._,____ and lublcrlbod boloru m",
,(\.<> / 'Lt7 / '
+'(>/L'n,,'l.t( 'yAh..t'-tl.v_
.....<'h...__U_ .._.._ _..__.... ..~..-......r'.._._'_..._H........_..-;._~_.._'.., _.._.~
~..t\!Io"!, lIt<llllllllltlxMK
Richard ~/ Jllt'dan
.6.7.5_S.t L.:J-eh.nS, DrlY.o__, _.'...__.._ _.~,___...._
-,
..:.:P.::..,.;"",,_A" 'I~""" .'-.~(&..5s.::"''''bl,-,~;,,*,19.IL<L-
(, ('" " \.J
~~~_~'1'~"'--'-"'-a.u-_____,__, ' ' .
f/OTARY ~uul.lo. Ilnrrlo'IJllrp" P~lJllllln CUll Pu,
Mv Comm',,'on ~x"lr09 M9Y 11, 1081
,Q.t\.mp.,IiiU... .&nn.a..y..l.v.ll.nl.1.I_.J.1..Q.1L.__.:....._......
IIddtlll
Date 01 O.alh ,-___---...l__"...__.___.._,.._._...__.1..l.\W_.~_.._____._,__1.9.12__.......:......____.__.
Diy ,f,1o,nlll ' Y.',
INSTRUC:TIOHS
,I. An Inventory mUlt bo IIIod within Ihree monlh. after ~PPQlntmont 01 purlC)n~1 reprolenletlvt,
2. A .upplement Invontory mUll b. IlIod within thIrty daYI 01 dllcovory 01 ~ddltlonal assoh.
3. Addltlonallheels may boet/ached III io purlon.lty or roally
4. See ArllololV, Flducl.rlol Aot of 1949.
.
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APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDEtH DECEDENT
'*'
COMl.\OWHfp \'1 II OF I'OHlSYlV^NI^
llEf'^lnMlNl OF I~EVrI'HJE
UlJHEAU OF COUNTY COl.LECTIONS
... --....-
DATL ~:/JL'i/1:!.'.. .---
IlPPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Appllcutlon Is horeby mode lor ClXlsent 10 the trons/or 0/ tho following securities 0/ a Ponnsylvanla
Corporation Or a Notlanal Bonking Assoclallon located In Pennsylyonlo:
Duuphin D"l'oHll '.I't'UBI Company
(0)..,.Z.B3...,.....JbLJnow Dllllphin D''l'OHit Corporation). ._ .,...._.(C).~..I'I.1'.!'.l~>n.!~!'.'~'!~___.__._.
(NOTE: In dascrlblng socurltles on tor In (0), ob Ole, olthor tho numbor (l/ shores 0/ slock or the lace amount (l/
rugistorod bonds, In (b), tho name 0/ the Issuing compony ond In (c) the class 0/ stock Or the staled Interest rate
Qnd mqturltr doto qf registered bonds)
(,/I0!71( 2); 7/12f72(57); 9/1ll/72(i,j;10/20/72(l); 11/27/72(100); 4/18/75(14); and 11/4/7('(93)
ISSUED ON ___. .8'\",.11 b[)Vll n.._' and having a TOTAL MARKET V AWE OF $ 8,4')O__....__..__n_
(Dot.)
os 0/ the do to 0/ dooth of the decedol1tr
Matilda n. ,lordan on
.--------_...._~---.._-- ,
(Hume of Decedont)
.Tun~ 1979
(Dot. of d.oth)
who wos late 0/.J']'Lf3t",Tohn' f:lJ~l'i'{llL.G.L\.!1.:U~_J!ill, g\ll.n.l!oX!l\!\fl._E..~__..,_..__._._,_...___._._
(St,..1 and Numb.1) (Po.IOlli") (County) (Stot.)
The securities are reglstorod os /ollows: .__.......
---- .----------_..._~--~.__.-------_._-
(Nomo Of n{lmOI In which cOftlflcatGl are regllto,"d)
ADM I N I STRA TOR))__....~!"ll~~~~JS-.J..'.'l'd~l2...........- (~72S,t.. Joh n'.fl.D.!'i~'~Lgnm E..,H i.!!LP A .J19_!.L_
EXECUTOR (Nom.) (Add,...)
NAME OF APPLICANT." ,)Uch~l:(I.r~.}21'tlan.
COUNTY FILE NUMBER.1L-...79:..J.U..7..- ADDRESS OF APPLICANT('15__S.t._J~mi.Jl...DtiY.Q......c.illl1.1Lllill.- PA
L' , ' ! 17011
BUREAU FILE NUMBER.-- "......_..___SIGNA TURE OF APPLlCANL..... U {~!,(.:.~ix!..J.'.
~OTICE, IF YOU PAIL TO PROPERLY FILL I~ A~Y PORTIO~ OF THIS APPLICATION, IT WILL NOT BE
CO~SIPERED COMPLETE A~D WILL BE RETUR~ED TO YOU FOR COMPLET10~,
..., .-..--... _._--_.__.~~...__...- . -. _.._-~ -....-...-----
,
-_._......._-----_..._.._~-~-_..-..-~--------'
_____...._.___~_._..___._......_~_.___.~____.__.J
.u'. _n.____..__...___. __ _____. .__._.._.....H_
COMMONWEAL.TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES
___..___.n ,. nn.".."" m..___~ D^TE~4oJ.:z.'J.'.,.,--
I hereby consent to the trans/or of tho obovo socuritios now roglstored In the nal11e 0/ the aforesaid
Decedent and wolye tho /illng 0/ a certl/lcato carti/ylng to the paymont 0/ the transfer Inheritance tox to which
the property of sold Decodonl Is made subloct pursuant to tho provisions 0/ tho Act 0/ June 20, 1919, P.L, S21,
os amended and tho Act of Juno 15, 1961, P,L. 373, as amondod, This Is ulso In accordance wllh the provisions
0/ tho Act of April 9, 1929, P.L. 343,
This Consent to Trans/er the heroin doscrlbod property oporatos unly In re/eronce to the estate 0/ the
obove.nomed Decodent,
~.'
Wb
Signed lor the Socretary 0/ Revenue
By-1l1L,'w.......Jlu.J) , "
( .. (Slonot"") J
k(fLJ~ Kt Q......,L, I') L~ulL, ,. t ilIHL,...,J'v."f
IT~'I.) ,] l (Co"nty)
C(P~'\'~t,'I'; 'l':,-I OF !'0h'ISYLVANi^
I) I: f' :, ,.; T ,'1\.~ >,) 'f :l ~ '\ f: '/ E t~ U (!
1I111lE^tJ 01' COI'NTV COLLLCTlON!
APPLICATION f()f~ AHD CONSEHT
TO THANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
,*.'~'
" (\
" ,
I
""0'; TE '=--;'-;:, 'I iJ~;' _._~~._....
~PPLlCATI01! (MUST BE FILED IN TRIPL.ICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is horoby made far coosant to the transfor of tho followlny securities of a Ponnsylvanla
Corporotlon or a National Banking Assoclollon locoted In Ponnsylvanlu:
(a L~ J ! B_ __...(b) ._WJ}.(\.o..ul~ g...Vl.t~ ,!1)t!l~IL~ to-,,!. 9 '>l: TICl .r.aqc>I~__.__.o_ (c) s.c>!nmOjL.!l tocL____
(t~OTE: In describing securltlas enter In (a), ab Ole, elthor tho nlJl11ber of shares of stock or the face omount of
registered bands, In (b), the name of the Issuing company ond In (c) the class of stack (lr the stated Interest rote
and maturlt{ dote (If roglstered bonds,)
3/?5/69( 00): and 3/25/('9(18)
ISSUED ON----1'...2.~-'-'!>.9...Y2.----, ond haying a TOTAL MARKET VAolUE OF $bllIL_"l5
(Do'.)
OS of the date of death of the decedent, Matl!paA_J~~!!~!)
(Nama (Jf Docodont)
, an
,Tune 1. 1979
(Do'' of d.o.h)
who was late of.67~..!?J:!_JohI~~E!...DrI~~..'.'l..mpl:li.!}.,,....g'-1.1J11~~..rla...n~'pA
(S.,... and Numb.r) (POI' Office) (County)
(5'0")
The securities are registered as follows:
(Numu 0' ntlmes In which co,tlflcatu are ,aglltftr,d)
-.....-----'~_.-
ADMINISTRATOR) Richard E, Jordan
EXECUTOR) (Nom.)
675 pt,-..!.()!.l!,~~_DriY!:._..Ql~P J-lIlJ.....E.A
(Add,...)
NAME OF APPLICANT _...--!~lS.hal~~l E;._ Jordan
17011
;;
COUNTY FILE NUMBER__1.L::...19- 321- ADDRESS OF APPLlCANT67,? St. John.' 9 Drivo~..Q!1m..E._!-II1l..... PA
'! " (/, 17011
BUREAU FILE NUMBER_____SIGNATURE OF APPLICANT. /._.:.._~'::'i(i "((/(1".
HOTICE: IF YOU FAIL TO PROPERLY FILL IH AHY PORTIOH OF THIS APPLICATIOH, IT WILL NOT BE
COHSIDERED COMPLETE AHD WILL BE RETURNED TO YOU FOR COMPLI!TIOH,
--~--,--------~-----------_.-._....__._-----_.
__...___~__._,._.~______.___._.__.~__.~-~---_..-----,..0- -....--.---
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES '
.. --.-.----0- DATE (\)I,~I".>,/'lb',)
I hereby consent to the transfer of the aboye securities now registered In the n(lme of the ~foresald
Decedent and wolve the filing 01 0 corllflc(lte certifying to the poyment of the transfer Inheritance tax to which
the property of sold Decodentls made sublect pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
os amonded and the Act of June 15, 1961, P.L. 373, us 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 aperotes only In reference to the estote of the
obove.nllmed Decodenl.
~~J~~
~I, ,\
."'1 .'''.'.'
:'of, "'4tJ'"
1.);:1'....;
Signed fer tho Secrotary of Revenue
/)1'" J) '~'i!
By-1J.!.i' l~\..._LJ~1.cd'
~ (Sl~nattl'o)~.
(', I II i [,I C'\ 'I \ I
I ill I l ~ J\ rll'l.';"\' . ~i.,L'\_,D" .. ,.ll.'lIl~U..L1.~~n
I (,,111..) ,) " (Co,n'y)
"
"",11"- .rJJ 1,131
.
(f ,(, ~() ,~< I .I )(l;
COMMONWEALTII OF PENNSYL V A.NIA
llEPMTMENT OF IlEVENUE
lllllW,\U OF COUNTY COLLECTIONS
',{,' I
-~-
'~.~
ngSIDe~T DeCEDe~T
~\JPPI ,TGM 1'~N'~~,
COUNTY OF ,.c;JJMJ.I]!:ill-,A !i!.?_,_
TM"FJO-R"TAHTI --- Ttlj;"r~l~;~n ~;'~~l-hu ~;m;j)'it'lt'~I'i-n "t'11I11 IIlld (i'll-;d' i,~ :lt~I';II~.'I~I~.':"wllh uii '~~t'~;~;I;~,~i',. ,~-ilw -'li~'l~~~I-~;-;~'r-\VIII~'--~ith~' .-.. ='"'
Cuunly whore deocdllnt rt.\tihllldj It"lllrn iH dlltl wllhllllllln\ monthH urWr dlilO IIf (llqlth, tmlllfoiH 1111 IIJ(tulHdun iN lUlllHud
h)' thu Sl'llrlllury tlf I\u\lttlluc. (SCCtlllll 70;\ uf 'hll '"Il('rllUIU~lJ Ollt! EtHnltl Tn" ^Cl (If ICJ61.)
~~ -,,-.~-- .-, -',-'~-"~-" -- .-
_. ~ ~. ....
.--,-.--
n
~ .~
- ~ . "1- "_.'~"-.-'--'--.,
IN TIll! MATTt-:il OF TilE ES'IWI'E Oi' } AI'FJIlAVIT OF
m.__..-.,Mal:ildu lIollllll .T"J.:dall__._____.__~_____. EXIWIITOIt
(rr~TR P,lILl. tLAMH Ofo'IIlJ(CLWFNTI
T- amp' on l'owne up
Lot. of __Ql.Ul.lWJ!!.!ld _____~__ County All,IIINIS1'[lATIlIt
Stat. of
Pnnnflylvnni~l
Cumbo:rland
') ",
County of
.IUCHAHD IG. .lOHDAN F.,ooulor
Adlulnilllrlltm ---~"f7h-;-;;~;;;:T;h;.~;~d.lI'-d.~-"'lno duly IWClln, dopo.. and .ay
UCltledt'llt (lIud _ .Tuno _ t 19~12-{t..tol. lea vine (t lOll will, copy Q' which I, h.,.to attac:hlrd. )
(MONTHl (DAY) (Vl!ARI Intutate
~'m. ,nd addr... ,f '!I''''y" } Pa..!!.!J..!LB!1<HldS, Hhllads, Sinon & Hendcrshot, 4.!..2.. North
oth.r Quthorllfld ,epru.nla'lv. 10 wham
.11 .o"..pondono. .hould h. m,lI.d, Third Sl:rool:. llarl'isburg, Pennsylvania 17101
ThaI II. .ueh Exocutol' doponenll. fumlllllr wllh Iho o(fnlr. of .nld 0"11110 and Iho p"'porly OOU'lltollnll
I EXIiCUTOH.MlMINln ffA TO AI
Ihc 1I..0Is Ihoroof nnd Iholr flllr Inllrkol vnluo,
Thai ollho t11110 of dooll. Ihoro WIIS no ollfo dopo.11 bo. relll.lorod In dooodonl'o IndlvldulIl nil III 0 , or Jointly Wllh, or
a" otonl or dopuly of nllolhor, or In doeodonl'. Indlvidllnlnollle, wllh right of noco.. hy IInolhor liS "l1onl or dopulY, wllh Iho
oxcepllon of Iho following: -
=-..-
.~'~--~_'~-n.=~~====,",.=~=-< -;:::.-.c-==",-",,=-"
.=~
-=-=-
--
-
NAMP. AND A,UORP.Sfi OF nANK OR oTtlE~n INSTITUTION
IN WHICH DECEDENT Rl!NTHD A B.~FF! OF.f>O~UT BOX
--=-"'l'r~N ---"-......-..
J~
THIS SAru OEPOSIT DOl< n~NTgD
--.!~..~.~,~H! 0 N N AM IHi 0'"
REl....TIONSHIP Of" JOINT
"OLDERS TO Df':cf'-OP.NT
.-
~== -_.''-'-
~
ThAI Ihc conlenls of snld safo deposll hox or hoxo" are Ileml7.cd nnder Sohednle._
with Ihe oxcepllon'of Ihe follllwlng, for tho roooono hOl'olnllflor sol forth:
of Ihls rOlllrn,
ThaI S./,.clut. A ouaehod hcrelo IIl1d mlll!O pllll hereof .lIl. forlh flllly nnd In dol811 all Ihu roal proporly
In Ihc COlllmonlYeollh of I'onnsylvllnln of which docodonl diod hllvlng nn Inlorool Iheroln. It IIlso .ot8 forlh lhc
morlll080 cncnmhtllncos IIpon ollch pllrcol of rool pl"Ol'erly 01 Ihe dnle of delllh, ulvlnll Iho nmollnl ./111 duo 01
dcolh, nllmo of 1II01lS08eO, dnte, rlllo llf Inleresl, IInd hook and page of recnrd Ihoreof. It 0100 001. forth In the
colomns provldod Ihorefore Iho oo.,,,soll vahlillinn of olloh of "nld parcels, the lIotlmllted mllrkol vIIIllO thoreof
110 of dale of doolh of decedenl,
Tho I S.h.dot. B nUnc hod horoln IInd ""Hlo pllll horool' 001. fmlh fnlll' 11",1 In ,101011 1111 pcrsoll.lllroperty
whort,"o\'ol' .II\1aled ownod hy Iho .Ieeodllnl al Ihe lilile of denth; 1111 moneys Idl hl' Iho doc.donllll Ihe IllIIe of
dCllth, whether 111 deeeclent's Imllwdllltu pusStJSSiOll, slnndlllg 10 decedent's credil ill ImllkH of ueposit, savings
hRnks, (rust compnnltl!4, nr other llllltltllllllllH1 wlllqhcr Indlvlllunlly, or in Irust for OilY olher person ur pr.rSOIlK
giving "Iso scpllrululy Iho llccrllcd Inlerust Iht1rl!lll1, If uny. down (0 Ihe lust Interesl duy prim to dc~ccdcll,t~
<Ienth In the cnso IIf Rllvln~s hnnk!'!! unelln the daft' of t1l\(Jl\llt!ntt", elclltlt In nil olher CIHiCSj nil hnlld~, pn~tl\1
Si\\'ill(.tS, trunsury corllflclllcs or ll(ltl'~ nud IlthL'!' cvidl'llce III' ilHlcbtcdncSH (If the United SWtCK to the d(l~
ccdcntj nil nhllgnllolls, whether by Sllltlltc or ,IHll'l:Il1Cllt the)' llre dcsigllnlcd n~ lilX hel!! (If thc United Stutes,
or llllY slllte, or 1101l1lcnl suhlllvision Ihl'fl!of, or or un)' fOHl1gll cnltnlry, which Uft! owned Itt the time of dl'I\lh;
nil \\l'IHlng llpparl~l! Jcwulry, sll\'crWIII'I~, pil'l\Il'l'~, books, works of lH1t "lIl1~CII(lld furniture, hlH~lH', l.'IHrlllItt.:!t,
llulflllHlhllcs, hoats, ami lIny lIull nil lIllwr 1l\~ISllllUl cllillhds tlf wllllt.'i(J~'vcr, kint! or Illllmc, left hy dcCtuJenl,
III1!cll1l'r with tlw fnirly c'ilimatcd markel VHIIIl'- Ihl.'l'cuf; nil hUlld\; ami I1Htrtgllgl~S ludd hy decedent nnd of nil
Clllllllti title nnd owlnu dceoill!!!t lit tht' time or d(~nlh, nllll nil promlssor)' tlotcs tH (II her II1!-ilrlll1lcllls In wrltino
for the paymunt of Illoney ot' wllil~h dl!ec(h!l\t died possessed, of WllAtsollV(:r nntuw, with futeresl thereun, If
lillY, "IvIIlH Iho (11"" 1'1111111 IIl1d O.tillllllell flllr mllrk"l VAllie Iheroof, and If su.h o'llnllllud flllr lllllrkol valli. ho
less Ihnn tho flletl vnlllo, II IUltS forth hrlul'ly the rOf1!o1l1ns for Hueh dcprccintiulI us to cnch Illllllj all moneys
l'lIynhl" to tho cstlllt! fwm IIfu IIIJillfl1lll.:11 policies curried hy dC(lCdcnl; nil nnnulty nnd CndUWlIll1nt CtHllfltOIS
tIll! prlHH.'l'<IJi of which \\-'(!rll pUYl\hll! upun t11ll dt!lllllllf tho deel'llt'lIl; nil II lid Ihl' (~tlrplJfnh~ stocks llnd dlvld(!nds
dlle Ihcl'cfln und t1nlHlitl Uti of the tin Ie of dl"ilth, honds nful lICl'fllcd InllHcHt llllHOOI1 tn thll duto of eh:cCUtllll'!'>
dt'lIlh IIlld nther In\'l'stmtlnl sN'mltll's pwrH'1I hy lhl' ,kecdel1l III the time uf dU/llh, wllh the mnrk~1 "nlllu thuu-
(lr 1I t Hlwh lime.
;
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CO Vl ~ ~ ~ i
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i I g ~ w ~
i Q ~
~ SiJ 8 ~
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Ilf.KlOt:S'I' m:ut;UEN'I'
COMMONWEAlTH OF PENNSYlV^NI^
OEP^RTMENT OF REVI:NUE
BURE^U OF COUNTY CO\.LECTIONS
COliN')'\' (W
*
"
Iturm nee-nu
CUMIlElll..^ND
IM11(H\"'A"NTl '1'111" I'IIIHI'II till I" " hi' f\nl1lpl11lfl1t !1I11t1l-utl IIIHt l'lllll' t~l1i1lt\III,t11 with ,,-Ill IIltl\llhtltll 'With lill\
HtlKtNl.lll' cd' Wlllti fll' Ih" rnlllll~' wtllll'l\ ,t"I'IlIItl/11 1"'t1ldntll Hotlll'n IH 11111\ wll.hln nUll ynnr "nnl'
111t1.11 01' tlilltth, IIl1h\HK nil ,,,(11111,..1011 Iii p;l'lIllltld \Iv tllll SIH'I'411ill'~' ul' !\1l\,UlI\lIl. (Hllt'tluIl7UII of'
11m IlIh4l1'It.Ulllltl Hud 1';HIIII.lI Till( AI'1 cd' 111111.1
---_.._-_._-------_._~-~........-._-
IN 'fn..: MA'rTIo:n nt' 'l'I"~ F.H'I'A'I'.~ (n'
Mutlldn
}\\lII11O ,[lll'rllIl1
IHtalo 'ull "IIlIn HI tl""f"l\rllU
JIll 1ll1)dt'11 TUWIlllhip
Cum HII' IInd
Pt'nnaylvaJl In
'}M'...IllAVI'I'11t'
f.Xt:Clll'nll
AIlMIlIKll'",^,'G1l
CeWl\,
I..le .r
"mm~lI'X
of thtl f\Mlat, or 'hr.
J"I
RICllARD E. JOIUJ^N
Abovtl-n;'nll'd dl'cedr.nl hl'IIIJ dUly Hwurn, dtlJlo.tI Ii
~lor
HIlII. nr
(~oun')' at
Cumht't'l!lIld
~lld II' n
J)..r..,d~nl dltd
.TIIlHi
1\I"MIII
1
o~~ I
,19 79 ,j 1l'IIIlltl 1t'llYIl1l1 II I..t 'dHI i'lillf (If "hl{'h I. hu.," Ilu.chlll, }
"'",,) I ;,'It\..of.'\!''
Rhoadn, ltllllada, Hino;l I\, Ht'IHlul'fllwt, 410 Nnl'th
Nlm. Ami r,lliluu lit Iltlorn1f or}
fllllIlI Rtlthnllltlll rt'IlIIJnnhtlY, to
~h(!m "II l:olrl"llfll"lnl\~1' ,tlnlllll II"
m/lllcrtl,
Pllul H.
Third Stl'1I0t, 11"I'I'11Ihu1'11, PI\lmaylvlIlIll\ 17101
'I'hat UlI 1I1u'h ....,E.:l>Il,C,U.tp.l~........,..,,'''''' dlJlHl1\llllt IH familiar wllh till' ufTuh'H (If Hllhl I'ntllll, Ilnd t.Ile IlrOpllrt;.- con.
II;Hl'lIlllr,!t.llmiIlIRlllllllr)
H1.I11IlllIl( t.hlJ IlHHllt.>> t.lwrl1of alld IIw11' filii' IIlI\l'KI1t valtll',
'I'hllt Ilt tho lIml' uf dl1llth lltl'I'I1 Willi au Hllfl1 dl1pOllil llllx l'I1nlllh'I','d In dl',',"II1nl'H Indll'ldlllll nllnw, III' jolntl~'
wllh, 01' IlH uK'nlt 01' dl1IHll;.- of ullnthlll', <II' III d"I111,It'nt'n indll'idlllllllUnll', with l'll(ht of """""" hy nnot,het' 1I1IIIKllllt
ur dl1puty, wllh t11l1 IIx,",pllun uf IIw fullowlllK :-...
NAMY. ANIl AnnR~flR 0'" IlANI< OR OTllY.R INSTITUTION
.~Lt-!..!I!,r:~t._~~'YlJt:Nr NP.NTF.1l A RM'V, IH!.I'lHHT nox
_...._...NONE....-....--...-----.,....--'..---.-.........-'....--
TiltS tL-.H np.l'ofHT IK)X RI'.N1'fW
IN NAME OR NAMF.A Ot'
MRI.ATIOH811lI' 0.' JOINT
1I00,UJtRR TO nK{'IW"NT
___._"___." ___.u._____
--- - ".-.--_._..._..~...__......_-
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fOt.Ufl1,
ThIll. 1.110 nun!,nl\(,M or' Ruld Ruff' dopoRt t,
wi t.h t.ho OX(~nlI1,lnn () f' I,hn 1'(l11owh'AI f'ur
"UX nr hUXtlH nrn t t.flmI1,0l1 tulliol' 90hollll108
t.tln rflnHonH hnrul1ll1f'Lur Hnt furt.hl
fir t.hlft
Thl\t, Schpdu/f' ..1 nt.l,nohod hnrot.n tlllll mnlhl 11/11'1. hUI'(IOr HIl!.H f'orth 'fully f\llll In dotail ,,11 (.lIe
runl Ilrul'orty 111 t,h~ CUl1unnnwonlt.h HI' POl\I1HylVHIl1n ot' whit'll dlllllldnnt dlflfl h"vlll~ /Ill 11ItnrnHt t.horo!". It
I\lfto Hflt,A t'll1't,1I tho morl.gllJl,fI nnnllmhrl\n~OK IIJlIIII ntlnh lllll'I1I'1 ul' r('nl prll)1I'l'ty 1\( lhn Itntn of' doftth, Ktving
thn nmullnt- Ht,lll (luo f\l. ,Iunt.h, 1ll\n1U of' 11Itll't~nKHO, Ilnto, 1'111,0 uf' '"t.n"tlHl, null hunk Illld pnK" nr rnoord
l.hnl'onf'. II. /llH/) HOUl f'ort.h Itl t.lln (lO]1ImI\8 pI'ov1clfHI t.hflrl~('nl'n tlll' tlHHHHH11I1 vnlUIIUun of' unnh uf Rnid
llnrl1111H, Uln- HHtllllltt,llfl mnrknt. vnlllll t.hllrl!llf IlH III' (1llto lit' ,ll1utl1 of' dlll'I'llul1t.
Thill. Scl'(ldulp 11 nU,Il(',IIIHt hl!I'id,() ,\",1 mnllo pllrl. l\nrl1l1f' HlltH f'ort.h "",)' "lid In Ilnt."11 all porf40l1ftl
1'I'(l)lnrt.y Wlll'I'IIHIIVil1' Hltllllt,llcl oWII'1I1 hy 1l1n Itn(Hllh"'t Ill, thl! Ilw' ot' 1,.1nUll ,," monnYH Il'f't. h~' t.hn Ilnilndnnt
lit. tit" tlmo nf' Ilonth, whu l,hll I' III dIWIHh'Ilt.'H Imllll'dtlltll pOMHIlHHlflll, HtnlltllllJl, t.n Iln(Wlt""t'H (!rIHItt. III hnnkll
lit' (I(lJluMlt., sl\vtnw, hunkH, t.rlIHt. l'lIlllllltlll11H, nr lltl!flr InHttt.IIllotlHI whl'thor Intltvtdlll\lly, nr In t.rHlllt, f'or
I\HY ol.hllr pnrllon (/1' PIlI'RUIIN J1.tVIIII!, f\lHO HflJlllrlll,fllY till' 11f'1!rl1HII 11Il.lll'f\1'it, t.hf\rflnn, If' 1\11)', ftown tu tlif! '''At
tut.nl'nfll. t1I1Y prior t.o dnnolhml.' H IllHlth III tlln l'Il,"W of' Hllyll1~H 1l/lllkH, "net 1.0 thl! dnt.fl HI' (hH'fH'ont.' H (IORt.h
'n 1111 nUlI' I' IHltHlRl 1\11 hnndH, IlllHttd HHVlllJ!.H, tl'llllHury ("'rt.lf'tllllt_I'S or lIotflt4 IlIlll oth"r nvtcll1l1on or In-
Ilnllt.ucll1nHH ClI' I.Illl 111111.1'11 Ht,nt,oR to ttlf! (1IIond"llt,1 fill llhllv,I,t.llll\HI whptllnr lIy Hlflllltn or Il~rflflmnl\t. thu,:!
HI'" .tmIIWlIll,IHl IlH t.IlX t'rfW, or UIIl till I 11'11 HI./ttl","" 01' 1111)' Hlllt.n, or pnllt.lfwl SlIlIl'IvlHlun t.hnrfH)r, ur ot'
nny l'orul.l1.lI nO\1Ill.l')', wldt1h 111'11 nWIl41I' Ill, thll j,ltlll' flf' 1\I'HIIlI fill wllflrlll~ 11I1pllr1ll, ,11'wl.1ry, Rll\,orwnrf1, ptl'-
t.\1fHH, hnnkH, workH 01' 1\1'1., !1f1IlHPt!1l111 1'111'1111111'11, l!flrIH'S. 1!/ll'rlnp,nH, Htlt.lIlllnhlll'H, hofltH, nlll' fill)' null "II
lIl,hlll' 11f'l'fWlIlIl nltlltl,l'IH 01' whnl.HO/lVIlI' kt!lllol' 1lllllll'P, lill'. "Yltc~el!(h!lll, 1.O~1/'I,hor with Ihn fltlrl)' 11HUmfltNI
1111l1'I<1l1, \'111111' t.hlll'fll"'1 lit I lllllllh. 111111 I1lill'I_J1;llcrf>H IInl!1 h~' IhH.ultlllll IUlII 1If' III I dl\tm!i Ihlll 1\1111 nwlnp; IhHlfHlnllt.
,It t.llll 1.1\1111 Ill' 1II"lI,II, lUll I 1111 J1"lInlIHHory llnlHH lIt' flt.lltll' InHIT't1Illf'lJlfi In wrtltll'~ f'Hr Ihn 1"\Y"'''lIt nf'mnllflY
01' wllldl IlnlHHllllll. (ltl'd POHHflSHIl(I. 1If' whnl.!wnVHI' lIUI,t1I'Il, wi III 1lllnrl!st 1 111\ 1'1HIII , I f' nll~', ~tytl1~ UH1 I'f\('!n
vllllln ul\ll I1H 1,1 11I11 t (!il 1'1111' mltl'kilt. Vllluf' thornnf', 111111 If' fHlCh .'Hllmlllllll "nil' 111/1 1')\11 t, vulll" 11(' InHM Uln" thn
f'11I~" vlllulI, 11- !HllK l'ol'lh hl'llll'ly t,ht' rllllfWllH t'or HIWI1 Ilppl'lH~IIlt.lflll IIH 10 nllnll tt.f!\II1 Hl1 mOllf.)'ti I'ny"hlo
t.o t.hn I!Hl.fd.ll I'rom lll'n IllHIII'/IlH'(l IlnllctOR I'nrl'tflll hy IhHwllnlltl fill 1l111ltlll,y 111111 f!Il,IIlWtnUl\t. ('olll.rncUt tho
J1"IHlI!IHls Ill' whlnll wllr" Ilfl)-'uhlt\ \11'011 t.llu IhlUl.h 01' tllfl ,ltl(~llClcll1ll Itlllt "" till' \'HlrlHlrntfl ",t.onk" nllll dtl,'tlhHI11R
rlllll I,llnrnnll /tllll IHIP/IHI flH of thll lllltll nl' Ihlllll" l.Ullc!K 111111 fll1(1rlllort lntl'l'flst thl'rllutl tn t.hf't ""tu of llnno-
It lIlli'S dnll tll IIl1fl nl,llllr t nvps tmnlll, !ipmlr ll.l OH lIWllI!l1 IIY tlln llflonllnnt. n. t, t,l1o U roo n l' IhlR tlh wi th tl1f' "IRrkot
vnlufI Ihlll'f!Ot' HI, HIWI! Umo.
Itl tilt} (11\80 n" HlllltH'lttoH of' olnKo or ""mll~' onrpnrnt.lnllK, Utn VlllwJR 'roIHlrt.IHI 1t1'U UK ('nr UN
IloHHthlo HuhMtullt,tnt.oll 11)' flllltllnlnl RI.IlI,flOllfl1hl !If ""n tJflrplIrut.llIIIH, Hhuwlllp, t,ho n"HlItH 1111I1 Illthlllt,loH
t ""rl1n I' ItR nf' thn tin 1,(1 (J f' IIUIl t.h. 1'hu H'1110Ih,lll n 1"0 Rill," f'flr'th f,hn III t.Ot'ORt. II t' !loBull!lll t- Ill, 1.1111 1.1 mn nl'
Ill'lllh III tlfl)' (Hl"'pnrt1l0rMllll1 ur hllK I 11011", IUlll III HIIIIJlorf. nf' tllfl "lllIlO clf' Ht!nh IlItut'l\Ht Ihnl'f1 1t4 Illtllo)(tlfl In
Kulll "(1I1ml" I Ii, "I'1I1I\(1lnl IItntll"'Ol1tH Rhmdn/J; tllflllMHnts "fill ltuhlllt.los nf' ""III ('n"l'lll'lllurHhlp or hIlHIIlIlHH!
A l'ufl~' IIr Uu' nll-pnt'tlUlI'Hhlp n~rllnmntlf" (If' urlll, n Htllt.nmflflt Hlltttll"" fUI'fh thll II/dlll'n 01' tho "~ri111I!ll)I\l.)
tnWlllllll' With fl Ntlltlllllllllt Hlltt lll~ f'ol'l.h ltlll Uhlll'ullt.nr or l,hn hll"llltlHH, It,H 1'H'fltloll, "Ilil HIWII otll\'r l'nlltH
pOI'lflllllllp, t,u t.hn hllHIIUlfilH IIH 'llllY 1111 l"ll'tlll""!' III n f'nir 111\11 .I1lMt Rl'llrnlHI\l of' IIIH IhHHlllnllt.'tt tUtlll'UHt
Ilull'lIl11 IlI11H!. IIn Hu1lnlltt"lt, It HhOllll1 niHil "'"I l'III'lh tl1 Itnmli'_IHt fnl'ln, t.c'AIIt.hnr with thn f'l\lt, IIl1ll'kot \'nlUll
I Illlr011 f', nil)' flUllll' (lrfJIllll'f)' OWllUd lit' hn'lllnlllhlld hy Ulfl fllllllHlnlll. nt tllIl t tllln fir d(lntlh
1'I\I! .1)(""d"l,. ( ul.t.f\llllll(( hUI'nt.H IlIIII '11/11111 IlIll't. hllrnllf' HIlt.H I'nrUI n I J'ur. III1HWI1I' tu Buuh tnllllll'~'
PUlllf\lllnd t.1I11rulll "11I11111.11.. I1RHn 0" tt'tHl""OrH f1f'PI'lIft"I''',\', rlllll 01' )InrrHJl1l11, wlthlll two ~'nllrH of' tlllClOltulltlH
dt~l\tll, In (lollt.lllnllltltlnll 0" Iluotlllpllt'H .Innth, III' IlIt.Hndud tu t.nk" of'''"nt lfl pOHMlIPHdnn Ill' 1Il1,111Ylllllllt nl, nI'
n"tlll' dtlnt,h, ~1I111 HflluIIllIln HOUt flll'l.h l.IlI' Jluturll /Il1d VUIIlIl or Hllllh proJl(ll'!,)', 10 wllum t.I'IlIII'1f'f.lrrncl, l.ht'
rl'll1t.lolIHhlp IIf' t.hn l.rnIlH"OI'''"M t.o Uw Ih~(Hllhlfll'l thlt pl'lIl'llrt.'nllllt.U Hllnru rflPIIJ\'flll h~' Illwll 11'llllHt'tlrnu nlltl
IiI 1 nf,tlllr f'(lfll,H nf' /I porl,lllf1llt ll11turn rflJ{llr,IIIIK Mnllt l.runMf'orH, 111 t,h" IlRHf! Ill' t"/t""f'nrfl tllt.nllllt,,1 1.0
l.f\k(1 II f'f'ont, JII IlnHHIUlMI CIII ur on.loymnnt. tit or ftf'tnr dont.h, thoro 1M nlHn flt.t,n('hfllt III t.tHI ftllhntllllll n flnllY
nf' t.hfl II'IUII, I.I'UHI. tlRrlllHnllllt nr ol.llt'r 'nHtrllnltlllt. 11rnntlllA t.llll truMt. TIH1rl' iH 1\1"(1 ~tll. "ort.1I 111 t\nld
Hnhlllhllu H l1HI, uf' 1111 I"'ullol'!')', I'nlll 111111 pnrflolllll, wtt.h ItH Vlll11U, whtnh 1"1,..RtlH Ill. dUllUd111l1.IH I'unt.h 11)'
vlrtllll (If' t.h" O)(nl'O I PHI hy lIuuollUlll., HI t.hnl' Irullvlclllul1 )', 411' .Iulnt.ly wi Ih /1l1nt.Il(q', ur 1I1l~' IHlWlll' lit' npl'ultll...
mUllt VHHt.lHllllllollorlfmt, 011.1101' huttvlllunlly or .I"lut.1~-', tlY t.hft will, clonel, fir ol,hllr IIlHI,rllmI11l(. 0(' IIIIUIIIIII',
wlt,ll n (luI'Y nfl tho tllHtrlllrlflnt. oronthlA Kuch powor "tt.twhOtl to thl! Rohnlllllo,
Thnt. Schflrlull' () nt.t.l\ohl\.1 hUI'Ot.n /\1111 mflll(l plll'l. hUI'flflf' HlltH f'1l,'l.il thll Ilflltl(1H 1~1l" IllldrllHHoH ot' 1111
Ilf?rRllllA hnnnf'tolnll,V tntornstod In t.hlH Ilftt.nt.o 111, l.hn 1.11110 llf' Ihltloclnllt.' H ,Ionth, t.tln I1l1t.III'1I lit' f,hofr I'OR'"
1'0 l\t1Vl' IntoroRt.H, t.hotr rollltlol1Hht}l, if' nny, t.o 1.110 ItnOf1dollt., t.oJ(ut.hor wlt.h t.lln lI~flH Ill. tilt' UTIlI! u,'
clU(1(Hlont.'a (tollt.h ot' Ill) "1lnorN, unllult,IUlI,H flllIl hnllUrlnlllrtoH 1'01' llro IHlIlfl" dneoclnlll.'H WIJl. It nl"!)
oOHt.IlIIlK It f1t.nt.nmnllt. Hhowtnl1, whloh of' I.lllt hnllflf'tclnrlnK nMlf'l1 III l.lln dllCHlflllllt'R wtll, If nny, ellolll'rlur
t.n duoollont., tho lint-fiR of' t.hlllr .10nt.ll, t,hnll' tHHUU, IUIII t.h'l rnlnt.tollRhtp nl' HIIl1I1 IAHUll t.ll thn hOlluf'lolnrYt
1'hnt. Sc/1(ldul(l r ntt.l\ohncl h(11'ot,(1 Ilmt '"/1110 n PI\I'f. hornof' HotH fort,h nIl prol't1t't.y, 1'(l1l1 ntH' pur..
Hnunl, nWt1llfl hy tho duuoflnnt. ,Jointly with Illtothnr nr ot.hor!i, Inoltllling IIIt.nI1AII1111, Ht./\IUIIIlJt.ln tllO IlftO\O
or t.ho 1100.)110"1. I\IHI nthnrH, IlluH t.ho df\t.O and )lInen 01' ruoorcl or IIlRtrlmlllllt,,. nf'rnot.lnR tho VflAt.It.llrn fll'
rOl\l nHf,nt.n 111111 tho c1ntll ot' 1I0(llIiHlt.lOII or purHollnlt.y, pIllA tho IIl1mo, l\ltrtrlHHt ""11 rnlntlnl1Hhlp. If nllY,
or on-nwnorH t.o UlU flooollollt.,
Thut Sc/lp.rlvle r ut.t.l\ohod hnrotn "nil m/\Ilo /I pnrt. horonr Ant.H forth f'lll1y 111111 III 11111,1111 nil dohtH
lllltl tlo(I1I01.1011H ollllmocl rur allfl Oil hollnlf' of' lhlH ctonollollt.'H oRt,nto, tn(dulllng "lll1orl~l fJlI:pOUHOH p"ldl
!'nmlly oxompt.Jol1, whoro 111')1110111>101 OOHt.H of' nflmlnlAt.rnt.1nll nr thtH HAI.nl,ol (101mHOl f'ooH /Inll f'wlto1lU'ylA
oonulllsHlollH "fllll or l.n ho pnletl nOHt. oxpol1(lo(1 f'or hllrtnl trUHt.R, t.om11AtollllR or Arnvnmnl'korH, fllHI rn) 1_
~InllR HorvtnoR, In onnRnlltloJl(!n nf' t.ho cl(ltlt.h of tho clooOfhmt.1 doht.R RIlII ollllmR owing IIT1I1 111111/111' 1\1. tlmn nr
rtoathl t.aXOR nonrlloll chnrgollhln for pnrllHlIll'lor t.o (looollollt.'" 1I01Il.h ((1X~('l't. l.hllfw 1I1lnv,ollllllrlnr Rlllll.101l
nl\1 of' t.hn Illhortt./Inlln nnr1 EAt,nto '1'lIx ^~t,)1 t.oJ,!;nt,hor wtt,h II Ht-nt.nmonl. I)fl nollnt.nl'nl 111(l(1~0I1 f'lIl' nhllKII-
tlonR, If' UIlY. It. tH fl~roofl t.hut. thn f'IdllOlllT'.Y will proRflllt. pronf' of' Rnlll nlnllllllll nl,11gnt.loflR upon 1'0"
't\lI1Ht, thnt. If' tlw '"nOllllt lIotuul1~' [llllet In Hnt.l.lomont. nf flny 1'00. nommlHHlolI or rloh!' tH I'HlH t.hnll tho
oRtlmllt.ml "",nllllt f~llllmlllp; nnllllllowOII, (hul. t.hll Ham(l will 1\0 rOIll)rl,o!l to t.llll nll~IHtl'r (It' WI1IH, IIl1et t,hnt
t.11ll Ilmollnt 01' t,IlX IIRfll1AR(1I1 olUl ho rtl/IRRf1HHotl III IInnordnnon t,horowl U"
Thnt, t.ho totlllft nf t.ho npprnprtnt.o IWll1mllR JI1 HlJholtulnR "A", 'In", "e"t "E", 111111 "F" "H c1JI'llIlI.U(1 l.hnrf\llI,
hnvu'lJuon Cfll'rtocl rorwl\rd und prnpol'ly rn,l(tHt.llrod III UII' Rllmml~ryt
Subscribed and sworn to before me this
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6,.75 .,1>J.".,~T.Dhl.1i.~:::f?.!:J.y.~.."....'.."m" '."....",,'., ,...,...' "......."
( StTeet Number)
Clll1lpI:JI.H."PQ1)))ay,IvlIull! DOlt
(City or Town and St4re)
NOTE: Bllf'nrll HtlJ;lItn~ nf'f'trll1vlt. muk" HlIrn nil hlllnk Hp/tfHlH ill t.ho IlI't'1I1l\\'11 /lnd Hohufhllf!H nll1lnXflll 111'0
1'1111'11 III with IInt.nllH nf' tho word "NfJllfl"t IlIIlI 111 1ll\Hfl ttln IUHHllH Irwl1Hlo 1'111'0 /lud t1111tRlnd RfHHlrltl(1H,
~ol'llI'IIIl!~ of' ntoRfJ or f'nmlly C'ol'flOI'lltIIlIH~ llr 1111 llllnt'(1Rt III nil)' 1~(l-pllrtl\fll'HIIIJl or Illll:;IIlIl~"', UtilI, 1111I
ll/aUI 111111 Ht.llfnmnlll.H rl1'1l1trolllllu1nr t.lIo 1"II'HJ~rllph flllo\'~ 1'4111\1 1 lip; 10HI!hll!hlll' "11" 111'11 1It.t.nnllllil, .'INn I1IHk.,
I!nl't.tdll t.hllt. nnll1mn #1 In tlln "Hlln'nlll,~,n hnH 1mull 11rollt'rty oump)nfnlt nM /lhn\'n-dlrlloIHtl,
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r,1~' ('11'wid'-'!11 1',,)1 'I II, l";n
llnel.", (1:'.1,1)
1'0\1\10"'11'1:,11.'1'11 OF I'I':~~N\'\'I."NI,\
'I'II,\NNI'I:1\ INIII':ICI'I'MWI'; TAX
1CI':NIIII:N'I'llI:t'I.:m:N'I'
SCIlEDlJl.l~ '''I)''
'*
JII~NEFICI^IIlES
._~--..._~._......... . ---..- -- - .
.........-.~_...-.~.._. - - . --- .- 11J.:t,A1'IONSIIII'
1I~:NI':"'I<'IAIlI~:H ANIl AIJIllll':HH~:H W SltllJoChlldro~ or SUIIVIV~:JJ Ul\'l'lj; INTF:RF:ST 01"
It nl jl I nil IlllnlllH IUlll "lIlll'IlARU" Ilr nil who I oultlrnlllo chi dron UJ<:CI1;r>NN'r OF DENE~-ICIAIIY
Il\IIIII\ Inlt'I'I'lIl, VOHt.lld, unnl tnnoll!, nl' oLhor oro \nvolycd, HO\ S'I'A1'I~ YJ<:S IN F:STA'nl
Wlfftl, III Oijthtll) forll this fecI,) 011 NO IIIH'I'1I
,...-.".----- .-....- --...-
1l..1cllll.l'.dJL...lol'dan, (,75~.J.ulllU .DI'ivo, r'n",,, I. 111. Pa, i ..tb.o..hn"" rip n I'Y nR mud in
1\I'llls III IIndlV of U1I1 LIIst: Wllln nel 'l'ost:anwnt: 0 lho Doco( "nl:. dnt:oel f. UUIIsl Z9. 1973.
-.-....---..--....
llowI' VIll'. tho salel RlchR' rl )~. .To rein u hR' unrln.. ,I, I'll or J;'" 1", '" I.." ?7 IQRn.
---
(Ox'1('lIlodn Diadu inlCll' of all IHOp ll'ty pUBsing \l1H or It:om 1\ of SII Id W II I n R n r"Bult: of
".- .... ...- '_'n_~_.___~
w.l1il:.h Dls<'\Dlnwt'. "1111 of tll<' 1'08 ....ul,I.... "'HI I' """ 1,,,1,,,, 1.1 onu "..nn.. I.,,, "..nl """u",,,,,1
Hnrl 11lIx-'c!!t..D~(!.!.!u~~r1_ of iu i1w ll'"<,,,rllnu no,'t:i )118 of this WllI" will p ISS undllr Hem V of t:he
-
~~lldWJ)!...~)Il\lEb.!n Dnposlt: J~~ _u11<1 TI'\IHt: Com unV~lcc. lBSOt' bv me I'UOI' t:o Dauohin Denostt.
:r.!'~u.f!,LC()mpnnv). t:o bo unvll,'nod lV Iho 01' ov I B ion of SIIJAl1 nm V,
._----, .---.-.. ---
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""I"","n" fllrt,hor ""Y" I.hat all the ahuvo-named hone('IO~f\rlo. Me living f\t thlR time oxoeJ1t hllloWI
NAME
DATE O~. DEATH
1U:SID~NCF:
J ~
;alO'
: Ii
~ 13'
~1i1
~a&l
(1)
8UMM^I\Y (^s 11\11)(11'\11(1)
Jlllllll'l'Ollorty "....,.."""""""""",,,.,,,..,,,,,,,....,,,..,,,,,,,,,,,,,,,......(80\1. "^") .,.." ..,,.,,O.~,
I'ursonlll Prnporty """",,,,,,..,,,,,..,,..,,,,..,,...,,,....,,,,,,..,..,,:,,,,..( Soh, "D") ',/j,7.J,7Q,..6)
Trunsfol'S "... ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,:.,,,,,,,,..,,,,,,:,,..,,,,,,,,,,,,,,,,.( Soh. "0") . ."..."",,,," ,o,'~""
J,ointly.. o.wull,d, Br,q,pfI,d,y:",..." ..,.." .""""'''''' ",,',,'" ....(S ,:;,\1"" !.IE'?,...""., ",",,0, ,".,
...,......,..".""".,,,,,,.,..\,.,',,,",,,',,..,"",.,,"''''',...,"""";""'-"-;"'"''
...,,,,,.,;,,,,,,..,,, "'"
Gross Tllxublo Estuto ..
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.1;l7,J19.. 4J.."
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I, ~ ~ 01 l'
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(As J)l!t(ll'lnlllml)
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I{ESIlII'.NT 1l1'.t'1';llI':NT
SCllliIlIlLI'. ''I'.''
JOINTL\' OWNIW 1'1101'1',lnV
'*
('OMMONWI'.ALTII 01' I'I'.NNS\'L\'/\NIA
'IUANSI'I'.IIINIII'IUTAN('1'. T,\X
INSTRt/(''I'II)NS: TIltH !;1l111l1hlll! I1lIIK( IllHnluHu 1\11 ltrnIH1I't,)', ruul IUlII l'OI'",n"l\l. (IWfllltl h~,~..hlflt Jointly
lli!.~lllthor Ilr Ilthnl'H, 11I1'IIUllll" tllt.l\llgthlt1ft, l"tllncllfl~~ 111 thf! f11111l1l lit' t,h" dUllllclnnt. 111111 IIt-hlll'III I,IHI.
roal tlNtllll1 flrHl" HH ulIll"l1tII1H, "r ,1ntlll. t.HnAII!.", p-,tvtllp' IIt'tnl' (I"HIlI'lpt-IUllt tVI llllttont,1l11 1l1lll11r fil1tlllllulll
"A", IlluH t1w Ilntn uncl lllulIfi of' ,'utlnrd ul' II1HI,rllllll'lIl. IlI'f'uIltinp, vnHtl t,lll'ft, lutl. Iln TlOt. tllulwto olltlrot,lnft
Ul' lIul Ill' Ntl't.U rflul tlHtUt.U VUIIlIl III IIHt.Ut.U Vlllullt,lon 11111111111I1 PurNollnl prnpul'(.)' "1\1I1Il1111u 11"1.(1(1 "" III
Rohcllhllt1 "II", pltlH IllltU lit' flOqtltHll.loll, nnll Lilli ll11lllfl, n(hlrflNk lIllll l'Olut.JnllNh11' (1f' 'lilY) ur ('(I"owllurs t.1l
t.hll floroltont I
I 'OuHI'r 'pi Inll uf Pt'(llHlI'l.)'. Unto n f' A(',qutH t tlnn, Nlth\ll 111111, }Itll'(IlJllt,llgn I~Ht,nt,n 1lI0'AI\TlU<:NT VAI,IJA1' ION
Ailth'oHH nnct l\olttt.1nulihlp (If' en..Ownorflt ullcl PI nOli VuIlIo Hhnrn Va] un t tllll (JAIITION-lln nnl W.'II,n
or Ht\(lurl' nt' IllAtrUl1ltlll1. who rn I\IlU I l'~;; t,n t.flt In 'I'lItft fllIllnn.
I 00 xx 00600 I :;~~/, >0 00 6- Q Vnluo or Vnlun uf'
>0 XX U ~ 0< :'\6~ ~ ElIt.lro lJoIHHlnn t' H
I N 6- 00 . I~~ I:'{.-.~ -2y' x,,' pru)lo r t.y Il1tOl'ORI.
.
All of tho following items were hold by Decodent a 1d hOl' hUB )llnd,
Richard E. Jordan, In an E statn by t.he Ent.l'et1os
1. Residence, 675 St.. Johns Dl'ivn,
Hampden Township, Cumborland County
Pa" descrlbed In Deed Book T25,
boginnlng at pago 934
- 0 -
2. Savings account - CCNB Bank, N.A.,
New Cumberland, Pa,
.. 0 ..
3. Savings account - Dauphin Deposit Bank
and Trust CompanYI Harrisburg, Pa,
- 0 -
4. I:lavlngs account. - Dauphin Deposit Bank
and Trust Company, Harrisburg, Pa,
- 0 -
5. Checking account - Dauphin Deposit Ban~
and Trust Company, Harrlsburg, 1'a.
- 0 -
(,. Checking account - CCNB Bank, N. A, ,
New Cumberland, Pa.
- 0 -
"
7. Investment account. - Investors Dlvorsl-
{led S(1rv1co
- 0 -
8. Fl1l'nlture and mlscellanoous household
items
- 0 -
ALLOFTHEABOVEPROPERTYL
EX.EMPT FROM J;>ENNSYLVANJA T~ANS' ER
INHERITANCE TAX
llIliort.. LlliR tutut nPl'nHil.n "111J11ll1y OWll(lfl I'rnpol'ty", 8ol10l1uln "I':"
in thl' "Ml l\opnrl,o(l" outlll!UI (lfl thlJ lUKt ll/lKU or t.htH l'nf.llflh
!vl,fYL ~ ,
E. G. HOOVEn eG.
JIIWIU..RY
A""PlAISAt..
Jl!WB:t..AY
APPRAISAL
JIWIU.llnn DINCK tC'lDt
RUDIUTURI!t1 JI{WIU..IU4 u Cr.ATll"lkO UKMoLOC.ll8T
AMrmIC~N nltM Bonl.TV
~S NORTH THIRO STRltt:T
HARRISIlURO, PA. 11101
Ap;nl;.;l"i~~r~'"~-"" .--.....-.---- =:-...=~~..::1l=__=;..::.::.. ~_. ~.. --~..,. ..-,~~--.--.-
-.-.-.~--'" ...-...~.. -..-...... .~
t.:otnta Dr Mral rUohord Jordan
~ Mr. Rlchard Jordon
July 213, 1979
Hum 7.........Lod1un 11.1 kUl'ut Wl11to !Jold rlng mounting oat l~lth
ong oval h013tllfJ proclouu Top 1'1 l: , tall l'olJnrl llr1l11nnt out dlaml1l1da
and Db tnporod bO\juutta out dllllnnndll. The prociflul3 TOpFJII tnb1nlllll'GD
11.6 X O.O~ x 4.9 mm and wa10ha 3.fiG eta., thoro ora no Incluulona
and tho color io B flnll ooldcm brOl~n. Foul' of tlm round dlotnonds wa1gh
.05 cllrLlt Bt1ch, four hlal0h ,0::\ corllt oach and two 1~l'llgh .16 carat
lJBDh. Foul' of tho tnpormJ tlllguuttQ dlamonda woltlh .l)(i carllt BFlOh,
two walgh ,DO coret oach. Tho totRl woiuht of all dlomonda 10 1.25
corats. All dlomondo color orad~ A.G.G. I, clarity orado flawless
and ora ~911 cut and flnlehed.
ValUE! ~;'J!j0. 00
Itom S........Lodloo platinulll ond 14 ktlrnt (~hltlJ Gold fariey rlno
1fI11untlnlj) oat wI th onB cabechon cut hluD lltllr l,mppt,lro and t14lonty
alo11t round brUl1l'mt eut d1r.lIl1onda. Tho star ai'lpphlre rneouurol3
11.22 l( 9.7 x 8.B6 nm ond hlflinha 10.40 c~lrll1;o. Tho color io a ntQdlum
blul3 and thora oro no L1PP~lrl1nt ll1cltmlonll. Tho utar 111 ShUl'P ond
ill I~Oll cDntorad. fourtclAn of' tha dlll:nond~ 1~~11('lI1 llpproxl11iutuly .03
C!U'ot Buch, fourtonn hllill'.'iI1 I3pproxlmotl31y .Oc, cornt ooeh. IIU totiJl
wai\]ht of tho diomonds ill 1.40 CI.'\ri'ltu. 1\11 dlomondo l1l'O good color
ond quality und era wall cut.
Valull $14llO.00
1tom 9......Ledioo platlnum rlno muuntlno Dut wlth ton poor ahapod
diamonds end fourto13n round brl11lant cut dlomond~, Thu pOiJr ohapod
dll3tnonds waigh 1.74 carate ond tho round brlll1llf1't cut cJlul:londo
wa1gh 1.70 cerota. All of the dl~mondB orij good color, quality and
arB wall cut.
Vl'Iluo a~oo.O(l
Itam lO........lud1ua 14 kOl'~t I~hltu guld oval tlll1zan1te tlot. 1~1th
olxtDDn rrJund ul'lll1ont cut cllUlnondll. Tho dll11nondo hla1l']h IJpproxImattl1y
.03 ol1r~t Bl1Ch, aru good color, quul1 ty cmd ol.lttlnlJ. Th!J tanzon1to
Thl. IlPprnl.l\l conaUt\lt~ OLlr cnrchllly .tuclltd C'lplJ\lon 01
Cl ther rctnll roplncoment rOJt throllifh ollr '/lclllllu
[J tho dl.tro.. 'Dle. nr.'un valu.
o. tho Iftlolnll) dOl\crtbod nbover InlotM III thto mO\llltlng(1I hAVil l1tnnlUed
obllJt'V~Uon, Wo MMuno no Unbllll)' with rI1M)ll'ct to nn)' fIOU(ln that ma)'
ba tllken on 1110 hn.lt of thll nJ)prDlsnl,
--.-. "i\jlp;,.iir:,", ."___4'
E. G. HOOVEH eG.
JEWlIl.llY
AI'PRAISAI..
JKWII~I("O ulNOE IUpl
ntml_n:n.lJ Jr.waLt:n ...... cl:/tTll"llm GIlMoLOl')I\H
AMEnIC^N UKM flcellTY
30 NORTH THIIUl BTRIO!T
HARRISnURG, 1''',17101
JIIWIlI..RY
",.,.RAll!IAI..
-~'~--a=;~~"7"'..:::-'--
Appraisal Furl
~~~"il=:;'__"._'":;;';;;:;;'''~:___"''f;c;'~~~~~-;;;;=.l==.o::..;.;:-;;.:..,.,,;_-~..u~~~.'''''..----
Ellt'!ta of Mrfl. Illchlll'd Jord~n
~ Mr. RlchArd Jordan oontlnuod
_____..._._~_r..-...-....--.-~....-.---..------------.--..----~.--.------..
July :W, 1'J79
I tOIn le..... .,.. L1!lr.l1\ln 10 karnt, IJhl tla oold trl/;1n\lulnr Ilhnpl'ld
drmolo nurrlnCja. ThAl1Snrr1noo cnntelln lrJ rL1Unt1 tJr:llllont cut dlomonds
In IlClch ,~ poll', 011 ora ODod colar, qUi:ll1ty Dl1d urn wall lOut
und wal0ho approdmBtaly . Or.. oarnt unch.
Villus 5500.[10
Itllln 1?......I.ndloB 14 knrnt vullo., \load baZBllll~t pioro~d dlnrnond
eurr1noa. Tho eorrlngll hnvu u total woluht af 1.00 curata, ara gn~d
Dolor, quallty und ara woll out.
Valus &450.00
, Item 10....... Uf.\$eo 14 karat Yollfll~ gold ring rnlluntin\l oDtlllllll*h
thraa small and lJno lnr(Jllr mnrqulua flh,~Plll1 QubnCl1on, an\Jol ukin coral
atonllp.
Vi\luo ; so ,00
1tol11 10..1....14 k13rc1t yt;lllolJJ IJold 1'0110 tluoign tJrllclut. Tha bl'llo111t
la Imt wi th five Elvol cabuchon annal sk1n corale und four round
brilliant out dlGmonda. Tho oorl'llD OIuosurll 5.!:> )( S.O 111m, arn \Jooel
qual1 ty Bnd haYs a h1011 pol1oh. Tha round brll11nnt out d!lomonde
waigh approxlmntaly .OJ corot ooch, aro Quod 00101' quality nnd arB
wnll cut.
Vnluf;! j::WD.OO
Itom 2D........AnUslu akln 001'01 broclst Dot 111 U 14 knrnt yallow
~old l110unting ~11 th D rll'1rlmtlnud border. Tht4 eorlll io pelllr allopnd.
Volull tC,O.tJO
ItDm 21......~ngRlo okln oorell QorrlnOIl For plurond DorU.
ar'1 (l )( 6 mm end ora ('ICCrJ C1uul1ty.
Tho CON1111
VnlUD ;;75.00
Till. npt1rlll,nl IlPn_tllIlte. our ll/lrDtully IhHUClC' C\plnlon 01
o 'h~ rotnn rcplnc(>numt cou, through our 'Ilcltlth....
o the dl.trcu ..11'1 natllre vahl/J
", tho nrUale(p) dllllcrlbelt "bavo Imotllf i'II the mountlnaU) hive tlermlUed
oblon'QUon, \Va nlll~lInO no 114blllt)' wllh rC~pel.'t 10 an)' 'HltluR that trill)'
hI! tnken (In tho 1llUll ot 'lib "fll,,,.I,,.l,
. '~h.'" ~'-'-^IiP;aTiei--'-~--
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