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HomeMy WebLinkAbout79-00407 f.;, .., ~ roo. I - N :i " " -, , _-h- - p. --- "" , , . " .' " . .~ p.., I " t) ~ . ~ (=1', ~ ~ 0 lr-l '8 " ,'J- ,,' , , " " J'- " -j. .,.1, If "r',-III A , ~O~\MONWEA). TI~ OF I'ENNSY~VANIA DEI'ARTMENT OF REVENUE IIUH EAU OF COUNTY CO~LECTIONS APPLICATION FOR AND 'CONSENT TO TRANSFER 5ECU'~ITIES REGISTERED IN TltE NAME OF A RESIi)E~1T DECEDENT '* APPLlC.ulQ!:! (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application Is hereby mnde fnl C ..,sellt to tho t,ollsfor of tho following socurltles of n Ponnsylvonla Corporation or 0 Notional Bonking Assoclnllon loeotud ill POl1nsylvonla: DATE ...'Y"'I"/? r (aL2 ,~h~-., .Jb)J'ENNSYWl\NII\ PO\'lIm & LIGH'l' COMPANY (c)u,__,OOIl''"Ol\ _......__._n__ (NOTE: In doscrlblng securltios onlor In (n), ob ,,",a, oithe, tho numbor of shores of stock or the face amount of roglstered bonds, In (b), the nome of the issuing cOlnpnllY nlld in (c) the closs of stock or tho staled Interest rote and molurlty dnte of registered bonds,) ISSUED ON-2.8..11.pt,~70..." and having 0 TOTAL MARKET VAtUE OF S. (Dot.) as of the dato of death of the decedont, _,I.t'IL, D',..Oope (HulI1u of Dt'c:udont) ., on .1.../'lU'Oh:LSlZ51..-.....-- (Dol. 0' d.ath) who was lato oL_8'~11e.c'nSt:t'..t (Stroot C1nd Numhel) Oarlisle (PoIlIOfllr-l\l (,l\!I!lP,~J.and. ,_. ...._....FA__.._..__"- (Counly) (Stott) The securltlos ore registered os follows: . 1'1.'& O.Oop,.."--'_.'''---'' . (Noma Clf "Mltll In which cvlllflc<ltos cue fCIQII,,,.d) ADMINISTRATOR)) __..__~~_~'. Oopo EXECUTOR (No,"n) 11250 !leach Blvd,.#J6Lil~1;llndlA-.20600.-,._. _____d_' (Add....) NAME OF APPLICANT ..J.lIAl'It\. OOJ,lL..------------ COUNTY FILE NUMBER~:l!n;..:~._/-'. 'ADDRESS OF APPLICANT 112,0 B.!MJbd!l1...'V,\1'utl~._.(;iWltondl" BUREAU FILE NUMBER_____uu".. 'u SIGNATURE OF APPLICANT ,.Cjt~.,:::}:l1.LIJ t;~06u~.._._._, NOTICE: IF YOU FAIL 'fO PROPERLY FILL IN ANY PORTION OF nus APP(JATION, IT WILL N BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOll FOR COMPLETION, - -. - ._~~-------_._--~-_.--~-_.... .- _______.__.n_ ___._.______._ .--.- -~_. -.-.-.- COMMONWEAL TH OF PENN5YLVANIA - DEPARTMENT OF REVENUE CgN.SENT TO TRANSFER SECURITIES DATE"}. ~.'.(e -,11 1 hereby consent to the transfor of the above socorities now roglstered in the nome 01 the aforesaid Decedent ond wolve the filing of (I certlfientc cCltlfying to tho paymont 01 tho transfer inheritance tax to which the property of sold Decodent Is mode subiecl porsonnt to the provisions of tho Act of June 20, 1919, P,L, 521, os omendod and the Act of June 15,1961, P,l, 373, os (llIIondo,1. This is also ill accordance with the provisions 01 t"e Act of April 9, 1929, P,l, 343, This C"nsent to Translor Ihe "oroin d,'scrlbod p,ope,ty operates only In reference to the estale of the nbove-named Oecodent, 5igned for.~~retarY of Rev~nue ~ . j'. ~ By _uu___ . . .... ..._~- (Slonntu,l') (T1I1.l (Cauntv) " . ~ , .'/. ';' '( 'j () 'I R~V-440 (0,701 COMMONWEAL'I'H OF PENNSYLVANIJ\ DEl'ARTM8NT OF REVENUE BUIUi:AlJ OF F1I::1.,1) OPERA'I'IONS 1/21-79-407 * ResiDENT DECEl1EHT COUNTY OF ...(j '-)1f18t~, L~Nb 1M PO R""";r AN T ,"--~P:ri;I;';~~u~I~;III1'" hll-l;;;;~~lli::7";;;J;u'j -1- 1IIuif;ll\il III ;Julll j ~_];l-l~;~" ~lll;~~ II ul';I~~:II~;~II'-;';ii~i~(\ :;'''t~~j~,~~;'~~;i \V'j IT;; ";;i'"li~I~'-~ ..._-~ Cuunt.v Wh"Ul dlll1t'dull1 I""hlt-II. HI~II1r11 IN ,hw \\'111111I111111' lIIolllh" "fiN llntr H( IIMlh, unlt,,," 1111 nXltltlfflOIl IN 1IolUIlIcd h,v 'Ill' Hlllal'lIH)' IIf Ih"U'IIUl', (SI'l~ljoll 70' IIr III\! 11lhl'rlluIH'I\ /llId I';Klnlt~ 'I'll" ^,'\ or IfUtl ,) y,r'-'- .-. --p -.. ~.._... ~ ..---. --.. .",,-- -"' -" , -........~..,-_.,. ..- ~ - ~. ~ ""'- .~ lett. of CUlllborlund } <\l'l'lfl^\'1'I 01' I'XI'('IJI'OIl ,. AflMINIS IIl^TOIl ,-"uullt)! IN TIIH M^TTliIl 01' '1'111.'. HSThTI' 011 InA I), COlli: --~-'fliT~~-T Ii" Vlll:i:.~'Mi ~ij'f-'--ll'r;(: I::i)i;.~i "11 5,.,..1 J'orm~lyJ\lJm,in County of ,,~':I.I!I~o.~.l!!!ld, Joon M, Copo - ~-J'" llurvivinl) joint tonont l'I"""'ltll' .~"'......._.. of th. allaht of the abon-nomod d,ced.nt b.lng duly 'WOI", d.p'" and "r llcccllrall tlllld _~~urch 7 ..1 ItJ.~?w~__J ICIIlot. IllOvlnu<< IQ,1 will, 1I0PV af which I, ".fPlo attpgh.d, } IMONTHl II'A'(1 1,(I'AI~...lnt"htl" Nanlll and arid,... 0' ottor".y 01 } ....___r!~.~.!:Q~ .~~.~_~~~~ler .________.~____~__._...._.._..__.______.___. oth., Gutllodud r.p,...ntutlu to whom 011 cOlr"f1ood.nce should L. mil II,d, 4______.___,___. .__.~__._..___..._._ __~..__.__.._._._....-.__..__.__._..________._~._._____'_____" ThlltllH HlIlIh_..JlI:!E.Y.iVOl',_....____de~lll1UIIIIH I'lImlllllr wllh the uHnlrH III' HIlId eHtllte IInd Ihe pro~erly OIlIlHtltlltlll~ l to XI' \;u TDU.AllMIt~IS Hf A TORI Ihe IIHHelH Iherellf II lid Ihelr 1'1I1r IlIl1rket vllllle, Thill 1I111111 Iillle (If ,Iellth Ihere WIIH 1111 ,"fe dellllHlt hll' relll.lered III decedellt'" IlIdlvlllllolllllllle, IIr JIIInliy with, nl' IIH ugelllllr de()lIty III' IInllther, .01' 101 dell,,,lenl'H Indlvldlllllllllllle, 11'11" rlshl (If lIeceOH by IIl1nther u. useot III de~llty, with Ihe e,cel'lIlI1I III' the fllllnwins: - I;..::;=r.:=;:'."='l"t,lc~~__ ....,.~.~.~"""'~t>i""..~oo;~'3..,'=,=_~'"...."=. .;"'=::-.-=_~;;;=-,-:-_'1=,::o;:...'_"'_,_:;";_;_.-.;=..-.=..=::='_*:t._z...~~- _ ;="'~~="""='~:"_==<--~'-'" NAMI~ ANn ADUIH!U OF nANK on OTH~R IH&TIT\J110N nun tI,\f'f 11I!:fIOllIT nox Rl::NTVn RUL.ATIONSHIP 01' JOINT IN Wtll{~III)Ecrr.',l!Nl RI!NTI:l.l ^ BAf1I~ Pt.!f'OljlT nox IN N^MIC on NAMES Of HOL.rH~R9 TO Ofice.r)f;:"H _~ruBt ~l1llJ.ll1Y-------,-----,- =.ffo!!,J?..!-. Cq~J,1!19,~)PDn "" ,__ _-!!!!g 181:______ ,_. Cor lill-U4_1~_,_..___,.____...._..____,____.__,_'" __,2J2!l_____.."'_m._____,.. ..._ ___'___'_ ~..__~___~.___.~____.____.__.___...__ _______.__.__n___...~.__._____ r-------- ----. __~T= I=~-=;-===----:=r;.~. -= Thllt lhe oonlento III' "uld "ufe de~IIHIt box lIr boxoH lire Itomlzed llnder SehelluleH 'with the eXec~tloll nl' the fnllowlng, fill' the reaHORS herelnnft., Hot furlh: of thlA return, Thol Soh.rlul. A IIltoched Iwrotu illld mndo ~ilrt her cuI' HelH forth fully illld In dol.1I oil Ihe roull"u~erlY IR Iho Communwealth of l'ennHylvilllln or whld. deoednnl died hllvlns nn IlIteroHt lI",rolll, It nlHoAetA fotlh the llIortgage eneumbraneeH upon eileh pllreel III' re'li ~ruperty III Ihe dllle of denth, slvlllS lho nmnUll1 "1llIlIuo at denlh, IIl1mo of murlgusee, dille, rute of lntell"'t, IIl1d bOllk illld pilS<l ul' reollrd (horonf. It illoo lIetA.forlh In Ihe enlulll'," I,,"vldell thorel'lIre the il'Ho"ed VlIlullllon III' elleh III' H\lId ~nrool", the oHlilllllted mnrkot vullle thoreof IIH III' dnlo III' deillh of delledonl, Thol Soh.rlul. !l nlt\ldled hen,11I ilnd nllllle ~lIrl hOlellf HelH 1'",lh filIII' lIud III detoll 1I111.e1'HOIlIII ~Iu~erty where oliver HHlIuled IIwned hy the delledent ul the time of donlh; 1111 1I111110YH left by the decedont lit the lime of donth, whothor in <leoedllnt'" imnwrllllltJ IIIHHWHNiol1, Hlllndll1~ to decedent's credit in hllnks or dOPOHIt. s8vlnRH hunk>>, truNI (JnmIH\nt~s, or other IIlHlilntlllJ1s, whufhcr indlviduully, or in trust fur nny uther porson or pCfROnH slvlng IIIHO "'~lIrntely the lI"erll,'d Inln'esl (hereon, If 1111)', dOll'n 10 the 111111 IlItereot duy ~ri", III deeellent'lI death In tho tJIUW of savings bnnkH, lllHI In lito dnll' of decedenl's <lenth ill 1111 other "Jases; nil bonds, pONtn! HlIvlnss, tren"ury cetllfleute" or nuteH \llId IIlher l,vIdenee or Indebtedn,,"" III' the 1I111tod SllIleH tll the de- cedcnt; nil (JbIiRlIliulI~1 whollwr hy ,.,111 lull' or (\HrCClIltlnt they IlfC dcslltl1utcd llH lux frec, of (he United Slnloti, or nn)' Billie, or political SUlllllvlNinn lhcrt~lJrl or (If nny f(lnli~n counlry, which Ufe oWlIl'd Ilt tho time uf deuth; 011 \VeRrlnN IIfll,nrcl, Jowelry, !,;jlvcrwllrc, Jlj(~lllrcs. hOllkH, wurks of arl, hOlltwhold furniture, horSCH, cnrrlnMcH, aulumfJhlloN. bOOIH, 1I1HI nny lInll nil lltlwr flcflrwnul ehllltcls flf ,\'hntsoc\'vr kind Of 1I11111re, left h)' decedent, tOS"lher wilh Ihe flllrly o"lIl11l1ted IlIl1rkel 1'1110" Ih"r"ol'; 1111 IllmdH IInd ,"orlSllseH 1",ld hy decedenl nRd or 1111 clnlmti (hilI find owlnu decedent nl lhe Iilnt~ of denlh, und nil r'lrnmiNsnr)' "ntt~s nr other Inslrumullts In writing fur the (lllymmlt of money of which decedelll ,.Ilt1d 11()tiHcssl~d, of WhlllHlIcvcr nnturcj with InleroHI thCrt\Ufl, if lillY, Slvlllg till' fll"e vlllou 111111 e"lIll1l1lCd 1'1111' mu,k(11 vlllne Ih"rll(,f, IIl1d If Hlleh eHtlmute,1 flllr mllrkel vRllle ho lesN thnn the fnce ....alm', II sets forth hrinfly Iho f(~nH(lnS fur such dCl1fl~c1Rtlnn UN to cnch Ilem; nil monoys rnynhlc tn lhe CHtllh~ from life hlHlIrtlflCC polidlJS l~nlflc.'LI hy dl:codol1l; 1111 llnlluity llnLl (}Ildowmcnt (JOlltruotH the ~rooeedH or whleh were IllIy"hl" II~OIl th.. delllh of Ihe decedclII; 1111 IInd the cnrplllllte HtockH Rnd 1I1vldelldll due thoreoll und 1I11~1I1d II" of Ihe dllte of lIellth, hlllldH IIl1d lIecrlled InlereHt Iherenn tn the lIute nf deeedellt'o death RIllI nther InveHlmellt "eemllloH (lwlled hy the dOlledeRI lit the tlllle of deulh, wllh the murk"t vllllle Ihere- of u t ouoh lime, , . " In thu IH\ffO 01' ~oollrlt.1ofl 01' olotw or l'Illlll1y onrllt~rnt,j(Jlllit t.llU Vf\lllflH ropurt,ntl nrn 1t8 fur ilK l'ultHthhl HuhRtnllt.tnttHl hy flI11\11I,lI1\ fit,nt-O\l\t1ntH uti UIU llorllnl'utlnl1~, Hhowtllt( tho ftH5f11,M !tUft lJuhl11lttlR thl'l"'1I1' IlH (11' tho flnto uf' chlllt.tll 1'l!n Hnhochll" IIIHO !'tutH 1'01'1,11 1.110 ltlt.ol'nHt 1\,1' ,10(l(Hlol1l. nt. thu ttmo nr lln"th ill '\fIr nU"llIlrt,nnrflhtp or hllHI l\utHlf IIllfl In HIIPllurt, of' till' vutuu ttl' fnwh IU\-OI'oHt, t.lllll'fl tH Ill1ltuxtHl In Hlltll Hohll1\111111 f'IIlHllnlnl >>tl\l.ull\lintR I\hnwllll', thnnHHol,K ulld Itll!I{ltl,lt'" flf' HHtll (H'''lIftl'lllnrHtllll or hlIMIIIUM", .\ ('opy 01' till' t~CI"pHrt,I1UI'"ht\1 ",~l't!llmtlntit (lr 1)f'Utl II HtntnlTlnYlI. Hllll,IIIA f'1l1't.h thfl Hut.III'1t or IIItI ll~rl'nmullt.) 111",1' 111!1" W 11.11 II h I,n t.Ulllflllt. HO t t.111~ ('or 1.11 1,110 ohnrllCl tor tl f' t.llll II\IH IlIllKK, I t.N Illlllt t 1 till, /lull KIWh ut!lur l'IU11.H \ll'I'lntlllng to IIll! hll~llInHH kN mil.\' Iw lUll'l,tllflll!, tu 1\ f'fl\r nllll ,IIIHI. '\Pl'fnIHIlI Ill' Lito clnullllnnt'" lnl,f'I'HHt 1111'".,111 mll..;l 1111 ~lIbtll't.t.fHtl It Hhlllllll ulfto lint f'urt.h In ltnndl'ntl fBI'nI, t.tlJI,t1thl1r with tI\l' flllr Ilmrknt. vnll1l1 t 1II'I"'ll!'1 1\11)' nt.IIH" IlfOp"I'!.Y IIWllIut 0" ho '1"01\ 1 111111 II,)' tho 1IIlOIl/Inlll III tllU I.tmll nfl Ih'nt-llt '1'111' S(/,t!dlJl~' (. fll.l.nc,!lnll h"I'I1I.I\ Illlrl ,,1/11111 lIlll'l. hi>I'flpl' HutH {'IlI'11l 1\ 1.1'1111 Ht1l1wnl' to olluh ilHIUll'Y ('olltnlllHII 1.111'1'0 III 111111 ITlUIO OOEJIJIlf't.I'UIlHt'IlI'HOf'\lI'UIHll'i,y, 1'llld 01' pHl'RIlIIlII, wllhll1 lwu yuurH or donoctol\t'fI 111'11111, 111 11t1I1!.UOlpllltle.'u, of' CIH(\j\fIOIlI.' H i1ollt.h, lit' tlll.lltlilml 1.0 t.Hlef' nl'f'(\(ll, III IlllttHI1HHlnfl or Cllljoymnnt at nr Ill'tnr 1I01lth, Hldfl H(1)lIlfllllll, HutH l'01.th t.lw 11111111'" 111111 Vldllll ot' Hlloh 1'1'01101'\.)', t.o whnm I.I'f\l1"forrml, t.ho l'I'lnl.lollHllt II nf' lIlo l.rHnH I'Hl'nnH tll t,hfl "o(wlltllll., t.ho pl'nl'ol' tlllnnl.n Hhurn l'OOlllvol1 hy onoh t,rllnfll'orno ftnd fill olhflr "'wIH ot' ft Illlrt.tnol1t Ilf\I.\lI'f\ rnWlf<lIIl~~ Hulf! tl'lltlHl'orH. ," U\It fHlHI! Ill' tl'ullHf'nrH I11tonehHt to Illlil' t'I't'~ln1. 1'1 PUHHlIHHlnll 01' nll,lnYl1\nnt. Ill. 01' n('t.flI' rlf'llt.h, t.lllll'l\ IH f\IRO nl.l,I\l1huIl to tho 1'I0111HIIIlo n oOI1Y fit' !.lIt' dUUII, l.ruHt. IIp;rfHJntOtlt, or ol.hnr II\Hl.l'lIll101l1, 1!I'tlnt.tug t.ho IrIlHt., 'I'hfll'" In ulHn Rot {'Itl't.h In Afttel H('lltHIIlln /I ItHt of' Ill'! Pl'ClJlfl1't.y, roul nllllllfll'HOIlld, wtth II.A vnluo, whtnh 1111t.tWH ul. dnnotlontlH fhlnth hy vll'tun of' thn (lxoro18(1 hy dOfludollt., fllthor t1ll1lviflunl1y, ol'.!otnlly vdt.h Ulltllhnl', 01' nllY pnWOl' uf' appoint... 11111111 vutll.tlll tndO(!(tltulltt nlt,hll1' hllltvlfl\lHlly 01' .I(JITll.l~', lly t,lIn wlll,!lpolt, fiT' nl,hor tnRI.rumOIlt. ClI' l,"ot.horl with Il (~npy III' tho tnAt,rllmollt, nront.tnp, 9110h POWOI' lIt,t,nnhtlfl t.1I tho Hld\lHllllu. Tllnl. ,.....rht'du/i' 0 nl,tnoll(lIl hnt'lHo nnll ",lIllo purl. !In,'onl' H(ll~ 1'01'111 Iho 1\1I11\IIK /Ifill 1I1lch'ORROR of 1111 pllfHOI1H hUlluj'lnll\11y 1.nt.oroKlncl tll t.lltft !lRt.nto Ht. UIl1 tlmn of dnl!l1r1nl1t.' R IlulIUl, 1.110 Ilnl.ltfU of' thoir l'flA- 1111tlt.1\'t! Illt.ortlHt.H, t,holr l'IlJllt.lonHhll't It' /lny, t.o t.hfl clO(lll/tlllll., t.lll~ut.hor wlt.h t.ho IlV,UH at t.ho tlI110 or Iltlt'llllflllt.IH clllllt,h nf' 1\11 ",lnorA, 1\1lnutt.nnl.H 1\1111 hOlwl'lnIHI""" ('or 11f'n 1I11l'Or (tI10llftf\nt.IH Will, It, RlAo nOll!.HIIIH /I Ht,utllnwnt. Khowtnl( which 01' tho honof'1oluritlH t\lIl11tlcl III t.llo c1Clt\o<lfllll.'tl will, Lf 'my, !tLod l)rlor 1.ll tlU(Hlftullt. t.tln flntoli of UlOtl' flonth, 1.lInll' tHHun, IUIII t.hn l'fllntllHlHhl}l nf' "Hllh !titUlO t.o tho hCllloflolRry. Thn~, S..~/lvdu/p E ntt.nohOfI hOl'o1.n "ud nlIulfl 1\ f11\!'1. hnrnol' HO!.!! l'nrth nl1 llroport.y, "01\1 ami por.. HUllll1, IIWI10II hy l.Illl rlooollont. ,lolnt.ly with Ill1ot.llnr 01' ntho\'", illcllllll1\~ Inl.nll~lhlo, !it."1ll11n~ In tho namo of' !-lIn dncw(\ot\t nllfl othorA, pll1B thn lllll,n find plluHl of rOllCJl'(l of IIlHtl'tIIl1l111t.fi fJI'f'(IOt.1.I1~ UfO \'(\Rt.tturo of ronl flHt.f1t.t' 1\lIIt tho etnto nf' ullqulHJt.JOfl 01' lHlI'fHHllll1.Y, phi" t.lln 11(11110, tHlltrOSft (ulfl rolltf.lonshlp, if ROY, of no..oWIlOl'R t.1I tho etnoodont.. Thill. Sc/'f'du/" f" ntt,nohlld hnl'ntn unet mUflo It Plll'1. l1oronr HntH fOI't.1l j'ully und in dot,nll 1\11 doht8 Iltlll IhHllIotlollR olnlmod for 1\1l'1 {In hohult' nf' UdH doonllout.fR lltltnt.o, 1t101111ttl1~ {'unornl oxponROR pRlrll l'um'ly tlx(1mpl,loll, whorn np}lllollhlol 110Ht.A of I\llmlntftl.rllt.iflll or thtH flHt.nl,nl onttnHol I'f~OH I\n(\, rufl1.o1nry'R l'onJml!HllnrlH pnld ur 1,0110 pnldl 1.'\0Ht. llxpl11\ll(1tl I'or lIm'lol t.I'UAI.H, t.olnhf:lt.oIlMI nl' KI'nvnmarkora, Imet roll.. p'11'\I(~ fWl'vioOH, in ('OIINOtjIt0I10n nf !.llll clunt,ll nt' t.I10 1I0Clot\llnt.1 (IohtH nnd oll1lmfl owtng lllul \lurnlll (It t.imo or 1I1lUUiI f,'tXflR IUHJrllncl OhR1'~Ollhlfl f'or portoft prtor l,u llIHHHlont.' H 1I0/lth (0'.11; (11'\1 t. t.hoffo ollowofl \llldo.. Root.1otl nt" flf' t.ho IflhurlLnnuo 1\1\11 J<;Hl.nt.C1 'fux l\nl.)l j,tlJ.f.tll.hul' wit.h n MUd.onlont. or cnllnt.nrn1 1'1Oftgml for obliga.. I.lonH, II' nny. It, is f1~rond t.hn.l. Ulf) f'\(ll1ulnry wtll proflnnt. proof' nt' flntll ol/l.'mnd llhUI(nt.1onfl upon ro... 111I!'!;!., thnt. If thn I\I1IO\lnt. ne1.Hully flldd In suLt.1omont. or flflY fill', flOnlllllHHlon or rlohl. 18 10RR than tho oHt.llnntucl nmollTlt olnJmtnR t\11l1 1\11owU(I, t.hl1t. t.hn Hl\mn wtll ho rOl'ort.o<l to t.Ilo lItlg-lHtl1r or WillAI and that tllll 1I111t1tlllt ",' t,ft)( l\uROFlA(lfl Hun 1'0 1'lll\HHflHHflfl In Ill!{~llrt'Urln(' t.hllrflwl t.llt 'rllflt tho (nUlIR of tho '\P\lI'opl'tnt.f1 llolll1!\IlB III HohncluloH "Aft, "B"I fte", ")1;", "'HI "Ii'" nR IHrooiod thurnl", 1111\'1' "nHIl enn.ttllt f'ol'w(lrfi nllll 1l1'()l'orlr l'ol~l.lt.nror' ill thn fhlmmury. Subscribed and sworn to bofore mo this ,.""j,Hl1.."""" .'1'1 (...,:....!Uy ., day of . !\\lBus~... <J / / '.' I !t,,~,. .' "..\.;.. .,'\):L:: / J,i) ( ." llJ~,Q"... .,)., .....q;:;~?lJ;.j~~"'''''"."''"....,, .......~{J..Sb""&~,r;:l":~.i."""'~,',,.,,,,......,. .... .;S~if)~~;~&~lO"",,,. No'rEI Bfd'nru HI~lltI1K nf'I'illl\vll. ml\kfJ KtlrO f\11 hll\nk Hpnllllflln t.!to nf't'tllnvll 1111(1 Ht~hHfllllo~ UI1110XUlI /lru f'IIIIlII III wIth Ilot/lltH ur Ulll wnrfl"Nollll", t\1lf' Jl1 OI\H" tltn "RHOl,H trtol\lllu l'Ur(l 1I1111 \1111 I Rt.ott HoourltlOllI, Sltr'urllll1H nl' (!lnHo nr ('nrolly IHll'porntlf'llH or 1\11 tl1UlroAI. In 1\I1Y Do-p't"lllflrHh,tp or tlllHlnOHK, U\ld. t.ho IlnUl 111111 Htnt.nmt11ll,fi rOfllllrml IlI11lnr t.ho PI\l'l\AI'nph Ilhnvo 1'(lllll.tn~ Ul Hnhtlfllllu "I'" nrll /It,t,llOhflfl. A1HU mnkn <'IlI'l.lIln th/lt. (Hllumll N1 III t110 tlMllflmRI'y" hUH 1wUII pl'nlH'trly l1ontplnt.fl(l l\H IlhllVf,..(1trnl1tfHI. , .~...~~~..... ,f,'''''', 01'''' - -~""""~'l( ,{l;,"',,;' ','IC::I^J..Sko\J. I ,:' :,J II \' DONM,\M KNIJTSON I {AQ"f:,(:',I~ IJ(lrI"" 1'1"," '(,''''':''''''IIA .' ~i'll;~;.'// O:f.'1r;nr CO~;rllY ~ ........----O~..~ My rnmrll, wl,jJlr.'s IlIL I ~ Hun j ~"""''''?<'';;.'.~.'''~'''I..: ,...,.. ~"-v'..-"'~'-',-- .,...~, ,.'"./ \< ,'" :~ ;..( r: t ~ -" v: i' 9 '" ~ :H'v ' U:1J , 'ii' a ~ 1; Ht: ~ Ai, S\l~tM,'I\\' (SI/iI, "A") (~(Ih, "B") (S~h, "0") I\lIul l'ropo~lY ' 1'(lI'NIII1\11 I'I'll\lorly , TrulINrorN r.iI'I'SN '('usuhl" gNluh: - -. ~ ~ ) I - ?o '~ li:i ~ '~ ~. ~ ..i: ~ ~ ,~ ~' I.ll e d ~ ~ ~ ~ ~. ;.-; ~ -..-- l<o ~ ; 0 ... <= ,~ .;:( e c ~ '&' ... J:J 'c: ~ ~ 'S - 'c: 1::' ~ E .;, e '" - " E - j IS .... ....... J i::'..r, u (Ii (As III'PIII'Il,d) $ $ $ $ $ $ , I' , . "~--TJ),' _..~- (A, 1l1'l1'lllIlIll'd I ~ ~ $ $ $ $ ~ i"" ~ ~ ~ ~. ~ ~ ~ I III P ~ ~ . I=l ~ ~ ~ ~ , "" C\l 8 ~ i ~ ~ 0 i 0 ~ ~ ~ z i ::i ~. ~ ~ ~ z ~ ~ 8 ~ COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU Of EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSERSMENT '*' . -! ~. , ) ) (,I I , TO:-'-<'-'</I'/J"-'r A"J. '., ,1,Jlfl-"~(,,,",1 /11 '~I) 'C'l:r-li, . J,/7:I' j!~ ./ (:I;d A.i.;,'Lf~.J (/G:;' - f),J ( j ,.' / . ESTATE i,I/'(ld,'/'j L'~/ /'..',~ll <', ' (l,( . / 'I ). ..'f ._ i i ('....:l .( ~_ I / ~/ _ /;,_1,)1"1 COUNT'! FILE NO: '.. I .1 I--J~' "I (i ,) DATE FILE NO, COUNTY . " '4..' ',/''j DATe OF DEATH //,d4~:.I..,)' /y;;- . , / /;0' j / ".' / ".' J /, ..,-{ , ,/;.~~. ~(':~~-_.._- App,alsod Valuo 01 Ealata: Reel Eeta'e . .--.-....---.. Peroonal Property + /J't:. 1~~~' + ,0',;, I)/{ /~, .,JtI/ ,!t) ( (f, / . . /{, LI(J () . /) 1.,-- ,(..!. d I, "/ ."J~I ,'1,1/ .1 V' J(1lnlly Held Property/Translar. TOI.I Ora.. Estala TOlal Approvod D.duotlons Claar Valua of Eetata ..- -~ .'-~"'_. Less: Approved Charitable Exemptluns :: Amounl TaKable @ 6% Rata .,,;:J~,!) (.!( ,,} ((' . ..:;'),1/ /]iJ / . -:j' fL, lax due J U. 1/::> Of; () 23' ,I Cla.r Velue of ESlate Subject to T.. Amounl Tax.ble @ '6% R.le I.x due TOTAL PENNSYLVANIA INH~RITANCe TAX DUe . ~ i/!./f', ,?;y will be ..***- A five peroent dl.oounl tUlallng . gran'ad If tho Inherltanoe Tax I. peld by . AMOUNT PAID DISCOUNT INTEReST TAX CREDIT . + . 1--_ . , t . .--- t . La.. Crodlt.: DATE OF PAYMENT Inlera.1 aoorue. al the rala 01 six (0) paroenl per annum on tho unpaid balenoe of Inherlt.noo Tax from ___ 10 dele of paymenl, Inlare.1 duo II paid by__. ~..___ I. ' BALANOE OF PENNSYLVANIA INHERITANCE TAX DU~. ~)j . ~-I ~ cJ, ~ l }t !t(",1 1",'1 (e/I.lc<' - J, ~-'.'." .-- + ." /.:, \..,k" . AS88..ed by', I.. I ,,;' . """".../ Buo Informellon on RoverU Side Agent o~ th. C monwe.lth ,/ ,!~~,>;151 .~ r. INFORMATION. To Inlllre proper oredll 10 Yllur oooounl, Iho noma of Iho 081010 ,~nd fllo mlmbor al,olllrJ ho oluorly prlnl' ed on Iho oheCk or money order, Thll euoument II mod. In eooordone. wllh Soollon 7011 of II,. Inherll.noo ondfl'lnle To. AOI 01 196\ (72 P,8, B 2465.7081, To the e.,enl Ihel Inherltenoe te. I. I'old wllhln IIHUO 131 monll,. oltor Iho dooll1 Ilf 1110 dooodonl, e dl.ooun\of flvo 151 peroent Ie ellowed 172 11,5, g 2498.710). Inherltel100 Te., olhor \hon te. on 0 ""1Ir0 InlOlo", 18 dllO ot 1110 dolO Ilf Iho dooodol11'0 dooth und booomo. delinquent 01 Iho o.plrellon of nine (91 monlhe olter \ho <Iooodonl'. doolh (72 11,5, fI 2408,71 \). InhorllOnoo Te. on a fUlUre 1I110rOll Ie p.yehlo wlll,ln Ihree 131 mon\h. oltor Iho I",nllor lokol offllOI In I'01800810n ond enjoyment ond II delinquent \ho,ool\or 172 P,8, Y 2408,7\ 21, Cnloulnle Inlor0811rom 11.0 <Iollnqll"nl <Ie'lo ehown on Ihe,feoe of Ihll fotm 10 \he dete of oolllel peymel1t "alng 1110 lollowlnu Inlor081 loblo: _____...___....._ __... ........_.".. _ ___..._ ..__... __l~'" -......- ........... -:---........ -..... -.......... ...-... -....... .........-....... ---.. - -.--..- 1 monlh ,008 4 mOl11hl ,020 7 montll1 ,036 \0 monlho ,060 2 momhl ,010 6 monlhl ,026 o mon\h. .040 1 I monthl ,056 3 monlhl ,016 6 momh. ' ,030 9 month. ,046 12 mOI1\l1o ,080 I dey. ,00017 11 doy. ,00186 2 I doyl ,00352 2 deye ,00034 12 doy. ,00203 22 dOYI ,00360 3 dlYI ,00051 13 <Ioy. ,00220 23 dOYI ,00388 4 deYI ,00068 14 dey. ,00237 24 <Ieye ,00403 5 daya ,00086 I b dllYI ,00260 26 dOYI ,00420 8 deye ,00101 1 deyl .00287 28 doy. ,00437 7 day. ,00118 17 doy. ,00284 27 deye ,00464 8 deys .00136 18 dOY' ,00301 28 doye ,00471 9 daya ,00162 19 dOYI ,00318 20 doya ,00488 10 day I ,00100 20 doy. ,00336 30 dOYI ,00500 ... - - -- ----....- ...--..-----... ---...... --... - -- _..~ --... - --...- -.- - -...._,-- --- - -- - .......---...,... ---..... Any porlY In Intereat, Including \ho Commonwonllh ond .ho porlonal rop,oaenlolive, nol lollollod wllh Ihe eBl.olmonl mlY objeot 'thoroto wllhln .1.ly (801 day. ollar ;Ioolpl of 11111 Nollo. 01 provldod by Seolion 1001 ollhe Inherltonoe and e.lolc To. Aot of 1901 172 p,S, G 2486',10011, ' Make check or monoy ordor pllyoble to: "Rogleter cf Wille, Agont" Mall to tho addreee Iletod bolow: mf.Q.flMAIt~. T~ Inauro propor orodlt 10 YOIH 'ROcount, Ihe nemo of Iho olln,u ond 1110 numbor .hould "0 olaarly print- ad un tho chuck cr money ordcr, Thl, naU8lmont Ie modo In aocordonoo wltlt 6001l0n 708 of tho Inherllanco ond 8aloto TBM' Aot of 1981 (12 P,6, 6 2485.708) To tho oMtem Ihal Inhorltanoo la. 10 ptrill within Ihro. (3) monlhe uftur lho doolh of tho docodonl, 0 dleoounl of flYO (5) poroont I. allowod 172 P.6, 6 2485,710), . Inheiltunoe To., olher lhan ta. on 0 IUlUro Inloroet, I. duo 01 tho doto cf Ih. docedonl'e dOOlh and b.comee dellnqllont '1 Ih. ..plrallon 01 nino (9) mcnth. oller thu dooodonl'e doetll 172 P,S, 6 2485.71 I), Inherllanoo TOK on B fUlllro Intoro.al la poyoblo within Ihr.o (3) monlhe ollor 1110 Iranafor lakoa off 001 In poa808IlDr, and onJoym.nl.ond la dollnquonllhor.ollor (72 P.6, ti 2485.712), ColcIII.l. Inlero.1 from tho dollnquont delo ehown on tho fnco 01 lhle form 10 Iho dOID 01 oOlllal poymonl IIelng 1110 following In\Olo.llol1lo: ----.....-.....--- --------.. - --...--.....-... ....--.. ..............- - -.--......-...-........ -.............. -- .------ --...- -- - --...- 1 month ,000 4 monthe ,020 7 mcnlha ,035 10 monlhe ,050 2 manlha ,010 5 monlh, ,025 8 montha ,040 11 monlha ,055 3 monlha ,016 6 months ,030 9 month. ,045 12 monlhs ,080 1 doya ,00017 11 doya ,00188 21 dove ,00362 2 dove ,00034 12 daye ,00203 22 daye :00389 3 daya ,00051 13 dayl ,00220 23 dove ,00388 4 dayl ,00088 14 dOYI ,oom ,24 daye ,00403 5 daya ,00085 15 day. ,00250 26 daya ,00420 8 daya ,00101 18 daya ,00207 28 doya ,00437 7 daya ,00118 17 doVa ,00284 27 day. ,00464 8 doya ,00130 18 day, ,00301 28 dOYI ,00471 9 dOYI ,00152 19 doyo ,00318 28 daya ,00489 10 daya ,00188 20 day. ,00335 30 daya ,00500 -- ------------------- ----.... -........... -- "'," -... ---- -- ...-......--.--... - - ...........-...---..--....... Any patty In Inloroal, Incllldlno Iho Commonwoollh and 1'110 paroonol ropta80nlaIlYo, nOI ao,lallod with tho oa80umanl may ob)oct Iharolo within alKty (80) doya alia, recolpl 01 thla Nollco oa proYldod by Soctlon 1001 of ,ho Inhorltanoo unci Ealalc TOM ACI of 1981 (72 P,S, 9 2486, 1 001), Make ohook or money Qrder payable '0: "Roglster of Wills, Agon," Mall 10 Ihe addrese Ilstod balow: