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I, CllAlU.O'l"l'J\ D, JACOBli, o'r Carliulo, Cumher1nnd CO\ll1ty,
Venn~y1vaniu, doc1are thia to bu my Lust Will und revoko nny
wJ:llf.1 'jJrevJ:oua1y 11\11<<0 by mo.
I. I bequonth my autCllllobi10s, houuoho1d llnd personal O:UootB
and nny othor tnnl~iblll J'01'ElOnI11 property of like lH~ttl1'O to my
huabnnd, Chnl'loEl ~. .1ncolm. Should lilY hUElbllnd, Chl\1'loEl S.
Jaoobs, not survIve mo, then I bequcnth 1111 fHlch tnngib1e jJ01'-
,SOlinl j1rojJort)' to my llon, John Miohllel .TncolJl3. Should IllY son
.10hn Michl\Ol Jnoobs not bo living nt the tlmo of my dcath, I
bequoath said perRolllll ,'i'ojJcrty to my grnnd dauglUiWistio Lyn
Jacoba.
II. I devisc and boqucnth 011 tho reoiduo of my cstl\te of
whatevcr nature or whorever situated to my husband, Charles S.
Jaoobs. In the ovont my husband, Charllls S. Jaoobs, not sur-
vivo me, then I devise and bequooth all of said rCEliduo to my
son John MiQhae1 Jacobs. Should my son not be living at the
time of my death thon I bequeath oIl said residue to my srond-
daughter
, Chriatie r.yn Jacobs.
111.1 appoint my hUElband, Chal'los S. Jacobs, to be exeou'"
tor elf' this my WJ,l1. In tho event he foils to (!ulll1fy or
oousos tQ aot, thon I appoint my aon, John lolichaol Jacobs, to
be oxooutor. I direct thllt my executor need not fi 10 bond in
thia or any other jurisdiotion.
IN WI'I'lmrm WIlBIUWF, .I have herounto set my hltndnnd son1
to this my T"nat Will, thIs I~' ~I\Y of September, 1075.
/( <.LJ _"" ?-'IiEAL)
(7
'rho proocdin{'. instrument was on the dute thOl'oof signed,
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A Ll i .(. l~7'r
published nml deo1nred by Chnrlotte D. Jacobs as and for her
Luat Will in tho jJrosoncc of us, who at hor requost, in her
presenoe and in the preAonoo of
ouch othor have subsoribod our
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~./ct.2,t't!11 J?(}::-,,'-f r~U
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numos as witnossos.
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OATH OF SUBSCRIBING WITNESS
C()MM()NWI~AL'I'II <w I'I~NNHYLVANIA ! '
HH:
COlJN'I'Y <W CUMIII-:HLAND
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hllfhl'() nw Itkhul'd I';, Allclnl'Holl, 1<<1j.lIHllll'flll' Ulll I'I'ohuto of WIIIH IIllcl gl'untlnH lottol'S of Admlnli\tl'utlun
In unci fhl' Huhl CoulIl.y uf OUl1lhorluncl, In I.ho Cllll1monwoulth uf' PlnlnHylvunlu, pOI'Honully cllmo .............'
.,."" S~~,~?-, (t,-[;;" ,,;~ ,:, "t.,1-,?-,~, ,f, ,(~"'" 1:~, t?" ,,:f N, (,~,,?:,~7:,~~:,. ,l:~,'", '. ~ ~,/T:,~~ ,l,~:~,~~.~f!..F:;;-~,.,..",."" ,..,.......
tho HuhHel'ihlnH WltllOHHOH I.Il Uw fhl'llHohlH IIIHI.I'UIl101I1. of wl'itillf.{ IHII'pol'tlnlf III Ill! I.ho IUHI. Will unci
'I' t f' ((qA-ILLOT r~: 'D, ,.r'ACd RS 1) (,I ')'c"'. I. s 1.1. ?J'-
oHlnnl(Ul, 0 ".,,,,,,,,,,,..,,,,....,,...,,,,,.,.,,,,,,.Nf".........,,.w...,,,.,,,,,,..,,,,,,.,.,,,,,"........ n .(.-( ,,,,,.....,.1.....,,, "....1... " ... ..,
I t I' A{f'{~'1U ""11>/)1.. It 7t\N //i(lIAI~'l,IICJ ('II I I 1(' '1) I' ,I
1\ AtO "..",J)I'T'C;'''.~y".(.!.I....""""..".."..."".,,,.I.,.y,,,l'T,I.~...f;'f.".,."........."......, j III )ur une .,oun"y U" ((l(.(H1Hl(
who Iwln/.{ dul.v ......,$.w.~P..,t!.......,.......... l\oeol'cllnH 1.0 luw, clopoHouncl HUY. ~hul. ..,..,?.r!.'!!.,L'....,l:Y"t..€..f!.
C IJIJI2 ,-" 77E :7>, j-IlC: -'B 5'
,...".,..""......,.."...",,,,,,,...,...,....,,,,.,,,,..,,,,,,,,...,,,..,
PI'UHUIII.. IIllcl HIIW und hOlll'd I.ho I.llHI.U..,T.t?:.t,X..................,
HIHn, HOIII, JlubliHh, !lI'OnOUnCllllncl cloollIl'O I.ho Hllld InHtl'lIl1lllllt ofwl'iling IIH IIncl 1'01' h..,~:.R..... 'l'IIHl.lln1Hnt
IIllcl LIIHt Will, unci lit. thn tlmo of'so cloinH ...............rt!.,~,........,....,........,WUH 01' souncl IInd dlHJloHinH mind
momol'Y Ilnd \ll1c111I'HtundinH. 1.0 U1l1 hOHI. of ........,T.~-!.,~,U~,...................knowll1t1J:l(J. OhHOI:vut.ion lIud hollof',
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AFFIDAVIT OF DEATH
COMMONWEAI.T ROF PENNSYLVANIA ~
... SSl
COUNTY Ol~ CUMBERLAND
C 14/J-tJ LES S, T;e e(l f;.s
.........".,.... ,.,.,...., II ','.f.'.........,.",..,....,...,",..,. .........,..",.,.",... If ".,......;., ",,,,,,"" i.;.. ..',,,..1+. Ii -' ...,.., ';" 1"" '0'.'" .lloing- duly
<:' ' n'/ . .0JuWLO nE.
................w.(:,.y..~.Ih.Il(.............. sllya thllt liB neul'ly UB olin hl! uHcertuill<1d the BulcI decede/'1l. .........f}l(...'.';'..........,
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., ,... ,It'" .:::JJ....,,",. -:1...1. ,r:;:t;: ,I!!. ~:",.,.., .,1.... ....,...."...".,,,,,.. t.'......' It,.. i"""'" .....,.... t 1.1. '0 ",.,,,...,,,.....,., t.:.". H"""", .dtod on
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..,..,5f~.I.Y.{?,~..t................... I.ho ............(,E.!.~,.....dlly of ...............d:f..IJ;.r./:-;.....~........,......A.D., 19.79,
at or nbout ...,.,'''"....,.fl.t.,q.'~........"..,' o'clock, A,M.
..,',..,.."..".".,....~"~}!,V,8;.t!.,'"",,nnd Allbacribod thtH
..,..................)J~,P............... duy of ..::?.y.,~.j:.,.....
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Hlohul'd g, Andlll'HlllI. HUHiHI.OI'
OATH OF PERSONAL I=lEPRESENTATIVE
COMMONWIML'I'!1 (}JI' I'I'lNNHYLVANIA}
COUN'I'V 01" CtJMlllmLAND HH:
1I0foro mo, tho HOHlstol' thl' tho PI'ol1l1tollf' Wills lInd I{l'lIntlnH of' Lottol'H of' Adrnh)lstrlltlon In IInd for
I (' I' C I '1 d . II' CliUJ72 L~ ~' .!', <.lAcO B S '
t 10 iounty () urn UII un ,pOIHonn y cnnlu """"'"''''''''''''''''''''''0'''''''''0'''''''''''''....'.."'.'.....,.."......tt...,..........
who, botn" duly """o'ii?,~~,q.r?.M." do ....".... dopcu~() nnd HUY thut uH",,,,,,/!f,,~~~...!{..r:P.!;.,...,..H"tt"""t,,Il,,,,....
of tho hlst Will II lid '1'ostamont of ......C,/.cl,IJ,I.l,...k9...r..l..{i;..,.."I.?,(....~l:1.s~.o1'..~,...............,...........docollsed
.........N.1:...,..... will woll nnd truly admlnlstor tho Winds IInd chlltt.ols, rlHhts IInd credits of suld decolIRed
according to luw. And nlso will dlllgontly comply with tho provisions of tho lnw rolntlnl{ to Transfor
Inheritances. .....5.:tr,(..t<~..tI... nnd subscrlbod
before me,
'" "'''''''''''J~ D", 19 ,Z,?""",
"~'''''.e;,-"",,,...,,,,.,,,,,
Richard E. Anderson, RegIster
,J~I.t.~.,\J..1dr1if.:~....,..,",.,..".,......"....,",..,....
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QECREE
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n I be 19th ,JULY '79.
o t romor" rod t.hut on t 10".,........,.......".. dny of ...........,.........;...."..."......,........, A.I),! 19 """.., thoro
, ",' Char lotte D. Jaoobll
WUR prohnted nnd rocordod t.ho hU-It ,Will nno I uHturnunt of ..""...".......""."'.........."........'......01.....................,
1 I' North Middleton Township, ') '.'
uloo "".......'''''''''...............'''............".."......,...........,.t Ciumhnt'lnnd C..ounty,1 onnRylvnnlu, J)oconRod, l",ottcrH
. ,., ,.""""" '.. ..~.~~~.~~,~~~.7.r...., WOI'1l f.(1'lIntpd to ... '. "...,..,., ...,...9.h~,~.~~,~".~. ~H.~.~?9,~!'!,..........." "."\..,.."
,
Wltnos8 my hllnd IInd nfficllll sonl tllll dny IInd YOl\l' nfhl'osnid,
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Hichlll'd I';, AndorllOn, Hpf.(iH({'I',
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COMMONWEAL TH OF PENNSYL VANIA
OUPARTMENT OF ReVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANce TAX DIVISION
INHERITANCE TAX RETUHN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
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Rce-tOl ll-131
COUNTY OF
Cumhor1i1nd
"
Thl. rnlum nlU.t he camplotad In datal I and filed In dupllt'at., with th. ROI,III"u of Will. In tho Coullty wh.ro Iho IlpcCldanl ro.llIad within !llntl
month. altor datCl of death, union (In utlulllon I, granted hy tho SUfllltar.,. of Revenue.
- .,.
.__......__._...,._..........._ _.___"._n_'~_ _u.~..._
21-70-410
~:III:\Il' Nil, __...___111.__ I, ___S.1~ll.r:.!E!lm ::l~.;Mi;\~~_()~J!!u_~.._._._lIf _~~.yrow.I1I,I~~,~~~,~,i~~;~_~~l~r::~~~~
MI.c, '
hl\ln~ Iluly s\\'orllll~'I'(Irtllll" III IIIW, dC!llltWH Illld kU~"i thullll' l!i lh~ __.__~~!Q_9~~!!q_~______.__ .____n. ---
, (1')(1'(:., AOI,\" \..1-:-01111'(;, Ull;.l
III Ihll e,IUIII of Chnr10tte U, Jacoba Inlo ol___llorth_1,lldd.113t,orlc, 'rllwnahip
lCITY, 1l0lWllnH, OR luwrUlIllf11
dOCUII,,',d, IIl1d Ihllllhll whllle of Ihe o,lIIte of ,"ld 1I0"edolll, who died Oil Aprll,l!l, ,1070
([JAH'::!
l1oll.I,lellof Ihc lI,"el' 1I.10d hdow II11d Ihll' IIlll1wllhle dohl' lI11d doduclioll' oxco(ld"d Iho fill, mll,kell'ulu" IIf Iho II.H(lIH Illtd
no Pcnllltylvnniu TrllllHfllr Inhcrllnllcc Tnx hi due,
Swc.rn and lub.cflbod h.for. mo I [i fI'/
24 ' Jul' 79 " ,Y (--
tho ~'~7dav ai, }' 6)19 ,.d::u.. ~cJ....-<?_.. '/,L..~j;;:J___c_,....'u___u
..,.-- it -, '."""'.-1, .._.n.' IBI<lNATOR <.'
_.n...." __ __'_(eLLJU.. ::.,_ ~.$\.l?"~~(,U c
Executor
"'_n"'___'_'_
i TIT\-.Rl
TYJMI of Au.11
Real f.'lal., P.",
PfO~I!Y, Jointly
H.ld Prop. or
Tran,f.,.
~,n' l! I" ~~ I; \' n
Mv((',ri ." i'..d,l,l')nO.~
(ldl,L, ,I" (A.t,~qh,f\~~IHC)Il~1 ,h"t, If ntUllaty)
t)ucrl"li(lon of A...t
e,tlmat.d
Mark.,
Value
Deportment
Valual!.P.n...
CAUTION
(Do nal writ.
In !hl.. c.
Porsonal prop.
ShurD in reaidue from as tate of
John S. Dysert, fnther of decodent
1600,93
TOT ALS
1606.03
\ ~()lt" <13
REPORT OF INIlElUTANCE TAX AI'PRAISElI
I, Ihe unde,slgnod dnly nppolnted Inherltunc. Tu. AppmlHe, in IInd fu, Ih. ubnl'o CUlIllly d" 'ospoolfully 'epurt thnt I hnV<'
upprlll,od tho ,.nl nnd po,sonnl p'''pe,ly n. ,eporlod In Iho fo".,gnjng 'UhcdUI~ III ~:hnlucR SO,I furlh UPPUHIt. ou"h Ilolll in
Ih. In'l co\ll'JU'rl" jh. 'IrM. -. ---'-;1 /} ,"; l.t.,' I J /1 u...._...
IlRlcd: _____....u.c..f_1_8___ -91,9-----.-.....- ,IINHHRITANC~ TAX APPR^lflRRI
DEBTS AND DEDUCTIONS Am'""t
Nature of ClaIm. Clulmed
Harne of Payee
Amoun! Apploved
b, Regl.t.,
Charles S, Jacoba
George n. Fullor
for funeral
claim for merchandise
lj1uguzines
x-rnya
reimburse cost of probate, ad-
vertisinH, filing tux form,
flUol1y exomption (hus1Jnnd
uttorney feo
192B,OO
131,62
7,95
325.00
Ewl nr, Brothers
Fingerhut
McCull' a
Hurria Asaoci ntes
George 13. Faller
50,65
2000,00
50,00
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TOT ALS
4493.22
IlI'.l'OIlT Ill' TilE RElIISTER 01' WILLS
I, Iho undethl"nod dilly clocl.d lIo"I.III' uf WIIIH In und fur Ihll IIhn,. ('onuly, dn ,o'poclf"II\' 'ol'urllhal1 huyo ullnwod
dcdul'tiol1s llllhc Rlllounts set fnrlh In the uhllvu ~chcdlllc flN cluhncd, except where I hnvc Met furlh II gfeater ur teHNer IImollnt
ill the Inst column to tlJ: rlB,ht. which gfcnter or h.lSRCr umllunl rC1HcscntN the :UI1l Allowed n~a d(.'(I\lC,tiOI\,
. 'I \,1, ~J (' J lit) (~ . J l.j,
IlIIIII nl AI'I',nvIII: ,. ('(~X-4-,o-D~ . , 0<, ".IJtA,.,Q.. ----
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