HomeMy WebLinkAbout79-00420
t'-Jo 21"19
.,.
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estat e of .
IlUflAlNIC H. HEll'!'
" deceased.
To Ricllard E, Anderson, Rouislor o( Wille. (or the County of ClJmborland,
in the Commonwoalth of Pennsylvania.
IS
Petltioner(s) are the execut Oil '. named in the Last Will and
Testament of .,., ~O~~INI\.s..,Hle,R~' dated Hay 11 ,_l~?~__._.
Decedent was a citizen of the Unlt~d States and q rusidcnt of
XlXlw~ . .
,_,__q/1.!.!_!sl,~_,__.___._,_._... Borough, Cumberland County, Commonwealth
of Pennsylvania,
Decedent died on .....~.[I.!:!:!!.d_ay.._.__...._._,.._,. tho.. ,.3OJ:.1L.. day oL__.JuIlB..,.....__.._ ,
A. D, 19.. JL.., In the County of "Ull~rh,ill n' N" __, State of
,__~~n!l!IJ_l:.vlIl~i~n_..._...___...._, ..a..__ at tho agtl of ,.....~8_,_ years,
has has her
Decedent has not been mmried and ha!; not had children born to him
since the execution of the above described Will,
Decedent was possessed of personal properly to the value of
__,...._,,!!Jl.e_~.ti.(Il.Il~-<3A_._ .._ ,.". and of rool estate to tho YClluc of
1l01\e
05 nec.lr as can be ascerl'c.linecl; sold real
estate situated as follows ,,11/11,..
___......____...........-____.__. .~..._....._,.~_~_..,. ._..._.._~__..'~' _........___.L'._.__~____._.___.__.
.
apply
Therefore, your petltloner(s) respectfully applies for the probate
of the said Last' Will dnd 'Testament' and for Letters Testamentary H\ereon,
Dated ..__JulY-_.k1979 -..--_____...__~,_,_
Name and address
of Petitloner{s)
COMMONWEALTH OF PENNSYLVANIA f
. ss
COUNTY OF CUMBERLAND
Dellnis C. Csverly, Senior Vi' & TO Farmers Trust Company
tlj&'
It ,-
I !, 'I.
d I b I ' t' b' d I sworn
name n a ave app Ica Ion, elng u y ,___....... ..... ,_..,...
say(s) that the statements set forth In this petition
best of _,.__!~:':.a._.....,__..___ knowledge and bel ief,
___....5.wcr.ll_,___, and subscribed before
\
~e, '--_~Q5n,[jJ\ 19,7,9., ..,
---,..t. ___,_~,__ ...l....
Richard E, Anderson, Register
according to low
are true. to the
Filed; ,1uly 10, 1979
Attorney:
,lnmes Il. HlImer, EHq.
,>
..
, .
min.-d lllII Hllutil m,l\~;btl1t.l'l1.t
1, IWMM Nil S, WIlI(T, of tlw Borough 0 f Cnr.1 Is 10,. CUlllbo1'lund
County, 1'0nnsylvunJ.n, doc.1n1'o this to ho lilY lll!lt will IInd 1'ovoko all
wIlls which .\ huvo ]J1'oviolls ly lIIndo.
I I dJ.roct lilY oxocutor horolnofto1' namod to pay all
of lilY jUllt dohts, funoral IInd udmllllst1'ut:1on OXPOIlS(l!l, IInd 11.11 trllns for,
inhcrltll'llcO, ostato und succossion tnxos wid eh nhnl I hocomo duo hy
1'Oll80n of lilY doath out of tho 1'oslduo of my O!ltlltO.
II r gi vo aud bcquonth uiltO Tho Jllrst Iivnl1g01 Jcul
Luthorun Church of tho Dorough of Cnrllslo nnd Its VicInity tho sum
of Ton Thoullund ($10,000,00) Dollu1's.
III - I llh'-:o a.II},~,.hoqUoath lIn~o,CarUslo 1I0spital of
JI~c, ,({'(': FWE /:II;,W ~-...oC', <><,
PonnsylvnnIa, tho sum of ~ 'I houlland ($:Hf-;-6iHh:O:tl) !loll aI's.
Car1Jslo,
IV I givo and boqtlonth unto Dickinson Collogo of
Carlislo, l'onnsylvnnin, tho smo of Plvo Thousand ($5,000,00) Dollars.
V I givo and boqtlonth unto lilY cousin, Jossio Louiso
Van Dovondor, tho sum of Ono Thousand ($1,000.00) !lollars if sho shall
survivo 1110.
VI I gIvo and boqllouth unto I10wnrd M. Wort, .Jr" my
stop-son, und Ilarriet Wort, tho widow of my decousod stop-son Raymond
Wort, and Ilsthor Pox SingIsor, my sister-in-law, ull tho rost, rosiduo
and romaindor of my ostuto, in oqual shuros, and if docoasod, to his or
hor surviving issuo, pOl' ~tirpos, und if no surviving issuo, thon to
lapse.
VII I uppoint Parmors 'l'rust Company of Carlislo,
Ponnsylvania, us oxocutor of this my lalt will nnd tostamont.
IN WITNESS WIIERIlOJl, I hnvo horounto sot my hand and soal
t.his 17t~day of May, J974.
(J) ,
__'...:;J.rfJJ/ FJ' /1. \
I"~ )/ nt'
(SEAL)
Signod, oaled, published and cloclufOd by ROlllaino S. wortI tostatrix
ahovo cll1Jlonod, ag nnd fot' hot' Inst wil 1 und testamont ,n our prelonco
who in ~r j1l'OllOnCo, ut hor roquost, and In tho presonco of oach othor
hn 0 h~)'ol/~~~frihod alii' nnmos us uttogtlng wi tn05SOS: /
/t H,,~I C1l!dA (/, Ct'K-L~(O)jl-//
(I
.
OATH OF SUBSCRIBING WITNESS
COMMONWI':AL'I'H ()to' I'gNNHYI.vAN1A
\ ~~:
CO\IN'I'Y 01<' CllMIlI')Hl,ANIl
'I'hl~,,,,,,,,,,, "" ""'''' '" ," "~,f.l),, """,.""" """"" ,," '"'' duy of, ",.., '''' '" :!,\I,lX.." '"'''''''''' ,," '" "'" ,,"" '"'''' A,D" Ill" '''~~
Illlfill'e me H1chul'd I~, Andel'~on, H(ll-ll~t.ol' fol' tho Pl'ohut.o of' wms und ~l'nntlnfllollol'H of AdmlnlHtl'ul,lon
In und fill' Hllld County of' Clllllhorlund, In tllll Cmnmonwoulth of' 1'0nnHylvunlu, 11I\I'~mw\1y OUlllO """""""
,\),~'.I,\,I,'.'! .'.'" ,9, \,' ~f! ~~ ~!; Yo" ,/,"" ,gr"9,,, s>J""""""""""""",,"""""""""""""""""""""";"""""""""""""""""""""""
tho HuhHorlblnfl wltnoHHoH to the fOl'oflo\nfl inHtl'llmont of writing \lUl'pol'Unl-l to he tho lll~t WlIl und
TOHtulllent of' ""'" '" l\\wmJ,\w, "~,,, ,}1,QX,lj" "'" """" ,",'" ''',' "",' "" '" '" "" ,,'," """" Dut.ocl """"" t)IIY." ,I; 7. ",J.~,7,~1"", '"
1 .~ f' l\ul'Olluh of Cnl'Uulll (' I 'I 1(' . I' d d
UlAd) """""""",""","""""""""",,,,,,,,,,,,,"'"''''''''''''''''''''''''''''''''''''"",,,..' ,um)OI IIn( AllllhY u" OCOUHO
I I I d I U~IOI'I\ ' dl ' I I w d I 'h' \10 was
W)o )0 ng U Y """""""",,,,,,,,,,,,,,,,""",,.., UCCOI' ng ,0 u , OpOBO UO( HUY, 0 /10 """"""''''''''''''''''''''''''''''
pl'o~onl, und HUW und heul'd Ihe l.o~tlltl',!.l!"",,,,,,,,,,,,,"""'"
1~.'?r~H A!1H,. ft f., .':{'?,r,~"""""""",,,"""""""""""""""
slfln, ~eul, pub\l~h, pl'onounco und dochll'o Iho Huld InBIl'umonl of'wrltlng UH unci for h"""""""" 1'OBtumont
Rho
'''''''''''''''''''+''''''''''''''''''''''''''''1
und Lust WlIl, und tlltho limo of BO dulng
.~ of H(lUnd und dl8111lBlng mind
m,m'ry "d und"""dln" "' tb' b.., ,,' ...............!!!.~... .......... ....: ..../";/~~,;:)n ",d OOU"
...".. .~,o/.9.r.'Q...."..,... ,.t..., ,,""1'"'' und, BlI~,8" O,"b'" 00'"'' ......il:t.tt,4.C:JU.<I.:,J::::.,.... ....
I So), 1\ ,.."",,,,,..,,,,,,,..,,,..,,,,,,,,,,,,,,..""" "",,,..,,,,,,,,,,,,,,..,,..,,
""""..""..\..\0, " ,H ,:;;~1!..~""""..",,,,,,,,,, ,""" "" ".... " " "".... "..,,,,,,,,.. ,,,..,,,,,,..,,,,,,,,,,,,,,,..,,',,..
Rlchurd E, AndllrBon, ReglBter (
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA l BB:
COUNTY OF CUMBERLAND \
1~~,\W,t~.. ,~,:, .,~,l'!~~;; ~X..,.. ?,!;\"\ ~\":,, ,yg" ,~" :~'~" ~:~~!1)?';,~" :~:~',';l,~,~" ,~~~r.!!!1?" "",..""""..,",.., ,..'",.. ,..,:',,',.., ,..' ,being duly
!!~~;;\\"..",......"............,,',....'" BUY8 thut UB neurly U8 can be aBcertalnodthe said decedent ..........,....,,,........
1~~~!!~!1~" ~:, ..~~,;,~,.."".",....""""""..""".."""";"""""""",."""",.."""....,:"""".."....""..,,.. '..'""", .."" ,.... ,dlod on
5aturdav
...",..."."'........."......'.,..'..'.,......
Ihe
'., 1...,.tI.,..,.~R~t1..,....., dElY of t' ,....~~~~...t.....,..'ttH.'... .."".." .... ",
.~.)
A,D" 19..,?,?"
ul or about
10130
o'clock, :...M,
.".,............."".,..........,.....,.
fiwQ,;n"....., to " ..,.......,..." """ ...,;",nnd Buhscribod this
"',."...".,...,',..,?~.~;........".'...... dny of I..t,.,.~.~~r"""",
19, 7.\\..", beforo \
....' " ,....JJ€(1MJt" " ".. """" ,,,,,,,..,,,....,,....
Hichnrd 1'), Andol'HOn, Ho~IHtcl'
OATH OF PERSONAL REPRESENTATIVE
COMMONWmAIJI'H ()to' I'I.lNNHYLV ANIA }
COUN'I'Y 0\1 CllMlIloatLAND Ht1:
Holilro mo, tho Hllf!IHtor f'or tho I'I'ohol(' of' WlIlH und I-ll'untlnll of' Lo(.tol'll of AdmlnlHtrntlon In Ilnd fill'
tl (' t j' (' nl 'I I ' 1\' llonniR C, cuvorlv, Rooi.ot VI' & '1"0 Ilnrmura 'frllHt: Go,
10 ,oun yo All lot nn(, pUlHonn y CUll\(l ",,,,,,,, "..""......... ",,,.. "".. "....,.... ".... ,.."..,,,...,,,,,,,,..,," ",,,,,,,,,,,. ..,
who, h(dnf! duly ,..,",..~~?~,~~..,"".., do ,~~..,,' dOpOHO und HUY (,hilI, uH""I\l\\\m\~,\l.l'..,"""..""""",,...,..,~"""""....
of tho IUHt WlIlund 'l'oHtulllont of """..,....!W,I)1(lJ,I,'!"..,~,!"W~!:,~..,""''''''''''''''''".."....'''''''''."""""",,,,,,,,doC\,usod
,...."....\w"""".., will wollllnd truly udmlnlHtc!l' tho l-l'J()dH und chutlolH, 1'lj.lhtH tlnd cl'odltHof' Huld dOcouHml
occordlnj.l lo low, And ulao will dlllf!ontly comply with tho provisions 01' tho 11I\I' l'olntlng to 'l'rIlIlHfbr
InhoritnncoR. ...",~~?r.~...It""'" und Rubacribod
?
befol'll me,
,..........,..17,\1 .. J, ....,.."...."..",,,0.AA,. ~.t 191.~"t1.....,--
f\,---,
...",...........".,' " .......'.H.':.'C.""..,.".......,...,
Rlchurd E, Anderson, ReglaWI'
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DECREE.
Be It remembered that on the ",,,..+.~~~,,,...,,, duy of ........"'"..""'~~,~,Yi....,''',,..,,..,,'' A, D" 19~~".... there
wus probated und recorded the lust Will und 'l'ostu\nont of "",,~Rm!!,;,l,)~..,~...,,"~~,~,t..,........,"""""',..,,"'"''
late of '",......,c::,~,~~,;,~~~.."..,,,..,,''''',........,,....,,,,....''''''' Cumhel'lllnd County, PenllsylVllnlll, Decellsed, Lettorn
""",..""" ,."" ,~:~,~,~~~,~~,~,~~,~""" were I-lrnntod to ,,"" ".,',..,;....,f.~,~J,1)~,~f! ,,:;:~~,~,~..9,~m~~!:\y.,,',..,..,',....,"'"
Wiln'~ on, h"nd end ,m,,,,\ 00'\ ""n d" ,nd "" ,\bro"ld. ...........I.. (t.~~.~.:.. .:.. .........
Hlchlll'd Ii, Amlursoll, Hll!llsIAlr,
.
<, I 'i' I J I :'
RCC.U ("'.HI
COMMONIVI':!\I.TlIlll' I'LNNSYL \' ANI"
DEI' "lnMENI (lI' IW\'I'NtlJ':
1l1.llWALI CJIo' ('llLlNTY C'll\.I.I'TTlllNS
.
COUNTY OF
(;U~UlI~l\I,hNll
RESIDENT DECEDENT
IMPORTANT,
Thl. ,o,urn 1Il1l.lhe e;;;;;,'lew.l"i'l1 11011111111111 01'::'.111 'h,,'li;,,;i,~, II'llh-~'o.lIill;'i,~,i, wlii; 'I'" I\"MI~;I" 111 Will. :,1 Ih" ,-
Cuunty whore decedont ru.ildod; I~N\trn It< duo within nllll\ 1,,0nthH nnl'l dnt" of dl'ulh, llllh\tlll 1111 tHillll1"lull 'N 1lIlIIlH'c1
hy tho SocrOlilry of ItO'.lonllll. (Scl'llnl\ 71L\ ur Jlw l11ht'tlllllll'\' 1111\1 EltllllU Tux 1\\11111' J1~ftI.)
-
-
-- --
-.- ~
-'.-"~~"- .
",- ..
,. IIolol_
IN Till! MATTER OF TilE ESTATE OF
HOHAINE S. WERT
---""---'ISTA.TE PULl. NAMF-'OFri~D'iiN'V-
}
Courlty
1',n.('II'I'lll\
.\IIIIlNISTI\^'I'llIl
,IFI'IIlA\'1T III'
I..t. .1_---'lumbgr).nmL------..--..-..-
S'.'. .1 _,~nnay*"al\!a---..-.-'---',}
C Cumberland ..,
ounty of ___.__________._______....~___._.".'
Farmora TruBt Compaoy
!KW~XCOOlf{ .-..--;r.;h~~~.~"~~h;;b-~~;:~-~;~;d -d~~,d-~~l h,lnu ell/Iv .WU"'1 d'II".'
I!lI.ooutot
_.__""~~._,__+__&.__~.....&L...--_.,-
DCCl\dcnl dilld
.Juna 30
d"dur
I 111]~~+-__~{'''I'''' lo",lnu, I"" wlil, l'rl.1 wh,.h l,hor.llI .11..h.d, )
'YO' .,,, R.ltMOllf .
(MONTHl
Hame and add,e.. alultornev 0' }
other authorlud ,epruentatlve If! whom
all c:o"upond,nc:. .hould ba maliI'll,
tlJA'(J
,J!IIllI\fl1\!
Ollll Wl!l1t
\11111\('1' I gll'IIIII'C\ .~_..,~.
\llllh III, I l;nl'l_tl1tl.LJ~./!L17()1~~..-..~---
~L~_~________'_~-'--" .....-,..
Thill, ns slleh__-.Il3..~.E..\!~.()E__......__.._"i'1ll'lH'lIl is 11111I11111' wilh Ihl' itllitllh 01 hithl "klIlIU itll" Iho prollorly oOllktllutlU"
(E X r,: CU TO R' APMINI fl r H^ iOHI
the nS!H\IS thereof llnd their fnir mllrkot \'ltllw,
TII11I ullhe lillle or "enlh Ihere WIIS 1111 Sill'" ""III!hIlIIll\ 1,,~lh"""" III "1"",,10111" ill,lll'i"uitIIlIlIllO. II( JIIIIIII\' wllh. Ill'
liS lIg.eulor ,lepIII\, IIf 1I1\11lh"r, or III "el.o"elll'k ilHllvhlllitl UIIIlU', \\llh lIuh/1I1 it",'I'", hI' itlllll"Or liS IIg01l1 or "epul\" with Ihe
exception of Ihe 1'f11In\\'ill~: -
,.,~".-c~",n..=.-"--',,;<;li"...~ ~..:or-;-
,===-a~
;;-~.__.__._._~.._='''''=.,.-''---...;::;''''=.=,.'''=''-....,'..;'''C.''...'.i=''-..,,-~.,"""
NAMI! AND AODIHi.SS (II' OANK ot~ OTttE.H lNIIT/i'\JT101~ l1Uh hAH IlI:I'Ulill IWI( Ill'tn hO
l~ WHICl1 [)I-'CfDlcNl' HI;NTFD ^ Ii ~f"E IHiI'C1f111 HOX ItJ IlAMI' illlljAMUl Of
= .- - -----.....-..,... --_.,-,-""'.~..
tH::L.ATlON&t-1H" Of" JOINT
ItOLor.RB TO OI!CEO~NT
NONE
__~..._....----o--'-,.,....~.T_'_~._cr._' \..
~.~.~~_.__" .__.__Hzn.'--'-'-'-'_ ...-.
._."~.'_h~_..Z_._________ ----......
----. -----.._------_._-~.. _.---_.,-~ ,-_...
....._.._____________ __~_z__.~..~.__.~.~_.. ,....----..,.~--
...,._,,,.__u.,..-,_.~,u
_._______~u._.._____.,,_..~_
._..,,-_..-_.._._..~--------
-
.,...-
~J:IT..-.....=_il~"'''' ~T""""""-""F.--- ..-~~~.....""-"""''''.,.,.~=.'''-~\.
Thllllhe eunlonl' ul SlIld Hllfo depllHll hll. Ill' IH'"'' 1I1l' 1101ll11.od IIndvr Sohodlllok___.of 1111. ro 11I[1\ ,
with Iho oxooptlonllr lho following, rUI Ihu 1'0IlSIIII." .lIorolllllflor SOl rorlh:
ThIll Schedule A IIltllehed helelll IIl1d III1Hlu IHIlI h",ollf ""Ih furlll filII\' 111111111 "01"11 1111 11"'10111 prupvrly
III Ihe Comml1nwonllh III' 1'01l1l"~'lvllnlll III' whi\ih de","I"1I1 ,III.d 1t1l1'11I" 1111 1111"1".1 Ihol'ulll, II IIlso kulS forlh Iho
mullgngo cneumhl'lIncos II1'0n ell"h I'lIreel of 1'0111 1""1"111\' III 1111I '.111111111' "lilith, ulvlng Ihe 1I0\llllot .1111 dllo III
donth, nurnu of mnrtgl\gl'O, d{lh'-, rute or IntCfUsl, nllel hllok 1I1ld IllllH' ullcl~"I't1lhurl'C1L IlI\1fw HclN forth lit thu
colnn1l\R \lmvl"h,,' thorofure; thc nssc!iscll VIIIlIilt11l1l of l,ur!lll!' J, It Itl Illlf~!(llh j lhe c"tinH'lcd murkut vnlno thereuf
I\H of date of donth of dceedcl\t,
Thll' Schedul. B III1I1Ch",1 hllll'llI 1I11e1 11I11,1.. jllleI 111",,"1 hI'" IlIelh lilliI' 1111",111 e1,'11I1I 1111 jlolS 1111 II I proport\'
whcrcsovor situnhHI ownud hy thl! lllltilHlenl III llip IIIllH Illlh'lllll; 1111 t111l11l'p' It,ll h)' the dUClldcnt at Ihu time of
dCI"h, whether in dl)l:IHlcnt'll Inll\H'IIIIlItJ llllH lil1",,'..l1l1l , '1tltlulllljt III 1h'1!1'lh~llt'h ('H;,IlI In hilllkH of dl~lllIHitl !ul\'lngH
hnnkH, tntHt cnntllllnlllH, or ollwl InHlIltltlllllh, wlH'lhl'j 1I1l1l\'ltltlully, III III ttlllil. flH un~' IItl\l~1' lH,'-rHlll1 or (lOrSOnk
glvinS utso HCllluntcl)' the IHTllll'~1 iltllJltnd 1!l1\\I'IIII, II 1\11\', II/lWII tll thu IIHiI Inlutl~t;l 1I1l~' l'l'inl' III decedent's
deillh in thl\ enSD 111' Hllvinl'-" hUl\kh, 11111.1 III 1I1l' dull' III dl'I'l'lh~IlI'!; II1'Ulh In 1111 11th or l'UllCSj nil hllnd!ot, postn!
sn\'il1gs, trcntlury ccrllfkllh!!; III I\IIII'I! iltlll 1I111~', r\IlII'IH'1J Ill' IlIlh~hh!lllH'r;h Ill' lhc Unlled SIntON to Ilw de..
cedentj nil nhliynllllnh, wh~'llwl h\' hl,thlli' 01 'lltH"'IIII'lIt Ih"y 1\(11 dl't.hwnlcd 1\'" lUX frct~, or lhe United StntcH,
or nn" fttlltl', III' lulllth:ld ktlhtll\'itdllll 11Il'1\'1I1, III 01 Ill'" lorl'illll fllllllll'\'1 "hkh IIfC owned 111 the time of t1111\thi
1\11 wcnfil1lot IIIl1HHl'l, jl\\why, "lh'i'lWIIU'1 Illl'IIIIl'~, hllllk'i, \\lIlkN Ill' nfl, Iwusuhn\d rumllurc, horMCS, cllrrll\ges,
i'UIIHHlIhlletil hont", 111111 HIIY 111\11 1111 tllht'! PI'll;lIllnl dlillll'l!t nl whnlNIIl'VI\C, kind or Illllure, left hy decedent.
logether wilh the fnlrl)' ~.!;tilllilh'll 'lllll~l'l \'lIhll' Ihl'II!III~ 1111 IlIllllhi nl\d I\\IIIHUlllt.l-~ hl'leI by decedenl nnll nl' nil
c1nil11s diU: IIUtl OWlIllt IIl'I"'111'lIt ill Ihp IllIlI' 01 dl'Hlh, Illltlnll 1I111IllI"litHY Ilotes or other 1l1NlrUIlHHttN in wrlllng
for lite 11I\YIIH'nl HI II\IlIH'\' ill whlt-h Ih!lI'lh'lil 1111\11 tHl'\~I\"I'I!tl, III' WhlllslIlH'l'f nl\ture, with Intefll",t thereon, If
uny, "I\'ll\~ tlw flll't1 \'lIluI' 1I1Hl l'hllnHIIi~11 li\ll 1I11llki't \lllth' Ihl\lUlI1. Hlltl It' "uL'h I!SI,imntcll fi,ir mnrkct yuille ho
!ctdi thl\lI till' 1'111'1\ \,111111', II 1j\1(... lwlh IHldl, IIII' 1l'~I!ttll\h 101 "'111:11 th1f11l:l'lI\IIIIl\ ns In el\ch Itcl\\; 1\11 munCYN
IHlyuhlc In tlw i.'hlnll' frotH II1t1 11ll\llIlIlIi'I.' \\ollrh'~ "111111'11 It)' dITI'I!tn\l; nil nlln\llt~' Ilnd onduwl11cnt cnntrnut..
1111' 1l1'00'l'IHIN "f whld\ \\,(,It' I'II\lIh1t1 11111111 till' ilHlllh IItlht! tkl,t,dllllt; 1111 nnllll\ll cnrpmnlc NtockH Rlld dl\'hhll1ds
dUl' Ihl'f('1I11 nml Ullllllltl iii, III Ihl' dilti! III tlt'illh! III1IHIII IllId ill'I:IIH',1 Inll'l'l'lil tlwl'clIn to the dlllu of decedent's
lIcuth 1I11l11l11H'1 III\'I'lttmrlll hl'l\lld; , I \\i11'11 h~' l!lll 111'1;1'111'1\1 III tlli! 1111\1' Ill' i1011lh. with tho n\lukol vulue thcru..
of nt ~lIl'h IIIIH'.
III tho IltHW nt' .HH1\l,'tt:l(t~ uf' oInHo 01' f'flmtl~' llorpOl'nt.!OIHi, tho vullltlH rUllol'I,II11 IU'U ll~ f'ur ns
1'0MHlhl11 h\\hHllllltln!,(ld h~' f'tllllllo.tnl f1tnlUlIlul\l.l1.fJi' Ow IHlI'l'(lI\IILluIIHI HhnwJng t.ll(l UtHIIl!,H 111\11 .11/\1I111t,111H
thtll'tHl!' IIH {l f till! ,\n t,(1 (d' ,hllt LIl. Tho Allllolht I II' /11 H(l 'tlO tH ('or t,ll tho t II tOI'Ofl t, n f' (hH1tHtt\lll, n I t!ln t 111111 Ill'
"nnth III nl\~' 110~)lllrtn\\rHHIIl'(lt' 1l\IHIIHIHHI 1\1111 111 HtllllHlI't. nf"t.ho \'(\1\10 of' 9\1oh !lIt.t,roflt thtll'fl tn HII1\U)(Il(t In
Hutll tlohl'dllttll I'IIIIII\I\I/d flt,nt.omllut.S nhowtnn thnl\lHHltM l\nd llnhtl1tt(Jfl of on!(l oO""l'IlI'tll"I'Hhlp nl' hIlHIllIIHH.
" l'Ol'~' 01' t.hf\ 1~0-'11111't.tltll'khlp 1\~I'fHHlInnt.1 (If Ol'Ht I n t.t,IlLf!lllt:'nt twt.LlllJJ; "(\I'1.h l-tH! IInl.lll'f! nl' tllo '1\~r(1ftmtlllt)
ItlAt'thol' wtUI II 61:1\t,(l1I111111 RlIttlll'~ l'OI'l.l1 11111 nhl\I'UHt.I'r nl' tho \HIHIT\lIHR, Itfl loonttolh !l1If1 Hllll\! llt.hl1r l'nl\t:s
}ll't'IHllIlllg 1.1' tllll bW;\IlIlHH /lH mll~' 1111 PIl\'tlllflll1 l.o lL f'rdr 111111 ,IIIHt, flf1ll1'u\tud 01' t.1Il! Ill't1l'dolll.l" tlllornHt.
l)lI'l'nlll mll~t Ill' Hllhl11lt.I.llfl. tl ..lluHld UlhO filit t'ol'l.h In I t01ll1 Zllfl l'OI'llIt 11lJ(fltlllJl' wll.h Lho l'"tl' HIUl'lwt VnlHtl
tlli'l'l'lll'l HllY II UItl I' JlI'Opol't~. oWIII',1 ClI' IllHllllllI\.llotl hr thll 1I00Il(II111t nl. tho t 11lll' nl' tlnlll,ll.
Tho Sch('du/t' C Id.t.nlllwll 1IOI'I)t,o nnd 1111\1111 pnrl- IInt'unt' Hotfl fo,'I.ll II tl'1I0 hnflWI'l' to lllll~h -ll1ljllll;Y
oonullnod t.hol'oln Hill) In t.ho onfW ot' t.1'nIlHl'tlrH III'pl'Optlrt,~', rnf\t n,' pOI'Finnlll, within two ~'l1n1'H lit' IlnoOl'ollt,1 H
r1nntll, III tJUllt.1'1l1plutlull of' t!UOI!I}OI\t.1 H fiO/IUI, 01' tntfJllllud to lhkn of't'oot ill pllHsoHHtllll 01' I!I1.1oj'lTlOnt nt. 01'
!ifltl!' (\1l1\1.1I1 HHlll fW]jl'lltllll Hut" ('01'1.11 tlt(! IWt\l1'fJ 1l1l1l \'nl1111 of' HHoll pl'oport.YI 10 whnln t,t'lU\s('orrlHt, UIl'
I'ld n t, tOllsld I' 01' t.lw t1'll11H ('OI'IIIlH t.o lhn 11l.'I~fHlnl1 t-, Ihll 11I'0}10I' thH\H t.o Ahlll'O rttno t \'ol! h~' o/loh \.I'IlII!'! I'll rf10 /ll1d
ntl otlllll' ('/I0\,H 01' II JtHl'l-Illf'nl fl/\tlll'\.l I'Pglll'ftlll/'. HIl-td tr/\l\HI'o1't'l. III I.hn nURfl 0(' t.I'HIIA('nr!i In1,01Hlo(\ t.o
tl\kll nt'l'ot\t. III tll'~HlH\..loll 01' HIl,lnYlIltlllt. ht. 01' nf't.llr fl(lllt-h, thnt'" 11i nttin nt.tnohllfl tn thl' HoIIlJflllln n OOIlY
nf' tlll1 111'Ufl, 11'IlHt. tlJl;rlH.111l1!1l1, OJ' lll,hllr IllHI.rUl1lont. (1rnnLln~ t.1lt! 1.I'\lHt. 'fhurll Is /dlin ioH1t, l'tll't,1l In fHdd
Hohtlthtlll'l I I tlt_ of' 1111 1"'Opl!I't.YI I'llul Illll\ !I"t'HOIlIII, wll.1I ILH vnlllf'l wlltoh pllf.HflH HI, t1I'IlOtlllIlL'H (lnnl.h hy
Vll'lUlI 01' thl1 llllUI'I\!HIl hy Ilf'eotlollt., ntt.hul' tnl\tvl(htltll~', 1I1'.I{d"t.l~ wlt,1I /\1lnt.lllH', or llU~' 1'0\'t'11\' n(' u1'polnt...
llJlltlt, VIH;l.i>llI1l1h\(!ll(ltltll., olt.hfll' Ilullv-tclllnlty 01' jolllt.l~', hylho wltlJ ,'ontl, ClI' nlllol' InHI.I'llllIl'lIt, lit' IInnlhol',
wtt.11 II t11111'y 01' thn IIIHt.I'llIllf'llf, (JI'(lnLltll~ fluotl 110wflr Iltt.Holwtl in lhn RtlhlHhlln.
Thill, I.,'(hrrlu/f' 0 nt.t,/whml Itlll'I",1l Ilod lIl/uln Jllll'!. IWI'no(' H01.H "(11'1.11 t.hlt III\IIINI IlIlfl I\I\dl'IlHFWH HI' /111
\I1!1'HlI1lH 1101111('14'1/11 ty Int,f1I'IlHt.ml 111 tlllH lHil.nl-n HI. Ulf' l_IHlll of' "flondonl' R 1l01ll.ll, tllo IlHt.lIl'iJ 111'1.11011' I'OH.
I"lnt,I\'1I 11l1.1\1'III{I.I{, 1,11011' 1'{lIIIt.llIll~hIJlI If' lillY, 1.11 t.lIn IluntHln1lt" l.lIp;nt,lj(lf' with t,hn nl~tl!-l III. I,hn llmll of'
('OOf1tlollt,'H (Iontll 01' 1111 llItlllJI'Ht 1I111l11tt./llltH 1\1\11 !lof\lIt'ltlllll'tnH f'or 111'(1 1111(1 II l' rl(\Of1ltnltL't,I Will, It. ulf;n
eOlll./I1nH h -Atnt-PIllont- HhC1wlnl~ whllJh (1(' t,hl! Ilflllof'tcllll'(IlH \1(1l11llrl 111 tlln dtlt'fHlol1t,'H wltl, It' II11Yt 1110il )ll'tol'
t.o t\!HH1lIt'III" tlln dlll_OH 0(' 1111"" dnll1.ll, 111111/' JHHIIfl, IUllt t.1lt' l'olll.t1oIlHlllp Ill' H\wh IHHIIO to Hlo hIHIlll'lnll\I'Y'
Thllt. S-:fl(>dulp t /ll,t.llollnll hnrotn IIIHI I11Hltll Il Pill'!' l1l'I'nu(' Rllts fort.h III 1 \IN''lfll' l,~', 1'0111 ltllll pnr-
HOltn', uwnnd hy tilt! IhllH'llollt. .In11It,1~' wtt,h tlnnl.llf1I' or nt.tlOrfi, Inotll<1tI1I,~ IlItl\lll~tlllll,. HI,IIlHtlnA III l.Iw lI,nin"
of' thu tlonwlolll, (ltH1 oLhfll'i"I, plllH l.hl' dlllO nlll' plllen of' I'oonr<l of il1Rtt'U11Itll1t.H of'('(I(It.ltl.u; \,110 vf!Ht.ll,\U'U ot'
rUIII ,'stllt.1' 111111 t.lln t1utn lit' noqlllklt.lnll nf' lH'I'Hnlllllt.y, pll1R tho lI/lmO, nlirlroHfI IITIII rnllll.lollHllll't II' nny,
of' (!u"oWIlOI'j; to Ulll I\lHHHtl!1l t..
'1'1lnl. Sc/1tldll/t> r nl.1.IHl!lO!\ !l1l\'Otn IIIH' Illllllo n IUlI'i horonl' ROt.H fot't.h t'1l11~' 111111 11\ tlilt-ntl nIl dflhes
llnd r1IHhllll.lo1\(i; lltlllmnd I'll I' HIlII on holl/lt I' 01' t.lltH lIonndont.' H l'Rt.ntn, Il\ollH'lll~ 1'\11101'(11 IIXpHIIHOH llldcll
f'llmlly nxnmpt.lo11t Wh(>l'j~ IIpplll'n\Jll'1 lIOAt.H 01' nctmllllHt,I'ltl.Jon of .tlltH HHt.lltOI O(l\llHWI l'flfH\ Hl\1I f~lcl1(IIIlI'yl H
nllnulltHHlollH pH111 tlr In 110 1'11111; '110H!. llxpnn(lml l'nl' 11\11'11\1 tl'llHt.H, t,nlllhRI,OI\OH 01' r,rIlVnltllll'\{I'!'R, I\llll rn1-1-
j(iouH Hl)J'vIOIlHt III nOllfw\fIlI'llon uf' t.ltll ""nU, or !.lIn dnun,lul1!.' Iloht.R 111111 111Hlm~ OWlll~ /lllrl llllpllld lit, I,tme lit'
clnntJll I.UXOR IIIWI'lIIHI f\tlnr/!,flllhlo ('or plll'IoII \II'lor 1.0 IhH10(iont,1 H l\Ollt.t1 (nx\lOl' I. t.hnHo nl tnwl,.t! HlIllnt' Hnot.\OIl
Bot 01' thn IlIllfll'tLnllllO 11111\ 1-:">1.111.1> TuX t\ld,) \ \'o~~nthlll' w1th II Ht/d,omnnt. lIl' f\C1llnt.lIl'ul 111 ('11Jl,llft I'or nhltgn-
I.lolIH, If' /IllY, It. 11i 1\~1'''1',1 ,,!lilt, I.hn ('lllll(lIIl\'~' wilt PI'IlRllfll }lronf' II" Hulll n1nllllf!d obI I gttt. Illlltl upon 1'0-
ll\lllStl thnt. If tllll 1l1tlOl1llt, 1l1d.II,,11~' POlll In Ht!t.Ullmollt. 0(' nny ('(W, C10Inl1llRRlnl1 nr dohf, is 1l>loift thl\ll tho
JJHllmnt.nlt 1\l1llHllll ('ll1lll1lmr; /llIIt nllowndj t.hllt thfl H/llnll will 1In rllpOl't,(HI t.o t.hn l\n~'Htt1I' Ill' Wlllfi, Ulle! t.IlUi
t.ht! nll1mlllt of' tnx IIHHIH.HtHI llUlI ho 1'"IlHHOHHt'd III Itl1(1fll'I\llllIW t.h('I'l1wl U"
'I'hlll thn toll\l" 0(' t.h~' IIPPI'dlll'lnLH on1umnH In HtlholtllloH "A", "U",
hnvn hl'flll ('1\1'1'1.011 f'OI'WIlI'lt HI1r1 pI'npol'ly l't'~tHtnt'Ultll1 tho Hllnullnr~',
"0". lIll;" , IItHI "1>''' uti II I 1'\)0 ttHI t.hUl'olUt
:l~, r;<~?.. 7~ c:." Ji~<"j;:;
<:-'-('l"'C/l1~' . ''? '-'9 111/-/. U::.~~)(.r
dillY of /)-;II1./'. a'~1~,llUL""~h~~~~~~:xt~;;~tr;~!t"''''''''''-'
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(AI" ,< l\ [,f1RIl. ,~UMi\l i([,\Nn c'1)I)N1Y
I,ll i:'JI.\~II"'!\'lll1.I'III1S AUO. 16. 1981 (Cltll or Totun and ,S14le)
M"lIlh'n, PIJIlII!,~I\'llnhl A'HWl\\ion 01 NOIIIlU
S(l'I'I<: UI!f'ol'tJ Hll!,llllll1, 11f'I'llll\vll- 1l1f1IH'! fHll'H nil h1flllk tllllHHlH tll 1,110 I\I'f'III/\vlt "wi Hldlf'fhlll'!-\ IlTlllOXnll Ilrn
(,1111HI III \~tl.h llllt"I\~ Ill' tho word "Nnlli!", hlllt ill (WHO t.ho HkHl't-ll tlll~llltln I'/trl' Hlld 1I1111ktnd HfHHll'ltll1R,
RllI'Hl'Jl-IHH Ill' nlOHI' Ill' 1'lulIlty I'CII'pnl'lll.lntIR 01' 1\11 IHl.nruHt. 111 Hl1~' nO~pHI'tlJl!t'Hlllp 01' lllIHII1I1HH, l.Ilfll. tIllJ
dH III Iwd Ii III t.I'IIlHlItH l'(tllllll'I'(\ IIndo I' 1l1n plll'lI,~I'lIpll nll11\'U "11111 t 11ll-'. (.(J HohlHhl t jl "U" Ilr'l! II t.u,n)ll',I. .\t Nil l1lukn
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ULv..,l\1 (H.711)
DePARTMENT OF Rr:VF.NlW
IIUIIEAU OF r El D OPflIlATlON~
1',0, flOX 2970
IiARI1IRUIJRO,l'flNNA. Hl0h
J COMMONWEALTH Of' PFI\INSYI. VAI~IA DATI! --l.l...Jlll.c,embe.X'
nESIDENT If~HfI1ITANc.:E rAX (;OUNI'I.f,!i.!'ll.,-!!,l./II\l\
API'IlIW;\ MI'l\ll
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Whorna!!, Homlll.nll n~_.~.!:~~._.n..n..__..____ \al" "I _~X'l.l.lIl.ll
III tho COllnty of ....Q..I.lml\.W.ll1lll,_....___,.____ C""11110"WO"lth 01' I'nnn,;ylvanin, I\,.vi;",
tho _ 30th __ d"y 01 ._._.l.'l!LQ..~_.._,---.-- 191.<)"" solwd nnd POS80HI>"" '"
!!ub.loct to Inhnrltnnotl 'l'/lx lI11dol' Iho law!! 01' IIII! ClIII'II'" "wl"al!h "I' 1'("\I'H'ilvlllliil,
Thorofol'o, I, Enndt'n !':tonD .______. ,an iljJpriliflOr dilly appoinl.od itCll""t1''''1 '
having booll dOHlgnlltod 10 ll1akn a fall' alld cOII"u1ollabk ,II'I',al!!0,n('111 01' tho !!"id olllalo, and to allHORH oll,l ill~ I":' ,
valuo of nIl nnnuitlo!! Ilnd Iifo ORlolo!! (jl'owlnq oul'lll' Iwld olllalO, \IOl'llby filo lho I'o\lowillg appraIHornonl.:
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oj ,111V futnto fllf 1110 or 1m YlJllr)1 ttHl r.OIl1Il1I11'''''",ll\h hUlllhy III<IJIll~'.ly r,-"Ulvfl~ 111l! lilll'l II. ",\pI'II"I. illlll Il~~l"," 11.111\1." Inlwlil,111CU lii"Oi 11\ ,Ik 1,.-'/1
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Havo boen duly Hworn aCCJordlng 10 law, I do hOl'ohy conlfy \hill t1w ilbow! llppl'abomont iR maclc In COI'I("7'~'
with tho law on thiR 1 lth clay of _J!.e..CJl.~cr(J:X~ Fl... .
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APPI.ICATlON FUR CHAIlITAULE EXI'MPTION
PIHIM PENNSYl.VANIA lIlANSI'ER INHEIHTANCE TAX
(Al:tllf Muy ]11, 1956, P.l.. li'!J", UIIII Ad <11 J,mll 15, 1'}61.
P.L. 3'13, (It 1Il11fl1lcl.,dl
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c.~'M"'otIWt:Al. TIt or f'HH~SV I. VAllIA
Of.PAIITMfNT 01' Ilf.VI'IWf.
BUREAU 01' COUNTY COI.I,f.CTIOHS
Al'pllcotlon I. h.roby fil.d for th. approval
of an exomptlon from Po"n,ylvQnla Trnn,for
Inherltor\co TaK un tho hon,for of tho proporty
d.lCrlb.d b.low,
I. Butoau Fllo :i 21 79 Ii 20
2. Dot. of D..th .Juno 30, 1979
3, Doto of Applovo I ..:L1\j.. 'I' Ll,/I/
~ \ ,
4, N.m..af Doc.dont . Jloma'1nu S. Wort
~__..u.._____ .__ n~__ _ ,'n
5, Th. Commonw..lth'. .ppral..d v.lu. of tho prop.rty for which .n ..omptlon I. clalm.d I. $ ____...~5L~OO.OO --'-' ,
(Not., Wh." the property I. oth.r thon a .poclfl.d .mount of c..h, tho o.omptlon c.nnot bo opprovod until th. voluo of
tho prop.rty ho. beon ..tobll.hod by oppr.I..1 by th. Commonwoalth, o.copt In thou ca... whero tho omount of tho gift
or boquest repr..ooh 0 ,totod froctlonol or porcontago portion 01 tho ontlro o.tato or tho ontlro r..lduo, In tho.. .....
.nter .uch froctlonal or per..ntag. omount .bov.),
6, Ch.ck the monn.r In which tho tron.fer wo. .ff.ct.d .nd ."bmlt a copy 01 tho da.um.nt authorlllng the tran.f.r, unl...
.uch matorl.1 has beon prevlou.ly fll.d,
WILL iX;
DEED [7;
TRUST INDENTURE 17;
SURVIVORSHIP 0;
OTHER 01
(If .th.r, ..plalnl..___......,....
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7. Corr.ct Bu.ln... Nnm. ond Addro.. of Chorllohle Orgonllatlon r.celvlng prop.rty,
NAME __... Ca.l:'lisleJ!o.~.I':!!.'lL_.._..,._ .._-~.---_.,.._-..,-_..
ADDR ESS _.Q.arli.f!1~,_P..e.11l.1!l,..J..I91L.----.,-----_._--,_._-
8, I certify thot the Informotlon contoln.d heroin I., to the be.t of my knowl.dg. and b.ll.f, truo and corr.ct,
Slgnatu.. of Applicant __.il.f1\u....!i[JQ,!,11.~f4- ::JO-------
Farmers Trust Company
P.O. Box 220
Addres. of Appll.ont ___Carllsla.-P.enna.....J.l1111
Exocutor of Estato 0 t Sept. 28. 1979
Official TIII.____,____.....__,..._...._,___.__..____ 0'___
\
1-----
\ Approv.d'.F or, the S.cretory of R.vonu.
I ----1\~~~k,!
\ (I..()lf-v\~\'y"~,u,, ~I R~I.t~r of Will.)
. (~VYI ('l\!k:i_R..--
~county) ,
i\, .~ I' \ ( r r'
--.----(~Dat.. APp~y.;) I ~1.1--
This form mUlt be completed In trlpl:eolo and alllnroo cOfllOl delivered to tho Roglt'orof Will, for the County In which tho docad.nt
ruldod, or In which Illth'" waro llluod for a non.ruldol11 dotod,,"'" utClto, If tho decedent was a non_tulde"t af Pennsylvania and
lotto'fl were not IlIued by a Ponn.vlvunlll Raulltor of Will., dollyor all throe (,opltlt Ib tho Ohoclor, Bureau of County Collection.,
Penno. Deportment of Revenuo, 26 S. 4th Stroot, Harrl,hurg, Po.
___,-~... not wrU. b!!..",-~~I. Ilno. For Offl.lal U.. Onl
Ref.rrodto Bureau Hoadquort.rs
Approved 0 ,
For S....tary of R.v.nu.
D.nl.d' 0
---------------.--.--.--
(Inltlol. of R.glat.r of Will.)
(Autho'lud Slgnotur.)
.._-_._~-_..------------... .-
(County)
(Tltl.)
(Oat. of R.f.rral)
(Oat. of Action)
. S.. rev.ne ,Id. for realon'
MUST DE PILED IN TRIPLICATE
fl' , . .1 1\-1,111
APPl.Ir.AlIO~IFOR CllARITABl.r: I'XI:Mf'TIOtJ
FIlUM f'I,tJtJSYLVAtJIA TflAtJSI'I'U ItJlIl' IlIT AIIC I' TAX
(AI:1 cd Muy 1ft, 1956, P,t.. 11~1i', !Jnl! Act ~,f JUIU'! IS, Wid,
P,L. 31J, 01 llHlfltllletll
COMMO"WEAL TlI Of' PE""SVLVAtIlA
" OliPAllTME"T OF HI!VE"lIE
IlUIlEAU Of' COU"TY COI.I,ECTIOIlS
Apl'llr.otlo" I. horohy f11.d for tho approval
of an ,,,<omptlun from Ponnlylvunla Tran"for
Inhorltonco To. on the tron.f.r of tho proporty
d..crlh.d bolow:
1. Burotlu Fila /I
2, Data of Oo"th
3, Ooto of Approvol
4, 1-1 nm'!.-,?fJ)ocodo" t
21 79 1,20
.Juno 30, 1919
j(, ~j.~' ,{ ,L, (1('/11.
_ ,__.n!!_~Il1_\!jn_o .H.\~o_rt__p__ _.,..,
5. Th. Commonwoolth'. appr.l..d valuo of tho praporty for which .n ..omptlon I. clolmod I. $ ____j_'DJLQ,LQJL,_.__._n__~_'
(I-Ioto: Wh.r. the prop.rty I. oth.r than a .poclflod .mount of c..h, th. o.ompllon c.nnot 1,0 .pprav.d unlll the valu. of
the property ha. b..n o.tabli.hod by oppr.l.a1 by tho Commonwe.lth, OKcept In thou c.... whor. the amount of the gift
or b.qullt r.preunll a .tatod frocllo".1 or p.rcont.g. porllon of tho antiro o.tato or tho onllro r..ldu., In tho.. co...
.ntor .uch fractlon.1 or perc.ntng. amnunt ohovo).
6, Ch.ck the mannor In which tho tr.n.fer was .ffoct.d and .ubmlt a copy of tho dacu,n.nt autharl.lng the tran.f.r, unl...
.uch materl.1 ha. b..n p,"vlou.ly f1lod,
WILLlf)(;
DE ED (I;
TRUST II-IOEI-ITURE 01
SURVIVORSHIP 0;
OTHER 01
(If other, ..p1aln)_.... __________
__._~"_o. ...,......, .'0'. __. ________.__ ._.. .._.._m~~___._U._'~_O__________.._
7. Co".ct Bu.ln... I-I.mo and Addro.. of Charltablo Organl.allon rocolvlng proporty'
I-IAME ____...!li..Q..}<;![lson ColleijlL-______________,
ADD R ESS ~-CAr..liSll.l.,-I'..CnlliLL_nO..l3_,..____.__..__
B. I cortlfy that the Information contaln.d h.roln I., to tho 1,..1 of my knowledg. ond b.li.f, true and corr.ct,
Slgnatur. of Applicant J1M1.d..~ji3u I, k,_ I ufl TLl_____
Uarmers Trust Company
P.O. !lox 220
Addre.. af Applicant .-Cll.rll A] "--r.enna"....l1J1lL
Official Title _____gxocut.'~E,__o..!....!l..sta_~,e..._________,__Oat._ Sept. 28, 1979
Thl. fDrlll mUI' be oam'/lotad In trlpllcato and all thrll" coplol delivered to tho RoghhH of Wllh far tho County In which tho decedent
ruldad, Of In which leHorl woro I..uod for a non_resident dQcodont'. eltato. If tho docodont was. a non.rtuldettt of Ponn.ylvanlo and
loller. wore not '..ued by a Ponn'ylvanla Reglstor of Will., dollvor all throe coplas to Ihe Director, Bureau of County Collection.,
f-'eMuo Deportment of Rovenue, 26 S. 4th Stroot, Hnrrl.buro, Po.
____ Do not wrlt~ below thl. Iln.. For Official U.o Onl
Approv'.d: For the S.cr.tary of Rev~nu.
Refe"ad to Bur.au H.adquarter.
Approv.d 0
For S.cr.tary of Revenu.
O.nled' 0
(Initial, of Regl.ter of Will.)
(Authorlud Signature)
(County)
(Tltl.)
(Date of Rofo"al)
(Date of Acllon)
. See rev,,,' ,Id. for "olonl
MUST BE FIl.ED IN TRIPl.ICATE
Ii!!':! il".',1
APPl.ICATlOlj lOll CIIAIlITAl'LE EXEMPTION
f'Il0M I'ENN~Y1.VANIA TIlANSFEIlINIIEIlITANCE TAX
lAct of M\lY 2R, 1956, P,L. 1757, (jl1d Art 01 Jut1n Pi, 19(11,
P.L. 373, (II lImn"ded)
.
COMMONWi:AL1Il Of' PEHNSVl.VAtIlA.
. Ilf:PAUTMF.NT Of: ftF.Vf.tUIl;
IIlJREAU OF COUNTY COI.I.ECT'ON~
Applleatlon I. harohy 1110.1 far tho approval
of an exCtmptlon from Pt:lnn>>ylvnnlu Tran.fnr
Inhorltan,o TOK an tho tran,for of tho property
d..crlhod below,
1. Buroou Filo II
21 /9 1,20
3, Data of Approval
.Iune :\0, 1979
\;\ ~~ . ,~~! ,Iit' Y/_m.'~_
. ,
J!9Jl!n11li'-J;L.\il1.LL ,.,_ ....m_._ ,
2, Data of Death
...1,..1!!'.me of. Oecoden t .
5, Th. Commanw.alth'l apprallod valuo of the property lor which on oKomptlan II claimed II $ ._l(~-,.~Q()-,.~J.l_ --.-'
(Note, Wh.r. the prap.rty il ath.r than 0 Ip.clfl.d amount 01 calh, the e..n,ptlan cannot be apprav.d until the valu. of
the prop.rty ha. been ..tabll.h.d by apprallal by tho Commonwealth, eKcept In tha.o cal.. where the omount of the gilt
or bequoat r.pre..nll 0 Itated fractional or percontago portion of the oAtlre e.tat. or the ontire r..ldu., In tho.. ca..a
ent.r luch fructlonal or percentage amount abol/a),
6, Ch.ck the manner In which tho tran.f.r waa offectad and aubmll 0 copy 01 the document autharl.lng th. tranafer, unl...
auch mat.rial haa been pr.vlau.ly filed,
WILL lll;
DEED {l;
TRUST INDENTURE !7;
SURVIVORSHIP 0;
OTHER 0,
(If ather, uplaln).__.._~__m.__..__.m__...m_-
'.. -----_._..._--_._--...._._~......__.~-_._---~_.~......----------.-
7, Correct Bualn... Nom. and Addre.. of Charllahle Orgallltatlan rac.lvlng prap.rty'
NAM E ,_.____1:'.! rl?L Ev !1.f}!le1 t.~!1J_.J,!,l_~J10.!".!1.!1 Ch!!.!2!.'I!........___.,...,__
ADDRESS_ SQ.!!!'h ,!.edford ~t-'_LCar_!!_s}.<!-.." EI!.!....E(j!L_-.
8, c.rtlfy that the Inlormatlan contained her.ln la, to th. b..t of my knowledge and b.II.I, true and corr.ct,
Signature of Applicant JI,~.Al.L-'J.::L:JLLf.hp~~_.lli~"1 ~r{~__..__..
. 1 Farmers Trust Company'
1'.0. Box 220
Addre.. of Applicant Ca.~~.lQr:p.llnnQ.....J..7~LJ-.
Executor of Estnte
Official Till. __..~__:...._.._..__...--....._----_..,___..__Dat.
Sopt. 28, 1979
--~_.------_.-
This form mUlt be completod In tr/pllcuto and 011 threo cople. dollvftrod to the Regl.ter of Will. far tho Counly In which tho dell.dont
resldou, or In which InlttHI wore IlIuod fOf 0 non.tOlldonl dac:odent'l uloto. If tho docodenl wa, a non_,uldont of Ponnsylvanla and
lotton wore nat '..ued by n Ponnsylvanla Reulltot of Will., clallll'Dr all throo coplo, 10 tho Director, Bureau of County Collection.,
Panno. Oopartmdnt of Rovonuo, 26 S. 4th S'tllUI, HurdlburD. Po,
Do not wrll. b.low Ihla line. Far Official U.. Onl
---_._------~.. ~---~--_.. ..-. -
Approved, For tho S.cr.tary of Rav.nu.
t.) I I A "'f lJJ\M ( .~I!. ,
----1...;. (1v1~.Lll-E\~~S-
(AOk,~\V.~."a' R.gl~t.r '.1 WIIIL'.
\~ ,~ ll..c\;' ll~1;!..i
,\ " (County)
. _~,,/\1; () ,\, (~
~ of Appr~val) .
R.I.rr.d to Bur.au H.adquart.r.
Approved 0
For Secretory of R.v.nue
Denied' 0
~----_._---_.--------~~
(lnlllal. 01 R.gllt.r 01 Will.)
(Autharlud SI gnatur.)
~-~--~..~_._~---'_.
(County)
(Title)
(Data of Ref.rral)
(Oat. of Action)
.. Se. r.v.'" .Id. for r.alon'
MUST BE FILeD IN TRIPLICATE
;
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0 i-: n ~-,
,
",.
rl'8~ .;
I""i& '"
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,
-.... 4J -tJ
" ~~ I ~ ~ ~ ~~
I
\J i!5 ~ c>:: u ..
~8~ '~~!i1 ~~
ur~ ~
..... ~ . 0 ~
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(I i I~;~I
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~~
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,-u"r'l~1}.)i"f"'I"'pUi''i" )1t10')
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P.lll;q pn'<'l'lwrl f ; I, C!II rp J0 ill/)
h",;:},..., /1/" I" ',1-",,,,
~..' " ""11 llOIHl-j -.' -' - ..' 'tf (II
,rql,jp r-jll? -
P,I(lJ,l!jlll"''')lll'-'' ...... '\!!Jl."'C';."'J~
~. IU",,\_, """"''1
O.f v'l ;'J";'i41.
; j ~
.'
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.,
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0j~~~
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-"
...~._..--.
.
.lliLQ.!lMAI1Q.N.
To Insure proper crodlt to vow ootlounl, Ihe I1ll1TlO 01 Iho ollWlo 0,,,1 1110 '\\Imbor SllOUld lio oloorl\ prlnl-
ed on ,he oheok or monev ardor,
Tl\ls OUOUITlOnl Is modo 1/1 llGllO,dAnco with Sccllon 706 01 Iho Inhorllonoo ond Bslelll Tox'Aot 01
1961 (72 P,8, 9 2485.70al,
Tb Iho oxlont Ihel Inhorllonoo tox Is pAid wllllln Ihroo 131 1110nlll. .flor lI'lI doolh 01 Iho dooodonl, 0
dlsoounl at flvo 15) po,oonllo olluwnd 172 I>,S, 0 240li, 'II 01,
Inherltonoe To., olhm Ihon lox on 0 lUluro InlorU61, III duo otlllo dOlO ollho doood0I1I'8 doo:h ond beoomes
dollnquent el tho oxplrallon 01 nine 191 months oftor Iho doclldllnl'Y doolh 172 1>,6. ~ 2405.7111,lnherllonoe
Tex on a fUlur. \rl\ore.1 ',. pavable within th'o. 131 mOl1th. "florlho uon.lor takoll offocl In pOISon Ion and
enjoyment ond I. dellnquanl Ihoreoflor (72 P:S, 6 2485.7121, Coloul.to Inlor061lrol11 Iho dollnquonl doto .hown
on tho laoe olthl. form to tho dole ot aotuol paymenl u.lng 1110 following Intoroot IAblo:
" '
-------.......-- ----.....--.. -..........---...- --- ...---... -_....-..~ -.... ".....,,.., -...... ....~". -....,.----- -... -- -... - -.....-
1 monlh .005 4 month. ,020 71/10nth. ,036 10 montl" ,050
2 monlhl ,010 5 montha ,025 o manilla ,040 11 1/10nll1s .056
3 mOnlhs ,015 6 monlhs .030 a mo.1\118 ,046 12 monlhs .060
.--,-.-..--...--.
1 dlVI :00017 1\ dav. ,00180 21 d.VI ,00352
2 dOVI ,00034 12,dAva .00203 22 <laV. ,00369
3 daVI ,00061 13 <lav. ,00220 23 dAV. ,00360
4 dav. ,00008 14 dava .00237 24 dav. ,00403
5 dave ,00085 15 dAV. .00260 26 ".V. ,00420
6 dav. .00101 10 dAV. ,00207 26 dava ,00437
7 d.V. ,00118 17 d.y. ,00284 27 daVI .00464
8 dav. ,00136 18 daya 00301 20 day. ,00471
9 <Iav. ,00162 19 dnva ,00~la 29 dav. ,00488
10 dav. ,00109 20 dOv. ,00336 30 dava ,00500
__ ___ ------ -...-...'-"'1--"- -,-- ...:,'_..... -.. -.--. - -- - - ---.....,...-... .........--- - - - - - ----..-...-... - --.....
Anv parlV In Inler~.l, Inoludlng Ihn Commonwn.1i11 And tho' pnr.ol18lteprnflnnlnllvo, no\ .oll.fled whh
111. ...e.al11.rlI rn.v oblnol 1,I1.rolo wllhln .Ixly 1001 d.y" ntlor rooolpl of thl. Nolloo a.provldod bv Soollon
1001 of tho 'nh.rlt.non and 8fllalo TA. 'lol 011901 (72 1>,5, 6,2406.\0011.
Makoohool( or ITlOney order pnyablolo:
"Raglator of Willa, Agonl':
Mall 10 tl10 addreas IIstod balow: