HomeMy WebLinkAbout79-00435
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No. 21.79
. ..,.
PE'r1TION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
In the Estate of ___("!jLtJ(.:E_.._~. 5j-/.JljvU>~J.L.G-f':l~_..__, deceased,
To Richard E, Anderson, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania,
-"""10 ~ 0
Petltloner(s) ~the ~xecutQl3,,~J_d_ named in the Lost Will and
Testament of -Ci:-K1t_'--.E._..J~SJ~LJLH.I3..LB6:~"4_ dated .!:.Lf1:1..tJ Ii? C (-J I en?
Decedent was a citizen of the United States and a resident of
E:. fiST 'Pc (\Illig ~()rJ.. 0 Township
+-Cf--""'T7- .seroblflkl, Cumberland County, Commonwealth
of Pennsylvania,
Decedent died on .s_ u
() 1 H
N I2.A " the ___9....__ day of -:r tJ 1--",
I I
A, D, 19...::J...~, in the County of __.r...J.i....M-l3J=iRf,.1LNh- State of
_---E.ldV (1/ t Y L \I VI.JJLj,1L-_ at the age of 87 years.
-- M& 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
.11 2. 3,. or; If} ''.2 ______ and of real estate to the vahJc of
N () ~) E os near as can be ascertained; said real
estate situated as follows , N o..:t....---11:fflj c 1'1 R / ~
op" Iy. flll'L Y
Therefore, your petltioner(s) respectfully Q~S for the probate
of the said Lost Will and Testament and for Letters Testamentary thereon,
Dated ---1 ';2. :::r u I-. '1 ) q 7 '1'
Nome and address
of Petitioner(s)
~V-"'--- ~, ~~'~
~ II fI/(;e & -) I r....
,,-,I-I/' . n 'f:'..I .
~/"'CC(A.,,,-,- "~ 7?<:tt~'
WIL.lII'1Wl FLO RIl..
-..J:J.-l.O'l C H c; ~111L 1I T ~ I.
_,f.AMP .1-1 I -4--f-A. I '7011
COMMONWEALTH OF PENNSYLVANIA t
COUNTY OF CUMBERLAND \ ss
.:r- 0 (II c ~.E../..Q rJ. I ('t-' I",> fo.J D_lliJ!-- L 11'111-'1 K__J:"k....Ll.RLCl::.
named in above application, being duly S U..I.Q.&'tU ____ according to law
say(s) that the statements set forth in this petition are true to the
best of ,-1- l-J 13-. I ~
knowledge and belief,
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and subs~ribed beforek.-..__ . dO ~ J.~( \ A--'L'-er
~'.1' 1~
.~__~.~f.~~ tL-~ _ ' U --L_.~___
~w..o f2 (\J
me, '--Tf?;r._^LU.'r-1"-',~- 19._].3___
______,_.:..-:~~A./"~~'___\,_',~. u..._
Richard E. Anderson, Register
Attorney: hL' J\J\:J. Y
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F (lOr II/E. v.
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, gl:aduate) as well aamediaal. caro, wi I;hout t'bgard to his or her
I pllrent;s ability to ptovido for auoh support, education, mainton'-
anoo and medioal. at.t.ontion, ot' to mako payment. for t.hose purposes,
without f.Ul't.her l:osponsibHi,ty, t.o such boneficiary or to such
beneficiaries pare tit. or to any person taking cal;e of such bene~
ficary. Any princ,t.pal or. inoomo not 130 applied shall bo dist.ri-
buted to suoh benefi.cary absolutely when he or she attains the age
of twenty-five (25) yoars. If he or sho dies before attaining the
i . age of twenty-five (25) years, the trulOt shall terminate and such
i
: aharee shall be distributed tohls or her personal .representative.
ITEM 4, I direot that all taxes that may be assessed in
consequence of my death, of whatever nature and by whatever juris-
diction imposed, shall be paid from my residuary estate as a part
of the expense of the administration of my estate.
ITEM 5. I appoint my daughter and her husband, JUNE E,
FLORIG and WILLIAM R. FLORIO, Co-exeoutors of this my Last Will,
should my daughter and her husband, JUNE E. FLORIG and ~ILLIAM R.
FLORIG, fail to qualify or ooase to aot as executors, I appoint
my granddaughter, BONNIE E. BEHOFIST, executrix of this my Last
Will.
~
~.....9.... I direot that my exeoutrix, guardian, or trustee,
or their sucoessors, shall not be required to give bond for the
faithfull performance of their duties in any jurisdiotion.
IN WITNESS ,whereof, I have hereunto set my hand this
day of !.~.'V-'C~/ .1977.
4.4ki
.
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!JIlL, 11; 1/, (j xj~J..UC4tItSEAL)
, GRACE I. SHUMBERGE~.r r I
The preceding inetrument, oonsisting of this and two (2)
other typewritten page each identified by the signature of tho
testatrix, GRACE I. SHUMBERGER, was on the day and date signed,
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OATH OF SUBSCRIBING WITNESS
COMMONWI':AL'!'\1 <}Jt' I'I':NNHYLVANIA I
ss:
CO\JN'I'Y 01" CllMlllmLAND
'[,1,tH."" II "" ",., ,..." r"" t" :~" ~~ ,""," ,..... ,..' "'".,,,. (Iny of' .".,.', I ,..,. ~:"u.,~,~,,,,,,,,,,,, ",...".1" ,. I".t A, I)" 19,1.f!i:.,
hoflll'(1 mil ,lUchul'd I';, Anclol'son, HOf{lslol' flll't.ho PI'ohutlJ of WlIlH IIncl f{I'untlnf.{ lot.lol's of Adllllnlsll'lltlon
in unci fbl' ~uld Counly of Cnmhot'lllncl, In tllll COllllllonwollllh of' P/mhsylvlInlu, 11IJI'Hontdly ClI11l0 ......,.......
,.".,. " ,~~ N P.:-. \\."" ,E....".". ,~, ,0., V,O/.Iir.""" ,n,(!I.i). """~ ,/. (.",?ii',#;, No""" ,l~"".," C., 9.,y,. N.,~, "..,."""""""",
t.ho subHcl'lhlnl! wilnossos lo tho fbl'l'Holnf{ lnstl'ulllont, ;,1' wl'it,inf{ PUI'POl'tlull to ho t.ho IlIHl Will nnd
'rostumllnt, of' "Q:.R,t.tC.ffi,.., ...:t.-~.. ,5..H, ,L)..,M13,~.(?,~r. ,#,B. ........"".... ))lILucl ,A....M.dac./.-J..... /.p.J::7. 7
lato of.... ,T..Q.W,N,S" I:'j,,/, ,p.,.., ....,CJ.'E..., ,1i;';1.1,S,]""" p.tf:,N.IlI(f..~.I),f.:"I,l"... CUlllhorland County I'll" dOCllUHOd
who bolng duly ......S..k<..l..O~,J.,.:............, llccol'ding lo luw, duposo und suy, LhllL ..:t::r'!i,(:;';,f"'....U..(Iii,~};...
prosent, 11lld sow and hoard lllO tOHtU.~.,~,l\t,';)("',.."..,",.,' ,..........""'...1.'....'.....;,....",,,,....,....,',.,"","""""","
silln, Helll, publish, pl'onouncollnd duclnl'e tho snld Instl'umunt ofwl'itlng UH lInd for h..,4;f.R...., 'reHtlll1lent
nnd Lust, Will, nnd lIt the tlmo of SO doing ..........:$..lt,#i..........................WllS of sound lInd dlspoHlng mind
momOl'y und undel'stllndlng, t.o the bost of ,:.......6.JLR......................knowledgo, obHlll'vutlon und belief.
....s...~,u...O,:(il..,tY.,........;........ und ,subscribed bofol'o
.L.... , ..,.... .....,)....:a............."...............
..,....g? ," " (."2r~"""'"
,..,{,;:"~,~,~"'..".'r?~""........
\,l6! ( ( , ~ i '. .,.~.
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...,......" "."....".,.........".....,...,.."..""..,(..,...,.,..."".......,
Richard E, Anderson, Register
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSY!N ANIA I
8S:
COUNTY OF CUMBERLAND
...........~.,.L~,:N.~.....".c;;;;:,.\.,..tE.b,'I.,~,l.,'~.".,'....,..,..."...'.".."..,..."..';;1111...;...""..."""..."..,...being duly
.......,'5,w,O.~.i\L..,........., says thut os nelll'ly 8S can be ascertained the sl\ld decedent ..............:...........
...,. .G. g..fj, ,.Iii:......:::c:: II ~" ,.$., ,ti..W. ~ .'~ .1iJ:.f?t... ,r;,;i;..&..... ,., ""..,..,.. to H H.'.';.... Ii........' "."... H.,"".... It II .died on
~7~ ",. ~
..,,$..,U..,W,.:\?!:I1.................. the .......,Q......,..............duy of ..............:{[..Lt.,"'.~,......,;......... A.D., 19"...:1
at or about ."""..S...l:...-~".O."..."".... o'clock,-(..M,
.........S,..W"O',P....N,................and subscribed this
x:.,""~1\-""~,,,Iie..,,'~!.Q""'1-~""',.,,"'.."..,..."..
....",,,..L~..J,,~::.-...............,,.,,. day of .:~:.t.!..f.:'''::-./''''
\
Hl, ],?t.., hofol'o \
.............J.rf:~(:.\.\~(O........L:"..,......."...........
Rlchlll'd K Andol'son, Hllf{lslel'
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAI,1'H OJ" PI~NNHYLV^NI^}
COUN'I'Y 01" ClJMBlmLAND HS:
Bofllro mo, tho HOIIIHtor fOl' till! I'rohllto of' WtIlH nnd IIl'nntlng of Luttel'H lIf AdmlnlHtl'ntllln, In IInd fOl'
tho Count,Y lIf Cumborlllnd, pOl'Honnlly cllmo ~..I(..tY.,r,;..!ri"..f?,~,Q~c.-,..I.\/lI,I1,..,U.U,h,~:,U~t.:I..,H-,\,F.:f..,9.IK.! Go
who, bolnll duly ..,'!;,..\.v...J;l,f.?..M., dll ,,,......, dopllHlIllnd Hny thnl, IIH..,C,C..o;:..,~..'J(!r'U;;,!r!.,1:(;jf.tS;:............,
lIf tho IlIlIt WtIlllnd 'roHtllmont of ....~..a,~,~....,J:,'....:S:,I7J..l./..n1..f$,!?~.f.\..(f,o(.;i..~...................,doconllOd
,:r..H.IiC.y.... wtll woll nlld tl'uly IIdminlHtOI' tho goodH nnd chnttolH, 1'llIl1ta /lnd crudltH of Hllld dacoallOd
IIccordlng t.o law, And nlslI will dlllgont.Jy comply with t.ho provlslolls of't.ho IlIw rolatlnl{ to 'rransfer
Inheritances, ..,S..W..O..~,()(.. nnd subscribed
before me,
............,f!"\ .. l,~...................,~ ...., A, 0" 19 ..7.~.....,
1 ,j\ ' - '....
\I ',i I .1,,\,,--" '
, ' ,>'1
......."......... o. to "., ".......Ca..4'....1l"".1l'''.''".IOI!l.1I1
Richard E, Anderson, Register
'I::,....~,..t,'\,~.R~....;,...................,.....
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DECREE
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Be it remembered that on tho .""".~,~~1}'''''I'' day of ....".....,'"..~~J.~..'"..IIO"'..,...."I' A. D., 19'7.~....t there
was probated and recorded tho last Will and T08tamont of ....~.~~.9.~...~.:.1l~'~1~m~~.~cp,~,~...."..,u,."..."".."..t
late of ..............!l!~,~~...~~,~~~~,?!:!?..?!,9.~.t;',M1?........., Cumborland County, Pennsylvania, Deceased. Let.ters
..... ..,.,., ,.......... ..~~.~.~~~~~,~.~~.r." woro IIru nted to .. .~~,~~,. .~.......~ ~ ~.7. ~~,.... ~.~~.... .?f.+. ~.~,,~.~!'.'IO'~ .~" ,~:~,,?,~~~.
Witness my hand anti official ROllI t.ho dllY nnd YOllr nfllrORald,
............................\..~L\<~f.,(~....,/..
Hichll~~ I';, AndorHlln, Hoglswr,
COMMONWEALTH Of PENNSYLVANIA
COUNTY Of CUMBERLAND
III
and .william R, Fl!,riSI I!Jx.ecut:~;,~~___..~_ ,d___ ...
. acccrdlnll to I.w, dOpOlOI .nd UYI th.t ho .EXlll1.Ut.O'!:.Ii..._ ._.....: ..:..
01 tho eltato 01 ... GF.~Cl!._!.'....S..h~m~!~~~__~___._._
Cllmp Ii'u 1 C b 1 ,.I d d d h h
lato of ' ., um or .n" County, p", eceu. .n t.t t 0
within II an Invontory mado by June E. Flori.s &Wl.lli,!lJ1l.R., Fl~ri.9the uld...J!lX!~.l-!~t)!!__
of tho onllro Olt.to allAld dccodonl, conlllllnll 1>1 all tho pOllcn.1 propdrty .nd r..1 oltato, a.capt r..1 ..t.to oulllda
tho Commonwealth 01 Ponnlylvanla, and that the flllurol oPl'cllta uch Itom of tha Inventory roprOlant lt'l fair v.luo
ftI of tho dato of dacodcnt'l doath, '
June E, Florig
bolnll duly . (lP.P9i~t~d
~. <~. --'-....,.\...., and lublcrlbod bofora mo l ~. L ~'"f.O'
,-.S;1. -.../ / ;; ;; ';I '. \:l-,,-...C.'ii~;S~~r;j;i.-'..-~_...n ---
/~-,------,-___19 .__./--
cST I. ., .." /. I
<:..,,' C(+.,.{) K~} C!('!l.-lcr~ .<
J' , " 'r:I'('YNg ,7
~, ,) 'f I. k Y r U Ill. 1('
;\901 M"lkol SI. (liu,"pclon Tw/,,/
CAMP HILL, PA. 17011
D.ta of ~~o~~~I~~:.P.I~~iya.2~~ e~~~~'7.~ ._____'_.._...__. _. ___"~'__~'__'___"___'_______
DAv Month Vur
. ,. :J&~t:t~~;: j1.'1:'tl7L--.-'-----...~...-
. _.4~0J;l _CJ:le.IJ..~I1I,!~_.~!._, _...... _~._..__~~_..
Add,,"
Camp Hill, Pa, 17011
INSTRUCTIONS
I, An Invantl>ry mull ba fllod within three monthl aftor appolntmant of parlon.1 rapra,antatlve.
2. A lupplamant Ihvontory mUlt bc fIIod within thirty daYI of dl,covcry of addltlonel,a".",
3. Additional Ihoall may ba attaoh.d ftI to pmonalty or realty
4. Sa. Artlcla IV, Flducl.rl.I Act of 1949.
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STATEMENT OF DEBTS
AND DEDUCTIONS
0' __.., _________________ COUNTY
I\HU AnlNT 0' THI coMMOHW....l.TH
..)J
T" Grace L Shumb(ll:gol.'
1l8TA ~ OF ____--.-
I..ATii 01' --E.~IllP
l\[DUCTlllNS ALLOWIU IN
. /(.0/', V~ I, (,
o.,'t, ':,;/ROVE\,I,)I'/~V \:\L F,I ',0
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(' \, r. .: RtUh'" .f Wllh, lJ",
, 1 . \ 'I'A ,:"",
Hill '
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Hit LUM OF
--"-----
,July 8, 1979
-- -
-
, PATr'. Hn, 01' N....MI Oil" PAY.I nIM"RK' "MOUN'T
VQUCH"~
I J' VI';!
,Jul 12 Reqiater of Wille Probato &. shortll 1? ""
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I 13 cumberland Journal 1,eqa 1 Advortl.sinq lA hn
1"aw - -
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Aug 14 West Shore Times 1,oga 1 Advert l.e ing 19. 39
, bQ_
B. R. Boa le, M.D, professi,ona1 sorvices l'
, Myers-lIa 11 Funeral Homl" Punora 1 sorvl.cell 1 970 78
-
professional Pharmacy l'roscrintiona 31 ~l
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1l1ue Ridge Haven West Balance due ?CJl 0
-
Vernon R. Phi.Hips, M,D. Balance duu "r. nn
Joan &. William l"lor ig Executors fee 1 18'; ,;9
Henry F. coyne Attorneys fee 1 18~i ;<J -
Reserve for costs of fi linq mail notices. nhotocooies 100 hn
I
, $4,926
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OATE 0'" FILING AP,.,...."IlMINT '")1 ft \J
1 r'il) \/
DATI 0' DIATH
COMMONWKAI.TH OF FINN.VL.VANIA }
COUNTY OF fL~'{.I/I,/>J.,J!.t_!. II'
I, _ifune E. l'lOr~g &. Wl..ll"TIim R. Florig
MV MHOWLIDOI AND 11t.11", THI ,O"IOOINQ II A JUIT AND ,ftU lII: "AT.MINT 01' DI.TI,
AQ)r.4INI'T"~TION 'UI""lnlp TO THI InAT. 0' Grace I a Shumb13rQsr
INHI,.IT"NCI TAX "U"'-Olll,
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Hlftll., CI"'I"", THAT. TO 'MI 'L'T a'
'UHI""'L U'PlN.1I AND IlI.PIlN'U 0'
DIClIA'ID. All DIDUCTIOHI I"Q"
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OWO"" ~~~II~"~' ~ ..'a.. ". T,"" " / ' aAY Of' ,")} , ,IJ , f' ,./',') , ,\
~CC~;;2.---, . 1I..2..:i::- " ~ (I &,"v [" '_ .11 '...11
~"'<d) ,.0 ('~. ()
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C/\,,:,jJ Illll, (1,\ 1/ 111
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Rce..1I Ito"31
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COMMON\\HALTlI OF PENNSYLVANIA
IlEP,\lnMI'NT OF I{EVI'NlIE
IIUKE/\lI OF ('OUNTY ('OLLECTIONS
'< 1,/ )(1) ll' C,J, 'S'
'*
ResiDENT DECEDENT
COUNTY OF mn ClJr.lI~I~IU'II.N.I)_.
IMPORTANT,
Thill rOlurn mll"1 he (l(ll;ll'l~ltllllllll"IIlIlIlIUi ili(~11 'I;;dlli;i,;~;;~,~i, nlllltllwhl1(l, with IIIl' Itt'MIKu'r ClT\\'lli;',~r t"~' .- --
('nullt)' Whtl'('t d'''HHh1111 H'tdilIHI. HI'tllln IN dill' within 111111\ 1ll1l1l1h't Mil" tlnl~ uf Ih'lHIl. IIllhlMH UII ulltonHllI1l hi yrnUhll1
hy Ihe HllurllltHY Ill' Hl'\lt1IUW, (~I'I'lllln 711.'1 III" Ihl' 11111l'rllllllI'l' IIIHt !':HILllt' Tnl( AI'11I11Wd,1
~ ..__.~ . -.
...
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LotI of
CUMBERLlI ND
} 0\1'1'11'''1'11' III'
1',XI'('III'OII
_ ,\IIIlINISTlI"'IOI(
...nunly
IN TilE M"'l'THlI OF Till' FSTo\TF 01'
GlU\CE I. SHUMAEROER
'--~'-TiiT-A"Ti1;;u-(':t~M-i(7.iF-i'iE-O;I)i:-N 1; .
P ENNSYLVANIlI
Statl of _..__..._.__,..,_.._.._~.~ .,.._ n_
Counly 0' _~<:.u.!'!~.E}~~N~
June E. F10rigand Wil1iam,~'_ Flor~'i!_..__...,
AdrulnhilrnlClf ----.-~_..;;._;h~--;~-i;.i~-~,.~h~'~h~~~~I1n,.,~d d'.e',denl b.lnu dilly twom, d~po.. and toy
Ih'clll!tlnl died July 8, M' 111_79M_t'Ot'UI. loavlng Q leul will, C"'f1r of "",ltlck It h."lo allo'ch.d, )
(MONTlll (flAY! IYFAHl Intulnl.
Olh.~::~h:~l~::~:~~:t:fn;~:~::.'~ :hom} ___~__..~:Gni!._~~__C~~~_~..__C__ ill 17011
nil ""..pond,n" ,hould h. ","".~, _____290 __~ar~~_~._~!._.L,_~mp H , !?~_.._____
Thllt "' '"eh_~)(ec.utoE.s.____d"llIlnel\l I, 1'1111I11111' wllh 111\1 111'1'111" or ,"hl o,tlllo IInd Iho p"'porlY elln,llillllll[l
(EX f:' CU TO R- Af)MINI $T 'fA TOIII
Ihe liNNets therclIr nnd their ruir mllrkel \'ul\le,
'I'llntllt tho lime of dnulh there WUH !lOIH,l'e dep"slt hus r1lHitt:tercd Inlleecdullt's illdi\'lduullli\I1lLl, or juhlll)' with, ur
liS IIgent or dCIHlty or llllllther, nr In decedolll's Indivldlllll 111\1lle, Willi ri~hl (If nUl'CtiS hy unnthol' II'" n"unt or dUI1UI)', with the
oxeoplloo Ill' Ih" r"lIowIII[l: --
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NAME AND A()nFH~S8 Or' flANK OR OrtlER INSTITUTION
_.....-=.~t-lICH OFGEOEIH RHNTf.O A S .n{ ()l'POSIT flUX
THill SAn: Of::I'Oall nox Hunl".f1
IN Nt,ME ()n t~AMlc!, 01'
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fHH. ^ Tlm~aHIP o'r JOHj l'
I-iOL.OI!RS fa (lFCr:I)~
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Thill tho eontollls of ""ld 'life deposit hll. ur hoxOB lire 1I0ml1.od IIl1dor Sehodule,__uf thl, retmu.
with tho oxoopllnn,nf Iho fnllowln[l, for Ihe rOll'nn' hornlnnetor "01 furlh:
Thnl Scheelu/e A IIt1nehod ho,olll IInd llI11de I'IIrt he,oof '01' fnrlh fully nnd In dololl IIl1lho ,onl proporly
III tho COlllmnnwollllh nf PenllBylvnnlll or which do"odont dlo" hnvln[l nn Inloro't Ihoreln. II 01,0 Bot' fo,lh Iho
n"'''[lIlBo onenmhrnneo, IIpnn olleh pllrcel of ,onl properll' nl Iho dllle "I' donlh, [l1\'ln[l Iho IIl1lollnl ,1111 "ue III
donUt, nnme Qr mnrtgogee, dnle, rate of Interest, nnt! hunk nud lHlge or rccol'd Iholenf. It nllHl sels forth In the
COIUml1H Ilrtlvldod therefuro the '''HiCSlit,HI vllluutlnn of cuch or /'inld plluads, the osllmuled market vnluo thoruuf
n' of .Inlo nf dOllth nf dcoodonl.
'I hol Scheelu/e B 1It1l1ohod ho,olo nlld IlInde pnrl her""r ,,,IN rorth rlllb' nnd III dolnll 1111 po"nlllll proporty
whcresClvur sHuntcd owned hy tlw decedent nl llle time of denth; nil n\lIne~/s Idt hy lhe decedent nt the time of
denth, whother In decedent'" illlll1cdlale pus session, slllnding to decedel1t's credit In hunks of depuslt, savings
IlI'llks, tru",( cumpllltiel'l, or other Instllllllnns, whelhcr Indl\'iclulllI~', or III lrust 1'01" llllY other persoll fir perSOI1H
giving Rho !icparately the accrued InltHcsl tIlC,rt'On, If uny, tlown to Ihe IlIst Intore~il 111\)' prillI' III c\ecedent's
dOAlh in Ihe CtlsC ur suvinSH hanks, ntHl tn the dllte of dCl'cdent's dCllth In 1111 oilier cnses; nil hllllds, postAl
snvl,I1YN, Ireasury certificAtes or nolos nnd olher e\'lclcnce of Indehtedness lIf Ihc United SIIlleN 10 tho do..
ecdel1l; nil nhllyntlunH, whether hy sllIhlle or 1ll,ll"cl'lllclIl thl')' Ilrc dc~;jglli1ted as 11lX frcl~. of the United StuteH,
or 1\11)/ "'tille, or pnlllicnl subdlvlslol1thcrcor, or Ill' llllY foreign country, which lire oWl\ed III the time or denth:
nil wearing ullparol, jewelry, sllvel'\\'IHc, Illl'lures, hooks, works or i\r1, houschuld furnilurc, horses, cnrrluHcs,
lIutnmuhlles, hOllts, IInd IlIlY nnd ull IIlher IlcrsClllul clmllels of WhlllslIc\'cr, kind or nllture, left hy decedent,
together with thc rnirly csllmi\tod mnrkcl \'111111' thercor; 1111 honds nm! Illortp,uges held hy decedent IIncl of all
c1ulIl1H tlue nnd owln" decedenl III Ihl' lime II <Ienth. IlIHI nil llrnmlssllry notes or lither II1HlrUffiollts In wrlling
fur Ihe f)nymcnl nf moncy uf which llendellt died IHlSSl'sscd, of whalsflcycr nuturc, wllh inlcresl thereon, If
'lilY, "h'lng Ihe fncc vulul' nnd l'stlmllied fllil"lIlllrkel vuluc IherelJf, IIml ir stlch c~tllllnted filiI' mnrkcI Vllhlt! ho
loss IhBn the fucl' \'nluc, it 'H'ts rmlh hrlt'fly 1Ill' rllll"'lJllS for 'tlleh dcprcclnlillll IHI III eneh item; IlIl1110ncYH
Ill\ynhle (0 the eK(nlc rrolll lire IIISl1f11llt'I' 11lI\lril~s cnrrled hy decl't1t~llq nil Ilnnlllly nnd endowlllent eontruel'"
Ihe lnnCl.1CdH nf which Wl.'re puyahlt, 1IpUII Ihe dUllth Ill' Ihe dccelll'llt; all nnd tho t:oqHJrnlc t;lncks IIncl dividends
duo Ihcrl.'tHl and Unl'llld II'" Ill' Iii, .1,111' Ii! dl'lllh, hOllds flnel lH'nlled Interest lhcrc~on 111 thtl dute (If (h'cedel1t'",
dcnlh unci nlhcr In\'cstllil'lll "'.' Iii ,I ,I i1l'll I,~- 1111' dl~ITtlelll III llle lime III' dellth, with Ihe mnrkL'l \'oltw IheHl..
or III Hlteh lime.
11\ t.1UI tJlUH! ot' I'wlHtflHtUH Ill' nlllHfI III' 1'1111I11,\' l10I'IH1I'uL:UllH, 1,11(1 VlllUllH 1'('1I(H'I,IHl Itl'H nM ('1\1' IHi
plI"'''lbll' Hl1hhllllll InltHI l\~' f'tl\lllll111\1 f11,lIllll1ltlIlLH tI(' till! 1\111'111111/11.111111'1 HIl(Jwlll~ tho HHHnl.1;l 1111" Ilnht' II inH
tllll"flIlI'Ht( Ill' Ihfl tllll.O ul' Ilnul.l" 'I'1I11 Holllllhllll 11IHII HI!fH l'ul'lll t,tHI 1I1hll'lIJ1I, 'ClI' IlnclfHltllll. nt. Ultl limn !If'
111'/1 tilt II /lfl~' l.n"I'" rt Uti rHh 111 01' tJll'" t '\fIHNI 111111 I II lill)I)IIII'1 Il f' thll \'1l111i1 III' Ml"wll III t,tll'IIH 1 Ililll'fl ) H IlIlIlIIXIHI to
HIIII! ~1j'1tf'ltlll/l1 l'II\HllcJlnl Htlll.rHIllIlllH ,",hllwIIlJ~ 11l1l1ls~wtN 1111" 1IIIltlllt Ins III' HIIII\ nll'"plIl'tllul'HIt11' III' IHIHIIIIlIHI,
,\ l'OI'S 01' 1111' 110-P'll'tll(JI'Hldp UI~I'tlIlnl\\IIL, (If' 111'111, il HI II 1,lll1ltl 11 I 'lilt II'H~ l'IH'lll 11111 11111,111'11 ul' Ih" 1IJ.~1'1'1111111111)
lug,'ll!"I' Atilt" Hlnt;111II111I1 HttltlllV, 1'111'1.11 t.llt! fl!lHI'llolill' 0'(, !-lIt! llIlHIIII'KH, IIH 10('111 I nil. HIlII flllilll IlIIWI' f'nnlH
11I'I't;.,nltl", 1.1 11111 IHIHII\IIHH IIH 1II1l~' Iw \li'I'111l1'1I1 In II fllll' IItllljllHI Itppl'UtHIl\ fll' IhJ.l IhlllWlllllt.IH 11l11!l'H~L
I lit' I" III !Illh\ I'P~llhI1l11t.llll. II HllolllIIllIHU Hilt. 1'III'I,h 111 111l1ll1..t1d 1'111'11\, !-oW'lllnl' wi I,ll t.lln I'nll' 111111'1(111 \'!llnn
1111>1'" d" 11I1~' lllllfll' pl'IlJlnl'l~' IIWllfld 1,i1' llnqtlflldlltlC\ lIy lip' ,ltluHdnnl HI Ihl' 1111I11 01' Illll1lh,
'I'llfll,O,('du/f' r: IILIII1'l1nd lIul'nl" 111111 JIlUdll 11111'1 11l1l'Ilfll' HnLH 1'01'111 II II'lll./UlHWUI' t,1I 11/wll tllllllll'~'
l'1l11llllw'll 111"l't,111 flllllllltllll 11(IHtlUt'I,I'IIIIHf'llI'M"I'PI'lIl"'1'q', l'I'ItIIlI' 1"'l'fHlll'lI. \~'llhlll t,wn ~'IIIII'H III' IInlHtlltllll'H
tll'/llllt ill l'fllllt'III)l1ntlllll of' Ihlntldlllll.I'1 111!/l111. 01' 1111.1111"1'11 III 1111~H Il('f'Ilf'I. III pUHHllHHtoll nl' IHI,ln)'I1II!)I!. III UI'
Ilf'II'I' !1lliIU't HIIIII HIIIIlIlIlIIIl Huttl f'UI'I,1l !.Ill! IIIlt,tn'" 1111t1 \'HIII11 ,nf' HIlI'Il Pl't1pl1j'I~'. 1,0 Wllfllll f,1'IlIlHf'OI'r",lt t.lw
I'fI)IlI.lfllllihlp nf' l.hll U'/IllAf'nl'iHlH tll l-lIn rlf!IJll\llllll, IIll! PI'Ol'fll'I.IIIIIIIi.ll HIIHl'll l'fH'nl\'IHI h~' IInn}1 t.rllllHf'tll'lIl1 /tlltl
HIl IIlhol' f'nul,1t nl' II IHII'lllllllll-llnl.lIl'l\ l'Oglll'tllllJ!, Hulll 1.\'lIl1lif'fll'''', III Iho PItHf' IIf' 1.1'lI11Hf'llru 1111-1,"11,,11 III
lid", I'1'I'nnt In pnAHIIHHllIl1 III' 1111.1"YlllOlll. Ill. Ill' HI'llll' IInll \.11 , l!Inl'n tH nlHo 1111-111'11,,11 1.1) 11ll! Huhnduln II llOllY
uf' Illn 1111011, II'llMt It~t'(lOIllUTlI. or oUll~I' IIIHt,rllmnllt In'untlng I.Ill! II'UfoIl., fl'llI!I'n II{ /IIHII Hnt, l'III't,11 III HHIII
fi(lhndllll' fl lllil, 0(' 'III PI'IlIH!I't,\', rOil I 1llllll'iQ'HlII1111t with ItH Vllt\lltl whlnl1 PllI-,!o\IIH HI. till(\tHIUIII,IH tllllII." h~'
vlrtlll' Ill' l\ill flxllrolHU hy Iltl(lt)ll11Ilt., 1I11,hnr' IllIltvllhIH11~'t ol',IIlJlll.l~' 'n'ltll 111101-111'1', (If' 1I11~' POWOI,'clt' 111'1'111111-
11\11l1t VI''''iI,I'fIIUcIcHlHllnlll., filth"" Iwllvtdllllllj' 01' .IlJIIlII~', hyl.lw will, IIfllltl, III' ulhl!f' illHLl'lllnnll1. of 'II 11111 11111',
wil.li H ('tlp~' ot' 1.11" 1IlHl.rlll'\lltlt, 11l'11I1tlllJ!; HllOh IHIWfll' 1l1.t.lll'hl'cl to till' Hoillltlutll.
Thill, SChfJdu/b () nt.t,ltohl,,1 11111'''1.11 111111 IIIHdl' !llIl". hlll'oo!' Hfll.'i l'OI't.!l !lIt! IIlImOH Hllfl IHhlrnsAllA II.' HI I
pl1l'HOllt; Ill'IIHt'tn.lully IlIt.OI'nHt.llll III tills "stllt.n Ill. 1.11(1 llllln of' IIt'I'fIlll'lll' H d"HUlt tho II/ILIII'U tit' t,lInll'. I'OH'.
plll'II"1' IlIlt\I'llAtfl, l.holr 1'ldnUnIlHh)p, II' nil:.', 1.0 l-lIn 11111111110111, l.ogfllhnr wlt.l\ thl' H,~tJ~ nt. t.hl~ \.1m" 01'
IIHI"'II011t'H ItNIl,h nf' ull 11l1iHlrH, ItlllIutt.nnl,H nllll hlll1tll'II1!HI'llH; 1'lIt' Itl'" 1111I1111' ftll(HHlnnl.'H Will, IL 1I1HO
I~ClIlLIlIIlH /I Ht.IlI.nmol1t, Hh(lwlll~ whloll nf' Illf! Ilfll\(1l'tntlll'lml nlulIllfl III l.hn fl(lI'fltlt11111A wll'l, II' /lilY, Illnll }l1'lol'
to 111',,,,111111", l.hfl (tutOH of t,hntr dnnth, t.hllll' IHRun, /Inri '-lin l'ollll,lollHhlJl 01' HllI\ll ISHUlI l.o Ulfl hnllul'tnt/lt'Y.
il'hntl S.:II(ldl.'/ro F /ll.t/whol' hnl'nt.fl HIIII Illluln H \1111'1. 1101'1\01' tlntA t'lIt'l,ll nll JlI'1l11l11't.Yt 1'0111 Itllfl pnr"
H~l1lnlt nWllnrt hy 1.110 ctonnllfllll. JClIlll,lY wlLh ll11utllfll' III' nlllorH, IfI(111Ifllnl~ Ill!.llllgthlo, NI,lIl1llttlfl; 111 Ihll II II 11I1 t
nf 1.11" IlnllClllf1l1t nllll Ut.tWI'A, plllH I,hll tlnt.H 111111 pinon III' I'IIIJOI'IIIII' IIIHII'ltInnllt.H II(,f'olll.tn/-!; tlln \ofo:tlttlrl! 01'
ronl !lHtnl,I' I\lllt l.ho dllt.tl ot' lloqlllHIl.lull of' pnl'HlIlI1I1I,y, plllH t.ho !I/lIllO, IldllJ'OHH 11111\ l'olnl,lnllHhlpl It' 1I11~'~
CI f' C!l1"oWI1P.I'R t.1I lho 11f!oolhHlI"
Thllt. SC/;NItJ/1? r nU.llct1tld l\lll'nt.o /Inti 11111"" n plll'l, 110"0111' Hn!,H 1'111'1.11 l'\llly /Inti In ,hl\.nll HII dc'lltH
(II'" 1l1'1111o\.iollH 01111111011 for Hllrt fill 11(1111111' or t.hiH dnof!"nl1l,IH nAUltl!, Illllll1dll1A 1'11111'1'/11 nxp"IlHIH; pltltll
I'nmll~' oX(lmpt,1ol1, Whlll'O /lp)l11111111101 IHUlts 0(' 11I111111l1Hl1'lltlOIl of' l.hlA I1tHIII,PI nOllllAnl j'nlJfoI /11111 liul\cdHI,,\'1 s
ennulllHHlons 11/\11' or t.o lln pllletl cOAI,llXpnlllllld f'ol' 11l1l'lnl 1.I'\HIl.Ht tUlllhHt.lllltlH nl' jl.I'IIVnIl\HI'kol'A, 111111 rill I..
/-!;tll\lM sOl'vlnoH, III nntlHnlltllll\tll1 01' I,hn IIIIII\.11 01' t.Ilo llOOIHllllll.1 tlnhtA 111111 1~llllmA ow11lg /llltl 1I11111111t /It tlmlJ oj'
,Ionthi !.nlwH nocrunll I1hllrRlHlhln f'ol' 1101'1011 pl'lor to tlt1IJIlCln1\(,'H dluth (mcnn\lt, LlloHll 1\1Inwn'd IInlllll' Hpo1-loH
nlil Ill' thl! ll1hnrltntlHl' 111111 J.:HI.Ilt.1' 'I'/lX AI,I)\ l.ol~t1l.11(Jt' WIUl 11 HI II t.llmonl. Ill' l~tllll\I.OT'nl ptl-,tl,Q'IHI rill' nllllJ-!,Il"
l.lllllRt If' 1I1IY. II, IN nAI'IuHt thltt. till' f'lllllnllll'y will pl'"St'llt. 111'00f' III' K!lld 11l1llmHlI nldll~llt.lflHA "pnn 1'''-
llIIllHt., thnt II' thn IIll1ntlHt, lloLlIl\ll~' Jlllllt In HIILI,lllmon', Ill' /lilY f"HI, fJIJl1ImltlHIIlt1 or dnhl. \fi IflRR,I,hl\l1 till'
oRtlllllll.lttl 111I1111l1l1. (!l/llmlnp; Hnll IlllOWf'rl, \.11111, t.1I11 HI1ll\(l wilt 1111 ""I"II'I,ocl III 1111! 1l1!v.1~I.tll' fll' \\'11IB, /tllll t.ll/lt
t.hn IIf1101l1d of' tltX HRM!'!'!Htlll MIlt 1/" 1'I'ItHHIIHNlhl III Hnool'llHlIOt' l,hlll'llWI tll.
Thill. l.Ilft t.III,HIA fir tho 1\1'1'I'oll1'1I1LI' l~nlllmllH III HI'lll!lllllnR "t\", "I'". "en, "1':"1 n1\11. "I.'" 'IH 111 t'l1(1 1.1111 I.hol'nlll,
hnv.. lnUlIl (lIll'I')f\l' l'nrwl1rtl nwl P"(lpnl'l:r l'lIp;iHtol'(HI 111 I,ho SUllllnnl'~',
Subscribed nnd sworn to l)"foro me thl" /, ~.~... @, ~I Q ~ '~
. u .. .. .,?:,:!. "'"9;'ne E. F10ril) <;.)
\ . /}/ )/ . /2 ~1.l)/ .
(!:i~>:l., ....,. ...111...'/5" . w-f~ti~iJj;~~r:R~ir~J.iiI~'i~~r"''''.''''''''..
. c"1,~~I:~~~~'p~~7~~ 4109 C~si:~~r&t;~~jE!~~
~901 M.ukot f>l, IIICl",pcI"" ywP,1 Camp Hi}l.,.., pa.., 17()p
CAMP HIl.L, f'A, Jill" (City or Town an,l 8t4tD)
NIl'I'I';1 Ufl ('Ol'n H 1~1l11l~ It f'f'l (tllJ,t.y ~t.H"ml\iS~nfe}CpliltosldlH\uIQN,PI\~'1! III Ihf! It ITlfl/i\' II 1l11f1 l'wl1l1lhll tlH HIlTlnxud HI'O
1'111flll III witt! dO\.1I1IR"or Ow W01'lt "SUllll", 111111 III f'HIIIl thl' IlIHif't,H 111,,111111' t'/ll'n Hlld \1I11tHUlIt RI"'III'Il.IIlHI
HfHJlll'lt.lnH Ill' (lluRn nl' l'llmlly f'III'lHlrllt.ltlIlS nl' 1\11 IItII'I'lHd III IIII,\' l'O-Ptll'llll'l'Hldl' Ill' htlHIlIlHiHt lh/II till!
tlllt.1l 111111 1i1,lIt,t'mnllt,H r~III1IT'Il(I lif\lltll' Ullt )H'cl'III\I'Hl'h 1l11(1\'n l'IlII1IIIIH 10 Hl'l\I!dulll I'B" 111'1' II 1. 1-nl\lIl'll, .\1HII 11111\'1'
{ql'lnln t.lInl flClltlllln 111 III t.lln "!illn~lllu'yl1 !lIlH li1'rtll pI'Hpnltl~' t1l1l1lptfllf!l1 llHllllll\'fJ-tlll'f'l'tnll,
.",.",.",.",." dny of
lJ ' : I:!
( .1'" L)/'
...."c...,L,,,(.,. (,.,.~.. r.-. .. ' ., r .
!H!V-411'la-1ftl
t~mN()NWI'.AI.'I'1I 01' I'HNNSVI.\'^NIA
TIIANSI'I'.11 INIIHllITANI'H TAX
II I'S III I'.N'I' II HI' Ell\'.NT
.~
,.' '.,.
. ,. .,. .'
. ... ' ,~ ~
SClllmllLI\ "1>"
III ~NI ~FI(,I"I{ I liS
_.______._.1_..._~.~____ ~-- ------~~.-.~"-~.- -......-.....-.- ~......-,..;.... ._."---~.-...---_..__..._....-.....-
IIHNIWII'IAIUIlS ANIl AIlUlll!SSIlIi IlHI.ATIONSllll'
(Stule fulllllHHllH 11l1d nddlCHNCH IIr IIll who III 'I.P'"llh~.n "' SlIIIVI\'HIl 'UATH INTHllIlST 01'
hUVll IIn tllllllll"', VUNlod, conHIlHUlll or ulher- IlIo>>IIIIIIIIIU ohlld,ulI IIIWHUIlNT Oil IIHNHFICIAIIV
wIN"" In CHt!"C) IIfO Illvnh'utl, liol STATIl Villi IIlKTII IN HH'I'^'I'I'.
, (IIrlh Ihl. rllol,1 011 NO
.. "--'- .
---_.._.__._._-~. .-- . - --.---.-----.....-
___~,:t.~.:._~.:.._!lor ig - --.-- - .---.-
4109 Cheatnut St.
. ~
Camp Hill, Pa. Daughte.=:...... yes Legal__ Reaidue
.- -
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________M
---... .
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."4
---..--.--.-----------+--..--,---
..E.ep.~!.~orthor .ay. that a'!..!.h..!!bove'namld, blnlllclarlo. aro living at ,hi. 'Iml ,IMOO,,! bllowl
---- ~-~_._---
HAM! '
DATE OP DEATH
RESIDEHC!
--
----
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1fi
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..
Ruul Propurly
POrHUUIIl Ptuporly
TronsfufH '
SUMMARY,
(Seh. "A")
w (Soh. "II")
(Seh, "e")
, (I) ,
(AH ROI1llrlud)
,
$
$-
,
$ ,
,-
.
(2)
(As lluturnllnod)
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ClrUNH 1'uRoblo l!Rlot~
H[~~.J9 (11-"17')
COUl1ty, NUl1,bor und Num._~.~?l) .Cllmh."pland
f'llo Numb.r. ,. .......... 21-'l\1..:, 0 II 3.5
SUMMAUY
E .toto Nomo 0'_ _.~...Jllll.!!~h(l.!'.Cf\ r
{I.^nl ~~^MU
.. Grll.on
(r-IH" I N^1.\l ,
I .
- tl'H'iT^I~1
COMMotlWr!AI.T11 Of' l'r:tWSYLVANIA
TIlA~Sff.R INtlf.RITANCe TAX
IHiSIDelH OeCeDf.NT
Doto uf 000111. .
7-B~79
.____.~''"____.___~'_.~_._.~.. _...~__~_.__._...~T__--<._._... ~~.. ~...~--"
IlErorH OF INHr:RllANCE TAX APPRAISER
~____~__"__T-O+-+_'__'_'____.~__'~'~""_"____"'~_ '
I, tho undorollll1od duly uppolntod Il1horitonclI Tux Apl""\"" III ",,,lie,,, tbo County of CllfhllP'lll,lld '
Ponlllylvonlo, do tOlpo.tfully roport that I bavu approllod tho rard "ntl p."o,,,,1 propurty a. r.purto In tho foregoing roturn at
tho valuon oot forlh appooito oach Itom In tbo 10lt column to tho rlllht In Sc:h.d"loo "A", "n", "C", and "e",
Ootod, __........1-.11o!.emh2.~7 9___
:1
...._____,..J..jr..'l..LlLt,:u.lJ ~/( au)
11~1'IHII^NCI' lAX ^I'I'H^ltH'll
-="''::- ......,
:-=-:;1: r.-==""-~_T~:7~""-"~_-:-~~~~~:::":':;' -,,:;'.~:_,;:.:,;---~~: ~'~:;"-c.~----
w___
jlt:PO.RT...QF THF.Ulr:GISlER CI,F WILLS
I, tho und."llIn.d duly olcctud Rugl.tor of Will. In and for ____~ Call1'ty, Ponnoylvonlo, do r..pcct-
lully roport thot I havo allowod doductl.n. \n tho "moant. cloll".<I by doponont, oxc.pt .0 to tho.. Itom~ whoro · groolor or
I....r .mount I, lOt forth In tho I..t column to thu rluht In Sehoclul. "F", which gr.at.r or I...or amount ropr."ota tho lum
ollow.d 00 0 doductlo.,
Oot.d, ---...
prol''>lEll 01' WIt L'>
-----.-
~-
ADJUSTMf.NJ8
()Of. IHAnnlSnUnO I SE ONLVI
OOt
10'
~Ot
30'
nEMAINoeR APPRAIS~MeNT COO~
9 ,.
INVENTORV
RIlll PrOllorty (Schodule AI
Peuonal Proporty (Schedulo 01
Jolnt.Held Propn,ty (Schedulo EI
Troll,forl (SCIUKJulo cl
TOTAL OROSS ASSEl'S
LoSt OobU ""d D~luoUol1s
(SCHEDUU PI
CLEAR VALUE OF ESTAn
VAI.UFo AS APPRAISr,[)
$ 00
23,711 3
Db
00
~ j , -rn-. gr-
4.LJ~ 56-
18,785 27
~O.
93-
=
Valuation Df IIfo OItattlll or ..:&.._
annultlcl'., tt .t' 1'0' ""I"" .,_____ $
J:.fiINCIf'J-1I
--t
"::-t=
~I'f
=f"'
ESTATe TAX AsseSSMENTS - $-
TOl'AL TAX
!12ill!.
a% $
.-"- $
G%
16% $
$
$
~-
$
L ==1:
$
$-
<;OMf'UTATION OF 'TAL
FOR usa: Of' RaGIS':l'R ONl-V
TolC on $
Tox on $
TolC un $ _
Tn)( on $
Tolt an $
EICBfllptlons
Totnl E,hlla
-....
(')
A. CtvlllollCod by Clmrllnhla
EKonlptlon C.,tHlca'ol luuDd
by Ilia Soclrl',tory of Revenuo,
LAU tOil provlou.ly paid
BALANCE
Leu 5% of hilt If po III within
3 1II0nthl ofhlf cllHlth
BALANCE IlF INtlERITANC~ TAX DUe
Add IntftfOfilnl Inft! of 6% hum
~
10
AMOUNT Of ESTATC
I!lfolo tOJ( pulil
$
-
TAX A:;SESSEO
~ ________.o_,.+~_
"~- , -----
$---
BAI.ANce DlIE
Add Intoful ot Hlto of 6% from
10
TO" AI.. TAX BALANCE
PAlf,....__.____
Suppl.montol C.doo' (FOR USE It~ IlARRI5111lRG OHL Yl.
s ..__..___--;~
$
$ :--"_H._____'..
,.....________.. ,..,_ _ "_~'_'~T.................__~________,___.~~_~_'T'_-~"'''''_
--:---
4B-Adluotmont
49,.Adlaotmont
56-Annuity
l,o-Llfn r:.,tntL
92.,ll,,,,,,,lndN AN".I.al .
lJ]-HOITiUllldM D'Jdudlon
'I3C-Chnrlty
94-Ro",nlndor Ro~ldn.
96~Succ 0$11 vo
,Lila EBlOlo
FOR USE Ilr' I Ff,ISlER (lHI.Y
'--".--,,'j)J US:IM F. N'ii:~."------
HOlE: Whllfn 'lUh"!'IIl/Of11 ildl'll~tt1"'ljh "IIi' mudt. 1<1 lh~ (Ihovf.' C(I!lipllll1t!nll of lux hy tho I~ogl'tor of Wills, far proDor roa&on,
,llIlI(' hllClldll III 11,,11'1 bdww, wIth '.hot! L'xplrUlcltlon. '
. '
l:OMIvlONVlE/\UH Of PffJIJSYL V/\NIA D/,'I -LllL;.ll.LlJuhlU'J.!l.,1Jl-..
IIESIUEI'H II\II-IEIII ri\l'JGr: TAX COUNTY .c..uDW.U:t'~Il.LL...__.__.-
^1'l'nl\m!'I\~r'~IT ,"'!In 21~ 'I U ~ 01':1 b
-- -------- ---......---------. .
Ill; v.4tl7 In."II\)
OOl'AnTMENT OF nOVONUU
OU[lEAU OF FIr.LD Opr.nATIONR
11,0. !lOX 20'10
HAIII\IRIltJlHl,I'ENNA,17100
Whorflc1S, n"';l~&l.-I.- r:hllmhn"'frf'~ Into of rilR:t Pnnt'pbo~T.\W_.........."_._,.......
In tho County (1f CU.ln1l.!!.!,)III1CL__,__,____,. C(1n',nlOIlW(!,llth of 1"'I\lI',.,.I'I;1I11i1, 1'''''111<1 ,Ii,": "
tho Hi'h d41YOl' \lulv_____ 191!l..,l1oizodandp()~;~;e!i!;';d(lldll{)':I'IIi\
Rubjoct to Inhorltanco Tax undur tho lmYH uf tho COllllllf.\IlI"",lllh of I'.WIII'"ilv,llllil:
Thol'ofol'o, I, f~nnrll"'n n~.2..t}~''''H ......-__.. ,,\It ,1PIH:li:;p\, dulv '\!'POlllti,-'d ;il-,,_;,y-diwi lI, 1'1\'/,
having beon cloglqnatod to 1l1al',e a fall' ilnd cOI1"cl<)Il,'lhlo ,lpPI,)IHOI'i\Cnt of tllll ,;;lid ",t<\ll1, "'1'11(1,1';'''''' ,11,,1 Ii..: Ih.' ""d,
value of all annuities and lIfo ostatcs growing out of gald l:::t1lto, heroby fill> tho followill\i appr~lg\'nlonl:
In Itl0 0'0'0111 tllAI nny 11111110 Intorin! In tllh 1111,11,\ t\ ",lll'IIHrfl(111l PllUflUllH1 01 (l11)<I'l/IIhllll In {I,II.1\I'hl1 Ih\I,~ "I \'\;1 (!I";11\1l;1l1 .lllt>! Illl' U-"I",1(1111'
01 <'IlIV o,Utlllor Offlll! for yonn, Illn (:{]\\mlllllwfhlltlllllllutIY \i),-pr'lt\ly tr~lHVIU 1111111\111110 ,1111HI\II" and .15'111\' \till\\fN InhlHlI.ll\{lI \,ll<fJ' "t 11ll' 1,1,,;'1111, "11>1,,,,11
rllto 011 llllY Illrh lulmo IntnruU.
-' "-~''Tjf,n'i''--'''''-""Airj7-rr.7,~;:7iI'''-
UtfJf-:HIPI ION 01' 1\',';1 . \'/\1.\JI:r, M.id" 1<11 l!lIII>111,\I;I"
1 ,'~ I'W!l,,',l'1
.~-l
Ro D , f' I':l f' n +ll ,----~ :~_..llOJUl___"h
Pn\""lQnnR] PYlnpfl,.,ty ---- -- _!~.?2~ !~- .
't'V'lnhoftn'r'\J.:l .. -- ___lLc.n.n- ,----
.lnl "to' ]' ()wt1nc1 ---.....-. --*"~... ._~-*
'rnt-A' - - --.-- ~,-_.. .. ll11.-7.l.l. Jl.3.._
-. --' ----- _.-._.
--,---- --
- ------ ,-
----- --'
-- _0 -_...:.- _.-........-+...._~ ----
.-
-- - --
- -- --
--.-- -,--
.- ---
.--..- -"
-
,.- --.--- ---
- 0-
,
--
I ,
. . - --..-
- _...~ --,-
0 - -.--
.---.' wn_. --..-
-- .- .0._-
-- - - f---- -_.".~ -.---
-- --:=-=.:.
- -
Havo boen duly sworn acoordlng to law, I do hcreby cortify that tbo ahovo appri\lsl>m0I111H mado in conf(lI'jniIV
with the law on this _ '1 t I' day of 11" \. '%i~~' ,,17 19 .:.2.,
. . Id,I1' l till!'! -
!\'IlPfill'.II'
----_.-----~--_._....---~_....
(r~lI(tll.!l( " I,d !.l r fJol1
11l1f1..___
, P(lilnd.
(1'<1';11'111'1'1