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No', '~~i .I 487
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PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
In the Estate of _____~:o..~gP!!I~~..~,.:r!!.t:)~~~.o~___..,._,___,____..__, deceased,
To Richard E, Anderson, Register of Wills for the County of Cumberland,
In the Commonwealth of Pennsylvania.
~
Petltloner(s) ore the execut(),):su 'h_ named in the Last Will and
Testament of .__i[QeE1PIU.!'LE.__P'!..,!,119!'1.1)~.o.!'l .._,_____,__ dateduF,El~lOu;lry 22,,1974
Decedent was a citizen of the United States and a resident of
;=;{j'II.I,-
Camp Hill______._ Borough, Cumberland County, Commonwealth
of Pennsylvania,
Decedent died on __--"-Sundi!ly the ___J5th,__, day oL..i!ul.L-______,
A. D, 1979 , In the County of ,~~rnbe..rl'!!!9___._,_____._.____, State of
Pennsylvani'!__.------- at the age of .'!.L__ yeors,
flee- ~- her
Decedent has not been married and has not had children born to lIiIrr,
since the execution of the above described Will,
Decedent was possessed of personal property to the value of
S ", l"lOQ~OO_ ,____ and of real estate to the value of
No real estate
as near as can be ascertained; said real
estate situated os follows __
apply
Therefore, your petltloner(s) respectfully 41111111[ for the probate
of the said Last Will and Testament and for Letters Testamentary thereon,
Dated Ann".. t- 3 ] Q7Q
Name and address
of Petltloner(s)
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Charles W. Thompson '
'914 Lenox Street
Camp Hill, pa. 17011
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W A Cl[On F. Prowell
COMMON EALTH OF PENNSYLV NIA R,D.tI1, Mt. Wolf, Pa.
ss
COUNTY OF CUMBERLAND
Charles W. Thompson an~Cleon F. Prowell
named In above application, being duly ___J2,WQffi.__,___ according to low
say(s) that the statements set forth in this petition are true to the
best of
their
Sworn
and
knowledge and bell~f" . '/ ' l) ,
subscrl ed before ..~-' { Ii} ~ .) / ( ? ( {{ / (. 0)'Y /;1 (
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Attorney: 17101
Stanley C. Fellows Harrieburtl,P
700 Blackstone nu~ldina
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Ichard E, Anderson, Register
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OATH OF SUBSCRIBING WITNESS
COMMONWI.;AL'I'1l Ol~ 1'1~NNRYLV ANIA / ~~:
COlJN'I'Y OF ClJMBlmLAN\1 \
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hofOl'f' nlO H1chul'cI g, Anclol'~on, H01l18(,ol' fOI' tho I'l'obuto of Will8 IIncl Hrllllting 10(,tor8 of Adminllltr[ltion
in und fol' HlIld County of Cmnhol'lund, in tho Commonwolllth of 1'0nnHylvllnill, porllonl\l1y cllmo """,,"""
,"',' ,9, ~::!-,I;I:;1;!':l.Y", 9,:", !-f,~, ~ ~,9.Yf,~" ,\\r.~."" l't). ffilil" M.", l;',QWIlJ:I"",.,"""""'"''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''
tho HuhHcl'lblng wltnll1l1l0B to tho forogolng In~trumont of writing purporting to he tho IIlRt Will IInd
'rOHt.lIment of """.;r.~J;l.'i\Pn..i.OIi',.,p',. ",'j;'n..<;\(I)p,~QJ)., "",.."", ,.""" ,.",.." ",."""",., Dlltod "."f.~,l;l A, ,,(,/1,., ,,;I, ~,7,it."".
lut.o of """..,,,,,,!;;flJm:l..J;I..i.)';\',,,..,,,,,,,,"""''''''''''''''''''''''''''''''''''"""""""",",. Cumborlllnd County I'll" docolI~od
who heing duly """ ,l?,WR,J;',l)".",,,,,,, ,,,,,, ""'" lIcco\'(llng to law, dOpOHllllnd Hay, thut .."~1:.~,y.""""",,,,..,,,,,,,,,..
proBont" und HIIW und hUlIrd tho tOBtn,U,l)iJK"'..""'"",....".. .J.OBlilph:Lne".fl.,..woomFson'/"""""""""""'"
HIgn, H(lIl1, puhllHh. pronounco IInd docl[ll'o t.ho RlIld InRtrument ofwrltinH IIBlInd 1'01' h"e,r, ".. ",,, 'l'oHt[lmont
lInd Lnllt Will, [lnd ut tho time of BO doing """""..""",~nli',.."""""",,,,,,,,WUR of Ilound und dlRpolllng mind
mmnol'Y und undol'Rtnndlng, to tho hOIlt. of '" _,the,i't'"""".."".."'"''" ""knowlodge. ohRorvnt.ion and bolioI',
Sworn d' d
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Rich[lrd E, AndorRon. Rogister
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AFFIOAVIT OF DEATH
COMMONWEAL'l'H OF PENNSYLVANIA / A8:
COUNTY OF CUMBlmLAND \
""."""."", ~;):I,~ F. ;+,If. !,!, , :1.r", ,'f.l1fi>ffiP.~,9.n"." ,nWil,bl'lP.c;\."""""""".", '''''''''''''''''''''''''''''''''''''''''' "'''''''' ,bolng duly
""'''"""~,YiR,r.n,..",.."".,,......,'' RUY8 thut IIR nllurly [18 clln be uRcortulnod tho ,Buld' decodent",......".""....,,,,,,
"."""."""" ,'!.? !:,,<<;JJ~~,~, ~~'" ~,~" ::r:):I,'?~p',~?,~"""""", i"""""""""""""""""'" "" i",,;,.,""""""'" '''''''''''''' ," ,died on
.."......,:!!,u.n~,~,y."...."".."...,,'''' tho "",..J:,~.tb"""""",,'dIlY of'" ",.." " "..X',I,\;1;)(.....'" " ". ".., " " " " ,,,.. A,D,. 19~,~"..
at or nhout "......".."?.:,'~.~"..,,..,",.,'"'' o'clock, t.;',..M,
",..... ,... .,., ..,.,.~~~.t;,I~j'" ,. ,...",. ,.. ,nnd HuhHcl'ibml thtH
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."."."..,.,..,',......~~~..,.,.".....,'" dny of. .,.~,~1,9.~~,~.~".,
I!l, ~~..". before
llil'hlll'( K Andpl'HOn, I{ltl1ist.PI'
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL'I'H (W P~~NNSYLV^N'A}
COUNTY OF CUMBEHLAND SS:
Befol'O me. tho Hoglstor Ibr tho Probllto of Wills IInd gl'lIntlng of Lotters of Administration In and for
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the County of Cumberlllnd, porsolllllly ClImo .."C,ha.r.le.e."W.",'J.')),ClOlPIlI,QO");"",..U;:',;,7,,,.r:,,,,I..i';'I.I..t.(.t...
who, being duly ,':j,'cl,QX'n,,,,,,,,,,,,,,,, dOSJ1.....,. dopoav nnd sny thnt ns.....Exs.Qu.t..or""..."""..."....,..........'H.....
of the last Will and Testllmollt of ..JQseph;l,ne"p,.,,,!1'.homps="""....,""" ,......"..........,,,..,............doceased
,,,,,,,,..l.l~..,,,..,,,, will weiland truly administer the goods llnd chutwls, rights and credits of said deceased
uecording t.o law, And also wlll diligently comply with the provisions of tho luw relating to 'l'ransfer
Inheritances, .."TlUC;es.....,....... and subscribed
before me,
79
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.................
Richard E,
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DECREE
Be it remembered that on tho ,,,,,,,,,~,~~,,,..:,, dllY of ".."''''''''",..,~);\9,H,Ijl,1;"",,,,,,'',,. A, D..19 "7,~,,, thore
I tod d d d tl I t W'II d 'f t t f Josephine P. Thompson '
WRS prO)8 an rocor c 10 UR. I un eM omon 0 ..".........".""...".....".."...."......'............."""".......,
Into of...."',..",.."~,~~l?,,,!H,~~,,,,,..,,,,..,""",....,,,,......,,... Cumbel'lund County, l'onnRylvnnlu, De(!ouRod, ulttors
.", ",,'.... ".. ,~~,~,~~~~~,~,~~.y., """" WOI'O gruntod to ",~h,~,~,~,~,~,,~:.., ~,~~~~~~,'?,~..,~..~,~,~?,~'''~:',:." ~,:r;,?~~,~ ,~,
Wltnoss my hnnd nlld officlnl so1l1 thll dllY llnd YlIlII' nfbl'f.lSllld,
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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CHARLES W. THOMPSON and CLEON F. PROWELL
____..~ .._.__~_____._..___ _.__.___."._____...~.'...n._..__.__. .. ._.__..n_~__u_,.~+_._____________..__~___~_~._._
bolng duly .,_m:tQBJ[...__.,_ according to low, dopo.OI end ..y. th.t they_arA the .,--
_.___._.9.()':EK~5:l~~?:t:.~~--n--...nn of tho e.tate of JOSEPHI~E P. THOMPSON-:-:-:-:-
late of.n,]3orough.of ,Camp Hill, ,..... ..._____., Cumberl.nd County, Pa" deo....d and that tho
withIn I. on Inventory modo byC.h~r.;L!ilJ!..W..'r.\)9!!ll?Sqn_.\'><. c).eo!:!.JI'._R..row,~d- said Co-Exeoutors,
of tho enllro o.tote of said dooodont, oon.l.tlng of all tho "."on.1 property .nd reol OItate, 'uoept real .stot. ouhlde
th. Commonwealth of Ponn,sylvonlo, end that tho flgur,e. \>PPO~I.t:Z/':O.Oh Item of t. he )",,~tory repr...nt It's fair velue
01 of tho d.te of deoed.nt s death, ,.~' , I IV (/J ~ ," IAl" ,,<},..I/ '
, ' ,: (r.MUll) v{i iI 'l:lI" (11.-1.-'0'''
Sworn end .ub.crlbed before mo, \ _~, 07 I~VjfJ/ '_____....
September 11, 79 h~uto' ' Adn,lnhl..'or
19 -,-~_
127A It C !., ~ ,j; ~:i:~- ::::~ 17011
, ) My r:""'ITII","; t.,' olorV Publi. Addro..
"~mJbUl'\I' 'IA II Ifll 5~PI, 18, 1981
Dlluph/n-C:ovltly
Date of
15th July
Death ,_~_..__,_..._____.__~
DIY Month
1979
VII'
INSTRUCTIONS
I, An Inventory must be fIIod within threo months .lter appointment of person. I r.pre"ntatlve,
2, A .uppl.ment Inventory must be fllod within thIrty d.ys of discovery of additional au.h.
3, Additional she.h may be attaohed as to personalty or realty
4, See Artlcl. IV, Flduol.rl.s Act of 1949,
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NONE
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Trallsfl'r~ within TWO YII,AHS PrlllT to Ihlll1h
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NONE
That ilt the tlllHl or dellth Ihere wus 1111 sufe dl1JlllSlt !lox rI.lltlsWrl'l\ in dCl'l'd\.11n's name, llf joinlly wlth, or as UW.'lIt llr dl1PII!)' of unother, IIf Itl dCl'l'dClll's
Individual tHll\le, with rll1htll( IIl'CCS'i \ly nllotlwf us ngcllt Of dllPUI)', wlth I Ill' exccpllon of lhe lpllowlng: '
NAME ANIl AIlIlIIESS OF BANK Oil OTHEH INSTITUTION
IN WIIIClllll'lT,IW-NT HI'NTFI) A SAFE 11I'I'OSIT BOX
TillS SAFF,IlI'I'OSIlBOX IU'.NTI'1l
IN N,\~1I', OH N,\MES OF
IlEl.ATIONSIIII' OF JOINT
1I0LIlF.HS TO IlECFIlI'NT
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HI'LATIONSIIII' SlIllVIVI'.1l MWOFI.1I'E
BENEI'IClAIUES ANIl ADOHI'SSI',S Of stcp'llHlther 111" 1l1't'I'IH',NT TFNAtolTS OH INTI',HEST OF
ISllltc full llames of IIllul1d their uddr~s'ics who 111\\'0 111\ 1ll1'~h11llU11' l'hlldrcn ST,\TI' \'I'S ,\NNIIIlANTS III'NEI'ICIAHV
Interest. \-'Cstcd, contlngcnt or t1thcrwlw, In csllllc.l Ufl' III\'O\Vl'd, st'! OH NO AT IlI'ATH 01' IN ESTATl':
"IfIll lhl, flll'!.l IlITl'llI'NT
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Charles W. Thomnson ~'Y Soouse Yes Leaal , Residue
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1914 LenOK st
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Hill, 17011 ,
Camp Pa.
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Rev. Cleon F. Prowell ,~\V; Brother Yes Leaal Beauest S7,500.0
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Mt. Wolf, Pa. 17347 \
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IlFSllIENT m:n:III.:NT 1lI-:IITS ANIIIIJ:1I111'T10NS I'I,AIMEII
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---- IIEIIT Oil l'I.AIM NATlIlm 01' SAME ,I MOl IN'!' TillS ('OI.lJMN
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delJcd"1l1 dlt.!d rl,.',..ltlhlH wllh II ~IHlU.\1J IIr chlldrcn"
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('nUlncl fut"'.
I.'lduchlry (~lln1l11l'ljlun.
OTln:R IImrl'S ANII Cl.AIMS
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NOTEl The elltate MAreel to 'ul"lslJ the ItrAbler fir Will" II the QmUUnlllcltlully p"I~I.Jl:'~~Omf,!nl (If IIny reOI c(tl;~~nn fir dohl L, Rrenter fir I('K' II1IIn the
..el...t.d ...n.ne.I.lnt.d and allnw.d, 1f;J1/;(t Lft:J ,It) ,f-fv(l;II-.yo1itI?V
Sllh"',lh.d.nd",nmlnh.I",...oehl", ,,l,~.\:h,,4!'.Y, ,9,:(:""""" '" ,~cBYl",:t.." I?~""" """ """""".",
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, ,.,.....,1, 5},~.4. Lanox .St.reet,. I............"...,....
ISI'I.it.'INumhl'tl
') I. IMRY E, COOK, tMOIY PIII,Ii(
1'1" I J.. f) I (,I -,v. ~ My (","""";,,,, 1.""" \"1'1. IB, I'IBI Camp Hill, Pa. 17011
,.,./. ..;~4'.f..l, "'('-"'. ....\-,,'.'C'.v'./. r:. "~'II:I'..,,-..dl!_. .',.... ])i'll~flill Lv'Jllly",.., ...,." .j,......., ......... ............ 'I.. '..,.,... ,.....
, Notary Public - 1{'Il"nr'!II..nllndSlall'l
lIulnR t!1\lcn duly sWllrn ltcl'ordlnR '0 '"wl I do herehy (~crllfy Ihftt Ihe "hon" llpptltl~l.'","nt 1'1 I1Illdl' In l'onfurMllty willi Inw 11I1 Ihl'l
........................"......... ....,..,.. j. I... ....., dRY.o' .,.....,.,.......,........,............,...,...... I 19
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Apprab:llr
In the cvent th.t Iny lutureIn'''relllIn thb ",$111111 I,~ trRnfilcrred In pnlilie.\~ICln IIr IlnJoynuml '(I l'I1U..I('ral hlu "' Ihe dl'l'(Idcnl IiICer Ihe "'plrallon 01 any
1:'1I'.le lor 1l1L' IIr Inr YL'.arlll Iln', e!lnlll1onwll"'.h hlltehy "'I1fellftly rC'ler\-'ltli Ch(l rluhl III 'pprlt"Ie nnd RI!H.\.li!ll Wlndct InherhnRl'1l IUell allhe I~wful cullMhmtl
raH~ nil any lIul'h 'ulure InCotllll'.
REI'OR'!' (1(1 'I'm: 1I1':IlISThll ()II WII.I.S
I, 'h" unclotlllAned duly Illl'C'ed HfRllIler of Will, In Mud for. . . . . . . . . . . . . . . CIl'lIIC~', "I.!nn'lylvllnllh tin reJipct'lh,lIy rellllrl tlu.. I han' ..Uowed dl'hl!l
"nd d"dlU'.lon,. In .he Anlflallh (''',Imed hy dl.'poll('nf, nt'cpt all In Iholll Itel11l1 ~hl.'te R Rn'.Het ur lencr ..mullnll~ !ll.t fnrtll In Ihl.' '"'ll l'nlumn to Ihe 'IAIl.
In !!..ld !wlwdule Mhuul wIII"'1 A'''lIter IIr Il'III""r "mflllllt re,.rellcRt'" the !111m "Unwed IU II dl!thU'llnn.
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I'",,"ty, NUlnbor nnd Namo_(.2J..~.u,c.uUI!.~,p.J,.IW.d,_
; I. Numbor _______________.J}_- ?~::.Q,~. 07
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(LA!IT' NAMI;I (FIRST NAMHI
SUMMARY
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tlNITI^I.1
COMMDtolW~"'1. TH OP PEtoltolSYI.V...NI...
TR...tolSPER INHERIT...tolCE TAX
RESIDEtolT DECEDEtolT
REPORT OF INHERIT ANCE TAX APPRAISER
i, tho undonlgnad duly appolntod Inhorll.nco T.. Appraller In ond for the County of r.llmh",,1 nnr1
f' ,i \'lIl1lu, du ro.pocHully roport ,h.t I b.vo .ppr.llOd tho real and penonol proporty 01 rep.rtod In the foregoing return 01
II I,,,,,, "of forth oppaalte oneh Itom In tbo lOll column to tho right In Sahodulol "A", "8", "C", and "E",
7 Novernhor 1979
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ItmEHlTAt~CI~ 'rAX A!Jf"tAISF.R
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REPORT OF THE REGISTER OF WILLS
I, rl", IIndonlgnod duly olectod Roglator of Willa In and far Counly, Pennaylvanla, do r.lpoct-
I'",t th.t I hav. .I,I.wed doductlon. In tbe amounta clulmod by dep.nenl, o,c'pl 01 10 tholO 110m. wher. a grealer or
I, ,,. "lIIcunt II aol forth In Ibo lOll column to Ih. right In Schedule "F", which gre.tor or le...r amount ropro..nll tho lum
, ,d \H 0 dod~lctlont
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f,
IH':ol!lTEH OF WILLS
'\11. ,,'dv Wohndulo AI
PO\;, j i'ruj}UI1'( (Sohedule UI
Jol!; kid f'wllllr1Y (Schoctulo E)
ir:l' .,'i" (Schudulo Cl
,,\L onoss ASSETS
Lit,. 'I, '" 'lfHI Oocluotluna
'.' "DULl: FI
(a,1 Ii V/\LltF. OJ: ESTATE!
r.
r.
AOJUSTMENTS
ODE IflARRISBURCl USE ONl,VI
00'
10+
20'
30+
REMAINDER APPRAISEMENT CODE
INVI:NTOI1V
VAI.UE AS APPRAISED
--
...L..._
+
40.
93.
VII' I, "f Hft.l OJlI(lIOI or ~
on", .,......."..."'.."._$
PRINCIPL.E
ES' TAX ASS~SSMEtolTS _ $
t=
"'"d=
VAL.UE
r"
ESi'!L~'F REGI5TE~ ONL.Y
TOT'" I. T"'X
~
2% $
51' $
16% $
$
$
--
$
$ t:
$
$
COMPUTATION OF TAX
Tax L" :'
Tu~
Tn ~
To-.: ,
lOT
[:K';'''I.i,'II1o
"(;1 Illlv
(') AI ovldonced by Ch.rltoblo
Exemptlon Certlflcot.. IlIued
by thl Secretary of Rovenue.
Lou IUK previously paid
BAl....tol C E
1.", "f Iff., If pold wllhln
3 ,;, Idhr dU(llh
,....1(1
AM. I' i OF ESTATE T"'X "'SSESSED
[:5;' jdr thlld
BAI....tolCE OUE
Ad, .<.,,1 ill 1(110 of6%from
to
$
$
t:::
$ r-
$
$ t-
$
$
$
B..., .iI;L ai' ItolIiERIT...tolCE T"'X DUE
Adl 1"",1 "I rulo of 6% from
TOT...1. TAX B...I....tolCE
PAID
5,. ''''011,,1 Cod.11 (FOR USE IN I1ARRISBURG ONL Y)
,!j II "1rru'lf'lt
-'il1tllmt/nt
. ,,"wlly
6O-Llfo Elt.I.
92'1 Romalnder Apprallal
93-Remalndet Ooductlon
93C-Ch.rlly
94-Remalnd.r R..lduo
96~Suace..lvo
Life Ellat.
: U~f OF REGISTER ONLY
ADJUSTMENTS
IWI I" Wh.r. lubu"..n! adlultmo,'h 0" made 10 tb. obov. computation of lax by Ih. R.gllt.r of Willi, for prop.r r.alun
samO Ihould 1>. nal.d below, with Ihort ..planation, '
I 1 ~,
/; iG
... ~
~ '8:
OJ ,.~
, 'El
~' ~ ~ F.3
f ~ ~ 1 ~'
~ i
d !; l$
z ~ ~
~
rg' 0 'Is
! .oS
'~ 'Is "5
... i'
VI 'Q ~
,~ ~,
c:l
s~ :.l I '~
11='< j. U U
", V..I"/I^"1l j:'OMMONWEALTH OF PFNNSYI,V, . :,A 1'''''' :/._..Ila.\LDlIlh=-..l.ll..2S.
lIliIW'~~JI;\rt:Wlg~]llr~K7Nir-JH n~SIDENT INHLHITANC[; I AX C(]ilNl V _.LlunlutJ'.l-L=,cL_.___
IIAfllw:;i~J'li~\~~~~~'~ 11~:",-_ ____~:~.lAISI'~: NT __._.___ .__. _~~~_~~_ .~~~~:~_.O~J.~I-=-:..:...=~__.
Whero"n, _,Toflophine P. 1'11.Ql!!1W.9.lL-..._ Iilleof ,...,.1~","p lIill _____,
In tho County of Cumhorland COllll11onwo,lJth of Ponnnylvanlil, hilVIIl<J diod on
tho If)+h _. clnyor (1111)1 t9.1.!J.I~iolzodandpomiO!;godofanOfit.all!
flUbjo(:t to Inhorltanco Tax undor tholilw8 01 tho COl!ll!lonwealth 01 Ponmlylvaniu;
Thoroloro, I, Sandra Stono I an appraisnr duly "ppolntod llccordin\110 law,
having boon designated to mako a fuir and cOllsdonllblo appraifJOlllUllt ollho said ostato, and to assoSs and fix tho cilnh
valuo 01 illl annuitios and lifo ostatos growin(1 out 01 said ostato, horoby 1110 tho lollowlng appraisoment:
III till' UVl1l1\ !lUll ,illY futuro IntltroH 111 tllh l,slllto l~ Irllnslorrod III pnUHHlllll or nnjllYllIllllI to ulllnturilll1olr$ nl Iho do(;odunt <'IIIUI tllo f))'Jllr,lllnn
(.1 I\IlY Mltttu ''It Illn or lor yo,1rs, tho (';ulJIITlnllWlhllllll1orohy !Jl(\Hu\\ly rll'lrlfVU\ ttln rlcIllllflllPprlllitl MId aUfJ" tramlOf InllorllnnclJ lllliOf ill 11"-' Iilwflll [lill,IllIral
(.llu Oil iH1Y \11(-1\ Ilrlllltl Intoru\l
- - .. -
UUiCIlWllON OF Asstl .1!t:lI'I'- fl.l,jirill','11l1l'111
\j Il,t lJL:~j MMln1"f Illll1lll1<1l1r"
TII> Pllrp"<;I!~
$
Pv~l ~AtiltQ u,
nn~onnn' "~nnn~"" $5 065 40
'r.r.illl.8 f e t' II ..,
,Jointly OWllon tie
Total <';r, . OR r, 40
.
--~._- --.
-
--- ---
- -
- --_.~ ---
.
, --
. ,
.
1--. . ,.-
-. --
- ,
- - - ----- ,..-
-- I--
, ---- I--
-. ,- - . -- -.-
- --- - ..--- -----
- . --
:-. - ---=-..:::::...=:.-
--
Havo boon duly flWOI'n aocordinq to law,' do hOl'oby cOl'tlly thill tho abovo appJ'ilisomollt in Illade in conlormity
with the law on thin _ 7Th day 01 "ovo,"),,," , 19 .lll-,
\j(!iicl',,-, 1 \.lInt.
I\PIII 1l1~1I1
(UII",lllll .IlH1 '.lli'r!f
~__!.!~~_!: ~.~.l~~~~
. Ponllil,
P'"q ()I!ii'"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAl. NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
COUNTY FILE NO:
,) 1- 7,/ I/r ?'
DATE
/1'1//,j (, /7:< (;!
~-, -/
,
_-.J(I~(I.iN"AJI; l~/ }Jh,y~'I/'!x~P/
TO: (///1" i,' S If), f;J(.'I'V"""'\/ ..,
'. . I -I
(1''; V U ,: r:;"; j', / 'f;!, ,,,,/J; /, I.
EDT A TE
/1 ;-1 ). /; tVox
'J
("1,1) (' 1/1;, I. /,'/f,
,
,c..-.,
)/
FILE NO,
c<;J!'?,9. ';/[(1
!7(t/ /
r''lf /U(1li~ /~ ,) IJ '/7
- '
COUNTY
";/1\'1,50", fi l)1 Iy J~J
DATE OF DEATH
'/,. / :-.~. 7/,
Approlood Voluo of EstOlO:
Rool EolOlo '
.
.., 0 ,..J..
!J"; 0 1".< 1/7)
Porsonol Proporty
+
Jointly Hold Propsrly/Tronolors
+
" CJ ,-
Tolol Orons e"olo
,
If (I (, ~,-, / ()
Totol Appro.od Doduollon.
f~ ,~.~'j~/'(i 0
Cloar Voluo 0/ Estato
.
,,2J'6! ,11(/
Lons: Approvod Chorlloblo E.omptlone
.-~- (.) ---
Cloar Voluo of Estoto Subjoot to To.
.
,:J ;'-.-'('/' tjf)
Amount Taxoblo @ 6% Roto
.
10' duo
.
Amount Taxobla @ '6% Rata
})!.>'d./, ~/(,
\ox duo
.3 [!y. {,i./
11/' (/ /,/ 'I /
_ Ci '! 'v'_
TOTAl. PENNSYLVANIA INHERITANCE TAX DUE ·
· · · · · · A flvo poroontdlsoount totaling ·
will bo grontod If tho Inhorllonoo TOK 10 paid by
LOBS Crodlls:
DATE OF PAYMENT
') - I 7. ,?f
&
AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
/ 'If" (,'C! t P '7, (, S- o L-___ . . /')'~3, (,. 8"
t .
t 0
.---
Intoroet ooorue. At tho rot8 0/ el. (61 poroont por 9nnum~.
on tho unpold balonno 0/ InhorllUnoA 'Ink from ~..!l.:.i~'-:'..!f-'2__--
to dota of paymont, In\oroo\ duo If pAid by__._.______..._ 10 _n._'
BALANCe OF peNNSYLVANIA INHeRITANCE TAX DUE
.
,:J :J,o, ,,")
a'&~-I.,
',Jt.l\ 1t'V1/ ~ i..r
..ii (.1 " ",
y;;. p'. . '-.' ,
A.o.8Bodby:, ..,.L'.. ,i'. ",J,
Agenllu, the r:tmm W"llh j,-
Seo lnlOflflolion {Ih ROVCIfAO Sidn / 1.'.<} J('. I,' Jl ,. ..j A.,
"(/ '() ('U'
"7 ," '..,
? '(.,..~,-.~ ~....,fT
, / 'in
01' -,1./, f:'1'