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No. ~1.I.1~;-
PETITION FOR PROBATE OF WILL AND
..J9H
LETTERS
TESTAMENTARY
in the Estate of ._._.u_ _..MI\RI 'I.1.Ul, uRClGKEY,u...___._.... ...__, deceased,
To Richard E. Anderson, Register of Wills for the County of Cumberland,
In the Commonwealth of Pennsylvania,
IS
Petltloner(s))(ff~ the execu\:r.ix.......... named in the Last Will and
Testament of _.____~ari.!:~.~_B?ok~L_.__._. dated .JimL71
Decedent was a citizen of the United States and a resident of
T~p-
Camp Hill Borough, Cumberland County, Commonwealth
of Pennsylvania,
Decedent died on Monday, the 16th. day of July
A. D, 19 '1=9 ?71n the County of Dauph.in ____, State of
Pennsylvania at the age of ~_ years.
has has her
Decedent has not been married and has not had children born to him
since the execution of tho above described Will,
Decedent was possessed of personal property to the value af
$25,000 and of real estate to the value of
$50,000
as near as can be ascertained; said real
40 N. 30th Street, Camp Hill, Pa,
estate situated as follows
apply
Therefore, your petltloner(s) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon,
Dated July 25, 1979
Name and address ,/
of Petltloner(s)
q;'~ oR~ ?f;;~-,^-
Elizabeth Rockey Fag~r
428 Deerfield Road
Camp Hill, PA 17011
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
~ ss
Elizabeth Rockey F'ager
named in above application, being duly
say(s) that the statements set forth
sworn . according to law
in this petition are true to the
Sworn
her knowledge and belief,
and subscribed before ~ ~~~~)" df ~..
best of
79__
- .~_._--_._--------_._---------
Richard E. Anderson, Register
~ (1 iJ
-.-,'., _.._---,-----~- -~----.
August 15, 1979
Attorney: John E. Siiks
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OATH OF SUBSCRIBING WITNESS
COMMONWI~AIJI'H ()fl' PI~NNSYLVANIA !
HH:
COUN'rY OF CUMllImLAND
'l'his.",." tl .....,'..." ,. ." ,.,'~,~~~, ,." "",.., " " ,.,...., '...., ,.. duy of' ......, to "" It" ,...,." ,~,~~~'~'~"'"'''' ",... ...,..... A.D" 19~~"",
before me Richurd E, Anderson, Registor for the Probate of Wills and gnmtlng letters of Administration
In and for suld County of Cumborland. in tho Commonwealth of Ponnsylvunlu. porsonuily camEl "'" "",, " ,
Robert J. Trace and Sara R. Hosler
......."..............,.........""".,.."..,..".......,...,.,...",...".....................""....".",.,"....,.,........."",........".....,....".".,.,.,""0'"
the subscribing witnossos to the forogoing Instrumont of writing purporting to be the lust WlIl und
Testament of ".",,,,,,, "~flX',:j,j;~,,,Il.,,..~R.9.~!il,Y,,,,.,,,,.,,,,,, ,," ,""'" """',""""",'" Duted """ ,9:';',~,~,7, ~l, "",.,."""."
lute of '" ,,""" ""S~~,I2",I~,~~ ,~",~~,7.~~l,'l.h,,, """"" """" """.,,, "',,"""",' "'''''' Cumberlund County Pa" dllcHused
who bolng duly ,,,,,,,,;,m'!,9,r.fL,,,,,,,,,,,,,,,,,,, according to law, dopose und suy. thut ,,,,,~.~~);',,,~!1.t,~,,,,,,,,,,,,,,
present, und SIlW und hourd the testu"~,J?,~~,(,,,,,,,,,,,,,,,,,,,, """,!1~,J?,~.~,~"1~,~""~,?~~.~Y.,L"""",,,,"''''''''''''''''
sign, soul, publish, pronounco und declure the suld instrumont of writing usund for h.~);'"",,,,,,, Testament
and Lust WlIl, und at tho tlmo of so doing ",,,,,,,,,fil,l:I\l,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,waR of sound Hnd disposing mind
memory and undol'stnndlng, to the best of ",.."""....,th!1,+.F...,,,,,,,,,,,,,,,,,knowledgo. observation and belief,
Sworn
....................,.........,......",....... and 8 Bcribed bofore
-) ,.---'-.
-< o/\A<'-rj.' /A~~.."
..'''~' .....".,vrr;:.....,.....,' '',.,.....'IT'~'.rr'....'',................
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f,._. _ _ ' .{ I J - ", - _.' _I .-, j
....f.' ~l"t.. " ..,......,.. .)....'.'.11'.........,. 1,,,1.,(, ..,;:,,,. ,to.,.......
...,......,................................"............,..............,.........
AFFIDAVIT OF DEATH
COMMONWEALTH Ol~ PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND I
....,,,,,,,.......... to ..~.~.~.~~~.~~ ,~... ~9.~ ~.~.~,. ,~.~~.~.~". to to....."...;.....".. ,..., ,.,.~... i.. fl"" II ..., Of It.. II;'" H '1""", II ...beillg duly
sworn .
...."......................."..."".".".". B~YB that as noarly 8S can be ascertained the said decedent ..."...,.................
.... ".., ,........,..,.. !:1,~. ~ ~.~.~, ..~.:... .~~~.~.7:r....,...........,..,......,..,...,.........",....o........,......."" .........,.......,.. """" .... .died on
......,"...~~.~~:7'.~,......""....,...... tIle ....,...~.~~.~.........;......day of .,',......",.....~~.~.~."..,'''......i........., A.D., 19~.:.~.,'
at or about ."..........."'~.~.~.~~''''".....,,. o'clock~,'...M.
"."",..",SW,QX'I:\"!;.o.",,,,,..,,,,,,,,,,,and subscrlbod this
9L,~/D ~
""',.(;.~O"",..,..,"",.."..~/.C!:..,,,.., ,....,"~, ~
...,.....,,,...~.?~~...,""".....,,.,,..,, day of ''''~~~.~~~",....",.
19, "I?" bllforo
Hichard I~, Andlll'Hnn, HllJ(iHtor
OATH OF PERSONAL REPRESENTATIVE
COMMONWl'lAL'I'H (W PI'~NNSYLV ANIA }
HS'
COUN'l'Y OI~ CUMBlmLAND .,
Bufol'o mo, tho Ho[(istor for tho Pl'Obnto of' Wills nnd [(mntlng of' \'ottol'S of Admlnlstrutlon In und for
, . Elizabeth Rookeyf'ager
tho County of Cumbor) nnd,- pOl'Ronnlly cnmu ".. ,.,-.""",.,...", ,." '0" ,." It ,t It ,t ,.....,. '0 ""., ,... ...i...."'; I.....' I..., ."" ,. 10 ,t.",
who, being duly """"",/il,\'i\?;t;'XI""" dolil,\!\""" do pose IInd SIIY thut us""""/j:,~l'lR,lJt;t;',:I,lI",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
of the lust Willllnd Tostumont of' "",,,,,,,,,,,,,~,~,7.~,~,~,,~,~,,,,~~~,~,'::y.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,""",,,,,,,,dOC(JlIRed
,,,,,,,,,,,,,,,!!!n,f;l,,,, will wellnnd truly udministol' tho goods IInd chuttels, l'ightsnnd crud Its of suld docouRed
nccording to luw, And IIlso will diligontly comply with thu provisions of' tho luW roIlltlng to 'l'rullof'or.
Inherltuncos, "",,,~W,9,r.n,,,,,,,,,, find Bubscl'ibud
before me,
., 19..7.~",,,,
,,,?f,:~,,,,,,
""'~~-
.. ..
Richard ',Anderson, Register
,.,.Il11"..ti...,..'.,..,...."'.II..'.H....'.'.....,.,'..,',,,,......,..,......
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DEOREE
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Be it romomborod thnt on thu ".."..~.~,~,1~",,1l, duy of ..,,"'''t''tlii.''~~~'~~.~j''II'1i.''i'''1'A. DIt 1" ,.tl?~lt thoro
was probntod nod rocorded tho InHt Will nnd 'l'oHtnlllont of' "..."",':1~~J,'~f.l,,'~!,~...~~.~~~,y....P"",,.."."...H....."
lllw of "..""".."'<;;~!1'~"".+,U,"p.!;l,~~~~,'il.l1,(,,,,,,"'"'''''''''' Oumbllrlllnd ClIllnt,y, Pllnnsylvllnill, Docoa"od, LotWI'8
...,......,.,..,~~.~~!;',J.l1~~,~~.~.'I.~...,."." wot'(\ Hl'nntod to ."", ..~,~. ~,~.~~~.~.~~, ..~~~.~.~r., ,. ~~,cv.~,~..,.",..., "." .".,.. ,..... ,."
Witnoss my hllnclllnd nfllclnl HUIlI UIll dllY IInd YI'III' IIfhl'I'Sllid,
Hidlllf'(II';, Antl('l'Hnn, HI'J{iswl',
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~E\1449 (8'70)
COMMONWEALTH OF PENNSYLVANIJ\
IlEPI\R'I'MEN1' OF REVENUE
flIJREJ\U OF FIEl.D OPERJ\,],iOl~S
,21-79-499
.!Jb
COUNTY OF '. CUMBERI..AND---- m
RESIDENT DECEDENT
...._._.~.__.~~~~.,~+.n ,._ _,~"""""""",~--",,,,,,,,,,,,_~,,,,,,~,,,,,,..,,,,,-,,,,!",,~._-='l'!'1t~~T_--.'!'"~~ _~m__~_~~____'_ - .._d___~_
IMPORTANT I Thltl;fOlinn mllat hl\ llllllllllr-li1ll in ,\tnllll IIlul fill!~1 in I!lIplltHlh', with IIllutll\dll'll, with the Ih'siHtllr IIf WIIlH lIt till'
Cuunty. Whllrt\ dUlltHIOlI1 rIHdlh't!, Ih*lff\ Iii tllw wlthlll lIilll' 1Il11llthH I\I'wr i1ale of t1{\uth, Unll\HH 1111 tnHcnliillU 1M 81UIlllld
by th{' SOllrt'liuy of Ih\IJ.I'lIUl'. (SL'uilllll7(1.1 of thl' IllhcdIllIH'f' 1\1,1(1 EHllll~ Till( AI.l of tllhl ,)
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IN TIIH MATTHII 01' TIIJI, Jl,STATE IW
} AFFlflAVIT Oli
. HXEClITOl1
KI)t.){~JmJl!K
. ...__._____l1ARlTAJL,RQCKEY..._.
(!lTATI! FULl. NAI.U, Of' nECEI)I~NT)
..m" Q1IM1J&RLAND - .
Sial. af ___. .._,~IlliNSXLVANIA__..-.}
'"
Cauoly af _..___.QlJ1'1~F:.RLAND.__-..--.....
......__ ,,_,n"'''' ....J~lJ~~b..~J:h.. R....J;'as.e.r..__u......_..._.._.__.__...__._.________ E '.."'0'
Ad.MJk)'ifHHJIIlIX of the ..tote 01 the aboy..namod deced.nt Lelnu dul.,. .worn, Ilepon 8 Pilnd fay 8'
Decedent dhal___ Ju~ 16. 19....79 {te.tate leuvlng a la'l""""III, copy of whh;h If h"olO attach.d, )
IMONHtI WAYI I'(P.AW h~lCtHX
~.n" and ndd,... af alla'noy " } __..29h~~~~ 1 ik~_lm~f!q!-I_..b.!'no1Q.l-.Jl.1Jke-~_~~.Yill
alh.,aulhall..d,.p"..nlall,."wham 2109 Market Street, Camp Hill, FA 17011
all corr..pond.nte .hould \.n mailed, .._~.__~~~u..n_..__..___.____~_____~__~____,~_n_'____.~---______.~_______.m
Executrix
Thill I" ,,,"h_......_.__._......__._<l.p,,,,.,,' I, r,""llllIr with tho .ff.lrs "I' ,,,i<l ."",. IIl1d tho prup.rty e"",titll'ill~
I EX!'.CU TO R- ^nMH~IS Tn II TO r~l
Iho nHNols thcr(~nf nud thldr fnlr murkct vnllll\.
Thatl\llho lime of dCAth there wnli no Hafe deposit hox rcgistorL\d in decedont' s Indlvlduulnllntu, or juintly with, ur
1\8 ngcnt or deputy uf l\l\othor,llf' In dc{~edcnt'H Individunl nl\mc, with right of l\CCCliR by luwther 11M ugon1 or deputy, with the
..e.ptlol\ "r tho rollowil\~: -
Luto of _
County
_.. .'_ _~~~~d:=...,==...=,...=-=-..'"""c-.=....,~.==u.=---="-.-'-,-.,..-C:O:.-"'..:;:-.:~=.="~=-~~.-_,;;;=~~:;..::.:;-;<..,=--...:.".=="..~;:;'::"-,.-=r- =,====,
NAMt: AND AOnHl!S!l Of' AANK on OTHER lNfiTITlITION THIS SArf1. DEPoSIT !lOX R~NTEb RUl.ATIONStiIP Of" JOINT
IN WI11CH OE<:E,)f'NT R(\NTEll II \l^FE nEF'OSIT "OX IN t~^MIf. OR N^,,.llf9 Or' HOI,DEUS TO ()f:CEUf:NT
_ CCNB Banktr ~A, _______..____--=_-__.J_~_co_ent~ng . DRUght.eL__
-5~~t ~~~l, a~~~%H~J;JL..-_.----_..-.----_.._JU1z..al2.e.th.Ji.-.F.agaL,- --.-..
___..!!l.E...______ ._.__...._m ..- --,------- .--.-....---.--..-...-----....---.... ----,------
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~ ."'~=u;n,_===_~.~~~.~...=~.=..-===....,.="'=-._..:.--'
Thnl tho oo"lell'O uf onld ."fe d.11l18it bo. ur ho.o, IH. ilo,"i1,od olld.r lI"h.dlllo,
with Ih. ....ptlOIl of 'h. followlnu. 1'0' Iho ,"a'"n' horolnllfl." '.1 forth:
B of thlo ,.tllrn,
Thll' Schec/u/e A 1I!1l1lli",d horo'" IInd mlldo pllrl h.r.of 8"1' for'h flllly alld In d.\.1I "II tho roal prnporty
In tho C"mmollw."lth of 1'0nn,ylvlI,,\1I "I' which d"".donl di.d hllvin~ '"\ inl.r",1 ,1""oin. It n18" ,.IS for'h ,h.
morl~"~o .n.llmbrnne., IIpon ,,"eh pllrool of ronl prol,,,,ly III ,ho dllle or donlh, ~ivln~ tho alll,,"nt ,1111 duo at
dei\lh, nome of mortgagee" lInte. rnle (If intcresL IIntl huok [lnd l)flSt, of record thurnof. It nlRo RUIS forth In the
co'nmnN Ilrnvlded therefore tho IlsscsHcd vnlul\tlon uf lll\ch of sulll pnroc1H, the estimated mlukcl value thefu"r
UR of dlltc (If duntll nr dr.{;{ahlIH,
Thill Scheclu/. B n!lllehed ho,e'n IIn<l nUlIl" I'1Ir1 hor."r ..18 rorth filIII' IInd III <leillil 1111 p.r,ollalprnpor'y
whurCfwver sHullted llWlWd hy the dcc~~dcnl I\t the limu of doulh; nil II1l11U1YS left hy the decodent III tho lime of
d'.Ht.lh, whether in dCC~~lhlllt's ill1mc,ljlltc \1l1Htil1l'.siull, slllndlng III dcn~dcllt'/; credit in hunk!! of defluslt, lillvingH
hnnkH, IrUNt COOllll\ni"tl, or nthur institutions, whclhcr Indi\'ltlunlly, nr In Irut<iI for noy uther pCr!UH1 (If pur:WI1S
giving l\1tH) supIHatvly thu uccrucd interest therenn, if I\ny, down to lh(l InNI InlurCHl dRY 11r1m to duocdcnl's
dcnlh In tlw el\so (If !ll\\'in~s bnuks, nnd In tho dllH\ IIf t1c(:lH.lcnt'l'l dl'llth In 1111 olher tllSOSj nil hunds, pmltnl
HRvtnilH, trc"sury (:urtificllh:N or Ilnt\:s !lfld othol" lwldclHlc of Indcbtotlra'ss of till' United StllloN lu th(~ dc-
ccdollli "II ohHGAllnn"'. wholher hy stntulll Of 1l1\1l'Cmcnt they nw dl\!,d~nl\tcd RN tux frocl IIf Ihu \lnited SIRICN,
Of nny Mll\te. or p\llltlc,,1 sublllvlsion lhcrt\of, or of Itl\}' frmd~n t:nlllltq', whkh tHe oWlled I\t thl1 time uf lIt!lIth;
1111 wCluing UPIHUtl!, jl1WdrYI silvl~rWllre, f1it~IU(t!S, huuks, works of nrl, hOIl!-iChnhl furniture, IwrNtHI, olllTillltCS,
l\utmnnhih!s, hUAts, IllHI IIny IIl1d nil flllwr pursonul chnttuls (If Whl\lstll1Vl'l' kind or IHdUIl~, 1l1i'1 hy dctJedcllt,
tngelher wllh the fltlrly chllmlltoll Illnrkt11 vIIlIw thl.Hl'uf; nil huntls !lnd llIorhtugl\!o1 held lIy dl'ucdtlut Dud flf 1\11
c1ulms thw nud owing ()tli:ed'lul III lht~ ttnll' of ,h~lllh, un" 1,11 prlllllh~!oimy floles nr u1hor i1tHtrunIents in wrltin~
fflr the J1nymenl of mone)' of whidl ttlH;l'th~1I1 diNI ptHiSlqdwcI, of whlltslH'vcr nulurc, wllh InhHIHil thcflHlI\, If
lUlY, "Ivlng tlw fnee ",due IlIHI mlllmnlcd t'nir TlIl1.lkt.t vnlllc IhcH',of, lllllt If flueh uHtimlllcd f"lr fllluket vlduo ho
lutiti limn tho fR(JO vlllllC, it "ols furth hrilll'ly the U'I\NlIll" tur Hut'h dl'llIndntlnn nli In ol\eh 110111; 111l111C1tluytt
11llynhlu tll thl' l\Htntl' fwm lift; In'H1r"O(~tl llnlidtJH cnrrind hy dlll\cdonl; ntl nnnuity !lnd l~t1doWlHunl llllntrnel~
thtl IlrtlC('l~d" of whld, wurt\ Iltlynhlt\ UIUlIl tlH\ tlll"lh of the tlt~Cl.~thH": nil II lid tin' cUrjH1rntc HInck" ami dividend"
dUll thereol1 nnd unpnid II!; of thtl th\tt\ (If d{\lIth, hlJlttlH nud IH'l~fIIcd intol'lHtt thtHl~nn In lhl.' dulo Ill' dcccdl\I\I'!;
denth nllt! IIlhl'f inVlJHtm(~l\t NN:urlllt'" (I\\'IH:I' hy the drcl'.dcnt n1 tlll~ lime lIf denlh, \\'hh Ihe markl\! vnluc IhcfOa
tlf nt "Uldl tiow.
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III tho Uf\80 \'11' Roour1t,108 (II' olntH! U\' rnm11Y nnrllf,rnttOIlHt thu vnllllHI rOllortol1 nru ,,8 fnr as
pUMMihln Huhfttnl1t.tnt.Olt 1)y ('1Iln,,01'\1 Ht.nt,ouloutH of Lllo onrpnrlltlnlla, "howlng U\ll USHol,f1 111111 IJRhtltt.1oH
tlll'I'oot' 1\8 of' tho clf\t.o of dlll\U.. "rhu HolllHlulfl nlHo Hot,H fort.h UUl tnt.orOKt., (If Iloo(l(lont, fit t.lw t.1",0 or
llORlh 111 l\flY oO"l'tlrtnorHhtp hI' hUHlntH''', f\lllt, In "\111[1111'1, nf' U\fl vnlt10 of' HtlUll InloroRt, thoro iH ul\Hoxod to
Atlt(l ndl{l(tnlu, I'JIlf\notnl al.ntomnnt.H Rhowltl~ UlnRARotn !lnll ltnhllll,lnH flI' HRld oO-f1tLrt.llorHhlp nr 11\lHhHlKH'
A ('liP)' ll!' tilt' oo-pnrt.nol'Rhtp 1\,~I'(HlmtHltl (Ir ol'(d. l\ Htnl,l1mIJllt Ht!t(,tnu. f'tH't.h tho nutllrn of' thu tl~ronlllont,)
tlll",.tl,,'" wllh tl Hf,nLumollt. f4nt-lttlll, 1'01'1.1\ I. he ,,1U\I'ftut.or of t,hn hils I tIllRH, tt.s 111nut.1UI1, anti HIl(\h nt.hor ('/lOt.H
)l\'rllllllIIlA t.o tho h\lKtlWHfl I\H mny hn pllI'tlnlllll. I,ll n ('ntr IIfHI .1I1H!' npprfltslll nr' l-IlO ctuClflltontlR Int.flroKt.
thnl'lIl11 rllllHI hIlMllhmlt.t.f'fI. It H!lOllld 11111/1 fWt. f'''I't.h In It.uml'llHt l'Oflll, t.(}~nthur wlt.ll t.ho fatr mf~rk"t VI\It1o
llHlrf!ol', /lilY OUH'I' Ilrnpnl'ty nWIUHl (lr hoqllnnth(l(l hy t.h(\ Ilnrlllflflllt. nt- th(1 Umll ot' dnf\t.th
Tlltl .'l'Chf'dulp C nt.t.nnIHIlI hlll'Ol.o /11111 In/ltlo 1llll' I. hl!I'{lOt' Hflt.fl fOT'I.h 1\ 1.1'\1(\ IlllRwnl' t,{l olloh inquiry
(:nlllrtllllut Illurnln litH' III Uw OAsn 01' II'lIl1f1ft1I't{ llfpl'opurl.y, 1'llHl 11\' pornnHlIl, wtthln t.wo YflnrH of tlllooclont'R
111'1\1111 III (~0T1I.11tn)llnt.Joll nf' dllnmlflnt.' R lIul\l.h, 01' IlItHu(lnll 1.0 t.nlw nf'fnct Iu pllHROHSlolI nl' onjoymont At or
I\l'l.f'l' (\(1111,11, HIlIII H(lllflll1l10 Hul,A i'OI't,Il Ihn nnturll Hlld vutllll of' H\lnll I'rnplll'l.YI t.n whum t.rnnHfnrrod, t,ho
1'1' tnt, I until! i l' n f' l.110 t.l'fU\H ('(lrOnH t.o t.hl! Ilonlll'U" t" tho pT'upor f, 101l1t t,n Hllnrn l'OIlO I vnrl hy onoll l,rnnH f'oreo nlllt
Id 1 {lthllr ('not.A 0'" n port.1IlClllt nnt.1l1'O 1'f\lVlr(1tn~ HII\II t,I'f\nHl'orH, In t.ho (H\Hn 01' t.1'llnRf'orR lnt,onder' to
tll kl' 'I j'f'lIe t t II IH1FlHHHH i (HI (J r UII.! nYl1\flll t. Ii t (I I' Il f'tn r rlf1flth, tllfll'O t H f\ I Rn It I. tHollt!(l lo t.ll'l Rollo(hl10 It oony
nf' till' (huHt, t.ruAt, f\Rr{IOmolll. or fll.hnl' Ills1.I'IlI11tltll. llt'tHlt.ltW, 1.110 !,I'Wlt,. "l1nl'l) In (1IHO Hf,t. f'ort,ll In aaid
f><'IIPllulo II tiHt or tIll 11l'opllrty, r'lnt 1\111' IHJrHtlllul, with It,f! vllIIlOI whtoh PHUHlH lit. ""ool'nnt,IA floath hy
Vll't\lf! ot' t,ho fJxorcl8o hy clooodont" oltllfJr 1T1<I\v1c'tlull~'t nr.1l1lnl1y \'fIUt IllluLho1', nr nny l10wfJr of' Ul1l1oinl.-
lTllltll vf'Hl,l'(111l(loo(l(lnllt, olt.hol' lltltlvhhtlllty nt' .I(ltTlU~', hyt.hl:' wtll, (\(Hld, OT' ol.hnl' IIlRt.1'tIIlwnt, of nnnUlOr,
w Il.h 1\ eHIII~' of' t.ho tnMtrumollf, oronUl1A ""oh pownr IIt.!.nllhud I.CI thn Hnhnlhtlfl,
TIHd, Schf'dule 0 nt.f,noluJft I1IH'ot,o nnll trllu'n purl, hflrnol' tints "ol,tll U\fl n/lmllA nllll IHtflroRAORnf nIl
I'lJrH(IIlB hOllnf'lolnl1y Int.orfl8Lod In thin llRI,ntn nt. th'! t\lt1ltJ of' clnol'd(llll.' H rhH\l,h, thl! tlllt-III'n nf' thalr ros..
IHlot.1vn JnttlrOHt.8, t,hoir rolntlollHhlp, if' nny, t.o t.llfl IIHen(II'Il!., f,ol~llthfJr with ttll' nJr.oH nt. t.ho tirno of
cllJelHlol1t.1s llontll 01' ull mlllorA, nlInult.f\tlt.H illllt IWfluf'lotf\rlflR I'or II1'fl 111\1\01' rhHHHtunt,lfj Will, It also
UOTll.Il11lH n Nt,nt.omont. HhowtnA whinlt nf' tltO hPTIof'lutnrioH nlll110d t1l thfl r'nl!flltnut,'H will, If IUl)', dlod vrior
lo f1ooolltmt, t.hn tlnt.oR of Ulolr donUt, t.holl' IHHUo, mull-hll l'olnt.lol1Hlllp of' H\wh IftH\llJ to tho bonoflolnry.
'l'!lllt Schedule E nl.tnoholl horot,n #Iud ",nd" n I'Ul't, Iwrnuf' HOLH fort.h nl1 property, ronl nml )lar-
HOltlll, OWl1o(\ hy t,ho ,tooochmt ,1olntly wlt.h HlIOt.hlll' III' nl,horR, tno1wllnJ:t, Intnn~fhll" H1.nntllnp; in t.ho namo
of' t.1ll' 110('.(I111l1l1- I\lllt nt.llnrR) pIllA t.I\O <tnt.n nnd pllwn of I'o('orcl of' I11RtrulIumt.H nff'oot,ln~ t.ho \ost1ture of'
rOl\l ost_IIt.f! nnlt tho dnt.n of IlO((UtHtt.tflll of' IHl1'HOl\nlt.y, pl1tR t.ho nnmn, IllhlrnHH ft.nll rolnt.ionshtl1, if any,
flf no-uWnnl'H 1.0 tho l\ooodol\l..
'I'll"t. Sr./lpdule F nt,t.nohncl hnroto nnd nHldo 1\ llnrl. IH'!I'ont' HOt.H fnrt.h J'-ully /\lId III I\ot,nll nIl dehts
Illl(l tlnrl\lllUOflfl cllllmod for IIllel Oil holllll f' 01' t,hiM (tonorlont,l R oHtnt.n, 1II1111lllhlK f'lIno1'al uxponAofl paidl
t'lulltl~' uxumpt.!on, Whfll'O n)1p110nh1HI (HIHI,A of' nllmlnlRt.rnUnn of' t.htH (Jf;jt.nt.ol 00ll11Ho1 t'OOA unci f'urltotnry's
l'omnllHllln1\l.. ptd(1 or t,n ho pnltt) ~Oflt. nxptlnctOfI f'nr lmri"l t,rIlHt.R, t,ornhHt.nnlJfl or Rrnvomnrkors, linn rol1-
~llllls HflI'vlno8, JlI con~ell'lnTll\11 of t.ho dunt.lt nt' tho elonne'unt; dnhtH I\TII' (llnlmA nwlnA lUlll Hllplllll lit t,imo of
dl!f\t.Il1 I.l\XHH llllcrlulfl ollnr~ollhto "or lwrlocl prior tu IllJ(lOltnnllH 11HIlt.h (m:nopl, thoRn 1l11owol1 unilor Root,ton
Or.1 (If tho lllllorlt.nncf) lUld li:Htnlll 'fllX 1\(11,) l t.()~f1I.hUl' wtt.h n ~t.l\tnlnnllt. nf' 1101lnf,nrnl pl(ldl(orl for (lhl1gR"
t.fOIlA, If III1Y, It. 18 l\Arood thut t.ho fl(hwlnry wtlt PI'(HHHtt. lJt'nnl' nf Hn'll clnlulfHt nhl',~at.l()n9 upon ro..
(IIWHL, I,htd. If' t.hn 11!nol1nt f~ot.lIntly pnlll In ~nl.t.lomnnt. of uny rtlf1t ntJlltllllHfllnn or ,\ollt, iR 10RB Utfll1 tho
tlHt.lIllf\t.('ll nmmlllt, llllllllllng Hlltl nl1nworlt l.hnl. thn Hllmtl wtll hl! l'flIHIt't.IlI' t.o thtl 1\1l1~IHt.nr 01' WillA, and t,hat
t.llll IIlll(lImt. 0(' t.nx nHAoRRel1 ClUJ lHI T'OnHfitlHHtHI III Illlenl'dtlll~(' UU1I'llwl t.h.
'I'hllt. l.hl' to!nlq flf tho nllpropl'int.n enlumnH III HI\hIH'ulnfl "A", "n", "C", "I'~", I\tlct "Ii'" "" dlroot.od t.ho1'o1n,
hllVf' Ill'OIl l'/tl'T'tIHI 1'nrwnr(l I\IllI pI'lIpnrly 1'(!~IHt.nrlHl 111 t.hn HlImnmry.
Subscribed and sworn to before me thla . """""""""""" "
...fi.'!!; d1 of ,
'z//(lj'fJ.;1 /II' G (,
Thelma S, MICalll!in. llo\,,'v ~Il\l~'
Mv C:ommlUil'll b:l,ili l Jllh ".I)~O'
10m llli\l, 111\ (. . ,.Jul1\V
NO'!'I';: 11'~'nrH Hl~nlllg nf"'lclnvtt. mnkn IHlrll /\11 hll1nk "1"ltw.1 III Ulf! nf'!'Hlllvtl. hilI' fHll1lll'UtUfI "'\I\o)tocl uru
l'tlll,(1 It, wlt.h dot.nll" or f,}ttt wnrc' "Nlllln"I.'\III\ tllllnHo tho nHHt1t.H '"(\\llllo rUT'n /lilt! U1t1tflt.nll Hnnurlt.lo~,
flHl'lIl'ltlllH 0" r.tnRo or fnmlly (HlI'llC1rnt.llllift ur nil fllt.l;J'l1Ht. Iii nllY {W"Pfll'l.IIf11'HhlI1 or hUtiltloHH, thnt. UHJ
(11I1ft 1111(1 Htnt.fllTtfillt9 roqulrflll tltH'Ur t.ho pnlll\~I'nph l\hIlV~1 t'nlntll1~ 1.(1 HI1111'rlt11n "II" /\1'11 f\tt.l\ohofl. Atfltl mhko
('!lI't-nIH t.hllt (Jotllmn HJ hi t.ho "HH"",nry" hhH hool1 -llrnllo1'ly onm\llntotl 11ft ltl!nvn.,<llru(,t.o(l.
Ap1;';\'l
, (, ,~
,10.".8..0, .
.......~i~~t~~la~;[I'~'~"
428 Deerfield Road
........... ........, (st:,:~'et'N~;;;b;J"'''''''''''..''..'''''''''''.'''"'''''...
Camp lUU.l'A,17.01L
(Citll or Town and S14te)
Ilelll
No.
!tHV-"!!1 (e"1I1
~~A
..
COMMONWEAl. TIt OP PENNln VANIA
TRANSfER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTlUlCTIONSI Thlo Sehedllle 11I1101 dlocllloe 1111 IlIlIylhlo IIl1d 1IIIIIIIylhle l'erolllllllllWperly IIwllod !!!dlvi<hll'l.!l:..!'l:..!1!.;
\!.~l'~I'!!I~.I!o 1111I0 IIr hlo delllh, I'wp"r1Y IIWII.") hI' Ih" dlleedelll Jill III I)' wllh 1I1111lher "' II,hers IIlIlMI he 1I0le,I
IIlId"l Sehedllll'''E'', 11I11I1I"lhle p.roolllllllI'l111erly, Iltlod 111 Iho 11111110 IIr Ihe de<'ed""I, hili I'IIYllhlll III delllh III 1I1111lhor
or others, Incllldlu" hill nul 1I1llllctl III P.O,(), U.S. SU\'llItH BIIIHI!'i IInd IClltutlvu IrnslllCClIlIl1lh, musl he lllilodt lIcspllt:
the flwllhnl they IIfO 1I11t III' tlw Illlmlnlsl4.lrcd CHllllt~1
TlIlINlhle l'oro,"I11 IWllport)' Mhllllld ho 1I1110d 1"1,"1 (e,y. Jowelry, 11'011I IllY IIppllrol, IIIIIIM"hllld ""lIdM, IIl1d
furnlshllll'oN, hllOkH. lutillllngs, IlUlfllllUhllch, huuts, vlllt)
1lll11ngihlo llunwlIul prClllorly, stICh liS huntlN, IrcllH1Jr}' ccrtlflcnloh, until, till hlllld llull III hllllk, swoks,
ll\ortgnuc!i, lillicH, tORelhor with IlCCfllCd Illl(lrl~Hl or dl\fldcndH, HulllrlCH or wng\IS. IIlHllfuncc PUYllhlc III thl! l!l'dllhl or
1"1,1 lIel "')' III ollld ollpII"lly, I'lIrllloTHhl1' IIIIIIroolo, IlIlllreol IlIlIn)' nndlolrlhuled "Olllll' /lr or 11Il'lIllIe fr"lIIl1llY IIf"I1llrly
l",itlln IrUM' nnder Ih" wlllllr nI(l'II"II1""1 IIr 1I110Ih"r, e\'llll Ihonuh loolll"d IInlold" IIr Ihe SIII"',IIIII", 111110 IIr d""lh,
llhllllld ho Illllod In Ihlll oehudnl",
l'I1iM
Lllllllnd duoerlhe rlllly
IINIT I',STIM,ITliIl
VALLIE MARKET
VALUE
IIJl.I'AIITMENT
VALtIATION
(1111 nol write III
Ihlo Ml'lIeU)
1
Checking account in CCNB Rank, N,A.
11745-616-3
Savings account in CCNB Bank, N,A,
11002-101424-6
Proceeds of sale of furniture and
antiques at auction
Value of remaining furnishings retained
by family, as per attached statement
Medicare reimbursement
Aetna Life & Casualty - refund of premium
Miscellaneous jewelry, as per attached
appraisal
Sale of 2 beds and dining room table
Common stocks in various companies as
follows:
9,637,41
5,804,25
7,255,00
32.00
,52.00
131. 75
150.00
1,113,60
2
3
4
5
6
7
8
9 980 shs. Wellington Fund @ 9,32 'I,p"ft, 9,133.60 'Iori/.80
10 13 shs. in Pennroad Corp, (now Madison I 17, (,.1
Fund) @ 14-3/8 /9. 'In. 186. 87
11 8 shs, U.S, Rubber Co. (now Uniroyal) @ 5-1/ 8s:c"~ 41. 00 9c.,5"O
12 300 shs. Duquesne Light @ l5~ 1!J~r.J.. 4,650. 00 1ft" f7, ';0
13 450 shs. Delaware Fund @ 11.84 1/.7'; 5,328.00 ~-.t f 7. /)-0
15 738 shs. CCNB Corp. @ 12 8,856.00
16 16 shs, National Central Financial Corp. j '1'1. cD
@ 22iu .t/ ~ 382.50
17 2 shs, Keystone Oil Products 6% pfd.
@ 60 120. 00
..._.....__1...._,_____.,
----------
Inlllllllhlo 101111 "1'PIIOitU "l'uroonllll'rnpurlY", Huhednl" "II" In
IIII' "too 1I<'I'"rI"d" "011111111 on Ihll 1ll1l111llYll Ill' thlorulnrn.
xx
2,873.98
.r~ 771.1'.0 ()
~Il'
fWV~~n.} (11.781
CO~IIIONWEALTII 01' PENNSYLVANIA
TIlANSJlEII INIIEltlTANCE TAX
RI'SIIII':NI' IJI/('EIJENT
SClllo:IlllLl\ "11"
IlPNHI:)( :11\1111 I,S
n -----.. 'r.- ---_......;-----_..--~_. -.--.-....-- ._--~..__...~.-.._.. - .~..._.~_..----_.__....--.~~--_......
IlENEI'ICIAIIIII.S ANIJ AlJllIlI~~SI!S IU\I.ATIONHIIIP
(Sill 10 full IUIIT\OR unt! nddroHHoH u(1I11 willi (If ".P.dlllcltoll '" StllIl'lVEIJ IJATE INTEIIHST IlII
hnve 1111 11111'rcHI, ,voNlod, C<l1l1l118t1tll or (lthor- 111081111111I'" olllhl"'1\ IlHCliIlENT 01' III1.NI\JlICl,lIlY
whw. I" VHlt1t\') lUll involvlJlI, H(,t STATH \'1(8 11111'1'11 IN I!STATI!
fnrlll Ihl. rn~l,) Oil NO
---'--"" ...-- f--.-- .-. -----
Elizaboth R. Fager ~.aughte.~..._ Yes 100%
----,-_. .------..........-- ---._-_._-~._-~_._-
428 Deerfie1d Road .
---.-. - -~-~'--'- .- ~-'~' ..--
Camp Hill PA 17011 ~--,- -.- ---
,
- ..---.---- ..-.-.-- ..---.. .-
,
- -- --
.
-.... --
" ,
- - -- - --
-
- .. --_..._- "M.,.___
I
------. .. --
--.-. ! - -
..----. - -- --- -------.-..
;...---.---- '_H_ ---
I
--- -- ---
--
-- - ,--
.
--~- - ..._M__ ___.n_ ~--- ---...-.
--. --'---' ....
- ---
-------.-. -- , -
. ---
.. - -
. -
.
o. ... - - -------
, -
,
,
-- -
.. ,-- ---- -. ._-~_..... .-.....----.--
---- --, '- ..--.. ..--. -.-.---
,
__-'---_4 ---- -_. -'- -.- -----
--..--- -.- ,-
- , - -- - .;:;,.~-=-':-- .=-:::-=:..;;:---;
-._-,,--_._------------..----.._-------_..""..~.~_._.. "...----..;._........._.,.._-~.-...~_._-_.~-
Deponent further .ay. that all thit above.namod beno/lolarlo.,aro living at thl. tlmo OK copt boloWI
~"':::".::-..::---::.:=="--- - , _ __---=i-. ~_==__--:.::=..__...____---==-:;....___---:::::=-_"';'1
NAME
DATE OF DEATH
RESIDENCE
-..--------.
-..---
:=:::::u..-:-
HuMMARV
(Suh, "A"l $
(Suh. "B") $
(Heh. "e"l $
. _--i-
. '
$-
,.
~~ "l
g, t
:Dd
H'~
Hi
~ I>il
R~ul l'rnp~rty
PurNonnll'rnporty
'I'tllnNforN_
(IrnNN l'nxnblo I!,Nlnlo
I I ]
n
....
a,
~ !5 ,Il ~
~ ; ~.~ ~ II.
. i' ~
0 e ~
z ,8 lJ. 'S ~
ll.'
!l Q "S Ii;i
'~ ,~ il ~,
-
II
"S ~. llll
_:~ ~ "S 'L
J I
u
[;"" 3
,oct: u
(I)
(A N (t~pnrlod)
(2)
,(AN llulormlno'Jl
$
$
.
.
$ w
$
IIIV.1\1l4 I X. P.llOI
File Number
Estate Name 'n
Date of Death _m
Social Security Numbor
INHERITANCE TAX SUMMAIW SIIEET
(BUHI~^lJ LISE ONLY)
21~79~0499
Har1 ta II. Rockey
7/1(,/79
RF.PORT OF INHERITANCE TAX APPRAISER
I, tho und.Illun.d duly appolnt.d Inh.rltanc. Tax Appral..r In and 101 tho County of Cumber' and ,
P.nnlylvanla, do I..p.ctfully r.port thnt I have applal..d tho 1001 and porl.nol propolty .1 ropo,todTnlhiilOregolng --
return at tho valuOl ..t Inrth appallt. .ach Item In tho 10lt column to tho right In Seh.dul.1 "A", "B", "C", and "E"
.._____...-!/i,,~.L:ff.ld dN j)
INHrlll TAtlel" fl\X AflPRl\llWfl
Doted. ______t!lly_.S-,-+ll-llCl___
----~._.,. ....--~------- .-,. ..
------~._.~
INVENTORV
R.al Property (Schedule A)
Pe..anvl Property (Sch.dule B)
Jolnt.Held Plaperty (Schedule E)
Transfe,. (Sch.dule C)
TOT AL GROSS ASSETS
Le.. Oebu and Oeductlon.
(SCHEDULE F)
CLEAR VALUE OP eSTATE
Valuation of IIf. .,tat.. cU
annultle,. . . . . . . . . . . . . .
_.'~.'.-:.;,===r.<Jr.--~ -~.~
FOR USE OF REGISTER DNL '(
TalC: on $
TalC: on $
TalC: on $
Tax on $
T u It on $ ,"
ElC:emptlon.
Total e'late-
-
L.UII Credlh
PATE OF PAVMENT
. u .__~_."__.
-- -~.,...._~.._._.-
...~------_.--_.... --
- -- .------
VALUE AS APPRAIHP
COPE
APJUSTMENTS
(HARRISBURO USE PHLY)
REMAINOER APPRAISPMEHT COPE
._~
50,0 00+
52 774 00 10+
'-' ---- ..----.-
.___~___~ltQn.a_ _____ _~+._____n.____..
______lL9!le___.. 30+
102.714 00
12+
$
.----;"..----
40-
03-
~~:..-:::::.::::;.::::::::;=~.=;:..=;::::;_._:::~:;. ;T.';::;: --;-;:~~:;~::.:...:_ .:-::-;::".:::;:-:~ ~-_.::.: =--=;~-----"-'"
.M.ll
FACTOR
PRINCI PLU
---
VAI.UE
l:DPE
--
-
,'~-r-='='"
F-
!i.Q.Qjl
COMPUTATION OP...!Al!.
$ -
$ ~
$ ---.---
$--
$
6%
\5%
-----
-
TOToU. TAX
INTeREST FROM
BA~ANCE
$ ------'----
$ .........-.:----
$ ___-C_,
_ TO -'---~_
AMOUNT PAID
$
OISCOUNT INTE<<EST
+ $ - $ .
-'...-
+ ---......- ....-~--..._~
OAI_ANCe $ _ ___~_._'_7~__
TO ".. S
>
~.,_....._-~-~~-~-~----
~X CReDIT
$_,.,-..."
INTEREST FROM ,,-
BAUNer olle
"
QJ
...
~ ~ ~ ~ u
0
~ c:
'tl .
~ 0 . ... ..,
~ :t: ... '"
!S .... ....
, '" :t; ~
~ ~ .... QJ
.... .Q
\:-- ~ El El 0'\
I I '" '" ::I Ln
.- W U N "'"
....
---..
f(j ~ ~ i
J.r..
0 Vl 0
0 0 ~ ~ ~ ~ z i
i z ~ z ~ ~ ~ ~
I,;
Po<
': ;
HI V-'ll'} (11-111)
COMMONweAL Hi OF PENNSYLVANIA
OEPARTMENT OF REVENUE
OUREAU OF FIELO OPERA nONS
APPLlCA TION FOI~ AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*
~~~~
Jan. 3D,
1981
~PPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is haroby modo lor cansont to tho trolls/or of tho follawinl) SOCIJlitlos of CI Ponnsylvanla
Corporation or 0 National Banking Association loco tad in Pannsylv(ltliu:
DATE
(oLu__o_nB____,_jb)__.n !111t~onal .Cuntr.ul Financial Corp()rutio~h cOlwnon _.._____._
(NOTE: In doscrlblng socurltlos ontor In (a), ab 0;0, olthor tho numbor a/ shuros of stock or tho fuco amount 0/
roglstorod bonds, In (b), tho namo of the Issuing caltlpClny and In (c) tho clClss of stock or tho statod Intorost rato
and maturity data a/ roglsterod bonds,)
ISSUED ON ______..... ..__L.____' and having 0 TOTAL MARKET VALUE OF L
(Dnte) I
us 0/ tho do to 0/ dOllth a/ tho docodont,------'-.___r:'~l::_~~II_H. n.oo 'oy
(Nomll of Dor:udonl)
22.50
.. _, OIL..
J.\I1~ _1_~!-,}J7~_
(Onto of don.h)
who was late oL_:~~_II~~.tl), :lOyh Streo_~,_ Camp lIil1,
(Strrtot and Humhor) , (Polt OHlen)
Cumberland, PA
Tho socurltlos oro roglstorod as /olloWSl_._______.I'r.f)tJ V. 1~(),:LI)Y
(Ntl'110 or nClmOl In whlcll cClfllflcnlnl (lFornulltarofl)
(Cnunty) (Stntn)
I
~~~U~(2:..__.~:~~1~~.~1~?~~;_~O<:1~(IY,~~!Ct'r'n II:>!: j\('(;rf1.~;'<1r,;",~:illd,. Camp !I.:I,l!LJ~h..
F!H'AlMlY OfR~PPLICANT .John E.SJll~a __________,
COUNTY FILE NUMBER.2.L.:.Li" V H ADDRESS OF APPLlCAN{' 0\; Box 737, Camp Hi 11.... !^__
BURE AU FILE NUMBER __._._ _ ______ .__ SIGNA TUR E OF APPLICANT ~/~ ~') _~"'" '-___.__._
NOTICE. IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APP~ATION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR tOMPI.ErION.
- -----..-,--..---- ..... .... ....
COMMONWEALTH OF PENNSYL VANIA - DEPARTMENT OF REVENUE
CCl!'l.5I:NT TO TRANSFER SECURITIES DA TE~!t!>/((f(1- c~)fJ"/
I hereby cansont to the tronsfor of tho obovo securltlos now rogistorad in tho nomo of tho n/orosoliJ!
Docedont and wolvo tho /i1ln\1 a/ 0 cortlflcoto cortlfylng to tho poymont 01 the tronslor Inhorlt[IIl"O lox to which
tho property 0/ sold Decedont Is modo subjoct pursuont to tho provisions of tho Att of Juno 20, 1919, P.L, 521,
as amondod and tho Act 0/ Juno 15, 1961, P.L, 373, CIS omondod, This Is 01,0 In "ccordonco with tho provisions
0/ tho Act 0/ April 9, 1929, P,L, 343,
This Consent to Trons/er tho horoln doscrlbod proporty operotos only In roloroncoto tho ostoto 0/ tho
obovo-nomed Decodent,
Slunod far tho Socrelmy 0/ Rovo~uo
~ t') '-.L) .
, ../ )/1 .~. / . .
By ',' /I(.ti'~/ ';, ?/rL'u-'uj
/J (5IUh:!2HIl) / j ,/ J'
;L.~:jt-~, {,,',..' t.?tO/Lc)l't E:I' ;1'-"'( u___
jtTl)r1 (Cflllfl'Y)
"
,.
n~~7{;-- COMMiiN~~iE.O:.1ii:V=lA - ."..,.... ." .":;Ill;t:~
g, OFFICIAL ReCEIPT. PENNSVLVANIA INHERITANCE AND ESTATE TAX .
II, .' -_"..~.c.cc..,..'.' ...~.. .... .--.- .. . __u.w~._~..__. .._...__._.____._~_.~.=.=c...=....~=="~==
=
_ RECEIVED !!!!.~~~~~~_~~~~~.r.o.RTY~'IVB.- .HUmBBD_.DO.1aIaAlW_~.~~-'":"~~~~_=__~.~~.~~~fttTt1tTr!
" lopro5onllng Ptlnnltylvonlo InherlloJlco or
a Fro"" ArllOld, s1JJca"._Bayay, At.t.y.. _um__ ._._!:'I,,!,~_ TC1,-~~~_~o-,~tI\.~I~~~~n_~'la.'.".'....__.___.__
~ A o"..-B~=~~~__r.~9U) 2';' la, 01\ $ $
/<I
II
~ FII. No, 21-7Sl-4i9 .Dalo 01 Doalh .7...16...1919.. 15'1< To. 01\ S
__. C.IIlP..Ji.i.ll~_._l&... U91.1..
6Vc Tm: on
$
$
$
Counly..
e.....bal'land
Iff- lox on S. $
E.lolo To" Acl 0/
May 7, 1'127 $
TOTAL TAX CREDIT $ .4,7'6. A4
Lo" Ilv. porc.nlum 01 la' II
paid wllhln Ihr.o monlh. 0/1.,
dolo 0/ doalh $ 2:16.94
Plu. Inlor..1 01 tho ralo 0/
_%Irom_.___
10 $
. TOTAL AMOU~IT PAID $, 4.1500.00
~
Date 01 Paymont
1 Nomo of Decadenl
Octob.r .~_...a7lLm___-..
MARlTA H1..J\oqJg[X..._...__
,.. 'narks:
"PAID OM ACCOUN'I.'''
lnM~lP~,~@&~"lli: SEAL
NOTE: This TrlpUo,ul Receipt to be ret.lned h'Jf ludlt purpo...,
":.!hnIA~~,..(
HaJ:olc!lI~f\Wr1an.. Deputy
~91.~.r(~) will.
R.colvod by
NOTE In acupllng th, 1I0nt'" Inll'rllnn':l lOll on lulur. UII1It1, JIIlOI !('Ilne uDul" of tho Ill.
ttnonl or I.nont for VtCHt, Cllltvlflen"d by Ihil "'fllpt, II It vndonlc>od thut tho CO/lllllfJnwftnllh ,hnll
I not h, PI.c1uded or preyent.d f,om her,oft" ou'''lng addillol'lullllhIlUllll(il 1m 01 tho d,nth ollh.
III.. Ilnonl or l.nnnl lor ,'.011 wh.n.~.r n appear. Ihot luch additIonal 'o~ may h, IlljJolly duo (Inti
coll,tltblt lor ony ,ltuon whallo,,,",
Ill'v.',11 (0..,0)
COMMONWEAL T1i OF FENNSYI.VANIA
OEPARTMENT OF REVENUE
IlURP.AU OF FIELO OPERATIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*( t\
:A,. l
,
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYL \' ANIA DEPARTMENT OF REVENUE:
Application Is horoby mode for consent to the trunsfor of tho lollowing securltlos of n Ponnsylvonla
Corporation or 0 Notional Bunldng Assoclntlan locotod In Ponnsylvuniu:
Tho Ponnroac1 Corporation (now Nac1ison Fund Ino.)
(oL1L~!l.!l!~._.jb)-.Mllc1bon.F'undlnc"""d' .. (c) COIlU\1011
(NOTE: In doscrlblng socurltlos ontoI' In (a), ob 010, ollhor th~ number of shoros 01 stock or tho loco amount of
roglstorod bonds, In (b), tho namo of tho Issuing compuny and In (c) tho cluss 01 stock or tho stotod Intorost rato
and maturity duto 01 roglstored bonds,)
6/13/39
ISSUED ON --.1Llli}Jn....dd.., and having a TOTAL MARK ET VALUE OF H06. 87
(Dot.)
as 01 the doto of death 01 the decodont, J~Il~B&Jl..l~99J<~y.
(NUITlO uf Oocollol1l)
DATE :!/211/nO
. . , un . J,uly ).,6.,--1.9.22_____
(Ootu of doath)
who wus lato of..._.~9...North 30th Streot ,Camp Hill .
(Stront and Numher) (Post OffiCII)
(County)
d penneyl vania
(Sto'.)
Cumberland
Tho socurltlos oro roglstorod os lollows: .F.r(3deri,ck Valentine Rockey
(Homo or nUnltla In which c(lrllflcotol Clro roglstortlcl)
MMjq~)..E.J.i.o<:~b<'!.tlL~Clck.El.Y_F'Elger I. 4.28 D13orfielc1Rd " \-c\lnpHU1, dJ."'lI
EXECUTOR) (Nom.) (Arld,,,..)
NAME OF APPLICANT John E. Slike ,Esquire ... ..d"_
2109 Market Street,P.O. Box 737
COUNTY FILE NUMBER..;J..:::a-l1.t1 ADDRESS OF APPLICANT Camp H.ill, penne~ 17011
BUREAU FILE NlJMBER.......____..._.,___.._.SIGNATURE OF APPLICANT 0l~ C_. . .._._,
NOTICE, IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLIcd;-ION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETlot~,
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEVENUE
CON~I::.t!ITOT~ANSFER SECURITIES TE\ \/).'.... ;' Lei Ii
DA . r\.l, .l,.~,c. It V
I hereby consent to the transler 01 the obovo socurltlos now roglslElrod In tho nnl110 of tho aforesaid
Decodent and wolve the IIIlng 01 0 certllicato cortllying 10 tho payment of the Ironsfor inho,;lollco tOK to which
tho proporty of sold Docedont Is made subjoct pursuant to the provisions of tho Act of J"no 20, 1919, P,L, 521,
os omondod ond the Act 01 Juno 15, 1961, P,L, 373, as omondod, This Is 01',0 III occordollee with the provisions
of tho Act 01 April 9, 1929, P,L, 343,
This Consent to Transfor the horoln doscrlbed proporty oporatos ollly In relerenco to tho ostato 01 the
obovo-nomod Decedent,
~~~
i'f~li) 'A
-.. fi,l'. i.,.
.,.,'" ;~r'.,
.,....., "lti,'l'l...,1.
Sig~o~{ ~lhO Sccro~ur,~ of R"~~nuj .
By'}J{\IIQO I" \'\) .c. )IJV'''\'~d
V(.. ~. (11<1'''''"'[1, . 1\ .
I \ 11tl..'V\jYi ~\~".'\\ol' (,I ,c;/ tJ dL" CV""'~'\~(!q~
'\ IT 11f); (l)\llllY) I
III V.'ll'/ 16.11\)
COMMOHWEAL Tti OF PENHSYLVAHIA
DEPARTMEHT OF REVEHUE
UUREAU OF FIELD OPERA T1DHS
APPLICA TION FOI~ AHD COH~[NT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*'
APPLlCA.IJQti (MUST BE FILED IN TRIPLlCA TE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is hereby modo for c ol1senllo Iho Ironsfor of Ihe followinll secolilies of II Ponnsylvonlo
Corporation or a National Banking Association locotod in Ponnsylvllnill'
National Central Bank (now National Central :'inancilll Corporation)
(ol........l~..h~r~fL(b)l'Il:ItionfllCentral Financial Corporation (c) cO/lllllOn...._....
(NOTE: In describing sccur/tles onter In (<1),01, cwo, ollhor tho numhor of shuros 01 stock or tho loco llmount 01
roglslered bonds, In (b), the nama 01 tho Issuing compllny and in (c) Iho clns,; 01 stock ur Iho slnlod inlorost rota
and maturity dote 01 roglstered bonds,)
12/07/70
ISSUED ON _l>l_O'ZLE._.m' and having 0 TOT At. MARK ET V AL.UE OF $ 382.50
(Dato)
os 01 Ihe data 01 doatl, of tho docodonl Hl\Ti tu 1I. Hookey
f__~'_F___ . _,.". .
(Nomn of Docl/dc1nt)
DATE 3/3/80
, on July 16'u19?~....__
(Dntu of duolh)
who was Iota oL~.o..J-lorth 30th Street, U/unp l1ill,
(Strnot and Numher)
(Pn.,OHlcCl)
Cumbadand, l'onnay1va!lA....
(County) (Stohl)
The socurltlos ora rogistorod as lallows: . 1:'rud V. Hookoy
(Numo or nClITHlI In which ct,r1lflr.utoll oril rtlulltornd)
AIUlINtXXb:IGR) Elizabeth Hookey Fu';(or, 42B ussrf!old Heal, Camp Hill, l?A
EXECUTOR r..-......... .. . (Nam.) ... .... . (A,ld,m)" '.
NAME OF APPLICANT Jol!H l.!;. Slikf,l, ~FiJ\j\.\.i.re .
i ,.., 2109 ).Jarket St., P. O. Box 737
COUNTY FILE NUMBER.2J~_f.,,:,...'i'..'_ ADDRESS OF APPLICANTCallll~) Hill,:; 11.4h ...
BUREAU FILE NUMBER .............u._...... ... SIGNA TURE OF APPLICANT. . . ..____..
NOTICE, IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLI ATION, IT WILL I~OT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION,
COMMONWEAL TH OF PENNSYLVANIA _. DEPARTMENT OF REVENUE
CONSENT. TO TRANSFER SECURITIES . .' }. t! (, ({lid
DAlE }}, L. rd..
I hereby consent to tho translor of the above socurities now regisfored in tho nOl1le of the "fofl'sold
Docedent and walvo the 1IIIng 01 a cortiflcato corlifylng to the poymonl of tho Ironslor Inhorll'I',eo 11IX 10 which
Iho property 01 sold Docodont Is made suhjoct pursuant 10 the provisions of Iho Act of Juno 20, 1919, P.L, 521,
as omonded and tho Act 01 Juno 15,1961, P,L, 373, os mllondon, This iy. (II." in (lccardoneo with tho provisions
01 the Act of April 9, 1929, P,L, 343,
This Consont to Transfer tho horoln doscrlbod propOrly oporolo~ only in roforonco to tho o~tato 01 the
above-nomad Docodont.
SI~I~:dJ!I'r Iho SC~rOI(~y, of ROVOI~UJ.
By 1 tu~~S, ('. Xl I( .;. -' lIv--c-Cl.
~ ISIV'''''r'') ! \, I . ,
l"'.'~r~~tv' i)j , fl' ,\\,",t_ V L~\ ,V".... C.~V",~(IJJ(\,t.,Q
\ \ 1~llf.)' rcClU','1(y)
10 Yo_"/ (n./Il)
COMMONWEAL TIt Of PEIINSYLVANIA
OEPARTMENT OF REVENUE
IlURI'AU OF fIEI,O OPERATIONS
APPLlCA TION FOR AND COtlSENT
TO TRANSFER SEClIRITIES
REGISTERED IN TilE NAME'
OF A RESIDENT DECEDENT
.1tJ}....'.iJ~..,.
~~~
8.PPLlCATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is horeby modo for consontto Iho transfer 01 tho followin\1 socllritios of 0 Ponnsylyanlo
Corporation or 0 Notional Bonking Association located In Pllnnsylvaniu:
DATE J/:}ilO .
(aL2S.har:oll___uJh)_I<.tl'yB.t:qn13 Oil PJ,'O<,l\ICt,1iI Cot"1>Qt"ftt1on . (c) 6' oUl1lul~tive..I?~~L
(t-IOTE: In describing socurilies ontor in (,,), "b 010, oithor Iho numher 01 slwros 01 f,lock or tho f"co amount of
rogislerod bonds, In (b), tho namo of tho issuing company and In (c) tho c1uss of stock ur tho statod intorost roto
and maturity doto of reglsterod bonds,)
ISSUED ON~1~~.5'_~!<l.1____, and having <I TOTAL MARKET VALUE OF $120.00
(0(110)
os of tho data of death 01 tho decodont Huri tl1 H. RockGlY
, ~--~~--------~_..__.._.. ...
(Nama of Dor.od(Hlt)
_. tu_-!~--~.----
01\ July 16, 1979
, --, -.-... ... ". ....-~+------
(Dr;-.'Q of doath)
(Stroot and Numhut)
(Po,' Offlco)
t:umhet'lo.nd, Parulllylv:~m,!L~
(Coun1y) (Stnt~~
who was 1010 oL~~_ul-l()l:'~11_JOth Stroot, Cant),! Hill,
Tho socurltles are roglstored os fallows:"'l:~Jd V. Hockey
(Nom€' or nOITHII in which cortlflcl1tu!l (UCI Ill91'Iorod)
~~) Elizabeth Hockey l!'o.Yllr, 42!l llaarfielu Hoad, Camp Hill, PA
EXECUTOR )-------u-u-(N;,;;~)-... .... . IAdd,,,..)-. ._.u_____..
NAME OF APPLICANT John l~. Slike r Enquire
. nOli l'1arket St.,' P~6.-Box-73Y-
COUNTY FILE NUMBER1::t~_:1tt..._'i'i~_ ADDRESS OF APPLICANT Canl),.l Hill, 1'1\ 17011~____
BUREAU FILE NUMBER__._.______u._ SIGNA TUR E OF APPLICANT C'::}A.~,. We.. .--.--_
NOTICEI IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS API1LI6TION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION,
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CON~I:I'lT TO TRAI'lSFER SECURITIES E~ 1v'''. ~ I (I Iv ,
DATIIUt.'(,)r .~_\)
I hereby consent to the transfor of Iho oboyo securltios now ragistctccl in tho nontO of tho 1I10105111d
Docedent and wolve the filing of a cortificata corllfying to tho paymonl of the Ir",,,,f,,r i"he,lllIneo I"x 10 which
Ihe property of sold Decedent Is made subjocl pursuanllo tho provisions of the Act of Juno 20, 1919, P,L, 521,
as amended and the Act of Juno 15,1961, P,L, 373, os omondod, This is 111'0 in nccordonee wilh the provisions
of tho Act of April 9, 1929, P,L, 343,
This Consent to Transfor the heroin desctlbed proporly aperotos only in reforonco to tho estato of the.
above.named Decadent,
~'''~
j........
.. {!I'f, t\
.:;,\',,- ~.l'>lt
Sig~l..ol fO.. r tho ~o..c.ro. tory of Rove.nlJe
,t) I t\)4 \) 'v.) 'J
Byr()..~,vl.)" ,\'i (,~;}Jv'l...2....
1511"""''') (\ (' ~/i
(V\'('i'-I~JJ( 1\4\.,". .I, t L.\\1It. \.1"" j) (k''i1~
n, Tltl,,)( _ '(C(/lOlly)
\ i
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
$II
ELIZABETH R.FAG!l;R...
~....~_~ ___, ._c_.~__u._,..____~.___. ....~-,---.-.__..__.
bolng duly .lIworn ~ ~ccordlng 10 law, dopolOl and iaYI thats ho .. _"'~""_"""_".__'U"'- ...'- ......
it:. )i;xecue.b 01 Iho Ellalo 01 _.._J1ari.ta._.H.._.Roa1te:y____...~_.__.--'----".-
1.10 01 Camp .J:!j,11 Borough , .__._.___".~,_, Oumborland Oounty, Pa" decealed end that the
within Is an Invonlory mado by. her. ,,__ ..,.-,. . ._-, the sald_-6Xecut1:u_'_
01 Ihe onllro ollalo 01 said decodonl, conlllllng 01 all Iho perlonal prop.drly and real olhle, excepl real edale ouhlde
Ihe Oommonweellh of Ponnlylvonla, and Ihol Iho Ilgurol oppollte ooch IIem 01 Iho Inventory repro lent It'l fair value
al of tho dolo of docodont'l doolh.
Sworn to .___ ond lublcrlbod boloro mo,
~pri1 -.,(i7:;--..__._19 ~_Q._
. ". cJ .J1h. C-tl1_~.~<o_C<..._~ _
Thelma S. McCausllo, Notary Public .
My 'C~mnl"iqn ~,~"" J~v I, 19KQ
Comp Hili, PA CUIIII,,,lanu C..",ly
. >JJJ I J - A /,;'7 ~ .' I.
..-L,":J~;:.~~e./~~----
428 Deerfteld Road
~'___.._ _uu._ ft.....,_.____..__._......_.' .__.'*_.___~__.__..__..". .._-~----~---
Qa.!l}p_.1H,!1-~I_~._J7 OlL~_,_,,__,,_.'
Add,,"
Dote 01 Death
'lQ
Day
.:.. ~... .._......J:Y.l~-'"".___.-_.._-___....l9.l9...__.~._._..._~,:, -__.., --'
Month Vot,
INSTRUCTIONS
I. An Invonlory mUll bo fllod wllhln thro. monthl o/lor oppolnlmont 01 porlonolrepresontotlve,
2, A lupplemont Invenlory mUll bo filed within Ihlrty dOYI 01 dllcovory 01 additional oneh.
3, Addltlooollheeh may be ottooh.d 01 to porlooDlly or roolly
4, See Artlclo IV, Flduclorlol Act of 1949,
.CI
~ e e .
1 0"
~ l!l ril ~
~ ~ ~
~ ~ ~ H M .
I ~ H Q '~ Q)
t'...; ~ ~ . i!cl ~ ~ f
LL I:tl J.
~ IS 0 ~I Cfl ~
I~ J
.
, I.:i
r -
z 4It .e
1
'0 J ' 0
.,
:3 1 oW
re J'
Inventory of the r.al and p.r.onal ootat. of
MARITA H. ROCKEY
.__,decea.ed,
"---"'-",:=;,.;;;:=-..;:;::::::;-.;..::;-:::-.r~~'.:-';;:;'::::;;;-:-_'.;.:.::;:;-.-;:-_-~;;.::~.=;.:::."':.!....._-:-:'~;~~.~.:..:::..::~:_:;:;;~-_~;;~;;;:.:-~~::::::.=:::::~:.:;.=-::-~.'~.:.::-:.~..:.::~-=:;'-':;'::=_4=H='::"'~-"=':::::::';'--=_-:;:'
REAL ESTATE I
Sing1~ family dw~lling loc~t~d at
40 North 30th 8tre~t, Camp Hill, Pa.
which was conveyed to deoedent by
deed dated May 12,1952, recorded in
l5"A"85; ae per attached settlement
shll'et
50,000 00
PERSONAL PROPERTY:
1
2
3
4
5
6
7
8
Checking account in CCNB Bank, N.A.
11745-616-3
Sav1,ngs account in CdNB Bank, N. A.
#002-1P1424-6 .
Proceeds of sale of furniture and
antiques at auction
Value of remaining furnishings retained
by family, as per attached statement
Medicare reimbursement ..
Aetna Life & Casualty - refl,tnd of prem1,um
Miscellaneous jewelry, as per attached
appraisal .
Sale of 2 beds and dining room table
Common stocks in various companies as
follows I
1,113.60
9,637.41
5,804.25
7,255.00
32.00
52.00
131. 75
150.00
9 980 shs. Wellington Fund @ 9.32 9,133.60
10 13 shs. in Pennroad Corp. (now Madison
Fund) @ 14-3/8 186.87
11 8 shs. U.S. Rubber Co. (now Uniroyal) @ 5-1/8 41. 00
12 300 sha. Duquesne Light @ 15~ 4,650.00
13 450 shs. Delaware Fund @ 11.84 . 5,328 00
15 738 shs. CCNB Corp. @ 12 8,856 00
16 16 shs. National Central Financial Corp.
@ 22~ 382 50
17 2 shs. Keystone Oil Products 6% pfd.
@ 60 120.00
02,873.98
..'~,~r;; (/1-1111
COMMONWEAL T1i OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OP FIELD OPERATIONS
U__.____..._._..
APPLlCA nON FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
.
llPPLlCA TIQtI (MUST BE FILED IN TRIPLlCA TE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is hereby modo for consent to the Ironsfor of Iho followlnu socurilios of 0 Pennsylvania
Corporollon or 0 Notional Bonking Association loco led In Ponnsylvonlo:
DATE.
. Nil;> 5,JJ.Il-P
(oL_..3.ClL.__(b).___ --_J)tJqll(;l!ln~ .rJ.~hLCQmpany . (c) COIlllUon__ .__._.
(NOTE: In describing secur/tles ontor In (a), ob 010, olther tho numhor of shores of .tock or tho face amount of
reglstored bonds, In (b), tho nome of the Issuing compony and In (c) Iho cluss o( stock or the stated Intorest rote
olld maturity dote of registered bonds,)
ISSUED ON _~ar!.ou~_.___._.__., and having 0 TOTAL MARKET VALUE OF L
(DOl.)
os of the dote of death a( the decedent Hllrita 11, Rockey
, ----_.._~...~._.~._-.--~--~- --- -- - . -- .
(Homo of Oucudollt)
/,,650
-'---'-'-~-.._-.~..
__ , on
.'n 7/)M.79,_....__,.._
(Onto of don''')
who was late oL_._.__~+..0_.Nor_t_h30 th S t1:'Qe t _. ClJrnp Hill
(Stree' and Number) (Po.t Offlco)
The secur/lies are registered os (ellows: ..,___..
Harita H, RockQY
Cumberland. _.EA.__.
(Cnunly) (Slola)
ADMINISTRA TOR) Elieabeth Rockey Fllger
) .-____n_ (N;m~i-'-" n._.
NAME OF APPLICANT
21-79-499
COUNTY FILE NUMBER____..____._ ADDRESS OF APPLICANT
(NUhlO or "Omus In whIch c:orflflcCltoll mil mul.tored)
. - . ---. .-----
EXECUTOR
1/28 Deerfield Road
-.
(Addtuu)
JaImE, Slike, E:!lq,.____
Camp }lill.L?L
BUREAU FILE NUMBER___.__.____..__SIGNA TURE OF APPLICANT
NOTICE, IF YOU FAIL TO PROPERL Y FILL IN ANY PORTION OF THIS APPLlC
CONSIDERED COMPLETE AND WILL BE RETUf\NED TO YOU FOR C
--..-------.---
.-_.._~._,,---- .._---~-------~----_.-.._--"._- ---.._---
. - --. . --. ..---. --.. .-.-~..---.-_..-.. ._n .___ ..
,'"",," f...~~.<,~.
ION, IT WILL NOT BE
L ETlON,
COMMONWEAL TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
~Ot-!.S~~TI().TRANSFER SECURITIES DA T~n~ 5Jq.rv
I hereby consont to the trons(er o( tho obovo socurltlos now roglslorod 111 Iho nUmo o( tho o(or.(sold
-----...._------~.~--.
----.-.- --------_.._~---
Decedent olld wolve the filing o( 0 certlflcoto cortllylng to tho poymonl of tho trolls(ur Illhodlollco tax to which
the property of said Decadent Is made subject pursuant to tho plovlslollS of tho Act o( JUliO 20, 1919, P,L, 521,
os omondod and tho Act a( Juno 15, 1961, P.L, 373, os omondod, This Is olso III occordunco wllh tho provisions
of tho Act of April 9, 1929, P,L, 343,
This Consent to Transfer the heroin doscrlbod proporty Opototos ollly In reforollce to tho os tote 01 the
obavo-nomed Decedent,
Slgnori/OI tho soc. t. otory 01 R.e venuo
~"I ,111'1 ..\ \n~ _",I
By.. 'I. It'lt IJ .~J' ") ( l)1N'1",- .__
i'<\\If\.J )~J~(~~X:'~':;'j"l.\\lt~ C\lv.~l,J~~\
\ ~ -~~ lilt J \ II (County)
/'
1~:-;-t1tll.llI)
COMMONWEAI.TIi OF PENNIYLVANIA
OEPARTMENT OF REVENUE
BUREAU OP FIELD OPERATIONI
APPLlCA TION FOR A~ID CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENl
~~\
~~tf~
DATE.
11ay
~, 19BO
APPLICATION. (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application Is horoby modo for consont to tho trunsfor of Iho follo\'llnll ,oculitlos of 0 Ponnsylvonlo
CorJlorotlon or 0 Notional Bonking Association loco tad In Ponnsylvnnlu:
(ot.)J'...JbL..f'C')n ('01:1'0)':11"'1.011 (c) Coo'",an
(NOTE: In doscrlblng socurltlos ontor In (0), ob <NO, olthor tho numbor of shoros of stock or tho loco amount of
roglstored bonds, In (b), tho noma 0/ tho Issuing comJlony and In (c) tho e1uss of stock or tho stotod Intorost rota
and maturity data of rogl storod bonds,)
ISSUED ON_.__~r~~/l.()_....._, and having CI TOTAL MARK ET VALUE OF $.
(D.to) ..
CIS of tho doto 0/ dooth of the decodont, _._~..~r..~t.ll. 1~.:_.r~oekt,.I'
(Humo of Docodol1t)
t'., e ~i6
" on..
7/1(,/79
,____._.....~.-o~ _.._._______
(Pulll ot duath)
who WClS Iota of..._.... ~1():'lor{:l, .3Cl{:\,..Srn>d el\\p 1!111
(Stroot and Hurnhtlf) (Poit Offh:o)
l:n1: i tll r. l1()(;\ray
CU1'lherlnncl
Ph
(County)
(5t.t.)
Tho secorltlos are roglstored as /ollaws:....
I
(Holl1o or nnmol in whIch l:o,II'lcI110" (\f0 fonl.tonHI)
ADMINISTRATOR) l't i:>:nhn1:h non"...y r:\I'I'l~
)..--....-. ...-..-.-.....- -..... --...
(N.mo)
NAME OF APPLICANT
?1-7tJ_f,')(]
COUNTY FILE NUMBER__...:.:....__..:..__...:... ADDRESS OF APPLICANT
~0n rC0rrtDl~ Rond
r.nmp 11111, PA
EXECUTOR
( Addfllll"l)
.Tohn ~:. !a~klJ,~:S..q~__....._
Cllnp lli 11. , l'A
BUREAU FILE NUMBER .............mn_.-. SIGNA TURE OF APPLICANT......,.
HOTlCE, IF YOU FAIL TO PROPERLY FILL IH AHY PORTIOH OF THIS APPLICATION, IT WILL HOT BE
COHSIDERED COMPLETE AHD WILL BE RETURHED TO YOU FOil COMPLETION,
---.----...., -----.-...--...---.--..-.-----......- ----~...
COMMONWEALTH OF PENNSYLVANIA -- DEPARTMENT Of REVENUE
. ~QN_~ENT TO TRANSFER. SECURITIES E' '\y) . '-. 1 C!,.L/)
DA T .\u Owl,:;',. .(.J
I horeby consont to the transfor of tho obovo socurltlos now re\llstofod In tho n<1lHn of the ulareso(id
Docodont and wolve tho /Iling 0/ 0 cortl/lcato cortl/ylng to the poymol1t "f tho Irul1slol illholltlll1CO t(lX to which
the property 0/ sold Docodent Is mode subject pursuant 10 tho provlsiol1s (II the Act 01 JUliO 20, 1919, P,L, 521,
as amondod and tho Act 0/ Juno 15, 1961, P,L, 373, (IS ol11ondod, Thl~ Is ul:oo In (lccord,",,,e with tho provisions
0/ tho Act 0/ April 9, 1929, P,L, 343,
This Consont to Transfor the horoln doscrlbod proporty oporotos only 111 roforonco to tho ostoto of tho
abovo.nonlod Decedent.
~~.~
,.~"
l~t~rJ'. t\
.,::':",/;]~. ",t
SlllnO(j,f('r tho se. crctury 0/ Ravonuo
~ht( 'UJ.J~,'~.~ ~~Y{\~(jv,\,,<c
l \ 11111"")')'''1' I C' Ii I
l(\)~I:VN'i\" \"q, ~\:.,\,I,. \'1 ~J JJ/..lVv"\\N,d',, tv!1
~ (1\Illl) \ (Cllunly) \
TlIP. SUM Of I .LW:J.,.,"-I
'7t. J''f J~htl
DAn APPROVP.D _..~.IC" .._ ..,_L.LL.,.
Of ..__Clln]~_<;!_;-lan_~_ COUNTY II~ l (J IJ 'IV! )" d
AND AOf-NT Of THE COMMONWEAI,TH 1 /J :.!..._:::...:'t~,_~___.."'_ ;-'~.!~_.lJ./.fit '
'_____ .____...______.___.._._ '- ~ :~> c'C;11(..lLJ~r-l2S{;? JJ~(~l_'~~'"~.':_~,~.:'IL~ ~A':::'~:.._..(!_
f.HATC OF Marita H. Hockey LATE 01' Camp Hill Borough
._..~_._._~_..__._._._._..~. ___.~_ ____T.+_._~._....____~*_____,.._..... --.---....---..--..
OPf ICI! OP THe
HP.OI!HII OP WII.I.\
,:),/..79- i9y
STATEMENT OF DEBTS
AND DEDUCTIONS
DEDUCTIONS ALLOWP.O IH
IWV.'-Ml (11./111
DATf. OF FILING APPRAISEMF.NT ______.._...._______ (.ATE Of' DEATH Ju1~_11L_1Jl.2...._._...___.____..__..__.
~-:..~~~:~~~..-:~~~~~~==..~.:~n~;;~:~:~.~:~~~~-::..-'=O::=':."J -.- -- :~-~.---nl'e'~-~~~~'---='~.C=~~~._-"'~~lll:~:'~
.._. n__._ ...__.. . _. L.._.Q~_C(lDl1()rJ __R~~g()17--~_J~;~~-~Q_~;;17;;~ll~~'--':=~.:--~~~=~= ..n. ~:~9 '. ~-~--::
. A!:I f.l.~_.F,__ K.e 11_~.rL_'!'1l_l{ ..g_Cl .1.~__ _}.9.Z.9.~_ c:.hCl.9_L~_~.~__________,__ .. _~_2_l.!_ 3.1_
Truman..Hor.ne:r,. }t1c~.m'____'H:r.r_E1~J1_CJ.o) 1_~_c:l ~i.9!l_.____._.__~._.~.. .___ _ }}... ~~._
PP&L Electric bill 21 79
___ ____.___"..._,. ~.____._L_.______."_ ___,_.~~_.._._,_.. ......___.____....___...~__n~___..._______ ---..- .--- ------
.______~m__._ ___n__ ._..___B.~n. () f r~--'___.____.. "_u
Hummelstown Ambulance
_ .... ...rho'~9_J3J_1~_______.___.____..._______ ______1.9._ 2.2_~
Ambulance service 41 00
. ._._~_. .... _._ _...._..., ~_____~__. __._~._ .____~_.___'" __.,.._' .'. _.n _.--'.T__~____..__"
_. _~~-:=i_~t:.,!_rg_ X-~~X.__~~__~.~.:...._. __~e~ic~1._bil_~__
Riverton Cons. Water Co, Water bill
37 00
..- --~-_._,. -.---
11 82
_...____h__._..n...". .4_.._..______..~ ..~.'_. ,.._'u. _.n___..____._.___.____________... .~"__. ,'n___' ----.-'.. --_._--~-,._--_...,_....
___,,_...~lpine,~~':'~.~ng .!~c:l1\:._____.._ yebt:.__c:lL decedent
Myers-Hall Funeral Home 11unera1 expenses
.--.--,.---.---- --.-... . .._..~.-.. -'-'--'"-'. .......,._~---- -, ---.-,.--.--.. ---.-.-----...-.---.-...,.......-----.--------
37 29
.._-_......-~- -
2,758 0
.. ____.... .....~B.~.r_i.~_~~.~~~~_go~______._.___ L.!l.B_~~_ ad
~,______._ ..______ _9.':1~_~_er~.~n~_,J..<l.~__~1_O'~E11~~,______ _~ega 1 _<l.~,"_
):~&_L..____._. __..___~_____,.. _.___ _ge c.~;:.!c bill
____,__21
18
Riverton Cons, Water Co. Water bill
--~.~----.........----'- -. -., ---,-~~. ~_._....-...~-' ..-.-.-- .~_.- ---..-
_ ._____ ___Co.m.ll\QU\@M th._tl{l,j:J..,-_J~_~ul~..____ _ Ref1!D.9 of trust overpaymelli. _-19__
Robert J, Trace, Esq, Witness fee 10
.---_.._~--_.._._._..~-~------_._.... .--....--------.. ------------------.--- ~_._._--,~
Sara R, Hosler Witness fee 10
.. n. ,no ." __._____,.._._..__._._____~___~____.._.....__ -.
PP&L
Electric bill
9 3
._.__. _________..__.~.._...n_..' .__..~_...n___~_..__._.______...__.._~ ..--.......-..- - --
,...:.---.-'--".
.. ~~&L!!l-~t1-rg-.I1~Bl'i:.t~l.-h.------- -..~H~Ti~c O~i T~diCal bil.l..._._ ._--+--~ -
E~i21J1_beth_R,J!'f.\geL._... n.._ _~1{e~u~r._tx~ CO]]ffij.ss ion..__.____ .2.J_llt2. 9___
Arnold, Slike & Bayley Attorneys' fees 5,149 0
Reg'fEi-tarof wn Ii:j-----" --.---l'I1Tng-Ycics---- ~r 0-
Jack Gaugh_en _.ReEl~to.r . m__ ~!l~es_.!3~p_en!J_E!_~ fqr house .__._1..LJ.02,~_Q_
Register of Wills Reserved for account 50 0
:It i/ttv ~t: /. I .\ 10 ll~ fl',~1: ";'1 n-:~ri';S/t:it;;;7;JT'i(.l ;;r-:-~~~'~~-~=: -- ; .,- t?J .,;'1'
C:OMMllNWl:AI.T1I or PfNNSYI.VANIA I total 41-.-746'51
C l 1 I lIt
COUIHY or um Jer ane
I. .. ...". . . _n:E1f~~~et~_R~_.Fa.B::._..u__.______..__ HEREIlY CERTIPY, THAT TO HIEnf.ST Of
My 1<fIOWI.EIHJE ANP 1I['lll'F, TlW I'Clll1;GOINt< I~ A Jllll' AI~D TRlIt: STAH~\eNT OF DEaTS, PUN~R^1. EXPENIEI ^NtI
I.XPI'NII'S or- AIlMltllSlllATION IlIilMITHD 10 TliI; E\THE or-.__.._...__.__......MIlt:4t..a-.lL-Ro.gklil}'
IHcC(;ASEIl, AS IlrIlIlCTII)NI f'OIlINtlfiRiTAHCE lAX PURPOSEI. /1 . ._.....-) P.'
/11, _.<ltf~i &I,,;~__jj-, '::7.<.~!!L (L.S.)
IWO,(..'W 1III,"'Il\l\[DIIFll1flr-,MI1111\ _l..L:~.m_. DAY or- F.l eabeth R, Fager (
. .~ !"r')~l\ /..jAV;l?-l;H((;-(,l~::;~~.___...___
,
Th'llm~ S. M,C""lin, Not,,,y P,,"'i,
Mv (','I,!.\;,,1 , t' I ~ I, 1"'It!
/0 ~~'1"(
r."" '(I