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HomeMy WebLinkAbout79-00555 {,':.- . " " ., ,-I' '1.1 " " " 1- !' iP j 'II. r",' " ", I" " "~I ,,' .t. " " , ," dl- , " 1- ,', I "'1- L-' L ~ ' . I , ' ,1- '" "I' -/ j'l.' ~' I. , ,. ": '.' " ". ,. ", ,,, , " .' " '" ,. I" , " , . " ,; " '!I ... " , , . '" . " ,', I I I I I' '( .' I :-/- I .' , , ,I f ,. ,j, I 'i " ,o) ," II I';,' I'. ,.,. 'i". ,,' " " . ",I ,. ,::i .J, C ", " ,." I, , . .,if " .' " '., 'J' ,. " ,- " :,. ,,' " " , ., '. ., III' " ". " '" " " 'I " NO, 21..79, 5G.5 I,NJ:I~~~~~~~o (~1?,~",~~1J;,~"JJlr.~~~'~'~'~'~'~~'~~~:'~/~1~1)' '" ,A.;_.~. ~ .) < /J. J",,-<~I" '. HII""'If'I""r~"""';~"!'""~.,,;,,ji;"""""'"''''''''"".,.,..,,,,,,,,,..,,,,...,,,,,,,,.." To 1\01llHtor of WIiIH 1'01' A~o TQllII&" \' lll' CI\~bOrlllnd. In tlw C0l1l111lll\\l'lll\lIh 01' PonnH~'II'IlIlIIl, "'h p '\'1 I' ,1t_~eA ,1,,1(;,,, d ' I 0 ,0.. Oil ,0 ......".. ,......,,,.., .... ,,,,f......... '.c ",\,,' ""..""" ".. """(l"';l," ," " f'" " " "",*'," " "".... "",,,..... """;..""",,,.... ','"'''' '." ,;,,,...,, ..",'",....," rOHpoclt'n II~' Hholl'ol h I hll ( ," 't/~.. ..r.~" .fr" ,~I\~;\,,,...,, ",...."" '"'' ',',"'"'' WAH A reAldont 6f ....,,,,....,4,;;k~~~''''''''''''''1\'''''''''''''II~~;:'Il~11- ,Cnlllh,ol'lllnd COl,ln(~', Stlllo o,r l'onnR~I. van III, IImi A CIUten of Unltod BIlltcR, nnd dopl\rtod thl" 1I1'011\to"tlllo In thuCounty (If..,,,,,..,..,,.,,,,,,,,,,,,.' ;""" """,." ';""1""'" ,,,,,.... un!l BtHlo of :.., ,: 'w../f&1r.Uf',~~1t;", ',""""'" ,'" '''UJ.l,'.W~''''1','I'' "."""" I'" I' ,,,,,;,,,, Ij" II '" ,""'1' <.:br#. h 0 "', 5-. "Co".//., 'A 1" 7.,'/ on ttrt'll'111111"...tJ'I'1111""""'11 t 0 ""'tll"I,,(,~i,,;'!'!""""""II" (tn~' of """.t""'i~i~.t,t...r...,.1...."."".,."..,,, ,D'l', 1"1 ,.,"t"l Ht tho 1111'0 of ..,,j~~,,,,, ~'om, ' L1;t , '. 'fhllt the Hllld ..,,,,,,.....r&.I.~I..tl,,,j,,~I'\~if.'fI,,,..,,,,,:,,,,,,,,,,,,,,.., IloCO"HO(I, IMt HUl'vlvlnll tho foll(lwlng namod widow or ohu8bHnd, ~olr" "nll next to kin, to wit: !'IlIme "~~'~k#. .tf.:...l!f.dit.i,~,1, .'''''''''' ",,,,,..,, ,'< /; I ..flll'"'1I , .L\{"'~'~~'l'Ht!.",,,,,,,,,. >>.Im".,a",.,~r.:yj,(f.\'d\~"r,1." Holl1l1on"hll1 RCRldence I /'11 c:. ~ ~ ,('::1 "lW,ti1Ji tf,~f;.t~f.(,,,,:.. ...".t~~~fi,;"...l..~" ,t,~t.Y.", .~T~.,(~.~t.~.".,~t:.~::8:rl"~ :r: "::J 1.;.1.2...,., ,d\~!,r.J" '1Ja~+t.f.~,:r", t!:.tJ:, /. ,;"",.."..(-:f(tf~li""""""""""" . Aj!'l~ I:t:-, ,,,',, "I! .r,~, ij .0".....,,,, ,,,.,.,... ,it..."."..~,..,.",..!"",.."" .".""..."j",,,""""l,,!.,.,.j,,.,..,,,.,....,.,,.'",... ,,,...H"Il'l!'"'''''''''''''''''''''''''' ,.""""""",,,,,.,""'II"''''t1,",...,qjjj'I..,.,..,,,,,. 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The "H.ld decedont Wlla ponHoH8od of pOl'aonllllll'0I101'Iy to,tho o~t1ml\tOll vllluo alld,o(neAl,matlllo, 10HH Inoumbrllnco, 10 tho oHtlmHtod vllluo of $..,,,..r.1;\(,!j,........,,..,., llH nlmr llaoertlllnod: i' ,ur."tJc:i of $""""~,,,""'I;'''''''''''''' 118 olin bo Thllt tho auld '(tolll. mHtllto In HO fill' llH IH known IH loelltod 111 ",,,<<.1&..,,,,,,..,,:...,,,,....,,,,,.,....,,,,,,,,.....,,, ""'''''!',.,.."..i<...",.,,,,,,,,,.''..''''''IH!l...''.....,,,..,,'',,..,,....,....;"....-......;.,....""".,...".....".".",..,......."Il'"..''..;'''",,,.....,..,....,,,, fol' 1,0tt01'1l of Admlntatl'lIl1on In the. abovo Therofore, YOllr potltlonor(H)' rospoctfully nppl~'(I08) nAmed eatl\to.' Dated ,.....,r.~j1J.;;~\"..L7."""..,,,, A, D" 1\,7:1.., " " 81gnature,'und Addros8 01' Polltlonol:(8) ...""""",2i?(,(',d"2!l;,f~;4.~".;"~;;..,,..,,... :5 ,'7 ., "'1' ;~,!. t't."'ilk!:~1.''9''6.,;, c., "I'" .".", ... ,."""",.. "" ,.,. ".' ~ (! "J // "...,. f!. ;~,. ;~~{;:"..\... ~~ "'....,,. i",..,,,..,,,,,. It H'"'' "t""" ,.11'."" ~. ,,,.,,,..,.,.,,,,,,,,,,,,.,..,,..,,,,,,,..,,,...,,,,,,,,,,,,.,,......,,io,.,ti...,..u" OOMMONwmALTl-I OF pgNNSYLVANIA 1 AM: COUNTY OF CUMnmRLAND ,',"'," ."""""....,.., ",',' ."" ""', 1'iI;Ir;?{(,., ,II, )1f:1!~,<7.~.,,,,,,,,,,,,,,,,,,,,,,,, "', ,.",., ,,' "'" "'" ,. ,.""""". ,,',"" """ ,.., nnmod In the Abovo HPllllcutlon bolng duly ..".."d~~!.?1!,';7;""'"..,",..,,'" lIeom'dlnll to IIIII', 81l~' thut lho fllcts 80t fOlJh In th~)'bovell,jll1l1Cllllon 111'0 tl'\lO to the hOHt 01' ,,,/~~,'?,,,,, knowlodllO IInd hallol', ~!r!{,~,"kJ,\oj T;(;:, ....""." "....".,.."" 'I"'" Rnd 8ubsc.ribed 1 ".,.",..,,'" ."" '''''' '." ,; "'.'", ,.,..,."....;..,,,...~. ". "..,,, """ "'" .... ,t . .y' ',1/ ..y_ ,'} I} ,...,t-, betore, me, ""...... .1i-;:',-t.!.~~~d~,.,.:;:".,,,,,_d~t;,..-.e.G.~;f;;..;....,,..ll"j ,,,,,,..: ..',"'~,~.~~~,~~~,~.,.~,~''''".""..A, ll" 10.Y.~,,,,,' ",' """ ..""""......""""..."..,..,,,,,,,,..,,,,,,,,,,,,,,,,,,,,.,,,,''''',',, la-Ill ''''''''''''''.!,''''''''''''''''''''''''''''''''''''''''''''''''''';''''''"""t"."" """""",",,,,;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,;;;;,,,,,,,,.,,,.,...,.,.,,,......,,;; HoglRlol' ~'lIedl 11~,~~~.~m1?~~.", ,'+'9.""", ,~~.I~"",,,,,,. ''''lO' Alt[Jl'Ill1~': (Q\'CI') " cOMMONWIAI.TH 01' PINNIYI.YANIA COUNTY 01' cUMURLAND I ) ... 'n' ~~e~1:!"I.h,~MentZe~. nu....... __.._.OO___"'T"-_" boln9 duly .)~ytO!!L,.,.. . _. oooordlng to law, dopolol and UYI thlt ho . ._~!_Jin~.u_,.."_..n__",_.'u, .. _ .... ,...'~~Anh.j;;'I1t.Q~. , 01 Ihq Blloh 01 .._J,g,lm_.1u.-.M~nla.I~.__~.,,_c____'_'.'_"_ lit, Olh ,the >>orouqh of CllrliBle r, .. _, Cumborlln.JCounly, P..I, d.oOlaod Ind thlt the within" on Invonlory madn by .h~IIl., '. _... _ . ,..__, Ih. uld ..h~lni!.;~.!,1;,or_ "I the onllro 011110 01 IIld dooodsnl, conllltlng 01 IlIlho porlorlol prop.~,rlY and rool 011110, OKOlpt 1'011 oltele ouhld. Iho Commonwoolth 01 Ponnlylvonlo, ond Ihollhn (lgllrol 01'1'01110 eaoh, IIsm 01 tho Invlntory roprollnl 11'1 hlr vlluo .. 01 Iho doto 01 dooodonl'l doolh, " . ~worn _ond lublcrlbod boloro mo, '~~""~K~o/~~.-..._....,. 314 <1 .l4'r1n9.11QAd..... ...__._~.. _'~_'" ... ~~,,~~~~',.n_~ , ' ~AVAHA ~. 011UIIOIfll2 ., 110 AnY PUD 0 BOUnl^MI'~ml. H>Vill.OIII'. r"^HK~IN 00" MY OOMMiijalUII Exr/nno Aua. lO,I"" ..._qat.'.lJ~leL.__I,';'_..._._.__,___._... ",dd'lII D.y .8,. _'''_'O.'''.'' .., .,.JH~p,1;.,t._ .u, ..",...__"".__.._._ill2_,,__._._....,_~_._'O.'O ._, Month Y.., Oalo 01 Culh ""'.''o''T 'INSTRUCTIONI I, Anlnv,lntory mUll bo lIIed wllhln throo monlhl Iltor opp~lntmonl 01 plllonll reprllenlollve, 2. A luppllment Invonlory mUll bo 1II0d within Ihlrty dOYI 01 dllcovory of oddlllonll euell. 3. Addlllon.l lh.ell moy bs .lIochod II to pmonolly or rOllly I, 4, Sot Arlloll IV, Flduolarl.. Aol 01 1949, ~ i ~ I 1 lI'\ 'II lI'\ ~ ~ ~ ,.~ I lI'\ I I ell .!. r- l!i ~ ~,l!i ~ . J r4l [I - ~ ~ ffj 0 ... Z g 1 'l; 1 JJ ~ ... j d J " Ace-,. 14ftll '. , COMMONIVEALTII OF PENNSYLVANIA DEPARTMENT OF IWVENlJE IlLJRHAU OF COUNTY COLLECTIONS '* ", .::X 1-; f .nr:-;- , RUIDBNT DaCIlDIlNT - .. --:--~-----r_ .. Thl. 191U1onlll',1 bo OOlUlllolod lu II0ulllolld (lIod 111 ,IUllllonlo, WUh nil ollnolwd, wUh Iho 110111'10' ,If Will. of lh" COUIIIY whoro do08duul rO.ldod;' ROlnll1l. due WUhlt,"llle'nll'llIh. 'lIt1or dnl. o(.donlh, uol... "uo.len.lon I. ,1If111110d IWlhO 809,Iolary of 1I.~oUUo" (~oolluu 703 of Iho Inl\orltllllecolld E8lnlll T8XAol uf 1961.) , ' , COUNTY OF OUMBI!lRLANlL__ IMPDRTANT, - -r--- - - Lat. of IN 'J'llf! MATTllll ,OF TlIl!l!Sl'ATIl OF JOijN A . ' M:mm'2H!lR (1~'~i~l\~ "d'oU'r\eY'"~r' Botouqh' of. Oarlisle pennsvlvania OUmberland , ' } AJlJlfllAVIT OF XltlllOlmGlI: ' County AnMINISTRA'l'OII, Slat. of ,-J UI KeithA. Ment~er, _ of th. ..tate Qf lh. ClboYlI"oam.d dud.nt b,lng duly IWUlnl d.pou S and .or S September 8 , 19-1.2...J~, ~~~Hl!;~IlC~~~lI~~",}, IMONtHI IPAY) IY"A'" \.In'''''t. , Nom. an~ ,~~rou ,I on"noyo,} George, F. DOUg las, Jr. .110.. <iulholl"~,,,p'''.nlotl'' ,. whpm 27 W. Hirlh st., Oar lisle, PA 17013 all GO"tlflcmd.not .hould bet I'I1Clllod, . ':;II. . ,. ,. '1'hol"n nuoh-A.dministratordollUlllllH I. I'nmlllur wllIllho IIffnlr. of .old o'lulO ond Ihe propOrly UUI\II II lullllU (f:tX &:CUT,O A'ADMINIS,T RATO~) Ihe n8ael. Ihereuf !\I1d Iholr fnlt ulOIkel vulue, Thnl nllho 1I~le lOf denlll lhor~ WIIS nlO slife dOlloslt blOx toul.lerud iu dooedeol' s IlIdll'IdllolUUIIW, lOr jolnlly wllh, III' an ftselll ur d~puty()f nilUlher, or III 11090delll'. Il\dll'ldlllll olll\1o,wllh rluhluf 1I00eMsb)' nnolhor lIinselll or del1llly, with lIi\l exoepHllU of Iho flOll'Owlnu! -' , Counly of Admlol"'nlor . x~ O.oo"onIIUo" NI\"rlK "Nil 'AbOAHU 01'" PANK OR OTHKH IN8Tt'l'UTION IN WHICH OQ'CEOHNT RHNTUD A ',I.fl'E( DEPOSIT'nO)( THI$ .!IAfl'Ei D~fl08IT BOX Rf:NTfiP tNNAMa OR NI\MfUOf" Ra~ATION8HIP 01" JOINT HOL.Oft,U TO "HeRoaN" Thnt Ihopoohlolauf snld sofo doposll box or boxe,n ore II0rnl~Ud, uudllrSohodules__or' lhh r~IUtn, wllh lho oKooplloll'lIf fho followhlS, for Ihe ronslOlls her~llIoflOt aOI forlh! ' ThntSchecMe A ollaohtld horolo nlld,'11ode porl,horoof .etaforp'1 f\llly llrid In ,dotal I 1I1'llho,real properly '. In thoOnmrnollWOnlth of PoulI.yll'unlo of whloh deoodellldlrd hllVlllu nil IlIlorosllheroln,h IIlslO seU flOrt,h lho morlauso onoumbrolloos U\1olloooh purllol o( renl prn\1orly IIt,lhll 'dlllo nf doalh, alvlua tho nmoulIl slllldiil" al donlh, nnrno of mortsl\ueo, dnlb, rnlo of 'oloronl, olld bn'ok nlld '1111Uo, M rooord thoreof, It ola9 ;selK forth Inlho' oolumn. provldod (horofore the IInKe.aed vnlulllloo uf olleh el' .nld'l1"roeln, Iho osllmnlod lI1arkol vullOo thereof IIn lOf dolo of donth of dooodunl. ' Tllllt Sohe,clu/. B IIlllIOhod heroIn ood mndo pnn horelOf .U.'8 forlh full)' aud In ~otnH 1111 porsonal prorofl)' Whete.ol'or ,sltunlod oWllod by the' do,'edool n,l tho time of donlh! 111111101)0)'. left by Ihe deoodolll nltho limo nf delllh, wholher h, doood,enl'shnll1odlnlU l,oaKe.alotl, .Ioodlou lodooudolll'. erodlt In hlloks of dupn'll, nlll'loa. bnllka, Irusl oompuolon, 01' olhor hulltlilllllls, wholhor IlIdlvldllllll)'. nr 10 IrUKI fur nil)' nlhor pllr.no IIrl'ur8111\8 ull'lns nl.lO .oparnl,oly'lhe noorued Inluresl Ihoronn, If no)', dowo I" thu 10.1 1I110rosl dny prlnr ,10 du'c,odllnl'K doalh In the on." of 8ol'IoSs bnnkn, and',110 the dnlunl' docodoui'K don,lh hI, nil olhor ca.llnl ullllilllll., /lUstll'l 81\l'lnuK, Iroftsury oorllflcntq. ,or Iloles nnd .othor ol'ldonco or indoblildl"'.. of Ihe UIIlIed SlIlh" 10, Iho Ilu. COdOUI; nil obllgnllol1n, wbolllor by .Inlule ur nurOol110nl Ihe)' nro de~lunnlod oK IIIX froe, of Iho,llnllod Hloto_, ur allV ,.11110, Of,pllllllonl .uhdlvl.lun IIl"roof, or ur' IIny fUl'clUII ouunlt)., whleh IlI'e uwnud III Ihollllle ul' dqulhl nil w"arlusuppnrel, JUII'olry, .lIverwaro, plcluros, bOI*., II'llrk~ ,uf orl, huunoh"ld 1'1111I11111'0, hIlIMU', .'nrflllgU'1 ,- -. _t", o 1I10ll1obllos , bOil Is, nlld nny olld nil ulhor pur.ullnl chnllds IIf II'holsuol'or. kllld ur nolllre, 101'1 hI' ducudullt, losolher 'With tho fnlrly onllll1l1lod 'llnrkel Valllolhcroof; 1111 bUild. nlld IIwrluooo. hold 1'1' ducudunHlIlI1 011111 0101018 dllO nlld oll'hlg ~ecodonl 01 tho 1,1010 uf denlh, IIrli! nlllltl'll"..ury 11010. IIr ollior Inslrnl11cll" ill \\'r1l1118 for Iho pnymOll1 of monoy of whloh deoodenl dlod 11U~.0.lIod, urwhulnoul'or IInluru, wllh Inl.rll.1 ll!orulllli,lf 00)', slvllla lho Cno" 1'01110 alld osllmaleti l'olr'1I1!\lkul vohio'lhereof, alld Ir.lleh O.thill1loll CII Ir: nHllk 0 1 vl1lno'ho 10.. Ihall Iho taoeYnlllo, It 'ols forlh brloriy Ihe ron.nn~ for slIch deprooldllllll lis Ic,'iollCh ltofllll1l1l11ll1llll'. I'nya,blo,'lo tho osll1lo from 111'0, Insornnco pollole. cntrlod b)' doooder"lnl,1 Rnnulty ulliI OIHIU\l'I11""1 CUllllllcl. tho prnoeods oC,whlohworo pnynblo.\lngn tho,denlh of Iho .dooodonl; '1\l1l~1I1 Iho cnllHlrlllo .wok. Rlld dlvhluwh duo Ihoreo;, ftud ,lIuplltd ". of 1110 dole III' donlh, Imnd. IIl,Id ueeruod 111101'0", Iherunn IlIlhudl1to nl' dOliodonl'. denlh IIl1d blhor IlIvo.lme,)1 .Odlllili". owned bl' thodooodolll III Ihullme of dOlllh, Ii'lIh Iho IlHukcl'\'uIIIO'lhol'u' of III slIob limo. .. , , 11\ thll UflilO fll' ~oo\lI'1t.t,U8 or 01080 or fnmlly oorllorut.io"M, tho vnlllnt4 rOpi:1I1(,(HII\llU us l'ar 0.. !,u""ll,lu allh~l,,,;tlfltulI h~' 1'11(111,"1") flt"tumOl1tn f tho oorllUl'lItluu., .hoWll1g tho ollMt8 nl111 llnhllitlus thUl'tlf;1' ,na ul' thUIIIII" uf' I,,,,,th, ThO,lIoholllllo IRa, Botll flll'th thu lntoroRt 01' 11000,10111, "t \,ho ltOlo, of ,lfJI\Lhdn, nil)' ~(I"pnrtl1t1rHhlpnl'hllKJ1tmlf" ,IHUI in fHll'purt of' tho vuluo nf' Huoh t1lt,(tr~Hjt UlOl'fI ta nnnox{Hl to' aol.I'I\iJI,."lul", l'l"ou.,I,,1 Idol,"o"",tll IIhuw'ln,! !.l\O"nRot. IIlul llol,llHlon of,nnl,1 ou.,..rtl1"l"!I'11' nr h,lnll1o~n. A 0011)' nf t,IHl'On-l1tlt!ttlfll'Rhtp f\f~l'IHlIIIIJIl", (lr 0I1n1, n f1tntolllonl Hotting f'ol't,11 tho iW{,lu'u Ill' t.1in ,lljJjrO()"lOnt) tuguthnl' willi " Ml,nlnlllllllt. fl(ltt,Jll~ t'nr\.h tho ohl\1'nfllor or the hU8tno8H" ita lool\ttnllt nnd H\lllh othor ('flot,s portnlnlllK to thfl IHIHIIIOHH I\K l1iHY hn l'OI'(.tHllllt tu nf'ni" Hnd JUHt.' nptIN\1t1ul 01' tllu dllllndlll\t.l a' intf'rost. thUl'ollt II1\lflt:ho f.lllhmIU,ll<l. It. HtllIHllt l\lAn .tlut furLh in tt,qll\lulll f10I'111; ,iogot.hor wHh Lilt' l'lIlr ltlul'knl.'Vnlue lIIUrnuff fillY 1I1,llnl' l1ri.lIWI'l~'OWlllld 01' 1lO{IUnnllwd hy t,ho Itocwrtont l\t tho Ump 'nf' <lUUt.lh , ' , Tlw Schpdulrt (.' IIt,ttlllhof\ 'hol'ottluncl I1l1ulo IInl'''' haroof HotH fort.h,n truo nnRWOI' to IH\oh 11Hlutry oontnlH(1(t t.hornln l\w1ltl UI(I (ltuHHIf' tqUlal'orK ()f'}II'(JJlort,~', fonl tll' l1OrQ'nl1nl, wi thin t,w'o YUl\rH nfi <lulianontl H "lilith, II' ""1'1,01111'111"'''1' "I' <I"""llol't'" I'Ollth, 01' 11'1,011110<1 I,n (,lIkll IlI'{'on!, In \iO"801l,lnl' or olljuymont nt ur .UI't,nt', lIMlt',hl Hultl flohtllhtln Milt." f'(wtll t.llu unt,\tfll utili Vfdun nf' HUOt! Jlr"port,~', 1,0 whom l,rnllR&'0rrod, the rolfll,lurlHlllp, nl' tho 1.l'I\U'fil'nt'IIUH t.<I t.hn dllOOltollt" q\(l llruporl.lotWI,O 8huI'O rooniVlllt 'br IH\Clh \,1"lflf4f'oroo and ull,nthnr, ('IUlUl n(' II' l'UI't,ttltlllt, IlI\t,lIl'O 1'(Ip'nrrltla~ Rid" t.rnUftl'ors. Tn t,l1(' O'I\RII of' t,I'mt"I'lJrf~ lnt,onrlort t.o tuko ot'f'oul, In I"'HUH"'IH I 111\ ,01' 1111,IClYI1l(JI\t. nt, nr uf'l,ur .Iont,h, Lltlll'O la IflAn nt,l,nullo!t t,() qlll f1l1hOlhno II oonY 01' Lhu (\UIHI, "rufH UBI"l!UIll'UV(II' nUlllt' IUH!,llllnlont. tll'onl,tng I,ll" l,ruHI,. ThArl~ iIt nlAo flok f'ort.htn snitl sohelt\llo II llflt, 0(' nil pl'(lJlOI'tl~" l'tlll'IHlI\ PUI'H(lnnl, wt t,h lLH VltlHf1, whtnh 11lHdl(Ht nl. doomlnnt.1 H clnnt,h hy vlr,lUU 01' t.ho 1-11(o1'0IRu hy c1u(lUllnllt, tll'I,IlUI' 1I'1lItylch\ully. o11,1nlnUy with ntUJt.hnr, nr l\1W pllwur 01' hI11Ioitlt.- rnul1t vv'ttt,IHlllIfloIlOllout.t ntt.1I01' tlliHVI{htl\l,ly nl' ,lutl1t,1y, hy lho,wlll, '(looct, or nthnr tl1sLI'lImollt 0(' nnothor, w I tit Il (lOllY n f' U\U ItlH 1,I'lIl11nnl, ol'un U 11~ 'HlWh plJwt,r tl t.t,nhhod 1,li l.tlu HohtHlulol Thlil SChf'dlJlt' 0 1I1,t.IWhtHt IHl1iut.O nucl ",fulu 1"11'\' 11f"'flllt' Rut," l'orUI 1,110 nn",mt ntHI nddrnH8fHl of' nl1 t!tlrH(ll\H tlllll(l('tolldly Inlnl'jlat;llCl ,111 tlllH IIKLutu Ill. tIIll tllIIn \1f' lItHltHlnlll.' A Ih'tid,hl U1U 1I11t.HI'tl of' 'tholl' "08- tltlilltVI' Illt.nruHt,H, t,lIldr .'nllltlllllfllllll, If' UIIY, t.o Ul0 ,IOnOllultt'f l.ol\uLhnr w(t.hA,ho UIVIH II!, t.ho t,1mo of dfluu,Iont,if,j d~n't!hof'lll1 mll1ufH, t\l\flUtI,UJlt,g /lit I' hOllof'lotnrluy 1'nl' "rn tltHlor Ilooorlolll,'>> Wtll, 11. n180 .oont.t\,twI H"H(,nl.nItlOll\. f1howlllt; whloll uf' Uw hOlluf'lulnrlnR lltll1lncl In t,hn finondonl,'a wUl, 11'1111)'1 (\toll prior ,to c\Ol.lodnnt;, tlI11 lllll,OH nr tholl' "0/\1,11, UHltr' I"""n, lUlfl UtI) rolnt.loItAh'tJ nr t'\lolt IflfltlU to tltl' hnrlOf'loillry. 'I'hltt, S(hedule E ,tltt.f1oltod hnrol,o 1\1\11 I1H\llo n purl 1101'001' 80,t.~ fnrt,h 1\11 II1'o}lUI'I')'1 1'0111 ,nUtl per'" Honnl, oWi\t1d b~' Utll '11noodnnt, .Io111,t.ly with ItllOUUH' nr',(lt..hora, ,1no'lulling tnl,l\t1Alh1o, f'lutlH"n~lit M~n 116(110 ", \ of lttO dooorlonL 'ulI,11 1Il.1wl'H, lilllH tht! ditto ntH' plooo nf' I'ooord'or iI1Rt,l'\lIllonto nl',lnpt!lllg 1.110 vlIRl.tLut'U ,of ron,l oat,I\I,o ntHt I.hll flnl.u (Ir IHlqttlult.1nll of' 1IOr~01lItlt,y, lllllR U,O "nmo, n"rlrOHFI f\ml'rolnl,1nuHhJ1'1 1(' nny; or oo"nWnl11'fi in 1.11(1 llol'otlMd" '!lhnt, S'c/!lldvl" f' nt.tnolturl htll'nt.o, dUll Tl1l\(10 It pnt'l horoof RotH forth fully 111\11 In IIUt-flU 1\11 dobt.a RlHt cledllotlollo 'olILI11Il)cl f'nl' fUPi'1l1t lIoh/11 f' uf t.hlA l1oolHtOil 1.1 H OR Ln to, ,llIoltll1 tnR f'\lI1(1rl~1 4lxpcJlHWH pRitll f'llmUy:oxnrnpUol1, whoroH1'I'1101,h)nl ,!(,"I,s 01' Illlmllll,t.rotloll or thin o"l,otul "HIl1l1l01, 1'00' H,,<I I~IIflolnl'Y' s 'ou!l1ml,,,,lnl1~ 1,""<1 or 1,0 ho I'HI,II 0"",1, uXI'U1101lHt fur 1mrlnl !.I'IlIlt.n, t.ornl"I,ol1dO or IIrIlVU'I!Il'kol'H, on<l 1'011- glol'R ,nrv10o.",11l'0IUI"'"IIl'''"''' ,or 1110 <10,,1,11 or, tho <loOlll\Ol1q Iloh!.n 011<1 0101rnn OWI1111 111111'1111'1\111, fit tl1l1o of' dOl\(,1Q' I,IU!:OH uno1'lIo!:1 ehurp,ullhln f'nr pnrlrlll prior 1.0 ,tOt,oltontl a (lontl1 (OXOOlll, Ul0HO (\l1tl\'t'I.\{1 11l1fh,r8ooi1on oot"of Uw {"hartl,unou I\tJtlJo;lit,nt,t1 11'11" Ant)J tnl(oUlol''wil,h ,II fltut.olllont, ur on11nL(lT'nl 1111l.lgml "01' nbl'lgn- ttollfl, t,f'nny. It. Ifi.II)l;1'I'Hll t,llI,t, t.l\O I'lltt!ctld'y wt11 tl1ioRnnL,tll'Oof,' nf fUtirt olnlillud nhlll~litln"H \l1'on ro" 'Iunnt, I.hi,t. If t.h" """l\IIl!. 'Wh,"flY p""1 In 'Rol.I,lllmontnf ""Y reo, oO~lrnlRtilon or rllllll. 18 1""' I,holl {,ho oRti~nnf,(Ht nmcHl1tt'(\lntlllIlUli Hllit nl'toWlllt, thnt. 'tho anmu w~l1 Ill' rOl'ortort to 1,110 l\ogtRtJUI' of'\HI18, fmd t,hl~tj t,lio'. ttlttull11t. (II' I,UX i\H,HllftHOil nil" hu l'nOSA,lJfHJlll\ t 11 llocordtl1lon UlottOW 1 U1I Thllt t.ho I.ll\,ll1ll 1f1' I,ll" "PI"'"j'I'lot." notumulI In Hollollulos '^',' 'U', "0', 'I~', on" '1'" "" "trout'''1 thor"h\l hnvo iinoll (lurl'I~{t f'Il1'Wutll, Ulla pl'npol'ly i'o~lHt,orO(\ tll t,ho SUIIUl\f\ry. ' SubPCl'lbcd and sworn to hcfol'o mc this . ,I). , , ~,~""",~t\":i"""\C'\,S ~,)"d,""l' or,;,~Cl~m1'~r , :~""~~~i~i\..~<;: ;$.\\' '\:\'. ;t,...~I" 1i,;rG~.!'!JT\'.JhW~ .,..".-zdd.2t4~;;;t;;~,,,,,,,,,,,,,,,,,,.,, ~JI:IllIUllllllfAdmlll18trat01') , ,..~,kl:4"jlP,;:,~"1l9,,,,,B,Q,!llo'l... """".""":""""""",,,,,,,,,,,"',, (Street l')"umbor) ... q,~;:,*AIi!:!'!i\.!,,,r.,!:!',.,....,,17,Q,~,~.,,,,...,,.,.....,,,,,"',"" , (Cltll or Tow>> and St4te) NOT)!:j l\Hf'nliu i'41"-l1ll1g jtf'f'IIInv1 t m'llko "'HI'tI Itll hlnlJk f;PUIHlft in tho nt'fic\uvtt. unci twhntllllf'''' nnnoxoflnro 1'i11o{1 III, wl't,h clnt.tillH nl' t.ho \'illt'(1 "NOlin"', tlHlt In oHAO t,lll.1 IHIHOt.R inolllrlo ,,'n1'o' lltlf' ttnllRtOf' ftoollrltloRJ 80tJurllluM nf' ol(iHO lit' f'11I1il,lY IHlI'lW1'Ut,!07\A Ill' nit IlltoroRt III ,1~n~',oo"n1't't,I\OrKh'J1 Or'h\IMI1l0NA, Ult\t tho dntll ntHI Ktnl,OfJ1lllltK 1'11111111'1111 IUlllnl' tho PII1"\ftt'l\pl1 Rho\'o 1'llllltlUI\ t.o HollOrhtlo "It" f\rO nltnnhO(I. A1Ru muk" (]f1rt,ulll that, ,(lllluoltl lit III thfl "~HI1Ulll\lI~,11 hllH hOl1n 11rOporly;coml'lotnd fifl nhuv,o"llIrflot,lilli ....'".....,..".,,,,,..,,,,...' 1\l..J~, QOUTHAI.H' 1'(,)1 ',';'/.i;:',j~;: lli/lli;:llll 00, MY COI.l;.!!; '!L'H i-",'JmJ IWU, 10. 1OQ1 . . 'nce-VI' ~.~.~ ',;-~';':j' .' - - "',(01 .r- ,j.J~-o '1!, , ~""": ('\1' ' 1,"-., l:"ky...'l.' l'IIMMII:iWV,\1.'I'11 IIi" \1,'NN~Y1S,IN I A 'l'I\^Nl'iI"I,'1l I,NIWlIlT NI'I': 'l'IX Hnl!i;;lllilll': 11('" 'I'll IN~II':Il'; 1\1l:l'l\I1I,:N I' \II':('I:\WNT I. --- _._--_-.--..._...~ -, (1) nllllhllHHIIIIlI. within U\'II rUlIl'H ul'dflldJll 'nlllkf, 1111,\' (,l'illlUI'IlI' III' nil," mllLllI'lnl pHI'l 111'111\1'0111,11101 \\-IUni\l1, rt1tllllVlllKil \'ulllllhlu HlIllllfhHltllll-II 11llllltldl'l',I'I.11l11 Ih(lI'III'~I1~';' -(MliiWlll' ~'II!,' (II' lIu)_.;.,N,CL..._' OJ) Ilt" ll\!t\lllh'llt. wi !.ltlll ,two Yi'lll'H Ill' tlUlltll, 1.1'/lIPil'np pl'OPIlI'I-Y ("'0111 hIIIlHltll'- tu II I llit;ul I' unci 1111\11,11111' Ill' ot.hUI'.K (1IWIIllIlIlI~lllilllltlthl) -In ,I"lnt IIWlllIl'Hh I 1''0' L\II'iWil\'YOH Ill' llu);..~ltQ,,,,,_ (II) 11' t.lln IlI1HWU1\ t-ll (1) Ill' (U) I\IIIIVl1 1"1 III Llln nl'f'II'tllllll\'fI Htl\(,ol '(II) ^I~(i -11"1' ituntillollt, III, t lIun Ill' (,I;HIIi/fltl' _~-'n._'-'-;---'_" (h);,HI:"tn n(!'(hni!'lduIILIH huulth lit I.ltltB fit' JHi~klllp.llln l.t'ltlH;f'I'I', (Not,1) I), (n) (:nllHlI (1(' thlOl1lljlllL1 K IltlllH" (Not,l! n. (,\) IlJdtIOlH1thl1,It'1 III hiM 111'111.1UlI'l l1Iulw I\tly 1_I'HIIHf'(ll' of' tJ"tllllll'I.,V If, I t.hutll, l'IHHllvttlJ~ /I \'ll1ttnhln or luh1illwto IwnAI(I{ll'ul,lnll l.l\1I1'flf\ll; whJull WIlH to t,HI~i' ,,"l'i.telt, .In I'hHHIlHHIClIl 01' 1I1l.lnY/IIIII\'1. nt, fll" fl('Loll IilMCt~'"th'/ (AnswlH' )'mi lit' hn)~~...,_ ; -, (tl) WitH UIUI'n fillY l'oHHlhllll.~' 1,lInl, I,hll llrfll'ul'ty tt'tmHf'OI'rllfl l1l'~ht, ,'ul,tll'lI 1-0 tt'l"l~f'lll'fll' (iJ' 'IIIM UHl.ittO, ('I' IHI 'HlIh.l(lC\I, I,(J IIIH 11Ij\'l'(t1' 01' 1III;I'(IHIt.lI\li'~ (AllliWfll' yi'!; Ill' flo) (l,)'-WIUIt" wi," tho tl'/IIH-i,l'u I'll II I !-\ lI~n .lIt, UIIII! Ill'. IItlnfHII1IlI.1 H dIlUI,h? ---:--,..............- (n) IUd llnoelllul1t. lit III H I I f'lIt, I IItU 11I111\11 ~Itly t,I'/lIIM f'ur wi t.li(ltll, l'cHHlI Y I,IIA II YUlWlhl" Htl\ludolltlll t,u (j(illH I "oru tllIll t.lwl'uf'ur IIWhll' wltl nil t.1'III1Ht'111'!'t', Illojl'I'IIKH I~' 01' I lItJll11l111 Y 1'(tHOI'VOH 1'111' III H "111'11 Ill' 'un~'llo!'llul Wllloll Ilno" Hot In f'uut, filiiI' lIuf'ClI'" hi" fin II t.!t1 ' , (1I) 'J'lIn pOH~nHHlfln C11' nll,lnYII\OIl~" (1(' 01' t,tlfl l"l(H~, W Inf!(~m(l Prom '''lit; I'roJ!(II't)' t.lllmHf!(1I'rnd't (AIlKwnr YlIH II" flU) ~~~.. (h) 'J'lln ,1'-11-\11(. t.o' ,ltltil~f1l1t.n 'Llli' l1i,rHnnHWl10 HII'lIl! JlflHHHHH fir f1Il,loy t.llll proplll'l,y l,I'HlIHI'111"'(1t1 ClI' IWlnllllJ Lll(lI"lI"I'lItll? '(AllKW111' ~(IH III' 1111) _._--MO ~- ' ' (0) If' thu nnHWU1' tu (l\) (II) nhovo'IH III t,hn Id'f'trllilll,I\'f'j Ht,nl.ll whllUtfll' Lhn 1"~lIt WUH l'OHIlI'Vncl If\ 'c1nnodoni 1\1 ono, ,,)r 'u l, IIfJIIH _.__.....~___u._~_ -- .,', -. _.--~-_.,'--~~----, .,..--......----.~~ "-'.---<" .---~.~-_..-. (7)' '-UJc1llnOfHII1t\L IIl.htKllf'olllllfl mnkn II U'/lIlHf'(II', thO'(~OIlH\fllll'lll\nll fill' Whtuh WitH .!J'Ilf1HI'OI'l)C)' H'IU'UInIHO 'to )lilY t1\IlUIlltl 1.(1 III' lhl' t,hll Iiuno"lt. lIt' lilli'" 01' t.I'/lI\IiI'llt'()rfl (J\ItHWIII' YI'N 01' nu) ~2.-..._ Hi) Did dnOUllutlt, lit IHI~' t,IUIIII t.rnllHf'fJl' 111'lIpul'I,~', tho 'hollol'lol/l1 Otl.ltl~'lIl(lllte,f' wlllo" W~lH "ulh.J(Hi,l, t-o ohulIgo, 1l0tHtlUlfl () I' It 1'~\_HOrVI'd IHlvmr '1.0 1I11.tll', /IUl1'IId, or I'll\' (1 I(IJi- nl' whl(I\lllflltl iI' 1~!IV(q' t, to IlrlOClllnnt U1ulol' t,t1rnUi Or t,rl\llRI'or nt,'IIY UIHlI'lIl1(J1I n(',JIIW? (1\I1HWHI' YHH til' 1111)_ NOR'~___". ' (n) Irl,ho .nntlwnr t.o (H) n\lflvH Ii-\ III tll" II l'f'l t'Il1ltL,tVlll WHH tho lH1WOI'Ln nll,Ol'" nlltondt fill I'u\'okn t.IIO'.lntvI'''' 0~1, ul' tho hUt!III'llIllll'y_",..,.urvt!,1 III 1,1", """,,,Inlll. ,,'II'"fl lIl' \.I", 11l10lllllllllOlIl,1 nU""..'.1 ' (Al1fiWor, YOH ur nil) _.....HQ~-r.. ' NOrl'l~ 11 '11110 nnHworM to t.lltHtl! fl\1~I."'Lloll'" ~hll\lld hn Htll1IHII'LIJI' hy 1I"I'III/lV' t. ll~'; t.ho lIt,t,olllllltg phYFllotl\!1 118 I woll tiff n, copy ur t,htk,tQ~LI,h Il(Jt-t,II'tont,llt , NOJrJtL 1)1 If'Un~W01' Ln IltlY (It' t1ln l\tlnyn II\llJHl.loHW h Yflli, Mid, rOl'l.ll hn,luw II (ltHHlI:.II't.lnnnf' Ut~ l'rcJ1H!rL~( trnnaful'l'Uttllt,IA f'nll' l11nrknt, VH11111 III, c1nl,() of' (IUIlUII tllI!.ll," of' t.1'lln~I'f\NI !inti to V'hlllll t.I'(lllfirul'1'cull wIth ,rnlnt.lnllHhllJ (Jf'jl.rllll~f'orooH t.n (hlO(ltlol1t, If' 1I11Y~ HlIhl1llt CHIllY of' '''l~' l,rll",ti-;JlIllll or tlHttrllllllHlt,t 11't;I'f1nH"" 1'OfA ""I} iHIl'll1Illlt t,(J \in 1101l--1./IKHhlfl,ulHO Hllhllllt dnl.ntll1t1 HI,ltt,tll1\flllt. nl' fllnt.H 011 whlnh @1I11,1 01(\1111 tH1JlI!iOrl. No'rlC III I,tMt. npplll1/1hlU 1'I'.nJll!r~,y .holllw III Il1lttHlnr III wld(l!l pl'lJvldnd.\1I f'i(lh(1llllr~s' At III nr li:. oo:_~-,-=~~o;:-~,=r,.,:;u~o;..-~...-,;-~..;t'-,~:.==~..,,;n...;;i-;,..-.l-=-':-;:::;;c;=~~=~::--;:;:;::;::~:"~' ; ITlm IH>:HOllljl'I'llIN )t1\H!{t':'1' V ^Un'~ , W.I,I",llt''I1) 111~I'T, V.\1,ONl',ION (ll"I'\.' only) NONE -.........--..,. N,&nC j ~)1f1r IUAHrt, t,'-'IH t,{11,ll! 1J1I110M.ltn "il'rllllflf'ut'H", MHlll1llqtll "en III l-lIil "^" HOllur t,ur,l" 001,tll1l1llll1 "'If! I'll H 1"':llItJ~f1 tll' till H l'jj!.HI'lh " /;j . . ROp.)7 ~U.63) l'OMMONl\'tl,\I.TIl '~' I'tJNNN\'\'I.^NIA 1'lIANSt'llll INIlt:IlI' Net: 'rAX IIt18I1lt,N'l' IlI~l'I,:tltl l' SCIIt~I)LJI.1\ "I)" '* III~N~:lqr:IAI\ I Jell - -. '", ......,~'"- liNi.M'ION8111l1 HUIlV IVI'1l - IiENmFlCIARltn8' ANO'MllllI~A8~:!l , W '8ltll"~ '11c1rr. or 1II"('t'IW~1' IIA'I'I\ lN1'I~Ill'.Il'I' Ill" Statu rull 11~~iPK naIl alldronKI'A or !Ill whn I O""lmo(~ 0 II dron s'I'A:rl,' \-1'8 01" n~Nt~"ICAAIIY 111'0 an lotol'ost, voutod, oontlopaal.' 01' nthol' aro \nv~ VOt ,IMO\ ., ". ," 11111'1'11 N /11' 'rl~ " who. ill oHtutol tort 1 t IlK fAO") 011 NO , . 1 Iii Re:Lth A:. 'Mentzer' , son vas . 3144 SDrtna Road , , , ' , , , O~r1t'S1e, , Pt\. 17013 , , " JOhn'Mentzer .. A"n , ti..... , l/A %Miahae1Zderlitr. R.D.. : , , " Boiltna Sbdnas.Pa. .' ..,' " , , , Linda Gtbbnev , dauahter \lAS , ',1/4 ."- , , 3144 t;lbdnrl Rdlold ' , Oarrisl,,: P!l.. 17013 , , , ' , , - c John H Birla! Ann "AA /4 share - 1165 , ;- P. O. Box , V,idor. 'rexall 77,662 " , , I, , , , , , " , , " , " , " , , " " . , , " " , , ," , - , , ,. ,. , , , , , , " , " - , , .' , , , , ~ , . '" ,,' " , , , , . , , , , , , " , , " " ,,' . , " r,f , '. . " - . , , , ' , . " " , , ," , ,,' , , " , ! --;;, , , , , , , , .. , , , , -- . , . ~ ( h lJaj1on~nt f\\rtl,or SIlY. thot nll tho ahovo.Uofl\ad hono,flolnrios lira ,ll vinl! at thls timo oxoopt bolnwl NAME PATEl ot' DI11ATH nmSIDENCE ,,~ It' III I ~ " SUMMM\Y lIulIll'rollurly """",,"""'"'''''''''''''''''''' ",,,,,,,,,,,,,(Soh, "A") l'!lrS!lnnl Pro\lor\y' "",,""""" ",,","'" ,,', ,"',,"""" "",,,,,,,,,, (Soh, "8") ',Trnl1sfor8 "i""",,,,,,,,,,,, ,,,"""""",,"'" "","",," "" '" , ",,,,,,,,,,(Sch, "0") ,~"".,"n""'''''' ".;,."". .'" ""..... ''''. -""",..,.".."... , ,.;";,...........!'"".,,,.. ,."..,.."""..,.,,,,,,,,,, ",'j ",,' , ... ,.ft . I ,-I I (1) (As l\('llnrt(lll) .,00 . "J,~.9~.4",7,a "'''''''''''''1' . ,',,' "'," ."""",,,,,, ,,'"'' .,,,~,~,P~4,73 " (2) (AN 1)(ltutmIIlClI) OrORi 1'nKlIblu Estlllu ""''',,' ",,,,, ' . $ $ $ . $ '" ;J l cu' .-I' I Ill' ...t, . It) M: ~, IJ'l ~ ~i 1 N ~ ~ lill b r ~ ~ i Ij;j' ~t . r-l 0; Ii I' " N t>1 ~ ~ .0 ~ ~ ~ ~ ,l:ll ~ 8\ Q;, \&;' ' ~' I . .-..~ , 0, III 0 o<ll ~, 13 ~ ~ m' ! 1 8' ~J 11 B :!l "eI !' ,,-, 2:1 j ,/- " . ~cc.lft, " , ,'* COMMONWLiA';I'1I OF I'IlNNNYINAN'A TI(ANSIIIiII INIIHlUT/\NCIl TAX Ill!SIUIiNT nIlCH\lIlNT SCIlIt\l(JI.ll "E" JOINTLY oWNtm 1'1l0PHllTY 'IN8TII1ll1TIU/OIS, Thla "ohltllulo '",Ullt dl"o\lIsooll 1'001'01'1,)', rool 1111'\1'01'0'"11\1, nWlloil h)' \,110 II0QO'\01lI. ,llllnLly ,wI II' lIiwlhor III' III,hol'.,' IlIollllllnll Intunstblonl IItlllllllnll III MIO I\Omll 01'. t.ho ,Iooodolll. UI"l othlll'." 'oint r"1I1 Ilstol.O ('I,rlll" 118 o"I,lrol.los, (IrJolnt tonllnts, Mvh,ll brIo)' Il0Horlpt.lon, 01 hllUMI."d 11I1l,llIr 80hlllluIII '"I', p1l11 UIO 111l1,lIllhd,fl11\~1I of rooord 01' Instrillllonl, olTootlnll yon\ltlll'o,'IJ\lt 1101101. Illeludo,ontlrotlllH IIr oul 'III' ~tlll,o roo, ',," 1.11 to yulllO In 0111,01.0 Vlllul,tlon, olllumlh I'orlonlllflroporty nll(lIlld bll lIstod ns In ,8ohodulo "II', 1'11111 dotll"lIf ,1101IUI"1 \lon, ond thQ nomo, ndllr,u8n "ndrlllntlonshlll (If' qll~) of, oo.own~r. t.o ho Ilooellllnt, ' , . PollorlpUon 'of l'ruport.y, potu of' AoqulnHlq'I,Nomo AddruKs olld 1I1l1ntlonshlp of' Co.OWllor., nnd \llnoo of l\lIl1orll'of lnatrl m nt who 0' l\oQll'Jstoto, Unll. Vnluo floroontogo Shur" l'Jetol,o Voluotlon PlWA,I\Tll/lNT VAJ"tlM'ION O^UTION~Po nol. ,Wrlt.o In ThIs 8 ROil, Voll'o of Voluo 01' Inn U ro Pooodoll t' ft Pro ,art 1111,111'001, N~NIll " " " ' " .Ihlort this toto!" oflllosito "JotIlU)' OWnoll I'roporl,y", 8ohodulo ".:" I",tho "As I\ollorl.(}~" OOIUl1tl on UIO lost !logo or this roturn, N.J.17N Y~di' . AU V-4n4 tnonl 5UMMARV . County, l'Iumbor ond MomoJl - OUmberland I'll" N'Inlbor ..2k7j:oQ5;!5. \Jotll of Doall; ~....i~tit.mll!!r.Jh 1979 11"",. Mamo M,ntUL ._...1olm II.MT N~Mm (~II"T N~MUI - 1.1-.- IINITIA~t COMMONweAL TH Of P ENNSVLVANIA TRAN$PER INHERITANce TAX' ResiDeNt DecaDENT RIlPORT OP IHHIlRITAMCIl TAX APPRAISIlR , I, tho undll,lgned duly appointed Inherltanoe Ta~ Appralur 10 'on~ for the Counly 01 O~b.l'land '" " ' P"","yl.UlI!a, dorupeollully roporllhot I hove appralud Ihe reol aod perlooal properlY a, reportod In 111.0 10..golog."llIrn 01 tl.., ."Iuo. lot lorth oPPo"I,o ooch Item In tho 10~t oolumn 10 the right ,In 5chodul.. "A' , "B", "C", and "E", . ' 'P.tr.1il ~ vapUIU'Y 31. 1980 iF! .. , ",," j j ) , _, Li 'I ill / .. /11 iI _J/,,- / INHtdtlTANctt TAX ApPRAHI\Ht .... ~,T:~~'~'~~ BEPORT OP THE REGISTIIR OPWIL.LS I, tho ~ndonlgn.d duly .loolodRegl,.erol Will. In ond for , . County, Ponn.ylvanlo, do re.peol- luUy I'.port Ihot I have allowed doduotlon. In Ih. omount. olulmed by deponenl, .xo.pt a. 10 Iho..ltem' whll' a grool.r or 1,,>1,1>1 u",ounll, ..tlorlh In tho \001 oolumn 10 111.0 rlgblln Soh.dulo "F", which greal.r or 10..., omount 'ropr.untt th.oum ,<,II.o"..lulo d.duotlon. PtIH1lh".....,_ AEOISTtIR 0" W11.l..5 INVCNTOIIV VALue A8 APPRAt8BD ODS'II1NdM,m'lflJBe ONLVI 00+ 10+ 20+ 30+ REMAINDER APPRAI88MENT CODe' RUlli PI-Iltl/lny (""hodul, A) P'rRnn'~I.'ruIJOrtv (Soh'dute B) Jol!\t+I.lrlpr.pOrtv Illohlldlllo el '-TrlHllihlf!lISQhoduloO! , 1'OTAL (ln08S A88ET8 L'II~ f)ilullI,t,\tId Ooduatl0l11 IsriitiiPU~a PI OI,nM VA~Ua OP e8TATE n 40. VAI-UIl Vulut!lln!l of 1110 "Itato. or .!..- Gnnillthll!ttt I t t ,.,.t.,. It t" ..t~ $_ PRINOIPI-Il t: f!ACTOR \=: - BSTA"" TAX ASSESSMBNTS - $ l!.Q.J:L\IJ'S> 01" RItGIBT.R ONI-V, Ta. on'$'.. ,._ To I( un $ _.... Tcuc till $ Tax on,$ J.;-. .jp')f IJII S. BxomptlmH' TethiLIl"t(!ttl OOClII OOMPUTATION 01" TAl< $ f $ $ $~ ('j A. iovld...~d by Charltablo Exompll.. Corllfl..'.. I...od by Iho S..f8Iary af Ravon.o. , TOTAl. TAX L...,tn.pr.vl...ly p.ld $ llALANCe $ l.,tpii fJ~i;;"r-lnk: If paid within 3 ;HjJutlpi tlft~-, detolh ' $ , llALAtH:t: Of' INHERITANCE TAX DUE "dd tiHIJuiir.tnt rtl.tct, of 6% f,QIrt _~,.,.._P__.....'t(i AMCI'lJtH bp IlSTAre TAX ASSESSED $. e..toll"lllk pnld $ llAI.ANCe DUE AdJ' InluftlHI ul ~ul(J af 6% hanl t. Slll'l'lIlInonlnl Cbd..l (POR usa 1M HARRISBURG OMI. Y) 91i_$ucc...lv. LII.a.tato 411,I,Ji ~.t'1l.nl II'i"/,dlu.tmonl ,M..Annu Ity " 6O~1.110 11.101. 92+R.ma\nder Approl.ol 93~Rema l"dOlDeduollon '9 3C~Charllv ~4-Remolnder R..ldu, \(11, use OF RBOISUR OMLY ADJU$TMIIMTS ~.,.."... '- ' HOU!I 'WI,ore, oubo.quenl adlu,.I\11.nlo are ,made lO,.th. abaye oompUlallon 0' tax by Ihe Regl"Olol Will" lor proper rea.on, oamo ohould b.:r\cI.d o.low, with .hort explanation. + 83- IBW ,. j,., '; ", , " , , ;1 I' I' 1 I ~ a ... ~ I'l C. -t ~ u. 'li1 ~ .~ ~ ~ ~ l - < '~ i' ~ ~ u. .r, ~ t2 I:> ~ L\.o C. a: !~ '"8' .~ ,~ 'S ~ ~ " l :i .... 'S . ~J <> >, ~ ,!!l i j 8 ~ U ii 1/ ,\ Hf,V"4IUI Clhoclft) ) /... f / , .J ',__' '"oJ OIDUCTIONI A~~OWID IN I (.":<..' TNI IUM O~ ,/;,,~ 1I~6 r ~, , llATBPPROVeo ~LJ.<'(1 I '\ XjL, ,. ~ '!2' "(';i , ~- -- .v",~. -'-..0.0.-__ _!~~laTa" 0" wh.,l.tl, MJ l!'~ T orr Ice O~ Till REOlnER or WIl.~1 OP _Qumber,land cOUNty AND AOI,HT t)r THE cOMMONWBAL'rH , S'l'ATElMENT Or' DEBTS AND DEDUCTIONS ---........-- ~-t- , , . . .. - ~- - - ....--.,.. ---... - ....------... ,01. Tft HO,O~ NAMS O~ PAYU RSMARKI AMOUNT VOUCHSR ~--,.-. '1'<--+;''T""~ -_ .B.!l\l~!l t: e r of W illll , of ~dmin!str,ation', , Letters -~- '_.....,..~....-It.~ ~ , .---- --- " Short Oertificates 32 00 -_1-'_ -"--<--+-<_........,.6....._ ..........--- - -- - -- , Cumbsrland Law Journlll 'Advertise Letterlil 16 00 .........---.----,------ --<---T--'n_.__.....___r. .-__H-I_______...__ --'.'- r-:_" , i ., Cumber land PUblishers. ' Inc. hdvert:l.s~ Letteu 16 65 -_.._-;~~ ..,,---.........._""......... -~- ._.............;;- _..to " " Darr"Thuroma Ins.. Inc. Administrator I s Bond ~ -.QQ.. -. ---.- Koffman Funeral Home FUlleral expenses 2,61)6 ~- ---... " , _Br.istol Memor ill 1 HOSDital Medical reoord .. , 5 00 - -~-.,......--- .. ------- ----------.. !.!9'hter Q! Wills 11' :l.ling Inventory _---.c~_ 00 'e, , --- pi " , Exxon Bal. of ,A.cClount " 7 04 - ....--- - . - PennDot ' Tra,tl.sfer of',t'itles , _l!L 00 " ---. ~.l... , " . Regil!.t.er of Wills 11' iling Appraisal 3 00 , ; ___a. Reserved I , -------- ~- ~Regi8hr of Wills Filing Debt.s and Deauotion$ 3 00 ---~ '-"-+;."'--- -- -*.,-- '" George 11', Douglas. Jr. Attornev I s fee , , 956 '24 -- --- - , , i: Lavana L. Brechbiel Notarv - - '..... -- 7 00 ~'''---,-;~. - -- , ,. .. ~,-.--- _..Bl\lgist.er of Wills Filing First. & Final Accoun 35 -9.Q.. ,_0.--;____ - , "-- '~-:-r:"'.~7 ..:....-"~..f.... .- Cumberlandval1ev , ,- -- , I Memorial Gardens , Companion bronze, mElmorial 1,440 00 , ,.,...-ri_~.-----J':'..~... __t..__ - - - - '-'---~.'..;-,..- '-......-...........--.-............ ----.........---"-.. , , -- - , I' " ~----~- .'_~_"'_"''''~b. ~-,-,...---...-----..........-- '- ' -.....~ ......<....-............ !-"-- , I, ------....,.... ...~~.--'-'+""..... ---.."_'+--;,_....,.<--0.--__ -- ..'----.......... ---- i -" , , , --....;."..............- ---.______....H_~. --.-.....-..---- - , .- ---------........"-- - Tota 1 - 5,286 96 r ._,...... ~=~n~"'_"_"~'l.;!:.'~-,.~...;;l;;l;:;"'-~=.':;[;.-,'_~...~ .. ~~t'"" - . - .- -~=:-::: -~"~-J_h~=_~ enA TI! or JPtIN A. MIlllfl'Z/llR \. DATI! OF mlNO APPRAISllMSNT ~ {&", 'c/' ~An O!'.....;.Borouqh 1(( I?l DATil O~ DlIATH of Car1:l.s1e ---;O~-----r"" Sepbember 6. 1979 COI,\MOHWeA~TH 01' "e,NNIY~VAHIA I CO\!~TY oP..9..~m~,!.;'.land _ SSe , I, -.~--...~~--"..Kdt\LA._MliI~_, __~ HaRSDv CQ~TIPY, THAT TO ,1'HE IIEST'OF MYKNOWI.CDGE MjO,nE~lllP, Tlla POREGOINO IS A JUST AND TRue STATllMUNT,OP DEBTS, PlINERAl. EXPENSES AND BXPENSES or ADMINISTRATION SUBMITTBD TO THBBSTATB op_..!!ohn ~. Mentz,er__~~~___ oaCIiASBO, AS OBIlUfTIONS POR INHERITANce TAX PURPOSES,/ ,0' ,. d,,' /',"":', U\ \. ~a-# )?2..?fz) (1..$.) R~ AND SUllSC IBD 'PORB Mil THIS ~~, _ DAY OP, ' J.!!1uar~ ,19 , ~~~ zPltl) i -~ 8~Q~~ o I ~u '" ~~~~ 8ffl~o ~~~~ ~[:j , f,l 1~i1Tl', Pr]n""7'-rii't\'V,~ !,no:') ,'I ,\) (, I I J.)f 841 ~B '411Mn,ni uOllnql". It> oln .p040U PO\!OdOHi l/IIM '1'.'IU"P II, ;-"11 1I1 PftU400P lIuunqPlolP pllll ~llf"'lO'lqe Pe",'"if"n luno"o""':i';:~l;l ";')//':1({, lIJ ; .88 ~F:l ~i~ {:j{:j~~ ~ ~ -s ~~~~ P:;,~ - fI ~ '. ~~ ~ ~1{:j !l . " ~, I \'.l~ " 1.\ " ~ \,'" " '''' ''''1 " (\ I ~'" 13 ~ ~ ~ f1< f " ,; , " li " Y.' " :0 " :j " II! i, , , " '" I~ " , ;) ., : ;, " :!I i c', " -:-1 ( ,,, '" , .Ii ~ "-~ 0. ,,' ~ \, " ;1 71 .I '" , " '. ~ I ," Xi .. , " )",. (!) ~ " , ,~ J , .,0 " " " " ::J .~ H " . " 'I' " " " " :: .' , I 0 ~ ~ a " .Ll C[~f . 0 ~ ~ '.":) " " -, " I,., !i i ')', " " ,-<. H , L&: 0 '. ,,-, 'Ii 4. ~ Ii ~ '. I " " " a ' H- I ,', \, ~ ' II. , " ,;i '" liJ !; '-, ;-j ~( , : " ~ . " " :' (!) " ,,' .; , : , .. II: " ~ " 5 ,,' " ;:j , @ " f,'l , !i ,~ i, '.-, " " ::j Cl " 'I' : : " .r! !: " " 'J I , ',' " :1 ." " to' , " u ;l , t-l lQ H r.. ,jJ " '" , '/1 ; ~.,~ l:~ , . COMMONWIALTH 0.. PINNSYLVANIA I' COUNTY ap C\lM..~J.AND J Reith A. Mentaet " "' '--"'-'~ -"'" ...,.... .".+---.;,,~ _"~4""""'''_r''''_''_"",, ~,_ ,_ ___T" .ii..__....... .'"+__h.__+>-___ , ~.....,."~. ~-,7--H_. --~--.n---.--..~.,.->~--......-~,.-~~._."'.........-..-~--.......,.l--'-.' ~ .__" ,. q~ln~ ~41y ~~.8wo>>n-.~~...,~.~o'oordln; to I~w, dopo.~, ~"d laYI that h~ b.-tJl.."..~.iniattato.t'~__ -+~.'"'.-",~~.".~:.~..-.,:,,' f .. ,.'.'.. -~- 01 theEltalooIJol1!L~~ Menta.r ',='--___ I~te 01 .. ,~oroufjJh' 0 Carli 81e, ...... __, . ..._, CumborlanJ, Counly, Pt" deooole~ and t~tt the Wlthln,h,an InventorV mado by "'I<.~th~A.,M4mtluu:..,__ .;"" ..._.uc"':"".', the lald-A~.:Ln1a.ll?:A.tC.t'_ 91 tHe ontlroutate 01 laid doo~dent, oonllslln; 01 all tho pmol1al prop'dr,ty end rul oltate, exoopt real elhl. ouhl~. ,\ho Comnnonwealth 01, Pon",ylv~nla, and th~t tho Ilgurosoppollto uoh Itom 01 the Inventory, ropr..ent lt'l laIr value u 01 tho, date 01 dO,oedont's doath.' , , . " -.,...!iovemQ~.:..._. / t,' ~ ~~C.,: ..' " "'~ Notuy 80 19__~ ~"~~',#~~.." , ,.,x..,~3"~4'~~, _."....-"__"..~__ x:H!!ltttttHx Admlnhtrlto , ' "Wl'ltOn ...tQ..and lubmlbod belore me, .~_.,~ ~-.-o~.,_____....__~_.__~.........__~~_+~_~. ANNE M, r:OX,t!(llnlY I'(Jiirl' CMlIsIU 'c'U1Il1j", Cn, rOiiln: Mv Clllllll1ll1!lhlll f;o:~i1!I)~\ )lIh' 14, I f~ l 3144 SprinfjJRf;'\. " .' Carlisle _a. 17013 .~~..~-;,,,,.,.~~-_~~_l....."+,,,..~~_,___~___~____..~-----.,_ " Mdroll Pate 01 P'ath ..._u_'---~_.._,u_..,-"~.._..~~c..,,,,,:,,_,_._,!,"~~~_~.._.___2~.~_~__.__...:...._._. ' ' DIY 'Mnnfh , V.., ,i , INSTRUCTIONS I, An Inventory mUlt be flied, within throo monthl allor ~,,'polntmont of perlonal reprOlontatlve, 2. A,lupplament Inventory nn4,tbellled withIn thirty days of dhoovory 01 addltlonaluse,t., 3. '~ddlllonallheeh ma~ be athohed u to petlonalty or ,realty 4, . See Art10le IV, Flduolarle.1 Aot of 1949; , ~, 'i) l"! .' 'J , i - J . ~ ~ ,,~ 1 ~ ~ m .~ .-I i "if I, ~ g; ~ . ~ ~ Q;. ~ '~,~ ! . r-. ~j . I<Il Qj jl ~ ~ 1 & ~ '1l ] I :3 E 1 1 ! d it 0, :<1 1;1':-' ~ ~if; .' Q.. tl,:t N ""f i ts , . tlt. ~ , t:' ""j"-, e;II, ,l;J i lnlJ lit" '~~ II " I I j ~---:--'::::::;;;:r~___ .:..... =.;1;;.-...... .. UHNEPIOIAlllaS ANI> APDllQUSES 18tlte 'uUn'lll" .nd addr".." of flll who hlvo An lnterett eUhor Vot,erJ, oQlltlngont cwu'har IntefM,1 BENEFIOIARIES ~.. lleLATIONSHIP TO DEoaPHNT INTHfl8ST OP PENQPIOIARV' IN SSTATa - - - aURVIVED AOP PP LIPE DEOaDHNT TENANT\! OR STAn vas ANNUITANTS all Nn' AT DPATH OP _. ---p'BOHDHNT Reith A. ,Mentzer '..- --~-""'i:.'.1:rJ7:1.nq"'Rd',--,-~-,-_._~ '._"~"'" .--~.." ----~-..... . , , ca;l ~A.......______ J.QD.._____ "'y'es.. _. ,. aotin MentZer , -- g/o , M1'Chlnil--2111~q1ln'T..tt.Do -,..-~.._..-.-.- -'--~--'" ~1~~~ ,~~~~ga..-2l4.7."_'__ ,-aQn__~~ ~ -, "J,l"1t1t'11l5"rtlYq-c"Rt'l-;--- ~~$I PA.~a~3 }(XXXXXXXXXXXXK.. r-t.-.-,_;,,_,,;! .. ., _,-- ~XXXXXXXX~~XXXXXXXX xxxxxxxxxxxxxxxxxxx ~__ _J.L./l, shAre .........-- J.L. \ share - ....\iauqhte ~ _.J.L sh(lre ....JIRR* xx~XXXXXXUX- " '.J' , t. '.;;, it_; ~ \ h,i ...' w,: (.,)r' Q, (III; ',z-- . (" ~l'" N Zt:l ~;;1. .f.i - ffi<t = .",1 ,;jIB I~ I,,, :<:)- ~ ~~';) ~J <..l Ui ,.. ~ ~' 8 'l; ~ ~ ! 2 m Ci'l ~ 0 IS 1= m m 'II, ~h 'II, 'II, ~ '2 II: 0 ~ 0 "T1 ~ ." , ~ I m i g f :;J , .s INfORMAT.ION PLAOEF;OR' FI kiNG - Th~ return Is (0 ba fllo,llnduPlIoRlo with t1w Roolslor of Wills of Iho oounty wharUlntl1D daoodllnt re,slded. T.IMtl POR PI ~IN'Q;" The return Is due nine months ~fter tlw d~?edent's doath, unlsss on oxtenslon for 11I1~p hbs boon applied tor and grftntod by tha Seoreterfof ~ovenue within the nlno,mol1tl, porlod, . . , FAILURE TO ,PILE ~ETURN - Seollol1791 .of, tho 1961 Stetllto provides that ", . . any person who willfully felll to f1le.ft return..or other report required bf,hlm " , sh,oll (,0 perSOnally lIab'le ' , , to R pOI1~lty of 26% of tho tax ultlmntely found, (0 bo cilia qr $1,000 ,whlohever Is the lesur to ho rooovered,Pv the Oapsrtmont 0' Revonue as dobls of like amount Rro reooveiftbls bll law." Il~V,~'1 \1,.0) COMMONWeAL TH Of peNN8VLVANIA oePAIITMINT Of nlveNUli TIIAN8fllllNHIIIITANon TAl< IIIBIDINT DeolDeNT SUPl'LllMlm'fAL INHERITAN(fF. TAX APPRAISEMENT '*' ._-~-- ....... J.II Estete of MENTZER, John A. Fllo No, _ 21-79"0555 !Jounty , Cwnberland Onto of DOllib 09/08/79 o IIWO lit *oY 1\ 1\" 0 "11 0 t . ..lItO. ,,,,, "". 0 "0"'''' oil or OIl oym'"1 10 ,011'oi'l;;';iilioTii7inr,; "...'1'01.il.tll!8 .~pl'"'lb" 01 10Y 1111" far 1111 or 'or YH", thl Commaowolllh hl,.lIy "p'Hlly ''''"Y'' Ih. ,Iohl '0 ,,'p,.I'" ,,"I....... "o".lorloll.,lIoo" I.... ., II.. 18w1111 0011,'."1 r.I. ao 10V .uah lutu,. 101..111. " .--.. . ~-"'- ' , . I " I j I , I , , , , , , . , , , . , , , , , , , , , , , , , , DEPARTMeNT'S A RAISED VALUE None 3,100'.00 None None PROPERTY REPORTED BY THE EBTATIE -..-,- ,_____0..___o--.........---...........--.-. 1, TOTAL REAL PROPERTY - 8CHEI)ULIl "A" '. . , , 2. TOTAL PER80NAL PROPERTY - 80HIlDULE "B" , . 3, TOTAL 'tRANSFERS - SOHEDULI' "0" , . , ,'. , 4, TOTAL JOINTLY OWNED PROPERTY -' SOHEDULE "E" t. I I .., ,. I' I j I j l' \ I TOTAL REPORTED PRO~~RTY PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH 3,100.00 -~ ..- -------~- ----- - - TOTAL UNREPORIED PROPERTY TOTAL GROSS A8SETS 3,100.00 'LIFE ESTATE OR ANNUITVCALCUI.ATION -~ ---... , ..---.-------.--...-. .-------- -- I do horobY cortlfy thot the ,~l;;;v;;.apprili.;;;m;;;\.i5 modo 11'1 conformity with' Ponnsylvol1lil low and, hilS beonfllod this dilY with tho Register llf WIII~., .) _~'(f'J !'Ii'!~ArJ,I{i , fWPIlAIBEH .' ~ ~, ~ ~ ~ (;) I t-t ~ l '" . ..l ~ I ~, m a ~ It'\ i,' ~ 10 N l"'l' , .... ~ ~ "" , (;) ~ 0 ~ i ~ 0 ~' ! ;a:, z i ~ ~ ~ ~ ~ ~' " I.', I" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION COUNTY FILE NO:.i!2. I " '/ (1 J ~ ~~~/ .. ;"." ..;, Appraised Valua of E"ola: Raal Ealala Parlonal Prnparly JolnllY Held propaflylTranafera TOlal Ciro.. Ellala Total Approvad Oaduotlonl Claar Valua of htata Lalli Approved Chnrltabla Examptlonl ClaarValua of EI,ala sublaot to Tax Amount Taxablo @ 8% Rata Amount Taxabla @ ,8% Rilla ......'. Will ba gran\od ,If tha LOll Cradltl: ~ OF PAYMENT /.0.:1- I?/ " DATE ESTATE .-' FILE NO. COUNTY ;? *' , r.W I ~ .~~ ~ \ '. ....- --. . -.., .:' ~' -v CA", 1-h. (k_ ~(,I- '. ,C.<'::'<.' C DATE OF DEATH.... . L 1- t . . . . lax duo . , ,iOTAL..}', ENNSYLVAN.,IA .INI:ll!RITANCE TAX ~UE ),rv.jI.N,J. t;". 1(. /";J :t. '/'. ::" k, Itl / , C' (~.~~ A flva poroant dlooount tolallng L- Inhor!tanoa Tax II paid by . / 9;11 ? t.." ~. .-.__(;:---Y.L, / ''1 ~ 'II( cil:;'iLH UI i.I_:,; l AMOUNT PAID OISCOUNT INTEREST TAX CREDIT a) ?Cj' ?V+ . . . . . 179 ft/ , + . --- + ., . , , tax duo Inlorell Moruaa' at fha' rate nf Ilx 181 paroonl par annum on Iha UnPaid balanoa of Inhorllnnoo To'x from \0 date of poymont. In\orolt duo If paid, by - II BALANOE OF PENNSYLVANIA INHERITANOE TAX DUE l~') ~'J ~J \:) .,:> " " ('t j -~~ , \,-'.... ,~ \""l:"~ ~' -', .J" <. " - - " I<~ ,. " ~ ~'\< . 'U :y -J, , C') cd r.' ~i1l p,-,! -" .'_",.t.l .1. ~_, ma Lo,' I' ;B 111,.._ ,,.111'1 ~~-: ,";" j1.":l "'I . ur;1 .... Jlj :~ :r: ','. I' .1 ,.' . " 'I,; , I.: :.. en ., i ~.'~ ...\ It ., ~.~ ~ ~ ::l ~ ~ ~ 81 ffi ~ Ii : ~ lJJ ~ ~ 0( o lJJ l!) " . 0( ~ I ! ~ ~ \ 'il I' \-.(, 'fJ I \j l''I-, ..!... \~ ---- I I ~ 0;: ~ nfJ [~. 1'1 ..,.U i-h-:r. ~:!~! , (...\1 " -,! ;' ~~ :,~: ,:1':0, ~ -.: ( ,i ~ '0:0 r"m ,."r, VIm "WI f~[l -, 'I "'i ,{';j m ..,. 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