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Home My WebLink About79-00699 I .. '\ ,~ At H ;:r::: t1l ~ . ~ : g , E-< . r>~ t1l 0 " ~ I ~ A ~ t~ ~ l-:l ~ ~ A I 0-- ...... '. . . . .... ~.. :I '& , I~ UI No. 1.1.19 {',;'r , PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY in the Estate of J ohn D~ Landi s , deceased. Harold B. McLane, Deputy Ta R;,-!,o,d c. .A\"dGI~5P1, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania. IS Petitioner(~ lWl1! the executor_______ named in the Last Will and Testament of John D. Landis .____ doted .JlllYJ5., ]976 Decedent was a citizen of the United Stotes and a resident of East Pennsboro Township ~'ff, Cumberland County, Commonwealth of Pennsylvania. Decedent died on Fridav the -1Lth day of November , State of A. D. 19.1l-.., in the County of Cumberland Pennsylvania at the age of 100 years. lOOIlI mlt llll~lt Decedent has not been married and has not had children born to him since the execution of the above described Will. Decedent was possessed of personal property to the value of $65,000. and of real estate to the value of None as near as can be ascertained; said real N/A estate situated as follows ~ Therefore, your petitioner(s) respectfully applies for the probate of the said Last Will and Testament and for Letters Testamentary thereon. Dated November 21, 1979 Name and address of Petitioner(s) Dauphin Deposit Bank & Trust Company 213 Market Street Harrisburg, PA 17101 Bv: 1~1'! ,;-10 );' d if!. . Assistant Trust Officer COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND Brenton M. Hake, Assistant Trust Officer of Dauphin Deposit Bank & Trust Company named in above application, being duly sworn say(s) that the statements set forth in this petition according to law are true to the best of his knowledge and belief. Sworn and subscribed before ,:'f,. ,-/;, -j) .j'j,h Assistant Trust Officer of Dauphin Deposi.t Bank & Trust Company /c~q. me November 21 19 79 , I '\ -j -, '--<, '- 1..) t ~" ..J_ h,,'f1 - ,\...j ? ,: ',..- "'-)' I . ' .,.....-......J.'j!: (, '. "..' t1M01~ B. Me ~ne. trlU1U9' pi\' 110 d C. All t;;hJOII, Keglster November 29. 1979 Attorney: David S. Kohn ;;, i '/ /, ~.~) '" 0 !:: Z :5 :r: z I o ~ ~ III ~ ~ in ~ UJ 1-" 11'I ell ~Clll'lxz rIl ~ ~Z~~~ ~ o <: B 6 0.. ~VlO~lJ ~ ~ " '" "" . CI. " 0 - ^ " R > - '" :j ~ <: ;( ~ Cl '" < ~ ..., :r: I ~ ~ JI , . . . . OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA 1 ss: COUNlY OF CUMBERLAND r This .....................................~~.~:............................... day of ........~.?::~!'!b..':'.:............................................ A. D.. 19..?~.., before me .............f:I.~.~.~.~~...~:....~.7.~.~~!.~...~~.~~:X..........................................., Register for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came ......... JI.!\)(~!!. ..~.,...KRh)).. ^. .....QI:\!!!... 9J........ ................... ................. ............... ..................... ......... .... ...... ...... 4...........................................,..................................,................,...,..............,.....,...,...............................,.................................... the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ....................~.?~~..~.:...~~~~~.:.................................................................................... Dated ...~.~~y....~.?!...~n~.................. late of ......~.'!:~.L~~!:.~~.~~E!?..'!:~~!:~.~.~.p................................................................... Cumberland County-, Pa.. deceased who being duly ...~.~~E!:..................................... according to law, depose and say. that .....I?~y.~~...~.:...~!?!:.'.'.................. present. and saw and heard the testa.t9.r............................... ...........J.9.h!!...I!.,...1i!)),9JL.................................................... sign. seal. publish, pronounce and declare the said instrument of writing as and for hia............. Testament and Las W'II d th t' f d' John D. Landis f d d d' . . d t (, an at e (me 0 so omg .................................................................. was 0 soun an lsposmg mm . memory and understanding, to the best of ..................~.~~...................................... knowledge, observation and belief. .............(lWQx'O'.............................. and subscribed before ....~d:.::..................... ~:~..1?:..':m~=.;;j~............... ~~~~t;t ............................................................................................ ...................................................,........................................ AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA 1 ss: COUNlY OF CUMBERLAND I Jlx.~1IJ;RI}...~,...!!.~J~.\'.,...A~!iJ~.!;i!n.t.Ir.!!~!;..9J.f!,sf!.r;...o.LP.!!.,:,.p.\1.!'~. .!?~.p.O'~~.~...~.~!1~...'!-.~~..'];E.':'.~. ~..g!?:....... being duly .......~~.9.r.~................................ says that as nearly as can be ascertained the said decedent ............................................ ............. ........} !?!:!:.. .p.:...~.'!-.~~~~......... ..... ........................ ....... .......... .................. ..................................... ............ ..... died on .......~::.~.~~L...........:.. the ........~~~~.....m..m......... day of .y~.~~!'!~.':.:................................................... A. D.. 19.?~.... at or about ..........~Jl\................................ o'clock, A. M. ..................~~!?.r.l,\............................. and subscribed this 21st ...................................................... day of ..~.~y.!:!'!!?';'.~...... ;' -" .-Ji'. .../J..U.!,~(C!.'=../..1..........~.1-./::~............................ Assistant Trust Officer ,-:J..n.. before ~l.J.l~K)\1.L;)t.(!..,~................... Deputy RegIster. 8(;1 " '. OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA 1 5S: COUNTY OF CUMBERLAND , f This ..................................!.?y..:?~............................ day of .......Nm..o\ulbor..:......................................... A. D., 19..7.9.... Harold IJ. McLane. Deputy . . before me ................................ . ... .... ........................................................... RegIster for the Probate of WIlls and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania. personally came ............ ..........W ~ ))J.,WL~... ..J:l.i\Wk..... .,.......9.!'I.~.. .9..f......... ...... ................. ....... .............. ............ ................... 4..................................."..,..........,..,.......................................,...,.........................,...".......,...........,..................,......................... the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ....................;J.p.hn..'O.....!.illl.cj.:l.~....... ...... ............. ............. .......... ..................... .......... ..... Dated J.ulJl...L5....191.6. .................... late of ......~!\!;!;..!?\!.t:\!\~!l9X.9...^Q!m.~.\1.~p.................................................................... Cumber'land County, Pa.. deceased who being duly .....~~.~E!!................................... according to law, depose and say. that ....\tl,),;U.~.lJl..!l......l;1.?wk..li'.~.$...... present. and saw and heard the testa..tm:............................. ...........JohD...D~..Landis..................................................... sign. seal, publish, pronounce and declare the said instrument of writing as and for h..is............ Testament and Last Will, and at the time of so doing ........J.9.hn..'O.....!.illlilis............................. was of sound and disposing mind. memory and understanding. to the best of .................l:\!.~........................................ knowledge. observation and belief. ............~.~~E?................................ and subscribed before \ . / .. .....................:.(J..~.....~......................:.,.................. \..(.:-.~\.\.,'.h\..\\;,C...~~....................................... \~~~~~~.~"'~................... DR~~~t;r I .........................r..............,............n.................................... AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA 1 l ss: COUNTY OF CUMBERLAND Br.enton..I1....Hake.....l\~.~~!lJ.@~..:rx.\I.~.!;..QHJ.~~;:..9.f...P.;j!l1lbJ.\\..J).~JI.\l.~.~~..>>.,,\\k..illl.<l...'IJ:llJi.t...CQroll.fJJJ:j being duly ..............!!)f.'?En......................... says that as nearly as can be ascertained the said decedent ............................................ ................... ..... .~~~!)...~:...~.~.l}.~.~?........ ............... .............. ..... ............. ..... ....................... ......... .............. ...... ....... ..... died on ......~~~~.~X...............:.. the ...........~~~~................... day of ........~.~y.':~~.':'.:.............................................. A. D.. 19..??.... at or about ...........~J.l\............................... o'clock. .t,. M. ........................$wom.. ..................... and subscribed this .............................~.~.~~............... day of ..~.9.':'.~.~~.':..... 19"3,, .be~o~e . "--f.llc I ~ 1 .\\ ..' ..............";}..k.~....,...:..~;... .(1~~..J..;~.lt:~"'.,.,............... 1 L . ~ " . ~ ../- '. / .!....'..!...!...;~::.L.......2~..-;:i... .<1.&:................................ Assistant Trust Officer Deputy Register. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA) lss: COUNTY OF CUMBERLAND ) Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the Brenton M. linke, Assistant Trust Officer of Dauphin County of Cumberland, personally came ..DajlQslt...Il.ank..nnd..:Cclls.t;...coulp'm.y........................................................... who, being duly ....~.wR.m..............., do ..~s...... depose and say that as ...........I,x=uto................:.............................. of the last Will and Testament of ..............~~.h.~...~:...J.'.~~~~~.......................................................................... deceased .........~.~.............................. will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances. ....sw.o.rn..to........... and subscribed before me. ~tU--61'- 77l . ;Li.e ...y.............................,..................................................... Assistant Trust Officer ~~;~~.:~~m~D."J' Register ;C'. ............................................................................................ <l\l ~ ....: " oi. 5 - l:i Q I.L. 0 ~i co' *i <l\ ..J -a N <l\ t;j) <l\ ...I 0 k \D till ~ ~ (J) I 'r-I: - .. ,!" <l\ - "" ~ t): "" r- <:j' E-<: II ~ to' I ""1 rotj > ~ .5 0 N .' :z; .~ Ai ." co: " ~ ~ <:j: ." Ltl: "" ~ co' 0 - 0: v *' " ~l ~ ." ~ ~ " ..... . " ." 0() ..!l ~ ~ ~ c: " ~ lJ.l " ~ DECREE Be it remembered that on the ..........~.~.~~.,.>.. day of ...................!:!~y.~~.~................... A. D.. 19.?~.... there was probated and recorded the last Will and Testament of .......~~~.n...~.~...~~.~.~~.................................................. East Pennsboro Township . late of ............................................................................................, Cwnbcrland County, Pennsylvania. Deceased. Letters ........................'!:!~.~~~.~.~~.~y............ were granted to ........p.~~p.~.~~..!?!!!P.9.!!.~~...!!!H*'...!!\..~.~!!t:...t;;!?~p.~.~y Witness my hand and official seal the day and year aforesaid. ! '--to / )0.' , / ......~~.$\...:p~...trI"....0..,;r(~::.......Deput'1.. Register. ~ .. . _ .:=::JIU ~ 'I ll.'411 mI"'> . . . I ~~)iOi:i;;3;':;:4X\3i"7':9 .'.: .... COMMON:'p~~J~TO:" ~~~~~YLVANIA . .lml\1, . ...... . '.... . OFFICIAL RECEIPT.' PENNSYLVANIA INHERITANCE AND ESTATE TAX .14jlil,~ ',li'! ",r'-' ",,",,'..."- " 'f~I,\;)\::~""i{\'" ,t, ',', ,', ". e RECEIVED -_.-- l .,... o. o. ... ..6' ij ,~--,.- -",--,' ~"::":"'~;"-----'----'-":""";_:"""--''':'''''';''';''--_.;:'';''''''';;'-'~- - -. -F-lVE-HllNDRED-F-P/E-&--4Sl100-- _____ ---------- dollors I epresenllnlJ Pennsylvania Inhorltance or Eslote Tox due !rom tho following eslole: F,rym'--J)lWpain Deposit DI1RK -Io-TI'\1at.. 2'/1 TOll on $ H&1'FisbW!'g, Penna. l7~---- 6% Tox on $ File No. 2:1.-79-699 Date of Deathll-l6-l919-- 15'1, To, on $ Dote 01 Payment FeBl'llary 19. l~Bo % Tox on S Estate Tox, Act of Moy 7, 1927 Name 01 Decedent 10HN D. WWIS County C"l7lberJ and TOTAL TAX CREDIT less five percenlum of tax if paid wllhin three months after dote 01 deolh Plus interest 01 the role of _CfCllrom to Remorks: t1PAID ON ACCOUNT" '[j'OO~[p[L~@&'ITrn SEAL TOTAL AMOUNT PAID NOTE: Thi, TripHcate Receipt to be retained for audit purposes, '- Received by NOTE: In otcepting the tronder Inheritance to~ on luture estotu, prior to the death of the We lenont or ten,)nt lor years, os evidenced by this receipt, II is undentood thai the Commonwealth Iholl I not be precluded or prennted from hereafter o_lenlng additional inherllonte to~ ot thll deoth of Ihe Ilfo lenanl or lenanl lor yean whenever II appears lhat such additional lo~ may be legally dUll and collecllble for any realon whohoever, s s $ S ~ s l s 53S.9S $ 26.69 s s 5115.'15 51 ure Harold B. McLane, Deputy RcgillteI 01{Ti~1l1l \ 1- _ - -- - - - - -- ~ - - ~. -.- ---. .-. - - - .-.. ,--- .-' -".. --" - --. -- -- -.. --. -..- _._- - -. - -. - - -- '- COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Brenton M. Hake, Assistant Trust Officer of Dauphin Deposit Bank & 55: Trust Company being duly.. _sJ'iQ.tn. . according to law, deposes and says that he . ts_f..X e cut 0 r of the Estate of.J.o.hlL.Il._Lartdi.L__.._____ late of East Pennsboro TWD. .. .___, Cumberland County, Pa., deceased and that tho within is an inventory made by Dauphin Deposit Bank & _trust Co._, the said__Inv.en-Lor-y___ of the entire estate of said decedent, con,isting of all the personal prop.,ty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it', fair value as of the date of decedent's death. 19.<:'~C> Dauphin Deposit Bank & Trust Co. Executor of the ~.. state of J~ .~. Lan d i s B-!I.!_P:i'dii:-L- ..7Jt. ~ ElCBcutor . Administrator Assistant Trust Officer J LA J ~ ~ p j J~ and subscribed before me, NO A PUBLIC Mv ComminiOll Expires February t. 1981 HauilbufQ. PA Dauphin Counlv n)_~aI.KgU.t. Harri sbu rq_, Pa. 17tQl Addron Date of Death ___.__L6.th_.._._._.___._.~0_"'.e.mb.eJ" Day Month lq7q Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. I ~ 3:' ~ VIi 1-1 -0 >- I " I- W '1'""; ~I ~ I >- '" I- -0' .. '~ W <( c:1 " 0:: 0. I- 01 u t" 0 0 VI rei ~I " " I w w 0 o-i en >- :r '" ...J ~ .. " I- 0. I ~i - 0. " I Z I- ...J U- 21 .. ~ I I: ...J <( 0 . 0. I 0 ~ W U- <( W 0' Q!' ~ ~ ,. > 0 Z '" 0.1 .;. <( :1 c:1 .....1 - Z 0 " I, 0 .c:, ~ .; I' VI z 0 ~I 0 I '" u z '[ w <( ...,' 0. , "tl Ii I c ~ .. , - -;: I 'I 0 " I Ii .D .... " E "tl - ~ ..!! 0 .. 0 ...J U i.i: co . REV455 (l.BO) CCMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT OECEDENT SCHEDULE "F" ST A TEMENT OF DEBTS AND DED:MTIONS 'J I ..----..:/~,.t'.. ;">-1'" '.~~~,.,.'~-=---=::..':,~ ;;c;::..:.;~',-. ...'-";;:::...."-'-;6. 19,1', . Estate of John D. Lnnd'lH Dale of Death Novemher ]6, 1979 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: File No.';?I- ltJ-C'l? Claimant Relationship to Decedent Claimant's Address ITEM NO. OATE NAME OF PAYEE REMARKS AMOUNT 1979 Nov. 23 Richard E. Anderson Re ister 0 Pro ate [vHl/, IV' p 29 lolilliam B. Ha\;k [vitness of John D. Landis Hill 10.00 30 David S. Kahn Hitness of John D. Landis ['ill milea e mil s ra lu Landis 30.00 Dec. 6 James S. Kourv Jr. Professional services 11 1 and 11/16 70.00 6 Jesse H. Geigle Funeral Home Funeral expenses for John D. Landis 2,310.90 10 Cumberland Law Journal Advertisin estate and roof of publication 18.00 Ethical dru s for December for .lohn D. Landis TOTAL THIS PAGE I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. $2,536.50 Slr.NA1URE OF ATTORNE'{fFIOUCIARV DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN n~.E SUM OF S f' Wd.. <; 0 C}~fi . a. ~t?dl\I,,'~h:::.:J:' ,',I".::,;:., . . .-!fj'.-J 1"1 {',\( ., . i \ .j .~ ( AT 1<',') ( '. lId, -:ot (It I. . PERCENT. ;-:.Ill,.-, /1,1, ,( I ,\ "'71_.' 'I', ~ Ii' JII (in /1 REGISTER OF WILI...S J'",( (Il'" I. ..../>i,' DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being ciaimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. t'" '" 0 (') ~ tr1 ~ ~ z > 0 0 (f) C) n c:: " ~ z :::: z t'"' tr1 tr1 ;>; Z :<l 9 - 9 t'"' Z Z tr1 ..., tr1 Z ::' ::' ..., ><: (f) tr1 - (f) Z 0 (f) 0 ..., ::' "1 "1 :<l ~ ~ 0 "1 - "1'l 0 - Z (') - :l> t'" c:: (f) tr1 0 Z ><: ><: ~ tr1 tr1 ~ :l> :l> :<l :<l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. - RfV.455 (1.80) C'lMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS ----------------:;.=-~~~.;...;'.~===~~~ ...-:.....:.:...--'-'-~.~_..~~,..... Estate of John D. Landis Dale of Death NOVl'l1Ihor 16. 1979 WHEN CLAIMING THE FAMI l Y EXEMPTION, COMPLETE THE FOllOWING: File No. Claimant Relationship to Decedent Claimant's Address ITEM OATE NAME OF PA YEE REMARKS AMOUNT NO. 197Q Dec. 13 Charles Faus t ^nnrai~al fnn fnr "n;n~ nno " "M^" . ~ nn 1980 .Tnn R Patriot News Comnanv Sroremenr nf ndverris;no M~r~ " nn RESERVE FOR PAYHENT OF THE FOnO VING: Dauohin Denosi t Bank and Trust Executor's fee Comnanv - 2,875.00 David S. Kohn - Attornev's fee 2,875.00 Reserve for filinl! account 100.00 TOTAL THIS PAGE I 55.906.00 I hereby certify that to the best 01 my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. SIGNATURE or ATTORNEY/FIDUCIARY DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S P t/-iI.:;,.~ AT I-~r; l ?1~? ~) /~ ~ ')/1"./11" ':';;"1" /'11/"" I,,,,'.; ,.;/ ')t:V;/<!" /J~t.~..,:' \,l;',"'.F,"1 ~/; ,:/." I:'"'' I' _:t'4k..aA"J1 i" /"1\" {,. J)\./ I. A. /I ' ijEGISTEfl OF WILLS V (/~.Ii' ./t..,;( "I/,,'f, PERCENT. {II' . (l I" /~ ,'- DATE GENERAL INHERITANCE TAX INFORMATION " Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. c '" tl n > r<1 ~ :s z >- 0 0 tl <Jl C) (') c: tl >! z ::: z ~ r<1 r<1 ;>; Z ;>;l 0 - 9 z Z r<1 ..., r<1 ..., Z P ..., -<: r<1 - 9 <Jl <Jl Z 0 <Jl 0 ..., 0 "1 "1 ;>;l ~ ~ 0 "t1 - "t1 0 - Z (') - ;l- t'"' c: tIl r<1 0 Z -<: -<: S; t'1 r<1 ~ ;I- ;I- ;>;l ;>;l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount c:aimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remcrks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. COMMONWEALTH OF PENNSYLYMlIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR CHARITABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX (Act 0' Muy 2ij, 1956, P.L, 1757, (lnd Act of June 15, 1961, P.L. 373, os amenlled) Application is hcrcby filed for the approval of an cxemption from Pcnnsylvanio Tronsfcr Inheritance Tax on the transfer of the property described below: 1. Bureou File II &~ / - 77' - t;.c;y_ 2. Dote of Death. ~ovember 16, lY79 3. Dote of Approval -'';r'~L~--_J_q\J ,~_ 4. Nome of Decedent Jo'hn D. Landis 5. The Commonwealth's appraised value of fhe property for which en exemption is claimed is $ (Nofe: Where the property is other than a specified amounf of cash, the exemption cannot be approved until the value af the properfy has been established by appraisal by the Commonwealth, excepf in those cases where fhe amounf of the gift or bequesfrepresent5 a stated fracfional or percentage portion of the entire estate or fh" enfire residue, In those cases enter such fractional or percentage amount above), 6, Check the manner in which the transfer WQS effecfed and submit a copy of fhe documenf authorizing the transfer, unless such material has been previously filed. WILL 0.; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (If other, explain) 7, Correct Business Nome and Address of Charitable Organization receiving properfy: NAME Masonic Homes 1/2 Hesidue ADDRESS Elizabethtown, Pennsylvania [] See listing on reverse side for additional charitable organizations covered. 8. I certify that the informafion contained herein is, t(l the best of my knowledge and belief, true and correct. Dauphin Deposit Bank & Trust Company, Executor of the ~~, ta t.~1 .0 f_ .J,O_hn E.._ ," Land is Signature of Appl icant ~ j_ . /. ." /..j'l-'. c,jC I '..~ -~~~"'--rt.-/~-----;. I .1~...jA_~-t::'::~)j~ ~"'.'_'; f--- .:-!/_/<_ .~..:'_'- Address of Applicant 213 Market Street. Harrisbu'rg. Pennsylvania 17] OJ Official Title Assistant Trust Officer Dote 1- ,. - i'" . L This form must be completed in triplicato and 011 three copies delivered to the Register of Wills for tho County in which the decedent resided, or in which lotters were issued for a non-resident decedent's estote, If the decedent was 0 non_resident of Pennsylvania and letters were not issued by a Pennsylvania Register of Wills, deliver all three copies 10 the Director, Bureau of County Collecttons, Penna. Deportment of Revenue, 26 S. 4th Street, Harri~burg, Po. Do not write below this line. F(lr Official Use Only APPROVED: For Ihe Secretory of Revenue REFERRED to Bureau Headquarters Approved 0 For Secretory of Revenue Denied* 0 (i9~ister. of\ (,J,), ~ (County) . \~'" t (~ I q~~d -ate of Approval) (Initials of Register of Wills) (Authorized Signature) (County) (Title) (Dote of Referral) (Date of Action) ~ See reverse side for reasons MUST BE FILEO IN TRIPLICATE PENNSYLVANIA INHEHlTANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheriti1l1ce mId Estate Tax Act of 1961 provides that the following persons shall prepare and file a relurn: a. The personal representative of :he estate of the decedent as to property of the decedent administered by him and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or acqui re knowledge; b. The lrilnsferee of pronerty upon the transfer of which Inherili1nce Tax is or may be imposed by the 1961 Statute, including a trustee of properly transferred in trust, provided that no separate return need be made by the transferee of property included in the return of a personal representative. 2. PLACE FOR FILING The return is to be filed in duplicate w;th the Register of Wills of the county wherein the decedent resided. 3. TIME FOR FILING The return is due nine months after the decedent's death, unless an extension for filing has been applied for and gr8nted by tile Secretary of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife, son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others. 6. PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAiLURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the laxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's estate or against any property belonging to a transferee liable for the tax. 8. FILING OF FALSE RETURN Any person '11110 willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1901 Statute, be p,uilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding Sl,OOO or undergo imprisonment not exceeding one year or both. qUESTIONS CONCERNING PROPERTY TRANSFERS ,... I. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No".) No 2. Did decedenl, within tl'/O years of death, transfer nronerty from himself/ herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) -1JL 3. If the answer to one or two above is "Yes" and the transfers are clairned to be nontaxable, provide the following information: a. Age of decedent at tirne of transfer. N I A b. Copy of death certificate. c. Affidavit by the attending physician indicating the state of decedent's health at tirne of transfer. d. All other inforrnation supporting nontaxability of transfer. 4. Did decedent, in his/her Ii fetirne, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) No a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) __ b. What was the transferee's age at time of decedent's death? 5. Did decedent in hiS/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) No b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. N/A 7. Did decedent in hiS/her lifetime make a transfer, the consideration for which was transferee's promise to pay incorne to or for the benefit or care of transferor? (Answer "Yes" or "No".) No 8. Did decedent, at any time, transfer property, the bmeficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terrns of transfer or by operation of law? (Answer "Yes" or "No".) No 9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) N/A . ~ . her nursing visits to our home. Inheritance Tax to be paid by my Residuary Estate. ITEM VI. I do hereby give, be'lueath and devise to my friend, Martin L. Book of 1201 N. Second Street, Harrisburg, Pennsylvania, the sum of Two Thousand ($2,000.00) Dollars, provided he survives me. Inheritance tax on this bequest to be paid out of ~y Residuary Estate. ITEM VII. I do hereby give, be'lueath and devise to Reverend Hertzler of the otterbein Methodist U, B. Church all the old currency type United states bills in my safe deposit box at the Dauphin Deposit Trust Company at 6th & Maclay streets, Harrisburg, Pennsylvania. ITE}! VIII. I have talked to Jesse Geigle, funeral director, about conducting my funeral and desire he should take care of me, ITEM IX. I do hereby give, be'lueath and devise to Edwin L. Garrett, my nephew, of 4320 Allen Road, Camp Hill, Pennsylvania, the sum of Three Hundred ($300.00) Dollars, and to my niece, Erna Garrett Pletz, of 319A Twenty-Ninth Street, Penbrook, Pennsylvania, the sum of Three Hundred ($300.00) Dollars. Inlleritance Tax on these be'luests to be paid out of my Residuary Estate. ITEM X. I do hereby authorize my Executor hereinafter named, to convert all my property, real, personal or mixed, into cash at public or private sale. ITEM XI, All the rest, residue and remainder of my estate, I do hereby give, be'lueath and devise unto David F. Landis Trust Estate, established by my deceased son, David F. Landis, of which the Dauphin Deposit Trust Company is Trustee, to be used for the p~oses set forth therein and to be distributed according to the provisions of ~aid Trust /' I / t .- ( &i'....\...{t..'.....- ! .. (If . ,- ',<,:"i 11 )"' Jolm D. Landis / './ - 2 - , :".""""" '..t,:l.iin.... ,,'1')." ~';4~;"::~. :;t: '\.-.:,-_,,',"...'''.:1: ,,;..;.t-' ':'~:'";II,~\:~" ,""",\.'.' ;;." '.~,~'~(..;-~~ _';I.J'.~',..\).;.,\::"!,,::t!;,~..~,'ji~~ '~i\'~"J..".iJII"':"'. ::, , ~~~'.".t' ~'.l>':i~.-&o>Il:...."..~;.rtl.'l~'~'r"'l. ~'{~''';.i.~:;I'\''';' l"~~";'.;:'?:,:';;tV'~)'"' \, ~::\:'.~~"7 1:.'".;;-;'; 1'l.~f:~.f~'t'(;'\''''.''ltP.~.' :..~t;1:_~'~~.ttt..'!' ,:, J~"~tj(~&t~'! -~; .Ni~'<"'~"~"~I:'>:!I''''i>""C'',~",,,,,.,.,;-,...;,'''\it. ';~. .~b':""'\"_~'I't.;k-1..:..:.LI"~,,,;",t'!J:"':iI';' '~~mj.~: .. . .;im'~"~ ~.,.: ""w.I.l' r.:~:.., . l!' ,....,:t", ~ "" f.,,' ,.......'. ~,. '...,.~ .,;.;...,.#'"11"'.....',0;,1.'" '..,,'.1' j"i-l 1; .;...." ~ . ,':;:;L,- ':...... ," ...,' '.;If ,~. '.....:~. >~~. '~,~, i~~' ~.;1::; ;.'.~. '~.~~-'- ;:..;~-...~\l!..." . '~-i. .....,........ '~'~ '" ~' ".,~, ",~ ~,. . , \~.f:... ':' ..~.<:~%':~j...,"-!d...,:,}; "J:!'~U': ~.....;;~.~~_\~S"!;, ..il~.t~':il!~ ;; .J;''''' ...,. . .':," . ,...t.."..,~.\".."ii:mt'~."I'''''.t,'"~,w,,,~~\'' .I-"~~'!\' .,Ii"U'....!t:'~."...,.~..}:.A..'1,~.. ,,',',~..,;~,~11' "~"'" . '''''.'.'' ;t,i..~,j1l'~"b~.(...,9f t. f""/t~'~~'~.~'~"f:t:..:,"- ..,,('Y..~.' ~~1f.\t~ r:.'t~tl'" ~1~~~; -v.\.~IJ,r:.\.:itoll ,n1iJ. I.", .... '. i.j .f'; ,# w'..:;'" .:::.. '''",Q1;i'' .1" ."" ,".,. ......:;1';' '~",. .' ...;rp, ", '1:.' (,'1 ,,'.... :-'t) .r?,;;, . ~.1 ,,'_~. ,,~..( ,;"".:r... .': ':.. .1:hi\1;'.N;'J'c. ~",.~~~s..,.:~ I . ....". n. !~~,'Gi. "il, ).,!:.,...", ..1;1"<1 . , QEV,'l53 \1.80) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT OECEDENT SCHEDULE "D" BENEFICIARIES ~ hi, I ~~I!:..l\ (Instructions on RlJverse Shle) Estate of John D. Landis BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH M~~nni c Hnmp~ 1/2 Resin"e Elizabethtown, PA (see below) Shriner's Hospital for Crippled 1/2 Residue Children (see below) Philade10hia PA TI:Le La<;t Wi 11 & Testam ent of John Lan !dis beQuea hs the es ate residue to the Trust under the Wi 11 of !lis son David F. Landis. The distr 'bution listed is as per the Trust under th e Will of David F. Landis who died arch 18, 1972 reference No. 273 Year of 1 9 72. --.. I - rhe above beneficiaries are living at this time except for the following: NAME DATE OF DEATH rH!'1'454'( t.IiO) COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "E" JOINTL Y OWNED PROPERTY '1:. ,", ...\,~ \'~,... ~:"\l' I;; """ ro~. .T.f1 r \ - .l'fr.~J'I'li"'L ~18P' (Instmctions on Rr.verse Side) Estate of John D. Landis - p TOTAL E VALUE OF DEPARTMENT ITEM R DESCRIPTION MARKET C DECEDE~JT'S VALUATION NO. VALUE E INTEREST fOfficial Use Only) N T None TOTAL THIS PAGE N~ .-&lJ1C. " .' . , INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must Include all property, real and personal, owned by the decedent jointly with 8nother party or parties as joint tenants witll right of survivorship. Both tangible and intangible property are to be included. List real estate first. 1, Describe all real property as indicated in the instructions for Schedule" A", Describe all personal property as indicated in the instructions fN Schedule "8". Include the name, address and relationship to the decedent of the co-owner (s) and the date the joint ownership was established, 2, Indicate the total market value of the jointly owned property. 3. I ndicate the percentage of the decedent's interest, 4, Indicate the market value of the decedent's interest. r- '" 0 n >- '" ;;. :s z ;I- 0 0 t:: C/l " Cl n c:: 1:1 -i Z ... Z r- tT1 tT1 ;;. 0 - 9 r- :r. z :;:J - Z Z i"1 -i i"1 -i ~ 9 9 -i ><: C/l i"1 '" Z 0 C/l 0 -i 9 ." ." :>:l ~ ~ 0 'TI - 'TI 0 - Z n ,~ ;;. r- c:: '" tT1 0 Z ><: ><: ::; ~ tT1 i"1 >- ;;. :>:l :>:l Fi I e Number INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONL Yl 21-79.::.9692-.. [I) Ori ginal o Supplemental o Remainder REV_4B4 EX+ (HOI Estate Name ____..rohn.PLl..I,w)JJL--nnn Date of Death Na.v.emher_1G.,J979 Social Security Number ---'lJ&~JO-ll.l~:L REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser In and for the County of Cumberland Pennsylvania, do respectfully report that I hove appraised the reo\ and personal proporty as reported In the loregolng rf'tum at the values set forth opposite each Item In the last column to the right In Schedulos "A", liB", lie", and IIEII Doted: January 8, 1981 A~.'ti'h :, )'11/,;1,1 . i ) INHERITANCE TAX APPRAISER INVENTORY VALUE AS APPRAISED ADJUSTMENTS CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMeNT cooe Real Propert)' (Schodule A) Porsonol Property (Schedule B) Joint-Held Property (Schedule E) Transfers (Schedule C) TOT AL GROSS ASSETS I None c;7.d10 None 00+ 92+ 10+ 20+ 30+ .n __. n,Q4Q. ZL_nn Leu D.bts and Oeductlons (SCHEDULE FI CLEAR VALUE OF ESTATE 40- 93- FOR USE OF REGISTER ONLY CODE PRINCIPLE VALUE CODe I COMPUTATION OF TAX S $ $ $ $ o Life Estate o Annuity RATE FACTOR T 0)( on $ 6% T ax on S 15% T a x on S -- Tax on $ Tax on S E)(emptions Total Estate TOTAL TAX INTEREST FROM BALANCE TO $ $ $ INTEREST TAX CREDIT S ~ $ L~ss Credits DATE OF PAYMENT AMOUNT PAID DISCOUNT S t S -,_... INTEREST FROM BALANCE TO $ --------. $ S \}-. ~ ~ I \:; ~ o - 8:>< ~8 OZ ..: 0::0 H UO Z U": :> UlO H ~~ ~ :r:H Z M>:Z ~fil ril O~ 0. :;: riI::O :r:U 8 ~ '" / H ~ o ~ .~ o Ul t~ HZ filOZ OU 8ZriI Ufil ":":0.0. Cl 8H HO (/) t-I ~ Z .. fil . Ul Ul ..: ..: Cl":ZHH fil fil:;:~Z :r:Z Ofil": 8:r:~8~:> 00 :;:H Zt-:l ::0:>< H fil UUl 8 Z ..: Z H fil 0. -Cl :><fil 8Ul ~~ ~ Q)"'t:l C"C ..... o..c Q) +-0 Q) t:: .... ~ ..... C en eJ a 0 :=l OJ "0 ~ "C J,..,.... c: 0. ~ Q.l ~ Q) ..:3 ~.~ ~ ,.....q .. ~ o :;::....... Q.l~ (1) 0 ..g "C o a c: c: a1 .S? t: 0; .~ E ~ 2i u ~ 0. ,s t~]';: "'l! " - ~ ~,~ 8 C1.l .!!: "'.r: >-< ~ ..... 'Jj ..... tJ..... .g B .1 o _~ :s Q) 1"11-0 :.; 0 J,.., - "'0 C) u 'O'c; ~ ~ ..... C. OJ C) t: :: .L: ..... CJ .... ..... ~~ "'C a>.o~ (l.I: IV ho ..... OJ "'9 M ~ E] ":""~ ~... C) :::: 'I-' . (/) 0 Cd,: :E .... c::: .5 :12 e:1 C ~ t) U) ~ r:: ~ 0.- 0 ..... t.C ~ 2 en _ :1 C t: ... c..... c ~ C '.."'.: ..0 ~ d g t!? ..;; E J:)~..d 0 'S c, ,-, r'" u gj .S C) ~ ~ :5 ~ 0 ~ .... ,- ~3 t..l i. E..c g c~ 3 _~ .. " .r: ~ .r: .~ or. " .... St o ~ ..... c: " <U <U E c: '" ~ ~ ...ci5 'Qj "'::I ..c '0 i5:: .~ 0 n . nf-;; 0:> ",:<> 0 .....~ S::u ..;.::~ (';"')0 ru, :z: ifi;u jj~~ ~ ~o ,11(11 ~~:~ N -:9 ~ '.'7'l -'" '" ~>;; '0 ." ':-.\ ~ '" 1':2 U, 0 ~ ;f.. ~~. III = ;t g. ~ . ~ ~ Cl =e~ I:: Q V'l .. U Ci i.,"" ~ := III J: ~ := =~ .'11 . i " " -: - :' 1~, <> ;1 ... ~R ~ U'\ ?0- pe: ~ M ...l <: Z l:<l ~ CJl 0 ;:.. ?o- H A ~ ~ '" '0 0 <: <1l ...l . M <: A H - Ql U z ffi ~ 0 0 f\J - 0 ~ 0 M CO ~ - ..., <) f\J 0 ~ ~ ~ 0 ... f-< 0 '" 0 Z 0 '" fJl >< f-< 0 - ~ Z f-< ~ f-< ~ Z Z ..l 0 - 0 ~ pe: ~ ::<: ~ ..l Z ::;:: Z 0 U ~ ~ g; ~ '" ~ 8 0 z ~ 0 ~ :i STATE OF PENNSYLVANIA ) ) SS: ) COUNTY OF DAUPHIN I hereby certify that on this ,/ '/ (i, day of 'Xn).<,~,-i.LA-i, 1980, before me the subscriber, a Notary Public in and for the said State and County, personally appeared Brenton M. Hake, Trust Officer of Dauphin Deposit Bank and Trust Company, the above-named accountant, who being duly sworn according to law, deposes and says that the foregoing is a true and correct account of all the rights, goods, chattels and credits which came into the hands or possession of Dauphin Deposit Bank and Trust Company, Executor as aforesaid, or into the hands or possession of any other person or persons for it. The affiant further says that no person claiming to be interested in said estate, whether as creditor, legatee, next of kin, or other- wise, gave written notice of such claim to Dauphin Deposit Bank and Trust Company, Executor as aforesaid. Dauphin Deposit Bank and Trust Company By: J Ju .7~(O,---}/Z -J.JL r Trust Officer \\\\"UUU" .....~~~l!?t~~~.~ sUbscri,bed before . .,...~" (10.. ^ '11.. .1, --" 8 : .",.~ th;U;>;".':;t".' day of ivr" , 19 O. :~.'" ..' ";i:'..'c<"\ ~ :-< _: C) C"J~~'~" ~ . "', '4 ,,"''', ., :::: ~ 1~/ II' . .. _. (',:/./ ",.'. <:.;;/1 ./. j(. /' /.' .; ,~,,,,;.(:::' "'l.,-<~~_L:r: l ,. /\J._';_~YI..~.n:_.-I.) ..-). -' . .' - "': {,.' '. .' ~ary ublic '.'." ~:~:~~'~~~,:X~:~~~~:'~'" Exhibited County of Er,za~clh I. Bonk Nobry Public Mv (omm:!;;::n tl{~lrcl !l;llil lb, 19~j /llIf,i;bOJr~, Po. taul'hil\ (OUIOI',' into the Office of the Register of wills in Cumberland, this)(\1Cday Of!]L~.;~t~(_, 1980 and for the by Dauphin Deposit Bank and Tr.ust company lIBER . oj 7 I",L t. ,~;) By: /~t, .,':{.'___ 'jIL -ILIc~_ Trust Officer COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' COUNTY FILE NO: ;<1 '}el, ;" I" " i,l:, (/ DATE ,I, \ fit" / d I 9 I? I ~ ' 'I ESTATE '~t.fvv ~y) Ii ;;.(1 I;<!,(o,qq I"~ i\ '1 t1 ' COUNTY \.A.V'M\<!." '~N Y ()", '. DATE OF DEATH II tV I (;. ,I ~ '7 ~ . I . r'/-';I 0(' ,~ ,jl ~ ./, .( TO:. ':I'~ ;~ l~frlIJ~-', ,;i 1 ,~ .' Av .1 '.' .'q I . \, ,J I ,\11, i )...-::~.> r "'( --'1 '1 I... f ..l('li "": . ". '\; ("':") 1"J..l~) !} FILE NO. i ii . / 'J J 1.:[" Appraised Value of Estate: Real Estate s Personal Property + 57 ()LIO,'?;? Jointly Held PropertylTransfers + Less: Approved Charitable Exemptions s 5"7 Dl).o, 'Jk 9 IltJd 50 sL/-y 591(;;;'% ,_: {l~.;(~1.,J),JJ- ~' :_f,' {) t'>J,~' Total Gross Estate Total Approved Deductions Clear Value of Estate Clear Value of Estate Subject to Tax s if. if'] t) ,j Amount Taxable @ 6% Rate s tax due s * .. .. .. * * A five percent discount totaling $; will be granted if the Inheritance Tax is paid by 1,./oV ~'" . ,J ;;. ./(, ;{U I - J(,~ J.", (.pi 3. 5<' I' .,\., '"' r s ~:=::,~ -' .." - S 3~ 0.5 ....----....- q I. S 0 c.. iU,S) ~. ~, 9 TitJ..f.//r13. ?y Amount Taxable @ '5% Rate VI <'7. () ,; tax due '" ."" TOT~~ PEN~~~~VANIA.y'HERITANCE TAX DUE -('- I - ";',Y""'. I ~U;((',".' '. Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT 0<.-1 q !,-'o $50S- Y5 + s~b'bi) 1 . I';; tl q ( L'rj .7 + INTEREST TAX CREDIT ,< ),~ : S 5' :J .) .(.1'1 9 ~. '7: _-'_ _.1 /,;,5: ~"17uIW : s : + Interest accrues at the rate of six (6) percent per on the unpaid balance of Inheritance Tax from to date of payment, Interest due if paid by annum is ., BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ . 0.",' i <-"Jl~ See Information on Reverse Side ~J / .' ~ ~ ~ , I \,"- ~ I ~ "<\ '0'0 .,,~ (VQl"O.c E " w ~ . " . ~uo>' "'".w .~ c'O'O '\ 3C.~' o (11 :: ....:zo~ C :J 0. Q) ..J :l .c 0 .. 8'i: o.,C - u ~ r. c: ~ '0 '; .2 N-I '''0;;''' - I _! c OJ:J ~ Oo\Q~:g"'~ {)-..\.::,~~;iq .......: III ... '0- ~l'" 0 ';:'.l;: ~l - ~.., ......:" 0,,'- ,..i'lI n '3J :J 'I'" - 0 ~'~:l t) "' o E-<>< O::E-< ~Zo< OPH UOZ uo< :> UlO...:i ~~~ :t:...:iZ p<O::Z O::rilril OIllP< :;: rilP :t:U E-< Z H '" o ~ 000 E-<Z 0:: ZO< Z><ril 0 -0 :::> HZE-<Ullll ><ril O~><:t:O<O<HUl E-<Ul UZZP<P<E-<OZ ZO< UO<O<P:;:UlZZ :::>ril o<~P<O<OrilO<ril -OU :;:OU ...:iP<P<Uril ...:iE-<O ril H 0 O<H UO E-<:t: . E-<:t: 0 ;2:Ul E-<UlE-<OUlUlZ' ~~~o::iil",z~~:'S~ ril:::>OE-<O:t: Oo::Z OOO::Ul O~E-<rilO< Z E-< Ul E-< 0:: " 0 III I:> .o;Z rilHO :;:...:1 H UUlE-< ril :::>>< E-<:t: UOP E-< UUl UlP< PP<U 0< Z O::~ Ulrilril...:i Z HO< OX ril ",0 ril P< 'OO:iE~g..~ ~~~;gE ,~ ~~8uu I;':; :-..C) '7.l Cl)...... 0 .......... ..c Co....... -g c; ....... "0 7' Co '1-1 .... ..... C) ::: c c; 25 ..... >. U .- ~ eJ ... ~ ~ E w ;: ;;- o '+:: -S Q) C) ~aSce.8 ~ ~ ..... r: ... ""0 '"0 .8 rJ -1: C) .8 :.-...:: ;;.. ..c C 1;1 tf.' .... ..... ~ '"':: c ~C;tt;;~j t:'Uc.":;.!~ '" ...::' a 15 ~~ '.l ''2 ..,..;:::: .... 1-: ~ '- ....... B 5 b 0 ~8~~8 1; ~ ~ '; ...... .. ~ ... 8 u u '" " '" " .8 7J S o 1) ~ " " M ~"P o " ~ ': '" c ~ o " V' ~ Cj c: c. ..... ~ "- " " M ~~ a S _. ~ s... 0'(1 'C'.) ,..,,"" .) ~; J..< ::.:: ...' ,.. 0 ... V (!) v ,;'1 ~ '';1 - QJ " " 0 r; <;') cx3 nj.;"\ ",::0 C::C' 0 ""..... :r'--,~ me'> co" ._0 , . = ",;JJ ;;~ i:::l ..10 ,., ~) <: ;'"P1 'n , . ,~i~ >:;:. .~ _..:., :'):>- ~ ,"1 '.' .;~ .." r, . ~I' 0 .> ;..,., ,,', .., ,..' .\ =~. III I:: < =/llD. g.,g.,(!)' ~ e '" = ::> en I:: = Vl .IIIU ~ i.... ~ ::I III :r: /ll ::I =~ ~I.~ ~ (,., 'J' ~ ''':--1 ....:, " .;- l" ., ,.c: "" "" ::; ~ ... Edwin L. Garrett - Distribution of Bequest per Item IX of the Will $ 300.00 Erna Garrett Pletz - Distribution of Bequest per Item IX of the will 300.00 Otterbein United Methodist Church - Distribution of Bequest per Item IV of the Will 2,000.00 East Harrisburg Cemetery - Distribution of Bequest per Item III of the will 600.00 TOTAL ADVANCE DISTRIBUTION $ 5,832.00 PERSONALTY INCOME RECEIPTS 1979' Dec. 13 Interest: Dauphin Deposit Bank and Trust Company Master Savings Account $ 6.80 19 Interest: Dauphin Deposit Bank and Trust Company certificate of Deposit 20.00 1980 Jail:" 8 Interest: Dauphin Deposit Bank and Trust company Master Savings Account 389.59 10 Refund Travelers Medicare Benefits 34.16 Feb. 13 Refund Blue Ridge Haven West 439.11 March 4 Earnings: U.S. Treasury Daily Repurchase Agreement 386.49 April 2 Earnings: U.S. Treasury Daily Repurchase Agreement 601.71 May 2 Earnings: U.S. Treasury Daily Repurchase Agreement 689.77 June 3 Earnings: U.S. Treasury Daily Repurchase Agreement 522.74 July 2 Earnings: U.S. Treasury Daily Repurchase Agreement 309.95 Aug. 4 Earnings: u.s. Treasury Daily Repurchase Agreement 318.33 Sept. 2 Earnings: U.S. Treasury Daily Repurchase Agreement 345.08 Oct. 1 Earnings: U.S. Treasury Daily Repurchase Agreement 421. 21 Nov. 3 Earnings: U.S. Treasury Daily Repurchase Agreement 514.91 TOTAL PERSONALTY INCOME RECEIPTS $ 4,999.85 USE h . 7 .. . t,vJ v I,...L -3- STATE OF PENNSYLVANIA 55: COUNTY OF DAUPHIN I hereby certify that on this /.; U; day of '/(1,."",.j:~./, 1980, before me the subscriber, a Notary Public in and for the said State and County, personally appeared Brenton M. Hake, Trust Officer of Dauphin Deposit Bank and Trust Company, the above-named accountant who being duly sworn according to law, deposes and says that the foregoing is a true and correct account of all the rights, goods, chattels and credits which came into the hands or possession of Dauphin Deposit Bank and Trust Company, Executor as aforesaid, or into the hands or possession of any other person or persons for it. The affiant further says that no person claiming to be interest- ed in said estate, whether as creditor, legatee, next of ]{in, or otherwise, gave written notice of such claim to Dauphin Deposit Bank and Trust Company, Executor as aforesaid. Dauphin Deposit Bank and Trust Company BY:&f!d~'L)t .d~~ , Trust Officer -- ...,.S~:fje~', and ,~ubscribed before ..... ~e'; c~i,f{..;-(,; '/ it, day of It,,). , :~'Y.'::>." 'C;O.' <y'. : .. ~80 '~'.' C"~ :.:t1: ~"J',. .:,' ~..'. ~~ : ~:C;t[.C) ;\ <-:'. t:a. # -4; "","!i<t~,t...!,"'" ;.."O"/':' 'c,.<<;l..!::...{ :Vi: , . r ,/,..'/ "., 'r'" ,. "J '...,. I '~f 't:.." :t I, l..(..' - t.. ~. /) . ,.' '"t ....'( ...... 0 ary ""; ,.... "i.;'~l"'" .'''11::::;'..,.'' '//' / / , ;<:)...._....._11:.-_'- ul:ilic Elizabeth J. B.n\o. Not,ry Public Mv (omm:l:iO~1 h;>ilCI A~ti: lb, 1?34 H.ni:bul;. P.s, Oiluph:n (ounlV llm ~7 I,',~l f') ...... v"l!1 Register of Wills in and for the day of ;JUt.lI..tl'~' 1980 by Dauphin Deposit Bank and Trust company By: /lti..,-l'(.'J,. )k. .;...lL-<: Trust Officer Exhibited into the Office of the County of cumberland, this 2( F- " " " . ", " "I 1 , , . I IJ.ST WILL AND TES'rAlotENr OF JOllli D. LANDIS I, JOIDl D. LANDIS, residing at Blue Ridge Haven West, Camp Hill,. Cumberland County, Pennsylvania, being of sound mind, memory and understand- ing, do maks, publish and declare this to be my Last Will and Testament, hereby revoking and making null and void f!II'Y and all Wills and Testamenta or lO:i tinge in the nature thereof, by me at any time heretofore made. I I~~ I. I do hereby direct my Executor, hereinafter named, to pay all my just debta and funeral expenses as soon after my decease as may be convenient, ITEM II. I direct my Executor hereinafter named, to place foot markers on my grave. I was born July 11, 1879, and to reserve mon"y to pay for foot markers to be placed on the grave of my daughter, Irene Landis, born October 9, 1906. ITEM III. I do hereby give, bequeath and devise to the East Harrisburg Cemetery, 2260 Herr Street, Harrisburg, Pel'lIWylvania, the sum of Six Hundred ($600.00) Dollars to oars for my burial plot, and the burial plots of my son, David F. Landis, and my daughter, Irens Landis. . \ ITEI1 IV. I do hereby give, bequeath and devise to Otterbein Methodist U. B. Church, Third and Peffer Streets, HarriSburg, Pennsylvania the sum of Two thousand and 00/100 ($2,000.00) Dollars. ITEM V. I do hereby give, bequeath and devise to Edythll Baoautow, Nurse, of Hershey, Pa. the sum of Five Hundred ($500.00) Dollars, provided. she survivee me, she has been kind to myself and my family during " ./1.> t(V1.vJ~. '(Of/rV" / /J olm D. Landis / , " 0" .. . . . . . '. '.. . y . " '. , , '" , " ' . , '. '.