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PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
ANNA P. COLVIN
----.----
, deceased.
Harold B. McLane, Deputy
To nisi'larel C. ,'\RSSHlSR, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
IS
Petitioner(s;) JOreXthe execut rix____. named in the Last Will and
Testament of ANNA P. COLVIN dated ~~ovem1Jer 5, 1979
Decedent was a citizen of the United States and a resident of
;r:owr.lStl:ipx
Borough, Cumberland County, Commonwealth
of Pennsylvania. Thv.'(.sJ.-'\(
Decedent died on---"'M:OO-y (
A. D. 1979 , in the County of
Mt. Holly Springs
the
29th
day of November
Cumberland
, State of
Pennsyl vania at the age of 76 years.
Xx~~~x XX~X her
Decedent has not been married and has not had children born to x!'\fmX
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
55,000.00 and of real estate to the value of
15,000.00 as near as can be ascertained; said real
estate situated as follows Cedar Street, ~lt. Holly SprinR;s,
Cumberland County, Pennsylvania
I'i:Ipp~x
Therefore, your petitioner(~ respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated December 5, 1979
Name and address
of Petitioner(s)
~"I' /' Y /..''17 r .'
f I" /. l~ It l,. .-. (~>,......- ....
-
ADALINE V. STOVEq
55 Mountain Street
Mt. Holly Sprin~s, PA 17065
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
ADALINE V. STOVER
named in above application, being duly
say(s) that the statements set forth in
sworn according to law
this petition are true to the
best of _
her
knowledge and belief.
S\~orn to
and subscribed before
/;/?/ .
'.
""c..
//:. " ,
, .~. (.. '-'
. ,
ADALT~~E v. ~TnVER
me December 19 79
\~' I: l~'l';' ~. /
- "'t~., . 711c... :
~o -. pL~ne, 'Dep~t:y ~
I1lcllare [, "PI ersen, Iieglster
}s%
Filed;
"::>/-71-11'1"
December 6,
/ C' . ..Jl~ S'
1979
Attorney: l'nl'nJd S. 1p\'Iln,
'. J
"f'
"
ltt$t Will aM Q}~~tttmtnt
I, ANNA P. COLVIN, of the Borou~h of Mount Holly Sprin~3,
Cumberland County, Pennsylvania, do make and publlRh this no and
for my last will and testament, hereby expresslY revol<in~ flny and
all wills and codicils heretofore made by me.
1. I direct my executrIx to pay all of my debts, runerRl
and administrative expenses as soon as convenient after my decease.
2. I direct my executrix to sell and dispose of any and
all property, real and personal, owned by me at my death, either
at pUblic or private sale and upon such terms as she shall deem
for the best interests of my estate and to make good and sufficient
conveyances in the law therefor.
3. I give, devise and bequeath the proceedS of said sale
or sales as follows:
A. To Brethern in Christ Church, Mount Rolly Springs,
PennsylvaniR, $l,nnn.On for ~eneral purposes;
B. To Carlisle Hospital, Carlisle, Pennsylvania,
$500.00 for general purposes;
C. To my nephew, John Fisher, Jr., of Lebanon,
Pennsylvania, $500.00;
D. To Ethel Gumby, of Mount Holly Springs,
Pennsylvania, $250.00;
E. To Edna Gurnby, of ~jount Holly Springs,
Pennsylvania, $250.00;
F. To Mrs. Evelyn Blackburn, of Mount Holly Springs,
Pennsylvania, $250.00;
n. To ^llce Lichty, of Carlisle, Pennsylvania,
$250.00;
H. To Alice Weaver, of Carlisle, Pennsylvania,
$250.00; and
I. To the Chica~o Diocese of the Roman Catholic
Church, Chicaro, Illinois, $250.00.
~. All the rest, residue and remainder of my estate, real
~.
COM~~WEALTH OF PENNSYLVANIA I 8S:
COUNTY OF CUMBERLAND \
ThiS...........,...S........................................... day of ....................................................j........, A.D., 19........,
before me Richard E. ~e.(son, Register for the Probate of Wills and granting jotters of Administration
" .'
in and for said County of cuni~jand, in the Commonwealth of Pennsylvania, personally came ..............
//
...........................................,................~.........................."..,.....................;::..,.............,..................................
the subscribing witnesses to the foregoi~instrllment of writing lfrporting to be the last Will and
Testament of .... .......... .......... ...... ...... ............ .... .).~.. ................ ..,//..... .... Dated .. ......... ............. ............,....
late of ..............................................................................................{............. Cumberland County Pa., deceased
..."
who being duly........................................... according to III ,depose and say, that ........................................
',,--
present, and saw and heard the testa............................ ..., ..::,~...................................................................
sign, seal, publish, pronounce and declare the said' strument of writing as and for h................ Testament
OATH OF SUBSCRIBING WITNESS
I
/
/
and Last Will, and at the time of so doing ..... ........................................... as of sound and disposing mind
memory and understanding, to the best of ..............................................know ge, observation and belief.
............................................... and su scribed before
/
..................................................................................
..................................................................................
........................................... ........................................
..................................................................................
Richard E. Anderson,
AFFIDAVIT OF DEATH
ONWEALTH OF PENNSYLVANIA I ss:
C UNTY OF CUMBERLAND \
............... ...... ......dd':.(:(..(.d(.C......f....~~:!.,<;?:;;<(..................... .... ....... ...... ............... ........................being duly
............2.(:~,!f::!.:!.................. says that as nearly as can be ascertained the said decedent ..........................
..................................d{;;(,;;;r:.....,e...0:LI.:,;.-::.'....................................................................................died on
//'/-;;(.7(':-''/ th /;" d f ///,./,'j'!'('''/ AD 19""/
..............0'............ ....~..,............... e ...................1............ ay 0 ...........:..:...................................... .., .(.......,
at or about ................z..:.:.:.~;:............ o'clock,'-.:.M.
.........--;;~.~.;V..c;i.';.a...../,';:.............and subscribed this
(' ,,"'" d f .J'" - , . ,
......................~....................... ay 0 :(..r..(..'.:~~~;'.::..~...
.
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... :~/..l:.,~~ .~.,..;. .1..;.... ~'::.. .:~;.(:: ..'.::. ~'...........................,.......
..,'"
19, r..:-/...., before
'l___,. < __. I
/",,,,/_ ."( I-
<,-'/-, .,;"'/~-
'":1f~:~.~#.~.~,)yf.../;~~'f...............................
Ri~l.al d E. .~.R8i:JIIlORt Register
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA} ,.
COUNTY OF CUMBEHLAND SS:
Bcforc mc, thc HeJ-(istcr fill' the Probate of' Wills and J-(rant.inJ-( of' Lettcrs of' Administration in and for
d .' ---
...... ~,' .:'J " /,"? ,.~
the County of' Cumbcrland, pcrsonally camc ..... .:1..(I:'~~(:.~.:,.......(:.....,:?../:.v..(,;............................................
who, being duly .....~r,,~(.({.':'::.?....... do .......... dcpose and say that as.......<X[(e!.:..~.r.:...............................
of the last Will and Testament of .......1::.~;::.........('.....C:~.~..t:::.~..............................................deceased
....?/!.c:::.......... will well and truly administcr thc goods and chattcls, rights and crcdits of'said dcceased
according to law. And also will diligently comply with thc provisions of the law relating to Transfer
Inheritances. ..;~0.:.<?,::(.1....~.. and subscribed
before me.
......D.c.(s-:::!.-1:(,.~......;;:....... A. D., 19?/.'.......
'-'1/ GVlJ~ ~nF.~ Cv\'J1.,
....I.~t:.. ........ ................ .Deputy........................... ...'"
Rkluud E. ,/J.Ud~L.,~Ll, Register
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. .t..(.~!r.,i...:,~.s-:... .~x:...i.t:.{.~;:.............. ...... ... .,. .,.
/!c/o(/.........-l.- /7. S- /Z'v~..-t...
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DECREE
B 't b d h t th 6th d I' -7;y((/l'/Y'~' AD 971 h
e I remem ere t a on e........................ ay 0 ........,........................................ . .,1 ........, t ere
~ "..,
was probated and recorded the last Will und Testamcnt of' .........~?C.:-::........,:.......0:.!.j~.':.:J.......................,
late of ...D.q,.~9.:,:.yl.... 9" ..f:.!.(../i:/0/- .,;al:((.::" t:umberlund Count.y, Pennsylvania, Deceased. Letters
.~7f..7./.:?/:.:.':~:.!/~::.:;L ............ wcre grantcd to ....... ...!!.:::.~: .:':.:.:. .r.. ..... .!~..E~t:.~:~.-:::.... ....................
Witness my hand and ollicial scal thc day and ycar af'OI;ejid.
/'~J--I M - .'\ J
' __!1q .'\..r...J}~.7.,.r.'::I,.,:"'.=c ...........J)eput:y.
Hklhud E. AIl2....,..,.., Register.
.9~1
.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
Adaline V. Stover
being duly __sw.orn_.. ._ "ccording to law, do poses and says that ::he is__.the____._ -.- ----.-
_ ,e_x.~c_Ll.t.r.!,x of the Estato of ' flnna_.J'.__Colvin________.______
I.te of Mount HQllv Spr'inf's _..___.__ __ ,_, Cumberland County, Pa., deceased and that the
within is an inventory mado by . her---' the said___C_XeC_U.tctx_-.--
of the entire estate of said decedent, consisting 01 all the personal proporty and real estate, except real estale outside
the Commonwealth of Pennsylvania, .nd that the ligure. opposito oach item 01 the Inventory represent it's lair value
as 01 the date of decedent's doath.
Sworn to
and subscribed be foro mo,
/',(' day of J
__ anuarv
3. cJ2ttu.....
19130
- ,
. ", . . .~' I 7..., ,... ,/
~~l.......,......__!.;L"---_.......--~r'::1..--
Executor .. "",dmini~r-
A~line V. stover
..~5.__[VjQ.untain~ree__~_.
Mt. Holly Springs, PA.
R?GCil A. rw;:!, i\"i:r^\I~'{ PIJ::lIC
LISLE BOROllr:H C'I'II)[OI "'0 C
' ,.' -'\ 1\ (./ OW'TV
MY COMMISSION EXFHIlS U....J.'3: 1:J,~~")
...~--_.-...-~ ---------
Addreu
Date of Death __ _____ _29______.___________._N.o.lLemher:.-.-.--~-.-----li7..9
Day Month Yur
INSTRIJCTlONS
I. An inventory must be filed within three month. after appointment 01 personal repre.entative.
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 Arlicle IV, Fiduciaries Act of 1949.
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. Ollice 243,6195
~~
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GEORGE L. EUENEH.
AND ASSOCIATES
REALTORS
;,PF'HAISER - SALES, PROPERTY MAI~AGEMENT
139 WEST HIGH STREET
CARLISLE, PA. 17013
J:llll.IHry If, 1~nlfl
Hrn. .10!'0pf~ r. St..vcr
~5 ~~nunt~in StrCl't"
Llnunt I!olly 'prin':". i':1.
17'1(-,'}
:;,,= Juhn 1'. ,1<,<1 r,nno Colvin Prol;erty
rf'der :;Lrf'ct. 11nlJnt I!olly Sl'rinqs, Pa.
Denr t'lr~;. ~tovcr:
I rH1 a licenBf!'! Hl);11 rf..t~tt; '-:rr;kcr, lir.cn!!p-d by the r:Oll~mnn'."anlth
cf PnnnRylvanin, ;.;nd h:-Jvu t:.PI:'r\ ~-lr'ti.vrlv cn\.;~lIird in tile real C!.itHt.C
htlninco5 For the p~l:;t l'i.rt.l:t:"E'rl \'r~r~l in tl'r-. r:IJir:t'Prl~tnd County ar.po.
I ;.llf, tI10i'OIIOhl) f;-lr'ilinr ~'J\t.h 1"'.11 ('f~t:d.r' villllen in ~.h.iB r~rf'~.
Pn TuC'",luy, :.;(\f"t..t:+"r 1'~, 1")7~/, 1 ip~':II"'ct("~ t.be :Ibov(' '['cr'~rf;llcp.d
prornrty to :Ict,,,p,Lnp it.: r:dr ',,:!r! cd: v:>I\,,', nn or ]"tc iJctntnr, 1~79.
tllP !H-'riod of <If':II,!., nf Ir. nnd '1--\. 1~"lvin.
TiliH 2G X 24' 1'",,''''';' I'] od "~I rllr.I:lln' j'l l",,:\tu,; nn 111 i rr",!ulor
sha;)cd lnt :JIltl tll('fP :lfC 1"\"G JP." ;.; l,q t.lr' ;.r(l~)'~rt:y. ('Lnl~ de!':'!! d~~~crlbinq
~ pnreRI nf th(~ jlfC,'rrt.y j~) l'(.'-.-,rrl.....1 in 13_r_2.iJ1 ar:d:) elnr.ification of
!:he lot in r~r'!Jr"'" ill 13-;'-1','::, The 11'\: Ii'''''' ill'''' 1I0t cJ",".rly ('~tahliBhlld
on tlH'I prO;JC'rty ;IP~! Ht~ thertf'::T' r.-rr~r to LI.n dt'cd:~ Hl"'d nInn:1 ~~llrvey in
the prUl!,I1H!1i.nn r'l \c.ur Htt.f~r'I('\.. T"I' '":llfVf'Y .:t:JtC!4: t.l'r. ["r(~r-t'rt:y Fronts
on "10llnt n i n '-j I' rp{~ I i lIlt I./(~ ~l ff' r:'~' r i ill' n t t h i r ~~houl d hC' r.orrpc t. 0(1 to rend
CCd;11' :.tr('('t. nlld ..l:TP,IT"l I cIrrI{. t ('n t~l:lt ':.tl'f"'lCt a l./i~llh nf !I:~ font..
It :lprenr~~ t.tH,! hOl\',r~ \.r;,l:~ !.lJi::' 1.1"' Ll.,c ;'id ,qlll)lt.~ nnd in of r:'lthnr
~t,E'f~P r.nnHt.rllctinn. ';{:l;,.-Iti.'ji"'> l-~! '_~'r :)]II::'lI'IH r-:iclinr! '"t:1E in:it;-111pd on the
home t.ut !\hn\"~j cnn:::.i'lt~r'll'df. dptr'~'inrHi.jf'n. The h()u~le it~ 24' Id.de Hnd 2G'
d~(>p un11 thf' intrrtC11' cnnC',i~::t.~~ nf livlnr ri,l"';, kjtr:hf"fl. po\vt!l:'rrflol:l uud
one bcJrool'l. A.t t:l"~ rf'~,1r ir: ~\n rnt'l n~~el! ,If/rell hut i t if~ notr.d thnt no
I.:ath .\!1 provi'!otl.
TI,r fPI9r.~II("nl cC 1.1lo l:ropr.rl.\. h:-;,s il (Ii rl-. floor ;jnt! thorn i:l evidence
t-I':It: sprillrJ i'lnt:'!r "lU'.':~ :-i,.'rf.':\r in ':.',r. !'.'l~;c~:'~r!lt periodically. TI"I(' h:lnement
ront;)in~ hot. "/rltpl' h(:[ltr~l' nl1d it ',,;';~i t;t:lt-f~l! t.I'ilt t.here \las ,1tl nil fired
rurfl:lco :lilprnxi..:,1ll'l" ~ Y(';ir~i ld~!. Yhf'I'C' j!, no o:lt.!drle crollarw:,y hut no
rd.E'rn fer ;'J(:cr~~t.',. 1 t .\:.-l;~ 1 p:1rn('...--l tt'1t tl,I'rp i,:: , 'H'plic tnnk or unknown
dil:;pll'1ioon rind \.':It.,"ri~: :.,ll'..l'] ipr' Ly t.t f' 'it..J_1y L!;\t~r Cnl'-'pnny. TI,rrc iR
:-1ll.i~ Gtorr;'it~ rl:;(l\'('1 ~"If' ~j r~il: f trlDr.
REV..449 (8-18)
;; / II 1/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATiONS
.*
RESIDENT DECEDENT
COUNTY OF _CUMI3J,;'!lLAL,J..IL____'__
IMPORT ANT,
, -
This return must he cOlllpletcd ill dl'tail nml filed in dlJplll;att', with all altlldll'd, ....,lIb lIlt" Hcgisler of Wills (If Ihc
Cuunty whcf(~ decedent rcsidcJ; l{l~fllrn i~ dm' wilblllllllll' munlhs after dale u\ dc,lIh, tlIllcs~ un l:XIClISiol\ I~ grulllcd
hy thc Secrctllry or HC\I("l\Ilt', iScl:!iol\ 70.1 olthl' lnlu'rinllll'c and ESlillt' '1'1\:< 1\\;1 of 1%1,)
IN TilE MATTEI! OF TilE ESTATE OF
1 ,\1' FillA VIT 01'
----- f EH:CllTOI!
-oWl.Il,>;IS:I'IlA:I't)R
County
.ANJ:-JAJ'...--CDh\UN
(STATE FULL NAME OF DECEDENT)
Let. of ,QUM13ERLAJlJL_,_____,_,___,_,__
Stot. of PENNSYI.VAl'IlA.-
County oICur~BERr.At~D
},,,
ft.dmtnTstmtor-
ADALINE~Sj'illLER_____
of the ollote 01 ,he above-nomod decCldont being duly Iworn, del'o!\e
and say
Decedent died ;~ovember 2g
(MONTHI
Nome and oddres I of attorney or }
olher outhorlud rllpUll..ntolive to whom
011 corr..pondencll should bll mailed.
(DAY}
, 19__7_~ 10,tOl" leaving 0 hut will, copy of which Is herctoattocherl, }
(~intestole
IRWIN, IRWIN & IRWIN
--.l:!4 South futnoveY' StY'ef't, CeY'liRlf', PA
That as such executrix deponent is f"miliar with the affairs of said estate and the properly constituting
(EXECUTOR-ADtvllNISTRA TOR)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of nnoth'~r, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF I3ANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
CnmmnnWf'R 1 th Ne
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
F:ELATIONSHIP OF JOINT
HOLiJERS TO DECEDENT
l
That the contents of said safe deposit box or boxes are itemized under Schedules B
with the exception of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made parl hereof sets forth fully and in deta; I all the real property
in the Commonwealth of Pennsylvania uf which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon ellch parcel of real property at the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent,
That Scheclu/e B attached hereto and made part hereof sets forth fully and in detail all personal property
wheresover situated owned by the decedent at lhe time of death: all moneys left by the decedent at the time of
death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in lrust for any other person or persons
giving also separately the accrued interest thereon, if any, down to the last interest day pritlf to decedent's
death in the case of savings bunks, and 10 the date of decl:dcnt's death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of iudebtcdnt:ss of the United States to the dc~
cecent; all obligations, whelher by statute or agrel~mcnt they arl: designated as tax free, of the United States,
or any stalc, or political subdivision therenf, or of any foreign country, which ar~ owned at lhe time of dc;ath:
nil wearing apparel, jewelry, silverware, pictures, books, works of 3n, household furniture, horses, carriages,
automobiles, hoa:s, and any and all other personal chattels of whatsoever kind or nature, left by decedent,
together with the fairly ~stimated market value thereof; all honds and mortgages held by decedent and of all
claims due ant.l owing decedent at the tiOlt: of death. and all promissory notes or other instruments in writing
for the payment of rnuney of wlli(,Ji lkccdcnt dh~d possessed, of whatsoe\'er nature, with interest thereon, if
any, giving thl~ face value and estimated fair market value thereof, and if such estimated fair market valuc be
less than the face value, it scts forth briefly the fl'asons for such depreciation as to each item; all moneys
payable to the estate from life insurance policie~ carried by decedent; all annuity and endowment contracts
the proceeds of whkh were pnyable UpOIl the death of the decedent: allllnd the corporate stocks and dividends
due thereon and unpaid as tlf the Jute or dCillh, hllnd~ and iu.:crucd interest thereon to the dale of decedent's
death and other investment sl~curitiC's o\\ncll by the decl'dellt at lhe tilllc of death, with the market value therc~
of at such time.
In the Cllse of' SIH~llrlties of' clnsl' 01' l'llIlIll)' l:nrllr.rHl.lolls, t.1ll' Vlllul!s I"!portf~d /irlJ as ('ar as
posslhle HulJstllnt.lntf'11 h)' rtllllTH:llll sllltemHIlt.s of' the corpoflltlollS, sllowlllg Ill!"' IIS~jf:!t.S /llId IlllhJlitlp.5
lh'-'rt~ot' liS of t.hn llllt.e 01' dl'lltl1. Thn Sdll~lllllf' nlso sets I'orth 1.11.' Intel'l'st. ()(' llf~el!elelll. fit till! t.lme of'
c1elltll 'II nllY eo-pllrtnershlp or hllslnesR, IUlII in support. 01' tit.. Vllluf' fll' s\lch Intl'rl'sl l,tH~r(! Is IllUlexlllt t.o
snlll sl:llplI1l1e, fllllllH:lnl stlllf'ml!rll.s showlnr, thl' I\SSI~t.S nml Ilnhlllll.'s 01' sllld l:o-flllrllll'rshlp or hllsh1P.5S.
..\ I'nl'Y flf' till' eO-Jlllrtner:il1lp /I,~rf!l:ml'llt, (If' OI'ILI, II stll~.f'r1ll'lIt, splt,llll-!; ('orlh 1.111' IHlt.llrf! nf tI\l! 11~rel'ment)
tOI!;I.tllf'l' with II st.ntt'lrlt~nl. sl!t.tlllJ,!; rort.h I. he ellllrll<:I,{'r nl' I,Ill' hllS1llPss. Its IOf'IIt.lof1, Hllrl sHeh ot.lH~r ('IICts
jlt>rlIl11l11l~ tn till' huslllf'sS liS mn)' hn pl'I't.lllf~1l1. t.o It fltlr IInel .1IISI. npprnlsnl of' t.lll~ dl!'~'!lll'nt.'s lnt.l!rm.t.
tlu'rf.tll mllst hesulmlltt(>ct. II. should ItlslI set f'ort.h In ItI'rnlzl!d l'orm, tfl~"l.Iwr I'Ill.h L"I' rlllr mnrkl1t Vldlll1
!.!lert.ol'. un)' ot.her propert.). OWIU.r1 or lleqllf!lltlwll hy Uw rlnl~l!df'lll. lit 1.1\f~ t.lme nf' flr'IIl.II.
The Srfopdule C Ilt.l/lclleet Ilf!rpt,(l Ilnet 1IIltfh~ 11111'1. h"I'('ol' sf!l.s f'ort.h II true lutSwer to f!llCh inquiry
conlntw'u tllert~lll nwttnt.he ['nst1of'trnTlsrersof'pl'operty, rl~1l1 01' per'soIlI1I, wlt.llln t.wo years ofdecndent':i
c!l.'/lth. in cOlltf'mpll1Lton of' llecedl'Tlt.' s rleath, or Int.f::nflnfl t.o t.llkf~ ef'f'nel. tll possession or enJoyment. at. or
af'ter death, snld schedule sets fortll t/w rJrt!.lU'f! Inlll vlll11f' f)f' slIeh property. to whom transrerred, the
relationship of t.he trllllsferec5 to the rlccefhmt., t.hj~ proportlonat.e shure rfH~elverl by cllch transferee and
all other ('ncts of' fl pertinent nnt.l1re r(l~ardtllJ.'; suid trllnsff~rs. In the cnse ot' tl'lHlsfers intended to
tuke effect 1.n 1l0ssesslon or enjoyment Ill. or Ilft.f!r detlth, t.herl~ Is nlso Ilttllf:ll(lrl tr) the scheflule II COllY
of' the deed, trust agreement or other instrument erelltill~~ t.I11~ t1'ust.. Tlll~rl~ Is also set rOl'th in said
schedule It list of ull property, renl and pP'I'!:Wnlil, w1t.h Its vnlue, which pfl~ses nt, decedent's death by
virtue of' the exercise by decedent., el t.her indlvidul111y, or joint.ly wll.h Ilnother, or IUlY power of a.ppoint-
ment vested in decedent, either indlviduully or Jointly, by the will, deed, or other instrument of' another,
with n copy of t.he instrument creating such power flttfiched t.o the schedule.
Thnt Schedule 0 nt.tnched hereto /lnd mflde part. Iwrr:ot' sets f'orth t.he nHmes nllrl nddresses of all
persons beneficially interested in this est.ate Ilt the time of decedent,' s fhHlth, the IHlture of their res-
pective interests, their relationship, if any, to the decedent, togl~ther with the ages lit the time of
decedent.'s denth of a.ll minors, Ilnnuitnnt.s nnd benefJcinries for ltfe unrh~r decedent's Will. It also
contains a. statement showing which of the beneficiaries namell in the llecp.dent.'s will, if any, died prior
to decedent, the dates of their denth, their issue, IUHI the l'ci/.l.tionship of' snch iss\lf~ to the beneficiary.
That S.:hedule E attached hereto and made a part, hereof set.s forth nU propert)', relll and per-
sonal, owned by the decedent ,jointly with another or othel's, inclwUng intangible, standing In the name
of the decedent nnd others, plus the dat.e and plnce of record of instruments effectinJ; t.he \estiture of
real estllte Ilnd the date of acquisition of personnlty, plus the name, /lddress nnd relat.Jonship, if any,
of co-owners to the decedent.
That Schedule F attnched hereto nnd made n pnrt hereof set.s forth ftlll~' and in detnU all debts
and deductions claimed for and on behalf of this decedent's estate, including t'uneral expenses paid;
family exemption, where applicable; costs of ndministrat.ion of this estatej counsel fees and fudiciary's
commltisions llllid or to l)e paid; cost expended for burinl trusts, tom.hstones or gravemnrkers, and reli-
giouS services, in consequence of the dellth of the decedent; debts nnd claims owing anti nnpldd at time of
dellthj taxes flccrued chargenble f'or period IlrJor to decedent's death (exc.ept. those allowed under Section
651 of the Inheritance and Estllte Tllx Act); together \'Iit.h n statement of collateral pledged for obliga-
tions, if lmy. It 1s agreed that the fiduciary will present pl'oof of SElid clatmed oblJl,!;ations upon re-
quest, that if the amount actulllly pllid in settlement or nny fee, commission or debt is less than the
estimated nmount clniming /lnd allowed, t.hat the same wHl he report.ed to the Hegister of Wills, and that
the u.mount or tax assesserl can he rellsscssecl in llccordlUlce t.herewl t.h.
Thllt the toul1s or the Ilpproprinte columns In Schel\ules "A", "B", "en, "E", and "F" a5 directed therein,
hnve! lleen cllrrlecl forward and llroperly regist.ered ill the Summllry.
Subscribed and sworn to before me this ,....
m....'..' ,.."...! ~'C . .... day of. ..1: ",nuan
O~f'3' ,,3 C(l,(,--
f\GG:~U 11. I;,'. i'!, ::-~;.. ".t I':: ':' ' .
,:r\!\L1:;1 ~-_ 't;:~...lH! I" [:1, ')":\ ;;:' '; . ~-" '.t:dY
MY CO:/i!,~iS~.:':.,1 L..h .L:J lU ;~, J.J~,_I
r
..19,..8.0
.G.......(,.""."......h.::.l...';;';:..../.........,~.._,......:..'...,.i..............~,.............".""."............._...
Ad 1 ,(Exel;\Ltor-Administrotor)
a lne V. Stover
I) 5....Mo unt.a.ill..,.st-..,......"..."...,.,.........,..........,...,.",--....--.-,
(Street Number)
I'lt.. Holly.Springs,..PA....
(City or Town and SUIte)
SOTE: nl~t'orl~ slJ!.llin~ nrf'iduvll. ml1lw surf' /111 hlnnk SPIl('I'~; In tile 111'1'1<\/1\'11. Hud s(~hf'chlll'f- Ilnnexerl Ilre
fllll'tl 1n w1th df>tlltlS or the word "NOlie", all'\ in l~lISI' 1.11\' IlSSl'ts tl1l~I\llle J'nTt> rllll! ullltRted securities,
seellrlt.tt's f)l' close or family corpor11tlnns or /111 iHU'rI~~;t III all)' f'il-plIrtlll'rshlp or huslness, thltt the
dllUl Htlll StlLtPItlf'\It.~ requJrcfl under the pnrllRrllph IIbOVI' r,~;attnp; to S('III'I\lI}I.' "'Il" nt'!' Ilttrlchee\. ,\150 mllke
C(lrttttn t1wt. column 111 In till"! "Sunlll/lry" hns hPl'll prnlll'rl~' (,0:111'11~tPd uS 'lho\,'~-llirl>ctl!ll.
(JII'e" 243-6195
tFi!~
~Gr.'Q
..:.,.1:....:
GEOH.GE L. EnENER
II1JD ASSOCIATES
REAL1 ORS
AI'PI~AISER . SALES - PROPERTY MANAGEMENT
139 WEST HIGH STREET
CARLISLE. PA. 17013
l:I1111H ry Ij, 19W~
Ilr!l. .JO!Jf.?pl: r. ~tliV('1'
~') ;:olJntrl1.11 ~~tr(lpt.
~lnunt 11011;' Sprin=!~;l \"1.
1 7 '1 (-, II
::\': JtJhfl C. ,lnd /\nno r:olvin i'rul'~rty
r r' .; ;l r I.j I. r p CO t, ; 1 (1 un t II n 1 .l Y ;; II r i n q n t P a .
r' e II r ~.: r!1. ~,l {l v (' r :
1 ;l,l'l U 111...t~n:;t'! ',('11 r'~!.l~l r'r~I'1'1 li"i"'I\~lrd l:~ t:'d' CCI\",qll""I~:llt.h
rf Ill~nnsylv:lllin, :lt~'l 1, IVL' !>t-','f' ~.j,1 lvr'l'l l'll. >lIJ'I,1 in t.l~f" r(.:t1~'ll:dl'
11\I!1inr:!Hi for tll(1 :"l:_~t \'i:".,i.l:'PI' \f,"r'i in l'~. i:IJ!!t.rQ'1;Hl\1 [ollnl"y 'lr('il.
1 :11(, t.lw rOil n Ii I} r"" i l i" r 1.1 ill, \'." J ,.: t" j r, v:,j 1I" 'l .; f\ 1'.1. \ '; "r 1';1.
('In TlI(""..~;I"y I ~1.'("'I,'f,.I"'r
nrnj1~l'ty te, .\"t<:r".;n'.' it':
till" !:J.:>riod of dPilL1. of r.
1!, 1""/':, 1 jP:~'!I~r'~('l,1 tl\~ :lhOVf' rer..rnlicet1
:"dr rl1;t \."'tlh~ "I:, or ];:tc (';cl".cdi:r, 1'?79,
,In,j 't"j. 1'(,1 vi n.
ThiH 2L X 7./J' ('r:;"(,I11. t'l()c~ ~~trl!cl:"tr(' .i'1 ld(~:Il:ed on '1,1'1 irr" IIJ1ur
~tl~l:~p.d lnt anti t.lli'ft' nfe 1'\",,: 1r' :'; tr~ t.lr l'rU))I~rty. l nl~ \lc['(1 .:p~'crlbinq
B jHlrc:pl nf tl1f~ prc'I\(,l'ly j(', l'\,lf':q"ln:1 in 1)_f"_7:l1 [:Jnd n elHrjfil'~tion of
t'he lot in 1'e('IJl',hlll ill 13-r..~1"1:'. T~"I" Ie'!. lif\(~f; ore not c.1('~~~r)}1 eHtahlishcd
on t.I\fi properly ;11,[1 \l'i~ tli9ff;rr,r r,,-f'l.'r tc Lt." df;'cr1~~ and alr;n :1 ~lIrvey in
tlh~ (InnnofHliqp of yr:ul' Ht.tf:ff1r>\'. Thf' <':!Irv('y ':~.;Jtc~~ tl'(~ pfPl"prt.y frontn
nn t.ll111ntnin ....ltT('!~t l,ttt: \/(~ ;JTf' r;": ri '!\'Ilt 1:1',j 2 :d1ould hf' t:Clrl'f'ctod t.o rood
Cedar ;-;trf'~t no'] :-q~I'('r'r'i tc f 1'(,rt I'll t"~lt ~,trr"ct ;~ ",/i-ILl' nr II'; fo~t,.
I t il pro a r r, t. huh II fU~ \'};j:~ t.1I; 1:' i. ~ L L t; :' i.l 1l}l!I'j'~:; D n r! i:1 {] f r td: h r. r
('hef:p conntrllctin". (;(:'i"..,ti'~,~l t -I'll' nlH!:'ll'lll., !~idinq loj:l!.' inrl!;'11r-d on the
hon'lt'" I,ut nho\''''') enlL;l'ler"I''tl(~ df't""!'ilirr~l.i{'n. The hou:,e it~ 24' I/lde Hnd 2(1'
df"flP <In.\ t.hf' interior ctlr.l,:'ip.t:~ nf .l,ivilF r~;I"';' kjtr:llpn, pOI'Idrrrrlol:} ,HId
one bc,Jt'C'nl'l. :\l tl'l~ l"r".-'t' t''': ~ln I'rl('ln'.l~" :'I"rr~l hut it ig notr.d I.h:it no
t.' U ,. 11 \ Ii n r 0 v i ~l {~d .
TII" b:19p'lir"nt rf I,\'u rC'~ll(~ll.\
i'I';I\'. ~,prlnlJ "Iatr~r :1\1I.'~; 11'r''','lr ill
c~ont i1 i fl~~ 1:(1t l'l1 tpl' !ltn ~_ (~r :1 n,~ i I
rttrn:iee '.Iilf\rnxj ,::11 Ill" .'~ vr;,r~) :,1
:,t.rr~; fer ;'jCCr'~~~. It .....1:, 1,-..:.)'/,(,,1
r1 i r.p t I '1 i \'ill:, ;. n. i ;,',\ t. \" r i (~ ,; I II', \' 1 i I'"
:ll\.i{~ ,',t{1r,,~:t" n:'n\''"'' ~_I"., :ir ,I r"I'
h::.c; ;] (Ii r~' f.1 '1nr npd lhr.r" j'-j evidence
I:.,.., \"'!!;(:. r"t: ~~.r.ri(lrljc;jlly. 'rltr h~nBl!10nt
,,", :.1.,'; .:,1 t I...l t"~re IIN:. ,',1\ "i 1 fired
lh;'rr i ; :1I1 'Jllt'li dt~ Cf'.1 J::t\/'l) Iput no
r~ '~l' 1,:\01'1''' i "1 ~p:,llir. t;1n\( IJl' unknown
1.\ tl '~I"i! vr;d~~I' r'll ~'(H1Y. 111:-'1'(' iA
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rr'!le rol](l\':-inl~ nr'" 1\1,. I}.jtll"" \..'II~":I ~'Il r,[', : " :
as 01' :'~OV(~ll\hc'l' ?'1, l')"/IJ:
; i ',: ,." "IIIT"li'
1. 8TLVI~:\
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c. h,].1 t'f'; - I il. I)(J
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.
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a. $l311.(1C) ,Ii :!'l]I,.()~! = ,:',~~l().(~".................,...,............$
:3, 1\0/[ HALl":;
:],
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-
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.
Commonwealth 41\;\
National Bank '!i1i~
.
December 17, 1979
OtC '[ 8 1979
Irwin, Irwin & Irwin
44 South Hanover Street
Carlisle, Pa, 17013
Ue: Estate of Anna P. Colvin
Dear IIr. In-lin:
In reply tc> YOllr letter dated December 6, ]979 on the above estate, the
folloHino, information listed below is as of D,O.D. November 29, 1979:
Savinp,R Account -
$3,259,18
Opened - 7-31-72
II L8-0010659-1
Accrued Interest - $29,59
Accollnt in the names of .lohn
& Anna P. Colvin
C. Colvin
Savinp,s Account -
$9,953.92
Opened - 9-3-71
fl18-0007583-8
Accrued Interest - $58.23
Account in the names of .John C.
Anna P. Colvin
Colvin &
Certificate 0 f Depos its -
Prine. Accrued Interest Issued
/118-4149 $7,714.45 $298.76 4-16-79
18-4394 4,212.6Ii 90.82 7-25-79
Botb accounts are in the names of John C. Colvin & Anna P. Colvin.
If you have any questions, please feel free to contact us.
Very truly yours,
/
"
,
,/. "'-' ~.."'" ~
'. -c_"!
~.., ./ . .--
<" .-/
/
.~ ( -" ~ -. \
John U. Hart
Sr. Credit Analyst
JRH/ci\
The Commonwealth National r.1Ilk, 10 Suuth M,ukel SQtI.1tl'. H,misbutn. Pa. nl0B (71715G4.9500
l'tl\\~ll\'\~'!:'I\I:~>11 Ill" IIL"S\~YIX,,\'\I:\
i'1tl\\~}-'~"lt ISI:~.~!lIT:'\'tT T\\:
l,.;I'IWlll'l.l< 'iI'"~
T:,\\'':ITHI..;
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(1) llll! t!l'I'l'dl'lll. ',11111111 1\1'\1 ~l':'I'~;urd"ilt!l. Illill... 1111,\' Il'lllIS!'''l' Ill' !Ill,\' lllatl'!"!:11 111l1't, 01' Ills I'sl.ll!l', without
rl'l'pI\'IIl~ a ralu;dlll' /ll~d Illli'l\1l:1tl' 1'1I1lSldl'I'lllltlll tlwl'I'l'nl":' (,\110..;\1'1')' YI'S 01' I1n)-1~_O__
(~) 11Id ,\,.,.">\"",, .11101" "'" )"'"'' ,.I' >\""'10,1""",\,,,,, 1'1'''1'''1''' \,,""U loim,,,'I\' '" llim,..i\, a"d ""011.1"'" ""
l,llll'I'S (1IWIll!lllH~ II spollsl'l III .Iolnl. (lWIIl'I'~~lIlp'.' (\ns\',"" YI'S 01' 1l0l_.ND.....____
(:I) 11' tht~ III1SWl'r 10 (I) ell' (:..!) illlll\'1' is III tl\l' 111'1'11'1111111\'" ~,l,all':
(Ill ,\!.~I' 01' dl'l'l.d"lIl. Ill. 1111ll' Ill' tl'HIl~;l'I','11L-L___
(h) Stat.. 01' dl'("'t\l'l1t's l11'alt.lllll. lilliI' ol' 1l11l1dll:!, I Ill' t,I'I!llsl'l"'. (~fll" 1).
(c) CIIIISI' 01' dl'I~I'c1"IIt.' S dl'lllh. (~otl~ I).
(4) !lId ctcl'-edf'llt, In Ills 111'1'1.11111'. 111111,1' HIl~' tl'lll1Sl'I'I' (If' pl'llpl'I'1.Y .....1 "ho II 1. t'1't'I~I\'IIIg; It \'ulllllhlc or ndf~I"llltl!
c(ll\~ithn'at.loll t1WI'l'l'ol' .....hll~ll WIIS t.o \.I11\l' t,'I'I'l'l't. 'll possl~sslClll III' 1'1I.l0Yllll~IlI, Ht. or Id'l.l~I' llis dtlllUI'!
(Answer Yt~S 01' 110) NO
(Il) \\"IIS t.lll'1'1' allY possibility t.hal. Ull' propl'rty 1("HIIS\'I'I'I'I'.11I11g;lll. l'I~\,IlI'11 1.0 t.rnl1sl'f!l'('r or hiR
,lst.IIH~ Ill' hI' Sllb.lI":\. t.n his 1'0\\'1'"!II' IIlspo-.;1 I. 1011'/ (,\IIS\\PI' ~'ps 01' 110) NO
(II) Wl1al. WIIS t.Il1' f.J'llIIst'l'r'I'I!IS ;/;!,I' lit, 1,lull.' HI' dpef'lil'lltls dl~IlI,I1'? 2LL-
(5) !lid Itf'ef'clnllt III his 1II'ptil1ln l1lakt! 11llY l1',lIlSl'l'I' Wlt.llllllt. l'eeel\'llI~ It valllHtJlpancllldpqllllt.e l~onsiderlltfon
there fur UIltII~I' \'ihldl trllllsf'nror I'XJlI'..ssl~. or IlIlpll!'ll}y l'l~SI~I'\"~S 1'01' his lil'p 01' 1I11Y IH~I'locl widell Ilocs
lIot in f'1ll:l ellll heroT'!' his dl!:ltJi:
(n) The possl"'ssloll or Inl.ln~'l1lelll 01' 01' thl! l'lp;llt to II\l~ol1l~ 1'1'0111 t11f' prnJlt'rt.y u'ansl'PI'rml?
(Answl~I' ~'I!~ 01' no) No
(Il) Till"! ri~llt In dl~slp;lIl1tn Uw persons who shall Jlflssel-iS or en.lt)~' till! property trllnsi"orrel1 or
Income tht'I'ld'l'om? (Ans\,>,p,r yes or tlo) No
(0) If the IInswcr to (5) (h) ahtl\'c Is In the llfflrtTllttlve, stnl,e WIH!ther th';' l'lp;ht WllS roscrvpl! In clecedcnt
Illone or otllt'l's N/A -~-"-_._------------'-----"----"-
(7) nltl decedent in Ili~ 11I'I~t.ll1Ie llIak!' a tral1sf'I~I', thf' eOlls\t\I.'rat.ifJll {'or Wlllch 11'llS tl'lIT1Sfl!rl!(~ls prolldse t.o
pny income t.o or \'01' !.lll' hl~IlPt'iL ur ellre 01' l.ransl'f.'rol''! (,\ liS""''' I' yPl-i 01' 110) --11.0
(8) DId decedent, Ill. any tllllp, U'1I11sl'l'l' protH~r\.y. t.Iw hPlwf'i<:lal t'IIJI.\YllIt'llt of' wllldl was subJect t.o <:htlllge,
hecause of' a l'l'l-iI!1'\'I',1 jlc,WI'I' t.o ulIYI', /l1ll1'1Il1, or l'I!Vllkt', 01' Wlllt~ll I~C'11'ld rl'VI'l't. to (ll~C~I~lh'llt. lmlle!' terms
of t.rllnsfl~r 01' 1)~' ol'l~rllt.lon 01' lnw? (,\ns.....I,'I' yos 01' 110) NO -
(n) If the Ilnswor 1.0 (H) IIIHIVl'ls ill the al'l'il'H1/LLlve, .....IIS Llll' pOWl'l' tn alIPI', II111Plld, or l'l~voke tile Inter-
est or the henf~l'Jelllry l'I~SI'I'VI'd In \.Il1~ (11~Cedp1\l alolle or till' lleeellcllt IlIlel l,l.'ll~rs?
(:\nswer yes or 110) NO
~OTE1: The tlnswcrs to t.hPsl' tl'll'st.lol1S should lie Sl1PpOl'\.,I~1\ hy af'l'iclavil. hy thp. IIlt(,lIdinJ.!; physIcian liS
wp.ll us II copy 01' \,lIP IIeat-1t cl'l.t.ll'lelltt~.
~O'fE 2: If llrlsw('i' to allY lit' t.he a!Jtl\,I' quest.lollS Is ~'I'S, Sl~t. f'01'1.1I hl'lo\\ it de~l~I'lptl()1l of' tile property
transferr!!tl, tt's fall' l1ulI'kP.l vltlltl~ at daU' of Ilplll.ll, i!ltl.t'S of' t.rllllsf',!rS and t.u Wllt)lll tl'lLllsft'rT'(>,I, with
rellltIonshlp or trlllll">l'p.r'-'I's to lh!CI'lhml.. If' Ilny. Submit copy 01' lIny t.I'\lSt .Ieell or I Tll-it.rumcnt, iI' trans-
fers urn c},lIimell to he llon-tllxllhle, 1Ilso l-iu111ll11. lll~tllilt'rl sl,alel1lcnl. or I'acts Oil whIch slIlll clu.lm Is basell.
~OTE :j: List nllpll{~lIhle pl'op..rt.y helow In manlier in wllidl pl'n\'Icle'l In SI'jjnclulf's A, II, or I':.
ITE~I
\IESCHIIITl(J~
~L\Hl\El' VALUE
(Estim:ltccl)
DEPT. VA1.UATIO~
(Dopt. Only)
NONE
------"
\
I
~~O]jE
,
11.i'\\::---
IU"I'rt tlds lnt'd 01'1'0..;11" "'1'1"111"""1''':'''. ~c'IIl'''IlI(' "I'" ill till'
"\.. H"flort'.,," ,'.J111Tl[n 1111 1 !~I' II">I II I:~" '11' lid..; 1'..1111'11.
~
B 'Il ::
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._ 4.l ::l
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E U
10:
s~~
::l ~ ::
U ~ 0
~ E 0-
K ~
::! 0::
Real Property
Personal Property_
Transfers
SIIMM,\RY
(S~h. "A")
(Sl:h. liB")
(Sl:h, "(''')
_._~------_._-
Gross Taxahle Estate
---------
.--.--- - p. - .-
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(As Reported)
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(As Oelermined)
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RCC.3 (4-13)
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, 1956, P.L. 1757, and Act of June 15, 1961,
P.L. 373, as amended)
i+-
~~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed lor the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1. Bur.ou Fil. Ii _'__'?L-I2'::-_E_R__________~~_
:: :::::: :::::VOI _ t~~:y,/ ;g~ Ic1i~-'
4, Nom. of Decedent ftJA P. COLVIN
5. The Commonwealth's appraised value of the property for which an exemption is claimed is S 1,000.00
(Hate: Where the property is other thon a specified amount of cash, the exemption cannot bt, approved until the value of
the property has been established by appraisal by thc Commonwealth, cxcept in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously Hied.
WILLm;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Harne and Address of Charitable Organization receiving property:
NAME
Brethern in Christ Church
ADDRE~ Mount Holly Sprin~s, Pennsylvania
o See listing on reverse side for additional charitable organizations covered,
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
Signolure 01 Applicant
/ ( , 7/ j~' . '
/ I /J/~ '~_-Jr.t ~ '..,-. _./-t'>)y" (.,/
ADALINE V. STOVER
Addre.. 01 Applicant 55 Mountain Street, Mt. Holly Springs PA
Ollieiol Title
Executrix
Dote
.TanuaY'Y
1(.,
19RO
Thll form must bn completed in trlplicote and all three copies delivered 10 the Roglster of Wills for the County In which the decedent
resided, or in which lotters were issued for a non_resident decedent's estate. If the decedent was a non_resident of Pennsylvania and
lettera were not Issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write below this line. For Ollieiol Use Onl
APPROVED: For the Secretory 01 Revenue REFERRED to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
J.
(&I.,,_lr- _f Re9i..sler III Wills)
_ \,\.. ''"'1)..~~ Go J~
(County) )
r (\ ....,
'-'1\-
at. of Approval)
(Initials 01 Registe, of Wills)
(Authorized Signature)
(County)
(Titl.)
(Dote of Referral)
(Dote of Action)
.;, See reverse side for reasons
MUST BE FILED IN TRIPLtrATI'
RCC.3 \4-73)
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of Mcy 28,1956, P,L. 1757, and Act of June 15, \961,
P.L, 373, as amended)
COMMONWEAL TH OF PENNSYLVAtllA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hareby filed for the appra',al
of an oxemption from Pennsylvania Transfor
Inheritance Tax on the transfer of the property
described below:
1. Bureou File '1_~,}_::.I9:n~-n_-~-' '--------
2, Dote of Death _ Novemher 29, ] 979
3, Dote of Approval _~r,,-~_f~L-_l!1 ~ (J
4, Home of Decedent A INA p, COLVIN
S, The Commonweolth's opproised value of the property for which on exemption is claimed is $ 500.00
(Hote: Where the property is other thon 0 specified amount of cosh, the exemption connot be approved until the volue of
the property hos been estoblished by appraisal by the Commonwealth, except in those cases where the amount of the gilt
or bequest represents 0 stated fractional or percentage portion of the entire estate or the entire residue. In those CaS"
enter such fractional or percentage amount above).
6, Check the manner in which the transfer was effected and submit 0 copy of the document authorizing the transler, unle..
such material has been previously filed.
WILL lJ.;r-.
DEED 0;
TRUST IHDEHTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, explain)
7. Correct Business Home and Address of Charitable Organization receiving property:
HAME
Carlisle Hospital
ADDRESS 224 Parker street, Carlisle, Pennsylvania 17013
o See listing on reverse side for odditional charitable organi,ations covered,
8. I certify that the information contained herp.in is, to the best of my knowledge and belief, true and correct.
Signature of Applicant
I~ ;/; t~:'v~ .~/ ~./l:~~.c:. <:"
ADALINE V. STOVER
Addr..s 01 Applicant 55 I~ountain Street , r~ollnt !lollY SnrinR:s PA
Thl. form mu.t be completed In triplicate and all three capl.. delivered to the Register of Wills far the County In which .he decedent
,..Ided, or In which lett... we,e IIIuad 10' 0 non.resldent deceden"s estate, If the decedent was a nan.r..ldent of Penn.ylvanla and
lett... we,e not IlIued by a Pennsylvania Regl..e, of Wills, dell,e, all th,ee caples to the Ol,ec.o'. Bu,eau of County Collections.
Penna. Deportment of Revenue, 26 S. 4th Street, Horrisburg, Pc.
Officlol Tille
Executrix
Dote ,TanUflrv i (" . 1 g80
00 not write below this line. For Official Use Onl
APPROVED: For the Secretory of Revenue REFERRED '0 Bureau Heodquarters
Approved 0
For Secretary of Revenue
Denied* 0
nu,,,v.;:le:rer 01 Wills)
[,v. ~'\IA~
County)
r/, Q ~O
(Initials of Register 01 Wills)
(Authariud Slgnoture)
(County)
(Title)
(Dote 01 Referrol)
(Dote of Action)
" Soe reverse sid, for reasonl
MUST BE FILED IN TRIPLICAT~
RCC-3 (4-73)
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, 1956, P.L. 1757, and Acl of June 15,1961,
P.L. 373, os amended)
COMMONWEAL TH OF PENNSYLVAtllA
OEPARTMENT OF ~EVENUE
BUREAU OF COUNTY COLLECTIOllS
4. Name of Decedent
S. The Commonwealth's appraised value 01 the property lor which an exemption is claimed is $ 250.00
(Nate: Where the property is other than a specilied amount 01 cosh, the exemption cannot be approved until the value 01
the property has been established by appraisal by the Commonwealth, except in those cases where the amount 01 the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
1. Bureau File ,,___~~-_!2~7~B--u_~-"_-
2. Date of Death ___ "jn(ernber 29, 1979,.,
:\ - . 1\ I(Ho
3, Date of Approval .____~.-1-77-L. /
^NN,~ P, cnLVIN
Application is hereby filed lor the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
6. Check the manner in which the transfer was effected and submit a copy of the document authoriz.ing the transfer, unless
such material has been previously filed.
WILL l!J7-
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Name and Address of Charitable Organiz.ation receiving property:
NAME Chicago Diocese of the Roman Catholic Church
ADDRE~ Chica~o, Illinois
o See listing on reverse side for odditionol choritoble orgonizotions covered,
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
Signature of Applicant
/'/1'. "/""
I I ///..'J:.t)"lA/ // J ,'~7 y" (
ADALINE V, s~OVER
Address 01 Applicant
55 Mountain Street, Mt. Holly Sprin~s FA
This form must be completed in triplicate and 011 throe copies delivered to tho Register of Wills for the County In which the decedent
resided, or in which letters were ISlued for 0 non~residont decedent!s eslale. If the decedent wos a non_resident of Pennlloylvania and
letter. were not Issued by a Pennsylvania Register of Wills, deliver all three caples to the Director, Bureau of County Collections,
Pel1na. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Ollicial Title
Executrix
Date
January fe, . 1980
00 not write below this line. Far Official Use Onl
APPROVED: Far the Secretory 01 Revenue REFERRED to Bureau Headquarters
Approved 0
For Secretor)' of Revenue
~i/v.JJ:fS-\\r- j!,ir-~~
.z.~SI, t ~I Regrer of Wills)
... ~p~ } q~ ~..,~ }
.' "-
~ (Counly)
't,,-, / rJ I q~'t1
ate 01 A'pprovo!)
Denied' D
(Initials 01 Register of Wills)
(Authorized Signature)
(County)
(Title)
(Date of Relerral)
(Date 01 Action)
... See reverse side for reasons
MUST BE FILED 1M TRIPLtCATO
OFFICE OF THE
REGISTER OF WILLS
"".. '\, t/ " ,,;. ":..,:
OAT'f:'AfJPROVEO .J'-1~'~-' ( "
., \" I
, !I, lu,' t \'r't,.:.:::C(:c l('~iJ
. !. 1'~:"'TI" OF WILL';, MIJn -
. \ 1.401., I
___,~_ ~\i.Ut~1.: "I ___
\ \
ESTATE OF ANNA P. COLVIN LATEOF r,l'l'., IIOLLY "PI{[JW~J_YJ\.
hlll..\ 11'/ .I('j il
DATE OF FILING APPRAISEMENT ...l/1(,.,./80 _ DATE OF DEATH 11/20/70_______.___.'____
STATEMENT OF DEBTS
AND DEDUCTIONS
DEDUCTIONS ALLOWED IN
HIE SUM OF S 1(\ :;,(jf, 'Ii:
, -
FlEV-4:15 (0"78)
OF CUMBERLJ\I~D COUNTY
AND AGENT OF THE COMMONWEALTH
- -
DATE NO, OF NAME OF PAYEE REMARKS AMOUNT
VOUCHER
--,
12/05/70 Rer:is ter of Vlills Letters etc. ll7 iliL
-- -~--_.- -
lliQ5L19 Cumberland La\~ Journal J\dvel'tisln,\ 18 00
12/26179 Eveninr: Sentinel J\dvertlsinr\ l6 65
01/0:U8Q.. ,Joseph VI. l1ibsQtL___ l.J..werR] eXpel1RPS 1 ,710 00
12/27/70 Carlisle hosDital rnedlcal bill 5 50
)')/')7/70 r~",n ~ 1 '" hn~n'l t.,,1 Im",rl-'~o) hn) 0; on
01/02/80 r~G~l Ph""'mRcV Drur:s. etc. 71 44
01/11/80 IR"'gis ter of Wi Ib PiliflZ-lnventorv. etc. 0 00
Re rds ter of Vlills Account 'U 00
Recorder of Deeds Releases 70 00
R T,.",d,., I ,"nt."",i "'~ ?o; o;n
Ad"nn", V S' - r,,,,,,,,,,t.,.,i,, f"'''' "' 451 6ll
T"'"1i n T"''''< n ,. T,.,wi n I At. f",,,, '< bill Ab
12/27/70 Carlis Ie HosDital medical bills 146 IL
12/27/70 Met-Ed Electric bill 7 19
01/08/80 Carlisle Hosn1tal medical bill 18 00
01/02/80 Carlisle l-IosDital medical bill 1 10
01/11/80 (1",nrgp. L. Rhpne-r ApP!'R; SR1 40 00
01/11/80 Adaline V. Stover Reimburse Labor EXDenses 110 00
01/11/8_12. -, Estate of Romaine S21dle Reimburse for Bills paid 150 00
01/11/80 H. Robert Davis , n.D. r,ledi cal Bill ---25.1. 00_
- hi :J.~{. c;L.L,
TO'l' AL- ----I~;;;; 6]~'
- - - - - ---
COMMONwEALTH OP ~ENNSYLVANIA I
SS,
COUNTY OF CU~lBERLAND _
I Adaline V. Stover ___ HEREBY CERTIFY, TliAT TO THE BEST OF
MY K'NOWLEDGE AHD BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF J\nna P. Colvin
DECEASED, AS DEDUCTlDHS FOR INHERITANCE TAX PURPOSES.
.'s
SWORN AND SUBSCRIBED BEfORE ME THIS_,
....:Lill)ua 19.J&
(
. , I ,.-J.,' 1../
A~alirie V. ~t~ver
(L.S.)
DAY Of
: '{ P',"~,: i:
1''-', ('I..... I ,",'" C;~':,TY
,,1) cc'.:r.~ :,:;l,:'~ L'
,",' . ~'.. .:..!
JNFORMATION
To insure proper creelll 10 your {Iccounl, Ihe nallal ul IIHJ t~Slil\U ilnd filu numbar should be clearly print.
ad on lho check or money ordor.
This assessment is mode in nccordancc with Seclion 708 01 till! InhuntCIr\co lInd ESlnto Tax Act of
1961 (72 P,S, 9 2485,708).
To the extent Ihal inheritanco Ulx is paid within ltlreo (3) months nfler the denth of the decedent, a
discount of five (5) percent is allowed (72 P,S. ~ 2485.716).
Inheritance Tax. otller than tux on a future interest, is duo nl tho diJtfJ of the dccednnfs death and becomes
delinquent at the expiration of nine 19) months after the decedent's death (72 P.S. ~ 2485-711). Inheritance
Tax on a future interest is payable Within three (3) months alter the transfer lakes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485.7121. Calculate interesl from tho delinquent dote shown
on the face of this form to the date of actual payment usmo the following intorest table'
------------ --------- ------------- ------------- - - --- - --- --.---------- - - - ----
1 month .005 4 months .020 7 months ,035 '0 months .050
2 months ,010 5 months .025 8 months .040 '1 months ,055
3 months ,015 6 months ,030 9 months .045 12 months ,060
1 days .00017 11 days .00186 21 days ,00352
2 days .00034 12 days .00203 22 days ,00369
3 days ,00051 13 days .00220 23 days ,00386
4 days ,00068 14 days .00237 24 days ,00403
5 days .00085 15 days .00250 25 days ,00420
6 days ,00101 16 days .00267 26 days ,00437
7 days ,00118 17 days .00284 27 days ,00454
8 days ,00135 18 days .00301 28 days ,00471
9 days ,00152 19 days .00318 29 days ,00488
10 days ,00169 20 days .00335 30 days ,00500
-- ------------------- ---- - - - - - - - - - ---- ---- -- - --- ---- - - - - --------- -----.
Any party in interest. including the Commonwealth and the personal representative. not satisfied with
the assessment may object thereto within sixty (60l day!> after receipt 01 this Notice as provided by Section
1001 of the Inherilance and Estate Tax Act of 1961 (72 P.S. \ 2485,1 001).
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
-'-NFOAMATION
To insuro proper credit to your ilCCOUrlt, Ow llumtJ (jf thu l.!!;wtc ilnd lilt! numbor should bo clulIrly prinl-
ed on tho chock or money ordor.
This assessment is made in accordanco with Section 708 01 IIw InheritanCo and Estate Tax Act of
1961 172 P,S 9 2485.7081.
To the extent that inherilsnce Inx is poid within throe \31 months oher the death of tho decedent, 8
discount of five 151 percent IS allowod 172 P.S. 9 2485,7161
Inheritanco Tax. other than lax on a futuro interos\, is due at the dale 01 the decedent's dell\h and becomes
delinquent at the expiration of nine (9) months afler the dccmlent's death (72 P,S. S 2485-711). Inheritance
Tax on a futuro interest is payable within three (3) months after the transfer lak.es effect In possession and
enjoyment and is delinquent thereDher (72 P.S. S 2485.712). Calculale interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
--------------------- ------------- ------------- - - -- - - --- -_.- ------- -- -- - ----
1 month .005 4 months ,020 7 months ,035 '0 months .050
2 months .010 5 months ,025 8 months .040 " months .055
3 months .015 6 months .030 9 months .045 '2 months .060
1 days .00017 " days .00186 21 days .00352
2 days .00034 12 days .00203 22 days ,00369
3 days ,00051 13 days .00220 23 days .00386
4 days .00068 1 4 days ,00237 24 days .00403
5 days .00085 15 days ,00250 25 days .00420
6 days .00101 16 days ,00267 26 days .00437
7 days .00118 17 days ,00284 27 days .00454
8 days .00135 18 days .00301 28 days ,00471
9 days .00152 19 days .00318 29 days .00488
10 days ,00169 20 days .00335 30 days ,00500
-- --------- --- ------- -.---- - - - - - -- --- - - - -- -- - --- -- -- - - -- --------- -- ----
Any party in interest, including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (60l days after receipt of this Notice as provided by Section
1001 of tho Inheritance and Estato Tax Act of 1961 172 ps. 9 2485,10011.
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
~
~:. .
"
"
CJ',
c ~' ;t
"-. .J
c,. C::' t ~ _ .. ,
0'" t::. "
0:;(' \.',
0-'
uC:; :" ~'
w"J ~
",,'" '.",(..;
(:5
INFORMATION
This document is the Notice required to be given under Section 709 of the Inheritance and Estate Tax Act
of 1961 172 P.S, section 24851.
If the tBx is paid within three (3) months after the decedent's death, a discount of 5% of the tax paid is allowed
Inheritance Tax becomes delinquent nine (9) months after the decedent's dealth. Interest is charged at the
rate of six (6) percent per annum on the amount of unpaId tax. (SEE EXAMPLE BELOW)
EXAMPLE: If a billance 01 tax due of $2,000.00 IS in a delinquent status from 3-3-80, and payment is made
on 5-23-80, the interest 1$ calcullJted as Indicated below:
STEP 1
Determine the rJte of
interest from the tlble below.
STEP 2
Multlply the balance of
tax due by the rate 01
Interest
STEP 3
Add the interest
to the balance 01
tax due.
Interesl from 3-30-80 to 5-23-80
Results In: ---
2 Months :::
20 Days ;
Rate of interest
.010
+ .00335
; ----:0 1335
Balance of tax due
Rale of Intere!>1
INTEREST
$2,000.00
x 01335
$ 26.70
8allnce of tax due $2,000.00
l'l'US Intl!rest to
Date of Payment (+) $ 26.70
TOTAL tax and
interest to Dilte
of Payment $2,026.70
-. .-. - .-.-.----
------------------------------------------------------------------~.--
1 month ,005 4 months .020 7 months .035 1 0 months .050
2 months ,010 5 months .025 8 months .040 11 rnonths ,055
3 months. .016 6 months ,030 9 months .045 1 2 months .060
1 day ,00017 11 days ,00186 21 days .00352
2 dlYs .00034 12 days ,00203 22 days ,00369
3 days ,00051 ' 3 days ,00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days .00085 1 5 days ,00260 25 days .00420
6 d,ys .00101 16 days ,00267 26 days .00437
7 d,ys .00118 17 days .00284 27 days .00454
8 dlYs .00135 18 days .00301 28 days ,00471
9 days .00152 19 days .00318 29 days ,00486
1 0 days .00169 20 days .00335 30 days .00500
---------------------------------------------------------------------
Any party In Interes\' Including the Commonwealth Ind the personal representatIve. n01 satisfied with the
appraIsement and Issessment may object within SIXty (601 days atter receIpt of thiS Nollce IS provIded by
Seclion 1001 of the Inheritance and Estate Tax Act of 1961 172 P,S see, 2485 - 10011.
MAKE CHECK OF MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT"
DETACH THE TOP PORTION OF THIS FORM AND SUBMIT WITH YOUR PAYMENT TO THE REGISTER OF WILLS FOR
THE COUNTY SHOWN ON THE REVERSE. SEE THE INHERITANCE TAX INSTRUCTION BOOK FOR ADDRESS.
J
REV, 1547EX I' -B2 I
BUREAU OF EXAMINATION NOTICE OF INHERITANCE TAX IASSESSMENT
PENNSYLVANIA DEPARTMENT OF REVENUE APPRAISEMENT ALLOWANCE OR OISALLOWANCE' CONTROL NO. 101
PO BOx B327 ' I
HARRISB'URG PA 17105 OF OEOUCTlONS, ANO ASSESSMENT OF TAX ,
, ,~_"'_,.~___~~_~<._,~~,___~~~__.,_~_,__,^__JDATE .Qf!:::t.Q.-S,?___._
ESTATE OF COLVIN ANNA P FILE NO, 21 79-0718
OATE OLQ.E.ATlL.l'l,:-j!3-79.__.__________._ .----_________,_,cPUNT..Y...._G,UJ18ERLAlJD. _.
NOTE, TO INSURE PROPER CREOIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX
PAYMENT 1'0 THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF WILLS,
AGENT." IF TAX PAYMENTS ARE MADE WITHIN 3 MONTHS OF THE DECEDENT'S DATE OF DEATH. A DISCOUNT
OF 5% OF THE TAX PAlO MAY BE DEDUCTED.
IRWIN ETAL
44 5 HANOVER ST
CARLISLE PA .1 7013
~1:Jl': __A_L9~~ _ ~H)~ .!-!N.E_ __ _ _ __ _ _ . __ _ . .
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
.- - - -. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS ANO ASSESSMENT OF TAX
ESTATE OF COLVIN
ANH"
P FILE NO.21 79-0718
DATE 09-20-82
T A.\ RETURN WAS, 1 ,: I ACCEPTED AS FILED
APPRAISED VALUE OF ESTATE,
1. Real Estate (Schedule A)
2. Slacks and 80nos (Schedule B)
3. Closely Held Stock/PartnershIp Interest {Schedule Cl
4. Mortgages and Notes (Schedule Cl
5. Cash & MIscellaneous Personal Property (Schedule El
6. JOintly Owned Prooerty (Schedule F)
7. Transfers (Schedule G)
8. Total Gross Assets
. APPROVED DEDUCTIONS AND EXEMPTIONS,
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses (Schedule Hl
10. Debts/Mortgages/liens (Schedule I)
11. Total Deductions
12. Net Value of Estate
'3. Charstable Beauests (SChedule J)
14. Net Value Subject to Tax
ASSESSMENT OF TAX:
15. Amount of hne 14 taxable at 6% rate
16. Amount of line '14 taxable <it 15% rate
17. PrinCipal Tay. Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (-I
DATE # INTEREST H
01-17-80 034302 431. 59
04-08-80 034495 .00
02-25-82 010838 76.93-
THIS ASSESSMENT IS BASED ON. 1 SUPPLEMENTAL RETURH
NO INTEREST IS DUE IF PAID BY 02-25-82
IF PAID AFTER DATE INDICATED SEE REVERSE FOR INSTRUCTIONS.
ACN 101
I CHANGED
111
1 21
( 31
( 41
( 51
1 61
1 71
.00
.00
.00
.00
3,451.64
.00
.00
( 81
3,451.64
( 91
1101
1,164.89
.00
(11)
1121
1,164.89
2,286.75
.00
63,354.67
( i3l
1141
(15)
(161
.00
63,354.67
X.06=
>-'15=
( 171
.00
9,503.20
9,503.20
AMOUNT PAID
8,200.37
10.48
378.74
TOTAL TAX CREOIT
BALANCE OF TAX OUE i
8,944.25
558.95
RE-:- AIN Tl-!!S F':lRT!Or-.' 1=0R YOL'R RECCRJS
(If Balance Due IS less than $1.00 no payment is reqUired)
RECOli":
~n' ~.
'S? \\' 'In
INFORM A TIOI'<
ThIS document 's the Not,ce reauired to be g,ven under Sect,on 709 01 the Inherllance and Estate Tax Act
of 1961 (72 P.S. section 2485).
II Ihe tax 's p"d w,lh1O Ihree 131 month, alter tne oecedenfs death, a d,scount 01 5% 01 the tax p"d IS allowed.
Inhelltance Tax becomes dehnauent nine 191 months alter Ihe decedent's o.ath. Inlerest 's charged al the
rate of six 161 percenl per annum on the amount of unp"d taY., ISEE EXAMPLE 8ELOW}
EXAMPLE: II a balance of tax due of $2,000,00 's ,n a dehnq"ent staluS from ~, and payment is made
on 5-23-80. the Interest IS calculated as mdicated below:
STEP 1
Determine the rate of
Interest trom the table below,
STEP 2
MUltlplv the balance o~
\8). due o\, the rate of
Interest
STEP 3
Add the interest
to tne balance 01
tax aue.
interest from 3-03-80 to 5-23-80
Results in:
2 Months
20 Dav,
Rate of Interest
= ,010
= + .00335
----:01335
Balance of tax due
Rate Qf Interest
INTEREST
$2,000,DO
x ,01 :i:>L-
$ 26,70
Balance of lax due $2,000.00
PlUSlnterest to
Date of Pavment (+) 26.70
TOT AL tax and
interest to Date
of Payment $2,026,70
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - -- - - - - - - - - - ---- - - ---
, month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,010 6 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
"'" 1 da\' ,00017 11 davs ,00186 21 days ,00352
"'J ~ '""" 2 days ,00034 12 days ,00203 22 days ,00369
~ 3 days ,00051 13 days ,00220 23 days ,00386
-::. . '" 4 daYS ,00068 14 days ,00237 24 days ,00403
<: ,~
ct, - - 5 da,'s .00085 15 days ,00250 25 days ,00420
.-,' \~, <:) 6 days ,00101 16 days ,00267 26 days ,00437
,') 7 days ,00118 17 days .00284 27 days ,00454
"F 6 days ,00135 18 da\,s .00301 28 days ,00471
9 days .00152 19 daYS ,00316 29 days ,00488
'0 days ,00169 20 days .00335 30 days ,00500
--- - - ---- - - - -------- -........... - -....-." - -- -- - - - -.- - - ..- - -.---.....
Any parlv ,n '''teresi, 1001"d,ng the Commonwealth and Ihe personal represental,ve, not salisf,ed w,lh the
appraisement and assessment may object w,'h,n s>x1V 1601 days after rece,pt of th,s NoUce as prOVIded by
Section 1001 of Ihe Inhe"tance and Estate Tax Act of 1961 172 P,S, sec. 2485 - 1001),
MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT"
DETACH THE TOP PORTION OF THIS FORM AND SU8MIT WITH YOUR PAYMENT TO THE REGISTER OF WILLS FOR
THE COUNTY SHOWN ON THE REVERSE, SEE THE INHERITANCE TAX INSTRUCTION 80DK FOR ADDRESS,
\ J
I
I
1.
I
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!
REV. '593EX (, '-82)
~ _.
_, ENNSYLVAN'I\.OEPARTMENT OF REVENUE
BUREAU OF ACCOUNTS SETTLEMENT
P.O. BOX 2055
HARRISBURG, PA 17105
INHERITANCE TAX
RECORD AO~USTMENT
ASSESSMENT
CONTROL NO,
101
DATE
ESTATE OF COLVIN ANNA P FILE NO. 21 79-0718
DATE OF DEATH l;l-29-79 COUNTY CUMBERLJIlij;)
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF
WILLS, AGENT,"
IRWIN ETAL
44 S HANOVER ST
CARLISLE PA 17013
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
<!~-r .A!-9r.1~ _ -rH)~ ..L!N.E_ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
<<INHERITANCE TAX RECORD AO~USTMENT<*
ESTATE OF COLVIN
ANNA
P FILE NO,21 79-0718
AOJUSTMENT BASED ON:
ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Estate (Schedule AI
2. Stocks and Bonds (Schedule BI
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages and Notes (Schedule D)
5. Cash & Miscellaneous Personal Property (Schedule El
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule Gl
e. Total Gross Assets
111
( 21
( 31
( 41
( 51
( 61
( 71
DEDUCTIONS AND EXEMPTIONS:
g. Funeral Expensesl Administrative Costs/Miscellaneous
Expenses (Schedule HI
10. Debts/MortgageslUens (Schedule II
,1. Total Deductions
12. Net Value at Estate
13. Charitable Bequests (Schedule JI
14. Net Value Subject to lax
( 91
1101
TAX:
15. Amount of line 14 taxable at 6% rate
16. Amount of hne 14 taxable at 15% rate
17. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+1
DATE # INTEREST H
01-17-80 034320 431. 60
04-08-80 034495 .00
02-25-82 010838 30.66-
. IF PAID AFTER DATE INDICATED SEE REVERSE FOR CALCULATION
OF ADDITIONAL INTEREST
RETAIN THIS PORTION FOR YOUR RECORDS
ACN 101
DATE 05-04-83
11,500.00
.00
.00
.00
61,584.38
.00
.00
73,084.38
( 81
4,616.53
6,814.82
11,431. 35
61,653.03
1,750.00
59,903.03
(10
(121
(131
(141
(151
(161
.00
59,903.03
)(,06=
)(,15=
(171
.00
8,985.45
8,985.46
AMOUNT PAID
8,200.37
10.48
378.74
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
5.07CR
.00
5.07CR
(If Balance Due IS less than $1.00 no payment is required)
~EV.150C EX + (9.al) ':1
BUREAU OF ~XAMINATION
PENNbVLVANIA DEPARTMENT OF REVENUE
P,O, BOX B327
HARRISBURG, PA 17105
Decadent's Nema (Last, First, and Middle Initiall
DECEASED co.lvln, Anna P.
SOCIal Securlly Number
195-07-1139G
INHERITANCE TAX RETURN
RESIDENT DECEDENT
File Number ?1-'!'l-0'/1'1
o ete of 0 Bath
Decedent's Addrass
Cedar ,;Lrect
r.IL, Jlol1y Spt'ln[,s,
PennsylvanIa
CHECK
" Original "eturn 0
2, Supplamantal "eturn W
3, "emainder "aturn 0
BLOCKS
4, Life Estate D 5. Federal Estate Tax 0
Return Required.
6, Dacedent died testate 0 7, Docedent maintained a living 0 8. Number of safe deposit 0
(AlIach copy of Willi trust (Attach copy of trust! boxes invantoriad
All correspondance and confidentiel tax information should be directed to:
Address 114 South Hanover Street
APPRO.
PRIATE
CORRE.
SPONOENT Name
Irwin, Irwin & It'win
Talaphone No.
(7171 21i9-2353
City CarUsle
State PA
Zi
Recepituletion
1. Real Estale (Schedule Al (1)
2, Stocks and Bonds (Schedui. B) ( 21
3. Closely Held Stock/Partnership Interest (Scheduia Cl ( 31
4, Mortgages end NolaS (Schedule 01 ( 41
5, Cash & Misceiianeous Personai Property (Schedule El ( 51
RECAPIT. 6. Jointly Owned Property (Schedule F) ( 61
UlATlON 7, Transfers (Schedule G) ( 71
8, Total Gross Assats (total lines 1,71 - See attached
AND 9, Funeral Expenses Administrative Costs/Miscellaneous
Expenses (Schedule HI ( 91
TAX 10, Debts/Mortgages/Liens (Schedule II (101
1" Total Deductions (total lines 9 & 10)
12. Net Valua of Estate (Hne 8 minus line 11)
CAlCU. 13. Charitable 8equests (Schedule J)
lATlON 14, Net Value subject to tax Uine 12 minus line 13)
notl.ce
( 8)
$ 3,~51.64
$ 1,lh4.89
(11) 1, IGII. 8"
(12) ;>, 2tih. '/5
(13)
(14) 2 , 2 f3 (, . 75
Computation of Tax
15. Amount of line 14 ta..bleat 6% rate (15)
!include values from Schedule K)
16, Amount of line 14 taxabla at 15% rate (16) 2,286.'!5
!include values from Schedule K)
17. Principal taxdue (add tax from line 15 plus tadrom line 16)
18, Total Prior payments:
(a) Amount Paid __
(b) Plus Discount
(c) Minus Interest - 30.73 (18) (30. n )
19, 8alance Due (Hne 17 minus line 181
Make Check Payable to: Register of Wills, Agent
... PLEASE RECHECK MATH. ..
x,06=
(171
3113.01
343.01
x,15=
(19)
373 .74
Under panalties of perjury, I declare thet I have examined this return, Including accompanying schedules and Slatements, and to the best of my knowledge
and belial, it is true, correct, and complete. Declaration of preparer other than the personel representative is based on aii information of which preparer has
anY.knoWledge,
','" " ,).,/ i/"': . ,.
i l. .",/:. I ,~( I ..., ('7--c.. L/
SIGNATURE OF PERSONAL REPRESENTATIVE(S)
55 ;~ountajn Street
ADDRESS
Mt. Holly Sprln~s,
February 211. 1982
DATE
PA 170(,5
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
11/1 South Hanover Street
ADDRES~
Carllsle, tA 17013
February 24, 1982
DATE
;'v.",,,.+ (..01) , SU PPLErmNT 1\L
- i~ SCHEDULE "H"
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES,
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS AND
RESIDENT DECEDENT MISCEllANEOUS EXPENSES
ESTATE OF
Anna P. Colvin
ITEM DESCRIPTION
NUMBER
A. Funeral Expenses:
1.
B, Administrative Costs:
1, Personal Representative Commissions
2, Attorney Fees
1,
C. Miscellaneous Expenses:
Carlisle Memorial Service - gravestone
Recorder of Deeds - transfer tax
Irwin, Irwin & Irwin - attorney fees
Roger B. Irwin - notary fees
Stephen Fisher - survey
Harry Donson - Coin appraisal
Met Ed - electric bill
Register of Wills - filing fees
FILE NUMBER
21-79-0718
AMOUNT
/
n ex>
r' ",'"
, .~ , " ,'-'
,", rrl~
, ..-, ~o
.-r: ,;,;t)
....1,... ,,., !et
I: ~ CJ :iT1
'.:.."
0".' ' .
r .
,- ,"J
.~ ",
);
$ 1150.00
120.00
277.50
1.50
280.00
25.00
4.8q
6.00
TOTAL (Also enter on line 9, Recapitulation)
$
1,164.89
(If more space II needed Insert eddltlonal .heeu of lamo size)