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NO. 21.80
PETITION FOR LETTERS OF ADMINISTRATION
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I\e~ister or \\'ills 1'01' Ihe ('1111111)' III' ('lImherialld. ill \ hi' (""111\10"W,'all h III' I'clIlI:;)'I"allia.
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.\ . "OI"r'O" 'I'oWII:-ihip (' I I I (' I .t t 1'1' 1
waS a res" ent 01 ..........................................................llnl'1!tlxll ' 1111111'" aa' .Ollll )'. ,; a c 0 elllls)'-
vlIniu, und a Citizell of Uniwl Stlltes. and depa,.ted Ihi:; life illtestale in 11ll' ('ollnty or ,~:.::::r!.'.:).J,',I):'d.
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1I e HIlI( ............................................................................. ,ceca:;el, c :;lI,'vivill~ e'o "ing
nllmed widow or hll:;band, heil's alld aext to kin. to wit:
Name
I\elatioll:;hip
Residence
:'. 'J r: - 'J,o;,: 262
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S2,rl-i,slD, Pp,nna. 17013
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That those above named illclude all or the next or kin, so far as known.
The :;aid decedent was posseRsr.d of pel'"oIHlI propert)' to the estimated "allle of $.4.\?9.,.Q.9..................
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and of Real Estate, le"s illcumbrallce, to the c,;timated vallie of $.....!>g.t.1~................... as near as can be
a"certained.
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That the said Real I':state in so fat' as is knowlI is located ill
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Lone
Therefore, )'our petitioned") respectfull)' appl)'(ies) 1'01' Lellel's of Administration ia the above
named estate.
of Pet it iOller (:-,)
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Dated .}.,'.r..v.~.r.:{.....~~............... ...... A. D.. ]\1.f.Q...
Signature and Addrc""
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COMMONWEALTH OF I'Ej\j\SYLV Aj\IA
COUNTY OF CUMBERLAND
in the abo"e application hein~ dnl)' ...........:;:,:'D,:::~....... ................ aeeordin~ 10 law. say that the facts set
forth in the abo,'e application arc trne to the Ill'S! of .....\~\:\.... knowll'd~e and heiid.
before me,
and snhscl'ihed 1
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INFORMATION
To insure proper credil 10 YOllr account, the name of tho c5tnte and file numher should be clearly print-
ed on the check or money order.
This assessment is made in accordance with Section 708 01 Iho Inheritance and Estate Tax Act 01
1961 172 F.g, 9 2485.708).
To the extent that inherilance faX is pnid within threo (3) months after tho death of the decedent, a
discount of five (5) percent is aHowed {72 F.g, \ 2485,7161,
Inheritance Tax, other than lax on a future interest, is due at tho dule 01 tho decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's doath (72 P,S. fi 2485-711). Inheritance
Tax on a future interest is payable within three (3) months aftor the transfer lakas effect in possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the dale of actual payment using the following interest table:
------------------------------- -- - ---- --------- - - --- - -- - ---~----- -- -- -- -----
1 month ,005 4 months .020 7 months .035 10 mon:hs .050
2 months .010 5 months ,025 8 months ,040 1 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 '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 ,00264 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 Commonwt~allh and the personal representative, not satisfied with
the assessment may abject thereto within sixty (GO) days alter receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. S 2485-1001)
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: