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~CC.,33 (4,.73\'
COMMONII'EALTII OF PENNSYLVANIA
DEPARTMENT OF IU'VENlIE
BUREAU OF COllNTY COLLECTIONS
*
COUNTY OF --1U~lli.f.RLlIND
RESIDENT DECEDENT
IMPORTANT,
This relllrn lIlusl he eoml"etrd in "elllil "0" riled n' ,11'1"0 ,,'r, IIilh 1II1II1tll,h''', lll1h ,hr J(r.,s,et 01 1I'i1ls of the
County whm llrerdrm [I'si""I, Ilelll,n" ,Inr lll1hlll lilli" 1I101llh, "rirr tlllle 01 ,Irlllh, un,,"," IIn rXlension is glOm",1
hy the Seen,'tary of RC'H~1Hle. (Scc(1U11711~ \If 1111' Inht'rllilllCC a1\lII'-stllll~ Tllx ,\~ll)f I'IhLl
. _". __.. n__ __ _n___u._____
~-
IN '1'111' \IATTFII OF Till' I'STA I E 01, } ,11,1 111 A 1'1'1 01
PEARL M. BROWN_------------ I,XI.l'I' 1'011
{STATE FULL NAME OF OECI:.DENTI
Cumberl and lItl'llt:<~1'K1I1tIK
_----------- County
Late of
State of
Pennsyl vania
County ol..-LJ,lrnbl'rl and
P~gy"_Jl,Je lacLoJJi.s__
of thll ellole of the abavoonamlld decedent being duly swaIn, d~po!ia 5 and say 5
-} '"
ExeCUlOr
Decedenl died
October
27
, ItJ.l!l-{IIl5tato leoving 0 10.1 will. copy of which il hllreta otlached. \
(yEAH) '11'11/N"T1111J' J
-A.otImH"~l'ttittt:-
IMONTHl
Mama and oddrels of attorney 01 }
olhar authorlud raprolontotivt' 10 wham
all correspondenco ,hould be mailed,
(DAY)
Landi 5 & Black
36 South HanoveL-Straet. CarlisJ~17~13
ThaI as such deponen' is famil,ar wilh Ihe affairs of said estate and Ihe property constilUling
l r:XECUTOR-A+~+tHS-.......~eoRl
the nssl:ts thereof illlllthcir fair market value.
ThaI at Ihe time of dealh there was no sare deposil hos rcgister,d in dcccdent's individual name, ur joiully wilh, or
as ageut or dcputy of another, or in dceedcnt's individual lH"ne, wilh righl of access hy annthcr as agcuI or depuly, with the
exception uf the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S.~FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX REr~TEO
1l~ NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
one
That the contents of said safe deposit box or boxes afC itemized under Schedules
with the exception-Ilf the following, for the reasons hereinafter set forth:
of this return,
Thai Schedule A altached hcreto and made part hereof sets furlh fully and in detail alllhe real property
in the Communwealth nf Pennsylvania of which decedent died haviug an interest therein. It also sets forlh Ihe
mortgage encumbrances upuu each parcel of real property al the date of dealh, giving Ihe amounl still duc al
death, oame of mortgagce. dale, rale of interesl, and honk and pagc of record Ihereof. It also scts forth in lhe
columns provided lherefore Ihe assessed valualiun uf each of said parcels, Ihe eslilllaled market value Ihereuf
as of dute of death of decedent.
ThaI Schedule B attached heretu und mude part hereof sels fn"h fully and in detail all personal properly
wheresuver siluated owned hy the decedent at Ihe lime 1'1' dealh: all moneys left by Ihe decedent althe time of
death. whether in decedent's immediate pnssessiun, s,,,nding '" decedent's credit in hanks of deposit. savil'gs
hanks, trust companies, or olher inslilulinns, whether in,Jjvidnally. or in trust fnr any olher person or pe"OIlS
giving also separately Ihe accrued inleresl Ihereon. if any, dnwn to Ihe last intereSI day prior 10 deceden!"s
death in Ihe case of savings hanks, and In the dalc of decedenl's dealh in all nlher cases: all bnnd" postal
savings, treasury certificales or noles and uther evid,nce of indehledness of Ihe United State, 10 Ihe de-
cedent: all ubligalions, whelher hy stalule or agreemcn' Ihcy arc designated as tax free, of Ihe Uniled Slates,
ur anv state, or pnlilical suhdivision Ihereof. or of "oy foreign country, w!,ich are owned at the lime uf dealh:
all wearing apparel, jewelry, silverware, pielures, hnoks, works of art, household rurnilurc, hnrses, carriages,
automobiles, buals, .nd any and all ulher personal ,hallrls of whalsnrver. kind or nature, left hy decedenl,
logelher with the fairly cSlimated markel valuc thereof: all hllmls and mortgllges held hy deeedenl and of all
claims doe and owing decedcnl al Ihe time III' dcath, aud all prom,ssory notcs or olhe,' instrulllenl' in wriliug
fur thc payment of mouey of which drectlcot died IHIs>essed, of whahnever n:Jlllre. wilh illleresl thereun, if
any, giving Ihe face value and estimaled fair markol valuc therelOf, and if such eSlimaled fair markel value he
Icss Ihan the face vuluo, il sets fUrlh hriefly the reasnns for such del'recialilln as 10 each item: all moneys
payable to the estale from life insllrance pulicics carriod by tleccdrnt: all annuily and cndowmenl ",mlraCls
lhc procceds of which were I'ayah\c nplln Iho dealh of the deertlent: all and Ihe corporate stncks and dividends
tlue thereon and unpaid as uf the date of dealh, hnnds and accrued Illteresl Iherenn to Ihe tlale of decedent's
dealh and olher in\'eslment seeln,',:' "wned hy the tleceden' allhr time "I' death, wi,h Ihe ",arket value therc-
of at such time.
,;
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III till' ('IISI' III' "1'1"I~'I' II'" 01' ~ll1sl' Ilr 1'Il1ll1ly C~Ol'\ll)1'1I1IoIlS. till' \'IIII1I'S I'PPIII'll'd 111'1' Ilfi fur us
l'o",lhl<' slll"l"ollnl",1 h) 1'111,,0,'1,,1 sl""''''''O''' or II". ,'ol'I">I'"lloos, sl",wlo" tio' "',,'Is ,0,,1 11,,'dIIU"s
'h",'"or os "I' Ih" ""'" 01' ",'oti,. Ih' "'1,,,""1,' "Iso ""l>. r,,,'lh U", Ild.",'''sl or ",.",,",", '" ti,,, II"," III'
,I"nlh III "0) ,'o-I""'"",,,sldl' 01' ,,,,.,1,,,,,;<;. """ III s"I'I'",'1 "I'll", ",<1,," "I' ",,,h 1,,1"""sl I'",,'" Is """"X"" 10
snhl s,",,,',I,d,', 1""'''''' In , "",,,,,,"II'S ',howlll" U,"n"aq" n".1 IInhlllll'''' or snl" ""-I""''''''I'shll' 0" 1",,1""'"
A "01') "" tio' ,'o.lolI"o",.shll' "."",'n"',,1 , I II' o,'nl. n ,.In,,,,,,''"1 ""Ill,," I'o,"h II,,' ,,,,"0'" "I' 'I", "VI"",,,,""1)
'0",.,1,,'" wlti, n sln""""'" ..,''''0.' I"'rlh II,,' ,'I""'n,'I.,,,' "I' ti", h""lo""', \1s I,,,,nlloo. n,,,1 ",,,1, oil"". 1',,,,ls
10'1'1"10,,,,,10 ti,,, ",,,10"" '" n,,,. I... 1''''''10''0110 n I'n'" '"I" .I liS I nl'llI'o'sol "I'll..' """,,,,,ol's 'o,,,,',,sl
Un,,',,11I ""IS I 1"'sol,,,,II'''''' I' sh"ol,1 nl'," ',0 I ro,.,h III 11"",1/,,,1 1',,,''''. '0""'1"." ,IIh "..' ,,,II' "'''1'\"" "010"
tlu'I'Ptd', 1l1\~. nllll']' prllp,,!.t.\ "1'111'1\ 111' lipq11l'lltlll'd liy tli.. cll'l~l'd"lIt I\t t.lll' tin,.. nl' cll'lltl1,
TI", ';<1','''''/'' '>11""1"''' ,,,,,"'10 HII,I """I" I'nl'l h,.,.""r s<'ls ro,'lh 0 1.1'11" nllsw"" 1.0 ,.""h \1'1"II'Y
COlllolll',,1 U,,'I'''III Hlnllllll,,' "0'"0""'HIISr",'S 01'1"'01'''''')' ,'''n1 "" I'""oonl, wlllllll 'wo )"OI'S 01' ",.",..I"II"s
d"H Ih, III ,,0111 ""'1'1 n" ,'" "I' ,I",., '''''0 I' S ",." ti,. ",. 1111 "In,,'d to '" ",. ,'1'1"'''' III 1'0,,""" 100 0" "11.1 "Y""'"' Ill. III'
01'1.1' ""'>lh, snld s,.""""/,, _"'/." "",'Ih U,,, 00111"" n".: ';n111" 0" slI"h 1"'01""'1::. 10 w..o'" ,,,nIlSr"I'I',,,I, .h"
r"lnllollsl<11' 01' II'" ".'''IS,.'.....''s '" tio' "","'''''11', II'" I'l'op'"'IlIlIlO''' sl""" ,.,,,,,'1""" II)' """11 /1'nlls\"'l'e,' Hll'1
ull oU"'I' r,,,,ls "I' " 1"'1'1111"'" IIH'"I''' I'""H...IIII~, sHI,1 'I',,,,sl',,,.s. III .he "'os'. ,,\, /1'I"...I".I'S 1111,,,,,1,,,1 '0
tnk" ",'f""t III l'oss""IOII ",. "11.1")"'''"' n' "I' 111'...1' ,1"H.h, .h"I'" Is HlslI ,1I."".h",1 '0 .h" ",he,llIl.. H CIIIIY
o\' .h" """". 11'1Is! HI\",''''''''II' 0" oti".,. IlIs/1'II"""" cl'"nUIII\ t.llo t.l'ust.. 'I'h"r" Is IIlso so'1. 1'01'1.11 In slll,1
.cll",lnl" Il list nl' 1111 prnp,.,.t)., ",,"1 '0,,1 lo,,'snnll1, wll.lr It. vllln", wi""" I'""'''S Ill. <1""''''''0'''' ,1')/II.It Iry
vlr.u" 01' tiw """'"Is" hy ,I"""",'nl, ,'IU,,'" 10oll"I,lulllly, u".Iolutly Ylltll Ilnn\.l,el', or Iln)' I"""" 01' Ilpl'olnl.-
menl. ""/.<',11,,,1,,,'''<1''111.. "1\.1,,,,' In<lI\'I,h,"II)' or .I,,,ntl), hyLlIt' will, ,10.0<1, nl' 0\.1"'" InsU""11"nl. 01' 101OI.h"r,
with Il l'Op)' o\' IIIl' Ins\.I'llltl"Ill. (~reHtlll/!; sueil pn\'wr nLtllelll'li to !-hl' scilf'tlIl1e.
Thill Sr/w/"I,' D II I. I. II ",,,'ol I""""." ",,,1 mll<l" I'"rl. h"".OI' s"l.s l'ol'llr II,,, ,o'm'" IIn" n,ld,'''ss''s 0" 11]1
persous ,,,,,,,,1'1 d 1111.\' 10 I."""S I.,'" I" I.h I s "s 1.11 I." Il I. \.I,,, time 0 I' ,I"""ol"n I.' s ,leH I,h, 1.1r" nil I.'''''' 01' II,'" r ,.,,5-
p"oU,," 101"""sts, Ih,'I,' ,.,.laLlooshlp, II' IIOY, to \.I'" ,1"",,,1"111., 11I~el.h.1' wllh \.lit' """S Ill. II,,, tlm" of
dee"denl.'1I dOIIt.1r 01' ,"I 1IIIIIOrS. 11IUlI""",ts IIn,I,,,,,,,,\'1e1I1I'I"s 1'01' III''' 11TlIlol' ol""",I"lIt's 11'111. It nlllo
cont.lllns II s'"l.om"ol. slt"wlo" wlil,.It "r ,"" l",n,,\'1elllrl"S nllme,l In I.lIc """col"nt.'S will, II' IIn)', ,11.,1 prior
10 ".. C ",10011 I. , "'" ,11I1"S 01' thd" "Olltlr, IIlt'lr Iss"", 1II"ll.h" l'oll1tlonslllp "r sllcll IllS"" '0 \.110 hon"l'lclllry.
Thill. 5;;I-ed,,'" t' ntlIlOIr"" hol".'t.o IInol """I" II 1'"1'1. lI"rcol' sets fo,'l.h 1111 pl'op"r.)', ,...,01 ,,,"1 per-
sonlll, ownoollry U". ,1",,,..lonl. .Iollltly with 11110 tho,' or nt.lr.rs, IlIcl",lIn" Inl.lln,,11r1c, s"o"lIo" 10 th" '""'"'
or tll" olc""ololll. .0,,1 oll'''''S, plus lire ,IIlI" ",.<1 1'111"" III' l'ecol',1 of Insl.l'Ullleot.s ,,\'I'oetlnl\ 11", Icst.ltUI''' or
I'ClIl "stlil.c ",,01 11r,' ""I" .." '''''luIsILlOII or l'O'I'sonall), I'IIIS tll" ,,,,mc, lI<101ress ",,,I r"llItlonslllp, If IIny,
o r CO-OWII(~I'S I,[) t\1I' tlecelll'n t.
'J'lrllt. Scl>nd"le F lIt.tllel",<I lr"I'''t.O 10,,1 "",,10 II I""" ""I'"of .".s I'ortll rully 1111" In ,I"tlll] 11]1 ol"uts
nnd ,1"olu"tI,)l1S cllll,,"'ol 1'<>1' IIn<l ou ,,,,1111\1' or tills d""ellellt.'S "stllte, IlIclndlnl\ I'lIn"I',1t ,'xl,,'nll<" 1'"101:
I'lImlly .',elllldlou. wll'''''' "1'1'11,,"11]"; eost.s 0/' lIol",lnlsU'IIUon of .lrls estlltC: eonnse] I'"es IIn<l fu,lIelnry' 5
cOllllllIsslons 1'"101 or '.0 Ir" 1'"1,1: "OS, "'1"",,1001 1'01' IlI,rlnl trust., tomhstonOs or 1\,,\\'''"'''l'k''''S, IInd 1',,11-
~Iolls s"I'"I"es, 10 ""n"",\""n'... or 11r" """I.h 01' UIO' ""ce,I,,"t: ,I"hl.s /11101 cllllms owlll" 1111" 0111001,1 Ill. time of
d"ntll: t",es IIC e ,.",,,1 ell"I'"",,1I1', \'or 1'..1'10,1 1'1'101' to ,lece,lcllt' s ,I..".h (o,c"1'1. I.hosc "1101',,,1 1111""1' S.."lIol1
n51 01' t.h" Il1h" ,. \1.1111'''' "lid Esl.al... T"x ,\d): 1.01\""'"'' w\l.h " stllte",cnl. 01' coLl"I."I',,1 I'le,lw,,1 \'",' ohl ign-
tlOIIS, If ,,"y, It Is ""r""" that 1.110' I'ldll",,,ry will pl',,"'nt.l'rool' ,,1' s"ld cl"lme,1 oh]I,\"tlOIlS 111'011 r.-
'Illest, UII'1. II' U,.. ""'00111. ",.101111) 1'"101 In sCl.tlem,,"1. 01' 1I11Y I'''e, "o"/I/llssloo or ""'''' Is less t111111 t.he
e.II",,,t"" III",olllt '" almlll" 11",1 II]loW",I, I.h"l. U", SlO"" will he ""1""1..." to 1.110' \l,,~lslc" 01' WIlls, UI,d thn..
the HJ1\Olmt 01' till( asst'~~~I'll ell!\ \11' rPIl~sessl'cl III IH~eordHnel' thnrel'o'tt.h.
Th/lt 1.1,,' 1.0Ulis 01' "'" "1'1'1'01','1"'" ,'"I"""lS III Hche,h,l"s ",\", "B", "C", "E", 11",1 "I'" ,... iIl,...d.,,1 U'''l'elll,
hlAve llPI~'1 (.IIT!.l....'! 1\ll'W/lr,t HUll l'rcl\u"l'ly rf'J!.IS\.l!I'j'C\ in tht' SllmmHI'Y.
SUb~Clibcdd RY.'0l'n to before me this
~3 J:f1::L
.~'"
C'I:: L (.':I..'!..:' i.' :<,
My COl1lnils~io' fxr;I':', :::i.rf. 19. 1';'83
19,J'P
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~tt~Ai.?;;f~~~:~~~'ladonis
EiI)7...~~ll]i,H.Qns.tr.e..et
(Streot Number)
Carlisle PA 171)13
(City or Town and State)
...................~,.
"'.';
~1!Ti':: B"l'o....-I",O\III, "l't'I""v11 ",,,",, so,,'" ,,11101""" SI'''''''S III II'"~ ,"'\'1,1"\'\1. /III" ,,,h"';1I1<', '"l11e",,1 ,or"
1'111..,1 III ,llh ",.I,,\ls 0" ti... .."." "So,,,,". ",,,110 "as" II", ",,"Is 1'1"111.1.. 1'''1''' ,,"<1 1I1111s"',1 s,>01l1'1IIes,
s,,"III'I'I"s Ill' "10'" 0" 1',,,,:\1) ,.,,,.,.,,,""1\011" 0" "" 11I1"I'.osl III ''")' ""_1'",'I.II",'shll' or bIlSIIl"SS, Ihlll. the
,IH1" ,,",1 sl""''''''III- ""'1"1",,, ,".."'1' "..' 1"""'''''''l'h "ho\'" r>'!.>lIIIK 10 S",,,',II1I" "B" III'" ""a"h,',I. ,\lslI /I",k..
c..I'\loIlI th"l. ,'..ll1mll ..I 10 .1," "S,u'u,,'"'''' "..- 1",,," I'rol'..rl\' ,'oml'l..."" us "bo\'".'III','''I,.,I,
REV.450 (8-78)
COMMONWEAL TH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
b
It!';!,. .
.....~, .
~~
____.__.____P___
Real properly in Pennsylvania, with slutelllonl 0{1Il01Ig<l'le encumbrances upon "<lch porcel 01 d"c:lh d dece-
dent. Property held by the decedenl us lenanl in COllllllon will, unolher or olho" sliOuld be idenli1iod
os to quonlulIl of inlerest and Ihe eslim<lled value should be Ihol 01 the decedenl' s interest only. (Properly
held os jolnl lenonts with right of surviorship or IClloncy by enlireties should be reported on Schedule "E.")
---.---.--..------------.---.-
The rool property lucotod In tho Commonwoolth 01 Ponlll;ylvlInlo should 110 (1) (2) (:II
ducrlb"d by 10' and block numbor, slreo' and s'rool nUll1uor, tOGI!,hur wllh OEPAIHMENT
a general doscrlptlon of the property, with 0 rufarencu to tho rocord of thu ASSESSED VALUE VALUA T10H
conveyanco by which the decedent teak title; If l] form 5tole numbor 01 o. Fall YEAR OF EST IMATE D CAUTION
cros; o\so statement of mortgogo uncumbr.Jnce5 upon lloch parcel at doalh OECEOEHT'S MARKET VALUE (0;:, not wrlto
of docodent. TOKOS, Ollsossmon's, accrued Inlorest on m(jrtUI190~', otc.,oro DEATH In this apoco)
to bo listed on Schedule uF" end lllU5t not be deducted from till:. lichoJulu.
I:CNE
Insert this totol opposite "rcDI property", Schedule "A" in lhe X X X X X
"As Reported" column on the lost page 01 this return.
Ncnc
~~/(
RCC ~35
~~~
eO\\MONWE,\LTlI OF PENNoYLVANlA
TltANSFEI\ TNlIEItT'!',\NCE TA,(
ItES!I,l'.:;, I,ECEIlENT
I~STIWCTlO~S: Tills Selled1l1', mllsl ellsdose ,,11 \.lIl1~llIle 11I"11,,\.,,,,~lhle pe"sollol 1,,'ol""\.Y oWlled I ,,,II vi ,111,,11 V
hy IlIe ,I""e,h",\., "I \.II<! \.111I" 01'1115 11",,\.h. 1"'01""'1.)' oWlled Ill' \.he ,le",,,I,,"1. '\lIll1l.1y wi 1.11 ""Otl"" 0" otl",,"
mllsl. I'"~ IISl.e,IIIII,lo,' S"h"dlll" 'E', 11I1.1l1l1~lh]" p","lIl11a! p,'operl.Y, Utled III \.he '"1111" 01' tll" ,1"''''''''111., 11111.
puy"hl" ,,\. ''''01.11 10 ,,"o\.h"r or olh",", 11Ic1\1lIlIl~ hll\, 1I0\. Ilmll."d \.0 p.O,Il. 1I. S. SlIvlll~S 11011.15 "lid \..,111.11-
t IV<! U'lIS\. o"e"'III\.S, IIII1St he Ilsl.e'\, .1,,51'1 t" I.lIe 1',,"1. tllII' III"y Ilr" 1101. 01' I.he "dmllllste,'"d "51."1.".
T,,"~lhl" persoll,,1 prop"rl.Y sholll,1 he 1151.",1 I'lrsl. (o,g. .\,'wol"y, we"rlll~ "1'1"",,1, '''''lsehold
J\ouds, h1l11 f\ll'nlshllll;s, hooks, putntlllgs, llutOlTlolll1es, tlOllis, l~tC.)
11I1.'UI~lh'e persollll1 properl.y, slleh liS hOllds, trellsllry eorlll'le"tes, el,,1I Oil hllnd ",,,I III h,,"k,
sl.oeks, lIIorlg"~cS. 1I01es, I.o~elhcr with "ee"lIed Inlerest or IlIvl,lollrls, s"'''rles or w"ges, I"Sllrllllee puy-
uh1" \0 III" 051,11\,0 or 1'I1111c\"ry III 5,11.1 e"I",eII.Y, p"r\,lIe,"lIlp 11It<:resl.", Interest 1I,",yll,lIstrlhUled
osl."I." 01' or 111"011'" I'l'om OilY proporl.Y hold III trllsl. 1I11<1or tllo will or ogreomollt of ,,"ol.lIe,', OV"II 1.II0llgh
]ocul."d 0111.51.1" 01' I.h" S\."\.,,, II\. \.lIe \.Ime 01' Ile"l.h, sh1l1l1,1 h" IIsl.o,1 III this s"h,,,llIlo.
SCIIEIl1llY "11"
l'EIlSIIN II L I'IlIWEIlTY
I tern l'l'E~1 UNIT ES'f[ M,\'f~J) 1l~;PMlTMEN'f VALUATION
NO. List nnt! describe fully VALUE MMlKl,r VALlIE (Do no t write In
this space)
None
\
I
\
\
Insert this tot.al opposite "P(~rsonltl Proper t:y", Schedlll ~ "U" 111 X X iV..~,ItL'
the "As H(>portetl" en) tll'llJ\ nil the 11.lSt pa~e of till S T('turn. )i~.:/~
BCC~l"
,','\IMII\W],',II::'lI lW 1'l'~",YI.I ,I \ 1,1
r\A~~F~,'H I\J:~'~HIT:,\t'I" 1\'\
':"1:1"111'1.1-' "I'"
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t:J ,_ :F
,. I -. ;~,l:'~;::, ~(\
(, ,"~.'" '"
.f,...'...;,;,.......,;.,.,'.
ii\::S 111:':\',!, \l!.Tl<lll:\T
(l) \Hel clP{'I.t\t'lll. \\llIilll 1\\0 Yl'lll'~~ ol'dt':lI!l. III!!I;!' all,\' II'aw,r,,1' 11(' ;111," 11I:ll"ri:d Ilill'l Ill' ld~; 1'~~lilt.I'1 "\11111111
rt't'plvlllf!; a \';lluab!1' ill!ll ad,'quatr> l'llIISld"I''''llo11 Ihl'l'l,rqr";' ('rISllt'l' ,Vi'S 01' 1lI,,_Yes---.,--
(~I Illd .1,.",'.1""', wi II Ii " I.W" )""'" "I' .1"",1,. 1.1''''''1'..,' 1"'''1''''''1 I'",,,,, "11",..1 r ,,, Idl""" I' ,,,,.1 """'I,,,,' ""
c,IIIl~I'S (11\l~lwllll)!, H SllllllSI') ill .llllnt. OWllI'l'slllp? ('\IlS\\'t'I' ~'I'S Ill' tlnJ-1i9__..___
(:1) 11' till' HilS"''' I' 1.0 (I) 01' (:.!) IIllo\'.' Is III tltl' lll'rll'lIIiI1IVl' ~;l..ill':
(Id I\~!,l' 01' dt'eptll'lll Ill, lilliI' or l.1'UWil'l'!' ----.*
(h) StILlY of c11!I~pdl'llt.tS 1I1'11Itll Ill. t.lml' Ill' 1Il1lJ.,:I "l-', Ull~ trallS!'I'I', (\011' 1).
(e) CUllS!' 01' c11~ePllpIlI.IS II..alll. t';IILI! I).
(,I) Illtt dt'cellont., lnltls 1II'I'I.Illlt~, lllHI.;f' !IllY 11'IlIIS!'t'I' of' pl'Opl'l'lY without l'l'l'f!lvlll,L!; a vIII llldl 1 I.' Ill' atleqlllltl!
l'ollslderllt.lnll t.hfll'('l'lIr wllll'lI WIIS 10 t.HI"~ d'l'lll'\. 111 lIfISSt.'sslllll 01' .'n.lo,VlI1"I11. Ill. or al'l.l'!' Ills lil~Hl.h',l
('\lISWI~!' )'i'S Ill' llll) No
(II) lIas tlll'rl' /lilY jlllsslhllll.y UPl!. UII' l'rllpt~rty tl'llllSI'I'I'!'I"\ IllIJ.',ltl. l't'llll'll (0 1.I'IIIlSI'I'I'I'I' or Ills
I!SI.III,1! Il" IJI' Sll!J.lI.(~t 1.(1 his po 11'1' I' of disposition? (,\IISW('I' ,'I'S Ill' 110)
(Ill Wllil!. \\'Il~ 1.111' 1.!'i1nsf'I'I'PO'S 11;.!.1~ Ill. 1.llnl~ flr III'I'pdl'llt,ls f"'lIt.h? .
Ui) Uilt (lc~c(-'cft!llt. ill Ills II fet,lrlw milk!.' 1m,)' !,"IIIlSf"" 1'i11111l1l1 1'1!1:1!lvlllg Il val~l~dpqlllltl.' I~OIlSldt'I'l\t1flll
therefor 1IIlller ,"hll~11 l.!'anSl'P!'111' expJ't!ssly 01' ll!lpllt'dl~' !'I.'SI!I'\,t'S I'll!' Ills 111'.' or nllY 1ll'l'l(ul whll~1l Illln.s
lint tn 1'1l1~t. 1!1Il1 111,'I'IlI'I' Ills dl!~It.II:
(II) Till! possI.,sslIIII or (!Il.lnyrn(!!lt of II!' till! !'IJ.!;IIl. to Illl~Oll1l! I'I'OIll Ulf' prlll'l'l'ty tl'/lnsl'el'rl!II'l
C\m>WI~1' yps nl' JlO) ~_
(h) 1'1Ir! ri~hl t I) ll'!slJ.!;IIHI.I~ the pl!rSOIlS \'tho shall possess Cl!' pn.ln)' 1.111' property t,rllllsferrllll or
111t:(l]W~ t.III!T'I!I'r'IHU'.' (Allsw(!r y(!S 01' no) --.-No_-
(n) If' tl1n nnswl'r to (!l) (h) IIllovp Is in tiln lIf'fll'IHlltlvl!, sl.ute Whl!t!ll'r IIp' l'i~lLt \'t'IlS I'I!sorvnl! In decl!dent.
alone or nt.llel's __.~_.__...____.n~_____.__*________*____..n_ -
(7) Did IIp-cetlent III his I I I'pI. Iltll' Illllktl II t.rH1Isl'pr, \,111' (,IlIlSidPI'Hl,\nJl {'O!' \l'l1il:11 \l'rlS l,1'llflsf'I..rC(!'s prollllsn to
puy income to or 1'0" till' hl'llllf'l!. of' 1~IlT'f' 01' I rllllsl'I'!'or'l C\IlSIH'1' ~.I'S fll' no) --110*_
(H) Did rlecedent, lit allY tlllln~ tl'Hltsl'p!' J1ropl~rt~.. Ihl' hl~lll!l'IdHJ I'll.lnynwlIL of' \l'llil~h \l'IlS suh.leet to chnnge,
heeduse of'.'l rllSl!rVI!d pOW!' I' to 11Itl"', IIl1l1'l\ll~ or I'l'vol.:p, Ill' II'l1lel1 I~ntlld l'l'vprt to o\l!I~l'dl'llt. I1Tlllel' tt~rll1s
of trllllsl'er 0" by Olll~I'lIllol1 0" IlIw'! (,\IIS.....I',. ~'I'S 01' 1I0)--1i9_
(iI) If t.he anSwer to (H) IlhOVI~ Is III UII! nt'I'il'll\lltlvl', WitS thl' pO\\'(-'" t.1l alll':', IlTIllmtl, 01" 1'f'Vllkl! tile Inter-
est of the heIlPI'ldal'~' "l'sl'!'vl'd III Lilt' dl'el!d"llt alolll.' 01' thl' l!1'cPllelll, Itnd n!.lllll'S"
(Answer y(!S or no)
~OTr: 1: The IlTlswers t.o till'S!! II'\I'St.IOIlS should hl~ SlIllJlOT'llld h~' IIITiclavlL h~' 1.111.' atl.c'lldill).!; Jlh~.!;tcllLll liS
well os Il copy ot' till! death CI'I.l.i I'lentf'.
:';OTg~: It' IlIlSWf.'I' to Ilny of' tlll~ II\)OVi' qUf'StIIlI1S Is ,VI's. SI't. l'u!.tli h..11l1\' II r11!SI:I'lpLillll of' t.lle prolH!rty
trnTlsl'erroll, it's fall' HIltl'ket vllIIII~ III, dat.I,> elf' tll!ut.ll, elll1.t~S of tralls!'!'!'S a fill l.ll wholl\ trllllSI'I!I'I'ed, with
relationship of' trall~jr('r!!f's to cl(~I:I'dl.'llt., 11' IIIlY. Sllllmlt I~UPy 01' all)' t.l'llst dt!l!d or ItIStl'IlHlt.'llt, if U'lIns-
forSo are claimed 1.0 he llon-I;IXllhlll, 1I1so suhmlt. elf'tallprI SIIl\,I:IlII~Ilt. 01' l'ill~l.s nil wIdell sllld cllllm is {lased.
NOTE a: List, IIJljlli(~lIhlf.' lll'oll\!rt.y beloW ill IIUllll\f!J' III wldl~il p!'l)vlded 111 SdwduII's :\. B. O!' E.
ITEM
lJESCHIIITIfl:\
\1i\ltKET VALlIE
(Estl1!111t.e(l)
IlEPT. VALUATION
(lll'pt.. Ollly)
1.
Cash bequest to granddaughter,
on October 26, 1979.
Susan L. zeladonisl
l,OfJO,rlfJ
2.
Cash bequest to grandson, Thomas M.
on October 26, 1979.
Zeladonis,
l,0'10.0fJ
3.
Cash bequest to daughter, Peggy A. Zeladonis, on
October 26, 1979.
9,OOO.OfJ
__I
Insl'rt this l.ol.ld f1JilU\'i I tJ> "Tr:lIIsl'.'rs", ~ch('tllll I' "C." 111 till'
"As H!~I1(jrt..il" l~tlllltTPl nil till' 111..,1 11'1;1,l' 1)1' this r(~tllrll.
ll,fJfJfJ.fJfJ
I j . (, (.', .' t'
<iN
,
\'
LAST WILL AND TESTAMENT
DF
PEARL t~. GRmm
!, PEARL M. BROWN, a legal resident of the Borough of Carlisle,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, puhlish and declare this as and for my Last \Hll
alld Testamellt, hereby revokin~J all other wills and codicils heretofore lIIade by
11\1\,
FJHS'!': I direct I.hilL all lilY .ill';I; ddll:S '11111 rlll\l~I'ill CXPCII',":;,
including lilY (Jrave IlIarker, shall be paid from the assets of lilY estate as soon as
practi cab 1 e after my decease.
SECOND: I devise and bequeath the residue of my estate of cvery
nature and wherever situate to the following individuals in the shares indicated:
A. To my daughter, Peggy A. Zeladonis, eigh~Y percent (80X) of
the residue of my estate.
B. To my granddaughter, Susan L. Zeladonis, ten percent (10%)
of the res i due of my es ta te.
C. To my grandson, Thomas M. Zeladonis, ten percent (10%)
of the residue of my estate.
THIRD: Should my daughter, Peggy A. Zeladonis, predecease me
or die on or before the thirtieth day following my death, I direct that her
share be divided equally among my grandchildren, above mentioned.
FOURTH: I dire'Cot that illl taxes thilt lIIilY he assessed in
':1111'01''\'11'11'''' III' lilY d",ll.h "I' wlb'!l'vl'Y' 11"IIIt'I' illld IIY Wllil!,:VPI' ,jlwl.,dlcl.loJl '111I1'".",11,
',lIilll 1,1' I';lld 11'11111 lilY l'I".ldll,'I'Y 1",1,,,1.1' .1', .1 I'ill,!"r 1.11" "XP"II'." "I' 1111' II dill 1 11 I.,..
lr"IL!OIl uj: III.Y t~~;(;nl.d.
FIFTH: I nOlll'inate, constitul.e and appoint lilY daughter. Peggy A.
Z,~ladonis, Executl'ix of this lilY Last Will and Testalllcnt. In the event of the
r'~lIunciatinn, death. re:;iqllation or in,)h'll ity to ilCt for ilny reason whatsoever
"I' 1.I11~ s,lid I'.'qqy 1\. /1"lild"III.;, 1 nOllli 1I<l I.,!, con:,tHIlI.I! <lllll <lppO'ir11. lilY '1r'"nd-
d,Hi'lII!.:I', SU:..III I.. /,,1.1.11111;;;, l'xI!,,"l.rlx "I' I.hl., lilY \.".,1. WI\'\ ,,,,,I '\I".l.illlIl!lIl.. J
, h"I'I'hy I'el j,.v,~ lilY LXI'COtl'ix 1"'11111 1.I11! IIl'cl!ssil.Y of pllsthlg seClJr'l ty in coJlncction
!i \'J\\.I\ 1\,,\' ,j"\,\,,,~ ".~ ,~",'h \11 ,'II\' illl'\.,dktillllill \~hich sill! lIIay be cHll,'d upon to
I ",~:L 'i,i~\-'(\-\\' ~'::l 1 '-'lll ,;..dd~ to\' \'-',/ IiI dll ~\" .
IN WI 'I NLS~i \~lllI(UII, I IIdVl! i1()I'UUlltO ~l:l lilY hond and '.1)01 to Lhh lilY
Last Wi1'I and Testament thi s 177j!.day of /-7",<::..:(;/.$/-' 1979,
_.,. f?..JL c._..t'. ') I!.U?~,[ CU.U.1 (SI'I\I)
I'\.I\I(L M. II11l1WN
I
I
I
\
! Prilrl M. Brown. as ilnd for her Last Will and Testament, in the presence of us,
$i~)l\ed. $cJlcJ. pub'lisl10u and d,:clureu by the uboVll-nallied Testatrix,
/
\
,
\
, ,
. I '\. ,'~ ..... ,
I I \ t' . -. I' / ~" , ~..
~ L-\f '<<.LL-l.-':'::::.. C., .
.,.. '...~. ..... ....
~ ,
:: > It"
~ ;"' c
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"6 ~.=:
~e.t:
--:: ;.
~ (;J:-
': ~
- ~-
::I r. l-
e " "
~ E ~
w -
- -
H('al property
l'ersonal Property
Transfers
Joint Property
(II
Sli~l~IAHY (As 11"1'"1'1",1)
(Sch. "A") ,
(Sdl. "B") ,
(Sch."C") ,ll.nOn.oo
(Sch. "E"), 2.25B.5B
,
,13 .25B. 58
Gross Taxahle E~tate
l- '0
- Z .
t>l .
~ ~ ...;
. ::;;; .
;.. e OJ .-.:
t>l . ~ '"
'" Q '" :;;
~ .~
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= ;.l 0: '" Co.
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0 ~
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c f-
Z f- ::E ..c: .0 '- -<:
'" 01 E
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ex: ~ Cl:
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;... .;: - C (;
...
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{..\, l)dl'l'lIdlll''')
,
,
,
$
$
$
. . .'
RCC~3a
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTL Y OWNED PllOPERTY
*'
INSTRUCTIONS: Thl~ scherlule must disclose nIl profll1rty, rl~ul llwt IH~I'sollnl, OWI\l'fl hy the Ileel~r1rmt Jointly
with "tHIther or others, Incllldlnp; Intllngihles, stf1n(lln~ In tlw II/Ull'! 01' till! deCI!dent unll other's. L1Rt
renl pst.ate first, liS entireties, or ,\olnt, tellllllts, ~ivtn~ briel' description, us lndt.cutetl ullder Schedule
"A", plus the dnt.e Iinci pIneo of' rtlcord of instrument. otTud.IIlK vesLlt.ur'n, 11IIt. do not Incl\llle entireties
or oul of sUIte rt~lll estate vlllue in estate Vlllulltlon l:flI lImll. Persolllll Ilroperl.y shoulcllJll listed U5 In
Schedule "U", pIllS dllte (If Itcqulsltlon, Hnd the IlUlIIl.!, ,ultlr(!ss /lilt! rel/lt.lollshlp (if' nny) of' co-owners to
the (lecedent.
DescripUon of Properij', Dnte of' Acquisl tlon, NllmH
Address anet Relationship of Co-Owners, Ilnd Plnce
lor Ilecorrl of InstrlUnent, where 1lE'IlI Estnte.
)()(XX) X
:x %00(< Y
Y ~ :XtX
2
Savings Account No. lB-D04080l-3 at Common-
wealth National Bank, Carlisle, PA, in
names of Pearl ~. 8rown or Peggy A. Zela-
donis. Date of Death amount: $3,599.08
plus interest of $14.19. Taxable at one-
half (y,) value. 9'-"v..( /:1./J/15~
Checking Account No. 076-00l897-B at WIB,
Carlisle, PA in names of Pearl M. Brown or
Peggy A. Zeladonis. Date of Death amount:
$9D3.8B. Taxable at one-half (y,) value
&r"u.{./ '///"/1~-
Cnlt.
VIlIue
Estlll.~
Vll)UIlLton
Insert this tolllI opposite ",lotllt1~' (jIol'IU.tI Property", Schedule "E~,~?_",~,~8. ~~
In the "As I\'~florted" COl11l'1l1 on tile lust. flU;Z;I~ of this ret.urn. -...-'
pc rCl'1I tnge
Shure
~~~~
~''X/66'
~
3,613. 7 (~~~L 1 ,B0~.fi4
I
903.3B (SQ%, 1151.94
Dm'AlITMENT VALUATION
C ,\UTroN-Do no t Wri te
I n This Snaco.
Value of Value of
l"ntlrp. Decedentt s
property Interest
,:'..,~ ~:f. ,r-J'
.
';1,01
,
\
.~ ~ ~ ~
~ ~ 0
z ~ ~ ... u.
0 ~ a:: 't:l
~ c:
rJl OJ '"
;l z ~ r-
III ...
,..l ~ .~ OJ
< ... ~ .0
Cl ;z: '" ... E M
... 0 OJ '" ::>
I>< a. u u M
I>< ...
, 0 ~ 0
~ '"
'" 0
~ 0 '" Z 0
... ~ '" ~ fo- 0
;z: ~ ~ !-< ~ ;z: ;z:
::l 0 ... 0 ~ 5 ~ '101
::s ~ ~
z Z !-< ~ Z
~ ~ '" 8 0 :l
~ Ci
OFFICE OF THE
REGISTER OF WILLS
Cumberland
OF COU NTY
AND AGENT OF THE COMMONWEAL TH
STATEMENT Of' DEBTS
AND DEDUCTIONS
DEDUCTIONS ALLOWED II'
THE SUM OF I 'I ).~!J~ 11
DA TP. APPROVED 'JttaO-12 ' IfS c)
1/aM,MI L3. YJ/f,c X'~
,]'E'ltTj REOISTER UfO 'YIl.U, AO':.:tn
HEV."!l~ 11l-7Bl
:~'--'
--'--
---
ESTATE OF PEARL M. BROWN
LATE OF BOROUGH OF CARLISLE
DATE OF FILIHG APPRAISEMEtH
DATE OF DEATH October 27. 1979
-
. -
-
DATE NO, OF NAME OF PAYEE REMARKS AMOUNT
VOUCHER
19/9 . -
-Oct. "111 ler Funeral Home Funera 1 Bill l,'lnn n'l
---" --
_t:IQY~ .l:\oi:fmgn::RQ.thJunor" ~nmo I'lInpr" iillL- q7t; 74
-
--1'JllY.- ~Jru;.an.Llela.do.ni s . _"1..is.c.JJJJle.r.aL.lxp.ensP' __.120 nn
----~
No\{. Peagy A. Zeladonis Fam11 v Exemp1iQ1L ~nO'l n'l
1980
Jan. Landis & Black Attorney Fees lnn ~
Jan. Landis & Black Advanced Costs & Nota ry Fees 9 nn
---
-.-- -
- ---..--....-- --- -
- -
-
.
--- --
-
----' -.
- -- --.--------- .
---- -- _..- -'
--- -"
---'- ---_.~_. -.---- .-------
-"~- ---..--.-.-.. -- ------.---------
------ ---...--.------.- ---.........------------------- -
=-===J~:..~..-].~~~~=o~--==::.~:~=:=~=,~:. .-- - TOT ~L D,2n5 J.L
. - -
COMMOI,WEALTH OP PENNSYLVANIA \
55,
COUNTY OF _.C.!l!11.lJe.rJ~!li...--
I, _.._.__.__ ..p~ggy..8.!__~~_a_<!QJl_i?_'__......_ ..._.___ HEREBY CERTIFY, THAT TO THE BEST OF
MY KNOWLEDGE AND bELIEF, T:I[ FOREGOIHG 15 A JUS'I I.ND TRUE STATEMEIH OF DEBTS, FUNERAL EXPENSES AHD
EXPENSES OF ADMINISTRATIO" ;UBMITTfD TO THE ESTAT: OF _J'.earl11:-Brown, ---
DECEASED, AS DEDUr. nONS FOR INHERI,.NCE T. X puRPOSES.
d .
SWORN ANI)SUBSCRIBED BEFORE ME ,HI; ;1:3__ DAY OF
~<111;- --t,.P-- 17 /SJo
--. " r/ ... .-41~-----
I
,
--,,"~. -
') , ~ ,/,'
/:~~ I ....,.. . --}' "..-: /. .///.//
Peggy A. Zeladonis
(L,S,)
,',lof i.>Jli'oIl,,':'~~";' !..J.i."'-- ~~..L 'ii, l.tiJ
? '1::> -')