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HomeMy WebLinkAbout80-00163 ',\ ~ ~ , ~ ..~ . ~ ::e: I :xl .C':) ~ CD tJ ~ Q ... OC) 0 ." ,. ,- N , 0 B z VI 1&1 '_'l" 'f - . - . .'- . ~ . . **** WILL **** I, ETHEL M. FAIR, of Camp Hill, Cumberland County, Pennsylvania, do make this my will, hereby revoking any and all wills at any time heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral be paid out of my estate as soon as may be convenient after my death. SECOND: I give my tangible personal property to LOIS M. FAIR if she survives me. FOURTH: I appoint MELLON BANK, N.A. as Executor of this my will. I give to my said Executor, in addition to the authority conferred by law, the power to sell any or all of my property, real or personal, at public or private sale, at.such time and for such price and upon such terms and conditions as it may see fit, or in its discretion to retain the same for distribution in kind, and the power, but not the duty, to invest any cash without being limited to "legal" investments. No bond shall be required of any fiduciary hereunder in any jurisdiction, and no individual fiduciary shall he entitled to compensation. ~ '" ~ ~ ItI Cl ell 0 Cl . to ~ Cl '" '" f<l 0 ~ Wl ';;j " 1!5'" -; '" 'rl ~ ~~ ~ M :;:0 ~ ~ ;;l N ~ 1 ~ g 0 M ;3: ~ f<l W ~ C ~ ::.:: ~ f<l ~ !;j ~~~i . ~ . ~ ! . ;1 ,., ,} II, """, o_.i . ..._ .' to . , , OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLV ANIA I 8S: COUNTY OF CUMBERLAND \ This... .......... ......" ,.. ....." ,.."" ,{::.~~~:.,..... ........"""". day of,.. ,PZ ~ :.~ (.K......,."..,.....,..""...., ........", A. D., 19.1).9.... Harold B. McLane, Deputy before me Rielo.lu Ii ~. },Rliu.-n, IWgister for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came .............. Russell s. DeBilis and Kim J. Griffith ......................................,......................................................................................................................................... the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ......,..... .~~,~~.~...~~. :...:' .~~::......... .... ,. ,..,.,.....,...... ....., ,..,........,.. ... Dated .~.':l.~::,..~~.~....~.??~.......... late of ............,.............~~,~p....~~.~.~..........."...................,........................"". Cumberland County Pa,. deceased who being duly ..........9.'ii~.;-.n...................... according to law, depose and say, that ........................................ Ethel M. Fair present, and saw and heard the testa~!:.~.~......................., ............................................................................. sign. seal. publish, pronounce and declare the said instrument of writing as and for h.~.J?.......... Testament and Last Will. and at the time of so doing ...................~.1::~........................was of sound and disposing mind memory and understanding. to the best of ..................~::.~~.7.................knowledge. observation and belief. ......,..~~,?:::!:........................... and subscribed before Q~;~.g.../J.~.l;JL~........,............. ..:::f$.V.U:l. .::;.)...~~~'A~;t,U..H......".....................,... ,~QlhJ~l;Jr.f.(.?/.c'v.),\.~....~.~~~.~~. R:~hd.._a ,E. .A..1..duLJJ.R, Register .................................................................................. AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ SaraJane L. Motto, Assistant Trust Officer, Mellon Bank, N. A. . ....... .......... .....,....,.,.....,......, "."..... ............,.............,............, ... .., ......" ,.........., ,.,.., ......................., ..., ......bemg duly ................~.~~.~!!:.................... says that as nearly as can be ascertained the said decedent ,......................... ....,........".~.1:h!!tM~. ..f.~.~?;......... ...................., ........., ............ ....',..,..... ...... ....,. ..............., ........,....., ............died on Saturday 29th December 80 .................,.............................. the ..............,.................day of ..................................................... A.D.. 19........ at or about .......................................... o'clock, ....M. ,..............:'!:f.O''f..f!:..............,..........and subscribed this 28th February .............................,.................. day of ........................ 19?R....... before ~~ /' ""I, /It .......... .i;.. r!-.;~!/;:/ .::'.::::'. :3... ::.~.I. f.'.:... .~.'~....................... SaraJane L. Motto, Assistant Trust Officer " '-1J..C:v:}.it:H.),.')~..~.L';:'I"L,.. ,.. ........~.~~~.~~.,. R:_L-9"A v A._~~",:,.....n, Register ;2'" /.0'''''_<' .1, [:. //Jr;"". ,. ....._ ~"'~ .(',...,1. . CJ 1-[0 -It,; J I _~~), / ?~l"'':' rc-l"-J ",V'<l { I I I ) !lia5 112 .sOOM REV 2-7B , (100 C~rl. per boo\..) I (F[;E fOR THIS 1 ([RTlfICA TE $'2.00) J I I I I I I I I I " I I I I I I WARNING: It is illegol to oller Ihis copy or 10 dup1icato by pholo~I(J1 or photograph. COMMONWEALTH 01' PENNSYlVMIIA DEPARTMEm OF HEALTH.VITAL STATISTICS N9 1560963 I.OCAI. HEGISTRAH.'(S CFRTIFIC.\T1()~ OF DEATH 1(.'.;,'cr,,1 No, '.'-'''-''.------ c ' / " ~;:'~\~~:::~d _,_.__1~1J.'-'-L-n--",-,.n j (I.Vl_,<.d~---" ,.,=1.1....1.....'---....-.--.-. . I /'" /'1 ~ ')"". It ,\m'f{ . l () /J Re,slde. nee .21CLJ'l..... lL'---'nLA,"'.......'-'=-'. L._ 1/ ;),-L~l1.J.v..L. L. L.J...'.'c,,_,"~t.J._,~.,-L,-- Nllmbft SIr!!",' !.ilY ~DWI1 . , ,) COUI"V. SIal" l'lace Or (,'} L ~.' !/. I.. " DeRth _________...._",1<,. ~I....'_L..c J...,,~, m .._,...'.n.'.'." _,,__ ...- ,-,.J...",..~ ,...0 .d,,- <C.____ I'e"osylvnolll ''') (0""" "," 'OO""'J" 00 Tow~~ , Sex .____,_,_.::/~~L.~h".....e.'__,._n"'" ,. Hale 01 Ikllh .,.,_.,..JJ,_,)., ,'1..:.1-'7._ ,,..,- ______Illl," ,- Lul_t..... Dille 01 Birth _.//.:..L5::../J:Lc/- Ili,thphlre ,u.nn/], ,_ L-L.~L...."__..J{,,,~,.__n ~lnrll,,1 S'"I", -J~'7.G J.' I .-.- - -t I . .' " Sodul Securlt)' No. .2..j_5_:_~_1~:Jj1-J. Occupation "__' \L(L..I......f....'-(_;:~.-......-.... Vetr.nlll's Serial Nu. --.---.---- , Intl.'rvul Uct",cen Onset and Death MEIlICAL CEIlTIFICATE Purt I. Death ''r'BS caused h)': Immediate Callie (11) ___il.L:t;;'-:.I-=L'-&J..,,,,L,,.,,Nl,,-r...'L.j,-.,-.lJ~<a~- Due To (b) _- -------~--~----..._-----_._------_. Due To (c) ___.__...___.._.____.___..____.._______'__._..._..._..____-.-~---~..." I.urt II. OTHCm SIGr-;'I"'JC.\~T C()NI)ITIO~S: conlrihnlilll; hI (h~alh hut lIot rcbfcd to HIl: imml>dialc cause '~(1'Cn in I'nrl1 (a) Acchl('nt, Sulcidl' or Homiclctc ________._______..___.~__.How did illjllry ocrur I !'l'umc nnd Title of Person I) !) i). ..f'. Who C~'rtifil'{1 ~~""S~ 01 He"lh (:!.H';J~O., ('oroller, ,~l/'E') -.---:.~-d-/i7.-.I-\.,.--LL. ~V.LL..-"-::1-~_ Addr'" ---~'-n- ,~I::,J..i~.~l-,,----'-.---.----l~t\LL"-'1.- 'LL.U!..~---- 1 srr~ti.' Clly :J This is to ct ur' (hut the illfnrm:ltio~ Icn' gh'l'fl is l'orl"ectly (~()pil'd frum an Clri~i"al ~CI"(jfiC:ltc or death duly tiled ,'t"ith me as Local RCAb mr. Tbc oriRimll culilic:.lle will b~!.(l;'w:"~e~I:,'. 'ile S'''(7VII:lI ~"t;sJi)s Ornee lor per",,,,,",,! lilil.g. ('.), (,.,,(c.. -d~./..TI-vJ 22.222 . . ~ ___._._.___J______....l__._._____________ I / lotl~t R~viurlJr 01 Vilal StoH.!;u Oi~!llcl No, , 2S29_0arJ:lc-Y~0r,~ ---.,-- ~. ., .1 f:t~tl Ft1<04 City, Borough, Towmhlp Helm, ~ur~,_'______.._,._U___H_.11. .. -3 I. 77 Dll!O;- R~c~i...cd uy latol Rcobtr~r __._______.____~__.._~__..____._...__.....___.. ."".....__.'"__~._._.._.....___.__________.._"__...m_"~....__ _._ ___._..._______.____._.____._____ -----_._--_..__._---_.._-_.-..-.--_...._~ _.__."._~---~._._.........".~..__..__.-._.._-_. .-.-..".----------.----.---------- .' ~ No, 21-80 16a PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY in the Estate of Ethel M. Fair , deceased. To Richard E, Anderson, Register of Wills for the County of Cumberland, in the Commonwealth ot Pennsylvanio, IS Petitioner:&J.:~ the executEL..__ named in the Last Will and _ dated JulliLlZ,] 9 79 , resident of Testament of Ethel M. Fair Decedent was a citizen of the United States and a XElwflGh(pc Borough, Cumberland County, Commonwealth Camp Hill of Pennsylvania, Decedent died on the 29th day of December State of Saturday A D. 19..12-, in the County of Cumberland Pennsylvania at the age of 95 years. ~ Kii!SC her Decedent has not been married and has not had children born to Rim since the execution of the above described Will. Decedent was possessed off ~grsonal property ffiCm'e'{~~~IDfx no and of/real estate to the value of as near as can be ascertained; ~Mx~k ~~t(~l!I:/lI::lmXOO;tjElWS:: the sole asset of her estate is a trust of which Mellon Bank, N. A. is the Trustee and will p~rform all functions that would be performed by an Executor if there was a probate estate. .....I ]/l1'l1.ll.!4C Xlxemkx~~ilt:OOJileoX~ID1spectfxrl4~X1WM!l!S{:forx:theXj:1JXli<2\1tteX li\k~I0let2txlx~wm~l!St~~~l&il\d::xilfP{kmetX~o:l'9xtl:1Jnall'lx Dated February 6. 1980 Name and address of Petitioner(s) Mellon Bank, N.A. Mellon Square Pittsburgh, Pennsylvania 15230 By: 1--,u-k~u>>Jl/j; " (/ SaraJane L. Motto A~F;h::lt~nt T"'I1~f. orf; f"P'r COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND named in above application, being duly say(s) that the statements set forth in according to law this petition are true to the best of knowledge and belief. and subscribed before me, ______ 19__ Richard E. Anderson, Register Filed; At torney: 'h&V.451\'1:1301 COMMONWEAL TlI OF 1'.NNIiVIVMIIA , llEPAH'fMENT Of' 11EVI:NlIli . TIlAN~fHIINII~HITANCE TAX IlLSltH,m tlECEOENT SCH::DULE "6" PEHSONAl. PROPEiHV (lm'lfIf::tifJ{IS on Rt:v~:(s:.. Side) Estate of 1\'1'111':1. N. "'Mil _...............__.............___.-.._~=-=~.....=..r_,.......>r. ._.==-""=.......- - -=----.--:=..-=-- ~ ITEM NO. UNIT VALUE ESTIMATED MARKET VALUE DESCFlIPTION I. FIRST PENNSYLVANIA BANK - INCONE ON IIAND AND ACCRUEIl 1'0 12/29/79 FROM DEED OF TRUST OF JANES M. FAIR 901.06 2. RUTGERS, TilE STATE UNIVERSITY - REPLACEMENT OF CHECK DATED 6/13/75 $89.21 IUn'IREMENT ALLOWANCE FOR PERIOD 12/24/79 THROUGH 12/28/79 65.08 154.29 3. UNITED STATES TREASURY - RIU'UND OF 1979 PERSONAL INCOME TAX 108.35 4. CAPITAL BLUE CROSS - REFUND OF UNEARNED PREMIUMS 15.50 5. IILUE RIDGE HAVEN WEST CONVALESCENT CENTER, INC. - REFUND OF OVERPAYMENT 75.96 TOTAL THIS PAGE 1,255.16 ~'f:.I!..", ):t 'u' .,. DEPARTMENT VALUATION (OFFICIAL USE ON!. ) .1 I- z w :E: I- '" 4: 0.. W Q I- CIl ::l "'Ill 1-.. ~ I ... o ~ ... '" " ~ W I- "" l- v:> <l w .. z ... ..J ~ .. -'" ... c:: C L!.l III 0- n 0:1 "I L!.l '" U. C '" LU '" u: ,.J ..e !l 0 0 - '" u. c.. l!) u f.c ~ '" '" ::> 0 UJ c.. '-' c:: X <t 0.. 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W Cl I- '" .::l "'", 1-", f ... o " '" '" W W lz << ~ :> " ,.. o ;z W '" << ... :> to w .... to << ... ,.J W 0: W > W ... .... W "' W '" Ul W U 0: :> o Ul 1: o 0: ... W 0: ... W 1: o U ;z ... o W ~ ... lii W cl Z ~ ~~ c Ill;' CQN cffi .E~ ""03~ W :Eo ~ OIl W U ... '" 0. ... W '" '" ;! . .~ , REV04S4 (l.eol CO"MMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JDINTL V OWNED PROPERTY {lnsrructions on Reverso Sidel Estate of ETHEL N. FAIR ,~~ ~ p TOTAL E VALUE OF DEPARTMENT R DESCRIPTION MARKET C DECEDENT'S VALUATION VALUE E INTEREST (Officiol Us. Only) N T 1. NATIONAL CENTRAL BANK - CHECKING ACCOUNT NO. 61-312471 ESTABLISHED 1/28/70 IN NAMES OF DECEDENT AND LOIS M. FAIR; ON 6/20/79 MARY E. LOTT'S NAME WAS ADDED $1,559.31 50% 779.66 TOTAL THIS PAGE 779.66 ,;> ~ I ~ ~ ~ i I < :.c I I>.l I>.l u ~ :>- :>- '" I ~ '" :::> <I n 00 :.c n~ ",,'" Z H u "'.1 0 < C-:o M'" 0 c;')<> r.. ~ @ 3:", i:n~ I>.l ..:1' "'. ,=::0 tIl . ..:1 ..:1' < MO .:;':l ...0 ;J :.: '" bJl ..:1 :0", -t i"lrT'1 0 ~I r.o W ~'-~JC ....1 ..:1 '" I >:1: >.;":' < "' Cl..; "', Z". 0 .,;M1'1 :.c 0 ~I :.: O:z: ., _r.: 0 z H " :::> n' ~ "' " U (....(f} '~_''1 - 0 n N ',(t"O; ~ - :~g ~ !( 0 0 ;ll c';;l ~ =: ~ t:.. !-< 0 tIl 0 Z 0 <I) '" >- f-< d - I>.l I>.l Z Z f-< f-< I>.l Z ...l d - d < ~ z ::<: I>.l I>.l ....1 Z ::; Z, f-< Q ;J U " Z - ~ '" ~ C 0 < ~ I>.l U Ci l'-< :i .J '~saJa~u! s.~uapaoap a4~ jO Onle^ 10~JeW 041 a~eo!pul '\7 '~saJa~u! s,~uapaoap a4~ jO a6e~uaoJad a4~ a~eo!pul 'E 'A~JadoJd POUMO AI~U!o! 04~ jO anle^ ~a)!Jew le~o~ a4~ a1eO!pU\ '~ 'pa4S!lqelSa seM d!4SJ8UMO ~U!O! 04~ a~ep a4~ pue (S) JaUMO'OO a4~ jO 1uapaoap a41 O~ d!4suO!lelaJ pue ssaJppe 'aweu alj~ apnloul '..8" alnpa40s JOj SUO!~onJlSU! a4~ U! pa~eo!pu! se AlJadoJd leUOsJad lie aqposaa ',,'of.. alnpa40s JOj 5UO!~OnJlsu! a41 U! pa~eo!pu! se AlJodoJd leaJ lie aq!Josaa 'L '~SJ!j a~e~sa ICOJ ~s!l 'papnlOu! aq 01 aJe A1JodOJd alq!6ue~u! pue olq!6ue~ 4~08 'd!45JO^!AJnS jO ~46p 41!M s~ueua~ 1U!0! se so!ped JO A1Jed JaLl10ue lj1!M AI1U!0! 1uopaoap a41 Aq POUMO 'leuosJad pue leoJ 'AlJodOJd lie apnlou! lsnw ,.3" alnpaljos ,,3.. 31n03HOS DNI131dINOO l:lO:l SNOI10mllSNI ,', ~ ~ ~ \.0 <>: 0 ~ 'n 0.. 0 '" z ~ ~ [>C, '0 ~ 0 >- .... ~ ~ .... "" 'n .... Vl ::r: \.0 ::> .... Q) Q) ~ ...l .c ~ < ~ '" N - r<l U U ~ U Z - 0 I:. I:. - 0 ~ I:. d ~ I:. ~ 0 Vl 0 z d Vl ~ Vl >< ~ d - ~ f-o ~ Z Z Z f-o ::l d - d ~ 5 ::<: ~ ~ z " z Cl U \:I Z - ~ Vl ~ 0 0 ~ - i:: ~ u Cl ...l U~V.45S EX-I 1:J.i101 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF IlEVENUE TIlANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEIJULE "F" STATEMENT OF DEBTS AND DEDUCTIONS ==':.:'-'-'=--=--.....:..:.-'-'=...:."..';..;.....;'-"-.--''''-;..._......~.__. ..___ ,'-.....'-....0--. Estate of ETHEL M, FAlX DJtp. of Death__._!.3i29/79_ File No.;LL:J'O - I (;!:; WHEN CLAIMINGTHE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: 8. 3/31/80 W. ORVILLE KIMMEL FUNERAL HOME, INC. : 9. 4/10/80 PENNSYLVANIA DEPARTMENT OF REVENUE 10. 7/17/80 BRACHENDORF MEMORIALS 11. KIRKPATRICK, LOCKHART, JOHNSON & HUTCHINSON 12. flELLON BANK N.A. Claimant Claimant's Address ITEM DATE NAME OF PAVEE NO, 1. 1/17/80 PROFESSIONAL PHARMACY 2. 1/31/80 BELL OF PENNSYLVANIA 3. 2/22/80 DECKMAN HAYDUK ASSOCIATES 4. 2/25/80 COWLEY ASSOCIATES 5. 2/27/80 REGISTER OF WILLS 6. 3/10/80 BLUE RIDGE HAVEN WEST CONVALESCENT CENTER 7. 3/11/80 LOIS M. FAIR Relationship to Decedent REMARKS DRUG CHARGES FOR OECEMBER, 1979 SlmVICE THROUGH 12/10/78 SERVICES RENDERED SlmVICES RENDEREO 12/29/79 COURT COSTS CHARGES FOR LAB AND X-RAYS REUlIlURSEMENTS, AS FOLLOWS: REV. R.E. GRUSSING - 1I0NORARIUM K. LANDIS, ORGANIST - HONORARIUM PENN HARRIS MOTOR INN - LUNCHEON FOR FAMILY ACCOf~ODATIONS AND TRANSPORTATION TO ATTEND FUNERAL FUNERAL SERVICES BALANCE DUE ON 1979 FINAL INCOME TAX RETURN PLACEMENT OF 11EMORIAL MARKER ATTORNEY'S FEE OUT OF-POCKET EXPENSES C0l1PENSATION 750.00 12.84 AMDUNT 60.99 .64 30.00 17.60 8.00 14.00 100.00 50.00 73.82 436.62 2,625.80 148.56 270.00 762.84 3,500.00 TOTAL THIS PAGE 8 098.87 I hereby certify that to Ihe best of my knowledge and belief the foregoing is a just .1nd true statement of debts, funeral expenses and expenses of adminislration submitted tD the estate as deduclions for Inheritance Tax purposes, MELLO BAN~ N.A. ,~RTY-IN-POSSESSION . ,~ 1./ .. (_ ~4,,~ . 51G 'ur~r: or ATTorwr:: /--1 JUCIAqy DATE OFFICIAL SE ONLY DEBTS AND DEOUCTIONS ARE ALLOWED IN THE SUM OF $ :5?cJ q g, :?1 , /1)- PERCENT. AT /1 t ,/ //}. 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JO 'as nods ou S! aJaLll)1 'e!UeAIAsuuad U! paIIJ!WOP palP OLlM jUapaJap e jO as nods e Aq paw!ep aq Aew 000'1:$ jO UO!lOWaXa Al!wej It 'alnpaLlJs S!Lll 01 paLlJene aq PlnoLls pawlelJ BUlaq slqap aLII JOj Alll!qe!l s,alelsa aLII JO s,IUapaJap aLl!lJoddns 01 aJuap!A3 'pel!j 51 UJnla\::l xel aJuelpaLlul aLII WOLlM Lll!M SIl!M jO JalS!6al::l aLII jO leAOJdde aLII oll~a!qns aJe a)elsa ue lSU!e6e pawlelJ Gu!aq Slqap lilt 'Ja>\Jew aAeJ6 JO auolsqwOl 'lollepnq e jO lSOJ aLII BUlpnIJU! sasuadxa lepnq pue leJaunj 'saaj AJeIJnPl) 'saa) AauJOne 'UO!leJls!U!Wpe )0 lSOJ aLl16ulpnlJUI alqew!elJ aJe SWal! Ja410 'alelsa JO luapa~ap aLII Aq paJJnJuI slqap 01 uOI1IPpe UI 'alelsa alqexel Jaq/S!ll lSUle6e alq!lJnpap aJe Llleap JeLl/s!ll 01 Jopd lUapaJap alll Aq paJJI1~u! sa!lll!qell pa!)S!leSUn NOll'1fIi\lHO:lNI Xlt133N'lflIH3HNI1\tH3N3D - .......__-..:x~16.... --- -- - - .-.- -- -_.--. -_.---- ,-.--. ----- ---,-- .. ... -- .---- ---- -- ---. -- --., - --." ~ --.- - --- - ._- - - - -- ~...-.... ....-.......--:---.- -- "'-"- lI. REV.1162 EX ~.. . COMMONWEALTH OF PENNSYLVANIA. . 4 NO, K296 59 DEPARTMENT OF REVENUE :. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX :' It ! " . '" I IjI II a I l,IlECEIVED Il FROM TAX AT 6% TAX AT 15% Mellon Bank, N.A, TAXAT_% ADDRESS Pittlilburgh, PA ESTATE TAX '--~~T~~-~~~~i'Ti(iN-:---D;c-;;b~~--29~--i9:;9--- 20=80"163 FILE NUMBER DATE OF PAYMENT July 21, 1981 NAME OF DECEDENT Ethel M. Fair COUNTY C umber land m o ~------------------------------------------- POSTMARK DATE . REMARKS: ~I ~ "REMAINDER OPEN" RECEIVEO BV SEAL I HEGISTEIl OF WILLS ~ TOTAL TAX CIlEDIT LESS DISCOUNT PLUS 'liINTEREST IFRDM 9=l9=tlO. TO~"'iB 1 .04635 TOTAL AMOUNT PAID ;" .I ,. / . . . / .(' ,I I 1..." .-. ~, (./"1 -. OIGNATUIlE $476.07 22.07 $498.14 ..,t... ., .;' / ',/ ;'t."'"t..>c..2/ L _-"~ v /. - -----"- -.---- -- - -- - ---- - -- -- - -- - -'- ~_._'----_.- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT ~:M. ~ COUNTY .E)LE fiO: " f" (.V"':j, t TO: l'Y\c,M,-tY' ,JLl'l ;}/-/'u-rC3 h ~',~:!'\.-(\ ~ . i.. v.",__ B C\....~.". k' 11 ('/ I t t'1t Al ' "I'~ , I ! ~\ .,' I ;--"j' -- ;' ..~ " ,\ ~ !:) J , 1:, 'II DATE ; ..(/, '1 (I 'J --1Y] -7 (' .-1 (),A/1_-" ESTATE /+~/'f\) . FILE NO. ;J I :( () .. / ( '\ V COUNTY I,~J\"-'VI I; /, . , I'. I r , . ) (.-~',-"'; () ". .; ( DATE OF DEATH ;,-' (, /, 1 ,. ):,1'7''1_ , Appraised Value of Estate: Real Estate $ Personal Property + Jointly Held PropertylTransfers + $ Total Gross Estate TOlal Approved Deductions Clear Value of ESlale $ Less: Approved Charitable Exemptions Clear Value of Eslste Subject to Tax $ Amount Taxable @ 6% Rate $ tax due $ Amount Taxable @ '5% Rate tax due * * .. '* . .. A five will be granled if lhe Inheritance TOJAl PENNSYlVANIA,INHERITAN. CE,TAX DUE 19.-~~-ko ~h 7-~' ~/) L. ()I/<:,:3S-) percent discounl olating $ Tax is paid by $ (!-7(" 0 '7 ",'J-;t- ",'~ 07 I-Ifr, I ~7. Less Credits: DATE OF PA VMENT AMOUNT PAID DISCQl.!!!L INTEREST TAX CREDIT '1 ( .,) I-{,f $ V-\7b,(J17 + s $ co? C\ u'7 $ (/n-, J.!L , + : + : (~:,Vo(' Oy...,~, (u/\,. UClhi InlereSl accrues at the rale' of six (fit percent per \Jannum on lhe unpaid balance of Inheritance Tax from to date of payment. lnleresl due if paid by is .-.. i G'"';"-~.r ....~0. . s.."",'r$;j(;;' BALANCE OF PENNSVLVANIA INHERITANCE TAX DUE Assessed by: $(>0 Information on Reverse Sido AgonllorthlCommonW8alth, ,....~~ ., .( , 19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT. A. DCheck here if you are requesting a refund of your overpayment. 20. If line 17 is grealer than line 18, enter the difference on line 20. This is the BALANCE DUE. A. Enter the interest on the balance dUB on line 20A. B, Enter Ihe 10101 of line 20 nnd 20A on lino 20B, Moke ChICk Payablo to: Rogl.tor 01 Will., Agont ..BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.. U~der penallies o~~ perjury, I declare that I have oltomined this return, indudin~ accompanying schodull" and .stalements, ond.IO the. best of my knowledge and belief, It Illruo, corr~d d ~~mplote',1 dOdar~1 01011 ,0010.lale has boonteparte nll,ue roarket '91u.. oeda'ft'!,on 01 B~porf'Alh's~a'rt~."POrfl'Jlal r'5~1l0Ii'e I. bosed on alllnf r nOff) of~whith..prepa r has an~wledge. He IOn anK, l'f ./\., t' .U. x , l.C'!:, g, '" . ~: ~_ /{ "r <-::''7.'~-J Assistant Trust Officer '~)l .\, ~,\ ,((',-Co SIGNATURE Of PERSON RESPO SIBLe fOR FlUNG RETURN ADDRESS DATE B : i\\Ql:.,\..~',.-..J ('Y;;l:;.\!\!: (- Assistant Tax Officer ,',( 0<.., .,l \', foi" , REV.I~OO EX+ {B.B:'l I ~ .... III uo.w" wO...u :z:,,<(0 uo. .. a. '" <( ",!Z Ww 0:<> ..Z 00 uo. !Z w <> w U w <> llNHERITANCE TAX RETURN I RESIDENT DECEDENT (TO BE FILED IN DUPLICATE FILE NUMBER ,,;(/-,)16.. /(,.3 WITH REGISTER OF WILLS) - - - _.. - _._n _ DECEDENT'S NAME (LAST, FIRST. "NO MIDDLE INITIAll DECEDENT'S ADDRESS Fair, Ethel fl. C/O lllueridge lIill Convalescent Center Camp hill PA 1,* COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE BURIAU OP: IXAMINATION P,O. BOX 8327 HARRISBURG, PA 17105 DATE OF DEATH December 29, 1979 SOCIAL SECURITY NUMBER 258-54-5991 Cumberland Count o 2, Supplementol Return 0040. Future Interest Compromise ~ 3. Remainder Return 01. Originol Return 04, life E.lale 06. Decedent died testate 0 7. Decedent maintained a living trusl IA"och co of Will) IA"och ca of tru.t) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME ADDRESS Mario Santilli Jr, Mellon Bank. N,A, P ,0, Box 185 Pittsburgh 05, Federal Estate Tax Return Required T otol Number of safe deposit boxes -g, TelEPHONE NUMBER (412) 234-0801 PA 15230 CITY STATE ZIP z o ;:: :3 ::I ,.. 0: <( u w .. 1. Reol E.lole (Schedule AI ( 1) 2, Stock. ond Bond. ISchedule BI ( 2) 3, Clo.ely Held Slock/Portnenhip Inle,e.t ISchodule q (31 4, Mortgoge. and Nale. Receivoble (Schedule D) ( 4) 5, Co.h, Bonk Deposits & Miseelloneou. Penonol Proportyl 5) (Scnedule E) 6, Jainlly Owned Property (Schedule FI 7, T ron.fen (Schedule G) (Schedule LI 8, Tolol Gro.. A..el. (10101 line. 1.7) 9. Funeral Expenses, Administrative Costs, Miscellaneous ( 9) Expen.es (Schedule H) 10, Debts, Mortgage Liabililies, Lien~ ISchedule I) (10) 11. Tolol Dedudion.llalolline.9 & 101 12, Nel Volue of E.tale (line 8 minu.lin. 11) 13, Chorlloble and Gavernmenlal Bequosts (Schedule J) 14, Nel Value subjed 10 lox (line 12 minus line 13) 15, Amounl of line 14 loxoble 01 6% role . (include volue. from Schedule K or Schedulo M) 16, Amounl of line 14 loxoble at 15% role (include value. from Scheduie K or Schedule M) 17, Principal lax due (odd lax Irom line 15 plu.tax fram line 16) ( 81 88,106,63 1.825.00 (11) 1,825,00 112) 86,281. 63 (13) 86,281.63 (14) )( ,06 = 86.281,63 )( ,15 = 12,942,25 (17) 12,942.25 Interest ,;;j n, 76.246,12 11 ,860,51 ( 6) (7) (15) (16) z o ~ ... ::I a. :l: o u ~ Amount Paid Discount 18, Total Prior payments: (181 (19) + (20) 120A) 120BI 12.9U,25 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE /I-/~-.:? I' POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, That I LOIS M, FAIR - have made, constituted and appointed and by these presents do make, constitute and appoint MARY F, LOTT my true and lawful attorney for me, and in my name, place and stead to ask, demand, sue for, collect and recieve all sums of money, dividends, interest, payments on account of debts and legAcies, and all property now due or which may hereafter become due and owing to me, and to give good and valid receipts and discharges for such payments; to sell assign, transfer and vote, in person or by proxy, stocks and bonds and securities standing in my name or belonging to me; to buy, exchange and sell securities of all kinds in my name and for my account at such prices and for such other securities a5 shall s~em advisable to my said ~ttorney: to sign, execute, acknowledge and deliver in my name all transfers and assignments of securities; to borrow money and to pledge securities for such loans as shall seem advisable to my said attorneyr to consent to reorganization' and mergers and to exchange securities in connection therewithr to manage real property and to sell} lease, convey, ,exchange and mortgage real proper ty, and foreclose mortgAges and take title to property in my name or in the name of a nominee as my said attorney shall deem advisable, and to execute, acknowledge and deliver deeds, with or without warranty, of real property, le~ses, mortgages, releases, satisfactions and other instruments relating to real property as my said attorney shall deem adv isable: to place and effect insurance: to do business with any bank, and particularlY to endorse all checks and drafts made payable to my order and to collect the proceeds thereof: to 5 i9n in my name checks on any and all bank accounts standing in my name or in my name jointly ~ith one or more other names, and to withdraw funds from ~aid accounts, and to open accounts in my name or in'the name of my said attorney; to enter any safe deposit box maintained in my name or in my name jointly with one or more other names and to have free access thereto for the purpose of depositing or withdrawing therefrom property of any nature whatsoever; to prepare, sign, verify and deliver any and all Federal income tax, gift tax, social security tax or other tax returns, and any and all claims for refund, abatement or credit of such taxes; to institute such proceedings at law or in equity as my said attorney shall deem advisable for my reliefi to transact any and all matters of any kind whatsoever in connection with Federal income tax, gift, social security or other tax matters and to appear before the Treasurer of the United States, the Tax Court of 'the United States, the Commissioner of Internal Revenue, the Internal Revenue Service and any unit or division of the Internal Revenue Service or any agent or employee thereof, and any othet officer, Department or BureaU havin9 anything to do with or in any way related to my income tax returns or income taX liability and/or gift tax returns or liability for gift tax as donor or donee and/or social security tax returns or liability for any year or years, either past or future; to appear for me in all actions or proceedings to which I may be a party in the courts of Pennsylvania or any other State or in the courts of the United States and to sign and verify in my name all complaints, petitions, answers and other pleadings of every description, to exercise any of the foregoing powers in respect of property or matters in my own name or in my name jointly with one or more other names and to join with others in so doing: to make such payments and expenditures as may be necessary in connection with any of the foregoing matters or with the administration of my affairs; - 2 - " l. , , '\ " . \. ~ ... REVOCABLE DEED OF TRUST MADE this 12th day of June. 1979, between ETHEL M, FAIR, of CampH!ll, Cumberland County, Pennsylvania, (herein called the "Settlor") and MELLON BANK, N.A., a national banking association authorized to engage in trust business in the Commonwealth of Pennsylvania, (herein called the "Trustee"): The Settlor desires to create a revocable trust of her interest in certain property listed in Schedule A, and therefor hereby transfers and delivers said property to the Trustee, together with all the Settlor's estate, right, title and interest in and to the same. The Trustee is willing to accept the trust and to hold said property, together with any additions thereto and changes therein, (herein called the "Trust Estate") in trust for the uses and purposes set forth below. NOW, THEREFORE, in consideration of the premises and intending to be legally bound hereby, the Settlor and the Trustee agree as follows: ARTICLE ONE The Trustee shall hold, manage, invest and reinvest the Trust Estate and shall distribute the net income (herein called "Income") and principal as follows: (A) During the lifetime of the Settlor, the Trustee shall pay the Income periodically but not less frequently. than quarter-annually to her or for her benefit and shall also pay to her, upon her written request, portions or all of the principal. The Trustee is authorized and directed to pay Income and principal for the benefit of the Settlor as directed in writing from time to time by either Lois M. Fair or Mary F. Lott and to pay to Lois M. Fair or Mary F. Lott such amounts as they may request to reimburse them for any amounts expended by \ limitation of any authority given to it by taw and without the necessity of obtaining the consent of any court, the following powers: to accept and retain'in kind any securities or other property delivered to it by the Settlor or received from the Settlor's estate or elsewhere, inclUding shares of Mellon National corporation: to invest and reinvest the principal of the Trust Estate in any kind of property, real or personal, or part interest therein, without being restricted to investments which are legal for trust fundsJ to give options for sales, leases and exchanges: to borrow moneYJ to sell, pledge, exchange or mortgage any real or personal propertYl to compromise claims; to lease real or personal property for terms exceeding 5 yearsl to vote shares of corporate stock, in person or by proxy, in favor of or against management proposals, except that the Trustee shall vote shares of Mellon National corporation only as directed by a competent adult Income beneficiary of the trust in which said shares are held: to carry securities in the name of a nominee; and to distribute the Trust Estate either in cash or in kind. (B) The Trustee may resign at any time by petitioning a court of competent jurisdiction to designate and appoint a successor Trustee. In the case of the merger or consolidation of the Trustee, the resultant company shall become successor Trustee hereunder without notice to any party. (C) The Trustee shall be entitled to receive annually compensation for its services hereunder in accordance with its schedule of compensation currently in effect when the services are performed, but not in excess of such compensation as would be approved by a court of competent jurisdiction. During the lifetime of the Settlor, such compensation shall be charged wholly against Income, unless the Settlor directs otherwise in writing. For any services performed by it.in - s - . r ~ iP 0 c.. S 'M ~ >-l t" ~ ~ ~ t>l t>l M t" ~. r f-' t:l N 01 ;.: . gJ . · e.. :.: f-' "l ~ Cl n 'l) 0 :.- pn .", "l H ,.'l) :<l III ~ ~ Cl M pC en Q ll' >-l i:tl ~ ~ III ~ ", $1,000.00 ~at~d July 1, 1959 Due July I, 1959 Bond ~o. M33430~4H @ $1,000,00 REG: I1ISS E'fiiEL M. FAIR $1,000.00 Dated SepteT-ber 1, 1959 Due Scptamb~r 1, 1979 Bond No. ~!391.~314ll @ $1,000.00 REG: MISS ETHEL M. FAIR (E~mCRSE~) $1,000.00 Dated Dec~cber I, 1959 Due December I, 1979 Bond No. M7011037H @ $1,000.00 REG: MISS ETHEL M. FAIR OR ;.;as. l-'.A.'l.Y ASKEW FAIR $1,000.00 Dated }lay I, 1961 Due May I, 1981 Bond No. 06518152H @ $500,00 REG: MISS ETHEL M. FAIR O? mss LOIS M. FAIR , Bond No. D6518153H @ $500.00 REG: MISS ETt'ZL M. FAIR OR MRS, HELEN FAIR HO:L\'ER $1,000.00 Dated February I, 1962 Due Februa~J 1, 1932 Bond No. D6849633il @ $500.00 REG: MISS ETHEL M. FAIR OR MRS. HELEN F. HOR~R . Sand No. D68!,968411 @ $500.00 REG: MISS ETiiEL :1. FAIR OR I1ISS LOIS M. FAIR $I,OOO.OC) Dated August I, 1966 Due August 1, 1986 Bond No, MI0~009S1H @ $1,000.00 REG: MISS ETHEL M. FAIR OR M3.S. HELEN FAIR 1l0,,:;ZR $1,000.00 Dat~d April I, 1967 Due April 1, 1937 Bond No. mOiS9S5511 @ $1,000,00 REG: XISS ETHEL X. FAIJ;. OR ~i:{S. HELEN FAIR HO!UiZR (Control No. 334S15) $700,00 THE UNITED STATES OF A'~RlCA Savings oor.d., Series E Dated April I, 1959 Due March I, 19.38 Sond Nos. C 3aS 537 6031/14E J $100,00 ~'ch REG: I1ISS ETHEL:-{, FAUOR }:?S, H"I.r.".N' AI" 10"'"- ., - F" i ",ic.,\ (Control No. ,834508) . 2 H, lJJ,OO $l,OOO,OO $3,000,1)0 $3,000,00 $1,000.00 .$1,000,00 . ,.; . . I 5T.\r: ;.\PIl')d. ::,.'.'[:;l~S .'.:.J ~.c~\~: ,\3Sl"'::,\r:~:: (~:'J~;r :-'RO~: PAC::: 7) J,lt,~.j Fl!hru:Jt'y 7 J 1977 (C:'l:.. Dat..l) DUe ::cnrll.lry 7, :?71 ")~r :"}~~'~',J.11 .''1':~CI' ~(ri~. ~/i/~9) Gtf. ::0. 101-:1-25732'.i ~1,000,'1'1" :t:;G: LUIS:1, ,AI:, :;R :~.i:E;' ~I, ,:;,11 :iER SISTER JT TE~ *RE.~n:ST ;:OR 1,;r:'llC:'.\;;,\:. OF S.WI::',;S AC';';'::'f .\r,'/,':HED SIC:;W BY ETHEL M, FAm 0\::0 ~JIS :1, F.\U--:;OT :;;,r:o (Control 30, 33~801) Dated ;'(,:!rch 1~, :977 :Jue March 14, 1973 Ctf, ~o. 001-20-~5960 ~ _1,000,00* REG: HELE:1 ~AU ;IO?J;E:l C"- ETHF.L ~!, FAIR JT TE:: *REQ'..:EST FOR ~'llTF!)RAWAL OF" 3,\VI~lG:5 ';'C;OC!'il' ATTACHED .i~G::Er: BY ,-T!IEL :-\, ?\IR--;;OT :JATSD (Control ~o. 034804) D~ted :13Y 3, 1977 (Orig, Date) D'te May 3, ~979 por rene"'al notice (Oris' 5/3/78) Ctf. :10. 001-20-26165:~ $3,'100,')0* REG: ETHEL H, FAIR -:R HELE:; FAIR HGR::S:1. HER SISTER, J: TEN *rJ::QtJZST FOR :;IT}-!D:lA~';AL OF ':;AVI~~GS _-\CC01;;n' ATTACHED SIGNED BY 3T!1EL ~!. F,u:t- -~OT DAT,-:J (Control ~o. 534805) D~ted ~l,'y 3, 1~77 (Jrtg, )~te) Due M3Y J, 1979 per renew31 notic. (Orig, 5/3/78) Ctf, :10. 00I-:()-~~l'l6 ~ S3,JOO.l~.k RL::G: E':i!r.L;'{, FA:.. CR LOIS M. FAIR :iLR SISTER JT TEN *REf,~'ZST ?OR. 'IIT::~M'';AL CF SAVI,i::;S AGeo;;::r ,\TTAClIED SIG,I~D BY LOIS ~l. .''\lR--::OT DAED (O::ontro 1 :10, 534306) STATE C.\PIT.\L S.WINGS A::) LOA:,; ASSOGL~Tl'::, HARR;S3UR~, n 6 3/4'7. Si:I~le P3:',ent Savin;;s Certificat.' C13." VII D3t'.\d AU:-!,U5t. ~Ot 19i3 (Cri~. D~te) :lup :..'lg1lS~ :.1, 197.) p'~:" re"1~"~'ll '"lott:e (l)ri?;. 2/:.J/iC,', Ct f. ::0. .....43;: j Sl, '),1),101'.' REG: E7!!EL ::. :.\iR OR :'t.'!5 :'L ~:AIR (SISTER) o.J'1" T::': *RE:lL'r:ST ?O:t ',E::~J:L~,'..l,\L ,J? :i.;'/r:KS :\CCl)i'~=! .\TTACHE~ ,:"~:D 3Y ~:::EL I,~. :.;~?~-LlH3 :1; ::.;:?--::\~T ~.\r::~ (Con':roL :::. j;!.7(7) . - -,.~ 1"" J J....... STAT::: CAPI'i.\L 5,\\'!~:(~ .:.~:o :...c.,,~: 6 If:?. ~i.r' ::,_1 !1':-::er.t ';:l'/ln:::; Dated August 6 1974 "Due Au:rust :;, t973 1~:' rene'Jai. Ctf, ~o, ~~~13 j 51,1)0,00' :U::--: :'r"~:. :'. :-:\I.{ ,'.\ :',::3 :--1. ,\S';,/ J:':' I', ~!, '3.',1& IS g ':i\G I i'A 7,~r::: l.Ccl~'''! Cl..i<:'; '/1. nottce (Odg. 8/6/75) /:... ::, :::::: T 'T'-" ~ 1.:J ~.... ,', ':';{,:, .:OJ.. ....... . ~.. .~:q.~;. 'L, . '::::;'.{,\:,;.:. ::\ ,,:::J j,\ :1::;::; ',I.. ".\:~ '. . ...J'_';;- .-....'4.....oJ :~:; :; . ~ ..... . )..J",..oJ (' ' .~~... ': i.: . , . 'J. .' -' '6 \ \'is' .~EV, 1~47EX (01-B6) ~:~ I~I \ ' co,",w"'l'" Cot ru,,,""'''''.~' .~i':\'.~ NOTICE OF INHERITANCE TAX \ or:r:.l\lVlll1 or I\f',f!jil[ I }~.:.. .:r;(;~JI' \ ACN ,,,,,,,,, 0' '''"''''''''1 ,m' ~\, ':i:9'$;:-','" APPRAISEMENT, ALLOWANCE OR DISALLOWANCE \ . It, i'O" 131' .: OF OEOUCTlONS, ANa ASSESSMENT OF TAX , .:;'..':;~"~". PI, ..;.;.~~.:....,,~~....__.~=_.~~_~__,".L~..=~.=.~.~=.==~.~=.'=.~'_"..~_._~~___=__-_~~)Pe-I-.E_._J"f.~l..?~~JL~~.-~,,~~ ESTATE OF F"IR ETHEL 11 FILE NO, 21 80-0)63 9.ATLOF OEA1tLJ2=-2S1-7~__._--_._.---_._------"---'-'---------'.'- ____<;.o~N.D'-_~UMBER"!\.ND.-----.- NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY, MAKE CHECKS PAYABLE TO "REGISTER OF WILLS, AGENT II . JrlN 5 198'1 102 MARIO SANTILLI JR MELLON BANK NA PO BOY. 185 PGH PA 15230 \~~~~~:~~U~~Gi~~~R OF-\ f~~;"~ "::"~:~;:.~Ew,,, \ CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS - . . . - . - . . .. . - . . - . . - . . - . . . - . .. - - - . - ... - - - . - - . - . . . . . . . - - . - . . - . - . - . - - - . - . . . - NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV, 1547EX (01.B6) ESTATE OF FAIR ETHEL M FILE NO, 21 80-0153 ACN 102 DATE 12-15-86 TAX RETURN WAS: (Y. 1 ACCEPTED AS FILED RESERVATION CONCERNING FUTURE ~~RE~SEE REVERS~ APPRAISEO VALUE OF RETURN BASEO ON: REMAINDER RETURN ,. Real Estate {Schedule Al 2. Stocks and Bonds (Schedule Bl 3. Closely Held Stock/Partnership Interest (Schedule Cl 4. Mortgages/Noles ReceIVable (Schedule 0) S. CashlBank Deposits/Misc. Personal Properly (Schedule E) 6. Jointly Owned Property (Schedule Fl 7, Trans1ers (Schedule G) 8. TOlal Assels ( 1 CHANGED ----- ( 11 .00 ( 21_75.246,12 ( 3) ,00 ( 4) .---:.QJL. ( 5) 1l.850.&-. ( 6) .00 ( 7) ,00 ( B) 88.105.53 APPROVED OEOUCTIONS AND EXEMPTIONS: g, Funeral Expenses/Administralive Cosls/Misce'laneoUs Expenses (Schedule H) ( 91 1.825,00 10, Debts/Mortgage Llab'lItles/Lien' (Schedule II ( 1 Q) - ,00 11, Total Deductions (111 12, Net Value ot Tax Return (121 13, Cha,itable/Governmental Bequests (Schedule JI (131 14. Net Value ot E,tate SubJecl to Tax (141 NOTE: If.n .ssessment w.s issued previouSly, lines 14, 15 andlor 16 and 17 will reflect figureS th.t include the tot.l of ..JJL returns .ssessed to date, ASSESSMENT OF TAX: '5. Amounl of line 14 laxable at 6% rate '6. Amounl of line 14 laxable at 15% rale '7. Principal Tax Due 1,825,00 86,281.g. ,00 86,281.63 (IS) (16) ,00 86,281. 63 _K06=_ X,1S= (17) ,00 12,942,24 12.942,25 TAX CREOITS: P A VMENT DAlE RECEIPT # DISCOUNT (+) INTEREST H AMOUNl PAID ~ INTEREST IS CHARGED FROM 10-06-85 TO 12-30-86 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.- * IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST (IF BALANCE DUE IS LESS THAN $1 TOT AL lAX CREDIT BALANCE OF TAX DUE 12,942,25 INTEREST 304.97 TOTAL DUE 13,247.22 OR IS REFLECTED AS A "CREDIT" (CRI. NO PAVMENT IS REOUIREDI ..,~O:;;;..:;J RESERVATION: Estates of decedents dYing on or before December '2, 1982 -- If any future Interest in the estate is transferred in possessIon or enjoyment to Class B (collateral) beneficlanez of the decedent after the expiration of any estate for IHe or for years, the Commonwealth hereby expressly reserves the right to appraise and assesS transfer Inheritance Taxes at lhe lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 1740 of the Inheritance and Estate Tax Act, Act 255 of 1982 (72 Pa. C.S. Section 17401. PAYMENT: Detach the lOP portion of this Notice and submit with your payment to the Register of Wills. --Address Inlormallon IS listed on page 13 01 the booklet. "Instruclions for Inheritance Tax Return for a Resident Decedent." --Make check or money order payable to: REGISTER OF WILLS, AGENT. REFUNO (CRI: A relund 01 a lax credl!, which was nol requesled on the Tax Relum, may be requesled by compleling an "APphca"on for Refund of Pennsylvania Inheritance and Estate Tax" (Form REV-13 1 3). Applications are available at the Office of the RegIster of Wills, any of the 24 Revenue Dlstnct OffIces. or from the Department's Forms Service Unit 24 hour Forms Ordering, telephone lines in Harnsburg - (7171 233-3443. in Philadelphia - {2 1 5l 351-2065, or In Pittsburgh - (4121565-3601, OBJECTIONS: Any party In interest not satisfied with the appraisement, allowance or disallowance of deduclions, or assessment of lax (including dIscount or interest) as shown on thiS Notice may obJecl within SIX I'; (60) days of r'eceipl of thIS Notice as follOWS: --by written protesl to the Department of Revenue, Board of Appeals, P.O. Box 8480, Harrisburg,PA 17105-8480 OR --by election to have lhe matter' determined at the audit of the account of the personal representative OR _ -by appeal to the Orphans' Court. ADMIN- ISTRA TIVE CORRECTIONS: Factual errors discovered on this assessmenl should be addressed in wrillng 10: PA Department of Revenue. Bureau of Individual Taxes. P.O, Bo>'.. 8327, Harrisburg, PA 17105, ATTN: Post Assessment Review Unit (717l 787-6505. See page 3 of the booklet "Instructions tor Inheritance Tax Return for a Resident Decedenl" for an explanalion of administratively correctable errors. If any ta>c due IS paid Within three (3) calendar months after the decedent's dealh, a five percent (5%) dIscount of lhe lax paid is allowed. OISCOUNT: INTEREST: Inlerest ;s calculaled on a daily basis at the following rates: Delinquent Date ~est R~ Daily Interest Factor 5/27/43 to and including 12/31/81 1/1/82 to and Including 12/31/82 1/1/83 10 and including 12/31/83 111/8410 and including 12/31/84 111/85 to and including 12/31/85 1/1/86 to and including 12/31/86 --Taxes that became delinquent on or before dehnquent balance is paid In full. --TaxEls lhat became delinquent on or after Januar\' 1, 1982 are subjecl to a variable Interest rate lhat changes each calendar year. --Interest is calculated as follows: 60' '0 20% 16% 11% 13% 10% December 31, 1981 will maintain a ,000164 ,000548 ,000438 .000301 ,000356 ,000274 conslanl inlerest rate until the INTEREST = BALANCE DF TAX UNPAID X NUMBER Df DAYS DELINQUENT X DAILY INTEREST fACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculatIon 10 fifteen (15) days beyond lhe dale of the assessment. If payment IS made aUer the interest computation date shown on lhe Notice. additional inleresl must be calculated. 1l<-'I,.J.B07 (EX) (12-B6)~~' j COMMONWEAlTH OF PENNSYlVANIA ,f t DEPARTMENT Of REliENUE ' ' . . BUREIIU or INDiviDUAl TAXES '....,'....\ . ~ttr:Ji.. ' r.o. BOX 8321 ' ..~~.. HARRISBURCi, P,. 17105.R321 ACN 102 DATEl:l,Q;:llJi ESTATE OF FAIR ETHEL M FILE NO, 21 80-0163 DATE OF DEATH 12-29-79 COUNTY CUl1aEBLMD 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, INHERITANCE TAX STATEMENT OF ACCOUNT MARIO SANTILLI JR MELLON BANK NA PO BOX 185 PGH PA 15230 PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE Amount Remitted to Regisler of Wills CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR FILES - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .. - - - - - - REV, 1607EX (12-B6) .. INHERITANCE TAX STATEMENT OF ACCOUNT .. ESTATE OF FAIR ETHEL M FILE NO, 21 80-0163 ACN 102 DATE 12-30-86 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE, SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, THE APPLICATION OF ALL PAVMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRD~ECTED INTEREST FIGURE, DATE OF. LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-08-86 PAVMENTS (TAX CREDITS): PAYMENT RECEIPT DATE NUMBER 10-03-86 229076 DISCOUNT + INTEREST (-) ,00 AMOUNT PAlO l 12,942,25 12,942.25 .,., 00 ,- ",'" np, -.J C:;.u r~~ 3:", S!o tn, :;; ",;0 ''''0 ...~o ~?i Z 1'1("-' "J I ~:) 'l>-' -- -.J r, .....h ('"';7 -,': ." .-" -V ~ _.f" ,', , PR!NCIP AL T AX DUE:..............,.........................,...............................................,........................................,',..........,.... TOTAL TAX CREDITS 12,942.25 BALANCE OF TAX DUE .00 INTEREST ,00 TOTAL DUE .00 (IF BALANCE DUE IS LESS THAN $1 OR IS REFLECTED AS A "CREDIT" (CR), NO PAYMENT IS REQUIRED I . IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST j J/ - i7~ ,). BUREAU OF INDIVIDUAL TAXES INIlERITNIC[ fMl. UIVl!>IOtl nE"'. i!60601 IlARIHSnURG, Ph 171i!6"0601 C011l10tlWEALTH OF PENNSYLVANIA DEPARTl1ENT OF REVENUE Ii'IHERITANCE TAX STATEMENT OF ACCOUNT 't\. (,!-;. ~~:~ 'I '~'~rt"', <:l/!i I,':\...~~:-;'" ~ '. 'ff1h~"~~~~ '-;:f";''"'~.Jy~;~'. R[V-JUT EX ~IP lU.UI MARIO SANTILLI JR MELLON BANK NA PO BOX 185 PGH PA 15230 DATE ESTATE OF DATE OF DEATH FILE NUtlBER COUNTY ACN 08-05-96 FAIR 12-29-79 21 80-0163 CUI1BERLAtID 101 ETHEL M Amount Remittod MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CU11BERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit tho upper portion of this form with your tnx paymant. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....cI REv:i6(jjTi"AFP-((J3':96y---u-liiiji-INHERITANCE-TATs;:ATEiiENT-oTAccoi:iNT--jilili--------------------- ESTATE OF FAIR ETHEL M FILE NO. 21 80-0163 ACN 101 DATE 08-05-96 THIS STATEMENT IS PROVIDED TO ADVISE OF TilE CURREtlT STATUS OF TIlE STATED ACN IN TilE NAMED ESTATE, SIIOHtl BELOH IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, ANO, IF APPLICABLE, A PROJECTED INTEREST FIGURE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTtIENT: 05-11-81 PRINCIPAL TAX DUE: 1,976,07 PAYMENTS (TAX CREDITS): PAYl1ENT RECEIPT DISCOUNT (+), AMOUNT PAID DATE NUMBER INTEREST (-) 03-31-80 XD034478 75,00 1,425,00 07-21-81 XB029659 23,03- 498,14 OB-03-96 WRITEOFF ,86- 1.82 TOTAL TAX CREDIT 1,976,07 THE DEPARTMENT HAS WRITTEN OFF THE BALANCE DUE AS UNCOLLECTABLE BALANCE OF TAX DUE ,00 INTEREST AND PEN. ,00 TOTAL DUE ,00