The URL can be used to link to this page

Home My WebLink About80-00325 i:i ~ ~ ~ ~ ll:l ~ ~ ; Po . H f!; .ll:l ..~ [/) ~ ~ , !Xl , I;< , e t!l is ! ~ ~ g: . ~ [/) f.<l' 0 ~ ~ i ~ ~ ~ ..... 0 6J ~ ," .... . CJ \0 0 .... z. ali No. 21-80 a2;; PETITION FOR PROBATE OF WILL Alip LETTERS TESTAMENTARY in the Estate af\~~\:I.\~ ~'~;\\\Q) ~~\)~\\\\\~ ' deceased. Mary C. Lewis Ta niE'Jl<lara L .^.R88fS9R, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania. IS Petitioner(s) me the execuU:.>~-_.,- named in the Last Will and Testament of'-'~~~h~Il..~,,~~\~~\;\\).\h~\dated .~\_,:)~,\..i~"\ Decedent was 0 citizen of the United States and 0 resident of ":.~ \ \.\). ' Township ~\,\)Q \\"~~~____ 8ol:G~l+,. Cumberland Caunty, Commonwealth of Pennsylval\ia. \ \. ~\ Decedent died on ~IU.>.J\~~\~~\\ the __\\S_;- day Of~~\._--r A. R 19~-r in the County of _-,--~.:..It..'\k'LhL__"-------'--' State of ,,~'<\.~%~,,\~____ at the age of ~'\- years. i:lG& Ae5" her Decedent has not been married and has not hod children born to him since the execution of the above described Will. Decedent was possessed of personal property to the value of .. ,~()() .\S'\') and of real estate to the value of X\C\'C\5) as near as can be ascertained; said real estate situated as follows ~ ~ Therefore, your petitioner(s) respectfully applies for the probate of the said LastWil1 and Testament and for Letters Testamentary thereon. Dated April 23. 1.980 Name and address .~L ~~~k, ~~ of Petitioner(s) //- .J +33d 7'" S7.' C-'-" / / // K,tJ/>I'//lt750N Il/c "1'15 tJ S COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND ~~~~Q" ",~Q,~\\~n ~j)\'f)\ named in above application, being duly ,~\\,\w'(\ according to law say(s) that the statements set forth in this petition are true to the ~:,:\~ knowl,dg' and b,li,f. . ~ _ and subscribed before ..~.c:::. ~4ct-rl/f/!71'/ L,.y:; me April 23 19 80 ")}2 {t d~ '.1 . Af~~td c. A~t:.::~, Register ~ ...~) j~ flJ {; Filed; dJl-~tJ -~"OI..~- Hay 15. 1.980 I/-slr~-l AttorneY:~"'--s:.,'\~I!.'.\J~\')"l~\;'~ ,~\j. ~J OATH OF SUBSCRIBING WITNESS . . ~ALTH OF PENNSYLVANIA I ss: COUNTY OF C ~ERLAND \ '."'" This..................................:..................................... day of .........................................7 .................. A.D., 19........, .. before me Richard E. Anderson, Register for the Probate of Wills and gl'll~Hng letters of Administration in and for said County of Cumb~d, in the Commonwealth of Penn&y(~ania, personally came .............. ................................................................'............................................./............................................................. the subscribing witnesses to the foregoing instrument of /w~ng purporting to be the last Will and , / Testament of .. .......... ...... .... ...... .......... ............ ........ ....),'.. ...:::...... ...... .... .......... Dated .......... ................ ............... late of................................................................................... ......................... Cumberland County Pa., deceased who being duly........................................... accprlling to law, depose and say, that ........................................ ./ ' present, and saw and heard the testa....:;/:........................, ..............~:............................................................. sign, seal, publish, pronounce and ded-;:;'e the said instrument of writing as and for h................ Testament ,/ ~ and Last Will, and at the ti/of so doing .................................................was o(sound and disposing mind memory and understanding, to the best of ..............................................knowledge, observation and belief. // ". .. / .............................:.................. and subscribed before , .................................................................................. .................................................................................. ,./ .................................................................................... .................................................................................. Richard E. Anderson, Register AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ ...........................~\&.~'i.~..l~.~I.~~~f.>..~,~\:I,~...........................................................being duly ..............~~);J:\.:0,.....\\..... says that as nearly as can be ascertained the said decedent .......................... ...............~~~'l;~);,.5;)~~~.'\~~}.;.,..:h0.\9_\\.\).~.~,..........................................................died on .....~.~~~~~\.......... the ...\\:l~...................day of .........~.\~~\\............................. A.D., 19:X,(J, at~ibout ........~:.~~.................... o'clock,\~vM. ......S:~\.DDU::~......................and subscribed this 23rd April ................................................ day of ........................ 19, ~.9....., b(!fore ;4:~.di~A~...~~ ..:..t1f.~..e,...!!~~.::!............................. R~... . _ II . []nl~t~H;t.cr OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA} COUN'I'Y OF CUMBEHLAND SS: Bel\JI'e me, the ReJ.(i>;tel' 1\11' the 1'1'01>:'.11' of Wills aJld waJl:;'JlJ.( of Idlpl'H of Adm.iniHtl'tltiOJl in und for V\\ \. (', \ " ,!.:"", ~\' \~S the County of Cumberland, pe"Honally call'" .....~'\..~.~I\,"~t,....:.'.0.~~.):fu...\.. i'\.'f.\~......................... who, being duly ...~illl'.:l\.'r.\......... dol::.~l,...... depoHe and Hay that aH.~./iS..~~.~\").$'.l.............................. of the lust. Will und Testament of ...~~~\,)~~,S~\\.\<'\.)s:,.5h$~"-~~')')'~\'...........deceased ..~'?................ will well and truly administer the ~oodH and chattelH, riJ.(hts and credit.s of said deceased according to law. And also will diligently comply with the provisions of the law relutin~ to Transfer Inheritances. ~~<;?:o~.... and subscribed before me. ..........~.J?~~.~.....??......................... A. D., 19.~?....... i1!1~'~d'~~;~'~i:Z~'"'''''''''''''''''''.''' .d~...i!:!-r:?;':.:d4r.:~:~..;~?lj/2. .................................................................................. :.0 0, tIl: 0> Cl' gj cg.; a' 0> .U ~r :0> ,0 I'al: U. S\ 1'1: ell: 0 Ill: *': rg\ Ill: ,.,. it:: 1'1, ...I 1-4: 0 1'1: PI: 0 N I' ...I gr !Xl , '" 0: - ell: - E-!: - I: ~ ~r ~ .: iii I"l: 0: ..t 1'1: ~\ .8 tl\ ~ 0 "0 00 ~\ 0> ~ 0 "0 1'1' I Z .. - 0 r-: N $ u *" 0> ~ .. 0> ", 0 ", b.O 0> - Z [>:J l'l OJ .~ OJ (:l.. ~ DECREE . lSth Hay 80 Be It remembered that on the ........................ day of ................................................, A. D., 19 ........, there was probated and recorded the last Will and Testament of ......~~~.l?.Y...~.?:.~!~::.~.~.~~...~::.~.~~.~?.~~I.'i!~........., I te f Silver Srping ~awnship C . a 0 ............................................................................, umberland County, PennsylvaOla, Deceased. Letters Testamentary Charles Prank lin Camp ........................... ...... ................ ...... were ~ranted to .... .... .... ..... ............. ...... ......... .......... ..... ...... .......................... Witness my hand and official seal the day und year aforesaid. . . ......7;!4..,.~li....(i;~:..1f;.~~f.!..;......:. J It "a L. llr-, RegIster. . .....,..../ r ( r' " . .- - I. l.'; ~- r'" "~' \,.,1 :.~;;;'I .. ~':j~~ _J ~ U " \ 0 ;>, - U V' 1-1 ~ tJ> r:1 <l1 tJl ~ 'tl ~ "'M ~ ~ <l1 1-1 <l1 "" .0 p..-l 0 1-1 Ul 1-1 <1J <1J l~ <1J .j.J 1-1.0 .\ .'" .j.J Q) S '"'-, <l1 " :> ~ .j.J CO .-l U OJ 'M "' <1J Ul - 1 l:: P. .,-iI.4-l',.-t " 1-1 0'<:: <1J Q) OJ . P\'<:: Q) ~ <l1 .j.J .j.J l:: ~ <l1 <l1 0 l:: H U..-l E-< <1J 2. 0 c:.... 11.1 l:J'''. 0:(1' OF,[ ,'. ~.!~ /0:::""" ~' "',' fO .- c. ~" v''. f tl; < w' -J. ',- "C ~ '- \:- "": . U ~J ~: ~ -_, ,:1 ..... . oJ, -:1--., c :5 ~"J.! ";1 6 ~ ~ i., :::1 u ... a. t:. ,''''"=J u '0-; ,. /Ji <1: :.. ;: C l , J .. 0 ~. i d ~ ;, .~ '.J ,,-,' ,: :) ::,,,j .~, ~3 ',1:' .'1 I ~ ~, -a ---'""-I ,.)! ~ ,;~. .~... ~..' 0 '.') '.. ';_';;'" 4~::l 1":: .:::; ~.~ 0 ~ l\J.::J () :-- .'" l:: " o o o 0<: ..-l <l1 l:: 'M r>.. 'tl l:: <l1 .j.J OJ 1-1 .ri r>.. ;'~3 ~J ., ., ':; .~ '-..J j/~~. .- ~ . ~ ' " ..', ,; ; ., ,:4 "'-.:l, .. ,-Y4~'>\ , I 0,'......... ,,\ ---.: ~; ~ ::, r:-: """;'" >:'",j :-..,J. '~l , " '.~ , \ Ii ., ui ~ ~ :s ~ w ~ :J ~ ~ ~ 0 X o ~ u Z ;: LL 0: ~ 0 w l= ~ N Cl 0( 0: 0 W (!) ~ Z 0( ~ ,. . tIl N Z · Z o w . D- ei iii . -' tIl -' 0: 0( U ~ :D ,:., '.w ., , " 0 ,J !: . J , ., .:; ,,.., 0\ , ::r. ,. " -,":.!. \...' .- Cl"~' 1..1.1 ." c:~,r 0. C]) 'L.;: n:~; "'- '.tn ~O: Hu:t~ Ul Q.l t:~ ro oJ iO .c~ J:: C]) c:l .j.JC]) oJ ,..; " oJ:>"'; \ '" C]) U.-l ~ "'J:: '.1 C]) i~ J:: 0 ~'Ul ~ 0 ..r! ~ >< Ul nl<l-l "') .j.J.r! :;:OU OJ:::> I U ;:l.r! <l-IC]) . 00 0.j.J 0. ~ <l-IU nl.r! o .j.J C]) H.c 'tl~ .j.J Ul III I .j.JJ::;:l III . ~ C '-,. -I-loJO +J.r.: c \1 ;:l,..;U UlOlO Q) O~ ~;:l80. U C])- oJ ,aUl ,a Ul . C])!3J:: .. ~ Ol:>' .c oJ C])Q)J::.jJ .j.Ju.c ~.j.J.r! c 0. .j.J ~ ::l J::.... ~ J::;:l 0.0 HOO HIl1UlU 'tl C]) Ul o 0. o ~ '" <l-I J:: 00 .r! .j.J.jJ >: ::l <1J.o s.r! <1J ~ .jJ.j.J nl Ul .jJ.r! UlCl ,. ''', "" l~i'~"': ;.;---- c. . ': ,../' -, . co'., ..-p. ;. l~ t. ~ . 01- ~ <.... o:<n '::C. . '. oC:. - "" Ut/.! CI_ -:~ LL.lo:::: ....-" I..,:,'; 0:: co ._1'- . '-' .' (: \.~, ' . ~...... (\ , d' -~ -.'. \ 'r. :, (;' ~:. ~f , \ .' --:,;"", \'.. ~. ,_. ..' ,... ,_. ." I: .', 0: ., 0( ui Z ~ ~ ~ 0( > ..J Cl ..J w ;; ,. :J ... ~ <II ... Z 0 0( ~ ~ z " 0 ,. :r 0 Ul 0 Ul !1 m .. ~ IL z :r ci 0: ~ .1Ii 0 ~ ..J W I: ~ l/l ... J Cl 0( 0: 0: 0( 0 u w Cl BENEFICIARIES BENEFICIARIES AND ADDRESSES (Slato full names and addHtSSM 01 nil who huvo an IntorMt eithor vested. contingont or olhtlf intflrtJ511 IlELATIDNSHIP TO DECEDENT SURVIVED DECEDENT STATE YES Oil NO AGE OF LIFE TENANTS DR ANNUITANTS AT DEATH OF DECEDENT INTEREST OF BENEFICIARY IN ESTATE ---------- -.-- Kathryn Arlean Richardf?.9!1....__. Molly pitcher !Iotel,13 S. Ban ear-l-i-s-le,-Pa.-HOB---- .-J!c:l~9!~~ ,.__yes_ ____ -- ver 1/8 - -.---- Minnie Margaret 'comp R.ll. 1, Box-38 New B lOQJllf i.e.ld._Y-..<l_....lI9JiJl daugh.--- --yes 1/8' ----.-- ------- ~udy E tizabeth-Itiem pt~-I Carlisle, Pa. 17013 daugh-o- --ye .-li8 'K~nn~t-h 1\,..+-\1",... r.on'UP..T 29 S. Penn St. lLSQn _y_e 1/8 Edgar Bryan Coover 1/8~ ." 0 C'\ :P m :P :iE son yes :P 0 0 0 ~ 0 R.D. 1, Box 499 Gl C'\ C 0 s: r m Z ~ II' 'II, r m 7< :Xl Shiremansdale, Pa. 'II, II m -i m Z -i -< Ul m Ul Linda Kay smyser, dau, yes 1/8 ", Ul 0 -i 0 -n :Xl 54 Fairview St"carlisle,pa, -n ~ Charles Franklin Camp, son yes 1/8 ::0 ~ . 0 433 G,7th st., Fr, Richardson, la ka 9950 t:J ~ z Bobbie William comp, son, yes, 1/8 1013 N. Taggart, Clarksville, nd, 47 30 ('l ...., ('l ~ Il> rI' -< -< tT\ ::r m (1) ::l (1) m :P Ii 0 Ii :P :Xl 1-' 1-' 1-" :D Il> Il> ::l ::l . (1) P. I'd IJ;l Il> ~ , rI' rI' (1) Ii 0- Il> .g ,.., INFORMATION o ." ." n j; ... c:: III m o Z ~ PLACE FOR FILING _ The return is to be filed in duplicate with the Regisler of Wills of the county wherein Ihe decedent resided. TIME FOR FILING __ The ,eturn is due nine months after the decedent's death, unless an extension for filing has been applied for and granled bV the Secretary of Revenue within the nine-month period. FAILURE TO FILE RETURN _ Section 791 of the 1961 Statule provides that ", , . any person who willfully fails 10 file a relurn or other reporl required of him, , . s\lall Ile personallY Iiallle . ' ' to a penalty of 25% of tl,e tax ultimalely found to be due or $1.000 whichever is the lesser to be recovered by Ihe Departmenl of Revenue as dellts of like amounl are recoverable by law," REY.484 EX+ tHOI INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONL Yl o Original o Supplemental o Remainder File Number ___.__'?1.::.80-03.~-,-,-.,-----..- Estale Name ___"_,,,.Mary,,Catherine,But ter,bo.ugh-----.- Date 01 Death _._~pril ,,~6. 12~~_____ Social Security Number 202-20-3652 ._-_.~_._.__.__.._.._... I, the undersigned duly appointed Inheritance Tax Apprais.. In and for the County of Cumberland Pennsylvania, do respectfully reporl that Ihave appraised the 1001 and personal property as reported in the foregoing return at the values set lorth apposito each item in the last column to the right in Schedules "A", "B", "COO, and "E" REPORT OF INHERITANCE TAX APPRAISER Dated: March 12. 1981 //;"M/" )'-lff~/I(}),J ) INHEPITANCE T^X APPRAISER INVENTORY VALUE AS APPRAISED CODE ADJUSTMENTS (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT COOE ...-----.- - 92+ 8.83 00+ '0+ Real Property (Sc:hedule A) Personal Property (Schedule B) joint-Held Property (Schedule E) Transfers (Schedule C) I TOT AL GROSS ASSETS Nnne NQ!1!L . .8.832 35_ 20+ 30+ 93- 40- L.ess Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE o Lile Estate o Annuity BATE FACTOR PRINCIPLE VALUE CODE - \ ~ \ FOR IISE OF REGISTER ONLY T ox on $ CODE COMPUTATION OF TAX S S S ~ 6,. " 15~;} T ox on $ Tax on $ S_ Tall. on $ $- Tax on $ Exomplions Tolal Estate TOTAL TAX INTEREST FROM GALANCE TO_ $ $ $ Less Credits DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST lAX CREDIT S \ S = $ = BALANCE S INTEREST FROM _.._____ TO __ .- S S ~ I . r:l . i>: ~ ~ ~ ~ ~ . 'C Z ~ ~ i>: 0 :>- :>- ril ~ 'C ~ ~ '" I ;J M ...l 1-0 OJ 0( .0 - " !l u Z \D M - ; " ~ 0 ~ - 0 ~ ~ ~ 0 ~ ... 0 '" 0 Z 0 '" '" :>- ... 0 - ~ Z ... ~ ... ~ Z Z 0 - 0 !Xi ~ ::<: ::3 ::;; ;S ~ ~ Z Z 0 U ~ l!: ~ '" ~ 8 0 z ~ 0 :l .!l'JFORMATION To insure propor credit to your account. tho name 01 tho ostote and lilo number should be c10arly print. ed on the check or money ordor. This assessmont is mode in accordanco with Soction 708 of tho Inheritanca and Estate Tax Act of 1961 (72 P,S. ~ 2485-7081, To tho extent that inheritanco tax IS paid within throo {31 months oftor the deoth of the docedont. 0 discount 01 livo {51 percont is ollowed {72 P.S, ~ 2485- 7161, Inherit once Tax. other than tax on a future intorest, is due ot tho dato 01 tho decodont's deoth and boconle. dolinquent at tho oxpiration 01 nino {91 months oltor tho decedent's doath 172 P.S. ~ 2485-7111, Inhoritance Tax on a future interost is payablo within throe 131 months alter tho transfer takes olfect in possossion and enjoyment ond is dolinquont therooltor (72 P,S. ~ 2485-7121. Coleulato interest from the dolinquent dote shown on tho faco of this lorm to the date of octuol paymont using the following intorest table: ------------ --------- ------.--- - --- ---------- -- - - - --- - --- --- ---- - -- -- - - - -- -- , month .005 4 months .020 7 months .035 '0 months .050 2 months .010 5 months .025 B months .040 ' 1 months .055 3 months ,015 6 months ,030 9 months ,045 12 monthS .060 1 days .00017 " days ,00185 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 tho Comll1onwealth and the personal representative. not sotisfied with the ossessment may object thereto within sixty (60) days after receipt of this Notice as provided by Section 1001 of tho Inheritance and Est.te Ta, Act 011961172 P.s. 92485.1001). Make check or money order payable to: "Register of Wills. Agent" Mail to the address listed below: INFORMATION To insure proper credit to your account, tho Ilamo of tho estate and file number should be clearly print. ed on the check or money order. This assessment is mado in accordance with Section 708 of tho Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485.7081. To the oxtent that inheritance tax is paid within throe (3) months after the death of the decedent, a discount of five f5) percent is ellowed (72 P.S, 9 2485- 7161. Inheritance Tax, other than tax on a futuro interest, is due at tho date of tho decedent's death and becomes delinquent at the expiretion of nine 191 months after the docedent's death 172 P,S, 9 2485.7111. Inheritence Tax on a futuro interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P,S. S 2485-712). Calculato interest from the delinquent date shown on the face of this form to the date of actual payment using tho following interest table: ------------ -------- - ---------- --- ---- - - ---- -- - - - --- - --- -------- -- -- - - - ---- 1 month ,005 4 months ,020 7 months .035 10 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 deys .00017 11 days ,00186 21 days .00352 2 days .00034 12 davs .00203 22 days .00369 3 deys .00051 '3 days .00220 23 days .00386 4 days .00068 14 days .00237 24 deys .00403 5 days .00085 15 days ,00250 25 days .00420 6 days .00101 16 days .00267 26 days .00437 7 deys .0011 8 17 days ,00284 27 days .00454 8 days .00135 18 days .00301 28 days .00471 9 days .00152 '9 days .00318 29 days .00488 10 days .00169 20 days .00335 30 days .00500 - - --------- ---------- -- - - -- - ----- -- -- ---- -- - ---.---- - - - - --------- ----... Any party in interest. including the Commonwealth and the plHsonal representative, not satisfied with the assessment may object thereto within sixty (60l days after receipt of tl1is Notice as provided by Section 1001 of thelnheritanca and Estate Tax Act of 1961172 P,S, 9 2485-10011, Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: , SUPPLEMENTAL I INHERITANCE TAX RETURN FOR ESTATES WITH GROSS ASSETS UNDER $10,000.00 , ":ommonwolllth 01 PennsylvanIa Department of RovonulI Tran.ter Inhorltance Tal< R"ldent Docodent R8".484 EX'" (1.00) Estate of Mary Catherin~ Butterbau9h Dato of Death -April 16. 1980 202-20-3652 Last Address Sample Bddge Rd,. R.D. 7 Social Security 1/ (CitY) Eno],., Pa. (Statal Bureau File # (Zip) County File # 1. Decedent died: o Intestate (without a will) Q Testate (leaving a last will -- copy attached) 2. ~ Executor/Executrix 0 Administrator/Administratrix Name ('Ih~,..'~c: 1<'l'";:a,,"'1 in rnmr Address 433 G st, Ft, Richardson, Alaska 99505 (City) (Statu) 3. All correspondence should be mailed to Ga Attorney 0 Fiduciary. 4. If an attorney is representing the estate, indicate: Name George F, Douglas, Jr, Address P,O. Box 261 carlisle , (CIty) Pa, (State) * ~/'J/ .3.....< C;-- " cO ,_. ",'" ~M ~ 'J~:l? ;11~ -" = ~o .;.)~ u,::r.J = _;CJ -:1.:: Olrr, .,.; ,:;:J ". r--.> , ,'-, , .' ,. CD , (,2:Jp) ::C. 17013 (Zip) REAL PROPERTY _ Identifv real property located in Pennsylvania by lot and block number, street address and Include a statement of mortgage encumbrances as of the date of death. NONE Total Estimated Market Value I Department Valuation (Official Use Only) Date Nama of Pay.. Natura of Dabt Amount Funeral expenses paid Family exemption (will not be allowed unless decedent died residing with U plllent, spouse or children.) Administration Eltponses Counsel Fees Fiduciary Commission (Other Debts and Claimsl Total Under penalties of perjury. I dedare that I hove examined this return, and to the best of my knowledge and belief. it is true, correct and complete. kz' ., < f/ ~A d/l. ' -, ~/. \ ~~/?/.-'/"/~ .-/"~A/'., ~,",,/~~,zj ~"Pr/ ,{23 0'U-e. / / 't'; Signature of Fiduciary I ' Date I do herebY certify that I have appraised the assets contained herein in conformity willi Pennsylvania law. >= ... Z 0 w Appraiser Date Ul In the event that anv future intarest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent aftor the 'oxpiration of any :l ... es.tate for lite or for years, the Commonwealth heroby c)(presslv rcserves the right to appraise and assess transfer inheritance taxes at the lawful collateral <( rr.ta on any such future interest. U it ., u. e Debts and deductions arc allowed in the sum of S at cI percent. 9hA'J'J 1/ ,~ .L/-~ -/-,YL /' :;j/_~) ( "egister of WilY Date DEBTS AND DEDUCTIONS BENEFICIARIES BENEFICIARIES AND ADDRESSES (Gtata full names and addresses of nil who hava an interast either vestod, contingent or other intorostl RELATIONSHIP TO DECEDENT SURVIVED DECEDENT STATE YES OR NO AGE OF LIFE TENANTS OR ANNUITANTS AT DEATH OF DECEDENT INTEREST OF BENEFICIARY IN ESTATE r::: ." 0 (') ~ m ~ :; ~ 0 0 <:) '" <:) Z Gl (') C <:) -i ;: r m Z ~ it 1r. r m ^ :Xl ,'" Ii, m -i m Z -i -< '" m u; 11, '" 0 -i 0 " :Xl " ~ 0 0 Z " " c:; i> r -< -< c: m m Ul ~ ~ m :Xl :Xl 0 Z r- ~ INFORMATION PLACE FOR FILING _ The return is 10 be filed in duplicate with the Register of Wills of the county wherein the. decedent resided. TIME FOR FI LING _ The return is due nine months after the decedent's death. unless an extension for filing has been applied for and granted by the Secretary of Revenue within the nine.month period, FAILURE TO FILE RETURN _ Seclion 791 of the 1961 Statuto provides that ", . . any person who willfully fails to file a return or other report required of him. . . shall be personally liable. . . to 11 penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue as debts of like amount arc recoverable by law," s.. "" Q) '" :> ,...., ~ ~ .... ~ 'n Ul ~ ~ ~ Q) '0 >- .:: '" '0 ~ 'n 0 .:: s.. '" '" '" Q) .... ;:l .<:: co: s.. ..l ..., 0... Q) ~ '" ~ '" .0 ~ LrI < u I"l - Z '" " u :>. .... u - 0 s.. 0 '" - '" .:: '" ~ ::: r.<l 0 '" ci ~ '" !;; 0 '" 0 Z 0 ~ '" >- !-< 0 - ~ ~ ~ Z Z z B i:l:: ~ ::l ci - ci r.<l ~ ,. Q U ~ Z ~ Z ~ 0 0 z li '" :l ~ u ~ l>. . ."'-.... -- -=< -- --- ""'~ ~- ........ -- ..", ~ ~. ; ~i'J~~Fi,w..' -: . COMMONWEALTH OF PENNSYLVANIA 4 'NO:Ko 0 0 5 5 2 . DEPARTMENT OF REVENUE f ." . OFFICIAL RECEIPT . PENNSYLVANIA INHERITANCE AND ESTATE TAX I'"~ . .- III . If = " .~ 1\ ~~g~VED Georve F. Dou la8 Jr. BI II - ;,~~j 'X TAX AT 6% TAX AT 15% TAXAT_% ADDRESS 21 w. High Street ESTATE TAX '. Carliale, PG. 11013 ---es-TATEINFORMfiTi1iN:- -- -------------- DATE OF DEATH ri1 16, 1980 TOTAL TAX CREDIT. 351.19 FILE NUMBER 21-80-325 DATE OF PAYMENT March 13, 1981 MARY CATHERINE Btl'l"l'BRB vi LESS DISCOUNT NAME OF DECEDENT PLUS (FROM % INTEREST TO_I COUNTY Cullberland m TOTAL AMOUNT PAID 351.19 ------------------------------------------ POSTMARK DATE REMARKS. "PAm ON ACCOUNT" SEAL RECEIVED BY . , I u.'. ..,k-- . I .'f) ? '.". ,I ~/,~~~ SIr.W~:f/..L...uJ Register of Willa I REGISTER OF WILLS - -'-'-.- - - --.-- -- -- -- - -- -. - - - - -. - - - - - - - - - - --.- I j I I I ] i I i I I i 1 I , , i J ..-.... -- ~ --- -- ~ ~ ~ ~ ~ --~ ~'AEY"IUEX"'l':'" ' "" I I Itt~Wi:,;,:y::j,,:c::t.'I::;I:':V '.' COMMONWEALTH OF PENNSYLVANIA 4 NO'llk 29458, l' , DEPARTMENT OF REVENUE 1)0'~:;:',,' 'OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX It' ' -- ; II a. ~-" RECEIVED ~ FROM - TAX AT 6% TAX AT 15% . TAXAT_% car1i11e, ,- - ESTA TEINFCiiiMATicifC--- DA IE OF DEATH PA 17 ESTATE TAX TOTAL TAX CREDIT ,e_" I i LESS DISCOUNT Qh PLUS % INTEREST (FROM TO_' m TOTAL AMOUNT PAID IIILlIfi ADDRESS 27 W. FILE NUMBER DATE OF PAYMENT NAME OF DECEDENT COUNTY ~ ------------------------------------------- , ,POSTMARK DATE 1--" SEAL RECEIVED BY , ~ ~,.' iil ?'. '..J . / /(' (,.;' S NATU,R . -' t.. . ( "PAID IN FULL" REGISTER OF WILLS - - - - - -- - -- - -_.- - .-_..- -- - ~-- - - ...._- ...-.-- --- - -- - - - - - - - - --