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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLV ANIA I S8:
COUNTY m' CUMBERLAND \
This, ..............,.......... ........?~.~~...... .......,..,. ...",..". day of." ...'"..", !:I.'::Y...".."......" ....., ...'" ......,. ..."" A.D., 19~.?'....,
Mary Lewis
before me RiollUddiliotllDlclRPSIOII, Register for the Probate of Wills and granting letters of Administration
inand for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came .........,....
..................,....,.,...g9!?~. F.!;.,..~.~...t':W.~F..f!.I.,.g.~:....~!'!~., ':~'..r.J:!~!!:~!'!...~:.., .~y.~.~!'!.. ,.,....,.... ........ ...' ,............,... .., ......
the subscribing witnesses to the foregoing instrument of writing purportin~ to be the last Will and
Testament of .,.,.. ,.......EF.!~,I;\~...~......W.~.l:1 !'!..,." ,.........., .., ...................... ....... .,., Dated .~~F..<;:.h,.IR.~ ...~~.? ~.......
lateof...................l:,0we:L'..""1J:en..'l'0Wfrsh,j,.p.......................................... Cumberland County Pa., deceased
who being duly ..............,........,swarn......., according to law, depose and say, that .the.y...were........,..........
present. and saw and heard the testa~~,L,......................, .....f.F..<:'-.~~...~:....I:!~I~!'!......................,......,..........
sign, seal, publish, pronounce and declare the said instrument of writing as and for h................ Testament
and Last Will, and at the time of so doing ................................!:.~............was of sound and disposing mind
memory and understanding, to the best of ............,..........the.ir............knowledge, observation and belief.
sworn .
,........................,..................,.. and subscribed before
. ...................,....,..:f.'
..1?1r.1/.1...e.....,..!/wd......,...................
'D ~ ..1~-l--,.~;ter
..................................................................................
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
.............................R:~:,:,:l:.\....s....(..,.!.\,~.:.,~..)-;"", .......,... ...................................................... ................being duly
......,......:~:"....>.,.,.'....................... says that as nearly as can be ascertained the said decedent .............,............
................... .flitll.,,!;,...... .1..,... ..\,.< r..\!. ~.,............,...............,.................,..........,.....,.........,.....,........,............. .died on
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.......\-:>I~J.t.,:.~'..':.~.................... the ..........J....................day of .........:.;.'.~.....f...........,..,................... A.D., 19.(1.';?,
at or about ...............,......................,... o'clock. ....M.
..................,...~~~F..~............,..,..and subscribed this
....................~.~~~............,...... day of ....~:.~.'f..............
19. ~9...., before
r) . , ,( JJ
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,.:.q;il(j,,1.j.:;....(2.;...,t;.{Y.;~::7:/....................
RI.L. Ji1, . ~jJ I -, ~~tster ,
1~O
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF CUMBERLAND SS:
Before me, the Register for the Probate of Wills and granting of Lettel's of Administration in and for
the County of Cumberland, personally came ...........9,),.~,,,.1,;........:S.......,(..,./.\.:,:,,L,,,,................................
~.}
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who. being duly .....Ii'.,."','....'............. do !.J:..... depose and say that as..........f;,f.<\:c..".tr~'...i.................................
of the last Will and Testament of .................1~f.,:\,,,\.......J,.....,....\.~,.:JL(.....,....,................................deceased
.........~.~~......... will well and truly administer the goods and chattels, rights and credits of said deceased
according to law. And also will diligently comply with the provisions of the law relating to Transfer
Inheritances. ........~~?~.'::........ and subscribed
before me.
May 21 80
,....................................................... A. D.. 19............
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DECREE
Be it remembered that on the .......~].~~:........ day of .............~::::L........................... A. D..19~.?..... there
was probated and recorded the last Will and Testament of ,.....~,~:~.~~...~......\~~.:-.~~...................,........,.........
late of .........Y:.9.:':'~.!:..hn~.'::............................... ........... Cumberland County. Pennsylvania. Deceased, Letters
..."........ ...... ,X~.!!. ~,'!-.'!~~.':I.!:? .r:.'I........ were granted to .............,...... ..~~ ~.'?~:!7.~.. ~.:... ~.a ~Y:ii!:. ?:::.......... ...... .....,..
Witness my hand and official seal the day and year aforesaid.
......':::/2. !(U.~i-"'(!.':"" ..i~~1!...
{ki,~' f" . d I ~~1I. Register.
"
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
5S:
Rober~S, Callaghan
._~___,,_..._m _.._.__.,._________.._ .
----- ~--'--- ..--..-------.----------.- --_.__..__.,~-_....-..-_.-
being duly _._~___, __._,..._ according to law, dopo.es and s.y. that she .J:xec.utrlx_--..._-...._, ..-.-
___..__,_,__..___._____._____ ",.,_. __ .,. of the Estate of ___.Frank .~-=~ells--------
late of Shiremanstown -.. --, Cumberland County, Po" deceased and that the
within i. an inventory made by, Roberta,S._..Callaghan. .- - .. ,..-.--, the seid..Jlxer.utrlx_-,--
of the entire estate of said decedent, consisting of all the personal property and raal e.tate. except real estate aulside
the Cammonweaith of Penn.ylvania, and that the figure. opposite each itom of tho Inventory repre.ent it'. fair value
a. af the date of decedent's death.
.22 19 ,fe,'
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E~:-Admini,tr r -------
J~>'L-
_ and !.ubscribed before me,
,_15 Carou-t!.JLtxeet
Harrisburg, Pennsylvania 17112
Address
Date of Oeath ______.~__...___..__--.--' May
Day Month
1980
-----
Year
I, An inventory mu.t be filed within three months after appointment of personal representative,
2, A .upplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be atlached as to personalty or realty
4. See Article IV, Fiduciarie. Act of 1949.
INSTRUCTIONS
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REV-449 (8-78)
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COMMONWEALTH OF PENNSYLVANIA
RECO~~F;9'Of~IC( rc DEPARTMENT OF REVENUE
REGI. ,,' I BUREAU OF FIELD OPERATIONS
'80 QFi;' '"
RESIDENT DECEDENT COUNTY OF __Q!!rnb~r t~.1I_d
_~l[E~::.Q.':'.~i~.: ~~.~. ~-:- .' - . . ..- .-..' .. - -.
IMPORTANT: This:rb1'tHi-i'mu!Ot'hc C~)lI\pItHt~d III l!l't:lil and tilt'tllll dl1lllll:all.', \~ilh ;dlllllilr.:hl:d, with 1111" RCjl.istl'r of Wills of Ihe
County whc:rc l!rc~dt:!lf rl'sidl'd; Rt~lltr!1 I'; 11m' witllilllune 11101\111" :lfll'r ILlll' or [kalil, mde!<s all r.:xtl'nsiOIl is ~nlllted
by the SI.'o.:fl'U1I')' of Rl"ler1llt~, (St~l'linll '/OJ uf tln' Inlwrilam:e ;ll1d 1'.',t,IIC Tin .\1 I ,,1 19/d.)
~~ ---
.;;-____... .....;;.~~.,;;,;;~~-=.,;;;.;.o;....-'-'._.
IN Tim MATTER OF TilE EST,\TE OF
} AFFIIlAI'IT Ill'
EXEClITOI( ix
...,\Ju.u.."-.l~~,",,-+QH,..
Frank L. Wells
ISTATE FU~~EC:'[?{lr:~Nl;
L.,. .f Shireman~t?W.t:l!._~umbe.~and
County
State of
Ppnn 5.y.1.llania
} ",
Executor ix
C.unty of Cumber land
Roberta S. Callaghan ' .____,__d__
.,A.dm1nitrtTn'rnl" ---~r;~~~~C1boYl\:~~~j'dtleed;;-l:llinq'd-ul~ sworn, cep05t\
-.-----.------
ondst:l)"
Decedent died
May
13
19 80 ___J ~~1I1oln 1l)'.t..-1n9 a lost will, topy of which is her'llo alloched, }
~i1oIol_~
(MONTH)
Name and address of ottor...ey or }
other authorized repreunlati..-e to whom
all corres.pondcnce should be moill:ld,
:DAYI
Norman P. Hetrick
---_._-----~-_._----.--,.__...
P.O. Box l26~~0 N. Third St. I HbS" Pa.
l710B
That as snch Executrix deponent is t';.lluiliar with tht~ affairs of said l:stale and Ihe propl~rty constituting
(EX E CU TO R- ADMINIS T R ^ ',0 f-~J
the ass~ls thereof nud their fair markc.:l value.
That al the time or dealh there was no safe d':pnsit bo:!. rcgish.:rt.:d ill decedent's ilu.1ividuillnillllc, ur jointly with, or
a.s agent or deputy of alJot!;cr, or in decedent's individuul name, with right of at.:ccs~ by .mother a~; agent or deJluty, with the
exceptiun of the following: -
NAME AND ADDRESS OF BANK CR OTHER INSTITUTION
IN WHICH DECEDENT RENTE.E.. ~AFE OIiPO~~OX
THIS SArI:: DEPOSIT BOX RErlTEn RELATIONSHIP OF JOINT
IN tlAME OR NAMES OF HOl.DERS TO DECEDENT
- =~
=t=
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Nnnp.
That the contents of suid safe deposit box or bnxes arc itemized under Schcc.1ulcs.-NLA_of this return,
with the exception of the following, for the reasons heft:inaftcr set I'orth:
That Sched'Jle A attadlCd hl:rcto and made part hereof sets forth fully llr.t1 in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It alsn scls forth the
mortgage encumbrances upon each parcel of real property at the date uf dcath, giving \he amount still due at
death, name of mortgagee. date, rate of interest, and book and page of rccord thereof, Il also sets forth in the
colunms provided therefore the assessed. valuation of each of said parcels, the cstimalcd market value thereof
as of date of death of decedent.
That Schedule B altached hereto and made part hereof sets forth fully and in detail all personal property
where saver situated owned by the decedent at the time of death: all llIoneys left by lhe decedent at the time of
death, whether in de(:edt~nt's immediate Pl)sscssion, standing 10 tkccdent's credit ill banks of dl~posit, savings
banks, trust companies, or other in~tit1ltions, w1}cther individually, or in !fllsl fur any olher person or persons
giving also separately the aecrHed intercsL th~~rc{Jn, if any, dOWll I(J Ihe lasl interest tlllY 1lrior to decedent's
death in the case of savings ballKs, and to the dale of tleccJI:nt'~ dc~lh in ;~.ll other cases; ~II honds, po~tal
savings, treasury c;;rtificates or not~s at:d o!hef n':J'~ncc or ili;j~htl:dnt.:"s '.'f !~I~ United States to the uc-
cedcnt;tsll obligalions, whether by :;Iatutl: or agrcl"m'.:nl tlllY arc (h~sigllatcd ;b (;1:0, free, of the United Stales,
or any state, or political subdivision thereof, or of any fort:ign country, which <ire owm'd at the timt.: of deuth:
al1 wearing apparel, jcwclry. silverwart.:, pit.:tUfl'S, books. works or art, household furniture, horses, carriages,
automobiles, boats, and any and all other personal chattels of wh:llS(lCVCr k,ind 1\1' niltnre, Idt hy decedcnt,
together with the fairly estimated market valuc Iheleuf; all hlJrllls aT~r1 mmtt~ages held by <h'ct'dt'.nl :ItlJ of all
claims due and owing dcccdcnt at the lime of ueath, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever ".\ture, with interest tht.:rcon, if
anYI giving the face value and estirnlltcd fair market value thereof, and \f such cstinHlll'J fair market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all mon~ys
payable to the estate from life insurance policies carrieu by decedent; 1111 annuity and endowment cuntracts
the proceeds of which were payable upon the death of the JccL'dt>nt; all and the corporate stock~ IInd dividends
due thereon and unpaid as of the date of death, bonds anll accrued interest Ihert.:on to Ih\~ datc uf decedent's
death and other investmcnt liiccurities owned hy the dt.:l:(~dcnl at the time tlf ~lt:uth, with the (l}alk(~l vallie Ihere.
of at such time.
In the cn!'lC of' s(~I~HrIt.to~ of clo[.;'~ or l'uml1" l:('t'l'cr:II,lllll~l, Illl' vnllll'f> reportflll 1\I'f! itS Car 1\6
possiblt! sllbstnnllntf'rl b)' 1'1 IlflllC1111 slHtl!l1llllllS of' Uw ,:ol'}lllrutlllll!i, _..;IIOWlllg t.hn IIKscls 1II1l1 111t1d.11Ll~s
thereof' IUI ot' t.l1I~ dnt.1! 01' dcnr,!lo TIll! !>cllndllll! ltl!HJ !wU, forth 11l1' 1111.('1"''11. rll' Ile(~(!lh.'tlt nl. Ihe tlnll~ of
dent,h 1n 11lI~' co-p'1rlnp.rsl1lp Ul' hUHllle~s. nllll In SUI'I"II" Ill' ,hi' VIII Ill' or sueh Intl'rnst I.Iwr(l IH ItlHl'~Xt!ct lo
snld scht~,hltl~, 1'I111111('ln1 stntemPllts !i!1flwlng UWilssel!; rllld 11111',1111,1,"; 01' SHlfl N'-Jl'lrl,lH~rshlfl or hIlSIrH!5!1.
,\ cor~' of t.1I1' co-pltrtlll'l"slllp n~rl~t'ml'll\., (If' nrllt, It "11l!I~JlI"n'_ ',"II,III1~ l'llrlh tJlP. IIntnrl' ()f' Uw ,t.(~r-.'f'l1lnlll)
tOJl;ether wllh It stlltl'tlleul. setllng 1'01'1,11 l.b.~ f'hlll'HI~U~l" 'II' Iii!' hIlSilll'SS, IUi 10(:11111)11, IUJd sueh oUll~r !'/Jet.s
pertnlntllg to the hllslness liS nlllY Ill,' pl'rt.lllf~llt. 10 It 1111" IInd .lll~;' UPlll"ItI"'ll of' Lhe Ilor:ellellt'c; tlll..,~rn:it
theretn mllst hi! ~llhmltt~cl. It ~hfllllel II)!-;O Sl'!, 1'1I,.th In It"llllzl't! t"~l'ln, I.nJ~/,t.her with the f'lllr nJnrknt vuluH
ther'eol', IlflY otller proJlp.rty oww'!1 or be(lilP/ll!lpd IJY 111,- d'-cl'dr'll' III !!ill !.11ll1~ 01' c1C'uth.
The Scl1er/ule C ItLtllr~lled Iwrl.to lUll! mild" pll!'!. 1L,'rf'of SI~t.S l'ol'l.h II U'\H! nnswer to CflCh illllu!.ry
conllllned therein aTllI 1n lhe C6S(~ Ill' fl',lllsf'.'!':, orpl'lllll'rl.~, J"f~nl or l''--'I'SOIUtl, wllhin two yenTs of' decedent's
death, In contemplation of decerll'nt's d(>iIUI, Hi' 11ltl'fldt'oJ In '"k;' ,~rl'l'r:t In Jl(lSSesstoll or enjoj'ment at. or
a.fter dent.h, snit! scht~dule sets fort.h t.he llllturf' llllrl VIl!W~ 01' sll~h PI'oIH_'rt,y, to whom trnnsl'erred, the
relationship of the transferees t.o the decedent., t.he prolHII.tlllnllte sllllre receive,I by I,H\ch trllnsfpree vtul
nIl other fncts of a pertinent nllt\lrH r('gflrlll/l~ Slltl~ trnl\sf'I~"S. In the cllse of trlmsfcrs intended to
take ef'f'ect in Ilo!'>sessIon or en.lO)'J1lI~nt Ill' or IIt't.I'I" dnnt.h, th.!N~ 15 Idsu ut tnehell to the schedule n cony
of the deed, trust ngreemcnt or other Instrlll'll~nl l:rl!/tttng lhn trust. Thl~r'~ is also !'l.ct forth tn said
schedule tl l1st of Ill1 property, renl find perSOTllll, wlt.il U.s vHhw, which ph::.ses Ilt decedentls death by
virtue of the exercise by decedent, elHlcr 1IlCliv!.fIIlIlJ1y, orJoIntly with /-lnotllcr, or any power of' appoint-
ment vested in dccf'(lent, eIther Inctivichllllly or .Iolnt1)', hy the will, deNl, or other Instrument of another,
with a copy of thc instrumcnt creating such power Ilt.tltchclI t.n the Hcllec1ule.
TIJ/lt Schedule D attuchclI hereto /LOll mllde purl. twreof set~ f'orth tile nllmes Ilwl Ilddresses of 1\11
persons bene1'Jcially interested In this esttlte nt, tile timp ot' dcc:cdene!i rlenth, the Ill!turn of their res-
pective interests, their relnttonship, if nny, to tll~! decedent, togf!ther wIth the ngm; at. the time of
decedent's rleath 01' IlIl m1nors, annultlltlts fUlII iJ'~Il('f'lclllrIHs t'or life willer decerlent's Will. It nlso
contains n statement showing which of the henef1cinrie~ t1fUTlCd hi t1H~ decedent's will, if any, dled prior
to decedent, the dates ot' their dellth, tlwll' jS:ille, IUJ(: the re111tlnllshlp of s1lch issue to the benef'lcinry.
That Scl1edule E nttnched hercto and nllHle a purl. Iler(wr set.s forth nll property, renl Rnd per-
sonnl, owned by the deccd~nt .1ointly with another or otherS, ind1lfi1n~ intllngible, standing in the name
of the decedent and oth(>rg, plus t.he date flnd plnce ot' recnrd of Instrmnents effecting the \-estiture of
real estate nnd the date of uC'llllsition of p(!rsonn1ty, plus t,lw nllme, ndrlress and relationship, if any,
of co-ownerS to the decedent.
That Schedu/~ F attnched hereto and mnde n pnrt hereol' sets forth fully nnd in detail all debts
and deductions claimed for llmi on behalf of' thi!\ d(Hlctlcnt's est.llte, Incltuling funeral expenses paid;
fnmll~' exemption, where nppl icuble; costs of ndministration of this est/ltr:; counsel feeA and f'udiclary's
commissions paid or to be paid; cost expended ror llurlnl trusts, tombstones nr grnvemnrkers, and reli-
gious services, in c.onsequence or t.he denth of lIw decC'dent; Ilt~ht5 and clnims owIng nnrl nnpn,lf1 Ilt time of
death; t.axes accrued chllrgcahlc for period prinr to deceo\(mt'!i dl'at.ll (except those allowed und2r Section
65101' the Inheritance ILnd Estate Tllx ,\ell j to!;I'lher \\'11.h II 5t1lt,(!IllI!nt of collnt.erlll pledged for oblign-
tlons, if'llny. It 1s llgrecd that the fIduclnl'Y will pf"'~~:;("l\t. proof' ot' snid claimed obligations upon rc'.
quest, that if the amount llctually pnld in sett,Iement, of Ilny fee, commI~slon or debt 1s less than the
cstimated amount clll1mlng IInd allowed, Uwt t.Iw Sllmll will hI! rr'lHll'tl~d to the Heg15ter of Wills, und that
the amount of tnx flssesserl can he renssHfiSI~t1 In llce()r(11UII~'-~ therf~l'iit.h,
Thllt thc to tals of the npproprinte col limns in Hche(hll es "A", "B", "e", "E", flnd "F" as dt. rec t.ed therein,
have been carried forwnrd and prol,erly rl~g;lstp.red In thp. Summary.
Subscribed ond sworn to before me this
,
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",6.~.......",."."...
........M...."~"..,....."'..,..,......."..
'" day of ,C.)i![r::/;-o.cl.-
....,..qj,?Zo!:!cf<~ -tJl;r;:;'y PLJDl.rC ,,','
My Commisslon Expires Jlnu3rY 26. 1981
HmjJburg, PA Otuphin Countt
s
.. 19,..,,y,
.:R~~~!~d;;;8~~%~--...,..,..--..
35 Carolyn..S,tree,t.............. ....................,_..,..,_..,..
( Street Number)
Harri~l:>IlJ:g,)?!I,' "U,H?
(City OT Town and StIlte)
NOTE: Before sl~nlnJ!; nffldnvlt tnnk(~ surn 1\11 bI/lnk :'1\(11'1'''; III 1.h.. Ilt'f'1dllVlt. unci sehectHles nnnf:'Kcd Ilrc
flll(~c1 In with ,1P.tflllS or the wore! "SOlIl'", 111111 In ('IlSt' t1\1' hSS"!S 1nelurle rtlre lUlrl unlisted securlt.i~s,
S(~curlt1es of close or f'nmlly corpurllUIllIS or 11II Inlprl'sl. III HI\~' ('o-pllrtnershl)1 or business, thnt the
lints RllIt stflt.ements required Hulier fhp. I"lrup;rllph H!lO\'" rr>)nt.lll).:. tll H('hl'rIull~ "H" nrp, nt.tflchecl. Also make
Cp.rtl1tll t.hat column #1 in t.he "SUnI1lHI'Y" hIll'; tHlp.n pro]',"'1y ('oJ!\ph'tt~c1 us ItllOve-ll1rect.efl.
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. Transfers
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File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-BO.':.Q3!t5-
Ul Original
o Supplemental
o Remainder
REY-4U EX+ tHO)
Estate Name ______Frank _L. Wells
Dale of Death
5-7. -BO,_,__.
Social Security Number
REPORT OF INIiERITANCE TAX APPRAISER
I, the under.lgned duly appointed Inheritonce Tax Appraiser in ond for the County of_~,
Penn.ylvania, do re.pectlully report that I have approl.ed the real and personal property a. ieporiOdTn the foregoing
retum at the values set forth opposite each item in the last column to the right in Schedules flAil, 118", lie", and "E"
Dated:
2_24_81
.JjAl ty1 /" ) (ft ^ /I J .,,{ )
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
3
00+
10+
92+
Real Property (Schedule A)
Penonal Property (Schedule B)
Jolnt.H.ld Proporty (Sch.dul. E)
Transfer. (Schodule C)
$
none
none
20+
30+
TOT AL GROSS ASSETS
__37-,Jb~__85-
Leu D.bts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life E.tate
o Annuity
40-
93-
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
T ox on $
CODE
COM PUT A nON OF TAX
$
$
$
$
$
6%
Tax on $
15%
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Less C,edits
DA TE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST
S + $ 5 =
+ -- =
BALANCE $
TO
TAX CREDIT
$
:;:
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M ~
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c>: M
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-
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100 ~
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100
, Ii; 0 CIl 0 Z 0
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,.' OPF ICE OP THE
REGISTER OF WillS
. } / <. ;' /'~
'j( / >,;;/ _'.1'1 J'
~1~[i:NifFOF LlEBTS
R~ DEDUCTIONS
DEDUCTIONS AllOWED IN
THE SUM OF _ S l,i1~,:n-
DfM};:ROVEtm ,~ Hi!
-llf.Ltt.~~'-WII f~f!
OF Cumberland COUNTY
AND AGENT OF THE COMMONWEAL T11
'80 DFG 1 B p'l / "
ESTA TE OF
Frank L. Wells
CLERI\ -ORP~Nr:', ':C:"
CU~I8[ 'Il" ~eA;':~ 'or.
Sbiremanstown
DAT F Fill G APPRAISEMENT
J. -.;(1-'1 L DATE OF DEATH
5/13/80
EO' N
DATE NO, OF NAME OF PAVEE REMARKS AMOUNT
VOUCIlER
-
6/11/80 1 Amerigas April gas charges 6 66
6/11/80 2 Lester W. Erb. Inc, Fuel oil charRes 109 60
6/11/BO 3 Bell of Pa, Anril telenhone chorRes !. 1?
6/11/80 4 Riverton Consolidated Water Co, April/May Water cbarges 9 37
6/11/80 5 West Sbore Cable Co. Cable charges 15 32
6/11/80 6 PP&L Anril/Mav chanes 22 Q1
6/17/80 7 Bell of Pa, Mav telenhone cbaroes !. 1?
6/17/BO 8 FHN Associa tes, Inc, Medical services 216 00
6/17/80 9 Leland F, Patterson, M. D. Medical services 125 00
6/23/80 10 Evening Sentinel Publication of Estate Notices 21 50
6/23/80 11 Community Phvsicians. Inc. Med ical services 2" nn
6/23/80 12 Meyers Funeral Home. Tnc, Funeral exnenses 2 oaR an
6/25BO 13 Tive, Hetrick & Pierce, P. C, Fee Advance 1,000 00
7/15/BO 14 Bell of Pa, June telephone charges 4 32
7/15/80 15 PP&L June charoes 11' Qn
8/'6/80 16 Amerioas T..~~ ^"^_nM , "'
8/ 6/BO 17 PP&L Jul" charoeo 10 "
8/12/80 18 Bell. of Pa, Julv charnes /, 00
8/22/80 19 Riverton Consolidated Water Co. water charges 9 40
11/ 1/80 20 PP&L AURust bill 12 82
0/ 1 80 21 Riverton Consolidated Wa ter Co, Final Bill 4 02
7/15/80 Commonwealth National Bank Check charoes 5 45
9/8/80 Harrv M. Wimer uctioneer's Commission Advertis' on 694 14
-
1
SEE ATTACHED LIST FOR ADDITIONAL ITEMS Sale preparation
COMMONWEAL TH OP PENNSYLVANIA I
1\ ~ SS'
COUNTY OF /''jCL''-I{M;'LI'~ .
I X QQ~"h ~, C'oOOC"j,(rtA-v HEREBY CERTIFY, THAT TOTHEBESTOF
MY K'NOWLEDGE AND BELIEF, THE FOil'EGOING IS A JUST AND TRUE STATEMENT OF DEBTS, ~UNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBIAITTED TO THE ESTATE OF --E!l'/Iv K L, .' c:L '-- ~
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES.
, X (.),J1.,t;." -2 CbQO<8Q~IlM./ (L.S.)
SWO~RN A 0 SUBSCRIBED BEFORE ME THIS ~';! "'hI... DAY OF
~-k/) 19~
a.-.."--<.....~.7 -f.:. {1,., ~~.
NOTARY IUBLlC'
. My (ommiuion Expirel January 26, 1981
Horri.bw;. PA a.uphi/l ('lrIly
..
, ,
r'
STATEMENT OF DEBTS AND DEDUCTIONS
(Continued)
Date Voucher Name of Payee Remarks Amount
10/ 3/80 -zr Holy Spirit HospItal Medical Services 195.61
10/ 3/80 23 PP&L September bill 22,98
12/ 2/80 24 Helen Orris Newspapers she
paid for Mr. Wells 2.45
12/ 2/80 25 Mt. Zion Cemetary Care of relatives'
cemetary lots 18.00
12/2/80 26 Mt. Zion Cemetary Perpetual care of
the above cemetary
lots 400.00
12/ 3/80 27 22 E, Motor Sales Automobile Repair
for purposes of
resale 305.57
Reserved Robert S. Callaghan Executrix Fee 1,000.00
Reserved Register of Wills Filing Inv. Etc, 9,00
Reserved Register of Wills Filing First &
Final Acc to 45.00
Reserved Tive, Hetrick &
Pierce, P,C. Attorney's Fees 848,94
Conunonwealth
National Bank Check Charges 5.45
Reserved Cumberland County
Record Satisfaction Fee 7.00
INFORMATION
To insure proper credit to your account. the name of the estate and file number should be clearly print-
ed on tho check or money order.
This assessment is made in accordance with Section 708 of the Inheritllnce and Estate Tax Act of
1961 (72 P,S,! 2485-706),
To the extent that inheritance tax is paid within three (3~ months after tho death of the decedent. a
discount of five (5) percent is ellowed (72 P,S, ! 2485- 716),
Inheritance Tax, other than tax on a future interest, is due at the date of the decedent's death and becomes
delinquent et the expiration of nine 191 manths after the decedent's death 172 P,S, 9 2465,711), Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment end Is delinquent thereafter (72 P,S, ~ 2485-712), Calculate interest from the deiinquent dete shown
on the face of this form to the date of actual payment using the following interest table:
--------------------- - ------------ ---- --------- - - ---- --- -------- -- -- -- - -- --
I month ,005 4 months ,020 7 months ,035 10 months .050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
I deys ,00017 11 days ,00166 21 deys .00352
2 days ,00034 12 days ,00203 22 days ,00369
3 days ,00051 13 days ,00220 23 days ,00366
4 deys ,00066 14 days ,00237 24 days .00403
5 deys ,00065 15 days ,00250 25 days ,00420
6 days ,00101 16 days ,00267 26 days ,00437
7 days .0011 6 17 days ,00264 27 days .00454
8 days ,00135 18 days ,00301 26 days .00471
9 days ,00152 19 days ,00316 29 deys ,00466
10 deys .00169 20 days ,00335 30 days .00500
------------------------------ --- -------- -- - ---.----- -- - --..------ ---..--
Any party in interest, including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (601 days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961172 p,S,! 2465-1001),
Make check or money order payable 10:
"Register of Wills. Agent"
Mail to the address lisled below:
INFORMATION
To insure proper credit to your account. tho nome of tho ostate and file number should be clearly print-
ed on the check or money order.
This assessment ili mado in accordanco with Soction 708 of the Inheritance and Estate Tax Act of
1961172 P,S,! 2485.708),
To the extent that inheritance tax is paid within throB (3) months after the death of tho decedent, a
discount of five (51 percent is ell owed (72 P,S,! 2485.7161,
Inheritance Tax, other than tax on a futuro interest, is due at the date of the decedent's death and becomes
delinquent at the expiration of nine 19) months alter the decedent's deeth 172 P,S, ! 2485.711), Inheritance
Tax on B futuro interest is payable within throB (3) months after the transfer takes effect in possession and
enjoyment end is delinquent thereafter 172 P,S, ! 2485.712), Celculete interest from the delinquent det. shown
on the face of this form to the date of actual payment using the following interest table:
-------.-------- ------ - ----------- - ---- --------- - - - -- - --- -------- -- -- - - - ----
1 month ,005 4 months ,020 7 months ,035 '0 months ,050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 '2 months ,060
1 days ,000 17 11 days ,00186 21 days ,00352
2 days ,00034 12 deys ,00203 22 days .00369
3 days ,00051 13 days .00220 23 days ,00386
4 deys .00068 14 days ,00237 24 days ,00403
5 days .00085 15 deys ,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 '8 days ,00301 28 days ,00471
9 days ,00152 19 days ,00318 29 deys ,00488
10 deys .00169 20 days ,00335 30 deys ,00500
- - --- - ----- --- ------ - -- - - - - - - - _.- - -- - - - --- - - - --_._- -- - - - - --------- - -----
Any party in interest, including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (GO) days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961172 P,S,! 2485.10011,
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
n ~ ..,,""
,-
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AND, each of us hereby stipulate that in order to avoid
the time and expense of the filing of a formal account and
schedule of distribution, we agree that no account i~ necessary
and we do hereby agree that we do consent to distribution being
made without the filing of an account and schedule of distribu-
tion, the same to be with the same force and effect as if they
had been filed and confirmed by the Orphan's Court Division of
the Court of Common pleas of Cumberland County.
THEREFORE, we and each of us, do hereby remise, release,
quitclaim and forever discharge the said Roberta s. Callaghan,
Executrix aforesaid, her heirs, executors, administrators and
assigns of and from the said estate and from all actions,
suits, payments, accounts, reckonings, claims and demands
whatsoever for or by reason thereof, or for any other use,
matter, cause or thing whatsoever, touching upon the Estate of
Frank L. Wells, and his deeds as Executrix of said Estate, and
each of us do further hereby covenant and agree that should any
liability come due to the Estate of Frank L. Wells after the
signing of this agreement, we and each of us do hereby covenant
and agree with each other and the aforesaid Executrix, that we
will contribute pro rata, our share of the estate to satisfy
any and all claims, demands, suits or causes of action which
may be successfully prosecuted against the Estate of Frank L.
Wells or the aforesaid Executrix after the signing, sealing and
delivery of this Family Settlement and Final Release.
-3-
BUVII i03 f"GE ul)u
"
"
;.
STATEMENT OF ACCOUNT
Assets
1. 1975 Plyrnouth.....................................$ 1,450.00
2. Furniture and other household goods in
house at 141 S. Locust Street, Shiremanstown,
Pennsylvania. Sold at public sale on
September 8, 1980...................................2,989.21
3. Savings Account - Commonwealth National
Bank #16-0010704-7.................................24,214.58
4. Checking Account - Commonwealth National
Bank #162-942145-2..................................1,211.85
5. Social Security Benefits..............................314.20
6. Proceeds from Prudential Life Insurance
Policies #99590803, #99590804, #543506306...........1,788.28
7. Refund - Holy Spir i t Hospital......................... 235.07
8. Medicare Reimbursernent8................................68.00
9. paycheck - Camp Hill Borough...........................22.70
10. Refund Bell Telephone................ .... ....... ..... .3.46
11. Refund - P.P. & L......................................IO.59
12. Refund - Aetna Life & Casualty.........................33.00
13. Balance from Purchase - Money Mortgage on
property at 141 S. Locust Street, Shiremanstown.....4,469.34
TOTAL. . . ... ... . ...... .... .. ...... . ... .. . ........." . .". $36, BID. 28
Debts and Deductions
1. Amerigas/April bill"... ..". ......... ... .......... ...... .6.66
2. Lester W. Erb/Fuel Oil..........."........"..........,,109.60
3. Bell of PA/April bill......................".........". .4.32
4. Riverton Consolidated Water Co./April-May bill..........9.37
5. West Shore Cable Co........"...........................15.32
6. P.P. & L./April-May bil1.................".............22.93
7. Bell of PA/May bill.....................................4.32
8. FHN Associates/Medical Services.......................2l6.00
9. Leland F. Patterson/Medical Services..................125,00
10. Evening Sentinel/Publication...........................2l.50
11. Community Physicians/Medical Services..................25.00
12. Myers Funeral Home, Inc./Funeral Expenses...........2,298.00
13. Tive, Hetrick & Pierce, P.C./Advance................l,OOO.OO
14. Bell of PA/June bi11........................."..........4.32
15. P.P. & L./June bil1...................................,,11.90
16. Amer igas/June bill...................................... 7.87
17. P.P. &: L./July bi1l....................................13.11
lB. Bell of PA/July bill....................................4.32
19. Riverton Consolidated Water Co./May-August bill.........9.40
20. P.P. & L./August bil1..................................12.B2
21. Riverton Consolidated Water Co./Final bill..............4.02
22. Commonwealth National Bank/Check Charges................5.45
23. Holy Spirit Hospital/Medical Services.................195.61
24. P.P. & L. September bill...............................22.28
25. Helen Orris/Newspapers..........................~.......2.45
EXHIBIT B