HomeMy WebLinkAbout80-00392
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NO. 21.80 39~:
PETITION FOR LETTERS OF ADMINISTRATION
IN THI~ EST An; OF ....,Z;>.\J.,a...v,ap'..,Dy.~,~................................ IlI~CEASEn.
Mary C. Lewis
To ,...."..,..."",..",....."..,.."".....",',.,""',.,"'"".."""""""",..""""".."""',..,"',.,,..,",.',
Register of Will~ fOI' the County of Cumhel'iand, in Ihe Commonwealth of l'emlHj'lvania,
The Petition of ........i:).\),.,a..'y,an..Py,ls,~......, ........" ,.........".."" ..............., .......' ............................. ...."
"...,.,..",.""..,....,.."""..,.........,""',.,'" respectfully ~howc I h that ", ,.. "~J:\~"".""",,.,...,.. """.."""..",.."..","",...,..,
was a resident of ..,Q,<;\mp'..,!J.PJ................................~~:~ . Cumherland County, State of Pennsyl.
vania, and a Citizen of United States, and departed thi~ life inteHtate in the County of ,........,..................
Cumbe;x;land......,...... and State of ""p.enns,)1.1y.ap.ia",..."""" "..,.,."..,..."""."...,...."..,.,",..,",....". "...."".."
on ................",..""""......." the .."...."?~,1;!L""""".".,, day of ........~C?y.~lI\p.,~!."........."......." A. D.. 19....?~",
at the age of ."..8,6""" years,
That the said ......~,~,1.i!-."y.i!-!:!...P.y.~~"'"..........".."........,........ deceased, left surviving the following
named widow or -husband, heirs and next to kin. to wit:
Name
Relationship
"""P..i!~8.\'!,S~I".."".,',., ...
"...,?,~~~!::.~~E"..,..,.."", "
"""D,aug\1,te,r"..", ".., ..,,,
Residence
Gg;r;,i'f19J):\~"J.~..,,,,~r~~,!'!~~:F...,,..,..
P..9.I9.Shy.".f..~,~~.\'!,L."""',.."."..,,..,"
Bet.t.y...,Cook.....",.."" ",.... ".........",..,
,~~,~9,..~.~?=,~,~~,~~"~~:,,1,,,,~~~p....Hip A .
302 Greenwood Ave.. Punxsutaw-
".."........1'.,""""",..,,,..,,"",........,..,"""'"
ney. l1.
.5 0.3. "M}1,rj;.J..~..Ay.e. ,,,',' ,f,).\TI::l';I1,U,\; a"i3lt y .
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
......................................................,.........
That those above named include all of the next of kin, so far as known.
The said decedent was possessed of personal property to the estimated value of $..4....Q~,R.,.1.Q...."..,,'
and of Real Estate, less incumbrance, to the estimated value of $....nQJ:\e..."............... as near as can be
ascertained.
That the said Real Estate in so far as is known is located in ....................""....."................."...."........
..............................,...............................................,..............."......,....................,................".................,........................
Therefore, your petitioner(s) respectfullyapply(ies) fol' Letters of Administration in the above
named estate.
Dated ........".o!.!-.':~e.....~,~"..................., A, n" lJ3.~.....
Signature and Addres~
of Petitioner(H)
/l~MJc~ /( 6uJ~Jiv,-/
,r.."'...,.......".........................'........'....................................
..9.~J.:,!!.J,9.i.n~,..R.,....~.:h).\p..a~~,L........".............."..
.. 18.1 0", ,Carl isle,.. .Ro,a.d, ....,.. ,.." ........ ,.., ,............
..9.~mp..)t\..n,'..J~A..EQn",.............................."
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF CUMBERLAND \ss:
......,...."""..".."...."......Ge.raJ..dine,..R..""Br.ubaK~r.:,,,,"""." ,...".,.""", ,..,.." ."""....,.."."".....""..".....,' named
in the above application being dulj' ........S.w.Q.rn"......."..............., accOl'ding to law. sa)' that the facts set
forth in the above application are true to the best of ....her..... knowledge and belief.
.......,..,.."..,,',..,;.~~~~., "....',...,..,.,' and subscribed I ""...tZ'''' ".,..,",.,';..,.~""",.,",..,""/}:.., "'"''C::A/'''
be or me. I ~1(.<~4.<;:.e.~.~:.+:-:,,!{,",&.ZJ:.<;:~:f,""',..~~U
....~,...~....,......,~.~~~....~~..,..~............, A, D.. 19~~.....
i .qc .....'Jlltl/~..l!."..,)jJ~....,..:....",...
~ C (/ RegIster
Filed: .."'~~~~."..,~!?L....~~~.9....."......".",,...,..... Attorney :/.;:,,,~1h7..~';~k~Is.,Il.17,.,,..~s. f. .
~/-r&J-.:3 y /1-1)..-/. (over) I.:J..,/ S6\lt\"S/I"~'. 46,.19101
............................"..........."....."....'...."".......'......itJ;)
"""...".,..,.."...""""..""",..,',..,',...,',.."......'"......", :;,-
>- >- an
....
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en ...
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-
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Estate No. ...~.~~~Q........~.~~
BOND
KNOW ALL MEN BY THESE PHESENTS, ThOll we. .... .~~e.1Q,;l.nl!.R...~NQ~U..........................
. . . . . . . . . . . . . . . . . , . . . . . . . . . . .. .. .
.....................................
......................, principaL.......,
and
...m)IJl'lfA,.()Mt[~'l.'l:.OO..I1.1mWIT...COI>l1'AN.t'... .
..................................................
......................................, suret.y.........,
.............................................................,.
are held .nd firmly bound unlo Ihe Commonwealth or Petltlsyll'atlia, itl Ihe sum or .Six.Thousand,Fou:c.........
JI1lnIl:t:eil...lI,l\d.OO/:1.00",,,,,,,,,,.,,,,.,,,,,.,,,,,-,,,,, Dollars (s.....6.400.00...,..), 10 be p.id 10 the s.id Commonwe.lth,
her certain attorney or assigns, to which payml'llt, w(,.'tf and truly to he i1Ti1<Jc. we do bind oursrh'cs, jointly and
severally, ami our and each of our heirs, CXC(utors, administrators, SllC((:SSQrs and assigns, firmly, by these presents,
for and in the wholc of lhe said sum.
SEALED .nd dated the .............. ..J9.th
............day of ............~h............................ 19..~9...
\'\IHEHEAS, Ihe above named ......
......~.~a,1r;l;l.:n,~.1l....)j:rn9MI1;r..................................................
................................................................................................................................................................................................
has or ha\'c made, or is or arc about to make, application to the Registcr of \X'ilIs of Cumberland County,
Pennsylv.nia, for the gr.nt or Iclters. ...............Clf...A,~m,l!tr:!'l.1;,t.Cl:n,...............................................................
on the esl.le or ...j~ule...:V:andyke...
................., late of ........................................................,
Cumberland County, Pennsylvania, dcn:ascd:
THE CONDITION OF TI.lIS OBUGATION is, th.t ir Ihe said personal represent.lil'e ............ or .ny of
them shall well and truly administer the said estate :lccord ing to law, this obligation shall he void as to the personal
representative or representativcs who shall so administer th e said estate; but otherwise, it shall remain in force.
-----------------------------------..-------
1-.k_?c~:JIfl~.l~_:!!:!...1sEAL)
Geraldine R. Brubaker
SEALED .nd delivered in the presence or
-----------------------.--..----------------.
---------------------------------------
(SEAL)
-----------------------------------..-------
----------------------------------------
--------------------------------------
COMMON\X1EAL TH OF PENNSYLVANIA
COUNTY OF CUMBEHLAND ss:
Personally ,Ippem" b,fOlc me, ,I <l'(\,~....fl.~~... .' . 111 .nd ror the (ounty .nd
sl.te, .roresaid . ~\Jv~...R.........~~........... ................... ....... .......,.
Of...~,..~... ....~.'{\ .................nd
.......................................................-.............................
.............................................................,.. ............ ....................of..... ................. ............................................................
surilies on the .bove bond who being dull' sworn (.ffirmed) .ccording to law, depose .nd s.y that they e.ch own Re.1
Estate \\'olth the whole of the penal sum n.med in the .bove bond. over .nd above their debts and the debtor's exemption.
.
Sworn and' fuh"ribed before me this
_" ~.. \. , L:.~
...... . "'.,.",.v.,....,'.......::,!'........r... dav of ,\};\ q.~f&'"
... lm~S . uru1iJRcr. ,,,0 .:'II)' l'(fr,)1i
" 0' \1.Q . .. rll Cornmillion [,pi", Jon. 11. 1982
'" > 19..". .... -UL Joy Twsp. PA I.&n~'lllr County
"') '. ,_. h r'. (\, ~
.\.f:>..'Y~~:...,\.....;..~....).':...\.-'-"-'~.'"-"'...."'.:........
...............................................................,.........,........... (Se.I)
...............................................................................,... (Seal)
................................................................................,.. (Seal).
........................................................................,............ (Seal)
\
'.
-
THE ICTNA CASUAL TV AND SURETY COMPANY
Hartford, Connecticut 06115
LIFE & CASUALTY
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT
KNOW ALL MEN BY THESE PRESENTS. THAT THE A;:TNACASUAL TV ANDSUAETY COMFANY, D corporation duly organizodund(!r tho laws of the
Slale of Connectlcul, LInd having Its prinr:ipal oHic.e in the Cily 01 Hartford. County of Hanford. Stille of Connecticut. hath mildo. constituted and
apPOlntod, and does hV these presents mnke. constitute and BIJPoint S. A. Eckcrd - -
01 Camp Hi 11, Penn s y 1 v an i a . its lIue and lawful Auorncy{sHn.Facl, with (ull power and authority hereby contorrod
10 aign, execute and ar:knowledge. al any plueo within the United Stales, or, if the following lino be filled in, within the arefl thore desig-
nated ' the followinU inSlrllmcnt(s):
by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nalure of II bond,
recognizance, or conditional undertaking, and any Jnd all consents incidHllts thereto not exceeding the sum of FIVE
HUNDRED THOUSAND ($500,000.00) DOLLARS -
and to bind THE A:TNA CASUALTY AND SURETY COMPANY, thereby as hIlly and to the same extent as if the same were signed by the duly
authorized officers of THE IETNACASUAL 11' AND SURETY COMPANY, and all theacls of soid Attorney(s!-in-Fact, plJrsuant to the authorit" herein
giv(!n, are hereby rotified and confirmed.
lhis appointment is made under and by authority of the following Standing Rosolutions of said Company which Resolutions arc now in full force
and effect:
VOTED, Thai each of the following officers: Chairmal1, Vice Chairman, President, Any Executive Vice President, Any Senior Vice President, Any Vka
President, Any Assistant Vice President, Any Secretary, Any Assistant Secretary, may from time to time appoint Resident Vice Presidents, Resident
Assistant Secretaries, Attorneys-in-Fact, and Agents to act for and on behalf of the Company and may give any such appointee such authority as his
certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of
indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officars or the Board of
Directors may at any time remove any such appointee and revoke the power and authority given him.
VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance. or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the Chairman, the Vice Chairman, the President, an Executive Vice President, a
Senior Vice President, a Vice President, an Assistant Vice President or by a Resident Vice President, pursuant to the power prescribed in the
certificate of authority of such Resident Vice President, and duly anested and sealed with the Comptmy's seal by a Secretary or AS5istant Secretary
or lV a Resident Assistant Secretary, pursuant to the p::>wer prescribed in the certificate of au tho I ity of such Resident Assistant Secretary; or (bl duly
executed (under seal, jf required) by onc or more Atto-neys.in-Fact pursuant to the power prescribed in his or their certificate or certificates of
authorilY.
This Power of Anorney and Certificate of Authority is signed and sealed by facsimile under and by authority of the following Standing Resolution
V!)(ed by the Board of Directors of THE .ETNA CASUALTY AND SURETY COMPANY which Resotutionis now in full force and effect:
VOTED: That the sigr:ature of each of the following officers: Chairman, Vice Chairman, President, Any Executive Vice President, Any Senior Vica
President, AnyVicc President, Any AssistantVice President, Any Secretary, Any Assistant Secretary, and the seal of the Company may be affixed by
facsimila to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or
Attcrneys-in-Fact for purposes only of executing and attesting bonds and undertakinGS and other writings obligatory in the nature thereof, and any
such power ofartorney orcertificatc bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such
power So executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with
l'espect to any bond or undertaking to which it is attached.
IN WITNESS WHEREOF, THE IETNA CASUAL1Y AND SURE1Y COMPANY has causad this instrument to be signed by its
Vice President ,and its corporate seal to be hereto affixed this 22nd
day of Oc tober . 19 79
Assistant
r1;::::~:~':<;\
:1 C(,~~ ,,:
\~,~~:",.,,,,~~f
THE
.ETNA
CASUAL 1Y
AND
SURETY
COMPANY
8y
?,.?' ~r-
Assistant vlce President
State of Connecticut I
ss. Hartford
County of Ha~ford
On this 22nd day of October .1979, bafore me personally came R. T. RIPPE
to me known, who, being by me du1v sworn, did depose and say: that he/she is Assis tan t Vice President of
THE .ETNA CASUALTY AND SURETY COMPANY, the corporation described in and which executed the above il1strum~nt; that he/she knows the
seal of said corporation; that the seal affixed to the said instrume~t is such corporate s8al; and that he/she executed the said instrument on bohalf
of tho corporation by authority of his/her office under tho Standing Rasolutions thereof.
"":;;~'~~~'~';';~~""
:' 01~<?: 't'"
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\ '\,01,.'(, f
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CERTIFICATE
0~~90~the Company. in t:.~;~:,~:'~.,~artfOrd. State of Connecticut. Oated this
{f ItUlIOAO.\\' B W
\::,:~:':':,:,:~::~l Assistent
,
,
,
......
\.
..
.....
..
LIFE llo CASUALTY
THE AOTNA CASUALTY AND SURETY COMPANY
Hartford. Connl1clicut 06115
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S).IN-FACT
KNOW ALL MEN BY THESE pnr:SENT~.lHA T THE A:TNACASUAI.TY AND SURETY COMFANY, n corpOffllion duly organilcc1 under thelawsofthe
State of ConnectH:Ul nnr1 hclVtIlIJ it!' IJrlllC1po11 offlcn mille Cilv of HMtlord, Coullty 01 tllHtford, Slate of Conrwcticul. hath madn, constitulnd and
appointed. ann dons hV the"I' fHt'!.ftlll!i I1lIl!W. conSliltlto line! appomt Shi.rley ^. Eckerd .. ..
of Camp I-li 11, Penngy 1 vania ,ilS trun nnd lawful Allorney(s)-in.Facl, with lull powpranc1 authority hereby conferred
to sign, exocute and I\c~now'crl!lo. at any pIneo within tho United Stales, or, jf the following line be filled in. within the area there dosig-
nated ' Ihe following inslrllmoll!/sl:
by hls/her solo signaturp. Elm'! Rct, any .1ml all honds, recognizances, contracts of indnn1nilV, and olhm wrllings obligRtory in the naturo of a bond,
recognizsnf.c, or conditionalunclcrtaking, and any and all consents incidents thorelo not exceeding the sum of FIVE
HUNDRED THOUSAND ($500,000.00) DOLLARS -
,
and to bind THE IETNA CASUALTY AND SURETY COMPANY, thereby as fully anti 10 the ~mrne cxlrmt as if the ~arne were signed by the duly
8uthorizedoHicnrs of THE It: rNACASUAl TY ANDSLJRETY COMP/"NY,and all the acts of said Altorncy(s).in.Fact, plHsuant to theaUlhority herein
given, are hereby ratified Clnd fOllfirrnoll,
This appointment is mnrte I,"der and hy authority of the following Standing Resolutions of saic1 Company which Resolutions are now in full force
and effect:
VOTED: That each of the following officers: Chairman, Vice Chairman, President, Any Executive Vice President. Any Senior Vice f'resident,AnyVice
President. Any Assistant Vice President, Any Secretary, Any Assistant Secretary, may from tIme to time appoint Resident Vice Presidents, Resident
. Assistant Secretaries, At1orneys.in-Facl, and Agents to act for and on behalf of the Company and may give any lJur.h appointee such authority as his
certificate of authority may pre~crihe to sign with Ihe Company's name and seal with the Company's seal bonds, recognizances, contracts of
indemnity, and other writings obligatory in the nature of a hond, recognizance, or conditir)nal unrlertaking, and ill1Y of said officers or the Board of
Directors may at any lime remove any such appointee and revoke the power and authority given him.
VOTED: That any bond, recopnlziJnce, contract of indemnity, or writinR obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the Chairman, the Vice Chairman, the President, an Executivo Vice President, B
Senior Vice President, 8 Vice President, an Assistant Vice President or by a Resident Vice President, pursuant to the power prescribed in the
certificate of authority of such Resident Vice President, and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary
orbya Resident Assistant Secretary, pursuant to the power prescribed in the certificate of authorilyof such Resident Assistant Secretary; or lbl duly
executed (under seal, ifrequirl"dl hy one or more Attorneys-in.Fact pursuant to the power pre~cribed in his or their certificate or certificates of
authority.
This Power of Attorney and Certificate of Auth.:rrity is signed and sealed by facsimile under and by authority of lhf.! following Standing Resolution
voted by the Board of Directors of THE A:TNA CASUALTY AND SURETY COMPANY whkh Resolution is now in full force and effect:
VOTED: That the signature of each of the following officers: Chairman, Vice Chairman, President, Any Executive Vice President. Any Senior Vice
President, Any Vice President, Any Assistllnt Vice President, Any Secretary, Any Assistant Secretary, and the seal of the Company may be affixed by
facsimile to any power of at10rney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or
Attorneys-in.Fact for purposes only ofoxocuting and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any
such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be volidand binding upon the Company and any such
power So executed and ccrtified by such facsimile signature and facsimilu seal shall be valid and binding upon the Company in the future with
respect to any bond or undertaking to which it is at1ached.
IN WITNESS WHEREOF, THE A;TNA CASUALTY AND SURETY COMPANY has cau,ad this instrument to be signed by its
Vice President ,and its corporate seal to be hereto affixed this 27th
day of March .1980
Assistant
/F~::':"~'~~~";;~\
V~.:;:'~:~~}
THE .ETNA CASUALTY AND SURETY COMPANY
-:-J - <,j ~
Bv__..JS.c..LK4fJ."'
Assis{ant Vice President
State of Connecticut I
55.
County of Hartford
Hartford
On this 27th day of March ,1980 ,beforemopersoniJlIvcBmt! R. T. RIPPE
to me known, who, being by me duly sworn, did depose and say: that he/she is Assistant Vice President of
THE .ETNA CASUALTY AND SURETY COMPANY, the corporation described in and which executed the abo'le instrllment; that he/she knows the
seal of said corporation; that the s80laffixed tl)the said instrument is such corporate seal; and thai he/she executed the said instrument on behalf
of the corporation by authority of his/her office under the Standing Resolutions thereof.
(:,:.~~:~')
" r ....
'-.,~~ni)".nL'\.JYL.J)JLr 'Y)
~J~'i&t;iOn a_pires March 31. 1984 Notary Public
CERTIFICATE
I, the undersigned, See re tary of THE .ETNA CASUAL rv AND SURETY COMPANY, a stock corporation of the
St81e of Connecticut, DO HEREBY CERTIFY Ihat the foregoing and adached power of Attorney and Certificato 01 Authority remains in full force and
hi' not been revqked; and furthermore, that the Standing Resolutions of Iho BOllrdof Directors, as set lorth in the Certificate of AUlhori1y, are now
In loree, D
Signed end ~e.le at the Homo Office of 1he Company, in the City 01 Hartford, Stat 0 ConnectIcut. Dated thIS
jj7,Z; 19 f& ,,""" C-
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l1".,~:~~"h~: 8Y___V'!...c.~______ -- -- -- '---
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\. .~, ,,,.:.... .-lecre .1r:y
(8-11122-10) (11)3-79 ,,,,,,,,.,,,,..,,, PRINTED IN USA
dllyof
J
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.
.. RCC~'03 \3-731
,
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX OIVISION
",/ ,)/', ;: ('-' ';
J ,- . ,.- I .;..
'':'/j '/ ( .,' ''w-' / .. '-~,~-
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESlDENT DECEDENTS
*'
COUNTY OF Cumberland
This return must bo completed In detail and flied in duplicate, with tho Reglstof of Will. In tho County whore tho docedent resided within nln'," I
month. after date of death, unloll on extonslon I, grantod by tho Secretary of Revenue.
Will
Admn. No.
19_ I.
Geraldine R. Brubaker
b~~g ~1It~SPA Road
of
tADDRESSl
INAMEl
Administratrix
(EXEC., ADM., LEGATEE, ETC,1
tale of 1810 Carlise Rd. , Camp
iC1TY, BOROUGH, OR TOWNSHIP)
Misc.
being duly sworn according to law, deposes and says that9\c is the
of Ihe estale of
Zula Van Dvke
Hill, PA
deceased, aod that the whole of the estale of said decedent. who died on November 28 , 1979
IDATEI
consisted of the assets listed below and Ihat allowable debts and dednctions exceeded the fair market value of the assels and
no Pennsylvania Transfer Inheritance Tax is due.
19~
..," .r-
IY~ .f ......" "_:' .
. Rea~li.tol~ Pen. . l'
0": ....P.rqperty, Jointly.:,::: ':,"" ,"
< ....Hild.Prop. or ~', ,f .,,'/ ',;,
~. qTrolidetl""""'< ,~~
'~,'" ;.' "', \. \ '.... "
';', <'{;'" 1-,\ '.",
Persbna:l"~,,,,""
(J, /J /J ,- 'IJ
~Vr.c&.II'..e...
(SlGNATUR
}W__t-d-~c...-VAdminis tratrix
( TITl.EI
ASSETS
(Attach oddltlono~\f necenary)
.. De'l'cri'ptlon of Anet
estimated
Morllet
Value
Department
Valuation
CAUTION
(Da not write
In this see)
Inheritance from Jennie E. Thomas Estate
(decedant's sister from Venice, Florida)
$3,186.71
Dauphin Deposit Bank & Trust Co.
(Burial Account) (Acct. No. 13-13103)
778.65
Dauphin Deposit Bank & Trust Co.
(Savings Account held jointly with
Geraldine R. Brubaker - $1,282.68)
Clothing
Joint Propert
Personal
641.34
50.00
TOTALS
$4,656.70
4~ ~S-t., 70
REPORT Of INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the above County do respectfully report that I have
appraised the real and personal property as reported in the foregoing schedule at the values set forth opposite each item in
the last column to the right. r:.:' '/-;#/ // ,/ /
J 1 23 1980 A "."/" , r "y
Dated: u.y.. t t1NHERITANCE TAX APPRAISERI
Name of Payee
Musselman Funeral Home
Geraldine R. Brubaker
Rolling Green Memorial
Park
Timothy F. Nicholson,
Esq.
Timothy F. Nicholson,
Esq.
Register of Wills
DEBTS AND OEOUCTlONS
Nature of Claim
Amount
Claimed
Amount Approved
b" Register
Funeral Expense
Family Exemption
$1,579.23
2,000.00
Bronze Memorial
400.00
Legal Fee
Long Distance Phone Calls to
Florida
Letters of Adm., Short Cert.
Inh. Tax Return
300.00
9.80
TOTALS
continued
REPORT OF THE REGISTER Of WILLS
., Ihe undersigned duly elecled Regisler of Wills in and for the above County, do respectfully report that t have allowed
deductions in the amounts set forth in the abuve schedule as claimed, elicept where I have set forth a greater or lesser amount
in Ihe last cnlumn t~o II\e right. whieh ~eater or I~;ser amount represents the :.:~tll~Wed as a d;~uel~ " /
Dale of AI.prnval: kjl.ol /26 , )1 ft l!/l.1..(..f f' .." lJ"tf.-f.,v
11-7;.11 ' Yf~J
1) Husband and wile accounts.
2) Joint occounts with a balance under $llO.OO
3) Accounts held by the decedent Individually
A report is reqlJlr~d on:
SECTION 742 OF THE INHERITANCE
AND ESTATE TAX ACT OF 1961.
1) Joint Savings Accoul1is
2) Joint Chocking Accounts
3) Trust Accounts
4) Joint inv8stment accounts, such as
certificates of deposits, share accounts,
and !fO forth.
5) Accounts held by hUlbond and wile
and third parties.
"When money is deposited or invested In a financial
Institution located In Pennsylvania In tho nomos 01 two or
more persons other than husband and wife or in the nome of a
person or persons in trust for anothur or others and one of the
parties 10 the deposit or Invostmont sholl dlo, It shall be the
duty 01 the Ilnancial institution within ten (10) days oller
knowledge 01 the death to notily the Department 01 Revenue
thereol giving the name 01 the deceased person, the date of
the creotion 01 thelolnt or trust deposit or Investment, the
amount Invested or on deposit 01 the date of deoth with the
Ilnanclol institution and the nome and addre.. 01 the
survivor or survisors to the account. No notification shall
be required in regard to such account when the deposit at
the time 01 dClGth does not exceed three hundred dollars
($300)." (Emphosis Is added).
No report is required on:
,
"
-----,......._<~~-~.... ~.,....
~f!P(Ht is required on:
SECTION 742 DF THE INHERITANCE
AHD ESTATE TAX ACT OF 1961.
1) Joint Soving'i Accounts
2) Joint Checking Account'
3) Tru,t Accounts
4) Joint Investment accounts, such as
certificatos of deposits, share accounts,
and '0 forth.
5) AccDunts h.ld by hu.band .nd wi/.
and third portles.
IIWhon money Is deposited or invested In D financial
Institution loc.t.d In P.nnsylvonl. In tho non,.s of two or
more persons other than husband and wife or In the name of 0
person or persons In trust for another or others and one of the
p.rti.s to tho deposit or Inv.stm.nt shall dl., It shall b. th.
duty of tho financial Institution within ten (10) doys oft.r
kn.wl.dg..f the d.ath to notify tho Dep.rtment of R.venu.
ther.of giving tho n.m. of the dec....d person, tho dote of
tho cr.atlon of tho I.'nt.r trust deposit or Inv.stment, the
.mount Inve.t.d or on d.poslt .t the d.t. of d..th with the
flnanclalln.tltutlon ond tho n.me .nd addr... of tho
survivor or survisors to the account. No notification shall
bo required In reg.rd to such .ccount when the d.poslt ot
the tlm. .f death do.s not exceed threo hundred doll.rs
($300)." (Emph.sls Is .dded).
No report Is required on:
1) Hu.band ond wife occounts.
2) Joint .ccounts with 0 balance und.r $3>0.00
3) Account. h.ld by the d.c.d.nt Individually
"
NAME OF PAYEE DEBTS & DEDUCTIONS
Geraldine R. Brubaker Long Distance Phone Calls to
Punsutawney, PA
Geraldine R. Brubaker Funeral Meal
Active Insurance
Services Administratrix Bond
Geraldine R. Brubaker Administratrix Fee
AMOUNT
CLAIMED
$ 31. 00
50.00
57.00
235.00
$4,684.03
AMOUNT
APPROVED
I i
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MUSSELMAN FUNERAL HOME
Donald C, Musse:: m
PHONE_~~~
763.7440
Dnvld L. Mus..lman E.'abll.h.d /895
324 HUMMEL A VENtlE I.EMOYNE. PENNA, 17041
(riM. Zula. L. Van Dyke
I'IM. ~rwU.r!in.e 7? Btw!JaJ(eJl.
/8/0 aJJ.1...de 'P.oad
Camp W, 7'en.na.
Nov. )J/79
'hwleMi.oMl <leJl.V.l.ced 1/.eM.eJl.ed. .in.cLudi.n.g- CIlAhei.
~~CIl.ete 6wU..a1 vaul..t. '
TO FUNERAL EXPENSES or
1125.00
jiiJ. 00
55.00
(aM. experr.d.i.tuA.M made fol/. tAe con.ven.Lmce ot ih.e. /anl.l/f"
C.6.i.:tuJM.!l.J.J1. na~JXlpeM 18.48
Fl.oweM5f.J,(XJ (aX. J. 00 Oeli.vMff .75 5), 75
S. in rn.i.nJ.A:tM 15.00
ve op'#M 'Ro.LlJ.n.rt; (jll.een. (f!ll&eIUJ 215.00,
. 0 piM at delz:tlt ce11llflco:te ' l2. 00
~0rJ $1 [ide - "/~-7 q,? ::,
Sue ~'e I: ~<.1 _ 2.. ~.-5:..~
~ ) /-rf 3 l\. 2- 3
FOR APPOINTMENT PHONE_
?Y' r1 ~~~ 763.7440
/520..00
31*.23
I.'!j~. .?)
To I' .!,,; ," ),',
I!J nn tI", Ci ',"J
11 ::,; .,.
19G1 II:' " ,
r,',
Tr '!'i ',,','
di:,COlln:; i f;\'i~ (:<, p"
Ini,t:riT "I >.~ \,'
clelinqUl'nt ;;t ti'" ".,;"
Tax on a fIJ!UfI) 1!,~r'r',"_,l
I'
enJ'J',.r.,l'nt u!,:d i,;
on the Ide;:: 1.,1 Ill;'.',
il',
1 month
2 months
3 months
.CX)(_i
.010
.,:["
n'"
.'..1.1
'-;1'
1 days ,OV(J~ 1
2 days ,C.i'~){):;;l
3 days .O:}{)5i
4 d'-lYs ,{)('.{jUl
5oJ'iS ,O(f)~;G
6 dllYS ,(y')1(Jl
7 doys .DOllS
8 dfJYs OGi :~S
9 days ,00152
10 days ,OO1C1
-- - --- ---'-" -. ..----..-. .~._._--,._-
An',' p~lrly ;n q'",'n;" i~i' :'iJ,;
the 25S(~::;SIlWn! mi1\, ()~,; "
1001 olllie kth;r:!i;!]:; c, II ': 'l; I~'I'"
"
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