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COMI.ONWEAL TN OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPL ICA TION FOR AND CONSENT
10 TRi\hji'Ef( SECURITIES
1~F.GISn:I\m II~ THE NAME
OF A RESIDENT DECEDf:NT
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APPLICATION (MUST BE FILED IN T1(IPi.lCAT[\
TO THE PENNSYLVANIA DEPARTMENT OF REVt'NUE:
Applicolion is horeby mude for c01sonl 10 the tlonsfcr of Ihe following securities of 0 Pennsylvania
Corporation or 0 Notional Bonking Associo:ioll lo(.n:cd in Pr;>nnsylvlll1io:
(Cert No. 1l29~() - 4l sharp.s; l;ert. rio. N:';C09 - 71 shares)
(a'~1.+<:hareS"-I-{ )"jhe-flfners...tlattona, Uank of Pott~vH1 c.------- (cL-cOllloon-w-toek--
(NOT~: -'fn desdjbing'~ccuri"f'cs cnler In (~Ci , nb Q/e, either tl~c IltJll1bl'..'r of shOles of stock CH the face amount of
registered "",ds, ;n (b), the nome of the ;".>uing ,:CI/;PO"y onil in Ie) ,1,(' closs of stock or tho stored interest rote
and maturity dote of reuistored bonds.}
D~TE-~Jd:L\,.WJ (~ Iq,ft?
"' '-, ".,.
ISSUED 0" April 2->, 1!!~~ (i~29,,0IJ I' 'rOl'AI IJAI'KE:T VII UE OF S
"-c-- - --,.,-r,---"-971" Oifll lOVlOg () - ,,\ \ - - - -8-85-fT.-Jtl-----.
-cP~lJ1~r ,), I JGJ~) . .
os of the dote of dealh of the dec~~ent, -----Tiormant-. -leeu------------- ___ .___, on-AjJr-H~{},_19g9
(~lOlme of DCl":l!dnnt) (Dato of doath)
who wos lote of --rzr2J.-S1i11~"on--f"rry l~oud;-:le~i r_Ulr:h;;rland-,--CumbcrlancrCountY~'-Pl>n'1syl'lan1'J
1SIrI!Of {j~d~umb("~ (~o.., "bTne'-') (County) (StOIO)
The securities ale registered os follows: -rton"anr, -LeE!'andDoris-R~--l(rfner-t:t:-1Itl-jr.H1'!ndl1t5 Ii-i-ttrtight
nft;IlUl or name,> in which c("rtiHcato~ OfQ registered)
,. T of survivorshi p and not .15 tl!nants in C011lf1'On
SURVA~MIR I slf~~1rrTlij!';N
~)(MN1~R~Xfj(Xr-'Jllrfs-~tW,m:r;-:n7-H; -H~cc. Str~ct ;-l'ottsvi7JJ.lI.:;ff'r---rl'YJ]----
XXXXX .~ XX NAME OF APPLICANT ___ r..oris--R,-Kr1net'---.------
COUNTY FILE NUMBERc2.1~J'-Q....1:_~_!L ADDRESS OF A PPLlCAI~L ~~~t~V1m~-~:-:i4eOl
(, 1..
BUREAU FILE NUMBER_____...____..__.__._ SIGNA TUR E OF APPLICANT_____.__;;_-.:..~...::~. ( . ,'~-
NOTICE: IF YOU FAIL TO PROPERLY FILL iN ANY PORTION OF Tim APPLICATION, iT WILL NOT BE
CONSltlEREO COMPLETE AND WILl. BE RETURNED HJ YOU Forl COMPLETION.
COMMONWEAL TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES C\h~._ L, {lit
I bereby consent to the transfer o;t~,~-~~~v:sC~()r;ties na:'-r~~i:I~:d in the nom~~fTt~~~fO
Decedent and waive the filing of 0 cerlifical. rl.,tifying to the payment of the tro"sfer inheritance tax to which
the properly of said Decedent is mede subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
os amended and the Act of June 15, 1961, P.L. 373, os amended. This is olso in occordonce with the provisions
of the Act 01 April 9, 1929, P.L. 343.
This Consent to Tronsfer Iho h'"o;n described propcrty operotos only in reference to the estate of the
obove.nomed Der.edent.
1''-
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{'71. .~'~ r)r~;~.tf
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Signed for thc Secretory of Revenue
'-/\J~ C. -/ '
By___I_ . v-----aQ"~:W', -4~r6\
<:7' 1\;9!,c'Jld C l'
(~, '--- . t\ I .
,if:::../! !0)t1\ \J . \j__ A-..,,\"\ ~,h J-
.J "\j \ Ti111]}'b (County)
---
7"
"', \\."/i,."'I'..'(;......", ,..,.. ~,:'-"';.' ..'..' .:..... ,', .. ''''''''. '.:. .',.... c'...., '-. " ".-,' .', _"..-, ",'.',''' ,,<,,'. .' .
,~~~{),;;'X,+h:,,;r"':i/~OIlllIlllONVvEALTHOF, PENNSYLVANIA , ' ,.
~1\).;lij~i)0r;;~j~~I.~~E~,~,iT;R~6E',PT.~E~~;~~~~~~~Fa:~~~~:NCE 'AND ESTl TE TAX
f"~'~\I1o"'I.!..,~-'.......,.,-"'j'.,~,.., '," " ___...'.."......... .'u._ ..~,.~."..~___~...,__ .........___.__ ._. .
~
" RECEIVED
II
a From.
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" ~6/1~-------------__-_- dollars
.
represenling Ponnsylvan:o Inheritance or
Estate lox due from tho following estate:
HUHDRJm TRIR'I'Y
001'1. R. lICriner
C/O Jon F. LefaveI',
:11'7 'fhhd At.r..t.
leq.
2-A Tax on
$
$
..w CUIlberland,
17070
'a.
6% Tax on
$
$
21-80-400 Dolo of Dealh4-20-1980
f Filo No.
Dolo 01 Paymenl
15'lc. Tax on $
$
June 12.
1980
% Tax on S
Estate Tox, Ac' of
May 7, 1927
$
Name of Decedent
a:>llMAH I. LIB
$
Counly
t!,.~'harl.nd
$
662.75
Remarks:
TOTAL TAX CREDIT
Less five percentum 01 tax if
paid within three months after
dale 01 deolh
Plus interest 01 the rate of
_%fram
10
$
$
33 .19
· PAm Olf ACCOmrr-
lJ'rn~[p[]J@ill'[j'rn SEAL
$
630.56
TOTAL AMOUNT PAID
NOTE: Thil Triplic'1e Recalp110 be retelned for ludh purpoI.I.
I
Received by
NOTE: In accepllng Ihe !rander Inherltal"e to. on 'ulure estates, prior 10 ,he death 01 the We
Ilnant or tenonl far years, as e...ldenced by thl5 recelpl, II Is 'understood that the Commonweollh sholl
nol bl precluded or prevenled lrom herl'lI'lr aueulng additional Inhlritonce ra. at Ihe death of rhe
Iif. llnant or lenont lor years whlnever It appears that such oddlllonalto. may be legally due and
coU.dlblelor onv reoson whatsoever,
.:/'
(Title)
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REV-449 (B.78~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FlEW OPERATIONS
*
I
RESIDEHT DECEDEIH
COUNTY OF _-.J.l!.m_~~!lan<!.__
....- .-
IMPORTAHT:
.-----.----
.... ---.- . . -_.- .--- .-.
This I~turll mU!.t hI: l~ul1lpll~tttl III tleraillllld flied III IluphcillC, willi lilt atllH.:I\l'd. v.illl the Rcgiswr of Wills of the
Cnullt)' wlwrc dcccdcllt rCliidcd. H.l'lllll\ i:.. dlll~ within 1I111t' nlltlllhs aftt'r oillc uf death, unless 1111 extension is grunted
hy till' Sccrclllry of Itl'\lCnue. (St'l;( il)lI 7(1.1 01 tlw lnlll~l italll'c and EsllllC Tllx Act of 1961.J
."._.__,__",,__,___ .___ ~.. ___.n
IN TilE MATTEK OF TilE ESTATE llI'
Norman E. Lee
ISTATFrUi-~MTOF~rjr-:~j-i-i ---..
-}
C",unl,!
^ FFlllA \'IT OF
SURVIVING JOINT OWNER
KXKK~'()Oll
Cumberland___ __ ------
pennsYl_y.~~i~____1
Cumberl and, J '"
Jose~ S. Lee, Survivin~Joint Owner
~)(KiXKXOO){ --~;:-I-;;;(t of-;h,~L:v:-nomod-d:~~:;-bcln~J~~;~d~po.;~~d .ay 5
1I101oll<'lllXXKXXIIK
Lota of
Stato at
County (If
)(~l!Jl\ll.X
Decedent died
April 20
1<J!ill---.1_ '
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lMONTH) lD/,yl
Homo and odd'llu 01 nttornfOY or } JlQrI.....J___~_aFaver.. ESgui re
o1h.r outhot'lud rlpruenlotlve to .....hom 317 Thi rd Street
011 '0""90od"" ,h"ld b. malld. .Jlew...C.umb.erland. PA l707L
S ., J' t Owner
That as such urv1v1ng 01" Jcponcnt is fan:iliar with Ihl.: ~tlTajrs of said cstate IInd the proJlcrty clJnstituting
*l\-X')(~XI(~X~l(~l\-nx&X'
the assets thereof and their fair marklH value.
That ill the time uf death there was no safe deposit box registered in deceJent' s individuillnamc, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy. with the
exception of the following: -
NAME AND ADORES~ OF BANK OR OTHEH IN~l"ITUTtON
IN WHICH DECEDENT RENTED A ~AFE DEPQ:ilT BOX
THIS SAFF. DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
_ 1
~
That the contents of suit! safe deposit box or boxes are ilemized under Schedules
with the exception of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached herelo aad made part hereof sels forlh fully and in delail all the real properly
in the Commonwealth of Pennsylvania of which decedent died having an interest tht~rcin. It also sets forth the
mortgage encumbrances upon each p01rccl of real property at the date of dealh, giving the amrJunt still due at
death, name of mortgagt:e, date, rate or interest, and hook and page (If record thereof, It also sets forth in the
columns provided therefore the ussesscd valuation of each of said parcels, lhe estimated market value thereof
as of date nf death of decedent.
That Schedule B attacbed herclo aod made part hereof sets forth fully and in detail all personal property
where~w\'er situat~d owned by the decedcllt at the time of death; all moneys left by the decedent at the time of
death, whethtJr in decedent's immediatc l"ossession, standing to decedent's credit in banks of d.eposit, savings
hanks, trust companies, or other ill:aitutions, whether individually, or in trust for any other person or persons
giving also separately the accrued interest thcrc()n, if any, down to the last interest day prior to decedent's
death in the case of savings banks, and H} the date of decedent's death in all olher cases; all bonds, postal
savings, treasury certificates or notes and other I.:vidence of ind~btcdllcss of the United States to the dc~
cedell1: all ohligations, whether by statute or agreement they arc designated as tux free, of the United States,
or any Slate, or pulitical subdivision thereof, or cf any foreign country. which arc owned tit thl: time of death;
all wearing uprate!, jewelry, silverware, pictures, bouks, works of art, huusehold furniture, horses, calTiuges,
automobiles, boals, and ;lny and all other personal chattels of whatsoever kind or nature, left hy decedent,
together with the fairly estimated mnrkd vulue thereof; all hunch and mortgages held by decedent Bnd of all
claims due and owing decedellt at the timt: of death, and all promissory nntcs or other instrunlt:nts in writing
fo( the payment of money of which Jecedent died pos~esscd, of whalsoe\'er nature, ,,,,ith interest thereon, if
any, giving the face value and estimated fair market vnlue thereof, and if such estimated fair market value be
less than the face vuluc, it sets forth brie-fly the reasons for sucll dcpl'ccintion as to each item; all muneys
.payable 10 the estate from lire inl'urancc policies carried by decedent; all annuity and endowment contracts
the proceeds of which were paYilble upun the death of the decedent; all and the corporate stock~ and dividends
due thereon and unpaid us of the date of death, bonds and accrued interest thereon to the dale of decedent's
death and other investment securities owned by the decedent at the time of death. with the markel value there..
of at such lime,
[;;t81
,
In the case 01' sl~c\lrlties of close or ruml)y eorpcr1lt.I()[I!;, t.he vIlIllCH reportl'rl arf~ liS fur us
possible substnntlnlccl by l'tn'l.l\c\!\l gLnt,'.:'Olfmts of t.he corporut.toIlS, shnwLn~ till! fISSI~t,'~ nnn llfthlllttes
tht.>reof' fiS of the /tItle 01' (1~llth. 'fhe ~che(hllf! also sets fflrt.h till! Interest llf' decedent fit tJw t.ime of
dent.h in ~lflY co-partnership or 1J\lf;'n~s:;f find 1n :mpport nf ltll! vldue 01' "ll,~h Interest there Is nnnex~rl to
suitl schel\ule, flnullctfLl :,tltf'ment.s 5howLng; t.hcflssets !U111 11'lhllll.l.'s 01' -"Illel cn-Iltlrtrwr_ihl[l or hllslne"is.
A copy of (h.. co-pnrlnt~rs!llp ,1gr'?emcnt, (If orlll, n st,llt..mpn!. s.-..tUn~ ('ort.1I the 'lIlt.url! of' t.hl~ Il.l;rl~erncnt)
togetllCr wllh 1\ slld,t1mnnl setlin.!!; rorth the ellllrnct.er of tll.... b1l5Inf!'is, its locnUtJn, and slIdl other f'l\cts
pertldntng to the bustness fiS mny he perttnent, to It fnlr Hnll .lust. I~\lprlltsnl ot' the decedent's Int~rest
thcr("'in mllst he suhmlttf!rl. It shoul(l nlso set forth in Itemlr.l~d fllrm, tr'J,';~tlH!r with th12 fall" market, vallie
tlwreof, Illl)' other property ownf~d or bequcnt.lwd by the dCCI!dt'!nt, fit Uw time of deat.h.
The Scf1edule C attached hereto lllld mnde part hCl'f!of sets fort.h tl true Ilnswer to cRcll inquiry
cantnined thercln /lnd in the case of transfers ofpropcrtj'. real (II" personal, within two years of decedent's
death, in contempl/ltlon of decedent's de/d,h, or int.cmted t.o t.'lke effect in possession or enjoyment at or
after denth, said ~clwdllle sets forth the nature ltOlI vn1ue of such property, to whom tl'81lst'errecl, the
relationship of the transferees to the dl~eedent, the proportionate share received by each trnnsferee and
all othf:'r fncts of Il pertinent. nat.ure regarding Side' transfers. In the Cllse of t.ranst'ers intendecl to
take effect in possession or enjoyment at or aft.er rlenth, t',here is also rd,tached to the liched1l1e a COllY
of the cleed, trust Ilgreem~nt '~;oU{~~ instrumen"t creating the trust.. Ther.~ is also set forth in said
schedule 11 list of all propert.~., real nnd persona.l, with its value, which paf.'ses at decedent's cleath by
virtue of the exercise by decedent, cithl'!r tndividua11y, or jointly w1 th another, or any power ot' appoint-
ment vested tndccedent, either indtvidually or jointly, by the will, deed, or other instrument 01' another,
with I.l ~opy of the instrument cref\t1ng such power tlttached t,o the scherll1le.
That Schedule 0 attached hereto nnd made part hereof' sets forth the nnmes finn addresses of all
persons beneficially interested ln this estate nt the timt~ of decedent's nCllth, the nature of their res-
pective interests, their relationship, if any, to t.he decedent, together with the Ilges at the time of
decedentls rlellth of all minors, annuitants and beneficJnries for life unrler rlecedent's Will. It also
contains a statement showing which of the beneficiaries ntuned ill the decedentl s will, if any, died prior
to decedent, the dates of their death, their issue, IUHl the rellltionship of such issue to the beneficiary.
That S~/1edule E attnchec.1 hereto and made n part h~l'eof sets forth all property, real and per-
sonal, owned by t.he decedcnt jointly with anothel' 01' others, including intangtble, standing in the name
of the decerlent llnd others, plus the datc and place of recor,' of instrwnents effecting the \;estiture of
real est.ate anrl the date of acquisi tion of personal ty, plus the name, l\lidress and relationship, if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for ann on behall' of' this decedent. 5' estnt.e, including funeral expenses paid;
family exemption, where al'p] Icab1e; costs of aclmlnistration of this estate; counsel fees and rudiclary's
conunlssions paid or to be ]laid; cost expended for burial trllsts, tombstones or gravemnrkcrs, and reli-
gious services, In consequence of t.he dcoth of the decedent.; debt.s nnd cl nims owing nnd unpaid at. time of
denth; taxes accrued chargeahle for period prior to ,lecedent' 5 death (except those allowed under Sectton
651. of the Inheritance and Estate Tux Act); together wit.h u statement of collnternJ p1edgerl for obliga-
tions, if Iloy. It is agreed that the f'tduclnry will present proof of' su.id clll.tmerl obligations upon re-
quest, thst if the amouut. actusUy psld In settlement. of "IIY fee, commission or debt. is less than the
estimated amount clu1.m1ng and 1ll10wed, thllt the sllme will he report.ed to the I\eglster of Wills, ancl that
the lunount of tax nssesserl CIUl he rellsses~ed in llccordtmce Uwrewith.
That the to1.llls of thp. a}lprol'rib.te columns 1n Schellules "f\.", 1IB", "e", "E", find "F" as directed theretn,
have bf~en carrIed forwllrd and proper1)' reg1stered in the Summnry.
Subscribed and sworn to before me this
~tJ-IA. d f C.L,.L
.... . .A....... ~y 0/)'.1 1
L" ~. A"-'
5qt.A..--L-C /d.0'<d..t"-C.;.0-!--
./J SUIOnno M. ltaverrc. l'Iolary PuIlIi<
'-' My Comll'liniOtl bpirtl Jiln. 13. 1983
tie. Cum\erl.nd. PA Cumbetftn; County
c
,19.80..
;/
.~,.,,,....,....,.,,.........,-,..__..
~OTE: llf!fore si~n1nJ; Ilff'1dllvit mnke sure Idl hlnnk Sl1Rl:t~!:' 111 t.he at'fldltv1t llnrl schedules annexed are
filled 1n with i1l'tails or the word "NOlie", luut in l'ase t.he ussets tnclude rtlr(! allrl ulIliste.' securities,
securlt.1es of close or fn.mi1~' corl'orut.1oll!,; or an Int(>rt'~st 111 l.lll~' CO_Po.l't.llC"rshtll or business, thltt the
ctllt.ll IUld stllt.enlfmls refllli)""'" uuiler the IH~ruJ!,l'aJ1h UhOVI~ relating, t,o Schedule "11" nre att.llched. ,\150 make
cHrtlltn UUlt column #1 in t.he "SlIfllnfll'Y" has he~ll I'rnpl"lorly cmllpl(!ted as nhove-dlrected.
"c::c-U(...731
'COMM~.u.TH OF r'IMHSYLYAHIA
DEPARTMENT OF REVENUE
aUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECIDENT
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent os tenant in common with another or other, should be identified
os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by ontireties should be reported on Schedule "E.")
The real property located In the Commonwealth of Penhlylvanla .hould bo (1) (2) (3\
delcrlbed by lot arid block number, Itr..t and .tr..t number, tog.th.r with DEPARTMENT
o general description of the property, with a reference to the record of the ASSESSED VALUE VALUA rlON
conveyance by which the decedent took tltloj If 0 forln .tot. number of a. FOR VEAR OP ESTIMATED CAUTION
crnj also .tatemom of mortgage encumbrance. upon eoch parcal at d.ath OECEDENT'S MARKET VALUE (Do not write
of decedent. Taxe., oue..ments, occrulJd Inter..t on mortgage., etc.,ar. OEATN In thl.spau)
to be II.ted en Schedula "Fit and mu.t not b. deductod from thl. schedul..
NONE
,.
Insert this total opposite "real property", Schedule "A" in the X X X X X
.. As Reported" column an the last page of this return.
o
t?u~
,
REV-453 (6-78)
CO~lONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCIIEDULE "I)"
BENEFICiAl(II'S
-, - -
BENEFICIARIES AND AIJIJIU;SSES RELATIONSIIII'
(Suite fulll1l1mcs IInd addresses of nil who Of !>Iep.childron or SURVIVED IMTE INTER EST OF
have lIn intt'rest, vested, contingcnl or other" illegitimate childrclI IlECEOENT 01" IIENI,I'IClARY
wise, in cstntc) ure involved, sel STATE YE~ IlIllTlI IN ESTATE
forlh this facl,) OR NO
Joseph S. Lee ~ - Yes ftduJ~ of-a
311 Moncure Drive --,-
A1 ;. VA ??::l111
,
,
-
Deponent further says that 011 the above-named beneficiaries arc living at thi 5 time except below:
NAME
DATE OF DEATH
RESIDENCE
A report Is requlrod on:
SECTION 742 OF THE INHERITANCE
AND ESTATE TAX ACT OF 1961.
1) Joint Savings Accounts
2) Joint Chocking Accounts
3) Trust Accounts
4) Joint Investmont accounts, such as
cortlllcatos 01 dopa sit, sharo accounh,
and so lorth.
5) Accounts hold by husband and wllo
and third partios.
"When manoy Is dopasltod or Investod In 0 linanclal
Institution located In Ponnsylvanla In tho names 01 two or
maro uons othor than husband and wllo or In the name 01 a
eorson or porsons in trust lor anothor or othors and one 01 the
parties to tho deposit or Investment shall die, il shall bo the
duty 01 thol1nanclallnstltutlon within ton (10) days altor
knowlodgo 01 tho death to notify tho Department 01 Revenue
thoreol giving the namo 01 tho deceosed porsan, the date 01
tho creation 01 tho iolnt or trust doposlt or investment, the
amaunt Invosted or on deposit at the dato 01 death with the
Ilnanclallnstltulion and the namo and address 01 tho
survivor or survivors to the account. No notlllcation shall
bo roqulrod In rogard to such account whon the deposit at
the tlmo 01 death doos not excoed threo hundred dollars
. ($310)," (Emphasis addod).
No roport Is roqulrod on:
1) Husband ond wife accountS.
21 Joint accounts with a balance undor $:JlO.OO
3) Accounts held by tho decedent Individually.
:~~~~,:;,\~,,,,,,;,..,_. '~
"
A report I. required on:
SECTION 742 OF THE INHERITANCE
AND ESTATE TAX ACT OF 1961.
1) Joint Savlngl Accounto
2) Joint Checking Accounll
3) Tru.t Accountl
4) Joint investment accounts, such as
certificates of depollt, shar. aecounh,
and .0 forth.
5) Accountl held by hu.band and wife
and third parti...
"When money II depallted or Inve.ted In a financial
In.tltutlon located In Pennlylvanla In the namel of two or
mare ""nanl ather than hUlband and wile or In the name of a
p':.rson or persons In trult for another or othe,s and one of the
partl.. to the deposit or Inveltment .hall dlo, it shall be the
duty af 1I1e flnanciallnstltutlon within 'en (10) day I after
knowledge of the death 10 notify the Department af Revenue
thereof giving the name of the dec....d penon, the date of
the creatlan of the lolnt or truot deposit ar Inveltment, the
amount Invested or an deposit at the date of death with the
financial inllltutlan and the name and addre.. 01 the
survivor or survivors to the account. No notification shall
be required In regard to luch occount when the dopollt at
the time of death does not exceed three hundred dolla..
'($3)0)." (Emphalls added).
No report Is required on:
1) Husband and wife accountl.
2) Joint accauntl with a balance under $3)0.00
3) Accounts held by the decedent individually.
"
0 ~ ~ ~ \.D
~ 'd
:j:. ~ l:l
Z ~ ~ III
M 'd
I 0 s.. <i
~ . Q) III
'" ril i ~
-0 ;:l ~ 0 Q)
6., ...l .0 M -"" M
0( :0 a M
~ Z g Q)
\ u ;z; 0
~ 9
~
~ ~ ~ 0
~ 0
~ ~ ~ 0 z d d
1;; 0 en >< E-<
I.:i en I.:i Z Z
- ~ E-<
Z d ~ S ~ I.:i I.:i
::l d ~ Cl u ~ Z
Z Z E-< ~ 8 0 -
~ en Cl "" ...l
- I.:i
~
IN'~ rp:w 110N';
111 il\'~ur'~ prup.:r (,ft'dll III )'tl'll ,I'" ('\.'''1, t"I~ t..,:,l" uf!1 I" P~!I~I"rlllll~ IllIl!\I)>" :)HJldd h.~ Cll~ally prrnt
erJ Un tht! CIH'Cr.. fJf !!mi,"',' ortJpr
1961 ("/2 P.S, ~.i ~<H.;~l /08)
Ihl~, i:;';!)I'~:~ril"nl is Ill;!'!>' III .J:', ,Jl,!;ll". '! wid' p'. '.1'\ ,1d (d ~I,,: 1-lh,'r!';lfH'~ lln'.! L~,l;ttu 'Lt:< Act (If
1;) tht: I!:.:t,'nl :'"I~ Pllle:I', ;'1\;' tal<. '. I:' !:.I..,~ t!'P'!' I)i ,,'.flff,'. .J'Wt 111(' rJ,':I!:1 ))1 th,' dl i:t'!l.;nl, i.l
discount ollivo IS) percellt I~ aliowllO en I'S, ,,,8:,,. /10).
lntwril.If\Ce T':I)(, OlllCr th;:m til>'. on;i ;uil.,H~ 11\11!!l.';I, I: dli'~ :1; lill! (Lj:l~ of tIll! (WC(.'dl'nt'~: de;l\h iJ11d becomes
delinqucrtl ;It till! t~>,.plt<Hion ...( rllnn [qj n IOf)ll,'; ,,;I'~I \Ill! !fu(,,'dt'!'I'~, (luaU) ("/2 P S ~; ~ljfh-711 \. lnhNlwnce
Tax on a futtJfH loluest i!; payaule witllfo thn:l! l:!} rno!~lh', ;J!lpr Hw tr,Hl';f,~r t(1k,~s ldfe('t In p(Jsse~sjun and
enjo..,.rncnt and 15 e](llinquenllht;['I;;llwr (12 l'~i r ;~,1D~ "7\;ll Cdll:uhit~ l1\tr!rc~;t flull\ th,.' dcllrHlllt'I'\! UJk 5ltown
on 11',e l<1c,1 of th;':) form to tlw d'-tte oj ,IUlI,.1l pilYlllell1 U~1I1~ Ill(; fllll()~':I!"\1 rll;('ru~,t I;Jlll,;
- -----.----- - --- --
1 month
2 months
3 months
1 do..,.s
2 days
3 days
4da'f's
5 days
6 days
7 dUY5
R days
9 days
10 days
())tl
025
,CXJ5
,01()
,015
4 rnunli15
!.i month:>
6 months
o:w
7 f!~nn,i,s
U n\Odlil',
~l Il!..r,li I';
- --'- -- -- - - -" ----
0]5 10 n10nlll:) ,05Q
040 II fl1onlll~ .055
Ocl~) 12111(H11I1s ,060
~', 1 doys ,00352
22 days ,00369
23 dnys 00386
24 day~ ,00403
25 days ,00420
26 tiQYs ,00437
'2"7 diJ'fs ,00454
28 l~J'(S ,00471
21] day~-; ,00488
30 days ,00500
---- .-.----..-' _.....~._-,---
(l0017
.00034
,00051
,0006U
,00065
,00101
,00118
.00135
,00152
,OO16Q
11d:IY:;
12 d:IYS
13 dilY~~
CJldG
007.J3
.uo:uu
.OO~l,)
OO~IU)
(J{j;/('j"J
OC,28,l
,00301
,Ol!3\;;
.OUJ:i5
-------------------------------------
.-.- - --- -. -.-.-. -".--.- - -- - - -. ---"-----.- -----.
1 . ~ l~ ,: y \:>
\ b da\(~
1(i dip.,-'.,
l-/lhl's
18 c!:lyS
19 ;1,1\':.
:'.0112','!;
Aoy parly ill il1t('!e~;I, includil,q l11e COfl\OllO!\\....',.;liJ!lh ~lI1d ~)",_, p!!r'.;or,al Il'P!(:~;(1ntiltIVf'. I'ot SBlisllud with
tho assessment may ohJt>ct tlWI8to Wnhln ~',1^11' (001 ddY::' ;d~u 1("-,';;1': of this NetiC!: ;"IS provided by Section
1001 of the lnherrtance ~IlJ !:sww lax Act 01 l!Jt)i (i? pS ~ 2.\85 HJiJll
t\tlk~~ c!H.'ck (ll !1.1"1':'r' '-'1'it'l ~,"'~;'lll\" Ii,
"P.el.J'~ll:f of WIII~, f.ql'I,I'
~/,.1t1 \'.1 :lli :!,ln~:~', b',:"d ;:"iU'.',
REY-4!US (8-18)
DEDUCTIONS ALLOWED IN
OFF ICE OF THE
REGISTER OF WILLS
..:; 1- ef'IJ ~ '1,tJ i'
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF $ t;""~ ~~.
_~,DAH APPROVED\>.,t~~. q II
)Yl~ '
..:., . . ,
.- nE ISTER or 'N1l.L.S, A'GE
OF Cumberl and COUNTY
AND AGENT OF THE COMMONWEAL TH
-."-) /""'"'
ESTA TE OF Norman E. Lee
LATE OF New Cumberland. Cumberland Countv. PA
DATE OF PILING APPRAISEMENT i I.. Ill- If) , \, DA"fE OF DEATH --8Qril 20. 1980
DATE NO.OF NAME OF PA YEE REMARKS AMOUNT
VOUCHER
Holy Spirit Hospital Profess i ana 1 Servi ces 7 60
Professional Pharmacy -----t;:ofessional Services 78 48
Blue Ridge Haven
Nursing Services 225 00
-
Or. Harry Brooks Professional Servi ces 55 00
Dr. Stanley Wetmore Professional Servi ces 12 00
Allen Funeral Home Funeral Exnenses 3 135 82
Community Physicians Inc. Professional Services 1 84
,
Holy Spirit RadioloQY Assoc. Professional Services 42 00
Dr. Raymond Grandon Professional Services 62 40
Recorder of Deeds Fil ing Rel eases 20 00
.
Jon F. La Faver Lega 1 Fee 1,945 00
,
i ,
-
,
_.n_
_L 5,585 14
"
G
COMMONWEAL TH OP PENNSYLVANIA I
COU NTV OF kA.-l!/ a!{U<.O(, 55:
I, ___,__,.kl..'\.apjL.S. Lee _ HEREBY CERTIFY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF. THE FOREGOltlG IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF No,.m~n I' I""
DECEASED, AS DEDUCTIONS FOR INHERITAMCE TAX PURPOSES.
ll..,\I, f
Jos'eph s: Lee
'i"
(L.S.)
DAY OF
/
Suz.nne M. lmeUe. t/ot.ry Public
My Commiuion hpiru Jan. 13. 1983
III. Cuonborlaod. PA C&unbWod COWIlI