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HomeMy WebLinkAbout80-00407 l7.I e ~ B ! S ~ i ~ . ~ ~: e ~ :, ~ .. ~ l7.I, i ~': 2 ~ " l7.I m i ell .~ .~ a Q . :i! ~. :- 4:) - 00 0 I - N " - . . II ~ 0 Z tit LIJ .' . 'last l~lIltll anb ~estament I, W. EARL KEENS, of West l'ennsboro 'l'ownship, Cumberland County, Pennsylvania, declare this lnstrument to lJe my last will and testa- ment, hereby expressly revoking all ~lills and codicils heretofore made by me: 1. I authorize and empower my executrix to sell any realty owned by me at my death, at either publiC or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 2. I devise and bequeath all of my estate of every nature and wherever situate to my l'life, ZOE L. iillHNS, providing she shall sur- vive me by sixty days. 3. Should the gift in Paragraph No.2 not take effect, I de- vise and bequeath all of my estate of every nature and wherever situate, in manner and form following: (a) I bequeath the sum of $500.00 to my niece, MaryMae Cramer, free and clear of any inheritance or estate tax or taxes. (b) All the rest, residue and remainder of my property I give, devise and bequeath, equally, to Audrey M. Milspaw, Pauline A. Mains and Roger G. Kerns, 4. I nominate and appoint ZOE L. KERNS, to be the executrix of this my last will and testament, she is to serve as such without bond Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Pauline A. Mains as substitute executrix; also to serve as such without bond, with the same powers as ,are given herein to my executrix. IN \HTNESS \'/HEREOF, I have hereunto set my hand and seal this !1'~ day of August, 1960. /. I '. /:~ i') /",l ,(.1 'v l - c -, W. Earl Kerns Signed, sealed, published and declared by W. Earl Kerns, the / J "',.V1 w-x.( SEAL) testator above named, as and for his last will and testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as wltnesseshereto. '/ '2 . ,)?;~,,\c.- / ,). c.i~....~ ,. /j ri./ld 4 () , /,w,~--C-p(.~ ~ OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND This 13th day of June 1\.0.,1980 , before me, Register for the Probate of Wills'and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came RoGer B. Irwin, one of the subscribing witnesses to the foregoing instrument of writir,g purporting to be thela;t Will and T~st"ment of W. Earl Kerns Dated August 17. 1960 late of West Pennsboro Township. Cumberland County Pa., deceased who being duly ,'.' 'according to law, depose and say, that he was present, and saw and heard the testa tor .:,W. Earl Kerns sign, seal, publish, pronounce and declare tl\e said instrument of writing as and for h is Testament and Last Will, and at the time of so doing he was of sound and disposing mind memory and understanding, to the best of his knowledge, observation and belief. Sworn to ('~fj (),C~ Rogef: . Irwl.n and subscribed before ?}J1, (! ,~ rJ1a~c. Lewl. Register AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA t ss: COUNTY OF CUMBERLAND \ Pauline A. Mains being duly sworn says that as nearly as can be aseertaine<1the said decedent W. Earl Kerns died on Wednesday the 4th day of at or about 6:30 o'clock, ~. Sworn to and subscribed this 12th day of June April A.D.,19~, /-;:.;('1' /; /.' .,_, C"? //~')a'_'" /l'a./ l:'aU.Ll.ne A. Mal.nS 19~~, before "/1 (~ {tJ. ~~ Register ~:-:3 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA $S: COUNTY OF CUMBERLAND ,- Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of Cumberland, personally came Pauline A. Mains who, being duly sworn ,do es depose and say that as Executrix W. Earl Kerns deceased of the last Will and Testament of she 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. Sworn and subscribed before me. June 12 A.D., 19~ ?22#, e ~ ~. L~& S Register y' . -' l'aJ..-L/;n-(~. c;, /l;'Cl_"-;;-I~V/ Pauline A. Mains h; 0\ \ ~ en' al :Cll ~f :c; :Cll ,~ u.. ni rtl: " en: "" :tl:~ 0 ':. "\ ..!Ol -I +m 8 1": rJ1l': r--~ ~ 0: -I ~~ ~ '<1', .... .-ll I: - 1<1:<: :-;:: 0: ~ :<:: ::= ,. Q): en: ~r.i 0' 1:: I' s:: E<: :so .-l: .~ fill 1-:1: Q' 1'1, <1:: ~ 'tl . 'OCJ" ~, ~ en' . 0 :'M ... - Z .:.-l 0 '<1', NI :;:,M c; rtl: 2 :...-l ~ Cll 1:l .5 ,3: 'tl bl) ~ a ~ :-;:: '" ~ r.-. DECREE Be it remembered that on the 17th day of June ,A.D.,19~, there was probated and recorded the last Will and Tesiament of W. Earl Kerns, a/k/a william Earl Kerns late of west pennsboro Township , Cumberland County, Pennsylvania, Pauline A. Mains Deceased. Letters Testamentary were granted to Witness my hand and official seal the day and year aforesaid. .~t:',l '." .- v0l~ r? Mary C. Lewis )rJ i. 1(<./e-Q'/ / Register COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55: Pauline A. Mains being duly sworn according to law, deposes and says thats he is the Execut;-ix ,.-.......- _________ 01 tho Estate 01 W. Earl Kerns, a/k/a William Earl Kerns late 01 _lh jl,...!I.l",JlelNVJ1Je,. .W~.st..'p':mI1.,,1Jor(:>_ TO\0ship ,Cumberland County, Pa., deceased and that the within is an inventory mado by ,..!'.aY.1.!!!g, fl.,,,. Ma,!!Il'____m_ .__ _. _,_,__, the said Executrix 01 tho entire estate 01 said doc.denf, consisting 01 all the personal property and real estate, except roal ostate outside the Commonwealth 01 Pennsylvania, and that the ligures opposito each item 01 the Inventory repres.nt it's lair value as 01 the data 01 decedent's doath. S:vo'YVl J, and subscribed belore me, ~7;: ~ ~"ff~_ HAMIL10N c. DAVIS, Netary Pullllc Newville, Cumberian,d cas, P;'mbor 22 19111l My Commission Expires ep e I l;Jufi.-,,;,,-, a .7;''l'~-e/ Executrix Exocutor - Administrator Pauline A. Mains R. R. #1, Box 425A '---'Newvilie-;-Penna. 17241 Addrou Date 01 Death 4 June Month 1980 Day Year INSTRUCTIONS I. An inventory must be filed within three months alter appointment 01 personal representative. 2. A supplement inventory must be Iiled within thirty days of discovery 01 additional a..ets. 3. Additional shoets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act 011949. '" c ... Q) ~, .J "'" \. I ()o s::--- M, -0 ..., G-- "'I :j,. r<l' .c -- ~I "" ~ -d ~ w .... 0 ~ !< M '" ~ "" ~ ~ W M ~ Do Q. f-O 'M 0 u 0 0 III ;3: ... ~ I w '" w 0 c I- J: Q. '" .0 ~ f-O ..J U. '" ,; lY z U. ..J o1i 0 ". S Q. W 0 -< '" i- > Q! Q) Z Q. Z 0 c c '" .. " - III Z 0 0 '" c '" U Z w -< ... Q) Q. Q) ;3: -c ~ c ~ M ... -.: ... 0 " '" .tl -c r<l ~ E ... ..! ~ " " ..J U Ii: ._ ~n ____ \ ,~,~~\\):WJWi:::,~',i'!,\~.r:J':'."':, COIVIMONWEALTH OF PENNSYLVANIA . O~"D8"'3" "2~'- /: :'. ...: ..,' DEPARTMENT DF REVENUE ' , l~i~~l~iW::~\: '!, ",OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ,ESTATE TAX, If'" '" ,.' " , ' ---. .".-- ' -- - m ,- - . ; RECEIVED It .~ From, I ,,," t File No, Dote of Payment __________~MrY-o.. HUNDD~ I'01l.'1'H~VB " 10/100-------------,,;lIlIors represenling Pennsylvania Inheritance or Estate Tax due from the following estate: c/o NCCre." I)Bvil. 22 II. Rir IIb'_~ Attya. 2'k Toll. on $ IIM1ViUe. 17241 $ JIB. 6% lax on 21-80-407 Dale of Deoth 11-4-1980 15';,,10)( on $ s.Dt.-bar 9. 1980 % Tax on S Estate Tax, Act of Moy 7, 1927 Name 01 Oecedent W. D~. lCIlIUR County "'<:tmarks: I"tt_"-rt.rwt TOTAL TAX CREDIT less five percenlum of tax if paid within three months ofter dote of deoth Plus Interest at the role of _'7cfrom to -'AJD Olf ACCOUllT- 'ITOO~[p[L~@li\[j'~ SEAL TOTAL AMOUNT PAID NOTE: Thl, Triplicate Receipt to be retained for .udlt purpoles. Received by NotE, In ac"pllng the transfer InherUance tax on luhue estohll, prior to the death 01 the life tenont or ttnanl for years. os evidenced by Ih.s reulpl, II 1$ understood Ihol Ihe Commonwealth sholl not be prlcluded or prevented Irom hereafter oueulng addlUonol InherUonce tax 01 Ihe death of the Ill. lenonl or tenanl lor years whenever It oppeors that such ..ddlllonal tax may be legally due ond collechblelor any ua.on whatsoever, I $ $ $ $ I $ $ 2,l.ftS.1G $ $ $ 2.145.10 Law Offices McCREA & DAVIS IOHN MoOnEA III HAMILTON C. DAVIS 22 B. mOil ST. NEWVJJ,I.I~, PA. 1724.1 (717) 771).3211 w. n. MeCREA (1808-1080) JOliN McCREA (t033-I07U W. n, MoOnEA, IlL (l038-'U76) McCUEA 4: MI.:CnEA (I038-Um. SALLY I. WINDEn 24 W. KINO ST. SUIPPENSnURO, PA. 1121S7 (717) 632.6713 September 9, 1980 ~ / -rO -~ U I ~rs. Mary Lewis, Register of Wills Cumberland County Courthouse Carlisle, Penna. 17013 Dear Mrs. Lewis: We file herewith the Inheritance Tax Schedules for the Estate of W. Earl Kerns. We calculate the tax as follows: Gross Estate consisting of personalty - $43,831.22 less Debts and Deductions of 8,079.59 Being a taxable estate of - $35,751.63 at the rate of 6% Lax payable is - $ 2,145.10 Thank you very much. Sincerely, McCREA & DAVIS -!YaJI~t C~~~ ~;~lton C. Davis HCD/vs Encs. INFORMATION To insure proper credit to your account, tho nama of the estate and file number should be clearly print- ed on the check or money order. This assessment is made in accordance with Section 708 of tho Inheritance and Estate Tax Act of 1961 (72 P,S, 9 2485.708), To the extent that inheritanCe lax is paid within three (3) months after the death of the decedent. a discount of five (5) percent is allowed (72 P,S, 9 2485.716), Inheritance TalC, other than tax on a future interest. is due at tl18 date of the decedent's death and becomes delinquent at the expiration of nine (9) months afler Ihe decedent's death (72 P,S. 9 2485.7111, Inheritance Tax on a future inlerest is payable within three (3) monlhs afler Ihe transfer lakes elfecl in possession and enjoyment and is delinquent thereafter (72 P,S, 9 2485-712), Calculate interest from Ihe delinquent date shown on the face of this form to the date of actual payment using the following interest table: --------------- ----- - - -------- - --- - ------------ - - --- - --- -------- -- - - - - - -- -- 1 month ,005 4 months ,D20 7 months ,035 10 months ,050 2 months ,Dl0 5 months ,025 8 months .04D 11 months ,055 3 months ,015 6 month~ ,D30 9 months ,045 12 months ,060 1 days ,00017 11 days ,00186 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 ,OD250 25 days ,0042D 6 days .00101 1 e days ,00267 26 days ,00437 7 days ,00118 17 days ,00284 27 days ,D0454 8 days .00135 18 days .00301 28 days ,00471 9 days ,00152 19 days .00318 29 days ,D0488 10 days ,00169 2D days .00335 30 days ,00500 -- ------------------- --- - --- -- --- --- - ---- --- ---.---- - - _.- --------- ----... Any partY in interesl, including the Commonweallh and the personal representative, not satislied with the assessment may object therelo within sixly (601 days after receipt of Ihis Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485-1001), Make check or money order payable to: "Register of Wills, Agent" Mail to Ihe address listed below: PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the following persons shall prepare and file a return: a. The personal representative of the estate of the decedent as to property of the decedent administered by him and such additional properly which is or may be subject to Inheritance Tax of which he/she shall have or acquire knowledge; b. The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Statute, including a trustee of property transferred in tfllS!, provided that no separate return need be made by the transferee of property included in the return of a personal representative. 2. PLACE FOR FILING The return is to be filed in duplicate w:th the Register of Wills Df the county wherein the decedent resided. 3. TIME FOR FILING 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. 4. FAILU RE TO FILE RETU RN Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report required of him. . .shall be personally liable. . .to a 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 are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife. son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others. 6. PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax. I F TAX IS PAl D WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAILURE TO PAY The taxes impDsed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's estate Dr against any property belonging to a transferee tiable for the tax. 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both. R~V.45 J. 11.801 COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "S" PERSONAL PROPERTY '* (Jnstwctiofls on RVIJt.'fS/J Sid{!) Estate of W. Earl Kerns ESTIMATED DEPARTMENT ITEM DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL YJ 1. Cash on hand $ 31. 61 2. Bank Accounts: Checking Account _ The First National Bank of Newville, Pa. 11052-354-2 W. E. Kerns 1,611.62 Savings Account - The First National Bank of Newville, Pa. 11052-354-2-20 principal 1,289.35 W. E. Kerns accrued into 12.03 Certificates of Deposit - The First National Bank of Newville, Pa. 052-354-2-61 Certificate #AR 1644 principal 30,000.00 W. E. Kerns accrued into 130.00 052-354-2-62 Certificate #434 principal 10,000.00 W. E. Kerns accrued into 274.75 3. 1 Share C. V. Coop. Stock 10.00 4. Medical Reimbursements 471. 86 TOTAL THIS PAGE $43,831. 22 1-3. fSI, .:U.J ~ REV;.452 ('.80) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT ESTATE OF _ W. Earl Kerns SCHEDULE "C" TRANSFERS INSTRUCTIONS: 1. Answer the questions on reverse side, 2. If the answer to any of the questions on the reverse side is "Yes," provide a description of the property transferred per Schedules "A," "B," or "E," its estimated market value at date of death, dates of transfer, to whom transferred and relationship of transferees tD decedent. Attach a copy of any trust deed or instrument relating to the transferred property. ITEM NO. DESCRIPTION ESTIMATED DEPT. VALUATION MARKET VALUE (OFFICIAL USEONLYj NONE TOTAL THIS PAGE N hI.b QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No".) 2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) - 3, If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy of death certi fi cate. c. Affidavit by the attending physician indicating lhe slale of decedent's health at time of transfer. d. Ail other informatiDn supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) b. What was the transferee's age at time of decedent's death? 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) - b. The right to designate the persons who shail possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) 6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) 8. Did decedent, at any time, transfer property, the broeficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) 9. If the answer to eight above is "Yes," was the power to aller, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) . REVr4S3 (1.S0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "D" BENEFICIARIES (Instructions on Reverse Side) Estate of W. Earl Kerns *' BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH Audrey M. Milspaw DauQhter Yes Sui Juris 1/3 Residue I Pauline A. Mains DauQhter Yes Sui Juris 1/3 Residue Rolter G. Kerns Son Yes Sui Juris 1/3 Residue I \ , i I i i , , , ----. i ( , " - . ! : - , I . ! i The above beneficiaries are living at this time except for the following: NAME J r DATE OF DEATH Rl!V-45~ (1-80) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "E" JOINTLY OWNED PROPERTY ~, wa (Instructions on Reverse Side) Estate of W. Earl Kerns P TOTAL E VALUE OF DEPARTMENT ITEM DESCRIPTION MARKET 'tE DECEDENT'S VALUATION NO. VALUE N INTEREST (Official Usa Only) T NONE , TOTAL THIS PAGE N 51u." M I1A' . (I INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be included. List wal estate first. 1. Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property as indicated in the instructions for Schedule "B". Include the name, address and relationship to the decedent of the co.owner (s) and the date the joint ownership was established. 2. Indicate the total market value of the jointly owned property. 3. Indicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest. t: "" 0 n 6 t"1 >- :E z ;1> 0 0 '" 0 - Cl n c: 0 -l Z 3: z t"' t"1 t"1 '" Z ;1> 9 9 t"' ;>;l Z z Z t"1 -l t"1 -l 9 9 -l ><: '" t"1 - '" Z 0 '" 0 -l 9 'r1 'r1 ;:<l ~ , ?:i 0 'rj - 'rj 0 - Z C"l - >- t"' c: '" t"1 0 Z t"' >< ><: >< ~ t"1 t"1 >- ;1> ;:<l ;:<l I I M ... ~ N ~ " ~ ~ M Z ~ ~ M 0 >' >' ~ ..: i'.1 r>:l p., rfJ 'tl \ ;:l ;?; M Q) ~ ~ "" M .-l . M " en 1 Q) - ~ l>l ~ \ u z - 0 I:. l>l '" I:. - Z U ..... ,"t 0 ~ ~ I:. 0 I:. \ lii 0 '" 0 z 0 - ~ '" >' ... 0 ~ B ~ ... ~ z z ::l 0 0 ~ ~ ~ \ z z 0 u ~ ~ ~ ~ 8 0 z '" ::l I ~ 0 ~ .1 I \ , , , , \ GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred IIY the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimabie including the cost of administration, attorn6Y fees, fiduciary lees, luneral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Retllrn is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule, A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. I i I I i t"" 'tI i::J n > t'1 ~ ~ z > 0 0 " 'Jl Z C'l n c:: i::J ~ z 3: t:: t'1 t'1 ~ Z :<I 9 - 0 Z Z t'1 ..., t:1 Z 9 9 ..., -< 'Jl t'1 - Vl Z 0 Vl 0 ..., 0 'Tl 'Tl ::<l ~ - 0 Z -< t'1 ~ -< tTl ~ ~ o 'Tl 'Tl - n - > t'"' c:: Vl tTl o Z ~ ~ INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amo~nt claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the per~cn \/I.'ho has assumed the responsibility for paying the debts.