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528
No, 21.80
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
BLANCHE K, STAZ
, deceased,
Mary C. Lewis
To nie""arel C. AAelerel3R, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
IS
Petitioner(s) are the execut 01'5 named in the Last Will and
Testament of BLANCHE K. STAZ dated JUNE 3. 1977
Decedent was a citizen of the United States and a resident of
~~Ai19
Borough, Cumberland County, Commonwealth
CAMP IIlLL
of Pennsylvania.
Decedent died on
AUGUST
day of
4th
,
~IONDAY
the
Stote of
A. D. 19~, in the County of CIJIoIBERLAND
PENNSYLVANIA at the age of 78 years.
~ )'Il!l)' her
Decedent has not been married and has not had children born to t!mQ
since the execution of the aboye described Will.
Decedent was possessed of personal property to the value of
$ ':8.500,00 and of real estate to the value of
$ 78 .900 .00
as near as can be ascertained; said real
495 COUNTRY CLUB ROAD
estate situated as follows
Ci\}W HILL, PENNSYLVANIA 17011
apply
Therefore, your petitioner(s) respectfully X>llI'Oi.~ for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated AUGUST 12, 1980 /r of.c,fj. l-G.
Name and address Rob rt K, Staz/9
of Petitioner(s)
Club Rd" Camp Hi11,Pa.
17011
Lew; sbe1'1'Y Pa. 17339
Pa. 1710B
Hamilton Bank/222 ~Iarket St" Hbg.,
(fbrmerlY Na"lonal Lentra!, Hank)
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COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
ROBERT K. STAZ, JOlIN ~1. STAZ, ,JR.. AND HAMILTON BANK (formerly Natioanl Central Bank)
named in above application, being duly SWORN according to law
say(s) that the statements set forth in this petition are true to the
best of THEIR knowledge ond belief. ~,I''''''l~- ~
SWORN and SU.bscribed before ~....e . sa.,
August 12 19 80 oh ~t. ta
mel
,-JJP,l1i t!. .~ d Il~"oo "ok (f.~," N'''.,,1 Co."ol Boo')
Ri~ &. p,:4;:', Register
fll.
Attorney:
Filed: August 13, 1980
~ (-!"o J6~
46.0
6/1/77
. ' -
LAST WILL AND TESTAMENT
OF
BLANCHE K. STAZ
I, BLANCHE K. STAZ, of Camp Hill, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do
make, publish and declare this to be my Last Will and Testament,
hereby revoking all wills and Codicils by me at any time made.
ITEM I:
All inheritance and estate taxes becoming
due by reason of my death, whether such taxes may be payable by
my Estate or by any recipient of any property, shall be paid
by my Executor out of the property passing under ITEM V of this
Will, as an expense and cost of administration of my Estate. My
Executor shall have no duty or obligation to obtain reimbursement
for any such tax paid by my Executor, even though on proceeds of
insurance or other property not passing under this Will. In the
absolute discretion of my Executor, my Executor may pay such
taxes immediately or may postpone the payment of taxes on future
or remainder interests until the time possession thereof accrues
to the beneficiaries.
ITEM II:
I hereby exercise all powers of appoint-
ment which I may have at the time of my death in favor of my
Executor, and all property subject to all such powers of appoint-
ment shall be included in my Estate and be governed by the provisions
of this Will. I direct further that my house be sold and the net
proceeds added to my Estate.
ITEM III:
I make the following bequests:
(al $1,000 in cash to the Camp Hill presbyterian
Church.
(bl To my son, ROBERT K. STAZ, the following
Page 1 of 9 pages.
(3) My antique brass urn and umbrella
stand with the lion's heads.
(4) My set of pyroceram dishes.
(g) To my only granddaughter, DIANE, my sterling
silver service.
(h) To my grandson, JOHN III, my bronze music
box from Vienna.
(i) To my grandson, ROBERT K., JR., my cuckoo
clock and the music box which plays the "March of
the Wooden Solders."
(j) To my grandson, PETER, my xylophone and
music book, and the birdcall music box.
(k) To my grandson, DAVID, my antique safe
and the music box which plays "Annie Laurie".
(1) To my grandson, DOUGLAS, the balloon bed-
room lamp and stuffed tiger and the "Seven Dwarfs"
music box.
(m) To my grandson, THOMAS, my bull and matador
figurines, and my twirling maypole music box.
(n) To those of my grandchildren who are
living on each Christmas following my death, my
antique sword and scabbard, initially to my eldest
grandchild, to be kept by him (or by his parents
while he resides with them) until the first Christmas
following my death. thence to my other grandchildren,
in turn, for one year each, in descending order of
age. thence again to the eldest and so on, my last
Page 3 of 9 pages.
759
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and one such share shall be added to each such
exi&tent Trust; provided, that if any of said
Trusts herein created has previously been terminated
by payment of its assets to or for the benefit of
its beneficiary, the beneficiary who received payment
of such assets shall be considered an "existent Trust"
for the purpose of this paragraph, and one such equal
share shall be paid directly to such beneficiary,
but only should he or she be then living.
ITEM V: All of the rest, residue and remainder of
my property, undisposed of in the previous portions of this Will,
I give, devise and bequeath, in equal shares, to those of my
sons, ROBERT K. STAZ and JOHN M. STAZ, JR. then living and those
of my said sons then deceased but represented by then living issue.
One of said shares shall be distributed to each of my then living
sons, and one of said shares shall be distributed, per stirpes,
to the then living issue of each then deceased son.
ITEM VI: No part of the income or principal of the
property held under the Trusts created hereunder shall be subject
to attachment, levy or seizure by any creditor, spouse, assignee
or trustee or receiver in bankruptcy of any beneficiary prior to
his or her actual receipt thereof. My Trustee shall pay over
the net income and the principal to the parties herein designated,
as their interests may appear, without regard to any attempted
anticipation (except as specifically provided in this instr~~ent),
pledging or assignment by any beneficiary under any Trust created
hereunder, and without regard to any claim thereto or attempted
levy, attachInent, seizure or other process against said beneficiary.
ITEM VII: In the settlement of my Estate and during
the continuance of the foregoing Trusts, my Executor and my
Page 5 of 9 pages.
7f.'l
Trustee of each Trust shall possess, among others, the following
powers to be exercised for the best interests of the beneficiaries:
(a) To retain any investments I may have at
my death so long as my Executor or Trustee may deem
it advisable to my Estate or Trusts so to do.
(b) To vary investments, when deemed desirable
by my Executor or Trustee, and to invest in such
bonds, stocks, notes, real estate mortgages or other
securities or in such other real or personal property
as IllY Executor or Trustee shall deem wise, without
being restricted to so-called "legal investments".
(c) In order to effect a division of the prin-
cipal of my Estate or for any other purpose, including
any final distribution of my Estate or any Trust,
my Executor or Trustee is authorized to make said
divisions or distributions of the personalty and
realty partly or wholly in kind. If such division
or distribution is made in kind, said assets are
required to be divided or distributed at their respect-
ive values on the date or dates of their division or
distribution.
Cd) To sell either at public or private sale
and upon such terms and conditions as my Executor or
Trustee may deem advantageous to my Estate or Trusts,
any or all real or personal estate or interest therein
owned by my Estate or Trusts severally or in conjunction
with other persons or acquired after my death by my
Executo~ or Trustee, and to consummate said sale or
sales by sufficient deeds or other instruments to the
purchaser or purchasers, conveying a fee simple title,
Page 6 of 9 pages.
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free and clear of all trust and without obligation or liability
of the purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the validity of said
sale or sales: also, to make, execute, acknowledge and deliver
any and all deeds, assignments, options or other writings which
may be necessary or desirable in carrying out any of the powers
conferred upon my Executor or Trustee in this paragraph or else-
where in my Will.
(e) To mortgage real estate.
(f) To make leases of real estate.
(g) To borrow money from any party, including
NATIONAL CENTRAL BANK, to pay indebtedness of mine
or of my Estate or Trusts, expenses of administration,
or inheritance, legacy, estate and other taxes.
(h) To pay all costs, taxes, expenses and
charges in connection with the administration of my
Estate or Trusts, and my Executor shall pay the expenses
of my last illness and funeral expenses.
(i) To vote any shares of stock which form a
part of my Estate or a Trust and to otherwise exercise
all the powers incident to the ownership of such
stock.
(j) In the discretion of my Executor or Trustee,
to unite with other owners of similar property in
carrying out any plans for the reorganization of any
corporation or company whose securities form a part
of a Trust or my Estate.
II
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Page 70f 9 pages.
7F-3
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(k) To assign to and hold in a Trust an undivided
portion of any asset.
ITEM VIII: Any person who shall have died at the
same time as Testatrix or in a common disaster with her, or under
such circumstances that it is difficult or impossible to determine
who died first, shall be deemed to have predeceased her. Any
person (other than Testatrix) who shall have died at the same time
as any then recipient of income or in a common disaster with such
beneficiary, or under such circumstances that it is difficult or
impossible to determine who died first, shall be deemed to have
predeceased such beneficiary.
ITEM IX: If at any time any minor child shall be
entitled to receive any assets hereunder, NATIONAL CENTRAL BANK,
Harrisburg, Pennsylvania, shall act as Guardian of the assets
payable to such child. Said Guardian may receive and admini.ster
all assets authorized by law and shall have full authority to
use such assets, both principal and income, in any manner said
Guardian shall deem advisable for the best interests of such child,
including college, university, post-graduate or other education,
without securing court order. Said Guardian shall have all the
rights and privileges as to the Guardianship(s) and the assets
thereof as are herein granted to my Executor and Trustee as to
my Estate and Trusts and the assets therein.
ITEM X: I hereby nominate, constitute and appoint
NATIONAL CENTRAL BANK, of Harrisburg, Pennsylvania, and ROBERT K.
STAZ and JOHN M. STAZ, JR., or the survivors of them, to be my
executors, herein referred to as my "Executor". My Executor,
Trustee and Guardian specifically are relieved from the duty or
Page 8 of 9 pages.
'.
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obligation of filing any bond or other security.
IN WITNESS WHEREOF, I have set my hand and seal to this
my Last Will and
Testament, consisting of this and the preceding
this -;11 I rei day of JJ Y1 G , 1977.
<<~fsf.t ~EALI
eight (8) pages,
We, the undersigned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament, in the
presence of us, who, at her request and in her presence and in
the presence of each other, have hereunto set our hands and
seals the day and year above written, and we certify that at the
time of the execution thereof, the said Testatrix was of sound
and disposing mind and memory.
(SEAL)
R.2:2:!W:~.~~::" q;
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7Acn.~~"'" D ~rn::.d (SEAL) Residing at: 3/ jJlv.A~_~ ef
T1urj,a" Vd'JJCf 1,0.... J7 0 'S"J-
Page 9 of 9 pages.
765
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....
CODICIL TO I\'ILL
OF
BLANCHE K. STAZ
I, BLANCHE K. STAZ, of Camp Hill, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do
make, publish and declare this to be a Codicil to my Last Will
and Testament, dated
I. An Item I A shall be added to my Will after Item I,
I~hich provides as follows:
I give all of my stock, both common and pre-
ferred, in East End Dairy Corporation, in
equal shares, to my two sons, ROBERT K. STAZ
and JOHN M, STAZ, JR., or the survivor of
them.
IN WITNESS WHEREOF, I have set my hand and seal to this,
a Codicil to my Last Will and Testament, this Ie.
day of
A-Ird
, 197r.
~~a."k A:~. (SEAL)
Blanche K. Staz
We, the undersigned, hereby certify that the foregoing Codicil
was signed, sealed, published and declared by the above-named
Blanche K. Staz as and for her Codic iI, in the presence of us,
who, at her request, and in her presence and in the presence of
each other, have hereunto set our hands and seals the day and year
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SECOND CODICIL TO IHLL
OF
BLANCHE K, STAZ
I, BLANCHE K. STAZ, of Camp Hill, Cumberland County, Pennsyl-
vania, being of sound and disposing mind and memory, do make, publish
and declare this to be the Second Codicil to my Last Will and Testa-
ment, dated June 3, 1977.
r.
ITEM III (a) shall be amended to read as follows:
"$1,000 in cash to the Camp Hill Presbyterian
Church" to be used for the purchase of bells for
the bell choir."
IN WITNESS WHEREOF, I have set my hand and seal to this, a
Second Codicil to my Last IViII and Testament, this I~ day of
April, 1979.
(f3Ia14~ ~ C?/'J3
Blanche K. Staz
(SEAL)
We, the undersigned, hereby certify that the foregoing Codicil
was signed, sealed, published and declared by the above-named
Blanche K. Staz as and for her Codicil, in the presence of us, who,
at her request, and in her presence and in the presence of each
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other, have hereunto set our hands and seals the day and year above
written, and Ne certify that at the time of the execution thereof,
the said Blanche K. Staz was of sound and disposing mind and memory.
WITNESS:
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residing at /79. llJ111U-:thJ~J~
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
This. ..,. ."..........,...........~~~~ ...........,..................... day of... ........ .... ......~~~.l;l.~~............ ................, A,D., 19~~,.,,'
~a~~ c. =8
before me R:.... . AI. , 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 .............,
.. ..................\~~~r:!:r...~:...~~.~.::E.~~~P.f......~.r.:...!......~~.~...c?~...................,....................................,..........................,
the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and
Testament of ....,',....,.,..,.~.~~~!~~..~:..,?~~~,......... ..........,...."..... ...................... Dated ......~~?7...~.!...~~.:.:.,........,.
lateof.................~.~P...!~.~.~~..~?:.?~.!\~.................................,.."..................... Cumberland County Pa., deceased
. . sworn d' I d d h he \ms
who bemg duly........................................... accor mg to aw, epose an say, t at .................,......................
present, and saw and heard the testa.~.::~~......................., .........~.~.~.:~~...~.:..~~~~.............,.........................
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 .............~~.7............................knowledge, observation and belief.
................!!~~:':.~................... and subscribed before
,...01I.U#n.l!..:.~~...........................
R:",L'4~a E. J.........u,~~gister
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND \
..';.,;'.t'.~
, W~,'lRobert K. Staz, John M, Staz, & Marshall J, House, Trust Representative .
.... ........... .......... ,..., ............................................................ '''fur '!lamr !:torr' 'l\'all'k"'( 'f"T11leTty"Nati:orrllft~~l)
.......................~.o/,9.m................ sayslthat as nearly as can be ascertained the said decedent ..........................
... ........................................ ....~.~.~~~:..~:...?::~~........,.................................................... ........ ........,..........died on
..............~!?!\~!\L..................,.. the .......1.r.~...................day of ..........~~.I~.~.~.~........................."..... A.D., 19..~~.,
at or about ,......................................... o'clock, ....M.
............................~~~,J?:............and subscribed this
...........................}.~~f1........... day of ..............~~9..':':st
19,E!Q....., before
Hamil ton Bank (forme rly National Cent ral Bank)
.....,~2et~..e., ~~,d.....................
RI",I.u..d E. .: ....~.., R%~~r
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. . ' Trust/ Representati ve
~",feN ll;ft;-
Robert . St
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John M
(Ii.amc 0); nom,,-' In .,j,.I.b ..(',n,o'Oto" ,oO/"'fiod) Pl' 17011
~UI Loum;ry ClUb Koaa, amp 11 , ennsy vanla
R. D. #2, Lewisberry, Pennsylvania 17339
222 Mar!@!; Street J;irrisburg. Pennsvl vania 17108
(Add,o,,) Robert K. 5taz,
NAME OF APPLICANT _.John M. 5taz. Jr,. lIamil ton Bank
r
COUNTY FILE NU BE DDRESS OF APPLlCA L 5 bo
ROBERT K, 5TA J M. 5TAZ, JR, HAM1LTON BANK
_ .,1 .J/
BUREAU FILE NUM R SIGNATURE OF APPt. N v: ~.k.t..,..J;UY-l' /l:v/,-,_
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF HIS APPLIc'~tT8 ~ w'llLH~l:\,.eBI:R~pi-esentative
CONSIDERED COMPLETE AND WILL BE RETURNED TO OU FOR COMPLETION. CO-EXECUTORS
. COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
DATE 09/18/80
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for coosent to Ihe tronsfer of Ihe following securities of 0 Pennsylvonio
Corporotion or 0 Nolionol Bonking Associolion located in Pennsylvania:
(a) 62 (b) Pennsylvania Power & Light Company (c) Common
(NOTE: In describing securities enler in (0), ab Ole, either the number of shares of stock or the face amount of
registered bonds, in (il), Ihe name of the issuing company and in (c) the closs of stock or Ihe sloled inlerest role
end maturity dote of registered bonds.)
ISSUED ON
various dates
1,178.00
, and having 0 TOTAL MARKET VALUE OF S
(Datu)
os of the dote of death of Ihe decedent,
, on
August 4, 1980
(Ooto of death)
Blanche K, 5taz
(Name of Decodent)
who was late of
495 Country Club Rl)ad, C3II1p Hill, Cumberland County, Pennsylvania 17011
(Street and Number)
(Po!:t Office)
(County)
(State)
The securities are registered os follows:
~Irs, Blanche K, 5taz
ADMINISTRATOR)
EXECUTOR )
Robert K, Staz
John N, 5taz, Jr.
Hamil ton Bank
(Nama)
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE /7J
CONSENT TO TRANSFER SECURITIES DATE~--6 ~J; /f'ftv
I hereby consent to the transfer of the above securities now registered in the name of the of ores aid
Decedent and waive Ihe filing of a certificate certifying to the poyment of the transfer inheritance tax to which
the propertl' of soid Decedent is mode subject pursuant to Ihe provisions of the Act of June 20, 1919, P ,L. 521,
as amended and the Act of June 15, 1961, P,L. 373, os amended, This is also in accordance with Ihe provisions
of the Act of April 9, 1929, P.L. 343,
This Consent to Transfer Ihe herein described properly operates only in reference to the estale of the
above-nomed Decedent,
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(County)
HCC-n tV-UI
COMMOtt'wEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVEIlUE
BUREAU OF COUIlTY COLLECTIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
DATE 09/18/80
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby mode for coosentto the transfer of the following securities of a Pennsylvania
Corporation or 0 Notional Banking Association located in Pennsylvania:
(0) 10 (b) East End Dairy Corporation (c) Common
(NOTE: In describing securities enter in (a), ob Ole, either the number of shores of stack or the face amount 01
registered bands, in (b), the nome 01 the issuing company ond in (c) the closs 01 stock or the stoted interest rote
and maturity dote of registered bonds,)
ISSUED ON various dates
,ond having a TOTAL MARKET VALUE OF S
0.00
(Dahil)
os of the date of deoth of the decedent,
Blanche K. Staz
, on
August 4, 1980
(Name of Decedent)
(Date of deoth)
who was late of
495 Country Club Road, Camp lIill, Cumberland County, Penns)'l vania 17011
(Street and Humber)
(Post OHice)
(County)
(State)
The securities ore registered os follows:
~Irs, Blanche K, 5taz
(tiJuno 0); nom.' in whJeb e".ili,a"tara rort',...,ed) Pl' 17011
~l~ LOUDery Club I<oaa, amp 111, ennsy vania
R, D, #2, Lewisberry, Pennsylvania 17339
222~~-Street,~rrisburg. PennsYlvania 17108
lAddren) Robert K, 5taz,
NAME OF APPLICANT _,John ~I. 5taz , Jr,. lIamilton Bank
COUNTY FILE ~~DRESS OF APPLlC NT 5
ROBERT K. 5TA JOHN M, 5T1\2, JR.
BUREAU FILE N M R SIGNATURE OF APPIL CANT B
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF I HIS APPLI ~O ~ ILL: ~'O~eB /igpresentati ve
CONSIDERED COMPLETE AND WILL BE RETURNED TO OU FOR COMPLETION, CO-EXECUTORS
Robert K, 5taz
John M. 5taz> Jr,
fl'lmil ton Bank
(t-lame)
ADMINISTRATOR)
EXECUTOR )
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ~ j"
DATE ',"
1 hereby consent to the transler of the above securities now registered in the nome 01 the loresaid /
/fflJ
Decedent and waive the filing of 0 certificate certifying to the payment of the tran~ler inheritance lox to which
the propert)' of said Decedent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
os amended and the Act 01 June IS, 1961, P,L. 373, os omended. This is 0150 in accordance with the provisions
of the Act of April 9, 1929, P,L. 343.
This Consent to Transfer the herein described properly operates only in relerence to the estate of the
obove-nomed Decedent.
Cf~. r.
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Signed for the Secretory of Revenu.e
By ~rC?-'~
.1 ;gno,", ~~~~..A-
(County)
. .
October 24, 1980
RE: BLANCHE STAZ ESTATE
Marshall House
Trust Department
Hamil ton Bank
222 Market Street
Harrisburg, PA 17108
Dear Marshall:
~~-"/
WALTER K. SWAHTZKOI'i", .JR.
401 NORTH fflONT SfFltE T
HARR.ISBURC, PENNSYLVA1'"^ 11101
(117) 234.8084
You have asked me for my oplnlon of the value of 10 shares common and
30 shares 4% cumulative preferred stock in East End Dairy Corp. owned
by the Blanche Staz Estate. The facts are as follows:
The common stock has no par value and the preferred par value is $300
per share. The common stock represents 1% of the voting stock of the
company. The preferred is non-voting. No dividends have ever been paid
on the stock.
There is no open market or exchange on which these shares are traded.
These shares are not subject to any restrictive sales agreements. The
corporation shows a deficit retained earnings position in its June 30, 1980
financial statements and a net worth of $39,470.00. There have been no
transfers of this stock, the corporation being family-owned. I am aware
of no other similar corporations to use as a comparable.
The condition of the industry is such that profit margins are thin. The 't
price of the raw material is government regulated for the purpose of keeping!
artificially high for the benefit of the farmers. The company can only
profit in high volume situations and it does not presently enjoy that status.
Based upon these facts and my knowledge of the business of the company as
its corporate counsel, it is my firm opinion that these shares have no
value. A 1% interest in a closely-held corporation is such a small minor-
ity interest that it lacks any ability to control or eyen influence corporate
actions. The non-payment of dividends negates the use of income to determine
value and makes the shares,' in my view, unsaleable.
~er ...~~~~
/~;-0~/-~it~
r~, tzkopf, Jr.
WK /chg - c: Staz
C"Mi.\ON ~AL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
t\PPLlCATlON (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for calsent to the transfer of the following securities of c Pennsylvania
Corporation or 0 National Banking Associotian located in Pennsylvania:
DATE
09/18/80
(a) 100 (b) East End Dairy Corporation (c) 4% Cumulative Preferred
(NOTE: In describing securities enter in (a), ab o.'e, either the number of shores of stack or the foce omount of
registered bonds, in (b), the name of the issuing company ond in (c) the class of stock or the stated interest rate
end maturity date of registered bonds,)
ISSUED ON 12/01/1972
,and having a TOTAL MARKET VALUE OF S_ 0,00
(Do'if)
as of the date of death of the decedent,
Blanche K, Staz
, an
August 4, 1980
(Name of Decedent)
(Dote of death)
who was late of
495 Country Club Road, Camp Hill, Cymberland County, Pennsylvania 17011
(Street and Number)
(Post Offico)
(Counlyl
(Stotc)
The securities are registered as follows:
Mrs. Blanche K. Staz
ADMINISTRATOR)
EXECUTOR )
Robert K, S taz
John M. Staz, Jr.
lIamilton Bank
(Nomo)
(tiol'W 0); nom.' ;n .,!>J,b ,,,,.Hlootato,a "rl"",ad) Pl' 17011
~~" LounJ:ry C1UD Koaa, amp ~H, cnnsy vanla
R, D, #2, LeNisberry , Pennsylvania 17339
222 ~Iarket Street. Harrisbur~ , Pennsvl vania 17108
(Add.a..) Robert K. Staz,
NAME OF APPLICANT John ~l. Staz. Jr,. lIamil ton Bank
-5' ;;,g' -
COUNTY FILE DRESS OF APPLlC
ROBERT K. ST JOliN M. STAZ, JR, IIAMIL)'ON BANK
BUREAU FILE NUMBER SIGNATURE OF APPL\ ANT ~ ",l/ f .f~"d-
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF. IS APPLIc'il.'tTd ~. ILL: l'lH~eBHg~resentative
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION, CO-EXECUTORS
COMMONWEAl.TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATE~ .It /f.fiJ
I hereby consent to the transfer of the above securities now registered in the name of the faresaid
Decedent and waive the filing of a certificate certifying to the payment af the transfer inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
as amended and the Act of June 15,1961, P.L. 373, os amended, This is also in accordance with the provisions
of the Act of April 9, 1929, P.L. 343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above-named Decedent,
Signe~1:zs:cretarY of Revenu
/. 1/ 'J
By /f,D f!..'. '/'r-<L/
~ (S.lgno a) ~.., // ~
__ tz r...-J _ ~:~!n~::!- _ ~<.
(11 ) ounty)
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HAMlLlON BANK
Post OffiCI Box 1071
Harri.burll. ""nnlYl..nl. 17108
1717123402711
Mary C, Lewis, Register of Wills
Cumberland County Court House
South Hanover Street
Carlisle, Pennsylvania 17013
Re: Estate Blanche K. Staz
Dear !>Irs; Lewis:
Hamilton Bank is acting as Co-Executor of the above named Estate. The decedent
died August 4, 1980.
Enclosed herewith is an Application for and Consent to Transfer the securities
as listed thereon, The Estate is not yet in a position to file the Pennsylvania
Inheritance Tax Return. The proper fonns will be filed in due course and what-
eyer Pennsylvania Inheritance Tax and/or Estate Tax is ultimately found to be
due, will be paid. '
If requested by the'Department of Revenue, we will file a bond in a fom
satisfactory to the Department of Revenue.
October 14, 1980
RTC/mIi1
Enclosures:
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'/'f.s-t5--~if.-tid~.f (,1."1
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HAMILTON BANK
Post O1fice Box 1071
Harrisburg, Pennsvlvanla 17108
(717) 234.2711
Mrs, Barkley
Cumberland County Register of Wills
Cumberland County Court House
South Hanover Street
Carlisle, PA 17013
Re: Blanche K, Staz estate
Dear Mrs. Barkley:
Enclosed please find the original and a copy of the First and Final Account
of the above-referenced estate. Also enclosed are the various Releases and
the Family Settlement to be filed in the Recorder of Deeds office. \'Ie are
requesting a recorded copy to be returned to us for our file. As you know
from our telephone conversation the other day we do not want the First and
Final Account frIed ,~ith the Court. A check payable to the Recorder of Deeds
is enclosed in the amount of $61.50, being $49,00 for recording the Releases
and First and Final Account and $12.50 for recording the Family Settlement.
If there is anything not included for the above purposes, please call me at
(17) 234-2755,
Thank you for your kind assistance in this matter.
Vert truly yours,
(Mrs.) Suzanne M, Knight
Trust Administrator
SKM/mm
May 4, 1982
Enclosures:
P.S, A copy of Blanche K, Staz's Will and Codicil to the Will and the
Second Codicil to the Will are also enclosed.
IN THE COUNT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO:
YEAR OF:
ESTATE OF BLANCHE K, STAZ, DECEASED
LATE OF BOROUGH OF CAMP HILL,
cmmERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
ROBERT K, STAZ, AND JOHN 101, STAZ, JR., AND
HAMILTON BANK (FORl-lERLY NATIONAL CENTRAL BANK)
AS CO-EXECUTORS
Date of Death
Letters Granted
First Complete Advertisement
of Grant of Letters
Account Stated To
August 4, 1980
August 13, 1980
September 19,_1980
December 31, 1981
SUMMARY & INDEX
PRINCIPAL
Pages
Receipts 2
Net Gain on Conversions 3
Adj usted Balance
Less: Disbursements 4-6
Balance Before Distributions
Distributions to Beneficiaries 7
Principal Balance Remaining
$ 154,906.47
4,458,37
$ 159,364,84
21,498,36
$ TIt, 86o:4S'"
79,510.48
$ 58,356.00
INCOME
Receipts
Disbursements
8
9
$ 11,718,62
10,924,06
794.56
$ S9,150.56
COMBINED BALANCE REMAINING
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"EXHIBIT "B"
COMPOSITION OF NET BALANCE
PRINCIPAL
CASH
$
56,00
58.300.00 $ 58,3S6,OO
SHORT TERM INVESTMENT FUND
INCOME
CASH
$
764.56
794.56
TOTAL INCOME AND PRINCIPAL--------______________________________$ 59.150.56
.i:"('~ P'''~ (',":"
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1981
Aug 19,
Sep 28,
PRINCIPAL RECEIPTS
The Accountant charges himself with the Inventory and Appraisement
as filed, $ 144,690.02
Also with the Following:
Refund on overpayment of 1980 Individual Income Tax
552.60
Refund, cancellation of General Liability Insurance for 495 Country
Club Road from Engle-Hambright & Davies
17.00
Interest on joint CCNB, N.A, Account #21429
Prd Jul 26, 1980 to Aug 4, 1980
145,30
Refund from CCNB, N,A. for safety deposit key when found
3.00
Transfers from income for reinvestment
9,498,55
TOTAL PRINCIPAL RECEIPTS-------------------------$ 154,906.47
:;cc;: iiJD PllCE 2LO
(2)
1980
Nov 17,
Nov 26,
Dec 3,
1981
Feb 4,
10 Shs,
Chessie Systems
Proceeds
Carried at
300 Shs,
International
Carried at
Proceeds
PRINCIPAL CONVERSIONS INTO CASH
Inc., CODUllOn
$ 394,53
339,38
Harvester Company,
$ 9,056.25
8,373.39
Common
100 Shs. Santa Fe Industries Inc, , Common
Proceeds $ 7,970,32
Carried at 5,981.25
200 Shs, Southern Railway Company, Common
Proceeds $15,390,67
Carri ed at 14 ,362,50
50 Shs. Tenneco, Inc"
Proceeds
Carried at
Common
$ 2,165,79
1,971.86
62 Shs, Pennsylvania Power & Light Company, Common
Carried at $ 1,178,00
Proceeds 1,028.14
533 Shs. Harsco Corporation, Common
Proceeds $18,405,62
Carried at 17,222,56
200 Shs. UGI Corporation, Common
Proceeds $ 6,079,21
Carried at 5,237,50
GAIN
$
55.15
1,989,07
1,028.17
193.93
1,183,06
841. 71
$ 5,291.09 $
NET GAIN TRANSFERRED TO SillWARY---------____________________$
~~':c: tJ8 PLGE 2f.),
(3)
LOSS
$
682.86
149. 86
832, 72
4.458,37
,
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I
1980
. Aug IS,
Sep 2,
Sep 10,
Sep 19,
Sep 30,
Oct 7,
Oct 22,
PRINCIPAL DISBURSEMENTS
Cwnberland County Register of IHlls
Letters Testamentary
Per Page Charge
10 Short Certificates
$
55.00
24,00
10.00 $
89.00
United Locksmith's, 2 keys to 495 Country Club Road,
Camp Hill, PA.
1.49
Cumberland Law Journal, Publishing Letters Testamentary
18,00
CCNB, N.A"
Payment for lost Safety Deposit Box Key -
Cwnberland County Register of Wills
4 Short Certificates
3,00
4,00
Anne F, Keller, Tax Collector
Personal Taxes
15.00
Joseph McGraw, Inc.,
Property appraisal - 495 Country Club Road, Camp Hill, Pa.
125.00
Hosiery Corporation of America
Balance due
4,40
Myers-Hall Funeral Home, Inc.
Funeral expenses
1,308.00
Harry Wimer, Appraiser
Appraisal of Personal Articles
40.00
P. M. Pinci,
Grounds maintenance at 495 Country Club Road, Camp Hill, Pa,
Mike Clark,
Removing Air-conditioning Unit
160.50
18.00
Raymond C, Grandon. M. D.
Professional services
279.00
William J, Daylor, Appraiser
Property appraisal - 495 Country Club Road, Camp Hill, Pa,
G. T. Watts, Inc.
Storage of Canopy
100.00
27,50
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(4)
1980
Oct 23,
Dec 31,
1981
Jan 9,
Jan 15,
Jan 21,
Jan 26,
Feb 26,
Mar 5,
Mar 17,
Apr 2,
Apr 10,
Apr 20,
Jun I,
Anne F. Keller, Tax Collector
1980 Real Estate Tax to COWltry Club Road
$
538.56
Landis Jewelers, Inc,
Jewelry appraisal
35,00
West Shore Times,
Publishing Letters Testamentary
19.81
Smith Glass Service,
Repair of windows - 495 Country Club Road, Camp Hill, Pa.
115.54
U,S.F. & G, Company
Homeowners premium
182,00
United Locksmith's Inc,
Purchase 2 door keys to 495 Country Club Road, Camp Hill, Pa,
Cumberland County Register of Wills
1 Short Certificate
1.91
1.00
Anne F. Keller, Tax Collector
1981 Real Estate Taxes on 495 Country Club Road, Camp Hill, Pa.
232,85
Engle-Hambright & Davies
Liability insurance premil~ on 495 Country Club Road, Camp Hill, Pa,
29.00
PA Department of Revenue
1980 Individual Income Tax
155,94
Internal Revenue Service
1980 Individual Income Tax
689.00
Brackendorf Memorials
Balance due
38.00
Cumberland County Register of I~ills
PA Inheritance Tax
8,000.00
Master Creditors Bureau
Retrieval for Hosiery Corporation of America
4.40
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(5)
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1981
Jun 10,
Pealers Flower Shop,
Altar Flowers
Nov 17,
$
21.20
Federal Fiduciary Income Tax
Pennsylvania State Fiduciary Income Tax
84.19
Patriot News Company
Advertising Real Estate, Prd, Oetober 1980 to Jan 1981
Pennsylvania Power & Light Company
Electric service to 495 Country Club Road, Camp Hill, Pa.
Prd. September 1980 to August 1981
98.22
214,97
Riverton Consolidated Water Company
Water service to 495 Country Club Road, Camp Hill, Pa,
for quarters ending September 1980 to June 1981
107.31
53.02
Walter K. Swartzkoff, Jr., Esq., Attorney's Fee
2,894.52
Hamilton 8ank, Executors's Fee
5,789.03
TOTAL PRINCIPAL DISBURSEMENTS----------____________$21,498,36
l. ;'''. PI C- .?",'O
eOCK ".~..J I t _
(6)
..-.-..".--........-.........-.... ........--.....-...-.
1980
5eP23,
Oct 6,
Oct 23,
Nov 18,
Dec 2,
Dec 11,
Dec 16,
INCOME RECEIPTS
Interest
U. S. Treasury Bills
$ 4,000.00 due 1/8/1981
$
115.06
Short Term Investment Fund
Prd. Dec 1980 to Dec 1981
10,339.75
U. S. Government Securities Fund
Prd. Oct 1981 - Nov 1981
35.37
Dividends, Common Stock
200 Shs, Southern Railway Company
200 Shs, UGI Corporation
62 Shs, Pennsylvania Power & Light Company
300 Shs. International Harverter Company
533 Shs, Harsco Corporation
100 Shs. Santa Fe Industries Inc,
50 Shs. Tenneco, Inc.
10 Shs, Chessie Systems, Inc,
200 Shs. Southern Railway Company
184.00
88,00
32,86
187.50
266.50
65,00
62,50
6,40
184 ,00
1981
Jan 8, 200 Shs. UGI Corporation
88,00
1,164.76
Miscellaneous
John M. Staz Marital Trust, Final Income Distribution
19.33
Transfer from Principal to pay Federal Fiduciary Income Tax
44.35
TOTAL INCOME RECEIPTS-------------_______________$ 11,718.62
'-r' J",.t,p'o- G-:::;
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INCOME DISBURSEMENTS
1981
Feb 3,
Transfers to Principal for investment
9.498.55
$
Pennsylvania Power & Light, Electric service. 495 Country Club
Road, Camp Hill. PA.
4.08
Sep 10.
Pennsylvania Power & Light, Electric Service, 495 Country Club
Road, Camp Hill, PA.
Federal Fiduciary Income Tax for year ending 7/13/1981
1 , 196. 36
8,05
. Nov 17.
Pennsylvania Department of Revenue, Fiduciary Income Tax for
year ending 7/31/1981 125.53
Hamilton Bank Commission to 3/10/1981 91.49
TOTAL INCOME DISBURSEMENTS-______________________$ 10,924,06
BOCK L:U pm 2;:3
SCHEDULE OF DISTRIBUTION
Balance for distribution, as per First and Final Account
Da ted December 31, 1981:
Hamilton Bank, Trustee under the Will of Blanche K. Staz,
Under Item 5, Trusts for the Grandchildren:
$ 59,1S0,56
Di ane Staz
John M. Staz I II
Robert K, Staz, Jr,
Peter Staz
David Staz
Dougl as Staz
Thomas Staz
$3,000
3,000
3,000
3,000
3,000
3,000
3,000
$21,000,00
Camp Hill Presbyterian Church, Bequest under
Item III of the Will 1,000.00
Robert K, Staz, One-half Residue, as per
Item V of the Will 18,575,28
John M, Staz, Jr., One-half Residue, as
per I tern V of the Wi 11
111,~7~.2R
$ 59,150,56
,., II 'J':')! '. '7 1)'''';-
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ft:i:..'I't~ ,. ,,,",,,,," ",."", .,,' "<'.br4~"""-';!""'
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Inventory of the real and personal estate of
BLANCIIE K. STAZ
deceased.
100 Shs, Santa Fe Industries, Inc" Common
Accrued Dividend
I 339, 38
6, 40
\ 17,222, 56
266. 50
9,056, 25
5,981..25
65, 00
1. 10 Shs, Chessie System, Inc, Conunon
Accrued Dividend
2, 533 Shs, Harsco Corporation, Conunon
Accrued Dividend
3. 300 Shs, International lIarves ter Company, Common
4.
5.
6,
7.
8,
9,
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
200 Shs. Southern Railway Company, Common
.I
1l
" 14, 362, 50
11 1,971. :\' 88
II ,.
!, 1,178. 00
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Ii 5,237.150
I' ,
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!I 2.04 7 '13~
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! 4,000,100
i .!
i 168.100
i I
I 7. 29
50 Shs. Tenneco Inc., Common
62 Shs, Pennsylvania Power & Light Company, Common
200 Shs, United Gas Inprovement Company
10 Shs. East End Dairy Corporation, Common
(Deemed worthless - See attached)
100 Shs. East End Dairy Croporation, 4% Cum Pfd.
(Deemed worthless - See attached)
Proceeds from Hamil ton Bank Che cking AccolUlt #66324796
(Date of death Balance $3,239.84 less outstanding checks)
Proceeds from Cumberland County National Bank, Certificate of Deposit
#F-38976, matured prior to death
Reimbursement, Capital Bl ue Cross Claim
Refund of credit balance from Bell of Pennsylvania
II
I 71. 20
I! 1
Ii 5.550. i 20
I! I
11 28.4, 80
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Refund from cancellation of Reader's Digest subscription
7. 28
Refund from Dr, Raymond C, Grandon due to over-payment of bill
Jewelry and Sterling Silver FlatNare (See attached appraisal)
Additional reflUld from Dr, Raymond C, Grandon
Proceeds, Hamil ton Bank, Surviving Trustee under tl'e Will of John ~I. Staz
(Marital Trust)
2.951. 38
Miscellaneous furniture and household items as specific bequests, as per
copy of attached appraisal
835. 00
Proceeds sale of remaining household effects
939, 77
Present Value, 495 Country Club Road, Camp Hill Borough, Cumberland Count ,
PA" a 2 bedroom, two-story aluminum and stone d\~el1ing \~ith a one (1)
car attached garage, on property further described as recorded in Cumbe
County Deed Book H, Vol. 13. Page 220 on July 15, 1946 - Sold July 30,
This property \~as sold under a Sales Agreement
with Robert J, and Edna L. lIynick at the purchasing
price of $75,200, payable as folloNs,
Sales Price
Less Down payment
$ 75,200,00
15,200.00
$ 60,000.00
and
181
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The delay in receiving the full payment lUlder the
attached Articles of Agreement requires that the
unpaid balance be diSCOlUlted to determine present worth:
$60,000,00 - Principal Value
14% - Interest
25 year - amortization-$722.36/mo x 36 mo. :
Balloon 10/01/1984
$ 25,012,93
59,011,57
$ 84,024.50
(Cont'd Page #2,)
I'
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,
COMMONWEALTH 01' PENNSYLVANIA t
COUNTY 01' CUMBERLAND J
ss:
....,
being duly sworn according to law, depo.e. and says that th,y __Exel:lllar:i-
of the Estate of Jlaru:lllLKJtaz
late of the Borough of Camp Hill. , Cumberland County, Pa.. deceased and thet the
within is an inyentery made by _._-1lamilton-Il>llllL--- ,---'-' the said Co-Executor
of the entire estate of said decedenl, consi.ting 01 all the personal proparly and real eslate, except real eslole outside
Ihe Commonwealth of Penn.ylvania. and that the figures opposite eo it'W' of th nv resent it's fair value
os of the dale of decedent's dealh. -(;~, -" Robert K,
We, Robert K, Staz, and John ~1. Staz, ,Jr,. and Peter ^. 5c111~iers, Vice President of
Hamil ton Bank
-----..--------.---------
-O-{)JtUafl ai, _19 r,}
~jll lQ. '. JOj-!1J.M/d...-
.'~ .'~.',".....". ,";
John M.
.,
"
H:noric:hllrg, P^ 17101
Addr."
\.:
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1r'
Dale of Death
4th
Day
Augus t
Month
1980
Y..r
INSTRUCTIONS
I, An invenlory must be filed within three months after appoinlment of personal representotive.
2, A supplemenl inventory must be filed within thirty days of discovery of additional assets.
3. Additional .heets may be attached as to personalty or realty
4, See Arti~le IV, Fiduciaries Act of 1949,
:l
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Inventory of the real and personal estate of
BI.A.'lCIlE K. STAZ
deceased
Page #2.
Discotmted by current rate
$60,000.00 at 16% for 36 months - Interest
Principal
$28,800.00
60,000.00
$88,800,00
$88,800.00
84,024.50
$ 4,775.50
- at current 16% (less)
- at sales agreement rate
discounted by an annualized rate
of 16% = $3,059.46
$7S,200.00 (less)
3,059.46
$72,140,54
$ 72,140.54
TOTAL INVENTORY OF TIlE REAL AND PERSONAL ESTATE OF BLANCIlE K, STAZ $ 144,690.02
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEOENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
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Estate of IlLANCIIE K. STAZ Date of Death08/04/l9S0 FileNo,,:::?/-;tt)-5~(?
WHEN CLAIMING THE FAMIL V EXEMPTION, COMPLETE THE FOLLOWING:
Claimanl
RdaliolJ:ihip 1(, [)ccf'C!rnt
Claimant's Address at time of Decedent's Deatll
ITEM .- u I
NO. OATE NAME OF PAYEE REMARKS AMOUNT
1 \n~98~ TM' _ "'hnma~ LPN Pri vate dutv care for 88 hours, .Jul 2 ,
1980 to Aug 4, 1980 for Illanche K, St IZ 620.00
, ano 10 1>_0; ~~...,. t'li 11 ~ r'lmb-rland Countv Letters Testamenta rv S 55,00
Per lla~e charRe 24.00
In Shn"~ r...,.ti ficates 10,00 89,00
3. Seu 2, United Locksmiths 2 keys made for 495 Countr)' Club Road 1.49 ,
4, Seu 4. PA Power & Li~ht Comllan)' Electric service - 495 Countr)' Clud R . 35,33
S C:_n 1n ,,.1 ~nrl ronntv L3I~ Journal Pub Ush Letters Testamentarv 18,00
6. Sep 19, Register Wills Cumberland Count)' 4 Short Certificates 4,00 .
7, Sep 23, Riverton Consolidated I~ater Co, 'mter service 495 Countr)' Club Road 12.68
8. Seu 30, Anne F. Keller,Tax Collector Camp Hi 11 School District Personal Ta x IS,OO
Q T..."an" Tnr Annraisal of real estate 125.00
1n U"'", __. 'M ...~ ^~..._'^. Bil] nast due 4.40
. a
11 ... _H~11 Hnm... Funeral exnense 1 308,00
12. HarT'V M. I~imer Annraiser Annraisal of contents of Home 40,00
13, Mike Clark Move air conditioner 18,00
1A P. M. D'n...' Trim shrubberY & haul trash 160.50
, " G' ... . ~, 1'1 Professional services 279,00
1/'; nr~ 3, PA PO\~er F. Li~ht Comnanv Electric service 495 Country Club Rd 18.93
17. Oct 7, William J, Daylor Appraisal of real estate 100.00
18. Oct 14 Patriot-Ne\~s Comnanv Advertising real estate 18,72 I
19. Oct 17 Patriot-News Companv Advertising real estate 15.12
20. Oct 22 G, T. Watts Storage & removal of ahnings 27.50
I I
CONT D PAGE # 2, TOTAL I
I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral
expenses and expenses of administration submitted to the estale as deductions for Inheritanc& Tax purposes.
SIGNATURe OF FIOUCIARY
DATE
OFFICIAL USE ONL V
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $
AT
% TAX RATE
R(GISTE:':U OF WILLS
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the decedent prior to his/her deoth ore deductible ogainst his/her taxable
estate. In addition to debts incurred by the decedent or estate, ather items are c10imable including the cost of
administration, attorney Ices, liduciary fees, funeral and buriol expenses including the cost 01 a burial lot, tombstone
or grave marker and other related burial expenses.
All debts being claimed against an estate arc subject to the opproval 01 the Register 01 Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being
c10imed should be ottached to this schedule.
A lamily exemption may be c10imed by a spouse 01 a decedent who died domiciled in Pennsylvania. If there is
no spouse, or il the spouse has lorleited his/her rights, lhen any child 01 the decedent who is a member 01 the same
household can claim the exemption. In the event there is no such spouse or child, the exumption can be claimed by
a parent or parents who ore members 01 the same household as lhe decedent. The lamily exemption is allowable only
against assets which pass by 0 will or by the Pennsylvania Intestate Laws,
NOTE: Compensation paid to on estate representative; namely, an executor or administrator, lor services
perlormed in administering an estate is reportable lor Pennsylvania Income Tax purposes. This taxable income
item should be reported on lorm PA.40.lndividuallncome Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the lamily exemption is being claimed, indicate the claimant's name, address and his/her relationship to
the decedent. Enter "Iamily exemption" in the remarks column ond the amount 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 explanotion in the remarks column lor each debt claimed,
6. Enter the amount of each debt being claimed,
7. The form must be signed by the person who hos assumed the responsibility lor paying the debts,
IF ADDITIONAL SPACE IS NECESSARY USE 8ll" x 11" SHEETS,
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COMMONWEALTH OF PENNSYLVANIA
DEPARYMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
Estate of BLANCIIE K. STAZ Dale of Dcatl1Aurllst ,I, 19snilc No.
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Relationship to DeccUUr1t
Claimant's Addre~s at time of Decedent's Death
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
" Oc;9~~ Anne F, Keller Tax Co 11 ector Canm lIil1 Schon 1 ni str; c" n.n1 r:sta"~
taxes on 4~5 Countr,' Cluh Haad 538,S6
22. Oct 24 Patriot-News Comnanv Advertisinr Ileal Estate I 1R,7/
23. Nov 3, Patriot-Nel~s Company Advertising Ileal Estate 18.72
24. ,PA PO\~er & Light Company Electric service 495 Count1'\' Club Rd. 14,49
25 Nov 21 Pat riot-Ne\~s ComDanv Advertisinr llen1 I=sta..~ ,.r. d~
26. Dec 10, A POI~er & Light Company Electric service 495 COlUltry Club Rd, 11. 23
27. Dec 23, ~iverton Consolidated Water Co, I~ater service 495 Country Club Road 13,83
28. Dec 31 andis J~"ele~o ;nn ~ ;00' TA',,-'_.. .< nn
I ,!?810 H
'^ n_" , "_L~ ,
29. I~, .A_ . _L,' n, _ on
-
30. Jan 9 ~est Sho~~ 1';m~o P"n1; ol1;no I.~t._-- - . ,n 0'
,
31. Various iamilton Bank Comm;sdnn nn <:0' AO AQ<: <7
32. SeD 3, Stuard Derrick Real Estate Broker I s Commiss ion on Sale of 495
Countrv Club Iloaa 5 2/id.00
33. Sep 3, \nne Keller, Tax Collector 1981-1982 Real Estate School Tax 538.56
34. iamil ton Bank Executors fee 5,789,03
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TOTAL I .~llLQd<:,Od
y knowledge and belief the foregoing is a just and true statement of debts, funeral
ti sub t d to the estate as deductions for I nheritance Tax purposes.
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r "R f I _ f" DATE'
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S
AT
% TAX RATE
REGISTER OF WILLS
l'';Tr.
GENERAL INHERITANCE TAX INFORMATION
,
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible ogainst his/her taxoble
estate. In addition to debts incurred by the decedent or estote, other items ore claimable including the cost of
administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of 0 burial lot, tombstone
or grove marker and other related burial expenses.
All debts being claimed against on estate ore subject to the opproval of the Register of Wills with whom the
Inheritance Tox Return is filed, Evidence ,to support the decedent's or the estate's liability for the debts being
claimed should be ottached to this schedule,
A family exemption may be claimed by 0 spouse of 0 decedent who died domiciled in Pennsylvania, If there is
no spouse, or il the spouse hos forfeited his/her rights, then any child 01 the decedent who is 0 member 01 the same
household con claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by
o parent or parents who ore members of the some household os the decedent, The lamily exemption is allowoble only
against assets which pass by a will or by the Pennsylvania Intestate Lows,
NOTE: Compensation poid to an estate representotive; namely, on executor or administrator, for services
perlormed in administering on estate is reportable lor Pennsylvonia Income Tax purposes. This taxable income
item should be reported on form PA.40-lndividuallncame Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
: !
1. If the lamily exemption is being claimed, indicote lhe claimant's nome, address and his/her relationship to
the decedent. Enter "family exemption" in the remarks column and, the 'lm,punt claimed in the amount column.
2. Assign consecutive numbers to each item listed, \ '.
3. Enter the dote on which each debt was incurred and/or paid,
4. Enter the names 01 each payee.
5. Provide 0 brief explonatian in the remarks column lor eoch debt claimed,
6. Enter the amount of eoch debt being claimed,
7. The form must be signed by the person who has assumed the responsibility for paying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE BW' x 11" SHEETS,
, ::OMMOtlWEALTH OF PENNSYLVAIIIA
DEPARTMENT OF REVENUE
EUREAU OF COUNTY COLLECTIONS
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act 01 Moy 28, 19S6, P.L. 1757, ond Act of Juno 15, 1961,
P.L. 313, os amended)
Application Is horoby filod far tho approval
of an exemption from Pennsylvania Transfer
Inheritance Tox on the tronsfC!f of the property
doscribod bolaw:
1. BuroauFilo~ ~/-~{)-5.;;/?
2. Dato of Doath ~August 4 , 1980
3. Dato of Approval ~~ -1~ /fll".:z
'N fD d BlanGf{e K. Staz
<t. orne 0 ece ent
5. The Commonwealth's appraised value of the property f", which an exemption is claimed is S 1 )000 .00
(Note: Where the property is other thon a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by ~pprQi501 by the Commonwealth, except in thosc cases where the amount of the gift
or bequest represents a stated fractional or percentage portion 01 the entire estate or the entire residue. In those cases
enter such fructional or pcrcentag6 amount obove).
6. Check the manner in which the transfer was effected and submit a copy af the document authorizing the transfer, unless
such material has been previously filed.
WILL:tV;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If othor, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Camp Hill Presbyterian Church
ADDRESS
23rd and Walnut Street, Camp Hill, Pennsylvania 17011
o See listing on reverse side ror additional charitable organizations covered,
8. I certify that the information contained herein is, to the best kn wledge an belie
ROBERT K, STAZ
919 Count!'y Cl b
JOliN M, STAZ, JR.
R, D. #2, Lewisii
Addross of Applicant _ HAl-IIL TON BANK Co xecutors Estate Blanche K. Staz
222 Market Street, Harrisburg, Pennsylvania 17108
By: --::?';j:t,,~~~1 j', .;:::..,,"- ~larshall J. House
Official Titlo Trust Representative (/ Date 09/1 R/RO
Signoturo of Applicont
d correct.
syl vania 17011
This form must be complated In triplicatc and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which lelters were issued for a non-resident decedent's estate. If the decedent was 0 non_resident of Pef1nsylvonla and
letters wero not Issued by a Pennsylvania Register of Wills, deliver alllhree copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not writo below this lino - For Official Uso Only
For the Secretary of Revenue REFERRED to Bureau Headquarters
Approvod 0
For Secretary of Revenue
Den i ed. 1..7
(Initials of Rogistor of Vlills)
(Authorlzod Signaturo)
(County)
(Titlo)
(Doto of Roforral)
(Dato of Action)
" See reverse side for rco~ons
MUST BE FILED IN TRIPLICATE
This soctlon will bo comeloled ~r. Bureou Hoadquorte.. only when tho application far oxemptian has been denied,
Date:
Tho application for exomptlon contained on tho faco of this farm has beon denied because
Hotel Any party In intore.t. including tho Commonwealth. aggriovod by this action may within sixty (60) day. altor
tho doto of this notice exercise their rights of Protest, Hotice, or Appeal in accordance with the provisions of applicablo
Pennsylvania Inheritance and E.tate Tax Acts.
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COMMONWEAL TH OF P ENNSYL VANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
ESTATE OF BLANCHE K, STAZ
(Instructions on Reverse Side)
ITEM
NO.
DESCRIPTION
1. Present Val ue, 49S COWltry Club Road, Camp Hill Borough,
Cumberland County, PA., a two (2) bedroom, two-story
aluminum and stone dwelling with a one (1) car attached
garage, on property further described as recorded in
Cumberland County Deed Book 11, Vol. 13, Page 220 on July
15, 1946 - Sold July 30, 1981
This property was sold Wlder a Sales Agreement Idth
Robert J, and Edna L, Hynick at the pruchasing price
of $75,200,00, payable as follows:
Sales Price
Less Down payment
The delay in receiving the full payment
under the attached Articles of Agreement
requires that the Wlpaid balance be
discoWlted to determine present worth:
$60,000.00 - Principal Value
14 % - Interest
2S year - amortization =
$722.36/010 x 36 mo.
Balloon 10/01/1984
DiscoWlted by current rate
$60,000.00 at 16% for 36 months _
Interest
Principal
$75,200,00
15,200,00
$60,000.00
$25,012.93
S9 ,OIL 57
$84,024.50
$28,800,00
60,000.00
$88,800.00
$88,800.00 - at current 16% (less)
84,024.50 - at sales agreement rate
$ 4,775,50 - discoWlted by an annualized rate
of 169, = $ '3,059.46
$75,200.00 (Less)
3,059.46
$72,140.54
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If additional space is necessary, use all" x 11" sheets.
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TOTAL
ESTIMATED
MARKET
VALUE
$ 72,140.54
$ 72,140.54
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DEPARTMENT
VALUATION
(OFFICIAL USE ONL Yi
SCHEDULE "B"
PERSONAL PROPERTY
tH::V"4" ~Xt Ul..eO)
COtM.IONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE ,AX
RE~DENT DECEDENT
Estate of
(Instructions on Reverse Side)
BLANCHE K, STAZ
DESCRIPTION
UNIT
VALUE
1. 10 Shs. Chessie System Inc" Common 33,9375
Dividend on above @ $.64 per share payable
9/2/80 to shareholders of record 8/1/80
2, 533 Shs, Harsco Corporation, Common 32.3125
Dividend on above @ $.50 per share payable
8/15/80 to shareholders of record 7/15/80
3, 300 Shs, International Harvester Company, Common 30.1875
4, 100 Shs. Santa Fe Industries Inc", Common 59.8125
Dividend on above @ $.65 per share payable
9/2/80 to shareholders of record 7/22/80
5. 200 Shs. Southern Rai lI~ay Company, Conunon
71. 8125
6. 50 Shs, Tenneco Inc, , Common
39,4375
7,
62 Shs. Pennsylvania Power & Light Company, Com 19.0
200 Shs. United Gas Improvement Company 26.1875
10 Shs. East End Dairy Corporation, Common
(deemed worthless - see attached)
100 Shs, East End Dai ry Corporation 4% CtnD, Pfd.
(deemed worthless - see attached)
8,
9,
10,
11.
Proceeds from Hamilton Bank Checking Accooot
#66324796
12.
Proceeds from Cumberland Coooty National Bank,N.
Certificate of Deposit #F-38976
(matured prior to death)
13,
Reimbursement claim from Capital Blue Cross
14,
Refund of credit balance from Bell of Pennsylvan a
15,
Refund from cancellation of Reader's Digest
16.
Refund from Dr, Raymond C. Grandon for overpayme t
, of bill
Cont I d on Page #2,
TOTAL
II additional space is necessary, use B\," x 11" sheets.
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ESTIMATED
MARKET
VALUE
339.38
DEPARTMENT
VALUATION
[OFFICIAL USE ONL Yl
6,40
17,222.56
266,50
9,056.25
5,981.25
65.00
14,362.50
1,971. 88
1,178.00
5,237.50
-0-
-0-
2,047.34
4,000.00
168.00
7.29
7.28
71.20
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COMMONWEAL TH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
TRANSFER INHERIT ANCE TAX
RESIDENT DECEDENT
Estate of
ITEM
NO.
, 17.
18.
19,.
20.
21.
22.
SCHEDULE "B"
PERSONAL PROPERTY
~rA
'~t~
~.
(Instructions 011 RCVIJrSO Sido)
RI.ANr.JIF. K STAZ
OEseRI PTION
UNIT
VALUE
ESTIMATED
MARKET
VALUE
DEPARTMENT
VALUATION
{OFFICIAL USE ONL Yl
PAGE 1/2,
Jewelry: See attached appraisal
Lady's oval diamond cluster
Bangle bracelet, gold-filled
Bangle bracelet, gold-filled
Lapel-pin Waltham watch
Hunting case Elgin watch
Lady'S diamond ring, yellow gold
Class ring, yellow gold
Bar Pin, six diamonds
Pendant, yellow gold
$4,600,00
2.50
2,00
15.00
25.00
27.00
24.70
160.00
160.00
5,016.20
Proceeds from Hamilton Bank, Surviving Trustee
of the John M, Staz Marital Trust
2,951. 38
Chest of sterling silver flatware
534.00
Miscellaneous furniture and household items
as specific in-kind bequests, as per copy
of attached appraisal
Proceeds from sale of remaining contents of home
835,00
939.77
Additional refWld from Dr, Raymond G, Grandon
for overpayment of bill
284.80
TOTAL $ 72,549.48
If additianol space is necessary, use 8\2" x 11" sheets,
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, witt:in two years of death, make any transfer of any material part of his estate without receiving
valuable and adequate consideration? (Answer "Ves" or "No",) 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 "Ves" or "No".) -1!Q....
3, If the answer to one or two above is "Ves" and the transfers are claimed to be nontaxable, provide the following
information:
a, Age of decedent at time of transfer. N/ A
b, Copy of death certificate,
c, Affidavit by the attending physician indicating the state of decedent's health at time of transfer,
d, All other information supporting nontaxabililv 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 "Ves" or "No",) 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 "Ves" or "No".) Nn
b, What was the transferee's age at time of decedent's death? Il,'A
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 "Ves" or "No" ,) NI A
b, The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Ves" or "No",) NO
6, If the answer to five b, above is "Yes," was the right reserved in decedent alone ( ) or decedent and 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 "Ves" or "No".) NO
8, Did decedent, at any time, transfer property, the bmeficial 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 "Ves" or "No".) NO
9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved
in the decedent alone ( ) or decedent and others ( ),
"
"
i
. REV-453 EX1 00.1301
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE D
BENEFICIARIES
(tnstnlctionr on Reverse Side)
Estate of
BLANCHE K. STAZ
Cam Hill Presb terian Church
North 23rd & Walnut Streets
PA 17011
N/A
DATE OF
BIRTH
N A
INTEREST OF BENEFICIARY
BENEFICIARIES AND ADDRESSES
RELATIONSHIP
SURVIVED
DECEDENT
Charit
$1 000,00 Be uest
Staz
Cl ub Road
Daughter-in-lal~
Yes
08 08 1934 ~Iiscellaneous furnitur
f, household items:
41S.00
9
02 23 1938 Miscellaneous furnitu
& household items,
$115.00
~
Hilda Tavlor
Friend
Yes
Unknown
Miscellaneous
items: 40.00
Diane Staz
R.O.#2
Grandaughter
Yes
03 10 1971 Sterlin Silver
Bat\'l.are_Ll/~th
John M, Staz III
R.D,#2
Lewisberr . PA 17339
Grandson
Yes
~Iusic Box &
interest in
$17.14
Staz Jr.
Cl ub Road
PA 17011
Grandson
Yes
01 21 1965 Cuckoo Clock
Box & 1/7th interest
in Sword: 32.14
e #2
The above beneficiaries were living at the time of the decedent's death except for the following:
NAME
DATE OF DEATH
If additional space is necessary. use 8W' x "" sheets.
REV-453 EX+ (10.S0)
COMMONWEALTH OF PENNSVLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE D
BENEFICIARIES
."*'
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(Instructiont on Reverse Side)
BLANCHE K. STAZ
BENEFICIARIES AND ADDRESSES
RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
Grandson Yes 03/10/1971 Xylophone & Music Box
& 1/7th interest in
S\~ord: $47,14
Grandson Yes 01 30 1966 ~lus i c Box 17th
interest in Sword:
Peter Staz
R,D,"2
Lewisberry. PA 17339
David Staz
R,D,#2
Lewisberr PA 17339
John M, Staz, Jr,
R,D,"2
Son
Yes
09/15/1968
in Sword:
2,14
09 08 1966 ~lusic Box 1 7th
$32,15
M1-
oods :_$.3.0.00 and
1 2 Residue
06 12 1938
Douglas Sta:t,
919 Country Club Road
Cam Hill PA 17011
Grandson
Yes
Thomas Staz
Grandson
Yes
PA 17011
Robert K, Staz
919 Country Club Road
Cam Hill, PA 17011
So
~e.s
Lewisber
PA 17339
Hamilton Bank Trustee
under Item IV of the Las Wi1
Testament of Blanche K, Staz Dece sed
for the benefit of the randchildr n 7
The above beneficiaries were living at the time of the decedent's death except for the following:
NAME
DATE OF DEATH
If additional space is necessary, use 8'12" x ".. sheets.
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KITCHEN
refrigerator
contents of cupboards
Gi\RAGE
fan
freezer old
washer
dryer
odds and ends
BASEHENT
odds and ends
BEDROOM #1
bed
dresser
chest of drawers
stand
cedar chest
odds and ends
BEDROOM #2
bedroom suite
chest of drawers
desk
chair
cane back chair
odds and ends
SITTING ROml
bronze lamp with marble base
studio couch
rocker
floor lamp
bookcases
odds and ends
praying hands bookends
Lincoln bookends
,brass candlesticks
Limoges china service
_ golf clubs
brass urn and umbrella stand
pyroceram dishes
$ 50.00
10.00
5.00
30.00
40.00
10,00
15.00
10.00
30.00
25.00
40,00
5.00
20.00
10.00
75.00
25.00
20.00
20.00
25,00
5.00
20.00
10.00
20.00
2.00
15.00
5.00
10.00
10.00
15.00
150.00
30.00
25.00
30.00
:"';~:".''',~.'': ~/
/
.'
-3-
music box
cuckoo clock
xylophone
,birdcall music box
-safe
music box
seven Dwarfs musix box
,baloon lamp
.May pole music box
,bull and matador figurines
sword
.turquoise and coral pieces
d;.t, )~ Yh. vtJ~
Col. Harry M. Wimer
Auctioneer 'and Appraiser
$ 25,00
20,00
30,00
10.00
15.00
25,00
25.00
10,00
25.00
20.00
50.00
40,00
TOTi\L
$1589,00
-' ;~: "'-1,- -.,.. ,
.-, .
.'
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COllllTY COLLECTIONS
RCC-43(S-7b)
NOTE: TO BE SUBMITTED IN TRIPLICATE
REPORTING FINANCIAL INSTITUTION
ADDRESS
lIamilton Bank
222 Narket Street
Harrisburg, PA
ZIP CODE 17108
D;'
. .l. ,_
:,: '10
02../ - J' 0 - oS&. i
Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act 011961, we
herewith submit the fallowing report:
ACCOUNT NO, OF JOINT, TRUST OR
INVESTMENT DEPOSIT
NAMES ON ACCOUNT OR
INVESTMENT
DD66324796
Blanche K Staz, and John M Staz fr.,
DATE OF DEATH
8-4-80
DECEASED JOINT DEPOSITOR, TRUSTEE
OR INVESTOR
Blanche K Staz
ADDRESS
495 Country Cl ub Road
Camp Hill PA
COUNTY
ZIP CODE 17011
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR
John ~1 Staz
ADDRESS
RELATIONSHIP TO DECEDENT
Son
DA TE ItlVEST/.IENT WAS ESTABLISHED
WITH THE SURVIVING DEPOSIYOR.
BENEFICIARY OR INVESTOR
?
BALANCE, INCLUDING INTEREST
PAYABLE,AT DATE OF DEATH $
$3,239.84
117~41bft{~C!ffi/
SIGNATURe
Administrative Officer
TITLe
DE",~ICK n(!AL (STATE, INC., heflil\llter referred to" Rell E.ult Drok.r," Agen' for o.~n", h".iN"er ,.f"red '0 bOlh Indlvldu.Uy Ilnd eo'
IllCtlvtlV II Sillier:
THIS AGnEEMeUT mid' .net .nt,,1Id InlO thl.
~!,1j1 ~'a'Uf~r:-\\I' n:1.:\:!:"~t,~~"a\
~ R(J\L E$TATE. I:'lC,
MREEI.1ENT FOR THE MLE OF REAL ESTATE
30th dav.1 July
'8 .J3.L. b,,~e.n STUARD
("..,
C':"f:.,-~T.1n.
Robcrt J. Huni,ck Edna L. Hyn1.ck
hCl"lnllftar rofened to bo,h Indlvidul\lIy fIOd collnctlwly .. Buyer.
Ower heleby 1I!,!'eoS to buy the 'allowing propelty:
_495 fountry ~.!_ul3 Rood. Camp Hill, PennsylJl..an1a
Cumbcrlond County
upon the 'crms end eondl1lonl I' 'OIlOM~
,. ~~~~E~ .::t!' . NOTE' tf . CAS'H' O~I' ,iQ~inir ~i this ' . . .. . .. .. .. .. . . . . .. .. . .. .. .. . .. .. .. .S
^Gltemtlnt. receipt of V'ohlth I, hf!r,h\' ncknowtodged . . . . . . , , . . . . . . . . . . . . . . . . . . . . . , . . . . . ,$
AND
1:l/J1L
75_.1'pQ.0lL-
~_OOO.OO
On or be'orllh,
d.y 01
. 19_.lncll'h......,...,.,....., ,$
13,200.00
60,000.00
.2i..200.00
C.lh.Ca'hlor.ICheck,OretrtllledChec't.llI'lnlemlnl,.,.....,.,.,....,..,',........,... ,$
Fln.ntln.........h "".w: , . . .~r.ti!:,1c,~ . P.t: ./l,greement. , , . . , , , , . . . . . . . . .S
TOTAL rRICE . . . . . , , . . , . . . . , . . .S
Thl. "Ilf.eam'!nt IIJII not conllngrnt l'rmn nuyer obtaIning ffnllncl~ It 'ollows:
tAl' Princ:lpnl Amount . 6Q.., OOO~ .
10' Ty", of FlnonclnQ --:rA u.i.c-1.C.S 101 Mulmu~ InleulIl R.ll ..1!l%_~ per Innum.
lei MlnlmumTtrm ;J YIIIIIII. lEI Termln.1 dell for obtlllning mortgog. commitment
Rul EUDte Dro1<er II not Ittponslbl' 'or Dffongln; IIn.neln;, but mny edvht! II' 10 ponlbll lourcel,
2, SPECIAL CLAUSES: Sce Attach9Ji Ad_denJ!!J,m
Seller' 9 ogree to...i-~,'p-a_i,u.UlkeILBj;.o..rJIL.W1.ndo"'R hl"fn.."
N/A
acJ;_U.':men t.
3. SETTL~MENT: Upon the 'ellure of nuynr 10 meke SCHlomf!nlbY pllylnplhn purchnse money In lull on or tMfore_ 0 ct. ~ - 1tl-9.1
or wilhln flny cwtt'nslon of Ih,. sl'ulemr.nl rlnlr. this Aq'~f'lmcnt sh~1l be void end 'hI: flmnunl pnid by the nuyer Ihnll b! lor!eiled liS liQuidr:'r:d d "I"l';:r:s.
~::': ;'! ':n'~:~: ~::: ~I~;~{l::.!~~'~ };':'l,.~",: :'~':_lY..l;~')<' f~'~,:t~tIX :(lj ~O(tXl)~ ;~K )~':-l~': 'i\:'~~; X:r;t~r,~tx-:.~~< ~:~rx:':-k?:~~ :':~~): :1:"1' 'i':'::-:'::"': ,...~,
,,~L,.1 <,..,..v..".... :~.I.h."i~' ,...tt~"'tr.~p. FOlml'lllendor of deellls hell!by WillVClt. 11 thIS l)I]rtclnllnllS conlmll~nt upon hnanClng. I I' uI,Uull' 'J..J'hwJ
ellrctd that if, afl'!r full coopn',lt;on oll1-lycr. IIloreseid linllOclnllll not ont/lin.d the L1epollI shall bot ",urned. leu Iny upenlt Incurred on h' II~I' 01
Buyer. Ind this l'I)lumenllhaU be null Inl' voId.
4. PERSONAL TV: All plumbing. II :.,tingllnd lighting fh:IU'tI, Ind 'Vllcms i'Il1PUrlrnanl ,horelo ond forming I pari ,hereof. 01 well"s .It ,an!r.l.
laundry tubs. T.V, cntennls. m;uts ond f"lor sytle",... loge'her wiln 'treen storm safh 3nrlfor dools. shades. owninlJS, venetIan bUndl. cQuplin1\ "Ir eutG'
matlc wOlhen Ilnd d,yen. etc,. Itldilllot (..'\'l:tI, l;o,niet't kl1chcn cabinets, drllpery rOl.h. dro1pory rod h:m'Wllrll, curllin rodl. CUlllin rod h",d~'''ll. n..
lurel. other plllMlnnenl filllurel. NC.. 1111 t. ~~I. \hruhbeIY. planting, now In alan PlOpr.rtv. .1nd rcm,ining helllng and cooking luell norod on pr'!In,ICl, II
any. unlell spoclflcally ellCllPted ,n this 1': 'cr.mf!nl. shen be Induded In thr. IDle Ilnd purchale plict!. None of the .bO.... mentioned ileml ~.II b. r~moved
by Seller from premh.. .her dill" of this ,'l'cr.ment. Saller shall tfallYllr good Hlle to all the .,tieles ducrlb,d In Ihil pa'l'1llph. and anv olher Ihcturtl
or Iteml of ~rsonallY ,peclllcaUy schedulort ond to be Included in Ihilllle, whlth IIln lilted III follows:
Edstinn Air Conditioner in Dining-B..C!.9m.
5. TRANSFER TAXES:
Rcal Emlllrenlltlt texoIIMII be paid II folloWS: .J;IJJ.e_", by Buy" _OfiEL% by Seller
aliJl.J;_UeJIte.lJ.t
6. POSSESSION: pOI!>:S\lon shoilU be gl~n
R,nlllllll the rale 01 __N.lA
un.II__ settln..ment
dollols per rlllY Ihall be paid by
N/JI
ilQ,antrdlllobovt,
7. STATUS OF WATEn AND SEWEn: Seller wllrmnu th'nl thll rroverty II sorvlced hy .-P-IdQJ,ig,_WSlllf IInd~tJ.b 1.;. --:_-
sewer. Fullher. Stllel WOrtlln" Ihal thlnn syltemlate fully Pllld (or and,..1 01 ,too ,talt ot Ihis o-:;rnml'nl. fire In Sl111ftetory C1perlltlng condition. IIl'for.
..id sySlems Dre p,lvale, Scllel w<!rrllnU Ihlll he hat no In'Ofmatlon thnt publiC wolrr IInd SO'MIr will be ossonod or Inllalllld for. loo't tix IGI monthl
.fter the d,,11l of seUlemcnl111 nlOlrs"id.
e. MUNICIPAL IMPROVEMENTS: Srl1cr hos no noticr! of ~u"ltiPnllmproVflmcnls (luch RI s,dllwallu, curbl, elc.1 c.ccp'
9. ADJUSTMENTS AT S(TTlEMENi~-iDlilr.s, ronl\~ wlIlcr IInd lC\"o'llr rantl AnLl all olh(', periOdic clolml ,nd chnl.;::s upon lhe obow dllcribed
premi~ol sh/'lll bP. apPllr'innr.r1 .lllhO ,Ime of It'tllr."'r.nl. PUlch:rSl! priel! Includes IIICI oil remaininll in 131'\1: 01 lime 01 sl!tUem<:nl.
10. RISK OF LO:;S: 5ell<:r shllll b'll'll ri~k of ton from li'll 01 olh'" r:;,uu,,'IV 'Inlil tlml! 01 \Ctllcmenl, In the e\ll:lnt of tJ.lm3g~ 10 the prop<:rt'{ by fiFt
or other CtlSUllltV, Duyer ,h"lIll~vlI thl! nptlon 01 rr.\cindinq Ihh WJ'Il~ment nod rtCf!lvin~ hand mnney paid on Accounl or 01 o<<.epting the properly In In
lhen r."ndllion wilh Ihe ploceeds of ,'"v !nsulolncr rr.cowry ohteinnhtr by Sallel.
t 1. TITLE: Seller ,hllll COnV1lY In Duy!!1 Il~' 'Il'nllrlll w:ltranty deed !J')od Inti ma,kr.tl\hlll 'ilia lwhlch con be cenlliod by BUYI!I', attorney or insured
lit Slill1dard r31'" lJy a Iltll! comllllny re!lulnrly In~'JrinQ tltln in rc""sylv.,nial ,"hjnct to building, lonlng and d'!ed Illslrictinnl. and easements 01 rtcard
or yi"hlr. by iMllcclion.
12. REJECT IOU OF TITLE: In C3~1l m;llrri.11 eltlocU "'II found In Ihl! till", /llItI rtflOrled 10 Sf!II'!r. ,hrn. If It!':h ckfcc.lIlllt not curlJd by Sell~' ....ill,.
In SlxlY (lj()1 rill'is, thll Cr:lntrilr:1 ,h;lll b'lcoml! null Dnd void .Inrl moni", llaid hy nuyer 'hnll bit rr:tulnr.d,.,t Ihe oPlion of DUV"r. SClllll "!I'rel to ,he appll.
ulion of \0 muc.h of thlt purchaY! mOf'le'l' a~ lelJuirrd 10 Itlt! p.Wmnn' 01 liens lInd encumhrllncel at ~e,tlemcn'.
13. AGENT'S L1AOILlTY: 11 i, und'mlnod ,hilt the l1e.' Eslc1!C Droker II aclin~ as "O'!nt only anrllhallln no C"I" whatlOllVt!r be held t.nbl. to
eUher party 'or ,he performilncr of Ilny II"n' or covll,,;'!nt of 'hi, II!lferm,nt or 'or dllm"~1 for non.pr.dormllntelherrol,
14, DEPOSITS: AU pay,"~nll on ncc"unt of thil trnn\actlon shIll be relainl!d in a lepIHtlte escrow nCCl)unl for Ihe \.lanellt 0' Ihe parlios 10 ,hit
Irllnsllclion. pursu.~nl to ,he Pules llnd nll']"l;Jlion, of lhe SI,'le Real Eltll'e Commil\lon. In CIlSt' of , co.bloke ..Ill, said plymantl shall tM held by Ih.
liltinqbrokr.r. '
15. INSPECTION: It it undcrs,ood lh,ll lJuvel hIS inspected Ihe prope;ty lor h" walwd thft rlghllo do tolondil not relYing upon .ny repllllentl.
lion by St!lIcl. his "genl or ","'<el.
16. ZONING OH OEEO ReSTRICTION Sr.lll'l w3"nnls Ihllllhe prl!\tnl use of the propnrly vtolnlel no ulstlng loning ordinance or 'OIIullllon,
nor deed reurlction'.. nod Ih.~t Srller has no nOlice whats()l!ver of any prnposrd 10flin\1 c.hnn'3'.
17. COPIES: Thil 1llI'f'~"'enl. Illleculerl '" qUIIII\lpllc<lt~, (ontainlthe fInal and ..ntlr. tlQrl!emtlnl batWf!(n tht pullu e"eopla1 Olharwi" p,ovldMt
hertln. COO"~I of this IllJleemr.nllhllll blI hr.lrI b~' ,he Real E:.tl1e Droker,
1B. lEGAL nESrONSlDllITV: This II" I&~p'"y blndinn conulct.1f nol und,,,loorl. conluh your IUCOtRllY,
19, AI;'PROVAL: Thll ll9'eement illubleel to the wIU,r:n IlPfHDVll1 01 SeUtl.
IN WITNESS WHEREOF Ihe uld Plllt!lII hllve hereunto <<'l th.lr handl and Icnll, IIIlendin!llo bind th"m,rlvcl, ,hlllr hflirs, IIdminhllaton, e)cculOn
ol'\d anign., All peril.. hereby IIcknowledR' receIpt of a lully.eucullld copy of this ~ cement. ..
WITNESS: . _~",.""S::UARO~' CK I'l ~L~ ~tNC. "/
<;:.'--'" ~ , ~<>;J::#:.I. ...- /1- "'"
n_-"....../;r.J/~< OY./..- .~ _ . c:---:::_.S..II
-c;....---,..... . IA nl en,,)
none
I
\
\
\
I
I
I
.-1'
_'Snl)
Buyer
J'
t5..11
Buv"
Olle 01 ^pproVll
.________. b1lng
S"ner "' the property herl"lnllboW dlltcflb~d. hereby apP'o~llh'l AgrllOment .nr1Inl,!1In It. Inlc"'~nQ therl'll'V tn b"lIGgllit.x.l>ound Aelll Ellatll (\ro\lr II
lIu1holl,..d to deduel Ind fllllf' ..I.. commllllon frO'1'I prOCMdl olletU.mef'lt. Es ta te BJ.ancne M. ::s ta z
7'v.N~"~: I I ,( - .-;.4'1'
, '~I to J( 0 . ( 'f{ J'rl I.. <' B~: 2:1.J;.,~..r ".f-e./;.'';,y( ....J",:. IS.."
V:Lce Pres. Soli" Hamilton Bank
__I IS.a11
SlIlIet
LhtlnfJ BrO~II' COPYI Whlt'l Morlva9' CO. COPYI Gre.nl ou.,.1r COPYI VellOWI S.II" CoPY, Pfnkl Buyer Copy; Gold.nrodl
.19-
ADDENDUN lollJERE SALE OF REAL ESTATE
IS BY ARTICLES OF AGREEMENT
THIS ADDENDUM is entered into this 30th day of July , 19 81,
bc:tI'lccn (Stnz Eotni:e) and as Seller and
JI,ob-"I't~....,.J:4Ul.t~, and r::~lnt1 L. Hvnl.c/: as Buyer, Whereby Buyer
hils a91"eed to purChase the fOllowing property 495 Countrv Club Rood.
'Cnmp Hill . upon the terms and conditions as follows: purchase
price of r;'15,200.00 payable:
(a) $ 2.000., at Signing of Agreement of Sale,
(b) $ 13,200., at settlement, ,
(c) $ 60,0011" by the terms of Articles of Agreement of Sale with
interest of ~l!L..% of annum. computed as though ,the term was 25 years, '
in monthly installm:!nts of $ 722.26 , plus 1/12 of yearly taxes and insurance,
(d) the balance of the purchase price, payable under the terms of '
the Articles of Agreement, shall be payable in full on or before OC'I;.1. 1984
. ,
The Articles of Agreement of Sale will contain the usual clauses and shall
include the follO\'/ing:
.'
A, Ri~ht of Seller to inspect the premises.
B. Obligation of Buyer to maintain the premises in good and
substantial repair.
C, No substantial alterations or repair without the written consent
of. the Seller.
D, Buyel" to complY I./ith hOUSing code standards, fire, safety or
other governmental requirements and be responsible for all muniCipal.
assessr.lents,
E,. Se'iler has not received any notice of violation of any governmental
regulations, ,
F, Transfer 01' tiD:es to be di vi ded equally at the time of deed transfer.
G, 'Buyer PUl"chasing the property in an "as is" condition,
H. Agl'eement milY not be' assigned liJ?/X[{Ll1Je;rXWi't>h\iU"XI'.(r,.(j>(;;~ul~:YG'\J\l~l$I1:tX
o~r,,<~r,xl~'jX. . o.
r. Seller obligated to pay any personal property tax imposed as a
result of the AI.ticles of Agl"eement.
J. Buyer to obtain insurance, at buyer's expense, to protect the
interest of buyer, seller and any existing mortgage holder or other
finanCing institution.
K, The question of whether an existing mortgage can be assumed by
the buyer or sold subject thereto is a legal question to be ansl'lered
by the buyer and the buyer's a'ttorney so far as Stuard D21"l"ick, nor any
of its representat i ves, is authori zed or permi tted by 1 al~ to render
:;uch an opinion.
L. Seller' 01" Seller's representative shall be responsible fOI' compliance
with any disclosure by the "truth and lending act" or othel" applicable'
s ta tutes.
11, Usual clausr.s as to default and the right to confess judgement and.
I"eacquire POsse:sion of IJI"emises,
N. Othel" speci;.] pl'ovisions as follows:
O. PUrChiJSD1'S ['Ducrve the right to pay cff principol bOlonce remaini,'1/'
All of the othel" tel"OlS and conditions of the Agreement for the sale of real
estilte dated the 3..0t~ dilY of Julv ! 19 81 , bet\'leen the pal:ties
shall be in full fO;'ce and effect and appllcalile to thlS addendum. and the partIes
hei'::to have set thril" I;~nd ~l1d ;,eil1s intending to bind themselves, their heirs,
administrators, eJ:e':utol'S, and assigns, All parties hereby acknowledge receipt
of a fUlly executed copy of thi s addendum.
*at any given time.
lo/iTNESS
(SEAL)
HLTNESS
(SEAL)
i'L!c.U.J .'. j; i
IHTliESS
Estate Blanche M. Staz,
......".-0?' '
-,-""""" .....""'"---~, "".' .
ByO...C~(":;....-; Y.<p/.", I( '.:;SEAL)
V~ce Pres., Hamilton Bank
(" Ii- I~U;rt I r/
(j
l~nNESS
(SEAL)
Schedule "e" must include all property, real and personal, ownad by the decadent jointly with enother
party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be
included. List real estate first.
INSTRUCTIONS FOR COMPLETING SCHEDULE "e"
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"" "tl tj 8 )> tT1 E; :.;;
z )> 0 tj VI -
Cl n c::: tj ...; z 3: z t""
tT1 tT1 ;.:: Z f;l )> 9 - 9 t""
Z Z tT1 ...; ...; z
9 ...; -< tT1 -
9 VI ~
Z 0 VI 0
9 'T1 'T1 "
~
-
0
'0 Z
~
,
,-' ~.]
". U"" .' .;~
L- .' r
c:..;" N "',..1
u.: 2 , ,.-:.
0;-. ~J
(%:1." -:> ' ~ -< -<
0'- f~
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...,"-' ~ ldU S; S;
a;.cr. .J
"
~
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---- ._- ---- .-..-.------------- -- --- ---- --- -------
..._tta. --. -----
".REV.1182EX
~. . COMMONWEALTH OF PENNSYLVANIA
4 NO. K 29435 DEPARTMENT OF REVENUE
. . OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
I
'"
.
..
It
=
III
~
RECEIVEO Hamilton Bank
FROM
ADDRESS
P. O. BOX 1071
Harrhburq. 'A 17108
'--gfTteT~[~~~~AT10N7A-;;;;t--4~-i980---------
FilE NUMBER 21-80-528
DATE OF PAYMENT April 15, 1981
Blanche K. sto!:
NAME OF DECEDENT
COUNTY C ulllbu land
-----------------------------------------
~ POSTMARK DATE
I "-~
"PAID ON ACCOUNT"
SEAL
-.--..
TAX AT 6%
TAX AT 15%
TAXAT_%
ESTATE TAX
ill
ill
RECEIVED BY
REGISTER OF WILLS
..~a.
~
TOTAL TAX CREDIT
LESS DISCOUNT
PLUS % INTEREST
(FROM TO_)
TOTAL AMOUNT PAID
. " I
'II /
// ".v';
, /
'8,000.00
$8,000.00
,~-/.. /
0' ,:)/...<&-C~
SIGNATU
,
-----------------------------.-.---
REV-1500 EX + (9.81)
BUREAU OF EXAMINATION
PfNNSVL\lAN1A DEPARTMENT OF REVENUE
. P.O. BOX a327
HARRISBURG, PA 17105
INHERITANCE TAX RETURN
RESIDENT DECEDENT
File Number ;l.. \- '&0-0 5d.8
Decedent's Addr...
Ljtj5 c.ou~r'f C-\u.b Rood.
C:al'rl Hi II, {>A 11011
CHECK
I. Original Relum 00
2. Supplementel Return 0
3. Remainder Return 0
4. Life Estete 0 5. Federal EstateTax D
Return Required.
6. DOtedant died testat. rvJ 7. Oec.d.nl maint.in.d a living 0 8. Number of safe d.pesit 0
(Attach cepy of WillI ~ trust (Allach copy of trusll boxes inventoried
All correspend.nce and confidential tax information sheuld be directed to:
Cemputatien of Tax
15. Ameunt of line 14 taxable at 6% rato (15)
linclud. values from Sch.dul. K)
16. Ameunt of lin. 14 taxable at 15% rate (16)
linclud. valu" frem Sch.dule K)
17. Principal t.x due (add tax from line 15 plus t.x from lin. 16)
18. Totel Prier paym.nts:
(.1 Amount Paid
(bl Plus Discount
(cl Minus In"'''t (18)
19. 8al.nce Du. !lin. 17 minus lin. 18)
M.ke Check Pay.bl. to: R.gister of Wills. Ag.nt
... PLEASE RECHECK MATH...
APPRO.
PRIATE
8LOCKS
CDRRE.
SPONDENT Nam
Recapitulatien
1. R.al Estate (Schedule Al (1)
2. Stocks .nd 80nds (Schedule 8) ( 21
3. Closely Held Steck/Partne"hip Interest (Schedule CI ( 3)
4. Mortgages and Notes (Schedule D) ( 41
5. Cash & Miscellaneous Pmonal Property (Schedule EI ( 51
RECAPIT. 6. Jeintly Owned Property (Schedule FI ( 6)
ULATION 7. Transfe" (Schedule GI ( 7)
8. Total Gross Assets helal lines 1.71
AND 9. Funerel Expenses Administrative Cosu/Miscellaneeus
Expenses (Schedule HI ( 91
TAX 10. Debts/Mortgages/Liens (Schedule Il (10)
11. Total Deductions ltetellines 9 & 101
12. Net Value of Estate !line 8 minus line 11)
CALCU. 13. Charitable 8equests (Schedule J)
LATlDN 14. Net Velu. subject te tax Uln. 12 minus line 131
Address
City
Zip
-UtI40.~
1~,I\",q. "t~
I~ ' ~. 1\
~ ,3 3.a~
(81 IlqI1~g.L\!5
(11)
(12)
(13)
(14)
, ~~~~~~'.~1
x.06=
x.15=
(171
(19)
Under penalties ef perjury,l declare thOlI h.ve examined this return, including accompanying schedules and statem.nts, .nd to the ~"t of my knowledge
and b.lief. it is true. cor ct, and complet.. Oecl.retion of prep.", ether th.n the personal representative is based on all inferm.tion of which preparer has
any knowledge.' ..3 / / J I f ~
SIGNATURE OF PERSONAL REPRESENT IVE(S) AODRESS f f DATE
~EV0455 EX. (3.801
COMMONWeALTH OF PENNSYLVANIA
'OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCT!ONS
-- ----
08/04/1980 . /)'j_ (/ '...c 0
Estate of BLANCHE K. STAZ Date of Death File No, 'Y ;) (.; , ),..7/l
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Rolaticllship to Decedent
Claimant's Address at time of Decedent's Death
ITEM
NO.
DATE
NAME OF PAYEE
REMARKS
AMOUNT
LPN
Private dut care for 88 hours, Jul 2 ,
1980 to Au~ 4, 1980 for Blanche K. St z620.00
a d Count Letters Testamenta
Per
$ S5.00
24.00
3. Se
4. Se
6. Se
7. Se
8. Se
'f' a es 10.00
2, United Locksmiths 2 keys made for 495 Country Club Road
4 Electric service - 495 Country Clud R
t aw Journal Publish Letters Testamenta
19, Register IHlls Cwnberland County 4 Short Certificates
23, Riverton Consolidated I~ater Co. '<ater service 495 Country Club Road
30, Anne F. Keller,Tax Collector
Camp Hill School District Personal Ta
of Home
~
estate
ue
ense
12.
13.
Har
IHmer A raiser
~Iove air conditioner
Trim shrubbe
haul trash
an
Prof ssional services
Electric service 495 Count Club Rd
Appraisal of real estate
o t 14 Patriot-Ne\~s Com an Advertisin. real estate
Oct 17 Patriot-News Com an Advertising real estate
20. Oct 22 G. T. Watts Storage & removal of awnings
CONT'D PAGE #2. TOTAL
1 hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral
expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes.
SIGNATURE OF FIDUCIARY
OFFICIAL USE ONLY
DATE
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $
AT
% TAX RATE
REGISTER OF WILLS
DATE
89.00
1. 49
35.33
18.00
4.00
12.68
15.00
125.00
4.40
1 308.00
40.00
18.00
160.50
279.00
18.93
100.00
18.72
15.12
27.50
GENERAL INHERITANCE TAX INFORMATION
"I ,
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her toxabl;
estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of
administratian, attorney fees, fiduciory fees, funeral ond burial expenses including the cost of a burial lot, tombstone
or graye marker and other related burial expenses.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Eyidence.to support the decedent's or the estate's liability for the debts being
claimed should be attached to this schedule.
A family exemption may be c10imed 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 ex_ption can be claimed by
a parent or parents who are members of the same household as the decedent. The fomily exemption is allowable only
against assets which pass by a will or by the Pennsylyania Intestate Laws.
NOTE: Compensation paid to an estate representative; namely, an executor or administrator, for services
performed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income
item should be reported on form PA.40.lndividuallncome Tax Return.
t"" ~ tj n E; tT1 e; ~
z 0 0 VI Z Z
Cl n 2 tj )! 3: !=
tT1 t:1 ;.:: " 9 - 9
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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 amount claimed in the amount column.
2. Assign cansecutive numbers to each item listed.
3. Enter the date on which each debt was incurred and/or paid.
4. Enter the names af each payee.
S. Provide a brief explanation in the remarks column for eoch debt claimed.
6. Enter the omount of each debt being claimed.
7. The form must be signed by the person who has assumed the responsibility for paying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE 8Yz" x 11" SHEETS.
"
. .c _._L~ND RETAIN fOR YOUR RECORDS
No.00517068
f,C<.OUf.r ~.jO
;.ccrY.Jri' 'J,"'.'!
04-53417-00 Blanche K. Staz Estate
TIO:A'.5 c. (H! (I r\~,'!
;, ... (-'l' ~ ; 1
73-402
1
1 :18 : 83
S ********67:.39
CfSC~,Dll~lrl
Additional Inheritance Tax due
fN.ll1Q
Register of Wills, Agent
Trust Funds
~ HAMILTON BANK
bem
j
REV. 1547EX (10-82)
f:JREAU OF EXAMINATION ; NDTICE OF INHERITANCE TAX '
PENNSYl,\:-"o'JIA DEPARTMENT OF REVENUE I APPRAISEMENT ALLOWANCE OR DISALLDWANCE IACN
<, HARR~S~U~g\~32{7105 I OF DEOUCTIONS. AND ASSESSMENT OF TAX i
. .__ ~ ,_ DATE 12..:::.Q.e~
ESTATE DF STP.Z BLIINCHE Y. FILE ND. 21 80-0528
pATE OLP!,ATH Ol3.::.Q~=.a..o CO,~NTY CUMa,~RL1\Iili
NOTE: TD INSURE PROPER CREDIT TO YDUR ACCOUNT SUBMIT THE UPPER PORTION DF THIS NOTICE WITH YDUR TAX
PAYMENT TO THE REGISTER DF WILLS OF THE ABDVE CDUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF WILLS,
AGENT" .
SUZIINNE KNIGHT
222 MARKET ST
HIIMILTON BI:
HBG
PII 17108
CUT ALONG THIS LINE
- o. _ _ _ _ _ _ _ _ _ _ _ . _ ~ _ _ _ _ _ . _ - - - .
101
PLEASE RETURN THIS
PORT ION TO REGISTER OF
WILLS IF PAYMENT DUE
NDTICE DF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT DF TAX
REV. 1S47EX I 10-B2)
DATE 12-08-82
ESTATE OF STIIZ
BLIINCHE K FILE NO.21 80-0528
Ii:) CHANGED - SEE ATTACHED NOTICE
TAX RETURN WAS: I I ACCEPTED AS FILED
APPRAISED VALUE DF RETURN BASED ON: I SUPPLEflEliTIIL
1. Real Estate (Schedule A)
2. Stocks and Sonds (Scheoule Bl
3. Closelv Held Stock IPartnershlp Interesl (5ched,ule C)
4. Mortgages and Notes (Schedule Ol
5. Cash 6,; Miscellaneous Personal Proper tv (Scheaule E)
6. JOintly Owned Propertv (Schedule Fl
7. Transfers (Schedule G>
8. Total Assets
APPRDVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses (Schedule HI
1 Q. Debts/Mortgages/LIens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Cha;"itable/Gollernmental Bequests (Schedule JI
14. Net Value of Estate Subject to Tax
ASSESSMENT OF TAX:
15. Amount of line 14 tay-able al 6% rate
16. Amount of line 14 taxable at 15% rale
17. PrincIpal Tax Due
TAX CREDITS:
i
I
I
I
INTEREST IS CHARGED liT 06 PERCENT FOR
DIIYS FROM 08-04-82 TO 12-23-82-.
I PAYMENT
DATE
~4-15-81
I
I 08-03-82
I
I
I
RECEIPT
#
DISCOUNT (+1
INTEREST H
029435
049703
.00
123.4B-
142
. IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION
OF ADDITIONAL INTEREST
RETAIN THIS
ACN 101
RETURN
(11
( 2)
( 3)
14)
( 5)
( 6)
( 7)
72 ,14D. 54
.00
.00
.00
72 ,549. 4B
1I,715.II
23,333.32
( 8)
179,738.45
( 9)
(10l
18,945.04
.00
1111
1121
(13)
(14)
18,945.04
160,793.41
.00
159,793.41
115)
(161
160,753.41
40.00
9,645.20
6.00
9,651. 21
X.06=
X,15=
(17)
AMOUNT PAID
B,OOO.OO
1,709.54
TOT AL TAX CREDIT
BALANCE DF TAX OUE
INTEREST
TOTAL DUE
9.586.06
65.15
1.52
66.67
(If Balance Due IS less than $1.00 no pa\'ment is required)
Purpose of Notice: to fulfill the reC;Ulrements of Section 709 of the Inheritance and Estate Tax Act of 1961 (72
P.S, see lion 2485-709).
Objections: Any party in interest not satisfied with the appraisement. allowance or disallowance of
deductions. or assessment of tax (Including discount or interest) as shown on this Notice
must object within Sixty (60l days of receipt of thiS NOlice.
Objections may be made as follows:
- by written protest to the Department of Revenue. Board of Appeals
- by electing to have the matter determined at audit
- by appeal to the Orphans' Court
If any tax due is paid wIthin three (3) months after the decedent's death. a discount of
five percent (5%) of the tax paid is allowed.
. the discount period IS calculated In calendar months. Example: date of death 1-15-82.
discount penod expires 4-15-82.
Discount:
Interest:
Except for tax on a future interest. inheritance tax becomes delinquent nine (9) months from
the date 0 f death.
. Inheritance tax on a future interest becomes dehnc;uent at the expiration of three months
from:
- the dale of election to prepay or
- the date of death of the life tenant or annuitant
Interest IS calculated on a daily basis from
- delinquent date 10 date of payment on any tax unpaid on delinquent date
- date of last delinquent payment to date of payment on any unpaid balance.
Interest is charged at the followmg rates:
Delinquent Dale
Annual Interest Rate
Daily Interest Factor
5/27/43 to and including 12/31/B 1
1/ 1IB2 to and ,ncludlng, 12/31/82
6"
"
20%
.000164
,000548
The rate in effect when the tax first becomes dehnquent WIll remain constant until the
delinquent tax balance is paid In full.
Interest is calculated as follows:
INTEREST = BALANCE OF UNPAID TAX X
NUMBER DF DAYS X DAILY INTEREST FACTOR.
. Any Notice issued after the tax becomes delinquent will reflect an interest calculation to
fifteen (15) days bevond the date of the assessment. If payment is made after the
Interest computation date shown on the Nottce. additional interest mU!it be calculated.
To Remit Payment: Detach the top portIon of this Notice and submit with your pa~'mcnt to the Register of Wills
of the county shown on the Notice.
. Address information IS listed on page 13 of the booklet. "InstructIons for Inheritance Tax
Return for a Resident Decedent."
. Make cheer. or money order pa}'able to: Register of Wills. Agent.
REV.147D EX 111.BIl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
P. 0, BOXltJ27
HAR~SBURG. PA 17105
INHERITANCE TAX
*
EXPLANATION OF CHANGES
DECEDENT'S NAME
ITEM
SCHEDULE NO.
IFILE NO.
EXPLANATION OF CHANGES
TAX EXAMINER:
PAGE
---- _ _ _ -- -- -- _ --- --.- _ -- _ --- ---- --- - -- - --- --- ---
L
-
-
-
-.--
~.
~'
REV.1182 EX
COMMONWEALTH OF PENNSYLVANIA
NO l0705~1 DEPARTMENT OF REVENUE
. ~FICIAL RECEIPT. PENNSVLVANIA INHERITANCE AND ESTATE TAX
ill
Af!i
m AMOUNT
Assessment Control No.
RECEIVED FROM:
r:
probate
67.39
...flto" ....'It
. .0. ~_19.71___, ___ ______ -----
.J'r.i~~DL..._...__).11gJL- --
I
L ~
ESTATE INFORMATION:
FILE NUMBER
NAME OF DECEDENT
DATE OF PAYMENT
21-80-528
a K.
~u.ary 191~ST1983
MI
POSTMARK DATE
COUNTY
DATE OF DEATH
REMARKS
.TAnnA-:Y
C\UIIberlud
A WIt: 4 1980
[i] TOTAL AMOUNT PAID
67.39
~
I
II
"
;
~
_u_JJ
RECEIVED BY
,.' · .i t:. "..) -'
'-///IU..J t' ,'),IPl.J
. , ~NATURE
SEAL
REGISTER OF WILLS
I
I
I'
!
------- -- -- --- --- - ----------- -----~ ---------
....
.,.
...-~-.
rL
.... --- ..,.-" -- ........
..""
.....--
...--
~-"...~,=~....,'.'rII+ JI
J
REV. leD? IASI
DEPARTMENT OF REVENUE
BUREAU OF ACCOUNTS SETTLEMENT
P.O, BOx 2055
HARRISBURG. PA 1710S
101
ACN
INHERITANCE TAX
STATEM~NT OF ACCOUNT
DATE 06-27-83
ESTATE OF STAZ BLANCHE K FILE NO. 21 80-0528
OATE ,OF DEATH 08.=.O~.::!l0 COUNTY CUI'I.8J~RJ.JlliD.
NOTE: TO INSURE PROPER CREOIT TO YDUR ACCDUNT SUBMIT THE UPPER PORTIDN OF THIS FDRM WITH YOUR TAX PAYMENT
TD THE REGISTER OF WILLS DF THE ABDVE COUNTY. MAKE CHECKS PAYABLE TO: REGISTER OF WILLS. AGENT.
SUZANNE KNIGHT
222 MARKET ST
HAMILTON BK
HBG
?A 17106
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
c;:y'!: _A_L9~~ _ ,!:HJ~ "L!N.E_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ " _ _ _ _ _ _ _ _ .. " _ _ _ _ _ _ _ _ " _ _ _ _
.. INHERITANCE TAX STATEMENT OF ACCDUNT ..
ESTATE DF STAZ BLANCHE K FILE NO. 21 80-0528 ACN 101 DATE 06-27-83
THIS STATEMENT IS PRDVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN
BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, THE APPLICATIDN OF ALL PAYMENTS. THE CURRENT BALANCE. ANO,
IF APPLICAaLE. A PROJECTED INTEREST FIGURE.
DATE OF lAST ASSESSMENT OR RECORD ADJUSTMENT, 12-08-82
PRINCIPAL T AX DUE:..................."'..........."'.........................."...."'..................'"............................"'........................
9,651.21
PAYMENTS (TAX, CREDITS):
PAYMENT RECEIPT
DATE NUMBER
DISCOUNT 1+1
INTEREST I-I
.00
123.48-
1. 80-
AMDUNT PAID
04-15-81
08-03-82
I
01-18-83
029435
049703
070521
8,000.00
1,709.54
67.39
TOTAL TAX CREDITS
9,651.65
BALANCE OF TAX DUE
. 44CR
INTEREST
.00
TOTAL DUE
. 44CR
(If Balance Due is less than $1.00 no payment IS required)
* IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST
RETAIN THIS PORTION FOR YOUR RECORDS
REV. 1S93EX (11-B2)
~F.r.;N!.""LVANIA DEPARTMENT OF REVENUE
BUREAU OF ACCOUNTS SETTLEMENT
P.O, BOX 2055
HARRISBURG. PA 17105
INHERITANCE TAX
RECORD AD~USTMENT
ASSESSMENT
CONTROL NO.
101
DATE
ESTATE OF STAZ BLANCHE K FILE ND. 21 80-0528
DATE OF DEATH COUNTY C
NOTE: ' TD INSURE PRDPER CREDIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS FDRM WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF
WI LLS. AGENT."
SUZANNE KNIGHT
222 MARKET ST
HAMILTON BK
HBG PA 17108
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
CUT ALONG THIS LINE
-- - -- --- - - - - - - --- - - - - - - - - - - - - - - - - ---- - - - - - - -.- - - - - - - - - -- -.- - -- - -- - _.- -.
"INHERITANCE TAX RECDRD AD~USTMENT"
ESTATE OF STAZ
BLANCHE K FILE ND.21 80-0528
ADJUSTMENT BASED ON:
ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
,. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule BI
3. Closely Held Stock./PartnershIP Interest (Schedule Cl
4. Mortgages and Notes (Schedule D)
5. Cash & Miscellaneous Personal Property (Schedule El
6, JOintly Owned Property (Schedule F)
7. Transfers (Schedule G)
a. Total Gross Assets
( 1)
( 2)
( 3)
( 4)
( 5)
( 6)
( 7)
DEDUCTIONS ANO EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses (Schedule HI
1 D, Debts/Mortgages/Liens (Schedule II
1 to Total Deauclions
, 2. Net Value of Estate
13. Chantable Bequests (Schedule J)
14. Net Value Subject to Tax
TAX:
15. Amount of line 14 taxable at 6% rate
16. Amount of hne 14 taxable at 15% rate
17. PrincipII Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT 1+)
DATE ~ INTEREST H
04-15-81 029435 .00
08-03-82 049703 14.30-
01-18-83 070521 .00
( 9)
(1m
ACN 101
DATE 10-26-83
72 ,140.54
.00
.00
.00
72,549.48
11,715.11
.00
156,405.13
( 8)
18,945.04
.00
(111
(12)
(13)
(14)
18,945.04
137,460.09
1,000.00
136,460.09
(151
(16)
136,420.09 X.06=
40.00 X.15=
(17)
8,185.21
6.00
8,191.21
AMOUNT PAID
8,000.00
1,709.54
67.39
TOTAL TAX CREDIT
BAL~NCE OF TAX DUE
INTEREST
TOTAL DUE
7
1,571. 42CR
.00
1,571. 42CR
. IF PAID AFTER DATE INDICATED SEE REVERSE FOR CALCULATION
OF ADDITIONAL INTEREST
(If Balance Due is less than S 1.00 no payment is required)
RETAIN THIS PORTION FOR YOUR RECORDS
.'
:c:
:.f.' :-'.
UJ C f;~
u~ . ::i: v,t..-,
~.. . <.>
-=Cl
u.." N ~;;t;
0"
L' :J:<l.
6n..: I ~-J
\.LJ1.,.1 >- 0""
co,- 2
a::"" ,""
c- x:~
~<=> c::.~
...... "" ~u
",,'" SO u
Discount:
If any tax due is paid WIthin three (3) months after the decedent's death. a discount of
five percent (5%) of the tax paid is allowed.
. the discount period is calculated In calendar months. Example: date of death 1-15-82,
discount period expires 4-15-82.
Except for tax on a future Interest. inheritance tax becomes delinquent at the expiration of
nine (9) months from the date of death.
. Inheritance tax on a future interest becomes delinquent at the expiration of three months
from: .
- the date of election to prepay or
- the date of death of the life tenant or annuitant
Interest is calculated on a daily basis from
- delinquent date to date of payment on any tax unpaid on delinquent date
- date of last delinquent payment to date of payment on any unpaid balance.
Interest is charged at the following rates:
Interest:
Delinquent Date
5/27/4310 and includIng 12/31/81
1/1/82 to and includIng, 12/31/82
1/ 1/83 to and includIng 12/31/83
Annual Interest Rate
Daily Interest Factor
6%
20%
16%
.000164
.00054B
.OD0438
Those estates that become delinquant on or before December 31, 1981 will maintain
a constant interest rate. The rate in effect when the tax first becomes delinquent will
remain constant until the delinquent tax balance is paid in full.
. Those estates that become delinquent on or after January " 1982 will contatn a variable
interest rate. Thus. taxes that remain outstanding from calendar year to calendar year will
be subject to the different rates in effect on each January 1.
Interest is calculated as follows:
INTEREST = BALANCE OF UNPAID TAX X NUMBER OF DAYS X
DAILY INTEREST FACTOR.
If a tax balance remains outstanding for more than one calendar year, a separate interest
determination must be made for each year at the applicable rate. (Only one calculation
is necessary if the estate maintains the constant interest rate.)
Any Notice issued after the tax becomes delinquent will reflect an interest calculation to
fifteen (15) days beyond the date of the notice. If payment is made after the
interest computatIon date shown on the Notice. additional interest must be calculated.
To Remit Payment: Detach the top portion of this Notice and submit with your payment to the Register of Wills
of the county shown on the Notice.
. Address information is listed on page 13 of the booklet, "Instructions for Inheritance Tax
Return for a Resident Decedent"
. Make check or money order payable to: Register of Wills, Agent
--
i
i
I
REV,141O EX 111.811
COMMONWEALTH OF PENNSYLVANIA
:.~PA~TMENT OF REVENUE
"UREAU OF EXAMINATION
P. O. BOX 8327
HARRISBURG. PA 17105
INHERITANCE TAX
",.
*
EXPLANATION OF CHANGES
DECEDENT'S NAME
ITEM
SCHEDULE NO.
Fl LE NO.
EXPLANATION OF CHANGES
TAX EXAMINER:
PAGE
..
...
::c
U' . ,
~. co 2,"-:
, '
~~ c:c :');3
"-
ll." ~c
0.-:. N - -
O.:L I :z::{
w"-' "'"" ~:d
01- ~ 0-
""" ,w
0- ~;a
",'"
w.... 0;":-
",'" C""\ ....:::>
~ -'u
u
(.<l1.<L.J.~ R~,.J,L\.. 1 .Ho.L ~~.:.'-
FAMILY SETTLEMENT AND FINAL RELEASE
IN
ESTATE OF BLANCHE K. STAZ, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Blanche K. Staz
late of 495 Country Club Road, Camp Hill, Cumberland County, Pennsyl-
vania, deceased, died on August 4, 1980, having first made and published
her Last Will and Testament dated June 3, 1977, and two codicils thereto
both dated April 16, 1979, in which she named Hamilton Bank, formerly
National Central Bank of Harrisburg, PA, and Robert K. Staz and John M.
Staz, Jr., as Executors. A true and correct copy of said Will and
Codicils is attached hereto, made part hereof, and marked Exhibit "A"l
and
WHEREAS, on August 13, 1980, said will was duly probated,by the
Register of Wills of Cumberland County, Pennsylvania, and Letters
Testamentary granted thereon to Hamilton Bank, Robert K. Staz and
John M. Staz, Jr., as'Executorsl and
WHEREAS, the Executors have proceeded with the administration of
said estate and have prepared their first and final Account and Schedule
of Distribution. A true and correct copy thereof is attached hereto,
made a part hereof, and marked Exhibit "B"; and
WHEREAS, the parties hereto desire that the Executors not be
required to file said Account with the Orphans' Court of Cumberland
County, and that the net estate of the decedent shall be distributed
without the necessity of filing a formal account.
(",cf,,>', '1':/" p.r' 2;',:;;
_ . .~oJ lId': 'JV
'.
NOW THEREFORE, KNOW YE, that we, Robert K. Staz of 919 Country
Club Road, Camp Hill, PA 17011, Marjorie M. Staz of 919 Country
Club Road, Camp Hill, PA 17011, Robert K. Staz, Jr. of 919 Country
Club Road, Camp Hill, PA 17011, Thomas Staz of 919 Country Club
Road, Camp Hill, PA 17011; Douglas Staz of 919 Country Club Road,
Camp Hill, PA 17011, John M. Staz, Jr. of R. D. #1, Lewisberry,
PA 17339; Elizabeth D. Staz of R. D. #1, Lewisberry, PA 17339;
John M. Staz, III, of R. D. 'I, Lewisberry, PA 17339, Diane Staz
of R. D. #1, Lewisberry, PA 17339; Peter Staz of R. D. U" Lewis-
berry, PA 17339; David Staz of R. D. #1, Lewisberry, PA 17339;
and Hilda B. Taylor of 1105 Columbus Avenue, Lemoyne, PA 17043,
being all of the named beneficiaries under the Will of Blanche K.
Staz, intending to be legally bound hereby mutually agree as follows:
1. The parties hereto, and each of them, agree and acknowledge
that they have fully and carefully examined the First and Pinal Ac-
count of Robert K. Staz, John M. staz, Jr. and Hamilton Bank, for-
merly National Central Bank, Executors of the Will of Blanche K.
, I
Staz, deceased, and Schedule of Distribution relating thereto, and
find them to be true and correct, and acceptable to the parties hereto
and each of them, and, further that each of them has received a copy
of this Agreement and of the said Account and Schedule of Distribution.
2. The parties hereto do hereby release, remise and forever dis-
charge the Estate of Blanche K. Staz and Robert K. Staz, John M. Staz,
Jr. and Hamilton Bank, Executors, of and from all manner of acts,
suits, claims, accounts, accountings, debts, dues and demands whatso-
ever which they or any of them or their legal representatives or
assigns may at any time hereafter have, against the Executors, the
said Estate or the assets thereof, from, for, touching or concerning
any of the assets and property of the said Estate and/or any claim or
interest thereto or therein, and the adminitration, management, col-
Page 2 of 7 pages.
~r,c.: .,'" I PL"; '1;:,:,
_...#fJ 'n t:.,'JU
lection, sale or distribution of any of the said assets and for or
on the account of any money, interest, income, assets or proceeds
out of the same, from the time of the death of the said decedent to
and including the date of this Agreement and Release.
J. The parties agree to provide special Bafeguards for the pro-
tection of Robert K. Staz, Jr., Thomas Staz, Douglas Staz, John M.
Staz, III, Diane Staz, Peter Staz, and David Staz, minor beneficiaries,
in that said interest belonging to them be maintained in their sepa-
rate trust fund at Hamilton Bank, formerly National Central Bank.
4. This instrument is a full and final Family Settlement Agree-
ment by and among the parties hereto, both fiduciary and individual,
all of the'same having'been arrived at, concluded and executed after
a full and complete disclosure of the assets of the said estate and
the rights of the parties therein and thereto and all of the parties
hereto, and each of them, agrees to abide by the terms hereof. This
instrument is to be considered with the same force and effect as if
' I
the filing of an Account and Schedule of Distribution had been filed
and confirmed by the Orphans' Court Division of the Court of Common
Pleas of Cumberland County.
5. The parties hereto, and each of them, agree that they will
at all times in the future and whenever necessary, appropriate or
convenient, make, execute and deliver to the said Executors, and/or
to the other party or persons, any and all instruments, documents,
conveyances, deeds, releases or other instruments of any kind necessary
or convenient to carry out the intention of this Agreement and/or to
permit, assist and enable the Executors to fulfill their duties with
reference to the said estate and all of the assets thereof.
6. The parties hereto, and each of them, acknowledge and under-
Page J of 7 pages.
, "l- ;-\1")' t ~.. ~ ri;:.....
SC:i'. _ 01 I ..;..t: ~'J'
stand that there may be some future Pennsylvania inheritance taxes
due on behalf of this estate. Should this situation arise, Robert K.
Staz and John M. Staz ,Jr. ,two of the Executors and beneficiaries here-
under, agree to be responsible for the payment of any such taxes out
of their share of the proceeds of the estate.
7. This Agreement constitutes the entire understanding among
the parties hereto, and each of them acknowledges that no representa-
tions or statement of any kind, written or oral, have been made to
them or any of them prior hereto by the Executors or by any other
persons or party upon their behalf.
8. This Agreement shall enure to the benefit of all and shall
be binding upon, the parties hereto, and each of them, their heirs,
executors, administrators, successors and assigns.
IN WITNESS WHEREOF, the parties hereto
1/ en
respective hands and seals this day of
have hereunto set their
~ /
,.,4.....-cl~.c:.< j,.
, 1~82.
IHTNESS:
Hamilton Bank
)"1 "-'~-"L ~.. .,
By 2........ ~ ~~J-'~~ '/'.t, ~ -,f<" ~'(.:'.
) , Executor
~~ t'f.s>. I \x:tt:::
Robert K. Staz, Execu~r
".
..~,(~ "A . l_-?
individually
Page 4 of 7 pages.
il.1';" 't' ;::', F"'''',-: Q:J..8
...~'...\ ..vu Io"l- "-,
"
parent of
~
III
r., parent of
III
~~--?,~
Eli eth D. Staz, pare f
John M. Staz, III
8~INLIJ ~
Diane Staz
~z~
,
ohn M. Staz, Jr., parent of
eter Staz
, Page 6 of 7 Pages.
. '-\f" 'II'. ('t-O
~CC;\ :/.\,.;;) PI"., t:..;
Page 7 of 7 pages.
~~.bE&L2a;0~
Eliza D. Staz, parent 0
Peter Staz
)~~
David Staz
., parent of
'.
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"j":,:'!
...tJ.....
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RECEIPT AND RELEASE
FROM
CAMP HILL PRESBYTERIAN CHURCH
':-/ /~ t'-t:f' 17 /J
KNOW ALL MEN BY THESE PRESENTS that I,L..-<../ (.......r..H_~_~~.
representative of the Camp Hill Presbyterian Church, hei.r of Blanche K.
Staz, deceased, do hereby acknowledge that I have this day had and
received from Robert K. Staz, Executor of the Estate of Blanche K. Staz,
the sum of $1,000.00 in full and complete satisfaction and payment due
the Camp Hill Presbyterian Church as said heir.
And therefore I ;--[ vi 1~ ./]..,--z-'V'"-[JZ...._ron behalf of the Camp
Hill Presbyterian Church, the said heir, do by these presents remise,
release, quit-claim and forever discharge the said Robert K. Staz,
Executor of the Estate of Blanche K. Staz, her heirs, executors and
administrators, of and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever, for or by reason thereof,
or of any other act, matter, cause or thing whatever.
IN WITNESS
leI>
.) .. day of
WHEREOF, I have hereunto set my hand and seal this
Y"'\'""lit..", ". l..._ , 1982.
WITNESS:
C
'- .~..,,~-,._:.~:U.,~
\-l,
/7
.'.t\-<'Y:L-._
CAMP HILL PRESBYTERIAN CHURCH
'-7 ~ _ 177 .;q
By: t.. (./ 't...-r~&, '..~e",,"'I,
C~Lv, ~,~~/tLeCI
Uf / ) 'h'/ )
~~ %<<<f :
,
scc~ tJU r~CE 2C2
i
...~._,t.
'.
RECEIPT AND RELEASE
FRml
HILDA B. TAYLOR
KNOW ALL MEN BY THESE PRESENTS that I, Hilda B. Taylor, 1105
Columbus Avenue, Lemoyne, PA 17043, heir of Blanche K. Staz, deceased,
do hereby acknowledge that I have this day had and received from Robert
K. Staz, Executor of the Estate of Blanche K. Staz, the four turquoise
and coral pieces and a paper angel in full and complete satisfaction
and payment due Hilda B. Taylor as said heir.
And therefore I, Hilda B. Taylor, the said heir, do by these
presents remise, release, quit-claim and forever discharge the said
Robert K. Staz, Executor of the Estate of Blanche K. Staz, her heirs,
, I
executors and administrators, of and from all actions, suits, payments,
accounts, reckonings, claims and demands whatsoever, for or by reason
thereof, or of any other act, matter, cause or thing whatever.
IN WITNESS WHEREOF,
'l''''d f '. /
"'" r,: :"1 ay 0 v(."~A'4'V'.,
I have hereunto set my hand and seal this
1982.
~IITNESS :
../ / ~1 J I . ')
, " ; /" ,...- ";1 '-l' . , ' I J '
" '.,tr.,/ '-' " t /\.-<.,./, /'/
"./ /
t .'
. ,
,: / / ~,
.-;...t ,~,,~, /)
,
Hilda B. Taylor
~ "
'/ J.' ,
~",.4 :~-:...-:.'"'Z.,../
/
, ,
,I
BCC!~
',/,:;;! PI" <')/- J
........... 11\,,_ <.J\J
,
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,..,.~..;.....,. ., -
CODICI L TO lULL
OF
BI.ANCIIE K. STAZ
I, !lLANCIIE K. STAZ, of Camp Ilill, Cumherland County,
l'eMsylvania, being of sound and disposin!: mind and memory, do
make, publish and declare this to he a Codicil to my Last Will
and Testament, dated
I. An Item I A :;l1all be added to my IHll after Item I,
which provides as follows:
I give all of my stock, hoth common and prc,
ferred, in East End (lairy Corporation, in
equal shares, to my two sons, ROIlERT K. STAZ
and JOHN M. STAZ, JR., or the survivor of
them.
I~ WITNESS WHEREOF, r have set my hllnd and seal to this,
I
a Codicil to my Last Will and Testament, this It; dar of
Alrl(
, 197'1.
_~~a",k ;1'f, if~(SEAl.I
Blanche K. Staz
We, the undersigned, hereby certify that the foregoing Codicil
was signed, scaled, publi'}hed and declared h~' the ahove-named
Rlanche K. ~taz as and for her Codicil, in the presen~e uf us,
who, at her request, and in her presence and in the presence of
each other, have hereunto set our hands and seals the day and year
SECOND CODICIL TO WILL
OF
BLANCHB K. STAZ
I, BLANCHB K. STAZ, of Camp Hill, Cumberland County, Pennsyl-
vania. being of sound and disposing mind and memory. do make, publish
and declare this to be tho Second Codicil to my Last Will Rnd Testa-
Dent. d~ted Juno 3. 1977.
I.
ITEM III (a) shall be amended to read as follows:
"$1,000 in cash to tho Camp Hill Presbyterian
Church' to be used for the purchase of bells for
the bell choir."
IN l'lITNBSS WHEREOP; I hnve set lilY hand nnd seal to t415, a
Socond Codicil to my Last Will and Testament. this I~ day of
April. 1979,
-A~r
,- Blanche IC. Stal
(SEAL)
\':e, the undersigned, hereby certify that the foregoing Codicil
.
~IOS si&ncd, sealed, published and declared by the above-named
Blanche K. Staz as and for her Codicil, in the presence of us, who,
at her roquest, and in her presence and in tho presence of each
-. .--...-..-
other, have hereunto set our hands and senls the day and yoar above
I:dtten, and WCI certify that at the time of tho oxecution thoreof,
the said Blanche K, Stal was ot sound and disposing mind and mc~ory.
I:ITNllSS:
AJ~r
residing at
.'
~A-II
residing at
.
'.
Page two of two Pages
.'
COMPOSITION OF NET BALANCE
.
CASH
SHORT TERM INVESTMENT FUND
CASH
PRINCIPAL
. ..4..........
.- .. ~...
....,. .
$
56.00
.....-...-.....
58,300.00 $ 58,356.00
INCOME
$
764.56
794 . 56
TOTAL INCOME AND PRINCIPAL-----_________________________________$ 59.150.56
(1)
.
,
i l
1980
Oct 23.
Dec 31.
1981
Jan 9.
21.
26.
Feb 26.
Mar 5.
~lar 17.
Apr 2.
Apr 20,
. Jun 1,
Anne F. Keller, Tax Collector
1980 Real Estate Tax to Country Club Roau
Landis Jewelers. Inc.
J e\~el ry appraisal
West Shore Times,
Publishing Letters Testamentary
Smith Glass Service,
Repair of windO\~s - 495 Country Club Road, Camp lIill, Pa.
U.S.F. & G. Company
1I0meowners premium
United Locksmith's Inc.
Purchase 2 door keys to 495 Country Club Road. Camp lIill. Pa.
Cumberland County Register of Wills
1 Short Certificate
Anne F. Keller. Tax Collector
1981 Real Estate Taxes on 495 Country Club Road, Camp Hill, Pa.
Engl e-Hambright & Davies
Liability insurance premium on 495 Country Club Road, Camp Hill, Pa.
PA Department of Revenue
1980 Individual Income Tax
Internal Revenue Service
1980 Individual Income Tax
Brackendorf Memorials
Balance due
Cumberland County Register of Wills
PA Inheritance Tax
~laster Creditors Bureau
Retrieval for Hosiery Corporation of America
(5)
s
538.56
35.00
19.81
115.54
182.00
232.85
29.00
155.94
689.00
38.00
8,000.00
4.40
1.91
1.00
"
1981
Feb 3,
Sep 10,
Nov 17,
.~'''.1oO'''''''''.;,-..;_..:,
INCOME DIsnURSE~IENTS
Transfers to Principal for investment
Pennsylvania Power & Light, Electric service, 49S Country Club
Road, Camp Hill, PA.
Penns)'lvania Power & Light, Electric Service, 495 Country Club
Road, Camp Hill, PA.
Federal Fiduciary Income Tax for year ending 7/13/1981
Pennsylvania Department of Revenue, Fiduciary Income Tax for
year ending 7/31/1981
Hamilton Bank Commission to 3/10/1981
TOTAL INCO~ffi DISBURSE~ffiNTS--_____________________$
(9)
$ 9,498.55
4.08
8.05
1,196.36
125.53
91. 49
10,924.06
.\is:.i:~1:'
STATE OF PENNSYLVANIA
)
: SS
)
A F F I D A V I T
---------
Robert K. Staz, and John M. Staz, Jr., and Peter A. Sch\<iers, a Vice President
S\10rn and subscribed to before
\4l, j} V\ '
me this /9 day of l-Lf>Jv...L,
A.D., 1982.
g~~~ .J1LIrtfJ~d-
and Senior Trust Officer of Hamilton Bank, fonnerly National Contral Bank, the at-ove
COUNTY OF DAUPHIN
named Executors, Estate of Blanche K. Staz, being duly sworn according to law, deposes
and says that the foregoing account is true and correct to the best of their knowledge
and belief, and that no person claiming to be interested in the said Estate as
creditor, legatee, next of kin, or otherwise, has given notice of his claim to the
deponents, in writing, or to I~alter K. Swartzkopf, Jr., its attorney, in writing.
/[:J /J
U~-("\.-~
[1'
Robert K. Staz
d
ohn M.
d
HA/oIIL TON BANK ~
- ~'.-' ?C' ..<?")/I <.; / . . './( , .
By:-----~-e-L V..:A; . .[t .-... ""-,-
Vice President & Senior Trust Officer
'.
EXECUTORS ESTATE OF BLANOIE K. STAZ, DECEASED
CHERVIl. S~~fORO.I:~'"o1'{ rll~l1C
llARRIS6URG, DM, ,: : CO:INlY
IA'( COlltnSSIOH EXPi::c.; NOV. 12. 1985
Mcnlbor. PI"nfiylYlnl, A:.sodalio" 01 Notarin
~,t1t~~~1:;;"~~~:;:0T;8:'?~:',:::~:t:3=7'':.''- ,,-,u~J~;'~ ,. ""'-'-:;'-::~.'-~'~:,~::~:",;,'.~_~:~~~:,::::"
..- --. -.. ....~. ----..
" ......."" .......-..,,-.
-.. "-." -- -.-.
'I.,', ",
....-----.
SCHEDULE OF DISTRIBUTION
Balance for distribution,'as per First and Final Account
Dated December 31, 1981:
Hamilton Bank, Trustee under the Will of B1~nche K. Staz,
Under Item 5. Trusts for the Grandchildren:
$ 59.150.56
Di ane Staz
John M. Staz III
Robert K. Staz, Jr.
Peter Staz
David Staz
Doug1 as Staz
Thoma s S ta z
$3.000
3,000
3,000
3,000
3.000
3,000
3.000
$21.000.00
Camp Hill PreSbyterian Church, Bequest under
Item III of the Will 1,000.00
Robert K. Staz, One-half Residue. as per
Item V of the Will' 18,575.28
John M. Staz. Jr.. One-half Residue. as
per Item V of the Will
lR,575 2R
$ 59.150.56
m:v'I~OO t:~ I ('J.Ol)
BUREAU OF EXAMINATION
PENNSYLVANIA DEPARTMENT OF REVENUE
P.O. BOX 8327
HARRISBURG, '01.17105
INHERITANCE TAX RETURN
RESIDENT DECEDENT
/7 '
J/.<.vN"'?
File Numb" ..t/ - j' () - C'.r vi :1
4. Lifo Esllte 0 5. Federal Estete Tax 0
Return Required.
6. Decedent died lestlte ~ 7. Decedent mlintelned e living 0 8. Number of safe deposit 0
(Auech copy of WillI l6..J (fust (Auech copy of Irusd boxes invantoriad
All cormpondence and cunfidentieltox informetlon should be directad to:
Neme "JjiJ.t'/if- ~. A"-' ddre ....:
, //.'"
Telephone No.
Compullti.n.f Tex
15. Amount of line 14 taxeble at 6% rete (15)
(include vllues fm m Schedule KI
16. Amount of line 14taxtbltttl5% rete (161
linciude values from Schedule KI
17. Principaltlx due (edd tax from line 15 plus ttx from line 16)
18. Total Prior peyments:
(II Amount P.id
(bl Plus Discount
(c) Minuslntertll (18)
19. Bellnce Due (line 17 minus line 181
Mike Check PaYMlle to: Register of Wills, Agent
. .. PLEASE IIECHECK MATH' . .
DECEASED
Decede rs Neme (Lilt, First, end Mi~dle Inltllll 1/
-A,& , " ,11;.
Social SecurilY umber Dete of Dalth
~. " ) - ?,r;.n'
1. Originel Raturn lEI
CHECK
c'- t'.y.. - '(,
2. Supplemental Raturn 0
APPRO.
PRIATE
BLOCKS
CDRRE.
SPOHDENT
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Recopit,lttlen
1. Real Estate (Schadule AI ( 11
2. Stocks and 80nds (Schadule 0) ( 2)
3. Closely Held Stock/Partnership Interest (Schedule C) ( 3)
4. Mortgages and Notes (Schedule 01 ( 4)
5. Cash & Miscellaneous Personal Property (Schedule EI ( 5)
RECAPIT. 6. Jointly Owned Property (Schedule FI ( 6)
ULATION 7. Tranders (Schedule Gl ( 71
8. Total Grall Assets (total Iinas 1-71
AND 9. Funeral Expenses Administretive Com/Miscellaneous
Expensll (Schedule HI ( 9)
TAX 10. Debts/Mortgages/Liens (Schedule 11 (10)
11. Total Oaductions ltot.1 lines 9 & 101
12. Not Value of Est.telline 8 minus line 111
CALCU. 13. Charitable Bequests (Schedule J)
LATION 14. Net Value subject to tax lline 12 minus line 13)
Decedent's Address .. /
-#-I,f"" (IvC(4'r.<:X Cl/uf, /Cd'.
{/,,{.t.1/ ;0/~ /;/ .; N/I
3. Remainder Raturn 0
City
State
..;
, ~
.~
;7..2. P/tJ.')~..J
,
/~ .,~ ~ 7l1/'
,j~ ~~~ ~
( BI
'f - ~C!'
. ,
,
/,,/ f'Y".f":t1y
.
(111
(121
(13)
(14)
.
I
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I
JII
x.06=
x.15=
(171
(191
Under penalties of parlulV,l declere that I heve examined this return, including accompenying schedulll end stltements, and 10 the bell of my knowledge
.nd belief, it is true, correct, end complete. Declaration of preparer other Ihan the personel rlpresenlltive is basad on ell Information of which preparer hll
any knowledge.
SIGNATURE OF PERSONAL REPRESENTATIVEIS)
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
,
ADDRESS
DATE
ADDRESS
DATE
..'., '.
~. :...