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1tI. AEV.1162 EX "
.~.. , . COMMONWEALTH OF PENNSYLVANIA
4 NoK 29553 DEPARTMENT OF REVENUE
" , OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
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~I RECEIVED
I.' FROM
I . ADDRESS LO E. High street
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TAX AT 6%
TAX AT 15%
willi.. F. Martson, P.C.
TAXAT_%
ESTATE TAX
34.42
Carlisle, Par 17013
'--ESTATEINFCiRMATio'N;;;;;;--'2-a -19-aO'-----------
DATE OF DEATH -.". ·
TOTAL TAX CREDIT
21-80-607
May 28, 1981
FILE NUMBER
LESS DISCOUNT
PLUS %INTEREST
IFROM TO_I
DATE OF PAYMENT
m
m
NAME OF DECEDENT
EDNA S. MONISMITH
CUlllberland
34.42
COUNTY
TOTAL AMOUNT PAID
-------- ------- ------------
POSTMAR K DATE
'EMARKS, "'Am ON ACCOUb1T"
SEAL
RECEIVED BY
REGISTER OF WILLS
No. 21.80
~;07
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
, deceased.
FnNA ~ MONTSMTTH
_}JA,RY C. LEWIS
To ~ard C. Ander8DFI, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
IS
Petitioner(:) Cl'e the executrix named in the Last Will and
Testament of F.r1n.. ~ Mnni ,,~ dated April 15. 1978
Decedent was 0 citizen of the United States and a resident of
T[l::l'1ship
r...r1; ,,1 P Borough, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on Thursdav
the
28th day of
August
A. D. 19.8.0-, in the County of Cumberland
State of
82
Pennsylvania at the age of
~ :Re&- her
Decedent has not been married and has not had children born to mm..
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
Unestimated and of real estate to the value of
years.
None
as near as can be ascertained; said real
NONE
estate situated as follows
-101"1',-
Therefore, your petitioner(~) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated
September 19, 1980
Name and address I.
of Petitioner(~)
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Virginia M.
/-!-I-C;(1,l
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Hogan
420 "D" Street
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} ss
VIRGINIA M, HOGAN
named in above application, being duly "'Jnrn according to law
say(s) that the statements set forth in this petition are true to the
best of
knowledge and belief.
npT'
sworn
and subscribed before
me September 19 1980
, ~~. ~~d!.~er
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Filed:
, ":</-r.? - b 0 7
Attorney:
William F. Martson, Esquire
WILLIAM F. MARTSON, P. C .
September 22, 1980
/1- /.JS'"- 'f
21.80 ~)07
No.................................
Renunciation and Request
------
In the Matter of the Estate of ............E.PNA...S.....l-lO.N.ISMIIH................................................................................
To .............MARY....C._...LEW1S..............................................................................., Esq., Register for the Prohate of
Wills and granting Letters of Administr.tion for the Cou nty of Cumberl.nd, in the Commonwe.lth of Pennsylv.nia.
......1..., the undersigned, being named...as....o.n.e...of...the,...two...Exec.u.to;J;s...in...the.................
......Las.t..,Will...and...Te.s.tament....oLEDNA...S.....MONISMIIR.,....dat.e.d...Ap:t:il...5..,....l.9.7.8 .
..................................................................................................................................................................................................
...... ..........................................................................................................................................................................................
..................................................................................................................................................................................................
do hereby renounce .........my................................................ right to have letters ..!e.s.t;.am~J:I.t.ax:y..........................
.......................................................................... on said Estate issued to .......me..............................................................
................................................................................................. .................................., .nd do herehy request you to grant
the s.me to .........Y.l.E.G.IN..IA..M......RO.GAN.......~I:.~Q....~.p..::....s..t.I!?!?~......Q.~.F.J.:!,.~l~......rA....).Z.QJ:?.......
Witness..................h.nd..........,......nd se.1.............. ..this.... ...,...J.t....a.......................................................
day of .......se.p.t.embex:.............................A. D. 19.~..p.
Sealed and delivered in Pl'csence of
'~~4;mmmm "~~r<tt:ttirfi4(m(l.aJ
..i/.....................,......... .................... ........................ ..... ....... ........... .... ........... ....n...m .............. (L. S.)
...............................................................................
..................................................m...........(L.S.)
................................................................................
.................. ..................n............mm........ (L, S,)
.......................................................................n.......
................................................................(L,S.)
.......................................................n.......................
................................................................(L.S,)
................................................................................
...........,....................................................(L.S.)
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LA ST WILL AND TESTAMENT
I, EDNA S. MONI SMITH , of the Borough of Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind and
memory, do hereby make, publish and declare this to be my Last
Will and Testament, hereby revoking any and all former Wills or
Codicils by me made.
1.
I direct that all my just debts, funeral expenses,
testamentary expenses and all inheritance taxes shall be paid
from my residuary estate as soon as practicable after my decease
and as part of the administration of my estate.
2.
All the rest, residue and remainder of the estate, I give,
devise and bequeath in equal shares unto my children, absolutely.
As of writing this will my son, Charles Monismith is deceased
and I direct that his share shall descend equally to his children
and in the event that any of my other children shall predecease
me, his or her share shall pass in the same manner to his or her
issue surviving.
3.
I hereby appoint Virginia M, Hogan and Lester G. Monismith
as Executors of my estate and I direct that neither of my said
Executors shall be required to post bond in this or any other
jurisdiction to secure the faithful performance of their duties.
IN WITNESS WHEREOF I have hereunto set my hand and seal
this S*' day of C.F ,1978.
(SEAL)
Testatrix, EDNA S. MONISMITH, as and for her Last Will and
SIGNED, SEALED, PUBLISHED AND
the above named
LAW OFFICES
WILLIAM F. MARTsoN. P.C.
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COMl10ll\iEALTH OF PEi~NSYLVAiUA )
55
COUl~TY OF Cm1BERLAl.~D . . . . )
I, EDNA S. MONISMITH Testa~ix, whose name
is signed to the attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge
that I signed and executed the instrument as my Last Willi
that I signed it willinglYi and that I signed it as my free
and voluntary act for the purposes therein expressed.
EDNA
of
Sworn or affirmed to
S. MONISMITH
C1"~> ' 1978.
&lVLc<.- ~,7)U;ru,!J~}, (,(l
and acknowledged before me bYl
, the Testat rix, this s't/, day
;i:?~~#UZ1t'--x/Ml"i
COMMONWEALTH OF PEID1SYLVLUUA )
S5
comITY OF CmmERLAND ' . . . )
\-le, ~,~;( fJf!.u\L~iI(l.,-,( ~-,.M", x! Bh"i/I<,,'C,.
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw EDNA S.
MONISMITH . Testat rix, sign and execute the instrument
as her Last \'Till; that EDNA S. MONISMITH
signed willingly and that EDNA S. MONISMITH
executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight
of EDNA S. MONISMITH . Testatrix, signed the
Will as witnessesi and that to the best of our knowledge the
Testat rix was at that time 13 or more years of age. of sound
mind and under no constraint or undue influence.
~~ l<. O~QJ([
Address (0 . (+~
MAR'! LEA ;;r,ENK, Notary Public
Corliste, CUlT,ber,ond Co., PA
My Commi . '.',. 27, 1981
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Sworn or affirmed to and subscribed before me, by
f{1-1"~c!.;!I. ()<.Jt,t00!1th.< ~~r_ y! E'chrJIo-k-
--II. ~ '.J
this 6 ~ day of 0.:nvC , 1978.
71Iti.Acf. CX~ ).JI.'-J~'
Notary Public
N,",-\,L :..~;.. > .' '. :-J-,t"rv PubHc
Ccrlis~f;, CL.:-;~,(.:.,." -- , ~,,\
My CoIl.'"', ). 2", 19o~
L^W OFFICES
Wlt..UAM F. MAATGON. P.C,
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OATH OF SUBSCRIBING WITNESS
MMONWEALTH OF PENNSYLVANIA I ss:
COU OF CUMBERLAND \
This....... .............. .......... ..................... .................. day of... ........ ............. ...... .............. ......... ..... .....
nderson, Register for the Probate of Wills and granting lette of Administration
;~=:r:.:::;:~:~~~~::~~~::~::~~~:~~':":::P:~~~I::::":::11:==::
the subscribing witnesses to the forego~g instrument of writinlvpurporting to be the last Will and
/
Testament of ................ .... ............ .... ........ .....~<.:.:.................. ...../....... ........ Dated .. ........ ...............................
...... //
lateof..:.......................................................................~X{...................... Cumberland County Pa., deceased
who bemg duly........................................... accordm{t.o l'llw-l, depose and say, that ........................................
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present, and saw and heard the testa................................, ....... ....................................................................
sign, seal, publish, pronounce and deela~e said instrument of writ as and for h................ Testament
and Last Will, and at the time 0 ~oing .................................................w.. of sound and disposing mind
memory and understandin ,to the best of ..............................................knowledg
......................... ..................... and subscribed before
............................................................. ...................
....................................................................... .........
.... ..............................................................................
.................................................................................
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA! ss:
COUNTY OF CUMBERLAND \
..................... .........Y.IRGltilA..I1_..110GAN. .............. ............................ .............. ................................being duly
..........SWD.t:n........................... says that as nearly as can be ascertained the said decedent ..........................
............................. ..........E,UN/I....S.....H9NISMI:rJ;l...... ........ .................. ............................. ........................died on
...........'l:b:v.l:ll.Q.aY................... the .........Za.t.h..............day of ..............b:v.g~.l>.t;......................... A.D., 1980...,
at or about .......................................... o'clock, ....M.
..................~:1.R:':.~......................and subscribed this
.................}.?~~.................... day of ..~.7.P.~.7.~.7.!:.
19, .~.~..., before
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~....../....~.~!,.;I::.'.:.;.\~......!..U..,.../I.::l~.\ .~,\,..............
Virginia M. Hogan .)'
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RleR . 8n, RegIs I'
Mary C. Lewis
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF CUMBERLAND S8:
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for
the County of Cumberland, personally came ...........yJm;J.~;J;~..!1.:...H9.9.M~...................................................
who, being duly ..,!l.W.9.r.TI.............., do ~.!L.... depose and say that as....);:.~~f.1J~X.~~................................,......
of the last Will and Testament of ...............J;;p.~.~..~.:...!'.I.9.NJ.~.!1I!:H..................................................deceased
.........ab~.......... will well and truly administer the goods and chattels, rights and credits of said deceased
according to law. And also will diligently comply with the provisions of the law relating to Transfer
Inheritances. ........~.Wg:;:n......... and subscribed
before me.
...~..~..;_.;...".!............. A. D., 198.Q......
ii,.::.~~;~~:~~..................
Mary C. Lewis
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Be it remembered that on the ........~~.~.9:....... day of .........~.~p.!-.~~.~~................... A. D,. 19 ~.9...., there
w b ted d d d th I t W'II d T t t f Edna S. Monismi th
as pro a an recor e e as I an es amen 0 .............................................................................
late of ..........~~.7.~~.';l.~~................................................, Cumberland County. Pennsylvania, Deceased. Letters
....................:.~:.~~.:~:.~~~..,... were granted to .................Y.~E9.~~.~~..~:....I;!~.~~...................................
Witness my hand and official seal the day and year aforesaid.
.94~
.
PERSONAL PROPERTY _ List all tilngihlo Bnd intnngihl~ personal propurty owned imhvitlulllly by the dect!"
dent at tho timo of doalh.
Euimated
Markul Valuu
Departmenl Vnluation
(Olficial Usn Only)
Department Valuation
(Official Use Only)
NoNE'
List all safe deposit boxes reginered in the decedent's individual name, or jointly with, or as an agent or deputY of another, or in decedent's individual
name with right of access by another as agent or deputy. Include the name and address 01 the bank or other institution where the safe deposit box is located.
the namels) in which the box is registered and the relationship of the joint holders to the decedent.
1.
Optional Payment Share Certificate No. 143671,
Cumberland Valley Savings and Loan Association
Balance at date of death
Accrued Interest
382.79
3,47
$
2.
06-6-1064-1, Dauphin Deposit
Balance at date of death
Accrued Interest
Personal Funds Account - Church of God Home
Refund, Hoffman-Roth Funeral Home
Refund, United Telephone Company
Bank
Savings Account No.
and Trust Company
170.44
1.43
166.99
55,02
6.60
3.
4.
5.
Total
JOINTL Y.OWNED PROPERTY - List all real and personal property owned by lho decedent with anotherlsl
as joint tenants with right of survivorship.
786.74
Estimated
Market Value
NONE
NONE
Total
NONE
TRANSFERS _ Lin all real and personal property transferred within tWO years of dealh.
Estimated
Market Value
NONE
NONE
Total
NONE
Name and Addu"! of Bank or Othar Institution
In Which Decedont Malntalnod a Safe Deposit Bo)(
Name or Names In Which
Safo Doposlt 80)( Is Registered
Edna S. Monismith
with Vir inia M. Ho
Rolatlonshlp of Joint
Holden to Decedont
Dau hter
NOTE: You may expedite the processing of this return by filing with it and as a part of the return, letters from financial institutions or mortgage holders,
certifying to amounts on deposit or owed by the decedent as of the date of death. Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,
8CL"unt number and tho exact namo or names in which the account is registered.
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16 West High Street. Carlisle. Pennsylvania 17013 249.2525
Law Offices of.
William F. Martson, P.C.
AU: Wm. L. Earp, Estates Administrlltor
Henderson Block
Ten East High Street
Carlisle, Pa. 17013
CUMBERII1ND
191LLEY ~1NG,5
. AND L04N ASSOCIf\TION
September 26, 1980
RE: Estate of Edna S. Monismith
Date of Death R/20/00
Dear Mr. Earp:
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Upon checking our records we find only one account in the name of
the above captioned estate, under social security #20B-24-0350.
Account Number: #143671
Name: Edna Monismith
Principal Balance:
$382.79
Iht. from 7/1/80
thru 8/28/BO
$ 3.47
Total............... ..$386.26
The above mentioned account #143671 has been closed as of
September 26, 19BO. If you need any additional information regarding
this matter please contact this office,
, cZd04
Richard L. Kuntz
Accounting Department
ymr
D
Dauphin Deposit Bank
and Trust Company
MAIN OffiCE: 213 MARKET STREET. HARRISBURG. PENNSYLVANIA 17105
117 255.2121
William F. Martson
Henderson Block
10 East High Street
Carlisle, Pa. 17013
Attn: ~illiam L. Earp
Dear Mr. Earp:
October 15, 1980
Re: Edna S. Monismith
August 28, 1980 Decea.ed
In regards to the above mentionec, We submit the following information as of the
date of death:
Savings account #06-6-1064-1 balance $170.44 interest $1.43 (Edna only)
If we can be of any further assistance, please do not hesitate to contact us.
JCS/lf
Very truly yours,
if, ,,~-( .
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, J chnn C. Stover
Account Service Officer
CHECK NUMBEI3
EDNA S MONISMITH
0131253\
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80553
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-85\3 b.bO
NAL BILL REFUND CHECK
R NUMBER 243-7242
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0011
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THE UNITED TELEpHONE COMPANY OF PENNSYLVANIA
1170 HARRISBURG ~IKE. .CARLlSLE, PEtW.SYL"VA:NIA 17013
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1312531
60~ 1 54'
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NA.TlOH"L. ctinR"L 8,,14K
to..."''''SIU..,.rCI.IN'''
11/04/80
PAY *********6 DOLLARS AND bO CENTS
$*:**~~****6,bO
10m /F NOT CAS1IED PITH"'\,' 90 lIArS
THE UHI,EO TELEPHONE~OMP"NY orPENN5YLV.-.NI/>.
.4..lhori:,d Sip!~tu,~s
"PAY TOTHE
" 'ORDER OF:
EDNA S MONISMITH
C/O VIRGINIA HOGAN
,420 D ST
CARll SLE P A'
170\3
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Acct. Nn.
1?eceived [1'011I7./ J? s,,, "/,, 1,0 /-I. I L..L 0 ~~t: $/ t-. g' 9 f
rj. ,I / / . ~1 LP C' Hf;-tl P'ym',. d~~ ('Ld
/?y' A'-I-tI?7d'1,.)... h'J..;''': ...J.</I. /7U /;h'11 .
(] ,. _'vo (liS
FUN~~L ~ .550
SERVICE ~ n " J. ~,L..,L /.11 <tt.
-=R.nJmJ~~~ m/77r~'1..-:"','?/LX' '"L'..L. '~4'..u.....
o Cash --' _ NAMEOFOI:CI:ASE:O 'J /~~{;.A'-(..~
[1l/'g.eCk #/.~. h'0 7/::- i,"OJ (f;(,ft #=
D/Soc;,' Sccur~'y HOFFMAN-ROTH S~': ~hg. O,'t?7 f('
o V A aenefh 4!. Funeral Home, Inc,
o Inluran~ q 79%0 J3iJjU,L;~~'~Of});;~lfi1' ~~r. $648
ESTATE OF EDNA S, MONISMITH
Virginia M. Hogan
420 "D" Street
Carlisle, PA 17013
Ruth Logan
430 North College Street
Carlisle, PA 17013
Isabel Franklin
270 South Pitt Street
Carlisle, PA 17013
June Conrad
82 Fairview Street
Carlisle, PA 17013
Evelyn Hipple
317 Linden Street
Marysvi11e, PA 17053
Mabel Monismith
3609 Mentone Street
Apartment 5
Los Angeles, CA 90034
Iva Piorkowski
510 Boeing Avenue
Reading, PA 19602
Lester Monismith
706 East Loockerman St.
Dover, Delaware 19901
Lee E. Monismith
818 Glen Road
Fort Lee, NJ 07024
BENEFICIARIES
Daughter
Daughter
Daughter
Daughter
Daughter
Daughter
Daughter
Son
Son
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
YES
One-tenth (1/10)
of Estate Residue
LAST WILL AND TESTAMENT
I, EDNA S. MONISMITH, of the Borough of Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind and
memory, do hereby make, publish and declare thi.s to be my Last
Will and Testament, hereby revoking any and all former Wills or
Codicils by me made.
..
1.
I direct that all my just debts, funeral expenses,
testamentary expenses and all inheritance taxes shall be paid
from my residuary estate as soon as practicable after my decease
and as part of the administration of my estate.
2.
All the rest, residue and remainder of the estate, I give,
devise and bequeath in equal shares unto my children, absolutely.
As of writing this will my son, Charles Monismith is deceased
and I direct that his share shall descend equally to his children
and in the event that any of my other children shall predecease
me, his or her share shall pass in the same manner to his or her
issue surviving.
3.
I hereby appoint Virginia M. Hogan and Lester G,. Monismith
as Executors of my estate and I direct that neither of my said
Executors shall be required to post bond in this or any other
jurisdiction to secure the faithful performance of their duties.
IN WITNESS \VHEREOF I have hereunto set my hand ~nd seal
this 5~ day of ~ ,1978.
Testatrix, EDNA S. MONISMITH, as and for her Last Will and
SIGNED, SEALED,
rei 10 _9.-G-m['71~ntmJ~ (SEAL)
PUBLISHED AND~tARED by the above named
LAW o.."CC6
tWAM F. MAlntON. P.c
!
-1-
CONHom~EALTH OF pmlHSYLVhiHA )
SS
COUNTY OF CUHBERLAHD . ., )
I, EDNA S. MONISMITH Testa\):ix, whose name
is signed to the attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge
that I signed and executed the instrument as my Last Will;
that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
~1.. C- ,>J., 7JlJ;J'LL9 ~" (1/
EDNA
of
Sworn or affirmed to
S. MONISMITH
C/"~ ' 1978.
and acknowledged before me by.,
I the Testat rix, this s'H, day
z~uC?li~ >1M,""
COMMONWEALTH OF PENNSYLVAHIA )
SS
COUUTY OF Cill1BERLAND . . . . )
v1e, ~ K- IJUA~I/ t7,,~{ ~..,.M>. xl &?tA~
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw EDNA S.
MONISMITH , Testatrix, sign and execute the instrument
as her Last vall; that EDNA S. MONISMITH
signed willingly and that EDNA S. MONISMITH
executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight
of EDNA S. MONISMITH ' Testatrix, signed the
Will as witnesses; and that to the best of our knowledge the
Testatrix was at that time 18 or more years of age, of sound
mind and under no constraint or undue influence.
X1~ k'. O~~
Address (0 . r+,~
('
M.\RY LEA St-:fNK. N:>'ory Public
Corli~~e, Curr.Lcrlond Co., PA
My Comm;,," . . -,~. 27, 1981
niL . It ,t ~,dV
Address /1' If air ffJ' ,&If.
('/I'I,lJt. (,r,1
, .
Sworn or affirmed to and subscribed before me,. by
fd;;,;...v/l. 1J~,~iI t7-/~( -d: ,.Mr- ~ E'ch70G-.-t,-
this 6-t<. day of ~ . 1978.
'71~lA.-.f. ~ >4ZJ
Notary Public
'\'\ARY LEA s..::.::~. t'bt:'ry Public
Corl:s.1e, CtotT,tJt:r'c-d C'~.. PA
My Com....,"', . ,. 27, 19a~
BENEFICIARIES
..
BENEFICIARIES AND AOORESSES
(Stl,e tull names and addroiS05 01 all who hnvc an intorMt
eithor vested. contingant at other interest)
RELATIONSHIP
TO DECEDENT
SURVIVEO
DECEOENT
STATE YES
OR NO
AGE OF LIFE
TENANTS OR
ANNUITANTS
AT DEATH OF
OECEOENT
INTEREST OF
BENEFICIARY
IN ESTATE
:..
CharleS-Monismit
SON
--110
Chi1dr.ep nf ChaJ:lesJ1anismith'
M,." en ",.1 ntt:e-S,t"m T.ot-L4
Pine Ridge Village,Carlisle,PA
171)1
(ru,_",,,,,nti "1:"10 (1,"0)
tatt:' 'Qt:lcd rl1\O
)
n,!:l1t:J. Mnn;!::;mirh
~ F .~"l"m. o""eon--9130
(See Attached Sheet)
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INFORMATION
PLACE FOR FILING _ The rei urn is to be filed in duplicate with the Register of Wills of the countY wherein the decedent resided,
TIME FOR FILING _ The relurn is due nine months after the decedent's death, unless an extension for filing has been applied for and granted
by the Secretary of Revenue within the nine-month period.
FAILURE TO FILE RETURN _ Section 791 of the 1961 Statute provides that ". , ,any person who willfully fails to file a return or
other report required of him, . , shall be personallY liable. . , to a penaltY of 25% of tile tax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by law,"
REV..4S1 EX+ (1-eOI
COM\\ONI'iEAL TH OF rENNSYLV/,NIA
DEPARTMENT OF REVENUe
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
~
~."'-,
~:
, ,,,;~'. '~"'"
'.. ~.. .\
..\......t~.~.~!~..tr;
[2]ORIGINAL
o SUPPLEMENTAL
Estate 01
Edt.'a~,~~isl1!!th. .,
File No. __1.1:~<1-0607
Coun ty
Cumberland
Date 01 Death August 28, 1980
In the eyent that an)' future interc!Ot In this estato Is trnn5ferred in possession or enjc)'mc:nt to colloteral heirs of the decedent after the
expiratlan of any estote far 11(" or for ytlOH. tho Commonwoalth hereby oJCpressly rosorvos the right to oppraise ond onen transfs,
Inhs,ltancs tOlCes at the lowful collotcral_~ulo o~ an)' such futuro Intorest.
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
ASSET SUMMARY
DEPARTMENT'S
APPRAISED VALUE
none
Unrepo'ted 5
Unreported 5
Unreported 5
Un,eported 5
5 none
5 786.74
5 none
5 none
$ 786.74
1. Toto\ Reol P,operty - 5CH, "A". . . . .. $
2. Totol Personol P,operty - 5CH. "S". . . . 5
3. Total Jointly Owned Property - 5CH. "e" $
4. Tota\ Transfers - 5CH. "C". . .'. . . , . 5
none
786.74
none
o LIFE ESTATE
DANNUITY
TOT AL GROSS ASSETS
DREMAINDER
TOTAL VALUE
s
I do hereby certify that the auave appraisement is made in conformity with Pennsylvania law and has been filed this
day with the Register of Wills.
_jll)~tO.,'/"I--l(t~;)l1ir{l) June la, 1981
APPRAISER QATE
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