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LART WIT,L AND TESTAMENT OF ROBERT F:. SAMUEL
I, ROBERT E. SAr~UEL, of the Township of Hampden,
County of Cumberland and State of Pennsylvania, being of
sound and disposing mind, memory and understanding, do
make, publish an~ declare this to be my Last ~ill and Tes-
tament, hereby revoking and making void all former Wills
by me at any time heretofore made.
1.
I direct the payment of all my just debts and
funeral expenses as soon as conveniently may he after my
decease. All Estate, inheritance, succession and other
taxes imposed or payable by reason of my death with respect
to all property passing under this Will, or otherwise, shall
be paid out of the principal of my Residuary Estate as if
such taxes were administration expenses, without apportion-
ment or right of reimbursement. I authorize my Executrices
to pay all such taxes at such time or times as they deem ad-
visable.
2.
I give and bequeath to my wife, Evalyn R. Samuel,
all of my personal effects, all household furniture which
belongs to me, and my automobiles which are not a part of
my Salvage business. Also, I give and bequeath to my said
wife a sufficient amount of my Estate which, when added to
her own assets, life insurance proceeds passing to her upon
my death, and jointly held property belonging to her by vir-
tue of survivorship, will equal one-half (~) of our total
gross assets. ..;: ,'.' ,
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134
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3.
All the rest, residue and remainder of my Estate,
real, personal and mixed, whatsoever and wheresoever situate,
I give, devise and bequeath to Evalyn R, Samuel and Joyce h.
Fox, Co-Trustees, in Trust for the following purposes:
(a) The Trustees sball pay tbe net income derived
from this Trust Estate to my wife, Evalyn R. Samuel,
for and during her natural life. In the event that my
said wife should exhaust her own assets, Joyce A. Fox,
as Trustee aforesaid, shall have the sole discretionary
authority to determine to use and consume so much of
the principal of this Trust Estate as may be necessary
for her comfortable support and maintenance, including
medical, surgical and hospital or other institutional
care.
(b) Upon the death of my said wife, I direct the
surviving Trustee to use the income from said Trust
Estate, as well as so much of the principal as is needed,
according to the discretion of the Trustee, for the sup-
port and maintenance, including medical, surgical and
hospital care, and education, of my son, Thomas E. Sam-
uel, if he has not completed his education at the time
of the death of my wife. When my said son has completed
his education, or if he does not seek an education higher
than High School, has reached the age of eighteen (18)
years, he shall no longer be supported by the income
or principal of this Trust Estate, at which time the
balance of principal and accrued income shall then be
distributed in equal shares among my three children,
-2-
.......
Joyce A. Fox, Rose Marie Samuel, and Thomas E. Samuel,
except, however, that the sum of Seven Thousand Dollars
($7,000.00) shall be deducted from the share of Rose
Marie Samuel, since this amount was advanced to her by
me to purchase her residence property at 306 North
25th Street, Camp Hill, Pennsylvania. I f any of my
children shall have died prior to receiving his or her
share in said Trust Estate, the same shall then be held
in Trust for the issue of such deceased child, if any,
until such issue attains the age of eighteen (18) years,
except, however, that said Trustee shall have the autho-
rity to apply such portion of the principal of the share
of such issue for his or her proper support and educa-
tion as may be necessary for those purposes. If any
of my children dies without issue before receiving his
or her share aforesaid in full, then such share, or the
remaining balance thereof, shall be added to the shares
of the others, equally.
4.
I direct that the interests of all beneficiaries in
the Trusts hereby created, whether in the principal or income
thereof, shall be free from liability to attachment or obher
legal process issued at the instance of any creditor or assig-
nee of such beneficiary, and I direct that no payment shall
be made by way of anticipation of sums which may thereafter
accrue to any beneficiary.
5.
I hereby authorize, empower and direct my Executri-
ces, as such, or my Trustees, to sell, at public or private
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sale or sales, and to convey any real estate which I may own
at the time of my decease, and to give good and sufficient
Deed or Deeds for the same. They shall have sole discre-
tionary authority in this regard, and shall not sell real
estate at a sacrifice.
6.
If any of the beneficiaries of my Estate shall be
minors or mentally incompetent at the time that a payment is
due such beneficiary, and such minor or incompetent has no
Guardian appointed to see to the application of his or her
income, I authorize my Trustees to make needful expenditures
out of said income for the proper maintenance of said bene-
ficiary .
7.
I authorize and empower my Executrices to borrow
money for any use deemed proper by them in connection wi~
the administration of my Estate.
8.
I hereby nominate, constitute and appoint my wife,
Evalyn R. Samuel, and my daughter, Joyce A. Fox, to be the
Executrices of this, my Last Will and Testament. If my
daughter, Joyce A. Fox, shall have predeceased me, or if for
any other reason she is unable to act as Executrix and/or
Trustee under my Last Will and Testament, I appoint my daugh-
ter, Rose Marie Samuel, as substitute Executrix and/or Trustee
in her place and stead.
IN t>lITNESS WHEREOF, I have hereunto set my hand and
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Lellers of Administration in and for the County of
Cumberland, personally came
EVALYN R. SAMUEL
and
JOYCE A. FOX,
who, being duly sworn
, do
depose and say that as
Executrices
of the last Will and Testament of
Robert E. Samuel,
deceased
they will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And
also will diligently comply with the provisions of the law relating to Transfer Inheritances. Sworn and subscribed before me.
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DECREE
Be it remembered that on the--15.t11-day of Octoher.
,A.D.,19.J!L, there was probated and
recorded the last Will and Testament of
ROBERT r:. SAMUEL.
late of
Hampden Township
, Cumberland County, Pennsylvania,
Deceased. Letters Testamentarv were granted to
Witness my hand and official seal the day and year aforesaid,
F.VAT,YN R. SAMlffiL and JOYCE A. FOX.
~l/r {! ~
Register
.
RCC..33 (4-73)
.::2/-g'(') - /;5S'
COMMON\\'EALTII OF PENNSYLVANIA
DY:~~J~P'k"J'lJ~Q\:~I~VENU.E
BURb\\fl~s~.(~tlNTJV:'(.QLLEC nONS
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RESIDEHT DECEDENT
.B!:~
COUNTY OF (,IIMrlRlH,IINn
IMPORTANT,
Thi!'o rCIUIn must lw cumpleted in lIulnil nnd riled in dUllliclUC, with 1\11 nttnchcd, with the Register or Wills of the
COUl1l~' "heu.' dc~('dl'111 u..~idcd; nctum is due within rllllC months nfter dule of dClllh. unll'!Os 1111 extension is granted
hy tilt' Sl'crClal)' of RC\lClluc. (Section 703 (If tile lnhcrililllcC' ami Estule Tax Act uf 1961.)
I~ 'I liE 'IAI TFIl Ill' Till' ESTATF OF
} ,\FFIIl,\VIT OF
~'lCXXO:R EXECUTRICES
X)llllm~XroK
__.__ROBERT-...E.._SAMllEL
I:>T,'l~: f-ULl. tjJoMI:: Of DECEDENT,
Late of __CUl1Iberland-
S'ote of _..P_ennsyl.vania
County 01 ~_CurnI;>,erland
County
J ..,
.___.EVALYN_R._SAMUEL ann ,TOVI"F. A !"(IV,
A>tOOXOCOCi~X of lhe ntalCl olllie abo\ll!.namcd decedent being duly IWOln, depole
F:~t::loC'''+-''''; CD CO!
and lay
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!MO~~THI
Nomo olld addres:\ of ~tto.ney or }
othet oUlhotlled 'tlDtr!UHllclive 10 whom
all ~OtflUpgn,.jrnc., 5hotl.. ' ,!.
1 'I
(DAY)
, 19...B.O-{tOIIOIIl loovlng 0 last wIll, copy of which I. hereto attached..)
lYE"AR; ~
George.J-l. Houck. Attorney-at-Law
-N;:tTinnnl H~nk 'Rn;1rling, M,::a~h~ni,..!=;hn"'gr P::I
170'i'i
Tlwt :'l~ ~lH;ILExecufo...; ("'p.~,_deponel1t is f.llniliar with the affairs of said estate and the property cunstituting.
(,:,' Eel) rOR-t.Dv.INISTRA TOHl
the assets Ihcn:llf <llld tlll:ir fair 1l1arket value.
That OIl thc timc (If deil1h there was no safe deposit box registered in decedent's indi\'idual name, or jointly with, or
as a!:'=cnt tlr deputy of anothcr, or in dccedent's individmtlname, wilh right of access by another as agcnt or deputy, with the
exccption of thc following: -
NAME AND ADDRESS OF B/,NK OR OTHER INSTITUTION
IN WHICH DECEDEf4T RENTED t. 5 .FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF'
RELATIONSHIP OF' JOINT
HOLDERS TO DECEDENT
-The...Eirst: Bank-and Trn"t: Co
_aLMechanicsbllr.g..---Ee~Dzani
That the contents of said safe deposit box or boxes arc itemized under Schedules R
wi tl1 the exception of tlte fullowing, fnr the rea~nns hereinafter set forth:
of this return,
Tha' Scheelule A allached here'o and made part hereof sels for'h fully and in delail all the real property
in the Commonwc;lIth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
morlgage cncumbranl.:es UJlon each parcel ur real property at the date of death, giving the amount still due at
death, nilme of mortgagee, dille, ratc of interest, "lid hook and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuiltion of each of said parcels, the estimated market \'alue thereof
as of dale of death of decedent.
That Schedule B illtilChed herelo and made part hereuf sets forth fully and in detail all personal property
wherCSI~\'er situated owned by the deccdcnt at the time of death; all moneys left by the decedent at the time of
death. whethcr ill dccedcnl's immediate Jlossessioll. standing to decedent's credit in banks of deposit, savings
tmnks. trust cor.lpanies, nr other institutions, whether individually, or in trust for any other person or persons
giving alsu separately the accrued interest thereun, if an)', down to thc last interest day prior to decedent's
dCiIlh in the casc of savings banks, and tu the date of dccedent's death in all other case!'; all bonds, posta.l
savings, treasury ccrtificatcs or noles and other c\'idcllce of indebtedness of the Unitcd States to the de-
cedenl: all obligations, whethcr by statute IIr agrcelllcnt thcy arc dcsignated as tax frec, of the United States,
or any stalc, or Ilolitical !'lIl11li\'ision therenf, or or any forcign country, which IIrc owned nt the time of death;
,i:: ,,\...1l;11t-: .tIlP,lll'::' jl,'\\l.:h), :o.ihcf\\ure. pictun:s. !Juoks. works of art, household furniture, hurses, calriages,
automohiles. boats, and any and all other pcrsonal ch.lllcls of whalsoever. kind or nature, left by decedent,
togcther with the fairly cSlilll:ltcd market v:llue thercof; all honds and mortgages held by decedent and of all
clilim~ duc :tnd owing decedcnt at the lime tlf dcath. and lIlI promissory notes or other instruments in writing
for the payment of 1ll001l:y of whh:h decedellt died J1~ssessed, of whatsoevcr naturc, with interest thereon, if
:II1Y. giving thc facc valuc and eSlimatcd fair m;lfkct \'nluc thereof, and if such estimated fair market value be
less lhun the face \'aluc. it scts forlh hridly thc reasons for such depreciation as to each item; all moneys
payahlc 10 the estatc frolll life insurance policics carried by decedent; all annuity and endowment contracts
the proceeds of which WL'f llayahle UpOII the death of Ihe decedcnt; all and the corponlle stocks and dividends
due thereon :.Illd unpaid as nf Ik' c1atc of dcath. bonds and accrucd inlcresl thereon to lhe date of decedent's
dcath .11111 othcr ill\'c:-.lml'nt S':l' :li-.:s owned by the decedent at lhc lime of death, with the market value there-
of llt such timc.
,
In th~ caso of securlt.ios of close or rumll~' corporations, t1w \'/llues reported 8fe liS far as
ros!\lble substanttflterl by f'lnnr1ctal stlltemunts uf lllf! corporlltions, showtnJZ; the llssets llnct I1nhl11t.1cs
thereof RS of the date of denth. The schedule nlso sots forth th~ Jfllcr~!H IIf (h~cl..'lhmt. III lhe ltmt! of
death In llOr co-partnership or buRlness, and In support of the \'nlue 01' stich tnt.efPst. thero 1M 1I1lTlcxed to
said schedule, flnllnc1al statements showing tho assets and 118hl1 lUes of said co-pnflTHH'shlp or hUMtnf!8s.
A COP)' of tho co-pftrtnertlhlp ftgreement, (If oral, R stfltcrnont setting forth tho nnturc IIf tlic dgrcomont)
together with ft statement sett1nJl; forth th~ character of tlm bustrmss, Its location, ftnd such otlH~r facts
jl('rtatntng to the busincss flS m8)' be pt!rl1ncnt to a fair lint! just apprlJ.isul of' the c1t'c4!dent's interest
therein lIlust be submitted. It should also set f'orth in itemized form, togl~ther wi th the fair lIlarket valllo
thereof, 8.n~' other propert);" owned or bequeathed b);' the decedent u t. the time of cl~ntll.
The Sthtdult C attnched hereto Ilnd made pnrt hereof sots forth II true nnswer to each inflUlr)'
contained therein and in the case 01' transfers of pro port)', real or perso"fll, 1'1'1 thin two )-'ears of decedent' H
death, In contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature llnrt vulue of such prnpert)', to whom transferred, the
relationship of the transferees to the decedent, the proportionate share roceivcrt b)" cach trnnsferee and
all other facts of a pertinent nature regarding said trlll1sfers. In the CRse of t.ransfers intended to
take effect 1n posseSSion or enJo)7nent at or after tlcnth, there is also bUnched to tht:! schedule II copy
of the deed, trust agreement or other instrument creating the trust. Thor.' is also set forth in sRid
schedule a lis t of all proper t)', real and personal, wi tl1 its value, which Jln~;scs n t decedent I s death b)'
,"irtue of the exercise by decedent, oither individually, orjointl)' with another, or any power of appoint-
ment vested in deccdent, either individually or jOintl,y, b)' the Will, deed, or other Instrument of anoUler,
with a copy of the instrument creating such power attached to the schedule.
That Sthedule 0 attached hereto and made part hereof sets forth the nllmes nl1f1 addresses of nIl
persons beneficially interested in this estate at the time of decedent.' s (tenth, the nntllrc of their res-
pective interests, their relationship, i r any, to the decedent, togother with the Ages nt the time of
decedent's death of all minors, annuitants and beneficiaries fa I' life tinder (Iecedent's W11l. ..It also
contains n statement showing which of the beneficiaries nruned In the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, Md the relationship of such Issue to thp benericlnry.
That S.:/ledule E attached hereto Rnd made II pnrt hereof sets forth nIl propert)', real and per-
sonal, mmed by the decedent jointly with another or others, including intllnglble, stnnding in the name
of the decedent nnd others, plus the date and plnce of record of instruments effecting the vest.1ture of
real estate and the date of acquisition of llersonnlty, pIll!; the name, address and relnt.lonshlp, if any,
of co-owners to the decedent.
That St"edult F attached hereto and mnde a part hereof sets forth full)' nnd in detR1l all debts
and deductions claimed for and on behalf of this decedent.'s estate, Including rUne rill eXllcnses flaidj
famUyexemption, where applicable; costs of administration of thlR estatej counsel fees Ilnd rudiciary's
conunissions paid or to be paid; cost expended for burial trusts, tombstones or gr(l\'cmarkers, and reli-
gious services, in consequence of the denth of the decedent; debts and cl alms owing nn.I unpnld ut time of
death; taxes accrued chargeahle for period prior to decedent's death (except those ullowed under Section
651 of the InheritMce and Estate Tax Act); together with u sl..utement of collntertll pledged for ohliga-
tions, if any. It is agreed that the fiduciary wlll present proof of suld clnlmcll ohliglltlons upon re-
quest, that if the amount nctually paid in settlement of Imy fee, commission or d...ht. is less than the
estimated amount claiming and allowed, that the same will he reIlorted to the Hf!glster of Wills, and that
the amount of tllX nssessert can be reassessed In uccordnnce therewi tho
Thnt t.he totals of thf! nppropriate columns in Schedules "'\", "B", "C", "E", ami !'IF" us directed therein,
have been carried forwnrrl Bnd properly registered In the Sl1nunnry.
Subscribed and sworn to before me this ""..."""""""""""",,
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(Street Number)
",',' Camp",.11ill",,,P,ennsy.1vania/,..,l.10,ll
(City or Town and State)
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,,,,,.,,.,,,,,,_,,,,)(#.1........., ,,'..', day of ..' ..November,..."'"".., 19B,O",...
_",~,r~;I".."'L7, ,,', Notary,l?ub,lic""
My Commission Expires Aug. 11, 1983
SOTE: Defore stgnln~ Ilff'tdnvit make sure nIl hlunk spnces III t.he nlTldltvit llllfl scheflulcs nnnexcd lire
filled in with dclulls or the worrl !'ISone", llIut in cnse the Ilss(>ts hll~]1Il1e rltrc nll'1 ul11lste.1 securities,
securities of close or family corporntlotls or IIn inlerl!st In nil)" CO-flhrtnership or huslness, thut the
rlllta ami stntements re'llllrerl under the pnrnp;rnph ,,110\'(> rl!lnt1n~ to Scht'rlull~ fIn" Itrl~ Ilttncllf~ll. Also mllke
certRln t1111t column #1 in the IISumrnnr~'" hlts been properly complet(>d us ,.hove-direct.ed.
rl1\1MI)~\\'EI\LTlI OF I'F~~SY LH~ \,\
TH.A~Sr'EI\ !~lIE!;lTA~("E T.\~
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HES!\lEH !lITF!lI'::\T
(1) Old d~Cl~thml. wlll1111 t"'n yj~llrsol'd..::tt.. ::1;,1,;.- 'IllY 1I',HISr.." or 11Il~' IIFIU'I'1 d 11,11'1 "I' Ids PSI,'tt'., l\1t.hClllt
rt!ce t\' in!; II ,'II luflbl P IlfICt 11Iit'lll1l1l.t. ,"un'" I 11"1'11 ,. llll! t1l1'I'I'I'0 ,.',' (,\11";\\"1" "0.; II f' 11(1) No
(2) Did dPCl'lh'lIl.. ....(Ihin 1 \'to ::,;I'III'S Ill' ':"1111, 1.!.lIlsl'l'r pr"p"J"'\ 1"1'0:11 1III1Is,'lf lnl:l"-l~i'~ :lllfl 1I11flllll'r or
others (111clwlim~ II sl'OllSI') ill ,joint. (l\'l:I"I'"ldp'.' (:\11<';'\1"1' )"S ,It' !lO)_N.o_
(a) It' the IlTlSl'l'er 1(1 (1) Ill' (:.n ;lIHl"" is ill 1.11,_' HITirmal.l\"I,' o.;1.;ll.':
(Il) :\1;1' of (h:'I~,'dl'llt. lit. I illlf: "I' tr.'tll~;rl'l' _--::..._+---
(h) Stille of d.'e~'lh'ntls hl';dth :11 til~11' f,r mllkjll~ tit., trilllsl'l~". (So!.t'l).
(c) Cmlst' of' dec,,'dt'llt' ~ .j,o;lll.. (~(III' J).
(,1) Did decedent, in his 1 t r..tlnlP, ltlllk.' all~ trllllS!"'I' lit' propl'I" Y ....'11.110111. "t'e.~lvllI~ II \'ltlllllhll' oT' IIlh'lllIlIl.l'
consider/lUlltl tllp.rnf'or whieh \VIIS to t.ak.. I'f'f'l"~t III possnso.;loll or "1I.10YW!Ilt. III, III' :1l'l"I' his 1""ltll'l)
(Answer j'PS fir IIII)--..:No..--
(a) Was llu~r'~ llny Jlf)ssihllit~ thai HII' Jlrfllll-'I"l~' tral1sl't~I'rl_~.1 1lI1;!,11!. l'I!IIlT"1 III 11'IIIlSJ'I'I'I'r or III,..
estut.1! or h~ stllJ.leet 1,1. 1110.; 1'0\1"]' oj' Ilt:-,pnsi.t.llIlI? (.\ns\\'pr Y"s .lr 1111) ___No__
(I>) What. was l.hl~ trulIst'j'r,'els a~l! lit. tim" II:' d"I'l'd'~Tlt's d'~/It.1I'~
(5) Illd dece,"'"t III his II t'e"'"" ","k" 1111,1' trIlIlSt''''. .lth""' """,,1\'1,," II Vlll 1111"1 " 111101 ,<<h"IIIII'" "''''''''''''/11.11111
thcrcfor ul1cl,',' ....hl dl t.rllllst't'rllr "Xi\"'~s~ 1 Y 01' l,"plll'ell Y l'.~Sp.r\'\'s I'llI' Ills II fa> Ill' /lilY ,",,'j fill whl.'1I ,ll)l'h
not in f'ael.. cJIlI 111~f'(Jre Ilis dt~ath:
(11) The possession or ("!Il.loymCllL of' f,r j tiP right to II\l~OJl1t. l'rom 1.11" Ilrllp"I'I~' II'JlII...I"'I'I"'fl'l
C\IlSW'~I' :-'ps or HO) --Ho___
(b) 'fhp rl~ht. 1.0 ltf's1.c;nlltc t.h" 1\t'rsflllS who sl1/111 IHISSt.SS nI' 1'11.tCl)' t.11I' Ill'llp"I'I.)' tl'lllltil'III','n,1 III'
11U'U1ne t,hl'l'l'l'rnl11'1 (Answl!l' Yl'S nl' 110l N.O_
(6) [f the llUS\Io'Cr to (f)) (h) allnve Is in l..he nt'l'lrlTlfLtl\''', st./LI,e Wht'Ull'I' t.llt' rlJ..',1t1 ...II!'> ..ll....I'Vllll III dl"~'~III.Ilt.
alone or nt.II{!rS ------------------..---..-----.------.--~
(7) Oid f1ec['chmt 111 his lil'cllme IMke Il trllllsl'f'rl till' ("ollsld~I'ItI.lUl' for ....hleh ",ItS l.I'IlIlNt'I'I'P~.1 N PI'lIll1l,'" t.u
pfl~' income to 01' 1'01' the 11'mefl1. 01' f:lll'l! of trIlTls{\>rol"! C\l1SWI~r )""s fll' 1111) _.No._.__
(8) IHrl rlececient, III an~r time, truus!'!'r pl'operty. I.hf~ bellf.f'tel,,1 "II.lnymt'1l1 Ill' ~Illl'h \\H~ stllJ,I"I~1 III l'IlIlll)l,tl,
bccftusl~ of' It rescr\'t!tl llelwer tu alu'j', Hll\pwl, or ""\'01.:1', or 'I\'lllt'l: .~fl'lltl """"1'1 III '1",'~',lt'lll 11I11h'I' t.~'I'm..
of trnnsfer or by f)1"~ratl"n of Ill......? C\ns~"l' yC-'s ur 1I0)--NO_.._._
(9) If the anSwer 1.0 (H) 11llfl\'I! is III lite Ilt'l'il'l1llltl\'I', \'<IIS t1,,~ p"'!\t'l' loll Itlll"', lltll"ud. 0" l't'VIII.I' fh.. lutl'l'-
est of the henf!t'iciary l'esprvl'tl III 1.111' d,~cp.denl alow: 01' th.' fl"'l"'fl'~nt. III1tI '1Ih"I'!,':
(Answer ;yes or no) ~a_
SOTE1: Tile answers to thesf' 'I'Jestlmls shulIlII ht! S\1PPOl'tPII hy t1f't'llIlIvlt ,,~ 11ll' 1l11."lIo1lllg ph~",I.'tllll lIltt
well as u copy of' the clcnth cel"t.t t'lcnte.
SOTE 2: If' nnswcr to Iln~. 01' the uhnvI! l{ltr'~l.luns Is Y"s. Sl~t. !'u,'I.ll hl'lol'l' II c!I'!WI'lpl.lllll uf' t!l" 1','uIH'rt.r
trnnsfcrrell, it.'s fair mUl'ket. \'all1p. at. Ilatf! 111'11"11111, .11I1."s ot' tl'lll\o.;l'l'l'S 111111 to ....hfllll 1I""ISt"'l'I'j'.I, wlt.h
relationship tlf t.rllnst'erees to ~leef'flent., I I' IIIIY. SlIhmlt. copy of' IITl~' I rno.;l, oIl'f.lI fI" tllSl.I'lllnl'lll, II' I.I'''IIH-
fers nre clntmNI to be non-t.axnble, also slIlllntt. lie t.1I I 1 (!/I st,Ilt.Pfll<!llt ot' ('II"!.S nil Iohll'!l 0.;11111 l'l1l11l1 IN hnHI'~I.
:-tOTi<; 3: List IIppltCllhlf? l'rop,~rt.~' hn'ln.... in "IIIIIIl\!r In ....hleh prll\'ldf!d In Sdl'~111I1.'s \1 III III' F.
--.,--..-------- -
.u__._________..._
ITEII
!JESCHiI1TIOS
~t'\IU(ET \',\1.1'1';
(1':st.tl1lut,l'fl)
I1EIIT. \'.\I.I't\'I'IIIS
(IJ..pt.. 0111 y)
NONE
NONE
J
_____.-1 ___..__.._____,J
Insert this totnl QP(losJt~ "Trllnsf'ers", SI~IiI'lllll~' "e" III tin'
"As Reported" colul1U1 on the last IIlIW~ Ill' thiN 1'1'1111'11.
NONr.
Nlll"-,
'tJ1jIL
REY-.." Ce-7eJ
CO~1II0NWEALTH OF PENNSYLVM1A
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCIIEDULE "D"
BENEFICIARIES
M'~ li>
~~.~~~
.~ ..it""~.J
BENEFICIARIES AND ADDRP.iSES RilLA TIONSIllP
(State Cull np.mcs and addresses of all \'.110 (If step-children or SURVIVEIl DATE INTEREST OF
have un interest. veslcd. contingent or other- il1('gilimate children IlECEIlENT OF BENEFICIARY
wise. in csltHe) ute invulved. sel STATE YE~ IlJRTII IN ESTATE
forth Ihis fact,) OR NO
F,"''''1yn R_ Samuel VA" IT~ ~o 1:' ~n
?,? ':If;+-h ,I- R"'sidu",~ Estate
"~mn <H 11
PAn Ii" 17011 I
" 1:'^~ n","nh+-o," Vo",- Ono_"h~_.'! 11/3\
?"n~ ?n.'! .
h.~"~ ~ 171l 0
'RO!=;A MrlTip Sam"",] -"+-0'" Yes One-third (1/3)
306 Nnl"+-h 25th Street Relllaindel"
", ._ u,;"
n. ,"~..1..~,. ~ , 7n, ,
1:' ,1 "^" VO"'- I Ono-+-h; rd 11/3)
2]2 NOTtJ1 36th Streo+- I RAmainder
" ,n ui1 1
UOl,'
..
"
_n___ . -- -
-
D~ponent further says that 011 the above-named beneficiaries are living ot thi 5 time except below:
NAME
DATC OF CE~ii;
RESIDENCE
~
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10"
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= ~ -
u = E
:oJ e c.
:'. U
!:! c.:
Real ProperlY
Persona I Properl)'
Transfers
.Toin~ly OWn,,'" Prnp"rf-y
Gross Taxable Estate
SUMMAR Y
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(Seh. UB")
(Sell, "C"}
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REY-4U EXt tHot
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
[i] Ori ginal
o Supplemental
o Remainder
File Number
21-80-0655
aober.LE.--Sam1lll1
Estate Nome
Date of Death
September 1,. 1980
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and lor the County 01 C
Pennsylvenlo, do respectfully report that I hove appraised the real and personal property os reporte in t . oregoing
return at the values set forth opposite each item in the last column to the right in Schedules "AU, "B", "C", and uE"
Dated: February 11. 1981
.-fI'(i.-r:-'''''7 J -Rhlln.e,l)
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
coaE
ADJUSTMENTS
(HARRISBURG USE ONLY)
REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Personal Property (Schedule B)
Joint_Held Property (Schedule E)
Transfers (Schedule C)
s
00+
'0+
20+
TOTAL GROSS ASSETS
N 30+
38.086. .73
Len O.bts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
40-
OLlIe Estate
o Annuity
FACTOR
PRINCIPLE
VALUE
RATE
FOR USE OF REGISTER ONLY
~
COMPUTATION OF TAX
$
$
$
$
Tax on $
6"
"
Tax on S
15~g
Tax on $
Tax on S
Tax on S
$
Exemptions
Total Estate
$
$
$
TOTAL TAX
INTEREST FROM
BALANCE
TO
Less Credits
OATE OF PAYMENT
INTEREST
TAX CREDIT
AMOUNT PAID
DISCOUNT
S
+ $
S
$
=
+
=
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
S
S
92+
93-
CODE
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
.
TO:
,
~' 1
/.. :i'.i~r:"-/.,;..i("'" >)J '/'-/ '-/---:'J...- ~: ",f
, ",
; )") ..:-!.. - /'. ;,..- - - /. ,~" -~ .
I l/ //1 r;/ n,'z___.. /(....,./ .. .' _.t~:--/.
, /, , /1
"j' /, / -.fr/, "
.~/ I//'/' //""'_" /./",1."'" ,../i', ///f'.,'._
I ' I
(/
ESTATE
,', ,',1;:.",
I
.....'/
.J . Jr'.V.--
,/? /'/Y'j
'"
/, ~
./,)",,, ,""~I;' /'
. _. . ...-r_".i'_
COUNTY FILE NO:
/-
,', -- "
" ,
DATE
FILE NO,
/:';) ..
-
. ','-: . ~~ ~:..
COUNTY
11,//" /'."-.V-.'''/-
DATE OF DEATH
~. I "/j.,A
/," "/I"//.~ ;.t.1 j/ -:I _/~, f/
Appraised Value of Estate:
Real Estate
Personal Property
."/ ,or, I "
$ ~,.' ,,' -t :;-
, .
I ,., ~,,,r/
+ I - J,/
,
,'/ ';
- ,.
, "
Jointly Held PropertylTransfers
+ ----'--
Total Approved Deductions
~I/ "I . .- -;.,
s / " !.:'. , ,
/
i {,;.'. : ; L(:
Total Gross Estate
Clear Value of Estate
$ :,,1./',':;.:/3
I
------~--
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
'/ '/' /;~/!
$, .; /,1, "7 ,,'~'.
.,/~
Amount Taxable @ 6% Rate
','y' ,
$ ~..' v <,,' ~'::r. ,/'::'-:
tax due
s / )(')9.0/
I
Amount TaKable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
s / ld'! 0.0
'* '* * '* .. '* A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
/,} ;'}-'
/ . /". ,(J
sl' :/3 /~1
+
S ,/~. - ,j.', --
$
=
s
~/I/:/ .-: '.;>
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
S.....:' /
~ /' ~,
'.. ' ,/ i(..I.~
r,
Assessed by: ,/: /, " \..,
See Information on Reverse SIde AoentforthltCOm~ wea!lh
r' ,+~j.,--""
",' 0; .
--
./.:-/~.-t"'J
/
----.------.- - -.--
-~=c-'_...:=--.-~.--,.--. -..
*
' , ,
, ." ," '\
REV.455 (1,801
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
Estate of ROBF.RT E. SA~\lJFr, Date of Death srp'T'i-"t,p.F.P 11 r 1 q P n
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
File No. 21-00-655
elaimant
EVA T.VN n. SlIMlmr,
Relationship to Decedent
~POlTSF.
Claimant's Address ?,? lJ()R'PTI 1h'T'P qrpRP"P.'T'r ("]\, HP l=TT.T.. PENlJSYTJVl\NTA.. 1701'
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
D~~~ ~" l'''''~ T ~"".L.r.'l""'~ mo.........~ en"'" ._,. ~o nn
-, 410000
Mn~~o'~~~ "" " Tl~~o "", .1 ':...,.....~....~=~
.
'.." 1 1 , ZI C..1' ,.. ,~ " ~ M " __1 "';'.... -- ' no ,On
" " R~ ,,--'"~ """ -; ....-- "-P~,,~ .,,, nn
" . ,." .. -, -~" M",~;~~l p '" " no
D_"__ v"'~" r. "",1", " f" "'e,H ~~, l~"T''''-~O~ 'n_On
1.l-',. c. .,.. ;..~1 .~~,,~1 pv~"_~"'~ A' n nn ,
.'
- ..
Po~~ ""0_ _" T.T< 1 1 ~ '"'1;~~ " nn
. -
"'.._ , u. p ~._,.._' . ,.. ".. ,~~ , .,nnn 00
..
-r_v__ 1\, "'~.. T-' ' ,n"_~ v' '",~; Q"n nn
" 'C' I".. ,~ ,"ee 10nn nn
n
n", 0 "',;;
~~ "'n
~I ::::I ~'l::n
~j~ ~ ..~CJ
; ." -;:" ';,0
:::= ,6
Wz "'1
'::.,; - -,
- >0 ,
-' .. ".'
" "
TOTAL THIS PAGE I S9603.00
I hereby certify that to the best of my knowledge and belief the for going is a just and true. tatemcnt of debts, funeral
expenses and expenses of administration submitted to the estate a d actions for Inh rit ce Tax purposes.
V "'-r;"- 12/]0/80
ClARY DATE
OFFICIAL USE ON
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S Cjt,tJ3. tl-C
/
AT
(,
PERCENT.
,~t.:J
,:(-/11'1
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate.
In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot., tombstone or grave marker.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed
should be attached to this schedule,
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania,
If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim tha exemption. In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent.
c "" 0 n > t'1 > :s
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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 consecutive numbers to each item listed.
3. Enter the date on which each debt was incurred and/or paid.
4. Enter the names of each payee.
5. Provide a brief explanation in the remarks column for each debt claimed.
6. Enter the amount of each debt being claimed.
7. The form must be signed by the person who has assumed the responsibility for paying the debts.