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HomeMy WebLinkAbout80-00666 ....' \, ',' .., '1 . ~ ..,....". ...;..' ~ ,,' ~ ~ ,,' ~ CI) 0 H ~ ~ .. ~ t:I ~ ~ . l:) (,' H :& t4 a Iii g ~ 0 00 '. - '- t"f 0 .-.. ," ~ " . ,.'; 0 :J . e" Z ~ , ~ " , . ~ ;;f c <:c ", ~- .. - u.: 0' S -, a;: v: ~ ", - 0(3 Uw ;..~! ~cr N .' ..To :.J lX' _J.~' C;. -- ~1.80- GGG 2 ,^ -' .- ul'. Q" ". L.4,';";..o-. c:. .. ,-,z.:. , '-'u.. C'J ~u:: ..1- 'P ..> cD i""'; '" .~I,'Il ,"1(") :~~3 ,. E-4 Z 0: ~ 1I1 III " Z . S Ul " .. 0: " Ul . ci ~ u <( . I'l ii: :t . a: ~ . u. ~ ;J iii tD r.. ..l 0 , Ul 0 ~ u ii: 12 >- 0 d <t " a: 0 .J 0: <t .... .., z - J: ;., III E-4 :t ~ ..::I , ~ -' . ", 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 who, being duly Sworn Helen M. Davis ,do es depose and say that as F,xecllt rl x of the last Will and Testament of John L. Davis deceased She will well and truly administer the goods and challe!s, rights and credits of sold deceased according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances. Sworn and subscribed before me. August i7 , A.D., 19~ <JJJ."--.~ 111. fJ-I.-,<~ /jJ}t/;/ (t'. .:X:'-'/~;/ I Register ., :;: c. 0: c', L:_~ '.' C-, .. '" .... ;;:r. . O<::i) .,". ~L..l - . ",,"" N .. .) ~ ... c... 11 . . .(U :Qj . l~ . 0'\: co: U. ''''I 0 en: ..-j: >: ,.!o: ..J oj; ~ Al ..J - ,. - . - ....:ll .~ $ .21 ::= .. = u; 0; .~ E-<: '"l -g rill 'E "I: 0 <q'i ~ "C ~ = ~ tIl N; co: '" ~r ..: co: .-i~ 4->: Ul: ~: bll' ~ ..: r."; ...... ~i r.!) \0; \0: c'. \0: ,: eo: 0; . : co: .,.. : Nl I: .-I; . . C\ll , . , i 0 Z 2 ~ S Ul r:il DECREE Be it remembered that on the 18th day of ,A.D.,19 82 ,there was probated and A\l/1:lInt recorded the last Will and Testament of Mechanicsburp; John I.. OIL vIs , Cumberland County, Pennsylvania, Deceased. Lellers Testamentary were granled 10 Witness my hand and official seal the do)' and year ofore.nld. - . ' ,1~) Helen M. Davis 'g - i:i: late of OATH OF NON.SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA} 55: COUNTY OF CUMBERLAND This, the ./ / 17 It- day of A.D. 1982-, before me, Register for the August Probate of Wills and Granting Letters of Administration in and for the county of Cumberland, in the Commonwealth of Pennsylvania, personally came who being duly Patricia L. Saylor and John S. Lencioni Sworn according to law deposed and say that they are well acquainted with the handwriting of .John T.. DRVi" to an instrument of writing whose name is attached as Testator purported to be ------ the Last Will and Testament of John L. Davis late of Mechanicsburll: , deceased and that the said signature is true and genuine, and that the said John L. Davis is now deceased ~~ Sworn and subscribed before me, ~ / 7.ffi-'- this _ _ day of AUll:ust A.D. 19J32- ~{I~1f (J, ~.uH'~/ f Register ( per Deputy Register 4<1 . C' .. a.- ,. CL ~ .J - ~ '. r.::,,.. "- '.' :J;:f.'j ~ ,"R CJl:j <">W N , ~r.:: ;..... fO c. -, '" --". - ". c, '. ~" l.; - Cl' u: ~ , ".' <'"li:5 <'>w ~ j ~'t: N ~"j (X' C~l REV.!lIO t::J(+ t7.IlO) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF R~VE"UE TRANSFER INHERITANCE TAX RESIDENT DECEDENT Estat. of INIiERITANCE TAX RETURN FOR INSOLVENT EST ^ TES (Instructions on Rov",so Sid.) COlJHTYNO. c?J-ff~-tf,t:.tb John L. Davis Lost addr.ss 330 s. WashilUl:ton,Apt. 7 ISlR!;;ET) .. z ~ Mechanicsburg, Penna. ~ ICITY) ISTATEI '" <> Dot. of Death ]70'15 IlIP) Anri! 2'5, 1Q80 Social Security Ho. 191-05-0930 TYPE OF ASSET Car Stock ~ .. '" ~ ~ '" OFFICIAL USE ONLY DATE 5-5-80 5-5-80 ~ 9-10-80 a 4-30-80 t 4-30-80 6 7-14-80 '" o o z '" ~ ... " '" o OFFICIAL USE ONLY I J - N.(}- / DESCRIPTION STATE NO. ( ) E.ec. () Adm. Olhe,Survivin,o: Helen M. Davis spouse Norno t- o: .. U => <> ;;: Social Security No. -198-1)8-0627 Addre.. ~ington St -. Apt:. #7 ,',l'lI:l,.. Mechanicsburg, Penna. 17055 lell...) (SlI.lll {ZIPI U:1(iI~r rH'tItl\lil!S of P'HjUrv. I declarc 111M I how r.)(smlnCd this return ond to the bon of my knowledge ond beliel it is true, Corroct and complete. .9'~-j171.J)ru,~ CY d 16 17h SllJfl,Jluf(' 01 Fluu,lo1lY Calc ( ESTIMATED MARKE r VALLIE DEPARTME"T VALUATION (OFFICIAL USE ONLY) 1979 Oldsmobile cutlass Duquesne Light (50 shares) t:. /3, .r'/~- 3800.00 (715.00) G'l 3. 75'" NAME OF PAYEE Petruney Flnleral Home Mutual Aid Ambulance Restland-Lincoln Mem. George petruney Restland Cemetery Westmoreland Hospital · f/ V,(J. jj- EDU c.. "rIONS ALLOWED TOT AL ''/; y. '/ E. 7 S- ~ &.-?- ') J.'r:' ') I _i"'JJ4.1{f ,1 rJl },r.f APPRA.ISER December 4, 1980 DAlE NATURE OF CLAIM AMOUNT CLAIMED Funeral Expenses Ambulance Bronze Memorial stone Cemetery Road Use Interment Fee Hospital Fee Family Exemption 1730.00 go.OO 950.00 40.00 300.00 32.15 2000.00 TOTAL 5142.15 ~f-t(/ e. ~/(N'~/ REOWER Of' WILL -r-fl DATE Il'ISTRUCTIOl'lS ASSETS: TYPE OF ASSEl _Indicate whether the a..et i. real e.tate, pe"onal property, tran.fer or jaintly.awned. DESCRIPlIO~ _ U., all a..ets owned .olely by lhe decedenl or owned jointly wilh another parly or partie' as tenant. in cammon or as joint tenant. with right 01 .urvivorship at lhe time 01 death. Include the decedent'. percentage. of ownership, the name (.) and relation.hip to the decedent 01 the.urvivlng joint owners and the e.timated market value 01 the decedent'. intere.t a' 01 the date 01 death. Include inlangible personal properly titled in the name 01 the deccd~nl but payable at death to another party or partie. including but not limited to P.O.D. U.S. Saving. Bonds and tentative tru.l account.. Li.t any property transferred by the decedent within two years 01 death lor which he/.he did not receive valuable and adequate considerctian. ,.' " . ., , Desc,lbe all real e.ta'e laca,tedin Pennsylvania by lot and block number, .treet oddr;.., numbe;ol acreS and include 0 general description 01 the land and buildings, Also, include the book and page number in which lhe deed i. recorded and the cl(ocf title 05 indicated on the deed. . 'I, DEBTS & DEDUCllOl'lS _ Un.atisfied liabilities incurred by the decedenf prior '0 hi.'her dealh ore deduc'ible against hi./her ta,oble estate. In addition '0 debts incurred by lhe decedenl, other item. are claimable-including the co.t 01 administrolion, attorney lees, liduciary lees, luneral and burial e'pen.e. including the co., 01 0 burial lot, tomb.tone or grave marker. Li.t the dote on which each debt wa. incurred and/or paid and lhe nameS 01 each pay e.. Provide 0 briel explanation of the nature 01 each debt claimed and the amount being claimed Evidence to support the decedent's or the e.tate's Iia~ility lor the debt. being claimed should be attached to lhis return A lomily exemption may be claimed by a .pau.e of a decedent who died domiciled in Pennsylvania. \I there i. no 'pouse, or if the spouse has lorleited hi./her rights, then any child 01 the decedent who is 0 member 01 the ,ome household can claim the exemption. In the event there}. no such spouse or child, the exempti~~ con be claimed. by 0, parent or parents who ore members of the same hou scheid os the decedent. ~ ~ ~ ~ ~ l> Z '" l> '" 3: 0 ;0 m c m ~ '" '" 0' ;; 0 '< ~ ; -0 ; ~ 0 ;; ;, ~ . c m '" m or ~ 0 0 ~ 0' ~ ;. e- n 0 ~ !: "1l '" n >- m >- ~ % >- 0 0 '" '" '" m " n c: '" -l ~ ... m "" % ;0 >- Z % ... % Z m ... m -l ? = ? ? ... -< '" m '" ? z 0 '" 0 ... ;0 \ ? 'T1 'T1 >- ... 0 Z ... m ... m "1l :>: o Z m Z o ~ ~ j -< m l> ;0 -< m >- '" !:! :!! ,). Il'IFORMATIOl'l PLACE FOR FILING _ lhe return is to beliled in duplicate with lhe Register 01 Will. oflhe county wherein the deced~~t 're~dcd. . liME FOR FILING _ The return is due nine month. alter the decedent's death, unless an extension lor filing has been applied lor and granted by the Secretary 01 Revenue within the nine.month period. FAILURE TO FILE RETURN _ Section 79101 the 1961 S'otute provides that" , . .any person who willlully lails to lile a return or other report required 01 him shall be personally liable. . .100 penalty 01 2S'. 01 lhe to' ultimately lound to be due or $1,000 whichever is the less to be recovered by the Department 01 Revenue oS debts 01 like amount arc recoverable by law.1f . NOTE: Fees paid to on estate representative: namely. on executor or administrator, far services performed in ad. ministering on estale is reportable lor Pennsylvania Income Tax purposes. This taxable income item shoud be reported an lorm PA.40.lndividuollncome Tax Return. . <,~ ". , .' - - . "''';'''i,i , J . ~":'...'. " '- , ,.t<.. . . '.~..;~~~ , . " ':....:... ,1 ,.-. ~j' '. ...".1 '. .,Ji-.... '''''''' r. :,; ,/ '~?<'N:"~; - I' .. 'I ". l .":'.j- . :."..; ''''','''-,' , " . , '-......:. ,. ~<~~-'_..-.. .'. " ,1." ~(iQ&,(&&lCI~(lhlLlMM&.&.\:tU{lm&MHM&&{&:&~&illiCl(\(l( ,(,(,(ll,(,(l(\('1\'itJI(,(MI(:Lf! ...;] ,. I . /j' >,.. " ,=' ~ 'jl(; ---Ll/"'"/ .~i ~.' I.' ~ ....;:::. . ~ //l//((/I("('"(fr/II ii'..... ,'\'" ,,,.,,~,' ,,~.<, ~ ::9: ,;,. / . II ..;3 . '/")1." '';'' ._/_....... --' - /'r{f(f;!/ ,;;:: ~~ ~/ .,~ 100:~ :;0 .A" . '::0- '""" /)" ,I ,,- 'Z" ,..... < J / .'., j ,I- =2. ,'x..'.';"'-<:' .~.,-<<,.~-,-..... '0'.' 1',,(.'. ).,. ,'fI.J' (. ;,;: ~ If:' j _ .f~)I'" ..; I j" . /.: ,~/'. ~ 4 J;J. ,If.~ c.t:) ..,./, -~. ,};If"c.'....,.__.;_. r 'L /... ;:::::..-. ~ =-- ~1l)1Y))W))~\~'I;)~)~\);I);))\)))))~)))~#)WV?)Wjl)1))))1'));)wY?J1')')))1)"I)I))))))))))))W)1)W)))'))~ . ~ . .' I..t..;,.;.,;\ " "., I ,\.~', ..~~: 7.' . ~~i~;;:.i." :,~~~-J '~l;::"';;;::-;~!jf~~ I, .\.~ "', "~..' . V' ~l., ~!'"':It ... ( . " I~~~ ,; .1 !~.;q': "'l~:,..ir: "." "'~.I .,.......,'" '1..'S" r,)l.-, l"~~' l' '14ft"." +-;~"'.. :.t. .:',,,,. .;" ~:~"~"':'(~ ~~{, ...~~t::f_ J., ~;~"'~~,,:.. i'.,-"e~"" . .tI.'~;\,'(;~'r.i~- '. ~\f-{': '. .i',. ~'P~!..':.t~;:~~ ~y'h ",.;.. .In-.JI,\....l',{.,<.Jo..J~~., ", :~.v. ..' ..:21 .~-!';o; ""..,,"'1,0 ; . It',,,. ~....,,~.; ,'S ,;},..~.~ii'1~tI. ~". .."., .\". :.1, }''''.' .~I~'.:~\~:~.... P;':":'J. t~ ,"',".ll< ....t.:,,'.. "'.1 ,~ ',I:",'V,,~ vl:t.~l';.;".t.,~. t'::j' '~"~''''I'~;';o\';''~~~~';-.,fT''\ . ;;11,",l:)o.~ni'-"'r-.::,'r:1';~' "'ot "'\1,"'~" ,''':-J:./...., .' .i~.~~::':?:i:.~;7.:~~-:\: . t;~\ ;.~.,...::,:l. ~'~'t ;,\.f .,~.,;l\,.,~~:.',', .~":.f-~J ':':,~~~ff!~j~:.:~:~:~:R:.,: i t....,..,';tJ.... ...,., .,C.);"~~J.>:\ ~i "';... ..~, :,1;\;, ~~'~h~~l}.>~t.' :.;'~',~.}:~~; ',; :~'l .' '~".'..'. ...1\.,.. .....~, .,' ~.;.;..U.~.:r.-..:.. '. .' ;~...",~~'I~':' of..' '. '/":~' . ..-'\ ". . ..,,' ..'.. .11 : ;lj. . i\;~'l::.:r '''{i~:'~~. . ~~. ):J~~:~;~1::'~f.,';,~ ~{i('}':I' l~:~; i.:C;)t(/~~';.f, i'~,~:,! .~. 11'r~" ., ...~J.'r '1 . . " ;' :':<;\":': ~"(~.';;.i,.,;t ~; )Hi;.::;.C :Y'0:\~St. ~,':"If.1>"\'.I.~.'f(':,,~~., i ~:: +)~.~,~~ il, :~: "1~;.'~.: . ),Ct "l-,. . '_!, ..' ~ ......' I , ., "'1' J f-; ~ ."eC'" .- I ....", ;..,.....(,.'-... .~.'f"i,. .;:..'~t~.~'~~.r.;.i,.~:.'~.~J.... ..,t . ,;~; ,,"'.f.:; .';> r.~1...,-y...'~.:r.J '.:;~' ;".~:. ;;,:!~..; 'o.:'~.,:~.l ' , ';~E~:~i'.:;~~.:i:;. :)L: ,l,' --""1..1"1',-"" "~"'1: i'..t...;.~\,r;"I"':'I";..'" . . 1~;:?' \::~.;~i;Jt~.: f..: .', '. '-'l~~f.' ..... ~..j. ~., . " .~;.: .~>:~\;.,,: '.: ~': ~r' . .:;~l"'!:;..t~:k.~' ,'" :;1':1.' . ';,,'~!.;;.~,.'.,~ ......::-:~::-;,-~(l~~ __ . " Statement ., Mutual Aid Ambulance Service. Inc. H P. O. Box No. :l(,. 0 G"'l'n,hurg, 1','nnsylvillliilo 15601 ~~"7i':.~.J::...t;.a~~~i.t~~1.w:m;:~~'!.:i.tw'~~~~T~ I'hon(' R37 613~ . \.10r-.n ~..":,..; c/o oachnrd ZJu,; J. '-. G::t Cl')llJ'\.: tflG,1 '.Jr. ~il~~rnch\.':':, ~..;. .,'.. , :), . ~ 1 , . Date Trip II 4/?';fto :..., MEMBER FEE NON-MEMBER FEE MILEAGE CHARGE ( OTHER CHARGES ....' ................................ $ $ $ $ $ ,...,. ...,.,..,."..'".", ""O,;"'f: miles) .".....,.....",.,."".... :..':':,/;) TOTAL . !'!"l"~\-'i!~; ;r,".::~..i]..c.f'r :.,-l !'J'..:. ':Y.l:'\i ~"1."'O T~. . !'.{:; ',1<3 r; tt. :~!"~l;';. ':t'::~' .'..;. ~l"l _-~. I .... \ \ n.. \..l.~ JlJ~J ~~ to s-~~x'~~ \-\_~....- ......... SECOND NOTICE "DUIINElI PHONE I 128'31711 Oi)l'o. p. lMrlllll'U J~l\lll'rlll ~Oml' RESIDENCE PHONE I 820..,.0" 732 8RUNOT STREET ~ VERONA, PA. Ii. /J ,....... F.L . I 7 /' L'/.o; FUNERAL STATEMENT IN CHARGE OF _ L ,1.:_/..1.. - /-1____ FUNERAL SERVICE FOR (f~..II/J_J.. 7;J/.2.L~D__{i/L.:'.:L/.1LY..!.")) DATE OF DEATH /Z2?f^-.5?':j~J. J-r' Prolessional service including care and preparation of the deceased; arrangement and direction of reviewal and funeral; preparation and filing 01 necessary notices, authorizations and consenlS. Use of establishment, facilities and paraphernalia, acknowledgement cards, register book, memorial cards and local newspaper notices. This service with casket as selected ,( 8 (). /1" - V8J.1Ul'l"r J5A'~-.r'Ec{jS"L",(~ /:'tY'<'//."-' c)':"'L'" .511'/1,9'."> .A..:f................... ." c' I ''/J.,n ['.'1. I'", / Outside receptacle as seleded _LJ.!.r_.._-d.._~~-Lil.L~__- .... ...................... $./li.1--:- ,'" $ _ I"~:.,- <'e" $ ...................".., Clothing For /ll!I'IIi?li/'^ (irk5'-"'I.!N;'/1,(J,~ D.,.,.,." /h'~I'~ ) ............................ $ .~ il. (l-t' . .........................-........... $ For ................................... $ $ / t, 7a. t'-{l For TOTAL OF OUR CHARGES .................. CASH ADVANCES FOR YOUR CONVENIENCE For Flowers ................. ............................................... ........................................... .......................... $ $.-fl /' C $ /./ (: $ $ -YC'."'''': $--.-- $ .A L'. t'-C. For additional automotive equipment ........................................................... For 'raiA, ,i~tance funeral coach ........................................... ............................... ................................ I I i \1 I' I \ For ~emetery or crematory charges ................................................................... .......................... For newspaper notices P.C1f{.IJ.,I::.~.~. ::..Y /(J.i,!r,.,'..;.:..6' if f.!!!':.",i............. ...... ............... .......... For Clergy honorarium ..... .... .......... ............. .... ........................ ......... ....... ...... ......... ................ ......... t9J ~ ,',. For transcripts .,((1..... ......0..... ...... .A.t'?... .......................... ...... ..... ...................... ............... .......... Fer telegrams and long distance telephone ............................................... .................................. $ $ $ $ $ For tent service ...............,.......................................,......................................................................, .......................................... For .......................................... For .......................................... For $ ~ cr. ~r:' TOTAL OF CASH ADVANCES ............ Total for Our Service., Merchandise, and Co.h Advanced for your Convenience $ / 7"iti. ,{? ------ I By , I Date ! , \ I .1"'111 ______4___.____ . _OOI.lI\r:"i ~ ",onlh,fro", Iht dl't 1I,,,of III IClIlII COllllculi.. "'0"11\1.,1111111111'I111110'1 ~ ,.cfotlll. lul ;lIll1t1f1lnl.hich Ill',. b.lll1loJII. bl,;",.i"1 011 --' "_1,,4 (GnU,u,',.! Oft Ih. IIlIlt IIn oluch Il\d ..tr, lIIonlh th,,-ult,r IInlil tht lulllmOlln! h..lol it paid. In Ih, '.1111 'fly inlllll",'I\II~.11 1101 b. olid .t.." d..l. Ih, hold.. 1IIIIOIIIIU .1 h' ,l,ctloll dul... Ih, II/I ""'Ollnl 01 'hilllol.I~.n. fllll,in'II' 1/1IC1"d. '","'Idill." dill ...d pn,bl, .~d 111I, pt,cud 10 (olltel lh. lI"" II 0"" tll. "".""'. ,nd","" .~d '''11.'101. do 1I."b, ''''11'..'' III' ,110111'" 01 "n1' Cellft 01 RIcordl .lll'nll II., (0,"",011*..111\ 01 P,nnul.,n,. 01 .n, 010,,51111 or hnil:lI\' 011111 Un.t.d 51'1'11' 1:)1111' 101 th.", or .n., e1lll,," .nd .il\ or .,I"tlll d,c1u,llonll1,d. conf,.. iwdtrllllll.ttillll'1I1 ollhlm 'II .n.,. (outl,n 11'1. ComIllOIl..ull~ oll"M"I,.ni. 0' &11'1' ol~., S..I. or h',tlor, oll~t U...,I.rj St.:.. &lid ;11 "'0' d 11'1. fl.... Ot If" hold., 01 ,hll 1I01,lo,lh, IUIII d.... ":"dtU'bl'lh"'c,,, ~llh COil, 01 ,wil,nd .Uorn.... 1(011I11I''''011 011 ,.\ 10, coU.cl.on .,Ih r.I.I\' 01 .n IlrO'1 ellrj ",1~0~111.. of ...CWllO". ....rj ;"'OU."tiOIl I~d ..1.11110" UpOll'"}' I.,.,. h hll.by ..... .lId (ond.multOIl .,.ud 10, IlId Ih, ...mpl,on c"U prope.l. I,om 1.'1' end III. on .... ...cwho" '1t".1I tl ~."b, "pII"I.. ......d elld...o b,III',1 0' 1I''''II:,on II 10 lI. c!.llll.d IInd" o. b.,. .1,1... 01 ell' ,..mplton I... no.. in lotee or ..hle'l m.. hc...111I b. 1I,,,lrj bl' III.,. SI,II 0' Nellon 111. m..t'l, ,"dC'"" .nd Swl....IClt. h...b, ...... D.IItIlI...."I. d.m'PlCI, 11011(101 dhhonot, IlId p,olll' ollbl ..,Ih.n 11011. T~I m'~1I1 ...111\., nOI., ..h.... mo.. lhall on.. 1~11I b. 10....1.,. .."rj "..r.lI, I..blt 11"'011 SuI' N',Olr."',.ndp".bl. .1 Sui App1ir~iO" .:~ l!f'....:....... ........., \Ierclnallcr .._1--. I .,.....~)~............. . THIS AGREEMF.NT. mlldu \1li................ .. ,~or ... . """':.\-\'c ;;~;\I;'s~van~. \f1146. d Li I 'j till' 5\ft'e\ M01}fOCH . :j '" -3 'I ........... ........ between Res\lan . nco n ." .CIIlOI' ".ra~"s. It~('... 990 Patl~. . .,'. ,,'l.~......- ';, J '1':" ..", ""';i";,purchnscr". can~d "ColJlpany". AND ,'.. ..... "4- :f..;.......... .. ~ ..........,.;.... ........t...........':.:. ...... herelnaf\er enlle d ,II 10 \11' of i": '. . .._. . I.. .", " .', . ..[/..... ,..... .... f h' h<,nrflt or.n .' . ht f , l~:."f"'''..''.'''\o'''''':'.''''''~':' '/;' .~, /.~, I" ,........ .' ...... ...... ," \ c h\alO or \. h xr\uswe fl~ 0 , . t<' ., C mpany ul\rl'" a , larr. f\l' t e , rrs to '..j ::: '"WITNESSETH THAT: Th. Purrhs,,, 'I\re,'s \a'1my n1\t11M II e,<,I11\1\\\I.e. ,tl\eflllent'l h,ch the porchn..r Ugr 'i:ifP\li'.h....r. his heirs or ...illn.. in .<<,arda",e with tl,,' terms lll"",r, II.. tl~.tr \ ul1d ,\uiv,''i'te,\ f'~ .w'" . ( r 1'( re<,ei"t.af )"hieh ~.\nterment af.memben of the UUI~ln rAn:, and s,'rv!""S herl'il1ah<lCl'U'tlC '. . Int IhtOal< .. e " "')('. ,.:...6n the tj....,.,' . . . " ' f.,II\lWO:S.,' "; , "'\S'- .....~.." . ;,:{ ;t'~1 ~\O !olle Complny the .um or~..,' .... pillS inll'fl'st, p"y"h'~~', " . ('. ... .<. ; 7''';' 1'1' ". . ." ..!'/. : ,..;;:; " '''II.hereby aekno1"ledll.d, In,l $ :. .". ",' (nn 'ih"" ':' ",,7 '\\bY n..~.~~ D, j~;'i)fl:ii<< .: . ~I'I 1.'.,'., ~t.u. . ... '111 . tnh\t !\,\,II ,,,,, ~.I'''' ,,~...'..\.,. ~p"..~..d.y or each tucl"C'rdmil month tlu'rcnftc:r unll II ,-. I.'7'!'J', . . COVF.REO 1Il.:HI'.lIV ,\NI'.: Pri,e $., .' '-r' , . THE ITEMS . {/!>O. 0 f!> . .. . Adult IntC'rmt'ntSpuC'r's. SrI'. No ..in ........pnce . '. ...,' j,. ~2....~... .BronzeJ\f(,ulo". . . .: .' ..' . pOl't! $........-......;. : ,. rl:1l1.'.1110n' ." I ~. 1 ~..iI;i!;;' ..? ~~ ;:;}X.?;~'I~.;r.'~(";:1W,qt~';"" ;...........~'1i)"'.tt,~w;:~:a.~...~~t~;.~ll;J<L~~~;~';~~:~Si L~ ~.:'~ ~r: t:" ;..... t '\. . " " ~.".., ,f"~'!t" ,I,' 'J I 1)1. . t. : :"~.,' ,.' '. ". . ,'lIg l'OMP^,~\' ^,il{r.l':~ .. '.. 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"""', ..,..... "",..1 ."" "..I...."'"' "r.1I impravrme-nt.. !luII.hnll' an,II""rrlt\. ..r ..,,,t Celll~I~f\'. onrl"'\LIlIo:: ...ll1"..'~I,..I.. r , \r, hr".t ..1.I.l........ I" ",. h ....r Jr. ,,,' .." ".w.. .10, ""..".,, ,....0., .,,,,,,,,,,,,\ h" .. .,,'. ,"""... .', 0 ." ..".. ',;"., .",,,,, " ,,,.,,.., .., I ..". h"", U" .\,," .., "". "W"""" '.,,,,10.... .oov ,,\,,' .n,\ nchanle It roll' an)' ulhe-r IO{IUI(lU ,,1 r(IU"l ~':r ""101 \-"I\l~ ""\,,,I\..,r "....,I..l,\r ,n t.t"""",.II.u~ 11 i. undm'''''' .nd ""lOt .10.' no ,..""'",, ....ii ,.. ,,,,..\. '" ."""".". ...... n" '\n.'''\......", ""., 'm,,'''v.'''''.' ". n.. ".." ",,\.. .,,,.., ,,'" ,,,,,........, ..,.""",,\, '0 ""m" buriala Ihndn, othHwi.r tlanllrr ,hl,1I1.e nl.'\" Il," .,1....1 sm.l1.., "."- '" II ,t,-\d"I,,'.1 ~~,I,,'1l ,,' fit, 1'1,.,,,.1 i'."~ Upon "thllm,...f ".. ,..d,"".' "f .10.. ..,,,...... ",,' '''.' ...", ,,' "ii <t,,, ,I,.." ,', ...".,,,, "",.",...". oh.. C..",..,,~,. ..."" ,..', \".,," "..ii ... ,"..., \" <t.. ..,,,'oom. h, ... elm'W, d"d i. oh, ",,' ,.,m.'" 00""".'" ,,,....,,... "010. U,,' ",.., ..",,\ .". .."".., .....i1 ,,,\.. ""., "."\"""'." ,,' <t.. ".""."" C.."'I........ "". ......"" '" .,..." "'''' ,.....".. .,. aiSoptC'd (or Ihe- iOllrrmll1 of thr r-tfffl<)lllll purk. Sol' \I!lle. 1111,1 r('f...&I..t"'Il~ 1l11i\' t,.. ~r'''. 1I1',.n ""l",.~I...1 tl... (,.""I,.,V C"'''I..,n\ I ,.:t".. 2. COMPANION URO~ZE MEMOI<'AL. T.. ,...,,\1. ....,,,"'.,,.. ."""."'''''' 'W. ,.""....",...\ ".,\ ..."...., ,,'."',' ,,,,,I ...",""",.\..i1 ...,,,,, ., . ....... .\... .fII.... '0. ..in,,,..d .... ..."'.. ',m ""h.." .."."",,,,, ""'\"" U,,' C""",,""'. ,..', ",.".."""..."\1",,, ,,,. ,,,,,,.,,. ".... .".. '" "U.., "". ".,,,,00' '" ...",."...\ .\0... .n" .h.n be- ilUlllle-d inlh'~lll1l1d-l.in('oln :''''1\1. I';\rl.oll 110.. "tr ,..1....1...,11.). Iht" j..nlll\" "' ~,.nll ", p,,~'mrlll \II lull tl"~ 1"'111''''''\''''\ lor th.. C"OlI'dny, . . J. BURIAL V AUL TS. T. ..",i,\" . . . . . . .."..., ..""I". .",.., ",\. h,. ""-.,, IV..""",,,,, "... ....k".""....\ ",.".. S.,,\ ""i" ,.. I.. K7 ", 11 .... .n" m.nu. ,,,""... or".., ",nf.",d '''.'''''. ,\.\,," I,.' ..,\I..,....".i1.. ......" s"" ,,,,,,,,,I..i1 ,,.. ...., ,,,,, ".......:0 I"". ,.......,.. \I '''''''''''''. ",'m I..,,,.i ""I. ,. ..~ ""..".., on. ""io. 0' ",don on R.",."d.LI",,,I,, ".'m. ",,,,' ".,... U.." .... C"',.,,,..,..,, S..",,,,, .\.",,,...\ ,.. '.010 ,,' \10.' C"""",.,. ,I,.. ..J.,. . .I",i'"'' .."...., ",,\ .",,, '" v...'" will be placed .11 I mrrchand,tr 'fUll.' IU...."'" Ouarlntrc of ptrlounlncc: Th.. i. o,d.. '0 mu" "..r.'m.... of "'..v",..r .10' .....10..."" on,\...v". "',.....\.., "". .,......... .10, C.m,.."" ."'.. .10'" .. will ... ..i,'. ."., ..\m i. " ",," 'u.... "....... .od ,"",,"om.1I 0.10.. 'unJ.....",,,... m".". ......,,,. ," "".... ~'..I.."I."..... ~\h ..".\.\. ",,,.,,,.,,......,.,, ..",. t,,, ..", "".......1..' ""., ",,"" .hon .,.10..",... Th' .."...n' ,..d..to..ld 1oU..'u.d.h.\1 '.m..."'.... on ..., .."\",,, 10m" 'n. 'h. ........"...,,,,,,,"..."'" ,,,. <t.. ,.......",.... ,..", ..."'." .'".d ,.. .....,.... ....,.. 'm"..f .10. uu.. ....."...". l"~\ncom. .....CfcfIOlil 'I.Q 'be uud fOf U..r hulllllrlUUnl HIll' C"n'r.n)'. 0' .It ",,"unr""c' II~ 1I,,".~1 of D,....Chll\ ""'}. ,ld"'lIlll" 11,,' ""lOun! uf m"nn' ,.. I,r pl.c..t! an 'he IIUlt lund '- ~ bf ~\4 (con, \llt ,.,\ Qnlf Of ",O,1f In.lal1m..nn III .1 Ille Inn.. ..r ,h" ..1.. '" I..... (\lfnt It.r uk II flllh i ;~,~i;;;~:r~',"~> >;.;.,:::: .. ,:' ' . nOTH PARTIES AGREE A. T,h.C Ih""lfrr.mrnl il 11'11,..,..,1 ,"tll ''11101.~,,II''II, I,v .01,,1 "rl....~n "'''I""I''~ hn~I", At:l) Ih~ C;...,,\"'IW ,.ull..', .,.v'-n",,1\ ..111 "j;"'" 1101'1.1 ""I1..".\....,,"m '" thl' he,1 of It' .bilicy. wllh.1I or Ih.. '..nl,tl'" "",Iff ,II ....nlll.I'" p......rou ,n II" ,,,,,,,...n I,.,.-on II,'" .1, I.ul ", I',. ..~.,."I "I ...." "..1. '"""'''' I,,,,,, A, h "j li...1 ,,! (", ,,11... "'HI"r~. \'''''''11,11'''1' ton1fol O( Ihe (","p.ny. it .h<luld ,... IIl1p.....t,lr 1(1 .Irl",'f th, ,."u.t ",~I' ,."".1". .,,,,.,,',,'-1 I"" ..., ,,,-. u..,.... ""......~.,,' IIl..I" ".h ,," "..\ .......,\..Ilr. 11".I,.,r.h"~r1. ,,,~ h....~ "r ""'"n,. ..ill.cce-pl mtr<.h.ndlle "",ct. '0 II.r 1,...t..1 Ih.. C":1lI...n~"~ III..hl..... ",~I t"... ,,,1'01.1,,1'. 11.,.",,,, ll~ ",'.ul}' """11,..,..l,k "' .-\..<T","I "",I '1\1<1111\' '"1~'~''1o''' ""Il! 111lll'.'W\" ....hllh ..r" av.ilable Ind .1. ca't nol r1(re.hIlIlI1l..,rnt .II'}' n.IH. ". h..r, ," I" .v,.,..,I. ,,,d hull." ., ",,,I ~"hol,,,.I" Ill.,d"."."~' ,,".nlll'r j......., ,n ,."~II" II." (""'11;11111'" 11".n II... I1If'feh..n,"'" providtd (or hrfem. then thr Com,'lIn}' ...t,ees I" rdllld I" Ih.. P"lCh,,~,' II,.. .1.11, ,,'n'.' III ....1-1 ..,,~"', II tl".. I',;n ,,,,,'111 1",,\,,<1,... I", Ih,' I"Hl'lL..,,' ", \,Inlll' 1II.1IVI.{".ll \1.1""" 1111111."1" nO' ",om..nio. m.mo...\..h' Pu"h...'. 10.. 10,,,..., "..,.... ...,. 10".... "." "\"'"'' ,,,.,\ ".\,. ."" ,.. ".,.",.. ."...,.,,,,, ''',,'' ",,,i,.. .'",... "'co ".\.\0,.". .".. ,,,,,,,,.... .....\. .,..\>>10\.. B. Time i. rnade of tht .."..nfe of thl' nllTt"II1~nt 811<1. ,houl j th" l'lI".III"rl <l,-fnult 1m Ill'.r.. 111<111 "1\1,' C"") ,1"...\ m 11\1\ "llh.' lnol..U:ll'III 1',,)"m..nt11,.,..ln l'rU\'ILt..rt. lht Campany may, It its opti~r. decllre thIS 1I.,....II\..nl nu11lOn.t \.,.,,1 IOn llrllllll ,'lIl'''~I11<lIh 11...,..1 ,I<-rt. tr.1l.,," 1.\' :1" T'..ldl.I~"r '" h:<I,.I.'lr.1 ,j"''''.I;'' C. Purch..,tr Ih.1I havr Ih.. !llthl Ilnv tlmr un\.-n ir. .t,fulIII h..rrlll"I,'r II> ~,Il "1 IIlln,lrr hi, mt..lnl 111 tt,,~ ..~..,m,,"t. "'Fh tIMIl"'" 1Il,,~1 hr,t I,.. ......"r,tr,t upon thl' ),....\1;. of thl: Comp.ny bdofe- 'ame .h_1I tJrrum,. ..!frrtl"r. Compfln\' .."......, ". Imlll'!.. Ill,,'n 'r....lI..~I. III'IJ,,,,,...t u..n'r,.. h"lIn. D. Thil I,reernent conhlilll ..1I1hr "o,'~n..nU pml pl<llllll.r\ 1"'lwrrn tl,,' 1,,,,llr.. nll,III" ,,~,'nt .u Irl"r\qlt"li"" of rith-r r.ut\" I",~ IIlIlh"li1\' I" m,..hh.. .1I,11:> or ..hanRI' any of the terml and cond,t,on, hrr..m ert furlh. nOI II,r lelm' n,,' <"<'lhhll<"I' "I th.. ,..... 'I't ..11".\l1lull Thi. alrrrmtnt .haU brc.lm" d"cctivr whrn ,;o,:nrd to)" 1m llUlh",""'\ om.i..",1 Ih.. ,\,,,,O',,n,'. ..n,1 th..r....rt..r it ,h,,1I (l1'rh' Inunll';n.' nil.\. inul" t" tht htn~flt" nr th.. Cumf'llny. It..o''''oo" .. ....,... ,.d '10' hw.. "\00'.""'''''' ,,,'u,,,.. "..t "..,.'" "I ".. p,,,,t,,..,,. ''''' . ".".". l\," \'"""..... " ",..""...., h...''', " .1",i1 ..,,"'\. .10. 10m. "." .....", .f the purcha'eT II if they Vo'efr IptClfiuLlly set Ollt. Witness,... !. ..... \: DatC' of hirth of Purchaser,; Purch<1sc:r Purch<1sr.:r (SEAL) (SE....L) .":';. ..... (Represent'l iw) Accepled by .. $. ... MOHl'\lC'\'ille, PC'nnsyh'ania__ 19 For value r~c~i...ed, I e.....e, jointly and St'\'l'fally) promi<;1' tn p:w to tht' (Jilin of HC'5tlant\-Linl'1lIn :\h~rnnria\ Parks. lilt'. -----. --_._--'- ---.--. _nOl.l".r.S ~ _____1 wlthl" fIlo"th,ffollllh.dat. hlllollncQu.1rol\,.C..li.. ",onllll, intl.lIl11,nllol' ..t.ellh,11l1 inlllllr..nl..hich 1II1' bl unlQJ..1 b.,i,,"in, Oil --' 19_",d cOllliM.I", Oil the 1.1II. d.y ol..eh Ind 1"" 1II0lllh 1......11.. 1/111,1 Ihl 11/1l11ll01/1I! h"IOI;1 p.id. I" Iltr ...nl .", illlllllllllnl ,1t.1I1101 br o.id ..t.", d~,.lh. hold.. h...ollll" 'I h' ,1,eUoft d.cl... Ih. 'ul .1II0ulIl Ollh" "01. Ih.n "lIIlll1'''' ,,"clld. ,mm.dlll.l, dill IlId PU.Il'1 'IId "'u plotI'd 10 tollltllh. "...t .1 (:IItt Thl """'1. ,11;1"..., .",d '''..,....10'1 do h",b, ,"'".W" Ill., .110111''1 01 ''''I (t'u.t 01 R,COldl ..;Ihill Ih, Co"'mo".....ltl\ 01 P.".."I,,"'I 01 '11' 0,11.51.1. 01 T ""10" 01 ,h. 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