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Home My WebLink About80-00718 ". "r. '"".- -,., ':.., ~ ~ . >< .~ ~ I .. I ~ ~ i ~ . t) rn I . t!l t) fIJ :- i E ~ .r- Q '00; [--.' "i.."_: 't"04. "0 .6J - IU -= LIJ .... ,t,_;, .. " o .z .~: . . '.,''. ;)',,: ',' ~ r-l .. .!: '. '. ".J >:,1.." '.~. . ': '-~~ "'"" :~, },') f6 No. 21-80 '718 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY In the Estate of MARY G SWI TZER , deceased. To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania, Petllioner(s) Is (are) the execut or named In the Last Will and Testament of I1MLG Swi tzer dated October 27. 1980 Decedent was a cllizen of the United States and a resident of New Cumberl and Tol"l1TS11tp (Borough), Cumberland County, Commonwealth of Pennsylvania, Decedent died on Thursday the 30 th day of October A,D, 19~,ln the County of Cumberl and ,State of Penna at the age of .J!.Q.....years. Decedent has (has not) been married and has (has not) had children born to him (her) since the ex. ecution of the above described Will. Decedent was possessed of personal property to the value of $145.000.00 and of real estate to the value of None as near as can be ascertained; said real estate situated as follows Therefore, your petitioner(s) respectfully apply(ies) for the probate of the said Last Will and Testa. ment ~.nd fo~ Letters Testamentary theron, . .. .~ ..., ."',Dated":..:. H .T-, ,,".' 0- ..... u_ C). 6;-: Wl,.' 00- "'u) 85 WW ",'" Name and address of Petltioner(s) FcJ -' . ;--. I :>- = = 'ne, . w =", ~z g:<e ",-' 0'" ,w ",,!!? ","- w'" -'w '-' <=> 50 Mailing address: c/o Lois B. Copeland, Trust Officer 1~10 C~dar Cliff nriv~ Camp Hi 11, Pa. 17011 COMMONWEALTH OF PENNSYLVANIA l COUNTY OF CUMBERLAND l ss Commonwealth National Bank, by Robert K. Reitzel, Trust Officer named In above application, being duly sworn statements set forlh in this petition are true to the best of S~Jorn to and subscribed before according to law say(s) that the his knowledge and belief. me, _ Nov. 7 1980 __1Ji!dLL~_e, '~d.~:J (J -'---'-"~~glster Filed: November 10, 1980 0< /-,f~ - 7/ ~ //-I.~':<'- $ "fflt~j'l~f/ Tr t Offi cer Attorney --7/ r !!!:J-- :...--- Harri sburg, Pa Stanley C. Fellows Blackstone Bldg., , , . , LAST WILL AND TESTAMENT OF MARY G. SWITZER I, MARY G. SWITZER, unmarried, of the Borough of New cumberland. cumberland county, pennsylvania, being of sound mind. memory and understanding, hereby revoking any former Wills by me heretofore made, publish and declare this my last Will and Testament in manner as follows:- I direct my executor hereinafter named to pay all my just debts, funeral and burial expenses as soon after my decease as practicable, as well as all inheritance taxes, whether state or federal, which may be assessed against my estate, or on any property passing as a result of my death, whether or not forming part of my estate, as part of the costs of administration. I direct that my funeral and burial arrangements shall be in charge of the Jesse H. stone Funeral Home, 408 Third Street, New Cumberland, pennsylvania, and that my place of burial shall be in the Jacob H. switzer lot in Mount olivet Cemetery, New Cumberland, Pennsylvania. I direct my hereinafter named executor to cause a suitable marker to correspond with the other markers on said lot in the name of Mary G. switzer to be erected at my place burial. I further direct that religious services shall be in charge of the pastor of the Trinity United Methodist Church, New cumberland, pennsylvania. ~~o ~~ , " , '. " I give and bequeath my father's watch (Jacob H. Switzer) to Stanton E. Weaver, if he survives me. I give and bequeath all my jewelry, personal possessions and all household goods to my grand-niece, Bonnie M. Weaver. I make the following cash bequests:- I give and bequeath the sum of Five Hundred ($500.00) Dollars to Trinity united Methodist Church, New Cumberland, Penn- sylvania, for general purposes. I give and bequeath the sum of One Thousand ($1,000.00) Dollars EACH to the following named persons, if they survive me:- l. 2. 3. 4. 5. 6. 7. 8. Bonnie M. Weaver Susan Weaver Bates Linda K. Abel Kathy W. Phillips Kenneth E. Weaver Charles B. Weaver, 3rd. Richard Weaver Dwayne Weaver All the rest, residue and remainder of my estate, I give and bequeath as follows:- A one-half (1/2) portion thereof to my grand-niece, Bonnie M. Weaver. The remaining one-half (1/2) portion thereof to be divided equally between Susan Weaver Bates, Mary K. Weaver, Betty M. Weaver and stanton E. Weaver, or to those of them who survive me. I nominate, constitute and appoint The commonwealth National Bank, Harrisburg, Pennsylvania, Executor of this my last Will and Testament. this IN WITNESS WHEREOF, I have hereunto set my hand and seal J...'7-dv day of October, 1980. );~ CJd"tA7P~;!ld4(~ Mary G. swit:'zer (SEAL) -2- 31.1 - ~f~~1!~1;~}t,.~:, -"'~~~~'t!x~"~~$;J"\"~ " " ~ ~~".~}~D:~{@;~~";}:~:, 'i:-'" . - "~,' ""1';"r.~~, ':. >: - ,f'i I r. ". 'J~;/;J:!!':~Jg; .' ." "'''.':' E-t 0 I CIl ~ 5 0:: o ~ 0 " ~ E-t ril >-1 j ~ N ~ lJl N >-1 9 N r.l E-t r<1 1< ~ = ~ Eo< " .. H ~ ~ ~ ~ ~ ~ :;: 0>< N t ~ ... lJl l<l z N N 0 ~ z ::! = Il. t.? Il: ~ ~ 15 0-1 r<1 0 N . 0-1 >-1 .. u g ~ ~ ~ .. j = ~ ~ <: = ~ . f-< . E-t C/l ~ lJl ~ 0-1 -. '- ~. , OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Rcgister for the Probate of Wills and granting of Lettcrs of Administration in and for the County of Cumberland, personally came Robeert K. Rei tzel, Trust Officer, Conlllonweal th National Bank who, being duly sworn ,do es dcpose and say that as Executor of the last Will and Testament of I',arv G Swi tzer dcceased i t wHl wcll and truly administer the goods and chattels, rights and credits of said deceased according to law. And sub~ibed before me. ank Offi cer Register ,~ 0' : ell <Jl cg; : os : ~ ~\ : ell ,0 U. <:, 0 co: ad "", 0: UJ: N: ..-: .-lj rn ...l 1-: 8 CO ii ~; ~ .-l ...l "': ltl w: l" r- ~i .... .. ~l .... 1 - .~ (), 0 S >-: ~ E-t: QJ: CO <>:: = ril' >, I <t. .~ 0: .-l :>: 'Cl 0: Z: N ell 10 ." .-l, 00 0 ... "': Z 0 ""i , C,l - ~ N .s ell 11 .5 ." bll .... 0 s:: OS ,~ <Jl p., r:.. Z [:<:l oj Be it remembcred that on the lOth DECREE November 80 ,A,D.,!9_, there was probated and rccorded thc last Will and Testament of day of Mary G. Switzer late of , New Cumberland , Cumberland County, Pennsylvania, Commonwealth National Bank Deceased, Letters Testamentary were granted to Witness my hand and official scal the day and year aforesaid. .,!4 ,~. uJ.':'r. ~d<<.t (J tj1,,.,"- /. ." ~ RegIster .~'--------- , .~_...... -- -- -- -- - - ~ - -. "-'REY;I111UX;.' ;... '.,' r~~~fH';~i;j~-0~;;\':"':";' ., COMMONWEALTH OF PENNSYLVANIA \ 4 .~c1:( 0004551.' ,,' DEPARTMENT OF REVENUE i. 11!ilt:~"i"k',"'" o",eIAL REeEl'" · PENNSYLVANIA INHERrrANeE ANO ESTATE TAX I. .. . \ . 101 . 'II \ II , = lI! ll"" ~ . RECEIVED 1.\ 'FROM - 16,720.00 TAX AT 6% TAX AT 15% C~nweal~h I11IUonal Bank TAXAT_% ADDRESS 1510 cedar Cl1ff Drlve ESTATE TAX .--ESTATErnFOAMATKlN,-------------------------- DATE OF DEATH OCI~. 30, 1980 21-80-718 C Hl11, pa. 17011 TOTAL TAX CREDIT NAME OF DECEDENT MARY G. SW1'rZZR CWllbadand G m LESS DISCOUNT PLUS % INTEREST (FROM TO_I FILE NUMBER January 30, 1981 DATE OF PAYMENT .cOUNTY ------------------------------------------ TOTAL AMOUNT PAID 'OSTMARK DATE ,'MARKS .PAID ON ACCOUNT- SEAL RECEIVED BY .' ;' t' /,' I.! c.~# / l./ (.,- ....{,..;!.../ Mary;t::. iJiWlIRE R891.~.r of wl11s .:\ t REGISTER OF WILLS :-} 1- ("', - 7.; 0' ,_,"'- (.J { .'J - .-- Inyentory of the ,eol ond personal estate 01 ~ Mary G. Swi tzer . Real Estate None Tangible Personal Property 1.: Diamond Ring; appraised at 2. Watch; appraised at 3. Jewelry; appraised at 4. Coins; sold at 5. Household goods; appraised at Intangible Personal Property 6. Received from Mary G. Switzer Trust under Agreement # 19246-01-6 the followin9: $5,000 Homestead Savings Association Certificate of Deposit 7.5% due 4-26-81 Accrued interest on above $30,000 United States Treasury Notes 8.375% due 8-15-81 @ 96.34375 Accrued interest on above $20,000 United States Treasury Notes 11.375% due 12-31-81 @ 98.0625 Accrued interest on above $10,000 United States Treasury Notes 9.25% due 5-15-82 @ 94.90625 Accrued interest on above $9,000 United States Treasury Notes 8%.due 2-15-83 @ 90.5000 Accrued interest on above $11,000 United States Treasury Note 7.75% due 11-15-81 @ 94.8750 Accrued interest on above $5,000 United States Savings 80nd Series H decoased. 1,150 00 10 00 107 \35 892 05 I 462 50 II ,I II II \1 I 5,000.00 I I 126.91 1\ 28,903.13 I 523.15 19,612.50 7fiO.41 9,490.63 425.75 8,145.00 149.92 10,436.25 392.38 5,000.00 "-. - COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 'l J ss: Trust Manager. Commonwealth National Bank .ccording to law, d.pOS.l and says that Sh.. executor of the Estat. of Marv G. Swi tzer late of the Borough of New Cumberl and , Cumb.rland County, Pa.. d.e..s.d and thet the within is an inv.ntorymed. by _Lois...B_.copp..land, Tr'lst-Manager ' the said executor of the entire estate 01 said decedent, conlilting of all the p.rsonal prop.rly and real estat., .xc.pt r.al eltat. outside th. Commonwealth. of Pennsylvania, and that the ligures OppOlit. each it.m of the Inventory represent it's fair value al of the date of dee.dent's de"th. Lois B. Copeland. being duly sworn The Commonwealth National Bank and subscrib.d before me, './ ~/----,,// 19 81__ LCl!.J 1',. Gr'l'l1. H':l!C1:'"! t'l,.:hlle Lower ,'\!!rl1l T',-:"., ::,~:::1)~;~~1~~ ...:'o'_w.l1 P':I'.. Jr. 6'~......-. _~.., _.-.,..~~ ;_11 ~. ....... Sworn , By: 1510 Cedar Cliff Drive ~p ~ill,Pennsvlvania 17011 Addr... Date of Death 30 October Month 1980 Vur Day INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheels may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. :",-. c: .. _.<. ..~'h I.- N ...; !:-'. Cl- cne .W Ie -':'.:.0 I.' -C ('~: r- .t.. s= C~'. I '.c::t '" ld ~ ~; ~~ .- ""- .. 0.... ~ 3U::: OJ CE::'-') ,u.J 0-' ""~ .D '-'~ ""~. E u.Ju.J - u.J:::l " ",'" 50 .cJ'-' u '-' :i: .,; >- OJ " ~ UJ Z ~ ~ t- OO UJ <( 4- .. VI CO a.. t- O u CO :3: .-< 0 VI .. \1 0 UJ UJ C '" 0 ... "- :r: a: .s= .. .- " I I- a.. .. Co .- C Cl Z t- .cJ U. E\ " ~ ell ~ <( 0 0 CO U. .cJ 0 a.. u. ~ I Ul 0 <( UJ .. ,.:. .-< > Z a: 0 <( N ,! z 0 :;:: CO C u C (/) " 0 II - VI Z ell 0 >0 a: <( ~\ .s= U ell Z w ... a.. +' -0 .- C s= ~ to II ... - +' to' 0 .. (/) :::\ ..0 -0 ... .. E - ~ 0 oo " 0 -' U u: CD " PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act 011961 provides that the following persons shall prepare and file a return: a. The personal representative 01 the estate 01 the decedent as to property 01 the decedent administered by him and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or acquire knowledge; b. The transleree of property upon the transler of which Inheritance Tax is or may be imposed by the 1961 Statute, including a trustee 01 property translerred in trust, provided that no separate return need be made by the transleree 01 property included in the return of a personal representative. 2. PLACE FOR FILING The return is to be filed in duplicate with the Register 01 Wills 01 the county wherein the decedent resided. 3. TIME FOR FILING The return is due nine months alter the decedent's death, unless an extension lor liling has been applied lor and granted by the Secretary 01 Revenue within the nine-month period. 4. FAILURETO FILE RETURN Section 79101 the 1961 Statute provides that" . . .any person who willfully lails to file a return or other report required 01 him. . .shall be personally liable. . .to a penalty 01 25% 01 the tax ultimately lound to be due or $1,000 whichever is the lesser to be recovered by the Department 01 Revenue as debts 01 like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate 016% on translers to lineal descendants, such as lather, mother, husband, wile, son, daughter, grandchildren, grandparent, son-in.law and daughter.in.law and at the rate of 15% as to all others. 6. PAYMENT OFTAX The tax assessed on the transler of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's estate or against.any property belonging to a transferee liable for the tax. 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both. 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 lorm P A.40.lndividuallncome Tax Return. REI/-';!lO 1\"1l01 COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECF.DENT SCHEDULE" A" REAL PROPERTY * (Instructions on Reverse Side) ESTATE OF ~!y_G,-j~tt~er OEPARTMENT - VALUATION (OFFICIAL USE ONLY ITEM NO. OESCRIPTION ESTIMA TED MARKEl VALUE None TOTAL THIS PAGE None '", INSTRUCTIONS FOR COMPLETING SCHEDULE "A" Schedule "A" should include a detailed description 01 all real property located in Pennsylvania and held solely by the decedent or held jointly with another individual (s) as tenants in common. Listthe decedent's percentage 01 ownership and the estimated market value of the decedent's interest. (Property held as joint tenants with the right of survivorship or tenants by entireties should be reported on Schedule "E".) All real estate located in Pennsylvanio should be described by lot and block number, street address, number 01 acres and general description of land and buildings. Also, include the book and page number in which the deed is recorded and the exact title as indicated on the deed. If the property has been said, allach a copy of the selllement sheet. If the property is subject to a mortgage encumbrance, includp. the name of the mortgagee, date, rate of interest and the outstanding balance an the date of death and allach a statement from the mortgagor verifying the outstanding balance. Property taxes and interest on mortgages as of the date of death, assessments and other encumbrances should be listed on Schedule "F". Do not deduct them an Schedule "A". RE....~.4~' r;.... ill~Hol COI-'MONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY (Instructions Olr Revers(! Sid/!) , Estate 0 Ma ry G. Swi tzer ITEM NO. : UNIT VALUE OESCRI PTlON Tangible Personal Property 1 Diamond ring; appraisal attached 2 Watch; appraisal attached 3 Jewelry; appraisal attached 4 Coins; sold at 5 Household goods; appraisal attached Intangible Personal Property 6 $5,000 Homestead Savings Association Certificate of Deposit, 7.5% due 4-26-81 7 Interest accrued to date of death on item no. 6 8 $30,000 United States Treasury Notes 8.375% due 8-15-81; OTC 96.34375 9 Interest accrued to date of death on item no. 8 10 $20,000 United States Treasury Notes 11.375% due 12-31-81; OTC 98.0625 11 Interest accrued to date of death on item no. 10 12 $10,000 United States Treasury Notes 9.25% due 5-15-82; OTC 13 Interest accrued to date of death on item no. 12 14 $9,000 United States Treasury Notes 8.0% due 2-15-83; OTC 15 Interest accrued to date of death on item no. 14 16 $11,000 United States Treasury Notes 7.75% due 11-15-81; OTC 94.90625 90.50 94.875 17 Interest accrued to date of death on item no. 16 18 $5,000 United States Treasury Series H Bonds 19 $5,000 Tennessee Valley Auth. 7.35% due 1-1-98;NL 58.375 -$' ~~~~ , . ;'.~l~ ......:~.~~l!.,...t .~ <." f:~~~!-~'''''.~'.#.' . ESlIMA lED MARKEl VALUE 1,150.00 10.00 107.35 892.05 462.50 5,000.00 126.91 28,903.13 523.15 19,612.50 760.41 9,490.63 425.75 8,145.00 149.92 10,436.25 392.38 5,000.00 2,918.75 If additional space is necessary, use B!i" x 11" sheets. TOT AL CONTINIlt"n DEPARlMENl VALUAllON [OFFICIAL USE! ONL YI INSTRUCTIONS FOR COMPLETING SCHEDULE "B" Schedule "B" must include all tangible and intangible personal property owned individually by the decedent at the time of death. Property owned jointly with another party or parties should be listed on Schedule "E" - - Jointly Owned Property. Intangible personal property titled in the name of the decedent but payable at death to another party or parties. including but not limited to P. O. D. U. S. Savings Bonds and Tentative Trust Accounts, must be listed on Schedule "B," Tangible personal property should be listed first. Examples of tangible personal property are jewelry, wearing apparel, household goods and furnishings, books, paintings, automobiles, boats, snowmobiles, aircraft, etc, Intangible personal property includes cash-on-hand and in the bank, stocks, dividends, bonds, mortgages, treasury certificates, notes, together with accrued interest, salaries or wages, insurance payable to the estate or fiduciary in said capacity, partnership interest, etc. An interest in any undistributed estate or income from any property held in trust under the will or agreement of another even though located outside of Pennsylvania at the time of death should be listed on Schedule "B," r A completed Partnership Interest Report (REV-B94) must be attached for each partnership or joint venture, and a completed Closely Held Corporate Stock Information Report (REV-B93) must be attached for each closely-held business interest or sole proprietorship reported on Schedule "B." COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE T.\X RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY (Instructions 0" Rt'vt.>rse Side) Mary G. Switzer DESCRIPTION UNIT VALUE 20 Interest accrued to date of death on item no. 19 21 85 shs. General Motors Corp., common; NYSE 49.375 22 550 shs. Commonwealth National Bank, common; OTC 26.75 23 Dividend on item no. 22 of .58 per share declared on 10-15-80; payable 11-10-80; to holders of record 10-30-80 24 104 shs. Exxon Corp., common; NYSE 76.125 25 100 shs. Duquesne Light Co., common; NYSE 13.0625 26 200 shs. Pennsylvania Power & Light Co., common; NYSE 17.50 27 123 shs. American Telephone & Telegraph Co., common; NYSE 49.25 28 16,900 units The Commonwealth National Bank common fund A-I; NL 1.00 29 Interest accrued to date of death on item no. 28 30 Principal cash 31 Income cash Items no. 6 through 31 were assets of the Mary G. Switzer Inter-vivos trust no. 19246-01-6 with The Commonwealth National Bank, Trustee 32 Refund from the Internal Revenue Service of 1980 Individual Income Tax 33 Refund from Pa. Department of revenue of 1980 Individual Income Tax 34 Claim payments from Medicare 35 Claim payments from Pennsylvania Blue Shield 36 Refund of Security Deposit from E.S. Young on New Cumberland apartment 37 Premium refund from INA Insurance Company ~*~ ..:r:f.~,. icd.i~ "' '~~l ;~'~':"~4":':'t, "."';'~~P"-'-"" ESTIMATED MARKEl VALUE 121.48 4,196.88 14,712.50 OEPARlMENT VALUATION {OFFICIAL USE ONL Y/ 319.00 7,917.00 1,306.25 3,500.00 6,057.75 16,900.00 133.24 2,439.15 188.45 1,554.00 22.83 84.00 21.00 80.00 12.79 TOT AL CONTINUED If additional space is necessary, use 8'2" x 11" sheets, Rt::V-4~1 I: ",.'(e-f:!OI COI-'MONWEAL TH OF PENNSYL VANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY ~~~ 'f;t~lt?ll ,,:'.:;'.~f't:.r' (Instructions on Reversa Sida) Estate of Mary G. Switzer ITEM NO. OESCRIPlION UNIT VALUE ESllMA TED MARK ET VALUE OEPARTMENl VALUATION (OFFICIAL USE ONL Yl 38 Refund from 8ell of Pennsylvania 39 Refund of appraisal fee from Steinmatz Coin and Currency Inc. 40 Refund from Blue Ridge Haven West 2.90 25.00 351. 90 If additional space is necessary, use 8l2" x 11" sheets. TOTAL 154,452.80 / p: t/ i/.r;2, ':N .\~"~:i:' r, :;; ~i' 4O,,",:'j,..!\, I.. : ii ; ,i " : ,U.':':_-. .~ ,-t.::'_::::;" , '. . -.-; . \'~,' , . , """ . ~. /..--......./ ~) ,: \--;,) ". l,' II'........ --"" ,..... ,..... : ~ . ,I"J ~ I .' ! -:-. .. - ",- - cY(oU/t' i~.J./(' ,: <:=: \. ,i ./ '.=--, .....: '-' 2129 11.{""cd Street, CiI!':'lp Hill, Pi, ! 7~,: " . ., ",+ I. .' ,. , k...: L..:,. . ,",.., 737.8024 7:7.4719 October 24,1980 Commonwealth National Bank 1510 Cedar Cliff Drive' Camp Hill, Penna. 17011 Attention: L. Copeland Concerning the jewelry pieces of the Estate of Mary G. Switzer, the following items have be n examined and oppraised. Lady's 14 kt. yellow gold watchr Case #389981, Girard Perreaoux movement #5819841, gold filled band attached. Value 5 22.00 Lady's yellow gold filled wrist watch, case #2608218, o Swiss movement, no name, no band. Value S Lady's platinum diamond ring, a filiaree mounting, < the diamond approx. 1.15 ct., perfection grade 3, I color grade 2. There ore twelve full cut diamonds set in filigree, approx. 3 pts. each. Value 51,150.00 4.00 Lady's 14 kt. white gold ring, a 10 x 8 mm. octaoon cut synthetic bluish/green stone, bezel set. - Value S 4.85 Hunting case watch, 14 kt. yellow'gold case an Illinois movement #784704, seven jewels, movement, brok~n. #40437, obsolete Value S 40.00 Lady's wrist watch, 18 kt. white gold case, a fifteen jewel Hafer movement, needs repair. There are four single cut diamonds, approx. 1 pt. each, and four synthetic blue sapphires, gold filled stretch band. Value 8.50 Pocket watch, open face, whi~ gold filled case #6680574, X a seventeen jewel Waltham movement #23699490, a plated chain and knife attached. Value 3 10.00 Strand of simulated pearls, graduated from 5.5 to 9.5 mm., spring ring catch. Value S 1.00 Envelope of loose pearls. Value S None Sterling silver pin, 42 mm. diameter with an 11 mm. round citrine, poor color. Value S 4.00 '. - !: '("..--....,y.) . r - .' I. ,., '---. .. ""'- j;J r .~.' I I <<ffh';:~':'k'~ ~ Estate of Mary B. Switzer Page 2..... Strel,.~t, Cc,"T1p Hill. Pi, 17.j!' ...., I\r~lc:-ir~1' \"; :.... :: '~ci\.'~" " ::~~. io;-. ~ .:' . . L: I I. , . ': . , . , ", ,r ....-... ;-...-: . .' , - ,-.., , \...."-"""'" ~ .. . .-' II' , . ,U.--. \. ."-tJ.:~; . '\.. .' "~J": \"..-. . ~..:'S;/ ....-1.. - \, ! '.~ \ '.-/ \'.' f. . . \;.\.,. 1. ..... I.... 737.8024 737.4719 Ster~ing silver monogrammed disc pin. Value ~ 1.00 Yellow gold filled disc pin, engraved front and back. Value None Bangle bracelet, yellow gold filled, broken hinge. Value $None Tie pin, 14 kt. white gold, a diamond apprax. 3 pts., full cut, set in filigree top. Value $22.00 These pieces have been examined without the stones being removed from their settings, and are appr~ed on that basis. This is a fair market value at which the property would change hands between a willing buyer and willing seller if both had reasonable knowledge of relevant facts and neither was under compulsion to buy or sell. 'I" 1..,- .' i t /L. .' (t : t. I. -'I: to' R.W.Landis,.Registered American Gem Society , \ Jeweler RI'IL/ es . 717 ~234-ii31 ,J/tWUf M. 'lu Une4 /lftIPr4i44l 01 /lHtk}<<e4 ad 'PCWJH4t ~~ 1919 'iJ'UJ(J&("(Jod StMet ~~. 'Pa. 17/04 November 20, 1980 To whom it may concern: I, the undersigned, appraised the following items in the estate of Mary Sweitzer, to the best of my ability and have no interest in same whatsoever. Commonwealth National Bank - Executor sofa cabinet base table and four chairs nite stand drop leaf table, 4 chairs, server 2 lights as is fan chair chair as is chair radio-record player typewriter old TV rug magazine rack, stand fan stand card table 3 tables 2 porch rockers stool bedroom suit contents of kitchen cupboards $ 5.00 2.50 10.00 5.00 70.00 1. 00 2.00 3.00 5.00 1. 00 5.00 1. 00 30.00 5.00 1. 00 3.00 1. 00 1. 00 1. 00 1. 00 1. 00 200.00 20.00 TOTAL $374.50 W. )~rn_ . W~/-":-- Col. Harry M. . Wimer Auctioneer and Appraiser Phone 234-8838 . ,. <11nl. ~arr!J il. 111l1imrr Auctioneer & Appraiser of Real Estate and Personal Property Harrisburg's Only Full Time Auctioneer 1919 Brookwood Street Harrisburg, Pa. 17104 December 30, 1980 To whc: it may concern: I, the undersigned, apprai5ed the following items in the estate of Mary Sweitzer to the best of my ability and have no interest in same whatsoever. Commonweal th National Bank - Executor linens doll as is silverware neckpiece box's full cabinet full kitchen utinsels TOTAL $ 10.00 50.00 10.00 2.00 5.00 10.00 HOO 88.00 Col. Harry 1,1. \'limer Auctioneer and. ^pprai5er QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No" ,) NO 2. Did decedent, within two years of death, transfer property from himsel f/ hersel f to himsel f/hersel f and another party or parties (including a spouse) in joi~t ownership? (Answer "Yes" or "No".) lliL- 3, If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the lollowing 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 01 transfer. d. All other information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) Nn a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) NO b. What was the transferee's age at time of decedent's death? NfA 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) Jm- b. The right to designate the persons who shall possess or enjoy the property translerred or income therefrom? (Answer "Yes" or "No".) NQ 6. \I 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 "Yes" or "No".) NO 8. Did decedent, at any time, transler property, the blJleficial enjoyment of which was subject to change, because 01 a reserved power to aller, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) yc~ 9. If the answer to eight above is "Yes," was the power to aller, amend or revoke the interest of the beneliciary reserved in the decedent alone ( X) or decedent and others ( ), '-f-'t - ~~. a_~5"-QO .......,................................ .../~.;;;.ooo,..o.o. ......;rf,"l')~.-:::O/..7. ~ .', Commonwealth National Bank D,lte Cash Amount S TlUst Agl cement No. '- This TRUST is estetblished belw~~n The Commoll\l\'calth National Bank as Trustee and the undersigned as settlor. The settlor hereby granu & conveys to the Trustee all right, title and interest ill the cash amount indicated above and to any other assets or liabilities set forth on Schedule "A", which may be attached to and made a part of this agreement. 'In managing these and any other assets subsequently tramfcflcd to this TRUST, the Trustee is charged with the lollowing duties: keep the assets safely;.use the care Jod attention which a reasonably prudent man would devote to th;:'\'llanagement of his own financial affairs considering Ihl! economic.; condillom of the time; advise the settlor monthly of the past month's transactions and the valuatIOn of (t:,selS held at month l!nd, and annuallv of any neces. sary information for the prcnaration of the settlor's tax returns: lIiJns1er the net inCOIlll! each month to the principal of the TRUST for reinvestment, to or for the use 01 the settlor, to the settlor's checking account as indicated below, or to other persons in amounts dc'Scribed in a separate letter delivered to the Trustee. In addition to those powers granted by law, the Trustee may exercise the following powers in order to perform the above duties: receive proceeds from the sale, maturitY, call or conversion of TRUST assets; invest in and buy or sell assets (including real or personal property, dommon funds managed by the Trustee. and obligations, deposit accounts, or stock of the bank or its affiliates) subject to the set~lor's guidelines indicated below; borrow money at reasonable rates and pledge TRUST assets as collateral, should it be prudent to do so; pay any necessary expenses, including reasonable Trustee's compensation; allocate transactions between income and principal as the Trustee deems best; and handle rOll1ine matters according to the Trustee'~ best judgment, including but not limited to making timely exchange of temporary i~Sllf;;'S for permanent. f.'>.ccuting proxies or voting shares, buying or selling fractional shareL ond exercising. holdmg, or scllrng ,,':arranIS representing rights received in corporate recapitalizations or I ~0rg;,nlz~tiollS. The senior Olav altel or amend thl! TRUST in any way provided that such char.ge does not result in making thl: TRUST irrevocable Of creating dIspositive provl!;ions to take effect at or after the settlor's death. The settlor ma~' add to or withdraw from the TRUST'S income or principal at any time, subject only to providll1g reasonable nOllce, and may provide 'tor automatic funding by indIcating below. The TRUST shall terminate upon the settlor's death with principal and undistdbuted income being p~id uno thl: settlol's estate. The Trustee may expend TRUST income or principal in behalf of the settlor at his direction or In behalf of any naml!d beneficiary to the extent of his beneficial interest. Only the settlor shall have the po\.\'el to assIgn or encumber his interest in thr TRUST or other. wise cause its assets to become liable for the payment of a beneficiary's personal obligation or debt. The Trustee is responsible for losses caused by its gross negligence but not tor other los~es such as, but not limited to, those created by fluctuation in market valuations, The Trustee is not required to account t~ anyone, except as described above, unless expressly directed in writing by the settlor or his personal representative. Either party may terminate this TRUST at any time, subject only to providing reasonable notice. This agreement i~ not binding upon the bank until such time as it has been accepted by an administrative officer, who will be assigned to the TRUST; this officer will be in contact with the settlor and may be called upon by him at any time, INVESTMENT GUIDELINES ........... Commercial paper ....__..... Treasury bills ........... Taxable bond. ........... Tax exempt bonds ........... Common stocks ....LL. Trustee's dIscretion INCOME TRANSFER ........... For reinvestment .,......... To checking AIC ........... To address sho,"vn li'lA /( Y G- .suJ: -r Z.&~ ~ f/ COmmMtLJ6/1L../tf (vAT'- (1p.tJ , IA 13~.. ~~.,~8.i.,C!~.l!.~J -r. (), 7"' V)sf$lature ~~F:: . ..,.........,....,....,. of each ..........,....... .mpf/?.Y.....G,..SU)/..T~e.1\-r/A and add it to this TRUST for investment f'lntea name. ~ 172. -OI-3t./-, ~ .....S{.t't;d~.~..~~ r8.. j;n';';';.;,;.....,........ s.oc:SC.'.NO:.......f,;..t; ~...;11/-f!J...UlA~.4v<j -L ,;.~rtY-;Siale. "z;p'coae o.iie"oi .6;;i,;.... ...... li~.~!o'f.~. 0... .................. .................._._..!.?!::~? tJ C"ec~in9 Accoun1 No, AUTOMATIC FUNDING I I The Trustee is to charge mv checking account S __.m..~............._ on the ONLY YOUR ATTORNEY CAN PROVIDE LEGAL ADVICE FC.'F\V 191 JKG . REV-453 EX. (10.801 COMMONWEALTH OF PENNSVLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEOULE "0" BENEFICIARIES (Instructions on Reverse Side) Estate of Marv G. Swi tzer BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH T,,; ni ty Iln; tpn Mpthod.U-LChuo:11- r:ha,.; tv Beouest of ~500.00 4th and Bridne Streets New Cumberland, Pa. 17070 Bonnie M. Weaver Grandniece Yes 8-23-42 Bequest of $1,000.00; 2403 Pineford Drive !, residue of estate; MiddletOl~n, Pa. 17057 personal property appraised at $2,611.90 Susan Weaver Bates Gra ndni ece Yes 7-21-55 Bequest of $1,000.00; 2915 Pineford Drive 1/8 residue of estate Mi ddl etown, Pa. 17057 Linda K. Abel Grandni ece Yes 12-15-47 Bequest of $1,000.00 1111:: A,.n"n n"';\I" Scotia. NY 12302 Kathv W. Phillips Gra ndni ece Yes 9-10-50 Bequest of $1,000.00 930 Chambers Street Steelton, Pa. 17113 Kenneth E. Weaver Grandnephew Yes 12-1-42 Bequest of $1,000.00 423 Park Hills Drive Mechanicsburo. Pa. 17055 Charles B. Weaver III Grandnephew Yes 1-5-46 Bequest of $1,000.00 1021 North Vew Street Q,,+hlDhDm p~ 1 Rnlll The above beneficiaries were living at the time of the decedent's death except for the following: NAME DATE OF DEATH . REV-453 EX'" (10.80) COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES (Instructions on Reverse Side) Estate of M...y r, Sw; tzpr BENEFICIARIES AND ADORESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH Richard Weaver Grandnephew Yes 6-22-52 Bequest of $1,000.00 D n H? Rnv 11?l; SulDhur Sori nas Road Duncannon. Pa. 17020 Dwa vne Wea ver Gra ndnephew Yes 7-8-58 Bequest of $1,000.00 2220 Chestnut Street Harrisbura, Pa. 17104 Marv K. Weaver Niece Yes 10-25-22 1/8 residue of estate 4q S Fnllrth Street Stee lton. Pa. 17113 - Betty M. Weaver Niece Yes 8-20-20 1/8 residue of estate 1285 Colonial Road. Apt. 13 Harri sbura, Pa. 17112 Stanton E. Weaver Nephew Yes 7-27-17 1/8 residue of estate; 2310 West Marion Ave. watch appraised at $10 Punta Garda, FLA 33950 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 B%" x 1'" sheets. INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right 01 survivorship, 80th tangible and intangible property are to be included, List real estate first. 1. Describe all real property as indicated in the instructions for Schedule "A," Describe all personal property as indicated in the instructions for Schedule "8," Include the name, address and relationship to the decedent of the co-owneds] and the date the joint ownership was established. 2. Indicate the total market value 01 the jointly owned property. 3, Indicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest. t'" '" 0 ("\ ?; tTl ;l> :E Z ;l> 0 0 Vl 0 - Cl ("\ ~ 0 )! z ::: z t'" tTl rrI ;>; " 9 - 9 t'" Z Z tTl ..., rrI ..., z 9 9 ..., -< Vl rrI - <Il Z 0 <Il 0 -I 9 .." .." :>:I ~ - 0 Z -< -< rrI rrI ?; ?; .- .~.~.\.......,....,..~ . - LAST WILL AND TEST~~ENT QE ~.~l\~,~,;I.:,~.h.."'''')ou'~;-~~1~ .J MARY G. SWITZER ..l I. MARY G. S~ITZER, unmarried, of the Borough of New cumberland, Cumberland county, pennsylvania, being of sound mind, memory and understanding, hereby revoking any , .. former Wills by me heretofore made, publish and declare this my last Will and Testament in manner as follows:- .... 1 direct my executor hereinafter named to pay all my just debts, funeral and burial expenses as soon after my decease as practicable, as well as all inheritance taxes, whether state or federal, which may be assessed against my ,1.._ .A,....\. ..1.. ~~ -,!-.Mi estate, or on any property passing as a result of my death, whether or not forming part of my estate, as ~art of the costs of administration. "". I direct that my funeral and burial arrangements shall be in charge of thE Jesse H. Stone Funeral Home, 408 Third Street, New cumberland, pennsylvania, and that my place of burial shall be in the Jacob H. switzer lot in Mount Olivet cemetery, New Cumberland, . ..~-- .._....__._~ Pennsylvania. I direct my hereinafter named execuco: to cause a suitable marker to correspond with the other markers on said ..,lr ~.I('~~............-..t1..,IJftl~ lot in the name of Mary G. switzer to be erected at my place buriaL . I further direct that religious services shall be in charge of the pastor of ~he Trinity Uni~cci Methodist Chu~ch, NeW cumberland, pennsylvania. '.' .. .. .~ -.-....--.: ----..- ....- _.:;;~;::~~~~;i;;~ . ..-. . "l;:"'lr"'h'~'i'" .," ~ 1-- "~l!:;"-~""~ ''-'t''.. .. "::.' : .~I" . ~ ":": ;~~!f(?i~~i~ Cj!f~:~;5~~~~i~~~ '.'.. ..'." ~{:...;_'~::': ,",'".j;.:".7.";:.4 ..,.' :',,' .'~:.~- ..:. . . , 'p.'. . .r. ~ .. . .:;:"...;~-'~':...~.:, ... .::~::..t'~"':~/.~\: ,~";:..:;" . I ~ ~_ . ~::<<:...:;' ". , ...., ,....... .' ;.~-.:~.: ."". ....y:... 7. ....;:... ,.~., .' '. ~~ ....... ':.~.~-:':.~...::...:,.::... ,.:.' . ..- .- ;,...": ~~.'~ . rlil .::;';.' ":'~:'..: . ..- _..':-.~...:... .-. ..-.... .~_. ... I give and bequeath my father's watch (Jacob H. Switzer) '~~~f".".~ to stanton E. Weaver, if he survives me. ...-..... ..'., I give and bequeath all my jewelry, personal possessions and all household goods to my grand-niece, Bonnie M. Weaver. ........:; ",-,''-::' .... I make the following cash bequests:- .,.:"-4 ,'. .~. .." ',. ,.,1 I give and bequeath the sum of Five Hundred ($500.00) Dollars to Trinity united Methodist Church, New cumberland, Penn- ".. ., sylvania, for general purposes. I give and bequeath the sum of One Thousand ($1.000.00) Dollars EACH to the following named persons. if they survive me:- .~ . '1'~~'C~~~ l. 2. 3. 4. 5. 6. 7. 8. Bonnie M. Weaver Susan Weaver Bates Linda K. Abel Kathy W. Phillips Kenneth E. Weaver Charles B. ~eaver. 3rd. Richard Weaver Dwai'ne \','eaver "'. All the rest, residue and remainder of mi' estate, I give and bequeath as follows:- A one-half (1/2) porcion thereof to my grand-niece, . '.' .~ '..i' ~'I .;::. Bonnie M. Weaver. The remaining one-half (1/2) portion thereof to be :.;01.:.... ".' "":~" '..::. . ..; ".. ..~::~~~~,~ ....~ -.::.. :":::~::~.':'.~::.~J divided equally between Susan \~'aaver Bates. Mary r;. \~eaver, Betty M. Weaver and Stanton E. Weaver, or to those of them who su~"ive '.;." me. ,.' 1._...L'~':ii"~'J" ''Ii I nominate, constitute and appoint The commonwp.alth ~ational Bank, Harrisburg, Pennsylvania, Executor of this my last Will and Testament. . .,' . '.;'-'~' . IN \\'IT:;ESS ":HEREOF f ~ hay'? hereunto set my hand and seal .... _.........~_.'_.__..... J.'7-rfv day of October, 1980. ,.......t this "',' /-- , " ''-;'''''" -- ..,':'. ~'c., -' '.', ;.ian: G. S..:itzcr -2- ~;:;:';:~~K;:~~i~~~~.~~ __L__ (SE1,L) !,EV..UA EX+ tHO) INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) [J Original o Supplemental o Remainder File Number _2hBOdl1JR Estate Name Mal'Y_G...-Switzer:.. Date of Death October 30~-19~~__ Social Security Number _112-0~~66 REPORT OF iNHERITANCE TAX APPRAISER I, the undenlgned duly appointed Inheritance Tax Appraiser in and lor the County 01 Cu~b~d Pennsylvania, do respectfully report that I nove opprai sed the real and p.rsonal property as reporte in t · oregoing retum atth. values sotlarth apposite each item in Ihe lasl column.la the righl in h.dules "A", "8", "C", and "E" Dated: Seotember 1R, 1QR1 RAISER INVENTORY VALUE AS APPRAISED I I AOJUSTMENTS I CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE 9Z+ Real Property (Schedule A) $ 00+ Personal Property (Schedule B) 10+ Jolnl.H.ld Prop.rty (Schedule E) 2lH Transfers (Schedule C) 30+ TOTAL GROSS ASSETS _---15i1,A52- 93- 40- Leu O.bts and Deductions (SCHEOULE F) CLEAR VALUE OF ESTATE o Lile Eslate o Annuity FOR lISE OF REGISTER ONLY Tax on $ CODE PRINCIPLE VALUE CODE \ COMPUT A TION OF TAX S S S S S ~ FACTOR 6" " 15~o Tax on S Tax on $ Tax on S Tax on S Exemptions Total Estate TOTAL TAX INTEREST FROM BALANCE TO S $ $ Less Credits OATE OF PAYMENT AMOUNT PAID DISCOU~IT INTEREST TAX CREDIT s + S S = s = + INTEREST FROM BALANCE OUE BALANCE TO S _ S S REV.SI8 F? (7-801 . COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS NOTICE OF FILING OF APPRAISEMENT Commonwealth National Bank 10 South Market Square Harrisburg, PA 17108 RE: Estate of County of File No. M~H"'Y r:. '3tJ; t'7e-r r.l1mhAl""~nti ?1-QQ-n7113 Dear Sirs: You are hereby notified that the o"igin~' appraisement in the estate of Mo"y n ",.,it~",.. has been filed in the office of the Register of Wills of r,..mh",,' onn County on ~"pt.pmhp" 1R , 19.B1... Said appraisement reflects the following valuations: Real Estate Nnna. Personal Property 1 <;4 ,4<;\> RO Jointly Owned NonA Transfers NnnQo Total 1<;4,45? RO As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may obiect thereto within sixty days after receipt of said notice as provided by Sectian 1001 of the Inheritance and Estate Tax Act of 1961,72 P.S. 2485-1001, P.L. 373. Date Rppt.Amhp.r 1R, 1QR1 S1,"..--:A~~" ~- Title r.hi Pot" ilppY'::d QPl"'O NOTE: This is not a bill. 'tl '" 0 p:; ~ ~ ~ ~ :2 .<:: 0 ~ u ..... < s.. ~ Z ~ ~ :> .a ..;, 0 :>- u p., ~ \ Q) s.. ~ '" '" ..... ;J 'tl ..... ..... ,..l '.... 0. ..... p:; 0 :I: < p., - Q) 0. U z \ :l 0 f;j - 0 ..... ..... "" - P'l ..... u "" ~ 0 0 ~ ~ "" l:., (-0 0 '" 0 z 0 ~ ~ <r. :>- (-0 0 z ~ ~ (-0 ~ z z ,..l 0 - 0 ~ z ~ ~ ~ ,..l z ::E z (-0 Cl ;J U " Z - ~ '" ~ 8 0 <( - ::; ~ Cl p.. ,..l , t ..~""'-, .~~,-~_-- - ---.----.......... -... (dl~n;f1t2~~~;:,;i,;;;;: ; ," "COMMONWEALTH OF PENNSYLVANIA ! ""'1"";'29678'"" ' ' DErARTMENTOFREVENUE I 4~~' ,',',:, , ' , ',; 'OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX : \'" , " '" . 'II II = ~ H ~~g~VEO TAX AT 6% TAX AT 15% TAXAT_%_ AODRESS ESTATETAX '--ESTATE iNFciRMA TiON,-------------------------- DATE OF OEATH TOTAL TAX CREOIT 12.621. 27 FILE NUMBER . -------------------------------------------- COUNTY C umber land m m LESS DISCOUNT. PLUS % INTEREST (FROM TO_I DATE OF PAYMENT ul 30 1981 NAME OF OECEOENT Mar G. sw i tl!:er TOTAL AMOUNT PAID $2.621. 27 POSTMARK DATE REMARKS' ~ SEAL RECEIVED Bv I (! "PAID ON ACCOUNT" SIGNATURE I REGISTER OF WILLS --------------------------------- REV...ClO (?,.78) APPI.ICATIOtl FOR CIII.RIT ABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX lAc' 01 Moy 18,1956, P,L. 1757, ond A" 01 Juno 15,1961, P.L. 373, as amended) *- 'Y: .. lit;. -.' -.": COMMONWl:;.AL TH OP PENl\ISVl.VANIA DEPARTMENT OF REVENUE BUflEAU OF FIr.LO OPERATIONS Application is hereby filed for the approval of nn ~xemption from Pennsylvania Transfer Inheritance Tax on the transfer of the property described below: 1. Bureau File ~ 2. Dote of Death 4. . ....:1? /C//? / - G awitze~ 3. Dote 01 Approvol 5. The Commonwealth's oppraised volue 01 the property lor which on exemption is cloimed is S 500.00 (Note: Where the property is other than a spocified amount of cash, the exemption cannot be approved until the value of the property has Dcen established by appraisal by the CommQnwealth, except in those cases where the amount of the gift or bequest rcpresent:; a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or percentage amount above). 6. Check the manner in which the transfer was effected and submit a copy of the document outhoriz.ing the transfer, unless such material has been previously filed. WILL (J.; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (II othe" exploin) 7. Correct Business Name and Address of Charitable Organiz.ation receiving property: NAME Trinity United Methodist Church 4th and Bridge Streets ADDRESS New Cumberland, Pa. 17070 o See listing on reverse side for additional charitable organizations covered. 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. The Commonwealth National Bank Signature 01 Appllcont By: (lp!(r) /t'lL.v'~1 10 South Ma{{et Square (/ Address 01 Applicantljarrisbur-S. Pennsylvania 17018 Estate Tax Manager Official Title ----Exe.cutQr Dote /', /e- -;;1 This form must be completed in tripJi""te and all three copies delivered to the Register of Wills far the County in which the decedent resided, or in which letters were issued for a non-resident decedent's estate. If the decedent was a non.resident of Pennsylvania and letters were not issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of Fiold Operations. Penna. Department of Revenue, P.O. Box Z970, Harrisburg, Po. 17105, Do not write below this line - For Ollici.1 Use Only AP PRe v ED: For the Secretory 01 Revenue REFER RED to Bureou Heodqua,ters Approved 0 For Secretary of Rcvenuc t..-;!..Jj Denied- 0 (Initials 01 Register of Vlills) (Authorized Signature) -7' (County) (Title) iDate 01 Referral) (Dot. 01 Action) * See reverse side for reasons MUST BE FILED IN TRIPLICATE INFQRMATION 10 'nluru prop"r crudll 10 your necount. thu nnmo olthu oSlalo and fjlo numbor should be clearly print- ad on tho chock (II monny ordor. Till.. nUUlIInlun1 IS modo in nccordancu with Section 708 of the Inheritance and Estate Tax Act of 1061172 P.S. ~ 2485,7081. To tho oJl,lunl that inhoritonco tax is paid within three (3) months after the death of the decedent. a dllcounl 01 1".101 porcont IS nllowod 172 P.S ~ 2485,716). Inhorllunco TOI;. othor thon lax on a futuro interest. is due at the date of the decedent's death and becomes dnllnquonl 01 thu cJlpirution of nino (9) months after thl:' decodenl's death (72 P.S. ~ 2485-711). Inheritance Tal( on n futuru Inlerest I~ payable within three (31 months after the lransfer takes cllect in possession and onJoymont nod IS delinquent thereafter (72 P.S. 5 2485.712). Calculate mterest from the delinquent date shown on 1ho fnco 011his 10fm 10 1ho dOle of actual payment USing the following illlerest Hlble; - ---------- - --- ---- - - - ----- ---- -- - - --- -- ---- -- - - - - -- - --- -------- -- -- - - - -- -- 1 month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 monlhs .025 8 months .040 11 months .OSS 3 months .015 6 months .030 9 months .045 12 months ,060 1 doys .000 17 11 dnys .00186 21 days .00352 2 dRYS .00034 12 days .00203 22 days .00369 3 days .00051 13 dnys .00220 23 days .00386 4 days .00068 14 days .00237 24 days ,00403 5 dnvs .00085 15 dnys .00250 25 days .00420 6 dnys .00101 1/; days ,00267 26 days .00437 7 davs .00118 17 days .00284 27 days ,00454 8 days .00135 18 days .00301 28 days .00471 9 days .00152 19 days .00318 29 days ,00488 10 dnys .00169 20 days .00335 30 days ,00500 - - ------------ ------ - --- - - -- - - --- -- --- --- --- --------- - - - --------- --- --~ Any party in intcrcst. including the Commonweahh and the personal representative. not satisfied with tho OSSBssment may object theroto within sixty (60) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act 01 1961 172 P.S. ~ 2485-1001 I. Make check or money order payable 10: '.Register of Wills, Agenl'. Mail 10 the address listed below: '-'.4.14...~~~.,.~~~~'lIIIQ,.-.,~~.'-'";~ - ."- ", ':.l . ,- a: ..,c- , : ~J ~_. w\-,h, C.:-" "" <;:' r:"t: N ;:.:""~ WI; I.l:;;;!. 01- ,- ..=ow ",,,, i5 00 ~~~ UUJ a": 5 l:!'" ~ ~u 9=' u :0) <1:1 1iI...:l ....:l:>t .P1111 Z Z~ g o iii 111 ~P1 ~ O. H .~~ C o ~ ~tJ 8 8~ 111 el.~ ~ ~ E:leH ~ zS~ 0 HtJ:> . o z ....:;.. .. ,,:. gj ~ ~!.tl~ H 0 iii . :;: e~ lI1:I:SH . g tJ ~ t!lO :> P: ....:l ~lil~~ ::;:1iI~~ !.tl~IiI~ o e C 1iI~!3~'[;l 8 tJ <I: <l:ril iii 88:;: tJ 1I1~1iI01il ril...:lZtJC 8 zEl 00 HtJ C8tJ rilO<l: 111 III OH...:l Cl.P:<I: 08Z P:UlH Cl.H!.tl C ~~~ 8 Zlil8 ~SgJ filCH 8ril!.tl ~:I: 8tJ!.tl UlUlO ....... (l)"'::l "" ... C ~;:; U -:: ~ *~~2g .::: .... c.I ":j 0_ :.::: '? 2. :: 2:: ~ c.> ;; ("J ~ <.-. ..... 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THE COMMONWEALTH NATIONAL BANK kA.~ Trust Man ger BY: Sworn to and subscribed before me this .;?~ Lij~:t, .W\) c, -." , ..lit n~3 ":'0 , :',1 ~, , . :..< " is' f."~ l:> .. .~~~ ~ C"'\ , C'J c.-;: :"l.; ~:l W\,.... ,- 2.{~ 0'- - ' ""I) ~ Oc, c;. .:.-!:? U'u O?~ ~IX ~ je.:. 1'0 U Ij'" It;(,/:, ~(,' . 1"'- e I ~:'~... ~ ~ 0 - .: 0 OJ - I"'" " 2 J~_\~ t.C~ .!O .., E ,., II~" :E :$ ~ " - ~ I'''"'' " .g .. " E , 0 '" j'~,;:' fiI' . ~ Ii< " ... " ~ " !mi c:l .~ " '" ~<l: ~ 0 ~ .c ~ 0 .g a " " ~ ~ I~it: Pl~Z ~Ii<~ ..- c:l '" ." c:l !i<, . 0 ~ ~ ~ ... - ;:l ~j ~ " Z~H HO~ ~ 0 " ;1 l/) 0 ,~, c. --:J ..;I I"'" OPlUl ~ ~..: H Cl) "' r~' c:l ~ E ,~,. ~.!;: 006 H 0 ~ .~ " ',., ~ ' " ~ co Jl\'1;:_ .~ ;.. ~ " 0 . ~ CJ ~ CJ 0 ;'J j 0 ~ c"' I'''' O~H CJ Z - ~ o-l ~ ~ '....- - ::! 1"":(: CJ Q ~g :> ..: " 0:7 .' :> " o-l B ~ r.... -' c. 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"" t:.., )' COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No, of ESTATE OF MARY G, SWITZER, DECEASED LATE OF THE BOROUGH OF NEW CUMBERLAND FIRST AND FINAL ACCOUNT OF THE COMMONWEALTH NATIONAL BANK, EXECUTOR DATE OF DEATH: October 30, 1980 WILL NO.: 21-80-718 LETTERS GRANTED: November 10, 1980 FIRST COMPLETE ADVERTISEMENT OF GRANT OF LETTERS: Cumberland Law Journal - November 28, December 5, 12, 1980 Patriot Evening News - November 24, December I, 8, 1980 ACCOUNT STATED TO: September 30, 1981 SUMMARY AND INDEX PRINCIPAL ~ I Receipts 3 $154,707.80 \ Net Gain on Conversions 5 796.16 Adjusted Balance $155,503.96 I Less Disbursements 6 35,804.13 \ Balance Before Distributions $119,699.83 Distributions to Beneficiaries 7 60,229.85 Investments i Capital Changes I \ Principal Balance Remaining $ 59,469.98 \ INCO~'E i Receipts 10 $ 8,765.98 Less Disbursements 10 644.79 Balance Before Distributions $ 8,121.19 Distributions to Beneficiaries Income Balance Remaining $ B.121.19 Combined Balance Remaining $ 67 ,591.17 ~:'~1 U:\:.~ .lLJlJ :':,~[ _u COMPOSITION OF NET BALANCES Account Value PRINCIPAL Value as of 9/30/81 $11,000 United States Treasury Note, 7.75%, due 11/15/81 $ 10,436.25 $ 10,893.41 Cash and various accounts temporarily invested in Commonwealth National Bank Common Fund A-2 49,033.73 49,033.73 TOTAL PRINCIPAL 59,469.98 59,927.14 INCOME I Cash and various amounts temporarily invested ,j in Commonwealth National Bank Common Fund A-2 8,121.19 8,121.19 I TOTAL INCOME 8,121.19 8,121.19 i I I , COMBINED PRINCIPAL ANO INCOME $ 67 ,591.17 $ 68,048.33 ~J~2 Lij~i. .1.UlJ :.~C[ ~ 2 PRINCIPAL RECEIPTS Per inventory attached Subsequent Receipts: 12/24/80 Social Security death benefits OS/27/81 Internal Revenue Service, refund from 1040 07/16/81 Pennsylvania Department of Revenue, refund $152,875.97 255.00 TOTAL PRINCIPAL RECEIPTS 1,554.00 22.83 $154,707.80 PRINCIPAL CONVERSIONS INTO CASH WITH NO GAIN/LOSS 11/06/80 16,900 units Commonwealth National Bank Common Fund A-I $ 16,900.00 12/17/80 $5,000 Certificate of Deposit with Homestead Savings Association, 7.5%, due 4/26/81 5,000.00 01/28/81 16,720 units Commonwealth National Bank Common Fund A-2 16,720.00 02/09/81 $5,000 United States Treasury Savings Bond, Sed es A 5,000.00 03/31/81 50,000 units Commonwealth National Bank Common Fund A-2 50,000.00 07/27/81 2,650 units Commonwealth National Bank Common Fund A-2 2,650.00 09/09/81 6,500 units Commonwealth National Bank Common Fund A-2 6,500.00 09/10/81 6,500 units Commonwealth National Bank Common Fund A-2 6,500.00 LI),r, .t.UlJ :.~~[ 333 3 Principal Conversions (continued) 02/19/81 200 shares Pennsylvania Power and Light Co., common Account Value $3,500.00 Proceeds 3,218.89 08/17/81 $30,000 United States Treasury Note, 8,375%, due 08/15/81 AccountValue $28,903.13 Proceeds 30.000.00 1,096.87 $ 1,976.11 796.16 NET GAIN AS SHOWN ON SUMMARY PAGE PRINCIPAL DISBURSEMENTS 11/06/80 Landis Jewelers - appraisal 11/10/80 Surgery Inc. - medical expenses 11/10/80 Register of Wills - probate will and short cert ifi cates 11/10/80 Professional Pharmacy - ethical drugs 11/18/80 Cumberland Law Journal - legal advertising 11/19/80 Register of Wills - two short certificates 11/24/80 Thomas Kunkle D.O. - professional services 12/02/80 Jessie H. Stone Funeral Home - funeral expenses 12/10/80 Cowley Associates - professional services 12/11/80 Pennsylvania Department of Revenue - estimated income tax 12/11/80 Internal Revenue Service - estimated income tax 12/15/80 Patriot News - legal advertising 12/19/80 Register of Wills - three short certificates 01/29/81 - 07/28/81 Register of Wills - inheritance tax 1I~", ""-5 U,J ..1.UlJ r~G[ 5 281.11 $ 1,179.95 $ 40.00 75.00 61. 00 22.36 18.00 2.00 36.00 1,905.00 135.00 25.00 475,00 54.75 3.00 19,341. 27 Principal Disbursements 04/07/81 Mt. Olivett Cemetary Association - repair work to headstones 50,00 5.00 12.75 04/07/81 Register of Wills - cost for filing inventory 04/30/81 Holy Spirit Hospital - professional services 07/28/81 Register of Wills - cost for filing debts and deduct ions 6.00 2,500.00 09/08/81 Stanley C, Fellows, on account - counsel fee 09/11/81 Commonwealth National Bank, on account - executor's fee 4,000.00 Reserves: 150.00 2,134.00 3,723.00 30.00 1,000.00 $ 35.804.13 Closing Cost Stanley C. FellowS - balance of counsel fee Commonwealth National Bank - balance of executor's fee Pennsylvania Department of Revenue - fiduciary income tax Register of Wills - inheritance tax TOTAL PRINCIPAL DISBURSEMENTS PRINCIPAL DISTRIBUTIONS 02/20/81 Bonnie Weaver - distributions per will the fo 11 owi ng: Transferred to Account #19487-01-6 on a/c share of residue $ 25,000.00 Household goods Jewe 1 ry Cash 462.50 1,267.35 1,000.00 $ 27,729.85 .6 U~:., .WlJ r~~[ 8:::;6 \ ,i <- "i I ! , : Principal Distributions (continued) 02/24/81 Susan Weaver Bates - distribution per will 02/24/81 Dwayne Weaver - distribution per will 02/24/81 Kenneth Weaver - distribution per will 02/24/81 Richard Weaver - distribution per will 02/24/81 Charles B. Weaver, III - distribution per will 02/24/81 Kathie W. Phillips - distribution per will 02/24/81 Linda K. Abel - distribution per will 02/24/81 Trinity United Methodist Church - distribution per will 03/31/81 Stanton E. Weaver - distribution on a/c share of res i due 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 500.00 6,250.00 03/31/81 Mary K. Weaver - distribution on a/c share of residue 6,250.00 03/31/81 Susan Weaver Bates - distribution on a/c share of residue 6,250.00 03/31/81 Betty M. Weaver - distribution on a/c share of residue I I I ,\ i I : , I TOTAL PRINCIPAL DISTRIBUTIONS 6,250.00 $ 60,229.85 PRINCIPAL INVESTMENTS 11/05/80 1,939 units Commonwealth National Bank Common Fund A-2 $ 1,939.00 11/12/80 13,000 units Commonwealth National Bank Common Fund A-2 13,000.00 12/02/80 3,253 units Commonwealth National Bank Common Fund A-2 3,253.00 12/19/80 5,000 units Commonwealth National Bank Common Fund A-2 5,000.00 _ 7 '-'j~, J..UU :"~~E ~J7 Pri nci pa 1 Investments (continued) 12/31/80 1,000 units Commonwealth National Bank Common Fund A-2 1,000.00 01/13/81 40,750 units Commonwealth National Bank Common Fund A-2 40,750.00 01/16/81 1,780 units Commonwealth National Bank Common Fund A-2 1,780.00 02/05/81 1,218 units Commonwealth National Bank Common Fund A-2 1,218.00 K02/12/81 5,000 units Commonwealth National Bank Common Fund A-2 5,000.00 02/24/81 28,684 units Commonwealth National Bank Common Fund A-2 28,684.00 03/12/81 1,690 units Commonwealth National Bank Common Fund A-2 1,690.00 04/22/81 1,608 units Commonwealth National Bank Common Fund A-2 1,608.00 06/02/81 1,642 units Commonwealth National Bank Common Fund A-2 1,642.00 06/04/81 2,382 units Commonwealth National Bank Common Fund A-2 2,382.00 08/19/81 30,045 units Commonwealth National Bank Common Fund A-2 30,045.00 08/24/81 1,000 units Commonwealth National Bank Common Fund A-I 1,000.00 09/23/81 6,500 units Commonwealth National Bank Common Fund A-2 6,500.00 LI~,~ .LtJG I'm :::;J8 8 INCOl'1E RECEIPTS $11,000 United States Treasury Note, 7.75%, due 11/15/81 11/17/80 - OS/29/81 Interest $ 460.12 $10,000 United States Treasury Note, 9.25%, due 05/15/82 11/17/80 - 01/13/81 Interest 187,51 $1.500 United States Treasury Series H Bond 12/04/80 - 02/15/81 Interest 163.78 12/04/80 $5,000 Certificate of Deposit with Homestead Savings and Loan Association, 7.5%, due 04/26/81 Interest 48.20 $20,000 United States Treasury Note, 11.375%, due 12/31/81 01/02/81 - 01/13/81 Interest 458.79 $5,000 Tennessee Valley Authority 7.35%, due 01/01/98 01/08/81 - 01/13/81 Interest 74.52 $30,000 United States Treasury Note, 8.375%, due 8/15/81 02/17/81 - 08/17/81 Interest 1,989.35 $9,000 United States Treasury Note, 8%, due 2/15/83 01/13/81 Interest 145.51 General Motors Corp. , common 12/10/80 Dividend 102.00 12/10/80 Exxon Corp., common Dividend 312.00 Ameri can Tel ephone & Tel egraph Co. , common 01/D2/81 Dividend 153.75 li,~~ l.U~ r~CE 3J9 Income Receipts (continued) Commonwealth National Bank, common 02/10/81 Dividend 319.00 Pennsylvania Power & Liqht Co, , common 01/02/81 Dividend 106.00 Duquesne Liqht Co. , common 01/02/81 Dividend 45.00 Commonwealth National Bank Common Fund A-I 11/30/80 - 12/01/80 Earnings 129.09 Commonwealth National Bank Common Fund A-2 01/26/81 - 09/10/81 Earnings TOTAL INCOME RECEIPTS 4,071. 36 $ 8,765.98 INCOME DISBURSEMENTS Reserves Commonwealth National Bank - executor fee $ $ 644.79 644.79 TOTAL INCOME DISBURSEMENTS THE COMMONWEALTH NATIONAL BANK By: li~,~ -LtJG :'~~E 360 10 nC'.!.4!i~ F')(.f. (3.80) COMMONWEALTH OF PENNSvLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEDENT SCHEDULE "F" STATEMENT OF DEBTS ANO DEDUCTIONS Estate of Marv G. Switzer Date of Death 10-30-80 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: File No, 21-80-718 Claimant Relationship to Decedent Claimant's Address at time of Decedent's Death . ITEM DATE NAME OF PAvEE REMARKS AMOUNT NO. 1 Nov. 6 Landis Jewelers Aoora i sa 1 fee 40.00 ? " 10 Tnr ,<inn.' 7" nn 3 " 10 Register of Wills, Cumberland Cc Proba te of will & short certificat s 61.00 4 " 10 Professional Pharmacy Ethi ca 1 drugs 22.36 5 " 18 Cumberland Law Journal Esta te noti ce 18.00 6 " 19 Reoister of Wills Cumberland Cc Short certificates 2.00 7 " 24 Thomas P. Kunkle D.O. Professional servi ces 36.00 A )pr ? ,lp~~p H Stnnp- " Hnmp FI. , on<: nn 9 " 10 Cowl ev Associ a tes Professional services 13" nn 10 " 11 Pa. Department of Revenue 1980 estimated income tax 25.00 11 " 11 Internal Revenue Service 1980 estimated income tax 475.00 12 " 15 Patriot News Co. Estate notice 54.75 , 13 " 19 Register of Wills, Cumberland C Short certificates 3.00 . 14 \nr. 7 Mt. Oli vpt r.pmptprv Rpna i r wnrk nn n~.' "n nn 15 " 7 ReQister of Wills. Cumberland C Cost of Filinn inventorv 5.00 In " 2q Hnlv Snirit Hosnital Professional services 12.75 . Holy Soirit Hosoital Paid by insurance 3.717.48 , Reserves: Stanlev C. Fellows Eso. Counsel fee 4.634.00 The Commonwealth National Bank Executor I s fee 7.723.00 Closing costs 150.00 TOTAL I 19.144.34 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 estate as deductions for Inheritance Tax purposes, The Commonwea~th National Bank ../ _., /. ",' I By: I ....",! ." .1..,,' E~tate Tax MC;Jr. /, it) ;:Of SIGNATURE OF FIDUCIARY DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S / '1, J Lf t.f. ~ if AT - jIj % TAX RATE tj-c/.f-J'; 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 C05t of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker and other related burial expenses. All debts being claimed against an estate are subject to the approval of the Register of Wills with wham 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 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemptior.. 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. The family exemption is allowable only against assets which pass by a will or.by the Pennsylvania Intestate Laws. NOTE: Compensation paid to an estate representotive; namely, an executor or administrator, for services perfarmed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income item should be reported on farm PA.40.lndividuallncome Tax Return. t: "0 " n E; tT1 ~ ~ > 0 0 Vl Z C'l n c:: " ~ z ::: z t'" tT1 tT1 r: Z ::0 9 - 0 t'" Z Z tT1 o-l tT1 o-l Z tT1 - P 9 o-l -:: Vl Vl Z 0 Vl 0 o-l 0 ":l ":l ::0 <;;; .. ~ '" (5 "': . , ;.. ~ z ... ~~ c, 0 ")P C") i~: c.1. --:-J LlJ'.. of5 0.... erV- . ' co 0- ~J:: u'" ""w ~ w=> 0:'" SO -'U U -:: 0<: tT1 [T1 > > ::0 ::0 INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the c1aimont'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 ond/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. IF ADDITIONAL SPACE IS NECESSARY USE 8h" x 11" SHEETS.