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Home My WebLink About80-00791 {j."T:'l}' ,...l.~- , ; . '~h"'-' f'-' .-., .{ttil~~,.'" - ~\"-'-' : :tll~.7t~.,\.\.,~.,-.;;", . ......J ~ ~..:/' :"~; :, ;~{i."'i' ,~~f;:{'.:' .'t.~i';hf...,. ~~t~~,t;, .. ~i.'},'. ~.~t~.... ~~t~J:>{}:';- :{...~~'.:-. ~g'~(" ,',-, ',., ,..,";;:' ..~.~~._,',}~i;;" . ' ~; ". .' . <~':!..:"<' ",t- ~~~{" .... "( "; ',; -.::, '.~j .', .. ",: CIl CIl ~ I " '.; ....~.. :~. ~ . CIl >< ~ .,' . ".i. ,", "' ~ ~ ;/. .;:1 '.~ ~ I i t) ~ -"".'.> '.><,',;.' H-C': 1.....' ....- 'C,. (..~ t!l g; ~ rIl o H ~ o ~ .-'. " I CIl ,,' e - 00 0 . - N ~ .. . .ID 'lI', - \0 '. ~, :-;0, 21-80 "";}"\ PETITION FOR LETTERS OF ADMINISTRATION IN TilE E5TATI, OF .....~II::.~I~.TI'J.:....)!.I.'9.~~...........,......................, JlECEAS~;[). To ..,.... .~)~, !:Y....(; ......! .'~.:~ .!.~.....................................................,................................. Regh;t~r of \Vills for the COlll\t~. of Cumberland, in 1 he CUllltllOllwcalt h of Pel1ns~'I\'ania. The Peti tion of ....... .f:.';'.e.~.. .\y,:... .I!.~.? .~.~.. .~~ !~.~... .I~,:,.I.~ ~.I: .t.. .~v.:,.. !I.I.? :?!?.... ....................,.................".......,........ Jenettc III ass ....,..............................,.........,...,. ....... respect fully showel h t hat ....~..... ..............,. .......,.............,.....................,.,.... 'd t f 'Iccllunicsbul''' XNX~ltID{1 (' I I I C I 5t I f P I was a res) en 0 ......1: ...........................<>.....................I\ol'ongh ' 11m ,el' al" oun y" a e 0 ennsy - vania, and a Citizen of United Slates, and departed this life inlestate in the County of ............................ ~!-!mR.~, !':,~.~r..<;I;................ and S la I e 0 f ..... e.':'.!~!:.'?Y..!. ~ ~.n. ~~........... ........,..,... ..., .....,........ .............. ..............,.......... ..., on ,.,r.If.~~.~~;r................... the .............?!:.~,.................. day of ......l?~!':.~.'.'!!!.'?!:........,................ A. D" 19,~.9...." at the age of ....R.L..,.. ~'ears. That the said .......y.~f.I.'?tt<:;...!n.'?~~..................,....................., deceased, left sUl'viving Ihe following named widow or husband, heirs and nexl 10 kin, to wit: Frcd W. Bloss son Residence 101)0 Somel'set Road ... P-.'?I!.t [2.!:~", ..!'!,~.~~...~1~,~~,':'.~...Oa8B70'92 36 3lJI) Ilcrltage Dl'lVe ...JJ.I:.i.<;',L.'.1:R!WI?\1il).&...N~w,','J!~r.I?~y 2fllLJ IJel'l'Y Stl'cct ...~~li-~~IT~~.a~c'j"'e.r~~l~J.Y.f),Qt'!..) 710lJ #65 i-Ianchestcl' 17055 . "t:i~~"j; ~ '~i ~'~ b~;~g ;....pe ~'~sy' i:v'a~'i a Name Relationship ................................................................ ............................................ ..~~.~~,~~., .\~ :....~.~.~~,~.............. ...,......... Va lorie Bloss son ............................................ ................................................................ ,..... .....?~ .':'J\!,I. ~ ~ .~~.... .......... ..l;;!J.~,.Y,n..!n.g~.~..................,...,......... ........ ...~f!.y.g~.1. ~~.r....... ........ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ That those "hove n"med include all of the next of kin, so f"r "R known, , . unestimated The sllld decedent was posseRRed of perRonal property to the estmmted value of $......................,........... "nd of Real ~;Rtale. legs incumhl'llnce, to the estimaled valne of $..~.'!.~~.~.~!~~?~.~~....., as near as Can be ascertained, That the said Real I';state in so fat, as is known is located in ......!!.'?!:?~~!~..?~....,............................. i-lechanicsburg, Cumberland Coun ty, pcnnsylvania ........................................................................................................................................................................................ Therefore, your petitioner(g) I'egpectfully apply(iG:) for Letterg of Administration in the above named estate. of Petitioner(:.;) ........~<.l!......Dl.....!8A,~,....,............., 10110 Somerset Road Deptfol'd, Nc\~ JCl'scy 08fJ96 ....:...:/iZ:c..."Ed;.;::/3...~.:::::::::::: 3lJII \Ieri tuge S tl'eet Ill.'ick To\mship, Nc\~ Jel'sey OS723 .....................................,................,..........,."................~.----------'- /-.-:h) ::,.. .-;.-; ~ 1__) 7----- L .",' Dated ..~~~.~!~.b.~.~~J~.~................ A. D., 1 !1..8.(I... Signature and Address 0~t) COMMONWEAl.TH OF I'EN:-:SYL\'ANIA 1 lss: COUNTY m' CUMBERLAND Fred \~. BLess und Hobel't \~. BI ass .......,..........,....,....,...... .,.,............ ................... ...... ................................. ...... .....,................,...,........ ..................... named in the above IIpplication twinl( dull' .......?~~.':',!:!!.............................. accordinl( to IIIII', Sll~' thllt the facts set forth In the above IIppliclltion are truc to thc bcst of ...~h.",j,\~. klloll'ledl(e and belief. b"'e'Sf"o\ir.'!e'~m.I!"e".'''''''''''''''''''''''''''''''' ........ and snbscribed 1 .......,":::.z:?,.. /1'" .....,..... .......,........... ............,., ............ ......d~J<....,.lJ.:...~..,................, ....?J~.~.~.r:".~.Q."...................~....... A. D" 1!l..~.9.... ...j?~:t7..r/./l../~,................,.. ......22~7..ti!..'....'~~~i'~~~~'... Filed:. .......~.~.<::,:....~~....~.....,.~~.~.?...,....................... ........................................................................................ Attorncy: ~.~~.I.'.!l~.I@~,....r:!S~N!mL~..F.:,~I<;;!SF.:,~ OATH OF PERSONAL REPRESENT A TIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss: Fred \~. Bloss and Hobert \~. Bloss . .............. ............... ................. ................. ..,... ......... ............... ....,........ ......,.... ........... .................... .......... petitioner( s) being duly ..........~,~!?,r.!!..................................... according to law do ............ depose and say that as the administra ,1;.~!:.:;;.,..... of the estate of ........,.......,~,~,!).~,t.t~...!lJ!?~.!?.....,.....................,'..,...,..,...........,................. ........................................................................................................................................................................................ deceased ....);)).~y............ 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 Jaw relating to Transfer Inheritances, ....?W.9.!:.~............................,............. and subscribed before me. .....21M~~.r...J.Q"...~............... A. ~,~.!?,Q.... ii':iJ.~~'-~m .........,::tt:.&.......cJ,..,&t:.~..................... ...../l~&r-If/..,~~................ DECREE Be it remembered that on the ..,.....?~.'.:~........,.... day of ..............'?!;!S,~!!lP.,~E,............ A, D" 19..~.~... Letters of Administration in the estate of ....,.~~,~~.'\','!:~...\~!l?~~.....,.................................................................. .............,. ..... ......... ..... ..... ......,... ...,. ....., ..,................... late of ...!l!i.r.!i ,I} g!),.. gK...M.!i!s:!l.i\nJ,.;;~.p.Il.l'.g.......................... Cumberland County. Pennsylvania, deceased. were granted to ............,........................................................, FRED \~. BLOSS and ROBEIlT \~. BLOSS ........................................................................................................................................................................................ Witness my hand and officjal seal the day and y~,~.~..~~.~~~-1#...a.:..., ~,~..:.............. (..(~ (J /1 Register ! c2t;. ." . ~- Es tate No. .~.~.~.~.~..,..........??t _. BOND KNOW ALL MEN BY THESE PRESENTS, That we, ............................................................... .......... ........F..IlE..n....~~.,... ~yJ.~~.~t~~...I.lO.IlI:.wr..\~.,....1l1 ps~.. .... ....... .......... ................. principal...Ii.... and ......../J..Nmt>..;?tAh..'-;;,...fi.b.t;~!ryl.fjt>...G(.IAI14""0. (d mI47-....................................... ....................................................., suret..~........t ..........................................................................................................-........ I .1 '-! arc held and firmly bound unlo the Commonwealth of Pennsyl...ni.. in the sum of ....:r.!!.lJ~.TI....f.~.Y.);:..................., ..~~Ig.Y.~.~~~...~D.d....q.()I..1.Q.l:l........................ Dollars (s..3..'?,QP.l!..P.O....). to be paid to the said Commonwealth. her certain atlorney or assigns. to which payment. well and truly to be made, we do bind ourselves. jointly and severally, and our and each of our heirs, executors, administrators. successors and assigns. firmly, by these presents, for and in the whole of the said sum. SEALED and dated the ................1..()~I.'.............. ..... .......day of . Decembe [' .................................................., 19.J.9... WHEREAS. the above named ...................Xr:~.~. ..\v.~...B.~()~.~...il.I1.d....~.!?,~.~.'"~...\Y.,....~.1.!?~.l?....................... .................................................................................................................................................................................................. bas or have made. or is or arc about to make. applic ation to the Register of Wills of Cumberland County, Pennsylvania. for the grant of letters ....'?[...l."\~!~.~I1.i.~.~"'.~.t;.i..O'f.!............................................................................. on the estate of ........~.~.n.~.t..t.~...ll.1.().S..~...................... ....................... late of .!-l!?r..o.!-!.g.l.1...o..f...M~.g.l.1i!.lJJ.g.~!?\lrg, Cumberland County. Pennsylvania. deceased: THE CONDITION OF THIS OBLIGATION is. that if tbe said personal representative .~......... or any of them sball well and truly administer tbe said estate accord ing to law. this obligation sball be void as to the personal reprcscntati\'c or representatives who shall so administer th c said estate; but otherwise, it shall remain in force. __n~__-~.l:~:u- (SEAL) _n/?tIlL~4-j{.:;-j1-k (SEAL)' --------.-------------------.------------.. _ ___u____u__ __u..__n____________u__ (SEAL) ::l~==:-:i='-;;;::::~~rl~~;{7f~~;~: \ i I L.e. ..-' -. COMMONWEAI.TH OF PENNSYI.VANIA COUNTY OF CUMBERLAND 55: Personally appeared beCore me, a. ....... ........ ..... ....................... in and Cor the county and state, aforesaid ..................................... ................................. .... .... ..... ............................................................................................ 0(....................,........................................................................and............... .................................,.................................................. ..................................................................................................of..............................,........................,...............................,.............. surities on the above bond who being duly sworn (a[{jrmed) according to :.w, depose and say rhat they each own Re.1 Estate worth the whole o( the penal sum named in the above bond, over and .bove their debts and the debtor's exemption, Sworn and subscribed be(ore me this ..... ... ........... ................... .......... ...... ...............,.............., (Seal) ........ .... ...... ........ ..................... ...... ............... ................. (Seal) ..... ...... ....... ...... ..... ................................... ..................... (Seal) ....... ..... ...... ....... ...................... ...................................... (Seal) .......................................,............... day o( .......................... A.O, 19.......... ............................................................................................... '- . , CERTIfiED COpy -. GENERAL POWER OF ATIORNEY No."..,',.~.~.!.}~, """,....", "," Kno.. aU Me" b1 ,bM Pre.."UI Th.1 UNITED STATES FlDELlTY AND GUA~NTY COMPANY, . ,orpor.tion org.nbed .nd nuting und.r th. law. of tho Stile of Maryland. and havin, ill principal omce II. the City of Baltimore. in Ihe Stlte of Maryland, doea hereby constitute and appoint Ralph G. Viehman, Jr. olth. CilY 01 !Iechanicsburg ita t.rue and lawful attorney in and for the State of I State of Pennsyl'/ania Pennsylvania for the following purpose.. to wit: To sign itl nlme u surety to, Ind to execute, aeal and acknowledle Iny Ind .U bondi, lnd to Ulpeeti.ely do and perform &DT ucl .11 .cll .nd thing. sel lorth in Ih. ....Iuuon 01 the Board 01 Dlrccton 01 the ..id UNITED STATES FlDEUTY AND GUARANTY COMPANY. . certi6ed copy 01 which i. hcreto .nnexed .nd m.de . part of thu Power of Allomey: .nd th. aald UNITED STATES FIDELITY AND GUARANTY COMPANY. througb DO, It. Boud 01 DlrectoA, bereby nti6.. .nd con6rma .n .nd wb........r lb. aa1d ~ Ralph G. Viehman, Jr. may lawfully do in the premilea by vUtUll oltheae p.-nll. In Wilne" Wh....,. Ihe aa1d UNITED STATES FlDEUTY AND GUARANTY COMPANY bu ..uaed thia l..tram.nllO be ...led witb ill corporal. .eaL duly '''OIted by tb. .ignallUO& 01 It. Vlce,P....d.nl and At.illanl Samtar\', thil 9 t h day 01 June ,A. D. 19 78 uNITED STATES "DEUTY AND GUARANTY COMPANY. (Signed) s,.. .~.?,~,E!.z::t.. .~.: ..R~ ~I,~,~,E;,.........,.......",.. Vic..PrailU.... (SEAL) W. B. M. Hingeley ....................................................... (Signed) ,fuislDM S.crewy, STATE OF MARYLAND. BALTIMORE CITY. } II: On thi. 9th day of June . A, 0, 1978, belor. me p'IllOnolly em. Robert E. Dellike Vlce-Presid.nl 01 th. UNITED STATES FIDELITY AND GUARANTY COMPANY and W. B. !1. Hin/Zeley ,Assi.tanl Secrelary of ssid Company, with both 01 whom 1 am p.rsonally .cqualnted, wbo being by m. ....rally duly .wom. said Ibat th.y, tho said Robert E. Dellike .nd W. B. 11. H i n gel e y wero respecuvely the Vic..Presid.nl and tbe A"I"anl Secretary 01 tb. said UNITED STATES FIDELITY AND GUARANTY COMPANY, Ihe corporaUon describ.d in and whleb executed thelor.gomg Power of Attorney; that they eacb knew the seal of said corporation; that the seal affixed to :!laid Power of Anorney waa such corporate seal, that it ".. 50 6xed by order of the Board of Directors of said corporation, and tbat they signed their names tbereto by like order as Vice.President ..d A"ist"l Secretary, respecu",lr, 01 tb. Company. 8 My commi"ion expi... the 6... day in July, A. 0, 19..:C... (SEALI (Signed) Margaret M. Hurst ....................................................... No/lJr7 Publk. STATE OF MARYLAND IlALTlMORE CITY. } Set, 1. Ro b e rt II. B 0 us e . Clerk 01 the Superior Conn of Ba11lmo", CilY, which Conn iI · Conn 01 Record, .nd bu. leaL do b.reby certify that 11arp;aret l.l. Hurst . Eaquire. bef.... whom the annexed affidavits were made, and wbo bas thereto subtcribtd hi. name. wa. at the time of ao doing a Notary Public of the State of Maryland. in and for the City of Baltimore, duly commissioned and swom and authorized by law to adminilter oath. and take acmowledsments. or proof of deeda to be recorded therein. 1 (unher certify that I am acquainted with the hllndwritins: of the said Notary, Gnd verily believe the :!Iignature to be hia genuine signature. I" te.dmonr Whereof. I hereto let my hand and afiix the ~al of the Superior Court of Baltimore City, the same being a Court o( Record, this 9th day of June ' A. D. 1978 Robert H. Bouse ............................................................... (SEAL) (Signed) Cltrk 01 rhe Superior Court 0/ Ballimorf! City. .-:~. FS 3 (0071) .::.1 l.. ~ ..j . ~ c.:;;' Cl,..:.-. I.' N u 0".. Q. y;8 i:'::' :Zc:: lJ..l, 0- <-, C'-' -...: 6.:- - o:~ laJlll ~ ""0:: O~.- ::g O"J ""U> 'm 0- i2L u'" lUlU C> ......=> ",'" SO ...Ju u ,..---:-------------------------------- -- - ----~----- I I I I 11 I I 1--------------------------------- j , I . i I I ! I 1 I , , I i I , , j I I I I i i , 1 REV.l1G2 EX ;~t<P'cX';;; ..1,;'.. . COMMONWEALTH OF PENNSYLVANIA. .. NOLo499A' . . DEPARTMENT OF REVENUE , 1fFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX. .. '~"';I:"" , I,." t,:;~' I , : i,_.~~ t ~ .,' .'f-."' .' -_ 0;. ~ _ m m AMOUNT ACN Assessment Control No. '-''CEIVEO FROM: Probate Pred w. Blo.. " Robert W. BlolI" 0/0 Snelbalcer. MCCaleb .!!.Elicke . At:ty.. _44-.Jl...~_St:Z'e.t____.._____ Meehania.bu~~ Pa. 17055 447.59 L ...J ESTATE INFORMATION: FILE NUMBER NAME OF DECEOENT DATE OF PAYMENT POSTMARK OA TE JUNTV DATE OF OEATH REMARKS 21-80-791 BLOSS JBIIlB'rrB QAJ~_.r 81~ST1982 MI C\IIlII)erland Decllllber 2 1980 ~ I , ---_J [i]TOTAL AMOUNT PAID 447.59 SEAL , , ",rUb c..:- / RECEIVED BY _.;/.' ~'; /)//" , , . ( ~ - pNA RE . I. -- ~- . - " ; ,:_-. : ~-.:; 1,"--.' (: '.'\: ~ : _ ~_:_; K _ ........ ~ . -- _n ...-.-- -- .-- ='-- ....___ _._ _._ _~ __ __ __ _ _ __....-.- ...-_ .,....-z __A __ , ".tv~h.n.;".;,--...'.:,'-" . '-' ,.. ,'. ' " " , . Id':'lil:::::-:;..;>::.., '. , .' '. . COMMONWEALTH OF PENNSYLVANIA I 4 NO;K{'29768" .'; ..' DEPARTMENT OF REVENUE \ ,(');'":.{'>."';. .... OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX .- . ., II = iI ~ Fred N. 110.. .. Robert N. B1 U. ~~g~vEo 8nelbaker McCaleb.. Elicker ~, ADDRESS 44 W. Main st. TAX AT 6% TAX AT 15% 88 ~~....!..-% ESTATE TAX Meohanio.burg, PA 17055 '--ESTATEINFORMATioN:--J);~;mi;"i-2~--i9(iO----- DA TE OF OEA TH TOTAL TAX CREDIT $4,000.00 FILE NUMBER 21-80-791 OATEOFPAYMENT September 11, 1981 Jenette B1088 m m LESS DISCOUNT PLUS % INTEREST IFROM TO_.l NAME OF OECEDENT COUNTY cullber land TOTAL AMOUNT PAID $4,000.00 POSTMARK OA TE REMARKS, SEAL RECEIVED BY .... /j /; ./. / /'.i.. / to.,., C- . SIGNATURE Ii , "'AID ON ACCOUNT" I REGISTER OF WILLS ",- Estate No. .,.?L:~.(!.~,?~L......., BOND KNOW ALL MEN BY THESE PRESENTS, That we, Fred W. Bloss and Robert W. BLoss ............................................................. .. ..... ..................., principal~....... ................................................................................................... United States Fidel.i ty and GUllL'llnty Company and ........................................................................................... ....... ....................................................................... ........................................................................................... ..........................................................., suret.y........, arc held and firmly bound unto the Commonwealth of Pel1"'yh'ania, in the sum of ....F..rx:l:E.~.N......................._....... ..~!1g.~~.A..N.~...'!:!'.ct....~.o.l..1.9.9...................... Dollars (S..l..~,.QP.9.,.P.9.....), to be paid to the said Commonwealth. her certain attorney or assigns, 10 which payment, well and trul)' to be made, we do bind ourselves. jointly and severally. and our and each of our heirs, cxecutof$, administrators, succ(:ssors and assigns. firmly, by these presents, for and in the whole of the said sum. SEALED and dated the 2IJth June 19...~.?.. ........day of .........................., WH EREAS, the above named ...... YL: ~.?...\~ :.....B.l.~.s.13... ": T1.~..I~.[)b.~.L:.t... \~:.....B.l..[).13.~.......... ......................... ..............................................................................n.................................................................................................................. has or have made, or is or are about to make. applic ation to the Register of Wills of Cumberland County. Pennsylvania, for the grant of letters ..o..r...~.~I~~~.ll~.~.t.L:~.t.j:.ol1................................................................................ on the estate of ........~.~.!!.~.t1;"'....IIJ.().s.!'...................... ......................., late of ..1l()E().~~gI1....9.r....t1.~~.!!~!:1.~!?:'!.~}Irg Cumberland County, Pennsylvania, deceased: THE CONDITION OF THIS OBLIGATION is, that if the said personal representative S.......... or any of them shall well and truly administer the said estate accord ing to law, this obligation shall be void as to the personal representative or representatives who shall so administer th c said estate; but otherwise, it shall remain in force. SEALED and delivered in the presence of ---.. -~r- - 'r--~ !..~----- (SEAL) ~~ ~B'foss ___.a.~::-v.ndf~-,A-~--n _ (SEAL) Robert Iv. IIToss n _.n_____n___n.__._._ ___ _____n___n_ (SEAL) _ _~~~ .!'_e_~ _~ _t_".~: ~ _ _ _~~ ~:~_i_~~ _~n~'.'.~:.:'_n ~!;~r.) ___~J:Zi:..,:cZ~----- (SEAL) Steve Murray - Attor~ "n Fact ----------------------------------------..-- ------------------------------------------. ------------------------------------------.. ----------------------------------------..-. ---------------------------------------.--. ! , I I I , , , , i ,I , , ! , ; ....-- -'AI. COMMONWEALTH OF PENNSYl.VANIA COUNTY OF CUMBERLAND ss: Pl'rsoll.1I1}' appl'an:u hc:forc 1I11', .1. in and (or the county and state, aforesaid ................... ......... .-........... .-,...................-.................................................................. o( ........... ........ ............ .. ...... ................... .... ........ ............. ......... and..... ..' .............................................................................. ..................................................................................................of..................................................................................................... surities on the above bond who being duly sworn (aHirmed) according to I.w, depose and say that they each own Real Estate worth the whole o( the penal sum oamed in the above bond, over and above their debts and the debtor's exemption, Sworn and subscribed be(ore me this ..................................................................................... (Seal) ..................................................................................... (Seal) ..................................................................................... (Seal) ...................................................................................._ (Seal) ....................................................... day of .......................... A.D. 19.......... ............................................................................................... ~~ c' '. N -"'< w.- 2.;;. '.-, o~-- 0::1.'" . .:~ , - 0-' '-'~ ..- ~o: '" ~-~.:;, ~ ''-' A,.---- CERTIFIED COPY GENERAL POWER OF ATl'ORNEY No...,..,..~,~J}~.,...."...,",..". KnoID aU M." by II&ae PreHn" I Tha. UNITED STATES F1DEUTY AND GUAR,\NTY COMPANY. a corporalion orlaniled and e:datinl under the law> 01 the Stale of Muyland, and bavinl ita principal olice at the City of Baltimore, in the State of Maryland, does hereby corutitut.e aDd appoint Ralph G. Viehman, Jr. 01 tho City 01 Mechanicsburg Ita lr1IO and Iawlul aUomey in and lor tbe Stal< 01 . Stale of Pennsylvania Pennsylvania for the foUowinl purpolel, to wit: To siln ill name U lutety to, and 10 eJecute, leal and acknowledle any and an bond.. and to rapectltely do and perform any ud. all acta aDd thlnl' se. lorth In the resolution 01 tbe Board 01 Directon oltbe said UNITED STATES F1DEUTY AND GUARANTY COMPANY. a certified copy 01 which i. berelo ann..cd and made a part 01 IblI Power 01 AUomey: .nd lbe said UNITED STATES F1DELlTY AND GUARANTY COMPANY. tbroulb ... il. Board 01 Directo... bereby ntifico .nd confirm. all and who........ tho aa1d Ralph G. Viehman, Jr. III&Y lawfully do in tho premIoet by Ylrt.. 01 tbeoe P"CnlL In "'llnoI' "'''oreo/. tho said UNITED STATES noEUTY AND GUARANTY COMPANY bu ..uoed thIa IDOtmmoIl' to be oeaIed with ita cozporal< ..oL duly .....lad by lbe .iIDO..... 01 u. VI...Preoidenl and Attlllanl So......,.. thll 9t h day 01 June . A. D. 19 78 UNITED STATES nDEUTY AND GUARANTY COMPANY. ( Signed) B,...~.'?,l?,~::~. .?!.. F! ~!IJ.~,~,...................... Yl<:..p,.,/JIo1\L (SEAL) W. B. M. Hingeley ,...................................................... (Signed) Auilla1II SOctfl4l7. STATE OF MARYLAND. BALTIMORE CITY. } II: On tbls 9th day of .tune . A. D, 1978. beforo mo pOl1OoeIIy camo Robert E. DeNike . Vic..Pre,iden' of tho UNITED STATES F1DEUTY AND GUARANTY COMPANY and W. B. M. Hingeley . Astittao. Secretory of said Company, with both of whom I am penonally acqu.in.ed. who being by m. _.rally duly sworn. oaid lba. they.th. said Robert E. Denike and W. B. M . H i n gel e y were respectively th. Vic.,P....iden. and .b. A,si,t... Secretary of tho ,aid UNITED STATES noEUTY AND GUARANTY COMPANY. .h. corporauon dcocribed in and which executed tho foregoing Power of At.omey; that they eaoh kn.w .b. oeal of said corporation; tho. th. seal affix.d to said Pow.r 01 Attorney was sucb corpora.. oeal. th.. i. wu .. fixed by ord.r of th. Board of Directora 01 said corporation. snd .ba..bey signed their nam.s thereto by lik. order .. Vic..Prealdent and Aailtant Secretary, respeetinly, of the Company. 8 My commillion ..pi.... th. &ra. dsy in July. A. D, 19..1.... (SEAL) (Signed) Margaret M. Hurst ....................................................... NOI4rT Pabll<:. } STATE OF MARYLAND BALTIMORE CtTY. I, Rob e r t H. B 0 use . Clerk 01 the Superior Court 01 Baltimore City. which Court II a Court 01 R.cord. and bu a ..aL do bereby certify that l~a r g ar e t H. H ur st. Eaquire. belore whom the &nDl!:J:ed afiidavill were made. and who baa thereto lublCribed hiI name. was at the time of to doing a Notaty Public of the State of Maryland. in and for the City of Baltimore, duly commiuil)Ded Ind .wom aDd authoriz.ed by law to admini.ter oath, and take acknowledamenu, or proof of deeds to be recorded therein. [ further certify that I am acquainted with Ihe handwritins of the Mid NotarY. and verily believe the ,ignature to be hillcnuinc signature. ,,, Te.llmony Whereof. I hereto let my band and affix the eeal of the Superior Coun of Baltimore City, the same beiDI a Court of R.cord. tbla 9th day 01 June ,A, D, 1978 Robert H. Bouse (Signed) '........ .......... ,.,.. ,.....".. ,..,..",..',.,....,."..,... Sot. (SEAL) Clerk althe Superior Cour, 0/ Baltimore City. FS 3 (a,'n """=:'" .- '.,.." ~5~ --.". ". :~':;':"-.. ..:::.~~,...-~ "l'::";:~~',: ::"::<, ;', ,',,,:. ::~7 .;,::,\ '.' . ~,- . ., ';' !" 1 I t I J \ I \ , LN RE: !:STi\T!: 01' .JEN!:TT!: BI.OSS, lATE OF '1'111; BOIWIIGII 01' ~1ECHi\N I CSBURG, CUNB!:RIJ\NIJ COUNTY, PI:NNSYI,vI\N 11\, IJ!:C!:I\SEIl IN '1'111: COURT OF CONNON PI,I,:i\S OF Cl.I~IB!:RI.J\NIJ COUNTY, I'ENNSYI,VI\Nli\ ORPIli\NS' COURT IlIVISION NO. 21 -HO-7U 1 I'E'I'ITLUN FOR ORIlER 01' COURT EXCUSING TilE ENTRY OF i\IlIlITJONi\i, SECUR] TY I'IJRSlI/\NT TO 20 I'I\.C.S./\. :135] '1'0 TilE 1I0NORAllI.l;, TilE .JOlll;ES OF S/\ III COIJRT: The Petitiun oj F,'ed Ii. Illoss and Robel't Ii. Bloss, i\dministl'atul's of the Es ta te ur J ene tte Bluss. IlL'eLasL"I, I'espee t ["<I JI.y "elH'esen t as rol.IO\~s: L Tha t .I<ene t te Il Iuss 0 j" J 27 SUlI th i\I'eh S tree t, Borough 0 r Neehanicsbuq.>;, Cumberland LUlInty, PL'nnsylvan.ia, died intestate on Ileeember 2, ]980. 2. That I.ettel's of i\dminist,'aUon \~el'e i,>;l'anted to YOlll' Pet:ltionel's on Ilecembel' 22, 1980, by the Rel,>;lstel' oj Iii Us of Cumbed.and COllnty, Pennsylvania. 3. Tllat seeul'ity is being entel'ed by YOlII' Petitioners \~ith the said Registel' of Wills in the slim of $5U,000.OlJ by t\~O sepul'ate bonds, each wi th the Uni ted S ta tes Fide l..i ty allll Gual'un ty Comp.\ny as surety on the bonds. One bond in the amount of $35,000.OlJ has been entel'ed on IJecembe" 22, 198U and the othel' bond in tlll~ amDunt uf $15,UlJO.00 has been obtu.ined -by your Peti'U:bncI' and wi II be riled pd.ol' tu this p, tit:i.Ol. Ii. That the total value ol the pel'SlJlHll estate oj the deeedent wh ieh has come into the hands 0 f the I\dl11i nis tl'a tOl'S of the Es ta te is Fif ty- Fi ve Thousand TllI'ee Ihmdl'ed Tld." ty and 13/100 ($55,330.13) Dollars 5. That the Il"e"dent died seiF-ed ui a pUI'eel ol !'eal. estate LAW OFFICES SNELBAKER. McCALEB a ELICKER I.ocated at .127 South i\l'dl St,'eet, lID"tlLll,>;h Dj' ~ll'dlani.csbul'g, Cumbe!'l.llnd COUll ty, Pl'nnsy Lvunia, l.'(1llsisting ur a t\vO stOI'Y iJpicl, dVJel1..ing house. ~',:...~' ..; ,....(' :'I:",~ :=::"';') .1.~Jd I.,,,, ~"'V\..J . . ;1-11/-/ REV-1500 EX + (9.81) IiOREAU OF EXAMINATION PENNSYLVANIA DEPARTMENT OF REVENUE P,O. BOX 8327 HARRISBURG. PA 17105 Decedent's Name (Lest. First, and Middle Initiel) DECEASEO BLOSS JENE'l'TE Sociel Security Number Dete of Oeeth 043- 22-5568 Deccmbet. 2, 1981J INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21.-8lJ-791 Decedent's Address 1.27 South Avch Stveet Heclwniesbuvg, pennsylvania 17055 CHECK 1. Originel Return 0 2. Supplementel Return 0 3. Remainder Return 0 5, Federal Estete Tax D Return Required. 6, Decedenr died tastate D 7. Decedent meinteined eliving D 8, Number 01 sale deposit D IAttach eopy 01 WillI trust (Attach copy 01 trust) boxes inventoried All correspondence and confidenti.ltax informetion should be directed to: Computation of Tax 15. Amount of line 14taxeble et6% rete (15) 7'1 ,01'1.01 (include values from Schedule KI 16. Amount of line 14t.x.ble et 15% rete (161 (include velues from Schedule KI 17. Prineipaltex due (add tax from line 15 plus tex from line 161 18. Total Prior payments: (al Amount Paid ~ DUO. 00 (b) Plus Discount Ie) Minuslnterest (18) 19. Balance Duelline 17 minus line 181 Meke Check Payebleto: Register of Wills, Agent ... PLEASE RECHECK MATH'" APPRO, PRIATE 4. Life Estele D BLOCKS CDRRE. SPONDENT Neme Snelbaker, McCaleb Telephone No. (717) 697-8528 1\ Elicker RECAPIT. ULATION Recapitulation 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3, Closelv Held Stock(Partnership Interest (Schedule cl 4, Mortgages and Notes (Schedule D) 5. Cash & Miscelleneous Personal Property (Schedule EI 6, Jointly Owned Property (Schedule FI 7. Transfers (Schedule GI 8. Totel Gross Assets hotel lines 1-71 9. Funerel Expenses Administretive Costs/Miscellaneous Expenses (Schedule H) 10. Debts/Mortgeges(Liens (Schedule \I 11. Total Deductions hotel lines 9 & 101 12. Net Velue of Estatelline 8 minus line 11) 13, Charitable Bequests (Schedule J) 14. Net Veluesubject to tax liine 12 minudine 131 AND TAX CALCU, LATlON Address '1'1 West Main Street P. O. Box 318 ~leehaniesburg, PA SlIte 17055 Zip City ( II ( 21 ( 31 ( 4) ( 5) ( 61 ( 71 $36,000.00 o:i N ~~ '''~ "'<,') ;.:0 . :l:i~ , ". ~ 55,1.90.13 2,1.35.22 r..; v.J ( 81 $93.32-5.35 ( 9) (10) 15.317.00 3.9911.311 19,311.3'1 74.01li.Ol (11) (121 (131 (14) 7li. 01/1. 01 x.06= 'I .IJ'IO.8ll x.15= (111 '1,'1'10.8'1 (191 Under penalties of perjury,l declere thet I have examined this return, including eccompenying schedules end stetements, and to the best of my knowledge end belief, it is true, c9rlJlGt, and complete, Djclaretion of preperer other than the personel representetive is besed on all inlorm.tion of which preparer hes anyknowledge.l ~--t.SlC~!;l"'''-- '191 I<ing Me. ,Apt.J-7 col.1ings\~00d,N.J.081.08 _ ~"_ / /1:tff:!..t/41L.J~~~ '11111 t1rq...ir:lgp nr> U y>"i 01< '1'nhmc::hil' M.J.n~7?~ ~-~(J :1"L. SIGNATURE OF PERSONAL REPRESENTATIVElSI ADDRESS . . OATE e "ie e '/ ) /.. _ ~ ,lill West ~Iain Street . ~ / .tt~lechaniesbuv PA 17055 E OF PR'EPARER OTHER THAN REPRESENTATIVE ADDRESS RrV.",02 IX+ It.tll SCHEDULE "A:' REAL ESTATE COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER21_80_7 91 JENB'l'TE BLOSS (All proplny Jolntly-ownld with RIght of Survlvonhlp mu.t bl disclosed on Schedule "F'" VALUE AT DATE OF DEATH ITEM NUMBER DESCRIPTION ASSESSED VALUE 1, ALL that certain lot of ground situate in thl Second Ward of the Borough of Nechanicsburg, Cumberland County, pennsylvania, Having erected thereon a d\~elling house kno\m and numbered as 127 South Arch Street, more particularly described in Deed Book "B", Volume 20, Page 1110. $36,000.00 Sale price TOTAL <Also enler on line 1. Reeapitulalionl $ 36,000.00 IIf more .pace I. nleded In.ert addItional .hl.t. of IIIml .In) UV.1511lX+ 1'''11 . , SCHEDULE"H" FUNERAL EXPENSES. ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JENETTE BLOSS ITEM NUMBER 1, 1, 2, 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. lLl. FILE NUMBER 21-80-791 DESCRIPTION A, Funeral Expenses: \~. \~. Chambers Company, silver SpL'ing, ~Ial'yland - Funeral expensl's B, Administrative Costs: Personal Representative Commissions Attorney Fees C. Miseellaneous Expenses: Register of Wills-Lettel's of Administration and short certificate s Cumberland f,aw Journal _ advertising administrators' notice west Shore Times _ advertising arnninistrators' bond County Clerk, Brooklyn, New York - copy of marriage license Hutter Agency _ Administrators' bond premium Lester G. Connor - real estate appraisal utter Agency _ fire and liability insurance premium Register of Wills - filing fees Recorder of Deeds - 1% realty transfet' tax Grandon Real Estate, Inc., - Real estate broket"s commission lutter Agency _ Administratot" s bond premium lutter Agency - liability insurance premium rthur 1'. Loscher _ automobile title transfet' fecs Reserve for filing aceount, releases, notary fees and miseellaneous costs TOTAL (Also enter on line 9, Recapitulation) (If more .pece II n..dld In.ert additional ,heetl of ume .Ita) AMOUNT $ 2,353.50 LI,559.50 11,559.50 110.00 18.00 22.00 4.00 lLl8.00 100.00 183.00 15.00 '360.00 2,520.00 1118.00 100.00 11.50 17 5.00 $1.5 317.00 IIV.UI21X+ (,..n . . SCHEDULE "'" DEBTS OF DECEDENT, MORTGAGES. AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JENETTE BLOSS FILE NUMBER 21-80-791 ITEM NUMBER DESCRIPTION 1. Hechanicsburg \~ater Company: Account 2. UGI corporation: Account 3. penniJ. powct' & [,ight Company: Account li. UGI COl'pot'ation: Account 5. ~lechanicsbut'g Water Company: Account 6. Bell of pennsylvania: Account 7. Hechanicsburg Borough: se\~et' and l'cfuse account 8. Aurex corporation: l'epail' larynx pl'osthctic 9. Scat', Roebucl< & Company: Accollnt 10. pomet'oy's: Account 11. Hasterchat'ge, CCNB: Account 12. KOt'vettes: Account 13. Het'd Chiropractic Clinic: professional services 111. Lucas Gulf Set'vice: Account 15. Reynolds Servicentet': inspection and t'epait' of automobilc 16. Hoffitt, pease & [,im Associates: pt'ofessional services 17. Michael [.. Glick, ~1. D.: pt'ofcssional scrvices 18. Steven P. siege1baum, N.D.: professional sCt'vices 19. COl1ll11unity Physicians, Inc.: pt'ofcssional sel'vices 20. loly Spirit X-Ray Associatcs: pl'ofcssional set'vices 21 National Naval Hedica1 Clmtct': Account 22. Holy Spit'it Hospital: Account TOTAL tAlso enter on line 10, Roeapltulation) (If man .pace Is needed In.ert additional .heets of same size) AMOUNT 59.32 128.31 8li.25 128.98 62.011 71.88 5li.20 li3.01 316.17 [;3.91 527 . 2li li85.17 55.00 lili .n 80.lili 1135.00 469.00 120.00 35.00 36.00 99.00 596.31 $ 3,99li.311 RIV.no. EX+ ('''II COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE "F" JOINTLY OWNED PROPERTY ESTATE OF JENCl'TE IlLOSS FILE NUMBER 21-HO-7<Jl (Thl."h"ul. mull b. comp'ot" 'f tho doc".nt, ot ,h. tlm. of hi. o. hor d.oth, ownod onv p.op.nv o. o loin' ..n.n' with ,h. .Ighf of .u.vlvorthlp,) Joint tenant(s): A, Chery NAME IIloss B. C, ADDRESS 3U5 'l'homns Drive #8 ~ledlUldcs/JU1'g, I'^ 17U55 RELATIONSHIP TO DECEDENT Daughter ENTER ITEM LETTER FOR DESCRIPTION OF PROPERTY TOTAL VALUE DECEDENT'S DOLLAR VALUE OF NUMBER JOINT TENANT OF ASSET % INTEREST DECEDENT'S INTEREST 1. A, Stntement Savings ACCOl nt No. 016-112216-3, CCNII lIank, N.A. , opened 3/10/79. Balance on date of death $2,118.70 100 $2,118.70 Accrued interest 16.52 100 16.52 TOTAL (Also enter on line 6, Recapitulation) $ 2 135.22 Jointlv owned propertv: (If more spec. I' nHdtld Int.rt additional sheott of 'am. ,Ize} ~lV.\IOlE' . _. .' " "1' ~"~";;'\~,,:." . COMMONWEALTH OF PENNSYLVANIA ," '.' '. 'l."' ':f~,~~~0K' ::NO: . DEPARTMENT OF REVENUE . . ~,:.,:~0704709FICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX .. m ~ m AMOUNT Assessment Control No. '-j '~EIVEO FROM: probate I 'fhe !'iot Bank .. Trust Co._ l -aLCL-IMDakU._lIcCUII1L._Bllcklr, Attya. 44 w. Main it~.j;_________ MeChaDiC.~' Pa. 17055 31.15 L ESTATE INFORMATION: J FILE NUMaER - NAME OF DECEDENT BLOSS LAST OATE OF PAYMENT MI "OSTMARK OATE \lUNTY .TE OF DEATH REMARKS c\lllberland DIK'-'ber ~_2. 198Q tilTOTAL AMOUNT PAID , , 1\ I: 1: r l' \: 1\ 1 ._-~-----'_._------_._------ -----.----------- I RECEIVED BY l)~.)/~ ~ ,. ........ 5 AT SEAL' REGISTER OF WILLS REV, 1547EX II-a21 ASSESSMENT CONTROL NO. 101 J BUREAU OF EXAMINATION : NOTICE OF INHERITANCE TAX PENNSVLVANIA DEPARTMENT OF REVENUE: APPRAISEMENT ALLOWANCE OR OISALLOWANCE HAR:S~U~g:'p~32;7 105 OF DEDUCTIONS, ANO ASSESSMENT OF TAX . _ __ DATE l"Q.;;,t~.::.e.L- ESTATE OF BLOSS JENETTE FILE NO. 21 80-0791 DATE OL~Ef;J"J:L).2-0c..80-- _ __ .______._. _____________c:OUt>lU-c:!lKBERl-TlKD- NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF WILLS, AGENT." IF TAX PAYMENTS ARE MADE WITHIN 3 MONTHS OF THE OECEDENT'S DATE OF OEATH. A DISCOUNT OF 5% OF THE TAX PAID MAY BE DEOUCTED. SNELBAKER EThL 4... Vi MAIN ST PO Bm: 318 MECHhlllCSBURG PA 17055 PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE CUT ALONG THIS LINE - - - - - - - . - . - - - - - - - ~ . - - - -- - - - - - . .---- ----_.-- - - ----------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BLOSS JENETTE FILE NO,21 80-0791 TAX RETURN WAS: I i: 1 ACCEPTED AS FILED APPRAISED VALUE OF ESTATE: ,. Real Estate (Schedule A) 2. Slock.S and Bonds (Scneduie Sl 3. Closely Held Stock/PartnerStllP Interest (Schedule Cl 4. Mortgages and Noles (Schedule D) 5. Cash & Miscellaneous Personal Property (Schedule El 6. JoinUv Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Gross Assets APPRDVEO DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative CostslfoJllscellaneous Expenses (Schedule H) 10. Debts/Mortgages/Liens (Schedule Il 11. Total Deductions 12. Net Value of Estate 13. Charitable BeCluests (Schedule J) 14. Net Value Subject to Tax ASSESSMENT OF TAX: 1 S. Amount ot line 14 taxable at 6% rate 16. Amount of line 14 taxable at 15% rate 17. Princlpid Tax Due TAX CREOITS: PAYMENT DATE RECEIPT # DISCOUNT (+) INTEREST (-) 6.75- 09-11-81 029769 THIS ASSESSMENT IS BASED ON: ORIGINAL RETURN NO INTEREST IS DUE IF PAID BY 09-11-81 IF PAID AFTER DATE INDICATED SEE REVERSE FOR INSTRUCTIONS. ) CHANGED III 121 ( 3) ( 4) I 5) I 6) ( 7) ( 9) ( 10l DATE 10-12-82 ACN 101 36,000.00 .00 .00 .00 55,190.13 2,135.22 .00 93,325.35 181 15,317.00 3,994.34 19,311. 34 74,014.01 .00 74,014.01 (111 1121 113) (14) (15) (16) 74,014.01 .00 X.06= X.15= 117) 4,440.84 .00 4,440.84 AMOUNT PAID 4,000.00 TOTAL TAX CREDIT BALANCE OF TAX DUE 3,993.25 447 . 59 (If Balance Due is less than S 1.00 no payment is requiredl RETAIN THIS PORTION FOR YOUR RECORDS REef',;"" j: t~ ::: . '8Z ;lCl l " pI' ." INFORMA TlON This documen~ is the Notice reauired to be gl'Jen unaer SeClIon 709 of the InheritancE' and Estate Tax Act of 196 ~ (72 P.5. se.:tlon 2485'. If the lax IS pellO wlttl1n lnree (3) month~ after the deceoenr~ death. a discount o~ 5~o ot the lay patd IS allowed. Inheritance Tax becomes delinquent nme (9) months after the decedent's death. Interest IS charged at the rate of SIX IS) percent per annum on the amount of unpaId tax. (SEE EXAMPLE BELOW) EXAMPLE: If a balance of tax due of $2.000.00 is in a delinquent status from 3-3-80. and payment is made on 5-23-80. the Interest IS calculated as Indicated below: STEP 1 Determine the rate of interest from the table below. STEP 2 MultIply the balance of lax due bv the rale of Interest STEP 3 Add the interest to the balance of tax due. interest from 3-03-80 to 5-23-80 Results m: Balance of tax due Bale_O~!:.e~t INTEREST $2.000.00 x .0fl3.?_ $ 26.70 Balance of tax due $2.000.00 PTUS;lnterest to Date of Pavment (+1 $ 26.70 TOT AL tax and Interest to Date of Pavment $2,026.70 2 Months, = 20 Davs = Rate of Interest = .010 + .00335 --:0'1335 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . - - - - - - - - - - - - - - - - - - - - - - - - 1 month 2 months 3 months .005 .010 .015 4 months 5 months 6 months .020 7 months .035 10 months .050 .025 8 months .040 11 months .055 .030 9 months .045 12 months .060 11 days .00186 21 days .00352 12 days .00203 22 days .00369 13 days .00220 23 days .00386 14 days .00237 24 days .00403 15 days .00250 25 davs .00420 16 days .00267 26 days .00437 17 days .00284 27 davs .00454 18 days .00301 28 davs .00471 19 days .00318 29 davs .00488 20 days .00335 30 davs .00500 1 dav 2 days 3 days 4 days 5 days 6 days 7 days 8 davs 9 davs 1 0 davs .00017 .00034 .00051 .00068 .00085 .00101 .00118 .00135 .00152 .00169 - - - ---- - - ------ - - -- -- -- - - -- -- - - - - - - - - - -- - - - - --- - -- - - --- - - - - - -- - -- - --- Any party in interest. including the Commonwealth and the personal representative. not satisfIed with the appraisement and assessment may object Within sixty (60) days after receipt of thiS Notice as provided by Secllon 1001 of the Inheritanee and Estate Tax Act of 1961 (72 P.S. sec. 2485 - 10011. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT" DETACH THE TOP PORTION OF THIS FORM AND SUBMIT WITH YOUR PAYMENT TO THE REGISTER OF WillS FOR THE COUNTY StlOWN ON THE REVERSE. SEE THE INHERITANCE TAX INSTRUCTION 800K FOR AODRESS. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I J ss: ._ .__.l~I'c\L.\~.._IlLus-,; JlIl,U{9ilC I't I". 1I1u.Hs b.ing duly S\VOt'n .___'__ occording I. low, do po... ooOd 'OYJl: thol th.y_-"l.L'.C-J;hp Administt'uJ:'01'S______________ of tho estol. of .Wllcttc 111055 101. of _tllC_llorougll.oLNcchani'-'sblll.'g ___________, Cumb.rlond County, Po" d.c....d ond thet tho wilhin i. en invenlory mod. by __FI''''-Q_~,-ill.'''-''-s (llld Huil':'I'!=_~._1I1os~. tho $Oid Administrators of Ihe entire ..Iole of $Oid dec.d.nt, con.i.ting of oil the p."onel prop~rly end r.ol ..tote, except reel estet. outside Ihe Commonw.olth of Penn.ylvenia, and Ihot Ihe figure. oppo.ite eoc)1 ilem of Ihe In,v.9Jntory re~'s foir volu. a. of tho d~lo of decedent'. deeth. _ *'~ (J [,) /8~,,- _ w 4f..u. l Ac1ndllis tra tor 5\vo1'n ond .ub.cribed before me, .4.14. j~,-:- ~~ [) ,...,.,).yo }f)(R)(t){~. Adr.\ii\htnlnr ~-f=':J'WbCJ'v :2./ 19 0 '2.. 1191 King Avenue, Apt. .j-7 (/4'-/:1.~~ ~ ?'A!p" ~' col.Lin~s\vood, Ne\v .Jcr.sey ::JiHOS _ _ _ /.1 3611 lIel'itnge Drive .~~ARET RITA V-'N ANGl ..- IV'U"' Bl'ic]< Township, New Jersey 08723 Nolary Public of New Je Nleommission E.pirM Jon. 27, 1981 I' ...dd.... r .,..>l J "";:)1...,01".-" ,':.~" ',l..:.lb'~~..rd>i,l h.'1C~of' \-'he """'l.' h,; c.'~ 0'5 ~I'tf\v~...~",,\ j ''I ~'). ~ ~ ok -'1\..- ~C;l.h.L..("'re ",\ ~b~.-~ I.J. l'I"':~' . ,- L "', 'e: ~,~ II Dote of Deolh __2Pd DAV Dece e Month 19RO Vu, INSTRUCTIONS I. An inventory mu.t b. filed within three month. after appointment of pe"onol r.presentative. 2. A supplement inventory must be filed within thirty day. of di.covery of odditionol os sets. 3. Additional sheets may be altached a. to personally or really 4, See Article IV, Fidueiarie. Act of 1949. r:--' ~ '. II..' - t:~~-' w..1~:! '"" :0 ",- '-' ::l <>:: .n Ul ~ () ,,.. U <:: H >- '" ..,; ...:> .<:: to ~ I- W ~ ~ '" < () to v.: w m .'Y. " H ... ?- m ~~ u to " co en 0 0 II> 0 C '" ~ w '" w ...:> "-' .. ~ to r-- I- :I: ... co 0 0.. C I LL .,; ~ Z I- ...I <l: 0 0 -< 0 0.. LL ...I ~ ~ u:l: ::0 w 0 -< w E-< ~ ,;. S<-< I > '" H Z E-< ~ - ~~ Z 0 ~ 0 C N C Z '-' ~ II> Z 0 '" .; '" ~ 0 U Z w -< .., co .... ~ ... ... :<: " <l: to co - -;: 0 " ...:> .D ... -" ~ " E 0 z - ~ ~ 0 rn to ....I U ii: CD REV, 154BEX (10-82) BUREAU OF EXAMINATION PENNSYLVANIA DEPARTMENT OF REVENUE P,O. BOX B327 HARRISBURG. PA 17105 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON uDINTLY HELD OR TRUST ASSETS DATE 05-09-83 ESTATE OF BLOSS JENETTE DATE OF OEATH 12-02-BO COUNTY CU!lBERLAND FILE NO. J \ - 50 - 1 ct t S.S./D.C. NO. 043-22-5568 ACN 301 BLOSS CHERYLL PLEASE RETURN THIS PORT ION TO REGISTER OF UNKNOWN PA 99999 WILLS IF PAYMENT DUE CUT ALONG THIS LINE - - - - -eUREAu-o"F-exAMINATibN- - - - - - - - - -NOTICE-O{INHER-I'rANCE TAx- - - - - - - - - - - - - - - - - - - - - - -. PENNSYLVANIA DEPARTMENT OF REVENUE APPRAISEMENT. ALLOWANCE OR DISALLDWANCE P.O. BOX B327 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG. PA 17105 uOINTLY HELD OR TRUST ASSETS DATE EST ATE OF BLOSS JENETTE DATE OF DEATH 12-02-80 COUNTY CUMBERLAND FILE NO. S.S.lD.C. NO. 843-2:2-5568 X) ACCEPTED AS FILED ( ) CHANGED uOINT OR TRUST ASSET INFORMATION ACN 301 TAX RETURN WAS: FINANCIAL INSTITUTION: FIRST BANK & TRUST CO ACCOUNT NO. 800-646-2 TYPE OF ACCOUNT: (X ) SAVINGS DATE ESTABLISHED 06-15-78 ) CHECKING ) TRUST ( ) TIME CERTIFICATE Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due Less Tax Credit Balance of Tax Due Interest T clal Due NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION 2,493.64 x 50.000 1,246.82 .00 1,246.82 x .15 187.02 .00 187.02 19.29 206.31 (If Balance Due is less than S 1.00 no payment is required) OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE A80VE COUNTY. MAKE CHECK OR MONEV DRDER PAYASLE TO:,,", ....... . .r, REGISTER OF WILLS, ~GENT:":-; _..- , - , ::0 INTEREST IS CHARGED FROM 09-03-81 TO 05-24-83 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.- * IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST RETAIN THIS PORTION FOR YOUR RECORDS . ! f.'.' I I RESERVATION: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral (Class 8) heirs of the decedent after the expiration of any estate for life or for years. the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral (Class B) rate on any such future interest Purpose of Notice: to fulfill the requirements of Section 709 of the Inheritance and Estate Tax Act of 1961 (72 P.S. seclion 2465-709'. Objections: Any party in interest not satisfied with the appraisement. allowance or disallowance of deductions, or assessment of tax (including discount or interest) IS shown on this Notice must object within sixty (60) day!; of receipt of this Notice. Objections may be made as follows: _ by written protest to the Department of Revenue. Board of Appeals _ by electing to have the matter determined at audit _ by appeal to the Orphans' Court Discount: If any tal< due is paid within three (3) months after the decedent's death, a discount of five percent (5%) of the tax paid is allowed. . the discount period is calculated in calendar months. Example: date of death 1-15-82, discount period expires 4-15-82. Except for tIlx on a future interest. inheritance tax becomes delinquent nine (9) months from the date of death. . Inheritance tax on a future interest becomes delinquent at the expiration of three months from: _ the date of election to prepay or _ the date of death of the life tenant or annuitant Interest is calculated on a daily basis from _ delinquent date to date of payment on any tax unpaid on delinquent date _ date of last delinquent payment to date of payment on any unpaid balance. Interest is charged at the following rates: Interest: Delinquent Date Annual Interest Rate Daily Interest Factor 5/27/43 \0 and including 12/3 I 16 I 1/1/8210 and including. 12/31182 111183 to and including 12/3 I 163 6% 20% 16% .000 I 64 .000548 .000438 Estates that become delinquent on or before December 31, 1981 will maintain a constant interest rate. The rate in effect when the tax first becomes delinquent will remain constant until the delinquent balance is paid in full. Estates that become delinquent on or after January 1, 1982 will contain a variable interest rate. Thus, taxes that remain outstanding from calendar year to calendar year will be subject to different rates in effect on each January 1. INTEREST = BALANCE OF UNPAID TAX X NUMBER OF DAYS X DAILY INTEREST FACTOR, . If a lax balance remains outstanding for more than one calendar year, a separate interest determination must be made for each year at the applicable rate. (Only one calculation is necessary if the estate maintains the constant interest rate,) Any Notice issued after the tax becomes delinquent will reflect In interest calculation to fifteen (15) days beyond the date of the assessment If payment is made after the interest computation date shown on the Notice. additional interest must be calculated. To Remit Payment: Detach the top portion of this Notice and submit with your payment to the Register of Wills of the county shown on the Notice. . Address information is listed on page 13 of the booklet, "Instructions for Inheritance Tax Return for a Resident Decedent" . Make check or money order pavable to: Register of \ ,.1 . _. I I i ~ REV. le07 (AS) DEPARTMENT OF REVENUE BUREAU OF ACCOUNTS SETTLEMENT P.O. BOX 2055 HARRISBURG. PA 17105 DATE 06-27-83 FILE NO, 21 BO-0791 COUNTY CUJW;;Rl.J\ND THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT MAKE CHECKS PAYABLE TO: REGISTER OF WILLS. AGENT, ACN 101 INHERITANCE TAX STATEMENT OF ACCOUNT JENETTE ESTATE OF BLOSS DATE_OF DE!!!i-lZ.::.02=.60 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT SUBMIT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY, SNELBAKER ETAL 44 W MAIN ST PO BOi: 318 MECHAI:ICSBURG PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE PA 17055 C;:L1~ ..A.!-9~~ _ ~Hl~ _L!N.E_ - - - - - - - - - - - - - - - - - - - - - - - - .. - - - .. - .. - - - .. - - - .. - - - - - .. - - - - - - - - - - - .. INHERITANCE TAX STATEMENT OF ACCOUNT .. ESTATE OF BLOSS JENETTE FILE NO. 21 80-0791 ACN 101 DATE 06-27-83 THIS STATEMENT IS PROVIDED TO AOVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, THE APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-12-82 PRINCIPAL T AX DUE:................................................................................................................................................... 4,440.84 PAYMENTS (TAX CREDITS); PAYMENT RECEIPT DATE NUMBER I 09-11-81 029769 11-08-82 049942 12-30-82 070470 DISCOUNT (+ I INTEREST I - ) 6.55- 31. 04- .26- AMOUNT PAID 4,000.00 447.59 31.15 TOTAL TAX CREDITS 4,440.89 BALANCE OF TAX DUE .05CR INTEREST .00 TOTAL DUE .05CR (If Balance Due is less than $1.00 no payment is required) . IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST RETAIN THIS PORTION FOR YOUR RECORDS v/. *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX ~OTICE OF ASSESSMENT OF AMNESTY NON-PARTICIPATION PENALTY AND STATEMENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN JENETTE BUREAU OF INDIVIOUAL TAXES INHERITANCE TAX DIVISION DEPT. 210601 KARAISIURQ, PA 17121-0601 UW.UIIU "'CU.KI CHERYLL BLOSS 59 WILLIAM DRIVE CARLISLE PA 17013 05-13-96 BLOSS 12-02-80 21 80-0791 CUMBERLAND 30133255 Allount Relnltt.d MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTE: To insure proper credit to your account, sub_it the uppar portion of this for. with your tax pay.ant. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... iiE'v:i6'iiiAiC€x-A-F'ji-'fciij:96j----.iiii-iNH€Ri;;ANC'E--i'Ax-Si,'A'TEHENi'-bTAccoiJiiT --iii.--------------------- ESTATE OF BLOSS JENETTE FILE NO. 21 80-0791 ACN 30133255 DATE 05-13-96 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS.A SUHHARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 05-05-B6 PRINCIPAL TAX DUE:. 187.02 PAYMENTS (TAX CREDITS), PAYMENT DATE 01-18-96 RECEIPT NUMBER AMNP PEN DISCOUNT (+) INTEREST (-) 52.21- .00 AMOUNT PAID NOTE, THE 15r. AMNESTY NON-PARTICIPATION PENALTY IS COMPUTED AGAINST THE LIABILITY NOT PAID BEFORE JANUARY 18, 1996, THE FIRST DAY AFTER THE END OF THE TAX AMNESTY PERIOD, THIS NOTICE IS TO ADVISE YOU OF THE ASSESSMENT OF THE NON-PARTICIPATION PENALTY. THIS NON-PARTICIPATION PENALTY IS APPEALABLE IN THE SAME MANNER AND IN THE SAME TIME PERIOD AS YOU WOULD APPEAL THE ABOVE REFERENCED LIABILITY. PLEASE NOTE THAT THIS NOTICE DOES NOT EXTEND THE TIME PERIOD FOR THE APPEAL OF ANY LIABILITY OTHER THAN THE NON-PARTICIPATION PENALTY. INTEREST IS CHARGED FROM 09-03-81 TO 05-21-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.- AMNESTY NON-PARTICIPATION PENALTY HAS BEEN ASSESSED TOTAL TAX CREDIT BALANCE OF TAX DUE ,00 187.02 217.07 404.09 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TQTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. INTEREST AND PEN. TOTAL DUE . .' IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORH FOR INSTRUCTIONS. ) PAVKENT: 00 c: ... 3('> ~ ~. . U"-- \t:i 0\ :off? con In. S' I: f:' Co .;. -< Detach the top portion of this Notice and sub.lt with your pay..nt ead. payebl. to print.d on the r.v.r.. .Ida. I \0 (~ . 0. _g tht nae, end ad;rtju :J!.( --;::. ~ ~.:.. :"~' ...i Cl;Q. r, If RESIDENT DECEDENT eak. chack or eonay order peyabl. to: REGISTER OF WILLS, AGENT. If NDN~RES]OEHT DECEDENT aaka check or aon.lt orde,. paltabl. to: COHHONWEALTH OF PENNSYLVANIA. All p.yaents rec.lv.d shall b. appliad flr.t to any Int.r..t which eay b. due with any r...lnd.r applied to the t.x. REfUND (CRl: A refund of . tax cradit, which wa. not r.qua.ted on the rax Raturn, .alt be requestad blt co.platlng en ftAppllc.tlon fo,. Rafund of Penn.ylvania Inh.rltanca and Estate T.xft (REV-1313). Applications are availabl. at the Office of the Regilt.,. of WUII, any of the 23 Revenue Ohtl"1ct Office. or froa the Dllp.rt.ent.. 24.hour an'NIIrlng .ervic. nueber. far for.. ord.rlng: In pann.ylvania 1-800-362.2050, out.lda Pannsylvanla end within local Harrl.burg .raa (717) 787-8094, TOOl (717) 772-2252 (Haarlng Iapairlld only). REPLV TO: DISCOUNT: PENALTY: INTEREST: Qua.tion. r.gardlng arrar. cont.lnad on this notlca should ba .ddress.d to; PA Dapart.ent of Revanua, Buraau of Individual Taxe., ATTN; Pa.t Ass.....nt Ravlew Unit, Oapt. 280601, HarriSburg, PI 17128-0601, phana (717) 787-6505. If Dnlt tax due Is paid within thra. (3) calendar eanths after tho decedent's death, . five p.reont (5~) dl.count of the t.x paid 1. allowed. Th. IS~ tax lIMne.ty non-p.rticipatian p.nalty 1. ea.puted on the tata~ of the t.x and Intarast .......d, and not paId befa,.. January 18, 1996, tho first dalt after the .nd of the tax .~esty p.rIad. Inter..t I, chargod beginnIng wIth first day of dalinquency, or nina (9) aonths and one (1) day fro. the date of death, to the date of pay.ant. Tax.. whIch beea.. delinquent befora Januarlt 1, 1982 blar Intere.t at the rat. of .Ix (6~) parcent p.r annul calculated at a dally rat.. of .000164. All taxlIs which beca.. d.llnqu.nt on and aftar January 1, 1982 wIll b.ar Intar..t at a rat. whIch will vary fro. cal.ndar Yll8r to calendar y..r with that rat. announced by the PA aapart.ant of Rav.nua. Th. appllcabl. Inter.st rata. for 1982 through 1996 arel V.ar Inter..t Rat. Dally Int.rast Factor Vaar Int.r..t Rata Daillt Int.re.t Factor 1982 20;( .ODOS48 1987 .. .000247 1983 16~ .000438 1988-1991 11i: .000301 1984 1l~ .000301 1992 .. .000217 1985 13~ .000356 1993.1994 '" .000192 1... 1D:C .000274 1995-1996 .. .000247 ulnt.n.t I. calculat.d .. follow.: INTEREST = BALANCE OF TAX UNPAID X NUnaER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Anlt Natlc. issu.d afte,. the tax b.eo... d.llnquent wIll r.flect an lnt.r..t calculation to flft..n (15) days beltond tho date of the a.......nt. If pay..nt 11 .ad_ aft.,. the lntere.t coeputatJon data shown an the Notlc., additIonal Inter..t eu.t b. calculatad.