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No. 21.80
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
"J(~t -
,.~V
In the Estate of
Caroline G. Hepford
, deceased.
To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania.
Pelltioner(s)llX (are) the execut ors
named In the Last Will and Testament of
Caroline G. Hepford dated August 14, 1959
Decedent was a citizen of the United States and a resident of East pennsboro
Township (~, Cumberland County. Commonwealth of Pennsylvania.
Decedent died on M:mday the 15th day of December A.D. 19~, In the
County of Cumberland , State of Pennsylvania at the age of ~ years.
Decedent \mll;(has noll been married and JmK(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 $35.000.00
and of real estate to the value of
$10.000.00
as near as can be ascertained; said real estate situated as follows No. 202 Valley Street and
also a five (5) acre tract of land along Salt Road, both properties being in East
Pennsboro Township. Cumberland County. pennsylvania.
Therefore, your pelltioner(s) respectfully apply~ for the probate of the said Last Will and Testa-
ment and for Lellers Testamentary theron.
Dated
Dec. 19, 1990
-l .J
Name and address l,~-/.'.....0'71..Rb
of Pelltioner(s) John G. Hep'W
----Valley Street, Sll!I1ll8rda1e, PA 17093
J:::>c,
Samuel P. Hep
317 4th Stree , PA 17093
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND l ss
John G. Hepford and Samuel P. Hepford
named in above application. being duly smm
statements set forth in this petillon are true to the best of
_SwQ~__ and subscribed before
ac?ording to law say(s) that the
therr knowledge and belief.
me, Dee _ 19 1980
q-4tflJ-;/_fl_~ d!~.
.f ~t.eglster
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Filed:
December 23. 1980
Altorney Jon F. LaFaver iJfJ.ffLl
J 1-/72--1
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L'\J'l' \:ILL ..l.i. 'l'~STJ'~~.~Jl1'
I, CIJlOLI!',G G. 15PF0HD, of Su:.,"!erdele, Cu;.iberlr.nd COtUlty, Pe!Ulsylvunia.,
beinG of sour.d !:,ind, E;e:.oory end tL'lderst:mdil1[;, do lQai;e, ;oubli:Jh and declare
this my Last 'dill uld 1'cst~c.::.ent, Lereb:! revi.,ki!l!?: ...nd ;.;<:J-:ir~g vuid all \dJl
or ,.tills b~r Ire E'.t any ti:~;e heretofore !i:E~de.
As to such estat.e "-s I rossess at tI:c tJ.:;:e of !~y decease, 1 dis}!ose cf
in :::anner as fol2..C'H8:
1. larder and direct t.'ld nIl !OJ' just debts, leC;1l11y collectible,
and my f,meral exrenses, be fully i",id and sat.isfied by !!;y EXGcutor, herein-
after narr~ed, as scan as cQnve:~iently I:1,.:.Y be done [l.fter my decease.
2. I deviee tmd bequeath all t~le rest, residue and re.::;~ainder of my
property, both rGal and personal, ~Iheresoever situated, of ,.:hich 1 shall die
seized or possessed or to \lr.ich 1 :"ay be entitled, O~ over ,.[hich I shall have
po~rer of testar'.entary disp~sit.ion, to :T.y beloved husband, Joi'n ],;. Hepford,
r.owever, cnl:r so lone ns !~e sh:J.ll live, and t.:-lcreafter the Frocaeds from the
SE.le of all my proFert;r, botl', re'ol and . ersonal, unto my belovcd six ~6)
children, in equal sh~res, ::.bsol,"t.ely.
3. In the event lC.y beloved hneband, John :S. Hepford, shall predecease
me, or is not livinG s~y dc.ys 2fter t.1,e date of lilY decp-ase, 1 bequeath the
proceeds from the sa.lc of all :'1y pro~~ert,:r, both renl and iersonal, unto rJy
six (6) children, L~ equal shares, p.bsolutely, as follows:
Jolm G. Eepford
S3.li1ncl P. nepfc!"d
CiliirlGs S. j'eFford
Carol J... I:Gpford
licbert C. Herford
;.'ltilda He ;o1'o1'd Eallr;pJ1
4. In the event t'P.t ,my of 1.1;1 :~.): children dies uithout leaving any
child or children, his share s1,all be divided ec,unlly a;:;on8 the rrJ1naining
children. However, if anJ~ of my children dies leaving u child or children,
! bell.lleath his a hare, ~:.bsolutely, l.Ulto 1.i;; child )1' children. 'llhe contents
of this paragraph is cnually a;;l'li.c3.ble t.) l'araf,rarhs munbered "2" and "3".
-1-
OATH OF NON.SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA} 55:
COUNTY OF CUMBERLAND
This, the
22nd
day of
December
A.D. 19 30 ,before me, Register for the
Probate of Wills and Granting Letters of Administration in and for the county of
Cumberland, in the Commonweallh of Pennsylvania, personally came
Vera Rhoads
.tAI'" J/lM 1=-:; /1
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I'IA //MA~/
who being duly
~m according to law deposed and say that they are well acquainted with
the handwriting of Caroline G. Hepford
whose name is attached as
Testatrix
to an instrument of writing
purported to be
the Last Will and Testament of
Caroline G. Hepford
late of East Pennsboro Township. CunDerland Cotmty, Pennsyhmni.'l
, deceased
and that the said signature is true and genuine, and that the said
Caroline G. Hepford
is now deceased or absent
Strom and subscribed before me,
this
22nd
day of
December. A.D.
~ . /
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Register
19'30
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per
Deputy Register
OATil OF SUIISCRIIIING WITNESS
COM~NWEALnl OF PENNSYLVANIA i ss:
COUNTY'~MlIERLAND
~
This '~ day of'A.D.,19 ,
bcforc me, Regisler for IheFr,obate of Wills and granting letters of Administration in and for said CouillY of Cumberland, in
thc Commonwealth of pennsyiVa~, personally camc . /.
~ '
Allen W. Saussaman ./
, //
lhe subscribing witnesses to thc foregoing ins~lI1ent of writir,g purporling tobeihc last Will and Testamenl of
, .'
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"Dated August 14, 1959
" /,,/
, --
:"Cumberland County Pa., deceased who being duly
,
sworn according to law, dcpose and say, that he was', present, and saw and heard the lest. trix
Caroline G. Hepford /'s~SC~I, publish, pronounce and declare the said
/' ,
instrument of writing as and for h er/ Testament and Last Will, and at thc time ofso~oing
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was of sound and disposin~)11ind memory and understanding, to the best of ~s "-
knowledge, observation.and belief. "
Sw:>rn/ and subscribed beforc"'",
/ Allen W. :;aussaman
../
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Caroline G. Hepford
late of
East Pennsboro Township,
she
"-
,
Rcgister
AHIDA VIT OF DEA TII
COMMONWEALTH OF PENNSYLVANIA l ss:
COUNTY OF CUMBERLAND ~
John G. Hepford and SaDUJel P. Hepford
S\\Urn
<ays that as nearly as can bc ascerlaineolhe said decedent
being duly
Caroline G. Hepford
died on
l>bnday
thc
15th
day of
o'clock. A. M.
December
A.D.,1980 ,
at or about
11:45
Sworn
19th
and subscribed this
D-L h lf1!:i
fjL-,-;u,,,i ()7 ~ L7!I~~(
day of
December
19.80q bcfore
/. 7(4 AI
f), qi/'~d
Registcr
647
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of
Cumberland, personally came John G. Hepford and Sam.tel P. Hepford
who, being duly sworn
,do
depose and say that as
Executors
of the last Will and Testament of
Caroline G. Hepford
deceased
thev will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And
also will diligently comply with the provisions of the law relating to Transfer Inheritances. 5w:Jm
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and subscribed before me.
Dec. 19, A.D., 19~
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DECREE
Be it rcmembered that on the
23rd day of
D,=cember
80
,A.D.,19~, there was probated and
recorded thc last Will and Testament of
Caroline G. 2epford
late of
East pcnnshoro Township
Deceased. Letters 'I"estarrentary were granted to
Witness my hand and official seal the day and year aforesaid.
JOh'1
,Cumberland County, Pennsylvania,
G. :'cpford & Samuel P. Eepford
. ,-
648.
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""RfV.lIIZEX "'. '. . .' ", '
.JJ'::'tK'O'00540' .' COMMON:~~~J~T~~ :e~~~~VLVANIA ,
~~~. ","" ,,' OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
I '
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.
Of
II
=
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, 1
, RECEIVED
,1 FROM
--
TAX AT 6%
TAXAT1S%
AODRESS
John G. He ford &r SlIIIIuel P.
C 0 Jon F. LaFaver. Bsq.
317 Third street
H_~rd %
ESTATE TAX
New Cumberland. Pa. 17070
TOTAL TAX CREOIT
4,421.05
'--E"fTATEINFORMIHiciF.r-- ----1-5---1--9-80-
DATE OF DEATH Dec.
DATE OF PAYMENT
21-80-795
March 9. 1991
FILE NUMBER
COUNTY
CAROLINE G. HEPPOR!)
llWIbe:rland
m
m
LESS DISCOUNT
PLUS % INTEREST
(FROM TO_ J
221.05
NAME OF DECEDENT
------------------------------------------
TOTAL AMOUNT PAID
4,200.00
POSTMARK DATE
I ",M,"" 'PAID OR '.""Ol'"
SEAL
.../
RECEIVED BY
I
REGISTER OF WILLS
'---_.---- ------ -- --- ----------------
COMMONWEALTH OF PENNSYLVANIA L
COUNTY OF CUMBERLAND j
55:
Jom G. Hepford and Samuel P. lieEford___
being duly
according to law, deposes and says that tho/ __ar.tlb~-Exec.\.lt!lrs
of the Estate of Caroline G. Hepford
late of ];.as_t_p.ennsboro-Township---- _.. ___ ._-- ----------, Cumberland County, Pa., deceased and that the
within is an inventory made by Jom G. HeRf~mLamLS~l-P~- ijepforlL-., the said Executors
of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside
the Commonwealth of Pennsyh'ania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's :::t:~bscribed before me, ' Ill.. .Jj~4f!.. ^
1 JdJ..",v,J~~..,,---
ExocutorS-
,
(Jom) (Samuel)
. _202 Valley Street and 317 Fourth Street
sworn
19f/
::...-/
//:
Gee-
Suunn. M. L.nofto. Notary Publi<
My Commiuion b..liftS Jln. 23. 1983
New c.mbeo'.4lIlI. PA Cwnbcrl>nd County
Swmerda1e, PA 17093
Addr."
Day
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Month
1980
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INSTRUCTIONS ;g~
I. An inventory must be filed within three months after appointment of personal representativ~~
2. A supplement inventory must be filed within thirty days of discovery of additional a..ets. ':;;.
3. Additional sheets may be attached as to personalty or realty :::~;
4. See Article IV, Fiduciaries Act of 1949.
15th day of
:E I
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REV.455 (1-S0)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT. OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
'-f-i-~L ~L~ J
SC~EDUlE "F" 0 I
STATEMENT OF DEBTS
AND DEDUCTIONS
J'l %1
-*,
Estate of CAroline G.Hepford Date 01 Death December 15. 1980
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOllOWING:
File No. 21-80-795
Claimant John G. Hepford
_ Relationship to Decedent Son
Claimant's\'4ddress 202 Valley Street. SlIIlIV'xdale. PA 17093
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
lIohn G. Hepford "amily Ex~tion 2,000.00
!Register of Wills Letters & Certificates 38.00
ack W. Richardson Funeral Hane F\meral es 1,990.01
'illiam A. Sullivan, M. D. Professional Services 282.00
CamP Hill Nursing & Conv. Center !Final Bill 522.50
Holy Spirit Hasp. Rad. Assoc. !Professional Services 9.00
Holv Sni.rit Hasnital iPmfessional Services 180.00
Tohn G. Heoford Rei h,h. for t of nrivate nurses Ser\ . 560.00
<1-"'1 P. Hepford !Reimbursement for costs advanced 25.00
!John G. Hepford \Reimbursement for Costs advanced 40.00
!Richardson F\.mera1 HaIe Death Certificates 12.00
. PhYsicians Professional Services 7.82
l'rofessional Phannacy Prescriptions 13.32
['he Patriot-News Co. Legal Advertising 22.50
-~~~ Legal -.;~mg 11_..\ 1.f~UU
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~'''''S C. :'zani.s, '~1~' , P.C. o essional Set'V1.ces 23' :
recorder s urnce 11./0 LransJ:erl.ax 4UI.
- .. ~tary Fee
on F. LaFaver 2.00
Ton F. LaFaver !Legal Fee 4,325.93
~gister of Wills !Filing Account 75.00
Recorder of Deeds Filing Releases 50.00
TOTAL THIS PAGE I 10.821.26
I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement 01 debts. funeral
expenses and expenses of administration submitted to the eslate as deductions for Inheritance Tax purposes.
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SIGNATURE OF ATTORf\I.E IDUC1ARY DATE
OFFICIAL USE ONLY I'
DEBTS AND DEOUCTIONS ARE ALLOWED IN THE SUM OF $ /;) 21:< /. .:1 &> AT
/
I,
PERCENT.
9-//-1"1
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by tile decedent prior to his/her death are deductible against his/Iler taxable estate.
In addition to debts incurred by the decedent or estate. otller items are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker.
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed
should be attached to this schedule.
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spouse, or if the spouse Ilas forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim tile exemption. In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column.
2. Assign consecutive numbers to each item listed.
3. Enter the date on which each debt was incurred and/or paid.
4. Enter the names of each payee.
5. Provide a brief explanation in tile remorks 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.
REV-449 EX" (3-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER IHHERITAHCE TAX
RESIDEHT DECEDEHT
AFFIDAVIT OF
FIDUCIARY
(Initruction50 on Rever!lo Side)
~J.-'_Ld. 1 -.;1- ~ I
~*
Dote of Death Decenber 15. 1980
Social Security No. 181-38-0834
Bureou Fil e No.
tCITY,
IS1 A TEl
(ZIP)
County File No.
21-80-795
1. Decedent died:
( ) Intestate (without 0 will)
( X ) Testate (leaving 0 last wi II __copy attoched)
2. Is the filing of a FeJeral Estate Tax Return required for this estote?
Yes_ No X
3. (X) Executor/~
) Administrotor! Administratrix
Nome John G. Hepford and Sanue1 P. Hepford
Address 202 Valley Street
Sunnerdale, PA 17093
317 Fourth Street
Sunrerda1e, PA 17093
(CITY)
(STATE)
{ZIPI
4. All correspondence should be mai led to (X ) Attorney
) Fiduciory.
5. If on at!orney is representing the estate, indicate:
Name Jon F. LaFaver
Address 317 Third Street, P. O. BoK 101
New Currberland, PA 17070
(CITY) (STATEI (ZIP)
List oil safe deposit boxes registered in the decedent's individual namer or iaintly with, or as an agent or deputy
of another, or in decedent's individual name with right of access by another as agent or deputy. Include the nome
and address of the bank or other institution where the safe deposit box is located, the name (s) in which the box
is registered and the relationship of the joint holders to the decedent.
NAME AHO ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDEHT MAINTAINED A SAFE DEPOSIT BOX
NAME OR HAMES IN WHICH
SAFE ~EPaSIT BOX IS REGISTERED
RELA T1nHSHIP OF JOINT
HOLDERS TO DECE DEHT
Under penalties of periury, I declare that I have examined this return, including accompanying schedules and
statements, Gnd to the best of my knowledge ond belief it is true, correct and complete.
~!:}jl/:'~
r.lcVvJ'W~~r:' (y}tiiz.i<r4I(
j . SIGHATURE OF FIDUC1~.(
'7-/- f1
DATE
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMIl.TION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 plOvides that the following persons shall prepale andlile
a return:
a. The personal representative of the estate of the decedent as to property uf the decedent adlllinisterr;d by IIi III
and such additional property which is or may be subject to Inheiilallce TilX 01 which he/she shall have or
acqui re knowledge;
b. The transferee 01 property upon the transfer of which Inheritance Tax is ollllay be imposed by the 1961 Statute,
including a trustee of property transferred in trust, plovided that 110 separate retn"l need be made by the transferee
of property included in the retull1 of a personal representative.
2. PLACE FOR FILING
The return is to be filed in duplicate with the Regislef of Wills of the connty whelein tile decedent resided.
3. TIME FOR FILING
The return is due nine months after the decedent's death, unless an er.tension for filing has been applied for and
granted by the Secretary of Revenue wilhin the nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report
required of him. . .shall be personally liable. . .to a penalty of 25% of the lax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department 01 Revenue as debts of like amount are recoverable by
law."
5. TAX RATES
Inheritance Tax is payable althe rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife,
son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others.
6. PAYMENT OF TAX
The tax assessed on the transfer 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 unlil 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 wilh any interest thereon, are a lien upon real propeity, which lien remains in effect until
the taxes and interest have been paid in full. The taxes liIay 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. FILlNGOF FALSE RETURN
Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 oi the
1961 Statute, be guilty of a misdemeanor and, on conviction tllOreof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
I REV.451 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONALPROPERTV
'*'
(InstructiollS 011 Reverse Side)
Estate of Caroline G. Hepford
,
i ESTIMATED DEPARTMENT
,
I ITEM DESCRIPTION UNIT MARKET VALUATION
NO. VALUE VALUE IOFFICIAL USE ONL Y}
I
I
( 1. rom Checking Acct. 1t180-1760-8 588.46
,
,
, 2. CmB Savings Acct. 1/008-700572-4 662.48
I
3. CCNB Cert. of Dep. ft17067 9,050.76
i 4. Ilauphin Deposit Savings Acct. 1132-1-01368 4,091.03
5. 262 shares CCNB Corporation camrm stock @ 10 2,620.00
6. Proceeds fran Prudential Insurance Policy ft16 259 79 191.24
,
: I
- - --
TOTAL THIS PAGE r 17,203.97
1/Ij,2tf3'oP7
, .A 1'3
RE\j..Hl~t,.eal
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
ESTATE OF _ r.A1"'nl ine (';. H~pfnrd
SCHEDULE "C"
TRANSFERS
*
INSTRUCTIONS:
1. Answer the Questions on reverse side.
2. If the answel to any of the questions on the revelse side is "Yes," plovide a description of the properly transferred per
Schedules "A," liB," or liE," its estimated market value at dale of death, dates 01 transfer, to whom transferred and
relationship of transferees to decedent. Attach a copy of any trust deed or instrument relating to the transferred property.
ITEM
NO.
DESCRIPTION
ESTIMATED I DEPT. VALUATION
MARKET VALUE (OFFICIAL USE ONL Yi
o
TOTAL THIS PAGE
o
_f)--
~IJJ
,
!
,
I
i
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any transfer of any matelial 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 lrom himsel f/ hersel f to himsel f/hersel f and another party
or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ..JJ2-
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following
infonnation:
a. Age of decedent at time of transfer.
b. Copy of death certificate.
c. Affidavit by the attending physician indicating the state of decedent's health at time of 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".) no
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? n/",
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".) no
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Ves" or "No".) no
6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. nla
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, transfer property, the beneficial enjoyment of which was subject to change, because of
a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of
law? (Ans.wer "Yes" or "No".) no
9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Yes" or "No".) no
'. .
REV0453 EX+ (3.80) SCHEDULE "D" '*'
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT {Instructions Oil Reverse Side!
Estato of Caroline G. Hepford
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARV
DECEDENT BIRTH
1 1 H Son elL
317 Fourth St. sunrerdale PA 17 3
2. Matilda He ford Hallman ter Yes Adult 1 6 Residue
4140 Wertzville Rd.. Enola, PA 17 5
3. Charles S. ford Son Yes Adult 1 6 Residue
210 2nd St. s~da1e PA 17093
4. Robert C. ford Son Yes Adult 1/6 Residue
\'.. 1215 Weldon St.. M:mtoursville, P 17754
5. John G. Hepford Son Yes Adult 1/6 Residue
202 Vall St.. sunrerdale. PA 170 3
6. Carol L. ford Son Yes Adult 1 6 Residue
109 Valley- St.. Sunnerdale PA 170 3
\
\
i
,
I The above beneficiaries are living at this time except for the following:
DATE OF DEATH
NAME
. . ".
REV..5. EX'" (3.eO)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "En
JOINTLY OWNED PROPERTY
*
IInstruetions on Reverse Side)
Estate of
Caroline G. Hepford
P
; ITEM TOTAL \ VALUE OF DEPARTMENT
NO. DESCRIPTION MARKET DECEDENT'S VALUATION
VALUE INTEREST (Omeiel Use Only)
T
1. CCNB Cert. of Dep. #28507 dated 11/10/80, in th
, names of Caroline G .Hepford or Jolm G. Hepford
Full value included herein. 10,135.20
2. CCNB Cert, of Dep. it28344 dated 8/22/80, in the
names of Caroline G. Hepford or Jolm G. Hepford
Full value included herein. 11,299.45
3. Ck1e-half (1/2) interest in house and real estat
situate at 202 Valley Street, Sunnerdale, East
Pennsboro Twp., Cunberland County, Pennsylvania
'Ibis real estate was held jointly with decedent s
son, Jolm G. Hepford, by virtue of a deed
recorded December , 1977, in Deed Book "p",
V01UIe 27, Page 183, in the Clmberland County
Recorder's Office, and has a real estate tax
assessment of $15,760. One-half (1/2) value
included herein. 7,880.00
,
TOTAL THIS PAGE 29.314.65 ~? JIl)65
AS
. .'
. ":t........ "I':..1i'J: .,
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
I.
I
I
I
I
,
I
:" , Schedule "E" must include all property, real and personal. owned by the decedent jointly with another
party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be
Included. List real estate first.
., ,
1. Describe all real property as indicated in the instructions for Schedule" AU. Describe all personal property
as indicated in the instructions for Schedule "B". Include the name, address and relationship to the
decedent of the co-owner (s) and the date the joint ownership was established.
2. Indicate the total market value of the jointly owned property.
3. Indicate the percentage of the decedent's interest.
4. Indicate the market value of the decedent's interest.
,
I
'i "C U n > r.1 >
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REV-tU8 FO (7.80)
.
COMMONWEAl.TH OF PENNSVl.VAN1A
DEPARTMENT OF HEVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Mr. John G. Hepford
202 Valley street
summerdale, PA 17093
Mr. Samuel P. Hepford
317 Fourth street
summerdale, PA 17093
RE: Estate 01
County 01
File No.
r.~rolinA G. HApfnrn
r.l1mhQ.,...1~nn
:>1_RO_07QI;
Dear Messrs. Hepford:
You are hereby notified that the ""';g;n~'
appraisement in the estate 01 Caroline Go Hepford
has been filed in the office of the Register of Wills of f':lImhp.rl and
County on !,;"ntp.mher 4 , 19 Jl.1. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
T ran s fers
Total
40,000 00
17,"O':l 97
"9, ':qu ~5
NonA
RIi,I;1R Ii:>
As to such tax that is paid within three months from dote 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 dote of death, interest at the rote of six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may abiect thereto within sixty days
after receipt 01 said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Date
~Q.ptgmhQ~ U, 19A1
,;,.,d ~"'O ~c.t-
Title Chief Aooraiser
NOTE: This is not a bill.
REV-51B fa (7-10)
.~
. COMMONWEALTH OF PENNSVl.VANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELO OPERATIONS
NOTICE OF FlUNG OF APPRAISEMENT
Mr. John G, Hopfor<!
202 Valloy Street
SUIlIIlerdale, PA 17093
Mr. Samuel P. Hepford
317 Fourth street
Swmnerdale, PA 17093
RE: Estate af
County of
File No.
CRroline Go Hepford
r.llmM",,1nnn
~>1_flO_07Q'i
Dear ~lesBrS. Hepford:
You are hereby notified that the nrigin,,'
approisement in the estote of Caroline G. Heoford
has been filed in the office of the Register of Wills of Cnmoorland
County on l'leutember 4 ,19..8.1. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
40,000.00
17,::>m.97
~91":l16 ""
None
86,<;18.62
As to such tax that is paid within three months from date af death, a five (5%) percent
discount is ollowable. As to any tax thot remains unpaid ofter 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 Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Date
~pt.AmhAt'" A, 10R1
Signed
cd-pL"~.-
Chief Appraiser
Title
NOTE: This is not a bill.
REV-"5} EX+ Cl-eo>>
~-~
~I
. ' ~
~_{iJt' , '
':.' ~.
CO~W,ONWEAL m OF PENNSYLVAr,IA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
G10RIGINAL
o SUPPLEMENTAL
Estate of
File No. _--.n~80-019.5
Caroline G. Hepford
Coun ty
Cumberland
Date of Death --December 1<;,-1980
In the event thai ony rutura interest In this estatu Is transferred in possession or rnjeymont to colratera( hefrs of the decedent af'er ffle
expiration of any oslale for Ilfo Dr for y.,ors, tho Commonwealth hereby expressly reserves the right to appraise and assess tronsfor
Inherltoncr taxes at Iho lawful collall!lral rale on any such future inlerost.
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
ASSET SUMMARY
DEPARTMENT'S
APPRAISED VALUE
1. Total Real Property _ SCH. "A" . . . . .. $ --AO..,OOO. 00
2. Total Personal Property - SCH. "B".... $ 17,~01.97
3. Total Jointly Owned Property - SCH. "E" $ ?9,114.6'i
4. Total Transfers - SCH. "C". . .'. . . .. S None
40,000.00
17,203.97
?9,114_fi'i
s
s
s
s
$
Unreported S
Unreported S
Unreported S
Unreported S
MonA
o LIFE ESTATE
DANN.UITY
TOTAL GROSS ASSETS
DREMAINDER
86,518.62
TOTAL VALUE
$
I do hereby certily that the above appraisement is mode in c,on;;pormit with Pennsylvania low and has been filed this
day with the Register of Wills. ~ !!j'
~ ' (..JL' L Lf!-....---r Seotember 4, 1981
APPRAJ. -R DATE
~ ~ I:l::
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REV.~I" EX+ tHOI
File Number
Estate Name
Date of Death
Social Securi ty Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
Ii] Original
o Supplemental
oRemainder
21_80.07Q'i
C~rnline G. Hepford
December-15.. lQ80
181-38-08..34
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser In and lor the County 01 Cumberland
Pennsylvania, do respectfully report that I have appraised the real and pe..onal praperty as reported in the forogolng
re",m at tho voluos set forth opposlto each Item in the lost column to, ho rl9ht in ~dules "A", "8", "C", and "e"
Dated: September 4 I 1 QR 1 t....o ~(., .<-t-"
INH ~ITANCE TAX AP AISER
ItlVEtlTORY
Real Property (Schedule Al
Personal Property (Schedule B)
Jolnt.Held Properly (Schedule E)
Transfers (Schedule C)
TOTAL GROSS ASSETS
Leu D.bts and Deduction.
(SCHEOUlE F)
CLEAR VALUE OF ESTATE
o Lllo Estate
o Annuity
FOR USE OF REGISTER ONLY
Tax on $
Tall. on S
Toll. an $
Tall. en $
Tall. on S
Ell.omptlons
Total Estate
Less Credits
OATE OF PAYMENT
VALUE AS APPRAISED
I I ADJUSTMENTS I
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
$
92+
00+
10+
2')+
None
30+
__86,518_ _62...
93-
40-
~
FACTOR
PRINCIPLE
VALUE
CODE
I
CODE
COMPUTATION OF TAX
$
S
$
$
6%
\5%
$
TOTAL TAX
INTEREST FROM
BALANCE
$
$
$
TO
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
+ $
S
=
$
=
+
INTEREST FROM
BALANCE
TO
S
COMMONWEALTH OF ~ENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
COUNTY FILE NO:
,A / - /,'1
-
,. I ~.'
DATE
.., J ,-;-: /.(~ ) ;',0 I ,/2/
,r (. ,
C/. /," ",I....:; j, /J
, /1,-. ,..... ~ .",' 1./ _.' )....... # I. /"ri.#--
" /1'
, _"'l:r
;// _ '.....J - '7'/"'5 "'.'
ESTATE
TO:
'''fi
,
, . I'!
/~ /, " . ' ../. )
/~ t, i,1
FILE NO,
1/ .
!I;.. /1
,
/
7' f,/ .,' , " 'I
,~. /./"" ~", / '. '
,.-
./,.! :' ' " "./( J / j /
.
"/ :',/J /~II ;,1 /',., '/'~~/1'/{
:;l""
.' ""/:..' /,:.1
/~i ",',t'/I//.~l/){'~
( _ /, '~'Or?)
DATE OF DEATH, j,/'I.....,.I.d'...//..; //,.)
/
COUNTY
j
,
Appraised Value of Estate:
Real Estate
$ ...::'1; "./,--:'.,' '--11
. '/ -:.' ~ n
1 , .
. .. 'I :?/"/, " 'J
"
J
$ , ,-Ii' -. ';
'. . , " .r.
.
J
- IIi >- , 1 .'{/
J ,
Personal Property
Jointlv Held PropertylTransfers
Total Gross Estate
Total Approved Deductions
Clear Value of Estata
$ '/":- ' Ij' '; - 1
.- (. :/(/
,
-..-..---
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$ /~:
'II :'-',(/.
Amount Taxable @ 6% Rate
$ .il) 1.1 '/ 'I
,
.../
""'Jf./
$ '" '1',,/ I .;-e,L
/
tax due
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX OUE
$ ~/.J:t//- /. )i"~
I
* * * * * * A five percent discount tutaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
:;( <7 ,.
) - ,.,'" j
$ .!../ .;- I /I
.
$ :>_/'.'
/,~ I.-~--
,
$ //-/;J/
-
/J 1.-;
$
=
of)
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
$
/ -;)/1 r/ q
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
-.,.'
Assessed by: .. . ( " k. -( A
See Informstlon on Reverse Side Agentf Ih"Co~/fMn~.lth"'.
,I ,.....-,
/} '.. ;"':~.;..I" j
,1[C:~~i'i.-I'~ G (/
INFORMATION
To insure proper credit to your account, the name of the estate and file number should be clearly print.
ad on the check or money order.
This assessment is made in accordance with Section 708 of the Inheritance and Estate Tal( Act of
1961 (72 P.S. ~ 2485.7081.
To the extent that inheritance tax is paid within three (31 months after the death of the decedent. a
discount of five (5) percent is allowed (72 P.S. ~ 2485-7161.
Inheritance Tax, other than lax on a future interest. is due at the date of the decedent's death and becomes
delinquent at the expiration of nine (91 months after the decedent's death (72 P.S. 9 2485.711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafier (72 P.S. fi 2485-7121. Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
- -------------------- ---------- --- ---- --------- - - --- - --- -------- -- -- -- - ----
I month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .015 6 months .030 9 months .045 12 months .060
1 days .00017 11 days .00186 21 days .00352
2 days .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days .00437
7 days .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 days .00169 20 days .00335 30 days .00500
--------------------- --------- --- ---- ------- --- ----- - ----------- -----.
Any party in interest. including the Commonwealth and the personal representative. not satisfied with
the assessment may object thereto within sixty (601 days after receipt of this Notice as provided by Section
1001 or the Inheritance and Esta.e Tax Act of 1961 (72 P.S. ~ 2485.1001).
Make check or money order payable to:
"Register of Wills. Agent"
Mail to the address listed below:
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
"1/ C.
COUNTY FILE NO: c><; (\ () - 7 c, .5
TO:~('i"l1 i cfr, ""\oJ'..:"-' F"'-l
-1/ <7 d~L _.M- . P- (). i3rr.L loj
/1~J C..AJN}I\..v.L.rJl ~ r ().. " '10 '70
,
DATE . ~\ Ir;f _ (I 1Cj'Y,1
ESTATE (J)."~:~O ~1 4Jf4iY~
FILE NO. a J .. t' 0 '71'5
COUNTY GJNY O-ll~,.J
DATE OF DEATH (~cOt'n.lCi\.. /5.. I ~ to
Appraised Value of Estete:
Real Estata
s
+
Personal Property
+
Jointly Hald PropertylTransfers
s
Total Gross Estate
Total Approved Deductions
$
Claar Value of Estate
Less: Approved Charitable Exemptions
s
Claar Value of Estate Subject to Tax
Amount Taxable @ 6% Rate
s
tax due
s
tax due
Amount Taxable @ '5% Rata
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
s
1;(0 '1:
fit . * * fit * A five percent discount totaling S
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
'7 Ct
$/a(O~
DISCOUNT
INTEREST
TAX CREDIT
$ /;) () ;:.:!-
g -11- yl
+
$
s
=
+
=
+
=
Interest accrues at the rate of six (61 percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid bv
is
!?O () '-1 0 I
s \,] (^.lVv\ l~
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
, ,
/ / /, / ,;,' { .~ .., /
Assessed by: / " ,./ ,A. '.-. , /.....;:;i;..-" .
See Inlormation on Reverse Sido Agent forth. Common~.h~ /
i)~1 f/. ,Lv./'
"ice". u;:,'I..L:.. I " ..J ..-
INFORMATION
To insure proper credit to your account, tho name of the estatO and file numbor should be clearly print-
ed on the check or money order.
This assessment is made in accordanco with Section 708 of tho Inheritanco and Estate Tax Act of
1961 (72 P.S. ~ 2485.708).
To the extent that inheritance tax is paid within three (31 months after the dealh of the decedent. a
discount 01liv8 (5) percent is allowed 172 P.S. ~ 2485.7161.
Inheritance Tax. other than tax on a future interest, is dUB at the dato of the decedent's death and becomes
delinquent at the expiration at nine (91 months alter the decedent's death 172 P.S. ~ 2485.711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent therealter (72 P.S. ~ 2485.7121. Calculate interest from the delinquent date shown
on the face of this form to the date 01 actual payment using the following interest table:
---------------------------------- ------------- - - ---- ----------------- -----
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .015 6 months .030 9 months .045 12 months .060
1 days .00017 11 days .00186 21 days .00352
2 days .00034 1 2 days .00203 22 days .00369
3 days .00051 13 days .00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days .00437
7 days .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 days .00169 20 days .00335 30 days .00500
----- ---------------- --- -- - - - - --- ---- ---- -- ---- ---- - - - - -..------- ---....-
Any party in interest. including the Commonweallh and the personal representative. not satisfied with
the assessment may object thereto within sixty (601 days after receipt of this Notice as provided by Section
1001 01 the Inheritance and Estate Tax Act of 1961 (72 P.S. ~ 2485.1001).
Make check or money order pavab1e to:
"Regisler of Wills, Agent"
Mail to the address listed below:
11
I .----- -- ,~-- -~ -- ---- ~- -= -. --
\ ~ilf~f~~~i~iiCl" RE::,:~:=~E:::E=~::~:::~ ESTATE TAX
I r"'F"':" .
I =
\ ~
I =
I: "'~.
I!
(I
I \ " ~~gK\VED
i i ~" AOORESS 317 3rCl st.
I:
\ ;
John o. & s8muel Repford
\
TAX AT 6%
TAX AT 15%
TAXAT_%
ESTATE TAX
m
m
RECEIVED BY
TOTAL TAX CREDIT
Sl20.79
I
I'
.--es'i'ATEINFORMATiCiN:--------------------------
DATE OF DEATH
FILE NUMBER
LESS DISCOUNT
PLUS % INTEREST
(FROM TO_I
TOTAL AMOUNT PAID
$120.79
OATE OF PAYMENT
// /1
(
~~NA/e~/(f~.J
NAME OF DECEDENT
COUNTY
--------------------------------------------
POSTMARK OATE
REMARKS:
Q
.PAID IN FULL"
LI
(I
I
REGISTER OF WILLS
~---------------------------------,-
SEAL
n 05
nr ",,::0
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LAST \.aLL 1..:"\D ?2STA~':'~~"1\
I, CAROLINE G. IU;;P.~ORD, of SUlnmerdale, ClloT.berland County, Ponnsylvania,
being of sound mind, memory and understanding, do ma::e, publish and declare
this rK'f Last ~lill and Testa::.ent, hereby revoking and malting void all will
or willa by Ille at any t:imo heretoi'ore :nr.do.
As to such estate as I possess at the t~ of rK'f decease, I dispose of
in manner as follows:
1. I order and direct that all my just debts, legally colloctible,
and rK'f funeral expenses, be i'ully paid' and satisfied by Jroy Executor, herein-
after named, as soon as conveniently may be done after my decease.
2. I devise and bequeath all the rest, rosidue and re:,1a.inder of n-;y
property, both real and personal, wheresoever situated, of which I stall die
seized or possessed or to which I may be entitled, or over which I shall have
power 01.' testamentary disposition, to rK'f beloved husba"'1d, John E. Hepford,
however, only 50 long as he shall live, <4'1d thereai't.er the proceeds from the
sale of all my property, both real and parsonal, Ul'lto my beloved six (6)
children, :in equal shares, absolutely.
3. In the event my beloved husband, John E. Hepford, shall predecease
me, or is not living sixty days a1'ter the date 01' rroy decease, I bequeath the
proceeds 1'rom the sale of 'all my property, both real and personal, unto my
s:ix (6) children, in equal shares, absolutely, as 1'ollows:
John G. He'01'ord
Samuel P. Bepford
Charles S. Hopford
Carol L. r.epf6rd
Robart C. Hapford
,~tilda Hepford Hallman
4. In the event t.hat any of my six children dies \'lithout leaving any
ohild or children, his share shall be divided equally a."Ilong the rornail'ling
ohildren. However, if.' any 01' rK'f children dies leaving a. child or children,
I bequeath his share, absolutoly, unto his child or childl'On. 'l'he con:t.cn't.o
of this paragraph is equa.lly applicable to Paragraphs numbered "2" and "3".
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1- 2-81
1- 5-81
i 3- 4-81
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I 5-22-81
6-11-81
7- 1-81
7-29-81
8-14-81
8-26-81
9-10-81
9-24-81
9-28-81
10- 1-81
10-15-81
1- 2-81
l.AW O"lces
JON F. LAFAYER
317 T"IItO STAUT
HEW CUlollltltLAHO, PA.
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FIRST AND FINAL AcmUNl'
OF
JOON G. HEPFORD and SAMUEL P. HEPFORD
Executors of the. Estate of Caroline G. Hepford
late of East Pennsboro Township, Cunber1and County,
Pennsylvania, deceased.
rEBITS
Your accOlmtants charge themselves with receipt of the following items:
Close COO Checking Account #18017608
Close Dauphin Deposit Golden Passbook Savings Acct. it32-1-0136-8
CCNB - Interest on C/O i~017067
Travelers Insurance Co. - Medicareclairn (Holy Spirit Hosp.)
CCNB - Interest on C/O i~017067
CCNB - Interest on C/O i~017067
Redeem CCNB C/O #23844
,Prudential Insurance Co. - Proceeds from Policy it16 259 679
I\CCNB - Dividend
CCNB - Interest on C/O i~017067
I Redeem CCNB C/O #28507
iCCNB - Interest on C/O i~017067
iCCNB - Interest on C/O i~017067
i Jan Wiley, Esq., Attorney for Fmnanue1 United Hethodist Church - Net
i Proceeds from sale of real estate on Salt Road, East pennsboro Twp.
. CCNB - Dividend
\Trave1ers Insurance Co. - Medicare claim (Dr. Sullivan)
\CCNB - Interest on C/O i~017067
crnB - Interest on C/O i~017067
I crnB - Interest on NCM Estate Checking Account
IcrnB - Interest on C/O i~017067
: COO - Oividend
"~I COO _ Interest on NCM Estate Checking Account
\Redeem COO C/O i~017067
i.\C10Se COO Savings Account #0087005724
iCCNB - Interest on C/O i~017067
i\Tota1 Callh -
\1 In Kind - 262 shares CCNB Corporation cOlIIlPIl stock valued at -
! CREDITS
! Your accountants credit themselves with payrrent of the following items:
!
i,Jack W. Pichardson Funeral Horre - Funeral Expenses
ilWilliam A. Sullivan, M. O. - Professional Services
,!Carrq:> Hill Nursing & Convalescent Center - Final Bill
i\H01y Spirit Hosp. Radiological Associates - Professional Services
! Jolm G. Hepford _ Reimbursement for costs advanced to pay Holy
. Spirit Hospital and Private Nurses
lIblK J.Uc, i'l~( 21'7
$
656.58
4,101.49
54.38
8.00
54.38
54.38
11,197.50
191. 24
55.02
54.38
10,683.46
54.38
54.38
39,601. 20
55.02
206.40
54.38
54.38
238.01
54.38
55.02
281. 89
9,000.00
693.28
52.57
7~:628:~8
1,990.01
282.00
522.50
9.00
740.00
1- 2-81
1-26-81
2- 2-81
3- 2-81
5- 1-81
5-22-81
7- 1-81
9- 9-81
10-12-81
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l.AW O,"IC:~.
JON F. t..AFAYER
517 TIUftO IITl'lU:T
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ISarrue1 P. Hepford - Re:illbursement for costs advanced
\' Register of Wills - Letters & Certificates
John G. Hepford - Reinburserrent for costs advanced
\Richardson Funeral HOll'e - teath certificates
Col!\111lrlity PhysicianS - Professional Services
\IProfessiona1 Pharmacy - Prescriptions
I'llie patriot-News Co. - Legal Advertising
I Cunber1and Law Journal - Legal Advertising
\Register of Hills _ paytrent on account of PA Inheritance Tax
John G. Hepford _ Reinburserrent for payrrent of real estate taxes on
I Salt Road lot
I\LoucaS c. Tzanis, M. D., P. C. - Professional Services
Brachendorf ~ria1s - Marker
Register of Wills - Filing Fees
\ Register of Wills _ Balance of PA Inheritance Tax due
I Jon F. LaFaver - Legal Fee
I Register of Wills - Filing Account
I"""''''''' of: - Filing Re1~'~
RECAPITUIATION
Total Debits
Total Credits
Balance for Distribution - Cash:
$ 77,566.10
12,749.05
$ 64,817.05
Balance for Distribution - In Kind:
262 shares CCNB Corporation ColImJl1 stock
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Hr.WCUMIlC'U....ND,PA.
lIil.~ .HJe, 1M 218
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$ 25.00
38.00
40.00
12.00
7.82
13.32
22.50
18.00
4,200.00
6.18
7.00
235 . 00
9.00
120. 79
4,325.93
75.00
50.00
$ 12,749.05