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HomeMy WebLinkAbout81-00034 ,'." 'd4 M .... 0 ~ ~ ... lU r-l . ... 0 eft Z LI.I OATH Qt' 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 smith who, being duly sworn , does depose and say that as Executor of the last Will and Testament of Lucy Ellen Walters deceased he 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 Tranrl:.(. In~eritanees. ~wor ~ j"d sl~bScLi.b(e Jd befo~e2e. January 14 A.D., 19~' I C-tCv., Ld )./._k<<t-.",Y -..ry7f/U>i..~- // -:J . ,'/ d:- . ~~~ Register ,.,; .-l' 'lIl ,ol l%l :~ I""'lr :'" ='::l u.. vi "", c:: ~ CD' 0 e-.: #1 .-4, ..;: ..!oil \0, <:j'I .".. .-l, "'" -1 -; 0 '" z, 0 >t} l'I: i:Q I' -1 01: - ..., .-l: .-4: - ,. Ill: .~ ~l CD: - .-4, ~ ::I, I' 3: 01; d: ,.... .-l: ~ Ill; ftl: 1'1, :><, .~ ~\ CO u: ..:l 0\' ;:>: '" . 0 .-4' ''Cl 0\: N .... 1"-, Z 0 " #, ~ '" 11 .... '" ..:l bD 0 ~ .- ~ .~ tIl r... Z r.1 ol DECREE Be it ,~emembered that on the 16th day of January 31 ,A.D.,19_, there was probated and recorded the last Will and Testament of Lucy Ellen Walters late of East Pennsboro To',mship. , Cumberland County, Pennsylvania, Deceased. Letters Testamentary were granted to Witness my hand and official seal the day and year aforesaid. J01111 Smith 0;~.ry ('/ ~ IN RE: ESTATE OF LUCY ELLEN WALTERS, DECEASED, LATE OF EAST PENNSBORO TOWNSHIP IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. ,,:J/ - ,r; 0, 3'1 RE: CONFIRMATION OF ACCOUNT SET ASIDE; EXCEPTANT GIVEN FIVE DAYS TO FILE FORMAL EXCEPTIONS ORDER OF COURT AND NOW, May 4, 1982, at 10:09 A.M., it appearing that Mabel Bolden was in court this morning with the intention of filing exceptions to the First and Final Account and Statement of Proposed Distribution in the Estate of Lucy Ellen Walters, and having failed to make her presence known until after an order was entered confirming the accounting and directing distribution, That order is vacated and the confirmation set aside, and the said Mabel Bolden to be given a period of five (5) days within which to file formal exceptions. By the Court, ,J. William C. Dissinger, Esquire Samuel L, Andes, Esquire :jml " P' n' .,,' I" t'Sr-!!, .;.v,;._:~ ,I,I,~ J.<J COMMONWEALTH OF PENNSYLVANIA , COUNTY OF ~MIf ss Before me a Notary Public in and for said County and state, personally appeared JOHN WILLARD SMI~R who being duly sworn according to law, deposes and :;says that the facts set forth herein are true and correct to the best of his ,. knowledge, information and belief. (' \ -'t/ ( -' \J Sworn to andsubscribed ,." : I<efor9 me this J2ii.day ,_(',\~t S'M':/b~LttUf ' 1982. : J~ /'&~::': ;"iP~1o.. '. ;\iZ;?"'>:!)f;::l!~flftIu~/.I.~f ....'....l.. _ .r... 'M' !i~~~ .,' , " " . (" ;-- 1 ':":.... i ,\' '.~ ~', ' ,.' " ' I " I ).~,(".. . . " , "..,....,' 1,\! \,;:;~:'I~:i~..iG.\ I':, ;..;:~ ,;;:;;, i~. ;:j.:J i I Member, Pcnnsi'!v:miil ,6.~S:J(::i:4~lIj of i~"!.~li~~ Smith ,I 1. il DISSINGER & DISSINGER "TTORNEVS AT LAW 400 SOUTH STATE ROAD i' MA,nYSV1LLE, PA 17053:! TEL. 717 957.3474 i, i b'=C~': jJjU r.!,Cr J.;~B I I, I I i ) , ;; I: " " " .. I. it . .' :! : , II :k ,g , '~>.;, ....,. . i'(\I.- . /,'. j,) 'I' \ '~ I I II !\ LA~T UILI, fJ!D 'i:~S-rj,.;:.:i'r q " II \: I, " " " II II :1 i\ , i\ ColOtp HU1, cu;!\b~rlll.nd County, pon:'\Gyl'J:\ll1,,., ,,,bIG or: nOllnd r.nd d1ol'on1nB ll1r.d, , ii C01lory e.nd ut\t\orot.,:U:l<l1l1i.l, do t::lko IJ'-1blloh ll:-.d dcnl!\::o 1.:11(\ to bo Il'J Lnllt \ln1 \ ! I' and TOl;U1:l0nt, hOJ."Oby rovd(loe; !loll \11113 ad. cod1cllo horetofore JP,ll.(\0 by 110, , , 07 LUCY ELWI \11.1,'4;';'.:1 ITi>:)! I, I d1reot thll.t Illl tlY dobtn P,l;o' !:Imom exponaoD, 1n~lud- 1ng JJY cOlilOtory lot IIond gra.ycr.lt\1'kor IIond all olql,mCOQ of lAY lnat UlnoD', shall bo pa1d frOG IlY rea1dcnry "!ltate 0.6 floon ll.8 practlcll.ble ll.ftor ay dea.Ul e.u part. of tho oxpenso of tho w1n1otl:6t1on of IlY O!ltnte, ITEM U, I dovis" llond boqUIla.th 'i!lY watch and e.ll 81 jOllolry to Leady Wentz (Krs, wUl1atl WlllltZ) of l:llola, PGII/l/Jylvan1e., Ii i; lTEl4 III, All thll ro8't, roll1duo ILlld rorr.o.1ndor of Jr! eD~to.3hall .:: be oold MIl tho procoodo dividod cqu;~lly jx,tllll0n John Sn1th of R, D, 1, " I ~, i: Box 1911., 1".a.ryl3v111o, PGnnsylVllon1e.l Donn1B Doldon of 16 Mc.r~l !load, Brookside , llallll.rlt, Delavnrol Il.lld Pogr;)' SJdth.of !l, D. 1, Box 191A, }1R.ryGvillll, Ponnsy1- " " " va.n1&, eiUlX'e Md eh&ru aUke, ti , 'i " ITEM IV, For ronnonl3 I anro not to di!lclooo, I ohoosO to 10ave . noth1ng to 8:J d&uj7,htor tlable Dolden of Martal Road, Brooluddo, Nawarlt; DOlallAX'<l, !: I'tr:lI V, I d1roc t tho. <~ o.ny nnd ,,11 I nherl V.nco, E& ta to and ;1 I. , T~nsfcr 1:.I1.'JC00 1npo2od upo, 'A:./ ootato pa.lslns un::lor 'IlY W1.11 or othor>l1se, be pl.l.1li out or tho prlnc1po.l or flY I'\'Jl.IldUl\l""1 oatl\to, I I I 1- :" x. ,\I h I \ /, \ I' Il DlSI-;I:-':U I<':I~ .\: DISSI ;\;(lJ<':I~ ~'TlOf~NEYS AT LAW 400 SOU Ol 51 ATE ROAD MAflYSVILLf:. r'f:NN5YLVANIA 170~3 MARY A. E'ITER DISSINGER WILLIAM CHESTER Dl.ssrr~GER c ~ 0' February 1&, 1982 :)H,C~ 717D57.3474 717 9~7.2nS RESIOtl'lCr; 71', D!57.2C7t'; IN REPLY REFER TO FIL.E NO. 79-258 f.lr. John Hillard Smith R.D. 1, Pox 191~ 1'~rysvi11e. Pennsy1vonia 17053 Dear Mr. Smith: 'I'his is to advise YO" that ,Tohn l'iil1ard Smith, "Y.ecutor under the will of V.Jcy Ellon ;-.1alters, rler:0i\Se..l, (later1 f)cto'b(~r 1, 1979, has filed the first an'.l final account of his administration of the saB decedent's estate in the Office of the Register of Hills of Cumberland County, Per.nsy1vania. The account will be cal1.0(1 for auo1it before the Honorable ,Ju,lge S!lUgart, on :':ay 4, 1982, at 9:3IJ ~.r,:. in Courtroom 110. 1, CUmher1anu County Courthouse, Carlisle, Dennsy1v,lnia. 1\ copy of the account will be furnisher' on request. This notice if; G!mt to you uS i'.n intf'!rester:-: party I in accordance with the Rules ()f Court. The Fxecutor .:t.ckno"'le\~ges your interestr; in the estate, compri~;ing (}~ one tbir~1 of the residuary bcqlle~!tlle,..l to you in Clause II of the Jocedent' s will. ,~t the a.tldi t the Court will 00 adv incu that said interests are recoginized l:'j' the F'::~~Cl..ltor ann thrlt awards Ghould be entered acc:"l:"din'Jly. You are not required to uppcJ.r at the audit. !~O\olcvcr, if you do not appear in person or by cOllnsel, the r.onrt ,,'ill assume that you agree with the accounting an<1 the distribution prol'osed by the a.ccount- ants. f.;incerG,ly YOllrE:, William C. Dissinger I'ICD:pS I?> -).. I)IHHI:-';UI":I~;" I)IH...q:-';UI'~I~ ATTOHNF-Y5 AT l.AW 400 SOUIII ~T^lE flOAO MAHYSVILLI:. PtNr~SYLVAt~I^ 17053 February lG, l'i32 'j" I'.:~ 71'! P!l7.3474 MARY A. ETTER DISSINGER WILLIAM CHESTER OISSINGr,R ~ l1D ~ o :'17 9~7.2.77A RE910Et,Ct: 7 I 7 ~~7.2r.,t. IN RfPLY REFER TO 79-2'jR FILE NO._______ Hr. Denis Bolden 110 patter horn Drive Fox Chase llewark, Delaware 19713 Dear 11r. Bolden: ~'his is to advise you that John Hillard Smith, 8xecutor under the will of Lucy Ellen ~';iJltarfi, cJeceaFied, <Jated. OctobE:r 1, 197'), has filec1 the first ani! fini\l ilccount of i1is aclministration of the uair] decedent's estate in the Office of the rO'Jister of ':'ills of Cumberland County, Pennsylvaniil. The account .....ill be calle., for iludit before the Honorable Judge Shugart, on Hay 4, 1'382, at 9::10 ;'..r-~. in Courtr.oom No.1, Cumber1anrl County Co',rthouse. r.arlis1e. Pennsylvania. i\ copy of the account will 1:0 furnished on '''''1'lest. This notice is sent to you tHi an intc'!::'csted party, in accorrlanc::c with tho Rules of r.ourt. 'l'he l?xccutor acknowlenqes your interests in the cstat~, comprising of one thirrl of tho residuary bequP.:ilthe.~1 to you .in Clt\use II of the decedent 1 s \'rill. At the au(lit t.he Court \01111 be ofI.,lvise(l that said interests are recoginizec by the P.xccutor. ~nd that awards should be entered accordingly. You are not required to a!!pear at the .."\u~it. HO\\TeVer, if you do not appear in person or by counnal, the Court will aSS\1m~ that you agree with the accountir,g ann the distrihlltion propose<1 hy the account- ants... Sincerely yonrs, ~,-alliarn C'. Di.ssinger t-:CD:ps ~-3 I)II-;....;(:--;U 1~1~ ,,\: 1l1~,'.;I:--;U I':I~ ATTORNEYS AT LAW 400 SQLJrtt ~rA1E ROAD t.,lMO'.,VI1.Lf r'FttN~~YLVANIA 17053 MARY A t: 1 rr.R OI!:"!:iINul:;;R WILLt.\M (;HE5TfR Dr5~U~GER 7abrtlary l~, lJ;~: 11" ~\!.'1':Hn4 ',n ~~7.;;:77a 'H<;ltJE:~;Ct 717 9~7.2C7G ~ o IN REPLY REFER TO FILE NO --l=-n~'- iX:J. '.'Ubll ~-Qlrfc-n 19 N.:'\rtall ~'.O.\': T!roo;;:rdr:,c, r,'c.wi,rk. ~).o::la.\mr.l 11';71 J l~ear ~r~. ~ol~~~: ';'r.lz iu b"l :l';vi~:f. 1",1'.: tlu.... ~'):-1i1 "1.1 l..:;r I ;~:~"~t.i!, :':::C:;"~~C'1.4 ludur tr.a ','ill o~ !' '.!t:y ':] l::-n . ',11 t:t~,~:!J, ,1',,!(:I)!!:'>t~ 'f ~ 'i;":t.~;~')Ct,")"<'l" )., 1~7q, La.b' file.] the firDt t~n.: (inn1 Jaccnnt or :,1:3 ;,\:';;:d.nir..ltl':.~.i\..'m of ~;J,(1 awill (locC:'.ir...nt't. estlJ.tc i:-: thl.i: ':'fficu ',Jt tho.:! \t.'<:;,iutcr 0:..,:111:.' o:Z Cur.l~'f!rlcll\"! '~ol;nt:y, P+:'-H!ltiylv;'l.!li:... .~ :','~''';:sCJ~:..t 'Id 11 ~.~Q ~'.:tllt':':l~ :~r):- .?\u'lit bofore thl! rQncrnt,l~) ":u'I~(: ;::},'l:./:;,rt., 0::;;:: ~~.:'lJ. J., 1~+3'::, ,~~. '; 3(: "'" i.'.. irl ~~f.)t1rtroO:!1 "10. 1, Sl.t~b~,l.anl', :(';'-.In-':'~' r:'Jl'!.rt.LOt.~t~, ::.:.rl1~1t!', PrH1n$yl\'lUli~. .\ copy of the ;Jccount .l!ll :.:n :"urolnJlc: on rt"1.p.II.\8t. :!,d.~~ notiL'':': .i.~, ~;U~.~. tc y~~' ;:";;', ,",I. lU'J.ai, Ct',; .i;LLor \oIho hag; oC.'iV1h..,l ...lith t::.Q r:~OL1tc:;S, t"'~:,ti\tc~ ,T~r.J rL~'.,;.cinric~ -:ch.~ (:'I; 11)72, li'JQ4. .~tt:: -~<,'"Ci.;~/,: "':--:~.','l'.;j,.~ .'.:,..:..; r~:::Li~'';' C:' i'....'Jr ,=:.!.,::L, i;'1 ~~)(; i:\'t,ount. \'"If :)11,9:0.(.:-;, ,......\:: :,:':Idl'~; ::'lti .;..(!.t~'I;nti':l~j l:.i ;"'l~;t ..~I:.. 1:'1 lil..... .\t Budi t t;,~ .~r.~'Jr1: Hi 11. ~:'\.~ ""i.; j.vi.~.~:: t:Mj.J t". 31h~ ,,:l:at t~Cl\ \::~I:~t:;l;tJ;l.' ~'!:d.l": ;;:"3 c1i-:j,.... :~,1!. 1 :::!..;:, J.."j ;..::';; J"1()t !.l(~O:'n pp.i:1 ;\~ t.;;~tX';:1!' ,:~': r::j'.:JT~l< ;"'(.;; (m,toru~1 &CC()r.~1 i~1';::, .. 'icJU Q J~L,;: ,..,ot. t c;au1Y'I,r t'7i i'~l.il;~',.I~ t~:: ::~.a :\T~:' ~~. : :0'..]0'V'0:: lit J"Ol; ~o not ~r,.....~ar in l_ur~10h 'JJ: '~. ..::oni1::.t:l, ;-.i\;J l'Oilr-::' '.'1,1.1 i1!HJ\]::1C th.:J.t yuu 3iJr',Ht \r.'ith trJC :JcCl..lu~(ti:};.: i'l~d ;~':'t:f:r1-;-''.1".:.ior: :',t'0[,O!iC,: ~~j,' t:lli I~t:col~nt.jnt:.s. -/11"\' ': cuI i' i'I~~1.l r::: ~ ','1111,,,,, ....ls::!iinc:cr. Hcr;lp~ cc; SQ"'u~:!. "~'Jlt;le~, :,:s'l'lil:'e c .... -J , , - Proof of Publication of Notite in The Patriot and The Evening News and The Sunday Patriot-News Under Act No. 381, 1\[lJlfO"OO Mn,' 16. 1029. Commonwea, Uk of PennsJllvania, } COllntll of Dauphin ,,": James A, Shoon b' d I I' t I d d' ...................................,....[;...........................,....,................. ClOg u y sworn aeeor, 109 0 aw, eposes sn says. That he is theHe.t.,lIQ.Y,.Mr.,l:,~f THE PATRIOT - NEWS CO., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harri,burg, County of Dauphin, State of Pennsylvania, owner and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT.NEWS newspapers of general circulation, printed and pnblished at 812 to 818 Market Street, in the City, County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT. NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th, 1D49, respeetively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and bl' h d' th' I }letro \\Ie;lt h' h d th 1rd 10th and 17th dny pu IS e 10 elr regu ar ridltlOns and Issues W Ie appeare on e ....rl'......................f.....,...................... ,o.f...F..ehr.ull.r.y...,1.Sl$l.....................................,.....................................................................,......,...............,........., That neither he nor said Company is interested in the subject matter of said printed notice or adver. tising, and that all of the allegations of this statement as to the time, place and eharaeter of publieation are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolu- tion unanimously passed and adopted severally by the stoekholders and board of directors of the said Company and subsequently duly recorded in the offiee for the Recording of Deeds in and for said Count)' of Dauphin in Miscellaneous Book "M". Volume I-I. Page 317, ' . Copy of Notice or Publication .................,........,.. .. 'I..'<tI~.../j.J:.~.. ,i..........;"Co:: ..........., Sworn to sUbs~n d fore me IS ..., . e ..day of " EST~TE,~OTICE' , F.!':,~!.:~~.r..{' . . 1981 a2~' / ~', 'th . Letters .,Test.mentary, In the Estate'.ofLUCV,lmen-WaUer$. ................. '# ",.. ':.S" ''>1'!,' ,,; ,.' 'er;1 ....~ late:'of,IEast.pennsboro,Town' HAR S8U~l;, Dt.UJ ."R~ , ;"ublUt shlp,'CumberlandCounty, pcnn. I ,iVlvanla,;havlng been granled to M'" MY COMMISSION E,XPiHfS 'G, 5. 1984 the~"'rJdel1:lg'ned.a,Uperson' In. y CommISSiOn expIres ....'t....H...........I..~...... ......{.. lIibrecpto'sald :e,tateare reo Menloer, rl::nnsylvaQIJ fI'i;;Jl allOll 0 r~O!tHleJ I'qlintt!:ttom.kelmmedr.lepay. S f Ad . · 'e..... ( l~il~WM)m';~;~~u~I~:'ri: fatement 0 vertlslng osls ! "JohnWlIIllrd_Smllh',,'. . Box."IA :..~-,r~,,;. Marys.vllle, Pennsylvenle 11053 'ortolleretlor.l'leYl , WlIIlamC. Dissinger, Esquire 201 Maple AvelJue,' Suite I.B Marysvllle,Pennsvlvanla 17054 ....J!.;i"~~.tI}E~r.,,~,,,p.J.~,:?,~!.l.;;:.:.E'........,....,............... ..HR.r'y'.i,J.Y,i..!J.\l.,...,f.!i!.!m~.y'.+.y.?'.1} :+.?.J.7.9.2} To THE PATRIOT.NEWS CO., Dr. For publishing the notice or publication attached hereto on the 20,01 above stated dates. $........"".............,.. Probating same $...............7.5........ Total $........?Q,,1!?..,.... Publisher's Receipt ,for Advertising Costs THE PATRIOT-NEWS CO., publisher of THE PATRIOT and THE EVENING NEWS and the SUNDA Y PATRIOT.NEWS, newspapers of general cireulation, hereby aeknowledge rceeipt of the aforesaid notiee and publieation costs and certifies that the same have been duly paid. THE PATRIOT.NEWS CO. By ",,,,..,,,,,..,..,,,,,,,..,,..,...,,,,,,,,.......,,,,..,......,,..,,..,.........,,,, J) ~-) 05 ':.::i-;.. ",'" ", i.,.{tI ,.. ~;2g ." q:O ~ ;':"J l,iCl '" <,'::1' . , , 'c, t) " '" ::: ..., s.' ~ .- " ~ ~ CJ :;... " ~ - C S @ ~ '.~ ~ .. ~ " ~ 0 ,', c- c' " ,~ ~D :) " 0 "l:l 2. - i_. >-< ..c:: ~ '" -l:Q ,,', ", 'J 'J - [l: " Ul ~. gJ Ul " -~ ~ " g .n 2 W 0 ~ G " ~ ~ .; -, :;" ", ., ~(~ " [!J o ~ m Ol ,S ." ., .' oJ z < ~ '" '" ;:.: ~ ; " ~ ., "" c ~ ~ z ~ ~ .. on " lD ~ ~ i ~ E-< 0 => ~ c " .... S " 5 . Z N oS " " lD " w ~ ~ ~ H " ~: " " ~ Z E-< >-< " -' ~ u ~ B m ~ ci " ';:: u 0 ~ Ol r>. p '" " r:"-J " d > ~ - 1\') ...: 0 l:Q P f) .~ ~:~ ,- m Ul m . U ~ ~ H H ..c:: ;::: :.;: '" III > z Ol ~ E-< ~ ~ t~ .- " W I Z C r>. 13 '~ Z E-< "" ~ ~ 0, ~' ) S ~') '0 " ...> [l: z ~ w . 0 tl ~ ~ ~ Ul " ~ u :- . ~ a "' r; .: >-< ';:: W c ~ 8 \\) H 0 t~ " ~ ~ c . !il ...: :3 >< Ol Q '" --;; .. ~ ~ ~. ~ '" ;:; [!J ~ lJJ " .~ M H H Ul E-< c s~ " ~~ " E 0'.:1 ~ 5 Q~ I Z ~ Q >-< c' r..' " Z . 0.- <J C " " ..J 0 ;; " ~ .z Ol U ljl .- " " m U ~~ Q Ol Ul Ul ~ u ~:~ " 0 ~ lD .. m ~ ',' - ~ Ol '" 0 0 " >-< ~"J ,s ... en lD > Ol ~ Ul ~ -" '" I '" '6 . j;; i Ul ...: - "~1 ..::; c' "" 0 < " .. ..c:: 'd j I ~ tl " 2 i": c ,^ U ',- '" . '" '" r: s: r. " u ... :.., z Ol 0 Ul [:j i'; " " " " 0 ... ~ HU '" Z Ol ,. Jl (; " ,~ c " ~ " ... '. 2 11 0 8 ';:: :. .. CJ ,"" "" u .c r ~ " ..c:: ~ :) '" / . . : . '. DISSINGER & DISSINGER ATTORN(':VS AT LAW 400 SOUTH STAn: AO,lD MAnYSVILLE. PA 170~3 Ttl-. 717957.3474 i COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. Estate of LUCY ELLEN WALTERS, Deceased Late of East pennsboro Township FIRST AND FINAL ACCOUNT OF JOHN WILLARD SMITH, EXECUTOR i: Date of Death: December 10, 1980 ':Letters Granted: January 16, 1981 First Complete Advertisement of Grant of Letters: February 3, 1981 ,Account stated to February 10, 1982 SUMMARY AND INDEX PRINCIPAL i; Pages 1 $40,238.95 1 -0- 1 $40,238.95 1 7.844.39 $32,394.56 2 -0- 2 2 -0- 32,394.56 Receipts Net Gain or Loss on Conversion ,Adjusted Balance Less Disbursements ,Balance before Distributions Distribution to Beneficiaries Investments Capital Changes ,principal Balance Remainin'J/' l- INCOME , Receipts Less Disbursements 'Balance before Distributions Distribution to Beneficiaries Income Balance Remaining 2 2 $ 2,329.95 -0- _ 2,329.95 -0- COMBINED BALANCE REMAINING $ 2,329.95 34,724.51 34,724.51 J''-'" 1";1 bGC!:,J::; pm 0 t.:i:J " ,i . ", fRINCIPAL RECEIPTS ': Inventory Filed :' 10/14/81 Per Copy of Inventory Attached (Exhibit n An) $40,238.95 Adjustments to Account Values NONE i: Subsequent Receipts Ii NONE I! , !! , " 2/25/81 2/25/81 2/25/81 2/25/81 2/25/81 DISSINGER & DISSINGER i ATTORNEVS AT LAW .400 SOUTll STAn: ROAn; MAI\YSVILLE. PA 170!S3 2/25/81 6/ ,2/81 6/ 2/81 TEL. 717 9!57.3474 6/ 2/81 6/ 2/81 6/ 2/81 10/30/81 2/ /82 2/ /82 TOTAL PRINCIPAL RECEIPTS $40,238.95 PRINCIPAL CONVERSIONS INTO CASH NONE i , I , I ! , , , I $ 20.76 i I 18.00 I 1,947.85 I, I' , 35.00 I J , ! 537.95 , I 6.33 , , 30.00 i I I 25.00 I 2,011.95 I I 3,167.06 I , I 5.00 I 20.00 I 88.00 I , 19.49 I , , 7,844.39 I PRINCIPAL DISBURSEMENTS Patriot News, Ad. of Grant of letters Cumberland County Law Journal, Ad. of Grant of Letters Ronald C. L. Smith Funeral Home, Burial & Funeral John W. Smith, Reimbursement for Costs of Probate and Letters Blue Ridge Haven West, Nursing home care for decedent Professional Pharmacy, Medication for decedent Anthony Yannone, Appraisal of Jewelry Dissinger & Dissinger, Reimbursement for costs advanced Dissinger & Dissinger, Attorney Fee Register of Wills, Inheritance Tax Register of Wills, Cost of Filing Inheritance Tax return Rice Memorial Works, Headstone ingraving Register of Wills, Cost of filing First and Final Account & Distribution Register of Wills, Inheritance Tax TOTAL PRINCIPAL DISBURSEMENTS f Or" l' f'!) P " j "0 ,'U;\ .,:";v .\(,[ ,<) -2- . COMMONWEALTH OF PENNSYLVANIA I, COUNTY OF CUMBERLAND J IS: W g~-::tL _19 g/ ../ Exocu'or . Administrator /7 i{"-:11 '( Date 01 Death 10 Day 1?- Month lQBO Vur INSTRUCTIONS I, An inventory must be filed within three months after appointment of personal representative, 2, A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be altached as to personalty or realty 4, See Article IV, Fiduciaries Act of 1949. " -d >- w .. ~ ~ ~ !;( '" w .. 0. ... U .. 0 III .. 0 w w C '" ~ '" I- :r: 0. ..J L1. .0 0. ... Z L1. ..J <( 0 ) 0. W 0 <( w , ,,:. > Z ~ ~. , . Z 0 c C ~ III Z tl 0 ~ Z w <( .... 0. ." c . '" - -.: 0 .. oS> ." "" .. E . ..! 0 '" ~ 0 ..J U u: .. :', cO ,'- ",'" ~~~~:-,~ ,,' ","" (;,n " _,.0 , f):~1 ..,., Jr'" ':J ..,-, :,j :,.,: f , " '" " - ~ , 2 ~ .: ~ r: ~ "0'0'0) 0 " '" n " 0 eJ C)'U.r; ~ .., :!! ,5 " ~ gJ E lJl r~ ... ,", ~ :.;.: ,9- ~ ~ ~ l'l ... ~,t >. ] '" ::; " III ~ t +. r) lilUJ " C i,J ....J 0 ... " W 0 .!':J "' :;:: " U U ... l!l m " u t- o " ' 5 . " ... ....., '" '" '" a! c m ~';'I U , 'i) ~ gi " 'p, () .n ';j te. " Z < ~ t- :;c 0 0 " 0 .;3 ", () C ~ t- ; ~'1 ~ - C ~ (0. " 3 ~ . ).< c '.= U H "" ." .~ ... 1II ~ ~ Ii ~ Z 0 0, OJ U '" ~ .' .' ~.: 8 n < z I- o " 0 ;; ~ " ~". ~ 1II " w ~ e ~ ~ .Q o~ '" Ul 0 ~j j~ '" '.:J ~ ~ u., g III o ~" c..c () " 0 " 0 ~ ~ III "" Il< " l..:" :;] Bl '" " U ,,' ... > ~ ~. 1';' ~ .< " " 0:, '" " " E " ~ ;.. c: "" III UJ III 0: i ~i " z '" .~ " ~ r1l ~ z d cr.~ t11" ~~'~ ~ 0 ';; :: ... ~ c tl Il< H ~ .' " d z c: " .::= z ~ :c.:... boi c " 0 " ~ ,; 0 :;:: .., :.!4 ~ " W ~ '" B ;J ~;j 0: .. t- o , c-..; l'J L :- H c: ~ .. .., .. "'- W c ~ 'f"""i H III 'i>-~'t~ ~ :3: CJ 0 c'j on ... ~ C UJ tJ ~ ~ .. p: .~ "" " ~ r:: " 0 ~ l!l ~ M ... '" ~~u , ~ g .~ .8 :>. "t,) 0 .. Z 0 " l- i ::..: .. CJ CJ ~ " ~ '" !:5 0 '" ..0:: r:: " ',0 ... ~ 0 ;; g CO Oe:! " ... - u '0 ~... "' 0 ::0 ~ .~ " .. " :-, .S ~ III C, " . " " " 1II V III ~ C:', 1;lS >< ~ " III 0 I "" ~ III ......:1 gJ to U ~ 44 " .., l,.:':.. " 1II > Ul ;J .. '" " () i., ':j , " ~ ~ .. " " ~.o c _ 0 H [') >< " f.:. ~.; .. tJ " ---..-> 0: ltl._ ~ () ~ ;~ 0 0 < 5 '" u '" ~ Ol - " ~ ::;: [') If III " ~ >> ej {.) :') '..' S ... u 0 '" 0 l'.:: .!.< .' " ';:i '0; ....J .' " ' 1:: <, ~.. .~. u "" "" " t:i ~~ ,< :-... . .. . ,>. 0 " ',-.., <J " () " U ,- " CJ ;0 U t1 u CJ :Q e < c, 0 ~ " ., :: 4., ,u " .~ " , . ;.::: " - .. QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of dealh, make any transfer of any material part of his estate without receivinp, valuable and adequate consideration? (Answer "Yes" or "No".) NO 2, Did decedent, within two years of death, transfer property from himself! herself to himself!herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ~ 3, If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: 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 heallh 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" ,) b. What was the transferee's age at time of decedent's death? 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".) ~ b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) NO 6, If the answer to five b, above is "Yes," was the right reserved in decedent alone ( ) or decedent and others ( ). 7. Did decedent in hiS/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) NO 8. Did decedent, at any time, transfer property, the bElleficial 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? (Answer "Yes" or "No" ,) NO 9, 11 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 decedimt and others ( ). nEV-453 EX-t (10-801 COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES ~, ~' " . ' ;~,.~.il~~~~P.!':'.t. "J,~l~:_.., (Instructions on Reverse Side) Estate of Lucy Ellen walters BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH ell Leadv Wentz , Eno1a. PA Step dauahter x Jewe1rv-$1,OOO.OO (21 John Willard Smith Grandson x one-third R.D. 1, Box 191-A Marysville, FA (3\ Pennv Smith Granddaughter- x one-third R.D. 1 Box 191-A in-law of residuary Marvsville PA (41 n"'nn' ~ Bolden Grandson x one-third 11 n Pa ttorhorn Orive . of residuary ",'" ('''.~e Newark, Delaware 1 "71' ----_.--_.._---~- - The above beneficiaries were living at the time of the decedent's death except for the following: NAME DATE OF DEATH If additional space is necessary I use 8%-" x 11" sheets. REV.454 (1-80) COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX R ESIOENT OECEDENT SCHEDULE "E" JOINTI, V OWNED PROPERTY (lm;tructiol1S on Rl.'ver.m Sic/e) Estate of Lucy Ellen Walters P TOT AL E VALUE OF DEPARTMENT ITEM R DESCRIPTION MARKET C DECEDENT'S VALUATION NO. VALUE E INTEREST IOfficial Use Only} N T NONE TOTAL THIS PAGE /I~~ ~ /fl INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship, Soth tangible and intangible property are to be included. List real estate first. 1, Describe all real propertY as indicated in the instructions for Schedule "A", Describe all personal propertY as indicated in the instructions for Schedule "S", Include the name, address and relationship to the decedent of the co'owner (si and the date the joint ownership was established, 2. Indicate the total markel 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. r '" 0 n >- M ;.. :s z >- 0 0 0 t/l " C'l n c: " -1 Z ... Z t'" M M 7: Z >- ~ - ~ t'" ;7.l Z z Z M .., M -1 ~ ~ '"' ><: t/l M - t/l Z 0 ! .'fO 0 .., ~-. . 0 ." .0 ." ;l:l ~ - 0 I ~ 0 '" 5: 3 ~ ." ., :i~.i (5 .." ""'" n 00 c:i Cl:' ~' c: 0 Z - w' : ;:::_J fr 'I-" ... >- 0;- . c:.: C'~-j 'I-' f1 t'" 0: VI m r 0- co I eJ c: u'" ~;:r. " I", III t/l WW n..~ I-' Ig M ",'" ~ ~u OJ \X:l ,..> ::l 1m 0 0. l::l Z i::l 1;0 t'" I-'~ ~ ><: ><: -< ~ -J I-' <0 M M 010::::;: m ;.. >- I-'OJm f ;:0 ;0 I-',::l en:I: II-" rt OJ IOJ I~ . REV-SI8 FO (7.80) .~ ~~~ COMMONWEALTH OF PENNSYLVANIA CEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS NOTICE OF FILING OF APPRAISEMENT Dear Mr. Smith: Mr. John Smith R.D. 1, Box 191-A Marysvi11e, PA 17053 RE: Estate of County of File No. LlI("Y Rll p.n W;:!1 tpl",q Cumberland 21-81-0034 You ore hereby notified that the Or; g; nol appraisement in the estate of Lucv Ellen Walters has been filed in the office of the Register of Wills of Cumberland County an January 27 , 19..,g. Said appraisement reflects the following valuotions: Real Estate Personol Property Jo in tl y Owned Transfers Total NONE $40,21R,q~ NONE NONE $40,238.95 As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rote of six (6%) percent per annum is charged. ,Any party in interest who is aggrieved by this notice may object 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 tJ/lz7/i'~ I I Sign~ ..--i;L)d~ Title NOTE: This is not a bill. Chief Appraiser REV.4U EX+ (MO) INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) o Original o Supplemental o Remainder File Number 21-81-0034 Estate Name Lucv Ellen Walters Date of Death December 10, 1980 Social Security Number -ill-16-8645 REPORT OF INHERITANCE TAX APPRAISER I, tho undo..ignod duly appalntod Inhoritanco Tax Appraiser In and far the County of Pennsylvania, do respectfully report that I have app,'aised the real and personal property os reported in the foregoing retum at the values set forth opposite each item In the last column to the right in 5che les "A", liB", "C", and "E" Dated: r)f'.z.?/% 2. . ~ ' .'~ INHE TANCE TAX APP. ISER ADJUSTMENTS REMAINDER APPRAISEMENT CODE INVENTORY VA~UE AS APPRAISED CODE (HARRISBURG USE aN~Y) Rool Proporty (Schodulo A) $ NONE Da+ 92+ Personal Property (Schedule B) 40 238. 95 10+ Jolnt.Hold Proporty (Schedulo E) 0 2ll+ Transfer. (Schedule C) NONE 30+ TOTA~ GROSS ASSETS 40 238. 95 Leu D.bts and Deductions 40. 93. (SCHEDU~E F) CLEAR VA~UE OF ESTATE o Life Estale !!!ll FACTOR PRINCIPLE VA~UE CODE o Annuity Ell1l USE OF REGISTER ON~ Y !;Qll COMPUTATION OF TAX $ $ $ $ Tax on $ 6% Tax on $ 15% Tax on $ Tax on $ Tax on $ $ Exemptions Total Estate TOTAl. TAX INTEREST FROM BA~ANCE $ $ $ TO Less Credits DATE OF PAYMENT INTEREST DISCOUNT + $ AMOUNT PAID TAX CREDIT $ = $ $ + = INTEREST FROM BA~ANCE DUE BA~ANCE TO $ , . ... <Il aJ :0< '" aJ > '" :z= .. Ol'\ aJ .... ..... ~ ~ ~ 0 ::; <Il 'tl l-< 'M .... Z I.tl I.tl aJ l'4 ... " :>< :>< ..... aJ I.tl ~ " <<: ..... P< CIl "" , ;:> '" '" i ..:i '" ..... '" I ..... ""' ..... '" I <: ..... 0 'M ..... I - 01 CIO :z= l-< i U Z aJ - 0 a ,.a I ~ - u 0 ~ a ..... '" '" ! ~ ~ " .;J ::l ..... CIO 0 H t) t) ..... I ~ ~ ~ ci I ... 0 CIl 0 Z ci CIl I.tl CIl :>< ... ci i .... I.tl !-< I.tl Z Z Z !-< I ..:i ci - ci is ~ 5 ~ I.tl 01 ( ..:i Z ::E z Q U " Z ] ~ ~ 8 0 <: i ~ '" - I I.tl Q ~ ..l I ! , i I I I I I -- ~~~y'f) (1(:1l~1,1 ,~,>~" ~"J.~~' ______.___.._~__~.___.___,..~___* . _ .... -- --A REV.455 (1.80) , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS Estate of Lucy Ellen walters Date of Death December 10, 1980 ___ Fil" No, ~.{J ''li'J',:;''! WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Relationship to Decedent Claimant's Address ITEM DATE NO, 1. 2/25/81 2. 2/25/81 3 . 2/25/81 NAME OF PAVEE REMARKS OLLo<~ n-F T.e..t.t~rg I AMOUNT Patriot Cumberland Co. Law Journal Ronald C. L. Smith Advertisement of Grant '0 "7(:. Advert' Bur ia1 and ;lnt' q47 Rt; 4. 5. Funeral Home 2/25/81 Blue Ridge Haven West 2/25/81 John W. Smith 6. 7. 8. 2/25/81 Professional pharmac 6/ 2/81 Anthon Yannone Cost of Grave Reimbursement for Costs of probate and Grant of Letters Medication 9. 10. William C. Dissin er A raisa1 Reimb r ement fo CQat advanced Attorne 's fee 2<;.nn William C. Dissin er Estimated Additional Adm. Cost I .l= TOTAL THIS PAGE I 1,.!,..!J2_J:4- I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debt/funeral expenses and expenses of administration submitted to the es~at~, as de~uctiOIl\fOr 11l1~erita,ncc Tax purp~,s~s~ ,~ .;' \,0___'-_ ,.)".L a I I, / SlaNATur~E OF A"TonNr:Y/r:IDUc'IAi~Y _h. nr,Tr: OFFICIAL USE ONLY DE8TS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S .1/ t, 11. tl / AT --- (P !!tIt; PERCENT, q7)()-'tf.,l~~. qI?~ GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. if there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the 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. t"' '" 0 n >- t"1 ~ ~ z >- 0 0 0 [JJ C) n c: " ..., Z s: Z t"' t"1 t"1 ;;:: Z ;<l ;>- 0 - 9 t"' Z Z t"1 ..., t"1 ..., z 9 9 ..., -< [JJ t"1 Vi Z 0 [JJ 0 ..., "'r1 ;<l 9 "'r1 ~ ;>- 0 ..., "rI - 0 "rI - Z n ~' - -, >- ", t"' " ;:,::~~ c: c. "0' 'C [JJ Ll' t"1 l.w!;. a...' /;0" 0 Cr:(.I". a 'L,-, 0<:; .~;s Z U"J t;::- ;;; ~a;: - I::':::" -< -< EO -,u ~ u t"1 t"1 >- >- ;<l ;<l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1, If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column, 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid, 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed, 6, Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts, COMMONWEALTH 01' PENNSYLVANIA COUNTY 01' CUMBERLAND l J ss: --.--..---..-------.-. .- .. John Willard smith .,--,-.-- .-..,--. ------..-...---- ____ ..._... __.___,._._ ____.._ .__d" . .------.-.. being duly sworn--. .__ according to law, deposes a"d says that he .,__,is_the....executor--,--- _______,-,-----,.--,..-.....-------_..-' of the Estate of Lucy E. Walters late of ___. E,as.t, pennsborough __._,____, Cumberland County, Pa., deceased and that the within is an inventory made by ...J:ohn_.Willar.d-5mLth..- ,-- -, ------, the said_e~Ut.OX-.- of the entire estate of said decedent, consisting of all the personal prop.,ty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. '1'/ I ;' ~.: 1'//"(<:",1/1/'/ , ,I ~I 'I' ' 19 / / 1-StrQ,^~lJ .~~ , 0- Ex",lo." Adminillrotor / ,<'>>,(/-) ,-( J and subscribed before me, , \'--~'r-c/ Ii I < " . ", f.-I -----:' .' f</ / B TTY J6 JONESJIllII,RlI'URlfC MAnYSVlllE OOliOUGlI, f'ERR\ Cilll;ITY MY COMMISSION [XPIHES JiW 16, 1984 Ml'lllber. P{'nnsVlv~nlil ,4r,~(1(':'!tlr,l~ fJI ~H~"h -----. Addreu Date of Death 10 Day 12 1980 Month Vear INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. n _r ,,-!rn ~;J) ~;;;~ ~~~i ~:~ J . ,,1..'7 05 ",,'" ~ r:'"''ri :-3 :20 ',~J :.0 _.!~ ~ J') .l>o " " ,- ,.~ ' , >- .., " ~ t1l ~ w ~ ~ I- III ~ w 0( ~ ~ !':: 0.. I- t1l u ~ '''; 0 ~ 0 w Vl -I-' 0 '" III ;>00 a:: w " CD l- X 0.. .-l' 0.. III c I- -' u. ~\ ~ '''; ~ ~ Z u. -' 0( 0 0.. 00 UJ 0( w :l: I 0 a:: I ,;. .0( ~ > z ~\ 1 ~ '1\ Z 0 c U 0 . Vl Z 0 0 a:: ~ u e z w 0( ... "- .., '''; c ~ 4 HI - -.: 0 ~ I ..0 .., ... ~ E ~ ~ 0 ~ . 0 -' U u: CD COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF EXAMINATION *' OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT COUNTY FILE NO: . / .' , 'I DATE /"~'} ./. .' /_.v.-:./ I / .' J./.,,;... ,(I, / I .,' " _, / ,"_ I /,- '/ - / I, ,'" ,,'1 ",( / I, ~,,"I- / I ' " I: .' I /A /;-. ./.: c.- I TO: .>1: 1/.' "'.h' ( .. ' ESTATE .. i // . I;....:. , .. ,I '//;,1. FILE NO, , ';:,., I , :'J ; , ~ ~ . L .. , I ,Ill: ",' .>.....!.,?' , , ,/,;" //, F .' DATE OF DEATH ....> /".{- if' < ),,;-j' /;151) I COUNTY , ' ~' Appraised Value 01 Estate: Real Estate $ ..--.--- Personal Property + ,/ ) ,,:':t ,/"} .' Jointly Held Property/Transfers + _._--_.-~_.- Total Gross Estate $ /...// ....,. ...,,/ ,./,) , / ~- Total Approved Deductions ^ .//-, I. /i. ~/, t: Clear Value of Estate $ ".~j ,,'://, / / Less: Approved Charitable Exemptions --~-_.~ --.- Clear Value of Estate Subject to Tax S //; I~,://, // Amount Taxable @ 6% Rate $ -1..'/ , J ./~) tax due Amount Taxable @ 15% Rate I I ~ J/ tax due .' $ ///j / (;>1 I ;' 7/ / I' 0" S _, //I!, ,,~II, / //:. Cj ****** TOTAL PENNSYLVANIA INHERITANCE TAX DUE /. , $ -:", will be granted if the /~.-.!.1.(.1 "t'~> \ :t.C_./C4.L. ,'" . ('in A" five pare'e'nt discount totaling Inheritance Tax is paid by / .. // . "i LL" , : . .//__~~_ 7 V ;,,/,7/ j/'- ".' I (( , , :J Less Credits: DATE OF PAYMENT "/ AMOUNT PAID INTEREST TAX CREDIT DISCOUNT jd-/~'-)'I , $ :::i'li ,) /i(" i $ ;;"/1" ? t'~/ / + S $ = + = + = 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 $ /"/ .. 'I' I -~ ,I _ BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE - I ' , ,~ .':'::./JA" './....,_l(-....i,:.~!...,:.- ..,' "/"); /'(,'--/ ~I 'AsseSS~d~; '," / /'1. " I I;~' ,'\,'" See Informetion on Rever58 Side Agentfortl'l..CommO~'l8l1h' I /,/ v ...'X/I ", '-f'_)./'" REV. 1583EX (3-B2) 101 ~ BUREAU OF EXAMINATION ASSESSMENT PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX CON1Iildl9",~ P,O, 80X 8327 H~lfi1U wIl1\!lft:. RECORD ADJUSTMENT oAJl-81-00U ESTATE OF FILE NO, DATE OF DEATH COUNTY NOTE: TO INSURE PROPER CREOIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYABLE TO "REGISTER OF WILLS, AGENT," lIllliua C. Di..inger, ..q, 201 Map1. Ann_ SlIit:e 1-8 Kazyevi11., PA 17053 PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE CUT ALONG THIS LINE ----------------------------------------------------------------------- Luay Bl1en lI&l~~INHERITANCE TAX RECORD ~~-:.uil~~W 101 4-29-82 ESTATE OF FILE NO. ACN OATE eoU.CtiClll of _11en. All.... lilt ADJUSTMENT BASED ON: VALUE OF ESTATE: " Real Estate (Schedule Al ( II 2, Stocks and Bonds (Schedule BI ( 21 3, Closely Held Stock/Partnership Interest (Schedule Cl ( 31 4, Mortgages and Notes (Schedule DI ( 41 40,238,95 5, Cash & Miscellaneous Personal Property (Schedule E) ( 5) 6. Jointly Owned Property (Schedule F) ( 6) 7, Transfers (Schedule Gl ( 71 40,238.95 8, Total Gross Assets ( 8) OEOUCTIONS ANO EXEMPTIONS: 9, Funeral Expensesl Administrative Costs/Miscellaneous 4,697,84 Expenses (Schedule H) ( 9) 10, Debts/Mortgages/Liens (Schedule I) (101 4,697,84 I" Total Deductions (Ill 35,541.11 12, Net Value of Estate (121 13, Charitable Bcquc!>ts (Schedule Jl (131 35,541.11 14, Net Value Subject to Tax (141 TAX: 24,027,40 1,441,64 15, Amount of line 14 taxable at 6% rate (151 11,513,71 X,06= 1,727.06 16, Amount of line 14 taxable at 15% rate (161 X,15= 3,168,70 17, Principal T.ax Due 117) TAX CREDITS: PAYMENT DATE RECEIPT # DISCOUNT (+1 INTEREST H AMOUNT PAID 10-14-81 2-26-82 It 69753 L 010839 18,00 - ,43 - 3,167,06 19.49 NO INTEREST IS OUE IF PAlO BY IF PAID AFTER DA TE INDICATED SEE REVERSE FOR INSTRUCTIDNS, TOTAL TAX CREDIT BALANCE OF TAX OUE (If Balance Due IS less than $1.00 no payment is required) -0- RETAIN THIS PORTION FOR YOUR RECORDS \ ,I INFORMATION If the tax is paid within three (3) months after the decedent's death. a discount of 5% of the tax paid is allowed. Inheritance Tax becomes delinquent nine (9) months after the decedent's death. Interest is charged at the rate of six (6) percent per annuf"!l on the amount at unpaid tax. (SEE EXAMPLE BELOW) EXAMPLE: If a balance of tax due of $2.000.00 ;s 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 tax due by the rale of interest. STEP 3 Add the interest to the balance of tax due. Rate of 2 Months = 20 Oays = interest = ,010 + .00335 ,01335 Balance of tax due RaM of interest INTEREST S2,OOO.00 x ,01335 S 26,70 Balance of tax due 'PlUS Interest to Date of Payment (+) TOTAL tax and interest to Date of Payment $2,000,00 $ 26,70 Inlerest from 3-03-80 to 5-23-80 Results in: $2.026.70 ---------------------------------------------------------------------- 1 month ,005 4 months ,020 7 months ,035 10 months ,050 2 months ,OlD 5 months ,025 8 months ,040 1 1 months ,055 3 months ,015 6 months ,030 9 months ,045 1 2 months ,060 1 day ,00017 " deys ,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 -------.-------------------------------------------------------------- MAKE CHECK OR MONEY ORDER PAYAB~E TO: "REGISTER OF WI~~S. AGENT" OETACH THE TOP PORTION OF THIS FORM ANO SUBMIT WITH YOUR PAYMENT TO THE REGISTER OF WIL~S FOR THE COUNTY SHOWN ON THE REVERSE. SEE THE INHERITANCE TAX INSTRUCTION 800K FOR AOORESS,