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HomeMy WebLinkAbout81-00052 No. 21.81 :)2 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY In the Estate of George Reilv Bailey , deceased. To Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania. Petitioner(s) J!l{(are) the execut or~ named In the Last Will and Testament of George Reilv Bailey dated August 2. 1965 Decedent was a citizen of the United States and a resident of East Pennsboro Township ~ Cumberland County, Commonwealth of Pennsylvania. Decedent died on Thursday the eighth day of January A.D. 19.1iL-, In the County of Cumberland ,State of Pennsylvania at the age of ~ years. Decedent MlIl{(has notl been married and}l)OO{(has not) had children born to him :merxslnce the ex- ecution of the above described Will. Decedent was possessed of personal property to the vaiue of $ 425,000.00 and of real estate to the value of as near as can be ascertained; said real estate situated as follows Therefore, your petitioner(s) respectfully appl~for the probate of the said Last Will and Testa- ment and for Letters Testamentary theron. ___ . (~'i ...-1 -:;> ---_ / ;> .. ~:::J-< ~ "- /. I;~~. fJ'~~v Name and address! -L lizabeth Scott Bailey and (' . of Petitioner(s) Dated Janua,t' 14, 1981 The Comnonwealth National Bank COMMONWEALTH OF PENNSYLVANIA l COUNTY OF CUMBERLAND j ss Elizabeth Scott Bailey and The Commonwealth National Bank 10 South Market Square Harrisburg, Pennsylvania 17108 named in above applicat!9n, being duly sworn according to law say~ that the statements set forth In thiS petition are true to the best of their knowledge and belief. Sworn to .z: I L ~ f ~-"-... 'C~'; and subscribed before ~':.~ <.1>--' ,-' '- '-'4_,,- -, / , /'" > ~~~-4, ~eqf&:'-:;a, ~~~:tl -I'-/t f ~~ter ~ ra .... /5'1- Filed: January 26, 1981 -D C;p Attorney NalITIan Smith Sh' \ '": , ,~ss~r & Hall 6 North Third Street Harrisburg, Pennsylvania 17108 --- ,..... --_.-.-------_...-.._----_.---_._----~ , .' .', " , ' ~ LfS'l' (,] LL I\NIl TESTfMENT OF GEOKCF. REILY HA J LEY I, GEORG8 R8ILY BfILf:Y, o[ the City of Harrisburg, County of Dauphin, State of Pennsylvania, do make, publish and declare this as ;md for my Last HilJ nnd Testament, herehy revoking i1ny and all forme.r Wills and Codicils by me at (loy time made. nRST: I give and bequeath all my jewelry, clothing, silverware, household furniture and furnishings, automobiles, personal effects, etc., exclusive of cash, stocks, bonds and other securities, together with all polici.es of insurance thereon, unto my beloved wife, ELIZABETH SCOTT BAILEY, if she survives me, for distribution to herself or by her among my children and family as she may deem best, but without responsibility on her part to account to anyone for distribution of the same. If she does not survive me, then the property herein bequeathed shall be divided among my children in equal proportions and in accordance with their selections, the issue of any deceased child (0 receive his or her parents share. SECOND: 1 give and bequeath unto MAYNARD OTSTOT, in appreciation of his loyal and devoted service over many years, the sum of Five Thousand Dollars ($5,000.00). THIRD: If my wife, ELIZABETH SCOTT BAILEY, survives me, I give, devise. Dnd bequcnth unto my Trustees, hcreinBfter named, to hold in trust es a separate trust such amount as may be required to give my estete the full marital deduction ellow.1ble [or Federel E"teto Tax under the . " .' ", "". Internal Revenue Code, as in effect at the time of my death. My Executors shall so divide my assets that the property, including cash, aiiocated to this separate trust will have an aggregate market value fairly representative of the net appreciation or depreciation to the date or dates of distribution, in the market value of all property available for such purpose. If my death and that of my wife occur under such circumstances that there is 1\0 sufficient evidence that we have died otherwise than simultaneously, my wife shall be presumed to have survived me. (a). The net income from this trust shall be paid over to or for the use or benefit of my wife, ELIZABETH SCOTT BAILEY, for and during the term of her natural life, payable in quarterly installments or mOre frequently, if desired. (b) In addition to the payment of income, the Trustees shall pay over to my said wife such portion, or portions, of the principal as she may request. (c) This trust shall terminate upon the death of my said wife and the principal and any undistributed income shall be paid over and distributed as my said wife shall, in her Last Will and Testament, appoint, including the power to appoint to her estate. If she makes no such appointment, the same shall be paid over and distributed as a part of my residuary estate. FOURTH: All the rest and remainder of my estate, of every nature, kind and description, whether real, personal or mixed and whereaoever situate, I give, devise and bequeath unto my Trustees, hereinafter -2- \. " . '. '. of Harrisbuq~, P~nnsylvalli,<J, the sum ur Tell Thousand Dollars ($10,000.00). (d). Thereafter, for convenience of description but not [or the puqJOHC of mrlnugement, this trust sh~lll be. rugarded as divided ioto as many cqunl shnres as there arc children of mine and issue of any deceased child of mine surviving my said wife, the issue o[ any deceased child to count one share, and 1 direct my Trustees to distribute th~ income and/or principal of this trust estate in the followi.ng mann~r: 1. The ne t income from this trus t shall be paid ov~r to or for the use or benefit o[ my children and tho issue of each deceased child of mine per stirpes and not per CApita. 2. In addition to the payment oE income, my corporate Trustee, in its sole discretion, ,....henever it is dt.~emed necessary, fitting or proper, shall pay over to my said children or their issue such portion or portions o[ the principal as may be nec~ssary or required ror the mai.ntenance, general wel- fnrc or education of my said children or their issue. Any Stich p<'\ymcnt shall be charged Rgainst the shnre oE principal from which said chi.ld or his or her issue is or are ri.!ceiving income and upon -4- 8f.5 " " ..,: . . . .~. . '.. \ . Executor and Trustee or any notes issued by it; D. To cause securities which may from time to time comprise any part of my estate, or any trust created hereby, to be registered in their names 88 Executors or Trustees, or in the name of Bny nominee. or to take and keep the same unregistered and retain them or any part thereof in such condition that they will pass by delivery >'ithout discloSing the fact that the property is held in a fiduciary capacity; E. To make any loans either secured or unsecured in such amounts, upon such terms, at such rates of interest and to such persons, firms or corporations as they deem advisable; F. To retain the principa 1 or corpus at' any part thereof of my estate, or any trust created hereby, in the form of cash; G. To borrow money for any purpose in connection with the administration of my estate, or any trust created hereby, from my Executors or Trustees as individuals or as fiduciaries under any other trust agreement, or from such other persons as they may desire; execute promissory notes or other obligations for the amounts so borrowed and secure the payment of any amounts so borrowed by mortgage or pledge of any real or personal property of which I may die seized or possessed or which may at any time form a part of my estate, or any trust created hereby; H. To renew or extend the time of payment of any obligation secured or unsecured payable to or by my estate, or any trust created hereby, for so long a period or periods of time and on such terms as they may determine, and to adjust, settle, compromise and arbitrate claims or demands in favor of or against my estate, or any trust created hereby, upon such terms as they may deem advisable; I. To vote, in respect to any securities which may at any time form a part of my estate, or any trust hereby created, upon any propositior -7- '. j. , ,. . . or election at any meeting and to grant proxies, discretionary or otherwise; vote at any such meeting; to join in or become a part of any reorganization readjustment, merger, voting trust, consolidation or exchange, and to deposit any such securities with any committee depositary, trustee or otherwise, and to payout of my estate, or any trust created hereby, any fees, expenses, and assessments incurred in connection therewith, and to charge the same to principal or income as they may see fit; to exercise conversion, subscription, or other rights, or to sell or abandon such rights and to receive and hold any new securities issued as a result of such reorganization, readjustment, merger, voting trust, consolidation, exchange, or exercise of subscription, conversion or other rights; and generally take all action in respect to any such securities as they might or could do as absolute owners thereof; J. In their discretion to allocate to either principal or income or between them any and all taxes (especially capital gains taxes) which they as Executors or Trustees may be required to pay on behalf of my estate, or any trust created hereby; K. To divide or distribute, whenever they are required or permitted, my estate, or any trust created hereby, and to make such division or distribution in kind or in money, or partly in kind and partly in money, and that for such purposes the judgment of my Executors and Trustees as to the value of the different items shall be conclusive and final upon the beneficiaries; L. TO hold and administer the trusts created hereby in one or more consolidated fund in whole or in part in which the separate trusts or funds shall have undivided interests; M. To determine, in connection with making investments, whether to amortize premiums in whole or in part; N. To engage attorneys, investment counsel, accountants, agents and such other persons as they may deem advisable in the administration of my -8- . ' ...t , " '.' '. .... of my estate, or any trust created hereby, and to make such payments therefor as they may deem reasonable and to charge the expenses thereof to income or principal as they may determine and to delegate to such persons any discretion which they may deem proper, The Executors or Trustees shall not be liable for any negligence, omission or wrongdoing of such counselor agents, providing reasonable care was exercised in their selection; 0, To exercise all power and authority, including any discretion, conferred in this Will, after the termination of any trust created hereby and until the same is fully distributed; P. To make distribution of either principal or income, as the i i I ! , I i I i I i I i I I I ! I i ! i I i I I , I I case may be, to or for the benefit of minors as if such minors were of full age without the intervention of a guardian, with power to apply such income or principal, in their absolute discretion, to the maintenance, education and support of such minors either directly or by payments unto such person or persons as they may select, the receipt of any such payee to be a full and complete discharge to them, The Executors and Trustees sha 11 have the full power to accumulate any income not applied for the foregoing purposes. Q. Should the principal of any trust be payable to a minor or minors, the Trustees shall continue the term of said trust as to said minor or minors until it Or they attain twenty-one (21) years of age, paying Over to said minor or minors, or for their use or benefit, the proportionate shares of the net income of said estate. The Trustees shall, in their discretion, be authorized to accumulate said income for the benefit of said minor or minors. R. No title in any Trust Estate, or in the income accruing therefrom, or in its accumulation shall vest in any beneficiary, and no beneficiary shall have the right or power to transfer, assign, anticipate or encumber his or her interest in said Trust Estate, or the income therefrom, prior to the actual distribution thereof by the Trustees to said beneficiary. -9- ". -.\ . , ,- . . ',', '- Further, neither the income nor the principal of any Trust Estate shall be liable in any manner, in the possession of the Trustees, for the debts, contracts or engagements of any beneficiary; S. To join with my wife, or her executors or administrators, or consent to, as the case may be, in executing and filing of joint income tax, gift tax or other similar tax returns as they shall deem advisable, and to agree on how the tax shall be shared if at all; T. To elect to claim as a deduction for income tax purposes any or all administration expenses which are deductible for either estate or income tax purposes. No adjustment shall be made between principal and income because of such election. SEVENTH: I direct my Executors to payout of that portion of my residuary estate referred to in paragraph FOURTH hereof all transfer, inheritance and estate taxes, including interest and penalties that may be due as a result of my death, including any and all such taxes that may be due on any bequest and devise contained herein or in any codicil hereto, whether of principal or income, including future interests and remainders on jointly owned property, on all property passing otherwise than under this my Last Will and Testament, On the proceeds of any insurance policies or annuity contracts payable on my death, so that the same may be paid in full without deduction for any such taxes. EIGHTH: I nominate, constitute and appoint ELIZABETH SCOTT BAILEY and THE HARRISBURG NATIONAL BANK AND TRUST COMPANY as Executors and Trustees of this my Last Will and Testament. NINTH: In the event of the failure to qua lify, reSignation, or removal of the corporate Executor and/or Trustee above named, -10- " ~ < ~ IJ:I Z "'-l cl:I < l:<: Z "'-l ~ H ::a ~ ~ < ~ H CY ~ . :; ~ Z > Cf.l 0 IfI 9 m Cf.l "'-l .J Z "'-l u ~ ;; z ~ ~ - ;;: :II w :j . t/l . ~ 0 ffi ,; ~ >'-< ..... ~ :Ii 0 "'-l 53 z ~ l:<: !:: . " .0: ~ ffi m "'-l '" . m :j G . t/l it l:<: G ~ H Z < ;i: 0 ~ < :ll "'-l ::; ~ G 0 to Cf.l Z < ::5 "'-l Z p.. Cf) , ..; '" '" .. '" ~ 0 il:i <ll ~ ... o-l z ill .... a: ~ 0( r. ! CQ '" ~ > = <1l " g ~ <1l Z lZ u ~ z .... i: :II ~ o-l ... Ul . r.n . . .... ~ 0 ffi u 0 ~ ::i z .; .... .~ Ul j '- u = 0 ~ ... ~ ~ 8 :'. m . " ::i @ r.n ~ = .... l:l Z < '" .. x ... :'. S :0 .. Z ,"':"';""-'; ..., ~-' ,,) ,'. .' RE~.455 ll\~O) COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE ;1 RANSF.ER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS .. .., ~, ~~"~~ . ~~~'r..' --,!I&,'A." ~~"'.......~ ~~~' -~~,--_._--_._,.------- File No..jj-tf -. rV Estate of George Reily Bailey Date of Death 1-8-81 WHEN CI.AIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Relationship to Decedent Claimant's Address ITEM . AMOUNT NO. DATE NAME OF PAYEE REMARKS 1 Jan. 14 Pennsylvania dept. of Revenue 1980 Income tax estimate 850.00 2 " 14 Internal Revenue Service 1980 Income tax estimate 4 OOQ..,.QQ. 3 " 15 Penn Electric Statement 5.53 4 " 15 Professional Pharmacy Statement 122.49 5 " 15 Aetna Casualty Company Insurance premium 55.32 6 " 15 Penn Electric Electric Service 5.21 7 " 15 Gulf Oil Company Statement 75.81 8 " 15 May.A. Lavin Nursing service 80.00 9 " 15 Eleanor Bryan Nurs i no servi ce 610.00 10 " 16 Register of Wills Cumberland Co. Letters testamentary 129.00 11 " 16 Register of Wills Cumberland Co. Short Certificates 12.00 12 " 21 Commonwealth National Bank Agency fee 371.82 13 " 22 Marguerite Zimmerman Nursing service 80.00 14 " 23 Elizabeth S. Bailey Reimbursement for ministers and - organists fee 450.00 15 " 26 IrT ~^~M^' 7.84 16 " 26 Aetna Casualty Company Billinq charoe .55 17 " 27 Register of Wills Cumberland Co. Certification of Will ? nn 18 " 29 Cumberland County Law Journal Advertise letter~ testamentary '.B...QQ. 19 " 30 J. Gaughen Realtor Aoartment renti!.l 700.00 20 " 30 Freedman, Kanenson and Lewis I Associates Professional 80.00 21 Feb. 2 George's Flowers Funeral e~!l~n~__ 495.02 --- "_r__ " REV.455 E)(+ (3.00) COMMONWEALTH OF PENNSYLVANIA .' OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS ~ ft(,~~~ ,~~'\'}r;~ ...~...J.l ,_ ~u.,.., ~I ~. ,:>~, v.d.~r;,!i.:;j, .'- . Estate of George Rei 1 V Ba i 1 ev Date of Death 1-8-81 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOllOWING: File No, Claimant Relationship to Decedent Claimant's Address at time of Decedent's Death ITEM DATE NAME OF PA VEE REMARKS AMOUNT NO. The Commonwealth National Bank Co-Executors Fee 25.621. 00 Closino costs 2.nnn no .- TOTAL I 65.819.19 I hereby certify that to the best of my knowledge and belief the foregoing is a just and frlle statement of debts, funeral expenses and expenses of administration sub itfed to the estate as deductions for Inhsl itance Tax purposes. The CO~l1)onwpa1,tJ1 National Bank tl. ,'-c Ry: (j;;. 'Ii ,-' . "\;'/L ", I'<t.tp T~y M2" I j! .,1 ;'.1 SIGNATURE OF F:{bUCIARV ' 0 TE ' OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ AT %TAX RATE REGISTER OF WILLS DATE SUPPLEMENTAL ~ tII.., .l"'~ ~ "i'~ I, '~I r~:r;<i. ~'.~~~" .. , ,,,. ,~~".iJ...." ~/: r...,.... ....... ~ 1f"J.- "~I'.I .~!~V Y,f. "~.:.l. REV.455 EX+ (3.60) COMMONW~AL TH OF PENNSYLVANIA DEPAKTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS -_..-. ---_. Estate of George Reil y Bailey Date of Death 1-8-81 WHEN CLAIMING THE FAMilY EXEMPTION, COMPLETE THE FOllOWING: File No, 21-B] -52 Cloimant Elizabeth Scott Bailey Relationship to Decedent ~DOIJSP. Claimnnt's Address at time of Decedent's Death ITEM OATE NAME OF PAYEE REMARKS AMOUNT NO. Oct. 26 Elizabeth Scott Bailey ~.m;'v ~, "inn 2 000 00 I , TOTAL I 2.000.00 I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inhel itance Tax purposes. The Commonwealth National Bank By: i. ',-of. <vr ,J':/'v,,~"/ Ec:tntp T~)( Mgr- ,'/. -:; :\ I SIGNATURE' OF FIOUCIARV DATE OFFICIAL USE ONl VI DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ AT % TAX RATE REGISTER OF WIL..L..S DATE I \ '-J ! , .. c i ;;;: i.' i'~ i !, ""I:-~' , .."-.. ~ 0\ "0. I r;.:.. ,.:...,. ~~ lIJI,. 2: .~ 0"-- O~J c::"j Z .~.:9 0(:; .",i, '-'w ~:5 ~,a..= ~ ~U ~ '-' \ i I I \ COMMONWeAL. Hi tJF PEr:rl.j':LVM./lA DE?ARTMENT OF RE'I_t.IJE BUREAU OF COUIlTY COLLEcr:ow; ,\fJ;JLiCA ..,()~; FC.:; MID cai'l: :I.:r TO TRMISF[[: :ECl.:RITIES !'\2CISTERED I:: THe NAMe OF A RESID[:i.iiDECEDcIH I .......1. ,. 1'-, . ":;.,.,,,-:11, ~ :"j: ...:'.:.l-fC",L; :(!-"~ ','.IL _~,~.Li:'r. J.rl. {D ,,~~~\':.',~,:,: :,:;.1; . :r"~J".'),~';"':;"I" APPLlCATIQf. (.\',UST 2:: r-:U:D iI'l TfI~PLlCATE) TO THt: PEt,flS':LVAN!A DE?,o\/r;'II.EiH Oi' Rr:VE~IU2: Ap;,licotio" is :i::,r~by rncda for i.C~5Cilf to Inc trcr.sfcr of th(~ bllc'.'Iin(j r.~c.:.rri!i~::; of (J l)~:H~'::;i'henja CorporcJtian or {i ~~(ItiO.HiI Sc:~killg As:;ocioliG!1 IOCCltcd in r)cnl1$)'lvoni~l: 'D~,T~ .~iipR"I~'J~~~iqil (a) _\ 0 0L ~\l':; (b) __lJ..:,(bJ: ,._____._._______ __._m__.________.._______. \") _._.c..DIYIi\1QU.___...__ ______ (NOT!:: In dcscribin~! sec\Jrities enter in (0), oG Ole, cilh~1' tLeo llu:l1bcr d $h(:(I~~ of $tock (lr .he ic:c..;: 11.".1011(11 vi registered bOj~ds, in (1:), th~ name r;f 11H~ is~:uil11J com puny cmd in (c) ':hc C:C1~~ of $~'Jck 0: l!lC ':~Gt",d 1;1~,~((.:5\ . :Ji'~ and mOfUTity dolo of "''1'51,'",J bellr-s.) . ~ w ISSUED ON -I.'Cl.j-LD!,S ___, and havillO e TOTAL .Y.iIRKET V A LUE O~ S __~_;.Q.t:9...JiO ...----...----. (Dol,) II n Q... ~ as of the dele of doath of the docodent, ..,' \:JeoRQ,e. Ke II..::LJ.KJJJ...J:;.Y" en_~Jo11...J.+.-,qjL__ (Namo tlf Deccd.1nt) (Cote oi dcc,!hi who wes Icle of_t.'~~Lrc:.IJllQb:,_(Q IU.:~ CQmf! WiIL-J_Clt.d\,J;ulai0_1_i?cY."....__________ (~~rL:I::f o.,d Nur:1Lcr) (Po!.IOificu) (CounTy) ($:0:') Tho socuririe5 ere rogis:orcd es fallcws:__(lt:..~c.~!::;.r~{.n_~,OI.{~J</------ (l~~tio or Mmes in which ccrtificorcs Olll rcgi;;\crllJ) 11 "'\'0._:. '=." .W'!) C~:!:\J'llo.'i\.j,l't.cu~ i\),'l\L 2:,flJJ!{.. 8. O..J),C.K-f.D..!Q.,,_Jib.i..,J?cLI1LD$ ~EXECU lOR) (No.,,") J: IAdd,m) U n iVII,',!.: OF API~UCAiH _c...Q,'}\r!!lDll/):(.dL~Ld0. i'tIb._.I2/jNK..._ COUNTY FILE NUI\BEn~L::ZL:2~ADDRESS. OF A?PLlc.lIJrr___;ii;lll1e..-i1$__abo.~.~__... --..-----;- BURE'U -IL~ I UI'''-'' S,,,.IA-ru"'" O~ APC'L'C".ITttt tJl(aif)) J/lAtC<.B ,.,. i C ~ "DC.. I Gl'tJ, .....1:. . I .....1 I _~.:-__. -~ - - ---+ NOTiCE: IF YOU F,\IL TO PROPERLY ;:a.L Ii~ AliY POP-Timl OF THIS APPL AT:O:" :~~L ,,0 L,' C0\.. CONSIDERED COMr'LE'if. MID '/IILL 3E RETURi'l"D TO YO~ f'OR CO,\.,PLETIOtl. Co:,',),:Oi,I'IEAL TH 0;= PEN:~SYL VANIA - DEPAfn'\\E~lT OF REVE"U:: COW, eN:!, -m TRANSI-~I'\ SEClJ"~ITIES D.' I!: ~/f!l I ner~by consc-n~ TO tho:> rrc.l~f~r~: t:,c \JiJ(jv~ ::.ecuridLlS now r~9isH.'rcd in tn~ I1Q:llC 0; :llCf:c;,,:';J " Dec~JeL'lt ar,d waive the :ilinf: or G ccrlifi:alc certifying to :he pa}';1:2:lt of tllJ trcnslcr in:10:i'<1ilCC' to:-' ;0 ",:'l":!: the prO!Jcrt, oJf said D~c,~dc:~l is :~;~dc sl;bicc:t pu:su(Jnt to the' provisio;l$ of Ihe Act of June 201 19'19, ?,~.. 5:;"" as amt:.'T1clc:d end the Act of June 15, 19/;1, P.L, 373, as o:nc:ldca. Ti-lis is ul.so in 2.ccordoll":l.? with th..:: pr.,j.:1s~JJ~~; of Iho A:t of April 9, 'I';2?, P.L. 3.1::. This Conse~1 ;0 Trc:1:.dcr the herein described p['o;;(~rly op(~r:::;'f.'S onl)' ill r~.f~r.:n..~C' to ::;l..' c~tt;:0 oj :;1(; obevc..nomi:d Dcccd"nr. -' "'p f::~. .-:'" '~'~'(;':;",'",:"'...i . . , - , . .',"J~ .. I. "/,j"."a l' \~""<i,?;,,~...-J'\\) , ~ -.-, ,..... ,,' , '. ~ 1 '~;'.''''''';I>';'';''''''.- ::'" 10 i'(X""Y~ iZ \ '0~:'''~._ _ ti!:L~ 7?'~ leo,,,,,; " We the Executor/Administl'idl." [118 Ls!a~e as irau'!',ree shown on the fronl of this [orill dn hel'eLu guarantee ~ho pagmen~ within Ihe time prescriLe~ h~ law, 01 al1~ Pennsylvania Inheritance Tax which may he IIue ou ib Irwler of the securities listed hereon for which a ~ef;"'.l to lrwfer is granted. THE COMMONWEALTH NA4u.':, . Date!!/io/-~)JL~ f11 t!e4-- Authorized SignatYiJ....iIA. ~()r~' COMMONlif.l.LTH CF PEt/,L', '_VA,ltA OEP,\RTMENT Of REVEt-We BUREAU Of COUIHY COLL,Tf1uH\ ;\I~:'L~l.;" I ,I..iil tt'.. l~rE) I...UI':Jci'.l Te TF.AN$I~Ell 52CUf(ITI::5 ilEG!STr:I~E[J U THE llAME 01' II f~ESIDE[; I' DECEDENT i ',. "f;:',\' .,.'. I.; f( ::'~ :)'.,1 \. ~ \".' ". F'i.. ."',y<I..l":'v ;~""~'" ;. ",:i j j .:I,".)I".t.i"".;'- ---..---. --~._. ~_.-~- D ,I.T::Q PR!L..IlD1"9i.1 APPUCATIO:'1 (MUS-" [\i: r=ll::~ I~.I T?ZlfJL!C/ITE) ------ TO nit: PENi'ISYlVAI~lt. DcPAI,Ti,\E~IT OF r(c'lE'I~UE: Appliculion I,; horoby !roodo fo, cw"onIIO Iho trondo. oi i!,,' fellewi", socudtio" "f" P001S;'i'lC.,;., Corpo,'niion or 0 Hotionul BC1:,Ur'~, A5:>ocilliiorl :l,)colcd in Pt:nnsylvurdo: (oL_. 3t~) ::..\,_(1: L_85,r:'JI~'; :L._NE:;:I:;,~f~~._. r~!).r-,l.~._ ___ ._.--- \ 0) __~.Q{}JmC'n...- --.------. (NOTE: I" doscribir.g "ocoriflos onlO' ;11 (r.~, 'JI: OJO, Oi:!l"' the oun,,-or of oh,]:e" 01 'tad. or tho :0'" e.ncc.: ,,: regiSlered bends, In (bi, Iho ",1:"" of tho iosoill, CO:;Ir:cny [,Ill; ill (c) tho cloos or stoek 0' tho ':0'"' ;,"""$1 'o:c' and mJlu.ity dole of rogi,lored bondo.) ISSUED ON _J.1i.h '!.~_I.\~____._, "'Hi hevi,u 0 TOTAL MARKET V ;,LU:: Cr- s __~L~"'&"'0.~-..._-_._- (DaIC) .n os of the dole of death 01 the docccle"I,~eN1(.!.6 !?t'.L~L6AILE.t( , 011_ 0an.:.j.d~JL_. (NamoJ of Dcc(.donli" (D,;;t~ of dcOI;'~ who wus late of.-i~~.2~L1D..:Jh.,[~:.. TU:~-I o.QjlLP~ULJ_~,{.uy,bcrlD_~_rd.._)_.f?Q-'-.__._._.._- (~r:Jcl end Nu:nb~r) (Pc.:;IOHic,:) (Co....nly) ():J:lli The socurilios ere regl5ro;ed a. iollows: _.._.G..;;QE~-- R~ Jlf,~.c~lt::'~(-._--------._.-._- (l.~crlnc 0: flumes in ,..-bieh .:crli!i":'(lh'~ ure rl't~i5:~n~(;) AS;" , 'L::} Go-EXECUTOR ) Cj)i!lil@l~'r.MlL-Q.Qt{~LlLt J?..:.D...:l'CQJ<-...J.9J.Q-r1:It;>~\'I-J2~). .I)JQ~_. (C~om(j) (AdJt<:ss) \j l'U,!i.E OF APPliCANT _C,C(II/',1c')\(A.'t.oNk.JQg:tt&:'\I1,t.--. COUN-" -ILE NUll";::" OJ '-K1-5...../-.iY'-S' OF PPl'CA"'- <^.''\l" A<: "'b:;,oe I r r ,p_.L..:::\....t:_____~ \ULj\c,) A I 1\1_.....~..Hle..--\}:.;l_~l_- --_._._-_._-_._~_. BUREt,U FilE NU/.H3c!(. .SIGNf,TUf<E COP APPLI':,\JH .&,J-.)tLa.t.\G-?! ''J1J. bD.-L~_ HOTICe: iF \'OLl FAil 70 PRO?ERlY Fill Hi ANY POIHION 01' THIS A?PL'tC,,-iION. ;,,.~: o~F CO;~$IOERED COM?LETE /,I:D ',/ILL BE RCTURNED TO YOJ ;=OR COM:'LET!ON. .._.._-----~._----------_..- -..---.---- -- .- ----.------.-. --------------------.-----:-- CCiIl:'.\ON\iEALTH OF PENNSYlVAI,IA - DEPi-~TMEIH OF RE'/E~UE COi~g~:'~ TO TRANSFER SECUR~r~ES ",-C (jt '/7 /)" Id/I DA, Iii ___ u:..,~- /" I l hcre~1>' cor.~":f:l to the t:ansbr oi lhc: obGVIJ sccuri;ics nOW rt:CJi5j\?j~d in Ir,c !1.:imc of !he 1(~~~,:,'.ld .--.-----.----- .-- Decode;,: Jne "u'vo The 1;;;",; of 0 ""rrifieolc c;rtifying to the pa~m"": 0; tho Iro",lo, ;nho:llo:.co :"" '0 .-:1,;,1: the rro!,erl, of soid Doc"",o,,: io r.'nd,) s""icel pc,suen! to lho prov;s;o", ni tho /-.el -of Ju:.o 21:, 1?~~', I'.L. :;::1, os Clmcf~ccd ar;c lhc: Ac: '.:d June: 15, 1961. P.l. 373, as emended. Thi;,; is u\so in accorG.::nc0 iliih ~hc ~j'o\'i~,;;,15 of tho Act of t,pril 9, 1929, P.L. 3'13. T' '. r t t'" I' , . ., 'I d "f I.' I nl::.i l...on$":"11 ::; I rcns l:r t.1o,j 1:(:r(:111 ,1Z~C,1 ~c prcpe:l,/ opc,~tus O:l,Y In rE: c:enCiJ h:. i ~~ (::J.:nc .:Jt j ~~ obovc.nor,v~d Dl~~~di,!ni'. ',"t-., p ',,, .'1 .''fr:"',''''",",'), ;~, ~....:::: :"~. ';r~~") I;':"i<~",::):,~",,(" .:-;~~l ,.....:::l'~..) ,..~.-, '*, r)./- 81-5J-. IICC-H!l-1I1 ('II.II\III~\H:,\ I.TII III' I'J.:~,~ SYI.V ^ ~ I A 11l~plll'LlIIPrd, ot' Hl'Vl'f1l1f' ENTIIY INTII SAI.}: IWI'IISIT IIIIX TO IIEWIYI': A \1'11.1, 1111 n:,IIETIWY [WI';/) -;.,; " -' . {.J.... ~:) ~. V~l.': 'l.-~CJ 4..~ :1.:...,,:, ~~'.~ OuJ '0) "1: [:l::> ...,u <..1 J,mu<4ry 12, 1981 (/)n 1.(0 of' En I.,'.y) " , ,,- c. ..1-. (,.;-",~ U:. l'_'~, C)'...' bt.:.:.: ~~ ~~ 0,", (,)uJ 'cia: 1. If' - ~ ..., ~ Name of oecec1(!nt: George R. "ilnJl~___ ---------.---.---... 2. Address of' (if~cpdp.nt: 3. Date 01' clenth: 3610 Logan bm.~,_AP-t..-An......Qw...l!.:!'l.LJi4.....__:t7011 January 8, 1981 4. Name nnd address of person who requps Led Lh(~ Or!'ll il'lg of" I.!H~ hox: James L. Smith. Jane W. Sipe Commomwe~th N.M.!.9l1;jJ Bi\I1k...1Q.lldlarke.t.Sq. ,_ Hbg_....J.~-',. 17108 5. Name and address of the fi.nancial Instttlltioll W!H'I'l' I.hr' S;jf'(' df~Jlnsit box i.~ located: Commonwealth National B~pk 10 S. Ma.rket,~q"LHarrisbur,g. Pa., 17108 --------.------..------...-.------ G. Number of' box: 134-E 7. Title ulIclor whir:h box is 1'(O)\;stel'''<I: ......Q.e_orge~_R.LBi4ney_.... 8. Was there a will ill t.he box? (Yf'H (H' ~n) Yes !J. If )'CS, stnle date of will, IHUIH~ Itnd Ild(!"(IsS of' p~l'slllJd.l l'elll'cIS(~fltntjve, if named in the wtll_1 and !lame and addrpss n(' :t1.te'I'!!.',\', j I' :ln~;: 8/2/65 Codocil 4/22~~ }Irs. Elizabeth Scott B.~l~Y~il.nIe_as~abc_ve_{t_ C.onnnol)w!!altILNattQ.llaLlliUl~._.__ ~ ------~---------- Anel now this 12 tin.\, of' January cprt.if'y ulld.0r }lPlwlt.\ or ppr'jtlry t.hnt U:" :iI"WI' to the b(lst of m.y kIlOl.....II.d).,. Illld h.,] il'!', .___' 1:1 81 . J hl'l'l'h,\' I", "1' 1 I, '~PI'r','1 I dill: ('I\IlI~ll\j I' j Y(~"ef-~-~-- E. Val..rLLLantL-_.__~ /o4naR:er Pl'int \':WI" :lfld Ti 1, Ip 1../;:....." COMMON'-\'E/.I."rH OF fl;'t1N~YLVMllA DEP"RTMENT 0, REVLtIJE BUREAU ~F COUNTY COU.E':TIOt'S iI!'i'L1CI,TIOrl FC'j i\:.iD ((]~:S;:I:T TO TR/,tJSi'Ej,~ ~ECURITIES ~EGISTERED !,l THE NM/,E I OF A RESIDEI;] DI:CEr,EIH ..__,_____1-. __,,____..._ ."...._____' , ,'" ~I,::C~';~ :l~': :),~: ,; }~,#I,_ -t"'f'!' ..I~t f, I,,;' I~':~.:,;;".'''' :';~,)"'l.;" '....... .~.; APFLlCA TIO~ (:~US-I BE FILED iN TP.IPLICA TE) TO TI1E PENtlSYL VANIA DEPARThlErn OF REVENUE: ' Ap:,licutioll i, ""leby ",ode Iilr e<AlSOll! 10 the liullsfe, d 11,; fo!.I,,~oCU'i:'.:S "i (, ':-,,,,,,,,:>1\'00;(, Corpo'oHor. or u ~jotional Bnllking ,\"sociolioll locllled in Pelln:;ylvO:lIC:: 111 (o)_i"Gi)-L_cl]~(b )_C.ClO1I11l!ll ~\..':<..a.l.iJd;~u if (11L0L.&llL,___._~:=. __ Q oi)l,}1 (11.1.", ,....____.._ (NOTE: In describir.~ 5ccuritics c'lller in (aJ, ab o.'c/ ci:hoJr the nUI:1bc-r of :.IHH~.~.,.\i; s;od; n 111,:: Ie::'.' (:In':;U,'1t of registered bonds, in (b), the name of the issuing company Ol1l; in (c) ~he c!(lS~ c1L~trJcI: vI !:\C !.,t::~,::d ii:f,::r..:'z~ ~t:tc and majurity doto 01 regislered. bonds.) .,: " ,,' LJ/.T:::i-)P~IL -;L"?i/:l.U ISSUED ON _.01) (i 6)t~___, and hovir.g a TOTAI_ HARKET VALLIE 0:= :; ___J'J.I.r)tz}7~~_9:___...,,_ (Dotoj. n [) 1 os of tho deto 01 death of Ihe decedent:. , ~~~\l:::\e:. hC;'.Jj....!:Lb::>.LL.EJt~, tll_..JDU__'S,1.!3.p.L___ '1tin'mc'd DoccJ~n:) ~:-)o\l! c.i (ll.;C1hl who wos latn 01 Ea~;\ 11L!l.~6<"1Q~1 ~Fl._Q-O-!JlI1 n:1Lln_(~'-.\.J1'nG( c!(~"d 120'-_.______..___. (Street and t~umbcl) (Po:;IOfiico;J) (:>.L.llfil' \S:u:;:; (' . The securities arc regi5:md os 101Inll's:___J.lt:QJI\C._(2eJJif___.i~K) ~j'~'-:I_____.______..___.,.___..____n.._ (~Ic~ ur nam'~!i in which t:urtilicr.tu', . rt' rtrjj~t..;rcd\ ,",'Iltl:: . ,d Jill .r' ' fl A!L:: ~ :~T:..-;-ClR))..J:he1.C1i:l. t,V:t. !6)L(fi'Q Nh flbil roiL kt-PC ._e'til'!L. r. .~=.~b~ ..J1LD1Q'L l:c-EXECUTOR ~~Nom'l _. ::1.). U ti.:' NAME Of APPLICANT ___';ec)(l..~, ())J~t<'_..__________..__ COUNTY FiLE NU,.BE:R .Q-<jJ,-5,~ ADDRESS OF t..PPLlCA;H_.~~\~ll-':____~__. --------- . ;;"-f!l\1VJl '\v, ; BUREAU FILE NUI,\5ER. '... S!GNA TURE OF APPLlCilrfi' .1J'1-A'!f...ay-n..-f/,1 ". ".~- NOTiCe:: IF YOU FAIL TO ?~\i)\oPILL It, ANY PORTION OF nllS f.Pi'LiCI:ilOt., IT \,'ILC~ft'jTq,fi7Ct;.1::.. CONSIDERED COMPLETE AND WILL BE RETUR"EI) TO YOU FOR COli,PL"'TION. ~Ja:"'w .... ._. ,._ .... ','''' ..'JI~ _.._~t__ COMMONWEALTH Qii'~~l:I..V~~~IA - DEPARTM,ENT 0;= REVENUE coITs~~T TO rRANSFER SECURJ"i!ES ~,{? )0 I ". Trc <f. l',f' Vi'" I '-__ _ n-)._ I . I ,. ,', .' . '. , hereby consent to lhe tran&fcr of t:1e above seCUriTIes now Icgl~jer~C 1/1 'no nmno (,i',' ;!-.r;.. ,,';r:'~',Cla Docedont ond. weive the Ii ling O~~{tjfica Ie .cert ilying to ~he parmen! of/~.lf}ro.'ll1fSIl inheri 10llco to x in Alich the propcrtj' aT said Dc:ccdant is ll1~i~~t 'pursuant to thlJ provisioi:s o{!;:"J!>~~JlJi1C 20, lS'l~, P,L. 52~t fit 10 .. ',~ as emended and lha Act of June 1Ilr'/)~,r;'?L, 3i'3, lJS omc:1ded. This is ol:;.)::,ilt.....d~1r..,;C wilh the i=ru'ti~~l:l:b .......3 . "~'" of the Act 01 Apii 9, 'i929, P.L~: ,\~llIl!d ~ This Consent to Trar;delld' hC'iP.,!,n dQ~cri:~cd prUpt~rty op(:rat('.::. o;ji~' iJ~ :c:~rC'llc~\ Ie tLl.' J.i "I" ' UHI..' . obove"named Decedent. . ., ::::;i(1!~ C T 111\: .;'A ..__ _w tl I1rI -~ ~111 I)" ,....\~ '\t"'t ~'f'7'~" ~~~fO, lk Q\f,'~ib'~\ f.~:(~.~,;;:t':L- :;:'OUI11;', COMMON'HEi,L'iH OF F .:N8S\'L 'I AllrA DEPARTMENT OF Rf.VEI'U[ BUREAU OF COUNT'! ClLLECTlON~ /,i-I'L',:,.,-:'i0~II:li'. MW CiJHSErri TO n~ANSFi:1\ SECURITieS r~EGISTERED I(i THE ~IA/.',E OF t, RESIDEr, i DECEDEi'lT ;:~ X> ;;. ,.t~'?"'\.-';~' ~'C''.:j...,(~:f;~i' r~~ . ~J ~~I.~d.;: '\'l ~ f. }'" ,. ,"" -:J:. ~'.'\J' ,'- ,'''' .~'..'_. D \ n; m 5 9.~ I ~L:CA.I!.Q.t! (MUST BE FILED :N TRiPLICATE) , 1._ --- CK{._+/.. - .. TO THE PENHSYLVM:IA DEPART.',IENT 0:= REVENUE: Application is hC,:,cby mace for ClXiscnt to the trcnsfcr of tnc fo:!owin9 securities of u P."nnsyj'/c;iia Corporation or 0 NotirJ,1ol Br.iikil1') A~socio1ion located in Pcnns),lvanic: (aL1QQ~.5-(b)_.~!.iE.() I L ;-~_________n.._______ (cLJ2Cr1.1.!J.1?J.t?. --.----..-- (NOTE: In describing s~curiti~s cr:!r.i :r. (0), ob Ole, citf'cr tilt: number of shcrcs of stod~ OJ. the Lice 1J.11vL;n: c'~ registered bCJnds, in (0), th:) name of :hc issuin[l corr,pany ond in (c) the class of slock or the ~toj..:!d illi.::r,:~j :(J~';' and maturity date of reg:sl",ad bOl'ds,) .--..-------- .--..... ----..-.-..----- -- ---.-.---.---..-..----.--.. iOOltl) as of the date of death of the decedent, U.')f~1 OU;?__, and having a TOTAL MARi<ET VALUE OF S._4.na.1 5!!,;) :_2Q___.____ ,(J,eo~e. Ke; I!,f. i&iks./__, an_.J..CliJ.J_rL'11,.L 'iNOnlC of DoccAcnt) (Dule of Ol~Clth) who ",as laic ai 2(\5\ 11i1Jlsb~,(~", TwP) COI)1P i-k 1I-1_.f.~.fHbk.c.fQl.,d.I__eL'___.__ (S'rc!.:1 cnJ t~lJmbctl (Pos: OHil;c) (COU:'lj') (Sy.:lf~) ISSUED ON The sl1curities ore r(:gi~tcred.os foHows: Q, c.OJ.5.\e.. i2~-'-~(__._6o tJ 'e~I-______.__.____.___.. (NornlJcr names in which cl:rtificotcs Jrc tc,]i;lcrurlj ~ M:;:,I.;!:T;(,,~) ihe. Q()I\JJ}lOJll.L't.rl1J.tLl.J.QtLbollLl_~....Q-,. b.QUQ.LO~~~-I.2!_CLLO'J._ Ul EXECL:TOR) U'oc"c) (Add,,,,) V Hi.l,lE OF APPLlCAi-rf __ :)al1L<:U)S O~Ite.____.______ COU"-Y FILE 'U ~ CR 1.. \-~ \ -":,'2 ,"DR' ESS OF' PPL'C 'Nl- II' /I II "I ,~ /,\",,-, ..__ .\lJ A, ,." ~--.-\----t:--'-T '_I .. - , ---, "-!~ ,- ',,, ' {4 lltl /-d::v-~ BURc~U riLl: ~lU'\\B::"______-,:',,N,., lURE 0,- APPLiCf\'~ I .011- .-.- D1-.---:;r--.}_--fY' NOTICE: IF YOU FAIL TO PROPE,<LY FiLL it; AI~Y PORTION Of HilS APPLICATION, iT WILL ,:OT l>" r<<.s Om(~e. CONSIDERED CCMPLETE A~" WILL BE RETURNED TO YOU FOR COMPLETiON. _m__._.__~..___.__.__ .-.----....--..--.-.-----.--- CC:;'!,MON'iIEAL TH OF PENNSYL VAtI!A - DEP ARTII,E~IT OF REYDWi: COHSEilT TO TRA,'jSfER SECU~ITIES ~ /: -j;/dd/ .-- - .-- ~ 7~ I uA I,:.. ..on' non/, I hereD, COl'lSl.:nt TO the tra,~sfCt of triO:: (Jbove s2curitit:s nc,w rcgi$:~rcd in the: name of lhc: iv .::a;u -.----.-.--------------.--------.-----.-. ---.--..--.-.- .+..~_. Dececi~.lt end .....aive the fiJlnu oi G ccrtifico!e c0rt;jyin~ tc ~hc r:r;:YlIlCr,~ :d ';"(,c trc;"ls:cr inh€.'riTcllc;;.' t~~: TO .,,,.hie\' the prcp~rfy or soid D~:<:,Jcnt ;:; r;I(.~C' subj[:c:t pursucnt to ~hc provi:s;cns l)f the .\.:t d JUI10 ;.0, 1919, F.i.. 52i, os emenced end the Aci cf JJJI~~: is, 1961, P.L. 373, as cmc,'nlud. This i$ QISl~ in Gccordcnc~ .,,,ilh the plcl,,'i:)i~,m:; of tho Acl of April 9, 19::i, P.L. 3,:3. This ConSE:n1 to Tr-=ns~'H the hcrc-i"l ci.::scrihcd jJr0rcrty OPC/:Itp.s on1i' ir. reft'rence- to ::',0 ~sl,')IC of,~:o above-named Decedenl. -- I'. ..\ Ji .~.i. , ,/'r;.....~..J; .~:. ~~.~-~ 'J~~'A 'V1 .' ('(.11 '~Tl 'I' ....'i,',.'..r:'~ ',"/, -.-~. ,..,.'J .J........':t..l.,;,;',J.: .. '..... Inventory of the real and personal estate of George Reily Bailey Real Estate None Tangible Personal Property 1. Household goods, appraised at 2. Jewelry, appraised at 3. Coins, valued at Intangible Personal Property 4. George R. Bailey Agency Account #1366B-00-9 with The Commonwealth National Bank consisting of: $10,000 Commonwealth of Pennsylvania General Obli- gation Bond at 6.10%, due September 15, 1988, N.L. at 80.977 Accrued interest on above 6,607 shs. Commonwealth National Bank, common, OTC at 26.75 2 shs. Eagles Mere Association, N.L. @ 1,000 1,000 shs. Gulf Oil Corporation, common, NYSE at 42.5625 300 shs. Hershey Food Corp., NYSE, at 23.75 300 shs. Hershey National Bank, common, N.L. at 31.00 1,000 shs. U.G.I. Corporation, common, NYSE at 33.00 139,826.00 shs. Money Market Trust, N.L. @ 1.00 Accrued earnings on above Principal Cash Income Cash 5. Accrued income from Edward and Elizabeth R. Bailey Trust Under Will #05016-00-1 with The Commonwealth National Bank deceased. I , 8,097.70 II 191.47 I. , I I 176,737.25 I 2,000.00 I 42,562.50 7,125.00 9,300.00 33,000.00 139,826.00 566.13 24.40 3,801. 26 14,875 00 1,943 00 187 50 i i I I 23,231 71 8,386 32 .J ~ COMMONWEALTH OF PENNSYLVANIA I. COUNTY OF CUMBERLAND J The Commonwealth National Bank by Jane W. Sipe, Vice President ar,d Trust Manager, and El i zabeth Scott Ba i 1 ey__________________ being duly sworn __ according to law, deposes and say' that he __Cll..::Exe.c.u~ ____ of the estate of Georqe Rei 1 Y Ba i 1 ey late of the boroyqh of Camp Hi 11 , Cumberland County, Pa., deceased and that the 'th'" d b Th~ Cgmmonwea lth N<1tiona 1 Bank and th'd Co-Executors WI In IS an Inventory ma e y E-l-Ha etl1-Scott--Bil-i-i-ey---- ___ ___, e sal of the entire estate of said decedent, consisting of all the personal proporty and real estate, except real estate ouhide 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. The Commonwealth National Bank By f}.~ "U.r. d~-iLu ,:} Co- Exoc:ufor.. A rrrinlltr6tO'r and 55: Sworn and subscribed before me, --"\c\-,e\ (;.., ) Eli abeth Scott Bailey, 10 South Market Square l{arrlSQUrg, pa. Add,en ; lINIlA M. MclAUGHliN. 10 ,",I r :lIG III,RRISBURG. OAUPHIN COUNTY MY GOMMISSION EXPIRES fm. 18. 1985 Mt!mber. Penn!iylvanlJ Associ3tion 01 Notaries Dale of Death . 8 1981 January Month Pay Yeer 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 J 949. >- QJ ~ ." ~ .... w ~ u ~ ~ ~ '" .... .~ ~ w ;5 <0 4- ~ <0 o. CJ 0 u 0 III ~ ~ :J: 0 W W >, .<:: 0 '" .. I :r '" ~ . " -- I- o. ~ o. '" E """ Z .... ...J LL .~ ::s ~ ...J -( 0 a.' 0 o. 0 W LL <( w il s.. s..= , 0 ,.:. ~<( -- > '" 0 Z .0 . I Z 0 c c: Cl ~ QJ .; r III Z QJ 0 '" :ill .<:: U Z w -( .... .. Vl "- "'I ." c ~ : - -;: 0 ~ .ll "tI -" ~ E . ..! 0 ~ ~ 0 ...J U ii: '" . -.... 6. Proceeds from John Hancock Mutual Life Insurance Company, Policy #ORD-1143241 7. Proceeds from John Hancock ~lutua 1 Life Insurance Company, Policy #ORD-1122419 8. Proceeds from John Hancock Mutual Life Insurance Company, Policy #ORD-1143242 13,723.65 5,435.18 8,234.19 9. Proceeds from Massachusetts Mutual Life Insurance Company, Policy #1-418-792 10,741.86 10. Proceeds from Penn Mutual Life Insurance Company, Pol icy #1513107 7,246.54 11. Proceeds from Penn Mutual Life Insurance Company, Pol icy #1341382 7,270.84 12. Proceeds from Penn Mutual Life Insurance Company, Pol icy #1380080 2,880.45 13. Philadelphia Life Insurance Company, Pol icy #129179 14. Social Security check dated January, 1981 15. Refund from Blue Ridge Haven Nursing Home Total Personalty 10,172.68 437.90 1,595.28 $516,362.10 CB/0477 /83661 ~ , oX ~'-~n !.t', l~ "'- ~-~ O. <..',', U.. .. ,~. .. c.' 0: ~~~? 6...: I w:.... >-. 0>-' c..: Wl1.l u::u: = ' Cl':i 0.- :-t:~~ w"" 0:5 ...,w ~ bJw ","" IX' .J U . . RF", 1593EX (11-B2 J P;~NSYLVANIA DEPARTMENT OF REVENUE \ BUREAU OF ACCOUNTS SETTLEMENT P,O, BOX 2055 HARRISBURG, PA 17105 RECORO AO~U5TMENT ASSESSMENT CONTROL NO. 101 INHERITANCE TAX J _ OATE 04-1i;:83 E5TATE OF BAILEY GEORGE R FILE NO. 21 81-0052 DATE OF DEATH 01-D8-.ll.l COUNTY CUMBERLAND NDTE: 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 DF WILLS. AGENT," JOHN E GARRY COMMONWEALTH NATL BK PO BOX 1010 HBG PA 17108 PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE ~l!~ ..A.L9~~ _ ~Hl~ _L!~E_ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . "INHERITANCE TAX RECORD AO~USTMENT*' ESTATE OF BAILEY GEORGE R FILE NO.21 81-0052 ACN 101 OATE 04-14-83 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION VALUE OF ESTATE: 1. Real Estate (Schedule AI 2. Slocks and Bonds ISchedule BJ 3. Closely Held Stock/Partnership Interest (Schedule Cl 4. Mortgages and Noles (Schedule OJ S. Cash & Miscellaneous Personal Property (Schedule El 6. Jointly Owned Property (Schedule Fl 7. Transfers (Schedule Gl 8. Total Gross Assets 111_ .00 ( 21 .00 I 31 .00 141 .00 (51 516,362.10 161 .00 ( 71 .00 ( BI 516,362.10 DEOUCTIONS ANO EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/Miscellaneous Expenses (Schedule Hl 10. Debts/Mortgages/liens (Schedule l) 11. Total Deductions , 2. Net Value of Estate '3. Charitable Bequests (Schedule J) , 4. Net Value Subject to Tax .00 67,819.19 ( g) 1101 67,819.19 448,542.91 .00 448,542.91 11'1 1121 113) (141 TAX: , S. Amount of line 14 taxable at 6% rate 16. Amount of hne 14 taxable at 15% rate , 7. Principal Tax Due TAX CREOITS: \PAYMENT I I DATE . \ 10-08-81 \ i 12-04-82 i I I , \ ~ ' RECEIPT # DISCOUNT (+1 'NTEREST H .00 29.25- 069733 070405 .- TOTAL TAX CREDIT 1- 7 .668. !l2.--! , BALANCE OF TAX DUE ! 54. 77CR I ,INTEREST .00 i ; TOTAL OUE 54. 77CR I (If Balance Due IZ Ip~~ tn8!'l $ 1 .DC no payment IS reQulredl . 'IF PAID AFTER DATE INDICATED SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST RETAIN THIS PORTION FOR YOUR RECORDS PURPOSE OF NOTICE: PAYMENT: REFUND (CRI: 08JECTIONS: AOMIN- ISTRA TIVE CORRECTIONS: INTEREST: To fulfill the requirements of Section 1745 (b) of the Inheritance and Estate Tax Act, Act 255 of 1982 (72 Pa. C,S. Sect,on 17451, Detach the top portion of this Notice and submit with your payment to the RegIster of Vvills. --Address information is listed on page 11 of the booklet. "tnstructlons for Inheritance Tax Return for a Resident Decedent." --Make cnec~ or monev order Cayable to: REGISTER OF WILLS, AGENT. All payments received shall flfst be applied to any mterest whICh may be due. with an~' remainder applied to the tax. A refund of a tax credit. may be requested by completing an "Applicatlon for Refund of Pennsylvania Inheritance and Estate Tax" (Form REV-1313l. Applications are available at the Office of the Register of Wills, any of the 24 Revenue District Offices, or from the Deoartment's Forms Service Unit 24 hour Forms Ordering telephone lines in Harrisburg - (717) 787-8094, in Philadelphia - (215) 351-2065 or in Pittsburgh - 14121 565-3601. Any party m mterest not satisfied with Ihe assessment of ta): as shown on thiS Notice ma\' object within sixty (60) days of receipt of lrllS NotICE' as follow:;: --by written protest to the Decartment of Revenue, Boarc' of Apceals, P.O. Box 8480, Harrtsl:lurg, PA --b\' election to nave the matter determlnec at the audit of Ihe account of tne personal representative --by appeal 10 the Orphans' Court. 17105-8480 OR OR Factual e'rrors discovered on thl:; assessment snould De adoressed In Writing tc' Ph. Deoartment of Revenue. Bureau of IndiVidual Taxes, P.O. Box 8327, HarrisDurg, PA 17105-6327. ATTN: Post Assessment ReView Unit 17171 787-6505. See cage 3 of tne booklel "Instructions fo~ !nheritance Tay Return for a Resloenl Decedent" for an explanation of adm;nlstratlvel~' correctable errors. Pennsvlvanui Estate Ta)' based on tne Federal EstatE Ta): return oecome!'. dellnouent a: the eXpiration of eIghteen (18l montns from tne cate of oealr.. Taxes whIch oecame dellnauent bet ore January ~, 1962 be2: mlere:;: ct tnt' rate of 51>: (6%) cercent oer annum calculated at a daily rate of .000164. All taxe~ whICh became aellnauent on or atter J.muaq' 1, 1982 will oear interest at a rate which will var\, from calenda" vear to calendar vea" wltr that ratE' announced bv the Pennsylvanla Department of Revenue. ThE' apollcable Interest rales for 1982 tnrougr 1987'are: Year Interest RatE' Dali\ Interest FaClcr lezr Intere::.l RatE? 0<111\' Interst Factor 1982 2m, ,000546 1ge~ 13(,. ,000356 1982 1 6~" ,000436 '95~ 1m: ,00027< 1984 11 ~~ ,000301 19B7 9~", ,000247 --Interest IS calculated as follows: INTEREST . BA~ANCE OF TAX UNPAID X NUMBER OF DAYS DE~INQUENT X DAI~Y INTEREST FACTOR --Any Notice Issued after the tax oecomes delinquent Will reflect an lrterest caiculat10n to fifteen (15) days beyone the date cd the aSSeS5mel'lt. 11 pavment IS made after the Interest computatlon eLate shown on the NotIce. addltlonal mtcrest must be calculated. fJ ~, r '" ~......~ '.1:.\";1" C""- -RESIDUARY TRUST- INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ~fV.15CO ex. 12.871 z o ;:: < .. ::l .. ~ o u )( < ... ,DECEDENT'S COMPLETE ADDRHS ... z ... " ... U ... " "'~9. 'f::~ COMMONweALTH o~ PENNSYLVANIA. OEPAlllMfNI Of ~EVfNUf POST OHICE BOx 832i' ~"'UItS8UIlG PA 11105.832:- 'DECEDENT.S NAME (lAst, fiRST, ..NO MIDDLE INITlALI Ba i1 ey, George R. 'SOCIA~ SECURITY NUMBER 172-01-3599 FlU NUMBlR COUNTY CODE 21-81-52 VEAR NUMBER DATE OF BIRTH 3-16-99 3610 Logan Street Extended , Camp Hi 11, PA 17011 iCgut\,~ CUIi:berland !DATE OF DEATH ! 1-3-31 ... ... < ",-'" v"'''' .....u :00 u"'... ..., .. < _ 1, Original Rerum ~ 2. Supplemenlol Relurn B. EnTer li'le 10101 of line 20 and 20A on jine 208, This is the BALANCE DUE. Mak. Chick Pavabl. ta: R.gist.r of Will.. Ag,n, .. ..BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.... u~d'r oenOlll'l 0; oequry, I Ol(lor, '1'101 I hoye uomlned lnil relurn. Including occornt'lonv,ng tcnedulel ana IIOlernen". ond 10 Inti cell of mv Itnowleo91! onD oeltl!f 11 '1Irue. correct ond comelele, I oeclore Inof 011 reo I ellole hOI been reDorled ollrue mon'e' value. Declorol'an of preporer Oln"r II'I0n Il'Ie Der!onal reOrelenlQlllI1! 1\ OOleo on aU informol,on 0; wrtlcn oreoorer 1'101 onv knowleoge. ,},CtNArURE OF PERSON RESPON!.IBLE FOR FILING RETuIlN ..OORE!I~ The COI,:I:;ol1lvealth IJatiOi1dl 8ank, Trustee ~IGNATURf OF PIlEPAllfll O~HER THAN.llllEPWfNU,TlVE AOORES!. By: tufa.J c..J4A-,<- I . _ 4. limited Euale ~ 40. FUlure Inleresl Compromise (for dale. of deo,h after 12.12.82} i] 6. Decedent Died Teslale C 7. Decedonl Maintained 0 living Trusl (Alloch copy of Willi (Attach copy of TrUll} ALl. COIRESPONDENCEAND CONFIDENTIAL TAX INPORMAnON SHOllLD IE DIRECRD TO. NAME COMPLETE ;M.ILING ADDRESS I... "'Z ...... "'a "'z 00 v.. COi,j";llllll'ea ltil Ilationa 1 T LEPHONf NUMBER I 8ank 10 SoUtll I~arket HarrisbUI'g, PA 7l:,0-:3112 z o ~ ... ~ ii: ~ ... '" 1. Real Ellale (Schedule AI ( 1 I 2. Slack. and 80nd. (Schedule 8) ( 21 3. Clo.ely Held Slock/PaMne"hip Inlerell (Schedule q (3) 4. MOMgage. and Nale. R"eiyable {Schedule 01 ( 4) 5. Cash, Bank D.posits & Misc.lloneous Personal Property( 51 (Schedule EI 6. Jainlly Owned PrapeMy (Schedule F) 7. Trande" (Schedule G) (Schedule L) 8. Talol Gran Assets (tolallin.s 1-7) . 9. Fun.ral Exp.n..s, Administrative COlts, Misdtllaneous I 9) Expen.e. {Schedule HI 10. Deb". MOMgage Liabililie., lien. (Schedule II 11. T 0101 Deduction. (10101 line, 9 & 10) 112. Nil Value of ESlat. (line 8 minus line 11 J 13. Charitable and Governm.ntalBequesu (Schedule Jl lu. Net Value 5ubj,ct to Tax (line 12 minus line 13) 15. Amount of line 14 tax obi. at 6% role (Include values from Schedule K or Schedule M.) 16. Amount of line 14 loxable at 15% role (Include values from Schedule K or Schedule M.l 17, Principal lox due (Add tax from line 15 and from line 16.) 1 B. Crediu Prior Payments Discounl 14,390.16 InlereSl 254.380.07 ( 6) 17) 50.0:1 (101 (15) 254.836.07 (161 + i 19. If line 18 is greater than line 17. enter Ihe difference on line 19. This is Ihe OVERPAYMENT. aQII..:r.r.I...,......I_.,(.11..U...'...I.,~111.h...,l.lnr.T:Ir.'I_.,.HI...l.......:J.:..li.,..,..... 20. If line 17 is greater Ihon line 18, enler the difference on line 20. This is Ihe TAX DUE. A, cnttor the inleresl on the betionce due on line 20A. _8. Street 171~ n,." ~'" ""0 "'-, r::i;, :t-- ;;::~; 0:7; n,.: t.":-" ~ t-' (111 1121 113} (141 x .06 = x .15 = (171 (181 (191 (201 (.:lOA} (208) x: 3. ~ 5. 1:-'.':":' ( 81 as sf Remainder Relurn 4 - 3 -38 (for dales of death prior It' 12.13.821 Federal Estale Talt Return Required TOlal Number of Safe Deposit Boxes ~ ",'" ,.,,~ V>'" ...0 ,,.,..., -;:19 ''- ,.:=, .,-., -0 '-;.- ,., ..:'1 z Qt... o ~ - ~ 254.386.07 50.00 254.336.07 none 254,336.07 15.290.16 15,290.16 14.350.16 900.00 57.43 957.43 ;jATf :::.H PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (",jIN THE APPROPRIATE BLOCKS. ~ ' o. YES I NO 1. Did decedjnt make a transfer and: I W Ix a. retain tlie use or income of the property transferred, ....................................... b. r<;"':lin ~~a ;ight to designate who shall use the property transferred or its incoYr.C". __.! X ~'t.j . c. retain ci'reversionary interest or .................................................................... d. receive the promise for life of either payments, benefits or care? ..... ....,........... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................. 3. Did decedent own an 'in trust for' bank account at his or her death?..................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. '. X X X X , .,,',", j. ': i~1 ~~ .., COM.'v\QNWeALlH Of Pf~lNSY(VMjIA INHeRITANCE T.\~ RfTUIl:N ~ESICENT OECEOENT SCHEDULE "H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCEllANEOUS EXPENSES ~ ~ PI~ase~P~~nt or Type FILE NUMBER 21-31-52 ESTATE OF George I{. Ba 11 ey ITEM NUMBER DESCRIPTION AMOUNT A. r Funeral Expenses: I. B. Administrative Costs: I. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions poid 2. Attorney Fees 3. Femily Exemption Cleimen' Relelienship Address of Claimant ot decedent's death Slreet Address City Stete Zip Code 4. Probate Fees C. Miscellaneous Expenses: I. Fil ; ng fees 50.00 TOTAL (Alse enler on line 9. Recepiluletienls 50.00 (If more 'pau i, ne.d.d, inl.,t odditional,h..ts of same sin) " of my cst~t~, or nny trust crc3tcd hereby, nnd to make such payments th~rcfor .15 they :n.:1Y d~cr.\ rC.1sonnbLc and to ch.:lrgc the e:<pcnsc9 charcoE to income or princip31 35 they m.:1Y determine and to delegate to such persons any discrction ,~hich they mOly deer.! proper. The. Executors or Trustees shall not he liable for nny-negligence, omission or wrongooing of such counselor agents, providing reasonable cnre was exercised in th~ir selection; O. '!'O exercise all pOt/er and authority, including any discretion, conferred in this I~ill, after the termination of any trust created herc.by and until the same is fully distributed; P. To make distribution of either principal or income, as the case may be, to or for the benefit of minors as if such minors were'of full age without the intervcntior. of a guardi.:!n, with power to apply such income or principal, in their absolute discretion, to the maintenance, education and support of such minors either directly or by payments unt~ !'".... ~..':':"~r t)r persons as they 11l.3y Ill: J.t:t..I,., tht! receipt of any such payee to be a full and complete discharge to them. The E~ecutors and Trustt!es shall have the full ,., power to accumulate any income not applied for the foregoing purposes. Q. Should the principal oi any trust be payable to a minor or minors, the Trustees shall continue the t~:~ or J~i~ :~ust as to said minor or minors until it or they attain t~..enty-one (21) ye.:J.rs oi age, paring over to said ~inor or minors. or for their use or b~nefit, the proportionate shares of the net income of 5.Jid estate. The Trust:!es shaU, in cn.!ir discre:ion, he authorL:ed to accumulate said i.nco~e for thl! heMfit of said minor or minors. 1\. ::0 :il: l~ in any Trust Est.:tte, or in the inco~e accruing ':':. ;.:.- ...,;..::;,~,uiat1.cn sh.Jil v~st in ':HI:.. beneiicio1ry, and no the:- .~~ ...., I benefici.uy shall h.1ve the right or power to transfer, .Jssign, anticipate or encumoer hi9 or her i.nccrcst in 5.1i.d Trust E:it.Jtc, or tha income therC!from, prior to the 4ctu.11 Ji;icri.bution thereof by the Trustees to said benefici.1ry. -9- .. , ' . . Further, ndther the income nor the principal of any Trust Estate shall he li~blc in any manner, in th~ poss~ssion of the Trustees, for the debts, contracts or cnsagements of any beneficiary; S. To jnin with my wife, or her executors or administrators, or consent to, o. the case ma.y be, in executing ond fiUng of joint income tax, gift tax or other similar t.:IX returns as they sha 11 deem advisable, and to agree on hoW' tho tax sha 11 be shared if at all; T. To elect to claim as a deduction for income tax purposes any or all administration expenses which are deductible for either estate or income tax purposes. No adjustment shall he ~de between ~=i~~i~al and income because of such election. SEVENtH: I direct my Executors to payout of that portion of my residu3ry estate referred to in p3ragraph FOURTH hereof all transfar, inhe~itance and esta~c ~~~~~, including interest and gp~~)~;~, that may be due as a rasult of my death, including any and all such taxes that may be due on any bequest and deviae contained herein or in any codicil hereto, whether of principal or income, including futu~~ interasts and remainders on joincly ol.l1l~d prcr-~::'~j'. .::~ .,,:,:: ;:=oF.:::'::" pa5si:-..:; C::.!7'":",':' .1.,-- '_.~.:.:.: t:l~J OJ' Last lau and Testament, on thl! proceeds of :10:' insur:1nce poLicies or annuity contr:1cts payable on my de,:u:h, so that the sar.1:! ma)' be paid in fU1l1.-ithout deduction for any such taXes. EICHTH: I nOr.1it1."c~, con'ititute .and appoint ELIZ.\!l:nt SCOTT 3.\U:Y and TKZ HARRISBURG ..:.::'.... - .. :... ',:--: :-:":':::,!, Co'iPANY .15 Executors and T~ustecs oZ this m)' Last will ,lod Test.:lment. llI:;,!,R: In the event of the failure to qU.:1lify, rc:;iGnation, or removal of th~ corpC'r:J,t~ EXecutor .lou/or Trustee .lbove n.1med, -10- F!tGi ~7{? j/- //17- '-I- -, :Ai\IT,\L TRUST- 'fiLl NUMBER 21-31-52 COUNTY CODE VEAR NUMBER llfV.I~OO Ex,. '2.871 '. ~ INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) IDAlf OF DEATH' ! 1~-,)j (DECEDENT'S COMPUTE ADDRESS 3610 Lugan Street Extended Camp Iii 11, P,~ 17011 Cun:berl and w 40. Future Inferesl Compromise (lor dol.. of d.o,h oft.r 12.12.821 [16. Decedent Died Tesfole r; 7. Oeceden, Maintained a Living Trust I (AHoch copy 01 Willi (AHoch copy of Tru"I AU CORRESPONDENCE,ANO CONFIDENTIAL TAX INFORMADON SHOULD IE DIRECTED TO: NAME COMPl MAILING ADDRESS Co,,:,nonVlealth National Gank 10 South Ilarket Square TlEPHON'NUMIfR Harrisbur9, PA 17103 ! '19. If line 18 is arealer tnon line 17, enter Ihe djfference on line 19. This is the OVERPAYMENT. acr~m!'ll'l"""I_';I'~'.'I'''''''''I'I''''"I'''.'.liJrrr.r:n_.....!.I...I......I.:J.:.t,.I."I....I. 20. II line 17 is grealer fhon line 18. enler Ihe difference on line 20, This is the TAX DUE. A. Enter Ihe Interest on the balance due on line 20A. B. Enter Ihe Iota I of line 20 end 20A on line 208. This is the BALANCE DUE. Make Chock Payable to: Register of Will., Agen. .. ..BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.... SI NA VII By; ADDII Estate Tax Specialist >- z ... Q ... U ... Q COMMONWEAlTH OJ PENNSYlVANIA DEPAIITMENT OF IIEVENUE POST omCE 80x OJ2'! HARIUSBURG PA I'! 105-8327 IDECEDENT'S NAME ILASI, FIRST. AND MIDDlf INITIALl :] 3. :] 5, Remol1lder Return (for dotes of deeth prior to 12.13.B2) Federal Estete Tax Return Required TOfal Number of Safe Deposit Boxes Gailey, Geor~e k. I SOCIAl SECUIIITY NUMBER 172-01-3509 ,DATE OF BIRTH : 3-16-99 ! , I ICOUI\I~ _8, n ft._- nr- ::0' c"" ::0", :3:"" ""n ....'" 5; ""0 ,.,' Vi", ::::as! :z: ....0 r-- fllrr, >~ W :1,'9 z,,,: <:) "'.:'1 0:1':' ~ "~ ." n ' a . ~:~ o(.~ ::), <"". - n -;,," VI ':" ~.? ::.,; ~~: ( 8) .1>170,972".29 "." (11) (121 (13) (141 x ,06 = 50.00 170,922.29 none 170,922.29 10.255.73 ... >- :.::!'" u"',. ......u :00 u"'... ..... ... 00: _ l. Original Rerurn ~ 2. Supplemenlal Rerurn x ,15 = 1171 10,136.54 _ 4. Limited Estate (ISI (19) (201 120A) 120B) 113.80 7.58 126.33 I >- "'z ..... "'a "'z 00 v... 717 ) 700-3112 -- und., ..nou", .i .."u'y, I 0"'.'. 'h., , h.,. ".m,n.d .h.. r.",", ,nCluo,no occomoony,ng ICh'"u'., ana "."m.nll, ana '0 'h. ..11 01 m, know,..o. .n. o.,,,f " I. IIU., c."." .nd comol.... I o"lor. 'ho' .11 '.01 ..'a'. ho. bun "oon.o. a. IIU. mo"" 'a"". D'Clo,o!!on oi 0".0'" o'n" 'hon 'n. ."'ono' ,e';'...n,o!!" " :30S80 on ojJ in/ormollon Of ....."'ien Dreoorer nOI on... kno.....leooe. jIQ",...TURE Of PERSON RESPONSI8LE FOR FILING RETURN ~ODRES5 CATE The COII<,lOmleal th ;,ational r,ank, Trustee z o ;: ~ ::l .. iL ~ ... '" 1. R.ol Ella'. (Sch.dul. A) 1 I) 2. Stock. and Bond. (Sch.dul. 8) ( 2) 3. C1o..ly H.ld Stock/Porln."hip Int.r... (Schadul. q (3) 4, MOrlgog.. and No'.. R.c.ivabl. (Sch.dul. D) I 4) 5. Cash, Bonk Deposits & Mileellonea". Personal Prapeny( 51 (Sch.dul. EI 6. Jointly Own.d Prop.rly (Scft.dul. F) ( 6) 7. Tronsf." (Sch.dul. G) (Sch.dul. l) I 7) 8. T alai G,o.. An... ('olollin.. 1-7) 9. Funeral bpen..., Administrativo COSfS, MiKltlloneouJ ( 9) exp.n.., (Sch.dul. H) 10. D.b... MOrlgog. liobili'i.., li.n. (Sch.dul. I) (10) 11. TOlol D.duction. (tolollin.. 9 & 10) /12. Net Yalue of Estat. Ilin, 8 minus line 111 I 13. Charitablo and Governmental BfJquellS (Schedule JI /14, N., Volu. Subi.ct 'a Tax (Iin. 12 minu.lin. 13) 50.00 170,972.29 z o ;: :! ::l .. ::s o u )( <t >- 15, Amoun, of line 14 taxable at 6% rat" (Indud. ,alu.. Iram Scft.dul. K or Sch.dul. M,I 16. Amoullt of line 14 taxable at 15% rote I (I"dude volues from Schedule K or Schedule M,l I 117. Principal talC due (Add fOx from line 15 end from line 16.) , 11 B. Credits Prior PqylJleJ\ft 10,100.0'+ Inlerest (15) l7CJ, 922.29 (161 Discounf + OAfE ", '.'''. q ~~ ,,; , I '. :. .~~.. of'> .... , SCHEDULE J BENEFICIARIES , ::"''''0,.....'.....:' ~!.....~'~.......i. ...., '1IloI,'.! '., ~I'L' ~'. ~!SIOf'.' :U::!:'!'.' FILE NUMBER ~STATE OF GeUI"ue I;. ~a i ley ITEM NUMBER ITEM NUMBER ' 21-131-52 NAME AND ADDRESS OF BENEFICIARV AMOUNT OR SHARE OF ESTATE RELA T10NSHIP A. Taxable B'JoueSlS: I. Tile CU;;::;:ulllveal th ;:atiunal Bank, Trustee Residue Beneficiaries Anne G. Hackney and uescendants ~usan b. Scott and Descendants i::li~abeti1 iI. ~aldastai;i and Descendants Daug hter Daughter Daughter I nCOl,le frOl:l Trust for 1 ife. Upon the death of each Daughter, the then rema i ni ng pri nci pa , is to be distribut to her decendants per stirpes. Please nute that the 1 ife tenant, at her death, exercised her General Testamentary i PUVler of ,\p~ui nt,;:ent in favor of her i Inter-Vivus Trust Agree,;-,ent with COII:n:oll\.;ealth I Ilatiun.al Bank. Copies of the life tenant's I last ,iill and Testa:;lent and her Trust ;,greei,:ent are attached. I , i , I NAME AND ADDRESS OF BENEFICIARV AMOUNT OR SHARE OF ESTATE B, Charitable and Governmental Bequests: 1. i.une TOTAL CHARITABLE AND'GOVERNMENTAl BEQUESTS (Also enter on line 13. Recopilulalionj (If more spac. is n....led, insert additional sh..ts of sam. sin) s r:one I I I , I j I I I I I I ,-'It.-. '" .:-,;.. ..... '- "- - L;'ST lJILL Mm rzsr/oNENT OF GoORGE REILY BAILEY I, GEORGE REILY B'ILEY, of Che Clcy of Harrisburg, Councy of Dauphin, State of Penn'Ylvonl', do make, publish and declare this as and far my L,'st 1.:lll nnd Test.m'nc, hereby revoking any and all former Wills and Codicils by me oJt .::Jny time. made. 'IRST: I give and bequeath all my jewelry, eloChlng, Silverware, huus'hold furniture and furnishings, aUtomob~les, personol eUeets, etc., exelusiv, of cash, steeks, bends and ether securiti.e" teg"h" with nIl pOlicies ef insurenee thereen, Unte my b,lov'd wif., ELIZ.tJETH SCOTT B.\IU;Y, if she Survives m" fer discributlen Co her,Ol, er by h,r omeng my ehlldr.', ",.~ ,,,..cly as she may de.m bes<, '''0: wlChouc respenslhilicy en her porr Co oeeeunc te anyene for distribution ef ch, sem.. If she does not survive me, then che property herein bequesthed shall b, divid,d 'mong my ehil",," in equal preporeiens enu In aetordanee WiCh their selaetlons, th, iasue of any deee"sed ehlld to receive his or her pllr~nC3 ShDr~. seC'JUD: Fi\.'~ ThClllSJnd DoIl.:Jrs ($5,000.00). t &iv~ a~u b~que.1th Unto H.'.'.......,,\l,.' .....J..:iTOT, in appreciacion ef hi, ioyoi and d,voCed service ov," many years, the SUm ef TIIIRD: If my Wife, ELIZABErH SCOTT BAILEY, ,urvive, me, I Sive. d.vise "nd hequeaCh un Co my Truseees, herelnafc,r na"ed, Co hold in trust .1S , separatu crust such "mOUnt as m.y be required to give my use", ch, full mora.11 duuu,"io!! alle"."lu ior reder,'i Eseate l'ox under Che - ':.~ .: . : ..c.~_.... .........:.:......; "'t.';;::.::' ....... .'.'. , /:'.~ ~ ..... incrcmcnt5, rents Jnd profits ther~fromi B. To sell, exchange, partition, lell~c or other....ise dispose of any propcrtj' or p.:l.rt thereof, real or personal, of which I mily die seized or posscssed or t~hich may at any time ferm part of my estate, or any trust crented hereby, <1t public or private sale for such purposes and upon such termS, including s<1les on credit with or without security, in such manner and .:l.t such prices as they r.lay detcrmin(!, includins:; the right to lease re31 est.:l.te for periods in excess of five (5) years and for a tera expiring after th! termination of any trust. In the event of .3 sale, exchange, partition or lease of any of the prop::!rty of my estate, or any trust created hereby, there shall be no Ibbil,~ty on the part of the purchaser or purchagers to see to the application of the purchose money, but ~he same shall be held and dispos::!d of by such purchaser or purchasers, free and clear of any of the :....~: ~ . provisions of any trust created hereby. Insofar as my Executors are conr.~".~ nothing in this paragt.aph is tc :'c:. .:....II,,;;~ut!d to work a conversion at my real estate unless and until the power is actua 11)' exercised. C. To continue any investment which I may have made during my lifetime .3nd which may form a part of my estac.c, or any trust hereby created, or to invest 0[' reilwest any funds in my estata. or any trust created hereby, i.n "',::,o':lerty, real or per:iOn.,l. of an>' kind or nature, including stocks, bonds, mortgages, other securities. and common trust funds of the c::orpor.:l.te Ex.ecutor and Trustee, Ilithout b~ins li:nited or rcstrict.:!d to investm::!nts as now or may hcreoftcr be ?rcscribcd fer fiduciaries by eh.:'!: laws of the Commonwealth of Pennsylv.\nia or nn>' other state., it being ~;; intention to give m>. Executors nnd Trustees the same power of investment and reinvestment :.,'hich ! myself possess ....ith respC!.c.t to ~:/ o....n funds. Thi~ po....cr specific..lll:l includes the authori:ation to reenin, buy or sell nny sh<1res of the stock of r.lY corporate -6- , ':: of my estate, or any trun created hereby, .:lnd to make such pJj'mc:nts thc:rcfor as they m~y d~crn reasonable and to charge the expenses thereof to income or principal as they m:lY daten'mine and to delegate to such persons any discretion ,~hich they may d~er.l proper. The Executors or, Trustees shall not be liable for any.negligence, omission or wrongooing of such counselor agents, providing reasonable C~re was exercised in their selectionj O. To exercise all paller 3nd 3uchority, inCluding any discretion, conferred in this l.lill, after the termination of any trust created hereby and until the same is fully distributedj P. To make distribution of either principal or income, as the case may be, to or for the benefit of minors as if such minors were of full age without the intervention of a guardian, with power to apply such income or principal, in their absolute discretion, to the maintenance, education and support of such minors either directly or by payments um:e ~.....h :""O:~~:" f')r persons as they rnay .!tt:!tll.."", the: receipt of any such pa.yee to be a full and complete discharge to them. The Executors and Trustees shall have the full power to accumulate any inco~2 not applied for the foregOing purposes. q. Should the prinCipal or any trust be payable to a ~inor or minors. the Trustee:s snaIL continue the t~=~ of 3~i~ t~Ust as to said minor or minors until it or they attai.n C~:enty-one (21) years of age, pa)'ing over to said minor or minors, or for their use or bene:fit, the proportionate shares of the net income of S.1id estate. nle Tru3t:!es shall, in cheir discre:ion, be authorized to accu.lluliltc said inco:ne for the benefit of said minor or errinors. R. !:o title in any Trusc Escatc, or in the income accruing the: _~_'.."" ':'.: .:.~..: ";":';~,,,;;ui.lticn s0.111 vast in any benefiCiary, and no benefiCiary shall h.1ve the right Or pO~er to transfer, assign, anticipate or cncumol.!r his or her interest in ~.1id Trust E~c.1te, or the income. therC!:from, prior to the actual distribution thereof by the Trustees co said benefiCiary. -9- , ." .. ". ., or its sucr.essor selected in the mannar hcr~inaftQr get forch, I hereby authorize, and empo!""er the individua 1 survivor and him or her only to nominate, constitute and appoint another reputable trust: company as its succ::!sso:" Executor and/or Trustee by an instrument in 1Jricing. duly executed and ackno....ledged by said individual survivor. T:::lTH: If my wife, ELIZABETH SCOTT a~ILEY, predeceases me or for any reason does not act, desire to act or continue to act 45 Trustee hereunder, such vacancy may be filled by an individual to be select~d by my than adult children. ELEVENTH: I ~~=~c: :~~t ~~ =~~ of my Executors a~d trustees shall be required to give any bond or other security in any court or jurisdiction for the faithful performance of eheir dueies. IN ~lIT:.;C:SS ~Rr::OF, I have hereun::o see my hand and seal this *">.~ day of ~ ~ A. D., 1965. ~~-~~ ~ CZORGE REILY BAI"t.Ey .. ...... ~(SEAL) SIC::~D. SEALZD, PUBLISHED and DECt.\RED by the .:!.bove GEORGE REILY BAru:'i, .15 and for his Loise Will .1nd TC5t.1menC in th.! of us I who, at his request, in his presence and in the prase nee of. ho1VC hereunto SUaseribr.!d Our na:n~s .1S \litnessas. named Testator, presance each other I l~~b'h."'- ,. ~ ~'-" \ I' -\-< '1_""'"" -,....... ...... R.Ll./ f..;.. I Li!.; ....hJ1.. C t ,./ 'G\I\. r-,J.~ J.... 3M nht.l6"''''_'~ ~ ,\ddress R~, ~...d-~4, M~ -11- . ?E464A KAS:'"p 7/12/84 I il ~ i REVOCABLE AGREEMENT OF TRUST I, ELIZABETH SCOTT BAILEY, am transferring the property listed on , Schedule A attached hereto to THE COMMONWEALTH NATIONAL BANK, of 'j I ,1 I " 'I I, ,; :1 " ,I Harrisburg, Pennsylvania, as Trustee, and I therefore direct my said Trustee to hold tha said property and all other property added to this Trust by me or by others (hereinafter called "principal"), In Trust, and to distribute the principal and pay the net income at least quarterly as follows: FIRST: During my lifetime: I Iii writing and to accumulate and add to principal as much of the net income as I may " I: Ii !i :1 jl ;I :i " II i 'I ! il II II II I I, II II (a) To pay the net income to me as I may direct in so direct. (b) To pay to me or as I may dIrect In writing as much of the principal (even if aU) as I may from time to time so direct. (c) During any period in which I am incapacitated by reason of age or illness (mental or physical), to apply for my benefit as much of the net income and principal as Trustee, in Trustee's sole discretion,' deems advisable for my welfare, comfort. support or any other reason whatsoever. The receipt of any payee of a payment for my benefit shall be a complete discharge to Trustee. Any net income not 50 distributed shall be accumulated and added to principal. SECOND: Upon my death. (a) To divide the balance of principal Intu as many equal shares as there are daughters of mine then living snd daughters of mine then deceased represented by descendants then living, and I. To P&j' .~h.:l ::l:.:.::- ~,. .:. . -...... -.---..- daughter to her then living descendants. per stirpes. ,I :1 , ~ ,; il , ?E46lA k:AS:wp i/l2/84 any reason during the period of incapacity. Income not so applied shan be i' accumulated. invested, and If not sooner applied, paid to such individual upon , " " gaining capacity. .1 " I (m) With respect to a principal share vesting in a i beneficiary who is a minor or who, in the opinion of my Trustee, is otherwise incapacitated by reason of age or lUness (mental or physical) when such share vests in him or her: to hold the share during his or her Incapacity and to Invest the share and all accumulations thereon; to apply so much of the Income and ,I principal as my Trustee deems advisable for such beneficiary's benefit for any reason without considering other funds available to him or her; and to deliver the i " ,I 'I .: capacity. In addition, at any time to pay the entire share to the surviving parent 'I Ii balance of principal and Income to the beneficiary at such time as he or she gains of the minor as natural guardian or to the guardian of the person or the estate of , " the minor or incapacitated beneficiary to hold for his or her benefit. The receipt :1 of a parent or guardian or such other person as may be selected by my Trustee to ;1 receive a distribution under this subparagraph shall be a full and complete 'i :1 discharge to my Trustee. .1 I' SEVENTH. (a) A beneficiary's incapacity shall be cetermlned I II solely by the Trustee. II (b) The receipt of any payee of a paymen, fo, the i I benefit of an incapacitated beneficiary shall be a complete dischargt to my ! Trustee. II instrument other than a Will lodged witb Trustee, to amend or revoko this I, II I 'I EIGHTH: I reserve the right at any time or times, by ,':ritten Agreement of Trust In whole or in part, provided that the duties, powen and llabilitlfu: r,f T"....',.,. SMAil nnt h_ llubstantlally Increased without Its written consent. I may add other property to this Trust and eny other person may do the " I same, provided that Trustee gives Its written consent to each such a~ditlon. I ! -5- I i II " , Value or Shares $20,000 $ 6,000 600 sos 200 shs 15 shs 150 shs 15 shs 45 shs 200 shs 4,600 shs 800 shs 1,600 shs 408 shs 15 shs 2,224 shs 15 shs 800 shs 300 shs 15 shs 400 shs 1,000 shs 15 shs 200 shs 500 shs Elizabeth Scott 8ailey riA 19525-01-3 Schedule A DescriPtion Master Reserve Trust Pa, St, GIO Hwg, 4, 70% 12/1/86 Penna, St, Tpk, 3,1% 6/1/93 Alcoa American Can Co, Ameritech (AIT) AT&T (New) 8el1 Atlantic Corp, 8el1 South Corp, Campbell Soup Co, Commonwealth National Fin'l Corp, Consolidated Edison Co" N,Y, Hershey Foods Corp, Kimberly Clark Nynex Corp. PPG Pacific Telesis Group Phillips Pete, Co, Quaker Oats Co, Southwestern 8ell Corp, Texaco, Inc. UGI Corp, U, S, West, Inc. Upjohn Westinghouse Electric r Tax Cost 8asis $ 72,808,32 19,895,00 5,242,50 3,600,00 4,884,92 821. 35 2,264,88 833,61 1,075,50 4,834,43 19,794,60 8,050,40 15,491. 76 5,142,98 782,22 9,543,19 705,54 8,555,38 1,543,15 754,16 4,000,00 6,500,00 7l0.68 4,278,00 2,787,48 $ 204,900,05 Market Y!.!J!!.. $ 72,808,32 18,406,BO 5,940,00 20,250,00 8,900,00 1,003,12 2,587,50 1,066,87 1,299,37 12,450,00 142,600,00 20,500.00 53,600,00 16,473,00 954,37 65,608,00 841,87 28,100,00 18,900,00 860,62 13,450,00 17,250,00 888,75 11,200,00 10,312,50 $ 546 , 251. 09 I , I I I I HEI59 DSB:bkr 12104/84 2. I hereby revoke Paragraph FIFTH in its entirety and substitute therefor the (ollowing: "FIFTH: To the extent that they have not been paid from my testamentary estate as provided In my Will, death taxes (and Interest and penalties thereon) Imposed as 8 result or my death cpon the principal of this Trust, upon property passing under my Will (other than any appointive property passing thereunder) and upon proceeds or insurance on my life, but not otherwise, shall be paid out of the principal passing under Paragraph SECOND, each share thereot, whether (i) outright or in trust or (il) valued in accordance with s'Jbpara~raph (a) or (b) of Paragraph SECOND, to bear a 'pro rata portion of such taxes." Executed in duplicate December I -S:"1984, In the presence of: Ii., i'>o ~ ) . W~ ~",.,L -it SJ ~~c.)- " Elizabeth Scott Bailey -......... "1 Received ti.l1d Accepted: ATTEST: COMMONWEALTH NATIONAL BANK :J&;rzu Q fhrlJ "'UsT C>Fplc~ By: ..4t:12/c()1 " ~ I:' /v'a.<<1..u>. Trost 0,:.:::1' -4- ~ " I I :! II , ! I I I \ dated SECOND AMENDMENT TO REVOCABLE AGREEllENT OF TRUST 'NHEREAS, by Paragraph Eighth of a Revocable Agreement of Trust July ll, 19a1, between me, ELIZABETH SCOTT BAILEY. as Settlor, and COMMONWEALTH NATIONAL BANK of Harrisburg, Pennsylvania, as Trustee. I retaintd the right to amend or revoke said Agreement in whole or in part: NOW, THEREFORE. pursuant to such right so retained and further reserving to myself the right at any time further to amend or revoke said Agreement, I hereby amend said Agreement as follows: 1. I hereby revoke Paragraph SECOND substituted by First Amendment to Revocable Agreement of Trust dated December 15. 1984, in its I' I I II 1\ II I entirety and substitute therefor the following: "SECOND: Upon my death. (a) If my daughter, ANNE KING BAILEY HACKNEY, or any of her descendants survive me and that certain :\tortgage by and between my said daughter as ~10rt~agor and me as ~ortgageel dated September 9, 1986, as the same b'e amended from time to time (the ":\10rtga~e"), forms a part-of the principal hereunder, I direct my Trustee to value the ~10rt~age, for the purpose of division of the principal into $hares under subparagraph (c) hereof. at a value equal to the principal amount outstanding of the Mortgage, together with any accrued and due but unpaid interest outstanding thereunder, and 1 further direct my Trustee to allocate the I 11 1 I i II I' I' il \10ru;age so valued to the share of my daughter, ANNE KING t:IAILt.'t HACI\Ni.t, or, In tne event she fails to survive me. LO the share of her descendants who survive mej and -l- - i; II :1 Ii II held under the terms thereof as applied to circumstances then existing. (d) To pay to or apply for the benefit of any descendant of mine so much ot the principal the trust from which he or she may receive income as my Trustee deems advisable for his or her maintenance, education, health and support. In the exercise of this power for any person, funds available to him or her from other sources shall be considered by my Trustee. Payments so made shall be charged against the trust generally. (e) Except as provided In Paragraph SIXTH(l), aU trust income accrued or undistributed at the death of an income beneficiary shall be paid to the succeeding Income Or principal beneflciaries.t1 -3- ^ ..---- -_._----_.-~-~----------.-........__..- .-.-.. --_._--_._-_..._-_.~-_.-- ..---- --.-- '> D M401722 COMMONWEALTH OF PENNSYLVANIA NO, DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYL V AN IA INHERITANCE t;ND ESTATE TAX IHV.11112EX(12-B/t1 ~~ Bank T I I I I I , I n ! .. .-.....-..--.--....--.--------- - - ~--~_.~_._._..~-- _._-~--~.~-_._.__.- ..__.~_.,_.,_._._. ......m... RECEIVED FROM, i ACN ASSESSMENT ., CONTROl LiII NUMBER AMOUNT Commonwealth National Trust Department P. O. Box 1010 HarriSburg, Ph 17108 .101. _ $10~J.3 6.!i4~ ESTATE INFORMATION, fJ FILE NUMBER 21-81-52 m NAME OF DECEDENT (LAST) . Dilley I] DATE OF PAYMENT r.lI '......l,J.!Ut8 IiII POSTMARK DATE :OUNTY I I I , i I J I IFIRSl)--'---iiiiy.--i George~_.__..J.3.L~J I ________.__...__1 I fOIOHHf I I ;';"J / -,.-' a.J I SEAL ~' I, . ;.'; ~." . RECEIVED BY;! -lj.4~,--r,.;;.- i ,- ~ 1 ... } NATURE j '(j I ! . REGISTER OF WI l L:; . r- - -------,------ - ------ -----~ I ! DAlE OF DEATH cumbflr~and..........___________r-...----.. ___ ___I .anuar.yJ,J9J31 ~ TOTAL AMOUNT PAID ..... $10 ,136.5A__ REMARKS '" 1 REV-1847 EX (12-88) * 'C::~MONWEAlTH OF PENNSYLVANIA NOTICE OF INHERITANCE TAX DEPARTMENT OF HEVENUE ACN 103 BURE.U OF IHOIVIOU., T.m":\,'.~ '. . APPRAISEMENT, ALLOWANCE OR OISALLOWANCE OEPT, 28080' OF OEOUCTIONS, ANO ASSESSMENT OF TAX HARRISDURCi, PI. 17120'0601 DATE - 7- ESTATE OF BAILEY GEORGE R FILE NO, 21 81-0052 DATE OF DEATH 01-08-81 COUNTY CUM8ERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS, MAKE CHECK PAYA8LE TO "REGISTER OF WILLS, AGENT", REMIT PAYMENT TO: COMMONWEALTH NATIONAL BK 10 S MARKET SQ PO BOX 1010 HBG PA 17108 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Amount Remitted CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS - - - - - -- - -- - - -- -- - - - - - - - - -- --- - - - - - - - - - - - ---- - - - - - - - - - - -- - - - - - -- -- - - - - - -, REV-1547 EX (12-88) NOTICE OF INHERITANCE ESTATE OF BAILEY ACN 103 TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF OEOUCTIONS ANO ASSESSMENT OF TAX OATE 03-27-89 GEORGE R FILE ND,21 81-0052 TAX RETURN WAS: (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISEO VALUE OF RETURN BASED ON: REMAINDER RETURN \, Real Estate (Schedule A) 2, Stocks and Bonds (Schedule BI 3. Closely Held Stock/Partnership Interest (Schedule C) 4, Mortgagas/Notes Receivable (Schedule 01 5. Cash/Bank Deposits/Misc. Personal Property (Schedule El 6, Jointly Owned Property (Schedule F) 7, Transfers (Schedule GI 8. Total Assets n ) CHANGED ("")~ c__ ::!:x lX, "'0 ~:tJ ( 11 .O~_: 12) 170,972.2W;': (31 .00':-' ( 41 .00 151 .00'.. 161 .00 I 71 .00 ( BI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/Miscell;meous Expenses (Schedule HI 10, Debts/Mortgage Liabilities/liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule Jl 14. Net Value of Estate SUbject to Tax NOTE: If an assessment was Issued previously, lines 14, 15 and/or 16 and 17 will reflect figures that include the total of ALL returns assessed to date, ASSESSMENT OF TAX: 15, Amount of line 14 taxable at 6% rate 16. Amount of line 14 taxable at 15% rate 17. Principal Tax Due TAX CREDITS: ( 91 1101 50.00 .00 (11) (12) (13) (14) (151 (161 170,922.29 .00 X,06= X,15= (171 PAYMENT DATE DISCOUNT 1+) INTEREST H AMOUNT PAID RECEIPT NUMBER 07-01-88 01-30-89 401722 441079 .00 7.55- 10,136.54 126.38 L 00 \0 ::I: ",. ::0 N --.J :!2 N ~ ./>0. ::o~ ;-1 ~~-)o m:O ,-;0 ('l1'T1 -. f;-:l -' - . ~ " ..':f 170,972.29 50.00 170,922.29 .00 170,922.29 10,255.34 .00 10,255.34 TOTAL TAX CREDIT BALANCE OF TAX DUE .03CR INTEREST .00 · ~FP:~DI~:;;~:LT~~E~:;i SEE REVERSe ~OR CALCULATION TOTAL DUE .03CR IIF BALANCE DUE IS LESS THAN $1 OR is REFLECTED AS A "CREDlr' ICRl. NO PAYMENT IS REQUiRED) ~. .... ......- RESERVATION: Estates of decedents dying on or before December 12, 1982 -- If any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) benefIciaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly rElserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B "'(collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: To fulfill the requirements of Section 1740 of the Inheritance and Estate Tax Act, Act 255 of 1982 (72 Pa. C.S, Section 17401, Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on reverse' side. --Make check or money ordar payable to: REGISTER OF WILLS, AGENT, All payments received shall first be applied to any interest which may be due, with any remainder applied to the tax. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 24 Revenue District Offices, or from the Department's 24-hour Forms Ordaring talaphone Iinas in Harrisbur9 - (717) 7B7-B094, in Philadelphia _ (2151 550-2065, or in Pittsbur9h - (412) 565-3601. OBJECTIONS: Any party in interest not satisfied with the appraisement. allowance or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17 t 28-1 021, OR --election to have the mlltter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN - ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit,Dept. 2B0601, Harrisbur9, PA 17128-0601. 1717) 7B7-6505, See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-15a 1) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the t;lX paid is allowed. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calcUlated at a daily rate of .QOO 164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 1988 are: ~ Interest Rate Daily Interest Factor .Y!:!. Interest Rate Daily Interest Factor . 19B2 20% ,OO054B 19B6 10% ,000274 19B3 16% ,OOO43B 19B7 9" ,000247 " 19B4 11% ,000301 19BB 11% ,000301 19B5 13% ,000356 19B9 11% ,000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAIO X NUMBER OF OAYS OELINQUENT X OAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an 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. J '~.'N' " ",.U, '\(~~ C.tMMOHWfAlTH OF PENNSYlVANIA DEPARTMENT OF REvENUE BUREAU OF INDIVIDUAL TAXES DePT. 280601 HAflflISBURG, PA 17128.0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, A~~OWANCE OR OISA~~DWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ACN 102 ESTATE OF BAILEY DATE OF DEATH NOTE: TO INSURE PROPER CREDIT TO PAYMENT TO THE REGISTER OF DATE FI~E NO, 21 COUNTY C YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX WI~~S, MAKE CHECK PAYAB~E TO "REGISTER OF WI~~s, AGENT", R GEORGE REMIT PAYMENT TO: COMMONWEALTH NATIONAL BK 10 S MARKET SQ PO BOX 1010 HBG PA 17108 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 I Amount Remitted ~l:J! _Ag)~~ - !f!I~ _l!~E_ _ _ _ _~_ _R!=!~I~ _ ':~~~R.. !"9~!'9~ _ ~q,R.. .Y9~~ _ R..E_C9f19~ _ -:"'.. _ _ _ _ _ _ _ _ _ _ _ _ _ . REV-1547 EX 112-88) NOTICE OF INHERITANCE ESTATE OF BAILEY TAX APPRAISEMENT, A~~OWANCE OR DIsA~~DWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX GEORGE R FILE NO,21 81-0052 ACN 102 DATE 03-27-89 TAX RETURN WAS: I X I ACCEPTED AS FI~ED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VA~UE OF RETURN BASED ON: REIlAINDER RETURN 1. Real Estate ISchedule AI 2, Stocks and Bonds ISchadule BI 3, Closely Held Stock/Partnership Interest ISchadule CI 4, Mortgages/Notes Receivable (Schedule 01 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6, Jointly Owned Property (Schedule F) 7, Transfers ISchedule Gl 8. Total Assets ) CHANGED n a! nr- :offl Efr- \0 ( 11 0-" 1""", 254,886:0~= "10 ( 21 :z ';;:::0 "" '-10 ( 31 .O~::;~ ::0 r'l'" . ~' C"J ( 4) .Oe;~ N . , .otc, ..... ''1 I 5) ~- -::-.' b~ :J2 161 .0 " ,,-, "rf I 71 .00::' - , - ( 81 ~ 254,B85.07 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expensesl Administrative Costs/Miscellaneous Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule Jl 14. Net Value of Estate SUbject to Tax NOTE: If an assessment was issued previously, lines 14, 15 and/or 16 reflect figures that InclUde the total of ~_ returns assessed ASSESSMENT OF TAX: 15. Amount of line 14 taxable at 6% rate 16. Amount of line 14 taxable at 15% rate 17. Principal Tax Due TAX CREDITS: ( 91 1101 50.00 .00 (11) (12) (13) (14) and 17 wi 11 to date, 50.00 254,836.07 .00 254,836.07 (15) (16) 254,835.07 .00 X,06= X,15= (17) 15,290.16 .00 15,290.16 PAYMENT DATE 07-01-88 01-30-89 RECEtPT NUMBER DISCOUNT I + I INTEREST H AMOUNT PAID 401721 441080 .00 57.16- 14,390.15 957.43 TOTA~ TAX CREDIT BA~ANCE OF TAX DlJE .27CR INTEREST .00 · ~/tifol~icJJ~~T~iE~:;i SEE REVERSE FOR CALCULATION TOTA~ DlJE .27CR IIF BALANCE DUE tS LESS THAN $ 1 OR IS REFLECTED AS A "CREDIT" (CRt NO PAYMENT IS REQUIRED) ~. RESERVATION: Estates of decedents dying on or before December 12. 1982 -- If any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficIaries 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 Class B (coilateral) rale on any such future interest. PURPOSE OF NOTICE: PAYMENT: To fultill the requirements of Section 1740 of the Saction 1740), Detach the top portion of this Notice and submit with your pi:lyment to the Register of reverse side, --Make check or money order payable to: REGISTER OF WI~~s, AGENT, All payments received shall first be applied to any interest which may be due. with any Inheritance and Estate Tax Act, Act 255 of 19B2 172 Pa, C,S, Wills printed on remainder applied to the tax. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be reCluested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13 1 3). Applications are available at the Office of the Register of Wills. any of the 24 Revenue District Offices. or from the Department's 24-hour Forms Ordering telephone lines in Harrisburg - 17171 787-B094, in Philadelphia - 12151 560-2065, or in Pittsburgh - 14121 565-360 t. OBJECTIONS: Any party in interest not satisfied with the appraisement. allowance or disallowance of deductions. or assessment of tax (including discount or Interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue. Board of Appeals, Dep\. 281021, Harrisburg. PA 17128- 1 021. OR --election to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes. ATTN: Post Assessment Review Unit,Dept. 28060 " Harrisburg, PA 17128-0601. (7171 7B7-6505, See page 3 of the book.let "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150 1) for an explanation of admlnistr.utively correctable errors. . DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death. a five percent (5%) discount of the tax paid is allowed. INTEREST: Interest is charged beginning with first day of delinquency. or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January " 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1. 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 1988 are: Year Interest Rate Daily Interest Factor ~ Intgrest Rate Daily Interest Factor 19B2 20% ,OO054B 19B6 10% ,000274 19B3 16% ,OO043B 19B7 9% ,000247 19B4 11% ,000301 198B 11% ,000301 19B5 13% ,000356 19B9 11% ,000301 --Interest IS calculated as follows: INTEREST . BA~ANCE OF TAX UNPAID X NUMBER OF,OAYS OE~INQUENT X DAI~Y INTEREST FACTOR, --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment If payment is made alter the interest computation date shown on the Notice, additional interest must be calculated. -