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, I'I \i'RANOIS, W, WmRT I at tho !3ol1ough or Onl1Ha le IOumbdl'land Oounty I
Par\nl'lYlvnn1al deolal'e \'hia,:tnl3trllmont to bo my j,aat will ana, testamont,
h~t'ebY 'expt'/Jssly rovoRinL~ 0.11 willa aM aoct1oJ.1s hat'etorOl'O ma'i,le by me.
1, I d1l'oO t my oxeoutOl1s to pay all or my deb1;s I funeral and
admin1att'ativo ax~ans6B as aopn as ~ay bo dono oon~eniontlyartel1 my
c1eoease.
~, r authot'izeand empower my exeoutorB to Boll uny l'ealtyo~ned
by me at my death and nab spoo1rioallY dovised or bequeathed here1nJ
at either publio at' private salol and to give good and suff10ient deeds
'bhto1vefOI1I 1nf'ee simple, us I oould do ,if' living.
3. I g~ve the surn or $1,000,00 to the S/?,lem Stone Ohuroh
,Demetery ASBooiat ion r()r .pel1petual oape on nhe Wel1t plots "and $1,000.00
,
to the Plain~1eld Ohul1oh of' God Cemetery for perpetual oare on the
Wert plate and I give I devise and bequeath all the l'es t I residue and
l'emainder' o,!' my estatel or evel1Y nature and wtier-ever situate to Mable,
B . Wert , an'd if she is not li vin!,;, to hel' thl'ee ohlldrenl John H. ,Wert,
Jr'.. Robel't E. Wert arid Gayle W. Fry, share and share aURe.
, ~. I nominate and appoint Roger B. Irwin and Harold S. Irwin I Jr.
"
to be the exeautors of this my last will and testamentl they are to
serve as suoh without bond. Should they die berore my ~eathl renounoe
or ,refUse to serve for any l'eaSOnl or die leavin/!; any or my estate
una,C\min1stered, I nominate and appoint Mable B. Wert as subs ti tute
exeautrix,1 also to serve as suah without bond, with the same powers
as are .1ven herein to my eXecutors.
0-
5. I, hel1eby suggest that lilY personal t'epresentatiVe retain th~
j, '
~,e,rvioes of', Irwin, Irwin' & Irwin as attorneys in t,he sett!Lement oi'
'I)lY estate.
~N WIT"lESSWliERL:Oli'$ I have hereunto se,t my hand and seal thia
1.1.'0:' day of Augl.\st I 19'77.
'!h-~"",-)-,-'-? ,yV. V-/._~.Jl' '
, FRANisil~~'R~1-'~-t../..f' ' (SEA~)
,Signed I sealed j publiShed and deolared by Froanoia W. Wert I the
tea11ator abov~ nam,edl as ~nd f'o~, his laat will and'testElment, in t,he
presenoe of' us, who at his request, in hispreeenoe and in the presenoe
of eaoh other have subsoribed our names ,as witmisses her,eto,
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BGT~I A. MOnnIBON
a.nd J I MAlU8 JONgS
, 1:110 \;ontat;o'!, Ilnd tho wJIH\rlllfJClfll
t"epPlllotivaly" whoso nt~motl lU'(j o;\i\l'Iecl t;r) \;ho fOl'eq?:o.lng lnfJt;rUrnont,
boinu. ril'fl t duly 11~(Or"nl do, h{J1'nby (j(Hl1/.lrO \;0 t;hE' ttnrlor";d,r,n(H!
ulll;hpl';l ty tlll\t; t;he tfJotnt or ul,gned lllldoxnolit:od' tho :l!1f11;l'\lmr,nt
aa,hia Luat Will "und that. h0 hl,'ld n.\.r,IIC't1 \'11 Illnr.~lY I rind ,,\;hut 'he
e,xaoutecl J.t as h10 f'l't!H'J nrld vlllun\;!\I'Y aot ['01" (;t 1 Ci PUl'pOflaa \;116re1n
ElXpreflaec\, am' thut ouch of the wi tner:lfHlI3. 11'1 tho 1)1'00 e nl)C1 L\rId
haar1ng Q,r the toutn\;qr I s1.gnrld th,'! \'I1J.1 IH) Il w;t t:nena nnd that
to tM beat or tht'il'i Imowlodgo tho tllstat:or was/,ll: thl,\t t1mt'J
eighteen Yllur'fl ofu(l;a Of' oJ.dero, of ClOlll1Cl mlnd and \lOdIH', no
oonSl:rulnb O~ UndUo lhfluen6el
r~"rc.-i,. IN 0 t.?!~
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FHA CIS W. WEH~ '
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a'TZI A. MORnISON
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OOMMONWn:Wl'll QP' Pb~NNSYI,vANIA
OOUWfV OF 01JM13mIlT.,AND
SSI
SUbflCl'lpedj' flworonto and ao!<nowlodgod 1Jofo!,(j !nO by'
FRANCIS W,I WERT
,'~ tlho \,OI>\:n1.:o1" ~ and nub'ool'J.bad
tincl owol"n' ,t<1 bfl rop~ ml!l by
amTZI A, MORRISON . .and
J, MARltE JONIJJS
, wl1.:nnBflOO, ~hiB
~~"I' day of'
A t\e;\.l$ t
1977
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Ronrll 0, II I'm, 1I!l1^,1'( 1'110110
OAIlLlSLI: 1I111llJIII ,11111.1111111 Mill COIINTV
MV COMMISSIUN IXI'IIIIS UCf, 3, IUBD
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OATH ()t'IIICRRONAI, RIWRmmNl'A'I'IV~
COMMONW[!ALTII (lJ1 PENNSYLVANIA SRI
COUNTY 011 ClJMIIURLANIJ
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lIefore mo, Iho ROlIlslul' I'or ,tho l'l\\blllo of WII!R IInd 1111I11111111 01' LolloI'S of AdllllnlslflllIollltllllld, for tho County of
CUllIherllllld,.pursoll,lIl1ycmllu_1!HI'old flL,tl'w:l.n. .II'. and~::Ol' 1,\, [I'Wln
who, hulllll'd(lIy",- a wp!.'n I do____dullORU nnd BllY thlll liS
onhe IU8t Will olldTestnllloll1 of li'n^~n 1\:1 \~', vnm'l'
OxoOU\;OI'1l
_"":-deoonsud
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We will wull llnlllr\lly udl11lldslor Ihu 1I00ds IInd ohllttels, rlllhlR II11dorcdll8 of 8nlddooousod lIooordlllS 10 luw, 'And
11180 will dlllsollll,y oOl11ply with Ihu prllVlslol1s or Iho luwrcllllll1g III Trllnsfur lnh r'laIlCo~ '" ," und Ilh~crlbod bofore 1110,
. Ji'eb. 27 A,I), 19 Bl ,'/tc"r./: ....
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110 II romemberod thilt 011 tho 2nd dllY of IIlu'oh
recorded the lost Will nnd TC81al11onl or l~MNCIS VI, WI!mT
,A,D,,19~i thore ~n8 Pfobulcdnnd
tuto of
Nowvl11e B~rough
Decea80d, Lettors Teljl;arno\1\;aPY \\Iuro sronted to
WU;ICS8 ,mY hUfl\land ofrlelalsellhhu dny and year aforesaid,
. . . " '
111lpold S,
. Cumberlund County, pcnt18ylvunlll,
Irwin. Jr, .Roger "~ I~wln
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{/ " ' ,Reglsler
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COMMOHWRA~ TH OP PRHHsnVAHIA
ORPARTMaHT OP RaVRHUR
TRAH'PRR IHHRRITAHCR TAX
RUIORHT ORCRODHT
AFFIDACVIAIT OP
FIDU ,RY
(In,truct!on. on R.v.lI~ ~I"o)
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(CITYI
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(ZIP)
Dalo of Doari\ .._.U2UJD..
Social Socurlty No, _J.711-03-3906 ~~__'n..
Buroau 1"110 No. ~
County Fila Na. __,.21-8J.-_J.51
e.tate 01 . Ji'rEtn.91a W.' Wort __.__
I.asl Addrea.....JU S-,-XHLSt.
-.S!..ar:l~~.~!:A 170J.3,
1." Doqedent dledt
,. ( ) Intestate (without 0 will)
(X )T~state (loavlnQ 0 luat wlll--copy attuch,od)
2. la'tho IllInQal a F,nderalEstato Tax Roturnroqulrod lor this os toto? ,
3. (X ) Executor/Exocutrlx ,) Admlnlstrotor! Administratrix
,. i ',' , . _ '
Name HaI'old S. II'willL1".!:.. anq Rogot'_.!3_w.rwin
AddrllSS 44 South HanovoI' St.
Yos__ Nil
X
OaI'lia1e
(CITVI
PA
170U__
IBTAT~I
11.11')
4. Allcorrespondence shuv,ld be mailed to ( X) Attorney
5. B a~ attorney Is represontlno the estate, Indlcatel
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Name
II'win. II'win & Irwin
Addre,~s
44 South Hanover
Oavlia1e
(C'TVI
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PA
IOTAUI
,1.1.t all, sa(,e deposit boxe',rell, Iste, rod 111 the decetle,pt'sllnd,lvlduql nomohor loin, tly with, or as an allent or, deputy
01 another, or In,docedent'.,lndlvlduol name with right 0 acaeas by anot or as a~e~tor deputy. Include tnlf nu,,,,,
'~nd' addr.~. 01 the bank or other IlIstltutlon whero tho solo ~oposlt box Is locatod, the nomo (5) In whlch'tho hUH
Is relllst.red ondthe relationship 01 the lolnt holders to tho doaedent. ' '
HAM' AHa AoOR8IS OP PAH~ OR omRR IH$TITUTJOH
'IH WHICH ORORORHT MAIHTAIHBO ,I. SA~R OBPOIITPOX
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HAMB OR HAMBIIH WHICH
SAPE ORPOIIT pax II RaOISTBREO
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Under penalties 01 perlury, I docl'aro that I hove o~amlnod t,hls return, Includlnuacconlpc1nylnD'lohodUI.. and
Matements, and to th'o best 01 my knowledgo and boliol It,l~ truo, corroqt uridcompleta. ' ,
-+-<.-..------
SloHATURB OP PIOUCIARV
01\11
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~~..'L~EHIB.NCETI\X GENERAl. INFOI1MATlON
1, ~~PON~lpLE FPR RF.TURN ,
l' ... ,
Secllon 701 of tho Inheritance, and Estate T/lx Act of 1961 provides thai tho following persons sholl prepare aod fila'
o return: " .
, '
a, The personal ropresentatlve of Iho eslate of Ihe deoedent os to proporly of the (\ecodor,\ adll\lnlstorod by him
and such /lddltlon/ll proporly which Is or may be subJect to Inherltanoe Tax of which he/she Shall hovo or
/lcqnllo knowlodRO; ,
b. Tho Imnsforeo of PiO/lorty UIJOn tho transfof of which Inhorllmlco Tnx Is orlnoy,be Imposed by the 19618latute,
Includlnwolrustoo () proporty tronsforrod In trust, provldod Ihat no separato rotulI: neod bo mado by tho transferoo
of proportyln~ludeclln tho rohHn of lIpor!ionfll rnprosontntlvQ, .',
2, PLACE FOR FILING
--_.~.--
rho roturn Is to be 1110(\111 dlllllicnto with Iho Roglslor of Wills of tho coullty whoreln Ihe decedont resided,
3, tiME ,FDJUILING
Tho rollHnls dilO nlnolllQnths nltor tho docedont's doath, ulllos~; an oxlollslon for filing has be on applied for and
grAn lorllly tho Socretory 1'1f l1oVOllllO wi thlll Ihe Ilhlo-month porlod,
4. EAUJJHEJ] FILE RETUI1N
Secllon791 ollho 1961 Sloluto provides lIwt " " ,any porson who willfully fnlls to file 0 return or other reporl
reqnlrod olhlm, , ,shall he porsonally 1I0hlo, , ,to aponalll' of 2~% of Iho te,x ulllnwtely found to be due Or $1,000
whlohevor Is tho lesser 10 bo rocovered hy tho DoportnlOnt of Revenuo as debts of like amount uro recoverable by
law,"
5, TAXRAT~S
Inhorltance Tax Is poyoble at tho rate o( 6%on transfors to Ilnoal descendants, such as father, 1110ther, hllsbnnd, wife,
SOil, doughter/nfflndchlldtOll; nrandparent, son,ln,lowond daunhtor.in-Iow ond olthe roto of 15% as to all others,
6,fAYMENT OF TM
Tho tax assossollon the lrnnsfor of Ploperty reportod In tho return Is due 9 months.nftorthe deoedent's death, ,Interest
at tho rate.af 6% IJer annuli! ocoruos theroolleruntll Paymenl,l s lI1ado, All paymonts reoelved aro II rst applied to any
Interost which l11ay bo due with anyromalndor aplJII \ld10 tho tax. IF TAX IS PAID WITHIN 3 MONTH$ AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE IAX PAYMENT IS ALLOWED, "
All ohocks should be modo payahle 10 tho"Roglster of Wills 01 the county wherein the deoedont resided and are
reoelved subject to the flnol dq,tormlnal!on of the Department of Revonue,
7,EMLURE'TO PAY ,
'The taxes IInposod, togolher with 'i1l1Y Intorost thereon, area lien upon rbol flroperly, which Ileruomalns.lneffeot until
the toxos ondlnlorest havo beon paid In full, The taxes moy be sued for against any raal property In the docedent's
ostate or against any proporty bclonlllng to a transferee Ilable'for Iho tax"
8, FILlN,G OF FALSE RETURN
Any persoll who WillfullY mnkos a false roturn or report roqulrod of him sholl, In accordAnce wlthSectlqn 793 of the
1961 Stlltute, bo guilty of a mlsdol11ollnor and, ollconvlollon theroof, sholl bo sontencod to pay A fine not oxooedlng
$1,000 Dr undorgo Imprisonment nol oxcoodlng ono yeororboth, .
ULV.4I.iJ I'XI (HJoIIU)
OOMMONVlEA~ TH OF FDNNUY~VANI^
ODPARTMDNT OF RDveNue
TRANSFBR INHBRITANOE TAlC
RBSIDANT !)DoSOeNT
SCHeou~~ "0"
n~N~PICIARIIlS
(IIIS/fllolllIlIB IJ/lllllVOrsO SliM
, Estato uf
11'rlll1o:l.fJ W. WOr't
BIlNEPIOIARIIlS AND ADDRESSBS RELATIONSHIP SURVIVED OA1'S OP INTERIlST OP BIlNePlolARV
DBoeDBNT BIRTH
....-...-+-.-----~~...._. _~T.--_'~-...+_.O,.~~~--~.- ~-_...--...-.......-_....~--" -<-...........~-- - :\11
Salem Stone Ohuroh , QOO , 00
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- - -
, p}ainrie1d Churoh , '$1 000 00
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Mable O. Wert ',' tl1atof'-1.n-LflW Yoo rOBJdue
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The above beneflolbrlfts worellvlnQ at t~o time of tho daoadont's de nth exoopt for tho following:
NAMB
,DATE OP DEATH
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If addltlonalmaoa Is naoallarv. Ula aw' x 11" sllnall.
~8 FOR QOMPl.ETIMO ac'IiEOULa "E"
Sohedule "e" m~8t In,olude 011 properlY, roul and IlllrsQlwl,ownGd by tho dooodont lolntly with unothor
partY 0, r Iwtlos OB Joint tonont8 wlthrluht of RurvlvQrshlp, Both tunolblo ond l'1ton01illo pr.oporty lira 10 bo
Inoludacl. LlsII'oal oBtato first,
1. "Dosorlbe all raalproporty oslncllotllod In tho InolruollonUfor Solwclulo." A", Dostlrlbo 1111 PllrsOJwl property
00 h1dloatodln tho Illstruotlons lur BOhadllla "13/1, InoludlllllO nllmo; IIdclrollQ UI1c1 rulllllol1shllj to tho
deoodent of 11\0 oo,Owner Isl.ond tho dato thojolnl ownorsl)lp wos ~stol\lIsliod,
2. Indloate tho'total market voluo of tho jointly ownod proporty,
~, 'Indleota tho poroontaoe of tho dooedont's Intorost.
4, Indloate tho mllrket value of tho,dooor.lant's Il1torost.
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MeMOBR& OP THF. J1HI~APeLFHIA.PAI.TIMOI\Il AND NeW YORK STOCK eXCHANGBS
A~SOCI^,,'8 MBMOBR OP 11-18 AM811lCAN STOCK BXCHANGe
,- . ,,' ,
BST^"~I5HUP 1 B4A
W. H. NBWBOLD'S SON" CO., INC.
p, o,eox 98
B wusT HIGH sTReuT
CAR~IS~B, raNNSVWANIA 17013
(717) 2A9.2B1B
"
Harell 4, t!Hll
Rogat S. It win , Bsq,
4460uth Manovar Bt",
Carlisle, Pa, 17013
Ral B/o prancis W. Wurt
Dear ROBiar 1 ,
The following, prices are for tho aocuritlo8 we are holding in
the above os tete ,as of the datos ~hown, which arotho lotes
4_tes priot to ot after Fob, 22, 1961 whieh wris the date 0
d\lath,
Penna. 'Pwr. 6< Lt. $6.00 pfd. J 2/20/81 $55.00 (onlysalo) /;h . '(0."".
2/2,4/81 IIi-56; lio- 55 -,):lel1n 55,75
.,.
Pittsburgh 6< West Va.R. R. 2/20/61 lIi-5.r, 1,0-5 1/8,Mean 5 ~/16' 'j" ,..r.,,$', ,.,
~8000 S td ~ Packaging 6% due 4/30/90 - 2/20/81 - $50.00'", "
2/26/81 - $50.00 .
1200 II II II II " 2/20/61 $46.00'"
,
2/26/81 . $46.,00
III"""
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The tuson fot ths dUfetllnce in the $8000 piece IInd the odd ,lot
$200plece is thet'odd lots ofbQnda ttado $3.00 to $4.00 away
'from the,round lot piooes. '
Should you need any additional informaiion rogarding this sstate,
p1us\l do not hesitate to call me.
SinoerelY,
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Wa1tor I'. Wrtson
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1:, FR^NOIS w. Wlm'l' , 01' L 110 l\or'oll/r,h (I f' 01\1'11.fJ 'l.e, Gumbor'land Oqun1iy,
pennBylvan1.n. deolo.J'o tll.i.B ,IIWUl'lIml)l1t to 1)(1 lilY )CUlt wlllnnd UGotwnllnt.
, "
hereby expreaBly l'()vok1rl/~ all willn ond (I\?d.l.o:l.lu hOl'otof'oJ'fj maela by me.
1. I dil'edt lily oXOOlll;O.l'1I to ptlY a'll 01' my dobta, .f'un01'nl tind
adminiDtJlf.lt1.ve axpOnSll13 flr /loon 1\[\ mllY bu t!ono ,oonvan1.ontly at't~H' my
deoeaB(3.
,
2. 1 l:luthOl'lv.e and empowoJ' my'oxoOI.lI;Ol'H to tlOllllny l'oal.ty owned
,
by me at my death lmcl not npoo1.fi,i.\!J,1;Ly dov1.fled 01' boquoathed herein,
at eith~r pUbl.1.o or pplvntD Dulo, nnd to ~:I.vo good and BUffiolont deede
therefo!'1 in foe o1.mpl.e, nn I could do 11' living.
3. 'I g1.ve the SUIII of *1,000.00 to tho ,Sulem StoneOhuroh'
Oemetery ABBOo1flUon rol' POI'IH;ltual onl"U on thE! Wert; plotB and $1,000.00
to the Plainf'ielcl Churoh br ,God Cernt~t:cfiy rol' perpetual oare on the
Wert plata and :r. g1.ve. devlae and \)equ(~f.l(;h all the rest, !'ealdue and
, remainder of my ostate. or 8YOry natul"o l~nc1 Whert'Jvt'J!' situate to Mable
13, WEl1't. (trid H ahe ia not l:1.v:1.nr.:. to her threo ohDdren. John H, Wet't,
Jt'II,Robert m. Wert and Oftyh1 W,' ,F'PY. Ohill'0 and ahare IlHke,
q. '~ nomlnate and appoint Ro~ep S. Il'w1.n and Harold S. Irwin, Jr.
" ,
to be the exeuutol'a of \;hlo IHY laat will flnd teflt:arnent I, they Ul'e' to
.,eerve aa aUoh, wJ.t110\lt bond. nhcluld tlley' d:lo before my cleath. I'e,nounoe
or'r$fuse (;0 servo' foJ' Hny I'oas'bn., or dll) lOE\ylng any oi' my oatate
"-~~"="'=."'I,
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J:, Ji'RANOIS W, Wlm'r, or 1;116 l1ol"our;il nl' Om-lisle, Cumborlnnd County,
.1'onnDYIVani'u, cteolL\l'o ,,(;11111 ,!.lloI;l"umnnl; to iln rn,y lLlB,t will nnci !;ofltumllnli,
,
Iwl'(lb~ aX!>t'13lll3ly l'ovok:lnll, ul1 w:l.:L:I.f1 ~l'd(!o(U.(Jllll hlll'oliof'Ol."fJ mndGl by me.
1. :r d:11"0oli my oxnllul;OI'f1 \;0 paynl1 0" lII,y(lobta, l\ll1ol'ul qnd
,Actminlatl'llt.l.Vl'l o.xponalHI n/l f!(I()11 af! IT\fI,y htJ dono oonvenJ.ol1tlY (If'tormy
"
deolilase,
"
~. I !\ul;hol'lv.e 1.'\ I III ornpOWOI' illY O)(ooutl)['fJ to eon l~I'lY realty oWnl?cl
bY me at my d\ioth und not n[)6o:l!'.toul1Y dovJ.sod ol'poquonthaQ horcJj,n,
,J,
fit either publ.to Dr' private nulu, and to give good Dnd aurriolant cleede
therefor, in t'eo s:ll1lple, (W :r oould dn:!.r l.1.vinn.
,
3. Igi,ve the S lUll or in, 000,00 1;0 the Sulom t),tone Ch\1roh
Cemetery AIlBooiut:l,on ['(H' POl"potual Oell"1) 011 the Wl,rt ploto Il,n~1 $]~ ,000.00
to the Plaint'ield Clhlu'oh ot' Clod OElml~t;ory for perpetual oare 'on ,the
Wert plot!larld :I: g:t've, devJ.se amI bf~queath all the t'ellt, raaJ.dua and
remaindel' or OIY estli\tlil, of' CJvor'Y'natuNl I:\nd Whet'r-JVI!!t' s1.,tuatd 1;0 Mable
B. Wer~, and it aho ia not :r:lv~nR, to her throo ohi1dren, John H. Wert,
J,r., Robel't EO' Wet't aMI allyl,) W, 1~I'Y, ahal'€! and fJhal'Cl f\1..l.ke,
" II, I nom.tnate and !\J1polnl;aoiT,ol', B,'Ir'win and llal'old S, Irw;tn, J'l',
to be the el\Qoutol,'O 'or th1.s my last \dll nnd testamont; they al'6 to
,
Berva aa fluoh without bond. 8hould I~hoy d:le be 1'01'0 my c1f~a tl1 I rcmounoe'
o~'rerUse to Barve ror any f'OBSon, or d1.o loaving any ot' my ostate
ul,admJ,f\il3tered, :r .nominate and E\ppo;Lnb Mablo 13,. WeT.t na subatitute
"
exeoutrix, alao to S()'l've lHI sue,h w1.thout brJr\d, W1.th, the aa.mo power's
IlS al'e given herein 1;0 mY f)l\eoutora,
~." I horpb.y allggest I:hat my pot'l'Iom\l representative retain the"
aervioes or Irw1.n', Irwin & ll'wtn as 'attol'lloya 1.n the BettlElrnC;lnt or
mY estate,
IN WITNESS WHEREOFj I huvo herClunto Aet my hand und Beal th1~
LL~ duy of'AuffiuDt, 1917:
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-,- T"RANdE ilr~rm~,t<'\n'/)L_n (SEAL)
Signed, sealacl, Pllb1.i~h0d and doo'lnl"od by l~l'anofa W. Wert, thr:l
tf,'lstator abOVe ,11arnEl(1. 'ua and 1'01' h111 lfll1l~ vl:L11 und toatF.\lllentl in the
preeenoeot',ua, who at hJ.a poqueBt, j n hj.l, pl'OlJenpo undin the pl'Ollonoo
ot'eaoh othar havo ,Eluba,ol'1bn(l Oil!' l'Iiln\OIl IHI wHnoollen heroto, '
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GENERAL INHERITANCE TAX INFORMATION.
Unsatisfied Ilabllitlos Incurrod by tho dooodoht prior to hls/hor d~oth llro doductlblo a~alnst hls/hortaxdblo
estate. In addition to dobts !rlcurrod by tho doeodont or oBtolo, othor Itolnl oro ell1lnlablo Including the cast.of'
administration, attornoy foOl, fiduciary foos, (unorol and burll1l oxponlos Including tho cost 0(,0 bUllal,lot, tombslane
or !I.ravo morkor and othor r,olatodburlol oxponsos. ' ,
All dobh baing clolmedagolnst an oslate aro subloct to the ollproval q( the Reglstor o( Wills with whollltho
Inherllance Tax Roturn IS,f1lod. Evldenco,to support the docodent's or tho ustato's liability for the debts being
claimed should be attached to this schodulu.
A family exomptlon may beelallnod by a spouse o( 0 decedont who died domiciled In PonRsylvanla, If there Is
no spouse, 01 If tho spouse has (orfelted hls/hol rights, then any child of the decodont who Is a membor of th~ ..ame
household con claim tlio oxemptlon, In tho o,vont thero.!s no such spouso or child, tho oXlII11ptlon can be clalmod by
a parent or Ilarnnts who are mombors of tho samo houaohold as tho docedont; Tho family oxemptlon Is 'allowable only
against allets which pasa by a will ar by tho Pennsylvania Intolllcto'Laws.
NOTE I Componsatlon paid to anestate reprosentatlvo; namoly, an oxecutor or administrator, for seMen
performod.ln ,administering an estate Is roportable for Ponnsylvanlalnoome Tax ,purposes, Thl.' taxable Income
Item shou.ld be roparted on (arm P A.40.lndl vlduallncomo Tax Roturn,
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INSTRUCTIONS FOR COMPLETINGSCHEDYl.E "F,"
I
1.11 the family axomptlonls bllln(u;la1mod, Indleato tho claimant's nanle, pddreu and hls/horrelatlonshlp ta
the decodont, Enter "fomlly exemption" In the remorka column and the amount clolmod In the:omount column,
2. 'Aulgneonucuflv,o numbers t,o oach 110m listed,
3. Enter tho dato on which each debt was Incurred and/or paid,
4. Enter tho nomos of oaoh payee. ,
5. Provide a brlof oxplanatlon In tho romarks column for ooch dobt claimed,
6. E~ter the amount of each debt being clclmod.
7. Tho form must bo slgnod by tho porson who has aBBumed the rosponslbillty (or paying the debts.
IF ADDITIONAL SPACE IS NECESSARY use aW' x 11" SHEETS,
lli.fOAMAT.lQIY_
To In811ro l!fopor ,orodll In Y911r noeollnl, 11'" nOl1l0 01, 1110081/110 /Inti 1110 11",nbor .lwlIlcI IJo olonrly "rlnl.
od on Iho ohook 01 monoy orllof,
Thl8 n88ns8monl la mn<lo In """",cl"nOo wllh 8001"'" 'l00 o( Iho Inhol,lI11noo o"d 0.1010 To. AOI of
1961 (72 p,S, 62466.7001,
To 1110 o,'on' Ihnl I~horllo"oo In. 18 paid wllhln 1I11On 1:11 ,"0111h8 ohor IIHi cloolh 01 Iho <locadonl, 0
~18001lnl of flvo (6) poroonl18 allowod (72 p,s, 6 2400.7101
Inhorllol100 Tox, olhor thon lOX on n flll\lro Inlolo8\, 10 dllo 11111111 !Jolo 01 tho cloooclonl'8 d08th o.nd bocom08
dollnquonl 01 Iho oxplrollon of nino (9)monlh8 oft or tho dooodom'. doolh (72 p,S, 62406.7111, Inhorllonoo
Tax on 0 fUluro Intor08t 18 poyoblo wllhln throo (3) monlh8 oft., 1110 Iron810r lok08 ofloct In p08808l10n ond
onloymon! pnd 19 dollnquonllhoroohot (72 p,s, 6 2406.7121, Colallllll. In\Ol081 from tho dolll1quo~t uolo 8hown
on Iho fooo of 11118 form to Iho doto of oOluol paynlont u81110 Iho foliai'll no Inlor081 toblo:
,. ""------.....--- .........-.........-... --........-............ .....- ...--- ......- --- _.~- -... ......- - -...... ......,. .........-- -- ---... - -- --
1 month, ,005 4 months, ,020 ' , 7 monlhs .036 10 monll\8 ,050
2 monlha ,010 ' 6 monlh8 ,026 o monlh. ,040 11 mOlltha ,056
3monlhl ,01~ Omonlhs . ,030 9 monlll. ,046 121110nlhl ,060
---
I doyl ,00017 11 doy9 ,00186 21 daY8 ,00352
2 daYI ,00034 12 dny. ,00203 22 (IOY8 ,00309
3 daYI ,00061 13 tIIIY. .00220 23doY8 ,00386
4 daY8 .00060 14 doyo ,00237 24 daY8 ,00403
6 daYI ,00006 16 doys ,00200 25 duy' ,00420 .
~ dQyl ,00101 16 dny. ,00~67 26 doyl ,00437
7 daVI ,00110 17 dOY8 QO~B4 27 duy. ,00464
B ~aYI ,00135 10 <loys ,00301 20 dOYI ,00471
B dayI ,00162 \8 dnvo ,00316 29 dnY8 ,00488
10 daYI ,001'09 20doy. ,00335 30 dOY. ,00500
- -,- ------""".- ----....---..- --,- - ...-_..... --- ......_~. --....... - +- ..-.........-~-- -.... "".- -....-..-......,.. -...... "...
Any purlV'n Intoftlol, Includlno Iho COfl\lnonwuollh ond Ihll 1'0'"0001 rupro.oniullvo. not 'H01Is\IIId wllh
Iho MIO.o",ol1l mny Qblot>l Ihorolo Wllhl" .IXly IGOI dllY. olillr looollll 01 Ihl. Nollco n. proVldod by Socllon
1001 of Iho loholllonoo nntl U8tuln Tux Ani III 1.801 (7,2 p.O. U 24Gb.1001J,
Mako ohook ar rnanoy order poy'lble to:
"Rogletor of Wills, Agont"
,
Mal! \0 tho address listed below:
INPQRMAmm..
To 'nlura propor orolllt 10 YUilr oooounl, thu IHlmo 'of 11111 'Ollnln und fila numhnr Ih~ulll lIo olonrly pllnl.
ad on Iho uhock or monoy ardtH, .
Thll aBBIiBBmonl II mallo 111 oocordunoll wllh Boollol1 706 01 Iho Inhorll."ou unci Rltaln 1'0. AOI of
1801 (72 P,S:G 2488,706),
fOlho oylonl thot Inhurllllnoo to. I' po III wllhln throo 13) InOnlhl ahor 11111 danlh of tho dododol1t. .
dleOOunl of flvo 16) poro.nll' allow.d (72 P,S, 6 2466.710),
tnhorllonOd TOli olhor Ihon tOI on n futuro IntorOlI, Is duo at Iha dOlO of Iho d.oodonl', daolh and booomoo
dallnq~ont at tho olplrot/on of nino (01 monlhs ohor tho duoodanl'O dooth (72 1',8, G 2466'711), Inholllonoo
r.1 on 0 futuro InlorOl"" paYnblo wllhln Ihruo (3) monlha of lor Iho, tronolor tukos off 001 In pouo..lon and
onjoymonl and II dollnquonllhofoohor (72 P,S, G 2466.712). Coloul.to Inloroll from Iho dollnqulnt d.l. 'hOWn
. On,\hn floo of Ihl',lorm to tho dOlO of ootuol paymont uslnO Iho followlno Intnroallllhlot
,.
.....-.....--...':-..-..............,-----.....-........... ...-.,..--"'!- ..,,- "'-'''---'''-'' -....-. .....-.........'("---..........- ....--- --.....-
1 month ,006 4 monlha ,02' 7 monthl ,0~6 10 rnOnlll' ,060
2 monlh, ,010 6 monlh, . ,O.S 6 monlhl ,040 1 1 monll1l ,068
3, month, .018 6 monlha ,030 9 montho ,046 12 monlhl ,060
1 dOYI ,0()(l17 11 dOYI ,00160 21 dOYI ,00362
2 daYI ,00034 12 doyo .00203 22 dOYI ,00309
3 dol'l .00081 13 dOYI ,00220 23 doya ,00386
4 day, ,00066 14 doya ,00237 24 day, ,00403'
6 dove ,oooS6 10 days ,00260 ..26 day, ,00420
6 doya ,00101 10 days ,00207 20 daY I ,00437
7 dava ,00116 17 days ,00284 27 dOYI ,00484
8 doya ,00136 16 doya ' ,00301 29 ftoV' ,00471
8 dOl'I ,00162 19 doya .00310 29 daya ,004SS
, 10 days ,00169 20 dlJYB ,00336 30 doya ;00600
--.... -- -________...__.._...... _~_ _ __._ _....._........ .i_..._ _...__ __ ...;...'....___....._ _ _ ....,";" _..._..._..._. _ _ ~.._.
Any, parlY In InlOlo&I, Includln9 1110 Cpmmunwoollh ond Ihol>0I80nol ropro.onloll,Vo, nol BOllsfllJd wllh
Iho sno,B8msnl may obloot Ihal810 within 11.ly (60) doya oltor '90011>1 uf 1I1la NulloD oa I>to\'ldod hy Soollon
1001 of Ihs Inho,II&,noo and Gmlo T,ax Adl of 1961 (12 p,s, G 2495.. 1 0011,
Make ohook or money oreler payabla 10:
"RaglsttH of Willa, Agent"
Mall 10 Ihondoress IIstod below: