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HomeMy WebLinkAbout81-00156 NO. 21..81 i, ; if, PETITION FOR L.ETTERS OF ADMINISTRATION IN 1'11Io1. NH'I'N"'~ OF ""."""""<11\Wl.lfJW~li'f.l,.M."ACBL",,,,,,,,,,,,,,, llICI'IM!'\l'Jll. 'rO It It !..,t1fJh~ !,~., ,j I~W~1iI1" ,'" H" ,II .~'". """", ,"'"'''''''' II; "" '"'''',''''' ,,,,,,,,,,",,;, ,....,.""" 1l0ulK!ur 01' WIIIK 1'01' th,' COIIIII)' III' ('11111'1"'1'1111111, 111.lh" ('Olllllillll\\'(lIi1lh III' 1'IIIlIlH.l'll'lIll1l1, . . " 'I'ho Put I Lion of ""'" 1'1 ,SalV.4\,torli$ ..0.." Aar..1. ". t",;""" ",,,,,,,,,,;. " "!"'" H., H' Ill" "'" ,,,,.,, "" Ii, !I'l" ".',\'.1 !Ill I q H' I" Ill'" "ililll.'II!t,;",;,,,lj"'Il"""'''''''''''IlII.i,,,,, I'UHpu(\tflllly Hho\vol h 1 hill ""'f~r.~~~KhP'"Mt",oorrJ""""",,,,,,,,..jH'IH!tH'"'' WIIK n rOKhlon! ul' ".".~.Ii\\;"P.IiW:1!lRR,J;'P'"",,,,,',,,,,,,,,,:~P . ('ulllhurlllllll COII.III,I', HIII!~ oj' I'UI1I1KY,I. Vllllln, nndll Oltl7.uII of Unllllll S!lItuKi IInd c1I'lllll'tlJlll hlH III'll IlIlllHllllo In th\' ClllIlI!)' of """,.."...""",,,.,,,, Ilj~J~"""!l'"'''' unci sfnLu. of ,.",f.~J),~'y'*yp,.~'~!:\"""""""""""""'if""""I'"''''''"''''''.''''''''''''.'''''''';;''''''"1111 on ;,I!';t:J.c;la~"""it;'''''it'''''''' iho H"~QtJ',\"""""",_""""",, lln~' of ",.J.i:<ilQ~f;\t.y,-",,,,,,,,,,,,,,,,,,,,,,,,,, A, I'>" 10,,,a~"-'1 nt thomru ot' ..",B2,,,,,,; ,\'ont'R, '! ! ,Tlmt tho Huhl "1l,."~I,l~~~,~,~"t':1,~"l~~f.A""",,,,,,,,,,,,."""'"H''''' d(lClIHfHld, 10ft HUI'vlvIIlK tho rol1owll1R' nnmed~~ hoh'H 1I11c1 IWXt 10 kill, (0 11'11: Numu HollltlOIlKhlp HUHldollco ".~~~",~1;QJ:~, .;~ I" '~';'~H 'H' ",'" ,,,;,,,,,, I'" '""''''"ll",~~n""",,,,;'''''i''''' ,7.~:~"ffl?,},~,~.,,~1;"III,II~~b~~~~~$l' PT\ 1529'Wnt:ersi.;1e Drive, Chesapeake, ...."'IlIl.'..It'''",,,,,,,,''.'''I''.''''I'.''I!I''''''''',,, 110 Wesse~ Hills Or., Coraopolis, WI PA Vaul O. l\Ori ,II"""""""II'''''''''''''''''''';'I'"",,,IIU',,,,,,,,, l\l:'nold S. l\Od Soh ""'"''''''11,11;''''''''''''''''''''''''' Son """""""'''''''''''''''H'''''''''''H"",H"'''''it..,, ''''''''''''''H'''''''''''''''''''''''''''' ''''''''''''"iI..''''''H''''''''II''"...,.........II.II..''.. ":,ll:**~~'It:1t.,,n:!;\,~~t,'"'''''"I''''I'''.''' "",,,,,~~'Ff!)~~""H""'"I''' ,~,~:~J~~f.~~,~,~*~, J~tdlll~~*~lf"I~~ IIIIIIIIII'IIIIIhIlHH'''''''''''''''''''''''''''''''''''''1!' """'''',,,,,,,.,,,.,,,,'''''''''''''''''' ,;,;",;,,,"11';""'''''''''''''''''';'''''''''''''''''''''''' , , , I. , , , , , . , j ~ , , I' , , , , , . , , , , , , 1 1 . , , ,., , , , , , , , , ' , , , , , , , ; , . , , , . , , , , """""''''''11'''''''''''''''''''''''''' ""'"'I""",,,,,,,,,,,,,,,,,,,,,,,1I11'''''''''''''lill''''' ,liHIll"II"""",,,""Ii" "'"''I''''''''''''''''Il''''''' ,,,I..,j;'''''''''''''''''.i.,,''"I'fi.'I'' """""''''''';11''11''''1'1111111111''''111111''"111111111' I ; i , i , . ,. , . " II " 1111 " II , , I ~ " " ,,' i " " II . , , I " II I tlll'll' " " , . 111"".,,,".,,1..,..11"'''''''''''''''''' ",''''"'''H''''"''''"II''''II'''.'''''''''.''''''"'''''''I' .'"IIII..illll'''''''"h,,,,.,,,,,,,",",.,,,,,,,,,,,,,,.i,,,1 ''''''''''''''''1''''''';'''''''"'''''''''' """"';""""'!"""',',',I'II"""I.'I.'I'I',.,.11'11'" , , Thnl thoKo Ilhavo 11II1110dlnuhlllo'llll11f thu nox! (,I' Idn, ~() fill' ilK klluwn. " 'l'ho Kllld dlloudlllll WIlH pOHKO~~od 01' 1101'Ronlll PI'OPlll'!.Y Co thu o~t1nlll!l1III'IlIIlU or $....7.rI~R,9.I.9.g....."...... IInd of 1\0111 1'~R!t,tll,' IO~K 1IIIlIlIl1bl'1l1l00, to !ho(lHtlmllt(l(1 ""hill ol'$..7."lil),Q.,OP"""",,,.... IIR Illlllr IIH olin be " ,. _ . I' lIKoertlllllod, Thll!l)lO Hllld Halll 1')H!lltll III KO 1'111' ilK IK kIlO\\'o IH 10UIllod Iii "'~;\..~"Wl'lli',\;\'t'X~;\.,+.i'l"Bf?11I.~""If.p,.ljl,\;..,'" Pehns!:x:1ro'l'OWl1ship, C\.1nlbet.'lanclCounty, Pennaylvania 17025 ' , . 1111'11"1.,.,,,,,,,,,1""'"''''''''''''''''''''''''''''''''''''''''''''1''''"''',',,,''' """",,,,,,,,,,,.,,,,,,,,,,,,,,,,,,..''''''..11'''.....'',,,,,,,,,,,,,,,,,,,,"""II",i. i'l'horofQI'O, YOII!' llot,ltlollon(t\<H1'uRPlloll'ull.\' IIPply,(iuH),' 1'01' l,all<lI'~ or AdmllllKtrn!lonln tho IIbove Ill1l11ud antnt.ll.', .' ,1\ ,"" '.\' . 81 1\. IJ" III......". J ,I, Signature Illlcl AclcI\'IlHK . " ,i ,~I ,'I /?;~~' , ~ c>--r. "'" .". .- .-, ,_ (, .t., 1"""_ }.), t,." ", . """,;11,(, 1 "'''' H' (..(,."'~,',''''';''''''''',.!'(,,,?r,(;Ht''''I''''..It..,' Salvatore B. Aor.V . ",1'1 \}Iitod ",. "Ma~C1hl~ " 1I'"'''''''''''''Il'''''''''''';''''''''''''''''''' 01' 1'!'1II Illl1lJl' (H) gf\l1'lGlr 0; f30qar, E~lrl;l west: Main -Sti'aet/ ah1.remanst:own, PA ",.".".""."""".""""""""""""""".""I"'II"ll",.,.""I"I,'", 17011 "lip "";'""""""""""",,,;'\i;,,""'iiil"'::"""j""""."",.",j"""",t1 )j.::.f!,::", ':/ . , , -cJ] ,.",.".".,......,.,.,..,.,.,.",..'.'...'....,.,.'....."..........,."...(~/ OOMMONWI'1AIo'I'1I (JIi' 1'1';NNHYJ.Vi\NIA nOUNTY(W ClJMBlnHl,ANil } ~,~ I 011111 il,,~ It." ..""", II....' ", .jil.i", ,'""", Sl\t4\1hIIOllIU,.13.,. ,l\QJU"" I"""""""""';" ,.,.,,,,,,,,,,, ,,,,,., Ii ,,,,,;, t." '-"""" "" IIIl ,iI nRmad In ,the ,lIl1nl'u IlPJlllulltlnnhulll1l' dllb' ......"~~I,L",,,,:,,,,,,,,,........', 1\('(!ol'r1hlll' to lilli', RIW lhllt thll (Mtll Bul forth In thu Ilhuvu 1IJ1J1l1ulltlUII III'U 11',1,111 10 11:': IIIIKI or ,~lJ.fI;;;.;:;;:,~IH~W!~j~ItIl,I~Hlt'~IJI!i-~ . } it""1 !WII Ii.. 'llf!t~,t;"'.",,, ,t!", Ii. H"""'" ntHl tHl htWllhotl ":' eat{,~'€o~rtff1\~r:r.l.j",tr. e'l (ir, .1'''~f-,-..q"" I '" It 111'011 before mo, '''''''''''''''''''''''''''''''''''''''''''''''''''''''1''''''''''''''''';"/"""1111 """'l,jj;;I'n"~~Pi'.,.,:,~,,,..,,.,,,,,,.,,,.,,,,,, A, 1);1 11~~""" ..".91(it.W,,:,(!.,.., 4~(.f.:('~..."........""..,.... . , ' f .1~' HoItIKtOl' ""'''''''''''''''''''''''''''''''H....'''Hf"",,'''''''''''HH''''''''''''''1111'' "",,,,,,,,,,,,,,,,,,,,.,,,,,,,,,.....,,,..,,,,,,.,',...,,;',,"',;.,,'""",."",ij,," J~tled I 1"~~.~~'t',,,~,,,,,,l~,~.~,,..,"",',;;""'iI'.' "",,,..,,,, ^ t lUl' IlU,\', l '" ~lU\l(ilB I,D"., BG:>g€Ui",; ;E&qJ\llwo"" "It"" 5 \'lest Main street'; Shiremanstown, OATH Of' PERSONAL . REPRESENTATIVE COMMONWlnALTH 01" PInNNSYLVANIA lKII' COUNTY 01~ ,CUMl3lCHLAND . i". III Ii I;"'''''' .,,1 IIi>" ~Ii\~ 'Y.f\~X.ffl. J~.,. .l\Qk~. II It """'" II. H II It".,,,, ~ '"'' It,,," II'" II II I"'" I""'" II' H...",.. "I"'" It.. t potl tlonor (R) belmr duly ............sWom.,......,..............,..,..,...... IIceordlnlt to IIIW do lilB'...... depoae IInd allY thllt ,lIa t,he adnHnlstra ., ,~tl"'''1 of thci ORt" te' ,'or .t""." .~.t;\~~ti,;~,. fflt".~!;',t.~t. "' ,,/0. U" ,..tllIlI' ".. .Ilt. "'"'' I'" ":'"1111 ",,,""'1 II'''' " , "'I, "'n"..ill""II..II,j~'.",.";'-'tl".j,"'".....,tl""""',,;.,,,.U.......!''''''''III"."",,,,,,,...,,i,'''''''''llI,,..,.,,,,,.t1,lI,,,,,..,,.,,.'i',......'''...H'.IlI!"I111.i deceaaed .,...\111....,..;....,,, wtlI wellllnd 'truly lIc1m\nlater tho Il'ooda 1I11c1 ehllttela, rllrhtilllncleredlta QfA!\ld cleeell8ed, lIeeqrdlnll to IIlW, And iliAd wtll cllIlllel,~ly comply with tlio 11I'ovlAllll1K of tho IlIW rollltlng to TrllnAfor InherltllnceK. . BWQt'n I b II ,jIlHlI."...H""IH..H""'H",,,II.."I,,.tt""'" all< flU Her ,)od " ' , , bofore m'c, : March !l A I) 1981 ','/.':J:~.?J.'.~I:".~:'~~'~"'.'.'.'.';;.',.".'.""'"'''' till"; . 't . 1""..../ ~.I../..., ifff"'....~, ~.<,.~~,.................., Hellla r " ,. '" / ' '7 ,/ , ':' ..1;4:)' 0' , /_ .< _ _ _ I / .~!;,- ;., "~_'. _7 ' \.., , 111-('(..(-, . . .' J' L. ,J...to ~... ... ,'rfu ,.. ,.,t.. ...'.i.... .,.k!. .. ....f,;... ./i.....'...... ......,.".." 6a!Va~Ore,u, J\ori '''I"",,,,,,,,,,,,,''''"'"'II'"''''''''HIII''''''''''I"IIII'''''''"'''"Iliilli.II.11 " DECREE Be It romomborad ihut on the ....I'I....~~ln;"I";"I"" dl1Y of IHII."",,~~,f.~I~H....t1itljllll"i<"1 Ai,'Dl1 19~1.lii LettorMof AdmtnIRtrp,tlot\ In tho oRtntc of """,,1111"" """"'ii'HII""'''''III..~,..~l.~".~.~~.Itt.t~-'''~~'~~'I..lli'llliilllIII" ;..il...." ..",111 j "".".. "", ."."H. Itl 'H" ''',' II." .'""....IIt1.III" I. Into o-r I ,j..", j, .lItl.j'H" i 1~~'~'~I"~!n.I~":~M"I~/,',W~~~I,,J;\~~1l wcro,llrllntedto .,.....jjl."'~,y,"'if.t;l;,"...".,....M1:',L...........I... OUlllborllmd Opunty, Porin~y\vllnla, deecll8ed, , ' ' .. i i"" II I" j.". II 'II....."....,..!'......,......"..".. II H' I"'. it 11.11."" I""'" "I II lit... II... II ',"...11 II'" " "III" II II III j,,'" Hili H III'"'''' "" H 1111111 "" 111111"" , ., 1, WltnesK my hlIndllnd Oftlolll\ Aeel tho dllY IInd yel\r lI(orcalllc\' - ~' ....,...............":.<0.;~~(;~",dL,, . ~ f~".~ad.."... , ('" ~. Register ., EIltiti~'i1Y,!\tliAlllij E RI T AtiQLtM-9I~.f"161J1i[]BMAl!Q~ 1. ,f.&.lillWS ~EsPONm.aLEFOR REtURN SoctlOI1 70101 tho Inhollll1nco nnd Estnlo Tnx Act 01 J9611Hovl(lm: IlInllllu following Pllllillll!: ~hnll prrmafo und ,1110 11 roturn:' . 11. Tho porsonnlfolHosClnlnllvo of tllo ostlllo of thu duclIIlunl .Hilo plOp(lfly 111 II III diIC(I,\lllnl iHlmlni~tlHod hv lillll I1l1dsuch ndditlonl1l propOlty which Is or IIIny bu slIbJucllo InlllJl;lilllCII Tnx of wlllcllllOir:llll shnll IInvo or aQuulro knowlodgo; b, Tho Irl1nsforOo of pro/JorlY IIpontho lrllnsfoi of whlcl! InhoritulIGIl Tnx is Oflnny III! IlIIpnSlid hVllro 10Gl Stututo, Includlug 11 trustoo 0 proporty tronsforrodln trust, 11Iovidlllllllolllo I:OplIlillo rbtlllllllf)(JlI hu modo hy tho trllnslOloo of proporty Includlld In tho rololll ul 11 pnrsunlll roPl050ntl111 VO, . 2.pLAOE FOR' FILING. .Tho roturn Is 10 ho fllod In dupllcolo with tl10 Ileglst"r of Wills 01 tho coUilly whorolnlhll donllllont resldod, 3. TIME FOR FILING , Tho raturn Is duo nino lIIonths nftur tl10 docodont's dooth, un,loBs 1111 (lxtoosIO(rfol IIl1n~ h,Hi hoon nppllod lor olld granlod by tho Socretory qf Rovonuo wilhlll the 1llI\O-lIlOntl1 porlod. , ' , 4, ~AILURE TO FILE RETURN Section 7910Hhe 1961 Slatute provldos thol". , .ony porson who wlllfullylnll!l to file a return orolhor roport required of him, , ,sholl bo porsonallY Il0hlo. . .to a ponnlty 91 2!i% of tho,lnx ultllllalolyfound to bQ<(luo or $1,000 whlchevolls lho lossor 10 bo rocovorod by \ho Oopmtmonl of Rovonuo as dohtsol Ilko arnounl 010 rocovoroble hy law." 5, TAX RATES Inhorltonce, Tax Is poyohle at thomlo of 6%oh Iral1sf9rs 10 IInool doscondhnts, such as lather,lIIotllor, hushoud, wlfo, " son, daughtor, grnndchlldren, r,rondpOlont, son,ln.low.ond doughtlH.ln.ll1w and at Iho rnto of 16%ns to oil uthors, 6, nYM~NT OF TAX Tho laX ossessod on thetronslor of properly roported I" tl10 rotulnls duo 9 luonths oftor tho docedent's dealh.'lntorest 01 thO'll1to uf ~%poronnUlI1 OCCIIIOS thereafter unlll Pl1ymonlls mudo., All paYlllorlls ronelvod 010 IIrstl1ppllod to any Inlorestwhlcl1moy be doe with any remalnde,r appllod to lho tax, IF TAX ISP,AID WITHIN 3 MONTHS AFTER THE OECEDENTIS DEATH, A DISOOUNT OF 6% OF THE TAX PAYMENT IS ALLOWED. ' . All checks should ,be, mode poyabla to tho Roglsloro[ W, 1115,of tho conllly whurllln tl1ll docodout rosldod and,mo received sUbJoct to Ihe flllaldotolllllnotlon ollho Depmtlllont of RlIvonllo. ' ' 7, FAILURETO PAY T"he'loxeslrilposed,tOgetllel wllh any Inlorost thoroon, moo licmllllon rool plO'liorly, whlcl,lllon romolns 'n offectuntll Ihe laxes ond Inleresl hovo been IJald'ln full,Tllo taxes IIIOY ho ~lIod for o~olnsl ony rool property In Ulodecedent's estate or ogolnst ony proporty belonging to 0 trallsforee lial)lo fOI tho tox. ' , a, FILING..Qf.JALSE RETUflN . Any person WIIO Wlllfullymokes 0 folse roWrn or roporlrequlfod of Irlln 5hnll, In accordanco with Soctlon 793 01 thO' , 1961 Statuto, be guilty OfllllllsdOlllonuor, ond, on .conVlcllonlhoroof, sholl 1>0 sonlonclJ(1 to pny 0 Ilno notoxcoocllng $1,000 or undergo Ill1prlsolll1lCllllnol oxcoodlng lIno yem or both. . ~IV.U4 IX.,"'DI INHE:RITANCe: TAX SUMMARY SHEET (BURE:AU USe: ONL.Y) FII. Numb.r ~,-e1-o1R.~_~__~.~~_....~._..u._____._~ ealat. Nom' ~-,---__' .al:lnuQr.rll,l1...:Acr;L.-.-~.._.-.._-~- [iJOrlolnal D Supplomental o Remainder, Oat. 0,1 D.ath --,--._~~br.~~.ry_.g9.L12~1__________..,_ SOQlal Socullty N~mber 192-3.0-!t29/1 - REPORT,OP INHERITANCe TAX APPRAiseR - ' .. I, the und.r,lgn.d duly appolnt.d Inhltllana. Tax Appralllr In and lar the Caunty alcum~al'J,~nd P.nn,ylvanla..dalllp,atlully r.port th~t I !lay. appral"d Ih. Ital and pltlanal praperal r~'part. In t ,Iar.galn~ "!\1m ot th, valu.. lit forth oppaall. ,aah ll,nlln tt" lall oalumn to th.,' ht In Soh. .. "A", liB", "C", and I a" Dat.d, NOVAmhAl" 1~, 'IClB1 M'" "" INVINTORY RulProp.rly (hhl~ull A) ~orlOnal Praporly (Soh,dul. B) JolntoHlld Proporly (Sohodull B) Tran.f.ro (Sohldule C) TOTAl. ClROSS ASSBTS l.1" O.bl. dnd OedU'llon. (SCHeDUl.e PI Cl.BARVAl.Ull OP UTATe P Llle E.t~te o Annull'( VAl.UB A' APPRAISBo caDB ADJUSTMBNTS " (IfARRI'B~RO un DNl.V) RBMAINPIR APPMII,BMBNT cope I 00+ ...!!:L ,12 8 06 10+ .____ NQNU; ~ .NQ.MlL.~ 30+ :__m_H._~_.,22,23.1. .39.m .__.. ----.....-.------.- --_.~- 40. u. y. _______ ...... _b --.--, J!hll rACTOR PRlljCIPl.e VAl.Ue CODB - ...... - I:. peA LJA1tD,P RRQISTE!R OHL_V To. on $ To. on $ To. on $ To. on I To. on I 8olmpllon. Total B.,.,. wa. OOMPUTATtON O~ W S _ I I I_- I " --- 6% 15% I ..-- TO _ blSCOUNT INTeRBIT .j 'S - I '. + " BAl.ANCe $ TO .1 $ I -----" I TOTAL TAX INTDReST PROM BAl.ANCe l.... Crod'" DATI oP PAVMeNT AMOl!I~T PAID ~ ~ ~ '8 ~ f ~" ~ t . " "" ~ . ;tl III I ~ .- f"1 .:t ,.., ,- I J ~ ~l ' "! co t.. f"1 .,. " """ "'"' IJ" ~ 0 Vl 0 d ~ Vl g '~ d ~ z z . . ~. 0 0 (;:\ t5 ~ z' ~ z ~ ~ 8 :J QENe~AL INHERITANCE rAX l~rOI3t\1~T'Q~ Unaatlsfled IlohllltlBR Inourrad hythu doondont, prior to hla/hol' doath ora dotlllotlblougalnalhla/har taxable es\~ta. In addition to dohta Inollrred by llw deoedont or oatato, othor Itoma nl'n elnlmllillo Inoludlng tho OOSI of administration, attomey foos, Ild(/Olary foos, flll1Ol'lll nnd hurlnl a~,pollaOR Inoludlng tho 0001 of n burial lot, tomilotone or grove mel'kor. All dohtB bolng oldlmod lIonlnst nn oatote ore sUhJeot to tho npprovnl of tho Roolator of Willa with whom tl1e Inherltanoo Tex Rotlll'llla fllod. Evldenm) to sllpport tho dooodont'a or tile ostnto'allllillllty for tile dobts bolno ololmod ahould bo ettaohod to thlB aohodlllo. A familY oxemptlon <,11 $2,000 moy ho ololmed by 0 apoLlao olllelooedollt who died c1omlollod In Ponnaylvonla, If thero Is no spouae, or II tlloapouso has forlolteclhla/hnr rights, then any ohlldof the dooecJontwho la 0 member of the samo houaoholcl oon ololm tho oxomptlon.ln tho ovont thore la no suoh apouso or ohlld, tho oxomptlon oon bo olalmed by 0 pororH or plll'Ollts who 01'0 momhars of tho Ramo housohold os tho dooodont. Tho (amlly exemption Is ollowablo only aualnot aSBots which paBS by II will or by the Pennsylvania li1tosta\;! LnwB. c ~ 8 8 E; ~ ~ ~ z ~ z iri ~ ~ ~ I::l I p .~ ~ ;l . z p p z 0 0 P 'Tl 'Tl .... t~1 5 ~ ,. Z ~ .' 0. .' "l. c: ... ., If\ ~ I.;' )~ ,- f~;l;;; - I~ :_j ,.. ~~. ~ n! !:o:. e'lll fT'. ~!.! 1(".\ 8") ;7~i~ ~U., i:O U'w ~ ~ f;S w- ,., '-, , INSTRUCTioNs FO'R COMPLETING SCHEDUL.E "F" I, If the family exemption la bolngelalmod, Indica to tl1e olelmant'a nome, addreas anel hla/her relatlonahlp to ,he deoedent, Enter, "family oxemptlon" In the remarks'oolumn and tho amount olalmed In the amount oolumn. 2. Aaalgn Qonseoutlve numbers to oaol1ltem listed. 3, Enter the deto on wl1loh eooh dobt'waslnourred and/or pold. 4, Enter\he nemos of oecl1 pOYee. 5. Provldo a brio! oxplanatlon In thorelTlorks oolumn for eaoh debt ololmed. ~'.. Enter tho amount of oneh dobt bolng olalmod. , . ( The form must be signed by the porso(1 who has esaumed the responsibility !orpoylng tho debta: jt/.E.Q.ftMAIlQJi. To Inouro prop or orodll 10 you, o"ounl; Iho nnmo ul Ihu 0'11110 nnd 1110 nUlnhDr .11OUlcl hu r:\ou,ly prlnl- od on tho ohook or monov ordo/, This OSI088monl 10 modo In oooorclnnuo wllh 8,,01l0n '/08 of Iho Inhorllllnou ond gulOlo Tu~ AOI of 1981(72 P,6, 6 2496- 7081, To Iho o~\Onl Ihot Inholllonoo 10~ 10 "old wllhln thruo 131 monlho oftur Iho doulh of Iho dlltlldonl, Il dlsoount 01 Ilvo (6) ~oroont Is ollowod (72 r,6, fi 2460.7101, . Inherltonoo To~, 01l10r IIwn tltX on 0 IUIUlo Inlo,uOI, 10 duo 111 1110 dOlo ul Ihu dlloedonl'o cloltlh unci lioool11os dellnquenl Al thu a~plrnllon of nlna (9) monlll. oftur Iho duoltcla'1I'S duolh rn r.8, fi 2486.7111. l'1IIO,llIInoo Tsx on 0 fuluro Inl%ol 10 pllYAlilo wllhln IIUD. (31 monlllo '111101 iha I,onof., Ink"o ofl(,ol In po.."..lon.ncl enJoymenl and 10 dellnquonl Ihorooltol 1'12 r,6, fi 2486- 7121, OolOlllolu ullorool from Iho (Iollnquonl dolo .hown on tho fooo of thll form 10 tho dolo of OOlUol poymllnl ullng Ihll follllwlnll'nloruollnhlo: ...______.........._ ....._ ____......~ ___..__..._ _ ...._.... " F' ....... __ ........._.... ....... _.. .. ..._._ _"H'" _..... ...-._....." ...~. -.............. -......- , monlh ,006 4 monlh. .020 7 mont/Is .035 10"lonlhs ,060 2'monlhl ,010 6111011111S ,026 o monlh. ,040 11 monlhs ,066 3 monlhl .DI6 6 monlhs ,030 o monlh. ,046 12 monlhs ,060 , I doys ,00017 11 dny. ,00186 21 doy. ,00362 2 doys ,00034 12 dOV. .00203 22 dnyo ,00389 , 3 days ,00061 13 dnys ,00220 ,23 tluyo ,00306 4 days ,00068 14 tlUYo ,0023-/ 24 days ,00403 . 6 daYI .00006 I ~ tiny. ,00260 2 C day. ,00420 6 days .00101 .. 1 dny. ,00267 26 dny. ,00437 7 doy. ,00118 17 tiny. ,00264 21 doys .00464 8 days .00135 18 dovs ,00301 28 dnys .00471 9 dnvs ,00162 19 day. .00316 29 tlnys ,00498 10 dRYI .00180 20 daya ,00336 30 doys ,00600 .. _ _ _~_...;...._....J... ..._-_ ___.._..... ....__....._.. __........ _ __ _.~ - ...--'-.-.. .__w-____ - - -... -....------ - ..-...... Any porly In Inlero.I, lnaludlng Iho Gornmonwotllth nntl Illu l,orsonol ,upro.onluIIYo, nol .0,lsUod wllh thl useumont mov obJeol thorolo ,wllhln "I.Iy 160) dOV. oft or roclllpl of Ihlo Nollno os provltlntl by Bootlon 1001 of IIlIl Inhorltonae Rnd HBluI.Tn. AOI 011901172 p,S, tl 2496.1001). Make ol1eok ar money order. poyable \0: "Raglster of Willa. Agont" 'Moll to tile udcfroBB IIstod balow: