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HomeMy WebLinkAbout81-00166 " No. 21.81 106 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY' In the Iastate of ~Rr 0 .J::th_$-tl-x:r..eC -" de08l\Ssd, To Register of Wills for the County of Cumberlal)d, In the Oommonwealth ofPennsylvl\nla, pelltlone'~ Is ~the.e~eout r-l~- named In the I.aet Will and Testamsnt oL )t.I~r 1> , ()~ffi,>'o~("' datod .1~Q, ~...Jll "8' ,", Deoedent was 1\ oltlzen of hie United states and a resld\lnt of,{:FI, 1=:-f'P~""'.s IiJ 8(' 0 Township (liert1l1ah), Cumberland Oounty, Oommonwealth of Pennsylvania, Deoedent died on. tM-A.;uL day of ~(,Uf/I' r A,P. 19,..U, In the g~~~~~hl ~~~i~e~nJ~';rled and haa (ha~ 8~~:) ~~i~fie~ bo,n ~~ t~~maf~e~)f e~:l t~:a;:: eoutlo,n of the above desorlbed Will,: J:t .... Deoedent Wae posssssed of personal property to the value of --tr- 9 j ~ 0 and of real estate to the value,of ,M.' 0 ae near as ,oan be asoertalned; eald realosHlte situated ae lollows p.J, Fl. Therelore, your petltloner(s)'reepeotfully apply(les) fot the probate tif the said I.ast Will 'and Te~ta. ment and for I.etters Teetamenta,y thsron, Dated . marc;-)... f'.' / I( i I , Name and address of Petltloner(s) ~5a. rJ~)(1:U:- 6 ('J , ~~ ch t;rc..h ftd c: NIY"l((' 11 11....1.. f..J7 I COMMONWEAI.TH OF PENNSYI.VANIA l OOUNTY OF OUMBERI.AND f ss ',..~,-PJLI-..o.C-e-- ~-"_..J1----J3-f1.$)~ <r named In above applloatlon, ~e(ng, duly ,s"v_'>()r"J , aOQordlng to law say(e) that the statoments set forth In tl11s petition are ,truetQ tho best of--h.:e.,C-. knowledge and belief. SWOIUJ. and subsorlbed beforo .__...~,_____ me'~71f!l~~~~h_J~_~~ 1e8.~__ , ;..:'.,IJI,~Z't,f;/.(j;~:n{l.,P~ ,::ud~l ~_._~..-19~.~~-~ , " I" 7ROgIster k/'l/J Plied: MlU'dh 9; 1981 nunm - Attornoy,jiC.i \' W' . .>'b "t N ?" d oS T" H~.~"I.,..,~ fr1 ii ~ " " " ~ f:l ~ ~ i &J ~ j " , , " " ;j, " ~ u.1 Z A ,tti ~~i" 'f8 ~:~ ~ ~,~ [Ilitl ~' ~,m, ~ I, \' !' . . OA'rU nt' I'~;MHONAI. RI.;JlR":S~:N'fATIVE COMMONWtlAI:nl OF PENNSYLVANIA fiRI COUNTY 011 CUMllllRI"ANP Ilofore 010, Ihe'Rcglsler for Iho I'rohalc of Wills and sruntlng of l.,eUen of Admlnlstrallon h\ and for tho Counly of . ' '. Cumborland, porsonnlly clune ~l1f# -,-Q ~fI.x~r . dO,_ > doposo and say tha~ as , I; ~ ~c...t.J ;- r 1)( ~ I C'_ N't )' I> '('I'l,' B rfi<Tfll' - , who, boln" dUIY~,.u t,I'f'J.J of tho last Will and Testnlnonl of , . -,---dccca.cd ,:"'wlll well and truly admlnlstor tho gOl,lds and chat~els, rlshts and oredll' of Rllld deceased'accordlns 10 law, And , , also, will dl1l80nlly cpmplY with tho provisions of Ihe law r,0lalln8,lo Transfer Inherltanccs. ~1.J"'N....ttd subserlbed bofore me, M1Vr'b.-~ r A,O" 19!U. ~~I'1jq.~~ ,_ ''1//:14(1' c . Yh.""t"~e8Ister v I ~I COO'! LL l(l co 0 *' ~ ~ ~ -I ,~ l8 -I, i ~ ~ . ~ - ~ co ~ III ,.. ~ ,1:1 ap, N I' III ~ 0, , Nl ~ ,~ I ~ ~ 1 {. I' DECREE Bo It remembored Iliat onlhe ~ day of-1tJr:/ rc...\i... ,A,O,,19~ J ,there was, probaled and recorded'tho last Will and To~tnment ofJ ,e:..\' 19r D IYU~ A,J"' ~ t" --".Iate of, ~ " .' ", ...' ." ' A 11 ~ r l~P}\JNS. (jJ 1:1.('0 T(1-t-"~~& J... 1(>. ,cumberland County, PennsylvlInla, Pcconsod, Lellor~,1~Tn lVIeJJ1R ry wore granted 10 Po l.\) f' '( ~, ,N. /3J1l( '1't..r Wllllcaa my hnnd 'and official senlthe day and year aforesaid; J ' " , ~ ) " " 'J"'" , (/ "",. " ' I " " . '/ " ~t{f~/(! '{;;;;</~'~~/ , , ' (./ /" Relllster PAYIlliNIl fl,',oh thl tllP portion of ,;,h Notlol and IUb_1t with your pav.,n' ..dl PIIVllbl, prln'ld an thl,rlv,r.. .Id.. ~~ H~ :TJ~ I, ' (() (. ~ .x' (, , \', "'< I-I "1 (, L I F' \0 j;3 ':L 'l . i,,' Iii )\l ,. ~,\ \1, ~ Cl to thl na., ind ftddr... II PUIDIN! DICIOIN! ..k. .hook or ,0n1V ordor IlIv.bl. to, REGXSTER GP WXLLa, AGENT, II HON-PUJOIN! DICIDIN! Ilk. oh.ok or .onlV ord" povobl. to, COHHONWEAL TH OP PENNaVLYANXA, All p.~..nh rtotlVld .hlll bt ftPPll,d fir.' to anv Inter..' which ..v bl dU, with any r....lnd.r IlPpll.d to"'h. tlMI R8~UND (CR)I A r.fund of _ tlM or.dlt, which wa. not r.qUI.t,d on thl T.~ Raturn, .'V b. r.q~~.t'd bY GORPI,ttn, an "ApplJOItlon fQr Rlfund of. Pennlvly,nl,. ."hlrltlno. end E.t,'. 'aMtI (fUW-UUl, AppllOlUoni ar. ly,llIbl..t thl OHIa. of, thl R.,ltt.r of WUlI, Dny of thl U Rlv.nUI Dltt, Jot Offloll or frOM thl D,perh,,"t', 2ft-hour .n.w.rlng ,.rYlo. nuab.r. far f~r.' ord.rln,1 In P,nn.vlv,nl. 1-100-162-2010, out.ld. Plnn,vlvant. .nd wUhln 10081 H.r"ltburg .",. (711) 111-1094, TPP' (117) n'''U!i2 CH..rinG htpalrtd onlY). REPLV TOI QUlltlon. "GirdinG Irrorl contltlnld on this notta. .hould bl .ddr....d' tOI PA DIPart"nt of Rlv'nu., aurllu of IncUvldual TaWil, ATTNI po.t 'A.......nt MIldlw Unit, nlpt. '80601, HlrrlsburD, PA 11UI-0601,lphonl I7In 717-6&0&, DI.COUNT, , If'ny tlM due I. Plld within thr.. ()) ollendnr lonth. .ftlr thu dlc.dlnt', death, a flvl plrolnt (IX) dl'oo~nt of thl \1M p.hJ "allowld, ' PENALTYl Th. 11~ tlM a'n,.ty non-plrtlolpatJon Plnlltv I. Goaputld on the tot.1 of thl taM and Int.rl.\ .......d, and not 'Plld h.far. J.nulrY U, 1996, thl fi'r.t dlY afttr U\I Ind of thl tlM ',.nltty period. tHTERF,8T1 lntlr"t It ohlr~.d bl,lonl"' with flr.t d,y of dlllnqu~nDY, or nln. C') lonth. and on, OJ d.y frol thl d"1 of d..t~, to thl dati'of p.v..nt. TIMI' whloh blo'.1 dtllnqulnt blforl January I, 1912 bill' 'nttrl.t .t the rate of .IM (6~) p.rolnt p.r InnUI olloulfttld at ft dlllv ratllof ,000164. All tIMI, whloh bIO"1 dlllnqulnt onlnd Ift,r Janulrv 1, 1982 will blar Int.r..t at a rat. which wlllvftry frol aallnd,r Ylar to oll.ndar vI.r wlth,thlt rat. .MOUnola' by thl PA n.plrt..nt of AIYlnu.. lh. applIoabl. I"t.r..t rlt.. for 1912 through 1996 Irll VIII' Int.ri.t Alt. DillY tnterl.t Faotor - VIII' Int.r..t Rfltt UIIlvtnt.rl.t Paotor 1912 1961 191~ 1986 1916 ..tnt.,.lIt 20~ ,ODO&~& l6X ,OOO~I' llX ,000101 IIX ,0001&6 lOX ,00027~ 1. o.louS.ted I' folloN'1 1917 191&-1991 1992 1991-199~ 199&-1996 ' 9X IIX 9~ 7X ,Yo ,000247 ,00010\ ,000247 ,000192 ,00OB~1 XNTBRBST . hAUNCB OP TAX UNPAID X NUHaBR ep DAYS OBLXNQUBNT X OAILY XNTBRBST FACTOR "-Anv NoUo. It'lfld .ft.,. the taM bIOO..., d.llnr,ulnt will rlfllot an Intlrllt oalculatlon to flft..n ell) d"V" blyond thl dft'. of thl ........nt, If ~.v...nt I. .edl .ft,r the Inttrl.t oo.putltlon dati .hown on thl Hotlol, ,ddltlonal Inter..t IIV.t b. oaloul,t.d, aunH1'lDnw..Uh of tlenn,yIV.nli DI,"Wr,,"' of A.v.nu. T,,",'-I, Inll,'IUnat To A"ld'lh DluIlhm', A,y.484 ax. (1.001 INHERITANOE TAX RETURN FOR ESTATES WITH GROSS ASSETS UNDER $10,000,00 ~"I a.lllle of RICHI\RD M. BI\XTI!lR (lUlU of OOlltll February 22, 1991 ~Oll Addroas 606 pOlJlar Churoh Road Boelllll Boollrlty 1/ , camp Hill, Pennl3ylvania 17011 BurllOIl Plio 1/ " (allY) (s..t,) IZlol t9/-!il ~ County Fllo 1/ ( (,I G. 1. Dsoudolll tllod: o 'Into'lolo (wllholll a willi 1&1 Ta.lole (Ieovlng 0 laSI will - oopy Ittoohodl , ' 2, [Xl 'ExooU\or/Exooulrlx D Admlnl.trolar/Mmlnl~irolrlx Namo Dolores, 1\. Baxter Camp Hill, (OIIVl Pennsylvania IBI,II) . n 2f ji~ m~' 17011 r, {; S)c;a "{I:. (Zlo) ,. :'t; "'{'j !l' ~I: ... .r!).. \0 "i f;~I; ,~. '!;"J \")"'.' ',1' l:'")fl, i!if 0; (~~ .- , ,~ 'IIQl HI ';.'-.'.; 'I ') , l.4:J , ~- "" " Addr,elB 606 poplar churoh Road 3, All oorro.pondonoo .hould be moiled 101&1 Attornoy OFld\lolary, , ' 4, ' If Oil attorney la, roprolentlng Ihe estale, Indloate: Noma Thomas L. Wenger, Esquire 50B North Seoond Street' Harrisburg, Pennsylvania IClIyl ' (SIIIII 17101 Address 1111,1 R~AL,PRopaRTV,,~ IdlnlllV fUlllrOpl/1V 10011.dln P.nowIYlnl. bV 101 .nd,~locknumb", "'"I .ddro.. dnd Blllmll.d Inolud. I lIOI.monl 01 monOlg, .ncum~'.no"'o', 01 ill' d.II ol,dUIII, .MMket Vllu. D.porlm.nt VolUlllon (Olllolal Ut. Onlyl ,- NONE" Total o .... C) --- jl ~ . ,. PI!lRSONAL PROPI!lRWY Qont~nued. , , l1n~tec.'l States Government Series II III II send ~ I leSUI!l OAT!I SI!lIU1\L NUMBIllR 1/74 5 i50 746 292 ;3/74 . 5 150 758 579 4/74 5 165 lB3 200 6/74 5 173 155 499 7/74 5 lB6 043 693 8/74 !l 196 343 39B 10/74 5 204 150 36B " 11/7 II 5 216 724 699 12/74 5 299 730 324 2/75 5 243 442 454 3/75 5 Zt34 000 190 5/75 ' 5 252 481,25B 6/75 6 002 521 644 B/7t3 6 002 560 466 9/75 6 002 5BB B56 10/75 6 034 454 3B4 11/75 6 030 910 37B IllS~lMATI!lD MARRET VALUE 460.28 ; "',,' I ,. , I' I', BeNeFIOIARIII AND AODRe88U8 'I'... MI no"''' Ind odd,..o.. of .11 who hovo In In'''..' .lIhl/ V..I.d, oonllnV.II' 0' olhl/ Int"..11 PIlNBFIOIAHIIlB RILATIONIHIP TO DUoeDeNT IURVlveD DUOeDeNT eTATH YU OR NO Aoe OF LIPe THNANTH OR ANNUITANTS AT DeATH OP DuoeDI INTIRIIT OP BeNePlolARV . IN eaTATH ._. DelorG..!..^ l...J,'l.!lli!:!'!!L___._:--__ .~P9ua.!!- JGB ...--- c: ~. ~ 8 ~ ~ ~ !l ili ~ 0 11' !i ~t. F ~t. 1t. m ~ I 1~ 0 0 'T1 'T1 - i! ~ ~ ~ ~ m i ~ , - " INPORMATlON PLAOE POR ~ILING ":Tho roturn Islo bo fIIod In dupllooto with tho Roglstor of Willi of tho oountY whoroln Ihn dooodont rosldod,. TIME FOR FILING - Tho rot urn Is duo nino monU,s pftor Iho dooodont's doplh, unloss"n oxlonslon for filing h"s boon oPPlled for and granlod by Iho Socrolarv of Rovonuo within Iho nlno"month porlod, FAILURE TO PILE RETURN - Soollon 701 01 tho 1061 Stotulo provides tho\ "., ,onv person who WillfUlly fallo 10 flte a rolUrn or othor report roqulroll of him, , , shall bo porsonolly 1I0blo , , , to 0 pon"ltv 01 26% af tho lex ultlmatoly found 10 bo duo or $1,000 whlohovor Is tho IU"lIr to bo rcoovorod by Iho Doporlmont 01. ROVO'lUO os dobts of Ilk. omount oro rooovorublo by low," , I, It " Ii I?ElRSONAL PROPElRTY oontinue4. United States Government Series II mil Bondsl ISSUEl, DATE I SElRIAL NUM13ElR , 1/74 5 150 746 292 3/74 5 150 758 57\1 4/74 5 165 183 200 6/74 5 173 155 499 7/74 5 106 043 693 8/74 5 196 343 390 10/74 5 204 150 368 11/74 5 216 724 699 12/74 5 299 730 324 2i75 ' 5 243 442 454 3/75 5 254 000 190 5/75. 5 252 481 258 6/75 6 002 521 644 8/75 6 002 560 466 9/75 6 002 588 856 10/75 6 034 454 384 11/75 6 030 910 378 ElSTIMATElD MARKET V1\LUm 460.28 1; Fllo Hymbor INHERITANCE TAX SUMMARY SHEE1' (BUREAU USE ONLY) --"'--. - -- 21-01-0j611 m Original o Supplemental o Remainder ~~v.~u ~X+,\"'OI " Eltate Ham. __~___.__.I~~~~~!,d ..~'_J~,~~t.op_~~~_._ , Fabvutll'Y 22. 1001 Oat. ef Death. __..._~~........__o.c--_~.,..._._._;__i.... ,Social S.curlty Numb.r ___..~~,~~__u~.m.~ REPORT OF I~HERITAHCE TAX APPRAISER , I, th. und.lIlgn.d duly appalnt.d Inh.rllanc. Tax^pp'al~.,ln ~n~, for th. County of Oumbel:'land , P.nnlylv.nla, do ,..p'ctfully r.port that ,hav. app',alud lh. 1101 and p.,.qpal plOP" .. ,epart.~ Ir th',' for.g,O,lnr lltum, at th. valu.. ut forth opp..lI. .ach II"" In th.l..t eolumn to th. rl ht In hh I.. "1.', "B " "C", and' IIf Pat.dl Ootobel:' 2. 1981 INV8NTORY' VALUB AS APPRAISBD CODB ADJUSTMeNTS (HMRIIDURIl USB ONLY) RBMAINDeR APPRAISBMBNT COOB Ria' Property (Sohldull A) P....nol PropOlty (Sohldull B) JolnhHlld Prop..ty (Sohldull 8) T,ah""1I (Sohldull C) TOTAL GROSl,IISSITS 00+ 12.216 78 ,e+ 19,083' 00 10+ NONE ~ ___..___21,299 2!!- __ "..____ u , , : LI.. Olbt. and Oldultlon. (SCH BOULe P) CL8AR VALue OP ,UTAT8 o 1.111, I.tot. o ^nn~lty .... u. !!ill ~..E.W PRIHOI PL B VALUe CODe paR lUll OP ASOISTBR ONhV Tax Oh '$' Tax on 5 Tax on S ,Ta. On 5 Tax on $ hlmptlan. Tatal htato Wi COMPUTATION OP TAX $ $ 5 $~ $ ~ 611 1611 TOTAL TAX IHTBResT PROM BALAHC8 TO S I $ $ l IHTeRUT TAX CRBOIT - 5 Q $ * LI..Ctodlh Oil Te OP PAYM8HT , AMOUNT PAID I DISCOUHT t $ t IlIl"AHce TO " I r' .;'" ~ ' .~ t , , r , I )" ,. ;-----. ) S ~' ~ ~ ~ E j ~ 18 ~ j '~ . ~I mil to l'l C'l ,~ ~. i 1;'0 ~ to ~P;~ ;:1 ~ 0 to ~~ ..... ~ d ~ 0 z , ~ ~ ~ d d I', 'i ~ d , z z ~ Z', ~ ~ ~ ~ 8 ,~ --................-....-- " , ,. . .,) I; COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OP REVENUE BUREAU OP EXAMINATION OPPIOIAL NOTloe OF INHERITANCE TAX AElSESSMENT . i .,...,.- /"-,,/,, 'I. ./.'/J"'/ " ,. , ,- I' TO: I i' f' ~, I , , 1-" .' -, ..:',- ,.' 1'-',/ __..,..t) _,i;_;) I~/ -./:1.: , ,I., . , '/ ( ,>' >,' , I /.( t.. . .. ,! / I , 1 , .f' DATE EElTATE I , ,1 ;,' ( i I _;/ . u;,"'_ ) -',-~-,/ " .)/'//'("'/ i _ . . COUNTY PILE NO: / / . i-L --- PILE NO, I i. I ,/ (,,' (/ - /ld , I _. _ ,/ --,I '1 '~.--' t -' I Ii ,'" / " -) j ,/,/ ( / COUNTY / ( / ~.. ,/ Ii (: I i ;1 ./:..1J.J/__t'~( DATE OP OEA TH I ;' '/'~l '.j ,'/1; .>f I/! Appralaod Valuo QI Eatatol Rool E"ate PQrlonol Plopolty . t " ,-'j , I/o i' 1(.' I '-' 1,1 . JolnllY Held Proporty/TronIIQr~ t ./ // :;-':j.; , ,--"" , L' To1'ol 01018 Eatato . :'i/ , iI,! ./. " " . " Totol Approvod Ooduollonl ,-" _' {i - Jb , '/ _~I i. _ Olur Volue 01 Seteto . ,/} ,,, ;1,/, ;_,/ ill I' i LOll: Approvod Oharltable E~ompllonl Clear Value 01 Eetate Subjeatlo Tax . 'I /,/.) '1'/ AnjUunt Taxeble @ B% Rete L....;,.; i./ ", oj .; " ,- ~ -- tax due . /-' // -//:'J'() , Amount Hxeblo @ 1 B% Rate lex ,due TOTAL PENNElYLVANIA INHERITANOETAX ~Ua . / '):'/ y. r,;" C,J I · · · · · · A llvo paroanl dleoount totaling .' ,will' bo grontod If llio Inhorllonoo Tox 'II palq by Leu Credits: OA TE OF PAYMENT AMOUNT PAID , OISCO!:!!::!L INTGREElT TAX OREDIT ,.,,-- U j ,. /' ~,.iJ ,. .I-l .-' ,.f . ;> I ;.., I _ "I} , t ., (" ,,ii,) ! 1:1 . ", ;~) (l if. r' /, Y ,_,f I ~ , I ,~;:(/ . / ',co; , t ,- .. ~,/f/ , ' /." , " + . !ntere8t eCeruel at tho reto of elx 161 peroent por annum on tM unpaid bolanoe of Inhorllonoo TAX from to dato of poymont, Intorelt duo If pnld bv~_~_ II BALANOEOP PENNSYLVANIA INHERITANOE TAX DUE ,. j"/V ;/ '7' . , J, .,. . !.: _ / ,',.' i. .1 / " HI \ii~;l d ( iliJiQ,tlMtlli1lN. To In.v,e p,opor o,odll 10 YOIII oecovnl, 1110 110100 01 11111 0"010 olld fllo IIumhll' olll<uld ho oloo,ly 1',1111' ' o~ on IlIn chook 0' monoy ordo" Thlo 118800emoll1 Is modo In 1I00o'dllnuo Willi Suciloll 700 01 Iho 1111111,1\11"00 0,"1 1'8111\0 Tox Acl 01 '1001172 p,O, U 2486.7001. To "'0 eXlenl Ihol Inho,ltonoe lAX Ie "old within Ih,oo 13} ,,,olllhe oltor Iho <loolh 01 1110 <looodonl, 0 dleoounl of five 10lperoonl Ie oltowod 172 I',S, 9 2406,7101, Inho,llonoo Tox, olho, IIlon loX on II fUIlIIO Inle,oe\' Ie duo nl H,e delll of Iho dooodonl'e dlllllll IInd hooollloe dollnquonl 01 Iho oxpl,ollon o,f nlnn 19} monlhs oflor Iho dooode'II'o d08\h ('/2 P,8, Y 2480,711), Inho,ltonoo rex on n fuluro Inloreel Is poyeblo within H"oo (31 monlh. oltor Iho IIlInlfo' lokol 011001 In poo9oulon end enjovmonl nnd Ie dollnquonl Iho,eoftor (72 P,S, 9 2406,7121, Colculele Inlo,oellm," Iho dollnqunnl dolo ehown on Iho fooo of 1I,ls IorIO 10 Iho dOlO of oOluol "ovmonl lining Iho followlllO 1111U10elloh10: ...,---.--_........... ...-...-......_.. --..........-........ --... ....-...............---......-..... -..- ........- ...--........--.. --...- ...- --......- , lmonlh ,000 4 monlhs .020 7 monlh. ,036 10 monlh. ,060 2 monlhs ,010 6 molllhl ,026 llmonll," ,040 11 monlh8 ,060 3 monlhs ,010 o monlhe .030 9 monll18 ,046 12 monllll ,000 ..-...-.-- 1 dovs ,0001"1, 11 dl!V" ,00100 21 dove ,00302 2 dove ,00034 12 dovs ,0020:1 22 dllYs ,00309 3 qovs ,00001 13 dov. ,Dona 23 doV" ,00380 4 dovs ,00068 ,14 dllV8 ,00237 24 dove ,00403 6 dove .00086 16 dOYII ,00200 26 <loVI ,00420 o dovs ,00101 10 dov8 ,007.07 20 <lIlV. .00437 7 dOVI .00119 \7 doV" ,0()204 2"1 dOV" ,00454 o dovs .00130 10 dovl ,00301 20 doys ,00471 9 dol', ,00102 10 doV. ,00310 29 dovs ,00405 10 dovs ,00109 20 dovs ,00336 30 dovs ,00600 .. _ _..._ __....__... ___ ..._......_..... ___ _..._ _ _._...-t~~ _... _,. _ ..._-.... - - -..""r.-..... - - - - - - ----..""":........ --.......... ilInv,pmlv In Inlo,oSI, Inolud\ng 1110 ComlllonwolIlIlI IInd 11111 p","lInlll ,opro.onlollvo" nOI ~oll.lIod W11I1, Iho' n8BoBBlllo~1 mov ob/ool Ihorolo wllhln 11.ly (001 dllV8 lillo' 'Oflllipl of 11110 Nollco II' fllovldod bV 811cllon " '1001 of 1IIIIInl1o,IIonoo ond ESlolo Tllx Act of 1001 ('/2 1',8, \, 7.4ll0.1001), \,). MUko ohool< or money ardor payable to: "Ro{Jlolarof Willa, Agonl" MallIa the address lIalocl bulaw: