The URL can be used to link to this page

Home My WebLink About81-00241 ., j:j ~ ~ tIJ ~ If ~ H fJ3 ~ .,-i . . ~l: ..:l IIct N ~ ~ r- eo ...... I 0 ,.. .(\1 ClJ - . IU 0 - WI Z UJ IlEGISTlm OF WII.I.S OF ...f..':!.~I?..,"."X~.\'!.~....... COU1\T\21-81 NO. PETITION FOil PIlOBATE OF 11'11.1. AND I.E'rmnS OF AIlMINISTIlATION CU~I TEST,\~IENTO ANNEXO LETTEIlS OF ADMINISTHATION DE BONIS NON LETI'EIlS OF AmllNISTHATION DE BONIS I\ON CUM TESTAMENTO ANNEXO 241 ill the Estnlp uf ........~.!?..J;,.Y.""k~"..,I?.h.JJ?,g"""....,,..,"""'" dt'l'(~ast,d. 1','1 it innl'r (s), ....~g.~.~.....l3.~.~~.!.... .~..~.J\..:.......................... ................................'......... .................. ..'.......... nlll'W'(s) Ihnl: l1; lIllfllJ< 1. PetiliOlwr(x) JQK'xtH'KlIt)K(){IK'S'tc:OOiXot'~a< KJ'Xoldf;'K Hod appli(!.s for Iclh'l's uf lIdminlstralioll ..C?,,,~.~,:..?-,,~,,..,,..,,......,..,,,,.........,,..,,",....,,,,....,,..,,...,,.,,,,. in till' "I)ll"c' l'llpliollt'd ('stah', 2. Dt'l'NIl'nl dind nil .................M.iJ.x:.~.\1.....;(,(l.....J..~.e.l..,............ nl ..................M. ill lit<. Coo Illy of ..~.~.~p..~.~,~"..""....".....".,,' Stall' of ".g.~.~.f.\;.~.y.}-.y..~.~~.L~,..,.. al Ih(' lIW' of ........~)."..""..". years, having IIlndl' ..,!:!,?.~.... Lnst Will nnd Tnslnllll'nl dnlt.d lit<, ..?,!:l..t.h.. dny of ........~,g.p..t.g.m1?.9..h......... A.Il: l!J~..(l... * \Vherci'n .....~.h.~.. appointed ......"".g:.lJ.~.~.1?.l?,,~.h. .".~.~.J;..~.~....~.I},~,l?9.,'"..,......."",,..,.......... Exec~.t.*.~..~... Which Excc .~.t;::.!.?f.lms sillC(~ .,;::.~.D:!?~.r..9..~.9.....~.!).....~.?..y.9..;:....9.,~...s;.c;;.,~.~...,~.~.D.~.,r.....N..~.!':!.:.............. Oil 011 ..."........... <lilY of ...........................,.........'",,,,, JI)"......, Lelll'l'!': of Aumillistrulinll w<~re granted tn .................. ..~....~.\'!,g....S.~.~..~,'?~.~.....~.~.~.'".g,...1:I.~."S.~....?}..!...J2.2.9..:.................................................,..........,....,,,........... d.h,lI, d.h.lI.c.t.u. 3, Letters of Atlministmtinn c.La. an' nc(.d('d hl'('lIl1s{' ....9.t....t.,h,~..,..t'.~,D..9..\.J,P..g..~JJ.9..n....9..f.... ..!;,!:..~....!::,?';.~S.!:'.t~.~.?';..,......,,,..........,,",,....."'..,........,..... alld peliliOIll'r()4);:,~lts ill ...J.t?..".... eaplleiLy as ..p..9.m.!.p..!?~...................,............".,..........................,........... 4, Dc('cdcllt diNI domiciled in ...'p',e,n.ns.y'.l.:v..a,nia.............." with his last family or principal (state or coulltry) residence nt ..n,?....$..j;..<l.j;.~.....$..!;...~,.<e..!;..,.....W,~.~..t.....f..<lJ...y..t~.w..,..,..p..~.T.\.n.~.y..+..Y..fl.T.\J.~,........",........... WlK ~mx 5. (Where decedent died testate) J)(!cedent was not married and a child was not born to or adopted by decedent after execution of the will (and where applicant i.~ alleged spouse) nor was decedcmt divorced from applicant llfter execution of will and at dCilth, 6, The said decedent WllS pOS~il'ssl'd of Goods, Chattels, Hights and Credits to the estimated value of $................""......."". and of Hcal Estatc. to the estimated value of $.1~"d?..Q.9...~.9..9... as near as can he ascertained. 11mt the said Heal Estatl~ in so far as known is located in ".We.s.:t:...,F,aix:.v.ielll... Borough, Cumberland County, pennsylvania. ......"...................."......".....,................"......................'...........,......",......".................".............,....,..............."......................... 7. (Where decedent died intesti\t<. as to any portion of this estate). Petitiollcr after It proper search has ascertained that decedent was slIf\'i\'<'d hy the following-named persons entitled to distribution IInder the Inleslale Act of 1947: Name Relationship Residence 1. ....""'........."........"..".."''''"".........."...."."......"..........'''.."..""..,,..'''..........","......"..................""'......."............,,............, 2........"'''''''".."...."..,..,.."'''.........."......"......,..,....'''...."......",,...".."......".."..........."......................""..,..,......"'........"""...." 3..,............""........"......"............"'.."..",..""......""'..."..".......,,....,......"......"..........".................."'........""......."..""....."....,, 4. .".........,....".."......,.,............,......,,'......................,........................."......................,....,.......",....................,..................,..,.... 5....."'.",.."........""....."......"......",...."".."""'......,,..................................,..........."......"...."......"........",............"'....,...."""" 6........""......,.."..""...."'......"........"...."....,...."....,,,,,,,..,,..,,....,...................."....."...................,....,....""""......""...""'..""",,. ..............................."..............,............................,.........,....."........,.................................."..................",.................................. .[1Ply Therefore, pctitioner(x) respectfully applies for (probate of the will presenh>d herewith and Eor) Ie tiers 4 at'h~};raliOIl ................,...,.............."......"".............'i111....s...nk'.'r;N...~J,........,"'''"..,''''''''''".. Dall'd: .."....".:.."..:.i?.. ....,..."... Signed: ..i.11!t-~CbM~&:tr.e..'i't:s..........'" Address: C'6.rop"'H'i:,1:.i";'''..p.e.n.n'!:lyl.v'6.n.i:'a...... COMMONWEALTH OF I'E1\1\SYLVANIA l SS .....".."",........""................",..........".."'.."".",...."........""....... ..,.........".........."""....,,,..,,...................COUNTY: J ......J.am.e.s....Smile.y..,.....T.r,u s.t.,..O.f.f.i"e.r"..Q.f....,j;,h,~................."........."......."."... Ihe l'l'tilioner(lA) in the aho\'e application, l11'illg duly ....S.W-QX.>>..."..., ll(.'cordjn~ to law .~ay(s) that the statements set forth his in this petition are tHW to the hest of ........................ knowll'dgc aud 11l'1icf. ' tile. .,.."."..1~.~.::.e..L..""......,......,....".." 1!J".......... ...."...:...................,.................. .........."........".."............. ,.) 1,- ,~' '....'" .J ..'::1//<<.f-I..l,~.....1;{;;,f.:.{:':::.\~:.~; ...................."..."""'.."......"'.."".."..""........",,,,,,,.......... Fi""l: Apr i1 14. 1 981 Allonll'Y's Nallll' :tlld Address <-.)/-'8'1 -;1,'11 ......".."..""""...............""."....."...."."..."............".......,........":~ (":.;~~.;.....,....".."...,.........."'................."."............".".........".......~ OATH OF }'EUSONAL UEPUESENTATIVE COMMONWEALTII OF PENNSYLVANIA COUNTY OF CUMIlEIlLAND i ss: ............y.f!..m~.~....p..!!'.u.~..Y..,....:r.);.!!.~.LgJ.U.S!;'..~..!....c::.c::.~.B....,J.3,'!:.~~,.!....l'l.:..!':.:.............................. petitioller(:<) Ill'ing dilly ..."............";:;.~.~.E,~~...."............."....,,.. :I('cordillg 10 law do<:,~...........,,,.. dl'!lOSI' and say that as tlw admillisll'll tQl:'...t:...t..,...f th,' I'stal<' of ....".........J1.i\...Y....!;."....p..hJl!~...................................................................... dl't','ased ............................ will w,,1I alld truly admiuist"I' Ihe goods and challds. rights and c",dits of sllid deceased, aeeOJ'ding 10 iaw. And also will dilig,'ntly eomply with the provisions of the law relating to 1'rans(('r "lherihIUC('S', ..........!?W.9.F..~L................................... and sllhserihcd before me. ..............~?~.0........IJ?~~'t.............................. ..........fl.px,i,..l.......6............................., A. I).. HlJU.... Hegisl<.r DECUEE Ill' it 1'l'mcmhcred that on II", ........J.4.!;)}.................. day of ..............!1:I?!:J,;J,.................... A. D.. 19...~;h... . Letters of Administration c. t. a . in the estate of ....Mil-x:y....r......,Sbiblfil...................................... ..................................................................................................... laic of .....W~.~.!;;...f.!:!.;i,.+.Y...j,~K.................................. Cumberland Connt)', Pennsylvania, dceea".d, were granted to .....!;;!;;!:!~....!I~l!.~./....~.,.?:\.,.............................. .................................................................................................................................................................................................. Witness my hand and official seal the day and year aforesaid. Hegister , ;:;, c" <;') ;,:>,:<:1. ~, 0, ,~ ,. "" U)Ci Wo.. . ,-,J I...;. :;~r~ I?: 0:' :~~ C~:r I W~~~ a..' 0; .1:-' C'''' C- oe:: crt,) o(jJ "'" ,"" ""lD u"" "1: ::to:: ~ eJ::J ~ ...Ju u L(t./ 3 I, ;-....... .- , t\! :;l' c. cr ~., ~.., L ......::; ~, .~':" (.1..: .'.( ~': ~J\ 71:',,; Cif;~ I g::~ c el'''' o. (,,'1...., o..:V') "'" ':':-p~~ Ot::-~ r'" :~: "'''-' uJ-' ~a:: .- --,'-' SO u 0: W . ~ " ..: .J z :l z t~ il. 0 Z - ~ 0. ~ UJ H . III D. . :r- III z ....... ex. Ul 0: J: ~ 111 0 . ~ 0 ~ Z z >- o-l ::E -, ~ 0 >< .<ij ~ ~ ~ III < ~ ~ 0: W >- ::E ....... , ~_. r CODICIL 21 ~81 ~41 CUMBERLAND COUN1Y, ss: This ............!'!.~.!1......................... day of ...........<'\P.l:.i.J.................. ............................ A. D., 19/k19.&1 before me ........~~!)'...~.:...~<;:~~!!................................................., Register for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Common. wealth of Pennsylvania, personally came ..IVJ.~:':.!:9.":Y.--....~~.~~:..!!..1~.J:<;.......................................... ......... ......'.'X:'.S....().t....the sUbscribing witnesses to the foregoing instrument of writing purporting to be a ....................codieil to the last Will and Testament of ......lMBX...t.... .~m.H.J;;...................................... Dated .Jj;?.+L.7.9...... late Of....w.~!'1.t....f.g.:\..+.)IJ!o)i..!l.Q);'P.lJg.l.L.......... Cumberland County, Penna.. deceased who being dUly .......!?~!?r.!}.. according to law, depose and say, that .................... present, saw and heard the testa.tx:.i.x....., .........Mi;l,l;Y...L.....Shi.pe................sign. seal, publish, pronounce and declare the said instrument of writing as and for a ............ codicil to h.!;!.+.......Testament and Last Will, and at the time of so doing ....sh.e.....was of sound and disposing mind, memory and un- derstanding, to the best of their... knOWledge, observation and belief. Sworn to ............................................ and subscribed before "" .2" t/ .'/'1 .. .\L ~Id:;"!..... ../.. ),.t:.t.t:.((, 1.:1~... d.c:f.~t.(,./.l.t"-'J..(---' ;'1' /J.~ J .'2Jf"7J...{./,.(/g~. ............ Register. , :1'.) '._.t "... ................................................................................. ...............................................................u................ ". .~.,,_..--..'.'..,." \ 21-81 2-11 No................................. Renunciation and Request .------------ In the Matter of the Estate of ..........W\.1.W...J...,...::?!!.:\?.!L.................................................................................................. To .......MARX...C....LE\o!I5............................................................................................, Esq., Register for the Probate of Wills and granting Letters of Administration for the Cou nty of Cumberland, in the Commonwealth of Pennsylvania. ..........+., the undersigned, being the .......~~~".':!1;Ej:":..!:'.~l1\e:.cl...i.I1...~~.~...c.~.d.~~.~.l.y~...t.h.:...~."':~.t......................... Will and Testament of the above decedent ...............................................................................................................................................................................................,.. .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. do hereby renounce .........................................!\IY.................right /0 have Letters ....:r.~~.~~~e:n..~ilEY.............................. .......................................................................... on said Estate issued to .....................~:.................................................. ................................................................................................. .................................., and do hereby request you to grant the same to . ..........~g~.?.. .!l~.'l~.!...I;I.I\.................................... .......... ........ ............. .............................................. ..... ........... Witness.. ....'i':Y...... ..hand............... .and seal....... ....... . .this.... 2nd .................................................................................. April Bl day of ..............................................................A. D. 19........ Sealed and deli\'el'ed in pl'esence of , c>: .'/ ., f '" P'l '. ."::((:j.d./!..c.c.L.,..iJlli2f2.c.e.,...)Vfi<y2fW ................................................................(L.S.) .........~...................................... ................................................................................ .............................................................................. ................................................................(L.S.) ........................-...... ................................................ ................................................................(L.S.) ................................................................................ ................................................................(L.S.) ................................................................................ ................................................................(L.S.) ........................n...................................................... ...............................................................(L.S.) .1 '.~ 0 ~H OF PERSONAL REPRESENTATIVE COMMON~ TH OF PENNSYLVANIA ss: ND ~ ./~ robatc of Wills and granting of Lcllcrs of Administration in and for the County of s: / h.,,' ~I 1'" oe(-,'f(~ , . ~ ./ /./ who, being duly . do depose an ):~s'/ of the last Will and Testament of .,/ "-- deceased // ......... will well and truly admlnister (hc goods and challels, rights ~credits of said deceased according to law. And also will diligently COmPI~Jlilh'th;-;;:visions of the law relating to Transfer Inher~ and subscribed before me. / '......, /~...~-- -.....: ,......- A.D., 19_ '-'" Cumberland, personally came . / "-, ~, / //" '::J :-! i::,'l. , 0- ..... "" ,,_,w .. .- . :.~ CJ, a.: ::;c .....2.: i.~;; I --<;;: j Ctc ~~c _J 0' c- oE5 0::10 Cl:j cr 'm :C'" c.J,,, ('(::5 ~c: ~ ~u >0 c.J Register ..... ..... .~ ~ I:: .~ 't:l ~ .... o u OJ .... 't:l I:: as 1'-: ",: ",,: *~ ~ o? a> ~r . <Ii "1 .-i 'M: ~: Pi .0:1 ~ r-l: ~ '<1': N N: I, .-i: "': ,: r-i: ~ N: cO 0 . : T-i Z N ~ .5 Z Ul ril u.. o ...J ...J - ~ ;..; :OJ :~ :OJ :u :OJ ,0 ~, P<' H: 0:: 001 .' ...1, :><: ~: ~1 l.f'l: ",: *; .-"i o o r:Q OJ bll ~ 'i ..... .~ r:r. DECREE Be it remembered that on the day of ,A.D..19_. there':V!I.sprobatedllod late of recorded the last Will and Testament of ...--..- ------- --" , Cumberland County, Pennsylvania, ------ --- Deceased. Lellers ------ were granted to ------ .Witness-my hand and official seal the day and year aforesaid. rl:" 3 Register COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND i J ss: _n,Ja~~(J J!.- _:>E1ilf'Y L'1'r\lflt_Adn~}::i5.tr" tor,_ CC_'I~ r,Hn~, -':"~~~______-_-----n being duly _ 5WOITI..-_. _______ according to law, deposes and says that he_ore nresf'nts CCNE Rant.... N. .lLdmtnist.rfl.tor..L_.Q_~T.,--f.\-,-._----- ___.__ of the Estate of Marv L. Shi ne late of __We_s:t.1"airview ____..____. ---, Cumberland County. Pa" dece.sed .nd th.t the within is an inventory made by __CGNlLBanlt.-- .N.-A.~--- ___ -------, the said Administrator CTA of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwe.lth of Pennsylvania, and that the figures opposite each item of the Inventory represent it'. fair value as of the date of decedent's death. Sworn - ..d "b",;b.d b.I". .', l CCNB Bank, N.A. ~ Admi.nistrator, C.T.A. of the Esoate 01 M~Y L. Shipe .BY: /lcu,wc (/ cJ!,~I()A Trl1st Administrato y ~~~Y.o1{. Ad(ynhtrator, C. T. A . _.~~O.L Mark.!!t street I 19 pi ". NOTMiY PIIE:Ul' r",' C01:;..L- ,I ,)1 : , );. ," :"Uf ~ CU:lltC;)j,IJ ''';JL:llt~ t ,i(1II:i~1";\1\11I _Q!3BP HiX~ennsvlvania_ AddrllU Date of Death ___?JL____. O"y I;larch Month 1981 Yur INSTRUCTIONS n I.. An inventery must be filed within three months alter appointment of person.1 representativg::;; -"" 2. A supplement inventory must be filed within thirty days of discovery of additi~nal assets. ~~ 3. Additional sheets may be attached as to personalty or realty. i!.!::j :1"'1' 4. See Article IV, Fiduciaries Act of ! 949. 25:: ~_~C./~ 17011 . OC ",::0 ~ m~ "'0 ~ V;:::o .-to f"lrT1 I ':",l.? 0-. "<~ ~, "Q . ,,., ~ ,0 :-.,. ,; ,_n -" -0 >- w ::;;: UJ . ~ I- ~ W <( W c.. I- u 0 0 VI W W UJ '" UJ 0 '" ,.. :t ~ w ~ c.. u. c.. c Z I- -' ~ ~ ! u. -' <( 0 c.. 0 , W 0 <( w >- :l: 1\ > z '" + <( Z 0 0 c '.- , 0 I - VI Z 0 '" U Z ,I UJ <( ~ 11 c.. ." c ~ 'I - -.: II 0 ~ Ii .JJ -" w E ." + , ..!! 0 ~ 0 -' U u: I%l ~ REV.449 EX. (3.80) COMMONW~ALTH OF P~NHSYLV,\HIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT AFFIDAVIT OF FIDUCIARY (Instructions on Reverse Side) * EstDte 01 r,carv T,~. Sh i ne Lost Address .~..5-.;:tt::ljJ>.-5.tr"et Dote of Deoth r.:8.rch 28, 19B1 Social Security ND. ??1-lR-1?B2 ___\~pst FRJr-y.l ow , PA l. 702 ~ Bureou File ND. ICITY) tSTA TEl {ZIP) County File No. ?1 _Pi _?l.1 1. Decedent died: ( ) Intestote (without 0 will) ( X) T ostote (Iooving 0 lost will--cDpy ottDched) 2. Is the filing 010 Federol Estate Tax Return required lar this estate? Yes_ No X 3. ExeculDr/Executrix (X) Administr't\~liJ(&l!il\lIt;Jf~l\-~ Nome CCI'111 111'1 n k. N. ft.. Address 2101 f,18.rkpt st",,!pt Camn Hil.l. Pennsv1v8.nia 17011 (CITY) (5TATE) (ZIPI 4. All correspondence should be moiled to ( ) Attorney ( X) Fiduciory. 5. If an attorney is representing the estate, indicate: Nome Thomas I. Mver's, ESlluire Myprs, lliyers, Flower &- ,Jolmson Address Thi 1"0 &- fMt!'ket stree+s Lemovne. Ppnnsvlvania (CITY) (STATE) 170ll'3 (ZIP) List 011 sofe deposit boxes registered in the decedent's individual nomehor jointly with, or os on ogent or deputy of onother, Dr in decedent's individuol nome with right of access by onot er os ogent or deputy. Include the name and oddress DI the bank or other institutiDn where the safe depDsit bDx is located, the nome (s) in which the box is registered ond the relatiDnship of the ioint holders to the decedent. NAME AHD AODRESS OF BANK OR OTHER INSTlrUTlON IN WHICH DECEDEHT MAINTAINED A SAFE DEPOSIT BOX NAME OR NAMES IN WHICH SAFE DEPOSIT BOX IS REGISTERED RELATIONSHIP OF JOINT HOLDERS TO DECEDENT eeNB Bank, N. A. f\':ary IJ. Sh i PI? No ,Toint Holders ,Juniata fr 1o:nol8 ROflc1s Eno1a, PennsvlvRniR , 1. ?02 ~ Under penolties 01 perjury, I declare thot I hove exomined this return, including occomponying schedules ond statements ond to the best of my knowledge ond beliel it is true, correct and complete. , CCNR ~Ank, N.Aot ~rll~'n~s~r~tnr, C.T.A. of 1; I' }?,,~t.I';:P rAT" J" SI1 1 T'<" u'e": I. '-;')'iJ;\, 'J''''"Rt Aclmjni!'trA~-or('2?-J'1 --?, . U SIGNATURE OF..~IDUCIART OATE , PENNSYLVANIA INIIERITANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the IlIheritance and Estate Tax Act of 1961 provides that the followill,( persons shall prepare and file a return: a. The personal representative of the estate of the decedent ilS to properly of tile decedent ildministered by him and such additional property which is or milY be subjecllo Inheritance Tax of which he/she shall have or aCQui re knowl edge; b. The transferee of prnperty upon the transfer 01 which Inheritnnce Tnx is or mny be imposed by the 1961 Statute, including a trustee of property transferred in trust, provided thill no sepilrate relurn need be made by the transferee of property included in the return or a personill representiltive. 2. PLACE FOR FlUNG The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided. 3. TIME FOR FlUNG The return is due nine months after the decedent's death,unless nn extension for filing has been applied for and granted by the Secretary of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 791 of the 1961 Statute provides that". . .any person who willfully fails to file a retum or other report required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser te be recovered by the Department of Revenue as debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife, son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of i5% as to all others. 6. PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annum accrues thereafter until pilyment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued for against any real property in tile decedent's estate or against any property belonging to a transferee liable for the tax. 8. FlUNG OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with ~ection 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or botll. Codicil 1., Mary L. Shipe, of West Fairview, county of Cumberland, state ,of Pennsylvania, having made my Last Will and Testament bearing date the 28t\1 day of September 1968, do' now make this Codicil .which is, t::l be taken as an adr'iticin to and a part of my Last Will and Testament.,. ,'I" t. . , First: I revoke that Cumberland County National Bank and Trust Co. as my Executor. I name and appoint M:s. Elizabeth.MiOrie Shipe as my Executor of my Will. . Second: Two oil oaintings by Mrs. Isabelle Hissinger be given to Roberto and Isabelle Johnson. Third: Betore personal items and furniture are sold, ~rthur B. Shipe, t, Jr., Darwyn L. Shipe and Elizabeth Marie Shipe with mutual agreement can have what they want for selves. Fourth: Mrs. and Mrs. Stanley Peiffer are to be given two remaining graves at Rolling Green Cemetery if wish to be buried there. If not their wish, graves to be .sold. ,J.., /.. 11,;.'1..4.'/'--"':-' -.:....,'; ,.~_.... (Seel) / '. Wi tnesses: -< >/ , ' l' 1/ I '...fk':".., r t'a.-i-U:l'} I "'=~/AU~' {r , ) , /I/.,ij"l ~ I I. ..I --.) Z ' " ~,. " ~..... l_"-"'t-..........-Lt,.....<...'-' , ~ I I '-- ~'I ':/: '7' ' , / I ,.,,::1 ,.b,,,./=,,, , . ,i /.'~. " ~ ' '- '(,Ar/'L//'2.-, I ' t' t,7- "C- ' .... t ~ -J ... /c ./ ---.....,.. _.,,- '. ...... \./L(.I "~'I' Ut....(..t... C( , ' In witness whereof at the end of this Codicil to my Last Will and 'Testament I hp.ve subscribed my name and affixed my seal this ::;/ 7 ,', de')' of ,..'/,~J,,~"r/ 1970 , IMPROVEMENTS " . ' 'L . 'anp. 45' .x 170.... C:I ,. . r "1' ves' r el ./>".' ot )17.0 ..:::..r. _'___." ___.... _..__M'___ .(II1~ tue lon, .KI!. IIIB _..l..._.....___._...__....____...".. fOpOS!: _..-.._...........~_..- .' . Living units ..6.ne._.Con'lfl,ction _..!L1.!-IJI.!~_.9..Y-~.r....tt:ilIn.e.__.-..---:-.-~-..-..---..-....--..-. Slorie;..__.1.__.:.._.Age....G.5- . Dosement 3/4 ba sl'!ment.....siOne...wa.1l.s.;_.concr.e.t~-..n<Jl}l'-:---.-.-...-.--..-.-..:---.-:.-_-..-::- . . . T}'pc: , .47'5 State Road, West Fa'irview, P^ 17025. . '. " ht floo'::W dhl . pR_.__Ic...-l--IlP..--Clo'els-...-Y--DOlh.-.?,B~. Olher .fr..o.n:t...&._.s..i~IUlW1:.......' .2nd floor; Lfl.. '.. DIL-.- K_:':"_IJIL-.L.':", Clo,et,__.;3_ nolh._O.D.e-- Orher .:....._..none Snd. floor~t.R .' Of? . K_" 1lR..:-.-:--:. Closet;._._:__~ 1J0th._':'_.":- Olher _.:.a.tlli.~~-:-- .," .' ..:... TYPE OF Pl~MB1!'lG: (0): Dolhroom _:-IU.~...2..LQgUmL. nQ9i~.Jl.\lUkilL.tuh...-s.inlu:ab.ine~' I' . -----...:.---..--=---...:---...--. --.-..- . . . ..... . (b) Ki'tchen _ Tile..\:@.:Us...:...el.ei:~.D...v.e.DJ::..r::an.ge.,....car..p.e.t.ed.J.laar...-...cnpp:e.r pip~s. . '.' steel'cab';l1ets' .:' . . ......,' ..' jNTER10;W;;II~. _: l'losler ~ y5~.2..__.:.-=~l?ry..:=:~-=-~~~===.~.- Ol~~r _.JUJL..1.,Lis.ri.cii;n:~-=-~~~..,.- , Fl09rs . P1 rle '.' __._:...--:-----:- Woodwork __.J!.iHntgsL-.:- Nolu",' Fireplocc.__1LQ:....--- Il'ASEMENT: Foundation _2.t.Q!!.~~__._.:___..._..Floor _._._<;.!mC;r-etEL._-..---.:__.-.--_:..ExCClvblcd :...._.7&..:-.__% . ' Healing: rype ..:..JQ..t air . :~_""':-:-__:_FueL":":""Q.iL-...--..-._...-.-jir Conelilionin~. no ---:...- Waler hooler .~...~-_.:-'::.-.--:...--:....:.:_--_":'Woler .sofrener .:.._n.Q:.~-.Lounc'ry tray;._I1lli.~.r::.drYer ROOr: ryp. ..2JJl..!;.!l-.tgt..22I!L Condilion......_.aY.e.r:a.ge..:......-._..~...-..Gull"'s ond downspouls_:.--Y:as....:...--- '. MI-CEl'LA' NE'OU' s' .' I 'l I" :' .... . n~~{' .' . ';'. . S 80 0' s'. . ~O' ~; . => : nsu 0 Ion ..:_.._M..._._~.-:-M_.__.___"':"...M-..-....._..__...._-..--:...M torms .__.__._",0 crcens.-:---.;-I::>., .CONOITION..C.).;,:.I.... 'v~r~..9"'ood"'" '. . '. . . :P. '.' 'fll'f fb'\I'. ',' I : 0 ~ enor ___,/_ __..__...____......___._..:..._._.....__.._....__.____ .Clnollllng use U I e 0 Ul (lllg: .' lb) Inlerior ..:.._-=.v.ell.:..gQ.Q.d--.-.---.~--.-.-.-------.--.-'---.-. . 50 .Y.~~t:L..,- . 'GARAGE C I " ..' concrete .block ,. It f ,cn" s.""ngla N f two.' : on~ ruc.lon '.. ___.__........,.--.--R.-......----.-.-.......- 00 ~tf..l!__LU ~_.- o. 0 cor$__~_.. . ". . Size....:....fQa..L--.~ryp.e of doors _.._Qve.r.head.-.-.:..-.-..-.. Orivewoy .:..::.....w,g,c..~Jl.~!Jl . 'OTrlER BUILDINGS: __J1.1ll1JL--~.--..-.--;:.:...---.:-.~..-_.::.......--_..-------..---_..--:.--..:.....::....::_...:.. . UTllITIES:.Sewe~ .__:...JllJj~lic.._":"- Woler _......PJ.llllli----.Gas _...llf.S...._.___...._.Electric __...lle.s.. .' Wen _.!l9..-.:" .' . . _.___..-__ .Seplic tcmk_.....rlo.....__..Size _.:..-- . STREET IMPROVEMENTS: 'Volks _.:..fQ]Y"el;g,..ravi~g_.__rlli!.c.,-..c. anel Guller ___CJ!r;.b....on.l.Y.AlIey _4.~_..-""':"" TAXES: Current generol ~]L91L-~35_Q_._..---5peciol ossessmenls _n.onlL..ktlQ~n C. ltlt N........hb. h.' 'd' . d" static" . O"u"E T: "e'9 or 00 tren ------- ..-'.---.----.. ..- : Type structures ~.ingl~JI. <pnii-dilichprl ._....:._Conclilion -C.\l.f.r:ajjL___Age 60-70 yrs.: Any oreo delerim"nlal influencesi ria This property could rent for $_.~O'; 00 per monlh. . The markelability. of this property is' .-J!Q9.Q----- .._____..._..._~.__M___.......M__.~..M__M.._.M.____._....".MM.__M.....M.____ -- '. .' .' ~ ~ Recommended necessary repairs onel possible cosl: . '. ".. . . :app.r.ais~d' "as is'" . i . ".' ~ '. 1 .... " . PJ~tl'lon skelch and/or perimeter Clrowlng of b"il,ling. 1. Washer & dryer incl.uded. 2.. R!lar flagstone patio llx12 3. 'Front porch'- s~de porch enclosed. 4. Carpeting tnroughout. 5: Two air conditioners. 6. . lio wat~r pro~le~s' 'observed. ;.:~:Ij, J 1 ~ 1:.1.( J! v . . {;/I", ; 1 . ,l/{ .-,.'{ .I" ,; /' K~;. ~ 1 ChSll: Jlcport. t.ot..u onljo 2 ':;TOC~;: L1::;t. 1n dct.ail ever}' .cc~on or pro Cor red ecrt,ltlcOl.C, ~nrront or other rl~ht' found in box. St.ocke arc t.o be doslcn3tcd by nnmc of com~~t certificato number, data of cortirlc3t.o, nlUllO in which t1t.ock h rec1tit.crod, nWllbor of ah;u'co and cluso of aLock. (3) 01lLlGATIO~IS of U.S. COVEWUlE.1lT: I1wn\!cr or plece:;, dlloteo of 190uc, fuco .valuo, n:UU03 1n which rllchl.orcd. (4) OOlIDS: D':ol(Itlsto by nllltC, Mount., DCtlal n\1Jllbcr, or at.hennao. . (5) SAVnlCS BANK or P/ISS lOOy.s: Sl.ut.o nlWU of deposit-or, number of book, lut. dot.o llppC.3rinc in book, nCJnU of b3llk tffi1 branch, and bnlnnco. (6) J&lEl.RT, CODlS, S'l'MtI'S, HAllUSCRIPTS, ETC.: Uot. and describo ao tull1 0' po"ibloo (7) liD\. Docd" Mortr,oCltD, Current. ln~r~~co pollcle~ or other cvldcncc~ of lndobt.cdnc9o. 0 All other c~nt.~nl~. 6.fjoIJD;: Iu;c.,sr.:.€&{): (;,er;;G-/!? Sit,"'/: /2. 7E1 12$ G/U:C. /!I.' SI:lI",o 11../77 1/ 2S .~ Mid IVY" /... i . iJOIJOS: /I. tJ. 51111';;:'.J t 110/2 ljJb<we S/JE: S,l//~C 25 /2./77 . .If 25 /2-/7 S YVPAlIJ,c Sill/ii:: I/;?,S IZ-!7( I2.S 12/71' '1/ '-> 111!:7 ((/lIllA). /II. SHIP. /I 2 S 1,-/7r /<IWW 1'1. .It. '~_rAJ /... ~ Z,S 1"2./77 SII~L 1.1. e. !>IIIPC C:liouP I IVS: ..el/.JC/i ~ -80I1J{); '. (l1~7 t. 511/1'$ , . -It zs "/69 If 100 (/73 1/100 1/71.- illoo 3/7.5 J/fQ/7v 6/7J " c.j7z. " 3/7> ",,/..,s 3/7.5 .. So 1/73 " 10/7:1 " J17> ,./otiS. 75 7/75 117'1 " /1:5 1"10[2; .. /173 7 ''''0/75 //?,O 9/72- .. 1/7j ,. ~/71.- 'DO -,/71{ ~SUJloJ75 .. 7/7"2- .. 1/7)' .' 1./72. . 7'/?'f . , J7' t/73 /. "'F" Oo 10/71- " 6}7,- " l{ 75 ., 77 .. 9/7) " 9177- " 1/7'1 Oo ~)77 "7/77 .., /7) . .' 9/71- .. 7/7'{ 1/77 b>>12./77 .. 9/73 .' 9/7'- " :J /74 G/7{, .. Gin " 7/72 .. .3/7'1 Oo 6/7' " 6/.7t- ,,& !7'f "7/72- " 3P:t. 6j7t "I. bv . ::'/73 "6? 'f " , 7 tf7t .., l.I I I \ And noW thb 2/~rd8,/ or /JA~lt I 19~, I hereby cert.1.1Y undar pannltr or perjury \-hat. tho abovo Tocord :\..:1 conoct. l\fld complet.o to t.be be:!\. or rq knowlcda;o and belief. ~t~~ ~ I AI-''' tl+fy I1ft-- Print 11,u1l0 Ilnd Titlo ' ~ c1. ~- Jn~~o~~rosmJt 7i12IIi:I /7(),P1IN1s7Rl/Ja<L Print N(l,lUO and 'l'lt.la I NOTC: UI. IClp:u'I1t.. ohoot.:a 1t nocosQary. I- I 1 f. :0'-.. ! i I i I I I, I' ! l- I " . ...." QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material part of his estate wilhout receiving valuable and adequate considemtion? (Answer "Yes" or "No".) _Nil...- . 2. Did decedent, within two years of death, transfer property from himselflherself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answf!1 "Yes" or "No".) -1!2. 3. If the answer to one or two above is "Yes" i1Ij(llhe lran~;ff:lS ilre clainled to be nonlilxilble, provide llie following information: a. Age of decedent at time at transfer. b. Copy of deatli certificate. c. Affidavit by tlie attending physician intlicilting 1110 stale nf decedent's hCillth at lime of transfer. d. All other information supporting nontilxilbili ty of transfer. 4. Did decedent, in his/her lifetime, make any tr,lIlsfer of property withoul receiving il valuilblu or adequate considemtion therefor which was to take effect in possession or enjoyment ilt or after his/her death? (Answer "Yes" or "No".) No a. Was there any pOSSibility that the property tr8nsferred might return to trnnsferor or his/her eslale or be subject to his/her power of disposition? (Answer "Yes" or "No".) No b. What was the transferee's age at time of decedent's death? -- 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment alar the right to income from the property transferred? (Answer "Yes" or "No".) .J:iQ..- b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration lor which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) No R. Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revp.rl to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) No 9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) REV-453 EX+ (3.BOI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT Estate of Mary TJ. Shin. e . BENEFICIARIES AND ADDRESSES ,J Street West Fairview, PA. 1702S Darwyn L. Shipe 2122 Dunstan l,ane Lawton Oklahoma 73101 Roberto Johm'\on A r!'\!'\ Unknown Isabelle Johnson e!'1!'\ Unknown SCHEDULE "D" BENEFICIARIES (lnstrllctions Oil Reverse SidoJ RELATIONSHIP SURVIVED DECEDENT Son p.f-: Son Yes DATE OF BIRTH J,,,,,.8] T.er;al '* INTEREST OF BENEFICIARY ~o 'l0 SO % None Yes 1el':81 Snecific Painting None Yes 1.el':81 Specific Paintin. The above beneficiaries are living at this time except for the following: NAME None DATE OF DEATH REV04S4 EX+ (3.801 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT. SCHEDULE "E" JOINTL Y OWNED PROPERTY '* (lnstrucrions on Reverse SidoJ Estate of Marv L. Sh i pe ITEM TOTAL \ VALUE OF DEPARTMENT NO. DESCRIPTION MARKET DECEDENT'S VALUATION VALUE INTEREST (Official Usa Only) T I None - 0 - - - 0 - I I I I I , I I ! I I I I I I , , I I I i i i ; ; I i , I I I i , i , , . TOTAL THIS PAGE - o - - 0- A7J INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent iointly with another party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be included. List real estate first. 1. Describe all real property as indicated In the instructions for Schedule "A". Describe all personal property as indicated in the instructions for Schedule "B". Include the name. address and relationship to the decedent of the co.owner (sl and the date the joint ownership was established. 2. Indicate the total market value of the jointly owned property. 3. I ndicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest. C 'tl tl (") 6 t"1 ;J> :; >- 0 0 Ul I:l - Z C'l (") e tl -I Z s: Z t"" t"1 t"1 ~ Z ;;:l ~ ~ - ~ t"" Z Z t"1 -I t"1 Z \1" ~ 0 -I ><: Ul t"1 - Ul Z 0 co 0 .., '- , ' ('0. ~ 'T1 'T1 :1:1 ~ ,.:) ~ 0 t-, o. :,' I ~.J \, .' 7-:l_', I "" - "" \... \C ~;~ 0 c.... - ..-,,. , Z (") - Gju.. "c:.o: ;J> pl--' =; ~.:;Il_i t"" o::.V'J 'w c.... """<' c:: u"" 0..:::; ,,}.J ~ ..,- Ul 0::'" ,'-' t"1 eX> U . 0 z ><: ><: ~ ~ t"1 t"1 ;J> ~ ;;:l INFORMATION To insure proper crodit to your account. tho name of thu eslatt! und file numbur should bu cloarly priOl- ed on the check or money order. This assessment is modo in accordonco with Section 708 of tho Inheritance and Estate Tax ACI 01 1961 (72 P,S, 9 2485-7081. To tho extent that inheritBnco tal( is paid within threo (3) months afler the death of tho decedent, a discount of five (5) percent is ellowed (72 P,S, 9 2485,716). Inheritance Tax, other than tax on a future interest, is due al the date of the decedent's death and becomes delinquent at the expiration of nine (9) months after the decedent's death (72 P,S. S 2485.711). Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P.S. 9 2485.712). Calculate interest from the delinquent date shown on the faco of this form to the date of actual payment using tho following interest table: --------------------- ---------- --- ---- --------- - - --- - --- -------- -- - - - - - -- -- 1 month ,005 4 months ,020 7 months .035 10 months ,050 2 months ,010 5 months ,025 8 months .040 11 months ,055 3 months ,016 6 months ,030 9 months ,045 12 months .060 1 days ,00017 11 days ,00186 21 days ,00352 2 days ,00034 12 days ,00203 22 days .00369 3 days ,00051 13 days .00220 23 days ,00386 4 days ,00068 14 days ,00237 24 days .00403 5 days ,00085 15 days ,00250 25 days ,00420 6 deys ,00101 16 days .00267 26 days ,00437 7 days ,00118 17 days .00284 27 days ,00454 8 deys ,00135 18 days ,00301 28 days ,00471 9 days .00152 19 days .00318 29 days ,00488 10 days ,00169 20 days ,00335 30 days ,00500 -- ------------------- --- ---- -- --- ---- ---- -- - --_._--- - - ----------- -----.. Any party in interest. including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (60) days tltter receipt of this Notice as provided by Section 1001 of the Inheritance and Estete Tax Act of 1961 (72 P.S. 92485.1001), Make check or money order payable to: "Register of Wills. Agent" Mail to the address listed below: '1-. ~~ IlF-'l.455,':':'X+ t3.HOI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS - -., __...:~-Z'''''''''~l.....:.::-%'''...a.=-'''''''''___ Estate of ~"arv J" Shim' Date of Dsath 1!2P/rJ FileNo, ?l-P.l-?/,' WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Arthur R. Sh i Tl0. ,Ty'. Relationship to Decedent Son Claimant's Address 47'0 state St.rppt., "10!'1t. Fa 1 rVl PW , PennRvlvania 1702<; ITEM NO. DATE NAME OF PAYEE REMARKS AMOUNT <;. F. W:. Opnel .Jack G8\lP'hen , Realtor Boro of West Fairview Fuel Oil Deliverv AnpraisaJ Fee ~\rash << SeWf,r Service $ 4.00 , . <; 207. 6 200.00 66.00 1. 2. ,. 4. .ister of Wills Fee for Short C0rtificates ,J. W. Richardson Funeral H me - Funeral Exnens" 7. j,iverR r,1vers Flower<< ,Toh son - Re imbursernent for Letter, of Administation & Short Cert. J. ':Iesle'l Kugler, Tax Coll.ctor - Countv P, "oro Real Esta e Taxes ,<;.00 6. 10. 11. 12. 11. 14. i'i. 16. Riverton Water ComDan'f 6/22/81 Internal Revemle Service '.'later Servic0 Pederal Income Tax Due for vear end inl'" 12 '21 81 111.12 1 '0.00 110.00 106.00 28.04 4 0 4 .00 39.08 q.J~o 8. '0/1/81 Pa. Department of Health <;/4 81 Claude C. Wolfe Fee for Death Certificates Annraisal Fee q. Vlalter' fv1. ,Tacobi Ins. Agv. Homeowner's Insurance Premium Bell of Pa. Telephone Service Fee for Short Cert.ificates Rolling Green Memorial Par - Grave Marker F. M. Oppel Renairs 8, j".aintenance ,<;.84 17. Rep-ister of Wills Fee for FBi np' Inventorv Debts & Deductions and RCC q.OO W:vers, Myers, Flower & Joh son - A ttorne'l' s Comnens.ation _1.L 000.00 SubTOTAL THIS PAGE J~dQ.4.93 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 ~1\\ldta~eB~'li1Phedlfft*~l5s t~~drur{;il~H,n'h~~rpes.e~. A. of tileI'. s ;,at y. . 1'..ry L. Sf11T1e. . ;:'._)<1."/ p: . .l ,,)', __ > ,'''',i'4.,,'-' ", t'" c+rl' +'o~ ..... I r) , (SIGNATURE OF ATT EY/FIDuctAr~Y DATE OFFICIAL. USE ONLY Reserved Fn DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S II) 03(} /. d i AT I t -I- I.!J---- PERCENT. iJ cf~.~ IJ-=-tYI DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities Incurred by tbe decedent ~rior to hislher death are deductible against hislher taxable estate, In addition to debts incurred by the decedent or estate, other items are claimable inciuding the cost of administration, attorney fees, fiduciary fees. funeral and burial exp~nses including the cost of a burial lot. tombstone or grave marker, All debts being claimed against "n estale are subject to the approval of the Register of Wills with whom the Inheritance Tax Retllrn is filed. Evidence to sup~ort the decedent's or the estate's liability for the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania, If there is no spouse, or if the spouse has forfeited hislher rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same Ilousehold as the decedent. The family exemption is allowable only against assets which ~ass by a will or by the Pennsylvania Intestate Laws. C ." 0 n > t"1 > :\E > 0 0 0 U1 ,0 .... 7. C'l n c: 0 -i Z ~ Z t"' ;-:'! .~ ;>; z :>:> > 0 - 9 t"' Z Z t'1 -i t'1 -i Z 9 9 -i -< U1 t'1 tii z 0 U1 0 -i .." :>:> 0 .." ~ ~ 0 - "11 0 "11 - Z t"l - > t"' c: [Jl tTI 0 Z -< -< ~ t'1 t'1 ~ > > :>:> :>:> INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant'S name, address and hislher relationship to the decedent. Enter "family exemption" in the remarks coiumn and the amount claimed in the amount column. 2. Assign consecutive numbers to.each item listed. 3. Enter the date on which each debt was incurred andlor paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimabie including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's iiabilitY for the debts being ciaimed should be attached to this schedule. A famiiy exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited hislher rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. The family exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. C ." " n > rn > ~ > 0 0 " '" " z C'l n c: " ..., Z '" Z t"' rn t"'1 :>: Z > 0 ~ 0 t"' ;;:J - z z rn ..., rn ..., Z 9 9 ..., -< '" rn - '" z 0 '" 0 ..., 9 "1 ;;:J "1 ~ ~ 0 ~, 'rl - 'rl (' co " " 0 - , . :~: -- z n - ....--.,: 'C > ,':,;' I ,.- t"' L:.JII) '!:,',;t: c: o~- OCr.l1 " 1..;-1.0) '" ot:; l.l:l rn <'>w ~.~ 0 ~'" ~ W.- \'0 -'u Z <.> ~ -< -< rn rn ~ > > ;;:J ;.; INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed. indicate the claimant's name, address and hislher relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign conseclltive numbers to each item listed'. 3. Enter the date on which each debt was incurred andlor paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed, 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. I I I I I i i I I I ~: I 3. I 4. I I i I , I I I I I 1 REV.",O.' EX+ 17-&0) COMMDNWE.\l.TIi Of' PEMISVLVNIII, DEI'A1HMENT OF IlEVEilUl TRANSFER INHERITANCE TAX RESIDENT DECEDENT * f5~~ r~;:!~1!~ir~j>' INHERITANCE TAX APPRAISEMENT [i]ORIGINAL o SUPPLEMENT AL Estate of -Hary-L.__ShipL_._______...___._______ File No. _______2.1..,S.1-"02.!l_L County _.__Q..u!!l_b~r'la.illL_.. __. ._.__ ____________ Date of Death .-J:1.2.!:ClL~...J.9.lll. In the ovenl thot any fuluro interest in this estate is transferred In po!Oscssion or cnioymanl ;;collatcrnl heirs of tho decedent after the oxplratlon of any ostote for life ar for y"ars, tho Commonwealth herehy expressly resorves the right to approise and assoSS honsfer Inheritance tOX05 at the lawful collateral talo on OilY such futuro.interest. PRDPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH -------------------.. ASSET SUMMARY DEPARTMENT'S APPRAISED VALUE Total Real Property _ SCH. "A". . . . .. $ _39.,.5.0.o...-QQ......- Total Personal Property _ SCH. "B". . . . $ 7'5,121.10 Total Jointly Owned Property _ SCH. "E" $ None Total Tronslers _ SCH. "C". . .'. . . .. $ None $ 39,500.00 $ 75.121.10 $ None $ NnnA $ 114,62"10 Unreported $ Unreported S Unreported $ Unreported $ o LIFE ESTATE DANNUITY TOT AL GROSS ASSETS DREMA~DER ,-- ._.._-----_.._-~. $ TOTAL VALUE I do hereby certify that the above approisement is made in conformity with Pennsylvania law and has been filed this day with the Register of Wills. ~~J.' h ~::!:~ :!f&~--Y>~ Allgll~:T;'" '9"1 LrI N 0 ~ ~ <( ~ ~ ~ ..., 0... <( Q) Q) "" Z ~ ~ s.. :> '" 0 :>< :>< ..., Q) on ~ > '" s.. ;:J 'n ro ...l ~ <( ~ - ..., ~ U Z s.. (I] - ro Q) ~ 0 :E :;0 ~ - 0 ~ ~ ~ 0 ~ ... 0 Z ... 0 '" ci '" ~ '" >- ... ci - ~ ... ~ Z Z ci z ... ~ z :.:: -l - 0 <( ~ ~ -l Z ::E z ... Ci ;:J U ~ Z - ~ '" ~ 0 0 - ::'; ~ U Ci 0... -l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION *' OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT COUNTY FILE NO: ;;; I. t I - d. III .2 ",\,,1 :3 I ~ i I ~ " ,." ._~! r;>/' r<:U, F-- d I ie' I.. ~ il I ( I DATE I . I TO: [C I\J -p, B(,^~ 4-~ _p I't-E-r ,30~ CCiflDof -1tffl f (, Ct ESTATE FilE NO. COUNTY I :, I' (-', ,__....U:/V..,.,V.ll.-.li '-,' ~ . . '!yWA '. ,;()- 19...KI I '71.J / / DATE OF OEATK Appraised Value of Estate: Real Estate $ Personal Property + Jointly Held Property/Transfers + Total Gross Estate $ Total Approved Deductions Clear Value of Estate $ Less: Approved Charitable Exemptions Clear Value of Estate Subject to Tax $ Amount Taxable @ 6% Rate $ $ tax due Amount Taxable @ 15% Rate tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE u.'5 $ c;J3GoI ~ * '* * '* '* '* A five percent discount totaling will be granted if the Inheritance Tax is paid by $ Less Credits: DATE OF PAYMENT AMOUNT PAID INTEREST TAX CREDIT $;;::'U~-- DISCOUNT Cj-3- 6/ $ ;)3",/[!5-+ $ $ = + = + = Interest Bccrues at the rate of six (6) percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid by is (1 I' ,,] ~ I(V" ":1, _ eALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ , ,-r:..// Assessed by:'/ .'_ See Information on Reverse Sido AgentforthrCommori","llh" ,)';::;#'4:-(;' ~.-I. '(/ . ~ ..'~ '::j~,~~~J~.r , INFORMATION To insure proper credit 10 your account, the name of tl10 estato and Hlo number should be clearly print. cd on tho check or money order, This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485.708). To the extent that inheritance tax is paid within three (3) months after the death of the decedent, a discount of five (5) percent is ellowed 172 P.S. 9 2485.716). Inherilance Tax, other than tax on a future intereSl, is due at the date of the decedent's death and becomes delinquent at the expiration of nine (9) months after the decedent's death (72 P,S. 9 2485-711). Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P,S. 9 2485-712). Calculate :nterest from the delinquent date shown on the face of this form to the date of actual payment using tho following interest table: ------------ -------- - - -------- - -- - ---- - - ---- -- - - - --- - -- - -------- -- -- - - - -- -- , month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 months .025 8 months .040 11 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .000 17 11 days 00186 21 days .00352 2 days .00034 12 days .00203 22 days .00369 3 days .00051 13 days .00220 23 days .00386 4 days .00068 14 days .00237 24 days .00403 5 days .00085 15 days 00250 25 days .00420 6 days .00101 16 days .00267 26 days .00437 7 days .00118 17 days .00284 27 days .00454 8 days .00135 18 days .00301 28 days .00471 9 days .00152 19 days .00318 29 days .00488 10 days .00169 20 days .00335 30 days .00500 -- ---------------------- - - - - - - - -- --- - - --- - - ---_._- -- - - - ---------- --- --. Any party in interest, including the Commonwealth ilnd the per~onal representative, not satisfied with the assessment may object thereto within sixty (60) days aher receipt of Ihis Notice as provided by Section 1001 of thelnheritence and Estate Tax Act of 1961 (72 P.S. 9 2485-1001). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION "10. 21-8l-24l Estate of MARY L. SHIPE, Deceased Late of the Borough of West Fairview FIRST AND FINAL ACCOUNT OF CCNB BANK, N. A., ADMINISTRATOR, C.T.A. Date of Death: March 28, 1981 Letters Granted: April l4, 1981 First Complete Advertisement of Grant of Letters: May l, 1981 Account Stated to August 25, 1981 SUMMARY & INDEX Pages PRINCIPAL I I 'I I ! i I $115,069.56 4 l,l21.06 $116, 190. 62 5 2l,l51.l7 95,039'/,5 6 l,538.78 Receipts Net Gain or (Loss) on Conversions Adjusted Balance Less Disbursements Balance before Distributions Distributions to Beneficiaries Investments Capital Changes $93,500.67 Principal Balance Remaining INCOME Receipts Less Disbursements 8 9 $ 2,321. 94 -116.l0 Balance before Distributions Distributions to Beneficiaries $ 2,205.84 -0- Income Balance Remaining $ 2,205.84 _$95,706.5l COMBINED BALANCE REMAINING USER 99 P~cE 790 6-29-8l 6-22-8l 7-20-81 PRINCIPAL RECEIPTS Inventory ~ Per Copy of Inventory Attached Adjustments to Account Values Subsequent Receipts Arthur B. & Darwyn L. Shipe - Reimbursement for Tax Due on U. S. Series E - Bonds Prudential Insurance Co. - Dividend on Life Insurance Proceeds (Payable to Estate) TOTAL PRINCIPAL RECEIPTS 3 lIBER 99 PACE 792 $114,62l.10 l2.82 435.64 $115,069.56 COMMONWEALTH OF PENNSYLVANIA COUNTY OF .CUMBERLAND I ) ss: Ja::'le~ '. ,_Smi.~_(!}LJl~~l:;;_t_{\~m_it1if3:t!,a ~o.!" LCC}~2 E-an_J.:.. __J~_,-_!,. being duly !'-.'IO:!:,.l1_ _______.___ "ccording to law, depo,e, and ,ay' that he JeIlrcsgn'\:~__QC_N:3._ 12.2:"!Y._,_ N. IAdmini!':tr:~:to.r1._Q-'.T.A._~___ 01 Ihe. E,lale 01 r"a~L. Shine ________ lale o(_\'!,,_s:LE?ll:'Yigl'{______ ------____________, Cumberland Counly, Pa., decea,ed and Ih.llho within is an inventory made by -.C_CNB..J3ank_._N._A.___ ___ -=-_____ , the said Adm1n1st.rg,to.r CT of the entire: estate of said decedent, consisting of all the personal propl!rty and real estate, except real estate ouhide the Commonwealth 01 Pennsylvania, and that the ligures oppo,ite each item ollhe Inventory rcpre.ent il'. lair value as ollhe dato 01 decedent's death. CCNE Bank! N.A.~ Administrato.r, C.T.A of the Esoate 0.1 M~y L. Shipe By,Uc;q,z,:c (/ .'\t,,-~, Trust Administra {/ )E*,~. Adn;TrJJtrator, C. T. A. . - ~ Sworn and subscribed before me, ( ./1 -:2 CI . /..... ......,.-,....< ,1{__ /f - ,7_ ~ ~ ",f. ,., -g~. '-- ~-/. / ' / 19 pi , - I . . J \.> - --- 2101 Market Street /f ",.-,_ . // NOTAII\' Ptl8Lil' Camp Hiil. Pennsylvania Add..." 17011 r,';) C:r;,,71.~,i~.r;:, "',~~ ;.c~ ~: ;rl;,~ C:;:;,;,~;:.i"j ";'~:':J.l) f "nr:~\:''':101;'l Day Marc_h._':"""__U181 Month Yur Dale of Doalh 28 INSTRUCTIONS I,". An inventory must be filed within three months alter appointmenl of personal repre,enlative. 2. A supplemenl inventory must be filed within thirty days 01 discovery of additi~nala'..els. 3. Addiiional shee" may be allach~d as 10 personally or realty. 4. See Article IV, Fiduciaries Act 01 1949. >- -0 c I- W ~ I >- "" I- '" , w -<: ., , c;,,; "- I- u I 0 v> ., c Ii 0 w "" w Cl '" >- I .. c f- "- u.. c.. c II Z I- -' '" ~ -' -<: 0 "- 0 W u. -<: w :I: > 0 Z '" i- -<: ,. " Z 0 Cl C I. ~ Ii r v> z 0 '" U Z , w -< ... I' "- "to C , .. - --;: , 0 ., ! .D .>< ., E "to " ~ c 0 c 0 , -' U u: '" 4-21-81 4-28-81 4-28-81 4-28-81 4-28-81 4-28-81 4-28-81 5-1-81 5-4-81 5-4-81 5-12-81 ~ 5-14-81 5-20-81 6-8-81 6-8-81 6-22-81 6-23-81 6-30-81 8-25-81 PRINCIPAL DISUURSEMENTS Register of Wills - Fee for Short Certificates J. W. Richardson Funeral Home - Funeral Expense F. M. Oppel - Fuel Oil Delivery Jack Gaughen, Realtor - Appraisal Fee Borough of West Fairview - Trash & Sewer Service Myers, Myers, Flower & Johnson - Reimbursement for Letters Testamentary & Short Certificates J. Wesley" Kugler, Tax Collector - County & Borough Real Estate Tax for 1981 Pa. Department of Health - Fee for Death Certificates Claude C. Wolfe & Associates - Appraisal Fee Walter M. Jacobi Insurance Agency - Homeowner's Insurance Premium Bell of Pa. - Telephone Service Register of Wills - Fee for Short Certificates Rolling Green Memorial Park - Grave Marker F. M. Oppel - Repairs & Maintenance Riverton Consolidated Water Co. - Water Service Internal Revenue Service - Federal Income Tax Register of Wills, Agent Pa. Inheritance Tax - Gross Less Discount Myers, Myers, Flower & Johnson - for Legal Advertising Register of Wills - Fee for Filing Inventory, Debts & Deductions, & RCC Register of Wills - Pa. Inheritance Tax - Balance Due Reserved for the Following: Myers, Myers, Flower & Johnson - Attorney's Compensation CCNB Bank, N.A. - Administrator's Compensation Arthur B. Shipe, Jr. - Family Exemption Wildeman & Obrock, Certified Public Accountants - Tax Preparation Fee Register of Wills - Reserve for Filing Account Reserve for Possible Federal & State Income Tax Liabilities and Other Contingencies $3,600.00 (180.00) Reimbursement TOTAL PRINCIPAL DISBURSEMENTS 5 UBER 99 PACE 795 $ 4.00 3,379.59 207.96 200.00 66.00 35.00 111.12 15.00 110.00 106.00 28.04 4.00 45.00 39.08 9.40 35.84 3,420.00 43.98 9.00 2,386.11 4,000.00 4,546.05 2,000.00 50.00 100.00 200.00 $21,151.17