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HomeMy WebLinkAbout81-00315 NO, 21..81 PETITION PORLETTERS OF ADMINISTRATION IN 'l'lm l<JIol"'A'I'11 (I\<' ,......,9mp.~9.~'I.",I1l,\,..I,m,"~~\~....,..,'''"..".., I 11')(' 1M I'll': \>' 'n-t I'" \. 'w ;1,1) 'Po II ffl~,~~.; l~"'" ,+t~,W.~~, ,.,., W,~~~,*?1,~,f" $_''''!'' ',"""" I""'; ,,,,,,,,,,:, P""'"'''''' "<I;'"'' HI1!(IKll!I' Ill' WlIIK fill' tho ClJlIlIl~' Ill' U\lIlll1111'IIIIIII, III till' ('(lIIII1lIJIi\\'Ulillh (If J>IJIIIIK'~'II'IIIIIII' 'I'he I'ulltlllll III" .."..~,'rt~,I'!,J;\.~,...I:\,'....,:\~,;:~,~"..," ,.. ,."..""" 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I t"" II ""'1111 on ,,::r.}:1.ll'~"'~Itj\~".""tfHI'" tho """.t,R;\;l)'''''''''''''H'''''' dn,\' (If ",f)~ti';'+'H!f,,,,,,,,p'''''rtiH'lf'''''H A, l~'l lU"~'*"'lI ,\llhe nllU of ,J,~......,,, ~'onl'II, 'I'hul tho Hnld ....,..~,!'-:~,~,l?,~,y...,~"."..!:I.\~,~,~,~".."..,""'"..""....," clOClJlIKOd, lul'( KlI.I'1'11'1111l Iho 1'0llewh1l1 nllmod widow 01' hllKlll\l1d, hoh'K'1I1111 l1uxl 10 kin, In wit 1 , ('lIl1lhlll'llIl1d Cnlll1( ~', Hllllo nt' POI1I1Kyl. Nllme HulnllllllKhlp HUKlclol1ce 'I'JP,'\-l,ca ~,n~", ,~1 ,t, I '. ,Ij ~,~.~?i,.", '."""""" I." Fflther ' "",,11''''''''''''''''''''''''''''11'''''' l'~'~a~'~'I~'M,t,,:\,~!jl,w..,p',l1;"I...,9.~mp 11:\.11, ,.,,,,jll,.I'I"";I"'I,j,,,,,,,,,,,,,,,,,,,,,""""1.,."", "",,"""fl""""""'''''''''''''''''' ""';''''''''''1",,;,.''''''1''''''''''''''''''''''''."""., ",\11~~~,11, IIW"iI"li,f~h,k,Z...." 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IIlI CI~1l bo I\lIoerUUnacl, Thnt tho auld Honl 1~t\tnto III HO 1'1\1' HH IK known I", locntml In "."."""..,"\..'"...~.....,,,..",;"..Ii...IIH,H..'.~'''. ..."I..';...;I""'...,...',."i'."'."".,.."....,'.".,It""""""""",",,""i"""""';"';'"".,.""",."1"......,.."....".".""",.,.,.,"."",.."j,,'IU"" 'I'het'uful'u, YOlll' l1otlllnnol'(~) l'oRpoulfully uppl)'(IIIK) 1'01' Lullol'H of AdllllnlKtl'ulllln In tho "!love nAmed oHlnle, J>ntocl ....,I1l,~lI'....+.!?",.....;,.."..,..,..""""" A, 0.. III,~,~,.. 8,lgnature IlIlll Addl'llRK of l'ullthllllll'(R) () ~' ~~~ v, . ,<.4'.'" , """"'ff.",..t:~.,(1' 'iWr",.I~~" ,...., , ..,.., ".',n..,.........,.i.."i.",,,",,' mug. ell, I ertz v 120 est Clearview Drive """"",,,,,,,,,,,,,,,,,,,,,,,,""""";"'1"""""""",..",..",.""","j'I'1 i.,.. .~;l;',~,~,: ,n~ ,~.~. (", ,~,~,~.:. II ,"~.~.~}t; "" "' 111111 ",0:,'''''11'' ""....",."..."""'!',,,,,.......,,iit'''''IH;'''''..''.,..'''.''''H, II :< S ,l,-.::J,. OOMMONWli:AI.'I'11 ell" 1'I':NNHYI.vANI/\ C:OUN'rY Ol~ CUMIlI'HII,ANII \ UN 1 "'''1 HIH t '''' ",W.\.J,Ci'lw,nfi\ 1l,~l,t", JI~1r'.~~, I""..""" I., ,."",,;.H',;';""" <;""""''''''''''''I",;,,,,,,,,,,,,,,,,,,,,,,;''''''.\''j,; ,..,,,it 1\1\0\0(\' In Jho nhovon\lllllolll.llllI IJlIIIII( dllb' ,,,,,,l;l,W,~);',n,..,,,..,,,,,,,,,,,..,..,:,,,:, 1ll!l!Ill'd I 1111 10 hIlI', un~' t hnt thl! fnotH Hot forth In lilt, .lIhovn 1I1l\lllont IIlII 1I1'Ii 1.I'II\,ln Ihl' IIllHt Ill' '~H"'"'' k '1(1,\\'hl~IJloJI\l1 2'" II \" '.' ,,,,~tlRt;:J)t""""""'H';\"l""""'I.' ..,..;"" nlld MuhHt!l'tlJud 1 ,,(Ir'~;f;t1!; "~tIM~t"I.f.jl./.ft. '''...".....',...,''''''.''''';;'11.'''''..., lJlu"ana H. ,Hartz n .." ,.boforo m(t, " "."."",,,,,,,,,,,,, "" H." H.d I'" ,<"." """'" I""'; I 01'''''''' '''' I" !"' '"~~i;'''''''''''''''''~''''''''''''''''' A, ,I)"llll..~t.. """..,..,..,...."",..,..........",....,......,..,,,,....,,..........,,..,........, ..:...'~I../.(/.ld.t....,4f..:\: ,~t:,(.1.~~;~'I'~'t;;;:.., ""..""...."",....,,,,,,,,......,,,,,,,,..;,,,, ....,,,,,,,,'..,,,,,....,,,,..,,,,,.. (i'lI~d I ..,,"~~X..,~,~,!,"""~~,~,~..,,"',..,..,..,''''''''''''',.. AttIJI'IIU,I' I 'l}fP8J;:~~~<<i\rq;,H"""..'''''''' ~I r~ (7ocf~ OATH OF PERSONAL REPRESENTATIVE . ()OMMONWIi1AW'H Ol~ PIi1NNSYLN ANI A COUNTY iWCUMl3ICRLAND } HHI , ." Ii" .".."" i It >>l~g~lt~tI .I'l..., II!J~ J;il;a tilt.,..",,,,,,, lit j ,"'''''' " t1'''''''''';'' Ill'" Ii"'" 1ft' ,.,,, 11'11 .!!.IIIII.. j" II" ",; j"1 potJ tlonar QlI) being cluly ""I.~>>:~.,t};1."'1""..II"Il'..".II'II..""!!'.'" ncc~rcllnK to It,w (to fI,~.ltllll (161)0140 and fU\Y thut n~ the udnltnJRtrn ir,c?',lt". .1111" ! of tho ORtu to of '"11 .;.c;t?;.~.ca9,t:~, "W. ,., IIJ1,~t.: ;tr,~ III' t. Ill"" 1411. """ it," ft... II "'" "'" It. ,,,'tii! i, 'i., i'H': , 'P.. till II II \I j I"'; '" "",.' "r'~"'" I II" II II" i ,,,'', I' '1I1"'" II'" it"'."",.." tll i '''''' i"" "ll. ,"." I"" lit II'''' "" n'"'''' 1'1 {,,,..,,..,, '."1111' II II It.II II".tt" t," lIooOUMlI "...Po,!!!....,:;..".., wlll wolln,liI truly nclmjnlRtol' thllgoo(IH imllchnt,tolR, rlghtH nnd crodtt$ ot RRld deo~lIHod, ROcordlllll to Inw, And nlHo will 'ctllhlently comply with tho provlRlonH of the luw relntlnll' to TrllnHfer InhorHlInceH, lIij"~IWi<?~.~"'H......'lI"',"".t1,..."I""..,. nntl HubHcrlboct before m~, ''''''t;!,~X....t~,I......"".."......"........'tJ A, D.. lO....~,;J;.. ~"~""#~'" DECREE He It romomborflc1 thnt on the ..H"I':.I~I9.~.~.,.jil".." dny or i.."jM~M.I"i;'I"I"'''"I''..''''.II..t1' f,.i 0'1 lU;'"'~lIi LettorR of AdmtnlstrnUon'ln tho cstnto ot~ "'jj...g.~~~,8~~II.~lfll'.tl~.?i'.~~..tlll''''tt'II'...IIIt..'''..II..II'''1I.,"i'...'H'llllI1 II"H' il' lI.i' 1'1' II "" ""H'" "" '''' ,'11111.' 'I,~.ltjjlll"",,"""'''i I!~ Into of ,,\i#il.~~~^,III't'r;tWXlJi\h.1p'II' "'"'"Il'iI"'ll!lll"IIIIlH'il'! ,fli Cutnberlllnd (jounty, PonnNylvlIlllll, dccOIlHed, woro grllntod to ....W,\tlj{!\l.n~"',\i"."Wil,l1,1;,~......,ii,..,""'ii......' .(7 . '4' ;' // ....A: ' , ""i"(1lIf:1f:7..f.11~.., ,,;'f.ti.ff,;'/;1?~I...,II'"I..\I.'..,..It..'""'''i''jllli ,...U(-f;ma H.' I3nll 'd'. , ,""'''''i''''"lillll''''fI'f"'";'''''''"'I''/lI,,,'"'II'''''"I''''iil,'IHlilllill" .iil.lilIIIlIIIIII..i'"H"...."Il!II11i.'...,IIIII".....i1illit'lt'"".III.'11"11''''11' '"ttlt"""II"''''illlll'"lltlt,,''i1,",,",''li't''ltllllltt'''',''~II''''tlIllllill"; WltllOHH my hRnd IInd'oll1c1111 HOIII the dllYlInd YOllr 11(0'8111 >~ 1) ..""....'"..,.. ,p{t~"..~,,:.., II . ,Hlhlllltlll Rogls ter " , t; t' , " 5 ~ ,Ill ... ... 10 < 0 ::;) ::E B B 8 , ti Q ~ GI CI Z < CI 0 ~ 8 III 0:: ::;) ,. C/) 'E I.I,J 0 ~ :c ~\ Cll l- :c p ~ ~~ "'Ii") j:,::'it ;.,.1';1 '1 \/1 i1\~_1 -I ;~UI ,.- 'J' iO., r '')' ......, 'i'.l J I.: ~ l,/\ '>~,: ""] . ' ,-.... ;<0 ,~ '.0 /(1 ~~, .,") '0'1 ,,' " " ~ i . , . I.i1I LIPU. CASUALTY THI! AlTNA nA61)AL TY AND SURETY OOMPANY Hnr1fortl, Connecllcut 06115 POWER OF ATTORNHYAND CERTIFIOATE OF AUTHORITV OF ATTORNEVlSHN.PAQT KNOW ALL MEN AY "'WBR I'AEseNTS, 'II!A T TlWIIiTNA CAIlUA\.TV AND HlII\nY COMPANY, n o"'l'o',illll1l1 IhIlV<llonl1l/odllll<fl1l Iho Ilwt 01 the SIIIO of COl1noollolll, ~lul hovlno II, 1"'11011111' "lfleoln IIhl CIIV 01 iilutfolll, (;.illnIV hi iillHlolO, f1111111 01 O"iu'I'elleul, h.lh nwlo, oon'tllulnd IlId I"polnlld, Ind dOel ~V Iho.o p'o.onl. 1I111kll,,00n'llIlIll1 IIlId 01'1111'111 nhfr.ley ^. l';cknt'd " . ' 0' ,(lamp 11111, PenneY 1 vani a ,1I.1t1l11 .1II<iillwllll AIIOlllllvl.),III,I',,,,,, wlil. 1IIIII'lIwo,ool,I nlllhmllv IImobv ""of."ed 10 "On, oNooulo n/1<1 10kllewlod(10, II 111'1' ,,1000 Wllhll1 Iho UI111011 Bin">.. "', If Ihe 'lllIlIWlllOlillll h. 'lUlld III, wllhlll Ihl1 n/O. Ihore dllIIO' nn\od ,Iho II1'I"wlllo 11I.11Il<1I!I<,1I.): bV hll/ho'loln Ilonl(ulo nlld 101, InV ol1d olf bOllnl, 10""0111/",IO"U, 111"""'01' III hl<IIItnlll\V, 111111 olho.' w,lilnu, IIhllllolorV In Ihol1ohll. oil bOlld, roooonlil"oo, or oondltlonol,ltndolllkIIlO, 0110 onv IlId IlIoonoOnllll1ah'Onlulhrllll\o not e!Cooodin'" the Hum or FIVB ' IIUNPRRD THOUSANP,($500,OOO.OO) DOLLARS . .nd 10 bind THE AlTNA r.ABLJAL TV AND BURF-TY COMMNY, Ihorohv lID 111/1'1' II nil III Ihll oll,n" "xl,,"1 lID If Iho .~nlO \'10'0 .Ignl/d bVl~. dolv , oolho,l,odoffloer' of THEA!TNACASIJAL TV ANDSUHBTV COMPANY, onli oil "," olil. 01 o.lel AIII>r,wyl.).lt. ,1'110', PII'.'"ll1llo lho ,"lho,IIV hor.ln g,von, .re horobv rollflod .nd lillnfl,,"od, , Thll .ppolnllno.1I11 modo lindo' ond bV .\Jlho.lty 01 Iho followlno Blol11111l0 A"80lullono oloohl Gllnlpllnywhh,h 1I."olullona 0'0 noW In full foroo Ind .H.ol: ' ., " VOTE!); 'thol..ohof Ih. folloWI"" oWoo,.: Chllrmon, Vlao ChRl,mon, I'to.ldlllll, Anv RNOOllllvlI Vlllo P'""llonl, AIIV AOlllo,VlooPrllld.nl,AnvVloe P,o.ldonl, Anv Allllllnl VIO.l'rllldonl, Anv Boo'olol)', AIIV AII'olonl Boo'Olol)', mllV fremllmo 10 limo ollPolnl RMldonl Vloo r'''lld.nl., R..,donl A..llllnl Boorolorlo., Al1ornov..ln,Pool, and Aoenlllo 001 '0' and on boholl of Iho COlllnonv ondlllnv olv. InV nUllh oppollllo, ,"oh oUlhorlty o. hll o,"l1lollll 0' oUlhorl\v tnlv p,"orlbo 10 .Iop with Iho COmponv', nnmo nn" .onl wllh Ihll Cmnllonv'o .001 hondl, ruaognlllnO,I, oonlllOI' of Ind.mnllV, ond olhor wrlllnOI obllOllol)' In Iha nolu,o of. bond,roooonl/nnau, or oOI1d1I1~nnl IIl11lnrl.klno, nlld nnv of .u,d offloo.. or Iho Boord of DI'tIOlo" mlV at IInvll/11o rolmovo odV luoh Ippolnloo ond rovoko Iho powor ol1d oulhorlly /lIVonhhn, ' VOTBD: Thll onv bond, roooonl/lno., oonlllol 0' Indomnlly, or wrlllno obll/lnlorV In Ihu nlllllrn of 0 Ill1nd, rooognl.onoo, or oondlllonol undll1lklng Iholl bl valid IlId binding upon Iho Componv wh.n 101110n.d bV Iho Cholrln.u,lho Vloo Choltlllon,lho Prnllt!onl, 011 ONoOUtlvo Vloe Prolld.nl, I Son lor Vloo Prelldonl, 0 Viae Pro.ldlnl, on Alii lion I Vloo Prolldonl or hV 0 AOlldonl V'vlIl',olldonl, pumlllllllo the powor prolorlPed In Ihe ooHUlallo ollolhorllv of luoh Ro.ldonl Vleo Pro.ldonl, ond dVIV ollnolod IIno Iflolod with lho CampflnV'D Hflll' bV 0 800,oluI)' 0' AIIlllonl Seorllol)' or by 0 ROlldonl A..lttlnl SI.rolel)', pu"ulnl 10 Iho powo, prvoOrlhnnln Ihu ourtlW,ltlo of oulhnrllv of luah An.ldenl Aul.lonl Sooletlryl or (bl dulV eNooulld lundo, "II, If roqlllred) bV one or moro AlIornoVI.I",FilOI pUlluon'III Ihopowol 1"...r1bod In hili at Iholr odl1lflcelll or 01111001101 01 IUlharltv, ' Thl. POWIl of Allornov Md Col1lf1oolo of AulhotllV I. Ilonud onduoolod bV foo.lmllll unllllr ond bV oUlho,lIv nf'1ho fall "wino Slendlng Resolution volod bV tho AOI,d 01 Ol,eolo" of THB AlTNA CMUAL TY AND SUnF.TV COMPANV wllloh Aouolutlon 'U now In full fo,oo ond eHoOIl , VOTEDI Thlt Iho Ilgnllule ofoooh.of tho lollowlno offloo,,: Chairman, Vloo Oholrmon, Prolldonl, Anv Uxollullvo VIOl Proeldonl, Anv Bonlor Vloo protldont, AnyV/ol Pruldlnl, AnV A.llllonl Vlo. Protldenl, Anv SlIololory, AnV AI.'llonl,s.o'Otnly, flnd Iho 0001 ofthl CompollV mlV hooffleld bV 10..lmllo 10 Inv power '01 1lIorn.v or 10 Inv 00111f10010 relollng IhoroIQ.llppal"lIl1/1 Ho.ldont Vlao Prolldonto, ne.ldonl Alllllont BtIOratorlOt or Allornevt,ln,Plot lo"purpotu onlv of oNlaullng Ino IlIutlno bondl ondundonlklngl and olher wrltlnoo obllgolol)' In Ihe nllure thereof,lnd any .uoh powor of ll10rney or ooHlncllobeltlng ouoh loollmllo Ilonoluroor fooolmllo 0001 oilellho volin onli bllldlllo upon thl Compnnv Ind Iny luoh powor 10 oenculad Ind 0011100d bV .uoh l.ollmll..lonoluro ollt! laollmlla 0001 Ih.1I bo volld ond blndlno upun Iho Company In Ihe futuro with 10lpeot'I0 onV,bond or undl"lklno 10 whloh 1111 Olloohod, ' IN WITNBSS WHERBOF; THE ~TNA CASUALTY AND aURBlYOOMPANY hOlo.u.od IlIln llilltllmonllo bo..lgnod by II. Ass18tan~ Vice President 1 and III oorl>orll.800119 ho horOIO oHlxodlhl13rd dovof December , 19 80 ,,""""'" ."', \f ~"II "" ,','" I,", ~1!ii4Illf(,"11 ,,;\ rl,l,../i ~J ,4. ..~' "'~I '~"" ""u,,"'" THE AlTNA OASUAL TV AND 8UR&ry CoMPANY ~~o , ' av~-:-.---'~ -"-'.:.~ A::i%'~ Vice p~estdent SI". of Cohhaotlolll } County of HoHfo'd u, HoHfo,d Onthlt 3rd dov 01 December ,19 80 , hoforo n.o po"onollV oomo R. T. RIPPE , 10 /110 know~,wha, bolno bV m01llllvawoll1, did nopou ond .ilv: Ihol hn/.ho I. A9SlB tant. Vice pruiden~ 01 THB AlTNA CAI!UAL TV AND SURSTV COMPANY, Iha oo'porotlon d.oo"~od In Olfd wh/oh ONBOUllld Iho obovo Inolrurnenlllhal hl/.h. ~~O\Vd Ihl .,,1 ohold oorporallom Ihltlhl ...1 Iffle.d 10 Iho IIld InlltUll1onll. .uoh corpo,olo 100/1 omf Ihnl h./uho ONoolllod Iho .01111nlllul11lnl on behalf 01 Ihl oarpotlllon bV oufhorlty 01 hl./her'offloo undor Iho Blond/no 11010Iuilonllhor~o', ",'~~~:'U'i,i"" (",',' <1'".::';') , .. ~ .. ' "'/8\~ ",.,~I"'il;" 1";""- f'j"UOI,,,I' ~r .~~JlO...m, M\jrnJinl":"" .",,,.. MM,C" 31,1084 CBATIFICA TB I, Iho und,,,'onod, Seoretary of THBAnNA CASUAL TY AND BUReT'\' COM~ANv, 0 .look oOlporallon,oflhl $\lleoIConnoolloul, PO HERIBY CBATIFV lhollllo 'arooolno and al1nohod I'ow.t of Al1o'lIoV olldCorillloalo bf AUlhorlly remoln.lo full forCle Ind hu not blon IIVOklldl ond fu"~almoro, Ihlll~1 Alondlng Rllelullono ollho Boo,d 0' Dlroololl, 01 oollorlh III Ih, Col1!flollll 01 AUI 9 11'1', II. now In lara., D ' J.' S)di1i~ln~lld II the Heml O"t/oe hi Comp,nv. I" Iho ally 01 Hanford, SIIII 0 Clol1noollolll, 1l01~d Ihl. ~ dlV 01 L, ,19 ,"'''''''''' ~- " ~ .(i;':~::,;:;,~::::::) IJY_~~V<_____ -_.- -- , .~ "j 1/' S~c't'e\:.Ary f8-1vaa'S)(MI 307 , .."":"",,..:.." PRINTED IN U 8 " " HI' ""..nt'> 10(1' O-IIQI COMMNlwe~~TH O~ peNNIYI.V~NI~ . Dr.P~R1MENT OP REVENue TR~NSPHR INHERITANce T~X RHSIOHNT OHCEOHN,T INHERITANCE 'fAX RETURN , FOR INSOLVENT ESTATES (111~lrUCllol1~, all Rovorao Sldo) COUNTY t~O. 21-81~315 STAra NO. TYPE O~ ~ssn OESCRIPTION Personal Aooounc No. 002-34~()5270 at State Property Capital Savings AS/Olooiation ersona1 Aooount No. 002-\10-01234 at State roperty capital Savings Assooiat.ion ersonal Jeweloor Jewelers & Dist.ributors - roperty Wages ersonal Midstate Computing serv'ioes, Inc; - roper.ty Wages Eitalo of GRI1lGOIW lD, IiIDRTZ Lo.t oddr... 120 West ,Clearview p~ InnUHTI Camp Hill , ~a. 17011 I"IHI' ' In^Tf.1 11.1~1 Dolo of Doo'th April 16, l!lBl ..---- So.loIS.aurllyNo. I'l( ./(,S~;>(,8 ( ) IIXOD' (~Adm. Oth.r NOlno JlJuqene lL Hertz l79~20-7013 - I.i ~ " " It S.a101 Soaurl ty No. 120 West Clearview Drive Addrou (U'ttHiI~TI Camp Hill, Pat 17011 I"ITYI !aT^rUI nlPI Unllnr l1unulllft' of pnrlllfV. Idooloro that I tWiG olulmlnoo thll'roturn Dnd 10 III' bUlI.f IllV k"owIU~n' .nd ~ul'O' II.. trUO, ao,,'OI ,nclaolllD,.IO, 1')'1/ I J ' ~!J .. .. ,. / " .. ~"-"-~- .' /- .. .. .-' , / " . 4f-'.f" .I,! "',>- _ (, ,~ .~'I In'turo 01 F1tIuc:lary ,... Pal8 ' EnIM~THO M~RKE I V~~IIE PEP~RTMHHT V~~U~ TION OPrlCI~~ usa ON~Yl $ 282.44 ~ ~ ~~ r.., 1\ 58\1 18 ~g 1;1 . ~ mS ~ . .. ;l'i~l " ;:t.~ ., Ir:~ ,- -' ,,1\ ~t-. " I '!I',.I 101.78 " : i ~ 01 !~~I 1\ I'., ., 1:.-' ;) j:;r ... 643. 77 '-,I IV 46. 06 ersonal roperty United States Treasury - Tax Refund *Continued on llttached sheet TOTAL I do hereby oertl fy th,ot Ih(Je ,obov.'~?,1I war. opprol.. ,'1'~,- / ,---~<:rr.tA ......1.. .0." .~-:rc::.. L- - Pit H ~ OPPICIAL . USI ONLY D~TE N~MEQ~ PAVU Myer.s-Ha11FI.meral Home Eugene Ii. Hertz State Capital Savings Assooiation Catholio Cemeterie~, Diooese of Harrisburg Joseph A. Gansbigler, D. D.' s. Robe~t .L. ~yers III Administration lDxpenaes OPPICIAL USI ONLY I r; tjg-!. tJ-(J OErJUC.TIONS ^t..I..OWIH1 _r-.z~:!1- H~TURH OF cLAIM ~MOUNT C~~IMHO Funeral expenses Family Exemption Balance of Loan $2,486.00 2,000;00 758.92 705.00. 245.00 175.00 64,98 Cemetery Lot and Gravemarker Dental Bill Legal Servioes o 'UlnlP~ MPl eUIP)UIIPnpl^lpul'OV'Vd UIJPI UP pllPO"O! oq pn04' 'lIlll1 oIUO)UI olqPMPI, wl'll. -,olodm" MPlllIUO)UI pluMI^"luod .101 olqPpodp.I 81 PIlllWo liP lJupoI"UIIU -pO UI pOIUlOpllcl 8P)I^.I0' lPI ',OIIl.ll'IU\UIpP .10 .I01!\)OMP Ull '^IOllIPU !MIIPIUoIP.ldO.l 0lPI80 'IP 01 Plod ,oP:1 1310N , ' . 11''''01 ^'I OlqolO^Oalll 'lO IUOO\OIl o~IUo Ilqol' 10 oO('O^Olllo lu'oIIJO~'d 0'11 ^'ll'olo^oaol oq 01 yO'l "II '1 "^"'laI4'" 000" $ lO 0111' oq 011'"11'1 AI010'"1l10 MOl 0\1110 %g~ 10 AliOIlO~ 0 01' , , .1'\"11 AII"u08lod 011110'1' 1111'110 I'UlAObUIIlOdOI l~'IIO lO 'UOIOl 00111 01 '1101 AlloIIIIM o'IM 1I0uod Allo' , , II 10'11 80I'I^oJlI olOllllS 1961 '''\110 16i uoII'oS - HnlHll a, d 01 alll1'lvJ . 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U. 0 e "l' 0 0 z , ti ~ ~ ~ Iii 0 c:l ~ c:l i i z z u.J ~ z I ~ lj u.J u.J g u.J I>l ~ Q ~ Z ::!: ~ Q ~ 8 8 Q. ::J z ~ ::1 [ or,! r- r-I G, ,'- .ri'1 'y ,- ~~ , co (:) r- "l' .li UO r- .... r- r-I r- ... ~ i u.J ! :c lb irl I- ;: ~ o 'IUOPO'OI" O~I '0 pIO~D' OO~ 01U0' 04110 uoqlUolU olo 04M '1lIOIod 10 Iuolod 0 Aq pOlUlola oq liD' UOlldlllOMO O~I '1'11'1' lO o,"nd. 4a",oU '1 ""'IIIUO^O 041 UI 'uolldllJoMO 0\11 IUllll' \lo. pl'~O'OP~ 01U0. '~110 JQqlU'lU 0 '1 '4M IU'P"'Op "\lID 1'114' Auo u'41'I14011 104/~1~ p'I"ll'l '04 ,.o,d. '4111 l' ....ood. 011 ',1 OI'~III'OIUO^IAIUUOd UI pOII'llUop pOII' O~^lIIIOpOO'.p 0 10 08ood. 0 Aq pOlUlolo 'q Ao.'" UOlldlUOMoAlllUol V u,nlOl 'I~I 0I'po~,"1I0 oq pl"O~' pOUllolo Ollloq '1901' 0~1 lOI AIIII~oll".olol'O O~l ,0 i,III'PO'op O~l poddo' OI'oUOpl^il , " 'p'lUlolo ftuloq lunOlllO 041 pUo 1'01.101' '401' 400010 ol.nl.U 0~110 UOHouoldu 10llqo Opl^lll,d 'o~Aod ~ooo 10 .0,uoU 0'11 pUo plod 10/pUIIPOl"OUI iO'" ,qop 4000 4014M Uo ,0101' 041 Iii; 'lO~lO\llOAOlO ,0 'UO!,qlUol 'I01101l09 010 I,oa 0~IOUlpIl1alllu'uod~o,10Ilnq pUO,IOlOUOI".OI A'OIOOplI'''OI ~OU'OIlO 'UOIlO'IiIUllUpo 10 ,'ooo~I OI'ipnIOUI olqolUlolo OlD llU'"1,419 'IU'pooop '41 A~ po"ooUI 'Iqop oi UOHlppo UI '.'0". olqo~ol 'O~ II l'UloOo olqHonpopo,o '11001' !O'II'I~ 01 lOl/d IUOP"OP 04' Aq pOllo'UI ,0HlllqollpolI'Holun - a ,,' 'poop 041110 pOloolpUI io 0111I laol<o 04', puo 1'01"0'0' 'I 1'001'0111 4a,I'IM UI ,oqlUnu oOod puo ~ooq 0~1 opnloUI'o'I" 'IOUIPllnq pU~ pUol 041 jO uoHdl'OIop IOlou06 o opnloul puo 'oloolo loqlUnll '''.'1'1'0 ,o'll' '!Oqu,nu ~oolq puo 101 Aq .luo~,IAiuuod UI P.,o,ol 0101" 100l ,110 oqlu"O , " _ 'uollolopl'uOO Olorlbopo puo, olqonloAo^IOOOI IOU PIP 0~8/'~ 4014'" 101'1'001' 10 'lIooA oMIII1411M IUopooop o~, ~q!OUOI'~o" Al,odold Auo"11 'illlnoooo 1.011 oAllolUo, puo 'pu09'01l1^OS 's'n 'O'O'd 01 pOlllUlllou"n9 OUlp"IOUI '011'0 lO,~"Od l0410UO 01 ~IooI' '0 olqoAod ,nq IUOpooop 0~110 o,uoU '41 UI 1'0111I AlI~do,d lo.ollod olqlOuolUI opnl~ul '410.1' 10 olop 04110 10 ,IO'O'UI '"u'pooop 0'1110 OOIO^ 1.~'olU 1'01011111" o~, puo 1l0UMO IUlol OUI^I^lll' 041 10 IU'p."p 041 01 dI41~oHnlolpUo(I) oU'oU 041 ',dI4"OUMo 10 oOoIU",Od 'IIU'pO.op 0,4' opOlaU\ '1\1001' '0 01U1I '4' '0 dI4,,0^I^lni 10 1401' ~IIM'IuouoIIU.lol.o lO uolUlUOO U\"uouol ',D "OlllOd ,0 AlIod ,0410UO ~IIM.AI,".1 pOUMO ,0 ,uopoo.p "41 Aq ~Iolo' POUMO "0"0110 "11 - NOlldlll::lSilQ 'p'UMO.AI'UIO! ,0 10lluoII 'AIl,dold'louo"od ",olIO 10" '110"0 o~I 1041O~'" ol.olpul- U~g" .19 ildAl 1~.LilSSV ~l'lOIJ.::lnll~ " ..~ "4- , ABsm'l1S CO NT INureo IJ).Ypi'J of Asset D~acription I!lstinlateCl Market Value, personal Ptoperty ~ersqnal Property Jcj,nt. Caah $ 20.00 19B1 U. S. Income TaK Refund 500.00 Joint Account No, 002~00~02615 at. St.at.e Capital Savinga Associat.ion in the ~oint namespf GregorY.. ,Hertz or,~ugene H. Hertz~ his father, opened 2/20/76, date of death balance ~ $5,733,47, percentage of owner~ ship ~ 50% ' ~,B66.74 15 Series re, United StJtea' Savings Bonds (no record of denominations) ."redeemed at CCNB Bank, N, A. April 21, 19B1, in the jcint namsa of Gregory I!l, Hertz or Eugene If, Hertz, his father, in the amount. of $939.BB, percentage of ownership - 50~ 469,94 The following Seriea ~E united States Savinis Bends in the joint,name~ of Gregory E. Hertz or mugene H. Hertz, his. father, percentage of ownership- 50%1 , Joint. , , 2 ~ $100.00 - Nov, 19BO (Not eligible for payment.) 50.00 1 - $100.00 ~ Dec. 1980 (Not eligible for " payment) , 25.00 2 $100,00 ~ Jan, 1981 (No!: eligible for payment) 50,00 1 ~ $100,0() ~ J:l'eb, 19B1 (Not eligible for payment) 25,.00 " TOTAL $5,669.91 ,I' !1 COMMONWEALTH OF PENNSnVANIA DEPARTMENT OF REVENUe BUREAU OF EXAMINATION OFFIOIAL NOTIOE OF INHERITANoe TAX , AsseSSMENT . TOI {'/I' ( " """il --. .." .' .. ,~. / ,,~'1. -4 : >" , j!:_ ' , ~ i~/,)" "),: /',) i -- :" /r (' '( / "It :; tJ I.~//"l(/'/,: '" )~'i //J \',1 ':1"'-' i ,J;, ,/ '/1',-'" . _,I ~J. EST A'rE i' { I r' / .'/' ( ~ /... , i !',,"" c' ,'" /~"1 ).' I: ~\>,- ,~,':-//..'~ .. , ( '1''/ ~ . f/ ;' ,/ 1/,1'/ " _ f ,,,,~,-_H J>-- ..'-{" . y it.l-t:- r,.,r~ ,,-/ (/ -oj / I'} ,~~ . COUNTY PILE NO: :/,,','j I I . r _ , l "; /' ."j OATE FILE NO, , 1/ ,,ct', ,I"; OOUNTY ' .-> .'.. j,)1 /1/ I //1,-)./ ,((:.. [,,1,"'._ ~.. ," -r-- OA TE OP OEArH... /( "" f , // f / I ',' ..,' "' (F~ - - . - .-.1 /'/l/ , Appralsod V,luo 01 Ealalol Real Ealele peraonal Properly $ _.~_n-<-...".,'..m~~ :t /,.';". t-. ;1 '/ / / .. ..' Jointly Hold prbperly/Tranaferl + .,._,,__.._'_'TT_'__'.'''~' Tolel Oroll Ellale ' . ., '/ .2../...' . ,1-)" /,,_ (,," f, ; ".1 " Tolal Approved Oeduollona ;.. i/ I // If (/. '/ /i Clear Valuo of Ellale $ , ,~-,,~'~"-'+""'----" Lo..: Approvad Oharllablo Exemptlonl Clear Value of Eat ale subJeol to Tax .L ~.~...~-'O...., ...._~__.._.._1... Amounl Taxable @ ~% Rato . t~x due / " ,~: #'/:), /.; // _"';--l(~'.r'-'r..>j{ J" IV.d;'1'. )(.I'Y I Amounl Taxablo@ 16% Ratn tax d~e , i , ' . " , iOTA~ PENNSYLVANIA INHERITANCE iA~~G~'f/r:." 4,e \<r. Ci::'j,'l(:';/.;:; * * .. ** .. A flvo peroent dlaoounl lotallng L will be grantod If Ihe Inhorl\anoo Tax la paid by. _ Len Credltll OATB OPPAYMENT AMOUNT PAlO ..D'SCOUNT INTEREST _ TAl( OREDIT . + . . . . + . + . -- Intereal aoorun al tl1a rate of .Ix' (6) poroenl por annum on the unpaid bolnnco of Inl1etl\anoe TAX from. 10 dole of poyme"ll Inloroll dun If paid bY, " la , ,',: ,o', ....1 "":')J, /' . "",./ BALANOE Of PBNNSYI.vANIA INHBRITANOE TA~oua;!/)(I&i1""'; If IL / .,,',,';/)0,,"/ J " ".(', , . --' J.. -: . l ,,_./- Aalt"tdbyl ,.,,' /~/J1.'-;" I "::,', ....') Bo.lolo'(I1.II.o 00 Rov".. Bldo "'Oal1V~I~,~m/ I'~ ,//./' ,rj{ ,<~;!._I._t_. cj t" A iii ;.1',11 Ii l" .-1 ./ v