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PETITION FOR LETTERS OF ADMINISTRATION
IN 1'1I1~ ESTATE OF ...."."~9.?,~",f.,~....P~.~.~.~f.1S1,~!;.........."...,,. ()ECl~ASI~n.
Tn ......... ......~,~,r.y., .~,~... ~~.~.i,s.,............,............... ........,..... ,............ ......,..." ........,
HcgiHlcl' of WiII:-; for the Count,\" of ('uml,el'lalld, ill Ihe ('nmlllollwcalth of PeIlIlH~'l\'allia.
The Petition of ......P.OJ:p.j;,l:1y. ..~f.l,\J.i?,$....... ..,c...., ........ ........ ......"...." ............,..........."..... .......' ..............., ..,..'
......".."".,.... "". """""""",.. '" "" "",., l'eHlled full \' showe t h I ha I ..... ..N.9.Ci J:1..,f.,:....?~),HI1.<:l~,r., ,......................,
. '
wa" II resident of ..W~$,1;..,p..~nll.i?,I;>,9.);',o...................,;I~:~~P ,Cnl11l1erland Count.I', ~(ate of PennHyl,
vania, and II Citizen of United States, and departed (his life intestate in the County of ,C.\1mQ~J;',L;;\n,ct,
,'..',....""'.."".""""..,..'",, and S ta te 0 I' """,' ,I?!:!ll,(\ 1i1.Y.+. ~!? ))J~".",..".""",."""""..""""..,."".",..",....""....,.."" ....,
on ......Mgng.,~z............... the .......J&tJ:l..................., da)' of ......M~y.................................,.., A, D., 19..~,J....,
at the age Of.:"..,',7,5...., I'eurs,
That tJi:e~ ;~id ......',N9,~):\...f."....P.!:!,:q~1l,g!:!,r........................... deceased, lcft surviving the following
named widow or husband, heirs and next to kin, to wit:
Nllme
Relationship
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".."..,N.oah.")?~.H~nm~I/.."~r",,,, ,
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Norman Dellinger
................................................................
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son
son
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....,....Be,tt.ie...5t.aub..".."....""",.."
....................................,...,."........,........,..
Residence
.,!:,1..,'~~,~P."g,~9,~r.\~",!!-,~,:.!..,,!?~,!:,~s burg,
PA 17019
"15']",W.",lT.i.ne"St..",,,.5hi.r.eman stown
PA 17091
,R.....D,..."l!,LBoney."Gt,Q)J',e,.........
, PA 17035
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c/o Jack Gaughen PA 17339
Realtor 3800'Market st. Camp
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R. D. #3, Box 355, Dillsburg,
......................'............'................p'ji..'..1 70 19
"l.8",Camp",G.r.aund.,ll.d.,...,nil.lsburg,
PA 17019
.........""".........,.....,......."........................
That those above named include all of the next of kin, so far as known,
The said decedent was possessr.d of personal propert,\' to the estimated value of $..,2",O,QO,.00..........
and of Renl ERtate, ICgK incumbl'ance, to the estimatc!d value of $........':'7.Q:-:-."""..."..."" as neal' as can be
ascertained.
That the said Real [';state in so fa I' as is known is locatcd in ............J:lO'NE........................,................
"...................................."................................................................................................................................................
Therefore. you,' petitioner(~ respectfully appl~'(ies) for Letters of Administration in the above
named estate,
Dated ..........MaY...,2,2........... ............. A. lJ" J!I.!l,L.
Signature "nd Acldress
of l'etitionel'lxl
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COMMONW/';AI.TIl 0/0' l'io:N:\S\'J.VANIA
COUNTY 0/0' CUMBI;;HLANIl
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1
ISH:
.."........".,,,.,,.....,,,...........,,,,.,,,..,,,.,,...,,..........,.......,,,...........;,
in the lIhove applicatioll hcillg' dlll,l' .......swo!:n..........................., accOl'dillA' 10 law, Sll~' that the facts set
forth ill the ahove applicatioll HI'I' 11'111' to the hl'st or .....her... kllowledA'e IInd belief.
......,....,.........SWorn.., .......... ............ IInd slIhsCl'ihcd I "., ""... "",., ,,'" ...,',..",..,..........",. """".."",."", '"""...."..,
,~~~~~:,;,~~.n...,............................, A, Il" 1!I,~~....,
:i....,..,..,..~..,0/~..,e,4(.~....,
~'; "" ;;;'; tf T" Registel'
~i1ed: . :........~;;;....................,..........,.............,.,......
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} ss:
..,.., ................ ,.......... .QO!:',Q:t.hy....N a us S,....,............,.., ............ ,.... ........ ,..,.............. ................ ........... peti tioner (>1()
being duly ......,......s;wcrn................................ aeeording to law do ,es...... depose and say that as the
administra ...tr.ix.., of the estate of ......,Noa:n...E,...,Dellinger...............,........................,.....................,..
........................................................................................................................................................................................
deceased .............. I...... , will well and truly administer the goods and ehattels, rights and credits of said
deceased, aceording to law, And also will diligently eomply with the provisions of the law relating
to Transfer Inheritances.
.",........,S;WO,l;T.\.."......................""., and suhscribed
~;:~l?mx. A..D, "'LI~&7~m
R~~{t~....t!..:...~d.........................................................,................,............................,..
DECREE
Be it remembered that on the ..........},n~........... day of .........,May,..........,..,.............,.. A. D., 19....IU.
Letters of Administration ill the estate of ................ .lllo,ah..E....,ns.lli.nl;lS.r........,.............,.......................
. '...,...." ......,.."..", ..,.......,..".." '....,...... """ ....,............ late of .We s t", p',eXln.Sbcr.c..!V~wn 6,h.ip...., ........, '..........
Cumberland County, Pennsylvania, deceased, were granted to .........Dor.o:th.y,..Wauss........,...............,..
.........................................................................................................................................................................................
Witness my hand and offieial seal the day and year aforesa~ . ~~,
' .................q;p~..,L?..,~!.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
ss:
Dorothy E. Nauss
being duly sworn according to law, deposes and says thatS he is Administratrix _
__ of the Estate of Noah F. Dellinqer ,
late of .......J1.es,t..Pennsbor.o...Township_ , Cumberland County, Pa., deceased and that the
within is an inventory made by Dorothy E. Nauss ., the said Administratrix
of the entire estate of said decedent, consisting of all the personal prop.rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
August 20
~-'.
J:'J/YlD. 7n 7?7.(J{A<) ./
TINA M. MYlil:i, NOTARY Pt.tillC
OlllSBURG BORO, YORK COUNTY .~ '
MY COMMISSIDll EXPIRES APR. 15, 191J!4 f.
Member, PennsylvanIA Assoclatien el N~.'les if'
19
81
It!, I' 7J;:- 6, ~h.,.,/
r . Administrator
R. D. #3
Sworn
and subscribed before me,
Dillsburg. PA 17019
Addr'lI
Date of Death
18th
Day
May
Month
1981
v..,
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional a..ets.
3. Additional sheels may be attached as to personalty or ,ealty
4. See Article IV, Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
Noah F. Dellinger
deceased
. _n____'. ___________._
------
Funds held in private account by presbyterian Homes, Inc.
as of 5/1B/Bl
Funds held in escrow account by Presbyterian Homes, Inc.
as of 5/18/81
TOTAL
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$2,99 45
35 10
$3.35 55
-
ITEM PERSONAL PROPERTY _ List all tangible and intangible IlCrsonol proporty ownod individually by Estimated Department Valuation
NO, the decadent at tho timo of death. Market VOIUl' (Offlciol Use Onlyl
1 Funds held in private account by Presbyterian
Homes. Inc. as of 5/18/81 $2,998.45
2 Funds held in escrow account by Presbyterian
Homes, Inc. as of 5/18/81 359.10
I Total $3,357.55 ~ }fh~fj
ITEM JOINTL V-OWNED PROPERTY- List all reel and pflrSonal property owned by the decedent with Estimated Department Valuation
NO, with another party or parties 8S joint tenants with right 01 survivorship. Include name, address and Market Value (Official Use Only)
relationship to the decedent of the joint owner(slend the dats the joint ownership was created.
N
0
N
E
f Total -0- -- . AO
ITEM TRANSFERS _ List all Toal and personal property transferred within two years of death. Estimated Department Valuation
NO, Market Value (Ol~icial Use Onlyl
N
0
N
E
r Total -0- 4'J>-' ,,1'2
List all s8fe deposit boxM registered in the decedent's name, or jointly with, or as an agent or deputy of another, or in decedent's individual name with right of
accen as agent or deputy. Include the name and address of the bank or other institution where the safe deposit box is located, the narne{s) in which the box is
ragistered and the relationship of the joint holders to the d(lcendent,
Name and Address of Bank or Other Institution
In Which Decedent Maintained a Safe Deposit Box
Name or Name$ In Which
Safe Deposit Box Is Registered
Relationship of Joint
Holders to Decedent
N
o
N
E
NOTE: You may expedite the procening of this return bV filing with it and as a part of the return, Intters from financial institutions or mortgage holders,
c8rtifyingto amounts on depo~It or owned by the decedllnt as 01 the datft of death. Such letters mu51 be signed by e responsible olficer of the financial
Instl1ution or mortgage holder and indicate clearly amounts of principal and inlerest in the decedent's account at the date of death and the tYpe of account,
account numtisr and the exact name or names in which tho account Is fogincrcd.
DEBTS AND DEDUCTIONS
ITEM 0010 NOllllt 01 Payee Nature of Debt Amount
NO,
1981
1 6/12 G. Kenneth Cocklin Funeral OKpcnsos paid _ _$2..061. 00
Family IIxemption (will nol bo allowod unltlss duenden! died
rosiding with D potent, spouse Or children,l
Administration Expensc6
- - ,-
2 8/21 Jane M. Alexander Counsel Fees 165.00
3 8/21 Dorothy E. Nauss Fiduciary Commission 165.00
IDtner DobIS and Claims)
4 5/26 Register of Wills Grant of Letters 13.00
5 5/26 Register of Wills Short Certificate 2.00
6 5/26 Register of Wills Filing Renunciation 1.00
7 7/08 Social Security Adl .Refund of overpayment 294.70
8 9/02 Register of Wills Filing Inventory & Debts & Ded. 15.00
9 9/02 Tina M. Myers Notary fees 6.00
10 9/02 Register of Wills Reserved for filing release 5.00
I Total $2,727.70 AtE
Under penalHes of perjury. I declare that I have examined this return. ilnd 10 the best of my knowledge and belief, it is true, correct and complete.
". /d,4~ t '-JhH1!'4/_
f _~::,ture of F;duc;a,y
I do hereby certify that I havo appraised the assets contained heruin in conformity with Pennsylvania law.
---dt-~(/ # ".~ /1-10 _~I
...-- ~ -Ytd AP~~ Dale
In the ovent thaI any future interest in this estate is transferred ill possession 01 enjoyment to collahual heirs of the decedent affer lhc c>l.piration of any
estale for life or for years, Ihe Commoll~alth hereby expreSSly H!serves the right to appraise and assess transfer inheritance taxes al the lawful collatelal
rate on any such future interest.
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Debts and deductions are allo\Wd in the sum of $
"R 1,;f, 1, 1!J al h % I" rate
'-al~ (]~
-LL(~ Reg;..er 0 I,
J4d-=J!l_
Date
BENEFICIARIES
~------_.__..:.."..,,~....;::~..=.-------='==-='-- -_.-~,
BENEFICIARIES AND ADDRESSES
(StoIC lullnllmos nnd addlcsses 01 011 who have tin intulU~1
either vestod. contingent or other lnwrcStl
RELATIONSHIP SURVIVED
TO DECEDENT DECEDENT
STATE YES
OR NO
AGE OF LIFE
TENANTS DR
ANNUITANTS
AT DEATH OF
DECEDENT
_..----~'- ----.-..-
_157 W. pine ST. Shiremanstown, PA
Leo Dellinger ___----------\-'-son---
R. 9. I~l H{)ne-y-GFGve-,-PA------'------
Donald Dellinger son
~~. ~~ Lewlsberry
Nnrm~T1 f)p 11; ngPf" -------~-
c/o Jack Gaughen Realty 3800 Mark t
M~cnael uelltTI~r
11 nQ li'l nri hnnn:::\ T,::Inp MP("'rp:~ni
RorQthX ')Ng':tj_~ r"h\.~~~.._~'
Bettie staub
18 Camp Ground Rd. Dillsburg, PA
daughter
daughter
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INFORMATION
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INTEREST OF
BENEFICIARV
IN ESTATE
--------.- ---
?Lyrs:_--~-LB- residue
yes---- 4"9" yr s .
yes 44 yes.
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yes 54 yrs.
yes 40 yr5.
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Melvin R. Dellinger son ycs
- .__._.~.___ ____._._.____ ...____......_______.___. _______._n
14 Camp Ground Rd. Dil_!~.?~rg1-.1'!2- -------- -------
Noah Dellinger, Jr. son yes 50 yrs.
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PLACE FOR FILING _ The relurn is to be filed in duplicate with the Register of Wills of the county wherein the decedenl resided.
TIME FOR FILING _ The return Is due nine monthS after the decedent's death, unless an "tension for filing has been applied tor and granted bV the Secretary
of Revenue within the nine-month period,
FAILURE TO FILE RETURN _ Section 791 of the t 96 t S'atute provides that". . . any person who willfullv fails to tile a return or other report required of him
. ' . sh811 be personBlIV liable. . . to a penallv of 25"" of the tax ultimatelv found to be due or $1,000 whichever is the lesser to be recovered bV the
Department ot Revenue as debts of like amount are recoverable by law:'
OEDUCTIONS _ Unsatisfied liabilities incurred bV the decedent prior to hi"her death are deductible against his/hor taxable estale,ln addition to debts incurred
bV the decedent or estate, other itemS aro claimable including the cost of administration, allornev fees, fiduciary fees, funeral and burial e,penses
Including the cost of a burial lot, tombstone or grave marker. and other related bu,;al e,penses
FAMILY EXEMPTION _ A famllv "emplion n"V be claimed bv a spouse of d decedent who died domiciled in Pennsvlvania.1f there is no spouse, or If the
spouse has forfeited hiS/her righls, then any cn,lit of the decedent who is a member of fhe same household can claim the exemption. Ie the event Ihere is
not such spouse or child, Ihe e,emplrun can be claomed bv a pment or parell\(, who are members of Ihe same household as the decedenl. The familv
exemption is allowable onlv against assets which p"s bv a w,lI or bV the PellllsVlvania Inteslate Laws.
FIDUCIARY COMMISSION _ Compensation paid 10 an estate oapresentative; namelv, an execulor er administrator. lor services performed in administering an
estale IS reportable for Pennsvlvania Income 1" pu'poses This ta"ble illcorne ,tern should be reported on Form PA-40, Individual Income Tax Relum.
R~V.4e4 EX+ (~eOI
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
Estate Name
Noah F. Dolli nger'
----------
ILl Original
o Supplementol
o Remainder
File Humber
21-81-332
Date 01 Death
HaY..--Ia.--19.81
Social Security Number
202-20-.Q12.9
I, th. und.rllgn.d duly appalnt.d Inharltanca To. Appral.ar In and lor th. County of Cumberland
P.nn.ylvania, do respactfully r.part that I hava appraised tha raal and parsanal prop.rty as repartad in tha laragalng
.m. .. ., wl'fl .. 10""""", fl~ "m ., ., ":'::~ .jj~'" S , d.'" "''', "''', "C", '"' "'"
Dated: November 23, 1981 C.:--- . " tlf.,()-
. 11'0 RITA-NeE TAX AP RAISER
REPORT OF INHERITANCE TAX APPRAISER
i ADJUSTMENTS REMAINDER APPRAISEMENT CODE
ItlVEtlTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
i
\ Reol Proporty (Schedule A) $ NONE 00+ 92+
I Personal Property (Schedule B) 3 357 55 tot
i
\ Jolnt.Hold Proparty (Schedule E) NONE 20+
i Tron.fer. (Schedule C) NONE 30+
I TOTAL GROSS ASSETS $3 357 55
\ Lell D.bts and Deduction. 40- 93-
(SCHEDULE F)
I CLEAR VALUE OF ESTATE
I o Life Estate
I RATE FACTOR PRltlCIPLE VALUE CODE
-
\ o Annuity
,
,
,
\
FOR USE OF REGISTER OtlL Y
T ox on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6%
15%
Tox on $
Tax on $
Tox on S
T ox on S
Exemptions
Totol Estote
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Less Credits
DATE OF PAYMENT
AMOUNT PAID
S
OISCOUNT
ItlTEREST
$
TAX CREDIT
=
S
+ $
=
+
BALANCE
TO
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
TO:
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DATE ' " /../, r( / <//'/
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ESTATE . ~/ II.."., -: :'.::; /(, l .
COUNTY FILE NO:
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FILE NO. ./ 1_
COUNTY /';.1 , " I, 1:1 A t -!-(.,A...-
'.- ....,
DATE OF DEATH //l:y /~ /IF I
. r '.'
, r J. _ /. ,
: I, ," CO ~ i j'
,.:~"'.,~ ~ t
Appraised Value of Estate:
Real Estate
$ '-------
Personal Property
+ ...~ ~f /)-//
/
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/ "
Jointly Held Property/Transfers
+
Clear Value of Estate
$ ~I .:; /, - 'I J';--'J
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<," -' '/-'/ " I
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$ "
Total Gross Estate
Total Approved Deductions
-----
Less: Approved Charitable Exemptions
-
Clear Value of Estate Subject to Tax
"d '/
$ /.,~ If ) /)
Amount Taxable @ 6% Rate
$
/... ?':J. :;." /)
.
lax due
$
-; 1, '1 "'I
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
117q
, .
* ",. '* '* '* * A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
+ $
- $
" $
+
"
+
"
Interest accrues 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
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$
;);l. '/ (7
" -1)