HomeMy WebLinkAbout81-00405
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No.21-811>"!j
PETITION FOR PROBATE OF WILL AND I.ETURS TESTAMENTARY
In the Estate of
Blanohe F. Nawe~l
, deoeased.
TQ ~llgUlter of Wills for the COUnty of Cumperlantl, In the Oommonwealth Qf Pennsylvania.
Petltloner(lI)lUK(are) the exeout o~s named In the Last Will and Teetameni of' Blanche
Il'. New.aJ.1 , '__. dated __
Deoedllntwall a oltlzen of the United States and a relll~entof Ealilj;. Penl1~boro
. Tow'nshlp .~), Cumberland County, Oommonwealth of Pennllylvanla.
j, -.' .. " ,
DeOlldent dledQI)'I'hl.\):'sday th.e ~2.nL.. day or . July A.D. 1 LlU_,In the
Oounty of Cumber +and . . ' . , State of .".J:I\ at thuge of .....'Z..._ years,
Deoedent .. (has not) been married and ~.8t(has not) had oh,lidren born to.lltm (her) sl(1oe the ex,
eoutlon of the above desorlbed Will. .
Deoe~ent was pouessed of personal property to th$ value of. .' . ~~O, 000 t 00
. and of realestalllto the value of $40.000.00
ae near liS oanbe ascertained: said, real estate situated as fOllows 15 Fargreen Road /
ma"t 'Penns),)9rcIT'ownehlp, Camp Hill, PA 17011
TherEiforfil,yoUr petltloner(ll) rellpeotfully IIppl\l!lllll) for the probate of the said Laet Will L\nd TestL\'
. , ment Md for Lettere TestamfilntarY theron,
. Dated
COMMONWEALTH OF PENNSYLVANIA
OOUNTY OF OUMBERLAND .
Name and addressi) l~o.j a. R. iJ J~Q...e
,.of petltloner(s) Donald H,NBwell
~~,~~;:~~. '..0....'. 'A '760'
--170~ ~O~~HoUBeApt.
. 660 Boas Street, Harrisbl.\r~, PA 17102
} ss
---llQna,ld R., Newill anLJaan tit Neweli.....
nallied In above applloatlon, baing duly . sworn .aooordlng to law 8lly(-, tha.t the
statemsntasetforth In this petition are true to the best or._thei:!;' knowledge and bllllef,
..-aWQrn..and subsorlbed b~fore _D oJ.!.... ,.' ,~'-o,}...~..J!
m~~'__JUi.. "-IP t~,~~) ,..-L 7I...,f1.
:/1'~.e_~
_.."---,-, .._._--....,-,._..~_.--..~-._.'.._"._~---~--,_.__.__..._,~.r_""..A_~
Flied:. JUly 7, 1981 ~tfr~~y M; Balaban, Esq.
j' 223 North Front street
,'0(~/:,,5~.'--Yc'6- //,(,/./.. / @"'-nWq) it~~;i:g~r~;8:A 17108
..
'."
WILL
I, BLANCIlI~ T!', NEWELL, of Camp 11111, PenMylvania, !;leing of
sound mind I memory, and undarstanding Clo make and I?,ublish thia'my
Last Will hereby revoking and making void all wills or oodioils
made here~ofore by me.
FIRST, I give and bequeath all my tangible, personal
propel:'ty to my beloved husband, MNDALL L. NEwmT,L, . provided;
howeve~, that if he dges not survive me fora period of sixty (60)
days, I give and bequeath to my su~vAvin\l ohUdren s.o muoh of said
property as they may eaoh *eleot, and the rest shall be sold and
the prooeeds added to my residuary esta.te.
SI!JCONO I All the ~esidUe of my estat.(:l, real and Pli!rsonal,
and wh~rever situatli!, I give, devisa, and bequuath to my hUSband,
RANDALL L. NEWELL. If he does not survive me, ! give devise t and
bequeath /;laid resic1ue t('l my ohil.dren in equal shar.elilas may be
11ving at .the time of my death anl;l to the issue then'living of my
Clhi1drliln lIS may then be dead per stirpes,
(a) If at tha time of distribution of my estate any bene-
fioiary thereto is <ill a minor, such benefioiary IS shar$ shall
hot be dhtributed to him or her but shall be deUvored to the
guardian of the estate Of said bonefioiary and. retained by add
9uardian until. the bendioiary attains the age of' twenty-one (2U
years. l)urin9 suoh minority, the guardian shall pay' so muoh of i
the inoom~and prinoipal as it 40ems advisable for said minor's I
welfare, oomfort I reorsat-ion, support, .and edl.loation to the person I
havingoustody of him or hsr, without liability on tI~e Par.t of .liha I
gUardian to see to the applioation thereof, or shall pay it direot
for suoh purposes, and shall add the remaini~g inoome to prinoiPa11
to be invesl:ed as lIluoh,
Page 1 of 2 pages
947
REV'ler )')(+10.811 //...cf?7.J/./ 1
BUREAU OP EMAMINATION INHERITANOE TAX RHTURN
PENNSYLVANIA DePARTMeNT OP flHveNuH RESIDENT DEOEDENT
HAR~~~~:,~~~7108 _ _ Fllor/umbor 2l":81~405
Oecedent'l Nemo (~11I, Flnt, ond Mlddlo InlUell OOGodont'l Mdroll
OSOeASeD, NeWeU~,tal1oheD'. ____ 15 l~urql~eel1 Houel
SnclllSecurltyNumbor OetonfOouth Ci\mp IlUl, P^ 17011
195-32-0988 Jul 2, 1981
~ ......-...........--.~.-,-...
CHeCK 1. Orl~nol Return lliJ 2. 8upplomontol Rnturn D ~,Romllndor Return 0
APPRO'
PRIA Te
6. Foderol,ElIltoToK 0
ROlurn Required.
O. OeCldent died tellote n 7. Oocodont molntolnod IlIvlno 0' O. Numbo,r of lIfe depollt n1
(Attech copy of Willi ULJ trlllt (Attoch copy of trull) hOK8Ilnvontorlod L.!:...J
All corrolpondenoc ond oonlldonUl1 tlK InformeUon Ihould ho dlrootod tOI
4. Wo Elll10 0
BLOCKS
OORRe.
SPONOENT ,Neme
Karen
Telephone No.
717
~alaban, Esquire
234-32,82
Olt
RECAPIT.
ULATION
AND
Rec,pltulatlon
1. Reel Ellata (Schedulo AI
2. "Stookllnd BondI (Sohedule B)
3, Ololely Hold Stock/Portnenhlp Illtoroll (Sohedulo 0)
4. Mortgegol enll Notel (Schodule 01
6. Oall1 & MllcellaneouI Porlonnl Property (Bchodulo EI
0., JolnUv ownedProporty (SoheduleF)
7. Tranlfe,. (Sohodula 01
S, Total Oroll Allitaltntal IInol 1.71
9. Funerol EKPenm 'AdmlnlmeUve Ooltl/MllcollanaouI
E~pen"l (Sohedule H)
10. Deblt/Mortgag8l/~lenl (Schodulo II
11. TotolDeduotlonl ltotolllnOI B & 101
12. Not Valuo of Ellate (IIno 0 mlnulllno 111
13. Cherttable Oaquolll (Schodulo JI
14. Not Valua lub/oot to ta~ (IIno 12 mlnuI IIna 13)
(11 $55.000.00
( 21 -0-
(31_
( 4)
( 61
( 01
( 7)
-0....'
-0...
'42,010,.29
2.(/78,65
, -0-
(01 $ 9 9 . 68 8 . 94
TAl(
( 9) 5 . 055 . 69
(101 9,825.38
(101
-0-
(111 14,881,07
(121 84.8Q7.87
(13) I' -0...
(141 84.807.87
~.O6' 5,088.47
~.16' -OM
(171 5.088,47
OALCU.
LATION
compUtation of Ta~
16. Amount of IIno 14 IIKablo at ll% rata
(lncludo valuel from Sohadulo KI
16, Amount of lire 14 taKabl18t 16% rato
(lnclUdo ValUOl, from 60hodulo KI
11, Prinolpal t~~ duo (add ta~ from IIno 16 plUI tadromllno 10)
19, Totel Prior paymontll
(a) Amount Peld - 0-"
(bl PIUI OIIOnU"t - 0-
(n) Mlnullntoroll ~ (1 - .
19, Balanco Duo 0100,17 mlnuI IIno 18)
Make Ohaok Poyablo tal Raglllar of WillI, Agont
... PLEASE REOHECK MATH" .
(161
84,807,87
(10)_
-0-
(191
5,088.4'7
Under panaltlal Of perJury,1 doolaro that I havo oKumlhOd thll retuln, Inol4dlngaOcompanylng lohedulol end Itattmontl. and to tho ,boil of my knoWlldga
and ballof.1t II truo,oorl1lot, and oomploto, OaoleraUon of praparer othor than tho pellonal roprolonlltlvo II baled on III Information of which praparor 11.11
an~knOWIOd9jl ,,' I I
-t<7'1\. ;:'%'(f/eW' , 6~0 poasStreet. Ilarrisbu;~C!. P^ 17102 ;', !(,.ri:J.
81 NAT~f\l! O':PSRSp,NALR,/\fR, bOSNTATIVSIS) ., 'AODRSSJ . '" OATS
j)lY\t,Cl..t.L.],., lllJ.IA~ 3004 Columbia Ave. Lancaster, Pl\ 17603 3-II."ql.-
~~... h ,A..If~~ P. o. Box 1284 , Harrisburg, P^
81GNATURS OF PRHPARSR OTHeR THAN RePRESENTATive ADDRESS
17108
l'II.'/~
DATE
MV.lil'lUli'("I\1
ll'uge 1 of 2'
SCHEDULIl 1/1i'
DEBTS OF DECEOENT,
MORTGAGE$, AND LIENS ' '
-.....==_...._~ -- ,_.== -PIL.r-N"uMii[:'[1--
__..~1-B1~405
COMMONWEALTH OP peNNSYLVANIA
INHIlRITANOIl TAX ReTURN
RIl81DIlNT DIlCIlDIlNT
ESTATE OP
B1anohe F. Newell
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8,.
Y.
10,.
H.
1~.
13.
14.
15~
16.
17.
18.
19.
20.
~1.
22.
23.
24.
25.
26.
27.
28.
29.
'30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
4~.
44.
,45.
46.
__~~_____.~_M~_---'---'__~____""'--
.~._r<...""""'-"-.'_"_.
--
-- ----.-.-..........-- ~-----------._~-..,--
OfiSCRIPTION
NRTA InsurLlnca
Bier! Anesthesia Assoc.
A.Z. Ritzman ARaoc.
Bell Telephone
1'.1'. & 1... '
Riverton con. Water
NEA ,Insurance'
Professional Pharmacy
Dale Lesperarce
Brenda Froet
CharlellWrigh t
Donald Newell
Char les Wr Ight
Chuc~ Bricker,Auct.
Bricker's Auction
C.G. Buser & Son
Oharles Wright
Paper boy
Pendrak~l<andra,
CONB Bank
1'.1'; & I..
Bell Telephone
Holy Spirit HOb~.
West Enola,Fire Co.
Pendrak~Kandra
C.M,. Detwqer
conimwlLh of PA
U.S.F. & G.
E. Pe'nnsboro Twp.
Keyatons 011 Co.
Internal Revenue Servo
Charles Wright
IUchard Zeidera
Patriot NeWa
POIlL Office
Barr'll Rental
Allyn Urologistll
M. Mills '
a,ell Telephone
P.P. & I"
Fry CommunlcaLiona
Allyn Urologists
M. Mills '
ennetb Ginte,r I TreflS.
P.P. &L.
Ch,it leB Wr I h'
pr el1d um \laymel1t
Mod leal Expenslls
Madlcul 11111
Phone Bill
Electric bill'
Water blll
pr llmi um puymeqt
Drugll
NurslT1f~ Services
Nursing Serviclls
Gruss Cutting 3 wks.
Reimburaement of nurse paym'
GraSB Cutting
Appru,isllJ. of furniahlngs
Commlsalon
Jewelry Appruiaal
Gruas Cutting
Final blll
Medical Expenses
Miscellaneoua
Electric bill
Phone bill
Medical E~pen~efl
Ambulance service
Medical Expenses
Real Estute Appruiaal
Pub. Sch. Retirement check
Homeowner's tnsuran6e
Sanitation & Sewer
0'l1 for house
Underpayment of TaX
GrUBS Cutting 9 wks
Trash rel110vfll
Ad for Yard Sale
Stamps, for Estate
Tabl~ for yura sule
MedlcCll Expensea
Medlcul IixpenBes
Phone bE 1.
Electric bill
Nelvapaper (lei
Medical Expensea
Medlcsl Expenaea
Property Talles
EleeLr Ic bill
GrasB' Cuttlnr,,5 wks
Page) subtotal
Of mot. 'Plollt nooded Ihurt addltlt!nal 'heett of IlIml ,I.,)
-
. AMOUNT
$ 20.25
260.00
221.00
9.48
48.30
17.42
19.00
29.00
363.90
321.l0
27.00
294.00
9;00
25.00
l02Y.25
28.62
9.00
6.00
45.26
43.62
48.42
27.47
6.75
10.00
181. 04
120.00
389.67
91. 00
48.90
229.40
.10.08
81.00
70.00
3.00
3.60
5,31
215.52
544.00
22.28
22.,84
20.68
53.88
136.00
598.99
6.51
$5817.54
lu!(entory Qfthe reol ond p."onnl utat. of
__"._...n ,~_......_"J3.+~.nql)l":l ))'" u N!'lV/9JJ. T'" '".__' de~eo ud,
__=-~..".._.:..=,O~=.c_="~~,,~."',,.~C,C:,"':..,"'='''''''_C0;'.~'-,-~,"~'""",. .,,, ","':c-H,a.~,~..".L,.8,,~:=.2..ccJ>~<if~-~ . ;.",:~~,,:'"
All ~hut ~ectfin piece oc pucceL of lUl1d sltunLe In Lhe TownshIp
orma~U Pennsboco, CounLy ofCumbecland, and StaLe of PennsylvanIa,
moreparLlculucly bounded Ul1rl described us follows, ~o WiLl
BEGINNING at u polnL on the southecn lIno of l1ar!~reen RCl/ld \IIhich
point is at the dividing line betweel1 Lots No. 83 und 84 on Plan
ofL.ots hecelnuHermenUoned 11I1() which point Is ulso six hundred
fifty-six und twenty-seven hundredths (656.27) feet more or less,
from the southeastco(n6r of th~ Intersection of Circle Drive und
l1argreen Roadl
THENCB, North sevenfy-seven degrees fifty minutes Bast Jnd ~long
the southern line of Pa~green R~ud u distunce of Sixty feet to u
point at the dividing line between Lata No. 84 and 85 on Plan of
Lots herel~aftec'mentlonedl
THENCE South twelve degrees ten minutes Euat and along lhe .
divldinB line between Lots 84 and 85 a distance of one hundred
fifteen feet to a polntl '
THENCE South seventy seven degrees' 'f I ft~. minutes West a distance
of sixty feeL to a pointl
THBNCE North LWelve degrees ten minutes, West and alol1g the
divldirig line between LoLs 83 and 84 on plan of lOLs hereioafter
mentioned, a distarice of one ,hundred fifteen feeL to a point
on the southern line of fargreen Road, the point and place of
beginning. '
BEING Lot No. 84 on Plan of Lots known as, Country .Cl.ub Park
which plan Is recorded In the office of the Record~r of Peeds in
and for Cumberland County In Plan Book 8, page 39,
HAVING erected thereon a one story brick dwelllng known ail and
,numbered 15 Fargreen Roud, Camp Hill, Pennsylvan>lu
, ' ,
Ladies' watGh
Ladles' witchband
Ladles' 14K whIts gO,ld ring
U. S. Mint Set, 1956
TV set
Breakflist set'
Air conditioner
Mahagony desk
MiBceLLaneo,uB household fur.niture
Ladde~'
Mower
Carnival dish
Banjo
Aluminum gUder
Hlde-,a-,bed sO,fa
Spring & matttess
Presser
Fivs"plece bedroom suite
Two b~dding
'table and 7 cb.drs
Wardrobe
Sofa
Yellow lazy boy
Refrigerator
Set of BavarIan dishes
Wardrobe
eh I na closet
CabItlet
Washer
Pryer
Pllhumld If ler
Four colleCLg~'s plateil
Accordion
Mar.ble LOp table
Ker.osene table lamp
Seven Mothers' Pay plaLes
subtotal page 1
55,000 00
200 00
17 00
1,150 00
40 00
128 00
42 25
59 SO
59 50
2,437 10
30 00
40 00
32 00
32 00
50 00
85 00
44 00
30 00
135 00
75 00
60 00
32 00
75 00
80 00
.. 175 00
50 00
65 00
420 00
5,0 00
70 00
45 00
55 00
44 00
160 00
175 00
40 00
00 00
,0
.
;. \
.
Inv.nlory .Ollh. r.ol ond p.r.onol '11"1' 01
,_____...~^__n.~I!J,AnQh~ JEt .J~€lW,ltll-,'-'-"__n'__ d.c.o ud.
~:~~r;a~l~~~
Ladies' coat
Wi ndsor cha i r
1972 Pontiac Orand PriX
~""=~'=C",=,_""",,,,,,,,,,,,,~_.,,,,,,,,,.,,,,,,,,,,,c,,C~-"""_"";".r.~g13,"~a,~J!c,"~-' -_L~X~_~"CO~~o""~,,d""~,,~c,~-'T~'.c.m~
1,20 .00
, 5 .00
5 .00
3 .00
80 .00
Dreyfullll Liquid Assetll, Inc.
P. ,0. Box 12139
Newark, NJ 07101
Account #115986.3-8
Mr. and~rs, Steijen ,Ynyder, reimbursement for utl1lt1ell and taxes
NRTA..AARP Inlluranee T,rulIt, premium refund
Cath-on-hand at time of d~ath
U.SF&O Insurance Co., premium refund
Aetna Iijllurande COi,auto pre~lum refund
PuqlicSchool ~mployell' Retirement System,
r~tlcement allowance July I-2nd .
American FIlm!).)' Life AS,surance Co. ,med, leal
expense rsimb4uement , .
American Family Life Aasurance Co., nursing
csre relmbusetnent ",. .
NRTA Insur_nee CO~l nur~ing care r~lmbursement
Amli!rloan Family ,Life Assurance Co"
pumJum refund , '
Professional Pharmacy, prElseriptlon refund
Refund of overps>'ll1ent on, Inheritance taM for the
Estate of Fredericka N. McIlwain (Blanche Newell
. .
\" II
" , ,r~. .
3,02 .73
.
33 .90
2~.2,~
PI.D
2:.00
3100
2 .02
1127 ,DO
55 ,DO
1,35 .00
.00
1 .00
94 .10
sole heir)
Bank Accountsl
CommonWealth National Bank
10 South Market Square
Harrisburgl PA17108
Re I Estate ,of Fredericka N. Mc llwain
Checking account #622-002953-9
Sjvlngs a~cqunt #62-0041413-1 principal $22,472.94
Interest 3.23
3,05 .77
22,47 .17
CONB Bank, N.A.
331 BrldgeStreet
Nel'iCUmberland, I'A 17070
Checkingacoount#652~744.4
~a~lngll ~cc()unt #006-018726-7
Subtotill Page 2
Subtotal page 1
TOTAL pageR 1 & 2
2,47
20
$38, LO
61 58
$99,68
.
.
cOM"'ONWIA~TH O~ I'INNIYL.VANIA I
COUNTY Of cUMIIRl.AND r
I"
._J)Qnd~.3 LuNflWllU ,(md. ,JIllAO I,., NawG.ll .... ..~. ,~. u.u.u....uu*.___~___.._ nn~..__H..C.n_~.
b~I"~ duly _'LI\'LQ):.l).., .., aooordlnl,l 10 law, do po,,' and UYI thlt th~ ..aJ;:~,_th~_"n;'_'___~'_'u-._
.Qgj!lllKGQ.l.lt.C.rJI.. .. - of tho Eltato of _Jll.ulQha-lL.~Nawall--~-.~.__.._-
lat. pf....IP~'t l?enDllbo~o 'l'9wnll\:jip ~_,"---'--I OUMb.rland Oounty, Pa" d,o~,a..d and ,thatth.
w,lthln II an Inventory m~do by ,D()r\eIls:lJ~...NaW.e.lJ...4..JeanJ.","NaweJ.l..., t,h. lald-Q~IllXlilQ.ltm,lI-
of tho onl1ro oltalo of uld doo.d.nt, oonll\tlng of all tho perlonal prop'~rty and rul '1IIt.,.xc.pt rul, .,ht. ouhld.
tho COMmonwulth of Ponnlylvlnll' end that tho f1gUrDl OppOllt. oaoh Itorn of iho Inv.ntory r.pr...nt WI f.lr v,lu.
II of the d.to of d.ccdont'l dotlh. .
RtolC)RN ,..--and Iublorlbod bofore m.,
"/lZ (I " lLLL
~. , n.vX~ 4. ('3 ~
IQltltU "l'f, "of'" .~It' CJ
H'lfl'~r', ~'" "" ...
My eoOlml>6lo" ~pi'" Otll, 9, 1905
._O.h\~LJL..~.M~ ,t~~~&l~~~~~~t~~~03
EMllutor . Mmlnhtratcr
._1~<t:Ll}i,~i:fL ~g~ ~ ~~;~Stt?!~2
.n'+_'__._----.-~.~--r----+'-.-
Dlit. of Duth "n__~'_ ._..L'n..._.u_.-'...m_--"n_Jllll~.-,--" :\,99,2
DIY , tMnth Vur
INStRllcTIONS
I, An, Inv.ntory mUlt be lIIijd within thra. month. '.ft.r appointment 01 p.rlQnal repr...nhtlv..
2. A luppl.ment Inventory MUlt bo iliad within thIrty daYI of dlloovory ol.ddltlonal.......
" Addl\lonal, ,hu" may b. .tflohed I' to porlonalt.y or rulty
4. S.. ArtlolelV, PlduolerlnAct of 1949,
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!~PORMA TION
Thla dooumMt la Ihe NOlloe requlreq to be g!ven under S,ollon 109 01 Ihe Inherllanoe and 8"all T.~ ,Aot
01 196 I (72 P,S. ..ollon 2496), " '
If Ihe t.~ la paid within thr.. (3) month a .lter Ihe decedenl'a death, I dlaoounl of 5'11 of the II' paid la a110Wld,
Inherlllnoe T.x beoomea dellnqulnt nine (9) monthe .lter Ihe deoedenl'e d..th, Inlernl la O~.,ged .t the
r.te of .Ix (6) percent per Innum on the .mount of unpeld le~, (Sae EXAMPLE SeLOWI
, ' ,
eXAMpLE: II I belenoe of 'ex due of '2,000,00 la In e delinquent elllu. frcm 3-3-80, Ind peyment Ie m.de
on ~-90, Ihe Inlereel 'a ollcul,lId .. Indicated below:
BTlP I
Oellrmlne Ih" rile of
Inlernt from Ih8 I.bll belnw,
BTlP a
Mulllplylhe \>alence 01
ta~ due by the rate of
Inlereel,
IITeP 8
Add Ihe ,1"ler,at
to the bll.nOI cf
ta~ due.
Int.rnl' Irom :l-03~90 10 5-23-90
Ruulta In,
22~og~~: : t '%b~35
R.te of Internt . ,01335
Balanoe of ,,~due
~.t8 of Intere.t
INTEREST
$2,000,00
~ ,01331\.......,
$ 26,70
B.I.noec f I.~ due
Plue Inler.et to
. ~f p.v1enl (t)
I~ an
Intere" to Oele
01 Plyment
$2,000,00
$ 1/ 5, 70
U.P26,10
---~----------------------~-_._----_._-----------,~----------_.~----------
1 month .005 4 monthe ,020 1monlha ,035 , 0 montha ,060
2 mohlha ,010 6 monthe ,026 8 morilhe ,040 11 month' ,066
3 monlha ,016 6 monlha ,030 9 monthe ,045 1 2 mcnlhe ,060
1 d.y ,00011 11 dlya ,00186 21 dayo . ,00362
2 d'YI ,00034 12 d.ya ,00203 22 d.ya ,00389
3 dlya ,00051 1 3 daya ,om~ 23 daye .00386
4 d'YI .000S8 14 dava ,0023 24 daY a ,00403
6 dive ,00086 16 d'y, ,00260 26 d.ve ,08420.
B dlYe ,00101 16 day, ,00261 26 daye ,0 431
1 dlY' ,00118 11 day, ,00284 27 daye ,00464
8 dlY' ,00136 18 dave ,,00301 29 dlye ,00471
9 day. ,00,182 19 d.ys ,00(118 29 day. ,00488
1 0 dav' ,00169 20 d.yo ,00335 30 daye . .00600
--'~~------~--~'~-~----------------------------------------------~----~
Any partv In,lnl8reel, Includlhg Ihe Commohw..lth and Ih. petacnal teprellnt,lIve. not UIIIllld Wllh ,Ihe
appr.illm.nllnd ...."ment mlY o\>j,ct within, al~ty (601 dlY,' ,liter reCllpl of thlo Notlc. .. provided by
Section 1001 of Ih. Inheritance and Ellt." Tax ACt of 1961 (12 p,S, 110, 2496 . 1001).
MAKE CHICk OA MONev OAll!A PAYABLe TO: "AeGi.TeA OF WILLS, AGSNt"
O,8T ACH THE TOP' PORTION O~ T~IS FORM AND SUBMIT WITH VOURPA YMENT TO 'tHE REQISTeR O~ WILLS ~OR
THe COUNTVSHOWN ON THe ReVERse,seE THE INHERITANoe TAX INSTRUCTION BOOK FOR AODRESS, .