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COMMOHW8~L TlI OF 1'lltllnnVM~I~ AflPllOUACVIAIT OF
oar~RTMeHT or RevaNU~ FIC IRV
TR~HSFftR IHHa~T~HcaT~X
1Ie1108HT llaceD'HT (If1s,ttUGllons on Rever" 5Id~)
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Eslllle 01 Stoward '1'. 'I~aylor.
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\,,051 AdlholLCiH,M!\rK<3.t. @t.raat:.._........._.
New cumberland, VA 17070
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I f:\-l YI (liT ^ till (liP)
Date of 000111 IJ~ne 1.0, 190 J. _..__.._______.
501:101 Secudty No. .J..2.2:0:J..3779~_ --
Bureau Fllo No.
County FileNo. 1::~~/-/j/~t/IjJj
-..:.--..........-.......~--
1.Cooedont dlodl
( x) IntO$lolo (without 0 will)
( ) Tosloto(loovlng q Ill$\ wlll--copy attached)
2. I. tho flllngo! 0 Fodural Estoto Tax r~otllrn roqulred for thln,tote?
3. ( Execlllor/Exoculrlx x) Administrator! Administratrix
Nama ._1"E.~.~_ E. Ta y 1 <?.:..-._...
Address _J:J.~~A~M\l!pe.r_~l..str~et
__Harl:'j.~bl,\E.~L..!,ennsYlvariia 17104
1r.I'fYl (fn^T~I" ('lIPI
Vu__ No. )(
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4. .AII co rrnpan dOllcll should ba moilod to ( x) Attorney
5; If an attorney Is reprosentlng the eslole, Indicate;
Namo ~JeraLlIxer~-L.~lower ~ Johnson
Fiduciary.
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Addr05S ..2Q.~_.f::I.~_rk~_~. S1::.~~~._____
_.k\l1ll9..Y.llilJ...i$L~van ia 17043
(cl'rVI ("TAr~1 (~IPI
List all, safe deposll boxes rel\lSIe, rod In Ihe decodoPI',', lndlvlduql na,mtl Q, r jolnlly Wllh"".or 0'01\ agel\I or d,e, puly
01 ana thor, or In decedant'a"lndlvl~uolllame with rlghl of oceosa by (lnolner as ogtnl or dopuly. ' lncluUe I~e name
and oddres~ of Iha bank ,or olhor Inslllutlon where the safe depo,ltpox 1,loooIOd, the name (a) In whlehlho box
I,reglaterod and tho reltillollshlp of the lolnt holdera 10 the decedenl. .
p .--'--~'-- ~--=-"UlI::;t -
HIIMS OR N~MSi IN WHICH
SIIFS' oS~OSIT 80XIRSOI$T~RaO
. HIIM~ ~HO~DONBSS or S"NX aNOTHER IHSlIWTIOH
IN WIlIeH DBeBDEHTM~IHT^INBO ~ SAPE DsroslT nox
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t-lone .
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Undar p\ll1alllOl o/porlury, I declare Ihot I hovo examined Ihl~relurnl Including accompanying Ichedults and
'Ialemonts, and ta tho bast 01 my knowlodge and belief II Is IrUO, carrecl and camplelo.
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SION~TURb OP PloUCI~RY (
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~IONB p,~R COMPLETING SCHEDULE I~E"
. 8Olie<lule "E"mult Inolude ell pruperty, reeloncl porsonal, ownod by 1110 deoedenl jointlY with ul1othel'
partY or l*tl84 8Ilolnt tenantl with right of lurvlvorshill, Both lan\1lillo anc\lnlanglble proporty orG to be
Incllldad. Lilt reel "tate flrlt.
Desorlbe ell reol property 0' Indloaled In Ihelnsll'uollons for Sohedulo "A". D()Rorlba all porsonl1l proporty
ollndloeted In tho 1118Iruotlonl for Sohedulel'B", Inolude the name, uddruRR u.rId rolullonshlp 10 the
,deoodent of the oo.owner (,l end the dote the lolnt ownersl1lpwoB ostabllshed,
Indloato tho totol morketvaluo of 1110 jointly ownod proporty.
Indloeto the por~ontaga of Iho dQoodont's Intorost,
Indlo8to the merkot velue of the dooedor1t's In.torost.
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COMMONWIALTH 01' PINNSYLIIANIA I.
COUNTY 01' CUMIIRLAND .I
..,
, Frank 'l'aylor.
b"l~g~dul~~_'='=-;~~i~~~-: __-~ aop~;d~~ to--law, do;o~~I';~ :a-y';~h~;'-h~u:~I.~~=:'=-_'~_'=:.:..-.:._:'.,~:._
_.~_ Jilxecut?.1:'_____ _.___.._u_. _ .__.u_ .".. of tho Elhte of .....s.!:~~a x:~..!ay.!.<?!.__._ ____...u_______.
New ,Cumberland b d
I,.. of .'-'-"'- .,.' ...._u__......, CUnl erl.nd County, P." eoeu.d .nd th.t tho
within II an Inventory mado by ____ F.r._1Il1_k..~t\,)' 1pf...__u.__ ___ _ ____', the uld Jilxeouto!_....:.....
of the .ntlre eltate of uld deo.dent, oonllltln9 of all the perlonal prop'~rty .nd rul utate, exoept rul uhte ouhld.
the Commonwulth of Pehnlylvanla, and that the flgurel oppOIIt. eeoh Itom of the Inv.ntory r.prOl.nt It'I fair valu.
u of the date of d.oedont'l duth '.....=:/_' --I??
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Sworn _ and lublorlbod before me, Frank Taylor
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NOTAlIY PUut
14, CoIl!lllI"OIIl1~lrol 0.0, ~l, 1QU,
1.HIoJlIt, Po. ou.w.t1Qud 00\10')
81
19 ____
ex..,to, . AdMln"t,.I"
1944 Mulberry Street
HarriSburg, Pennsylvania
'----'.----.... .------- Add'..--;-----.
17104
. . lOth June.
Date of Duth _________.___....:....._.__._u_____-------.---
O'V Month
].981
Vu,
INSTRUCTIONS
I. An Inventory mUlt b. flied within three monthl alter appointment of perlonal r.pr'unhtlve,
2. A luppl.ment Invantory mull be med within thirty daYI of dllcovery 01 addltlonel....ta,
3. Additional Ihoeh nlay be attaohed al to porlonalty or realty
4. S.. Artltle IV, Plduolorlu Aot of 1949.
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~AL I~HERITANCE TAXINFOR/-IATION
Unsol\slie~ 1I0bllitios Incurre~ by tho docodont prior 10 hls/h~r dooth (!to doduct,lblo ogolnat IIls/hOl tOKoble
"to 10. In o~dltlon to debts Incurred by the doco~ont orosloto, othor I10ml ore clollnublo Inclu~lng tho eo.t 01
odmlnlltrotlon, ottomey leoB, Ii~uclory leOl, lunorol ond burlol OKllonllll including tho COlt 01 0 burlollot, tombstone
or grovo morker ond othor rolotod burlol OKpunBOS. .
All dobt. bolng clolnlOd ogolnlt on ostoto 010 aubloct to tho opprovol,of the Register 01 WII,I. with whom the
Inherltonce To~ Returnlllllod. Evldotlceto support tho decodent'a or tho estoto'.lIoblllty lor the dobt. being
clolmod should be ottoohed to thl. schedule. .
A lomlly eKl1mptlon moy be clolmod by 0 s~ou'o 010 docedont who dlod domlcllod In Pennsylvonlo. II Ihere la
no ,POUIO, or II tho BPouse ho.lorleltod hll/hor rights, then ony child ol.the decedent who 110 member 01 the !.ome
houlohold con clolm the eKomp,tlon, In tho ovenl thore I. no suchspouu or child, the eKltI11pl\on con be clo,lmed by
o porent orporent. who ore mum\ler. 01 the ',ome houuhold OS tho decedent. The family eKompl\on II o\lowoble only
ogolnst auetl which pou by 0 wlll.or by the ~ennBylvonlo Intntote' Lows,
NOTEI Componaal\on pold to on e~loto repreaontol\ve; nomely, on oKeoulor or odmlnlltrotar, lor sorvle..
performed In odmlnllterlng on utate II reportoble lor Pennsylvanlo Income To~ pijrposes. This to)(able Income
lIem should be reported on,lorm PA.40.lndlvldual Income Ta~ Return. .
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INSTRUCTIONS FOR COMPLETlliG SCliEDULE UFU
.1, IUhe lomlly exempl\on Is belngclolmed, Indlcote the c1olmQnt'a nome, oddr... ond hls/hor, rolotionshlp to
the dacedent. Enter IIfomily exemption" In th.,remorks c;alumn ond Ihe omount claimed In the omount column.
2, Aulgn consecutive numbers to eooh Item listed. . .
3. Entor tho dote on which eoch debt WOB Incurred ond/or pold.
4. Enter Iho nomos 01 eoch poyee,
5, Provide 0 brief explonol\on In Ihe lomork. column lor ooch debt claimed.
6, Entor the nmount 01 e,oeh debt being clolmed, .
7. Tho fornl mullt be signed by Ihe peroon who hOI olSumed the responalblllty lor poylng Ihe debta.
IF ADDITIONAL SPACE IS NECESSARY USE a%" x Ii" SHEETS.