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HomeMy WebLinkAbout81-00476 No, 21-81 t\'r6 PETITION FOR PROBATE OF WILL AND LETTEFtS TESTAMENTARY I --~ C I;J/II . In the a~tate of---Ar~WL----'-.)~_...J..-1!..JJJJJl-,_.._,~---- _, deoeaeed, ToRegl~terof Wills for the County 01 cumberland, In thoOommonwoalth of Pennaylvanla, Petltloner~ Is (<<l:el the exeout (j~ named In thll Lest Will and Testament 01",,- -J;.Ctr[1 r~ ~S'.' ~ R \,!ltJ, dated ~ llk.'I ~f)i ) 0 '7 g( Deoedent was a oltlzen of the United Btates and a reslctent of . Township (Borough), Oumberland Oounty, comrnonwealth of Pennsylvania, oeOeden\dled,on~__-,-the~JlPqaYOf \J1Jl-Y AjD,1~..iL,lnth" oountyol ,. ," -'! )) ,StateofJ17,_attheageof_yeara, Oeoedenthas(has not) been married and has (has not) had ohlldren born to hlfT! (her) sino" th" ex. eoutlon 01 the above desorlbedWIII, I ' ',' .. ' Deoedentwae poseeseed qf personal property to. ths value 01 L)!j t,C;T 1M l'r'lE:,D N o Nt-- " end of realestli\te to the value of as near as oan be asoertalned; said rsal estate situated as follows . Therefore, your petltloner(s) respeotfully apply(leS) lor the probate of tlie said LIIst ~llIand.Te8ta. ment ana lor Letters Testamentary theron, Dated ~UJ 'I ' <q 1-f~LR:.j , 1Ht, FlfZ.si @flNK. of TP- U~ C6'I Name,and address ..1fl~JM<<lc~W~ Pf::t \ ,'!Pol I II",,,) ,~ 8 ";-': ,-, ' ~, /705'" -~-~-,-' ob M,."",M 0,' NWEALTH 9",F. ,PENNSYLVANIA } 09UNTY,~F OUM.,'~' ERLAND_ '" ", ss . , ---,-~_Jl)"b~L~-L-tLB (7r'2-.-, . " . . named. In above appllcMlon, bel,,\! duly --.,s;:W-~- aoooralng to law say(s) thllt ,the statements aetforth In this petition are true to tho beat oL.~i~ '5 knowleaOellndbellelj "-:2? " --.~: " L,' .:'_.~'-~-' , '-,'-l7il7l1Jt,: . 71 ~~~.., 'eglaler"'" --~-~' 'rJJfAX..... I Ipt;:;, JUl, ~/-g/-L/7/; 31, 1981. ..,.,.. .._.,.'.'--.Alt-orn~:j,~.' @~&~~i~'tll~~el) ( - .1., ", ,- ,~ .. p~ I; Ii 5!l .' , .' . ffi ,..:'1" ~ e~ ~ m-' (t) - ~ i! WVl , rl '-'i'~' " p,''', ,~. ',,: 0;,'" ~, I lh ., I l' " . ;, ~., , - .. ' '..... OATil (w slJIISCHIIIIN(J WITNI':SS COMMONWIl!\LTllOF PIlNNSYIiVANIA I ss: COUNTY OF CUMlllJRLAND This , ,.'". ,..?/~'" _~__duy (lf~_ (:....~j.~j/ ." A,I),,19~, bO,foro mo, R"OU,I810r for llw pro,' bnlo or w, Ills nlld IlrlllltinllloltOI'H oTMrilllillsl,~,,1 I0I1I~J,I~~f{Jf~1 Counly of gU,lll1bOI'IUlld,' In lho COll1l1l0llwonl\h of i>ollllSylVlIl1lu, porsollnlly onll1o___'P.tf-}.iL.M,~,/):..,...-J~-, , . _--.-A:i1JL...-- ,)tyNE.T /{J, Ff'lR.8--Y - Iho'SI\bsorlblnu wltnossos 10 thoflll'oSolnlllnslrUI)10nl of wl'lllllll fllll'l101'1lnlllo bo lh~ hlht WlIlllnd Toslumo11t 01'---,,- JOlt/I;;. -S',(- (llllti-- /Jnlod _..,J..Uk! 10. /cl'P( , IlIto of CUll1borln11d County I'n" doool\HodWho bol118 duly ~lIooordh)ll,to IIIW, deposo 111141 iny, thnl, -nll,'1 _flfOSOI\l,"nd'snw n11d honrd tho losln 77< I 'Ie 1t1$lrlllno11t 6f wrltlnllllS III;d for h ,r.r< _1'oslnll1ot1tllllq Lnsl Will, nrd 11\ tho tlmo of so dol11IlSi'lY~' /'l.l''rp'F"' S, tR..U I/J sllln, sOlll, 11\lbllsh, 11ro1101ll)00 nnd doolnro Ih08nld , " .\Vb8 Of80U11d unddlsposlns mind mon;orY"11d lI11dorslnndln8. to,lho 110S1 of 7lll'"-I~ knowlodgo, obSorVl\tjPnn11dbollof. /1 ',' ~:I > , ,SlVeM',.y , , , " n11d 8ubscrlbo" boforo ,;00/1 IX/A (~d) iJ-1,-1&;I1.,> , + 0.-1" ,f IN, (::/ (.J-. ~../ _~~l'{l ?p~ RoS\stol' AFI/\I)AVIT m' m:A'r,H, CO, M,M,9NW, llALTH"OF,PBNN, SYl.VANIAl, 8S: C",OU,NTY,OF,C" UM,B, ERLA~D, ' ... \ ' " .', .,. ...', ~-Y~f" 'P, KkilT:.:J ' bolnllduly ."'i~8. snys Ihlll1l8 nOlll'lYlls on11 bo IIsool'llIl110<1 tho sulddQoodo111 t,(~-rn f. '(I r:. /1 U 1 AI _..,;.-dlo~ on '^,P,,19~, III or aliaul '? ~ .~() , .qt(J()IfY, .' .5}~~d~Y "'~IJ)ft. --- 'tMf tho. ~^-~!-;..:. ,LdIlY of ..17 . o'clOck, ...l..-M, y ( ) /.'/ alld subsorlbed 1111$ OL9"~ a, >f~ol~/ .. ....." .., .;..1.' 245 , Cumhcrh\nd (;ounl)' I Pennsylvania. ~he j!'iist J3anK ~Trus,' t CQ',Of," EIchen csbur~,,' e., ,;. ' ~d-.eX#:;f~ ' ~ ", ' ," Relllster OATH m' Plo:RHONAI. IU;PIU;SF.NTATIVE COMMONWllA\.1'I-1 OF PBNNSy\.V^NI^ "81 COUNTY all CUMIIERI.^NI) Ileforo mo, tho ROlllklor for 110 Pl'obalo of WII1~ al1d ,lrantlng of I.ottors of Mmlnl.tratlon In ,nil for Ihe Oounly of Oumborland, pOfsonallycumo ' UhiJr'?''', As.(. IqAdl/(' r:.Pi< F" ,i. ((;. (k::r () fFI(t;<?- who, belnll duly~i dO-/;;<; 'dopolound .ay thaI as (. 'ffc [' 1Te{8 . oflhol08lWUlallclT08lamontof . I\.QI'ilF~ c.fJ.IJ/N docoalod ~~wlll woll and Irulyadmln\ltor Lho load. and chullol., rlllhl. and orodl18 OflO,ld docea80d aUQordlna 10 hiw. And al.o wll1 dl!laonllY Qomply with Iho provl.lona oflho 11Iw rollltlnalo Trl\nlfo[ I ~bororo mo. ~ Dot 19ZL '. - " ;{i l. h~ \.l \~.\'i .,~ ..... I : v~'L ~'r._, "_~x , _ ;tot-t . l~(; 5'J 1"11) ~~ o ~ 1 ,~ \0 ., ~ ',", ,.... (\J CO cl I , ,-. ~ C\1 .1 .! '.;. u.. o ..J ..oJ ~ , , ~ J i ,ra l 1 I";l . tIl Ql t,~ "~ N ! Do II femembefed Ihal olllho 31st recorded Iholllll WI\1 and T081amollt of DECREE July S. Ervin l!&..D.,llJ el ,Ih'fow" Pfobalod.nd lalo of day of Lott1e Shirllrq,.nstowl'l Decealod, uller& 'l'llll'\iament&.ry '-,,-wero arallled 10 Wllnoss mY hllrld,.andofflclal 8eal Iho day and year aforeBlIld, ,..... 246 I '* ;( /- f/- 1.!7~ ~..---- ~ -"---- Ilce..HU RECOIl[![lH\fCF\,~1 'R'E(HS~'F:. I i\ ()OMM()NW1~II 111'11 OI~ljleNNBYIN ItN XII llopllrtHl1l)1Il; oj' l\ovonuo '81 ,.1\1\ 29 /\"'1' ",,-"- '1'0, , I~N'I'IIY INTO SIIli'\ClllWo.fJIT OOlnK-O,I1I'Hf\I'I'SCP('O:' 111J1!IOYI!l II WIl.1, 0.11 OEMlDTmly'WlROCRLAI1D l~1) ;", ..luly281.1gBl (Dalia or lJ1f\lir)') ".'1 j, Nnnle 01' dlloedol\t.\ Lottie !l. R1:v!n 'Blue Ridge Hsven West, Camp Hill. M Julv 27. 1981 Iol. ftclltr08H or ,IOllodent.\ ~. Onto 01' donth\ 01, NillOll nl1(1 olhlrnsa of porson who raq\leot()d the <\poning or ,the ,bOM\, Wq.yne 11. Klllltlll AVP~,Trullt affinat'. TIle F~t'8tBsnk amI 'ftllot Co.. ~eQh~\l1y~QuJ,~t 'fl), Pp&5 fl. NOnlO and ndcl'I'oSS of, tho fl.nanoia1inatitution whero the ,Safe deposit"boX,ili I 00/1 tad 1 "'hf,l l1h~v., 1'Jon\( ~~rJ TIl"vt I;:ql1ll'~~1! ,Noil'! OR" M~J:\'''. ~t"'D..tP \ ~An~dn~ q,phil~gJ- - 'P~ r1n~5 ,,', fl. 'NllInl)or ol'box I '75'J 7. 11'1t,10 \I1l(\or ~llinl1 ,boX :Lo rag!,sterod, 1.ottiA a.. l)~vin H! WIIsthllre 1\ will in thll boX? (Yes, or No) n, II. ,Jf )'08! sta to onto l)f wtll" nallle and address of1)eroona1 renresatltl\Uva I if namod ill tho will, andnl\lI1~ll,nd address of attornef,if atlfl i' .... J\Ily 20, 1978.' j At~orneya Snelbake~. MllOa1'lb "~1:l.c~,,tl. ~ttor\l"ft\o~q~~ 'R11 ",kAt'", nClqui ~A .. ,--"~- lind' now t.hia 2~\:hdl\)' or .July (:ert,\l'y Ilna~l' llenn1tttii'perjurf th/lt't1ie abovo to tho I)Mt. or 111)' knowlbdge aM belief. , 1U ,eLi.' t herab>' reoord io oorreot snd oOlllplete ~/l VII ,~ {J;.; I~ ?f11141~c , 8,ignature ]"r'''''''~rtif 'R1\~:\t'3 rntii'l l'g<} \l'''a.t.ll Olark CC~MONW.A\.TH 0' PINNIYl.YANIA l cOUNTY 0' CUM'I_LAND J '" " ,I'IAYI\1l 1"" KAu\:z....t-.Mfjlmn,l;...U5l.lilJ~il1Wl.~-lll1il ",.,'RI' r\PfJ ner baln9 duly ..:...!.\'l2tL-.~-~~ lOoordlng to law, dopol8l end uYI thaI he hi 'iX9t;"\t9r ..........................._---'"--...,..:...--'-"'----.'~-_.- 01 tho ~llato III ~ott1e S, Ervin 'ala ol_..._.IDl\2bl,~.'-'~-'''- ,_,_"".'".,,___ , Cumb.rlan~ Counly, Pa" d,c....d end thet th. within II en Invtnlory ""do by Thlt_EJ..n!;..,lliluk"and TrIjBtCQ~~ " th, lAId ' ~"\lDdnDr 01 Iha alltlre "Iala of lAid dooadonl, conlhtlng 01 ell tho porIonal prop.~tly end real ",.1., 'Moopl r.al "tete lIuhlde fb,a oornm(lnw"..llh 01 Ponnlylvonl., .nd that Ihe flgurol (IPPOlito oaoh \tom ol,lho Invonlory reprelent It', lair value . al 01, Ihe dote 01 dooodont'l death" The l'irB~ ,Bank and 'rr 'tC pany, Mechan10sburg /, ExeoutOr staC, ,0 La J!!.- .-Ii) vin, DeC\ilaBlild <lU,,'1''Vl 1;" , end l~blCrlbod bofor. mo, '" I } t'-- . / . ,,' i-9;~ / \<1 :,J.?, L 19 r ~, r",:t11A{ (/, 'f. dUJ.....- rp,;r I , tMlra, tWlt\HY l'UnllC . ''. ",' , !!'.:!~_I,', cu~-;mrf:;.AI~D coumv M\CUMMIS:;II)I~ LXi'IIII,n M'II, 14, 1984 M"i'IIIO',I'eA\\,jlyalll~ ^,$o~,"lIvn vi 'NvWios ,,'ta or- t \'. o. BOil. SO ~..-----:- _ Meohl\nioIilPUl:\J I ~Ji\ 17055' , Add".. bal, 01 De.th _'lWEt4'llIl:-Sli:V1ilN'rH o_v H\1l] P v.t,' ("::"'1 C'"." '( F!i~-; . " INSTRUCTIONI ;;\; ,_ .. '. .,. ,_ '. '" " '.' ._h " ,i,nlnv.nlory m~,1 b. flied within throo month I altor appolntmont of perlonal reprllontatlv,li, " !. ' .,..'; _ - _ _ ,- _" - .?':i-_ 2; ,., .uppl.m.nt lnvontllry miat b, fllod wlthl" thirty daYI 01 dllcovory cil.ddltlon~1 alleh,:,,; t. "'d~lllC!nal ,h..h may be ettaehod iii tll p.llonelty or rulty 4, h. Artlel, IV, f\lduolarl81 Aol 01 1'149, ,__ill!L'i M~nth ~ gJ ~llIl ,.,.,"' ,. S'll!! ,...1~ 'I!~ 11-'1 ,-J .... ::;) 'lj ,- " .....s 1 i~ \ , ~fl A ! - " ~ J 1 ~H~ ~ ....... . ~ ! """. j '0 :3 ~ .w J 'OJ' Ii Invent9'Y Qf th. rool Qnd por'Qnal "tQte 01 LOttie s. rerv:l.n d.~eoltd, N,l:'lIt,:, Bllnk IIn\1 'riullc Co.. ~ ChllQkin9 lIooo\lnt ~9' 140 521 ,6 PannllY1Vllnia ~l\le Shield, 65 speoial ~ amo\lnt d\le ' redo Inll\lrllMe, QrO\lp '" Rllfnnd on l?l:ami\lm pai\1' PennsYlvan:L~B1\la crOIlB, me\1iQare" various, paymentll o.api1:a~ 1311.1\1 Ct'QlIll" Rofund on pr;emiumpa:l.d Bll.\e Rid9lil Haven West.. Ro;Ifun<;i qll aooounc paid ~:I.rllc Bllnk /lnd TrUlIt co. .. Certifioate of Depollit ffa20B AOQrl.\ll<;i :LocatellI; on certifioate of Depoll:\.t 2,679 5 35 0 79. 0 455 0 ';,58 it 16 0 59,000 0 a,,503 0 '1'o\:l1l1 InVentOry & Appraillemont " !:.fNNSYLVANIA INHERITANCE TAX GENI:RAL INFORMATION -_.~ 1. PF.BSON~ RESPONSIBLE FOil flt;TURN , Sect!lln701 of. the Inheritance and Estate Tax Act of 1961 provldos that the following porsol)s shall propam and file a return: e, The porsonal representative of the ostnlo of the decadent as 10 property olthe decedent admlnistored by him anQ such additional property which Is or may bo subject to Inhorltance Tax of. which he/she shall havo or aqqul re knowledge; b, Tho tra,l1sferee O!llfOrerty uponlho transfer of which Inhmltanco Tax Is or may be Imposod by Ihe 1961 Statute, ' Including n trustoe 0 proporly trllnsferlOd In trust, IlfOVlflod lI1Otno sepftroto rotufl1noodbe nwde by the transferee of proporlylncludo(llnlho rotum of a personal ruproslJntollvo. ' . 2. PLACE FOR FILINO Th6r.olull115 to bo fllod In duplicnle w!lh tho Register of Wills oJ the county whorolnlhe deced~nl resided, 3. TIME fOR FILING The rolun\ Is due nll\e IIlonlhs aHor the docedenl's denth, unless an oxtonslon for filing has bean aPlllled for and grAntod by tho Secretary of Rovolluo wllhln tile nlne.month pori ad, " 4. EAILURfiTO I;ILE RETURN Section 791 of Iho 1961 Stlllute provides thaI" , , ,ony person who wlllfl!lly falls to file 0 iotumo,r other repurt required of 1,\l1n, , .sh~11 be porsonallY lIablo" ,to a penalty of 25% of Ihe tax ullimatelyfound to be due or $1,000 whichever Is tho lesser to bo recovered by the Department of Rovenue as debts of like aulounl are recovorable by law,'" ,... ,. 5, TAX BATfi~ Inherltm\co Tax Is payable nl the rato of 6% onlransfers to lineal de~cendanls"Sl\ch e~,falher, lilolher, husband, wife, son, llaughter, grandchildren, grandPArent, son-hHaw and daughler-In-Iaw and allhe rate of 15% as 10 all olhers, , 6, f.8YM.1l..tITO rTAX I " The lax assessed on Ihe transfer of property reportedi1\ Ihe relurn Is due 9 months after Ihedecedent's death, Inlerest altho rale,' of 6%" P, er ann,u1l1 accrues thareafler unl,l,l payment Is modo." All payments received are flrsl apPlied, 10 an,Y Inlerest WhiCh Ill, ay be due wllh an,y remainder app,lled ,to Ihe, tax, IF TAX IS PAID WITHIN3.MONTHS AFTER THI: DECEDENT'S DEATH; A OISCOUNT OF 5% OF THE'TAX PAYMENT IS ALLOWED, . . - - ' All check,s should be ,01, ade pllyablo,l,olhe Reglsler of W, Ills O,f the county, whoralnthe, decedent resided andere 'received subjecl to the final delermlnatlon of Ihe Deportment of Revenue. ' 7. FAILUREJOPAY The'H1Xe,S,lmpose,d,t~g,ether wllh ,any, Inleresl thoreou, era a lien ,upon "r,eal prope,rty, whl,ch lien temalns Ineffecl until Ihe taxes on,d Interest hAve beon pal,d In fUll" The taxes may be sued ,for agalns,t any real properly In the decedent's eslate or agalnslany property belonging 10 a transferoe liable for the t~x, 8.FILINGOF FALSI: RETURN A1iY~Qrson Who willfully makes a UUse return or,reporl roqulred ofhlmshall, In Accordance with Secl10n 793 of the 1961 Statute, be gUilty Of A mlsdemeauor and, on conviction thereof, Sl1all bo senlenced,lo pay a fino not exoeedlng $1,000 or undergo Il1lprlsonmenlnot oxcoodlnl!oneyear orbolh. gUESTIONS CONCERNING PROPERTY TRANSfERS 1. Old docedent;'Wlthln, two years of death, make any tronslor,of any lIIatorlal port of his ostoto wlthoul receiving valullblo and ,adeQUoto conslder~tlon? (Answer "Ves" or "No",) lip , , , 2, Dld,decodont, within two yoorsof denthttrnnsfor IHoporty r~oln himself! herHolr to ltllllsolVherself,and another porty or parties (Including 0 spouso) In lolnt ownorshlll? (Answur "Yes" or "No".) '-lli!.... 3, If the answer to one or fwo aboVe Is "Yes" and tho transfers aroclallllod to ho nontaxablo, provide tho following Informnllon: " " ' a, Age of decedenl at time of transfer, b, Copy ofdoalh certificate, ' c, Affldavll bY the attondlng physician Indlcallng Ihesloloof decedent's hoalth at \line of trunsfer, d, All other Informallon sUPllQrllng nonlaxablllty of Iransfer, ' 4, Old decedont, In his/her ,II, flill Ill, e, mitkeany Iransfer of properly wllhollt roc,olvlnR a valuable Or,adeqUale con~ldoratlon therefor whlchwastotakeeffoct,ln possession or enjoyment at or after his/her death? (Answer "Yos" or "No",) ~o a, Wits Ihere ooy possibility thet Ihe property Iransferred might relurn to Iran$feror or his/her estale or be subJect 10 hls/herpoworof disposition?, (Answer "Yes" or "No",) 'b. Whal was Ihe lransferee'sMe at lime of decedent's death? 5, Old decedentlO his/her Ilfellme make any transfer wllhoul recelvlnr a valuoblo and adequate conslderatlqn Iherefor under which transferor 'expressly or Impliedly reserves for his/her I fe or any period which does In fact andbeforo his/her dealh: ,. , " a, The poss~sBlon or enjoyment of or the right 10 Income from the properly transforred?(Answer "Yes" or "No" ,) No b. The right 10 deslgnnlethe persons Who shall possess or enjoy the properly transferred or Income Ihereftom? (Answer "Yes"or IINo",) , ,~. If the answer to five b, above Is "Yest" state whelher Ihe right was reserved In decedert alone or others, 7, Olddecedliilllh his/her IIfelimomakea trnnsfer,theconslderntlon tor, which was transferee's promise to PIlY locomo to or for Ihebene,fIt or core of trarsIeror? (Answer "Yes" or "No",) NO , 8, Old decedent, at any t1mo,ltMSfer properly, the haleflclal enl.oymenl of which was ,subject 10 chahge,heceuse of ' a ,reserved power to alter, amend, or revoke, or which could reverl to decedenl,undertermsof transfer or by operation of law? (Answer"Yes"or "No" ,)' NO 9, If tWOl1swerto eight above Is"Yes,"lwaslhe power to alter, amend or revok,e Ihelnlerest of tile beneficiary resorved. In Ih6 decedent alone orthedecedenl and9Ihor~? (Answer "Yes" or "No" ,) , Ii RUY'404 II',O} COMMONWEAL TH OP peNNSVLVANIA pePARTMBNT OP RBVUNUB TRANSI'BR INHERITANOe TAX ReslDBNT DBCBDeNT aetatoDf L9,ttie .hJirv!n ITBM NO, DEsqfllPTIClN I' - None SCHeOULE "E" )OINnY OWNeD PROPP.RTY * , (l1II/WlIl/OII'lm Rt/Vt!r'o SIc/o) p--"'---- n=:'" TOTAL p\ VA\.ur; or DEPARTMI!NT MAR KIlT DEOEDENT'S . VALUATION VALUE INTI!REST (O((/nlol U,o Only) --- - "#v___ '1!Ir-.o -- TOTAL THIS PAGe None -- , ~ ~ ~ ,~ , ~ 0 ~. " i z I "J,L. 0 ~ ~ 0 \1i 0 z 0 "~ ~ 1-0 0 0 ita ~ z z .~ g ,~ ~ ,~ "z H " ~. ~ 8 ll.l , - 'lB9~9lUI $;lllapaoaIJ aljl 10 anIM)9)puwe4lelllofpul '\I '1$9~9JUI f1,luep9oop 1141 19i1681UilO~ild 84l8leq!pul 'S '^lJodo~d pUUMO ^11Ulo!o41 jo enl8^ 19>\~BUlI810lS41 8180lPUl . . '/: . " :pa4BilqBlsH8M dl4sJaUAAO lUlo', a41 OIBp 941 PUe (Sl JaUMO'OO a,41lowepeQ,eP .94101 dl4SuOllele~ pUB U8Jpp8 'auluu 941 apt110u I' "a" alnpa40s ~ej $uol\onmul9ljl UI pOl801P\l1 $8 '\~lJoc;lo~d 18UO$~od IIOOqjJO$90 ',;I'd" elnp9ljOSJOj BUOI10nJ\$UIOljlu!peI9oIPUI 8U ^1~odoJd IUQJIIU aqp08ea '~ ii' 'IUlj sl818elsOJ IS!~ 'popnlOUI , ~~O~UJB^HedoJd elQl6uulul, pU99IQ16uU1410a 'dI4s~0^IMnfl 10 1461~ 4W^ B1UQuellulol8U leHJUd JO,~U9d ~~~ljIOUU 4l\M ,^llulolluapeI)Op eljl ^q pauMo 'Iuueued pUe IU9J' ^Uei;lo~d lIu epnII)UllSnUl.,S.. elnpuyOS . ' .',9., a1MilHOSDNIJ,a'idWQO \:lOd SNOIJ.on\J:LsN'I rH!.V.4ft6 (1.80) CtlMMONW~A~TH OF I'~NNBV~VANIA DEPAl\TM~NT OF I1~VBNUB TRAN8FER INHBl1ITANOB TAX R~8IDaNT PBO~OBN1' SCHEDULE "P" eTATUMUNT Of' opaTS AND llef)UCTIONS - . 1'~' .~.~ri .__.;":'O--_~ _~~~~""'lii.-.I~,",,_,,""_j;c"'-""""',"=;'-'h-'-""'-'""'''''''''''~;''''''-~- Estateof_ r."hr.ifl (I. I....vln DUlllofDoath Julv 27, +901 WHEN CLAIMING THe PAMIL.Y EXSMPTI,ON,()OMPLETe THE POI-LOWINGI Clelmant Claimant's Address -- _ Relationship to Daoadent -""'" _...' - I~~~ DATa NAMS OF pAV6B I1SMI\RKS AMOUNT 1901 " 1 - .~e9iaterqf willa ~ LettGrll_~ amen\:arY &lIhor\: otlrtifioate.!L-. 41.00 ~~- " I ~'''' 7 P."~ T, CO ~ Final ~otrio bi 1 I,' 1.79 . "' u~1.. ~_._,~ , ,-, ~ n.'-. ' I.." " 11'0, 1 ~ - '\, M Whehmo..". M: D, 4 'M ~ Bal. nae due 14.00 : R ,,; .'~n ., ~ RA".nne lAne 79.04 1'0 Sent.' , ' " -, ~ ,-". ., .n" T.AW .. .~ lIi1\a llilj;ten .. " 18.00 ;, I' ". '''h, " -- ',' 3 IWeet ore 'rimee ~ l\dvertiaina . ettere ," , 17.25 R S M"ere Hall Funeral Home . Funel a1 bill , 1,481.00 0, II ;.. ., .. .ht';'~ ~' n." 'nile , , 570.00 -,~ . 24 " T.eWe" .". FI,.e <"'0 ~ l\mb~lancel Servioe , '35.00 , l'harmaaV ~, Final 42.75 11 Dot. 9 l'rofesaional b 11 , ", ." , , , , .. , , - Hilda ~erbe ~claim for 'servioel & expenses 670.00 --......' ~ , '. _It t.;",. . 'l'" j , " , ~~~n"aisem~nt. Debts artd , " " I' , ~, "'lot j ~ne I"...... ,- 1~.00 " "HI " '.,. " , - , ,,~ P~..It"':' , " " , ' " ," , m';;"~' _L ,,"~.. ."'..m.....~ ,,~ I.."",,~~..' . 'P.4 , 3.241.32 " ...;',. -, " ,'" ",,,' P44 ',~,~4' .32_ I "..~, M~""'4" r. .." ,_L ~ , , , " , ReserVe for fili!'l9 lIOoount, "eta. " , , , 100.00 ,,, , , 'I , , , ' ..' - '.' '" , " ' ..' , " , .. , , , - I hereby certify t~at to the best, of my knoWledge 811dbellei expenses al1d expenses of administration sllbmlttQd to the est TOTA\. 'rHIHAGSr. ,', $9,583&L., t and ,true statement of debts; fUneral !.I rHence Tex purpo$es, , A (;> a oeBTS AND,OIlOUCTIONBAI1E A\.\.OWeD IN THE SUM OF $_ AT ~EACENT. "~1l'9TI!" Of' WII.~9 DAn QeN~RI)~ INt:lDBIT~NCe TAX INF06MAT~ Unsath,f:ud IIl1bll,ltl~s InulIIrod by tlHl doendent prior to hls/hor doath uro cimluctlblo against hls/hor taxablo ostato, In addition to dobts Incllrrod by, the duoudrHlI oreslalo, othorltom8 ora clohnahlu Inollldlno tho c08t of pdmlnl8\rQtlon, attornoy fOl\8, IIduclary 1.008, funoral unci burial uxpunsus including lho 008t of a burlullot, tombstone or Orovo marker. All dobtspllln{j ololmed ogoln8t un oototo ora subloot to the epproval of the ROlllstor of Wills with whom tht) Inheritance Tax RlllUm Is filed, Evlclenoo to support tho dooedor1t's or' the 08totO'8 liability for ,tho dobts bolno olalmed 8hould bo ottoohod to tills 80110dulo. A fomllyexemptlol1 01$2,000 may bo clolmad by e spouse of 0 deoedent who died domlolled,ln Pennsylvania. Iftharo Is hO, 8pOUSll, or If thll spouse has for.felted hls/her rlIlht8, then anv ohlld of tho deoedent who Is a momber of the 88mo househo,ldoen clo,lmtho oxomptlon, In tho evont thero Is no suoh 8pOUSO or ohlld, the, exemption Oan be olalmod ,by 0 parent or paronts who oro membora 01 the Rome household as the dooedont, ~ ~ ~ 8 ~ ~ '~ I ~ ! ~ ~ 0 z ~ ~ . , p ~ ><: ~ ~ ~ 0 I "t1 " ..... 0., , , 0 ;;~ ::ri I ,. 'I"'.~ " 0"( II j; ~~ ;~_t "oJ C~l! ,",,,1--; n~t', t:i:! ~i " 1..11 Bli' ~f~t. lU~ li?J II"d ,.J-' ,~ ~'" "~ I 5i t'fl i g , !l":IstflUCTIONS FOR COMPl..nl~CtsCHl!OUI.E,."F" 1. If the family (lxemptlon Is boll1g olalmed,lndloate tl1eolalmaht's nomo, eddres8andhls/hor rolotlol'shlP tp ~h(l deOOdont, EnW "family oX\lmptlol1" 111 thuremerks ooluf11nend tha omQuntolelmedln the Ql'nountool\lmn, 2, AS81gnconseoutlvo nUmbers to oaoh Item listed" ' ' 34,'" Entor tho dllte 01,1 whloh oech d(lbt was Inourt'ed end/ol' Paid, Ent~r the n~m08 01 oeohpeyoo, 6, provld,e e brlQf explenotlol1ln the r0I1111rks oolumn for eoch debt olelmed, 6, I;nter:tho ll/nount 01 oaoh debtbolnll olahnod" ' 7, The fOrm tnust be slgl10d by the persotl Who has osslHnod tlwre8ponslbllliy fOl'payll1g the dobts, "I ~?f.;i; ~ij , l~j I I ~ ~ r- ) ~ ~ " :>JF'! 1'1 ,,:::1 ;.;:;..! ,r:_1 " N ,.(Z' }3' ~ .--"~, INpORMA110N Thll dOQ~",.nt II ,Ih. NO\!Q' r.qW.dIO ~, glv.n~nd.r S'Q~on 709 01 Ih. Inn,rl\lne.,nd a.lalt T,~ Ael of le8' l7a P,lS, ..e\!on 2485),' ' If Ih, It_ I. o.ld Within \hr.. (3) month. ,ft., \h. d.e.d.nl', dtllh" dl.count of s% of \h, la~ p,\d " ,llbW',d Inh,lllInO' 1.k p,bomo' dtllnqu,hl nln' (9) month""" Ih. d,o,d,nt'. d..llh, Inte'''II' eh.rgld .t Ih. ,r'\a(lf .1_ (8) perc,nt P" .nn~mon'lh, ,mQunt of unolid III<, ISU eXAMP!.~ ~e!.OWr ' 'aMMP!.a, II. p,I,ne. of \I_du' of I~;OOO,OO I' In . d,lInqu,nt *letUI f.om 3-3-80, .nd p,vm,nl I. m.d, on S-~3.80, .Ih, Inlt,,,111 e.IQulet,d II ,ndlo'lld b.low! ' . Inltt.,1 ftbm $~30.80 \b s~R3.eO R..~II. In' " " ',c. . 2 Monthl ., ,010 ",' .",,~OJ:),yl . + '~m R,I,q)f'l~\.t'., . ' , , " l;l.I.ne, ,of ,,_, due ~". of' Int~W I ReST ,2,000.00 . ,0"35 1 ,10 ITlP,~ Add Ih, Intel hI 10 Ih.b.I'ne. of "Ia~d~., , ~"'ne. 01 lt~ d~., I~', ,Inlt""" 10 ~tt ~ p,.yw,nt (+) TO A _.n " Inl"',' to , Oat, ef p'Y!!l.nl '2,900,00 1 2~!'0 ITlP1 O,\ttnlln,' Ih, "It of 11\1""", from Ih, l.bl.b,low, BTlP a Mulllply th, p.I,no, 01 , lI~du. bY \h' r.', of Inlt...~ 12,028,10 , ""'........~ _....,;. _... _... ...._._ __ _ _ _ _ _ _...;..:..... _.. r;iioi.-:- -,;..;- -,..--'- - -...- --.- - - - --- -... - - -... - - ~ - '"!"".... -.. - - -;.;.- .I ",bnlh ,008 4 monthl .020 .7 menth. ,038 , 0 monlh. ,080 2 mohlh. ,010 8 !!lonlhl" ,025 8 month., , '840 " month. ,on 3 mOhlh. ,0'8 8,!!lonlhl ,0~0 9 monlhl ' 4S , 2 mOhlhl ,oeo , d'Y 'goo 11 " dm ,00\86 2,' d'YI ,0g3a~ ~dlYI , 0034 '2 diy, ' '.00203 UdlYl ,o.se dm ,0006' '3 dm ,00220 23 dm ,oosal ~'dm ,000el;l '4 dIl'l ,00231 24 dm .og~o 5 dm ,ooon 's dlYI ,oom Udm t20 Sdm ,00'01 'e d,y. .00267 dm' , g437 7, dty. ,001\8 '7 d.yl ,00284 21 CltYI ' 454 8 d 1'1 .gO'3S , 8 d.y. ,08S01 28dm ,or' 9 dtYI ' 0\112 '9 dm .0 3\8 29 d'YI '8 488 \0 dm ,00lee ao dlYI ,00336 30 am . &00 ,~~~_~~~__~M~_~~_~__~~__~~__~~_~~-~-_~_~_~~~~_______~_~~---~~~~~-~...~-- Any oltly In!~"r'.\, Inol~din~ Ihl cotn!!lQnW..llh .ndlh' Plr'on.lt.~r..,nl.\Iv.. nOI ..tI.II.d Wllh th. tll,' PI.I..tn.,.,n, I,,"~ ....,..m, 'nl mIl' , Obl','o,', wllh',n t1~IV (00), d.y. ,ft," "OIlP\ l!f Ihlt NOM', .. P',O,Vld'd bY" S,OIIOh 100' 01 Ihl Ihhltl~Q' Ind.,ltl' T.~ AQI 0"P81 (72 P,S, ..Q,24S11 . 'DO\)' IoW<I QIoII!CK 0' MllNIYO"DI" PAyAa"e, TOI '"IQIITU OnIJl."~, ,AOINT" ClI!TACH 'tHe .rOP PORTION 0' THUI FORM AND SUBMIT WITt-tVQUII PAvMam 'to 11011 I\IQI8TII\ OF WIl.!.& FOR THe COUN1V SHOWN ON THS RIVIRSS, ,8&1 THI INHeRITANce 1A)(,INSTRUCTlQN BOOK PO,R AClOIUSB,' ' .!!i!'2RMA TION Thllllooumlnl II Ihl Nollol rlq\Jirld to bl glvln undlr $lollon709 ,af Ihl Inherll.no, .nd 6"'" T,~ AllI 01 '981 172 P.S, lIollon 241181, ' If Ih, I,~ I. p.ld Wllhlnlhr.. (~I monlh, .fl,r Ihl dIOldlnl'. d"lh, . dlloolint af sf. of ,Ih' 1I~ plldll .1I0Wld, Inhlr!lInol T'. blOOml, Illllnquent nine ,(91 monlh,.fllr Ih" dloldlnt'. dlllh, Ihll,"1 II ehl,gld II, ,hi t.wofll. lel p,rolnl per Innum on Ihl,l,mounl of unplld "., (See,eXAMPL& B&40Wl . ' eXAMPLet If I bli~ne' of l.xduI 01 12,000,00 II I~ . dlllnqulnt IIIIUI frqm ~~3-aJl..n~ p,ymlnl II mid' " " ," on e~2~-eO, Ihl Inl..1I1 II Olloulllld.. Indlallld bllaw: ' , ' n.p'l Dlllrl1\lnl Ihl tilt, of In\,'"\ Irom ml 'I,bll biloW, lTap 2 MulllplV Ihl blllnol of , I.. dUI bv Ihl rll, of In\er,," STaP G Add Ihl InlOrlll 10 \hl b,"no' ,of II. dUI, , ' Inl,rt" Iro",'?-O(lMSO \oS~2(1~aO R.luillln: ," " , ' 2 Monlhl. ,010 ,20PIVI ~ + '~i/M RI\.Of \nllrU' '. " , IIIIInOI 01 II' due Bilt. of ,':In,,tflrft ,N eREST U.QOO,OQ ~ ,Q~\Vo- I' 1IIIInol 01 \.. due Plul,lnIer'II\O '~, of P,I",nl HI \lxlh " Inllre" 10' PIli 01 Plym.nl 12,000,00 I 26.70 12.028,,0 1 ,monlh" ,d06 2 monlhl .010 (I fonlhl ,016 4 mon\hl 6 mOnlhl e monthl ,020 ,02e ,030 - ,",'- - - - - - - - - - - - - - - - - - - - - - - - _.- - -.- - - - - - - - - - - "" - - - - - - - - - - - - - - -.. - '- - - - - - - - - - ,0eO .OU .080 --- - -'- -,- - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - -..,..; - _.- - - - -- - -,.,. - - - -- - - - - -- . --. 1 d.y 2.dm (I deYI' '4 dlVI 6 dlYI !,ldIVI 7 dlvl e ,IlIYI 9 IlIV' 1 0 dlYI ,,08, 017 .0 0(14 ,0006\ ,00088 ,000811 ,00101 .001111 ,00'38 ,001112 ,00189 11 dlYI 12 dlVI 13 dlVI 14 dlyl 1 8 dlYI 1 8 dlye 17 dlYI 1 e dlYI 19 dlVI 20 dlVI 7 monlhl a monlh' 9 monlhl ,036 ,040 ,048 10 monlhl ", monlh. 1 2 melllhl ,0,8382, ' ,0 389 '803,88, , 0403 ,00420 ,08437 .0 484 .($ 47\ ,0041111 .00800 ' AhV plr\V In Inletlll. Inolu(ilng Ihl CeminonW"llh .nlllh. WlenllrtprelerlllllVe, no\..llIf"d Wllh I~' 'PP,~,".menl .nd ......!Ti.hl ",IV objlOI V\'11~in 'l~lV (eOl dlYI Ihtr rtOtlp\ Qf Ihll NQtloe ",provided by atQIlOrl 10,0 101 I~I lnh.,llIn~t Ind 6"11' TI~ ,MIOf 1 ge 1 (72 P.Sd.Q, 2488 - 1001l; I!lAKI CHICK 0" ~ONIV o"lllR ~AVA.~tI TO,I !'RtlOtl1~R O,~ \rI'~~" AOlirt" TH8 ~6J~f~;~5~~P o~O~~~O~l:$~R~~I,S ~i:~~NFNHS8~~~~t~lt~xV?~:T~~J~5~T Ilb~KT~Me~6tjfeR6~~ WILLS PQ~ ,001se ,00203 ,002~0 ,00237 ,08~1I0 ,0 2S? ,00294 ,00301 . ,00318 .OO~~II ~\ dm aa dlYI a3 ~IVI a41llVI a 6 Il'V,' U IlIV' a7 dm 2$ Il.VI 29 d'VI 30 dlY'