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HomeMy WebLinkAbout81-00479 .' t", ~ , Li.' I'd, -j,',: ~'L" i..' "LtI,1.j ,:,!"U -!!iti~ :~\O' :~U\ ',JJ.ri '" " '. , , <;,-, ;'(r-- c:.. '~l trd' .., - -;;1: ~~~ :;-:4' t:;;.,,;j h..I\"1 1-_,,(, ,::,-"" ga l.:, .~, ;'" I I ;:, " i f!l \' ~' j' 1 g .. . .., " . ,II:! J ~J ~ '.. .' OATU at' SUI)SCIUIIING WITNI(SS , COMMONWEA\.TH 011 PENNS,<\..VANIA I 1&1 COUNTV OF CUMDERI,ANO \ j' This" ,,', . 3'";r." "..,...-duY 91' a"L14"'-'" '. A.0,,19 6~ , boforo mo, Roalstcr for Iho Probulo'of Wills und llra~lIng \o\\orl of Admlnlslrutlon In una for laid cOllnly 1,11' cumborluna, In Iho c9mmonwonllhof ponnsylvanla, porsonAIlY 9umo_,"" ,. ~OD.J.'t._-J_t_ TI'~,~. ..1lII 1:J,ia. s. _ ~1.11.l' ,. Ihe sllbWlblng wllnoSl08 10 the fQrollolng 1I1slrumont of wrl\llIg PIIl'portlnll to be th~ lasl Wl\land T 4slumoll19f -- . Inte of 'f'1.I~t~N.._.~nTII~TrrR. B9!ld .ot Yaw _n..l.m."'a~" DUled _ '" W' ,+ ~7 I ] 919 cumberland CounlY Pa" dooealoa whQ, belna dilly t.h.y v':r. prosonl. alld SllW und hourd Iho tost~~lO~l! slllll,soal, pUbllsh,pronounoe ulld ~oolnro 1110 suld .VOlln aooordllla 10 laW, dopose alia lay" Ihul ~A,]m& G~i.tw~~t. Inslrulnonl9rwrlllna al lInd for h'lO TestAmonl and L.asl Will, and nt Iho limo of 10 doln, '.~. WI\S ofsountj aM dlsp(lslna mind momory und IIndorsll\ndlna, 10 Iho boslOf knowlcdae,oburvl\llon I\nd bolioI', au1' '''Ol'n to " _I\nd subsorlbed bofore #~', ,'~"':S""~; ," ' Gt.'o.J: ~',~.j RoalslOr AfflPAVIT of pEATH C~~,1MO,NW,eAL TH,' OF pe~NSVL. VANIA t SSI ,CO!.lNTVOF cUMBERL.ANO ~ bolng dilly ,tanltYllhU'D!il' Jl'. $IIYs Iht\1 l\$ noarly 1\8 041\ bo asoorll\looo,lho 8,1I\d dooodonl ~h.l.. Gui.twhit. dloll on A,P,,\9.JU.., ~u..4"1 ae~h .t"'1 Iho day of 1\1 or aboul . SV9l'n to '1tO~ .o'olook. ",. M. , ands\lbsOrlbodlhls .J~ day of' a<'*4.-(~ '~,.n...c~ . ...., .... ~' . , ) .,. ',' "',,'~, 'tI,,', ;2",:-r<,~,-", Roglslor . . .? . -- " 253 .... No.21-81 ,1',9 .paTITION FOR PRQI3ATE OF WILL AND LeTTERS TliSTAMENTARV In Ihtl alllllle 01 ~QIWll gQ~8'1'Wl!r'l'l Ideoelllld, 't9 Regllter 01 WillI lor Ihe Oounly,ol oumtllrland,ln Ihe Oommonweallh 01 p,nneylvanla, .. p,tltloner(ll,l. (MI) the eKeoul I'M ""med In the 1..11 Will and T..tamenlol 'Thlw O~l.~,l;la,~ll, ".dated' ~"Il\'+ 1'7t \I , ~ 919 Ceoeden,t wee II oltlzen ql the Unlled 6tlltll and a rllldent 01 " t.l~..q.l"l".'" ~*' ~, (BOrough), OumberlllntlCounly, Oommonwealth 01 penneylvanle. Otloedent dll\:l on Tu.~*y the ,Atlt dlly,ol JIlJ.f, A.O. 1~,...lU..-lln Ihl .' g~~~~~~:.(ti..~i):~~:rrl~d andtEhe' S~~:~ ~~dot'l:r~n born ,~t~e:~;.ir'lnlZI~:Il~:: .qutlon of Ihllabove de80rlbed Will, " Oeoedenl Wall pOlle,..d of per,onal properw to Ihevalue of, \!n..+.hat.... . and 01 r.al eetate 10 ttie value of n,~...t.,,;....aA ,,( II nellr .8 olin bt aeoertalned; ,.Id relllGalatll elluated alllollowe ~ ..'. ,542 BI':I.cl.~. f1u,Ji'lt Owab'l'land. ,.~~. , .", ' ',,', · ' ' Tharlllorel your pelllloner(l) rellPeollully Ilpply(leel 10,r Ihe probale ,of the 8ald ~.et Will and re'III' menl.and lot l.e,\lI" TeIllamentllry Iheron, . oal.dtl-(/f/./J~ \~ /C;:~? . N~~~:~,~~..iJfIiI~ " - -1- . ' 9QMMONWI!AI.1'H OFPENNSVI.VANIA l OO\.lNTV OFOUMBERI.ANO .~". III ," .. .~". ~~. na"1f1d In Ilbevlepplloa\lQn, being duly ~rl> acoordlng lelawuY(llthillhll &Ialement, 811t forlh .In Ihle pelltlon .re true to Ihe b,*,of ,hi".. "knowlldglll'\d blllel" ."lI'R '11__ anel IUblcrlb,d before ;~~~~,~ I~~ ~ , - 01"" t/' " ~~ , Fllld: August 4. 1981 Attorney . U,rrt J. Tl'aol. Ilaq. r..g.~.t St. Ral'r1lbuI'll1 P. 2) ..57"") 1101 Wti5.Y.l..YAN.Ll\.1till!~lIIANCIIl.AX GI;NIlBN,J.MLQJ1MAJl9!! 1. P ,S S SPONSI DLE FOil RE UllN S~otlon 70\ of Ulolnhorllnno9 ond Ealoto InK AI:t 01 1961Plt,vldos Ihat Iho followll1M pOISOIlS shulllHOpOIO alld flfo 11 return: ' " 11. Tho POISOnnllolHosenlnUVo 01, \ho,JIslnlo 01 tho dooO(lolI1 us 10 IIIOllully (If tho dncndmll ndlllllllslnrod by him ondsuoh oddlllonollHollolly which Is 01 lliny,hn slIhjo(:llo InhurilllllCO Til~ iii which ho/shn shall hovo 01 acqulro knowlodgo: b,Thetronilferoo of IHOpurlYUI101llho lrollslor 01 which Inholllnnou Tox Is 01 lllilY ho IlIiposod hY tho 1961 Sln\lIlo, Including 0 lrustoo ofproporty trnnslorredlll trllsl, I!lovldod Ihnlilo sopnrnto 10hllllll0011 ho 1I111(In hy Iho IllInsloroo of proporly Inolodod III the roturn of il pOlson1llllllHosOIllnllvo. . ,. ~. f,bACEFOR F.111~.Q The return ,!s to be flied In dupllcato with the Roglslor of Wills of tho cOlllity whoro,ln tllo docodont rO$lded. 3, mlE FOR FILIN.9 Tha roturh,ls (llIe nll1olllol1ths aftor the decedont's, doolh, unless,an oxtonsilln tor filing hos poon aPllllod for and gran led bY' the Secretiuy of Revenuo wlthlnlhe nlno-lIIonth porlod, . ... 4. ~ILE RErUR~ Section 79\ of tho 1961 Statute provides 1I1al " . . .any person who Willfully fnlls 10 1110 a loturn or olller report required of him, ,.shallbe porsonally Ilablo,. .to a penalty of 25%QI tile tax Ultimately found to bo dllo or $1,000 whichever Is the losser 10 be recovered by the Depnrtmonl of Rovonue as dehts of,lIkearnounl nre recoverablo lly law." ij.~ , Ifiherl\anceTI1K,l,S payable ,at the rille of 6%,ontra!lsters 10 linoal desCGndnnts, such as father" mOlho, r, Ilusb"nnd, wife, , son, daughter, grandchildren, grl1ndparent, son-In-law and dauRhlor-in-law And al tho ralo 01 15% as 10 all othors, 6\~ ThetaK assessed ol1.the transfer Qf property repotted In01e relurnlsduo 9 Inonthsaftol the dooodonl'sdeath. Intatost at, t,he ,tatoo, f6%,per annu,m accl,uos t,here,ofter unt,llllaymO,nt 1,8 mlldo'AIII,lnYI\10n\s received are f1rst,lI\lplled 10 en,y, Inla,re,sl,whl0, h may ,bodua with an,Y,',remeln, derapp,I,'ed to, t1la taK, IF TA.X ISPAID,WITHIN3MONTHS AFTER THE OeOEOENT'S DEATH, A OISCO~NT OF' 5%PF THE TAX PAYME~T IS ALLOWED, . ~J~~~~:~k'~~r~~l10 brh~'r~elde~~~~I~al\~n~~~'I~~ab~~a~II':ll:n i~\h~e~~~I~I~.whoraln tho decodoni rosl dedand ate , ' 7. tAl,\,VBE,rOPAY '. , ~h:t~~~~\I~~rnsl~dre~i ~ao~l:rb~~~l p~~~l ~ti~r,~ t, ~h~~anXO~r~l :Y'~~1 s~~~:l f~~a~~~~fs~r~ly~~~~I~ ~~~I~[t~n\6n11~ JI~:J~~~\, r,nslll Qslate orAAalnsl any property belonging 10 a Iral1sferee,lIable for Iho tax. ... , .6. F.ILINGOF FA~SE RETURN ~~lP:{~~O~~o ~~II\'W'I~fma~~r~~~:~~~:~\:ld:l ~I: '~~l~llc;ro~lili~~lr~Jr',ll~~:,llal;~ ~~I1~~~~~~a\~~~~1 f~~~t~p1. ~~~O~dm: $1,000 or undargolmprison01enl not exceeding aile year or both, ,. . -=-= .\ j' , ;" ,\ "C1 of"6t,,. g. Conn-o,. ,E3 1/1' "ARfCl't ''tIU''''' OAMP, HILL, I'INN'Vl;VAHlA /FOIl w.o,,~ 'APPRAI8AL. CF THIYAL.U~ QJIl1\Tlno~tl'Bl Port Mt,D. J. 'Shupp ~l6 Rb.emont AVlnul, NIW Cumblt~aria, PA ~7070 1 herehy certlly thnt I, hRye personally ellal"lned the property doserllied,al alt' Sl:Oty, sin'il~1 'llmily D\oi81ll.nv ~nd Dtllllohld :1 eu a.ravI; Sl.t:u.tI41 1142 atid;- IIttllt, N_W cumbetlan4, fA and It 10 lilY ol1lnlonthM tho value of ultll1roperty a' of Ibe 28th July A.P, un II ' ''l'HII\'l'Y''JUOHT 'l'HOUIIAND ..,., .""';" ($3S,OOO).;... It.... .pOlf):.fIlt8,'" " ., _J,"" , -,. ,- .' " , ''rhe 'property wal appralled aa a whole owned In fee II,"ple and unen:~ul)1bered , by any Indabtedne"" , '" ,,' ' " ' , " '" ,I further, ~ertlly that I have uo Ilreaent or~ontelllplated f~ture Intero'lt ,\ri:tho " ,prollerty appralaed or tho rellllt 0(' thla aliprnllal and that thla' apprall.,\ Will made In" conformlty'wlth the Itandardl of praotlco of the ^nlOrlcan Inltllltte ,of Real Ibtate A~prallofl, and tho' ,Soolel)' or Real 'Eltate Apprallefl, of which I ~l\1 a Il\ember, . . . The 'American Inltltuto 01 ROllI !tltate App,rallefl conducl. a voluni~ry pro~rall\ of continuing edncatlon lor It I dellgllated nlembers, MAli anll aMI who meet tbe mln" mum ,atandarda of thla program are, awarded per,lodlc 'educatlonal cerl14ca~ldCI, I am cerlU\od under Ihla program Ihrough December 31, 1983, ", , p" Ie ~J.ti;~: , ;- '--:]q , LIMITING ,',OONDITIONS d"l Tht a~lnlall 0.1 valu"xpr,siOd above Is Ihe reoutl oland I" .ubJtn 10 the data annon. ::: tlone desorlbod In dolall n 1110 ~OOomlllnylll' ropOlt 01 ' 3 " ", n.....', " No t..po~slbl\ll~ II U1unlOd ro.r nlOllI/I 0.1 a It'" nftlurt concernln. tht, appreli.1l ' psroWlfb r:.tfon~u~t)\o'~ rJI"~~~~~la.\,la 10. be u..d In conJunotlan wlit\' tnQlhor .pjttla~l; , lIeh 1111 reod,n It Inva Id.' . , ' .....~ I ,-, ~,",~"""N'",,,"'~,""', ~~.....)..1 ~ MAIN OFPlca 331 BRIPGE STRGeT New CUMBSRl.ANP, PENNSYLVANIA 17070 BANK (7171714.1000 blRSCT Q, N. II"'N"', N...., TOI . lUll Xlo.to . ~~a 01' Peo,dent . . ,'rhe t'0:L:1.ow1ns 18 a. oOlllp1ate reoor\\ otth' o.'bove l\eolll1\lI\t'. ..ooo"n~~ "' 01' , p"te at neath ~.Pt Aooo\lht 37,"+"01. oart. 01' naPoll1t $'~OOO.OO 37'"15502 oert. o1',Oapodt$ 5.000.00 , oertiot' pepoeit ,$ 5,000,00 37-"13470 oart. 01' l;leposit II ,.000.00 Olltti or Oepodt l',l ,.000.06 , Dl!:te 01' Death Aocrued Int. - $ 8.34 (l 8.34 ~ 29.17 $ 29.17 Q 6.a, N~etl on AOOQ\lht ,p"t. Qf creat10r. (M:\. O>mllve) .' ot.101nt 1 The1.ma. Ou1etwh1te EetMr ShUpP Th.~a. QU1etwh1te ID.therShupp 12/IU.!76 12/21116 Thelma. Ou1etwh1te De.v1d t.. ShUpp, lMl/n 'rhelml\ Cl1,lht1'll\1te Da.V1~lJ. ' Shupll' ," 'rhelml\Ou1et~h1te. IDllther,Sh\lPP 10/1/75 8/2'/77 G. LI ,MtuhVIP. .,'",' ".', " " '".A"~hor1IBd 61l\'n'~turo IlrV.46a LX-t (lO-tlD) COMMONWEAL TH OP FENNSnVANIA DEMRTMENT OP REVENUE TRANSFER INHERITANCE TAX RHSIDENT oecaDaNT SOHIiOUI.E "0" Bl!NF.PICIARIES (lnatrllOI/tlllS on Rovorso Slrltl) r , - t~.' ,~{", Estate of ftt.,.~_ l1t1~.twhi in. IlSNI!FICIAR,I,I!S ANO ADPRl!SSl!S RI!~ATIONSHIP SURVIVeO DATE OF INTERa8T OF BENEFICIARV OEOEPl!NT BIRTH ..the!" G. $)1l,lpP liliB~er --..,lu.- -- Llnl v, nf '''JtI~ . .~ .-'- - Ill.~ -" . , qlt2 Bddlr' St.. NIW --- "IW OWllblrlan4 , Pa. 17070 , a"ioblrland. 'enna. li! Rlmair\d.er liar ~i -... .... ..- Y... T.......1 ~~ of 1,,),6 ~ntel'l.t 1I'All " lilt? Bk'idlrl St.. NIW ".w OUlllbulan4. fa. 17070 , P.. , , , . v.. ., Ii.!' n.. , , GI'!U\400N,phlw Yes Lual Ooins - "nl. - . , 9!lO WaJ.Q"t Stk'lft ~ Philad!.~phia.__~a. .12.+'0..7-.....__._. ...._.._~-'--_..____ __'__'_~'----__.'_n_ -.....-...---.------ -------------,_.- , Solid... SI\l\1l\'l (Sblllin) ..Nhll. Y.. " Llftl AlI1lthy.t Ring 3OP., N.S:I,xt~St. , , , " S.rr:l,abu*'81 P.. 17110 , , " , -----~-~ --------~.,~,...."...~-_.._...-_.,.~ _...___~..1.~_~ ~.-..----------------~ .~-.....--* ._---.-,~, .. pianl Jh\\PJl Clrand-N:Ltoe ~(~ YI. .~_ .._J..l!8~L__ c-~_He~i.\llllIJ~~r!'.\I. --~-'--' -- ----".--.. ..-.... ._.._----~-~ ------., 'l~ 10"Iil'ollt Av.. Bl'Ilolbt Naw O\lllblrl~. Pa.17070 " , , ......--...--.-- Gayll Hora." oranll..Niloe t.. Lt,al --- .;, Lars. So....b Braol" --c- .. - B.c>kDrivI let - - J)a"ph:Llli Pa. 170~,8 , " Lliah B.th , Grand-Ni.o. Y'B LeP! 1 SllIall Scl~U'eb Braoe. XlIII.ton _ )2It,Pille str..t , l.t PIi. 1"11) "c Shelton. , - , , , The abova beneflolerllll ware living at tha tlma of tha decedant's death except for tha following: NAM~ S~ %rllI. KillS.toll..Siet.r St..ltont Pa. 1711' lJA'rE OF DIlATH No....mb.r lltl 1919 If addltlonallpaoe II naoallaty, ule BW' K 11" Ihoott, " \WJ3UCT\2t'J8 FO~ COIVli'l.l,i il'i~i tiGiliolJUl.l.: "I.:" Sahedul, "Ii" mUlt Inelude all prllPorty, roalond pnrs()n~l, ownod by tho doaodont jointly with anothor party or partlas allolnt tanaml with right 0.1 survivorship, Both tanglblo and Intonglblo proPerty ora to ba Ineludod, L.lat real ostato first, " Posarlbo all r,al property aa Indlaotod In tho Instruatlolls for Sahedulo "A", Dosarlbo all parsonol property allndlootod In tho Instruotlons for Sahodulo "B", Inaluda tho nama, addro88 and rolatlonshlp to the ' deq,dent of tho oo,owner (s) and tho data thalolnt ownorshlp wel establlshod, 2, Indlaata the total market valuo of tha)olntly owned property, 3. Indlo,ate tha parcentago of the daaodont'a Interast, j',. , . 4. ~ ... Indicate' the market value of the dealldent's Interalt. t ' ~', ' "j, t" , if:' i ,., . ., j" ., . 8 " g .~ ^ ,~ 'l: , . II': Z ~ 'm ,~ 0 .. ,p, i ~ " , ~ 0 '1'1 ,-, ..... . i Ii , i " " . . ,f', '" .. H .. ,",-t; ~, . 'fl .. "', ',I , , '-P, . ",~ . . , " i.. ':'-, '~ , :~ ~.. . :iJ;: . , . 'i":l ~ ~ ~ :z: S ~ . Z P I" .' ,\ ' " '...: . '" ,1 ,; I' " " ;. -'.' , . .. ,;" 'f ,r.,";' ,1 I ., "J' ;:" . 'i ii', , ' , " i,' ,; , , p I , , ,It .. 'i ,I .. '" L;:' J 'I, " ~l,lI\jONI'~II\Lli! l}\; j'l ilJh,YI8ANIA DUI'IIIrlMIiNlllF I(~V"NUH TRAN8PUn INHanlTANOU VAX nl8lDQNT call.DDNT I3ltete of ,'.L'Hl!lLMA au+S'l'IIII~~E :rl!M ,c .lO, ., "/0. '-'T. DBSCRIPTION lli:<HllIJLi"I:i" ,," JOINTLY OWNijP PROpl!RTY IIm/rllot/OIl' Oil Rovurle Slt/ol OIP OONIl,N., ^. ..;W":~"170 .. 10/1/'7~ Joint with'IlIlVid L. Shupp .. Grllnc.\..Nophow' olD OONIlIN. A,.. '7"'169139 8/a,/77 Joint with ~pthGr Shupp, Siotor s.v. Mot,. CONlh ~. ^. .. 001000.596...5 10(241 6 Joint ,'(I:l.~n, Mro. EIther ShUpp and Mro. Nollio Nelson.. Sht'rl ," ,. TOTAL P\ VALVE OP paPARTMSNT MMKI31' PIlOSPBN'r'8 ~AI.U~TION VAl-I)!! INTBREST (0 f)o(lll , '0 OnIV) '029,17 V, 2!51/..,8 .5006,2' ~ a50'.~, 6067,~.5 1/~ a02a" ~~ TOTAl. THIS pAGE . 1,040,16 Orand ~otal 02~!169,6~ - '1 (J Jl&./r; ~~ 11()~:A~tJ nUY'4.1 uxt 11...\ COMMONWI:l~L TII 01' Pf;I~NSYLVI\NII\ INHERITANCE TAX DI'''I\RTMENT OFIlEVENUI, APPRAISEMENT TRANS~RR INHURITANCa TAX, ' RIIIDII~'l: 9lfillDBWT , ' ' ',,' I!IORIGINA~ L1 SUpp~eMENTAL. - e.tate of ---tl1aJulll. QU~Ilt,;wbit,;ll.---..n_-'_---'-- Pile NO._n_....gJ~lU!"Qit1iL.n....H..-.__H....__..- Co~n ty O!,\llIblll"lQl1d Date of Daath ...IW.f-28.,-1.9111 In tho 'V'At th., .ny futur',lnl.,..t In!hl,', ..tal.I',H.n.f.rt"d In p......I.n.' .n,loym.n! t. ..II.I.,al .Ii.. Ih, d... .n'. t.. tho ..pl,.II.n 0/ any .,I.to f.' \If. ., f., y..", Iho Comlll.nwo.lth ho"by ..p"uly IOurv.. tho rlqhl la .pp,.I...nd ...... H.n.f.. .. . I . loW I. 11.1...1 .10 on IIn .u.h fulu'o Inle,..1 ' F'ROPl!RTYNOT INCL.UDEP IN ReTURN aUT APPRAISED BY THE ,COMMONWEAL. TM -.-...............-...-------...... _.._~ - , ASSET SUMMARY DEPARTMENT'S APPRAISED VAL.UE -- - ,. Tot,o' R.oI P,op"Iy - ICH. "A". . . '" $ 2. Tolol P"'onol Property - SCIIo "8". . . . $ 3. Totol Jointly Owned Ptqp"ty ,;,ICH. "B" $ 4. ToIol Trori.fe,. - Icli. "C". . ." . I .. $ 11t5~!5.71 14~t~e4.'11 e9 t 160.63 l>JmJl\1 Untep.rted $ , Unrepolted $ Unreported $ Unreported $ $ _ 11, Pi~Pi. '1.1 $ ~3a!t, '11 $.$ , 11\0, (,3 $ ~QtJ~ 186,081.05 L.IPI! I!STATI! ANNUITY , TOTAL. GROSS ASSETS ReMAINDER ~- I do htttby ,o,rtlfY thClt,the aboyeappralsemant Is made In conform with Pennsylvania law and ho. been filed this day with the Regilt" of Wills, ", .~. November 6, 1981 D"tt\: TOTAL. VAL.U& $ 1. 1,"/",. I.,', ....., t1. p:roP'rl1, ,4f!, Bridp &t....t, N'w O\llllbll",ll.ll4, P!l-.Jfwo · ....U11 .to17 ,..... dw.ll11l1 . Lot " + Ie 17' +. Apprabtel..t 1,0,000.00 11II - _ -, Cub 888 ..... .. 1,.* If A (OapUal St/)Ok) . l~ 6, ....... PN (oo-oA Stook)'" 16 5/8 254 A.... .ClNJboUllll (00\IIlI0A "ook)'. 16 ,/8 220 __" VDiro1*l p(OOlllllOn .took) .9. obMld~1 Aoot. - oau ,.... ItA'.. )48.oa40-' ..'ri..... Aoot, . "I~",A, OOl-7f709,..4 ..'ri..... AO\lltl. . oQm ... N.A, 001-7lil?O'1"" a.l'll, 01 Ptpollt _ 0ClQ.1Mk It. A. 18-30,s1 Clen, ollltpit .0Q0i ......A, la..)17flo. OIl'll. 01 ~OJlt - 0Q0i l$t1_ ".A~ 18-,)27) aal'll. 01 Dtpollt _ .. ... II.A. 18-)4092 aal'll. ol~pOtd.t . oau ... ".A, lJ6-119886 Clen. 01 JlI>>oalt- caQ)\aIlk ".A. 56-119887 1(11.000.00) I$IoJld. tQ.6'~a?6 . 1 (11000.00) . .. .. 16):/IOa?' R 1 (1100Q.oQ) . Ioall .. '16':/IOa?~ · 1 (11000.00), .~lMlM 16):/10279 R 1(11000.00) .. ,*' M:l.6,:/I0218 . 1 (':l.QO()~OO) .~M .. l11to9966 . 1 (11000.00) 11014 M 16):/10271' 1 (IJOO,OO)'." D 8a69029 . 1 ClJOO.CX>) lloJl4 D8a690aa It 1 (llJOO,OO) II,.... D 11067904. 1 (IJOO,OO). ~ D 110~790~>> 1 CIlICO,oo) I 801lll D 91:546aO II 1 1IIt;!.1 0pI1 ti~ .:1. IfIIIll ~'~1lI (00.-.1) 1 Cfwoo4)1....>. ... 1 Ntl..aolcll~ 1 Di......101f.tlt... 1 81111 1)1___ IIUI.cl 1 Ioaft\> "'111' C~) 11<< 00lcl 1 Soarab >>raoelet (Medium) 1 Soarab ~rao~let'J(S~all\ 1 OalHornia. Gold YJ Gram Clo n 2. ,. 4. \ ,. I 6. , I 7. 8. : 9. I' I 10. I 11. 12. 1). 14. 1'. 16. 17. 18. I 19, 20. 21. ,22. 2),' 24. 2'. 26. ~. 28. 29. I ;50. )1. :112. ". I )4. ~5. ;~: Invenlory ollhe real and peraonal a8\ale 01 V"'~ (Jl1A~IItU __..._._ deaell88d ~_ .........,.._...r...___...._ . .... r___~___""~ _, 111.,,'" 71 ,. . );l.' 4, 9)a4 00 ' 1(6) u 1il'!86 2' ~~ 00 7046 70 ;L2,~ 81. 11,'1' . Jl 2$.804 l' 10,)90 )9 ",184 " 14,8:52 J8 1"'2 09 ;LJ1+2 09 1000 . 00 1000 00 ,1000 00 1000 00 1000 00 1000 00 1000 00 ,,00 00 !JOO 00 !JOO 00 !JOO 00 ,00 00 1:/10 ()() 17~ 00 700 00 22' ()() 7!1O 00 J!IO 00 ", 60 _l~S " . 9ENE~AL INHERITANCE TAX INFORMATION Unsall~fled lIabllltlnlncurrod by tho decodont prlot to hls/hor doath aro doductlblo agalnsthls/her taxable ..toto. In addition to dabtslncurrod by tho docodont or ostato, othor 1I0l11s aro clalmoblo Including the CO,lt 01 administration, attorney lees, Ilduclary loos, lunorol and burial exponsos Including the cost 01 0 burial lilt, tombstone or Iltave marker and other l~!Ated burial e,xponsos. ' " All debts being clalm'd ogolnst an ..tate ora subloct to tho apllroval ollho Raglstor 01 Wills with whom the Inheritance Tax Raturn Is Illed., I!vldenco.lo suppurt 1110 docodent's or tho o.tato's lIabllltyJor the debts being claimed should be attached to this schedule" , , A lomlly exempli on may be clolmad by 0 SPOUIO 01 a decedont who died domiciled 10 Pennsylvania, 1/ thare Is no SpoUIO/ or II the SPOUIO hOllorlelted hls/hor,rlghts,thtn any child 01 thodecep,ant who Is 0 momberol tha same hous,ahold can C,lalm the oxompllon. In tha ave~t the~e,ls no such spoUs' or child, the~xlll1pllon, can' be clahllOd by a partntor parents who ore memb'r,ol, thOlame hou.ohnld 'lis tha decadent, Tho lamlly exemption Is allowable only og~lnst o..ets which pas, by a will or by ,the,Pannsylvqnla Intelltate Lawa. ' NOT!!I CompeCllQtlon paid toanutalorepre..niatlve/ nqmaly, anexecutotor ~dml"I"ra'tar,>lor services perlormed In apllllnlsterlny aneltatt I, reportahl, far Pennsylvania Income'Taltpurpn,s.Thls taxahle Income I tern should ba, raported on lorm P A.aD.lndl v,lduallncome Tax Retutn. " .. ~ i' . . " r;' Ii,! r' 'C (4, " ",. i: '" :;..:~,:~ L , N ""' _1 >'.--" ~~~ ...-t_ ,f.--:i'c' "I 1\\:' ~4" I": Ii! ~ (".lIl,) ,--tri ~I~ffi ~ r.la ,Ii.! fiO 1M i:l ~ .,~ ~" ~ ','~ ~ . '. :,~ , ~ ~ '~, J,l el,' $! m ~ ~ ~ , ~ ~ " ,! '2 i " .=1 ......, '", INSTRuctiONS PO 1. II,tho family axemptlon Is being claimed, Indicate the ola'l\11ant's name, add res. ana hls/heU.lallonshlp to th, deCedenlt !!nter "Iamlly exemptlan'l In tha rel1\orks column and the ol1\O,unt claimed In the al1\ount column, 2. AUlgnconlllcullvenumbers to each Itam listed. 3. ~nt.f',the dolt On whloh each d.bt was Incurred cnd/or paid. 4,/ IIn,t., the n~mesoleach payee. , " , , " S. Provide a brlelaxplanation In tho remarks column lot eoch debt claimed, 6, Jhtet,theamounl ol,each d.bt being claimed. 7.' Tht lormmust b. signed by ,the person who has allumed the rosporialblllty lor paying th(debts. IF ADDITIONAL SPAce IS NECeSSARY USE BYz" x 11" SHEETS. mp.QUMAILQlL Tu 11111!r. l>!ollUr olotlll '0 ymlr aU,C"IIrIl, 11\11 "!"110 01 Iho .81010 and 1110 numbo, al)Oul~ bo cloorly prlnl. ud ol1lho uhock ur nHlnoV ",dor, Thll o.,t"81nOIil I, ,nadt' In IIccordanotl wltl1 S."ti"" 700 01 1110 Inhorltonoo nnd Eelolo Tox Acl 01 leOl ria p,e, 0 24"0.7001, , T. lh. .,11111 Ihel Inherltanco lax la polll Wllhln Ihloo 13) munlh. 01101 Iho <loolho' tho 1I000donl, II dl.oollnl 01 llyn 1011)Oloonl I' ollowod 172 r,e, Y 2486.710). Inhllltlnol To" olhol Ihon tll( on e fuWlo l!\Iaroa!. I. dlto .1 Iho dOlO 01 11,. dooodonl'e doolh and bOOOO1oe daltnrlull\! el tho explrollon 01 nino 19) monlho nflor Iho dooodol1l'e donlt' (72 P,S, 9 2480.711). Inhorllonoa Tn un I luIulO Into riel 'Ie puyoblo wllhln Ihroo (31 momhe altol Iho ,llanefor lokl'a off 001 In ponoeelon ond IAlovmaOl Inti I' doltnquont Ih.ronllol 172 P.S, 0 24QO.712), Cnlculnto InlOla"lrom Iho dollnquaql dlle el)OWn 011 the 'ooa 01 \IIIW IUlm to Iho dote 0,1 aolllel pnvmonl ullng tho following Inloloet labia: iIIM.__..u'.._.....~..._..._... ..........._.... ~_....__.........__.... ---.-... - h ---.-...- ,.. - ..,;-- - ............ ...... -----..- -.-...... - """.. -- I manlh ,008 4 monlhe .020 7monlho ,035 10 monthe ,080 2 manlhl ,010 6 monlhl :028 S m61\Ihe ;040 1,1 monthe ,088 3 monlha .0\6 o montha ,030 o monlh. ,046 12 monU,a .000 I dDva 00017 11 dove ,00106 ~ 1 dDva ,00382 2 dlVI .0003.4 12 dey. .00203 22 dove ,00360 3 daVI 00061 13 dove ,00220 23 day. .003.08 4 diva ,00088 14 dOH ,00237 24 dove ,00403 ,8 dlY' ,00006 18 dO,Ve .00260 26 dove .00420 8 dlVI ,00101 18 day. ,00207 26 dove .00437 7 daya ,00118 17 dove ,00284 27 dove ,00464 P dDva ,00138 18 dRye ,00301 28 daye ,00471 II dlya ,00182 10 dovo .00310 20 dove ,00488 10 daVI ,00180 20 doyo .00336 30 davo ,00800 ,- ., ..._ _t.;............_...._......_................... --....-...-..., ---...- --........ ---'- --... --... ----- - - --....-..-...-- -......-..... Any IlnllV'ln Immoet, Inoludlng the CommonWD.llh and Uw pOleonel roproeRnlellyo, nol htleflod Will' thl Dllaeamanl mal' ohlool Ihelolo willlln IlxtV (80) dove Oftol rocelpt 01 Ihle Notlcn a. plovlded hy Seollon 100101 llle Inllerltlnoe opd ~e181D Tex ~Ol 011061 (72 P:S,~ 24,08.1001). Make o\\eok or monoy ordor pavable to: "Ro,lllstor of Willa, Agont" M$II to the addross listed below; COMMONWEALTH OP PENNSYLVANIA PEPARTMEN'f OF RI!VENUE BURBAU OP I!!(AMINATION OFPIOIAL NOTloe OP INHERITANCE TAX AS81!88MENT - t:' I - I.j')( -r'; ('r .' I ~~")~ , ".J _ ..,. ' DATE U} I , ESTATE PILE NO, COUNT'! DATE OP DSATH , Apptaleed Value of Eatata: Rul hl"a Pat,onal ProporlV . + Jolntlv Held ProparWIT,.n.far. + Total Gro.. eS",. . Total Approv,d Oeduotlon, Claar Valua of Eatata . La..: Approvad Charitable Exemption. Claat ValUa pf Uat"e SubJaot 10 ,Tax . Amount Taxable lDl 8% R"e . tax due /Ii', Amolint Taxebla lDl 16% Rate lax'dua \" TOTAL PENNSYLVANIA INHERITANCE TAX DUB . " " · " .'. A flva patoanl dleooun\ totaling ~ Will! be gtantad If' the Inharllanoa Tax " peld bv La.. Ctedll,: OAT&. 6p FA YME~T )( ~..:\O ....k.r AMOUNT PAID DISCOUNT INTERBST TAX CREC1!L. .'t{"k$. I}? +, . . . . . I-f &.5'. '7 7 + . + . . I",,,e.\ aOOtu', " the tala of alK (6) patoant per annum on Iha unpaid' be lance of, Inhatllenoa TeK f,om \0' dala of jl'Vlnenl. Inl8,oat dU8 If paid bV 18 llAI.I\Noe OP peNNSYLVANIA INHBRITANoe TAX Due HU,'.!!,w,n 01 WiLl ,; . )9K; . f.I. J'..5: . 7 ? lli.E.ORMATION To Insure proper oledlt to youloooount, 11.0 nama of Iho 08lel0 e~d ilia number ,ehould no oleerly prlnl. od on Ihe ohaok,ol monay ordor. This 08888emenl la mede In 'eccoldel\Po with Sooilon 709 of Ihe Inhorltenee end Ealale TOK Aol of . 1901m P,S, 6 ~40B.700). To Ihe eKlenl Ihal Inherllenee leK Is peld wllhln Ihreo (31 monthe after the Qealh 01 Iho dooedeAI,' discount 01 ftve (BII>810enl Ie elloy.'ed (72 P,S, 6 248B.710), Inhorlteneo TPK. other then I.x on e futuro Inlel08l,.ls duo 0\ tho deto of IIw dooodonl'e dooth end becomes dollnquent at 1118 eKp1rellon 01 nine (91 montha .fter \I,. decode nt's d.81h m P,8, 6 249B.711), I,n.herlteneo TaK on e fulure Inlereal la peyeble within throa (3) monlhe efter the \renafer tokes .Hecl IA po..e..lon and tnjoymont and Is delinquent tharoefter In P.S. 6 2486.7121. Celouleto Interest from the (Iellnquont dete ehown on Iho leoe of 1,~le 101!" 10 tho daIS of eOlual peymenl using Iho lollowlng Intaresllabls: ..................-........,---.........---.. ...-........----... -.-.... ---..... -........_---...- ''','' -...-.,.. --- ..--------.......-..... - -- ....'.. ,1 monlh ,006 4 monlhs ,020 7 months ,036 10 monlhs ,080 2 monlhl ,010 6 months .028 8 monthe .040 I I monlhs ,066 3 monlhs ,Ole 6 months .030 9 monll18 .045 12 months :000 lidaYI ,00017' I I deys ,00196 n deYI ,00362 2 daYI .00034 12 daya ,00203 22 days ,00389 ,3 dlyi ,00001 13 doya .00220 23 daya ,00380 4dm ,00089 14 daya .00237 24 deYI :00403 " 6 deYI ,00066 18 deye .00260 20 days .00420 BLd.YI ,0010' 16 deys .00267 26 dey, ,00437, 7 deyi ,00119 17 deye ,00264 '27 deYI .00484 . 8 daYI ,00130 16 deYI .00301 26 daYI ,00471 8 daYI ,00162 19 deys ,00311,1 29 \laYI ,00498 10 daVa ,00109 20 deys ,00330 30 deye ,OOBOO .......... ......_ .....__..._ ..._........_.._...... __ _ ___... _ _ ........... ..:..:...... _... _ ___ _ ~..' _.._.~,~'__ _ _ _.. .....;..,......_ _.....Iioo!.....~ ... Any pal\V In Ihlaloll. Including Ihe Commonwealth und Ihe poraonal repluenlu\lve, notaollllled Wl\~ Iho ,"8Illmonl mlY objeat theretoWllhln elxly (601 deye after reeelpl 01 thle Nolleo .1 provldod by 6eell(>o ,,1001 oflhO,lnheritence end E8\81eTaK Act of I eOl (72 P.S. 9 248,5. I 0011 Make ohack or Il)oney order payable to: "Regleler 01 Wills, Agent" Mall ,\0 Ilia address Ilsuid below: ,. HCC."~ \9-681 COMMONweAL TH OP peNN5Y~VANI" DePARTMeNT OP ReVeNUe BUR~AU Of COUNTY co~~ecTloN5 APPLICA TION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT '* _,,' ~ ......~_.,~__".~._,"...._~.L..~..._ .,_~__.._ ~ (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVeNUEI Applleatlon la hereby mode for connntto, the tronafor of tho following aecurltl.. of 0 pennaylvonlo Corporotlon or a Nallonal Ba~klng Anoela"on locot.d In Ponnaylvonla: (0) 6, .u...~b) , 'tftM)'l'f!lP1. ,ow... _UsI\\Oo. .--,.(c) OoMOA, ' (NQTEI In ,d..crlblng ncurltl.. anl.r In (a), ab 01', .Ith.r Iho numbor of IhorOl of aloek ar Iho faco amounl of roglalorodbonda, In (b), Iho name of Iho Inulng eompony and In (0) tho clan al,ltock or tho atctad Inlor"I tot. and moturlty data of reglatotod bonda.) ,.. , ' DATE ..Rto. J'7 lt61 ISSUED Ot{Vtll'l~o D....u ,and hovlng a TOTAL MARKeT VAiLUE! OF $.1063.13 (Oat.) a. of tho dato of,death of tho decodant, . "'.1., ~.twlP-~' .00.1111, a8.L.U&l, (Nam..1 D...d.nl) " (D." .1 d..'h) who wRa latnf,4a lhi,~" lb.., (5t,..t .~d N~mb..) (County) .... (".,.) Th. "c~rltl.. or. r.glalerod " followal N.w ClWlIb...land (P..t ,ow..). Ki..lbel-. ~.,wb~'" (Namtl ., nam.. In which .."III..,.. ." ,agl,'.rod) Owab...ll111ll . , lM~ .t.n1e,lbu1lP. J... 316 Io..moll' Avt..l!tw Cl\la\'bulllld. Pat 1'7010 EXECUTOR) (Nam.) (Add"..) N.AME OF APPLICANT 1l0~1i~" iI~ b,lI, . COUNTY FILE NlJMBER'~/~,f/.f';1? ADDRl:SSOP APPLIOAN,T 111 Lco\lll'.'....,. lI4l",hlllU"~i BURI!~U PILI! NUMBER " ' SIGNATURE OP APPLICANT ,,~2J"'."'''''-'~'C~ ''',~'':;: HOTI(;lIll1'YO~ PAIL TO PROP,IlRLY ,PILL 11'1 AHY PORTION OPTHI5APP~fc~TIOM, IT~II.L HOT n ~ CONSID8R8D COMPL6TH AND WII.L BE R~TURH8D TO YOUPOR COMPL8TIO,H. COMMONWEALTH OF PENN, SYLNANI,A ... D,E,P,AR, TMeNT, OF ReVENue,,' /,' '} C . , .,.., ' CONSENT TO TRANSPERSE!CURITIE!S , ",PA'I'~-IMJR..s/fJ'1 Ihore~y con..nl 10 lho Itansfer of the obov. ..curllles now roglalered In tho nome ollho ofotuald . I ' i' j,.' .-,." .-. - . " "'" .... ", ... ' Daced,nlond waive Ihe, filing of 0 cerllflealo cer,IlIylng 10 Ih.poymento'l~aItO,nafer Inhorllanco lOK 10 which the property of said Decodonl 'a mode, sublecI pursuonl tolh. provlalon. 01 I~e AClllfJune20, 1919, P,L, 521, ,_'.-' ,. . - ,I; ._ -.' .. j' os amend.dorid IheAclof June 15, 1961, P.l.. 373, a. amanded. Thla 110110 In accordQnee wllh Ihe plOvlalon. ollh.Aclof April 9, 1929, P.L, 343, Thl. Conlanl t~ Trdnlfo,r tho herein d~.crlbed property opotalnonlyln tolorence 10 Ihe ulale of Iho ab"v"namad' Deeodenl. *' $llIn~d for,lho herelory of Revenue ' By" c(Jl~c1.~~ ~ Ie "to)" '2 " . It '_~", " "cL~~~ , (C.unty) I .---"';'" _.' . :! "." , '.. ; ~ " I ;1, . , ' -t'I.~+~+-~O-t-"""",,-~_."-_""M'""'_._."r'';'" : ~,,;','~:"";':" ';.t ,,- '-"'.1' . , " :jJ II.... . 'I ~ ~ i .f'~..,_.-.'~~: iC~:.:~.:;~" ".- ;>. 11' \ ,~,~.',.. ~ t') r t' ,_I ~ -f /- . : ' , ., '\ , . , ..- ). ~. ~ . . , , ......_~~-r i' j '. ,.i ,J'''; . . "'f \ . , . , .,. " ."" . , ". " .-, _i"',; . ," . , .j , . ~ . ,-. ... ~ , , .AJ't'IP^ VI'!' , . , . \"'''''j . ,ne-'leta lll.Ubll Cl1rt1tlc/1ta or .J)eI1cait tlo. ~.1..Ak1.~-:-:'" '" .' , , , , Pl\t.Q~~. .; " , . . ' . .... . ' ' X/Wtt.'the undQrllilrnlldlillreby lIutbdrJ ~a the CUlo,bcrJ,anr.l QO~t:r Itation B tUle!. '('runt COlr.lHu;lj' 'l.0 c1\!1l,lJto '''hI!' '''l:\I.I,~q' ,,' ' trmQ wJ CQrtM!c~tQ ot 'DIlP91i't1 nUlII . , , '.". " . , ' " , '. " '\ " " " '~ ' "'." ."'. -. ;',1 _t. '; , . .JI-,' .f . ._ . '-f""~... .-.... Signed,. t;J.1. ~ (Ir r ,#, ' ~';;d.,..tf~~ " . It "W1ttlCtl!l ~ , ' , , . ',. ," Signed, " " 'I, . ';, :' i ,Dnte \\ .,~\\~ , ' , ;~" ~ . NOr",ti-v,.,_,."", . " ,....()tn"'III' . . .. Q ~h all l' '('_"J';.Irt.,,. .... _" t rnp"I.I1',r -.. .' N""",h: ", I. I I ~\O,..,.- :.;.~d . ,,' I ,7' , C...,/)', , . ;;t.1~:;~.t~:0J~ . ~o1iaX'Y' Publlc .' , " ., " , , L. " .-. , , Ethibi!; 2 , " " , , " Cl1rli<:l('r,ta/1 IIl'll \lIU j.wo)\ll'W 6,' ':1,r.t;I;(\'(1,iiM:\lhitjl or:L~ riM tl"rJ ":','\l1iiQ'~'I#\"(o" aI'lL\' 1.1i",,;~uh\'\~hit~u' \,:1'11':" \lW'I\:&){t1.;('~ c'lIte \t/llr;l\ltcii,lIbad. '" ',",' '. " \ ./ ",~ '. ' . . " " ' ""~ " : -',\\-;s~~~\'\;~\\';V'.......~- t. ~ ;:~\. 1'.tt1d'b.,Qt:rtJ,~., I" " t,., 'Ii..~i t., " ."tI . ,~ , ' , . , , t ' ~ t '. , , ;.1 , , " ".t'~.P'I, ... _ IT -'-~.". . , " . " 'j.' , , . . . . , " , '. "01 '\ " " . , , . " I'IV. 1107 (AI) DePARTMeNT Of ReveNue llUReAU Of ACCOUNTS seTT~eMeNT lNHII'nANoe TAll P.O, BOX 2PDD, ITATe"'INT or ACcoUNT , HAR~ISBURQ, PA 1710,D \'lATe "TATI Of Qul1lSTW1HTI1l ' THI1lJ.,MT\ n~e NO. 2~ ,!3~-04'1a !lATa Of DeATt! l;l'1-2!l-!'i1 ' QDUNTV P\JMll111~L~NI?' NOTal TO lN8UIIIPIIOPII\ Ol'IOn TO VOUI' ACCOUNT IUIMIT THI UPPIII PDI'T10N or THII rOIlM \11TH, VOUII TAl( PAVMINT TO THI IIIQllTl1I or \llL~1 or THI AIOVI COUNTV, MAKa cHeaK' PAVAILa TOI III~lITIII Op'\I~~L', A~INT. ACN 301 SHUPP DT\VJD t.. ll2, POPJ.,Ml T\VI1l NI1lW,O\JMBI1lRt..T\ND PT\ ,17070 P~EASE RETURN THIS PORTION TO REGISTER OF WI~LS IF .PAYMENT pUE 9Y't .Aj.9~9. tl-lJll J.1N.8. . . - . ... . - . . . . - . . - .. .. , . ~ . .. ~ - .. . .. .. " - . .. .. .. . .. ;. .. . .. -- . .. .'. .. - . . .. . .. . ." ,'. IN!'1BII1TAN,CI TAll ITATlMINT Of AcqOUNT .. IITATlOrO\JIllSTWHI'r11l THlllt..MT\ fl~e NO. ,2~ Bl^047\l ACN 30~ OATI o,ew03-!33 "','H, UtTA, T'MIN,T 1, I PIIOV,IOBD TO, A,OVI," Of THICUIIRINT ITATUlI OP ,THB, ITATell AcN IN THI HA",BO ISTATI. IHDwN 'I~O\l,II,A lIUMMAIIV Op,THI PRINCIPAL TAll Due, THI APPLICATION Of ALL PAVMINTI, THI CURRINT 'A~ANca, AND, "IrAPPLIOA8LI, UIIO\lIOTID INTlRI8T ml!Ml., .," , ' , .. , " DATe Of LAST AS8eSStvleNT ,OR ReCORD ADJUSTMeNTI 04-1B-B3 30l.7~ PRINCIP A~ TAX, ove,"l"''''',,,,,,,,,,....,,,,,,,..,,,,,,..,,,,''',....:,..,,..:''''''''''",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,......,..,,,,;,,,,''''',..,','!'''''''', ' AMOUNT PAID - 30l,75 l2^06-!'i2 070442 'INTBI\,9lS'li JS CIIl\RG\l:P l'ROMl2'"07-!32, ,*0 '06~~II"S3 l\'1''1'HjU~l\TIIlB l\1"Pt..lCl\!3t..lll AS OU'1't..INlllP ON THIS RIIlV\l:RSlll,SIDI1l OF THIS FORM.- TOTAl. TAll CRlllnl 'I\~ANCI DP TAll DUI INTIIIIIT 268.04 36.'/~ .- 3.l7 TOTAL aul 3lil.se (If lhl.n~. O~. I, I... th.n . \ ,eena p'Y"','n\ " t.q~lr'df ~ IP PAID APTl!ATHIS OATe see ReveRSe sloe pOR cl\~IMA'\'ION 9FAbOITIONA~ INtERes'\' , ' IIITAIN THI.PO~T10N ~Oll VllU~ lIaCOAD.