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HomeMy WebLinkAbout81-00570 CIl ~I p.. H :z: CIl ~ 0 E-t ~ 0 III "" CIl E-t Z ro:I Z ro:I p.. II: 0 E-t ~ CIl ~' is <l: f>l ,.. CO . - ,.. 0 N ... ! II'l .-4 . as -1 ! i i i I I I i I , , , , . i : " Ii< 0 0: .. E-< III L ;e; .J Ii I".iI jjj c ~ ::E: ~ Ci. 0 E'i 0-1 !o "'1 N 0_ ..::'" In c. tIl N . I- -- ~, ~ [-< w W: . ~ u .. H ~ z c . . . L . [j .. Ow' 0- q 0 a:; o~ III z. .~ J <~i~ al: H '" . .0 I".iI ~J:nf Sf 0-1 U J: Ill'" o. 0-1 :z _ ~ d .. a: :! to z. H ~ :r 0" ;:;: .J t '" . E-< 0: u t/l 0( ~ :s III 0 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Register for the Probate of Wills and granting of Lellers of Administration in and for the County of Cumberland. personally came who, being duly SNOl'n Laur'a Snydcp , does depose and say that as Adam E. Leitzel, Executri x of the last Will and Testament of deceased Rhe will well and truly administer the goods and challels, rights and credits of said deceased according to law. And i1igently comply with the provisions of the law relating to Trans~~nreritances. S~J()l'l1 and s,?bscribed before me. , ,I ~>71 r Ii </ (~. , J2._, , IT' .D., 19 I, fr, I/l c...".v /,), .' 'A.d..,,,) ", /4--- 1/" J( '4~V.(,LtL- ~.,t'}Iu'-.lc1 /\, ! 6--,;-'\'['" /( (/0<..... "':7 ,j J () Register , ;.,; .-i ~1Il <X:! :~ C) .., ....r :", :., ,Q ...0: 00: U. 0 ~ ,-'1 co: 0 d ,,1 ~ .-t~ -I ,~ 8 "" 1'- N [-~ It'i -I H l:tl QJ: tl, " !~l - .0, ..... 1___1 - S: - .~ co: ~ QJ: 3: . ..." I: u: ....c I,l c: Pi NO .~ ....: QJ' T-, 'tl CI>: Ul~ lX)~ :.;' III O'l: n 'tl . ; 0 'l: .. N: Z 0 "" ""1 ') C\I: :l ~ ~ 11 .3 'tl - 0 c: cE .~ '" r<. Z :.::l '" DECREE Be it remembered that on the 18th day of :3eotember .A.D.,19..lil-, there was probated and recorded the last WHI.nd Testament of Adam E. Leitzel late of East Pennsboro 'rownsh'i p ,Cumberland County. Pennsylvania. Laura Sny,1cr Dtceased. Lellers Testamentary ~ere granted to Witness my hand and official seal the day and )'ear aforesaid. 533 ) , , 1..-,. ./ ,I /,~ ~ // (< f" , ( l /1 l ~. / /!r4'~,I""-../ Resister , .......-.....---' ~ .. ~ , i:' u l;->-l:.I..c"'O.!l >. ., .,,1 " \J c.<: c;.s~5o::: :; ~ E </l ~ ~ ::l It) U :S ~ :r: 8 o .~ 0 u 0.......... u 0 C ~ "<i v .. yoo.................~ ... t': = ~ .... 0 0 0 0 ::J =....... '0 .~ u >- c: ... ... c 0 ~ c ,2 u '> ~ > 0 ... ... -< v >- .~ 0 ctl tU ~..c ell ... C. IU Q. ~ ~.<: ~ ~ IIJ .. U c........o"'CDlOc.tl... ." ::E '+o_~::l u 0 e G: v. U u '5il~ \0 b 0= ell It) .....!a E >- ctl r:1 <(..:.t: ~." .<: ::J 0 wtt;g'O .__oc",u CJ .. cr: 'i u ctl..c C U IlJ ... - ..., -< t................ u ... ~..c..c~ - ~ .. c ~ 8 0 z '&... u ~,o'"O,ou=o::: "'0 Z ...; ~.iit:;.....1Il U -< ilJ u..c: Co ..c 0 ... ~ ... u VJ... ..c:..c 0.. I-;' .. 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Leitzel Date of Death June 21, 1981 Social Secu,ity #"- 6 / - / b - ,- -S - ;:) I Last Address Blue Ridge lIaven West Camp Hill. Pa. 17023 Bureau File # (Cltv) (Stitt) (Zip) County File # J, 1- f / - ..:5 71J 1. Decedent died: o Intestate (without a will) KJ Testate (leaving a last will - copy attached) 2. [li Executor/Executrix o Administrator/Administratrix Name Laura Snyder Address R. D. 1 Elizabethvi.lle Pa. 17023 (City) (Stlllte) (Zip) 3. All correspondence should be mailed to Q Attorney LJ Fiduciary, 4. If an attorney is representing the estate. indicate: Name Earl Richard Etzweiler Address 101 N. Front St. Harrisburg (Cltvl Pa. 17101 (Zlpl (State) REAL PROPERTY - Identifv real property located in Penn5v1vania by lot Bnd block number, meet address ond Include 8 Itatement of mortgage encumbrances as of the d.t~ of death. Department V.lultlon (Official Us. Only) Estimated Merkel Value Hone 11- .:3/3-.;)J Tot.1 -0- ,A. ~- " ,,""'fT ..-.. - . -- ....r , . t '. I~ST WILL AND TESTAMEN~-9J' A~~~~~Il'ZE~ I, ADAM E. LEI'l'ZEL, a reGident of WaGhingLon Township, Dauphin County, PennGylvunia, being of sound und disposing mind, memory and understanding, do hereby make, publish and declare this instrulIIent to be my LaGt Will and 'restament, hereby revoking any and all wills by me at any time heretofore made. ITEM I: I direct my hereinafter named Co-executrices to pay all my just debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon, as may be convenient after my decease. ITEM II: I give, devise and bequeath my house trailer and all furnishings therein at the time of my decease to my niece, Laura Snyder, of Elizabethville, R.D .Ifl, Pennsylvania. ITEM III: All the rest, resi.due and remainder of my estate, be it real, personal or mixed, of whatever nature and wheresoever situate which I may own or have the right to dispose of at the time of my decease, I give, devise and bequeath to be divided in three shares as follows: l. One-third to Salem Lutheran Church of Elizabethville, Pa. 2. One-third to my niece, Katharine Leisenring,of Shamokin, R.D.#2, Pennsylvania. 3. One-third to my niece, IBura Snyder, of Elizabethville, R.D.#l, Pennsylvania. I'l'EM IV: I hereby nominate, constitute and appoint my two nieces, Katharine Leisenring and Laura Snyder, co-executrices of tl1is my Last Will and Tentament, wi tl1 full power in their di;ll'retion to do any arid all t.hinp' necessary for the complete administration of my eGt.ut.e, \d ill 1'll] 1 powel' to se] 1 at )lllblic or private saJe and ~litlJOllt ;))'der lOf CClITt any real or personal l G((CiII," {' i>.fC' 1 &""'- I. (SEAL) BENEFICIARIES BENEFICIARIES ANO AODRESSES ~St.t. full n.mes and addt",," of ,.11 who h.\lo an interMt either vested, contingent or olher intBtlt5tl RELATIONSIiIP TO DECEDENT SURVIVEO OECEOENT STATE YES OR NO AGE OF LIFE TENANTS OR ANNUITANTS AT DEAn, OF OECEDENT INTEREST OF BENEFICIARY IN ESTATE ~ ..----------- ".-----.-.. Sa 1,'m-Lutheran__Church E1izabethvi11e, Pa. 17023 ___,,_____ None__,___-_,-.. ..--" 1/3rd Resid\.,& ___.____..______ __._______ ____0- Katharine Leisenring R.D. 2 Shamokin Pa. 17872 niece yes of age 113rd Residue _....__...____.. ____m..._._____.. ____~_~ -----.--- .----.---..---- ..-.._----_. .__.--.-- ----..--.-.------ --- --- --_.._j----- .----..1'------ LauJ::a S[,yder R. D. 1 E1izabethvi11e Pa. 17023 ,--- --"niece- es- -of-ag c Z m 11 " )> Gl m 11 o o () ;t; m ., II I () )> m )> ~ 0 0 ~ 0 c 0 ~ ,.. z )> ;1 ;1' ,.. ., JJ .... Z m -< VI m !2j VI 0 0 " JJ " ~ 0 z o ... ... n ); I" c: Ctl m o z ,.. ~ - -< -< N m m ~. ; I )> )> ,,' , JJ JJ "' Co..! .'.,; a:' ~ ~ -~ {..,~ . to:.:. -'~ u..., ~~:3 ~cr. - tx' .. (0 ...., ".' INFORMATION PLACE FOR FILING _ The return is 10 he filed in ouplic,ltc with the Register at Wills of the (;ounty wherein thp. decedent resided. TIME FOR FILING ._ The return is due nine months after the decedent'!i death, unless an extendon for filing has been applied for and granted by the Secretary of Revenue within the nine.month period. FAILURE TO FILE RETURN .... Seclioll 791 01 tile 1961 Statute pro,ides tl1at ", , , ally pe"on who willfully f.ils to file a return or other report required of 11im , . . shall he personally Iiahle . , . 10 a penalty of 25'){J cf t:'c tax ultimately found to be due Of $1,000 whichever is the les!lcr to be feCal/Ned by the Department of Revenue iHi deuts of like amount are recoverable by law." REY_414 EX+ (HO) INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) File Number 21-81-0570 (]] Original o Supplemental o Remainder Estate Name Adam E. Leitzel Date 0/ Death June 21, 1981 Social Security Number 201-16-5521 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly .pp.lnted Inherlt.nce T.x Appr.lur In .nd lor the C.unty.1 Cumberland Pennsyly.nl., d. ...peclfully report thot I hoye .ppralud the re.1 ond personol property .s rep.rted In the I.reg.lng retum at the value. ',.t forth opposite each item in thela.lt column to.the ri t i~SCh', les flAil, "B", "e'" and uE" , ~ / D.ted: January 4, 1982 " . '.. 1? . INHJi~ITANCE TAX APP SER ADJUSTMENTS REMAINDER APPRAISEMENT I CODE INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY) Ro.1 P,oporty (Schodulo A) 5 }Jrmp 00+ 12+ Per.onal Property (Sch.dul. B) 3 88 45 '0+ Jolnl.Hold Proporty (Schodulo E) None 211+ Transf.r. (Sch.dule C) None 30+ TOTAL GROSS ASSETS 3 988 45 L... D.bt. and Deduction. 40- n. (SCHEDULE F) CLEAR VALUE OF ESTATE OLlie E.lat. RATE FACTOR PRINCI PLE VALUE CODE o Annuity FOR USE OF REGISTER ONLY Tax on S w.t COMPUTATION OF TAX $ $ $ $ $ 6% Tax on $ YaK on $ IS% Tax on $ Tox on S eumptlons Total Estate TOTAl. TAX INTEREST FROM BALANCE TO $ $ $ Len C,edlts DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST $ TAX CREDIT S + $ = $ + ; BALANCE TO $ 5 .., Ul '" Q) '" 13, 0 ~ r- ~ ~ ..: \,j ... r1 ..: Q) ~ Z ~ !:= " -<: 0 :>- .., :x: p.. .."' ~ Q) Q) . 'tj III '"" bO r1 '" ;:l 'tj r1 nl .... .... r1 ...l "' p:; :x: ~ < - t= Q) 0. .Q U Z '" ::I fij t= - 'tj r1 8 \>.0 0 -<: '" t) \>.0 - 0 ~ ~ ..: \>.0 \>.0 0 E- o III 0 Z 0 III III :>- E- o - ~ z ~ ~ !Z ~ z Z ...l 0 - 0 ..: ::<: :E 0 ~ ~ ...l Z Z !- ;:l U " - ~ III ~ 8 0 ..: z ~ ~ 0 "" :l " I.AW Ulfl'ICl!S EAIlL RICIIAllD ETZWIULI!11 lIorln.OIWNltuT MJI.LI~HSlllJHn, I'I~NNS\"J.\'^NI^ I1CHiI MllLERSOUFla TCLCPHONE 711-69,2-0,1519 101 NORTH FRONT STREET HARRISBURG, PA.17tOI lE:LEPHONE 717~23B-5201 August 17, 1981 Register of Wills Cumberland County Court House Carlisle, PA 17013 Re: Estate of Adam E. Leitzel Dear Madam: Please find enclosed the original Will and the Petition for Probate regarding the above matter. Sincerely yours, ) f'- /' /-~ ~..<.' -( .l~: t, ~~ / , , Ii) i t_/ '/ j>." ^ Earl Richard Etzwefler ERE:db Ene. COMMONWEALTH OF PENNSYLVANIA '[ COUNTY OF CUMBERLAND J 55: Laura Snyder _.,om..,_. ..___._._________.___~_______._____.__.___.. boing duly _swot"n.,---- according to law, deposes a..d says thats ~u --------.---' --- is the Executrix of the Estate of Adam E. Leitzel _._---- .------.-- lato of _Ea_s.Cn_Pennsboro Township__ _ _,________,., Cumborland County, Po" docoasod and that tho 'th" . t d b L -S ~ th 'd Executrix WI In IS an Inven ory ma 0 y _._ au~a. -ny-uer----.... .____~___.. e 1"1 .;.., of the ontiro estato of said docodent, consisting of all the personal prop.rty and real e.tate, except real o.tate outside the Commonwealth of Pennsylvania, and that the figure. oppo.ite each itom of the Invontory repre.ent it'. fair velue e. of tho dete of decedent'. death, Sworn end subscribed before me, ..--( ___~~y!'_~:"_.":..'{~_____.._ .... '// ~<: Euc.vtor . Admi"idr.tor . 7?",-:.r, ,._,~i 7" 19 ~'/ /i ? C~ , /JICt 4,1 A J.^~.. .fC~ 1---' / (liJ ,d <777 (?rrywnJ, UjVI /-/0 -;-2. b1izabethvi11e R. D. 1 Pa. 17023 Addr.ss Oete 01 Deeth 21 June Month Hill Vur O.Y INSTRUCTIONS I. An inventory mu.t be filed within three month. after eppointment 01 personel representetive. 2. A suppl~ment inventory must b. filed within thirty day. of discovery 01 edditional e"eh. 3. ' Addititn~1 .heeli may be attached as to personelty or realty ___ '.1 4. . See Artme IV"fiducierie. Act 011949. " ,'~c: '" i'l I .. .... ! l.d c.: \~;b C:}I~" u..' 0;11) c::> 0(3 'i:J ;:,t;-;. U"J ~.~S ~Q:; ~ ~w SO u "'=> ~ .,; .. UJ ..... M ''0() ~ I- .. ~ UJ -< Q) " D. l- N u . \ 0 " 0 UJ 01> ... C '" ,.. '" UJ .o-l . . - I- J: D. Q) I:: Do. c ~ I- ..J u.. .. ~ Z -< 0 ....l 1::' Do. 0 u.. ..J 2: \ 'I W 0 < UJ ~I i- -< > Z ~ . I Z 0 ~ ...1 c ! c ~ .; 01> Z ~ till 0 ~ U z I w -< "'I ... D. "0 .., ~, c ..: .. - 0: 0 " .J:l .., ... . E - .!! 0 .. ~ 0 ..J U it fD COMMONWEr~LTH OF peNNSVLVANIA nEr/~rrrMEf-.jT OF Ht::vENlJE l1lJIH.AU 01' FIELD OprnA1-jONS APP~IC.\TION FOR CHARITAB~E EXEMPTION FROM PENN5Y~VANIA TRAtllFER INHERITANCE TAX (Act "f Mt1y 'A, 1956, P.L. 1757, UI.ij Act of June 15, 1961, ~_' _~ .~_ 3_~.~:__ ~:__~m.~.~l~.~ d_~ c2J -f.1 Arrlic:otion is hereby filed for the- approval of on CXC!lllfltion from Pennsylvania Tralldct Inh~ritancu Tax on the ftan:,fer of the property d\l!o('li6IH! below; 1. Bureau Filt~ :. 2. Dote of Death t, ,-.:{ I--? / ,~(! &-J J' . .,,'. ,/V.&UI'" ",'" n~ _r."lfL._____.... Adam E. Leitzel . -. ..-- 3. Date of Approval. 4. NOnie of Decedent 5. The Commonweolth1s QPprai~C!d value of the property for ",hich on exemption i!) claimed is S _~..!13r.:d R~~iduen__' (Note: Where the property is other thon 0 specified amount of cosh, th~ exemption cannot be approved until the value of the property has b~8n eS1ablished by appraisal by fhe Commonwealth, except in those cases whero the amount of the gift or bequost represent!; a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or percentage amount above). 6. Chuck fhe manner in which the transfer was effected and submit (1 copy of the document authorizing the transfer, unloss such material has been previously Hied. WILL ,x; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTH ER /7; (II other, e.ploin)_____._._.__,~__..__.,_.,__._.____.__.____, 7. Correct Business Nome and Address of Charitable Organization receiving property: NAME .--___S1;l.l.~m_Luther.aIL.C.hux.ch_ _..'.._..____.___..._.______ Eli~.abet~vil1e .__p~'-_!}O~~.____._ ADDRESS o See listing on reverse side for additional charitable organizations covered. 8. I c:crtify thot the information contained herein is, to the best of my knowledge and belief, true and correct. r:, . /7 ) ,I I ~/ ) IJ;~ ~ y ...I- /. ' ) Signature of Applicant --:7.., ~-':7t~.&"k...:'-C~~.'.-...(:<:\..-'---. Addre.. 01 Appl icont 1_9.L~,.._F:r~!l.!=_..~~_,-,_!I.!l_~t:.!~burgL~~' l710l Officiol Title ,. Atto.rney .,_______ Date _._!} /l9 / ~!..____. This form must'be completed in triplicate ilnd all three copics dcli'iercd to the Register of Wills for the County in which the dcc~dcnt resided, or in which leUt:'rs were i!.sued for a nvn.resident decedent'" estate. If the decedent was a non-resident of Pennsylvania Bnd letters were not issued by a Pennsylvania Register of Wills, deliver nil three copies to the Director, Bureau of Field Operations, Penna. DCllartmcr.t of Revenue, P.O. Box 2970, Harrisburg, Pa. 17105. _ 00 _not "!."~t!-!!!.ow thi, J~E-!:..!or_~f_!5i?! U,c _O..!!!r.____ _ APPROVED: For the Secretory of Revenue,} REFERRED fa 8ureau Headquort.rs Approved 2 ~ . ."."t/ , For Secretary 01 Revenu. -- ~~;~,~~ 1-- ",,,,.,, ., ,,,,,;;,:; ;,,,,,- - '~"~"",;",,;;,;,",,,", , d)J./!;:f.'...n:'~'. _ ., :_._ ____. {/ ,(CountYj I -.-_ALtL.l1cL~__.g /1%1. ,; (DCJtl~ of Approval) I (Counly) (Titl.) -...-..-.-.--------- (Dato of Refrrroll (Dot. .1 Action) . Se-eo reveru .ide for r.Oions MUll CE FI~ED IN TRIPLICATE This section will bo eompl otod by Buroou Hoodguortors only, w~.2l'Jllicotion fo, oxometion hos boon donied. Doto: ______- The application f;)f exomption contained on the faco of this form has boon donied becauso .~-_.--- ----------.-.--.-----...------------- ._~------- ------_._---~_._- ...----------.---------------------. ----_.__.,--~._-_._._-----_._----- Hote: Any pa,ty in Intorost, including tho Commonwoalth, og9riovod by this oclion moy within sixty (60) doys oltor the doto 01 this notieo oxo,ciso thoir rights 01 Proto st. Hotico, or Appool in occordonco with tho p,ovisions 01 opplicoblo Pennsylvanlo Inhoritance ond Estote Tox Acts. '" ~' :::r 'n) ~" ~. I -" ',.. I l."~' . C 1,_;; c)' L~ ".H" C:::" c= o~, if ~'. u.... ~'" - ....:d !" L.1 REV.455n.80) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT OECEOENT SCHEDULE "F" STATWErn OF DEBTS AND DEDUCTIONS _.._.________~_ _._.___.___.___..... .. ._u_,_ _..._. _.._ ----------.-..-----...---....-.-.... -.. -.. Estate of Adl1m E. Lei tzel _ Dale of Death....J1!!le 21. 1981 WHEN CLAIMING THE FAMI L Y EXEMPTION, COMPLETE THE FOLLOWING: Claimant _ Relationship to Decedent Claimant's Address ITEM - - - -.... _.. ____._n.__.._.. ....-.- - .-- .~_..".._-_. ...-. NO. DATE NAME OF PAYEE REMARKS AMOUNT 1. 9/4/81 Register of Wills -- Jaking Affidavit 10.00 2. D. Irene Deibler Witness Will 15.00 ~ 10/1 0/0' T)ON~ ~"n~ ni' t.H" ~ 'Letters Testamentar:(, 1 Short :;ert':i, [i '- a te . 24.08 I,. 1,,, J~~ I ~ 1'.._1..__', __ , n... T_w:n~; h.clv.e.r.t.is e-I,(.> r j-",. ~ , Q nn 5. 10/30/8 II- The Evening Sentinel Advertise Letters 26.68 - .. Repister of Wills File Inventory & Debts 10.00 ~ u -o"'~r F11n~,...~' Bnm^ Ri1' ~ ?on nn II R"",i"..",. nf !.Jill" File Charitable Rxemntion 2.00 9 - Earl R. Etzweiler Attorney Fee 199.00 1n Barbara L. Etzweiler Notarv Fee 1. 00 -- 11 Earl R. Etzweiler Posta!!e 5.00 ,') T_..__ ,,_..,,^~ .!Executrix Fee 199.OO , - - - - ----~ - TOTAL THIS PAGEL.3. .739 .6L,. I hereby (ertify that to the best of my knowledge and belief the foregoing is a just and true statement of debts. funeral expenses and expenses of administration "uhmitted to the estate as deductions for Inhe.itance Tax purposes. I . T('m' -1 t.) i'j fJ DAT[ OFFICIAL USE ONL Y DEBTS AND DEDUCTIONS AilE ALLOWED IN THE SUM OF S , ,.. r. ( (' ~II'''''' ..J' '-j '. ~.- ,'- - )" / .,,- .,,".,. '--------;7 AT J .. G'> PEIlCENT. , ,~J /- /-/:7 'DA1T GENERAL INHERITANCE TAX INFORMATION -- . Unsatisf ied liabiliti"" i",'u!! ,'" by I,I,C dell"I,,"1 prior to his/her death 3re deduct ible a!lainst his/her taxable estate. In addition to debts incurred by the Ih,eed""1 or e,tale, other items are claimable including the cost of administration, attorney fees, fidllcialY Ices, IWll!rdl and IJLJri:ll pxpenSI;S including the cost of a burial lot, tombstone or grave marker. All debts heinil claim"d 3'ldil1>:1 a" !)state all! ,;ubject to the approval of the Register of Wills with whom the Inheritance Tax Return 1$ tiled, blll[!I)cC to suppon the decedent's or the estate's liahility for the debts being claimed should be attached to this schedu.e, A family exemption of S2,000 may be claimed by a spouse 01 a decedent WllO died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/he, rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be 'claimed by a paren: or parents who are me,,,"er, of the same household as the decedent. - "C :::; n ::- r'l > ;S :/. ::- 0 0 c; Vl " Cl n c: " -i % .. Z t'" '" 1'1 ::- 0 ::: ::> t'" Z ;:>; Z ;:::l >-' Z C /. ~ -i M t1i - () -< IJ1 <Jl :/. 0 If) 0 -i () ..,., ;;ll ..,., ~ I ~ 0 "l'l 5 "l'l Z n "'. :;; " t'" l:: N c:: Cl I ;,:."'1 <Jl i,,;~ ' ' , M ul Cj'] "'"'.'''~ 0 U::I.' , ::;0 I::':: 07;; :~,~ Z (.)G:"J r.::::; t'" ~u: - Ld~) .... -< 0< ~ ..1 t'ri ~ u m ::- ::- ;:::l ;:::l I !t!.STl1lJC.~'-()NS FOR COMPLETING SCHEDULE "F" 1. If the family exernpl iOIl i" 111';"\1 cl";lI",d. II1dicatu the claimant's na",e, 3dd.ess and his/her relationship to the decedent. Enter "faIl1ilv (~^enlptjon" III lnL' remark::; column and tile Jlllount claimed in the amount column. 2. Assign con~eculj\ll; 1l11l1lIH)(1 iu 1"(H.:h Ilem listr-d. 3. Enter the lL.Jte (ill '.'\'lllch cdch deht \,\'ii~ illClH1Cd ;;nd/or pJid. 4. Enter the 11JIl1\;$ oj ei.lch PdVL't'. 5. Pruvidu i.:I brief ('Xpl;l:\,;;iWi 1:1 :!1(1 :(':1klk.~; cl)1l.n'\!l1or each di~bt c1Jin't.'d. 6. En1t~r thp iHl\OUlll 01 ('dcll,lit'l>l Il' IIll'1 i'I.!ll1('d. 7. The form nHJ~il be ~,i;;:i,\d j,y ii".' i'L'r::(1'" ,,'.-hi ll.j~; .r'i~,tJ!1wd tile r(~5ponsi\)ili1y lor paVi;lH the debts. I\\\~ 1. 'If~ .I -. .- " Q) CIl ~ o ..c: lJ H ::l o U C"'l t/J >.0 .-< lJ.-< .-<~" 'M ~.-< ::;:0 U~ "-' Il< 0"0 ~ . H C\l Q) Q)............ lJHCIl en Q)'M '..1.0 ...... bOSH QJ ~ C\l ~UU ~ \ ~ Il: 3 C ''') ;.l 0 \ ...l ~ ;: c-... ~ I- ~ I>l " " " ., >- " .. x >, I N I- .- " x ~ I- ~ ~ . f-o . ~ iJJ ~ ~ u >- . I- ~ ;: x ;.~ >, . ~ " 0 >- ~ 0 >- = " 0 Il: ~ ~ ~ ~ 0( ~ . ~ " ~ l- e ci ~ u g = x x ~ 0 0:: >- 0 :t.' " ...l x S ll: ~ x ~ ::; -. iJJ ~ '. co ~ ... :{ 0;-: <-~ (,1 r'.J l:',_ \{) I l::l ~~ '.' . II) .:: (:'/':C ~\ ..J :::) 0: G6