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, NOI.1.VW~O::lNI XVJ. 3::>NV.1.\~aHNI ,v~a~
QUESTIONS CONCERNING PROPERTY THANSFEHS
1. Old decedent, wlthlntwo yenls of dealh, maKe OIlY transfer ef any motorial port ,of his estate withoul rocolvlng
valuoble.nnd ad8quate cOnsldoratlon? (Answer jlVos" or "No",) "(1I1l .
~, Old decodellt1wlthln two years 01 doath, transfer IHoporlY from himself/ l1ersolflo hlmself/horsoll and anothor Party
. or partlos (Including a spouso) Injolnl ownership? (Answer "Ves" or "No",) XJuL.
3. If tho onswer to one or two abovo Is "Ves" and Ihotransfers ara clalll10d to bo nontaxablo, providlltl1e followlilg
Information: . .
n. AQe)f decedent al tlmo'of transfer, ", "
b. Qopy,of denth.certlflcate, ,
C. Affldavll by the atteadlng physician Indlcntinglhe state of decedent's health at time of transfer,
d. All otller Information supporting honlaxablllty of transfer, . . .
4. Dld,.de,ced, ent, In, his,/her IIfetl,mo, make"any tranSfer, 0, f prollerly without recolving 0 valun,blo or adequate conside,tat~,lorv ,"
therefor Which was to take effecl 11.1 PossQsslon 01 enjoyment at or ,after his/her death? (Answer "Ves" or IINo"'P.~'
a. Was there any possibility Ihat Ihe properly transferred might ratum to transferor or his/her ,estate, or be sUbJec~:U.r
10 hls/h8r power of disposition? (Answer "Ves" or "No".) rllll.>, HU j (l'.!.nc mm,u:
b, What was the lransferoo's age at time of decedont's death?
5, Dip deoedent In his/her lifetime maKo.ony transfor Without receiving a valuable and adequate consideration therefor
under Wl11ch transferor expressly or Impliedly resems for his/her life or any porlod which doeS In fact end before his/her
death: . Ot)l:{ III
. a, Theposses~lon Or enjoyment of or the rlRht to Income from the propertY transferred? (Answer "Ves" ,or 'INo" ,) ..J.2lL't
b, The right to designate the IJ(lrsonS wHo shall possess 01 enjoy the property transferred or IIl00me therefrom? ownet'
(AnswerIlYes"'or "No",) 1)t11~' Ull j"'~.tlC (JW1l\l'J: ' . .
6. If the answor to live h, above Is liVes," was tho right reserved In der.odonl nlone ( ) 01 doced~llt and others ( ),
7. Old decedent In hls/hetllfetlme make a transfer, Ihe consideration fot which was transferee's promise to pay Income
.to or for lhebeneflt or care of transferor? (Answer "Ves" or IINo" ,) No .
8. Old decedent,al any lime; transfer property, the b\11eflclal enjoyment o.f which was sublectto change, because of'
a reserved power 10 alter, anlend, or rovoKe, or Which co, uld revert to decedent 1/!lder terms of transfer or by operation of
laW?, (Answer liVes" Or "No".) Ollly 41 Joln'i,; tonant . ".
9, If the answer to eight above is IIvesl" was the power to nl,ler, amend or revoke the Interest of,tl1o beneflclnry reserved
In the decedent olone ( ) or decodon and others ( ). D,codeut llnd other. ". jotnt t~",antl .
IWV-4U3 EXt (10.80)
CCMMllNWBAL TH Of PBNNaVLVANIA
DBPARTMeNT OF ReveNU8
TRANapeR INHeRITANCe TAX
RBSIDeNT DeOBDeNT
R\\Uoll R, Nutter
estate of
SCHEOUL.E "0"
BENIlFIOIARI1l8
(In,lrllollon, on ROVBrlO Sldol
BllNEFI01ARI88 AND ADDR8881l8 R~\.ATION8H1P tlURVIVEO OATil OF INTIlR1I8T OF B8NIlP1O'IARV
D80EDllNT BIRTH
.
Gold~Q A.Kovacovic Dni.\nhter Yos - J~nt:l.rlll
612]. '~e'rt:tNUle Road ,
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The above bellaflolarlea w&rellvlnllet the time of the d&oet\ent'a daath exoept for tha followlngl
NAME
DATU OF bliATH
None
II addltlonollplolll neoellary, uaoIlYo")( '1" Iheltl,
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W!IR~CTIOrw:9RCOMPI.ETING SCHEOUL.L:l::
~Qhequlu."E" mU$llnolu.de ,~lIllroperty, real otidpersonal, ownadby thadaoadent Jointly with another
pllrtv.or partl,s.slolnt tanants with rluht of survivorship. Both tangible end Int~nglbla property ore tob" .
Inoluded, I.lst real estate first, . .
1, C'torlb" 1111 real proporty as ltidloatod In tho Instruotlons for Schedul~ ".A." Doscrlba al,l persclnolprdparw
..Indloated In, tha Inltrl.lotl.ol1i for Schadulo "B ," I nolllde the namo, oddress and relationship to the .
decidontof the oo-owner{s) and .tho dMO the lolnt ownership wos established,
2. Indloatethe total m'erket value of the lolr1tly owned property.
3, Indloate the pOI'oontooe of the deoadant's Interest,
4, Indloato the market value of the deoadent's Interest,
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LAST W~~~ AND T~STAMENT
I" ,RUSS,~LL R. NUTTER, of the Towneh:l.p of Hllmpden, Count)' of
Cumberland and State of, Panna)'lvan:l.a. be:l.I'IS of sound m1nd ,mo11\or)'
and understanding, do maks,publhh and deolare this to be m)' last
Will and TI,istal11ent, her(lb)' revoking. and making void all fOl.'1T\or wU18,
cod1oila al'ld other t8lltllmllTltllr)' dispos1tions by me at. any time her9to-
foX'e made.
, 1.
I dirollt m)' ElIooutr:l.II, hoX'e:l.naftor namod, to pa)' as soon IIU rJlIaC-
t1cabl. after m)' d.cea8ll all m)' justdebta and the explll'IS8S of my last
111ne.sand bur1al.
2.
~ stv., ,dovi.. and b(lqueath all of m)' estate - rell1. perBonal and
'miKod - unto m)' w1fe, Ed:l.th M. Nutter, absolutely.
3.
Should Ill)' said wUe predeooe8ll mo, thon and in chill,: event, 1. g:l.Vll,
deviaeend bequeath aU 'of !l\)'oeid este,ee unto m)' ohildren, Gold1e A.
.
Kovac(lvic, ~rlene F. Burns. Nadin(l R. Groft, Cure1s L. Nutter, Carolyn
V. WOQdwetd, Gerald lo. Nutter I Wenda lo.' Hall, and m)' stepson, Clarenc(l
E. ~rsey, (lquall)', share and share a11ke.
13.1/vJ'(}lt-J ,.)4:t).uJ' .. 4.
I hereby nominate, consll1tute and appoil'lt m)' deughter, Goldie A.
Kovacev1o, (lllecutrill of this m)' last W111. Should my ea1d'daughter
predece~se me, then and in that event. I nom1nate,'cbnst:l.tute and aP"
po1nt my daughter, Wanda L. Hall, 811(loui:rb of this my last Will.
,
IN WITNESS WHEREOF, I, RUSSELLR. NUTTER, tha t.(lsllatoX', have,here-
UntO ..t m)' hand al'ld sllal to'this my last W111 and Testament th1e ~~
day'of Octo~er, 1975.
Je,l,o.uli JP. }IA.l'fj;;:;;
(&'BAL)
Si.glllld, Sllu1,o)(h pUbli,lIhll\' III\d dUll 1, urll'\,lllY~hll ,,!I11VIl 1\/,IlIlUd llull/lull H.
Nuttet a8 and ~or 'h,18 last W111 nnq T9stamo~t 11'1 the pr, Qsanco ,of up,
whQ, at hie requutt, and in hill presence and in the preBOnCc 01 eAch
bt\\or, \\ave hereunto sub"cribe\\ OUlt IllImllll 1\11 Witlll!AllaIl l:\IlIt"'I:II,
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