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~epORTINa INSTRUCTIONS 1. It thl b.nk account IP,pHI.d 011 Ihll "QUO, will bhl.pn"'d .nd nllld bv Hl. ..hllo fleftIOI'fY, pl.n ,n, "XU In blook II~II flf PMt 1 of tb. "Jolnt/TrUI' A.ooount T". ~'Hlln", 'Ion \hlt dVPllut,,-.nd_t1lpIIC"t onpl.. and "\llIn to th'.P.nn,vlv.nla DIP.r,m,nl of ".v.nUt, "willi 01 htmllnll\lon, P,O, DOl( 8321, H.fll.bUlg, P,4, 17100. - , " II-thl Inlorm.Hon .nd o'Ic;~I'lIun In th.'ncHll;I' II! C:OfllOt 'nd d,ductlont If' nnl bttlnllolltmlt(I, plnU Ii" "X",ln blook "A" nl- ""1 01 the "J(llnt/TrUI' AOODUnI Tu "DUHflJ', 81gn the ~upIIU" .nd IIIPIlIl.U O(lPln IInd .uhmll thlm Wllh VOUI OhU~ feu th, .mount of-,.. loth, AI;II'II 01 Willi of th..O()l,lIIIY Indla"lld,_ Th.t DIPIHtmant nl.ReVhnu. Will 1""1 an ofllol.' .......m.,H IPtmn "IV, 1U"XI upon ,.vlew pI Ihe Joint THIll 'ADOounl hk htWln, 3, If thl nollo. InIOimIlHbn'lllnOCH.,.Ot IndlCtI q~.IIf1,d dlduetlnn, III b.ln" OI'.I.mld'lOlom.lllltl Pllrt 2 (UI\II u(oulftllonl (If the "Jetlrlll Trult AOC!Dun, Tn I\,tyrnl' 'ClCluldlng to Ihll 1"II"UoIlO"I he low, Sign th. dUllllul, 'nd lllpllo,l, 00,,111 flflU tubmlt thlm " with your ohlok lor (Ill ,mount ,of Uw to It" Rllllll,r af Willi of lne otlllnty IndIOlll.d,' tho bopllrtmlnl 01 RaVlnUI will IUUI '11 oHloll1 .."..mini I~orm AIV, \04.')(1 l.IPQI'I flvilW (II thl 'J(llntlTHI~\ Aooounl Till( RllUm ' It, Ad,dlllanll aom""nll ell fMpl'"llllonl 't1bulo bo m.<It 11'1 Pari t1 "Olh" I"forln,tlon", I. Th. ~plntlTrul1 AClDount,l'k A.tlnn mUll h. OUMl~lllld ~nd 1.IUfn.d Wlthln,HllIty,,1301 d'Vi 01 thl nolloo d.t. or In,olllol.1 ......menl (Folm AIV, 'Utl)!;1 will b, lUUClo blud qn Ih. notloe inform.Hon, , a. Inh,rlUlnoe tltc 'hl~omU g,llnqullnt nln. monthll "I" Ih" dIQ,don,l. d~lIt1 dloldenll., n.ml wa. 'ddld II, ,II mlllt., of ,~onvenl'l1~t, , ~f death, ,JcllnllY held PfQP"Iy IJ "Mablo tve'n1hClugh 1110 '," nl:1 'm Ud I'J TAX CAlCU,ATION INSTRUCTIONS f!:;"; I:":j i~,~ '! ,. ,~ """. UllL I - ,; tn..' Iht dati Ihl IOOQUnl wu OrlpltlptlV ..t.bll,ho~. ~D. 'If II b.nk ,poC1l,lnl Wit ..tabll.h,d Within Iwo yurt of tMt d.ilIh of 1he dIQO~Dnt, II Ii pl..umod to hllVfI beln .';.bllthDdo"O In oont,mlJletlon Qf duth.' ISU IX AMPle hI. 'I Ih. ilccounl Wll' 1.labllth't1Wllh fUndll thltl WOrt IIgl.IDrad III Ih"n~1ltjj(linl'''''; own'tthlp' and maln,.lntdJoln\ly It., ,tnore than IWn yU" prior 10 dlltlh, thll' ACOQunt woulg b(l tflxnbll 10 thtl'Ullltrtt CJl1hO'l d'~'d.n,t,t ownlnhlp lSSE RXAMPLIf AI, PocumtnlollClT'l 10 IndlcMo IhtOl191n,I ttatu' 01 tho IIccourH mu.t btl lIubrnlH.d Wllh 1".11 JOln1lTru.' AUQlln1 TIlM AtHlrn, ( 2. InUI Ihl totel blll.no, of Ihl ;coaunl Inclu~lng Inlilul I. 01 Ihl d.le 61 dlAlh. 3: Tht Pllfunl of lhl,'C(l'ounithllt It,UM'bla feu ,aOh i\HViVPI I' d,tlfmlnt(i a, followl A, The pltOln,1 taM,bll for jolnl b.n~, llooounti',U"bll.hed Mlote 1hfln IWO,Ylell prior to"hl decodenl'. dUllh III d.tlrmln.d.. foll~W', , DIVlbBb bY To,,1 Number 01 OIVIPID BY tp"~1 NumbDI 01 )( 100' Plloonl hMablo JOHII ownetl ,SurVIVing' Join! OWnf". hamDla Al A lOlnl IIccount reolltored In tM ".mv pf Iho d'Qld.nl ~M Iwo othcr pOriO'II.. 1 O;IVIDIO BY 3 DIVIDlb 8Y 2 I .107 ~. 100 I 10.7%jPI,u~'1'l1 H!lCOble If 01 hqh 6~IYI...nfl a. th, perOlnr laM.l1Il;l fOI JOII'll blink alloaunUU"plIlhodwlthin IwCI year. of thed,oed,,,I', dtllth or atcnunUownld by th, d,c,d,nt bill held In tlll.1 ,fOI Ino\hir' IndlvldUIIH,llttun I1ln811011111l) I' (letfHmln,d fIi,' fOIlOWI; i, PiVIPPP IV Tout Numb., ofSllrvi~ing'U'(Ilni Own.r. or 1nl&l een.fltl~riel to: 100 I Potolnl UJ(/lble bim~I.\ Joint .ooounl ngl.I,\ed Ih th. neme ollh, dl1;8donl find 1~n 011'111 pe"on''Ihd o,"blt.hod within tWD ,Yti'lfl of dU'h; 1 DI,VIDBD BY ~"&O ~ 100 I IHW,IPolllonlhkflble 101 hQhSurvl...orl ", Th' .mount .\lb/iOl Hi tal< Ulnld.l il d'lurmll'!GdbY mllltlplylng lhl ,ooounl balince Hlne ILbV Ihl p.rolhl \'I(ibl~ {line 31; ,b. In, Ii thltotal ()I)hl dObtll,lInd tll,cUJbtlonl lIittd In Pllrt,,3, AlloW.blt dlIJI. .nd dlQUctltHli1 all de"rmlnecl i. 101l0Wi: A: Vall ar. ItD/lIly,'o~ponilbl, 'll'Il PIymorH, !I, You ,otuMIY PllId Iho dD~U IIftar. lhO dQflth 01 ,,,. deofnfnt find Q'lln furnl,h P'bol 01 pllymon\. C" 'thi um',dlbl' 1111 /1ot Qllllmed' Oh the deoidenl" ,lnh&llll!lhCO H~ RuWln 01 by 'flY Qlher lurvlvor; t), Dlb'" being ,~lelm'Q mUll be fvltv, Itomilad In P'f,l 3, If .ddltlonlll 'plICO II n,edld, uu plain 8 11; J( , ," ah..U, Proof of pavril'hl It1IlY bl 'fil:qlllitfld' bV Ihl Dlp.rtmonl of RIVlnllt, ' t). 'h'.~,Qunt t,dblt II lilt 01 lit dlturmlntd by ,ubtrlclIng thldaptl and dod\Jt\!t1ni !lIne 81 hom the Imollhl ,UbJDOt 10 '.k 111"_,41. 1." antet 1t'1.tpptop,l.lt ti!xril' IIlnt ?la' ditltmlned bllow; A, Han,fe,. 10 Unul cf'~o.nd,."h HIOIUdlng'filhOt~ mOlhil, huibend, wifo/,'on, dauontlli gtllndohlldr'n, Qlindrartnla,",on-In.l,w. dauOhter-Intlew .r. tlkllble 'I & PIIQUtlt. . . . .. t5, Trantf," lo'nonllnoal'lnOlUdltIQ tHDlhftr".llttL Imoll, allnt, nephlW, .ndnl.C' II" Ihlblell 11 pllotn'. e, 1'hl .m~unt Qj' u)( dUllll1nt 81 I. det.tmlnod bynlulllPlylhg 'ht amollnt 1ftXabll (IInl 6\ by the tllK ia,e (llho 7l; OISPUTED_~ 'thl J'Olhtltru.' .Acoount TIk Rolurn I' tUb/eret to lInp;olJill by thl D'~M1rnfnl l'If RfI....nu.. Th. I.)tJl_V.i ;may WUhln 'IMtytOtll day' of "" elM.ol 11\41 olllltllll iluoumlnl IFOlm AIV. \U8RXI "OffIOI." Nollo(t 01 Inhltitlnoe 'ffM ,A,ppierlum.nt, Allowllnoll 01 DIUllowanOlol,OttlI.lClIon, find A.....'fl.nt 01 11)( cn JOintly Held 01 TfIJl1 MUtt"; tlle',I PIQI.t, With tht POMtYIVfml1l DIPtrttmonlof "Iv",n\l". bQ""d ,01 App"la:or an i1ppeH With thl laoal Orph.n.' C/;Iu!t. IS.. S'Oll,~n ')0,01 al tht InhtflUlnOI ,nd hUlo Tal( Act 01 1e~1 '(\2 It,S" Section ;48&-1001.1 R..lrJ(. fnri> 01:rJ it',,, '-'1 Ii'? ,'I ., " No,21.81 .~ ,,~_~,:~I PETITION FOR LITl'.ERS Ol ADMINISTRATION IN 'l'lm 'QH1'^,I'I~ 010' ,..(i,\n~1.',i\...M..".~m..r.ll~,L,,,,,.,,,,,,, ImCI')Ml~JI>, 'I'll .""",,,,,,,,....,,,,,,,,,,,,,..,,,,,..,,.,,,,,..,,.,,,,..',,....,.,,,",,,,,,,,,,...,,,,',,..,,,.,.,,.,,,,.,,,,,.,,,,,,,,. HOIIIHtol' or Will" J~' $r, ~:n1pll.\' Of)1;~:G;"IIII\'" 11\, till' l:OOllllOI\\\'Ollllh O( 1'01\1lH,1'11'1I11111. '1'1lQ Po(.I(.lon of ,(,.J)"IJ"", ,~,~,6,~,...""a;", " ,.;./,:6~~,,,.,,,.I"',..",.,'\.,:,.,,'"''''',.,,''(''''''''',,.,,'''''''"""""'."" 1IIIoIH"H', It",,,,,,,,,,,,,,,. II""'..!~.',,''''',...., l'OHllul.!trlllly Hhowot h t hnt .",\\,m,~,\,\.~,,, ,m,II.,.........t1 ,~X',:(\,~,r"" "...."" WIIH II r~slctOl\t of ,.."u.-t~,~,r."".\\.\\,~,r,\,,,,,.,,,,.,,,,,.'l;~:i~~~J\~JI ,(1111111)(11'1111\11 Count~'! Stutonr l'ollnsyl: vlIllll\, IInd l\,CItI~on OrUlllIOd StllloH, /~I CIOJlIII,tol\1 hlH IIfn IIIIOHIII(o In (ho COt/lilY of ,,,Ci",mh~r..l.\\.n.A "'"',''1''''' ..'If;'......'.-..'''..'''''.. IIIllI SIII(o of """X~,t1.IUi,Y.. ,1.l.I'l.flliL"."t'\.."""..'...:.:':.:..,,.............'''..!I...'IiH.HI''.lill..I)'.. on ",.. ", . ,1J..~;:';',~!l'r"''': Iho ..."."",JJ~..~".".,,..,,'" ""~' of '''',.."x~~I.,Q,u..\',t"...,,''',..,,'''' A, J),,'lll,,9;.., ,;, lit tholl/lo or "Y),Ci....c'O/1l'". \' c. ".' . ... . 'I'llIlt tho "1I1d ...x:~,m~,.. "\.i\."..M",,,,,~.t~J:.I\.tt~.,,.,,...,,,,. dlll'Il/I"'lIl, lof( HU"l'll'lnll tho followh,,!, ""moll wIdoW or hU8blllld" hnlrH IInd noxt tu kln,lll \I'll.: ~"'" -, , " -:l.e.l'? ,..':'~.'.:".'..'rf~..:~...... I"'..".,'..'.~~., 1l01lltlol1Hhlp "./.e~41:i.:...,..."....i...""," "&:tf':~t"...,",,....,,',.,"""" HOHldnnco 1)(!i,t111:1. ~ . . /J2. fl , b'C """'"' ?In. ""'''j/,' ""..., . ,r.~"/'-.ff..'''..~..''''''''\1 ".~~,r,nr.:'.rl~.,,~.4~~ ..~.".~!...2.z&?,,;,~ ' l. H'H",d?:~t., "",."""",,,,,, """""'"li,"'"lI11Ii\'''"I....'lti''''''''''''''''I!''''' """"''''''H"..""t"",..Ht....Il,,, ",.,."""..ll..""'''''I!''......iinlllIHIl.......''lIllj;;' , 1I11"'"''''''';;'''''''''''''''''''''"''''''''ltHH""."" """""ljl"It.H..""""",,,,,,,,,,,, ""'"''''''''''''''''''''Ii'''Hill...li..''i.,,,.''IIIHJi''' i'HII;..i..i""..,....,.,II"""..!I,..,jj."",;""""....." """"''''';'''!!''!'''''''''''''''''''''' ......."...,""'''...'-''.II'..'''''....,tltt...''.''''".lIl'' lI1l"'jp'lIll111H.Hi""""''''-""""",,,,,,,",,,,,,,,,,,, """""101"""""".,.,,,,,,,,,,,,,,,, '.',';'''''''''''''''''''''''''H''"'lIi;,,,,,,,,,,,,,,,,,,,,,," . , . ""!;""'i""",I""",...ii,'j;','I'-'-';"""",,",,""," ''''n'''''''''''''''',;"";",,,,,,,,,,,,, ....,,,,..,,,,i....II...:.,."'...i;".H"II'"i"."'ii.il'". '"''1'''''';;''''.'''''''''''''''''''''''11'1111'';11';'''''''' .".,,,.....,,,,,,,,,,,,..,.,,,,,.,,,,,,,.,, ". ~""Ii'"" "'" ,,,,,., "''''''"ltI,""IIIII', "'''111'1111 Thnt thORO nbovo 1111mod Il1cludo /III of tho 110xtofkll1, HIl fill' n8 klloWl1i . ' Tho llitld'doCllllolltWIIR {lIlHHOHHocl or llQI'8(1I1111111'oJlnl'ty tll tho o"tilll!\lod 1'01\\1: "f $....,~..;l.,~..O..\'..,Q,~".. llnel of, Ronl I<1Htllto, 108H hlCllmlll'l\nol1, to tho oRUm/llnl1 I'lIhlO 01' $........N.~).(l:!.'"....,";.., IIH 11OIIl' IIH 01111 bo 118cortlllnod, Thllt tho f!ltld Honl J')~tllto In RO. fnl' IIH IH known I" IrJ()lItnd In """""1'",,,,,,,,..,,.,,;,,,,.,,,,.,,,,,,,.,..,,...".,;;" '''.'''11.'.''...11..:..''.."......,,,,,,..,,,....,,,..,..,;;,..,,,;,,,,,.,,""'''''''''''''''''''''''''''''''''''''11'''''''''';''''''''''''''''"".....'..."'".III1;'II...i1"il; Thoroforo, YOUI' !lotltiollor(8) I'ospnctfully IIpply(JoH) 1'01' 1.0((01:" of Aclllllnl8tl'lltlol11n tho IIbove 1111ll\ed 08tllt~, Ilahu ..zrf!.,:,/.~~....t:/.... ...."..,.... A, D., 111,.1.1" Signature III\d Add"ll"" ~-y ~., .~&J../x: /):) C~7a;~~,~""~,~"~~*;~,~'{,,,,,;j.""i Ill' 1'0tItI01H1I'(R) /~ :::2 ~.L,.' /? " ,.,.,..,;.,r.,_??!J,.""",r.::-~~.~~".,.~,1Frf.'t~-";""",,, , I_f , ';4?2o(!"~"~~;f~'<l<k,?;~""y",~",,,L,?.f..,'rJ,V--- .. // . . . ''''''''''''''''''''''"''''';'''I'"""",,,,,,,,,,,j'''''li,,;,,,,,..;,,,,,..,,"".. ~l,:((l-/'" ~~:; .~~ L/"\ . ( COMtv!ONW I';A 1/1'11 \ "" :~-~, . t'''';d7f.v;;.,~ .p' /.(., 1/1' ..1/1 111I'nlod .."""""",; """~I'~I"..1t, h'l'";1;;".,...."~::.."~,,h...t::.;f,,,~,.,,..'!,..,,"'" 111 t,ho Ilhoyo nl1[lllulIUOll hullll.\" <1111)' "..;.\{~/.-"',:.~.,A,~,...., ,,,"...., " 1I1'I'Ol'dl",\' to 11\11', 1\1I~' (hilI tho fnotll 111\1 'forth III UlIlnhovl' IlppIlCIl\!OIl 111'11 (1'110 fll 1I111 IWHI of .............,.. kllowlo<lll'o Ilhd hollM. l\lId "lIhHl!l'Illlld 1 betore me, "".t/l.t.Z::......./0..".."..~"....'" , A, lJ" l\I"r.,(.. ,......"...cJ>>dtt",~/.,',. ~.."""".".,,., '1''('' 't( 1\01llH[ol' Flied: ,.q""""",,,p:,~~l-?,~r,,.l~,.A..,~..9fJ;\.,,,,,,,,,,,,,,,,,, 01" i'1';NN:4Yl.vANIA r..OUN'rY 01-' Ot1Mll'~HI,ANIl. ,..,,,,,.,,.....,,,.......,,,,,'.,.,,,,....,,,'.',,;.,,.,. "U'''''''H''''''''''''''';''''''O",,,,,,,,,,,,,,,,,,,,, "."..."".""",."".....",."""""""........",,,, """,;",,;1'"'''''''' "!,{;YQ..t:I,~'~..,,4.,, "".~(.}."k~".., h , , , ; , " " , , . " , .. " , , , , , . , , , . , , it .. , . " " ~ .. . . .'. . . " . " , " " . " " . . . " , ,. .. . . . . " . .,...,.,.,.....;l.."..".,....,..;",.."..""...........,..1""""""""1""'.'1 ^ IlOl'l1o,\' : """""""""""''''','''''''''''''''';'';'''''',''''''.',...,.1 COMMONWEALTH 010' pmNNSYLV ANtA qOUNTY OFCUMBEHLANP } HSI ,.., o! ~~F! ...... ~~ '"5' (Il 0\' " R ;;i: ::::r': Ie '0'" ":~ '~: :~-~ .~ 1'-; . to; 0\ "...) , l,.. , "" '0 .;J OATH OF PERSONAL REPRESENTATIVE being duly IIdmlillstru " ' '. . /----; . . .. .hi .' // ,I ~ ~'" .1t11.I'I...I...;;.,.....!I".'....\I.:'........."....",.,.....Ij..,..."..,...,~'I..laj,l~:-;~'...~.I.&.~1(,-f.~.~"1'1'" poiftionor(s) .....4aI,)~'"'''',..."....,,''''''''' IIccorclll1Y (0 Inw,~",,,,,,,.. deposo und 'RIlY thut 118 the 1"'.1'"111.... of tho oRtnto of ..'I.~).,4..1C1r.~~m..d4~(k7:W.~.~II'..'....III.,......'.....II...1.;1'1.111.111"""'1' .~ 1.."11;'..1.;.1.111.......1,.,.."..;1.."..1....11'.1..'1"""""""""""'1"""""'''''''''''''''''1'1,III,........,.,..,.I!.II".I"""'I"""""I;"""....,.,..;.11.;. deoeused ..""",;,t;"""" will well und tl'uly ndmhllslol' Iho ll:ood" I\ncl chnltols, rlllht8 I\ne! credits ofsl\ld l:leceased, l\c,cor\lIl111' to Inw, And nlllo will cllllll'onlly oompl~' with tho provision" of tho lllw relntltlll' to TrllnHfer Inhorltnnces, l'III1"I_,jjll.'IIIII,,,,,,,,-o;.;...I;IIIII."""'''''''' und HubHorlbod A, D.; lO,e/." ,."@1l:u,~..,:""",d..,:",~1~6,~"",;", """"""""""1......;.111.1"'1"111111";;'1"'""";,'I'II;Il""'IlI",",lllt;',1 DECREE Be It remembered Ihat on Iho ".. ,,,,,,,,,J.9,1l)J,,, ,,'. dny ot """,:,Qr.,th\R.~X',,,,,,,.,,,..,,,,..,,, j., D., 19,,8l... .Letters of Adm'n18t~atio"- Ih the ostato of ..,..."""..t;J}m.~,rl-.~~"J.1"II'H~~.!i.tDI~rH'''''''''''''"I1l'i1!!,i1""'H1I1Hlllt'''"' ;, ;".,,,.,. 11111' I! 1'''''''''''1111''''''''.'; ". "". """"..,, ,,,;,,,,.,,",..' lato .of "',"" ""'" ...\I.~P;ft~I/,.(\.J,;l,~r.\. ,mQ.WXlR,\1~l~ilIiH"t""HIl Oumberland County, Pennllylvllllla, deQellRed, were ll'rllnlod to .........T~l,\t,r.,hrl,~/I."I.\...."l!fl.r.),),hl.J.rJ.,,,..,,"" i .....'1;"."1'.;.11.."";,..,'..""..""..""..",.,.,.I."!...,.".";.",;,'-,"III....",,.,,;.,,,IIII."'I'."..,..'.;...11.1;1.1....'11'11'1.'..".11'1'.....""".Ilii'I"""', trlt~ WltnosH my )lllnd andoffic\!LI Real the dlly ~nd yell I' IIfo~~~ald,y. , ;. I """",.,(t}::)u#",(L~. ' ;. '''.''Il'li'lli'IIlIl'i1 {I Register