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HomeMy WebLinkAbout81-00705 ,/; ." !' q,; ;, ,,1 -,! 'c 't. ," i I ' ' ~ . I ij ~ ~ i ~ . u ; ~ ~ -. t::\ ~ i " "8 -j' I,; ) J,' ~ I' OOMMONWIALTH Of PIHN5YLVANIA I OOUHTYOPCUM8IRLAHD J It, __~_~__".." ___,__,__._________' ,__,~,_,_ ,"" _.l>lJI!JI~L ^" _~(I~~.. ,,_,,_~_H_~ ~____H_~'_"~"H _m_":"~,. -.--. b~ln9 duly aworn _._____..__ occordlng 10 low, dopolol and 10YI Ihol sho ,,_t\tc;1...VJ!ra\ID..l\.L.rellr(la~iliB _~J\nd lell!U.!!~______..._u__...._pu__'" 01 Iho Ellolo 01 ____Q1yAn....llt.-.JtIl.d:...--..:.-,-'-----~- 101.01 ,Dorough ~f CllrHalo . ~_'h_' Cumborland, County, Po" dooou.d and thet the " within II en Inventory mode by:_____.NirJ'OllLAL..KIUlK..--_--__.._ .__'-,______, tho "Idllara, rop. &" tolllltllO 01' the enlir,o ,1111010 ollftlddocodonl, ,ccnlllllnll 01 all tho porlonal prop'drty ond roel OIht.,uoopt rO,al "tate ouhldo t~a Oommonwealth 01 ponnlylvan,la, .end that tho IllIur" oppo"Io uch Itom 01 th~ Invontory ropruont 11'1 lolrvalut u' 01 tho doto III dooodont'l doath, th,1.8.,,~,~~day of Nov, 1~;;'n4'Y1 ...a.....:777~ $HARON A. MOSRA, Notary Publlo 0,rIl818, PA, Cumberland Qounty MY,Oomll1leslon expires Jan, 14, 190,6 19 ..!.~ . }YI.A;d...'--~I--~ a'__nJ4.c.A e...utor ' ^dmlnll".tor - ftworn and IUblCrlbod boloro mo, Hidam A, Kook ..~-................_~-_-.----......-~ _ItLElIst Nor!h. Street, Cllrli a le.t..!A 17013 ^ddrtll if Pate IIf Puth ___ ISthnn_____' February PlY Month 1981 Vu, .~---" IN&TRUCTIOHS I., An Invontllry mUlt bo fIIod within throe monthl olter appolntmen' IIf p."onal repruontatlve, a. A I,upplon\entlnvontory mUlt bo IIl,ed within thirty daYI o(dlloovery of addltlonol "'0\1, 3, A~dltlonal Ihuh may bo atteohod at to pDrlonolty or ,.ally 4, See ~r.t'clo IV, FlduclarlOl Aot IIf 1949, ~ I .z:.. I QI I< " t 1 , i ~ .J... ~ 11 ~ <1r ~ ~ w i if I 9 ~ , t-, ~ ~ .,'! ~ ~ , ~ j .....;7 , ." Cl ~ ~ 1:1 li, r I. .. ~ :a: ~:--t lit ".!J. ) Jl t;,F' ;H.t( ''''1111 -:.:.... ~~,:2~ ~h ~ ~i ld '0 <." :...~~H 'V j llJ tJ;f:j 3 5i5 ~u If u " "'J , o";>(",g 1- 7 CS "'-. (/ ."/R, I "!;'1.r\lu tiMt 11-1101 COMMONWU~ TH OP rENHIY~VANIA DEPARTMENT OP REVENUE TRIINIPER INHERITANCE TAX RElIOeHT DUCEDEHT INHERIT ANCE T AX RETURN FOR INSOLVENT ESTATES (Inatructlons on Rovorlo Sldo) COUHTY 1'10, STATe 1'10, l'erRonal DoBey's M final paychec\\ l'erRonal Coin Collection PerRonal Tools Personal Jewnlry and wutch 1'0rRonal Clothing Jolntlrow od (o'l1tiretieR- \Iuaband and \<Iifo) .. 1/2 valuo, 19'7(,'(ilcCaiiii1tillO---"(al,450 ,00) 1/2 houRohold fllt'niahlngo ($ 750.(0) E,tatl 01 Clyde 0 , Koel\ La.t oddr... -L.3 1~1I8t NO.4th Strl!ot laTnU(1) ! ICITYI c pOil11Rylvania ,I"^HI 17013 1""1 oarlialn Dati al Dlath ,llnbt'unn 15. ',UUP $a;lal Security 1'10, I 7/1 -:lli:.1 7lfl TYPE Up ,,"er DESCRIPTION ~ ( ) huc, 1'1 aJ'" ( ) Adm, l( Oth.r Midl\lll A, Kud\ I'nraohal Roproaontntlv an(~ I,ollotno ' S~91al Socurlty H~, 207_?p-!)()?7 ~ '" ~ Addru.. _ 43 gnat North lHroat (U"IH-H'O oadiHlo PonnHylvaniu 17013 (f~I"'Y) (lllAll.!!' _ '_ \llPI UIldnr IHHHtltlol ol110tlurv, I doclaro that I hlveoMlmlllerJ.thl. rotutll and 10 Ih. h'.'1 01 mv knol'll.do' "'d b.II.. IIII \rue, Qorreotend aDmpl.'e. "" ( / fi ~LL.J,"'.-ik.n~)\ (,(, J-.('(-"IC.~ II- :)I'i.~1 6lQl\lIturu 011"ldllClafV oat. EITIMATBD MARKS T v"~\Je $ 60,00 $ 188,1\0 $ 4 ~ ,00 $ 75.00 $ 100,00 DEPARTMENT V"~U"TION (OPPlcIA~ un ON~Y) 1 " 111 , L~"1 iii" , !'_l Il'i ,~,... 1 05 -' ~l!l 1,4?(~, I!Hg IW"' "'1 , ;t:l !'.) o 'I ; :1 'Q , , ~j , TOTAl. $ 44R,80 I do hlruby aertlly t at the DbDve DUIU wire Dppralud ,In aacordancl wit . -~~ ,~~.~~, ' ...-C <~~ ~"~~I"'R V' OPPlCIAL USI ONLY DATE NAMe OP P"YU Register of \~ll1H Offlce Ruby D. WeekH. EsquIre Sharoll MORer HoffmanM!\oth Funeral 1101\10 GravemQrker co 'be IlurehnHe,d IlNC l'lw rmac y CarliRlo lIoBpitQl Ilelvedore Modical ConCur lloro,\lgh of: CarHalc VOl Corporation United Tolephone Compllny I'I'&l, .~ m Q ~ ~ .. III Q OPPICIAL USI ONLY , NATURe OP C~AIM AMOUHT c~AIM8D $ 10,00 $ 150,00 $ 4.00 $ 1,,996,25 $ 7 S 86,R6 $ 152,50 $ 90,00 $ 2tl.35 $ UL311 $ 20.01 $ 37,38 $ 2 593.73 FIlillg ,,11000 Attorney I'eoa Notllry lIoou Funora 1 n ~pring of 1982 ~lndioineH-r:inal U In,,"a Finnl hORpIeal bill FII\QI medical bUla Ilil\ol water bUI Final goa bill FInal phono bill Filial olndtric bIll TOTAl. . /'c'~) ',UOIOij MOL OW(1)UI IDnI'IAll'ul'O~'Vd WJOI UO pOjJodOJ oq pnolll UIOII OWOOUI OlqPMDI II'll 'Iolodmd MP10WOOUI DIUPAI~I\HlOd JOIOlqDIJodOJ II 0111110 liD lluPOI'lUIIY .po UI pOUIJllpoci 180lAJOI JO, 'JOIIIJIllullUI'P JO JOIO)IlM8 UD '~IOUIDII i8AIIPIUel8JdOJ 811,1118 UI,I 01 Pllld 180~ 19J,ON ,,'MOl ~q olqOlOAO.OJ 010 IUOOWOO~IIIO Ilqop IP 00\10AO~ '0 IUOWIlOlloO 0'11 ~q p.,OAO.OI oq 01....1 O~I IIIOA'~OI~M 000'1$10 Oop . 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