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PETITION FOR PROBATE and GRANT OF LETTERS
Estate of '/1'// t- ~I AM H ~f20I..,:lJ Al-8R/6Hr No. .:(1 - 0 I - 70 I
also known as i/IIILL/AH 1-1. AlJ31<161-ITTo:
Register of \\jlls for the
J Deceased. County of C:J)I-1~EI!LANb in the
I q?; Z If 0 9 9 ~ Commonwealth of Pennsylvania
Social Security No.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executAI""
in the last will of the above decedent, dated ,4 P f2, I L, (r; flt
and codicil(s) dated
n~ed
, 19
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
h {S
(list street, number and muncipality)
Decendent, then 71 years of age, died :riA '-}of /3> , ~ ZoO! ,
at r'.A{!.L-15l.,E' AILE" {--105PrrIJL"
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
I , 000. 00
,
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron.
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1.. 58
COUNTY OF CUMBERLAND J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to o. r a. f.firm. ed. and. su bscribed { ~. .. ~~
before me this . 25th day of {, ?/LI;_ _ _ ~. ::s
JULY ~2001 . a
_ ~ma,1A1 C. [pi ~ Register I
liP ~ Lf0 ._~
No. 21-01-701
H. ALBRIGHT
Estate of WILLIAM HAROLD ALBRIGHT A/KIA wrIJ..IAM , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JULY 27, ~2001 ,in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated APR. 15.1996
described therein be admitted to probate and filed of record as the last will of
WILLIAM HAROlD ALBRIGHT AI KIA WIIJ..IAM H. ALBRIGHT
and Letters TESTAMEm'ARY
are hereby granted to YOKO MATSUO ALBRIGHT a/k/al YOKO M. ALBRIGHT
"/YYl^-'1 0, ~ D,-- /lB Jof"t,
Register of vlills
FEES
$ 18.00
$ 3.00
$
$ 12.00
::>.00
TOTAL _ $ JQ 00
Filed .... .JULY .27,,2Q01................
Probate, Letters, Etc. .........
Short Certificates( 1) . . . . . . . . . .
Renunciation ................
x-pages
JCP
ATTORNEY (Sup. Ct. LO. No.)
ADDRESS
PHONE
05.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fllmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~/ -OJ -701
No.
ll,.~ \\. ~~~~
Local Registrar
Fee for this certificate, $2.00
p
7578056
,nIL 1 7 2001
Date
S'
H1OS. 1<< R.v. 1191
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
E1PRINT
IN
"ANENT
\CKINK
H
ALBRIGHT
SEX
J. Male
STATE FIl.E NUMBER
SOCIAL SECURITY NUMBER
3. 193-24-0883
DATE Of OEATH (Monlh. Day. Year)
e. July 13, 2001
UNDER 1 OAY OATE OF 8lRTH BIRTHPLACE (C~y and PlACE OF OEATH {Check only one ... instructionS on OIhel side)
~ Mlnut.s (Month. OIy. Year) Sial. 0' Foreign Counlry) HOSPITAl:
Feb. 27,1930 Huntsdale, PA Inpatienl 0
7. ...
CIT FACiliTY NAME (II not inSliluliOn, glv. SI,eel and numberl
~=~)o
Ie.
RACE. American Indian. Black, White. elC
(Specify)
White
10.
DECEOENT'S
ACTUAL
RESIOENCE
(See instructiOns
on oth8f SiCe)
171. Stale
PA
MARITAL STATUS. MI,ried
Nove' M.rried. Wi_.
Oivofced (SpllC~)
Married IS. Yoko Matsuo
North Middleton
SURVIVING SPOUSE
(If wife. give maiden name}
KIND OF BUSINE S/INOUSTRY
l1b. Coun
Old
decedent
Uve In .
Cumberland townsnip1 17d.0 :iri~:-;:i~:'OI
MOTHER'S NAME (First. Middle. Maiden Sutname)
19. Nora Sarah Rice
INFORMANT'S MAILING ADORESS {St,""" CitylTown. Slate, Zip Code)
1914 Fryloop Avenue, Carlisle, Pa. 17013
PLACE Of DISPOSITION. Name of Cemetery. Crematory LOCATION - CitylTown. St.le, Zip Code
0< Other Place
17C.!Xl Vat. decedenllived in
twp "
2001
21c. Yorktowne Crematory 1. York, Pa. 17404
NAME AND AODRESS OF FACIlITY Hgffman-Rot.h Funeral Home
22c. 219 North Han VE!r ~tre~t", , '
LICENSE NUMBER OIlfE SIGNEO
(Month, Day. V....,)
23b. 23c.
WAS CASE REFERRED TO ME~L EXAMINEAlCORONER?
Yes ~ NoD
2..
I Approxim.le PART II: Other signlfic.nlconditiOna contributing to death. but
: lnt8fY.1 between not '.....ing in the under1ylng c.use given in PART I,
I oneal .nd 1Ie.th
2:Ja.
TIME OF OEATH
OATE PRONOUNCEO DEAD ~MonIt1. Dey. '!\!ar)
K 12:18 P ~ a July 13. 2001
17. PART I: Enter the _aaea. injuries 0< compliC.tions wl\tCh caused lhe deeth. 00 not .nler the mode of dying, such as cardflc Of 'espiratory .rrest. shOc!< or heart '.ilure.
List only one cause on .ach Hoe.
Han n
DUE TO (OR AS A CONSEOUENCE OF):
DUE TO (OR AS A CONSE~UENCE OF):
DUE iO (OR AS A CONSEOUENCE OF):
d.
WERE AUTOI'SY FINOINGS
A~BLE PRIOR 10
COMPLETION OF CAUSE
OF DEATH7
Narurl'
o
o
~
Homicide
July 13,2001
MANNER OF DEIlfH
OATE Of INJURY
(Month. Day, Year)
TIME OF INJURY
Aprx.
INJURY AT WORK?
No~
_0
NoD
ACCidenl
Pending Investigation
lie. 21b.
CERTIFIER (Check only one)
'CEIlTIFYlHG PHYSICIAN (Physician c~ing cause 01 death when anoth8f physician has pronounced cfealh and completed item 23)
To__ot myknowtedOe. de.th_d...tolheoaUM(s) ond man...... 11.ted. ................... _..................
Suicide
n.
Could not be cfele<mlned
Coroner
'MEOtCAL EXAMINER/CORONER
On u.. beale of examination and/or Inveatlgatlon. In my opinIon, d..th occurred at tnellme, date. and pille.. end due to the C.U"(I) Ind
manner.. at~ed... .. . . . . . . . . . . . . . . . . . . " . . " .. .. . . . . .. .. .. '. . . . .,. . . . . . . . ... . .. . . . .. . . .. . . . .. .. . .. . .. . . .. . . '" .. .
318.
REGISTRAR'S SIGN.o;TURE ANO NUM
t:\. ~~~
tal I t3.l '101
DATE SIGNED (Monltl. OIy, '!\!ar)
o 31C. 31<1. July 13, 2001
NAME AND AOOAESS OF PERSON WHO COMPLETEO CAUSE OF OEATH
(ltem27)lypeo,Print Michael L. Norris, Coroner
M 6375 Basehore Road, Suite 01
~n Mechanicsburg, Pa. 17050
:E FILED (Month. Day. ;J~ I to d,\j:) \
'PAONOUNCING AND Ct:ATIFYlHG PHYSICIAN (Physocian boII'1 p'OtlOUncing _ and C8rl~'ng 10 cause 01 deathl
To _ _t 01 my knowtedOe. _ occu.....s.,lhe tlrM. d.... .nd place. .nd clul to the cauae(l) .nd m.n....... ltated
LAST WILL AND TESTAMENT
OF
WILLIAM HAROLD ALBRIGHT
I, WILLIAM HAROLD ALBRIGHT, Social Security Number 193-24-0883, of
the State of Pennsylvania, declare that this is my LAST WILL AND
TESTAMENT and I revoke all other wills and codicils previously made by
me.
FIRST: I appoint my Wife, YOKO MATSUO ALBRIGHT, as my Personal
Representative concerning this will. If she is unable or fails to
serve, I then appoint my daughter, SARA EIKO ALBRIGHT to serve as my
Personal Representative.
a. I request that my Personal Representative be permitted to
serve without bond or surety thereon and without the intervention of
any court, except as required by law. I direct that my Personal
Representative act in unsupervised administration so as to administer
my estate with a minimum of court supervision. If it becomes necessary
to have ancillary administration of my estate in any jurisdiction where
my Personal Representative is unable or does not desire to qualify as
ancillary legal representative, I appoint as such ancillary legal
representative such individual or corporation as my Personal
Representative shall designate, in writing.
b. I direct my Personal Representative to pay the expenses
of my last illness, the expenses of a funeral appropriate to my station
in life and custom of living (including a suitable monument or marker
for my grave), and written charitable pledges which I have made. I
grant my Personal Representative the power to extend or renew any debt
for such time as my Personal Representative shall deem appropriate.
c. All estate, inheritance, succession and other death taxes
with respect to all property passing under this my Will shall be paid
from and borne by the principal of my residuary estate, without regard
to reimbursement, as if such taxes were administration expenses. My
Personal Representative may pay such taxes at any time deemed
advisable, whether or not then due and payable.
d. My Personal Representative is requested to settle my
estate as soon after my death as may be practicable, and to payor
deliver every legacy or bequest to my beneficiaries without waiting any
time that may be believed to be customary in probate matters.
-~k~~
PAGE 1
5 PAGES
ilL
~
n
e. I have served in the Armed Forces of the United States.
Therefore, I direct my Personal Representative to consult with a Legal
Assistance Attorney at the nearest military installation and with the
Department of Veterans Affairs and the Social Security Administration
to ascertain if there are any benefits to which my family members are
entitled by virtue of my military service.
f. I may leave a letter of intent with the executed copy of
this will for the purpose of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. I request, but do not require, that my Personal
Representative honor my wishes therein expressed.
SECOND: I give, devise and bequeath, absolutely and forever, all
of my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my Wife, YOKO
MATSUO ALBRIGHT, as her sole and absolute property if she shall survive
me.
THIRD: In the event that my Wife, YOKO MATSUO ALBRIGHT shall not
survive me, I give, devise and bequeath, absolutely and forever, all of
my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my children,
SARA EIKO ALBRIGHT, WILLIAM HAROLD ALBRIGHT II and HEIDI JANE ALBRIGHT
and to any child or children that have been or may be born to or
adopted by me, in shares of substantially equal value to be divided as
they may agree.
a. If any of my children shall not survive me, then I give
the share of that deceased child to my surviving children in shares of
substantially equal value to be divided as they may agree.
b. If none of my children survive me, then I give, devise,
and bequeath, absolutely and forever, all of my estate and property of
which I may be seized or possessed, or to which I may be entitled, at
the time of my death, wherever situated or of whatever nature, be it
real, personal, or mixed, to the descendants of my child or children,
who are to take per stirpes and not per capita, in shares of
substantially equal value to be divided as they may agree. In order to
receive a share of my estate under this paragraph, a descendant of any
child of mine must survive me.
~~/~OF
PAGE 2
5 PAGES
~~~
c. If they are unable to agree, the division among my
children and the descendants of any of my children who fail to survive
me shall be made by my Personal Representative, in that person's sole
and absolute discretion. I empower my Personal Representative to sell
any or all of such property, if such property is not distributed in
kind hereunder, and to distribute the proceeds among my said children
in substantially equal shares. Any determination of my Personal
Representative as to what should pass or be sold under this paragraph
and to whom it should pass or be delivered or at what price it should
be sold shall be conclusive.
FOURTH: Except as otherwise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not. Insofar as I
have failed to provide in this will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake.
FIFTH: Any beneficiary who fails to survive until one hundred
twenty (120) hours after my death shall be deemed to have predeceased
me, and the gift to that beneficiary shall be disposed of accordingly.
SIXTH: Definitions:
a. The term "children" as used in this Will includes adopted
and afterborn persons. The term "children" as used in this Will shall
not include step-children, the natural born or adopted children of a
person's spouse who are not the natural born or adopted children of the
person. A relationship by or through legal adoption shall be treated
the same as a relationship by or through blood for purpose of
succession to property under this Will.
b. The term "descendants" as used in this Will means the
immediate and remote lawful, lineal descendants by blood or adoption of
the person referred to who are in being at the time they must be
ascertained in order to give effect to the reference to them.
c. The term "Personal Representative" as used in this Will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such a fiduciary.
d. The term "per stirpes" as used in this will means that
whenever a distribution is to be made to the descendants of any person,
the property to be distributed shall be divided into as many shares as
there are (1) living children of the person, and (2) deceased children,
who left descendants who are then living, of the person. Each living
child (if any) shall take one share and the share of each deceased
child shall be divided among his then living descendants in the same
manner.
__~~~OF
PAGE 3
5 PAGES
~pJ
2o~
~
SEVENTH: In addition to any powers granted by the laws of the
state in which this will is probated, I hereby authorize and empower
the fiduciaries named in this Will, to the extent of the discretion
herein granted, to sell, exchange, convey, transfer, assign, mortgage,
pledge, lease or rent the whole or any part of my real or personal
estate, to invest, reinvest, or retain investments of my estate, to
perform all acts and to execute all documents which my fiduciaries may
deem necessary or proper in regard to my property. If any of my
fiduciaries elect to receive compensation for services, such
compensation will be that allowed by law.
EIGHTH: If any part of this will shall be invalid, illegal, or
inoperative for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Personal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this
VA
/5 - day of ---.fJ(kIL , 19 ~ , set my hand and seal to
this my LAST WILL AND TESTAMENT, consisting of 5 typewritten pages,
each page bearing my handwritten signature.
This document was prepared under the authority of 10 u.s.c.
section 1044, and implementing military regulations and instructions,
by Robert P. Formichelli, who is licensed to practice law in the; State
of New York. _ / .
~ (SEAL)
WILLIAM
-'l~Af'~~ OF
PAGE 4
5 PAGES
LA
@
The foregoing instrument was, at Carlisle Barracks, Pennsylvania,
this I~~ day of ~t1?11 , 19S7~ , signed, sealed, published
and declared by WILLIAM HAROLD ALBRIGHT, the testator, to be his LAST
WILL AND TESTAMENT in the presence of all of us at one time, and at the
same time we, at his request and in his presence and in the presence of
each other, have hereunto subscribed our names as attesting witnesses,
and we do so verily believe that the said testator is of sound and
disposin mind and memory at the date hereof.
~c.~{:s --&R,
Soc.See.No. Soc.See.No.
OF cadd{ . /1
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OF
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/70/3
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PAGE 5
5 PAGES
L
~
v
73if
COMMONWEALTH OF PENNSYLVANIA
CUMBERLAND COUNTY
ACKNOWLEDGMENT
I, WILLIAM HAROLD ALBRIGHT, testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law, do hereby acknowledge that I signed and executed the instrument
as my Last will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
(SEAL)
AFFIDAVIT
.~ .? ~d#, 'XD)4 4
R'~cJY"l.j /J ~ Z
, and
We,
-Esht:- G-eot:J:;)~ , the witnesses, sign our names to this
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his Last Will; that the testator signed willingly and
executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witness; and that to the best of our
knowledge the testator was at that time 18 or more years of age, of
soun d and un r no constraint or undue influence.
i~i~ssC, ~ Wiet-, A~-L
Subscribed, sworn to and acknowledged before me by WILLIAM HAROLD
ALBRIGHT, the testator, and subscribed and sworn to before me by
AlJI'd ?k~;~ff ,/?IJS.4 ;4, Kk!rt oJ V <"" 2.. , and
- ~ U ~
ESkf- G-EDek , the witnesses, this 15- day of
APRIL- , 19 qfc.
~(:~S~MY connnission
Notartal ~eal
Kim C. Guyer, Notary Public
C,rtllll Bora, Cumberland County I
My comml..lon Expires Nov. 10, 199: '
~,l\; f\:.!I'IMY . of Nota .
E
...--'"
Will No.:
CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
WILr~/AH HARD~7) ADBRIGH,
JULY /3, 2-001
2-001- oOi7o I
Admin No.:
Name of Decedent:
Date of Death:
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the OIEhans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on N 0\1 I, lAJO I :
Name
Address
yof<() Mlt(Sl.{D A'--'13~/6H.f /qllf FP-,/{"OoP AV6r~U~, {JAr<~t5[E/ PA
( s (; L--E 1../ f 1/<. ) 11 () J "3
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: Iv oV 2-1 2,001
Signature
YD/<D HA[SLtD At8!2IGH'(
Name
/ql4 Ftz'/[,ooP ,qUfNU(, fA/ZLI5lf'j
Address P A 11 D/3
(11'J) '571- J~qqL/-'
Telephone
Capacity: ~ Personal Representative
o Counsel for personal representative
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
LNIl.,f..,(AM HA f!.o/..,D At..,Bf?-1 tbH,
C/J
'rJK
1
~
Date of Death: JU Iy 131 J- 00 ,
Will No.: 2,001- 0070 I
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes JZl No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No IRl
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes 0 No f8I
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: -#JJ(o~ ~/)j( d~~:i?t~
Signature
Yo ko H. fJ, /6 r ,. 9 h.f
Name
2
CCJ
...",..
:s
~
J
..0
..... c--
,-
-j -~
.. ...;
::;;c
/q I t{ Fry loop Av-ei1u-e", e ar{i ~( pt:t '70/3
Address
("'r")
p
7/'7,. 243- 0 z-Zr~
Telephone No.
Capacity: ~ Personal Representative
o Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
-
~
Date: 6/10/2003
ALBRIGHT YOKO MATSUO A/K/A
1914 FRY LOOP AVE.
CARLISLE, PA 17013
RE: Estate of ALBRIGHT WILLIAM HAROLD
File Number: 2001-00701
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 7/13/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~ 7rJ9;/:;&;{at~I.~
DONNA M. OTTO :v ~
DEPUTY REGISTER OF WILLS
cc:
/File
Counsel
Judge
15~56101D1
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Requrced
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
_ _ _ _..
__ _ __
..... ............................... .....
___
Yoko M. Albright (717) 985-6513
___
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82)
REV-15x0 Ex ~o~_~o,
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
DEPARTNENTOF REVENUE County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN n h
PO BOX 28060 RESIDENT DECEDENT ~` ~ ~ I d~
Harrisburg, PA x'7128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
193-24-0883 07/13/2001 02/27/1930
Decedent's Last Name Suffix Decedent's First Name MI
__
Albright i William H
.... ....................................
(If Applicable) Enter Surviving Spause's Information Below
Spouse's Last Name Suffix Spouse's First Name, MI
'Albright Yoko M
Spouse's Social Security Number
- - - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
First line of address
1914 Fryloop Ave
Second line of address
_.__
City or Post Office... _ State..
Carlisle PA
__ _ __
ZIP Code
~.:
REGISTERLLS USE OK1LY
a ~.__ ,
..1_7
.. ~I
~~ ~~ 3 ' ,
~ ..-- ~..
E FILED f V "'"'
~'J
17013-1030
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~ DATE
06/16/10
ADDRESS v ~
1914 Fryloop Ave, Carlisle PA 17013
SIGNATURE OF PREPARER OTI-iER THAN REPRESENTATIVE DAl'E
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
L Lsos61o1a1
Side 1
1505610101
.~
C"~
~'7~
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~
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1505610105
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: William H. Albright 193-24-0883
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1.
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C} ..... 3.
4. Mortgages and Notes Receivable (Schedule D) ........................... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6. 79,623.00
__ __ __
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G} O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ' 79,623.00
9. Funeral Expenses and Administrative Costs (Schedule H) ............ ....... 9. 3,883.00
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ....... 10,
11. Total Deductions (total Lines 9 and 10) .......................... ....... 11. 3,883.00
12. Net Value of Estate (Line 8 minus Line 11) ....................... ....... 12. 75 740.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................. ....... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ................. ....... 14. ' 75,740.00
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x .0 0 75,740.00 15. ' 0.00
16. Amount of Line 14 taxable
__ _
at lineal rate X .0 _ 16. ',
17. _ __.
Amount of Line 14 taxable _
at sibling rate X .12 17,
18. ,.. ,,
Amount of Line 14 taxable
at collateral rate X .15 1 g,
19. TAX DUE ......................................................... 19.' 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
1505610105 1505610105
REV-1500 EX Page 3
rlo~ar~ant'c [_mm~lpte Address'
File Number
DECEDENT'S NAME
William H Albright
STREET ADDRESS
1914 Fryloop Ave
ciTY
Carlisle
STATEPA j Z1P17013-1030
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments -
B. Discount
3. Interest
0.00
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
o.oo
0.00
0.00
0.00
0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" iN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? x
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ 0
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE lT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value ofi transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116. (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed an the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)}.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a){1.3;1]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-15og EX+ (oi-lo)
~ pennsyLvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
William H Albright 2001-00701
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) I ADDRESS I RELATIONSHIP TO DECEDENT
A.
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1. A. 03/12/80 Checking Account Citizens Bank Account # 1921024517 1,275.00 50 637.00
2 A. 05/02/98 Waypoint Certificate of Deposit Account # 8000006264 30,450.00 50 15,225.00
3 A 11/10198 Waypoint savings Focus 50 Account# 90715574 3,762.00 50 1,881.00
4 A 12108169 Residential Home 1914 Fry loop Ave Carlisle PA 68,500.00 50 34,250.00
5 A 12130/83 Land High Mountain Rd Penn Township 55,260.00 50 27,630.00
TOTAL (Also enter on Line 6, Recapitulation) I $ 79,623.00
If more space is needed, use additional sheets of paper of the same size.
~ i
REV-1511 EX+ t].0-09)
pennsytvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
William H Albright 2001-00701
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Services for of Funeral Director, casket, Death Certificate & Coroner Fee 3,845.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Names} of Personal Representative(s)
Street Address
City
Years} Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant`s, attach explanation.)
Claimant
Street Address
4.
5.
6.
7.
City State _
Relationship of Claimant to Decedent
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
State ZIP
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
ZIP
38.00
3,883.00
r.
• ~.~
.i 20i-CT-Warranty Deed-Shorn Form~Act 1909-Double Sheet
Henry Hall,. Inc.., Indiana. Pa. .
MADE THE 8th dap of Deeernber in the year•~
o f o~cr Lord one thousand nine h~.tndred s i ~ t y -:nine
. BETWF.,~N
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and
RAYM4 ND J. DRUGOTCH and CHRISTINE DRUGOTCH, his wife,
of Carlisle, Cumberland County, Pennsylvania
f Grantor ,
WIL~,IAM H. ALBRIGHT and YOKO M. ALBRTGHT, his v~rife,
of Carlisle, Cumberland County, Pennsylvania
Grantees
WITNESSETH, that in consideration ~of Nineteen Thousand ThreE Hundred and
No One-hundredths......($19,300.00) .......................... Dollars,
in yiuncl paid, the receipt whereof is hereb-~ ccckno2vledged, the said y~ranto7g do he7°eU~ grant
rend convey to th.e said ~raratee s ,their heirs and assigns
ALL that certain tract of ground situate i~n North Middleton To~rn-
ship, Cumberland County, Pennsylvania, :numbered and described in
accordance with Plan No. 5 of Schlusser Vi~.lage, said Plan being
recorded in the Office of the .Recorder of Deeds in and for
Cumberland County in Carlisle, Pennsylvania in Plan ~..'B ook ~, Page 3,
as follows:
BEGINNING at a point on the Western line of Fry Avenue., which point is
Three Hundred Seventy (3~'0) feet North of the Northern line of Wagner
Street, which point is the Northeastern corner of land marked G. H.
Sehlusser~ as shown on said Plan of Lots; thence in a Northerly
direction a distance of Eighty (80) feet to a point in the dividing.
line between Lots Nos. l32 and 133 as~how.n on said Plan No. ~ of
Schlusser Village; thence by the Southern line of said Lot No. l33
i:n a Westerly direction a distance of O:ne Hundred Fourteen (11U~)
feet, moreor less, to a point i:n the Eastern linE of Lot No. 125;
thence by the Eastern line of apart of Lot No. 12~, all of Lot No.
12b, and through Lot No. 127 to a point .in the ~ Northern line of said
tract of land marked G. H.' Schlusser; thence by said tract of land
marked G. H. Schlusser in an Easterly direction, a distance of One
Hundred Ten (110) feet, more or less, to a point,the place of
BEGINNING.
CONTAINING Eighty (80) feet, more or less,. in front on F'ry Avenue
and extending in depth along the Norther lime a distance of.' O:ne
Hundred Fourteen (11~} feet, more or less, along the Eastern line
a distance of One Hundred Ten (110) feet, more~or less, a:nd having
a width in the rear of Eighty (80) feet, more 'or less.
BEING improved with a one-story frame dwelling known as 191.E Fry
Avenue, Carlisle, Pennsylvania.
BEING the same which Jack ~. Sittman and Jean A. Sittman, his wife,
by deed dated April 30, 19e3 and recorded .n the Office of the
Recorder of Deeds for Cumberland County in Deed Book." ", Volume
and Page conveyed to Raymond J. Drugotch and Christine
Drugotch, his wife.
.-
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4 V~
IvWhihiR ~~~ ~~1...~~4'~~~'~~.1(~..l~~~fi~~C DO.~ ~tS'~. CtY'M~1~ ~,+Q.~ Pd
~i.'£hi ~ !~. ~~ Roel Estate Transfer Tax
BOOK ~~ PAGE ~9~ ~~~ comb. c~. o~5t. cot. ,~9+: c--xS .
AND the said grantors hereby covenant and agree that they and each of them will warrant
~ei~erally the property hereby conveyed.
IN WITNESS WHEREOF, said grantors hcare hereunto set them' hands and seal s
the day and year first above written.
~ZtgttED, ~Ecx1ED axt~ ~E!{~'E~ED
{n the ~itre~ence a~
~'
SEAL
SEAL
---- s~AL
---- S AE L
State of PENNSYLVANIA
ss.
County of CUMBERLAND
On this, the day o f , 196 c~ ,before me,
the undersigned officer, personally appeared
RAYMOND J . DRUGOT CH and CHRISTINE DRUGOT CH
known to me (or satisfactorily proven) to be the person whose names are subscribed to the ' ;'~~ ..
within instrument, and acknowledged that they executed same for the p~icrposes,the~~in '.~ ~;'; ,`~•.
.....~.
r
contained. .. _.__....___.._~ . . ~ `~.•~' ~. ~~~'~~,~`~ w`~,,r~ ~ ~~' -.
-.... r
IN WITNESS WHEREOF, I hereunto set;:- nd and o,~ici sea. ~ r ~ ,:. ,~f:~~~ '~ r~ "
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------------~ly~~amnrr3~~un-E;cpTresEictaber-?5;-~3t~--------:-=----- ~n ------- ~ , ~ a
Carlisle, Pa. Cumberhnd ~a~ o f O f~ccer. _' :.1 ~ i
State o f STATE
ss.
Cozcnty o f
On this, the day o f , 19 ,before ~ri•P,
the undersigned officer, personally appeared
known to me (or satisfactorily proven) to be the person whose name subscribed to the
urithin instry•ccment, and acknowledged that executed same for the p~-crposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
--------------------------------------------------------------------------------------- ~s s
Title of OfJieer.
do hereby certify that the precise residence .and complete post o fi'ice address
of the within named grantee is / ~ / ~ ~~ ~,.,~__ , ~'~L„i,(~ ~ ca ~-
~~ ~ 19G ~'
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Attorney for _ "~ ------•- -------- ------------ - --------
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C0147MONYT'EALT.FI OF PENNSYLVANIA
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f -- ------------- ~------- ----------- -----------------------~ (~
~' ~ _ a~ o ------ - - -- --- - ------
~ECORDED on tfL2s ----------=-~ ---------------- --- d J f ------- --- ----
A. D. 19.6_ in the Recordery's o,~ce of the said County, irc Deed Book '~~~
.. ° ;::,.
Vol.
Given Zc7zde7° my hand am t)c seal o he sai e, the ctccte above written..
y
------------- -------------~-----------=---------------=---------, Recorder.
210T-Deed Guardian's, Trnatea'a, Executor's or Adminlatrator'a (Corporate or Indi.viduul)
Henry Hall, Inc., Indiana, Pa.
~~ji~ ~r~~e~tu~e,
N1.=1DE THE 30th da~~ of December in the year
of o~cc~r' Lord o-rte thoZCSand nine hZCndred eighty-three (1983).
BETWEEN JOHN REUBEN DILLER and JOANNE ELAINE DILLER, Executors of the Last
Will and Testament of Reuben E. Diller, late of South Newton Township, Cumberland County,
Pennsylvania, Deceased, parties of the first part,
GRANTORS,
AND
WILLIAM H. ALBRIGHT and YOKO M. ALBRIGHT, husband and wife, of North Middleton
Township (mailing address: 191'1 Fry Drive, Carlisle, Pennsylvania 17013), Cumberland County,
Pennsylvania, parties of the second part,
GRANTEES.
WHEREAS, Reuben E. Diller died unmarried on the 16th day of September,
1983, seized in fee of the hereinafter described real estate, and by his Last Will and
Testament dated NIay 19, 1981, with First Codicil thereto dated July 12, 1983, since his
death duly proved and remaining of record in the Office of the Register of Wills in and
for Cumberland County at Carlisle, Pennsylvania, in Will Book 91 Page ,and filed
to Estate No. 21-83-599, provided, inter olio, as follows:
"12. I hereby nominate, constitute and appoint my son, John Reuben Diller
and my daughter, Joanne Elaine Diller, or the survivor of them as Executors of this my
Last Will and Testament and further direct. that neither of them shall be required to post
any bond to secure the faithful performance of his or her duties in the Commonwealth
of Pennsylvania or in any other jurisdiction."
WHEREAS, Letters Testamentary in the Estate of Reuben E. Diller, Deceased,
were issued by the Cumberland County Register of Wills to John Reuben Diller and Joanne
Elaine Diller on the 26th day of September, 1983, without the requirement that any bond
be posted by either of them, which Letters Testamentary remain in full force and effect,
and,
WHEREAS, Section 3351 of the Probate, Estate and Fiduciaries Code (20 P.S.3351)
gives a personal representative power to sell at public or private. sale any real property
not specifically devised, and,
Tn7HEl~EAS, the hereinafter descrik~ed real property iNAs not spPCifc~Rlly devi.~ed,
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asoynn ~aalttQ •~ uagna~ `uos sty off. pa,~anuoa pus palusa~ ~Ip~ a~sd `ZT auznto~ ~„M„ Moog
paaQ ut 'stusnl~suuad ~atsttasO ~,s ~flunoO pust,zagcunO .zoo puB ut spaaQ ~o .~ap~zooa~ aye ~o
aot~3O ayI ut `5fi6T `OZ ~.zsnusr pap,zooaa puB `5fi6I `Oti ~asnusr pa~.sp paap ~fq 'usut al~uis
`.~aIIIQ •d uyor yottin~ punt ayI. ~o tIs st pusl ~o ~.os.z~ pagt.zosaP ~AOg~' ~H.L
•sa,za~ (~/I-LE) ~Isy-auO pus uanas-t~~.ztyy ONINI~ZNOO
JNINNIO~g ~o
aosId ayI oI saya,~ad (98I) xis-~I.y,~t~ pa,zpunH auO ~~.saM saal.~aP fi/£-II yT,zoN `aa,I~ad
. a~aoaO ~o ~taau~.zo~ .,~o n~ou puB aa~ut~at~~aH •Z •d ~o ~ft,zau~ao~ ao nnou spud r~q aouay~
:sauo~.s o~~sayoaad "(E`•ItiI) sy~ua~-aaays, puB auo-~SluannZ pa.zpunH auO `~ss~ saaa.~ap Iii y~nos
's;zan$aS ~~:~_~. •:~~;~.o t~ia~utao~ ao nnou spurt ~q aouay~ : auid s o~ sayoaad (90 T) xiS paapunH aup
'~.saM saa,z.~aP 9Z' ylno5 `,zall.anoH tuBtiIiM Pus sataH at~~.sag ~.za~~BauaS y~agsztI~ Pus
as b ~ aauixo~ ~.z~"~~c,~au s us ~ aouo~ :sduc~s us ~snoo s 3s OKINNIJ~g
~ tO ~ I ~ ~ ".~ P I q y~ ~ P Z
:s~ollo~ ss ~pagt.zasap, pus papunoq ~8iusnl~suuad ~o a~.s~.g pus pust,zaqu~n~ ~o ~~.unoO ~uuad ~o
dtysuMOZ ayI ut a~sn~is ~utaq pus ~ut~t punt uts~.unoui ~o tao.zsd uts~aao I.By~. ZZ~
~'~~~~~~'~~'~f,x ~sat~a,zt~.ua aye. ~q s~.usua~. ss 'su~tss8 pus saiay / 's aa~usaO
~~ '= dTaL[~.
p~~.n a '~o~Ij/~~.~~. ~.~~~uo~ puro asroala.~ `uaz?ro `11as `u2roB.u~?q `~urocB
F t.
~~•~5 ~ ~~ 1~ .rte ~i ~ I '~j ~L ~ S ,°t ! ~. .• ,.
~:~»;,~ ~. op `s~uasa.~d asai~~ Rq puro `pauccz~uoo puro pasnaga.~ `paua?fro `plos
"~°' : ,... 5`.. `y : ~ ans aB a nzou aro ~ a.~a sL oa.~a ern dzaaa.~
`roazc2roB.~roq `pal.urocB y p p 1 x R u ~ ~ ~
a.,~~:. `~oa~ca~~~a~c2lap pu%.~uzlvas a~~ a~co~aq puro ~ro
s aa~.us.zO pzros a~{~ ~iq pzrod puny{ uz ~ aye o~
`sa~ro~S pa~ZUn a~{~ ~o ~cauout 1n~~nro1 s.~v?1 oQ - ----. (0 0' ~ L E `~ Z $) - -
----anr~-~fl.uanag pa,zpunH aaayy pussnoy~, anon-~~uaM,L ~o ucns a~{~ ~o uoz~ro~captisuoa uz pure .co{
~saol.us~zO pzros a~~ ~ro~1 `H~L~SS~11ls1~1 ~~III1,LI~~CI1ti7 S'II~~L ~l~1O1~I
' TOGETHER with all and sing~dar
wa~~s, •zvaters, Zvater•-courses, 7•ights, liberties, privileges, hereditame~tts and appurtenances what-
soever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents,
issues and profits thereof; and also, all the estate, right, title, interest, use, trust, property, posses-
sion, claim and demand whatsoever, of the said Reuben E. Diller at the time of his death
in la2v, equity or otherwise howsoever, of, in, to or out of the same:
TO HAVE .4ND TO HOLD, the said
hereclitarrze•nts cerzd premises he7•eby granted and released, ~or mentioned and intended so to be; with
the app~tcrte7zances, unto the said Grantees, their heirs
and assigns, to and for the only proper use and behoof of the said Grantee s, their heirs
oj• assigns, fo7•eve7•.
.=1nd the said Grantors,
cowencc~rzt , promise and agree to and with the said Grantee s, their
heirs and assigns, by these presents, that they,
the said Grantors,
have root clone, corrz7nitted, or ~;no2vingly or zv~ill-ingly s2c~"ered to be done or committed, any act,
7rz.cctter• o-r thing whatsoever 2vhereby the premises hereby granted, o~r any part thereof, zs, are, shall
or -nzay be -impeached, charged or i-nczcmbered, in title, charge, estate, or otherwise howsoever.
WITNESS the due execzctio~rc hereo f the day, month and year fi7•st above Zvritten.
of the Estate of
ATTEST :
------------------------------------------------------------------------------
Secretary
WITNESS:
r mom..-~
~,~~~.,^1.-t Yri
State of Pennsylvania
County of Cumberland
On this, the 30th
1
~'y -------------------------------------------------------~-------------------------
President
' ~-/ ~ ~-.~ ~ -~~'1 SEAL)
Jib n Reuben Diller, Executor - ..~
l~ ~~. ~-- ~ .~ _,
~o~nne Elaine i~ler, Execu o~ ~~~ ~~J
-------------------------------------- - ----- - ---------- SEAL
of the Estate of
_ Reuben_E._Diller,_ Deceased
ss.
day of December 1983 ,before me
the Zcnde7•siyned officer, personally ccppea7•ed John Reuben Diller and Joanne Elaine Diller,
Executors of the Last Will and Testament of Reuben E. Diller, Deceased, late of South Newton Twp.,
of the State of Pennsylvania, County of Cumberland ,known to
~~ce (or satisfactorily proven) to be the perso-rc described in the foregoing instrument, and ackno2vl-
edyed that they exectcted the same in the capacity therein stated and for the purposes therein
cvyztccinecl.
q4 erlt i~ '.
I~rc witness ~zvher•eo , I hereunto set m~c hand and o ciccl seal. ''
~~ ~ 1
d ~~
--------- -- ~':_~Z''t^'~ ----~~=-----•--"--- ---------------------- *~_ ~ SEA ,.'fits , _
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~Ib~A~fY t~U~i~.l~'~, CA~fI-Y~~.~, CUNclI~~~iL.~11V1~ CdU~I'i''Y' ~0 ~` ~' *~ ^ ~ .
~~ ~~~IMl~d~l~i~ ~Xl~i~l~S ~-t1~lJ6r 1~„ 1~~' 7, 'y~~. o~ r, ~ r,~ ,
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~~~
CERTIFICATE OF RESIDENCE ~; f f ~,N¢,• r. x ,;~'~ `~ ~`
______________L_______________.____ clo tter•eby certify that the precise residence and complete post office address
of the 2v~ithin named. grantee is 1 ~ 1 ~l Fry Aven~_ce, Carlisle, P~'~ 17 ~J 13.
December 30, 19 -rte ~t~:.~''`~:___,.______~,r __
8 3 -w~==----------- -- ---------------------------------
~'~OQ~~~ ~~~~ ~'''~~. i ...~:, Grante
Attorney for ----------------------- -- -------------~----------------------
~~dc~ is 1
-------------------------------------
Title of Offices°.
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state of -----------------~Zi_?4 -------- G"-u-~t.~! --------------
ss.
Fount o ~~ ---- --- ----------------~--------------------
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RECORDED on this -------<~----- dQ~ of ----- --- ------ ~-'L`'R--------------------
A. D. 19~~, in the Recorder's Of,~ce of said Count~,~, in Deed Booki~~
.~
Vol. ~ __, Page
Give~a under m~ hand and Iie seal of the said o~face, the date above written.
~,. ,~
------------- -- -- ----- --`--- ------~ Recorder.