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HomeMy WebLinkAbout95-0067a~115 (~~ h H105. a~ ,13 Fay. areT nPEmlwT IM PERMANENT aLAac roc w 2 w U O 2 This is to certify that the certificate hereunto attached is a true and accurate copy of~ the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. Date AuG ~ +~ 2007 Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLYANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH i, i~ ~ '~1'- ! ~ NAME OF DECEDENT(Fin,. Mid06 Lrq $EX SOCIAL SECURfTY NUMBER~w• DATE OF DEAN IMOrM, Da%'AM, +• Charles i,. Shearer ,. ivlale , 217 - p5 - 4,01y4 ., AGE(laY BkY'd•,', UI1DE11, YFJIR WIDER, DIr DATE OFBERH BtlfR,PLACE IGYaAd PLACEOF DERM(LT J~«'"aro-arir~uaanaMUfdl MAIN ) Da,a /lolaa i MYaPw (MOrM,. Day Nrl Slw a Foragn CawN 96 Vn< jvov. 6. nays Crove ~ 0. 7. "°~°'°" NwYq o,Aar ha•,I.,t ^ ERIOumadwt G DCA ^ Iloa» IN RrdNw ^ ISOeWI ^ M COUNTY OF DERM CRV,BORO.TWPOF DERV FACEIT'/NAME PInd v.NUY«..pw atrea, an0 nurl,erl OF IIIBMNIC ORIGIN? RACE-Ama,ier Y~.n.SYgI. WNb. a1C West Pennsboro NP w.^E,M,paq/YGOan, IsoePM Cumberland K ~ PuMbRbr,alP. White ~ ~~ DECEDEITSUSUKOCCWRION IOIID OECEOEM N1 OFCEDENT'S EDUCRIDN MAlII01L STATUS-Martao S WMVINO SPOUSE IGAe Nnd o,aakdarAanomw (iaxllsle T re U.S. AR•IEDFORCES? Narr Marria,L~ Ra.a v»n,.br nMd.I a a«AaEw.; ao nau..rrWWad ~Y C•••u• 5 m ~ ~ "°~ '°'~ ~ .I « ower ~~ - y. „ „and Rubber Com ,,, „ DECEDENT'S MASING ADplESe1S.•M.CMyTO'.I,. ShM. 7900001 DEI:EOEENT•s Pennsylvania ,,,,,~„~,,,~•,,,,,~,•,I,~ w -gt P nnRbo o ,,,. 210 Big Spring Road ,n.sl+. ~ ...a ^°^• IN.b. Newville,Penna.17241 ~ , +~ ,T,. Cumberland '°~^~'^° "a°'°'°""i0 1Ta~ wMr, raMl iniai RQNER'S NAME ?Fry, MidAa, Lab . MOTNER'S NAME (F+ffi Mio01a. Maihn SMniny +.. Geor a Henn Shearer ,~, Anna iYlar iviell wFOrr,ANrS NAME (TyprPr'vq 'S MAaraG At101E3S15-aN,GM'6%•~ SIOa. zocoeN Helen lvi. Wiser ~0 South Penn StreetPShippensburgPPenna.1725 _ "E^'~aF~~rr~ DATEaFaspos,rlon PucEaFDISPOeR,oN.N.m.aa,n.Nllc....a,. LocaaN-c.y~YO.n,sab,apD,u. B"'a'~ G-^~°°^~ R•^~~^~•~ •D"•""' °MrP'°Cu b ~ m erland Palley West Pennsboro Twp. ~ °i""'~'" 2 ~an 0 1995 ~ ,. :,.. i~te mori ., b rland Count Pa . ~ ~ ~~ ~ + ~~~ t N00~219-L swing tsroiers s 1~~~~hP~~~ g~af~~~dg ~ 1 . O y N «I"r~oMbW,~nY bIM of myMnobop•, 0•MOOmnW Y,M tin.4o•aN PYn INW. LICENSE NUMBER DRE SIGHED owtYy erw haS,. lMOMh. D•%riaA ~ b0. f1.. 7fe. - ~•^I•M~o•~••q' OATEP 0 pA«an. D¢y.1Nr) YN9 CASE REFEWEDTO EAAMINEWCgipNEiyl Pr.oll rl,o pAaorlu. haYl p~lMkl !~ _ Wa^ z~. ~ M b . . M l7. YIAILT I: EMartlM daww,iMl•a•«magllc•li«M wNC.orro,Ila .De n«•rAw lM nbh «dY•10. aW,r « anaal. al,drJ,«naart hi•aa. i PART E: ~ ~ LYC«ryorr eaur anrMiw. ~I~IWgb ~lrvl ro '.II,ILV1ENwaaa .M I®111TE CAUSE (Pint I ~~~ NE'UYf; d TJi ~ Dl1E TD IOR AS A CONSEQUENCE OF}. SapuPntlaPYYalmnoi«r a ~ ~ ~L F E -'''~' f~"-I'l ~.~ DUE TOIGR AS A CONSEQUENCE DPI. , ~ uuBe,Da..r«i~«y <. tat•,i•aa0 a.~r DUE TO (OR ASACOlSEOUENCE OFk I rrWgn hrnl WT Q MIAS AN AU,OPSV WERE AUIDP$V FMIOR.GS MANNEA OF DEATH DATE OF EUURV T0.IE OFINJURY IWURVRWORKt DESCRIBE HOWINIIIRY OCCURRED. PERFORMEDY AL~IS.ABIE PRM11t 70 IMOAYI D•1' ~) cDAwLETIOHaFDAUSE r-~/ oFDE,aNY N.n•al lJ Ndnicio• ^ Apddwa ^ P•nG 5 ~.~.bon ^ Yr ^ No ^ hr ^ Nod w, ^ Nd ^ s,+cth ^ couldr,gt»ea,.an.,ee ^ Poi/,cEQFIN~uRy.alw.w r~„.« mno, am. M~ ~' wcAraN . . y. ts,.,w.cAyrro,,.,.sd., uaAalq..lo. rsP.«v, zb. ~.. .... ~, ~~~~~~~~' ~f ~ ~ PNY81C11W IP%YVl'yncxpl'~^9 tausa«G•Wwl,rr angrier M'MCw lw aorwx,ced Ceam and c«ngMatl l1an 231 . NATURE ANDT EOF e. ~ T uY lul•wMC9•. haN oxlrnA 01M b Ufa uurla) anl,na,a,ar r •bbA ..................................................... 310. 'PRONOUNCING AND CFATVYING PHYSICI/W,phy,cun pq%««gancagdrN any CBdM+q bcausaghaN) T LICENSE NU DATE SIGNED/ , ~ o,Mna.lwmy bw.aey., hag,ouvna altM,ar,hr, aria Pads.ame,~.rom...M.a,ammand.,...,a,.d .......................... ^ o,.. a 3 F o,a. NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF 'MEDICAL E)(AMINER/CORONER Q,ern 27)Typa«PnM ~, On,M GW of a:amlAMbn anNOr invesUgatbn, in my opinbn, EeatN occurred al,Na Hme, data, and plaea, anE d to tM eauaga) arM m.nnerp st•tw .. ~f ,-j , `C/4~5~ ~ y ............................................................................. ................ ^ ]t ' , \- u IVL'~J~.iL~ P RE ?STRAP S SIGNATURE NUMBER DATE fILED(Manm. Oay , ye arl A. ~ ` ~. V~1. ~~ ~\ __ , v PETITI®N I~'OIt PIt®BATE and GRANT QI+' I;ETTERS Estate of Charles L. Shearer No, ~~ - 9S ~.P also known as To: Register of Wills for the Deceased. County of Cumberland in the Social Security ~Vo. - - Commonwealth of Pennsylvania " The petition. of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age ar older an the execur r ix ~ in the last w. ill of the above decedent, dated August 17 , ~ 19 94 and codicil(s) dated (state relevant ciraimstanas, e.g. renunciation, death of txecutor, etc.) Decendent was domiciled at death in S:iimhP~1,an County, Penns}ylvania, with h ~ c last family or pnP'Acipal residence at 23 W. Main St. , 4Jalnut Bottom lsOUth Newton Tow~ah;p~y_ ~- Qist street, number and muncipnlity) r at I~ece~det~, ttiet~~9b.~_ y~ars o~'~qe, d~ January 17 , ~ 19 9~ wan ea t en er, ewv 1.Ce, Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execurion of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: L'ccendent at death owned properly with estimated values as follows: 48,000.00 (If domiciled in Pa.) All personal property S (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County S Value of real estate in Pennsylvania S 53 ~ 000.00 - situated as follows: 1 ~ W . Main S . , Wa 1 nn Sot om SPA VdHEREFORE, petitioner(s) respectfully request(s) the probate of the Iasi will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration e.t.a.; administration d.b.n.c.t.m.) theron. _ u b.~ = e1 en 1~~nTis er ~ o ^v S. Penn Street ~a Shi ensbur PA 17257 ®ATI~ ®I' PERS®NAL REPRESENTATIVE COld+fl-~ION~'EALTH OF PENNSYLVANIA COUNTY OF cur>BEIU.Ai~ as 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 tepraen- tative(s) of the above decedent petitioner(s) will well and truly adtninuster the estate according to lair. Sworn to or affirmed and subscribed before me this Z~RD day_Qf - ' ~'1'l • -~- ~~ . e~en :'Tliser r- ~. .. -".. ,.....,..., _ . , ,~.., ..r,v •r :..,x;,pk•,r,^-,M•,,~~-Tay'r 'r~+"'y~r1"~. c?:~„`5~+'^.~r"'h.R~fk!~~ .~" `~r'~'~j°'~ ~'"~~~'~y~ :. -..,rte .~, ....,. :... r.. _ ~:. ~ - ii .. i:3._ _ ..... . P ' ~, ~ ~ . 21 - 9 5 - 6 7 ~' 5~~ ~~ CHARLES L. SHEARER _ ~~ 9 6 : ~JG4i~ ~kJ~ ~~®~~ A ~ ~1~ ~ VYb..t~l~ 1 ~Y° R~~ 1 $ Y:eE1~ 1`~.i`~'~ Td©5y _ January 25 195 , in consideration of the lxtition on tine revet;a side hereof, satisfactory proof having been presented before me, rT IS c"3"Cc'~E1r3? that the instrument{s) dated AuPUSt_ ~7~..~,994 described therein be admitted to probate and filed of record as the last will of t'ha~„es L. Sh~grer -- -- ; and Lett~:rs i,~s ~~t~~I'~ are hereby granted to Helen M. Wiser FEES :~rooate, Letters, Etc.......... $ 235.00 Sl~art Certificates{ 2) .......... $_x..00 RerEuttciation ................ $ X-23.ge'S ~~ J C 7, - $~_ TOTAL .~. $ Filed ......JA,ti'.t1ARY..26...1.995.......... ATTORNEY (sup. Ct. I.D. No.) 701 E. King Street $_h, i~n~,pnGh~irg., PA 17757 ADDRESS 717-532-9476 ;" ~ om ~ CJ ~ D ,. _ y-. ~' ..) - M - C n O of ME, C~i..' L~ ~ --~-~, ~~ ~'t 705 PHONE !.J th ~~ _ 1. 1 ~ ~ ~ (T _~ ~ 7'. ~ . ~, i to ~ . '1 ,,Y 1 4t x,;'. ~. . ~ , k "1 !.. i :` I i~iai 1 e:~ '1 etters a.nd order to attorney cn 1-26-95. :. ~, - -- ~ -- '.. _.::: ,.~ .<:,:.. >,.....; • :r':r'1iMf ,c,i.. a9?+..:° r0.`*t"W~:?`9~7 kr ~~'.,e~,..'.~' v+rl.`n~~i~~x~,S~~T~".C: ' "°E ,~r~~'~~~ .~, 5 ~µ Zai.M .: ,..,. ~ /^}. a , ~ r. • ' I.,~~ ~ WfiF:.~I; :~.1`+! ~ a'li ~Il~ ~' i xi, ;,'-:~~`~~~'.~ i . S~.i~Al~Ft, of Walnut bottom, South l~lewton Tov~:zship, ~czruzlrerlard ~ j - i `w ~'o~a:~ty°, I~~:r~:4yt~%ania, decEaru this to b® my LASt Wall anzl 'i'estarz~ent end r~w~o~e s~ny ,,~itl ar ' ~. ~o~ c4i ;.~;~ °9~:o~ly maa4 by me. E i 'i ~ ~y is" .++~~ ~: I dire~:.t that all any just debts and frsa~ertl exper~s; s„ ~ctudin~, m, ~a-a~rernari:er ~~~ ~ ' ,u,;;,~ °~~,^; ofn~y last i?1~Eess, shall be paid. f_rorn my residuary estate Ens .goon a5 practicable j a. ~' >P ,„ ,,• .~`~ ~~r~;; ~~ a ~p2.t# of a.he acir~finistrataoE~ of rr~y estate. ~ ,' i, r ;g~:,~rl II: I gY',~e, revise and uea~h all oI'r~:y estate ofebery nature and ~a+hereso~er ~' szt~~~~_e m;: daughter ~Ielen IVi. Wiser, her hears znd assigns. ~ ,, ,; ~ ;'r ', k ~, II ~ ~ . ~.~ a: III: I direct tl~sat all xaxes that may be assessed in consequence s~f rEay death, of ~~as~a~evr~r ~~4 ire and by ~-~l>$tever jurisdiction Lx~gosed, shall be paid from my residuary estate as °" $ :: I ,~ .: ' ~~s'" '`'fir>" @'Yl`.'.r.S~S Of the adcratustratEO~n Of 1rCEy t'State. :a ii , ~~ I~vI F'rT: I aggoint Helen ~. Wise -executrix of this my Iasi Will and Testarrient. Ii ' ~ °' ~r~ '~I: I dire~t tlaa my ex~atrix or her ~.~cr~ssors shall not be requor~l to gsve bond ~' fc~- ~'~a ~'sr~tn,~~l perfor~r9r.~nce of their duties in any jurisdiction. 1 ',V ~i` I~ ~ j~ ~~ i 1 '=,; ~' '~' i ";`. ~~. 4 - ,~ ~. ,.. f. x~,:1." I e .~a,'. i' ~: I' 1~ ~I'I'a~TESS 4~Or, Y hereunro se# my hard and seal to this my Last Veil! and r I To .a a ~ 71~ da of ~ a, 1994. "1'~,~,arne~at, ~~tt~ on i% sheets of pmper, dated ibis _ Y ,, ~ /. ,+~ ~, ', ! Charles 1.. Shea.re4 '' ~'he preceding in trument, consisting of this and ane other typewritten page, each ~cle~tifi~~ by ¢he signature oftlae testator, CI~A12i.,1rS I,. SHEYt., was on the day and dais ~l;eFC+:f sk~;.z~~3, p9.~hyished and d.eclaaed by Cl,~g L. S1~EARirR, the testator herAin named, as ~~rac ~~.r S~Ys ~.~~st ill, in tlae presence of us, who, at his teque.t, in hip presence, and in the rsr:~:csl, c ~4= ~d~ch ether, have st~bscribed our nacres as witnesses hereto. ~ ~ ,~ I! ~~'~"~ ~ ' ~~*-- ~ residing at ~'~ ~ - ~L ~ _t~«,~~,t ~' ~ ~ ) ~ residing at ~~~~~ ~ ~ f~ .. __~, ii ~' I COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, CHARL]/S L. SHEARER, the testator in, and the undersigned witnesses to, the will, the attached or foregoing instrument, who have signed the. instrument, having been qualified according to law do depose and say: (a) that I, the testator, do hereby acknowledge that I signed the instrument as my evilt, that I signc-d it willingly and as my free and voluntary act for the purposes therein expressed; and {b) that we, the witnesses, were present and saw the testator sign and execute the instrument as his wilt, that he signed it willingly and executed it as his free and voluntary act for the purposes therein expres~.d; that each of us tun the hearing and sight of the testator signed the will as a witness and that'~o the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Charles L. Shearer `~~`' it ss \ .~ Witness Subscribed to and subscribed or affirmed and acknowledged before me by ~ CHARLES L. SHEARER, the testatorand I j the wit ses whose names are signed above. it ~ ~~ ~~~~ Notary Put~lig ~~ ~~ ~' L, :: i ,+ F..{ `~~ a .; t ~''. y~ ,, ~' a;.~ ~~- _.. _~~ ,~,a ~,-. .,T».'+~:",'"4 ~i,~t'Etrn.+i~a~fi,":Yk,~A}~~$a:: Y t~ ,'pp'~~'+~Se • .. . i ~ ~. ,' ,,. .....: , !~'la` ~ REV-1500 E%a 112-88) r -~,,~° ""~ COMAiDEPARTMEN?OFFPREVENUEANIA DEPT. 280601 HARRISBURG, PA 17128.0601 INHERITANCE TAX RETURN RfrSIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGt5TER OF WILLS) _ __ rns rsumocrs 21 - 95 - 0067 COUNTY CODE YEAR NUMBER __ DECEDE NT' NAME 11A51, YIRSt, AND MIDDLE INI11Al) DECEDENT' M A z SHEARER, CHARLES L. 23 W. Main Street v ;OCIAI SECVRIIV NUMBER DFTE Of DEATH y DATE OF BIRTH Walnut Bottom PA Cumberland 4044 ~ 17-95 1-06-1898 ~ 217 - 05 - c°~~I% Q~ 1. Original Return (~ 2. Supplemental Return ^ 3. Remainder Return (For dates of decth prior to 12-13-82) H ~~Y sov0 I_) 4a. Future Intorest Com romiso ^ 5. Fcdoral Estate Tax ~J 4. limited Estato P (for dates of death after 12.12.62) Return Roquired V yt° Decedent Died Teetate ~J 7. Uecedem Maintained a Living Trust _ B. Total Number of Safe Deposit Boxes ^ b Q . (Attach copy of Wiil1 (Attach copy of Trust) -_ ---- ALL tORRESPC-NDENCE ANlD COIV~IDENTIAL ?AX'INFOItA~A110Nr Hl~U1.D itiE°Dii~EG~d roi , - `•`~ COMPLETE MAILING ADDR SS NAME F Vf Z o f-~`~'~ 701 E. King Street ~~~M~ Sall~_J. Winder ~ -+"- A 17257 ' O ® MBER TELEPHONE Nl. Shippensburg, P ( ~ a 1717 i 532-9476 __ C7n 7~- 1. 1 _53 500.00 ________ Real Estate (Schedule A) ( ) s---- `' C' t:: '= c 2. Stocks and Bonds (schedule B) (2) -- - .Z ~ _ 3. Closely Held Stock/Partnership Interest (Schedule C) (3) ;; W ~ 4. Mortgages and Notes Receivable (Schedule D) (4) ___ ^ ~ ~_ ~ 5. 580.90 Cash, Bank Deposits 8 Miscellaneous Personal Property( S) 49, " , ~'' __ `~ .: f - (Schedule E) -p C ~ i,~ D ~ Q b. Jointly Owned Property (Schedule F) (b) ~ '~ 7. Transfers (Schedule G) (Schedule L) (7) - ( g) 103,080.90 n. 8. Total Gross Assets (total lines 1.7) a W 9. ( ) 2.,1]6 84 Funeral Expenses, Administrative Cost:, Miscellaneous 9 ~ Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) -~oA~T$v 11. Total Deductions (total lines 9 8 10) (i l) 4.0$2.L0 _ I 12. Nel Volue of Estate (line 8 minus {ine 11) (12) -:1~Q4~~2.0--_ - 13. Chr..ritable and Governmental Bequests (Schedule J) (13) - - 14. Net Volue Subject to Tar, (line 12 minus line 13) (14) _9.4.,~nn_ 70 = ~ 115. Amount of line ld taxable at b% rate (15) 99 000.20 x .Ob = -5, 940.01 _ (Include values from Schedule K or Schedule M.) 16. Amount of line 14 taxable at 15% rata (16) x .15 = -- (Include values from Schedule K or Schedule M.) Z ~ 17. Principal lax due (Add tax from line 15 and from line 16.) (17) - ~ 18. Credits Prior Payments Discount Interest a _-- + 2..47 L1Q - - (1 B) -.297 f10 g p 19. iF line 18 is greater than line 17, enter the difference on line 19. This is !ho OVERPAYMENT. (19) - -- x ~ 20. If line 17 is greater than line 18, enter the difference on line 20. This is the TAX DUE. 5643.01 (20) A. Enter the interest on She balance due on line 20A. (20A 0 ) -5~~ B. Enter the total of line 20 and 20A or. line 208. This is the BALANCE DUE. (208) Mak• Che~!:.^ayoble to: Register of Wills, Agsnt _ ~- ~8E SURE TO A4iSV1fER ALL~'i$U~S dN~ O ~ ~" ~ Il~j~i1(j''+~irr ':' ?~ -;~ ~ .- Under penoities of perjury, I declors that 1 hour. examined this return, including accompanying schedules and statements, and to the best of my knowledge and belleF, it is true, correct and complete. I declare that all real estate has been reportod at true marrcet value. Declaration of prnparer other than the personal reprosentafive is based on all infcrmation of which preparer Iran any knowledge. _ SIGNATURE OF PERSON RESPONSIBLE FOR fIIING RETURN ADDRESS GATE 3 r AT r _ ,., ..; -..~.. --+^R~~v?•'"'a. rf'r._+gar...t.,y*: 'P". ASrjATjE ~ ."~, .,;.t - ^,.~.r - - - r, F ~I I ~'- ,~~. ;.~:: ~~ 1 ;r _ __. ~~-.,:,~~ ~x~ iiz-e: } .c ~~ ~ ~~~~g~~~~~~ ~ C'0=.+i ^ .~'A,{~ s?r~var?ts I $~;<'"-d3~ 'n~°~~~c m~. s ~ ' ~..,.. ~ r _ ., i ~, .,, !~'~~.~ iii ~.::~,rlN'.e~.§>w _. {S'n ,. ro 4Y c•§:~.,~ ,:s5, a , ,. +~ a +,,:.? E>' K ta.v§vcrs~"~i~a 341:7,9 baa ski»t itksagC~ eaaz K,:~.scExr9~ a j e'~i~ reeer9 ~atsr~e a3rerv;~ fm~a repair?aei es ~rzir aanurket vcalu~ •.*~`-~ $a ,~.~r+~a ~ : ~~ ~=`a« o ocr ~~ e ~~e€c§t srrp~~y tva~a9d hs~ e:ae:~a~~rod i~a~w~a~ei ~ v~ri~~§~g 4;v}ysr cared t~ evt7€§ssg os4ai~s:, etaiphca±r ~w3reg e~dsta~++atle~~ a~ '`:.. , cr ~.c75., , !i~ :~ rti^~ r, 3a'4 -ar ~^7:es~i~c€~a css ?t:a a¢'ffi~:?79i frsc9s. ~ i;.rv'~~ , -- ---- -- L+ES~:Fti~7i0A: ~ YeE,fL E A7 i?A7E ;wL. ~~`~~. ~~. i ~ die DE6~7M . o;: 1 r ~ i~.zr; ~.~ ~ous~t~ 1 wP~-? aa_UQAmrY~-7igy C~,m~aer3.~snr~ Cc7unty, ._ Kr_ .-.,~.. r~~..*-.~~_._d ,._ ?3 5'F, ;ini .t-eet, Gralrntit 3ottom, being ~ nr,,+~C~vt'r'; ".t _~~ %i C]TT~~.~.:LP? ~1O13S~' ~nei ~;a~t3.~i',t?~ ~3L''Tr~ ia7C ga.rcel no, i ':•1- ~~:i• .-<:r'".'!_(~~? groaerty ,.rns so~.u at gubii,.. sale. A cogy o€ tl~~a ~i. _ .. .- :.~e~c~ anc~ settlement fi~.et: are ~.tta.cet>d ! 4 ~ ~y 500.0^ s , ~__. a a x ~ _ ;. ;~ ,~-; E r - i. i ' ;~it'a~ ~~§cc ~nt~~* v~ ~in~ Z~:x+isisar'c4i,aFi i ~;:? 3 ~3';. via i ---- --- -- __ _-___-- _-_ -------- --- - ~ - - -- -~_~_ _.._~~ ~i mc-a scats is is~~'~ a', irt7~rr a~~~liorci s~~cc9s c;( sr,;;7e srLn.~ .... .R ., o ., , i 4- i ii _ i f.> ~. ~',~"~<f i ?b'~.'~f •' ri .1 ~'- `~ ate., ;: r. ~- ~;,,~ -~- ~ - V.~k ~~ , 1 a;.i j i~~~~i~~f 3 ~ i N )6 ~v. %~~~ }} p~,M~IF.+4h~' ~'~F?tY ~J_ ;v~.b4i {,..:t ,, ,r.<,,:,~ Ga s..~ ,, ., : s i .?.s i?'t~ap vi 3~.s-cPxurnhd~ swat as ~i~az:aa..d n: se~,*z,.~v"~ ?%j~ ~-_~ -r~ i 1_, ~ .1 _._.. ii~k".:. ,. ~.. ~3~i7 -z CL},' C~t~C~"~T 1:'.::071,1;11: IiO. ~•.^ BFI i7l?.~ ;LP: Lt2{:. 2. ! F~ar,~,ers '['9~u~t: Cocspany, certificate of ue.posi~t in tine nwtne of ~~r}~.,,-{,~~-,t, ~,.~~<:o,wnt n~. oo~--~.c~~~io-:j & col-ios~.~.i-c 3.. ~ ,:,r~r..~;~ ,~.:c~ ~ ..sr7>cxrse.3 portion o£ 1°f.34~-? 9'S acl?c?o r~ety ~,~t_~?~... _=~~~,s.=. ,,.~ s::o~n orr sett?_e*tent atl2et 1 r i i i i I p i 1 li i ~ I i t I i i i I I f ~ 1 __--_-.-______._______._,__._.__~ S~s,+~aa.. ~,~,Ixo ®r,+~r an ~±~~ Jr, ;tw~,~slt!t+Jn,~~~!.~ (;+•>'-cn •sc~;'r.,^^~ rvi'~ x :'." :.ia~s!a v; rsrxv sp~cn fs n~-~*•;~:!.} 6~t ~.1 i.~ P'~ P9~ i F~,'rIa.35 i y~~,V(~'~st%0 :~69..~5 . _. _... ,..,:R k i ::++*, w-"^.--7r+*~v a.~ -+.^ n ^,.c,-+ ..*"-T'° .'~"'.a' ~ ..~ ~,~ .r'in~.<, ,~ rte`. ..., ., , ..,,.... .. Y ...,. @ x.si^~y~"r ~~^;~ . ~..'rti r ^4"`i',ir,k^~r.-N x ',+'>~~~nCr4~r. v:, REX1511 E%t (7.CE( }Yy ,,//~pCCpp~~ fps g "~l° ~""'~ A~iiN9STtdATII~E C®STS APDL~ CON,MON`N'cAITN C5f PENNSYLVANIA INHERITANCE TAX RETURN f6915CE~LAP~tEOaJS EXPEPlSES P6oas9 Perot or T o RESIDENT CFCEDENT yp E$TAT~ Gi' Fit hl11fN6~ER CHARLES ~~. SHEARER 21-95-0067 aT~~r' ®E5CRIPTlON ls7r9OUPlT ~Uh~1~~ 1• jEwia~; Brothers Funeral Home, balance due $ 14.00 ~. ~ eaa~ I. ~ Pe I 2. Attol 3. Fami d. I Grob ~. ItllgSC 1. Reg 2• Cum 3• The d• Rec ~• Bor twr b. 7. ~• I ~ s x . \ .. _ __ ~.., ,a.a, -. ,., ., .. ~ CC':- F K d.' ~ ~. ( ,3 t _ ____-- r- - -~ tt" '~' :w ti's#$.~~~~ n.~tr~z:~,5e~~~ t''ka'~'~' S.~"-g^?i i ~ .._r.. ~'i'8ik3@ ~Pi?R4 ~f E xz~ ~ae~~~~~~ 3 °ri - ._. --- •~ p , p cr.~pt::.an cnedictne r~cccunt- 2, j Gra?3~tr~ rv:cd.cial Clinic, outstanding balance nat covered by 0 a.n~ursr>ee ~9 1'~.p. ,_• _. ;_.. x? ~ler_tris b1.7.1 for house i ={. ~ ;~n~r:~,;.~; °)=•u~; Ri_l:~.irg Dept, final prescription r.~ccount balance 5. ~ 5~.ain ~e:lth Canter, balance for nursing tzome care i _ .... ' "'s t ~ ` ~~ ~_.._ j ~3P~0,Z3;4?~~ 28.03 $ b0.75 $ 1;'.52 $ 9.56 $18~'a6,00 ,_'"'' ; !~fl~E dtPiU AUU>KE55 CS" ~EfdEFR~a~~dY .. x- ~ ~~ i V:'C .~. i~. ' ~ 'w`.. •.r;a:c4;1~s Eegv~stsi i 1. Y t ~~2~.E:'it :~i. Gti~5Cr ~~{0~1 ~. Penn Street Sk,iF~p ~r~sburg, P~ 17257 - ~ <~_. ,, - , ¢rv.uos rx. «a~~ q~~y p~~ p p ~ .... CON.'1 n. HiA S.{ <•FtJN51lK~N1h Fn ~~Yin ~Y Y~~.f'.~4~~ t;7". Fl~oep~;;.C 7~T RgTU?t: ~ ~ .._.. --~---'--__._.~__.. ------- ~--.~_ _~ _ ~.T_~~ .yrn _~~~ C~F,kOQl6~T ~~' RE~+TBflN a!#1P ~ 5i~~8S~a fBF ESTdeTg ~sugrte-: a 100 lTw~,4 ~ N61RAE dONO ADDRESS flF ~ENEfICfARY ~d~~U-E-R--i! ' $. C!~arifaMe and Cyovernmenla! Bequests: ~. ;`R.~ ! i 1 ~~' 1 r d r ~._,._' AAlIf3UNT C1R 6HAR8 ®F ESTAT& (!~ rroara rvar.• Es s+a~de~, ~n:s~re6 cddl8b~act ~h~sets o$ a®ens apanj t. .., -~ ,-.~.- -- ~,"- '~i.?`R*rr",,'~.. ''°'YVrt`'1..'w;aF*4'r"4w~ r'-b,NSx'S3f?'r~~«..~i. '.~5~~`~y,„~yy ~y ~,t $R~ [`~~~~~~ c fi.f r ~ h `` ~y .per ` t . ~ ' Y .( 1 T0. ~~T 8 '~ ~ P Ci6~A i R.SP~N9~1 ~ +<~RM REV-1162 E%{~.Atl ~ ~ '-- ~ i. ~ i`.w ACN RECEIVED FROM: ASSESSMENT ~ , ' CONTROL ® AMOUNT NUMBER WIN1~Et SALLY J 1 -l3;ds4~3 701 ~ ~ I fV® S7EiEET 1 • 1 SI^l I Pl~EiVaAURi3 PA 1737 -- FOLD MERE ~= FOLD HERE ESTATE INFORMATION: FILE NUMBER • ~1-1~~5--0067 88M X17-0ffi-4044 ' NAME Of DECEDENT (LAST) (FIRST) (MI) 1:h1Ef~s"~~R CI~ARLES L ~ DATE OF PAYMENT 3!~Y /~~ ' POSTMARK DATE 1 ^ COUNTY ~ 1 Clt~9~£sRLA1^JA ~ DATE OE DEATH -''~ I` L? $ ~ a`r~~ . TOTAL AMOUNT PAID 1~9,~43.01 RE~,hARKS ~7~~ft` !-l~L+F'i~l 6"1 ~ SEAL i:,?-~,~Oi4! ~ RECEIVED BYE-,_' ~ ~ ~. ~~/~~®®~~II I+G51 NA IJRf ~- R{Em{STER O~ VlIILLS s ~ ~~; t~T~ aiLL~ ~~ . .. -.~.. ... ...... .. .c ~. n... r r ._, .....~ r ~"+"T. ~ ,r •. !^"!"La"r t. -.^M ?'V'wM'.,y'Y!I{ .... ., r Y~.. r~~-tT r ... . r ~~~ _ _ ~ ., ._ .. ~ ,A RPn" ~ 3 nl ~ :t~6 z14 `~ ~ ET S., cm ~ ~~ ~4` t l it f.~ t ~ "~ ,/1~ ~a~..l l ~ :a . _.__. .......__.__- ,I~iC~Ci:~i2 , x~s~ . ~ ~.-..~.~ i~ v ~. ~ur~rant 'to Rule 6.12 of the Supreme Court Orphans' Cor.~rt :~u~.es, ? report the foilo'taing with respect ter completion of the aet~~r.}.xsisi:x~a~.io:'t of the above-.captioned estate: ~:-~.Ye pr~hethEr administrati,^*~ of •the estate .~.s cc;;-plete: i~'y AVC~ 2 , ~- f the answer is i3o, state when the persona:i ~:^~rese~ztat.i.~afi reasonably be1..a.e~res that the adrn3.nistratio~l will be yo~z~letc~: 3, if the answer to N'o. 1 is Yes, state the followinc;: ~.a. Did the personal represent~itive file a final ~r^.ount. w,~ith t`.'ft~?~ Court? Yes No~_. b. '}'he separate Orphans ` Court No. (i f an~r) for r_h~, ae.r:sor,.al representative' s account is .., Did the personal representative stale an acroLr;3t infor~r?~.lly to the parties in interest? Yes~_ No ;:~. Copies of receipts, rele~:se,, ;c:~nders arci apg.ro~rals of foul. or informal accounts a:al- be filed with the Cer~c of tPa~=. i3r~.?~wrs' Court and may be attached to th~+is report. ~_,..~_ Signature s Y~asne (? ease type or pr~.nt ) ~ddzegs ~ ~ ~` ~? Capacity: ~.._..._Persot:a Represerat~3:iv2 ~~ _Ccaaazts~el •fox; p~zRhn~~:< ~ x~px:es~.~~st.~tive ~' r ,;, ., ~~ .; ~~ x,~"t;. ~.. . ~~;` `'~a4:z ~ 'Y s `4`' .'""~,"~~ ~`1-W~+'" ~'-- ~ts^3, •'-~K~~r ~..''.4; ta4,..pR'~r"Y~~4L, ~b yr~'~q'.rnm~~~av~ ~~~>r~-*^. ~'~°r^'' 1~~i-: ,A ,:'k*` `rt',~-1 ^'~o*, ;.^"'.f ~~Yv ~~,~y ~r'if ~Ct ~.s"'~ ., ~