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HomeMy WebLinkAbout95-0115~~-~~5'~~I~ 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. AUG 16 2001 ? ~_ Date Franc eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 r ~~ H106.itl Rsv.,/37 TYPE/MONT N PEINANElIT NALIE euaL COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VRAL RECORDS CERTIFICATE OF DEATH .~09~68 ~ ••• •••.••~••~•• I~"°°°•'`~ --- - sEx socuLSECURrrrNUwaEn - DATEaFOERNIMarIO.LIn,,, +. Oharles I,V. 'Baker a. Male >. 215 - 14 - 1475 ~ Nov 2, 1994 AITE1Lar SYr10e„ LroeL, rEAR UNDEII, OIY oaEOS EErtN 4E¢rymg~n.ACa iCapr,~wy~ w~eE DSOE~cNp~.~.«+r m._+...~.n,ew.o.dn.~,w) Mglrle = D'M IL•le. i MNIr IMWI. o.K wl, ShG L'm~.4~C31e Q 73 1 /20/ 2 Of1~ Ya 19 1 T,T~ EWq~MM•^ DM^ ~E ~y~ dlw Pa Neln ^ ReMO~s U rs~r, ^ a~ COUNTY aF OFFN crrr, oE.aN sACUrY NAME,IaA NeMaan. ql~.. rralenelemaeq aP NIEPANr;oaarL, RACE•Aawiun NaLn, s•al WMI...LG ~Oumberlan3 F P b ~°'~' ~ ,. enns oro 761 'dertzville R3. ,Enola, Pa w+elL :~R~„.,,°""''Q°" White OECEDFM'S USLULOCCURRgN g1ADf SU91NESSRipLIgTpY NI18 EVERN DEL~OEiR'S EDUCRIDN ,4 NMdwMOOlle nor U.S.AMED PoHCESf ~~~'M•n~ SPO~ WrerMlgaNL esm~r ri•i) N•.w Mr'M4 MEAe.+4 SI OlLwlcer~j.~ `MQ No^ Elec. En ineer 10. T.V. Station ~,a k 1+~« tI Marr 181 Ma3e1 n Baker, ,: ,.. , Y DlCEflENi'SMArwDADDRESEfSt•K Cay~Tann, sur.zbcaer aEC®ENrs ~.I 761 '~rertzville Roa3 T,aar pennsylva_nia ,Te.lilMe.eeceOenMrh- sas enns oro rq Enola, pa 17025 an ~" r ` ,~ umberlan3 "~.,:,+,, Ne aa.Or.M. . 1TR t7l^ WIN MAIelieeeet- Mte•le LRLIEN'S NAME(FeeL Miay.latll YOTNEITS NAME ~eeL tAeae. MYfYn Sulnertle) ,,. Harry Baker 7 Catherine Sparrow NPONMA/IT SNAME(fypWrYp s MARINO Ata3e1 n V. Baker `~'"~'""~"~ ~°°" y 1 Wer~zvi~e Roa~: Snol 1 0 , a, pa 7 25 METNOOOS D18PpSL„DN DREGPDrePOSIrgn PLACE OP DISPOSL}p,I. NeelydCerlern Gernrory LOC.vgN. CAylEeen, 91we.2bCoae El.r ^ c..llrlal a RMIIO.r eaA SIw^ • D•K MrL a O111x PNp ^ °eA"°"^ O°"'S°'~'" ,,,,Nov 3, 1994 „East Harrisbur Cem Harrisburg, pa g aT. PLr+ELw . . oR ACTrq AE SUCH ULf'cNSE NLNNER NALLE ANDADORESSDS RIWT' ,,.,F.D.011897-L ,xSullivan F, H. ,51 N. Enola Dr. F nola Pa ~ ~ ~ , , , Ila . iwaerelw tl10iv~Tw1pM•i0a•.arnxnn.ererwll..a.ranaWoaar.a. ucEN9ENUMEER DaESgNED irM. rr alaeer,. (Haan. D•rl Berl a43r •ArlboaeplMer py TIME OF DERV •I,pggp~pi4~ PRONDUNCED DFADIMareh.Dry, Peer) N118 CASE REFERREDlO MEDICAL EXAMINERIDORONER7 ,A O GOD 1a'M. as. ~/~ w•~ Ib^ ~ l7.NNTI: Eger rle 4•••eee. NMIrM•>ea•IWlcer}le rNdl ranee tlleeTetlr. D•na erM rM •I•s.d M LYt alMarunur or eerAre.. qip, eualeearaNa or retiN•Iery Mr•w. rbakvMer,AWe. ~Aprrolyle IMIRT F. OIMr b OuI ~T ~ Ecaf~MagtIFRaI / ~ iarwl ~aaMn na I~N~Yq InIMUIOMyYIE I.Irglaae.nl-. QY~e.,~~.~ ~..r,c,.T.r cr~ulr,kYWVt p~rf~,r ~ ~ ~ DuE ro pR As A Co+aEauENCE oPr ~~Se. Tm'r`~'r~ ~ EegL Wiyq YNerrAMe e i 1/~YMO DUEW(CIL ASACDNSEOUENCE OFk I CN ~ rrNrreewrs+Ml•T i DUE TO(ORASACONSEOUENCEOFR r'•rIMr4 el OrI11) LAST a I . MILS ANAIlIOPSY YYELE AUTOPSY FlWDIWfi9 MANNER OF DERV I PERT•OfrIEDT ArLILAElE M11011TO (~~.~~ TIME OF WJURY NJURYRNAJRKT DE9CREIE NOWINAIRYOCCIIRRED. COIIPIFTgN OFCAUSE ~/ OF OERM NeN•I DA NanYrl4 ^ Aaeelenl ^ Pen6p NwletlPlfen ^ 1Ye ^ NO ^ ~y Yw ^ Ne EO ~M ^ No ^ 9ukiE• ^ CaAa na b•CRwniinW ^ M• PLACE Of NJURY. At naM Iera wrM Nda,t oaks . , . LOCRION IStreel Ctyrtow.l. Serlp tEO. „ d'1I610. eY. (Spetily) C6RIf1EA ICIIerJC aa, orrl ~' aaf. ' C6TTIFYNOPNYSI . ~ CLAN ryhyeeieneeryyyg a.lwdarl when er.,rwrammynho VawncW era, era eamgale0 nen 231 SgN~EAND TRLE OF CERTIfl I+TaI•wr•uE•.a•aLneonwewelrLSlMeleMNahawwwrwba w S ................................................... ^ / ` IM 4J 'PRDNDLr0.•Nr,O ANDCEIITIFYNOPMYlN7AN IPnyscm eM pr LICENSE NUMEEq DATE SNiNEO,Main.Dp.1W1 Ter»eras(Ylaleal•aE..e.wla«I..w,La.r...ew.+lwva""n°n9l.a..a°~aewnln`~9a..a~'u.ae ~I...MLw ......................... at ~`1~ ~Z-- ,a rl- Z- ~j . NAME ANDADDRE39OF PE/ISON tY/10 COMPLETED CAUSE OF OEAaN MEDICAL DIAINNERICOpONEiI (nem 27) Type ar Pria a/ NM~~ bed MMnelWn ender Ime+DWLbn. M InY aWMpl. 0•eM oacurrW Y LM Wrw. daM. uM PMe•. anA dw Lo IM aueelt) NM /' ~ .................................... ....... I ~1 f ~ J REGISTRAR'S SMaNRURE A~![1 N)IMSER ~• -~ DRE HIED onN. DaY. Y rl ~,C _~ N h ~. OT ~ ~ 1 ACN RECEIVED FROM: ® ..ASSESSMENT ~ AMOUNT i CONTROL NUMBER i N D~Al.D ~ 6i.WV d-SG i w 105 MT. VEEW DRIVE -- - ENO~.A Phi 17025 - FOtD HERE FOSD MERE 1 ESTATE INFORMATION: ® FILE NUMBER y ~ ~, 21-1993-0115 s8~ 31-14-145 ® NAME OF DEC.DENT (LAST) (FIRST) (MI) BAKER ~HARE.ES N ~ DATE OF PAYMENT - J~ ® POSTMARK D E - + I COUNTY lJP1 AND DATE OF DEATH a TOTAL AMOUNT PAID _. ~RI-1.43 REMARKS MADEL.YN RAKER 8K . SEAL CHECKN 239 RECEIVED BY ~ uR . REGISTER OF-WILLS MAY ~~'`'`' ~'8. "_ ' ~~ yyy~.~ ~yw ,~; .S. . `~.. .-r...+t~*9. ""~.'Y+^IN 'M'~A~T~~. -..... ~ ,• ~ a '~-^Yy ..... n.',r .Y.,, ,... '~S't°.~1~]!;}N~'.`P,yr!'~'°T':^'a;, .i~I.:M r -..r'. RF'V-1500 EX + (7-94) COMMOt DEI z W G1 W O r ~ 4LTH OF PEtyiJSYIVANIA BENT OF REVENUE ? EPT. 280601 1RG, PA 17128-0601 'S NAME (LAST, FIRST, AND MIDDLE INh BAKER, C1IARLES W. 1~--~~-~ ~vu ~aVl FOR DATES OF DEATH AFTER 12!31 !91 CHECK HI INHERITANCE TAX RETUR " PovER°r`ca ~iT Is cLAiMED ^ RESIDENT DECEDENT FILE NUMBER (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 21-95- G 115 COUNTY CODE YEAR NUME 215-1t1-1475 111/02/94 (IF APPIICAlIEI SURVIVING SPOUSE'S NAVE (LAST, iIRST AND MIDDLE INITIAL) DATE OF BIRTH 1/?_0/1921 :CEDENT'S COMPLETE ADDRESS 761 Wertzville Road Enola, PA 17025 /O6 ~o ___ BAKER, MADELYN V. 1162-22-8231 ~- c" ~] 1. Original Return ^ 2. Supplemental Return Y C H w a ~ ^ 4. Limited Estofe =oo ^ 4a. Future Interest Compromise (for dares of death after 12-12-82) U a m ~ 6. Decedegl. Died Testate ^ 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) All CORRE ~ONDENCE eNte rnnEttanteutrw~ tww: csgr.a r~ . Y ... .~..~ y' Z NAME ~o DONALD B. OWEN, Esq. oz ~,g TELEPHONE NUMBER z 0 F- a a W z 0 a F- 0 v x a Counselor At Law 105 Mt. View Dr. ^ 3. Remainder Return (for dates of death prior to 12-13-I ^ 5. Federal Estate Tax Return Requirec 8. Total Number of Safe Deposit Boxl 1'b: I - ~- ~ I J/'nola PA 170; 1 . Real Estate (Schedule A) (1) Pd/A 2 . Stocks and Bonds (Schedule B) (2) _n_ 3 . Closely Held Stock/Partnership Interest (Schedule C) (3) -G- 4. Mortgages and Notes Receivable (Schedule D) (4) -0- 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (5) o „1 (Schedule E) ~~~-7-a~~-- 6. Jointly Owned Property (Schedule F) (6) - 7. Transfers (Schedule G) (Schedule L) (7) _ 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule H) (9) _ 4 .263.60 10. Debts, Mortgage Liabilities, Liens (Schedule I) (lp) - 11. Total Deductions (total Lines 9 8, 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Spousal Transfers (For dates of death after 6-30-94) See Instructions for Applicable Percentage on Reverse Side. (Include values from Schedule K S h d l M (15) ~8 s 714 • 4k or c e u e .) 16. Amount of Line 14 taxable at 6% rate (16) (Include values From Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rate (17) (Include values from Schedule K or Schedule M.) 18. Principal fax due (Add tax from Lines 15, 16 and 17.) 19. Credits Spousal Poverty Credit Prior Payments Discount ~ Interest + + ?~. If Line 19 is greater than line 18, enter the difference on Line 20. This is the OVERPAYMENT. ~^ 21. If Line 18 is greater than Line 19, enter the differelce on Line 21. This is the TAX OLE. A. Enter the interest on the balance due on Line 21A. B. Enter the total of Line 21 and 21A on line 21B. This is the BALANCE DUE. Make Check Poyoble to: Register of Wills, Agent - 4 ,263.60 (11) _ (12) _ R 7~ 11 11 )I (13) _ (t4) x,714. X14 x,_0~ _ 261. ~L3 x.06= _ x .15 = _ 261.li3 (i8) _ _ (191 -- - 1201 - (21) _ ~ 261 . ~+~ (21 A) __ (21 B) _ - - -- -~••~ .-..wgcn rvL VEVE:'llVlr3- Under penalties of perjury, I declare that I have examined this return, including a it is true, correct and complete. 1 declare that all real estate has been rep rted at based on all information of which preparar has any knowledge. SIGNATURE Of PERSON RESPONSIBLE FOR fILING RETURN ADDRESS MADELYN V BAK R. 761 Wertzville. d. T:xar•n~ri x - -- SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS -----~?AN~,1~,---9WEN-s-.-.Est x.05 M5 Cw i?~'. , Dan mg scnevules and statements, and to the bas mar~e~/v'o'lu~ D~j~~ration of preparar other than 4'L'~-~-`-~E-~1~-' °c`°'~ - hola, PA \~17025 ola~ . - ?fT025 If my knowledge and belie le personal representative DATE ~//~ j~T7- DATE (/ ~.Jl ~ ~ ~~ Act #48 of 1994 p-ovides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: • 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 • 2% (.62) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1% (.A1) will be applicable for estates of decedents dying on or after 1/1/97 ®nd before 1/1/98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS 8Y PLACING A CHECK MARK (-~~ IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: x 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, ............... x c. retain a reversionary interest; or ................................................................................... x d. receive the promise for life of either payments, benefits or care$ x ....................................... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding x death transfer proparty without receiving adequate consideratian$ If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving x adequate consideration$ ................................................................................................... x 3. Did decedent own an 'in trust for'. bank account at his or her death$ ...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~~ .~ ~a ~.~, .. 4 f t`J L~_5 Ci". ~ ~ ~ C.3 U Register of Wills of CUMBERLAND County, Pennsylvani Certificate of Grant of Letters Testamentary No. 1995-00115 PA No. 2195-0115 ESTATE OF BAKER CHARLES W Late of EAST PENNSBORO TOWNSHIP lleceased Social Security No. 215-14-1475 WHEREAS, on the 13th day of February 1995 an instrumer dated February 25th 1971 was admitted to probate as the last will of BAKER CHARLES W ~ . , late of EAST PENNSBORO TOWNSHIP , CUMBERLAND County, who died on the 2nd day of November 1994 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to MADELYN V BAKER who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA , IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office-the 13th day of February 1995. - ~~ ~ ' ( ~ ~ 4 e ~ ,, L~S'1' WILL APJ11 li';fAPil~;N1' (1T~ C11AR1,l;S W. RBI I?R !, rlilARl,rS lJ, eAt:~R, of P.rt^.I 1'~ nn~hr,rn 'I'nwnship, Camber land CounCV, T'r`nn.^.vlv•~riia, heinp of crnntd ml.nd, uv•nv,r p m,d nndc•r~:l'nnding, do hereby makr~, i.~il.li^I, :unl ~ir,rlare ILi~~ n~: ;tnrl fr.r nr~ I~+~~r IJill and "I'r•~(amrnf I,erehy revr+li„~ n~~l nral<inlt volt) any ttnd all. other wills: h1• me at noy time heretofote made. I. T direct that. my i?xecutrix lu~rri,taftrr named shAli pay all my'just dr•I,ts and fnnernl expenses as sons as r•r.nveniently may be done after my rlrrn:t!:r~. T1. i ,} All the rest, rosi.due And renmfnlrr of my estate, whether real, -~ pr•rsnnal nr mixed, And rahoresoever siluntn, f hereby give, devise and bequeati,. nntn my t,+ife, P1AT)I?l,YN V. 11AKGR, if r:h~• ~:nrvive.^. me by a period of thirty days:. 11 my .^.ai~l toile dons n,l survive m.• Irv n i+r,ri~,d r,f Lhirty days, then this (~, gift to'Irer shall be divested, and f fhr•n give, devise And bequeath my enCir.e ' A, i hereby Five And begnr`nrlt my furniture And tangible personal prnpr,rLy unto my foar cliildt'en to hr di,~iclyd among, them As they may Agree, c?t' , i( thr`y <wnnot agree, Lhen as my rxr<-ntnr sha11 determinr!. 11. All the rrs1-, residue and rr`mainder of my estate, whether t'r`a pr•r^.ona 1. or mixed, and t:~heresoever sltn:ii r, 'l: herehy give, devi,^>e and beyucroth tntln my hrrreinafter named 'Prustee tct hrtlcl in L-rust: for the welfare, support, mninLcnance and educattnn of my son, S'I'I?l'I:N C, RAKEK. Ply 'Prustee shAil use such sums from interest and principal As, i.n his sole discretion, are necea,:.- :try nn~1 pro~S~r"''f>9'i CtipAe'ptirp'8lt~b~t. The 'T'rucE shn7.1'cont'(ttiite utfCil~'Steven t:.' P:,Yr~r attains the age ..t Lwenty-one (:'ll ~`rnrs, or anti] Iris prior death, nt vhirh t (me 1-.his 'Frost ra,all termin-,ir ah~:~,lntely. Upon the termination of LI+?ee 'i'r-nst at the death or twenty-first hlrthdny o1: Steven C. Baker, my lrustce shall di.^.tribute Che then remaining l~rinrip~l and interest-, if ariy, unto my ir:.uc to r.gnal. shares, per stirpes. Page one of fnnr Pages ~fr'E'3 t~11~.' 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'~ ~~' ' Trt" Shc uld the a"h~rt d ,. , ~. ,,r 4v~n t ~ 1,ir r riz: '. .w 'v,~ ~+ ' ^t, f.rl ltr ' -~.~+w,•/jti Ix. ~ ~'t•!o n 1 rnUt` TA `'"~ v" ~ iaa~~ r y z a~~ ~.f~ ~~ ~~ ~ ~'~~I :c, tt~ ,.~ ~~ ' F^}P ^P1t1f6ti"tff r „" Fmn T 1 rr7 wrtrra~rit cbrititiuin fn 'f'rna(-~ bT g~1111I)rl iIn tlr(Minlr:!r ,; ~, r,,. ,.. r.~....,..,~ tmprnc[1e81 fog gn . rrn~nti, 'I'rltAtor, I„ I,In 1 CrCht r lir t`nrcnt- nr of hr, f may t,ny ~"rh share, ebbbliite7 t I`~repn mAlur :, Y, to ' ~ ••nlil mTnr,r r,r fl,~ n,irv,r'.a nnrnr 1„ :~ nnvin h ..,., mAy dA110$ f 14UC11 7T,Arr. f~ :, , n ,;,,,,~,.1 ~`~ ,""'It`+'^ inxtTrution of • I"`v:,hl, his ih;` u,im,r ~i ,,. it h15A[tIT.i1'1 ;9:OVTSIUN: 1 i 'I'ru•~t.,,. __:_~~.'_ r'^nr,flr'InrY raltnll hrCnntn s in t}la oPt:nioti nf' mnr,r:il1V Arl,tly^I•: ri ' nr'r'I`ar l rnt r•A, I'~"tr•ff.•1n r Tt,rAtp9 mA t'Y n nhnrr•. ,•Ithrr jfrln, ;~.,~ ,• Y APPYY'gt!cl, i n, r,mr. „r fnr rhr RuPPort And ar'lf'arr i,l, h"nnftcinr~- :iirrct} .Y ti*f 1 I. ~ ,. inr r.t vrnt inn <,f .~ Gtinrdinri, ,~ K}C}IT_i'O Ann ,i~ TltUSx• r ~ .: ,• -- -- __ r:b•ilI „•rr•fvr and ndd CO the '\ 1`rlnr•Il,nl oC thin 'ft~,,,t nn Y rXphr•r ~ .. ,,;, I, :rr nr,y rime mAy be given to'"t e I t n"1 nr I,L tnyRC}.f nt I,1' nn C1thr•I I.. ,rr - h Y i,,; Ia•,,,t, (JLiI ar ,,,:,r,,,,,, ih any oth~S. , t~~ I' j'12Q ~CT''jV}~_ i'I;QV7!~Y.ryl!I: '' Ali !'r r nr i l,n l nnrl 3 rIC rllr.rrll,trrt~n to the h,. ~~• rnna ahall~ nrttiT,'u~,>,~} nPtirisrq, hr• r ~ ..,, nn,l c}cnr oP Che debts •.; c n r I rnnt tuna Attd Ant f c• i rt OnCrar .,!y,'a pnt4tSnd Of :, n, l,, n,•f friary nnci. the anmc BhaT l nn~ ~ I I:,AIr r„ any levy, .~r rnrhmErit:y rv,,,.,,r i„n c,r srrtneR - ' tretion while iYt Ehr~ ;,„,,gr..pR lt,n of T1'UAtrr. ItTI 1. , '' '1'A X C---~~ : i f Att. y 89tArr, i„I,rrtt:,ncr, RucceeAiOri.C~'bth~t` des,,, t r,..r~ nrr Assh~sgd Ay~n f n9t Y ' • b 1fIHn!;nr , iI I,,, t hr nRRrts o£. this 7'PU~~ Upon r; - ;' drn t h af• to R I ,. (~ ~ .;y, Y ~tf, thi.a Trutst shelf hr•r„ i 1 n pr-r,portionAtta art t~.;1'nrate~ shail~ JS tlt~reof, r{' :.; .„y,~~+~cx.tlte nAn)e' iiU~ ~tif f,t f tr• i I,n I nlttl -._ - r ,'.µ +~., may PA the r`r r In,r.A n" Trupree rl,•.mA ndvisAl,Ir~ Y BalAirz &t acich r. 3:,+ T ,; 1 hrrrby n~mfnnte conrlt f r „1 ,. .,,,,t nl,l,r, Inr m , r'I fr(r•12, nn Y son-in-lA~+, WART:CN A. 'Truster nnr) r:urirdiAn c,f t I... .. ~ ~ t r.~,n r,f ml' minor son o'. - .. lfA i;G till r... „I Ir,U I^ f`n y?ra I' j i j if my wife, )1ldelyn V. 1Saker, .^.I,nnl'i i'rcdeceasc me. \. T hereby nornfnate > c'on^t i I u('c as I?xecntrix of arrrt al`point mY wffe, MADELYN f h i s, my 7,ast Id{ 1 1 V• IiAKf;R, arvd '1'rstmnent. Raker shrnvld If the said Madel hreclrr rase me, Ytt V. or r,llu•rrois;r :r,; vnr~h f,~i.1,^. to gnalif , I n..„• . Ihen ~notr, Y or ceases t:o act '` rmt"I i 1 ..r ,, an,l .n l'1"' i nl my s<rn- { n- law ~, ~ 151.'1'NIiK, as t:xerrt,tur , wnrtrr*~ ,ti, a `:l. No Pfduciary acting unde`r' Ibis Will shall be "l ir, thls uri required fi sclictirn, or fn an to Post bond Y lc~r isdirtirrrr in which he ma iN WITM;SS W111sR1i0F Y act. , I, Charlr's W. Raker this the Testator ha ' mY Last Wi 1 :rod Testamr•rrt• ~ Ve unto .,.I m° baud and sea ~: ~ 1 this r 1` '•~l,l,%{~,,ri A. lr., 1971. ~ti T1 dey n[ , i ~ r // _~`- -~•?s-~'-.--__- (s r•,n 1. srrlmn, ~,hnl.t:lr, rnllLr~;nr.n :,.v;l ,,, ~~ above-named I rr:rnr,r:n h}' Chnrlrs Testator tJ' Raker, thr as and for I. i s last Wi11 and ' °f rrs, tuho have testament in the '' hereunto subscr.ihrd nor Prescrrc~. the names ns witnesses 1'resc•nce of thr• at his Yequest `girl testator and nl' , in oaeh ocher. ;: -_-_ i ~ _ ,~ J /% l ) ~~ Page four nl Innr 1:aFr•G :np, ~ ;n~ ev ~ ~parl ~ SCHEDULE E '~?s~~' CASN, BANK DEPOSITS AND l:Oh1MOtJWEALTH Or pFIJNSYIVANIA MISCELLANEOUS INHERITANCE TAx.RETURN PERSONAL PROPERTY RESIDENT DECEDENT F S TA I E-(~ F_ -- --------- FILE Nl -- " t-yS-C)11> (All p,operly lo,nlly-owned wif~ the Right of Surv,vorship must be disclosed on Schedule FI __ - -- ITEM Nt1MBER 1- IRA - ;? . 1.9'7'j ~' ~. ~i• ].Of~~ r' S E' f' i~acll v~~~., Please Print or {Attach additional 8Y~" x 11" sheets iF more space is needed.i ~ %i~ r. ~ I nnl SfHEDULE H ~~ ~ ~ FUNERAL EXPENSES, cru.,r.u~rJwrnnrr nr relTrrsrrvnrnn ADMINISTRATIVE COSTS AND rrrrRE51UErNTFDE(.EUENfRrT MISCELLANEOUS EXPENSES FsrnrF v t _ '-- I',/1K1?R, ['IL/111f,L,F W. ItFM tlUMRER DESCRIPTION n. Funeral Expenses: 1. ,iolrn Su11; van Funeral linme ~'• r'ra.rrkl~n C^meteiy Associt3.t;ion/plot 3. F'r-~nkl i.n Cernet;e_ry /lssociation- R 3 c 1 3 5 h 7 R. Please Print or Type E NUMBER -- - 21_-y5-o_115 AMOUNT `~ 937.60 350.00 2.00.00 /ldministrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: _-_.___._____ __ _ _ __ _ _ _0_ Year Commissions paid _______- nttOflley Fees 375.OC Frnnily Exerntllion Claimant I`Inclelyn V. Baker__ - _ Relationship ---_~Zife__------------ _._--- - __ 2 000.00 -, /address of Claimant at decedent's death (11./02/411 ) Street nddfes5 f6' _WertzTi.lle_~~.~,a,_.F,nQ1a._PA.---17-02~--_-----_-_-- City _ ---State.------- Zi Code_ _ _ _ __ __ _ _ -- P Probate Fees i 2. vU Miscellaneous Expenses: CP/~ Fees - Income ta.xe^ - F?1~ State Income Tpxe.^- - 1.99!1/ Fl-li r3 i.~•lary Income taxes / State and Fedeal 300.00 Thank FoTr P?otes/Post.a.~e - Funeral. I 29.00 TOTAL (l11so enter on line 9, Recapitulation) $ 4 ,263.60 (It more space is needed, insert additional sheets of same size.) 04~. i°i~ rv ~~rn~~ n~.;~~` .,~.. , s ~c~L~naoNwenuH or rfn+r~srrvnrun INHERITANCE TAX RETURN RESIDENT DECEDi•~T ESTATE Of ITEM tJUMBER 1. ITEM NUMBER A. Taxa6 I.4l1 i )1 7<1. SCHEDULE J BENEFICIARIES FILE NUMBER ~L-95-o1t7 NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: -R FATE AMOUNT OR SHARE OF ESTATE --- -- ------ ----- ------ - ---- --- -- TAL CHARITABLE AND GOVERNMENTAL BEGIUESTS (Also enter on line 13, Recapitulation` $ (If more spoce is needed, insert additional sheets of same size)