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HomeMy WebLinkAbout95-0141 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 Fran eropoli, ' act Division of Vital Records P.O. Box 1528 New Castle, PA 16103 TYrEirRN~T D. iUMANENT BLA«.«~ H105.1l3 R•v.7JB7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH Q1dd?s~ ~~ d .G L~ y .d C ro ~.I W W O z ~~ NAME OF OECEOENTIFirM, k/itld•.LM SE% SOCIAL SECURRY MMIBEA DrQE OF DERHIk1~N. M.YI.r)- .. - ~• Ra and S. Gabler 7. Male a . 198 - 05 - 6315 a. February I I, 1995 AGEAyIBiMday) UNDERIYEAR UJDERIDAV DATE OF BIRTN BEITIWLACE (glyend IMartl D• Mier) SW M f C • A D PLACE OF DEATH(Chr A rxeyans-see vlr•ICOOnmc•wr aide) 84 rr. d I• •y Ham ( MNlaw . % 8/6/10 Sa aagn dx rY) urgan Township ,pgpRAl OTHER: ^ E"roe~'"'"'~ ~^ NlmbO Dyl., Hom• ^ RMldalc• ^ (SPscily) ^ COUNTY OF DEATH CflY, BORO.TWPOF DEATH FACEITY NAMEp na ilYihlGal,yrvsdrM •rM number) WAS DECEDENTOF HISPANIC ORIGIN? RACE•AmMe•nMgrl, Bkldc, WhlM,rrk:. no~7 we. ^ n,..,.waNCwen. P Cumberland ,Carlisle b, Carlisle Hospital uM0oR1gi~"° White ~ fa ' DECEDENT 6 USWLOCCUWPgN IGND OF BUSINESSANDUSTRV WASDECEDENTEVER Ei DECEDENT'S EDl1CRION MARITAL SDOU$-M•nkq SURVMIKl SPOUSE cch.k:,da.alldand•Yq mod u.s.AR M DPORCE$7 E N y - I m.w..uN•m.ianr.ne> daakYlYM•;donau••r•i•d.) Y••01 No^ IS.oorlan CaMp• ,,.,Histor Teacher 1e Carlisle H. S. „ , ~,~ 12 ` 'S+Ildas+> Widowed +~ ,e DECEDENT'SMAEn,o ADDRESS ISked. CAylWanl.swa, DECEDENT'S PA ACTUN. ,T.. StN DW ,Te.^'M,Oawha WMln ~V 1 ) ~ 1„~ . 604 Wilson Street Carlisle,PA ~~ - Cumberland ~dw+ , en°'ir10e> Carlisle ~ s' ~ ~ „a 1TS. . Mw•caMe s ROVER'S NAME (Fuel, Midde. La7p Samuel Gabler "~Ra"AMEtFr'I'"°°°''M`°"'S'"""'") Lydia Cramer 1. INFORMANT'S NAME (TypyRiry) E. Richard Gabler MPDRMANT'S MAEYA ADDRE38~•ea1, Cily/bwn, SINe. ZgCaie) 235 Lake Pointe~Dr., Akron, Ohio 44333 METHOD OF DATEDFDLSPOBDaN PLACE OF DE.TOSITION-N•m•aCan•eer%Cnmelay LOCRION•Cky/Town. 91w,apCOd• gl Qr«nebal^ R•marr kansw^ (MaM.Oar.MM arom•r wc. Darli7n^ o w +.. ~"~`~ ^:,a 2/14/95 „~S rin Hill Cemetery ~ippensburg, Cumb.Ct.,PA SgNRURE OF SERVICE ACTIHO AS SULH LKtNSE NUMBER NAME ANDADORESSOF FACILRY 011776-L ~ogelsanger~riclcer F.H.,Inc.,P.O. Box 336, Shbg.,PA 17257 Ilwm alhrArrl«rlEytp Tom.bramYbbk+•.a.awno~a.narm.wi~,m•rwgkc•su»a. LNUMeER plyMd.nrnaw•rM•aun.aewnw ISplakaearNT7k) DATE9gNED «rorr~l+..arrah. 1` ~ Monet. oe%w•r) m. t o V 3 C a.\..~ ~P }~ m h o ~~ , l 1. j"U kNn•2423 mu1WCOrrlpld•d Ey TMAE OF DEATH DATE PRDNDINICEp DEAD(Madl, O•%lber) WAS CASE REFERRED TO MEDICAL EXAMNERAOORDNER7 P•r•erl Ma OrOrgM107• d•em. of \~`<~- w•^ b. M 76 . . M ST. PARTF Enbr m•dr••e••. iryl•baamnq•cMlOm anldl oue•dm•a.m. DO rla arar m•mal•aO,Yq,w Lrara•ea raplr•mry arna, atnck orMVl/Wm. AppminrM PARE II: Omer LhA adyarou•onwM7r1•. ~ bE b~ ~ YIIMVY beI•••n rldbdr uq•ryklp pm•y val pyi MIEOIATECAUSE (Final 1 orrM Mld d•MII a wwamrlatlon 1 DUE TO (OR ASACONSEOUENCE OFk b r E•rry. N•argb •r•rl•dNl• TO (OR ASACONSEWENCE OF): .._ e•III•. Er•w INOOLLYMO I cA113E (Doses ar:Ipry c `~ < l'rP -~+! I I ~+~++•~ •.*nla Due ro(oR AS A coNSEDUeNce Dl-7: nwlNilp in deeYl) LAST ( tl WAS AN AUTOPSY WERE AUTOPSY ENDINGS MANNER OF DEATH DATE DFINJURV TIME OFINJVRY INJURYR WORMf DESCRIBE HOWINJURY ODCURRED. PERFORMEDT HIREABLE PRIOII ID Morro, O•%wa) . ^ / CokwtETpII GF CAUSE I.~'" oFDEArIIa N•Nrtl I,ankM, ^ Attldsre ^ PsrlarO MMStlp•Ilon ^ we ^ No ^ M. VM ^ No ws ^ No ^ SIYUds ^ Coad nd badsrormhrd ^ PLACE OF MUURY N h l - ome. um. ebaaL Mary. olllro LOCATIONISVM.C~vR t5mle/ buNkq,,1[. (Speal, 71b. ~' ~••' 701 IXRTFIER (Check oNy °ns) 'CEIITIFYMD PNY81GAI1(Rryscien c•rMYirq cause d rkra wtian andhx phyacian hu Ponouricad deNi and comPlelrM lkm 23) T6.1.0••1 aaY tn•rdedw dsstll a«un•d dll• b Y d . SgNATURE AND ER . w earm•1•) an rn•rlrwr NWd............ ~ 710. 'PRDNOINICNIO AND CERTIFYEIG PIIYBIGAN (Phrgcyn bM panwnen0 tleem artlcerayiq b cawed w.a) LICENSE NUMBER DATE SNiNE .Day. rear) .-. T•tll•!•el•Ir•Ykn•eAldy.d••tll Oaar•r•dHtlN tlm•.d•IA and pl•m.and du•blM erMN•rld rn•rlrw MaWM .......................... 71e. „"', D7-Ci7 l~Y. 11 Cl 714 ~ ~ AND ADORE PERSON WIp COMPLETED CAUSE OF DEIRH ~~~~~ orlB»e.r.a...Dln.BaD.Nar«aIY..B~w,l,ln ePklwn.d..m«ellr..d.l3»Nm..a.L...nawK•..nda,.wm. a ` ` 1 Z 'tZoU.l+a.sr LL3nn 1~•.....ei.~.~ !~!! . b ^ ~ a1.ID.r...ww ...................... _.....................................................:.......... a1.. C.r_,. 1. +~. Pfd ll o.~ . 7x REBISTRrR RE AN NUMBER I \. // ~ ~ . oAre FILq~ .Dar. war) L21 / 1 1 I / I ~. 7a { ~ ,~ ,,, - REV-1 0 EX+ (7.94 S` / ~ MMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRIStyURG, PA 17128.0601 z W O W U w v W Yi=Y U =oo ~'am a a h ~ W = ~ W d: ~ O = ~a FOR DATES OF DEATH AFTER 12131191 CHECK HERE INHERITA~It~ `tAX RETURN pOVERTOYUCREDIT IS CLAIMED ^ RESIDENT DECEDENT FILE NUMBER (TO BE FILED IN DUPLICATE ~. WITH REGISTER OF WILLS) 2195-0141 ,-, ~,~ `;`~., COUNTY CODE YEAR `; . N~~l1MBER DECEDENT'S COMPLETE ADDRESS y~•-- `~ 604 Wilson St., Carlisle, Pa. 17013 F DEATH DATE OF BIRTH 298-05-6315 "2/11/95 c°°~,, ICABIE( SURVIVING Si0U5E'S NAME (LAST, f1R5T A MIDDLE INITIAL( SOCIAL SECURITY NUMBER Not applicable » ~` `~"` 1. Original Return ^ 2. Supplemental Return Limited Estate ^ 4a. Future Interest Compromise (for dates of death aher 12-12-82) b. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) C RE5PONDE'NCE AND CONFIDEN~IACTAX INKORMATION SHOULD B rge F. Douglas, III, ESCiulre COMPLETEMAILING~ 17 1 243-1790_- Cumberland AMOUNT RECEIVED ISEE I ^ 3. Remoinder Return (for dates of death prior to 12-13-82) ^ 5. Federal Estafa Tax Return Required 1 8. Total Number of Safe Deposit Boxes 27 W. High St., P.O. Box 261 Carlisle, Pa. 17013 z 0 f- a J ~- a a U tz z 0 1= a 0 U x a 1. Real Estate (Schedule AJ ( ~ 7n 000 0O 2. Stocks and Bonds (Schedule B) (2) + 3. Closely Held Stock/Partnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 } 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property ( 80 s 763.15 (Schedule E) - b. Jointly Owned Property (Schedule F) (b ) 7. Transfers (Schedule G) (Schedule L) (7 ) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous (~ 34 , 810.13 Expenses (Schedule H) /i . 10. Debts, Mortgage Liabilities, Liens (Schedule I) (l0) 11. Total Deductions (total Lines 9 8 10) 12,~Nef Value o~state (t~e~ minus Line 11) 13.~'Cha7ritable arcs} GoveC~ner~al Bequests (Schedule J) -,~ ~ 14. Ne~Value Subject to Tai (~.ine 12 minus Line 13) 15 Spousal Transfers (for dalBS of death after b-30-94) --Sea-,Instructions for Appplicgble Percentage on Reverse (15) :Side. (Includ~values from Schedule K or Schedule M.) 16 Amount of Llne 14 taxablpaf b% rate (16} ~(n~~yde valul~es.~from Sche le K or Schedule M.) 17. C1 r~Tlsunt of lifrb' 14 to t 15% rate 197 , 453 .0~2 T~ (17) nclude values from S'el{elfdle K or Schedule M.) 18. Principal tax due (Add tax from Lines 15, 16 and 17.} 19. Credits Spousal Poverty Credit Prior Payments Discount Interest +_~ 1,4al.oo. !0. If line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. ~^ 1. If Line 18 is greater than Line 19, enter the difference on•Line 21. This is the TAX DUE. A. Enter the interest on the balance due on Line 21A. B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. Make Check Payable to: Register of Wills, Agent ..~~ -_ z (g) $250,763.15 (11) 34,810.13 (12) $215,953.02 18,500.00 (14) 197,453.02 x. __ x .Ob 29,618.00 .15 (18) 29 , 618.00 (t9) -1;481.00 (20~ (2t) 28,137.00 (21 A) (21B) 28,137.00 -' .,-_ --- ----.-....,..,.:,nr.,,.nac~JSVC hrvu'1V KCCLfp(,K'MATH~?" k. ~,~a+ r ,'G~,d n er 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. I declare thot all real estate has been reported at true market value. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE R FI IN RETURN ADDRESS ~,~,~ Wilmot Gabler, Executor DATE 5/10/95 -~ ATURE OFPREPARER OTHER HAN REPRESENTATIVE ADDRESS DATE Act #48 of 1994 provides 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% (.02j will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1 % (.O1) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98 • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (~) IN THE APPROPRIATE BLOCKS. 1. Did decedent make a transfer and: 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 on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..............................:.................................................................... 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. r n REV-1502 EX+ (12-85) r ~'~:yJ% COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCWEbULE A REAL ESTATE ESTATE OF FILE NUMBER Ra~rmond S ('abl ar 7195 (1141 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing selln~. ~ni+6p. hol.,., ..,.....~u_~ ,~ REV-1508 EX+ (287) .~ COMMONWEALTH OF PENNSYLVANIA . INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY tSTATE OF Raymond S. Gabler (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION NUMBER 1989 Oldsmobile Cutlass Ciera, selling price Personal property appraisal 3. Cash in Safe Deposit Box 4. Auction of Personal Property 5. Refund Time magazine 6. Refund, The Sentinel 7. Refund, National Geographic 8. Refund, Amer. Fam. Publications 9. Refund, News Chronicle 10. American Legion Post 223, death benefit 11. Dauphin Deposit Bank 12. Dauphin Deposit Bank, interest on certificate 13. Dauphin Deposit, CD 48000425440 14. Cash in change 15. Additional cash in house 16. Sale of breakfast set 17. Mellon Bank, savings account 18. Mellon Bank, checking account TOTAL (Also enter on line 5, (Attach additional 8~/," x 11" sheets if more space is needed.) ILE Please Print or 'E~141 VALUE AT DATE OF DEATH 6,000.00 7,370.00 58.00 2,586.15 40.96 11.33 24.00 25.38 10.00 150.00 191.09 172.60 60,036.99 33.10 127.00 100.00 2,344.94 1,481.61 $ 80,7 3.15 REV-1511 E%t )7-BB) ~,,,~„~ ~ SCHEDULE H !K:,~,-~, ` FUNERAL EXPENSES, ALTH Of PRNN5YLVANIA ADMINISTRATIVE COSTS AND ANC€ TAX R€TURN 1€NT D6C€0@NT MISCELLANEOUS EXPENSES c~iHte yr Raymond S. Gabler ITEM DESCRIPTION NUMBER A. Funeral Expense s: Fogelsanger-Bricker Funeral Home B. 2 3 4 C 1 2 3. 4. 5. b. 7. 8. Please Print or Type 3ER 2195-0141 AMOUNT Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 1995 Wilmot Gabler SS~rr E.Richard Gabler SS;'6 Attorney Fees C.Wm. Gabler SS~~ Catherine Gabler Tosten SS~~ City - State Zip Cod Douglas, Douglas & Douglas Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address Probate Fees Register of Wills Miscellaneous Expenses: Cumberland Law Journal 6,102.20 13,000.00 13,000.00 NONE 288.00 Evening Sentinel 40.00 Cline's Appliances 80.00 Sheaffer Lawn and Garden, Inc. 87.95 PP&L 32.50 Dr. David Hartzell 51.73 United of Pa. 10.00 Masland Assoc., Inc. 53.18 Borough of Carlisle 33.94 Troy Laundry and Dry Cleaning 36.91 The Hope School 18.63 Aero Oil Company 15.00 Larry E. Foote appraiser 127.35 Masland Assoc. 255.00 State Farm Ins. Cos., homeowners policy 66.06 366 00 Internal Revenue Service, 1040 taxes . 75.00 TOTAL (Also enter on line 9, Recapitulation) $34,810.13 SCHEDULE H RAYMOND S. GABLER 2195-0141 Hassler McKeon Assoc., tax preparation United of Pa. Borough of Carlisle PP&L Cline's Plumbing and Heating Darlene L. Moyer, real estate taxes Darlene L. Moyer, personal taxes Register of Wills, filing inventory and appraisement Register of Wills, filing final account Total 125.00 21.96 41.32 34.50 61.40 651.60 9.90 25.00 100.00 $34, 0.13 REV.1513 E%+ )4~R7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Raymond S. Gabler 2195-0141 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequests: ~~ Various nieces and nephews, as set forth in attached listing $7,370.00 2. Carol Gabler niece 2 000 00 3. Patrice Gabler niece , . 2 000 00 4. David Gabler nephew , . 2 000 00 5. 6 Kim Gabler niece , . 2,000.00 . Lin Gabler Prospect niece 2 000 00 7. Susan Gabler niece , . 2 000 00 8. Wendy Gabler , . 9. Douglas Flutie niece 2,000.00 10. Darren Flutie nephew 2,000.00 11. Carol Hightower nephew 2,000.00 12. Alesia Holland niece 2,000.00 13. Billy Gabler niece 2,000.00 14. Connie Bard nephew 2,000.00 15. William Flutie niece 2,000.00 16. Richard Gabler nephew nephew 341.80 17. Ray Gabler nephew 1,500.00 1 500 00 18. C. William Gabler nephew , . 1 500 00 19. Kathryn Gabler i , . ZO. Richard Flutie n ece nephew 1,500.00 21. Wilmot Gabler nephew 1,500.00 1/6 of residue ~~ ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: ~ Grace United Church of Christ $10,000.00 `~ ~~ Shippensburg University 5,000.00 '~ ,/3~ Lurgan Cemetery Association, Lurgan, Pa. 2,000.00 i~ Roxbury Methodist Church, Roxbury, Pa. 1,000.00 ~ ,~.~' Order of Eastern Star, Shippensburg, Pa. 500.00 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) I$ 18,500 (If more space is needed, insert additional sheets of same size) ,+ SCHEDULE J BENEFICIARIES RAYMOND S. GABLER 2195-0141 23. Ray Gabler nephew 1/6 of residue 24. C. William Gabler nephew 1/6 of residue 25. Kathryn Gabler Tosten niece 1/6 of residue 26. Richard Flutie nephew i/6 of residue ~ -~ _. o _. w ~ • LAST WILL ,AND TESTAMENT I, RAYMOND S. GABLER, of Carlisle, Cumberland .County, Penna., declare the following to be my 1-a~st will hereby revoking all ot~i~r wills aril codicils previously made by me. Item I. I direct my executors hereinafter named to pay all my just debts and funeral expenses as soon after my death as may be - convenient. Item II. I make the following bequests of personal pro er_t I wish to note here that I HAVE ATTACHED TO THIS P7ILL a lest of Watches, etc., with•numbers.and specific .directions to IDENTIFY THE WATCHES GIVEN in these personal bequests} A. TO WILMOT AND KI`1'7.'Y GABLER: 1 • Tc,~o Brass candleholders 2. Silver Candelabra and silver i~ea set. 3. Ladies watch-multicolored dial, in lick box. _ / q.. Grandfather's clock-Herschede _ _.._ _i. a. ,: ,~ P-~.`ti'hiie_...r-:~bb•- sl~ade.,,•~ ~<;,,_,_ 5•j' 2dy .•7rist watch, Lord Elgin ~"°-`` f~`L ~"~~: -:, 7: T~•ro Empire Sterling Candleholders ~' \~1 ~~~L~-•e-=-iSap-a-t-a--'~-~a~o-j-~? f~;r:. ,- ~:.~r~_.:»;_i~;~-;~~ c`.::~.~-:~:,~r~~;- 1-~,~ ._~,tf~.: ~ de by my t~other. ~ ~ ~;;-,`~. c~ j,~r. ~~•~14-= -1-9-~=-My-Wedgewood-cuf-f--l-inks_.and_-tie.__clasp-- ~-`~^ ~~'"""~~ ~v _ •~1~]~~~;~i.~'V~,'axzp---zn-flint-~'t'tt~, T r - 2-._.I'h~,_old U3a-t~h_'n Dome.,----~~~{~.~2---7-3.g-/-HamJ_ton ~~_:, B: TO RICHARD ANi"~ BARBARA GABLER: 1. Oid Dutch Braes Kettle 2• Pre-Civil War candelabra and pictures- 2 3. - - 4• Ethel Clever Sterli 5. .Cuckoo clock in diningSroomi Set 6• Hassock 7. .Ladies. Watch (Ruth,Lapel-and Multi-colored Watch) 8. My Father's watch (gold :Filled) in bank, 112414,102960, Roman Numerals 9• Multi.-colored Man.'s Watch.#1807160 9~42~ ~~~ r ~ E ~ 1.0 , Old Kitchen Mantel clock.- Waterbury w•„~-~,~~t,s .11 Captains.Chair carved,.- seat boarded: ~~~~ {;:~t. l2 Silver trays ~" .~ .~~ ~_~ ` 13t t ,r Small t fin er, ` ~.~.~~ ~~. «s ~ g pZamp (Uncle ;Thomas Crame . ,ry ~.c.~14~, Gabler picturexalbum r)' - - ~, ~~~~~'a15~ }`• Rn `~~ ~~ ~ (:2) 'and other '..pictures- - ~ ~~ ~~"16';=~i f q! -Red.~Ruby~of~,Mothers : _ ~. yT ~, ~;~ ~ Navy~blankett >~~~ __ - • .~~'f} ~ ~~; 1~ ~ - ~~ 1 ~ja ~ 18. Cuff links and•Tie clasp (Baroque) 19 . Men's Watch,f~,~Hamilton, ~~ ~ ~ 20. Student's Lafnp =~ 21. Dudley Watch -Masonic in bank and booklet abdut same 22. . My diamond ring. JZ ~ 23. ~~. . ~ 24 Bibles - ' ~ -~- Gabler & Cramer ; :~ ,, . 26. World War II Lamp 27. Hunters case watch silver, Kendal]_, Smith. Newark, N. J. 28. Watch - Swivel Stem 29. Watch, Gold r^ilied, disc dial face 30. The monies under frames ' a. silver ~ ~ b. coins now in use , c. wartime coins 31: 3? 'Jenny Lind trunk (c. 1850} - History of Transportation _ . Trrhate~rer Cardboard of je;aeiry, tie tacks anc? cuff links . ~:eep you like and sell th 33. , e rest, or give to family as desired. Swi_ngout P7atch and ai_1 other watches and clocks if not desired, , sell. 34. My batch, ;grist, W~~#~-~~ ~ ~~r~ 35. TT~ao bed comforters maw- by my Mother. 36. Two ink wells from Aunt Frances a. Violets-Hill. 37 b.- One of brass.pi_llars and-alabaster base . 38. Letter openers (silver_ and ivory), marble penholders Community Plate Silve 39. rware and container (furniture) One Gardinere flower container at d oor entrance 40. 1 School Slate - Uncle Tom Cramer at McKinney School, Franklin County 41 42 Tea Set, etc, in Secretary from Aunt Frances . Two iron dogs 43. 44 All Brass ice cream chair, red seat. . Antique Toy Iron auto and horse 45. setting One Watch, old and large, contains key for wincing and 46. One Victorian Table Desk. = 47. My father's watch (Standard} - 48. To Richard Gabler, a leather civil war watch fob, which i.s on the wall in the den $~~a~r _T _ ~~ '~'`~ t' 1 • Two Brass > bowl s t, 2 .` _'~x j .~,::~~~ Aladdin Lamp y#3 white shade -; '`~ -~ 13 r ~E1gin,~zWrist Watch ~ ''~""4; ~~.;Seat~•Plate+a'~in~ Secretary ' _ _ ~~ FY~M1f, 4 Y i i. u 1 f 5~~,~Silver~,~cuf<f~links£ and clasp ~ ~ ~ -` a ~r S` i{' t t~ '~+'. t r~~~`Y.-* i r {' Jl~'/~y~'y :,gip/p l • (.~ .ti,.tf .~. Y' Md ..... ~.. , ~. :. - - 6. Tie bar clasp with diamond 7. One quilt made by my Mother 8. Mantle clock ~,.,~ 9. Any undesignated Daltons and the like 10. My Landstrom's tie bar (Black Hills) ll. My father's watch #3760753 12. Ruth's set of dishes in furniture in dining room, Fostoria. _ ~„ ~ 13. Game Boards =.4 D. TO C. WILLIAM AND 2`~RTICE GABLER: 1. The Gabler Hanging Lamp in Dining Room 2. Ladies Wrist Watch 3. Two Brass Candleholders a• Gold Cuff Links 5 . Kitchen I~iantle Clock, Gingerbread (new dial plus works) ~ no markings. 5. My tie tack - Eagle and Pear]_ 7 , ~-'-~..DCit r .~Cjr0~--d- ~Te?~G''-1 ~ ~~_.: ;-flu s-z e a~-~ _ a l a.~-: 8. `~'F70 iron frogs 9. Roth's Dining Table and Chairs, 1 table cloth E• TO KATHRYN GABLER TOSTEN AND F7ILBUR TOSTEN: 1. 2. 3. 4. 5. 6. 7. 8. Clock, anniversary, large one Arghans to Kathryn and daughter. I~iy diamond tie clasp (round) bought in south My ttNo mantle electric lamps i~Iy pen and penc i 1 co]_lection Lamps - 5 sided, shade brass Banjo clock i jzy hobby case, containing miniature license plate and conten~s 9• 1 plank bottom chair rl~'- ~Q.__b_1-ue--'~rs:;:ve-t--e-l~ai~rs i7r ~-i-v-i~ng-room . ~ /?~ c~~:,.z~~~~,~-- f~.j~'4 11 • Two lamps ir.~. bedroom, ambE~r in color 12. All remaining frogs 13. bzy Boston Rocker 1 4 .' Two lamps - beaded., m~de i.rx Ital ~{~-~~--~~ /t-G~"~ - F • TO CONNIE GABLER BARD AND RICHARD;."~`~t.cy~.. 1. Cross-stitch luncheon set 2• Lip - Brass - 6 sided shade of flowers, on top of TV in basement. r 3• Al1_materials purchased from Connie Gabler given her ~" ,~, 4 Dresser Clock (J B) ~~~~ Y key; ring collecta.on '~ ~ ~~~ " ~~6 ~ Blue _ r contents iri case . 7~~-r ~ Pitcher squvenirs ,~ *~~S±lvery;rare~ s.rt ~ '' `' ~' ~~ ~'~ ~ i 1 kip then, zn container. . ~8~~The red velvet,,~~French~Chair - : -~ r. rcc, r aYA j 1• ,f r ~ .~' t4 ~ _'s'1' - . 1 ..t-wro. _ .,_ _ .. - _ - G. TO CAROL GABLER: 1. My wife's necklace in lock box (blue stone) 2. Carriage clock - three sided class, small 3. Paperweight collection 4. Dresser Clock (New Haven) 5. Diamond Ring ~~ 6. Rutht-s Cc~,lection of monthl~r figurines ;i7". B~-iiB=CZLS~'fLS-i_rhL~31"-~"~ :.r.- a. jH. TO PATRICE GABLER AND TIM BLAIR: r 1. Clock - Anniversary coach 2. Necklace ` `- 3 . Red dishes ~-- ~ ~ ~ 4. Old clock (Gilberts} 5 . Tim Blair, watch, I:1-1-r_nas jfL ~L'~i ~1 6. Lamp, kerosene -`on stand. 7. Dresser Clock 8. Blue Zircon ring 9. Avenue of trees - picture, blue boy 10. Captains chair, cane seated Il. The blue stone;aare dishes in kitchen as c~vell as the brown cookie jar, marked B, Grenoble to b~ divided betc•~een Car_o1 and Patrice -;...- - 12 . i•Sixed cup and saucer collection in book case . I. TO DAVID GABLER: 1. 3_ black iron chair 2. Small clock - carria~fe all brass 3. Al radios and TV's e;~cept the Magnavox Phoii.ograph and record p.Layer and RCA radio ir. use . .- J. TO KIM GABLER: 1.. Diamond Emerald Ring 2. Bell collection 3. My grandmother's chair. 4. Lovers seat lounge K. TO LIN.GABLER PROSPECT: ,;~ 1. My wife's diamond ring -~ ,~._ 2. Bird. collection ~~~ ~ ~~ ~~ ~z - _ ~~..- t T ~ .~ ~zr~ ~„~t ~ i -~ r~r( _~ - ]t ~ ~ _ - - ~rt v e S s' '~ ~C _ r ~ ~r - i t` y y'1 ~4, ~ ~~ ~ ~ ,x .x. L L~ i .~. 5 ~' - i r~ - h s~_. J'` - - _ - - 4t g: st , ~ - _ .,..-- _ _ ...... ...... .. _ ., .. ... ~ _~...r~.. -... ... L. TO RICHARD AND JOANNE FLUTIE: 1. Ny black onyx tie clasp and cufflinks 2. Jello-Clock - Electric 3. Ansonia Clock Co. clock M. TO DENISE FLUTIE BOLTON: 1. Table Lamp with glass font N. TO WILLIAM FLUTIE: 1. Clock - Seth Thomas O. TO DOUGLAS FLUTIE: ~~ ~l. Clock - Sessions '4 P . TO D_~'iRRED? FLUTT_E 1• Clock - Lion's Head, Black, E1_inehenhart Q . TO I.7ILLIAI~I HARRISON GABLER AND KAREN, HIS STIFE 1. Table Lamp.- Glass font in kitchen R. TO CARLA GABLER HIGHTOSvER AND LARRY: 1. Crocinet and Liner. Luncheon Set S. TO ALESIA GABLER HOLLAND AND MARTY HOLLAND: 1. • Cut Work Luncheon Set T . TO ~•~ILBUR TOSTEN: 1• t'y knife collection U. TO JENNIFER BOLTON 1. Fem. ,-- h 2 • -ch. '` V• TO SUSAN AND WENDY GABLER 1. My musical .Christmas decorations ~ .~.r - - . w ~. ~~' ,- ~ : W. TO SUSAN GABLER - ~• Y ~F ~~ - - ~,~ ~l . Ones gold fialed~pendant the:~diamoricl Waltham', watch -. size O' ~ the' one ~-iazth ~~,,.3.Et..~.~ in= zt ~-#565334.1 : - - - ~ + i - °~ ~ ~ ~ ~ ~ 4 J ~'t ' ~ ~° 1 ~ ,s ~ ~ ~ 5 ~xE ~F ` i ~ ±~ - x - _ _ t ~~ J - t -'Q ~ . ~ ~ ~X - _ X. TO ATENDY GABLER: 1. One gold filled pendant watch, Hunters Case, Size p, #6741275 ITEM III. I direct that my remaining watch collection and chains be given to Richard Gabler to do caith as he sees fit; that is, to keep, or to give to anyone cr:~ might have been omitted. I direct that my Masonic Ring and Pins and Cons istory=king and Watch and Tie Tacks - 32 degree, also be given to Richard Gabler. Item IV. I direct that Presidential inauguration mementos be taken by members of the family or sold and the proceeds distributed equally in accordance with Item XXIV. of my will. If more than one member of my family c,rants a particular memento, the one first mentioned in this Will shall have the preference. ITEi•t V. I direct that the bicentennial quarters , half dollars and do]_lars be distributed in accordance with Item XXV of my wi~_l. ~R~~~_L-g~.;Te th~Ti-me-Li~f~e--Boo-k~J _;~orJ_d--Y~a.r, II to F7ilmot Gabler. ' - - ~ ' -~~ . -r-'~-_~ __-f Z'TE~'===-_~-' r g i`TQ mY r am~a.].~_n_ Button C o 11 e c t io n t o S~~nns.~t?r~~..s-~~--~~=si~y; ~r~d'~~-`d:z re c t mlr~e i e c ui~ o r'l to f u rn i s h a ------c~- s-p-l-ay-c-a~se-~~-~t=iZ~~~c~=~~t-Eon~-C<~1_~e c t i o n t o b e p l ~d i n t h e --- Shippensburg University Library. -. ITEM VI I I~~ I give; tie.., Time=L'i.fe Boolcs_r--•"The Civ-i1.._.War~" to ITEr•S IX . Ta I.~Ii nerva Sixeas of Folston, C:eorgia, I give the "falling Springs" picture: via 'i~horaas Cok~le, ~~ercersburg, Pa. ITE2•i <"~. To Ray Gable::, I give the Gi,Zgerbread Clock (Kitchen Mantle Clock) , walnut fir ish, made in E ,istol, Conn. f Ingraham Clock Company. C-/~~ ITE2d XI. I direct that any jewelry o~:: mine or Ruth's, that I have not previously gJ_ven under this Will,. may be selected by my heirs, and any pieces not so selected, sold and divided in .accor_dance vrith paragraph XXV. herein. As set forth above, if more than one heir wants a particular item of jewelry, then the one 'first mentioned in this P7ill shall have the preference. ITEM XII. I request that my Executor remove the 8 needlepoint pieces made'by'iny Wife, Ruth, from. the chairs in .the dining room, e~and:~ the; one piece `~ of ~ needlepoint. on the. dresser bench in the x ~, ~ bedroom ,~ _ and -.give :;one. piece -each~of the. total ,:9 pieces: ao the ~o~llowin: eo , .~ .f ~., g p ple whose addresses can be. found in_ a 3 ~x :5 filing. card~box~f on the ~ desk; in, my Den: - ~~ t~~r ` g t-yi t-. t ~p t r .. , ~ "~._ ~~j~l~ d ~3 _. • - - 1. Wilmot Gabler 2. .Richard Gabler 3. Ray Gabler 4. C.William Gabler 5. Kathryn Gabler Tosten 6. Richard Flutie 7. E. Bousum, 206 E. Bird St., Shippensburg, Pa. 8. Carol Bradley ~, 9. Janice Brac'~ley ITEM XIII. To The Grace United Church of Christ, I give the sum of Ten Thousand ($10,0.00) Dollars,~to be placed in an interest bearing account, said interest to be cumulative, to be used as a scholarship fund for a student recommenced by the Consistory, and to be knoc,m. as: The Raymond Gabler and Ruth Jacobs Gabler Educational Fund. An amount of $1,000.00 from this Fund shall be giv~xi' to one student per year, with the stipulation that said student shall meet the follocaing requirements: . 1. Need of-the said scholarship ~~ 2. Student shal 1 be of good character 3. Student shall be a member of The Grace United Church of Christ. 4. Student shall have average or above average grades _ _ _ ITEM XIV. To Shippensburg Univer ity, I give the sum of I'i e Thousand ($5,000) Dollars, to be used as follows: A.. To purchase a conununion set for_ fife Chapel B. To purchase a choir director_'s stand of solid brass, engraved caith "In Memory of Ruth and Raymond Gabler" C. After the abo~re purchases, any re~uaining suTn is to be usE:d to establish a Schola:cship Fund in the ra~•~e of_ "Raym~.~nd and Ruth Gabler." Said funds can be loaned to a Shippensburg University Student of good chara~~ter and average or above averz~.ge .; grades, the loan antount to be at the discretion of Shippensburg Univers it ~. ITEPi XV. I hereby give my wife, Ruth's, 1938 Wedding Go~m to Shippensburg University to be placed in their .Archives. .ITEM XVI. I direct that the sum of Two Thousand $2,000) Dollars be placed in an interest bearing account at the Orrstown Bank, OrrstoFm, Pa., and the interest on that account be used to _ _ defray expenses of the Lurgan Cemetery Assoc ~tion, Lurgan, Penna. `: a ~ ~' -z-~ ITEM.' XVII ~ I direct. that the suni of ~ One Thousand ~1, 000 ) __ 3 i,~C ~- .. ~, ~,` ~ ~ }Dollars be placed ;=zn an interest, bearing account at the Orrstocm. x ~~' ~ Bank, _Orrs,town,' Pa .z, and zthe interesa onw that account,: to ; be: used to •' ~ ~•.• place Y~flowersj ate ChristFnas in'" the''~~~Roxbury ,-Methodist Church, ~, ~ ~ Ro~cbury,, Pa ;in memoiy of :-Samuel Gable"r and``Lydia Gabler, `wYio:: for ~`` S y ~ Yet ~ ~, fJ '1 - - .. '\~ 4 2xx1t11,+1 .Iy{ ~ ~ F ql SS.P f ti i s - - ~" ~ . 1 rrT~ ii dt •r - 1 _ _ _ ~-, 1 ~ many years gave of their services. Any unused interest may be given to the Church to meet expenses, the flowers to be placed by a local florist. 1=4._.~ 1 ~u~le n~3.s a r a~ received from me via hesusYe~s s a the ht Thousand ~r(~E~p-r,Doll~ars, which p yme t n is rt~~~.s ~Qunty-is to e deducted from any amount zhe receives under my Will . ~-- ~---' .ITEM XIX. I give the sum of Three Thousand (.$-3~frp~~rpollars each to the following: Carol Gabler Carol HightoT,aer Patrice Gabler Alesia Holland David Gabler ~ Billy Gabler Kim Gabler Connie Bard ,Lin Gabler Prospect Susan Gabler Wendy Gabler Douglas Flutie N Darren Flutie (~ ITEid XX. Denise Flutie Bolton has already received her $-~5-. Therefore, no bequest is made to her of that surn in this rr7111. - _ ITEI~Z XXI. William Flutie has received $1,658.20. Therefore, I give to him the difference between that sum and $~,000,~00. ITEM XXII. I give to the OES Shi c yJ~ Five Hundred ~ ppensburg, Pa., the sum o~ ($500) Dollars. ITEM XXIII. After all my debts are paid, and provided the.~~e i.~~ enough money, I direct that the sum of F• Dollars be given to each of the followin fifteen Hundred ($1,:~0.)) pL~.rpose of each of them buying a Grandfathers Clo k ofhtheipr_ oyrn cl;.oice . I~h~~, urposel-y-excliide~ Ri.chard_..F.lutie-;.- becau_~e 1_7_x. ha s al.~eady___rec~ ivied rrts~xe__than__$.1-;500---froiti -me--to-~he1p=~•him with-his _ house-payments; - Richard Gabler Ray Gabler C. William Gabler Kathryn Gab er ', ITEM XXIV. T give, devise and bequeath all the rest, residue and_ remainder of my estate in. `equal shares. to : be divided among #. ~lilmot Gabler, Richard ~ Gabler, Ra ~`~ Kathryn Gabler- Tost~en Y ..Gabler, C.William Gabler, ` and Richard~Flutie.. If~:~'any of them shall ' ~~ ~-pr decease me, their share s ,~~. ~; ~,~,{ti, ,F,r t y j hall ~ go to_ their issue er stirpes ~_ _ >.- _ . ~ Y ~- } (~ , t S -i ~~~ ~ '~ t ?r ~-. ~ 8 ,~'7'~ r, ~ ~ ~ ~ _ L L '~~ 7^ ~~ -~ r ITEM XXV. I request that the law firm of Douglas, Douglas & Douglas,.be chosen as attorneys for the handling of my Estate. ITEM XXVI. I appoint Wilmot Gabler and E. Richard Gabler, as my executors, and I direct that they may serve without bond. ~ ~~{ ~~~ ~ IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~Cly {-f;` the „1~ day o f May, 19 9 3 . -.`' C.~v.~ ~ . SLAL ~~_ Raymond Gabler .~ L G Signed, sealed, published and declared by the above named 3 testator, as and for his last will and .testament, who at his request, in his presence, in our presence, and in the presence of each other have hereunto subscribed our names as attesting ~•ritness~s ~~j~1%i~f _ ~ ~ '~ ~ij ~') -~ • '~ ./. _. t" { t7' ~.~ ~~ - r ~ P: ~ • j :: . c - 5 t t Y~ 7 J~~ + t - . - - ~ -.. _ F ~t 1 ~ a ~ .. . ~~(( ,, _ .: ~.... . ..~.. ~ . COMMONWEALTH OF PENNSYLVANIA COUNTY OF CJA~ERLAND , ~ We, ~/~~ ~.f and ~ i ~ ~~ ,~ the witness s whose names are s~ gned to the attached or fi~re9`oing instrument, being duly qualified according to law, do depose and say that cve were present and saw testator sign and execute the instrument as his last will, and that he signed willingly and that ~- he executed it as his wee and vo-~„intary act for the purposes therein contained, that each of us in the hearing and sight of the testator signed the will as .witnesses; and that to the best of our knowledge, the testator was at that time 18 or more years of alter of sound mind and under no constraint or undue influence. /~ ~~~ SG,=orn to and subscribed before ~ ~r m ~th-.is "~ day of~~?'~-~t--~ ~,!-1993 ~~.. i r _-_- ~ ~`-.__..--,~!.~ notary ,~ f~QTAfttAt. 8~LL knrte lvi. Cox. Pdatt+i+~ ~l~a Cris $C~O, ~ County _ruy CGmtraFsstat~ Expl;~a.lu~ 44, 4393 [ '~ s t+ ~Y, e ~, rr, :. .. -~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I, Raymond Gabler, 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. f ' Raymond Gabler S~,rorn to and subscribed to . before me this ~~i day of~n--d--u~; X1993. ~Y ~- ~~--~~ notar Y _ _. . ~... , ivory ~a~ s~v.. Awe fa4. Gmc. Pto#ary PubIFC C&rtis~a ESota, Cum6griand Caurre}r My Commission res Ju t4, t 993 _ - ~. _ s "~j . > ,~. Ry s -c `3. 3, t > ~ der .X ~-i~ ii. 1 A .+ l4 ~ T 3~ . ~ ~µ AR .711 r 1Fy[. f S ^J' f i rrt tir ~ ~y ti r ~ L~~"}ry\~~.,~i 2'~Y'~ ~4 • '4 ~F~'~~~k~..4'T ~3 #~1 k~ `. r.e~.~.~~~,~~~t n ~~ ~ - ~> •, ~S ~."'. ~, ~ c 2 ~;xi} rt w}.,r}T ^' Z7.~'1P,.,r, ,~~,- at"r ~s .4 r~~*:.i~ 1~'+~x'3,t"S ~1 k h - h ~~ l.~ T '~ r.. ~f yiR ~>`~L}r~' ~`~. s`~~"., ~ l+Yyl C~S~~~~~Yr~~s~`~~ri~ a~~'irvsr ~S ~..i { ~ :~ ,`i~ . ' ' *1 ~ ~ .:~~~T '~~~ 2. .~. .. , e~~ `° '~r~~~_~i,~ i-?~~ ~~~sa~x~w({K*r'-..~~'R~4&... ~t~~~~.#,'t~K ~~~~`~ ~ ~ :~ • - { jE.~ d ~i-1T~ j:~ 1 F: _~.. _~ ~i ~ r}~~t,''~, y. y~~, ;r, ~ ~~;~ ~ +! ~y ~ g €y ~~ ~5 x~"y .•7~2~ r ~~~~~~R ~~~~ ~ ~~~ ~.#~rw~ r.T~ - ~' -.+~ ~ t y~, ry x ~t Y , .~ yn'!~'S~ A -^.s~s~,"8 t ~: ~y;j'Ye~ ~1~ <<~^>~b~fyA~"~~ ~~aro^-'Y'k ~~irj" .F •~.a,~iaf - a} '~~:,, rt •rh3` . Y: r ~'} ~ .sa tl }. C.j AL1r"C 'tick a ~.- ~ 1,4. ~. .' ,:.. i5 ~ r {.+y .: Jir r-.~,°F,.... ..may t,. - , . .. _. ,, REV-1593 EX AFP (12-94) CONMONWEALM OF PENNSYLVANIA DEPARTMENTU: REVENUE BUREAU OF NDIVIDUAL TAXES DEPT. 2806E HARRISBURG, PA 17128-0601 ASSESSMENT INHERITANCE TAX CONTROL N0. RECORD ADJUSTMENT 101 DATE ~F IEATH ~~~ ~ ~ ~~~~~ ' FILE N0. 21 95- 0141 02-11-95 COUNTY CUMBERLAND NOTE: TOiNSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PARENT TO THE ADDRESS SHOWN. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: GEORGE F DOUGLAS III ESp REGISTER OF WILLS 27 W HIGH ST CUMBERLAND CO COURT HOUSE PO BOX 261 CARLISLE, PA 17013 CARLISLE PA 17013 Amount Remitted CUT ALONG THIS LINE __-___ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------ - -- ---------------- REV-1593 EX AFP (12-94) ~~-------"-"''"-'-"' INHERITANCE TAX RECORD ADJUSTMENT ~x -"-"-----""' ESTATE OF GABLER RAYMOND S FILE N0. 21 95-0141 ACN 101 DATE 10-05-95 ADJUSTMENT BASED ON: VALUE OF ESTATE: 1 . Real Estate (Schedule A) 2. Sucks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule Hl 10. Debts/Mortgage Liabilities/Liens (Schedule I] 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Net Value of Estate Subject to Tax TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rata 17. Amount of Line 14 taxable at Collateral/Class B rate 18. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) 05-10-95 ~ AA047745 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,443.40 (1) _ 165 .000 00 (2) .00 (3) 00 (4) 00 (5) 80 .76; 1 (6) 00 (7) 00 (8) (9l_ 34.810 1~ (l0) 00 (11) 4 810 1,Y (12) __ 210.9~~ 0 (131 18,500 00 (14) __ 792,4 ~ 0 (15) 00 X.00 = ~0 (16) ~0 x.06 = 00 (177__ 19 .45~ 0 X.15= 28 867 9~ (18) 28 867 96 AMOUNT PAID 28,137.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE DATE 10-05-95 712.44CR ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL, DUE-IS REFLECTED-AS A-'•CREDIT_•-(CR), YOU-MAY-BE DUE