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HomeMy WebLinkAbout01-0068 ~-I500EX'I!l7'! ~, ~'MMO_YLVANIA oeeARTMENT OF RE'@lUE . OE!'T.28llEQ1 HAMI au PA 17128.Q6Jlt OecElENTS~(l.AST,ARST,AND r.lIOOl.E\NmI.L)IM~~ ~~..~~ '.;~'I.'l.W'.~'-'''',,-'-,''.;I\O'''''''';"'' Canan. Geraldine J. SOCIAL. SCCURm' NlJMBfR REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT r- -- --~"~~~E~:~~-"'-"- i --.. J_~. . --},<~::;;~ . .. c... ...."......."...._.,.."./,. . I- Z W o W t,) W o DA11:.~ DEATH OATCOF8IRlH 06"1 ."',C,,",> c......".,. ..-,,,....,,,, 09 I 16 I 00 181 26 - 7764 (IF A?PUCABlE) SURVIIJING SPOUSE'S NAMe (lAST, ARST,AND MIDDlE INTIAW SOQ.Ol SEO.IM'I N'-"8ER .:'2 '1 'i:icrJtrVccoe '--;. " 20 o 1 .."'t!M 6 f1 -- I 30 THIS RElIlIlN MUST BE FUllIH OUPUCATE WlTllTHE REGISTER OF WillS IX] 1.0tigillalRetum 02.Supp\emefllaIRetum 03.RemaiI1derR.tum............,,".IH2) o 4. Limited Estate 0 40. Future Interest Compromise 1....._ ....12.12~~ 0 5. Fadm! Eslatll Tax Relum Required \iEl 6. Decedent Died Teslatll (AJIz> "" "WIll 0 7. Deced""t Mainlained a LMng TlUOt __"TMOl ..Q 8. T Olal Numbero! Safe Deposit Boxes 09. UtigationProceeds Recelvad 0 10.SpousalPovettyCred'~I""'''__I2.J1.I'''''''-951 0 11. Eledion III laxun<lerSec. 9113(Al t_ScI101 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPlETE MAlUNG ADDRESS David A. Eisenberg, Esquire 1132 Hamilton Street F1RAl...... (II_I Suite 204 David A. Eisenber Esq., LLC Allentown, PA 18101 TELEPHONE. NIJfA8eR 610 437-1410 .. " 1l~l2 !og UflD .. .. .... z .. Q Z o .. .. '" a: a: o " 1. Real Estate (Schedule A) (1) ,'NONE 2. Stocks and Bond. (Schedule BI (2) t NONE ' ~. ~:o$e!y Held CJrooration.Part':ershlp cr SC1/!--PMCrietcrsh:;3 (3\ , NONE- 4. Morlgages & Notes Receivable (Sdtedule 0) (4) r NONE 5. Cash, Bank Deposit! & Miscellaneous Pomona! Property (5) 12 ,407 Z (Schedule E) '. 0 6. Joinlly Owned Property (Schedule F) (6) ~ 7. Inler-Vlvos Transfers & Miscellaneou. Non.probale Property ''/. ...J (7) ::l (Schedule G or LI I- 8. Total Gros. Assets (Iolal Unes H) (8) ii: <( 9, Funeral Expenses & MmiIlislrative Costs (Schedule H) (9) 5 793 t) W a: , O. De~1S of Deoedenl Morlgage Liabilities, & Uens (Sdladu\e I) [10) 5 ,016 11. Total Deduction' (Iolal Lines 9 & 10) (11) 12. Net Value of Estata (Une 8 minus line 11) 13. Charilable and Governmenlal BequeslslSec9113 Tl1JslS (a,which an eleclion to lax has nolbeen made (ScI1edule J) z o ~ )(~ ;:~ a. :l! o u 14, Net Value Subject to Tax (Une 12 miIlus Un. 13) 15. Amounloflinel41axable at the spousal tax. rate , J See instructions on ~eBe side for appncable pen:;:entage 16. Amount of rrnel41axable at6% rate 17. Amount of line 141axable at 15% rate x .15 x .0 x .06 1 , 597 33 18, Tax Due 19. (12) (13) (14) (15) (16) (17) (18) CFc;,,';i<.L US!:j.1~oIl."" ~ '. -.-, i .61 ..1. 12 , 407 .61 .89 .39 , 10 .28 .33 j 1 ,810 ,597 , 239 60 .'"... ,239 60 > > BE SURE TO ANSWER ALt.QUESnONS ON REVERSE SlOE AND RECHECK MATH < < Indet oenalties of l*)\lty. \ dedare 'lhai I have axaminId ltIis tetun'I.1ncIudIng _+.....l~ing scn.ftlIeI n statBn'lInts. n 1D!he best rJ. my ~ and belief. it is 'aUt. correct a'ld complete. Qedtr.llion of ptepnr ctner ICII'l tile oef'SOnal i"IMX'eSaI'ltlllilM It "'iN..... on all iflfcrmalIoncfwhictl ot8D8I'Ilrl'tas a'lylmowledae ;IGNA E OF PERSON R PONSIBLE FOR FlUNG RETURN ADDRESS DATE 5849 Route 309, Schnecksville, PA 18078 ~II-o/ ADDRESS DATE 1132 Hamilton Street, Suite 204, Allentown Pa J),-I/-()/ " Decedent's Complete Address: ., STREET AOORESS 108 October Drive y Apartment 2 . ClTY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1, Tax Due (Page 1 Une 18) 2, CreditslPayments A, Spousal Poverty Credit B. Prior Payments C. Discount (1) 239.60 Total Credits (A + 8 + C) (2) 3. InterestJPenalty ij applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E ) (3) 4. Ifline 2 is greater lJ1an line 1 + line 3, enlerlJ1e difference. This is lJ1e OVERPAYMENT. Check box on Plge 1 Une1910 reqU''''-1 refund (4) 5. If line 1 + line 3 is greater lJ1an line 2, enter lJ1e difference. This is lJ1e TAX DUE. (5) 239.60 A, Enter lJ1e interest on the tax due. (SA) 8. Enter the total of Une 5 + SA. This is the BALANCE DUE. (58) 239.60 Make Check ~yable 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; .............................................................0 liD b. retain the right to designate who shall use the property transferred or its income; ................ 0 liD c. retain a reversionary interest; or............................................................................................. 0 iD d. receive the promise for life of either payments, benefits or care? .........................................0 [] 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? .............................................................................................. 0 0 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ......................................................................................................................0 IiJ 4. Did decedent own an individual retirement account, annuity, or other non-probate property?.... 0 IiJ . ~,~~.>,_..'-,_ ",.~',.. 1,.......\'. ,.,.1"~-:.;::~,.. "~'>'.- _c . _ ;"',..';,:L ';-~';:';')>"'4,~;'"' IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN ~_____...__.S'"~jIII""III 72 P.S. ~9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995. 72 P.S. ~9116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. 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 OATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please answer the following question by placing an 'x' in the appropriate space. ' Did the decedent create a tnust or similar arrangement which Is solely for the surviving spouse's benefit for his or her entire lifetime? Yes 0 No [] If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiaryOes). Enter the value of the trust on S<:hedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule 0 in orderto make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(ies). STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, MARY C. LEWIS Register for the Probate of Wills and Granting Letters of Administration &c. in and for said county of CUMBERLAND do hereby certify that on the 16th day of January A.D., Two Thousand and One. Letters of ADMINISTRATION C.T.A. in common form were granted by the Register of said County, on the estate of CANAN GERALDINE J , late of CAMP HILL BOROUGH ILA~~, rlK~~, M1UUL~) in said county, deceased, to N/K/A CHERYL SPINOSA (Ll\~'l', r lK~'l', M1UUL~) CHERYL ANN HORWATH I LA~'l', r lK~'l', J)IllUUL~) and and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 16th day of January A.D., Two Thousand and One. File No. 2001-00068 PA File No. 21-01-0068 Date of Death 9/16/2000 S.S. * 181-26-7764 '1a'iJ?1 / (I.';Cnu."pN. J~ II Register NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COi, Mh'"F t j OF :r 'l~;YL '}U'A.:l MF'n l' ,Il.UH V ,:,l fl '( I )CI\L r EGd~:; 'IJAf:' '::EI'P I 1-eI' nON I: F IJU\TIt CEI=1T. NO. T 4 6 6 4 8 4 6 ""';;"-' , : .11 0/ f';~ : i{~~I~\,!~~" i"~~': :>, .,~ "C:~ ~ ". ,h.~i \~, * . } ,.<€"h.',__,,:~, * ~ .\d ,~ ,,,il ::, ~,~" ,~<" ,/1 :~-.;,':',y" ,,__ ,\~t-;',\~Y ''"'~~ <)u Nl 11\~!!,;L '<-, ':!!!!.!!!!- _s~ III HQ~__ DateollsslJeolfhisce'lifiC<lliOn Name of Decedent _. ,._.___ __---G_-eJ'A..J...d.l.N'~ _ __ ~.. /. _ J,____ -'If) ___ ..____ C A 1./# tJ ,-",'I ~ Sex__.roMI1UI......___Sociai Security No. .__1.2.1- ~,-. lU'l____n_ Date of DeathJe.f'L IL, Loo". Date of B,rth 5vnr.. J.o.t.J.'ll.o__.__ Birthplace __?i.N.fI-_Gr.P.JL'l,fu.:..___n__~__~__________ Place of Death lJ.o.4-.{~::~~'.!JksJ';tIl.L----C.-.~;~r!..A.illL-.---~~S,~.:'~,L > __Pennsylvania. -- - Race_'t\f~lL._ . Occupation Stilt. 'WO(Ku .__..__. Armed Forces? (Yes or N.2l ~~_-.- Decedent's Marital Status .2:""or(.o~ ____on Mailing Address 4Jz-Qcfu.h.!'.c.J2~~-CA"1 ~u:~,;;L, 1'4, /7 ~:,~~ Informant ...M rlY"'''/J/4 J'IVI:tl1_______._ Funeral Director ..DI~ "nIp IYJ...s.UlfW_'J..;Jn.Itl2.C.lJt111N..__ Name and Address of /J Funeral Establishment H.L.J",yJ.rfu""idl J.I..",. 1'JII[,.l3Cj.j'.::fJLU"t,nLl(ew sf. 'r~.b^ ",<l, 17...3~.L.I2.Z.i'... J I I ~ Interval Between Part I: Immediate Cause : Onset and Death (a) , __fllLL.Sl1l.t-e-AL ~D(( h ., I:.!:..-~~ ___~_l.n________ , I I , I I -~---_._---_.~--~~,~-~~~~-~---,----_.-_.._..._- 1 (b) (c)____ Part II: (d)__"___..__~__~.~.____.~..___~_~_____";"_.._.~~______ Other Significant Conditions I 1 _,___~._.1--_________,___._,___ Manner of Death Describe how injury occurred: Suicide Homicide Pending Investigation Could not be Determined o [] [] Natural Iii Accident Name and Title of Certtier .___MiC.h..l Odl'lich~M.P. Address _~3.Jll.'ll4l..s1. , C' II IYJ ~ iLl.LL,---1A. (MJl.. 0.0, Coroner. ME) 17011. 7.~.k'1 This is to certify that the information here given is correctly copied from an original certificate of death duly tiled with me as Local Registrar. The orig',nal certificate witt be forwarded to the State Vital Records Otfice for permanent filing. ~;",@>u.~ ""-:.t.1;,f -"",S4L~~k#-OJL 3oJ....f..~,~,r,~/1n(kJ'lI1 . rl., \">: ^'~.,,€,.;;;,'I:::,....~t.l ....LJ.3H ~.ISlllex.(I.fil *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INNERlTANCE TAX REruPH RESIO NT OEC NT ESTATE OF Geraldine J. Canan FILE NUMBER . 21-01-68 Indude"'e proceeds of litigalion and "'e date 1he proceeds were received by "'e estate. All property jointlyo()woed with the right of sUNivoMip must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION PNC Checking account number 51-4016-3381 VALUE AT DATE OF DEATH 10,673.48 2. Household goods and furnishings sold by David L. Ebersole, Auctioneer. 1,029.00 3. AARP Membership refund 27 .00 4. 5. IRS Tax Refund - 2000 Erie Insurance - contents ins. refund 619.13 59.00 TOTAl (Also enteron line 5, Recapitulation) S 12.407.61 (If more space is needed, Insari additional sheets of the same size) /. . p/)X~,tx. 5 (f~,<fi',. 'j .('L ~ BUYER COlA I I- 1') lr Wt; ~~ 7 - - I --'I ~2 .. (," " 9~k: - e:<:.0 L{\ '\< k\\ ---:J BU~YER ,~;it ~ TV ~ Li<Jw ITEM LOU $ :;{7. ':?f @ d-.h fi4 _ 0CiJ!iiLU-.tJ . BUYER wL'k 11~ ITL~) _@ ~ $ ~ ,. I j 8'. -) - - @ $ o /.6/ Y.7b ',~~ ')/i"1 !,}/cit,K,<J S; ,-::;.. /I c- ~&q) @ ". q;~ ~5-C; -- 11 BUYER ho r~ ITEM G-O~) @ 17 ---- /, . 91\-ft'JL'l..:c 3.; 12 (A^<A'VI 14/L BUYER -y I.r. 'J:Z) U<fYdUI' 'y,n/ ITEM Ill. ~ $ ttD. ~ @ '(ovT:L3f.:: l~~:ER~ N.tL "-'/ j2;/,h_ ~/N$'~&' ~ ( LOl.!..... @ ,- , l;?..5 --c , , /Q ifb ; , - , 9 BUYER ITEM ~ ~ /hue{ f?,/ / @ $ <:) 2.0, ~ $ 1 ~4rJ BUYERyd1 r+ 4~ " -f.- ;l. <2- ITEM ~ $ "?J/' @ :<sy <> :2-.6,- $ f. @ 13 BUYER (-3) r~9 pi.!> IT~o;<<) @ ~ _$ 27 - "oo~'J5y....l ?~-j;;~ ~_ ITEM. / '-' LOT # ~$". @ -" "' 2 . BUYER . )/7/dii /~~5~/';U' :~~ ( ITEM '- ~O;r) @ - $ .-, 00 ...<.3. - 4 ..253 BUYER ITEM rt<l/d-') (t/ <,!> ~ ~ @ W' k t,,"r ~ $ //1 0"" //--.-- 6 BUYER ~ ITEM .YIJi' ;J~u1/Yj/c/ M ("IroI; J ~OT# - )ft @ ~ /~ - - $ ~. '8 BUYER ITEM Jar/; -;; ~~iii/ ?:l.JM/ ~ '- \i!:f!i) @ - $ - "' :;..J:3 IF: -- ' , 10 .5tJ BUYER ITEM ?g,A~ ( )j;-;;,j~ ~ ~ -@ = $ J.- 12 /7 BUYER ITEM Jf~ ~ ~ - $ 0.-1 @ 14 ./ BUYER ---:fj de-: h ITEM ~Jn1L ~ htL ,.;t;;;;l! ~ _@ = $ Jf. ~ 1 BUYER .::"a.1'w,\ ro.-t:J2.., ITEM .~. ffie10/l ,J.Ul.,tj~L) (~T~) #E, ~ -@ = $ . 3 - BUYER ITEM [l)n~ 'lJCf/~) 'j-' ~ - ~--'tJ."- \. Vd&) @ $ 5 BUYER m:51, ?A.J7/ Ta~ ~OT# tf:J3J ol~' -@ = $ I / .x.57 , I ;"".- \ ,I , I t7 B~R rrf1f (l~)t_ik'l.j (L,}/;; ~ '-~ @ $ '9 . 00 I /. --) t i . , BUYER cR5'j ITEM JA>1. L/8-Jz-lf}J~1 ' UOT# i/J _@ firALJ..{'= $ <.3.- /1 BUYER ~~.~"~ 6bJ: @ ~ $ .tl73 d.- /3 BUYER <~0 rJJ~;:L~ ~ ~ ITEM 9. -- . @ ~ $ 5 BUYER ITEM (;~) ~ $ I~. -- @ 7 BUYER ~7!3 ITEM fiNl"'l ~ ~ Jr ~ $ I. --- @ 9 BUYER .:;J.t; 7 ITEM )1-IIVtCl1~.dJ;;;.J./<>f-I!;1f LOT # /J 7~ @ ~$ 1.- 11 BUYER ~ "f;Jj" /ii'ffl//'I;i-: -= ~ $''1 @ $ )3.- ~UYER .;< gO 'Tzr~fO~Mtr cJ;M / @ ~ $ 6. ~ SHEET # SHEET TOTAL $ , , 2 BUYER ~7,3 ITEM ~ ~OT# tie> > " ~jgh $ /. @ /4 BUYER ,;} 7.3 ~ ..Pi' '/ 1JJ,~M~ ,,5'1 @ ~ $ ~7. -- 6 BUYER 7r ITEM ~~ (llPtkj ?>~ LOT # ~!/~ @ ~ $ 6'- . 8 BUYER ~~'r //.../ @ ,;;;J..8" $ I. ~ 10 BUYER .J'l3 ITEM ~g I'ft"rtd _(J"Yr-r;m~~MlJl~) (;v) # @ ~ $ ~:2...- 12 BUYER ITEM (: F co:;) ;{0 . /, .5(J i.:.A":" J- n U JQJ.~ @ ~ $ ?- 1fLI 14 BUYER ITEM '1 QC...a <l- if. ef.Lf}7.4/) ~O~; ) c'J @ ~ $ ~.~ RUNNING TOTAL $ d J & ~~ 1 BUYER ITEM C;~?~4- Or ~ '-~ @ ~$ :J. 7~ /.- , '3 BUYER ~7r ~f:!Af;,~~~t~ ~y @ - $ ~.- '- 5 BUYER :;. 7 ITEM N ~ .Pj~IIt7~ ~ ~ @ - $ ~-- 7 BUYER '7h ITEM LOT ~S"'1 @ $ /rJ.~ 9 BUYER ~7,'3 ITEM -;::( .4Jwa.xR.- ~OT# >>1/ \.. $ S.- @ 11 BUYER ,:;;< 703 ITEM (;, 1?t.du }./~ crA,M'L() ~ r:/ \Jf!j) @ ~$ jJ.- 13 BUYER , ,t) ~ $ @ . SHEET " SHEET TOTAL $ , , 2 3~ BUYER ITEM (b 1wiai;:;:; ~OT# ,R'; @ '- = $ <-3 -:- -- '4 BUYER ITEM v: 1=="";:} J \..t:) @ ~ $ ..5'0.-- 13 BUYER 11~ ITEM -:t?'IW- t""-f(lj Qft,.1J/tltftti ..-J-: ~OT# (I / .$ @ ~ $ Jf.-- '- 8 BUYER ~7.9 J-: J:p I ~uL) @ ./ ~$~.J.-- (10 BUYER {o {p ITEM~~M-f# ~~ COTy))td/~J I~ ~,j @ ~ $ ~.- '- 12 BUYER ,,~)I.,,~ ~t {).:J -if @ '- ~ - $ ~ .- 14 BUYER dt!J I. - . @ ~ $ RUNNING TOTAL $ a f !J.. 1 f17) BUYER ITEM Clf1o'/,f$/)/) (j;;i;/dN , LOT # .25'-/ f. - @ - $ 3 BUYER ITEM trcU-p f;lJ e1FO cl ()J~ ,-f J. - @ - $ 5 BUYER ~sV rr~, ,,:J ..4?", :.,..:. " ~5 @ - $ J. 7 BUYER ~73 ITEM 1J",,,1/: 73c:zLv..../ ~ f.- @ ~ $ 9 BUYER ITEM ~r 7,..".10 ~ ~ @ ~73 ~ $ /. -- 11 BUYER ITEM Pf'1d tl t,/'I:. /&; ~ ,) \e!!Jj @ - $ tJ.76 <3 - . /13 BUYER . bl7Y ~Mw'IJf'f" qf~ ~ G~ @ -$ ~.- SHEET # SHEET TOTAL $ '2 33--- BUYER ITEM _ b~.._!? ~ ~ ~ @ - $ <.31 '4 BUYER rr~"ifM' SJh- ::0. @ -$ 7. I. - '6 BUYER ITEM (J.L1J.t-t- ~ \21) @ - $ , ii BUYER .::<,6V 6-- . ;;;12"1 ~ 4kM.t./v" (jd.~'A %'1 @ - $ /.- 10 BUYER ~7~ ITEM ff;ttf;'/J }?,Uf~J.'4/;;.."Jlf?P, ~./ l-2!i!IJ @ - $ /.- .5'7 '12 BUYER ITEM ~6i;!!/~' ~--r ~ ~ @ -$ - $ 0': -- .;< ,')() 3.- RUNNING TOTAL $ StJ <:!!- BUYER ITEM A'JrJd' 0 LOT # ~70 @ - $ 1(.....- 3 BUYER ~ ~ ITEM ~!,;) ~ ?J.:;i; .u:J-1,u ('Jd:~ ~~CbA" \.8!t) @ -$ J.- /5 BUYER 7 BUYER ITEM ?fit!1J/tJ-fJ: ~V LOT # U .;<,{'7 ~s; ,-2. -- @ - $ 9 BUYER ITEM P-hi M- O';I~ ~ ~ @ -$ ;;)73 ~/- . 11 BUYER ~ ITEM ~aU it;/{~~ . ~ ~ @ - $ f.--- 13 ""~e ~ . ITEM {)t/(/':f ( LOT # ,;(.::) @ ~'J3 [))Clkf) c!,MJ;W - $ 0--:-- SHEET # SHEET TOTAL $ ''';:: , 2 c:<iR L/ BUYER ITEM 1::?I)wV ~ ~ - $ 0- --- . @ 4 BUYER "~:/'~ <i .tt.. .:{,511 @ ~ $ 6'b !. - "\ -B BUYER ITEM /~,1,~/y ~ ~ @ ?1 $ .3':- 8 BUYER ~ Lf C; ITEM ?A;1;.~~, dr ~OT# tl.!J/ @O.- " $ -/ " 10 BUYER )?7' 7=)4 l' :/o:t+-7Jr' / :<.:,/ @ _ $ -3.'- '12 BUYER :;.. rO "~ '1 t;""tZ./l jb/V @ ~ $ 2? ~..J 1:UYER 11/ ITEM J ,w/ltJ-k, M /JI.O q ~ ~ ./- ~ @ ~ $ 7. r1J. cJi! RUNNING TOTAL $ {Z\ - '1 BUYER ,-1.j~ ITEM ,~.- JLI.':;'N' /'J ~ $ 0.- ~ ' BUYER Lf V rrEM ~fl a&//F 4J . ~ ./' l0f!1J @ - $ /.- @ 5 .;?..!>1J '( _ BUYER \: ITEM~.aeu/ ~Yk~ ~ lE!!J )/J . -- @ - $ 7 BUYER a-b'{) ITEM f'd,,~//~ a~Nlht) ;;y.a. ~ ~ @ - $ 3'.- 9 BUYER &QL) ITEM Yc/J ~"V ~ ~OT# t / n - .3~ @ ~$ /. '11 d623 BUYER ITEM /1, (~~lIj rf~ ~ ~ @ L;(. __/ ~ '---- " - $ 13 BUYER & ITEM 7J ~//C Of-ri~ ~ ~ @ -$ /.- SHEET # SHEET TOTAL $ , , 2 71 BUYER ITEM {' ~, V; II. Wi j?"I//A-t ~ @ -- $ A.3. - 4 .R'IJ :~j ~"y @ " $ '" 13- - . 6 BUYER ITEM (lfi./;//1~ O:"Jdt ./:L ~ ~ \Jf}j) @ ~ $ .-< ....sU ~{;. -- 8 BUYER /7 ITEM ?~e}ci-"'21w- t0N~ (' LOT # lA!jLj) /d - @ - $ . 10 :< 5:3 BUYER ~~=;YS~NWh.' ..1-a- .A(' R~. ..-> - @ $ 12 BUYER ~~ ITEM ~ <:r~;;t;i/ //'1 @ -- -- - $ l~ . 14 7~ BUYER ~ $ f.- @ RUNNING TOTAL $ /33. q!l- ""'''''".,''". ~1liOFP94NSYlVANIA INHeRITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Geraldine J. Canan FILE NUMBER 21-01-68 Debts of decedent must be reported on Schedule l ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. H.L. Snyder, Funeral Home, Inc. 4,513.74 - B. ADMINISTRATIVE COSTS: . 1. Personal RepresentatiVe's Commissions , Name of Personal RepteSenlalive (s) Social Security Numbe!(s) I EIN Number of P"""nal Represenlalive(s) Street Address - City Slate Zip Yea~s) Commission Paid: 2- AtlDmey Fees to David A. Eisenberg, Esq. , LLC 800.00 3. Family Exemption: (If decedents address ~ nollhe same as daimants. allach explanalion) Claimant Street Address Cily Slate Zip Relationship of Claimant to Decedent 4. Prooate Fees to Register of Wills, Cumberland County 91. 00 5. Accountanrs Fees - 6. Tax Return Preparers Fees 7. Auctioneer's Fees and Costs to David L. Ebersole, Auctioneer 389.15 TOTAl (Also enter on line 9. Recapitulation) $ 5,793.89 (If more space is needed. insert additional sheels of lIle same size) It(II.r!r2;tll:.(I.t1l '* COMMONWeALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Geraldine S. Canan SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-01-68 Include unreimbursed medical expenses. ITEM NUMBER 1. Comcast Cable TV 2. 3. 4. 5. 6. 7. 8. 9. 10. DESCRIPTION Commonwealth of Pennsylvania State Employees' Retirement System overpayment A.T. & T. Boscov's P. P. & L. Verizon Ward's Camp Hill Apartments Meals on Wheels Hal S. Fineburg, M.D. AMOUNT 80.39 615.47 10.77 883.82 65.33 129.70 1,245.44 1,865.00 3.40 117,07 TOTAL (Also enter on Une , 0, Recapitulation) $ (If more space is needed. insen additional sheets of the same size) 5,016.39 ,.. """1"" *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN R 51 ENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Geraldine J. Canan FILE NUMBER 21-01-68 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE L TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Cheryl Spinosa Niece Half 2. Eric William Hochstrasser Nephew Half - ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON. TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) .. . ..-I Estate of 0t.?rcllcl/ne r G~j'1'(r1 also known as PETITION FOR PROBATE and GRANT OF LETTERS dJ-Ol --- ~ ~ C.T.A. No. To: Register of Wills for ~he , Deceased. County of UlrYl b e~f\Iq,cld: in the Social Security No. /0/ -- 2 t; - 711; LI Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older aJhe execut If. I t in the last will of the abov decedent, dated e:J.-,z and codicil(s dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (, LA-rl'i b~ )t:{r;d ~ ~~,o.unty, Pen~sylvania~ with.L) h ~ last fam~ or principal residence at 10 g Ccf-"bclL J-),c t&l~. L~iY(~ 1-tI1I. ~A { ('/!/J/jJ //1// ijtff'~o!lg IJ ) , f ) (list street, number and muncipality) Decendent, t~en ? 0 , ye.ars of age, died . [;ep1trr,heL 1(" , J# :2 O[">L'-;" at Hvlt <p,ti.it- ~IW I LnIY/fJ fh II (1./rt7b.-1J! jpJ?d (-42~~' PA . Except a follows, decedent id not marry, was not di~orced and did not have a chi d 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~1 oa;., 00 $ $ $ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. e~t:6v~~nl"llfi i~ C~J~nJ<L) c:: -g.g ~.= 3~ 11) '- :; 0 ~ c:: 00 en L//1 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I s~ COUNTY OF Lr;;H/6'H 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 a affirmed and subscribed .J- ~ day of , ~.. 1=9 J-. ~TlN 1+' i<:/t~ Register ini~tX~kcording to law. ~ /' CI) ()Q' ::s ~ - ~ ~ ~ /t - c::?Ool- /,-3 .. . No. 21-2001-68 Estate of C31tK:.t:Lld 'h-e- .J, ~"Ja-h , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW J a n u a ry 16, ~ 2 0 0 f 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 Jun l- ;),-:J.-; i L.l 73 described therein be admitted to probate and filed of record as the last will of Utl(J:\ ld '"'Ie .J C-a.rlan and Letters TkR1if/~r~~t*~if}fX~~~XX are hereby grant~d to , ~~X;;~.MlIJ~ Cheryl Splnosa Administrqtion C.T.A Cheryl Ann Horwath,n/k/a/ a~ &~sJJ? , t ~ ir4 f'A.9 (vJ:JIIEES '3 .00 Probate, Letters, Etc. ......... $ 50 . W . 1'6 00 Short Certlficates((P) . . . . . . . . .. $ 4 Renunciation . ( .2 ) . . . . . . . . . .. $--ll)--..aL .J Lf $ G. 00 TOTAL $ 91lQ~o -. . Filed .Januar.y. .16.,.2Q01.. S.......... 1>~\J\~ A E:senbei'1 2S5-iJ3 A ITORNEY (Sup. Ct. I.O. No.) 11.32-- ~rn'J J-tv11 Sf. F;'u;te lOlf fflle/1t-OfoLI'1ADDRESS ~,.A )8'JO / C:; J 0 / 4-3 -7 .- I '-/ } 0 / PHONE :J ;:., MAILED LETTERS TO ATTORNEY 1-16-01 01/02/01 ~ f!1 ~':a~ fT1 -. z g G)o .. ~.S' ii~~ i~icn ~J~t ~ i o (,) 09:21 REGISTER OF WILLS ~ 610 437 2350 NO, 435 [;103 ,I REGISTER OF WILLS OF . , COUN, Y OA TH OF SUBSCRIBING WIifNESS J ; Ii. ( Ih) b 'bO' h cO~lilcil ed h . h ( h)fb;. d 1 l'fi il d' · eac a su see! lfig wItness to t e WI present ereWll, eae l'i elng u y qua I .+ accor \ng to laJ. depose(s) and say(s) that J Jesent and saw ~ J.I j , th+estat . sign the same and that L signed as. witDess at tile r,lJest of testa! in L_ presen~e and (in the presence oflFeh other) (in lhe"bresenee of the other subscribing wirness(es)). I: I s...Jorn to or affinned and subscribed before I ; I I; :1 m~ this 19 day of I! (Name) J ~ i - 1'_: (Address) .j' Reg;ster _. 'Ii (Name) I i I] fi (Address) 21-2001-68 1 REGISTER OF WILLS OF LPJYjb, i 'An4 CO' NTY OATH OF NON.SUBSCRIBI:tN~ WITNESS, I CJte.~ J An., f!1>ftwath.. I'lIKA CJ/~'o/L ~' ,i ami EkL?! ~ j<e&Ch) a subscriber hereto, (each) being duly qualified accordtI)g to law, depos~ ) and say(s) that ~'7 A/lL. familiar with the signature ~f ~~ I . ~ .J . ~ I testat )e I JC.. of (one of the subSCrlt1lng wjtness~s to) th~ll! will presen: ed herewith and ! th t ~t-7 b )' h' ! h '~Il. 0 " !/h h d ., f a e leves t e s\gnatur-f on t e Wl lS In;~ e an wnung 0 I I GtttAldly)L ,oJ ~ ~AY1 ! , I to the best of tt-Jt.I'l(.. knowledge and belief. 'I Sworn to or affirmed and subscribed before me this "fth day of J~~~ca> K- L'_ Z,~ Register ~S"S~~ ~ ~. Jill ~2(J' J RENUNCIATION 21-2001-68 In Re Estate of c:,lKAldIYl~ .J. ~~h deceased. to the Register of Wills of ~b~land County, Pennsylvania. The undersigned eltl~ Wl~lllA.m Hochs/-Kas'sex. of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask{s) that Letters Tesfttmevd"rJ_, Sft'Y1OS~ be issued to WITNESS hand this qtA day of J &t.Y1 Lu:tllf.-'/, ,;J-6C)O ( C w~-I~~ (Signature) .;1.110 CAJtl'.J~'~hf piAu, hs/.", J/-f .:2.7-0'"1 I (A dress) (Signature) (Address) ,."-=' RENUNCIATION 21-2001-68 In Re Estate of 0ef'qld;'rle r GI'/Qr7 deceased. To the Register of Wills of Cu f!I1 b e f' )q Il cP f(' 4th/e.!!,? Ht>1'1 dTC(SSeI' The undersigned '-- !J. ~ ) County, Pennsylvania. Exec-i) tr\ x of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters -reS ~ r?1 efl Tn ry , Chel'\J J SO; noY, I r- be issued to WITNESS (1/11 hand this '27 f{ day of N{"\h?lI1bef.~ 2 oqv /,:!/,(S' 7 I '", c2-/~ .:-1 e-1< (.,i:;-/~\k..>-P.:("_~J";;';"N ";'~~';'---'-_ (Signature) 1l12~ !Cr;ler St. 41/er1 f-vu1f/ / e. 1ft/Of- (Address) (Signature) (Address) (Signature) (Address) 'Mll.RtJ1NG: 1T rs ILLEGAL TO ALTER THIS COpy OR TO DUPi.ICA Tl: BY PHOTOSTAT OR PHOTOGRAPH. l. ) I ,1( I ~\ Vi ~i OF PENNSYLVANIA m~'i\H M:Nf f !'::/I.LTHVITALRECOHDS . (> 1(.1 . I E Ii ~ F: A F ;E RTIFICA TION OF DEATH CERT. NO.. T 4 6 6 4 8 3 gl i',-,,;J!r 'f/~/~~-~;;,~~--.,~ ,\f.> \" \. \ t\ OF P f,A;'-':::;, ? ,....:;...'./.--- ---,,::r/jl--~\ ~. ~/"'~~\ //~/ . .~\.~~\ ft~ . . ~ \.~l\ i~~' _ , ~$":., ,:~~) t -- ',' .'. ,'i ~' - ~ " - ~/ \~. ~.,...:.: -'-~.' *~~. \:. <:::.>\ .... .' I~..... ~ ''G- ?'-.<) . /~l ,':. '/I' ........ . . ~'f \'~~~,:!II.1'(N"1' o~ ~';II.\II)\ "<:<<,.... l \ U III? 21~'i-68 ____ SlLpt. !LA OOQ______ Date of Issue of This Certification Name of Decedent . _____~ALcLLML--_--------~----------LA AI A hL____.______ -------.-----...---- ['",' khJcll( i,. Sex_.feJY1ALg.,___________ Social Security No. --J..S 1- J' ----:Z2-'-.L------- Date of Deal S ~ r t:.._~_'~tl----- Date of Blrth_:S.J1.NL~!J-j _L!l31L_____ Birthplace ~'Ne M_Q,Y-e 1 f4_:.._._____.______________________________ -.... Place of Deathld<)~J;~,l'-if~iLl~L C u ~",~~..l.. It 1\1 J -~~}t!"t~~---- Penr1Sy~vi'nl_Cl Race_H-"Wh.~'.t.2..___ Occupation Si~.::w.(} {K~ (' Armed Forces? (Yes or NQ) _ND_______________ Decedent's Marital Status ____D.~_v~'----.------- Mailing Address I ~lH~t" 0 ili1.~ r ~r~/' v~_~ O~'!.~" f!,~' L- Lr-~---.:il-__:;::--. --- . Informant_d1YlJ1ctl\_~...Al_A._rSM~th..____._._______._____ Funeral Director ~JJfLiYJl S"IU'1J~ r .7..JAam.~rlY1(l4l.--. .-.. Name and Address of; J Funeral Establishment fJ~~1J.n--tU1Yg1J!L-~iI.D.Mq, fif.) J3 9 tf/ruL9~h()l.~AI ~ ~'A1~ ~ft..:...l2~~t:__~}.,i.__ ; Interval Between Part I: Immediate Cause i Onset and Death (8) ___.fJv_d.StA1-~____8_LLa...lt>> D L / -,---_C; ~ r' h D~:._u_.____________________~__________________ (b) -...- ,~,,_'_--'-~-._' ._------_..>-----~.~.~------------~---._--_.._-----~--~.__.,._-....-_._---,-_._._----_._-_.-._----_._--------_..~-- Ie) ._. ._.____._________________.__.__.________.__...L....__....._._..__.._____._____..u._ .. _" ( d ) _____... .. ___... ___ _____________ .------ Part II: Other SIgnificant Conditions ---------.---------r--------------------.-.---..-.--.. --- __________.____________________.__.____L-___________ Manner of Death Describe how injUi"y occurred: Natura! Accident Homicide Suicide PendIng Investigation Could not be Determined n Name and Title of Certfier __________111.' chll~L 0 e lYlic:./1l' L ~ f IV/. D. ----------- (f'vU)., D.O., Coroner, M.E.) Address____u. _ ...._,f()~tlI-'6L~7 C A fI1 r. I-J ~~.--!.7 0 1/ - J. 2 ,9-[$ __~__._ --- This is to certify that the information here given is correctly copied from an original certificate of death duly flied with me as Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filing. ~J ;~, /i,;, /d~~,:I-~------- f~.",~_____ -.";-..':5,,...fL....,..,.-.li,.,...,.,'-.;J...,~,3.\....-.._-J--......-...~.-QO"'O_- 303 S,'h,Lf'eho(~I., ~~"'e. ~flOVe.1 fA, li'l~S' . . '1" Street Address City Bor~h_ Townshrp ( CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Geraldine J. Canan Name of Decedent: Date of Death: September 14, 2000 Admin. No. 21-01-68 Will No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 21, 2001 : Name Address Eric William Hochstrasser 2110 Cartwright Place, Reston, VA 22091 Cheryl Spinosa 5849 Route 309, Schnecksville, PA 18078 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: February 21, 2001 Q~(jJ~AH)(t j Signature Name Cheryl Spinosa Address 5849 Route 309 Schnecksville, PA 18078 Telephone C610) 767-1625 Capacity: ~ Personal Representative _Counsel for personal representative /' L STATUS REPORT UNDER RULE 6.12 Name of Decedent: Geraldine J. Canan Date of Death: September 16, 2000 Will No. Admin. No. 21-01-68 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 No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: May 15, 2001 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 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 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: 2/21/01 G ~--- ,~ ~ ..J Si~~ Cheryl Spinosa Name (Please type or print) 5849 Route 309, Schnecksville, PA 18078 Address (610 ) 767-1625 Tel. No. Capacity: X Personal Representative Counsel for personal representative (MAH:rmf/AM3) c STATUS REPORT UNDER ROLE 6.12 NAME OF DECEDENT: GERALDINE J. CANAN DATE OF DEATH: September 16, 2000 FILE NO. 2 1 01 68 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 X No 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 X b. The separate Orphans' Court No. (if any) for the personal representativels account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attacheq to this report. C~J.~ \ ---- SIGNATUtE ~ DATE: May 11, 2001 Cheryl Spinosa NAME (please type or print) 5849 Route 309, Schnecksville, PA 18078 ADDRESS TEL NO. capacity: x Personal Representative Counsel for personal representative ~ / b -;;L:;,;) - /.:g COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-25-2001 CANAN 09-16-2000 21 01-0068 CUMBERLAND 101 DAVID A EISENBERG ESQ STE 204 1132 HAMILTON ST ALLENTOWN PA 18101 )~I- ~ V * REY-1547 EX AFP Cl2-00) GERALDINE J Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4j-EX--AFP--fi'2-:0(jr-NOTicE-OF-'fNHEifiTANCi-TAi-A-PPRAisEi'-ENT~--Aii-oWANCi-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CANAN GERALDINE J FILE NO. 21 01-0068 ACN 101 DATE 06-25-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks 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. ~ointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 12,407.61 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (IS) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: (9) (10) 5,793.89 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 12,407.61 10.8]0 28 1,597.33 .00 1,597.33 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 .00 .00 239.60 239.60 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-11-2001 AA496590 .00 239.60 TOTAL TAX CREDIT 239.60 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 5,016.39 (11) (12) (13) (14) .00 X 00 = .00 X 045 = .00 X 12 = 1,597.33 X 15 = (19)= * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIp. (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) . -,. 1 . 111a13t Mill aub ffit13tanwut I~ GERALDINE J. CANAN~ of the Borough of Camp Hill~ County of Cumberland~ State of Pennsylvania~ being of sound and dis- posing mind~ memory and understanding~ do hereby make~ publish and declare the following to be my Last will and Testament~ hereby re- voking and making void any and all Wills by me at any time hereto- fore made. FIRST: I direct that all my just debts and funeral expenses~ be paid and discharged by the Executrix of this my WiZl out of my estate as soon as may be convenient after my decease~ and as may be for the best interest of my estate. SECOND: I give~ and bequeath to my beloved niece~ Cheryl Ann Horwath 418 Carolina Avenue~ Whitehall~ Allentown~ Pennsylvania l8052~ all of the jewelry of which I die possessed. THIRD: I give~ devise and bequeath all the rest~ residue and remainder of my estate~ real~ personal or mixed~ of whatsoever nature or whereso- ever situate at the time of my death to my beloved niece~ Cheryl Ann Horwath~ and my beloved nephew~ Eric William Hochstrasser~ 2324 Living- ston Street~ Allen~own~ Pennsylvania l8052~ in equal shares~ share and share alike. If either of them predecease me~ leaving issue~ then I give~ devise and bequeath their share in said residuary estate to their issue~ per stirpes and not per capita. If either my niece or nephew fail to survive me~ leaving no issue~ then I give~ devise and bequeath all my residuary estate to the survivor of them~ or their issue~ per stirpes and not per capita. FOURTH: My Executrix~ hereinafter named~ shall have the right~ power and authority to distribure my estate to the devisees and legatees either in cash or in kind. FIFTH: I authorize and empower my Executrix~ for any purpose of adminis- tration or distribution~ to sell any or all of my real estate for such price or prices and upon such terms and conditions as she deems best. I further authorize my Executrix to retain all stocks~ bonds or other in- vestments made by me for distribution in kind~ or in her discretion to sell and transfer such investments either in person or by attorney; to borrow money~ and pZedge any stocks~ bonds or other personal property of the estate as security therefor; and to exercise my option to subscribe' for stocks~ bonds or other investments~ and to join in any plan of lease~ mortgage~ consolidation~ exchange~ reorganization or foreclosure of any corporation in which the estate may hold stocks~ bonds or other invest- ments. SIXTH: I hereby authorize and empower my Executrix to carryon any busi- ness or businesses in which I may be engaged or interested in at the time of my death until such interest or interests can be turned over to my heirs or legatees~ as above named or set forth~ if not sold. SEVENTH: I hereby nominate~ constitute and appoint my sister~ Kathleen Hochstrasser~ as Executrix of this my Last Will and Testament~ and here- by authorize~ empower and direct my Executrix~ to do every act and thing necessary or proper for the full and complete administration of this my Will. Further~ my Executrix shall serve without the necessity of filing bond or security in any jurisdiction in which she may be called upon to act. ~ 11- . · ..p~ ;-. tlt';u~/".../(SEAL) GeraZdine J. ffanan f . . . . .. . l' .... EIGHTH: I direct that all estate3 inheritance and succession taxes3 interest and penalties on property passing under this my Will3 shall be paid out of the principal of my general estate to the same effect as if such taxes were expenses of administration3 and all legacies3 devises and other gifts of principal and income made by this my Will3 shall be free and clear thereof. IN WITNESS WHEREOF3 I3 GERALDINE J. CANAN3 Testatrix3 have3 to this my Last Will and Testament3 typewritten on two consecutive sheets of paper3 of which this is the second3 set my hand and seal this ~~ day /~J of;" / /. JP ;' 3 l 9 7 3 . j~ Pb<-- ;' l! d'''' /1 , ~ . / ~ -.".. '. . l t ~k.+-tl- ~,.u- ~~ . Cra'.:7ld ;1::;../ (SEA L ) "'" Geraldine J .(/Canan ************************** SIGNED3 SEALED3 PUBLISHED3 AND DECLARED by the above-named Testatrix3 as and for her Last Will and Testament in the presence of us who have hereunto subscribed our names as witnesses at her request3 and in her presence3 and in the presence of each other. );J ~uL '>>;~r?reSiding J ~~.q;J ~ 9P7~ residing ! / at If) iT (~ iJL. &, -b j/~~?;Jt<? / ~ ~/ f74, at / 0 f f)~~ CiJ'l.. CZwi IW