HomeMy WebLinkAbout01-0126
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Zelda H. Stewart No.
also known as To:
, Deceased.
Social Security No. 196-14-0525
;2/-o/-/d<.6
cumberland
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioners, who are 18 years of age or older and the Executors named in the last will of the
above decedent, dated December 5, 1996and codicil dated - N/A.
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or
principal residence at 192 Carlisle Road, Newville, West Pennsboro Township.
Decedent, then 83 years of age, died December 23, 2000,at Green Ridge Village, Newville, P A.
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: Decedent was married to William P. Stewart. He died on October 23, 1999.
Decedent 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: None
$ 550,000.00
$
$
$
$
WHEREFORE, petitioners respectfully request the probate of the last will presented herewith and
C1gra~~~enta~CJ4L~J _~~. ~~
Ca~Stewart Beatrice:( .r{'~~'- Gladys~ewart
192 Carlisle Road 11883 Mongul Hill Road 928 Baltimore Road
Newville, P A 17241 Shippensburg, P A 17257 Shippensburg, P A 17257
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYL VANIA)
COUNTY OF CUMBERLAND
SS
)
The petitioners above-named swear or affirm that the statements in the foregoing petition are true
and correct to the best of the knowledge and belief of petitioners and that as personal representatives of the
above decedent petitioners will well and truly administer the estate according to law.
(!/kt/ / 4k:~/-
Carl P. Stewart
~2-JrL~
/#r/~~
. Gladys . Stewart
~tJ
J)
7-
/~-=2tP6 -- /3
NO. 21-2001-126
Estate of Zelda H. Stewart, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW January 31st ,2001, in consideration ofthe petition on the
reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument dated December 5, 1996 described therein be admitted to
probate and filed of record as the last will of ZELDA H. STEWART;
and Letters Testamentary
are hereby granted to CARL P. STEWART, BEATRICE J. JOHNSON and GLADYS L.
STEWART.
FEES
Probate, Letters, Etc. ........... $ 375.00
Short Certificate(s) ..5......... $ 15.00
Renunciation....................... $
x-Pages (3) $ 9.00
JCP TOTAL $ 5.00
Filed.... .~~l}~ry. }J.:~t!. ?9.9.~.. .$.404 .00.....
Richard L. Webber, Jr., Esquire
Attorney LD. No. 59634
19 Brookwood Avenue, Suite 106
Carlisle, P A 17103-9142
(717) 249-5373
F:\User Folder\Firm Docs\Estates\I775-1 testamentary.wpd
CALL ATI'ORNEY RICHARD WEBBER
HI05.805 REV 9/86
This is to certifY that the information here given is correctly copied from an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fe, fo' ,he, ,cnaeQ", $2.00 ~~~
Local Registrar
No.
A.r; 2-~, 2c&'&#
Date
p
7060216
21-2001-126
qfty 2187
COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECOROS
CERTIFICATE OF DEATH
NAME Of OECEOENT(f,''lf M~--"-'---"
s. 83
COUNTYfY.DERH
v..
rt
~~-
Hours ! Wlnut..
IIkfHPUClICoI'y-'"
Rmoe'fS'01f""~
Franklin Co.
'TATI"lENUMllfR
----- S"-~ECUR''''"UM.ER ------rO.TEOFOCATH M""'" n., :...-:;;~
.. ll.e.-~ - 14 - 052~' DcI.' ,",Lllu.r.:., "?,{L~,,~
PUClCJ'oe:RHfChforllnoly.".... ..."....,ur.IO()f"'nn~~1 --r
HOSPtiAL-- .--.---------~---.. -.. -- ~ 61HE~ _ ;" --..- --..-- -- .--- .-.-
'- 0 :::::" lY' _ LJ =.,,0
Cumberland
DECEDENT'S USUAl 0CCUM10N
j~--~_:"c::::~=r
." Production Worker ,... H.J.
MaDEMY'S MA,UNOAOORESS (Str_.c~. s...llpCOOII
. ...
...W.
,..
"AntEA'S NAME IFit.. Middle. LHI'
to. William C. Stake
1NF'000000'SNMCcr~
Carl P. Stewart
,.. UETHOO OF DfSPOSmON
_IX! "'-'00 0 __.....0
_0 0IIw",-""
,. .,
'710.
...
-
......
Cumberland -' 'HoO :...":".:::'..
MOTHEA'S NAME' iF... Middle, ~&"t".".)
. Bessie Coons
INFORMANT'S MAIUHO ADDAESS (SIr...~. sa...lip Coo.t
192 Carlisle Road, Newville, PA 17241
OF DISPOSITION . Name Of CIIMtery, Crematafy lOC..-.oN . City(Ibwn, St.... liD COdII
orO:herfltllce
MAAlTAL smU8......
Never"""'1ed. WIdDweclI,
--
. Widowed .
....10 ....._...... W. Pennsboro
White
SUA\I1VIN(l SI'OUS<
1"........qrw."'IltdlW'o""""'1
192 Carlisle Road
Newville, PA 17241
Heinz Co.
DeClDENT"
ACTIJAL
RESIDENCE
....--.
onOlNlfSldeI
tI.
t"'SO", PA
Twp.
-
-
....L
17257
~---....-....-
"..,...,.. NIl......,..,. or dhttt III
. <*"'r,*-OfdNlh.
t ...... 24.,. '"'* be compIeI-.:t by
"": ..........~dht,.
27. MAT I: EftNt rN......... """"" Of eompfIc:atClnawfliCh ea
l.. Dntf OM ceUM on ueI'lllM.
-..ar. CAWe (FIN!
-"'-
'-.....olrl dlIIIhl-'
~~
DUE ft)(OA AS A CONSE'OUENCE Oft
r~lI'tlM.
'--
:OMMMddlNdft
I
, "--..-
".......... ...........
_. E_""""'INQ
'~~orlf'l!Ur'"
. .....It'*-f.,..
'~ItI~)LAST
[ :
..
DUE' lOfOR AS A CONSEOUENCE 00:
DuE 10 (OR ASACONSEOUENCE OF):
MS AN AU1tlPSV
PERFORMED?
WERE AUlOPSV FWONOS
MN.A8LE PAtOA 10
COMP't.ETtON tY CAUSe
OF DERH7
WIMmER Of OE:ATH
-
~
o
o
DATE Of INJURY
(~. Day, '*-)
TIME OF IN.lUAY
INJURY AT WOAK?
OESCAt8E HOW INJURY OCClJAAEO
-
o
o
o PLACE OF INJUAY. At home. farm,...... '-c:to.y. oInc:e M,
buIdIng._.~1
....
.... 0 ...0
....0...
....0
...
-.-....
Coukt null be~"*'
-WDICAlIXAMINeAICOftONEA
3,.~b::~~::'~I~~~I~~...~~ .~~I~~~: ~~ ~~ ~~~j~~: ~~~ ~~~ ~~ ~~ ~I~,.~~I~: ~.~~:~ ~.~~~~ ~~ ~~~~).~~
REGISTRAR'S SIGNATURE AND N
~/ ~I( 5f
Fi!
-- -
CEJIJ.... ICtlecll only ~
-CI!ltTlPVING PHYStCIAN (Physc... ~ eIuSoItd dHlh~." anolt.. Chvtc.." h.. Pl'onounced de.1h &rIO completed "ern 23)
T........ot.,lInow1ecfge..IllhOCCurNd.........aUMf...ndlhnNr...................................... .
...
"PIIONOUNCJNo AND CEMWYINQ ,"VIle'''' fPhvsc..., hnlh pronouf\Cll'lQ tSeMh ~ cet11tyw1o roc*,- tJ ...lhl
To the...........,~. ....th occur," at......... lMle,"" pfMe, ..... cru. to the cauM(.. aNI manne,.. ".11Id.
\Un
u.
:N.
-..e.c 2 (; ~ t:' c:J
Law Office of
FOREST N. MYERS
***
10000 Molly Pitcher Highway
Shippensburg, PA 17257
(717) 532-9046
c2/- tJl- IOL 6
* * LAST WILL AND TESTAMENT * *
I, ZElDA H. STEWART, of 17484 Amberson Road, Fannett Township, Franklin County,
Spring Run, Pennsylvania, revoke my prior wills and declare this to be my last Will:
FIRST: PAYMENT OF EXPENSES -I direct that the expenses of my last illness and funeral be paid
from my estate as soon as may conveniently be done.
SECOND: BEQUEST -I give, devise and bequeath all my property, whether real or personal, tangible
or intangible, together with all insurance policies thereon, unto my husband, William P. Stewart,
provided he shall survive me by thirty (30) days. In the event my husband fails to survive me by thirty
(30) days, I then give, devise and bequeath all my estate whether real or personal property, tangible
or intangible, together with all insurance policies thereon to my children, provided they shall survive
me by thirty (30) days, in as nearly equal shares as possible, per stirpes.
THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder of
my estate unto my husband, William P. Stewart, provided he shall survive me by thirty (30) days.
In the event my husband fails to survive me by thirty (30) days, I then give, devise and bequeath all
the rest, residue and remainder of my estate to my children, provided they shall survive me by thirty
(30) days, in as nearly equal shares as possible, per stirpes.
FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual
payment to a beneficiary, no interest in income or principal shall be (I) assignable to a beneficiary or
(ii) available to anyone having a claim against a beneficiary.
FIFTH: DEATH TAXES - All federal, estate and other death taxes payable on the property forming
my gross estate, whether or not it passes under this will, shall be paid out of the principal of my
probate estate just as if they were my debts, and none of those taxes shall be charged against any
beneficiary. This provision shall not apply to any property over which I have a general power of
appointment for federal estate tax purposes.
SIXTH: MANAGEMENT PROVISIONS - I authorize my Executors, as follows:
A. Retain/lnvest: To retain and to invest in all forms of real estate and personal property, including
common trust funds, mutual funds and money market deposit accounts and certificates of deposit,
regardless of any limitations imposed by law on investments by executors or any principle of law
concerning investment diversification;
B. Compromise: To compromise claims and to abandon any property which, in my Executor's
opinion, is of little or no value;
C. Borrow: To borrow from and to sell property to my husband or others, and to pledge property as
security for repayment of any funds borrowed;
D. Sell/lease: To sell at public or private sale, to exchange or to lease for any period of time, any
real or personal property and to give options for sales or leases;
E. Capital Changes: To join in any merger, reorganization, voting-trust plan or other concerted action
of security holders, and to delegate discretionary duties with respect thereto;
F. Distribute: To distribute in kind and to allocate specific assets among the beneficiaries (including
any custodian hereunder) in such proportions as my trustee may think best, so long as the total
market value of any beneficiary's share is not affected by such allocation.
These authorities shall extend to all property at any time held by my Executors or my Trustee and
shall continue in full force until the actual distribution of all such property. All powers, authorities
and discretion granted by this will shall be in addition to those granted by law and shall be exercisable
without court authorization.
SEVENTH: EXECUTOR. I appoint my children, Carl P. Stewart, Gladys l. Stewart and Beatrice J.
Johnson, as Executors of my Will. Neither my Executors, nor any successor shall be required to give
bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this Sc:;...day of l)~~ ,
1996.
'/.
Z
In our presence, the above-named Testatrix signed this and declared it to be her will, and now, at her
request and in her presence and in the presence of each other, we sign as witnesses:
If> kn~ /~1R/l flL
~f!f/-
COMMONWEALTH OF PENNSYLVANIA
:SS
COUNTY OF FRANKLIN
I, ZELDA H. STEWART, having been duly qualified according to law, acknowledge that I
signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the
purposes therein expressed.
~ ..J2-
ZE DA H. STEWART, Testatrix
J
~ r
.r \. t ~..
" 'J.
,
" /
'4 I f
'"
,t-.;.
," . ~"
-_>" ':.. {" I~"
r;-
, ,
.." '- .::
" ~. ~ ..../......,.........
,.'
'. 'i,,, ,,,......~..
We, ZELDA H. STEWART, the Testatrix in and the undersigned witnesses to the Will, the
attached or foregoing instrument, who have signed the instrument, having been qualified according
to law do depose and say:
(a) that I, the Testatrix, do hereby acknowledge that I signed the instrument as my
Will, that I signed it willingly and as my free and voluntary act for the purposes
therein expressed; and
(b) that we, the witnesses, were present and saw the Testatrix sign and execute
the instrument as her Will, that she signed it willingly and executed it as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the Will as witnesses and that to the best of our
knowledge, the Testatrix was at that time eighteen or more years of age, of sound
mind and under no constraint or undue influence.
EL H. STEWART, Testatrix
~6z.;L ~" ~
W~J.
~Ah~
Witness
Subscribed, sworn to or affirmed,
and acknowledged before me by the
above-named Testatrix and by the
witnesses whose names appear on
this Sb...day of ~~Q0L. ,1996.
~ .,J~
Notary Public
Notarial Seal
~ N. Mt,ers. NOIaIy PublIc
My Comm~ ~ Franklin Countv
~resDec.ll, law
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
"v /6-0206. /--3
REV-ln7 EX AFP <12-001
RICHARD L WEBBER JR ESQ
MICHAEL J HANFT LAW OFF
19 BROOKWOOD AVE 106
CARLISLE PA 17M'S
, .
'1 "
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
. ,COUNTY
'ACN
08-06-2001
STEWART
12-23-2000
21 01-0126
CUMBERLAND
101
ZELDA
H
AlIOunt R_i tted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=i6oj-Ex-iFP-n2"=ooy------...-iNHERITANCE-TAX-STATEMENT-OF-Accoi:iNT--.-..---------------------
ESTATE OF STEWART ZELDA H FILE NO. 21 01-0126 ACN 101 DATE 08-06-2001
THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW
IS A S~ARV OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAV"ENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-25-2001
P R I NC I PAL TAX DUE: ............-........................................................................-....-......--............................................................................................................
24.085.38
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-22-2001 AA478191 1,052.63 20.000.00
05-10-2001 AA496575 .00 2.881.11
07-10-2001 CDOOO035 .00 151.64
TOTAL TAX CREDIT 24.085.38
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PA~ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl.
YOU "AV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. )
\. /6-6U:J6'- ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-02-2001
STEWART
12-23-2000
21 01-0126
CUMBERLAND
101
RICHARD L WEBBER J~! :ESQ
MICHAEL J HANFT LAW OFF
19 BROOKWOOD AVE ,.~06
CARLISLE lPA.17013
)~
0/'
REY-1547 EX AFP '12-00l
ZELDA
H
Allount Rellitted
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
418,057.55
104,238.70
29,930.27
(8)
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HaUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=iS'4'-Ex-iFP-ci'2':ooY-NoYicE--oF-YNHEiiiTANcE-Yix-'APPR'AiSEMENT-,--iLL'OWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STEWART ZELDA H FILE NO. 21 01-0126 ACN 101 DATE 07-02-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
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. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
03-22-2001
05-10-2001
NOTE:
RECEIPT
NUHBER
AA478191
AA496575
DISCOUNT (+)
INTEREST/PEN PAID (-)
1,052.63
.00
PAYMENT MUST BE MADE BY 09-23-2001*.
(9)
(10)
15,676.58
00 =
045 =
12 =
15 =
(19)=
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
552,226.52
16.995 94
535,230.58
.00
535,230.58
.00
24,085.38
.00
.00
24,085.38
23,933.74
151.64
.00
151.64
. IF PAID AFTER DATE INDICATED, SEE REVERSE
. FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
1,319.36
(11)
(12)
(13)
(14)
.00 X
535,230.58 X
.00 X
.00 X
AHOUNT PAID
20,000.00
2,881.11
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
"
r-
iD
q>
x
w
&l
:>
w
c:
"
m
~
CO
r-
-.;;t
<C
<C
0
z
><
<( l-
I-
W D.
I- -
<(<( W
-I- 0
zen
<(w W
>0 a:
..Jz
><( ..J
en
zW <I:
zO -
wZ 0
11.<( -
!:: LL
a: LL
w 0
:I:
Z
~
Z
<C
~ en
>- w
(/) ><
zUJc(
z:J1-
UJz...l
Cl..UJc(
u..>:J
oUJe
a:_
Iu..::: <C
:;oe Cl..
<CI-~ .
~dJ~g~
z:2::l0[D
oli:c(gJ!Q
::i1<cw....:a:
<<Cl..a:Cl..a:
OUJ::lUJ<C
UOIDOI
(;
<D
o
cO
C\l
;:::.
()
C.
.
f- s.~
Z ',-'
:J Cl
a
::2 ,-.
~~..t
<( (U
!f1
f-
~....Ia:
a
z::2a:W
U(/)f-CO
<((/)z::2
Wa:J
~UZ
<(
:i!i
o
a:
1I.
Q
W
>
jjj
o
w
a: L
~.
-<
i
G: (T}
" .....
o
_.J C"
:> -'It
Q<!
c::
<i:a (J:
.:: 0 .....
uo
.....::;-0.
C::X:OW
o ... ..J
r.c 0 pl
liJ a::: W l-I
mmi-..J
W .....c;:
WC-:J<l
3': ...... (,,1 U
n;
..:r
....
0'-
~"
- .~
~~
)~_.
\:~ .~
~<~~ r~
\1, ~
~' " '.
.~-~
J) \,
U"i \
\()
,. -".'~
W
0:
W
:r:
g
12
o
o
.3
[ "
_.'
.::;
o
.~
'.'
("'
-,'
f\.!
~
o
;;(
0-
f-
Z
:J
a
::2
<(
....I
<(
f-
a
f-
"
~
If)
nJ
in
0
i
..:t
....
i i='
-0 (/)
er- a:
M ~
Z .el
lJ1 -
r.n l;
I !
- <I ~
..0 --A -
z nJ I-..J f)
0 ..... ~u ..... 0 a 0
i= 0 ~"J 0 C' Z 0 ..
<( I 0 0 <I 0
::2 .... ~~ ru '" .J ru J
'-I
a: 0 dJX 1-"- ...., e::: , ~
0 0 o<! dJOJ UJO W Ifl1
LL a:C!J ~~ :2('J ~o lIJ H\J .J
z UJiJj >-, 0,,- E 11i'
UJI 0,- <C -. ~o
W [D.... Cl..(T) :J on.:
!;( ~r.J ~(Jl u.. <C ~u ~,...,
0 :2
I- z UJ UJ I- Z UJ
UJ :2 l- (/) :J I-
(f) -' <C <C 0 0 <C
W u::: Z 0 Cl.. U 0
w
ffi
:r:
Cl
-'
12
..1
.J
>"' l-~
~ er: t;l
0,'1' '>I
... .....
UJ:a: tT
~
w
U
w
a:
o
"-
, ,
'-'
z
o
cn
z
I
o
'J
'J
OJ
Wo-
eJ
"*'4 ::#
cc 'x
;.... t..l
<IW
w..,.
mu
....I
(/) <(
~ w
a: (/)
<(
::2
w
a:
1
~1
~1
:5:1
~1
a:l
~1
001
ill 1
a:!
I
1
I
I
I
1
I
I
I
I
1
I
I
I
I
I
I
I
I
I
t
I
I
I
I
I
I
I
j
J
I
I
I
I
I
I
,
I
j
)
i
)
I
I
I
I
><
<C
t-
W
t-
<c<C
_t-
zen
<cW
>0
..Jz
><C
en
zW
zO
wZ
a.<C
!::
a:
w
::I:
z
<(
z
<(
::; (/)
>- w
UlWX 0
~:J~ CO
WZ...J 0
~~~ ~
O~Q r:::
Ill..> <(
~oi5 a.
<(I-~ -
WZLLoIE
~~O~:J
Oti:~~~
~<(W~a::
""a.lra.a::
OW:JW<(
UOmOI
iO
0;>
x
w
C\l
'"
>-
w
a:
Lt)
I'-
Lt)
<.0
a>
.q
<(
<2;
o
z
I-
D.
-
W
o
w
a:
..J
<C
-
o
-
LL
LL
o
I-
Z
Wc5a:
Z::2:a:W
OU>I-CO
<(U>Z::2:
Wa::)
~OZ
<(
:i!i
o
a:
LL
C
W
>
W
o
w
a: L
I-
Z
::)
a
::2:
<(
d
-...
(l)
m
(lj
Ifl
~.
c'
-...
fU
-.1"
0-
I
a: 01
.....) ~,...""
C.
-1 r-.
:>
~:l (!
Q
<1:0 <r
I 0 CI.
LlO
f-t ~....I) ..
f.l:::i:OW
O....-9.J
a:o en
LtJ t:: W I-<
m m to" ..-oJ
Ctl ......0;
IjJ [r- :J cr
J: o:-ot tn tJ
z
'0
i=
<( I
:2: .-.
a: '2
o ....'
u.. ru
Z ffil
W CO,-'f
f- 5iJ
<(z
tn~
wu::
In
fU
I()
o
I
-~
I i='
..0 Ul
Cr- a::
M !E.
Z
ill
l,.')
<!
.-<J ~O
fU I-..J
.-< ~w
o 2f.J
=-
~
I
H....
Zcr:
~<I
w:!
frlw
of-
~(J)
W
::2
<(
Z
.....
o
o
fU
1-',
d50
::2......
>-,
~tD
u..
o
W
I-
<(
o
o
o
o
o
""-
~c}
<(0
0,
iEo
<(
::2
I-
Ul
o
a.
-...
-....
m
i))
CU
1ft
o
<
a..
I-
Z
::)
a
::2:
<(
--1
<(
I-
a
I-
Q
--:;1
01".
cr
..J
cr:
w
m
E
:J
~u
Z
:J
o
U
~*
<r~
I))
~ .~
t ~
.~). \; \- ~. \
'''. \,.\.>...~,
, '''\.: """,::,\\
~<~. ...
",J
,..,.-
.J.
. l.J
.J r-
u)
>.....
in i:r ,,;)
o <r L:J
w:E: r.r:
~
W
o
W
a:
o
~
. ,
(:,
cu
,
I (ll
I-fU
l5 "
OfU
u.. r.
o
W
I-
<(
o
..J
Q
0::
cr
I
u
.....
cr:.
o
-,,-
U
n
f-
a::
<t
)3
W If)
11- 0
U)""'
0..#
:r::
..JU
:r cr LtJ
" <J: :r.
UU
--1
U> <(
:Ie: W
a: U>
<(
::2:
W
a:
U)
_1
.J
I
I
1
I
I
1
]
I
I
1
]
1
1
I
1
1
1
1
]
I
1
~1
:::!j
3:1
~l
a:l
~1
(/)1
ffil
a:1
I
1
I
I
I
I
]
I
I
I
I
J
I
I
I
I
)
1
I
I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG. PA 17128-0601
RECEIVED FROM:
WEBBER RICHARD L JR
19 BROOKWOOD A V
SUITE 106
CARLISLE, PA 17013-9142
u______ fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 196-14-0525
FILE NUMBER: 21-2001- 0126
DECEDENT NAME: STEW ART ZELDA H
DATE OF PAYMENT: 07/10/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/23/2000
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
REMARKS: GLADYS STEWART, CARL STEWART
BEATRICE J JOHNSON C/O
CHECK#109
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 000035
I
I
I
I
I
I
I
I
I
MARY C. LEWIS
REGISTER OF WILLS
AMOUNT
$ 1 5 1. 64
$ 1 51 .64
~
F:IUser FolderlFirm DocsIEstatesI1775-lcertofnotice.wpd
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ZELDA H. STEWART
Date of Death: December 23,2000
Will No. 21-01-0126
To the Register:
I certify that notice of beneficial interest required by Rule 5 .6( a) ofthe Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on January 31,
2001:
Name
Address
Carl P. Stewart
Gladys L. Stewart
Beatrice J. Johnson
192 Carlisle Road, Newville, P A 17241
928 Baltimore Road, Shippensburg, P A 17257
11883 Mongul Hill Road, Shippensburg, P A 17257
Notice has not been given to all persons entitled thereto under Rule 5.6(a).
Date:
. .
hb
J'f J )t?DP
W"f..----~
Signature
Name Richard L. Webber, Jr., Esquire
Address 19 Brookwood Avenue, Suite 106
Carlisle, P A 17013-9142
Telephone (717) 249-5373
Capacity: Personal Representative
~::J
-- -'
": r"o
,..0" ........
*
.
~/
oK
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Zelda H. Stewart
Date of Death:
12-23-00
Will No.
2001-00126
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: N/A
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 representative's account is: N/A
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
Cerk of the Orphans' Court and may be attached to this report.
Date: II /1 LII()~
-)'}4 ~
L;/, (,_
Signature
Richard L. Webber, Jr., Esquire
Name (Please type or print)
126 East King Street, Shippensburg, PA 17257
Address
( 717) 532-7388
Tel. No.
Capacity:
Personal Representative
X
Counsel for personal
representative
(MAH:rmf/AM3)
.
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/05/2002
CARL P STEWART
192 CARLISLE ROAD
NEWVILLE, PA 17241
RE: Estate of STEWART ZELDA H
File Number: 2001-00126
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 12/23/2002
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
MARY C. LEWIS
REGISTER OF WILLS
cc: J File
Counsel
Judge
~
'*
/b-.}C6~/3
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
C+FiCAL USE O,~LY
to
L/
Rl\':i'loDEX.I'~') .
COMMONWEALTH OF PENNSYLVAN~
OEPARTMENT OF REVENUE
DEPT,280601
HARRI$BURG,PA 17128-0601
FI1.E NUMBER
21 01 0126
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
1 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Stewart, Zelda H.
~
z
W
Q
W
o
W
Q
DATE OF BIRTH (MM-DD-YEAR)
196-14-0525
DATE OF DEATH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
12/23/2000
06/01/1917
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
I [gI 1. Original Return
I 0 4 Limited Estate
o 2. Supplemental Return
o
4a. Fulure Interest Compromise (date of death after
12-12-82)
I
D 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
w
~
~<",
o~~
w~o ~ 0 0
,00 6. Decedent Died Testate (Allach copy 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes
o~~
~m of Will) copy of Trust) -
~
< 0 9 Litigation Proceeds Received 0 10. Spousal Pove~,,~redit (date of death between 0 11, Ejection to tax under Sec. 9113(A) (Attach Sch 0)
123191and1-1-95
THISSECTIONMUSTBECdM~bETEP''''~LCORR.ES~ONDENCE AND CONFibeN'fI;.I.b+AXi\~~QRM/lI~IQ"!$~O~~OBE DIRECTEDT():. . . !)!"!' ,.
AME COMPLETE MAILING ADDRESS
Richard L. Webber, Jr., Esquire
IRM NAME (If applicable) 19 Brookwood A venue, Suite 106
Law Office of Michael J. Hanft Carlisle, PA 17013-9142
ELEPHONE NUMBER
717/249-5373
-
1. Real Estate (Schedule A) (1) None (lFTIOJ\L USE OM..Y
2. Stocks and Bonds (Schedule B) (2) None ..., !
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 418,057.55
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 104,238.70
z 0 Separate Billing Requested
0
~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 29,930.27
~ (Schedule G or L)
~
~ 8. Total Gross Assets total Lin s 1-7 (8)- .52
<
o
w
~
e
9. Funeral Expenses & Administrative Costs (Schedule H)
552,226
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9)
(10)
15,676.58
1,319.36
11. Total Deductions (total Lines 9 & 10)
(11)
16,995.94
535,230.58
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
535,230.58
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z 535,230.58 .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
~
~
~
~ 17. Amount of Line 14 taxable at sibling rate x .12 (17)
~
0
0
S 18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
24,085.38
24,085.38
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
, ..!. .>'BE.S.~RElto,;.I.Nllli'Il$!AI.l.Q\lEStIi!lNsi~N!l\a\l~~ESllle il!JIill!I!El:HI'CI< MATH<< '.
::::;'iL
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
192 Carlisle Road
TSTATE PA IZIP 17241
(1) 24,085.38
20,000.00
1,204.27
Total Credits (A + B + C) (2) 21,204.27
CITY
Newville
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InteresVPenalty if applicable
D. Interest
E. Penalty
Total lnteresVPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BAlANCE DUE.
(3) 0.00
(4)
(5) 2,881.11
(SA)
(5B) 2,881.11
Make Check
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;....... .............................. ...................... ~ I
b. retain the right to designate who shall use the property transferred or its income; ......................
c. retain a reversionary interest; or.. ........ ........................................... ..................................................
d. receive the promise for life of either payments, benefits or care?. .............................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................ ............................................ ................................ 00
o
o
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .......................... .................................... .................... .................
Q
181
181
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete. Declaration of
pre parer other than the personal representative is based on all information of which preparer has any knowledge
SIG~NA!l:aJ~RE OF PER:JSON 1hESPO~NSIBlE FOR FILING RETURN ADDRESS
, 192 Carlisle Road
Newville, PA 17241
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS-"--
.'ADDRESS
11883 Mongu1 Hill Road
Shippensbmg, P A 17257
-.5"/1"-- J 0 I
sj I J r;(
TE I
s/-do /
/DAT
5>-(710;
19 Brookwood Avenue, Suite 106
Carlisle, PA 17013
,\.}!L! .,t,) ,I" 11 1. \! L ,ullll
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 99116 (al (1.1)(i)].
1.1 I)
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. ~g116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. ~g116
1.2) [72 P.S. 99t 16 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
I FILE NUMBER
21-01-0126
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Orrstown Bank - Certificate of Deposit #0010033932 10,545.44
2 Orrstown Bank - checking account #000310018 13,907.71
3 Waypoint Bank - Certificate of Deposit #8000055018 105,657.88
4 Waypoint Bank - Certificate of Deposit #8000053101 85,710.08
5 Waypoint Bank - Certificate of Deposit #8000055926 105,657.88
6 Waypoint Bank - Certificate of Deposit #8000055020 10,618.84
7 U.S. savings bonds (See attached Exhibit A) 85,387.33
8 Heinz Benefit Center - pension check 90.68
9 2000 Federal Income tax refund 481.71
TOTAL (Also enter on Line 5, Recapitulation)
418,057.55
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
I FILE NUMBER
21 - 01 - 0126
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A Carl P. Stewart 192 Carlisle Road Son
Newville, PA 17241
B Beatrice J. Jolmson 11883 Mongul Hill Road Daughter
Shippensburg, P A 17257
C Gladys Stewart 928 Baltimore Road Daughter
Shippensburg, P A 17257
JOINTLY OWNED PROPERTY:
LETTER DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM DATE Include name of financial institution and bank account number DATE OF DEATH
FOR JOINT MADE DECD'S VALUE OF
NUMBER TENANT JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST
estate.
I A,B 11105/1999 PNC Bank - Certificate of Deposit 57,194.32 33.33% 19,062.87
#31300170237
2 A,B,C 11/03/1999 Orrstown Bank - Certificate of Deposit 106,341.77 25% 26,585.44
#5060063945
3 A 11103/1999 Orrstown Bank - Certificate of Deposit 98,799.78 50% 49,399.89
#5060063946
4 C 11/09/1976 U.S. savings bond #D202713713E 2,128.80 50% 1,064.40
5 C 05/3111977 U.S. savings bond #D204338486E 2,097.40 50% 1,048.70
6 C 04/15/1976 U.S. savings bond #D202687809E 2,146.60 50% 1,073.30
7 B 03/18/1977 U.S. savings bond #D203916443E 2,134.80 50% 1,067.40
8 B 04/15/1976 U.S. savings bond #D202687807E 2,146.60 50% 1,073.30
9 A 11/09/1976 U.S. savings bond #M202731031E 3,507.60 50% 1,753.80
10 A 04/13/1977 U.S. savings bond #D203916445E 2,072.60 50% 1,036.30
11 A 04/02/1976 U.S. savings bond #D201468374E 2,146.60 50% 1,073.30
I
,
I I
TOTAL (Also enter on line 6, Recapitulation) 104,238.70
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
FILE NUMBER
21 - 01 - 0126
This schedule must be comDleted and filed if the answer to anv of questions 1 throuoh 4 on Daoe 2 is ves.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF
Include lhe name of the transferee, lheir relationship to decedent and the date of transfer. DECD'S EXCLUSION TAXABLE VALUE
NUMBER VALUE OF ASSET (IF APPLICABLE)
Attach a copy of the deed for real estate INTEREST
1 Waypoint Bank - Savings Account #50267152 3,031.53 50% 1,515.77
2 Waypoint Bank - Certificate of Deposit #8000056365 62,828.99 50% 3,000.00 28,414.50
TOTAL (Also enter on line 7, Recapitulation) 29,930.27
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSlS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
I FILE NUMBER
21-01-0126
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
I Fogelsanger-Bricker Funeral Home, Inc. 6,134.10
2 Lighthouse Restaurant - funeral meal 475.20
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State - Zip
Year(s) Commission paid
2. Attorney's Fees Law Office of Michael J. Hanft -- Richard L. Webber, Jr., 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Carl P. Stewart
Street Address 192 Carlisle Road
City Newville State PA Zip 17241
Relationship of Claimant to Decedent
4. Probate Fees Cumberland County Register of Wills 404.00
5. Accountant's Fees
6. Tax Return Preparer'g Fees
7. Other Administrative Costs
I Valley Times-Star - legal ad 73.28
2 Cumberland Law Joumal- legal ad 75.00
3 Register of Wills - filing fee for inheritance tax retrun 15.00
TOTAL (Also enter on line 9, Recapitulation) 15,676.58
'*
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
I FILE NUMBER
21-01-0126
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Continuing Care RX
DESCRIPTION
AMOUNT
76.36
2
u.S. Treasury - Estimated tax payment made 1/15/0 1 for 2000 tax year
500.00
3
Pa. Department of Revenue - Estimated tax payment made 1/15/01 for 2000 tax year
125.00
4
Pa. Department of Revenue - 2000 personal income tax payment
618.00
TOTAL (Also enter on Line 10, Recapitulation)
1,319.36
'*
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stewart, Zelda H.
I FILE NUMBER
21-01-0126
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
..
J. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Carl P. Stewart Son 1/3 of residue
192 Carlisle Road
Newville,PA 17241
2 Beatrice J. Johnson Daughter 113 of residue
11883 Mongul Hill Road
Shippensburg, P A 17257
3 Gladys Stewart Daughter 113 of residue
928 Baltimore Road
Shippensburg, P A 17257
i
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
!
,
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
..
TO: Richard L Webber, Jr.
Law Office of Michael J. Hanft
19 Brookwood Avenue, Suite 106
Carlisle, PA 17013
FROM: ORRSTOWN BANK
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Zelda Stewart
DECEASED
DATE OF DEATH: December 23.2000
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
(1) CHECKING ACCOUNTS
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
000310018 Zelda H. Stewart 06-01-73 13,894.92 12.79
(2) SAVINGS ACCOUNTS
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
(3) CERTIFICATES OF DEPOSIT
5060063946
TITLE OF ACCOUNT
Zelda H. Stewart
Zelda H. Stewart
Beatrice Johnson or
, Gladys Stewart or
Carl Stewart
Zelda H. Stewart
Carl Stewart
DATE OPENED
10-27-90
11-03-99
DATE OF DEATH
PRINCIPLE & ACCRUED INTEREST
10,500.00 45.44
105,982.47 359.30
ACCOUNT NO.
0010033932
5060063945
11-03-99
98,465.97
33381
Date: 02-12-01
By:
Wendv Bullock
PO Box 250. Shippensburg, PA 17257 . (717) 532-6114. (717) 532-4143 Fax. www.orrstown.com
~IWayRRi.pJ
LOOK FOR U5. WE'LL GET YOU THERE.
FEBRUARY 16,2001
MICHAEL HANFT
19 BROOKWOOD AVE SUITE 106
CARLISLE P A 17013
The information which you requested on the ZELDA STEWART DECEASED
(Social Security Number 196-14-0525) is as follows.
Account Number(s) 50267152 800005310IJ 8000055018 V
Class of Account SAVINGS CERTIFICATE CERTIFICATE
Date Opened 032200 112499 012900
Principal Balance 3026.98 85410.26 105258.64
Accrued Interest 4.55 299.82 399.24
Balance at Date of Death 3031.53 85710.08 105657.88
Account Ownership JTO SOLE SOLE
Name of Joint Owner, if any CARL STEWART
Date Ownership Was Established 032200 . 112499 012900
Additional Information Requested PLEASE COMPLETE W-9
P.O. Box 1711. HARRISBURG. PeNNSYlVANIA 17105-1711
Toll Free I-B66-WAYPOINT (I-B66-929-7646) . www.waypointbank.com
\"1 WaYR.qi!lt
LOOK FOR US. WE'LL GET YOU THERE.
Account Number(s) 8000055020 J 8000055926J
Class of Account CERTIFICATE CERTIFICATE
Date Opened 121899 012900
Principal Balance 10581.06 105258.64
Accrued Interest 37.78 399.24
Balance at Date of Death 10618.84 105657.88
Account Ownership SOLE SOLE
Name of Joint Owner, if any
Date Ownership Was Established 121899 012900
Additional Information Requested PLEASE COMPLETE W-9
Slr;;;:;J?~~lL
Ka~ rY. 'to..n;J (J
Seni.cr <:ervices Rep.
8000056365
CERTIFICATE
YES
68828.99
62828.99
JTO
CARL STEWART
YES
}/~)..loo
P.O. Box 1711, HARRISBURG, PENNSYlVANIA 17105-1711
Toll FrEe 1-866-WAVPOINT (1-866-929-7646) . www.waypointbank.com
. ,Savings Bond Calculator CPah-)f rdJ ~tW Page 1 01"2
5 bond ...
Instructions Close Window rn-/F I
-
Series Denomination Serial Number Issue Date
II:.~on~s . .z.l $1~OO..._.d r/~
..
# Bonds Total Price Total Interest Total Value YTDI
40 539,900.00 564,618.33 5104,518.33 572
Issue Issue Interest Next Flna
~ Serial Number Date Series Denom Price Interest Value Rate Accrual Matnr
d203916443e 03/1977 E $500 $375.00 $1,759.80 $2,134.80 6.00% 09/2001 03120<
t/ ~d202687807e 04/1976 E 500 375.00 1,771.60 2,146.60 6.00% 04/2001 04/20'
, ~202713713' 11/1976 E 500 375.00 1,753.80 2,128.80 6.00% 051200 I 11120'
~~ d204338486e 06/1977 E 500 375.00 1,722.40 2,097.40 6.00% 061200 I 06120'
\j[' 20268780ge 04/1976 E 500 375.00 1,771.60 2,146.60 6.00% 04/2001 04120'
~ d2039 1 6445, 04/1977 E 500 375.00 1,697.60 2,072.60 6.00% 04/2001 04/20'
Cy X d201468374e 04/1976 E 500 375.00 1,771.60 2,146.60 6.00% 04/2001 04/20'
. ;' m202731031e 11/1976 E 1,000 750.00 3,507.60 4,257.60 6.00% 051200 I 1II20'
\...:.. d8417047ee 09/1985 EE 500 250.00 399.40 649.40 4.00% 09/2001 09120
d8417045ee 09/1985 EE 500 250.00 399.40 649.40 4.00% 0912001 09120
d8101736ee 09/1985 EE 500 250.00 399.40 649.40 4.00% 0912001 09120
d 18553031 ee 04/1987 EE 500 250.00 289.60 539.60 5.50% 04/2001 04120
dOl0262448ee 03/1986 EE 500 250.00 386.60 636.60 4.00% 09/200 I 03/20
d8417046ee 09/1985 EE 500 250.00 399.40 649.40 4.00% 09/2001 09/20
dOl0262450ee 03/1986 EE 500 250.00 386.60 636.60 4.00% 09/2001 03120
m27346792ee 04/1987 EE 1,000 500.00 579.20 1,079.20 5.50% 04/2001 04/20
m17327624ee 09/1986 EE 1,000 500.00 748.40 1,248.40 4.00% 09/2001 09120
vl043157ee 1II1986 EE 5,000 2,500.00 3,044.00 5,544.00 5.19% OS/2001 11/20
vOl043156ee 11/1986 EE 5,000 2,500.00 3,044.00 5,544.00 5.19% OS/2001 11120
m I 7327625ee 09/1986 EE 1,000 500.00 748.40 1,248.40 4.00% 09/200 I 09120
m I 7327622ee 09/1986 EE 1,000 500.00 748.40 1,248.40 4.00% 0912001 09120
m17327623ee 09/1986 EE 1,000 500.00 748.40 1,248.40 4.00% 0912001 09/20
m20896144ee 12/1986 EE 1,000 500.00 608.80 1,108.80 5.19% 06/2001 12120
m20896143ee 12/1986 EE 1,000 500.00 608.80 1,108.80 5.19% 06/2001 12/20
v 1404664ee 04/1987 EE 5,000 2,500.00 2,896.00 5,396.00 5.50% 04/2001 04/20
vl043158ee 1II1986 EE 5,000 2,500.00 3,044.00 5,544.00 5.19% OS/2001 11/20
x1351964ee 04/1987 EE 10,000 5,000.00 5,792.00 10,792.00 5.50% 04/2001 04120
xl351963ee 04/1987 EE 10,000 5,000.00 5,792.00 10,792.00 5.50% 0412001 04/20
x1355988ee 09/1987 EE 10,000 5,000.00 5,788.00 10,788.00 5.20% 0912001 09/20
hltp ;//www.publicdebt.treas.gov/servlellSBCPrice
3/15/01
. ,Savings Bond Calculator
xl355987ee 09/1987 EE
q247406154ge 02/1970 E
q2481302061e 03/1970 E
q2481307463e 05/1970 E
q2533096523e 10/1970 E
q2521061303e 09/1970 E
q2508839120e 08/1970 E
q250087979ge 06/1970 E
d203430521e 02/1977 E
q2467068061e 01/1970 E
m20273I 030e 11/1976 E
10,000 5,000.00
25 18.75
25 18.75
25 18.75
25 18.75
25 18.75
25 18.75
25 18.75
500 375.00
25 18.75
1,000 750.00
http://www .publicdebt. treas.gov/servlet/SBCPrice
5,788.00 10,788.00
118.59 137.34
118.61 137.36
118.61 137.36
120.94 139.69
120.94 139.69
120.94 139.69
119.25 138.00
1,759.80 2,134.80
118.25 137.00
3,507.60 4,257.60
5.20%
NA
NA
NA
NA
NA
NA
NA
6.00%
NA
6.00%
Page 2 of2
09/2001 09/20
02120
03f20
05/20
10/20
09/20
08/20
06/20
0812001 02/2()
01/20
OS/200 I 11/20'
-
Note
NI Not Issued
NE Not Eligible for Paymer
ME Matured (Exchangeable
MN Matured (Not Exchange
3/15/01
~wlmD~~a~~
. I AT .... ......"".. _YIltttT, MI"_ WtUo "A'
!m"" ~8S~~'1!>~
I ~ '"
I.~ \." ;:~~g S R;tewart 14f:-~0525
a. Penna.. 17262 , .1
!! Carl p~rStewart" "
~~~;~:~J>~Il;;~~:~~~~_~~~~~,~,l~y
i~2k~~+~=]l~., '( I J '"' .. ",,, ',--, ... :;O')~.. I' .. :..~:~:;;~::+~~~~
v"'fT_~...:'_. ,
~ ~.'~'{~i. .~~~~!1B~if>>M.~~
;>"-0. ~r~~ ,",;:;::=:-> _ .",.....",.,1: Oltt4lld.l.:.IIIIATUltIT'l'. HIUI~" Wtl..... ~"T, o. -
! m, ,.,,;,,~~, 197.Is:~=:';< "~~J!'J11:1..I'l~iMiJ'8,gIiJ:.(1)nTs,.}.~
I r~~~."" ., it~~~~-~:~-~~ ....:-_ -- - .;~.~ ~~
lih~ o~;:~j~~i:~ac~~'l;e"prt 19~~~-0525
if ~ !~:" ~", ~PA "\\~i
I~i' ;;..~9;rl 'o,te',;~",c ' "-/-
'"~. ~ _~~ ~ ",' fii;'Ci.', ,__..,__.~!.' ,j . i;:;cC~~__._
, --~.. - - '--~'--.' .-- I:;;:;:' .................--......--... . ..,,-...........-.,.........
~~.-:-~~~RrES-E \~; ::.~7:;,~,:;.._~.~ ~~~:::--, 020:: :< ; cd~ c::
~:[~~~~~=~~;{;.::=~7:~~:~:-;=:;:;~~~~~ii~*~
~.';".." "'I W " :... I
oW: _ _: - ....,) '. I
.- ~ ~ ;_..~._~'...
..~-;...;.:.;- '.~-
'!1001~!.1J]]~~~fu~Q!f~m..IJ~i
..T THe 0..'40....1. ....TV..'" "c.cor ....ILI,. ~.."
ml.'IB: l!l~!!fl'P.lJi.J)B.'(()'ms,.~~ffl
1"'-:) 196 14 0525
l-:rs. Zelda H. St.J,~' Or
_i~( :';~
st~(', .,
..', ,,.~
Perin, ,. "4rda
Carl
Spnng
P.
Run,
17262
>.-~
. 'ISSV~T ..-'
_~H!Clil$ ~'t"~
'.~.'/f~ ;f-:~:~~~~::S'
. <~l\.F5~~~~.C
;:::;:i':-':';" :.:~::::?~:::::)Aii);
,ORfl$tOfM... .,':
,~~~
;, ORRS'TO'WI'l~ f/!:"-
ISSUE.pAiE
~..rCl'lls_r~rp"l'~.
''('"-'-I'.~ .!J t, ,~~)o;.,
April' 1976:
.,t..Q,:;-f...., :-::::;:.i~;--
.oriol<'l\.;naelli)
..hp'R1~~f~i~
;',-'- -'.\:; - :.,~::;'~~~~:;::~~:;::':
;05~~~~
:-i t ..-
v: .. ..
I!! '-
IssuiI1A~-' -:~
WHleM lJ:;nl:liMfu,..,;'..
~'.' (.~ -.:i1;~~'.7
Nov. 19?~':' '
~I~"^,;::=::.."rdi.i.:'.
I . .... .........
~~1{1 ~i1l~~:~.:.
, ..-,
: ..-...--.....,...:.\
rmm~J~!lHJ!l(Df~
II'. .t..e 011'1."",," ..t"II'IU ..I...,.. till"'" P""
~l\'~~!!I1~oon~~
Zelda S. Stewart 1~-0525
Spring Run ,~'T.."
. ";'
Penna. l7262.,.~..' ~\
or ";".../ ,.
Gladys L. Stewart \b >i
-'" '.~~'~ ~~. . ~-m:~I~~.JJ. :.D~py.]j~;~i~'~. 'iIiI~I.~m
I I J.' ~y~~.@i~;;~_@~!tH~ -'-~" 'I 1 ~
. ..-. _......~~_ '~~._ "'T T...ll O"IG'......l.. """TV"ITt "'1l"C;0" Wll..L P"T ~~~_~
j" I,,,,, -E'''''',''. "". . v.":\"F!!J:m~rrm'lm~)]JroT'T~~'H~ ISSUE. DATE: .
II ... '!i;.' ~-1::t:;..:.l~:___~ :.011_:.;;..0'" ~ WHIC;HISTHl!..'t<<~t_c''t'~r..'
~ ~ " <j.; . '\ ,.. .'.' .,...
i ;!,. '''~ To Zelda S. o.te,.;a,.t i96-1'}-05:5 June - - '''77
! ~ ,. .~. S?:,in: :.lJr.., ?.:'. 17267 -'Mot:iT-,..~:;=::,-~-..u".I--
!~. -or- YhP..;IO tl B~1I~
.~ G2..9.dys .st~":.;art .. l.........a "aE"'~ ~
!i . ~il!:*,"~ t~19J'7
~- .> '. . \
~~.. ." = ."_.."'~__..___o<.__..~__..__.,,.. ORRSfO?m'. fA
.. ~.-- ._'ft~S.HIN<itON '.' (,pi" w:.,........._~_~""""'_~".". ...............................,.-
:~h~::~FnU;.sE \~):::::;~.:::::,:;.._......~ ,::,':~j;;-- 0204338486[:_'.
I~;:~:~~~~;;:i::=+:iii~~:~::":..: .. .:::~.;,-~-;-;-~~:.:~~.:.:~ii::i~ii;~~~~
:~.",,,, _'- '" ~~ ~. =< ~:t1l~15'i".u ::fDl(:~""'JP"~ i~~;P.l 'J.. ~.
I. ';1 I, I ~ . rg1llm~J@1t1~~t1\~J!J@Mt!i1.!!c~ . ~ '; I I ,j
m. / , -, - '0;:. ~ _ ,.t THe O..G1"'Al.. ,....TU"'1'l' HIEIIIt'O,. ""''''l.. P"... ~.~'-"""_.... -__9
':<I".... ' " w"'. UIi\lt!'J:III~lK'II)'Jl<J~~Ti)'fr)n~n- ISSUE:DAte'.'
tsr'i~~' :,- - ;.;.r,~:___~ ~~~~ ....l"tCH:3t!l:~MntP4't_9l:-:.
~k~'~' ,,~.><. 'to Zelda S. Stewartl.;9~14-0525 AP~..L~~~~~1:--
~~' :.. Spring Run, Pa. 1726~~'! /(){rl1owr,'~?"
~ i ;' Gladys ~: Stewart.: ii~ ( APR" r5'~6
~.. ~~., ~T""OT_ <.':
. ih ~ 1 \. --I .
I', . V' ".~
. . . . I" " ' ....-oR~OWlilo ~
~~~. ~~. ~ a'. !.. ~~_.. T~ -~'- .
. ~.~~, .. ....._..__._O~ uo<.......w__._ .' -- --.
I", ...-- 'tIASH .jGTO~ (.N.. ...e......................._...... t1I.......__..._._ - - '..
:7~g...-:~..:..<..- E~) ==::.=,:............... ,~~-- 0 -- --.:
It~~?:-:::~iU~S:.: :..... '~~~'~". _~ --: _'U~"~..::/:-... 2.02..?818.0'9J; ~
[f. . 0- ~ ,,",<..l-":"'-''-~ 1._ ...----~.--~~.'... ........:"--~.........- ._JoII___'.', -_.-_._-_.......-~-----~_.~. _....~.."'...."........~. -o-!..,.........caa;-..-..........."':r.I_
~
6;".~j,,'~:f,:~;;~~=!~~--m:.:'(' '.. ~.. ,~, ..,'I_-J '" 'of ,~,,,.... ,..,]>~~.~~,('O~~~~~:'S.
__"'-___ _~_~_ ..~"!._..~.........."_......n..............."...................._......_............ ~~ '- ~_!o<
,-~~.~"
....... .......=--w~ .u~:...~,,- . -,. AT','"I "l."~ _TV,""" ,,'''CW ""'-.... '..". - . ~.' ,
. 'HT""'''''''I7''~~;''..:'''...''::. 'IDlPD._DR.~&\nal . ">~':'I"SU" t or
. :<<" '., '';' _..l..,.~=~~=~ \. ' .....Cll). r~'...
. ".....~';.S~;:':.~Z~f'~-"2'. .~I_.
- Beatrice 'Johnson':'W:) : :, MIlDTIl::1O"I~~,). ,
.,,,,,,,,,~J,:~ I . QMd~'.~I..~
. /: :1i-}~.::~~tlt
t' . "" .. ' ;.; ...~,. -.:J '
[~." " ((l' ::::-::"=--=--:::;:::' '. ",..:: -'-' :
t~-t~WlI:;SE_)::'~7~..... _~820"~~!J
l,fJ ~lltr':,,~""~""_-I"'T.fI~~'i'~g~:;~~~
~~~~~~";J~~~'-~.m
AT THe O"'~~".\" "'AT....""T1' l'l1.1t'EQ" 'WIU. ".Ill' ~~_....... ~--J7
~~JI-'] llilrJ~gl~ll~"Q) Th.'(1ffGJl'A.~ w",',~ ~J.~;~~or / ~ .
Zelda S. Stewart 196;~0525 April i~~t''''~:' ....~.
Spr~ng Run Pa 17262.. -i.'O,w...-l-::::-C...i;....1.... ~
' or' . .;~.' . /:Jii~ri'ltllk. a
. Eeatrice J. Johnso:r(~<;':-'~ / ,_....<NT~... j
~[ '>f> \ AP.fUJ, ,161
/il" I ' " . l
:'.: ' 'i ". ~'j.,J r \'eAAHOWl(~P~, S
I~ ~ _.,;,tj4::~~' -~ ...,....u..__..__~ f: to;;.ot>,-4I'_.,___ ,.#. - _-~,::~ ':,
",,:.;.- ~A'H 'lOTo, . t~ J..............._.c_...___...... ....._........_..._._ '.. :l
r~;.: --.>- ..-" 'E .W_: "'.....-.-...-............... :""":~--"'---- ". . _.1
II~~~~~~~~~: ~~~ '_ ~~~~.:.:,BK2~~~~~3..~.:~_~~~
":",,,- >;~<",+~;l[~~~a~~'{''''''", ,-i. ~,.b ~:.. ,~," '.' ''';~~i:~+~~~~
"lH,",,- !c:-c:~:Jt::J.J. .L..;l' C:,J
~NL~HNK LIe V~~HRTMENT
412 705 0057 P.01/01
(;).PNCBAN<
Decedent Reporting
Firstside Center
P7-PFSC-4-F
500 First Avenue
Pittsburgh, P A 15219-3] 28
ISCP
Mach 12, 2001
Richard L. Webber, Jr.
19 Brookwood Avenue, Suite 106
Carlisle, PA 17013-9142
RE: Estate of Zelda Stewart, Deceased
SSN: 196-14-0525
000: 12/23/2000
Dear Mr. Webber:
Please find the date of death balances you have requested listed below.
CERTIFICATE OF DEPOSIT
#31300170237 Established 11/05/1999
ZELDA H STEWART
CARL P STEWART
BEATRICE JOHNSON
000 Balance: $56,997.14 + $197.18 accrued interest
Our office only provides date of death balances for IRA's, CD's, Checking and
Savings accounts. We do ~ Financial Transactions or Statement Orders. For
Further information please caU I-S00-4-BANKER or your local PNC Branch and
ask to speak with a Financial Service, Representative.
dJ~~~
Rachelle Sciullo 1-800-762-1775
A member of The PNC Financial Services Group
PNC B.nk NA Pitt5burgh ""nn,ylv.ni. 15265
----...., ....--.
r
~
:
c}
e
~
n
Oi
z
III I II1II1
f 0 :D "Tl
11: ii m 0
m m C'l :D
o C'l m> ~
;; -l <:
-l C'l z El
m :D G') Z
lXl m 0 G')
C 11: "Tl
:D ~ :D 0
;; 5 m "Tl
r- Z ~ ~
j,> z 11:
en In en >
CD en "Tl Z
- CD :D en
l!~O-lO
l!. - 11:
-.9,>>
z z
o 0
~ ~
m m
:D :D
"Tl "Tl
C C
Z z
m m
:D ~
~ r-
::r ::r
o 0
11: 11:
m m
~ ~ :D
\:;) III lI:
~ ~. i
=. > ~
~ ~ '0
fa ~ ~
DJ ~ ~
<
5' ~
IQ III
:;)
tit tit tit tit tit tit tit tit tit
~
..,~
o.
~:
ii
';:0
""
U
:!.i Ul
~..l .g'
!.
.,;: c
~ ;
;;':;: g,
~.. "V
!.~ ~
=~ i
h~
~f
1'_
&
r
!"
;
III
.~'
"'--
< '
t..,S) g
~'~ !!:
," Q.
-:'''i ~
~..,.
I .
,.
''''''-
~ ~ N
... ... 'll
i i i
lil
In
""
~
o
S
m
:D
lXl
C
:D
;;
r-
C'l
o
~
Z
m
:D
'>
In
en
CD
~
.9,
~ "0
~ iil
!!l~
C'l
III
a
In
11:_
1I:<~cn~
CD ~: 7:' 0....
3 0 5 l!! 0'
~ iiI !. ~ ~
"Tl;'llz;,?
~'2.~~fji
~;'CDC:
fI' ... a. en i
C'l1l: iiI
III m.
~ ~:
::r.
>,
Z'
0:
(ii:
~;
iC-
0.......
oil '1
t
('
~
"
"
1'),
..........
')
N
r- "Tl "Tl C'l~ i
= 0' ~ =:0 z
a. : :::"" 11: en
C'l~'<!l0 ;H
e:C'lC'lC'l~ :D
-e:~2~ !il
~ . n :u
ig/- ~
= 'ij ,~
il!~ ~
-:-~~a
"if~
z
-l m
iil ~
iil r-
oo ::r
o 0
i' 11:
oS m
C'l
ii'
.a "Tl
'< 0'
Q ~
:: 2
m~
it ~
:;) ::;
a. 0'
(') :;)
!!:
u~_\ _~_\ _{
--~ ._--------..~ :g
o "0 "0
:T ~ i
~ 3 :;)
CD CD
en a l!.
~ a.>
O. 0
- c
~ ~ ~
CD
a
lXl
>
r-
>
z
n
m
~~H
r~
- --
r-
m
en
~
~
0'
~
III
:;)
n
CD
o
Z
en
o
-l
:D
!j
tit
-ltlt
i \\
~0
,::,-'X
!! ..,
.. ""
- ~
8
tit tit
o
~
::t
m
::0
:::j
m
!I:
~
. ~ -. '.,. ... -."........--,.,.-...-
c
C)f~;P~
iaSii!il
~~~.~~
CD C'l >
f '" ~ .."
~ :2 ~ CD "Tl
:2lt!,a~
~' CD :;) :;) 0
flf~
~ I I ~
. I I ~
. I I ..
- l l
j r j-
-~
-:-
tit tit tit tit tit
tit ~
~\'l~r
~ ~)0
V\ ' (
'f' ....-.....
t...
co
f ~ ~~ ~
3 ::; i 0 m
g,!!ii1"Tl:D
!!gn~;1l
en 'CDC'lm
CD SiF~
~ i~~~
~C1'<en~
fll~~
I I I .. ~
r f ... m m
I l I ~ g
f f f ~ ~
- :- ~:
tit tit tit tit
~\ \
"Tl C'l C'l
o ! ii'
~ ~ ~
~ ! "'
C'l 11:
~. !
m g
s. CD
1ii' ~.
III
:T
C'l
CD
a.
if
AI
it
;.......:
:N:
ORIGINAl- F. F. D. OF A. 1884
DUPLICATE - CLIENT
TRIPlICATE - FUNERAl HOME
tit
m
11:
:D cr"~"~:::: ~
~"Q.Q.lI,.."C r-
en II i:.f:a-o 11:
Ollllio-..c: -
a-....lI.. Z
Z !,..-tS-"!, G')
"Tl 1 ~,,'!l C'~ :
g:.lICI-c:.t-'
m!'l~g! :
11: I g ::::Q.;-" :
CD "C 0 _".
~I:Sl~~Sg :
~ ;'i.;1!:
z"lIt...-.
C)"....~......
.. "'Af'lll:a:t.
.....- lQ-'
~::-... 0.... ....
...Q. "C .
'-"101:
l:r =l "C c: "C .
~"C~=....lI :
H'~'r it'lQ Sl" j .
:-IIII':,C::
::::lIlI..~.
'~!f:1I :
.....~.-..lI:
. ..loa-'
.. ~':1!':
.a :a-"C"C!:
....ocr:..
Q..C:..lQtIt
c}
e
$
tit
~
""-.C
"-
r".
~~I
~I~ ~
l!
o
II
..
S.
o
lD
AI
:7
Irltn
af,,'
~ ~ 0;:0.1
('; oif~JS
enc: " ~
~:D i -
< en ...
n moilll!
m ::0 if
~ ~ )11 f
i ~iif
~ I Ii r
Q : "!1
~ j ~ii
o 13j1
: :lllt
~ ~"II
~ flh.,
"Tl iiilii!
tit jfif
J, !ih:
t \ iilj!S!i
I (fjr
iil}
!f':" Ii'
.. .
:e
CD
S.
i' ~
it '
..........
/ I
i
-..:::.
>
IQ
lD
(\.\
\.JJ
"
tit "" tit""
\\\
tit
tit
, 'J
~
Vi
c~.
('
~
~
~
I'..
!I;> ....,
~ ,vi / ^
. ..1.;'.,> I\:
~ 1),
..
,t:
'-J
, J
"
""'-
(' 1
I:-
~
ffJl;ja;
"'<;; i,1!51iJ
~i~&~f.
~ . lI:;~""
~ ;; 2.;i
.g. ~ ~i.;~
'" . Ii 'g'll :7
c '- "'n~"
; '~'i 'I;'"
~ ~~of
a ~~h
f~ ~i-:~
E ~ i~a!
~ h1i
~ lX~~i
iHll
3 :oc. i
~ii'
.. 5'j!!l
91!!l~;
:t~!!l 5'
!s-~
i1h
~l;lI:
. ,.i
o~i~
i~il'll .
a-$ '" at
f.g:~. ,'"
i-" ~
1=, ~
ji".
lIIi~
],f~i
U=i
~l:O~
ll.g,U
.~!fi
~il!L
g,~~~
;t:;'m
~Ka
iU1!
~Hf
~
o
C')
~
~
>
I 'J ....
l,J ~ t5
(\ K' 'ij :v ~
~ .... ril9~"
l.' i? I ~ I ~
~ :D ~ :z:('")
_C).' ~
~~~~~ ~
o -":"'Y!z~~
lI: - lGena::D~
m I (,~ijf' ~
~ ~ ~ "en'~
III Z _" > ~
"'l.... _:
:-...,~. ~ - t""
~ ~ ~ ....,
e f '-. - ~. s
~ '~..., ::
d'1i' ~
i.' ~
AI , L-
a- {'")
tit
~li~
Ill~g:en
; i S' ::t
i CI .
~ G') 0
z iil ~
sa ~ z
n' n
m m
:::j
m
!I:
~
a.
lI:
/ J =
In
I , ~
o
s.
a
~
~
:;)
tit tit tit tit tit tit tit tit tit tit tit tit
\'
,------.---.----.----....-.......-.---..- -- ._- _.,~--~-.-.._.-...._-~....._._-.. -- ...-......... .......-. ..-...-...............--..........--... ...... -.- -..-.. -.....-.. . .. ..~ -...-
tIl
it>
r)'
l}
.,.,.,
,....
tIl
.g'
CD ,~
c'
;
g,
~' 1
~ "\
! '"f'l
.!e.l"'--
~-
?j
-l
!I;>
i
~
;
III
iilii'~ ~
..f "0
=l C7 .. m
! c:: . oCr ~
1 !l! ~
i!Bl .~
· i'~i C'l
t~i! ~
iJIJ ~
a=:;1 :D
!'is ~
(il! ~
~ 115:1 g
~ If;! :Ii
~ ni5.~ ~
E (!U.: m
3 J!il ~
i'~ 0
.i- ~
. n-~ m
- _ r-
:i8a. !:
~;.~ t5
5:.;:, ~
c~ ~
l~... ~
:!'i Q
i'U >
oll-f ~
;'~I 0
1:2' ~
ah: ~
: !.,& ~
~,& a 11:
c:a: en
:ll. ~
goo 8' -l
of < m
_i:. 0
i ;;1
n :D
~ ~
i ~
o ~
:;) a.
.. li
~ ~
III it
g ~
a >
5 n
i i
a: 'i
III S.
~
a.
c:
CD
it
!D
c:
:;)
..
:;)
g.
-g'
~
or
ii'
I
a
.
;:
tit
9!~
1.';'-...
- ,"
~ ~
..
:!0
CI)
C\\ S.
loJ i
(/1 ~
~ :;)
C'-' ~
III
~
.B'
In
CD
"3-
n
..
!"