HomeMy WebLinkAbout07-28-78
, '
"'Form RCC.IO ~l~~8'~ 3D ( DEDUCT'ONS ALLOWED IN
.. "",'" ;-. .-~...... lG If? "f
~
OFFICE OF THE STATEMENT OF DEBTS THE SUM OF ............ . ,....................... .......=...
REGISTER OF WILLS DATE APPROVED ,.~. ib,..,:;,~..I.IfIZ~
CV.J-1 6i=".RLAA//.} COUNTY AND DEDUCTIONS
OF ~2~~_
AND AGENT OF THB. COMMO~WIi"'LTH ~~'d ~I\t, ~O'
L 11 "Ii
Regllter of Wills, Ag~llt .- . .~:
AliI ,
ESTATE OF -5'/9 Mv E L b';2)o vY F: ( ';;/ ..... '" .. nonu 77'. ~ \.1 .... "
LATE OF
J" <lL ~ tq? <t' OATS OF DEATH '-- V .
.d /.;) 9 /7 X-
, DATE OF FILING APPRAISEM ENT , '
DATE NO. 0.. NAMi: OF PAYEE REMARKS AMOUNT
VOUCH5""
6/12/7E 126 Probate costs 21 00
140 Statement of Debts & Deductions 3 00
141 Form OCC-62 (Estates under $10,00D) 3 00
142 Notary Fees 12 00
.~
6/12/7 E 143 Witness to sicmature of decendent Travel Aha. to Carlisle & Re . 15 00
* Holy Spirit Hospital 151 95
5/8/78 104 Auto expense 50 74
6/6/78 122 Auto Insurance due 4/30/78 154 00
6/16/7t 129 Phone 35 00
6/16/7t 127 Funeral Expenses 1135 00
6/16/78 132 J. A. Savastio, M.D. 40 00
* Holy Spirit 25 00
* Change of 2 autom::lbile ti'Ues 4 00
~. ".
.
I
'.
"
, -
* not yet settled
{
[
COMMONWEALTH OF PENNSYLVANiA }
COU~TY OF t:OM /ff'>d~ AI n ..,
I, -S' ~ / /:z /'-y O""V~~P HEREBY CERTIFY, THAT. TO THE BUlT OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRU E STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES 0"
AQMINISTR,ATION SUBMITTED TO THE ESTA.TE OF ...5"A ,)...Iv et- r::; .nlJus P "Ecu..eao. All DEDUCTIONS iPOR
_..'fl'l'''':- '~'-,
INHERITANCE TAX PURPOSEs.
~, :0\\........ - ~
~;~o~~..~D'~d:~::,;.BED !lEFOAE ME THIS /7 A DAY OF
::: - '. " "<??~' -?l.
::;:-, ..~.... /b> ~_ ~ \&1 ~
:;.;,.:..~ "../ - ...;.
-,' ---... ...........- -' -.
;4:'" "'^ ~>v;:?.r-? /J./P ./
~.-1"-~~? C::4U,th""J ,z::4? L~
0:0....~A.~7 (~~2ATiOtAdN DeCARLO, Notary Public
,-:.",,'- 'h" r-. b I de p
....'I',v {j: ~MecQ.anicsburg, (un: er an 0., a.
'r"-~1)"~.."t~MY"Commission Expires Dec. 10, 1979
~ ,6~-
(L. S.)
,-