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Home My WebLink About06-18-79 - - .- ~ T_ -- .. III..,. ~ , ..... RCC-33 (4-731 . ;</- 7tf-.OY:~-7 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS RESIDENT DECEDENT 1 Ii i '" .t ,~ "j' COUNTY OF cl." IMPORTANT: This return must be completed in detail and filed in duplicate, with all attached, with the R gister of Wills of the County where decedent resided; Return is due within nine months after date of death, unles an extension is granted by the Secretary of Re'otenue. <Section 703 of the Inheritance and Estate Tax Act of 1961.) Late of c..IIel'la" .._,l.,..la C.....l'l.. } AFFIDAVIT OF EXECUTOR County ADMINISTRATOR IN THE MATTER OF THE ESTATE OF -... C. ItliM (STATE FULL NAME OF DECEDENT) County of )-" '. State of Administrator .._tit &. ItU... of the e.tote of the obove.nomed decedent being duly sworn, depo.e . Executor and .ay' : Decedent died .....t 22 , 19~{te.toteleaVing a la.t will, copy of which I. hereto ottoched.,l (YEAR) m&ftlft J (MONTH) Nome and addre.. of attorney or } other authorized repre..n.tative to whom all correS9ondence .hould be mailed. (DAY) tUlU,,, A. t__. ........ 'eO. _ 14.1, .... BU, ....'1...s.a 17~U That as such "C8tW deponent is familiar with the affairs of said estate an the property constituting i EXECUTOR-ADMINISTRATOR) the assets thereof and their fair market value. That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following: - -- "III THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF '''- \j. - a. RELATIONSHIP OF JOINT HOLDERS TO DECEDENT -- NAME AND ADDRESS OF BANK 0 OTHER INSTITUTION IN WHICH DECEDENT RENTED S.~FE DEPOSIT BOX That the contents of said safe deposit box or boxes are .itemized under Schedules ala of this return, with the exception' of the following, for the reasons hereinafter set forth: That ScheJu/. A attached hereto and made part hereof sets forth fully and in detail all the real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving the mount stilI due at death, name of mortgagee, date, rate of interest, and book and page of record thereof. It al 0 sets forth in the columns provided therefore the assessed valuation of each of said parcels, the estimated m rket value thereof as of date of death of decedent. That ScheJule B attached hereto and made part hereof sets forth fully and in detail a I personal property wheresover situated owned by the decedent at the time of death; all moneys left by the decc dent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks f deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last interest day prior to decedent's death in the case of savings banks, and to the date of decedent's death in',lI( other Ca$el ; all bonds" post,al savings, treasury certificates or notes and other evidence of indebtedness of the United State s to the' pe;;, cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States', or any state, or political subdivision thereof, or of any foreign country, which are owned a the time of death; all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages, automobiles, boats, and any and all other personal chattels of whatsoever. kind or nature left by decedent, together with the fairly, estimated market value thereof; all bonds and mortgages held by c ecedent and of all claims 'due and owing decedent at the time of death, and all promissory notes or other'instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with nterest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated f ir,market value be less than the face value, it sets forth briefly the reasons for such depreciation as to eal h item; all moneys payable to the estate from life insurance policies carried by decedent; all annuity and e~ dowment contracts the proceeds of which were payable upon the death of the decedent; all and the corporate stpcks and dividends due thereon and unpaid as of the date of death, bonds and accrued interes t thereon to the date of decedent's death and other investment securities owned by the decedent at the time of dea~h, with the'inarket value there- of at such time. -' .........,.. ,.J... '" , .r '. ." ~ ~ ;' In the case of sectlr'fties of close or family COI"PoP8;t1.<me.,: :t<ltit values reported 'are as far as possible substantiated by financial statements 01' the corporations, l!J~()1flng tile assets and liablliths thereof as of the date of death. The schedule all!JO sets, forth. tlle intere$t 01' decedent at the time of death in any co-partners~lP or business, and in SUPPort of the value of such interest there is annexed to said schedule, financial statements sllowing the aSl!Jets and li..bllit1.es of l!Jaid co-partnersbip orhul!Jiness. A copy of the co~partnership agreement, (if oral, a statement setting forth the nature of toe agreement) together with a statement setting forth the character of the business, its location, arid such other facts pertaining to the business as may be pertinent to. a .fair and just apprais'al of the decederltl' j!ti'lnterest therein must be submitted. It should also set forth in itemized form, together with the fair market value thereof, any other property owned or bequeath~ by the decedent at the time 01' death.,. The Schedule C attached hereto and made part hereof sets forth a true answer toeaOh inquiry contained therein and in the case 01' transfers of~'roperty, real or per"onal, within two years of decedent's death, 1n contemplation of decedent's dJath, ".or 'lbtended to take effect in possession or enJoyment' at or after death, said schedule sets forth the nature and value of suchpropertY;",w.whom transferred, the relationship 01' the transferees to the decedent, the. proportionate I!Jhare'receiv~d by. each transferee and all other facts 01' a pertinent nature regarding said transfers~ In the case 01' transfers intended to take effect in possession or enjoynaent at or after death, . there is also attached to' the schedule a COllY of the deed, trust agreement or other instrument creating the trust. Ther~ is also set forth in said schedule a list of all property, real and personal, with its value, which passes at decedent's death by virtue 01' the exercise by decedent, either individually, or'jointly with another, or any power 01' appoint- ment vested in decedent, either individually or jointly, by the 'w111, deed, or otherinstr~ent of an9ther, with a copy of the instrument creating such power attached to the schedule. That Schedule D attached hereto and made part hereof sets forth the names and addresses 01' all persons beneficially interested in this estate at the time of decedent's death, the nature of their res- pective interests, their relationship, if any, to the decedenh together with the ages at. the time of decedent's death 01' all minors, annuitants and beneficiaries for 11fe under deceden,t's Will. It also contains a statement showing which 01' the beneficiaries named in the decedent's Will, if.any, died prior to decedent, the dates of their death, their issue, andthe relationship 01' such issue to the beneficiary. That Schedule E attached hereto and made a part hereof sets forth all property;, real and per- sonal, owned by the decedent jointly with anothEir or others, including intangible,staridilig in the: . name , of the decedent and others, plus the date and place 01' record 01' instruments effecting the vestiture 01' real estate and the date. 01' acquisition of personalty, plus the name, address a,nd relationship, if'll.nY, 01' co-owners to the decedent. . Schedule F attached hereto and made a part hereof sets forth fully debts' - and deduotions cIa for and on behalt. 01' this decedent's estate, includinll f\lnel' ~penses paid; family exemption, where app le; costs o~ administration 01' th1l!J estate; c lil~1!J and,f'udic1ary' s commissions paid or to be paid; cos ended for burial trusts, tombst or gravemarkers, and reli- gious servioes, in consequence 01' the death 0 decedent; ~b c14tmI!J owing, and unpaid at time 01' death; taxes accrued chargeable for period prior to death (except those allow,d under Section 651 01' the Inherit8llce8lld Es..~te Tax Act); togeth th a s ntof col~ateral. plEldged for obliga- tions, if any. It is agreed that th~ .fiduowill prelfent pr9C)f 0,1' laimed obligations upon re- quest, that if the amount actually, , in settleJlle,J1tot any fee, commll!Jsion 0 t i~. less than the est~ated amount claiming and wed, that the s~ will be reported to the Pegister of and that the amount of tax asse can be reassessed in accordance therewitlli That the totals of the appropriate col~s in Schedules "A", "B", "e", "E", and "F~ as directed therein, \;!;~ ; , have been carried forward and properly .registered in the Summary. Subscribed and sworn to before me this ................................. ~7... ....~..~................ day of ....... ~~E~.~.,.,......................;..... lSt!.~.._.. ...............~ ....~.:::.L ..........~~._.....,............_..._......._... .-----..u--.....nc.......-M-~----. .~1J{-- ~~ANNE M.~ROWN, Notary Public ..~~!I!.1r"*.&~:.lj.l:if.~l............................... lO'rver Allen Twp., Cumberland Co., P.. (City or Tow" aM Sttae) NOTE: Before signt.fll Cf~~fc:~oYr3lgel?A2J. blank spaeel!J in the affidavit and I!Jchedules annexed are filled in with details or the word. "Hone", and in case the assets include rare and unlisted securities, securities of close or family corporations or an interest in any eo-partnership or businel!Js, that the data and statements required under the paragraph above relating to Schedule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above~directed. c..."_.,...,,,.......,.__""._"',,h..ii""I>".lIllIilIlH. . lCC-ea CoJllONWEALTH OF PENJlSYLV ANIA TIWfSFER INHERITANCE TAX * S11PPLE!mfrAL RESIDENT DECEDENT SCHEDULE "an PERSONAL PROPERTY *<'........'..........".. ,;., ".. -', " IN8IR~ION8: This Schedule _t disclose all tangible and intangible personal property owned individually by the decedent, at the t1ae of his death. Property owned by the decedent Jointly with another or others ...t be listed under Schedule .Z.. Intangible personal property, titled in the n.. ot the dec~ent, but p....l. at d.ath to anoth.r or others, including but not Uatted to P.O.D. U. 8. Savings Bonds and tenta- tly. t~t accowata, IIUIIt be listed, de.ptte the tact that th.y are not ot the adll1nlstered .state. Tangible p.rsonal property should be listed first (e.g. Je.elry, wearing apparel, household goOds, and f'urnlsh1ngs, books, paintings, auto.oblles, boats, etc.) Intangibl. p.rsonal property, such as bonds, treasury certificat.., cash on hand ~ in bank, atltolal, .ortgages, notes, together with accrued interest or divid.nds, salari.s or ....., inSUl'...oe par- able to the .state or fiduciary in said capacity, partnership int.rests, intereat Inanyundiatrlbuted ea. tat. of or inco.. troa any property held in true t under the .111 or asre.....t of another, .v. though loa.ted outside of the State, at the tlae of death, should be 11sted in this schedule. l~ 100 I'l'DI List and describe tully tm IT E8'fIIfATBD VAIAJK MARDI' V AUJI: DIPAIl'IIIER'l' VALUATION (Do not .rite in tbis ..ace) 1. ODe Onyx d... with twO _11 dia.,oo chips given by decedent to Kenneth Il.. ~U._, the Ixecutor, beDeficiary and co-owner of the aafe deposit box where it was depotlited atcllt u._ of the decedent's death. $125.00" 2. ODe worn engaae_nt rina with ..11 "'a1DOnd given to KeDD8th ll. Kline, the I:ncutor, beneficiary and co-owner of the ..fe depoa1t box where it _. dep08ited at the ti_ of the decedent's death, which was given by decedent. 100. TOTAL $225. "'2... 'tr.S'" "' 0 () Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" coluan on the last page of this return. x X 0..:. ~~. L-. ~. I":'. · , ";' . i., ~H . ,., , .,,' , . , . ..". '.. ,,,,, " I.,'''' "_,",,,. .' ., ~ ., 'I, ~." _ .. REV-518 (3-79) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P. O. BOX 2170 HARRISBURG 17106 IN YOUR REPL V PLEASE REFER TO IlWestiflltlon Dlvitlon NOTICE OF FILING OF APPRAISEMENT I....tlL 2. KJ.i.De 200 April D1"i 'Ye Cap Bill, PA 17011 (Executor or Administrator) In Re: Estate of Orpha C. KliDe C.berlud. County - File No. 2l-~" Dear 1Ir. niM: You are hereby notified that the _.,1A_1l-l:.1 appraisement in the estate of ~. c. ~H_ has been filed in the office of the Register of Wills of a..M?1..d County on J1lBA 18 ,19-'9-' Said appraisement reflects the following valuations:. Real Estate Personal Property Transfers Jointly Owned Total Jto5~ .., 225.00 .0De .oae "30.~ As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22,1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373. ~ Date J1ULe 18, 1m Signed L.. \2~~ ~__ti". -c Title NOTE: This is not a bill. . REV-457 (8-78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT SUPP1DD'.rAL DATE Ju. 18. 1979 COUNTY CuaharlAud FILE NO. 21-78-0459 Whereas, ()n)lIa c. nine late of Borou.rh of CUID Hill in the County of a_berland Commonwealth of Pennsylvania, having died on the 22nd day of Awruat 19 ~ , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo J'ulplliti ,an appraiser duly appointed according tolaw, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future Interest In this estate Is transferred In possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future Interest. DESCRIPTION OF ASSET UNIT Appraisement VALUES Made for Inheritance Tax Purposes aeal Pr01Mrt... $ 405 48 - ., - 22'3 00 ~ansfer8 R0118 Joint-Held PrOpert7 Rone 'I'tYII1. T. .. ...-... sti~ 148 , .' f , , , .. r Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 1St" day of ~ 19 ....2!l.. '---.e co ~ _~ Appraiser (Number and Street) 'R..,..,.isburr (Post Office) , Penna. . at / - /1-.( 5' ~t;-:/ RCC-33 14-7."' COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS r'\,"'- 0,/\/ '" RESIDENT DECEDENT COUNTY OF Cumberland IMPORTANT: This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the County where decedent resided; Return is due within nine months after date of death, unless an extension is granted hy the Secretary of Re1l:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN TilE MATTER 0.. THE ESTATE OF } AFFIDA VlT OF EXECUTOR ADMINISTRA TOR .___gI"P~~S:_. Kline (STATE FULL NAME OF DECEDENTI Late of Cumberland County State of Pennsylvania ) 55: County of _~~1!1~erland_ Kenneth R. Kline Administrator ----------;;f- the ;state of the above-named decedent being duly sworn, depose S Executor and sayS Decedent di ed AuguS t (MONTH) Name and address of attorney or } other authorized repres,entative to whom nIl ~0,.,.~",;pondeflce should be moiled. 22 , 19-ZL{~cstate leaving a last will, copy of which is hereto attached. } (YEAR) rm"""'Cl"te> (DAY) William A. Yocum. Esquire _P. O. Box_ ~4.ILg~!IlE_Hig_L_~ennsylvania 17011 That as such Executor deponent is familiar with the affairs of said estate and the property constituting ( EXECUTOR-ADMINISTRATOR) the assets thereof and their fair market value. That at the time of dea th there was no safe deposi t box regi s tered in decedent's indi vidual name, or jointly wi th, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the t::\ception of the following: - NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX R EN TED RELATIONSHIP OF JOINT IN WHICH DECEDENT R EN TED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT -'.-.--- -- - _~uphil!~2~~t Bank and Trust Company Orpha C. Kline and Kenneth son R. Kline -- ------ ~-_._--- ._~-_. ------ --------- -~---_.__.._._~- ~_.._.~-_._-_.._._.. That the contents of said safe deposit box or boxes are itemized under Schedules n/a of this return, with the exception of the following, for the reasons hereinafter set forth: (Will was kept in safe deposit box.) Tlta [ Schedule A attached hereto and made part hereof sets forth fully and in detai I all the real property In the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last interest day pri@T to decedent's death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal sav ings, treasury certificates or notes and other evidence of indebtedness of the United States to the de- cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States, or any state, or political subdivision thereof, or of any foreign country, which are owned at the tim(;, of de'lth; all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, earri:lges, automol>ilcs, "oals, and any and all other personal chattels of whatsoever. kind or nature, left by decedent, together with llic rairly estimated market value thereof; all bonds and mortgages held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the race value and estimated fair market value thereof, and if such estimated fair market value be less than the face vallie, it sets forth briefly the reasons for such depreciation as to each item; all moneys pay,-,bic 10 lhe c.state from life insurance policies carried by decedent; all annuity and endowment contracts 1 he pr"cced:.; of whieh were payable upon the death of the decedent; all and the corporate stocks and dividends dlle 111,'1('"'' "Tld unpdid as of the date of death, bonds and accrued interest thereon to the date of decedent's de ", i, ,,,,,I "11".'r i 11\<:,:"; lment securi tics owned by the decedent at the time of death, wi th the market value there- nf ~11 "uch til~~\'. .-- In the case of securities o:f close or :family corporations, the values reported are as :far as possible substantiated by :financial statements o:f the corporations, showing the assets and liabilities thereo:f liS o:f the date of death. The schedule also sets :forth the interest o:f decedent at the time of death in any co-partnership or business, and in support of the value of such inter'st there is ,Jnnexed to said schedule, financial statements showing the assets and liabilities of said co-partnership or l1usiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreem',nt) together with a statement setting forth the character of the business, its location, and such '1ther facts pertaini ng to the business as may be pertinent to a :fair and just appraisal of the decedent's tnterest therein must be submitted. It should also set forth in it.emized form, t.ogether with the fair market value thereof, any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each Inqui ry contained therein and in the case o:f transfers of property, real or personal, wi ",hin two years of decedent's death, in contemplation of decedent's death, or intended to take effect in possessicm or enjoymer,: .'it or after death, said schedule sets forth the nature and value of sueh property, to whom transferrect the relationship of the trans:ferees to the decedent, the proportionate share received by each transfe7'e', llnd all other facts of a pertinent nature regarding said transfers. In the case of transfers inten(I,~o1 te, take effect in possession or enjoyment at or after neath, there i~ also attached to the schedule a COllY of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said schedule a list o:f all property, real and personal, with its value, which pa~ses at decedent's death by virtue o:f the exercise by decedent. either individually, or jointly with another, or any power o:f appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument o:f another, with a copy o:f the instrlrnent creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereo:f sets forth the names and addresses of all persons bene:ficially interested in this estate at the time of decedent's death, the nature of their res- pective interests, their relationship, if any, to the decedent, together with the ages at the t.ime of' decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also contains a statement showing which of the beneficiaries named in the deeedent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary. That Sc~edule E attached hereto and made a part hereof sets forth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name of the decedent and others, plus the date and place of record of instruments effecting the vestiture of real estate and the date of acquisition of persffilalty, plus the name, address and relationship, if any, of co-owners to the decedent. That.Sc~edule F attached hereto and made a part hereof' sets forth fully and in detail all and deductions cIa or awl on behalf of this decedent' s e8tat.~, including funeral expenses family exemption, where appl . costs of administration of this estate; counsel fees and fu commissions paid or to be paid; cost e d.~d_for burial trusts, tombstones or gravers, and reli- gious services, in consequence o:f the death of -tlll?<-~!<~.dent; debts and clai ng and unpaid at time of death; taxes accrued chargeable for perioa prior to dec~;relTi7'S_ ._ except those allowed unaer Section 651 o:f the Inheritance and Estate Tax Act); togethe a stat~Iiierrt--o_Lcollateral pledged for obliga- tions, if any. It is agreed that the._ . ary will present proof of saidCJ:--aime.(t~bligations upon re- quest, that if the amoun~id in settlement of any fee, commission or debt-.-t-&-.l..~_~ than the estimated am~g and allowed, that the same will be reported to the Register of Wills,~-and--tl:lat t~~f tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "en, "E", and "~ as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this j3..~."."".." j) _Iii Il /)J if/. J 1 IIt1;. . /f/~'Il.C .""....""~.e:.ng~.!.h,."~.:..."'"..!..:!:g~."....,...,,.,,........,,..".."."."................,....,. (ExeCtLtor-2'1~UtMM) . ....~QQ...A.Pr..U...p.:r.:iy.~.........."...........".."".."..""",."..,,..........,............ (St'reet Number) .. .G~.~p")I.!n.~."..~~.g.g~y..!.Y.~,1}.!~..".,,..!. !9.~.~..........."". (City or Town and State) ..... day of ...."y~.1:lJ::'ll,.<i.J::'.Y"...... ..."...." 19.....z~.." ..........~.~...?!?.~~~..~..........."....... ~ <:'JS/..~jN[ M. 3kuNN, Notary Public : J :,,'.,',' :. ;1., (ll"i"~r:and Co., Pa. My Comrni~~jon Ex;)iz,):; Nov. 29, 1982 Notary Public My Commission Expires: NOTE: Before signing affidavit make sure all blank spaces in the affidavit and scheaules annexed are filled in with details or the word "None", ana in case the assets include rare and unlistea securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements required under the paragraph above relating to Schedule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. " . .. :).. .J; . J\ r ; ',J \' ~, ~." L," ,-~ .... , ;" -~ '-', '" , ) -n....) >_J .:, /'\ L '.'. "',C,Il,,;O'C,, .r: '~;J~~ O{) ';FlO~'~'1 ..\~ 0..:. j"J: .,;.1' ',~,' J 1'0... ti" JLtO#j:'~ I ','J, '--;.... ~.;-: j!. ,J ,I ') j , ~ ..;,"~_~ '::,.....;.J-. .~c~. ~ 'lA: 0\ 1 ...... >, t- \0: W . .... Z . c: (I) oci ::) w ~ ~ :s =: rt: z 8 Q w . w .:t"~ , en ~ > .... ~: . ....' fii <C ! 0: W . c: ~) ~ a: r-t: a:: 'ti" (I) ~ A- ~ ~ ~ 1 A- I LL. ~ ~ C , 0 .~ ..... }~ x .... I: "0 (I)' e ~ 'a 'a ~ t) ~ ~ g; a g; ~ ~ ::::;. ~ z 13 $ . ~ .s ~ (I) 1 c&1 .... 0 (I)' w c:t: ~ c:t: w q .... ~ :s ::E '" g '" u .3 J ,~ '" .... fa z ~ I ~ ~ ~ c: :s ~l1 ~ ~ a:: lIS ct:: ~ Q 0 1 <( -g ..0 ~ 's, .... lIS cu a: -s .... .... CL 'ti" c: fii (I) 0 w (I) 2: ..... I .I: w lIS Q:; 0 ~ J .... ~ ::J: ~ ~ .... '0 0 ""- I ~ z .S c: ~ c:t: :s ~ 'a ~ 0 ~ 0: t- .~ -g , . z ~ ~ $ ~ (I) 0.. :.:l w ...... ~ ~ k; 0 d en w a: J, ~1i ; r;J , ' ".,"',..,~~~""-,.".." "._.,,,,.u= _ ,.,"',. "'''Ii:''li.i!.I~~,," "j, ~_i~'''ili.mW;Jj,w( , R'C C-34 (4-73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE IIA" REAL PROPERTY *' Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant in common with another or other, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a- cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, ocerued Interest on mortgages, ete.,are to be listed on Schedule "F" and must not be deducted from this schedule. (1) (2) (3) DE PA RTMENT VALUATION CAUTION (Do not wr Ite In this space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMA TED MARKET VALUE House and lot known and numbered as 200 April Drive, Borough of Camp Hill, County of Cumberland, Pennsylvania, conveyed to Kenneth S. Kline and Orpha C. Kline, his wife, by Camp Hill Realty Corp., by deed dated October 11, 1962, and recorded in Deed Book "R", Volume 20, Page 75 on October 13, 1962. Title vested in Orpha C. Kline by operation of law in that Kenneth S. Kline predeceased her. (See attached copy of settlement sheet.) Gross sale price on open market was---------------- /.".. $45,000.00~ L / $45,000.00 I Ie -;, ) OL" C ,(''-~ Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. "''''ft..,.?,;.'' ...~ ", "~ .,' ,", '-c.,. """"";:'" ..l'./....~".".M~j'(...~. -- --- A. IJ.s. DEPA.RTMENT OF HOUSING AND URBAN DEVElOPMLNT 8. TYPE OF lOAN DISCLOSURE/SETTLEMENT STATEMENT 2 0 FMHA 3 ~ CONV, . 1 o FHA. UNINS. @l CENTRAL PENNSYLVANIA SAVINGS .,Net: '.";) ASSOCIATION 4. OVA 5 0 CONV, INS 6, FILE NUMBER I ~ LIT ~U~E~"3 ~ I r II T II LJ. J' .. A _I _~...II U. It .""'_ ___11_." .Il. '.utl. ;.. L~..II'-a 8. MORTG, INS. CASE NO. 1111- T I:!. II II 111'1 a _r ./1 fVTIIl C. NOTE: This form is furnished to you prior tlO settlement to give you information abOut your settlement costs, and again after settlement to show the actuel costs you have paid. The pr,sent copy of the form is: o ADVANCE DISCLOSURE Of COSTS. Some items are estimated. and are marked "(e)". Some amounts may change if the settlement is held on a date other than the date estimated below. The preparer of this form is not responsible for errors or changes in amounts furnished by others. )( STATEMENT OF ACTU.6:l COSTS. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they If. shown here tor informational purposeli and .re not included in total.. o. .IlIAME OF. aOIlIlO, ..Q (( I. IELLIII )~ t ~h F. LENDEII ~ I ~"-to. . ~R, c WS.~_ .~ t. J r ~~ '1.~f~ W..R....ILo.. , .t.... Q__ J ')033 ~ ~ '."--' '. -.. -" G. PtlC)PERTYLOCAnolll H. IETTUMINT AOENT ~ t-oATE, ~o 0 ~ Q~ c. ~S.~. Lj:''f~~i~ ADVANCE DISCLOSURE ~(1\~ 1')011 j f'lACl Of SETTLEMENT SETTLEMENT DATE Of PRORATIONS If \l.. _ 0 , DlfFEflENT.fROM <<).-<1-19 SfnliMENT i . . ..., J. SUMMARY OF 10RROWIII" TRANSACTION '-J K. SUMMARY OF SILLER'S TRANSACTIO", . . 400. GROI, .MOUNT DUE TO 'fLU": r'lO. 8RO.I AMOUNT DYI '''OM ao"ROWl": 401. Conkaet Sal.. Price .., ~ ~ ". ft^ . ConIrect..... price 1&.1 ~ oc. ...., 402. P....onal pr~ J> . ""80"" prQperty . ,J 403. 103. Settlement cher881 .. borrower V5'16" 2.~ 404. (from tine 1400, Section L) Adjuatments for itemtpaid by MI,. "' .1Re* , 1OC. 101. 405. City/lOW" ..... to Adjustments tOr ~. paid by...... in advence: 406. County t.... to 407. A.....mert.. '0 108. City/town tex.. to 408. c;;;;, rJ J7 "'1.. ' - I !;(, 'lL ~. 107. County tax.. to 401. to 108. AtMMmenta to 410. ,. 1ot. "-. .-V .,x '1~ to" I. J, 1(...,.. 411. to .. t10. to '. Ll;: \S~ 111. to 420. 01101. AMOUNT DVI TO .Iu,a" i~ 112. to NOTE: The following 500 'M eoo..... ~iont.... .flOt 120. GIIO.. AMOUNT DUE fROM aORIIOWER; 4(P. ')C5t. Olr requir~ to " C~pleted whp this fOrm i. u-.ct for edv*nc:. dt.<:loIur. of ....m.nt Coati prior to ..cd...."t. 200. AMOUNTI ftAtO av OR IN alHALF 0' aORROWIR: 500. RID"CTlONI ... A."NT DUI Tel lll,il": 501. Payoff .of fi,.i . Ioat{ "... -, ~ K'f:,.., cr. . ') - 201. Deposit or .arnest money ~.a_ - 502. Payoff of second m 10aA~ - ,.. .... 202. Principaj amount of newl08n(s) 31 , GO 503. Sent.ment c'*oes to MI'er . ." 203. Existing loan(.) taken subject to I (from ~ine 1400. Secrion L)' 3/ -; \ \ t"tJ 204. 205. 504. Existing loan(.) taken .ubject to Credits to borrow8f' tor items unpaid by s~I8f': 505. , 506. 201. City/town taxes ",1. to ... I. ,I -. :LI. t () 507.t.l ... J .1-'. '-~ " ('..J ~ '- . ,~~.OO 201. County taxes I , 11 to ./ '1 I 1 508. \\ 208, Assessments to 509. 209. to 210. to Credits to borrower tor ite."s unpaid by seller: , 211. to 510, City /town taxes, , J. to -.11 :11.80 212. to 511. County taxes 1'/ ' 1 to , '/ I 7 220. TOTAL AMOUNTS PAID BY OR IN BEHA,lF :)802 \ 'to 512. Assessments 'to OF BORROWER 513. to 300 CASH AT SETTLEMENT REQUIRED FROM OR PAYABLE 514. to TO IIORROWER: 515. to 301 Gross amount due from borrower 520. TOTAL REDUCTIONS IN AMOUNT DUE TO SELLER: " ) '" Z I ! (from line 120) <-iL ' \ ';.. + ;.., !L, ~\O - 600, CASH TO SELLER FROM SETTLEMENT: l02 Lpss :lrnounts paid by or In behalf of 601 Gross amount due to seller Lj :) \ \~)' 6 borrower (from line 220) (;8~'21 .~ CJ (from line 420) '(. ) 602 Less total reductions In amount due to (12,382..l/) 103. CASH (0 REQUIRED FROM) OR ~J1 '3l~ seller (from line 5.20) (OPAYABlE TO) BORROWER: 603 CASH TO SEllER FROM SETTlEMENT .~ 2.77~, (1(~ JD 1 RioV 615 AS & AS (1:123\ .:f R$ . .. ~ .- . - ---- . 3~~So.ct , , - _...., ....,.,n."'... .,_~.,..' ". ~~... '. '.-1I!!""""~"""''''''''''''''':'''f"',,,,",,,,.",, '''fl'< 'I""" ... __ ..!-._.___._--...Io.~.,_...._ ..... '''!. '.r "'" ,,,"'".''~I;''~,,,,,,,..,........,",",,,,,,,,P''' ~ ..~ ,~~.. '"~- SALEs/BROKER'S COMMISSION b.-cI on pt'ic. s .!dS~ 0 ? I PAID FROM I SEllER'S FUNDS I ._--~ ..I...,.,:.....:;lltt0'. L. SETTLEMENT CHARGES " PAID FROM BORROWER'S FUNDS 704. BOO. 801. 802. ~893. 804. 805. 806. 807. 808. 809. .~~. r\c 810. R11 900. 901. ~L. 903. 904. 905. 1000. RESERvn DEPOSITED WITH UNDER FOR: 1001. Hazard insurance mo. . S /mo. 1002. MortDaae insurance mo.. S /mo. ~. City prODertv taxes t :).mo. O~ I" '", /mo. 1004. County VlUII'Il'IlY taxes mo. @. /mo. 1005. Annual assessments mo. (t S /mo. 1006. <:.- V ~ b mo. @ S 3 Ii ... /mo. -:..;;.~. 1007. mo. (jjIl S /mo. 1008. mo. fit S /mo. 1100. nTLE CHARGES: 1101. Settlement or closing fee to 1102. Abstract or title search to 1103. Title examination to 1 \ "" u" ~ 1104. Title insurance binder to ~ \. ~ u..n +- 1105. Oocument preparation to ~""\"'""-- -c:: () ()_ ..1.106. Not~es to :J' Q ~'AL 1107. Attorney's Fees to (includes ~ items No.: 1108. Title insurance to (includes above items No.: 1109. Lender's coverage $ 3 '"' C ()v '.l'.L_Qwne..:) c~erage $ Y ~ " do ~~, I , 11. --~ ----- 1112. ------- .13. 700. 1--. 701. ~. 702. ~. 703. - Total commission paid by seller Division of commission as follows: $ 'bce . to \L~ (~ ~ $ }~50-to GQ~ ~€~ ITEMS PAVABLE IN CONNECTION WITH LOAN. Loan Origination fee , % (~1)-' ~ A loan Discount" . l. -,~ Appraisal Fee to _ I Credit Reoort to lender's inspection fee MortaaGe Insurance application fee to Assumotion/refinancing fee ~ R ~~_.__.__. ri r; ~o('- ) -- -- -- (I ~ ~ ())o~J ..- -------.-- c. _U ~...-~ W.3' ~..~. U' 71 1 0 ~. o't)-= .1 " "" ITEMS REQUIRED BV LENDER TO BE PAID IN ADVANCE. Interest from to . $ /day Mortgage insurance orernium for mo. to Hazard insurance premium for vrs. to yrs. to -. ~ t'} y.. I L I t I ------- .._~____._-.-J ~t"\'-I ,~ .- ----- -- to- l... 'ti r ___Q h --j ~ .~ ,QQ -.- ..L. ~o.^.... "\L4~ -- &.In . no '1....0 J ::;:;:/}:::::::::::::::::::::::::::::::;:y:{{:::;::::::::::;:;'?I?s: } II,I"!:.I!:'" - ------. ; LOO. GOVERNMENT RECORDING AND TRANSFER CHARGES 'liOi~~~rding fees: Deed $ 8 oR . Mortgage $ ~ 1202. Clty'/COU~ty tax/stamps: Deed $ .., < ~ -; Mort99 $ _.._--- .~ J~~.:..._~~~.~e tax/stamps: Deed $ "i ~ 0 ; Mortage $ 1204. ~J90. ADDITI,?NAL_~~TTLEMENT CHARGES .130..!.:-._~1l!~e'y'..!~_______ ~.302... Pes!..i~sp~iC?n to e..!..~3_.__ ___ _c. ..__ _ _______.. __~ 304. ._____...._. __.______.__. 1305. 1400. NO Tf. J , - O-'L.t---~~-._.. l.I5o.o~_ 1--- y~ -- --------j-.-----...-..-... ------ -----r -- --------.---- --1--------.-\. .-..-.--..._._____.__ I '-f---'--'---i---'---" ----- \ ~'::',(j, S 7 b 13 'I~ tJ Releases $ TOTAL SETTLEMENT CHARGES (Mrert1d on /intIS 103 and 503. S<<tionc J and KJ The Undersigned Acknowledges Receipt of This Disclosure Settlement St.arem.ellt an. d A~leDS to the Correctnes~ Thereof. \ ,,;, ) ,) 1/ /' <:".-,.~ ~_ ~~~..__ L,:/.~..;fl' ~/~l;'_. . / . - 1',' 8~_ <Y ;% (< --' .JF-n (r."/ ...~.t:.. ~.~ .______ ~~_Jtf.,/!d~L i/j~l{ / Buyer or Agent / Seller or Agent Under certain circumstances the borrower and seller may be permitted to waive the 12-day period which must nomJall'l occur between advance disclosure and rettlement. In tfle event such a waiver is made. copies of the statements of waivu. executed as provided In the regulations of the Department of Housing and Urban Development, shall be attached to and made a part of tlJIs form when the form is used as a settlement statement. " .. ., RCC -36 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent Jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bond,s and tenta- tive trust accounts, must be listed, despite the fact that they are not of the administered estat~ Tangible personal property should be listed first (e.g. Jewelry, wearing apparel, household goods, and fUrnishings, books, paintings, automObiles, boats, etc.) Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, stocks, mortg~es, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capaCity, partnership interests, interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of death, should be listed in this schedule. Item No. ITEM List and describe tully UNIT VALUE Bed and bedroom furniture. (Consisting of old bed frame, dresser, cedar chest, chest of drawers and night stand.) Credit of prepaid school taxes given to estate at settlement for sale of lot and dwelling located at 200 April Drive, Camp Hill, Pennsyl- vania. Insert this total opposite "Personal Property", Schedule "B" in X X the "As Reported" column on the last page of this return. ESTIMATED MARKET VALUE DEPARTMENT VALUATION (Do not write in /". this space) $ 100.0~ ~. 158.76 (" $258.76/ ~ S 8 -""1 (., I RCC-36 COMMONWEALTH OF PENNSYLVANIA TRANSr~R INHERITANCE TAX SCHEDULE "e" TR4.NSFEIlS RESIDENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) no (2) Did decedent, within two years of death, transfer property from himself to himself and another or others (including a spouse) in joint oWnership? (Answer yes or no) no (3) If the answer to (1) or (2) above is in the affirmat~ve state: (a) Age of decedent at time of transfer n/a (b) State of decedent's heal th at time of making the transfer. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no)-.!!Q.._ (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) no (b) What was the transferee's age at time of decedent's death? n/a (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The poSsession or enjoyment of or the right to income from the property transferred? (Answer yes or no) no (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) no (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others n a (7) Did decedent in his liretime make a transfer, the consideration for which was transferee's prolnise to pay income to or for the benefit of care of transferor? (Answer yes or no) no (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserverl power to al ter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer yes or no) no (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) no NOTE 1: The answers to these questions should be Supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom tranSferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) NONE Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. Nfn.--J- "",.~ .~ ~,.....,., ..t.~ .,......'","~ '!II' ~. .4"~' '~.h.' i' .... "'---".- "~~ -. ~. , <. LAST WILL AND TESTAMENT OF ORPHA C. lCL IN! I, OUM C. KLINE, of the Borough of Caap Hill, County of Cuaberland .nd State of Pennsylv.ni., being of .ound aincl, memory and under.tanelina, elo hereby ..ke, publilh .04 eleclar. thil .. and for my La.t Will and Testament hereby revOkina and ..king void any and .11 other willi by me .t any tt.e hereto- for.Mde. 1. 1 d~rect that., Executor h.relufter na.eel 'Iball pay all my juat debt. and funer.l ezp8aa.. .. loon .1 conveni.ntly ..y be done after ., decea.e. II. All the r..t. 1'..14_ .Dd re.inder of -.y .state whether real, perianal or atxeel, and whereloeyer .ituate, I hereby live, devi.. .ad beque.th unto my lon, DMNlTH R. lCLIHI. If 11)' I.ld Ion .hould preel.c.... me, th.n thta lift to hia shall b. dl....ted, .nd 1 then ,1ve, devl.. .nd b.q....th my entire eat.te, whether real, peTecmaJ. or: .is" .n4 wMreeoe.,.r lituatle, unto 11)' ..., JOlIN W. XLI-, .... ., daught.r, llTRICIA X. KIBE, in equallharee per .tlrpal. III. I her.b, aaalnat., conltltute and appoint my loa, UNNETH R. lCLINE, .s Ixecutor of tbil ., La.t W111 and Test.aent. If my '.id, 100 ehould predeceaae as. or otherwile f.il to qualify, or ceale to.ct .. lucb, then 1 n~iD&t., con- Ititute and appoint a,. eon, JOHN W. lCLINE, .a Ixecutor. IN WITNESS WHEREOF, I, <IlPHA C. KLINE, the Test.trix, have unto this my Lalt Will .nd Testaaent, let ay hand and seal this ,; I, J day of p].:J I 1973. SIGNED, SEALED, PUBL ISHF.D and ~"1 hLt.t1- / DECLARED by ORP~ C. KLINE, the above- ~ ,'1:V'j~ ~,",-- (SEAL) ., '. . . '" "~. ,-".......;,."'-....- ~.-"...:-. . - :..- . ~f"~I' v1l#w. ~ '~Fc. . ....... 'W 1 -r ..11. ......-:rr.,~'_.:.:__...... '~- . ~ .. ~ ...' . "-'."1.-'~' .,~ ""':l ~'. ,...._."~r.......,.,...- ", . ".,..,. \ .. ',.~ ~ Te.tatrix, a. and for her taut loi~ll a9Jod Te'CC.a<E-nt 1.0 l:h. pre'f'ne of oJ4, who h.av~ hereunto .ub.crlbed OUf njoQVJ& .. w1c.t\e..e. at h...r reque.t.. in th.' pre.enee of the Mid T..tatrlx aad O! f'l!cl-, .:>tMr. 1/4 {t(,-,rl.. . f) &r ;./~___. / ' 'l), , /" /~~,'....~~r~~ V L (1 r~ /. . .)-1 . . 2 ~~ .{ : L (~ ~ ... '" -- , .. .' '-' - - --. --'--- --...-.... . , . . RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY aye an interest, vested, contingent or other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Kenneth R. Kline son yes over age 21 ent ire estate 200 April Drive ~amp ttl.l.,l., .t"ennsy lvanl.a l/Ull Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE NONE n/a n/a , , SUMMARY Real Property .............. ....... ................................................... (Sch, "A") Personal Property ............................. ........ ... ....... '" ... ............. (Sch. "B") Transfers .............................................. ........ ............................ (Sch. "e") ... o . ...."'.... E<'II: tl: s:: '2 Q) e ...... ~ :s eQ)- _'P.o ~ e u ~ 0: "'u'O .B.....,QJ ::s",t: u ::s 0 ~efr ~ p:: .................. ................,.................................................................................... Gross Taxable Estate (2 ) (As Determined) ( 1) (As Reported) $~?'~9.~.~.~O .. . 258.76 $..................... . $.....NONE...... $ $. $4.s~258...76 $ . $. $ $ $. $ ~ ~ >< 0'- It\ ..;f. I: 00. r--.: I: ~ .-I, N: o ~ z ------ c o :c ell b '" :5 ::::: E' .... "0- :::~ f-o Z ~ :::; til (J) - < ~ ~ ~ < til ::I: f-o ~ o ~ ~ !: < ::; :'0 .~ :tlI .Q) .u 'Q) GlQ 1:1: ".( .-I: t.!:: t.. o ~ til f-< f-o ~ ~ o f-o (J) til .: O. tIl: ..c:: ~ ~: o ~ :j o ~ o ~ .-t .-I ...l ::d ! ..... o III .... Cll ...:l 'C. 1:1: tIl' .-I . ~: ~ ~. o Cll 'S Cll ~ ~, III C = III ~ ..... o .G' 5 .. o U ..... o ..c .::: Cll !lJ ::: c o e ... c o U ...:l -( rI.l - -( ac Do. Do. -( Q ~ l- ac o Do. '-W ac . . R C C-38 RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY *' COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent Jointly wi th another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or Joint tenants, giving brief description, as indicated under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name unit percentage Estate DEPARTMENT VALUATION Address and Relationship of Co-Owners, and Place Value Share Valua tion CAUTION-Do not Write of Record of Instrument, where Real Estate. In This space. Value of Value of Entire Decedent's Property Interest NONE I : ! I Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. N~ .. .. I .. COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 1X\J6 2 \j \918 RCC-43 (4-71) .... m..L om. __ _, 1'" NOTE: TO BE SUBMITTED IN TRIPLICATE REPORTING FINANCIAL INSTITUTION ADDRESS Pennsylvania Department of Revenue Bureau of County Collections Gable Building, 3rd, Floor 411 S. Second Street Harrisburg, Pennsylvania 17127 -=r:.:r~ lank . !:rut (b. e.. BUl, Pa. ZIP CODE J.7m Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: ACCOUNT NO. OF JOINT, TRUSi/:]. u "":'IlA INVESTMENT DEPOSIT ~~ NAMES ON ACCOUNT OR INVESTMENT 0qItIa C. 111M U' Jolla v. I1bt ......,. DATE OF DEATH DECEASED JOINT DEPOSITOR, ~EE. ...... OR INVESTOR C ...... ADDRESS 100 jpI'1l Dr1.,. Ca_JU.U. Pa. COUNTY ZIP CODE c-_~ l1V.U. SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR IOba ..~ ADDRESS ... RELATIONSHIP TO DECEDENT ... DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED...." BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ n6.G '~.~~. Signature ... ~ ft. ..... TITLE .. REV.SI8 (3-79) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P. o. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO I nvettiglltion Divi.ion NOTICE OF FILING OF APPRAISEMENT Kenneth R. nine 200 April Drive Camp Hill t PA 17011 (Executor or Administrator) In Re: Estate of O:rpha C. 1O.i.ne Cwaberlanci County - File No. 21-78-0459 Dear Mr. nine. You are hereby notified that the Orisinal appraisement in the estate of Orpha C. nine has been filed in the office of the Register of Wills of CUllber1and County on June 18 ,19.22... Said appraisement reflects the following valuations: Real Estate Per$Onal Property Transfers * Jointly Owned Total 45.000.00 2.58.76 None 163.20 145.421.96 As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373. Date J..... 18. 19?9 Signed LeA> t=" ~ Title .&.dmi ni strati"A OfficAr *Joint-Be1d Property in the 8JIOunt of 1163.20 represents Joint Account #14-3-0053-2 at the Dauphin Deposit Bank Be ~ust Co. in the names of the decedent or son. Account established 6/26/73. Balance at date of death NOTE: This is not a bill. 1326.41 (l' taxable) . ~V-457 (8-78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE COUNTY FILE NO. June 18. 1979 Cumberland 21-78-0459 Whereas, Or'Dha C. Kline late of Borolla}, of Cam'D Hill in the County of Cum"",.,..l And Commonwealth of Pennsylvania, having died on the ='='nd day of AWtUst 19 .2!L, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fulvniti , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future Interest In this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. DESCRIPTION OF ASSET UNIT Appraisement VALUES Made for Inheritance Tax Purposes RAAl .... $ 41).000 00 Personal Pronerty 258 ?6 - A NnnA *.Tn; n+'_H.l d ""'- ..L 163 20 I1V\lII AT. A C! cn:oms 141).421 ~6 *Joint-He1d Property in the amount of 1163.20 represents Joint Account #14-3-0053-2 the Dau'Dhin De'Dosit Bank & Trust Co. ~ at in the names of the decedent or son. Account established 6/26/73. Balance at date of death 1326.41 (~ taxable) . ; ! I , , i_ , I r- i I r-:-- r-- Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 1 R+.'h day of \.. ~ 19 22-. P -. t=' I OD Appraiser Harrisburg (Number and Street) (Post Office) . Penn3.. ~ :c ;;p ~ . m ~ :3l ~ ~ ::tl .....: ~ '0 ... 0 ~ a (\) ~ ~ (\) 0 '"1 m () III 0 0 (\) s::: ..... ..... ...... Z '0 :3 ..... ::J ::J C/) -I ~Q ~ ... ... Cil 0 3 0 (\) (\) (\) 5' ... ::tl a ~ III ~Q.. m g, :..... m z 0" a "1:J (\) f:: ~ ... 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I1l CD ... ... ~ .... _.> ~ -+J 1:: C _ ~. .~. (.~. ~.d ~ ~ mCD .I:l (J C -. ~~ - ... ~ "+J _ c: (; .~;" l~ C o -a ... :., ~) c\i ,.. ... .... '"' -:;:. <0" ,.q s:: 0 .t! ro.;.::.;.~....;O :=,~en CD j ,-~"~ '" iiJ ro (J ;:;.::; ... - .I:l .... :>- CDO~OCD - .a S ,S 0 ;.; ~g ~ ~ ~- fen+: c,'J:.o 0 cP'a 0 ~.~.t-S !:t'~ - ~,... ~ ~ ..c::- CD~ro..c::"C I-I-....'"d g~'-5 ~ o5i (J E-4 . - .....c ,..,,< t::l ~ r:Q 1-1 p::: E-4 en 1-1 ~ S r:.1 S ~ ~ u en .. - ~ III ~ j > ~~~~~ ....I-.,II.~ 0( fO II. .J <>~a~ III III 0: Z ~~d<~ ~ 0 S 0:. .Jl:o.:UJ .J <( 1Il.J ~ : x - II. :IE <( U ~....- ... . . ~ .::- ....... ... ,. -".", '.....'.... 'r.' ..'. .'. ._'..., '.r." ..."" ....... .....A ,.;.,4 ~...",.. ," ,,,-.,,. "JI'I"'Jj'" .....11 0/ ,,7" ", ,., .1,' .. - . r \ .. ..-..... .. .-.- " SCHEDULE OF DISTRIBUTION in the Estate OF ORPHA C. KLINE FOR DISTRIBUTION: CASH;"- - - - -- --- ------ --- -- ---- - -- --- - - -- --- -- --- - ----- --- "'f,'!"-----$ 25 ,,&is .16 .. IN 'KIND '(bed and bedroom furniture consisting of old bed frame, dresser, cedar chest, chest of drawers and liight stand)------------------------------------------ 100. 00 two rings, one onyx and one engagement ring 225.00 TOTAL cASH AND IN KIND-----------------------------$Z5,608.16 TO: 1. Kenneth R.,. Kline - a. Cash-------~----------------------------$25,283.16 b. Bed and bedroom furniture---------------$ 100.00 c. . Two rings ,one onyx and one engagement--$ 225.00 d. (Family exempt ion - Kenne th R. Kline $2,000.00 was included in First and Final Account as a debit.) COMMONWEALTH OF PENNSYLVANIA: 5S: 11PW~.~.~4~ Ke.eth R. Kine, Executor ~:. .~~~.~ Notfry Public SUSANNE M. BROWN Lower AI . Notary Public My C I~n .Twp., Cumberland Co., Pa. ommlSSlon Expires Nov, 29, 19. I.I&ve,"~<r- ~ ~ 198;;) .' " i(,...' 1 it ........, 'to.,._ 'i ti"t, .# "",",' l" , fr4' 1 ..;:') d7 ~\ ~ ~,t.~ ~', ~, "j 'l!t,;, ~.- 'j< 't },''!t ,t; . \." I. ,. '" ~r ~ ' LI8(R 94 fA~f 322 . , " '. ", "l 'J' ... o .... =' u ~ Il1'l i ~, 1'\ .. ~ ~ ~ J ~ ~ t! .. ~ !;2 Cll opt c:l ~ ..-I oil>-. =' co o ~ ~~ ~ . t) m ~ 4-l o ...-1 >: C1l ..-I.... .... opt c:l ... == =' Z 0 CO ~t) 1l1'l.,,~-g C1l C1l ... ..c::C04-lCll ....CllO..-l C1l ... ~~~i 4-l." Cll :s ~t) 0'1 .. el " Eli/illS ~...c ,~~~ ~cl.c ...2~~ c ... .. :J Z 0 .. 0_"" u .. Q.,e ~!.cc 0-.1 -OJ .2~ \'- " . '5 <rl;~:i. -. ... i'I!~i' ..... 3 C ... ... - g'O~t: Jilt) & e.='; (J .. .. ,,"0- ~, . ,.,. . '., s ~~ 8B ~a ~ .. H~ ~~ ~ ~J E-l== ~E-l ~~ tl "0: . ~ ~ ~ . 0 .... ~~ f ~ i j~ e J ..:= ~ O' .211 ;;:<1>0",,0 = U U U u ::l CI) .$ '"' .CI) 't:l I ~ Q,.E.E '8 · .... 't:l 1:: 0 Q, · O~::sm~~' CI) -:;," '.j;;/ ,u 0) U :>::: e ~ :p S cu ~ II) 'J O""O..o:$~=C1l r::: '.;;JvCl)~';; r::: oS 0:-::: 0 "" CI) ~ ... .... .., .,., t!I:i :t:: ~ 't:l 0 ::: =.iOl' .~ 0_QJ..Icl.... CI) -4.. .... :-~ = J 4W ~ ~ ~ .:;::' g ~~)~-1. ... .... ::~r ......l.,".~~ . J CIS 0 <t.' . <, "I ~ ~ ,.. "j .,; Q.'iOl ~!~f~~f~j~ r::::-.....: o. :>. $8(1)'t:lo ~ f<S~84JO !!lI'JlI'JS::<o~' ___4)0 .,.. _ -5 ..c: '''! ::2 "'.l'1 A .,-" ~~ .., .~ 2 "P :=E iii ~ :J > (,) ~ - < o < 11:- >-.JI"IC~ I- : I:: > .... < >< ::; ...I .... > 0 U ~ ~ III II: Z :=E II: o' 0( Z < 0 0 III Jl-iLllIlL .JI- UJ _ < 11...1 ~ :;: i - lL :I ~ ,L " <l>. . "t .., ~ C-.l ~ LW ~ ;:.'5 ~ 0') t:lr: ...... ,;Q :.:; .~ -. '. FIRST AND FINAL ACCOUNT OF KENNE TH R. KL lNE EXECUTOR OF THE ESTATE OF ORPHA C. KLINE Late of Camp Hill Borough Cumberland County, Pennsylvania, deceased .# . "" Date of death: August 22, 1978 Dates Letters Testamentary advertised: The Patriot-News Co. (Metro West Edition) - September 6th, 13th and 20th, 1978; Cumberland Law Journal - September 8th, 15th and 22nd, 1978. cASH AND IN KIND CREDITS - PRINCIPAL AND INTEREST Your accountant charges himself with receipt of the following items, name ly: Cash and In Kind Credits: 1. House and lot known and numbered as 200 April Drive, Borough of Camp Hill, County of Cumberland, Pennsylvania, conveyed to Kenneth S. Kline and Orpha C. Kline, his wife, by Camp Hill Realty Corp., by deed dated October 11, 1962, and recorded in Deed Book "R", Volume 20, Page 75 on October 13, 1962. Title vested in Orpha C. Kline by operation of law in that Kenneth S. Kline predeceased her. Gross sale price on open market was------$45,000.00 2. Mortgage Company escrow money from above property---------------- 405.48 3.. Bed and bedroom furniture consisting of old bed frame, dresser, cedar chest, chest of drawers and night stand-------------------- 100.00 4. Two rings, one onyx and one engagement ring---------------------- 225.00 5.. Credit of prepaid school taxes given to estate at settlement for sale of lot and dwelling located at 200 April Drive, Camp Hill, Pennsylvania----------------------------------------------------- 158.76 TOTAL cASH AND IN KIND CREDITS---------------------------------------$45,889.24 DEBITS Your accountant charges himself with payment of the following i terns, name ly: Register of Wills - short certificates and probate of Will-----------$ John E. Neumyer Funeral Home, Inc. - funeral bill-------------------- Cumberland Law Journal- Estate advertisement------------------------- The Patriot News - Estate advertisement------------------------------ Susanne M. Brown - notary fees--------------------------------------- Kenneth R. Kline - family exemption---------------------------------- William A. Yocum - attorney's fees----------------------------------- Register of Wills - filing of inventory, RCC 33 and Debts and Deduc~ tions---------------------------------------------------------------- Register of Wills - filing of First and Final Account---------------- K. J. Reitenbach Associates - estate appraisal----------------------- REAL ESTATE SETTLEMENT CHARGES FOR SALE OF DWELLING: J. R. Wix - notary fee----------------------------------------------- Recorder of Deeds - recording of corrective deed--------------------- Register of Wills - real estate transfer tax------------------------- K. J. Reitenbach Associates and Glise Realty - Real estate broker's commission--------------------------------------------------------- LiillR ~4 i rlu[ 31~ 30.00 1,758.00 18.00 20.25 10.50 2,000.00 2,262.00 9.00 31.00 100.00 2.00 9.00 450.00 3,150.00 Crocket Mortgage Company - home mortgage--------------------------------$ John R. Irwin et ux - costs assessed to estate due to delay in settle- ment as a result of the necessity for requiring a corrective deed--------------------------------------------------------------- Township and County taxes - taxes--------------------------------------- Register of Wills - State Inheritance Tax------------------------------- 8,649.97 125.00 21. 80 1.634.56 TOTAL DEBITS------------------------------------------------------------$20,281.08 SUMMARY TOTAL cASH AND IN KIND CREDITS------------------$45,889.24 TOTAL DEBITS------------------------------------ 20,281.08 BALANCE FOR DISTRIBUTION------------------------$25,608.16 liJUf 94 t ;I,;l 320 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND KENNETH R. KLINE, the above-named Executor of the Estate of Orpha C. Kline, being duly sworn according to law, deposes and says that the foregoing account is true and correct to the best of his knowledge, infor- mation and belief, and that no persons claiming to be interested in the Estate as creditor, legatee, next of kin, or otherwise, has given notice of his claim to the deponent, in writing or to William A. Yocum, its attorney, in writ ing. nj ~jJ /Jl4- Cl tJ/I/:f /, , . ,.f> /:)2< Kenneth R. line Sworn to and subscribed before me this a/ 7~ day of April, 1979. ./ . -:? --<di~~)?J? P/ 6~ SUSANNE M. aR6WH, NOt2ry Publie l?~er AII~n :wP., Cumberland Co., Pa. I'fI:Y Cort1l11lsslEln Bkpires Nov. 29, 19~ I hereby certify that the actual notice of the time of presentation of this account and of the character thereof has been given to every unpaid creditor who has given written notice of his claim to the Accountant and to every other person of whom the Accountant has notice or knowledge who claims an interest in the Estate as a beneficiary or next of kin. ~/ ~j;/ /)//- I ! J I J? . ,>'r ,t:.-.~df~~~ Kenneth R. Kine L;~LR ~4 f/lvE 321 ,.".,.' ~. _r-,- .-.. " .. .A LAST WILL AND rESTAMENT OF ORPHA C. Kl.I"a: I, ORPHA C. KLI~"'E, of the Borough of Camp Hill, County of Cut1beI'l:c>.llli and State of Pennsylvania, being of aound mind, memory and unlleratandi.t,g, do hereby make, publish and declare thia as and for my Last Will and Testament hereby revoking and making void any and all other -willa by me at any t!.me heretc ~ fore made. I. I direct that my Executor hereinaft'-or named aha 11 p8~' all. my jU:!l t debts and funeral expefUlee aa soon aa cunverden~'lJ mil)' 1)(: done !1ft~t' my decease. II. All the re6t, re8idue and reiIWi1nder of my estate whether real, persoiUll or mixed, and wheresoever aituate, I hereby give, devise and bt>queath unto my son, KENNETH R. KLINE. If my said 80n should predecease me, then tbis giit tl) him 8M II "4r div..ted, and I then give, devie. and bequeath my entiH' e.~dte, wllctht.,t- renl, personal Qr wf:w::e<i and vllAtre.oever situate, ur:tC' my san, .JOHN W. KLHffi, hnrl my daughter, PATRICIA K. KIBE, in equal shates per at irpes. III. I hereby nominate, constitute and appoint my son, KENNETH R. ~lINt, as Exel:utor of chis my l-^st Wlll and Testam~nt. If my said IIOll should predecPiille me, or otherwisf> fail to qualify, or cea.e to act 8S such, then I nomi.r.ate, CO"., stitute and appoint my 8 on. JOHN W. KLINE. a8 Executor. IN WITNESS WHl'R.!OF, I, (l{PHA C. KLINE, t!le Tf,statd,x, have :mto thIs 1 ... II ,": my Last Will and Testament, set. lilY hand and seal t lLS 0)'"; cia) OJ /'..' /"1 ~) oJ I -' 1973 . .~ I' " I, / " ;.., ___._~J....!:..' i.. h ~. . .// / /~ .t '-- :_,.L. (~,rP,: SIGM'D, ~;l'.J\JED, PU31.[SJlF.;) ano DEClAt:.~l) i)yll{PIIA C. "LINE, ~~ht-' 3:-_)",,- IIIIIJIIIIIIIII -, Il'~ _......'..-....#~-~_.... l"",""'e ';"\;I'..~fItr(-~.~t-.- "'-"f ~ '. ~ ----,,~~.- . . 0, ." '~ 'T .;:~... ... r" ~ Te.tatrlx, .a ~nd for her last .j~ .~ ":'esc'.....nt to eh. pre.f':1 l!Jt "''\. who h3v~ h~reunto lIuhecribed our n...lIloe' 811 \J1d'e..ea At nt'r reque.t. in ~'}" pre..nee of the ..,id Te.tat,-i.x and :>i t'1\':! vtt.P.r. ., , t'/" J.. / 4 ''I:: (~'>., "--l ));.1.,1 . --<Ilf<tI r ~ -L/ V f) I ,r"c 1~/~___ --' '>,,): /1", . ' (~ , , ,( '_2-",,1 ~~_ ~ . .. Proof of Publication of Notice in Tlte Patriot and The Evening News and The Sunday Patriot-News Under Act No. 158'7, }ll'prO\'ed 1\Iay 16. 1929. Common.wealth of PennsylVania,} . County of Dauphin S!l. ................~.~~.~;'.q...~.~....P..<?~~~F~.Y.........................being duly sworn according to law, deposes and says: That he is th~~.t~.^qy'.~~gr~f THE PATRIOT - NEWS CO., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harri~burg, County of Dauphin, State of Pennsylvania, owner and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT-NEWS newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT _ NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which i:~ secureiy attached hereto is exactly as printeG and ~etro West bl' h d' h' I d" d . h' h d h 6th llth and 20th davs pu IS e m t elr reg'll a e Itlons an Issues w lC appeare on -t e ......J......./.....................................Jl... 9.'K...~. ~ p. ~.~~ ~.~ t.: 1....;h 9.1~.~......................... ............................................................:............................................... That neither he nor said Company is h,terested in the subject matter of said printed notice or adver- tising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is dul, authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolu- tion unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly r~orded in the office for the Recordina of Deeds in and for said County of Dauphin in Miscellaneous Book "M'". Volume H. Pap:e 317. "''''. . "--. Copy of Notice or Publication ," .~- f rl me t .. ....day of ..,::~.~lt=] .... ",..... ... ~.... ce.tIf, r.. . If_RI......... ....... "lll ~~.... .... ~:~-== ....,. .... III f iii ..... ~-:. ~ ...".... de... .. ...... _.... _WItMut ...,to: C.nneth II. K /I... _ April DrI.... ~ ""n...'...... ""1 ~ . .tIIam A. Yocum. El4Ulra Attorney ~.O. Bole 6G 1115 caear' Cliff DrIve c.mp HUI, PanMy'''.nla 11011 -..-.--- NOT AR My commission expires .~X.~~.'!!!.'l!WP.rl. Harrisburg, PA Stltement .f Ad,ertis Y'! P)..~~~.. A~.. .J~ C~.l. ..~.~9.~...... ........................ ~ ~p.... tl:~.~~.,... .?.~.!...... ~.I9.?:J............... ........ ..... To THE PATRIOT-NEWS CO., Dr. For publishing the notice ot' publication attached hereto on the ab0ve stated dates _ $.+..9..~.?9............... Probating same $.......~.7..?......... ..... Total $.?.9..~.?.5............... Publisher's Receipt for Advertising Costs THE PATRIOT-NEWS CO., publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT-NEWS, newspcpers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifit:~s that the same have been duly paid. THE PATRIOT-NEWS CO. . 1l " . . . . . ...... ._ " If. ~ Proof of Publication of Notice in Cumberland Law Journal (Under Act No. 587, Approved May 16, 1929), P. L. 1784 State of Pennsylvania }. ss: County of Cumberland JAMES R. HUMER, ESQUIRE, Editor of the Cumberland Law Journal, of the County and State afore- said, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has since January 2, 1952, been regularly issued weekly in said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: 9/8. 12L22/78 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of JCDCral circulation, and that he is not interested in the subject matter of the aforesaid notice or .~J III rBt, _ ... III .....ations in the foregoing statements as to time, place and character of publicalioB .. hW. au., 0r,M C., dee'd. Late of Camp Hill. Executor: Kenneth R. Kline, 200 April Drive, Camp Hill, Pennsylvania 17011. Attorney: William A. Yocum, Esquire, p. O. Box 643, 1525 Cedar Cliff Drive, Camp Hill, Pennsylvania 17011. --:x. ~ 2Znd 78 PUBUC Expir~l July 14. T", ~r1.nd eou.r