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HomeMy WebLinkAbout07-31-06 -.J 15056051047 REV-1500 EX (06-05) PA Department of Revenue . Bureau of Individual Taxes PO BOX 280601 _ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year '\, \ ('- 'j \ '~--...,~ . File Number , ' ( C \1.l( ( Date of Birth ~07 I03;{5'/ Decedent's Last Name ,/OCo.:tOO'-/- 0303 19 /5 Suffix Decedent's First Name MI (;-D-/ I O-_~ h, e_(' (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name G-- a. I I 0.- if 0 e... (' Spouse's Social Security Number ) U Lj- 30 4J~o E: cLuj CL .. eX- ~ Suffix Spouse's First Name MI ICLY"") e E THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WllLlS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return c:::> 2. Supplemental Return c:::> c:::> 4. Limited Estate c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::> c:::> 4a. Future Interest Compromise (date of death after 12-12-82) c:::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::> 10. Spousal Poverty Credit (date of death c:::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes ~ J O-m t:.- 5 E G-CLI I o.a-h e.'- Firm Name (If Applicable) REGISTER Of WILL~; USE ONLY First line of address /4 S f) 0 r +~ Itr 11\3+0'1 tt-ve Second line of address City or Post Office IJ 0-- r r " .s b lA-" (f State ZIP Code DATE fiLED 'fA 17/09/3 03 Correspondent's e-mail address: Under penalties of perjury. I declare that I have examined this return. including accompanying schedules and statements. a 0 the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other than the personal representative is based on all informatio of which preparer has any knowledge. SiGNATURE O. F PERSON RESPONSIBLE FOR FILING ~lfRNl t1~-' - /~-../. _. / o,ATE. __ _ _:To. r-'0 es E. &a. 110...8 her.,; /tLf/iA -1 t / ----------L!.)(,__ lc:~ ~_Z/-Lt; /n..tz ADDRESS I'" " --p' f-L-~ _J.i_~_Jkr -++\ At I, (~+D rj if-u e jJCJ..r r I oS b u_r~ tf/ __L~{L9=i.~63 ____________ SIGNATURE OF PREPARER OTHER AN REPRESENTATIVE DATE ~jUU~tr'A a'-l~}Q: (){)l1 Cf4 ___________ '7//3/ cJ 6D~_____ ADDRESS 11 -" - - ') r, I ;) __llj'___'-~-(t!l--bon+ ~f / D. ~Y-- 7~ /0 ~ f-eeJ~_r) -~_1_-.!__2!.~~________ PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 ].5056051047 --.J ...J 15056052048 REV-1500 EX Decedent's Name: &i_wa teL t G-a-L~ h if RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c;:) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c;:) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . .. .. . . . . ... . . . . . . . . .. . .. . .. .. . 11. 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) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . . . 14. Decedent's Social Security Number ;~ 0 7 / () 3~ ~ / . . . ';?/000.00 . 4- 7 '"J. 4- ~ .0 0 (,SCf oct 1.00 7'i7 3 33.~ / 0 I 7 / .00 . I 0 I 1 I .00 777 /~;). .00 . 7 7.1__L!! ~. _00_ TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .o-'L 16. Amount of Line 14 taxable at lineal rate X.O ~ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 { I ~ 0 7 / · 00 uS 9 0 q f . 00 15. 16. . 17. 18. . 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 -0 -. '"'-9 (;59./0 . . d-9~5q.10 c;:) 115056052048 ---1 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDE T'S NAME war cL C-. STREET ADDRESS -... 4 ~e+hCln he/ CITY m e CJ'-l CUI I' c:;; JJ Lt r- c. Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE ?,t ZIP / 7 t; tJ-S- (1 ) ;)7 u59, It) Total Credits ( A + B + C ) (2) -0- 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in avalon Page 2, Line 20 to request a refund. (4) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) 2-9 i..P:J"q. /0 1'i11.~'S 3 J 470. 3'S' 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 I8J c. retain a reversionary interest; or.......................................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 l8J 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 l8J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 1.81 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 IX] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE iG AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. 99116 (a) (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 thEl use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(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. REV-iSO? EX+ (6-98). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF &wa (0- c.... G-a-L A e../'"" FILE NUMBER All property jOintl~ed with right of survivorship must be disclosed on Schedule F. ITEM NUMBER J. DESCRIPTION fl 0 f- e 1; ecei r/CL-b I e.. - .T QJn e s E. Go- U~rf e,/ VALUE AT DATE OF DEATH ;g "if 1000 . TOTAL (Also enter on line 4, Recapitulation) $ ? I 0 00. (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF t FILE NUMBER d W;;.; ;;.;, ... ~d' JOI~~,Lo~i ~I ~~'''d'''' d.~ 01 d"th. it m,ot b. "po",d " .oh.d,l. G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT '-1&1 i3ef'f(a.n ~I i tJ~ {f)eLha/1 ,c.~bug j74 1765S <." ..;,)f (JI,( S e A .JQn~ t G-cdLUVhef B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATIE OF DEATH DECO'S VAL UE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTL Y.HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A. ~~'O e. 'To fY\ ert' I I IT' '-~ )i eJc.€- Fe.n(\ e.r If :;00;0 JI\'"' \ .Iq~o qLf.tf'd+ If> 47 Z4-2. ~ $rn;P, A"CL-+ '67 Z. - ~57 8'7 TOTAL (Also enter on line 6, R1ecapitulation) $ Li7~'-/-~ (If more space is needed, insert additional sheets of the same size) REV-,510 EX+ (6-98. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ~clD..tLrcL- t..,. Go- L L~1h e/ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABlE) I 't 9 0 V f)cu e:;, If) / i 0:1- I ( 1;51) ~a. /) 1::. J (a n ~ Fe ( () 'I 6ecJ: I-I J o..m e.) t (::rO- nC'"fJ h <? (' II J t1 ..:Ju)/O- ~ &CLI(c~8hef /13 '7 cl1;Jdre'1 G76~1 D; CtJJe l 4cr; 113 t) dI () c/.f5D S roJC'S CO I~ M <:... - ? oJ ",0 Ii v ~ Co \(4.-(\ sf'e r 0 n '<;) f.DJ:::. ~ ..::h In e ~ E G-~ I L.t;)h er 1/.) JLLLCt If lSo.,Ia.8hQ( //3 c}J:rdfe'1 )/0 n t. L fief' /3 /57 ~ho.( e 5 Ge I) e.rc..j) IfJofvl S (Dr p \ --T (CLn 5 S; e f 0 rOo Ij ecJ:~ T.., '{' ~ f '- (-.." (:-0. I Ja-i] h e. r ~;"J vI I -./ ~ ,.,.,) -..... 0 ;:J L-t./I c{. A G(......II D-8he ( L';:J I c.. 1\ C LAc ( " 0250 / J ~ PI 00 3 ,/ <. -', -' I};:, 'r~; blrc:i 1/3; Lf ~60 ';)nQre5 [c L: I J <-1 ~ Co , [ -r rG. n s~ te r 0 r) ~ ea.--L OJ_ ..:ro.. ()\ e S f (seA- /lO<-Sh er 1/.3 ;; -J (). (,' Ct 4 G cc Ilag her 1/3JL~;h1le1 ~/(1ne L. I1cr' 1/) Lj 51 CD : s if ~,-t :s hcu e 5 rruc, hnOf\ci~ 0VU &(~:Lrc. J '( Cl n f c.[ () r-, I ~ eo..xh J 0 (rl e S F Gc<- I La-O h el'" 1/3'f ~ ul, "- I) GCL I ~h e { '13 ?C'h:l:l/r<] b,..1 G.- n 12_ L. ~'c ( I J~ 3l, I :;; ) / DO 10 IOcP;O J DO 0/0 J CO 0;0 I DC) 1)/0 TOTAL (Also enter on line 7 Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) TAXABLE VALUE ~(P?~gl. /I ;<. ;;LOO. (p;), 50 4-5900. 37, I 3 / ;(fJ9/f..,;;<, REV-1510 EX+ (6-98l. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER ESTATE OF 8 d We\. r cl e.5.:i . ;:''11':' o/~ This schedule must be completed and filed lf the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes. ITEM NUMBER io 1 DESCRIPTION OF PROPERTY INCLUOE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO OECEDENT AND THE OATE OF TRANSFER. ATTACH A COPY OF THE OEEO FOR REAL ESTATE. G, 3'-1 ?, 90 7 .:;lw e S ~IY\. r; '-"-'l &/ao<e<;(J=ol - 4 T (Ci...f1s~e (' en) ~.e.o..tt-) ",' . 1/3 .:JCl I'D I? s., i:. (seL Lto.'8f\ er ( ..:r eLl .. Cl 4 (, c,,( (ctS' h .;>j- I J "5 C-h ~ Id ( €.'1 ~;C< rl(~. L 4c.r i I)~ DATE OF DEATH % OF DECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE J I <-t- 508 I at/to jj J J t.f50 '2 3290,Cf13 ;S/x;.IE S 4I'filer'cQY) 4-m(la..p hu7.d...-A -- .r j,or_..I.1.r. I (OJ, 5 ,EI 0 n ~ \: ~J I Jum e s ~ &0...1 (aSh e ('" StL-L ; c{ A U-Ct-L l08Y\ Qr b/une, L AL'; " /1 ) ) .I I 1/3 r~"IJ(U) 1/3; ) S~lll lOoCfo 59;J} 'g 3D aq J:: II..:sra / es ftrnerlCD-r) CCf' +~ u.;of/ d.. b-r D uJ+-r, ~I L () co 1/'1 e Fa nei " 4 \ -,t' 0 n :; fc (' 0 1\ I,;; e.D.-.k. t'l ..J::,. f0 e s E Gcd (c-s? "- (" ,: 3 tch I IJ r ~') -J\v.l I c~ 4 6 ~ LCo.g \I2J- y 13 I ~ j'c( n e.., L. If c r I ~ ) Zz. SGT. t)'zs ~rales /her; cali Ocr' f:J) Irwn~ J3 (,.L II cd e (" 1= ~' rt.cJ,. - 4 ~-T (U,,'1 5 .fe (' 0 '1 ~ €A-t-I, '/ ,JCl..r<\Q$. E G-D.-llA8h~( 3 -1' u...L i c...... 4- GeLJ lAg 1-, Qj' II J C.h Il:* r e t) ~I'Q n e L 4.c. r /' 'I ~ I ( toto J ~ /00010 J/&G,) ~ lCO eft I J DO Yo ID0091 ~. To +-~ .h- 6fn ~ e..- I sc.J"\ of? d 1.1..1 e G- 'I ,- , TOTAL (Also enter on line 7 !Recapitulation) $ (If more space is needed, insert additional sheets of the same sizd) REV-1511 EX+ (12-99) ~. _Slji~. -~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF &ward. C.- &CL-(~he( ebts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Wi ec!ema...n FLLt1 e.J~ /.{-fYYLL. -if. 3$7 $0 ~l1a ;;t-r(!ei q 13 I, (JD SI--ee I f-O/) t; tf I 7 ":3 L I..J.J) cJ1 e C> f) - 1.(0 ss ':;, $-b.aL 1d,'i1..(./~ 61 G-e.rt1(,;,bb-rS ):kc... __ .3 S- () tJO ?+ noS ~ (n e c-h-CLfI IC.s DU- (?t B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees :.rCO. C5D 6_ Tax Return Preparer's Fees 7. ~ 0 ti +=;. C~, 0 ilS /9060 TOTAL (Also enter on line B, Recapitulation) $ I 0, I 7 I ,?O (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF f'd J/,>( /"'J /J L Wu-- VL L (5a.i...-Laqhe/ v NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 3Ct.() e... ( Go.. C CD-.~I'r:' r '-I CJJ L., de.. t-I::'1 r'1. c -.CJ r J r/~ rn ech 0. rj ; (s &r...l ( 't- 14 1/055- J"ct.fn e 5 E G-ec U4-8h e..r I <.j $" I) 0 r+h A,-r ( { ~ fon fttJ e...n I..L ~ '/JC,A..(/ I :,QU (&- p~- 17JD1 S u_L I c... 4 G-CL L LcLg h e. r LlC [,)() 1(11 V(1\ fleet.... (~I ,j I tv ,,~, I ' ~ "I J...J.O'ft; r"J +OW nl m 4 OI7'--J-?, ~'Ic<-ne.. L A-cr; J I 0 Wor.:d.- ':5ff e. e..+- J.Jcur,sbu.Jt ?4- /7/09 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Tlrustee(s) AMOUNT OR SHARE OF ESTATE s >ouse.. 3 /I ~{)7 / ,:) 0 f) ;t ~lq.~q7 ~CL~h-l e(~ ;t c219.~c,7 ~ D-uSh + cr # e:2 J '7./..//1 7 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) L!.LST iiILI,AND TI>:~Tl'.?T:'i T'l' OF 1-;s,IYL~'..Rr C.. G/\.LI.J:'.GI-P~P.. I, CL':,yf'.......- c. (\/\r..J..lAGII::~~R,. of i.J~Y)C):" .!\lle:n TO\'111shiT), ~:url.:'K~.J,"'10,ncJ ';ount~7, D2.nns:7'1v;:u1.ic., .'.:~claJ:c-' th:rs instr'l.F:":.e.nt to be -'y Jj.~:l,St '-~':lJ ~J.ncl '-L'C.:::)t~1Li.(?:nt, in ':-l2nn2r ~.nc1 ::O~~~:'. ~ollo\!in''": L. 1J<--:~-'eby exr)1:"'e.S21~,:r re'/ol:e 8.J_1 "'rj_11s and Cocl.5.cils :1Crc.to- (Y,---'C ~tGcle. by '-'C~. ?. } hereb~T ci_rcct T",1Y E::c;.clltri:-~ to T:'AY'" ':111 "C",y jvst de;YLS, ;:1~~ncr,'11 ~',Ylc-l [.1(i.~-.'~inistr2,ti'\T,:; e.x'-;,enS2S 011.t of \: 2stt\te, 88 soon ;.8 ~)J:",~ct"fcnble. c.fter ""~y (;::::nt1.;.. 'L '~~h0111(1 !:'rv ''1i_:''-::, Jr:'.np. 81..11::"'vi"',"'2. "~D for rl -:'2.11 De 1'5.0(1 of ninet;7' FolJ.coin7 c1 a:7s C~2r~t1-.;" , I c!cviE:e and h~(""!ll.E~ t'tLl. \.l. thE). '''',,",~';1.inc:?r of ~1 estate to J~ne '~. GaJ.larher. L'. '-.~~L()~'lc~ r"\.:,7 ':'7i::2., Jane ~. Ge,112:~h~r, Dredece8.sc "'2. or (":-; (~ ,)T1 Ol.... 1;e:'.:OJ:"'2 t~!.e. ninc.tiE~th c1ny ~~ollo':7inr'- "uy c!0tlth, T d2\7ise end hc.(".'eath the re"'lllinctel' of my este.te to my issue livinc' on th.e ninetv-first day follo\'nnrr -'-'y dec,th, Der stirpes. " J. -r nO:'Jinste ancl 2::)Yioint }!aunhin i'Qf)Osit '__'.'r"\.lst or ,,,any, Harrisburg, ~ennsylv8.ni8., trv.stee. of the. sb.are of '-"lIlY bcneficial"S' ~j7:~IO o.y lx, " ""Clinol'. The L:lcoc,e nnd/or n:dnc:D,"l 8f s,~1ic' trust '"'"\:7 )(: 2cc~.Jrt'.'.1<"ted or c;.,,:-r'c.:1c1cc; ";~Ol'-' "the. .~:::intC-:'.n?nc2., e.('~lc;-\.tjon 2nd S'.T!l'~'O~,~"t or S'L'.C~'J ;'~?ne:~";.C'i.t'.r"':.r ,~.G '~~'V tr~"1s tee. in :Lt s sole c1"is crc.t~: on r~ ......"r ctc1.--::ine.; ancl y t: rllstee) in t"e C_:",:lX'.n c1 i t1,lTe: of i_nco:'~(~. ;:Tl C\ / or ",'-:iJ C". "p 1 or such 7J11r-:-'0SeE:, '~p"=,", c:t its (l.iscr2~ti_on! t-lT)Dl"t L:~'}e s;-:r rl~~.Y"ectly 1,!it:l'J.out the. int(~.l'""\;:?r.t:i.on of 2< >---l.~;? lv~j.['n or ).:}'\7> "cee :=:)r'~'~)e to :~r:.,7 ~'!'?:::'2on l1c:..vin.'''~ the C2.r(~ or control ()f . - ,:..; fl}C ""'_"- r-.~~: C --' (~l "'.,. 01..... ,\T:! th ,\7Cl.O'- the ben(:.fi.ciar~7 re.sides, ~-7ithout duty on the T)~rt oE the tr ;~.;t2,2 to sUDe.~(,,\..7isQ or inc:.Jire into th.2_ aDD1.ic2ti OIL 0 th(~ :;:'pnc: s by 8T}';.7 leY'son to \..-rho'" ;~Iny T')cl.:lf':,.:::.nt is so ':'~~1c.. ~ll1.-le o::11arlc'2: 8f ::311Ch incor'.2 ,~).'L'~.(~/.::-:<c )"j.:.-.inc:::'.Del sh.8.11 T),::,ic: to such bcne.f<.ci.nry ~1'-'~:;OL-~ I'c~cl1,in'--' "-t?:orJ.ty, .....Y'to s:'1ch "":'0T'1.C:'.~~icj'~~r'\.~'s cstnte .,,.., i.l tn(: '~~vc.nt of (:C:ilt(~-lrioj'" tLc:reto. l - ,.". Ii I!<' J f). Y nOL:inate anc~ p..~)point TJ1Y \:Ii::::2, JAne." !?allEl--::;her, E:S -:;:ccutri~: of this -;-:1Y T,":'cst ':Ti11 ['~n(} ;l'C'.st a'-''-',e.n t; 2nd as Sll!")S'C i.tl.:"tc- ~>-:('(,;Jt()l"'S I non_i.Tl.~,l_te nnc1 8ppoint in orc1e.r of D''''efcre.ncc, ~:'ir~~t, :7 son, (:l."-:C~8- -!.~. 1';?~11,qr'her~ r~nd Sc.COli.ct, '-:':7 C!8"L:_=:~~htcr, Julia -\. ,r.-pll c~.(";1::.e r. 7. T clir0-.ct th[l_t ny ne.rso"(12.1 L-'er),l:-'eS,?r~"tsj:iv(: e..n(' tl..,,~.stce, flS ,.~C} t~.,--c jy' E;::CC~2E;~: ^)-::'::~, s~-,2_11 rwc: l."'ec1u i:ced to :i:il e bond or see;,,_' :~...";_t~:7' in i~ n:7 iu riscl ict~ on. Tn 'rr.TI,":",'-:'0 Tr;r:::".~r~nT:' ! he_\]::-:~ llcI"cnnto se.t: ~~y h2.nc' ,3nd seal I~.-",is iJ " -- v del;' 0" Sc.:;te"1!lSr, 1971_. Lv (8"'>_L) =<:. ~-~ned, sC.CJ.led, nr:hlished 2nd (:.eclc~re.c: by th~~ above nEL1C(}. ,'28 ~~or, ~cl~J2r( C n" 1 ,,?s STIC: 'for his ;.?_St: \!i~Ll and '-:: \='. S .,- p,- ~(~_T' .:: J.E ...y'n.... ~~'re_80.nCE:, -:;"Lo, in h is ~~rQse.ncc, 2t his re.quest, and in the ~reserLce 0 e.:--1C:j ot:~I-::: "''', h""~ C' he.reunto subscribe.d our \l.n'--'c:s 2ttC',E;t ';.6t -r .E:.S ,~1c:.,S. \ru~ , I,d. B~t;41< ~ , \:IvY'->~<e.L.. ~. r0 '--' )CJsr_. .~ r ',' ,i. _ '- ~jL-___