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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
*'
COUNTY OF Cumberland
This r.tur" mUlt b. comple.ed In detail and flied In duplicate, with the Regl.t., of Wllh In tho County who,. tho decadent rllllld.d within nln.
month. alt., dalo of doolh, unlo.. an utonllon II gran'ed by tho Secr.tary of R.....nu..
'\I'm
;\'amQ. Nu.
1'1_ I, --1!iu'&l.U1:..t.tn E. Ulmer of 315 IIn~"Rtnwn Rd, He"hnni"sbur~.
IN AMEI tAOORfSS'
('MfSCI. ahe
hcil1it duly swum IlcclIrdilllt In IlIw, dCIlU,",CS and SU)'lt thnl)lJt is the --S11J:.\thdno loin.t:..-awne..l:..-..-___~
t'r:ktc.. ADM.. LEOArtl;. ETC.!
uf Ihe eslole uf Eleanor E. Rossma!l IlIle uf Silver Spring Town!lJ!!l'___
tClTT. 80ROUGH, Oft TO "",,",S.t\PI
deeeosed. ond Ihollhe whule uf Ihe eslllle uf soid deeedenl. whu died un J=mbJ~_L~2._1218____,____.______
tDATEI
cUI1Sislcu nr the assets listed belli\\' nnd that ulluwuhlc dehts nlld deductiuns c~cccdcd the fair market ,'ulue uf the assets and
PA
nn Pennsylvania Trunsfer Inherilunce ToA. is due.
Sworn and subscribed b.fore mo
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1//.1 L41...u.ffi7, (I" it II~(-L
J (SIGNATURE)
Surviving Joint Owner
t TlTLEI
1
ASSETS
(A'tach additional .hee" If nec...ar)'}
Ducrlptlon at A...'
Estimated
Morh'
Valu.
Depa,tmen,
Yall..otlon
CAUTION
(Do not w,lte
In thl.. u)
('1 l..;;,jt~ ::'{IU~' L
Personal
1973 Chevrolet Sedan
6GO.G
Personal
Commonwealth National Bank checking
1/141 761 062 1
8.50
Personal
account
x=
O'
Thirteen (13) $500 U. S. Savings Bonds (Series I)
all issued in December, 1969, bearing Serial N s.
D9G59200H consecutively through D9059212H,
Inclusive. (All registered in the name of 6,5GO.OG
Eleanor E. Rossman P.O.D. Hrs. Hargarctta E.
Ulmer)
TOTALS
7,108.50
-r,loB.Su
REPORT 01' INHERITANCE TAX APPRAISER
I, Ihe undersigned duly appointed Inheritonee To, Approiser in ,!nd for Ihe above Counly do respeclfully re(lurl Ihal I ha"e
appraised Ihe real and personal propert)' as rcporlcd in Ihe fortgoing schedulc Bllhe ,'olues sel (ouh opposite each item in
Ihe 10s1 column to Ihe right. '-_'/ ,-" .-
Daled: ~,,)1l\..1. ::(.F., 1'1''1 IINHERITANCE TAX APPRAISERI
Nome Q' Payee DESTS AND DEDUCTIONS Amoun' Amoun' Appro"ed
Na'ure 0' Claim Claimed b, R.III.'er
Cocklin Funeral Home,
Di11sburg, PA 17019 Funeral Services 2,273.00
Hargarettu E. Ulmer Family Exemption 2,00G.00
Hershey Hedica1 Center Professional Services 41.0GG.77
TOTALS
45,273.77
~ ')3 '7?
I{EPORT 01' TilE I{ECJlSTER 01' WILLS
I. Ihe undersigned duly eleeled Regisler nf Wills in oud fur the abnve Counly. dn respeelfully repnrl Ihal1 ho,'e ollnwed
deductions in the amuunts scl fmlh in Ihc uhn\'c schctlule os claimed. except where I ha\'e scl fmlh 0 grenler nr lesser amnllnl
ill the lost CUIUIIIII In the ri~hl. which g"~lIler nr lesser nmllunl rellresenls Ihe '11m Uowed as 8 deduclion.
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Commonwealth ;1t\
National Bank ~
March 8, 1979
Jon F. LaFaver
317 Third Street
New Cumberland, Pat
17070
Re: Eatate of Eleanor E. Roaaman
Dear Mr. LaFaver:
In reply to. your letter dated February 21, 1979 on the above estate, the
following information listed below is as of D.O.D. December 22, 1978:
Checking Account - 0141-761062-1
$8.60 Opened on or before 12-21-69
Account in her name only.
If you have any questions, please feel free to contact us.
Very truly yours,
.~/~~
John R. Hart .
Sr. Credit Analyst
JRH/cg
"
Tho Commonwoalth N,lIon,l Bank, 10 South Markol Sqllnrn, Hnrrl,""'"' .ra. 17108 17171 504,9500
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