HomeMy WebLinkAbout79-00524
"CC.!i).3 {3eU) .
COMMONWEAl. TH OP. P8NN5YI.VANlIo
DIPIoRTMINT QP R8V8NU8
BURl ioU OP cOUNTY COl.1.8CTION5
INHfiRITIoHc8 TAX DIVISION
01! - 7 t.^ ~ r:.{0~'
INHERITANCE TAX RETURN ,
FOR INSOLVENT 8STATES ONLY'
9F RESIDENT DECEDENTS
?~/;' -77
*'
COUNTY OP (~~b:'..,~ A
Thll r'hH~ mUII,b. ..mpl'l.dl~ d.,.1I .~d fll.d I~ dupll..I., with tho R.elllor.f Will. In.1I1O Counly whore 'h. d...donl r..,dod wllhlr nln.
m.n'h. .hor do'o .f d.. 'h. unl... on ..I'''I.n I, era,,,.d I.y 110. h.rola,y .f R.v,"u" ' '
--,
mn,Nn" J'I~ 1, Jern'..Ann 'l'a.*Jllilr._ ___"r)l.O.lI 1d NIUVl.1.l.1a, p,,-
, . {NAMIH',,'" , I ^ljtlr~Ual
~~ '
tfllrri\; dull' oWllfI1llClIlI,dlllY III IIIII', dl'I'"0eH IIl1d HIII'O Ihlll he 10 1110 Jl,lt'vi vin~Q.\'/__~_,___ __u.._".,_~__.._~
" ' (HK{iCq A,m"" ~.tttl.\TEJ!, RTC,I '
~'I' tho 0"11111; 111' _~_~RQ,t!.~;J._J11,_'.J.1L\rner'___--"_"_H___~-' IlIle 1.I'Wliaf~t~~~6\~~F.gR!f8\9,'ftj'''lcUmbet'hnd-..GEl.
deoellsed, IIl1d Ihlll Ihll 11'1",10 IIr Ihe oolllle 'III' ollld decedelll, whll died 111\ ,~J1J.\P;l.I:L-~4Td'~l~L-- _ --.. uum____~__...__
Qllllollled (Or ihe aHHeto \lolod helllW IIl1d Ihlllllllllwllble deblH IIl1d \ledllCllllllo exeaoded Ihll fulr ",IIrkcI Vllluo ul' Ihll IIOHotH I\ml
lid I'OIllIIl)'lvalllu 'I'P\lIHfe' IlIhorll'\I\IIe Tnx IH dUo.
5waln.a~d '\lbmlb.d h.f.rom. " ,,". /' ',,' 1/ ,'. J
110. J~ day,.f"" v', M.L,",'ili.w.. 19 'I:L. .Ii" ri:L_1JLL~_u,,_'D_nr:L____,.._..~__w..;_~()~______~____,,_~
. .' ""T" '., . ~lJh. - s -. - ~., " 1- \&IONATUAIU I II TI. III
.. }'. '.' .... ,( : '. :f4'llrU CL:c- UMN J. "OVmf~, 11.lory Publlo "
TVP!.l AI..tl Y OnHlll$uloh, [."plrfl' ~vpl,~, 1902 OIjk1,tmlnt
R.al e,'attl p"" ,_ AsUnS hllmalfld Valuation
PH:'Dr~r'o~~I~: Y, (Altooh additional .hut. If'n,ulury) ~:I::' CAUTION
Trat1lf.tl P"arlptlon 01 A...' (Po not writ.
"In thl. II.
2 Shares - Atlantic Breeders cooperative $ 7.49 ,-fr.
9 Shares - Dauphin Deposit Trust Co. $ 252.00""-
3 Shares - cumberland Valle~ Coopera ti v~ $ 30.00 /
As s ociation
1
1974 Chevrolet Truck
V.ID.~; CCV144B172202
$2,850.00
-----~
TOTALS $3,139.48
.!3 1'a'1.~~
RIlPORT OFINIlURITANCIl1'AX AI'I'I\II1SllR
I, the ulldorslynod duly. nppohued IlIherllanlle Tax Appraloor 111 and for tho abllVeCI)Unty do (OOpooll'ully roportlhall. have
appraised, Iho real and pursollal proporty ao 'lIporlyd IlIlho fo,esol S "ohedule AI Ibe Vllh ,0001 I'orth "ppuoltll cach ,11011) III
tho la'~1 column 10 the rlsht, ,', '- ,'.... .' ) ", . ,
Datedl " 5 Qotoh/UL.lI179.. . - IINHRnlTANCU T~X PPOAIIURI --
Dun AHP PBDUCTIDH5 "m.un'
Not yr. o'C:lalm CI~lm.d
Nom. olPoy..
-
Amount ~PPIOYtd
'byR.gIII.r
1. Frank C. Egger 1. FUl'\eral Elxpense $1,636.00
Funeral Home
2. MoCrea & Davis, , 2'. Attorney's FeH3s $ 500.00
Attorneys
,
3. Jerry Ann Tarner., 3. Widow's exemption under $2,000,00
;"
widow 53121 PElF Code
TOT ALS
$4,136.00
IUWOll'l' OF 1'11I! liHCIISl'I!I1 01' WILLS
I. Iho IIl1de,"ISllod dilly efocled ItoslHlor of \VIIIH In alld fnrlhe nbove Cnllllll', dll reHpcclfllllY repmlIltnlI hllvo 1I111\wed
dodllcllnllM Itl tho I\Ill0Ulllo oel fnrth III Ihe IIhovc Mehedllle IIH clllhnod, oXeOpl whero ( havo .el I'nrth II Srolllor (1(,lellllll, all10llnl
In 1110 1001 Onllll,"11 In I hqlst:W,hle:",,s, r~lllor 1I(,loM.or 1111"'11111 r~l\ro'\t'll~t_IJ 0 II~,IIIIII V d,._~_~a~'ledllC,I,I,lI~ ','
Ilnle IIf ApllrllVlIl1 ~( ,l ,0,:,Jl)f)f 'J .,'. ,;>.~(, flVr
(Y:. W!IJ vI f~~v k IT:I \)'\f,k
~_!O-rX6 '/., 7 \\ \ r,.l "'i
ucc..n (6-611
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
____.________ .__~~_.__, ___....___,_,.'.....'m,__.._,_.,.~~___,......'_._'n_..._m. .......'r----..... '~...--...,--__"-n.._-. -. .~
"" . ,AE'.P..bJ.~g19.1! "DATIL "IIr,.\:,-.L't_jOf~&!
. .
TO THE PENNSYLVANIA DEPARTMENT OF REVENUEI
Application I, hereby made for consent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Ano'clatlon localed In Pennsylvanlal
*'
COMMONW~II~TH or peNN$Y~VIINIA
Of.PIIRTM~NT OP ReVeNUf.
BUREAU Of COUNTY CO~~ECTION$
lUoTEI 8 In dmrl~~~g ~:~~h~~sD:r.~~~~~~::"I~rr the number o{share's(cdf sto~~':'\~':"f;;;;-;;;;;~nt.ot
registered bonds, ,In ,(b), the name of the Issuing company and In (c) the class of stock or the stated Interest rate
" and maturity dat~ 01 registered bonds.) "
ISSUED ON ','111.1111 , and haVing P TOTAL MARKET VAIWEOF $ 268.0,0
'" (Do'.)
as of the date of death af the decedent,_-Robut II, "t..1I.' ' on llaroh 9r-19~-;---
, " , .. -(Romo 0' Oa..dan') (Do'. of d.a'h)
who was late of
R. Ddl-'--~-"'---N8W'ri-l1&
($tr." and Numb.,) (Po,' Offlo.)
-{1l111bel'land
. (County)
---PAr-----
(Sto'.)
'The ucurltles are registered as fallowsl,____..___.nobaJ:tJt~nl...T .
< (Nam~ ornnmot In which oerHf!catu aro ,Qgl.t,,,r.d)
"~
(1l'1.~ Ann 'l'aft\fl'-.----lhDJ1. Nll'lh:l.W'dl.F.t1-Wti;'. ---;-~-
NAME OF APPLICANT --,JIlU)'--Allu T,arni!lr .-___.____
COUNTY FILE NUMBERU~7'H24-._.~ ADDRESS 'OF APPLICANT .....Jl...n..,lll. IolAwv.' 'A.--RA-,l12.It1._u_.
BUREAU FILE,NUMBER , " ,SIGNATURE,OF APPLICANT C2LA--'kw.l/"-- :;:~~ ---
HOTlCEI IF YOU FAIL TO PROPERLY FILL IH ANY PORTION OF THIS APPt:lC~T1tfN, lTWILL HOT Bll
CONSIDERED COMPLETBANP WILL BE RETURNED TO YOU FOR COMPLETION, .
----_.-...-"---~_._._-_.-.-.-:........~_.__.-.~----'---~_..~._._....;;,...~-
COMMONWEAL TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE,\\
. . OONSENTTO TRANSFER SECURITIES DAT~h_..L2.Lqdj)
; I hereby consent to the transfer of the abovo sec~lrltlos now registered In the name of the afqresald
Decedent and Naive the filing of a certiflca.te certifying to the payment of tke Iransfer Inheritance tal< to which
the property of laid Decedent Is mode sublect pursuant to the provisions of tho Act of June 20, 1919, P.L. 521,
I ",
as amended Clnd the AQt of J~?e 15, 1961, P,L. 373, as amended, This Is also In accordance with Ih~ pro,vlslons
qf the Act of Apr119,i929, P.L. 343.
This Canaent to Transfer the herein descrlbed,property operates only In reference to the oslute af'the
,abov..named Decedent,
.
s'U1kor t~e Secretary of Revenue ' ,
B~' ,J 11!tJtJ;,]1JLcltY.~~~.,,~._~
" ($lpnf'uro) c. ~
(x()~\,~l;.. j~Qf(, -,~ \g,u,)\t!I"J~,"" . :<k-,y '\0 ~tQ
'. \II(Tltle) \J { (Coun'y) .