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Invenlory of the reol ond po"onol o.Ioto of
CARQ.!, YN_~.,_ADl\_/o1S ,___._.___ doceosed.
- _...u._..._._________..__..__. --,-
..----------..--- -
REAL PROPERTY:
None
PERSONAL PROPERTY:
1975 Chevrolet Monte Carlo, Coupe
$3,000 00
Founders Growth Fund, Account G29208
590 00
TOTAL
$3,590 00
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
_KJ;:NNE;'rJLE. ADAMS.._
being duly sworn .._..__ according to law, doposes and says that he .......is tll.~__... ___
_.___h.\l)?.p!'!c!)!;!"_. _Hum ..__._ ._.. of tho '€ttlf~=m deceased
late of _._. .. Mechanicsburg '___'__ ___, Cumberland County, Pa., deceased and that the
within is an inventory made by .._.._J.1.!.m..,____.m ___ ___...._, the said husband
of the entire estate of said decedent, consisting of all the personal prop.rty and real estate, except real estate outside
the Commonwealth of Pennsylvania. and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
Sworn to
and subscribed before me,
~~~ek-'& ~
....HtSB~"'Bm_. T-e::..-.:,....
___~.8 Robin Court
this y,,'1/dav of 6?<Lt..-, 19 79
t: /..vt /X~~.
NOTARY F:JBLIC
._.l1.echanicsburq, Pennsylvania 17055
Address
Date of Death
16th
D.y
December
Month
1978
YUt
INSTRUCTIONS
I. An inventory must be filed within three months after appeintment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Artic!e IV. Fiduciaries Act of 1949.
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RESIDENT DECEDENT
DEBTS AND DEDUCTIONS CLAIMED
NOTE: Lilt first five items in the spaces 80 provided, observe notations thereon, and instructions.
DEBT OR CLAIM NATURE OF SAM.E__..__ AMOUNT THIS COLUMN
-- !<EGlSTER ONLY
Musselman Fune~al !lome Funeral expenses paid . 2,106 20 $
-----
Kenneth E Adams Family exemption (will not be allowed unless I
---d decedent died l'esidinK with n spouse or children,) 2 000 )0
Administration ExpemlCs . -"
Counsel fees' I
Fiduci~ry commission'
OTHER DEBTS AND CLAIMS
(') See Note below
Rolling Green Cemetery Burial Lot 300 0
Rolling Green Cemetery Marker for Grave 575 0
I
Register of wills Filing Inventory and
Debts and Deductions 9 0
RESERVED TO PAY: I
I I
Register of wills Filing Petition for
Sma 11 Estate 10 0
Total $ 5.000 20
Note: The estate ag1".~es to advise the Register of Wills if the amount actually paid in settlement of any fee, commission or debt is greater
01' leas than the estimated amount claimed and allowed,
flubsCI'ibed and sworn to before me this". ..r.~:>. -:f. f:... '" . ..
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(Strett Number)
....... .."C-...~~:ay/J::':~""'" ..197~.
........,.,.,...,...,..,..,..,...,......,.,.".".....,. ..'~'.;Ajlic
NOTARY PUBT,IC. . ... 'c.d Co., Po.
i,',>, C'!;" :.iiC: l:n, 18. 1982
........ .~l~".I)AI;lA".1?!:!\l.x:g.,. .'f?1~..............
(City or Town and State)
--.----..-.-- _.------~.
-----------.---------------------
Having been duly sworn according to law, I do hereby certify that th€ above appl'aisement is made in confol'mity with law on this
, . . . . , , , . . , , . , . . . , . . . , . . . . . . . . . . . . day of . . , . . . . . . . , . . . , . . . . . , . . . . . . , . . . . . . . . . . . . . . , . . 'I 19, . . . ,
......,.....,..........,..........".,..... ..........'""...
Apprailltr
In the event that any future interest in this estate is lI'ansferred in possession 01' enjoyment to ('ollatel'al heirs of the decedent aftel' the
expiration of any estate fol' life 01' for yean,the Commonwealth hereby (>xpressly reserves the right to appl'aise and assess transfer'inheri.
taflce taxes at the lawful collatel'al I'ate on any such future interest.
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills irl and for. . . . . . . , . . . . . . . , , . . . , . . . . . . . . . . . , . .. County, Penns)'lvania, do respectfully
report that I have allowed debts and deductions in the amounts claimed by deponent, except as ta tholle items where a greater or lesser amount
i. Ht. forth in the last column to the right in said schedule above, which greater or lesser amount represents the sum aUov,.td as a deduction.
D.tod: .............................................
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REV..464 (6"al
County, Humber and Home 21 - Cumber1nnd
File Humber 21-79-0667
Dote 01 De.th 12/ 16/78
Estate Name ADAHS, _~~_:',~~~'~__._~___~
SUMMARY
{LA5T NAME)
(f'lflt.l N^MrJ
(lNIIIM.1
COMMONWEAL TH OF PENNSYLVANIA
TllMISFER INHERITANCE TAX
RESIDENT DECEDENT
REPORT OF IHHERIl ANCE TAX AP Pf<AI SER
I, the undenignod duly appointed Inheritance Tax Appraiser in ond ior the County of Cumbcrl,'l.lld
Penn'ylvonia, do respectfully report that I hove appraised the real alld personal property al> reported in the foregoing return at
the values set forth oppl'Jsltc each item in the la5t column to the right in Schodules. II A", liB", "C", and IIE".
D.ted:_ January 3, 1980
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It~Ht.r'11ANC~ I/'A ;,PI'HAI"I"
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and far County, Pennsylvania, do resped-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule IIF", which greater or lesser amount represents the sum
allowed as a deduction.
D.led:
RcGI5TEli OF WIl.LS
S
None
3 590 00
None
None
o 00
ADJUSTMENTS
ODE (HARRISBURG USE ONL VI
00+
10+
20+
30+
REMAINDER APPRAISEMENT COOE
92+
INVENTORY
Real Property {Schedule AI
Personal Praporty (Schedule BJ
Jaint.Held Property (Schedule El
Transfors (Schedule C)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE Fl
CLEAR VALUE OF ESTATE
VALUE AS APPRAISED
4(}.
93-
annuitIes. .... ........... ....._ S
Valuation olllfe estates or
,.
-"'-
PRINC1Pl-'=-
~ACTOR
VALUE
~
1=
ESTATE TAX ASSESSMENTS _ S
~
~
FOR USE OF REGISTER ONL..Y
Tax on S
TaxonS'
Tax on $
Tax on S
Tax on $
Exemptions
Total E!itote
~
COMPUTATION OF TAX
2%
6%
5
5
5
5
5
15%
TOTAL TAX
5
(') As ~vldenced by Charitable
Exemption CtlrtHic:otes Issued
by the Secretory of Revenue.
5
t=
Less tax previously paid
aALANCE
Less 5% of tax if paId within
3 months after deatn
S
5
BALAI~CE 01' INHERITANCE TAX DUE
Add interost at rate of 6% from
10 _
AMOUNT OF ESTATE TAX ASSESSEO
Estate tax paid
s
s
c
5 r
5
S t
5
5
S
BALANCE DUE
Add interest at rote of 6% from
'0
TOTAL TAX aALANCE
PAID
Supplemont.1 Code.: (fOR USE iH HARRISBURG OHL Yl
4B-Adiuolment
49+Adj'uolment
56-Annuity
6O-Lile Eot.te
92+Rem.inder Appr.io.1
93_Rem.inder Deducti.n
93C-Chorily
94-Remaindcr Reiiduc
96-Successi ve
Life Eot.t.
FOR USE OF REGISTER OHLY
ADJUSTMEHTS
HOTE: Where subsequent adjustments ore made to fhe above computation of tax by the Register of Wills for proper reason
same ,hould be noted below, with short explanation.. "
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~EV,457 (IJ.781
DEPARTMENT OF REVENUE
aUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISaURG. PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHl:nITA~JCE TAX
APPRAISEMENT
January 3. 1980
DATE
COUNT'( _ Cumbct:!~~..~l.
mE NO. ..1l:: 79-0667 _...
Whereas, C~:rolyn S. Ad;:qns _~ lat(~ of Ilcchnuic!iburg ___'
in the County of Cumbcrlr.nd __ CI)mrnol1'.,vca!th of Pennsylvania, h,jl/i,1fli_::
the 16th day of Decemuer _ I 9 ~, c;oi7.ed and possessr'cj 0: .", ' ....
subject to Inheritance Tax under tho laws of the Cornmollvll\,llh of J'L'IlIi::ylvdllia;
Therefore, I, GIOl'i:: J. Iticlll,rcl . an dpprdi"e' duly appointed ace(ml;,,'! (
having been designated to lllake a fair and conscionable app,oi,",rnc"1 "I' '.he silid 1":litle, and to assess and fiy ",
value of all annuities and life estates growing out of said ":;tatc, hereby file the following appraisement:
In the event Ihill ,lny hllulO ll\tl!to~111I Ihl~H~t,'ltll~ tr,lll~ftll[l'(J III p'J~~('~~i'oIl or 01\1"','1"0"1\1 \0 1:'111.,t'!f,11 II'!IfS 01 ttll! dl!cl!dl!llt "!tr~T :h' ,', ,.
o1.Jny estate for ilia or for Y!.liHS, the Cnmmoll\'/{!,llth lroll.:lJy U)(rlrIIHI'lllh(,HJ"~ II'" 1''1111 I" ,111\)[,11'". .wll i1~~'''~~ tlall~'I)1 jllhc:nlallc': IolxuS ;111/\( :.1:,
~to on ..ny S\lcl1luturc Intelest.
. -.--..- -~--
()E~;CH1PTION OF 1\5~)rT UNIT . ,".1 '",'.
VALUeS I , 1,,'
- """,,,,.-..,-,,~ ..".'....
[(eal l'l'opcrty $ \
!Ionei
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J?crsonnl Property 31.590)
I
Joint-Held Property None:
- NonJ
Transfers
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,
-....--.-1
TOTAL ASSETS 3,590 !
1
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Have been duly sworn according to law. I do }wreny c",.1ify ihat
with the law on this 31'G day of
the above ,1\)nrili~cment is made in conic'ITt\ i '
.. J"nw,l'Y ] q ~c..
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/.\1\1'1;11',((
(f"ulnIWI "qd Stlcet)
Ik;rri$burg
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JNFORMATION
To insure proper credit to your account, the name 01 the estato anel filo number should be clearly print.
ed on tho check or money order,
This assessment is made in accordanco with Section 70B of the Inheritance and Estate Tal( Act of
1961 (72 P.S. 9 24B5-70B).
To the extent thar inheritance tax ;s paid wifhin three (3) monlhs after the death of the decedent, a
discount of five IS) percent IS allowed 172 P.S. S 24B5.716).
Inheritance Tax, other than tax on a future interest, is due at the date of the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P.S. S 2485.711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485.712). Calculate interest from thr: delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
------------------------------- --- ------------- - - --'- - ----------- -- -- -- --- --
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .015 6 months .030 9 months .045 12 months .060
1 days .00017 11 days .001B6 21 days .00352
2 days .00034 12 days .00203 22 dal(s .00369
3 days .00051 13 days .00220 23 days .003B6
4 days .0006B '4 days .00237 24 days .00403
5 days .OOOB5 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days .00437
7 days .0011S 17 days .00284 27 days .00454
8 days .00135 1 B days .00301 28 days .00471
9 days .00152 19 days .0031S 29 days .004BB
10 days .00169 20 days .00335 30 days .00500
-- ------------------- --- -- - - - - --- -- -- ---- -- ---- ---- - - - - --------- ------
Any party in interest, including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (60) days ahel receipt of this Notice as provided by Section
1001 of the Inheritance and Estate rax Act of 1961 (72 P.S. 9 24S5. 1 0011.
Make check or money order payable to:
"Register of Wills. Agent"
Mail to the address listed below:
Form RC C .10
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DEDUCTIONS ALl.OWED IN
OI"FICE 011' TM~
REGI9TER OF WILL9
STATEMENT OF DEBTS
AND DEDUCTIONS
;;- (J (: (I .7,0
THE SUM OF" S
DATE APPROVED )f~.n ) f:; I q' r-L)
---" \fuJL[LJi~{~)r~...a_-
^ Rlgllter 01 WIlIt, "Agp.llih ------
'\:\'C
o. Cumberland
COU NTV
AND AGENT orr THI COMMONweALTH
i .
ESTATE OF
CAROLYN
S. ADM1S
I'
\ '
I I ,
l....n: 01"
Mechanicsb'. rg "
DA.TP: NO. 01'" NAMli: OF PAYEE nEMARKliI AMOUNT
VOUCH""
Kenneth E. Adams Famil v Exemntion S2 000 00
Musselman -Funera.L Home, 2,106 20
1-8 79 Lemovne Funeral Exnenses
Rolling Green Cemetery Burial Plot 300 00
Rollina Green Cemetery Marker for Grave 575 00
Reaister of Wills Filing Inventory and 9 00
. . . 7.
RESERVED TO PAY:
F~l~ng Pet~t~on for
Reaister of wills Small Estate 10 00
-
TOTAL $ 5,000 ,20
DATE OF FILING APPAAIIi![MKNT
, fj' I~D^TIi or DEATH
December 16. 1978
COMMONWEA~TH OF PENNSY~V"NIA
COUNTY OF ~umberland
KENNETH E. ADAMS
}..,
V'Wl)"JlI;~ND,'U.-'CRIBID UFORE ME TH'I ,/.
U~.<,..y.,,-(-.4-' ~ I. ~
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,~
DA't 0'
Dli:CIAIID. Aa DEDUCTION. 'OR
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;- ''':=-~-~'(.I--601
==-------..'
KENNETH E. ADMIS
Co., Pa.
Ii,., ...i..';I..j.i~.;~'I, ";'i'" L:" JJn, IS, 1982
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