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Jain~~ Held Property
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Value,
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Translers within TWO YEARS Prior to Death
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Thatal the time ordealh there was no safe deposit box registered in decedent's individual name, or jointly with, Of <lS agent or deputy of
another, or in decedent's individual name, wilh right of access by another as agent or deputy, with Iheexceplion of the following:-
._~_.. - --_on ____ .~__._._~_.__ __. .__ ___."
.~___. .__. -'0.' _______.. _____ .~__.._ .__... _____
NAME AND ADDIlESS OF HANK Oil OTHEIl INSTITUTION
IN W!lICII DECEDENT IlENTEIl A SAFE DEI'OSIT HOX
"'l~-:=~~-------
TIlfS SAFE DEI'OSIT BOX IlENTED
IN NAME Oil NAMES OF
IlELATIONS!lII' OF JOINT
1I0LllEllS TO llECf:IJENT
------ - ~
---------- ---
BENEFICIARIES
SIIII V!VEIJ AGE OF LIFE
DECEJlf:NT TENANTS OIl
ANNIIITANTS
STATE YES AT Ilf:ATII OF
011 NO
forlh this facl.) DECEDENT
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BE:-OEFICIAIlIES AND ADDIIESSES
(Slale full narnc:s of all 31lt1lhdr addrc'sSt'li who havl' an in-
ttrellt. YtJited, cotltil~('ul or ollHTWiS4::, illl'slalt~.)
I1EI.A TIONSIIII'
(If sh'p-childn:1l Of
illegitimate: ('hildn:n
arc'iuyulvl'd,st'l
INTEIlEST OF
llENEFICIAIl Y
IN ESTATE
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2555
ACCOUNT NO.
MIMO EARNING' WITHD.....WAL. IlAVINa, ....I.....Ncr;
OATI DIVIDEND ADDlI:D
.0.11-78 *7,10Z51l **7,10251t
07/1'1/78 .0 .0 2601.0 '1703. 3 'A1
9/13/78 .00 1950.00 .00 7753.63 A1
9/30178 105.67 .00 .00 785'1.30 A1
1/20/78 .00 500.00 .00 735'1.30 A1
2/21179 .00 600.00 .00 6759.30 Ai
/31/7'1 '95.87 .00 .00 6855.17 A2
3/31179 00.00 .00 .00 6955.17 A2
4/0217'1 .00 500.00 .00 6455.17 A2
5/25179 .00 1500.00 .00 4'155.17 A1
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THIS PASSBOOK IS YOUR RECEIPT.
PRESENT IT rOR EACH TRANSACTION.
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EDNA P. HARGEST <,
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EDNA P. HAH~EST 6.112 n
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REV"484 {8.181
County, Humber and Name
File Number 21-79-0707
Dete el Death OS/21/71...___.____.______
21 - Cumberland
SUMMARY
E.tate Name HARGES'r I
(LAST NAM1)
_ Edl!!'__________.P..!-.
(nR~;t tJ^MI'1 (INITIAl.)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
REPORT OF INHERI1 ANCE TAX APPRAISER
I, the undenigned duly appointed Inheritance Tax Apprai.er in ond lur tho County 01._ Cumberland
Penn'ylyania, do respectfully report that I have apprai,ed tho real and personal property o. reported in the 10rlJuoing return at
the voiue, set forth appo,ite each item in the la.t column to the riUht in Schedule. "A", "B", "C", ond "E",
Dated:
January 3. 1980
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Ir~Ht.HIT^tI':t' l.\X id'PKII.I,>LIl
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REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect.
fully report that I have allowed deductions in the amounts claimed by deponent, except as to tho!>e items where a greater or
lesser amount is set forth in the last column to the right in 5chedulc IlF", which greoter or lesser amount represents the sum
allowed as a deduction.
Doled:
HLG1STEI~ OF WILLS
INVENTORV
VALUE AS APPRAISED
$ None
712
None
None
1 2
AOJUSTMENTS
ODE (HARRISBURG USE ONL VI
00+
1(}t
2(}t
3(}t
,
IlEMAINDER APPRAISEMENT CODE
92+
Real Property (Schedule A)
Personal Proporty (Schedule B)
Joint-Held Property (Schedule El
Transfors (Schedule C)
TOTAL GROSS ASSETS
Less Oebts tJnd Deductions
(SCHEDULE FI
CLEAR VALUE OF ESTATE
93.
40.
Valuation of life estates or
onnuitle s.....................- S
PRINCIPLE
r:ACTOR
VALUE
~
ESTATE TAX ASSESSMENTS _ S
t=
~
\=
$
$.
~
2% $
6% $
15% $
$
$
S
t=
$
S
-1:=
$
COMPUTATION OF TAX
$=
E (') A, ovldeneed by Chorltable
Exemption Cortlflcates Issued
by the Secretary of Rovenue.
FOR USE OF REGISTER ONLY
Tax on ~
Talt on $
Tax on $
Tax on $
Tax on $
Exemptions
T otol Estate
TOTAL TAX
Leu tax previously paid
BALANCE
Less 5% af tox if paid within
3 months after dcoth
$
S
$
BALANCE OF INHERITANCE TAX OUE
Add intr:rost at rote of 6% from
___10
AMOUNT OF ESTATE TAX ASSES5ED
Estate loX paid
J=
Add intetest at rate of 6% from
to
TOTAL TAX BALANCE $
PAID S
L-
I
1-
,
BALANCE DUE
Supplemental Code.: (FOR IlSE IN HARRISBURG ONL Y)
48_Adiu.tment
49+Adfu.tment
56_Annuity
6O-Life E.tate
92+Remoinder Appraisal
93-Remainder Deduction
93C-Chority
94_Rcmaindcr Reiidue
96_Succcssive
Life E!>totc
FOR USE OF REGISTER ONI.Y
ADJUSTMEIHS
HOTE: Where subsequent adjustments are made to the above computation of tox by the Register of Wills for proper reason,
s.ome should be noted below, .....ith short explanotiofl. '
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REV-4ee la-al
, ;
DEDUCTIONS ALLOWED IN
THE SUM OF S /01 \7 (, '~
OAf! APp,ROVED\\ ~"'\ I~ I? f'rJ
'_ \ q _(;1 \ - /
(:\ \ .....::. ~'Y ,-/1 "-'tV
{X)~ "/', ~EO'STER OF WILLS, AGENT
OFF ICE OF THE
REGISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS
OF COUNTY
AND AGENT OF THE COMMONWEALTH
ESTATE OF (<j-iJ;l/)(. j/J&,) ,0 LATE OF 0/ //'J/!J!"'('
~ Ie v",
,llf}? J/, /'" ~
DATE OF FILING APPRAISEME~ 1_"'" -'I. 7'(;:7... DATE OF DEATH
,V, /?
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DATE
NO. OF
VOUCHER
NAME OF PAVEE
;:;11c;jl~
G/t(,/71
5j1,17Q
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IP!Q/71
bdb 70
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b(?-f 71
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fol&fl79
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121 ,I'. ff>'I1JF,;?@71/J
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REMARKS
AMOUNT
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~71 1'1;
COMMOHWEAL TH I P PENNSYLvANIA I
SS:
COUNTY OF ! ;"
I, /~c.k. ~ ______ HEREBY CERTIFV, TIlAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT O~DE~BT" Fl1NER~'IEXPEHSES AND
EXPENSES OF ADMINISTRATION SUBMITTEO TO THE ESTATE OF ~ r, --~--~-. -
DECEASED, AS DEDUCTIONS FOR INHERITAtlCE TAX PURPOSES. / /(:lIJ J /
~;Js:JdU~.A~~ _ (L.S.)
~WO~ A.ND SUBSCRIBED BEFORE ME THIS c;/l4f OAY OF
_(,,))zIH.Jv 0 19Jj
_ I",,-}nl) (! rJL,...1f -
DEBORAH A. DOll, Notary Public
Swa'ilJ,J Towr,S~lip. DalJphm County, PA
My (.lmliil,s~.u:l h;'lft.lS Mdj' J, 1982
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
TO: ~\, C.J'
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COUNTY..~' .Jv l.J..'J,t..'i '/'1/(. .,/
DATE OF DEATH_::~]y\~ Oi /
ESTATE
COUNTY FILE NO:
;~ / - r) (:_ 'J I) ')
DATE
FILE NO.
C'
Iy ') (i
.
1\) 0/1
Appraisod Value of Estate:
Real Estate
Personal Property
$
+ '7 I '!-d).. . Lf."6'
'-
+
$ y, I L/.)I ~f ('
/. C; '1(". ~ Y
,
$ !) / 0 ~, ~o
Jointly Held PropertylTransfers
Total Gross Estate
Total Approved Deductions
Clear Value of Estate
---
Less; Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$ .1;;- 1 6~1 ~O
-
Amount Ta,able @ 6% Rate
$ S/ C"b, ),U
tax due
$ :3 01. q 7
Amount Taxable @ 15% Rale
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
309.97
111' * * . 111 * A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAlO
DISCOUNT
INTEREST
TAX CREDIT
$
+ $
$
= $
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
10 date of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX 0
5('0 Inlormalion con Aeverse SIde
.INFORMATION
To insure proper credit to your account, lhe name 01 thu eSlate and file number should bu clearly print-
ed on the check or money order.
This assessment is made in accordanco with Sectlon 708 of tho Inheritanco and Estate Tax Act of
1961 172 P.S, ~ 2485.7081,
To the extent that inheritance tax is paid within throo (3) months after the demh of Iho decedenl, a
discount 01 five 15) percent is allowed 172 P,S. ~ 2485.7161.
Inheritance Tax, other than tax on a future interest, is due 01 the date of tho decedent's death ond becomes
delinquent at the expiration of nine (9) months alter the decedent's death (72 P,S, 9 2485-711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer lakes effect in possession and
enjoyment and is delinquent there\lfter 02 P.S. S 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
------------------------------- --- ------------- - - --- - --- --- ----- -- -- -- -----
, 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 .00186 21 days .00352
2 days ,00034 12 days .00203 n days .00369
3 days .00051 13 days .oono 23 days .00386
4 days ,00068 14 days ,00237 24 days .00403
5 days .00085 15 days .00250 25 days ,00420
6 days .00101 16 days .00267 26 days .00437
7 days .00118 17 days .00284 27 days .00454
8 days .00135 '8 days ,00301 28 days .00471
9 days .00162 19 days .00318 29 days .00488
l0days .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 after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Ta. Act of 1961 (72 P,S. ~ 2485.10011.
Make check or money order payable to:
"Regisler of Wills. Agent"
Mall to the address listed below:
..-ca. v---- r=..__ JIIL;L r.uo __..",. __ L.&...___..:>I::Z..... 1 ":"1.,,-
.~:>RI:<;..lt1/78)', ", '
111:;<,!e,.' .. '.... . COMMONWEALTH OF PENNSYLVANIA .
NOJ034321 DEPARTMENT OF REVENUE
a'if':':",. < ' , 'OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
If' .
; RECEIVED-------------
II
= From.
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W. L. Schumacher
THREE HUNDRED-NINE /I: 97(100 _ _________________dallars
rep esenling Pennsylvania InherItance or
Eslole Tax due from tho following estate:
~ ~dress 353 Blaeksm1 tll Road---- 2 t7, TolC on $
M Camp Hill. Pel1:R&. 17011 6% Tax on $
File No. 21-79-791 Date 0' Death 5 21 1919- 15'1" Tax on $
Dale of Payment
JaOQary 28, 1980
% Tax on 5
Estate Tax, Act of
May 7. 1927
$
$
$
$ ~
$
$ 3e~.~r
$
Nome a' Deeedenr -EDNA P. HI.RGE~T
Counly
Gl.IIIlIlerland
TOTAL TAX CREDIT
Less five percenlum of tox if
paid within three months after
dare of death
Plus Interest at the rate of
_%lrom
to
$
Remarks:
"PAID IN FULL"
IJOO~~lL~@illlJ~ SEA L
TOTAL AMOUNT PAID
$
~-91
NOTE: This Triplicate Receipt to be retllined for audit purpol's.
.'-.
Received by
NOTE: In occepllng the Iransler lnherilance 10_ on fulure e~talos, prior 10 Ihe death of Ihe lile
lenanl or lenant lor yearl, 05 oyldenced by Ihi5 receipt, il is understood Ihol Ihe Commonwealth shall
I nol be precluded or preyentod from hereafter aueuing addilional inherllance ta_ 01 the dealh 01 the
IIfo lononl or lenonl for year5 whenever II oppears thaI luch addilianal ta~ may be legally due and
collecUblolar any re050n whatsoever.
I
"
INFORM~lQhL
To insure proper credit to your account, till! nanlC of thu e5lOtc and IlIe nurnbtlr should he clumly print.
cd on tho check or monoy ordor.
This assossmont is l1lado in ar.:cCHdmlCIJ with Section l08 of the Inhcrllllnco llod Estate Tall. Act of
1961 (72 P.S. 9 2485-7081,
To tho extent that inheritance tax is pllid within thrtlc (3) months alter the death of tho decodent. B
discount of five (5) percent IS allowed In P.S. 3 2485.71Gj.
Inheritance Tax, other than tax on a futuro mtcrest, i~ due at the date of the decedent's dealh and becomes
delinquent at the expiration of mno (9) month~ alloT tlw dccedl!nl'S deuth (72 P.S 9 2485.711) Inheritanco
Tax on a future interest IS payable within ttHeu (3) manilla after the transfer takes effect III possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485-7121. Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment uSing the following intr.Hcst wole:
------------ ------------------- --- --------------- - - --- -- -- --- -- - ----- -- -- -- - -- --
, month .005 4 rnonths ,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 .00186 21 days .00352
2 days ,00034 12 days .00203 22 days .00369
3 days .00051 13 days ,00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days ,00085 15 days ,00250 25 days .00420
6 days .00101 16 days .00267 26 days ,00437
7 days ,0011 8 17 days ,00264 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 days ,00318 29 days ,00488
10 days ,00169 20 days .00335 30 days ,00500
-- - --- -------- ------- - - - - - -- - - - -- -- - - - --- - - - --- -- - - - - - - --------- --- --..
Any party in interes~, including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (60) days [Ifwr receipt Qf thiS Notice as provided by See lion
1001 of the Inheritance and Estate Tax Act of 1961 (72 P,S, ~ 2485.1001)
Make check or money order payable to:
"Register of Wills. Agent"
Mail to tile address listed below: