HomeMy WebLinkAbout80-00047
,
.
~ :
/
,
~ .
e;
~
~
a fil.
I ~.
~ ~;
s
~ l:Q,
I .
= I:)
~ U,l
(....1. e
~';..(1 I:) ,
..
:i
'&
,8
I~
UI
e
co
.
-
N
.
,{
RCC-l03 (3-73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
INHEl1lTANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
i - .2. 'I--f(l
*'
COUNTY OF CUMBERLAND
Thill: return must bo conlplotod ill dolllil and filoJ in duplicOI'J, with 1111.' R"~li""H of Wills in tho County whoro tho docedont rosided within nino
months aftor doto of doath, unless on cltlunsion is gronlml hy thl! Sor.II~lary d Rn....onuo.
--rI _._.n__._.___.
;.' t'/ \ ." (
1.__:.C!\KQkJl,.J,PNGfiI!AVI.- __.__.._....,,;1.9 Circle Dr. Camp Hill... Pa 17011
IrJM\l-1 IAODflF551
Will d /-go-'/l
Admn. No. 19_
Misc.
being. duly sWnrllllCl'ordil1~ III law, dl'I10Sl'S ami says lhal hl' is thL' _~~~_ga~_~~_________._______~___.___._____
.1:'t.1,(" ADM., LEGATEE, eTc.l
or the eslale or KE~~~'fJLLONGSHA\,
laic "r._~9. _Cifc,.le-J2G__.(;.Q!!!p.lllll, tQ..170.1l
IClTY, UOHOUC'ot-l. OR TOWNSHIPI
deceased, and that the whole IIf the ~:Slil(C nl" said decedent. who dil'd till Augus_t .~-,~JV}9___._~~_.-_._--
lDATEl
cOllsiSlt:d of tht: i1ssds listed hdow and thaI allll\\iihh: ddlls and deductions e\l:eeJed lhc fnir markcl value Ill' the assets and
no Pennsylvania Transfer Inheritalll.:c Ta, is due,
Sworn and subscrib6d before me
,If I,!" ' "J;'
thef-r--- day Ol,"I.ll'l_r-,,
( I . V:
l_,,',,-'" ,'/.' ,)-I\^"-I\,'
'" I
/', '(, \
'- .' ", ~
19 1-9",. CAl',o.1.Jh.. LO~G~10W~
/ A~!)!T"0"' r!l:'~I:!r"':'-ll, l-l-l"'1 !'lQ!l1rc-<;lGNf\.TUREl
1~,~,,__,,-,...I"""II',.,r-,"
Type of Auet:
Real estate, Pen.
Property, Jointly
Held Prop. at
Transfers
"~ 'J.c. r ..',I..!,
My CClr,-,~,~i:iJ~ :-:.;.i;,:; ii;"'I. 21,19:;...
ASSETS
(Alloch additionol sheets if necessary)
Oescfiption of Asset
Personal propert
1974 Catalina Pontiac (2 door sedan)
Pa State Employees Credit Union Acctn0038l22092
Surv~vin~_~pouse
( TITLE)
Estimated
Market
Value
Department
Valuation
CAUTION
(De not write
in thi.. ce)
$ 1,395.00
82.63
1,477.63 tip 11.r..,J
REPORT OF INHERITANCE '(',\X APPRAISER .."V I(
I, the undersigncd duly appoinled Inhcritanl.:e Tax Allpraiscr in ami fur lhe above County do respcctfully report that I have
appraised the real and personal propcrty as reported in the foregoing schedule althc \'alucs sct forth opposite each item in
the last column to the right. (1/'1', I., "IS" /." J'!
,< 1 6 1(1('> ~- b::J..!i.L!.;;J.t"~rj'tl /
Dated: !.nrc 1 . JoG riNHERIT M.n: T AX APPRAISER)
Name af Poyee
Myers-Hall Funeral Home
Oak Grove Cemetery
Fall River, Mass.
Register of Hills
Allegheny Airlines
Lewis C. Buffington, Jr.
Dr. S. D. Bharucha. M.D.
Neurological Surgery, Ltd.
Household bills as
Bell of Pa
Penn Central Oil
Carol D. Longshaw
Penn Dot
of 8/9/7\
Company
TOTALS
DEBTS AND DEOUCTIONS
Nature of Claim
Funeral Services
Grave & Internment & Care
Filing Fee
Transportation to Burial (Family)
Attorney Fee
Anethesist Harrisburg Hospital
Surgery & Medical Care
Telephone Bill
Heating Oil Bill
family exemption
Automobile Title
to surviving spouse
Transfer
TOTALS
Amount Amount Apploved
Claimed by Registef
$ 556.00
280.00
3.00
157.00
50.00
35.00
956.00
49.87
61. 79
2,000.00
4,15'.66
RFPORT OF THF IlEGISTER OF WILLS
I, the undcrsigncd duly t:lccled Rc!;i~ter of Wills in and for lhe ahove ('ounty. tin respectfully repnrl that I have allowed
deductions inlhe allHlllllh set forth in the ahove ~l'hedulc as claimed, CXCL'IH where I havc sct forth a greater or lesser amount
in Ihe last culumn ,1I,lllle ri!;hl. \\hidl gl'e.ll\:.' IIr lesser al1111ul11 reprcscnls the Sl,'t :\IIO\f"d as ~ dedu<linll, . ,;:D
. \) /. I'l \'" -~) r ~ j' ~. . J,. \, / ':J
IJale"I Apl'roval: 7('.' v_"', L ....',,,. r, 'yr'.]f"'" ~.
}i )~., t "-(i i,\ I\~
'., \\f\t.\.:v) Nll,\~j,tJ;~\ Co, VJ l~ I
;' /
/ /