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HomeMy WebLinkAbout80-00065 "i~:'. ;.;.,10:';,_, \" ~""" .~ "\~~/>.,:. ~'l.,;,.'-'." ~~~\t(, ,.... ,~:"', ;. .,',.: i....-. :c' . I~," . "i It:l {O '-J':" ,',.", < o 00. . - ',C'4 i ,( " r. ~ ~ I . ~ l , ~ , , : : , , , p., a ~ I ~'l!i o ;:' ~ 01 !i1: ~ lZl .. ! ~ '; a ~ No, ,21-80 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY . , , ~ <. i in the Estate of CHARLES G. BECKER , deceased. Harold B. McLane, Deputy To nid ,l\1 d C. A1'188fS8R, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania, IS Petitioner~) Q~Jthe execut rix named in the Last Will and Testament of CHARLES G. BECKER dated r~ay 23, 1971 . Decedent was a citizen of the United States and a resident of Township &roXlgb;xCumberland County, Commonwealth South Middleton of Pennsylvania. Decedent died on \~ednesday 10th day of October the A. D. 19 79 , in the County of Cumberland , State of Pennsylvania at the age of 93 years. xh~x ~x Xk~KX Decedent has not been married and has not had children born to him since the execution of the above described Will. Decedent was possessed of personal property to the value of , 5, unestimated and of real estate to the value of J, 0~a r s-/&' 7 none as near as can be ascertained; said real estate situated as follows xm~x Therefore, your petitioner(~) respectfully applies for the probate of the said Last Will and Testament and for Letters Testamentary thereon. Dated January 31, 1980 Name and address of Petitioner(s) () l~r' , 17 Y'u:ii ' ,I ~P77uJ 1\' DOROfY . TRIMMER R. D. 116 Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA} ss COUNTY OF CUMBERLAND DOROTHY M. TRIMMER named in above application, being duly say(s) that the statements set forth In sworn according to law this petition are true to the best of her knowledge and belief..- ~ \L1 III 1// _ .' .) and subscribed before .i J~~ /;7, //u~hr<U/ DOROT1. M. TRIMMER '~1 JT~\~c d,. _ I:e;:ty ~,~~J[, AR~~f~~~~egister SWOl"n Filed: February 1, 1980 d;)./-ftJ - &-J- /D- J{i~\- 7 Attorney: IRWIN, IRvlIN & IRWIN " \or 'last Dill anb ~tstamtnt I, CHARLES G. BECKER, of R. D. 6, Carlisle, Cumberland County, Pennsylvania, do make and publish this as and for my last will and testament, hereby revoking any and all wills heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease, 2. I authorize and empower my executrix to sell any realty and/ or personalty owned by me at my death, at either public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. 3. All the rest, residue and remainder of my property, real and personal, I give, devise and bequeath to my children, share and share alike. 4, I nominate and appoint Dorothy B. Trimmer to be the executri of this last will and testament without the filing of any bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Rhoda I. Stambaugh as substitute executrix with the same powers as are given herein to my executrix, and also with the filing of any bond. 5, I direct my personal representative to retain the services of Irwin, Irwin & Irwin, Carlisle, Pennsylvania, as attorneys in the settlement of my estate, WITNESS my hand and seal this 231 day of May, 1973. -G.dt(;,u~'I,6: /.1ecli,:/L// (SEAL) CHARLES G. BECKER Signed, sealed, published and declared by the within named testator, as and for his last will and testament, in our presence, who, at his request, and in his presence and in the presence of each other, have hereunto set our ~'r='"1blng :!J:""'. , ~vf .5; ,~ ~p,~ ,)' C\ 5 t4.J...r, OA TH OF NON-SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA l COUNTY OF CUMBERLAND j 55: This, the 31st day of January ~ Harold B. McLane, Deputy A. D. b~L, before me, Riel ,!I.!/ L. .~...!le, !!,.,.. Register for the Probate of Wills and Granting Letters of Administration in and for the county of Cumber- land, in the Commonwealth of Pennsylvania, personally come MARY S. IRWIN and HAROLD S. IRWIN, JR. who being duly sworn according to low deposed and say that they ore well acquainted with the handwriting of HAROLD S. IRWIN whose nome is attached as witness to an instrument of writing purported to be CHARLES G. BECKER the Last Will and Testament of late of South Middleton Township , deceased and that the said signature is true and genuine, and that the said HAROLD S. IRWIN is now deceased IDrXabsentxx 'Sworn nnd subscribed before me, thic 31st day of January A. D. 198~ Deputy Register per Deputy Register OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND ( . This....." .." ....,"",.......,,?~.~,~,. ..",....""., ,...,.,."..", day of, "" ,. '" ".,..." ,.'!.~!).,~~;I;.Y."..,....,..,"""',.,',.. A,D" 19"?g,,, Harold B. McLane Deputy before me R:<I.... J 1iJ, :mALl, .,1., itegister for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came .............. ROGER B. IRWIN, one of ................................................................................................................................................................................ the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and CHARLES G. BECKER May 23, 1973 Testamen t of ,'......,...., "..,....,.,...",.."...." ,..,........................",....", ,. ".,.."."",.... Dated ...."".."".".,....,..",...",...". late of ...,.~9.':l.~~,',!1,~,?~~,C;.~9,~,.~,?~!}.?h.~,p..'."..,"'",.,."""."....,..., .... ",. "." Cumberland County Pa., deceased h b. d I sworn d' I d dh he was w 0 emg u y .......................,........,.......... accor mg to aw, epose an say, t at ........................................ present, and saw and heard the testatRr..........................., .,..!1,I;!A~.~~.$...g,:...!?,J;:,9.!5.J;;!L.............................. sign, seal, publish, pronounce and declare the said instrument of writing as and for h,is........... Testament and Last Will, and at the time of so doing ..........,~~.................................,was of sound and disposing mind memory and understanding, to the best of .....,.,~,~,~...............................knowledge, observation and belief, .............~!1,9.r.I)...........,.....,.,.,.. and subscribed before '-1J.~!l3,'.}vJc~'"'-,........~=R.~=.r Rinkani If: \R ~on,"&:~~ter '--- !1-. 'J ".."...,.''R~~:..~w~,~~:...,..........,.,..,...". .................................................................................. .................................................................................. AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND ( DOROTHY M. TRIMMER . .......,.."",.., "..,......,'.."...... ,.,....,..,....."..""..............",.......""..",.,.,..,.,....,...,......,.."..,."""..,...""",...,.,...bemg duly ................................~:-!.'?,r.!},.... says t'-,at as nearly as can be ascertained the said decedent .......................... .,.....,."",.,...,..., 9.!:I.{\B);.,J;;~,.,9,:,.. ,I?F;!;,K~ 3",..",.."""""",.."",."."..,."..,..,..".",...."..""......".",."",.",.,..,.,." .died on ............W~,<;I,!1~.~,~!'!-,:t................ the ..........t9.~.h.............day of ,.,....,~.?,~:?,?~!:...........,................. A.D., 19.I~.., at or about .................~~,:,~~.............. o'clock, ~.:M. ..,.,....."..,.,...,...,..."..,...,S.WQX',O.."and subscribed this 31st January ................................................ day of ..,..................... 19, ~.9...., before ~~1.KR~}}7.~?7{L:'r~\,'=::!?:?,':.~~ ' Rn.lu,u.d. E. n....d""l~vlll Register 28'7 G ~ ,~ (If ~~ . . ..L:.I.:.&!.<-I!~1.".7;7......!.::z~<.7LZ.-;:??:~......,' :I OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l COUNTY OF CUMBERLAND f SS: Before me, the Register for the Prohate of Wills and granting of Letters of Administration in anil for the County of Cumberland, personally came ........~~,~~~.I,i,X,}!:..,:!:~,~.r~~~~.~....,.............................................. who, being duly ....R.~~Rr.X\............, do ..~,L, depose and say that !Is....'?,~!'!.9,\-!!i,r.t~.................,...................... , CHARLES G. BECKER of the last Will and Testament of ............................................,.....................,......................................deceased ..........~.J:\~........ will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances, .......~l'!,?,::.~.......... and subscribed before me. January 31 80 ........................................................ A, D., 19............ ~~~~B,:.JY.h~~~.~,~~.~~'! R Ii E.... .__u, RegIster ..,9.~~'~~m... .................................................................................. '''; 0: :Q.l CO, :~ Cll ~8 '1 :Q.l ;~ LL. N: 0 p::, (I): riI: =#:; Mj :.:: ltl 0 ....: >.1 --' riI '" l/J \D CQ 0 1-1: '-0 I --' ~ Itl' 0 ::::: ~: (I) - <:> ~ .' 1-1: I ~ U: ,!l: , ..... CIl e-o: ClJ: N riI ,5 1<1; r<.l 0' ..:t. 't:l D::: Q.l l.t'l: 00 0 .0:: 't:l :I:: ... 0'1: I Z 0 N: - 0; c..> =#:: N .2l ~ .5 ~ "" ~ 't:l Q.l Ul C ~ - .- r.:l .. r:.. DECREE Be it remembered that on the .........~.::~......... day of ..............,....~,7.?:7.~~.7.~.........., A. D" 19 ,?,R..., there was probated and recorded the last Will and Testament of ...9.~,~~~.~~...?,:....~~,~.~~.~................................., I f South Middleton . ateo .............,',......,.......,',...".."..",..."......"...,.,.,........, Cumberland County, Pennsylvama, Deceased. Letters ......, ................" ...'J:'~.~tmn!'l)').. t"U'.Y were granted to ."" ,)?,Q.!1Q.r.HX... 11,:..,1'3111)':1);,11...., .......,."...."...",................ Witness my hand and official seal the day and year aforesaid, J '_ --1>-~.j, (.fS..JJJ..i~'J,.....?.:~~.~~ t>:nl.n_~" A -~iJuR,.'negister. . . 20'8 ... 1:-' . . . . Inyentory 01 the real and personal e.tote 01 CHARLES G. BECKER deceased. Farmers Trust Co. - ck. acct. #4-0256-7 Prudentla1 Insurance Co. - Pol. #06-516-937 Swaim Health Center - Refund 7,016 18 2,617 02 560 00 TOTAL----------- 10,193 20 COMMONWEALTH 01' PENNSYLVANIA COUNTY 01' CUMBERLAND 55: uJl_o_:r.o.thy-M.- Trimmer ._ _._._- ---- u . . -'- u_ ---------- -----.-.- being duly _s.\'I.o.rn.__ _._ __ ._ according to law. deposes and says that s,e i:'l_~he -.-------.-- _e.x_e_Q.1,lja:i1>___._________ .____. __ .--- 01 the Estate 01 ...QIlatl.eJLJLJ.e..cJ<er lote 01 South Middleton Twsp. . Cumberland County, Pa., deceosed and thot tho within is an inyentory made by _.po.r9_t;Qy_M.o.. 'l'ri_mIll~_r_ ..-- - --.--, the ,aidexe.cut.riX- of tho entire estate of ,aid decedent, consisting 01 all the personal prop.rty and reo I eslote, except real estate outside the Commonwealth of Pennsylyania, and that the ligures opposite each item of the Inyentory represent it', fair yalue as of the date of decedent's death. Sworn and subscribed before me, 21 -d. (/) ,~ -l r,(J::_J./;1::r~wd _._R..JJ.~ F.e(Y\-o- I .' , /?2r~ 19 llo dtv--. Carlisle, PA 17013 ----- -"--- '" Addrou j- ~! ;..;. '.. :. j v . "." _..'....., .. . .'. ; . ...'~ Date of Death _.___..lllth.---- ______~.c.tDher_ Day Month 19-19 Yur INSTRUCTIONS I. An inyentory must b. filed within three months alter appointment of personal representatiye. 2. A supplement inyentory must be liled within thirty days 01 discoyery of additional assets. 3. Additional ,heets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. % ~ \~) ,\ \\ '~ \, d .,; "'- 10- ~ >- m I- I.U ~ ~ "-.,' I \ ~ '" I- H .. \:) I.U < ClJ " ~ Q" I- u 0 '" ~ ..:4 " m ~ 0 I.U I.U <:) ~ C '" '" :; ~, .. I- :r: Q" ClJ Q" ~ Z I- -' LL "'I .. ,'. -' < 0 Q" , LL 'I ~ 1\ w 0 < I.U .1 ,;. ~ '" J > z 01 ~ ~ , Z 0 c " C ~ .; I' '" z w, 0 " '" < ClJI d U ,,' I z I.U ... !\ Q" ~' cri -c HI I c ~ '\'\ m: - .. " I' II ,c' 0 -.: 'I' " c)' .D -, -" " E -c Ii ~ ..2 0 .. ~ 0 -' U u: CD REV-449 (8.78) COMMONWEALTH OF PENNSYLV ANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERAT;ONS ~--- ~ RE~IDENT DECEDENT COUNTY OF CUMBERLAND IMPORTANT: This return must he Cllnlrh!tcd in detail 311<..1 Well in duplicatl', wilh all utllldlCd. with the Register of Wills of the County where decedent resided; Return is dne within nine 1lI1l111hs artcl dult' lllllcilth. unless "" extension is gUlotcd by Ihe Sccrctury or Hl'\IC'IIUC. (Sn'liol\ 70:1 of lhe Inhr'r1lllllCC mill ESlnlc Tux Act or 1961.) IN TilE MATTER OF TilE ESTATE OF 1 AFFIIlA VIT OF --J EXECllTOR JtU:)ll~KXl'l)R County ..Ql.!.AR1ES G. BECKER . (STATE FULl. NAME OF Del..:l::uEr..IJ Lefe 01 r.lJmhpcl.a.nri Stato of Pennfly1v"ni" } n: County olCumberland Dorothv M. Trimmer ~~ii~K of tho ..Hllale of Ihll above-nomad decedent being duty sworn, depose Executor and laY Decedent died October lMONTHl Nom. and odd,e.. of aUorney or } other outhOtlzed ropr...ntotlve to whom 011 cOffu~ondenc. should bll moiled. 10 IDAYI 19 __7!:.LJ Icl'litate ImJvlng Q last will, copy or which Is herolo attached. } ~a4iiJ6*X IRIHN. 44 S. IRW.IlL.&~WTN Hanover Street. C8rliflle, PA 1701 '3 That as such executor deponent is familiar with the affairs of s.lid estate and the property constituting (EX ECUTO R~/lXlOOXtX~XOO<< the assets thereof and their fair market value. That at the time of death there was no safe deposit box reg.istered in deccdent's individual namc, or jointly with, or as agent or deputy of another. or in dect.~dcnl' s individual name, with right of access by another as agent or deputy, with the exception of the following: - NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX F rmer Tr t THIS SAFE DEPOSIT BOX RENTED IN NIoME OR NAMES OF RELATIONSHIP OF JOINT HOLiJERS TO DECEDENT That the contents of said safe deposit box or boxes are itemized under Schedules with the exception of the following, for the reasons hereinafter set forth: of this return, That Scheelule A attached hereto aod mode porI hereor <ets rorth rulll' and in detail all the roal property in the Commonwealth of Pennsylvania of which deccdent died having an interest therein. It also sets forth the mortgage encumbrances upon each parcel of real propcrty at the dale of death, giving the amount still due at death, name of mortgagec, date, rate of interest, and book and page of record thereuf. It also sets forth in the columns provided therefore the assessed valuation uf each of said parcels, the estimated market value thereof os or date nr death of deeeden.. That Scheaule 8 attached hereto anti made part hereof sct!t forth fully and in detail nil personal property whcrcsover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately lhe accrued interest thereon, if any, down to the last interest day prior to decedent's death in the case of ~avings banks, and to the date of decedent's u::lIlh in all other cases: all bonus, postal savings, treasury certificates or noles and other evidencc of indebtedness of the United States to tlte de- cedent; all obligations, whether by statute or agreement (hey arc dcsignated as tax free, of the United States, or nny state. or political subdivision thereof, or of any foreign country, which ar~ owned at the time of death: all wearing apparel, jewelry, silverware, pieturc!-i, books, works of art, household furniture, horses, carriages, automobiles, boats, and an)' and all other personal chattels of whatsoe"er kind or nr-ture, left by decedent, together with the fairly estimated market v~!~= thereofi all bonds and mortgages held by decedent nnd-of aU claims due and owing decedent at the time of death, and alt promissory notes or other instruments in writing for the payment of money of which decedent die.d possessed, of whatsoever nnture, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value. it sets forth briefly the reasons for such depreciation as to each item; nil moneys payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of (he decedent: all and the corporate Slacks and dividends due thereon nnd unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's death and other investment securities owned by the decedent at the time of death, with Ihe market value there- of at such time. In the cose ot' securitIeS 01' elos" or I'omlll' eorpaotlons, tin' yol",,. r''1,orted ore os I'or os 1,0sslhle subslontlote,1 by I'Inonel.1 st.flt"mcots 01' till' corpurfltlooS, showlog t.he flS5"',S .",rI 1I0hllltles tlwreof os 01' the rlote of deoth. The s"'...rlule 0150 set.S I'orth t.he Int.er,'st of dece,lent ot the t.Ime of deo.h In on)' co-portner"hlp or huslness, ","I In sUI'port. 01' tlw yolu" 01' such Inlerest t.here Is onnexed to solol scherlule, t'lnflllclfll st.otemellts showlllg theosSets flnel Ilohllltles or solrl eo-pllrtllershlp or huslness. ,\ eol'Y or th,' eo_pllrtnershlp ogre"m,"'t., (I I' orfll, 0 stlltem,'"t setUng I'ort.h t.he notllre of the nl\reement) together wi th II stotement settlllg I'o",h t.he cl.nl'flet.cr 01' the \IIISIt"'55, Its locotlon, ond sllch other I'oets p,'rtollllnl< to the hllslness liS mflY he I",rtlnent to fl I'olr on,1 .I"St npprolsol 01' t,hc rleeedent's Interest therelll mllsl he sllhmltted. It sholll<1 olso sd I'ort.h 10 Il<.mlzed rorm, together with the rolr mllrket. yollle thereof, Oil)' other property oWlle,1 or heqlleothed hy the decerleot ot the time of rleflth. The Scfopdu/e C ottocherl hereto 0,"1 mll,le I'ort hereof sets rorth 0 t.rue Ollswer t.o eoeh Inquiry eOlltolllerl therelll ondlnt.he easeol'tronsl'"rslll'prnp,,.t)', reol or I'ersollol, withIn two yeors of rlecedent's deoth, III contemplotloll of decedellt' s <Io,olh. or IIIt.en<le,1 to t..ke effeet III posse..lon or enjoymellt at or ofter deflth, sold schedllle sets furt.h the 1I0tllr" olld Vlllue or sueh propert.y, t.o whom t.rMSferred, the relotlonshlp of t.he trollsferees t.o t.he ,lece<l"nt, the proportlonol,e shflre reeelved by eoch tronsferee Md 011 other focts of 0 pertlucnt noture regorrllll!; slll<' tronsfers. In t.he eose or tronsfers Intende<1 to tnke efl'ect In I,ossesslon or enjo)''Ment ot or ofter ,Ieot.h, there Is olsn otl,oehe,l to the schedule 0 eony 01' the deed, trust ogreement or other lllstrument creotlng \,h" trllst. There Is 0150 set forth In sold schedule" list of nll property, reol olld personol, wi th Its volue, which po"sos at decedellt' 5 deotll by virtue of the exercise by decedellt, eltber Indlvldlllll1)', or .Iolntly with onother, or 11IlY power of appoint- ment vested In decedent, either Indlvlduol1)" or .Iolntly, hy the wll1, deed, or other instrnment of another, with II copy of the instrument creating suc!1 power nltRched to the schedule. That Scfoedv/e 0 ottoebed hereto and mllde port hereof sets rorth t.he names ond addresses of all persons benerleiOlly Interested In thiS estote Ill. the time 01' deeedent' s dellth, the nllture of their res- pectlye Interests, their relot.lonsblp, It' ony, to the decedent, tOl\ether wi th the oges ot tbe time of deeedent'S deoth of 011 minors, onnullllnts and benerlclories ror life uncler deeedent's Will. It olso contolns a stotement showing which of the benet'lclarles nomed In the decedent.' s will, If any, died prior to decedent, tbe dotes of their death, their Issue. Ill,d t.he relotlonshlp or sueh Issue to the benet'lelary. That Scfoedu/p E attaehed bereto ond mode 0 port hereof sets forth all property, reol ond per- sonal, owned by the decedent jointly with ouot.her or ot.hers, Inclndlng Intnnglble, standing In the nome or the decedent ond others, plus tbe dllte ond place or record of lustruments effecting the ,esuture of Teal estote and the dat.e of aequlsltlon or personalty, plus the nome, address .lId relatlonsblp, If MY, of co-owners to the decedent. Tbot ScMdv/e F ottached bereto ond mnde Il port bereaI' sets fort.h fully and in detail 011 debts ond deductions elnlmed for ond on bebolt' of thiS decedent'S estllte, Including funernl expenses pold; ramlly exemption, where applleohle; costs of odmlnlstrotlon of this estat.e; counsel fees and fudlelary's commlssloos I,ald or to be void; east expended for burlol trusts, tombstones or gravemorkers, ond reli- gioUS services, In can.e'luenee of the death or the decedent; debts ond clolms owing and unpaid ot time of deoth; taxes oeerued chargeable l'or period prIor t.o decedent's Ileath (except those allowed under Section 651 of tbe Inherltlll1ee nud Est.ote Tox ,\Ct); together wHh a stat.ement of collllterol pledged for obllgo- tions, If ony. It Is ogre cd thot tbe t'ldue\Ory will present proof of sold clolmed obligations upon re- quest., that If the amount octullUy pold In sel,tlement of any fee, commission or debt. Is lesS tbOn the estlmoted omount claiming and allowed, thot the same w111 1,e reported te t.he I\cglster of Wllls, and thot t.he amount of tax n5~csserl eM llc rcnsseSsp.d in accordlUlCC therewl tho Thllt the totols of the approprlote columns In Schedules ",I", "Il", "CO, "E". and "F" as dlreeted therein, have been co.rded forward nnd properl~' regist.ered in the SummnT)o'o :y )&,.~'/1 ,7~ .,.'.Vt::fi~~'!:fi~/f2f;;~;;;r"..'............,.._,........_- R...P.",.lI,.p...""."""......,........,.."..,....,..,....,..,....,........".."..,..,,_..,--_.. ( Street Number) Carlisle, PA 17013 . .... . ..,..'..(city ;;;:T~;;;~'~;;d's;t;;j ""......"..........,' Subscribed and sworn to before me this .........."..................... ........-........................... .." day of ,.&C~ ...... :.,J.z-I(~:/3- ~J ,I: c(i " .. .., ~:., ,...t..~":-:-' n! ",..19,,8.0,.. son:: lIel'ore sll\nlnl\ oft'ldovlt make sure all hlank spaces In lI,c arn,lavlt ond schedules onnexed are fllIe<1 In with details or the word "Sone", Il,,,1 In case the IOssets Illelllde rlOre IOnd ulIllsted securities, securities of elose or rnmlly corparatlous or on IIlt.erest III IOny co_pIOrtnershlp or busIness, thot the ,IoU. ond stlOt.emellts requlredullder the parlO~rlOplt IOhove re;"t1Il~ to Seh"dule 'II" ore IOttlOched. ,\Iso make certain tlll,t columll #1 In the "Sua",ary" has Mea properl)' completed IOS ohove-dlreeted. '"" ,:;;". \:,1,.-",' RC.C.34 (&.,i, COM.l4ONWEAL TN OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFeR INHERITANCE TAX RESIDENT DE~I!DENT SCHEDULE "A" REAL PROPERTY * Real property in Pennsylyonia, with statement of mortgage encumbrances upon each parcel at death of dece. dent. Property held by the decedent as tenant in cammon with anolher or ather, should be identified as to quantum of interest and the estimated yalue should be that of the decedent's interest only, (Property held as joint tenants with right of surYiorship or tenancy by entireties should be reported an Schedule "E.") Tho r.al property located In the Commonwealth of Penn.ylvanla should bo de.crlb.d by lot ond block numbor. .troet and .tteet number, togethor with a goneral d..crlptlon of tho proporty, with a rofor.nc. to the rocord of tho conveyance by which tho docedent took title; If a farm Itat" number of a. cr.., 01.0 .totemont of martgogo .ncumbrance. upon oach parcol at d.ath of doc.dont. Toxe.. a.....m.n... occruod Intero.t on mortgages. etc.,ar. to b. II.ted on Schedul. "F" and mu~t not be deducted from thl. schedule. (1) (2) 131 D~PARTMENT VALUATION CAUTION (Do not wrll. In thlsspac.) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEA TH E5T1MA TED MARKET VALUE NONE Insert this total apposite "real properly", Schedule "A" in the X X X X X "As Reported" column an the last poge of this return. l11mu "i.. COMMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX *~. .' , . REV....~U.U1.7e1 RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS: This Schedule must disclnse lllllllngihlc amI intangible pcrsonul properly uwned individuully by the decedent, at the time of his death. Pruperty owned by the decedent jllintly with unother or others must he listed under Schedule ItE". Intangihle pefsonul"rnllcrly, titled in the nllme (If the decedent, hut rayablc at dealh In anuther Of others, inclmling hut nnt IimitcJ (II P.O.O. U.S. Savings BtJ11l1s a1allcnlali\'c trust accounts, must he listed, despite lhe fnel that thc~' arc not uf the lldministcrcl1 CSllllc. T;l1lgihlc personal property should be list,,~d rirsl (c.g. jewelry. wearing "PI,arel, huuschllld gOllds, and furnishings. houks, 1'llinlings, llutlll11uhiles, huats, etc.) Intangible personul prnpcrty, stich as bunds, treasury ccrliCicalcs, cash on hand :llld in hank, SIIlCks, mortgages, nntes, togClhcr wilh Ilccruetl interest or dividends, salaries or Wjlges, insurance pi.tyablc III the cshlle m fiduciury in said capacity, partncrshi(l interests, inlerest in any undistrihuted estate of Of incolllc from !lilY prnperty held in trust ulH.lcr the will or agreement of anuther, e\'en though loclIted uutside of the Stille, tit the limc of death, should be listed in Ihis Sdll.:dule. Item I1l,M UNIT ESTl~''\TEO DEI'ARTMENT No. Li'1 and dc.cribc fully VALUE MARKET VALUATION VALUE (Do nut write in this space) l. Farmers Trust Co. checking account #4-0256-7 7,016.18' ' 2. Prudential Insurance Co. Pol. #06-516-937 2,617.02 - - 3. Swaim Health Center - Refund 560.00 ~ TOTAL 10,193.20 , Insert this total opposite "Personal Property", Schcdule HU" in XX fD /93 d..O the HAs Reported" column on the last (luge of this return. ( llCC-l~ ~.. . ~"~ ifi,~i.l. ~ 1,_." ~ " ,C',' 'A ,,"',;' ~, . ',-." I_...,.~..........J ..I:.........~."'.v,l:. ,',l\I\lol\;W,\1.;'1I II!-' 1'!.'\\,YI.I"\ 1,\ f'lA\"F~"1l 1\1:!'!:lll;'\I'j.' '1'\\ 'l'I'l-:liI'l.1-: "1''' Tl:\,\"TI-:l:S ii'::~ 11lE~T IlI'TFllF\T (1) Did ,h'el'llt'1I1. .....1111111 '.....0 ~.t.:tl.sCll.dl.ath. lIlal... :IllY 11'I",sl'l~r of' IIIlY lTl:lt",'11I1 part lit' his ,'stllt!!, without. rl'~I'I\'lll~ II \'alllahll' HI:II 11I11'1111'11,11 1~"IISI.\lI';11111l1 llll"','l'ur'? (,'Ils.....'!r P's III' 1111)-119_ (~) 111,1 ,\o'e"'\o'III. wl'hlll '''0 ) ,,,,rs 01' oI",,'h, """ISI',.. 1"'01"'1'1)' 1'1'"m 100m,..II' ." 100m"dl' ""'\ ""0U"" 01' I.thl'rs (Illc:lllllllll!, a SpUIIS'-) 111 Joint. O"IlI'I'sllll"! (.\IIS\'"'''' )'('s 1)1' 1I0)-H.o_ (:I) II' t.hl~ IUlSWt'r In (t) ell' (:.!) 1I11l1\'" Is III IIII! 111'l'IT'/llllt.I\'" statl.: (II) AI.!;I' nf' IIt'C!l'ch'lll. HI. time ot' t.I'lIll~if'l~r NA (Il) St.atl' 01' lh'C~I'lh!lltls IIl~lllth lit 1.11lI1~ Ill' tnllktllJ?; till' l.rallsl'el'. (~nU~ 1). (c) Cnllst~ or Ih!ef.'lll'f11.ls fll'nth. (:-"C1t.l~ I'. (,1) Dltl ttecedmlt" In his 1I1'l~t11l11', IIl11k(' ~lIl)' lI'IIllSf(!I' 0(' I'rOJl'~rt.~' .....llluml recldvllI~ n vfdlluhIe or Ulh!llllute consldCl'utlnn t.hl~I'nr()r .....hlc:ll wnS to tlt.m l!:'I'I~d, III pflssessinll or {'Il.1o,)'llIlmt Ill. (II' al'ter his Illmth? (Answer res 01' TlU) No (n) \\'tlS thl'rl~ IHI)' posslhlltt:,' 1.11111. tlw Jlrolll~rtj' l.rllJlsl'l'I'rl~d llIip;t.t rl~I.UI'1I to lI'unSn!rl~r or hIs l'sl.nte 01" Il,' snll,tl'ct. III his plI I'll.' I' lit' dlsl'l)sltlull'! (AIIS\\'CI' YI~S 01' 110) No (II) Whnt .....IIS th'! 1.I'ltIIsl'l~rl!e's lI;J;l! 1If. Untl! flf d,'ec'df!rlt.'s df'Uth? Mil (5) Old decedent. III his IJl'etlntl! IlIllkl~ Iln,}' trllllsf'l~r .....Ithout. recf!lvJn~ Il \'UlllUhlcllnd/lll('f1ll1ttc consldl!rl1tlon therefor tIIuh!r .....hleh trllllSfl!rllr eXJlr.~ssl~' 01' 111Ip~ led1)' l'eSI~rves for his It f'e or nil,)' IH!rlcul Which does not III filet 1'lItl !l1!I'OJ'I! his dl! II th: (II) 'I'I1l! pussf'sslon or f!ll.l()~'l1Iellt. of' ul' I.lil~ right t.o incomc ('1'011I tilt' Ilrf)pert~' t.rllnsf'crrl!ll" (AnSWl?r ~"f!S or 110) No (II) The ri~ht to !h!S~glllltf! the p(~rsons who stud I pussess or enjoy thl~ property tl'unsl'crrell or Income t.hnrf~fl'om? (Answer ~'es or no) No (0) 1f' tlH! lllls.....er tn (n) (h) llhUVf! Is in the ufl'lrnultl\'e, sl.lIte whether the rl.c;ht. .....as reserverl in dccf!clent IIlone or others NA (7) Diet Ilecedent in Ids lln~tlllle make u trllllsf'er, the consiflnrntlon for which YiUS trnnsferee's promise to pu~. income to or I'llI' t.he hen(!f'll. 01' 1:llre 01' transferor'l (,\IIS",OI' ~'f!S or IIU) .Jio (H) IHII decedent, lit allY t.illlf?, l.I'lIl1sl'l>r }Irnlll!rt.j', l.iw 11f~lll?f'l dill 1!Il.lCl~'IIl..mt. of' whlc~h .....as sull.lec:t to chnllge, heciUlse of' :t rf!SerVf!d puwer to 1l11.l~1", ttmellll, or rl!\'nl'f~, or willet! "~1I11Ifl 1'1,'VI?rt, to deccll('nt miller terms of trlll1sfer or h~' operntlull nf' Inw? (AlIswer ~'es or nn) No (0) If the unswnr 1.0 (H) IlhClVI! Is in the nf'I'II'l11lltl\'H, 'NUS ihl~ pnwol' t,) III tl~r, lIn1CJllJ, or I'l?voke the inter- est of the henf!rt.elary l'eSI'!rVf'll In Ow Ih!Cl!dent. aloue or tl1t.' IlcCt'Hlellt allll others? (Answer yes 01' no) No SOTE1: The nnSwcrs to t.hese lluest.lolls shulIt II he ~1I1lpol'terl h~' url'illuv 1 t hy the Il 1.t(!lIlli ng ph~'51 cJ an ns well os n copy of' thl! tlnath cl!,.t.1 [,Icnll!. SOTE~: It' ltTlswer to IIn~' of' the nhoVf! IlllesUullS is ~'es, set i'url-II Ill!J ow It dl!scrlptlnn of the pr()pert~. traJlsferrml, itl s I'lIir mUrkf!t, vallw nt. clute 01' ch~ath, Ilutes of' tr:lIlsf'l!rs unci to .....hom trlltlsferrc1l, with relationship 01' trllnsfcrfH>s to .Icccflent, If nil)'. Submit COP)' of' ltny t.rust <!l!f!d ur instrument., If trnns- reI's nrc claimecl to he nou-t./Ixlthln. u1so suhmlt l!l~tllilf!.l st,utelllcnt, (If' (':Icls on .....hich slttd claim Is based. SOTE 3: List lippllcuhlc prnJll...rt)' helow III mltllller In widell pro\'iltetl In Schedu1l!s ,\, II, or 1~. !TEll llESCHll'TIOS lLIlU(ET V,II.lIE (Es tlma ted) I1I'J'l'. V,I1.UATIOS (!lop.. Only) NONE Insert this t.ot./d npflOsllf! "l'rIlIlSI'I?rs", SciLetlll1C! "e" III t.hf' "1\8 ltol'nrtel1" f:olumn Otl t.Ill~ IllS!' P'l;~f! flf Lllls rl!tllrn. InCH tJ AI;V."'8!.ce"71lJ CO~foIONWEALTIi OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND AllllRESSr,s RELATIONSHIP (SUite rull nameH and addresses or nil who (U Ilep-dtildron or SUR\'I\'EIl DATE INTE[{I'~T OF have nn interesl. vesled, .:onlingent or other- ilh'gitimnlc childrt~11 IlECEIlENT OF IIENEf'f('fARY wise, in C~tule) ure invulvt'd, Het STA1'I; Yf'S IH/lTH IN E~TA TE rorlh this ract.) Ofl NO Dopothy M. Trimmer Daughter /ves nno_tch1,.,,, R.D.#6 /""""1,,10 PA 17011 Rhoda B. Stambaugh In""p'ht.pn Ives one-third 1159 Middletown Rd. Hummelstown PA 17036 Rohprt M. Becker Snn Ives one-third 4411 Packard Lane Camp Hill, PA 17011 - ----- - - -. _. SCIIEDlJLE "I)" BENEFICIARIES NAME DATr OF OEhiii RESIDENCE O"ponent lurther says that all the obeY.-named b.nelicieries are living at this timo except below: ~ 'sl/l"': ~.. - .=:" tt '. c: 'c ~ e "s.:! .: ""CoO .. E U i 0 ~ \.ou:O S - ~ ::i:r: ::: u =' ... u e c. ...: :J ~ a: . . S\l~\~IAR Y (I) (As Reported) $ -0- $10.lQ,.?0 $ -0- $ $ $~l93_,-2.P_._- (2) (A s Determined) Real pwperty Persnnal ProperlY Transfers (Sl.:h. HI''') (Sell. liB") (Seh, lie") $ $ 5 $ $ $ CII'OSS Taxable Estate ~ f- "" ~ Z u " ~ ~ ., ::;: ~ .... u UJ U '" U -' :z; !Jl - Q -< H :>, ..: '" ~ ClJ 0: u.. ,;: <( s:: P- O '" H H P- ;iI 't:l ;; 0- 0 ;! ..: uUJ :.: s:: ;. 0- "" +' ~ == ""f- a <1l ;., -< +' .; f-..: ~ ~ " z c( c z ,:: 1= ~f- '" H " Z H 0", u UJ ClJ 0- <( ~ u.. ~ t: 0 0 'C I- H .:: ;:j '" 0: Ul a -=: 0 - UJ ~ 0- ~ " ~ -;; z ~ f- w - o-l ~ u '" H '" f- ~ " ~ 'c -<: .0: ~ c: 'e '- :I: 0 =:' u ; E H :-::"=' a ;:; E ::=< c 0 -' u u . REV-..,.. C....7IH COMMONWEAL TN OF PENNSYLVANIA BUREAU OF EXAMINA TlON INHERITANCE TAX SECTION Sl'IIEIlIILE "E" JOINTLY OWNElIl'lHlI'Elny * INSTRUCTIONS: n,is schcdule must disclosc :1I11W'ollcrly, realltml flcrsllll,lI, ~ncd h\' Ihe decedent ifli.lIlv with another or others, inchuJing intangihles, standing in the namc of the dccedt'nt .Ind utlu'rs, List rcul eslate fust, .IS enlireties, ur joint tcnnnts, I;i\'ing brief dcscriptiol1, liS indicaled under Schedule "/\," pills thc date unc.lllll1cc of record of inslrument effccting \'cstiturc, bulllUl1tlt inclullc entireties ur ollt flf stale rcal cslale \'ulue in estule \'nluutinn coluJ11n. Persmml prnpeny should be listed us in Schedule liB," lllus dale IIf ilcquisilion, uno the nume, address and rclnlinnshill (if "ny) of co-owners In the decedent. Description of Properly, Datc lIf I\C(luisitiulI, Name Adlress and Relationship uf Cn-Owners, ami Place of Record of Instrument, where Real Estate. Unit V"luc Estilte ""lualiIlTl IlEPARTMENT VALUATION (OFFICIAL USE ONLY) Pen;cnlagc Share Vnlue uf Entin~ Property Vnlue of ()ecedcnl's Interest NONE Insert this total opposite IIJ()intly Owned Properly," Schedule liE" in the "As Reported" column on the last page of this return. Il ({'YI1 REV-484 EX" (3.801 INHERITANCE TAX SUMl.\p.RY SHEET (BUREAU USE ONLY) File Numbcr 21-l:l0-0lJb5 Estotc Name Charles G. Becker Date of Death 10110/79 Social Security Numbcr__.__~. REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritonce Tox Appraiser in and lor the County 01 Cumberland Pennsylvania, do respectfully report that I have appraised the roal and pcrsor.JI property as reported in the foregoing retum at the values set forth opposite each item in the last column to the ri!Jht in Schedules IIA", liB", "C", and IIE" Doted: ~brch 27, 1980 c:::::,~/lrL?/J.) ~7Ylt, INliERITANCI: TAX APPRAI$Ert ADJUSTMENTS REMAINDER APPRAISEMENT CODE INVENTORY YALUE AS APPRAISED CODE (HARRISBURG USE ONLY) Real Property (Schedule A) 5 None 00+ 92+ Personal Property (Schedul. B) 10,193. 20 10+ Jolnt.Held Property (Schedule E) r;onc 2lH Transf.r. (Schodulo C) !lone 30+ TOTAL GROSS ASSETS 10,193. 20 ----- --.-------.,.-. Leu D.bts and Deductions 40- 1- 93- (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of IIfo estates or RATE FACTOR PRIHCIPLE VALUE CODE annuities. . . . . . . . . . . . . . --- FOR USE OF REGISTER ONLY Tax on $ T ox on S CODE COMPUT A nON OF TAX $ $ $ $ S 6" " 15~g Tax on $ Tax on $ Tax on $ Exemptions Total Estato TOTAL TAX INTEREST FROM BALANCE TO $ $ $ Less Credits DA TE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST S + S S ; + = BALANCE S INTEREST FROM TO __ S BALANCE DUE 5 TAX CREDIT $ \,f) .. ~ ~ ~ " "\S ~ "" t.e <( " '" z' ~ ~ OJ I 0 '" '\J f<l . '0 '" t:l . <: ~ :J " 0: '" .-< .-< ...l CJ '" ... I <( .-< .... " ... .-< .0 " - d ... g II) ~ U Z .c d 0 '" - ~ 0 U U U .-< N " ~ - 0 ~ 0 ~ ~ ~ ... 0 '" 0 Z 0 '" '" >- ... 0 - ~ ~ Z z ... ... ~ Z ...l 0 - 0 ~ ~ ?i ~ ~ ~ Cl ~ ...l Z Z u ~ Z - ~ '" ~ 0 0 ~ ::: - ~ U Cl ...l . . OFFICE OF THE REGISTER OF WILLS . ~.?/. .(:) ( /. ~J STATEMENT OF DEBTS AND DEDUCTIONS . /, / DEDUCTIONS ALLOWEO IN THE SUM OF $ (!- q d, 7 (,(AlE APPRO~E; 'lJ)C\", ,~/_ I~ ["0 f(\L.M --lDn:- ___J(l't') l -I ., '\ R ,OlSTER OF '~ILL.S, -A6ENT "', REV....:!l:5 (8"78) OF CUMBERLAND COUNTY AND AGEN'r OF THE COMMONWEAL TH " ESTA TE OF SHARLES G. BECKER LA TE OF SOUTH lo1IDDLETON TO\oJNSHIP DATE OF FILING APPRAISEMENT ')I),\., :;,7 /(1, h' DATE OF DEATH O('TOBFR 10 1070 , , , , DATE NO. OF NAME OF PA YEE REMARKS AMOU~IT VOUCHER 10-10-79 Swaim Health Center Nursing services 1,302 21 10-::>0-79 P -IDlLw.....TrJ.mmS! r Jeleohone service 'U 02 , 10-::>3-79 Pa" 1 ltL......Trlmmer IRo; f'n~ ~a~ m;~" ,p1<nprl 10;0 00 1 n_::>U_70 ~;R'T'A Tn~lIrance ses Plan Insurance ,8 0;0 11_" .70 Doroth" Trimmer Postap'e ~lis c . exnenses 125 00 11_11_70 I-lnf'f'man Rnl-h Funeral Home Funeral services 1.962 00 11-::>9-70 nol"Q"O~O Mo";n",l r.pnl':o,.. Dr. Kretzing services 14 00 12-7-70 Bettv J. Vlil1iams Personal 'l'axes 15 75 1::>_::>R_70 Rn"hp C:lini"",l La,lL Lab services 10; 70; 12-28-70 Belvedere Medical Center Dr. services 120 00 l=.5.=1 0 Mark Memorial Works. Inc. f4emorial letterinO' 2'5 00 1_ _70 RpO'. of Wills Letters Inc. 22 00 1- -70 Ro~ nf' "'ill" !",;Hn~ Tn" Ann 11 11. 11 0 100 Reg. of Wills Filinll Account 33 00 tl T~",; ~ !M"l':",.." f'Pp~ 24 00 Irwin Irwin & Irwin Attornev's fee 509 66 Dorothv ~I. Trimmer Executrix's fee 509 66 Ro .c.o.r.de.r.-C!.L_D.~" RecordinO' releases 21 00 ,- -- Jt 0 ~'7 let: ._-- -- ---.-- .----- ~-- , --- COMMONWEALTH OP PENNSYLVANIA I SS, COUNTY oFlill.m9_e_rland I, _D..o_r..o_tb~~immeL- HEREBY CERTIFY, THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE FORI:GOING 15 A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTEO TO THE ESTATE OF Charles G. Bec!,er DECEASED. AS DEDUCTIONS FOR INHERITAI'!CE TAX PURPOSES. \i, , " :/ __ - L,(i-~I :0 ' //>~~ (L.S.) I 1'( DAY OF r('~'-~ ". '.' " I -,,\:;~!~~l: ~ ' ':~:_::'J (.S;j.";rv M~ CO:,ll.:i;;:"I:J:; LJ.ri,.~:'; 0..;1. Jt 10(.;0 ..- -- - ---~- ~---~ --. ..---. I ,'...._..... __~__ "'--'" .......... -- ~ - --- .z:.....o.... --. va- ~ ... :..JI 1//' !t\RC:C4(1178) COMMONWEALTH OF PENNSYLVANIA 1l~~J03'4479 DEPARTMENT OF REVENUE '!!;,:>..,' , OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX If"' ,...,. '" ; RECEIVED II = From, i ~ 'dre.. " II ~ F;le No, I Date of Payment ~ g. 'l'IIIlEB-HUNIliUm FIFTEEN & 94/100 representing Pennsylvania Inheritance or Estate Tax due from the following estate: _.d..Jlors lAPin. In/in. In/in. Attye. 44 S. H....oITer Street 2'ii: Tox on s Carliale, 17013 6~(, To}!. on s Fa. 21-oe 6S Dote of Death 10 10-1-9+9- 15'it Tax on s Mcu...1. 31, 1900 % Tox on S Estate lox, Act of May 7, 1927 Nome 01 Decedent CII1d<LEG G. BBOI<ER County TOTAL TAX CREDIT less five percentum of tax if paid within three months aher dote of death Plus interest ot the role of _%from to cmaberland Remarks: PAID IN FULL 'IT 00 ~ [f) [L~ @ill'TI'rn SEA l TOTAL AMOUNT PAID $ s s s s $ 315.94 $ $ s 315.94 I Received by NOTE: In accepting the Tronsler inherilonce Tall on fuTure eiTotes, prior 10 the death 01 the lile tenant or lenon! lor yeor5, 0' ovidenced by this receipt, it is understood thot the Common...ealth ihalJ nol be precluded or prevenled !rom hereafter oueuing additional inheriTance 10. 01 thl! death of the Ill. tenant or lenonl for yeotl whenever it appears thol 5uch additional to. may be legally due and collectible for ony reOion whatsoever. ~ 'h '-M {III"'; . \'" i CV':-1J"(5i9ritlfUr~1 . V" ''-^......... Harold B. Me ane, Deputy Regillter(Tif?e; Uilla NOTE: Thil Tfiplicel8 Receipt to be reteined for audit purposes. ~ II e ! t r - --- _. -- -- --- -. ..-- ! +_._._~-_..~-- ---- ----.- -- - -------- ~----~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' COUNTY FILE NO: TO: rfu \V't~~ J..t g \ '," /' {. . t,,'"l_ 1'1 '" f-V\)..Jr-fo. V::J'(N+J,.^ I ' _ L,I-ifJ~klY1 u-\~~,1 L()/~_ .~< ~! -fU , /" I...., .....' 'J .I I (I ;--1 DATE , t, 'Urn (. I.N'yn~h \t ' ' '\ ';S) \."!'\--'.- ~" ESTATE ~ ( U),J,cL ,) r FILE NO, COUNTY I" A) f DATE OF DEATH tj-~. / !) V I , ~"'7 Appraised Value of Estate: Real Estate Less: Approved Charitable Exemptions $ -- + ( 0 ) (/3 :)... U , I .~ + $ / C. ('1..:5 '/"" ,c:;1l '_,. il [,..). '7. .,; -:; $ -5 ;;I, S 5, b,) .--. L:: .).1." 5. , ",-' $ -= -' Personal Property Jointly Held PropertylTransfers Total Gross Estate Total Approved Oeductions Clear Value of Estate Clear Value of Estate Subject 10 Tax Amount Taxable @ 6% Rate $ C- -165 405 tax due $ .3:,/5.9 L/ Amount T..able @ 15% Rate tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE 3 G $ /5. 1 if- * * .. .. .. * A five percent discount totaling $ will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT $ + $ $ = $ + = + = Interest accrues at the rate of six (61 percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest duo if paid bV is BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ .3 / 5. c;y- J:..1 [ 1(1 '.1..-: '~ ~) Assessed by0-1 ~\fll (r;;> <-.f~ ,,-(-...9... Ajntfoflhocommon;Glh' [' Sea Informalion on Reverse SIdo ',' _ ,~.. "., t-:> . '-- . ,i G : i./~! ,.';-1, 'Z\ \ lJ..,'..v;; '. , L~") I; 'n-~'" "I"" - . '.\ '-.j t',,',;I,'.',' '.'.l'..,