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REV.523 (1()'7S)
&io~\\'t:.w.TII (It' l't:SNSn.\'ANIA
1Jt:I'AIlTAIt:ST (lto Ilt:l't:NIJt:
HUHt:AU lit' toft:I.1I IIl't:IlATIOSS
INllt:IlITASct: TAX IIII'ISIOS
OFFICIAL NOTICt: OF INlIg/uTANCt;
TAX AI'I'RAISt;~mNT ANIl ASSt;SS~mNT
OF ASSt:TS NOT SUnmCT
TO '\1I~WiISTRATION
*'
TO: -....- B. El'-th
F.1lraary 7. 1980
Date:
County
t!t..~.'.1Uf
1~ -tera BPi..
....L .1.. 0 I. Pi 1~
County File No,
Bureau File No,
We have received notice that, as a result of the death of En Bartner
on 3--- ]1. 19-29----., you came into ownership of certain property through right of survivorship, which
was formerly owned by the decedent.
Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable
and the liability for the payment of the inheritance tax due is imposed upon you, as transferee.
The property on which tax is hereby assessed consists of: ,)'Gillt rn.-H"I Aa_t #It:J:1 01& 817 J aM .L.h.t
........ ..~- ~ MI~~ at ~M i'Dlbwl ..... It 1"'~ O~ftell, ia ~hA --- td.,.., ala --- t
- ..-,~ta..._ 1___ loll _hHaItad ""'" ..... lV~.
appraised by the Commonwealth, as of the date of death, at S 1. ~~,s
50 % of this amount is taxable at the rate of ~ %
DATE OF AS$EB.SMENT
TAXABLE AM0UNT ",'
LESS: ALLOWEG 'DEBTS
NET TAXABLE)\MOUNT
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
: ~'l~:-:;:i :).01,. ~r7.,.~-l,*;-:"'I. '::"'"ri.tE~b. ,ll~:-:t~8~:;
- ';!lr,~llfl ~O!J3'" ""';!! '.:$:'.11;;1, :l99.C"....'~ r!e.'$33'l).. 781.2d)I!t :'.i.
"",':-..1;' , ," ':s,tc,,"' , '~~,''3!I.''~; D@HtlJlil~2291.~9:::'
"','.,,;'<;::,' ",C,' , ,',: ,.,'. 17' J':;,l '(j 1 if,: '{')"'!nsoJ.vent\'Forv'l'iix:',L
AMOUNT OF TAX DUE
If you pay the above amount within three (3) months 01 the
date of death of the decedent, or on or before
19_, you may deduct a discount of
5%of the amount of tax due, or
This tax became delinquent nine (9) months after death
(one year if death occurred prior to December 22, 1965
and fifteen months if death occurred on or after
December 22,1965 but prior to June 17, 1971) and in
addition to the tax, statutory interest at the rate of 6 % of
the tax per annUJ1T is:also due as of' 19
in the amount of
/, l!/:
'j /' /-
Insolvent For Tax
---------------------
---------------------
--------------------
----------------------
* If the tax is not paid by the above date additional
interest is due at the rate of 6 % per annum until paid
TOTAL AMOUNT DUE S lIt", Irfllolvent For Tax
>l i ' '_ '.
APPRAISED BY: \--?//,:, I, /1/ 1,../.:.1-;):1 I / ASSESSEO BY: <<I "1 ,M k.. "'h,..( cl!rA_^ I
(Inheritance Tax Appraiser) IAgenll(or tne4:bmmonweaii\;f!, ,
INSTRUCTIONS TO TAXPAYE~i(",.l.y .L.-'/""'ijjh-.. 'K i 1:1},--<....'
Make checks or money orders payable to:
To insure proper credit to your account
this Official Notice must accompany
your payment. Mail or bring it to:
REGIS'rER OF WILLS
Register ot Willa Office
Cumberland County Courthol.lle
CarliSle. Penna. 17013
- ~ (-2(0 ' O:;A {C - 3,,'97.$
NOTE: Any party in interest who is aggrieved by this notice may object thereto "within sixty daYSlafter receipt of
said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961,72 P,S, 2485-1001,
GlJI\CfUi'LlC..\ i~... <'_::~, T~:: ':);. '--'<'iLLS cory.
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::"--------
If you have already paid this tax to an executor, administrator, allomey, or other personal representative of the
decedent for forwarding to the Commonwealth, list below the date paid, name and address of the person t.o wholJi'
you made payment, their official title and the amount.
Date Paid
Name and Address of Payee
.---- .--. ..- .-----... ..-----.
Olficial Title
Amount Paid
Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses
or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended
by you may qualify as deductions against the gross value of the property in the computation of tax due, If any
such expenditures meet all of the three following tests, it is recommended that you itemize the payments below,
execute the affidavit, and retum this notice, The Register of Wills will examine the debts claimed and allow those
which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment
of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
,10 You were personally legally responsible for these debts, and
2. You actually paid these debts and can furnish proof of such payment, if required, and
3, These same debts are not also claimed, for tax purposes, by an executor, administrator or other
personal representative of the decedent handling the administration of the general estate of the
decedent or any other transferee,
, " Name of Payee
O'Rothermel Funeral
, Messiah Villa e
",Hershe Cellieter
,.)(ark"Memorial Wor
SCHEDULE OF DEBTS
Description of Obligation
orne Funeral
Nursin Home Care Balance
Footer For Marker
Marker For Cemeter
Amount Paid
1 .00
1 00
0.00
1 0.00
TOTAL $
2291.00
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF C'lHI\ \~j::lr:(l\cl J
(attach separate sheet if required)
SS:
.. ,.r .:.....' I,..' _ .
I, " v' 1::- "hereb~certify tl1at the foregoing is a just and true statement of funeral expenses
a d other debts of the decedent, e j/c{ dtt /j-//c; /- , for which I was legally responsible and which
I did payout of the property herein taxed. I further certify, that to the best of my knowledge and belief, these
same debts will not be claimed by any other person, for inheritance tax purposes,
SWORN AND SUBSCRIBED BEFORE ME THIS ~~7]:_ DAY OF ~)
Febrt((:(I-Y 1L~Q, ','D:II/'crc..cz. /3 Q-r-'I-etD
o!..j I SianatureolTaxpayer
-1 iV, <<bLet--T IJ1tJvRC
It/tfT71/</ PUI.3LIG,;Cfj4!/'j, co REPORT OF REGISTER OF WILLS
I, the '1j-n'd{(~(g"net;~uti'ef~cted ORegister of Wills in and for the above county, do respectfully report that I have
allowed deductions listed above in the total amount of S~l.OO ,
Date of Approval: Feb. 11, 1980 1\ ' M itJ::, ':/'Vv. JtrtvJ.S,>
C(\l~' " s~roltlii~, n 'w- -........
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLL5CTIONS
HARRISBURG, PA.
17127
*
Rce.., 13-711
NOTE, TO BE SUBMITTED IN TRIPLICATE
REPORTING FINANCIAL INSTITUTION
ADDRESS
Fulton s..r" -110 1.- Off.
IIg II. "In .t.
M. 1.~, ,.. 1711"
ZIP CODE ''JII''
P.nnsyl.onlo D.portm.nt of R...nu.
Bur.ou of County Collecllon.
Goble BuildIng, 3rd, Floor
411 S. Second Street
Horrlsburg, Pennsyl.onlo 17127
Pursuant to Section742, Pennsyl.ania Inheritance and Estate Tax Act of 1961, we
herewith submit the following report:
c:tIed&lrII .......
ACCOUNT NOo OF JOINT, TRUST OR ,&S 016 8'7 , ,,,_no
INVESTMENT DEPOSIT
NAMES ON ACCOUNT OR
INVESTMENT
I. ....... or
llefber. II. Ilfreth
6-17-79
lve ........ fill
......... II. Ilfreth
DATE OF DEATH
DECEASED JOINT DEPOSITOR, TRUSTEE
OR INV ESTOR
I. Burtnlr
ADDRESS
.....11Ih vm...
- ~_I-"''''1 II..
c. ;.
..-
COUNTY
ZIP CODE
SURVIVING DEPOSITOR, ....... I. Ilfreth
BENEFICIARY OR INVESTOR
IllS ""W. DrIII'8
ADDRESS MllII1IIIlc:ebura. ,.. nOJ5
RELATIONSHIP TO DECEDENT
Dlulhw
DATE INVESTMENT WAS ESTABLISHED
WITH THE SURVIVING DEPOSITOR, .............1_
BENEFICIARY OR INVESTOR - ... -
,.,.,
hVllllIS -
8-!6-7J
BALANCE, INCLUDING INTEREST
PAYABLE, AT DATE OF DEATH $
ChIIklllll 6IlI.98
11M... 51".&>>
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SIGNATURE
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