HomeMy WebLinkAbout80-00118
NO. 21.80
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, J. ,)
PETITION FOR LETTERS OF ADMINISTRATION
IN Tim ESTATE OF ....!:\~.~);:,!'!...1:I.......,~F.:.i\................................... tmn;ASED.
To ..............,.........,',.~,~.7.?~?:,.,~,:,.,~~.~.~~,~.!.,.!?~.fl.~~'t.,',......,.,",...,.,..,.,',.."..
Register of Wills fOI' the County of Cumberland. in the Commonwealth of Pe'1I1sylmnia,
The Peti tion 0 f ,.,. .R,!'!:;1..;I;!'!:!'!,.. ,l!; ,:...B. !1,!'!:,I.., ,:t, !:..........,..",..",."...,.,.,...,.,..., ........,....",....,..,..,.,....,.....,......
.. .......,.....,....,...., .........,...,........,...."", respect fully s howet h t ha t ."" !'!,!';MF.:,N...['j.:" ..1mb."..".......,.., ........... ...........
was a resident of ...~!:\~.I2I?!:,I;!~.~!:\r.,1i\........................~~:h">X . Cumhel'land County. Stale of Pennsyl-
vania, and a Citizen of United States, and departed this life intestate in the County of~.~!!!~.!:,f.~.~.IJ~...
........... ............... ..........,.., and State of . ....~!1n!:l. ?.:t. ;1..Y.!'!:!},~ ~......,..,',..".......,...,"",....,. ................ ..... ..........'........ ......
on ....f.rJ!!-.eY................... the .........~.?~.h................... day of ..........if.!'!:D.!!,!'!:F.,Y....................... A. D., l!l.~g.....,
at the age of .....~.~....... ~.ears.
That the said ........);jJ;:,~J;;N...~..,...R.,~l).,..................................... deeeaeed, left surviving the following
named widow or -husband, heirs and next to kin, to 11'11:
Name Relationship Residence
..p..\l.+J.?1?....J;;.:. ...I;\~.\l.,.....J..J;:.,. .............. .... .......1?9. D......,...,........ ....... B.:, P..,.. .lIJ. ,...!?9. JJJ;D,g...~.P..r.J. ng!'!.,
PA 17007
................................................................ ............................................ ................................................................
That those above named include all of the next of kin, so far. as known.
The said decedent was possessed of personal property to the estimated value of $..~D.E7.~.~.~,~,?:~.!:.~...
and of Real Estate. less incumbrance, to the estimated value of $.........D.9.D.~............... as near as can be
ascertained.
That the said Real Estate in so far as is known is located in ................................................................
Therefore. your petitioner(s) respectfully appl,'(ies) for Letters of Administration in the above
named estate.
February 20 Rn
Dated .................................................... A. D.. l!l.....,."-..
Signature and Address
of Petitioner(s)
......../jfllm..(.~~;:..It.:.......................
............. ..B. :.R .... ..II)........... .............. ...............................
...............~.9.~.~.~!:,!?i...~.p..~~.~.l!i~.J....~~..}.I.~.~L....
........................................................................................
COMMONWEALTH OF PENKSYLVANIA 1
COUNTY OF CUMBERLAND t ss:
..............................."...........p.!).J.+.!)..\'i,..lt...,'~,\1!)...".;r.r.,...,..,...".."....., ,.,..,..,......................".....'..',..'..,....,.... named
in the above application being duly ....1?,W.9.r..n............................... according to law. sar that the facts set
forth in the above application are true to the best of ...!:\~,~..... knowledge and belief.
.........................,.......,..,..Sw,or.n.,..,. and subscribed 1 .."..."'......:fj'....;7J'.........'i'?'...~...,....,........,..............
before me, t ' .............I.!.:.4.~..,(",:..1;........,~......................
..............!::~.~.7.~.~E't....~.~.......,....,.,., A. D.. 19.?.9..... I ,.........,.,'~~.~~~,~...~.:....~.~~,~,..~.,..:.....,',.......,..,........
~~lrr;;i~...!?~p..~!:y.
Register
................................................................................~
Attorney: ..J~\~!.~,!....~~\o!,~~...~,J~~!.~..~.
~~D
ACKNOWLEDGMENT OF SURETY
COMMONWEALTH OF PENNSYLVANIA
} ...
County of
I.
.. in lllld for s.lid county in tlm stiltl!
aforesaid, do hereby certify that .- . AttorIU!v.in.F.lr.t of STAll:
FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois, a corporation duly OIganiled ill1tll'xi!ttin{l until!! IIII! IdW\
of the State of Illinois, personally known to me to be the same pr.rson whose name is slJhsClihed to the fme{julll{j in!itllll1Wl11 i1\
Attorney.in.Fact of STATE FARM FIRE AND CASUALTY COMPANY. appeared helore me Ihi, day on pe'''''' .11"1
acknowledged that he signed and delivered the said instrument as his and State Farm Fift~ ami C,ISU':llty COI1lIMI1Y'S 1Il!l! mitt
voluntary act for the uses and purposes therein set forth.
Given under my hand and official seal this
day of
. l!L_"
MV Commission Expires
,19_
ACKNOWLEDGMENT OF PRINCIPAL
COMMONWEALTH OF PENNSYLVANIA
}..
County of
I,
o NOlary Pulllic
o Coullly Clerk
in and for said County. do hereby certify that
personally known to me to be the same person(s) whose name
'iubscrihed to Ihe foregoing
instrument as Principal, appeared before me this day in person and acknowledged that
signed, sealed and delivered s~id instrument.as
purposes therein set forth.
free and voluntarv act, tor Ihl! lIses ilnd
Given under my hand and ,.althis
day of
.19_
My Commission Expires
,19_
D Norary Public
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COMMONWEALTH Of PENNSYLVANIA
COUNTY Of CUMBERLAND
I,
J
55:
.~ALIALJ;:.JEA.~B,------_.
-_.~------
~--_._-_._------
being duly sworn _____ according to law. deposes and says that he ..i.L1J1e
__aJlm.lnJ.s..t.:r.a.tQ"-.-----,------ of the Estate of ..lie1 I'm M. Rea.-
late of Shippensburg BorouiSh . Cumberland County. Pa., deceased and that the
within is an inventory made by __.D_allas--E-.,--Rea..o-Jr... ._- - -----. the saidanm; n; '" trat.oL-
of the entire estate of said decedent, consisting of all the personal prop..ty and real estate, except real estate ouhide
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.
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\ l h;)l".n 1,- ..J. 19 80
(C'\Ylc':'bi:j(;\] '~~JUC
.. .... ..[:;..,11,
... "b,,,"" b,I,.. m" \
__ffd&/.-' I ~ x
)f:XeXIlt<K . Acfminhtrator
Sworn
Yit't(~
_Y3.' #l
,...~ \T,:,~',:F::l,ii-: r;T::'~,~ U~C.15. 1930
",. :,ha. p.- r.:-,:";',;;i1:': ;,~ :~ci:Url:"l of r:otoriu
Boiling SRrings. PA 17007
Address
Date of Death
25th
Doy
J an.uiU'Y
Month
1980
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional a"ets.
3. Additional sheets may be attached as to personalty or realty
4; See Article IV, Fiduciaries Act of 1949.
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REV0449 18.78)
COMMONWEALTH OF PENNSYLV ANI A
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERAT:ONS
-*
~:u- It:' . /1 ('
RESIDENT DECEDENT
COUNTY OF -.C.UMRF.RT.1Ul11
IMPORTANT:
Thil'i return muRt be completed in detAil nnd rilc~1 in duplic.llC. with ull atUlchcll, with lhe Register uf Wills (If the
County ....here decedent resided; Return is dm. within nUll' month!' ;lrH~r dllte of lIc.!lh. unless an extension is grunted
by the Sc:crctmy of Ite\lcnuc. (Section 70] of the Inhcrillllll':c ami Est.lIe Tux Act of 1961.)
IN TilE MATTFR OF Till! ESTATE OF
1 '\FrIllA VIT OF
- J X;XKOO)JXl)1
Al)~tINISTl~^TOR
County
JELEN M REA
{STATE FULl. NAME OF DECEDENT)
Leto or
CUMBERLAND
Stal. al PENNSYLVANIA
Cauntyal CUMBERLAND
} 55:
If-X9!'lI!1I!l(
....J)AT.T.AS 1<: RRA .rR
Administrator of tho estate of the a"bove.nomad deced.nt being duly sworn, depose
and soy
Decedent du:d Januarv
tMONTHI
Nome and addr... of oHorney or }
olher authorized repru..ntotlve to whom
all corrnpondence should be moiled.
2')
(DAY)
, 19 aO~~~~r~"~~r-"~~K~~."~~-)
~lntClslate
Irwin.
Ir~lin & Irwin
44 S. Hanover St., Car1ig]e, PA
1701 ,
That as such deponent is familiar whh the affairs of said estate and the property constituting
I EY.ECU TO R-AOMINIST RA TOR)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADORES!> OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT 80X RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOL~ERS TO DECEDENT
1 W. Kin Street
Shiooengburg, PA
172r:,7
That the contents of said safe deposit box or boxes are itemized under Schedules
wi th the exception of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A allached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedeot.
That Schedu/. 8 attached hereto aod made part hereof sets forth fully and in delait all persooal property
wheresover 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 possc~sion, 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 the accrued interest thereon, if any, down to the last interest day prior to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, p,lstal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; 1111 obligations, whether by statute or agreement they are designated as lax free, of the United Statcs,
or any state, or political subdivision thercof, or of any foreign country, which an: owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniturc, horscs, carriages,
aut'omobiles, boats, and any and all other personal chattels of whatsoever kind or nliturc. left by decedent,
togcther with the fairly estimated market value thereof; all honds and mortgages held ty decedent and of all
claims due and owing decedent at Ihe time of death, and all promissol)' notes or other inslruments in writing
for the payment of money of which decedent died possessed, of whatsoe\'er nature, with interest thereon, if
any, giving thl~ face value and estimated fair market value thereof, and if such estimated fair market value be
less thnn _ the face value, it selS forth briefly the reasons for such depreciation as to each item; all moneys
payable (0 the estate from life insurance policies carried by decedent; nil annuity and endowment contracts
the proceeds of which were pal'able upon the death of the decedent; all aod the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the datc of decedent's
death and other investment sccurities owned by Ihe decedent at the time of death, with the market value there-
of at such time.
/1- II- 7--
In tho CtlSC of St!l!lIrtttes nf closl"' nr fllmlJy t:orJlcrttttons, tilt. \.tlll1'~s rl'llnrll!d II.ro tiS fnr 11.8
pos!;ihln Nuhsltll1llllt.efl h). f'lllullcln\ stltlemellts uf' tht' eorpor11tlllflS, shnwltl~ l.hl"! tHHil~t.K lInd IJllhilJt1r.s
tlll'r.'o" tiS 0" thl! flltll! of ,I..nt.h. Thfl ""')wlllll.' III so Sl't.:-o I'nrl.h 1.111' Illtt'r..s!. of ftf'!c'~fhml. Ilt the tlmo or
ltenth tn IInr cn-I'urtm'rshlp or hllslnt~ss, IlIllI In stllJpnrt nl' till' vnlllt! Ill' such JlIl~'rf'st ther!! Is Ilnnexocl to
sulci SChl'ftlllf~, rtnlll1ctnl st.lttemlHlls showluj:!,lhonssels flll(1 Ihhlllt.I,'s 01' slllet eo-pllrl.norshlJl or hus11101Hh
,\ eop~' or UH' C'll-Jltlrtnl~rshl" tU~reHmt!llt, ('I' orlll, II stntf!lIll~nt. St'f.tln~ f'orth Oil! n"tUrf! 01' tht! t1~r'~"'lT\Ont)
IO~f'lhl'r ~'Ith n stRtt!ment sCltln~ I'orth the clUirllctl!r or t.lm hIISllll'SS, Its Incrlt.ICln, Rlld KliCh other ('!tctR
j'1'rtulntnp; to tlw hU!1ilness RS mllY Ill! Iwrt.lllIHlt to It t'lllr Uflll .lust t1llprlllsnl of' t.!U! Ch!lwllrmt.'" InteroHt
th~rf'ln "llIst hesuhmll.tf'd. It shull lei nlfoin set "urlh In Itf'mlzf!d "orm, tOJ;l!thf!r with 1.1lt~ fair n1nrket. vnlulJ
tht'I'f;!ol" ItIlY other proJlerl.)' ownpd or bC'lUt!ttllwfl hy till' Ilt!c.'dC'nl. ut till! '1m!! 01' d~lttll.
The Sc"~dul(> C nUllched hf!rl~t.n HllIl mlllle )lurl. IUlreol' set.s furth It lrllt~ IUls,,'er to eneh in1luiry
contnJned therein nnt! in the case ol'trnnsft!rs ol'llrnllert.~', rell1 or personl1J, wi thin t.WI) yenrs of dccfJdontt s
death, In contcmplntion or dcc(!dent.t s rlcuth, or Jnt.endf'!d to I.lJ.kc efff!ct In possess1on or enjoyment nt or
arter death, suid schedule sets I'orth lIw nnturH IUlll value or such properLy, t.n whom trtlnsfcrred, the
rp.lationshlp of the transferees to the decedent, the proJlnrtlonnte ShliN! receiverl by ollch transl'eree and
nll other fncts of n pertinent nnture r('~tlrd1nJ.; snlrl t.rnnsfers. In the case of' transfers intended to
tnkco ei'fect in possession or enjoyment lit. or after rlent.h, there is nlso nttachert to the scherlule n cony
or the deed, trust agreement or other inst.rument creut.1ng thf! t.rust. Thcrl) 1s 111so set forth in said
schedule 11 lIst or nIl propert)., renl nnd personal, with its value, which plt~ses Ilt dccedent' 5 death by
virtue or the exercise by deccdent., either incUviduully, or jointly yo'! th nnother, or any )lower of appoint-
ment vested in decedent, either individually or .1ointly, b}' th(! will, de(!d, or other instrument of another,
with a copy of the instrmnent creating such power nttacherl to the schedule.
Thltt Scht>dulf! 0 attached hereto and mnde part hereof sets forth t.he nlimes nor! addresses of all
persons beneficially interested in this estntc Ilt the time of decedent's rleath, lhe rl/iture of their res-
pective interests, their relationship, if' any, to t.he decedent, togt!ther w:lth the ages nt the time or
decedent's death of all minors, annuitants and beneficiaries for ltff' \lnrter rlecedent's Will. It also
contains a statement showing which of the heneficinries ntuned in the decedent! 5 will, ir any, died prior
to decedent, the dates of' their denth, their issue, fUll! the relationship of such issue to the benef'lciary.
That S.:hf!dulf! E attached hereto and mnrie n part l1Cl'eof sets forth nIl property, real nnd per-
sonal, owned by the decedent Jointly with anot.her or othe1's, inclurUng intangible, standing in the name
of the decedent and others, plus the date and place of' record of instrlUnents effecting the \-est! ture of
real estate nnd the date of acquisition of personalty, plus the ntUTle, n.-Idress flnd relationship, if any,
of co-owners to the decedent.
That Schf!dull> F' attached herf!to and mnrie a part hereof sets forth f'ully and in detaU all debts
and deductions claimed f'or and on behalf' of this decedent's estate, inclurling funeral expenses paid;
family exemption, wh~re applicable; costs of administration of this estnte; counsel rees and rudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in con'iequence of t.he death of the decedent; debts and claims owing ano lInpll:lrl at time of
death; taxes accrued chargeable for period prior to rlecedent's death (except those allowed under Section
651 of the InheritWlce nnd Estate Tax Act); together with a statement of collateral plertged for obliga-
tions, if any. I t is agreed that the f1duci ary will presen t proo f 0 f said cl aimf!d obligations upon re-
quest, that ir the amount actually paid in settlement of uny fee, commission or debt is less than the
esttmn.ted amount claiming nnd allowed, that the same will be reported tG the Hcgister of Wills, and that
the llmount of tax assessed cnn be rellssessed In 6ccordlUlce therewIth.
That the totals of the npproprlnte columns ill Schedules "A", "0", "C", "E", and "F" us directed therein,
have been carrJed forward anri properly registered in the SUnullnry.
Subscribed and sworn to before me thia ......"""."""""""."",
.""..,,,...,,,,.................~)~..... day of ,1I)<\I:',cl1.,.... ",'......"" 19",8"Q"",
~ C ' ~.: . (; '~.;G-:
."."......",..,~_"" .t7.~ ..L ,\1~B~;:n' ;,.., ""..::': {~,~J;~;"
"'~~:f1~ri:~,I,..."..,-''''--
R.D.#!
.._.................................~...".......".."_.........................w......_............__._..
(Street NUlnbl!f')
",J:l,(),;i"+.,~ng"",~.l?,r.,;hDg~..>"""!'.!L,,,,,},7.,QQ,7.,'""."""....
(City e>r Town and State)
SOTE: Bef'ore s1gning affidavit make sure nIl hlank Spn.Cf!~ In t.he nfCida\'it. nnll schefllllcs nnnexed lire
filled In with details or t.he word "None", and in cnse the nsset.s inchule rure Ilntt unlisted securities,
securit.Jes of close or ramily corportitions or an interest 1n any cO-Jlurtncrsh1p or busIness, that the
dntu Ilnr! statements required under the parul;rnph nIJove rl~1utlnJ!: to Schedule "n" tire at.tacIH_HI. Also make
certnin that column #1 in the "Surmlury" has been properly completed ns nho\'e-IIJrecteft.
:\ ::-~ .j.~' ~,'
;-.: j : . '~,"I ';
Invenlory of ,he real and porsonal oslolo of
HELEN M. REA
doceosod.
Personal Property:
Furniture and misc. household articles
Gash in r.esidence
First National Bank of Shippensburg
Reg. Helen M. Rea
checking acct. #55~-78~-3
855 00
31 70
516 97
Reg. Helen M. Rea & Dallas E. Rea, Jr.
CD#56~0-Aug. 9, 197~ - 1,500.00 - 1/2 interest
CD#656~-Feb. 2, 1976 - 3,000.00 - 1/2 interest
CD#66~0-Mar. 7, 1976 - 2,000.00 .. 1/2 interest
cD#6963-Sept. 6, 1976 - 2,500.00 - 1/2 interest
775 08
1,552 26
1,027179
1,286.20
I
2,0581~0
1,525.68
2,022 15
511 58
2,058 ~O
2,058 ~O
Orrstown Bank
Reg. Helen M. Rea or Dallas E. Rea, Jr.
CD#l91~ .. Aug. 30, 197~ - ~,000.00 - 1/2 interest
CD#l959 - Nov. 1, 1974 - 3,000.00 - 1/2 interest
CD#2090 .. May 30, 1975 .. 11,000.00 - 1/2 in';erest
CD#2323 - April 1, 1976 - 1,000.00 - 1/2 interest
CD#2~39 .. Aug. 31, 1976 .. ~,OOO.OO - 1/2 interest
CD#2~~0 - Aug. 31, 1976 - ~,OOO.OO - 1/2 interest
Cumberland Valley Savings & Loan Assoc.
Reg.
Helen M. Rea and Dallas E. Rea, Jr.
Saving Cert. #6693~19 .. Aug. 25, 1977 -
Saving Cert. #6700868 - Dec. 31, 1979 -
5,000.00
5,000.00
1/2 In .2,513j~9
5,03~FO
Reg. Helen M. Rea
Savings account #60033
3,386 63
TOTAL
27,213 93
he C..'4 (4-131
COMMONWeALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
,TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
.
Real property in Pennsylvania, with statement of mortgoge encumbronces upon eoch parcel at death of dece.
dent. Property held by the decedent os tenant in common with another or other, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
Tho roal property located In thl! Commo"woalth of Ponnsylvanla .hould bo
described by lot and block numbor, ,'rool and .treet numbor, logother wIth
a general ducrlptlan of the property, with a r.ference to tho rocord of tho
conveyance by which the decodent took title; If a farm .tntn number of a~
cres; also .tatoment of mortgage encumbrances upon oach porcel at death
of decedent. Toxe., o..elsmonts, accrued Intere.t on mortgagos, ote.,ore
to bo listed on Schodule ifF" and must not b. deducted (rom thl. schedule.
(I)
(2)
13\
aEPARTMENT
VALUATION
CAUTION
(Po not write
In this .pac.)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMA TED
MARKET VALUE
NONE
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
N c-, lL--
.-Vp/f.,
REY-4'1 Ce-7II)'
*
COMMONWEAL TH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "S"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule ",usl disclose 011 tongible and intongible pcrsnnlll properly owned individually hy the
decedent, at the time of his uealh. Prupcrty owned by the decedent jointly with another or others must be listed
under Schedule ICE". Intangible personal property, titled in the name of the decedent, but payable at dcath 10 unolher
or nthers, including hut nnllimited In P.O.D. U.S. Savings Bonds and tentative trllst accounts, musl he listed, despite
the fuct Ilmt they arc 1I0t of the itdminislcred estatc,
T.lIIgihlc pcrsnnall'lf"Ollcrty should be listed first (e.g. jewelry, weuring uJlparcl, household goods, allll
furnishings, buoks, painlings, automohiles, boats, etc.)
Intangiblc Ilersonlll property, such as bonds, treasury certificates, cash un hand and in bank, stocks,
mortgages, !lotes, together wilh accrued interest or dividends, salaries or wuges, insurance payable tn the estate or
fiduciary in said capacity, partnership interests, inlercst in any undistributed cst.lle of or income from ilny property
held in trust under Ihe will or agreement of uunlher, e\'cn though located outside uf thc Stalc, at the time of tlc.llh,
should be listcd in lhis schcdule.
Item
No.
I1HM
Lisl and descrihe fully
UNIT
VALUE
ESTIMATED
MARKET
VALUE
DEPARTMENT
VALUATION
(Do nol write in
thi s space)
1.
Furniture & misc household articles
855.00
2.
Cash in residence
31.70
516.97
3.
First National Bank of Shippensburg
checking acct. #55~-78~-3
~.
Cumberland Valley Savings & Loan Assoc.
savings account #60033
3,386.63
TOTAL
4,790.30
Inserl this lotal opposilc uPersonal Properly", Schedule liB" in
the "As Rcported" column on the last page of this rcturn.
xx
~ 71C'. Jo
.&J)1e
"cc-'\~
~...
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rltA:\~F~"n I st:~"~nT,"~l'F T\X
SC1!Jo:11I'1.\': "('"
TIt \'\"=FEn~
i\'::~ 11l:':'\'I' lWrFlH-:ST
III Illo\ ,10......10.'''. wlllol" I'" Y""I'S ,>I'd""",. ,,,..,,.. ..01)' ",,,,,,,1'.',' "I' .."y "'''1.'','1''' \",,1. ,01' his "SI."I.", wlllo'nll.
I"'",'I\'I,,~ .. ""I""hl.' ..,..I ",1"'1""'" .."""1,1",'''11",, 1Io..,'''r.,,''! (.\""w<". Y"" ,," ",,).JiO_
(~) 1l1.\ .10."."1,,,,1. wllhl" '"'' Y"'"'' "I' ,Io...lh. II'"nsl'.." I"'''I''''''Y 1','''''' 101"''''11' I." hl",,,.'11' ""d ..""I.h','" "I'
,.lhl~rs (illellllllll~" S(1C1l1sl'l in Joint. f1""I',.ship'i (\11:-;....'.1. Y.:s III. Ilol~~_
(:I) 11' the nIlS....I~r tu (1) 01. (:.n 111111\'" Is III till" 1I1'l'lrllllltl\"~ Slall':
(It) ,\!~l! of' ,11'el'IIl'IIl. III tllTW ot' 1.t.I\Il~;I'l!r --6-8_
(h) St.all~ nf' 111~f~l~dlmt.ls IlI'all.lI ltt. ttw' "I' llI11kllll~ UJf' trllllsI'P'.. (:-lnl.l'I).
(c) entlSI' n(' lh!t~l'd,'"tl s Ih'ltl.l.. (:\clll! I).
(,I) Illd <leeeol""t, I" his 111.....1"".. ",,,k.. n"y "'"''sl'.''' ..I' I''''I'''''I.Y wlll,""1. I'.'r<<l\'l"~ a \'..I"..hJr' "I' ,,,I"'IIIIIt..
eo"sloI"I'..t1"" 1,("'1'''1''''' which w"s t.<o I..."''' ,,1'1''''''' I" 1"."","'\<1" ,or' "<lI<I\'n",,,!. "I. <I" ,,1'1."" lots ,I"uth?
(Answ,,1' )'''s ul' nn) No ' .
(,,) ,."S U,,'I''' ""Y 1'<I",lh\llt)' tha' 1.1", \"<11""'1.)' l.,.a",,\'''I'r...1 ",,;;(,1. ,','1<"'11 I" I.l'uns\'.""'" ",. his
estllH~ Of Ill' slItJ.I,'et. tu hi~ 11I1I\"Pf (/1' Ill,<;l'fJsJt.JOtl'! (,\IIS\~PI' ~'f'S 01. TlO) No.
(h) What .....IIS 1.lLf~ 1.1.:mst'llree1 S 1I:,!.1~ lit I Ifill' or fll'l:I'lIent's i!llllth'! NA
(5) 11Id d..ce,len!. In his 11\'....lm" n1uk.. ..n)' t",""S\'er wIU,,'"1. I'"eel\'ln;;" \'alll..hl....'I<I,,,I'''I''''l.e consld"I'Iltlnn
U"'I'"l'ul' IIn,h" whl"h 1.,...ns!'..I'''1' eXI'I',,,,sly' or l"I'I\"oIly' ,...sel',,",S \'<1" 100s III'" "I' ,,,,)' 1'''1'1",1 which oIo..s
not in flU:t. enll herorl' Ills lh!ath:
(Il) ,\,1", 1'0","..",1"" "I' ''''.I<1)'""elll. <II' 01' I.h" dght I." ".."""e 1'..<lnI U,,' 1'''<lI'''l't). tl',""s!'''I'I'"d?
('\nswl"!r yt!S or JlO) No
(h) '\'h.. 1'\;;101. to d"slgnot.. 110" 1"'l's",,,, .It" slt,,11 I'<lsse"," 0" ''''.10)' th" property tl'llns!'el'l'.,,1 or
income th'~rl!!'rnl1l? (Ans\<l'cr yes or no) No
(n) II' th" IlnSW"1' t<l (5) (It) ..I",ve Is \n Ih" <lI'\'I"",tl\'e. stUl.e whet.her UK' I'I~hl. wus I'.>sel'ved In deredent
nlone or others NA
(7) 11101 .Ieeedent In his 11\",1.1"''' ",..k" Il tl'ans!'el'. the r<lnsl'I"l'utl..n ('''I' which ...s tl'uns('''l'e..' S 111'0mls" to
pol' Ineo",," to <I" 1'<11' U", l,en..!'\I. <II' ,,"l''' <I\' tr..ns\'''I'<I'''! ('\n""'1' Y"1S <I" no) No
(8) IlId oIeeede"I., Ill. an)' tl",", u.,,,,,,!"'1' pl'nl'''I'I.Y', U", h,,,,..\'I,,,..1 "".I..)'",ellt o\' which WIlS so".Ieet to ehllnge,
hecIlllse o!' a 1''''''1'\,..,1 P<lW"" 1.0 ..It.. 1'. <II""nd. ",. 1'''\'0'''', 0" whlclt CO<lI,1 ,."v..1'1. 1.<1 d""",,"nt "n,I..1' I"I'....~
of trltnsl'er or hy opernt.ion nt' IIlW? (.\nSWf~I' Yl~S m' no) No
(ll) II' the Ilnswel' t<l (H) ul".\''' Is In tit" ..1'l'il'"""tl\''', wus 1.1'" I"""" tn <II "'I'. ,"'1<,,,,1. or ,...v"k.. the Int..l'-
esl 01' th.. h..n..I'I"'.."Y "'''''1'\,,,,1 I" I.h" d..ce,lent ..I",,,, nl' th" .hle.,,\..,,1 ..",I nth..l's'!
(..\nswer yes or no) Nn
~OTE1: Th.. Iln,,"el'S t" I.h"s" <jllesl.l<l"S "It<llllol h" slll'pol't..d hy ..1'1'1,luv It hy I.h" utt."II,lin~ I'hyslellln liS
well 85 U copy 01' thl""! Ihwt.h el.)-t.i r1CIlV~.
~OTE~: I!' IlnS.el' to ..n)' <I!' th.. Ilh"v" 'I"..sll"ns Is )""'. s.... \'<I,.th hel"" Il d."edptl"n 0\' Ihe 1'1'01'''1'1.)'
Il'lInsl'el'l'..,I. II's rail' mal'k"t \'al.", at .Iat.. <II' ,Iellth, ,\..t..s 01' \...allsl'..I'S 11",1 to wh<lm Il'ansl'''l'l'e'\, with
I'elatlonshll' o!' tl',,"sl'el'''''S 10 ,\"e..,I,,"t. \1' '<1\)'. Sohml\. ropy o\' ""y \.I'IIS:' .1.....1 01' IlIst"lIm,,,,I, II' tl'III1S-
r"I'S Ill''' clol",...1 :'0 I", n",,-:'a,"hl". ..Is" slIh",1t ,\..:...\1,1<\ s,..te"","\. "f' ('allts <I" which s..loI 01111", Is hllsetl.
~OTE:J: I.lst "l'pIleohle 1"'''1'''1':')' 1",1<1' III "l/'I\II<,I' I" .hlllh 1",,,\'1,\,,,1 III SlIh..,hllllS A. \I. 0" ".
ITE~,t
lJESCItTI)'l'I(J~
MilKE'\' V,Il.UE
(Est.imated)
Cumberland Valley Savings & Loan Assoc.
Savings Cert. #6700868 - Dec. 31, 1979
Registered Helen M. Rea and
5,034.20
Dallas E. Rea, Jr. (son)
\
InsHrl this t.oVtl f)Jlpnstl.." "TI.aIlSrl~rs", ~chl!lllllp "e" In 1.111'
"As Hf!11urtp.d" r.f))lInUl un thl"' Illsl. I"l~l' of t.hls l"f'I.urn.
m~Pl'. VM.UATIOS
(11"l't. Only)
Sf c.JIl. ~ c
..>--g'1l
REV-"'! (8-781
CO~tdONWEALTIt OF PENNSYLVAl\'A
TRANSFER INItERITANCE TAX
RESIDENT DECEDENT
.~I'
t- ,~~~
,~{ ,~~ \'\
It...~4: .. ,', :1
~~c ~.- ..f~~~tl
SCHEDULE "I)' I
IlENEFICIAI(lES
-
8ENEFICIAlUES AND ADDRr:sSES REI.ATIONSIlII'
(State full numes and <lddrcsseloi or all who (If Itep-dl11drC'n or SllItVIVl.:U DATE INTEIlEST OF
have on interest, vested. contingent or olhel'" ilh'~itiml1le childra~1l DECEDENT III' lU::"n~F1C1AR'
wiNe, in eSlate) ure in...uh'cd. set STATE YES IlIRTII l~ ESTATE
forth this rllct~) Oil Nil
Dallas E. Rea. Jr. Son ve" ...hnl""
R.D. #l - -
Boiling Springs. PA 17007
I
--
-
- - - .,-
Deponent further says that all the above-named beneficiaries are living at this tim~ except below:
NAME
RESIDENCE
DAT[; OF DC~tii
~
Sill'"':
,,< -
=: It
" C
'a ~ e
._ ~ ::s
e- -
'" c. 0
<e"
. o'
""'u;,
.s ~ OJ
"", -
" " ~
OJ e g,
" OJ
!:!. e<:
~.-:
SUMMARY
Real Properly
Personal Properly
'[ra~srer~
JOlnt.LV
(S~h. "^")
(Seh. "U")
(Seh.IIC"1
::ich. liE'
Gross Taxable Eslate
-"
-.-.-....--.-.-.
(\)
(As Reported)
-0-
4,790 30
1~:~g~:~2
(2)
(As Delermioed)
$
$
$
$
$
$ ..2.1.....213... 9 2
$
$
$
$
$
$
r-- '0
- Z OJ
" UJ "
" :;; "
.... OJ Z
UJ u H
oo OJ ..J ~
- Q -<
-t '"
c.: u.. .~ :< H
0.
0. 0 ;; co: ol:l
lL
" -t "UJ ~ lL
.::: UJ ':::r-- .a: >. -< z
ci r-- r--< jg '" H
:c '-r-- e Q ~
Z .5 r-- e :z
Coo OJ -<
u.. UJ Co H
0 ~ ~ l-
e e co:
0 ~
.- c.: Z .n -S 0 z
- UJ r..l .<:: -;; lL H
'"
- r-- ...:l CIl OJ W ~
- ~ co:
III r-- r..l c "
'c < ::<:: ~ e H
_'s :;; 0 1:- 0
" e e
:::"0 ;; " e
:::~ e "
..J U U
REY-4U <<4-711)
COMMONWEALTH OF PENNSYLVANIA
BUREAU OF EXAMINATION
INHERITANCE TAX SECTION
SCllEllllLE "I'''
JOINTL \' OWNEIlI'IWI'I'RT\'
*
INSTRUCTIONS: TIlis schedule must discluse liB property, real <llld pcrslInal, lIwlwd h\' the decedentll1intlv with
another or others, including intangibles, standing in the namc lIf the decedent and others. List real estate firsl, as
entireties, or joint tenants, gh'il1g brief descrilllillll, as indicatcd under Schcllull~ "A." plus the lIate and place of
record of instrument crfecting ycstiture, hut dllllul include entireties IIr tlllt uf stale real estate yulue in estate
valuation coluJlln. Personal properly should be listed as in Schedule liB," plus dale (If acquisitinn, und the name,
address and relulinnship (if any) of co-owners to the cJeccdell I.
Description of Property, Uate of I\Ctluisitiul1, Name
AdJress and Relationship of Co--Owners, ami Phlee
of Record of Instrument, where Real Estate.
Unit
Value
Pen.."ent.'!:;c Estute
Share V."uation
First National Bank of Shippensbure;
Reg. Helen M. Rea & Dallas E. Rea., Jr
(Son)
CD #5640 - Aug. 9, 1974 1/2 775.08
CD #6564 - Feb. 2, 1976 1/2 1,552.26
CD #6640 - Mar. 7, 1976 1/2 1,027.79
CD #6963 - Sept. 6, 1976 1/2 1,286.2
Orrstown Bank
Reg. Helen M. Rea & Dallas E. Rea, Jr.
CD #1914 - Aue;. 30, 1974 (Son) ,000.0 1/2 2,058.4
CD #1959 - Nov. 1, 1974 3,000.0 1/2 1,525.67
CD #2090 - May 30, 1975 4,000.01 1/2 2,022.15
CD #2323 - Apr. 1, 1976 ,000.0 1/2 511. 58
CD #2439 Aug. 31, 1976 ,000.0 1/2 2,058.40
CD #2440 - Aug. 31, 1976 ,000.0 1/2 2,058.40
Cumberland Valley Savings & Loan Assn.
Reg. Helen M. Rea & Dallas E. Rea, Jr.
(Son)
Sav. Cert. #6693419 - Aug. 25, 1977 ,000.0
1/2 2,513.49
TOTAL-----
17,389. 2
Insert this total opposite 'IJuintly Owned Property," Schedule liEU
in the liAs Reported" column on the last page of this relum.
IlEI'AllTMENT VALUATION
(OFFICIAL USE ONLY)
Vulue uf
Entire
Properly
Value of
llcccdcnl's
Interest
/~.Jn.'1~
..u~
, ,.
.
-~~~>I
'Jt'~~~~\
un: '. I to,")
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMEHTOF REVEHUE
hllNEAlI Of COUNn COLLEcrION~
HARNI~UllRG
11I~1
Num; TO II" Sllll~II"I'l::U IN l'Il!l'l.ICAfE
Iilil'lJ{'l'INI; HNANl.:IAL JNSnrU'l'lON
ADllIU::SS
First National Bank
1 West K~ng ;:;t.
Sh~ppensburg, l"a. 1 Ii!.') {
ZIP CODE 1'It!.',} I
l'tllllll;ylVilllill [U,l),$rt\lll>llt of Rcvt:lluu
Burl!llu uf CUUllly Cullecttoll6
Gable UUlldJnll. Jrq.,rtollr
'/111 S. S"C(Jlld Stree~' '
/Iarrtliburg r ,Pu,!nJlyIVlJ,l\t., 17127
. 'I.'.,'
" ,
Pur6UIlllL to Secl tOil 742. Pellnsyl vanta lllherlllln~e
1961 ;Wl! htlrewHh Iiubmlt the followtlljJ ~Ilpurt; , '
, ,
,DATE O~' D~1lf
January 25. 1980
,
,', .
Df:Ci::ASED JOINT DEPOSlTOR. TRus'rEE
OR INVESTOR Helen M. Rea
, ...
. ,
, ADDRESS
207 Ridp;e Ave.,
Shippensburg, ~a.'
COUNTY 'Cumberlailq
ZI~ CODE' 11~5i '. ';,','
.', . ~, ....... ."1" ,," .
." .
. .'
"
SURVIVING DEPOSITOR., , ' , ' , " '
BEHEFICIAR't' OR INVESTOR:, Dallas, E: Rea, Jr.
4DD,R8SS R. D. 1, BOiling Springa;.1>a'.
llELATIONSIUP 1'0 DECEDENT Son
"
"
DATE DEPOSITOR J NVEST~T '
WAS E$TABLISIlED l'see attached
' .
list,
B4LAHCE, INCLUDINQ IN'f.E~ST
J>UE. AT DATE OF DEI\TU $ ~,282. 65
07J'~4d
S,(8~tllre,
~ .
","',"",.:",
'"" ,
\\ ~~ #<. --L.
A ' .'it~ $lTCE
,
..r' .
,
I.. '.
. .','
,., ,',
. '. '.:i:'
,
l:~ f"\
>>~ i \~~
-~~ .:".. ~ .'
FIRST NATIONAL BANK OF SHIPPENSBURG
SI-1IPPENSBURG, PA 1725'(' PHONE, (71n 532.2151
Feb. 25. 1980
Listed below are the four certificates of deposit registered in
the names of Helen M, Rea or Dallas E. Rea, Jr" and their value
as of her date of death January 25, 1980.
#5640
#6564
#6640
#6963
dated Aug. 9, 1974 $1500.00
accrued interest to date of death 50.15
$1550.15
dated ~'eb. 2, 1976 3000.00
accrued interest to date of death 104.52
3104.52
dated March 7, 1976 2000.00
accrued interest to date of death 55.58
2055.58
dated Sept. 6, 1976 2500.00
accrued interest to date of death 72 . 40
$ 2572.40
Grand total including
accrued interest at
date of death
$ 9,282.65
RCC-41 (4-'7'
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT OF REVENUE
BANK NO.
NOTICE OF DECEDENT ACCOUNT STATUS
DATE FIL.ED
Jcmum:7 31. 19<30
RETURN COMPL ETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
NAME
SURVIVING DEPOSITOR (B.n.Ilc1...,) INFORlolATION
REL.ATIONSHIP
TO DECEDENT.
E
ADDRESS
2U1 1l:ldgo '\VOIllle
SbiPP""RWrg, PA
1(.Ql
BANK/INSTITUTION ADDRESS
CumborlWld V!Uloy ";.wing~ Ul:d 1.()an AooociatiOll
49 YOl.lt King st1"oet, l30E 314
ShiPpezpuoa. 1'.11 17257
"
,
Q
STATUS OF ACCOUNT NOI (JOINT. TRUST, OR INVESTMENT
"oint
'" :J
NAMES ON ACCOUNT
*it llelom U. lloo or
Dall:18 ~. J1aa. Jl'.
SOCIAL SECURITY NUMBER(S)
lttt :206-32-261>9
DECEDENT IN FORMA ION
NAME
"
ADDRESS
~ P.id30 Avem.tG
CIT":.
:..hiPr>a'U)roz.c;. 1'11.
BALANCE OF ACCOUNT AT 000
INTEREST ACCRUED AND COLLECTIBLE AT 000
TOTAL
DATE OF DEATH
Jan.
COUNTY~~borland
'i72g~E
$ 5,eee.ee
s f'j.OO
s
BANK AUTNORIZA TIDN
I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
WITH SECTION 742 P r 80 E TAX ACT OF 1061.
SIGNATURE OF FINANCIAL INVESTIGATOR DATE
1-31-60
- --._'o.<;.,ll..~j
. .;~L)?,~~~
File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-80-0118
REV0484 EX+ 13.801
Estate Name
REA -!.H_e1en M.
Date of Death
01/25/80
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, ,he unde..igned duly appointed Inher;'ane. Tax Approi.er in and far the County of . Cumberland
P.nnsylvania, do re.pee,fully report that I have appraised tI.e roal and personal property a. report ad in ,he foregoing
return at the values sat forth opposite each item in the last column to the right in Schedules "AIt, "S", IfC", and "E"
Dated:
April 10, 1980
.tIlr'~/J 1,1l/,,l,,yj)
INHERITAt4Ca.: TAX APPR~ISER
AaJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
Real Property (Schedule A) $ None,' 00+ 92+
Perlonal Property (Schedule B) 4,790 30 10+
Jolnt.Held Property (Schedulo E) 17,389 42 ;'1)+
Transfers (Schodulo C) 5,034 20 30+
TOTAL GROSS ASSETS 27,213 92
Lei' D.bt, and Deductions =-1 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of 11f. ..totOI or RATE FACTOR PRINCIPLE VALUE CODE
annultl... . . . . . . . . . . . . .
FOR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
S
S
S
$
$
6"
"
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
S
$
Tax on $
15%
Tax on S
Tax on $
Tax on S
Exemptions
Total Estate
Loss Crodlts
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
s
+ S
s
=
$
+
=
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
5
S
'*
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPEP.ATIO/lS
P. O. BOX 2970
HARRISBURG
17105
IN YOUR REPL V PL::ASE
REFER TO
Investigation Divisinn
REV.518 (3.79)
NOTICE OF FI LING OF APPRAISEMENT
Dallas E. Rea, Jr.
R. D. #1
Boiling Springs, PA 17007
(Executor or Admil1istrator)
In Re: Estate of
Helen H. Rea
Cumberland County - File No.
21-80-0118
Dear Mr. Rea:
You are hereby notified that the original
appraisement in the estate of Helen M. Rea
has been filed in the office of the Register of Wills of Cumberland
County on April 10 ,1980 . Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
1<.790.30
5.031<.20
17.389.1<2
$27.213.92
As to such tax that is paid within three months from date of death. a five (5%) percent
discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months
when death occurred from December 22, 1965 to June 16,1971, inclusive; and twelvemonths
when death occurred prior to December 22,1965) from date of death, interest at the rate of six
(6%) percent per annum is charged.
Any party in interest who is aggrieved by th is notice may object thereto within sixty
days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax
Act of 1961, 72 P. S. 2485.1001, P. L. 373.
Date
April 10, 1980
Signed
.iJ}:;~Y/J / -A'1j.J~ If/l )
Title Chief Appraiser
NOTE: This is not a bill.
. '
REV-457 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
'*
Estate of
REA, Helen M.
File No. 21-80-0118
County
Cumberland
Date of Death 01/25/80
In the event that BOY future Inter..t In thl. estate Is tranderred in pnue"lon or enjoyment tn collateral holJl 01 the decedent .ftar the expiration of any
est.te for IIf. or for years, the Commonwealth hereby exprealy rO$8rvM the right to appraise and assoss uarder Inheritance taxes at thllewful collat.ral rate
on any such futurelnt.ref1.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "B"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "e"
None
4,790.30
5,034.20
17,389,42
TOTAL REPORTED PROPERTY
27,213,92
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
None
TOTAL GROSS ASSETS
27,213,92
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills.
4/ '),7?' , t)
JI-'(' ,) 11'111/), (
A!"'PRAISER
04/10/80
DATE
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~;,~,~C4(11178) 'COMMONWEALTH OF PENNSYLVANIA'
~No'J063021 OEPARTMENT OF REVENUE
:>~. , OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
11"
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= RECEIVED ---------------JlT.RVRN mnmll1m
II
a From,
I
~ ,ddress
.
/I
I,
A
)II
iI File No,
i Dote of Payment
~
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Ix:w:1 '1, T...n..., Il"Wf n, Atty.
NY~-POl'R ~ 21>/100-----__________.,j<>llors
representing Pennsylvania Inheritance or
Estate Tox due from the following estate:
" S. Ranovar Street
21ft: Tox on
s
s
Carli. Ie.
Pa.
17013
6l/i Tax on
s
s
21-80-118 Dole of Death 1-25-1980
15'/, Tox on
s
s
"prf,
l? ,
1QRn
1ft: Tax on S
Estate Tox, Act of
Moy 7, 1927
s
I
"
Nome of Decedent
81'.'" II
UA
s
Cou nty
TOTAL TAX CREDIT
less five percenlum of tax if
paid within three months ofter
date of death
Plus interest ot the role of
_%from
to
s
1.257.11
Remarks:
s
62.85
s
'iJ'OO~[P[lJ@!i1'iJ'rn SEAL
TOTAL AMOUNT PAID
s
1,194.26
I
NOTE, TIli. Triplicate RecoipttD be roteined fDr .udO purpo..., ,~ ~' ')l) L, 0
Rece,ved by ~ ~ ('/) (IIN>.I
NOtE: In Qcceptlng Ihe !ronder inheritance lox on future e,lale" prior 10 Ihe dealh of lhe llle 9 ur ---...
lenanl or 'enanl lor yearl, 05 eviden'ed by Ihh reteipl, il il under51aod Ihal Ihe Commonwealth Ihall Hara 1. I.cLane, Deputy
nol be precluded or prevented from hereafrer aueuing addilianal inherilanCIf lax allhe death of Ihe >>~f A+..... n# wf 11.
Ufe lenanl or lenanl lor yearl whenever it appean lhal such addilionallaJ. may be legally due and . (Tille)
colleclible for any realan whallaev.r.
---------------------_._----_._------------~_.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
*'
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
}I go -) I 8'
COUNTY.,FILE NO:
).),-J.L.l'iS L I'..c to{ -1..:...,
TO: 1/;..1 l.li.',d/'V, 11,",1...;,,1/ /^/.I"/J
/0
I'/.{r., .
c:;'
/I~. J. ,/.,v
/11 lilt: n'
DATE
/'l. IY..;;>-e;J
ESTATE
/h(
FILE NO,
~j J - (q. d - II ;;>
.-
.,)
/I~.I N C t/ L- /'..
S r
(" ~ 1\ /. ' ~ t i:-
,
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r' ,,;. l-l , ~ ..'.: ,. I. ,- ..J I)
/ "{";' / I
COUNTY
DATE OF DEATH
I ,. ,-~ .,,'
. ,,I ,.' (':0
Appraised Value of Estate:
Real Estate
$
+ i ?,/(),,jo
')., //'1)' "',
+ C\..V""-/....."\ ,VJ,.t.
Personal Property
Jointly Held PropertylTransfers
Total Gross Estate
$.d7;"n.9;).
/; 'l-c,,/, '17
,
$ ,pq III '<h-
Total Approved Oeductions
Clear Value of Estate
Less: Approved Charitable Exemptions
Clear Value of :::state Subject to Tax
$
Amount Taxable @ 6% Rate
$ d {I, '1-;-), Y'J-
tax due
$ /;;'~7,J/
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE $
'* '* '* '* '* * A five percent discount totaling $
will be granted jf the Inheritance Tax is paid by
less Credits:
DATE OF PAYMENT
'1-/,:2. -8'0
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
1191/00
=
$
/ -;. ';t(. ~)..-
$ 1;;,6-/'-
+
$
$
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
C; -
1 11/ ,l:-
S l.L/lv( I'...v ,< -
BALANCE OF PENNSYLVANIA INHERITANCE TAX OUE
/ j, /l ,.,-
(1',_ ./(/....... \'.
Assessed by: '.--r'i..-L,,,G, J/ ;!(',(,'vJ
See Information on Reverse Side Ai,ent f~rlh~ Common~allh _ _ . _.
)./&5"/ t..' './ /(~ c./~-,,,,~ (1 - (.If -Iv.
/ 1- 1-)-
di L :,: ~ ,j :
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REV-." ta-nl
~~/~fY.'//[X
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM Of
Off ICE Of THE
REGISTER Of WILLS
Of r.lIMRRRT.AND COUNTY
AND AGENT Of THE COMMONWEAL TH
._~.
Df(",ri REGISTER OF WILLS, AGENT
~_:.)( /:, i
ESTA TE OF HELEN M. REA
LATE OF SHIPPENSBURG BOROUGH
DATE OF FILING APPRAISEMENT ~arch 6. 1980 DATE Of DEATH Januarv 2'3, 1980
DATE NO. Of NAME Of PAYEE REMARKS AMOUNT
VOUCHER
-20-80 Rel!. of \oJ111s Letters, etc. 27 00
-:2.l=..RO ('"mh Law Journal Advertising 18 '1.ll.-
_"_Rn Qa~ nl' \v; 11" I", H "" ;nv l1. ~nn ,; nn
-14-80 Rerr. of Wills j?ilin". Debts & Ded. 3 00
_,~_Rn lola, :pr Cemetery Inc. Bronze Memorial 6,0 00
-14-80 Westminster Cemetery. Inc Cemetery olot 450 00
Dallas Rea Jr. Reimburse-electric-fuel oil 151 92
n~"~~ Qa~ ,Tn Qa' _M'~'~"a~ "n,~ R<; inn
-14-80 H. David Miller Jr. Ins. Administrator's bond 98 00
_,~_Rn - I ""nO'o'" H'llnp,.."l Hnme FunerRl "ervices 1 284 00
Ref!. of \oJ111s Filing account 33 00
Q"", n(' noad" 1QocnrdinO' release 7 00
- t:l T_.,.' n 11,1".." 1'00" ?~ nn
Dallas Rea Jr. Reimburse-phone bill 'i 10
-14-8n M; ch"el T. Donahoe 14.D. Medical services 326 00
-14_Rn h1P",~ m " lp Advertisino- 1'3 00
Dallas Rea. Jr. Administrator's fee 1,360 70
T,..."dn l1. T,..."dn 8....n,...npv'~ ('pp , ,,60 70
-14-80 Chambers bur'" Hosoital Hospital services 133 75
::.lka.D ,hu,..", Ane"t-hosi" A. sn. --Anesthesia services 'i'3 00
-14-80 McClure Newspapers, Inc. Public Ooinion adv. 14 62
Dallas Rea Reimburse-P P & L, fuel oil --l7l' ' R
water, e1;c.
, TOTAL 6 261 97
COMMONWEALTH OP PENNSYLVANIA \
COUNTY OF Cumberland 55:
I, Dallas E. Rea, Jr. HEREBY CERTifY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF.Jil:.len M. Rea
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES,
. .
It!
SWORN A 0 SUBSCRIBED BEFORE ME THIS
I, ' ~ 19lill.-
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(L.S.)
DAY OF