HomeMy WebLinkAbout80-00134
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REV.519 (6-78)
COMMONWEA~ TH OF PENNSY~VANIA
OEPARTMENT OF REVENUE
BUREAU OF FIE~D OPERATIONS
TRANSFER INHERITANCE TAX DIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
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COUNTY OF C; iJ.1<1_bS 1<2 .lA N d..
This ,,'um mu" b. o.mpl.tod 'n d.,.1I ."d Illod ,,, dupllon'o, wHh '100 RoOI".' 01 lVIII, In '100 C"",,'\' who.o ,100 doo"d",,' ",Idod wHh'n "Ino
months oftor datc of death, unle'is on cxton~ion 15 grantt!u by the Socretory of HO\'unuo.
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1')_ I, :_J,.-" .w:_ 'if ~e0'Ly.~L.._.._._ "I ;1 0 ,?JL'...~.l \ .:.-.:.LH)"J; I}:LI},-1-.v r-ltfJ~
ItlflMFI IAonr.Ci~,1
Misc, (\ .
h~il1g, lluly sworn llCCIJrlling In law, delHlses allll ~uy~ that~.he is the: ~?.~!l-lL.0:.~ -.~'---'--:--:---.-"''''.-''-.'--';------''- --..-.--....--....----.
Q [ 'LXLC.. ADM.. L,..GAl LL, U C,.
01 the eslate 01__ -.p_A!L_a.~._..J~.,'Y1':_.._O.Q.._......_......_._. late or..J" G:!"'.o..'./JYI ----,--.-- .--.-,.' ..---..-.---
~ (CITY, 'JOI,OUGH, OR TOV,'NSHIP)
deceased, alld ,hilt ,he whole 01 ,he estllte 01 sllid decedell', who died Oil Ct,,<-.'}W:t..-;:{(JI--.L9~!.~f--...
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eoosisted olthe IIsselS lisled hdow lIod Ihlll IIl10wllbk de It!> lIod dedue'ioos eseeeded the IlIi.. Illllrkel vlllue olthe lI>selS IIlld
....__.__...____n_.._...__
Will
Admn. No.
no Pennsylvania Transrer Inheritancl: Tax is due.
Sworn and. ~Ub5Cribod bofo~r mc
/ .1{ 111 d f .:t1,l/~U1::I]-j, 19..<'7(7
tho itle;g4LJ)J--
~!a1{;~fj/:2/.Jk/}1Zt?1~~-_214i:..~--~~~.
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'm~ Oc--rtld?"'Ut/.'-r> j( .J.(.J./} 1.t:A..- 10 / C; l?
Typcl of Asscl:
Real estal~, Pers.
Proporty, Jointly
Held Prop. or
Tronsfers
ASSETS
(Attach oddiliano~--;ts"il ncc(I$SoIY)
Description of Assat
Estimated
Morkot
Value
Dopartment
.voluation
CAUTION
(Do not write
in this space)
~~~
p~t';}
(S)~ ~J:~\...tu...J-. .91 QLl~\.cJ. tv_ ~L-\oc \tf\.~"",
1r\e~R~L-L~1 (fa..., (10.5'S
ClC..d # /50g'j-
_ .Joint Eropert Dauphin Deposit-Ivest Shore J?laza, Account
#13-1-0175-7 in names or Ronald L. Felmlee or
decedent or Ilelen L Felmlee established 11-5-73
with n balance of ~46.64. 1/6 taxable
A 1}.3 41. bCJ /1,341.69
11,1.10
141.10
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REI'ORT OF INIIERITANCE T,\X API'R.\ISER
I, the undersigned dull' appninled luh"itlluee Tas Al'praiser in and fur the above Coooty do respec,lully report thllll hal'e
appraised the real aud persuual p....perly liS rcported ill the foregoing schedule at the values set forth opposile each item iu
the last columil to the right. (!./". ',J Ji'?' ~ .P; J
A 11 ",,!:M.J~ic1i.Lt..LL
Dated:. PI' _ _3-, 1980 lINHI~RtTANCG: "-AX APPRAISER) -
J
TOTALS
Nome of Poyee
pEBTS AND DEDUCTIONS
Nature of Claim
Amount
Claimed
Amount Applovod
by Register
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TOTALS
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I/EI'i1RT OF TilE RE(i\STER OF WII.LS
I. the undersigned dull' ,keted I/l'gi"er ur Wills in and fur till' IIbUl'e Cunn')', do ,cspectfnlly repurtthll' I havl' allowed
dcductinlls in tlw amount:-. sel fllt"lh ill tile ahove schedule a~ claim;,:d, excL'pl where 11J:l\.c set rurth a greater or lesser amount
in the last column to the righl. which l;re~lter or lesscr alllount represctlts the SI!1l1 allow' as a deduction.
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Date of Al\pruval: \.<I(~'['l :2) .'l ~.,(,. f._
c5L,?d ; '0)'.6- ,.) ,\l'-..(~,~: ~\)EG'~~E~~~ .'LLS
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