HomeMy WebLinkAbout80-00157
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I<:DMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
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RC C~1()j\f3.7 31
COUNTY OF ~ERLAND
This toturn must ho completad In dotall and Olod In dupllcato, with tho Rogiatof 01 Will. In tho Counly whoro tho decodonl resldod within nino
month. aftar dota of doath, unlcss on ct)(IO"llon Is grantod by tho Socrotory of Rovonuo.
Will
Admn. No.
1l)JlQ.. I,
Marv C:. Walteru
INt.f.lf.l
~ 110 E. Oran~e St. Shippens-
l/lDDRE5!<1 burg, PA
Misc.
being duly sworn nccurding. to law, deposes ami says Ihlll3hc is the ~.i nrr spouse .-----~
IEXl':C" ADM., L.I:::OA1EE, 1..01C.1
of the cstnte of.G---E=k_W.al.t.er.s-.---------.-- late ofShipTlensb_1UZ. Bot'.9JdelJ...._....__
(CITY, uonOUvti, OR TOWNSHIP)
deceased, IInd Ihlll the whole of the eslllle of said decedent, who died on.No_\'.elnb..e.1'.-2.7_._19.7.8.___...____
IDATEI
consisled or the llsscts listed below and that 1I1111wahlc dchts nnd deductions exceeded the fuir market valllc or the ;lsscts and
no PCllnsylvuniu Transfer Inheritllnce Tax is due.
Sworn and subscribed before mo
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ASSETS
(Attach addltlanallhutl If neceua,y)
Description of Auot
Eltlmated
Market
Value
oepurlment
Valuation
CAUTION
(Do not write
In Ihll I eel
Type of AI~ :
Rool Eltale, Pen.
Property, Jolnlly
Held Prop. or
Tranlfen
:.n I.,;'. ",'~.,,:<J;J l.:':; ;;.. i <),,1. J, LIJ30
Personal t
proper y
Harold P. Walters C3tate
5,635.80
5,635.80 4'''6oJ5': J'O
REPORT 0 I' INHERITANCE TAX APPRAISER -flop/[
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the above County do respectfully report that I have
appraised lite real and personal property as reported in the foregoing schedule at the values set forth opposite each item in
. the Inst column to the right. ,,/1" , '1?' Ii J)
....\_.,(o.'f/1.1' ({I ,1'( "
Dated:. llNHERITANCE TAX APPRAISERl
TOTALS
Nome of Payce
DEBTS AND DEDUCTIONS
Nature of Claim
Amount
Clalmcd
Amount Apploved
by Regilter
TOT ALS
1,960.00
2,000.00
180.00
410.70
52.50
411.00
85.00
36.10
35.00
94.50
50.00
143.00
53.50
'88.76'1
99.12
Fogelsanger Funeral Horn
r~ary G. Walters
Eby Granite Works
Carlisle Hospital
Valley Medical Center
Belvedere Medical Cente
Dr. Thompr;on
Dr. Mac Kenzie
Dr. Stoupe
Shippensburg Clinic
Cumberland Valley fuT~ulance
Harris & Harris
Harrisburg Surgical -
Rite Aide
Rhea & Deric k
-Funeral services
Family exemption
Memorial
Drugs and supplies
Medical services
Medical services
Medica] ucrvJ.ceR
Medical services
Medical services
Medical services
Ambulance services
X-ray services
Supplies
Drugs
Drugs
REPORT OF TilE REGISTER OF WII.LS
I. the undersigned duly elected I~cgistcr of Wills in and for the above County, do respectfully repurt that I have allowed
deductions in the UIlUlUnls ~ct forth ill the ahove schedule as F.:Jaimcd, except where I ha\'e set fnrlh a greater or lessel' amnunl
in the lasl Clllumlltl lhe right. which g.rclItcr Hr lesser IImollol represents, tl c sum aJIOwed. as, a dl.:.'ductiUI1.
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