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RCCMI0313.73}
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESiDENT DECEDENTS
)_/,(- :U
*
l' COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
COUNTY OF CUMBERIAND
Thl. ,,'um mu.' bo complotod In dotal I aod I;lad in duplica'a, wi.h .ha Rogi.tu, 0\ W;lI. in thu County wh..a thu doCudant ".idod wllhin nino
months of lor dolo of duoth, unloss an 01(1011510n Is grantod by tho Soc:rulory 0' RO....'.lnuo,
Will ~';;I-'6o-l7l
^dmn, Nn, 'l)Jill.. I,..JOHN D. JACOBS
uf 531 Bosler Avenue , Lemoyne. PA
( "IlDf~E5!l1
(NM.1El
Mise,
hdng dnly s\l'urn lIeeurding tll I a I\' , depuses allll says Ihll\ he is the _SJ,\['ll.VJng--s.nO-US,fLOf--,------
...~..-.,.,...&.;oIo4,r"'Io.ol...."",~..."...lOo.l
nf-jlt""!I1..~rr __MAR):',-E. JACOBS-.--,----.,---'-----' IlIte ofLemOy,ne",_Gumb,erland--CounW,-Pl\
ILITY, IlOHOUGH, on TOWNSHIP)
deeellsed, IInd HUll the \l'hole of Ihe estllle of said decedent, whll died un __,_,Janua.ry-,30,,-J9,8..0---,..,..-,--'-'----
(O(l.TIO)
eonsisled of the IIsselS lisled hclol\' IInd Ihal allll\l'ahle dehts and dedllelinns exceeded the fair markel vlllue of Ihe assels and
no Pennsylvanin Trul1sfcr Inhcriwncc ')';1); is oue.
Sworn and subscribod beforo me
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day ~f..L12-
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( TITLE)
Type of Antlt: .' E ' I ^~'i\ 9 lQSl
Real Estate, pMw.Comm' Slon Xp\lC ': '
Property, JolnPi\wlisbu1'J PA D~llphlll (OLlnl~,
Held Prop. or
Transfers
ASSETS
(Atloen ndd1tlono~~if necossary)
Description of Asset
Estimated
Marlcet
Value
Department
Valuation
CAUTION
(00 not wrlla
in this SpllC,,)
Personal
1. U.S. Savings Bond - Series E
II Q 141315194 E (including accrued
Issued 3/42 interest)
Ma.tured 10 years from date
2. Personal pos ses sions
Clothing
Household goods
Miscellaneous
(~})
11,;,,("
Personal
300.00
150 .00
150.00
681.W ~nJ..~
REPORT OF INHERITANCE TAX APPRAISER .I/~fi..
I, lhe undersigned duly appointed It)heritanee Tax Appraiser in and fnr Ihe abnve Counly dn respectfully reporl thai I have
,ppfllised the real and personal properly as repurted'in Ihe furegoing schedule at the I'alocs set furth opposite each item in
the lasl enlumn to Ihe right. c' ,?,'t' ' ~" '/I A J
A i1 1 1980 &11-"0./ 'LUJ'_.,.<LL
Dated: pr 0 I "NHERITANCE TAX APPRALSERI
3. 531 Bosler Avenue, Lemoyne,
Cumberland County by Deed
dated 20 November 1953, Recorded on
September 30, 1953, in Deed Book N....
Volume 15, Page 1.....
(cont'd.)
- 0 - -----
:~~,:;~~'i:;"31 Estate
,';i.-,
Y' "enants-by-
'-, entireties)
/'---..--
TOT ALS
Name of Payeo DEBTS AND DEDUCT tONS Amount Amount Applovod
Nature of Claim Cloimod by Roglster .
Musselman Funeral Home Funeral services and arrangments 2,959.31
(Pd. - 2/8/80)
'lOlling Green cemetery Lot (Pd. - 1/31/80) 900.00
I ,{olllng Green cemetery Marker for Grave (Pd. 2/7/80) 700.00
Attorney Fees (ReserVe - handling estate matters) 200.00
TOT ALS
4,759.31
/j, '51, j /
REPORT llFTIIE REGISTER OF WILLS
I, the undersigoed doly elected Register of lVills in and for the ahove ('onnt)', do respeetfolly report lhall have allowed
deduetionlS in the anlllunlS xci furth in the ahol'e schedule as claimed, exeep' I\'here I have sel forth a greater or lesser amount
in the last column to the ri~ht, which grc,,,er or lesscr an1llllltl rcpresenls the sm allol\'cd as a deduction
\late of ApP"'l'al: *liJ 1/1 J tj iO ;
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Inheritance Tax Return for Insolvent Estates - John D. Jacobs Page Four
(t enants-by- 6. geNB
entireties)
Account *705936-7 588.62
John D. OR Mary E. Jacobs -
tenants -by-entireties
(non-taxable for estate purposes)
(tenants-by- 7. First Federal
entireties)
Account * 11-3857 332 .89
John D. OR Mary E. Jacobs ..
tenants -by -entireti es
(non-taxable for estate purposes)
Account * 2-27-006431 41,200.00
6 month certificate
Matures 4/30/80
Purchased 10/31/79
John D. OR Mary E. Jacobs-
tenants -by-en tireties
(non-taxable for estate purposes)
(tenants-by-
entireties) 8. eCNB
Checking Account * 003-000007 159 . 63
John D. OR Mary E. Jacobs -
tenants -by -entireties
(non-taxable for estate purposes)
(tenants-by- 9. Dauphin Deposit
entireties)
ehpcldng Account * 49-116800-40 323.33
John D. OR Mary E. Jacobs -
tenant s-by-entireties
(non-t axabl e f or est ate pur poses)