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HomeMy WebLinkAbout80-00189 ~.:", l~#'''i'. ~.:~.....;.;,....._---,.;., ,'4 ,..~.......,-,.,.__. ,0' j' t.,,', ,./ 5 '/ (() J' fe''!" ny' ,/(;,,"- RJ~v.-I/'/""-'1 ' '. 'ffici,)) tv/n'l /~Q, 17 'v / ( , 11;:\: '. I~ '1'0'1'111'; -,-; ~ - Ii II ,. 7- .. 0 ~ O~I~lm 01-' /ifj/.:5JdrY ?,):.s't)~ I :41t:",:/ (r4"J~CNEI 11 CCNtJOANK,N,A. ;, ,r.!J.NCWCUMUCnL..ANO,"''',l7070 " 'I FOII,61f.f,0_,~,~~_7! () ~ C't<flleYl;/C' .'/1, ;='e;lli'-"-" J :t,!'.""'';;.lIr'''''!'',';;;'''m::''- . _..' C11:0:l~,:1 ~2'i'~B!: 00[,00:1:127 ~Ii' ~ . -~~~... .~"l:\ll7.1:lllh'..".:.I~Ili'\'lt1''''',':''''''. '\"f}:J:~:'~"t'~aw:':'~.~'..1 tl .. 1:, ,', P L:,: R.o- i: (I ,..,,,; __1HZ. P..''___~_,___Si,(N ----- -,- .~_...., ..-, 111l/?,3( 60..1273 -m-. i ." ( ,^ , , I I. I . ~ \. . I C'"(J '-~:'i."Estate of Cath0ii"0":1~'eWJV.\IIH . 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I ~ Nr:W CUMBERLAND, PA. 17070 . r J~ . ~ L . . .. ~ /J C )~I ' ~ FO\l.Jj7-JSZ~,6...r.:D-,;L0__._:-- ,___~_ ',: __~ . _Y'-'\..-'._..i2-:.- 4...1!..'0...2..y ~c:.,: , ' ' ~."__",_,.;~<,:=,,~...,,~=,,,..,~~;,~}.:,~r~~,.~~~~,.ft~~~,:..~~~,~}.::':~~:~......_, .n:::~~~.~~'~"~=~:'<';; ~ l~ c. :-- '::-:-; .. '1 \J .. [_..~_~~____..~......~ -'::::;C1ll\Z .~_~ "':1tf'~I.'rl.'.' ~-~-~ ~~ ~~'.::Jo~. .~TI::' .. ....-- ....- '-'"' II -11"-..... t ". - -" ,....- ....- -~... "1- '... '~~. ~. NUMSEA I .' ' . I, I f\ i'~ , 3 ' i~' i' U' L \! All 00-'273 ( 1) 11.!.'!il? _31-_1!l ZJ. 3i3. j ;i3,:!!,t,," _ f'e.~/e,~. g"<.IC1',5'h~~..:.- -'''''''' -. _s,!j7. 20_._ . I~ .,$iX_iLL '. {}j!2.t3_tL().c..L ._____~ _n__' __ y_I";~___ - " - -- /& \)OJ.l..\HH .. 7- ,I ~ ' " Estate of Cather ine H. F.erber ~ c;""N~ 4~(l}'1.r f ;', 0 006-003327-1 q '--'" ~ . ACCT. No. ;1 CCNBBANK.N.A. " NItW CUMOltRL.ANO, PA.I'1070 ~. jJ .: i FOll_l'vd~,:..;;LZ?",'.s,.(t.d.5i'cH1Tn4 -l~:, l{1-kfJv0U'-'~~~-...&%C--:h : ;;~",....<<:4.rt' "':OHH2.'/':IBI: 0 00B2'i""~II' . ,"0000001:.91'0,". J...~ .:Ir:'.~..m.'~-;''''': ".~"."."'::.1H::U<t',,.~:,~.,,::,,.'l"=.~';'''''' ~;. ,':-'-"l::=~.._~.....:,~_I:.~J.l..:.~....~..'\ll:::tW1'Jt.'~~~.....~~~'tIl.ll,l;ttt'W'\':'.._.,;".~~I!~.;~~,;,.1\l~;,:.~~.'::.)I't'MI;llU/f,\::....~~::.\-='I6!.;:,~_...::;.l.=.~-:- .~.:':~1:t,.- ,~.,j ,'f' . , (" _~ ~. ~..~_~._~. ~~~,.~~...1I",I."'J1Jfu~~...:;;.~._......~-- --=....~~.:::;.;:;::...:-.Ii~........~.d. .. ;r'" .... --- - -... ..... .... -~ - 1i':f7 ...., I .. ; ,~ . r"" ;", . NUMBER' ~ . " . 4 ;. 4 -1, r\ 0 i 4 -4..-3-, ra '02 0 1/J/lf',,__11,-l!I.fJ2 l1O;;i73. 'i l~i\;'1'I1F ,.- j . I J,.. .. 1 i -r:. ll- n.e d .'" ,d' /):5 ( , S .'" /Ie I'-r 0', Olull':H'0l-:C1J2,,);J~5rlta ~c; I; ; vI- e,>t;12(f/~~ !U I~qfi ' /.,. t., . (7, ..)~".. -- -- ,,' ,?-(,/ "~ <..'... ~' ' --+4J.-.:--4 .,"'. ";7) " 2i(.io.-iJ()IJ.Ji,c.,d-ju1d--,---."---.~-,,. .__.!...L___', .L_~" t r c" h '. -/1<"'1" ))bo!.!..\lli' , ..... Es atE: O~ iJ.t erlne t~ .er er . ~", '-CCN~ '''', 'N 006-003327-1 ~ t,\}J ACCT. 0, , . " CCNl3BANK.N.A., ~\l/ \ ' . " New CUMIH::q~ND,I"".17070 .' , (' ~ ^. (: fJ I . ,It ..,/ I' -r: '.. . L [, ~ '! ../" i'l. .(/\)J~ c>/.t7~, .E::r~z~~i:~.~~.~ii~.L~~E.~,~~.,=..~~;~~~;~; /1' ... " . c. ~~~ '1~') If'''I r"'l .:--:~.. t/:,,' ~G.?.I,"""':;~'~' ..... \~ .7.::. ...."'r ~j ':':.:~' i~~1 f~ ~X' c) tt~.'~ :;~., '~'l,.:t,~.'f,'::~'~"';' .,.... ~;:..:... - ,._' ,\;-_"" "I..t',l',....:: (jj.-P\ ::"1";\': . t&~" ~.~. ~.\~1"1' <:.... " 'ir":o- "",:,'." $:', !~:..<:~ I .. , ,_ to:'\ ...... \ /J~ t,J o ('f; ,'/~"ft. til \'.~ c.r: ....J L~ ,.:: o t;:.-: lJ. -. 'M"') l.;7"~~ .1("':. o ~. v.... )., Z' :..J lL -?'" ~O 01- l-oCf) en ~ .. .-~:> o t) a::'(." o..ll.1 :)'.:1 lJJ :I: W,., 01- ...J a:O..... 01-.... u. 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': NCWCUMDl:rlLAND,,.,.....17070:..,,, I. .... 6fl . i ,~ " ~ 1...(~I:,~"..".~h_:_._.__"____ . ~~:~;.3 ;~~P3:~'I:' 0 :~~~~7~;'~ .1~L-d~~ot~:~;~~:, ~.....~tn'llfr!J" ".:.....:l"\ll:iIr:wn;;.....::~~w -..a:"\ll'n\l'f'.r.m ....... \\VlJi9"'~I.......--:~!JlJII:;..~:..l'l':ll=,,~.:.....':.l.lIl:lO:fI::tlt'Ii~'~v:Jl=I.:......:~~~.....:...l\a..l:crul..n::......-~=~~":......:~......_-t.IIllI'o:'.l!lI7~....J. ; 1 0 t,', 0 ',;' NUMSER ~---"=- \ " '. 'r...-:.~....':.:l'/IoO~..~.::.._~~....:.....~~.....~. _'.. J :... 4.~ ~,... ;j. ~ ... -~\C.._"'1II~_......., ~..~Ii:..f):w.;:..*.:..:M~~....:..~~~..~c....::;.~....~.:;;-( H NUMBER ' ~ 1(1 (, 1; ',', 6 Ii ,; ~. {.'~' tI ; . I t I ~ -' ,} /1119/2 J) 00,1273 I ~I":'''' ~d'=YALjJ,_ Fefr~,J - .... ._,,~~<.~ ~':<2:''''; 'I .t::.od<{~.t6..["'c:__tt."Jd_ .-' -- . .. ' i . ,.5/ B) , ji " r rU fl, "",-t "E "t"'t "f'-C"th'-' ["1"- OJ,LAIlS ,'. ' -:~ '. . "UH..'l,'.saeo a~nnel: eruer :' ~ ,CCNB 'ACCT, No, 006-003327-1 "f.L ..__ : ~ CCNB BANK, N,A. P ': I> '" . 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"""," ..~. ....~>..:.~........ /.\~""'"'. ....:>..'..... ........-. ~;.. ..:--~...~~~ . .;.,~...,_..~.~........,.",.~....~ .:...;,--.~.:;."..~. . ~.::~. .--...... .~:~~~' ......,....~ ,.......... .~'~..~ ..~......: , .,(9VN~~~.ri.~i:~~: :';;.....o:;o::r....~ ~.~.....':':t ',,'" ......~ :'., ..."...~>... ,-.........,..;.: ~...-.A~'.... ..... -:,,-, ~"",'I'... 'ur ... ,-'" PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 70t of the Inheritance ;1Ild Estale Tax Act of 1961 provides that the following persons shall prepare and file a return: a. The personal representative of the estate of the decedent ilS 10 properly of the decedent adluinistered hy him and sllch additional properly which is or may be subjectlo Inheritilnce Tax of which he/she shall have or acqui rc knowl edge; , b. The transferee of properly upon the transfer of which loheritmlce Tax is or may be imposed by the 1961 Statute, including a trustee of property transferred in trust, provided Ihat no separate return need be made by the transferee of property included in the return of a personal representative, 2. PLACE FOR FILING The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided. 3, TIME FOR FILING The return is due nine months after the decedent's death, unless an extension for filing has been applied for and granted by the Secretary of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue i1S debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife, son, daughter, grandchildren, gri1ndparent, son-in-law and daughter-in-law and at the rate of 15% as to all others. 6, PAYMENTOFTAX .The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest ,at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any .'~il1terest which may be due with any remainder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED, All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes milY be sued for against any real property in the decedent's estate or against any property belonging to a transferee liable for the tax, 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both. ~. REV.45J. (1.S0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE "TRANSFER INHERI'fANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY (Instructions on Reverse Side) Estate of Catherine H. Ferber *, ESTIMATED DEPARTMENT ITEM DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL Y) 1 Misc. items of furniture, wearing apparel and housewares at 3 Vine Circle, Hampden Twp., Camp Hill, PA 17011 $ '300.00 2 Savings Account - First Federal Savings & Loan Association - Acct. #1-19312 $4,700.16 3 Property Tax Refund for Year 1979 $ 240.48 4 Pro-rated Refund on Homeowners Insurance Paid $ 46.00 on March 10, 1980 - $61.00 - Nationwide Insurance Company 5 Medicare Payment approved for Service Provided $ 28.00 by FHWC Associates on 2/7/80 6 Service provided by FHWCAssociates on 3/12/80 $ 40.00 (date of death) in Emergency Room of Polyclinic Medical Center 0.00+ O.OOT O.T# 300.00+ 4.700016+ 240.48+ 46.00+ 28.00+ 40.00+ 5.354 . 6 4 T TOTAL THIS PAGE $5,354.64 , ..j'S,~'1 ' C, 1 ~tl.Ji' I "....".-......."..-.'............--...=cV.'..l_ i QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Diddecedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No".) No 2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ~ 3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. ,b. Copy of death certificate. c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer. d. All other information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) No a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) No b. What was the transferee's age at time of decedent's death? No 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No" ,) ~ , b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b, above is "Yes," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or, care of transferor? (Answer "Yes" or "No".) No 8; Did decedent, at any time, transfer property, the bmeficial enjoyment of which was subject to change, because of . a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) No 9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) RE.V.4!:i3 (1.BO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES * (Instructions 011 Reverse Side) Estate of Catherine H. Ferber - BENEFICIARI ES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY , DECEDENT BIRTH John W. Ferber Son VP~ 3/28/24 50% of residuary - 331 Harford Street estate Ha rri sburq, PA 17111 Betty J. Shank Daughter Yes 8/24/26 50% of res i dua rv 1485 Simpson Ferry Road estate , New Cumberl~nd, PA 1707n , , . , , , , , ' , - , , , , , - , The above beneficiaries are living at this time except for the following: NAME DATE OF DEATH . RE:V.454 (1,80) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEDENT SCHEDULE "E" JOINTL Y OWNED PROPERTY (Instructions on Reverse Sic!a) ~" .r ~', ' ; , Estate of Catherine H. Ferber P TOTAL E VALUE OF DEPARTMENT ITEM R DESCRIPTION MARKET C DECEDENT'S VALUATION NO. VALUE E INTEREST (Official Use Only) N T ) Joint Checking Account with CCNB in names of decedent or Betty J. Shank, Daughter _ Account #D06-0DO-464-5 $493.23 50% $246.62 TOTAL THIS PAGE $246.62 ' ,j~fc, (,,2..- .....' INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real "nd person"I, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship, Both tangible and int"ngible property are to be included. List real estate first. 1. Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property as indicated in the instructions for Schedule "B". Include the name, address and relationsl1ip to the decedent of the co'owner (s) and the date the joint ownership was established. 2. Indicate the total market value of the jointly owned property. 3. Indicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest, c "" tl n :>- '" :>- ~ z ;.- 0 0 tl C/l tl C) n c: tl o-j Z ::: Z t'" '" > 0 9 t'" '" ;r, Z ;>:l - Z Z '" o-j '" -l Z; 9 0 o-j -< C/l '" C/l Z 0 C/l 0 -' 0 "'1 "'1 ~ ~ ;.- 0 -l ~ - ~ 0 - z n :; t'" c: C/l tTj 0 Z t'" -< -< -< ~ i"i i"i ;l> ;> ::<:I ;>:l . REV-464 EX+ 13-80,1 INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) File Number _,_2;).-80-:.Q;)'~9_____._ Estate Nome _-Dntherine_H.,.Eerbel:...,_______... Dote of Death .J1a.r.ch_12. ,.1980.________,____. Social Security Number _160=-16,,867.7_...____._ REPORT OF INHERITAlKE TAX APPRAISER I, the undersigned dulyeppointed inheritance Tax Approis.r in and for tho County of Cumberland Pennsylvania, do rospectfully report that I have appraisod the real and personal property as reported in the foregoing return at the valuos sot forth opposite each item in the lost column to the right in Schedules "AU, liB", HC", and IIEIf Dated: Aup;ust 28. 1980 illiJ8/d J ;:1?/_;1".,J ) INHERITANCE TAX APPRAISER INVENTORY VALUE AS APPRAISED ADJUSTMENTS CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE Real Property (Schedule A) s 00+ 92+ Personal Property (Schadule B) 10+ Jolnt.Held Property (Schedule E) 20+ Transfers (Schedule C) 30+ TOTAL GROSS ASSETS _____,38.,601.26_ Less D.bts and Deductions (SCHEOULE F) CLeAR VALUE OF ESTATE 40- 93- Valuation of life estates or annuities. . . . . . . . . . . . . . RATE FACTOR PRINCIPLE VALUE CODE FOR USE OP REGISTER ONLY Tax on $ CODE COMPUTATION OF TAX $ $ $ S 6" " T ox on $ 15% .Tox on $ Tax on $ T ox on $ I Exe~ptlons Totol Estote TOTAL TAX INTEREST FROM BALANCE TO $ $ $ Less CredIts DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST -- + S S " + = BALANCE S TO S S TAX CREDIT 5 $ INTEREST FROM BALANCE DUE p:: ~ ~ p:: r ~ e'l. -< \0 Z W ~ 0 :>< o.l '" 'd =- M <=l ...l M 111 'M .-f -< ~ I< - " U Z P .0 - 0 ffi !i M "'" ~ - .-f ~ ~ <) t) 0 c:i ~ ~ ~ ... 0 '" 0 Z c:i '" '" >- ... c:i - o.l z E ~ f-o o.l Z Z ...l ci - 0 p:: z :.: o.l ...l Z ::E z 0 =- u '"' w - ~ '" ~ 0 0 -< z :::: - w u 0 ~ o-l I .' , IU:V.455 EX+ (3.HOI ] COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS PAGE 2 -- ---- =.-;;-==..=~~- Estate of Catherine H. Ferber Date of Death~l2/80 _File No, WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant John W. Ferber. Executor Relationship to Decedent Son Claimant's Address 331 Harford Street, Harri sburg, PA 17111 ITEM DATE NAME OF PAYEE REMARKS AMOUNT NO. 21 5/23/80 Sa 1 e of House SETTLEMENT EXPENSES (Copy of Settl ement Sheet _i S Adjustment of Taxes 46,40 attached) Adjustment of Sewa e 8ill 15.20 Stuard Derrick Commission on sale of house 2 310.00 Robert Derrick Pre aration of Deed 40.00 Commonwealth of PA Rea1t Transfer Tax 330.00 22 5/23/80 Robert L. Myers III Le a1 Services 50.00 23 Re ister of Wills Fil in fee for Inventor & Statement 6.00 24 Jo ce Anderson Notar Fee 1.50 TOTAL THIS PAGE I 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 as deductions for Inheritance Tax purposes. $6,028 .39 SIGNATURE OF ATTORNEY/FIDUr.:IARY OFFICIAL USE ONLY DATE DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S t t1,;J. 1'. !J q / AT 1.,'711 PERCENT. /;;~ e, I~~ ~ ~EGISTE OF WILLS Y-;<f-i'd DATE ..~ .... -----;-,....----=:.------------------.------------.-----..:-.- --...= ~ - W4~ii~~~}~';:~:ri:;:j;J)!"E,:CO'MMCiNWEA'Li:H 'OF, flE'i\INsvLvANI'A";':" .' :~i:':':::f~ ~~l?,~~~~i>;~'~ . lii~~~n:-i':.;')r\~[fpr ...;,.~f':~l" " i ", ~ \ J " . '~'-'''' . ; , \ . .,'; {" ';";Y'~l, '/r:ti;r'l'f' ,. ,:.Ael~?~~~)~~~~~i~~:,~::i~~~:~~~~~~:',~):~~~~~:~ci~:l~~8:~~;iy~;~~l'" , " ,,, ~~~~!.t~k9t~;V!l;h~1,\<~.;;~;\~,f::-rl;~I;.~,'j~1 j ,,~~.t'~l>:~':>(,"r '~. "'\ rr" ,-,' (' ,:, ,Yt1:.ir1:,; 11,~,"~",',,,.,':r/:~ L</J,'(~ 1~;'~~:i!1:~\ r'f',~~~";;J.."" RECEIVED'-..;.---------~------~ mJICDPIlD SIVIH'lY " 16/100-------------,,;,dollors representing P~nnsylvDnlQ Inheritance or Estate Tax du.e from Ihe following estate: From: John 9f. Fel'bel' 'jress' 331 BIl~fozd 8t:net: 27,101<00 $ Date of Payment .~..hAr 10, 1980 % lox on S Estate Tax, Act of May 7, 1927 $ $ $ $ $ $ 270.16 $ . File No. IlIlrpiabllll:V , 21-80'-189 Dote of Death 3-12-1980 Pa. 11111 6%ToK on S 15'1', lax on $ ':Nameof Decedent t!A"".YNR Rt ..."12. Cuabel'l&ft4 IOTAL TAX CREDIT less fIve percentum of 10lC if paid within Ihree months after date af death Plus Inlerest at the role of _%fram 10 $ 'AID 01 ACCOUIft' " 1rOO ~ ~[L~ @!l\1rrn SEA L TOTAL AMOUNT PAID $ 270~16 ' 'NoTe: Thl. TrlpUcate RIcoIPt to be retained. for audit pu,po.ell. , Received by ,,~OTE: In occepllng the tronder Inll.rllanel 10M on future.sIDIlU. prior 10 the dealh 01 tile IIle '..tenanlorltnantlor yeors, oHlyldonted by thls receipt, It Is understood thai Ill. Commonwealth sholl . no!, b. precluded or prevtnlod fro'm h.,eof'er Queuing odditlonollnherllonce lox at lh. dealh of Ih. )lr'tenont Of lenont for y~or' whenever II appear. lhol luch Clddltlonollol( may be legally due and ;:. tollecllbl. for any reOlon whatsoe....r. t/; , .': ~'i ":.,:, _:.....__..,.-___________~___'''.,'i ,.--V7''W:~,~:..;~\,.,r"..'' ,.~T~;,.","IC'7".' ;". ~,'\r<! '. . . ;o,~ '"I._ ~. .~ "0'. 1\ I ,/.,. :to ~,~::, ;',.7\..~'.'.1 ' ,~ -', /~- ,j.,.\\~.~ .,S',~t:...." ..'~:>""_" ..~' ., .,~~. ,) -;. ., :.1.-.-; ..,,', i;;Jt!/;\~,i ~:~~. , " OFFICIAL NOTICE OF, , INHERITANCE ,TAX ASSESSMENT ," ;"',,:: !.-",' DATE /J ~ ~ ~ 'I? r t/", ",,/:;):!: ESTATE OF /!.u'f~;IjIJiA:iJJ!!i~, .:?/~?tJ - /ir':;,frl'~%i:~' ,FILE,~,O. .." ;'_" ," ,'; ,\',,:,_._:,~ :.. ",,';~':,;':,,:',~,:;:~f-;::~;l~;~;~~~ , ' ~'~j" ",'fA' 'd ' :., ;"-l",,:,,^~l,,:"i,/~.l;;'~;' 1,',' . . ~ V/ "~l '.' .' " -':~"'-~':''''\\:';~''~,y,,)!;,~U~ l'.~ COUNTY.OF' ,A/,H, ...., " '_ ",<"./~t:/!f~~Z: \: ' For,CounlY b,'ormallon purposes only , ' , ~-) " '<'" , , !, ~oJNr/FIi.E NO: .- " 'c:? / -! tJ - /17 'WUA d..'/"~ijj+/;:i~;:?: ,,),,"" ",';,~ ' .. ' , DATE OF DEATH' ~,' <"\ : ,', I: ,;,:~;li1; ~~'t;~;: .. "--------------:----------::-----C::':'ir~jt~:~ ,~~~\~I~~~:.y~,I.~.~..,~~. Es~~to:, . , "" iU1041. ,~0\ . ,(;: ::!>'.<',}iy~I~::~yM~ ",-,,,',"",,, "'~'Aeal Estate '", $ ,rv" rv ' ,',,,. ';"'"oi'f't' })'f;i!?:it:"'p';~;?r.,:pr;;~~~, ' ' ' , , I~' ?' ~ - ,', ;':>)';i;}~~ "'i-:,;' ',>' '::, Jointly Held PropenylTrensfers ,,: ":i:,.\:..Iff,t> ~~;;'r'i'~~;j-,':!~:fF;~:i\:':~{',:';.::.;:'.:,:::.:c.~:;:'~t:;":~~'::::-,.,; .. , .~, c 'J r-/~iJ j, ,'; / ' ,:';\;R\::;t~~ .',:::~,.iTQt81,Gro88,Est8tel'~:".'.:. Y _ - - ~~ {L ..~:-( ""::-"',I,'::_,-,..."i:ft'~1: ""::$~ot~;ti~a';~'I:~?Ap;i},t,;,'t~.i-'/:d')<'D'/f,\d/\:C\'j',<';I' t' ();; t,.1 '1 " , t' \?:/fj~;~~ ,!' "p,rove e u ons _, ,_ - " ," :..,-i,';,',(.i'{i,f.'\" , . $ ..3;1 1/1:1, g'1 , $ .3:<, ~-1;;"n , ~" , . '-' :;ZI\:;?;I;I;';,;,:\),\i~h,~ou"'q~able@ 6% Aate S ....1,2, 1{"7:;l, Y:L tax du~, '$ {9.!J 't3.l"":\":';'~' ,.. """i;~:'~}:;;i":i;'< i,', , ' " ' .. ",; ,'i,:"":' ',l:t;Y: ":-;"j"','I,AJ11ount,T\Il!able @l15% Aate tax due ' ,,,.., ' " ,," ,:::i,t;~::::':::::;;~>::,\ , '" "~ " , TOTAL PENNSYLVANiA INHEAITANCET~X DUE : ':~' :;;f:+~'~!.'~;~~;;ri:,:"", .", Ii': DATE OF PAYMENT '" "~:'''''. .' ,l, :;;. .,,' " /":-:-;.;:,;..,:~,:,.,,~,,,:;>; .-:J-iil!j-?(), .-'-',',' .',' ,,-' ~' , '(:"'" I:,;, " 'I'.' I.:'. ~, , ,~ J-' 'AMOl.iNT PAID DISCOUNT INTEAEST ' , TAX CREon',; Y' "",.' $ /HJHiJ i+ $ t'~' ,.,- ' .!.},J (,: $ = " --.. ->'i' , ,(" -" '~";~~>\:."("~".' '. ,,:':,y /,' $ 'J ,,l.., -., /, '_' ~.r-",l'~ (.if;,:,"": ,..,./'7;:{ ,.r.> ,~~,:,' ,~,;-: :0' ;'. ': ':- Ii' ;o.J'o , + ,1fy.!J- = fF?I,ir;-::, ,>, J, \;\8'~t? ~ +' 0,,";\> ,)',-, /, '~;'., '" ':'," '.1,'.. " ,,', , '" .' . "'",' . , . ' " 'BALANCE OF PENNSYLVANIA INHEAITANCETAXDUE '$ '.! ;,j'id;;r); :",'"" ,,-;. " ':'J',' "::>','.' -.': "'-,', .,:,':\:::' ....,.-':..-.,. . :,' ~. "':;~'~:;',' Intarest will, accrue",at the ,:.tfi'r:,n,herl18nCe tex from " rate, o(~ six , (6) percent par annum on 'the unpaid I balanca' , of ' ' , to the data of, payment. " '/' "..-." .:In"rd:- ~, '/7" '",.' " ,:;, SEE REVERSE SIDE FOR INSTRUCTIONS , REGISTER,OFWILL'SCOPY . . OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ . '20 % MI'ftk-A do ThIs,......, ..................,.." ......".... .......",.........., ........ duy of..... ..........""...."......,....,....,."....".."..., ..... A, D., 19........, Harold B. McLane, Deputy before me Klcl,u,d E. 1....L.MPl, Register for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came .............. ...,.,......,...,',.....,....73t1:~P..~~~.,........g.,~......,t...f,(,~~~.tI..C,........,.."............."...,.,.........,.".... the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ............c!.J:.-rA.~~.':!..~....tf........&....r!!!~~................ Dated ....(!..~.t...~~..If.l.., lateof...............C~.Il...tl.t.?L...................,.........,.......,........., Cumberland County Pa., deceased who being duly .......5...w.Q,~.N............. according to law, depose and say, that .......5.I1.o(...w,f!..l...... present, and saw and heard the testa+.~.!.~....................., .....cf1..1J.~.tr..l~....tI:..'...f.f:.l5:l~.IJ:.,....... sign, seal, publish, pronounce and declare the said instrument of writing as and for h..~.s....... Testament arid Last Will, and at the time of so doing ................5A..~...................was of sound and disposing mind memory and understanding, to the best of ..........,...A..~......................knowledge, observation and belief. ...........s..~Q.&~............... and subscribed before A~.'::~~..,..~..Qf!..~~~.......,....... ~~)~~. !.~......?:;.'€~:X ltlduud E. Alldt:l~Ull, Regisf:i' AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA 1 ss: COUNTY OF CUMBERLAND \ ,........ .......,................ ................ ........ .4.??4...'Y.... ,...f.!!..~...... .t..~~.~.~ .I!::,.,...................... ..........being duly , ..........$..W.~!:.lY................ says that as nearly as can be ascertained the said decedent .......................... ,..............C.I!.t:.-a.:t.~l..~.~..,.tI..:......E.~.'5:.l~,&:..,.......,,.....................,...............................,died on ..........wul~.t/try..... the .............(.~.~....day of .........lJ1.~~t................... A.D., 19..'.() at or about .................:).,..:....l.f...$:....... o'clock,PM, ...............$..Yt.,9.&.~..............and subscribed this ......................~..Q..7!:o............ day of ...I.!:.?!:?:rJ.~ 19, .8..9, before '~~.1~1~19:-;~4a.~,........,,!?~p..~.~y. ItldlUid E. nlldcltlUn, Reg~2;~ . .fb.::.I':......:y.~.............. No, 21.80 189 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY in the Estate of C f+TII J:~ I/II€ fl. FeI(jJE~ , deceased, Harold B. McLane, Deputy To nieharel C. t,A0C3rI;)9r:1, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania, is Petitioner(s) o&f'EI-the execuLO (L. _ named in the Last Will and Testament of .1.11.Ttf.eLINe.Ii.L~~~ dated Ovf 2-1'(]6 Decedent was a citizen of the United States and a resident of ( f1 1.1 'fuvVlI~1 .il-' !1m,., TT I t.. '- Borough, Cumberland County, Commonwealth af Pennsylvania, I / "f11 J..AAb / Decedent died on j{ ~'I.;UdA-' the I'), day of rY'",''''~_, A. D. 19M, in the County of C fA WI ~U /11 ,J r:l , State of 7>./ ~ NS ? I II A- ~ /~ at the age of ) S- years. +,U~ hes- her Decedent has not been married and has not had children born to h:i= since the execution of the above described Will. .J,J Decedent was possessed of personal property to the value of 011 5000.0 1J and of real estate to the value of .$I' 3 o. tJOo, O() , estate situated as follows ?e ,.111 ()...,. 17t111 e15pl'{ Therefore, your petitioner(s) respectfully applies for the probate of the said Lost Will and Testament and for Letters Testamentary thereon. Dated /IIi Ih'tc-" '2-0 . If! 0 , 0 Name and address .> 1f 1M/ /(/. ~~ ,/ of Petitioner(s) / ' 1 W C / OnN . L-e~ pete 3:3 / IIl'1l?fol€rI C{ tJ~ HfJRtflS b~t; j fJa.. /7/1/ / ' COMMONWEALTH OF PENNSYLVANIA tss COUNTY OF CUMBERLAND \ ::JOAAJ W. F~1f h~ It: named in above appl ication, being duly ) W () {t!. W according to law say(s) that the statements set forth in this petition are true to the best of h, $ knowledge and belief, > 1t..)(J1f tJ and subscribed beforeJ1liw lv, --ivJ!'-eA.../ (/ 3 as near as can be Vli4I€ wac Ie. ascertained; said real (~fJ 11,// me, _ Ma!:c~_20 19~~_ l~~~~41~Qy~ Deputy_ Ri...l,6, J C. ^"d~H6n, Register ----7' /5', j f(, (o,~ March 20, 1980 Attorney: Fie-lt""''s' A. 2u /1,' p. (). lJO)( /I ~ I ' HA-IUls"8IJ.,~~. fP(I. 17/01