HomeMy WebLinkAbout80-00198
No. :l1:8.Q;, 198
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
),s ther t-lcComhs
, deceased.
Harold B. McLane, Deputy
To nid1!'\rd C. AFlelef86n, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
IS
Petitioner(Jt):me the execuL.r.iz~._ named in the Last Will and
Testament of Esther r'lcCombs __ dated ,July-l8. 1976.
Decedent was a citizen of the United States and 0 resident of
Township
Poast Pennsboro B.oJ:ClIll@nj: Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on ~'uesctay
the uth
day of
).lureh
A. D. 19~, in the County of [)Rllphi n
State of
Pennsylvania at the age of 81 years.
b.os;x x;basc he r
Decedent has not been married and has not had children born to >himx
, since the execution of the above described Will.
Decedent was possessed of personal property to the value of
~~90,000.00 and of real estate to the value of
None
as near as can be ascertained; said real
None
estate situated as follows
XXCIplJlll)l< "
Therefore, your petitioner(~ respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated March 24 . 1980
Name and address
of Petitioner(s)
') a
of l1~a' /.:rr/{N~t<.~k~'
'Ruth Patricia \,altz
26 Ashley Drive
Di11sburg, Penna. 17019
COMMONWEALTH OF PENNSYLVANIA f
ss
COUNTY OF CUMBERLAND
Rlltn PAtri ci R ',Ia1 tz
named in above application, being duly SHorn according to law
say(s) that the statements set forth in this petition are true to the
best of her knowledge and belief.r)
SHorn and subscribed before /i;:zlL
I \
1
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~' ~jarch 24 19 80
, - \.-.
~~Y(C-0)vWj" Deputy
Rid ,al d ,C. Al,ele, ~Oll, Register
r
~ ,~.
/610
Filed; March 26,
J I',)",S'~ J
1980
Attorney:
IJ. r:obert Stauffer /:c;ff1ii /)
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6.
I c;ive and bequelJI;h t.he ~,~um of Threc Thousand Three Hundred
(*J ,JOO.OO) Doll"rs 1:;0 my daughter, Bet.ty Pync, I:;he sume 1:;0 be
paid over to Dauphin Deposit; Trust Company, as 'l'rusl;ee for my said
daughter, Betty Pyne, in accordance with the trust, provisions
hereinafter set forth by me under Hem "8" (C), etc., of this my
Last Will and Test<ament.
7.
I direct that the inheritance tax on all of the above
bequests, be paid out. of my residuary estate.
8.
I give and bequeath all the rest, residue and remainder
of my estate, of whatsoever nature and wheresoever the same may
be situated, as follows, to wit:
(A) One-third thereof, to my son, Max A. NcCornbs;
(B) One-third thereof, to my daughter, Ruth
Patricia Waltz; and
(C) One-third thereof, to Dauphin Deposit Trust
Company, in trust nevertheless, for my daughter, Betty Pyne, for
the .following uses, purposes and term:
(I) 'ro manage, invest and reinvest the same and to
collect and distribute monthly, the income I:;herefrom to Betty Pyne.
(II) The Trustee may invade the principal of said Trust
as it, in its sole discretion, deems necessary to provide for the
maintenance, health and welfare of my daughter, Betty Pyne.
(Ill) Upon I:;he death of Betty Pyne, this Trust "hall
terminate and the undistributed income, if any, to[;ether with the
remaining principal, shall be paid out and distributed in equal
shares to my grandchildren.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF CUMBERLAND S8:
Beforc me, thc Rcgistcr for thc Probatc of Wills and granting of Lcttcrs of Administration in and for
the County of Cumbcrland, pcrsonally camc ....n~.1.nl...p.!!.!:X:!;.9.!,~...\.(~!.H~............................."......................
who, being duly ...?.l'!.9.r.!L............, do ~.?...... dcpose and say that as .....l~.~~.9.~!~);>.!;~.......................................
f h W'II d T . Es the I' l-lcCombs d d
o t e last 1 an estament of ......................................................................................................... ecease
....~~.~............... will well and truly administcr thc goods and chattcls, rights and credits of said deceased.
according to law. And also will diligcntly comply with thc provisions of thc law relating to Transfer
Inheritances. ........~.~!~.~.!:......... and subscribed
before me.
..:;;J~~.~.?~~~.........~~....... A. D., 19.::~~y
.::..~.......m,...~~...................
Rishara E. :.d\rlCl...jl~, Register
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DECREE
Be it remembered that on the .......?~.~.~....... day of ................~?~~.~.~...................., A. D., 19 ..6.Q.., there
was probated and recorded the last Will and Testament of ....I~".t..h\'l.r...i1.c.(;.Q,l)jR.9.........................................
late of .........Ea.st...P.emlsb.or.o...~~o.,mshi;p............., Cumberland County, Pennsylvania, Deceased. Letters
Testnmentary
....,.................................................. were granted to
l~uth Patricia Waltz
....................................................................i.......................
Witness my hand and official scal thc day and year aforesaid. /1/ . .
. .~.Y:!0:~.1s~~:nf!~~,.:.~~.~::.~
l\.lluld . ~UIG""I,;)vd, RegIster.
OATH OF SUBSCRIBING WITNESS
. COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMlmHLAND \
This......... ............ .......... ?~.~.~.......... ...................... day" f..................... ..~.~.7.~::...... ........................ A.D., 19...~.9..,
Harold B. ~lcLane, Deputy
before me RU.... d Il Ai.du RflPI, Hegistel' fill' the Probate of' Willo and gl'Unting lcttcrs of Administration
in and for suid County of Cumberland, in the Commonwealth of' Pennsylvania. personally cume ..............
ElIzabeth A. LOI~o Ilnc1 '1IlI'J'Y '1'. L():":o
................................................................................................................................................................................
the subscribing witnesHes to the lbregoing instrument of writing pUl'porting to be the last Will and
Testamen t of .......:~:II.t, bl).l~. .I:l.r, IIP.vll),?.................. ......................... ............. ..... Dated .. ~!!-.~IJ ~.!.. .~.?.?.~.........
late of ...... ..!~.~.~.~.. .~::.l!.:!~)~.~!:.'? ..:l:.<?:~!:.~l.~ .\; r:......... ........ ..... ...... .................. Cumberland County Pa., deceased
who being duly ........~~!.\J}:!!........................ aceording to law, depose and say, that ....~.1.:~.:r...~.~.:.~................
prescnt, und snw and hlinrd the teotn.~.r:~.:~......................., ........1f:~tQ.~.):'...j.'~~.~.~!!1.1?~.....................................
sign, scul, publiHh, !lmnounce and declare the Haid instrument of writing as and for h..'i'.r........... Testament
and LaHt Will, and at. till! time of HO doial-( .................~l.h~..........................was of sound and disposing mind
memory and underHtanding, 1.0 the IlCot of .....t.\1i1,t,r...............................knowledge, observation and belief.
C'
.......~!!.~r..r:............................. and suhscribed bcfore
2:1:.. \, I" C' s.)
...l............~.':-.~...~~~.....~..........-:.~t;";.kO...................
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..~~!&l..!.~S~.))lf....Ac~.~.\:..::........I?::.I?~~y
R.\.ol,u.d E. uanlin ..nn, HCg'lstm'
AFFIDAVIT OF DEATH
COMMONWEALTH QIo' PBNNSYLV ANIA !
ss:
COUNTY OF CUMBlmLAND
....,.................,...n )!.~. h... 1: ~ .t.:.~: .1. .9. j, ~.. .\~ ~}.::?:......................................................................................... being duly
............~~~~r..l/...............,......... HUYS thut us ncul'lyas can be ascertained the said decedent ..........................
I,::, I; h.l)' J':cComhn d' d
.........,....................."............".............................................."..................................................................... Ie on
....'):II.\'.or).\\:I............................ the ......./J;~lL.................day of .......!:l.~!:.~.~..............................:... A.D., 19...~~.
~. 'le' P
ut ()I' ul~I\I(. .......,....:;..'........................... o'clock, ....M.
:;\,'oI'n d b 'b d thO
......................,'.............................an su SCJ'1 e IS
24 th . ~larch
;..................;..........................,. day of ........................
Ill, ..f.';()..,h..thl'l'
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..... - ". I Y (I. Deputy
..... ,'.fM.... . ,.h.))t...(.{~v.i'-....,..""...".................
,U:, I".. .II~. .\11l111 11, Hp~lstel'
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SUPPLEMENTAL
~ I INHERITANCE TAX RETURN I FILE NUMBER
-tA~b RESIDENT DECEDENT 'i'o
COMMONW'AIII'O' PENNSYlVANIA I (TO BE FILED IN DUPLICATE 21-(l:ij:-Ol%
DEI'ARTMENl Of REVENUE
HA:~,~1~t~:~,.'?,',~fJJU 'WITH REGISTER OF WILLSl_ _
I- r[C[DEN~SNA~ElLASf;'iRsr. AND MIOl)[CIl1I1TATi-~DfCEOEN"S COMPLETE ADDRESS
~ McCombs, Esther 162 East Cumberland Road
~ ,SOCIAL SECURITY NUMBER lOAn Of DEATH Enola, PA 17025
___~__. }&>,;)... dd-_4/D9 I March 4, 1980. C'""r CumbeJ::l'!nE___________.__.
o 1. Origintl[ Rerurn LXI 2. Supplemental Return 0 3. Remainder Return
(for dolos of death prior to 12-13.82)
o 4. limited Eslore [}40. Futuro Interest Compromise 0 5. Foderal Estate Tax
(for dales of doath after 12.12.82) Rolurn Required
[]. 6. Oer.edent Died Testate 0 7. Decedent Maintained 0 living Trust - O.=.. 8. Total Number of SaFe Deposit Boxes
(Attach copy of Willi IAlloch copy of Trus'l _
ALL CORRESPONDENCE AND -:ONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
J1u :~~;;~:r.~;6:::::0~~":Oi~"uJ1f~~1.;:i:~; ,::::~;. _unO
Rlv,J.'Ofl EX+ (~.861
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1. Reoi Eslote ISchedule AI I 11
2. S'ocks and Bonds (Schodulo BI I 21
3. Closely Held SlockIPor'ne"h;p Inleres' (Schodulo C) (31
4. Morlgage~ and Noles Receivablo (Schedule Ol I 41
5. Cash, Bank Deposits & Miscellaneous Personal Property( 5)
(ScheduleEI
6. Jo;nlly Ownod Properly (Schedule FI
7. Tronsfe" (Schodule GI (Schedulo LJ
8. T 0101 Gross AHCls (10101 lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous ( 91
Expenses (Schedule HI
10. Debls, Mortgage liabilities, liens (Schedule II
l1._'Tolol Deductions !Iolallines 9 & 101
12.Nel Volue of Estate (line 8 minus linu 111
13. Charitable and Governmental Beques1515chedulc J)
14. Net Voluo Su~ioct to Tax (line 12 minus line 131
15.000.00
n 05
r :...,~
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-, ~ ,_., ~ ,I':'.
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f'.J .--
Pi.OOO.OO
'N
-0-
]5.000.00
-0-
]5.000.00
900.00
-0-
900.00
-0-
900.00
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.. .. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH" .
~~dcr penalties of perjury, I declaro tho I I hove examined this return, including occomponyi'ng '~'chedules (]~d slolomenls. and 10 the bosl of my knowledge and beliel,
illS Irue.1corrocf and completo. I declare thol 011 roo I oslolo hos been reported 01lrl;8 market voluo. Dodorolion of proparer other thon the personal representative is
Aasod 01] 011 information of whith proparor ho~ any knowledge.
f_'GNA1VRE F PE",ON RE5PQtlS""'fO'-ftllNG RElU'N- ADD"SS - - - h___ DATE
'S1~J: ,~o;, r';:f.I~;~~l~"!5 aU FA~til~ .~~;j), )(::- blif-a--. PfLC:LOlCL__ DA1E.c5l:1Lr(---~-
,;=:::::::::;;;""''',,,'''_-PonOlCld-4,S' q:lq(A~J..,,"-,I::>':lru PA- I. H)~ ~.:1.L~( .__
161
17)
I 61
(10)
(111
{12J
(13J
(1A)
(15) -----l5-,..iJ'O-O-.-O-O----x .06 =
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15. Amount of line 14 toltoblo 01 6% role
(Indude values from Schedule K or Schedule M.I
16. Amount of line 14 taxable at 15% rate
Ilnclude values from Sc.hedule K or Sc.hedule M.)
17.. Principal tox due IAdd tox from line 15 and from line 16.1
18. Credits Prior Payments Discount
+
19. If line 18 is grealer than line 17, enter Ihe difference on Hne 19. This is the OVERPAYMENT.
A.OChock here if you are requesting a refund of your ovorpayment.
20. If line 171s greater than Hno 18, enter the difference on line 20. This is tho TAX DUE.
A. Enter the interest on the balance due on line 20A.
(201
(20AI
(20BI
I/.~
1161
-n-
x .15 =
1171
Inlerest
I1BI
119)
B. Entor the tolol of line 20 cnd 20A on line 20B. This i5 the BALANCE DUE.
Ma~!:_~~.~.~k Pav_~~~':t_ to: ~e~.~~!!r of Wi_~,I,~L_~~!!nt
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (v) IN THE
APPROPRIATE BLOCKS.
YES NO
1. Did decedent make 0 Ironsfer and:
a. rotain the use or income of the properly transferred, .......................................
b. retain the right to designate who shall use the property transferred or its income,
c. retain a reversionary interest or ....................................................... ............
d. receive'the promise for life of either payments, benefits or care? .......................
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death
occurred after December 12, 1982, did decedent transfer property within one year of
d h . h .. d 'd' 2
eat. Wit out receiving a equateconsl eratlon. .................................................
3. Did decedent own on 'in trust for' bonk account at his or her death?.....................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
x
x
x
x
x
x
, ", ." .\ \! ",' ',e,:," ,\':~:~'4: .I..~ . ~,' i';\'''~,; :~~__-~:'..'."'" .'I:-2~..._~, i__~-'._, ~'i'lo.: ,', ,.'
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6.
I givo and bequeath the sum of Three Thousand ~'hree Hundred
(:113,300.00) Dollars to my daughter, !Jetty Pyne, the same te be
paid over to Dauphin Deposit Trust Company, as Trustee for my :J(J.id
daughter, Betty Pyne, in accordance "ith the trust provisions
hereinafter set forth by me under item u8u (e), etc., of this my
Last Will and TeGtament.
7.
I direct that the inheritance tax on all of the above
bequests, be paid out of my residuary estate.
ll.
I give and bequeath all the rest, residue and remainder
of my estate, of whatsoever nature and wheresoever the same may
be situated, as follo"s, to "it:
(A) One -third thereof, to my son, Max A. McC ombs j
(B) One-third thereof, to my daughter, Ruth
Patricia Waltz j and
(Cl One-third thereof, to Dauphin Deposit Trust
Company, in trust nevertheless, for my daughter, Betty Pyne, for
the following uses, purposes and term:
(I) To manage, invest and reinvest the same and to
collect and distribute monthly, the income therefrom to Betty pyne.
(II) The l'rustee may invade the principal of said Trust
as it, in its sole discretion, deems necessary to provide for the
maintenance, health and welfare of my daughter, Betty pyne.
(III) Upon the death of Betty Pyne, this ~'rllst shall
terminate and the undistributed income, if any, together "ith the
remaining principal, shall be paid out and distributed in equal
shares to my grandchildren.
-2-
~.~:;9
COMMONWEALTH or PENNSYlVANIA.
DEPARTMENT OF RE;VENI.!E
BUREA.U or INDlVlDUAl TAXES
P.O. 80)( 8327
HARRISBURG, PA \7\0&-8327 DATE
ESTATE OF MCCOMBS ESTHER FILE NO. 21 80-0198
OATE OF DEATH 03-04-80 COUNTY CUMBERLAND
NOTE: TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUDMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT".
REV-1547 EX (12-B7)
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS. AND ASSESSMENT OF TAX
JEFFREY A ERNICO ESQ
2405 N FRONT ST
PO BOX 1265
HBG PA 1 ?l08
ACN
101
REMIT PAYMENT TO:
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
Amount Remitted
.;~' 'n1..') -'/ '/.5-
9l,!'!: _A..L9~~ _ ,!:HJ~ _L!~E_ _ _ _ _>>::_ ~~! ~I~ _ ~~~~R.. !'9~,!,19~ _ ':~R_ Y9Y~ _ F!.E~9~!'~ _ -:"_ _ _ _ _ _ _ _ _ _ _ _ _ _ .
REV-1547 EX (12-87)
NOTICE OF INHERITANCE TAX APPRAISEMENT,
ESTATE OF MCCOMBS ESTHER
ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
FILE NO.21 80-0198 ACN 101 DATE 04-25-88
TAX RETURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: 1 SUPPLEMENTAL
1. Real Estate (Schedule A)
2. Stocks and Bonds ISchedule BI
3. Closely Held Slock/Partnership Interesl {Schedule Cl
4, Mortgages/Notes Receivable (Schedule D)
5, Cash/Bank Deposits/Mi~p. Personal Property (Schedule El
6. Jointly Owned Property ISchedule FI
7. Transfers (Schedule GI
8, Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses ISchedule HI
, O. Debts/Mortgage Liabilities/Liens ISchedule II
, 1. Total Deductions
, 2. Net Value of Tax Return
, 3, ,Charitable/Governmental Bequests (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
, 5. Amount of line 14 taxable at 6% rate
16. Amount of line 14 taxable 'at 15% rate
17. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
05-19-80
02-12-88
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST (-)
210.52
376.25-
063096
344760
INTEREST IS CHARGED FROM 02-13-88 TO 05-10-88
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM.-
. IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION
OF ADDITIONAL INTEREST
(IF BALANCE DUE IS LESS THAN $ 1
) CHANGED
RETURN
( 11
( 2)
( 31
141
151
161
( 7)
15,000.00
.00
.00
.00
.00
.00
.00
( 81
15,000.00
( 91
1101
.00
.00
14, 15 and/or 16
returns assessed
(111
1121
1131
1141
and 17 will
to date.
:00
15,000.00
.00
83,236.13
(151
1161
82,236.13
1,000.00
K06=
X.15=
(171
4,934.17
150.00
'5,084.17
AMOUNT PAID
;/
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i
4,000.00
900.00
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...,.........."..~."..".
TOTAL TAX CREDIT
BALANCE OF TAX DUE 349.90
INTEREST 5.05
TOTAL DUE 354.95
OR IS REFLECTED AS A "CREDIT" leRI. NO PAYMENT IS REQUIREDI
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RESERVATION: Estates of decedents dying on or before December 12, 1982 -- If any future interest in the estate is
transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate
for life or for years. the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
To fulfill the requirements of Section 1740 of the
Section 1740).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on
reverse side.
--Make check or moo.ey order payable to: REGISTER OF WI~~S, AGENT.
All payments received shall first be applied to any interest which may be due. with any remainder applied
Inheritance and Estate Tax Act, Act 255 of 1982 172 Pa. C.S.
to the tax.
REFUND (GRl: A refund of a tax credit. which was not requested on the Tax Return. may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313l. Applications are available at the Office
of the Register of Wills. any of the 24 Revenue District Offices. or from the Department's 24-hour
Forms Ordering telephoroe Imes in Harrisburg - 17171 787-8094. in Philadelphia - 12151 351-2065,
or in Pittsburgh - 14121 565-3601.
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions. or assessment of
tax (including discount or interestl as shown on this Notice may object within sixty (60) days of receipt of this
Notice by:
--written protest to the PA Department of Revenue. Board of Appeals. P.O. Box 8480. Harrisburg. PA 17105-8480, OR
--election to have the matter determined at the audit of the account of the personal representative. OR
--appeal I to the Orphans' Court.
AOMIN-
ISTRA TIVE
CORRECTIONS: Factual errors discol/ered on this assessment should be addressed in writing to: PA Department of Revenue. Bureau
of Individual Taxes. ATTN: Post Assessment Review Unit. P.O. Box 8327. Harrisburg, PA 17105-8327.
1717l 787-6505.
See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-15e 1) fer an
explanation of administratively correctable errors.
DISCOUNT: If 'any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of
the tax paid is, allowed.
INTEREST: lnterast is charged beginning with first day of delinquency. or nine (9) months and one (1) day from the date of
death. to the date of payment. Taxes 'which became delinquent before January '. 1982 bear interest at the rate of six
(Bo/a) percent per annum calculated at a daily rate of .000164. All ta:ICes which became delinquent on and atter
January 1.' 1982 will bear interest at a rate, which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 1988 are:
~
Interest Rate
Daily Interest Factor
Year
Interest 'Rate
Daily Interest Factor
1982 20% .000548 1985 13% .000356
1983 16% .000438 1986 10% .000274
1984 11% .000301 1987 9% .000247
--Interest is calculated as follows: 1988 11% .000301
INTEREST = BA~ANCE OF TAX UNPAID X NUMBER OF DAYS OE~INQUENT X OAI~Y INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is, made after the interest computation date shown on the Notice,
additional interest must be calculated.
REV-1S47 EX (12-87)
.~
COMMOIjWEAlTH OF PENNSYlVANIA
OEPAnlt.tENT OF REVENUE
DURE,t.U OF INDIVIDUAL TAXES
P,O, BO)( 9327
HARRISBURG. PA 17105'0327 DATE
ESTATE OF MCCOMBS ESTHER FI~E NO. 21 80-0198
OATE OF OEATH 03-04-80 COUNTY CUMBIDlLAND
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUSMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WI~~S. MAKE CHECK PAYAB~E TO "REGISTER OF WI~~S, AGENT".
NOTICE OF INHERITANCE TAX
APPRAISEMENT, A~~DWANCE OR DISA~~DWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX
ACN
101
REMIT PAYMENT TO:
JEFFREY A ERNICO ESQ
2405 N FRONT ST
PO BOX 1265
HBG PA 1 n08
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
I Amount Remitted
9l,J'!: _Ag)~~ _ ,!:HJ~ _L!~E_ _ _ _ _-:-. !'l~!~I~_I:q,'I!~R_ !'9f:l!19~ _ ~q,R_ Y9~f:l_ F!.E.cP!'l!?~ _ -:-.. _ _ _ _ . _ . _ _ _ _ _ _ .
REV-1547 EX (12-87)
NOTICE OF INHERITANCE TAX APPRAISEMENT,
. ESTATE OF MCCOMBS ESTHER
A~~OWANCE OR DISA~~OWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
FI~E NO. 21 80-0198 ACN 101 DATE 04-25-88
TAX RETURN WAS: (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: 1 SUPPLEMENTAL
1. Re.1 Est.te (Schedule AI
2. Stocks .nd Bonds (Schedule 81
3. Closely Held Stock/Partnership Interest ISchedule CI
4. Mortgages/Notes Receivable (Schedule 0)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property ISchedule FI
7. Transfers ISchedule GI
8. Total Assets
I CHANGED
RETURN
III
( 21
I 31
I 41
I 51
I 61
I 71
,...,-
:.-". I . ~
Cl:l
,'1)
:u~
;:~ ~~;
15,000.00'
.00
.00.
.00
.00
.00
.00
~
-.1'
( B)
15,000.00
APPROVED DEDUCTIONS ANO EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/Miscellaneous
Expenses ISchedule HI
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests (Schedule J)
14. Net Value of Estate SUbject to Tax
NOTE: If an assessment Was issued previously, 1 ines 14, 15 end/or 16 and 17 will
refloct figures that include the total of ~JJ. returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of line 14 taxable at 6% rate
16. Amount of line 14 tax&lble at 15% rate
17. PrinCipal Tax Due
TAX CREDITS:
I 91
(101
.00
.00
1111
(12)
1131
(141
.00
15,000.00
.00
83,236.13
(15)
(161
82,236.13
1,000.00
X.06=
X.15=
(17)
4,934.17
150.00
5,OB4.17
PAYMENT
DATE
05-19-80
02-12-88
RECEIPT
NUMBER
063096
344760
DISCOUNT (+)
INTEREST (-)
210.52
376.25-
AMOUNT PAID
4,000.00
900.00
INTEREST IS CHARGED FROM 02-13-88 TO 05-10-88 TOTA~ TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE BA~ANCE OF TAX DUE 349.90
REVERSE SIDE OF THIS FORM.. INTEREST 5.05
· ~/t~DI~icj~~LT~~E~:;~ SEE REVERSE FOR CALCULATION TOTA~ DUE 35J.95
IIF BALANCE DUE IS lESS THAN S 1 OR IS RF.F~ECTED AS A "CREDIT" ICRI. NO PAYMENT IS REQUIRED)
I
!
I
COMMONWEAL TH OF PENNSYLV~NIA I
DEPARTMENT OF REVENUE j TO TRANSFER SECURITIES
BUREAU OF COUNTY COLLECTIONS REGISTERED I~l THE NAME
OF A RESIDENT DECEDENT
-- _._-~--- -- -- ..----.--......-....--.. ...-.....--.......-.'..
APPLICATION FOR AND CONSENT
DATE_J:~Il:Y /'1
, 1980
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for coosent to the transfer of the followiog securities of 0 Pennsylvania
Corporation or a National Bonking Association located in Pennsylvania:
(~) 75 shares (b)~Jm Corporation ..__.________._________.(c)..__QQJ@!.OlL_
(NOTE: In describing securities enter in (0), ob Ole, eilher the number of shares of stock or the face amount of
registered bands, in (b), the name of the issuing company and in (c) the class of stock or the stated interest rote
and molarity dote of registered bonds.)
ISSUED ON Kov. 3. 1970
(Oate)
as of the date of death of the decedent,
,and having a TOTAL MARKET VALUE OF s..'1J?..7...50
(Name of Decedent)
,0nJ'~arc~JI:. 1980
(Daft! of death)
Esther i-1cCombs
(Street and Number)
(Post Office)
(County)
Pennsy1 ve.nia
(State)
who was late of 162::. Cumberland noad, 2nol~...___________~um_l:!..eE1and
The securities are eegistered as follows: Esther l-lcCom1:J_~_____
(Nome or names in whlt:h cnrllficatcs ore registered)
ADMINISTRATOR) Ruth Patricia ila1tz - 2.LA~tb.)&y..J2dy-e,..J)J.ll.s.b-~_"enna-'-110l9
EXECUTOR) (Name) (Add..,,)
NAME OF APPLICANT J. Robert Stauffer, Atty.
------MllrketSquare Bldg.
COUNTY FILE NUMBER 21-80-198 ADDRESS OF APPLlCANT-_J1''-"'"vrJl;.a
BUREAU FILE NUMBER SIGNA TUR E OF APPLlCAN ~ ~1-.t:.I--l .
HOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS A ICATION, IT WILL NO BE ')
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU COMPLETION. t:..~
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATE 111~ 19. (13rJ
I hereby .consent to the tronsfee of the above securities now registered in the name of the afa~aid
Decedent and waive the filing of a certilicate certifying to the paymont 01 the transfer inhecitance tax to which
the property of said Decedent is mode sabject puesaant to the provisions of the Act of June 20, 1919, P.L. 521,
as amended and the Act of Jane 15, 1961, P.L. 373, as amended. This is also in accoedance with the provisions
of the Act of April 9, 1929, P.L. 343.
This Consent to Teansfer the herein described property operates only in reference to the estate of the
above-named Decedent.
~':!...
tf...~...
F:.;....~l ~
Il . f,~I. :\
,', M.~'J: ,- J
:~"". ;'i,D;~
Signed for the Secreta;y 01 Revenue
By___1!JtlA.~._e~4-f-i.--c;J
~:"~~C""'''tfl
_w. ,,-' J.lZ.....J. . (!c,I..:J?t../.U&,.,t.d!_
(.) (County)
. . .
._. .,.. --....
REV-1B07 EX (12-B7)
.\ COMMONWEALTH OF PENNSYl'iANIA
DEPARTMENT or RE'iENUE
BUREAU OF lNDI'iIDUJ.t TAXES
P,O, BOX 8327
HARRISBURG, PI>. 17105.8327 .~ATE _....Q..~06-88
ESTATE OF MCCOMBS ESTHER FI~E NO. 21 80-0198
OATE OF DEATH 03-04-80 COUNTY CUMBJ;;8l.-l\liD
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT
TO THE AOORESS SHOWN. MAKE CHECK PAYAB~E ANO REMIT PAYMENT TO:
ACN
101
INHERITANCE TAX
STATEMENT OF ACCOUNT
y
JEFFREY A ERNICO ESQ
2405 N FRONT ST
PO BOX 1265
HBG PA 17108
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Amount Remitted
REV-1B07 EX (12-B7)
~1:!1.: !-.!-9~~_1.:HJ~ .L!fo.!.E" _ _ _ .-:,," _ }~EJ~i.N. ~9~~~ _p_O"RJLO.N_ ~9~ _Y_O.U.!'l_ ~I~~S.. - -" -~- - - - - - - - - - --
.. INHERITANCE TAX STATEMENT OF ACCOUNT ..
ESTATE OF MCCOMBS ESTHER FI~E NO. 21 80-0198 ACN 101
THIS STATEMENT IS PROVIOED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMEO
BE~OW IS A SUMMARY DF THE PRINCIPA~ TAX DUE. THE APP~ICATIDN DF A~~ PAYMENTS, THE CURRENT
IF APP~ICAB~E, A PRO~ECTED INTEREST FIGURE.
DATE 06-06-88
ESTATE. SHDWN
BA~ANCE, AND.
DATE OF ~AST ASSESSMENT OR RECORD ADJUSTMENT: 04-18-88
PRINCIPAL T AX DUE:"".",,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.'''.''''''''''''''''''''''''''''''''''''""."""""".""""..."""."",."".""
5.084.17
PAYMENTS (TAX CREDITS):
PAYMENT I "RECEIPT
. DATE NUMBER
063096
344760
365529
DISCOUNT \+)
INTEREST (-)
210.52
376.25-
4.82-
AMOUNT PAID
05-19-80
02-12-88
05-06-88
4,000.00
900.00
354.95
-
...r;-',
0;::'.--:::
05
,.:0
--.',
."
i.... '
~=
:",,):::0
/,'.~
()(')
, "~,~,
~
-:::l
TOTA~ TAX CREDITS 5,084.40
.
I BA~ANCE OF TAX OUE .23CR
I
,
I INTEREST .00
I TOTA~ DUE .23CR
I
* IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST
(IF BAI.ANCE DUE IS ~ESS THAN $1 OR IS REr~ECTED AS A "CREOlT" (CRl. NO PAYMENT IS REQUIRED)
'paWln:Jjl!':J aq lsnw lSD.JiJIU! Il!'UOlllppe
'O:J!lON S41 uo UMOllS Dlep UOl1elndwo:J ISiJ.JaIU! alll .Jane apew S! luawAed JI 'juaW5!ia551? a4\ to iJlep a41 puoAaq
5Aep (9 ~) ua')!J!' 01 uonl?ln:Jle:J lsa.JaIU! ue lOalla.J lI!M luanbullap 5aU.JO:Jaq xej a41 .Jane pan5S! a:J110N AU\f--
~Ol~~. lS;~;lNI A1I~O X IN;nONI1;0 SAVO .0 ~;BwnN X OIVdNn XVl .0 3~NV'VB = lS;~31NI
:!iMOIIOI SI? paleln:Jle::l 51 15aJalUI--
~ OCOOO' %ll 8861
L vZOOO' %6 L86~ I.OCOOO' %11 v86l
vLZOOO' %OL 986~ 8CvOOO' %9 ~ C86~
99COOO' %f:L 9861 8v9000' %OZ Z86~
.Jo}:Jl!'~ 15a.Jalul Al!ea aletl lsa.Ja\UI .JeaA .J01:J!!:! lSaJalUI Al!ea al!!~ 15aJaluI .JeG"
:aJe 886 L' 46noJlll Za6l JOJ Sall!'J lsa.JalU! alqe:Jllddde a41 'anuaAatl 10 luawl.Jedaa Vd a4l Aq paounouue
aleJ le41 41!M JeaA Jl!'PUall!':J 01 JeaA Jepuall!':J WOJI AJl!'^ II!M 4:J!4M aIeJ l!' Ill' \SaJalUI Jl!'aq II!M Z86l 'L ^Jl!'nul!'r
Jelll!' pUll' UO luanbu!lap awe:J8q 4:>!4M saxel IIV 'v9 1 000' .0 aWJ ^Hll'p l!' le pajeln:Jle:J wnuue Jad lua::u9d (%9)
XIS to aIeJ a41 Ie 15aJGIU! .Jeaq ZS61 'L AJenuer aJoJaq luanbu!lap Gwe:JGq 4:>!4M saxe! '\uawMd to Glep 941 01 '41eap
JO alep a41 WOJI !lep (L 1 auo pUll' S41UOW (6l au!u JO ',~:>uanbu!1ap JO Aep lSJ!J 41!M 6uluuI6aq pa6Jl!'4o 51 lsaJalUl
:1S3~31NI
'paMolle S! Pied xe1 a41
JO luno:JS,IP (%9) lua:>Jad aA!1 e '41eap s,luapa:Jap a41 JaH!! S41UOW JepUall!':> (El aaJ41 U141!M pjed S! anp xe1 Aue Jl
:1Nn08SIO
'9099-LSL IL ~ LI
'LZE8-90 L L L 'v'd '6Jnqs!JJl!'H 'LZES x08 'O'd 'l!Un Mal^atl luawssass'V lSOd :N11'v' 'saxe! l!!npl^lpUI JO
nea.Jn8 'anua^G~ JO luaWlJedaa 'v'd :01 paSsaJppe aq Pln04S 80110U S!41 uo pauleluoO SJOJJa 6u!pJe6aJ SUO!lSano
:01
A 'd3~
.~ 09C-999 IZ ~ vi - 46JnQS\lld U! JO
'990'Z-L9S (9l Zl - l!'!4dlapel!4d Uj 'v60S-LSL {L L Ll - 6JnqspJeH U! 'sau!! auo4dalal GUlJapJO SUlJO:!
Jn04-vZ s,lUaUllJedao alll U.JOJ~ JO 'saoHIO P!J1S!O anUGAatl VZ a41 to Aue 'slHM JO J9lS16al:1 a41 }O
aOlBO a41 1l!' alqel!eAe aJe sUOl1eo!lddv '(E l E l-^3tll "xel illels3 pue aoue,!Ja4UI E'!UeAIASuu9d )0 pun~al:::! .101
UO!l!!O!lddV" ue 6u!1Gldwo:> !lq palSanbGJ aq ,\ew 'uJnla~ xel a4l uo pG1SanbaJ 10U seM 4:J!4M 'l!paJ:> Xl!'l e jO punJaJ 'V :(~J) ONn:l3tl
'xe1 941 01 paHdde Japu!E'waJ Aue 41!M anp aq !lew 4014M lSaJalU! AUl? 01 pa!ldde sq lSJl1 llells p,M!aOaJ sluawMd It'lt
'ap!s aSJaMJ S41
uo palupd ssaJppl!' pUll' aLUeu 941 01 alqeAed 3peLU luawAed JnoA 4.IM llwqns pue 9:J!lON 5141 to uO!1Jod dOl 941 40E'laa
:1N3V'JA\ld
, REV~49 (S'78)
I
.~ / c. B' C;'- /9.g>
COMMONWEALTH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
~-~1-fO
\
......
~.
"
RESIDENT OECEDENT
COUNTY OF _ GWtlO.::-H'lu'ld
IMPORTANT,
This ~'ClU;~~~~!It-'I;l'-CO~;pj~led III d~;;lil ~~";'tl' I ;"i(;{i ";n dllplll:;ll(', ~J;'rh "III! nttlldl~~~i, wit h t he R~~i~~I'~r";';iWwjJI!i -l~f the
Coullty where decedent resided; Return i.'l due within !lim' lllout!:S "fler dUll: of death; ullJess allcxtcnsiufl is grunted
by thc Sccu.'lary of HCllt'llue. (Section 70.101" the InhedtlllU:c all.1 b;lalc Tax AI..'I of 1961.)
Lato of
C"trlnnrllmd
1 AI'I'I1lAVIT III'
J EXECUTOR
AIllIlr-<ISTRATOR
IN '1'111' MATTER OF TIlE ES'IXrE Ill'
E~thcr I,':CCOl;lbs _
{STATE FULL. NAME OF DECf.DEt..;Tl
County
County of
Stato al_...E.~lvanio
Cumbel'la nd
--},,,
Ruth Patricia Waltz
Executor
Administrator
01 the utoto 01 thl! obove.namen dl!cedent h"lng duly sworn, deposo and soy
i1arch l~, _' 19~ le5talolcaving a lost will, copy (If which is hl!tetaottachod. }
(MONTHl (DAyl (~-;;R~ll"'o"tatu
Nome and oddrltSl. of at/arMY or } .T 1) n'r)f'lpi: ~,+;nlli'fpr-r.-: qy'1rr- L(1QIU.tr..a_l.lld{~J."....lisir.hanj CSblJY'g,
Q/her nLlthorlud roprOlentatlveto whom
011 CortllSflOndonco should be nll'lilod. Penn8... 170r;r~
Decedcnt died
That as Sllch__~xecutrix depollent is familiar with the affairs of said estate and the property constituting
l EXECUTO R'ADMINIST RA TORI
the assets thereof and their fair markct value.
That at the time ofdcl\th there WIIS no safe llCIHISil bux registcreu in J~cedent's individual nume, or jointly with, or
as,agent or deputy of another, or in decedcnt's individual name, with right of :.Jccess hy OIllother as agent ortleputy, with the
, exception of the folloWing.: -
--.-------.-.
----- -
NAME AND AnDRESS OF BANK OR OTHER INSTITUTION
IN WHICH OECEOEtH RENT;O ^ S^FE DEPOSIT 80~:=
None
THIS SAFE UE"POStT BOX RENTED RELATlOt~S~ilP OF JOINT
IN NAI.\E2~!~~S o~.=~=-==- HOLDERS TO DECEDENT
That the contents of said safe deposit box or boxt~s fire itemized limier S,cl1edules
wi,th, the CXCclltion of the following, for the reasons hereinafter set forth:
. of this return,
That Schedule A attached hereto and made part hereof sets forth fully and ill detail all the r~al property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein, It also sets forth the
mortgage encumbrances \lpon each parcel of real pro{ICrly at the dale of death, giving lhe ilmount slill due at
death, name of mortgag(~e, dille, rale of interest, and bOllk and page (Jf record lhereof. It also sets fOrlh in the
columns provided therefore the assessed valuation of each of said parcels, the cstimated market value thereof
as of date of death of deccd(~llt,
Th'at Schedvlc B attached hereto and made parI hereof sets forth fully and in detail all personal properl)'
whcresover situated owned by the decedent at the time of death; ~t II moneys Icft by th~ decedent at the time of
death, whether in t1cct~dent's immediate possession, standing to del.".'dent's credit in hunks of deposit, savings
hanks, trust comp~lIljes, or otht'r institutions, whctht:r illdh'idually. or in trust for any other persoll or .pcrso'ns
giving. also Sepuro.lf.!y the ilccrued interest ,hereon, if llllY, down to the last illtcrc~t dny prior to decedent's
death ill the case \:If savings banks, :Iod 10 the J;dc of decedent's death in all o111l~r cases; all honds, postal
savings, tre:lsury certificates ornofcs and (Jlh~~r (~vjdent'c or ill(kb:l::dncss of lhc United Stales to the dc~
cedent; nil ohligalions, whether by statute or agreement they arc designated as lax free, or the United Stales,
or any state, or polit:cal subdivision thereof, or of any foreign country, which arc owned. attlw timc of death;
all wcaring apparel, jewelry, silvcrwan:, pictur~s, huoks, works of art, household furnilure, horses, carriages,
automobiles, boats, "a!1d any ..od all ()th~r iler.sonnl chattels or whalstlcvcr kind or IHlture, left by decedent,
together with the fairly estimated mn.rket value thereof; all hllnd.. and mortgages held by decedent and or all
claims due and owing dccedcnl at the time of death. and all promissory JUltes or Hther illstrulIlenls ill writing
for the payment of money of which decedent died possessed, of whatsoever nalurc, with interest lhereon, if
any', giving the face value and estimated fair murketvaluc thereof, amI if such estimated fair market value be
less than the face valuc, it sets forth briefly the reasons for such dcprcciati,un liS to each item; all moneys
payable to thc estllle from life insurance policies carried by, decelle-nt; all annuity ,altO endowment contracts
the proceeds of which were payable uponlhc death or lhe decedent; ~\II and the corporate stocks' aDd dividends
duc thereon and unpaid 8S of the date of death, bonds and accflu:d interest tlwren-n to the date of decedent's
death and olherinvcsrment securities owned hy the decedent :It the lime of dcnth, with the market \';lluc Ihcrc~
of at slIch .~ime.
\ I
In th(l C~\~W or s~cllrlt.lcs 01' ('lo"l~ Pt' fllJllt I Y ""rpcr111Ir,:I'-', tht: v'dups ,'pp"rt.lHl /'.1'0 liS "Uf 'IS
possible substnnttntcfl bj.f'llJllOelnl ~tltlf~l1ll'rlts 01' {PI' ,~',:'v"r.,Llnn',. sh(Jwlllf~ thl! HS~H~ts line! Jll1lJJlltlus
tht.~rcol' 05 of till? dlltl! of' 1It..nt.h. 1'lw sehf.!dlllt' Itlso s.'I~; 1'"rtlL till! llltl)rl,~:-;t I'J' (leCIlt!eJl!, nl. U\t~ lime of'
,lenth 111 I\I\~' co-pnrtners111p 01' \.msllw!:IS, Illll! In SllJlJH\l't nt tll.. \'It!Uf' or !ilH:h Intl:rl':it. Lherl~ l!J illllwxml to
said sclwdll14!J f'JulIllellll st.l\l(~Il1PIII,s sho\lo'll\~ t1lell~;';l!t,; 'lld llllhqHtt~~ oj' '\nlrl ell-l'nrlTlf.'r~htr ur hll~;llHHiB.
^ copy of t1u' cO-Jlflrtncrsllil1 fQ1;r(l{'l1I('nt., (If' nrnl, II '~Iil:,jll;'nl, ~il';ll'll~ l'1I1'l.h tlH' HIIl-lIr!! or t.111l It,~t'l~cwmt)
logel.lwl' wlt.h II stllllllll(>lll. St~tlln)1; tor\,lI t.lw ..hl,tl'(!('l,'!" 0' ilip 1!l1~;\!1"~-):i, it:, I OI:IL 1.1 un, Illld snell ollH'l' f'lletb
pf>rt.1l1ntl'~~ to the busIness liS Inll~' Ill.' P(>J't111l'l\! to I t :;1:" 'In,j .Ill',!. ''.f1)1l"al~..d of Llin r!pcpdnnt,l:-; Illt'_!rl~st
tlu~l"l~lTl must h~slllJnllt.t.f!II. It shouttl Ill:;!1 St~t. f'o:.th In 1!.I'ml/,l'd j'OJl'l. l.u)~,'(,l!O.,r ,dth t.he ,'nIl' mnr!,ct \'11111"
ther'wf', IUI~' othel' propcrty OWI\l~lt 01' lJOIj\ll~lltlll'd 1:,.'.' ..111' 1,..".,:l'.'lIl. Ill. t"l~tllM' of' Ilt~'lt,]J.
Till' Sr/1C'du/e C ntllil~lied ll(~reto /llIcl mlldl' lilli'\' :h'I'l'OI' Sf!I,S ['01"1,11 Il 1."lIe lU1swer tn Pilch inquIry
contnlncd lhel'nln f1llc} III the CliSI~ of' trltn!,if'ers oI'PI'O)lI'I'f.)', J."..d Ill' )If'I'!';()ufil, wtt.llin two )'ellrs of' deCHdent's
dentll, In cnntl'mplllt1nl1 or c1eel~r1ent's ttenth, 01' Illll~ll,!I'd III trlkf! l~l'l'pcl In I'OSRoSSJOII or, enjoyment ut. or
Ill'ter dnllth, slild schedule sets" forth t.1t!! /l:t/lIrp !dlil \' 1111' of slt('h Jll'opel'tYI to wholn trnnsl'erred, the
r~1(l.tioTl5I1tp of t.he tran~rerees to the dcceilenl1 U,pr\l'l'~I(\:'t,l{jI"II,': ~111l1'l~ r(~u'lYI~d by p.llch lrflTls('erCf1 o.nd
ull olhp.r I'IlCt:!i of II pertinent. IInture reJ!;nrli1Il:~ ~.;,:lrl tl"rlllSj",!rs. 'In the eIlS(! or lruIlsf'ers intended to
t,nke cl'fect In po~snsslon or en.lOj1nent nt 0" 111'11'1' ll,'/cU., UI,~n' b Illso I\ttllclj(~rl t,o t.IJ1' 5clH~tt\l]e 1\ cony
01' the deed, trust aJ;reemcnt or other Im;l.rIlTTll-,nt (!l"t'llt1!ll'. thl' t.rusl. '[!If!r,' is fllso set forth In fontd
scllcdnle II list. of Illl property, renl flnd jlf!rsonnl, wlU\ iV. \'olue, whlc~h pH~S"~ nt. deP,\~llcnl's denth hy
virt.ue of' the eXt~,:cise by deccltent, elttler IwlJ\'1dlllll1y. lIt' JnlllLly wl.t.h 1\1IoU,~~r. Dr flny power of apI1oint-
ment vested Inflec(>ltenl" either ltultvtdulllly 01' ,jOllltly, 11:)' {.Il(' \dll~ tier-d. ur other Instrument of nnot,her,
with II copy of the InBlrllment. creating such power /Jtt.llrhl!d t.o the selH'clll1c.
Thnt. Sc/1(>du!e' 0 att.llclw(l heret.o nnrl mnr\n {llll't !H'fl!OI' Sf'!,S I'orl.h t.he nllmcs and IH\drcsses of /lIl
persoll:; beneficially interested In this estfllc at tll(~ t.lme of' deel'(}rmt.'fj rl('!llh1 Ul(' I\lltul'e of' their res-
pective interests, lheir relationship, ir lHl~'_. tu til.: elee,'dent, tng\d~her with the nges at tlLctime or
decedent.'s (tenth of' ull mlnors, nnnultnlll5 1111(1 belwfil.~lllrte's for Il;'e I1nch~I' rtecedenlls Will. It o.1sn
contains n stlllcmcnt showJng which of the hCllcnctrlrl(~s nllmccl In lhe r1eeecicllt' 5 will, if nny, llied prior
to dCCCll(!rlt, the dutes of' t.heir dl~lltlt, Uwtr issue, /lJ\d t.he rl~llltlonship of such issue to the bene('iclnry.
That S.:!ledule E at.tnCht~fl hCI'e\.o nnt! 11l1Hll~ n {llll'!. h\!rl~o{' ~;ets fOl'ih nll propCl'l;Y, renl Jlllrl per-
sonnl, owned hy the dl~cedent .lointly with IUH)thel' or othC'rs, Inell!llln~~ Inl.lmglhle, f't1lndlng in t,hc flume
of the dccedcllt Itnd others, lllus t,he tlll.t.e and plllc'~ 01' \'('\'('\'11 of In~trHment5 t~ff'ecting the \e5tt ture of
real estate nnd the dnt(.~ of' ncC}ulsit1otl of persoil/llt.:/, pluS the nltl1lt:', 11Ih!r~~ss nn.! relfl.l.iollShip, if any,
of (lO-owners to t.h~~ dcceden t..
Thnt Schedule F nUnched heretonlld mudc II }Hi.rt. i1er~of' tojCt.s fort.h f'ully and in detail all debts
and deductions claimed for 11I1'} on hehnlt' of Ul15 \lecwlcnt.'s l~~;llltl!, Jnclur111lg funeral expenstH; paid;
fnmUj' exemption, where flppl1cuulcj costs or ndminlst.rllt.lon' of thts estab~j counsel fees 11011 fudlcillry' 5
commissions paid or to hc Jlllld; cost expen1leti for bUI"lnl trust.s, tombstones (j\' p;rnvemnrkers, and reli-
gious s~rvlces, in consequence of t.he dl.'lll,h 01' t.he tll~c,~(lt~Ilt.; .leilts IHlr! eJlItlllS nw1ng finel Impn1rl Ht. t.ime 'of
de/lih; tfixes l1~crlled churgenhle for I\prlutl prIor t.o Ilceelknt' s ,lent.1l (1.'~C{'pt. l.hose:: nHowed un<'er Soctlon
651 of the .lnheritll.lwe 1U1It ESf,llte 'rnx Act); tng;et:lll!r ....11.11 Il st,at.plH'!nt. of collnt,erl11 pletlged for obliga-
tions, if /tny. It Is n~reed thllt t.he flrludllry will. prj~l"l'rtl, rH'lJof 01' sHid clIt imecl ohl1l~nt1ons upon re-
quest, lIHlt ir t.he amount. net.ually pllill In setl.l~ment. of Itny fl)e, comndsslon or deht is less tlJ/m the
estimated nmo\lnt clalming; und nllowecl, thllt t.!1I) !;Ilme will hI) r('porte1l t.o t.1t(> lleg1ster of Willfi, and tlmt
the amount at' lax 1l5~esscll can he renssessetl In ILccnrrlllllC:I~ t.hCl'CWJ t,h.
That t.he totl11s of the! approprio.te columns in Sdl('dll1es "A", "un, "C", "E", nnll IIF" us directed ther4~ln,
have been carried for.....ard und prol'crly re~ht(~red .in tILe SUlTunnn'.
~
Subscribed and sworn to beforc me this .4SP............
"""71." ........ day ~........ €:rf.... 19....00
.......~.~..~;~~~JR;~f~~i;,i~.~~~.
/'\Y COMMISSION UPllllS Ai'11 ].\ 1:'01
,.~ b P . , ' , \. :.fe.' J
'rtll1 ct, enn$\'I~JIlI~ A5S0c1J!lun t" NlI1JII.-S
SOTE: Before slJ!;n1n~ l\rf'~dll\'lt. mllkt~ slIrp HIl hl',lIJ..: ~;11;" t". III 111l' fl[,l'1dIlV1l, HUrl liclH!dlll(,!fl I\nnexed ure
fl11",l\ jn willi t!{'tnlls or till' \IoIlI'I! nSOl\('", .'tlld III CdS\' th" II:->~;"ts 11I1'11l1le rure !Ill!! \1111\st.e.\ s(>r.lIrlt1es,
secllrll.ips 01' clos\~ or l'/llllll~' corJlllral.l. :1~: ~H' .,p \llll'rl'~j III /lilY Cll-Jlrll"l.lll'l'sll~p or lmsll1ess, thflt t.he
dul(i 11II11 slld,4~metlts re'lu~rl'd lJlJth~r 'he ]1:ll'~lr!;r!lplr I\i'n\'~' r\')ntlllj! to Sclll'l!111l' "11" IIrl' IlllBelled. Also mlike
cert.lltn thlll column #1. III t111~ "SU::!I1/lI'Y" IlitS .1)1,'f'fl prr)p;"rlY 1'1'olT11l1Ften liS Ilho\'('-dlr<~ctl~tt.
\
.'1""
\.
.~ /)
. ) 1//
Y '1//; )/l,l /::.....
1.j(kC:r-' ./4..f.h(,<!.,(=:..:Lf(<4.........'"...........
;,!_ ,~Exe~r,oT~J1~mi:i3fT"toT) if
.. ~.. \~ 11 L J ....:)r~.v_ ..... ..............................-...-.-..
(StTeet Numb....)
D:1 J..1 S,bUl.i:~,.,.... 11.::;.,......17019..."...
(City or Town and StIlte)
Item
No.
(1)
(2)
(J)
(4)
(5)
(6)
REV-4!11 t8-78)
..'~~
, '
~ ..'
~~ "- ""-
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "B"
PERSONAL PROPERTY
RESIOENT DECEDENT
INSTRUCTIONS: This St:hedule must disdose nlllangihle and intangible persllnal property owned individually by the
decedent, at the time of his death. Property owned hy the decedent jointly with another or others must he listed
under Schedule liE". Intangihle pen-wnal property, titled ill the nllllll.': of the decedent, hUI payuhle at death tn anolher
or others, inclmJing bul not limited to P.D.I>. U.S. Savings Blinds and ten tative t('usl act:llunts, lIlust he listed, despite
the ract that they arc nnt of the aLllllinistercd cstalt.:.
Tangible personal property should he listed first (e.g. jewelry, wearing apparel, IlOuse\1old goods, ami
rurnishings, books, paintings, autolllohiles, huats, ett:.)
Intangible personal property, SIIt:h as bonds, treasury t:crtificatcs, cash Oil hand amI in hllnk, stocks,
mortgages, notes, together with accrued interest or dividends, s;dllries or wages, insurance payahle to the estate or
fiduciary in said capllcity, partnership interests, interest in any undistrihuted estate or or income from allY property
hcld in trust under the will or agreement of another, e\'en thllugh Illt:ated outside or the State, at the time or dCOIth,
should he listed in this schedule.
r!EM
List and c..Icscribe fully
UNIT ESTIMATED
VALUE MARKET
VALUE
DEPARTMENT
V ALUAT\ON
(Do not write in
Ihis space)
140 shares of coml'lOn stock of Dauph in
Deposit Bank nnd Trust Company .(.DD.uPhin 6;J..1~
Depo\lit Cor'p.) 31. 75;
75 shares of cor:ml0!1 stock of CCEB Corpora-
tion. 10.50
126 shares of COlnTI!On stock of !\m8rican 1-15'(,:;'5'.
Telephone and Telegruph Co.clpany. l47 .S,O)
Proceeds of Life Insurance policioG Los.
76 64.0 999 ODd 9S ooe 664 issued by
Prudential Insurance Compnny O}~ /unerica
on lifn of ~ecedent. (See GI)PY of Claim
pa~~ent attached hereto)
Nortr:ac;e of ~;~(h':8,r'd G. ~:irth, '~'TT o.TId Cinc.J
L. OrlaskJ', dated .Januo.rJ' 1;~, 1979 ana I'€':-
cor'cled ,Tun1Jar~' 17, 1979 in the GU!',8DrlaniJ.
Count.v Recorder' n Office In i'Tort(:,'f11':e
, I.i. '- L.
Book Volu.me No. 656, !~8.t~e 726, SI.3CUP1.nC
briginBl principal 10Dn of $3,300.00.
3alonce as of :~arch 4, 1980:-
}'r'i.nci.pa.l.............................. .
Interes t aCC1~1.1ecJ to ~/J!.!EO..............
06,000.00 108n to John'~~lak, Jr., cvirieDc-
eo by J.uc]?:rrlent .Uote deted .J,').rn.J.u!~y 19, 1975
Balance a~ of :~arch 1.1-, 19f;0:-
Pr i nc i pal oi . . . . . . . . . . . . . . . . . . . . . . . . . , . . . .
Interest Rccrued to 3/~/Bo..............
Diamond Engagement ring appraised by
Hilliam F. Humma, Humlna's JeHelry Store,
3l~ "lest l1ain St., l'o\echanicsburg, Pa.
(Part of item 4 of Hill)
Ladies 3 stone diamond ring in ye110H
gold, appraised by V1il1iam F. Hllmma,
Hurnma's Je;relry store, 31~. \'lest !-lain St.,
!olechunicsbure;, Pa. (Part of item Ij. of 'di.11)
(1),1,1:5.00)
707.;;0
I~ qS{~ 00
l?' I ,/. -J
'1'130.
J
s:1 'i J., R R
J '
1, 156 .1~9
1,393.71
11. 03
5,947.60
52.014_
( 7)
400.00
(8)
150.00
PLEASE NOTE: Decedent broke un her home
in Se,ptember of 1977 and furnishings Here
sold 'and disposed of at that time and
therefore items in item 2 of Will have
abated.
insert this tulal uJlJlosite --Personal Prnllertylt, Schedule "B" in
the "As Rcpurtcc..l" column on the: last page of lhis rcl1;flI.
x X
/20 328.37) . ,201 o~ I. ~5"
~ , ~s:.'tlf.. '
RtV.484 EX" (3,80)
INHERITANCE TAX SUMMARY SHEET
(BUREAU OSE ONLY)
File Number .__,fl~- J>.1_'. C'/9J"_
Estate Nome ____Ltth.c.-:t'/_____.c'/LC.~=_.6s
Datc of Death ____.____._,x:::_Y---=--,fc2.________
Sociol Security Numbcc .
REPORT OF INHERITANCE TAX APPRAISER
I, tho unde"lgned duly appointed Inheritance Tax Apprals.e in and lor lhe Counly of Cumberland
Pennsylvania, dQ respectfully report that I have appraised the real and personal property as reported in tho foregoing
retum at the values sot Forth opposite each item in the Jast column to tho right in Schedules lIA", liB", ue", and uEIf
Doled:
October , 1 1980--
..-f!/jl~?( Id .II? if' A (, i( d.L-
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
CODE
ADJUSTMENTS
(HARRISBURG USE ONLY)
REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Personal Property (Schedule B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
S
92+
TOT AL GROSS ASSETS
00+
..to 0.2/ .25'0+
II. ,flcJ/ (17 20+
.
1/ 'I ,3tt"l r730+
-
_____g,O I__S' J>.L__ ~(L ___
Leu Debts and DeductIons
(SCHEDULE Fl
CLEAR VALUE OF ESTATE
40-
93-
Valuation of life estates or
annuities. , " . , . . . , .., .,
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6,.
"
Tax on $
15%
Tax on $
Tax on $
Tax on $
Exemptions
T otalEstato
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$--
$
Less Crodlts
OATE OF PAYMENT
AMOUNT PAID OISCOUNT INTEREST
S + $ S :
--- --
, , :
BALANCE S
INTEREST FROM __ TO _ .5
BALANCE OUE S
TAX CREOIT
$
~ ~
It), l..,
-..\\ "-
~ \1 ':,l.
\>." '0 ''-'l
'..
~ ~ ~ ~ ~
~ -( 'r
~ t:: t::~ ''-l
--- "" \-
I ~ "- !l( ~
'" 0 ~
<J ::> (j.,
~ ..:i , -::;: ,
-( Cl '"' ~ I..
- :z: \ \r~
I u 00
- 0 ')
-.. ~ -
'f'\( ~ ~ \ ~ ci
0
~. ...... ~ 0 z ci
... '"t 0 '" >- f-o 0
'" ~ '" f-o ~ Z Z
- ... ~ :><: ~
:z: ~ 5 ~
ci - ci ;:S Cl u ~ z
::l z ::E z ~ 0 0 :s
~ Vl U Cl Po.
~ ~
.
~ '.. .J.
lleV.455 ex+ 13"01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
*,
-
. ..-
Estate of Esther McCombs Date of Death 3/!L/8o
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Claimant's Address
ITEM
NO.
DATE NAME OF PAYEE
Re .ister of l'Iills
Ha fl Pol clinic Hos
Re of Wills
H. R. Bl.ock
Musselman Funeral Home
Donald V. Rohland, I1. D.
Harrisbur Pol clinic Hosp.
The Evenin~ Sentinel
The Cumberland Law Journal
S F
Internal Revenue Service
Pa. De t. of Revenue
Rerri. te of Wills
Re ister of Wills
Patricia Waltz
J Robert Stauffer
File No. 21-80-198
Relationship to Decedent
REMARKS
Letters Testamental" etc.
H s)i tal Bill
, Short Certificates
Preparation of 1979 Income Tax.s
Funeral Ex en8es
Doctor Bill
Final Hos ital Bill
Estate Notice
Estate Notice
A c un Due
1979 Federal Income Taxes Due
1 State Income Taxes Due
Reserved to filin. Account
Filin Debts and Deductions
Executrix's Con~ission
Attorne IS B'ee
62
5.00
102.00
2978.33
90.00
1 6.00
18.00
18.00
121).08
1375.00
7 .00
000 00
2000.00
TOTAL THIS PAGE 12 1
I hereby certify that to ,the best of my knowledge and belief the fore oing is a just and true statement of debts, funeral
expens,es and expenses of administration submitted to ystate as .~tio~s forl~h~tanc~ Tax purposes.
10 ~U /2/U/h
. SIGNATURE OF ATTOI'lNEV/FIDUCI DATE .
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S J.;J ~t;') ~_
I'
AT
.~~
PERCENT.
L~..J
/; REGISTE, OF WILLS
/./ -_:?(r JV
.. DATE
COMMONWEALTH OF PENNSYLVANIA 't.
COUNTY OF CUMBERLAND J
55:
Ruth patricia Waltz
being duly 'Sworn .ccording to low, doposos and s.ys th.t sho is
Executrix of Iho Est.lo of Esther f1cCombs
l.t. of -- -''''-1'. --. ""E' '''r'' -------- -.----, , Cumborl.nd County, P.., doco.sod .nd th.t tho
supp emen a th [) t . . W l' E t'
within is.n inventory m.do by Ru a -rWJ.a a t~_ ., tho s.id 'xecu r~x
of the entiro estoto of s.id decodenl, consisting of .11 tho porson.1 prop.rly end ro.1 ..t.to, except re.1 estoto outside
Ihe Commonweelth of Pennsylv.nia, and th.t the figuros opposito e.ch itom of the Inventory represont it's f.ir v.lue
.s of the d.to of decodont's death.
Sworn
and subscribed beforo mo,
"-)
,,/ 11 ) ;a t-
, 'X" d-I Jii I , I (/ " I'd
'I' EXlcutor ~ Administrator}.",
" Ruth patricia Waltz /
26 Ashley Drive
Harrisburg, PA 17019
Addr.u
Dot. of Death
April
o.Y
3,
Month
1980
Y..r
INSTRUCTIONS
I. An inventory must be filed within three monlhs .ftor .ppoinlment of person.l repr..enlotive.
2. A supplement inventory musl bo filod within thirty days of discovery of .dditional.Slots.
3. Addition.lsheets m.y bo attachod as to porsonalty or ro.lly
4. See ArticrelV, Fiduci.rios Act of 1949.
c.
N
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