HomeMy WebLinkAbout80-00211
211
No. 21.80
PETITION FOR PROBATE OF' WILL AND LETTERS TESTAMENTARY
in the Estate of Hary E. ~U.ck",y , deceased.
Harold B. McLane,
ilbNlaltJtxllo<:lmbraOO .Ac ti n g
Ta ~m:d~YA~llVRcgister of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania,
IS
Petitioner(s) are the execut..9X,!L__._ named in the Lost Will and
Testament of Hary E. Hicgy,__,____._____.___ dated ,Jlay_2l,-19J-9--.
Decedent was a citizen of the United Stot'es and 0 resident of
~mi~lwl~
Newville Borough, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on
Sunday
the
23rd
day of-.Jlar.cll
A. D. 19~, in the County of Cumberland
, State of
Pennsylvania at the age of 86 years.
~ roos her
Decedent has not been married and has 110t had children born to him
since the execution of the above described Will,
Decedent was possessed of personal property to the value of
$10,000.00
and of real estate to the value of
-----------0-----------
as near as can be ascertained; said real
estate situated as follows
None.
apply
Therefore, your petitioner(s) respectfully Xl1JI~ for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated Harch 26, 1980
Name and address
,
of Petitioner(s)
:LtL- ;:.p. ~~
/1, ohn. S talfuau
R, R, #3. Newville, Penna.
17241
?C:;;J4<d oE2t>-
.. Rus~j1.uPP
20 James Road, Broomall. Penna, 19008
COMMONWEALTH OF PENNSYLVANIA t
COUNTY OF CUMBERLAND \ ss
John W, Stabnau and J. Russell Rupp
named in above application, being duly sworn
say(~ thot the statements set forth in this petition
according to law
a re true to the
best of
their
knowledge and belief,
ond subscribed before g?-~<.-- ,;II, /J);~~
~v. Stabna~
Sworn
me, Harch 26, 19 HO
-1i~.1~~.~1r~~eputy
litteb:a' ooelSOO, Register
~i~~~tlJ~~l1fc'ting
.;;-r:::"7 ~ I c:/
...f!:'. ~>.-u~ ~'" ~~,,___
~ RusselllRupp
{}Io
Filed; March 28, 1980
<><I-Ro -,-<11 1/ -~J' ,.,'
Attorney:
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENN5YLVANIA~
55:
COUNTY OF CUMBERLAND
Before me, the Registor for the Probate of Wills anr! granting of Letters of Administration in and for the
~
County of Cumberland. personally came ..,...,J.Q)m"li'i..,.s,C.ab:nau...and....".Russ~Rllpp",..,"',....".....,......'..........,...
who, being duly ....!!!\',9,F.O..............,' do ............ depose and say that as ...);!i.~hH~R,J;,L..,.......,.................,...............,....
of the last Will and Testament of .....,................,~,"'D:..~.'...!'1,~,S~~Y.,'........................,..................................,.., deceased
.........~,~,':!.......,................., will well and truly administer the goods and chattels, rights and credits of said deceased
according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances.
..,......~.~~!:'!)....,........ and subscribed
before me.
..............,~~E,':',~..,~~,!.......,..................,... A. D" 19,!!.Q....
~'f.~~c---
Haro 1d<B\~~l!~ane
......J:r6~~~.....................,........,...
~~~-
...................,.............................#;:!....................................
a. Russel~upp
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DECREE
Be it remembered that on the ....?8~h.............. day of .............J!,~,J;.hh.......................,........,' A. D.. 19,~!L" there
was probated and recorded the last Will and Testament of ............!:'"r.L~,:...~~.':'~,~y...................................................
late of .....,~,l:>,\':..~!?,'?,c:>,\!g!!..!?.f...N~l'f.V,PJ~...................................... Cumberland County, Pennsylvania, Deceased. Letters
-a.
...... ,X'!.~,~ ~!'!,'!!)J,!\F.Y....., ............., ...... ......, were granted to ". ...J.Rhn, .......S.c.ab.nau...and....,l{usS,e.l.~RJ.ll1.p..................
Witness my hand and official seal the day and year aforesaid. ,{) I
. ~..'1J.I~ ...~..J~.. .....'-,/~,.,....
Oi.~ ........................
Harol B. MeLea . Aetin Register.
. .
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
.~1:l..s~E:l.l~.~u..py._~nd Joh1.l_ Stab1.la_u
55:
. -. .---. -_.__.------_.-.~-------~.._--'_.
being duly ..,sw.oXn___...__.._ according to law, depo.e. and "o{l thatt heY_.._iH:e th_e E){~9..Ll.~.or_s_..,...:...
of the E.tate of Mary E, Mickey
--.--.the.-Bclrough-oT-Newvliie
late 0('-' Cumberland County, Pa" decea,ed and that tho
within i, .n inventory made by..,... _...._,..'_. ...._.._t.I1g,m.._ ,_ _ ,-'-'-'--" tho ,aid Exe.cuto~s
of the entire e.tate of ,.id decedent, con,i.ting of all the personal prop.rty .nd real e,tate, except re.1 estate outside
Iho Commonwealth of Penn'ylvania, and that the figure, oppo.ilo each item of the Inventory represent it's fair value
as of the date of decedent', de"th.
Sworn and ,ub,cribed before me,
,~ c:2Q.t!::=.. 19 cfo
~?/~ L t/jtA~nU/(/
. flORENCE (, MASO f'('--
NOt31Y Plllltic. M:Hplc TwP., Oe\aWllIC Co.
My Commission Expires Jan. lG, 1981
Date of Death _J1~rs:J:L_._'?l/._l,..'L80..._--
D.y
I~' ",..-::.?
____._j.J.~~_~L.'.-~ ('C:::~~/:t .
Executor . ~~
I.
uff\<l.Y..Jj;,~~-,
---------..----.-- ------
Address
'-;>.." f)S?",,-<,= R,(, IS-<-.n~?~-ee, If (1",,/
Month
Year
INSTRUCTIONS
I. An inventory mu.t bo filed within three month, alter appointment of personal reprosentative.
2. A supplement inventory must be filed within thirty day. of di,covery of additional a"eh.
3. Additional ,hoets may bo attached a. to personalty or realty
4. See Article IV, Fiduciarie, Act of 1949.
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Inventory of the real and personal ostate of
..___,__Ma..D'_.!l.,..H!.<::.~."YL_____.__ docoasod,
_.._..__.......____...__.....__._.__.___._.,..._~..____. _......... ._ u..._.._.__._._~..______._____.___.__ --.-..--..----.---- .
___.___ n_"_" _.____...n_____." __.______ ___...____.... ...._...__.__m_______________n.._.__.._
Personal Property, miscellaneous tangible - as per appraisal of Sam Hiller
Jewelry: ring - $45.00
brooch - $50.00
earrings - $30,00
Automobile, 1960 Buick Sedan
Stock .. Commonwealth National Bank - 92 shares
Checking Account - The First National Bank of Shippensburg - //515-744-0
Checking Account - The First National Bank of Newville.. #064-321-1
Savings Account - The First National Bank of Newville - #064-321-1-20
Savings Account - State Capital Savings & Loan Association - #001-00-07282
Certificate of Deposit.. The First National Bank of Shippensburg - #4685
dated July 17, 1974
Cer,tificate 'of b'~posit - The First National Bank of Shippensburg - #2581
dated July 13, 1974
Certificate of Deposit - The First National Bank of Shippensburg - #5638
dated August 6, 1974
Certificate of Deposit - The First National Bank of Newville - #AR 1341
Account #064-321-1-60
Certificate of Deposit - The First National Bank of Newville.. #AR 818
Account #064-321-1-61
Certificate nf Deposit - The First National Bank of Newville - #AR 1771
Account #064-321-1-63
Certificate of Deposit - The First National Bank of Newville - #AR 1994
Account #064-321-1-64
Certificate of Deposit - The First National Bank of Shippensburg - #6255
dated July 21, 1975
U.S. Savings Bond - Series E, #677,235, $25,00 denomination
Medical reimbursement from Medicare
Certificate of Deposit - The First National Bank of Shippensburg - #8672
dated July 13, 1978 - jointly owned, Mary E. Mickey or Mrs. Pearl Jackson
3,225. 00
125. 00
200. 00
2,875. 00
6,898. 47
I
,
5 , 770'1 88
422 'I 55
10,126. 05
1,040. 83
10,415. 00
3,024. 92
317 35
528 02
5,672 51
9,054 15
1,048 54
77 16
233 80
663 61
MCCREA ~ DAVIS
ATTORNEYS AT LAW
NeWVllL[ 01: SIlIPP[N5aURll
PtN"'....
FIRST AND FINAL ACCOUNT OF
JOHN STABNAU AND RUSSELL RUPP,
EXECUTORS OF THE LAST WILL AND
TESTAMENT OF ~~RY E. MICKEY,
DECEASED, LATE OF THE BOROUGH
OF NEWVILLE, CUMBERLAND COUNTY,
PENNSYLVANIA
*******************************
Date of Death - March 23, 1980
Date of Letters - March 28, 1980
Dates Letters Advertised:
In Cumberland Law Journal - 4/18, 4/25, 5/2/80
In The Valley Times-Star - 4/9, 4/16, 4/23/80
THE ACCOUNTANTS CHARGE THEMSELVES lVITH THE FOLLOWING:
Personal property as per appraisal.. ",....." "'.',, ",."",.,
Jewelry (Ring, Earrings and Brooch),.",....."",..,.".."""
Automobile, 1960 Buick Sedan,.,.",.,.""..,.".,.", ." ." .",
Stock, Commonwealth National Bank, formerly The First National
Bank of Shippensburg, 92 shares"..."" '.."., ,..... ,.",
Checking Account, The First National Bank of Shippensburg,
1/515-744-0, Mary E,Mickey.................................
Checking Account, The First National Bank of Newville,
/1064-321-1, Mary E. Mickey.,...,......."..,........",....
Savings Account, The First National Bank of Newville,
//064-321-1-20, Mary E, Mickey."........,..."."..,.,.....
Accrued interest
Savings Account, State Capital Savings & Loan,
1/001-00-07282, Mary E, Mickey."",.............,........,.
Certificate of Deposit, The First National Bank of Shippensburg
(Commonwealth National Bank) 1/4685, Mary E. Mickey""".,.
Accrued interest
I', (....
~ ' ~~ v I
""7'''1
t. ,..;
$ 3,225.00
125,00
200,00
2,875.00
6,898,47
5,770,88
417,54
5,01
10,126.05
1,000.00
40.83
McCREA & DAVIS
AnORtnvSAT LAW
. '''.
Attorney's Commission, McCrea & Davis"",.".,...
Specific Bequest, Robert & Pearl Jackson, car",.,
Specific Bequest, Robert & Pearl Jackson, bank
stock plus dividends in exchange"",..""",..
Specific Bequest, Newville Historical Society.",'
Specific Bequest, Big Spring Presbyterian Church.,
Pennsylvania Inheritance Tax on Estate, ,..,.."."
Reimbursement, Robert and Pearl Jackson"".., .",
Reserve for filing fees and contingencies",..,."
3 ,072. 25
200.00
2,875.00
70,00
2,000.00
7,189,28
10,00
250,00
TOTAL $23,561,21
Balance for Distribution 36,445,48
$60,006,69
Income Account
Interest income from date of death to October 1, 1980:
Certificate of Deposit, The First National Bank of
Shippensburg (Commonwealth National Bank) #4685..".,.".."
Certificate of Deposit, The First National Bank of
Shippensburg (Commonwealth National Bank) #2581"....."".,
Certificate of Deposit, The First National Bank of
Shippensburg (Commonwealth National Bank) #5638",.",.,.",
Certificate of Deposit, The First National Bank of
Newville, liAR 1341.,."".,...,..,.".".,.",.",.,...,..,.
Certificate of Deposit, The First National Bank of
Newville, #AR 818..,..""".",..,.,."."".,.."".".."
Certificate of Deposit, The First National Bank of
Newville, liAR 1771..,.",."..,.."""""....".."".",.
Certificate of Deposit, The First National Bank of
Newville, #AR 1994,.,.",.",..."",.".",..,."""".",
Savings Account, The First National Bank of Newville,
#064-321-1-20,.,.."".."",.,."",.".".,.""""".,. ,
Savings Account, The First National Bank of Newville,
#064-733-6-20,.,..."".,.",.,...",.,..,."..",.".,..,. .
N[wVltlE &; SIIlPl'tN!lOIlRll Savings Account, State Capital Savings & Loan Assoc. ,
PU,HI<, 11001-00-07282. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
'::-'":'
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$60,006,69
$ 31. 33
313.33
101. 84
9,35
15.66
199,60
329,78
11. 61
173.13
278,79
COMMONWEALTH OF PENNSYLVANIA
ss,
COUNTY OF CUMBERLAND
John Stabnau, Executor of the Last Will and Testament of Mary E, Mickey,
deceased, being duly sworn according to law, deposes and says that the fore-
going First and Final Account is true and correct,
(SEAL)
John Stabnau
Sworn to and subscribed before me this
day of , 1980,
Notary Public
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF l/l.da''{~~~t...<...:
ss,
Russell Rupp, Executor of the Last Will and Testament of Mary E, Mickey,
deceased, being duly sworn according to law, deposes and says that the fore-
going First and Final Account is true and correct,
;) K'7
/ L::;,,~_.:' / t;~1lY3-
Russell Rupp
(SEAL)
S\wrn
-," ,
to and sub9~ib~ b~fore me this
ay of ({/~-[e.'?t-4:> ,1980,
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j.', FLO/lFNC~;A~ASONER
~. ~:~ \it;\,ary<p~~ljC. Mar~~~.~. Delaware CO.
\,':\~~~,~r~e"Jan, 26, 1981
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McCREA & DAVIS
ATTORN[YS AT LAW
NtIWILl[&,SH1PPE!ISDURa
PENNA.
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(SEAL) .
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PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PEIlSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritnnce nnd Estnte Tax Act of 1961 provides thnt the following persons slll1l1 prepare and file
a relurn:
n, The personal represenlntive of lhe estate of the decedent ns 10 proplHty of IlIe decedent administered by him
nnd such additional property which is or mny be subject to Inherilnnce Tax of which he/she shnll have or
acqui re knowl edge;
b. The transferee of property upon the transfer of which Inheritilllce Tax is or may be imposed by the 1961 Stntute,
including a trustee of property transferred in trusl, provided thnt no separate return need be made by the transleree
01 properly included in the return of n personnl representntive.
2. PLACE FOR FILING
The return is to be filed in duplicate with the Register 01 Wills of the county wherein the decedent resided,
3. TIME FOR FILING
The return is due nine months nfter the decedent's denth, unless nn extension for filing hns been applied for and
granted by the Secretary of Revenue within lhe nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" . . .any person who willfully lails 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 01 Revenue ns 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, grandparent, son-in-law and daughler,in-Iaw nnd at the rate of 15% as to all others.
6. PAYMENT OF TAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rale of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any
interest which may be due with any remainder applied to the tax. I F 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 wilh 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 may 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. FILlNGOF FALSE RETURN
Any person who willfully makes a false return or report required of hilll shall, in accordance with Section 793 of the
1961 Statute, be guilty of a misdellleanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo illlprisonment not exceeding one year or both.
I1EV.451 (1.80)
COMMONWEA~ TH OF PENNSV~VANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "8"
PERSONAL PROPERTY
(Instructions on Reverse Side)
Estate of Marv E. Mickev
ITEM
NO.
UNIT
VALUE
ESTIMATED
MARKET
VALUE
DESCRIPTION
6. Certificates of Deposit
1st National Bank of Shippensburg:
#4685 dated July 17, 1974 prine. 1,000.00
Mary E. Mickey into 40.83
#2581 dated July 13, 1974 prine. 10rOOO.00
Mary E. Mickey into 415.00
#5638 dated August 6, 1974 prine. 3,000.00
Mary E. Mickey into 24.92
1st National Bank of Newville:
#AR 1341
Account # 064-321-1-60 prine. 300.00
Mary E, Mickey into 17.35
#AR 818
Account # 064-321-1-61 prine. 500.00
MaryE. Mickey into 28.02
#AR 1771
Account # 064.,.321-1-63 prine. 5,300.00
Mary E. Mickey into 372.51
#AR 1994
Account # 064-321.-1-64 prine. 8,900.00
Mary E. Mickey into 154.15
1st National Bank of Shippensburg,
Mary E. Mickey P.O.D. Iva Ski11ington
#6255 dated July 21, 1975 prine.
into
1,000.00
48.54
7. Bonds
U.S. Savings Bond
Series E, #677,235,
Mary E; Mickey
J.' f't
$25.00 denomination
77.16
TOTAL THIS PAGE
31,178.48
.
DEPARTMENT
VALUATION
(OFFICIAL USE ONL Yi
REV.451 EX+ (3'80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of
Mary E. Mickey
ITEM
NO,
8.
DESCRIPTION
SCHEDULE "B"
PERSONAL PROPERTY
(ll1structlons 0/1 Reverse Sldo)
Medical reimbursement from Medicare
TOTAL THIS PAGE
UNIT
VALUE
ESTIMATED
MARKET
VALUE
233.80
233.80
'*'
DEPARTMENT
VALUATION
(OFFICIAL USE ONL YJ
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TO: Pennsylvania Department oi: Hevcnlle
I~urenu o( County Collectiorls
~oc~ ~ n IWJ
FROM: The First National Bank of Shippensburg
RE: Estate of
Marv E. Mickev
Deceased
Date of Death: March 23, 1980
It is hereby certified that the above-named decedent had, on the above date,
tile following accounts wltll us:
A, CllECKINC; ACCOUNTS
515-744-0
Mary E. Mickey (her name only)
~~6898. 47
Balance 3/23/80
opened at least 20 yrs.
B, SAVINGS ACCOUNTS None
C, CERTll'lCA'l'ES OF DEPOSIT 5 C. D. I s, listed
14685 7/17/74 Mary E. Mickey (her name only)
112581 7/13/74 " II II II II II
115638 8/6/74 " II " II II II
116255 7/21/75 Mary ,E. ~1ickey P. O. D.
7/13/78 Iva Skillington
#8672 Mary E. Mickey or
Mrs. Pearl Jackson
below
~~1 000.00
10,000.00
3,000.00
,
I
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,
Ij
Accrued Int. tJ-;:
1 yr 6eL datl;l of death l;.
. Ie $40,83 ""
1vr.6% 415.00
2hr.6~% 24.92
1,000.00 4yr.7i%
48.54
656.07
1yr.6%
capitalized
q,uarterly
7.54
--
$536.83 i
. Total accrued
interest to date"
of death
First National Bank of Shbg.
Total C.D.'s $15,656.07
Date: 3/28/80
IIY: ~r4, ~~^' \ '! "Jj f1~
First National Bank of Shbg.,Btock.
Mary E. Mickey also has 115 shares of
HEV.4S3 (1.aOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEDENT
SCHEDULE "D"
BENEFICIARIES
~
~
(Instructions on Reverse Sic/e)
Estate of
Mary E. Nickoy
- SURVIVED DATE OF
BENEFICIARIES AND ADDRESSES RELATIONSHIP DECEDENT BIRTH INTEREST OF BENEFICIARY
Robert C. and Pearl E. Jackson None ves sui iuris specific beeuest .
20 Chestnut Street Bank shares and car
Newville Penna. 17241
Newville Historical Society N/A N/A N/A specific bequest
69 South H!gh Street rine and doll
Newville, Penna, 17241
Big Spring Presbyterian Church N/A N/A N/A specific beeuest
Corporation Street $2,000.00
Newville, Penna, 17241
-. . ---~- --------- -.
Natalie S. Butler Niece yes sui juris 1/4 residue
812 Maryland Avenue
York Penna. 17404
.
Marv Hvde Butler Niece ves sui juris /4 residue
--
812 Mary land Avenue
-- -------
York. Penna. 17404 .
. . .
Mrs. Lois Hockinlt Niece ves ui ; uris ./ 4 residue
R. R. 1/2 Box 207 ,
Landenberg, Penna. 19350 .
Mrs. Kay Jamison Niece yes ui juris /4 residue
207 Hull Avenue, Harmony Hills
Newark, ,.Delaware 19711 ':
- .'
,
.
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
ilEV.4!i40.S01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
.'
(Instmcriolls on Revr.rse Side)
Estate of
Mary E. Mickey
-
P
TOTAL E VALUE OF DEPARTMENT
ITEM R
NO, DESCRIPTION MARKET C DECEDENT'S VALUATION
VALUE E INTEREST (Official Use Oll/Y)
N
T
=-
Certificate of Deposit
First National Bank of Shippensburg
. #8672
Mary E. Mickey or Mrs. Pearl Jackson
July 13, 1978 principal - 600.00 600.00
Interest - 63.61 63.61
.
.
.
.
,
.
-
TOTAL THIS PAGE 663.61 ~~JM
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RECORDED'OFFICE OF
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. REV-484 EX+ (3.80)
INHERlTANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
File Number
21-80-0211
Estate Name
H.:lry~<!ckcy.__
Date of Death
3-23-80
S . IS' b 182-22-7338
oCla ecunty Num or . --- . ---
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Apprai ser in and lor the County 01 Cumberland
Pennsylvania, da respectfully report that I have appraised the real and personal properly as reported in the laregaing
roturn at the values set forth opposite each item in the last column to the right in Schedules "A", u8", IIC", and liE"
Dated:
November 13, 1980
)!/,1f.'f /4 iff!,. )"J.Y.l )
INHERITANCE TAX APPRAISER
INYENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY)
REMAINDER APPRAISEMENT CODE
Real Property (Schedulo A)
$
-0-
00+
92+
Personol Property (Schedule B) 61,055 23 10+
Jolnt.Held Property (Schedule E) 663 61 2/)+
Transfer. (Schedulo C) -0.. 30+
TOTAL GROSS ASSETS ____ 61,718 ~_
Leu D.bts and Deductions
(SCHEDULE F)
CLEAR YALUE OF ESTATE
40-
93-
Valuation of life estotos or
annuities. . . . . . . . . . . . . .
RATE
FACTOR
PRINCIPLE
YALUE
CODE
EQR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
6'.
"
Tax on $
15%
'Taxon$
Tax on $
lax on S
I
Exemptions
Total Estato
Less Credits
DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST
S + I S =
+ =
BALANCE S
INTEREST FROM TO .__ S
BALANCE DUE S
TAX CREDIT
$
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,Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate,
In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker,
yENERAL INHERITANCE TAX INFORMATION
All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the debts being claimed
should be attached to this schedule,
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim the exemption, In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as the decedent,
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1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column.
2, Assign consecutive numbers to each item listed,
3. Enter the date on which each debt was incurred and/or paid,
4, Enter the names of each payee,
5. Provide a brief explanation in the remarks column for each debt claimed,
6. Enter the amount of each debt being claimed,
7, The form must be signed by the person who has assumed the responsibilitY for paying the debts,
INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
RCC.3 {1,.731
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28,1956, P,L. 1757, and Act, of June 15,1961,
P,L, 373, 05 amended)
COMMONWEAL TH OF PENNSYLVMIIA
DEPARTMENT OF REYENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approvcl
of an exemption from Pennsylvania Transfer
Inheritance Tax on tile transfer of the property
described below:
1. Bureau File II
4/- 90_ c?\/) II
.:::.....tJ...J___~_____
2. Date 01 Death _ MarGh.,.3.~,_1_980,_________
3, Date 01 Approval .-fJ!aAe,J ,-gt'J~'JjJ}
4. Name 01 Oecedent Mary E. Mickey
5, The Commonwealth's appraised value of the property lor which an exemption is claimed is S -2.,J).00. 00
(Note: Where the property is other than a specified amount of cash, the exemptiol1 cannot be approved until tho value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entirc residue. In thosc cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously filed,
WILL '*
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
01 ather, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Big Spring Presbyterian Church
ADDRESS c/o Pastor, 13 Parsonage St., Newville, PA 17241
D See listing on reverse side for additional charitable organizations covered,
8. I certify that the inlarmatian canta=7ein is, ~a7'7 01 my ~n07e and beli~I, true and correct,
Signature 01 Applicant~ M ('. /-~'-'-
Address 01 Applicant
22 S. High st., Newville, PA 17241
Official Title Attorney for estate
Date
This form must be completed In triplicate and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were Issued for a non.resident decadent's estate. If the decedent was a non.residcnt of Pennsylvania and
lotters were not Issued by a Pennsylvania Register of W11I5, deliver all three copies to the Dlroctar, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write below this line. Far Official Use Only
REFERRED to Bureau Headquarters
Approved 0
For Secretary of Revenue
J2L
<~ (Si ature of R,eglster of Wills)
L~{-nrAf' ,,4 .fd.,yu!L-
'/1 (County)
(Y/I J;;/;,e,,j ,:j(~ ,/ tjlV
(Date 01 Appraval)
Denied' 0
(Initials 01 Register 01 Wills)
(Authorized Signature)
(County)
(Title)
(Date 01 Relmal)
(Date of Action)
* See reverse side for reasons
MUST BE FILED IN TRIPLICATE
RCC..72 t6-671
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
APPLlCA TION
*~
COMMONWEAl-l'li OF PE~NSYLVANIA
. DEPARTME~T OF REYE~UE
BUREAU OF COU~TY COLLECTlO~S
DATE7JjJjJ,w31 NIJ
/
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for Calsent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Association locatod in Pennsylyanio:
(a) 92 shares (b) Commonwealth National Bank stock (c) COll1mol'"
(NOTE: In describi"g securities enter in (a), ab Ole, oither the number of shares of stack or the face amount of
registered bands, in (b), the nama of the issuing compony and in (c) the class of stack or the staled interest rate
ond maturity date of registered bonds,)
(converted)
ISSUED ON April 1, 1980
(Dato)
as of the date of death of the decedent,
, and haying 0 TOTAL MARKET V AWE OF $
2.300.00
Mary E. r.lickey
(Name of Decedent)
, on
March 23, 1980
(Date of de~th)
who was late of
20 Chestnut Street, Newville, Cwl'ibar1alld, pennsylvania
(Street and Number) (Post Office) (County) (Stote)
ADMINISTRATOR)
EXECUTOR )
John stabnau,
Russell Rupp,
(~ame)
Mary M~ck..y
(Nome or names In which certificates arc registered)
R.D.#3, Newville, PA 17241
20 James Road, Brooma~l' PAi19008
,/ (Add,? 1"1"
NAME OF APPLICANT J/-/., ,'/7 r//4v, .1
ADDRESS OF APPLICANT
.
The securities are registered as follows:
COUNTY FILE NUMBER 21-80-211
BUREAU FILE NUMBER SIGNATURE OF APPLICANT
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS AP L1CA TION, I WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATEt.f/;~3d,jftd
I hereby consent .to the transfer of the obove securities now registered in the name of the oforeso.id
Decadent and Naive the filing of a certificate certifying to the payment of the transfer inheritance tox to which
the property of said Docedent is made subject pursuant to the prayisions of the Act of June 20, 1919, P.L. 521,
as amended and the Act o! June 15, 1961, P,L. 373, as amended, This is also in occordance with the proyisians
of the Act of April 9, 1929, P.L. 343,
This Cansent to Transfortho herein described property oporates only in reference to the .estate of the
aboye.named Decedent,
Signed for the Secretary of Revenue
B,Y310~)~'~od .
. . ~a'iJ .Lf'L/~~hL...
. tlo) (County)