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RCcr-I03 (3-731
COMMONWEA~ TH OF PENNSYLVANIA
.. DEPARTMENT OF REVENUE
BUREAU OF COUNTY CO~~ECTlDNS
INHERITANCE TAX DIVISION
INHEI,ITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
COUNTY OF
Cumberland
This return musl be completed In doteil and flied In dupllcnte, with the Roglstor of Wills In tho County whore the decodent resided within nine
months after dote of death, unless on extension Is granted by the Secretl]ry of ReYenue.
Will c2/.f!t)-~SO
Adnm. Nil. 19_ I,
Pearl I. Keller Ill' 604 North West St:r.e.et
INAMr::J C l' 1 UODRESSl1 .
Misc. ar is e, .t'ennsy vama,
being duly sworn according to law, deposes allll says thlltSle is lite -Bl.ll:V.lld.n1!.-S.~,qp .
-- tEftC.. ADM., LE"GATEE, ETe,)
of Ihe eslatc of ~ay~.~elle!:...________ 1/lle of Carlisle Borough .
(CITY, BOROL'CiH, OR TOWNSHIP)
March 25, 1980
(DATE)
deceased, and that the whole of the estate of saiJ decedent, who died 011 ,._._
consisted of the assets listed below ami that allownhle dehts anJ deduL:tions exceeded the f"ir market value uf the assets and
no Pennsylvania Transfer Inheritance Tnx is dut:.
Sworn and subscribed before me ~. 17 a.
tho 10th day 01 April, 19 80 _~_--L_1~~~
- (SIGNATURE)
,Yf ~t::. ], I t-:~tarl Pub~i~:.~~1;~iS:~1 .C:~~l.~~~~~rlIt Keller
Notary Public,. Carlisle, umbcrland Counly
My Commission Expires t,lJW.lst 16, II1}{SSETS
(Attochoddlllonolsheets if necessary)
Description of Asset
SurvivinL~PJ1uSe _
( TITLE)
Type of Asset:
Real Estate, Pars.
Propclrty, Jointly
Held Prop. In
Transfers
Estimated
Morkot
Value
Deportment
Valuation
CAUTION
(Do nol write
inthisspoc:e)
Joint
House and lot of ground at 604 North West
Street, Carlisle, Pennsylvania
tenancy by
entiretie s
Joint
Miscellaneous household goods
tenancy by
entireties
Joint
Joint
Pers. Prop.
Cumbo Valley Svg. & Loan Asn. Cert. ofDep.
Farmers Trust Company savings account
1970 Ford Maverick Sedan ~
tenancy by
entireties
tenancy by
tenancy by
entireties
tenancy by
bo
ntir etie s
Joint
Farmers Trust Company checking account
Joint
Joint
Farmers Trust Company Certificate ofTh posit
Farmers Trust Company savings account
500.00
ntireties
ntireiies
5'0,0,00
REPORT OF INIJERITANCE TAX APPR 1. EI
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the above CnunlY do respectfully report that 1 havc
appraised the real and personal property as rcported in the foregoing schedule at the values set forth opposite each item in
the lasl co!umo to the right. $1. '/ 'If 'A I)
A 4 ~.I1I.:1 /J I,' ,'}(r. -
Dated: pri1 2 . 1980 (INHERITANCE TAX APPRAISER}
~ame of Poyee
DEBTS AND DEDUCTIONS
Nature of Claim
Amount
Claimed
Amount Approyed
by Register
Pearl I. Keller
Ewing Brothers Funeral H
Register of Wills
Family allowance
e, funeral services
Filing Inheritance Tax Return
2,000.00
1,869. 00
3.00
TOTALS
3,872.00
q
REPORT OF TilE REGISTER OF WILLS
I, the ulldcrsignc,J duly elected Register of Wills in and for Ihe ahove COUllty, do respcctfully relHlrt that I havc all(J\\'l~d
deductiulls in the amounts set forth in the ahove sehL:du1c as claimed, excepl whcrt~ I have set fmlll .. greater fir lesser amollnt
in the last clllumn tn the rit;ht, ,,11Ich greater or lesser .1I11ounl rl'presclIls the ~ a 110\\ cd as a deducliOl
l>ale"I'Approval: 0;/1'1 /g /Cj%/J ,0 ,u e.
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