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NO. 21-80 2'74
PETITION FOR LETTERS OF ADMINISTRATION
IN THE ES'I'An; OF J:U1~~...1-......,l1.q~~~.............,..,......... OECEASEO.
Harold B. McLane.
To ..........,......."..............".....,.,.........,................,.......,........,."...,......"........,.....,.....,..
Register of Wills for the Countif of Cumberland, in the Commonwealth of Pennsylvania.
The Petition of "..,',.....,..,.,..~,:......~,~..,~~.r.~,~~, ......,. ..,....,............."...................,......,...."...,...........,...., ......
......... .... .......' ,............,..",. ............... ,. respectfully s howe th that.. ..W. ~J !?~);:.,1..... }jQ.;":+.9,\'?......,.,..,...,...."........
was II resident of ......................MC)J),r;.Q.~....................1J,{~1f ,Cumberland County, State of Pennsyl.
vanill, and II Citizen of United States, and departed this life intestate in the County of ............................
cumberland pannsylvania
.... ........ ,.. .......,........... ...... and State of .........., ,........,.,.,... ..........', ,.... ...."..................,.......". .....,. ....,...,.. ........' .............
on ...........~~~~.~!............ the .........y1:~.~..,.............. day of ......,.AP.?:J1............................. A. D., 19..!}'9...,
at the age of .....1.w..... ~<1b L M
'Wl.!. ur . orrow
That the said ..............................................,............................... deceased, left surviving the following
named widow or husband, heirs and next to kin, to wit:
Name
Relationship
Residence
M. Mae Morrow
D~;~~.h;..M.:...iiiiii~;".................
................................................................
~~.~~.\'?.........,...,.................
~~.~.~~~~.~. ...,.........,..........
~~.~~~~.7.?:. ...,.....,...".........
~~.~.&~~~!.........................
.R,....P......?....M~,9.Mnl9..l?.!?,~:+.g... Pa.
170 Willow Mill Park Road
~~~~~~~~~b~~*~.~l'~~.~~~i~s burg.
:~;:i;.:::?:;.::~:~~:~;,;ii.~~;,~:~:~:::~: :
Lanette M. Yohn
................................................................
Darlene V. Morrow
................................................................
,...............................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
That those above named include all of the next of kin, so far as known.
The said decedent was possess..d of personal property to the estimated value of $lJne.stimated....
and of Real Estate, less incumbrance, to the estimated value of $.....N.g!:l:~................... as near as can be
ascertained.
That the said Real Estate in so far as is known is located in .....~.~,~...............................................,....
........................................................................................................................................................................................
Therefore, your petitioner(s) respectfully apply(ies) for Letters of Administration in the above
named estate.
Dated .......................~?~.~~..?~........ A. D" In,8.Q....
Signature and Address
of PetiUoner(s)
1. ,. J /'
......,'M~!.'i,d~!.~o'fr~~..'.,!,',:l-0!f..,.."........,...,........
R. D. 2
............................................"..........................................
Mechanicsburg. PaD 17055
........................................................................................
........................................................................................
COMMONWEALTH OF PENNSYLVANIA 1 ss:
COUNTY OF CUMBERLAND f
M. Mae
.............................."...,... ,............,........,........,.........,..........,.,............,...,,.. ,..."........ ,."....,...,...,........................., named
in the above application being duly ........................!!~.9.;",n........... according to law, say that the facts set
forth in the above application are true to the best of ..he,~...... knowledge and belief.
~~;~~'e"'" m' '~'"S.W.9J:P..... ........... ............ and subscribed \.................. ................ ,........ ................ ............. ................
........................................................................................
.......,....................,.........AP.;".tt?,~,. A. D., 19,.~.Q,.. ..,.,......",...,.....,...,...."......,.......,.........,."..................,.......
..jl.(~:.'cL5;(o... ,:....p.;,I~"9.)fJ.!:6ii.:,.';.k....,?'::!?.~.::;{. ."..,.,...;~;L..,..:!.j;.i.I:.....li..I:-:)..)Jd.(,:::............ .....,.....
Z2:,. - lei 'I'
" .'" .' . / Register
. April 24, 1980
Ftled: ..................,.........,.................,................... .....' Attorney:
(over)
Morrow
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REV-449 18-78)
COMMONWEALTH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FlELD OPERATIONS
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Rc:SIDEHT DECEDWT
COUf~TY OF____~_~~~D~_
IMPORT AHT,
.------..-.--------.
. . .._ m .....,_...._.._.. ,-,
This rCIlJrllllluflt hl~ \"'Olllllklt'lllll detllil IIml filed in dU\llil'ale, with all allildwd, willlllw I{t~~is\l'r of Wills uf the.
CllUlIlY \\'llt~n' dt~ct'dcnt n'~ldl'iJ; j{t'!lllll i~, dm~ withill nilH' 11lOlllh~ allt'l ..Lltt' or dt'atil, unless an extensloll is l;I.nllltcd
h)' thl: Sl~l:rCtaIY or RI~\Il'l1l1,~. (SI:t:/iOI\ 70] ul llll' 1III\I~l'ital1(:l' alld Fstalt', Tax At:l of 11~(II.J
.-- ..---..- ...
-
IN TilE MATTER OF TIlE ESTATE OF
______} =1'
.\D\IINIS'I RA'JR/IX
CuuI11y
Wn.BUR L. MORROW
(5TATE "WI.I. NAME Of" nEc'c:m::tHl
Lota of M
MONROE TWP. CUMBERLAND
.,----------..-..-.-.
PENSSYLVANIA
,
I
c CUMBERLAND f '"
ounty ot -----..1
M. MAE MORROW
Admini:;tmt~ix--Ml:-:~~::f;h'l ubo~::-~~;:d"d:~odo;b~in9 dul; sworn, dopaso S
Stolo of
X~
ond 1013
Decedent died April
{MONTH!
Nomu and oddrau of ollorn(l1 or }
Illher outhorl:r:ed roprounlollvo 10 whom '
011 COHu.pondenctl should bl) mollfld.
14
, 19~O ..J:BilG1COOWOlJ(XJlIlt~}
(y~inl(l'lnt(!
(D/,Yl
George B. Stuart
_3.Ji.QJ.lt1LHarulY..eL..St.rJ~_e.t___CB.r.lis.le~-11.0l3
That as sucIA.Jiministrat;ix .deponent is fUllliliar with the affails of said estate .\l1d the propc;rty cunstituting
( EXE CU TO R-ADMlr~ I 5T HA TOR)
the ussets thereof alld thc;ir fair market value.
That <lIthe time lIf death there was no safe deposit bux registered in dcccJcnt's individualnumcl or jointly with, or
as agent or deputy of another, or in decedent's individual name, with riglu uf access by .wother as agt~nt or deputy, with the
exception or the following: -
NAME AND ADORES~ at" BANi( OR OTHEr< INSTlTUTtON
IN WHICH DECEOE'.NT RENTED A 5>AFE DEf'O!iIT BOX
None ---
THIS SAFE DEPOSIT BOX RENTED
IN NAME Ol~ NAMES OF
~ -
RELATIONSHIP OF JOINT
HOLDERS TO IJECElJENT
=--.==-:=
That the contt~nts of ~Ilid safe tlerosit hox. or boxes arc itcl1liz~d under SchedtIles
with the exception of the following, for the reasons hereinafter set forth:
of this return,
That SchcJde A atwched hen:w and made part hereof sets forth fully and in detail all the real property
in tile Commonwealth uf Pennsylvania of which dCl:edent died having an interest therein. It also selS forth the
mortgage eneumbranccs upon each p~rcel or real llropcrty at the datc of llealh, giving the amount !ilill due at
death, name Hf mortgagee, unle, raw of interest, ilud hook unll page of record thefl~ur. It also sets forth in the
columns provided therefore the usscss<:d valuation of each of said parcels, the estimated market value thereuf
as uf date of death of decedent.
That Schedule B atltichcJ herelo and made part hereof l;cls forth funy and in detail all personal properly
where Hover situated owned by the dcccdcHt at the time of denth; all mOlleys left by the dccelltl1t al the lime of
death, whether in decedent's imnwdiatt', l)osscssiol1, standing to dcccdcnt's credit in hanks of deposit, sl1vings
banks, trust compaJlie~.;, or other institlitions, whether individually, or in trust for any other person or persons
giving ulso separ~ttcly the accrued illkrest Ihercon, if any, down III lhe last interest day prior to decedent's
death in the case of savings banks, and \(1 the d;ae of decedent's dCilth, in all other easel'i; all bonds, postal
savings, treasury certificates .ur,.notcs Jnd other cvidence of indebtedness of the United States lO the de-
ced~nt; all ohtigatiuJll'i, whdhcr by statutc (Jr agrt.'clllcllt they arc dcsigniltcJ as tax free, of the United States,
or any Slate, or political suhdivi'sion thereof, or of any foreign country, which lire owned at the time or death;
aU '~'euring aflpalcl, jewelry, SilVCI'V-iarC, piclures, bouks, works of art, household furniture, horsc!\, cltrriages,
automobiles, boai!), and any an~l all other persoll:.i1 chattels of wllatsocvcr kind or nature, Idt by decedent,
lOg~ther with the fnirly estimated mHfki.:1 ":IhH: thereof; all honds and I1H,ngagcs held hy decedent andu!' all
claims due and ~,\\'!ng Jeccllt.: II I at tbe time or death, and all IlmmissOlY nott:s or other instruments ill writing
fOf the payment of money {If Which decedellt died pnssc:-;:-.ed, of whalsoc"cr nalure, with interest thereon, if
any, giving the fact: value and estimated fair market value thereof, :lnd if ~uch estimated fair market "alue he
less than the face ".due, it sets forth briefly the reasons for such dcpreci;ttion us to coach iteffijal1 moneys
payable to the estate from life insurance policies carried hy decedent; all annuity and endowment conlractS
lhe proceeds of whieh were payable upon the dcath (If the decedent; all ;tnd the corporate stocks and divit.lends
dlle thereon and unpaid B!> of tbe date of death, honds and accrued interes( thereon 10 the d:ne or decedent's
death and other in\'~stment securities o,vncd by the decedent at the time ,of death, ""'itL the market value'there-
of at such time.
,
i ,~
1n the cnse of scellrlUes or clo!il~ or i'UlIIlly '~Ol'pcl'llt..iollH, tllH vII11I'-.'S n~Jlortcd [iff.' ILK far 0.6
possible SUllSt./llll.l11lC(lllY fllJ'll1Ct'll Stf\l.fJl1WlltS 0(' thl'! Gf)rpl1r1t 1.I OilS, ShllWlfl~ U\f} ~\SS~t.~ /Iud llabU!t.les
tlwreof liS of' th~ clnte 01' fll'rl<:.h. ThH schedule 11\:-;0 sots rOI'j)\ t!ln Interest. (1(' ftece1tent:. at the t,lmo or
Itellt.1l III /lilY co-pllrtner!->h1r or IJI/~\n"s'i, I\wl Ifl ;lllp\lOrt. nl' thl! VPll\lf~ of' Glh~h IntHrl!si 1.IlHl'C Is Itl\nt'x.:>d to
sntf. SChl'ttlllc, t'lnllnet'll :"llt.I'mnnt.s ~how(ng LI1(~ !\S'iHts !It\fl 11!\hllltlj's 01' 3/11(1 C(I-p:lrlnersh11' or hll~ln;~'ir..
,\ copy or till' t:n-l'lIrt.nl!l'shlp i\r-;r(~::rr.enL, (If' orn'l1 1\ stflIJ!Illf!nt. ,.;;>11.111"'; l'orf,1t Uw Illlt.llre of' t.11~l llJ.;rl~ement)
lo~,.tIH'r ....tt.h 11 stnh~m(~lll ~,et.t!Il~ forth tile ~tHlrll.ct<~r or r,ll'> ll11s1l1l'o;s, lis l()ef~l.Ion, lun! $1H~h other fl.let.s
p('rtlllnlll~ t,o t1w hllsltwss ns lIlll)' 111~ IJI.>rtlnenL to n. l'nlr IIllIl .lust npprlltsul. 01' ,t.he dece\lcnt:.'s 1pt.~rl!st,
Ih"""I" m"s, "" su"mllt.",l, It sh"uld /llso ,;"t..'f,);.t.h tn It.,,,nl,,,d I'orm, t."I,"t.I""'~I~lh ;l.hol'rAI?J';~~Jtvnlu"
t"erf~()f', /lilY otlll'l' propertj' oWlwfl or h.~(PWllI.IW(1 ll\' t.h~ d(!I~t'lh~nl. Ill, tlll~ time flf ll/'ldt,.
, ; ("'.~
L'
Tile SChC'dult> C 1lt.l.nelwtl heretn Ilnel mlll1.~ llnrt h"}"Nd' Sl!Ui fortll II tl'IW lU;lS'lI'r-r, t.rr e;~lr:h ,inql~irj'
contl\lned t11l!l'eill Hnd in t.he r'll.";f'! 01' tl'lltlsl'el':-i ()f'Jll'll!lfH'I,~'~ I'eld \II' )ll?rsollIlI l within t,'we) ye~,'rs' ~)t' decedent's
dnnth, in cont,emplntlon 0(' lIncp.dent' 5 ttent.h, or Intendnd 1,0 \.IIkn effect 1.n posscsslon or ~n,10~'lTlcht 8.t. or
Il!~l:tr"\i\enth, Sllill sclwd1l1t! sets I"ol"th the nn.t\lre /Iud vul1l'! nl' s\wh proncrty" to WllOln trAns1'l~rrHc\, the
~,- - - " " !' ... j'
l'clllt1onshlp of 1.1lf~ j,I'nlls1'en~1~? to the ',N~CCthmt., tlte PI'{)I'Ill'l,lollfll,e sl\llrt~' 'rr:>ef!lvClI hY cllcll trHII~~\~r(H~ Ilnd
nil ol.her f"ct.s 01" n perl.lllont, 1I"l.lIr" i:ei\nrrlJII~ ,,,lrI I.r"'" 1"" " , I" I.h" ellSO "I" t.rllllsl'"rs tiii,'nMrI 1.0
tnkn I!lTe~;.<~,~~,p,os,~e~~~~".~~~,.~I;,,:~?~.lQY1n~~!t~.p,t ,?~;)~r:.~~r ,/If!llth,\ipwrn I~, nlso 11.t.tllcilHII to th'7 :fiCIH~c:l\1I(! a COllY
of' the df~ed~ t.rust. llgrp.emollt or oiJier"lnstrllment, cI'elltlng the trust. 'l'hel'l~ Is lllso set', f'orth 1n snid
schedule It list. of nIl property, rp.I1l Ilnel Jlcl'sonlll, w1t.h its vHlue, whl(:1l Jlll~:ses Ill. clecetlent's dnllth by
virtue of the exercise by decedent, oithl,~r indivlehUI.I'fy;:~rlJIl41tI,ly'Wfth\lmother, or nny power 01' UPIHltllt.-
mont. vest.od I:' uep,:'1"nl, "e1t.l'~I', ,'.':rltv.1r1I1:ilIY ~r ,Jqtlll.l.y,hY U'.e wI] :.~, deerl, or ot.her Insl.rumenl. ot' IUlot.her,
wHh n copy of' t.he "insLrllmo'ht 'cren('fTl~ 'sunh po'wer' nl,tnchell to tttn"sdhr!dllle.
Thut Sc/1edule 0 nttllcherl hereto find Inl.lde pllrL hercof sets f'o'r~'l;: t:I'~ n'l~m~~ nnti 'llddrc5scs of nll
persoll5 heneftctfl.11y interested In this est,llte Ilt t1l<! tifllt~ of tieccl!lmes 11elll.h, the lIutul'e of their res-
pectJ,,, Inl.eresl.s, I.helr retfl!.lon,hlp, I f /lilY, t.o the d"c"de"t., t.ogel.hcr ,i th l.h" flges fit. t.he Umc of
decedent's rlellt.h of 0.11 minors, IInnu1t'lIll,S Utllt henef'ict.ul'ies I'or lifc llnnHr rlecedentts Will. It also
cont.llins n' stntemcnt showing which of' t,he hcneficillr1es nlIDlerl ill the de~edent's will, If' un~', dt.cd prior
to decedent, t.he (tnles of t.heir deltth, their issue, lUlli the rellltlonslt.lll C)f' such issue to the heneflclury.
Thnl ScbedulC! E lI,ttnchell heret.o Ilnci mltli:e Il pnrt her~(}f sets forth IlIl llrOllerty, real lmd lH~r-
SOIUll, ovmed by the deeedent ,1oint1y .....ith 11Ilot.lwr or othel's~ including lntnnJ.'!;iblc, stnnd\ng 1n ,the name
of the dec'f!rlent Itlld ot.hers, plus the date /lnd place of' recorll of' instrnments e('f'ect,ing the \-cst1ture of
rell1estnte ntlll the date of Ilcquislt1.on of pcrsonlllly, plus the n1lnle, uflrlresfi n.ncl relntlonshl1lt if any,
of co-owners to the decedent.
Thllt Schedule F nttnched hereto Itod mnde it pnrt heroof sP.ts I'orth fully and in detail nIl debts
alld dedllct.1ons elfllmed for flnrl on 1)0 hilI I' oj' t.hls deeedent.', "st.llt.e, Incllldln~ funer,,] "xp"nses pflld;
I'llmlly exemption, wh"re "1'1') ICllhle; cost., 01" Ilrlmlnlst.rfll.lnll of thIs estllt."; cOllnsel fees fllllt 1\,rlieifl"Y' 5
conuntsslons pa.ld or to be paid; cost expended fnl' hlll'inl tl'llSt.S, tomhstones or s.;rllvemnrkers, Ilnd reli-
gious services, In cOlIse'luenee of th" d,,"l.h 01' the deeerlcut.; d"ht." n",1 clldms owtng ",011 lUll' II t1.1 fit. l.ime Olf
deal.h; t.flxes nccrued chllrgellhle I'or perlod prtor to Ilecedent.' s ,I""t.h (exeol't I.hos" Il\lowed under S"ct.lon
H5l of the Inheritw\Ce Ilnrl Est/lte Tux Ael)j toget.her wit.h Ii swt.elllcnt of collntcrnl pledger! for obliga-
I.lons, II' flny, It. Is lI~reed I.hllt. t.he l'lrluc1llry will presellt 1"'001" 01' sllld clnt",,,d ohltgllt.lollS lIpon re-
quest., t.hllt. If the lunollnl. lIel,lInlly pldd in ""t.t.loom"ot. ul' IIny I'e", commission or debt Is less thflll t.he
est.lmat.e,1 Ilmuunt. d ntmlng IInd lI\1owerl, t.hllt. t.he Sllme will h" r',ported 1.0 th" lI"glstcr 01' WillS, 1100\ t.hnt
the lImount of t.I1X nssessect CIUl he rellsscsset{ III ncCOrrlll.nCf~ t.IHH'f~wi lh,
Thflt I.he tol.flls 01" t.he flpl"'oprl',t.', e,)IUnUls tn Seh",lules '.\', 'Il', '~', '1'", nnd 'I" liS di,'ceterl therein,
hlLVl~ been cnrrIed forli'lu'C\ (lud properlY registered in t.hl~ Sllllunllry.
Subscribed and sworn to before me thiB .,..,..,
at
"',.......6<.... .... day of "A\1gt,l~t: 1919
~/,..;. /I J'J
"71.~~ '7i:i~~~,,-. . ;1., _
-1>>t t1~ .R~ Yl?au4 6/ /7'~a-
:'j!.(,.",)!/ac.)llrJ:~..).-!!:.0::f..{C:........._.
(jI>rm."".Administro!rix
.,. R ."D.,..,2,.,....,....-,...........................,......-...-..-.
(Street Number)
Mechl1.t,l,i.:c;f.l!?~. ,...f,!'!.,..,OJ"IQS5...." ,.'...."..m'.
(City or Towll nnd State)
NOTI';: BerUI"~ signing 1lf'f1dnvil, mnke sure f1.11 hlnnk spuc:ps jl\ tile Ill'fidltvtl, hili! schcdult~~., hlHw>:etl Ilre
1'1tl..ll In \'0'11.11 th.t.niIs or the word "N(J'H~,", ItIlit 111 cmw lht! IISSt.'ts IIwludc rnrt:! /11\11 unllst.ed secllrltier;,
Sf~C\lI"it1es of elose or fllmBy COl'porllUollS or 1111 1Iltl~rl!S\. III 11ll~. C(j_plll.t,lH~l'shtp or 11l1~.llles8, tllllt. lhe
dld.1l 111111 stf\telM'Ilts reql1ln'd under the )l1l.l'lll\I'IlJlh nlJoV'.~ l'rdltlllll\ to SdWlIIlII~ "n" I1rt! (It,l.llch('f\. ,\Iso n1llke
cf~rtllln I.hl1t column #1 III the "~UJ1l!nlll'yll hilS tlccn prOlle1'ly cOl1lpl,~u~d:IS flhove-lltrec1.t~".
REV.4~1 (8"781
cOMMOI'lWEALTH OF PEHHSYLVAHIA
TRAHSFER IHHERITAl'lcE TAX
RESIDEHT DECEDENT
SCHEDULE "6"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule must disclose all tangible ami intllllgible personal properly owned individually by the
decedent, at the lime of his death. Property owned by the decedent jointly with another or others must be listed
under Schedule liE". Illtangihh~ personal property, titled in the name of the decl'd"IlI, hut payable at death to another
or others, including hut not limih:d In p.o.n. U.S. Savings Bouds and tenta ;ve II 1st a('counts, must be listed, despite
the fact that they arc 1I0t of the administered cstate.
Tangible perstlllnl property should he listed first (e.g. jewelry, '.'. \ ,1I111g apparel, household goods, :'Ind
furnishings, hooks, paintings, lIutomohiles, hoa ts, cle.)
Intangible persl'lllul properly, such as hOllds, treasury certificates, cash 011 hand and in bank, stocks,
mortgages, notes, together with uccruell interest or dividends, salaries or wages, insurance payable to the estate or
riduciary in said cupacity, partnership interests, interest ill all)' undistributed estate of or income from uny property
held in trust under the will or agreement of another, even though located outside of the State, at the time of death,
should be listed ill this schedule.
Item nml UNIT ESTIMATED DEPARTMENT
No. Li st and descri he fully VALUE MARKET VALUATION
VALUE (On not write in
lhis space)
1. 1966 Plymouth Coupe - sales price 150.00
2. 1976 Datsun truck - sales price 2,700.00
3. Savings account #504-862-4, The First
Bank and Trust CO., Mechanicsburg, Pa. 7,683.65
--,-
lnsert thi s total opposite "Personal Property", Schedule .tH" in XX 10,533.65 /OJ"S.3,&.r
the "As Reported" column on the last page or this return.
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SUMMARY
(S..:h. UN')
(Sdl. UU")
(Sell, UC")
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INrIERITA~~CE TAX SUMMARY SHEET
ReV.'B' ex' (3.'0) (BUREAU USE ONL Yl
------
File Number _____-._~j _:_.'i.Q.::.jl;L1 '-/-.
Estate Nome ____Mif.((t.;..--_L,_:--~tl2ff.!tQ.~J.-
Dole of Death ___..LLtf..::....Jl 0
Social Security Number ---,.------------.---
REPORT OF INHERITANCE TAX APPRAISER
I, tho undersigned duly appointed Inhoritance Tax Appraiser in and lor the County 01 _~er~a~d
Pennsylvania, do respectfully report thot I have appraised the real and personal proporty as reporte in t e oregoing
retum at the valoes set larth apposite each Item in the last column to the right in Schedules "A", "B", "C", and "E"
Dated:
'l..=J. .~- -.f ()
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INHERITANCE TAX APPRAISER
~---
ADJUSTMEHTS
(HARRISBURG USE ONLY)
IHVEHTORY
VALUE AS APPRAISED
CODE
Real Property (Schedule A)
Personal Property (Schedule B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
TOT AL GROSS ASSETS
I
00+
10+
o
~
____LC2./ f".9~
20+
30+
40-
less D.bts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
FACTOR
PRIHclPLE
Valuation of life estates or
annuities. . . . . . . . . I . . . .
RATE
.'i
FOR USE OF REGISTER OHL Y
CODE
6"
"
T ox on $
15%
T ox on $
Tax on $
Tax on $
Tax on S
Exemptions
Total E!>tatc
TOTAl. TAX
IHTEREST FROM
BALANCE
TO
Less Credits
DATe OF PAYMEHT
AMOUNT PAID
S
IHTeRESI FROM
BALAHce DUE
REMAINDER APPRAISEMEHT CODE
92+
93-
VALUE CODE
-
\ :
COMPUTATION OF TAX
$
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TAX CREDIT
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
COUNIY FILE NO: c..~) I - K' ().. () ') y-
TO:m ,)'01 .J::n:l rV1Jl &1-----'
Lie lli"rv,-~C;B \ 'X\l~-I'Lj
I V3 j ,~~~~0~ ~\J
C..(V~,_L/l(O- I V) 0 I ~
Appraised Valua of Estate:
Real Estate
DATE
C'f) ,,",) / '7 I (/ ;;-rJ
ESTATE L\ ~ iQ~! ),n_ ?i' "trrY1Ji..;j-t--J-
FILE NO, "'.;( / -- s:... 0 -,~ 17 It...
I" 1\ Ii I
COUNIY '__JJrv-<. \!~O" v,-I\"I~
.......
DATE OF DEA TH l~1,?~' 11/ I 9YV
\\ '
(-,~
"-J,~
Less: Approved Charitable Exemptions
s ---
+ /0 5 ,').~ I r.::
... . ...-;:) .~.
-
+
S ) 0 ;:;- .. ;;. &5
::> ,,;;J _l 1
? 3 J.3 )i:,.
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3 ~.:l.O ',., 1
s ' '-.-)
._-~
s 3 ,,:(.;l,() ~C'
'::;''1
Personal Property
Jointly Held PropertylTransfers
Total Gross EstBte
Total Approved Deductions
Clear Value of Estate
Clear Value of EstHte Subject to Tal(
,.
,.:s9
I
tBX due
s
/93 .)J,
Amount Taxable @ 6% Rate
s 3 ,;)/:; ('i
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE S
J?3.~1::'"
* * .. . * * A five percent discount totaling 6;
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
!tJ_"),L/--'ln S Icr3 .J.,\
+ S
S
=
S J V'.;>' ;J,,;)
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
", ~
$ \ 1<'~\::)v 1-;< l ~
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
See Information on Reverse Side
';,'lli,':'li.;;lii \.
- _.__ _'__.._ _.__' .___n' ___ ___ --.-...-..".-'--'-' '-.--
INFORMATION
To insuro proper credit to your account, tho name of the estate and file number should be clearly print-
ed on the check or money order,
This nssessmenl is made in accordance with Section 708 of the Inheritanco and Estate Tax Act of
1961 (72 P,S, ~ 2485,708),
To the extent thai inheritance tax is paid within three (3) months after the death 01 the decedent, a
discount of five (5) porcenl is allowed (72 P,S, ~ 2485.716),
Inheritance Tax. other than tax on a futul'o interest, is due at the date of the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P.S. 9 2485.711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S, 9 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
----------------------------------------------- - - ---- --- ---------- -- --'- -- --
1 month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
1 days ,00017 11 days ,00186 21 days ,00352
2 days ,00034 12 days ,00203 22 days ,00369
3 days ,00051 13 days ,00220 23 deys ,00386
4 days ,00068 14 days ,00237 24 days ,00403
5 days ,00085 15 days ,00250 25 days ,00420
6 days .00101 1/; days ,00267 26 deys ,00437
7 days .00118 17 days ,00264 27 days ,00454
8 days .00135 18 days ,00301 28 days ,00471
9 days ,00152 19 days ,00318 29 days ,00488
10 days .00169 20 days ,00335 30 days ,00500
- - - -- ------ ---------- --- - --- ----- --- - ---- -- - ---.--- -- -- - --------- --- --~
Any party in interest. including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty {GOl days after receipt of this Notice as provided by Section
1001 of the Inheritence and Estete Tax Act of 1961 (72 P,S, 9 2485.1001\,
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: