HomeMy WebLinkAbout80-00284
I
~
~
>-
~
CI1
~ .
~ ><
~
p..
H ~
l:I: !
CI1 ,
'?i ,
'0 ~
8 \\;,
~ Z ~
~ ,
~
8 I
.
~
~ 0
''l1I ' ~ ~
.
a) I")
N'
.,
O' .-
00 0
I
-
M ~ ~
. " .-l
0'"
z .li
N 21 80 ~...Li;
0, - . ".".".
PETITION FOR PROBATE OF WILL AND LETTERS TES'rAMENTARY
in the Estate of
~'.iHrY 1-:. rrate.::
,
, deceased.
Harold 13. !<lcLane, Deputy
To niGl,ll.1 d C. P,I',e1~r381"1, Regjster of Wills for the County of Cumberland,
in the Commonwealth ot Pennsylvania,
IS
Petitioner~) ~~ the executdx ____ named jn the Last Will and
Testament of Nary E:. Tate dated Doc. 30, 195[3.
Decedent was a citizen of the United States and a resident of
Township
Lower Allen Bl?TCl;fghr- Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on Thul'!:c1ay
A. D. 19~, in the County of
the 17th
Dauphin
Pennsylvania
74 years.
at the age of
mosr.x x.ha5KX he r
Decedent has not been marrjed and has not had children born to )bimx
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
:~So.ooo.oo and of real estate to the value of
N9i1e
as near as can be ascertained; said real
estate situated os follows
None
JOO.P.~
Therefore, your petitioner(s:) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Doted April 25 , 1980
f-- ~.
Nome and address r _____$4,~ ",-d -/ ~-'
of Petitioner(s) Frances I, Tate
60~ Whitefield Drive
l1ochanicsburg, I'onne,. 17055
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
Frances I. 'Tate
named in above opplication, being duly ___~n-!O"l1 according to law
say(s) that the statements set forth in this petition ore true to the
;:,.:orn
knowledge and beljt).:._/
~--
and subscribed before / 4",-/d: (..<>
i )-----.
< ~c il/?d-,
best of her
me, _
April 25
19 80
I :)~l
liil-atA. I:.? ,~lJ~. ,.Deputy
Ri(,1"!lId C. ~~gi,j~~gister
Filed; April 29. 1980
.::JI-I-c' -:2cf1- /1- 'It.. 'I
Attorney: .J.
i\o\)~~rt
(' ....-----;r
-> tc.\lf lor r;- !.> i;
L-'
, .
..
'.
LAST WILL AND TESTAHENT OF MARY E. TATE
I, MaI7 E. Tate, of the Borough of Mechanicsburg, County of
cumberland and State of Pennsylvania, being of sound and disposing
mind, memoI7 and understanding, do make, publish and declare this
my Last Will and Testament.
1.
I direct my Executrix hereinafter named, to pay all my just
debts and funeral expenses as soon after my decease as the same
can be conveniently done.
2.
All the rest, residue and remainder of my estate, real,
personal and mixed, of whatsoever kind and wheresoever situate, I
give, devise and bequeath unto my sister, Frances I. Tate.
3.
In the event that my said sister should predecease me, or
should she die at about the same time as I do, such as in an ac-
cident common to both of us, under circumstances such as to cause
doubt as to which of us survived the other, then in such event, I
give, devise and bequeath all of my said property, real, personal
and mixed, of whatsoever kind and wheresoever situate, to my friend,
Marie E. Grill, of 307 West Lancaster Avenue, Shillington, Pennsyl-
vania, in trust, nevertheless, for the following purposes:
To hold, manage, invest and reinvest the same and to apply the
net income derived therefrom, together with so much of the principal
as it may be deemed necessary to use by my said trustee, for the
comfortable support and maintenance of my Mother, Rena B. Tate
for and during the tenn of her natural life.
.
~ ~ ~~
~!ta~
~
~.,., ~ ~
~ ~ u)"'Bl~
~ l>. .c
Eo< "'o-illl
@ . M e ~ u
..: ~ r.a @$ .~]
~ ilJ .,.,.,.,
_< as u
~ ~ ... \2;'"
. :c
~
.. .
r ' , ..
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA}
SS:
COUNTY OF CUMBERLAND
Before me, the Register 1'01' the Probate of Wills and I-(I'anting of' LeUers of' Administration in and for
the County of Cumberland, personally came .J'):,~.r);:,0,:\..J..,..::',~,t..,r!,.........,..".."..,.,..."...,...."........,.................
who, being duly .aHo.rm................, do .e,{\..... depose and say that as .......!:;:,':l.(l\l.~.!:J.~....................................
of the last Will and 'restament of ..:;;~,~..X...1:~.....:;...?..~,0................."......,..................".............."..............deceased
...........!l.\;1.!'!....... 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. .;]1'l.9.r.D.............". and subscribed
before me,
April 25 ~O
........................................................ A. D" 19....<.......
.--i----- .
~ , /7 1 /
~~..~.~--=/4.,.::;a/i;.,...,.......
...tk.a&f.l~..!.3",1.??c/!:.:~!"" ';7~~~'~~X.,..,
R~"t......d E. .A&ndnlIJOn, Register 02'.L--&0/t'-:-.";:I~<-/
..................................................................................
:'t! 0
: <ll OJ
:w
:OJ O'l
. <ll ~~
:"
:<ll
,P
u.. N:
0 (0:
=iH
o;j': .>:
...J 0 "':
OJ: 0 N~
~~,f ...J i:Q
., N:
i.JJ ,: ~
~ .....:
0: - .~ u
N 00: ~ i ~J : ::: ['. '.1 :
\: [C..: [>.l ~:
.-I: ,,:1': ,5 0.:
Q N: r-;: 'tl ..:,
<ll N
00 0 " 'tl <!J
I Z r,ll: ... 01
- 0 :H:
N ~!: "
.B <ll
.'3 ;.l-~ : ... <ll 'tl
.,; 'tl bll <ll
W ~.~ . ~ OJ ~
Z ril . -~~ : '" 0- i:i:
DECREE
Be it remembered that on the .........~:.~.::...... day of ....."...........0.~.:,~.~..................., A. D., 19 ..e.R.., there
was probated and recorded the last Will and Testament of .;;/,r.;;,J.,...;:.~.t!':...............................................,
I te I' TO\lor Allen '"ol.rroohir. C b I dC t PI' D d Le
a 0 .........:.....;................:...:.......;::..... ........................, um er an oun y, ennsy vama, ecease. tters
Testal'tlenterv ;:'rsncos :~. 'l'8.tc ..
........................,....:.............. ..... ....., were granted to ......,.,.,..., .......' '.......,............. ..... ....,. .... ........ ,.......,...............
Witness my hand and official seal the day and year aforesaid.
'1
/.' >> /.
....,...A. .:?,:::.'C:!f....Q... 4' /d.!"<;,,.!?~I?':l:~y
R:_I..~.~. '. 9 "7'-.~ ister.,
;.' ~/ ,._~
-7.'." ,'/'
INSTI1UCTIONS
To insure nrOptll cr{~dl\ to yom iJ!:COIJllI. tllP r1,HIW of Illt, ('~)Ii1\l) ;11\d lill! fllIlTl\)l'r ..huuld IHl d1'iHIV !HUII
;.!d on the clwck or money ordnr
Thi~ a;;seS~';ll11~nt I!; llliHle HI ilr..:cord;llll:e Will, ~'~,:lluil lOU III till! II\h('ltt,JIlu.~ ,trlll [':oldl!! lax Act of
1961 02 r.s. ~ 2485 lOB}
T:l tile l~'(tr>nt thai mtwrilLlIlr,i! 'ijl( I:, Ililid W;[tllI1 Itl'\~(! i1) 111(Hl]h'; .dl('f ll\l~ dl'i1111 uf the dH:cdcnt, a
discount of flvu (5) percellt IS iJlluwed (7~ P,$, J 24Hb. -/10).
InlwrltilllClJ Tnx, other lhun tilx on ;1 futuro.! illtt~n:~l. I~, due 01 IIHl rJ;lftl of tIlt: decelh!nt'~; de;nh ,md becorrw5
delinquent at tho ('xpiralion of nine (9) montll!; uHl';! tlw r,lncedlm!'s (J(!Illtl (/'1 P S ~ 'JABIj.llll. ir111fHltiH1CP.
Tax on a future intc;H!5! is pilY<lble within tluCH! (3) !1HJnth5 ;Ifter tht~ Hilllsftn lak(!s elh~cf Ifl possC!5sion flnd
enjoyment ami I!.I (Jelinquent thereaher (72 PS (, 2480. 712~. Ca!clJl;lIp. iIlWri)'.;t 1101l) tilL' delillqlH:nt dato shown
on the luce of thiS form to tile diJte oj actual pilynwfll u~;jnn the fullowill\.J inlt!ff'~1 ldu!e
.".-- -.---.-------------
------_._- - _. - - -- -.--- - - - -- ~.- _.- -_. - - - - _.~ -_._.~ - ---.- -- ~_.
.050
.055
.060
lOmontlls
11 months
12 rnonth~
035
0.10
045
1 month .005 4 months 020 7 montl1~
2 months .010 ~ months .025 B Illnn\h,;
3 months 015 6 rnoHltll!> 030 9 munl~)S
------~-_._---_._.__.--
1 dnys .00017 11 dd)l:.> aU):,!)
2 days .00034 1 ;~ (j llY S OO:!03
3 days .00051 13 days .0022U
4 days .00066 14 dilYS . m,2J7
5 day's .0001l5 1!j ddYs UU:)~10
6 days .00101 18 days UO:!67
7 days .00118 17 JJys 002B4
8 days .00135 18 eJ;ws 00301
9 days .00152 1!)llay,;; OOJl !}
10 days .00169 20dai's 00335
.00352.
.00369
.00366
.00403
.00420
.00437
.00454
.00471
.00488
.00500
21 days
22 d::J'{~
23 days
24 d<lYs
25 days
26 days
2.7 days
28 (jay!;
29 ddYS
30 (jays
.-. -< -. - - .-. - - ----- _.~- --.- -~.
-- - -- - --.--- .--. - -- ----- _.- -- _. - - - - - ---.. _.~ -. - -< - ~ - -- .--
Any pJrty in interest. Including tile Cornnlonwealtll {lnd tlw pt;rson,d If~ple!';flnt"tlve, not ~utlslied with
the i)5SCS5nwnl may ohJi:!CI tlH:rcto \\IlUlin r,1;(ty (GO) .:liJY~ ;dll!r reu'lpt of this Nutlt:c as provided by Section
1001 of tllo Inl1eritance Jnd t:5I1Jtc la,- At:\ 01 1!)61 (72 P S.:, 2435.lO0l/.
M.lktl dll!ck (II !nOIILV O"d'_'l PiIYill,lt!!1l
"Re\ll:;fcr o! WiI I !.i, fl..(~()nt"
Milll to 1111: ud.j".:~;:.. l;~;!ed t!l;i\;\,J
..
~,? I 0 G'-:) '.') ~ 'I
COMMONWEALTH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
~*
"
REV-449 (8.78)
RESIDE~IT DECEDENT
COUNTY OF, "I" "," I," ',no,'
._.__;f..'.l.......c._...u ....<. ":'
IMPORT ANT,
Thi~ return 11l11Nl be l'uml'le!t~d ill Ill'tllil nut! file'tllll tlllplil.'OlIt', .....ilh :llllllllLt'h(~d, wllh lIlt' Itc'Ki'll" (If Wllb of the
County where lIct:cdcnlll.~,itlt'd; Rl'llll'lI l~ d!JL' Wllhlllllllll' rllllllll1., ;I!tl'l d.lll' of Ih'ul!l, 1l1l1l~SS IlIlll\ll'lIsiflll is grlllllCll
hr the Su'n'lury \,1 Ih'''rlHl~'. tS('l"u"n 701 ul 111.' 1111wIJtUII\'.~ alld 1'~!;Ilc' TllX AI"' III Iflhl ,l
--------.
.....-- ,,_...... - -'
..-....-...-....-. ---
Lotti of
r.1Jr'~h(,1'1,1~d
,".J
EXI':CC rill{
IN TilE MA'l'Tlm 0'; '1'111': LSTATE lJI.
,,\1"1,11)/\\'1'1' II!'
_..--11al"I~,T r,~ ...._TtLtL-____...__...__ __.___
(STATE FUI.L NAMf. OF I1FCtmE~ln
AIlMI'IISrll.\TIlll
"~Y ".,oJ "0\1' '1 }
Stote of __._:..;..../lJl....~\u:>.-!-'l~~__.___,________u
...
C f C,"''''nC."\,1' rlr'fj ,
ounty 0 J ,.."" ~ ,..,-..J,
Fra~'1cor.' . "Pate
Administrllttlr .-----~-;;;:~-;~I-~.-:f;I~~~b:~.namlld -d;;~d~-;-;l'~~-~"d~i;.' ,worn, d~posn
Executor
ami say
DeCl~dellt died -Lurr' i1 1 7 t
(MONTlil
Nomll and oddr". I of otlormlY or }
other outhotlud repruenlotlv" fa whom
011 corrupondence should b(l moiled.
(DAyl
rJ)
III (;1
','f FARI
fellUIl:' leaving a I'HI will. (copy 01 which i. heroin allQchnd. }
lolnll.:.t..,
':". ;':ob(;~" L :.J :-,r=~.~~1.'(;rl':'.:::l~r:':C t_._~-=C'~~:':E~E~.~~10.:L-,-~~___
".. C"'[1""\ ("'~-'l)""-" ~'J-...t~1""o. ] '7,Cr~,;[:~
1.'- ~,.,,\,-- .._,.,.:2......;_..L_~.:..--"__:..L~....,:...
That as such-.0.xnc1l.trix_____dcpollcnt is familiar wIth the affllirs of suid e:.latc antllhe property constituting
(EXECUTe) 1~-AQMINISTr\A Ton\
thc liS sets thereof and their fair market valuL',
That ill the time of death there was 110 s,lfe depusit bo\ rt.:gi:.lcrcd ill uc..:cJL'l1l'S individualnamc, or joinlly with, or
as agent or de,;puty or another, or in decedcnt's individualn:lmc, Wilh righl of access hy anothcr as .q;cl\t or deputy, with the
exception (Jr the fnllowing: -
NAME AND AD'~RE':55 o~ ~ANK OR OTH~R INSTITUTION -:-:.-=+;- -~-- ;H-IS S'A~E ;)~~-:;~. llO~-'~ENT-~-~ -
IN WHICH DECEDENT RENTED A 5AFE DEPQSIT BOX IN NAME OR NA..~[5 OF
==-= - ~ -~=- . -----==-- - =-
Thp. Piflst Bnnk and 'l'r1;s I:;C01";lrnr..:)- 01 . :<~n'" '.,~. rrr:te .or l'"f'i.1nccs
..r . " "1''''''' T",., I - 11' "j" 0
j'.wr.nanl.CS1) ", r'. ro.. I~-L_.\.~ ,I::: ,
;~~~~o~~~o~~:,.,::ic ?~~o l'70~1; +- ---=~":---""--~_~t_O"
-
REI.ATIONSHIP OF JOINT
HOLDERS TO DECEDENT
:3isccr
That the contents of suid safe deposit box or hoxes arc itcmized under Scjwdules_~()f this return,
with the exception of the following, for the reasons hereinafter !lcl forth:
That ScI,edule A attal:hed hcreto and made part IH~rcof scts forth fully anti in detail all the rea1llropcrty
in the Commonwealth of Pennsylvania or which decedl:llt died havillg an interest therein. It also sets forth the
mortgage cncumurances upon each parcel of real propeny al the date ell Jeath, giving IIH~ ilmollllt still due al
ul:ath, name of mortgagee, dale, rate uf interest, and book anu page of record thercof. It also sets forth in the
COlllllll1S proviued thcrerore the assessed valuation of each (If s:Jid parcels, the eSlimated market value thereof
as of date of death of decedcnt.
That ScheJu/~ B attached hereto and madc purl hereof sets !'Nth fully and in derail all pcrsonal property
whcresover situated owned by the decedent at the lime of death; ;1 iI moncys left by the decedent at the time of
death, whcther in dccedt,:nt's immediate pI)SScs~,;jon, standing 10 {h~CClknl's t.:rcdil in hanks of deposit, savings
banks, trust companies, or olher instill:.tion!'o, whL'lher illdiYiJually, or in trust fOI .In.i' othcr per!>oH or persons
giving also scparately the accrued interest lhereun, if any, dOW!l LO lhe las: intcrL'sl dllY rrior to decedent's
dl~ath in the l.;IlSC of ~il\'ings banks, (Ind :0 the datJ: of dl'cedt:nl's dCllth in all ntlu'r case:;; all bonds, postal
&3viugs, treasury cl:rtificatcs or noles an--1 otht'r t'Vilknl'c d i!l(:I~h:~',dJll"'';s (If :he iJnilL'd Slales tll the de.
L:edelll: all obligations, whether by statute {If agJ"l.:i::'li'jjt lill'~' arc dl'si~~!l;I!l'd as la.\ fri:c, (If the United SL.ltcs,
or any sLltc, or political subdivision therenf, or of any foreign country, whkh are uwncd at the time of del:rh;
all wearing apparel, jewelry, silverware, pictures, hooks, wurk... (If art, household furniture, horses, L'illTiages,
automobiles, bflUtS, and any and all other persllllal ('h:llleh or whahl,n.Vt'f kind or Il.tturc, left by dc{~edeI11,
together \\-'ith thc fairly estimated marhl value: Ihl'H~of; illl honds awl mortgages hcld hy decedclIl and of all
c1llims due <tllll ,1I....ing decedent al the lime of lh::lth. :lnd 311 pf'flnw:~nry .Wlt.... nr nlb/'r in~trllmt'nts in .....ritlng
for the payment of mO!1ey of which dt.:n~dcnt died possessed. Ill" whatsoevcr nature, with inlCrc"it lht.:rcun, if
anYI gi\'ing the face value llnd estimated fair markct value thereof, and if such c"itimated fair market value be
less than the face valuc, it sets forth hricfly the reasons for snch deprcciation ;IS In cach item; all money.,
payable to 1he estate from life insurance pnlides carried by decedent; all i.\nnuity and cndowml~nt ('.onlracts
the proceeds of which were payable upon the death of the dccC"t~nl; :.111 null the corpurate slucks and dividends
due thereon and unpaid 8S or the dute or death, hMlu:.aml accflH~u interest lhcrcon to the dale of decedent's
death and other invcslmcnt securiti~s owned hy the dt:(l'dcnt al 1hc timl~ of death, Wilh Ihe rn:lI'kl~t value lhere.
of at snch lime.
'.
In t1lP ('IHW or SO('HI'llt!!:; of' l'IH'il' or r/',MI11\
1108RthlH ~HlJ!lllll\ltlltl'cl hy I'lnhllelnl ~\.II!q"t'III.', (II' I:"
lht>r(!() f' lif, nf' till! 1111 HI (),' ,1t!1I th, Tlll~ Hdll'dlll t> III'lIl ';" I
ltenth 111 nn~' ('o.pHI'llll'rshlp 01' 111I'lllll'!1!), Hllll III ~llppl'rl ,)1 II'"
subl ~1'llt'(llll", I'llllllwlfll stlltl!nl\'llt~, ...hl'w I Ill', Ill"/";',"'"
A e\1I1~' nl' t.Ilt' 1~II_phl'tl\t'rslltJl Iq~t'l'l'rnl'lll., (If' 'lrill, I.
Illp,l'lhl'r with II stuLI'lllPII! sl~lllllj!, rOI.tll 1,lll' ci'lo! ",-t,
pl'rtHlnlll/!, to till' hllslnf's!-> liS !11UY Ill' p.'rlIIWIII 1(1
tilt'l'l!l" IIllls1 hl'Sllbrnlttl'd. It sholllll nlso ~il'( '11'I!; I" 1:"11' ,,'Ii
lhpr,!(d\ nllY ul.l11~r prop\~rty 0....111'11 or iillLl\ll'1I1,i"I)
,'1'
tl"I'
'.1', .''';uc't. r"IH)I'I~'d Ilft' '.l~ fur 115
.1.11..... lilt' ~ hI' U'; 0.;1' !.; /Lilli I J /Ill t II t.t IJS
iJlIIll,;,t ,If' 4h'C1,>lll'lIt f.'.1 I Ill' tiloll' ell'
fll ".l,d. llll,col'!';;!. \,lIl~l'j> I~, 1I1l1'I'),l'll 10
,'\11 !.,'
1'''1''1'
':.,'
\ 1111'
, 'd' , 1 ,
!;: .'
.- , '"
"1 ; "
I t' ~
1,,,-.
1I !' 'I /'. 1 ,I '11--\'" I' 11\1'\' 'I III P Il r III ~~; I" f'!;'"
f'" "1 II 'II" II 't jilT" ,. dl' ! Ii., 'I f! I'''f'lnl~ III 1
!Il"-
,'" It:; Illl"'L !.I 011, Hill! ~;lIi~1l lien'!' !'h'.'t.<;
";'I,r'II~;',1 or 1.11.. fl"';I'dl'lllls l11tl!I'PSt
"01':1..
1,t'!"" I hl'l'
wl;,1I I,hl' 1'1111' tlJllrl,ld \'hllll!
d"alil.
'ii'
-,'1
: 1\1" :\'11" ,,1'
Thl! Scl't"dulf' C 111.l,lIdll',1 Il"rl'lo nod mlld'- l"ll'l hl.,.,'"l '-.1'1-.; rol'lll Il I rlll! 11IISWI~r III lWl'h Inquiry
cont.nln..d I.h..rcln nndlnU", "",,,,.;I',,',,n,j',,,,,,,,,,.,,,,," ,.,,: .p'; """",,,,",,,,," t.,o y""" or d,.c..,lenl',
den II" ;n "ont.,'mplutlllo ol' d"""d"II'" "..,,,h. ,,"~ ,,,,,.,,.:.,. I" "1'1,,,1 I" ""..';'''SlOIl 0" "'<.IOY''''"'- "t 0"
.rt.er ,leuth, ,ul,1 schedllle s'H" J'""lh Ihe ""'""" "od ,1""..1 ,.",'n """I''',ly. 10 '.'hom t.,,'"" I',,, ""d, the
rdal.loll5hlp of the t.rnnsferees t.o U", ,Ie"t'd,'o'. th" 1"'"1'''''':''''''''' ,.,,,,,'e ",'c"'"'''' hy e"eh tr"",f".r",, nlld
,tll othe" r"cls of" pertl"""t nnl.llr" ,.,,"'.....IIII! ,..r" "'"'''''''''' III '.r", ,,'"'' of t.r<llIs!'..r>; \1It.elld,,,1 t.o
take e!'!'eet III p""e5slol1 or "".\O),"',nt ,,' ",. ,d't,',' """"., '" "Is" "wlI",,',1 1.0 tl... ,ch"olni" " ""Ill'
or the deed, trust up;reemenl. or ol.h,," I",..' ...""..lIl "'",,'',''' "'" 1,.,,<1. Th"r', Is "r," ",I. forth In s:\ld
sehedlll.. " Ilsl or nil pr"p''''I.Y, r..,,1 ,,,,,' 1"'1",,""1. "I'" ;'" ""''''. ','h:d, 1"1"'" "I. Ih,,,,,,relll." ,I.."t.h Ill'
vlrt.lle of U", exerr"e hy deced,,"t., "11.h,,r 'n"\\'ld",,'l,. ",' i..,,,'I, .W, "n,"'''''', "r "n,. "nwer nf' tipp"Jnt-
ment vf!st",jlnr\eeeM'nl, either In,llvld",dly ,n' .Ior..."..,. \1'" ..,I'. ,\,....'...r 0""'" Instrn",ent. "I' "noth"r,
with n copy of' the lngt.rllrnent (~I'elltln~ suell pO......l. HIUd"i!I'd 1'1 U\{' ~,dl1~dllh'.
Tllllt SC",'.Iull' 0 "t.t"ch,.d herelo nn,1 m"d.' r"n" 'N""I' ,"",.' I'orlll 1.1,,' I"""''' "n" "old rosse, 01' "IJ
I,ersOl" bOllef'lclaJll lllter."t.ed j" till' est"'" ", 1.1", ",,;' ,d' ""C'.'"I''' 1 , " .1.,,,1.11, t.h. lI"t\ll''' 01' U,olr I'OS-
peet.lve IIIt.erests, the I,. rolaUonslIll', 'I' "ny, t.o UI" .1"",..1"" I, ,..","Ih,'r wll.lI th" "ges nt. the time or
deeedent.'S dellth of' "II "Inors, nnnllltnlll.' "1,,1 1"'II,'rt ,. I"' I 1'" 1'01' rll'e ,nn'"r deeed'!nt'. W'll, It. "Iso
cont.lllns Il st..l.emeot show'ng which of the \,N'd.'el....j'" ,,,,,"e,. 10 "", d,'e,,,lell\." wIll, Lt' 'II\Y, died prior
to decedent., the dllte' of' Ihelr dOIlLh, "lnlr '''I''', "'"'",,' ,'>>!nl.lollshlp ot' sll('h ,,,III, t.o t.he heneJ'lelllry.
Thllt Sel,,,dule r "tt"ehed hereto 0",1 m"d" " 1''''' \,..,.,.,,1' s"I.' I'orth ,,11 property, renl "nd per-
sonnl, owned by I.he decedent. jolot.1y with "no\.hol' or n""'rs. Jnell1,\J"~ tet.nnglhle, st.llI,dIng III t.he nllme
or t.he decedelll nnr! ot.hers, pIllS I.l'" r!"I." "nr! pllu,o "r ".,."",! 01' '''S1rn~"nt.s "f'fee!lnl; t.lle ,est.lture of'
renl est."le nnd t.he dnle o!' "C'lulsl'!o" of' I'"rson 0]1.,., p'ns the '''''''', nd"r.." nn" r..lut.lon,hlp, If' any,
of co-owners to the decedent.
Thut Sc"edule F nt.t.llchc" he"e!.o IInd m"de II p"r!. h"...'" r sel' ..."., I> 1'lIny IInd In ,Ietoll "ll debls
nlld deduct.lons chimed I'or IIl1d nn b"h"lf' 01' lids d,.""..r..I\I.', ,,,',nt.., In<:l..rllng "11\1"'111 "xpensps paid;
f,mllyexempt.lon, where "l'l'lIcllble; eo't., o!' ,,,Imln's!.r"' ",;! 01' !.hl' ,>,'1"1.": ""un,e1 fee' nnd ",dlcl<rry's
commIssions pllld or t.o be 1"'1<1; eo,t. expen,I"" I'or In'.-I,,] t,us'.s, !.'I\"r.slo"es or ~rll\'em"rk"r', nl\" r"ll-
glouS servIces, III eons"'luenee 01' U", ,"',,'h 01' 1.1", ",,,,,'''''01.: .I,''''' "n,1 ",,,I..,, nwln~ IIn,1 nnl'"ld "t. Lime or
dellth; Wxes lIeert",,1 cln"gellhle 1'0" 1",,'10.1 prl',I' In """,.,;,'n.' " ,;""I.h ("""'1': I.ho'" ,,] Ln"ed \\nder S,'dlon
65101' t.he InherltlUlee ,,\\d Est."le Tnx Aeli; to,;"'"'''' willi" ,;I,,'..m"1\1. oJ.' ,'nll"""ru' I']""r,e" I'or I\hllgu-
lions, II' aoy. It Is ug"eed t.but. t.h.. f1,I>I<:Iary wil\ 1".",....nII"""". "I' ,,,',' ('\,,'m,'d ehll,\nt.luns \\p"n ,e-
quest, lhort. If' t.h.. "mollllt. acllllllly 1'''1'' In ,dt.l,,",,'"1 01' "I\Y I',.". enmm\J;slol\ I\r d"hl Is I..ss t.I,un Ihe
est.lmllted IImo\\nt. e'"lmlng 'Ill" 1111 owed, Ih"l. Un, "",.. wIll ".. r"l'ol'l..d t" II", 1I..p;1st.." o!' lIlll', luul th"t.
the llmount of' tnx IlSSCSSCft CUll h~~ r('IISSI!Ssptl 1n /le('Uf'dll\'\'I~ thl'l';>witl1,
Thnt t.he lotlllS of' Ih.. IIpproprlllto coil"''''' I" S,'h,',hd,'s 'A', 'no, "1'". '1':', 1111.1 'I'" us ,llrect.ed thereIn,
huve heen el~rr1erl forwllrrl a.nn properly I'cf!,lsi.\'ri'ct III till' Sllmlilnry.
Subscribed and sworn to before me this
". (/
f//
.dllyof.
".-.',,>.
-:.":':._..,
no
19..
;r--~'
v_-f-'
..:.-/1,(;r~:,~~~:<~:: ~j..-;-
(EroCtLtor-ildmin;.trator )
~, ' ~~ c r -1 [;:.l.<L)!rJ.V..~?...
(Street Number)
'I~
....<:',0':::............
.."..'...M....'.'....,.,..
"...........".........
i l",.
...::..~(.<..,c,~:... r, ~~o
-->' ,
/_-::._. . .( l ~
. .... ."...~. .. I'M ' -~..-- "
()03
...,.....~".."..,,~.
..,,:,' ,
"'."
1I ", ~ ',' "
::':c,
,d,
,
:.:c::..: ;;. C.1:.1. c, D.~>.\l,;.'.;".,.,
(City 01' Town
.. J.'.,';';,t., .1IQSS..
and State)
f,'fl'I;;.'
l~ : i:
:/v, \1'-,,,:,-
r,1~, <.r'; .. , .
son;: [l"rnr" "p;"ln~ 1If'l'Id"vll "wk" "".,. nil I""'" ''1,,,,.,,, :.. "", nr,'I>Idvll "".I '''''''>1,,11'' "11111.,,,,1 ,rr"
!'I 110,1 III with dl'tnlls or U.., .0...1 '~n'"". ""d ,,, ,.",,' I'''' ,,""'1" 'm.]",I,. ",,'e "",I "nllslod ,,,,,,,rll.les,
s"cllrlt.l..s "r 1'10'" or I'"mlly 1''''r'''''''I.I""s or "" Inl.'rl'sl I" """ ,'o"I""'I".,,,,"I!, or 1111,111"'" th"t Ihe
,lilt." ",,,I st.,,'...mellt, ""'IIIlr"" III1II..r 'r,,' rn''','.I',,!>I, dr.",.,. ",'Id""" I" S...".,IIII,' "II" ,rr" "UH"'''',l. ,II,,, Imlke
cerl.lttn thllt column #1 In the "SIlIl.IlI~ry" 111l:-' l,,'Pll lq'(>\I<'rl~' j'();!Ipll.,.'t\ llS '\"o\'('_,ltrl'ch~41.
. ,
".N'I"']!I "
COMMOIlWtALTtf O~"BMlISYLV"M1'"
DEPARTMENT OF ReVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIOEHl. DEt:I!DENT
SCHEDULE "A"
REAL PROPERTY
.
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent os tenant in common with another or other, should be identified
oS to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The rial property located In the Commonwealth of Pennlylvonla should b. (1) (2) C3\
delcrlb.d by lot and block numb.r, .tre,t and .tr..' numb.r, together with DEPARTMENT
o g,noral dncrlptlon of the property, with Q ref.rence to the record of tho ASSESSED VALUE VALUA TION
conveyance by which the decedent look title. If a farm .tat. number of a. FOR YEAR OF ESTIMA TED CAUTION
crll; 0110 I'otemont of mortoage encumbrance. upon each pare. I at death DECEDENT'S MARKET VALUE (Do not writ.
of deced,n'. To.... o.....m.n'., accrued Int.r..' on mortgag.., .tC.,or. DEATN 11\ ,hi. .poc.)
to b. lilted on Sch.dul."F" and must not b. deducted from this schodule.
None 1~ one
Inserl this lotol opposite "real property", Schedule" A" in the X X X X X
"As Reported" column on the lost page of this return.
none
N 6-n.V
.49f(
REV-4!)2 (8.781
COMMONWEALTH OF PENNSYLVANIA
TIlANSFER INHERITANCE TAX
SCHEDULE "C"
TRAI\ISFERS
-~-
1I~
Rl:SIOENT OECEDENT
(1) Old decedont, within two yenrs of doath, make nny trnnsll1r of nny materilll part of his 05tnto, without receiving a valuoblo end
lldu\lUtlto consideration tho rei or? (Answor yes or no) :; (l
(Z) Did deeedent, wllhln two years of deeth. Imnsfer property from him,elf to himself end onoll,er or olhers (Including a ,pcuse)
I in joint ownership? (answer yos or no) ~...::L--
13) If Ihc answe, to (1) or 121 above Is In Iha offlrmotive stale:
(0) Aoe of decadent lit timll of transfllr - ----
Ibl Statll of dccedont's hoallh at lil11l1 of moklno tho Iransler, INote 1). ;0. ,(!
(cl Causa of decodenl's death. (Nnle 1),
(4) Did decodent, in his lifetime, make any Ir.n,fer of property without receivino a velu.ble or adequalo conslderallon tharafor
which was to take effect in posses5iion or enjoyment at or after his death? (Answor yes or no) i\O
(01 Waslhora any possibility Ihallhe proparty Iran,ferrod miohl relurn 10 Iransfaror or his a!lalo or be sub]act to hi.
power of disposition? (Answer yes or no) r ()
(bl What was Iho transforoa's ooa allimo of docedonl's cleoth? "I ! \
(61 Did decodent in his lifetime make any transfer without receiving a valuable and adequate COmiidor~tion therefor under which
transferor oxpressly or impliedly reserves for his life or any period which does not in fact end before his death: .
(01 Tho po"...;on or enjoyment of or Ihe right to income from the property transferred? (Answ.r ye. or no) 1:0
(b) The right to desionate the person. who shall po..e" or enjoy the property transferred or incoma therefrom?
IAnswer yes or nol ;':0
(6) 11 ihe answer to (5) (b) above is in tho efflrmative, SIale whether the right was reserved in decedent alone or oth."
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the
benefit of core of transferor? (Anewer yes or no) ]: 0
18) Did decedent, at any time, transfer property. the beneficial enjoyment of which was subject to change, becou.e of a ra..rved
power to alter, amend, or revoke, or which could revert to decedent under terms oJ transfer or by operation of law?
(Answer ye. or no) II 0
(9) If the anSWllr to (8) abovo is in the affirmative, was the power to alter, amend.pr ,evoke Ihe interest of the beneficiary re.erved
in the decedent alone or the decedent and 0lhers7 IAnswer yes or nol [1/ A
NOTE 1: The answers to the.e questions should be supported by affidavit by the attendino physician as well as a eopy of the death
certificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of tlte property transferred, it's fai, merket
valua at date 01 death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit
copy of any tru~t deed or instrument, if transfers are claimed to he non-taxable, also submit detailed statement of facts on which
said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A. 8, or E.
MARKET VALUE
(Estimated)
ITEM
DESCRIPTION
DEPT. VALUATION
(Dept. Only)
( 2)
Checkin~ ACCOu11t l~o. 181-328-6 wit~ The
Fi.rst ~3an1;;: ana l"l.'rust GOrlp2.n7~~ of Hechani "s-
bur&, Pa~~, opened 11!E/7() in t.hf_~ narj('s
of ['lO,1'y [~. Toto :1nd ""l'8_nCeS I. '~3te. 1,eS9.I+O
Sevinc;s .~.coount :10. 510-6P'7-7 '/lith The
Fi:r~st Bank and rl~ru.st COr:lp!ln~.~ of' 7.~echf;O.ni ...fj-
bur~, Pa., open~d 11/8/79, in the DaMes
of ilary~. 1'ate and ?rDnc~s I. TRte. 13,737.07
(1)
(3)
.................... ...... ........ .....
N07~: hll of above report~d at full
value GS 0-: the 6nte of d:;at::.. S0.A
Copy of "2.8.n1-: Let-tAr DUC.r::1.ttcd h8r8':11th.
Insert this total opposite "Transfers", Schedulo lie" in the
liAs Roported" column an the last page of this return.
1;~,('76.;~7
IS' cO '1(" 'f '7
J
-f.L9"C
"
9 'J'! ::
d -t 1t
=:
. 0
'6 ~ e
.... d.I:J
e- -
_.0. 0
. e U
10'"
" u .
o ."
- - "
" . -
u 0 "
u e g,
< "
~ 0:
StlM~IAI(\,
Rcnll'ropcrly ___.
Pcrsonnl Prnpcrty
Trnnsrcrs_
J:.c.in.tly....iliineot'ro pe rt y
rSch. liEd)
(Sch. "A")
(Seh. "BU)
(Sdl, lie")
('lfUSS Tuxable Estate
E- ."
~ Z " Po
'" ~ . .,.,
" ::< ~ .r:
;.- "
~ u CJl
'" " ~ ..J
- c:l <
< ~ '"
Ol U. 0 ,~ :(
Cl. E-< 'd
Cl. 0 r.: 0 C<
< ~ as ~ 0..
" ,,~ 0..
.c oCE- <ll rl ;" <
0 E- ~ E-< rl H .
:c rl <ll 0 a
Z .5 E- ....E- 0 %
000 <ll ~ " <
u. ~ f=1 Q,.
0 E-< H ~ l-
E --r. <ll 0 0 C<
.= Ol E-< ~ -5 0
-
" ~ 0 0..
~ E- H ~ w
- . ~ u C<
<I> E- [>1 0 ;,
'2 ..: ~ c
- 'e ::< ~ 0 ,::, 0
" c e
:-::'"0 .. 0 E
~~ <ll 0 c
-' ..l U U
...
.1
(1)
(A. Reported)
$ 0.00
$ 19.02tl.30
: ~~:~~
.$
$ _l;l2...9-Q.5~_
(2)
(As Ilelt:nninedl
$
$
$
$
$ -
$
I
I
I
I
I
I
I
I
I
\
\
I
\ (1)
I
I
I
REV-1;.64 (4-7l1)
COMMONWEAL TH Of PENNSYLVANIA
BUREAU Of EXAMIHA TION
INHERITANCE TAX SECTIOH
SCIIEllllLE "E"
JOINTLY OWNEIl I'IWI'EtlTY
*
INSTRUCTIONS: This schcl1ulc must discluse all properly, fClll and Tlcrsonul, oWllctl h the dCl.:cdcnt 'ointl with
another ur others, including intnngiblcs, stllnding in the name ot' the decedent IInd nlhcrs. List real cslntc Ifst, liS
entireties, or joint tCl1llnts, giving. hrief description, as indicated tinder Sdlt:dulc IIA,II pltls the dule Ilnd place of
record tlf illstnllncnt effecting vcstiturc, but donnl include entireties of 0\11 of slllle feul estate value in estate
Vllluntioll colulnll. Pcrsonul property shoultl be listed us ill SChCllulc "B," pillS dule of acquisition, and the nllme,
uddrcss ami relationship (if any) of co"owners III the llcccdclll.
Description of Proveny, Dllte of I\cquisitiotl, Name
Atklress nnd Relationship of Cn-Owners, and Pluce
of Record of Instrument, where Real Estate.
Unit Pcn:cl1la~c Estate
Value Share Valuatioll
IJEI',\IlTMENT VALUATION
(oFFICIAL USE ONLY)
(4)
Account No. 216-819311~ with First
Federal Savings and Loan Associatio
of Harrisburg, Pa., opened Dec. 31,
1976 in the names of Hary E. Tate
and Frances I. Tate, Jt. Ten.
Principal balance !~/17 /80-$3, 056 .l~6
Interest accrued to 4/17/80 was
$10.03
Class IX - Account No. 002-20-10047
with State Capital Savings and Loan
Association of HarriSbUI'g, Pa.,
opened January 6, 1977 in the joint
names of Mary E. Tate or Frances I.
Tate. Principal balance on 4/17/80
Was $37,000.00
Interest accrued to 4/17/80 was
$826.08.
Account No. 002-20-09062 with State
Capital Savings and Loan Associatio
of Harrisburg, Pa., opened October
4, 1975 in the joint names of Franc s I.
Tate or Hary E. Tate. Principal
balance on 4/17/80 was $1,000.00
Interest accrued to 4/17/80 was
$22.32.
Account No. 002-20-10048 with State
Capital Savings and Loan Associa tio
of Harrisburg, Pa., opened January
6, 1977 in the joint names of Franc s I.
Tate or Mary E. Tate. Principal
balance on 4/17/80 was $53,000.00
Interest accrued to 4/17/80 was
$1,183.30
Account No. 002-20-12692 with Sate
Capital Savings and Loan Associatio
of Harrisburg, Pa., opened March 8,
1977 in the joint names of Frances .
Tate or Mary E. Tate. Principal
balance on 4/17/80 was $2~000.00
Interest accrued to 4/17/00 was
$41.64
U. S. Savings Bonds, series E, all
issued in the joint names of Mrs.
Sar~ R. ~m~t~ or Miss Ma.ry E. Tate,
as 101101;S. \.,"~"'-V.llU.;t,'>?J. -8-<""J..~-t;X-
LI024517469E issued April 1973
RI01792036E issued April 1973
MI01173134E issued April 1973
M101173133E issued April 1973
MI0l173132E issued April 1973
MI0ll1~1~lE issued April 1973
(5)
(6)
50'/0
5 Oil,
50%
50;;
5a{;
5 a;'.
50%
5a{;
50%
/0-0'/0
50);
5~G
50);
50%
~~
Insert this tolal opposite uJl)intly Owned Property," Schedule "E"
in the liAs Reported" column on the last page of this relUrn.
Vllllle of
Entire
Prul1erty
1528.2
5.0
8500.0
413.0
500.0
11.1
6500.0
591.6
1000.0
20.8
28.0
112.0
560.2
560.2
1)60.2
560.2
Value of
Dceedent's
Intercst
,S's-. if
.2-.2...3.S"J.J
/1/7.(.0
//11.~O
/1/1, "0
o
REV_"!!,, C....70)
COMMONWEAL TH OF PENNSYLVANIA
BUREAU OF EXAMINA TIOH
INHERITANCE TAX SECTION
SCIIEIllILE "E"
JOINTLY OWNED PROPERTY
*'
INSTRUCTIONS: TIlis schedule must disclose all property, rcalllUll personal, ~11ed hv the decedent iointly with
!loother or others. including intangibles, standing in thc nlllllC of tht.: decedent illltl others. List real estale farsl,lIs
entireties, or joint tenants, giving brief description, as indil:ntetlunder Schedule HA," plus the lIate Ilnd plnce of
record tlf instrumenl crfeeting vesliturc, but do not include entireties or out of slale real eslnle vullle in cstnte
valuntion column. PersOIlIll property should be listed as in Schedule "B," plus dale of llc((lIisilinn,und the name,
address nnd rcllltiol1ship (if Ilny) of cOooOwners 10 the decedent.
Description of Property, Dllte of Acquisition, Name Unit Percentage Estllte DEPARTMENT VALUATION
A(klrcss lIud Rellltiunship uf Co-Owners, anll Plllce Vulue Share Valuation (oFFICIAL USE ONLY)
of Record of Instrument, where Renl Estate.
Vulue of Value or
Entire nccetlcnt'~
Property Interest
CONTlNUED--------------------------
CI029018308E issued April 1974- 107.2 ,3.6 /01,2-tJ
CI029018309E issued April 1974- 107.2 ,3.6 /o7,;z.O
CI0290l83l0E issued April 197!~ 107.2 ,3.6 /07.2-0
C10290l83llE issued April 1974- 107.2 ,3.6 /07,01..0
D101803791E issued April 1974- ,30.0 268.0 SJ~,oO
D101803790E issued April 1974 ,36.0 268.0 $"JI.,Oo
1he First Bank & Trust Co. Account #160-22 -3
opened prior to 1960 in names of Francis 1
Tate & Mary E. Tate Balance 2,771.57 ~
1,385.79
Insert this total opposite "Juintly Owned Property," Schedule "E"
in the "As Reported" column on the last page of Ihis return.
~2,20l.1
Si-/"'/' I, 7/
l? L '':;~
SCHEDULE "E"
~,g
REV-"73 ("'7;)
COM",ONWEAL TII OF PEN~ISYLVANIA
OEPARTMENT OF REVENUE
JUN 0 II 1980
BANK NO.
DATE FILF.O
(,-2-00
NOTICE OF DECEDENT ACCOUNT STATUS
Submit in triplicate within 10 doys after knowledge of
th e deoth.
STATUS OF ACCOUNT NOI IJOINT, TRUST, OR It~V€STMl:NTJ
'oint
E!HABl.ISHF:O DATE
3-8-77
r~AMF.:S ON ACCOUNT
SOCIAL SECURITY NUMBER(S)
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
Frances I. Tate or
Mary E. Tate
206-16-9299
NAME
SURVIVING DEPOSITOR Beneflclo, INFORMATION
RELATIONSHIP
TO O'::CIiPENT
sJ.S1:er
OECEDENT INFORMATION
t,AME
DATE OF DEATH
Frances I. Tate
Mary E. Tate
4-17-80
ACORESS
603 Whitefield
Hechanicsburg,
AODR ESS
10 HemlocK. Drive
DrivEi
Pll. 17055
CITY
~rland
7~!'P.lDE
Mechanicsburg, Pa.
BANK/INSTITUTION ADDRESS
BALANCE OF ACCOUNT AT 000
INTEREST ACCRUED AND CO!..LECTl8LE AT 000
TOTAL
2,000 00
$ 41 1';4
state capital savings Assoc.
108-114 N. 2nd. street
P.O. Box 1861
Harrisburg, pa. 17J.05
BANK AUTHORIZATION
I HEREBY CERTIFY THAT THE INFORMAnON CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
WITH SECTION 742. PI & E TAX ACT OF t061.
SlaN~TURE OF FINANCI,AL INV9TIGATOR"
/er' ". I II. ,-~
1 DATE ,- cJ
If -7 "
",
REV-<41J (....'\)I
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
..!UN 0 '11880
UANK NO.
DATt: FILED
NOTICE OF DECEDENT ACCOUNT ST ATUS
6--2-[,0
Submit in triplicate within 10 doys nfter knowledge of
the death.
!lTATUSOI' ACCOUNT NOI IJOINT, TRUST,ORINVESTMENTt
joint
E~TA8LISHLU DATE
1-6-77
NAM!:!; ON ACCOUNT
SOCIAL. SF.:CUnI TV NUM8ERIS)
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
Frances I. Tate or
Mary E. Tate
206-16-9299
NAME
SURVIVING OEPOSITOR Bendlclar JHFORMATJOH
REl.ATIONSHIP
TO R'iCHW'
orCEOENT INFORMATION
~AME
DATE OF DEATH
Frances I. Tate
Mary E. Tate
4-17-80
ADDRESS
603 Whitefield Drive
Mechanicsburg. pa. 17055
ADDRESS
10 Hemlock Dr.
CITY
Mechanicsburg, Pa.
BANK/IN5Tl TurlON ADDRESS
BAl.ANCE OF A.CCOUN TAT 000 $
INTEREST AO'O'2~ttW1"(je'4~F'.LE AT 000 $
TOTAL. $
BANK AUTHORIZATION
State capital Savings Assoc.
108-114 N. 2nd. Street
P.O. Box 1861
Harrisburg, pa. 17105
I Ht::REB'f CERTIFY THAT THE IN FOFf04AnON CONTAINED HEREIN IS A
CORRECT REPRESENTATION 0 F IN FORMATION IN OUR FIl.ES IN ACCORD
WITH SECTION 7042 PI&: E TAX ACT OF '9ISt.
SIGNATURE OF FINANCIAL. INVeSTIGATOR
l
OA.TE
...
-'
(:--
, //~
Y L/
". "
,
REV-473 (....,vl
CO"'MONWEA~ TN OF PENNSY~VANIA
'~E.PAP.T"'ENT OF REVENUE
,)Uil U <1 kHJO
BANK NO.
D.A.TE FILI:.:O
NOTICE OF DECEDENT ACCOUNT STATUS 6-2-80
Subrnit in triplicate within 10 days nfter knowledge of STATUS OF ACCOUNT NO. (JO'NT, TRUST,ORINVEsT"ENT)
'oint
the death.
E!iTABl.1SHEO DATE
1-6- 7
SOCIAL SECURITY NUMBeR(SI
NAMES ON ACCOUNT
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
Hary E. Tate or
France!:) r.. 'rate
206-16-9299
SURVIVING DEPOSITOR IBeneflclar '''FORMATION
DECEDENT INFORMA nON
NAME
Frances I. Tate
REl.AT10NSHIP t..AMl!
TO oEcEoEtS'ister Mary E. Tate
OAoil~ '1 '}"-'m~
ACDRESS
603 Whitefield Dr.
Mechanicsburg, pa.
10 Hemlock Drive
ADDRESS
17055
CITY
Mechanicsburg, Pa.
BANK/INSTITUTION ADDRESS
state capital savings Assoc.
108-114 N. 2nd. street
P.O. BO>: 1861
Harrishurg, Pa. 17105
BAl.ANCE OF ACCOUN TAT 000
~OTTE:cEST A6~.:.'2tr_'1.'O'b1!'fT'BCE AT 000
BANK AUTHORIZATION
ZIP co oF:
17055
: 37,g~g:g~
$ III , tj,~6-;m:;-
I HEREBY CERTIFY THAT THE INFOftotATION CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
WITH SECTION 742. PIta: E TAX ACT OF 1\J61.
SIGNATURE OF FINANCIAl. INVF..STlGATOR
l I
DATE
/'
(;d
",
DANK NO.
HEV-413 (4-191
COMMONWE~~ TH OF PENHSY~VAHrA
OEP~RTMEHT OF REV(NUE
DATE nL.F.O
b-2" '.,0
NOTICE OF DECEDENT ACCOUNT ST ATUS
STATUS OF ACCOUNT NOI (JOII'H, TltU5T, OR INVt~5TMENTI
joint
"OfA"L""ED DATe 10-4-75
Submit in triplicate within 10 days ofter knowledge 01
the death.
NAMES ON ACCOUNT
SOCIAL SECURITY NUM8ER(S)
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
Franc~s I. 'l'ate or
~\ary E. Tate
206-16-9299
SURVIVING DEPOSITOR
IHFORM~T10H
REl.ATtONSHIP
TO DECEDEsister
OECEDEHT IHFORM~TJOH
~'::f'l!.~OATH
NAME
Frances I. Tate
"'...ME
l-Iary E. Tate
ADon ~S5
ADDRESS
10 Hemlock Drive
603 Whitefield Dr.
l"lochanicsburg, p.a. 17055
CllY
Mechanicaburg, Fa. 17055
BANK/INSTITUTION ADDRESS
state capital savings AssOC.
108-114 N. 2nd. stroet
P.O. BOX 1861
Harrisburg, pa. 17105
8AI..ANCEOF ACCOUNT AT 000
INTEREST ACO'0'2!!:1~_0')6~lBL. AT DOC
TOTAL
B~HK ~UTHORIZ~TIOH
I HEREBY CERTIFY THAT HiE INf'OFf<olAT10N CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORM.\TION IN OUR FIl.ES IN ACCORD
WITH SECTION 74?'P I &. E TAX ACT OF '95'.
SIOH"TURE OF FlNANC(.I),L INVESTIOATOR
DATE
.,
SECTION 742 OF THE INHERITANCE
AND ESTATE TAX ACT OF 1961.
"When money is deposited or invested in 0 financial
institution located in Pennsylvania In the names of two or
more porsona other than husband and wife or in the nam" of a
person or persons intrust for another or other; and one of the
partie. to the deposit or investm.nt shall die, it .hall be the
duty of ilI.linanclal institution within ten (10) d.y. aft.r
knowl.dge of the d.ath to noti fy th. Deportment of Revenue
th.r.of giving the name of the d.c.as.d p....n, th. dato of
the croatlon of the ioint or trust deposit or investment, the
amountlnvest.d er on deposit at th. dote of d.ath with ilIe
flnanclal institution ond ilIo name and address of ilIe
survivor or survlsors to the account. Ho notification shall
be required in regard to such Dccount~ when the deposit at
the time .f death does not exceed three hundred dollars
($300)." (Emphasi s is added).
\
~~~qulr?_~.~
1) .Joint S.vlngs Accounts
2) Join! Checking Acc.unts
3) Trust Accounts
4) Joint investment accounts, such 01
certificatos of d3posits, shore accounts,
and so lorill.
5) Acc.unts h.ld by husband and wife
and third parties.
l'-to ropor' i 5 required on:
1) Husb.nd and wlf. occ.unts.
2} Joint account. with a balance und.r $llO.OO
3) Accounts held by the decedont individually
, REV-464 EX+ (3.80)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
File Number ._..?1-80-028L----
Estate Name ___II!!!'! E.~.!l!.\l__
.,.-----.--.--.-.. ------
Date of Death -AP~tl-1Z-,_1980
Social Security Number
..---------.
REPORT OF INHERITANCE TAX APPRAISER
I, the unc!e"lgned duly appointed Inheritance Tax Appraiser in Dnd IDr the County Df cumberk~d
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in t e oregoing
return at the values set forth apposite each item in the last column to the right in Schedules IlA", liB", IIC", and liE"
Dated: Septelllb.or 18, 1980
AI:.! &l!U'tl J /f'/ ~) dlf,f )
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Perlonol Property (Schedule B)
Joint-Held Property (Schedule E)
Transfer. (Schedule C)
$
None
00+
92+
10+
20+
30+
TOTAL GROSS ASSETS
____91..lf11.1(L --
Leu O.bt. and Oeducllons
(SCHEDULE F)
CLEAR VALUE OF ESTATE
40-
93-
Valuation of life estates or
annultl.s. . . . . . . . . . . . . .
~
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
T ox on $
~
COMPUTATION OF TAX
$
$
$
$
6"
"
T ox on $
15%
Tax on $
Tax on $
$
T ox on S
Exemptions
Tolol Estate
TOTAL TAX
INTEREST FROM
BALAN CE
TO
$
$
$
Lus Credits
DATE OF PAYMENT AMOUNT PAID OISCOUNT INTEREST
S + S $ =
+ =
BALANCE $_
INTEREST FROM TO__S
BALANCE DUE S
TAX CREDIT
$
~ :a *
~ ~ ~ m
~ ....
r( ~ ~ ~ ~ ...
Iol <l
\ rn Ql i
::> ....
~ ...1 . ~ ....
0( ~ I;
- I; Ql
U Z ; Ql ~ -1'
- 0 :. ....
~ .s ....
I ~ - t)
0 ~
fY ~ ~ 0
~
... 0 rn 0 Z 0
rJl rn >- !-< 0
- Iol Z
Z ... ~ ... ~ z
::l 0 - 0 ~ Z ~ ~ ~
Z ~ Z 0 ::> u c z
... ~ '" ~ 0 0 ~ -
:3= Iol U 0 ...1
---
..-:.-:-=:.~"--'-.'--~_---:::..=-~
*
ItEV.455 EX+ {3.t101
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEOENT
SCHEDULE "F"
STATEMENT OF DF.BTS
AND DEDUCTIONS
Estate of Har;rl':. "r, tn Date of Death.J.:.L11/e0
WHEN CLAIMING THE FAMILy'@x~P1'1bNP<?O~LETE THE FOLLOWING:
File No. 21-i~O-~'+Ll,
Claimant
Relationship to Decedent_.
Claimant's Address
ITEM -
NO. DATE NAME OF PAYEE REMARKS AMOUNT
Rer:i.Rtnr oj' ,'{LIb L(~ r, tcl';"; '['c::~ tnn":!~nta.ry 1,h.00
'~)lcthl1ny VC.lla,'i' ;:> c t 'i. rf' Tr,t-) n t
Vi.llarre :tl~nl i)~ Cr:)nt.er :~O~~ ';:d t:nl Crlre 20%.00
:\)"1(:31'8 Fl.ln(\rnl .. in(' F'J1l0ro.l 10'.11 2111)~.2)~
:or1n, .
Diy.on' s nha!'P1D c~~ ~1harrr~n c ~i~ E~i+ 11. (11J8. 11(1 .15
Hu\rrnc\nd B. i',o.rt!.n, r:'roas. l(~:eo CCllnt.7 t:'~ nd r]1 :;\.!;J8 ~ if' re-
::.ic1~:!t ';-;er c8.'::d,to. ta.:,:ns 9.80
COHley Associates >:nc:".ict?l 'Jill 15.00_
Herist.er of Hills I":i.li nr: Ar~ll'a'i.s3-1 3.00
Thc-: Ftr~~ t Ban], nnd lrrl.:s t .
..]on1.,B.n:,r 0:.' ~i:A c 118TI T c s bur C' r?8~': l.n;~ ;:) 8. fe J)f~f'OS i t '::';07 T nvento ry 10.00
J. "obert ~:' tn,1J.f't'p.r. .- At; torne 7' ~ .,.'r:~ c 1050.00
",:;q.
Pepistt'!, of ';)1.1,18 F'ilinr Jebts 8n(1 Doductions 3.00
-
TOTAL THIS PAGE I 5790.19
I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral
expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes.
_ ~)-:/IUU/J --Y?d;:
SIGNATURE OF ATTORNEY/FIDUCIARY DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S t;- r; C) 0 /? AT
/~;
1 L:,; '1.' PERCENT.
/'
~
GENERAL INHERITANCE TAX INFORMATION
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, funerai and burial expenses including the cost of a burial lot, tombstone or grave marker.
'" "(, ~ - ~,-: :.,....
All debts being claimed against an estate are subject to the approval of the Registe~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.
I
1
I
I
\
\
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. The family exemption is
anowable only against assets which pass by a will or by the Pennsylvania Intestate Laws.
r- "0 IJ n ~ t'1 ~ :s
z > 0 0 rJl
C') n c:: " ..., Z ~ Z ~
r-1 t'1 ~ Z '" ~ 9 9
z Z t'1 ..., t'1 Z
9 9 ..., -< '" t'1 Vi
Z 0 '" 0 "I
9 "T1 "T1 :xl
~
~ 0
- 't1
N 0 't1
-
9 z n
N -
>
Q.. t"'
c::
- rJl
I t'l
~ 0
Z
~ -< -< ~
t"1 t'l ~
> >
'" '"
INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
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.
~ i
1'---------------------------------------------
I
\
,
I
i
,<
t
1
I
M...lla"il!!.burv .
..-.... __ :0:::::0.__ __ :rcL ~ ...,,, ___......... _~ L~~ -"'-
~",RCC ~ (t1178) 'I ",', .. , , " " " ,
'1i1l:~?:r~f'j1,<:,:~;:.';i", ',\ " COMMONWEALTH OF PENNSYLVANIA ,::', '
1~'o~'I06~37"'''' ,'. DEPARTMENT OF REVENUE " .
iif~J!J" -! ,~.., ' :'!OFFIC'IAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
11~1l\'''.".,/f,.I., ...... '" ,
",<,1.'.:.'"",:;"",,',,;""""'-' ___..u u._._"
iii
; RECEIVED
If
a ''''1>ml
II .
=' 'fress
tl
-------------Sl~-.tva
HtJIIID III!1'l
TW2~Y-SavRN & ~6JIOO_________~~p_
.
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
rranae. I. Ta1:e
c/o J. RobeR 8tauffer,
Market SQJlArCl Building
B.q .
29c Tax on
s
s
17055
Pa.
6% Tax on
s
s
Fllo No.
21-80-28A. Dolo of Death 4-17-198Q.. IS'!, Tax on $
$
Dole of Payment ll<:It...'llar 1, 1 lIRO
o/~ Tax on S
Estate Tax, Act of
May 7, 1927
$
Nome of Decedent MARY B. TATB
s
j
County
CWlber1u4
$
6,527,]6
~,emarks:
TOTAL TAX CREDIT
less five percenlum of tax if
paid wllhln three months cher
dote of death
Plus interest 01 the rate of
_%from
10
s
s
-PAID I. :PULL-
'iYOO~[P~~@fi\'iY~ SEAL
$
6,527.36
TOTAL AMOUNT PAID
NOTE: This Triplicate Receipt to be retained for audit purposes.
j
~)
Received by
NOTE: In accepllng Ihe Ironsfer inherUanc.. 10. on lulure estales. prier 10 Ihe dealh of the Ufe
lenanl or tenonllor yeors. os evidenced by Ihis receipl, il is understood thallhe Commonwealth sholl
i nal be precluded. or prevented from he'eolter aueuing oddilionollnherilance lax 01 the dealh 0/ the
I 1If. tenont or lenant lor yeors whenever II oppears Ihol Iiuch addillanollax may be legally due and
collectible lor ony reason whalsoever.
M