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PETITIO\ FOil I'IIOIIATE OF 11'11.1. A:\D I.ETTI':IIS OF Amll:\ISTIIATIO\
ell II TESTAIII'::\TO A\:\EXO
I.ETTI':IIS OF ,IDIII\ISTILITIO\ IJE 1I0\IS \0\
I.I-:TTEIIS OF AIJ~II\JSTIIATIO\ DE IIO\IS :\ON CU~I
TEST ,IIII-:\TO,I \I\EXO
.,.,.,"
, ' '''';~'
ill till' E~lillt' of ./!.,h::(!........!.~;......~:-/O.OI.)...".,,' ........". dt'('('ased.
Pt'litiOllt'r(.Ii), .,."....""fIr.::.i:..\{,/...,......L~,:.~:-:.:..~!-?.,,,...,,'~,,,,..
a\le'~d') Ihal:
..",......,."......."."...........".............
is
I. PC'tirimll'r('!t') -/tn' h\'I'lll,"-mll' .\'l'ar,~ oj Hgl' OJ oldc'!'
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......\1".I..l...ll,l,;.......l..I.."t.7..:......"............"....................... ill lilt' aht)\'" captiolled {'slale,
}1"1'1 '/? /,'- ,1-',
2. 111.'l,('(I('1I1 diC'd nn _, ; t.L/......".....'-:.::..;;'...;.".,{....~,..C.""........... al "...,.".."".,,~t in the County of
/! (,);1 '-"1
l.~U.l!hli.f..<<.V;AI.J..I~.L,........ Stal<' of .........l.... ...~........,..,................ OIl lIlt' a~(' of ...,(L,. ,........"..... ypafs. ha\'il1~
Illildl' I:\.f./.~:....... Lll.~t Will alld Te.~tilllH'nt dated Ihl' ../;':711.. day of .../..l.t::{~::~:,::...7..."............... A.J): W2;f..
\1'1 ,eL(,", ' I I 1/.'///1;1'1 '// ,,)0"0 J' "L-c~
u'rCl1I .'>-lr.l;...,.... appolll ('t .............. ./...:.;.t.....l.........,~.j":.........~,....~..';;.....,...............,,............,........ '..XI.'C ...t. .............
\Vhich EX('l' l.'.:I,~;'..;\~... ha.~ sinc(' .........;l)!f.~(..l...,..,..........,.........,........,......................,..,..."................".........................
on
"J'ptl"
ami appli('s for Il.ttf'r.~ of administration
On .....,....."... day of ........,............................"...." HJ.."...., L(~tlers of Administration W!!fe ~rallted tn ..................
,...,....................."."....................."',.,.,.,,..".....,..,."....................,.."....,........."..,...........,......................".......,.",.......................
d.h.lI.
eLb,n,,",l.a, - I /"",
_-__ "1 f (" rV[/') I
:3, Ll'llNS of Administration c.La. art' Ill'l'<bl hN'i1US{' .............:".-:".........,:..I..(.....:(..~,..r.:.(.~..(,.."...........,...
. ." r ,', r' apply., ,"' , '
//I.!.!!1:.>:....ll1..:.~';),,;,..:;),'...':.."r.LL.....j,J.t:.,:;.~t.r.I.\.E..,:.":?..... and lH'titiOlH'r( s) applies ill .....I.h,,~.~,.... capacity n~j
/i 1--'/~~ld [' c,,' I -"II
,,,,,r.IL "(;_"/.;':f.7.f.,:'",,,,,,,,,I.,,,,<,,[;,(,,,,k,J,,,U.,,',o,,,,,,,,,,,, ,
4, Dt'l't'dellt dit.d domidk'd in ..l1,\~:.f;.).C:l.LI":.i.U.t!..~,!.!.............,, with his last family Of principal
I.: . . Jstate or ~l1l11tr)'), ;;; .-,
re,idellce LlI.""\td,'1",,,,,,u,L/.;:,(!!I.l,U,,,,,,,,t.I.V,l;,:,.,-,,,,J,J:,:.d,)..I:,l.!.E.,..."";:"'!':::,;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
was was
5. (Where dt'l'l'dt'nt diNI k~tatt~) DeCl,dellt was not married and a child was 110t horn to Of
adopt(.d hy decedent nftl'r l'XN.'ulion of Iht' will (ami wh('n' applil'illlt is alleged spouse) nor was decedent
divorced from applicant af!l'r ('xl'l'lllinll nf will and at dealh.
6, TIll' said dl'Cl'dt'llt was (loss,.ssed of Goods, Chattels. Hights and Credits to the estimated
vllhw of $.3.~0,Ifl;':~~\I".:::;0and of Heal Estlllt'. 10 thl' estimaled \'alue of $....!:2d)D.Q..:,9,~'ls neaf as
ean he aSl'l'rlailwd. That tll(' said Heal Estate ill .~o far as known is located in .......".......,."............."......".....
,,,,"',,J\;\\W,\~I\LI41.i~?,,,,,,n!.~c!.,~J..T,f,,,,,..,,"'"''''''''''''''",.."",,,,,,,,..,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"
7. (Whew de(,l'dt'nt dietl illtt'stah' as to any portion of this estale). P(.titiOlU'f after a propef
search has ;ls('(~rtainl'tl that dl't'l'd{'llt was sur\'i\'pd hy thl' follo\\'il1~'l1alJll'd persons l.'ntitlt.tl to distrihution
under the IlItestat<, Ad of W47:
Nllllll' IklaliOlIShil) Hesidcncl'
L"".!ff./'ftJ."",LII::U{J,,,,,,,,,.., "..",,,..,!,J.{:,!c'r{Ttl.,CiJI,o,,,1,2M 1.,,,,,,,,,..,,,,,,i.J';.,f.lL~HJi.E;,./:'d:,,,,
o
... ........................"....,...,.,........".,............,.,........,.,....,....,...........,..,....,..."..................,.........".........,..,.,........."....,..................
, '
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4, ""....'"..,,,,,..,..,,,,...,,. ..,......"...."".."",,,,,,,,,,,,,,..,,,..,,....,..,,,,,,,,..,,..,,',,,,....,',,..,'''',..,,,,,,.......... "".."",,,,,,,,,,, ,,"""" " ,,"" " "
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6. ....................
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a!'I,ly"
TIll'rl.fofl', pt'litiOllt'r( s) n.spel'lfully applit,s for (I'rohall' of tht' will l)J"l'S('IlIt'll her~\\'ilh and
fur) h''';' ,n![ad~il:i"raliUt~;I)!~d,C:r"d",,,,,,,"..""'7j'''/''''''''/I''T'''"'''/''''''....''''''..'''
Dah~d: \)L.. ........:.<rj'<:;....~:..t Sij!.lJt.d: .."i.l.'(..('.~..~:1./...:'.....\..._...l::.C.i~.6.-,r."..........."........
696'ldr..". [,),:1, "1y,1~)t'DL,,,,,,.'i.Lf!,,''''',,r.:[,,''''
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Cml~I():\II'I-:"I.TII OF I''':\:\SYLVA:\IA \ SS
"C,>.!JiI,f.'f.ly&!V.!~""""''''''',,,,,,,C:OUNTY: ( "
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....................,..."............. lilt' IwlitioIlN(.Ii')
ill Iht' ,lhm'(' applicalion. Ill.jug dlll~' ..-1.(.\..:(U.~-.1/1./ ..... al'('llJ'djll~ III l.lW 'iIY( s) lhal Ilw "ilalcTl1l'lIls SI'I forlh
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ill this pl'litillll an' tnll' 10 111l' Ill'sl 01 ,,r./::..:.....
...;,/~~~"':c.4~.,!........ ................. allll slIhsl'riht'd 11I'fol"t.'
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Attorlwy's NlIml' and Addrl'ss
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/ /70 Gl?
OATH OF PERSONAL REPRESENTATIVE
COMMONW8ALTH 01" PENNSYLVANIA
COUNTY 01" CUMBERLAND
1 ss:
," ,"" """" '"',''' """, ,If f..?'f1!"" '''' fJ/0.~: p",,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, '" '" """""',""'"',''' petitioner{s)
being duly "",.-j).f!.,O/:,('J."""""""""""""""", according to law do EL", depose and say that as the
d ' 't <;-,11,[ f th. t,t f //>,. /rJ /;: lvuJ /;1
a nllnlS ra Lh.t..r....,,, 0 l. es ,\ e 0 ..,.."...";'..-;.~(.i.,/.I,,'... .....",......"...,...""".......""""""....................................."......
..................................."...........................,....................................................................".................................................
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,
",,""jy.~,(:?,f1.(~""""""""""""""""" and subscribed
before me,
"""";2'<;J,q.l?,~,r...J33""""",,' A, D" 19"~,t,,
R~gi~I"'(!.""tp?~"""'"''''
"",:!J:;,~'1:,~::,:".i,(,l'::",:i?"""",,"""""""""""'"''''
............................................................................................
DECREE
Be it remembered. tWlt.,(lfhtlw ,~""""~,~~,IL"",,,, day of """",,9.~,t.!?!?,<;l,:r;''''''''''''''''''''' A, D" Uj,~,L,
L tt f Ad ' 't JJt,.15.~I~-.th".T.t"t. f r,J/cir/ ,) / .. 0.0
e ers 0' n11nl8 ra 1011 111 C es a e 0 """"...(;.:. .....r,......"",..J....l...:;.........."""................................................
"'" "'" ""'''''' ,,,"," "'''''' '"'' ,,,"'"''''''''''',''''''''' ,"",' '"'' In te of ",' lC. t/ 1. {,I ,WI., {;,,, '''',','''''',,','''''''','' """ """"""" ""
Cumberltmd County, Pennsylvania, deceased, were granted to """"",d{i.;I.:,iI.""Jd'"f.L::J"""""""""
............................................................................................................................,...........................................................
Witness my hand and oflicial seal tbe day and ~'e'u' afou: / 4- a. ~ '
""""""""'i?ft7'"''''''';,,~~'''''
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697
OATH m SUIISCIUUlNG WITNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND f
This If/tt 2J.st day of Hav A.D.,1980 ,
before me, Register for the Probate of Wills and granting lellers of Administration in and for said County of Cumberland, in
the Commonwealth of Pennsylvania, personally camc Elizabeth p, Quigley and George A. Vaughn, III
the subscribing witnesses to the foregoing instrument of wrilir.g purporting to be the last Will and T~stumcnt of
Edna B, Wood
Dated
August 29, 1979
late of Lemoyne Borough,
Cumberland County Pa., deceased who being duly
sworn
according to law, depose and say, that
VI
they
present, and saw and heard the testat rix
sign, seal, publish, pronounce aud declare th~ said
instrumentbf writing as and for h er
Testament and Last Will, and at the time of so doing
she
, '
was of sound and disposing mind memory and understanding, to the best of ou r
knowledge, observation and belief.
sworn
and subscribed before
~/Jl1Al (q. :f:r4X;;.J
Register
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA t ss:
COUNTY OF CUMBERLAND \
Harry H, Wood
being duly
says that as nearly as can be ascertainerl the said decedent
Edna B, Wood
died on
Wednesday the 23rd day of
at or about 10:20 o'clock, _~.
sworn and subscribed this
1st day of Hay
Apr i1
A.D.,19~,
~ 7/(, 2l-.J-
Harry H, Wood
19.~, before
.>Jl/,? 1~1 /
( :l
vJ~(VW/
Register
12'1
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of
I/A(I~ y
I?J.
( ( )/J::) /J
Cumberland, personally came
who, being duly .s r" .k),(l vi) ,do r S depose and say that as E Y r ('J lJ TO~-
of the last Will and Testament of eJ)V /J 0). if /() 0 /)
deceased
r-It-
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 s~scribed before me,
May J. A.D., 19~ ~ ,#y )-ft~.
~f "I-
, dAv/ (~' 'f/'q'~~
Register
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DECREE
/0- /.4- g'/
Be it remembered that on the
22nd day of
May
80 ."
,A.D.,19_; there was probated and
recorded the last Will and Testament of
Edna B. \'Iood
late of
Lemoyne
, Cumberland County, Pennsylvania,
Harry E. wood
Deeeased. Letters Test.amentary were granted to
Witness my hand and official seal the day and year aforesaid.
17~
,91?tLUr Iii /~<-U.~
r y ~
INFORMATION
To Insure proper credit to your account, tho nClmo of tho ustate and file number should be cloarly print-
ed on the check or money order.
This assessment is made in accordance with Section 708 01 tho lohedtnor.a and Estate Tax Act of
1961 (72 P,S, 9 2485,708),
To the extent that inheritance tall is paid within three (3) months after the death of the docedent. a
discount of five (5) percent is allowed 172 P,S, 9 2485,716),
Inheritance Tax. other than tax on a future interest, is due at tile date of the decedent's death and becomes
delinquent at the Bltpiration of nine (9) months after the decedent's death (72 P.S. ~ 2485.711). Inheritance
TalC on a future interest is payable within three (3) months after the trilnsler takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485.7121. Calculate interest from the delinquent dale 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 '0 months ,050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 G 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 deys ,00051 13 days ,00220 23 days ,00386
4 days ,00068 14 days ,00237 24 days ,00403
5 days ,00085 15 days ,00250 25 days ,00420
,
6 days .00101 16 days ,00267 26 days .00437
7 days ,00118 17 days ,00284 27 days .00454
8 days ,00135 18 days ,00301 28 days ,00471
8 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 (60) days after receipt of thIS Notice as provided by Section
1001 of the Inheritance end Estate Tax Act of 1961172 p,S, 9 2465,1001),
Make check or money order payable to:
"Register of Wills. Agent"
Mail to the address listed below:
1.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10,
11.
12.
13.
14.
In".nIClt')' and Appraisement Uat of Decedent'l Ealate.
(I) GENERAL ASSETS. Wllhln thr.., month. Illor h/& .ppolntment, every personll repre.enlllive shan Rle wllh the
reel.ter In Inventory Ind .ppral..ment.. verlRed by hla afflldavltl 01 an real and per.onal e.tate orlhe de,edent, except
r..l e.l.te out.lde or the Commonwealth: Provided, That an ane Ilary perlOnal repre.sentaUve .h.1I In,lude therein only
....t. ror which he It responsible. 2.0 PS-32.o-40t.
(b) REAL ESTATE OUTSIDE OF COMMONWEALm. The Inventory .balllnclude lithe end a memorandum 01 real
e.tate outside 01 the Commonwealth, The memorandum. al Ihe ele,tlon 01 Ihe personal representative may Indicate
the ..Iue Dr ea,h Item 01 reat catale Included Ihereln, bul the values so Rxed shall nol he extended Into the total ollbe
Inventory or Included as real eatate in subsequenl accountings, 2.0 PS-.'!20,40t.
IN THE MATTER OF THE ESTATE OF ,Edn~,)l: .1;I99~. .. .. . .. .. . . . .. . , .. . . , .. , . .. . .. . . . . .
Cumberland
lale of ,J,~1)l9Y\l~. 1l0,9ug\1, , . .' ,,' "in the County of :f>.tl'lY'and State of Pennsylvania, deceased.
INVENTORY AND APPRAISEMENT of the goods ~nd challels, rights ~nd credits and real estate which
were of the above named",.. .E~\\i1,ll... \'199\1,.,..""""""..,..."'.,........, deceased.
Taken and appraised the ..............,.... . " day of ,'.,..,., ' . . . . . . . . ' , , , . , , , . ., 19,.,..
(DATE OF DEATH: April 23, 1980 Adm~::'~~=" ~"u.
REAL PROPERTY
428 lIerman Avenue Lemo ne Cumberland Count
Penns 1vania bein the
western one-half of Lot 49 "c" in Plan No.1 of Riverton described in
Cumberland County Deed Book "II", Vol. 11, Page 165, Sold at rivate
sale
$ 17,000,00
PERSONAL PROPERTY
Checking Account No. 91-45-3542, Dauphin. Deposit Bank & Trust Gompany
Certificate of Deposit No. 2284, GCNB
Certificate of Deposit No. 2575, CCNB
319,65
1 008.79
1 006,87
633.73
1 004,59
1 004.59
1 004,59
3 013.78
1 406.43
1,472,89
52,79
2 842.33
1936,75
125,80
State Capital Savings Association, Account No, 002-00-06622
State Capital Savings Association, Account No. 002-20-16057
State Gapita1 Savings Association, Account No. 002-20-08940
State Capital Savings Association, Account No, 002-20-06456
State Capital Savings Association, Account No. 002-20-08700
State Capital SaYings Association, Account No. 002-20-14754
State Cap~~"l SaYings Association, Account No. 002-20-15404
State Ca),:Lta1 Savings Association, Account No. 002-31-03576
Net proceeds from public sale of personal property
122 shares of stock, The Greyhound Corporation
Cash on hand
15. Refund from Columbia Aecident-Health Insurance Company, Policies,
H-145028 and H-136333
63.42
16, Refund from Bankers Life & Casualty for unearned remiums on Polk
No. 800528546
723.50
34 620,50
(over)
The undersi~ned, f.1'I'.c.u.t.o.r. .. of the personal and real estate of .. .'':<\11'\ .~" .I'!,?q<). . . , . . . , . . . ,
late of .,. .Len!~~~~ .1~,?~O~?~l. , , , , . , . . , , , , . , , ' , . . . ., deceased, respectfully certify. that after having
been duly sworn, . I.l~. . . made the appraisement of the personal properly and real estate or said decedent
as set forth herein.
Personal Property, 6 17! 629: 50, , , , . ' . , ,
Real Estate, S.17. ,000.00. , '/. . , .
, .. ., ......)~ }.~/. t!-:~"!: :. . .,
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3^U V.LN'3S3l1c11l1 lVN OSlI'3d .:10 J.I^ VOI.:IJV
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheriti1nce i1nd Esti1le Ti1x Act of 1961 provides Ihatthe following persons shall prepare i1nd file
a return:
a. The personal representative of the estate of the decedent as to property of the decedent administered by him
and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or
acquire knowledge;
b. The transferee of property upon the transfer of which Inheriti1nce Ti1x is or nwy be imposed by the 1961 Sti1tute,
including a trustee of properly transferred in trus!, provided thaI no separi1te return need be made by the transferee
of property included in the return of a personClI representClt:ve.
2. PLACE FOR FILING
The return is to be filed in duplicate with the Register at Wills of the county wherein the decedent resided.
3. TIME FOR FILING
i'
,
The return is due nine monlhs after the decedent's death, unless an extension for filing has been applied for Clnd
granted by the Secretary of Revenue within the nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" . . .any person who willfully fails 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 of Revenue as debts of like amount are recoverable by
IClw."
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 daughter-in-law and 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 rate of 6% per annum accrues thereafter until payment is made, All payments received ere first applied to any
interest which may be due with any remainder applied to the tax. IF 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 Ule 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, togetl1er with 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 tile tax.
B. FILlNGOF FALSE RETURN
Any person who willfully makes a false return or report required of l1im shall, in accordance with Section 793 of the
1961 Sti1tute, be guilty of a misdemeanor and, on conviction thereof, sl1all be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
REV"4'OO {'-Bot
COMMONWEAL 1H OF PENN5YLVANIA
OEPAR1MEIH OF REVENUE
1RAN5FER INHERI1ANCE TAX
RE510E1H OECEOEN1
SCHEDULE "A"
REAL PROPERTY
(Instructions 011 Reverse Side)
ESTIMAH:D DEPARTMENT
11 EM DESCRIPTIOt-l MARKET VALUATION
NO. VALUE (OFFICIAL USE
ONLY)
1- 428 Herman Ayenue, Lemoyne, Cumberland County, Pennsy1-
, vania, being the western one-half of Lot 49, "C", in Plan
No. 1 of Riyerton, described in Cumberland Gounty Deed Book
"Hu, Vol. 11, Page 165. Sold at private sale J~~'<'O' $ 17,000,00 V
J:)tiv-L(r. flu:.")
.1A-UoLd,".f '1/ /(),
TOTAL THIS PAGE \$ 17 000.00 I M'Kl. () ()
,ESTATE OF
Edna B, Wood
...,_.--..._._---_.---.-._~.
--'--'-"
~~
QUESTIONS CONCERNING PROPERTV TRANSFERS
I. Did decedent, within two ye~rs of dealh, m~ke any transfer of ~ny IIwterial part of his esl~te wilhout receiving
valu~ble and adeuuate consideration? (Answer "Ves" 01 "No".) Yes
2, Did decedent, within two years of death, transfer property from himself/ herself to himsell/herself ~nd ~nother party
or parties (including a spouse) in joint ownership? (Answer "Ves" or "No".) -l>lo-
3. If the answer to one or two ~bove is "Ves" and the tr~nsfels ~re claimed to be nont~xable, provide the following
information:
a. Age of decedent at time of transfer.
b. Copy of death certificate.
c. Affidavit by the attending physician indicating the slate of decedent's health at time of transfer.
d. All other information supporting nontaxability of tr~nsfer.
4. Did decedent, in his/her lifetime, make any transfer of property without receiving a v~luable or ~dequ~le consideration
therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Ves" or "No".) No
a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject
to his/her power of disposition? (Answer "Ves" or "No".)
b. What was the transferee's age at time of decedent's death?
5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor
under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her
death:
a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Ves" or "No".) -1!2-
b, The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Ves" or "No".) No
6. If the answer to five b. above is "Ves," state whether the right was reserved in decedent alone or others.
7. Did decedent in his/her lifetime make a transfer, the consideration for which Vias transferee's promise to pay income
to or for the benefit or care of transferor? (Answer "Ves" or "No".) No
8. Did decedent, at any time, transfer property, the bmeficiat enjoyment of which was subject to change, because of
a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of
law? (Answer "Ves" or "No".) ---
'9, If the answer to eight above is "Ves," was the power to alter, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Ves" or "No".)
nEV.4~J (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
~,',\
~
(If,SlrtlctioflS Of' RflVCrSfJ Side)
Estate 01
Edna B, Wood
, .. -
BENEFICIARIES AND ADDRESSES RELATtDNSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
..
Harry fj, W_~.. Son -------- Yes Certificate of Deoosit
128 N, 4th Street -- .. and half of residue
..
Lemovne. Penna, J.7043
Helen Wood Dau~hter-in-Law Yes Certificate of Denosit
128 N, 4th Street and half of residue
Lemoyne, Penna, 17043
Earl Wood Grandson Yes $500.00
6 Diller Court
Boyds, Hary1and 20720
-----_.~---------------~ --.------.-.-- ---~---~--- ----~-- -,
Duane Wood Grandson Yes $500,00
1674 Quail Drive
Carlisle, Penna. 17013
,
GrPgor)L.lrood..... ..Gr.eat=-G r andsoIL,_ __yes_..__...._ ---- $,2ll.Q.".Q_L
6 Diller Court --,-_..-
---- ----~-- --'--'----'-- ----_._- ~--_.__.-~~._-_..-
Boyds, Maryland 20720
..
Randv Wood Great-Grandson voo Ic:?on nn
6 Diller Court
Boyds, Ha ry land 20720
Steven Wood Great-Grand~on Yes $200,00
R. D, 1/1 ,
-
Landisburg, Penna, 17040
..
The above beneficiaries are living at this time except for the following'
-
NAME
DATE OF DEATH
IIEV.453 11.801
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF I1EVENUE
TRANSFER INHEI1ITANCE TAX
RESIDENT OECEDENT
SCHEDULE "D"
BENEFICIARIES
~-
~
(Instructions on Reverse Side)
Estate of
Edno 1\, Wood
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
SUAnnllo _Wood_, Great-Granddauohte r Yes S200.00
It. Il, 111
I.nnd I Hhurll.' Penna. 17040
,J"ffrcy Wood reat-Gralldson Yes 200.00
H, Il. III
Lllnd IHhurg, Penna. 17040
,Jonnll'er Wood "reat-Granddauohte Yes 100,00 and furniture
r. I""n~ n, -"
I\oyds "'__..'nnA ?n7?n
--.'___.0'0 ..~._. ._.....____
,
,
-
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
"When money is deposited or invested in a financial
institution located in Pennsylvania'in the names of two or
more persons other than husband and wife or in the name of a
person or persons in trust for another or others and one of the
parties to the deposit or investment shall die, it shall be the
duty of the financial institution within ten (10) days alter
knowledge of the death to lIati fy the Department of Revenue
thereof giving the name of the deceased person, the date of
the creation of the joint or trust deposit or investment, the
amount invested or on deposit at the date o,f death with the
ftnancial institution and the nome and addre.. of the
survivor or survisors to the account. No notification shall
be required in regard to such account when the deposit at
the time of death doos not exceed three hundred dollars
($300)." (Emphasis is added).
SECTIOl<l 7420F THE Il<lHERITAl<lCE
Al<lD ESTATE TAX ACT OF 1961.
---.---.------...--
_u__" _. .--....-.-".,
"
^ report i$ required on:
1) Joint Savings Accounts
2) Joint Checking Accoullts
3) Trust Accounts
4) Joint investment occounts, such as
cortiflcates of deposits, share accounts,
and so forth,
5) Accounts h.ld by hu.bond alld wife
and third parties,
No report is required on:
1) Husband and wife accounts,
2) Joint accounts with 0 balance under $J)O,OO
3) Accounts held by the decedent tndividually
REV.454 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
~\
(lnstrtlctlons on RllVUrS() Sir/u}
Estate of
Edna B. Wood
p
TOTAL E VALUE OF DEPARTMENT
ITEM R
NO. DESCRIPTION MARKET c DECEDENT'S VALUATION
VALUE E INTEREST IOffici,,! Use Only}
N
T
1. 424 Herman Ayenue, Lemoyne, Cumberland County,
Pennsy1yania, being Lot No, 50, "e", on Plan
No. 1 of Riverton, improyed with a single two
and one-half story brick dwelling NPd"t.
S/1P,
$42,000.00 2/3 $28,000.00
2. 426 Herman Avenue, Lemoyne, Cumberland County,
Pennsylvania. being the eastern half of a
double house, and the eastern half of Lot No.
49, "C", Plan No.1 of Riyerton, described in
Cumberland Gounty Deed Book "X", Vol. 7, Page
75,
$17,000,00 2/3 $11,333,33
3. State Capital Savings Association Account No.
002-00-07616; account opened October 23, 1976,
in the names of Edna B. Wood or Harry H, Wood;
Harry M. Wood, 128 N. 4th St" Lemoyne, Pa., is
the son of Edna B. Wood,
429,47 1/2
$
214,74
TOTAL THIS PAGE $39,548.07
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
Schedule "E" must include all property, real and personal, owned by the decedent jointly with another
party or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be
included. List real estate first.
1. Describe all real property as indicated in the instructions lor Schedule" A". Describe all personal property
as indicated in the Instructions lor Schedule "B". Include the name, address and relationship to the
decedent of the co,owner (s) and the date the joint ownership was established.
2. Indicate the total market value 01 the jointly owned property.
3. I ndicate the percentage 01 the decedent's interest.
4. Indicate the market value of the decedent's interest.
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REV.455 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF OEBTS
ANO OEDUCTIONS
--------~-p--_._---
r-ii,' No, _21-80-336
--
Estate of Edna B, Wood Date of Death April 23, 1980
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Relationship to Decedent
Claimant's Address
ITEM .. .. , ---'- . ~.. __no ____ ..' ---.-". - -----
NO. DATE NAME OF PAYEE REMARKS AMOUNT
1. 5-23-80 Register of Wills ~etters Testamentary and Five (5)
Short Certificates 36,00
? ,,_~_Qn ~,-- ,,- ,-, 1,_1.,,' ....p Sprvic..e......- ~ '....lliL-
3, 6-6-80 !ABC Fuel Oil Comnanv ill for Labor ---- 17,25
, 508,24
4, 6-6-80 c, S. Willis & Sons Fuel. Oil I
5, 6-6-80 ilbert W, Parthemore Funeral Bill I 2,807.80
6, 6-16-80 PP&L Final Electric Bill 30,(6
7, 6-16-80 Patriot & Eyening News 1\dvertisements ~ublic Sale 58.80
8, 6-19-80 miyerton Water Comnanv Water Bill 3,35
9, 7-9-80 lTosenh HcGraw Inc. Real Estate Appraisal 125,00
10, 6-23-80 PP&L Final Electric Bill 4.28
11. 6-30-80 Dr, Blacksmith Hedical Bill 57.00
12. 7-9-80 David Carr AQencv Insurance Bill 2.00
13. 7-Q-8n : "u-I._-, --~ To<, J : T aao1 A~vartising '8 f)f)
14. 7-17-80 Register of Wills 2 Short Certificates 2,00
15, 8-6-80 West Shore Times LeQa1 Advertising ,16.75
16, 5-14-80 Real Estate Commission1~n~ attor ~ey fees paid at settlement of 426/428 1 720.00
17, 6-16-80 1~~~l..Estate Commission, taxes, f es in connection with settlement of ? 1\08.76
A.yeRl.:1e, l.emeyn
18. 9-11-80 I", izaheth P ouia1ev Attorne" Commission 1 600 ~
19. 8-80 Holy Spirit Hospital Final bill 11,90
20, Reserve for additional filing fe s 35,00
-
- --
TOT/\L THISPAGE\ 9,117,79
I hereby certify that to the best of my knowledge and belief the foregoing is " just and true statement of debts, funeral
expenses and expenses of administration submitted to the estate as dedur.lions for Inheritance Tax purposes,
, . /",~r-zl L-//-?L
S OF ATTO IlNCY:'C!!?;~____~~'~~~-'----------
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ ~ //7 1 q _ AT
&-
PEnCE NT,
ti ~ ')
.' ~ ',,'LL>-!4
_G1ST[I~ OF 'JILL~'
-:1-I-fil
_ -Z..__
DATI'
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible a(]ainst his/her taxable estate.
In addition to debts incurred by the decedent or estate, other items are claimable includin(] the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses includin(1 the cost of a burial lot, tombstone or grave marker.
GENERAL INHERITANCE TAX INFORMATION
All debts being claimed a(]ainst an estate are subject to the approval of tile ne(]ister 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. I n 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 remarl<s 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"
-'!-... ~ -~~-- - &
Ri';~f<,~(~l~~~ . '. ' COMMONWEALTH OF PENNSYLVANIA
~~O'p;I063202 DEPART~ENT OF REVENUE
=~i'~;)~\;:':"M;,"'" O~FICIAL RECEIPT . PENNSYLVANIA INHERITANCE AND ESTATE TAX
W"~i',:: ~I,.. q "1:""
; RECEIVED ____________________PIVB
It
'= Froln:
i
b"~ress
ij
~ File No, 21-80-336 Dole of Deolh_4-23-1980
i Dote 01 Payment July 17. 1980
~-
>La...___~".- ....,.
17"~'=:""
-
-.,','.i~~~:~,!,r
.,"
",';, ' :)y.::.:,t:
Harry II. wood
c/o Ilbabeth P. Quigley, I:
p,n, An.. 44&
THOUSAflll)_D_OLLJ'.R.B--..--.!""------------...---
reprc~onting Pennsylvania Inherltanco or
biota 1011. due from Ihe following estate:
dollars
.
2 (It TolC on
$
$
New B1Q01111l*1e14.
'a.
17068
6';" Tm: on
\
$
15'k Tax all
\
$
Nome of Decedent
$
I
mIlIA. B. 1IIOOD
% Tax on S
Estate TalC, Act of
May 7. 1927
$
.PAID 05 ACCOUNT"
TOT Al TAX CREDIT
Less five percentum of lox if
paid within three months after
dote of death
Plus Interest 01 the role of
_%from
to
$
1\,"1;., 16
County CWlber1an4
Remarks:
$
263.16
$
'IT[fJ~[P[L~@ill'IT~ SEA l
5,000.00
TOTAL AMOUNT PAID
$
NOTE: Thi, Triplicate Receipt to be retained tor audit purpole..
l...../
Received by
NOtE: In occepllng the Ironder inheritance ttl~ on future Ilstates, prior to the deoll\ 01 the lile
lenai'll or tenanl for years, os evidenced by this r.(.eipl, it is understood that Ihe Commonwealth sholl
I nol be precluded or prevented from hereafter omusing additional inherilanc. to. 01 the death 01 the
lIf. tenont or tenonl for yeors whenever it appears thot such additional 10. may be legally due and
collectible for any reason whatsoever.
..----------------------------------------------.----