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Home My WebLink About80-00388 "';\.i,.')' ) ..~ ",-'; ..~. .~ . >t CI) ~ ! ~ I ..~ " C C ...~ III III .~ CI) . U N A H ~ ~ 1 A ~ 1"1 - 0 eo. '. ,(J .. 'lR.' ID 1.0 ... , \ .. It loLl NO. 21.80 aSH PETITION FOR LETTERS OF ADMINISTRATION IN TilE gS'rA'('E OF ....~.~~~,..~~~.~~~.~.."..""..,"'"...."...".. IlECEAHI~I>. To .""" ",.,.........~~~X ..~,~....~~.~.i.~.... ...... ......,.. .,...."....... ..... ................. .,. ..... .... .., RegiMtel' of Wills 1'",' the Counly of CUl1liJel'ialld, ill the ClIlIlIuollwellll h of Pellllsylvallia. The Pcli tioa of ...CEc&.~..~.UNNJ::r.l:..,..... ...,....... ....,... ................ ...".... ...., ... ,.......... ...,... .".,.....,.. ......."..,..,.,... .,.......,.., .." ".",...",......."""...., .... .... ... respect fully show,,1 h t.ha t. . .....she"...., "... ,...,....,...,.,..,....". ."...,.".."....,...,,' Xl<sxIc~ waM a resident of .....,Mllcb.anicsburq.,......................110rollgh ,('ul1liJ"l'ialld COUIII)'. Stale of Pellnsyl- vlmiu, i1nd II Citizen of United St.ateH. and depllrted I his life iat."Htate ill t.he Couaty of Lllb!lnOD............. ...",..",."....,..""",....,..".,. and S ta t.e 0 I' .,.... J:',ennSy.11l.1IX1i.a.,.."..."........"....".,..,."........,.. ..........""...,. ..........,.,..,..,.., on ....~.~~~~!..........,.. the ........~lft~..................... dlll' of ......ne<:~r........................., A. D.. 1!l...7.9..., at the age of ......,ao..... yelll's. That the said ...EDITIl..DUI!IERREUX....................................... deceased. left ,;ul'viving the following named widow or hushand, heirs and aext to kin. to wit: Name Relatioaship Residence "CECELIA.. GUNNE.'I.'r,..,....,............."..... ., ..daughtal:...,...."..".. ...,.. .. 40-8. .North., Fi.lber.t, .street......," Meehaniesburg, PA 170.55 ..............................................................,. .................................,.....",.. ................................................................ ................................................................ ."........................,........"...". ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ That those above named include all of the next of kin, "0 far as known. The sairt decedeal was possessed of pOl'sona! propel.ty to the estimated value of $73.,422.:75............. and of Rea! Estate, less incumhrance, to the eHtimaled vallle of $....,DQne.................... as near as can be ascertained. That the said Real Estate in HO far as i" known is located in ..none..................................................... ..........................................................................................................."........................................................................... Therefore, YOUI' petitionel'(s) respectfnlly appl)'(ies) I'm' Letters of Administration in the above named estate. of Pctitioncl'(:;) ~...e~;r,k.4...'y......:9Jj?:J.!d:(21iL................. CECELIA GIJNImrT Dated ............M.:ll.~...~.~................... A D.. 1!1.~~... Signature and Addn,sH ........................................................................................ .~.Q!!..~!j;!J....f.~~...!il.g;"~I;,........."......"..,........... 1:!~!;!J.@;i,!;!!~W;g.,...~!l-...J,7.9,!?L............................... bClo COMMONWEALTH OV PEN"SYLVANIA 1 COUNTY OF CUMBERLAND . 1 ss: ..............,....,.......... {~:<~ .'::~.!.(,l:!.. ..... ..(~:./l,::.v.~..JT........... ......... ........... ...... .,...,.. ........................ ...... .... named in the ahove application beinl1 dnly .........5.k!,.:.~.a..1.1/................ a"conlinA' to law. sa)' that the facts set forth in the ahol'e application are tl'ne to the hest of ....d..f.!~. knowledA'e and helief. .........~(p,~,~~....k!.....,.........,.... and subscrihed 1 ..........;........................t:..............'...........~...... before me, \ X...~l'..;.t.L,"!,........:.d..,~I).l:!.utt..:................,.. .....................~.~~...~~.............,......... A. D.. In..~~.., ..................................................................................1JJ q;lt.lMje~~;;;;;;;;,;;:;;~ljf":J2-- FiI.', ......~.~,....1!.8................................... '"',,' "',,'''', /C;;:::;';~;:;>>1:;;;~ ,.':),;J ~t:. I'nl"/"Y' J~"T. ./J /')7 E.C'''r~v,[ S;JV/l"v,,=-1loSS- d. Date of Issuance January 10, 1965 Deoembel' 4, 1962 June 16, 1960 March 4, 1950 Deoember 15, 1950 November 5, 1949 July 16, 1952 November 1b, 1955 No. of Shares 1 Share 1 50 19 12 50 12 24 -..." -- 8f1~ 1tt):M'f,\'!f.,..J'I,<'....I<l~l('ii'I""l,' '-... I,,;" , "I" ~ . ,..' , ,J> I ,,.~~.;r,;ti' '.,;i~'*~;;,;\i0:1~i:\\\;;.1;":.,~::(, C?O~M,ONWEALTH.O.F PEN,NSYLVANI~ . . , ," '..}:i"1i';l;~' , eli"II"' .,-:1 ! 'h"4' J"",;o':' ... DEPARTMENT OF REVENUE' 1 , . j \ . 1,.. . ~:,.JjF;lcj:;t'R~CEIPT,. PEi-.lNSVLVANIA INHERITANCE AND' ESTATE'TAX .', " , .,i~f*~'f;l0~{]d>r'.~,l~~',.~, {:,;,' . ,. '., .' ..,__...,..___ " -'" ':"" J ~ ~ RECEIVED ________________TIIIITY_lIll1B ~ ij H1mD1l1m I'II''l'Y-orn: " 09/100----------,..j"llors representing Pennsylvania Inheritance or Estate Tax due from the following eslole: From: B8q. ''', dress " , 22 _. M.~ft Q~r8.~ 27(, Tax on $ s 17055 6%Toxoo S s Meahwa8buI:V , Pa. 21-80-388 Dole of Oeoth12-21-1979 s s 15'7" Tax on I File No. Dole 01 Payment Auvuet. 8, 1980 s '7" Tax on S Estate To)(., Act of May 7, 1927 s Nome of Decedent 1lDI'l'H DDPIBllllmtY County CWlbeJ:1an4 2,951.09 s Remarks: TOTAL TAX CREDIT less five percenlum of lax if paid wHhin three monlhs afler dole 01 death Plus inleresl at the role of _%from ta s s -'AID 011I ACCOUJil'1'M 'iJ[f;j~~[L~@ffi'ITrn SEA l 2,951.09 TOTAL AMOUNT PAID s NOTE: Thil Triplicate Receipt to be relained for eudlt purpoles. ~~~~/ (Tille) Received by NOTE: In accepting the Iransfer InherUonce 10. on lulure eslol85, prior 10 Ihe deolh 01 Ihe life lenonl or lenont for yeors, os evidenced by Ihis receipt, II Is underslood Ihol the Commonweohh 5hol1 I nol be precluded or prevenled from hereafter oueulng oddillonol Inherllonce lOll 01 Ihe death of the life lenonl or lenonl for years whenever II oppeors thol luch oddltionollo. may be legally due and collecllble for ony reason wholl08ver. ~_:________,_,___________,_,________________,.'7I l RfC.33 14."'31 COMMONWEALTH OF PENNSYL V ANI" DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ..., c; '> F,- ',-;:-'~ J -I) 'I -:' ) ') ''\ * RESIDENT DECEDENT COUNTY OF u ...J;UMIl_!':.~l:!L__ ------- IMPORTANT: -.- -., -.' .' .,-----_.,. This return must bc cumpleted in dctaillll1d filed ill dupliclIte, wilh ullllttlLChcd, willi till' I{cgislcr or Willi; uf lhc County where decedellt lcsidctl; Retmll is due withillllinc lllonths aflcr Jlllc of tll'lIlll, unless 1111 cxtensioll iN ~rlllllell by the Secrelury of Re'llClllll'. (Sl'ctiUIl70J HI' the Inherilillll'C ulIll ESIlIlC Tax ,\cl of 1%1.) .-,...-..... Loto of CumherlanL-_____ } AFFIIlAVIT OF -- ------ =:\TOI! County IN TilE MATTER OF TilE ESTATE OF ~IIX (STATE FULL NAME OF DECEDENT) County of CUmber land },,, ________.___kl!lt'lIKW Stat. of Pennsylvania AdminislnlWr CE.cE:L.IlLmmm:'r1' of the estoTe of The aboYe'nIlmod decedent being duly sworn, deposB and .ayS Decedent died DAC,..mbar 21. (MONTH) Name and address of attorney or } other authoriz.ed reprc!\cntative to whom all correspondence should be mailed. (DAY) 19~{QUIIllX~IOUlXllDCQCXIflItllJQGKlllCIX)Iaa.lIlllldllUl ) I.YEAR) inle..lole ALBERT Z. BOGERT. ESOUIilE ----.---....--- .-. ,.._.,_.-~.-.-._-- 22 East Main Street. Mechanicsbu~^-.__17l??_~___._ That as such depollent is familiar with the "Hairs III' snill ct-ilulc lllullhe properlY ClIlIKIlllllilllot (xti~ADMINISTRATOR) the assets thereof and lheir fair market value. That at th~ time of death there was no safe dep{l~it box registered ill dcccJelll' S ilHli\'hltlltllllltllC, ur juintly Wllh, or as agent or deputy of another, or in decedent's intlividllalname, with right III' lIccess h)' ullolher lll'i illtenl or depuly, wllh the exception of the fnllowing: - "_~"",-""-::';'~":"_'l._.-;;,::.;,,,,"':"';'''-:'_'':''''';'''';,,;',""_.=~~-.4I.<roc.~UII:I.~~ NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A S.\FE DEPOSIT BOX TI115 SAFE DrYOSI" llOX IiU~ 1 Ln IN NAME o~ NAME!) OF I4U. ^ 1I()1~~1I111' at' JOINT ltOI.IJFH!. 10 UfCI!tJENT .~ I That the contents of said safe depo'sit hox or boxes arc itemized under Schedules with the exception. of the following, for the reasons hereinafter set forth: of this relurn, That Schedule A attached hereto and made part hereof sets forth fully IlIlll ill dehtil nil the reul properly in the Commonwealth of Pennsylvania of which decedent died having an interest lherein. II lllsu sets forth the mortgage encumbrances upon each pared of real property at the date of death, giving Ihe 11I1\IIIIIIt still due al death, name of mortgagee, date, rate of interest, aud book and page of record thereof. It lllsu sets I'mth in the columns provided therefore the assessed valuation or each of said parcels, the eslill1lttetllllllrket yulue therenf as of date of death of decedent. That Schedule B auucheu hereto and made part hereof sets fmth fully lIlld in delltil ulll,enwIIIIIIHUIH.Ht)' where saver situated owned by the decedent at the time of oeilth: alllllllllcyS left hy Ihe deeCllelllllt the lime uf death, whether in decedent's imtnediiltc possession, standing to decedent's credit in hllnks lit' del1usil, sllvill~N banks, trust companies, or other institutions, \\hethcr individually, fII' in Irll'il for IlI\Y IIlher l,eltwn (lrIH:rsolls giving also separately the accrued interest thercon. if any, down III thc III !'! I iJlh~n'!I1 tlllY Plinr III decedent's death in the case of savings banks, and to the Jail.: or ~h:l.:cJellt's Ilcalh in ,lIllIll1el" nIM~'; all !luIHIs, IHlsIlll savings, treasury certificates Of Iloles anti IIlher c\,itknct' uf illllchlelllll'ss III' tlB: tlulted Sillies to lhe dc.. cedent; all obligations. whether by st:ltute or l'l;n:clllcnl thq Ufl' dnigllllll'tl ilk II" I'll'e, ur Ihe United Stutcs, or any state, or political subdivision thercor, or of any fllld~lI ltltlllllY, \\lIirh IIle O\\'lh~tllll the time uf dCl.llh: all wearing apparel. jewelry, silverware, piclurcs, htlCl~~, \\'tlI~S of 1111, hUII"'thllhl t'UllliIUH.:, hllll'tes, l;lIrrin~cs, automobiles, boats. and any OInJ nil othcr persllllal l'IUllIds ;11 \\hlllltIU'\l'1. I\illtl 1II 11IlIll1C, lefl h)' decedent, together with the fairly estimated Illarket \'ilhu- lhncu!; all hOllll", illIIl lI11lltllll~I'" hcltl h)' tlccellclIl anti of all claims due and owing decedent al the li1l1C Ill' t1Clt 111 , 1111111111 pIHtlll""IIII~' llllh'" III ull1l'1 illlttrlllllcnlli in writing for the payment of mone)' of whid, (kccJCl11 dil'd 11ll1't"l~""'I'II. III \\h,H"IU'HI 1I11I1I1l', with intl'lc!o.1 thereun, if any, giving the face \'alue and c!>'lirn:ttcd f;,ir mathl \1I11It' lIwlI"'r, 111111 I' I,lIdl C'l.lllllllll't! filii murkel value he less than the face valuc. it sets fmlh bril'f1~' IlIl' n'llllllll11 101 ,,"dl II "'''I't'1 III 11111 II!'! ttll'lIch ih,'lIl; IlIlIlUJ!1CYS payable 10 the estate from life inSlIrlIllCC pulidt'" t'lHlil'd h~' IIt't'Clh'lIl, 1111 UlllIlIllY illUt elHluWI11Cnl cnntracts the proceeds of which were payahle upon the tll'ltlh Ill' lilt. tkn'th'lIl. illl Illhl tlu' 1'1I'111llille "llll:kN and dividends due thereon and unpaid as of lhe date lit' lll"alll, houll" 111111 ilfnlll'tl IIlll'H'''1 lIU'U'tll\ III Ihe tlllte Ill' decedent's death and other im'CSlment securities CI\\IIl'lI h~' Ihe clt'II'c!1:1I1 III 11ll' 111111' III 11t'i.IIII, '" illl the AlIukel value therc.. of at such time. In the cuse of securities of' close or family corpOrllt.1olls, the Vlllues reporter! llre us flir liS possible substnnt1l1t.l'Hl h~' flnutlclnl stllt.crtwnts of' UII~ corpornliolls, showing the nssets unel lillhllitles thereof as of UIe dAte of' clenth. The schelin]!! I\lso set.s fort.h the Int.erest of' dccellcnt Ilt the tlme of death in nny co-pnrtnershlp or huslness, fll1l1 in support or tile value of slJclllnterest there is Ilnnexed to said schedule, flnnnclnl stAtement.s showtng; thenssnts nnd llnhl1lttes of' slllel cO-Tlf1rt.nershl.p or llllslness. A copy of th(' co-pnrt.nershlp ngrc!f~ment, (if oral, n statement Sf.tUIIP; f'ol'th t.he llut.llre of the /tgreemcnt) together with 1\ stut.ement. set.ting I'orth tile cltarnctcr of ttlf~ hIlSITll!ss, Its 10(~n.t1on, Itnd sl1cll other f'acts pertaining t.o the huslness liS IIlny he pertinent to n fnir Ilnd .l"st nllprnisll1 of' tile rlecerlent's intp.rflst therein mllst be sullmlttnll. It should u1so set forth 1n Itemized form, top;nt.her wit.h the fnir market vulue thereof, any other property OW1Wrl or bCflucnllwd by till! deel!df!ld, Itt. the L1rnf! of' dC/ltil. The Schl'dule C nttllcherl herp-to /lnd mnrle part hereof sets fOT'th 1\ true IlnBwer to. earh inquiry contained therein unrl in the cn..';"~ of' trnnsf'ers of property, renl or personnl, within two yenrs of de'c~dentl 5 death, in contemplation of decedent' 5 death, or l.ntenrled to t.J\ke effe~t in possession or en,1qyment lit or after death, said schedule sets forth the nature nnel vnlup. of stich property, t.o whom trnnsferred, the relationship of' t.he trnns1'erees to the (Iecedent, the proportionate share received by each transferee and all other fncts of n pertineTlt nature regarding slliet t.ransfers. In the cuse of transfers intended to take effect,in p.ossession <?r en,1oymt~_nt fit or after r:leath, there is 111so uttllclied to the schedule a cony of the deed, trust Ilgreemerlt or other instrument creating the trust. TheN~ is also set forth in said schedule fl Itst of nIl property, real Illle! personal, with its value, whtch pn~ses /lt decedent's death by virtue of the exercise by decedent, either individually, or.1ointl~. with /lnother, or any power of appoint- ment vested in decedent, either individually or .jointly, hy the will, deed, 01' ot.her instrmnent of another, with II copy of the instrllment creating such 'flower ntt"ached t.o the schedule. That Scht!dvle 0 attached hereto nnet ml1de part 11l~reof sets forth the nnmeS nnr! addresses of nIl persons henef'1clall~' interested in this est/lte at. the time of decedent.' s ne/lth, the nature of their res- pective interests, their rellitionship, if' Ilny, to the rtecertent, l.op;other with the ages at the t1.me of decedent's death of all minors, nnnuitants Rnll beneficiaries {'or lJ.fe I1IllIer rlecedent's Will. It also contains n statement showing which of the beneficiaries nwne() in the decedent' 5 wUI, if nny, died prior to decedent, the dutes of their death, theIr issue, Hna the i'elniionship of Stich issue to the beneficiary. That S.:hedule E attached hereto Ilnd mllrle n part hereof sets forth nll property, real and per"; 50nal, owned by the decedent jointly with Ilnother or ot.hers, Including intnnglble, stnnding in the name of the decedent and others, plus the date and plnce or record of instruments effecting the vestiture of real estate and the date of acquisition of Ilersonalty, plus the name, urtrlress nnrl relationship, if nny, o f co-owners to the rleceden t. That Scftedule F attached hereto nnrl made fl pnrt. hereof sets forth full,)' and in detail all debts and deductions claimed for ann on l)ehalf of this clf?cedentts estnte, InclucHng funer/LI expenses paid; family exemption, where applicable; costs of nrlministrntion of t.his estatej counsel fees nnd f\ldiciary's commissions paid or to he paid; cost expended for burinl trusts, tombstones or grnvemurkers, and reli- gious services, in consequence of the denth of the decedent; dehts Ilnd claims owing nnd unpaid. at. time of death; taxes ,accrued chargeable for period }lrior t.o rlecedent's death (except those allowed under Section 651 of the Inheritance find r:state Tax Act)j together with 11 statement of collnteral pledged for ol)1iga- tions, if any. It is agreed thAt the f'iduciary will present proof' of suid clllimed obligations upon re- quest, t1ltlt if the amount actually pELict in settlement. of finy fee, eommission or debt is less than the estimated amount c1 !Llming and allowed, that the same will he reported to the Ilegtster of Wills, and that the amount of tax assessed Clln be renssessed in accordance therewith. That the totals of the appropriate colunUls in Scherlules "A", "B", "e", "R", l\nd "F" as directed therein, have been ca.rried forward Bnd properl;y registered in the Summary. Subscribed and sworn to before me this ........................... 'lI-i ' 7 -; ......._......_....__.j/.-::: daYOf('_~~ ...19~.?l. _.......~:2~ ::-:~:,/ ~"" ~7 4 <-- M~-:il:ll;';:~ :r:. ::',J' "1:':"1': M, Ct.':1Il.;....i:,~, ~".;..:p;I;;~ Au,'.. .....~~..K)...9l.-V..~_.. (Eo:ecutor-Administrator ) . . 4 O.B....~or.t.h....r.ilhe.r:t....S.tr...at........ ..............,..-.............. ( Street Numb...) .~~.fj~~.'~~,~!.~.~,~.~.~~E9..L.,~.E.,.......J?0.!..S."..... .. .."........"..""...........'. (City or Town and State) '.c""",, . ,." i 1.;>1 NOTE: Before signing; affldnvt t. muke sure nIl hl:lJlk spllces in the llf'fJdllvLt /tnri sched1tle~ annexed llrc filled in with detl1115 or the .....orfi "Noncrt, /Inri in (:use the> IISS(>t.S illellJ(t~ rure Ilwt unlisted securities, securl ties of close or family corporntions or fln intr>rest tn 1l1l~' co-pHrtnersh1p or husiness, thllt the data /lnd stl1telllPnts requtred und~r t.he llnruJ!;rllph ahovp relatlnJ.!, to Scht!rtule "B" IIrf~ nttllcheli. Also make certain t.hat column #1 in the "Sumrnnn'" hilS h('en properly enmplt>l(>ct lIS Ithove-fHrl~ct('d. HESIllENT IlECICllI':Wl' SCIIEIlIJLE "H" 1'f<:IlS()~AJ, I'!\OI'I':IITY t~~ ~,(f.~ ......,..1 /'" ~~:m j.~t\ ,\\;t~.", '. 'W""'~"" 'F.<''''''''I~ . RCC -35 , COMMONW!l'\!ll'1I OF PENNSYLVAN [,\ 'l'I\ANSFER INIIICI\lTANCr-: TAX IN'~TIlUC'l'lOSS: TIlls Seh'.1ftule must dlsclosl~ nll UIlII;lhll! ItlltlllllltliJ..';illtl' pl!rSOIIHI 1II'IIIJt!I'!.)' 01'1111',1 I1Hlividu1tlly by tlw decedent, Il.t tILe t.lml~ 01' Ilts Ih~Hth. l'rOpt!\'t.y ClWWld il~' tllf' lil!l~I'dellL .!olntly wl!.1I /trull,hel' 01' ot.hers must. be Ih;t;ed llnd{~I' Schethlle "Ell. Intllll)!;lll1e IHH'Sllllld Pl'oJlln.t)', llth,.l III the nlunl~ of' tilt. decedent., hut pll~'lLble at deuttl to Hllothcr OJ' ()thf~rs, Incll1dll1~ hut IIUt, Itmltell to P.O.I>. U. S. SllvlJlJ..!;s nOlld~ lHul t,t!ntll- tlve Ll'USt Ilc(:ounl.s, lTlust be listed, (h~spit.l~ th.-! fuet tllIlt they Ilrl~ "Ot. (II' till! admlnlsti!I'ccl estlll-Il. 'l'nn~ible IH~nwnlll property should he IIs11!(1 fin;!. (Il.)!,. Jewldl'Y, weHl'1n~ Ilppnrel, household goods, Hnd furnishings, hooks, paintings, HUl.olll(Jhlll~s. llllllts, etc.) Int.nngilJle pcrsonn1 property, sucll ItS howls, Lrens\ll'Y ccrt.il'lc1ltes, CllSh on hund lUul in bank, stocl~s, mort.guges, notes, LllgeLllcr ','lith nccl"ucd illt..",.sl. Ill' cllviltends, slllnrins or wuges, insurance pay- flbIc to the estllte 01' flclucinry in sllid cnplwlty, pn,l'tncrship Interest.s, Int.\~rest in 11ll,yundJstributed estllte of or income f'rom 11TI~' rrupnrt~. held In trust IItHll!r t.he wIll or Ilgrecll1cnt. of another, e\'en though located outside of the Stnte, ut tht! time of' dcuth, should he listed In thts schedule. Item No. !'fEM lAst untl IIescribe j'ully UNIT VAWE ES'flMATEIl MAI\Kl~r V AHJE DEPARTMENT VAI,UATION (Do not write In this spnee) 1 . Atlantic Richfield Company - 200 shares common 11,1;- stock 79.125 615.825.00) 15:15"0,00 I ~8.'t37 6 . /(0 71.5'. 3J' 2 PPG Industries. Inc. - 578 shares common stock 28.875 $16.689.75) :I 39.31 ($ 6,726.00) t ?fl."; I 3 Tenneco - 177 shares common stock 38.00 '} ~/.l..lS" <3 ~ ..z.. oS; IJO 4 central Illinois Public service company - 180 12.125 $ 2.182.50) shares common stock Insert this total opposit.e "Persollnl Property", Schellule "U" In the. liAs ncporto!dft (lolumll on thtl lllSt pnge of this return. x X (41,423.25) if/I (,G,.t. /7 .lJ'9'l RCC-37 (12.63) (,OMMON\\'~:AI.TII OF PE:-;:-;g\'\'l,ANIA TRANSFER INIIER\TANCE TAX RESIDENT DECEDENT SCHEDULE "I)" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSIIlP SUIlVIVIm (If ,tcp.childrcn or illiTE INTEREST OF (5 tat.c full names and nddrNlllcs of nIl who ille~itimate children DEC\':Di':NT 01" BENEFICIAllY tl\'C an interest, vested, contingent or other are involved, set STATE YES IN ESTATE wise 1n estate) forth thi, fact.I 011 NO III liT II 2/24/16 408 North Filbert street ..~a 1 nn n.... ~..n.. Mechanicsburq, PA 17055 - I Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE .. o ' ~<~ '" " .. Ul: r:: '2 Q.I e 's ~.E "Co. 8 < e. ..:. 0 ~ oCJ'g ~ ~- " .. " " " Q " e Co &1 " ~ 0: Rcal Propcrty ....... Personal Property Transfers .. SUMMARY .. .(Seh. "A") (Seh. "n") (Seh. "C") Gross Taxable Estate !-< '0 Z ." ~ l.LI ... .", ..l " ::; " >< . 'U .( l.LI " Q '" Vl ~ - .( -< " ex: Q; '" 'S .. P- O " .. Ol P- Ol ..:: .( :c -< :c ~ ;., ... l.LI ... f-< ~ Q S 0 ~ :t '" -< ::; Z 0 f-< Z f-< Vl P- -.: '" ~ - i- ~ 0 c ex: - c Q; ~ 0 0 .. ., til "- ... " ~ ~ " ex: J:: 0 C .. ..... '0 ~. 0 'S :;;: ~ - '8 ~ .. - J 15 (; ::~ u u (1) (As l\cportcli) $ $ $ $ $ $ ( 2) (As Ddcrmilll'li) $ $ $ $ $. $. i'-: \ REV""S4 EX_ (3'~O) COMMONWEALTH OF PENNSVLVANIA . DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTL V OWNED PROPERTY (tnstructions on Reverse Side) Estate of ~dith Dupierreux ITEM NO. TOTAL MARKET VALUE DESCRIPTION Certificates of Deposit - Jointly with Cecelia Gunnett CCNB Bank, New cumberland, PA Account if14484 - Opened 1/15/77 Account ~14465 - Opened 1/15/77 Account i114486 - o!-,ened 1/15/7'7 Account i/141+67 - Opened 1/15/77 J\ccount 7[144,,0 - Opened lP5f.7'1 I,ccount 1i141k13 - Opened 1;15;77 Certificates of Deposit - Jointly with Cecelia Gunnett ~ Dauphin Deposit Bank, Harrisburg, pp, JHJ 1,01 Account 'if15-03-013430-0pened 1/20/77 5, 016 .14~ Accountd15-03-013431-0pened 1/20/77 5,016.14 -..- Checking Account - Jointly with Cecelia Gunnett Dauphin Deposit Bank, Harrisburg, P^ .~,ccount 1i,29-3'7-067-1 - Opened 11/b/75 664.19 ~5, 006.03 5,006.03 5,006.03 1,000.20 1,000.20 5,006.03 . p\ VALUE OF DECEDENT'S INTEREST . DEPARTMENT VALUATION (Official Use Only) . 2 ~2,503.02 " 2,503.02 2: ::::,503.02 ~. 500.10 i 500.10 :-i 2,503.02 i ~'50~.07' a.s-a f-. ~- 't , 2,5Ob.07 01.5"0 '1-. SJf I TOTAL THIS PAGE ~p6,1161.1') .'I.,'l-5"J,Ift-. ~ "2" 432.10 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 for Schedule" A". Describe all personal property as indicated in the instructions for 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 of the jointly owned property. 3. Indicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest. t'" "d CJ n ~ 171 :>- :;; ~ > 0 0 tIl 0 - Z C'l n e 0 ..J Z s: Z l"" tTl tTl :>:: Z :<l > 0 - 9 r' Z z tTl .., tTl ..J Z 9 9 ..J ><: Vl tT1 - Vl Z 0 Vl 0 .., 9 "1 "'1 \O:l ~ ~ 0 "'1 - "1 0 - Z n - > l"" c::: tIl t"l 0 Z -< ><: ~ ~ t""l 171 ~ > :<l RC~."2.t400771 COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE ~'AR 06 1980 .-IF ~"'J-l./L. ~ei" NOTICE OF DECEDENT ACCOUNT STATUS ,2./ - ,fa - OJ!'J' BANK NO. 60-83 DATE FILED STATUS OF ACCOUNT NO: (JOINT, TRUST, OR INVESTMENT CO 1 1 '\431 NAMES ON ACCOUNT SOCIAL. SECURITY NUMBER(S) RETURN COMPL ETED FORMS TO LOCAL COUNTY INHERITANCE TAX OFFICE (Mrs.) Ed1th Oup1erraux or Cacs11a O. Gunnstt NAME SURVIVING DEPOSITOR (Bo"f1c1ory) INFORMATION 1/1 '''7-- RE"ArIONSHIP V~ IV- I,J TO DECEDENT. DECEDENT INFORMAT N DATEOF DEATH NAME ADDRESS LinhR811dA ft; 9 N. f/I..lJ.&-Y:b /'l.:c.A(I.A1-"~~l'Y/ IV, 408 North F11bart Street C1P1~chan1caburg ce'tIMHerlBnd 2r7D5S AODRESS Dauph1n Depoa1t Bank & Truet Co, 213 Market straet Harr1sburg, Pennsylven1a 17101 BALANCE OF ACCOUNT AT 000 INTEREST ACCRUED AND COL.I.ECTlBLE AT 000 ToTAL. BANK/INSTITUTION ADDRESS BANK AUTHORIZA TION I HEREBY CERTIFY THAT THE INFORMATION CONTAlNI::O HEREIN IS A CORRECT REPRESENTATION OF INFORMATION IN OUR FIL.ES IN ACCORD WITH SECTION 742 P I Ii E T,AX ACT OF 1961. SIGNA'TURE OF FINANI;I.~1.. INVES.ilakTQR' '" i r, l' \':' ! .' '.. '. DATE ').. .. \ ,1 -C...:'"',"" " NAME SURVIVI~G DEPOSITOR (Benefld(lry)INF ORMA liON RELATIONSHIP TO UECF;,DENT. DECEDENT INFORMAT ON DATE OF OEATH DATE "' 3 ~ 3-k 4 ~ '0' ,r. ~' , " ~. " ~u \ \ ,', , ~ ,'" 02(-N -O.JPi REV-47,:! (8-78) COMJ.\ONWEALTli OF PENNSYLVANIA DEPARTMENT OF REVENUE Ytb& BAlIK NO. , DATE FIL.L'.{) NOTICE OF DECEDENT ACCOUNT STATUS Submit in trvplicote within 1 the death, :;rAT.!.,!5QF ACCQUN'f NOl {.JOlIlT, lIJU'iT, QIIIN'Il'.STMC:.NT CIJ 1:; O~~ 013430 t-"~ I AI11.1:.:.t1l....l.J II" 1 L. RETURN COMPL ETED FORMS TO LOCAL COUNTY INH ERITAN CE TAX OFFICE 1 15 ?7 N hML:S ON ACCOUNT 50 CI AL_ 5ECU RI TY NUt.tBER(SI (Mrl"l) Edith Dupil?rrBlIX or Lacelle D. GUl1n~,tt NAME ,. ADDRESS Unknown 406 N~rth Filbert street C1TMechenicsburg ce'lliW'tl'lsnd 2r7&5~ Deuphin DspDsit !3enk & Truet [:0. 213 Market street Herrisburg. Penneylvania 17101 HAL.ANCE OF ACCOUNT AT 000 INTEREST ACCRUED AND COL.L.ECnALE AT 000 TOTAL. $ : b.Llui!a'P-. BANK/INSTITUTION ADDRESS BANK AUTHORIZA TlON I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN 15 A CORRE"CT REPRE5ENTf\TION OF tNFORMf\TlON IN OUR FIL.ES IN ACCORD WITH SECTION 742 piP" E TAX ACT OF t961. SIGNA T~R~ 9-' FINANCIAL. INVY1TOR : ( \Jv," , . \ (...1 '"A~'1" L_r l.. " REV.473 ('8"7RI COMMONWEU TH OF PENNSYLVANIA OEPARTMENT OF REVENUE 60-83 NOTICE OF DECEDENT ACCOUNT STATUS ~@.& DATE FIl.EO 12 27 79 Submit in truplicote within 1 the deoth. STA TUS 0 F~>lfc"/N OB"I '~OI~i'i'Jl~('ntO'R IN VESTMENT Eo 11 a 7G RETURN COMPL ETED FORMS TO LOCAL COUNTY INHERITANCE TAX OFFICE N/lMES ON ACCOUNT SOCIAL SECURITY NUMBER(S) f.dl.th DuplarrlllJl< Csc;,lll'. D. G~n;1!,\.t NAME SURVIVING DEPOSITOR (BClnClflclarv) INFORMATION RELATIONSHIP TO DECEDENT. Cscella D. Gannett Deughter Unknown OECEOENT INFORMATION NAME DATE OF DEATH Edl.tti Duplsrreul< 12 24 79 ADDRESS ADDRESS 408 r11bert street ME!l'hnni csburg. COUNTY I..umbl!rl"nd !!'71JS5E CITY BANKIINSTITUTION ADDRESS Deup..nDepoeit Bank & Trust Co. 213 Merket Strsst Harrisburg, Pennsylvania 17101 BALANCE OF ACCOUNT AT 000 $ INTEREST ACCRUED AND COLLECTIBL.E AT 000 $ TOTAL $ BANK AUTHORIZA TION I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS A CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD WITH SECTION 742 P I a. E TAX ACT OF 1961. SI6~ATURE OF FINANCIAL ~_~EST1GATOR_ -lC \. ~ 'h~\ C. ----\._lr-.( '-":.\. " A report is requlrod on: SECTION 742 OF TIlE INHERITANCE AND ESTATE TAX ACT OF 1961. 1) Joint Saving. Accounh 2) Joint Checking Account. 3) Tru.t Account. 4) Joint invcstment accounts, such as certificates of deposit, share accounts, and '0 forlh. 5) Accou,;" held by hu.band and wile and Ihird partie.. "When money i, dopa liHcd or invested In a financial In'stltution located in Penniylvonia in tho nomOi of two or more perso.n1i othor than husbond and wife or in the nome of Q P.'erson or persons in trust for another or others and one of the partie. to Ihe dopa. it or Inve.tment .hall die, II .hall be the duty 01 the linancial in.titution within ten (10) days alter knowlodge 01 .the death to notify the Departm<'l1t 01 Revonue thereof giving the name af the deceased person, tho date of the creation of the joint ar trust dopos-it or investment, the amount invcs.ted or on deposit at the date of death with the financial institution and th~ name and address of the survivor or survivorj; to tho account. No natification sholl be roquirr.d i" regard to !Our.h nC:Cf)unt when th~ depnsit at tho time 01 death does not e.ce~d three hundred dallars ($])0)." (Emphesis added), No repart is required on: 1) Husband and wile accounts. 2) Joint accounts with a balance under $])0,00 3) Accounts held by the decedent individually. " """,~ " , ,'I' RCC-311 1,.5111 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIOENT OECEOENT Estate of Dup1erreux, C;dith (Last Name) (First Name) (Initial) SUMMARY IlATE OF DEATII..llill:....;;;l.l9:L:l'ILE NO. _~/_t{1_{j.1/r'f REPORT OF INIlElUTANCE TAX APPRAISER I. the undersigned duly appointed Inheritance Tax Appraiser in and for the County of (".I,,,,,, j/;"tI/1/rlJ) Pennsylvania, do respectfully report that I have appraised the renl and pcrsonnl property as reported in the foreguing relurn at the values set forth opposite each item in the last column to the right in Schedules "A". "B", IIC", and HE". Dated: 10-11, VO /iltJ,c_)II'tJ J;AJ/d/JJlJ) INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for County. Pennsylvania. do respeet- rully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater Of lesser amount is set forth in the last column to the right in Schedule uP", which greater or lesser amount represents the sum aUowed as a deduction. Dated: REGISTER OF WILLS INVENTORY Real Property (Schedule A) Personal property (Schedule B) Transfers (Schedule C) Joint-Held property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEOULE F) CLEAR VALUE OF ESTATE VALUE AS REPORTED VALUE AS APPRAISED $ $ VALUE AS REAPPRAISED $ 41 4'-~ - 0 - o 57 JJ4 '0 0,099 55 49,1,34 [j- Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ t= t= t= ESTATE TAX ASSESSMENTS $ FOR USE OF REGISTER ONLY Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Total ESlate COMPUTATION OF TAX :? 2% 6% 5% 10% 15% o $ $ $ $ $ ., " TOTAL TAX $ (0) As evidenced by Charitable Exemption Certificates issued 2,951 09 by the Secrelary of Revenue, o o $ t= Less tax previously paid BALANCE Less 5% of lax if paid within 3 montbs after death $ $ BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Estate tax paid $ BALANCE DUE Add interest at rate of 6% from 10 $ t= ----c $ $ ---L- 1= $ TOTAL TAX BALANCE $ PAID $ FOR lISE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above eomputatioo of tax by the Register of Wills, for proper reason, same should be noted below, with short explanalion. l- ." ..l ~ Z .~ <: .~ 1;1 t.:i .~ III - " - ..-. ~ <: :::: '" ~ " III '" '0 .... - <: " .... "" ~ ~ 0( p.. 0 '" Q p.. ~ !:l c '" <: t.:i c ~ :: i=: l- ~ .... t.:i < p.. .. c:i ~ :I: 0 l- ~ Eo< l- '" 0 " z ~ t:.l oS 0 .... ~ 0 ";j t:.l " c "" ~ ~ III 0 t.:i 0 c :c: ~ 0 g ~ i:- E 0 == E ~ <: ~ '0 :;: "ii is 0 _ '2 ....l u U =..c :::.,-: INFORMATION To insure proper credit 10 your account, the name 01 tho estato and file number should be clearly print- ed on the check or money order. This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485.708). To the extent that inheritance ta,'I( is paid within three (3) months after the death of the decedent, a discount of five (5) percent is ell owed 172 P.S. 9 2485.716). Inheritance Tax, other than tax on 8 future 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 therealt'er (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 deys .00034 12 deys .00203 22 deys .00369 3 deys .00051 13 days .00220 23 days .00386 4 deys .00068 14 days .00237 24 days ,00403 5 deys .00085 1 h days .00250 25 days ,00420 6 deys .00101 1 days .00267 26 deys .00437 7 deys .00118 17 deys .00284 27 days .00454 8 days ,00135 18 deys .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 (50) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estete Tax Act of 1961 (72 P,S. 9 2485.10011. Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: ,;) I _.~. ,,' 3..n DEDUCTIoNS ALLOWED IN Farm RCC.10 J. . , '." " I ,,/ . (, . . , ':'f', ) T"E SUM or... I 'I? 1'1,55"" oATE APPROVEO .. ., (it .;~ ;rIYu ___1;)11.<- _~~ ;/;;tl./u.J tRlgl r 01 Wilh~41 OFFICE 0" TME REGIBTER 01" WILLB STATEMENT OF DEBTS AND DEDUCTIONS o. Cumberland COUNTY AND AGENT 01"' THE COMMONWS"LTH ESTATE OF ;"dith UU>Jierreux CATE or CumberLlncl County (j)c.t ./4' . /q'/J OATE O. OEAT" December d. . lq7q DATE OF FILTNa APPAAlSi'iMENT DATE NO. 01" \lQUeM"" NAME 0' PAYEE REMARKS AMOUNT '-tnd 40 00 '..iestern ;;uret !.dminis tr'-t t rix and Lebanon Valle Br'ethern Halle Nursin' Ham' ershe [o[ectic'l Center Retired Persons Pharmacy Hedication 80 Hdrr G. Trefz Funeral Bill 1 80 Cumberland Law Journal ,\dvertisemen 80 ~':est :jhore Times t.dvertisement of' Letters .'30 Gecelia Gunnett [;drninistratrix Gommissie,n 2 fIlbert 6_ Bo::rert ~':sc uire Counsel Fees File Inheri tCince T<.lX & Final f\ccount 50 00 TUTf',L ~J,G99 55 COMMONWEACTH OF PENNSYLVANIA } /' .;:::' COUNTY OF d~,.J~'A-L~ ,~,.J ,('.<1 .., I, MP.t""P.T.Ta. r.:t1'N>>F.'Pfl ItJY KNOWLEDGE AND aELIE', THE '-OREaOING II A JUST AND TRU r; .rATEMENT ACM.NIITRATION IUBMlnlD TO THE ESTATE 0" F.nT'I'J.t nnOTF.R'aF.tTY INHIRITANCE TAX PURPOIII. HE.REllIY CERTlI"'Y. THAT. TO THE BUT 0' OP' DEBTS. FUNERAL EXPENSED AND EXPENSES 0" ~<I/' .WOIIIN AND W.SCRI8ID ea:erOlu: Mt: THIS .- /. ,., II l.22. .....'- /~.t"- I~,~ . A n y'f) UL~!, V ~ /V . ? DI:CUIID. Yj~v.:Jj . DEDUCTIONI ,..OR (L.I5.) DAY OF' , ~,p,rt~ !-8.('( .~!",;. "'!~r\' P\.~~~' '. M ',(..~;-J "':,. ':,w"l/d,,'H.! .(lI;'..... ~) ':'.. ....:,';: r '\1" ,;f 1.\.J.j. h..)n1yjj/ I I, ..~~~"-7,.,_"",,,_~,_, ,_,,"'--,_~'~"~' ..-. ---r,_.", -- I dl~i~$\r~i~t!Aif(;:;'}G:"!',";\".< 'q . C()MMOr..lWEALTH OF PENNSYLVANIA . .. If, : 4 :ij~K000248~'(; ..... .... . DEPARTMENT OF REVENUE :,... ..... ' , m;'~!.\'.<" ". . ()FFICIAL RECEIPT' PENNSYLVANIA INHERITANCE :AND ESTATE TAX I" .,. I ; I II I ~'" I l I 1 ~ I Ie RECEIVED Albert Z. Bert, .sq. f ~. FROM I ADDRESS 22 B. Main Street i Mechanic.bUI'CI. Pa. 17055 I --- --- I I i , I I TAX AT 6% TAX AT 15% TAXAT_% ESTATE TAX 13.88 TOTAL TAX CREDIT .neSTATEINFORMATION':' D~~--ii---i979 DATE OF DEATH .. FILE NUMBER 2lM80M388 LESS DISCOUNT PLJs. 005SJ,.)INTEREST (FROM gM21M80 To~4-80 DATE OF PAYMENT October 24. 1980 IDJTH DUPlBR1lBUX Cumberland 13.96 m m :.08 . NAME OF OECEDENT COUNTY TOTAL AMOUNT PAID ------- ------- -------------- POSTMARK DATE REMARKS. "PAID III rULL" SEAL RECEIVED BY / / / <' '.(! ( j "',,[1./1'..4../ / M.~~lUIf.-i1 , Rei1ster-oin'il11 t REGISTER OF WILLS -.-.---.---.------------ -,-----------.~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' COUNTY FILE NO: TO: (.1- ('.JJ_Q ; . /l., : ,~ 0JJ {~ ~~- .:;, ,) .J. jtq ~"'''Y''1.-;__{ ./,('., / Appraised Value of Estate: Raal Estate Personal Property ~ I. ,~/:I r:J-f.'J . dll_ 10,ru :::A::. CLlI~/IA~~~Q~~~ COUNTY C I.}^I', a~ 9J_ "J DATEOFDEATH~( ~.' 10' 1)7 '.;~ 1--. >~ , ,., ,. DATE \ f .'1....., I'^^.....II , """'-'~ " I f-;,.I ,r(l't ..... "~. , s + + Jointly Held PropertylTransfers Total Gross Estate Total Approved Deductions Clear Valua of Estate s s Less: Approved Charitable Exemptions s Clear Value of Estate Subject to Tax s s tax due Amount Ta,able @ 6% Rate tax due Amount Ta,able @ '5% Rate 111 . * * 111 111 A five will be granted if the Inheritance Less Credits: DATE OF PAYMENT / 0 , do y. fo s .v'.J:;:vc1 TOTAL PENNSYLVANIA INHERITANCE TAX DUE '1 ,,(. VJ / (j "'-I-'- 'feO ) . (Of) r.'<'i\J percent discounC"'tol Itflg $ Tax is paid by t - AMOUNT PAlO DISCOUNT INTEREST TAX CREDIT $ I ::7 Vv + $ S (,~ = $ I 'I. 4 (" . ~; (.I - + = + = Interest accrues al the rete of six (61 percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid by is ~in( ~'J, '1-A' ~ ~ I I'{, llJ Jk BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE \ / -.- A......d by: See Inlormallon on ReverlO Sida Ag ,.',j., I I 'frth' "-"I~:7t:.. . I '. . ., J t.. -I._,~ ..- . II v.. l.. \',' .._WInI ._.. .. ,""~ .~ -- .. --....,. ~ W --~-~ ..,. J~.~..'~..\~.'~..'.f..~..;\.."!1l.:'~..:;.'\"~,!,~,,;~,'.;;'.;\li.;f:..~.:..i.':..'c..":..'..:'..".C. bM.MONW.. EALTH O. FPENNSYLV.ANIA ". . ',. I ~~~~~~~lflW~d:~f.~iEiPf · ;;.:'~:::;;':',~::~iANCE AND ESTA" t~ " ; II = ij C.oel1e D. ounnatt f'-' ~~g~VED 1" 1 , TAX AT 6% TAX AT 15% TAXAT_% ADDRESS 22 ESTATE TAX TOTALTAX CREDIT ,'.4!lD. 7R 5 ,- - EfT'ATEIN-FCii'IMATiO'N:-----------------------.--- DATE OF DEATH FILE NUMBER 21-80-388 A 11 23 1981 LESS DISCOUNT PLUS % INTEREST IFROM TO_I DATE OF PAYMENT m m TOTAL AMOUNT PAID '1.4~8. 78 NAME OF DECEDENT cullbarlan6 COUNTY L__________________________________________ I POSTMARK DATE REMARKS: ",AIJl 011 MCOUII'!'" ~jJflAd , ~ it ,I, I,,' '. . " . ':f'// n' ;,;,l SIGNATU SEAL RECEIVED BY t ' REGISTER OF WILLS -.----,------.----------.--------.---.- DEBTS AND DEDUCTIONS Date Nama of P'Y08 Naturo of Debt Amount Funural oxpenses paid Fllmil'l exemption (wilt not he allowed unlu5s decodont died residing with 0 parent, spollse or children.) Administration Expenses Counsel Fecs Fiduciary Commission (Other Debls ond Claimsl Total Under penalties of perjury, I declare that I have examined this return, and 10 the besl of mv knowledge and belief, it is true, correct and complete. ~ U' Lv,- y/U....udo-J:/- /3 y;,~ R"/ , 'R ~ignDtu~f ~CiarY , Date ~'-t..tnLt1H 7",/\4. I , - I do hereby certify that I have appraised the ossets contained herein in conformity with Pennsylvania law. s: ",1ii~ via ) Ii}~ #"" J) oJ .1;4 II?! z 0 w Appraiser Date ' !l In the eVent thai ony future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any oJ estate for life or for years, the Commonwealth hereby axpffi5sly f~sC'rV~ the right to appraise and assess transfer inheritance taxes at the lawful collateral C r61e on any such future interest. 0 u: u. d g Debts and deductions arc allowed in the sum of $ at percent. " 0;J ~~' (27, .?J~~ ,~,;?t/;-?I I '9' of Wills Date , BENEFICIARIES BENEFICIARIES AND ADDRESSES (State full names and addresses of all who have an interest eithar yestad, contingent or other Interest) RELATIONSHIP TO DECEOENT SURVIVED DECEOENT STATE YES OR NO AGE OF LIFE TENANTS OR ANNUITANTS AT OEATH OF OECEOENT INTEREST OF BENEFICIARY IN ESTATE c: "0 Cl (") )> m )> ~ )> Cl 0 Cl (J) Cl Z G) (") C Cl -i ;:: .... m Z ~ '"' '"' .... m ^ ::0 ", ~" m -l m Z -l -< (J) m (jj '10 (J) 0 -l 0 ." ::0 ." )> .. Lf~, ~' ,. ::! L.. ct:: 0 0 () <:r. Ie Z ." F_ L' ." :....,: ;::.:rl ii c:. "'" ~~ Clr~. N > ult' 0' r- CI\-- cj~ -< a;:(J, c- ,'" -< C "'" ",,!:? m rn o't; m )> m u'" "'.... )> ~~ - I.l.l=' ::0 ::0 0 50 _,u 2 '-' ~ INFORMATION PLACE FOR FILING _ The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided, TIME FOR FI LING _. The return is due nine months after the decedent's death, unless an extension for filing has been applied for and granted by the Secretary of Revenue within the nine.month period, 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 tl1e tax ultimately found 10 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 law," ~ ~ ~ ~ \0 Z ~ ~ 0 >- ~ rn ~ ;:l ..:I .-< 0( '" - G> U Z ~ r-I r-I r-I - r-I C'- I ~ sa Il ~ ~ ~ :0: U I 0 0 ~ ~ I ~ t:; 0 '" 0 Z 0 I - ~ Vl >- !-< 0 I Z ~ ~ !-< ~ Z z I :l 0 - 0 Z ~ ~ Z " Z !-< 0 ~ U ~ ~ ,. ~ Z , - Vl ~ 0 0 , ~ - I ~ u 0 p.. ..:I . INFORMATION To insure proper credit 10 your account, thu Ilame of the cstata nnd file number should be clearly prInt- ed on the check or money order, This assessment is made in accordanco w'lth Section 70B of the Inheritance and Estato Tax Act of 1961 (72 P.S. ~ 2485.708). To the extent that inheritance tBK is paid within throo (3) months after the death of the decedent, a discount of five (5) percent is allowed (72 P.S. ~ 2485.716). Inheritance Tax, other than tax on a future interest, is due at tho date of the decedent's death and becomes delinquent at the expiretion of nine (9) months efter the decedent's death (72 P.S. ~ 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 lnlerest 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 deys .00203 22 days .00369 3 days .00051 13 days .00220 23 days ,00386 4 days ,00068 14 days .00237 24 days .00403 5 days .00085 15 days .00250 25 deys ,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 deys ,00471 9 days .00152 19 days .00318 29 deys .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 a5 provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. ~ 2485-1001). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: INFORMATION To insure proper credit to your account, the nomo of the estate and file number should bo clearly print. ed on the check or money order. This assessment is made in accordance with Section 708 of tho Inheritance and Estate Tax Act of 1961 172 P.S. 9 2485- 708). To the oxtent that inheritance lax is paid within three (3) months after the death of the decedent. a discount of five (5) percent is allowed 172 P.S. 9 2485-7161. Inheritance Tax, other than tax on a future interest, is due at tho date of the decedent's death and becomes delinquent at the okpiration of nine (9) months aher the decedent's death (72 P,S. S 2485.711). Inheritance Tax on a future interast is payable within three (3) momhs 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 to 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 days .00386 4 days .00088 14 days .00237 24 days .00403 5 days .00085 15 days .00250 25 day. .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 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 (60) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 172 P.S. ~ 2485-' 001). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: REV-~17 (6-781 . COMMONWEA~TH OF PENNSY~VANIA DEPARTMENT OF REVENUE BU,REAU OF FIE~O OPERATIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT ,,;{ /-, () ---,,jAr APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: "', Application is hereby mode for consent to the Ironsfer 01 the following securilies of 0 Pennsylvania Corpor6t,ion or 0 Notional Bonking Association located in Pennsylvania: (0) Up (b) PPG Induatrie., Inc. ____,____,,_h_(C)~~~ (NOTE: \, In describing securities enter in (0). ab Clie, either Ihe number of shores 01 stock or the face amount of registered bonds, in (b), the nome of the issuing company ond in (c) the c/ass of stock or the stated interest rate and maluri,ty dote of registered bonds.) .;,' 'I. ISSUED,ION, ( lJuly 22, 1977, and having 0 TOTAL MARKET VAtUE OF sJl.!~~h,~LI )l '. '\ (0.'0) ,[ os O/he dote of death of the decedent Edith Dupierreux on nee 2l't7.9 f \' -'. '" (Namt! of Do cedent) (Dale of d ath) \ ' ' l\l~was late of .09 Filbert St.: Mechan1c~burg, CUmb8r;_~d_ __,____m PA -+- .,', ",' (Street and Number) (Post Office) (County) (Slo\ef\' .t." I \ .(. ',' )' \ . 't,Hff:~,;~~urit.ie~,', ~re registered os follows: Edit1\. ~pj.en'e..\!;!!;_ ,___,__m"____ \.' .,~,;>.~~\~., ..,~,: I' ' (Nome or names In which certificates ora rogistered) \. ADMINISTRAirOR) Cecelia D. Gunnett 409 Filbert St Mechanic.burg, PA '(,j' U"I(Ia~) (Name) .-------(Address) \fj", NAME OF APPLlCANT~.c.l:l,~__~~, G~_~t;~ , DATEZ~al;Zf;J~!.f&1 ;~:', \,;' ", , COUNTY FILE NUMBER 21-80-388 ADDRESS OF APPLlCANT.l!_Q~ N.!.-l'ilbert SI;.. ",\ " ' ", ' MeClian1caburg, pATlOS.5 . 1\\ BI,lREAU FILE NUMBER SIGNA TUR E OF APPLICANT __m__u_____:, \ NonCE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE'f:" " . ",'" CONSIDERED COMPLETE AND WILL BE RETURNED TO,YOU FOR COMPLETION.->',".: I COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE " l CONSENT TO TRANSFER SECURITIES DATEOd. /~ /1/1 I hereby consent to the transfer of the above secudties now registered in the nome of the afaresa~d , ,1. De~edent and waive the filing of 0 certificate certifying to the payment of the Iransler inheritance tax Ip;whic~i . / it / the property of said Decedent is mode subject pursuant to the provisions of Ihe Act of June 20, 1919, P:.~. 521, . , ,I; : os amended and the Act of June 15, 1961, P.L. 373, as amended. This is 0150 in occordance wilh Ihe !piovislons of the Act of April 9, 1929, P.L. 343. This Consent to Transfer the herein described property operates only in reference to the estate of the above.named Decedent, ~l.. 'H'!~ j........; cr.' ... ,CIUI~, l' t/~". \4~~~t';~_ Signed"lo,rr~ h,~eS,e,c, retar,y ,of~,eve ue By _!:i!//d/t. ,({lor: L ) eUJ /) 15ign 0) /), I I. X:{;5f'.-iH~ !'vl Uk,(~l~U{I1;~;,d-- I'(rf) c) (County) , ~