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COMMONWEALTH OF PENNSYLVANIA 'L
COUNTY OF CUMBERLAND J
55:
William M. Bridge, Asst~!i!!.lLI!'UsLOf.ttcer,_llau!lhin D_eposit Bank and Trust Company___
being duly sworn ,____ according to law. deposes and says that he -.is .--
Executor u_,,___,__._ 01 tho Estate 01 Louise E. Stine
late olllQr!'-uglLoLCar)Jsle---,----. Cumberland County, Pa" deceased and that the
within is an inventory made by ..hilT!___________________. the said Executor
01 the entire est.te of said decedent. consisting 01 all the personal prop.rty and real estate. except real estate outside
the Commonwealth 01 Pennsylvania. and that the ligures opposite each ilom 01 the Inventory represent it's lair value
as of the date of decedent's death,
and subscribed before me,
,
;?1(!'1"~.'_/./""
,(,TA 19Jo
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Nolllry Puh:ic, l>1Ikll, :'J.11!,.'. ' ,;c,
Mv CO'n"'''o~',,''
1~'~'~
Date of Death
2nd
Oay
Dauphin Deposit Bank and Trust Company
/I / o'? ' 11, /1, "
Bv: if., Ll,~I<I"~ //j !;/I,'-' ('-//
eXleutor . ~1G1OY<ll~ Assistant Trust OIl1esl
2 West High Street
Carlisle, Penna. 17013
Addre"
June
1980
Month
Vear
INSTRUCTIONS
I, An inventory must be Iiled within three months after appointment 01 personal repre,entative,
2, A supplement inventory mu,t be Iiled within thirty days 01 discovery 01 additional assets,
3, Additional sheets may be attached as to personalty or realty
4, See Article IV. Fiduciaries Act 01 1949.
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RCC.33 14.731
COMMON\\'EALTII OF I'ENNSYL VANIA
IlEI'AlnMENT OF REVENUE
1l~,m~~'I~FrlltJ~rrv COLLECTIONS
*
//-/O-J'O
';;j-J? - ~ f
RESIDENT DECEDENT
'SO 1')nV.' iI
"
COUNTY OF Cumberland
IMPORTANT,
This It'turn tllll"l hc l:oll1\1I,\~~cll. ~ll l.lS,tJ,q ,lllld fLIed in,dupltl:lllt.', wilh 1I1l1t11l1t.~hcd, with the I(egister of Wills of the
t'lIlllltr \~hl'll' dCl.'I'dellt 1~~iil~'I\;'kctllrll iM 11m' wlthillllllle Hlllllths lifter dale of dl~Ulh, unless 111\ eXlcnsiun is grllntcd
hy llw SI'UCI;UY Ill' I(c'H'll11i~, (SI.~tlUil 70,1 uf the Inhcritlll\l.'C nut! Estllte Tux Actur 1%1.)
--=~
..-.-- .-
I~ IIIF\lATII'1! III, '1111' I'SlA'II,III' } ,IFFJIlAVII III'
.. _ __,_~_ouise_ E,_"~~!ne ____,______' ,____.__ ,__ I,XECI'rlll!
I' r^T[ rUl L Nfd,1{ :Jl [JEU-Dl:::NTI
La" of _cul)1~~rlancl______,_ Counly *x'il'AAt~xl!J\ll'~Jl
SI.I. .1 Pe!m~YJvani{l______ '"}
55:
C.un'y of _,C~mberJand-- __ _ ,__,_______ COmpany
, ' WUliam_M.,Br.idge.,--AssJs.tartt_Ir:uS,LQff.U;,e.r...~Qhin.lleposit Bank & Trust Executor
AX~)(,1Ot~lXX of tllO eslulu of .he obove.nllmed decedent being duly s.worn, depose and say I
Dccl'Jcnl clll'lt Jun~_____._~__. 1980_{lellatll luavlng a 10s.I will, copy 01 which Is hereto attached,,}
(MONTHl (Dr,y) (YEAR) irK~~
Nnllleul'lIluddrtBOfntlornt!"f or } Harold S. Irwin. Jr.
olher oulhollled rnprI'Slllllull\'{' to whom
,II ,"""pood,"," ,1"",1,' ..!L4_5...JJannw>.. ~t..!'!'t, CarlisI!'. PA 17013
Thill il:. slldL~Executor.__dcpnIlCJ1t is familiar with the i,rfairs of said estatl.: and the property cunstituting
I I: x F c: IJ TO fl- ADMINI ~T R II TO r~)
the ussets thereof i111d tl\l:ir fair market vallie.
That [ltthe timl.: lJf dcath then: was no safc depusit box registered in decedent's individual name, or jointly wilh, ur
as agent or deputy of another, or in decedent's individualnamc, with right of access by anolher as agent or deputy, with the
exception of the following: -
NAME ;.tHl AnDf~l:::SS OF 8ANI', OR OTHER INSTITUTION
H~ WHICH DECLDE"NT RENTE:LJ A S,~FE DEPOSIT BOX
----"----=---_.-
THIS SAFE OEPOS11 BOX RENTED
IN NAME OR NA~_ES OF
RELATIONSHIP OF JOINT
HOLOERS TO DECEDENT
NonlL-
That the contents of said safe deposit hox or boxes arc itemized under Schedules --- of this return,
with the exception-of the following, for the reasons hereinafter sel forth:
ThaI SeI,edule A a([ached heretn and made pari hereof sets forlh fully and in del,11 ,II the real property
in the Commonwealth of PCTlllsylvunia of which decedent died having an interest therein. (t also sets forth the
mortgage cncumbr:1I1CeS upon each parcel of real property at the datc of death, giving the amounl sti,t1 due at
death, name of mongage!.:, datc, rate of intercst, and book nud page of record thereof. It also Scts forth in the
colullIlls provioed therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent.
ThaI Schedule B :lttached hcretn and made part hercof sets forth fully and in detail all personal properly
whereso\'er situated owned by the decedent at the time of death: all moneys left by thc decedent at the time of
death, whether in decedent's immediale possession, standing to decedent's credit in banks of deposit, su\'ings
hanks, trust COr.1PUllil':i, or other institutiolls, whetlll::r individually, or in trust fur any other person or persons
giving also separalely the accrued interest thereon, if any, down to the last interest day prior to decedent's
death in the casc of sayings hanks, and to. the dale of decedent's death in all other cases; all hOllds, postal
savings, treasury l:crtifil..:ates or noles and oth~r ~vidl'nce of indebtedness of tIll: Ullited States to the de-
ccd~nt: all ohligations, whether :hy statute or agreemcnt they arc designated as tax free, of thc United Stales,
or any state, or Jlolitical l'iubdi\"isillll thereo!', or of an)' foreign country, which are owned at the time of death;
,d: ,', \..11 ill~ apJl,n I,.: I .11;'\\ L' il). :o,i 1\-L;fWarC, pictures, hooks, works of art, household furniturc, horses, c3lriugcs,
automobile!', boats, and :lny and all tither personal chattels of whatsoever. kind or nature, lel't by decedent,
together with the fairly estimated market value thercof: all hOllds and mortgagcs held by decedcnt and of all
claims du~ and owing decedellt at thc linlL' of death, ,Iud :lil promissory notes or other instruments in writing
em the payment Ill' l11tllley of which (Icct:dcllt died pOl'isesscd, of whatsocver nature, with interest thcrcon, if
any, giving the fal.:c \'all1l' all(1 estimated fair market value therc.:nt', and if such es1inmtcd fair llliukct value he
less thlln the ral.:l' \:lIUl'. il :o,ets fOrlh briefly till' reasons for slIch depreciation as to each item; all moneys
payable tll the estale from life insurance policies carried hy del,;edenl; all annuity and cndowment l,;ontracts
the prlll:eeds HI' which \\'I.'~ :,ayahle UpOIl lhc death of the decedent; all and thc corporate stocks and dividends
due thereon and unpaill ;IS 'J!" 11 d:lk of dt:alh. honds and al.:crucd intercst thereon to the Jatc or decedent's
death ,llld othcr ill\TSltllL'l\1 ',i ,:c; I)\\lll~d hy Ihe Jecedcnl at the time of death. wilh the market value there-
of ilt slIdllimc.
In the cnse of securities of close or fwnily corporations, the vnlllos rnportori lire as far n8
possible 8ubstantillteci by financial statements of the corporations, showing the !lSBet.s and liabilities
thereof flS of the dnte of death. The schedule also sets forth t.he int.erest of rlecelhmt at the time of
death in all)' co-partnership 01' business, and in support of the value of such 1nterest there is unnexed to
said schedule, financial statements showing the assets and liabIlities of' Hair! co..partnership or Quslncss.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nnture of' th.e tlgreement)
together with n statement setting forth the character of the business, its location, Ilncl s1Ich other facts
pertaining to the business as may bc pertinent to a fair anll .lllst nppralsul of the decerientl s interest
therein mllst be sllbmlttod. It should also set forth in itemized fOI'fIl, together with the fair market value
thereof, any other propert)' owned or bequenthed by the decedent a t the time of dent.h.
The Sch~dlJl~ C attached hereto and made part hereof sets forth it t.rue answer to each inquiry
contained therein and in the case of transfers of property, real or personnl, within two years of decedentt s
death, in contemplation of decedent's death, or intended to take effect 1n possession or enjoyment at or
after death, said schedule sets forth the nature and value of such propert)', to whom trnnsferred, the
relationship of 'the transferees to the decedent, the proportionate share recciver! by ench transferee and
all other facts of a pertinent nature regarding said transfers. In the case of trnnsfers intended' to
take effect in possession or enjoyment at or after death, there is also attached to the schedule a cony
of the deed, trust agreement or other instrument creating the trust, Thert~ is also set forth in said
schedule a list of all p\'operty, real and personal, with its value, which pfl~ses at decedent's death by
virtue of the exercise by decedent, either individually, 01' jointly with another', 01' an~' power of appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another,
with a COllY of the instrument creating such power attached t'o the schedule.
That Sch~dlJl~ 0 attached hereto and made part hereof sets forth the nnme's' nnn addresses of nIl
persons beneficially interested in this estate at the time of decedent's neath, the nature of their res-
pective interests, their relationship, if any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants anel beneficiaries for life unrlcr decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, lUlCI the relationship of snch issue to the beneficiary.
That SchedlJl~ E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with, another 01' others, incluriing intangible, standing:in the name
of the decedent and others, plus the date and place of record of instrmnents effecting the vest1ture of
real estate and the date of acquisition of personalty, plus the nnme, adrlrcss nnd relationship, if any,
of co-owners to the deceden t.
That Sc/l~dlJl~ F attached hereto and made a pnrt hereof sets forth fully and in detail 811 debts
and deductions claime~. for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
giousservices, in consequence of the death of the decedent; debts and claims owing nnr!. unpaid at time of
death; taxes accrued chargeable for period prior to decedent's {lenth (except those allowed \lnr!.er Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral plcdger!. for obliga-
tions, if any. It is agreed that the fiduciary will present proof of sllid clnimed obligations upon re-
quest, that if the amount actunll)' paid in settlement of any fee, commission or rleht is less than the
estimatcrl amount claiming Imd allowed, that the same will he reported to the Register 01' Wills, and that
the amount of tax assessed can be reasscssed in accordflnce therewith.
That t.he totals of the appropriate columns in Schedules "A", "B", "C", "E", nnll "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this ,..........,.........,..........Dauphin Depos~t Ba",k ,and)~ust/7ompany
..,............t:.t:L...': "','" day of 7k.'JM7d~~....., 199~.:..,BY;Z~~g~~~~~~:'=stf:iiniijSl"Ome~r
.,........,..."....,",(:J//j/.J,"'~~"")"" ,,'''' ..', ..'""""...."", ,,2~~~trJ;;~;;Jr;;;~;r.......'......,....,..,...,..,..,...._'
Carlisle, PA 17013
....(citii';;;;"T~;;;;:;'~;;ds;;;t;;)
r~('I,::IY i'u~tic, L~(ii!;IE, l.:umborrand co.
t'\' r\"~'n1;,:,v:~ :)':jt~" t'~br'::1-V ~3, 1933
NOTE: Befol'e signing affidavit make sure nIl blank spllces in the flf'fidavit llnrt schedules nnnexed nr~
filled in with details or the worrl "None", nnrt in case thc ussets include rure RnfI unlistert securities,
securities of close or family corporllUons or nn interest in Im~' co-partnership 01' business, thnt the
data nnll stfltements requiret! under the paragraph allove relntinp; to Schedule "0" Ilre attached. .\lso make
certain that column #1 in the "SuflI1Ill.ry" has been properly complet~rl AS ll11ove-dJ rected.
flU: c..J4 t 4-731
COMMONWEALTH 01' PENNSYLVANIA
DePARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECI!DENT
OJ.'
*'
SCHEDULE "A"
REAL PROPERTY
Real property in Pennsylvania, with statement of marlgage encumbrances upon each parcel at death 01 dece.
dent, Property held by the decedent as tenant in common with another or other, should be identified
as to quantum 01 interest and the estimated value should be that 01 the decedent's interest only, (Property
held as ioint tenants with right of surviarship or tenancy by entireties should be reported on Schedule "E,")
The real property located In the Comma,.wealth of Pennsylvania .hauld be (1) (2) (31
ducrlbed by lat,and block number, street and .treot number, together with DEPARTMENT
o general ducrlptlan of the property. with a r.ference to the r.cord of the ASSESSED VALUE VALUA TlON
conveyance by which the decedent took title; If 0 form .tote number of o. FOR YEAR OF ESTIMA TED CAUTION
cru; 01.0 .tatemant of mortgage encumbrancu upon each parcel at death DECEDENT'S MARKET VALUE (Do not writ.
of decodent. To):.., OIlOllment., accrued In'er..t on mortgogel, etc..ar. DEATN In Ihl. .poc.)
to be lI,ted on Sch.dule llF" and must not b. deducted from thl. .chedulo.
NONE -0-
,
Insert this total apposite "real property". Schedule" A" in the X X X X X
"As Reported" column an the last page 01 this return.
o
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,
-~
\WA'
REV-452 (8-78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "C"
TRAI\1SFERS
RESIDENT DECEDENT
11)
(2)
i
13)
Did decedent, within two years of death, mako any transfer of llny material part of his estate, without receiving a valuable and
adequate consideration therefor? (Answer yes or no) no
Did decedent, within two years of death, transfer property from himself to himself and another or others (Including a .pou,e)
in joint ownership? (en,wer yes or nol no
IF the answerto 11) or (2) above is in the affirmative ,tate:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the transfer, (Nole 1).
(c) Causa of decedent's death. (Note 1),
Did decedent, in his Jifetime, make any transfer of property without ruceiving a valuable or adequate consideration therefor
which was to take effect in possession or enjoyment at or after his death? (Answer yes or no) RO
(a) Wa, there any possibility that the property transferred might return to tran,ferer or hi, e'tate or be subject to hi,
powa, of disposition? (Answer yes or no)
(b) What was the transferee's age at time of decedent's "eath?
Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which
transferor expressly or impliedly reserves for his life or any period which does not in fact end before hi, death:
(a) The possession or enjoyment of or the right to income from the property transferred? (Answer ye, or no) no
(b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer yes or no) no
If ihe answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others
(4)
(5)
(6)
(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 care of transferor? (AnlWer yes or no) no
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a relerved
power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law?
(Answer yes or no) no
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the interest of the baneficiary re,erved
in the decedent alone o. the decedent and others? (Answer yes or no)
NOTE 1: The an.wers to these questions should be supported by affidavit by the attending physician as well as a copy of the death
certificate.
NOTe 2: If answer to any of the above questions is yes, set forth below a description of tile property transferred, It's fair market
value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit
copy of any tru~ deed or instrument, if transfers are claimed to be non-taxable, also submit detailed statement of facts on which
said claim is based.
NOTE 3: List appliceble property below in manner in which provided in Schedule, A, B, or E.
MARKET VALUE
(Estimated)
ITEM
DESCRI PT' ON
DEPT, VALUATION
(Dept, Only)
NONE
-0-
Insert thi, total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
N..'-Iu_.....
4\ifC.
REV';4i53111-1111
'~~
~.lf'~,'~
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".[I~I~~iif1tl'\.l'" ...
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COMMONWEALTII 01' PENNSYLVANIA
TRANSFER INIIEllITANCE TAX
IlFSIDENT IlECEIJENT
SCHEDULE "n"
B1'NEFlCIAIUI'S
-- - -- -
BENEFICIAllIES ANIl AIl\lRFSSES RELATlONSIIIP
(SUItC rult nllmC!i Illld ullllres!iCS ot' all wliu or ~Iep.cl\ildron or SlJRI'II'I':1l \lATI', INTEllEST 01'
have nn intCresl, vested, enlllifl~Cl1t or othcr- illcgitil1\l1te children \lECE\lENT 01' BENEFICIARY
wiNc, in CHIlIIC) llft: involved. set STATE YI','; BlIfI'lI IN ESTATE
rorth this rliet.) OIl NO
Lawrence W. Stine Brother yes lenal 1/2 of Residue
28878 West Worcester Road -
Sun Citv. Cal if. 92381
Rose M, Alvarez --- v..~ l..nol 1/4~sidu!'
23 Snllth ,,- "'.nli n..iv..
-
Po'n~ P...~ '11 ~nA~4
-
Marv Sweitzer Cousin yes 1 eaa 1 1/8 of Residue
R1~ - _L
Vn..~ PA 174n~
Fa i rv Hunt --- v..~ , ..no 1 1/8 of Residue
~~? 1.Ii"' On.1i
Vnrk PA 174M
,
,
,
"
--
Deponent further says that all the above-named beneficiaries arc living at thi 5 time except below:
NAME
DATE OF DEATH
RESIDENCE
NONE
--
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Form RC C .10
DEDUCTIONS AL.L.OWEO IN
~!"hi" $1-0'/
STATEMENT OF DEBTS
'REcnBlJF.n (,." '
AND '[Q~oUCTioNS
OI"FICE 01" THE
REGIBTER 01" WIl.LI
OF Cumberl and caUNTV
AND AGENT 01" THE COMMONweALTH
'80 NDV 10 1':.':1
ESTATE OF louis!' E. St.ine r.1 '-Ro...,fl"b'~MBorouQh of Carlisle
CUI'IPEr;\ t,~l" i I:, '
CATE OF F,C'NO AP..A'UMSNT /.. /J.. PI '_...~~~.. a. cEATH June 2. 1980
CAT!
NO. 0,.
VOUCHS'1Il
NAME OF PAYEE
REMARK.
19BO
June 19
19
Cumberland Law Journal
Re9ister of Wills
H ffman - Roth Funeral Home
Funeral Ex enses
Professional Services Rendered
Dru s
Institutional Care
Final Bill
Final Bill
Estate Notice
m wood Retirement Center
M G M Phannac
Homewood Retirement Center
i
Sentinel
Belvedere Medical Cor . Professional Services Rendered
M morial Service Cuttin
Reserve for Pa ent of the Follo n
Re ister of Wills
Recordin9 Inventory, Debts &
Deductions, & Filin Account
Affi davits
Executor's Fee
Attorne 's Fee
Co.
Jr
I AMOUNT
18 00
33 00
2,406 00
3 BO
8 91
66 95
26 B6
20 95
1B 00
107 40
80 00
75 00
10 00
1,513 00
1,513 00
5 900 87
COMMONWEAL.TH OF PENNSYL.VANIA }
COUNTY OF Cumh!'rland II' Dauphin Deposit Bank and Trust Company
I. William M. Bridqe, Assistant lrust Officer,
HP;:;Y CIRTIn'. THAT. 101M: n.' 01"
NY KNOWL.IDQI AND .EL.IEI". THE ,ORIGOING II A JUIT AND TftU I: .rATININT OF DI.T,. I"UNIRAI. IXPIHIItI A.ND O::"INIO 0"
AOMINI8TRATION IUII",I"ID TO THIIIITATI 0' I nuic;,p, F'. Stina 0 .....
IC 10. AI DEDUCTIONS I"OR
INHIRITANCE TAX '1.111I"0111. !
.. " /"'; /
/(/ ,._'(.1....._.;1, I,
,L...,,:.
v /~
I '
IWORN AND IU..CRI..D .II"ORE M. THII U....CX DAY or
-/;-.", ...",::; '" ~
'l/J /-1 (,.y l'~"."/''''
';','i',.
P" ,- ~'.'.
, ..__':":\'~ rJ,,~;", ..3.13,;3
(I.. I.'
INFORMATION
To insure proper credit to your account, the name of the estate 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, ~ 2485.708),
To the extent that inheritance tax is paid within three (3) months after the death of the decedent, a
discount of five (51 percent is allowed 172 P,S, ~ 2485-716),
Inheritance Tax, other than tax on a 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 fliture interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafier (72 P.S. Ii 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
------------ --------- - ---...----- --- ---- ------ --- - - --- - --- -------- -- -- - - - -- --
1 month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
1 days ,00017 11 days ,00186 21 days ,00352
2 days ,00034 12 days ,00203 22 days ,00369
3 days ,00051 13 days ,00220 23 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 1 8 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 (601 days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P,S, ~ 2485-1001 I,
Make check or money order payable to:
"Register of Wills, Agent'"
Mail to the address listed below:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
, BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
~-
~
,......
,Ccy
ESTATE
1/. 19;:(/
)i;,,,,,
FILE NO, .;:z J - X' () .. (10 L/
COUNTY CA~W j
\\, J "-
OATE OF DEATH JVv"d;;; I C) X'O
\ \
, }GVV1
/ '. E.
-.- '
C;l'III-M.A.o Ii.
COUNTY FILE NO: 0( I - :r 6 - LI () tj
ro'~1 J B,,,,,,,, t-
1/-4 <tJCWI"~ JsJ
UA0 do... 0 I ? 0 I. ~
DATE
i\ppralsed Value of Estate:
Real Estate
$
+
Personal Property
+
Jointly Held PropertylTransfers
$
TOlll1 Gross Estate
Total i\pprovad Deductions
$
Clear Value of Estate
Less: Approved Charitable Exemptions
$
Clear Value of Estate Subject to Tax
, Amount Taxable @ 6% Rate
$
tax due
$
tax due
.301b 9~ ~
LJ/. f,.l. .
-
'3 &58 b/
Amount Taxable @ '5% Rate
******
/ _\ TDT~ PE~SYLVANIA INHERI1ANCE TAX DUE )$
l -'v't\I.",~y-,\!fl.v"W .3- ~ X I II) 5_ /J'-~I
r (,01/5).') ,
A five percent discount totalirTd' $
Inheritance Tax is paid by
will be granted if the
Less Credits:
DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
5 - 11- f(/ $ 3~J ~ 'itJ + $ .. sL//,{,.;? = $ 3Cos&' , U
;. '.
+ =
+
=
, :
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
$ t:J0w '::) ~ J~
",/> '
,;- A r~J
/
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
See Information on Rellerse Side
':l.Li~. ,y \ ,II '.
INFORMATION
To insure proper credit 10 your account, tho nome of tho estate and file number should be clearly print.
ad on tho check or money order.
This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of
1961 172 P,S, 9 2465,7061,
To the extent that inhoritance tax is paid within three (3J months after the death of the decedent, 8
discount of five 15) percent is allowed (72 P,S, 9 2465.7161,
Inheritance Tax, other than tax on a 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. S 2485.711). Inheritance
Tax on a future interest is payable within three (31 months after the transfer takes effect in possession and
onjoyment and is delinquent thereaher (72 P.S. 9 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
--------------------- ------ --- - --- ---- ------ --- - - --- - --- -------- -- -- - - - -- --
1 month ,005 4 months ,020 7 months ,035 10 months ,050
2 months ,010 5 months ,025 8 months ,040 11 months ,055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
1 days ,00017 11 days ,00186 21 days ,00352
2 days ,00034 12 days ,00203 22 days ,00369
3 deys ,00051 13 days ,00220 23 days .00386
4 deys ,00066 14 days ,00237 24 days ,00403
5 days ,00085 15 days ,00250 25 days ,00420
6 days ,00101 '6 days ,00267 26 days ,00437
7 days ,00118 17 days ,00284 27 deys ,00454
8 deys ,00135 16 days ,00301 28 days ,00471
9 days ,00152 19 days ,00316 29 days ,00488
10 deys ,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 (601 days alter receipt of this Notice as provided by Section
1001 of tha Inheritance andEstate 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:
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FIRST AND FINAL ACCOUNT OF
DAUPHIN DEPOSIT BANK AND TRUST COMPANY
EXECUTOR OF THE ESTATE OF
LOUISE E. STINE
LATE OF THE BOROUGH OF CARLISLE
CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED
PRINCIPAL RECEIPTS
The Accountant charges itself with the
Inventory and Appraisement as filed
Also With the Following:
$ 30,269.20
1980
DeC:--I0 Received from the Commonwealth of Pennsylvania -
1979 Inflation Dividend Check
TOTAL PRINCIPAL RECEIPTS
95.00
$ 30.364.20
PRINCIPAL DISBURSEMENTS
1980
Ju~19 Cumberland Law Journal - Cost of Advertising and
Proof of Publication $ 18.00
19 Register of Wills - Cost of Probating Will and
4 Short Certificates \ 33.00
30 Hoffman - Roth Funeral Home, Inc. -
Funeral Expenses 2,406.00
July 2 Carlisle Hospital - Lab Fees 3.80
2 MGM Phannacy - Drugs 8.91
2 Homewood Retirement Center - Institutional Care 66.95
l. ~~\ ~;'J i"'.l.lt 69
-2-
1980
Ju'1'Y""" 7 MGM Pharmacy - Drugs 26.86
7 Homewood Retirement Center - Final Bill for June Medical Supplies 20.95
14 Cumberland Publishers, Inc. - Cost of Advertising and
Proof of Publication 18.00
16 8elvedere Medical Corp. - Professional ServIces 107.40
Sept. 9 Carlisle Memorial Services, Inc. - Cut Inscription on Memorial 80.00
, Nov. 6 Register of Wills - Cost of Filing Inventory and RCC 9.00
May 7 Register of Wills - Balance due on Pennsylvania Inheritance Tax 3,616.99
Reserve to Pay for the Following:
Dauphin Deposit Bank and Trust Company - Executor's Fee
Harold S. IrwIn, Jr. - Attorney's Fee
Recordi ng Fees
TOTAL PRINCIPAL DISBURSEMENTS
1,513.00
1,513.00
85.00
$ 9.526.86
INCOME RECEIPTS
1980
Ju'1'Y""" 1 Income from Louise E. Stine, Power of Attorney
Account from 6-2-80 to 7-1-80
Earnings: U.S. Treasury Daily Repurchase Agreement
~~OO $
8-4-80
9-2-80
10-1-80
11-3-80
12-1-80
1-2-81
2-2-81
3-1-81
4-1-81
5-1-81
TOTAL INCOME RECEIPTS
$
146.94
64.58
165.81
, 179.80
207.30
255.64
276.29
339.05
374.53
336.00
352.91
311.51
2.863.42
$ 3.010.36
INCOME DIS8URSEMENTS
1981
Aprrr-10 Internal Revenue Service - 1980 Fiduciary Income Tax
10 Pennsylvania Department of Revenue - 1980
Fiduciary Income Tax
$
133.00
34.00
','U
i. '.,,", u',~ i',.j!
-3-
1981
May 7 Register of Wills - Interest due on Pennsylvania
Inheritance Tax $ 41.62
Dauphin Deposit Bank and Trust Company - Commission
on Income (5% of $3,010.36) 150.52
Dauphin Deposit Bank and Trust Company - Service
Charge for Preparation of 1980 and 1981
Income Tax Return 50.00
TOTAL INCOME DISBURSEMENTS $ 409.14
5 U M MAR Y
TOTAL PRINCIPAL RECEIPTS
TOTAL PRINCIPAL DISBURSEMENTS
TOTAL INCOME RECEIPTS
TOTAL INCOME DISBURSEMENTS
$ 30,364.20
9,526.86
3,010.36
409.14
$ 20,837.34
2.601.22
$ 23.438.56
RECONCILIATION ACCOUNT
Balance as per First and Final Account
Less Advanced Distribution:
$ 23,438.56
1980
Ju~14 Lawrence W. Stine - Cash distribution of unearned
premiums from World Mutual Health and Accident
Insurance Company of Pennsylvania
BALANCE FOR DISTRIBUTION
53.36
$ 23.385.20
Balance Consists of the Following:
CASH: Principal
Income
$ 20,783.98
2.601.22
} 23,385.20
Exhibited into the Office of the Register of Wills in and for the County of
Cumberland this/""l~day of ):>;<1,/ ' 1981, by
Dauphin Deposit Bank and Trust Company, Executor
of the Estate of Louise E. Stine
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Y. \ /t.::.'" /" 'c' (,. " .'
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Assistant Trust Officer
-4-