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Home My WebLink About80-00442 . ~ .~ j:\ ..~ ~ 0 !>1 ~ , I , ell " III ~ , p., ~ H 0 1i3 tJ r.-;: ~ ::0: 0 !i ~ .:z:: 0 ~ E-o , . :xl r.<I 0 ~ ~ , ~ , 0 I-) ::0: CIl '.0' 00 ""'" I 0 .- M ~ .. ~' . JJ \0 ..0 Z 1ft LLI NO. 21.80 PETITION FOR LETTERS OF ADMINISTRATION IN TIm ESTATE OF ...........~9.I:l~..,ll"....I.lq.~'r,9N.......................... DECEASED. MARY C. LEWIS To .............................................................................................................................. .... ,', Hegister of Wills fOl' the Coullt). of CUlllhel'iand, ill the COl1llll01lll'eait h of l'elllls,\'ll'allia. The Pet i tioll 0 f ,......,. g~9h\l.r.~... fl.,." ).I.l? !:'tl? !!,..................,...,.....,................,......,..,...................."..........,..,',.., ...................................... ,. ..........,....." respect full,\' sh"lI'el h thai . ..... .~.l?,!).~..).I. ,....I.!l?F..tl?.I:1...... ........., ,............... .., WIIS a resident of ..............M.'?P..r.l?~.............................~~ . CUlllhel'ialld Coullt,\'. State of Pellllsyl- vania. and a Citizen of United States. and departed Ihis life intestale ia the COUllt). of ..P,~~!J?hJ.p.......... ............ .......... .................. and S ta t e 0 I' ,.,....,.. .t~~n..'.~!':;i}, X.a, !I,i. ~...,.................................................................. ,.......... on ....$.f!t\!!:'.\!f!y................ the .............,Ul'l.1:................ da,\' of .........Jun~............................... A. D.. 1!1..~.Q..... at the age of ....3.1....... ,\'ell1's. That the said ..............J.'?h!'.\..H.,...Hl?F..tl?.\L........................... deceased. left survivillg the following named widow 0" husband. heir's and next to kill. to wit: .,...,......."..,.,..,...,.,..,.....,.,....,',..,.,"""'"," ,.".."..,."...""...".""""..,",.., Father Hesidence 17503 Plaza Dolores .~.~n....!H.~~.?"...~f!.+.g.l?F..~!,.\l...~.?J.?8 same as above 'li'2'6"'i,i':"'Hi.iIs'iiche"Stree't~""iip't. 5 .~ .9.\l..lI\l.1:.9.P':i,R.... .1'.'i!.l\il.s..... 7. 8.212... Name Richard L. Horton Relationship ......... J.1il\l!i!.h ...1:.. .liR.r.J;9.0......... .......... .........l;'!gt.~.f!\'\1...!}.,..JI.'?F.tl?f!............... ..........,~.'?.th.l?,F.................... ...,.....J~F..'?t!).l?F........"........ ."...,.....,.,..,.."......,.........,......".....,"",..,... ",.""""...",....""""",.,",.,"" """,..".",...."""".""..,.,........,..,.,',....,'..,.. ...................,...........,.,...""."....."....,.."..,' ,.""",..",.."",.",.....".,"",..". ,..".""....,..""...,.,.",..",...".,..,...,."...,....... .........................,..,......,..,.."."..,..,""',..,'" ""........,..",.,..""",.....,',....,.. """"..,.,.,...,.,........,...,..."..,..,.......,..,........ ......,.......,................,.,..,..",.,.....,..,.,.."..," ...."",..,...,......"""."""....,"" .,...""..."...""....,.,..".........,......,..,..........., .....,.....,....."."..,.........,.",....,......,........,..,' "".,......,.."",........,....."....,',. ",.""...,..,...,.",......"....."........,..".,.........,. ............."...............,.........................,.".," ""...,...".."."..",.",....."...,"" ,...."",."",.",.....,...,..,.......,',.,........".,....,., That those above named include all of the next of kin, so far as known. The said decedent was possesse.d of pel',onal propert)' to the estimated value of $..!-!.~!:.~.t~mf!.t.~g....... and of Real Estate. less incumbrance. to the eslimate.d value of $..u.~.7.!':.~.~~~~~.~...... as near liS c~n be ascertained. That the said Real Estate in so far as is knowu is located in ....M.~!'!:~~.':!...:r.~~.~!':!:\~I:?I....................... ........~.l!I!:'.~~.JC~~.~~...~~.~~.~.Y..l...?.€!.~n..~y.~~.~.!I~.~......... .............. ..... ................... ...................................................... Therefore. your petitioned:<<) respectfully appl)'(ies) 1'01' Letters of Administration in the above named estate. Dated ....~~~~...~.o........................"... A. D. u&Q".. Signature and Address ,. ........dt.l:'Ild*I/..$:r7a.:......................... of Petitioncl'(::') ...,.....,. .R.~~.h.'!.r.~,. .11.,.., H.? r..t,l?,!?-........ ............................ """"""""."..""""..,."",.,...,....,..,..,...,.........,.....,............. 17503 Plaza Dolores ........... ~.a.~... n..i.~ ~.o. .~...~ ~.~ ~.~ ~.JC~~.~..... ~ f..~ ~.~......... COMMONWEALTH OF PEN"SYLV ANIAI ~ sa: COUNTY OF CUMBERLAND I Richard L. Horton ...............,........................,...................,.....,....................................,....,....,...................................,..........,.......... nllmed in the above application being' duly .......~~().r:n.:..."........................ according' to law. sa)' tbat the facts set forth in the abo\'e application arc true to the lWRt 01 ...11,.:(.,$......, knowledg-e and belief. ........~.I.':!?m....... ...... .............. ....,.... ... and subscribed 1 ....... ..... .~~:..~...:.. ,..~ '~"""":";g2i""'" .... ................ ~~.~~~~..~~:~~~~....a9.,..................... A. D.. 19..8.9..,. \ .:~.,.~:.'.~~.~~=~::.....~:....::.::::::..:.,:..:::::.,:::::::::: ..q;,~'f""{!."" ,~~.d...........:..."..... r / "'J"'" Heg'lSter Filed: .....~!?,J,.Y.......2....,' .),..?~9.......".... ....."... ....... "",.,...,.,........""..",..",..",,,",...,",..,'.",..,..."...,."".."",.." A t tOl.lH~~' : SNf;J...llM.\f;R... MGClILJ;;B...&..UICKER rf8/J (o\'er) "" , . CERTIFIED COpy GDm~POWEROFAnommrr No... ......~.~.I},~......... ..... ...... "nolll aU M",. lIr 11M.. Pre."n", Tblt UNITED STATES FIDELITY AND GUAfl/.NTY COMPANY. I 'orporlllon orllniud Ind emtln, under tho IaWI of thl StAle of MlI")'land, and having ill principII office at the Chy of Baltimore, in the Stale 01 Maryland. doc. hereby con.titulo and appoint Ralph G. Viehman, Jr. 01... CI.y of Mechanicsburg ita true and lawful Iltomey in lad lor tbe SLlf.e of I SUle of Pennsylvania Pennsylvania for tho foUowln, purpose.. to wit: To allft ita name II surety to, aad to execute, MIl and Icknowledic any and III bondt, aad to re.pecliyely do ed perform &DY a.ad all Icll aDd thlD,1 lOt forth In the _Iullon of tb. Board of DlreClOn of the ..Id UNITED STATES F1DEUTY AND GUARANTY COMPANY, I certlfi.d copy 01 w~lch II h....to IDnOl.d IDd mid. I pin of thit Power of Attom.y; and ,h. oaid UNITED STATES FlDWTY AND GUARANTY COMPANY, tbrou,b III, It. Board of Dlrecton, ber.by ntifiOl and CODfirml In Ind whollOmlr the oaid Ralph G. Viehman, Jr. may lawfully do in tho premioea by Yin.. of theM ~D"" In IVI_. I'I'h...o/. th. ..Id UNITED STATES F1DEUTY AND GUARANTY COMPANY h.. ceuoed tbillDltrumeDI to be oeaIed with III corpon.. lOlL duly mOlted by ,h. 111..tlll<l of III Vlce.Preid.DI and .....illII1t Secrelal'(, thla 9 t h doy of June ,A. 0, 19 78 UNITED STATES F1DEUTY AND GUARANTY COMPANY. (Signell) s". .~.9.~.<; !:~.. .~.~., R~. ~l. ;.~.<;.......,.........,...., Vic..Prul<lcnL (SEAL) (Signed) W. B. M. Ringeley .............................,......................... Au"""" Sfcr.f4t7. STATE OF MARYLAND, BALTIMORE CITY, } II: OD thi. 9 t h day of .t u n e ' A. D. 19'T 8, b.fo,. m. penlODally came Robert E. DeNike ' Vic..Pre.ideDI of ,h. UNITED STATES F1DEUTY AND GUARANTY COMPANY and If. B. M. !lingeley ,Assiatanl Secr.ta:y of soid Company, with both of wbom I am p.nenally acquainled. wbo b.lng by m. ...enlly duly awom, said ,hal th.y, tho said Robert E. Dellike aDd If. B. M. !lingeley were respecmely th. Vlce.Presid.DI and ,b. A.II.lanl Secretary of th. .aid UNITED STATES F1DWTY AND GUARANTY COMPANY, tb. corporalloD deocribed in aDd whicb executed the foregolD, Power of Auome}'; that the}' each !aI.w the aW of soid corporadou; thaI th. seal affixed to said Power of Auome}' WI' auch corporat. seal, tbat il waa eo &.ed by onler of the BOlnl of DireCtOIl of oaid corporadon, and tba. the}' signed their Damea tberetD by Ilk. order .. Vlc..PreeldeDl and Aiaiataol SeClOtary, r..peed..I" of lb. CompaDY. 8 My commluloD .:rplreo the 6nt dly ID July, A. D. 19...1.... (SEAL) (Signed) Margaret M. Rurst .....'.................................................. No/lJ1'y Pub'"'. STATE OF MARYLAND BALTIMORE CITY, L Robert II. Bouse ,Clerk of th. Superior Court of B.ltlmo.. City, whieb Conn if a Court of Record. aDd bu a lOaL do be..by certify thaI !~ a r g ar e t !~. II u r S t ' Eaquire, before whom the annexed aBidavitl were made. lnd who hit thereto subKribed bit name, Wit at the time ol to doins a Notary Public ol the State of Maryland. in and lor the City of Baltimore, duly commit.ioned lnd sworn and autborized by law to administer Glth. and take aclcnowledllDentl, or proof of deeda to be recorded therein. 1 further cenify that 1 am acquainted with the handwritinK of the uid NotarY. and verily believe the Shp11ture to be w&;enuine !Iilnature. In r..dmorty JF'Mno/, 1 bereto aet my hand and aftix the &eal ol the Superior CoW1 of Baltimore City. the !lame beinli I Coun of R...nI, tbiI 9th day of June ,A. D, 1978 Robert R. Bouse (Signed) ..........................................................,..., } Sel. (SEAL) Clerk o/.h. Superior CO"". olBGJlimorl Citro FS 3 (101'1) -:0" '- CPMMONWEALTH Of PENNSYLVANIA COUNTY Of CUMBERLAND 55: . _''''___._________ _'._,~,__'''_.. ___,_n,__ ,. baing duly _---5-wrJJ-.. __ ..__ according to law, doposes and ..ys that he _J'Lthe.-.---------. .--- __ .J\dmini13_tr.'1t<:>t:..-n--. 0__ __ _ _ of tho Estate of __--']_(~~.!.!.:-Hort~.--.-- late of Monroe TownshJp.---, Cumberland County, Pa., deceased and that the within is an inventory made by _1l.!c~la1Cl'I-~'~- I!o~to~. ____ .________, the said AdmJnistrator of the entire estato of said decedent, consisting of all tho porsonal property and roal oslato, except roal estate outside the Commonwoalth of Ponnsylvania, and that the figuros opposite oach item of the Inventory roprosent it's fair value as of the date of decedent's doath. ___~:icharc1 [., HortoD_________._ __.____.________________.__.__. Sworn and subscribed before me, !~5AdJ<'//::j{;/t7~- ~. AJmini,trcttor December 19, 1980 ~:Z2_U.<--J G.~ ___llSOU~laza DoloI'es ~_.-. e OFFIC' . I, SEAL " .~.. ETHELLEA WARD : a:.. :;, NOTARY PUBLIC - CALIFORNIA '.1 SAN DIEGO COUNTY I . 0" My ,omm. expires MAY I,~o \~\ Pu b Hc --- ---- San Diego, California 92128 Addreu ~ ;'''W''V''.'- _..'- June Month 1980 Date of Death _____nst__________ D.y Year INSTRUCTIONS I, An inventory must be filod within three months after appointment of porsonal representative. 2, A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ~ ~ U tj '" -d ~ >-. 'M ~ ~ w Sl ..c: ~ KI ~ I- UJ OIl N W -<( k ~ ~ 0.. I- ~ u :r 0 ~ " ~ ~ :r 0 w III iEl c co ,.. W I J: "' E-< '" ..: ~ I- 0.. 0.. c 0 Z I- ...J ... I ~ U ~ ex) U. ...J -<( 0 .' <ll 0.. () 0 I I W 0 <( w :0::[ 0 :;:: ~ .-I I > z '" ~I " 1: N Z 0 k c . I C 0 ~ ~ d Ii III z 01 :;:: 0 ~ "' U Z w <( "I ... 0.. -0 ..: c B I OIl I - -.: ~ 0 " ...0 :z " E ... .>< rJl - ..! 0 ! OIl " 0 ...J U u:: CD ; f'- 0 c ,. o' S, I" ~ C':' U u i.;:-' Q. ',/Jr;:, k . CJ c;':' <"'"l ,A"w 6.; 00:(;,;:- 4J:~, N if~ 0'- U ",,_J ct:v: !:!::! n: oc;: ?~J <.>'" >::'" ~Q; ~ 0;:'3: ",=> -'u <.> Inventory of the reo\ ond personol ..tot. of .JOIIN H. HOR1'ON d.c.a..d. REAL ES1'ATE 1. All that certain lot of ground situate in [~onr'oe Township, Cumberland County, pennsylvania, having thereon erected a one- story dwelling, more particularly described in Deed Book "T", Volume 26, Page 363. Sale Price Total Real Estate 9 900 00 '49 900 00 PERS ONA LTY 21+9 1+9 1,517 \ 00 1,525 50 100 DO 600 DO 131 DO ll,1+30 29 350 DO 810 . 00 72" 50 198 15 255 00 10 238 93 1. Cash in decedent's possession 2. Net proceeds from public sale of personalty 3. Settlement for collision loss on 1978 Yamaha motorcycle with Erie Insurance Exchange 1+. Proceeds from sale of radial saw 5. Proceeds from sale of riding mower 6. Erie Insurance Group: return premium on automobile insurance 7. Defense Activities Federal Credit Union: insurance proceeds on share account 8. Ford Econoline Cargo Van, 1971 model, appraised value 9. Household contents, appraised value 10. 10 shares 5% cumulative preferred, General Telephone Company of California at $7.25 per share 11. Balance in mortgage escrow fund: Association Fi"rst Federa 1 Savings and Loan 12. Social Security Administration: lump-sum death payment TOTA L PERSONA LTY RECA PITUIATION TOTAT, VALUE REAL ESTATE TOTAL VALUE PERSONALTY TOTAr, APPRAISED VALUE $1+9,900. DO 10,238.93 $60,138.93 .' REV.449 t 1.801 COMMONWEALTH OF PEHNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT AFFIDAVIT OF FIDUCIARY (In!ttructions on Revorso Side) ---.- ,-_.--,----------'-'-~-----_.- ..,__.___, _____,__, ,________n_ __*.___,. ----..- Estate of John H. Horton Dote of DeaNI .ilunc .~l.,_ 1980 Social Security No, 291-112-1735 --,.._-_._---'---'-- Last Address R.D. 2.'-. Box..!.I111, Eppley l~oatl_. Nechani~!'Ji~_~7052-- Bureau File Ha. (CtTYI t~TA TEl ( 7,lPl 21-80-11112 Coun ty FiI e No. 1. Decedent died: (X) Intestote (without 0 will) ( ) Testate (leaving a last will--capy attached) 2. Is the filing of a Federal Estate T"x Return required for this estate? Yes_ No X 3. ( E xecu to rlExecu trix ( X) Administrator! Administratrix Nome Richard L. Horton Address 17503 Plaza Dolores San Diego California (CITY) (STATEI 92128 tZlll) 4. All correspondence should be moiled to (X) Attorney ) Fiduci ary, 5. If an attorney is representing the estate, indicate: Name SNELBAKER, McCALEB & ELICKER Address 44 West Ma in Street Mechanicsburg PA ICITY) (~TA,EI 17055 (ZIP) ^~r !.bt: ~t\~,: . .>.. , ~,'<;. - i-I cP ",::0 :_~:~:~ <::> r'l~ :::> 80 , :n';l) .::> en .,0 ;-) c-, ~:,M ~~ '''> ~l;-O ,-" -;0 " .., .." OJ ,':i ,: :r'l"l .(:) " List all safe deposit boxes registered in the decedent's individuol name, or jointly with, or as on agent or deputy of onother, or in decedent's individual nome with right 01 access by another os agent or deputy. Include the name and address of the bank or other institution where the safe deposit box is located, the name (s) in which the box is registered and the relationship of the joint holders to the decedent. NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX NAME OR "AMES IN WHiCH SAFE DEPOSIT BOX IS REGISTERED RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is \ruo, correcl and complete. /, . ':i6'.1 .' . ../1 ./ ... / . L_~/:; ! ilr,'/;;; ~Y,j,r-7? _ SIGNATLiRE OF FIDUCIARY .JilL:/ // /:'/.l,'J{.! DATE " PENNSYLVANIA INHERITANCE TAX GeNERAL INFORMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheril;mce and Estale Tax Act of 1961 provides lhat the following persons shall prepme and file a return: a. The personal representative of the estate of the decedent as to properly of the decedent administered by him and such additional property which is or nlay be subject to Inheritance Tax of which he/she shall have or acquire koowl edge; b. The transferee of property upon the lransfer of which Inherililnce Tax is or may be imposed by the 1961 Statute, including a trustee of property trilnslerred in trusl, provided that no separalc relurn need be made by Ihe transferee of property included in the return of a personal represcntative. 2. PLACE FOR FILING The return is to be fiied in duplicate w:tIlthe Register 01 Wills of the county wherein the decedent resided. 3. TIME FOR FILING The return is due nine months after the decedent's death, unless an extension for filing has been apptied for aod granted by the Secretmy 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 Oepartment or Revenue as debts of like amount are recoverable by law." 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, gwndparent, 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 are 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 lo tile 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, together with any interest thereon, are a lien upon real plOperty, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued lor against any real property in the decedent's estate or against any property belonging to a transleree liable for the tax. 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 St~tute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one year or both. .. . REV.45111.80) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEoENT SCHEDULE "8" PERSONAL PROPERTY '* (I"structiOllS on Reverse Sido) Estate of .John II. lIorton ITEM NO. 1. 2. 4-. 5. 6. 8. 9. 10. 11. DESCRIPTION UNIT VALUE ESTIMATED MARKET VALUE DEPARTMENT VALUATION !OFFICIAL USE ONL YJ Cash in decedent's possession $ 2li9.lf9 Net proceeds from public sale of personalty 1,517.00 3. Erie Insurance Exchange: settlement for collision loss of 1978 Yamaha Motorcycle 1,525.50 100.00 Proceeds from sale of radial saw Proceeds from sale of riding mower 600.00 Erie Insurance Group: return premium on automobile insurance 131.00 7. Defense Activities Federal Credit Union: insurance proceeds on share account 4-,4-30.29 Ford Econoline Cargo Van, 1971 model, a ppra ised va lue 350.00 Household contents, appraised value 810.00 10 shares 5% cumulative preferred, General Telephone Company of California 7.25 72 .50 Balance in mortgage escrow fund: First Federal Savings and Loan Association 198.15 TOTAL THIS PAGE $9,983.93 7; 'tN. 'jJ .$I'Mi' ." REV"4:lZ (1~60' COMMONWEALTH OF PEHNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEDENT JIll I' t ESTATE OF _ 0 m . lor on SCHEDULE "C" TRANSFERS *~" , . 1>1 , ~ INSTRUCTIONS: 1. Answer the questions on reverse side. 2. If the answer to any of the questions on the reverse side is "Yes," provide a description of the property transferred per Schedules "A," "B," or liE," its estimated market value at date of death, dates of transfer, to whom transferred and relationship of transferees to decedent. Attach a copy of any trust deed or instrument relating to the transferred property. ITEM NO. DEseRI PTION ESTIMATED DEPT. VALUATION MARKET VALUE (OFFICIAL UScONLYj NONE NONE TOTAL THIS PAGE NONE " " QUESTIONS CONCERNING PROPERTV TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material narl of his estate without receiving valuable and adequate consideration? (Answer "Ves" or "No".) No 2. Did decedent, within tWJ years of death, transfer property from himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Ves" or "No".) ~ 3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, 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 state of decedent's health at time of transfer. d. All other information supporting nontaxabilily of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate 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 possibi lity that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" 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".) ..lio- 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. aoove 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 was transferee's promise to pay income to or for the benefi t or care of transferor? (Answer "Ves" or "No".) No ,8. Did decedent, at any time, transfer property, the bmeficial 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".) 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".) , REV.4!53 (l.SO) COMMONWEALTH OF PENNSVLVANIA OEPARTMENT OF REVENUE TRANSFER INflERITANCE TAX RESIOENT OECEOENT SCHEDULE "D" BENEFICIARIES '* (Instructions on Reverso Sirll}) Estate of John H. Horton BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH Richard L. Horton father yes intestate share . Janet T. Horton mother yes intestate share 17503 Plaza Dolores San Diel!o California 92128 - . ---- . . 1--- . - ------- . .- -- - - -. The above beneficiaries are living at this time except for the following: NAME DATE OF DEATH .... . REV.454 (1.80) -COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DEceDeNT (Instructions on Reverse Side) '* SCHEDULE "E" JOINTL Y OWNED PROPERTY Estate of John H. Horton I P TOTAL E VALUE OF DEPARTMENT ITEM R NO. DESCRIPTION MARKET C DECEDENT'S VALUATION VALUE E INTEREST (Official Use Only) N T 1. One (1) $25.00 United States Savings Bond, Series "E", registered to John Harrison Horton (decedent here- in) or Richard L. Horton (father) issued on June 1949; value on date of death $68.98 50 $34.49 2. One (1) $25.00 United States Savings Bond, Series "E", l:'.egistered to J. Harrison Horton (decedent herein) or Mrs. Chris Horton (former spouse) issued on August 1976; value on date of death 22.31 50 11.16 TOTAL THIS PAGE $45.65 '/.:;; ~ S- llr>.A' ~ 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 tangibie 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 properly. 3. Indicate the percentage of the decedent's interest. 4. I ndicate the market value of the decedent's interest. t: 'tl 0 n ~ t"l > ::; Z :>- 0 0 CIl 0 - Cl n c: 0 ...J Z ... Z t" tT1 tT1 ~ 9 - 9 t" ;>;: Z ::0 - Z Z tT1 >-1 tT1 >-1 Z 9 9 >-1 >< CIl tTl - CIl Z 0 CIl 0 '"'I 9 'TI 'TI ::0 ~ ~ 0 ." - ." 0 - Z (') ;; t" c: CIl tT1 0 Z t" >< >< -< ~ tT1 tT1 > > ::0 ::0 \ \ I , I \ ... <:: l!) I ~ ~ 0 ~ ~ ~ ..., s.. o>l \ ~ '0 Z .~ ~ ~ '"' 0 E-< M Izl :I: Q) s.. \ '" 0 Q) ~ il s.. .c <:: 9 ..l ~ ~ ~ ... N < <.l ~ OJ - I ~ z , '" sa i '" ~ , i 0 c:i ~ ~ l"- I;; 0 '" 0 z c:i Izl '" >- Eo< c:i - ~ z z ~ Eo< ea z :l c:i ~ c:i Z Izl Izl Z Z Eo< 0 ~ u ~ Z ; ~ '" ~ 8 0 :l Izl 0 ~ -"". .... GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register 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. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. t: 'tl Cl n 6 t'1 ~ ~ > 0 0 (fJ z C'l n ~ tl .., Z a; Z I:"" t'1 tTl ~ :xl > S:l 0 I:"" Z Z tTl .., t'1 .., Z S:l S:l .., ><: (fJ t'1 .... (fJ Z 0 (fJ 0 .., S:l ." ." ~ .... 0 Z o '<j '<j .... n .... > I:"" c::: (fJ tfl ~ ~ ~ i ! i I I j I i \ I ><: t'1 ~ ><: t'1 ~ INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in ~he remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. ~.. .I... GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death arc deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items arc claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial eXflcnscs including thc Gost of a burial lot, tombstonc or grave marker. All debts being claimed against an estate are subject to the approval of the Rcgister 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. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. r- "tl 0 n > t""l ~ ~ - > 0 0 0 [fl Z 0 n C 0 -l Z 3:: z ~ t""l t""l ~ Z ::0 :>- 9 - 9 z Z t""l -l t""l -l Z 9 9 -l ><: [fl t""l - [Jl Z 0 [fl 0 ..., 9 "'l ::0 "'l ~ ~ 0 'fj - 'fj 0 - z n - > t"' c: [Jl t""l 0 Z ><: ><: !< t""l t""l ~ > > ::0 ::0 INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the dec'edent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt bcing claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. INFORMATION To insure propor crodit to yaur accounl, tho nome of thu manto and file numbor should be cluarly print- ad on tho chock or money order, This assessment is modo in accordanco wilh Section 708 of tho Inheritanco and Estate Tnx Act of 1961 172 P.S. ~ 2485- 708). To the extent that inheritanco lax is paid wHhin Hlree (31 months after the death of the decodonr. 1I discount 01 live 151 percent is aliowed 172 P.S. ~ 2485- 716). Inheritance Tax. other than till( on a future interest. is duo ot the dale of the decedent's demh and becomes delil1Quenl at the expiration of nine (91 months alter tile decudent's death (72 P.5_ S 2485.711), Inhcriwnce 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, ~ 2485- 7121, Calculate interest from the delinquent date shown on the face of this form to the date of actual payment using the following intereSI 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 manths .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 1/; 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 (601 days after receipt of ~his Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 172 P.S. ~ 2485.10011. 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 *' COUNTY FILE NO: ;) /, f () L/ tf.. C~I TO: L qD ~":~?QA,'h,' (~'~~-fJ 'V ~Q'C~~/L. DJtiZ L/.lf 1.j1~1'<\1l ,"" J-), ~ ~ (j, X, '[I., I '7 () ~ ,,' '.:-{"Q "'0"1 DA TE'n,," "'. l Ir-. /1 fl (\ ~ :tJ-11 'li-' ESTATE, ~ ,,,n ,"". (\ I\,. .... _v' I,..... FILE NO. / ,;{! 87\ . ~J.'1- ~ COUNTY CVVY1 ~a-, [~. ~ o DATE OF DEATHd!..l^'.&L ~~ /9 f!j Appraised Value of Estate: Real Estate $ Personal Property + Jointly Held PropertylTransfers + Total Gross Estate $ Total Approved Deductions Clear Value of Estate $ Less: Approved Charitable Exemptions Clear Value of Estate Subject to Tax $ Amount Taxable @ 6% Rate $ tax due $ Amount Taxable @ '5% Rate 19)( due TOTAL PENNSYLVANIA INHERITANCE TAX DUE $ 9.t;9. (\,7 * * . * * * A five percent discount totaling $ will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT 3 -J/.., -~/ $9Yj O? + $ $ = $ yt:;Ci, <"17 , + = + = Interest accrues at the rate of six (6) percent per on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid by annum is JfJ & ~~I~~ .,.) :? ~ - BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE .' , ; ~' Assassed by: / ../ , , . Agent or It". COmmonyftllth See InformallOn on Reverse Side " i.... // ,,;' /1./ 1/' T;;- ./ 7 r:1' .'.r."" .n__(.....--t..... "1"" -- , .' /j / 1/ It>!FORMATlON To insure proper crodit to your account, tho name of tho estate and file numbor should be clearly print. cd on tho check or money ordor. This assessment is mado in nccordanco with Section 708 of the Inheritonce and Estate Tax Act of 1961172 P,S, 9 2485.708), To the oKlont that inheritance tax is paid within three (3) months after lhe death of the decedent. a discount of five (5) percent is allowed 172 P,S, !i 2485.716), Inheritance Tax. other than tax on a future interest. is due at the date of the decedent's death and beconies delinquent at the expiration of nine (9) months alter the decedent's death (72 P.S. S 2485." 1), Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereaher (72 P.S, 9 2485-712), Calculate inlerest from the delinquent date shown on the face of this form to the date 01 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 ,0003~ 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 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 Commonwealttl and the personal representative. not satisfied with the assessment may object thereto within sixty (60l dnys after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 172 P,S, S 2~85.1 0011, Make check or money order payable to: "Register of Wills, Agen1"' Mail 10 the address iisted below: