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Home My WebLink About80-00447 .-.: H ~ ~ ~ f;:l p., H .::;: ::I1 0 CIl 0 t;;J ~ 5 E-I . ! CIl ril 0 ! ~ 3 Ii< ...:l <:) - 00 0 I - rol fa) .... ~, . G 0 .... \0 Z U3 NO. 21.80 '? PETITION FOR LETTERS OF ADMINISTRATION IN THE ESTA'm OF F~.~RJ;J{,~~....J.:.,...~.sE.P..\V\1....... \lECEAS~;D. . MARY C. LEWIS fo .............................................................................................................................. Register of Wills f(JI' the Count). of CUI11LOl'illlld. ill tho COl11l11llllll'elllth of l'onIlS)'lvllnia. The petllion of ....{:;I.:AJ!:N'S.y.....:.r.:.... L.L,?;. S..l.\.!~/~J.. ............ ................... .......... .................. ........................ ........ ..... ..................... respect fully sholl'o lh that . .fJ.~.t.J:.N.":..J:.~....X....l,.".."'..,.~..D...~f~}....... 'd t I' Lc'w~: f.. (\LI... C; AI Township (' I '1' let. St. t f P nsul. was a res I en 0 .........."... 0..'>......... .. ,,,......;........'''...~or-Ough "um Jet .11H OUIl .~. ,l e 0 en J vania, and a Citizen of United States, and departed this life intestate in the County of .'f..'1..t:k6E-Il':::D/viJ ...................,..""..""",,'," llnd Statc of ."",f.,~,f\..i(~':J,~:.UJN.,lfJ""",.., ,..".".,."""...,.....""...."",...... .."""".." on ....".~f.tL"""""".,," the .."",~";,%J,,L.. dll)' of "..".."".f:-..\A.':!"..."...."""."." A, D., 19.rs.,~" at the agc of ",T?".".. yellrs, That the said .F.b9,Ks.,(I!.>.,~.."""'>~:.,,,~,7.~,f:,:p.,?.t.1..,,"'" deceased, left surviving the following named widow or -husband, heirs and next to kin, to wit: Name Relationship .~ D IV Residence ."\\Af.:.(~j:.,',l."...,.i::;~,':::~.'?M,,, ............................................ .fb~.\.,.,'~,~V\~\,~lIj::..,!S.~.l';)f) ..Jj.i):,6j~.l:J"if..?"Y,6~)...Ld."..J..1 i 0 ~.. ................................................................ ............................................ ................................................................ ............................................ ................................................................ ........."..................................................... ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ......................................."....................... ............................................ ................................................................ ................................................................ ............................................ ................................................................ That those above named include all of the next of kin, so far as known. The said decedent was possessed of personal property to the estimated value of $,~,/9."~.1"...",,.. and of Real Estate, le~s incumbrance, to the cstimated value of $....".1:.',lt..~,~~.':L".. a~ near as can be ascertained. Th t th 'd R IE>>. t' I' . k . I t d' L"vvC-lA( ^ L-L eN ---rw-f .. a e sal ea j s a e In so ar as 18 nown is oca e in ..........................t:r..".....................)......... ""......~.':!"t~..~l?..8.} ~)""..,th...:,'"..,.,"',........, ""..,,,,,.,,,,,,,,,,.,.,,...,,.,,...,....,,.,..,,",..,..,,....""'.""..........:...". Therefore, your petitioner(s) respectfully apply(ies) for Lettcrs of Administration in the above named estate. Dated ..$""-J,~.h1......,,................... A. IJ" 19..~J.~~ Signature and Address of Petilionor(s) - /1 ~i (AT Q ,,,,",.:.. ..t:Y.\~7....;.'S..J&,~..'"::Qr.:\:J....".,..,,.....,," 'J(Y ~ K\A (~ H.j f r J) c) A II .,......"\.,.."""."."",..,.""..",.,,,,,,...,,,.,..f:::..""...Y.."....", .."..tU\,~~f.:,!~.~.f6,'y;:..f.,O".....!..1..\.L~t ........................................................................................ COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF CUMBERLAND l ~s: "',.."."r.~hgY~:;{,,,.,..,'~:..,,b~.,;; (,)).~?!.~1"..".....,..,... .....". ."""" ..." ......'".. .."..,.'"..,...".....".,'" .......... named in the above application being duly .......-..s:..'&.:;o,J:,:U..""...""..... according to law, say that the fact~ set forth in the above application are true to the bcst of ..JU!...... know1ed e nne) eHef. "..""...".".....s.~~~...."""."..,,........ and subscribed 1 ';.c:""\":'''':'''''''' .:..t...,..,,:.. .,".."(.."....."- :, ...... " before m;~lY 3, l.::J.':\Y):!...f"...,Y....v.!~~~..\9,J.n..............,,' :::P;;;Y:i:::...' R...", I ........................................................................................ ~,ro Filed: .."~~.~;(."..~.~...".!.9.~~"..........,,,.............. Allo,'no)': (O\'Ct.) OATH OF PERSONAL REPRESENTATIVE COMMONWgALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND t HH: ,,,,,,,,,,..,,,p.hKV.~::\.. ..",...".s."""".,.~::.~., ~~j)...i.i'l.... .,.......,....".,' .."..".,..".,' .,.", "...,..,.", petitioner (s) being duly "."....oC\.W"\1:C);l...."."...""""""..,,. according to law do <f....\.'....... depoRe and say that as the d . '.t ..1."'1 fth t,t I' I=- LIJ ,) L- rJ'tc: -So L-c 81\ o^l a nllnlS ra ~...... ...".... 0 c es .\ eo"". ...........D...-;......."..,..".........,~...."".."...;....... )."...t.~. ............................ ..........................................................................................................................................................."........................... deceased ..".J\q;,...""." will well and truly administer the goods and chattels, rightR and credits of said deceased, according to law. And also will diligently cOI11Jlly with the provisions of the law relating to Transfer Inheritances. sworn . ."""..,.,,,,,,,,,,,,"',.,,.,,.,,.. ..."..,. ,,,,..,.,,, and subscrIbed before me. Z?7....~?-.~X...~,L...",~ A.. D'119.~.~.... R~1ll~."rJ,,'..f/;T'~..""..,......., ...~~+~:~"t.,.J~\:.~J0.~~:r.\::."..".",.........."....,." ............................................................................................ DECREE Be it remembered that on the .....""}~........,,.,,' day of ""..."..."'q.~Jy:..."........,,...,," A. D., 19.~g..... Letters of Administration in the estate of ................ ..."...."".....""..r.J9.,.,.!,m~.~...(:1,~""t-,~~9.m""....""...,,". Lower Allen Township . "..,." ...", "..........,,,,,,,..,.., ....",,,,....,.,,,,,,,.,,,...,,......," , late of "".,. ,,,,,,.,,.,.,.,' ....."..."".." ".." ,,,,,., .."""..., .......", ...... "" Cumberland County. Pennsylvania, deceased, were granted to "~~Ev:~X...~.~....L.~~.~~..".."....".,,""",,. ......,.~.;~~.~~~'~;.,~;;~~..~~~.~~~;~~';';~.~';.~~'~..~~;: .~~'~.,;:~~~,.~;~~,...."." .", ';;""""::;J""'~""";""" "......""";J/I.~r-.... ~~~"".... l (, 1ft;; ,:::--- ~",-., Estate No. :~~~~.~...............:..: BOND KNOW ALL MEN BY THESE PRESENTS, That we, ........................................I1?.r.1[~y....9..... J:.~~.c19m.................. ... ............................................. ................, principaL......, .................................................................... and ......................................................................................... ...I.l1;s.1!:r.~l1;~,e...9.'?lJlP.'l.~..()f...~.o.r..t.h....~~:ri.<:~............ .... ............................................................., suret..Y......., are held and firmly bound unto the Commonwealth of Penl\s)'h'ania, in the sum of .................................................... ilQne...~llJ.l~.r.~.d...~.:iJ<;l;y....~?'?':l~!"?~:*........... DolI:lfS (s.i};J,./i9~.Q9.Qjf.QO), to be paid to the said Commonwealth, her certain attorney or assigns, to which payment, well and truly to be made, we do bind ourscl\'es, jointly and severally, and our and each of our heirs, executors, administr:ltors, suw.:ssors and assigns, rirml)', by these presents, for and in the whole of the said sum, SEALED and dated the ........Jr..d................................ ....da)' of ...AWY......................................, 19......$.9 WHEREAS, the above named ............................... ............................................................................................... .......................~a.~y~;r..~.....L.~.e.<l.ClI1l............................................................................................................. has or have made, or is or arc about to make, application to the Register of Wills of Cumberland County, Pennsylvania, for the grant of leuers ...o.4...aPminis.tration............................................................................... on the estate of .......f.;J,,9.1:!;mc;.!)...S.....L~!)9.Q11\............. ...... ................., late of .....26...Arnherll.t..Drive...Camp, Hill, Fa. Cumberland County, Pennsylvania, deceased: them shall well and truly administer the said estate accord ing to law, this obligation shall be void as to tne personal THE CONDITION OF THIS OBLIGATION is, that if the said personal representative ...:7...... or any of representative or representatives who shall 50 admioister th e said estate; but othelwise, it shall remain in force. ~lM/V7Y'" Har~ey . S. -teedom SEALED and delivered in the presence of --------------------------------------- (SEAL) ------------------------------------------- ------------------------------------------. --------------------------------------- (SEAL) --------.------------------------------.--- _ ___________u____.... __________________ (SEAL) _I.~~~_#-- ~~~p..a~_~!_~1;~7~EAL) _JfiL.oI' _6':!f[4~((SEAL) Atto n -In Fact -----------------------.-------------------- ----------------------------------------..-. COMMONWEALTH OF PI'NNSYLVANIA COUNTY OF CUMBERLAND 55: Pc:rson;lll)' ;II'PcMtJ heron.: me, a.. . . ..... ......' .............................. in and for the counly and stat(,', aforesaid ................... ...................................................................................................................................... of........................................................... .................................and.. ............................................................................... ..................................................................................................of........ ............................................................................................ surities on the above bond who being duly sworn (affirmed) according to law, depose and say that they each own Real Estate worth the whole of the penal sum named in the above bond, over and above their debts and the debtor's exemption. ....................................................... da)' of .......................... ..................................................................................... (Seal) ........... ...... ................................................................... (Seal) ................................................................... (Seal) ..............."....................".............................................. (Seal) S\\lorn and subsnibcd before me this /\,D.19.......... ..................................................................,............................ .."... ,-~. INI\ POWER OF ATTORNEY INSURANCE COMPANY OF NORTH AMERICA PHilADELPHIA, PA. Know all men by these presents: That the INSURANCE COMPANY OF NORTH AMERICA, a corporal ion of the Commonweallh of Pennsylvania. having ilS principal office in Ihe City of Philadelphia, Pennsylvania, pursuanl to Ihe following Resolulion, which was adopled by the Board of Direclors of Ihe said COl11pany on May 2B, 1975, 10 wit: "RESOLVED, pursuanlto Arlicles 3.6 and 5.1 of Ihe By-Laws, lhe follOWing Rules shall ~overn the ('l(('cution for Ihe Company of bonds, under. takings, recognizances, conlracts and other writings in the nature Ihereof: (lJ That the President, or any Vice-Presidenf, ^s~j51.Jnl Vice-Presidenl, Residenl Vice. President or Allorncy-in-ract, molY el(eculc lor and in behJIf 01 Ihe Company ~ny and all bonds, underlakings, rer:ognizances, contrach and other wrillngs in the nalure thereof, Ihe same to he alte~ted whell neccss"ry by the Secrelary, an Assistant Secretary or il Resident Assistant Secretary and Ihe !leal of the Company affixed lhl'rcto; and 1hat thl' Prc!!iuC'nt or any Vice-President may appoinl and aulhoflll' ReSident VIce-Presidents, R('sident Ass1!!tanl Sl'crelaru!5 and AllfUm'Y'-IO-f.ICllo 'i0 {'l(('lUle or .,Ilt,q to thr. execution, of all such writings on behalf of Ihe Company and 10 affix the seal of tht' Company thereto. {21 Any such writing execuled in accordance with these Rules shall be as binding upon the Company in ,my fa!!e as lhough signed by the Pre~idt.'nt and allcsted by the Secretary. (3) The signature of the President or a Vice-President and the seal of the Company may be affixed by foH'!!imile on any POWN of allorney granted pur~uant to this Resolution, and the sign.,ture of a certifying officer and the seal of the Company may hI' affixl'd hy facsimile 10 any cerlificalr. of any such power, and any such power or ccrlificdle bearing such facsimile signature and sedl shall ht.' valid and bindm~ nn the Company. (4) Such Resident Officers and Allorneys.in-Fact shall have authority 10 ccrti(y or verify cop it'.. of 11m H.esulution, the By.laws of the c;r.mp,my, and any affidavit Ot r~cord of the Company necessary to the discharge of their duties. (5) The passage ollhis Resolution does nol revoke any earlier authority J;r.lnt('d by Rt!'iolulion of t/1(' Uoard of Oin'ctors on lune 9, 11)53," does hereby nominate, constitute and appoint JAMES R. FICKEL, JR., of the City of Carlisle, State of Pennsylvania , each individually if Ihere be more than one named, ils true and lawful atlorney-in-facl, to make, execute, seal and deliver on its behalf, and as ils act and deed any and all bonds, undertakings, recognizances. contracts, and olher writings in the nalure thereof in penalties not exceeding Tl<O BUNDRED FIFTY THOUSAND DOLLARS ($.25.0.,.00.0.OQ...) each, and the execution of such writings in pursuance of these presenls, shall be as binding upon said Company, as fully and amply, as if they had been duly executed and acknowledged by Ihe regularly elected officers of the Company at ils principal office, IN WITNESS WHEREOF, the said ...........................C....DANIEL..DRAKE................... ...., Vice-Presidenl, has hereunto subscribed his name and affixed the corporale seal of the said INSURANCE COMPANY OF NORTH AMERICA this ...."...... ...............2B.th.............." day of ...........................Mar.ch........................................ 19.......14...... INSURANCE COMPANY OF NORTH AMERICA (SEAL) by ...... ..................... .C.. ..DANIEL. DRAKJl,............ ..." .................. Vice. President STATE OF PENNSYLVANIA } COUNTY OF PHILADELPHtA ". On this................2!l.th..... .......dayof.. . .... March... .. . A.D. 19 ...74, before me. a Nolary Public oi the Commonwealth of Pennsylvania, in aod for lhe County of Philadelphia. came. ...C....DANIEL..DRAKE....... . . . ............. .. ................................ ....... Vice.President of the INSURANCE COMPANY OF NORTH AMERICA to m.' nersonally known to be the individual and officer who executed'lhe preceding instrument, and h~ acknowledged Ih..1I he (~xecuted the S.lme, and thoB lhe seal affixed to the preceding instrument is the corporate seal of said Company; that the said corpor.lle se.ll and hi~ siJ.;nJlure were duly affixed by the authority and direction of the said corporation, and that Resolution, adopted b\' the Board of DirL'clorS of saId Comp.lny, referred to in the preceding instrument, is now in force, IN TESTIMONY WHEREOF, I h,we hereuolo set my hand and affixed my official seal allhe City of Philadelphia. the day and year first above written. HH NANC'l..KARLA.GE'H (SEALI I\:olary Puhlic, mission expires November 21, 1977 .. , ersrgned. Assistanl Secretary of INSURANCE COMPANY OF NORTH AMERICA, do hereby cerlliy that the nriglOal T" NEY, of which the for-egomg IS a lull, true and correct copy, IS In full force ..md cficcl. S he~ot. I have hereunlO subSCribed my name as AsslSlant SecreloHy, and arfIXed the corpnr,~,'l ot ,hI' (lJrpor,,- / ~... dayof.. .J~II ........ ..197F1. n.-.4.- r2 'i ;;j/~v. )1 A ..... .... I ' A~mlanl .- '~I'~r~~~,~~f;l~~l'II:!\i:,',.~,;/;,; 'I . "COMMONWEALTH OF PENNSYLVANIA .. 'N~fJQ'6.')289.'" " DEPARTMENT OF REVENUE a,~\W.,,'\:), ,'~ :. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX If'''''''''!'':'''' ' 01 ; RECEIVED II ;: From, 11,,\ = l,dress ~ ~...,- - -------------~y~ HUNDRBD FIFTY ~LARS-------------------~Tlors representing Pennsylvania Inheritance or Estate To)( due Irom the following estale: ~..~. ey . x.ee4Cll1l 201 Briara1iff aoad 2 ,;, TOle on $ $ Harriaburv, Pa. 17104 5-23-1980 8Ic 6% Tax on $ $ t File No. Date of Payment 21-80-447 Dote of Death 15'''' To)( on $ $ Name of Decedent AugIWt 25. 1980 FLORBNCB S. LODe>>! 9" Tax on S Estate lox, Act of May 7, 1927 $ $ County c....ber1and 101 AL lAX CREDIT Less five percenlum of lax If paid within three months after dole of death Plus interest at the rale of _lJ(lfrom to $ 2,'5A.42 Remarks: $ 118.42 I -PAID ON ACCOUNT" $ uOO~[p[L~@ffi'ITrn SEA L TOTAL AMOUNT PAID $ 2,250.00 NOTE: Thl, Triplicate Receipt to be retained tor audit purpose.. v v Received by NOTE: In accepting the Ironlfer Inherllonce 10.. on future elloles, prior to Ihe dealh of the Iile lenont or tenant for year,. os evldencod by Ihls receipt. ,II II understood that the Commonwealth shall not be precluded or prevented Irom hereafter assessing addillonallnherilonce 10" allne death ollhe IIle lenonl or tenant lor year' whenever It appears thai such addltlonolloll may be legally due and collecUble lor any reason wholsoever. .-.-----"-.--.---------.------ ._-_.__.._._--_.__._---_._--~- PENNSYLVANIA INHERITANCE TAX GENERAL_INFOHMATION 1. PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act of 1961 provides thallhe loiluwin~: persIJns shall prepn!e rilld file a return: a. The personal representative of the estate of the decedent n5 to property of the decedent administered by him and such additional property which is or may be subject to Inheritnnce Tnx of which he/she shall have or acquire knowledge; b, The transferee of property upon the transfer of which Inherilnnce Tax is or may he imposed by the 1961 Stafute, including a trustee 01 property transferred in trusf, provided fhalno sep;uale return need be made by the transferee of property included in the retulll of a personal representative. 2. PLACE FOR FILING The retulll is to be filed in duplicate with the Register of Wills of Ihe county wherein the decedent resided. 3. TIME FOR FILING The return is due nine months after the decedent's death, unless 1111 extension for Iiling hilS been applied for and granted by the Secretary of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 791 of the 1961 Statute provides that" . , .any persall who willfully fails to file a return or other report required 01 him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue liS debts of like amount are recoverable hy law," 5. TAX RATES Inheritance Tax is payable at the rate of 6% on translers to lineal descendllnts, such as father, mother, husband, wife, son, daughter, grandchildren, grandparent, son-in.law and daughter-in-Illw 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 retulll is due 9 months alter 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 to the 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 property, which lien remains in effect until the taxes IInd interest have been paid in full. The taxes may be sued for ogninst ony real property in the decedent's estate or against any property belonging to a transferee liable for the tax, 8. FILING OF FALSE RETURN Any person who willfully makes a false return or report required of hiln sl1all, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, sl1l1ll be sentenced to pay a fine not exceeding $1,000 or undergo imprisonment not exceeding one yeor or both. .'1 REV.l"1'1o!'A'I' COMMONWEALTH OF PENNSVLVANIA SCHEDULE "6" * OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX PERSONAL PROPERTY RESIDENT DECEDENT (InstrLictions OIl Ruversc.' Sidr.) Estate of FLORENCE S. LEEDOM ITEM ESTIMATEO DEPARTMENT DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL Y! l. Household Furnishings: Living Room Suite 50.00 50.00 Dinette Set 25.00 25.00 Bedroom Furniture 50.00 50.00 Miscellaneous Chairs 40.00 40.00 Refrigerator 100.00 100.00 Miscellaneous Dishes & Cooking Utensils 20.00 20.00 2. Automobile, 1978 Pontiac Lemans Coupe, Title No. 3,475.00 3,475.00 A30241613 3. Jewelry: Man's 14 kt. Yellow Gold Consistory Ring with 245.00 245.00 Diamond approximately 0.35 ct. Lady's 14 kt. Yellow Gold Ring with 3 Diamond 170.00 170. 00 Beads approximately 0.15 ct; 16 Single Cut Diamonds, approximate total wt. 0.32 ct. Costume 35.00 35.00 4. Cash on hand 22.00 22.00 5. Checking ACcoWlt-Dauphin Deposit Bank 8,264.25 8, 264. 25~ r trS:.rO 6. Philadelphia Electric Company - Common Stock- (1~ 88 (,747.04 58 Shares - Certificate #NYC0568651-4/28/78 I ,1 I~ tJ'1~ 7. Pennsylvania Power & Light Co. - Common Stock- 19.75 (i, 975.00) 1'1I1>I,'1S" I 100 Shares - Certificate #AC143864 - 5/8/78 8. Merrill, Lynch, Pierce, Fenner & Smith - Common (206.30) ~DJI. 13 I I Stock - 10 Shares - Certificate #55997 - 3/6/74 I 9. American Telephone & Telegraph Co. - Common (2,743.00/ oZ-1,n. ~S- I I Stock - 52 Shares - Certificate #67T654492 -9/22/6 I 10. Northeastern National Bank of Pennsylvania - Commo Stock: ~Y.v Certificate #MAR 1865 - 11 Shares - 15 March 1973 ~.OO ~31. O~ .;.$"1.5'0 Certificat e #F13014 - 11 Shares - 25 Oct 1967 2 .00 231.00 ~S;. SO 11. James Dole Corporation - Common Stock- 19.50 136.50 Certificate #9287 - 7 Shares - 3/17/78 12. Certificate of Deposit - Dauphin Deposit Bank - 0,000.00 10,000.00 Certificate #15932 - 5 JWle 1978 13. Interest on No. 12 to 5/23/80 760.35 760.35 14. Certificate of Deposit - Harris Savings Association - 5,111. 50 15,111.50 Certificate #106820 - 2/12/73 15. Interest on No. 14 to 5/23/80 364.45 364.45 TOTAL THIS PAGE 45,002.39 QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years 01 death, make any transler of any material port of his estote without receiving valuable and adequate considemtion? (Answer "Yes" or "No".) No 2. Did decedent, within two years of deoth, tmnsler property lrom himself! herself to himself/herself and another party or parties (including a spouse) in joint ownership? (AnswCl "Yes" or "No",) ~ 3. If the answer to one or two above is "Yes" and the tmnsfels ole cl~lililOd to be nontoxable, provide the following information: a. Age of decedent at time of tmnsler. b. Copy of death certificate. c. Affidavit by the attending physician indiColing Ihe state or decedent's health at lime of tmnsfer. d. All olher informatioo supporting nontaxahility aflransfer. 4. Did decedent, in his/her lifetime, make any lransfer of property without receiving a vafuahle or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No".) No a. Was there any pOSSibility that the property lransferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) 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 impiiedly reserves [01 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 translerred? (Answer "Yes" or "No".) ~ b. The right to designate the persons who shall possess or enjoy the property lmnsferred or income therefrom? (Answer "Yes" or "No".) No 6. II the answer to five b. above is "Yes," state whether the right wns reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the considernlion for which wns trnnsleree's promise to pay income to or lor the benefit or care of transleror? (Answer "Yes" or "No".) No 8. Did decedent, at any time, transler property, tile bmeficial enjoyment of which was subject to change, because 01 a reserved power to alter, amend, or revoke, or which could revert to dececient under terms of transfer or by operation 01 law? (Answer "Yes" or "No".) No 9. If the answer to eight above is "Yes," was the power to alter, amend or revo\(e the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) --- REV-4!l4 EX+'(3~80) COMMONWEAL TH OF PENNSYLVANIA OEPAR'rMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDeNT DECEDENT (Instructions on Roverse Side) '* SCHEDULE "E" JOINTL Y OWNED PROPERTY Estate of FLQRENCE S. LEEDOM P TOTAL E VALUE OF DEPARTMENT ITEM R NO. DESCRIPTION MARKET ~ DECEDENT'S VALUATION VALUE N INTEREST (Official Use Only) l' NONE . I I , I 1 t ! i i ! , i j I I TOTAL THIS PAGE NONE tJ.4..." J M,l!.' v . . 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 "8", Include the nal11e, 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. I ndicate the percentage of the decedent's interest. 4. Indicate tile market value of the decedent's interest. t: '" ti (j ;Jo- m ;Jo- ::;; Z ;Jo- 0 0 ti cr. " - t'1 C1 (j c:: ti ::' z "" Z t"" t'1 ~ Z '" ,~ 9 - 9 t'"' - Z Z t'l >-l m .., z 9 9 >-l .<: cr. t'1 - ~l" cr. 0 cr. Z 0 ..., I.lJ:" r,' 0 "1 "1 '" ~ S:!;:j; t:,. ~ 0 ;U u..' "1 lt~Ll - - 'TI c):',: "", 0 - - 0"-, ~. ... Z (j -- '.. s:: WL.I n: '00' o~-- 0::'" t..:....: ',~l:. . t'"' ~ C(3 '"'- tow ~:'" "~ c:: C> :::to:: L:::'-: cr. ~ w.' t'1 l'O ,. 0 I Z -F- t'"' -< -< -< ~ ~ t'1 t'1 ;Jo- ~ '" ~ ~ ~ 8 ~ " :z: ~ ~ ~ > 0 :>< :>< 'M l/ \D ~ III . ;:> Ul '" Ul ...l f4 k 0( Ii " - ~ ~ u :z: .-< - ~ 0 .-< co ~ - '" 0 !;: ~ N ~ ~ 0 c;: ~ Eo- 0 III 0 :z: 0 III III :>< Eo- 0 - ~ :z: ~ ~ Eo- ~ Z Z ...l 0 - 0 c;: s ~ ~ ...l Z ::E z .. 0 u ~ ~ - ~ III 0 8 0 z ~ - ~ 0( 0 "" ...l ~ .,..- c,; / - ff{)- cj 07 Inventory of the real and personal estate of FLORENCE S. J:,EE.~.QML-_____d.c.a..d. . .----. ---- .-_. ---.---- REA L PROPERTY: 1. 26 Amherst Drive, Lower Allen Township - One Story Brick Ranch-Type Dwelling with attached Garage PERSONAL PROPERTY: 1. Household Furnishings: Living Room Suite Dinette Set Bedroom Furntture Miscellaneous Chairs Refrigerator Miscellaneous Dishes & Cooking utensils 2. Automobile, 1978 Pontiac Lemans Coupe, Title No. A30241613 3. Jewelry: Man's 14 kt. Yellow Gold Consistory Ring with Diamond approximately 0.35 ct. Lady's 14 kt. Yellow Gold Ring with 3 Diamond Beads approximately 0.15 ct; 16 Single Cut Diamonds, approximate total wt. 0.32 ct. Costume 4. Cash ou hand 5. Checking Account - Dauphin Deposit Bank Philadelphia Electric Company - Common Stock - 58 Shares - Certificate #NYC0568651 - 4/28/78 Pennsylvania Power & Light Co. - Common Stock - 100 Shares - Certificate #AC143864 - 5/8/78 6. 7. 8. Merrill, Lynch, Pierce, Fenner & Smith - Common Stock - 10 Shares Certificate #55997 - 3/6/74 9. American Telephone & Telegraph Co. - Common Stock - 52 Shares - Certificate #67T654492 - 9/22/67 Northeastern National Bank of Pennsylvania - Common Stock: Certificate #MAR 1865 - 11 Shares - 15 Mar 73 Certificate #F13014 - 11 Shares - 25 Oct 67 James Dole Corporation - Co=on Stock - 7 Shares - Certificate #9287 - 3/17/78 Certificate of Deposit - Dauphin Deposit Bank - Certificate #15932, 5 June 1978 Interest on No. 12 to 5/23/80 Certificate of Deposit - Harris Savings Association - Certificate #106820 - 2/12/73 Interest on No. 14 to 5/23/80 Certificate of Deposit - First Federal Savings & Loan - Certificate #737 - 12 Feb 74 Interest on No. 16 to 5/23/80 Certificate of Deposit - First Federal Savings & Loan - Certificate #2-17-208170 - 15 May 75 Interest on No. 18 to 5/23/80 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. $48,500.00 50.00 25.00 50.00 40.00 100.00 20.00 3,475.00 245. 00 170.00 . 35.00 22.00 8,264.25 747.04 1,975.00 206.30 2,743.00 231. 00 231. 00 136.50 10,000.00 760.35 15,111.50 364.45 5,000.00 129.52 1, 000. 00 25.90 ." .- COMMONWEALTH OF PENNSYLVANIA I COUNTY OF CUMBERLAND J ss: .------. --..-------. -.--.-- ._---,...~_.. ..--...---'--'-'-- .-----...---.- ----------.. HARVEY S. LEEDOM .----.------ being duly _~.!'n ____.___ according to law, dopose. ond .oy. thot he ____Is the Admlnlstrato!___ __._.___________.._______.____ ._.___. of the E.hte of FLORENCE S. LEEDOM late of Low",. AlI"n TOWllShlo , Cumberland County, Po., dece.,ed and that the within i. en inventory made by.. __..__._him.__._ _..._____n. -- - ---....--, the .0id_Adminis.txllt2..r- of the entire e.tote of .aid decedent, consisting of all the porsonal properly and roal eshte, except real e.tate ouhide the Commonwealth of Penn.ylvonia, and that the figuros opposite each item of the Inventory repre.ent it's fair value a. of the date of decedent'. death, Sworn and subscribed before me, ~~tFL~~:: 13 Februarv 1981 a I MAf l' J;,. tJ./I'-&4'J U JOANt-lE M, UPD~ROVE. Nobry rub"c Mv C",mm;l,lit>n Expire.! O'lolJer 4. 1981 FJiniew Twfl.. PA Vorl< (ClI,Zty 201 Brlarellff Road I Harrisburg, PA. 17104 Addr." Date of Death 23 D.y May Month 1980 Vur INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal repre.entative. 2. A supplement in~entory must be filed within thirty days of discovery of additional a..eh. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ~ '" '.'.. 0 >- ~ :a .,; , "' ~ I- W ~ ~ ~ ~ '" ~ ~ ~ w ~ t- o.. u ~ 0 III Eo< ~ ~ 0 w w . C (II '" ... :r: '" rn. I:l .. ~ I I- 0.. 0.. C 0 I- ..J u.. Ol .; ~ 00 Z ..J < 0 ~ := 0.. 0 u.. ~\ ~ I W 0 < w ~ ,;. .... > '" / co Z '" + ~ II Z 0 c C ~ ~ r III Z 0 0 '" 81 u z w < "(- ... 0.. ~ -0 f<<, c - ~ , -.: , 0 ~ , .Jl ~ E -0 "" + .! 0 ~ ~ 0 ..J U u: CD ~ -. . ' INVENTORY OF THE REAL AND PERSONAL ESTATE OF FLORENCE S. LEEDOM, DECEASED (CONTINUED) 20. Certificate of Deposit - First Federal Savings & Loan - Certificate 112-17-025900 - 24 Nov 78 21. Interest on No. 20 to 5/23/80 22. Certifieate of Deposit - First Federal Savings & Loan - Certificate #2-18-425872 - 10 Nov 78 23. Interest on No. 22 to 5/23/80 24. 25. Savings Deposit Certificate - Harris Savings Assn. 15 May 69 Interest on No. 24 to 5/23/80 i11-36368 - 26. Certificate of Deposit - Dauphin Deposit Bank - Certificate il14855 - 14 Feb 80 27. Interest on No. 26 to 5/23/80 28. U. S. Treasury Check - Refund - 1979 Income Tax 29. Medicare Reimbursement 30. Medicare Reimbursement 31. West Shore TV Cable Co. - Refund 32. American Association of Retired Persons - In-hospital Insurance TOTAL r~ (C ,. "- r:':: -2- 5,000.00 511.15 5,000.00 546.16 11,726.58 257.20 10,963.69 , 360.64 ~.: . , .. I 292.21 ! 580.00 46.40 9.63 1,830.00 $136,781. 47 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 iot, 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 fiied. 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. l'"' "d " n ~ t:1 ~ :s z :> 0 0 Vl C'l n ~ " ~ z ::: z ~ t:1 t'l 9 0 ?: ;ll ....; - Z Z t:1 ....; t:1 Z 9 9 ....; >< Vl t:1 - Vl ~ 0 Vl 0 ....; ." ;ll 'I1 ~ ~ 0 "%j - "%j 0 - Z n - )- c, " t'" L_ ;q Co;,:'; t: t.; N - Vl (..1 Ei: ~.')f3 t:1 G. 0 ~ol.. ~~ Z 9:. (V) ~ ~ c;....;. OM-.J >< -< wl.,l.," CI:! o::,c 0> tt: ';"w t:1 t'l ~ 0:: V) OC"J :.<.~ :> > u.., 0:::> ;ll ;ll ~~ - ju 00 , . u INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt c1ail11ed. 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. INFORMATION. To insure proper credit 10 your account. tho namo of tho estate and file number should be clearly print- ed on the check or money order. This assessment is made in accordance with Soction 708 of the Inheritance and Estate Tax Act of 1961 (72 P.S. ~ 2485.7081. To the extent that inheritance Hlx is paid within three (3) months Hfter the death of the decedent, a discount of five (5) percent is allowed (72 P.S. S 2485.716). Inheritance Tax, other than to). 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 future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P,S. S 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 '0 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 1 I days .00166 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 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 Ta, Act of 1961{72 P.S. S 2485.1001). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: INFORMATION To Insuro propor credit 10 your account. tho name of tile estate and file number should be clearly print- od on tho check or monoy order. This assessmont is made in accordanco with Section 708 of the Inheritance and Estate Tax Act of 1961172 P,S. 9 2465.706). To the exlent that inheritance tax is paid within three (3) months aher the death of Ihe decedent, a discount 01 li,0(5) percent is aliowed (72 P.S. 9 2465.716). Inheritance Tax, other than tax on a future Interest. is due ilt tho date of the decedent's dt~ath and becomes delinquent at the expiration of nine (9) months after tho decedent's death (72 P.S. 9 2485.711). Inheritance Tax on a future interest is payable within three (3) months aher the transfer lakes effect in possession and enjoyment and is delinquent thereafter (72 P.S. 9 2485- 712). Cnlculato interest from tile delinquent date shown on the face of this form to the date of actual payment using the following interest table: ----------------------------------------------- - - --- - ---.-- ~------- ---- - ---- I menth ,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 ,00366 4 days ,00066 14 days .00237 24 days .00403 5 days ,00065 15 days .00250 25 days .00420 6 days ,00101 16 days .00267 26 days .00437 7 days .00118 17 days .00284 27 days .00454 o days .00135 18 days .00301 28 days ,00471 9 days .00152 . 19 days .00318 29 days .00486 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 si~ty (60) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act 011951172 P.S. 9 2485.10011. Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: