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NO. 21.80
PETITION FOR LETTERS OF ADMINISTRATION
IN THI, ~;STA'm OF ",,,,,Ad~h,,B.l;;mche.,,DJ.1ke.,,,,,,,,,,,,,,,,,, DECEASED,
To ,,,,.,,.,,,,,M~);.Y,,,C, .", J..~:W;!"!L""""",, "" ",.""."" ,," """" "" """"""""""",,"'" ,.
RegiHter of WiIIH for the County of Cumhel'iand. in the Commonwealth of Penns)'ll'ania,
The Petition of ."" ""a~,r.);IJ~~",l,,,.P'~~~,,,,,,, ",'" ,,'" """"""""'''''''' ,,,"'''' ,,"" ",,,,,,,,,,,,, ",,,,, II' ",,,
"",,,,,,,..,,,,,,,,,,,,,,,,,,,,,,,"""'''''''''''''''' respectfully Hhowel h that """M,t;\h".a.l<:J,J:),~h~",P'g~!i\",,,,,,,,,,,,,,,,"'"''
'd t f Hgmp,den Township (' I' '1' I C u tv Shte of Pennsyl-
was a res I en 0 ......... 'rt ..,""""....."..........."".."'~ . unl lei .\lH. 0 II . .' . ..
vania, and a Citizen of United States, and departed this life intestate in the County of """"''''''''''''''''''''
""CJ.IllIP.e.f),iI,!).,g,,,.,,,,,, and Stat e 0 f .""".", r..~p,..':"!,!?,y.J:".I!':f.1:~,I!':""""",,,,,,,,,,,,,,,,,..,,,,.,,,,,,,,,"""""""""" ",,,,,,,,,,,,
on .."..'J1\~);'!1,gf:l:y.,,,,,,,,,,,, the """"""'~.~~,~"'"'''''''''' day of '"""".o.~.~,?~,~:':.....""..",,,,,,,,,,, A. D., In"!"?'".,
at the age of ,,,,,,~,t,,,. years.
That the said ",,,,,Mlil,h,,~l\l:!J:~h~,,,P'~~~,,,,,,,,,,,,,,,,,,,,,,,,,, deceased, left surviving the following
';- c~,
. ~, '
named widow or .J1usband, heirs and next to kin, to wit:
Name
Relationship
Residence
1504 Pine Street
Berwick PA 18603
"310"'Sf~""Jiihn"'s"'rirlvii"""''''
"c~m9'p. ")J.thl.,J~A"""SlIQ1L"",,,
2... ". nanover t.
Carlisle PA 17013
.......................J.......................................
,~~!1:j~~~f.1:".g.:""~~~~.l"}?:,~,"',,.,,
.R.1Jt.h, ,E, ..." ,0l!J~~)., ,.K+.;i,.Q!?,~,l?,!?",
.~.~j;.J;].J~.~,,,l,,,,,~~~""'"''',,.,,'''''''''
............................................
Son
'",P.f:I:~g~:;:.,,''''''''',.,,'''''
.,,,Pf:l:~,g~~~~"",,.,""'"''''
....................................................."".......
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..,..........................".............
..............................................."...............
................................................................
............................................
................................................................
................................................................
............................................
................................................................
................................................................
............................................
................................................................
That those above named include all of the next of kin. so far as known.
The said decedent was possessed of personal propert,' to the estimated value of $,,,,...?,.,Q,Q9,,.,Q,9....,,,
and of Real Estate, less incumbrance, to the estimated value of $"""..",.....9"..""",,,,,, as near as can be
ascertained.
That the said Real Estate in so far as is known is located in ...."......",,,,,,,..,,,,,,,,..,,,,,",..,,..,,,,......,..,,"
........................................................................................................................................................................................
Therefore, your petitioner(s) respectfully apply(ies) for Letters of Administration in the above
named estate.
Dated ....""J)Jly"]"""",,,,,,,,,,,,,,,,,,,, A. D., l!)"8.Q,,
Signature and Addl'ess
of Petitioner(s)
'1
-I-j~~- Q C~'-'-
""."" 'Be'i'i'i ice' "I'~'" DliKe" .",.""",.'"" ,"" ,..".....'",
"""".2.,~,~"'~.~""H.:~!:l:()Y.'~~"'~,~,~~~.~,.."",..,"""",,..
carlisle, PA 17013
........................................................................................
........................................................................................
COMMONWEALTH OV PENNSYLVANIA 1
COUNTY OF CUMBERLAND t ss:
."..' ..."".""".""""",,,,,,"" ,.." "",~~F..J;l,:!:~,e..";!:,~,,, .!?~~~'''''''''''''''''''''''''''''''''".,.,''',..".,''".."''''',,..,'''''''' ''','' named
in the above application heing dul)' """"..",sw.orn"",,,,,,,,,,,,,,,,, aecol'din~ to jaw, sa)' that the facts set
forth in the ahove application are true to the best of """,hl?j; knowledge and helief.
",....."""",..,."""."""",,"""'"'''''''''''' and suhscrihed 1 "",~~""~"t,~",,,....,,,.,,,,,,
I
\::""'"..:',.."::",:',::::::::::'"..:::,:':':",,',::',:,,',',:',::',,::::'::':::':',:',:::::::.~.2
...".".".,."."",.."""""""."".....,",.,,.,.,'".,"''',.,'''',.,''''''~
before me,
..,~.~.~y',J."""..",,,,,,,,,,,,,,,,,,,,,,,,,,,,, A. Il" H)"8.Q,, ,
, "'f /j! ....iJ .
,...,....,(,;." ,<t4.y/,"(.;,:"'i:.2ii~U,/;;~d."",,' ".""".
:; -.; HeKH~ter
~'i1ed: """..,'1.~,1.r."~,~"")'9.~l?"."""",,,.,,,
At tm'lle,\':
.R.!<:'H!1/?~... '''' /1... ..j{l:,-:J,f.u:.!v,.,(-J 9.
J"rc )(;>4" I~Cltfi'r~(""rr,
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1'1111<''''' ".". I 1'1') I') {"I
1tJ'.
(ovel'l
RECAPITULATION
3,771.67
s ...................
NONE.
s ..................,
Appraised value of Personal Property .....................................................................
Appraised value of real estate ...............................................................................
3.771.67
Total appraised value ..........................................."...,....................,.................... s ...................
AFFIDAVIT OF PERSONAL REPRESENTATIVE
County 01 Daupbin S8:
Bernice I. Duke.
..............................................................................................................................................
Exe..ut rix
Administrat
deceased, ueinl( duly.......~X?9.!'.u................................................ accordinl( to law depose and say tbat tbe
items appearing in tbe Inventory include a1\ 01 the personal assets wbere~er situate and all 01 the
real estate in the Commonwealth 01 Pennsylvania of said decedent; that the valuation placed opposite
earh item uf said Inventory represents its fair value as of the date 01 the decedent's deatb; and that
decI'd"lIt owned 110 real estate olltside the Commonwealth of Pennsylvania except that which appears
in a llWll\ornnclum at the end of the Inventory.
hC;;:~~;.J...,Itlel:~X;I;;~:~~:T~r~...~.~.~..l!ff?.~.~.~.'~:~:~! ~~~i.~d~~......................
.....~ "..;::'k.V;;...., YJ..... ,A. .19 ...... Ciil'"J,is Ie PA 17013
.,.' '..' 0' ".............1..................................................................
..............." \1...... ... .~.'l.. "!. . ............................. Addrel.
,.,~ j' ". ..; 0'" , .
, . "".'DI"NE l, \lUltER, Notary Public
" Morrisbur., O.uohlo. Co., Pa. INSTRUCTIONS
My Comml"lon Exp".s S."" 27, ,.A?
1. An Inventory mUlIt be filed within three months after appointment ot penonal representatlve.
2. A supplemental Inventory must be ftled wlth,ln thirty days ot discovery ot additional auell.
3. Additional sheets may be attached as to personalty or realty.
4. See Article IV. Fiduciaries Act ot 194.9.
l' ~ i! i..
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INVENTORY OF REAL AND PERSONAL EST ATE
-
In I~r _aUrr pf I~r felalr pf.......~~~!:I...~.~~~~..,l?~........................,.........,
vumDer~and '
laic ..i ........~~.~J.~.~J~.................................,..in the COllnty of~, State of Penna,. deceased.
JlIlIrntllrll of the real and personal estale which were of the above-named
ADAH BLANCHE DUKE . . '
............................................................................................... deceased, I aken and appraised
the .................. day of ............................19 (Date of death .~.Ql.??I}~..........)
1 Clothing, Jewelery and Personal Affects 50 0
2 Cash in Bank
CNB Checking #2521081550 1,228 99
3 Medicare Reimbursement 32 2
4 Banker's Insurance Refund 1,492 0
5 Loan Repayments 12/28/79 685 6
6 Cash on Hand 280 0
TOTAL
3,771.7
RC';C~33 t4~71Jl
~ )~ ?D _l~tl- ~;~\
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF IlEVENUE
BUREAU OF COUNTY COLLECTIONS
If..'
. .
RESIDENT DECEDENT
COUNTY OF
CUMBERLAND
IMPORT ANT,
This return must be completed in lIcltlil allll fHell in duplicllll'. with nllllltllchcd, with the Registcr of Wills or the
County wherc decedent resided; Return is due within niue months aflcr date of denth. unless IIn extension is grunted
by the Secretary of I~e\lenue. (Section 703 of the Inheritllllce lIud Estntc Tllx Act of 1961.)
Lale of
CUMBERLAND
} AFFIIlAVIT OF
EXECUTOR
AI)~lINISTRATOR
IN TilE MATTER or TilE ESTATE OF
ADAH BLANCHE DUKE
lSTATE FULL NAME OF DECEDENT)
County
County of
PRNNc::vnIANIA
CUMBERLAND
}."
Executor
State of
Administrntor
Bernice I. Duke
of the utate of the obove-nomed decedent being duly sworn, depolC! S
and soyS
lMONTH}
Name and address of attorney or }
olher authorlnd repreuntatlvo to whom
011 torrlUpondence should bo mailed.
(DAY)
, 1922--{~oltale loavlng 0 10lt will, copy of which /s hereto attached. }
(YEAR) Inlollale
Decedent died
October 25.
Richard A. Jameson. Esquire. 100 Chestnut Street.
Suite 206. Harrisburg. Pennsv1vania 17101
That as such Executrix deponent is familiar with the affairs of said estate and the I1rOperty constituting
\ EX E CUTO R~ADMIN IS! RA TO Rl
the aSSets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individualnamc, with right of access by anoth~r as agent or deputy, with the
exception nr the r"lIowing: - NONE.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S,~FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
NONE.
That the contents of said sufe deposit box or boxes are itemized under Schedules
wi th the exception,of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereor sels rorth rully and in delail all the real properly
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real l)rOperty at lhe datc of death, giving the amount still duc at
death, name of mortgagee, datc, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as or dale or death or decedent.
That Schedule B attached herelO and made part hereor sels rorth rully and in delail all personal properly
wheresover situated owned by the decedent at thl; time of t.Ieath: all moneys left by the decedent at the time of
death, whether in decedent's immediate possession, standing to decedent's crediL in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons
giving also separately the accrued interest thereon, if any, down to the last interest day prine tll decedent's
death in the case of savings banks, and to the date of decedent's death in all other case"; all honds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent;. all obligations, whether by statute or agreement they are designated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which arc. owned at the time of death;
all wearing apparel, jewelry, silverwan~, pictures. (woks, works of art, household furniture, horses, carriages,
automobiles, boats, and any and all other personal chattcls of whatsoever. kind or nature, left by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with intercst thereon, if
any, giving the face value and estimated fair market valuc thereof, and if such estimated fair market value he
less than the face value, it scll' forth hricfly lhe rea!'nns for such depreciation as to each item: all moneys
payable 10 the estate from life il1~ur:ll1ce policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon Ihe dcat!1 of the decedcnt; all and the corpurate stocks and dividends
due thereon and unpaid ;tS of 11\l' dah: uf dcath, honds and accrucLJ interest thereon to the date of decedent's
death and other investmcnt M'I.'lllill'::'o U\\1Il'41 lIy lhe dccedellt at the lime of death. with the market value there-
of at such time.
III tlu' l'llsn nl' st!~lIrltles 01' cloSt' or I'lI1nll~' t'fll'lllll'lI l. Ions, t.I1P VIlI\lPS l't~Jlorlerl lire liS 1'111' liS
poss,1hle "uhstllllttllt.l'll h)' f'llIlIlIcinl SUltPlnl!lltS 01' tI\I' l~nl'IHJI'lIl.lllIlS, showlnv. th,~ IlSS(lLs 1111<1 Jil1ldlLI,ics
tlll'rellt' liS nf the <Iut.C' 01' tll~lltl1. 'rlll~ sclwdlllo Illso sills 1'01'1.11 I,lip Inl.flrl'sl. nl' dl!l:I!dulll, Ill. l.l\l~ t1ml? 01'
tlt~llt.h jll /IllY cn-1'1l1'trwrsl1lp UI' IHlsIIH'ss, line! III SIIPIHII'l. nl' till' \'111111' 01' SIII:11 IlItnrl'st t.llI'r,' Is IllllmXI~fl to
suitt St'tll'ltllll', !'llllll1plfll st.ntl'II\I.'nts showlllp;l.llPIISSI~t.S IIntl Ilnldllt.lf's Ill' SIIIII f'O-PIlI'lllf!rslllp OI'llllSI1If'SH.
A--enpy of' till' l'O-JlHrtnl'l'sldp Il~rl!f'mjlllt, (Ir nrlll, tI stlll-PllII'lll s..lllllJ!, 1'0['1.11 1.11" WIt.III'I' "I' till' tl~r"I!IllI!IJl.)
lOllf'tlll'r '" I th II S tll l.f'monl. set t. t HI-!; 1'01'1.11 thn elllll'llr: l.flr I) f' t.III' In IS Illf'SS. I ts I oelll. tOIl, nlld slwll ()lJll~r rill: ts
P~'tt,ll:dll':~ 10 till! hllS!llflSS liS l1lU~' Ill! perl.1I1f!llt to II I'lli,' 111111 ,just IlpprnlSll1 01' thl! dl!el~delltls Illll~I,,!sL
thl~rplll '1i1\"llll~Sllhmlt.tnlt. It. shollld nlsn Silt f'orl.h In Itf!1nlznd form, l.oJ.!;fll.hm' with till! fall' 1I11l1'kol \'I1I\ll~
lI\1'I'I'(lf', :III~' uth('I' prnpl!I'tr oWllp.d or !)oqup.llt.lled hy till! dP.(:"I"~llt II t. t.Ilf~ !.Iml! of' dl!/ftll.
TIII~ Scl'edule C ltt.tllche<1 lIel'f!to IIlId Illnde 1'111'1. hl!I'I~nl' Sl~t.S l'ol'loll II l.I'Ilf' IlIlSWI~r' to e/lch Inquiry
contllin"ll 1.1)1'1'1'11\ IIwtlnt.lll? cliseol'tI'IIIlSt'l!I'Soflll'oP'~I'l.y, 1'1'111 oJ' Ill~rSo'llll, wltllln t.WO 'yollrs or f1ncerlenl.'s
r1Nlth~ III t'Olll.fll1lplllllnn of' IleCIHfcll(,'S ffellf.!l, 01' fnf.ellde(1 t.H Illk,! f"!t't'l'f!t III pussessJoH or en.Juynwnt l1t or
nfter death~ ~llill schpdule sl~I,S f'orth t.1ll! Illll.urH 111\(1 \'/11111' 01' sllr:h PI'f)IH'T'I.~', 1,0 whom t.T'llIIsl'errml, the
relnttflnsl1Jp or the trnnsfereos to the r1eceltf'!l1l., 1110 prnportlOIl/ltH shnre l'eef'!lvI!f1 llY CHell trlUlsI'eree 1lI11t
Ill! otllP.r rlll:ts 01' Il pert.inent. lInlHI'!! rel-!;Ilr'llnl!; sllld 1.runsI'Hrs. In l.Ilf~ 1~IlSI! Ill' tr/lllsl'ers IlIt,cn(lt~d In
tnke n1'1'ect. ill possessjon or en.!oyment nl or nl'tf'!r Ilelltht t.hl!rf' ts Illsn IIl.l.IlI:!iI'11 to tile- sellnllule II eonY
of the tteed, trust. agreement or other instrumellt ere/IUIlI-!; till? trust,. '1'her\~ is nlso set f'orl.h In sllld
schedull! 1\ 11.5t 0(' /111 prnpert~., ren] lIIHI perSflfJlll, with its vul\ll~, wldeh 11Il!"SI,'S at dl?cetlenl,'s death h~'
virtue of' tlll) exercise by decedent, either indivitluI111~'l Ht' ,jointl Y wi t.h nIlIlUu>r, or 1m)' pnwnr of' /l\1point.-
ment, vesterl indecerlent, either individulllly or Jointly, by Lllp will, tlep.d, or ot.her Instrument of' llllnthl!I',
with II copy 01' the instrument crelltill~ such lHlW~I' Iltt.llehell to 1.1\(> SChfllluin.
'Thnt Scl>edule D nttacheft hereto IlOll mnfln purl, "l~reof' sets f'orl.ll t.hl~ 11 II Illes Hllll llllrlresses 01' 1111
persons henefictnlly interested in this estnte lit t!1(! t.tl1lf~ 01' IteefHlentl s deut.ll, t.ile Iluture of ihetr T'CS-
pcctl\'e IIlt.erests, their rellltlollshlp, ir un~', to tile decedent, tng;C!t1ler wHh the Ilg;f?S I\t the t1l1ln of'
rlecedf'nl.'s detlth of' nIl mInors, annuttnnls und henef'lctHries 1'01' lire 11IIflt!r ,1eceflent's Will. It 1l1so
contntns (1 stlitement showing which or tilehencr1cillrles II1l1llefl 111 th,~ Ilncellent's will, 11' IIny, tlierl prior
to decedent;, tile rlates or their death, their Issue, IUlcl the rellll.iollsilip nl' sHcll Issue to thp belwflc1llry.
Thnt S.:l>edule E nttuclletl hereto nnd IIII1II(! /l Jlllrt. herool' sets fort.II nl] lH'ollert~f, T'enl lUlfl J1m'-
sona1., ownerl b~' the rlecerlent .1ointl~' with IlTlother or others, incll1il'n~ Int.an,!.!;ible, standing; In the IlItlll(!
of the decedent tlnd others, plus th"! d(ite nnd plnce of' rceorlt or Instl'uments 1?1'f'(!cting the \,estitllre of'
real estnte anli the dnte of IIcquislt10n or persolllllt.y, pIllS the IIl11nej IlIl<ll'cSS ll1l1t rl~lll.tioIlShlll, It' any,
of CO-O'o'o1Iers to the decedent.
Thlit Sct>pdulp F attnched hereto nod TI1/tdn II pl\rt h('rC!ot' sets f01'th rllll~' /tllll in Cll't/ll.l Itll dehts
and deductions clllimerl for nnrl on heh811' 01' thts Ilecnflent's estate, lnel\lllln~ runerlll expl!llsl!S Pllldj
family ex('mption, where upplicllllle; costs of ndministr/ltion of this estlltf!; l~lI\lIlscl rl!es /lnll 1'1Ifltclllr;\" s
commissions paid or to he pnirl; cost eX)le1Hh~.-t for hurhl trusts, t()mhstonl~S or J.!;rll\'emllrkcl's, /111ft rt!li-
gious scrvicest in consequence of' till? <lenth of the decedentj llehis and cl alms owing flnlt llllpl1tll /Lt, time of
dent.h; tnxe5 accrued chnrgcahll! ('or period priot' to deCHclcnt' 5 Ihwt.h (except. t1lOse flllowed \lillieI' Sl~ction
651 of the Inheritnnr:e 111111 Estat.e Tux Act); top;et,ht!r wl.tll II stlltement of' colla!.t'r.'ll ple,lg;l'fl 1'01' ohligll.-
tions, i.f uny. It is ngrecd tll/lt the I'1dllclnry wlll llr~S'-'Ilt proof' Ill' said dl\lml!lt nl)li~~nt,iolls upon I'e-
quest, that if tho amount ncttllllly puld in settlement of' 1m)! l'ef'!, (~ommlssl()1I or dl~ht. is 10SS th(Ul thl"!
estimnter1 (inlO\lnt clniming HU(t 1l11owcft, lhnt the slimp wtll he rf'IHlrted to tlll~ 1ll'l!;lst.cr of' Wills, /Iud tllat
the nTl10llnt of' tax 1l5SCSS(!fl clln hI"! rl!lISSf!SSf"'<1 hi lICC(l!'dlll1(!P t.Ilf~rt'wl th.
Thlit the tutuls of t.he Ilpproprlnte columns III SChl?ttllJt'S "A", "n", "en, "En, llnll "1'" liS cliret',ted t.here!1!,
have heen cnrrJed forwnrlt luttl prllperl~' re~iste!'ell in the Htll11l11/try.
..",.."......",,,,,,.,,.......'..
. ' Ilih
Subscribed and sworn to before me thiS ''', "',,""'"
dR,' of ..<.lp&nWi./L..: 195:; X~~,~"''''"''"._"
~.~ J,?"-tiid..&/ij 249 (:~~~h.'.~:~~;~;~i~l:~~!:,'".,,"-"
t~ No\alV public (Street Number)
QI~Nt L HUil ~\"(o"P', C l' 1 PA 17013
~~r~;~:~~:~"t.p\ros 50'1. ~7. 19&2 ar (Jiill~ T~';;" "~;.d' St,,~)
SOTE: Uet1nrl! slg;nlnp; nf'f'tltll\'tt. l1\1I1-;1~ SIII'I' all IlIallk ~lll\l~flS ill 1\1(' IlfTtllll\'tt. I\II,t s(:h('dllll's alllll'Xp(l Hrl!
fJllelt in with dl~tlllls or the word "Snlll'''. alld ill ,'aSt' till' as~'~ls 11Il'11111p rllrt' 1\11<1 Hlllisl!'ll st'I~llrlt.'I!s,
se(:llrities nf' close or f1lndl)' corporutiolls or llll tlltl'l".~~t III 111l~' ,'o-lllll'llll'rsldp or husllll'ss, t.lIlll. till!
Itlltll IInll stltt.flnlf>l1ts rl!(tlllrl~lt utlll..r 1.11(> IlIll'!I~raJ1h al'oY" I'plitllll).!. 10 SI'IIP,hlll' "II" IIr!' IlttlldlPil. \lstl mal,;t!
cp.rl.1dn tlllJt column #t JII t.he "'SlInun:lI'Y" hilS bl'l'll prllJll~l'l~' ('flI111l)1'Il'd us rd.ovl.-olll,..(~11'.t.
RCC-34 (4.131
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
*'
SCHEDULE "A"
REAL PROPERTY
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece.
dent. Property held by the decedent as tenant in common with another or other, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as iaint tenants with right of surviorship or tenancy by entireties should be reported an Schedule "E.")
The r.al proporty loeotdd In the Commonwtlolth of Ponnsylvanla should be
described by lot and block numb"r, .traet and ,t,uf number, together with
a general description of the properly, with 0 roference to tho record of tho
convcyance by which the doced.,nt took title; If a farm .tat. numbor of a.
crOl; oliO statement of mortgage encumbroncOl upon each parcel at death
of decadent. Tax.', a..eument., accruOld Intere.t on mortgagu, etC., ore
to bo lI.ted on Schedule "F" and must not b. daductlld from thIs Ichlldul..
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not writ.
In thl. lpaC')
ASSESSED VAL.UE
FOR YEAR OF
DECEDEHT'S
DEI. TH
ESTIMA TED
MARKET VALUE
None.
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
N ",.,,,-,,-
..l!19fl-
RCO-37 (12-63)
(,OMMONII'EAI.TIl OF I'ENNS\'HANIA
TRANSFEll INm:H1T ANeE TAX
RESIDENT DECEDENT
SCHEDULE "I)"
IlENEFICIAHIES
i
I
)(
r
1
I
BENEFICIARIES AND ADDm:SSES m:I.ATIONSIlIP SURVIVED
(I( step-children or DATE INTEREST OF
State full nllmes nnd IlddrcBscB of all who illegitimate children DECEDENT OF BENEFICIAllY
uve an interest, vested. contingent or other arc involved, set STATE YES IN EST ATE
wise 1n (lllto.tC) forth this faeL) OR NO IJl!\TIl
Bernice I. Duke daughter Yes. 10/8/21 Intestate share (1/3
Ruth E, Klinetob daughter Yes. 9/10/18 Intestate share (1/3)
Ben C. Duke, Jr. son Yes. 2/1/31 Intestate share (1/3)
-
. .
)
Deponent further says that 0.11 the nbovc-nnmed beneficiaries a.re living at this Ume except below:
NAME
DATE OF DEATH
RESIDENCE
None.
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SUMMAHY
..(Seh. "A")
..,.(Seh, "8")
.. ...(Seh. "e")
Heal Properly,,,,,
Personal Property """
Transfers '",,'''
Gross Taxable Estate "
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(1)
(As HeI'ortc")
Nqne.
3.771.67
$ ..
$.
$..
$...
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$.......3..771...67.
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(2)
(As Determined)
$
$
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$
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REV."U EX+ (&-lIO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
Ii] Original
o Supplemental
o Remainder
File Number ___.a1--80-0451;
Estate Name _--A9-,'!.h Blanche Duke
Date 01 Death
Octobe.r..2.2.--l929
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritonca rax App,aiser In and lor the County 01 Cllmberlrd
Pennsylvania, do respectfully report that I nova appraised tho real and personal property as reported In t e loregoing
return at the values set forth opposite each item in the last column to the right in Schedules IIA", liB", "C", and liE"
Dated:
January 8. 1981
..hY'.. " ,'ol'7f' /_ /I "y j )
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Perianal Properly (Schedule B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
$
00+
92+
3.770 67 to+
None 20+
30+
TOT AL GROSS ASSETS
___________},'1'J!) QL ____
Leu Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
40.
93.
OLlie Estate
o Annuity
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR \ISE OF REGISTER ONLY
Tax on $
~
COMPUTATION OF TAX
$
5
5
5
5
6%
TOK on S
15%
Tax on $
Tax on S
T OK on $
Exemptions ~
Total Eslofc
TOT AL TAX
INTEREST FROM
BALANCE
TO
5
5
5
Leu Crodits
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT INTEREST
--
+ 5 5 =
+ -- =
BALANCE S
TO 5
S
TAX CREDIT
s
5
INTEREST FROM
BALANCE DUE
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RC(N'(!,1/;78)f.;~"',h'li'~':" ,'i1.:;i" :"," 'CO'^M' MO'N' W' 'EA' LTH 0' F' "PENNSYLV' ANIA ," ,'"
' "'~4't}IJ:~'f_,.;~'t,',\" i , .j \ ~., :. . ; ,
;,1 B{1!)'4,"",:, ,:,,:',' ",,"; , ,DEPARTMENT'OFREVENUE, ':;':"''''''\
,*I:!I~,R4~,tO,fF'ICIA( RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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II"
S RECEIVED --------------olll
II
a From:
II ",
, 'Jress
y
~ File No,
i Dote 01 Payment
Ht1blDRID IIGHTY-NltlB
&I 97/100----------------__~rTbr5
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
Bernice I. Duke
249 S. Banovwr Street
29t Tax on
$
$
$
$
$
$ ~
$ 189.97
CUU.le,
Pa.
17013
6% Tax on
s
21-80-454 Dote of Death 10-25-1979
15%To)( on
$
'epteaber 11, 1980
% lax on !
Eslote Tax, Act of
May 7, 1927
Nome of Decedent
ADM BLAHCRB DUQ
County CWllberlan4
-PAm ON ACCOUNT-
101 Al I AX CREDiT
less five percenlum of lax if
paid within three months after
dote 01 death
Plus Interest at the rale of
_%from
10
$
, o~,mQrks:
$
uOO~[p~~@ill[]'rn SEAL
TOTAL AMOUNI PAID
$
189.97
NOTE: Thi. Triplicate Receipt to be retained for aUdit purpol81.
01~~~ ~.,dt('t~J
'gn urQi
y C. .
R~i~r O~ W111.
lie,
f
Rece'ved by
NOTE: In oceepllng the Ironsfer Inherllanee lox on IUlure eslolol, prior 10 the death of Ihe life
lenant or lenon' lor yearl, os evidenced by Ihls recelpl, II Ii understood thai !he CommonwQolth Ihall
nol be precluded or prevenled from hereafler OUtuslng additional Inheritance lox althe dealh of the
me lenonl or tenant lor years whenever II appeorl .hat such oddillonoltax may be legally due and
eollecllble for any reason whallaever.
------------------------------ -----.------.
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
TO:
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ESTATE
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COUNTY FILE NO:
,/ -'II _ r/ ))-'1
DATE
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FILE NO,
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COUNTY
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J' )' I /11-
DATE OF DEATH' '; ""{ 'f ,(,,. /,
J'/l 'I
Appraised Value of Estate:
Real Estate
Personal Property
$ ..-.-.----..
+ ,;:' ') ''/') , ,'" '/
I
Jointly Held PropertylTransfers
+
-----
Total Gross Estate
$ " II/: " j
} " ,
Clear Value of Estate
,; II 1)- ,/ '-I
$:/1,')-/\7
I ' '
Total Approved Oeductions
Less: Approved Charitable Exemptions
---.---
Clear Value of Estate Subject to Tax
$:1 / Ii ',:- /?
Amount Taxabla @ 6% Rat.
"I 1.,'/
$ ;, / I _J- _ !
. 'I
lax due
$ 1/,,/'/(
Amount T.xabl. @ 15% Rat.
tax due
/ ' , " TOTAL PENNSYLVANIA INHERITANCE TAX DUE
1_.;;,[ (;,1",'1 St'''-f:t :J'- /'j!() i:, Jc-l_J ./1, liM ,'() l?'/ )
l i I U. '/'
*: * ... * * W 'A five percent discount totaling $
will be grolited if the Inheritance Tax is paid by
$ I.'/(},'j/
/ 1/'/
1-llt/o
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
9-/1- 'it)
,
$ /i'/'/1
, '
+ $
$
= $/:;/'/'/7
+
=
+
=
Intorest accruos at the rate of six 151 percent per
on tho unpaid balance of Inheritance Tax from
to date of payment. Interest due if paId by_
annum
is
I".l,-,I','
1':\.
/ Ilj
:' /.1 4A,~1 ':/~'~ I c.t::U:A-C
" " (', ,." ~ I
Agentforth,eo n Ith
l ... II I-
I '_:u .1<"j5'Lf'-'
"
/ "
l/
$
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
As.....d by:
See Information on Reverse Side
iNFORMATION
To Insure proper credit to your Ol.:CQunl, tllo nomo of tho estate and file number should be clearly print.
ed on tho chock or money order.
This aSSOS!imont is made in accordfJncu with Section 708 of tho Inheritance and Estate Tax Act of
1961 172 P,S, ~ 2485.708),
To the extent that inheritanco tax is paid within three (3) months after the death of the decedent, a
discount of live (51 percent is ellowed (72 P,S, fi 2485.716),
Inheritanco Tax, other than tax on a future interost, is duo at the date of the decedent's death and becomes
delinquent et the expiration of nine (91 months after the decedent's death (72 P,S, ~ 2485.711 I, Inheritance
Tax on 8 future interest is payable within three (3) months after tho transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P,S. 9 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table;
---------..----------- ------ --- - --- ---- --------- - - -- - - --- -------- -- -- - - - -- --
1 month ,005 4 months ,020 7 months ,035 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 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) dnys after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P,S, fi 2485.1001),
Make check or money order payable to:
"Register of Wills. Agent"
Mail to the address listed below:
INFORMATION
To Insuro proper credit to your occounl, tho name of the estate and file number should be clearly print-
od on tllo dlock or monAY ordor.
l'hl!:t 1I5S0SSnlOnt is made in accordance with Section 708 of the Inheritance and Estate Tax Act of
1001 (72 P,S 92466.7061,
To tho oxtont that inheritance taK is paid within three (3) months after the death of the decedent, a
discount ollivo (6) porconl is ollowod (72 P,S, 9 2465.716),
Inhorltanco To,'I(, other than tax on D future interest. is due at the date of the decedent's dt:!8th and becomes
dollnquonl at 1110 expiration 01 nino (9) months afler the decodon!'s death (72 P,S, 9 2486.711), Inherilance
Tex on 0 IUlure interest is payable within three 13) months altar Ihe transler takes effecI in possession end
anJoyment and is delinquent thereefter (72 P,S, 9 2485-712), CelculMe interest from the delinquent dale shown
on tho foeo of thIS form to the date of actual payment using the following interest table:
-..---------- --------- - --------- --- ---- --------- - - --- - --- ------- - -- -- -- - -- --
I month ,005 4 months ,020 7 months ,036 10 months ,050
2 months ,010 5 months ,025 8 months ,040 " months ,055
3 monthS ,015 6 months ,030 9 months ,045 '2 months ,060
1 days ,00017 1 I days ,00186 21 deys ,00352
2 d.ys ,00034 12 days ,00203 22 days ,00369
3 deys ,00061 13 days ,00220 23 doys ,00386
4 deys ,00068 14 days ,00237 24 days .00403
6 deys ,00085 15 days ,00250 25 days ,00420
6 days ,00101 16 days ,00267 26 days ,00437
7 deys ,00118 17 days ,00284 27 days .00454
8 d.ys ,00136 16 days ,00301 28 days ,00471
8 days ,00152 19 days ,00318 29 days ,00488
tOdeys ,00169 20 days ,00335 30 days .00500
-- - -- ------ ..--------- ------- ---.-- -- - - ---- -- - --- -- --- - - - --------- -- ---~
Any party in interest, including the Commonweallh and the personal represenlative, not satislied with
Ihe ...ossment may objecl Il,ereto wilh,n sixty (601 days aller receipt of this Notice as provided by Seclion
1001 of thu InhUlllance and Estate Tax ACI of 1951(72 P,S, \ 2485.1001),
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: