HomeMy WebLinkAbout80-00518
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REV-451 t 1-80)
COMMONWEALTH OF PENNSVL VANIA
DEPARTMENT OF REVENUE
TRANSFER INHElllTANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*'
(Instructions on Reverse Side)
Estate of
Catherine Ing
ESTIMATED DEPARTMENT
ITEM DESCRIPTION UNIT MARKET VALUATION
NO. VALUE VALUE (OFFICIAL USE ONL Y)
Personal effects 100.00
Household furnishings 75.00
.
,
TOTAL THIS PAGE 175.00 / 7S; c-l
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QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving
valuable and adequate consideration? (Answer "Ves" or "No".) No
2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party
or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ~
3. If the answer to one or two above is "Ves" 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 possibility that the property transferred might return to transferor or hi s(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 lorhis/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".)
b. The right to designate the persons who shall possessor enjoy the property transferred or income therefrom?
(Answer "Ves" or "No".) No
6. If the answer to five b. above is "Ves," state whether tne 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 benefit or care of transferor? (Answer "Yes" or "No".) No
8. Did decedent, at any time, transfer property, the bElleficial 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 "Yes" 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-453 EX+ (3.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIAR!ES
'*
(Instructions on Reverse Side!
Estate of
Catherine In~
BENEFICIARIES AND ADDRESSES
RELATIONSHIP
SURVIVED
DECEDENT
DATE OF
BIRTH
INTEREST OF BENEFICIARY
E1e:mor TN",; j
905 Indiana Avenue
Lemoyne, PA 17043
dau hte
son
es
1 2
8198 Wildwood Drive
Stuart FL 33494
The above beneficiaries are IiYing at this time except for the following:
NAME
DATE OF DEATH
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AlJadoJd leUosJad lie aq!Josaa ',:v" alnpa4:>S JO} sUO!l:>nJlsul a41 Ul pale:>!pU! se A1JadoJd leaJ lie aqp:>saa 'L ,
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aq 01 aJe A1JadoJd a\q!5uelU! pue alq!5uCl 4108 'd!4SJO^I^JnS}0 145p 41!M slueuallulO! se sa!lJed JO A1Jed
Ja410Ue 41!M AllUlO! luapaoap a41Aq pauMo 'leUOsJad pue leaJ 'AlJadoJd lie apnloul lsnw "3,, a\npa4:>S
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REV~84 ex+ (3.80)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
File Number
21-80-0518
Estate Name
Catherine B. ln~
Date of Death
5-8-80
Social Security Number 086 12 1642
REPORT OF INHERITANCE TAX APPRAISER
I, tho underslgnod duly appointed Inheritanco Tax Appraiser In and lor the County 01 Cumberland
Pennsylvania, do respectfully report that 1 have appraised the real and porsonal property as reported In the loregoing
retum at the values set forth opposlfe each item in the-last column to the right in Schedules uA", uB", "Ctl, and "E"
Doted: November 26. 1980
If'')'iJ1d,l ;Rl~j,tJ/(J)
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISEO
CODE
ADJUSTMENTS
(HARRISBURG USE ONLY)
REMAINDER APPRAISEMENT CODE
R.ol Property (Schedul. A)
Personal Property (Schedule B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
$
-0 00+
175 00 10+
56.753 11 2/H
-0- 30+
$56.928 ~l
40-
92+
TOTAL GROSS ASSETS
93-
Leu Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities. . . . . . . . . . . . . .
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6'-
"
Tax on $
15%
Tax on $
Tax on $
Tax on S
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Len Crodlts
DATE OF PAYMENT
AMOUNT PAID
TAX CREDIT
$
5
INTEREST FROM
BALANCE DUE
,
REV-457 (l-aO)
CllMMONWl!AL TH or- PENNSVLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
..
---
Estate of
Catherine B. Ing
File No. 21.-80-051B
County
Cumberland
Date of Death 5-8-80
In the event that Bny utur. interest In this emte is "."ulned in possession or enjoyment to colhn8rnl heirs of the dllCodent after the Qxplratlon of any
estate for life or for years, the Commonwealth hereby expresslV felerVDS the right to apPflllseand lInou transf.r inheritance taXi'll 81 the lawful colllteral fate
on any such futurel"'"est.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "6"
3. TOTAL TRANSFERS-SCHEDULE"C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY -SCHEDULE "E"
-0-
TOTAL REPORTED PROPERTY
175.00
-0-
56,753.11
$56,928.11
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
-0-
TOTAL GROSS ASSETS
$56,928.11
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of WiHs.
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APPRAISER
11-26-80
DATE
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RECAPITULATION
S'1, /IS".
58 0,.0.61
1......1............
Appraised value of Personal Property......................................................................
Appraised value of real estate ...............................................................................
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'rotal appraised value.... .... ....... ........................ ...... ............. ...... ........... ...............
AFFIDAVIT OF PERSONAL REPRESENT-ATIVE
County of Dauphin ss:
.......p.~.~9.F...J.:...~~.tj,~~~9m,.. .r.~x.~9.n!!-J..g.!':l?J.~.~!':n.t;:.?!;?:y.~.. .............. .....................
~d~~\strat 01 the Estate o!..........g.?:J<.h.l??;.;!.n~...bng,..............................................................
<lee eased, being duIy............sWO.l:1l.......................................... according to law, depose and say that the
items appearing in the Inventory ioclude all 01 the personal assets wherever situate and all of the
real estate in the Commonwealth 01 Pennsylvania of said decedent; that the valuation placed opposite
each item 01 said Inventory represents its lair value as 01 the date of the deeedent's death; and that
decedent owned no real estate outside the Commonwealth 01 Pennsylvania except that which appears
in a memorandum at the end of the Im"entor)".
..R.W,QJ:P.......................... an~1 51 bscribcd ~ 17 . /J ~'
b I h. d I ..~..&~..::::r..,........... .......................................
e ore me tiS...................... ......... ay 0 Executor. A Im.trator
.......A1Jgg~!;:....... ....... ......., A. 19~.Q... . n e Le e PA 17043
"r.;,{l>~~ ~f f,'..e.fl~.d~-;"e;f. ...~~... ff(I.I",berlc/l..d Add....
~ e.f're,.;,..J;e (' O-f, 81 INSTRUCTIONS
1. An Inventory must ba tiled within throe months &fter appointment of personal representatlve.
2. A supplemental Inventory muat be died within thirty days ot dlllC::overy of addlttonal 111I818.
a. Additional I!Iheets may be attached all to personalty or realty,
C. Bee Article IV, FJduclarles Act of 1949.
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INVENTORY OF REAL AND PERSONAL ESTATE
3Jn t~r Sll1ttrr of t~r iEstl1tr nf......9.!l:~p.~.l?~.~~.);~g..............................:.............
late of .....~R!:!?);l.~l:\..RL);..~m9.Y.TI~..................in the Coullty of 8~~~~1fa~~of Penna., deceased.
3Jnurntl1rll of the real and personal estate which were of the above-named
..... ........f~);,I:1.~r.~n~..JP..g................................................ ...... deceased. Taken and appraised
the ......~J:.n...... day of ......Jt~y................1g90 . (Date of death ......'H~I.?!9.........)
Personal Property
Personal effects
Household furnishings
Jointly Owned Property
Eleanor I. Neijstrom, daughter
905 Indiana Avenue
Lemoyne, P A 17043
Dauphin Deposit Bank & Trust Co. (1/72)
213 Market Street
Harrisburg, PA 17105
Checking Acct. #48 10 2407
Dean Witter Reynolds, Inc. (5/2/79)
37 N. Second Street
P.O. Box 1186
Harrisburg, PA 17108
Securities:
Intercapita1 Liquid Asset Fund
$ 1,000 Excelsior Income Shares Inc.
100 Pa. Power & Light
$10,000 Lear Petroleum Corp 11.50% 1992
$10,000 Weatherly Mun W&S 5.80% 2008
$ 5,000 Methacton Sch Dist Rev 5-1/4 1991
$ 5,000 Franklin Co. Hsg Au 4.% 1996
$ 5,000 Penn REst Inv Tr 6-3/4 1984
Cash
N.B. The Intercapita1 Liquid Asset Fund
was established from funds derived
from a joint savings account existing
more than 2 years prior to death
TOTAL
Total M rke Value 0 r.
Value Dec. In erest
100 00 ,.10 0"0
75 00 H' I1"tJ
1,237 22
618 61
21,300 00 10,650 00
16,125 00
1,912 00
9,300 00
7,100 00
4,000 00
3,450 00
3,600 00
185 00
S'1, /If' 1./
J.AW QPI'ICHS
BALABAN AND BAI.ADAN
THOMAS R. BALABAN
WilLIAM R. BALABAN
KAREr.. M. BAI.ABAr..
1'1\J.IWIIONI~ (717) :!:J....:J:.!UI
:.!~a NOlrTlI FNOHT STIIr.:KT
r. O.llox 111)1)
IIAllIIlslIUnO, Pt-:NNSYJ.VANIA 17100
/ I" I :lr~'D
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November 12, 1980
Hon. Mary C. Lewis
Register of Wills of
Cumberland County
Cumberland County Courthouse
Carlisle, PA 17043
In Re: Estate of Catherine B. lng, Dec'd.
Dear Ms. Lewis:
Enclosed please find copy of a check deposit slip
and bank statement for payment of Pennsylvania inheritance
tax in the above-named estate.
If you have any questions, please call.
Respectfully yours,
/i~v /I ,4.~~
Karen M. Balaban
KMB/jr
Encs.
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DEPOSITED WITH
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Dduphin Deposit Bank
ond Trusl Compony
THIS IS YOUR RECEIPT
..
WHeN M~i(:tlG A DI:PQSIT AT A TElLe~s \Mt-lOOW, ALWAYS OBTAIN A'N OFfICIAlIlFCEIF'T.
ChflCks and olher itBm, ar~ receiv!d lor dl"pos" 511hjC"~t 1J the 11Iovisions of
Ihe Uniform Commercial Codo or any applieable collection 1l1llCCmenl.
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48-10240-7
I'^"\. NO,
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CA T1if:IUNE: B lNG OE(;U (;~C!iu~ 1.11\
ELEA~iOk 1 I'<E1JSTKUM
<;O~ INUIANA AV'i::
Lt:MOVN:: PA }"{u43
"lltVIOUS
~l^l(,,^l:HT OA1E
in/H/l>U
4
Cy' 8 14
>.~COUtlt
np,a.
ACCOUNT NUMBER
--..---- ..--...-
PREVIOUS BA,ANCE CRel)I;; 1" ,"'S ~lA1EI.IE<1T
;lw:'acq ,\;...q~~'~!._ ~iUMl\<;{j ~_'_.1~~~~'I.i:'= .__~ANCE~
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ACCOUNT ACTIVIl'f
---"
CHeCKING ACCOUNT 4U-lv::'J,u-1 '"
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C H E C K 5 C H E C K S C H l; ,. I\. S ."
O,.TE if ,\1~our...T / DATE: Ii M.::SU,', T 0,\1:, " MIUuNl
08/01 so.uO Ou/O7 )\J't'''I.uo ,...;,I\)u ,v3<iJ.Uu
08/01 50. Ou vi Oc;I'HI l.L.'IOV \,~/ll V~\l.Ov ....;.
"
07123 DePOSIT . . . . . . . . . . . . .. It,l....25+
0'//23 DedIT MEMO I.Oil- .,
j,. . . . . . . . . . . . '.' .:'
00/01 DErUSll . . . . . . . . . . . . 3000.00+
" Ojj/,,(l RdURNED CH:CK . . . . . . . . . . :;v.vo*
\ o8/Gb RI::1U~NlOD CHECK ;.J4-'{. ~...
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CA THER mE 6 HIG DeCO O'J~":; OR
ELl.:ANOH 1 NEIJST"Q:1
,05 INOIAi~A AVI.:.
LEf.\OYNE: fA no...J
CRWIlS
NUM3ER ;.MOUNT
.:.,cou~n
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ACCOUNT NUMBER
PREVIOUS BALANCE
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CHECKIN::; ,\CCOLiNT 46-10.:...0-7 'f
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C H C C K S
DATe. ;~ AMOUNf
0'1/12 30....7.06
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DEBITS
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STATEMENT
DATE
10/1u/80
PAGE NO.
O'.i/U/tiO
PREVIOUS
SfATEM:NT DATE
STATEMENT
BALANCE
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-10240-7
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ST^,IMrNT
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CA THt::RINE BING Ot::CU O!>0880 OR
'ELlANOR I NEIJSTROH
'Xl 5 INDIANA AVt::
LEHOYNE: I'A 17043
PAGC NO.
, 09/11/tlO
~ PREVIOUS ~
! t STATEMENT DAlE ,
PREVIOUS BALANCE CREDITS DEBITS STATEMENT
NUMBER AMOUNT NUMBER AMOUNt BALANce
I I I I
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4tl-10240-7 354411j9 0 100 Z 3 OUflJO 1 45~2t1
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ACCOUNT ACTIVITY . I,
. . . CHECKING ACCUUNT 4&-10240-1 . . . . .- I
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tHECKS
TE " AMOUNT
/12 3047.bb
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DATt::
09/17
H E C K S.
. AMOUNT
40.95
CHeCKS
OATE j AMOUNT
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CATHERINE B. ING N '3 ~'
: ELEANOR I. NEIJSJ'RQM O.
, A:; ~~ i', H",_ 1i 2 iA I D ~9 S'e1 60.83/313 01
~JN'~Nf~,~~'~ '. 1$3,o~7, "
:gtt y~ '~~.t"~N' oP'~~~"",",.,
~ '. &:~~:'! ',a~ ~.~f.\'S,~, ,O[ 8 3 .,' , .
:) .... = - . :
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011/12180
-10240-7
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. CA THERINE B INl> DECO
~LEANUR 1 NEIJSTKOM
905 INIlIANA AVE
LEHOYN~ PA 17043
4
8
0!)0880 ~
PAGE tlO.
1
lit
07/11/110
PREVIOUS
STATEMENT DATE
ACCOUNT NUMBER PREVIOUS BALANCE CREDITS DEBITS STATEMENT
NUMBER AMOUNT NUMBER AMOUNT BALANCE
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Its-10240-7 65~34 " 614~91 7 32.4pb 355~a9
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ACCOUNT ACTIVITY ,
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. . . CHECKING ACCOUNT 48-102.40-7 . . . .
C H E C K S CHEC K S CHi: , II. ~
TE . AMOUNT .I DATE t AMOUNT DATe if AMOUNT
/01 50.00 08/07 3047.bb Ob/Otl v~O.Ou
107 50.00v' 08/08 1~.10v Oa/ll V5u.OO
DEPOSIT . . . . . . . . . . . . 44.2:>+
DEIHT MEMO . . . . . . . . . . . 1.00-
DEPUSIT . . . . . . . . . . .-. . 3000.00+
RETURNED CHECK . . . . . . . . . . . 50.UO..
RETlIlNED CHECK . . . . . . . . . . 3047.bb+
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
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COUNTY FILE NO:
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DATE OF DEATH
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App,aised Value of Estata: tI
Real Estate
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Total Gross Estate
Total Approved Deductions
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Clear Value of Estate
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Less: Apcroved Charitable Exemptions
Clear Value of Estate Subject to Tax
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Amount Taxable @ 6% Rate
$ '.;: _: .~'I) /11-
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tax due
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Amount TaxBblB @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
'It *' *' *' * *' A five perctlnt discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
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AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
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Interest accrues 8t the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
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Assessed by:
See Informalion on Reverse Side
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d' .....- COMMONWEALTH OF PENNSYLVANIA
4 NOKo00368 OEPARTMENTOFREVENUE
. -' . OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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1'1 RECEIVED
FROM
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ADDRESS
TAX AT 6%
TAX AT 15%
TAXAT_%
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89.14
89.14
/~~'116.SI~i;E~'L,'-cJ
Re~~er o~ Willa
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Harriab\1J:9. Pa. 17108
ES1'ATEINFCiRMATiON7i&y 9---i980
DATE OF DEATH '
FILE NUMBER
21-80-518
Deoember 18, 1980
DATE OF PAYMENT
NAME OF DECEDENT
CATHBRIIIIB B. X!IJG
CUIIlberland
COUNTY
POSTMARK OA TE
REMARKS: "PAID IN PULL"
SEAL
ESTA TE TAX
rn
rn
RECEIVED BY
REGISTER OF WILLS
--
TOTAL TAX CREDIT
LESS DISCOUNT
PLUS % I NTE REST
(FROM TO)
TOTAL AMOUNT PAID
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
COUNTY FILE NO:
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DATE OF DEATH
Appraised Value of Estato:
Real Estate
$
Personal Property
+
Jointly Held PropertylTransfers
+
Total Gross Estate
$
Total Approved Deductions
Clear Value of Estata
$
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$
Amount Taxable @ 6% Rate
$
$
tax due
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
t'"9. It(.
.. * * .. '* * 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
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$ J:ci /k:
$ rq IV-
+ $
. $
=
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
Seo Information on Reverse Side
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