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No, 21.80 584
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
Marion Darr Sheesley
, deceased.
To MARY. C. LEWIS
of Cumberland, in the Commonwealth
is
Petitioner(s) CJDe( the executrix
, Register of Wills for the County
of Pennsylvania,
named in the Last Will and
Testament of Marion Darr Sheesley dated 24 Februarv *949
Decedent was a citizen of the United States and 0 resident of
X~~
Lemoyne Borough, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on
Thursday
the 28th
day of Auqust
Cumberland , State of
(SS .'71 J. /.r,
Pennsylvania at the age of ~ yecirs. .
Jdxu :ho& her
Decedent has not been married and has not had children born to kIim
since the execution of the above described Will.
Decedent was possessed of personal property to the yalue of
?
/8- o-v-o. C'O and of real estate to the value of
-
A. D. 19~, in the County of
ffaV~
as near os can be ascertained; said real
estate situated as follows
~
Therefore, your petitioner(~) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon,
Dated ~- 37d7fi# 6F~ /? gc; X 1f.~.&w C) /,U'/V\..v ~.td-I
Name and address
of Petitioner(s)
l1N'ut..t.l1. ,f. I.IIJ()~C.,<
~ /'rScP
Helen Irene Gill
328 Walnut Street
Lemoyne, PA 17043
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
Helen Irene Gill
named in above application, being duly
say(s) that the statements set forth in
sworn according to low
this petition are true to the
best of
her knowledge and belief.
and subscribed before ~ 1!-.-d!.(A"- C) ~ /~
Helen Irene G~ll
Sworn
me, sopt.....r 5~ 8'
t!. .
t:JJ?7 Register
,"'.
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Vaughn )'(). . <,':;:
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Filed:
II - /lq -- if
:September 10, 1980
Attorney:
Andes &
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I, MARION DARR ~HF:Ef'.LE'{,of t.he City of' Harl'lsburg I.n the COlln'Y
of Dauphin und Stat!) of PenrllJylvanla,rle mUke,l11lbllsh and de'~lnre i'.hls
to be my last wlll nnd testa'c.ent hereby revok~ne n.nd malting void nll
wills and wrt tIngs In the nature thereof by me heretofore made.
1. I dlreet my Bxecutrines,herelnafter named, to pny all of
my just debts, r'lncral expense s anrl trun sfeI' inheri tance tax on my
entire estate us soon as can conveniently be done after my decease.
2. I direct my said eXf','.utrices tn pay to the Harrisburg
Cemetery Association,Harrisburg,Pa. the amount required to nrovide
perpetual care of t.he graves of r.1y f~ther ami mother ar.rl for my gra e
in said Cemetery.
3. All of the rest,l'esidue ann remainder of m;r estate, real,
personal and mixed and wheresoever sltuate,I give,devise ann bequea
unto my t'IIO si sters, ~,Inrcella R. Liddick, Harr isburg,l'a. and Helen
Irene Gill,Lemoyne, fa. in equal shares.'hould either of m~r said
sisters predecease me then the children or child of said deceased
sister shall take the share its parent would have taken if living.
LASTLY, I nominate,~onstitute and appoint my sald sisters,
Marcelln R. Liddick and Helen Irene Gill to be the exe'lutrices of
this my lnst will and testament.
Il~ '!lITr:ES~, '::HFREOF I have hereunto set my "and and seal
to this my last will and testament this 24th nay of February A. D.
1949.
11 "A~ J) u hh . g PUJ?LlJ. ~
(SEAL)
Signed, sealed, publ1 shed and declared c;r Uv, above named testatrix
as and for her last will and testament in the lJresen'e of us who in
her presence at her request and in the presence of each other have
signed our names as attesting witnesses.
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OA TH OF NON.SUBSCRI BING WITNESS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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This ..::::::-.......':-?,~......................... Clay of .........,.....9~Ej::,'f!!lP.!'lF..................
A, 0, 1911Q....., before me, ..............~n'..(:;...;I..~W~~..............,....................... Register for
the Probate at Wills and Granting Letters 01 Administration in and for the county 01 Cumberland,in
the Commonwealth of Pennsylyania, personally came ........J?imJ....G.,..S.c;:).J.l-ll:l'i!.l;',1;"...S.l;'.,............
....... R-!\Il. ..t:l.~H+=:iil. .~.... .s.c;:nJ.\p.'i!X~........,..................."...,.... ...."...,..............., who be in g du I y
.. ..,.......S.I:I:QX!1................. according to low deposed and say that they ore well acquainted with
the handwriting 01 ....................!'1'il.J;"AR!\..Q.~F.F..,9J).~~~.+.~y.......... ....". ...... .................. ......,
whose nome is attached as ..................'r.el'itatJ:;i.:K...................... to on instrument of writing
purported to be ........................................,.........................the Last Will and Testament 01
.....................,.............,..... .~'ilX,~R!\..I?~F.F.. .9):).!'l\!.~.+~y.... ..............................,................
late of,.,....... ..,........j::,l;1.~..?9.+.9.lJ.9.h..q.~..~~!!'RY.~.'?....,. ..... ...,......,..... ......... ........, deceased
and that the soid signature is true and genuine, and that the said .........MiilX.i.p.l\..Qfl!=:r..............
............Rh~'?9).~Y........................ is now deceased or absent ...........................,.............
...........RW9.J;",1)..............and subscribed before me,
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...7.<(,dr.~.,...,/f._,.j'-:J:."'J~?f
this..............,... ::It;l:1.,...,..,.............. ...... ,day of
....,........~'!l.l?~~!1!~7.~........... A. D. 19S0............
......'9z(~...~.'.t(~;;i;;;i......
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per ..............,............,................,........."........
Deputy Register
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND
This day of A,D.,19
before me, Register for the Probate of Wills and granting tellers of Administration in and for said Counly of Cumberland,in
the Commonwealth of Pennsylvania, personally came
.......
the subscribing witncsses to'th~ foregoing inslrument of writing purporling 10 be Ihe last WiII,andTeslamenl of
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'--"""- Dated _ ,////
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cumberland'c~unty Pa., deceased who being duly
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//' present, and saw and heard the test.
late of
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according to law, depose and say, that.
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sign, seal, publish, pronounce and declare the said
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instrument of writing as and for h Tesfi\;;'ent and Last Will. and at. the time of so doing
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was of sound and disposing mind.rnen;~-..y and understanding, to the best of"'""..
knowledge. observation ~belief. " " """
/ and subscribed before ".
/////
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AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA t ss:
COUNTY OF CUMBERLAND ~
#C~h/ ]..<'h..,. <G/~L
being duly
,,<1.-1-"/0/./ it?A/;(!
.swOA'N'
says that as nearly as can be ascertained the said decedent
.s I/lic< I /Y
,
dicd on
7,L/vlf'S!JI'1V
,;( '(1ft day of
//UG r-J3 r
A.D..19~,
the
at or about
/ " Crt)
o'clock, ,4 M.
Sworn
and subscribed this
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5th
September
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x: /21-1' II t ~--1
day of
19'~~A4 t2, Y:
:LL.f f/ //J...Il~gister
9'1 p
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OATH OF PERSONAl, REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
,
COUN'iy OF CUMBERLAND
Before me. the Regisler for the Probate of Wills and granting of Lellers of Administration in and for the County of
Cumberland, personally came
H/"L,e:,,/ I,('6,vL'
who, being duly Su)u,('tV' ,do P-<;
depose and say that as
of the last Will and Testament of
rnA~/ON ..oAA'~ ~ECSL.~V
deceased
Srf&S will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And
also will diligently comply with the provisions of the law relating to Transfer Inheritances,.Q.4?;/ and subscribed before me.
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Register
September
5
A.D.,19~
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DECREE
Be it remembered that on the
10th day of
September
.A.D.,19~, there was probated and
recorded the last Will and Testament of Marion Darr Sheesley
late of
Lemoyne
, Cumberland County, Pennsylvania,
Helen Irene Gill
Deceased. Letters Testamentary were granted to
Witness my hand and orricial seal the day and year aforesaid.
~ fl, ~~
. ~ - Register
REV-.50 It-aol
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" A"
REAL PROPERTY
(Instructions on Rcycrsc Sidc)
ESTATE OF
MARION DARR SIlEESI,EY
ITEM E5TIMA TED DEPARTMENT
DESCRIPTION MARKET VALUATION
NO, VALUE (OFFICIAL USE
ONLY)
NONE
,
,
TOTAL THIS PAGE N~~. J
-
~
INSTRUCTIONS FOR COMPLETING SCHEDULE "A"
Schedule "A" should include 0 detailed description of all real property located in Pennsylvoniu
and held solely by the decedent or held iaintly with another individual (s) as tenants in common. List the
decedent's percentage of ownership and the estimated market value of the decedent's interest. (Property held
as joint tenants with the right of suryivorship or tenants by entireties should be reported on Schedule "E".)
All real estate located in Pennsylyanio should be described by lat and black number, street
address, number of acres and general description of land and buildings. Also, include the book and page
number in which the deed is recorded and the exact title as indicated an the deed. If the properly has been
sold, allach a copy of the selllement sheet. If the property is subject to a mortgage encumbrance, include
the name of the mortgagee, date, rote of interest and the outstanding balance on the date of death and
allach a statement from the mortgagor yerifying the autstanding balance.
Property taxes and interest an mortgages as of the date of death, assessments and other
encumbrances should be listed on Schedule "F". Do not deduct them on Schedule "A".
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REV.4S1 (1.801
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of
ITEM
NO.
1.
2.
3;
4.
5.
6.
7.
SCHEDULE "8"
PERSONAL PROPERTY
(Instructions 0" Rcvl:rsc Sida)
MARION DARR SHEESLEY
DESCRIPTION
Christmas Club Account
Blue Ridge Haven refund
Dauphin Deposit Bank and Trust Company
Checking Account #77-48-0236
Savings Account #07-7-1936-1
Refunds:
United American Insurance Company
Blue Cross
United American Insurance Company
American Family Life
Columbia Insurance
Bell of Pennsylvania
Brotherhood Relief Fund payment
Columbia Insurance - claim payment
Savings Bonds:
Series: Face Value
Date
H
G
G
G
G
G
E
$1,000.00
25.00
50.00
100.00
100.00
200.00
500.00
11/71
8/55",
8/55
8/55 <
10/55
8/55
10/59 feMora
Savings Bonds owed jointly by decedent
and L. Liddick, Jr., predeceased of
decedent whereby she became sole owner
by virtue of her survivorship.
.&'/.k.,.uf..j U'<- '6& /J/'tI.&'bl.! t<:::6t.4.~ fi'fLi.<<-&f'>/
U771. &"f,p/Ulj
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UNIT
VALUE
ESTIMATED
MARKET
VALUE
OEPARTMENT
VALUATION
(OFFICIAL USE ONL YJ
100.00
995.00
1,775.48
18,517.40
165.00
18.35
22.16
5.00
67.18
6.55
120.00
514.54
1,000.00
,
(2, 100. 2~
/'1-'11. to
TOTAL THIS PAGE If5,406. 93) ~f:PFI-. 'I'
.
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. REV..,. (\.", SCHEDULE "C"
COMMONWEALTH OF PENNSYLYANIA TRANSFERS
DEPARTMENT OF REYENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT MARION DARR SHEESLEY
ESTATE OF_
*
INSTRUCTIONS:
Answer the questions on reverse side,
If the answer to any of the Questions on the reverse side is "Yes," provi de a description of the property transferred per
Schedules "A," "B," or "E," 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 (rust deed or instrument relating to the transferred property.
'TEM
NO.
DESCRIPTION
ESTIMATED DEPT. YALUATION
MARKET VALUE (OFFICIAL USE ONL Y)
NONE
TOTAL THIS PAGE
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years 01 death, make any transfer of any material part of his estate without receiving
valuable and adequate consideration? (Answer "Yes" 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".) no
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the folfowing.
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. AIf other information supporting nontaxability 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 "Yes" or "No".) no
a, Was there any possibility 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 "Yes" or "No".) nn
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Yes" or "No".) no
6. If the answer to five b. aoove is "Yes," 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 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 al ter, 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 "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Yes" or "No".)
IiEV.4S4 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
*.
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. 1
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
(Instructions all Reverse Side)
Estate of
MARION DARR SHEESLEY
I . -
P
TOTAL E VALUE OF DEPARTMENT
ITEM R
DESCRIPTION MARKET c DECEDENT'S VALUATION
NO. VALUE E INTEREST IOfficial Usa Only)
N
T
1. First Federal Savings & Loan Assc.
Account #1-1-116280 joint with H.
Irene Gill 2,619.35 50% 1,309.68
2, Savings Bonds, U.S. :
Face
Series Date Joint With Value
-
E 10/59 G. Martin Gill 500.00 1,022.80 ~gfJ (5n.40, 10 ~.1, fO
H 11/71 G. Martin Gill 1,000.00 1,000.00 @& (500.00) 10;0-{). 00
H 11/71 H. Irene Gill 1,000.00 1,000.00 50% 500.00
G 11/48 H. Irene Gill 100.00 50%,\
G 12/44 " 25.00 (i 1+ '77. f~ 50% ;
G 8/55 " 50.00 2,100.21, c:oOt I ~, 050.14:
'-' 10"
G 8/55 " 100.0 50% 7'N,'10
G 8/55 " 200.00 50% ,
E 10/59 " 500.00 50%
H 11/71 Nedra Shubert 1,000.00 1,000.00 ~O%)I ~{00.00 I~'
E 10/59 Nedra Shubert 500.00 1,022.80 iiO% 511.401 1 b J.~.10
TOTAL THIS PAGE ,t4, 882.62) IJ. IJ t/- II
.
.
September 4, 1980
Samuel L. Andes
Andes and Vaughn
P. O. Box 332
26 South Eighth st.
Lemoyne, PA 17043
Dear Mr. Andes:
This letter is in response to your recent request for informa-
tion concerning the estate of Marion Darr Sheesley.
Below is an itemized list of all accounts with the decedent I s
name as of August 28, 1980, (date of death).
Account number: 1-1-116280
Account title: Marion D. Sheesley and H.
Balance as of the date of death. '"
Accrued unpaid earnings . . . . .
Total value on the date of death
Opening date: November 11, 1963
Irene Gill
52,608.74
10.61
52,619.35
Should you have any questions concerning this data, please
feel free to call on me or any member of our savings depart-
ment staff. Our telephone number is 232-6661.
s~nCerelYI ~"~~ ";I
"J :~f1t,/~ [:tI-/;--1Xttt1
. James R. HOff~~/
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Savings Counselor
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1J5d7'.6,S
,
234 NORTH SECOND STREET. P. O. BOX 1111 . H^RRIS13URG. P^ 17108 . 1717) 232-6661
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REY-414 EXt (HO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
Ul Original
o Supplemental
o Remainder
I, the undersigned duly appalnled Inherllance Tax Appraiser in and lor Ihe Caunly 01 ~bel'~"~d
Pennsylyanla, do respectfully report that I hoye appraised tho real and p.rsonal property as report~ in I e oregoing
return at the values set forth opposite each item in the last column to the right in Schedules IIAu, "Bit, "C.., and "E"
File Number
21-80-058/1
Estate Name
Marion Darr Sheesley
Date of Death
8-28-80
Sacial Security Number
189-09-1364
REPORT OF INHERITANCE TAX APPRAISER
Dated:
March 18. 1981
_fh7Ml,l/ "ftfl'J!".'/ )
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISEO
coaE
ADJUSTMENTS
(HARRISBURG USE aNLY)
Real Property (Schedule A)
Personol Property (Schedule B)
Jolnt.Held Property (Schedule E)
Transf.,. (Sch.dule C)
S
00+
10+
6 604
18 2lH
30+
none
31,408
64
TOTAL GROSS ASSETS
Lell Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Lile Estale
o Annuity
40-
~
FACTOR
--
PRINCIPLE
FOR USE OF REGISTER ONLY
Tax on $
fQQ.G.
6'.
"
T ox on $
15%
T ox on $
Tax on S
Tax on $
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
OALANCE
TO
REMAINDER APPRAISEMENT CODE
92+
93-
VALUE
CODE
COMPUTATION OF TAX
$
$
$
$
$
$
$
$
TAX CREDIT
$
REV.S1B Fa (NO)
~~
. -~~ ."
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Helen Irene Gill
328 Walnut Street
Lemoyne, PA 17043
RE: Estate of
County of
File No.
Marion Darr Sheesley
Cumberland
21-80-0584
Deor Ms. Gill:
You are hereby notified that the original
appraisement in the estate of Marion Darr Sheesley
has been filed in the office of the Register of Wills of Cnmberlann
County on Ma~"h 1A , 19.B.1.. Said approisement reflects the following valuaiions:
Real Estate
Personol Property
Jointly Owned
Transfers
Total
none
24,804.46
6,604.18
none
11,40R f,4
As to such tax thot is poid within three months from date of death, a fiye (5%) percent
discount is allowable. As to any tax that remains unpaid after nine (9) months (filteen months
when death occurred from December 22, 1965 to June 16, 1971, inclusiye; and twelye months when
death occurred prior ta December 22, 1965) from date of death, interest at the rate of six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty days
alter receipt of said notice as provided by Section 1001 afthe Inheritance and Estate Tax Act of
1961, n P.S. 2485-1001, P.L. 373.
Date
March 18. 1981
Signed
.hf"",:n 1(bd'lI,j)
Title Chief Appraiser
NOTE: This is not a bill.
REV.457 (1.ao)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEOENT
INHERITANCE TAX
APPRAISEMENT
*'
Estate of
Marion Darr Sheesley
File No, 21-80-0584
County
Cumberland
Date of Death 8-28-80
In the event that env future Interest In thll ellate Iltranderred in possolsion Of enjoyment to collateral hoirl 01 the docedent .ftllr tho ellplration of any
estate for lifa or for vean, the Commonwe3lth hereby 8IIpresslv roservu tho ri'Jht to appraise and DlSftSI transit" Inheritance taMes .t th.lawful coll.teral r.t..
on any such future Interest.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2, TOTAL PERSONAL PROPERTY - SCHEDULE "B"
3. TOTAL TRANSFERS -SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
none
24 804.46
none
6,604.18
TOT AL REPORTED PROPERTY
31,408.64
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY TH E COMMONWEALTH
TOTAL UNREPORTED PROPERTY
none
TOTAL GROSS ASSETS
31,408.64
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 WHls.
~QN tJ'f: 'I ) 'f(t~;' ,J }f,; )
APPRAISER G
3-18-81
DATE
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REV.4!55 (1-S0)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
-i tto~-
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
---..--"---
-_..~....-... --=..-
~ (\ I rt f'/
m*
File No. 21-80-584
Estate of MARION DARR SHEESLEY Date of Death 28 August 1980
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
_ Relationshi(1 to Decedent
Claimant's Address
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
1 9JlO/8f ~ister of Wills Letters Testamentary and short
certificates 26.00
Tax filing fees 6.00
2 10/27/l 0 Kimmel Funeral Home funeral expense 2.208.10
3 Samuel L. Andes attorney's fee 750.00
4 10/271 0 PP&L final bill 3,35
5 11/11/1 0 Holv Spirit Hospital final illness 16.15
6 West Shnrp "'<~~~ advertisina exnense 6.25
7 Cumberland Law .TOllrn;!l " : _< __ _u____ 18.00
TOTAL THIS PAGEl 3,033.85
I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts. funeral
expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes.
'j-/ I" II '/,:7
K.._&-,"~ '//VC~_/x.U(.( 25 Nov. 1980
SIGNATURE OF ATTORNEY/FIDUCIARV DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ .5tfJJ:3 lib AT
/
)3-
PERCENT.
:?J;1I4r/tE~ij~{J
.3 -.:::?~-O/
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the uecedent 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 fileu. 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.
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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 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,
DATE OF DEATH ;/;;r-1~'" ~ -r .:/5: 1151J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
COUNTY FILE NO:
.~~:" / - /"1/1... ,..~-,"? .II-
DATE
,/
TO: /"-"G.
'}
,?I (",
'~f-'
.-:( ..//,.",}~_r(/l " l/;
;'j -. ;/ '
ESTATE
FILE NO.
COUNTY
/ '/ () 43
Appraised Value of Estate:
Real Estate
$
+ ;/;/ ,'71 -'I, ,/(/:,
/
+ (/, t tI.tj J f"'
$ ~/ 'it':? (/; 'I
/
.. r, -.-
/)0:33 8"!;
-'
$_.:f :/;..; '1 c/
/
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
$)7 ;;;1</, 79
,
Amount Taxable @ 6% Rate
$)'/ ';;'N 1'1
,
tax due
Amount Taxeble @ '5% Rate
tax due
'*'
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oj, ,; /! /''/'
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;;, /! -L' ,
_ /./-i-J/ "'.....,... ....t'. ""'....?t~
$ f-;; /)-t,:..Jii.L
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
s .f y. "JZ:; /
f
* * * * * * 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
II ,or -
- ,:; ) - /))
=
s -lei ?:;~ IF
,
. ") --.-/
;;/.. :J ~t
s ;/--:- Pit 1 + $ ,'";;,)'I,? J- $
/ -
, ,
/-;;':;-;?/
".' -:J--",
;~ , /~
=
+
+
=
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
s
.....
/1,7 7:..,
'-I> .;J
- " "/
7,r'Y h
J
Assessed by: .' /; /;//1. I !f
See InlormatlOn on Reverse SIde Agentfort~eComrwe~lth
,'", ,. *~~1'r4.tz::~
t,L'_I~ILI I ~_ F J tI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
DATE ~ l~f .:;(() I q K'/
ESTATE \,\\~Ij"y\ c{)cv ilL JIv~.A./
,;!,1-rO- 5r,/- I
CJYvY1,~~LJN_~
DATE OF DEATH Cu....t1 ;{~, t 0 8t>
COUNTY FILE NO:
TO: ~cV\.,
dl. J
r"'
r-
'-'()1
Ii
FILE NO,
COUNTY
t\~-
Appraised Value of Estato:
Real Estate
$
+
Personal Property
JointlV Held Properlv/Transfers
+
$
Total Gross Estate
Total Approved Deductions
$
Clear Value of Estate
less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$
Amount Taxable @ 6% Rete
$
tax due
$
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
J ~ '7. <6-5
fr * * * .. * A five percent discount totaling S
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
Lf-.;10 -y/ $ 1<<-'1, Y.S + $
s Ib'(o5
s
=
+
=
+
=
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 bv
is
? - '""\ ~~
JrL(h,~
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
Assessed by: "-;/ :'(,>~~(,(,"r.J
AQentlo,.nh,,'C:O mmQ ':,alth,~,',,_ /
See Information on Reverse Sido :';...-/1 r, c.-./
.. ... " , I ,!/;) f.,</;.-!
r~--------------------------------
I ;:;::-::; ~-- -- ~ -- Fa ---~ ~.~A __
~...., COMMONWEALTH OF PENNSYLVANIA
4 NO.K 0 0 0 430 DEPARTMENT OF REVENUE
'. .' OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
I
'"
.
..
If
=
/II
"-
TAX AT 6%
TAX AT 15%
RECEIVED
FROM
It
S....l L. And.., "q.
TAXAT_%
ADDRESS 26t:h S. ICigbth street
LeIIoyDe, pa. 17043
ESTATE TAX
._- ESTATEiNFORMA'TiciN7--
DA rE OF DEATH
TOTAL TAX CREDIT
2.38
Aug. 28, 1980
DATE OF PAYMENT
21-80-584
olan. 20, 1981.
LESS DISCOUNT
FILE NUMBER
NAME OF DECEDENT
MAUOII DARll SBmZSLBY
m
--------- m
PLUS
IFROM
% INTEREST
TO_I
COUNTY
CUllberlan4
I POSTMARK ~
'IEMARKS W 011 111/ C.
TOTAL AMOUNT PAID
2.38
SEAL
RECEIVED BY
. ///.. (< r.
? .. ."/ / .1 /.. .-i.Z/ .
Mary/ C ~ l.eWi~NATU1Ir
Regiater;/of Willtl
'<:--.;:./
I
REGISTER OF WILLS
-- --- - - - _. -- -- ----- -- - - --------- -----.
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