HomeMy WebLinkAbout80-00612
f-Jl...If-IO
fOrm;" REV'" RHIS FOAM REQUIRED IN AU. ESTATES WITH GROSS ASSEm UNDER 110,000. UNOf:R SECTlOH 701 Of ACT OF JUNE 16. 1961, EFFECTIVE JANUARY 1. 1962. (FILE IN
DUPLICATE WITH COPY OFWlLLAnACHEDI
..
OFFICE OF'THE REGISTER OF WILLS
County 01
CUMBERLAND
01 1186 Letchworth Ibad, Camp Hill, Pa. 17011
IAddr..')
HELEN P. DOLSON
(Nlme)
she Transferee
according 10 law, deposes and says thai XACis the I EI)
(Ellec ,Adm, Leg. ... C
Blue Ridge Haven West, Camp Hill,
whose la~t residence was
(tlo 1 (S1re.!)
d h d' d Feb. 24, 1980
decoased. and thai tho wholo of the estale of said doce ent. w 0 Ie (Date)
Pa.
being duly
sworn
01 the eslate 01
FLORENCE E. DOLSON
East Fennsboro Township
(City. Borough or TownlhlPI
consisted 01:
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA WITH STATEMENT OF MORTGAGE CNCUMBRANCE5 UPON EACH PARCH AT DEATH OF DECEDENT, WHERE
PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES. alVE NAMES. ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Real Estate
Estimated
Value
. Personal Property
Balan::e in Florence E. Dolson Burial J1ccount
Parthemore Funeral Home (D3.uphin Deposit
Bank & Trust Co. J1ccount No. 15-11741-3)
after paym:mt of cost of funeral
~;,;tr'(C116
Parthemore Funeral Hone Funeral Ex];enses -
Balance paid bv parthemore Funeral Home
to Helen P. Dolson
c?1-1-fio- (.,{:J-
//- J27- I
NOTE: You may expedite the processing of this return by filing with it, and as a part of the return,
letters from financial Institutions or mortgage holders, certifying to amounts on deposit or owed by the
decedent as of the date of death. Such letters must be eigned by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest In the decedent's
account at the date of death and the type of account, account number and the exact name or names In
which the accnunt Is re stered.
JoInUy Held Property
Estimated.
Value
-.--------------------
Transfers within TWO YEARS Prior to Death
On July 18, 1979, decedent transferred to Helen P. Dolson
the ent~re balance ot Jo~nt account NO. L~-Uj~~7'~*at
Dauphin Deposit Bank & Trust Co. in the names of the
decedent and Helen P. Dolson in tne amount o~ ~L4,uuO.0~
plus interest of $73.49. Helen P. Dolson utilized the
account to pay for l~v~ng, med~caL and otner expens~~
Florence E. Dolson until her death, spending $9,172.00
of the account. (*Jo~nt account was more than 2 years 0
Thus: Transfer $14,073.49
Accrued Interest 142.54
Total 14,216.03
Less Expenditures - 9-;-i7i:OO------- /
Ralance ___._n.~.!.Q'~ 4.03 one-half ~~~.. 01 V
That at the lime of death there was 00 safe deposit box registered in decedent's individual name, or jointly with, or liS ageot or dcput~
another, or in decedent's individual name, with right of access by another as agent or deputy. with lhe exception of the following:-
NAME AND ADDIlESS OF BANK Olt OTIIEIlINSfITUTION
IN WIIICII DECEDENT IlENTW A SAFE DEI'OSIT BOX
None
TItIS SAFE DEI'OSIT BOX IlENTEll
IN NAME 011 NAMES OF
IlELATIONSIIII' OF JOINT
HOLDEIlS TO DECEDENT
BENEFICIARIES
Helen P. Dolson
1186 Letchworth Road
Cam Hill, Pa. 17011
Yes
Entire
AGE OF LIFE
TENANTS 011
ANNUITANTS
AT DEATH OF
DECEDENT
SUIlI'IVED
DECEDENT
STATE YES
Oil NO
INTEREST Qt'
BENEFICIARY
IN ESTATE
BENE.'ICIARtES AND ADDRESSES
(Slate full names or all and their addrrs..'iCs who have an in.
terest. vested. contingent or olhrrwist.. in r-.stalt':,)
RESIDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED
. NOTE: LlAt nnt five ilrmtlln tht spaCC'1I11O provided, ob~rve notations threeon, and inmructiona.
DEBT OR CLAIM NATURE OF SAME
AMOUNT
Funeral expenses paid
s
Family exemption (will not be allowed unleu
de('edent died residing with a spouse or children.)
/
,
Administration ExpenseJ .
Counsel ferll .
'"
--",
,
commillion .
Fiduciary
/
/
/
/
"-
'-
,
,
OTHER DEBTS AND CLAIMS'
'-,
(") See Note below
'-,
'-
"'-
//
//
"
-,
"
"
"
Total
Nole: The estate agrees to advise the Register 01 Wills if the amount actually paid in selUemeot 01 any lee, commission or debt is greater or !
less than the estimated amount claimed and allowed.
Subscribed and sworn to belore me this ,.'""
/~/t/' .?~
..~....~....................,.......
Helen p~ee
1186 Ietchworth ]bad
. .. . ... ... .. . . (si~;;r' N~;';h~;)""" .. .. . ....',.
..."..,. ,..2.~:~", day DC ,~,'\!U--""",tJ-\.<\-, " 19. ~.O
,.,., '~6i'AaYPliil~:'''Cs'''''''''''''''''''
My CommtROIl E.pIres DUO. 2\, 1981
1~BlQl1l" P... C......h..rl......~~
." ,c::~..Hi~Ll!, ,~a:.,17.0~1, ,. ,.,.",." ,.. ..,
(Citv UT Town and State)
Having been duly sworn according to law, \ do hereby certiCy that the above appraisement is made io coolormily with law 00 this I
.", ... . . . . .. . . . ..... . ... . .. . . . . . . day of . . . . . . . , . . . . . .' . . .. . . . . . . , . . . . .. . . . . . .. ... . " 19. . . . .
............................ ...........,.....
Appraiser
In l!'e eventth.t any lutur.e inlerest in this estate is transferred in possession or enjoyment to collllter.1 heirs 01 the decedent alter the
~xpi~tion 01 any estate lor hIe or lor years, the Commonwealth hereby expressiy reserves the right to appraise and assess transler
IDhentance taxes at the I.wlul collateral rate on any such luture interest.
REPORT OF TilE REGlSTEI\ OF WILI.S
I, the undersigned duly elected Register of Wills in and for, , , . , . . . . , . , . County, Pennsylvania, do respecUully reportlhatl have I
allowed debts and dedlrtiona in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in
the laat column to the right in said schedule above, which greater or lesser amount represents the sum allowed as a deduction. I
D'led:..,..,..... .............."....,.,."",.,...
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REY-4U EX+ (HO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
ILl Originol
o Supplementol
o Remainder
File Number
21-80-0612
Estate Nome
~'lorcncLE.,-Dolson
Date of Deoth
February 24, 1980
Sociol Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly oppolnted Inherltonce Tox Appraiser in ond lor the County of CUmberland
Pennsylvonla, do respectfully report thot I hove opprolsed the real ond personol property os reported In the foregoing
return at the values set forth opposite each item in the last column to the right in Schedules "A", flB", "e", and lie"
Dated:
December 31. 1980
Rl'h,,,/', )Y?/~'1f'1.j)
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISEO
AOJUSTMENTS
(HARRISBURG USE ONLY)
REMAINOER APPRAISEMENT CODE
CODE
Real Property (Schedule A)
Perianal Property (Schedule B)
Joint-Held Property (Schedule E)
Transfers (Schedule C)
II ne
00+
S
TOTAL GROSS ASSETS
tOt
20+
30+
Less D.bts and Deductions
(SCHEOULE F)
CLEAR VALUE OF EST A TE
o Lile Estate
o Annuity
40-
PRINCIPLE
VALUE
RATE
FACTOR
FOR USE OF REGISTER ONLY
Tax on $
COOE
COMPUTATION OF TAX
S
S
S
S
6%
TalC on S
15%
Tax on $
Tax on $
Tax on S
s
Exemptions
Total Estato
TOTAL HX
INTEREST FROM
BALANCE
s
s
s
TO
Leu Crodits
OATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST
S + S S =
+ =
BALANCE $
TO S
S
TAX CREDIT
s
92+
93-
CODE
REV.SI8 FO (7.801
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Helen P. Dolson
1186 Letchworth Road
Camp Hill, PA 17011
RE: Estate 01
County 01
File No.
FlnrAn~p. B. Dn1Qnn
Cumberland
21-80-0612
Dear Mrs. Dolson:
You ore hereby notified that the oril1:inal
appraisement in the estate 01 Florence E. Dolson
has been Iiled in the office 01 the Register 01 Wills 01 Cumberland
County on December ,1 ,19 JlQ. Said appraisement rellects the lollowing valuations:
Real Estate
Persanol Property
Jointly Owned
Traoslers
Total
None
114.98
NI"'lTlA
;>.<;;>;>.01
$2,636.99
As to such tox thot is paid within three months Irom dote 01 death, 0 live (5%) perceot
discount is allowoble, As to any tax that remoins uopaid alter nine (9) months (lilteen months
when death occurred Irom December 22, 1965 to June 16, 1971, inclusive; ond twelve months wheo
death occurred prior to December 22, 1965) Iram date 01 death, interest at the rote 01 six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may abject thereto within sixty days
alter receipt 01 said notice as provided by Section 1001 of the Inheritaoce and Estate Tax Act 01
1961,72 P,S. 2485-1001, P.L. 373.
Date
December 31, 1980
AcJ!/~"-4'/I/YPlt1JIIJHd' )
Signed
Title
Chief P,plll'aiser
NOTE: This is not a bill.
. "'~'.~_M ~-;'T-'~";;.;o-~..
REV-457 <<1,80)
COMMONWEALTH OF PENNSYLVANIA
. DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
*'
TOTAL REPORTED PROPERTY
2,636.99
Estate of
Florence E. Dolson
File No,
21-80-0612
County
Cumberland
Date of Death
February 24, 1980
In the eVtlnt that Iny futurelnterelt in thi.estatels trenstened In possession or enjoyment to collnteral heir. of tho decedent efter the expiration of any
estate for IIf. or for year., the Commonwealth hereby expressly reser~es the right to appraise and Bisesi transfer Inheritance taxes lit thalawful colllteral rete
on any such future IntlrBlt.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1, TOTAL REAL PROPERTY - SCHEDULE "A" , ,
2, TOTAL PERSONAL PROPERTY - SCHEDULE "S"
3, TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
None
TOTAL GROSS ASSETS
2,636.99
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 Wills,
"'1 ,. '/i"" j)
.AYJIJ8(f} / ,,,Pd,/r
APPRAISER
12/31/80
DATE
--------
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REV-4D5 (1-78)
..:.2/-rr.! - C;(:J--
STATEMENT OF DEBTS
AND DEDUCTIONS
DEOUCTIONS ALLOWED III
THE SUM OF
OFF ICE OF TilE
REGISTER OF WILLS
OF CUHBERLAND COUNTV
AND AGENT OF THE COMMONWEALTH
,,-=J. J-'e,_d ~
ESTA TE OF
FLORENCE E. DOLSON
East pennsboro Township
LATE OF
DATE OF FILING APPRAISEMENT
/J-3/-,1''O
February 24, 1980
DATE OF DEATH
DATE
NO. OF
VOUCHER
REMARKS
AMOUNT
NAME OF PA YEE
1
Register of wills
~~~~~g~R~n~~r;nn
6 00
1 50
50 00
2
3
Notar Fees
Myers, Myers Flower & Joh son Attorney Fee
TOTAL
57 50
COMMOHWEAL lH OP PEHNSYLVANIA
COUNTY OF CUMBERLAND
I, HE~EN P " DOLSON HEREBY CERTIFY, TliAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AHD TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF FT.mmNC'F. Po nOT.SON
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES,
v' ~?~.a.-rJ
lIelen P. Dol son, Tran s teree (L,S,)
DAY OF
SS,
SWORN AND SUBSCRIBED BEFORE ME THIS .2.:3-S:L
t ~^ 19<(\:l
) . '- ~;;; PUB~~6
My '..;a:l11llI,doO Esplre. Dee, 21, 1981
".I&1Oyne. PD. Cwnbellood eow>l1
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~COM~6~WEALTHOj: PENNSYLVANIA
~1'it.~~~!'~I'I""'ENT OF REVENUE
,8UREAUOF EXAMINATION
'~lf~~,~~~:~.;~:<:~:, '.:. "
-----_._--~-----
OFFICIAL NonCE OF
INHERITANCE TAX
ASSESSMENT
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DATE
( ;
ESTATE
FILE NO,
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~ /)19. '-19"
/
,a. due
.
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8
tax dUB
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TOTAL PENNSYLVANIA INHERITANCE TAX DUE
./5' .{/;'i'6
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.*****
A five percent discount
Inharltance Tex Is paid by
totellng
.
',will. .be 'granted if the
AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
. J?1J,5~ + 8 8 = . /57J ,6-1"
" + =
'-' ,-
+ =
'accrues etth. rate of six (6) parcent par annum
from
If paid bV
Is
Aslened by:
See Infotmlllon on Reverl. Side Age"
REGISTER OF WILLS
i .. ; I .~.r,~;:~~~~~':':e>:::"',, . ' :
,y !;'i't~!),~~O~WEALTH OF PENNSYLVANIA
... I~'N OEPARTMENT OF REVENUE
'z':{SUR'EAlfoF EXAMINATION
~. ,
....
OFFICIAL NonCE OF .
INHERITANCE TAX
ASSESSMENT
::,~\<:,~:>;:: J ::>. ,:',':
i~;collNTv FILENO: . Pl.1 - V () - {" I d
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),:,v;-:.';'::
;U'Appralled ValUB 01 eltBtB:
;~(:;:'::";::o:::B:~PBnY
Yi;;j;: :" .'Jolntly Held PiopBnylTrBnslB..
-~i:'2~1\;~~; .
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\::rTotll Approved DBductlonl
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'I;,}'CII.. Value cil Estatl
;K~j~;~:>,~;'?:"_;->"',":'\:':,,:' ','.
ti!,;i;'::2;L~~I:ApprOVBd ChllltlblB Exemptions
~;~h~::K',::'::~',:;'::.":'\:':;::.~:_:.,_ , ..1:_ _,"
t'i'IClee, Valili'ol EstetB Subject t~Tax
Ic"'sf~"~~_
~;'.\.{.:r':""'Am'ount.Texable @15%Rate
11;\. .. .' :"'/..~.~::'.;,;;'
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~~liI~~~~OF .PAYMENT
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"ltl'J';:liiterelt ,accrues at the rate 01 II. (6) porcent per annum
~\t";f~~.~~~~PI;:y~:~~~C~nt::.s:nh:~:e~~e p~~' :~om is
~"t':., BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
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COUN~ ~I~O~\
DATE OF DEA TH...::L:.Jl" . ~~
FILE NO.
.
+
+
s
s
s
s
tex due
t.
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tex due
TOTAL PENNSYLVANIA INHERITANCE TAX DUe ,t
~.
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* * * * . * A five percent discount totellng
will, be ,grented II the InhBritence Ta. Is paid by
.
AMOUNT PAID.
DISCOUNT'
tNTEREST
TAX CREDIT
$L/-,~a.,
+
$
Jj-,d., ->
$ ,1')3
.
=
+
=
+
=
REGISTER OF WILLS
~",
',',
.-Dale of Poymenl.eDt--1i1 24. 1980
% Tax on S
Eslole Tox, Act 01
May 7, 1927
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RUJmUD I'Ift'Y .. 54/10o---.-..-..--~allars
representing Pennsylvania Inheritance or
Estate Tax duo from Ihe fallowing estate:
,
'dress
,
G/o
..0.
~ JIDJI,
..... 115
"II.
2... Tax an S
r. --"YM.
la.
17041
6'kTaxon S
,file"No. "_aft-..,~
Date of Oealh 2.2..10RO
15% Tox an S
, Name olOecedent ...... 10 DOLSO.
,County
Remarks; ,
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)
,
~r
CuaMdan4
TOTAL TAX CREDIT
Less flye percentum of tal( if
pold wllhln three months after
date of deoth
Plus Inlerest at the rote of
_%Irom
10
s
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SEAL
TOTAL AMOUNT PAID
s
;:~I.
150.54';:\}
i~~
?~~:
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. ~ore: Thlt Triplicate RKelpt 10 be ret.lned for .udit pUrpoHI.
01~-..i
" Ign. re ','
(Tille)
Received by
. . ~OTE:, In Clcupllng th. tronsle, lnh.rllonte to. on lulurI ellales, prlor 10 the d.olh of th. Iif.
t.nanl or '.nant far y'Ofl, 01 I'Ild.nc<<f by thll "celpt, It II underllood thot th. Commonweolth ,hall
onol,b. precluded or pr.....nt.d from h.r.olt.r au.nlng addlllonallnh.rltance 1ax 01 th. d.ath of the
iiI. :I.nanl or t.nanl for y.ar' wh.n.....r II app.ars Ihat luch addUlanal tax may b. l.gally due and
collectlbl, for any r'alon whatso.....,.
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