HomeMy WebLinkAbout80-00627
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
..
COUNTY FILE NO:
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I. _' !~' . /.- ./ I
DATE
/ / /" ': '/ j,Sc/ /971
TO:
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ESTATE
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FILE NO,
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COUNTY
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DATE OF DEATH ._,'-.!..'/:.".,:A)"(:-U..// /~
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Appraised Value of Estate:
Real Estate
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$
Personal Property
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+ I I /' ,_
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Jointly Held PropertylTransfers
+
Clear Value of Estate
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Total Gross Estate
Total Approved Oeductions
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Less: Approved Charitable Exemp1ions
Clear Value of Estate Subject to Tax
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$ />t,':)
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Amount Taxable @ 6% Rate
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tax due
$ -; :;;-t) () . ;f; 7
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$ '/ IrJ,j9''t
,
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A five percent discount totaling
Inheritance Tax is paid by
$
will be granted if the
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
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Interest
on the
to date
accrues at the rate of six (6) percent per annum
unpaid balance of Inheritance Tax from
of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
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See lnlormalion on Reverse Side A~ent fO, qhc cO~ionweahh-
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REV-,US' (a..n)
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~~~'ttlF"DEBTS
~'lI.'Nb DEDUCTIONS
'SO nEe -5 I) J : I '
DEDUCTIONS ALLOWED IN
THE SUM OF $ /~ 9/7, 3 I
DATe APPROVEot);r././I~gtJ /'111
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ER OF WI L.S, AOl::NT
OFF ICE OF THE
REGISTER OF WILLS
CIDlBERLAND
OF COUNTY
AND AGENT OF THE COMMONWEALTH
ESTATE OF
LONA S. REIN
CLERK-Ui':I'H"',,, L;
CUH8fHLf.IW,",' :
LA TE OF Camp Hill Borough
/J /), ~/
DATE OF FILING APPRAISEMENT .~-:JO- (
OA TE OF DEA TH
September 22, 1980
DATE NO. OF NAME OF PAYEe REMARKS AMomlT
VOUCHER
Loyd Baird J Hinis terial services 100 100
Commercial Coin Co. Appraisal 9 58
Cardiovascular Hedicine Nedical expense 405 00
,..
Netropoli tan Medical Nedical expense 460 00
Camp Hill Presbyterian Church Church pledge 200 00
Landis Jewelers Appraisal 20 00
Dept. of Transportation Car transfer 19 00
Powers Funeral Home Funeral expenses 3,292 10
Patriot-News Co. Legal ads 21. 63
Cumberland Law Journal Legal ads 18 00
Register of Hills Letters Testamentary 62 00
Register of Hills Filing fees 6 00
Lorna R. Slike Family exemption 2,000 00
Arnold, Slike & Bayley Attorneys' fees 7,431 00
John E. Slike Executor's commission 3,715 00
Repister of Hills Short certificates 8 00
Regis ter of Hills Reserved for filin. account 50 00
,
. 17,817
31
-
COMMonWEAL TH OP PENNSYLVANIA I
COU NTl' OF ClJ}lBERLAND 55:
I, JOHN E. SLIKE HEREBY CERTIFY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, HIE FOREGOING I~ A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SlIBMITTED TO THE ESTATE OF LOMA S, RFTN
DECEASED, AS DEDUCTIONS FOR INHERITAHCE TAX PURPOSES.
3rd
EO BEFOR,E ME THIS
'9~
{-
John E.
(l.S.)
OAY OF
T j
helm. S. MICausfin Notary P bl'
Me. . . U Ie
Y ommufton ExpircJ Jur... I. 1984
Camp Hill, PA
Cumbcrfcnd COtlrl1r
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REV-449 (8-7El)
COMMONWEALTH OF PENNSYLV ANI A
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
$*
COUNTY OF
CUHBERLAND
RESIDENT DECEDENT
IMPORTANT,
Tllif. return must he compleH~rlll1 dcudlnnl1 fill-d in ,h1rlic;\h-, \\ith :111 :\Ilacl\l~J. "'lIll lht" Rt-p,islrr of Wills of the
Count)' where dccedem Icsidt'd; Return is thw with1l1llillc l110uths .Ifll"r .!II!(~ nf llL-alh, unless all extension is gfLulled
by the Scnctar)' llf UC'tlC'I1UC. (Sectiun iO) flf 11\1' Illhcril.lIIl'C Rlhl LS1.ltc Tux Act nf 19M,)
IN TilE \'ATTEIl OF TilE EST,\TE OF
LOHA S. REIN
{SlATE FULL Il/.Mr_ CF DECEDE.NTl
c"",, }
XIX'lIL'!:ClCMKXNXX
(\Frlll!'''!T OF
E~I'l'1'Tt\l(
L.ate of
Cumberland
Stale 01
PENNSYLVANIA
} st,
Executor
County of
CUMBERLAND
___..J,QI!,1.LE-,--s.u..ke ,-- - ------,-- ,----- - ----------'
~1QXKil{ of the ~,'al" of the obov".nomfld decodent bcling dul)' ,worn, <!IItPOU'l 5 and laY S
-----.-.--
Decedent died
September
22, . 1980
tutnl" Icovin9 O'J 10'" will. COllY f1' which is heleh) allachCld_ )
,.""
,O/.Yl
(Y E A"~
IMONTH)
~ome ond oddr... of attOlney or }
olher ol/thod:ud repreuIOta1lve 10 .....hom
011 co"u"ondllncll should be moiled.
Executor
That as such depont:nt is rami liar wilb the arfairs
(EJ;ECUTO r.-t..DIilINISTRA. TOR)
the assets thcreo\" and their fair market \'alue.
John E. Slike, Esq., Arnold Slike & Bayle~
2109 Harket Street, Camp Hill, PA 17011
nf silid l.-:-,t;\le ,nul the property constilllling
That at the time of d~ath there was 110 s.lfe deposit box reg,istcr..::d in det:edenl's inJi\idual name, ur jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of :ll;CCSS hy another ;IS agent or deputy, with the
exception of the following: -
NAME AND A.OO~ESS OF BANK OR OTHER INSTITUTION ~I"=-'':--THIS ~;-;~-~~~PO"SI;~~-;~EN~~.D -,
IN .....HICH DECEDENT RENTED A. SAFE DEPOSIT BOX -1-- IN NAME 0.. 10MES or
____ GCNH HanK, N.A. I -Decedent ana-Lorna R.-Slikel
21st and Market Streets \ '
Camp Hill, PA ' I
t :=L
HEL..TIOt~SH'P OF JOINT
HOLDERS TO DECEDENT
Daughter
That the contents of sllid safe deposit box ur hoxes arc ilcmi'l.cd under Schellules~_of this rcturn,
with the exception of the following, for the reasnns hereinafter set forth:
That Schedule A attached hercto ami m:lllt: part ht'rcnf sds forlh fnlly and in detail alllhe rcal property
in the Commonwealth of Pennsylvania of which dcced~nt died ha\'ing an intt:rcsl tht:rcin. It "h;n sets forth the
mortgage encumbrances upon each parecl of real property al the d:tlc of death, giving the ,lmnUl1t still due at
death, name of mortgagee, date, rate of interest. and book 11l1d page of ret.:urJ thereof. It also sets forth in the
columns provided therdore the assessed valuatiun of cach of SOlid p.:rccls. thl~ estimated markct value thereof
as of date of death of decedt:nl.
Tha( Schedule B aUllched hereto nnd made part hereof sets forth fully anJ in dewil all personal property
whereso\'er situated owned by the decedent at the time of death: a H mut\cys left by lhc decedent at the time of
death, whether in decedent's immediate possession, slandi!\g to llt,t:,~dC'nl's crclht in banks of deposit, savings
banks, trust companies, or oth~r institutions. \\'11t~lhcr indi\'hlually, or in trust for any tJlher person tlr persons
giving also separately the 3t:crued interest thtrr..:on, if any. dnwn 10 the last intercst Otly prinr to dccedent~s
death in the case of savings banks. llnd to the J;tle of d\.'Ct:dent'~ dC;\1h in all other l..:<t~cs: all honds, pustal
savings, treasury certificates or notes and tltht'r C\'ilkncc ur ir:.tlch~~dnt's~ pf :he United Slal.:s tn the de.
cedent; all obligations, whether hy statute or agrc(:\Il":llt Ih~y afe dt:si~~n:lteJ a~ lax free_ of Ihe United Slales,
or any state, or political subdivision thereof, or of any foreign country. which arc owned al the lime of death;
all wearing apparel. jewelry, silverware, pi~tures. huoks, work... of art_ household furnilure, hmses, carriages,
automobiles, boats, and any and all other personal chatlcls of what~(Jl'\'cr kind ur natufl:, Idt hy decedent.
together with the fairly estimated market v.due thcn:of; all t'ol1tls and mortgages held hy lIt'{;cdcnt ami of all
claims due and owing Jcccdenl at the tim.:: of dea1h. and all promissory notes or other instruments in writing
for the payment of money of which decedent died pussessed. of whatsoe\'er nature, with intert'st Ihereon, if
any, giving the face value and estimated fair market value thereof, anu if such estimated fair market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys
payable to lhe estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the dcccllem; all and the corporate stocks and dividends
due thereon and unpaid as of the date Gf death. bonds and accrued interest thereon tn the date of decedent's
death nnd other investment securities owned by the decedent at the time of death, with the market value thcre~
of at stich time.
In th(' CRse of scenril1es 01' ('ln~,1' I.r ft!l'lt!, 1" f'lllll,rt" "1" "lll"~ r"t'lJrlt'd nrp liS fur ItS
po~siblt~ !-lubstllntLllt~(1 by fJllllllCllll stnl('I>\I'Il~~, 'I!' [ii" .."I'.l:i"ll', .,hol\llh' ~lll' (l...sl'l'; /tud 1;llbl11t.II's
tht'r('ot" AS 01' tilt! ttnh' of tl~ltth. Till! ~iI'III'dlll,' I,I~"I 'i"I"; r"l'!ll :11' 11l1."I",~.,t ,\:' Ih'("~':f'I,1 III tlit! 1.1ntl~ uf'
deAt.h In tl.n~' c\)-ptlr1.ll~rshtp or Imsllwss, 111111 In Sllppnt': lit' 1:,1' \'111'11' of' s\lt~h IlIt'."rl'~l lher,' Is Illlllf'lh~d tu
snld sch~dllle, finnnclnl sttttl'ntr'llls sho\l\ltI~ 'h"lIS~I'f.. '1n~ Illllll1111,-.... (It' slltrl r()-l,,\r'TH'r!'ihlp or II\ISI1W!i...
A COp~" of till' (!I.)-l'nrtnershJp tlJ:;r"l~m('nt, (If (If/d. .I '~II,:' I",.'n! ',"lllll!~ 1'01'1,11 Ulf~ 1llltllrl! of th'l 11~rl~I'I1I'HIt,)
tov,etlll'r wJth t\ stlltl~/Tlf!tlt. st~ttin;!; fortll tilt" l+,lIrU(""r 1':. ,'llIlstf;'.:,~. Il'. 10CHtl\!I\, #till] :,IH!h ntll1'r I'I.lels
p('rtnlnlnA to t.he 111lshu!ss ItS lnuy lit. p"rUllo'lIl III /I ,',! I' /11111 Ill....' "II!H"ld'iUl 01' Uti' (h"I~'ldt'flll~. 11I1.f>rl~st.
thnrnln nlllSt. hcsuhmtt.t.f'd. It should 1I1~1I ~l'l I'nrlh ji, Ilyt:ll:,'d 1'1I"/Tl, 1.0/.."~IIl"r '",11.11 Ull' l'tdr mttrk,'t vul\ll~
t11t~rt~of, lll1~' other property owned or hl1(IIJ"/IUII'd lJ~' tl\l' oJ., ",].'l.1 It I Ib' '1'.lO' lit' d1'lltll.
The Schl'du/p C llt.lllCh,~d IIp-r''I'' 11;111 mild,' plll'l IH'I"~I'" ~"I:,,> fflrlh /I '-"IW IIUS\I\."r 1.0 l'H,"h 11ltllllry
contulned thf!rl!11l nnd In th(' (~lIS" (,I' tl"IIIlsf','r~ qj'prqp"\.' Y. L'I:H~ 0; l",rso'lfll, ',il thin 1.....0 rf~'lr~ of" 111~Cf!dt~ntl s
deutll, in cont.f'll1J1luttun of' dccell("lIt's ctl~ar.ll, (/I' 1111"1:'11.01 rH \'11,(' i'~'f',',.1 III jlossr....ston or ...nJoymfmt at or
after ttenth, snit! schedul(' sets forth tltI! Ilfllllrf' /tlld \' 1!!l" oj' suI'! rq"o!'r>rt.y. IfI ",'110m tr11Ilsi'erred, the
relationship of the trnnsfcreN; to t111~ flt~(,I,.il~nt, Iii" pl'\oji,)l"11ull:lll' ~tllll'" r"'.;f':\,l'd hy ellch trfinsff~rc'~ UlIlI
nIl othp.r fuct~ of It pertinent nature rl..~l!.llrdlll~~ '-dJrI lr'lllsl"r'.;. 111 till! ~llSI~..1' trlln'ifcrs tntendcft to
take ('ffect in possession or en.tormmll nl 01" /In''I' ,I....:tl,. :11";-': I:,,> Itl",o IltlHcl;I!lt to llJf! schedule Il copy
of the de~d, trust ngreement hr ot.lll..'r Insll'UI'I"nt t'r'"nti'I" ,III' trll":I. 'l'111'1"" Is ~l~o set I'nrt.h in suld
scheilllle Il list of' nIl properly, renl 11!Id t"~rsollld, ....)..:1 ii', villI!', ~!Il';:l il'l'''':S lit, dr~cf:'dent.'s df.?l1th h~'
virtue of the f'x('re!sc fly decedent, p.ll.her Illdl\'ldunlly, ol'lulllily .,.,tt.h Itlllll.hf'r. or nJlY pnwer of apflolnt-
ment vested 1nrJ(.'cpdplll, ('Ither IJlfI1\'idllllll~' or Joint I,\', fJY (hI' 11'111, (1(>,'n, or lith...," Jnst.!'lIm;:mt of' nnother,
with n copy of t.he Instrtunl!llt crp.lltiJl~ sucll IIUIU"" Illt.(u:llpd ;,'1 Ih" ~Cll('.-llllco
ThRt Schedu/t' 0 Ilt.lnchecl hereto lunl mnd.' pnrl. It"r'-",d' ~..t.s fort.h lh.~ Hilmes nnrl tuldrf!S5es of 1111
persons beneficially Int.erested In this cstltt!} lit 1ht~ til::(> III' rit'cl~dl'nLls Ileath, t.ht.~ nature ot" th~il' "~s-
pcclh'e interests, thf'lr relationship, if IIny, to till' t1er;.,I!PlIl. to~~t!th~r wlt.h the l1ge~; at lhe lime or
decedent's dettth of' nIl minors, nnnuitRnts 111111 h"'lll~f1{'l'lr1r's for 111'(' Ilmter r1ecedent.'s WHI. 1:t. Illso
contains a sta.tement sholdng which or the benGl'lci(jl';(~::; 'l1ullNl III t111~ rlnc('rlentts wlll, If nny, f1i~~d pr:lor
to rlcccctent, the dates of their rlenth, Llwlr JS~lle, null till"' relltl1nnshlp of such issue to the beneficiary.
That. S.:/ledulf:> E l1tt.achcd hereto nnd mild.., :t part h.-.rpol' s~ts forth nIl property, reAl IInd per-
sonal, mmed by tllP decedent jointl~" with nnol!l<'l" or nt.h.-.rs, lnr'ludlng int.nngihle, standing in the name
or the decedent Md others, plus the date and plllc~ r:t' \"1'l'l'r,t or Instrnments effecting the \esttture of
renl estate and the date of f1.cqulsillon or Jll!rsOlllllty~ pIllS l.h\~ nRmf'!. nrMrt's~ and loelflt:lonship, if any,
of co-owners to thp decedent.
That Schpdv/~ F t\Unched hereto Itnrl mnde It pnrt. h('renf sets forth fully nnd in detail all debts
nnd deductIons claimed for nnn on behnl (" of this tl('c:P:-:"II:':.; t'!'itlltP-, 1ncl1lfHn,~ funeral expenses paid;
fumByexemption, 'Nhere lIJ1pllcahlej costs or n":lllnlsl.rIlUO:1 of lhis est.ntl'; eounsel fees nnd j'udlciAryls
commissions paid or t.o be pnid; cost exprmrlf'11 for hllr!:11 trusts, t.umbst.ones or gravl..'mnrkers, find reli-
gious services, 1n eonsequf:'lIcp. of t.he IIl'nth uf' t.lle (II~~Pllf'llt: t11~"t.S IlIllI r:ll1tms owing fmll lInplltrl ilt Unle of
det\th; t.axes ftccrucd cllllrgeuhlf~ for periud prior t,t) 1II'CI'tlr'nt's dl~llth <-:xcept those llllow(.'d uUlter Sl~ction
65101' the Inheritance IUIII Estntc Tux Act); l.of:!.r,t.hl'r ""it.b ~I slnt.ement of cnllllternl plCIIg,crl for ohliga-
tions, if uny. It is agreed that the f'lrlUdlll")' ",ill prt'~erlt )Iroof ()f sull1 clalmt~rl ohligations upon re-
quest, thnt If th~ Ilmount. nctllnlly puld In settlenlfmt of any j'PI'. enmmlsston or debt is l~~ss tllltn the
esttmated amount clftlmlng nnll nlluwert, that till' Sllml~ will 1)(' t'l'pnrt.~d to t.he H('glster of Wills, and t.hnt
the funount at' tnx Ilssessed cltn be rellssessHd in llt~I'nl'ltlul('e t.herewl tho
That the totuls of thr~ npproprlnt{* columns ill S~ltetlll1r's "A", "H". "C". "Ell. luul "FIl f1.S directed therein,
have heen cnrried forwnrd Rnd properly re~tsl'!r'~d 10 ttw SlImmnry.
Subscribed and sworn to before me thiB
21:cc~~-------
/21 ~:x::t:~~A~:7:~:~t:~,,,,,,,,,,,.,__._,,_,__,
, ' (Street Number)
Camp H.il~"~,A.1.?O~l..",,, '"
(City or Town and Stilte)
,,,-,,;,,,,,,_t)3_r.,~,, """ """ day of ' " "",Decetnbe"
,,,,_.~/J~~'
Thelma S, M,Caullin. Notary Public
Mv CPmmiliilln !;>:lJjr('~ JlIlv 1. 198~
(clmp Hill, PA Cumberland
SOTE: ill! fore s J gn 1 n~ tlf(~rtr}l\, 1 t mukl' Sll rl' Illt III link spa! I'S In I h,> ulT Ilia\' 1 t unti scheclu 1 Cfi nnnexccl nre
rilled hi with llctulls or t.lle \'tord "Sllll"'" HIllI III ells" ltp~ ass"ls 11lclll(le rllre HnrJ un) tsterl securltl~s,
securlt.h~s of cJose or fllmlly corflflrlltl,'lls or IIIl Itll"rl'sl In !lll)' eo-pnrtnt'l"shll' or husiness, thllt t.he
dlltll lltHl Stllt.f'ments refllllrl~rlll1lCtf~r 'Jl.~ J'.'ll'll~rHpll lIhll\'i' r,'l:ltlll:~ In Sr:hl'(i111f~ "nil ttrl~ nt.tnchcfl. Also mnke
c(!rtrdn thllt column #1 In tile "StllIl:)lll"j'" has lwp.ll properly r~onlJll.~I,"(t ItS nho\'e-i1lrectcrl.
"l9ll.Q"
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COMMOMiIIIALTH 01' peNNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIOEN.T DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement 01 mortgoge encumbrances upon each parcel at death 01 dece.
dent. Property held by the decedent os tenant in common with onother or other, should be identilied
os to quantum 01 interest and the estimated yalue should be thot 01 the decedent's interest only. (Property
held os joint tenants with right 01 surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property locatad In the Commonwealth of Pennsylvania shoule! be
described by lot and block number, .treet and .treet numbor, together with
o general description of the property, with 0 r.f.renc. to the record of the
conveyonc. b)' which the decedent took tlll.j If 0 form .tot. number of a~
cres; also .totement of mortgage encumbrances upon each pore. I at d.ath
of deced.nt. To.e., o.....m.nUf accru.d Inter..t on mortgages, etC.,are
to be listed on Schedul. "F" and must nol b. deducted from this .chedule"
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTIDN
(00 not writ.
In this spac.)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMATED
MARKET VALUE
NONE
Insert this total apposite "real property", Schedule "A" in the X X X X X
"As Reported" column an the last page 01 thi s return.
/lft)~ ~
. .
REY-"!i' 18-781
-*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS: This Schcdulc must discluse all tangiblc and intangiblc IlcrslllHII prupcr(~' owned individunlly by the
dCI."cdent, ut the lime of his death. Property Clwned by the decedent juintly with .lIwther ur others musl he listed
umler Schedulc liE". Intllngible perNullillluoperty, titled in the n;ulle flf the decedent, hut payable at death to another
or others, including hut nut limited to P.O.I>. U.S. S.lvings BllIlds and tentative trusl accounts, musl he listed, despite
the fact that they arc not of lhe ildministered estate.
Tangible personal property should he listed first (e.g. jewelry, wcaring lIpparel, household gClllds, and
furnishings, bo]ks, paintings, uutul11CJhilcs, hnats, etc.)
Intangihle personal property, such as bonds, treasury certificutes, cash nn hand nnd in hank, stocks,
mortgages, nntes, tugether with OIccrued interest or dividends, salaries or wages, insurance pnyahle tn the cstnte nr
fiduciary in said capacity, rartnership interests, interest in uny undistribuled estate of nr income from any property
held in trust undcr the will or ugreement of nnother, even though Incated outsid~ uf the Stilte, ;'It the time of death,
should be Iistcd in this SdlCdulc.
Itcm
No.
I1l;M
Lisl and describe fully
UNIT ESTIMA TED DEP,\RTMENT
VALUE MA.RKET VALUATION
VALUE (Do nol write in
this space)
1,050.00
681. 00
479.20
30,109.29
2,353.43
45,318.39
100.00
9,441. 00
18.06 11,287.50
54.06 8,109.00
(21.5$ (4,312.00) lf1:l., &'0
57.69 18,518.49
~9./.2.S" (3,456.00) .3'1 !J-r., ,t.s-
(;:l.,/j$" (3,456.00) 31 0 ~,.?..5'
10.00
"
1975 Chevrolet Caprice
Diamond ring, as per appraisal
Coin collection, as per appraisal
State Capital Savings & Loan C.D.#002-15-01050
CCNB Bank, N.A.:
Checking Account #002-000556-7
C.D. 1/25762
Misc. furniture and personal effects
Intercapital Liquid Asset Fund #043-4019
Common stock in the following:
625 shs. PP&L
150 shs. AT&T ~'l..>V~
200 shs Burlington ~dea ''f'f; O{,;;.S
321 shs. General Motors
$5,000 bond - Texas Eastern Transmission,
6-3/4%, due 8/1/88
$5,000 Bond - National Fuel & Gas, 6-5/8%,
due 1993
Cash
Insert this total opposite uPcrsunal Propcrty", Schedule uB" in
the "As Reported" column on the last page of this return.
xx
6:38,681.30)
FfJ., R.J..:L,.30
~
. . REV-4!l3 (8-111)
COM\IONWEAt.T1I11F I'ENI\'S\'I."ANIA
TRANSFER INllEllITANCE TAX
RI~~\llENT llECEIlENT
SUIFIlUI.F "Il"
1\I':-;FFI('I,\ltll:S
- .
- I
BENEFICIARIES ANIl AllIIRI'SSI-.S IIEI.ATIONSIIII' \
(Slate full nann."s Ilmlllthlrc!\scs or 1111 "hu (II' tUep..dlildlcn U( SIlU\'I\'I:1l DATI:, IN TEll EST or
hu\',~ nn intl'feSt, VCSlt~d, contingent or other" illcgitimate dlihln"u IIECEIlENT 1\1; IlE:--:EFlClAIlY
wbe, in CI\HlIC) :'lfC in\'llln"d. Sl't STATE YF.s BlIlTH IN EST ATE
fur1h this fuet.1 OR r\O
Lorna R. Slike Daughter Yes One-third
1705 Linewood Drive
Camp Hill, PA
Edward Rein Son Yes One-third
9621 Nantucket Drive
Stockton, CA
Phyllis Gureck Daughter Yes One-third
6002 Roxbury Avenue
Springfield, VA
,
I
. I
Deponent further soys thot all the above-nomcd beneficiaries are living at thi 5 time except below:
NAME
DATE OF DEATH
RESIDENCE
~
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SUMMARY
Reat Property
Personal Properl)'
Transfers
(Seh. """) $
(Seh. "\I") $
(Seh, "C") $
$
$
$
CJI'OSS Taxable Estate
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(2)
(A s Determined)
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$
$
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Cml\IlI:-.iWEALTII OF I'ENlI:SYL\,,\NIA
Tll,\NSFFR INIIEllII'ANet' TAX
Sl'IlI'IlIlLE "I'."
.I1l1;\TLY lIW:>:EIlI'IWI'ERTY
RESIUENT IlEl'EIlE:--IT
INSTIU !('TIII;'I\S: Till s ...1'111'11111.' l11US l. III sc I (lSI' nil l'rol"~r ty, r," 101 /lwl pl~I'slllla I, ~~ hy l.h.~ clf",",'df't1t .IullllJ y
"1111 1lIIulll"I" ur IItllt>fS, 11il~11ll111I~ Illtllll~lhlesl sti.IHtllJ~ III tILl' IlIIm" 01' till' tll'CI~i1'~llt II/Ill utlH!I"S. 1.1~1.
fl'.d ,'s\/lI.' I'trsl. as '"lIlll"l.th's, or .I01lll. tt!llllnt.S, ~1\'111~ brt."1' dl'st.':"lJlf.illll, ;I~ Illtlll~lltf'd llllltl""!r Sdll~llul,'
".\", pillS tl\l' Ilntl' IIlllt plllGl! of' rl'l~()rcl nt" inslrUlIll'llt I-'l't'l~f:ttnt!. vI'sti tll\"', tlllt e1n Hot illl~llllll' ent.iret.ies
or Clul Ill' stall' I"."al f'slale \'11)111' In est.III,(' vIlJtI~ltl"1I 1:111\1",,1. jl'~I'sfJllIIl Ilfop"rl.y sllllul.l hI! Ilsl.t~11 llS In
Schpthlll~ "11". I'llIs dall! 0 l' Ill"llI i s I t.ieln, /l1ll1 t.1l1! Illtm", addl"f!~~i .ttlll rl'l a I.lllllsllll' (i f IlllY) () f' co-owners t.o
th~ c1l'ct'IIi'nl..
Clltt.
VuIue
ESl.llll'
VIIIUlIt.lnll
m'l'^I\TI.IE~T VALUATIOS
C/\UTTON-Do not. Wrl t.l~
In This ~ 'lei'.
11l're('III.II~I!
Shure!
VUltlH of"
Entire
propert.)'
.IlIue of'
Decedent.'s
Int.el'cst
NONE
Insert. this tolul opposite ".Iot.utly O\\'11ed PrOpl!rt)'", Schellll}!~ "E"
in the "As lleport,cd" COllll~1 on the lust pU;l;'~ of" tl:is return.
Nnu...,
~
RI!V-414 IX+ (NO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
jg] Original
o Supplemental
o Remainder
File Number
21-80-0627
Lorna S. Rein
Estate Nome
Dote of Death
9-22-80
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser In and for the County 01 Cumberland
Pennsylvania, do respectfully report that I have appraised the real and p.rsonal property as reported in the foregoing
retum at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E"
Dated: March 17. 1981 "'&Y/J/fiJJ:!f','"J.1,.I)
INHERITANCE TAX APPRAISER
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE DNLY)
Rool Prope,1y (Schedule A) S none 00+ 92+
Per.onal Property (Schedule B) 142 832 30 10+
Jolnl.Held Properly (Schedule E) none 2JH
Tran.f.r. (Schedule C) none 30+
TOTAL GROSS ASSETS 142,832 30
Leu D.bt. and Deductlans 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
OLlie Estate RATE FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER ONLY
Tax on S
CODE
COMPUTATION OF TAX
S
S
S
S
S
6"
"
Tax on $
15%
Tax on S
Tax on S
Tax on S
Exemptions
Total Estate
$
$
S
TOTAL TAX
INTEREST FROM
BALANCE
TO
Less Credits
OATE OF PAYMENT
INTEREST
TAX CREDIT
AMOUNT PAID
OISCOUNT
S
+ S
S
=
S
+
=
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
S
S
.REV.518 Fe (7.801
~~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
John E. Slik e
2109 Market Street
Camp Hill, PA 17011
Dear Mr. Slike:
RE: Estate af
Caunty af
File No.
Lorna S. Rein
Cumberland
21-80-0627
Yau are hereby natified that the oriB:inal
appraisement in the estate of Lorna S. Rein
has been filed in the office of the Register of Wills of Cumberland
County on M"l""h 17 , 19 ...8J.. Said appraisement reflects the following voluations:
Reol Estate
Personal Property
Jointly Owned
Transfers
Total
none
142.832.30
none
nOne
142,832.30
As to such tax that is paid within three months from date of death, a fiye (5%) percent
discount is allowable. As to any tax that remoins unpaid after nine (9) months (fifteen manths
when death Occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when
death occurred prior to December 22, 1965) from date of deoth, 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
after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Date
March 17. 1981
Signed
k'J:I/JA-,',1hf!~d"J(j )
Chief Appraiser
Title
NOTE: This is not a bill.
REV"4'7 (1"80)
COMMONWEALTH OF PWNSYLVANlo\
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
..
-"-
Estate 01
Lorna S. Rein
File No.
21-80-0627
County
Cumberland
Date of Death
9-22-80
In the event thet eny futur,lnter,st In thl. elUlt' I. trenderred In posselllun or enjoyment to collatoral hairs 01 the dDCedent aftl1r the expiration of eny
ntete for 11ft or for yoar., the Commonw8311h horeby expressly r8l8r~81 tho right to f1ppralse and assoss transfer Inheritance ta)l1tS at th,l.,wful collateral ratll
on any .uch future InterOlt.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "I!"
3, TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
none
142,832.30
none
none
[ TOTAL REPORTED PROPERTY
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
142,832.30
TOTAL UNREPORTED PROPERTY
none
TOTAL GROSS ASSETS
142,832.30
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.
i/11l ~: 7 r,O~J1,I,i )
APPRAISER
3-17-81
DATE
.
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No. 21.80 627
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
In the Estate of
LOMA S. REIN.
, deceased.
To Register of Wills for the County of Cumberland. In the Commonwealth of Pennsylvania.
Petitioner(s) Is (are) the execut or
named In the Last Will and Testament of
Lorna S. Rein dated Ju1v 19 , 1958
Decedent was a citizen of the United States and a resident of CRmp Hi 11
x~X~Borough), Cumberland County, Commonwealth of Pennsylvania.
Decedent died on
Mondav
the 22nd day of
Sept.
A.D. 19~, In the
County of Fairfax ,Stateof VA attheageof~years.
Decedent has (has not) been married and has (has not) had children born to him (her) since the ex.
ecution of the above described Will.
Decedent was possessed of personal property to the value of $115.000
and of real estate to the val ue of
as near as can be ascertained; said real estate situated as follows
None
Therefore, your petitioner(s) respectfully apply(ies) for the probate of the said Last Will and Testa.
ment and for Lellers Testamentary theron.
September 29, 1980
Dated
Name and address
of Petitioner(s)
~~ I? .
-rc- ~ ~ t. i'<.
A~ F. Slike
1/
2109 Market Street
Camp Hill, PA 17011
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND j
John E. Slike
ss
named In above application. being duly sworn
statements set forth in this petition are true to
Sworn to and subscribed before
according to law say(s) that the
hi " knowledge and belief.
p
me. SeEtember 29 , 1980
_qjztLty_~-,- ~tv-iJ
t' tI ~ter
0~6
Filed: September 30,
1980
Attorney
John E. Slike, Esq. ~
6Jfl-l
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.
in addition to those given by law, to be exercised in his sole discretion:
(a) To retain any real or personal property which may at
any time form a part of my estate so 10ng as he deems it
adviseahle.
(b) To sell at public or private sale, for cash or credit,
with or without security, to exchange or to partition, real
or personal property, and to give options for sales or exchanges.
(c) To make distribution in kind.
VI
I nominate, constitute and appoint my son-in-law, John E. Slike, of Camp
Hill, Pennsylvania, as Executor of this Will. Should he, for any reason,
fail to qualify or c.ease to act as such during the administration of my estate,
I appoint my husband, Edward R. Rein, Executor of this Will with the same
duties, powers and discretion as if originally appointed. Neither executor
shall be required to e.lter Bond or furnish sureties in any jurisdiction.
IN WITNESS WHEREOF,
I have'hereunto set my hand and seal this
day of r It
, 1958.
d~~~#
Lorna S. Rein
/?dA..
.
(SEAL)
Signed, sealed, published and declared by the above-named Lorna S. Rein,
as and for her Last Will and Testament, written on this and one (1) other
sheet of paper in the presence of us, who, at her request, in her presence
and in the presence of each other, have hereunto subscribed our names as
witnesses.
, Qat<//'/~~ Adi:~c"-I,.@.
!J + ~- / (/~ / ~I-a.
~1 K~~ Address
~" ._. I
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62
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OATH OF NON.SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA} ss:
COUNTY OF CUMBERLAND
This, the
29th
day of
September
A,D, 19~, before me, Register for the
Probate of Wills and Granting Letters of Administration in and for the county of
Cumberland, in the Commonwealth of Pennsylvania, personally came
James K. Arnold and Thelma S. McCauslin,
who being duly
sworn
according to law deposed and say that they are well acquainted with
the handwriting of
Lorna S. Rein
whose name is attached as
testatrix
to an instrument of writing
purported to be
the Last Will and Testament of
Lorna S. Rein
late of
Camp Hill Borough, Cumberland County, Pa.,
, deceased
and that the said signature is true and genuine, and that the said
Lorna S. Rein
is now deceased or absent
Sworn to
and subscribed before me,
this
29th
day of
September 'A,D, 19~
tJl(tUlj< (J. ~.(~~
(j Register
per
Deputy Register
63
. '.
OATH OF SUBSCRIBING WlTNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND f
This day of A.D.,19 ,
before me, Register for the Probate of Wills and granting lellers of Administration in and for said County of Cumberland, in
tIl ommonwealth of Pennsylvania, personally came
late of
sses to the foregoing instrument of writirlg purporting to be the last W'
Dated
according to law, depose and say, t
present, and saw and heard the testa
sign, seal, publish, pronounce and declare the said
instrument of writing as and for h
was of sound and disposing mi emory and understanding, to the best 0
elief.
and subscribed bcfore
Register
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA l ss:
COUNTY OF CUMBERLAND f
John E. Slike
being duly
sworn
says that as nearly as can be ascertained the said decedent
Lorna S. Rein
died on
Monday
the
22nd
day of
September
A.D.,1980,
at or about
1:30
o'clock, P. M.
Sworn to
and subscribed this
29th
day of
September
~
p
~'
>9. 80 ~'" 1
~'90~
Register
f>l
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of
Cumberland, personally came
John E. Slike
who, being duly sworn , does
depose and say that as Execu tor
of the last Will and Testament of
he
will well and fruly administer the goods and chattels, rights and credits of said deceased according to law. And
deceased
Lorna S. Rein.
also will diligently comply with the provisions of the law relating to Trans
~
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September 29 ,
>\.D., 19---lliL
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S"!QrR and subscribed before me.
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Be it remembered that on the 30th day of
DECREE
September
recorded the last Will and Testament of
Camp Hill Borough
~
Register
0'
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Lorna S. Rein
,A,D,.19~, there was probated and
late of
Deceased, Letters Tes tamentary were granted to
Witness my hand and official seal the day and year aforesaid,
, Cumberland County, Pennsylvania,
John E, S like
. €5
/7~ ?,(.~.....J
Resister
LL.,
",~.., .
REV-M7Ie-71l1
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF FIELO OPERATIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
'*,
- - _~ ____._ ____ L
DATE Nov. 7. 1980
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby mode for CCl1sent to the transfer of the following securities of 0 Pennsylvania
Corporation or 0 Notional Bonking Association locoted in Pennsylvania:
(0) 625 Jb)_~enn8x1vani~_~~",_eE~_I..ig.!1!=~~C~!!.1panL(c) Counnon
(NOTE: In describing securities enter in (a), ob Cle, either Ihe number of shores of stock or the face amount of
registered bonds, ia (b), the aome of the issuing company and in (c) the closs of stocl, or the stoted interest rote
and maturity dote of registered bonds.)
ISSUED ON 7/25/79 & 9/l.v.7~d having a TOTAL MARKET VALUE OF $_11..2..8..2
(Dato)
os of the dote of death of the decedent,___ Lorna S. ~~inu_. ,on 9/22180
(Nol",c of Oercdcnl) (Dote of death)
who was late of
1705 L1ncwo~.? Dr.!-ve.. ,_,~o!lI.!lp_H~1_1__~____Gumber1and
PA
(Street and Numbor)
(po!>! OHice)
(County)
(Stote)
The securities ore registered os follows: ~___~~mauS '_.ll.ei~.
(Name or narllC'!> in which cortificr..tcs arc registered)
~
EXECUTOR )
John E.
(Namo)
Slike ._210J_~Marke.t~ St:r.:e~t.._GamP--HiU......u
(Address)
NAME OF APPLICANT .__._~Qrn-tJ;~~
amp Hill, PA.
COUNTY FILE NUMBER 21-80-627 ADDRESS OF APPLICANT
BUREAU FILE NUMBER SIGNATURE OF APPLICANT _Ittu.-. P /~
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLI Ii. ION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR 0 PLETION.
---- -.-.------- -----4 __.
. ...-------------------
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO :!:!3AN~.t:ER~.E_~URlIIES DATE'2i~U C"l
I hereby conseat to the transfer of the above securities aow registered in the nome of th" ofor"soiCl
Decedent oad waive the filiag of 0 certilicole certifying to the payment of the troasfer inheritoace tax to which
the property of said Decedent is mode subject pursuant to the provisions of lhe Act of June 20, 1919, P.L. 521,
os amended and the Act of June 15,1961, P,L. 373, as ,,'nended. This is olsa in accordance with the provisions
of the Act of April 9, 1929, P.L, 343.
This Consent to Tronsfor Iho h",oin described properly operates only in referenc" to the estate of the
above-named Decedent.
~~~"
fg-",_..~,.
. \, r._' ~
l', t.1"l" ,\
! ,,~'~~~~:l>T~
~ned for the Secret~ry of Re.venue
By_ OLuj_ L),_':lIlI~-,-.~
~ '- (S;(J,\"r~,~<L(r\~ I.
.J~, "., (j.W. m__~ ~ ,
(TillC') 0 ounty)
i
i
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LOMA S. REIN
Inyentary af the real and persanal estate af
1975 Chevrolet Caprice
Diamond ring, as per appraisal
Coin collection, as per appraisal
State Capital Savings & Loan C.D.#002-15-01050
CCNB Bank, N.A.:
Checking Account #002-000556-7
C.D. ;i25762
Misc. furniture and personal effects
Intercapita1 Liquid Asset Fund #043-4019
Common stock in the following:
625 shs. PP&L
150 shs. AT&T
200 shs Burlington Industries
321 shs. General Hotors
$5,000 bond - Texas Eastern Transmission,
6-3/4%, due 8/1/88
$5,000 Bond - National Fuel & Gas, 6-5/8%,
due 1993
Cash
18.06
54.06
21.56
57.69
deceased.
TOTAL
I
1,050.00
681. 00
479.20
30,109. 9
2 353. 3
45,318. 9
100. 0
9,441. 0
11,287. 0
8,109. 0
4,312. 0
18,518. 9
3,456. 0
3,456. 0
1O.t
138,681. 0
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
JOHN E. SLIKE,
---- - .. ...-- ----- - ----. -.--- --------
b.ing duly __llli.o.r_o_" __, _ .. according 10 law, d.po... and .ay. Ihal h. - - ..' ..
__,_..~s Exe:_~t~J:..____..., _ ,_ __d of Ih. E.lal. of __.---1Oma S,..J\e1l!---.-----------
101. of Camp Hill Borough, ' Cumberland Counly, Po., d.c....d and Ihel Ihe
within is an inv.nlory mad. by. ,__ __ _him, _,__ . ,__,.-,.,,, -'-- - ...---, Ih. said__cxccutor,.--
of Ih. .nlire .slale of said d.c.denl, consisting 01 all Ih. personal prop.rly and r.al .shle, .xc.pl reel e.lal. outside
Ih. Comm.nw.allh of Pennsylvania, and Ihallhe figures opp.site each it.m 01 the Inv.nt.ry r.presenl it's fair velu.
as of the dal. of d.cedent's dealh,
Sworn to
_ and subscribed before me,
\
f: '
___, ,r,-~~---
Executor . ~1:bJt1xbtixKw
/ 109 ~larket Strect
---.-----
Deccmber 3,
~J~~
"
Thelma S, M,C.u,fin. Not.ry Puhl~
Mv (o:nmiuion Expires J:.;V I. 19l!J
Camp Hill. PA (u;r.bell~:1d CO'"mlt
19 80
.-_~mp Hill, P1\ 17011
Addre"
Date of Death
22nd
September
Month
1980
Vut
Oey
INSTRUCTIONS
I. An inventory must be filed within three months afler appointment of personal representative.
2. A supplement inventory must be filed within thirty day. of discovery of additional a..ets.
3. Additional sheets may be attached as to personally or really
4. See Article IV, Fiduciaries Act of 1949.
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-----+-.-.--.- ~~,.- -- ..-.---- ----_._.+_._._~ -- -- --.- -....-. ------- -------.-..-----.-
..-...... -- -- --
_ RElJ.ll~2EX
~' COMMONWEALTH OF PENNSYLVANIA
4NO K000277 DEPARTMENT OF REVENUE
. OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
If
'"
.
'II
II
=
w
KZA
-. --.... --- .-
~.-....
-
TAX AT 6%
TAX AT 15%
~,' RECEIVED
'J FROM
John B. Slike, B8Q.
TAXAT_%
ADDRESS 2109 Marlcet Street
ESTATE TAX
Camp Bill, Pa. 17011
TOTAL TAX CREOIT
'--eSTATEINFCiRMATION-:-S;p-t- -22- 1990
OATE OF DEATH .,
FILE NUMBER
21-90-627
LESS DISCOUNT
PLUS % INTEREST
IFROM TO_I
OATEOFPAYMENT
Mov~r 6, 1980
LOMA S. REIN
Cumberland
m
o
TOTAL AMOUNT PAID
. NAME OF OECEDENT
COUNTY
POSTMARK DATE
REMARKS "PAID ON ACCOtmT"
*'
1,052.63
52.63
1,000.00
SEAL
.. 'or'
'/ // /..,.:; C /i_Ut--c.a-/
MaZy t!~N'l1laVia
Register of Wills
RECEIVED BY
REGISTER OF WILLS
...........~~. l!:WJ.-+~