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RE Y-440 ('-eo)
COMMONWEALTH OF PE~NSYL VANIA
DEPARTMENT OF REVE~UE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
la-.3 - PO
*'
AFFIDAVIT OF
FIDUCIARY
(Instructions on Reverse Side)
Estate 01
ANNA M. fWOX:K
Date of Death
Social Sccurity No,
Februarv 29, ]980
204-52-5627
Last Address 118 SQutJLl'ayette St.
Shippensburq Penna.
17257
Bureau File No,
(CI1.V'
(STA.TE)
(ZIPI
County File No. .~ j--?cJ -~3,3
1. Decedent died:
(X ) Intestate (without 0 will)
( ) Testate (Ieoving a last will--copy ottoched)
2, Is the liling of 0 Federol Estate To. Return required for this estote? Yes_ No X
3.
E.ecu tor/Executri.
) Administrotar/ Administratrix
Name
Howard F. Hanrock (son and heirl
340 East King Street
Address
Shi.ppensbm::g
(CITY)
P,::r.nn.:::l
(STA.TE)
17'''7
(ZIPI
4. All correspondence should be moiled to ( X) Attorney
) Fiduci ory.
S. If an attorney is representing the estate, indicate:
Name
M::Crea & Davis
Address
24 Nest Kinq Street
Shippensburq
lCITY)
Penna.
I:"'TATE)
17257
(ZIP)
List all sofe deposit boxes registered in the decedent's individual namehor jointly with, or os an agent or deputy
01 onather, or in decedent's individuol name with right of occess by anot er as agent or deputy. Include the name
and address 01 the bank or other institution where the safe deposit box is located, the name (s) in which the box
is registered ond the relationship 01 the joint holders to the decedent.
NAME ANO ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT MAINTAiNED A SAFE DEPOSIT BO.
NAME OR NAMES I~ WHiCH
SAFE DEPOSIT BOX IS REGISTERED
RELA TIONSHIP OF JOINT
HOLaERS TO DECEDENT
None
Under penalties 01 perjury, I declare thai I hove e.amined this return, including accompanying schedules and \\
stotements, and to the best of my knowledge ond belief it is true, correct and complete, p
//-/3/-1 ,,/A-u-~l J7.))a1~~ <f-.2.2- ~o
SIGNATURE OF FIDUCIARY DATE
1.
FiEV-';'O 11"'SO'
COMMONWEAL TH DF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" A"
REAL PROPERTY
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(Instruclions on Reverse Side)
ESTATE OF __J1l'lN1\_l>!. HANCOCK
DESCRIPTION
ESTIMA 1 ED
MARKEl
VALUE
DEPARTMENl
VALUATION
(OFFICIAL USE
ONLY
Real estate situate in the Borough of Shippensburg,
Currberland COunty, Pa.known as and situate at 118
South Fayette St. conveyed by Alvin R. Hollar and Anna
M. Hollar by deed dated April 30, 1947 and recorded
in (to be recorded)
to Arthur W. Hanccck and Anna M. Hancock, his wife.
Arthur W. Hancock died Septenber 3, 1958, thereby vesting
the entire fee in the decedent herein, Anna M. Hanoock.
If'" fO,
18,720.00
TOTAL THIS PAGE
18,720.00
I?) 1.:LO, L'-C
~
REV451 (1-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*
(lnstrucf'ions on Reverse Side)
Estate of ANNA N. HJ\NCCCK
ESTIMATED DEPARTMENT
ITEM DESCRIPTION UNIT MARKET VALUATION
NO, VALUE VALUE (OFFICIAL USE ONL YJ
None None
TOTAL THIS PAGE None N~
-V-gI(-
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. REY-4&2 ('-eol
COMMOHWEALTH OF PEHH5Y~VAHIA
DEPARTMEHT OF REVEHUE
TRANSFER IHHERITANCE TAX
RESIDEHT DECEDENT
ESTATE OF _ ANNA M. HlINrYY'"K
SCHEDULE "C"
TRANSFERS
*
INSTRUCTIONS:
1. Answer the questions on reverse side,
2. If the answer to any of the questions on the reverse side is "Yes," provide 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 trust deed or instrument relating to the transferred property,
ITEM
NO.
ESTIMATED DEPT, VALUATION
MARKET VALUE (OFFICIAL USE ONLY)
DESCRIPTION
none
~bne
TOTAL THIS PAGE
None
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QUESTIONS CONCERNING PROPERTV 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! hersel f to himsel flherself and another party
or parties (including a spouse) in joint ownership? (Answer "Ves" or "No".) ..B2.- .
3, If the answer to one or two above is "Ves" and the transfers are claimed to be nontaxable, provide the following
information: N/A
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 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 lake effect in possession or enjoyment at or after his/her death? (Answer "Ves" or "No".) No
a, Was there any pnssibility that the property transferred might return to transferor or his/her estate or be subject
to his/her power of disposition? (Answer "Ves" or "No".) No
b, What was the transferee's age at time of decedent's death? Nn
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 hislher life or any period which does in fact end before hislher
death:
a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Ves" or "No".) -1!kL-
b. The right to designate the persons who shall posse~s or enjoy the property transferred or income therefrom?
(Answer "Ves" or "No" ,) No
6, If the answer to five b, above is "Ves," state whether the right was reserved in decedent alone or others, }T/~
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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 "Ves" or "No".) No
8, Did decedent, at any time, transfer property, the b61eficial enjoyment of which was subject to change, because of
a reserved power to alter, amend, or revoke, or whi ch could revert to decedent under terms of transfer or by operation of
law? (Answer "Ves" 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".) N/A
o REV0453 (loSO)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
'*
(lnstnlctions on ReverslJ Sidll)
Estate of
n.tJl\J7\. M nnl\V'YYV
-
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
Broce W. Hancock son yes sui .;n,..i" One-tenth
R.R.fr2, NewvJ.lle, Pa. 17241
Ha"ard F. Hancock son 'TO'''' "n; 4,,_;~ One-tenth
,jqU E. Kmg St. ,sm,ppensbUf~~s~'
Maxine C. Plasterer dauaher "0" "n; .;n,..;" One-tenth
~ E. 05~ ~~: '17257
<=1' "h yes sui ;uris One-tenth
R.R.#7. Shiw>n!':hnrg. o~ ,.,.,,,., "nn
.... son sui juris One-tenth
t p" yes
Hary E. Smith Qui.--;j"J:'ic: on~tenth
197 E. O~~ St, !J1~~ #2 daughter__ ~E'"
S ~ l. Pa. 7
Olive M. Byers u_ -,.; ...-;- One-tenth
. -. "'.... J
Shipoensburg. Pa.
1\.
118 S. Fayette St. daughter yes sui juris On~tenth
~lUppensOurg, Pa. 1/2~
~s!;h~~ A;..... ~ers ._-~- dauaher "es "n; .;n,..;" One-tenth
Diane L. Diehl aranddau no" ",,; 4.._;" One-Oientieth
Ebute #6 ,ShJ.ppensburg, Pa. 17257
FcC:nev E. Ibck arann""n nO" "..; 4.._;" One-twentieth
iHcfe~and Ave.
en ss.
,
.
The above beneficiaries are living at this time except for the following: no exception
NAME DATE OF DEATH
RCV04"S4 (I-SO)
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDtNT
SCHEDULE "E"
JOINTLY OWNEO PROPERTY
.
(Instructions on Reverse Side)
Estate of
ANNA M. HJ\NaXJ{
P
TOTAL E VALUE OF DEPARTMENT
ITEM A
DESCRIPTION MARKET C DECEDENT'S VALUATION
NO, VALUE E INTEREST (Official Use Only)
N
I T
None None None
TOTAL THIS PAGE None Nnu-
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'palls!lqelsa seM d!lISJaUMO lU!O! alll alep alll pue (S) JaUMO'OO alll}O luapa:>ap
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INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
III Original
o Supplemental
o Remainder
File Humber
21-80-0633
Estate Hame
Anna M. Hancock
Date of Deoth
2-29-80
Social Security Number
204-52-5627
REPORT OF INHERITANCE TAX APPRAISER
I, tho undorslgnod duly appolntod lnhoritanco Tax Appraiser In and for the County of ~erland
Pannsylvanla, do respectfully report that I have appraised tho roal and porsanal proporty as reporte in tho loregoing
return at the values set forth opposite each item In the last column to the right in Schedules "A", "B", IIC", and liE"
Datod:
March." lQR1
J1Yvi/" J fffrt1l} ~ j )
INHERITANCE TA.X A.PPRAISER
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINOER APPRAISEMENT CODE
Reol Property (Schedule A)
Penonol Property (Schedule B)
Jolnt.Hold Property (Schedule E)
Transfer. (Schedule C)
s 18 20 00 OD+
none ID+
none 2lH
30+
18,120 _OJ)
40-
92+
TOTAL GROSS ASSETS
93-
Less D.bt. and Deduction.
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life Estato
o Annuity
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONL Y
T ox on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6'.
"
Tox on S
15~o
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
$
$
$
c
TOTAL TAX
INTEREST FROM
BALANCE
TO
Less Credits
DATE OF PAYMENT
INTEREST
TAX CREDIT
AMOUNT PAID
DISCOUNT
s
+ S
s
$
=
+
=
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
S
S
REV.51a FO (70801
....~'
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COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
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NOTICE OF FILING OF APPRAISEMENT
Howard F. Hancock
340 East King street
Shippensburg, PA 17257
RE: Estate af
County af
File Na.
Anna t1. Hancock
Cumberland
21_80_0633
Dear Mr, Hancock:
You are hereby notified thot the o";e:;n~l
appraisement in the estate of Anna M. Hancock
has been filed in the office of the Register of Wills of r.nmhp"lonrl
Caunty on M"",.h 7 . 19 ..81. Said opproisement reflects the follawing valuations:
Real Estate
Personol Property
Jaintly Owned
Transfers
Totol
18.720.00
none
n""P
none
lR,720,OO
As to such tax that is paid within three months fram date of deoth, a five (5%) percent
discount is a\lowoble. As to ony tax that remains unpaid after nine (9) months (fifteen manths
when death occurred from December 22, 1965 to June 16,1971, inclusive; and twelve manths when
death occurred prior ta December 22, 1965) from date af death, interest at the rate of six (6%) percent
per annum is charged.
An)' party in interest who is aggrieved by this notice moy abject thereto within sixty days
after receipt of said notice os provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P,L. 373,
Date
March 7 r 1Q81
Signed
-!!{JVlJd / Ift',,;..,})
Title Chief Aooraiser
NOTE: This is not 0 bill.
REV-457 (l-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
*
Estate of
I\nn~ M H:mr.(")~k
File No.
21-80-0633
County
Cumberland
Date of Death 2-29-80
In the e....nt that any futur.lnterest In this estate is transferred in possession or enjoyment to coll.tural heirs of the decodent aft"r tha expiration of any
estate for life or for years, the Commonweslth hereby expressly reserves tho riQhtto appraise and aullSS transfer Inheritance taxes at the lawful collateral ratlll
on any such future Interen.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
18 720,00
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
none
none
TOTAL REPORTED PROPERTY
18,720,00
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
none
TOTAL GROSS ASSETS
18,720.00
LIFE ESTATE OF: 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,
.f/f,r'fI~' ,~i'l~J,tv) )
APPRAISEJ;.
3-7-81
DATE
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QENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/he, 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 filed. 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.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*'
TO:
~/- Ko
\'n c- G.Q<:l.. y.
;;:( II- [.(, k ..-_ .;\ L'n/l...L1
" '11'7 ~"-"-'~
J111" rN"l:JI"-"'j 0,
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DATE
J"""1 II /;;< I
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ESTATE ',j I" ." I, Y-(1 _ '\,Ii~VY' r rl)" ~
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DATE OF DEATH .\ Q l.J.... ~ ) q 'Y I
COUNTY FilE NO:
,II _
.'(--1 (I/\~,^",'
~
FilE NO,
COUNTY
I'),~r.;f)
Appraised Value of Estate:
Real Estate S 1'?;7~{\, t', r)
Personal Property +
Jointly Held PropenylTransfers +
Total Gross Estate $ J'( '7'.:J " (]I)
. -
Total Approved Deductions 3 5 39 00
.
Clea, Value of Estate S is. I xl ClU
less; Approved Charitable Exemptions --_.
Clear Value of Estate Subject to Tax $ It; I v, Qu
/ .
Amount Taxable @ 6% Rate S ) (:, I 'i' I. (IG tax due S q / () J((..,
.' . I .
Amount Taxable @ 15% Rate tax due
. ~ TOTAL PENNS:jLVAN~ INHERITANCE TAX DUE S
fJJvv.>) ,OVv~;;-~.iY;)' ~"'0.'1 I I. .;l,q 'l;' 0
* * . .. .. .. A five percent discount totaling' $
will be granted if the Inheritance Tax is paid by
q/()
f(f:;
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
+ $
$
= $
+
=
+
=
Interest accrues at the fate of six (61 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 $
J.f<.J '~\rL';-.v" II '
, '
(
e Com onwealth
q I (\, ~b
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Assessed by:
, ,___ . Aj"lfOf
See InformatIOn on Reverso S.do ,,"~'T\'.' _
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
.
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
.; /) -,/;: ~.
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",:Ol(;J /:J /~JI
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COUNTY FILE NO: _
/'
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DATE
TO:
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ESTATE
{'r,; ,('[l;~j
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_,ucf;
FILE NO.-';'// - ;0 - to:3.5
COUNTY / :;iv/7dfu'&",I'~
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DATE OF DEATH:>a:d-tt.::....>1-<t d~ )~,
d ~
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AppraIsed Value of ESlate:
Aeal Estate
$
Personal Property
.
Jointly Held PropenylTransfers
.
Totsl Gross Estate
$
Total Approved Deductions
Clear Value of Estate
$
Less: Approved Charitable Exemptions
Clear Value of Estale Subject to Tax
$
Amount Taxable @ 6% Rale
S
tax due
a
Amount Taxable @ 15% Rate
tax due
/"-" .
"Yi _ ..:;_TOTAL PENNSYLVANIA It-IHERITANCE TAX DUE
[;/i.., -i,,(,u...d: j/';7}) //,..J,,/-[;)..z;, ie. -/:..;--f'/
* * * * * * A five percent discount totaling S. ,).j::{ P"t/
will be granted if the Inheritance Tax is paid bV
S r;I/cJ.Zb
:2 'l '7 /
it/d,17
Less Credits:
DATE OF PAYMENT
DISCOUNT
AMOUNT PAID
INTEREST
TAX CREDIT
/ ,~ 0
{v-I!} - i1f
S '/ if ;/.71 · S
=
S 'ItJ;;(, 7<1-
S
+
=
+
=
Interest accrues 8t the rate of six (6) percent per
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
annum
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