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Home My WebLink About80-00644 'I:~':'(l{;i:!:~"~:', ,. ~~?:;::~'?:.:" ._~..{*.~..,:\",.,. "I"~t;i:,"';'" -. 11 :,:,1_, I ~ I ;,~*}::\.:::: ~,.<!'t'It.;~,:, ; :q '~;~'~~'..t';' }~~{f~%I',;;,. .' ..f!lM!."".."" j~~Jt~:J;:,~' . ~~. "ljl}':/:!'~;':~ '/. . l~.tJ."":-; Il~#>: ' , ....II' ., , '~::('" :"071.:'" ' ~~~)~~~~:,.':,~.,:.': ,~""......., f~'~;~t;;:,:;.: .' ""',.-. ~("- i,;..Ji . I.' :,:.,~:, ".\ ',~ " .' ~ ~ ~ ,':,'. = 00 .. - M "'.;', '. ~'. .'. ..,~ ..;' ...,'~ ....; ." --' ;~ ~',.-< '. .. . ~ T' ~ CIJ ~ ~ .. ''::: ., .\; ~ . '.. " i 12!; " I :xl <' -":.; ~ , :> " .. . I 08 r:Q .' '.. ;", .~ I ";-, I,' w- o ,. . ii' ti - lU - eft LI.I '\!R. \D " .,>....: :> ~;' ~ No. 21.80 *..1t] PETITION FOR PROBATE OF WILL A"~D LETTERS TESTAMENTARY in the Estate of Mary n. lIarmon , deceased. To MAllY C. LEWIS , Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania. is Petitioner{jj) \life the execut or named in the Last Will and Testament of Mary n. Barman dated 8 M"y 1 Q73. Decedent was a citizen of the United States and 0 resident of if~p Lemoync Borough, Cumberland County, Commonwealth of Pennsylvania. Decedent died on Wednesday the 24th day of September A. D. 19.JlJL., In the County of cumberland , State of Pennsylvania at the age of 94 has not has not her Decedent lho$~\'< been married and ImstXJllGR hod children born to,him since the execution of the aboye described Will. Decedent was possessed of personal property to the yalue of ft,. 2u cou u I,) 0 and of real estate to the value of . $1 _ 2.. '" I () i;X). i\Q years. estate situated as follows os near os can be ascertained; said 5t.:':l.1e <::i,,~ '" l~~,'('"r;::, P~. I , real x<itPlil~ Therefore, your petitioner(s) respectfully applies for the probate of the said Last Will and Testament and for Letters Testamentary thereon. Dated 30 September ] 980 _, //(;;2. c:-''' / I ~ ~rfJ....6iftz/c..'J'n-07?./ t Name and address LeRoy F.' Harmon of Petitioner(g) I- I I I 4701 Clearview Road Camp Hill, PA 17011 COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND LeRoy R. Harmon named in above application, being duly say(s) that the statements set forth in sworn according to law this petition are true to the best of hi~ knowledge and belief. Sworn and subscribed before , - /1 -----;, '--'2~ ...... ......../-/ '.' :' . -- I ,,1---,.(._., ./':\.-1-<1_ \.. p. _:...>t ,-1,1-'1"" ....,..,? I , LeRoy' F ;' VHarmon ' me, , ~;P"~:f,n'J 80 ~ Reg"'" ~'Io Flied: .':l.I- h.'. '1.y.. October 8, 1980 Attorney: Andes & Vaughn [#0 OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMB~~HLAND \ , . 7th October 80 'I his........................................................................ day of ................................................................ A.D., 19........, Mary c. Lewis before me iUdOJu"k~x~ltllt'lln, Hcgister for the Probate of Wills and granting letters of Administration in and for said County of Cumherland, in the Commonwealth of Pennsylvania, personally came .............. ...........................~. ~... p. ~.~ $1.J;'.~!!...\i!~ .~. ~ ~.;:..!! .~.~......~ ~.':\~.. .~.:... !:!y.~.l.-': ~.!...~ .~.9. ~ .~.~~........................................... the subscribing witnesses to the foregoing instrument of writing purporting to he the last WiII and Testamen t of ............................ !1.~.F.Y...?. ~...H !!.F.(1)!?z:\....................................... Da ted .... .e.. .M.Gl.Y. ..l~ :z.:}......... ..... lateof........~.Q~...?9.F..9.H9.Q..!?t..J,..'i!.(1)!?.Y.ng.,............................................... Cumberland County Pa., deceased who being duly .............f?W9...n................... according to law, depose and say, that ........t):J.O;:Y........................ present, and saw and heard the testat..r:ix......................., .....................~?;!:y...~.,...g.<;l;F.!!l.9.!L..................... sign, seal, publish, pronounce and declare the said instrument of writing as and for h.e.J:.......... Testament and Last Will, and at the time of so doing .................l?h~..........................was of sound and disposing mind memory and understanding, to the best of ................ng.+:.......................knowledge, observation and belief. ..............('iw.O'~I)...................... and subscribed before '........&+:.~.~.....,. 1.............(J/..,.6r.;..:"c.:.::.:.:..LL::L;:.;... ~:'~~ AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA 1 ss: COUNTY OF CUMBERLAND \ .............................................................~~.~??:'...:..:...~~.~~.r:............................ ...................... ..............being duly ..............,SwQr.n...................... says that as nearly as can be ascertained the said decedent .......................... .........................I':l.a~y...a., ...Hil.t:\1lR,u................................................. .... .................... .............. ...................died on ....Wg.c!,!!g.~gf!..Y........................ the .......?~~.l::................day of .......~.~.p.~~.~!?~.7:......................... A.D., 19..~.Q., at or about .......................................... o'clock, ....M. ..............,S.WQX'.n..........................and subscribed this .....................~.~:t::~.................. day of ....~.~p.~.~~!?~;r 19, !;I.Q..., before J-"'~) ~'Cl6:' A..j>' '\-- ./, -0 ~ ,I :::~:. :.'i.:,: ,:::/"0/":'0,.]:'.; ........: (!" .'(;;?2'1:1:X?:-:.'.............. ~~e" ~mmm R;~l.u D. J~.~uu, ~~er OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA} COUNTY OF CUMBERLAND SS: Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of Cumberland, personally came ......~~.~,..F:..J::\~:<:Y.!.~Ml.............................................. who, being duly ...l'?~~~.~........, do~..... depose and say that as....\;.l,~~v.::.................................... of the last Will and Testament of .......H:~~.....8.\......8.~.I/.VIt1111\-<1...............................................deceased .....b.~............ 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. ...s.~".J"""........ and subscribed before me. .....?fld.....~.7.P.~.7.~.7.:......~9............... A. D., 19~.~........ a ,/l, . J ~j.~.,:.~~...................... ,~~.;r;.~<v.~~1.j............... .................................................................................. :.,; oi : Q.l VI CD' Ol Cl'l '" ,-(r u '" A LL -;t: CD: 0 Z *1 0 CD1 ~ -;t: ~ ..>: ~ -;t: ...J 0 1-1: 0 . \0: l:Q QP ~: I ....J ::c .a: 0: - CD: - , ~ " 0: S P1 u: ..,: I U: ~: E-<: I'll ~ .5 ril1 0; "tl Q; .0: '" 0: 0 :<:1 "tl 00: Z ... 0: . : 0 ~: - $ u *: N '" .s ... '" "tl 0 "tl bll '" VI ~ " - Z ~ Ol Po. i:i: DECREE Be it remembered that on the ........~~.~......... day of ..............~.7.~~~~:7.................., A. D., 19 .~.~..., there was probated and recorded the last Will and Testament of .....!:l.~!:r...~.:...~.<:.~9.~......................................, late of.............~!:~.'?y.!.I.4!:..............................................., Cumberland County, Pennsytvania, Deceased. Letters .......................~.~~~.~~.~~.~.7.!.'.... were brranted to .................... ~.7.~~.y...~.:...~~~~~......... ............................ Witness my hand and official seal the day and year aforesaid. . . u.-.... __ r 1#.-REV.1HI2EX ~:;L. ... COMMONWEALTH OF PENNSYLVANIA 4 NO.Ko00331 . DEPARTMENT OF REVENUE ,. .. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX J .- . , II = ~ ~f ~ECEIVED IJ FROM ADDRESS ~ ~- -......._- ......... --- ,... Lemoyne, Pa. 17043 .--~~~Tg~~i.~~A T10N7S;;t-.--i4~--i980-- FILE NUMBER DATE OF PAYMENT 21-80-644 December 4, 1.980 , lAME OF DECEDENT MARY B. HAllMON Cumberland COUNTY .----------------------------------------- POSTMARK DATE REMARKS. .PAID ON ACCOWl'l'" SEAL ------ TAX AT 6% TAX AT 15% TAXAT_% ESTATE TAX m m RECEIVED BY REGISTER OF WILLS ~.._-.. - TOTAL TAX CREDIT 3,052.63 ~ " LESS DISCOUNT PLUS % INTEREST (FROM TO_I 152.63 TOTAL AMOUNT PAID 2.900.00 '~//"--/ (~ ,/{-'>f:-,(,-'-(,...:./ MIU:ySl'C't T'ilhi. Reqla~er of Wilt. - - - - -- --.- -- -- ---- ---. REV.455 0.80) COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS ~C\iq, ),c,)~*. . "'.~r \ J .. ~'u _ {. IN , ----------- ---,_..- ~ -.- -----_.__._-~ -- .--'-,~~ Estate of fJI.ARY B. HARMON Date 01 Death 24 september 1980 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: File No. 21-80-644 Claimant _ Relationship to Decedent Claimant's Address .. - -- ITEM DATE NAME OF PAYEE REMARKS AMOUNT NO. 1980 1 samuel L. Andes attorney fees 2 000.00 2 Nov. 1 professional Pharmacy medicine 21.68 3 oct. 8 Register of Wills probate fees and short certificates 41. 00 4. Register of wills tax fi ling fees 6.00 5 West Shore Times advertisina eXDense 16.75 6. erland law .T"'urnal advertisina eXDenSQ 18.00 7. Recorder of Deeds transfer tax liability Ann nn . TOTAL THIS PAGE I 2 503.43 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 dcPuctions lor Inheritance Tax purposes. .--// / ~;/ / .. _.:, _~.. ~/" .~-?'=,-n'L-,"'-?' j 11/26/80 '-- SI ,NATUR OF ATTORNEY/FIDUCIARY DATE OFFICIAL USE'ONL Y DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S ,::( IrJ --1. ./g / AT !p PERCENT. l-~-iI DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred bV the decedent 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 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 52,000 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. - "" 0 n > m > ~ '- > 0 0 0 (Jl 0 Z C'l n c " ..., z ::: z t"" m > 9 9 t"" m :>:; Z " ~ Z Z m ..., m ..., m 9 9 ..., -< (Jl (Jl Z 0 (Jl 0 ..., 0 ." ." :ll ::; ~ 0 - ." 0 ." Z ?i ;; t"" C (Jl .... m . C' .. '-' 0 .. "" '-, z ::.~' : c- VIL,;; t"" '. . f_, -< 4., :~~ -< -< CI' a m t=: ~ 6,' N .....4,: > > r_...J Wl.. % n::cr; :ll :ll 0.... 5 '='LJJ I a;,V; ~m 0- u"" c.::1: ........ ....=> ",'" ~ I ~ ...Ju u 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. , . REV...t!lO I '-6QI COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAY. RESIDENT DECEDENT SCHEDULE "Au REAL PROPERTY :~;i~~. ~< . ~'ir.' '. ~.~:.. (Instructions on Reverse Side) ESTATE OF MARY_B-!._~Q~ ITEM NO. DESCRIPTION ESTIMATED MARKET VALUE DEPARTMENT VALUATION (OFFI CIAL USE ONLY) 1. Real estate at 516 Market street, Lemoyne, cumberland county, Pennsylvania; deed into decedent in Book 14, volume 16, page 470, 14 July 1949; subject to agreement of sale at time of decedent's death for purchase price of $40,000.00 of which $15,037.86 was paid prior to death. See Misc. Book 256, Page 221. Agreement with Frank V. Brinser and Renee Kugler Brinser dated 17 July 1980. Assessed value $24,962.14 TOTAL THIS PAGE $24,962.14 'l4c~1" ')...1'1' I .A'~ REV.451 U.80) COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPEIlTY '*' (1nsrrucrions 011 RcvL'rsl..' Side) Estate of Mary R. Harmon - ESTIMATED DEPARTMENT ITEM DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL YJ 1. Dauphin Deposit Checking Account No. 40-920984 Roy F. Harmon predeceased; value reduced by checks written but not cleared at time of death. Copies attached. 6,643.6 2. Credit from Blue Ridge Haven 141. 5~ TOTAL THIS PAGE $6,785.20 ~,11S-: .?O ~ . REV-45Zlt-sot COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESrDENT DECEDENT Ma ESTATE OF _ ry SCHEDULE "C" TRANSFERS .. B. Harmon 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. AUach a copy of any trust deed or instrument relating 10 the transferred property. ITEM NO. DESCRIPTION ESTIMATED DEPT. VALUATION MARKET VALUE (OFFICIAL USE ONLY) None TOTAL THIS PAGE , ~ QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any tmnsrer of any matcrial part of his estate without recciving valuable and adequate consideration? (Answer "Yes" or "No".) no 2. Did decedent, within two ycars of death, transfer property from himself! hefsel f to himsel f/herself and another party or parties(including a spouse) in joint ownership? (Answer "Yes" or "No".) .lliL- 3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy of death cerli fi cate. c. Affidavit by the attending physician indicating the state of decedent's health altime of transfer. d. All other information supporting nontaxabiIi ty 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 tile 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".) nn 6. If the answer to five b. above 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 b61eficial enjoyment of which was subjeclto change, because of a reserved power to alter. amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) nn 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".) .REV-454 (i.SOl COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY ~~fl. ~ (Instructions on Reverse Side) Estate 0 f Mary B. Harmon . p , I TOTAL E VALUE OF DEPARTMENT ITEM 'tE NO. DESCRIPTION MARKET DECEDENT'S VALUATION VALUE N INTEREST (Official Usa Onlvl T 1. cumberland valley savings & Loan ACcount #20889; joint with Leroy F. Harmon ; son 8,157.69 500/0 4,078.85 2. Dauphin Deposit Bank & Trust COllpany; savings Account #12-00455; joint with Leroy F. Harmon, son 1,252.48 500/0 5,626.24 3. West Shore savings & Loan ASsoc. Account #05-1516; joint with Leroy F. Harmon, son L6,267.25 500/0 8,133.63 4. CCNB Bank, N.A. savings Account #003-700636-8; joint with Leroy F. Harmon, son 8435.30 500/0 4,217.65 TOTAL THIS PAGE 22,056.37 J.J.,OS-&,.3ZMf ./ File Number INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) 21-80-0644 REV-"" EX+ (&oeD1 Dole 01 Oeolh September 24, 1980 II] Original o Supplemental o Remainder Eslole Nome Hary B. Harmon Social Security Number 160-50-4563 REPORT OF INHERITANCE TAX APPRAISER I, the und...lgned duly appointed Inheritance Tax Appraiser in and lor the County 01 Cumberland Pennsylvania, do respectfully report that I have approi sed the real and porsonal property as reported In the foregoing return at the values let forth opposite each item in the last column to the right In Schedules HAil, liB", flC", and liE" Doled: April 8, 1981 .J../ILJdJ )'7'i'/:'IlJY) ) INHERITANCE TAX APPRAISER INVENTORY VALUE AS APPRAISED ADJUSTMENTS CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE Real Proporty (Schedule A) Per.onal Property (Schedule B) Jolnl.Hold Properly (Schedule E) Tran.f.r. (Schedule C) $ 24 962 14 00+ 6,785 20 10+ 22,056 37 20+ none 30+ 53,803 71 40- 92+ TOTAL GROSS ASSETS 93- Le.. D.bt. and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE OLlIe Estate o Annuity ~ FACTOR PRINCIPLE VALUE COOE I FOR USE OF REGISTER ONLY TalC on $ TalC on $ CODE COMPUTATION OF TAX $ 5 5 S 6% 15% Tax on S Tax on S 5 Tax on S EKemptlons Total Estate TOTAL TAX INTEREST FROM BALANCE TO 5 5 $ Less Credits DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT 5 + 5 S = S = + -- BALANCE S INTEREST FROM TO S REV.S1B FO (7-80) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS NOTICE OF FILING OF APPRAISEMENT Leroy F. Harmon 4701 Clearview Road Camp Hill, FA 17011 RE: Estate of County of File No. Nary B. Harmon Cumberland 21-80-0644 Dear Mr. Harmon: You ore hereby notified that the original appraisement in the estate of Mary B. Harmon has beell filed in the office of the Register af Wills of Cumberland Caunty on April 8 ,19 ..aJ... Said appraisement reflects the following valuatians: Real Estate Persanal Praperty Jointly Owned Transfers Total $24,962.14 $ 6,785.20 $22,056.37 none $53,803.71 As to such tax that is paid within three months from date of death, a live (5%) percent discount is allowoble. As to any tax thot remoins unpaid after nine (9) months (fifteen months 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 death, interest ot 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 doys 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 April 8. 1981 Signed ~P"..,J" dPf{lAflvl) Title Chief Appraiser NOTE: This is not a bill. . REV-4'7 (l.BO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEDENT INHERITANCE TAX APPRAISEMENT '* DEPARTMENT'S APPRAISED VALUE $24,962.14 6,785.20 Estate of Mary B. Harmon File No. 21-80-0644 County Cumberland Date of Death September 24, 1980 In the event that any future Intern1 in this estalal, transforred In possossion or enjoyment to eoll.ueral heirs of the dlClldent aUlIr the expiration of .ny estate for IIf. or for years, 'he CommonwlIslth hereby expressly reserves tho right to appraise and asses. transfer inheritance tawes It the lawful coll.ter.1 raw on any such 'uturelntered. PROPERTY REPORTED BY THE ESTATE 1. TOTAL REAL PROPERTY - SCHEDULE "A" . . 2. TOTAL PERSONAL PROPERTY - SCHEDULE "8" 3. TOTAL TRANSFERS - SCHEDULE "C" . . . . 4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E" none 22,056.37 $53,803.71 TOTAL REPORTED PROPERTY PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH TOTAL UNREPORTED PROPERTY TOTAL GROSS ASSETS 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. o!/lMl'l J-IPftJlrll(j ) APPRAISER April 8, 1981 DATE , ~ ... ~ ~ QI ~ QI " " z ~ ~ 0 ... 0 ~ '" < lol :l!l ... p.. 't:l Vl OJ " ~ .>: . '" N . " QI H \0 o-l '" ;g ~ " :!i QI >> 0 .0 U Z " '" e e '" - 0 ~ .... QI 8 H M r.. - It\ H H H M r.. ~ ~ r.. g r.. 0 !-< 0 Vl 0 Vl lol '" >- E-o 0 - z Z E-o lol !-< lol Z :l 0 - 0 ;:: !l::: ~ ::.: lol lol Z ::e: z 0 u ~ z tt ~ Vl ~ 8 0 - lol 0 o-l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT . TO: , ,{ J .' - , /\' :f.-tJ"~,4,' ~ :f' if /<>1/- . , 1 ' / J -- f (,,/:,1,-/-"--1/1.-, /~~ (.:~ /1 /' ,,3- 0~.;( ESTATE (./ . ,,' ...., /.0';// " ./1.1:- .:;A:J, ;I v / 1 ,: f I //)/:;/...},./ L Y'/tiil;k.O'A"/ i 0. (;,~/- "/1 - ~j., ~ :rL COUNTY FILE NO: _...'j ,,"/- (.: ;;/ - (~- 'i' 'l~ DATE FILE NO, / It; ~J " , ,'/~~~~;llD.(H-t~j../)/~.-L- ...'..,.-', I r' , ..-1 r',p/Lt'-1-t /U::-' \.....;' ,,, / I . COUNTY DATE OF OEATH/;U~t:;,-.l.cJ 7'( 11ft) / Appraised Value of Estate: Real Estate $ ",,:',// / l.:( /-1 , Personal Property + 'L"' / . ,:( ;J , "''7,- ~/. /',j ,./, () () ~~t:-, ,j '7 Jointry Held PropertylTransfers Total Gross Estate $ jj /()j . '/1 "I) :/V v,t' Clear Value or Estate ... /-)3 /;/j ( / $ ~./I J;' t-L.tJ . Total Approved Deductions Less: Approved Charitable Exemptions -- Clear Value 01 Estate Subject to Tax ,-/ ~ ..... $ ') ,)(/0 ,;.,{;:' Amount Taxable @ 6% Rate /~ -/ :< /-IJ ,) ;/ $ -' ; J ......,. J' tax due s:ftJ1Yd';< I Amount Taxable @ 15% Rale tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE s S () 7? .1;2. , '* . .. * .. .. A five percent discount totaling $ will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT II;j -to J-;)(). ? I AMOUNT PAlO $ /9r!J,O-O . DISCOUNT INTEREST TAX CREDIT .;<' -) --.-,) / "" $ '--'; !../o/'cc../ . /.-- -;- S/2j0J- S = ",,- "4 /_, :1/ . = '//- ~ 7 -" ;I ,.;.; . = Interest accrues at the rate of six (6) percent por annum on the unpaid balance of Inheritance Tal< from to date of payment. Interest due if paid by is - -c ' ~:"7 . -c 7,'1,- /.' ,// /-:[ S I../':.F ',,,,,',i,) v/~ BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE ....._", ' liJ J I Assessed by: /1/ Jl,/I.l.{ ~ //'{e:u,-t.a./ Agenl for Ihe Comm6nwe.'1h 5.. Inform""n on Rev.,," S,do 0 Y1., !!lKv lL I,' ~ ,.ILL:.) cI ~'"