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HomeMy WebLinkAbout80-00663 .....':l.,i~'. , ': . ~;r;' "~,':Z.;.'. t." .', 'tt~"~ . J~ ~ .:1': ....' 1;," ~ .1 \'. .',1-,I~~ 'il."\~t~~t,:l<~:;.' ~j~I,~.,.;;<".r.'.... ,., . . '-:<""l",..t,'t"t.""':" .~,~,j:,?:'1' J',' ,', I ." ~:' ~ . ; ;ij,~. ' Il~~''"' ~;(~,,',, \~,,~.' h~"i ,.: ,.p~':V:~.':.: '~~1'::', '..' ~.t~~.~,.: .,'. 1,';'\;;.... '~:'i:"'~, :~.:.(:,:. ~i~~(,:~'-<" . . ~. " ~iti" ~'~~\~ ' -/'!~~, ':, ,~,.. l, " ~tt? W;~:> ~l' . ; ": :i.;:'!,~. .'t~..~.~ . ~~', '~!~;.'! . Fl,....': ~tW;? ~~l~;" .... ~~~~~ ~ .;. q"' '.....I~. ..." . ,', '&;f;r:, ~iF~r;:?'~'; ~1.t{'r: ~"J . .. ~~'t~._1 I:.. ;9.,:" I'e ~\. ,.\.. I'~\; f5iL'" I'. ':~~1;~'~.- :i "~"I~' .- !t:. ~ '. . ~ -~.S(", ~........ .,'.' fix/ R~~.:;".. JL". ~J,::~:.;: ........ ',' ~F ..; ~..~.:,j,~,:.::." . , .. "'~>,., .~2~~<~ ~~~it~,:.' ~ . ~;:~,;~~.~,. . . .~lr..,~" J1:iI.~':~..,:": ':;""" .,< ~X:~t';.~ ~",...,_. -c.. ~~J; ~~1~~\. / " :"1 ..;.; .;, .'.' '.( ,. ~ ~ ~ ~ ;: :.-;,;. ~ CI.l :.: o H A Cl ~ ~ o :3 C':). ~ ~ . > CI.l H S CI ow- 00 0 " - ~. Jl 'tll. . J! \D O. z L:I '- .. .RfY,.,t9 (1-eO) COll~tlWEAL TH OF PENNSYLVAtllA OEPARTIoIEtlT OF REVEtlUE TRAtlSFER ItlHERITANCE TAX RESIDEtlT DECEDEtlT INHERITANCE TAX RETURN FOR INSOLVENT ESTATES ~ (Instructions on Reverse Side) ~ COUtlTY FILE tlO, :.:< ,- ,f" (" (, ~, BUREAU tlO. of 5~ 7 Gr.andvim~ Avenue , Camp Hill , Pa. 17011 <<ADDRESst EMMERT T. DICKSON (NAME) being doly sworn according to law, deposes aod says Ihat he/she is the Widower lEXt.::C., ADM.. LEGATt::E. ETC.' 517 Grandview Avenue of the estate of LOIS V. DICKSON laic uf Worml pv"hnro p" (STffEET AODRESS) deceBsed and that the whole of the estate of said decedent, who died on Ap"; 1 ?? J 1 ()Rn (DATE) consisted of the assets listed below and that allowable dehts and deductions exceeded assets and nO Pennsylvania Transfer Inheritance Tax is due. ./ l 11 TLE' TYPE OF ASSET ASSETS ESTIIoIATED IoIARKET DEPARTIoIEtlT VALUATIOtl VALUE OFFI I L NO NE NO NE ~ ~ - 0\ "'0 IJ,I ~ TOTAL NONE N IJ'>'\,U (OFFICIAL USE OtolL Y) I do hereby certify that the ahove assets were appraised in accordance with Pennsylvania law. 7 .ft I ~ ' /) ..."f1rAHlt1 /'-/1 f/lJ!l,j,fr', ~ npl"AmnA'" "1 '9Rn APPRAISER DA TE DEBTS AtlD DEDUCTIDtlS AIoIOUNT CLAIIoIEO $2,205.97 $ 900.00 $2,000.00 I DATE NAIoIE OF PAYEE Funera~ bill of deceased Grave marker, etc. Widower I s exemption 4/2 /SO 4/2 ISO Musselman Funeral Home Rolling Green Cemetery Emmert T. 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