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>>'"IlEV.1162EX
~' ',,", ' COMMONWEALTH OF PENNSYLVANIA
4NO K000233 DEPARTMENT OF REVENUE
, . OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
I
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~ TAXAT~
TAX AT 15%
RECEIVED Marjorie S. Capers TAX AT_~o
FROM
. . .
ADORESS 2109 Market Street ESTATE TAX
Camp Hill. Pa. 17011
'--~f~~T~[~~;~ATIoN~--APrli-il,--i980--------
21-80-675
FILE NUMBER
DATE DF PAYMENT
October 21. 1980
NAMEDFDECEDENT
BERTHA E. SHATTUCK
Cumberland
m
m
COUNTY
------------ -------------------------
POSTMARK DATE
REMARKS "pAD) Olll ACCOUNT"
SEAL
RECEIVEO BY
REGISTER OF WILLS
61.56
TOTAL TAX CREDIT
LESS DISCOUNT
PLUS % INTEREST
(FROM TO_I
61.56
TOTAL AMOUNT PAID
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MaryS~~A~ilS
Register of Wills
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commonw..lth of Penn.vlllanl.
"'aputm,nt of Rav.nuI
nan,t,r Inh.rltoncl T..;
Rnldenl Olcldent
Rlv-464 EX+ (1.ao)
INHERITANCE TAX RETURN
FOR ESTATES WITH GROSS ASSETS
UNDER $10,000,00
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Estate of BERTHA E. SHATTUCK Date of Death
Last Address 1117 Columbus Ave, Apt. 3 Social Security #
Lemoyne, PA 17043 Bureau File #
(CItY) (Stat') (Zip)
County File #
April 11. ] 980
195-03-0856
::? /- fe-(" 'IS
1, Decedent died:
U1 Intestate (without a will)
o Testate (leaving a last will - copy attachedl
2.
o Executor/Executrix
o Administrator/Administratrix
'{ _ surviving cotenant
Name
Mar j orie S, Capers
Lemoyne, PA 17043 .
~ '
(City) IState) (Zlpl
All correspondence should be mailed to rn Attorney o Fiduciary, $ .
3,
4, If an attorney is representing the estate, indicate: ~',
....
James K. Arnold, Esq. N
Name -
a
Address p, 0, Box 737 --
~
Camp Hill, PA 17011 '"
(City) {Statel (Zip)
Address
1117 Columbus Ave,. Apt. 3
REAL PROPERTY _ Identi!v real property located in Pennsylvania by lot and block number, street address and I Estimeted
include a statement 01 mortgage encumbrances as of the date 01 death, Market Value
1 Department Valuation
(Official Use Only)
NONE
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REV.518 FO (7.80)
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COMMONWEAl.TH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Marjorie S. Capers
1117 Columbus Avenue, Apt. #3
Lemoyne, PA 17043
RE: Estate of
County of
File No.
Bertha E. Shattuck
Cumberland
21-80-0675
Dear Mrs. Capers:
You are hereby notified that the ori ginRl
appraisement in the estate of Bertha E. Shattuck
has been filed in the office of the Register of Wills of Cumberland
County on December 4 , 19 llll... Said apprai sement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
None
None
4,023.85
None
$4,023.85
As to such tax that is paid ~ithin three months from dote of death, a five (5%) percent
discount is allowable. As to any tax that remains unpaid ofter 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 dote of death, 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
December 4. 1980
Signed
fb1 , it" 1 !)
..-"'. /' If { 'I J _ II' J1 Ilk/.
Title Chi"f ApprRi....r
NOTE: This is not a bill.
INHERITANCE TAX
APPRAISEMENT
~f_
~
REV"'? ,(1-80)
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
-
-
Estate of
SHATTUCK, Bertha E.
File No. 21-80-0675
County
Cumberland
Date of Death 04/11/80
In the event that any utur. intllrest in thl. estatell tranrfemrd in pOJSCJsJon Dr enjoyment 10 CollJtOllll heirs of the decedent otter the expiration of any
matt for Ufe or for years, the Commonwealth hereby expresslv roserves the ,ight to opprai~ end as~uss tran"fer inherltllnce taxos at the lawful colleterBI rata
on any such future (ntlrest.
--~
DEPARTMENT'S
APPRAISED VALUE
PROPERTY REPORTED BY THE ESTATE
1. TOTAL REAL PROPERTY - SCHEDULE "A"
2. TOTAL PERSONAL PROPERTY - SCHEDULE "6"
3, TOTAL TRANSFERS - SCHEDULE "C" , , , .
4, TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
None
TOTAL REPORTED PROPERTY
None
None
4,023.85
4,023.85
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
None
TOTAL GROSS ASSETS
4,023.85
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.
87 . 'Ii'" ;/
, /I}(I I J (,/'/'1.) Ir'. ,
AflPRAIS(R
12/04/80
DATE
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