HomeMy WebLinkAbout80-00800
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No. 21-80
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
In the Estate of Da isv E, Fulton
, deceased.
To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania.
Petltioner(s) Is (are) the executrix
named In the Last Will and Testament of
Daisy E. Fulton dated August 17, 1971
Decedent wH \I citi,zen of the United States and a resident of S - Middleton
Township (ml6rb~~ti), Cumberland County, Commonwealth of Pennsylvania.
Decedent died on Thursday the 19th day of June A.D. 19~, In the
County of Cumber la nd ,State of Pennsv lva n!fthe age of 1L- 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 Unes t ima ted
and of real estate to the value of Unestimated
as near as can be ascertained; said real estate situated as follows
C:Rrl i,;l..
Therefore, your petitioner(s) respectfully apply(les) for the probate of the said Last Will and Testa-
ment and for Letters Testamentary theron.
Dated December (~-A t 1980
Name and address
of Petltioner(s)
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, I 'DoriS~/J. wi1.liams
R Ott'o Avenue
Carlisle, Pa. 17013
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND l
DORIS J. WILLIAMS
ss
named in above application, being duly sworn
statemsnts set forth In this petition are true to the best of
according to law say(s) that the
her knowledge and belief.
Sworn
and subscribed before
me. /___.December~ 19 _8-0_
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Filed: December:30 t 1980
Henry L.
Stuart
r3J1ft
Attorney
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OATH 0.. SUIISCRIBING WITNESS
COMMONWEALTH OF~E~NSYL VANIA I ss:
- COUNTY OF CUMBERLAND r
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This day or December /' A.D.,1980 ,
berore me, Register ror thc Probate or Wills and granting letters or Administralion in and for said'County or Cumberland, in
the Commonwealth or Pcnnsylvania, personally came /'
/
the subscribing witnesses to the roregoing instrumcnt or writillg pnJ'I'Orling)"i:.:, last Will and T~stament or
Daisy E.Fulton Dated /~gust 17, 1971
late of
South MDdleton Township
/
/ Cumberland County Pa., deceased who being duly
/
sworn according to law, depose and say, that
Daisy E. Fulton
tl-tev were
present, and saw and heard the testA tr ix
sign, seal, publish, pronounce and declare the said
instrument or writing as and ror h er
Testament and Last Will, and atlhe time or sO doing
she was
was of sound and disposing !Jlirid memory atld understanding, to the best of
knowledge, observation and belier.
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sworn and subscribed berore
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Register
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA \ ss:
COUNTY OF CUMBERLAND
Doris J. Williams
being duly
sworn
says that as nearly as can be ascertainec\ the said dccedent
Daisy E. Fulton
died on
Thursday the 19t1, day or June
at or about 6:30 o'clock, p M.
Sworn and subscribed this
18th day or December ,
80
A.D.,19_.
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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 camc
Dori!; 1. tJi11iRm!;
who, being duly
sworn ,do es
depose and say that as
Daisy E. Fulton
Executrix
deceased
of the last Will and Testament of
she
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will well and truly administer the goods and chattels, rights and credits of said deceased aceording to law. And
also will diligently comply wilh the provisions of the law relating to Transfer Inheritances?worn and subscribed before me.
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DECREE
Be it remembered that on the 30 t h day of
December
,A.D..19~. there was probated and
recorded the last Will and Testament of
Daisy E. Fulton
South Middleton TOlmship
, Cumberland County. Pennsylvania,
late of
Deceased. Letters Testamentary werc granted to
Witness my hand and official seal the day and year aforesaid.
Doris J. Williams
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PENNSYLVANIA INHERITANCE TAX GENEHAL INfORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the lollowinr, pefsons sllall prepale and file
a return: ' ;" ,","" ..,' . , '
. . '
a. Thepersona!,:leiUllSelTlative:of the estate of lhe decedent as 10 plOpelty ollhe ~8ceden~ad1l1i\listeled by him
and such addilional property which is or may he subject to Inheritance Tax of which he/she shall have nr
acquire knowledge; c'r',. ' '. ,;. ,
b. The transferee of'property upon' the trans(er o( which Inheri lance Tax is olmay be imposed by the 1961 Statu Ie,
including a trustee of property transfened in trust, plDvided lhalnn sepalate letUIl1 need be made by the transferee
of property included in the leturn of a personal replesentative,
2, PLACE FOR FILING
The retull1 is to be filed in duplicate with Ule Register of Wills of lhe county wherein the decedent resided,
3. TIME FOR FILING ..
Thp, return is due nine manUls after the decedenl's death, unless an extension 101 filing has been applied for and
granted by the Secretary of Revenue within the nine-month period,
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4. FAILURE TO FILE RETURN
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Section 791 of the 1961 Stalute provides that",. ,nnYllelSOn who willtullyJails to tile,a Lelurn,o.l other report
required of him, . .shall be personally liable. . ,to a penal ty of 25% of the {ax ullimately (ourid to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as dehts of like amounl are recoverable by
law." .
5, TAX RATES
Inheritance Tax is payable at the rate of 6% on twnsfers to lineal desccnd,3JlCj, suchas father, mother, husband, wife,
son, daughter, grandchildren, glandparent, son-in.law and daughlef-in-Iaw ani! at th'e rate of 1'5% as to all others.
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6. PAYMENT OF TAX
The tax assessed on the transfer of property reporled in thti,retull1 is due.9;rnonths after, the dececlenl's death. Interest
at the rate of 6% per annum accrues thereafter unlil payment is made, All payments received are first applied to any
interest which may be due with any remainder applied 10 the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED,
All checks should be made payable to the Register of Wills of the county whefein the decedenl resided and are
received subject to the final determinalion of the Oepartment of Revenue,
7. FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real plOperty, which lien remains in effect until
the taxes and interest have been paid in full. The taxes may be sued for against any real properly inlhe decedent's
estate 01 against any property belonging to a transferee liable (or the tnx,
8. FILING OF FALSE RETURN
Any person who willfully makes a false retum or report lequired of hilll shall, in accordance with Section 793 of the
1961 Statute, be guilty of a misdemeanor and, on conviclionlhereof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
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REV04S0 EX+ (3.S0)
COMMONWEAL TH OF PENNSYLVANrA
DEPARTMENT OF REVENUE
TRANSFER rNHEp.rTANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
(Instructions on Revorse Side)
ESTATE OF
na.1sy_E..-EultOll
ITEM
NO.
DESCRIPTION
All that certain house and lot of ground known
and numbered a8 1304 N. College Street, Carlisle
Cumberland County, pa., which has been sold to
Steven N. Sheaffer and wife by agreement of sale
on installment basis dated August 15, 1979,
which agreement is recorded in the Recorder's
Office in Miscellaneous Book 245, Page 678.
Unpaid balance under said agreement of sale
as of date of death, namely, June 19, 1980 -
$19,986.37 c.l.4.-J.'>lA-""U .< ,Uf.
TOTAL THrs PAGE
*'
ESTIMATED
MARKET
VALUE
DEPARTMENT
VALUATION
(OFFICIAL USE
ONLY
19,986.37
19,986.37
REV-"'Z (NIOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEDENT Daisy 1
ESTATE OF _ _ E. Fu ton
SCHEDULE "C"
TRANSFERS
~~
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INSTRUCTIONS: (
1. Answer the questions on reverse side.
2. If the answer to any of the questions on the reverse side is."Yes,'!:provrde-:a description of-lhe'property -transferred per
Schedules "A," "8," or liE," 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 plOperty.
1TEMe ESTIMATED DEPT. VALUATION
NO. ' DESCRIPTION MARKET VALUE (OFFICIAL USE ONL Y/
COlIIIlonwea1th National Bank
1. Checking Account 1191-107631-1
Opening date - 1/4/80
In name of Doris J. Williams 366.20
c"
2. Savings account 119-0040496-1
Opening date - 6/19/80
In .name of Doris J. Williams 8,649.44
Accrued interest on above 23.67
TOTAL THIS PAGE
9,039.31
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QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any transfer of any material part 01 hi,s es(ate withoul receiving
valuable and adequate consideration? (Answer "Yes" or "No".) Yes ,(1' ': ... ... :'"
2. Did decedent, within two years of death, transfer property from himself! herself to himself/herself and another party
or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ~
3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following
information: Not claimed to be non-taxable.
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 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 timeof decedent's death?..J~~"';: i ~.'~~~;:,'I~r.; ~~:9'oJ;,~~r'~~:\1 .I
5. Did dece~ent in his/her lifetime ma~e a~y transfer without f,eceivin~ a valuable ~rn.fapl!.tJ!l,~te_co~s!q~f:ilti~~Il.'w~e!Q\,
~~~f~:whrch transfe(o!; ~W,!lt5sly or Implredly reserves for his/her life p.r,~~y_p~~od ~h,ich~dp~~ I~ f~~\ enpo;Q!l,~ore~ls/her
a. The p,ossession ,or enjoyment of or the right to income from ,the pr9Rlllty ,tr~O~\rr~eq?[ .(A~S,w,~l'~~,e?" :q~ ::N~'~), N~ ~:
b. The light to deSignate the persons who shall possess or enJoy the property t(~rsf~J~ or Lnc9m,eJJ1er~f,rom? ~ ,)
(A "Y" "N ") No \ .,.. ". .J.. ~J), dl_<],.
nswer esot'>. ,0.;;," .." c,:, I;" T ~;"'("r ~'O ~."" ,"
I. . ...... .1.. '.,.,~ ,. -.." I '___ .
6. If the answer to five:b.. a\j)ve is "Yes," state whether the right was reserved(in,l!.ec!l~en~aIQ,n!l or p.\!1e~.. . ::.. . .
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 bElleficial enjoyment of which was subject to 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".) No
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".) --
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nEV-453 0-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TnANSFER lNHERrTANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
'*'
(InstrucriollS on Reverse Side)
Estate of Da by K. FIll ton
BENEFICIARI ES AND ADDRESSES RELATIONSHrp SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
nn..f AT tJf 11 fAmA Daughter Yes Entire estate
8 Otto Ave., Carlisle, Pa.
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
None
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INSTRUCTIONS FOR SHCEDULE "D"
1. List full names and addresses of all who have an interest in the estate
either vested, contingent or other interest.
2. Indicate the beneficiary's relationship to the decedent. Specify if
stepchildren or illegitimate children are involved.
3. Indicate "Yes" or "No" if the beneficiary survived the decedent.
4. Indicate the date of birth of the beneficiary if the interest is a life
interest, term certain interest or a future interest,
5. Indicate the interest of the beneficiary in the decedent's estate.
For example: Specific bequests of a diamond ring. savings bonds
or cash of $5,OPO; bequest of 25% of residue; remainder interest; etc.
6. At the bottom of Schedule "D" state those beneficiaries who are not
living at the time the return is being filed and include date of death.
::,;10'
REV0454 EX'" (3.80)
, COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE HE"
JOINTL V OWNED PROPERTY
**
(Instructions on Reverse Side)
Estate of DailV E. Fulton
'1
ITEM TOTAL p\ VALUE OF DEPARTMENT
DESCRIPTION MARKET DECEDENT'S VALUATION
NO. VALUE INTEREST (Officlel Use Only)
None
,
-
TOTAL THIS PAGE 0.00 0 >""O./f'
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INSTRUCTIONS FOR COMPLETING SCHEDULE "e"
'Schedule "E;' must include all property, real and personal, owned by the decedent jointly with another
. party: or parties as joint tenants with right of survivorship. Both tangible and intangible property are to be
included. List real estate first.
1. Describe all real property as indicated in the instructions for Schedule "A". D'escdbe'all ~ersorfllr ~/bperty
, as indicated in the instructions for Schedule "B". I nclude the name, address and relationship to the
decedent of the co.owner (s) and the date the joint ownership was established,
2. ,Indicate the total market value of the jointly owned property.
3. Indicate the percentage of the decedent's interest.
4. Indicate the market value of the decedent's interest.
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INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-80-0800
Da; sy E. Fulton
June 19, 1980
Ii] Originol
o Supplementol
o Remainder
File Number
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Estate Name
Date 01 Death
Social Securi ty Number
188-32-3793
REPORT OF INHERITANCE TAX APPRAISER
I, the und'IJlgned duly appalnted Inheritance Tax Appraiser in and for the County af Cumber1 and
Pennsylvania. do reopectfully report that I nave apprahed the real and personal property as reported in the foregoing
r.tum at the valuel let forth opposite each item In the last column to the right in Schedules "AIt, uB", tiC", and IIE"
Dated:
March 16, 1981
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INHERITANCE TAX APPRAISER
Real P,aperly (Schedule A)
Personol Property (Schedule 8)
Joint-Held P,operty (Schedul. E)
Tran".r. (Schedule C)
AOJUSTMENTS
VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
$ 19,986 37 aa+
None la+
None 20+
9,039 31 30+
29,025 68
40-
93-
REMAINDER APPRAISEMENT COOE
INVENTORY
92.+
TOT AL GROSS ASSETS
Le.. D.bt. and Deductions
(SCHEOULE F)
CLEAR VALUE OF EST ATE
o Life Estale
o Annuity
Mll
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGrSTER ONL V
Tox on $
CODe
COMPUTATION OF TAX
S
S
$
S
6"
"
T ax on $
15%
Tax an $
Tax an $
s
Tax on $
Exemptions
Totol Estote
TOTAL TAX
INTEREST FROM
BALANCE
TO
s
s
s
Leu Credit.
DATE OF PAYMENT
INTEREST
TAX CREDIT
AMOUNT PAID
DrSCDUNT
$
+ S
S
=
$
=
+
INTEREST FROM
BALANce
TO
s
4 REV0451 0-80)
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
REsrDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
'*'
Estate 0 f
Daisy E. Fulton
File No, 21-80-0800
County
Cumberland
Date of Death June 19 , 1980
In the event thet any utur. Intor.,t In thllestlltl Is transfeftod In poS$OISlon or enjoyment to colloteral ho rs 0 the ecedent a ter the exp rat on 0 any
mate for life or for years, the Commo"wl3lth hereby expressly roserl/es the right to Ipprliso and IlUOSS trensfor inheritance Uxes It thelBwful colllur.1 rata
on any such future I"toroll.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
$19 986.37
None
9 039.31
None
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "8"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
TOTAL REPORTED PROPERTY
$29,025.68
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
None
TOTAL GROSS ASSETS
$29,025.68
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.
ill ",0""1 rli'ft Ii 1 . d )
APPRAISER
3/16/81
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REV.455 (l.ao)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
*
"
..'" " 1\
21-80-800
Estate of Daisy E. Fulton Date of Death June 19, 1980
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
File No.
Claimant nor is .T.. wi 11 i ams
Relationship to Decedent 11""ghl"""
Claimant's Address 8 Otto Avenue. Carlis Ie.. Pa..
17013
ITEM
NO.
REMARKS
AMOUNT
DATE
NAME OF PA YEE
MGN Pharmacy
r ou h
Carlisle Has ital
Belvedere Medical Center
Carlisle Radiolo Assocs.
Masland ASSDCS.
Carlisle Hospital
Medicines
Doctor bill
Balance of urine culture
X-rays
X -ra s
Dr, bills
Hospital bill
Checks
Funeral bill
Charge for checks
Lettering
Charge for checks
Family exemption
Reim. for:
144.25
15 00
2.10
37.00
25.00
255.00
27.80
1.20
,303.00
.20
100.00
.10
2,000.00
Hoffman-Roth Funeral Home
Carlisle Memorial Service
Doris J.Wi11iams
Henry L. Stuart
Filin
30.00
50.00
1 451.28
5A41. 93
r & Deds. 6.00
30.00
Withheld for settling estate
TOTAL THIS PAGE
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, deductions for Inheritance Tax purposes.
~
3-/1-81
DATE
SI NATURE OF TTORI\IEV/FJOUCIARV
OFFICIAL USE ONLY
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NOI!'I1INHO::lNI X'I1J. 3:JN'I1J.IH3HNI TvH3N3D
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*
COUNTY FILE NO: ;;( I - tOO' 0 I)
To;1JlI/Y'" 'l i .~l,t<\.,I.or~\.
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DATE
An')., ;:) II J Q ? I
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ESTATE (./ \ " i' -r." ..
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FILE NO, ;) I ~- fn II
COUNTY(~..__ ',' \1 J -JL. v.l
DATEOFDEATH-9-(.'J'/J._ /9.. /9 (j
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,
:~
Appraised Value of Estate:
Real Estate
Less: Approved Charitable Exemptions
J 0 q Yl_ '. 7
$ '"
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+ "'-- h
+ n t\ ~: l1 3/
0'
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$.::)9, ();J r; !...r'
( 11..(1 I C.;;
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" '\ -S- t<~ 'b-
$~c:14.
" ........ ,
-~-'
$"<.,) ",n '"' .<:;
,
Personal Property
Jointly Held PropertylTransfers
Total Gross Estate
Total Approved Oeductions
Clear Value of Estate
Crear Value of Estate Subject to Tax
Amount Taxabre @ 6% Rate
$ ;;C') 'S. X;; ci':
lax due
$ J3 _.lJY'. 1'i.3
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA rNHERITANCE TAX DUE
;$;;"
$ I 0 =, gJI :.:.
* * '* '* * 'lit A five percent discount totaling S
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
3-/9 -('I
I
$1'355.(1;3 + $
$
= $/3.. r;;r.; (\,2,
+
=
+
=
Interest accrues at the rate of six (6) 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
~~-
/' I /
Assessed by: o' I : / /!
See Intormalion on ReverCl!r Side
rNFORMATlON
To insure proper crodit 10 your account, the name of tho estate and file number should be clearly print-
ed on tho check or money order.
This assessment is made in accordanco with St!ction 70B of the Inheritance and Estate Tax Act of
1961 i72 P,S, ~ 2485-708},
To the extent that inheritance tax is paid within three (3) months after the death of tho decedent. a
discount of five 15) percent is allowad (72 P.S, S 2485.716j,
Inheritance Tax, olher than tax on a future interest, is due 8t the date of the decedent's death and becomes
delinquent el the expiration of nine (9) months aller the decedent's death (72 P.S, S 2485.711), Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. ~ 2485-'121. Calculato interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
------------ --------- ---------- --- ------------- - - --- - --- -------- -- -- - - - ----
I month .005 4 months .020 7 months ,Oa5 10 months ,050
2 months .010 5 months ,025 8 months .040 11 months .055
3 months .015 6 months ,030 9 months .045 '2 months .060
I days ,000 17 " days ,00186 21 days ,00352
2 days .00034 12 days ,00203 22 days ,00369
3 days ,00051 13 days .00220 2a days ,00386
4 days ,00068 14 days .00237 24 days ,00403
5 days ,00085 15 days .00250 25 days ,00420
6 days ,00101 16 days ,00267 26 days .00437
7 days ,001'8 17 days .00284 27 days ,00454
8 days ,00135 18 days ,00301 28 days ,00471
9 days ,00152 19 days .00318 29 days .00488
10 days ,00169 20 days ,00335 30 days .00500
-- --------- ---------- --- - - -- ----- ---- -- -- -- ---- ----- --- --------- ----....
Any party in interest. including the Commonwealth and the personal representative. not satisfied with
the assessment may object thereto within sixty (60) days after receipt of this Notice as provided by Section
1001 of Ihe Inheritance and Estate Tax Act of 1961 (72 P,S, S 2485.1001),
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
if"
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it' (y.uelEx '
~"\'"'' ,~' ,'. , COMMONWEALTH OF PENNSYLVANIA
,.} ,
'No ' ' DEPARTMENT OF REVENUE
l, :".,,:<<OOO,~66 OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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TAX AT 6%
TAX AT 15%
, RECEIVED
\ FROM
"
Doria J. Willi..
TAXAT_%
.
.
.
3 s. BanOver: street
culial., Pa. 17013
ESTATE TAX
AODRESS
1,355.03
TOTAL TAX CREDrT
'--ESTATEi'N-FCjR.rM.~7i9---iiBO--
DATE OF DEA1'l't': '
21-80-800
FrLENUMBER
LESS DISCOUNT
% INTEREST
TO_I
March 19. 1981
DATE OF PAYMENT
PLUS
(FROM
m
m
TOTAL AMOUNT PAID
NAME OF DECEDENT DAISY B. FULTON
. . ';OUNTY
CUIlIberlan4
1,355.03
-----------------------------------------
'OSTMARK DATE
,,~MARKS: n PAID Olll ACcotnrr"
SEAL
RECEIVED BY
~?I /1 /i;h C'. l: /A/~
'M' ~.NAfJAi.
Register of willa