HomeMy WebLinkAbout80-00805
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LAW OFFICES
MART&ON AND SNELDAKER
I,As'r \~II.l, AND TESTN'IEN'r
I, IXOTA N. BUT,l" of thc TOIvnship of I1runpdcn, County of CWI!bel'land
and COnmlOl1\iealth of Pennsylvania, bC'ing of sound and disposing mind,
memory and understanding, do makC', publish and declare this as and for
my Last NUl and Testament, hereby l'evoldng and making void all former
,~ills and codicils by me at any time hC1'etofore made.
~. I ordel' and direet that all my just debts and funeral
expenses be paid by my Exeeutrix 01' Exeeutor, as the case may be,
hereinafter named, as soon as eonveniently may be done after my deeease
SECOND. I ordel' and direct that all taxes I~hieh may be assessed
in consequence of my death, of lihatever nature and by Nhatever juris-
dietion imposed, shall be paid from my residuary estatC' as part of the
expense of administration of my Estate.
1.!!I.@. I give, devise and bequeath all the rest, residue and
remainder of my Estate, l'eal, pe1'sonal and mixed, whatsoever and where-
soever situated, unto my daughter, CHARLENE J, LOYD, absolutely and in
fee simple.
FOURTH. If my daughter, CIIi\RLENE J. LOYD, should predeeease me,
then and in that event, I order and direet that all the rest, residue
and remainder of my Estate, real, personal and mixed, Nhatsoever and
wheresoever situated, shall be distributed unto my daughter's issue
per stirpes by representation and not per capita.
LASTLY. I nominate, constitute and appoint my daughter, CHARLENE
J. LOYD, to be the Exeeutrix 01' this, my Last \~ill and Testament, but i
my said daughter should fail to qualify as such Exeeutl'ix or eease so t
se1've, then and in that event, I nominate, constitute and appoint my
son-in-law, \~ILLIAi'I H. LOYD, to be the Exeeutor hereof, eaeh to serve
6'(<8
~ of ,...
,
LAW OFFICES
MARTSON AND SNELDAKER
...
..
without bond.
IN IHTNESS ImEREOF, I, LEOT^ N. BUl.I., h(Jvc' hereunto set my hand
senl to this, my l.nst l\Iill and Testwnent which eonsists of t\~O
typewPitten pages to eaeh of \~hich I have affixed my signatlll'e
dny of ^ugust, ^.IJ., One Thousand N.inc lIuJIllred Sf'venty-five (1975),
~ 13'
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,eA} L,t/ lit,' ~~
(SE^L)
The preceding instrument, consisting of this and one (1) other
typewritten page, eaeh identified by the signatUl'e of the Testatrix,
was on the date thereof signed, sealed, published and declared by LEOT^
~1. BULl., the Testatrix therein named, as and for her Last l\Iill and
Testament, in the presence of us, \~ho, at her request, in her presenee,
and in the presenee of eaeh other,
hereto.
.-')
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OATil 0.- SUIlSCRIHING WITNESS
COM~ioNWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND
This 31 day of lJeeellllJl'1' A.D..19 An ,
before me, Regisler for Ihe Probale of Wills and granting lelters of Adminislrnlion in and for said Counly of Cumberland, in
the Commonwealth of Pennsylvania, personally came
Richul'cJ C. Snel.lmkel' and ,Janet N. rOI'I'Y
the subscribing witnesses to Ihe foregoing inslrument of writil.g purporling 10 be tht lasl Will and Testamenl of
Leota ~I, Bull
Dated _
^ugust ], ] 975
lale of
lIalllpden Township
Cumberland County Pa., deceased who being duly
SW01'n
they \lJeee
according 10 law, depose and say. Ihal
Leotn ~I. Bull
present, and saw and heard the lest" t1'LX
sign, seal, publish, pronounce and declare the said
inslru"!enl of writing as and for h e l'
she
Teslament and Lasl Will. and al the lime of sO doing
was of sound and disposing mind mco..ory and underslanding, to Ihe besl Of~' e1 t' /'
knowledge, observation and belief, .
!;\~O l'I1 and subscribed before -=f.::;;~ _' ~.i!e:-:aL-
,y ,,,-,,,;I }1) . ,~~
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t92f ()J.
14.47 -' ,r;y.(-f~
Regisler
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA! ss:
COUNTY OF CUMBERLAND \
eha Plene ,J, Loyd
being duly
sworn
says Ihal as nearly as can be ascertainenthe said decedenl
Leota N. Bull
died on
Sunday
Decelllbel.'
2] st
A.D,.19.J!Q,
the
day of
al or about
.I2:1J5
o'clock, ~M.
S\~ol'n
and subscribed Ihis
31st
/1;& ';1,,'
(j. .1~/!--r..u J. " "d",/L
/,
</
day of Decelllbe I'
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01 a
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Regisler
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTYOFCUMDERLAND
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Defore me. the Register for the Probate of Wills and granting of Letters of Administration in and for the County of
Cumberland, personally came
Chal'lene .1. Loyd
who, being duly
8\1/0 rn 1 do cs
depose and say that as th<e Exeeu tdx
of the last Will and Testament of
Leota N. Bull
deceased
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, 5\'0 I'll and subscribed before me.
Decembet' 31 "".D" I9~
she
Register
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DECREE
De it remembered that on the
31
December
,A,D,,19~, there was probated and
day of
recorded the last Will and Testament of
LC01'i\ ~1. BUI,L
late of
JlANPDEN TO\iNSIII P
,Cumberland County, Pennsylvania,
Deceased. Letters TESTAMENTARY were granted to
Witness my hand and official seallhe day and year aforesaid.
CHARLENE J. LOYD
q}l~~</ dI. ~~istGr'
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t " MY."IUK" ': '.' ,
~f.f;~'1'":';"" i. -' , COMMONWEALTH OF PENNSYLVANIA
4 'i.io.K000568 DEPARTMENT OF REVENUE '
\ It(:~''' , - OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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'I 'RECEIVED Charlene J. LO.....
I' I FROM z-
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I ADDRESS 44 W. Main street
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TAX AT 6%
TAX AT 15%
TAX AT ~.
liC:JU'X'f At.ty. .
ESTATE TAX
HeehaniClllburcj, pa.
17055
TOTAL TAX CREDIT
3,684.21
'--E5TATErnFoRMAT~ND-';o--:I1--i9-80-----------
DATE OF DEATH ..
21-80-805
FILE NUMBER
... March 19. 1981
LESS DISCOUNT
184.21
NAMEOFDECEDENT
LBOTA M. BULL
Cumberland
G
m
PLUS
(FROM
% INTEREST
TO_I
DATE OF PAYMENT
- -----------------------------------------
~OUNTY
TOTAL AMOUNT PAID
3,500.00
'OSTMARK DATE
"iMARKS: .PAID ON ACCOUN'l'M
SEAL
RECEIVED BY
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'M' @!~N-t:l .
R at.er of Willa
t
REGISTER OF WILLS
-------------- -----------------.---
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by 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 01 administration,
attorney lees, fiduciary lees, luneral 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 01 the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liabilitY lor 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 lorleited 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 01 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 lor paying the debts.
__0..__0__________
*'
REV..55 (1.801
COMMONWEALTH OF PENNSYLVANIA
O~PARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
Estate of 1.1'\". M 'Au11 Date of Death 12,'21/88
WHEN CLAIMING THE FAMll V EXEMPTION, COMPLETE THE FOllOWING:
File No,
:u 89 895
Claimant Charhne J. Loyd
Relationship to Decedent
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Claimant's Address ")Q1 ~ t!h..,,'''...nl'\lI-
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M..,.'ha.....c,.."".....g. Da........al.'.u.n... a
1.,nctl;
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
1 D.~' -~ -~ "'41'. - . . I.~ ^^
2 West Shore Times Advertisinll executrix' notice 16.25
3 Cumberland Law Journal Advert1ainll executrix' notice 18.00
4 Charlene J. Loyd Family exeDlDtion 2 000.00
5 Myera Funeral Home, Inc. Funeral expenBes 3,068.98
6 Elgin Granite Works Monument 412.50
7 ProfeBBionBl Pharmacy Account 27.62
8 Re2ister of Willa FHinll fees 9.00
9 Snelbaker. McCaleb & Elicker Attornevs fee 3 500.00
10 Reserve for filinll account. rele Be. notary fees and miBcellaneous COB s 50.00
TOTAL THIS PAGE I ~ Q145,15
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 deductions for Inheritance Tax purposes.
. /('~'-v Q,._ ~~{ .r-(6-n
SIGNATURE OF ^TT'i1~~C':/F10UC RV DATE
OFFICIAL USE ONl V
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S
AT
PERCENT.
REGISTER OF WILLS
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by tile decedent prior to his/her death arc 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.
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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.
S, 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.
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the following persons shall prepare and file
a return:
a, The personal representative of the estate of the decedent as to property of the decedent administered by him
and such additional property which is or may be suhject to Inheritance Tax of which he/she shall have or
acqui re knowledge;
b. The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Statute.
including a trustee of property transferred in trust, provided that no separate return need be made by the transferee
of property included in the return of a personal representative.
2, PLACE FOR FILING
The return is to be filed in duplicate wilh the Register of Wills of the county wherein the decedent resided.
3, TIME FOR FILING
The relum is due nine monUls after the decedent's death, unless an extension for filing has been applied for and
grantee by IllS Secretary of Revenue within the nine,menth period.
4. FAILURE -:-0 FILE RETURN
Section 791 of the 1961 Stalute provides that" . . .any person who willfully fails to file a return or other report
required of him. . .shall be personally liable. . .to a penally of 25% of the tax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by
law,"
5. TAX RATES
Inheritan~e Tax is payable at the rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife,
son, daughter, grandchildren, grandparent, son,in.law and daughter,in-Iaw and at the rate of 15% as to all others.
6, PAYMENTOFTAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rate 0 f 6% per annum accrues thereafter until payment is made. All payments received are fi rst applied to any
interest which may be due wilh any remainder applied to the tax, IF TAX tS 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 10 Ule Register of Wills of the county wherein \he decedent resided and are
received subject to the final determination of the Deparlment of Revenue.
7, FAILURE TO PAY
The taxes imposed, together with any interast thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest !lave been paid in full. The taxes may be sued for against any real property in the decedent's
estate or against any property belonging to a transferee liable for the tax.
a. FILlN G OF FALSE RETURN
Any perscn who willfully makes a false return or report required of him shall, in accordance with Section 793 of the
1961 Statul.e, be guilty of a misdemeanor and. on conviction thereof, sllall be sentenced to pay a fine not exceeding
Sl,OOO or undergo imprisonment nol exceeding one year or boUl.
REV..450 C '..eol
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
(Instructions on Reverse Side)
ESTATEOF _LEOTA H.....llUL~_
DESCRIPTION
ESTIMA TED
MARKET
VALUE
DEPARTMENT
VALUATION
(OFFICIAL USE
ONLY)
NONE NONC
TOTAL THIS PAGE NONC
REV.ASZ. t ,-eol
COMMOllWEAI.TH OF PEllllSnVAlllA
OEPARTMEllT OF REVENUE
TRAllSFER IllHERITAllCE TAX
RESIOEllT OECEOEllT [1'O'Y^ '\ 11U\' [
ESTATE OF _ ,. . ". "
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, dales 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,
ESTIMATED I DEPT. VALUATION
MARKET VALUE (OFFICIAL USE ONLY)
ITEM
NO.
DESCRIPTION
NONE
NONE
TOTAL THIS PAGE
NONE
N,\...-'YJfI.
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QUESTIONS CONCERNING PROPERTY 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 "Yes" or "No".) No
2. Did decedent, within two years of death, transfer property from himself/ herself to himself/herself and another party
or parties (including a spolJse) in joint ownership? (Answer "Yes" or "No",) .l!.9...-
3. If the answer to one or two al:ove 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 certificate,
c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer.
. d. All other information supporting nontaxabilily 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 the right to income from the property transferred? (Answer "Yes" or "No",) No
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Yes" or "No",) No
6, If the answer to five b, al:ove 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 beneficial 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",) N:l
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-453 EX'" (3.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEDENT
SCHEDULE "0"
BENEFICIARIES
*'
(Instructions on Reverse Side.'
Estate of
LEOTA N, llUI~r,
BENEFICIARIES AND ADDRESSES
RELATIONSHIP
SURVIVED
DECEDENT
DATE OF
BIRTH
INTEREST OF BENEFICIARY
Charlene J. Loyd
3913 Cherylbrool< Dri.ve
Meehani.esburg, PA 17055
duughtel'
enti.re resi.due
yes
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
,REV-454 (1.80)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
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(lnsrructions on Reverse SldcJ
Estate of
LEOTA ~l. BULL
. I ==s
TOT AL PE VALUE OF DEPARTMENT
ITEM R
NO, DESCRIPTION MARKET CE DECEDENT'S VALUATION
VALUE N INTEREST (Official Usa Only)
T
l. Cheeking Aeeount No. 252-~065"0-5 , Commun-
wealth National Bank, in joint nal11es of
Leota M. Bull (deeedent herein) and Charlen
J. Loyd (daughter) , opened on August lL~,
~972 . Balance on date of death $308 .27 50 $15l/ .lli
L .
-
TOTAL THIS PAGE $lSLL1Ll J.~-lJ. 1<1-
-
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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". Describe all personal properlY
as indicated in the instructions for Schedule "8". 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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COMMONWEAL TH OF PENNSYLVAt~IA
DEPARTMENT OF REVENUE
TRAHSFER IHHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
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[iJORIGINAL
D SUPPLEMENTAL
Estate 01
Leota M. Bull
File No.
21-80-0805
Co un ty
Cumber land
Dote 01 Death December 21, 1980
In the event Ihat any lululC (nlorc!>t in 'his estatu Is tran"ferred in possession or enjoyment to collateral heirs oltha decedent alter tho
oxplrallon 01 any estate for 1110 or lor yaou. tho Comnlonwcolth hUIGhy exprl'lssly reserves the right to appraise and ouess transler
Inheritance to)(.as at the lowlut coltofcral ra'" on any such future inlClteU'.
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
ASSET SUMMARY
DEPARTMENT'S
APPRAISED VALUE
1. Total Real Praperty - 5CH. "A". . . . 0 . .5
2. Total Persanal Property - 5CH, "B", . . , 5
3. Total Jointly Owned Prope,ty - 5CH. "E" 5
4. Total Transfers - 5CH, "C", , ,'. . . ,. $
None Unreported S
79.347,64 Unreported S
154.14 Unreported S
None Unreparted S
o LIFE ESTATE
DANNUITY
TOT AL GROSS ASSETS
DREMAINDER
S None
S 7Q,147.64
S 154.14
$ None
$
79 , 501. 78
TOTAL VALUE
$
I do hereby certily that the above appraisement is made in conformity with Pennsylvania low and has been !iled this
day with the Register of Wills,
J!I'I.M /.1 ./ff{~;' 11 ." j )
APPRAISER
June. 10. lQRl
DATE
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REV..(55 EXt (3.eO)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
-
Estate of Leota ~1. Bull. Date of Death 12/21/HIl
WHEN CLAIMING THE FAMilY EXEMPTION, COMPLETE THE FOllOWING:
Charlene.J. Leyd
File No, 21-81J-H05
Claimant
Relationship to Decedent
daugh tel'
Claimant's Address Jttime of Decedent's Death
3913 Chel'ylbl'ook Drive, Nechaniesbul'g, PA 17055
ITEM DATE
NO.
1
2
3
II
5
6
7
8
9
10
NAME OF PAYEE
REMARKS
AMOUNT
'harlene J. Leyd
Iyers Funera 1 Home, Inc.
19in Granite \vorks
Profess ionn 1 Pharmaey
egister of \Yills
Probate eosts
Advertising executrix' notice
Advertising executrix' nDtice
Family exemption
Funeral expenses
Nonument
Aecount
$
1/3.00
16.25
18.00
2,000.00
3,068.98
1112.50
27.62
9.00
egister of \Yills
vest ShOl'e Times
umber land L.aw .Journa 1
filing fees
nelbaker ~leCaleb & Elicker Attorne s fee 3.500.00
eseI've for filing aeeount, re lease, notary fees and lI1iseellaneo s
costs 50 .00
TOTAL
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 deductions for Inheritance Tax purposes.
/ i!.f.adl"..v J. '?f&"71vL 'J- ; '/- J: I
SIGNATURe"OF FIDU t'ARV DATE
OFFICIAL USE ONLY
$9,1115.35
DEBTS AND DEOUCTIONS ARE ALLOWED IN THE SUM OF S 9, ;.t/:;: 3.5~ AT
t
% TAX RATE
0{tl1#:."~;;~
1-/i, - if
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatislied liabilities incurred by the decedent prior to his/her death ore deductible against his/her taxable
estate. In addition to debts incurred by the decedent or estate, other items ore c1aimoble including the cost 01
administration, ottorney lees, liduciary lees, lunerol and burial expenses including the cost 01 0 burial lot, tombstone
or grove marker and other related burial expenses.
All debts being claimed against on estate ore subject to the approval 01 the Register 01 Wills with whom the
Inheritance Tax Return is liled. Evidence.la support the decedent's or the estate's liability for the debts being
claimed should be attached to this schedule.
A family exemption may be claimed by 0 spouse 01 0 decedent who died domiciled in Pennsylvania. If there is
no spouse, or if the spouse has forfeited his/her rights, then any child 01 the decedent who is 0 member of the some
household con claim the exemption. In the event there is no such spouse or child, the eXllfllption con be claimed by
o parent or parents who ore members of the some household os the decedent. The lamily exemption is allowable only
against assets which pass by 0 will or by the Pennsylvania Intestate Laws.
NOTE: Compensation paid to on estate representative; namely, an executor or administrator, for services
performed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income
item should be reported on form PA_40.lndividuallncome Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicate the claimant's nome, address and his/her relationship to
the decedent. Enter "family exemption" in the remorks column and the amount claimed in the amount column.
2, Assign consecutive numbers to each item listed.
3. Enter the dote on which each debt was incurred and/or paid.
4. Enter the names of each payee,
5. Provide 0 brie{ explanation in the remarks column for each debt claimed.
6, Enter the amount 01 each debt being claimed.
7. The farm must be signed by the person who has assumed the responsibility for paying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE BYz" x 11" SHEETS.
INFORMATION
To insuro proper credit to your account. tho nome at tho CSt31B and file number should bo c10iHIV print-
ed on the check or money order.
This assessment is made in accordanco with Section 708 of tho Inheritanco and Estate Tolt Act of
1961 (72 P.S. ~ 2485.7081.
To the extent that inheritanco tax is paid within throe (3) months oftor the dealh of the decedent. 8
discount 01 live (51 percent is ell owed 172 P.S. ~ 2485.7161.
Inheritance TalC, other than laX on a future interest, is duo at the date of the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P,S. ~ 2485.711). Inheritance
Tax on a future interest is payable within three 131 months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. ~ 2485-7121. Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
------------ --------- ---------- -- - ------------- - - --- - --- ---------- -- - - --....--
1 month ,005 4 months .020 7 months .035 10 months ,050
2 months .010 5 months .025 8 months .040 '1 months ,055
3 months ,015 6 months .030 9 months .045 12 months .060
1 days .00017 11 days .00186 21 days ,00352
2 days .00034 12 deys ,00203 22 days .00369
3 days .00051 13 days .00220 23 days ,00386
4 days .00068 14 days .00237 24 deys .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days ,00437
7 days .00118 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 (601 days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. \ 2485.10011.
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
CII^IU.ENE J. rpYll m_
- -.--...--....-..-------.--
being duly _'__ SW_~I~ ... according to law. depo.e. .nd ..y. that sho Is__thlC_. ...---.- -- --" .-- ---
______E~l?.euJ:.rjx 01 the E.t.to of __r.e9ta_ll~!.\!J.1.__-.--..----
I.to of Hampden Township .__, Cumberl.nd County. P.., decea.ed and th.t tho
within i. an inventory m.do by. Char lene ,J.. I..oYE..... .--' the ..id - Exeellt!'..i~_
of tho entire e.tate of .aid decedent, con.i.ting of all the person.1 prop.rly and real e.t.te, except real estate ouhide
the Commonwealth of Penn.ylvania, .nd that the figure. oppo.ite e.ch item of the Inventory repre.ent it'. fair value
a. of the date of decedent'. death. .
Sworn
and subscribed be foro me,
/j.! JJ 0--)
1._~~~!,.-__~f.i..U (,~_c~~L
Eucuto,v:~"
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nUl r.,I..,:'''"'' I I .I,J:. ,
My C0:':1,,1:>3:'_;1 b;.;:"~ Du:. 19. 1931
Camp tun, PA CumLerlllnd Co.
19
81
_.......?91?_C~~I'.ylbrool( Drive
~Ieehanicsburg, Pennsylvania 17055
.------_. ---- -------
Addr.u
Date of Death --- --
------- -----..--.------ ..------.-----.----
21st Decembel'
1980
-.----------'
Day
Month
reer
INSTRUCTIONS
I. An inventory mu.t be filed within three months alter appointment of personal reprelen!ative.
2. A .upplement inventory mu.t be filed within thirty day. of discovery of additional..seh.
3. Additional sheels may bo attached as to personalty or realty
4. See Article IV, Fiduciarie. Act of 1949.
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Inventory 01 the ,eo\ ond pe"onal e.tote 01
LEOTA N. BLII,r,
docealed,
REAL ESTA'l.'E
NONE
NO E
NO E
'fO'fAL REAL ESTA'l.'E
PERSONA LTY
1. Savings Certifieate, Aceount No. 4-16-0011351. The Harris
Savings Assoeiation, balance on date of death
26,979 15
1,601 30
26,989 01
1,602 12
12,975 4-1
772 57
8,4-01 34-
26 7lJ.
79.347 64-
aeerued interest
2 .
Savings Certifieate, Aceount No. 002-15-005R3, State Capital
Savings Association, balanee on date of death
acerued interest
3. Savings Certifieate, Aceount No. 2-36-103678, First Federal
Savings and Loan Association, balanee on date of death
acerued interest
4-. Savings Aeeount No. 2-01-312762, First Federal Savings and Loan
Assoeiation, balance on date of death
aeerued interest
TOTAL PERSONALTY
RECA PITU [J\TION
TOTAL VALUE REAL ESTATE
TOTAL VALUE PERSONALTY
TOTAL APPRAISED VALUE
NONE
$79,34-7.64
$79,34-7.64
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