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OATil OF SlJIISCIUIIING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND
This 5th day of January A,D.,1981 ,
before mc, Register for lhe Probale of Wills and granling 'ellers of Administration in and for said County of Cumberland; in
lhe Commonweallh of Pennsylvania, personally came
Jon F. LaFayer and Darlene M, Long
the subscribing witnesses 10 the foregoing inslrument of writing purporling 10 be lhc last WiiI and Tesl"ment of
Mary A. lDwer
late of New Cumberland Borough,
Dated October 9 , 1974
Cumberland County Pa., deceased who being duly
=rn according to law, depose and say, lhat they were
present, and saw and heard the testa trix
Mary A, lDwer
sign, seal, publish, pronounce and declare the said
inslrumenl.of writing as and for h er
Testament and Last Will, and althe time of so doing
she
was of sound and disposing mind memory and understanding, to lhe best.of their
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knowledge, observation and belief.
Sv.orn
and subscribed before
(I, r(~~~
Regisler
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND f
Harry L, lDwer
being duly
sworn
says thai as nearly as can be aseertaine<l the said decedent
Mrry A. Lower
died on
Tuesday
the 23rd
December
day of
A,D,,!9 80,
at or about 2: 00
o'clock, ~M,
Sv.orn
and subscribed this
lf~1r::!.kl X;LOi
'/ /
5th
day of
January
"." ~7
(!. '~~fH~)
,.
Register
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3AI.LV.LN3S311d3111'o'NOSH3d ,10 IILVO
GENERAL INHERITANCE TAX INFORM~
Unsatisfied liabiiities 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 of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cosl 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 $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 coiumn 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 Wll0 has assumed the responsibility for paying the debts,
,j-I'1-fI
RF.V-4,UII1-80)
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
AFFIDAVIT OF
FIDUCIARY
(Instructions on Revorse Side)
*f,
< ~
..n- -, '
Estate of
Mary A.,-J.ower
Dote of Death DecemQer 23.... 1980
Social Security No. 171-28-7236
Last Address _:i2.UQurth..S.treet.
New Cunberland, PA
17070
Bureau File No.
(CITYI
(SlA HI
(LIP)
Coun ty Fi! e No.
21-81-05
1. Decedent died:
( ) Intestate (without 0 will)
(X) Testate (leaving a lost will--capy attached)
2. Is the filing of a Federal Estate Tax Return required for this estate?
3. (X) Executar/~ ) Administrator! Administratrix
Name Harry L, lower
Address 207 Poplar Ayenue
Yes._ No X
New Cumberland, PA
(CITY)
{STATEl
17070
(ZIPl
4. All correspondence should be mailed to ( X) Attorney
) Fiduciary,
S. If an attorney is representing the estate, indicate:
Name Jon F. LaFaver, Esquire
Address 317 Third Street, P. 0, Box 101
'-
New Cumberland, PA
(CITY) (';TATEl
17070
(lIP)
List all safe deposit boxes registered in the decedent's individual namehor jointly with, or as on agent or deputy
of another, or in decedent's individual nome with right of access by anat er as agent or deputy. Include the name
and address of the bank or ather institution where the safe deposit box is located, the name (s) in which the box
is registered and the relationship of the joint holders to the decedent.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX
NAME OR NAMES IN WHICH
SAFE DEPOSIT BOX IS REGISTERED
RELATIONSHIP OF JOINT
HOLDERS TO OECEDENT
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and
statements, and to the best of my knowledge and belief it is Irlle, correct and complete,
~^M-~~
s'7;;;;;;;~.1 OF FIDUCIARY
:A fl//
, DATE
" !
REY-4t1Z (l-eOI
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECE~fNT
ESTATE OF _ !:'m A, lDwer
SCHEDULE "C"
TRANSFERS
~
W.., ,
^ ,
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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," 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. Attach a copy of any trust deed or instrument relating to the transferred properly,
ITEM
NO.
DESCRIPTION
ESTIMATED DEPT, VALUATION
MARKET VALUE (OFFICIAL US. ONLY)
TOTAL THIS PAGE 0
-fJ}}Jf..
.REV.4S4 (1.801
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of Mary A. Lower
ITEM
NO.
DESCRIPTION
NONE
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
'*
(Instructions 011 Row.'rsl1 Sidc)
TOTAL
MARKET
VALUE
P
'h VALUE OF
cE DECEDENT'S
N INTEREST
T
DEPARTMENT
VALUATION
IOfficial Use Only}
o
TOTAL THIS PAGE
o
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 property
as indicated in the instructions for Schedule "B". Include the name, address and relationship to the
decedent of the co-owner (sl and the date the joint ownership was established.
2. Indicate the total market value of the jointly owned properly.
3. Indicate the percentage of the decedent's interest.
4. Indicate the market value 01 the decedent's interest.
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REv."a4 EX+ t&-80t
File Number
Estate Name
Date 01 Death
Social Security Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-81-0005
Mary A. Lower
December 23, 1980
171-28-7236
-
REPORT OF INHERITANCE TAX APPRAISER
ill Original
o Supplemental
o Remainder
I, the unde"lgned duly appointed Inheritance Tax Appraiser in and lor the County 01 Cumberland
Pennsylvania, do respectfully report that I nave appraised the real and p.rsonal proparty as reported In the loragoing
return at the values sot lorth apposlta aach itam In the last column to the right in Schadules "A", "8", "C", and "E"
Dated: April 8, 1981
IHVEHTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Jotnt.Held Property (Schedule E)
Transfers (Schedule C)
TOT AL GROSS ASSETS
L.elS Oebts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life Estate
o Annuity
FOR USE OF REGISTER OtolL Y
Tax on $
T ox on S
Tax on $
Tax on $
Tax on S
Exemptions
T otol Estate
Less Credits
DATE OF PAYMEt-lT
VALUE AS APPRAISED CODE
$ 36,900 00 00+
9,988 92 10+
none 2tH
none 30+
46,888 92
40-
RATE
-
FACTOR
6%
15%
-
TOTAL TAX
IHT~REST FROM
BALAt-lCE
AMOUtolT PAID
DISCOUt-lT
--
S
+ $
+
IHTEREST FROM
TO
J!ltl.../" J-If9~JdHJ )
INHERI,.ANCE TAX APPRAISER
ADJUSTMEHTS
(HARRISBURG USE Ot-lLY) REMAINDER APPRAISEMEt-lT CODE
PRltolCIPLE
CODe
ItolTEREST
S
BALAtolCE
TO
S
S
=
=
VALUE
-
COMPUTATIOtol OF TAX
$
$
$
$
$
$
$
$
TAX CREDIT
$
-
92+
93-
CODE
\
RE:V.4~7 0-80)
'COMMONWEAL TH OF PENNSYLVANIA
DEPA~TMENT OF REVENUE
TRANSFER INHERITANCE TAX
RI!SIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
-
-
~
~
Estate 0 f
Mary A. Lower
File No,
21-81-0005
County
Cumberland
Date of Death
December 23, 1980
In the event that any future interest in this estate is transferred in possussion or onjoyment to Collntflral heirs of the decedent aftlJr the expiratIon of any
estate for life or for years, the Commonweslth horeby expressly reserves tho right to appraise IInd assQSs transfer Inhoritance taxes at thtt lawful collateral ratll
on any such futuro Interest.
-
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
$36,900.00
9,988.92
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTV - SCHEDULE "8"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTALJOINTL V OWNED PROPERTV - SCHEDULE "E"
none
none
TOTAL REPORTED PROPERTY
$46,888.92
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS $46,888.92
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.
1 )
PA,,,:, h1'II'J1J~l
APPRAISI:R
April 8, 1981
DATE
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
.
COUNTY FILE NO:
c-Y /.- /( / .. OS
DATE
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ESTATE
FILE NO.
/)1 '7,)
J, (J
COUNTY
DATE OF DEATH
~ ~ I C; .fd
Appraised Value of Estate:
Real Estate
$
Personal Property
+
Jointlv Held PropertylTransfers
+
Total Gross Estate
$
Total Approved Deductions
Clear Value of Estate
$
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$
Amount Taxable @ 6% Rate
$
tax due
$
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
33J>:! u
Less Credits:
DATE OF PAYMENT
.. * .. .. .. .. A five percent discount totaling $
will be granted jf the Inheritance Tax is paid by
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
5 -Y-- '\/1
$ 33)( / ()
+ $
$
= $ 3-3R. /()
+
=
+
=
Interest accrues at the rBte of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due jf paid bV
is
. 6J, ~ ),.~
C '~-
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
See Information on Reverse Side
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