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No. 21-81 !\~I
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
. .
In the Estate of ~ l. }.Jo. vi , deceased.
To Register of Wills for the County of Cumberland, In the Commonwqalth of Pennsylvania,
Petltloner(lllls (~e) the execut 0.,. named In the Last Will and Testament of VIV8~ I'"
1... f..ll\.rT dated July 2 3 J '~Gf
Decedent was a citizen of the United States and a resident of LIlIaJ e.. ~ 114<A Tou) Mol '" ,'f'
Township (Borough), Cumberland County, Commonwealth of Pennsylvania,
Decedent died on Sv '" d 0....,,/ the 77-J.. day of ~~_t,of>V" A,D. 19...i.JL, In the
County of [oJ""'- be.",lM.AA..d ,State of J?g . at the age of -'-Y... 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 .$ S' I 000.0 ()
and of real estate to the value of $'/0, OliO. U 0
as near as can be ascertained; said real estate situated as follows 2. If a C..ee k ~Clad I
Ca-...(J Itill LdWe.V AII~ "O\.ll.M.~k;'fIl Cv_b...... \_~ (clVM+.t, fe. .
Therefore, you? petltioner(s) respectfully apply(les) for the probate of the said Last Will and Testa.
ment and for Letters Testamentary theron.
Dated December 11, 1980
Name a~d address ~~~(\ r\~ ~~'~~
of Petltloner(s) [) \' ~ \ .
. ~ \ ,i 4 L
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'\)11\\1, c,IJr-",", ~C( /71,Jl
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} ss
Barry Hart
named in above application, being duly sworn
statements set forth In this petition are true to the best of
- sw~ and subscribed before
according to law say(s) that the
h~s knowledge and belief.
me, Dec. 11 1~ 80
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Attorney Ro~t...T ~. C\..O-'bf.....\~ ,J",.
9.0. ~rl- ,.,.., 7
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-----'"._'----.~-----.
Filed: January 7, 1981
':xl. fI- 0 J
j!-/71- ..L
,COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
'BUREAU OF COUNTY COLLECTIONS
I
IJPPLlCA TION FOR AND CONSENT '*
TO TRANSFER SECURITIES
REGISTERED IN THE NAME ' ~
OF A RESIDEtn DECEDENT
- ------ -----.---.--
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applica'ion is her.by made lor cmsent to ,he 'ransl.r 01 ,he lollawing securities 010 Pennsylvania
Corpora' ion or a Notional Bonking Association localed in Pennsylvania:
DATE February 12, 1981
(a) 10 (b) FOOD FAIR PROPERTIES, INC. (c) Common
(NOTE: In doscribing securilies en'ef in (0), ab "'e, either tho numbor 01 shores of s'ock or the lace amount 01
registered bmds, in (b), ,he nome allhe issuing company and in (c) the class ~I stock or the slated interesl role
and malurity dote of fegisl.red bonds,)
ISSUED ON November 16, 196pond having 0 TOTAL MARKET VALUE OF S 40.00
(Oat.)
os 01 tho do to of doath 01 ,ho docedont, Virginia 1,. Hart
(Name of Decedent)
on 'December 7, 1980
,
(Dele of doath)
who was lale 01 248 Creek Road, Camp Hill, c_umberla~~_cou_nty, Pennsylvania 17011
(Streat and Nun,b.r)
(PoIIOHico)
(County)
(Stato)
The securi'ies are registered os follows: Mrs. Virginia L. Hart
..------
(Nomo or nome II In whh:h coffiflcate& ora reglsterod)
kl'iMtNlmtKRClllt)
EXECUTOR )
Barry L. Hart, R. D. '1 Box 84! York Springs, PA 17372
(Home) (Addless)
NAME OF APPLICANT _ Bar~. Hart
COUNTY FILE NUMBER~!!!-J l' ADDRESS OF APPLlCANLR.D~L Box 84, York
BUREAU FILE NUMBER SIGNA TURE OF APPLICANT <0 1- tJ-rwltr
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLlCATIO , IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
Sprin<;Ls, PA.
: !
--I'
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE~
CONSENT TO TRANSFER SECURITIES DATE' ..;1~ /~ff
I hereby consen' 10 the 'fansler of the above securities now registered in ,he nome 01 t alar aid
Decedent and waive Ih.liling 01 0 cortilicate certilying to the payment 01 the transfer inheritance tax 10 which
Ihe propefly 01 said Decedent is mod. subject pursuant to the provisions 01 the Acl 01 June 20, 1919, P.L. 521,
os amended and the Act 01 June 15, 1961, P.L. 373, os amended. This is also in accordance with Ihe pfovisians
01 tho Act 01 April 9, 1929, P.L. 343.
This Consent to Translor ,he herein described property operates only in rclerence to the estate 01 the
obove.namod Decedent.
..-- ..-----....
, APPLlCA TION FOR MID CONSENT
i TO TRANSFER SECURITIES
I ' REGISTERED IN THE NAME
OF A RESIDENT DECEDEIH
__.._..,.__._._..__._.......____n~_ ....___. -.___
'*
COMMONWEALTH OF PENNIYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTION\
DATE ..f~~F._u,'!!.Y_1.~--1981
/lPPLlCATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applicalion is her.by made for ca,s.nt 10 the Ironsfer of Ihe following securilies of 0 Pennsylvania
Corporolio', or 0 NOlional Bonking Association localed in Pel1l1sylvnnia:
(0) 112 __(h)2Q.~!oCOt.-!~-_---,----___-.--".- __(c)...9-ass /}- Con~n__
(NOTE: 111 describing securilies enlef in (a). ab Ole, eilhor Ihe nUOlher of !.hares of stack or the face amaunl of
regislered bands, in (b), Ihe nome of the issuing company ond in (c) the closs of stock or the sloled ;nleresllole
and maturity dote of registerod bands.)
ISSUEDON...ill)ril 26.1974 ,andhavingaTOTALMARKETVALIJEOFS 115.00
(Oato)
os of Ihe dote of dealh of Ihe decedent,
Virqin.ia L. Hart______,______, an--p_ecernber 7, 1980
(Harne of Docedunt) (Dolct of deoth)
who was late of.~~_ Creek Road, Camp Hil~, Cu~!:>,':.0~.<!._.E~tlnty,,___~ylv-ania
(Streel and Humber)
(Po'!ll Of/ice)
(County)
(Stntc)
The securilies Ofe fegislered os follows:_'!.irgin)~-,l.~_;:_to..._____
(Nom" Of namel in ....hich ce,tiflcate'!l ara registered)
~JRlllrEIR)_......!!~~. Hart R.!), #1__,J:lox_.~4_!_,_~or.k_ Springs, Pennsy1vp.nia
EXECUTOR) (Name' (A,ld.m) 17372
NAME OF APPLICANT ___Jl<!rrLL.,_Hart
COUNTY FILE NUMBER,J',l- 1'/- tFl ADDRESS OF APPLlCANT__I3_.._~J!.J.- Box 84 , York Springs ~A
BUREAU FILE NUMBER SIGNATURE OF APPLlCANT_~w~ L~ X
HOTICE: IF YOU FAIL TO PROPERLY FILL 11'1 ANY PORTION OF THIS ^PPLICATION,~IT WILL HOT BE
COHSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF I~EVENUE ' ,
CONS~~I!.O....!RANSFER SECU~.IIES DATE (L./0_4l:./fJl1
I hefeby consent 10 the transfer of Ihe above securilies now registered in the name of I~.fid ,/
Decedent ond waivo Ihe filing of a certificate certifying to the poymenl of the transfer inherilance lox to which
the property of said Decedenl is mode subject pursuanl to the provisions of Ihe Acl of June 20, 1919, P.L. 521,
os amended and Ihe Act of June 15, 1961. P.L. 373, 05 umended. This is 0150 in accordance wilh Ihe pfovisions
of Ihe Act of April 9, 1929, P.L. 343.
This Consenl 10 Trnnsfer the herein described property operoles only in telerence to the eslole of the
above.nomed Decedent.
~~~
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Signed 7:j,e SecrelofY of Rev:;e. . '
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INVENTORY OF REAL AND PERSONAL ESTATE
___ ___..- ~__ ..n _...
..u__..'~___.. _______
;..;.;_. ,',;' _ -,'.~",C'.".. ,'.""'.-"l."
3111 tllr itIIuttrl' of tllr i.:ntutr
1';le o[ Borough of Camp,llill
of Virginia L~,Har~"
Cumberland
." ". ,ill tli.. C,,"IIY "r K>X~KlC.l( Slale of PClllla.. dcceaw!.
Jlnul'lItllru
,..,Virginia. r.."..Hart
Ihe ,5th, ,,, <lay of August,..
of the real and I'cr:jun111 estate whit-h were of the alJU\'e~n:lmtd
.. dl~l'(~a:,('(l. T:\kt'll nlld appraised
(\laic "r ,Icalh ,D~cemb~L,,7,(.,,)l9BO
"';:c,-::':',~'"C~=.;.,:;;;.,,.,. . ,..-:' 'T'-~:::'" --::;;:..,.:::";,,'
I
Cumberland County, Camp Hill Borough, pennsYl-\
vania. Two and one-half story stone dwelling 52,26~ BO
house situtae Lot #l of Harry Smith Sub- I '
division plan recorded in cumberland County
Plan Book 21, Page 10. I
,l~l '
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REAr..
ESTATE
PERSONA
ESTATE Household furnishings
Refrigerator
Stove
Lawn mower
1979 pontiac pheonix automobile
Cash in Dauphin Deposit checking account
Cash in Dauphin Deposit savings account
Harris Savings Assoc. Passbook account
Travelers checks
stock dividends
Liquidation of stock
'1"--'
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,
.'1
II 100\00
i 50 00
25'00
20 00
3,500100
,
42B,B9
649\6B
19 21
160[00
l7!50
163 00
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RECAPITULATION
..... $......~..!,P'Q.~. 2.8
$,..~,?",2!i2....,8,O
$ ..,~ 7 ,3.83,.,0.13
Appraised value 01 Personal l'ropefly .......,....,....,......
,\pprai!'ot'll \'alue of feal t.~talr
Total appraised value ..
b 1 AFFIDAVIT OF PERSONAL REPRESENTATIVE
Cum er ana
County of l{llU(IXm ss:
.""...,,5.,C1,r..t.:l'., L, ,~.,..Ila,r"t." .,.,.,. ."... "..",.. ..,.,...."",........,
Exceutor
Adl11inistrat of I h(' E,lalc of ..V ir 9 inia...L,. ...Har,t....,.,................................................,...........
lkccascd, heing duly.sw.o.+.n....................................................... ill'curding 10 law, dcpo:-;c und say that the
items appearing in the In\'l'nl(.ry include all (If the jlcrsnllal ilssets \\!lwrc\'cr situate nud aU of the
real estate in the Commonwealth of Pennsylvania of said lkcc(lcut; that the valuation plac('(1 opposite
c:u.:h item of said Inventory represents its fair value as of the elate of the decedent's death; and that
dcccllcnt owned nO real estate outside the Commonwealth of Penn!'ylv3t1ia except lhat whi<.'h appears
in a memorandum at lhe end of thc Invcntory.
.,.I1,Wq,~X\,.:..............,...... and <ubscribed \ ....,....~,.. _,.. ,~\~...! ~,' ,~,~ :-:'G~;
belore me th.....,6l:.h.....,.,...,..............day 01 ( ~. AdmlnI8lrntor".1l&?Yt'.;' Hart
"....M.7!,::-.\;:'....':".....~;.....~. D. 19 ~.q R.D. #l..,..,~().x....~1~dX~~~'~..,.s..p..~.i.!.l~,~,.'.,..~.~.
.,.,...~,~.cu._.. . =-<y.=: I
~." PATRICIA A SIGNEY, NOTARY PU IIC
, I SWATARA TVlP.. OAUPHIiI COUNTY
MY COMMISSIOII E~PIR[S JA~1. 26, 1985 INSTRUCTIONS
Member, Penn~ylvamil AssociJtlOll olllo:arias
1. Au Inventory mU::lt be filed within tbree months atter llllPolnlmellt of persollal representative.
2. A eupplementnlluvunlory mu~t be filed within thirty dl)'K or discover>' or Flddltlooal 1\118018,
3. AddlUOIlal sheet8 IDa)' be attached I'lS to persona.lty or renlty,
4. See Article IV, Fiduciaries Act at 19.19.
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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 came
ROo...."'/' H u.......-r
who, being duly ~wo...M.. , do e '" depose and say that as
of the last Will and Testament of V"V' ~. '^"- ~!' L... \\'(1..",,+
E.)I(.~(." +.. ..,.
deceased
l..E. 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. SuJo,<_and subscribed before me.
t\." ..... (".JL '"
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DECREE
Be it remembered that on the 7th
day of
January
81
,A.D.,I9_, there was probated and
recorded the last Will and Testament of
Virginia L. Hart
late of
Lower Allen Township
, Cumberland County, Pennsylvania,
Deceased. Letters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
Barry Bart
....,'1-,~1
, ((0,. (
q)~~.e :?~
RegIster
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
COUNTY FILE NO:
/
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,
DATE
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ESTATE
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FILE NO,
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DATE OF DEATH
COUNTY
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Appraised Value of Estate:
Real Estate
")
$
,." ,\
.f" /',
Personal Property
-"
+
.' /.' '.
Jointly Held Property/Transfers
+
-----..
Total Gross Estate
$ 'r/ " ( ., , ~1
" :1/
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,
,-
$ '., I -' '.'t: ,V)
" ~,y.
,....-.---.---.--
, :;.; ,~. >/;,7
$ -< ! ':
Total Approved Deductions
Clear Value of Estate
Less; Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
Amount Taxable @ 6% Rate
$ ;' / ";-:1? ,>-}
'/
tax due
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
* * * " * . A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
/1'y/
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$ "'1 ...: ",'"
+
$
$
= $
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Interest accrues at the rate of six (6) percent per ennum
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; // /.!.(."; (..
A;enlforfheCommo wealth
{
See Information on Reverse Side
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COMMONWEl,-l:.TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHEflITANC~. TAX
RESlllENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DFDUCTlONS
_ _ _ ==;:.:--,,=~...........u,.~,..,.........,.-,.,......,.....-.a.A'~"."'_":'';'''-'.'- ...."..~......,J,-....._._.....~~---~
EstateDf Virqinia L. Hart Dale Dr Death~c"mbeL1.,._J9B" File No,;2\-i\-CFL- !
WHEN CLAIMING nu:: FAMILY EXEMPTION, COMPl.ETE THE FOLLOWING: I
i
,
I
,
Hart
Relatirmship to Decede"t .
Son
Claimant's Address
R.D. #l Box 84. York sprinQ". p('nn~'{1..:.uJ.Jli;)
DATE
NAME OF PAYEE
. ....,...'.---. ~EMA~~.S .,. 'l=~M~UN;=
J?mn ily..J~Kr.:lll!?J i 9.!L.-._...-. ....--.-.-..-i...$.7.'.O'O'O,..Q.Q.....
lWimbuLs.ml1"-il.t.....f.iJ.ing..f.e.c.s.,- 7? <;4_
Arlvl'r r .L.s.iJ1\1....o.f.._.grllrltin.g-DLle.~...-!:~~
Tnc Advertisin'L9..f: g.E.~~..t:.}ng of: ltG~ 21.50
]~~.~~?~m&~~thY H~rt
- 2=.a .b.e.1:..t. n _ r. h a m.l:lel:.laio...
Cumbprl i'lnd COllnry La
Cumberland Publishers,
~. of: plL.=......v.LtiiLSl.OLUi.... ..Adc.l.il.ionaLco.py_..oL.dcaLh.,c:.eL
. v.s..\:.Qlli;..Jlil..lCI:.Q.d.ll.C t 5 ' Lb.i1.L.due....a L t.ime_oL,d.e.a..t.lL
"...Ri.d.g!~,"m.QJ.,iaL.Gj;u:.de.n . !g....s.cr.D~L_.-__-.-.--. 2.5...0,0-
....LDlILy....&-Ra.u.s.h---.--. ..BJIO""'tax_r.e.tu r.LL.tli.f',.1aL3.tiDn........- _..J.5.0..Jl.lL
RS._.__.. .J,.9.aD....Lax....d ue.... .__ .....U' ___~-1.,..1.6" n n
..J2tL..J2eot~..9LB..Q.Y..5'.nu~ ..1..2..0_Q_taX.51pQ__._._.____.'___'_.'_j_ 234.00
\~es t Shore 1'a x BUU~.'l.!!..__._.. .19 8 Q...'! a X...9.-"I~, ....,....,_ _...__......--l.---106~
Barry L. Hart ~g~~~u~~~~gP5c50€oa~a~tional 40.49
__' __:Y......____.. ...._,.. .___. u.,____ -.
Cumber l.A.nQ.J;J:.:L.....F.&S-,--.Q.LNi ~----p..ill:.t.iilLi,)1l1~.Li.t.:ance.-l;.ax ~L3JL
o K un k e l. Sur 9 i9~r..OJJU.--- .ID$;:~..ical_!ll.ll...f.Q.L_l.as.t_Uln.e.s.s _J.9 0 . 00
,
Raymond C. Grandon, M.D~ ~ledicaJ,_RjJJ....Q'!!"C at..ggJ;iu:>LdQ,-}!;!.----511...fL...OJL i
Neil.UI}!}pral Home. Tnc. Funeral exoenses ._.L.952. 30
A,. Z. ,R i~jiJam, As s 0.,Q.. J as t ; Jl nc_s lLJDg'li. cAl_Q.lJ.J,__, L_..2.-98......Q.Q.....
.,CDmmlIn i ry Phy" ie' ' , .. ' E.....<l..t....dal;e~ea.th-1----3.0~.oJL
..s.vi r it Hosp.i.L;lL_ .HQS.l.llLll.~.xv.e.l:l5.e-f..o..r..1:\S.t.ill.J:lP.'.R-'I-....9...28.L.2Ji...
Amoco oil Co. ..Q..asgJ.illiL bilLdug_i1.Lde.atl1..._.... ___fJ.Q.dL.
Store Bill due at date....9.Lqeath_- ...b-H,h2.L
.Q.!!lli.r..o.y..'..s....Df<P.t.. !':trH"(, .Hi 11 Clue..at..Jia.t.e._.oL...de.allL _.109_B.2.-
nhprr Jl~.__Chamb"rl;li n. ..J.L_..At.t.Or..n~..T'PP ~06_01-
TOTAL THIS PAGE j S~iL_(U5_. 52
i hereby certify thilllo tl1e best of my knowledge and belief the foregoing is a Just ^,ld true statement of debts, fun,,, al
p.xpcnses and expenses of administration submitted to the estate J'i deductions ~nhedtJnCe Tax purposes.
( ) ~\~ . ~.::.~\_._-
_ ___ _ !:,I!~r~^'-l~!" II ':1H,.i'~l~~.':.f 1.~:lIC'~HlV _:.-:=:-_I~~1J~==--.:--"-.:;-,=--;..:,.:.--:.,~=
OFFICIAL USE ONLY
[lnlTS AND DEDUCTIOI'JS ARE I\Ll.OWED IN THE 51..1',\ OF S _d~ /fJ!.i.dJ- ,\T --.-.L-.--. PEllCf'JT,
-~,44w#) -- --0:a~
I ERt ............. 1
GENERAL NH TA~ TAX INFORMATION ".,...,':,'.\..<:..>....,),.,,,,,,,,,,, I
;, ',01,'" '';11I:.11'1''
U.n~tisfied liab!lities incurred by the decedent prior to hi,s/her death arc ded~ctible ollllinst hlsliJlf:tAlCIllii~' ,tile: '. ,I
In addition to debts Incurred by the decedent or estate, other Items are claimable including the cost ohdmln"'Ion"l" ..,~o,
attorney fees, fiduciary fees, funenll and burial ex pens os including the cost of a burial lot, to:~~~n;~~t~:"!:~i1.~fJ
All debts being claimed against an estate ere subject to the approval of the Register ofWl"swij~~,eijW:,,:1
Inheritance Tax Return is filed. Evidence to support the decedent's or the estate's liability for the dobts being dllmed
should be attached to this schedule.
A family exemption of $2,000 Inay be claimed by a spouse of a decedent who died domiciled in Pennsylvania.
If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedentlllho Is 8 member of
the same household can claim the exemption. In the event there is no such spouse or child, the axemptlon can be
claimed by ~ parent or p~rents who are members of the same household as the decedent.
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INSTRUCTIONS FOR COMPLETING SCHEDU':L::E:
1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent. Entef "family exemption" in the remarks column and the amount claimed in the amount column,
2, Assi!]" cOI1$r.cutive numbers to each item listed.
:So Enter the daiC 0" which each debt was incurred and/or paid,
4. Enter the names of each payee.
5, Provide a brief explanation in tile remarks column for each dellt claimed,
6. Enter the amount of each debt being claimed,
7. ThefOlm must he signed by the person who has "s~umed the responsibilIty for paying the debts.
/,'5111,101
IMONW[AL TIt Or- NNN~VI.V''''"A
PEl'l\RtMCNT OF RLVWl:L
TRANSFER INflER'TM;CI: T.\X
RESIOENT IlfCfOf.NI'
SCHEDULE "F"
STATEMI:NT OF llC9TS
AND DI:OIJr.T10NS PAGg 2
~.
S':,.,J~"",'~'\.
.. (- ''1:'"
tV:;};.'.: "/ ~\, \.
H.,..-... '...1
#...t.,.......,....._\...
- .-.-.........-....----
-.::----
~---.~~_.-~,. - '''II----...,~......&.u'U...c..~=uo___
__I
lcol ~....H.art ,_____Datc of Dcath..Q.~!)lber 7, 19811
,N CLAIMING THE FAMiL Y EXEMPTION, COMPLETE THE FOLLOWING: '
File No,
nant Barry L. Hart
Relation~hip to Decedcllt Son
nant'sAddrcss R.D. #l Box 84, York Sprin~s, PennsYl~ia
24
2
2
2
2
rr~ - - _. . , .,. - -- .- -=
NAME O~ PAYEE REMARKS "MOUNT
---- --
. 8-5-81 Barrv L. Hart Executor Executor's fee 2,906.01
5. J 2-5-6 Private Duty Nurses Home care 1,232.00
'-
6. 2-]2-8 Cathy L. Hart Return of personal funds/school 649.68
7. 4-7-81 State Farm Insurance Insurance on home 86.00
8. 4-16-8 New lvay Pes t Control Expense of sale of home 35.00
--,
-- -
,
-
- -- - '-.
1=-_-
-
- -----
, . --
--- -.---.---
---.---- .
.
-- _. 1_____
----
- ~- - - ~ ~=~~
--
-----
j--_.~ - --- --
-- - -----
'-- ---
j .
--
TOTAL THIS ?AGE 1_~4, 9~:.6.2.__
eby certify that 10 the best of my kno\\/cdge and belief the fO'C9,)ing i5 a ju~l and true statement of debts, funeral
nscs and expenses of administfJtiol1 11Ibll1illed to the estate u5 d~ductioll5 for Inhorililllce Tax purposes.
- -'--- ----~-~- ~ 6FF~j(~'1i~~~'dil"",,,=_,!~;~ ____~.
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t',..~" r- T.,.... t" ~ q.- ". T' " ._., tiT
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t
PEnCt~r!'".
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. ;~ 1',.1 tq~\J\o'llTtF~'):,~.U;-
. ..',j ,r:.;, ,~~'t:'V~:~ "}f,1d;~',:
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible alJllin~t hil/h8r.tiiCObl4lii8ie,
In addition to debts incurred by tho decedent or estate, other Items are claimable Including the COlt of,.dmllllilUlltlon, ,
attorney fees, fiduciary fees, funeral and burial expenses includinR the cost of a burial lot, tombltOne:or grave marker. "
All debts being claimed against an estate are subject to the approval of the Register of W;;'I~~~I~_'~' ','Ii
Inheritance Tax Return is filed, Evidence to support thl! decedent's or the estate's liability for the debts being cIalmfli
should be attached to this schedule,
GENERAL INHERITANCE TAX INFORMATIO~
A family exemption of $2,000 may be claimed by a SpOllse of a decedent who died domicilad in Pennsylvania.
If there is no spouse, or if the spa usa has forfeited his/her riahts, then any child of the decedent who is a member of, ..
the same household can claim the exemption, In the event there is no sllch spouse or child, the exemption can be
claimed by a parent or parents who are members of the same househ,)ld 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 remafks column and the amount claimed in the amount col'lmn,
2, Assign consecutive numbers to each item listed.
~. Enter the date on which each debt was incurred and/or paid.
4. Enlllr the names of each [layee,
5. Provide a brief explanation in the femarks column for each debt claimed,
6. Enter the amount of each debt being claimed.
7, The form must be signed by the [lcrson who has assumed the fesponsibility for paying the debts.
~,. '
~(....,,~:) I ~,~I
COMMONWEAL TH OF PENN~\'LVANIA
OEPARTMENT OF REVENUE
TRAN~FEllINHERITANCE TAX
RE~IOENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
.r~
.... - ~.
..~ ' ,,"I..
(Inslruclions on R.y.rs. Sid.)
ESTATE OF VirginiLL._ HarL..____.____ --""..--'
,M
ESTlMA leD
MARKET
V ALU E
.=
DEPARTMe'Nl
V ALUA liON
(OFFICIAL USE
ONLY)
.---" ". . --
~"-_.
DESCRIPTION
1 Two and one-halfstory stone brick dwelling situat~ $52,262.80
Camp Hill Borough, Cumberland County, Pennsylvani
Being Lot #1 of Harry Smith Subdi.vis.i,on Plan
recorded in Cumberland County Recorder's Office i
Plan Book 21, Page 10.
Title to real property was vested solely in
Decedent's name as recorded in Cumberland County
ecorder I s Office in Deed Book "C", Volume 25,
Page 593.
TOTAL THIS "AGE I $52,262.80 ,1;(, .l,,-;('. &'rJ
"" ,___'-'C-.L?_,/.,___ .
~....- -
L,~a 111(r\Il.Nl Cll/\!,
70n lOTAI. S,\l.[S'gnUI\[H'$ CO\\,\lIS:;ION ".l~I't1II11IHll:,':5
(oj
-x..
PAlO rtW~,'
P,\lll IH(,'J
51' l t f H :~
O'Jjil', '.';' l ;r:~
pivi.,;ulI t.d C"/ll/l,i.\,iu'! UO'f.' 7(:C) oJ'. /,.f.:t!.~~
[U'W::AI
511 i Ll,',1l 'fl
FU"Hl'j ,'1
701. $ 'n
!07,_$ to
?9J Cornrnissil1l1 pJ,li Jt S, .,~. II ~nl
70,1.
...---.----. ~......--_...... .,. -
800 ITEMS PAYABLf IN CUNlJlCflON ,III tll.O,,:1
~Oi~i.o~r~Olig;;;~i_0n r-~,. %
80:>. LOJn Disr.ourll ,\,
-.-. ~ .-...
..~~_O ~:___~pp~~!~ ~~J. ~~__
_~~:._.~~~;J~~~~.(~r"t__.~ __ _..
~Q?:...~~~.~0__I~~~t!.~j_or~ Fi!I!_._..
BOG, ~!0:~.t.~a9.~~I!~~lH'-lnO! ^pp!ir.J~:rJ'l ht:
807. ASiurl;ption Fe~
-_. -
~.~,_.S.erv.iC8 Chdrgt~ - COmltUn!,':~a.L t.h ~l~i Li'.Jnal B:tn~:
809,
810,
-'.'---'---'-+-
811"-_._,_.._.__._........__...___... ..__ ._,.... .-...
900, !!E:'~.r.~OU.!~E.Cl_~Y_ LE~,O.Ef11.0BE P..AID IN A~)IJN:C,
}_O1. .I".ter,,, from.. 8/4/B 1 to 8/31/81'" 5 U . ') 3 4:.: d"'1
~~9?...~~l')~~~p~J~~.n.~L:;~::.._1(?:~Pr~r:lil;f"':l !Of__ mo.nth to
_~Q~~~!Z~!.~_~nsuranCt~ ~:.~rn~u~_ for Y~~!r', to
~9.~,__.__.._~~._..__. __ _. ... _. .__y~~r~ te)
905:....______. ..,.._..__.____'_ .._ __ .. .._ .....__.. -. .. .
1000, RE~ER\I~S_l?~~OSIJLf.!.~I.'!'!:!I,_E..N.O..5!l_. __.__,_ n.U' .
'_Q9LJ:f~':9~~I_if)5l~r_~~~.c.e _ ..._.. _.__~_._.2 ../f1<;:H}J!.I'iQil $_ .10. 00 pt~f man.tll.
l002.:_~~~t_g.JJle~_~~~r.~l':'~___ ...._. _____._ _ ___ _.__~.~r~t~~~ .~_ S peL ~l1ol.ltr;,.
1 Og~._~i.!..y prop~r:..~Lta:-,_r:.~ ____ ._. ._...._ ..._ ___._7___ ~~~'.!h!.~ ~ ~.n 3 ~,2.5 . _ pt) r n_l.9~_ t ~~
...!.Q.O.~_C.?~f'.l.Yl~~!,~~!y.~,,_e'..._._..._.._..J ..f11()f1.<.h'.@ ~.. 5..47 permo!1!t1..
l_q2?:._~nn!:J.~I..~~~':..ssrn~,~__..___ _... m._ _ ~l~ntl1s @ S J)~~ IllLH1!..h.__
1006'..S.choo.L.ReilLEstate Taxe.s..2n~l,-,h~.(;l.,L:H..S4 . . per.mo,"I)..
100~____._________.___ ......._.._____.. _ month_~_ ~.~ __ . perJnOr!~I'._
10()3. ____._..~on{hs @_3i____+____.~!.!!.l~r~_':.b..__..___._+__
1100, TITLE CHARGES
Sf' iLl ~1I \,1
to
(0
10
1,1.00.00
".'[. ... '..-[-..
,i90.96
'--' "----- --- -~-----.-
20.00
22.6-8
.45.29
63.08
'.l~;.....~ttlcmen!...?..r..c1o~~~._!~_.~. .__~<?_..__.__ _ ._..'__' . ~ _..__.. __ _._...._
1 102. Abstr~t or tit~~~~__.______!?__. ___ __._._.________.
1103, Title examination to
-----......-..- -.-. - .-. .- . ----- .
1104, }.itL~l2surance J!!"'.:!.~e..c_____~.o_ ._______ ___ __".__'_ _ ___._ ._ _~ .~.._.....__'"_~.___d - - ------- ---.- - --.
1105. Document p~eparatl~n.u_......l!'._._Roher.L.Chamhe.r.lain ,....lr_,.....E.squire.-- -..----., 35-..0
1106, Notary !~~_____,,,-_.__. .._.__.__n____.__.__._...____....___ ---.,---
1107, Attorney', fees to -- -
(includes above it~-"',s nu;~bers:-'-'-'--" .--.---- ---------- -.. --- --.- --- - -~ j- ~~~~~~I:~,~~~\\\\\:::\'1l~,\\\'~{~
1108, Ti!le i~~urance ==-'.'.i;- c;p.Lt.-;;J_..1\h~t:r';;'~t~ C~tn~a~y==~=-..-- __428~_').SJ
(includes above !!'!.'!!~ numbfJ~s.,~.lJ_a2.;----ll0.3 ;. ._-l.lO.4_.____.. _ ___.__._________l_. ,~;~i\~~\~~-:~\,{\;~:~::~~~\~~':>'~~~\\':,\,<:'\\
1109, Lender's cO'o'erage $ ,\' \\\\~:${"'~~\\\:>~:::.,~:,;;:\~.\,\..::;.'.;~,\':.,-: \\'",';
______.___.___._~.._..______... ..~ ..n.__.___...._.___... -.- ---..--..- .------.--------.-- ,\~\_\," \\~\,\\\'\\\\\,\\'~.,.,\'.\..,.\..\' ,,\\
1110. Own~:!..~ov~.~9.~____._.._.?___._...._._ _..___~__..______....._ __~__...____~___.u__.___._~.__...___.__._ .:..~~~i:~~.:;.C~:~~~.~,.>\....\,\. s..\.:-'..'~....:::
1111.
1112.
1113,
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. RecordinQ fe's._u__.JJ,~d $ ...J.O_.5o.._;.f'''9!)9?S~.s..9 .o.O..._...;.R.~,,-JS~U>.._ .._____.__l.~. 50-
1202"SHy/co!!!!!yJ~Jsl.rnes.,__D.!'~..3O"" oO_..LMgLl9.39"-.~,..-_.-... __..____'.._... --.. --.S-3D.OO
1203.. State 13!!Sla~os: ,. ,..__.Deed ~s.3O'..OO"..;}1Il9.r:t.9~9~.$ . ___....__ . .___.__. _ --- ---.---..-- -5-3-0.,.0.
1204...:.._____,._....._.__...___.._._....__,_..__._ ._." _,.. .._. _._..__....__....____ ..----- ------
1205.
1300, ADDITIONAL SETTLEMENT CHARGES
.~ SUfV'!Y....__......!~_..._ Ge.u:i t _oJ... Be tz .n__.'.'u._..__._ - '--..~'-.-._:..1----.~J-...9~9.'..-.6s.~ '_-'~~_... "._'.
M~~~~pestins:.~::...::..:~.~~_::_~:~~..~-=::~:::==='::. :::=..:,=----..-.n- -_. _ ~. '... - -.--
r1304' ..-'.-' .-
:::~;O~;L SETT:~M~~1';f~'~:'E~~~~~~ ~~,::~~:~:~~~}~~~~~02,;:';;ion ;~ _\;;:9.51 565 ~Q
.--..-.-----..-.-------.-.---.---..---.------.----- ---.-.- ~..
...-..---.- -.-----..--.-----.- ._-~--_..-
--' -_..~.._-----_.._-------------_._-_.
.--. --_._----- --.--.-.-
On Auqust 4 .19 81 ,tht~ undersigned i'lclmowlcdge receipt of a copy 01 this Stall.:rnenl. ,lpprO\'C
the same and authOrize tl1i! dlStllJrSem~nt I,,;i tht~ fumh 10 the pilyecs nillllcd thereIn
('f)
~\ ' 'f\ ,) ,
.,'-J..(;S,J.\f),,-. :-...,-,"'\'V',.J..-...!:. ,....tu0.".. Sp.lh~r
Barry L.'.~Jlart, E>:ecutor of the
Estate or'Virginia L. Hart
J /
/'--//)"..-/ ," , ,/
.....(... 'v-'l...~~',...~. L t--.....,L, ---:' Borrower
William H. Andring
Selic!
Borrow\~r
Rile :\. i\nJr i nq
HUD.' UNIFORM SETTLEMENT STATEMENT FOW.' !.I,,'d')V' 0
,.,. '''''''''' m '''''''' '" ,:,::",''''M::','-I Z-'-"'- .;;;,; m ,;;;--"""''''"''''''l
: 1 tJFHt. '} ~~JflfO~lt. 3 CO~~~, J'.I:j~', I
: 4 ~':JVA !> CJCC"'/Ir~~,
,
1 h fll';'-NI;~lll)t'r- 1'J I {l,W, N"lI,un
t. " ".1
"01.- ""\I~' 'U '>lAU. IUi.\L ~lJl'Pl '( CO ;'I,~ SI.tr,,,'11 !,' MO~"I",".,ll(> N J 0)(:'1< ,8 MOllqa9'~ 11'\\I',~Plr:t' (:,1\" Nll<lll'l"
h'C"'NO,TE,'7'-i;,'i~,/~',"',~'i': ';'''';i!iht'Cf to !Jh'r you .1 :.l.Ift-'fIlL.;',(ol ilClUJI"""I,'"",,,: c,!,rs, A,,,,,u"'" (laid /0 JIl(l iii" :he',";;;".".",,; ;;u",,';are s';own.
Iwms m,.ut.mJ "(oo,c.)" \\'.'rr fJJItJ fJlllSid,' tflt' rlo~i/l[l' (l1I'~' ,'lrl! ,\/I(JW!l fl(!f(' lor illfOf/n,lfiofliJl (JIJfJJO!./!S ./IIU ./(1..' flot ",clucll!d in
rill,' tot<ll.~.
O-."NAME O'F'8cjl~r~owfR, - I [ r'JA',~i_ eH ~;i It U\ (I r.;,H.',i. Of LP..:lf H .
,
,
Estat.e ot 'v,',ir',9in"a I..! I CUlI\lI\om,'calt,h National
Hart, Barry L.
. i _ . Hart, [-,XLcu\or I,
\ H. SU lLlMlNT !,Lif: N'
Lower Allen Township, ... _ .C^PITALABSTRAC:T~OMPANY
Lot #l Creek Road JPlACt OF SUTLEMf"" .... 8/4/81
, _'_'__.___ ._3~~~~;g~~~,~1.~~~~~L-- ~--_.-
..,_______u.._.___.._'__' 53-,4,C).2..-+5--
C~~~~~~!~I~~~I:AMOU~,T~.~~~O SE LLER:. .__'
._~ .2., 000.. OD~ ~?_ql._.f:~;,~ey; 9YI~~.~~r.S~~:'fl5(.I'I,IE!J~I,~'EL..__. _.n ------ ..-2-...0-00-...0.0-
40,000.0 O. \1,S.o2' S,t:I~~",nl.ch"9" tu. sr.:ler@",11001......565.00'
_,~ _____. _ 5.03. [~;stin~_lo_~nl~Lt~!~~'ll ~ubjecl t~. _ .__..__...___'_
~~)<i. PJyoft 01 flr~t mOII{lJ~-IC loan..
150:;.,. i';l~off.ol ?~co::c, .HlO:.I~ilg~ l~i.~n _ '
';OG 19 81 Co . & 'l'l'/lJ. Taxes
ISO), ] 981-B2Schoc)i Taxes
1"llS,Sr,wer " Trash 4/1/81 to,
'I"or, . 9/30/8
./.di,:srmt'nrs for i~I:If;.~ ulipaid by seIfer
I
fiO.-c';-iV/!~~~~{~~.(!!l to ~.II. \:'10 Ci,'J '~'':'''...'n l.:xes to
21'.:.._S:?~~_tI~~~. to :511 C:1",r.~'~' UyCs to
212. Assessments to I ::'::12 ;'.~~t'~~menlS to
r13-.---'-"-~-----'" 513 . ..-.....-.--.-..
..........-"..--.--------...-.- .. -'-" -'" ......----.----.
~~:; _=~==~ ,~= -- . J I~ ;~.~=~~~.-==.~.=.
r~ ";~"'"~,,,:" -' _1_,. j '!~~, ,{"",on,,; ,~;";, . ...~. . ..,' ',' ..~~-.". '.,
300,-C~:~:~:~~l~~\~~~;.I~~r\;;;.~ l;onR':\'~:!~O 0.0..,.00'1 (,(lU C^~~~.;:~;;~~~~~r;_;~~lm~-.;,~~;,~~R .L,?,?..,!-,.95.
;~,~ -G10S.s :moun\ ~~e-f~:~~,..~~:o\'el (!I(/I' 120) t6' 712.26' 001 Gross Jn1o\Jnt (be \0 ~('I'I>1 (Jme .JJOJ H__'__"___
, . ,_" ,.._. 5~,492_. 75.
I:O~ ! ..~.n~o~~" I':d ~V ~~:~fl~~:"',t:"'~ ,??O) (~'-O 0.0...0 0 ~ i (~()2. _L'" ::~~I'O"5 '" Jf"O~nl~~.'~~~' (Ii"~=~Ol ~3,X~2" .9..5\.
~03 ..:~H~,X ,r~RO~\\I..(' '~Ol GOHRO\:E'l .!~ 4 ,.712.:.: 6 .J r~~:l C^SH ( 'X TOI (~~l~;:'I_~:,~L~I~ . .__~.O ~_~~ 2 . 80
SETTLEMENT STATEMENT
William
and Rae
H. Anddng
A. Andring,
wife
his
J. SUMMARY OF BORROWER'S TRANSACTION
---
100. GROSS AMOUNT DUE FROM BOil ROWER:
",. ",,"'" "~~" - - - m . r ,000. on
102. Persona~prop~.tV__-_._m. _.......__.._____ -.----.-----.-.....--
10i~i~!le~e~_t~~~~~~i~_!.I?~r~~~~.r_{!!'!_C'_.~_~Q{)} __. ---3.,219.. 5-1-
'04.
1 O~_.._-=~.~=-~===~::: ~~=~.~:==.-... ,~-..:-.-=-:.~:~: ... -...:-
Adjustments (Of iccms p"ic! by sellC'f in advancl.'
lo6.Cltvii~ t.~~"---lo"'-"-'--~--'-""'-"
1 oi~"countv t.x.~-"'f-B7 4 7 81;~=-.r27 ~_~/'_ r -::.::::n::_~'~
108. AsseS5n1ents. to
..----.-------- -----.-.-...- ---_.._._-~- ..---.-
1~9.8L~..a2_School...Taxes ,,,"-'" .---..-..--
110. .___-8/-4 11l 1 ,.\:0..6/30/82- ......42-3.35
!..!l.S.e.wer & Trash..Jl/_4/8Lto.-,-,-... ,---
112, 9D.0/81 ..9,D
GROSS AMOUNT DUE
FROM BORROWER
_____'__.___. ,6.],12-.2.6
AMOUNTS PAID BY Oil IN BEHALF OF BORROWER:
201. Depoloi1 or earnest money
~:..~?~.~inci.I!~~oun-~~!-~CW-I~~in.!s)
?03._~.~.i~ting loan(s) t::~;.:r~ subject to
204,
--- ..----------- -.---.
~05,
--.--.....------... .--.-- ---.- --
206,
-.-----.--
~07,
-.-------------.
208,
-.---.-----..----.-
209.
. --..----.---.-.....--- - ..' -_. .-.-.-. - .---..
Adjustments fOf items unpilid bV ~'r.f1ef
Bank
I 5i. fHEMENT DAlE:
~--_._--- -
K. SUMMARY OF SELLER'S TRANSACTION
--------- ------ .~----_._.---_.._---_.-
400 GllOSS AMOUNT DUE TO SELLER:
-,---..---.- ..--..--_nn._f__-
~q_1. Contract Snll'~ prlcr. u 53,-000 . .o-O~
.::q? _P{'rso{jdl ptOJll'.1Y _ ~ -- ---- -~~-
403
- --- - -.. - ----- ----
.~04
.- -- ~--------
405. ' .-------..
AdjllsraWIIlS far ift.ms Piiid by .~I..'lI/!r in ad~I,"Jce
.. .__. ._.__._ _.-_ ___ .__..~...._.n~__" . u --.-.-------
~6~, .~~;~;,I\~'~';~~,'.\ J-8/ 4.:~--'r2/3r/8 r "-'3"7:'50
----... -- ._-_.~._--_.- -----.--....-.-.-...-.-- -----..--
400. ^.i~(>ssmcnts to
.- -_.......- - - ._-_.~~.....~.._.._.-.....~--. "-- -.--------.-. -.---.--.- ---------
40,9 1981-82.Schoo1..Tax."'----u .--.-.--...--
4.~0,...._,_. .....B/4/8Lto 6/30/82-, _,_423...35.
~LSewer _&._Txash8/4/Blnto..-- ..,__m_'
~ 1 ~ ,____..9/3.O,L8.J..
420 GROSS AMOUNT DUE
, TO SELL!'H
90.58
....466 . 67
..10].70,
-'
\
1
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,
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, ~.J
QUESTIONS CONCERNING PROPERTY TRANSFERS
I. Old decedent, within tYo\) years of death, make any transfer of any material pmt of his estate wilhout receiving
valuable and adeQuate consideration? (Answer "Yes" or "No" ,) NO
2, Did decedent, within two years 01 death, transfer plOperly from himself! herself to hili1self/herself and another party
__ or parties (including a spouse) in joint ownership? (Answer "Yes" or "No",lN.o. -
3, lithe answer to one or tYo\) above is "Yes" and the transfers are claimed to be nontaxable, provide the following
information:
a. Age of decedent at time of transfer, N/II
b. Copy of death certificate,
c. Affidavit by the attending physician indicating the slate 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 valuahle or adequate consideration
therefor which was to take elfect in possession or enjoyment at or after his/her death? (Answer "Yes" or "No",) NO
a. Was there any possibility that the property tran'sferred might return to Iransferor or his/hel estate or be subject
to his/her power of disposition? (Answer "Yes" or "No".) N/A
b. What was the transferee's age at time of decedent's death? f11/11
5, Did decedent in his/herlifetime make any transfer withoutreceivinR a valuable and adequate consideration therefor
under which transferor exprp.ssly 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 !o income from the plOperty transfelled? (Answer "Yes" or "No".) -!ID-
b. The right to designate the persons who shall possess or enlOY lhe property trans felled or income therefrom?
(Answer "Yes" or "No" ,) NO
6. If the answer to five b, alxlve is "Yes." slate whelherlhe right was rcserved in deccdent alone or others. N/'
7. Did decedent in his/hcr lifetime makc 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".) 1110
8. Did decedent, at any time, transfer property, the bmeficial enjoymcnt of \l11ich W:lS subject to change, because of
a reserved power to altcr, amend, or revoke, or which could revert to dcccdent under tCln,s of transfer or by opcration 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 ollhe beneficiary reserved
in the decedent alone or the decedent and others? (Answer "Yes" or "No".) NO
REV""! (I.eOl
COMMCNweAl TH OF peN~SVlVANIA
, DEPARTMeNT OF REVENue
rnANS;:ER INHcnl"iANCI: TAX
ne~l[)eNT DeceDeNT
SCHEDUL,~ "0"
cENcFiCI"RI~3
(l.fJ,'f,'J:t"Jflf on liel,A/.,l :;;dt..J
Estaleof Vieqinia L. Hart
BENEFICIARIES AND ADDRESSES
RELATIONSHIP
SUHVIVEtl
DECEDENT
DATE OF
BIRTH
.
INTEREST OF BENEFICIAF.
Barry L. Hart
R.D. #l Box 84
York Springs, PA
on
Yes
7-3-41
one-quarter
Diana Marcum
328 W. Allen St.
, Mechanics.bur PA 17055
au hter
Yes
one-quarter
Debbie Hart Thompson
6280 Carlisle Pike
Daughter
Yes
one-quarter
R,'\l( ~O,
Mechanicsburq, PA 17055
Cathy Hart
2 Arwin Street
Apt. G
Hummelstown, PA 17036
Dau hter
Yes
one-quarter
above beneficiaries are living at this time except fer the fol:owing:
--.-.----- -...---..---
-..--
. ~'~
N^M~ . . I
'_h'_'_, '. h.._, ... ...__. "___j__
---- .-----t-----
c:;r::: or C::~"j"I:
, .
EV...S.(l.AOI
:OMMONWIALTH Of PENNSYLVANIA
DEPARTMENT Of REVENUE
TRANSfER INHERITANCE TAX
RESIDENT DECEDENT
\
stateo! Virginia L. Hart
=-
EM
O.
DESCRIPTION
NONE
\ \
..../
~~~\
W~l
SCHEDULE "E"
JDINTL Y OWNED PROPERTY
(lnstrucllon, all R8V""" Sid.)
- -
p
TOTAL E VALUE OF DEPARTMENT
R
MARKET 1, DECEDENT':; VALUATION
VALUE N INTEREST IOlllclal Us. Only)
T
- ..
,
-
OTAl THIS PAGE ~ JA
T
\--
.j
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
Schedule "E" must include all proparty, 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 (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 nwket value of the ciecedent's interest.
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REV.5I8 FO (7.80)
'~1r
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Mr. Barry L. Hart
R.D. I, Box 84
York Springs, PA
17372
RE: Estate of
County of
File No.
Vir2inia L. Hart
Cumberland
21-81-0009
Dear Mr. Hart:
You are hereby notilied thot the od liinal
appraisemenl in the estate of Vir2inia L. Hart
has been filed in the office of the Register of Wills of Cumberland
County on Januarv 27 , 19 Jll. Said appraisement reflects the following valuotions:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
$52.262.80
5.120.28
NONE
NONE
$57,383.08
As to such tax that is paid within three months from date of death, a five (5%) percent
discount is allowable. As to any tox that remains unpaid after 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 date of death, interest at the rate of six (6%) percent
per annum is charged.
Any party in interest who is oggrieved 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
()/kTkL-
I I
Sign~)~--r-
Title
NOTE: This is not a bill.
Chief Appraiser
REY-U4 EXt (!Wof
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
[l] Original
o Supplemental
o Remainder
File Number
21-81-0009
Estate Nome
Virginia L. Hart
Dote of Death
December 7, 198~
Social Security Number 171-2ll=li951
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appral..r in and for tho County of
Pennsylvania, do respectfully report that 1 'have appraised the real and personal prop.rty as reported in the foregoing
return at the values ..tlarth opposite each Item In the last column ta the right in Sc dul.s "A", "B", "C", and "E"
rJf l/U~
Dated:
c::
A1SER
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTO RY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
Rool Pfoporty (Schodulo A) $ 00+ 92+
Perianal Proporty (Schedul. B) 5 120, 28 '0+
Jolnt.Hold Proporty (Schodulo E) NONE 20+
Transfer. (Schedule C) NONE 30+
TOTAL GROSS ASSETS 57.383. 08
Lell D.bt. ond Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Lif. Estat. !!ill FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER ONLY
Tax on $
~
COMPUTATION OF TAX
$
$
$
$
$
t=
6%
Tax on $
15%
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Less Credits
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
$
TAX CREDIT
S
+ $
=
$
+
=
INTEREST FROM
BALANCE
TO
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..-......
'!I. REV.1162EX
~ - COMMONWEALTH OF PENNSYLVANIA
4 NO K 29697 DEPARTMENT OF REVENUE '
, . OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
II
~
.
II
II
S
~
~l RECEIVED
n FRDM
ADDRESS P. O. Box 1777
__"'---__-=--
.....
""-"'-__r,.~_""","
~...~..
..,,,
TAX AT 6%
Barry L. Hart, Executor
Robert D. Chamberlain, Jr., Eso
I~"AT_%
TAX AT 15%
ESTATETAX
Harrisburg, PA 17105
TOTAL TAX CREDIT
$1,892.33
'--EsTATE INFoRMATioN
DATE OF DEATH
FILE NUMBER
December 7, 1980
21-81-09
DATE OF PAYMENT
August 7, 1981
Virginia L. Hart
Cumber land
LESS DISCOUNT
-- ------ ------ ---- ---
m
m
PLUS % INTEREST
IFROM TO_I
NAME OF DECEDENT
COUNTY
POSTMARK DATE
REMARKS
TOTAL AMOUNT PAID
$1,892.33
~
"PAID ON ACCOUNT"
SEAL
RECEIVED BY
Ii Ii /
/ /
/
/ .; I I (:
\.,../ t.- .~;,J ......
i/' SIGNATURE
'r' ,
. J
'^
II (, /,-.,-.,..
.,. ..{.Jl.,....'\/ .'
/
REGIS1ER OF WILLS
-~'-- -------.-- - - - - - -----'---.-.-.---.,----.---
.... -< ~.~;fI.i.i:l~t"'.f..."U'f:-..;;,~f,:.t~~...4to-,'i:~