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UEV.4!S~ EX I (J.1I01
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
_.--- -~---_.._-'----_... -,:,'~-,;.;,.......,. ,,_._~-
Estate of ALICE Iv. RICKARDS Date of Death-l2/..3.0/-aD-File No.~81-) 0
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
None
Relationship to Decedent_.
ITEM I - -,
NO, DATE NAME OF PAYEE REMARKS AMOUNT
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Short C"~";ficates
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TOTAL THIS PAGE \ 4 ?Rl 7n
Claimant's Address
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 estatee~')edUcliOI1S for ~nheri! nee :ax purposes,
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SIGNATURE OF :rTORNEVj mATt
OFFICIAL USE ONLY.
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S i.J :?/1 ()
AT
!o
PERCENT,
,8 -:J. .:3 -01
OA'fE
nLV.4q~l LX. (,HHJI
COMMONWEAL TIt OF .'lIH-l',iYl.VMlIA
DEPARTMENT OF REVENUE
TRANSFER INtlERITANCE TAX
RESIOEH r oeCEDl:lH
AFF IDAVIT OF
FIDUCIARY
(Inslluctlons on Roverso Side)
*
....-
... ___u .__.., __ ._..._..m__ __ .-..-.----.
...,......, _.._."U' ._ .'_' ... ' .,___._n
EStlllc of ._,.,1l.l..ICE \'1. lUCKARPS....,..., ,.,____
Lost Addrcr.s 351i'ESTCOOVERS'rREI::T.,----
Date of Death DECP.MI1EIL...lO'"..l9 Rn
Sociol Security No. --L1.1=2.4.=.51 ,?
,MECHANICSBURG ,..,.PENNSYL.VMllA
(ell',! l~T^H) (l.H'1 17055
Bureou File No.
?, -Rl=lO
County File No.
21-81-10
1. Decedent died:
( ) Intestllte (without 0 will)
( X) Testote (leoYing 0 last will--copy attoched)
2. Is the filing of 0 Federal Estate Tax Return required for this estote? Yes_ No )(
3. (X ) :fxJtO{CtM/Executrix
) Administrator/ Administrotrix
Name -Re:t.tie....Lo.uise-Ri..ckarn"
Address 1660 Browninq Road
4. All correspondence should be mailed to (X) Attorney
( X) Fiduciory.
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_Eennsauken,.....N"v' .1"1::""1', n8110
(CITY) IST/,TEI (ZIPI
5. If on ottorney is representing the estate, indicote:
Nome _ Geo;J;E-e M. H,QJ,lck. ESQuir",
Address National Bank Bl;Q.~din<;j
-Me.chanicshw:.q I P~TlTl~\T' U~l' ; ;:'l , 7"~ r;
(CITY) (STATEI .~ (ZIP) .
List all sofe depasit boxes registered in the decedent's individual name or jointly with, or as an ogent ar deputy
of onother, or in decedent's individual name with right of occess by anather as agent or deputy. Inclade the name
and address of the bonk or other institution where the safe deposit box is located, the nome (s) in which the box
is registered and the relotionship of the joint halders to the decedent.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT MAiNTAINED A SAFE DEPOSIT BOX
NAME OR NAMES IN WHICtl
SAF< DEPOSIT BOX IS REGISTERED
RELATIONSNIP OF JOINT
HOLDERS TO DECEDENT
,.....RQtL~_
.. ~,
()l\l'R
Under penalties af perjury, I declare that I hove examined this return, including occomponying schedules and
stotements, and to the best of illY knowledge ond belief it is true, correct and complete.
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/ SIGNATURE OF FIDUCIARY
~~, ,qj:l1
DATE
ESTATE OF ALICE W_~CKAlms
SCHEDULE OF HOUSEHOLD GOODS
--==--:=--=
Living Room:
Bedroom:
Dining Room:
RCA Color Television
3 Occasional Chairs
Sofa Bed
2 Bookcases
Desk and Chair
2 Stands
Rug
$75.00
30.00
25.00
2.00
35.00
10.00
15.00
3-piece Bedroom Suite
Lane Cedar Chest
Sewing Machine
T. v. Stand
Rug
100.00
25.00
5.00
2.00
5.00
Maple Table & 4 Chairs
Old G. E. Refrigerator
Metal Cabinet
I'looden Chest
IvIiscellaneous
50.00
5.00
10.00
5.00
25.00
TOTAL
$424.00
REV.4S4 EX-+- (3.80)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEOEN,
(1lIstructiolls 011 Reverse Side)
*
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
Estate of
ft~ICR W. RICKARDS
P
ITEM TOTAL ER VALUE OF DEPARTMENT
DESCRIPTION MARKET \ DECEDENT'S VALUATION
NO, VALUE INTEREST (Official Use Dilly)
T
NONE NONE NONE
,
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TOTAL THIS PAGE I
NONE
File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21~81-001O
REV.~a4 EX+ tHol
Estate Name
A 1 i ce.Ji, R i cl~js
December 30, 1980
[] Original
o Supplemental
o Remainder
Date of Death
Social Security Number
177-24-5112
REPORT OF INHERITANCE TAX APPRAISER
I, the undenlgned d"ly appointed Inheritance Tax Appraiser in and 10, the County 01 Cumber1 and
Pennsylvania, do respectfully report that I hove appraised the real and personal property os reported In the loregoing
return at the values set forth opposite eoch Item in the last column to tho right in Schedules IlA", liB", IIC", and liE"
Dated:
March 16, 1981
j). )
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INHERITANCE TAX APPRAISER
VALUE AS APPRAISEa ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY CODE (HARRISBURG USE ONLY)
Roal Property (Schedule A) $ one 00+ 92+
Perlonal Property (Schedule B) 13,640 40 '0+
Jalnt.Held Properly (Schedule E) None 21>+
Transfer. (Schodule C) None 30+
TOT AL GROSS ASSETS U.6AO__ _4.0
Lou D.bts and Deductions 40. 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
OLlie Estate RA,E FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6%
Tax on $
15%
Tax on $
Tax on $
Tax on S
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TD
$
$
$
Less Credits
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
--
S
+ S
S
=
s
+
;
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
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OATil 01' SUIlSCIUIIIN(; WITNESS
,COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND r
This 'it-h day of January, A,D,,19 81 ,
before me, Register for the Probate of Wills and granting lellers of Administration in and for said County of Cumberland, in
the Commonwealth of Pennsylvania, personally came
r.~npr.~ M nnn('l{
;'Jnrl
~IARY S. ROBINSON.
Alicp. l~. Rickards.
the subscribing witnesses to the foregoing instrument of writing purporling to be the last Will and Testament of
Dated_Auqust 21. 1979.
late of ....hoe. R",...nn~h nf' MPoron:ln; C'!~hnr~,
Cumberland County Pa" deceased .who being duly
sworn according to law, depose and say, that
they were present, and saw and heard 'the testatrix
, A 1 icp. IV. Rickards.
sign, seal, publish, pronounce and declare the said
instrument of writing as and for he r
Testament and Last Will, and at the time of so doing she
"
was of sound and disposing mind memory and understanding, to the best of
knowledge, observation and belief,
Sworn
'>-.~L
and subscribed before
0;"'7 t! r<~
Register
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA / ss:
COUNTY OF CUMBERLAND I
BF.TTIP. LOmSE RICKARDS.
being duly
sworn,
says that as nearly as can be ascertainecl the said decedent
ALICE W. RICKARDS,
died on
Tuesdav.
the 30th
day of
December.
A,D,,1980 ,
at or about
4:00
o'clock, ~M,
Sworn
and subscribed this
) )q --A'-_J ~
V-<..L7~ '/) tf:-.c:...L.< 'L..:.-' , \.-<-""'~'<A...,1 G/
5th
day of January,
Register
......r~n
(f.,V
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
RF.'I'l'IE LOllI SF. RICKARDS.
who. being duly sworn
,do es
depose and say that as
Executrix
of the last Will and Testament of
ALICE Iv. RICKARDS.
deceased
she 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 Trans~r Inheritance~, Sworn andsubs~~d ?efore me,
,T"nll"ry 5. A,D" 19--11L- "" 5 ftA..c:..-<..-/ ;0J:.U.L<6.L- ;I(...L"'-.€.A...!:..-cL.z....o
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tf Register
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DECREE
Be it remembered that on the
8th day of
.T:=Inl]~ry r
.A,O,.19....8..1.-. there was probated and
recorded the last Will and Testament of
AT. H'P' IV. RICKARDS.
late of
the Borouqh of Mechanicsburg,
, Cumberland County. Pennsylyania.
Dece~,sed, Letters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid,
RETTIE LOUISE RICKARDS,
,
'(30.
~
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t/ _ Register.