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No, 21-81
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
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In the Estate of
Ruth Musselman
, deceased.
To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania.
Petitloner(s) Is (are) the execut ors
named In the Last Will and Testament of
Ruth Musselman dated June 5 , 1957
Decedent was a citizen of the United States and a resident of Lemovne
Township (Borough), Cumberland County, Commonwealth of Pennsylvania.
Decedent died on Thllrsdav
the 20th day of November
A.D. 19.8..0...-, In the
County of Cllmbp.rl and ,State of ......Ea. at the age of -8.lL.. years.
Decedent illM (has notl been married and:l:las (has not) had children born tOlOtr,!l (her) since the ex-
ecution of the above described Will.
Decedent was possessed of personal property to the value of $12,000.00
and of real estate to the value of /If I )/ Ii"
as near as can be ascertained; said reai estate situated as follows
Therefore, your petitloner(s) respectfully apply(ias) for the probate of the said Last Will and Testa.
ment and for Letters Testamentary theron.
January 12, 1981
Dated ~ U.tl:U<
Name and address
of Petitioner(s)
~~~~r/);~'4 4! /'~A~
Dav~d L. Musselman, 500 Ind~ana
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Ave.,
COMMONWEALTH OF PENNSYLVANIA t
COUNTY OF CUMBERLAND , ss
De"; d T. Mn ssp. 1 man and Donald C. Musselman
Donald C. Musselman, ~t Rd.
Lcmoync, Pa.
named in above application, being duly sworn
statements set forth in thiscpetition are true to the best of
Sworn and subscribed before
aC90rdlng to law say(s) that the
theu knowledge and belief.
me,~nul!.ry ~ ~1981 _
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f eglster
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Filed: January 13, 1981
d< /-l'/- c:'(/r..
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Myers, Myers, Flower r. ,10hnson
Attorney 0 11 III
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH 01' 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 David L. Musselman and Donald C. MUSSELMAN
who, being duly sworn
, do
depose and say that as Executors
Ru th Musselman
deceased
of the last Will and Testament of
thpy
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 In ~it~nces.
1lIOnmt\bm' Januarv 12 A.D., 19_8L ,.---- -) fXAJ
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DECREE
Be it remembered that 00 the
13th day of
Januarv
,A,D.,19~, there was probated and
recorded the last Will and Testament of
Ruth Nusse1man
late of
Lemoyne
, Cumberland County. Pennsylvania,
(2,
Donald C.
j':usselman
....) 'J
-) ',L..(..-c.J./
/ Register' -'
Deceased. Letters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
David L. Musselman &
.... "
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REV.455 (1.801
COMMONWEALTH OF PENNSVLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STAHMEr)'; OF DEBTS
AND DEDUCTIONS
. ~ - ""..- ..------...- - --.
- ..-_.. .....-...---.---..
Estate of RUTH MUSSELMAN Dale of Death November 20, 1980 File No. 21-81-26
WHEN CLAIMING THE FAMIL Y EXEMPTION, COMPLETE THE FOLLOWING:
Claimant
Relationship to Decedent
Claimant's Address
ITEM
NO.
DATE
NAME OF PA YE E
REMARKS
AMOUNT
1
2
1/13/8 Register of Wills
Musselman Funeral Home
Letters & Short Certificates
. Mill s
Mrs. Betty Barber
Funeral Ex enses
Decedent's Account
Deceden 's Ac ount
Nursing Services - Decedent's
Account
34.50
310.00
377.58
6
7
8
9
10
Outstanding check - Cash
Tax Collector
1980 Tax
Service char e - decedent's checkin
Pa. Dept. of Revenue Decedent's
account
1980 income tax - Es
20.00
11.00
2.00
98.00
4.00
Vital Statistics
Death Certificates - Christ &
Lan ~s Musse man
Internal Revenue Services 1980 taxes accrued
Re ister of Wills Fi1in INventor, Debts &
Deductions & RCC Forms
50.00
9.00
13
David L. & Donald C.
us
Executors Commission
653.61
14
Myers, Myers, Flower & Jo nson
W~
Internal Revenue Service
653.61
ecur~ y
361. 60
100.00
Reserve for fi1in Account & c10sin
costs
TOTAL THIS PAGE 5 , 209 .90
I hereby certify that to the best of my knowledge and belief the fore oing is a just and true statement of debts, funeral
expenses and expenses of administration submitted to thQ.Wjta as c ions for her~ Tax purposes.
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SIGNATURE F ATTORNEY/FIDUCIARY DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S !ra rJ c/' f ()
AT
~
PERCENT,
~~)
c1-27-rl
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred hI' the decedent prior to his/her death arc deductible a(Jainst his/her taxable estate.
In addition to debts incurred by the decedent or estate, other items are claimahle includin(J the cost 01 administration,
attorney fees, fiduciary fees, funeral and burial expenses includin(J 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 10 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 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 01 the same household as the decedent.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the famill' 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.
5. Provide a briel 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,
REV-44Q 11-110)
. COMMONWEA~ TH OF PENNSY~V^NIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
AFFIDAVIT OF
FIDUCIARY
(Instruction. on Reverse Sid.)
j:"
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Estate of
Last Address
RUTH MUSSELMAN
Date of Death
November 20, 1980
Social Security No. 1Bl-32-4501
322 Hummel Avenue
Lemovne
(CITYI
PA
17043
tZ.:PI
Bureeu File No,
{!nATEI
Caun ty FiI e No.
21-81-26
1. Decedent died:
( ) Intestate (without a will)
(x) Testate (leaving a last will--copy attached)
2. Is the filing of a Federal Estate Tax Return required for this estate? Yes_ No x
3, ( x) Executor/Executrix
) Administrator/ Administratrix
Name David L. MusselIran & D:ma1d C. Musselnan
Address
324 Hummel Avenue
Lemoyne,
(CITY)
PA
17043
(ZIPl
(STATE)
4, All correspondence should be mailed to (x
Attorney
) Fiduciary,
5. If on attorney is representing the estate, indicate:
Nome Myers, Myers, Flower & Johnson
Address 301 Market St., P.O. Box 125
Lemoyne
(CITY)
Pa.
(STATE)
17043
(ZIP)
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List all safe deposit boxes registered in the decedent's individual name!,o! jointly with, or as an agent or deputy
of another, or in decedent's individual name with right of access by anot er as ogent er deputy. Include the name
and address of the bank or other institution where the safe deposit box is locoted, the name :s) in whic~ the box
is registered and the relationship of the joint holders to the decedent.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH D~CEDENT MAINTAINED A SAFE OEPOSIT BOX
NAME OR NAMES IN WHicH
SAFE OEPOSIT BOX IS REGISTERED
CCNB Bank, N.A.
Decedent, David L.
an Donald C.
~lusse1man
Third & Hummel, Lemoyne, Pa.
-
RE~ATIONSHIP or JOINT
HO~DERS TO DECEOENT
SOliS
Under penalties of perjury, I declare that I hove examined this return, including accompanying schedules and
statements, ~h~Z':~ and belief it is true, correct and complete.
...1J7;?ILU~-1 , ~ .Pff>/h ~
s~gnatw:e ot t'l.Cluc~ary SIGNATURE OF FIDUCIARY -
,
~ .19, Itfn.
DATE
PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance "nu Estate Tax Act of 1961 provides tlwtthe following persons shall prepare and file
a return:
a. The personal representative of :he estate of the uecedent as to property of the decedent admini5tered by him
and such additional properly which is or llIay be subject to Inheritance Tax of which he/she sl1all have or
acqui re I~nowl edge;
b. The transferee of prooerty upon the transfer of which Inllerilance Tax is or may be imposed by the 1961 Statute,
including a trustee of property transferred in trust, provided that no sepamle relurn need be made by the transferee
of property included in the return of a personal representative,
2. PLACE FOR FILING
Tbe return is to be filed in duplicate wIth the Register of Wills of the county wllCrein the decedent resided.
3. TIME FOR FILING
The return is due nine months after the decedent's death, unless an extension for filing has been applied for and
granted by the Secretary of Revenue within the nine-month period,
4. FAILURE. TO FILE RETURN
Section 791 of the 1961 Statute provides that". , .any person who willfully fails to file a return or other report
required of hint. ,shall be personally liable. , .to a penalty of 25% of the tax ultimately found to be due or $1,000
whichever is the tesser to be recovered by the Department 01 Revenue"s debts of like amount are recoverable by
law."
5. TAX RATES
Inheritance Tax is payable althe rate of 6% on transfers to lineal descendants, such as tather, mother, husband, wife,
son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others.
6, PAYMENT OF TAX
Tile tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death, Interest
at the rate of 6% per annum accrues thereafter until payment is made, All payments received are first applied to any
interest which may be due with any remainder applied to 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 nwde payable to the Register of Wills of the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7. FAILUR: TO PAY
The taxes imposed, together with any interest therc'On, are a lien upon real property, 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 in the decedent's
estate or against any property belonging to a transferee liable for the tax.
8. FILlNGOF FALSE RETURN
Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the
1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
\ REV.'HIO It-sOl
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" An
REAL PROPERTY
(Instructions on Reverse Side)
ESTATE OF
RUTH MUSSELMAN
--+-------_."~....__.._,-----
I
I ITEM ESTIMATED DEPARTMENT
NO, DESCRIPTION MARKET VALUATION
VALUE (OFFICIAL USE
ONLY)
I
NONE
.
,
--:-
TOTAL THIS PAGE NONE . . ~
,
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any trnnsfer of any material part of his estate wilhout receiving
valuable and adeQuate consideration? (Answer "Yes" or "No".) Yes .
2. Did decedent, within two years of death, transfer property from himsel fI hersel f to himsel f/hersel f 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 Ihe transfers are claimed 10 be nontaxable, provide the following
information:
a. Age of decedent at time of transfer.
b. Copy of death certi fi cate. .
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 properly 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".) Yes
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 dispositior.? (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".) -
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Yes" or "No".)
6. If the answer to five b. above 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".)
B. Did decedent, at any time, transfer property, the bflleficial 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 "Ves" or "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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File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-8J=.OOa6
REV-0184 EX+ t~eOI
Dote of Death
11-20-80
IiiiJ Original
o Supplemental
o Remainder
Estate Nome ____ Ruth_t1us_se;ll!l.,!n_.
Social Security Number 181-32-450.1
REPORT OF INHERITANCE TAX APPRAISER
I, ths undersigned duly appeinted Inheritence lex Approiser In end fer the Ceunty of Cumberland
Pennsylvania, do respectfully report that I heve oppraised the reel ond personal property os roperted In the loregelng
retum at the values set forth opposite each item in the 105. column to the right in Schedules "A", IIB", "C", and "E"
Dated:
March 18, 1981
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INHERITANCE TAX APPRAISER
ADJUSTMEMTS REMAIMDER APPRAISEMEMT CODE
INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE OMLY)
Real Property (Schedule A) I aa+ 92+
Penonal Property (Schedule B) 13 072 31 la+
Jolnt.Held Property (Schedule E) 7 726 21 21>+
Transfer. (Schedule C) 36 12 2 3a+
TOT AL GROSS ASSETS __.....2~S2.?_._ 44
Leu D.bts a,nd Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life Estate RATE FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER OML Y
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6%
Tax on $
15%
Tax on $
Tax on $
Tax on $
Exomptlons
Total Estate
TOTAl. TAX
IMTEREST FROM
BALAMCE
TO
$
$
$
Less Cl"odlts
DA TE OF PAYMEMT
AMOUMT PAID
OISCOUMT
INTEREST
TAX CREOIT
$
+ $
$
=
I
=
BALANCE $
TO
REV.SI8 FO 17,801
~~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
David L. Musselman
324 Hummel Avenue
Lemoyne, PA 17043
Donald C. Musselman
324 Hummel Avenue
Lemoyne, PA 17043
RE: Estate of
County of
File No.
Ruth Musselman
Cumberland
21-81-0026
Dear
You are hereby notified that the original
appraisement in the estate of Ruth Musselman
has been filed in the office af the Register af Wills af Cllmb""lend
County on March 18 , 19.at. Said appraisement reflects the following valuatians:
I
1
I
I
Real Estate
Personal Property
Jointly Owned
Transfers
Total
none
13,072.31
7,7?h ?1
36,12Q,q2
S6,Q28,44
As to such tax that is paid within three months from date of death, a five (5%) percent
disceunt is allowable. As to any tax that remains unpaid after nine (9) manths (fifteen months
when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve menths 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 wha is aggrieved by this notice may object thereto within sixty days
after receipt af said nelice as provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373,
Date
March 18, 1981
.J//M/J /'11'/,,;4),,1)
Signed
Ti tl e Chief Appraiser
NOTE: This is not a bill.
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REV"SI7 (8"78)
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF FIELO OPERATIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
DATE .;_~\:.: CL__.J...i.:!l_
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made lor crosent to the tronsler of the lollowing securities of a Pennsylvonio
Corporation or 0 Notional Bonking Associotion locoted in Pennsylvania:
(a) -125 (b) Dauphin Jc')o:,it 'l'ru,;t CO;c,')<ln'!"________________(c)._s:;ry1lr','')ll.____._
(NOTE: In describing securities enter in (a), ab Ole, either Ihe number 01 shares of stock or the face amount 01
registered bonds, in (b), the nome 01 the issuing company and in (c) the class of stock or the stated interest rate
and maturity date 01 registered bonds.)
ISSUED ON various c:ates ,and having a TOTAL MARKET VALUE OF s_J-~.Ll~.n__.OO..__
(DOlo)
as 01 the date of death of the decedent, PU~'I! !,lm;s;:L:V\i'____, on~Q_v,~mba)'" 2~, 19nO
(Nome of Decedent) (Date 01 death)
who was late 01
322 llumJ11e1 Ave.
(Street and Number)
I..0r:IOVn(~
(Post OHict>)
__~_ __rJ~!I~\~~G; r1 n l1_d
(County)
(State)
~,
"1\
The securities are registered os lollows:
j"' 11 ti 1 ..}1:!~~~~~1 L~"}~:__ _._~_~__.___ ,.. _.____~____
(Name or namos ;n which certificates ore registered)
~m~JRkTlOR~
EXECUTOR II: )
David L. :~uris~~lman f..
Donald C.. ~.'aRE'I~lJ~i:1n
(Name)
32'1 'rm"D€..1___lVQ_,__!_"LcmOYJ::lC J"l..". 17041
(Addrcs~)
NAME OF APPLICANT ...L:"'__,;:L_':':i!':':,,",_...El.Q\'l8X...,,c, ,Tofll',;iQIl
COUNTY FILE NUMBER '~1 -p 1 -')( ADDRESS OF APPLlCANT..LD.__.3c:,__~2:"~_~C'.GTI:;' Pri
BUREAU FILE NUMBER SIGNA TURE OF APPLICANT _~f1t-... L1
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APP'Lf~^'FlON,Ij; Wjl[~r~E
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ',^) ;1
DA TE_U1fu1
I hereby consent to the transfer of the above securities now registered in the name of the oloresbid
(%1
Decedent and waive the liling 01 a certilicate certifying to the payment of the transler inherita"ce tox to which
the property 01 said Decedent is made subject pursuant to the provisions of the Act of June 20, 1919, P.L, 521,
as amended and the Act 01 June 15, 1961, P,L. 373, as amended, This is ,dso in accoldance with the provisions
01 the Act 01 April 9, 1929, P,L. 343.
This Consent to Transler the herein described property opercles only in relerence to the estate 01 the
above-named Decedent,
,Signed fOI the S~c~et'IY of Revenu:
By ..lllCM),t C eiJe -L~~) "Tll) <4J$
) . 0 ' (Ignntu"l"') ,,',
-v . .)1 \ \ I
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(0 1 fU,lJ\Ff :-: ':..\ I U!' \ i)',
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OF J\ r.;F',.lllLr: 1 III ( I (~; tll
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A,'"lONWEAL Hi or PE~i~I~,YL V,',"-.I'f,
DEPARTMENl OF REVr.f',U[
l(AlJ OF COllNH COLl,EC11l)"~
[, :,1 [' i,ld Y 2 (), 1981
APPLICATION (MUST BE FILED IN TRlf'llCilIT\
TO THE PENNSYLVANIA DEPARTMEtH OF I<EVErHI[
Application is hcreby TllC1d..... kr Clnc.,.n! lr:' 1'1\1' 1I111\"i(', ni 1Ill'
:orporolion or 0 National Bunking ^~,::.O(ii)tion IllCt1tl'\~ HI PL'I\I\,,)'~V'lnl!l:
I IiI" ,', Ill'" ',.:1 "Id"''', d (l P("ln:;yl'l(]tlill
:o)_~?.l._ .._.__.jbl.. Di1uphin Dl~'posit 'l't-u"L L'ompCtny
'NOTE: In describing 5ecurific~, enter in (C!), nh :"'1.', 1'11~1(': ~\," 1\':" \q; ,I ,,',
~C'gistcr(.'d bonds, in (b), thl' nllrn!' of lhe i:,,>uilllJ (,Yl :j~:"'1 \':1 : ;1\ ,"'If' ~ ill',',
,nd maturity dote of registered bonds,)
i(\ l:olll1110n
:r!" i ",!(! ~ \.1 t1\l' In(i' (H1WUllt of
,II '.l()\ ~ "~I ,hI' ~~l<_.tj>(i i:d{,lc.<;f [(It..!
ISSUED ON :::,~_J:_i.~LlS--.
.. I ond (llni/!\l l Tel'! :',:- ".\;:
I \':,1 ,':~ ",1 .' 12 '-750. (1)
(Dolr)
(lS of the dote of death of Ihe dcc,".'. "I,.
HUl.ll ;,h.l;_;:3l~ 1Td!!
:'lrY..'(>lillh_-,r 20, 1980
d, "; d",'l'"
" ' 'I
who was late of,,3._.2.2,._I-Iummcl A\"':lll", I~'-',"!)"."""'" ,," ,1', 'I J' 1
. . .. ,-,' . ,)\, ,t j<.. f '1 ':: !l:;'~' va !l,i. d
;S':l")
(Slt('t.'l nlld t~ Ui" i,,-,,:
The securities are registered os 10110"':;:
:ZuLh !'lu;:;:~;'.:.' l::k\11
"f"')'
,'i,ll"
.. ., c'
:Aoo.lm.'S:tR)tW~ David L. ~i\J:J~l~lman ;1:)(1 uondld C. ~':u:-;~j,_~lf".an, 324 Hum::h.;l.i\vcnuc,
EXECUTOR ).......... \",,""', " ",. L,-,moync, 1'11, 17043
., \ "I':: 11'--: ','.,""'1 'f " 1'1 -.. ~ 11
\'IJ ,,' _,( ,,' I:.:.. n", "ycrs ,j'IYl~ls, ;' owur ~~ .Johnson
Attornovs f6r I~statc
COUNTY FILE NUMBER__V-:.S1-26. ADOld:',S Oi- ,\IJi'LI(',\111 l'. '0. l30x 125
'mayne, l'cnn~va~ia_17043
BUREAU FILE NUMBER ____nu- _ .._ SICtl,\TUf\E or ,\!'f'LlCAti W. <., "t> .~~
NOTICE: IF YOU FAIL TO PROPERLY FILL IN M1Y I'OhTlON OF IIlIS ,PPL'CATION, IT V!ILL NOI BE
CONSIDERED COMPLETE AND WILL HE RETlIRNEO 10 YOU FUl< COMPLETION,
--..-------.-.-.--.---.
COMMONWEAL HI OF PEriNSYL 'I t.I'~l,\ DlY /-.R 1','DH
CONSENT TO TlWiSH'!' SccClIi(!llb
OF !':F.YEJilJE ~
Dt:rE . ~
III lLc 11(1111(' of tIle (l,Qf' {lid
/ftf/
.._._.._____._______.__...____.___.m.
I hereby consent to thl~ lrnnder of tht':' nb:)l/c >;('(H\i\\(~ -, fll)" rl'o;,,\('!(:d
~lil !,,:n ,f", ':1;1"(111111((.' \0). lo,'lhich
Decedent end waive the filinfJ 01 (J ccrtrf;r~llc u'r!lIYI'\: I:) Ii;,' '1,:y::"-'
the property of said Decedent i:-, r:1(:dc ~:,u\::('ct P"q:.,II\:r11 !c,!':.. ','.1'
\:\ i'I-1 (,j J:iI\ ~"n, 1';19, P,L. 5~1,
os ClInended and the Act of June 15, r:,' 1, i'.L., ~.;:'~, 1"-
II: .
I ;"", ' ,II ~ : I". , : () 'J\ '-,1 () n 'S
of the Act 01 April 9,1929, P,l., :'U,
~" ,;( tlF:
This Cc':',!~l~nl 10 Tr\~(\'.r r I,
L~bovc.non~c~i Drcedcnl.
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PENNSYLVANIA INHERITANCE TAX GENEHA,h.lliIQfIMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 pruvidw; lhilllhe [allowiop. p",:,1IIS sllilll prepare and file
a return:
a, The personal representative of the estate of the decedent as 10 properly of Ihe dp-cedent <ldministered by him
and such additional property which is or Inay be subject 10 lnherililllcll Tax 01 which he/Sin) sllallllave or
acqui re knowledge;
b. The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Slatute,
including a trustee of property transferred in trust, provided Ilia! no separale retllm need be made by the transferee
of property included in the return of a personal representative.
2, PLACE FOR FlUNG
The return is to be filed in duplicate with the Register of Wills of the county wherein tile decedent resided.
3. TIME FOR FILING
The return is due nine monlhs after the decedent's death, unless an exlension for filing has been applied for and
granted by the Secretary of Revenue witllinthe nine-month period,
4. FAILURE TO FILE RETURN
Section 791 of tbe 1961 Statute provides that" . . .any person wllo willfully fails to file a return or other report
required of him, . ,shall be personally liable. . .to a penalty of 25% of the lax 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
Inheritance Tax is payable at the rate of 6% on transfers to lineal descendanls, such as fatber, mother, husband, wife,
son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others.
6, PAYMENT OF TAX
The tax asse~sed on the transfer of property reported in the return is due 9 1110nlhs after the decedent's death, Interest
at the rate of 6% per annum accrues thereafter unti I payment is made. All payments recei ved are fi rst appli ed to any
interest which may be due with any remainder applied to 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 wherein the decedent resided and are
received subject to the final determination of the Departmellt of Revenue,
7. FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest have beell 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 li;1ble fOlthe tax,
8. FILING OF FALSE RETURN
Any person who willfully makes a false return or report required of him sh;111, ill accordance with Section 793 of the
1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentellced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding aile year or both,
QUESTIONS CONCERNING PROPERTY TRANSFERS
,
1. Did decedent, within two years of death, make any transfer of any material pmt of his estate without receiving
valuable and adequate consideration? (Answer "Yes" or "No".)
2. Did decedent, within two years of death, trausfer 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:
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 non taxabi lity or 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",) ~J"
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",) 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" ,) -Uo-
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. above 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 bmeficial 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",) No
l;
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File Number
Estate Name
Date of Death
Social Securi ty Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
o Original
Q Supplemental
o Remainder
21-81-0026
Ruth Musselman
November 20, 1980
181-32-4501
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly eppointed Inheritonce Tox Approlser in ond lor the County ef Cumberland
Pennsylvania, do ..spectfully repert thot I heve opprelsed the reel end personel property as reported in the foregoing
return at the values let forth opposite each item in the last column to the right in Schedules HA", ItB", "C", and "E"
Doted:
April 20, 1981
INVENTORY
Real Property (Schedule A)
Personal Property (Schedul. B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
TOTAL GROSS ASSETS
Less D.bts and Deductions
(SCH EDULE F)
CLEAR VALUE DF ESTATE
o Life Estate
o Annuity
FOR USE OF REGISTER ONLY
Tax on $
-Tax on S
Tax on $
Tax on $
Tax on $
Exemptions
Totol Estate
Less Crodlts
DATE OF PAYMENT
" I
_,(/il'f /,) ) yf/l1i!,1.,,! /
INHERITANCE TAX APPRAISER
CODE ADJUSTMENTS
VALUE AS APPRAISED (HARRISBURG USE ONLY)
$ None 00+
None 10+
None 20+
9 600 00 30+
____.-2~j500 00
40-
REMAINDER APPRAISEMENT CDDE
92+
93-
ME
FACTOR
PRINCIPLE
VALUE
CODE
CODE
COMPUTATION OF TAX
$
$
$
$
6%
15%
$
TOTAL TAX
INTEREST FROM
BALANCE
$
$
$
TO
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
S
+ S
$
=
$
+
=
INTEREST FROM
BALANCE
TO
S
$
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Inventory of the reo I and personal .stete of
RUTH MUSSELMAN
__._____deceased,
l. 425 shares - Dauphin Deposit Trust
Company Common Stock @ $30.00 p/sh. 12,750 00
2. 1 - Series E Bond - $50.00
da ted - May 1945 154 10
3. 1 - Series E Bond - $25.00
dated - April 1942 84 50
4 . 1 - Series E Bond - $25.00
dated - September 1942 83 71
TOTAL
13,072 31
II
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
..__~ay ~(L k,_.,I1!!i?!?~).man ancl. Qona1d C . MllsseJ.malL-..--.-----.---- ....
being duly _._~~!l-_- ",,_ _ ,,__ according to law, deposes and says that t hey..,___.ar.e ...---.... ... .."...,,-
___....!'l-~.~cut:9.r_s " .' of the Estate of __RUTILMUSSJ?I,.l\AN ----...,-----
late of Borough of Lemoyne _.---, Cumberland County, Po" deceased and that tho
within is an inventory made by . .):.hem_ ....__.__.... ..- -.... ..-, the said_Exec.utO.r.s_.-
of the entire estate of said decedent, consisting of "II the personal property and roal estate, except real estate outside
the Commonwealth of Pennsylvania, and that the ligures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
sworn to
_ and subscribed before me,
\ ..~_ rY{".. .I.I-'A."
.~\
Dav~d L. Kusselman
hn,...A ~ dlu,.J Pf.~ Jol '''' ( -
-"1lonarcr<::. Musse man -
f.. 2 '^-'-"--'~"'^CS ' <1 19 1: I
Cl . ,~.
. -.~' N~TARY PU~""--'- 'tS
My Commi.sloo E:rplre, Deo. 21,1981
LemoyDe. Pc.. Cumberland Count;
--
Addr."
Date of Death -
20th
November
1980
Day
Month
Year
I, An inventory must be filed within three months alter appointment of personal representative.
2, A supplement inventory must be filed within thirty days of discovery of additional assets.
3. .. Additional she~t.s may be attached as to personalty or realty
;'" .- ,::'~.
4, ~~.e Arttc!eIV, EiBuciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
COUNTY FILE NO:
~ /.
/"/ ',' (
DATE
/; / ; " .'J', / (IP j
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ESTATE
COUNTY
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FILE NO,
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DATE OF DEATH .,~,:',
',' .'
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C- ~ ,/ I
Appraised Value of Estate:
Real Estate
s
Personal PropertY
+ - -"--
.-----
Jointly Held PropertylTransfers
+ <-1.5 'cA c....,
,; ,
s ,j , / .I.,,/!
I <J
,
Total Gross Estate
Total Approved Deductions
Clear Value of Estate
S J
/,
/
,~__./i ,~''-:.'J
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$ i_1' ". /' ......./J .,("....1
Amount Taxable @ 6% Rate
S
it;
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tax due
S
(J" '1(,>
,
/;.../)
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
S ,1.,- /j /;. /,.-)
_ .I i"" ~
* '" * .. * .. A five percent discount totaling $
wlll be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
S
+
$
$
=
$
+
=
+
=
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
S
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Assessed by: / /
S~e Informlltlon on Revers.e Sidft Ag nl or,th~com
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