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Home My WebLink About81-00043 -. (. " (.Y L.: C <,) L' E' V>(-~ c: . I"; ~,. ,.~ l. .' ~~i' c 0-. 6..:" ~ h.lL:.i :z ~~ 01- "': I::>W ",,,, 'w 0<:; .~- .-.<.. Uu.; r,,::> ~'" ~ ~u 50 u 3S-r:~. .-.....---. t 'w r.. ~o . . - n cd "'~ co - r')r'1 "'n c:'" G">o :J:~ =- v;:xJ rn , "" ..,0 ~o '"" tTIM r-~ - :09 "."0 ~::: '0 ;;:l~ :jt~ ,,1:._ ?El :::n '~,"J{3 ~:rt' ,.' (', ,::;, c .~ ~;~ '-'1 ~ < y u ::?l r.l Q p ~ c ~ ~ ~,t 0 III ~ q ~ ~ ~ 5 V] .( ;j ... III = z :r: < ... 0 Z , )< ~ - ~ ~ W . II: . Z f-- ~ ~ 11l n: tII t4 CI'l I<l 0 . ~ _ ~ n" ~ ~(PU .. . " ..,. " ...;, ':;j 0 U L:.... e: ~r,~~; <..:.... G::.'" Zr. l..L. ~l 0.. <==: c: ., :t:..-: - "-...J 0:'::. :z c:.::::c:: Lt.l'W Ow ~t:; ~ 'e:> ::<:-. . .... c", f5::) <'>w w", ~ ...J<'> a: p:l <..l COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLV.ANIA ORPHANS' COURT DIVISION No. 21-81-43 Estate of MAUDE McGANS, Deceased Lste of South Middleton Township FIRST AND FINAL ACCOUNT OF CCNB BANK, N.A., EXEClITOR Date of Death: December 31, 1980 Will No. 21-81-43 Lettera Granted: January 21, 1981 Firat Complete Advertiaement of Grant of Letters: January 21, 1981 Account Stated to June 19, 1981 SUMMARY & INDEX Pa~~ PRINCIPAL Principal Balance Remaining 3 $60,851.02 3 .00 $60,851. 02 4 !.h939.65 $44,911.37 5 2 $44,911.37 Receipts Net on Conversions Adjuated Balance Lesa Disburaements Balance before Distributions Investments INCOME Receipts 6 $-L230.44 $-L,730.44 Balance before Distributions Income Balsnce Remaining 2 $ 1,730.44 COMBINED BALANCE REMAINING $46,641.81 ll,lli'i HJ '-/lu~ I,..,l\...~ PRINCIPAL RECEIPTS Inventory Filed Per Copy of Inventory Attached $60,818.02 5-22-81 Proceeds on cancellation of Aid Homeownera policy IIHO 12703 33.00 TOTAL PRINCIPAL RECEIPTS $60,851.02 PRINCIPAL CONVERSIONS INTO CASH Gain Loss 2-3-81 $986 Trust for Short Term U. S. Gov't Sec. Proceeds $ 986.00 Account Value 986.00 3-3-81 $14 Trust for Short Term U. S. Gov't Sec. Proceeds $ 14.00 Account Value 14.00 3-26-81 $1,776 Trust for Short Term U. S. Gov't Sec. Proceeds $ 1,176.00 Account Value l.,776.00 4-2-81 Proceeds on sale of property in South Middleton Township, along Frost Rd. Proceeds $33,600.00 Inventoried at 33,600.00 4-14-81 $129 Trust for Short Term U. S. Gov't Sec. Proceeds $ 129.00 Account Value 129.00 4-16-81 $13 Trust for Short Term U. S. Gov' t Sec. Proceeds $ 13.00 Account Value 13.00 TOTAL .00 .00 Net Trsnaferred to Sunnnary .00 .00 -3- ll,'l..:"l "J' .' v. (HvL , U.JJ... 1-26-81 1-26-81 1-26-81 1-26-81 1-27-81 1-27-81 1-27-81 2-3-81 2-3-81 2-13-81 2-23-81 2-23-81 2-23-81 3-3-81 3-6-81 3-18-81 3-20-81 3-24-81 3-24-81 3-24-81 3-24-81 3-24-81 3-24-81 3-24-81 3-26-81 3-26-81 4-2-81 4-14-81 4-16-81 4-24-81 5-11-81 PRINCIPAL DISBURSEMENTS Ferman G. McCans - Reimbursement for refreshments after funeral Irwin, Irwin &Irwin - Reimbursement for probate costs Carlisle Radiology Assoc. P.C. - Professional servi ces Donald Slaybaugh - Reimbursement for coal & welding Met-Ed Co. - Electric service to 1-9-81 Carlisle Hospital - Professional services to 12-31-80 Kenneth R. Guistwite M.D. - Professional services Carlisle Hospital - Professional" services on 12-1-80 Joseph W. Gibson Funeral Home - Funeral services Carlisle Hospital - Professional ser~es on 11-26-80 Irwin, Irwin & Irwin - Reimbursement for legal advertising Met-Ed Co. - Electric service to 2-9-81 Ferman G. McCans - Reimbursement for trash removal on 2-18-81 Steven W. Barrett - Real Estate appraiaal fee for property at R.D. #1, Gardners Carlisle Hospital - Profesaional services on 11-6-80 George L. Ebener & Assoc. - Appraissl fee for property at R.D. #1, Gardners Met-Ed Co. - Electric service to 3-11-81 Expenses on sale of personal property R. C. Kramer - Reimbursement for 1 short certificate R. M. Lane - Reimbursement for expenses concerning public sale Donald E. Slaybaugh - Reimbursement for miscellaneous expenses & preparing for sale Faye L. Slaybaugh - Reimbursement for preparing for sale Ferman G. McCans - Reimbursement for preparing for ssle Pauline McCans - Reimbursement for preparing for sale Register of Wills - Pa. Inheritance tax less 5% abatement Donald E. Slaybaugh - Reimbursment for welding furnace Expenses incurred in sale of property along Frost Rd. Clair Slaybaugh, Auctioneer - Reimbursement for advertising sale Met-Ed Co. - Electric service to 4-3-81 Betty J. Williams, Tax Collector - 1981 South Middleton Township Real Estate Tax for property at Frost Rd. Belvedere Medical Corp. - Professional services to 12-31-80 Irwin, Irwin & Irwin - Attorney's Fee CCNB Bank, N.A. - Executor's Fee Reserve for filing cost., mailing notices, etc. TOTAL PRINCIPAL DISBURSEMENTS -4- l';IL;\ ~;:, u\J f/lv!. u';""'; $ 33.18 40.00 149.00 199.00 26.46 182.20 645.00 20.00 1,878.00 32.00 36.00 23.38 30.00 150.00 4.40 75.00 22.33 1,409.00 1.00 31. 20 555.72 297.50 495.00 297.50 2,470.00 5.00 220.07 128.42 13.79 58.50 11.00 3,050.00 3,050.00 300.00 $15,939.65 PRINCIPAL INVESTMENTS ~-= -- 1-26-81 $13,000 Trust for Short Term U. S. GOy't Sec. $]3,000.00 3-24-81 9,200 Trust for Short Term U. S. GOylt Sec. 9,200.00 4-3-81 30,000 Trust for Short Term U. S. Gov't Sec. 30,000.00 -5- l',,;i ~ J 1',iCe wi.- " IN RE: ESTATE OF MAUDE A. r~cCANS IN 'rilE COllH'1' OP' cor~MON PLEAS or,' CUMBERLAND COUNTY, PENNSYLVANIA PENNSYLVANIA ORPIIAN' S COUR'I' DIVISION 1'10. 21-81-113 DECREE OF DISTRIBUTION AND NOW, this AWARDING REAL ESTATE h, ""'Ppt ,~ day of September, 1981, at.;l J}O' O,,;hOCk, M., (E.D.S.T.), pursuant to the Statement of Proposed Distribution in the Estate of Maude A. McCans, approved by the Court on August 25th, 1981, an undivided one-third interest in the following real estate is hereby awarded, in conformity with the provisions of the Last \>lill and Testament of Maude A, r1cCans to Ferman G. McCans, of 127 West Broad Street, Hatfield, Pennsylvania and Faye L. Slaybaugh, of R. D. '1, Gardners, Pennsylvania: ALL that certain tract of land situate in South Middleton Township, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a stake on the South side of a public road known as the "Old Town Road"; thence by land of John Henry Kuntz, South 19 degrees East one hundred and thirty-seven and seven-tenths (137.7) perches to a stake; thence by land of S. Klein, North seventy-four and three-fourth (7~ 3/~) degrees East :51x and six tenth (6.6) per~hes to a BOOK 108 FACE !j69 stake; thence by land or Mary n. Zeigler, North 19 degrees West one hundred and thlr.ty-nine and four-tenths (139.Q) perches to H stake; thence by said public road, South 48 1/2 degrees West seven and two-tenths (7.2) perches to the Place of BEGINNING; CONTAINING five (5) acres and one hundred twelve and one-half (112 1/2) perches strict measure. BEING the same tract of land conveyed to John J. McCans of the Township of South Middleton, County of Cumberland, Pennsylvania, by deed of Mary n. Zeigler, John Shollenberger and George M. Myers, Heirs under the Will of Annie M. Fickel, dated September 24, 1936 and recorded in the Office of the Recorder of Deeds of Cumberland County, Pennsyl vania, in Deed Book "U", Volume II, Page 310. The said John J. McCans died intestate August 10, 1965, survived by his widow, Maude A. McCans, who inherited an undivided one-third interest, and two children, Ferman G. McCans and 11aye L, Slaybaugh, who inherited an undivided two-thirds interest. Maude n. McCans died testate December 31, 1980 s urvi ved by her two chi1dr'en, Ferman G, r1cCans and Faye L. Slaybaugh, being said devisees under the Last Will and Testament of Maude A. McCans, who now _2.o0OK 108 PACE 570 , , ! , ---- - -- --.---.---.--- -- -- - ----- ---_._--_._-- ---- I ..._.... =-__,.... __......... """"" ~_ ___ :r::::o: ___."".. ~~..' -._ ____...~' .W REV.116ZEX . ~I COMMONWEALTH OF PENNSYLVANIA 4 NO DEPARTMENT OF REVENUE , .K000574 OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX I ~ III ., II = jJ TAX AT 6% TAX AT 15% RECEIVED CCNB Bank N. A. FROM TAXAT_% ~ ADDRESS 331 Bridge Street ESTATETAX New Cumber111nd, pa. 17070 TOTAL TAX CREDIT 2.600.00 '--ESTATEWFORMAT~N~-------------------------- DATE OF DEATH Dec. 31 1980 FILE NUMBER 21-81-43 :OUNTY MAUDE McCANNS Cumberland m m LESS DISCOUNT PLUS % INTEREST IFROM TO_I 130.00 DATEOFPAYMENT March 27, 1981 NAME OF DF.CEDENT TOTAL AMOUNT PAID 2,470.00 '>OSTMARK DATE ..EMARKS "PAID ON ACCOUNT" SEAL RECEIVED BY /"'/1/ I ;" ' (, I . j , ,;( / _ /1.'/ / ,-(_..2../ ... ,! SlGNAIUR,E I.i ,.,ar;y c:. Le,W S 'I Register of wills ~ I flEGISTEfl OF WILLS Inventory of the real and personal estate 0/ Maude McCans deceased REAL ESTATE Property located in South Middleton TWp., Cumberland County, fronts approximately 533 ft. along Prost Road and extends in depth a distance of 140 ft. and contains 1 acre, 135 perches. It is recorded in the Office of the Recorder of Deeds for Cumberland County in Deed Book "A" Vol. 20, page 16. Sold for Tract of Mountain land located in South Middleton Township, Cumberland County, Pa., East of Route 94 and Fronts approximately 123' on the North Side of T-535 and contains 5 acres, 112 1/2 perches. Recorded March 9, 1939 in Deed Book Y, Volumn 11, page 25B in name of John McCans, deceased spouse of Testator and their two children. (Appraisal Attached 1/3 interest.) PERSONAL PROPERTY CCNB Bank C/D #FM26796, issued 10/6/BO due 4/6/81 @ 11. 968% Accrued interest on above to 12/31/BO CCNB Bank, Balance checking account #754-9504-4 Cash found in home Medicare Benefits National Casualty Co., Hospital Benefits .P~oceeas s21e personal property National Premium and Benefit Admini.stration Co., Premium refund. ".') . i~llJ 1,;"0,1408,0 .; ,.'~ 1;'1\',;130' ,"ci3 " IJ J .~." \il- t.o (- ;1\11' l8. . ,SID3tl , .' ""C,30B083ll ,.) ..\.':.....- 33,600 00 2,333 00 13,000 00 lOB 05 2,076 25 3 3B 520 00 371 43 B,761 95 43 96 60,B1B 02 i I , i I I I ) , I I I COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss: R. C. Kramer, Asst. Vice President and Trust Officer, CCNB Bank, N.A. ------.---- .----.-- ----,._.. ------- sworn boing duly according to law, doposos and says that tho Y. Executors of tho Estato of Maude McCans lato of _.E>5?Il~l:1i'!iddJ:~ ton .':['~\\Ins~_ie,__ , Cumborland County, Pa., docoasod and that tho 'th" . t d b CCNB Bank, N.A. th 'd Executors WI In II an Invon ory ma 0 y '1 e sal of tho ontiro ostato of said docodent, consisting of all tho porsonal prop.rty and roal ostate, excopt roal estato outsido tho Commonwealth of Pennsylvania, and that the figuros opposito oach item of the Invontory reprosont it's fair valuo as of tho dote of docedent's doath, , \c"n",-^-I ~C_CN8' 8A'NK;N:~ and subscribed before me, BY~>>4-.L_" As,J!tf"l'itt'e. ?rIJ!!ni!lrflo\l.1 Off.} '-Ct<.'~iSTti;;;:;':IK;lc"'I" ':'.7' '. ,..t:, .......... 2'101 I,,IG_I. ,,' <"rOo'" \ II. H \l;..', v; '_''';''1 CI;'mf.lll~;;,..~'~;',:1::;. 17Cll ~ /K 19ft( L-fJ. ;;,/1;/, \ <<.: p.~:::. -4 ..., Comberl~n'! ~.. ..Q';IIIJb:.;on E1 .:My:J. t~81 Dote of Death 31, December 1980 Day Year Month INSTRUCTIONS I. An invontory must bo filed within throo months aftor appointmont of personal reprosontative, 2. A supplement inventory must bo filod within thirty deys of discovery of additional assets. 3. Additional shoels may be attachod as to personalty or realty 4. Soo Article IV, Fiduciaries Act of 1949. . ~ " QJ E-t 'tl :l C .,; >- ~ 0 m M ... w .[..l ~ 'OJ< ~ '" ... QJ . w ~ . I l1. ...... U .. .... 0 0 v> Ul 'tl . '" :>- CO w '" w Z 'tl C " .. I I- :I: l1. 6 'M l1. c I- ..J U. ~ ~ .... Z :;: 0 ..J < 0 l1. :l: N W U. < W U > 0 '" :;: .<:: i < z .[..l Z 0 c C :l . .; v> Z 0 0 '" U Z w < UJ ... l1. ." c . - -.: 0 . '" ." .... . E 0 + . ~ 0 . ..J U u: CD _ This sectlon will bo campi oted bv Bureau Headquarters only whon the application for exemption has beon denied. Date: The application for exemption cnnt~illed on the face of this form ho~ been denied bocouse Note: Any party in interest, including the Cammanwealth, aggrieved by Ihis aclion may within sixly (60) days after the dote of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable Pennsylvania Inherilance and Eslale Tax Acts, J !; \' nEv.4t1!j EXI (J.KOl COMMONWEII~TH OF PENNSYLVIINIA OEPAKTMlilllT OF REVENUE TRIINSFER INHERITIINCE TAX RESIOENT OECEOENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS _ _._~",,,,,,,-=._=,,,,,,=,.::_.,",,,"..~."~-'-__1=."":-.- File No. ?1-81=:.4.3 Estate of Maude McCans - Date 01 Denth11L)J/80 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Relat.ionship to Decedent Claimant Claimant's ,L\ddress REMARKS IIMOUNT ITEM NO, OIlTE -9 Jan 26 NIIME OF PAYEE Ferman G c Register of wills carli 1e Services profession 1 rvic Feb 1 &Jr nt- LpgaL Electric is i e : McC"ns OL_working ,,~ and ex enses at Sale _pr~p"ring for ~ WOLkina~t~Se t't1rnac 2 LRe..iJnhllr,,~m~n~ for Weldi TOTAL THIS PAGE I CONTINUED 1 hereby certify that to the best 01 my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate (lS deductions (or Inheritance Tax purposes, Fa 1 Sla bau h i " cD .. 0 -g .... c: ~ o Ol E .... 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Q)'- 0 c:.!: _.c~= ..; -co - '" -.... U ro "", . nEV.45s EX. (J.liOl COMMONWEAI.TH OF PENNSYLVANIA DEPlIRTMI!I'lT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SHEET #2 SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS Estate of Maude McCilns Date of Denth___File No. WHEN Cl.AIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Relationship to Decedent Claimant's Address DATE NAME OF PA YE E REMARKS AMOUNT Clair Sla b tl h Met Ed Co. Recorder 24 Bett Ma 11 A r 14 16 nL. A 11') 'lectrir. 13.79 Irwin Irwin & Irwin CCNB Bank Executors Fee 3,050.00 300.00 Reserve for Filin TOTAL THIS PAGE I 13,585.58 I hereby certify that to the best of my knowledge and belief the~Wi~ANIi"'j,-",~e statement of debts. funeral expenses and expenses of administration submitted to the estaleii~-deaucTIons 1M 11\11lHlnnce Tax purposes, slr~~:n-;~"'"Y Jy~^!Eg,If''', OFFICIAL USE ONLY J DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S / :3,/)",:(I],:T1 AT G PERCENT, !? -,:}d - J/ DATE. GENERAL INHERITANCE TAX INFORMATION ....- .... Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including tile cost of administration, attorney fees, fiduciary fees, funernl and burial expenses inciudlng the cost of a burial lot, tomhstone 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 Wh0 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. The family exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. .. '" 0 C"l > t'"l > :'J z > 0 0 0 CJl " Cl n c: 0 -i Z ::: Z l"" t'1 > 0 0 l"" t'"l ;>; Z '" - Z Z tr. -i t'"l -i Z P $) -i -< CJl t'1 Vi Z 0 CJl 0 -i 0 ." ." ::<:I ~ ~ 0 - "fj 0 "fj - l, Z n , - , > '.: :l- ' .~;, l"" h ~: (. <= ~~ ;.-:': I. '"" ..- . CJl t::' I c_ t'"l C.:>l;' ~ ':::::;i 0 \.l.:~' ' '-."I,..! ,-.1' ~ 1(;) Z 2,t.? '.".- ~ Ot:;l ii:~~ (.)ld 1.1.l:,:) -< -< ~ -'u ~ \1;1'" ~ t'"l t'"l u > > '" '" INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed. indicate the c1aimant'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 brief explanation in the remarks column for each debt claimed, 6. Enter the amount of each debt being claimed, 7, The form must be signed by the person who has assumed the responsibility for paying the debts, 'REV-..8.. EXt (&-80) INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONL Yl File Number __2k8J."OO!13-------.- .-,.------.--.---- .-...-- Date of Death December 31,_ 1980 GJ Originn; o Supplemental o Rcmuinder Estate Name Maud!LtI.,gilM"_____.___..__..______..____... Social Security Number 180-10-4660 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser In and lor tho County 01 _.JlumbArl~nr. Pennsylvania, do respectfully report that I novo appraised the real and personal property os reported in t e orogoing return at the values set forth opposite each item in the last colul11n to the right in Schedules II A" , liB", lie", and liE" Ii I il , ,i, I, ) /. / \, '(' Dated: AultUst 19. 1981 \11/)(, 'i Ii.' Iii ,'()ill i / -./ INHERITANCE TAX APPRAISER INVENTORY VALUE AS APPRAISED ADJUSTMENTS CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE TOTAL GROSS ASSETS $ 00 00+ 02 10+ None 2fH 30+ 60,-818 02 40- 92+ Real Property (Schedule A) Perianal Property (Schedule B) Jolnt.Held Property (Schedule E) Tranlferl (Schedule C) ---.---.-- ---- 93- Leu D.b'l and Deductlonl (SCHEDULE F) CLEAR VALUE OF ESTATE OLlie Estate o Annuity RATE FACTOR -- PRINCIPLE VALUE CODE FOR USE OF REGISTER ONLY Tax on $ Tax on S Tax on $ CODE COMPUTATION OF TAX S S S 5 6'. " 15% Tax an S 5 T ax on $ Exemptlons Total Estate TOTAL TAX INTEREST FROM BALAN CE TO S 5 5 TAX CREDIT 5 (, -.;]- n REV.449 EX... (3.80) COMMONWEA,L TH Of 'f'ENNSYL VAHIA OEPAR.TMENT Of REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEOENT AFFIDAVIT OF FIDUCIARY (Instructions on Rovo"o Sldo) * - Estate of .....kIA\Jde ~tcCa_ns_,_,_ Lost AddressRJ:L_#J-,-J~Q<<:_2"?L_.__. Dote of Dearl, December 31, 1980 Social Security No. 180-10-4660 .J,>..cLJ;"J;l,Itl;!.r~,_J'JL-1}].24 Bureau FileNo. (CITY\ ISTA T!~, (ZIP) County File No. 21-81-43 1. Decedent died: ( ) Intestate (without 0 will) (X) Testate (leaving 0 lost will--copy attached) 2. Is the filing of 0 Federal Estate Tax Return required for this estate? Yes_ No X 3. (X) Executor/Executrix ) Administrator! Administratrix 4. All correspondence should be moiled to ( Attorney ( X) Fiduciary. " 05 ;o~ n~ - ~:~~ .,,(") (~,!o ;:5 ..~. c- ,,1;:0 r:.1,...., c:: .!O :~~, ~~ , ,'1" ~::: ~; I I ~-:l .." -~ W "~I ."'j c; . - .,~ I " , " "1;) ...; . , '"- .- :,., Nome CCNB Bank, N.A. Address _2..Ls.t._&....Ma.t:k.e.LSts. .........camILHill,_pA-J,70 1 ] (CITYI (STATE) (ZIP) 5. If on attorney is representing the estate, indicate: Nome -1l.ng.eI_..B...---..I=in Address 44 ~_ H:::Inn'7pl'" ~t-. Carlisle, PA 17013 (CITY) (STATE) (ZIP) List ull safe deposit boxes registered in the decedent's individual nome, or jointly with, or os on agent or deputy of another, or in decedent's individual nome with right of access by another os agent or deputy. Include the nome 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 relationship of the joint holders to the decedent. ,- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHIClt DECEDENT MAINTAINED A SAFE DEPOSIT BOX NAME OR NAMES III WHICH SAFE DEPOSIT BOX IS REGISTERED RELATIONSHIP OF JOINT HOLDERS TO OECEDENT CCNB Bank, N,A Mt. Holly Spring~ PA 17065 John McCans deceased Under penalties of perjury, I declare that I have examined this return, including occDmpanying schedules and statements, and to the best of my knowledge and beli~Cic~B'Uglf?,f{(fM:ri!omplete. ... .",", BY."__~ A~(I,.~~E if~"fll&d~ Off1J Hl7- ,a. 1911 DATE Office 243-6195 GEORGE L. EBENER AND ASSOCIATES REALTORS APPRAISER. SALES. PROPERTY MANAGEMENT 139 WEST HIGH STREET CARLISLE, PA, 17013 " , !1Arch 31, 19B1 R. C. I(rnmer, Trunt Ilrricor CUI1BER LA ND COUNT V NA T lllNH Il\ NI( AND TR US T COltl'ANV '331 I3rid~e S tl'ooL New CumlJorlnnd, I'n. 171170 DeAr !1r. Krflmorl I um n IJcnnncd 110nl [ntuto [Jroker, licensed by the Common- wenlth or I'onnnylvnnln, und hnvo hoon actively engaged in the real estate buoinoun rnr the pnot twenty-eight years in the Cumberland Countyaron. lAin L1111rouqhIy familiar with real estate values in this aron. On !1nrch 30, 191]1, I inspected the property of :'-laude 'lcCans to determine my opinion of its fair market value as of December 31, 1990, the dAte of her death. This troct of mountai n I and is located in S outh ~'Hddleton Township, Cumberlend County, Pa., East of Route 94 and fronts approximately 123ft. on the Nort.h side of T -535 and contains 5 Acres 112~ Porches. This property is wooded, however it appears the trees hnve no timber value. The elevation drops off from the road and it oppearD t.hnt. n lorge percentage ie swampy. Therefor, in my opininn Lhin property would hAve a fair market value of approximAtely'711110.00. In forminq thin opinion I conoidered the sale of a tract of land from Ilichnrd Hyoro to \'iil.li am Austin on Octot.-er B, 1979 of 10.5 Aaron for 1,17,OOO.1I0, recorded io Deed 1J00k "R", Vol. 28, Poge 709; ond nlon Il ichnrd "1yers to Gary \lnssey, on June 8, 1979 of 10.12 ocl'nn fur 1;15,501l.00, recorded io Deed Book "!1", Vol. 28. I'nfJe (,115. 1 hnv,' no i ntnl'ent nf any nature whatsoever in this property. Thin opinion In qlven hy me voluntarily and without liability on my pnrL Si~C~;lY'~~ ~;)2 E bener ' y r;U/jm ~ ~ ['~ r] r.:-.....i> ~,'-~ .J ~ .:~) CONlt.IAN',-, N A, MAIN niT ICE J311111IDGE SIREn NEW CUMIlEnL^NIJ I'ENNSYl VflNI^'17070 17171 230.U84\ 1 2 3 fl.1C c k i. ng ~s.c:.llli!l t f1 : Number Date Opened Dalance at Date of Death Name of .'foint OWner, i.f ~'l _Jll.M.U"'_ _2~7('. ~r ./" any ~i',)v inqa 1\ccoun t!!.: Number Date Opened Ba lance at Da te of Dea th N f' .... f - ame 0' JOl.n t Owner, ],. any 1 2 3 Certifica teG of Deposit: 1 Number it, 'If " Date I-I 'I III / Value at Date of Death 181/~ '''lS v Name of Joint Owner, if any - Ma turity Oa te 11/ "I 11 { Interest Rate /I:""" Interest Paid Quarterly, M."I-"lY Semi-1\nnua 1, etc. 2 3 Debts: Others: Estate of Co "'''J Date of Death: Il.... 0'*', J fl~ a l!. /II /3 84...t<. N A Name of ~~~kL~r Savings Association ~~L Signature of Bank of Savings 1\ssocia,t.ion. of~ial 4<,1. II""" {, ,\,.1J0.-j. Title QUESTIONS CONCERNING PROPERTY TR~NSFERS 1. Did decedent, within two yenrs of denth, lIlake nny lransfer of i\ny 111i\\efl;11 pi\rt 01 his estalu without recei'vinA valuable i\nd i\deQui\te considemtion? (Answer "Yw;" or "No" ,) _li'L_ 2. Did decedent, within two yei\rs 01 dei\th, Iri\lIsler properly frolll hilllself! herself 10 hilllsel!/llCrsel rand anolller pm\y or parties (including i\ spouse) in joinl ownOlship7 (AIISWCI "'{es" 01 "No",) -~Q-- 3. If tile answello one 01 two above is "Yes" i\nd lI,c 11:IIISII;ls "IC clJllIled 10 hc lIon[;lxi\ble, providc \hc following inforlllalion: a. Age of decedent at tillle of transfcr. b. Copy of death cerlilicate, c, Affidavit by the attending physician indicating the statc of decedent's 110i\I\h "' lilll!) oltronsfer. d, All other inforlllnlion supporting nontnxnbilily of lIilnsler. 4, Did decedent, in his/her lifclime, lIlake nny {rnnsler of property witllOlJl receiving" vnlunble or mlequate consideration therefor which wnsto take effect in posscssion or enjoYllleal nt or nller his/her dealt]" (Answer "Yes" or "No",) No a, Was there any possibility that the property trnnsferred lIliglll return to transleror 01 his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) b, What was the transferee's nge at tillle 01 decedent' 5 death? 5. Did decedent in his/her lifelime mnke any transfer without receiving a valunble and adequate consideration therelor under which transferor expressly or impliedly reserves for his/her life or any pericd which does in fact end before his/her death: a, The possession or enjoyment of or the right to income from the property transferred7 (Answer "Yes" or "No".) ~ b, The right to designate the persons who Sll?11 possess or enjoy 1he property trnns(erred or income tl1erelrom? (Answer "Yes" or "No".) ~ 6, If the answer to live b, above is "Yes," state whether the right was reSOlved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, tile consideralion lor 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 baleficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revp.rtto decedent under terms of transfer or by operation 01 law? (Answer "Yes" or "No" ,) No 9. If the answer to eight above is "Yes," was the power to alter, amend or rcvo~.e Ihe interest 01 the beneficiary reserved in the decedent alone or tile decedent and others? (Answer "Yes" or "No" ,) No !O:V.45J.I:X' IJ.eOI COMMONWEALTH OF PENNSYLVANIA nEPA/lTMENT OF REVENUE . TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIAIIIES *' (/nsttflf:riam nn nf.'Vr?rs(~ Sirin) Estate of Ml1ude McCans BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DECEDENT DATr: OF BIRTH INTEREST OF BENEFICIARY -~- Grace EllB Church at liri Gardners. 24 Specific $ Grands n e i $1.000.00 n Yes Le Hic $1. 000.00 Box ] 64 "G" 3 Dixie Slavbauqh R.D #2 Box 3085 York S rin s PA 17372 Grandaugbs~_r______y~~ L~S_ 1 .GJ:an.ds Gardner~. PA 17324 Ferman G. McCans on ------00---'--------1 I I I Rp~; nllP 127 W. Broad jIatfie1d. PA St. ]944'1 L. Sla bau h Dau hter Yes 1 2 Residue PA ] 7324 The above beneficiaries are living at this time except for the following: NAME DATE OF DEATH FfEV:454 EX-t. (3.801 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRAN'SFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTL Y OWNED PROPERTY IInstructiolls on Reverse Side) . Estate of Maude McCans If ITEM NO. I DESCRIPTION TOTAL MARKET VALUE \ T VALUE OF DECEDENT'S INTEREST DEPARTMENT VALUATION (Official Use Onlv) None TOTAL THIS PAGE -0- ~ ~ -<: -<: J.'-l J.'-l ~ :>< :>< :>< ...J z 0 J.'-l 1Il :::> ...J ~ U z - 0 JJ.. - JJ.. E-< 0 ~ JJ.. ci ~ ~ JJ.. E-< 0 tIl 0 Z ci 1Il 1Il :>< f-o ci - J.'-l J.'-l Z Z f-o f-o J.'-l Z ...J ci - 0 ~ ~ z ~ J.'-l J.'-l ...J Z ;::. Z f-o Ci :::> U l? Z ~ Ci Vl ~ 0 0 ..,-; :;: ~ W U Cl "- :1 'ISaJalU! s.lUapa~ap a41 10 anle^ la~Jew a41 ale~!pul '\7 'ISaJalU! s,luapa~ap a41 10 a6elua~Jad a41 ale~!pul 'E 'AIJadoJd paUMO AllU!O! a41 10 anle^ la~Jew lelOl a41 ale~!pul 'l 'pa4S!lqelsa SeM d!4sJaUMO lU!Of a41 alep a41 pue (S) JaUMO.O~ a41 10 lUapa~ap a41 01 d!4SuO!lelaJ pue SSaJppe 'aweu a41 apnl~ul '..8.. alnpa4~S JOI SUO!I~nJlsu! a41 U! pale~!pu! se AlJadoJd leuosJad lie aq!J~saa ',,''if.. alnpa4~S JOI suoJl~nJlsu! a41 U! pale~!pu! se A1JadoJd leaJ lie aq!J~saa 'l 'ISJ!1 alelsa leaJ lS!l 'papnl~u! aq 01 aJe A1JadoJd alq!6uelU! pue alQ!6uel 4108 'd!4SJo^!^Jns 10 146p 41!M slueUallu!of se sa!lJed JO A1Jed Ja410ue 41!M AllU!O! luapa~ap a41 Aq pauMo 'leUOsJad pue leaJ 'AuadoJd lie apnl~u! lsnw ,,3.. alnpa4~S "3,, 31n03H:>S ONI131dWO:> HO:! SNOI1:>nH1SNI RECOROFH FFler r:: n['~:;~ i i -, -(1' ., ~ ~ ~ ::; ~ Z ~ r.>.l \D 0 >- ~ O<l rJl 'tl ;J 0 ~ u ....l ::f: ..... <( I-< - r:l '" u z ~ ..:t - ~ ..... ~ 0 ..... co ~ - 0 ..... 0 ~ 0 ~ ~ ~ ~ 0 '"' 0 rJl Z 0 rJl '" >- f-< 0 - ~ Z ~ ~ '"' ~ Z Z ....l 0 - 0 ~ Z ~ ~ ::E 0 ~ U O<l ....l Z Z " Z - ~ '" ~ 0 0 g; ::: ~ u 0 :l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION COUNTY FILE NO: /" , 1- TO: /) ".( ..1 t / 1,/ "11/,; ... /, ~ .: "'.' " ),.,,/ 1,.i'l ..)- ,~' ~~; /1 / , 1"/1 {, J~" ,-:. ;..... / --- Appraised Valu. of Estat.: Real Estate Personal Property Jointly Held PropertylTransfers Total Gross Estate Total Approved Deductions Clear Value of Estate Less: Approved Charitable Exemptions Clear Value of Estate Subj.ct to Tax Amount Taxable @ 6% Rate Amount Taxable @ 15% Rata OFFICIAL NOTICE OF INHERITANCE TAX ASSeSSMENT " ", . ) . I-:, I ,,-,.-.' ( $ , ) '/ --"; /, ,-..t-,'} , . t H ;\//.'/J~ ,..; , - t $ ,j ."';~;' / , /,'" - / " .') ~:;t ,~;'''' ,.~/ i', !:L1 / .> ~/ 1/'1 ....' '-/: (:.-{/ ,t. ~, -'" 'iL $ -'/ t / ....,,/ ,.; 7~ $ 7/; f::2 'I '-/ / DATE ESTATE FILE NO. COUNTY DA TE OF DEATH tax due tax due //,' ...." j' . ,', ////, -- , . ,y"'" , , / " TOTAL PENNSYLVANIA INHERITANCE TAX DUE .. .. . * '* .. A five percent discount totaling S will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT :)-,)1-// AMOUNT PAID $) 111,1 , '-0 I . DISCOUNT INTEREST + S i ~;d '-tJ - $ TAX CREDIT " / = $..--: '/~ ,'}(i, I/~O / t = t = 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 bv BALANCe OF PENNSYLVANIA INHERITANCE TAX DUE As.....dby: See Information on Reverse Sid., is / /! , , , '*' ('" . ,'/V/ "" ,_.,." ,; l'?', (' , , . /,' //" ," J ,/,' ///~ L /1.M.....:;1..../ ,"/. :,;/::.( ... t. ' ;: /1 .....1 ... ,,'" ,~, _,....{ '. , "",1/,)/,1/1/0 " e. / $ ;, /,,) ;;;, 'I";' / ' $ ~. ') t! ;; (I t.J $ ;) ./1 / /T. :;:)