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INHEHlTANCE TAX RETURN ~^
FOR INSOLVENT ESTATES ONLY ~
OF RESmENT DECEDENTS
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RCC.103 (3-HI
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENTOF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
COUNTY OF Cumberland
This return must be completed In data II and filed In duplicate, with the Reglstor of Wills in tho County whore tho decodent resided within nino
month. aiter doto of death, unless on oxtonslon Is granted by tho Socrotory of Revenue.
Will
Admn. No.
19_ I. Janet T. Kepner
(NAME)
"j" R. D. 1. Box 216. Gardners PA
(ADDRESS' rn2r-
survivinl? spouse
IEXEC" I\OM., LEG/I,TEE, ETC.l
South Mlcklleton T..9wnsh~p__n____-_
lCITY, BOROL'GH, OR TOWNSHIP)
__ .:r',llY_~~LL~!lQ------- ..n_ - - --------
(DATE)
Misc.
being duly sworn according to law, deposes ami says thuShe is the
of the estate of
Robert Em9'!:Y_I(~ner _________'_ laic oj"
deceased. and that the whole of the estate of said uecedent. who died Oil
consisted of the assets listed he low and that allnwuhh; dehts and deduc.:tiolls exceeded the rair OIilr!.a:t value of (he assels illld
no Pennsyivania Transfer Inheritanc.:e Tax is dlle.
Sworn and subscribod bofore me
19.J!L C\ ~ ::r~.L~..-y, ,,",
My Commission E~pircs J~.f@ih~t'i~A~~pner
n;--emlislc Cumcerland Cout"
Type of Asset:
Real Estate, PelS.
Property, Jointly
Held Prop. or
Transfers
ASSETS
(Attach additional sheots if necessary)
Description of Asset
Pers. Prop.
Real Estate
1979 Ford Fairmont automobile
house and lot of gran d in S. Middleton Twp.
Cumberland County. PA described in Deed
Bk. "K", Vol. 20. p. 300
CCNB Savings Account
Adams Cnty. Nat. Bk. Savings Account
Adams Cnty. Nat. Bk. Checking Account
Misc. Household goods
Pers. Prop.
TOTALS
survivinK.I:lPouse___.. .
I TITLE)
Estirr,oted
Merket
Velue
Department
Valuation
CAUTION
(Do nol write
in this space)
4.895.00
Tenancy by
Entireties
"
"
"
"
4.895.00
't V'ls-. DC!
REPORT OF INHERITANCE TAX APPRAISER
1, the undersigned duly appointed Inheritance Tax Appraiser in and for the above County do respectfully report that I have
appraised the real and personal property as reported in the foregoing schedule at thc valucs set forth oppusite each itcm in
Ihe last column 10 Ihe righl. J-!/JNf; d J 1f't,A4..J..)
Dated:_ f)_If" pi (INHERITANCE TAX APPRAISER)
REI'ORT OF TIlE REGISTER OF WILLS
I, the undersigned ~uly c1eele~ Regisler of lI'ills in an~ fnr the ab"ve ('"nnl)'. ~t1 respeelfully repllfl lhall have llll,,,ve~
deductiuns in the 311111unls set furth in the .Iho\'c schedule as c1.timcd. cxc.:cpt where I h.I\'l' sel (mlh a grcalcr nr lesser ilmuunl
in the last clllumn In the righl. which grcalcr IIr Il~sscr :ll1luunl represents the :-.UllI alllwcd as a deducli~HI.
~?d '. ?- g
Date uf ApP,,"val: /' /!{l1t).-2a. Itfy/ . '" (. , I. /
If/'~
Nome 01 Payee
DEBTS AND DEDUCTIONS
Nature of Claim
Janet I. Kepner
Gibson Funeral Home
Register of Wills
Carl. Hospital
Dr.. Joseph Green III
Family allowance
Funeral services
Filing Pa. Inheritance Tax Retlr n
Expenses of last illness
Doctor expenses
TOTALS
0<./-';)-5/
U-1Sor-3
Amount
Claimed
Amount Apploved
by Register
2,000.00
1.877.00
3.00
3.272.65
50.00
7.202.65
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oll~V.518 FO (7080)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
NOTICE OF FILING OF APPRAISEMENT
Janet I. Kepner
R. D. #1, Box 216
Gardners, PA 17324
RE: Estote of
County of
File No.
Robert Emorv Kepner
Cumberland
21-81-0051
Dear Mrs. Kepner:
You are hereby notified that the Insolvent
oppraisement in the estate of Robert Emorv Kepner
has been filed in the office of the Register of Wills of Cumberland
County an March 16 , 19.11. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
None
$4.895.00
None
None
$4,895.00
As to such tax that is paid within three months from dote of death, 0 five (5%) percent
discount is allowable. As to any tax that remains unpoid 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 aggrieved by this notice may abject thereto within sixty doys
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
March 16, 1981
Signed
.J;'J"''''/d/ 'fi'f"JHJ)
Chief Appraiser
Title
NOTE: This is not a bill.