HomeMy WebLinkAbout81-00064
No. 21-81 1),1
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of
Martin A. Fishel
, deceased.
To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania,
Petitloner(jl) Is ~PIl) the execut r ix
named In the Last Will and Testament of
Martin A. Fishel dated January 21. 1981.
Decedent was a citizen of the United States and a resident of Lower Allen
Township (8lS~11Pl), Cumberiand County, Commonwealth of Pennsylvania.
Decedent died on Sunday
the 25th
dayof January
A.D. 19..e.l-, in the
County of Dauphin ,State of Pa. at the age of 1l..- years.
Decedent hell (has not) been married and ~ (has not) had children born to him (bel) since the ex.
ecution of the above described Will.
Decedent was possessed of personal property to the value of $ 7 . 000.00
and of real estate to the value of None
as near as can be ascertained; said real estate situated as follows
Therefore, your petltioner(6) respectfuiiy apply(ies) for the probate of the said Last Will and Testa.
ment and for Letters Testamentary theron.
Dated,. January 27, 1981
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Name and address
of Petitioner(s)
,/.~;;: ?:T'ify:;j~ ,
781 Orrs Bridqe Road
Mechanicsburq, Pa. 17055
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COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND j
Grace P. Trayer,
ss
named in above application, being duly sworn according to law say(s) that the
statements set forth in this petition are true to the best of her knowledge and belief.
and subscribed before /~.d'~ p J~..u:/) ./
, Grace P,7 Trayer
.pworn
me. _ Janua~~__ 19 lli._
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Flied: January 28, 19,31
Attorney
Robert L. Myers III S'J...
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH or 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
Grace P. Trayer,
who, being duly
sworn ,do es
depose and say that as Executrix
of the last Will and Testament of Martin A. Fishel,
deceased
she will well and truly administer the goods and chattels, rights and credits of said deceased according to law. And
January 27,
A.D., 19~
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DECREE
Be it remembered that on the 2 S th
day of January,
,A.D.,19~, there was probated and
recorded the last Will and Testament of Martin A. Fishel, late of
Lower Allen Township ,Cumberland County, Pennsylvania,
Deceased. Letters Testamentary were granted to Grace P. Trayer
Witness my hand and official seal the day and year aforesaid.
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Regist<<
Inventory of the real and personal estate of
MARTIN A. FISHEL,
decea.ed.
1. 1980 Chevrolet El Camino, 2 door
2. 1971 Shasta camping Trailer
3. Dauphin Deposit Bank and Trust company Checking Account No.
33-18-5115, opened 9/18/70, date of death balance
4. Dauphin Deposit Bank and Trust company Savings Account No.
14-6-07824, opened 4/19/78, date of death balance
5. V. A. Benefit Check
6. Civil Service Annuity Check
7. Cash
8. Medicare reimbursement
9. Social Security Lump Sum Death Benefit
10. 9001.38 shares of Financial Industrial Income Fund at $8.5075
per share
11. Defense Activities Federal Credit Union Savings Account No.
6846, date of death balance
12. Defense Activities Federal Credit Union group life insurance
policy proceeds
13. 300 shares Middle South utilities, Inc. stock, date of death
value 12 1/8 per share
TOTAL
5,400 00
800 00
1,939 24
1,323 42
54 00
570 184
,
46.150
587 66
255 00
76,579 24
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\ 3,159 05
1,500 00
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3,637 10
95,852 45
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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.___G..r<'l.C:..El...P~__J.'_ray.e.J:" L___._.. ______ ___. ._.............__
boing duly _Sjio.r.O_ _....._ according to law, dopo.e. and .ay. that sho ..~.~Exec~tri~____..__
------.-.--.-.-.-.-....._~.~...__ of the E.tat. of Martin A. Fishel,
late of Lower Allen Township , C.mborland County, Pa., decoa.ed and that th.
within is an inventory mad. by _....~:t::<'l~..e_P_...~J;:f!y.er_._. .__ __..___, tho .aid Executrix
of the ontire estate of .aid decedent, con.i.ling of all the persona' prop"rty and roal estate, except real e.tate outside
the Commonwealth of Penn.ylvania, and that the ligure. opposite each item 01 tho Inventory ropresent it'. fair valuo
a. of the date of decodent'. doath .
Sworn
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and .ub.cribed bofore mo,
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Ellecutor.~ n~
Trayer
Bridge Road
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~-%~L Q.... A_ L _
JOiCE R. ANDERSON. NOT AllY PU8l1C
H^MPOE~ll\'IP.. ClJl,IDEIlL/\NO COUNTY
MY COMMISSION miRES JULY 25. 1983
Membm, P€l1nsylvani3 AssocIation of ~olatle!\
1981
10
Grace P.
781 Orrs
J
_Mech.C!l)iQsbu~, Pa. 17055
Addrou
Date of Death
25
1981
January
Month
Day
Year
INSTRUCTIONS
r. An inventory mu.t be filed within three month. after appointment of personal representative.
2. A supplement inventory must be filod within thirty day. of discovery of additional a..ets.
3. c Additio",al .heels may b. attached a. to personalty or realty
See Ar#c1e IV, Fiduciaries Act of 1949.
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REV.455 EKt (3.60)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT DF DEBTS
AND DEDUCTIONS
-----.--------
Estate of MARTIN A. FISHEL Date of Death 1/25/81
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
File No. 21-31-6 4
Claimant
Relationship to Decedent
Claimant's Address at time of Decedent's Death
ITEM DATE NAME OF PAYEE REMARKS AMOUNT
NO.
1. /28/81 Register of Wills Probate & 8 Short Certificates 1$ 27.00
2. /29/81 Cumberland Law Journal IAdvertise Letters 1R nn
3. /20/81 Patriot-News Co. IAdvertise Letters 2< <"7
4. /5/81 Musselma: Puneral Home Funeral 2,134.15
5. 12/5.L81 Stover' s PhCl,..m~m' .4.4. .1l.D-.
6. 12/12/81 Sears, Roebuck and Co. Balance of Charqe Account 455.31
7. 13/4/81 Pa. Dept. of Transportatior Duplicate Certificate of Title 5.00
8. 1l/4/81 Pomergy's Balance of Charge Account 13.77
9. 3/4/81 UGI Gas Bill 19.00
10. 3/4/81 Bell of Pennsylvania Telephone Bill 21. 36
11. ~/4/81 P. P. & L. Electric Bill 19.82
12. ~/6/81 Humrnelstown Cemetery Assoc. Perpetual Care Coverage 270.00
13. r</17/81 Defense Activities Federal Credit Union - Loan 2,033.70
14. 1S/1/81 Russel Gingrich Memorials Monument 870.00
15. 5/12/81 Nancy C. Bretz Storage for Car & Travel Traile 195.00
16. /22/81 Internal Revenue Service 1980 U.S. Individual Income Tax 1 120.00
17. /22/81 Pa. Dept. of.Revenue 1980 Pa. Individual Incomp ~ClY 207 nn
18. '/2?/Rl r.' ler Fr""; "0,.. t. n,,,,h I. ,t-Clnl-<: _ ..Ill< nn
19. Grace P. Traver ~xecutrix Commission 4,798.00
20. Robert L. Myers III Leqa1 Services 4,798.00
21. Notary Fee T, Agf,~tcatwn ,!;or of 3.00
nventory , icate Cert.
22. Reserve for ~t~~~ Out ('"".." l<n nn
23. /10/81 Reqister of Wills File REV-449 D & D & ,rv q nn
TOTAL I $17,219.48
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 es!ate as deductions for Inheritance Tax purposes.
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- SIGNATURE OF Fl0UClAAV /OATE .-
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ /~,,:) / r. I/.?
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REV.455 EX+ (3.80)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
SUPPLEMENTAL
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
~
.
Estate of MARTIN A. FISHEL Date of Death 1/25/81
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING:
File No. 21-81-64
Claimant
Relationship to Decedent
Claimant's Address at time of Decedent's Death
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" 'I 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 ostate as deductions for Inheritance Tax purposes.
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,"'" StGt'ATURE O~IDUC{ARY r Z DATei'
OFFICIAL USE ONLY
tTEM OATE NAME OF PAYEE REMARKS AMOUNT
NO.
1 8/21/81 Internal Revenue Service Additional 1978 U. S. Individua $210.00
Income Taxes Assessed
2. Notary Fee Assignment of 2 Certificates of 3.00
T~t.Le
3. 9/16/8J Internal Revenue Service Balance due 1980 U. S. Individt jal 261. 93
Income Tax
.
-
.
TOTAL I $474.. 93
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ ./'1'/
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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 estote, other items are claimable including the cast of
administration, attarney fees, fiduciary foes, funeral and burial expenses including the cost of a burial lot, tombstone
or grave marker and other reloted buriol expenses,
All debts being c10imed ogainst an estate are subject to the approval of the Register of Wills with whom the
Inheritonce Tox Return is filed. Evidence .to support the decedent's or the estate's liability for the debts being
claimed should be a"ached to this schedule.
A fomily exemption moy be claimed by a spouse of 0 decedent who died domiciled in Ponnsylvania. If there is
no spouse, or if the spouse has farfeited his/her rights, then any child of the decedent who is a member of the some
household can claim the exemption. In the evont there is no such spouse or child, the exemption can be c10imed by
a parent or parents who are members of the same household os the decedent. The fomily exemption is allowable only
against assets which pass by a will or by the Pennsylvanio Intestate Laws,
NOTE: Compensation paid to an estate representative; namely, an executor or administrator, for services
performed in edministering on estate is reportable for Pennsylvania Income Tax purposes. This taxable income
item should be reported on form PA.40.lndividuollncome Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicate the claimant's nome, address and his/her relationship to
the decedent. Enter "family exomptian" in the remorks column and the omount claimed in the amount column.
2. Assign consecutive numbers to each item listed.
3. Enter the date on which each debt was incurred ond/or poid.
4. Enter the names af each payee.
5. Provide a brief explanotion in the remarks column for each debt c1oimed.
6. !:nter the amount of each debt being claimed,
7, The form must be signed by the persan who has ossumed the responsibility for paying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE aW' x 11" SHEETS.
.' 1.
REV.449 EX" (3.80)
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDEN,
*
AFFIDAVIT OF
FIDUCIARY
(In.truction. on Roverse Side)
Estate of MARTIN ~,...!'JEH~J:.,,_____
Lost Address_..?'.Qil.:r.?~~S~_, Street
..__Sa.!TILl1i~l, Pa. 17011
Date of Death January 25, 1981
Social Security No, 207-07-5485
Bureau File No.
(ell Y)
IsrA rLJ
(ZIP)
County File No.
21-81-64
1. Decedent died:
( ) Intestate (without a will)
( X) Testote (leaving a lust will--capy attached)
2, Is the filing of a Federal Estafo Tax Relurn required far this estate? Yes_ No X
3, (X) Executor/Executrix
) Administrator/Administratrix
Name Grace P. Trayer
Address 781 Orrs Bridge Road
Mechanicsbu~J Pa.
(CITY) (~TATE'
17055
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4. All correspondence should br mailed to ( X) Attorney
) Fiduciory,
5, If an attorney is representing the estate, indicate:
Nume __~obert L. Mvers III. Escruire
Addross 4341 Carlisle Pike
Camp Hill~ 17011
ICITY) (STATEl (ZIPt
List 011 safe deposit boxes registered in the decedent's individual namehor jointly with, or as an agent or deputy
of another, or in decedent's individual name with right of access by anot er as agent or deputy, Include the name
and address of the bank or ofhor 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 WHtCH DECEDENT MAiNTAINED A SAFE OEPOSIT BOX
NAME OR NAMES IN WHICH
SAFE DEPOSIT BOX IS REGISTEReD
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
Dauphin Deposit Bank and Trust Co.
Martin A. Fishel
3045 Market Street
Hill, Pa. 170~1
Under penDlties of perjury, I declare that I have exomined this return, including accomp~nying schedules and
statements, and to the best of my knowledge and belief it is true, correct and complete.
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, DATE.
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Dauphin Deposit Bank
and Trust Company
MAIN Of FICl: ~'I.l MAHK (:, S' 1111 1. "lIlIIII'dlll"". 1'1 tiN'. \ I \ "'11.\ '/111/\
", ~'b~2'~1
April ), 1981
Robert L. Myers III
320 Harket Street
(I, O. nuX 3211
Lemoyne, Pa. 17043
He: f!"rlin A. l'i:.;hcl
JUJ1uary 25, 1981 Decealied
Dear 1.:1'. Myel''':
In regards to the above mentioned, we submit the following information
as of the date of death:
Checking account #33-18-5115 oponed 9.iP-70 balance S1039.24
In the name 01' Martin FilJhel only.
Savings account #111-6-07824 opened 1,-19-78 bnlance S13"9.00
interc:st 54.42 In the name of Hartin Fishel only.
Safe Deposit Box 111/1-412 flartin only.
If we can be of any further assistance, plca[~e do not hCf;j tntc to
contact us.
Very tr'uly yourB,
\ .11' '1. ~", ,~. /-. ;. r l
l '-,. .
JoAnn C. :Jtover
Assistant Treasurer
JCS/lf
.
~-
DEFENSE ACTIVITIES FEDERAL CREDIT UNION
BRANCH
Navy Ships Parts Control CenICJt
OUlldlng 310
Mcch,ln1cshul\l. Po 11055
Tel 717.766.4153
717,790.3596
MAIN mlICI:
ti215 [ l/1nlllllllll
MudIlIllICSLJIHIl, P(I 170[1&
Tilt 71 7.GDJ.' 101
717.697,1162
1l1l,\NIIl
I 'II h..I'l lI,tll ,t. ~b
Uull,luI\/411
Clllltulo, fin no I J
Tol 717,243,3900
ilplll ;1,;:, l'llll
Hr. Robert L. r-lyers, III
P. O. Ibx 324
l..€noyne, Pa 17043
Rc: [,;state of ~lartin '1'. Fishel, Deceased.
Dear I4r. t4yers:
Reference is made to my letter to you datc.u ~Jarch 10, 1981, were I erronc.'Ously
stated that Grace P. Trayer was joint owner on the share (savings) account
with !'o\r. Fishel. The joint O\'ll1er of that account was Sarah 14. Fishel, his wife,
\'100 you had stated to 1112 \'Ias deceased. Hence the request for the short
certificat.e.
1 W15h to apologize for any inconvenience this Bay have caused.
Very truly yours,
II '
/. '{
j 'vi,'
,./1 \... /
"-..,."
, \
, \
'-... , ,,"
Judith N. - !"liller
D2ath Claims Officer
\
Enclosure:
copy of mc"l11bership card
"
I
,
I
,
1
!
i
.....-.1
, . I"~
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, make any transfer of any lIIaterial part of his estate without receiving
valuable and adequate consideration? (Answer "Yes" nr "Nn".) No
2. Did decedent, within two years of death, lransfel property IrOIll hilllsel(' hersell to himself/herself and another party
or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) ..!'!9-.
3. If the answer to one or two above is "Yes" and lIiC trilnsfers ale cI:lilaed to be nontaxable, provide the following
information:
a. Age of decedent at tillle of transfer.
b. Copy of death certi ficate.
c. Affidavit by the attending physician indicating fhe stille of rlecedent's 118illth al time of transfer.
d. All other information supporting nontaxahility of t.rilnsler.
4. Did decedent, in his/her lifetime, make any (ransfer of property without receiving a valuahle or adequate consideration
therefor which was to take effect in possession or cn!oYlllent at or after his/her death? (Answer "Yes" or "No".) No
a. Was there any possibility that the property transferred might return to trilnsleror or his/llCr 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 deilll1?
5. Di d decedent in h is/her lifetime mal<e any transfer wi thout recei vi ng a valuable and adequate consideration thereior
under which transferor expressly or impliedly reserves for his/11er life or any peried 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".) B2-
b. The right to designate the persons who shilll possess or enjoy the property transferred or income Iherefrom?
(Answer "Yes" or "No".) No
6. If the answer to five b. above is "Yes," slate whether the right WilS reserved in decedent alone or others.
7. Did decedent in his/her lifetime make a transfer, Ihe 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, tlilnsfer property, the bOleficiill enjoyment of which WilS subject to change, because of
a reserved power to alter, amend, or revol<e, or which could revert to decedent under terms of tlilnsfer 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
REV-4!53 EX'~ (J'80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
(JENEFICIARIES
~4
~
(lI1SIf/u.:tlon.Ii Oil flt/Vt.'r.\'tl Sic"')
Estate of MARTIN A. FISHEL
BENEFICIARIES AND ADDRESSES
SUHVIVED
DECEDENT
~
DATE OF
(JIRTH
Adult
RELATlONSHI~
INTEREST OF BENEFICIARY
Nancv C. Bretz
208 Locust Street
Camp Hill, Pa. 17011
Frj,eMrI
~- _J..~_._.___
Yes
10 000.00
Grace P. Traver
781 Orrs Bridqe Road
Camo Hill, Pa. 17011
. -----.-.--.-
---.--..-. ---.--.-
.-___._.w..__
Martin A. Fishel, ILl
2264 Berryhill Streot
Harrisburg, Pa. 17104
-...-. -Q.QlL__....
y
-- ----.-.
-.--.----.-- .-~-----~
-- ---~..._._._.
'- -.---
-----.-.-..--.-.... -...-
..--.-..... -.....- ..----
._---_.._~--_.. ..~_...._..__... --..-....--... ... -.- --.........--... -
._~-_...__._-~.. ..-.-----.------
.-.. .-.---...... --~--....--.-....---..-..--.---.
'--.- ._--_.._.._~-
----.--.-...--..-..-.
The above beneficinrios oro living ot this time eXcollt for the following:
NAME
DATE OF DEATH
~--_._-----._--~.,-~-
. .
REV.454 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
(Instructions on Reverse Sido)
Estate of MARTIN A. FISHEL
*
P
TOTAL E VALUE OF DEPARTMENT
ITEM R
DESCRI PTlON MARKET c DE(;EDENT'S VALUATION
NO. VALUE E tNTEREST IOfficial Use Only)
N
T
1. Series E Bonds in the names of Martin
A. Fishel or Martin A. Fishel, III,
his son, of 2264 Berryhill Street,
Harrisburg, Pa. 17104
1 - $25.00 issued Sept. , 1953 $ 60.84 50% $30.42
1 - $25.00 issued Oct. , 1953 61. 61 50% 30.81
1 - $25.00 issued Nov. , 1953 61. 61 50% 30.81
1 - $25.00 issued Dec. , 1953 59.83 50% 29.92
2 - $25.00 issued June, 1966 81.14 50% 40.57
1 - $25.00 issued July, 1966 40.57 50% 20.29
2 - $25.00 issued Nov. , 1966 78.58 50% 39.29
2 - $25.00 issued May, 1967 76.94 50% 38.47
2 - $25.00 issued June, 1967 77 .82 50% J8.91
3 - $25.00 issued July, 1967 116.73 50% 58.37
5 - $50.00 issued May, 1968 369.40 50% 184.70
2 -$100.00 issued May, 1968 295.52 50% 147.76
TOTAL THIS PAGE $690.32
tIe) )'.2
48
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I, the undersigned duly appointed Inheritance Tax Appral.er in and for the County of ~berta~d
Pennsylvania. do re.peclhJlly repart that I hava appraised the real ond personal property a. ,eporte in t e oregolng
rotum at the values set forth opposite each Item in the last column to the ri ht in Sc~ules II A" , liB", lie", and fiE"
A
REV....!" EX+ 16-801
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
File Number
.,2.1:8.1.0064
Mprtin A. Fishel
Estate Name
Date of Death
Januarv 2~ 1981
Social Security Number ..-2.01::.Q1:::5A6.5
REPORT OF INHERITANCE TAX APPRAISER
Dated:
Seotember 4, 1981
INVENTORY
VALUE AS APPRAISEO
CODE
ADJUSTMENTS
(HARRISBURG USE ONLY)
Roal Property (Schedule A)
Personal Property (Schedule B)
Jolnt.Held Property (Schodule E)
Transfor. (Schedulo C)
$ None 00+
Q~,~, '0+
6 0 32 2lH
one 30+
--96.,28.7- _~7
40-
TOTAL GROSS ASSETS
Lou O.bt. and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life Estete
o Annuity
Mll
FACTDR
PRINCIPLE
FOR USE OF REGISTER ONLY
Tax on $
CODE
6%
T ox on $
15%
Tax on S
To)( on $
Tax on $
Exemptions
Total 1:51010
TOTAL TAX
INTEREST FROM
BALANCE
. TO
L.eu Credits
DATE OF PAYMENT
INTEREST
AMOUNT PAID
DISCOUNT
S
+ S
S
+
INTEREST FROM
BALANCE
TO
s
[1] Original
o Supplemental
o Remainder
.~
REMAINDER APPRAIS~MENT CODE
92+
93-
VALUE
CODE
\
COMPUTATtON OF TAX
$
$
$
$
$
=
=
$
$
$
TAX CREDIT
$
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INIIERITANCE TAX
ASSESSMENT
'*
COUNTY FILE NO:
.'
. /,.,
,
" ,
/ I
'/
OATE
I, ;, I... J //
'je.!
/' (
TO:
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FILE NO,
/:'4.. ,~,;,. h
J
.../, / ,",
fl.' (' (J
/
COUNTY
,"
r:..'
/',//.' / /
OATE OF DEATH /,},,')U;";:/C1,
/1 J
II {/
)/)-I'l'y/
,/
Appraised Value of Estate:
Real Estate
$
--.----
Personal Property
+
'" '<"""/ .1.__
/~j' '.I I" G!"j
"
Jointly Held Property/Transfers
+
. j,., " 'i
/,/' (/ ..j ,/,
Total Gross Estate
$ '/.~
/
"..~,;'/) -} '}
,I / I. I
Total Approved Deductions
(/. ..../ 'l ,/ ',/
-, . ~-. , ,'.
Clear Value of Estate
$ '/ /".,/ >/
,
-~~...._-_.
less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$ }'I.v;/ / J
Amount Taxable @ 6% Rate
$ i.y,/ .if, Y
"
/'/
,
tax due
$ ;:- ,.;' 41';' /) q
.-- .-
Amount Taxable @ 15% Rale
.'
j' /,' , '.. .'L-(I , )--1
"
tax due
q /.~-('-l) /,"-11
I
$ 1)4-1- (')1
/ ,
TOTAL PENNSYLVANIA INHERtTANCE TAX DUE
.. .. ... .. * .. A five percent discount totaling &
will be granted if the Inheritance Tax is paid by
Less Credits:
OA TE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
d 1'7 0/
'/.{-:/'?~/;
$ r>.1 ,-:: ,-;,). ",~7',
,
+ S ~(':>'(1 1/7 - S
= $ ';';/.9/ <17
/
+
=
+
=
Interost 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 INHERtTANCE TAX DUE
$
./.... I" :'./ / ,j
'. -' .....;
Assessed by:
See Information on Reverse Side A;tnl orth.C, nW'IIl1h .'
;'(<iJ' 1.,'-'1,:....1
Id ..",I: :,!" l/
/ :l//
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*'
COUNTY FILE NO:
;;I-~;}
(...,'/
\j. i d r. I r rJ
DATE ...,,.~: -.,' 'Ixl
'-. \\... ' ~
ESTATE \-Y~ft::.v,_ L( 1 ,{'j~I,
FILE NO. ..), J g /" (/1
/ I'! ~ I)
COUNTY (AJ,/',-y', 0,.(.1,., y "",i
~ . "
DATE OF DEATH" {'N< d 5' 19 '(I
TO:
77]
"
,r,_,
-'\,..'t/)
';\
/ '/ () (I
Appraised Value of Estate:
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 Subject to Tax
$
Amount Taxable @ 6% Rate
$
tax due
$
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA tNHERITANCE TAX DUE
?d~ I ~
$
... * ... * 'It ... A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
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
'?/a'1 0
ij II'. - A. ,
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$
Assessed by: " ~/~j, < 0:
See Information on Rel/erse Side Agentfor~~ com'r~
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~ "- .'
i:ll.;j I 00 r.:! Z 8 ..:ien c - .. ~ ~j: CJ'rl
o ~M ~ H ~re 0 i:lH .... ... r:; 0< :I:~
d ll. ,.
CJr.:! co 0 ~ . 0 0 .<: ,. I, '" :;;: III
~Ol ~ i:l P< r.:! .... ~ ~i~ 0
r.:! M r.:! 0 CJ :I: :>, c .. " ,.. ~~
~ .. ]
:r:i:l~N ~ 8 01 U .- ':"1 .... ",
.. - "
E-iCJH r.:! enCJ en .... c, '. ,'", "J CJ
z~~ci 8 ~ e;~ OJ E to
c.> -. ;: " 5
en " 0 {.~
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n ~j C
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..... .... ,
~---~
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:.:,~,~"7~'::.;~'i'_'r".,:~.;:,:)i~.......~~~\t~~:~lSIl;U*;'J.'-";:~"'-'-'-""-'''''~''.'f,.'".,
8/10/81
3/23/81
5/19/81
1/28/81
1/29/81
2/5/81
2/5/81
2/12/81
3/4/81
3/4/81
3/4/81
3/4/81
3/4/81
3/6/81
3/20/81
4/17/81
4/22/81
5/1/81
5/12/81
7/22/81
Inventory Filed
As per copy of Inventory Attached
TOTAL PRINCIPAL RECEIPi'S
PRINCIPAL CONVERSIONS INTO CASH
$95,852.45
$95,852.45
Gain Loss
9001.38 shares of
Industrial Income
Proceeds
Account Value
Financial
Fund
$77,525.29
76,579.24
$946.05
300 shares Middle South
utilities, Inc. stock
Proceeds $ 3,307.60
Account Value 3,637.50
TOTALS
$946.05
Net Gain Transferred to Summary
$616.15
PRINCIPAL DISBURSEMENTS
Register of Wills - Probate and 8 Short
Certificates
Cumberland Law Journal - Advertise Letters
Musselman Funeral Home - Funeral Expenses
stoyer's Pharmacy - Medicine
Sears, Roebuck and Co. - Balance due on
Charge Account
Pa. Dept. of Transportation - Duplicate
Certificate of Title
pomeroy's - Balance due on Charge Account
UGI - Gas Bill
Bell of Pennsylvania - Telephone Bill
P P & L - Electric Bill
Hummelstown Cemetery Assoc. - perpetual Care
Coverage
Patriot-News Co. - Advertise Letters
Defense Activities Federal Credit Union -
Balance due on Loan
Register of Wills - Payment on account of
Pennsylvania Transfer Inheritance Tax
Russel Gingrich Memorials - Monument
Nancy C. Bretz - Storage for Car and Camping
Trailer
Internal Revenue Service - 1980 U. S.
Individual Income Tax
~IBlk .LlJU I'~G[ 189
- 2 -
$329.90
$329.90
$ 27.00
18.00
2,134.15
44.00
455.31
5.00
13.77
19.00
21.36
19.82
270.00
23.37
2,033.70
5,500.00
870.00
195.00
1,120.00
I
i INCOME RECEIPTS
j
) 2/5/81 Dauphin Deposit Bank and Trust Company
Savings Account No. 14-6-07824 - Interest
from 1/25/81 to 2/5/81 $ 2.30
I 4/17/81 Defense Activities Federal Credit Union
Savings Account No. 6846 - Interest from
1/25/81 to 4/17/81 55.21
4/24/81 Middle South Utilities, Inc. Stock
.J Dividends on 300 shares 121.50
I U. S. Treasury Bills - Matured
10/1/81 $50,000.00 at 96.486642 1,706.68
TOTAL INCOME RECEIPTS $ 1,885.69
~AflP '?~""1t.~A/
Grace P. Trayer, ecutrix
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss:
Grace P. Trayer, Executrix, being duly sworn according to law,
deposes and says that the Account as stated is true and correct and
that the Grant of Letters and the first complete advertisement
thereof occurred more than four (4) months before the filing of the
Account.
Sworn and subscribed
..~/."'~'" Toe me this 6''''- day
'1i~"" r . '_,
~,~\~:..s... .' /J.~~~..1i.-- A. D., 19 81.
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'. ').. ('!~~ II \ ""()yiE):~()ERSON. NOTARY PUBLIC
.... /), :;IA\.lPorN HIP,. CUMBERlANOCOUN1Y
""" I n LI'li-COMMISSION EXPl'IlSJUlY 25. t983
"I'le~:;'M~mber, PennsylvarHJ A~~QmtlOn (ll Nlll?ues
A.A'~ _ /V~...... "-P./J/
- Grace P. Trayer, Ex~utrix
lIBlil .luG r~~l 191
- 4 -
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF GI:'MBEnf.AND
55:
".
,Grace 1'. .'l'rayol',
bl'inq duly.. J;~1~o.;:n. llc~ordjlllJ lu Ill",", dllpnHn .,Ild L..,Y. tl1l1l :.Jllu .Iu l~HulllIl.a,ljt
_...,.. ........,.. of tho E.tolo of . r:lur,t~ll_;\.. .1'10110,1,..... ,...__,
late of LOl'/or l\!lcn TO~nohip , Cumberland County, Po., decoa.ed and that tho
within i. on inventory mode by. Grace P . Tr(jY-Qr... ... ......._. the .0iLE;~q),ltriL,_
of tho entiro e.tote of soid decedent, consi.ting of all the personol proporty ond rool estote. oxcept rool e.tote outside
the Commonweolth of Penn.ylvo11l;o, ond th,,1 Ihe figuros opposile eoch ilem of tho Inventory ropresont it's foir vo/ua
a. of tho dala of docedent'. do"lh.
Sworn
clnd subscribed before mo,
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.
19 Q!'_
_?L_r?J.!.c<:._"_,J), . ,'T.c.~'iss__,_
EXoClltor . ^&f*~);1tf~n.~'
Grace P. ~'rayer
701 Orro Bridge Road
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NtJull/1I1lL:ubul:<j I I',..
Addrou
l'/O~I!1
Doto of Deoth .....
25
January
1991
D.y
Month
Yoar
.-.---.-.-...------
INSTRUCTIONS
,. An invontory must be filed within throe months 11ftcr appointment of personal roprcscnftltivc.
2.. A .upplomont invontory must be filod within thirty doys of di.covory of additional a"ots.
3. Additionol .heols moy bo attached os to porson,lty or re"lly
4. SOD Article IV, Fiduciorie. Act of 1949.
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