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Home My WebLink About81-00075 .~.. !' , '. l j " In Il:: l' Il:: f;J .,... I co - . 0 ,... tal C\I ~ ..., .c . llJ 0 - .. Z L&.I / J_ " COMMONWEALTH OF I'EN1\SYLI'ANIA \ COUNTY OF CUMBERLAND \ ~s: ;~,,~,~,~,.~::;;~;~:~;:;:;;-:;:t~',:,','~~;;:',".','.','",'".','.;;~~'(;~::;~'I;'~.';~';',;'\~~','.;;;;,'~;;;;~'~~~'.;a~~:ms:~ forth in the ahov!! application aI''' tnl(! to the h,,~t or ..,,~.knO\frlg~ and. helierr; ........,",.,",...,!!~9.!:,I}".,.. "" ""."",' ",. and ~ll hsct'ibed'\ ,~,^-"'C,<:C f,...1 //1.,"';:..:,(;.,'-;-;.,.,' ',A,r.;Yd:,(";;::,"',.,""-;- before me~anuary 27 81 \ """"""""."",.:.."",."""....,..".,"""',.."""""..,..",..",...... :,ZlJ!~ld:;r;~;:",,' Filed: ' ....~~I:?~~!'-,~y...,2.,~..}~,~,1...........,'''''',....., Attorney: ,::J"F.,~I~Y..,....!J..:..W.E.i.G,t,t........,.. 1/<) EfJS! J</lJrr s7, 'Sttif'PErv5BuRrr, ('11.1'71..57 OATH OF PERSONAL REPRESENT~rtVE S':'"'2..-7S&~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 1 ss: ..................~.....9."..:v.,~...~t.........................."..................................................., petitioner(s) being duly .............I.Z!J/:?t!.<~...............:......, according to law do e.5....... depose and say that as the administra lr..I'f,-...,."" of the estate of ....fkw;.YI."E..:I/9!.:1..~(..~-",..,."."....."'.""...."...."'......,...."...,.",... ........................................................................................................................................................................................ deceased ........./JP...~.... 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 Inheritances, .........,..,......,',.,~"....,....., and subscribed before me, .............i!,~.I}~,~~y...n................ A, D., 19~.L.. .{fiJ~ll,~d.....m.... (I q' 0 , ',:"c.~~,<,.1}:r,",'l/a.f,~.~,._.J,.7JcC.c....,........L--- ............................................................................................ DECREE Be it remembered that on the .............~j,f.c;I:,.-.:,...... day of .....~' ... ....,.......... ....r.!?,P........ A. D., 19,i;U...... Letters of Administration in the eRtate of ....~..f..,v..W1:).. ... , ....~,"'............................................... ............................."......",...........,",..,',....,' ,.,.."",..,.,' late of .,f.)I.le.1th..,.. .1!.-4i{."!1....,T..i!.:f!.:.....".~ Cumberland County, PennRylvania, deceased, were granted to .....~....9:::...?)i:kY.1...~............... ........................................................................................................................................................................................ Witness my hand and official Real the day and year afore~~~1' 7 ,,JJ, J , . .............,~t21ur.j...t!:...,...../f!!.-<<::.f...:.......... r' fI 7H Register oil;.':: 21 -0 , NO, 75 . PE~I:ION, F?R LETTERS, ~ AD.,MINISTRA~I,~N ') To~~e':f'~f~~r."":"'!~~ m,f ",REf. ~:~;::;u:"\::f:f~~~C'~~:fy;:;;:f,~;;;:~c,,,,,::::":;~"f':::"::':::::~ ......................................................... '",,~'f""'. ,h..,: Y fh.' ....._.....~...r...."""'.'"'rg-.... 'd t f II. .,A, III..,.,-r.::. own,;hll (' \ \ I C' t' 8t't I' P ,1 was a reSI en 0 ..!.r.,l(/,w.:J......,r.:,(iMYt.!,((r.f................... . nm lei' ant ,oun l, ' ,I e 0 ennsy. orong , ,;, ,1 ~ vania, and a Citizen of United State,;, and departe thi,; life intestate in the County of ..~~.- ......................................., and State of ....,(?, , kU4................................................................................. ot~....,~............, the .......' , ,..' ..... ....' day of ........,~..............., A. D., 19$.0., at the age of .....'1.,'1.... years, , S':dt . ., " That the said ......~.....r.::....,v.()1(!...~,"~..~. decea,;ed, left ,;urviving the following named widow or husband, heirs and next to kin, to wit: " ," 'Name .....Ck0....9.:.."VGi!1,~....... ...~...~~...,V.cm..T...."'" ~..~~..fJ!CkJ:1",~,...."'.., Relation,;hip Residence ,. ~(), .':.....0,,,"'" ,..,"',..".)N.1A~..",,"',.. J!::.p..t!:.!...,,~~f'fr.1.<!.?zJ7 "",.,"""~.....~.?IJq,&C?"""",.,',.".,,.......~.'...........,."...,....". 1/ ,....,.,..,...~"',{'f!k.":!".!I1 /,~.2..,",....,.."..,.,"',.,.,...,......,......."'.:"'... ..............,...........,.."..........,',.................... ,...,."...,....,....""""",...,,..,.,.. ""....,.....,....",.......,.."....,...,...........,..,.,..., ..............,...,.......,...,....,.......,",.....,..,',.,.,., ...",....."".,.",.,........,",.....,'" "..",..".."..""".....,.......".,.,...".,....,.......... ....................,.",....,......,',..,"",......,..,',...., ...,....,.."""..........,""',.,...,',., "..",......".....,....,..,........,..,...,.,...,....,....".. ..............,.....,..."..."..,.....................".,.,... ,...",..",.,...."......,"',..,.,',.,.... ,..",...,...,."...""...,.......".........."............,.. .................,...............,..".......,."....,........,' ..",......."",..."......,..,',.....,"" ....,.....""....,..........,.,................,...,..."...,.. ..,.......,......,...................,.......,..,..."....,...., ..",..,.....",.....,.....,"",..,""',.. ,...,....,..",..,....."..,.,.,........,.........,....,.....,.. That those above named include all of the next of kin, ,;0 far as known, The said decedent was po,;sessed of personal property t'1 the estimated value of $.......G.Q't;Q:..Q'O'..... and of Real Estate, less incumbrance, to the e,;timated value of $..........7..QQ:C)......... as near as can be ascertained. Th.f \If. ",idf~f E,,"" ;. ~ f" .. ",,,.w" i. .",,,, ,,, ../J1<<th......ffY,J,....I"!j'".... .......,....~""t;;,..,/.,',..f.d-...~"""'."""'.."""'..""".."""""",..""",....""',..."....,,.,",.,"',..........',' "..,......... ,Therefore, your petitioner(s) respectfully app\~'(ies)" for LettHrs of Administration in the above named estate, Dated .............!..:..1.7....................., A, lJ., 1\1'6.../ Signature and Addre,;,; ~% of Petitioner (~) {lO-R ( st~~ ,f'tI.17ZS7 In - 0.. c., j -::7Ji&rYllD8~n3 . A>.~tJJ..:Y.(1rf"" .?",a:u:;w.., ...{!~l<J.].1J.'V ,.."",."""".""",.,.",...,',..,"":,.. .":,, t l\j',., tl"NVf' ....tB';.... ..",....,...... ,.,., ..... ............. ..... ............,.. ..t;.~rj '.(~l':j..:~i~......... . "t".:,i ii30~033~ ...........................................m..mm~... REv.,n le.78) COMMONWEA~ TH OF PENN5Y~VANIA OEPARTMENT OF REVENUE BUREAU OF FIE~O OPERATIOl15 APPLICATION FOR AND CONSENT TO TRANSFER SECURiTiES REGISTERED IN THE NAME OF A RESIDENT DECEDENT ~~~ ~~~ " DATE '\i,,, ,:,. - ~.,-.-.-,_...._._.~.- r? ~' ( APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE, Application is hereby made far consent 10 the trunsfer of the follo,,-;nlJ securities of u Pennsylvania Corporation or a Nationol Banking Association located in Pennsylvuniu, (a) 1 8hare (b) Coumonwe.a1th Na_~iQ..l!..~ll.an\t._n--,-'" ,.- ..n (cl.c_Owon _H,o_e~______-- (NOTE: In describing securities enter in (a), ab Ole, either the number 01 shures of stock or the face amount of registered bonds, in (b), the name of the issuing company and in (c) the closs of stod or the stoted interest rate and maturity date of registered bonds.) ISSUED ON Daeaaber 30, 1980 ,ond hoving a TOTAL MARKET VALUE OF L_~n.2Q.---. (0010) as of the date of deoth of the decedent, Donold F. Von SCt".<:'L~C. ___--, all. D!lClImbllr 5, 1980 (Name af Decedont) (Detc el death) who was late of R. D. ~1 ____-.!~.a.!18burg n.__._ _..__c.~II.~~~lld.__-_-.!'!L_- (Street and Number) {Post U.;',.....:! (County) (Stotc) The securities are registered as follows: Donald F. Von Seyoe. Jr. (Name or names in which certificates arc registered) __._...__..~__...__._._-_w.~_.._.-"-._.._---._.._--- Il1x ADMIN1STRA Teft) I!Xtt:t" m< ) Dorb J. Van Scyac . It. D. l1'n_Bh1pJl~b-"r~_P!.. 17~57____ (Address) NAME OF APPLICANT .n~J:~!.~~~.Il_~~Y~c:..._-- COUNT\' FILE NUMBER ,;( I 1\ / ,II f,' ADDRESS OF APPLICANT __R..:_D~__'~-,_Sh~!~~'bur8, Pa. 17257 BUREAU FILE NUMBER SIGNATURE OF APPLICANT .il~__(}..:-:.:.fl~~ NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLlCATIONph WILL NOT BE (J CONSIDERED COMPLETE AND WILL BE RETURN EO TO YOU FOR COMPLETION. (Name) COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE , CONSENT TO TRANSFER SECURITIES ~ DATEi'~\)\\ ,.:,z '0 I hereby consent to the transfer of the above securities noW registered in the name of the, aforesaid ....--.-.--.-------.--- .__.--~-_._.- .__.___..__.____m____...~ ..--....~-.--------- - -- I,:)g( Decedent and waive the filillg of a certificate certifying to the payment of the transfer inheritance tax to which the property of said Decedent is made subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521, os amended and the Act of June IS, 1961, P.L. 373, as amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transfer the herein described property operates only in reference to the estate of the above-named Decedent. ~'~~ (~..... , 1J',f.:' t\ . ~"tl!t{jjt l' )~j Signed for the Secreta~~,oJ Revenue B:="JJh.1f ~C-1,"C tLU:~:-J. ',' b-- {llj~ ,'--j' t r-(5' ",",.) ~ ,}Jf'r^ / '\ '- . ooQ 'I'\.. ".:J.tiflV:d,- tv.,,) Ji;1.~""'\''(-'--- ''f~~ F \ I) (Title) (Coun y . REV-517 (8-781 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT .~~~, 'r;)pJwJI~'\ APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Applicotion is hereby mode for coosent to the transfer of the following securities of 0 Pennsylvania Corporation or 0 Notional Bonking Association located in Pennsylvnnio: DATE__7~.1~~~1 (0) $29. ~ba~n Albirio"""Dnvealth..liat1onal....Bank ___.____ u.m___ (c) __COll\lllC)ll.___ m_______ (NOTE: In describing securities enter in (0), nb (Ne, either the number of shores of stock or the face all10unt of registered bonds, in (b), the nome of the issuing company and in (c) the closs of stock or the staled interest rote and maturity dote of registered bonds.) ISSUED ON 4-1-80 ,and having 0 TOTAL MARKET VALUE OF S_ $220.00 (Oata) os of the dote of death of the decedent, nonAld F VAn scy.Dc._Jr._____, on 12-5-80 (Noma of Decadent) (Dote of death) who was late of R. D. III (Streot and Number) Sh1ppenlburg. Cumberland Penlllly1van1a (Post Office) (Counly) (State) The securities ore registered os follows: DOIlll1d_ F. Vall Scyo~~d/oru~<:I..lIJl1:d.!,~__~8n S~Yo~. Jr. (Nome or nomos In which cartiflcatc~ arc registered) ADMINISTRAT~ ~~ ) Doria J. Van Scyoc, R. D. U1, Sh1ppansburs. Pa. 17257 Decedent and waive the filing of 0 certificate certifying to the payment of the transfe.r inhpritonce tax to which i I I I I I I I _'m___.. m_'__m._.~.___. ._, I COMMONWEALTH OF PENNSYL V ANIA- - DEPARTMEiTi-OFREVENU'E -- I CONSENT TO TRANSFER SECURITIES ~ ~ . DATE ~Wy 13: 19' ~ i I hereby consent to the transfer of the above securities now registered in the nome of the' farosbid I I I I I I I I (Nome) (Address) NAME OF APPLICANT .._llor1I_~:._"'-a~, Sayoc COUNTY FILE NUMBER d \- Y \ -- lS..... ADDRESS OF APPLICANT _._~~~:. #1. Sh1ppau.~~rg, Pa. 17257 BUREAU FILE NUMBER SIGNATURE OF APPLlCANT&l1&i:::J fl-I ~ ~A-C-- NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS AP~LICATION~~L. NOT BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. the property 01 said Decedent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521, os amended and the Act 01 June 15, 1961, P.L. 373, os amended. This is elsa in 'accordance with the provisions 01 the Act 01 April 9, 1929, P.L. 343. This Consent to Transfer the hcrein described property operates ollly in relerence to the estate 01 the above-named Decedent. Signed 101 the secretarY~OI ~evenu~ I v '1/ CVL C ' .' . I' : BY_._,LL._V"_-',Q.~. ' -:;;.~~. . '.' -', \ ISlgrU'O), t \J 1f:t-~ . (;1~~" A"h.i..~j! t,jJ1.,_(flJiY)l_'N0.W \ \. \ .....j^'=: ( (l1t}O) t (County) " \ I l COMMONWEAL TH OF P ENNSYL VANIA OEPARTMENT OF REVENUE BUREAU OF COUNTY COLl.ECTlOtlS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT APPLICATION (MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Appli~atian is hereby mode for censent to the transfer of the following sec'urilies of a Pennsylvania Ccrparatian or a Notional Bonking Association located in P..nTYlva~a: (a)r,~ h+- ~ (b)tk el" '''lh Ie.' -, /<1 ~ Jl,~j1)II'C' b.,,-",.L (c) C,'.'").. "" h-o 6{:, c,0......._ (NOTE: n escribing securities enler in (a), ab Ole, eilher the number of shares of stock or the face amount of registered bonds, in (b), Ihe nome of the issuing company and in (c) the closs of stock or the stated interest rote end maturity dote of registered bonds.) DATE N,':J :;7,::'1"//'/ ISSUED ON t/ - I-~ () ,and havin, a TOTAL MARKET VA-LUE OF S 2:2C1,::rCY (001.) , l) I l-l' r -r- as of the dote of death of the decedent, )),"', f I ,'......._"':>C' ~('C) ,) r, ,on ':2 - c;- - g-o , (Hame ~r Oecedonty C I (Date 1) ~1a~h) who was late of K'.) f/: ISh" "?'2\,'SJ]rll~ _i(-n)~_"r t-...,{ ) rr (Street and Number) (Post Office (County) ~I),,.~~ F VA-- (5101.) /' X'1'" C. ,) r. (I J(",o/::-r J t ~~." ., ~.I~IST.R~:r+la) CNCDff{)R ) The securities ore registered os follows:I0:I'''&/ r )j,,_ ~~'~1"--c.. -+ (Nome or names iJJwh;ch certificates ore registered) I J \', S 'J, l,.,- S"c"; c' c.... r:. )J. 4l J, 5 h; ~JvII5Jr},/ , IW/725"'2- (Nom.) V l (Add'....)) v' .:.- NAME OF APPLICANT _ .vi~ (",', J. ~.f,........ ~<.V' ('. C- COUNTY FILE NUMBER ,:;; J.- ,i?/ '-1~ADDRESS OF APPLICANT t)) -# /, C;,hir/'Jl:-'J15,b/., I.'i r9l1?'!:' 1 "I . '",1 (/ BUREAU FILE NUMBER SIGNA TUR E OF APPLICANT / c)- LJ e-:tl/A-, ,e> HOTlCE: IF YOU FAIL TO ~ROPERLY FILL IN ANY PORTIOH OF THIS APPLICATION, r WILt HOT BE CONSIDERED COMPLETE MID WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DAT I hereby consent to the transfer of the above securities now registered in the nome of tl Decedent and waive the filing of 0 certificate certifying to the payment of the transfer inheritance tax to which the properly of said Decedent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L.521, a.amended and the Acl of June 1S, 1961, P.L. 373, os amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transler the herein described properly operales only in reference to the "Slate of the above.nomed Decedent. ~'~ ~.n~"",,?) ~'Jr1';:-,'i:rt'A .r ^",-",\~"",~" HI'''''~.'''''~j:;.. ""'~. REV.1500 EX T (1)-81) . BUREAU OF EXAMINATION PENNSYLVANIA OEPARTMENT OF REVENUE P.O. BOX B3:1.7 HARRISBURG, PA 17105 11-1"13 -'-I INHERITANCE TAX RETURN RESIOENT DECEDENT FlloNumbcr ol j, 't/,0075 Docodont's Addre" R.D.i/./ Shi -pU\sbl.l.r~, PA 1'~'5? 2, Sup pia mantel ROlurn 0 3, Romoindor Return 0 4, Lifo Estata 0 5, Fodorol Estato Tax 0 ROlurn Roquirad. 6. Docedont diad testata D 7. Decodont maintained a living 0 8. Number of sofe deposit 0 (Attach copy of Will) trust (Attach copy of trust! box as inventoried All corrospondence and confidentiel tex informalion should ba directed to: Computation of Tax 15. Amount of lino 14 taxeble at 6% rate (151 I), 05~ linclude values from Schadule K) 16, Amount of line 14 taxable at 15% rate (16) linclude velues from Schedule K) 17, Principal tex due(edd tex from line 15 plustax from lina 161 18. Total Prior payments: (a) Amount Paid (bl Plus Discount (c) Minus Interest (18) 19, 8elanco Due Wna 17 minus lina 18) Maka Check Peyable to: Ragister of Wills, Agent ... PLEASE RECHECK MATH'" CHECK APPRO. PRIATE BLOCKS CORnE. SPONOENT Ne e Racapitulation 1. Real Estate (Schedulo Al (11 2. Slocks and Bonds ISchedule BI I 2) 3. Closely Hald Stuck/Partnership Interest (Schedule CI ( 31 4, Mortgages and Notes (Schedule 01 ( 41 5, Cash & Miscellaneou, Personal Property (Schedulo EI I 51 RECAPIT. 6, Jointlv Owned Property ISchedule FI ( 61 ULATION 7, Transfers ISchedule GI ( 71 8. Total Gross Assets (total lines 1-71 AND 9. Funeral Expensos Administrativo Costs/Miscellaneous Expenses (Schadule HI ( 91 TAX 10. Debts/Mortgages/Liens ISchedulen (101 11, Total Deductions Itotellines 9 & 10) 12. Net Velue of Estate !line 8 minus line III CALCD. 13, Charitable Bequests (Schedule J) LATION 14, Net Value subject to tax Wne 12 minus line 131 City State Zi 3,5"Clll.OD (P,'l'6lf,1!P ;;),.:10.00 ( 8) I D)10ar.1 \D (111 (12) (13) (14) 5, ~ Lf'l. q~ #'1, () 5'+.1 S,O'5Y."'1~ x.06= ~03,~'1 x.15= (171 3D3,,;).'1 (191 Under panalties of perjury,l daclera that I have examined this roturn, including accompanying schedules and stetaments, end to tha best of my knowladgo and bolief, it i, true, co ct, and completo. Declaration of proparer other than tho personal representative is based on all information of which preparer hos 'any knowledge. TIVE(SI SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE AOORESS OATE AOORESS DATE REV..449 EXt (9-60) COMMONWEAL TH OF PENNS~ L VANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT STATEMENT OF FIDUCIARY (Instructions on Reverse Sid:J) *'~" c' , ,1;," - Estate of Donald F. Van Scyoc, Jr. Dote of Death December J, 1980 Lost Address R. D. III Shippensburg, Pa. 17257 Social Security No. 204-30-8459 State File No. County File No. ."1/- xj - 7..1) (CITYI (STATE) (ZIP) 1. Decedent died: ( x) Intestote (without 0 will) ( ) Testote (Ieoving 0 lost will--copy DttDched) 2. Is the filing of 0 Federal Estate Tax Return required for this estote? Yes_ No X 3. ) Executor ( X) AdministrotllR rix Nome Doris J. Van Scyoc Sociol Security No. (STATE) (ZIP) ." 0:3 ~:?f~: N ;o~ ", '71C") ~~,; -,., l.,~o '/,;::J ..., -' "J ,.. :1"0-; .,.' I'':'.' .-;)\ - ". Address R. D. 1/1 Shippensburg (CITY) Pa. 17257 4, All correspondence should be moiled to (X ) Attorney Fiduci cry. 5. If on attorney is representing the estate, indicate: Name Jerry A. Weigle Telephone No, 717- 532-7388 Address 115 East King Street Shippensburg, Pennsylvania 17257 (CITV) (STATE) (ZIP) List 011 safe deposit boxes registered in the decedent's individual namel Dr jointly with, or os an agent or deputy of another, or in decedent's individual name with right of access by onotner os agent or deputy. Include the nome and address of the bonk or other institution where the safe deposit box is located, the name (5) in "N~ich the box Is registered and the relationship of the joint holders to the decedent. NAME AND ADDRESS OF BANK DR OTHER INSTITUTION IN WHICH DECEDENT MAINTAINED A SAFE DEPOSl1' BOX NAME OR NAMES IN WHICH SAFE DEPOSIT BOX IS REGISTERED RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Under penalties of perjury, I declare that I hove examined this return, including accompanying schedules cnd statements, and to the best of my knowledge and belief it is true, correct and complete. [) h'<J ~J / II J Jc>.. I DAT~ .rH::V..4~O'I'.1I0' COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF RE"ENU E TRANSFER INHERIT ANCE TAX RESIDENT DECEOENT SCHEDULE "A" REAL PROPERTY (Instructions on Reverse Side) ESTATE OF ~nald!'~.~.van Scyo.c, .,:r.r-'__._____.._._~__ ~ . DEPARTMENT ESTIMATED ITEM DESCRIPTION MARKET VALUATION HO, VALUE (OFFICIAL USE OHLY) Situate in North Newton Township, Cumberland County, Pennsylvania. More fully described in Cumberland County Deed Book S28, Page 674. $3,500.00 TOTAL THIS PAGE $3,500.00 , I I I , I I I I I I i i I QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two yems of death, make any transfer of any material part of his estate without receiying valuable and adequate consideration? (Answer "Yes" or "No" ,) No 2, Djd decedent, within two years of death, transfer property from himself/ herseif to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No",) .!i9....- 3. If the answer to one or two aboye is "Yes" and the transfers are claimed to be nontaxable, proYide the following information: a. Age of decedent at time of transfer. b. Copy of death certificate. c. Affidavjt by the allendjng physjcian 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 property without receiYing a yaluable or adequate consideration therefor whjch was to take effect in possession or enjoyment at or after hjs/her death? (Answer "Yes" or "No".) No 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. Di~ decedent in hjs/her lifetime make any transfer without receiYing a valuable and adequate consideration therefor under whjch transferor expressly or impliedly reseryes 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".) No 6. If the answer to five b. above is "Yes," was the right reserved in decedent alone ( ) or decedent and 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 reseryed power to alter, amend, or reyoke, 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 decedi'mt and others ( ). REV.453 EX+ (3.00) COMMONWEALTH DF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES *' (Instructions un RevNse Side) Estate of DOIl.1ld F. Vall Scyac, Jr. - SURVIVED DATE OF BENEFICIARIES ANO ADDRESSES RELATIONSHIP DECEOENT BIHTH INTEREST OF BENEFICIARY - .,.. -- Doris J. Van Scvac 1.1,1 c, R. D. III Shippellsburg, Pa. 1'1257 - - --_.-- -.--- -- ,- ------ . -----. -.--- -----.--.--.--.------ , , I The above beneficiaries are living at this time except for the following: NAME OATE OF DEATH REV.'" EX+ (3.801 COMMONW~AL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT (Instructions on Reverse Side) * SCHEDULE "E" JOINTLY OWNED PROPERTY Estate of Donald F. Van Scyoc, Jr. P TOTAL E VALUE OF DEPARTMENT ITEM R NO. DESCRIPTION MARKET 'i DECEDENT'S VALUATION VALUE N INTEREST (Official Use Onlv) T v 8 Shares Commonwealth National Bank, held jointly with Donald F. Van Scyoc, Sr., common @ $27.50 $220.00 ! . TOTAL THIS PAGE $220.00 I I ~ i>: -< i-tl i-tl ~ :>- :>- ~ z 0 ~ '" ::> ..l <( ~ z u I ~ 0 ~ ~ ~ ~ 0 ! ~ i>: ~ ~ 0 I-< 0 lJl 0 Z 0 lJl Vl :>- I-< 0 ~ "-l "-l Z Z I-< I-< "-l Z ..l ci - 0 -< i>: Z ~ ~ ;;; CI r...l ..l Z Z I-< ::> U l? Z - Cl lJl ~ 0 0 -< a: <( r...l U Cl "" :J 'lSaJalU! s,luapaoap aLll}O anle^ la~JeW aLll aleo!pul '17 'lSaJalU! s,luapaoap aLll}O a6elUaOJad aLll aleolPul 'f: 'AlJadoJd paUMO AllU!O! aLll}O anle^ la~JeW lelol aLll aleo!pul '2: 'paLlS!lqelsa seM d!L1sJauMo lUlo! aLll alep aLll pue (S) JaUMO.OO aLll}O luapaoap aLll Ol d!L1suOnelaJ pue SsaJppe 'aweu aql apnloul '"S" alnpaLlos JO} suollonJlSU! aLll U! paleo!pul se A;JadoJd leUOsJad lie aq!JOSaa ',,'</.. alnpaLlos JO} SUO!lOnJlSU! aql U! paleO!pU! se AlJadoJd leaJ lie aqiJosaa 'L 'lSJI} alelsa leaJ lS!1 'papnloul aq Ol aJe AlJadoJd alq!6uelU! pue a\q!6uel L1l0S 'dlLlSJO^!^JnS}O lli6iJ lil!M slueUallU!o! se sa!;Jed JO Aued, Jaliloue lil!M AllU!O! luapaoap alil Aq pauMo 'leuosJad pue !eaJ 'A;JadoJd lie apnlou! lsnw "3,, alnpalios ,,3,, 31na3HOS ONI.L31dlilJOO l:lO:l SNOllOnl:llSNI , . GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death arc deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items arc claimable including the cast of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial/at, tombstone or grave marker and other related burial expenses. All debts being claimed against an estate ore subject to the opprova/ 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 may be claimed by 0 spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or il tlte spouse Itas forfeited his/her rights, then any child of the decedent who is 0 member of the Some household con claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who ore 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. NOTE: Compensation paid to an estate representative; namely, an executor or administrator, for services performed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income item should be reported on form PA.4D.lndividuallncome Tax Return. c '" 0 n ~ tTj ~ :!l ;,> 0 0 '" Z C) n c:: tl ;! Z s: Z l""' trl t"1 '" Z :;::l 9 Z 9 l""' Z Z trl -l t"1 ...., 9 0 -l -< Vl tTj - rn Z 0 rn 0 -l 9 'Tl '"rl :;::l ~ - 0 Z "- :':1._ , \C " .. ., c.~. i,':.;' CL ' \;'.:. 21 l.W '.;"L.: c:U' u.. t!:. 00 ~r._...- -< -< '-'u.' fj~ tTj trl ~'" N ~ > ~ u ::<l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family 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 dote 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. IF ADDITIONAL SPACE IS NECESSARY USE B%" x 11" SHEETS. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55: Do~i" J. V a.n_~cyoc , ---".--...----...-...--..---.. being duly __,__.~WQrll-- ,__ according to law, deposes and says that she ..2:.s...t:!le,...._.._,_.., _.Ajm.J'l.i..!!,t,!:.a,t,rJ.x, 01 the Estate of .Dona1d..!'. Vl)ll__S,c.y.oc,...Jr..______ late of North iVeJiJ:Q~sl<J.-p ...-, Cumberland County, Pa., dec.ased and that the within is an inventory mad. by.. ,_her....--.-,-- -- --,..-....,..-, the said AdmiJ).!st(9,tLilL- of the entire estate of said decedent, consisting of all the persona; propdrly and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figur.s opposite each item of the Inventory repr.sent it's fair value as of the date of decedent's death, dl,IdU4J ~ ."rd,/~ //-r~ d"1 J.!J..J.(.L'~"'r-_19!J.~ II I / I 7 , , I . 'I. . U.. ~ and subscribed before me, ./J.?.1ML ~-;-u~ J ~~ -_:________ ~~xec:utor . Ad~J::---==- Doris J. Van Scyoc . ._-_...---~,_.--_..._---_._.._._--_._.- _._-----~-_._--- S!:i.ley A. ~ilrburg!!r, Notilrv Public Snippen~bul~, rA Clli'li~ui~nd C"unlY My Commiuion Expires Dc,cmbcr 17. 1982 -----..----. ..-.--------------------------.----- R. D. #1, Shippensburg, Pa. 17257 Address Date of Death .___.,_ __...... ._+_n__" _. __,.. .-..--+---.-- 5 _, _,_, December______,___J9.a.O_________ Month Yur O.v INSTRUCTIONS I. An inventory must be filed within three months after appointmeni of personal represer....aHve. 2. A supplement inventory must be filed within thirty days of discovery of additional assets, 3 ' Additional sh_eets may be attach.d as to personalty or realty 4;- See A;licle IY,: Fiduciaries Act of 1949. -'- ~ ' " c. . \0 ~- ~. C" :- .,~ W', CL ";;_J 01- '~;Il: c::.U"j t:: ,~tj 0(;:; u"" ~a:: N l::;='--; ~ :jC:-; w P- .... -" ... Ul \ ,.., " -ci >- ~ ~ I- W .' 0 ~ ~ ~ "" I- wi Eo< ~ w <( ~i ~ >.. "- I- " v 0 0 VI tJ' 0 ~ I w "" UJ tI':l' .., 0 IJi l- I "- "I :> I, Z I- -' U. '" ~ 1 u. -' <( 0 '" z "- Ii w 0 <( UJ :> ,;. > Z "" -" II .; .., - Z 0 ...' c , Ii 0 .' 0 0 I' VI Z 0 0 "" "", Z U z 'I UJ <( '" "- ro: "tI II '" c ~ " 0, - -;: II 0 0 ~ -" ii ~ E - ~ 0 -' U ~ '" ~ "- ,. ~ c . o :l: <( ... -0 -"! u: -" o o '" INFORMATION This document is the Notice required to be given under Section 709 of the Inheritance and Estate Tax Act of 1961 (72 P,S, section 2485), If the tax is paid within three (3) months after the decedent's death, a discount of 5% of the lax paid is allowed. Inheritance Tax becomes delinquent nine (9) months after the decedent's death. Interest is charged at the rate of six (6) percent per annum on the amount of unpaid tax. (SEE EXAMPLE BELOW) EXAMPLE: If a balance of tax due of $2.000.00 is in a delinquent status from 3-3-80. and payment is made on 5-23-80. the interest is calculated as indicated below: STEP 1 Determine the rate of interest from the table below, STEP 2 Multiply the balance of tax due by the rate of interest. STEP 3 Add the interest to the balance of tax due, Interest from 3-03-80 to 5-23-80 Results in: 2 Months = 20 Days = Rate of interest = ,010 + .00335 ,01335 Balance of tax due Rate of interest INTEREST $2,000,00 x ,01335 $ 26,70 8a1ance of tax due $2,000,00 Plus Interest to Date of Payment (+) $ 26,70 TOTAL tax and interest to Date of Payment $2.026,70 --------------------------------------------------------------------- 1 month ,005 4 months ,020 7 months ,035 10 months ,050 2 months ,010 5 months ,025 8 months ,040 , 1 months ,055 3 months ,015 6 months ,030 9 months ,045 , 2 months ,060 1 day .00017 11 days ,00186 21 days ,00352 2 days ,00034 12 days ,00203 22 days ,00369 3 days ,00051 13 days ,00220 23 days ,00386 4 days ,00068 1 4 days ,00237 24 days ,00403 5 days ,00085 1 5 days ,00250 25 days ,00420 5 days ,00101 1 6 days ,00267 26 days .00437 7 days ,00118 1 7 days ,00284 27 days ,00454 8 days ,00135 18 days ,00301 28 days ,00471 9 days ,00152 19 days ,00318 29 days ,00488 1 0 days .00169 20 days ,00335 30 days .00500 -----------------------------------------------------------~--------- Any party in interest, including the Commonwealth and the personal representative, not satisfied with the appraisement and assessment may object within sixty (60l days after receipt of thiS Notice as provided by Sect,on 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. sec. 2485 - 1001), MAKE CHECK OR MONEY ORDER PAYA8LE TO: "REGISTER OF WILLS, AGENT" DETACH THE TOP PORTION OF THIS FORM AND SU8MIT WITH YOUR PAYMENT TO THE REGISTER OF WILLS FOR THE COUNTY SHOWN ON THE REVERSE. SEE THE INHERITANCE TAX INSTRUCTION 800K reR ADDRESS. I LAW OFFICES OF JOEL R. ZULLINGER HAMILTON C. DAVIS A PROFESSIONAL CORPORATION 310 CHAM8ERS8URG TRUST BLOG, CHAM8ERS8URG,PA17201 (717) 264.6029 (717) 532-7570 FAX: (717) 264-1884 75 EAST KING ST, P,O, BOX 375 SHIPPENS8URG, PA 17257 (717) 532-5713 FAX: (717) 530-5222 10 BIG SPRING AVE, P,O, BOX 6 NEWVILLE, PA 17241 (717) 776-7663 Dear Ms. Lewis: January 18, 1995 Mary Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Donald F. VanScyoc, Jr., Estate No. 21-81-75 I enclose with this letter a check from my trust account in the amount of $5,000.00, representing a payment toward possible inheritance tax liability in the above referenced estate. This sum was escrowed from a real estate transaction and the executor and the executor's attorney have refused or failed or neglected to file any supplemental return or make appropriate payment. Please transmit the receipt to my Shippensburg office. Thank you very much. Sincerely yours, ~tk /~ Hamilton C. Davis For JOEL R. ZULLINGER A Professional HAMILTON C. DAVIS corpo~ion . :0 3 Ql \D :0 eo "'~. Ul CD (1 0"' <00 ~~ ,"; Co- i::5'o.. ~ S-9~ . ,..:. ~') I:J , '::~:' HCD/las Encl. cc: Sally J. Winder, Attorney Joel R. Zullinger, Esquire ~ ": - \0 ().' -, ..:..... (~ o "Oc: )>;:J. o w -0 ..::': ~'r; 0)0 ~.