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RCC-I0313-731
COMMONWEAL TH OF PENNSYL VANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX OIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
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COUNTY OF Cumberland
This return must bo completed In dotal I and filed In duplicato, with the Roglstor of Wills In tho County whore the docodent roslded within nine
months after dolo of doath, unloss an extonsion is grantod by tho Socrotory of Rovonue.
Will
Admn. No,
19_ I,
FRANCES M. SMT1H
III' 924 Gobin St.. Carl isle. PA 17013
lAODRE5S1
Mise,
being duly swurn nccmdillg to In"" dClltJSes and says that he is the
(NAME)
Lega tee
(EXEC., ADM.. LEGATEE. ETC.)
I II Ie (If_No.r.tlL11ickllctQIL.IOll'llShip-,
lCITY, BOROIJGH, OR TOWNSHIP)
deceased, and that the whole of the eslale or solid dccedent, who died nil __._. Octol~er _~3,~1~~L_.__._~__,._._.._,._~____
IDATEl
consisted of the USSels listed helllw Hill! thai nllowahle dehls and deductions eXl.:cedcd the ['air mnrket value of Ihe assets .llld
of thc eslulc of
EMLJ'.__S~JI1U,______
no Pennsylvania Trunsfer Inheritance Tax is due.
v' ~.z<t'-"..2lk~~?~~'L_L~gatee
F '1ISIG.t'lA.TU.,RE) (TlTLEl
'ranees l'. :->ml tl1
Typo of sset:
Real Estate, Pers.
Property, Jointly
Held Prop, or
Transfers
1. Personal
Property
2. Personal
Property
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ASSETS
(Atloch odditiono~1f necossory)
Doscrlption of Asset
Estimated
Market
Value
Deportment
Valuation
CAUTION
(00 not writo
in this spaco)
Gerald E. Conrad - Balance due on
Agreement of Sale
1977 Oldsmobile 98, Regency, 4-door Sedan,
NO. 3E69K7E144767
1,173.98
2,900.no
TOTALS
4,073.98
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REPORT OF INHERITANCE TAX APPRAISER
J, the undersigned duly appointcd Inheritance Tax Appraiser in amI for thc above Coullty do respcctfully report Ihall have
appraised the real and personal properly as reported in the foregoing schedule at the values set fOrlh oppusitc each itcm in
the last column 10 lhe righl. ~'.&-'u.,. ./ ';/f'/." ;, 0 J( 1. )
Dated: Ma:r{!h 1:>, '9R1 (INHERITANCI:: TAX APPRAISERI
Nome of Poyec OEBTS ANO OEOUCTIONS Amount Amount ApploYlld
Nature of Claim Claimed by Roglstor
1. Hoffman-Roth FlU1eral
Home FlIDeral Bill 2,302.10
2. Westminster Cemetery,
Inc. Cemetery Lot 400,00
3. Dauphin Deposit Bank &
Trust Company Automohile Loan 1,000.00
4. , Frances ~l. Smith Family Exemption 2,00n,Oo
TOTALS
5,702.10
51()/)./1J
REPORT OF THE REGISTER OF WILLS
I, (hc undersigned duly elected Register fll' Wills in and for Ihe .Ibu"e Cnunly,do respectfully =-crHlrt that I have allowcd
deductions in the amoun's set furth in lhe ahovc schedule as c1uimed, excelll where I have sl~l fonh :1 grealt'r fir lesser amount
in the last cn1umn to Ihcriglll. which grel.I1er ur le!o.ser amuUnl rcprl'senl!o. Ihe sum allnwcd as a dcductinn..
Dale nf Apprnval, q7~ /ldJ / a, J tJ f / - ?}?luz (j, 'YLUU/
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COMMONWEALTlI OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU QF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*'
TO:
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DATE , I / .1 "I I ,_ I '~
, ,of .Ii - n " ,/7
ESTATE I, I .
.. ,
FILE NO, .,J", 1- " I II )
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COUNTY '~ ( ':'1/ ":-(Jlo4 , --
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DATE OF DEATH , ",t" //"./:A./,
COUNTY FILE NO:
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Appraised Value of Estate:
Real Estate
$ .--....--'--
Personal Property
+ ./i I. /j ~ ~<(>.
1 '
Jointly Held Property ITransfers
+ -.--.-.--"---
Total Gross Estate
$ .,/ / ,I;'~. .i f"
Total Approved Deductions
- ,OJ ?>);; /l)
Clear Value of Estate
$ ..------
Less: A?proved Charitable Exemptions
Clear Value of Estate Subject to Tax
$
Amount Taxable @ 6% Rate
$
I e:t /'i /~
tax'doo',-""",lc-<:-1' . ,>? ,,).It './
T -
Amount Taxable @ 15% Rate
tax due
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TOTAL PENNSYLVANIA INHERITANcq~X;l?~...f~i'{"> I i ~!, J:l::;V
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* * .... .... .... .... A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
+
$
$
=
$
+
=
+
=
Interest accrues at the rate of six (6) percent per Bnnum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by is _
BALANCE OF PENNSYLVANIA INHERITANCE TAX'DY~"/.J.'H$, .j /,;t
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Assessed by: / /' /i .1' .'/ / ...,-:'
Agen' for th.-Commonwulth v / ~. '.
See Informellol'l on Revorse Side f :-'
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