HomeMy WebLinkAbout81-00208
No, 21-81
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
2()8
In the Estate of
Russell M. IDng
, deceased.
To Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania.
Petltioner(s)=iil'(are) the execut ors
named in the Last Will and Testament of
Russell M. IDnq, dated Novenber 16, 1978
Decedent was a citizen of the United States and a resident of Southampton
Township (~, Cumberland County, Commonwealth of Pennsylvania,
Decedent died on _ Friday
the. 20th day of March
A.D, 19~, In the
County of Cumberlarrl , State of penna. at the age of ~ years.
Decedentlms: (has not) been married an~(has not) had children born to him (_ since the ex-
ecution of the above described Will. estil]1ated
Decedent was possessed of personal property to the!\talue of $ 90,000.00
estimated
and of real estate to the/vaiue of $ 30,000.00
as near as can be ascertained; said real estate situated as follows : tract of lard with buildings
erected thereon, situate in Southampton Township, Cumberland County, pennsylvania
There/ore, your petitioner(s) respectfully apply(ias1 for the probate of the said Last Will and Testa-
ment and for Letters Testamentary theron.
Dated mClll.. 25, 1981
The First National Bank of ShipP<;!nsburq,
now ffiE'Xg.,a into cc;mronwealth National Bank
Name and address 1 West Kinq St., ShiP~sburg, Perma. 17257
of Petltioner(s) ;/,; /,;,' 7///","" I--
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By: ' Leslie W. Brant - Trust Manager
AND
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND j
John E.. Lam, Jr. and Leslie W. Brant. Trust Manager. The First N"t ion" 1 Ri'lnk of
Shlppensburg, now merged into Ccmnonwealth National Bank
named in above application, being duly ><worn according to law say(s) that the
statements set forth in this petition are true to the best of their knowledge and belief,
:r
Jo
ss
17070
SI\ern
and subscribed before
Filed:
March 30, 1981
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Attorney
Robert J. Yocum
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OATH 01' I'ERSONAL Rlil'RESENTATlVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMOERLAND
Before mc, thc Register for the Probute of Wills and granting of Letters of Administration in and for thc County of
Cumbcrland, personally cume John E. Lam, Jr. and Leslie W. Brant, Trust Manaaer. The First National
Bank of Shippensburg, now merged into Cannon"""alth National Bank,
who. bcing duly sworn , do dcpose and say that as Executors
of the last Will and Testament af
Russell M. Lonq,
deceased
they will well and truly administcr the goods and chattels, rights and credits of said deccased according to law, And
also will diligently comply with the provisions af the law relating to Transfcr InhcrilJlnces.
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Be it remembered that on the__ 30,~day of
DECREE
March
81
,A,D.,19_, there was probated and
recorded the last Will and Testament of
Russell M. Long
late of
Southampton Township
, Cumberland County, Pennsylvania,
. . . .
0f1
Commonwealth National Bank of
ShJ.ppensburg
!JJfl~ &. ~~4~ ,
RegIster
Deccased. Lctters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
Rcc.n (9-lJAI
COMMONWEAL TIi OF PENNSYL V Atll A
DEPARTMENT OF rlE'IENUE
BUREAU OF COUNTY COLLECTIONS
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:
Application is hereby made lor consent to the transfer 01 the fallowing securities 01 a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
'--'-OATE?l2l/.lt; /111
(a) 1400 shm:es (b) SlID oil Ccrrnll:! _ (c) Ca",on
(NOTE: In describing securities enter in (a), ab O'e, either the number 01 shares 01 stack or the face amount 01
registered bands, in (b), the nome of the issuing company and in (c) the class 01 stack or the stated interest rate
and maturity date of registered bonds.)
700 Uh.'l.',J\ID€ 20, '80
ISSUED ON 'MO sm.-.r"n. 30, '7;jand having a TOTAL MARKET VA>LUE OF $ 55,J5CJ.OO
(Data)
as 01 the date 01 death 01 the decedent, Fllssdl ;'1. long
(Noma of Oocodent)
on ~~>rch 20, 1981
,
(Doto of doath)
H. D. 2
who was late af__
(Street end Number)
Shi.ry~~nsLut-g ,
Ccld:c!r1and, Pemsy1va'1ia.
(County) (State)
(Post Office)
The securities are registered os follows:
Hussell M. Loll'J
(Name or nomIJs In which certlflcatos ore registered)
co- ~~6~:rool~lnor....r,"a1~~~~tiond1 lank, 1 "(O;j- i:in9C:~~!:~~i~'s:k:"~~;~.
NAME OF APPLICANT Est.atEl of RIl"""" r.l Trong
COUNTY FILE NUMBER 21-Bl-208 ADDRESS OF APPLICANT 1 H. !<inq St.. Shipt:eJl~ I'll
BUREAU FILE NUMBER SIGNATURE OF APPLICANT >1~dc:/:?/-"rI-
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS i~PLICrt1'~;~ff'Wlff. NOT BE
CONSIOERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE ~
CONSENT TO TRANSFER SECURITIES '-' ' C/t/I
DATE /0,
I hereby consent to the transler 01 the above securities now registered in the nome 01 the of re Id
Decedent and waive the filing 01 a certilicate certilying to the payment 01 the transler inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act 01 June 20, 1919, P.L. 521,
as amended and the Act of June 15, 1961, P.L. 373, as amended. This is also in accordance with the provisions
01 the Act 01 April 9, 1929, P.L. 343.
This Consent to Transfer the herein described property operates only in relerence 10 the estate 01 the
nbave.named Decedent.
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Signed lor he Secretary af,R. ev~ '
L--/) ,() ,j
By _' , :u-u/
~;2'v tltU~
~ (County)
nEV'"4~O 11'"dOI
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDUL E "A"
REAL PROPERTY
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(Instructions an Reverse Side)
EST ATE OF --Buss~~~~-.!-,OT!g~,_
ITEM
NO.
DESCRIPTION
ESTIMA TED
MARKET
VALUE
DEPARTMENT
VALUATION
(OFFICIAL USE
ONLY)
1. Property si tuate and knovm as R. D. #2, Southampton
Township, Cumberland County. Pennsylvania, being a
three bedroom ranch style, aluminum sided residence
with attached two car garage. Recorded in Cumberland
County Record Book E, Volume 26, Page 816, Dated 7-24-75;
sold at public sale
45,100.00
TOTAL THIS PAGE 45,100.00
';r.if"'1 Iff. H
,4
1'lt:y.&4~1 l:!Xt H~-80'
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT OECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
(Instruct;ons on RC.lVcrsc S;dc.')
Estate of
Russell M. Lon9
ITEM
NO.
DESCRIPTION
UNIT
VALUE
19. Refund from Capital Blue Cross
20. Refund from Internal Revenue Service of 1980
Individual Income Tax
TOTAL
ESTIMA TED
MARKET
VALUE
17.30
13.00
162,696.24
If additional space is necessary, use 8\," X 11" sheets.
DEPARTMENT
VALUATION
{OFFICIAL USe ONL Y/
/("l. 69~.24
,
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U,S. Treasury Series E Bonds (Continued)
50 Bond dated April, 1947
50 Bond dated flay, 1947
50 Bond dated June, 1947
50 Bond dated July, 1947
50 Bond da ted Augus t, 1947
50 Bond dated September, 1947
50 Bond dated October, 1947
50 Bond dated November, 1947
50 Bond dated December, 1947
50 Bond dated January, 194B
50 Bond dated February, 194B
50 Bond dated March, 1948
50 Bond dated April, 1948
50 Bond dated May, 1948
50 Bond dated May, 194B
50 Bond dated June, 1948
50 Bond dated July, 1948
50 Bond dated August, 1948'
50 Bond dated September, 1948
50 Bond dated October, 1948
50 Bond dated November, 1948
50 Bond dated December, 1948
50 Bond dated January, 1949
50 Bond dated February, 1949
50 Bond dated March, 1949
50 Bond dated April, 1949
50 Bond dated May, 1949
50 Bond dated June, 1949
50 Bond dated July, 1949
50 Bond dated August, 1949
50 Bond dated August, 1949
50 Bond dated September, 1949
50 Bond dated October, 1949
50 Bond:dated November, 1949
50 Bond dated December, 1949
50 Bond dated January, 1950
50 Bond dated February, 1950
50 Bond dated March, 1950
50 Bond dated April, 1950
50 Bond dated April, 1950
50 Bond dated May, 1950
50 Bond dated June, 1950
50 Bond dated July, 1950
50 Bond dated AU9ust, 1950
50 Bond dated September, 1950
50 Bond dated October, 1950
50 Bond dated November, 1950
50 Bond dated November, 1950
50 Bond dated December, 1950
50 Bond dated January, 1951
50 Bond dated February, 1951
50 Bond dated March, 1951
50 Bond dated April, 1951
50 Bond dated May, 1951
50 Bond dated June, 1951
50 Bond dated July, 1951
50 Bond dated August, 1951
50 Bond dated September, 1951
145.72
145.72
148.06
148.06
148.06
148.06
143.40
143.40
145.68
145.68
145.68
145.68
141.10
141.10
141. 10
143.40
143.40
143.40
143.40
138.88
138.88
141. 14
141.14
141. 14
141. 14
136.68
136.68
142.46
142.46
142.46
142.46
142.46
137.96
137.96
139.72
139.72
139.72
139.72
135.32
135.32
135.32
137 . 18
137,18
137.18
137.18
132.86
132.86
132.86
134.84
134.84
134.84
134.84
130.60
130.60
132.52
132.52
132.52
132.52
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Commonwealth /.
National Bank />.. .' ~
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Mr. Allen Rhinehart
Peoples National Dank
Shippensburg, Pennsylvania 17257
He, The Commonwealth National Bank, as the Executor/Administrator of the Estate of
Russell fl. Lonq , a }'esident of R n #? ~hirp'pn<h"r~ P. ,
Social Security # 163-09-3855 ,request the below information as of the decedent's date
of death, I~arch 20. 1981
Your cOrlpletion of the 'followin9 report will be sincerely appreciated. IF THE ANSHER
TO ANY lTEI1 IS "NOUE," PLEASE SO STATE. Kindly mail it in the enclosed stamped, addressed
envelope. Thank you. ' .) (.'" /7
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THE Cm'\I'10NHEAL TH NATlOI~AL 'BANK
SHIPPENSBURG OFFICE - Leslie W. 8rant
Trus t Offi cer
NOTE - If the space provided is inadequate,
please attach a statement giving full detail?
in the format given below.
.
Report from ^ . -;" /. /
7fv. ;:':':'</''.I:'''!: /.I.>l..T',/lo., " . :-:-.::t.-'- 't..-
(B k) ~.. . ~.- .,-""
an ,)1-\.:(." :?1:<: /. (,,:0. /--"1'\.;- I /rO',;:.',
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1. At the close of business on /lih/(! J{J 19,r/ our records showed the
follO'.~ing balance(s) to the credit of the above-named decedent. In the event that we could
readily ascertain "Ihether there vlere any balance~. to the credit of the customer not desig-
nated in this request, the appropriate information is given below. '"
Registered Owner(s)
Account Humber Type of Account And Date
Account ~stablished
Accrued *Interest Taxable
Amount Interest On Decedent's
Fi na 1 Retu rn
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*The amount of interest paid to the decedent or credited to the account from January 1 to
(and including) date of death. The amollnt Rccrued at date of death would not be included
in this figure.
The Commonweallh N"lional Bank, 10 Soulh Market Square. Hauisburg, POl. 17\08 (7171564.9500
Commonwealth
National Bank
Mr. Robert Crouse
Commonwealth National Bank
Shippensburg Office
Shippensburg, Pennsylvania 17257
We, The Commonwealth National Bank, as the Executor/Administrator of the. Estate of
Russell M. Long , a resident of R.D. 2, Shippensburg, PA 17257 ,
Social Security # 163-09-3855 ,request the below information as of the decedent's date
of death, March 20, 1981
Your completion of the following report will be sincerely appreciated. IF THE ANSI,[ER
TO ANY ITEM IS "NOtlE," PLEASE SO STATE. Kindly mail it. in the enclosed stamped, addressed
envelope. Thank you. , .'. '. . /,/ ~
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THE COt'1r.lONI,JEAL TH NATIONAL BANK
Report from
Commonwealth National Bank
(Bank)
NOTE - If the space provided is inadequate,
please attach a statement giving full details
in the format given below.
1. At the close of business on March 20 19 81 our records showed the
following balance(s) to,the credit of the above-named decedent. In the event that we could
readily ascertain whether there were any balances to the credit of the customer not desig-
nated in this request, the appropriate information is given below.
Registered Owner(s)
Account Number Type of Account And Date
Account Established
Accrued *Interest Taxable
Amount Interest On Decedent's
Fi na 1 Return
4127063735
11088123
10,294.38 $ 38.48
5,000.00 158.79
Checking Russell M. Long
9/11/78
Ctf. of Deposit Russell M. Long
7'.% 10/1/75
*The amount of interest paid to the decedent or credited to the account from January 1 to
(and including) date of death. The amount accrued at date of death ~lOuld not be included
in this figure.
The Commonwf'allh Nalional Bank. 10 South Markel Square. Harrisburg. Pa. 1'108 (7171564-9500
1. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving
valuable and mlenllate consideration? (Answer "Yes" or "No".) YES
2. Did decedent, within two years of death, trnnsfcr nroperty from himself! herself to himself/hersp.lf and another party
or parties (including a spouse) in joint ownership? (Answer "Yes" or "No",) ---liQ.
3. If the answer to one or t'NO above is "Ves" and the transfers are claimed to be nontaxable, provide the following
information:
a, Age of decedent at time of transfer. 78
b. Copy of death certi ficate.
c. Affidavit by the attending physician indicatinp, 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 receiving a valuable or adequate consideration
therefor which was tn take effect in possession or enjoyment at or after his/her death? (Answer "Ves" 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 "Ves" or "No".) NO
b. What was the transferee's age at time of decedent's death? N/ A
5. Did decedent in his/her lifetime malle any transfer without receiving a valuable and adequate consideration therefor
under which transferor expressly or impliedly reserves 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 "Ves" or "No".) ...llil...-
b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer "Ves" or "No",; 110
6. If the answer to five b, al;()ve is "Yes," state whether the right was reserved in decedent alone or others. N/ A
QUESTIONS CONCERNING PROPERTV TRANSFERS
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 "Ves" or "No".) NO
8. Did decedent, at any time, transfer property, the beleficial enjoyment of which was subject to change, because of
a reserved power to al ter, amend; or revolle, or which could revert to decedent under terms of transfer or by operation of
law? (Answer "Ves" or "No".) Nn
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 "Ves" or "No".) N/A
WARNING: It Is illcg31 to alter this copy or 10 llujJlicalc by jlhoto~t3t or photograph,
HIOS 112 !100M nEV 2.16
(100 COIl, por book)
(HE FOn THIS
CERT1FIC^TE 52,00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH-VITAL STATISTICS
N~ 2226580
I.OC;\\. ItEGlSTlIAIl'S CEllTIFlC,\T10N OF ilEAI'll
Ul't:i\ll'rt'd ;\'11,
Mlddlo
L,1"\,
Lost
Full :'\lllllC Hnssell
lIe J)cc('u\ccI
First
HcsldclIl'C <<. D. I 2,
NumhtH
PIUI'C IIf Cl1W:~~,8rl;~nd
, Dealh
, County
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DIlle uf IIirlh
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Slrcnl
SIYl '~PI1'-<" 111"',
Cllv or Town
CIl "~p,:",] 'Ind,
Cotlnty
p";!
Slalo
;{. lJL...:c...'-____..__.__ S0>1t1\" ' tOn.Jli .
Citv . Uorougtl or Township
I'l'lln'ilh'lllllll
lIah'ullh'alh
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Hal'l' ~bi1e.-
Uirlhlllal'e
Fr.>:';!}:" .
;\1arital SWim :".; dOI'Tr:'ld
Socl"1 Sl'l'mil)" No,
163-0~H8.55
(}LTll\llltinll li'O'r'(~; ,"n
Velcran\ SL'rial !\'u.
MEIlIC.11. CEIITlFICATE
l)lIrl I. Dellth Wll.. l'IIllWII hl':
Intcn'alllet\'iccn
On'ietlllull)ClIlh
hnnwdllltc ClllISC lltl
.-'l..cute ; .,,-oc~r.ii~Jl I~3c!:p .l.i:t
nucTn(h)
Art~rio.?cll'=!!"otic C:',!"jiJv:-: ~;c',l';:::,~ Di:JI~:'" 38
nue To{e}
1)llrl II. OTllEn SIGNIFIC'\~T CONIlITIONS: L'(ll\lrihntillL: In death hili nul related In thc imlllcdilltc C:lllse gh'cn ill
PilrlT tal
Al'('idCIII, Suicide nr Ilollllcldc
Un\\' (lid illjllr~ lIl'eur
Nalllc dnd Tillc of I'crsnn
Who Certified Clime flf nealh 1i\1.Il.. D,O.. ('ornner, M.E.I ;{o"'1?rJ. "(- c~~on.o. -11'l c>.. . D. CCYf"'Yno""
'\,Jdre~s
SlrClll
C;'<!'J..:l~:;]p, F~
Cily
ueen
Strolll Address
r:-ns':-u?'.:', j-';....
CUy, Borough. Township
3-?J-19rn
Dnle Aecolvod by LOCRI RegIstrar
Dalc 01 Issuo 01 ThlG Corllllctlllon
,
REV-453 l':X' (10.80)
COMMONWEALTH OF PENNSVI.VANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
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(Instructions on Reverse Side)
Estate of Russell M. Long
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE 0 F INTEREST OF BENEFICIARY
DECEDENT BIRTH
David E. Lana Grand nephew Yes Leqal Bequest of $10,000.00
26 Stephen Road
~tment 8-C
Camp Hill, Pa. 17011
Linda L. Frost Grand niece Yes Lega 1 equest of $10,000.00
R.D. #3 Box 3222
Etters Pa. 17319
John E. Lonn. Sr. Brother Yes Legal equest of $10,000.00
Illl?f"l III rI Gpttvsb"rn Road
CamD Hill, Pa. 17011
-
John E. Lonq, Jr. Nephe"l Yes Legal equest of household
908 Bridge Street goods; res i due of es tat
New Cumberland Pa. 17070
:
.
-
.
-
I I ,
The abO'ie beneficiaries were living at the time of the decedent's death except for the following:
DATE OF DEATH
NAME
If additional space is necessary, use 8lh" x 11" sheets.
,
REV-4t14 EX. (8-80)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PHOPERTY
(Instructions all Rl!vorsr. Sic/c)
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ITEM TOTAL V ALUE OF DEPARTMENT
DESCRIPTION MARK ET RCe DECEDENT'S VALUATION
NO. VALUE NT INTEREST {OFFICIAL USE ONL yj
None
1
.
TOTAL None ~.(...., '"
Estate 0 f
Russell M Lono
../fT 't!.' '.
If additional space is necessary, use BW' x ll" sheets.
"
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
Schedule "E" must include all property, real and personal, owned by the decedent jointly with another
party or parties as joint tenants with right of survivorship, Both tangible and intangible property are to be
included, List real estate first.
1, Describe all real property as indicated in the instructions for Schedule "A," Describe all personal property
as indicated in the instructions for Schedule "B," Include the name, address and relationship to the
decedent of the co.ownerls] and the date the joint ownership was established.
2, Indicate the total market value of the jointly owned property.
3, Indicate the percentage of the decedent's interest,
4. Indicate the market value of the decedent's interest,
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I.^ST 11'11.1. ^NO TESTNIENT
I, RUSSELL ~t. LONG, of Southampton TOh'nship, CUMberlnnd County,
I'cnns)')vanin, being of sounl! mind, mcmoT)' ~nd understanding. do make and
publish this my Last lI'i 11 ;lIld Tcst:lI11cnt, herehy rcvol:ing <lnd maldng void
noy nnd all former \d lIs by me at tiny time heretofore mnde.
FIRST. J direct my hereinafter named E);(,~ctlto~.s to Pil)' ,all my just..
debts and funeral expensc:i as 500n as cOllvcnic"tly may be after my decease.
..
SECOND. I give and bequeath the sum of TEN THOUSAND ($10,000.00)
Dollars, to my gl'nnd nephew, DAVID E. I.ONG, nbsolutcly.
......."......~,~',~.,.n".._.._---..;...._~.',..~
TIIIRD.
give and bequeath the sum of TEN TljOUSAND ($10,000.00) DoJ1ars
.
to my gr:mcJ niece, LINDA L. FROST, absolutely.
FOURTH,
I give nnd bequeath the sum of TEN THOUSAND 1:$10,000.00) Dollars,
to my brother, JOliN E. LONG, SR., of Camp Ilill, Cllmbcrlnnd COUllty, flcnnsylvani I
absolutely.
FIFTH.
give and bcqucath all In)' household goods to m)' ncpheh', JOHN E.
LONG, JR.
sunl. I give, de\'ise :md bequeath 011 tlle rest, residue :and remainder
of In)' estate, real, personal or mixed, ,.hatsoe\'er or ,dlCresoe\'cr si tuato to
m)' nephew, JOHN E. LONG, JR.
SI:.\'ENTIt J hcrcb)' nominatc, consti tllte and appoint TIlE FIRST NA"rIONAL
Bt\1\K OF SllIPflENSBlJRG, :;ihippcnsburg, Pcnns)'l\':min, :md JOHN E. I.ONG, JR., m)'
~.....-~
ncphcw, as thc Executors of this 10)' Lnst \\'il1 and Tcst:u;Jcnt, In)' said Cxecutors
to have full pOh'or and authorit)' to do an)' and nIl things ncccssar)' for the
cor.,plete administration of m)' cst:Jtc, inc.l\lding thc J1ol..cr to sell an)' and
all real and pcrsonal propcrty of "hich I mn)' dic seized, at public or pri\'o1te
sa)cs, in thcir discretion, and "ithout any Ordcr of an)' Courtj and I further
direct tllilt my said Executors not he rC'quired to file :In)' Rond in C'onn~ctiCln
~Ith the ~etllemcnt of my Estate.
IN I\lTr;ESS IllIEIUlOF, I, RUSSELL H. LO~G, ha\'c hercto sct m)' hand and 5('31
"
to this my Last lI'i 11 and Tcstament, \\rittcn on t,~o (2) sheets of papcr, this
7r.~~!..dL11J,
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REV.457 (1.BOI
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
_....~
,,""'. ,
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-
~
Estate of
Russell M. Lonq
File No,
21-81-208
County
Cumberland
Date of Death
3-20-81
In tho ovont that OilY futuro intorlt~ in this OSt.ltO i$ tramlorrod in possession or enjoyment to Gollatoral heirs of tho tl~t!dant aftllt t"8 uxpiratlon of any
ostato fnr lifo or tor yoars, tho Commonw&Jlth hereby oxpr~lv ro,'SOrve$ thE' ria 111 to IIppraiso and asress trllnsfer inheritAnco taxes at thlJ lawful collater'" ra'fJ
on Rny such futuro ~tflrest.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2, TOTAL PERSONAL PROPEr.TY - SCHEDULE "B"
3, TOTAL TRANSFERS - SCHEDULE "C" . . . .
4, TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
TOTAL REPORTED PROPERTY
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
---
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills.
n 03
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REY-484 EXt (HO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
FiI e Number
Estate Name
Date of Death
Sacial Security Number
21-81-0208
Russell M. Long
March 20, 1981
163-09-3855
REPORT OF INHERITANCE TAX APPRAISER
GJ Original
o Supplemental
o Remainder
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported In the for.golng
return at the values lOt forth opposite .och item In the last column 10 th.e rlgh In Sch. I.s "A", "II", "C", and "E"
Dated:
January 13, 1982
$
VALUE AS APPRAISED
CODE
INVENTORY
Real Preperty (Schedule A)
Perianal Property (Schedule B)
Jolnt.Held Property (Schedule E)
Tranaler. (Schedule C)
TOTAL GROSS ASSETS
$
Leu D.btl and Deductlonl
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o LIf. Eslot.
o Annuity
M1]
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
Leu Credits
DATE OF PAYMENT
AMOUNT PAl D
$
00+
162,696 24 '0+
None 2lH
None 30+
207 796 24
40.
FACTOR
6%
15%
TO
DISCOUNT
+ $
+
BALANCE
TO
INHE
ADJUSTMENTS
(HARRISBURG USE ONLY)
PRINCIPLE
s;Ql!,Ji.
INTEREST
$
=
=
$
REMAINDER APPRAISEMENT CODE
92+
93.
VALUE
CODE
COMPUTATION OF TAX
$
$
$
$
$
$
$
$
TAX CREDIT
$
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National Bank ~~
TRUST DIVISION ~
nUSTOfFICES
fMl'lH'HoNN ~m,~s~'i~
"'''HVI.! LANCAS!l~
IU"''''OM MfCH"'''''CS&U~a
Mlllll(ffOW~ .eu
NO, 18 2 4 6 7
ACCOUNT NO. ACCOUNT NAME
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DATE AMOUNT
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DESCRIPTION
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RETAIN THIS STATEMENT FOR YOUR FilES
THE "ru.CHED CHE(~ 15 IN PAYMENT Of lHMS DESCRIBED "80ve. IF Nor CORIlECT PlfA.SE NOTIFY us PROMPTlY. NO RECEIPT DESIRED.
"
Inventory of the real and personal estate of
Russell M. Long
deceased.
,;)/ - )j'1 . /:/0 If
Real Estate
1. Property situate and known as R.D. #2, Southampton Township,
Cumberl and County. Pennsyl vani a being a three bedroom ranch
style, aluminum sided residence with attached two car garage.
Recorded in Cumberland County Record Book E, Volume 26, Page 816,
Dated 7-24-75; sold at
Tota 1 Rea 1 Es ta te
Tangible Personal Property
2. Household goods, sold at
3. Household goods, appraisal attached
4. 1976 Ford Truck and tires; sold at
5. 1978 Ford Fairmont; sold at
Intangible Personal Property
6. 1,400 shs. Sun Company, Inc., common, NYSE @ 39.9375
7. U.S. Treasury Series E Bonds
$1,000 Bond dated March, 1961
500 Bond dated February, 1962
500 Bond dated April, 1961
500 Bond dated February, 1961
500 Bond dated August, 1955
500 Bond dated May, 1943
100 Bond dated November, 1961
100 Bond dated November, 1961
100 Bond dated December, 1961
100 Bond dated December, 1961
100 Bond dated December, 1944
100 Bond dated December, 1944
100 Bond dated April, 1949
100 Bond dated April, 1949
100 Bond dated April, 1949
roo Bond da ted November, 1949
500 Bond dated July, 1949
500 Bond dated October, 1949
100 Bond dated April, 1949
100 Bond dated November, 1950
100 Bond dated April, 1950
100 Bond dated April, 1950
100 Bond dated November, 1950
100 Bond dated Jul y, 1950
, roo Bond dated July, 1950
$1,997.60
952.80
998.80
987.40
1,138.60
1,647.00
196.20
196.20
196.76
196.76
318. 24
318. 24
273.36
273.36
273.36
275.92
1,424.60
1,379.60
273.36
265.72
270.64
270.64
265. 72
274.36
274.36
45,100 00
45,roO 00
6,043 95
351 50
3,300 00
I 4,375 00
I
I
I
155,912 50
I
COMMONWEALTH OF PENNSYLVANIA I.
COUNTY OF CUMBERLAND J
55:
The Commonwealth National Bank bv Leslie W. Brant. Trust Manaqer
being duly swnrn .ccording to I.w, deposes .nd s.ys th.t he executor
of the Est.te of Rus se II M, Lonq
I.te of Southamoton Townshi 0 , Cumberl.nd County, P." dec..sed and that tho
within is .n inventory m.de by --IhU.QIlli!lQ!Jl'!ealth NatioT)~Bank " the said executor
of the entire est.te of s.id decedent, consisting of .11 the person.1 property .nd re.1 eslate, except real est.te outside
the Commonwealth of Pennsylv.ni., .nd th.tthe figures opposite e.ch item of the Inventory represent it's f.i. value
as of the d.te of decedent's de.th.
19 '61
{A~ i!:
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Executor . ~l)4KO$X<<
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.nd subscribed b.for. me,
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C c. , " r", I .~v ,,!..f. 1..),
My 'JITtil11.,...I,.... ,::.. ."';":1 D! ~:o'.?:;')"
Mcm\.:o€r, I'CillISY\';L~;"~ 1\..,1\-.,,, .-.'
Address
O.te of O..th
20
Day
March
Month
1981
Vu,
INSTRUCTIONS
J. An inventory must b. filed within three months .fter .ppointment of person. I repres.nt.tive.
2. A supplement inventory must be filed within thirty d.ys of discovery of .dditional ....ts.
3. Addition.1 she.ts m.y be .ft.ched .s to person.lty or re.lty
4. See Articl. IV, fiduci.ries Act of 1949.
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U.S. Treasury Series E Bonds (Continued)
$500 Bond dated February, 1944
100 Bond dated AU9ust, 1943
50 Bond dated April, 1945
50 Bond dated May, 1945
50 Bond dated June, 1945
50 Bond dated July, 1945
50 Bond dated August, 1945
50 Bond dated September, 1945
50 Bond dated October, 1945
50 Bond dated November, 1945
50 Bond dated November, 1945
50 Bond dated December, 1945
50 Bond dated January, 1946
50 Bond dated February, 1946
50 Bond dated March, 1946
50 Bond dated April, 1946
50 Bond dated May, 1946
50 Bond dated June, 1946
50 Bond dated July, 1946
50 Bond dated August, 1946
50 Bond dated September, 1946
50 Bond dated October, 1946
50 Bond dated November, 1946
50 Bond dated December, 1946
50 Bond dated January, 1947
50 Bond dated February, 1947
50 Bond dated February, 1947
50 Bond dated March, 1947
50 Bond dated April, 1947
50 Bond dated May, 1947
50 Bond dated June, 1947
50 Bond dated July, 1947
50 Bond dated August, 1947
50 Bond dated September, 1947
50 Bond dated October, 1947
50 Bond dated November, 1947
50 Bond dated December, 1947
50 Bond dated January, 1948
50 Bond dated February, 1948
50 Bond dated March, 1948
50 Bond dated April, 1948
50 Bond dated May, 1948
50 Bond dated May, 1948
50 Bond dated June, 1948
50 Bond dated July, 1948
50 Bond dated August, 1948
50 Bond dated September, 1948
50 Bond dated October, 1948
50 Bond dated November, 1948
50 Bond dated December, 1948
50 Bond dated January, 1949
50 Bond dated February, 1949
50 Bond dated March, 1949
50 Bond dated April, 1949
50 Bond dated May, 1949
50 Bond dated June, 1949
50 Bond dated July, 1949
50 Bond dated August, 1949
50 Bond dated August, 1949
50 Bond dated September, 1949
$1,645,20
334,52
154. 10
154,10
156,58
156.58
156.58
156.58
151.66
151. 66
151. 66
155.44
155.44
155.44
155.44
150.54
150.54
152.88
152.88
152.88
152.88
148.08
148.08
150.46
150,46
150.46
150,46
150.46
145.72
145.72
148.06
148.06
148,06
148.06
143.40
143.40
145.68
145.68
145.68
145.68
141.10
141. 10
141.10
143.40
143,40
143.40
143.40
138.88
138.88
141. 14
141. 14
141.14
141.14
136.68
136.68
142.46
142.46
142.46
142.46
142.46
U.S. Treasury Series E Bonds (Continued)
$ 50 Bond dated October, 1949
50 Bond dated November, 1949
50 Bond dated December, 1949
50 Bond dated January, 1950
50 Bond dated February, 1950
50 Bond dated March, 19S0
50 Bond dated April, 19S0
50 Bond dated April, 1950
50 Bond dated May, 1950
50 Bond dated June, 1950
50 Bond dated July, 19S0
50 Bond dated August, 1950
50 Bond dated September, 1950
50 Bond dated October, 1950
50 Bond dated November, 1950
50 Bond dated November, 1950
50 Bond dated December, 1950
50 Bond dated January, 1951
50 Bond da ted Februa ry, 1951
50 Bond dated March, 19S1
50 Bond dated April, 1951
50 Bond dated May, 1951
50 Bond dated June, 19S1
50 Bond dated July, 1951
50 Bond dated August, 1951
50 Bond dated September, 1951
50 Bond dated October, 1951
50 Bond dated November, 1951
50 Bond dated December, 1951
50 Bond dated January, 1952
50 Bond dated February, 1952
50 Bond dated February, 1952
50 Bond dated March, 1952
50 Bond dated April, 1952
50 Bond dated May, 1952
50 Bond dated June, 1952
50 Bond dated July, 1952
50 Bond dated August, 1952
50 Bond dated September, 1952
50 Bond dated October, 1952
50 Bond da ted November, 1952
50 Bond dated December, 1952
50 Bond dated January, 1953
50 Bond dated February, 1953
50 Bond dated March, 1953
50 Bond dated April, 1953
50 Bond dated May, 1953
50 Bond dated May, 1953
50 Bond dated June, 1953
50 Bond dated July, 1953
50 Bond dated August, 1953
50 Bond dated September, 1953
50 Bond dated October, 1953
50 Bond dated November, 1953
50 Bond dated December, 1953
50 Bond dated January, 1954
50 Bond dated February, 1954
50 Bond dated March, 1954
$137.96
137.96
139.72
139.72
139.72
139.72
135.32
135.32
135.3?
137 . 18
137.18
137.18
137.18
132.86
132.86
132.86
134.84
134.84
134.84
134.84
130.60
130.60
132.52
132.52
132.52
132.52
128.36
128.36
130.22
130.22
130.22
130.22
130.22
126.12
129.70
130.02
130.02
125.92
125.92
127,50
127.50
127.84
127.84
123,82
123.82
125.32
125.32
125.32
125.64
125.64
121. 68
121. 68
123.22
123.22
123.54
123,54
119.66
119.66
-
U.S. Treasury Series E Bonds (Continued)
$50 Bond dated September, 1958
50 Bond da ted Oc tober, 1958
50 Bond dated November, 195D
50 Bond da ted December, 1958
50 Bond dated January, 1959
50 Bond dated February, 1959
50 Bond dated March, 1959
50 Bond dated April, 1959
50 Bond dated May, 1959
50 Bond dated June, 1959
50 Bond dated July, 1959
50 Bond da ted Augus t, 1959
50 Bond dated August, 1959
50 Bond dated September, 1959
50 Bond da ted Oc tober, 1959
50 Bond dated November, 1959
50 Bond dated December, 1959
50 Bond da ted Ja nua ry, 1960
50 Bond dated February, 1960
50 Bond dated March, 1960
50 Bond dated April, 1960
50 Bond dated May, 1960
50 Bond dated June, 1960
50 Bond dated July, 1960
50 Bond dated AU9ust, 1960
50 Bond dated September, 1960
50 Bond dated October, 1960
50 Bond da ted November, 1960
50 Dond da ted November, 1960
50 Bond dated December, 1960
50 Bond dated January, 1961
50 Bond dated February, 1961
50 Bond dated March, 1961
50 Bond dated April, 1961
,
50 Bond dated May, 1961
50 Bond dated June, 1961
50 Bond dated July, 1961
50 Bond dated August, 1961
50 Bond dated September, 1961
50 Bond dated October, 1961
50 Bond dated November, 1961
50 Bond dated December, 1961
50 Bond dated January, 1962
50 Bond dated February, 1962
50 Bond dated February, 1962
50 Bond dated March, 1962
50 Bond dated April, 1962
50 Bond dated May, 1962
50 Bond dated June, 1962
50 Bond dated July, 1962
50 Bond dated August, 1962
50 Bond da ted September, 1962
50 Bond dated October, 1962
$H.d .88
109.88
106.42
106.88
108.14
108.14
108.14
108.14
104.72
107.82
104.44
104.44
104.44
105.60
105.60
105.60
105,84
102.52
102.52
103.68
103.68
103.68
103.86
100.60
100.60
101.74
101. 74
101. 74
101. 74
101. 94
98.74
98.74
99.88
99.88
99.88
100.16
97.02
97.02
98.10
98.10
98.10
98.38
95.28
95.28
95.28
95.96
95.96
95.96
96.20
93.18
93.18
93.84
93.84
8. Certificate of Deposit No. 3263 with Peoples National Bank
of Shippensburg, at 10.48%, dated 9-16-80
9. Certificate of Deposit No. 4100606357 with The Commonwealth
National Bank, at 7.25% dated 10-1-79
$44,933.20
10,000.00
5,000.00
10. Accrued interest on no. 9 $ 158.79
11. Savings Account no. 036664120 with
Peoples National Bank 14,747.40
12. Accrued interest on no. 11 38.60
13. Checking Account no. 366641 with
Peoples National Bank 6,634.28
14. Checking Account no. 412-706373-5 with
The Commonwealth National Bank 10,294.38
15. Accrued interest on no, 12 38.48
16. Proceed from Christmas Club no. 0138444 with
Peoples National Bank 250.00
17. Pension for March from Sun Company 572. 65
18. Refund from Bedford County Press 6.00
19. Refund from Patriot News Co, 9.21
20. Refund from Capital Blue CrosS 17.30
21. Refund from 1980 Tax 13.00
Total Personality $162,696.24
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HEV.455 EX" (3.no)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
~.
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Estate of Russell M. Long Date of Death 3-20-81
WHEN CLAIMING THE FAMilY EXEMPTION, COMPLETE THE FOllOWING:
Claimi1nt
ClairnLlnt's Adclrcs!i at time of Dccmlont's OQath
NAME OF PAYEE
ITEM
NO,
4.
5.
6.
7.
8. Ma
9.
10.
June
DATE
"
16 Cumberland Law Journal
16 John L. A ett Funeral Home
21 Cumberland Munici al Authority
21 Cumberland Water Assoc.
1 Ausherman Brothers Inc.
5 Reed, Wertz, & Roadman Inc.
6 Cumberland Municipal Auth.
6 Pe s 1 ania Electric Co.
8 Emily Padamonsky, Tax Collector
11 United Telephone Company of Pa,
26 The News Chronicle
5 Pennsylvania Electric Co.
5 Cumberland Municipal Auth,
8 David Carr A enc
10 Reed Wertz & Roadman Inc.
11 United Tele hone Com any of Pa.
11 Re i ster of Wi 11 s, Cumberl and C
blic 0 inion
Cumberland Munici al Auth.
Re ister of Wills, Cumberland C ,
18.00
2,176.20
20.50
22.50
75.00
80.00
20.50
32.92
57.23
11. 76
15.00
14.76
20.50
116.00
35.00
11. 68
2.00
297.50
20.50
3.00
CONTINUED
File No.
Relationship to Dec{!dnnt
REMARKS
<
Estate notice
Funeral ex enses
Sewer bill
Water bill
Appra i sa 1 fee
Automobile insurance
Sewer bill
Electric service
1981 County & Twp.
Telephone service
Estate notice
Electric service
Sewer bill
Insurance
Automobile insurance
Telephone service
Letters tes tamentary
Advertisin ublic sale
Sewer bill
Two short certificates
real estate tax
21-81-208
AMOUNT
TOTAL
I hereby certify that to the best of my knowledge and belief the foregoing is a just and hlle statement of debts, funeral
expenses and expenses of administration submitted to the estate as deductions for Inhel ,tance Tax purposes.
"
"
"
"
"
"
"
"
"
"
"
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SIGNATURE OF FIDUCIARY
DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED INTHESUM OF S . =-3 7 Ii :;.1, ;;'71 AT
I
/2-' % TAX RATE
07/ t~ Q. tE {"(~)
f GISTER o;=.' ILLS
/-/IJ-I,;1"
. DATE
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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 estate, other items ore claimable including the cost of
administration, attorney fees, fiduciary fees, funeral and burial expenses including the cast of a burial lot, tombstone
or grave marker and other related burial expenses.
All debts being claimed against an estate are subiect to the approval of the Register of Wills with whom the
Inheritance Tax Return is liled. Evidence to support the decedent's or the estate's liability for the debts being
claimed shauld be attached to this schedule.
A family exemption 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 who is 0 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.
NOTE: Compensation paid to an estate representative; namely, an executor or administrator, far services
performed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income
item should be reported on form PA.40.lndividuallncome Tax Return.
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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 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 amaunt 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 BY," x 11" SHEETS.
,""
IlEV.<1S5 EX-t (3-001
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
-
Estate 01__ Russell M. Lono Date of Death 3-20-81
WHEN CLAIMING THE FAMll V EXEMPTION, COMPLETE THE FOllOWING:
File No.
21-81-208
Claimant
Relationship to Decedent
Claimant's Address at time of Decedent's Dei"lth
ITEM DATE
NO,
Jul
"
"
"
"
"
"
NAME OF PAYEE
REMARKS
AMOUNT
Co.
service
Cumberland Water Assoc,
Daniel Hershe
Scott Wolfe
98
Tele hone service
Wa tel' bill
Auctioneer fee
Work completed for auctioneer
14.11
22.50
930.00
39.00
Martin
Gotsha 11
Work com leted for auct.
Cl erk fee
Work COlli leted for auctioneer
Clerk fee
Electric service
Sewer bill
Dee s Realty transfer tax
Advertisin ublic sale
ional Bank Co-Executor's fee
Nota I' fee
191.50
167.00
13.72
13.20
451. 00
104.76
5 000.00
1.00
Reserves:
i ncollle tax 30.00
income tax 10 000.00
TOTAL CONTINUED
I hereby certify that to the best of my knowledge and belief the foregoing is a just and trlle statement of debts, funeral
expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes,
Pa. De a tment of Revenue
Internal Revenue Service
1981
1981
Individual
Individual
SIGNATURE OF FIDUCIARY
OFFICIAL USE ONl V
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $ ,:5''7, (1/), tl,f1J AT
DATE
/S-
% TAX RATE
017 M.d @ , I~ (' <-( ~j
I ()fEGISTER OF ILLS
/-/~-,fd..
.
DATE
,
GENERAL INHERITANCE TAX INFORMATION
Unsatislied liabilities incurred by the decedent prior to his/her death ore deductible against his/her taxable
estate. In addition to debts incurred by the decedent or estate, other items ore claimable including the cast of
administration, attorney fees, liduciary lees, luneral and burial expenses including the cost 01 a burial lot, tombstone
or grove marker and other related burial expenses.
All debts being claimed against On estate ore subject to the approval of the Register 01 Wills with whom the
Inheritance Tax Return is liled. Evidence to support the decedent's or the estate's liability lor the debts being
claimed should be attached to this schedule.
A lamily exemption may be claimed by a spouse 01 0 decedent who died domiciled in Pennsylvania. II there is
no spouse, or il the spouse has ladeited his/her rights, then any child 01 the decedent who is 0 member 01 the some
household con claim the exemption. In the event there is no such spouse or child, the exemption con be claimed by
o parent or parents who ore members 01 the same household os the decedent. The lamily exemption is allowable only
against assets which pass by 0 will or by the Pennsylvania Intestate Lows.
NOTE: Compensation paid to on estate representative; namely, on executor or administrator, lor services
perlarmed in administerir,g an estate is reportable lor Pennsylvania Income Tax purposes. This taxable income
item should be reported on larm PA.40.lndividuallncame Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the lamily exemption is being claimed, indicate the claimant's nome, address and his/her relationship to
the decedent. Enter "Iamily 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 01 each payee.
5. Provide a brief explanation in the remarks column lor each debt claimed.
6. Enter the amount 01 each debt being claimed.
7. The larm 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.
".. ;
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 clecedent or estate, ather items are claimable including the cast of
administration, attorney fees, liduciary lees, funeral and burial expenses including the cast of 0 burial lot, tombstone
or grave marker and ather related burial expenses.
All debts being claimed against an estate are subiect to the approval 01 the Register of Wills with wham the
Inheritance Tax Return is filed. Evidence.!o support the decedent's or the estate's liability far the debts being
claimed should be attached to this schedule.
A family exemption 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 who 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 01 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, far services
perlormed in administering an estate is reportable far Pennsylvania Income Tax purposes. This taxable income
item should be reported an farm 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 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 an which each debt was incurred and/or paid.
4. Enter the names of each payee.
5. Provide a brief explanation in the remarks column far each debt claimed.
6. Enter the amount of each debt being claimed.
7. The farm must be signed by the person who has assumed the responsibility lor paying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE By," x 11" SHEETS.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*'
TO:
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ESTATE
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COUNTY FILE NO:
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DATE
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FILE NO.
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COUNTY
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DATE OF DEATH
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Appraised Value of Estate:
Real Estate
$ ...(/ /) / I;L(),.l~()
- /
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Personal Property
+ //> -;,
Jointly Held Property ITransfers
+
Total Gr ass Estate
$ , " '/,/,~, ,/,1
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Total Approved Deductions
Clear Value of Estate
& ?,.! .-'jj;.. r; .~/ 1-/'/
,
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
$ /''/1/ -:'//,'- I/L/
Amount Taxable @ 6% Rale
$
tax due
$
Amount Taxable @ 15% Rate
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tax due
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TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$ ", "' /// /7-
,.. * * * .. * A five percent discount totaling $
will be granted if the Inheritance Tax is paid bV
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
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$ ''/'1'"1/) ,;.0
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+ $ ../" " ;';ft-: - $
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Interest accrues at the rate of six (6) percent per Bnnum
on the unpaid balance of Inheritance Tax from
to date of pavment. Interest due jf paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$ 7:-':
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, ' I
/ I /; ; (:,
Assessed by: ,'. I " "~
See Inlormalion on Reverse Side Agenffc{thepcmmory .hh
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INFqBMATIQR
To Insure proper credit to your account, tho nome 01 tho estate and file number should be clearly prInt-
ed on the cl1uck or money order.
This assossment is modo in accordance with Section 708 of tho Inheritance and Estate Tax Act of
1961 (72 P.S, ~ 2465.708),
To the extent that inheritance tal( is paid within three (3) months after the death of the decedent, a
discount of five 151 percent is allowed 172 P.S, ~ 2485.716),
Inheritance Tax, other than tax on D future interest. is due at the date of the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P.S. 9 2485.711). Inheritance
Tax on a future interost is payable within three (3) months aher the transfer tokes effect in possession and
enjoyment and is delinquent tharenfter (72 P.S. S 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
--------------------- ---------- -- - ---- - -------- - - --- - --- -------- -- -- - - - -- --
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months ,025 8 months .040 11 months .055
3 months .015 6 months .030 9 months ,045 12 months .060
1 days .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 14 days .00237 24 days .00403
5 days .0008S 15 days .00250 25 days ,00420
6 days ,00101 16 days .00267 26 days .00437
7 days .00118 17 days .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00318 29 days .00488
10 days .00169 20 days .00335 30 days .00500
-- --- ---------------- --- ---- -- - -- --- - ------- ---.---- - --- --------- ------
Any party in interest, including ,the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto within sixty (601 days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. 9 2485,1001).
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
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