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I, RICHARD EDWARD DEEM, of 206 North Everhart Avenue,
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West Chester, Chester County, Pennsylvania, do hereby declare
this to be my Will.
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__M~..-F~.:...._~_.~yfe fivet.usand i ~ / Q~lli;~ /tee
and clear of dea ~~e:s-;;.i()MAJ,~,,!O~r~__I~~NS, ~f 9 Greejhi 11
Road ,/ive_s.t-Cl1est~r, penisylvania,/ if she +-S'-m7e~ixty
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RICHARD WALTER DEEM, of Pittsburgh, Pennsylvania,
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if he survives i
I give the I
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SECOND :
I give the residue of my estate to my son,
me by thirty days.
If he does not so survive me,
residue of my estate, per stirpes, to those of his issue who
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so survive me.
THIRD:
I appoint my said son to be Executor of my
estate.
If he fails to qualify or ceases to act, I appoint his
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EXECUTED ~m December :;1..8 , 1967. I
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1iLJi~hard l'dwafd D~erm I C\~ !
VcW~tJ.. Ccf..1;J'a/lJ.- 7\JPMIt ':
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wife, MARCIA, to be my Executrix.
If any property passes to a
minor as a result of my death, I appoint the said MARCIA DEEM
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to be guardian for such property.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMBERLAND
Before me, the Rcgisler for the Probal~ of Wills and granting of Letters of Administration in and for the County of
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Cumberland, personally camc r< \ l. \.\ \'1 R'\) W i'l L"\ E f.:. \. ~ E IYI
who, being duly S \JJ (> ~ tv ,do '" S depose and say that as ~,X E: L 0 T (J e
of the last Will and Testament of \2 \ G \-\ \:" Ie. () t D W 11 R 0 '\) E E M
deceased
i-\ E' 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.5UJO r~ /J and subscribed before me.
~t'K\ L. ~O ~.D., 19R
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Register
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DECREE
Be it remembercd that on the
13 th day of
Apr il
81
,A,D.,19_, there was probated and
recorded the last Will and Testament of
Richard Edward Deem
late of
Lemoyne
, Cumberland County, Pennsylvania,
Deceased. Letters Testamentary lVere granted to Richard Walter Deem
Witness IllY haJ1d.and.official seal the day and year aforesaid. .a: .
i~ ~'S '222t!UAj (Ii, ;e~ .
C i1 Register
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>>'lREV.1162EX '", ", L .
~;""'i":':' " " . ' COMMONWEALTH OF PENNSYLVANIA
I, 4 'tiO'.K.' 29605' DEPARTMENT OF REVENUE
! '';'''' OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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= Richar:4 walter Deem c/o
iJ RECEIVED A. ThClll&8 'arke, Bsq.
I FROM ~
P\
, \ ADDRESS 126 We.t Miner street
TAX AT 6%
TAX AT 15%
TAXAT_%
ESTATE TAX
c.\
w..t Chester, pa 19380
TOTAL TAX CREDIT
58.50
'--~~~~T~J~~~~ATiON:,t~h-i9:--i:9Bi---------
FltE NuMBER
21-81-239
LESS DISCOUNT
DATE OF PAYMENT
J\1Ile 23, 1981
Richard Edward Deem
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PLUS
(FROM
% INTEREST
TO_I
NAMEOFDECEDENT
COUNTY ClDIIberland 1":'1
---------------------------- --------.- ----- ~
POSTMARK DATE
REMARKS:
TOTAL AMOUNT PAID
58.50
"paid on Account"
SEAL
RECEIVED BY
t
REGISTER OF WILLS
-------------.
-_._---'--_._~
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REV.~ll {e-lel
cOMMONWEA~ TH OF PENNSY~VANIA
OEPARTMENT OF REVENUE
BUREAU OF FIE~O OPERATIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
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APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applicotion is hereby mode for coosent to the Irtlnsfer of the followinlJ ,ecurilies of 0 Pennsylvonio
Corporation or 0 Notionol Bonking Associotion locoted in Pellnsylv(1lli,,:
DATE ... Jtm.~.L.~!.81
(0) 75 ahares (b) p.nns:r'lv~!!...Jl:_~ectria CoIllp.az:lY. .... __... (cL?~~~.~_..__..
(NOTE: In describing securities enter in (0), eb OJe, either the number of sheres of stock or the lace amount of
registered bonds, in (b), the nome of the issuing company and in (c) the closs of stock or the stated interest rote
ond maturity dote of registered bonds.)
ISSUED ON , and having 0 TOTAL MARKET VALUE OF S .?~S___~_. _.__
(Oat.)
os of the dote of death of the decedent, ~char~~dw~~~__I~~t.m.._..._._._, Oll._ ~ah 19, 1981
(Name Qr Decedent) (Date of death)
who wns late of 500 Walnut St., Apt._ A4 ,._~~e, Cumberland, P~~.!I'y1.!~ia
(Street and Number)
(Post Office)
(County)
(State)
The securities ore registered os follows:._.__._.......___....
(Nome or names in which ccrtificotcs arc registered)
.81RIl-fIm.'i!~) Richard Wal~r ~.m,lS~~._'!.a'!.h1ngton n~~~L.We~~_~.ster, PI. 19380
EXECUTOR) (Nama) (Add..,,)
NAME OF APPLICANT lU.<::hard \falter Deem
'lS60-Waiililngtori-Litn.
COUNTY FILE NUMBER~.. ~ ADDRESS OF APPLlCANTwe~.~_~~te..J:'.LPA._.19380
BUREAU FILE NUMBER SIGNATURE OF APPLlCANT\~JWJ1\\).Jk ~
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION,
4 .. ____...__.._._.__....._.._______.....__~.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES
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e nforesoid
DA
I hereby consent to the tronsfer of Ihe obove securities now registered in the nome of
Decedent ond weive the filing of a certificate certifying to the payment of the tronsfer ;nherilonce tox to which
the property of seid Decedent is made subiecl pursuant to the provis:ons (,f the Act of June 20, 1919, P.L. 521,
as omended ond the Act of June 15, 1961, P.L, 373, us amended. This is """ in (lcco,dance with the provisions
of the Ar.f of April 9, 1929, P.L. 343.
This Consent to Tronsfer the herein described properly ope,nte, only in reference to Ihe eslote of the
obove-eomed Decedent.
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Si(Jno(j.~e(fh 'Secretory of ~e~lue J ,J
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COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND J
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Ri cha;rSl_~_.._ Q.~el1}__
b.ing duly sworn. acc.rding 10 law, dopa... and .ay. Ihel h. is the Executor_._
of Ihe E.tal. of Richard Edward Deem
leI. of 2QJLWEJJ1\l:t.$:tuA4 ,..1em()Yn~.. , Cumb.rlend Counly, Pa., d.c....d end'lh.t Ih.
wilhin i. ..n inv.nlory m.d. by _. him, Ih. seid E,xecutor
of Ih. entire .stote of ..id dec.d.nl, con.i.ting of all the personal prop.rly and r..1 eslol., except ,.al e.lol. outside
Ihe Commonweallh of P.nn.ylvania, and Ihallhe ligure. oppo.ile .ach item of Ih. Inventory repr.senl it'. fei, velu.
a. of the dalo of deced.nl'. d.alh.
~ . - ~ and .ub.cribed b.for. me,
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GERALDINE W, PORTER, NOTARY PUBLIC
We~ Chester. Chester County, PA-
My Commission E'pires June 21, 1~2
~j\~~
Executor . AdminIstrator
1560 Washington Lane
West Chester, PA 19380
;- Addr...
D.t. of D.oth
19th
March
1981
O.Y
Month
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, INSTRUCTIONS
I. An inv.ntory mu.t b. fil.d wilhin three monlh. after appoinlment of p.rsonal repre.enletive.
2. A suppl.m.nt invenlory must be filed within Ihirty day. 5'f discovery of edditional ...ets.
3. Additional .he.ts may be attached as to'person~lly o'r really'
4. See Articl. IV, Fiduciari.s Acl of 1949.
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Inventory of the real and personal estate of
Richard Edward Deem, deceased
Page 2
27. 1974 Oldsmobile Cutlass Supreme, 2-door, 1750.00
automatic
28. Accrued interest on Eastern Airlines bonds 296.16
29. Accrued interest on Humana bonds 150.02
30. Accrued interest on piedmont Aviation bonds 107.51
31. Accrued interest on Teledyne, Inc. bonds 89.97
32. Accrued interest on Tenneco bonds 9.37
33. Accrued interest on 20th Century Films bonds 477.40
34. Accrued interest on United Brands bonds 21. 25
TOT AL $42,065.16
,
DECEASED
INHERITANCE TAX RETURNJ
RESIDENT DECEDENT
1/ ..:6 .3 t/ _ File Numbe~ ~ . 'i? \- ()d...~q
Oecodenl's Nallle ( est, First, end Middle liJi,tiel) Decedent'. Address
un. ' \' cd. SOD Wa..\f'\t.L-\-M., ~t. P.-4
Sociel Security umber Dete of Deetb ^ ^ LJ, -:l.
11",.00' dlolo'5 03-\'\-~1 Le.lY'\D~f'\I. \'n no..>
1. Driginel Return [X]
l
M......l~[H(a1) ~
. COMMONWEA~~;;lNSYlVANIA
[)(p~R'M[Nt or REV[NU(
IIJIIAU Of IKAMINA1ION
P.O.BO)(8JlI
HARRISRUIIC"M11105
CHECK
2. Supplemental Return 0
3. Remeinder Return 0
APPR 0,
PRIATE
BLOCKS
4, Life Estate 0 5. Federel Estate Tax 0
RelUrn Required.
6. Decedent died te.tate m 7. Decedent maintained a living 0 S, Total Number of safe 0
(Attacb cepy ot Will) ~ tru.t IAttach copy ef trust) deposit boxes inventoried
All correspondence and confidential tax information should ba directed to:
CORRE.
SPONDENT Name
Zip
Recapitulation
1. Raal E.tate (Sch.dula AI ( 1)
2. Stocks and Sends IScheduie B) ( 21
3, Closaly Held Stock/Partnership Intere.t (Schadule CI ( 3)
4. Mortgagas and Notes (Schedule 0) ( 41
5. Cash & Miscellenaou. Personal Preperty (Scheaule E) ( 5) 'ta,MJJ..e
RECAPIT- 6. Jointly Owned Property (Schedule FI ( 6) 11/ OtnY,Ol
ULATION 7. Transfers (Schedula G) (71
a. Tolal Gross Assats (totel linas 1,71
AND 9. Funaral Expensa. Administrativa Cost./Mi.cellaneeus
Expan.e. (Schedule HI ( 91
TAX 10. Dabt./MortgagasILiens (Schedule I) (to)
11. Tolal Deductien. (tetallinas 9 & 101
12. Net Value nf Estate Wna 8 minu.lina 111
CALCU, 13. Cbaritable Bequasts (Schadule Jl
LATION 14. Net Value subjact te tax lline 12 minu. line 131
Computation ef Tax
15, Amount ef lina 14 taxable at 6% rate 115) ..5.1. 0 l. O.IDS
(include valuas from Schadule K) ,
16. Amount of line 14 taxabla at 15% rate (t61
(includa valuas from Schedule Kl
17. Principal tax due (add tax from lina 15 plus tax frem line 16)
18. Total Prior peyments:
(al Amount Paid
(bl Plus Oi~count
(cl Minu~ Interest (tBl
19. Balance Due Wna 17 minus linelBI
Make Check Payabla te: Register ef Will., Agent
... PLEASE RECHECK MATH'"
( 81 S'l \d.q,-:L3
.
(tl1 '6 Ot.'6.5~
(121 5/,10 1,0. l" 5
(131
(t4) 51) 01.0, (,,5
x.06= .~ Olo -;. ~i
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x.15=
(171 .3)0 lJ, 3.l",
(t91
Undar penaltias uf perjury. I declare that I h.ve examined this return. including accompanying schadulas and stetements, and to tha bast of my knewladge
and belief, it is true, correct, and complete. Declaration of pre parer other than the personal representative is based on all information of which preparer has
eny knowledga,
SENTATIVEISI
ADDRESS
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PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the following persons shall prepare and file
a return:
a. The personal representative of the estate of the decedent as to properly of the decedenl.administered by him
and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or
acquire knowledge;
b. The transferee of property upon the transfer of which Inheri tance Tax is or may be imposed by the 1961 Statute,
including a trustee of property transferred in trust, provided that no separate return need be made by the transferee
of property included in the return of a personal representative.
2. PLACE FOR FILING
The return is to be filed in duplicate with the Register of Wills 01 the county wherein the decedent resided.
3. TIME FOR FILING
The relurn is due nine montilS after the decedent's death, unless an extension lor filing has been applied for and
gr8nl.ea by t'18 Secretary of Revenue within the nine-month period.
4. FAILURE;O FILE RETURN
Section 791 of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report
required of him. . .shall be personally liable. . .to a penalty of 25% of the tax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by
law."
5. TAX RATES
Inheritance Tax is payable at the rate of 6% onlransfers to lineal desc;endants, ~uch as father, mother, husband, wile,
son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others.
J
6. PAYMENT OF TAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. tnterest
at the rate of 6% per annum accrues thereafter until payment is made. All payments received are first applied to any
interest which may be due with any remainder applied to the tax. tF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF 5%OF THE TAX PAYMENT tS ALLOWED.
All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7. FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's
estate or against any property belonging to a transferee liable for the tax. .
8. FILlNGOF FALSE RETURN
Any persen who willfully makes a false return or report required of him shall, in accordance with Section 793 of the
1961 Statul.e, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
REV.451 (1.80)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OEcEOENT
ITEM
NO.
l.
2.
3.
4.
5.
6.
7.
8.
9.
10.
ll.
12.
13.
14.
15.
16.
17.
18.
19.
20.
2l.
22.
23.
I 24.
i 25.
,
: 26.
27.
SCHEDULE "B"
PERSONAL PROPERTY
(Instructions on Ravf.'rsu Side)
Richard Edward Deem
*,
~~......-.-~~='-=-.,."'" ...-=="'==-=="""'''''''''..,.'''_.....,..~t.,,,.,.'''''''''-O-.- _ ~--=-.,,"""'"
DESCRIPTION
Cash
$10,000 bonds - Eastern Airlines 11~%
due 1999 @ 82\1
$ 6,000 bonds - Humana - 11.7% due 1998
@ 83-1/16
$ 3,000 bonds - Piedmont Aviation - 12%
due 2004 @ 132-5/8
$ 3,000 bonds - Teledyne Inc. - 7-7/8%
due 1994 @ 65-1/8
$ 2,000 bonds - Tenneco - 9% due 1989
@ 76
$10,000 bonds - 20th Century Film - 10\1%
due 1998 @ 70~
$ 3,000 bonds - United Brands - 5~% due
1994 @ 51-15/16
60 shares - Jersey Central P&L - 9.36
pref. @ 55
20 shares - Tandy Corp. common @53-7/16
75 shares - Penn Elec. Co. - 9 pref. @13
50 shares - Potomac Elec. - 3.82 pref.
@ 25-5/8
2 - CIF - 9~ 3-months certificates @1035
Tenneco, Inc. bond interest owed
Penn Elec. Co. stock dividend owed
Potomac Electric stock dividend owed
Refund of 1980 Federal Income Tax
Tools
Luggage
Records
Books
Bed and bath linens
Jewelry
Miscellaneous items
Furniture
Furnishings
1974 Oldsmobile Cutlass Supreme, 2-door,
automatic
UNIT
VALUE
ESTI MATED
MARKET
VALUE
50.16
8,225.00
4,983.75
3,938.75
1,953.75
1,520.00
7,050.00
1,558.13
3,300.00
1,068.75
975.00
1,281. 25
2,070.00
90.00
42.19
47.75
124.00
75.00
35.00
10.00
20.00
25.00
20.00
15.00
570.00
115.00
1,750.00
TOTAL THIS PAGE 40,913.48
DEPARTMENT
VALUATION
(OFFICIAL USE ONL Y)
f{EV.451 ~X+ (3.S0)
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DEcEOENT
PAGE 2
SCHEDULE "B"
PERSONAL PROPERTY
~.
WiS
(Instructions on Revcrsa Side)
Estate of
Richard Edward Deem
ESTIMATED DEPARTMENT
ITEM DESCRIPTION UNIT MARKET VALUATION
NO. VALUE VALUE (OFFICIAL USE ONL YJ
28. Accrued interest on Eastern Airlines bo ds 296.16
29. Accrued interest on Humana bonds 150.02
30. Accrued interest on Piedmont Aviation
bonds 107.51
31. Accrued interest on Teledyne, Inc. bond 89.97
32. Accrued interest on Tenneco bonds 9.37
33. Accrued interest on 20th Century Films
bonds 477.40
34. Accrued interest on united Brands bonds 21.25
GRAND TOTAL " $42,065.16
QUESTIONS CONCERNING PROPERTY TRANSFERS
1. Did decedent, within two years of death, m,lke illlY translt'r 01 ,my material P,lll 01 his estate without receiving
valuable and adequate consideration'! (Answer "Yes" or "No".) ~..2.._
2. Did decedent, within two yeals or death, tfi1nSfCl property rrOlullimseW helsl)11 to hilflsl,lf!herself and another party
or parties (including a spouse) in ioint ownClship'l \A,ISWCI "Yes" 01 "No".) Yes_
3. If the answer to one or two above is "Yes" and the trilnsfers ;He claimed to he nont:lxilhle, prOVide Ihe following
information:
a. Age of decedent at time of transfer, 73
b. Copy of death certificate. Previously filed
c. Affidavit by the allending physician indicatinp fhe slate of decedent's heallh 11 lime of transfer.
d. All olher information sllpporlinp,nonlax.lbiJity of 11i1ll:;lel. see explanation on reverse side
4. Did decedent, in his/her lifetime, make any transfer of property willloul receiving a valuable 01 mleQrwte consideration
therefor which was to lake effect in possession or enjoyment at or afl.cl his/her death1 (Answer "Yes" or "No".) No
a. Was there any possihilily that the property lransferred might retum 10 lrillls[eror or his/ller estale or be subject
to his/her power of disposition? (Answer "Yes" or "No" ,)
b. What was the transferee's ap,e al time or decedent's dealh'!
5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor
under which transferor expressly or impliedly reserves for his/her life or :my period which does in fact end before his/her
death:
a. The possession or enjoyment of or the r.igllt to income froln the property transferred? (Answer "Yes" or "No".) ~
b. The right to designate the persons who sllall possess or enioy the property transferred or income therefrom'!
(Answer "Yes" or "No".) No
6. If the answer to five b. ablve is "Yes," state whether the right was reserved in decedent alone or others.
7. Did decedent in his/her lifetime nwke a transfer, th.e consideration for which was transferee's promise to pay income
to or for the benefit or care of transferor? (Answe("Yes" or "No",) No_
8. Did decedent, at any time, transfer properly, the bOleficial enjoyment of which was snhjeclto change, because of
a reserved power to alter, amend, or revoke, or which could revert to decec1ent under terms of transfer Dr by opeli1lion of
law? (Answer "Yes" or "No".) No " "'" . .
9. If the answer to eight ahove is "Yes," was the power.to aller, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others'l .(Answer "Yes" or "No".)
HEV.4~4 (l.801
CDMMDNWE~L TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DEcEOENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
'*
,.. ,
:, : ...., \
(lnstructiollS on Rovvrs(! S;chJ)
Estate of
Richard Edward Deem
P
TOTAL E VALUE OF DEPARTMENT
ITEM R
NO. DESCRIPTION MARKET c DECEDENT'S VALUATION
VALUE E INTEREST IOfficiol Use Ol/IV}
N
T
.
1. 30-month Savings Certificate (opened
1/16/80) State Capital Savings Asso.,
Harrisburg, PA 2929.20 50 1464.60
2. 72-month Savings Certificate (opened
8/16/71 - renewed 8/15/75) First
Federal S&L, Phila., PA 2346.31 50 1173.15
3. 48-month Savings Certificate (opened
4/26/74 - renewed 4/16/78) Harris
Savings Assoc., Harrisburg, PA 5550.72 50 2775.36
4. Passbook Savings Account (opened
3/23/79) Harris Savings Asso. 150.28 50 75.14
5. Passbook Savings Account (opened
2/8/75) First Federal S&L 839.41 50 419.70
6. 48-month Savings Certificate (opened
1/14/74 - renewed 1/14/78) First
Federal S&L 4065.21 50 2032.60
7. 48-month Savings Certificate (opened
1/14/74 - renewed 1/4/78) First Federal
S&L 1016.33 50 508.16
8. 48-month Savings Certificate (opened
12/14/74 - renewed 12/14/78) First
Federal S&L 1016.33 50 508.16
9. 6-month Money Market Certificate
(opened 12/24/80) First Federal S&L 12443.04 50 6221. 52
10. 30-month Savings Certificate (opened
1/15/80) First Federal S&L 1021. 79 50 510.89 ,
11. Checking Account (opened 1/6/81)
Dauphin Deposit Bank, Harrisburg 2749.58 50 1374.79
-
TOTAL THIS PAGE 17064.07
-
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 intungible flroperty are to be
included. List real estate first.
1. Describe all real flroperty as indicated in the instructions for Schedule "A". Describe all personal property
as indicated in the instnJctions for Schedule "B". Include the name, address and relationship to the
decedent of the co.owner (5) and the date the joint ownership was established.
2. Indicate the totai 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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COMMoNWQALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
SCHEDULE "F"
STATEMENT OF DEBTS
AND DEDUCTIONS
----~.
--.-.--. ..~-_. ._---_..-~=
Estate of Richard Edward Deem Date of Death _ 3/ 1 ~/81
WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOllOWING:
File No,
Clnimant
Relationship to Dec:edmlt
Claimant's Address at time nf Decedent's Death
ITEM DATE NAME OF PA YEE REMARKS AMOUNT
NO.
1. 4/10/81 Probate of Will 42.00
2. 4/10/81 Charles Evans Cemetary Burial charge 50.00
3. 4/28/81 Funeral and Cremation 345.00
4. 5/26/81 Headstone 385.00
5. A. Thomas Parke, III Attorney's fees (est. ) 1500.00
6. 9/7/8' Short certificates 6.00
7. 3/19/81 Executor's mileage Harrisburg & return 32.80
8. 3/20/81 Executor's mileage Harrisburg & side trips 120 mi 26.00
9. 3/21/81 Executor's mileage Harrisburg to home 82 mi 16.40
10. 4/10/81 Executor's mileage ~omfi to C~5~isle to ReadJ.ng 50.60
o orne mJ.
n. Seven trips to West Ches er to see lawyer 16.80
12. Executor's meals on 3/19 20,21,22, & April 10 142.63
13. 3/20/81 Flowers at funeral 21.20
14. 3/22/81 Truck rental and gas for moving furnishings .' 104.16
15. 3/20/81 Motel expense - Executor s overnight stay in Harrisburg 48.76
-
16. postaae 7.96
17. postaae 13.34
18. G. F. Norton apartment rent for March 193.00
19. PA Power & Licht electric bill 38.89
20. PA Power & Light electric bill 13.25
21. Bell of PA bill 5.78
22. Bell of PA bill 9.15
23. Master Charge bill 376.17
Sub- TOTAL I , d44 "Q
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~t~ a\\deductions,fo~ Inheritance Tax purposes.
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SIGNATURE OF FIDUCIARY DATE
OFFICIAL USE ONLY
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF $
AT
% TAX RATE
REGISTER OF WILLS
DATE
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities Incurred by the decedent prior to his/her death ore deductible ogeinst his/her taxable
estate. In addition to debts incurred by the decedent or estate, other items ore claimable including the cost of
administrotion, e!torney fees, fiduciary fees, funeral and burial expenses including the cost of 0 burial lot, tombstone
or grove marker end other related burial expenses.
All debts being claimed egeinst on estate ore subject to the approval of the Register of Wills with whom the
Inheritance Tax Return is filed. Evidence.to support the decedenl's or Ihe estate's liability for the debts being
claimed should be attached to this schedule.
A family exemption mey be cleimed by 0 spouse of 0 decedent who died domiciled in Pennsylvania. If there is
no spouse, or if the spouse has forfeited his/her rights, Ihen 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 con be claimed by
o parent or parents who ore members of the some househeld os the decedent. The family exemption is ellowable only
against ossels which flnss by e will or by the Pennsylvanie Intestate Lows.
NOTE: Compensation paid to on estate representetive; namely, on executor or administreter, far services
performed in administering en estate is reportable for Pennsylvenia Income Tax purposes. This texabl'e income
item should be reported on form PA.40.lndividuellncome Tax Return.
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1. If the family exemption is being claimed, indicete Ihe c1eimant's nome, address and his/her relationship to
the decedent. Enter "family exemption" in the rcmnrks column and the amount claimed in the emount column.
2. Assign consecutive numbers to each item listed.
3. Enter the dote on which each debt wes incurred end/or peid.
4. Enler the names of each peyee.
5. Provide 0 brief explanation in the rcmarks column for each debt claimed.
6. Enter the amount of each debt being claimed.
7. The farm must be signed by the person who has essumed Ihe responsibility for peying the debts.
IF ADDITIONAL SPACE IS NECESSARY USE BW' x 11" SHEETS.
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