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RCC.:U 14.73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BlIRI':,\lJ OF COUNTY COLLECTIONS
jJ - 8 } - :2 '/3
*
RESIDENT DECEDENT
COUNTY OF
r.l1MRPltLAND
IMPORT ANT:
'this IclUfl1 must he ctllllplclctI ill detail ami filed ill dU]lliclllC, with all ~'ttachcdl with the Register of Wills of the
('uunl~' where decedent l"l'sHll'd; RClUfl1 is dUl~ within nine months "fter dme of dC<lth, unless un extension is gruntcll
hy the Sl'cretillY Ill' R(~\Il'IHIC. (Sl.~tioll 70J flf tin.' Inhcrillllll:C ami Estate Tax Act of 1961,)
IN TilE llATTEIl 01' TilE ESTATE OF
} ,\1' FillA VIT OF
1'Ni.KllrnllR Surviving
,\XWK~'i'()jK
Heir
Gail B, We:jze 1
(STATE FULL NAMl: OF DECEDEN1)
Cumb erland
Lotc of ____________._________.
County
Statc of
p@illiY..l'lania.__.} '"
Cumberland .
xiX'X9IlIDl
County of
S~r.v.iving -heir ParlL1~W.E'.igel,----I.r-
~XIRI~lxtX*~ of tho estate 01 the above-named decedent being duly sworn, d!!pase
and soy
Decedellt died
Dp~p.mhp1"
IMONTHl
Name and address of attorney or }
other outhorl:.od rapresontativo to whom
011 correspondonc!! should be nlClilod,
R
. 11)....8.0-{~eslate leaving 0 lost will, copy of which Is heroto attached.}
(yEAR) '"'estol!!
(DAY]
J..nill., T rw j n &J.r.\'I'i n
44 South Hanover Street, Carlisle, PA 1701~
That as ~llch surviving heinJcpollellt is ramiliar with the affairs of said estalC und the properly constituting
~X~~~x~~~~~R~
thc u~scts therclll' ;\lHI their fair nwrkcl value.
That at the lime uf death Ihere was nu safc dCJlllsit hox rcgistercd in decedent's individmd name, or joinlly with, or
&1S agent or deputy of another, or in dccedcnt's individu.li name, wilh right of access by anothcr as agent or deputy, with the
exccptiun of the follow ing: -
N,\t.\E AND ADDRESS OF GANK OR OTH'::R INSTITUTION
IN WHICH DECEDENT RE~~~ A~~E DEP05IJ...~O.~_
THIS SAFE DEPOSIT BO)' RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
That the contents of sait! safe deposit box or hoxes arc itemized under Schedules
with the exception-of the following, for the reasons hereinafter set forth:
of this return,
Thai Schedule A attachcd heretn "lid made part hereof sets forth fully and in detail all the real property
in theCommollwcalth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each p;lfcd of real property at Ihe date of death, giving the amount still due at
death, name of mortgagee, datel rale of intercst, and book and page of record thereof, It also sets forth in the
columns provided therefore the assessed valuation of l'.ach of said parcels, the estimated market value thereof
as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
wheresover situated owned by the decedcnl at the time of death: all moneys left by the decedent at the time of
death, whether in decedent's imlllediate possession, stilm.!ing to decedent's credit in banks of depo~itl savings
banks, trust companies, or other instilutions, whether individually, or in trust for any other person or persons
giving also separately thc accrued interest lhereon, if any, down to the last interest day prior to decedent's
death in the C;ISC of savings hanks, and to the dutc of decedclltls death in all other cases; all hUlHJSl poslal
savings, treasury certificates or notes amI other evidence of indebtedness of the United States to the Je-
cedent: all obligations, whether by statutc or agrel.:l1lcnt they arc designated as lax free, of the Uniled St:lIes,
or any state, or political suhdivision thcreof, or of any foreign counlry, which arc owned at the time of dealh:
all wcaring apparel, jewelrYl silverware. piclures, books, works of art, household furniture, horses, cllrriages,
automobiles, hoats, and any and all other Jlersonal chattels of whatsoever. kind or nature, Icrl hy decedent,
together with the fairly estimated murkct valuc thereof: all bonds and mortgages held by deccdent and of 1111
claims due and owing. decedcnt al the lime of dcath, and all promissory notes or other instruments in wriling
for the paymcnt of muney of which decedent died possessed. nf whatsnevr.r nature, with interest lhereon, if
any, g.iving the r~lce value ilnd cstimated fair market "alue thercof, and if such estimated fair market vullle he
less than the face value, it sets forth briefly the reasons for such deprcciution as to each item: alll1lulleys
payable to the estate from life insurance policies carried by deccdent~ all annuity and endowment cOl1trncts
the proceeds of which were payable upon the death of the decedent; all and the t:orporate stocks and divideluJs
due thereon and unpaid ;IS of the date of deaih. bonds and accrued intercst thereon tn the date of decedenl's
death and other investment securities owned by Ihe decedent at tlie time of death, wilh the market \'alue thelc.
of at such time.
_ .d,/:ri]
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.
.,
III Ill.. 1'/lSI' '11' SI'l'lll'IUI!S 01' /'llIsl' or l'/Unlly ('lIl'pflrlll.!olls, tll.. \'1l11li~s 1'{~I)(II.tf'i1 111'(' IlS "nr us
pOHHllllf> fillh~IIHlII/lI"rl h~' I'ltllllll'llll Slllll'll1i'llt,s nf' 111" (~OI"Hll'llllo11S. Sll(lwlltl~ Ull~ IISSf'!.... IIl1d Illlhlllt.1es
11]lII'l'ol' liS 11" Ill.' dill!' Ill' ill'lIlll. Till' s('lll~dllll~ nlsn sl~l,s 1'01'1.11 IIII' illl.~'I'psf. of' df'f'f'dl'lIl. Ill. t.hf.' time of'
IIp/IIlI III IlIlY l'O'.p"I'IIlI','shll' or hIlSIIH'SS, alld III SUPPOI't. 01' Ult. \,11111(1 of' SI11~1i Illlyr"sl. 11l'~I'P It; IllllleXl'C1 to
snlll 'iI'II"dllll', rlll/IIII'lld slnt/'IllI'nls sltllwlll~ tl1pnssf~ts lIud IIHIlIIIII..... 01' s/lld ~O-plll'tllf'rshIJl or hlislll(~s::;,
,\ 1'.l1lY nl' Ill" (.n-pltl'ltll','sltlp 11l~r'''''lIl''llt. (If orll1, II SI,lItl'lTlt'llt spltllll-'; ('o\lll 1.11(> 111ll.ln'l' 01' UH' il~~I"'r>UlPllt)
10J.'."III"I' willi II "!IlII'!'l"1I1 sl'lllll~ l'OI't,l1 tlll! e/1ltt'II(~tpr fJf' 111.. IJIJsIII"SS, Its ItWHt.loll, 11I1IJ sllC:h other fllcts
1"'I'I.,tn\I'.l~ '" 1111' lI1Jslll"ss liS rnll~' Ill' 1'1'1'1,1111'111.1.11 II CHI" /JllIl .I11st IIpp1'1t1S111 lIl' t.llf' (\P(:('dPllt's tlll.P,"llst
I hl'l'" 111 mll..t h,....IJ!lmltl,f.d. It shlluld niSI) s'~t f'OI'I,1i In ll.f'mlzpd 1'01'111, In~,'III"I' l'ilt.h th(' !'Idr rnnrket vllllln
lhf'rpof; IIn~' nlhl'" propPl'ly OWllf'd Ill' tU'l]llpnlllf'd hy till' l!1'Ct'1!01lt. lit !.Ill! tlrnl~ 01' c!l'lIt.1l.
TIll' Se/lNful1' r; ntl.llf~llf'd 111'I'eto !llll! Illlll\f' pn"t hlll'I~Of' sPl.s I'nrl.lL II l.1'1l\~ HIJSI'iI'r to ench Illfjuiry
I"UI1I,lIli1l'1I I.ltl'n'ln 1l11f111lUIl! "IIS"flt'lrl\l\sf"!rsol'prllpl~"t,~', rpal 01' 1'., I'S (J!lll I , wllhln 1......0 Yflllrs of' rlecedentls
dl'IIt.lh 111 c~nllt.l'mJllatlllll 01' d"I'l'dl'lll' s d'-'fllll. or lllt,f'lldl~d 10 I,ll.;" l'I'I'flf'f. III Jloss,~ssloll 01' en.loyment ut or
Ilf'tf'r 1il'lll.h, slll,J sl:ll..dull' Sl.ts 1'01'1.11 t.1l.~ 1l111,1I!'" Itllfl VIIIII" 01' slIc~h !,1'1I1"'I'ry, (,0 wltom tl'(lI1st'erred, the
rp.Jntlllllshlp 01' t.lle 1.I'I\IlSf'f~I'I'I'S t.o t.lln decf'IIi~lIt, I.IJI~ pl'IlPfll'l.IIlIIlll.P ~!IHJ'f' rl!.:f!I\'.~d hy ('nch trllnsreree und
1111 ol.hl~1' filets of It pnrl.lllf'1l1. llH 1.11 1'1' l'I'~Hrl\ll1~ SIIII\ I.rlltlsl'l'l'S. 111 Ih,' f'IISf~ 01' I.rllllsf'el'S 111tendeil to
l.nkn f'f'I'I!Ct. .Ill poss'~sslon (IT' I'Tl.10)'llllmt Ill. or nl'l...r dIHIt.ll, L1I1'I'll \s /lIS(1 /l11.IlI'111'11 10 tile schc(lllJe II COllY
01' t.IH-' fll!!!ll, t.l'\lSI. n~rf't'lIIet11, or ol.II'!r InSU'II11llHll. (:rPlltllll!; 1,11(' l.I'W;l, TIll"'I' Is also set; fort.h In said
s(~hnd\ll,~ H list. 01' nl] prolll't'l,~', n!1l1 /illd IlI'rsfllllll, wlt.h Its \'Hlllt'. 1\'1l1c~1l '"I~,SPS III ,11!Ccclt~nt.'s rip-nth lly
vlrt.ue or Ult' exe,'clse h~' Itf!(~r>ltl'I1t.1 ,'IUI('I' Incllvldulllly, ol'.lI,ln1.ly with 111101,11"1'. Ill' /lilY power of (lPllo1.nt.-
men!- VIlsl.l!d tndlll:(,flellt., I'It.lli~I' 111l1lvldlllllly or .1f)lnl,l~', hy1.111' .....111, Ili'pd, 01' 111.111'1' Instrllment of' nnnthel',
wit.h a eopy ot' t.he Instl'\lm,'nl. l'I'fllll.11l1!, sHch powel' IIt.tllelll'd to 1.11" sL'll"tlII1".
Thnl. SChf'du/f! D ll1.tllc~IIf'1I hl"!I'Ct.O HIlfI Ill/tell! pili'!' 111'I'cuI' sf'ls 1'01'111 tiln '!Innes Ilnd tulrlresses of' flIl
pel'sons henel'lcllllly 1I1tcr(~st,~(1 ITl t.l1ls estllt.e lit. l.J1P. 1.I111C 01' dl'.~"dl'1I11s tlplttll, tile 1l1lt.llrl~ of their res-
pectlvH ilJterest,s, t.helr t'clllUonshlp, If' /I11Y, to t.he 1I('Cf'lil~llt., t.n;!;f~th'~1' with till' lll!;i~S lit. the time of
decedentls r!ellth of Illl minors, 1l1lTl1:ltlllltS Iltlcl bl~nf~f'lcll\rlf's I'nl' lif't' Imill'l' rlf'ci>l1ent's WII]. It also
eont.llJns II stlll,emr'llt. show1nl!; which or t.lll' heneflciarlps 1l1l11ll'd III tlJl> dl'cf'cl(lnlls will, 1." any, dL~d prior
to <lccndfmt, tlte dllt,p's of their tll'llt.lt, t.lll-'ir' 1sslll~, llIlll th(! ;'l'lnI.lClllslilp ,d' suelt Issu(! to thp henRf'lctnr:,.'.
TJlIIt :?.:"edu/ro E nt.t.acllcll hereto nnll IIIlHle 1\ !InrI. 11l~rl-'of spts !'orth 1111 properLy, I'cn] fl.l111 per-
SOl\l1] , oWller! hy t.hr> d(lcctlent. .foint.ly with [mother or ot.llers.IIl(:llJlllllt~ tnl.fln~~l.hl(', s1.nndlnp; 'In t1H! nnme
of t1w clp'cf!fhmt. HlIll othprs, pl1lS tll(l dftt.n and plncf! 01' record of' lnsl.l'\lmpnt.s ef'f'ecUng t.he \est1 turf! of'
ren1 nst.fltp nnrl t.ile lIntl! of ncqlltsl t.!OIl of personal t.y, plus till! nllm(!. l1:1d!'l'sS Hlld rel.lLt.1onshlp, 11' IUlY,
or co-owners to the decetlen t.
Thnt Sc/lpdIJ/p F Ilt.tllelll~d hercto Bud mllde II pl\l't Ilerellf sp.I$ fort.h f'ully IlIltl in det.llll all dehts
llllll df~ctllcUons clldmell for /lull nn hchnlf of Ods dl'l'f>ill'nt's I'st.nU', Including funerlll eXIHmses lHddj
1'un1l1y f!XCmption, where nppllcllhll'; cost.s of lIr!mllllslrntll1l1 of t.hls estut.I': c:oullsel rees luul f'ndtclnry's
COnlltltsstons )lfltd or to he pnlrt: cost. expentlecl 1'01' hurlnl t.r1lst.s. t.omhstones or grnvcmnrkers, ntHI reli-
gious services, In /:onsell1lt"lICI' of t1lf~ (h~nt.h of' the IIp{~l!dl)JIt,: dehts Illld ellllms oWlllg Ilnd 111\]l1l,1fl nt time or
d(>flthj tllxes Ilccrlled chargeahle for perio(l prior 1,0 IlecPli('nt.1 s rlpllth (excf!pt-. thosf! 1I11owl~d under Section
flra of' t.11,~ Illhf!rlt.lln,~.~ /lllfl Esl.lll.p Tllx ,\ct): tC)~rd,It('r with It st.atcment. of' collntllral ple.ll!;(HI for obltgn-
lions, If' lillY, It Is llJ.!;rf'eil t.hllt. t.hn (,ldllc~lllry wilJ 1,respnt I,rnnf' of slllcl el:llllJPd ohllgat.lolls tllJon l'e-
1IIIest., Lha!' jf' the nm01I11t. netuHIIr plt!ll In sett:lemnnt of /lilY f('p. l'olllltllss1on or dellt is 11'S8 tlmll the
estimll1.l"!11 flmollnt l'l1l111l111~ IIwl Illlowed. t.hat t.h(' slime will he report.er! t.o Ulf~ Hpc;lstl~r of Wl11s, lltHI thnt
1.111~ Ilml)llIlt 01' l.Il'X assessi!d C/lll hp rellssessp,1 III Iic(~(Jrdll1lCf! tlll!!',,,y,'] th,
Thill. till' t.ottlls fir till' Ilpprflprtnt.1' cnllloms in S('hf!dlll,~s "A", "un. "en, "E", /\Iut "F" itS cltl'cctelt therf~ln,
IIIIVI! 1l1'1'1l cllI'rlei! I'orwllr,t linel prnp(!l'ly reJ!;tsl.p.rpd In 1.IH' Slllnlf\lIr~'.
Subscribed and sworn to hefore me thiA
f\'
day of
. . ')1
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1
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/~ C-Utk._
.."" .' -
19.81
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it'll-,..,; ",' ";" ~L ",. ..', "''',. ....,
CfXcl!&1!o:i-~WYIUOI9 Surn vwg
Hi glL.S.tre.e.t...,.
(Street Numbl!T)
..Allen, EA17001.
(City or Town and State)
f,W l.u;,:r,1ls:,:;':; '-
;-'\.-, ,,,
":;(
L~.i
SCIrE: 1I1'1'oJrf' SIV,lllng: 1I1'f'lrlllvll 1I111k!' Sllrl' HII hlallk spa..,'s III thO' al'fldHVIt. line! sch('d1l1es annexnll lire
fll}('ll In with ,lpl.atls .)t' tllp .....1I1.d "~Ol1fl". ltlld III ('aSf' thO' assl'ls In..lllllt' 1'1l\,1~ !Iud 1I1111stpll securities,
O:;"l~"l'Jtlf>s nl' ('10",'> or f'lImlly l'lll'pnl'/Il.loll!-. 0\. illl \lIl.1'ri)sl III an\" t'll-P!II'IIH','slllp "1' hllsln,'ss, llwt t.Ilt~
Itlll-II 1I11t! st.'.tl'lll"nt.S 1''''11111'1'(1 llIltl.." Ill" plll'.'ll~'.llpll 1l1UI\'I' 1','lalln~ iel S('II"I!II!" "U" Ill''' lItt.aell('ll. .\Iso mllke
..'lrllllll t.hnt. (~'1111t1lll if1 III I!I.. "SllllllllHI'Y" ll:ls 110"'11 prtlp'~I'ly (,lll1lJlI"Ipd (IS Ilh(l\','-dirc~t.l'd,
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
'*
.,
.REV"4!)' le.711)
RESIOENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule must disclose oil tongible ond intongible personal property owned individually by the
decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed
under Schedule liE". Intangible personal property, titled in the name of the decedent, but payable at death 10 anuther
~Jr others, including hut 1I0t limited 10 p.o.n. U,S. Savings Bonds and tentative trust accounts, must be listed, despite
the far.:t llwt they arc not of the ndministcrcd cst;atc.
Tangible Jlersonal prnperty shouhl he listed first (c.g. jcwr.:lry, wearing apparel, household goods, and
furllishil1g.s, books, puintings, automobiles, hoals, cIC.)
Intangible personal property, such i1S bonds, trcasury ccrtiricates, cash on hand and in bank, :Hocks,
mortgagcs, notes, together with uccrued interest or dividends, salaries or wages. insurance payable to the csta(e or
fiduciary ill said capacity, partnership interests, interest in any undistributed estate of or income frol1l any property
helll in trust under the will or agreement of another, even though located outside of the State, nt the time of de;lth,
should he listed in this schedule.
Item I1ml UNIT ESTIMATED DEPARTMENT
Nil. List and describe fully VALUE MA.RKET VALUATION
VALUE (Uo not write in
this space)
Farmer's Trust Co,
Burial Fund No. 1-287262 455,4411
Blue Ridge Haven Nursing Home
. Refund: 540.00
TOTAL 995.44
-
Insertlhis total opposite "Personal Property''. Schedule "ll" in XX c; 'I s-: If'r
the U As Reported" column on the last page of this return. ~
.,
"
REV-452 (S.78)
COMMONWEALTH Of PENNSYLVANIA
TRANSFER INHERITANCE TAX
.
SCHEDULE "C"
TRANSFERS
RESIDENT DECEDENT
(1)
(2)
;
(3)
Did docedent, within two years 01 dooth, mako ony transfer of any matoriol pan of his estato, withuut rocolvlng a valua~lo and
adequato co",ldoration thorafor? (Answer yes or no) No
Old decodont, within two yoors of death, tron.fer ProllOrtV from him,olf to hlmsolf and anothor or othors (Including a IpOUSO)
in joint ownership? (answer yos or no) ~S-
If tho answer to (1) or (2) a~ovo i.;n the affirmol;ve stoto:
io) Ago of docodent at timo of transfer __:18_
(b) Stato of docodont's hoolth at t;mo ef m.king tho tr.nslor. (Note 1).
(c) Causa of dacodent's death. (NOlO 1).
Did decedent, in his lifetime, mako any transfor of property without rt!ceiving a valuable or adequate consideration therefor
which was to take offect in possession or enjoyment at or after his death? (Answer yes or no) No
(a) Wa. thore any possibility that tho property tronsferred might roturn to transferor or his ostate or be subject to his
power of disposition? (Answor yes or no) __No
(b) What was tho transforoe's age at time of decedont's ~o.th? ~/-1L-
Did decedent in his lifetime make any transfp.r without receiving a valuable and adequate considcrl1tion therefor under which
transferor expressly or impliedly reserves for his life or any poriod which daes not in fact end befote his death: No
(al The pOSlession or enjoyment of ortho right to incomo from tho property Iransferred? (Answer yes or no)
(b) Tho right to deslgnato the porsons who shall posseSl or onjoy tho proportv transferred or income therefrom?
(Answor Ves or no) No
If ihe answer to (5) (b) above is in tho affirmative, state whother the right was reserved in decedent alone or others
(4)
(5)
(6)
Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the
benefit of care of transferor? (Answer ye. or no) No
Did decedent, at any time, transfer property, the beneficial enjoyment of which waS subject to change, because of a reserved
power to alter, amend, or revo\e, or which could revert to decedent under terms of transfer or by operation of law?
(Answer yes or no) N 0
(9) If the answer to (8) above is in the affirmative, was the power to alter, a",end, or revoke the Interest of the henef;ciary re.erved
in the decedent alone or the decedent and others? (An.wer yes or no) No
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well os a copy of the death
certificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market
valua at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit
copy of any tr\l~ deed or instrument, if transfers are claimed to be non-taxable, also submit detailed statement of facts on which
said claim is based.
NOTE 3: List applicable property below;n manner in which provided in Schedules A, B, or E.
(7)
(8)
ITEM
DESCRIPTION
MARKET VALUE
(Estimated)
DEPT, VALUATION
(Dept. Onlyl
Dauphin Deposit Bank & Trust Co.
Checking Account No. 89-434927
Registered: Park L. Weigel, Jr, for
Gail B. Weigel
Opened: October 2, 1980
Certificate of Deposit No. 25-23935
Registered: Park L. Weigel, Jr. &
Gail B, Weigel
Opened: December 4, 1980
11,805.18
20,000.00
61,805,1~
'f1,12./
.{,,'fi:t,u<J1:,
TOTAL -
Insert this total opposite "Transfers", Schedulo "C"ln the
uAs Reported" column on the last page of this return.
J/) 1'/-1...3 0
Afy-tf
hEV...3'Il,'OI
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
*'
(Instructions on Reversa Side)
Estate of
Gail B, \velr:el
BENEFICI,l\RIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY
DECEDENT BIRTH
P"'l"k T, ....Jol.eigel,~ Snn ve.s One-half
High Street
Allen, PA 17001
O~ F, WeiO'el Son Yes One-half
u,~'" Q"~oo"
All "'n PA 17001
-.-- ----" -.
,
The above beneficiaries are living at this time except for the following:
NAME
DATE OF DEATH
REV-01U E)(+ (500301
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
[!] Original
o Supplemantal
o Remainder
File Number
21-81-0243
Estate Name
Gail B. Weigel
Date of Death
December 8, 1980
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that I have appraised tho real and personal property as reported in the foregoing
return at the values set forth opposite each item in the last column to the right in Schedules "A", IIBU, "C", and "E"
9', ' ".N't' LJ
,I I/; .'tlll / "I {(l11) 'fl.
INHERITANCE TAX APPRAISER
Dated:
April 30, 1981
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY VALUE AS APPRAISEO COOE (HARRISBURG USE ONLY)
Rool Property (Schedule A) $ None 00+ 92+
Porsonal Property (Schedule B) 995 44 10+
Joint_Held Property (Schedule E) None 20+
Transfors (Schedule C) 31 846 30 30+
TOTAL GROSS ASSETS ___.__._32_,S!tj
Leu D.bts ond Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Lile Estate RATE FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER ONLY
Tax on $
CODE
COMPUTATION OF TAX
$
$
$
$
$
6'.
"
Tax on $
15%
Tax on $
Tr.lx on $
Tax on $,
Exemptions
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Less Credits
DATE OF PAYMENT
AMOUNT PAlO
DISCOUNT
INTEREST
TAX CREDIT
S
+ $
$ =
$
+
=
INTEREST FROM
BALANCE
TO
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I.
J
55:
.__._._.._._ __._._..____...... .ParlL.L...Welgel,.. Jr... _.._...__._._.___.__._.__.____.__n....._.._
boing duly _~worn__ ...._..._. according 10 law, doposos and says Ihat ho.__J:.1l.. surylvi'lc._helL__
._ .._.._ ..... ...... of Iho Estalo of Go,1.LJl,__Wel c'el
1010 of Monroe 'l'ownship , Cumborland Counly, Po., decoasod and that tho
wilhin is an invonlory modo by... _ .... Park L._W.eigel ,...Ir. _____, Iho said__s.ul'.v.i.v.lug...helr
of Iho enlire eslale of said docedent, consisling of all Ihe porsonal property and roal oslalo. excopl roal ostale oulside
Ihe Commonweallh of Ponnsylvania, and Ihal the figures opposite each ilem of Ihe Invenlory represont ii's fair value
as of Ihe dale of decodent's dealh.
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JolOOo:(lIlot .lio.:4lK;j(jIl~l<Il( Survl ving
Sworn
High Street
\',1.:
Allen, PA 17001
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~'-,_':ny
Addreu
MY COMMISSION lXPI'(lS lei. S, lS54 .
Dale of Oealh ___8.....__..
Day
-D~mb..e.rc..
Month
1980
Year
INSTRUCTIONS
I. An invenlory must be filed wilhin Ihree monlhs after appointmenl of personal represent alive.
2. A supplement invenlory musl be liied wilhin Ihirty days of discovery of addilional assets.
3, Additional sheets may be attached as to personally or really
4. See Arlicle IV, Fiduciaries Acl of 1949.
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HEV.45'S EX. (J,1l01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "F"
STATEMENT OF DF.IlTS
AND DEDUCTIONS
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Estate of GAIL B. WEIGEL _____ Date of Death12/8/~0
WHEN CLAIMING THE FAMIL V EXEMPTION, COMPLETE THE FOLLOWING:
FileNo, ,// .r; .,.,Ii:;'
Claimant
Relationship to Decedent_.
Claimant's Address
ITEM DATE
NO.
1 2/19/8
2 2/16/8
3 2/16/8
4
NAME OF PA YEE
REMARKS AMOUNT
Funeral services $2,392.70
r~edical services 80,00
Medical services 48.00
Filin Inv. A ,00
Filin
Recordin Release
Notary fee
Attorne IS fee 1
6
7
8
Cocklin Funeral Home
William p, Graham,III,M,~,
Carlisle Hospital
Re ister of Wills
Re ister of Wil1s
Recorder of Deeds
Roger B, Irwin
Irwin Irwin & Irwin
TOTAL THIS PAGE I $ li. 2,,,, 7R
I hereby certify that to the best of my knowledge and belief the foregoing is'a just ilnellrue stiltement of debts, funeral
expenses and expenses of administration submitted to the estille as deductions for Inheritance Tilx purposes.
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SIGNAT E F ATTORNEY/FIDUCIAnv DATE
OFFICIAL USE ONL Y
DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S
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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 are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker.
All debts being claimed against an estate are subject to the approval 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 of $2,000 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 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,
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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 remcrks coltimn 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.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
I
COUNTY FILE NO:
(1, I >/ )
~;\ C J .1
OATE
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TO: I, ()-
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C'M
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(.,--=, 1
ESTATE
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'-
FILE NO.
OA TE OF OEA TH
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COUNTY
Appraised Value of Estate:
Real Estate
$
.
OJ 0.5.t) Lf
-'} (; IIC. .;;,'
.56.",..__,0
Personal Property
Jointly Held PropertylTransfers
$3';> 'tr"1/ 7(-
t/ .;135 '7 (y
" G
$~g- (-05 '1
-----...
Total Gross Estate
Total Approved Oeductions
Clear Value of Estate
Less: Approved Charitable Exemptions
$ ;A;.... (.D.5 17 G
Clear Value of Estate Subject to Tax
Amount Taxable @ 6% Rate
$ ~ F: ~,(\.0 C!6
tax due
$ / 'JIG,. 3(,
-_.
Amount Taxable @ '5% Rate
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
/ t7/(P 3-b
* * * * * .. A five percent discount totaling S
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 annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid bv
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$
I '71(, 3' f,
,
Assessed by:
See Inlormation on Reverse Sidtl
INFORMATION
To insuro proper crodit 10 your .:lccount. tho name of Iho cslalO and file number should bo clearly print-
ed on the check or monoy order.
Thls assessment is made in accordance with Section 708 of tho Inhoril3nco and Estate Tax Act of
1961 (72 P.S. 9 2485.708).
To the extent that inheritance tax is paid within three (3) months after tho doath of the decedent. a
discount of five (5) percent is allowed 172 P.S. 9 2485.716).
Inheritance Tax, other than tax on a future interest. is due at the dlllO ollha 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 interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P,S, !j 2485.712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following imerest IOble:
--------------------- ---------- ---------------- - - --- - -..- -_._----- -- -- --- ----
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 .000 17 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 .00085 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 (60l days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. S 2485.1001).
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
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.....-::
INFORMATION
To insure proper credit 10 your account, the name of tho o:>'.alo and file number should be clearly print-
ed on the check or money order.
This assessment is made in accordance with Section 708 of the Inheritanco and Estate Tax Act of
1961172 P.S. S 2485.708).
To the extent that inheritance tax is paid within three (3) months ofter the death of the decedent, a
discount of five (5) percent is allowed (72 P,S. S 2485.716).
Inheritance Tax. other than tax on a futuro interest, is due at the date 01 the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P.S. 9 2485.7111. Inheritance
Tax on a future interest is payable within three (31 months after the transfer takes effecl in possession and
enjoyment and is delinquent thereafter (72 P,S, 9 2485- 712). Calculate interest from the delinquent dale shown
on the face of this form to the date of actual paymont using the following interest table'
---------------------. ---------- --- ------------- - - --- - --- -------- -- -- -- -----
1 month .005 4 months .020 7 months .035 '0 months .050
2 months .010 5 months .025 8 monlhs .040 '1 months .055
3 months .015 6 monlhs .030 9 months .045 '2 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 day' .00237 24 days .00403
5 days .00085 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 (60) days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961(72 P.S. S 2485.1001).
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: