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RE\"~tO (11-78)
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF FIELO OPERATIONS
TRANSFER INHERITANCE TAX OIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF' RESIDENT DECEDENTS
COUNTY OF
This roturn must be complotad In dotall and flied in dupllr.ato, with the Rogistor of Wills in tho Counly whoro the ducudun! residod within nino
months ahar dolo of doath, unloss an Oldonslon is grantod by Ilu.'! Secrotory of Revonuo.
Will
Admn. Nu,
(N...MEl
.__~ of .l1._.D,~ _BoJ0..J.~..:.A,_~~.wril1.e1P-A
(Annrlr':t~l 724'
19__ I, Esther...M., Reed
Mi~c.
heing duly sworn according to law, deposes and says lhatSIl' is the _.fu.Lr-.Y_iY:lnA:j.oiQt_tQna,nt~_ "
(E~:l.<':., hDM., Llilit.TEI::, I;IC,\
of Ihe eslale of _____.Hflr_old_E.LR~e.d,_.J.~,....._....
lale of__Upner_Erank(oxdT.ownship
ItlTY, UOf~OU(,H, or~ TOWNSHIPI
deceased, nlld that the whole of the estate 01' said dcr.;cdclIl, who died on
_Jtlne ~L 1980
WAle)
cunsisted or the assets listed below and that allowahle dehts allll deductions c:\ceeued the fail' markct valuc or the ilSSl'tS anJ
no Pennsylvania Transfer Inheritance Tax is due.
~:.:;;. ,Ub,.:,:b:1d ~;;i;~_ 19~ _t4~iu?q-~---.~~r:Yi~~R~},en~rlt.. ..P.--
~. 6-~ 're' Jurie 13. 1983 Esther M. Reed
~5Ct: DOry tl Ie rlsa, urn ran Departmal1t
Real Eslatt. Pors. ASSETS Estimated VoIUOlie_"
Prap"IIY, Jointly Mar~ot
Held Prep. IIr (Attach additional sheets if necessary) Value CAUTION
Transfers Description af Asset (00 nat wrlto
in this <iprlCc)
Pers. Prop.
1st Nat. Bk of Newville account owned jointly
by Harold E. Reed Jr. or Esther M. Reed
The following item is reported in memorandum
form only as proceeds of settlement of a
wrongful death cause of action, see Hoover
Estate, '/0 Fiduciary Reporter 476 (Montgomer
1957)
a. Wrongful death settlement of $25,000.00
from Nationwide Insurance Co.
b. Additional wrongful death settlement of
$20,000.00 from Erie Insurance Exchange
35. 63~
,34 into
TOTALS
35.97/
.Jb-: 77
REPORT OF INIIERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the above Coullty do respectfully report lhatl I);]\,c
appraised the real and personal property as reported in till.: foregoing schedule at the \'alues set forth opposite cach ilc1ll11l
the last column to Ihe righi, (y~ . "ft'D.' L)
/~,' &-'1 (11 J 1...LLir...IL!1.J..' .
Dated: April 30. 1981 IINHERITAf'.;CE TAX APPI~AISERl --~-~-
Name of Payee
DEBTS AND DEDUCTIONS
Nalur~ of Claim
Amount
Claimed
Amount Appraved
by Rugister
Esther M. Reed
Register of Wills
Family Allowance
Filing Inheritance Tax Return
2,000.00
3.00
TOT ALS
2,003.00 -.,
tJ03.H)
REPORT OF TilE REGISTER OF WILLS
I, the undersigncd duly elected I{cgistcr nf Wills in and for the above County, do respectfully report Ihat I have allowed
deductions in the amounts sct forth in the "hove schedule as claimed, except \\here I havc set forth a greater Ilr lesser .1;Hllunt
in the last elllumn tu the right, which grealer or lesser amollllt represents the sum, )Io\\ed as a deduetiulI. L~
Date of Approval: tJ1!a.(.1 /i( .I 9f' / [', / " . '/ . 6-~
t -GISTEROF Yo' LS
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INFORMATION
To insure proper credit to your account, tho nomo 01 the estilto and file number should be cloorly print.
ed on the check or monoy order.
This assessment is made in ar.cordiltlco with Sectiun 708 of tho Inheritance and ES1111D Tax Act of
1961 172 P.S. 92485.7081.
To the extent that inheritance tax is paid within three (3) months after the dooth of the decedent, a
discount of live 151 percent is allowed (72 P.S.)2485.7161.
Inheritance Tax. otner than tax on a future interest, is due at the date of Iho decedent's death nnd becomes
delinquent at the expiration of nino (9) months aher the decedent's death (72 P,S. S 2485.711). lnheriwnce
Tax on a futuro interest is payable within three (31 momhs alter the transler lakes effect in possession and
enjoyment and is delinquent thereafter (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:
------------------------------- ---------------- - - --- - ----_.~----- -- -- -- - ----
I 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 1 2 deys .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 (60) da~'a after' receipt of this Notice as provided by Section
1001 of the Inheritance end Estate Tax Act of 1961172 P.S. 92485.10011.
Make check or money order payable 10:
"Register of Wills, Agent"
Mail to the address listed below: