HomeMy WebLinkAbout81-00370
No. 21.8'1
PETITION FOR PROBATE OF WILL AND
in the Estate of Edna W. Applegate f
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..
LETTERS TESTAMENTARY
, deceased.
Mary C. Lewis
To ' Register of Wills for the County
of Cumberland, in the Commonwealth of Pennsylvania.
is
Petitioner(s) ete-the executor named in the Last Will and
Testament of Edna W. Applegate dated 9-26-1968
Decedent was a citizen of the United States and a resident of
Camp Hill 1-ew.As~
Borough, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on
Wednesday
h 18th
t e
day of
March
,
A. D. 19JL, in the County of
pennsylvania
Cumberland
, State of
90
at the age of
.Aers- kle5 he r
Decedent has not been married and has not had children born to him-
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
/t1/ ()-c'-'() and of real estate to the value of
years.
as near as can be ascertained; said real
estate situated as follows
ewI'1
Therefore, your petitioner(s) respectfully applies foi'the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated 5 - 13 - 81 ~ 'oj
Name and address' '/~t.e.'t.-jA'~r;-u..~L
of Petitioner(s) '." James W. Applegail ()
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COMMONWEALTH OF PENNSYLVANIA t
COUNTY OF CUMBERLAND \ ss
James W. Applegate
named in above application, being duly sworn according to law
say(s) that the statements set forth in this petition are true to the
his
best of
sworn
and subscribed before I'
l~;
..
me May 13 1981
t1J;~Li &. ryUH~
Register
d-./- g l- :::/7 0 .N-, ?l. I~i/",-,-...{ .,:be
Filed:Juiy 27, 1981{1-J,(,.5 - 3 rS:';U.\3(ttorney:
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.
her request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses hereto.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENN5YLVANIA~
55:
COUNTY OF CUMBERLAND
Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the
James \01. Applegate
County of Cumberland, personally came ...........".,....,.."......,."..,..,........",.,",....,',......,......,......".....,............,................,....
who, being duly ..~.m..,.............,' do gf?....... depose and say that as Ez.e,C,Utor..........................................................
, Edna \01. Applegate
of the last Will and Testament of ...................................,..,........,...................................................................... deceased
......JilL............................ 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.
sworn
................................
and subsccibed
........................................!1':l;;(..}J,....... A. D., 19.?L.
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,d{0l~'~J'~'?:':::'~"""^~'''I'''':'::!. ~A~.(t.. _.e..,.....
, ,7 ames w. "I-'P eg'fff:.~J
before me.
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DECREE
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Be it remembered that on the ..........?1.~.l.L... day of ...................;r.\!J.Y.,........,.................." A. D" 19..~;J,.. there
was probated and recorded the last Will and Testament of ............));gX!!LK,...A,p.pJ~g,~j;.~.....................................
late of .............................~~~.p.,..~.~,~,~,...............,......................,' Cumberland County, Pennsylvania. Deceased. Letters
..........,..........,.....~.!!.~.'!;!!:ITl.~!),~!!-,!:y......... were granted to .. .., ,., ".J.,(l,m~ !?"J:l,...,Jl..llP.l,~&{l,j;.!L............,.... .......................
Witness my hand and official seal the day and year aforesaid. ~
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193 ........ .. /d.f':...c::...,...
. .
Register.
" I
Cumberland Co., ss:
B t b d tl t I "",' M,a.r"Y, ,C,', "Le,wi "S, Rtf W II
e i remem ere.. la ,.... ,.. ' , _ ,..mm..,' egis er 0 i s
f C b 1 d C P I . d I b d ' d .. Honorable
o um er an ounty, ennsy vanta, 0 lere y eputlze an commlsslonate......,......,....
.~~.~.~..~i,l_s~I1..K1ille.... ..,..,....., Register of Wills, of A,11e,g,l}enL..u _....County,
Pennsylvania, to take the affidavit of.,'!llrnes ?llnn...J_r:..,an~..~,a,~.r:~,~,~,~..~.:..~:~.~~th
subscribing witness 7t~ the last will and testament of.. ,E_d,n~..~,..i\.pp.l~g,a,l;~m..........
late of.......,.........C,alllpH,ill.._,m,m.....m,Cumberland County, Pennsylvania, deceased.
Said will bearing date the.._,.76th,..m day oL,$.ep,l;E!lI1b,e,J;',A. D., 19.9.(:1.., and hereunto
attached. By virtue of the Act of Assembly approved July 11, 1917, P. L. 803.
In testimony whereof 1 have hereunto set my hand and affixed my official
seal this.....,l.~~1:,day oL,....,I'~ax.. ...,p..A. D., 19131,.
, '..m"R~ii~'C
m....m,~~I,~,<?,~~~..............County, 55:
'........'':h;'~~,__,~~,~,~;;.~,~,. ~a~" ~~~~;:;~r"~~:'t~~ '~r:~a~~' o;~~ ::~r:ra:t~
'L f Ad ,. . , d < 'd C f Allegheny . h
Ing etters 0 minIstration In an lOr Sat ounty o"............mmm'j".....'.T'Jn t e
;viI ( I.... 01-' )ceh
Commonwealth of Pennsylvania, personally came... _ Ril!:,;-,~~i,~..~!..!!,t]::'.~.I!~!1....~~~....,
.............m.m.. .......... ,....mm ,m mm'" .......g:~,I1!~,~..I),tl,~,n!,.,o!.r,............,m.......,
one of the subscribing witnesses to the foregoing instrument of writing, purporting
to be the last Will and Testament of...,.........'m....~d.r~,ll..~l,...J\pple,'l,~~E!... m.....,.....
..__.m............'- ....,.._...... m' late of..,m, ,., ,.._ ,C_a!1'p,I:l,iJJm....,.... m.......m....'...
......m..'....m'_..' deceased, who being duly,.. m m......?-,.,.9.r,'L..m,.............according to
law, deposes and says, thaL.. ..tl1e,Y_'.,ep'! ,m..",.,mmpresent, and saw and heard the
testat.!C~x..." ..__..__!';~,l)j~..~,..App)~gat!"......m......__sign, seal, publish, pronounce and
declare the said instrument of writing
as and for h .fil,L Testament and Last Will,
h I. f d' she
and t at at tle ttme 0 so omg..p ,.,.
memory and understanding, to the best
, ".. \Vas of a sound and disposing mind,
of..l:h~Jr,..kno\Vledge, observation and belief.
......,__..S,,,,.()x:~'m.. and subscribed before
-i~;~-d-2?iL~:(/
Patricia A: ~E~:t') 6- 1-'0
.A- ,/"-
,---- ""iual11es Dunn. Jr.
. "
. ,~_....... Register.
IUTA W'rs 'N KANE, Rt~gistcr of Wills
"~,.......,..m..county. Pa.
19t
RCc;.33 1'.73)
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COmIOS\I'E.-\L TII OF PENNSYLVANIA
DEPARnlENT OF REVENUE
BUREAU OF CGUSH' COLLECTIONS
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RUSIDEtlT DECEDENT
COUNTY OF
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~...- ~.._...._. .-.-.- -..- -~_...,.".._. -.. .- ..-.....- . .._.....-..... .......-- -.'-'-'--. .-.
Till" relurn mulit he compleled in dC1nlllllld flied in dupllcntc, wllh nlllltlnchcd, with the Register of WIII, or the
Count)' where decedent rChldedi Helurn is due \\lthln nine monthli nher dote or death, ulllc!o!t IIn eXlenslon 15 granled
b)' llle Sectetllr)' or RCllenue. (Section 703 or the lnhcrhuncc nnd ElillllC To),; Act of 1961.)
Il,PORTANT,
....-
..0..... ______ .._...._~.. _...._..__._,_.______
Late of
Camp Hill, Cumberland
Pennsylvania
Cumberland
} .1r-r-mA\'I1' or-
EXECUTOII
^D~IINISTRATOR
County
IN TilE MATTER OF TilE ESTATE OF
Edna W. Applegate
lSTATE f'Ul..L r.lAME Of' DECEOENTl
State of
} ..,
County of
Administrator
.T=s W. Applegate
of the oltote of the obove.nomed decedont bolng dul)' Iworn, dopole
Executor
end .ar
Dccedent died
March
18,
(CAyl
" 19~{la"al' leaving a 1011 will, cop)' of which II h,rolo attach.d.,}
(YEARI ~
(MONTH)
Home ond addre.. of attorn.~ or }
other authorized ropresentatlve to whom
011 corrOlpondllnc~ should be moiled.
Thanes A. Beckley
240 North Third Street, Harrisburg, PA 17108
That as such Executor deponent is familiar with the affairs of said estate and the property eonstituting
(EXECUTOR-ACMINIS,TRA TORl
the assets thereof and their fair market value.
That at the time of doath there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER It>;STITUTION
IN WHICH DECEDENT RENTED A S.4FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
REl..ATlONSHIP OF JOINT
HOI.DERS TO DECEDENT
None
That the contents of said safe deposit box or boxes are itemized undor Schedules N/A of this return,
with the exception'of the foIlowing, for the reasons hereinafter set forth:
That Scheclu/e A attached hereto and made part hereof sets forth fully and in detai I all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. II also sets forth the
mortgage encumbrances upon each parcel of real properly at the date of death, giving the amounl still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
. as of date of death of decedent.
That Scheclu/e B attached hereto and made part hereof sets forth fully and in detail all personal property
wheresover situated owned by the decedent at the time of death; all moneys left by the decedenl at the time of
death, whether in decedent's immediate possession, standing to decedent's credit in banks or deposit, savings
banks, trust companies, or other institutions, whether indi\'iduaUy, or in trust ror any other person or persons
giving also separately the accrued interest thereon, if any, down to the last interest day prior to decedent's
death .in the case of savings banks, and to the date of decedent's dealh in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to lhe uo-
cedent; all obligations, whether by statute or agreemenl they are designated as tax froe, of the United States,
or an)' sCate, or political subdivision thercor, or of any foreign country, which arc owned at the tim.e of death;
all wearing apparel, jewelry, silvcnvare, pictures. books, works of art, household furniture, horses, carriages.
automobiles, baats, and an)" and all other pt...onal chattels of whatsoever..kind or nature, Ich by decedent,
together with the fairly eSlimaled market value thereof; all bonds and mOrlgages held by uecedent and of all
claims due and owing decedent at the time or death, and all promissory notcs or other'instruments in wriring
for the payment of mone)' of which decedent died possessed, or whatsoever nature, with interest thereon, ir
any, gi\'ing the face value and estimated Cair market ,'alue thercor, and ir such ~!iitimatcd fair market value be
less th~n the face value, it sets fOrlh brierly the reasons for such depreciation as to each item; all moneys
pa)'ahJc to the estate rrom lire insurance policies carried by decedent; all :10 nuil)' and endowment conlrncts
the prnceeus of which were I'a)'able upon the death of the uecedent; all and the corpnrale stocks and dividends
due thereon Bnd unpaid as of the date of death, bonds and accrued intcrcst thereon to the dale of decedent's
death and olher investment sccurilic~ owned b)' the decedent at the lime of death, wilh lhe market value there-
or at such time,
In the cnse of sr:curlties or clo~e or fllm11)' corpornL1olls, the "nInes rt'fHlrlcf! IlrH us ('ur us
l'o5~ih.le ~\1ustntll.1ld~~ll br fItlllllcin\ 5lnlcIllcnts of tile corpurations, !ihuwing the llsr.r~ls filill l1uhllitlcs
tht'I'eof us of the dute at death. The schcdulr! I~lso sets fortll tll'~ inlcr<"st of' cteccr!cml ht thr! time of
dC't\th ill /In~' co-pnrtn~rshll' 01' husinl}S5, Hull in S\I})POl't of the vuIlle of such interest t.ll~rr. i~ Illln"xcd to
sAid ~('h.'dll\(', fJnunc1nl stntemcnts ~ho\~lrl'~ the llsscts nOlI 1111\)11 tt.ies ur slJtd co-rlflrtll~r~.ltlp or lI\ISlnr~ss.
A ('ol'y of tilt' co-partnershlp lIL~rf'f~m{:llt, (If ornl, n stutl~fIlI;,nt :.ctt1nf, f'orlh ll:e natllrr~ of tlie Ilgrr}nrncllt)
t og,t.tlll' r wt th u s tn tell'\i!llt set till;!. fot'th the cllllrltC lc I' of th(! \.Ius I n'.'~s, its 1 oe/l tl (lll, nnd sllch olllCrf'tlcts
11l'rtolll\llg to the hustncfis /IS Illo)' 111! pt'rt1nont to u ftdl' lIllf) .~Ilst Cll'pl'ulsH\ 01' t.h',: c\r!c~c\r'lltls.lflt~rcst.
thereill Illllst he sllhmUll!d. 1l :;holllrt also set fort.h in ltt.'ml:'.l.!d f'(Jrl~1 t(lgl~thcr wHh lhf:t f{lll' murl;r:t value
thereof, ttll)' otht'r propcl't)' owned or lJCfj\ICllthl!fl by tilt.! ch!cl'il(~lll at the l1m(~ of dCll.th.
The Sc/1edule C ntlochcd )'lCrcto nnd WH':C pILI'\. Iwreot' sets forth u t.ruc unswcr to cuch inquiry
contl\lnerl therein /lllll in tILe cnse of trnnsfers of proper 1..)', rcal or personal, within two )'cars ur d~cedcnt' s
death, 1n contemplation of' dcc('!<lcnt"s dcnt.h, or Intcllflcd to t6ke effect in possessIon or enJorment at. or
after death, said schedule sets fort.h the nllturc and value of such pro\lcl'tj', t.o whom t.rnn~fcrrcd, the
relationship of the transferees to the dcccrl('nt, lh~ proportionate share receiverl lJ)' ench trflnsferee and
all other fncts of a pertinent nature rc~nrding said transfers. In the cnse of transfers intended to
take effect in possession or enjo)'ment nt. or after death, there is also at.tllcheri to the scheflule a COllY
of the dced, trust agreement or ot.her instrument creating the trust. Therl~ is also set forth in saId
schedule 1\ list of all propert)., real and persol1ol, with its Vlilue, which plt!;ses at deccti~nt's death by
virtue of the exercise lJy decedtmt, either Inc1ivlduull)', or joIntly with nnother, or nn~' po\'.'er of 811}loint-
meot. vested in decedent, either individually ar joint.l)', b)'the \'I'ill, deed, or other instrument of another,
with a COP)' of the instr\unent creat.ing such power nttltched to the schedule.
That Schedule 0 attached hereto r..nd mo.de part tlereof sets forth the nRmes anrl arldresses of All
persons beneficially interested in this ~stnte at the time or decedrmt' s death, the nature of their res-
pective interests. their relationShip, if any, to the decedent, together with thl! ages at the time of
decedent's death of all minors, annuitants and beneficiaries for Ii fe under rlecedent's W11l. 1 t also
contains a stat~ment showing which of the beneficiaries named in the dcccclcnt's Will, if an)', died prior
to decedent, the dates of their death, their issue, anrl the relationship of such issue to the beneficiary.
That Sc/1edule E attached hereto and made a llart hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, stAnding in the name
of the decedent and others, plus the date and place of record of Instr\unents effecting the \estiture of
real estate and the date of acquisition of personalty, plus the nnme, address and relationship. if any,
of co-owners to the decedent.
That Sc/1edule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate, Inclurling funeral expenses paid;
ramil}' exemption, where applicablej costs of administration of this estate; counsel fees and f\ldiciary' 5
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemnrkcrs, and reli-
gious services, in consequence of the death of the decedentj debts and claims owing anrl unvain at time of
deathj taxes accrued chargeable for period prior to decedent' 5 death (except those allo",'ed undt'r Section
651 of the Inheritance and Estate Tax Act) j together yt'ith a statement of collateral pledged for obliga-
tions, if ~ny. It is agreed that the fiduciary will present proof of .said cla.imed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
est1!"ated amount claiming and aUowed, that the same will he reported to the Register of \\'ills, and that
the' amount of tax assessed can be reassessed 1n accordance therewith.
That the totals of the avpropriat.e columns in Schedules "A", "B", lIen, "E", and "F" as directed therein,
have been carried forward and properlY registered in the Swnmary.
Subscribed and sworn to before me this ............-..-...............
___if:l.A,...._:::; ,..., . 'P," day of . .&.:U~,-;!",":.1:!..l"A~;.,~:....,_ 19Y_L
1/ C IV;
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'.?:,:..:,::.70.i!,!:;.:f.::..!:t..:._....,..~z.1:~-,..:1.:f.!.::,~-_? ~-
, / / (Executor-Adminmr4Icr) jJarres W.
, ':.1Q?_.!:I~9.f:.~..,~w.::,t......_....,..,._...._..,...J!I:lEleg~
(Street Number)
Mechanicsburg, PA 17055.
".....".,.".,..(C;ty....;;...T~;;;;~'..~;;d...s;;;;;;j.".............-,--"'--"-'
SOTE: Before signtt:lg affidavit make sure ttll hllLOk spaces in the nrflcll\\'it norl schcl1ules Ilnnexed arc
filled in .....ith detltlls or the worrl "None", l.I.nrl in cnSl:! the assets incl\.lflc rMre anrl unll~tcrl securities,
securities of close or famll:<' corpornt1ons or I1n interest. in fill)' co-pnrtnership or h\tsITlf!sr., thut the
d&tl1 111111 stlltcmcnt5 require,' \Inlier t.he rnrugrnph aho\'e relating to SC)Iec1ule "B" nre nttncllefl. Also mnke
certlll n tlla t column #1 In tile "Smrnnr)'" hns berm l'rol1erl)' compl cled 05 1l.1)(l\'e-cl1 ree ted.
:IlMMONWEAL TH OF PENNSYLVAI11A
OEPARTMENT OF,REVENUE
BUREAU OF EXAMINATION
INHERITANCE TAX SECTION
SCH EDUL E "B"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule must disclose alltnngible and intangible personal property owned individuallv bv lile
decedent. at the time of his death. Property owned by the decedent jointly with another or others must be listed under
Schedule "EI'. Intangible personal property, titled in the nume of the decedent. but payuble at deuth to another or
olhers, including but not limited to P.O.D. U.S. Snvings Bonds and tentative trust accounts, must be Iisled despile the
fact that Ihel' are not of the administered estate.
Tangible personal pro~erlY should be listed first (e.g. jewel!)'. wearing appurel, ho'usehold goods furnishings, .
books, paintings, automobiles, boats, elc.) . .
Intangible personal property, such as bondG, treasury certificates, cash on hand and in bank, stocks, mortgages,
notcs, together with accrued interest or dividends, .salaries or wages, insurance payabJe to the estate or fiduciary in
said capacity, partnership interests, interest in any undistribuled estate of or income from any property held in trusl
under the will or agreement of another, even though located outside of Ihe Slale, at the lime of death, should be Iisled
in Ihis schedule,
DEPARTMENT
VALUATION
(Official Use
Only)
ITEM
Lisl and describe fully
ESTIMA TED
UNIT MARKET
VALUE VALUE
1. 4 lots (sepulture) located in the Allegheny
County Meoorial Park, Pittsburgh, PA, Section
Nos. 773 4 and 7735 Block 2G held in the narre
of Edna W. Applegate, deceased
2. ' Checking Acco1.mt 1F312-000597-4, Conm:mwealth
National Bank, held in the narre of Edna W.
Applegate, deceased.
800.00
9,888.43
.
TOTAL
10,688.43
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SUM~IARY
. .(Seh, "A")
.. (Seh. "B")
........., ,......(SCh. "C")
Real Property....
Personal Property
Transfers ... .... ............ ... ......... .........
Gross Taxable Estate .................,.......,..........................
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County, Number and Nom"
Fi Ie Numher
Dote 01 Deolh____
Estate Nome _
Il.lST NAML:)
SUMMARY
U'I!l5T NAMf~1
COMMOIIWEAL HI OF PENNSYLVANIA
TRANSfER INHERITANCE TAX
RES/DEln DECEDEIIT
lINITI^1.1
REPOf1T OF INHERIT ANCE TAX APPRAISER
I, Ih. unde"igncd duly appointed Inheritance Tax Appraiser in and lor the County 01
Pennsylvania, do respectfully "'pori that I hove appraised Iho real and personal properly os roporled in tho loto!)oi"9 return at
the values set lorlh opposilo ooeh item in the lost column to the right in Schedules "A", "B", "C", and "E".
Doted:
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and lor County, Pennsylvania, do respect.
fully report that I hovo allowed deductions in the amounts claimed by deponent, except os to those items where 0 greater or
lesser amount is set lorth in the lost column to the right in Schedule "F", which greater or lesser amount represenls the sum
allowed as 0 doduetion.
Valuallon of lifa estates or ~ PRINCIPL.E
nnultl.s....................._ $--=---r-
=$ C
Supplemental Codas: (FOR USE IN HARRISBURG ONL Y)
Dated:
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule BI
Joint-Held Property (Schedule E)
Transfers (Schedule CJ
TOTAL GROSS ASSETS
(SCHEDULE F)
CLEAR VALUE OF ESTATE
'OR USE OF REGISTER ONl.Y
Tax,on,S
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate I
TOTAL TAX
Less tax previously paid
BALANCE
Less sro of tax If poid within
3 months after death
~AI.ANCE OF INHERITANCE TAX DUE
;dd interest C?t rote of 6% flam
t.
,eUNT OF ESTATE TAX ASSESSED
:'stato tax paid
BALANCE DUE
,4dd intelest at lato of 6~'f,cm
to
48-Adjuslment
49+Adjuslmant
56-'Annuity
REGISTER OF WIl.LS
VALUE AS APPRAISED
S
I ADJUSTMENTS
ODE (HARRISBURG USE ONLY)
00+
tO+
20+
30+
REMAINDER APPRAISEMENT CODE
92+
4().
93- .
FACTOR VAl.UE
I
CODE I
FI
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t=
CODe
-
COMPUTATION OF TAX
2%
$
$
$
$
$
6%
15%
.
$
('*) As evidencod by Charitable
Exemption Certificates lssued
by the Secretor)' of Re\lonue*
$
$
E
$
$
~
$
$
$
1=
$
$
TOTAL TAX BALANCE $
PAID $
50-Life Eolote
92+Remoinder Appraisal
93-Remainder DedUClion
96-Successivc
Life Estate
9 3C-Chari Iy
94-Remainder Reoidua
FOR USE OF REGISTER ONLY , ADJUSTMENTS
NOTE: Where subsequent adjustments are made 10 the above computation of lax by Ihe Registar of Wills, far proper "oson
Some should be nalod below, wilh shari explanation. ,
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DEDUCTIDHS ALLOWED IH
OFF ICE OF THE
RECISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF
I
OAT! APPROVED
OF Cunberland COU HTY
AHD ACEHT OF THE COMMOHWEAL TH
REGISTER OF WILLS, AGENT
ESTA TE OF
Edna W. Applegate
LATE OF ~ Hill, Cunberland Cotmty, PA
DATE OF FILING APPRAISEMENT
DATE OF DEATH
~!arch 18, 1981
OATE NO. OF NAME OF PA YEE REMARKS AMOUNT
VOUCHER
4-9-81 Internal Revenue Service 1980 Individual Incorre Tax 76 00
5/24/81 Bover & Ritter Preparation of 1980 State &
Federal Retum 93 00
Camp Hill Fire Company Ambulance Service 180 00
Ouickel Carmer and Rich /\ssoc . Medical Service 170 00
WIn. Murray, M.D. " " 75 00
Musselmm Ftmeral Horne Ftmeral Services 1,847 43
H. P. Brandt Ftmeral Horne Ftmeral Services Incl. Intenrent 1,412 48
8-10-81 Michael M. Geduldie:, M.D. Services 355 00
Ni"htin"ale Nursin" Home Services 613 79
Arnotmts reserved for
Beckley & Madden Cotmsel fees 1,065 00
.
Total 5,887 70
COMMONWEAL TH OP PENNSYLVANI^ I
COU NTY OF Cunberland SS.
I James W. App1ee:ate HEREBY CERTIFY, THAT TO THE BEST OF
,
MY KNOWLEDGE At-ID BELIEF, THE FOREGDlt-IG IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Edna W. Applegate
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPDSE:'J~'" " _ _/ / ' I, ,.....7---
" ...{, )' I r. ,,,,-_")r "~ /_f~,.d..~_{_i -(L.S.)
S'~O . AND SU,BSCRI. BED BEFORE ME THIS it., tI: DA~ ~F J Janes W. Applegate/ /
" ~....,.c 19J::...:..
, ) Lr ~_~~
Notary Public
'ssion Expires: 3-7-82
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INFORMA nON
This document is the Notice required to be given under Section 709 of the Inheritance and Estate Tax Act
of 1961 (72 P,S, seclion 248S),
If the tax is paid within three (31 months after the decedent's death, a discount of 5% of the tax paid is aliowed,
Inheritance T3X becomes delinquent nine (9) months atter the decedent's death. Interest is charged at the
rate of six (6) percent per annum on the amount of unpaid tax. (SEE EXAMPLE BELOW)
EXAMPLE: If a balance of tax due of $2,000.00 is in a delinquent status from 3-3-aO. and payment is made
on 5-23-80. the interest is calculated as indicated below:
STEP 1
Determine the rate of
interest from the table below.
STEP 2
Multiply the balance of
tax due by the rate of
interest.
STEP 3
Add the interest
to the balance of
tax due.
Interest from 3-03-80 to 5-23-80
Results in:
2 Months =
20 Oays =
Rate of interest =
.010
+ ,00335
,01335
Balance of tax due
Rate of interest
INTEREST
$2,000,00
x .01335
$ 26.70
Balance of tax due
Plus Interest to
Date of Payment (+l
TOTAL lax and
interest to Date
of Payment
$2.000,00
$ 26.70
$2.026.70
----------------.-----------------------------------------------------
1 month .005 4 months ,020 7 months ,035 '0 months .050
2 months ,010 5 months .025 8 months ,040 " months .055
3 months ,015 6 months ,030 9 months ,045 12 months ,060
1 day ,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 ,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 1 B days .00301 28 days ,00471
9 days ,00152 19 days .00318 29 days ,00488
10 days ,00169 20 days .00335 30 days .00500
------------------------------------------------------------.---------
An~ party in interest, including the Commonwealth and the personal representatlve, not satisfied with the
appraisement and assessment may object within "xIV (601 days after receipt of this Not'ce as prOVIded by
Section 1001 of the Inheritance and Estate Tax Acl of 1961 172 P,S, see, 2485 - 10011.
MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT"
DETACH THE TOP PORTION OF THIS FORM ANO SUBMIT WITH YOUR PAYMENT TO THE REGISTER OF WILLS FOR
THE COUNTY SHOWN ON THE REVERSE, SEE THE INHERITANCE TAX INSTRUCTION .800K FOR ADDRESS.
I1EV.ltJOO EX ~ (\).81)
BUREAU OF EXAMINATION
PENNSVLVANIA OEPARTMENT OF REVENUE
P.O. BOX B327
HARRISBURG. PA 17105
11-;(0.5 - 0
INHERITANCE TAX RETURN
RESIDENT DECEDENT
/.1
I'
UtI.I!"./l
File Number
~/~ fl/~tJ ,;f1CJ
CHECK
1. Originel Return ~
no'
2, Supplemental Roturn 0
Oecedent's Address .;.,} //
(Jfl/-f/' #;t(./ /,,1'{. /7CJII
(li.flo!,Aw/AIV) {~Clli.
3, Remainder Return 0
BLOCKS
5. Federal Estate Tax 0
Return Required.
6. Decedent died testate 0 7. Decedent maintained a living 0 8. Number 01 safe deposit 0
(Attach copy of Willi trust (Attach copy 01 trusll boxes inventoried
All correspondence end conlidentialtax inlormation should be directed to:
4. LileEstateD
APPRO.
PRIATE
CDRRE.
SPDNDENT Neme./."
,- ~
Telephone No,
Address
e,
City
Recapitulation
1. Real Estate (Schedule A) ( II
2. Stocks end Bonds (Schedule B) I 21
3. Closely Held Stock/Partnership ;nterestlSchedule C) ( 3)
4, MOrtgDges end Notes (Schedule 01 ( 4)
5. Cash & Miscellaneous Persnnal Property (Schedule El I 51 /(.1, 6 ;?~j': '1'5
,
RECAPIT. G, Jointlv Owned ProllOrtV (Schedole FI ( G)
ULATION 7, Translers (Schedule GI ( 7)
8. Tot.1 Gross Assets Itotal lines 1-7)
AND 9. Funeral Exp.nses Administrative Com/Miscellan'Dus
Expenses (Sch.dul. H) ( 91 ,.:) f:1 7,7 tJ
.
TAX 10. D.bls/Mortgages/Liens (Schodule II 1101
il. Tut.l D.,'u.tiu"s hOI.lli".s 9 & 101
12, N.t Vel, e 01 Estetelline B minuslin. 111
CALCU. 13. ChDritable B.quests (Sch.dul. JI
LATlDN 14. Net Valuesubiactto tDX llin. 12 minus lin. 13)
Slet. (/~,
Cemputation of Tax
15. Amount ollin. 14 t.xabl. at 6% rat. 1151 ~ fjt'(I, 7';
linclude valu.s Ire 10 Schedule K)
16. Amount 011in.14 taxabla at 15% rata (16)
lincluda valuas from Schedula Kl
17. Principal tax dua (add tax Irom Iina 15 plus tax from lina 16)
18. Total Prior payments:
(a) Amount Paid
(b) Plus Discuunt
{cl Minus Interest (18)
19. Balance Due (lin. 17 minus line 18) (191
Make Chack Payable to: Register 01 Wills, Agent
... PLEASE RECHECK MATH' ..
( 8) /C'. 6 Yj~ IJ
,
1111 .( :llIl/O
(12)
1131
(14) ~, flcrt', 73
x,06= ol.$fl.otJ
x.15=
117l 0( $"t? ~1
Undar panaltias of poriury,l declare that I have ..aminad this return, including accompanying schedules and statements, and to the best of my knowledge
and baliaf, it Is true, correct, and complat.. Declaration of preparer other than the panonel representative is based on all information 01 which preparer has
any knowladga,
SIGNATURE OF PERSONAL REPRESENTATIVElS)
ADDRESS
DATE
SIG.NATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
"
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ct . SENDER: Complete lIema 1,2, and 3.
.., Add your addre.1S In the "RETURN TO" apace on
~ revene.'
.~:::
1. The (ollowjn~ service is requested (check OIlC).
. D' Show to whom and date ddi\'ered, . . . . . . , . ,-~
o ,Show to whom,datC!,'and address of delh'cry. .-<
o RESTRICTED DELIVERY
Show to whom and date delivered. ".. . .,. .:-4
o RESTRICTED DELIVERY,
Show '0 whom, due, and address of dclh'ery. $_
( CONSULT POSTMASTER FOR FEES)
2. ARTICLE. ADDRESSED TO:
RitaWilaon Kane
Register of Wills .'
Courthouse, Pittsburgh,pa.
lC;?1Q
3. ARTICLE DESCRIPTION:
REGISTERED NO, r CERTIFIED NO,
, . 595681
I (AlwlyI obtlln Ilgnltul"l ot add,.... or agentl
I have received the article described above,
SIGNATURVO Addres e 0 'Auth riled agent
INSURED NO.
6. UNABLE TO DELIVER BECAUSE: <c' i:
'CLE"K'S
INITIALS
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