HomeMy WebLinkAbout04-17-79 (2)
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, R C C-3 3 (4-7 ZI)
COMMONWEAL TH OF PENNSYLVANIA
DEP AR TMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS.,v
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1/;1/17
RESIDENT DECEDENT
,
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COUNTY OF
CUMBERLAND
IMPORTANT:
This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the
County where decedent resided; Return is due within nine months after date of death, unless an extension is granted
by the Secretary of Re'.tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cumberland
Pennsylvania
Cumberland
} AFFIDAVIT OF
EXECUTOR
~NM~
IN THE MATTER OF THE EST A TE OF
Grace B. Fogelsanger
(STATE FULL NAME OF DECEDENT)
County
State af
---} '"
County of
X~N'Xi.'()K
Helen F. Coover
of the estate of the obove-named decedent being duly sworn, depose S
Executor
ond sayS
Decedent died
4.
, 19-7~{testote leaving a last will, copy of which is hereto allached. }
( YEA R) Jt1liilIi}QleX
July
(MONTH)
Nome and address of attorney or }
other authorized representative to whom
all correspondence should be moiled.
(DAY)
Robert J. Yocum, Attorney
116 East King Street. Shippensburg. Pennsylvania 17257
That as such Executrix deponent is familiar with the affairs of said estate and the property constituting
( EXECUTOR-~~~XX~
the assets thereof and their fair market value.
That at the time of death 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 fullowing: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
Dau hter
The First National Bank of Shi
One West King Street
Shippensburg, Pennsylvania 17257
That the contents of said safe deposit box or boxes are itemized under Schedules A J R, Fr10f this return,
with the exception of the following, for the reasons hereinafter set forth:
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount 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 Schedule 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 decedent at the time of
death, whether in decedent's immediate pos session, standing to decedent's credit in banks of deposit, savings
banks, trus t companies, or other ins titutions, whether individually, or in trus t for any other pers on 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 death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages,
automobiles, boats, and any and all other personal chattels of whatsoever, kind or nature, left by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if 'such estimated fair market value be
les s than the face va] ue, it set s fort h hri efly the rea sons for such depreciation as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable npon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as "r ,i., ,i..,' ..r death, bonds and accrued interest thereon to the date of decedent's
death and other investm' ,J by the decedent at the time of death, with the market value there-
of at such time.
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of'
death in any co-partnership or business, and in support of the value of such interest there is annexed to
said s~hpr!1I1e, financial statements showing the assets and liabilities of' said co-partnership or husiness.
A eo])v of' the co-partnership agreement, (if oral, a statement setting forth the nature of the dg;reement)
tog'cthcr wi Ih It statement setting forth the character of the business, its location, and such other facts
i'f'T" ~:.f': to tile business as may be pertinent to a fair and just appraisal of the decedent's interest
there;', ':llLOSt he su11mi tted. It should also set forth in itemized form, together wi th the fair market value
tller"'f, tiny other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers of property, real or personal, within two years of decedent's
death. in c(mtemplation of decedent's death, or intended to t'ike effect in possession or enjoyment at or
after death, said schedule set.s forth t.he nat.ure and value of such propert.y, to whom t.ransferred, t.he
re Ill. ti oT1shi P 0 f the trans ferees to t.he deceden t., t.he propor tj ona te share received by efich trfinsferee and
all other facts of a pert.inent. nat.ure regarding said t.rfinsfers. In the case of t.ransfers intended to
take effect in possession or enjoyment. at or aft.er death, there is also at.tached to t.he schedule a COllY
of t.he deed, t.rust. agreement or ot.her instrument creating the trust. There is also set forth in said
schedule a list of all propert.y, real and personal, with its value, which pll.~ses at decedent's death hy
virtue of the exercise by decedent., either individually, or jointly wi th another, or any power of appoint-
ment vested in decedent, eit.her individually or joint.ly, by t.he will, deed, or other instrument of another,
with a copy of the instrument. creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the nlimes and addresses of fill
persons beneficially interested in this estate at the time of decedent's death, the nature of their res-
pective interests, their relationship, if any, to t.he decedent, toget.her with t.he ages at the time of'
decedent's death of all minors, annuitant.s and beneficiaries for life umler decedent.'s Will. It also
contains a statement showing which of the beneficiaries named in the rlecedent's will, if any, died prior
to de. <'dent, the dates of their death, their issue, and the reI ationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof' set.s forth all property, real and per-
sonal, owned by the decedent. jointly with another or ot.hers, including intangible, st.anding in the name
of the decedent and others, plus the date and place of record of instnunents ef'fecting the ,esti ture of'
real estate and the date of acquisit.ion of personalty, plus t.he name, acltlress and relationship, if' any,
of co-owners t.o the decedent.
That Schedule F att.ached hereto and made a part. hereof sets forth fully and in detail all (lel>t5
and deductions claimed for and on behal f of t.his deceden tf s estate, inclucling tlmeral expenses paid:
family exemption, where applicable; costs of aclministration of this estate; counsel rees and fueli ci ar'y' '"
commissions paid or to be paid; cost expended for burial t.rusts, t.ombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decerlent; debt.s and claims owing and unpaid at time of
death; t.axes accrued chargeable for period prior to decedent's (leath (except those allowed under Section
651 of the Inheritance and Estat.e Tax Act); t.ogether with a stat.ement. of collateral pledged for obliga-
tions, if any. It is agreed that. t.he fiduciary will present. proof of said claimed obligations upon re-
quest, that if t.he amount act.ually paid in settlement. of any fee, commission or debt. is less than the
estimated amount claiming and allowed, t.hat the same will be reported to t.he Register or Wills, and that
the amount of tax assessed can be reassessed in ac co rrlance therewi tho
That the totals of the appropriate columns in Scherlules "A", "B", "en, "E", and "F" as directed therein,
have been carried forward and properly registe!'ed in t.he Summary.
Subscribed and sworn to before me this ",,,,,,,,,,,,,,.,,,,,,,,,,,
. " /;'---' /'
.....,...."J/..-+:?{~"",:;h":"""/~~:t.,::-c:.,,~,.:.,,....'uu...,,
(Executor-){~n~
16 u~<:l\l!J1:."l\!.9.::?.hJggl.9..n"..$.t.;r~.~t.. "."."..."""."."...."...
(Street Number)
uSh~JJJ?~~~?~!.!?;.'.u..~.e..~.~s.X~y.!l.~i'1. 1 ~?5?u" ,
(City or Town and State)
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and scherlules annexerl are
fIl1erl in with details or the word "None", and in case the assets include rare ann unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, thlit the
data and statements required under the paragraph above relating to Schedule "B" are attached. .\lso make
certain that column #1 in the "Summary" has been properly completed as above-directed.
~C034 (4-730) ,
COMM01f.Wf<<1.. TH 0 F PENNSYL V4Jtf"
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
.
Real property in Pennsylvania, with statement of mortgage encumbr<lnces upon each parcel at death of dece-
dent. Property held by the decedent as tenant in common with allo.ther or other, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as joint tenants with right of surviorship or tenancy by entir~ties should be reported on Schedule "E.")
The real property located In the Commonwealth of Pennsylvania should be
described by lot and block number, street and street number, together wi th
a general description of the property, with a reference to the record of the
conveyance by which the decedent took title; If a farm state number of a.
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule "F" and mUllt not b. deducted from this schedule.
(1)
(2)
(3)
DEPARTMENT
VALUA TlON
CAUTION
(Do not write
In this space)
ASSE-SSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMATED
MARKET VALUE
1. Tract of farm land with farm buildings erected
thereon, situate in Southampton Township,
Franklin County, Pennsylvania, containing
79 acres, more or less.
BEING the larger portion of that tract of land
which H.P. Main and Edith H. Main, his wife, by
their Deed dated June 6, 1931 and recorded in
the Office of the Recorder of Deeds of Franklin
County, Pennsylvania, in Deed Book Volume 242,
Page 116, conveyed to Crist A. Fogelsanger and
Grace B. Fogelsanger, his wife, and the said
Crist A. Eogelsanger died March 10, 1957,
survived by the said Grace B. Fogelsanger, now
deceased.
FULL VALUE (See attached Appraisement)
'---
118,000. 00
(Farm originally contained approximately 94
acres, but approximately 15 acres were condemnec
by Commonwealth of Pennsylvania for public
road construction on or about 1961.)
Insert this total opposite "real property", Schedule "A" in the X X X X X
II As Reported" column on the last page of this return.
118,00.00
\l<6JDOe.O;J
pee -~F
COMMON'IlK\LTH OF PENNSYLVANIA
TltANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
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! KSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
l,y the decedent, at the time of his death. Property owned by the decedent jointly wi th another or others
must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
t ive trust accounts, must be listed, despite the fact that they are not of the aclministered estate.
Tangible personal property should be listed first (e.g. Jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
estate of or income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time of death, should be listed in this schedule.
-;::1
NO.
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Checking Account No. 191-264-7 - The First Nation
Bank of Shippensburg, Pennsylvania
Savings Account No. 1-11756-5 - The First National
Bank of Shippensburg, Pennsylvania
Accrued interest on Savings Account No. 1-11756-5
The First National Bank of Shippensburg, PA
Miscellaneous household items (See attached
appraisement)
1956 Chrysler (Damaged Condition)
287 shares, Philadelphia Electric Co., common
stock
25 shares, Union Electric Co., common stock
8 shares, Potomac Electric Power Co., common
stock
12 shares, Cleveland Electric Illuminating Company
common stock
350 shares, Atlantic Richfield Co., common stock
32 shares, Delmarva Power & Light Co., (now
Delaware Power & Light Co.) common stock
60 shares, The United Gas Improvement Company,
common stock
32 shares, Delaware Power & Light Co., common
Istock
6 shares, Wisconsin Electric Power Co., common
stock
34 shares, Public Service Electric and Gas Company
common stock
18 shares, Pennsylvania Power & Light Company,
4 1/2% preferred
7 shares, South Jersey Gas Co. (now South Jersey
Industries) common stock
66 shares, Hershey Creamery Co., common stock
6 shares, White Consolidated Industries, Inc.,
common stock
260 shares, U.S.Rubber Co. (now Uniroyal) common
stock
27 shares, Pennroad Corp. (now Madison Fund, Inc.)
common stock
~'113 shares, Cumberland Valley Co-operative Associa
tion, Preferred stock 10.00
1 share, Cumberland Valley Co-operative Associatio ,
ommon stock 10.00
4 shares, City Investing Co., common stock 15.031
~8 shares, Orrstown Bank,Orrstown,PA common stock 80.00
~42 shares, American Telephone & Telegraph Co.,
Fommon stock
~4 shares,Dauphin Deposit Corp., common stock
68 shares, The First National Bank of Shippensbur
A., common stock
ITEM
List and describe fully
1
2
3
4
5
6
7
8
9
fO shares, Emerson-Brantingham Corp.
(nsert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
29
~ 726.89
\ '
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11,663.75
I
I '
~ '- 54.4
5,640.0
50.00
\
4,995.52.
'" 344.5
~21.5
'" ~44.87
~4l2.5
429.9
\
1,194.3
\q.29.98-
\168.0
\62. 8~_
'\868.50-1
~"'134. 31Ft
5,148.00
\33.12.
\~
2,015.0
\365.34
') , 130. 0
"'10.0
'511. 05
~,840.0
\
8,462.2
"3,008.0
~9,096.00'
UNIT
VALUE
17.406
13.781
15.1871
20.406
49.750
13.437
19.906
13.437
28.000
22.437
48.250
19.187
78.00
22.1871
7.750
13.531
59.593
32.00
0.00
x X
ESTIMATED
MARKET VALUE
/1'
\_0 _.
DEPARTMENT VALUATION
(Do not write in
this space)
$88,960.67 .
'3 q~D .'-0'(
\
RCC- %
CU\i!MU\'WEi\LTIl Ill-' P]::\,\,:-.;YIXANli\
Tl{A\'SFFl\ I\'m~:(fT!\,\'CF Tn
SCHEDULE "e"
TR\\'SFEllS
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](ESIDE'\T lWC1-:IW\,'f
(1) Dici rteeedent, within two years ot'cteath, make any transfer of emy material part of his estate, without
receiving a valnable anci adequat.e considern.tion therefor? (Answer yes or no) no
(2) Did deeedent, within two years of death, transfer property f'rom himself to himself and another or
nthers (inclwU ng a spouse) in joint ownership? (Answer yes or no) _ no
(:I) J f the answer to (1) or (2) above is in the affirmjitive state:
(a) Age of decedent at time of' transfer ~_
(b) State of' decedent's heal th at time of making the transfer. (Note 1).
(c) Cause of deeedent's death. (Note 1).
(4) Did decedent, in his l].fetime, make any transfer of property without receiving a valuable or ade'luate
consideration therefor which was to take effect in possession or enjoyment at or after his 11eath?
(Answer yes or no) no
(a) Was there any possibility that the property transferred might return to transf'erer or his
estate or lJe subj ect to his power of' disposition? (Answer yes or no) no
(b) What was the transf'eree's age at time of' decedent's rteath? n!31
(5) Did decedent in his I if'etime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in f'aet end before his death:
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) no
(b) The right to dl~signate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no) no
(r,) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in his lifetime make a transfer, the consideration for which WIlS transferee's promise to
pay income t.o or ('or the benefit of care of transferor? (Answer yes or no) no
(8) Did rtecedent, at any time, transfer property, the beneficial enJoyment of which was subject to change,
because of it reserved power to al tel', amend, or revoke, or which c01.1d revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If tl~ answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserve,l in the decedent alone or the decedent and others?
(Answer yes 0 I' no) no
NOTE 1: The answers to these questions should be supported by affidavit by the attemling physician as
well as a copy of' the death cen i fica te.
NOTE 2: If answer to any of the above questions is yes, set f'orth below a description of the property
transferred, it's fair market vallie at date of death, rtates of transf'ers and to whom transferrert, with
rela.tionship of' transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans-
fers are claimed to be non-taxable, also submit detailed statement of facts on whi.ch said claim is based.
NOTE 3: List applicable property below in manner in which provided in Sche(hlles A, B, or E.
ITEM
DESCRIPTION
MARKET VALlIE
(Es tima tert)
DEPT. VALUATION
(Dept. Only)
NONE
N~.
Insert this total opposite "Transfers", Sche(lule "C" in the
"As Reported" column on the last page of this return.
RCC-J7 ('~2-6J)'
l'o\il\!l)~ \\-EAI :1'11 OF PEX~SYYI.A0:I;\
TRANSFER INHEHITA"'CE TAX
RESIDENT DECEDENT
SCHEDULE "D"
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BE~~ EFI CIA HI l'~S
INTEHEST OF
BENEFICJAHY
IN EST.\TE
,
--
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J----
Life tenant
joint tenant
Remainder Beneficiary
I
W. Cds t Coover, 6699 White Churchl
Road, Shippensburg, PA
~GrandSOn
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_~~ainder
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Beneficiary
Daniel A. Coover 1864-310
Tamarack Circle North, Columbus,
Ohi 0 43229 _
Grandson
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Rp.TIp.-Ficiary
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DeT\onent further says that all the above-named henef'iciaries are living at this time exce-pt below:
.--- ~~-- ---- , --------
NAME DATE OF DEATH RESIDENCE
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Heal Property
Personal Property
Transfers
Gross Taxable Estate
SUNfMAHY
( Sch. "A")
( Sch. "B")
(Sch. "e")
C$ch."E")
$
$
$
$
$
$
( 1 )
(As Rl'portcd)
118,000.00
8~,960.67
00.00
321308.25
(2 )
( A ~ J)..t,., lIIi ,wd !
$
$
$
$
$ eb
$ )j
.239,268.92
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P.:CC-38
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly
wi tl1 another or others, including intangibles, standing in the name of the decedent and others. List
real estate first. as entireties, or joint tenants, giving brief description, as indicated lmder Schedule
"A", plus the date and place of record of instrument effecting vestiture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the (lecedent.
'x
Description of Property, Date of Acquisition, Name unit
Address and Relationship of Co-Owners, and Place Value
of Record of Instrument, where Real Estate.
^
x.
1.
x"
$10,000.00 Savings Certificate - State
Capi tal Savings and Loan Association,
Harrisburg, PA - dated 2-18-70 ~ 5 3/4%
registered in the names of Mrs. Grace B.
Fogelsanger or Mrs. Helen Fogelsanger
Coover, surviving co-owner is daughter
of Decedent (Savings Certificate No. 36)
1/2 taxable
$1,500.00 Certificate of Deposit No.153~
The Peoples National Bank of Shippensbu g,
Pennsylvania - dated 1-1-70 - registerec
in the names of Grace B. Fogelsanger or
Helen F. Coover, daughter of Decedent
1/2 taxable
Accrued interest on Certificate of
Deposit No. 1532 - The Peoples National
Bank of Shippensburg, PA $45.36
1/2 taxable
$6,500.00 Certificate of Deposit #1063
The Peoples National Bank of Shippensbu g,
Pennsylvania - dated 12-1-68 - registerEd
in the names of Grace B. Fogelsanger or
Helen F. Coover, daughter of Decedent
1/2 taxable
Accrued interest on Certificate of
Deposit #1063 - The Peoples National
Bank of Shippensburg, Pennsylvania
$229.72 1/2 taxable
Savings Account No. 023-633-0 20, The
Peoples National Bank of Shippensburg
PA - registered Grace B. Fogelsanger ;r
Helen F. Coover, daughter of Decedent -
Total including accrued interest
$8,192.46 1/2 taxable - surviving co- /
owner name, Helen F. Coover, was addedr ~ _ OJ
to account October 10, 1966 0
Real Estate: ALL the following described
real estate with buildings erected there
on known as 300 East King Street Boroug
of Shippensburg, Cumberland Coun~y PA
, ,
bounded and described as follows:
B~GINNING at an iron pin at the property
l~ne on East King Street, at the East si e
of Sou~h Washington Street; thence along
the sa~d South Washington Street South
forty-eight (48) degrees one (1) minute
East a distance of one hundred sixty-sev n
and three tenths (167.3) feet to an iron
pin at line of land now or formerly of
Helen M. Grove; thence by said land now
or formerly of Helen M. Grove, North
f~rty-one (41) degrees forty-six (46)
m~nutes East a distance of thirty-three
twenty-five hundredths (33.25) feet
2.
3.
4.
5.
6.
7.
and
percentage I
Share
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
Estate
Valuation
5,000.0( ,
750.01
22.6
3,250.0(~
114.8(/
<F
}/,,-
L~
4,096.2 /
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" column on the last page of this return.
3~,30~.~.s
continued SCHEDULE E ~ JOINTLY OWNED PROPERTY
to an iron pin; thence along land now or former ley of
John Fogelsmlger North forty-eight (48) degrees one (1)
minute West a distan~e of one hundred sixty-seven and
three tenths (167.3) feet to an iron pin at the property
line on East King Street; thence along the said property
line on East King Street South forty-one (41) degrees
forty-six (46) minutes West a distance of thirty-three
and twenty-five hundredths (33.25) feet to an iron pin
the place cf beginning. Pursuant to survey of John H.
McClellan, R. S., dated May 2, 1962.
BEING the same real estate which Grace B. Fogelsanger,
widow and single woman, by her Deed dated July 25, 1967
and recorded in the Office of the Recorder of Deeds
of Cumberland County, Pennsylvania, in Deed Book "V",
Volume 22, Page 176, conveyed to Grace B. Fogelsanger
and Helen F. Coover. (See attached Appraisement) _
$28,000.00 1/2 taxable
8. Accrued interest on Savings Certificate - State
Capital Savings and Loan Association, Harrisburg,
Pennsylvania, dated 2-18-70 (Savings Certificate No. 36)
$4.80 1/2 taxable
9. 59 shares, PA Railroad, Company, common stock @2.343 per share
Certificate dated 9-25-58 in the names of Grace B.
Fogelsanger ru~d Helen F. Coover, surviving co-owner
is daughter of Decedent. Full value $138.24
1/2 taxable
10. $10,000.00 Optional Payment Certificate _. Harris
Building and Loan Association, Harrisburg, Pa.
dated April 6" 1959 in the names of Grace B.
Fogelsanger and Helen F. Coover, daughter of Decedent
1/2 taxable
11. Accrued interest on Optional Payment Certificate _
Harris Building and Loan Association, Harrisburg,
Pennsylvania $5.92 - 1/2 taxable
'fOTAL
14,000.00
2.40
69.12/
5,000. 00,
2.96~.
$32,308.25
~---
/-
./
."--' - -.-
NOTiCE OF DECEDENT ACCOUNT STATUS opt. 10420
Submit in truplicat<~ w!thin 10 days after Kncwl'"edge of
the death.
.
;STATUS OF ACCOUNT NO: (JOINT, TRUST, OR INVESTMENT
I JQ~~ TePAants with Right of Survivorship
EST ABrl r=.LJ LJ 1 ~
4-3-59
lBANK NO.
I
I DATE FILED
; ~ 4-5-79
R CC*42 (4*77)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVE"lUE
NAMES ON ACCOUNT I SOCiAL SECURITY NUMBER(S)
*FOGELSANGER, Grace B. I 188-3i-5067
& COOVER, Helen F.
RETURN COMPL ETED
FORMS T0 LCC Al COUNTY
INH ER!T AN CE T l\X OfFICE
SURVIVING DEPOSITOR (Bellefldo.y) INFOKklATION
NAME I RELATIONSHIP
Helen F. Coover I TO DEfEDENT.
!
D~CEOENT IN FORMAT1Cl-l
..
INAME
I Grace B. Foge1sanger
t:\CDRESS
l 300 E. King St.
'CITY
I Shippensburg, Pa.
,BAi..ANCE OF ACCOUNT AT 000
i
llNTEREST ACCRUED AND COLLECTIBLE AT DOD
,TOTAL $ 10.004'. ,2
I BANK AUTHORIZA TION
I HEREBY CERilFY THAT THE INFORMATION CONTAINED f,SREIN IS A
lCORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
IVlITH SECTION 742 P I IX E TAX ACT OF :961.
!SIGNATURE OF fNANCIAL INVESTIGATOR
, rn I C;. u.~nrJ>-L~
\' DATE OF DEATH
7-4-78
",ODRESS
16 S. Washington St.
Shippensburg, Pa. 17257
BANK/INSTITUTION ADDRESS
rCOUNTY
~zIPf1~57
I _~
s 10,000.. OQ----
$ 4.32
Harris Savings Association
P. O. Box 1711
Harrisburg, Pa. 17105
DATE
4-5-79
REV-5IB (3-79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P. o. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Investigation Division
NOTICE OF FILING OF APPRAISEMENT
Helen F. Coover
16 South Washington Street
Shippensburg, PA 17257
(Executor or Administrator)
In Re: Estate of Grace B. Foge1sanger
Cumberland County - File No. 21-78-0403
Dear Mrs. Coover:
You are hereby notified that the original
appraisement in the estate of Grace B. Foge1sanger
has been filed in the office of the Register of Wills of Cwnber1and
County on June 25 . 19~. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
118.000.00
88,960.67
None
32,308.25
$239,268.92
As to such tax that is paid within three months from date of death, a five (5%) percent
discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months
when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months
when death occurred prior to December 22, 1965) from date of death, interest at the rate of six
(6%) percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty
days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax
Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Date
June 25, ] 979
,-0
", r.o ~.
Signed C7"':.--....::.)
("-
^
t \ i!
\. \...."".'1-~_ \"._./C
--{--'
"v' '. -..-'-'....^-..;
C'
?
Title Administrative Officer
NOTE: This is not a bill.
REV.457 (8.78) ·
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
June 25, 1979
COUNTY
FILE NO. ..11-78-0403
rl1mhorl!:1nrl
Whereas, Grace B. Fogelsanger late of ltoroul2:h of Shi ppf'nl'lhllrg
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 4th day of Julv 19 liL. , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fulginiti ,an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash
value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration
of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral
rate on any such future interest.
DESCRIPTION OF ASSET UNIT Ap~praisement
VALUES Made for Inheritance
Tax Purposes
Real Property $"R 000 00
Personal Property 88.960 67
Joint-Held Property 32 ~()~ ?"
Transfers None
TOTAL ASSETS 239,268 92
I
Have been duly sworn according to law, I do hereby cert" that the above app::ftisement is made in conformity
with the law on this 25t day of '-.. . une 19 --!..:i...
- ~-'>-C:::--.. ,.--,
c.. ,--",~__, \~ \. ~
~.
--*: .
"'-'~"'---' '-:",
Appraiser
(Number and Street)
Harrisburg
(Post Office)
, Penna.
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