HomeMy WebLinkAbout10-10-78
RCC":33 14-73)'
.. .
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
1 ;,
! l.~
RESIDENT DECEDENT
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.)
IN THE MATTER OF THE ESTATE OF
} AFFIDAVIT OF
EXECUTOR
~NJX'ElKWXlK
Charles W. Anderson
(STATE FULL NAME OF DECEDENT)
Late of Carlisle, Cllmherland
County
State of
Pennsylvania
Cumberland
Elizabeth
Admini stra tor
~ } '"
Chandler Anderson,
Executor
County of
of the estate of the obove-named decedent being duly sworn, deposeS
and sayS
Decedent died July 5
(MONTH)
Name and address of attorney or }
other authoriz.ed repres.entative to whom
all correspondence should be mailed.
(DAY)
, 191Ll~~leaving a last will, copy of which is hereto attached. }
(y EAR) \',ntestate
Garber, Fowler & Addams
28 S. Pitt Street, Carlisle, Pa. 17013
That as such Execu tor deponent is familiar with the affairs of said estate and the property constituting
1 EX ECUTO R-ADMINIST RA TO R)
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 following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
Trus tCompanLL
or
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
w~ e
That the contents of said safe deposit box or boxes are itemized
with the exception-of the following, for the reasons hereinafter set forth:
papers liaving no value.
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.
under Schedules B of this return,
personal and miscellaneous
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 possession, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons
giving al so separately the accrued interes t thereon, if any, down to the las t interes t day pri€IT 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, boa ts, and any and all other personal cha ttels of whats oever, 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
less than the face value, it sets forth briefly the reasons 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 upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interes t thereon to the date of decedent's
death and other investment securities owned 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 schedule, financial statements showing the assets and liabilities of said co-partnership or l1usiness.
A copy of the co-partnership agreement, (if oral, a statement setting fo;'th the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted. It should also set forth in itemized form, together with the fair market value
thereof, any other property owned or bequeathed by the decedent at the time of deatb.
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 contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom transferred, the
relationship of the transferees to the decedent, the proportlonate share received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of transfers lntended to
take effect in possesslon or enjoyment at or after death, there is also attached to the schedule a COllY
of the deed, trust agreement or other lnstrument creating the trust. TherR is also set forth in sald
schedule a list of all property, real and personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly wl th another, or any power of appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another,
wi th a copy of the instrument creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in thls estate at the time of decedent's death, the nature of thelr res-
pective interests, their relatlonship, if any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named In the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly wlth another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instruments effecting the yesti ture of
real estate amI the date of acquisition of personalty, plus the name, address and relationship, if any,
of co- owners to the deceden t.
That Schedule 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, including fUneral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiclary's
commisslons paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing and unpaid at time of
death; taxes accrued chargeable for perlod pri.or to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together wlth a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "en, "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this
,iIJ
(a
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., ,,", ~ , ()tf., L"I.,,)
~~:,,\,y..,~t(.~'~~~'~~l~\rt~)~;~;~:~.~_....,-;;;.....,..
"E" Street Apts.
...................................................... .............................................................................
(Street Number)
"" Garli,sle."..".Pa.......,1,701.3...
(City or Town and State)
.., day of ,..O.ctobex....,..
"7 / ~/;; 6") ^
.........,....k-((7.<~,..~:kt..'E~~RTS,'N~~~bt:~)
:li>1e, Cumberland Co., Pa.
"y Ccmmission Exp:rtls April 13, 198'
........., 19.7.8.....
NOTE: Before signing affidavi t make sure all blank spaces in the affidavit and schedules annexed are
f'illed in with details or the word "None", and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-dlrected.
RCC-"'4 (1-64) ..
COMMONWEALTH OF PENNSYLVANIA
ElEP ARTNiENT 0 F R EVEN UE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "AIJ
REAL PROPERTY
*'
Real property in Pennsylvania! with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Where property held os joint tenant or tenancy by entireties, report on Schedule "E". Property held by
the decedent as tenant in common with another or others, should be identified os to quantum of interest and
the estimated value should be that of the decedent's interest only.
The real property located in the Commonwealth of Pennsylvania should be (1) (2) (3)
described by lot and block number, street and street number, together with DEPARTMENT
a general description of the property, with a reference to the record of the ASSESSED VALUE VALUA TlON
conveyance by which the decedent took title; If a farm state number of a- FOR YEAR OF ESTIMA TED CAUTION
cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH In this space)
to be listed on Schedule "F" and must not be deducted from this schedule.
tJ Or')L
NONE
'- j
Insert this total opposite "real property", Schedule "A" In the
"As ReportedlJ columr on ,1 .. 1._& "'''",~ of thi", r""tll....
xxxxx
NONE
~DnL
RCC -35 .
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible 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 li&ted 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-
tive trust accounts, must be listed, despite the fact that they are not of the administered 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 any undistributed
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.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. List and describe fully VALUE MARKIIT VALUE (Do not write in
this space)
1. All items of personal property are listed
on the inventory filed in decedent's
estate, a photocopy of which inventory
is attached hereto.
II
?ERSONAL PROPERTY: 4
1. Clothing and other personal effects- i~$
2. Two (2) watches- ~f,"I':
3. 1971 Mercury Station Wagon, Serial No. lZ76N585742-
4. Cash on hand-
5. Five (5) American Express checks at $20 each-
6. Re-imbursement of Blue Shield 65 Special Benefits- +1'...-
7. Re-imbursement of Medicare Benefits- ~
8. Re-imbursement of pre-paid nursing care, Church of God .~
Home, Inc. - V, TI 839 91
9. Checking Account No. 10-91-900-7, Dauphin Deposit Bank ~
and Trust Company, Carlisle, Pa. (Bank letter attached)rr 1,31738
10. Checking Account No. 500-412-2, The Royal Bank of Canada, Ii :
Sydenham, Ontario (Canadian currency-$1,660.96~nk It~
letter attached) - '11 1,473 14
11. Certificate of Deposit No. 3602264, The Royal Bank of II
Canada, Sydenham, Ontario (Canadian currency-$35, 000; /:1 _
Bank letter attached)- ,1(31,042 13
'I
Accrued interest to 7/5/78 (Canadian currency-$458. 84 ~/ ~/
Bank letter attached) - -!j 406 95
12. $20,000 Debenture, The International Nickel Company of:i ;
Canada, Ltd., 6.85% due 1993, (value based on quotati~! :
from broker, a photocopy of which is attached) at 79. 00i-15 , 8001 00
200 shs. Pacific Lighting Corporation, Common; NYSE, at Ii,... i
19.50- ~! 3,900[ 00
200 shs. Philadelphia Electric Company, Common; NYSE, at~. i
17.4375- II },487i 50
920 shs. Dauphin Deposit Trust Company, Common; OTC, at pi I
32.00 bid- 29,440 00
16. Mortgage and Note of Emil Bartos and Helen B~rtos, H/W, I i
for $10,000, dated 3/25/71, interest at 6%, recorded :~
in Pinellas County, Florida, Book No. 3512, page 804, Ii i
on dwelling 5200 38th Street South, St. Petersburg,: I
Florida, reduced by amortization payments to- t 3,368: 61
Accrued interest from 7/1/78 to 7/5/78- V 2[ 81
I: I
TOTAL PERSONAL PROPERTY - !i$92,05~ 43
I' i
I'
I
-I
25i 00
20: 00
450' 00
5 00
100 00
68 00
307 00
~.
13.
14.
15.
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X $ 92,053.43
q~, 0.53. "'""0
,I
Dauphin Deposit Bani<
and Trust Company
MAIN OFFICE: 213 MARKET STREET, HARRISBURG, PENNSYLVANIA 17105
717/255-2121
Member F ederel Deposit Insurence Corporetion
August 3, 1978
Garber,Fowler & Addams
28 South Pitt Street
Carlisle, PA 17013
Attn: Mr. John B. Fowler, III
Re: Estate of Charles w. A~derson
July 5, 1978 Deceased
Dear Mr. Fowler
In regards to the above mentioned, we submit the following information
as of the date of death:
10-91-900-7 /CheCking account balance $1317.38 //
Safe Deposit Box #06-256
" "" #06-540
The checking account was in Charles W. Anderson's na~e only. Safe deposit
box n\unber 06-256 was Charles W. Anderson or Elizabeth Anderson. And safe .
deposit box #06-540 was in Charles .w. Anderson's A.:1ftl:' enly. 0(l fLlZ./J,..0t-'Tli A)/Jf.fJ..~c'P
If we can be of any further assistance, please do not hesitate to contact us.
Very truly yours,
Ci - 1',
-r:!A--~<--c;<:' g.j;,-l.'~'(_
Donlad E. Cromwell
Assist&~t Vice President
DEC/kak
f&^ ~
~, -:.
>.:,
~"'p~i
~J>-:.~~
'Yr,J -
,,=~~i?
TH E ROYAL BAN 1< 0 F CANADA
P.O. BOX 263, SYDENHAM, ONT, KOH 2TO
Telephone (613) 376-3616
August 9, 1978.
Garber, Fowler, and Ad~~s,
28 South Pitt Street,
Carlisle, Penna. 17013
~ttention: John B. Fowler, III
Dear Sirs:
')
J.,\"8 :
Estate of Charles
','
.., .
).nde:'S011
:n response to your letter dated July 24th, 1978 we have ~o
advLe that 1>1r. Anderson did not have a Safe Deposit Box, Safe Keeping
or a Savings A~~t at this branch. However, he had a Cheq~ing ~ccounv
n~mber 500-412-2 which w~in his r~me only and had a balance at date
0= dea:,il of tj~1,660.96.Y'l1f1r. imderson 8~lso had a Savings Ce~~ti:'ic&"ce :.::. .,~ ~::. ~.'~,' ~
~he amo1L~t of ~5,000.00 at 7i% which was held joint with }1rs. Anderson
~~t~ ~{ight of Survivorship and the a~oUl1t of acc7~ed inte~est at date
of death was ;,,;65.55. He also had a Savings Certificate for ,.;35,000.00 H ..;::... ./;,~
~n his nam~nly at 7i% and accrued interest to date of death was
.A58.84.~oth certificates mature on August 12th, 1978. All funds
a:e in Canadian Currency and the exchange rate on the date of death in
relation to Az,erican Currency was 101275%.
In order to determine whether any taxes are payable in Canada,
yo~ will have to apply to the Ontario Succession Duty Office, Hinist~y
of Revenue, Queen1s Park, Toronto, Onta~io, M7A lY2 and if no estate
tax is payable you will receive a release for these funds. Upon
receipt of the release please forward it to this bank along w~~h a
~o~arial Copy of the Letters Probate obtained from your local appropriave
Jour". '.~e will also require that the attached Declaration of Transcission
be completed by the appointed executor.
He trust the foregoing will enable you to co:mmence dealing vlith
the estate, but if you have any further questions which we might be
able to answer please do not hesitate to contact us.
Yours truly,
~!.--;...~/-~-, .-----,~-
/~ -
~[. J. Netherton,
l<Jansger.
-
MEM8ERS Of THE PHilADELPHIA-BALTIMORE AND NEW YORK STOCK EXCHANGES
ASSOCIATE MEMBER OF THE AMERiCAN STOCK EXCHANGE
ESTABLISHED 1844
w. H. NEWBOLD'S SON (1 CO., aNC.
P. O. BOX 93
8 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
(717) 249-2818
October 3, 1978
John B. Fowler, Esq.
Garber, Fowler & Addams
28 South Pitt Street
Carlisle, Pa. 17013
Re: Estate of Charles W. Anderson
Dear Mr. Fowler:
The value of Inco Limited, formerly International Nickel
Company of Canada, Ltd., 6.85% debenture due April 1, 1993 as
of July 5, 1978 was 79 BidJ-~he bond did not trade during the
week of July 2nd through July 8th.
If I can be of any further assistance, kindly let me know.
Yours very truly,
w. H. Newbp1d's Son & Co., Inc.
'\_ - ..V ~_,,7~..
e-,vt't-,~( 1. (Y'~e'>'-'
Richard K.' Stier
RKS hj j
Rcc-56.
. .
COMMONWEALTH OF PENNSYLVANIA
TRANSFER I:-iHEIUTANCE TAX
SCHEDULE "e"
T~c\NSFEnS
11ESIDENT DECEDENT
(1) Did decedent, wi thin two years of death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) no
(2) Did decedent, within two years of death, transfer properLY from himself to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) no
(3) If the answer to (1) or (2) above is in the affirmative 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 decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in posseSSion or enjoyment at or after his death?
(Answer yes or no) no
(a) Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or no)
(b) What was the transferee's age at time of decedent's death?
(5) Did decedent in his lifetime 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 fact 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 designate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no) no
(6) 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 was transferee's promise to
pay income to or for the benefit of care of transferor? (Answer yes or no) no
(8) 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 revoke, or which could revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as
well as 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 value at date of death, dates of transfers and to whom transferred, with
relationship 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 which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
1.
NONE
Wot\L
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
NONE
~Cf\L
~CC-37 (12-63)
COI\f!\IONWk.\LTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
\
h
BENEFICIARIES AND ADDRESSES RELA TIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
aye an interest, vested, contingent or other- are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO BIRTH
Elizabeth C. Anderson Wife Yes 10/25/11 50% of Income
"E" Street Apartments,
Carlisle, Pa. 17013
_T~.<:In A T'l_ . .- Daughter Yes 1/5/25 50% of Income
Ant. A-2
3032 Guineveers Drive
Harrisburg Pa. 17110
Douglas G. Potter
415 Curtin Street
South Wi11iamsport, Pa. 177 1 Grandson Yes 9/30/48 50% of Remainder
Charles A. Potter
402 Church Street
Athens, Pa. 18810 Grandson Yes 12/2/50 50% of Remainder
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
Gross Taxable Estate ..
( 1 )
SUMMARY (As Reported)
...(Sch. "A") $ -0-
.............(Sch. "B") $92,05.3,43
. (Sch. "C") $ .-:-0:-:
(Sch. "E") -0-
... .......... ........ .... $
$.
$..92.,.05.3..43
(2)
(As Determined)
.... "
BtI)"f""'4
f:<*
Vi ~ s::
'c Q) E
.- ~ ='
EQ)-
'00.2
< E.
,:. 2 ~
.s~2
;::l en ....
<.) ;::l 0
~ E ~
~ p::
Real Property
Personal Property
Transfers .............
JqiIlt::LY. .OWD~d.. J:>J;()per.t:Y.
$
$
$
$
$
$
f-< '0
Z Q)
.... iii en
<1l '" .l
Q) - Q)
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iii Q)
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...... <
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p.. 0 o:l =-
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w ~ w <
:z: :z: iii ~,
en
l-< iii l-< f-< := Q
0 ~ ::r: ~ ...-: 6:i Z
0 f-<
Z f-< (/') p.. ~
~ iii ...... !-
~ 0 0 CIl:
~ i='i .5 0
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.... iii <l.i ~
o:l f-< ...... :.- CIl:
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5] "" <l.i :::
.... (5 :5
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,RCE:-38.
HF.SIDENT DECEDENT
SCHEDULE "1'''
JOINTLY OWNED PROPERTY
COMMONWE\LTH OF PENNSYLVANIA
THANSn:n INHF1UTANCE TAX
Ui STRl'CT IO!'\S: This schedule must disclose all property, real and personal, owned by the .-lece.-lent jointly
wi th 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 tmder 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 decedent.
Description of Property, Date of Acquisition, Namel unit percentage Estate
Address and Relationship of Co-Owners, and Place I Value Share Valuation
of Record of Instrument, where Real Estate. I
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
NONE, EXCEPT JOINTLY OWNED
ENTIRETIES PROPERTY OF THE
DECEDENT AND THE SURVIVING
SPOUSE, ELIZABETH C. ANDERSON,
WHICH PROPERTY IS NOT SUBJECT
TO PENNSYLVANIA INHERITENCE TAX.
Nc~
Insert this total opposite "Jointly Owned Property", Schedule "E" NONE
in the "As Reported" column on the last page of this return.
t\J t) 'f\l~