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HomeMy WebLinkAbout02-05-79 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ~/-1j/'-2 7/ _taLt.- ~ IO-,:~:<~~ *_ I~r RCC-33 14-73) RESIDEtH DECEDENT COUNTY OF CTTMRF.'RLAND iMPORT ANT. This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the C CUnty where decedent resided; Return is due within nine months after date of death, unless an extension is granted bv the Secretary of Re\!enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) SUSAN R. JONES .H---------.,-i';~'-;:E FUL.l~ NAr0E- OF DECEDENTi } AFFIDAVIT OF EXECUT<m:X ~X:OOK 1"< THE MATTER OF THE ESTATE OF State d_._.. Late of ____~_ _ Cumberland Pennsylvania County County 01 ____ Cumberland } ", Al~infZ.~ _____________GRACR L _ BRENIZER, of the estate of the above-named decedent being duly sworn, depose S Execu~li..x and say S IMO~.~IH) May 15 (DAY) , 19-1L{testate leaving a last will, copy of which is hereto attached. } ( YEA R) iHKl6Xi Decedcm ,j, cd Name ",'d ad,hec $ ~I all'" ocy Co, } other auth,j"!z~d T'ep,~('>':entCit".f(' to whom all correspeonjenCB George M. Houck, Attorney-at-Law National Bank Building. Mechanicsburg. Pa.. 17055 Th:lt ~h ..uch ____~~ecutrix, deponent is familiar with the affairs of said estate and the property constituting c-X [CCU TO R-ADMINIST RA TOR) the assets there,d and their fair market value. That at the lime of death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agen, 'lr deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of Ill.: following: - NAME: ..V'H) j\C;:JKESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A S.,FE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT The ___First Bank pany-_of.. Mechanics S That the contents of said safe deposit box or boxes are itemized under Schedules A&R of this return, wi th 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 mortgflge 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 columlb provided therefore the assessed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. 1"11at Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wllcre~,cver ~Jtuated 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 banb. trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last interest day pri@T 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; a:;"Y"';1l6 ap[ial":, .iewehy, silverware, pictures, books, works of art, household furniture, horses, carriages, automrbiles, boats, and any and all other personal chattels of whatsoever. kind or nature, left by decedent, together wi tll 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, g.'vlllg 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 estall: from life insurance policies carried by decedent; all annuity and endowment contracts the pr;1ceeds of which 'nyable upon the death of the decedent; all and the corporate stocks and dividends due thereon ~:Ild unpaid a~' jl date of death, bonds and accrued interest thereon to the date of decedent's death ,Ind otner JL'(' st'reo' owned by the decedent at the time of death, with the market value there- of at sllch til11L', 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 sch€!dule, financial statements showing the assets and liabilities of said co-partnership or l:lusiness. A copy or the co-partnership agreement, (if oral, a statement setting forth the nature of tne 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 wi tli the fair market value thereof, any 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 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 proportionate share received by each transferee and all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to take eff€!ct in possession or enjoyment at or after death, there is also attached to the schedule a COllY of the d'~ed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said 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 wi th another, or any power of appoint- ment vested in decedent, either individually or jointly, by the 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 names and addresses of all 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 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 with 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 vestiture of real estate and the date of acquisition of personalty, plus the name, address and relationship, if any, of co-owners to the decedent. 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 ~lneral expenses paid; family exemption, where applicable; costs of administration of this estate; counsel fees and ~diciary's commissions 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 unpairl at time of death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with 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 th,~ 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. Subsl~ribed and sworn to before me this ~7 ...............................6..L.. /~~~~~e;;utri;;, ..R.......D..........#..8..,......p..os.t....'O'ff.ice.....Box.....i4..05.., (Street Number) ..C.a..rlis.le..".....p..enns.y.lv..ani.a.,......17013..... (City or Town and State) NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled 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-directed. . day of ....f.g)::n;::Y.9..;nr.I............. 19.7..~....... //:'" J' -cJ ....27 ......,....~~~~;:?"r.:',? j' RC C-34 (4-73) COMMONWEALTH OF PENNSYLVANIA DEPARTME'NT OF REVENUE BUREAU OIF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY * Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant .in common with another 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 IJS joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property located In the Commonwealth of Pennsylvania should be described b), lot and block number, street and street number, together with a general description of the praperty, with a reference ta the record of the conveyance by which the decedent took title; If a farm state number of a. cres; 0150 sltatement 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 must nat be deducted fram this schedule. (1) (2) (3) DEPARTMENT VALUATION CAUTION (Do not write In th Is space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEI. TH ESTIMA TE 0 MARKET VALUE 1. Land devised to granddaughter, Patsy J. Zimmerman, in paragraph of the Will of Decedent, containing 0.93 acres, and appraised by Lester G. Connor: "-I- 1,500.0Q \1'500.0::> 2. Land containing 3.28 acres, with mo- bile home >erected thereon as a permanent structure, appraised by Lester G. Connor: ~ 21,000.00 '2>l OOO.U;:;' ) 3. Land containing 4.02 acres described as Lot Number 2A in the Appraisal of Lester G. Connor, which the Decedent agreed to sell to her daughter, Betty A. Harry and her husband, Edward F. Harry, for the sum of $14,000.00, which sum was paid to the Decedent auring her lifetime. The land was no.t Deeded during her lifetime be- cause it had not been approved as a Subdivision before she died: \ /' -14,000.00 \.L{"oCA.u0 4 . Land consisting of the remainder of thle farm owned by the Decedent at thle time of her death, containing 131.17 acres, which includes the acreage of 3.92 acres in Lot Number l-}\ shown in the Appraisal of Les- ter G. Connor, and including the arlea in a right-of-way granted to Donald W. Brashear (not included in Lester G. Connor's Appraisal), at $1500.00 per acre: \ 196,755.00 \ctl:,.-rSSOi.: Insert this I~otal opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. 233,255.00 '-' ,<-"12 S S' 0-: L-- ..) .J, RCC -3.<; RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* COMMONWEALTH OF PENNSYLVANIA Ta~S~~R 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 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- 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 No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 1. Ten (10) Shares Pffd. Stock, Cumberland Valley Cooperative Association: ~ 10.00 100.0(}' / 'lOC.c;:,:, 2. Tw'o (2) Shares Common Stock, Cumberland Va.1ley Cooperative Association: 10.00 ~ " 2 0 . Off '20.D.~ 3. Checking Account #449-440-7, C. C. N. B. Ba.nk, N. A.: "'!' /tc -. S t ~ ' l \ 6,518.17 . 5. Refund from UGI Company: "" 3.78 '''''"- ,./ 4.95 '''- 200.001.. . . ~/ '" 708.00 '?:'. 1 't3 ({. ({ S 4. Refund from Bell Telephone Company: 6. Rebate for 1977 Taxes received from Commonwealth of Pennsylvania: 2-0 -:) . -::.:> 7. Household Goods: (08 c::> Insert this total opposite "Personal Property", Schedule "B" In the "As Reported" column on the last page of this return. x X 7 , 5 5 3 . 9 0 --r 1 S S -; '1 a RCC-36 COMMON1f1'EALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "c" T RAN SFEIlS RESIDENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part oChis estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) NO (2) Did decedent, within two years of death, transfer property 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)~~ (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) 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 reserverl 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) 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 DESCRIPT ION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) NONE NONE N'~ Insert this total opposite "Transfers", Schedule "C" in the "As Rel;Jorted" column on the last page of this return. NONE RCC-37 (:12-63) COMl\10N\\"EALTH OF FENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES BENEFIClARIES AND ADDRESSES ,state full names and addresses of all who have an interest, vested, contingent or other- wise, in estate) RELA TIONSHIP (If step-children or I illegitimate children I are involved, set i forth this fact.) SURVIVED I DECEDENT STATE YES OR NO DATE OF BI RTH INTEREST OF BENEFICIAllY IN ESTATE Mary Jan Six Dau hter Yes 5th Residuar Estate Patsy J. Z' R. D. #8. Carlisle Pa. 17013 R. D. #1 Box #201 Mechanicsbur Pa. 17055 Betty A. R . D . # 8, Box Carlisle, Pa., 17013 Grace L. Brenizer D I- I I Daugh ter~_-r- Yes E sta_te R. D. #;~ c~rlisle, Pa., 17013 DaVld w. __nes R. D. Carlisle Pa. 17013 Harry J. 110 Nor h Middlesex Road Carlisle Pa. 17013 1/5th I -r ~/5th ResiduaryE~~~~G Son_____ Yes Residuary_Estat~ Son 5th Residuar Estati i i ~ ~---- ,._- I ! I -~ I I --~- - Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH I RESIDENCE None NOne None --- ~~~-~--_.__._-_._.- ... -; s .... ~<~ ~: s:: '2 Cl) E Os Q).2 -00.8 ~ ~: ~u11 ~~t U :l 0 ~E~ f::! IX: SUMMARY ..(Sch. "A") qq(Sch. "B") ... (Sch. "C") (Sch...uK" ) Real Property Personal Property Transfers Jointly. OWned P.roperty Gross Taxable Estate ( 1 ) (As Reported) $ q2.33,255 ,00 $,]'qS.S3.~O $. ~()n.e $. ....None .$ $240.,80@.90 (2) (As Determined) $ $ $ $ $ $ ~ .rot ~ "0 .a Z Cl) U1 ... ~ U\ ~ C'j ..... ." ~ .l (]) ,..., Cl) < >< U 0 W Cl) rIJ if) "'Ci E4 '0 - ...... tJ) l:: < -< ~ 0:1 to ,~ ~ 0::; ~ 6 l:: ~. c c.. ~ 0 .r-f ~. ~ c.. ~ 2: t.:i -< t.:i ~ ~ Q) < ::c ::c w a. ~. ;... <Il f-< W f-< f-< . tJ) i: Q ~ :r: .... < ~ ~ Z ci Q) f-< 0 f-< ~ U ~ ~ Z if) ~ ~ ~ W ..... !- ------. 0 0 ~ tJ) r-i ..c c ~ P .r-! ..... 0 0 tJ) tJ) - c.. ',c w a: ~ C'j f-< ..... ;.. ~ ./:l 0 " f-< i: <Jl -< ..... !:' 0 '2 ..... 0 E 'E ~ Q.) S E - - ..... 0 ~~ ~ 0 ....:l U U R C C-38 RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRliCTIONS: This sche(lule must disclose all property, real ami personal, owned by the decedent jointly with 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 \mder Schedule "A", plus the date and place of record of instrument effecting vestiture, but 00 not include entireties or out of state real estate value in estate valuation column. Personal property shoulo 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, Name Address and Relationship of Co-Owners, and Place ~C"C'1 of f"'tcument, whece Real ",tnte. Unit Value percentage Share Estate Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's property Interest NONE NONE NO~ Insert this total opposite ",Joiptly Owned Property", Schedule "E" in the" As Reported" column on the last page of this return. NONE :<CC-39 (~68) COMMONWEAL'TH OF PENNSYL VANIA TRANSFER INt1ER1TANCE TAX RESIDENT DE4:EDEMT SUMMARY Estate of JONES, (Last Name) SUSAN (First Name) DATE OF DEATH 5/15/78 FILE NO..<1-1i'-fJJ..1! R. (Initial) REPORT OF INHERITANCE TAX APPRAISER I, the \Imdersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumber land Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values St:t forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E". . ~ Dated: February J'.'/, 1979 ~ ~4 ,-~.""tf~~ "..-i'~ INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Cumberland County, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum allowed as a deduction. Da ted: l"ebruary , 1979 REGISTER OF WILLS INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint - Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE Fl CLEAR VALUE OF ESTATE annuities. . . . . . . . . . . . . . . . . . . $ 1= t= t= Valuation of life estates or ESTATE l' AX ASSESSMENTS $ BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Estate tnx paid $ BALANCE DUE Add interest at rate of 6% from to FOR USE OF REGISTER ONLY Tax on $. Tax on $- Tax on $- Tax on $_ Tax on $. Exemptions Total Estate TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death COMPUTA TION OF TAX 2% 6% 5% 10% 15% . $ $ $ $ $ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. $ $ $ t= $ $ t= $ 1== L- E $ $ TOTAL TAX BALANCE $ PAID $ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason, same should be noted below, with short explanation. R E V-S 18 (8-78) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT Grace L. Brenizer RD 8, P.o. Box 405 r.::Irlil':lp) PJ\ ]7013 (Executor or Administrator) In Re: Estate of !=;l1l':::In R _ .TOTlE'S Cumberland County - File No. 21-78-0271 Dear You are hereb~ notified that the Original appraisement in the estate of Susan R. Jones has been filed in the office of the Register of Wills of Cumberland County on 8 March , 1912-, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total $231,2')').00 7 , 5 'i3 . 90 None None $240.808.90 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 obiect 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. J!:.}. '-.>" D ;P, Date 8 Mar~h 1979 Si gned d-Q..~ \,; t....,....<..- ,'.., , '>,....,,' Title Administrative Officer .....---.------ '-. Note: This is not a bi II. REV-45, (8-i8) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLV.D,j\lIA RESIDENT INHERITANCE TAX APPRAISEMENT DA','c 8 March 1979 -Cumberland COUNTY FILE No,2~::.Q2.ll_",~_ Whereas, Susan R. Jones late of Carlisle in the County of Cumberland Commonwealth of Pennsylvania, having died on the 15th day of M<>y 19....:JJ3, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo F1l1jiini ti , 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 collaterai rate on any sucn future interest. DESCRIPTION OF ASSET UNIT Appraisement VALUES Made ~or I ntleritailce Tax Purposes $ Re;:ll ~ ?~~ ?"" ()() pp....c",.... <>, ~ 7, <;<;1 QO Tt. - Nnnp Joint1v Owned None Ic'" ~, $240.808 90 ; ! , I I 1 I I I I . I , I b Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 8th day of March. ' 19 1.1..-. '\..\. g.:~') """,., .~. ....:,_.,.-.. i \ ,,- Apptaisel --'-- -"" Harrisburg (Number and Street) (Post Office) , Penna.