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HomeMy WebLinkAbout04-26-79 (3) 1,/U/'19 R C C-33 (4-; 3) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS .. RESIDENT DECEDENT COUNTY OF CUMBERLAND IMPORT ANT: 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'ltenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE EST A TE OF } AFFIDAVIT OF EXECUTOR XBll1lMJU:K4aXQl IRA C. KRAMER (STATE FULL NAME OF DECEDENT) Late of Cumberland County State of Pennsylvania County of Cumberland Merle C. Kramer, } .., ~~ Executor of the estate of the above-named decedent being duly sworn, depose and say Decedent died July 4, , 19~{testate leaving a last will, copy of which is hereto attached. } (YEAR) ~tXtX (MONTH) Name and address of attorney or } other avthorized repres~ntative to whom all correspondence should be mailed. (DAY) Myers, Myers, Flower & Johnson 1 West Hiqh Street, Carlisle, Pennsylvania 17013 That as such Executor deponent is familiar with the affairs of said estate and the property constituting ( EXECUTOR-ADMINISTRATOR) 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 THIS SAFE DEPOSIT BOX RE;NTED REL A TIONSHIP 0 F JOIN T IN WHICH DECEDENT RENTED A S..FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Farmers National Bank Ira C. Kramer Newville, Pennsylvania 17241 That the contents of said safe deposit box or boxes are itemized under Schedules wi th the exception' of the following, for the reasons hereinafter set forth: of this return, That Scheclu/e 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 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 decedent at the time of death, whether in decedent's immediate pos ses sion, s tanding 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 also separately the accrued interes t 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 promis sory 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 interest 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 a t 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 f~rth 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 lJ,usiness. A copy of the co-partnership agreement, (if oral, a statement setting forth 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 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 effect in possession or enjoyment at or after death, there is also attached to the schedule a co~y of the deed, 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 passes at decedent's death by virtue of the exercise by decedent, either individually, orjointly with 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 0 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 funeral expenses paid; family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary'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 Illlpaid 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 the totals of the appropriate columns in Schedules "A", "B", have been carried forward and properly registered in the Summary. if- Subscribed and sworn to before me this ..~{'::::........ ______________ _ day Of_;.,~- 19-2:2' .........~O<.~ ,...."......... NOTARY PUBLIC Carlisle, Cumberland County My Commission Expires March 26, 1981 "en, "E", and "F" as directed therein, ~~...........c....~.......~........._... MerlJ~~~utor ..~.~......G,h.~.~.t,n:g.t......$..t.;r.~.~t.........................................~.............. (Street Number) N ~~y.~.~.~..~..'.......~.~~.~.~X.~.Y..~.~.~.~.........~.??...~.~........ (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 "Surrnnary" has been properly completed as above-directed. RC C-34 (4-73) . COMMONW~AL TH OF PENNSYLVANIA 'DEPARTMENT OF REVENUE BUREAU OF 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 ~n 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 as joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule liE.") The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together with 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 must not be deducted from thIs schedule. (1) (2) (3) DEPARTMENT VALUA TION CAUTION (Do not wrIte In thIs space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEA TH ESTIMA TED MARKET VALUE 1. Farm situate in Upper Frankford Township, Cumberland County, Pennsylvania, containing 101 acres, 15 perches located approximately one mile East of the Bloserville Road along Township Road 441 (Fry town Road), deed being recorded in the Cumberland County Recorder's Office in Deed Book "L", Vol. 8, page 357. /" Appraised value /0 ~Lf-O.DO 115,000.00 I <. 2. Premises located in West pennsboro Township, Cumberland County, Pennsylvania, situate East of the Borough of Newville and fonts 264 feet along the North side of Route 641 and extends in depth approximately 55 feet, having thereon erected a repair shop and gasoline service station. Containing .337 Acre. Being a portion of the premises conveyed by J. Edward Chestnut and Viola S. Chestnut, his wife, by deed dated May 1, 1944 and recorded May 1, 1944 in the Office of the Recorder of Deeds in and for Cumberland Count at Carlisle, Pennsylvania, in Deed Book "U", Vol. 12, page 283. ..."" ~-/ S-O, 00 29,500.06 Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. 144 , 500 . 00 \ 4 Ll1 So 0 ,l} (;] Office 243-6195 GEORGE L. EBENER REALTOR APPRAISER - SALES - PROPERTY; 'i\jAGEMENT 139 WEST HIGH STREET CARLISLE, PA. 17013 August 1, 1978 James D. Flower, Esquire 1 West High street Carlisle, Pennsylvania 17013 RECEIVED AUG 3 1978 Myr::R - S, MYERS, FLOWER Re: Estate of Ira C. ~i~~J'i~ClN Dear James: I am a licensed Real Estate Broker, licensed by the Commonwealth of Pennsylvania, and have been actively engaged in the real estate business for the past twenty-five years in the Cumberland County area. I am thoroughly familiar with real estate values in this area. On July 28, 1978, I inspected the properties in the Ira C. Kramer Estate in West Pennsboro Township and Upper Frankford Township, Cumber- land County, Pennsylvania, to determine my opinion of the values as of July 4, 1978, the data of his death. PROPERTY NO.1: In Upper Frankford Township, a farm containing 101 acres 15 perches located approximately one mile East of the Bloserville Road along Township Road 441 (Fry town Road). It is recorded in the office of the Recorder of Deeds for Cumberland County in Deed Book "L", Vol. 8, Page 357 and contains two tracts of land. TRACT #1: contains 73 Acres 40 Perches and is the site of the improvements. The balance of the farm or Tract #2 contains 27 Acres 135 Perches. The improvements on Tract #1 consists ofatwo-story frame dwelling house approximately 22 X 26' with metal roof and a frame addition to the rear. This dwelling was partially destroyed by fire in 1939 and has been re-built since that time. The first floor contains a kitchen, living room bath and dining room. The second floor has three bedrooms (two do not have closets), There is no bathroom. There is an attic for storage. It has a full basement with a new oil fired hot air furnace,&electric water heater. There are single floors and the walls are plastered. The exteri is in need of paint and the spouting needs repaired. There are no storm windows. The other improvements consist of a frame bank barn with metal roof, attached hog pen; a frame wagon shed with corn crib and metal roof; frame Page 2. Re: Ira C. Kramer Estate chicken house 15 X 38' and several other outbuildings. The water supply is from a cistern. The type soil on this farm is a slate texture considered fair in productivity and of the 73 Acres on Tract '1 approximately 55 Acres IS tillable. This farm is assessed at $ 10.240.00 for tax purposes. TRACT '2: Fronts along the South side of the Road and is pasture and wooded, except for 17.5 Acres which are tillable, and is quite hilly in certain areas. In my opinion this property has a value of $ 115,000.00 as of July 4, 1978. PROPERTY NO.2: Located in West Pennsboro Township, East of the Borough of Newville and fronts 264 ft. along the North side of Route 641 and ex- tends in depth approximately 55 ft. and is presently used as a repair shop and gasoline service station. The ,improvements consist of a cement block repair garage 28 X 34' in size with two overhead doors, ceiling oil fired hot air furnace. A two-story cement block and frame gas station and garage 18 X 42' in size with metal roof. The first floor is a gasoline service station with one bay which is used for storage. This area is heated with a gas wall heater. An exterior wooden stairway leads to the second floor which was used at one time as an apartment, consisting of a kitchen with tile floor; living room; two bedrooms and bathroom, and was heated with an oil fired heatrola. This apartment has not been occupied for app~bximately 15 years due to the lack of sewerage disposal as a result of the small lot aren. This property is serviced by public water and is in fair condition. However, the lack of adequate sewerage facilities and no lot depth is detrimental to its value. The exterior needs painted and the stairway to the second floor should be repaired. It is assessed at $5150.00 for tax purposes. The gasoline tanks and pumps are the property of Exxon. In my opinion this property had a value of $29,500.00 as of July 4, 1978. I have no interest of any nature whatsoever in these properties. This opinion is given by me voluntarily and is without liability on my par. GLE/jm Encl:(4 photos) Very truly yours, ,/{/ ,/ /? /'.-- -, "l/, ," '/ ~ ' ~~/Cy //", ~ / 7/c"/:'-2 Georq~~. Ebener, REALTOR / , -- -... _.~---_..............,...~."" RCC -35, COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* 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.a.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 1. The Farmers National Bank of Newville, Pa., checking account 2. $1,000.00 Certificate of Deposit of Farmers National Bank with accrued intere date of death 3. $6,600.00 Certificate of Deposit of Farmers National Bank with accrued intere date of death 4. Certificate of Deposit # 18-3019 for $1,000.00 of Commonwealth National Bank plus accrued interest to date of death 5. Cash from Decedent's wallet 6. Sale of household goods at public sale 7. 191 shares Philadelphia Electric at 17.40625 8. 63 shares U G I Corp. at 19.90625 9. 26 shares Cities Service at 49.4375 10. 42 shares Delmarva Power & Light at 13.4375 11. 50 shares Willys-Overland Co. 12. 21 shares Charlestown Racing Association at $9.25 13. 6 shares Shenandoah Corporation at $9.25 14. 2 shares Cumberland Valley Co-operative Association, Common at $10.00 15. 37 shares Cumberland Valley Co-operative Association, Preferred at $10.00 16. Miscellaneous old coins and slugs \1. Cu.\'f'IbQ.f\dJ\c! \fQ U~ ~. Il \.-C()...r) - -r HAS+ ~OW\+ :r ('"cc C. ~ fa ffi.~x \\~ ~ -h Q I \'fI (1.X" \ ~ C. 1{ y-a ~f I (jll'!L~ o'~. t...~\-. 1 (Ie \ (p -, - \u-Uo -\-0 X-Cl \ilL.., Insert this total opposite "Personal Property", Schedule "8" in the "As Reported" column on the last page of this return. UNIT VALUE ESTIMATED MARKEl' VALUE DEPARTMENT VALUATION (Do not write in this space) " 330.81/ /' /' 3,324.59/ \94.25 "\. 55.50 "\. 20.00 ~70 .0 ~)\O\. 13 x X 21,210.52 ~3,3 \~.;lS . .. , .. ~ l;)(j I/L)8' r!' /,.~~ #' - ~. J ~~ ":',.'~' J::',/-;> - -- -- J. '- ,;,; .1..' It~'/ ;:'L If. ;.... ,... I -'" .t /- '" , v'" (liS::=' / 6.J .~~ j /~- Ie .".J /~ '-~I"\Y ( .Ioe; 2. i~- t ..- .' '., . \.,,..... I ,'.... '-, (. .." / ,~ )"-J.,.... Ir:. C:r~ /~ r~\V- Y' ::.:t.) !'Cc1 . Ir;.o~ -' , . -~)C So ';l "" ;1- ! 180 O/zd (2) ~~ .' /1 ~"2 ('/II.,'/f ; /90:"1 ,./(JI(~}/,~JC'. 19/1 I~ '1 .. c'-c'" c' --'" ') 2~ "5 70.:' > -'-' h CY l.;-' I 't., ..l '- .. ~._._~..,._. I THE FARMERS NATIONAL BANK No. 9588 OF NEWVILLE, PENNSYLVANIA 17241 WAYNE WOOD, President MERVIN J, MORRISON, Cashier CAROLYN H. KOUGH, Asst Cashier MARY E. KELSO, Asst Cashier August 8, 1978 Mr. James D. Flowe:r Mye:rs, Mye:rs, Flowe:r 1 West High st:reet Ca:rlisle, Pa. 17013 & Johnson Dea:r M:r. Flowe:r: At the date of his death,on July 4, 1978, Mr. I:ra C. Krame:r had a checking account balance of $330.81. He a1eo had a ce:rtificate of deposit fo:r $1,000.00 with $12.50 inte:rest payable, and a certificate ~f deposit for $6,600.00 with $396.00 inte:rest. Very t:ruly yours, ~&~tL~I,-'Jf ~.;t~. Assist~t Cashie:r RECEIVED AUG 9 1978 MYERS. MYERS, FLOWE.R & JOf-iNSON -._"'-'-'"'._-'-''~'''--'''''l''''' ( Commonwealth J~ National Bank ~ August 15, 1978 Myers, Myers, Flower & Johnson 1 West High Street Carlisle, Pa. 17013 Re: Estate of Ira C. Kramer Dear Mr. Flower: In reply to your letter dated August 3, 1978 on the above estate, there is a certificate of deposit #18-3019, the balance as of July 4, 1978 is $1,000.00, accrued interest of $12.97. The account was in Ira C. Kramer's name only. If you have any questions, please feel free to contact us. Very truly yours, (~2';f{< / /\.:., ) i. t. "...;. Daryl S. Myers Vice President DSM!cg RECEIVED AUG 16 1978 MYERS. MYERS, "'L()\I~i:.< & JOHNSJI'4 The Commonwealth National Bank. 10 South Market Square, Harrisburg. Pa. 17 1 08 (717) 564-9500 ~ _~h.'-' t RCC-Y6 COMMONWEALTH OF PENNSYLVANIA TRANS}~R INHERITANCE TAX SCHEDULE "c" TRA.NSFERS '* RESIDENT DECEDENT (1) Did decedent, within two years of'death, make any transf'er of' any material part of' his estate, without receiving a valuable and adequate consideration theref'or? (Answer yes or no) NO (2) Did decedent, within two years of' death, transf'er property f'rom 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 af'f'irmative state: (a) Age of' decedent at time of' transf'er (b) State of' decedent's health at time of' making the transf'er. (Note 1). (c) Cause of' decedent's death. (Note 1). (4) Did decedent, in his lif'etime, make any transf'er of' property without receiving a valuable or adequate consideration theref'or which was to take ef'f'ect in possession or enjoyment at or af'ter his death? (Answer yes or no) NO (a) Was there any possibility that the property transf'erred might return to transf'erer or his estate or be subject to his power of' disposition? (Answer yes or no) NO (b) What was the transf'eree's age at time of' decedent's death? (5) Did decedent in his lif'etime make any transf'er without receiving a valuable and adequate consideration theref'or under which transf'eror expressly or impliedly reserves f'or his lif'e or any period which does not in f'act end bef'ore his death: (a) The possession or enjoyment of' or the right to income f'rom the property transf'erred? (Answer yes or no) NO (b) The right to designate the persons who shall possess or enjoy the property transf'erred or income theref'rom? (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 lif'etime make a transf'er, the consideration f'or which was transf'eree's promise to pay income to or f'or the benef'it of' care of' transf'eror? (Answer yes or no) NO (8) Did decedent, at any time, transf'er property, the benef'icial 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' transf'er or by operation of' law? (Answer yes or no) NO (9) If' the answer to (8) above is in the af'f'irmative, was the power to alter, amend, or revoke the inter- est of' the benef'iciary 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 af'f'idavit by the attending physician as well as a copy of' the death certif'icate. NOTE 2: If' answer to any of' the above questions is yes, set f'orth below a description of' the property transf'erred, it's f'air market value at date of' death, dates of' transf'ers and to whom transf'erred, with relationship of' transf'erees to decedent, if' any. Submit copy of' any trust deed or instrument, if' trans- f'ers are claimed to be non-taxable, also submit detailed statement of' f'acts 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) NONE Insert this total opposite "Transf'ers", Schedule "C" in the "As Reported" column on the last page of' this return. RCC-37" (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFI CIARIES \ h BENEFICIARIES AND ADDRESSES RELATIONSHIP 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 BI RTH Judy Ann Jackson Granddaughter YES $10,000.00 R. D. # 4 Carlisle, Pennsylvania 1701 Children of Merle C. Kramer: Deborah J. Younq Granddauqhter YES $2,000.00 R. D. # 4, Newville, Pa. 17. 41 Lucinda J. Rook Granddaughter YES $2,000.00 27 Big Spring Avenue Newville, Pa. 17241 Merle C. Kramer, Jr. Grandson YES $2,000.00 67 South High Street NewvL1Le, r-a. .11 L4.1 B re t C. Kramer Grandson YES $2,000.00 23 Chestnut Street Newville, Pa. 17241 Merle C. Kramer Son YES Farm in U.Frankford 23 Chestnut Street Twp. CC.,Pa. in kind ".. ~ I~ . .. NeWV1.1.1e, r-a. 1"1 L4 L 1-'-,-u", -'-I" .L Mary E. Wagner Dauqh ter YES 1/2 residue R. D. # 2 Newville, Pa. 17241 Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE NONE RC C-38 RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY '* COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly wi th anot.her or others, including intangibles, standing in the name of the decedent and others. List real estat.e 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 "a", 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 of Record of Instrument, where Real Estate. 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 Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. NONE ~ e--L