HomeMy WebLinkAbout02-28-80
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SUPPLEMENTAL
~-'-iO
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
RESIDENT DECEDENT
COUNTY OF ~ v 1'1 i3t:/?'-- A .Vu
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.)
Late of
Cumberland
} AFFIDAVIT OF
EXECUTOR
ADMINISTRA TOR
County
IN THE MATTER OF THE EST ATE OF
VIOLET M. RUDY
(STATE FULL NAME OF DECEDENT)
State of
Pennsylvania
} os,
County of
Cmnberland
Ui6~
PAUL L RUDY
Executor
of the estate of the above-named decedent being duly sworn, depose
and say
Decedent died
June 27
(MONTH)
Nome and address of attorney or }
other authori%ed repres.entative to whom
all carres.pondence should be mailed.
(DAY)
, 19~{~estate leaving a last will, copy of which is hereto attached. }
(y EAR) Intestate
Murrel R. Walters, III, Esquire, 22 East Main Street,
P. O. Box 2467, Mechanicsburg, Pennsylvania 17055.
That as such Esecutor deponent is familiar with the affairs of said estate and the property constituting
( EXECUTOR-ADMINISTRATOR)
the as sets 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 RENTED REL A TIONSHIP 0 F JOIN T
IN WHICH DECEDENT RENTED A S..-FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Farmer's Trust CODlPany
1 West Hiqh Street
Carlisle, PA 17013 violet M. Rudv
That the contents of said safe deposit box or boxes are itemized under Schedules B
wi th the exception. of the following, for the reasons hereinafter set forth:
of this return,
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, trust companies, or other institutions, whether individually, or in trust for any other person or perso",s
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, pos.tal
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 estima ted 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 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 1n 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 husiness.
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, wi thin 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 proport1.onate 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 copy
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 pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested in qecedent, either individually or jointly, by the will, deed, or other instrument of another,
with a copy of the instrument creating such power attached td 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 unpaid 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 presen~ 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", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this ..~.I..~
.... day Of~..19..K.:a..
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My Commission Exp:res Ocr. 1/, 1983
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.
RCC-34 (4-73)
COMMoNlIEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF CdUNTY 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 jn common with another or other, should be identified
as to quantum of interest and th e estimated value shou Id be that of the decedent's interest on Iy. (Property
held as 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 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 must not b. deducted from this schedule.
(1)
(2)
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
Lot with Mobile Home situate at R. D. #4,
Box 239, Mechanicsburg, Pennsylvania,
Silver Spring Township. Deed acquired
August 25, 1970, from Robert M. Snively, et ux,
and recorded in Deed Book "T", Volume 23, Page
700.
(as per conveyance price)
Difference between estimated value and
actual purchase price
$595.03
- 0-
~. ~ ~rAAV~O n/
TOTAL
-
<G~y
Insert this total opposite "real property", Schedule CIA" in the X X X X X
"As Reported" column on th e last page of thi s return.
0-
J:f~
R C (}'4(35
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
CO~ThIONWEALTH 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 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 f'urnishings, 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
2
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. Lis t and describe fully VALUE MARKEl' VALUE (Do not write in
this space)
. Cash $5,000.00
. Clara J. Cassel - repayment of personal loan $1,660.00
TOTAL $6,660.00
I
I
Insert this total opposite "Personal Proper ty" , Schedule "B" in X X ~ ~&,O#Ot)
J
the "As Reported" colurm on the last page of this return. -ug rr:.
RCC-39 }5-681
COMMONWEAL TH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUPPLEMENTAL
SUMMARY
Es ta te of RUDY .
(Last Name)
Violet
(First Name)
DATE OF DEATH June 27, 197I21LE NO. 21-78-0435
M_
(Initial)
REPORT OF INHERITANCE TAX APPRAISER
Cumberland
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Da~d: February 28, 1980
J11 iA4 /4 } 7/f'/'-", JlILk j )
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for 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.
Dated:
VALUE AS REAPPRAISED
$
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 F)
CLEAR VALUE OF ESTATE
REGISTER OF WILLS
.
723
45
6,531
58
Valuation of life estates or
annuities. . . . . . . . . . . . . . . . . . . $
ESTATE TAX ASSESSMENTS $
t=
t=
t=
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED $
Estate tax 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=
$
C
I-
t=:
$
$
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.
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REV-SIB (3-79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P. O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
I nvestigation Division
NOTICE OF FILING OF APPRAISEMENT
Paul L. Rudy
R. D. #3, Box 240
Di11sburg, PA 17019
(Executor or Administrator)
In Re: Estate of Violet M. Rudy
Cwnber1and County - File No. 21-78-0435
Dear Mr. Rudy:
You are hereby notified that the. . - supplemental
appraisement in the estate of Violet M. Rudy
has been filed in the office of the Register of Wills of Cumberland
County on February 28 , 19 80. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
6,660.00
None
None
$6,660.00
As to such tax that is paid within three months from date of death, a five (S%) 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
February 28, 1980
Signed . )J.lJ/J./'f i /,/ ~ tf! --" A I'J 1ftl }
Title Chief Appraiser
NOTE: This is not a bill.
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF F1EL-o OPERATIONS
.p .0. BOX 2970
HARRISBURG, PENNA. 17105
SUPPLEMENTAL
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEM ENT
DATE
COUNTY
FILE NO.
February 28, 1980
Cumberland
21-78-0435
Whereas, Violet M. Rudy late of HamPden Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 27th day of June 19 ~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Gloria J. Richard , 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 APpraisement
VALUES Made for Inheritance
Tax Purposes
Real Property $ None
Personal Property 6,660 00
Joint-Held Property None
Transfers None
TOTAL ASSETS 6,660 00
-
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 28th day of Feb~A-"f 19 8~ .
fa } 7IfJ~~k4}
Appraiser
(Number and Street)
Harrisburg
(Post Office)
, Penna.
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