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HomeMy WebLinkAbout08-28-78 ... Form RCC-33-RI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONSA...,." Uu" ' COUNTY OF ppO'P....._ W.". . , !. "" RESIDENT DECEDENT IMPORTANT: This return must be completed in detail and f'iled in duplicate, with will attached, with the Register of' Wills of' the County where decedent resided; Return is due within one year af'ter date of death, unless an extension is granted by the Secretary of' Revenue. (Section 703 of' the Inheritance an!! Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF Lillian M. Barnhart .... ...............}:::UA:~: OF x ADMINISTRATOR County (state full name of decedent) Late of ..... .... .......Cumber.land ...(";; ~'.I1"/ld""-.)."''' state of . County of .. ~.=:::~:=;~:=-~:}", ..Fq....E.Hernley.,...daugh.t-er. .. of the estate of the above-named decedent being duly sworn, depose B Ii: r Administrator and saYS Decedent died .... ......cJ't1.D,e 51, (Month) (Day) 19...78... ....f testate leaving a last will, copy of which i. hereto attached, 1 (Y""r) L intestate J Name and address of attorney other authorized representative whom all correspondence should mailed. or} to be Ralph A. Sheetz,... 798Y.a.l~el,,~tr.t:l~~t. Enol., 1'a. 1702f) That as such ..............~~t.e.r............... deponent is familiar with the affairs of said estate and the property con- (J<:Xl'f~U tor-Administrator) stituting 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 RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT None ---, That the contents of said saf'e deposit box or boxes are itemized under Schedules return, with the exception of the following, f'or the reasons hereinafter set f'orth: of this That Schedule A attached hereto and made part hereof sets forth full v 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 theref'ore 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 lef't 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 also separately the accrued interest thereon, if any, down to the last interest day prior to decedent's death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of in- debtedness of the United States to the decedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States, or any state, or political subdivision thereo~ or of any foreign country,' which are owned at the time of death; all w.earing apparel, jewelry, silverware, pic- tures, books, works of art, household furniture, horses, carriages, automobiles, boats, and any and all other personal chattels of whatsoever kind or nature, lef't by decedent, together wi th the fairly es timated market value thereof; all bonds and mortgalles 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 f'or the payment of money of whlch decedent died possessed, of' whatsoever nature, with interest thereon, if' any, giving the f'ace value ann estlmaterl :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 i tern; all moneys payable to the estate from life insurance polictes carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of' dece- dent's death and other investment securities owned by the decedent at the time of death, with the market value thereof at such time. I ~ bl/t; I ,;</-1 1- /lu:Y~? I r ! /, .,/ z/ 'tl-.{' f:l~>r-'" / (J.- " y' I." / I l' \ ... , ;~C~-:l:la-'U CO\IW1NW"E:\LTH 01<' PENNSYLVANIA T'V\\'i'FEH INHE1UTANCE TAX ~lE'aTl)':N'r DECEDENl SCHEDULE ":~" IlEAL PHOPEIlTY 'leal property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at deatll of decedent. Where property held as 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 as 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 described by lot and block number, street and street number, together with a general description of the property, with a refer- ence to the record of the conveyance by which the decedent took title; if a farm state number of acres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes. assess- ments, accrued interest on mortgages, etc., are to be listed on Schedule "p" and must not be deducted from this schedule. (1) (2) (a; DEPA1tTMENT VALUAT ION CAUTION (Do not write in this space) ASSESSJ.:::D VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMATED MARKET VALUE lion Insert this total opposite "reed. property", Schedule "A", in the "As Reported" column on the last page of this return x X X X X NOD rr;'~ .Bee -3.') 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 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 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. Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No. Lis t and describe full y VALUE MARKET VALUE (Do not write in this space) ~ ~()() Cash $25.00 ......... ~ Insert this total opposite "Personal Property" , Schedule "B" in X X $25.00 fJ- ).0 0 the "As Reported" column on the last page of this return. .. , Rec - 3D rl1mlO:\'Ii'~\LTI! OF PF!\'NSYIXANL\ T1L\\SFF}\ I:\HEI\IT,\~TF T;\X SCHEDULE "c" TR\NSFEllS I\ES IDF:\T DECEDENT (1) Dirl rlecedent, within two years of'death, make any transfer of any material part of his estate, without receiving a valuable and adequate consirleration therefor? (Answer yes or no) no (2) Did rlecedent, wi thin two years of death, transfer property from himself' to himself and another or () thers (includi ng a spouse) in j oint ownership? (Answer yes 0 r 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' decerlent'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 enj oyment 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) no (b) What was the transf'eree's age at time of decedent's death? (5) Did decedent in his lif'etime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in f'act 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 posses~ 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 cOllld revert to riecedent 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 th~ decedent alone or the decedent and others? (Answer yes or no) no NOTE 1: The answers to these questions should be supporter! by affidavi t hy the attewling physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set f'orth below a description of the property transferred, it's fair market value at date of death, dates of transf'ers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust rieed 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 provideri in Scherlules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) NONe ,- y~ ..-.-..... rJ o ~'-~~_ Insert this tot'll opposite "Transfers", Schedule "C" in the "As Reporteri" column on the last page of this return. t'/ ~CC-37 (12-63) COMl\lON\\'EALTI! OF PEN~SYYLANIA TRANSFEH INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "I)" BENEFICIARIES \ h BENEFICIARIES AND ADDRESSES RELA TIONSHIP I SURVIVED (If step-children or DATE INTEREST OF S ta t e full names and addresses of all who illegitimate children I 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 li'J:lV ~. ~ GO? ~ LemO)'Jle, Pa. 17043 . Da~ter Yes 11- 30-21 Whole Es1;ate - - Iit'r'mf~nt further says that all the above-named beneficiaries are living at this time except below: -~--_.~_._--------_.- NAME DATE OF DEATH RESIDENCE NOD I --.. c RCc''':38 n.F~mENT DECEDENT SCHEDULE "E" JOINTIX OWNED PROPERTY 'CCMM0NWEALTH OF PENNSYLVANIA rHM\SF'EH Ir\HEHlTANf'E TAX I~SrRlTTIOSS: This schedule must disclose all property, real and personal, owned by the decedent jointly wi th another or others, including intangibles, standing in the name of' the decedent and others. List real estate f'irst, as entireties, or joint tenants, giving brief' description, as indicated lUlder Schedule "A", plus the date and place of' record of' instrument ef'f'ecting 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' Acquisi tIon, Name -I Uni t Address and Relationship of' Co-Owners, and Place 1 Value of Record of Instrument, where Real Estate. ! percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest 6 shares, COllD1On, bJIlerican Tel. "Tel. in the names of Lillian M. Barnhart and Fay 13. Hernley, Joint tenants, etc. Real eltate situate at 602 H'UIIDlel Avenue, Le- lDo;yne, Cumberland County, Pa.in the DAmel of Lillian M. Barnhart &: Fay E. Iiernley, &8 join1 tenants, etc. See Deed :Book 'D', Volume 15, Page 550. Appraised by Joseph McGraw, Inc. on June 19, 1978 at $30,000.00 V 61.937 I I one-half ~ .... $185 .81 ........--~ 7), (., t..-- l'ir: fl ! <. ~- I'f; ()()(). 00 ,/ n, ;0) ..~"J), ~/ one-half $15,000. , \ f ):,' 1\ '_.~ I .:...,j , . ,.,\ " "", .- I . " , Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. Yf1rCt; '. RCC-39 (5-68) COMMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of Lillian M. :Barnhart (Last Name) (First Name) (Initial) DATE OF DEATH 6-9-78 FILE NO. 21-78-0453 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland 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'J, andoo"E';. '-..0 r--" n -\--- -"'" '-"- I, \.' r- ~ _/--...~---__....---" \.....'"--' "---7 0:,---::, \. '.ju_'U ", "'---" - - C) January 4, 1979 Dated; INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for ClUIlberland 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: 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 F) VALUE AS REPORTED $ VALUE AS APPRAISED $ -0- 81 81 CLEAR VALUE OF ESTATE Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ t= t= t= ESTATE TAX ASSESSMENTS $ FOR USE OF REGISTER ONLY Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Total Estate COMPUTA nON OF TAX 2% 6% 5% 10% 15% * $ $ $ $ $ TOTAL TAX $ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death $ $ ~ $ 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 $ c $ C '- 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. *' REV-518 (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 Fey E. Hernley (Executor or Adm ini strator) In Re: Estate of Lillian N. Barnhart Cumberland County _ Fi Ie No. 21-78-0453 Dear Mrs. Hernley: You are hereby notified that the original appraisement in the estate of Lillian M. Barnhart has been filed in the office of the Relister of Wi lis of Cumberland County on January 4 , 19~, Said appraisement reflects the following valuations: Real Estate .:: Personal Property .,. Transfers Jointly Owned Total -0- 25.00 -0- $15,185.81 $15,210.81 As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. '\iY3. Date January 4, 1979 ( Signed Title Administrative Officer I -~ ~ ----.~- L,~ Note: This is not a bill. R C C-2 (2-64) . DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE January ll, 1979 Cumberland COUNTY FILE NO. 21-78-0453 Whereas, Lillian M. Barnhart late of Lemovne in the County of Cumberland Commonwealth of Pennsylvania, having died on the 9 th day of June 19----18-, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fulgini 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 collateral rate on any such future Interest. Unit Appraisement Description of A..et Value, Made for Inherilance Tax Purpole, Real Estate fJnn e> $ -0- _. Personal Property S 25.00 2') 00 Transfers None -0- Joint Property $15.185.81 15.185 81 Total Estate $15.210.81 <:1 <:; ?1n 81 .'-. -- Having been duly sworn according to law, I do hereby certify that the above appraisement is made in con- formity with law on this 4th day of January 19----1L. Appraiser (lI\IlDber anet Stnet) Harn.sourg (POlIt 0ftI.,.) , Penna.