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HomeMy WebLinkAbout03-08-79' COMMONWEALTH OF PENNSYLVANIA ~ / ° DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS RESIDENT DECEDENT COUNTY OF Cumberland IMPORTANT: This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the County where decedent resided; Return is due within nine months after date of death,. unless an extension is granted by the Secretary of Re~tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF AFFIDAVIT OF William Robert Stambach EXECUTOR (STATE FULL NAME OF DECEDENT) gate of Cumberland county ~(~tMkji;!(R~ state of Pennsyl vani a j S=: county of Cumberland Edward B Allen, Jr Executor xsli~tKl~~ of the estate of the above•named decedsnt bsing duly sworn, dspo=s$ anal say ,$ l Decedent died a~lJfle 3e 19~- testate leaving a last will, copy of whteh is hereto attached.. ? (MONTH) (DAY) (YEAR) {j(I~~1~! Name and address of attorney or 'Jon F. LaFaver other authorized representative to whom all correspondence should !re r..oiled. 317 Third Street, New Culnberland~ PA 17070 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 I THIS SAFE DEPOSIT 80X RENTED I RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A S.aFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT That the contents of said safe deposit box or boxes are itemized under Schedules of this return, with 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 mortgage encumbrances upon each parcel of real property at the date of death, givin>$• 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 wheresever situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last interest day pri®r 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 owns at the time o death; all .~~a~ing apparel, jewelry, silverware, pictures, books, works of art, hou~i , iages, automobiles, boats, and any ..and all other personal chattels of whatsoeve~~uM~ cedent, together with the fairly.. estimated market value thereof; all bonds and mortgages held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and 'if such estimated fair market value be less than the face value, it sets forth briefly the reasons .for such depreciation as to each item; all moneys payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts the proceeds of which wer: 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 secnities owned by the decedent at the time of death, with the market value there- of at such time. RCC-36 COMMONWEALTH OF PENNSYLVANIA TRANSb'ER INHERITANCE TAX SCHEDULE "C" TR4NSFERS RESIDENT DECF,DENT (1) Did decedent, within two years of death, make any transfer of any material part o is estate, without receiving a valuable and adequate consideration therefor? (Answer yes or 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) ~ O _ (3) If the answer to (1) or (2) above is in the affirmative state: (a) Age of decedent at time of transfer (b) State oP decedent's health 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 transferor or his estate or be subject to his power of disposition? (Answer yes or no) (b) What was the transferees age at time of decedents 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: (s) The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no) (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (?) 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) (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 co~ild revert to decedent under terms of transfer or by operation of law? (Answer yes or no) (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also submit detailed statement of Pacts 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 ~~T VALUE DEPT. VALUATION Insert this total opposite "Transfers", Schedule "C" in the ~~ "As Reported" column on the last page of this return. C011IAION\\'EALTfi OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" e _ ~ BENEFICIARIES BENEFICIARIES AND ADDRESSES iState full names and addresses of all who have an interest, vested, contingent or other wise in estate) RELATIONSHIP (If step-children or illegitimate children are involved, set forth this fact.) SURVIVED DECEDENT STATE YES OR NO DATE OF BIRTH INTEREST OF BENEFICIARY IN ESTATE Mildred C. Stambach Wife yes adult entire es~a~~ 6212 Whitehill Drive ec anics urg, Mar Dalton Stambach Mother es adult $5,000 be uest P. 0. Box 474 Shortsville, NY 14548 Deponent flurther says that all the above-named beneficiaries are living at this time except below: NAME I DATE OF DEATH I RESIDENCE (1) (2) SUMMARY (As Reported) (As Determined ) c P ty .................................. Real Pro er (Sch. «A.,) ........................................ $.. ......None .................... $................. C ~ p ty .......................... Personal Pro er (Sch...B„) ........................................ $.. ..24~.~.~QQ.,. ~~.......... $ ............................ .. _ ~o v ~ °i ~ ................. Transfers ........................................ (Sch. "C") $.. .................................... $ ..................... ... . ......................... o ~ ~ .. u ~ o ........ $.. .................................... $.......................:......... w ~ .................................. ................................................... $ , 800.00 240 $ ................. Gross Taxable Estate ..................... ........................................................... .. , .......... .. z ~ w h ~ ~ w a ~' Q e Q ~i W ~ : .~: N ~ C a G4 as 0 ~ 3 ~ a d W ~ P4 o ~ x E' w o ff ~ ~ co : s c a. ,_.,~. o ~ w ~ E a~ ~ ~ a b O a C w •~ ~ ~ ~ o ~' o ~ •~ ~ v c ~~7 U U R C C-38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "E" RESIDENT DECEDENT JOINTLY OWNED PROPERTY INSTRUCTIONS: Tliis schedule must disclose all property, real and 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 under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of stste real estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name Unit percentage Estate DEPARTMENT VALUATION Address and Relationship of Co-Owners, and Place Value Share Valuation CAUTION-Do not Write of Record of Instrument, where Real Estate. In This Space. Value of Value of Entire Decedent's property Interest NONE Insert this total opposite "Jointly Owned Property", Schedule "E" ~ ~~ in the "As Reported" column on the last page oP this return. O REV-a8A !8-78! 4rwnty, Number and Name File I°lumber 21-78-0327. I)~~te of Death June 3, 1978 1=state Name Stambach Wi 11 iam R. (LAST NAME) (FIRST NAME) (INITIAL) SUMMARY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT 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", and "E". Dated: August 21 , 1979 INHERITAKCE 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: REGISTER OF WILLS INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Joint-Held Property (Schedule E) Transfers (Schedule C) TOTAL GROSS ASSETS Less Debts and Deductions (SEHEDULE F) CLEAR VALUE OF ESTATE 10+ 20+ 30+ 40- 83- Valuation of life estates or % PRINCIPLE FACTOR VALUE CODE annuities ..................... $ ESTATE TAX ASSESSMENTS S FOR USE OF REGISTER 'ONLY CODE COMPUTATION OF TAX Tax on $ 2% $ Tax on $ 6% $ Tax on $ 75% ; Tax on $ Tax on $ $ Exemptions * Total Estate TOTAL TAX S 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 VALUE AS APPRAISED $ $ TOTAL TAX BALANCE PAID $ S S (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Supplemental Codes: (FOR USE IN HARRISBURG ONLY) 48-Adjustment 60-Life Estate 93C-Charity 96-Successive 49+Adjustment 92+Remainder Appraisal 94-Remainder Residue Life Estate 56-Annuity 93-Remainder Deduction USE ONLY) I REMAINDER APPRAISEMENT FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequsnt 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. H Z s W a~ ~ ~ ~ .~ d a `~ Q H W Z '" F., w 0 ~. ~ o ~~ W .~ ;~ H H ~ ... ~ c .., E 3~ Q J ~ Q w y a`~i ~ Q o A ~ 0. x (L W v ~ ~ +.~ L ~ ~A .~ ~" _7 ~ Q Z Q F w (~ Q W vs s v '= v r0 L e ~ ~ ~. ~„ ~ W `0 ~ ~; ° oc 3 `o c 3 ~ W 0 U 0 V REV-457 (8.78) ~ DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O.'BOX 3970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA DAre August 21 , 1979 RESIDENT INHERITANCE TAX COUNTY Cumberland APPRAISEMENT FILE NO. _21-78-0327 Whereas, Wi 1 1 i am R. Stambach late of __ Mechan i csbura in the County of _ Cumberland Commonwealth of Pennsylvania, having died on the ~r~l day of _ June 19L, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, - Sandra L. Stone , 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 tlecedent 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 1 UNIT 1~ nn.~.cn... e.. Made for Inheritance Tax Purposes Real Estate s none Personal Property 2401,800 00 Jointly Held Property none none TOTAL ASSETS 240,800 00 Have been duly sworn according to law, I do hereby certify that the above ap raisement is made in conformity with the law on this - ~ ~ st day of 19 ZL_ . Appraiser (Number and Street) Harrisburg (Post Office) ,Penna. . ~ - U ~- dp co r '_. ~ v: m• a~ W ~ ~ ~ W ~ ~ y s: A cam: w Q u~ ~ oc ~~ ~; ~ Z 1~ C ~n' ~ ~ W ~. Q ~ ~' ~; W v, rv • a~ ti OC U ~ ~ ti 't3 ~ Q ~ ~ O ~ ~ ~~" ~ , ~ ~ ~ ~ ~ ~ n i SC COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P. O. BOX 2870 REV-518 (3-79) HARRISBURG 17105 NOTICE OF FILING OF APPRAISEMENT Edward B. Allen, Jr. 307. Earl es Lane Newton Square, PA 19073 IN YOUR REPLY PLEASE REFER TO 1 nvestigation Division (Executor or Administrator) In Re: Estate of Wi 11 i am R. Stambach Cumberland County -File No. 21-78-0327. Dear Mr. Allen: You are hereby notified that the .,,-a.; ~.,>> appraisement in the estate of Wi 11 iam R Starnbach has been filed in the office of the Register of Wllls of Cumberland County on August 21 , 19jg~ Said appra(sement reflects the following valuations: Real Estate none Personal Property 2 0, 00.00 Transfers none Jointly Owned none Total _ 2 0 , 00.00 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. 373. Date _ August 21 1979 Signed ~~ Title Administrative Officer NOTE: This is not a bill.