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HomeMy WebLinkAbout07-13-78 "lCC-33 (4-73) '/ COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLE~~:O~\St;:- ,-( _ sjUl _ ....,. . L-- I -1,C) '>I i\ \,:{ \. _ \ t,.) .- ~ \.. ,w~ \,J' ,'"Y\. ~;..i:-~ COUNTY OF CUMBERLAND .....c.,.., RESIDENT DECEDENT 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'otenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) CLARA F. GRIFFIE (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUTORS ~ IN THE MATTER OF THE ESTATE OF Lote of Cumberland County State 01 _ Pennsylvania } .., County 01 Cumber land ~ Max W. Griffie and Dorothy Jean Kurtz, of the estate of the above-named decedent being duly sworn, depose Executor S and say April (MONTH) Name and address of attorney or } other authclrized repres.entative to whom all correspondence should be moiled. 2 19~{testate leaving a last will, copy of which is hereto attached. } (YEAR) ~ Decedent died (DAY) Roqer M. Morqenthal. Esq. (Bietsch & Morqenthal) 7 Irvine Row, Carlisle, Pa. 17013 That as such Executors deponent is familiar with the affairs of said estate and the property constituting (EX E CU TO R-ADMIN I ST R A TO R) 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 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 safe deposit box or boxes are itemized under Schedules wi to 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 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 gi ving al so separately the accrued interes t thereon, if any, down to the las t interes t day priM to decedent's death in fhe 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 there~f, or of any foreign country, which are owned at the time of death; all wearing apparel, jewelry, silv,erware, p~ctures, 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 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 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 secmities 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 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 tusiness. A copy of 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 th 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. Thert~ 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 indiyidually, 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 anQ 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 Sc~edule 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 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", "en, "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. r~!;v CC'Jnty Carlisle, rJa. EVr\;~c<:: \"'~'Iuary 27, 1979 "'t-' i I '..oJ oJ '-"" ~.~ .~~ -~_w~-- cIA ~ oJ 'iLK .~ ...............~;~~~~ R. D. 3, Newville Pa. 17241; and ..............................................................................f........................................_.............. (Street Number) R. D. 3, Carlisle, Pa. 17013 ... . ......................................~.........................,........................... ..........................,....,.. (City 07' Town and State) Subscribed and sworn to before me this ................................. ................J.e...~~~.... . day of .,-~. ."S:.~~.>;.. .. . ...... ....... 19.7..~...... - ~/ / (' , -..i /)'_1 (' ,Jf.y~\VJ>.--', "cDT' 7'Ll"f::' -Nr-I-""..tHY PUtlLlC .. ....... ......... ilt_f\ L- \-r\, viA ~ ( . \.._/') "Jv,-->-. A. ~.. ..........C' '''JANTGET. 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. RC C-34 (4-73) COMMONWEA:" TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITAI'lCE TAX RESIDENT DECEDENI SCHEDULE uA" 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 CiS joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real prlOperty IlOcated In the Commonwealth lOf Pennsylvania shlOuld be described by IlOt and block number, street and street number, tlOgether wi th a general description of the property, with a reference to the record of the conveyance by whl ch 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 fram this schedule. (1) (2) (3) DEPARTMENT VALUATION CAUTION (Do not write In th Is space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMATED MARKET VALUE Real Estate premises situate in Upper Frankford Township, Cumberland County, Pennsylvania, on Bloserville Road (Rt A5749), deeded to decedent by deed at X-13-331, sold to Edward B. Eberts, et. ux., for 4,360.00 $20,000.00 /' L_':)) \.,)~) C" t t"~,) Insert this total opposite "real prope.iy", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. $20,000.00 .-, .:_. L) \ t; () 0. I.YC Bee -3.5 REsrr".,. 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 bp 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 t]'ust 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 No. ITEM List and describe fUlly UNIT VALUE ESTIMATED MARKET VALUE DEPARTMENT VALUATION (Do not write in this space) 1. Household furniture, furnishings and other personal property sold at public auction by Chuck Bricker, Auctioneer, in May, 1978, for $ 794 . 62 V ,,/ '1 t y. ' I~c 2- 2. 4--'" Checking Account No. 4-1561-8 in Farmers Trust Company, Carlisle, Pa., balance at date of death of 560.89 r/ S;-.:.; 0 ,'t):\ Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the las t page of this return. x X $1,355.51 \ '- ) ;: \ RCC - 36 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "c" TRA.NSFEHS RESIDENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) ~O (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 ~/A (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) ~/A (b) What was the transferee's age at time of decedent's death? ~/A (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 whioh 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) ~O (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) ~O (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others ~ /A (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) ~O (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 conld revert to decedent under terms of transfer or by operation of law? (Answer yes or no) ~O (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) ~O NOTE 1: The anSwers to these questions should be supporterl 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 DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) ~ONE N \S\.-S_- Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. ~ONE RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES ( 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 BIRTH \ Max w. Griffie Son Yes ~ of house and furnishings~ - R.D. 3, Newville, Pa. 17241 and . . .l../.j OL - Dorothy Jean Kurtz Dauqhter Yes ~ of house and R.D. 3, Carlisle, Pa. 17013 furnishings~ and .., f.... 1" . ...:J -=r-=- '-' ~ Helen A. Griffie Daughter- Yes 1/24 of remainder R.D. 4, Newville. Pa. 17241 in-Law ($500.00) Joyce Shaffer, R.D. 4, Box Granddaughter Yes 1/24 of remainder 205. Newville Pa. 17241 ~OO.OO) Joan Harbaugh Granddaughter Yes 1/24of remainder R.D. 4, Newville. Pa. 17241 ($500.00) Susan Dietrick Granddauqhter Yes 1/24 of remainder R.D. 3, Carlisle, Pa. 17013 ($500.00) Larry E. Griffie Grandson Yes 1/24 of remainder R.D. 6, Carlisle. Pa. 17013 ($500.00) Lee E. Griffie Grandson Yes 1/24 of remainder R.D. 4, Newville, Pa. 17241 ($500.00) Everett D. Griffie Grandson Yes 1/24 of remainder Harrisburg, Pa. 17100 {~500.UU} Phyllis J. Ritchie Granddaughter Yes 1/24 of remainder R.D. 4, Newville. Pa. 17241 ($500.00) Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE NONE RCC-38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY INSTRUCTIONS: 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 first, as entireties, or joint tenants, giving brief description, as indicated Imder Schedule "A", plu.s 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 "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 Address and Relationship of Co-Owners, and Place Value Share Valuation of Record of Instnunent, where Real Estate, 1. Certificate of Deposit No. 11-00-2151 in Carlisle Building and Loan Association, in names of decedent, son Max Griffie and daughter Jean G. Kurtz (joint tenants with right of survivor- ship) with a date of death balance of 1 ,000. .333 A. Interest on above 2.0.01 .333 2. certificat~ Deposit No. 02-000-052 in Carlisle Building and Loan Association, in names of decedent, son Max W. Griffie and daughter Jean G. Kurtz (joint tenants with right of survivor- ship) with a date of death balance of ~,OOO. .333 A. Interest on above 67.5: (NOTE: Jean G. Kurtz and Dorothy Jean Kurtz are the same person) "J' 1 0 d P t" Sclledule "E:n Insert this total opposite Olnt y wne roper y , in the" As Reported" colullD1 on the last page of this return. 3)u6~ &, (., ..... "--. ~,663.00 7.3 .3~ , 73.2c '"",::::--.--. . ~ C. b{', 00 1,665.00 2 2 . 49 ,..,,--' --------. :f /1')'2 7~ DEPART1ffiNT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest / I .~ I", /' .I /) (,,) ",..'(../l.. ~, 9--f)..tJl~/ ( .",' '", ,~,' ,- ";, (~ .I . v ~5 '-\ ,~~ ~I. \:::) RC C-BI 16-73) COMMONWEALTH OF PENNSYLVANIA DEP ARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division NOTICE OF FILING or APPRAISEMENT Max W. Griffie Dorothy Jean Kurtz R.D. #3 R.D. #3 Newville. FA 17241 Carlisle. fA 17013 (Executor or Administrator) In Re: Estate of Cumberland Clara F. Griffie County - File No. 21-78-0198 Dear Mr. Griffie. Mrs. Kurtz; You are hereby notified that the origin~l appraisement in the estate of Clara F. Gr1ffie has been filed in me offiSe of the Re~ster of Wills of Cumberland County on eptem er 5 , 19~, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total 20.000.00 1.355.51 None 5.429.15 $26~784.66 As to such tax that is paid within three months from dote of death, 0 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 rote 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 September 5. 1978 Signed Title Chief Appraiser ........-.--... "",f .cr' 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 September 5, 1978 COUl'Ii'TY Cumberland. FILE NO. 21-78-0198 Whereas, Clara F. Griffie late of North Middleton Township in the County of Cumberland Commonwealth of Pennsylvania, having died on the 2nd day of April 19~, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Ira K. Gleim I 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 Asset Values Made for I n her; tance rax Purpoles Real Property $ 2~ 000 [00 Personal Property 1 ,355 fa Joint-Held l:roperty 5,429 [15- Transfers Nonel __ TOTAL ASSETS $2b'7~~ - T- .---- ~ - I ~-- L -- ---- L I F- n-+~ I_f-n I Having been duly sworn accordin~ to law, I do hereby certify that the above appraisement is made in con- formity with law on this 5t day of September 19~. Appraiser (lfumbe~~d St!"eeO narn.sDurg (Poet Office) , Penna.