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Home My WebLink About80-00673 'J~Y.!'" ~'if~\': i", ;,,.; .'; ~~,- .00)F."".~q:" '~. _ . 5.~~7)J;'?~: -~'~j'}/I~:,>" -..; ;:i "-~"';;";..--,., "~u:0j'.~,;.._: .flf!t!;;,. " ~t,nLfi; -:.\. .~j:~'~:~.,::.,. ~,J'"',r , ~,V;.:.,. ,. \~iir;." ~~:,t,~~-,/. .', ~'i:.$\C ' "~~~';:'{' i"'l,; ~~?"',., ~~j;:~'!:'" ,.,.~..I}'I'T"'" . ~1i;{\ .......~ '., . ,,.....,...... ,., "-.,-' ~~~~}~'. f:~h......" ". 1*,; ~,! .' ,:.:t".:-.:,-_ ,~ . ,.., .~~' ';'j..,;;~ " "".'iI'I ..";.;~{!;r. ::':'J:.:,<(;ti, ',':";:\~ ,.,'~ .~ .~~(~ ,_:~'i~ .,' h~~ l' .. ,;. . ~.f: CJ ~~t!~K :~.~,' . ~~','-Y',~:.- .. .:~t{f~~~~;~:~'/ . . '2:.>.....,. " ~,:f;~:':. ,~'~:}:: ~~: .', :/;i' / ~ ~ s:l {J] ~ . >t ~ .. ~ ~ 11< 1-1 td S {J] tI:l ~ . H r4 E-i :J: M ~ ~ . :IE: {\o I ~ t.D ;S 0 ",\'-, ". W- e::> 0 CO . - .! N * . IU 0 - r-l Z ~ ': " "i,. . t .. , \ ITEM 5: I direct that my executor. guardian or their successors shall I I i i I ..1 not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /]-1-4 day of January. 1973. r1 Pcw/~' jlU~ CLAUD' . SHULTZ The preceding instrument. consisting of this and one (1) other typewritten page was on the day and date thereof signed. sealed. published and declared by CLA UDE E, SHULTZ, the Testator herein named. as and for his Last Will and Testament, in the presence of us, who, at his request. in his presence and in the presence of each other, have subscribed our names as witnesses hereto. /~__. U~ OF \, Cj=......."-' ")V -?V ~ ' OF 0Jr-~L~,) ~ J() J.{'~ ' "Q , -t - I'-t N . .~ -t ""' Ol ~ S .. 0 " . ~ w ,- :Il I" < c:: ~ tIl ~ ....l In < - :..: Z ~ ~ ~ ~ ~ ::: Z ;? O:il ..t; hJ ~ ? r :: 0.. ts ,;-t-"f t; ~ ...: ~ ~ ci ~l'--~t' "', z < 0:" 0: ~ .~ 0 Z 0" ::> 1 \ { L~: :5 <: ~ !i: m SlJ '"<~~ ", ' ~~ (.J " ..l ~~(0\ - - s Cl ...~~ 1 . . . . , . OATH 0.. SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND f This 20th day or October A.D,,19 BO , berore me, Register ror the Probate or Wills and granting letters or Administration in and ror said County ar Cumberland, in the Commonwealth or Pennsylvania, personallyeame Jom t><1. "!il'5Y g Jmm t.) "lil..'Y the subscribing wilnesses to the foregoing instrument of writing purporting to be the last Will and Testament or CLAUDE E. SHULTZ January 17, 1973 Dated late of 418 Wren Ct.. Mechanicsburg, Monroe '!itJJ:>c:umberland County Pa" deceased who being duly "',"""" accarding to law, depose and say, that they were Claude E, Shultz present, and saw and heard the test. tn... sign, seal, publish, pronounce and declare the said instrument or writing as and for h is Testament and Last Will, and at the time of so doing he was of sound and disposing mind memory and understanding, to the best of knowledge, observation and belief, :.. .' \ / . r I~ and subscribed before G ' ~ . L--J 91 "~t M.~LE~ . _~ft' 7L;. u.J/~ . JOAN W. WILEY '.--/ t-'hp;Y' SWORN 4Jfz1 .f'~ Register (I AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND ~ jean 11.. Hale being duly Claude E. Shultz sworn says that as nearly as can be ascertained the said decedent died on '1'1\pc:r1~~r the 7t-h day of October A,D,,19BO . at or about o'clock, M, C:ldt"w'n and subscribed this + (1LCt~ 1~ ,;!JQ / J~. HALE ?nth day of nrrnhP... 19.-oo-~re h'fI (!! ._~~LJ Register OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Register for the Probate of Wills and granting of Letters of Administration in and for the County of Cumberland, personally came JEAN K, HALE who, being duly &\'JGrn t do ef: depose and say that as 1!:~(9autri)( of the last Will and Testament of CJJ' I~"!;' It SI4!: '1- T6 deceased cJ,....i11 well and truly administer the goods and chattels, rights and credits of said deceased according to law. And :.,; 0: ~31 <D: :os CD Ol ~{ : tJ :Ol 10 .r: u.. <D: 0 ~~ .-I: ..lll N\ ~ ",: ...J g r- ... ~l ~ s..c; :J) \0 ...J OJ: ~\ - .gl I - .: ,~ u: 0 - a: <D ~ UJ~ E-<: -1-1: I = rill U: .-I ~q ,~ 0\ N 't:l \0: gj [i] Ol ~ 't:l 0\: CIO : c ... .-I: Z c ~i I : tJ _: ~ C!'+, ~ U III 11 ~ 't:l be - 0 = ~ ,~ Z r:.:l os r.:. DECREE Be it remembered that on the__~).s t day of October ,A,D"I9 80 ,there was probated and recorded the last Will and Testament of CLAUDE E. SHULTZ late of 418 Wren ct. , MechanicsbUl"Q. Moneroe Twp. , Cumberland County, Pennsylvania, Deceased, Letters Testamentary were granted to Witness my hand and official seal the day and year aforesaid, Jean K. Hale . 1~~ ~~id (?'7tr~;J f/ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I J 55: JEAN K. IJALE.._~_____.~~ being duly -SWOl:Il-______ according to law, deposes and says that sho is the Executrix _______.__ ~____ of the Estate of CI~.L....SHULTZ lote of _4!8.J{ren ct, Monroe Twp.,. ____. ___, Cumbarland County, Pa., deceased and that the within is an inventory made by ---,--Jean-K.-Uale--.. .___ , the said~Edl( of the entire estate 01 said decedent, consisting 01 all the personal prop.rty and roal ostate, oxcept real estate outside the Commonwealth of Pennsylvania. and that the figures opposite each item 01 the Inventory reprasent it's fair value as 01 the data of decedent's death. Sworn and subscribed belore me, ~..~~f:x/ JEAN K. HALE -_-R..D--10, Rnv 11 Mechanicsburg, PA 17055 Address a~r-t- fthn /)~/ >>> c, ~~. ~, '," 7 '.,'1,'_-:",' 19 R1 j . 1 ~..:) ~ t '! . ;-.' ,-:',~'1. I :~.: lir,~~,:~-;.~,.':1;;; \ ~;.~: : I,ll' C'J:':."II.1:,.~:; :: '::.-:,~cr. P",ms~:'J:~ll , " Date of Death ___ October 7, 1980 Oay Month Y.., INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2, A supplement inventory must be filed within thirty days of discovery of additional assets, 3, AdditioQ~1 sheets may be attached as to personalty or realty 4, "See Art~e IV, Fiduciaries Act of 1949. , ~. ", c:( V"~' (:,; l., l.....1 c.. r..~l . l.l..ll,j Cl-' 0::(') 0(5 Ow ~c: .....0 I'- -1: ~.I' I :t:~;: "'-J ~rc c:: I l.'~ ",'"' ",:r.: ~ wB ~ -J <.J >- 1 ..,; " 0- W ~ ~ IX .... .. w <( " c.. .... u " ~ 0 " 0 w Vl C '" IX w .. .... I- J: c.. ~! c.. ~ Z .... -' LL .. LL ..J <( 0 c.. W 0 -< w ,;. > '" Z en - . Z 0 c ~ .... -~ 0 ~ d VI z 4 0 IX t..l () ~.~rJ z w <( c.. g " c - .. -.: ~ 0 AI ..c " " E - ..! .. ~ .:: ..., -' () u: REV-4491::Xt (3-801 CO)AMOHWJ:A!.. TH OF PEt-ltlSYLVAIHA DEPARTMENT OF REVENUE TRANSFER IN~ERITANCE TAX RESIDENT DECEDENT AFFIDAVIT OF FIDUCIARY (Instructions on Rnorse Side) . Estate of CLAUDE E. SHULTZ -..--"-------- 418 Wren Ct. Dote Df Death October 7 , 1980 162 10 8408 Last Address .___________ Mechanicsburg, PA 17055 Social Security No. Bureau Fil e No. (CIT'(f (5TA TEl lZIP) County File No. '/ //. ,/. '/;.' -,,I , '.f'/" L ) I. Decedent died: ( ) Intestale (withoul a will) (XX) Testate (leaving a lost will--copy attached) 2, Is the filing of a Foderal Estale Tax Return required for this estate? Yes_Ha xx Name ( JFAN K. HALE R.D. 10 ) Administrator! Administratrix 3, ~Executrix Ad dress Mechanicsburg, PA 17055 (Clnl (STATE) (ZIPI 4. All correspondence should be mailed to'<{{ ) Attorney ) Fiduci ory. 5. If an aUarney is representing the estale, indicate: Name Address JAN-M..-wILEY, ESQUIRE P.O. BOX 288 DILLSBURG, PA 17019 (CITY) (STATEI (ZIP) List all safe deposit boxes regislered in the decedent's individual nom,:, or jointly with, or as an agent or deputy of another, or in decedent's indiyidual name with right of access by onamer as agent or deputy. Include the name and address of the bank or ather institution where the safe deposit box is located, the name (s) in which the box is registered and the relationship of the joint holders to the decedent, NAME AND ADDRESS OF BANK DR OTHER INSTITUTION IN WHICH DECEDENT MAINTAINED A SAFE OEPOSIT BOX NAME OR NAMES IN WHICH SAFE DEPOSIT BOX IS REGISTERF.D RELA T10NSHIP OF JOINT HOLDERS TO OECEDENT CCJI1'IIDnwealth National Bank 4 S. Baltimore St. Claude E, Shultz Dillsburg, PA 17019 Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to Ihe best of my knowledge and bel ief it is WP~ correcl and complete, JFAN K, 11IU.E g--0-~J ,REV-450 EX+ (3.80) COMMONWEAL TH OF P ENNSYL VANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE" A" REAL PROPERTY * (Instructions on Reverse Side) ESTATE OF CLAUDE E. SHULTZ ITEM ESTIMA TED DEPARTMENT NO, DESCRIPTION MARKET VALUATION VALUE (OFFICIAL USE ONLY) ! ! , . i , TOTAL THIS PAGE -0- - <1 - ~/'j REV-451 EX+"(3-S0) COMMONWEALTH OF PENNSVLVANIA OEPARTMENTOFREVENUE TRANSFER INHERITANCE TAX RESIDENT OECEDENT SCHEDULE "B" PERSONAL PROPERTY '* (Instructions on Reversu Side) Estate 0 f CIAIII1F: F:, SI-l111.TZ ESTIMATED DEPARTMENT ITEM DESCRIPTION UNIT MARKET VALUATION NO. VALUE VALUE (OFFICIAL USE ONL Y) 1. Checking ACCOlDlt no. 222 832653 0 CorlITx:mwealth Na bona 1 1108,65 2. Savings A/c 22 0001939 2, COllTlXlnwealth National 5501. 71 (Interest to date of death) 5,54 3. Proceeds of Series E Bonds 171 Ea, $25.00 8,968,09 4. Col11llOnwealth National Bank interes t 15,06 5. Medicare, refund 9,20 6 Proceeds of sale of 1975 AMC Matador 1400,00 7 Metropolitan Insurance Co., benefit 997,51 8 Erie Insurance rebate 127,00 9 IRS, Tax Refund 300,00 10 Hazel Basehore, reimbursement for costs 1000,00 11 Concord Mobile Home, see appraisal 6,500,00 12 Federal Fmployee I s Insurance, benefit 1,843,85 TOTAL THIS PAGE 27,776f61 ~ ij 77'. C; / QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfcr of any malerial part of his estate without receiving valuable and adequate consideration? (Answer "Yes" or "No",) no 2, Did decedent, within two years of death, transfer property from himself/ herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No",) ----1JQ. 3. If the answer to one or two ilbove is "Yes" and the trilnsfers are clilimed to be nontaxable, provide the following information: a, Age of decedent at time of transfer, b. Copy of death certificate, c, Affidavit by the allending physiciiln indicating the state of decedent's hCillth at time of lrmlsfer, d, All other information supporting nontilxilbi Ii ty of trilnsfer. 4, Did decedent, in his/her lifetime, milke ilny transfer of property withont receiving il valuable or adequate consideration therefor which was to lake effect in possession or enjoyment at or ilflcr hi s!hcr dCilth? (Answer "Yes" or (No",) no a, Was Utere any possibility that the property transferred might return fa triUlsferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No",; no b. What was the transferee's age at lime of decedent's death? 5, Did decedent in hiS/her lifetime make any transfer without receiving a valuilble ilnd ildequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in filct end before his/her death: a. The possession or enjoyment of or the right to income from the property lransfelled? (Answer "Yes" or "No".)...IIO- b, The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) no 6, If the answer to five b, above is "Yes," state whether the right was reserved in dEcedent alone or others. 7, Did decedent in his/her liletimemakea transfer, the consideration for which was tfilnsferee'spromise to pay income to or for Ihe benefi t or care of transferor? (Answer "Yes" or "No" ,) no 8, Did decedent, at any time, transfer property, the bmeficial enjoyment of which WilS subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) ,,,, 9. If the answer to eight above is "Yes," was the power to aller, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No" ,) no oREV-453 &X+ (3.801 COMMONWEALTH OF PENNSYLVANIA , DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES '* (Inst'lJctions on Roverso Sido) Estate of CLAUDE E. SHULTZ BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF DECEDENT BIRTH INTEREST OF BENEFICIARY Jean K. Hale niece es legal 1/2 residuary Richard P. ll1un1TErt ne hew es legal 1/2 residuary The above beneficiaries are living at this time except for the following: NAME DATE OF DEATH REV..... ("50) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT (Insrructions on Revorso Side) . SCHEDULE "E" JOINTL Y OWNED PROPERTY Estate 0 f CLAUDE E. SHULTZ p TOTAL E VALUE OF DEPARTMENT ITEM R DESCRIPTION MARKET 1, DECEDENT'S VALUATION NO. VALUE N INTEREST (Ollicial Uso Only) T TOTAL THIS PAGE -0- -rJ - A/S INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "e" must include all property, real and personal. owned by the decedent jointly with another party or parties as joint tenants with right of survivorship, Both tangible and intangihle property are to be included, List real estate first. 1, Describe all real property as indicated in the instructions for Schedule" A", Describe a!lllerSonal property as indicated in the instructions for Schedule "B". Include the name, address and relationship to the decedent of the co.owner (s) and the date the joint ownership was established. 2, Indicate the total market value of the jointly owned property, 3, Indicate the percentage of the decedent's interest. 4, Indicate the market value of the decedent's interest, c "" v n ;,.. t'1 > ~ z > 0 0 v Vl :::; Cl n c:: v :-l z .". Z t'"' tT1 t'1 ;;0; Z ;;:l ;- ~ - ~ t'"' Z Z t'1 -; t'1 -; 2 ~ 0 .., -< Vl t'1 Vl ~: Z 0 Vl 0 -; ~ 0 ":1 ":1 ;;:l ~ '" ',' I , , ~ 0 , I ":1 <::: I ,'. n - "Tj '-' .... ~:: ~'t ~ 0 - ~ r--- ;::~~ In Z n - ~j:.: I ('J CIO > l..t.Ju.. --I i~ ffi c.:.;~- =: ~u: ~ l'1 t'"' o#u, c;: ,w :l , C OC} 0.> t-" l'1 '-'w ':.C;L: I" ('J :l 1 Vl ~'" 0::::> ' t-' '" t'1 SO ~'-' 'n> ~IR r 0 u la z I ()Q [. t'"' ~\ -< -< -< ~ t'1 tT1 I > > I t-' ' ;;:l ::0 ....,' I 01 UlI I I UlI I I I R!j:.V-S18 FO (7-80) ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS NOTICE OF FILING OF APPRAISEMENT Ms. Jean K. Hale R.D. 10, Box 11 Mechanicsburg, PA 17055 RE: Estate of Caunty of File No. Claude E. Shultz f":nmht:l",1:::1nn ::>1_80_06n Dear Ms. Hale: You are hereby notified that the "ri g;,..,,, 1 appraisement in the estate of r.1 ""cl,, R !':hn1 t.7. has been filed in the office af the Register of Wills of Cllmberl,md County on !':"pt."mh"r 1R , 19 B1... Said appraisement reflects the following valuations: Real Es tate NnnA Personal Property ::>7,77'" 61 Jaintly Owned Nnnp Transfers Mnnt:l Tatal ?7,771'. k1 As to such tax that is paid within three manths from date of death, a live (5%) perce~t discount is allowable. As to any tax that remains unpoid alter nine (9) manths (fifteen months when death occurred fram December 22, 1965 to June 16, 1971, inclusive; and twelve months when death accurred prior ta 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 doys after receipt of said notice as provided by Section 1001 of the Inheritonce and Estate Tax Act af . 1961,72 P.S. 2485-1001, P,L. 373. Date ~t:lptpmht:l'" 1R) 19R1 s;'"'d4~~ Title r.hi "t' Appraiser ---..-. NOTE: This is not a bill. COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT INHERITANCE TAX APPRAISEMENT ~ r~~' '-"."~~ ..~_. REV"S7 EX+ (7-eO) 1II0RIGINAL o SUPPLEMENTAL Estote of Claude~_Shultz File No. ::>1-80-0673 Caun ty Cllmb.er.lancL--._______ ._____ Dale of Death Od,nb"r 7, 1 980 In the event tho' any future interest in this estato is transferred In possession or enjoyment to collateral heirs of the decedent afte, the expiration of any eslate for Ilia or for years, the Commonwealth horcby expressly tesc'vcs the right to approlsI! and ossoss transfer Inheritance toxes 01 the lawful collateral rute on any such futuro Intorest. PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH ASSET SUMMARY DEPARTMENT'S APPRAISED VALUE ), Total Real Proporty _ SCH. "A" . . . , ,. $ ._NnM 2, Total Personal Property - SCH, "B", , . . $ ::>7,77(; ';1 3, Total Jointly Owned Properly - SCH. "E" $ None 4, Total Transfers _ SCH. "C". , .'. . . .. $ None Unreported S Unreported S Unreported S Unreporled $ S Nnnp. $ 27,77(;.61 $ Nnn~ $ Nonp. $ 27,776.61 o LIFE ESTATE DANNUITY TOT AL GROSS ASSETS DREMAINDER TOTAL VALUE S I do hereby certify thot the obove appraisement is made in conformity with Pennsylvania law and has been filed this day wilh Ihe Register of Wills, ~ ~ -..c> ~ Seotemb..... 1R, 1981 APPR -R DATE ~ p.: ~ ~ Co < <: 'r1 z t'-l ~ .<:: 0 :>- :>- 1Il 1:.1 ~ '" ;) Eo< ...:I OJ < 0 <r ... - <: U Z 0 - 0 ::;: ~ ~ - 0 ~ ~ p.: t:- O t.. ... 0 '" 0 z 0 '" <r. :>- ... 0 - ~ z ... t'-l ... t'-l Z Z ...l 0 - 0 < p.: z :.: t'-l ...l Z ;:;; Z ... Q ;:. U " t'-l - .~ Vl ~ 0 0 < Z ~ ~ U Q p.. :l REV...U EX... CHOI INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) File Number 21-80-0673 o Original o Supplemental o Remainder Estate Name Cl Bude P. Shllltz Date of Deoth October 7, 1 QRO Socia' Security Number 162-10-8408 REPORT OF INHERITANCE TAX APPRAISER I, Ih. undersigned duly appointed 'nh.rltonc. Tax Appraiser In and fo. the County 01 C~beritt:Dd Pennoylvanla, do ..opectlully roport that I ],ave appraised the roo I and p.rsona' properly 00 reporte in t . foregoing return at the valuel leI forth oppollte each Itom In Ihelast column to tho right In Sch ulos "A", "B", "C", and "e" Dated: !'lppt..mher lR, 19R1 , 'CODE' VALUE AS APPRAISED ADJUSTMENTS REMAINDER APPRAISEMENT COOE INVENTORY (HARRISBURG USE ONLY) R.ol Prop.rty (SchoduJ. Al $ Nonp ao+ 92+ P.runlJf Prop.rty (Schedul. B) :>7.771i li1 10+ Jolnt.H.ld Property (S.hod"'. E) Nnnp 21)+ Tranll... (S.hedule C) ~onp 30+ TOTAL GROSS ASSETS 27..-7:1.6 Ii' L... D.bt. and Deduction. 40. 93. (SCHEDULE F) CLEAR VALUE OF ESTATE , ..'i,";.',:,-;. R.EV-4'S !1.8D) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT OECEOENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS Estate of CL6.UOE E. SHULTZ Date of Death October 7 , 1980 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: . '(';" 72 File No.':'ll-,'v! -/ . ) Claimant Relationship to Decedent Claimant's Address NAME OF PAYEE REMARKS DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S !? h! y. 33 I AT //.J PERCENT, AMOUNT 26.00 58.05 107.00 45.00 25.71 107.00 33.52 179.90 150.57 107.00 34.81 235.61 107.00 34.46 15.39 107.00 70.00 12.00 280.00 50.00 robate will Patriot News Brackbill LaDeira Mobile Homes PP & L Brackbill lot rent a raisal elec tric lot rent Electric fuel oil & heatin re ir lot rent electric fuel oil rent elec tric tax collector rent fLD1era I dinner death certificates ave stone 33.24 TOTAL THIS PAGE 5,099.16 ---- I hereby certify that to the best of my knowledge and belief !J:le foregoing is a just and true statement of debts, funeral ~""" "d ~"o~ ,I odmlol"..Hoo "bmltt" fo <h, ,,". . d'd",l~ 0' ,,, lob, fI,,,, T ~ omo".,/;. Page 1 . .\~1k(l' ,It' ':</7 fl_ SIGNATURE OF ATTonNI: /FIOUC1A v 'OA E OFFICIAL l!,SE ONLY I ~ !!~' r,a/tEGIST~R 0 WIL~ 9 -u1 f'-tf'1 DATE GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate, In addition to debts incurred by the decedent or estate, other items are claimable including the cost 01 administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost 01 a burial lot, tombstone or grave marker, All debts being claimed against an estate are subject to the approval 01 the Register of Wills with whom the Inheritance Tax Return is filed, Evidence to support the decedent's or the estate's liability lor the debts being claimed should be attached to this schedule. A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania, If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption, In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. r- "C 0 n > t'l > :s z > 0 0 0 U'l 0 Cl n c:: 0 -l Z =:: Z t"" r:1 t'l ~ Z ::0 > s:> - s:> t"" Z Z t'l -l t:l -l Z s:> s:> -l -< U'l t:l tii z 0 U'l 0 -l .." ::0 0 .." ~ ~ 0 ~ - "rl " ~ ~ 0 '1l '. .. ;<r Z - .. n ~ ex> ("l :J-. ~ - ,.) ~ > ... .::: .-. t'l ~ . r . p, t'" c. ~~ ro t'l tc c: c r- " n ;:l rJl t-' Ul 61 I --..-' IlJ ~ () U'l !'l l.JjL:.; ,... J a- n ~ c'. :=. ~~ 0 a::l'l co: "W I)Q Z 0(3 'm Uw ?;;i: . ~ ~o: - w~ ;1l -< -< 50 ....u t'l t'l ~ u > > I-' ::0 ::0 ...., 0 U> U> INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent, Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid, 4. Enter the names of each payee, 5, Prouide a brief explanation in the remarks column for each debt claimed, 6. Enter the amount of each debt being claimed, 7. The form must be signed by the person who has assumed the responsibility for paying the debts, REV.455 11.80) , . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT OECEOENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS --.- Estate of ClAUDE E. SHULTZ Date of Death October 7 , 1980 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Claimant Claimant's Address ITEM NO, DATE 24 7/81 25. 7 81 26 7 81 27 7/81 28 7/81 29. 7/81 30. 7/81 File No. Relationship to Decedent NAME OF PA VEE REMARKS AMOUNT Bell Tel. of PA Re ister of Wills Re ister of Wills Re ister of Wills Nota oublic Jean K. Hale Jan M. Wile, re 6.00 25.00 25.00 1389.00 2083.00 inventor nota Executor's Attome s I TOTAL THIS PAGE 3 589.17 I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. K. E [(_ b R J DATE OF CIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S X; (p f!'. '33 AT IS PERCENT. 9r(M(f"(}."O~ tf-;(?-?/ :lATE GENERAL INHERITANCE TAX INFORMATION ., . Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate, In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of a burial lot, tombstone or grave marker. All debts being claimed against an estate are subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed, Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule, A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania, If there is no spause, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption, In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent, t'"' ~ u n > tTl E; :s z > 0 0 0 Vl Cl n c: 0 ~ z :: z r-' tTl tTl ~ ~ r-' ;r, Z ;;::l Z z Z tTl -I t:l ...., ~ ~ ...., -< '" tTl Vi Z 0 '" 0 ...., 0 "t1 '71 ;Il . ~ ~ "'" ;s: n 0 (") ~ - "rl , 0, () $" 0 "rl "'" '. '-;' n Z ?i ... ~ ;:l L. . " ..... ;; ,. r- <>~ (") t'1 I -. ...~ t"" co,, :- .-.:.~ Ul lLJ....J 5:---~ " ~ c: 01'. 0'. .... Ul <II ~v) ;;: . ..., III ~ 0(:::, ;:c:a a. ()Q tTl <">w :.0:;; 0 ~O:: ~ jG ;i2 Z co . u :( ..... -< -< t:l t:'l ~ ...., 0 > > V> " ;;::l V> INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1, If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3, Enter the date on wh ich each debt was incurred and/or paid. 4. Enter the names of each payee. 5, Provide a brief explanation in the remarks column for each debt claimed. 6, Enter the amount of each debt being claimed, 7, The form must be signed by the person who has assumed the responsibility for paying the debts.