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HomeMy WebLinkAbout06-08-15 1505610140 REV-1-1 504 EX (02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 1 5 0 0 4 5 4 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 4 0 9 2 0 1 5 0 7 1 2 1 9 3 0 Decedent's Last Name Suffix Decedent's First Name MI L I N H A R T V I R G I N I A H (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1.Original Return 2.Supplemental Return 3.Remainder Return(Date of Death Prior to 12-13-82) 4.Limited Estate 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) 0 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received 10.Spousal Poverty Credit(Date of Death [1 11.Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number G E R A L D J S H E K L E T S K I E S Q 7 1 7 7 7 4 7 4 3 5— REQJ TER OF WIL +SrUL SE c4 LYrT1 � J G G7 •�. First Line of Address r.'I 4 1 4 B R I D G E S T �" CO Second Line of Address P O B O X E ' `'" c3 E City or Post Office State ZIP Cade DATE FILLS c" rn CD s N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's e-mail address: G S H E K L E T S K I a@ S T O N E L A W- N E T Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSONSPONSIBr F (LING R TURN {DATE ' to' 4-o)-O 15 ADDRESS HOPE L . DOUGHERTY 123 MOUNTAI VIEW DR- , ETTERS PA 17319 SIGNATURE OF O E N REP T DA E ADDRESS GERALD J . S EKLETSKI ESQ . 414 BRIDGE ST. , NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side'l 1505610140 1505610140 J 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: VIRGINIA H• LINHART RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 1. 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 5 9 8 8 . 1 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 4 6 1 9 7 . 1 7 7. Inter-Vivos Transfers&Miscellaneous NProbate Property (Schedule G) t Separate Billing Requested . . . . . . . 7. 1 6 3 0 0 . 0 0 8. Total Gross Assets(total Lines 1 through 7) 8. 6 8 4 8 5 . 2 7 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 2 9 1 2 . 9 3 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . . . . . . 10. 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 2 9 1 2 . 9 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 5 5 5 7 2 . 3 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 5 5 5 7 2 . 3 4 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x .045 5 5 5 7 2 . 3 4 16. 2 5 0 0 . 7 6 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . 19. 2 5 0 0 . 7 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 esv-1mmsx(Fl) Page x File Number Decedent's Complete Address: 21 15 00454 DECEDENT'S NAME VIRGINIA H. LINHART STREET ADDRESS 335 WESLEY DRIVE, APT- 324 CITY STATE IMECHANICSBURG IPA Tax Payments and Credits: 1. Tax Due(Page 2,Line 1S) (1) 2,500 - 76 2. Credits/Payments A.Prior Payments B.Discount 125- 04 Total Credits(A+8) (2) 125-04 3. Interest (3) 4. K Line 2 isgreater than Una 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill|noval wnPage 2.Line 38hxrequest mrefund. (4) 0 .00 5. !fLine 1 +Line 3imgreater than Line 2.enter the difference,This inthe TAX DUE. (5) 21375 -72 Make check payable to: REGISTER /lFWILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN °X° IN THE APPROPRIATE BLOCKS 1. Did decedent make utransfer and: Yes No o. retain the use orincome of the property transferred .--..'—.-.--...----''—.—.'---.—'. El b retain the right hodesignate who shall use the property transferred mits income --......... ....... — ... o. retain oreversionary interest ---------------------------------' LJ fU d receive the promise for life of either payments,benefits mcare? ------------------. �[�� �[� � l If death occurred after December 1�1982,did decedent transfer property within one year ddeath without receiving adequate consideration? ----------------------------- LJ 121 [� l Did decedent own uolokno for'or hon accountoraecuh��Womh�doaN? --- �[�� �= 4. Did decedent own an individual retirement account,annuity or other non-probate property,which F� nun�inooheno8do��m�m�ion?-----------..------------------ [�--� �� |FTHE ANSWER TOANY OFTHE ABOVE QUESTIONS|SYES,YOU MUST COMPLETE SCHEDULE GAND FILE D^AS PART OFTHE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is io3percent[72R3.§9116(a)(1.1)(i)]. ' For dates ofdeath onorafter Jan. 1, 19Q5.the tax rate imposed nnthe net value oftransfers bxorfor the use of the surviving spouse isUpercent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates(fdeath nnorafter July 1.2OOO: • The tax rate imposed onthe net value nftransfers from mdeceased child 21 years ofage oryounger atdeath b,orfor the use ofonatural parent,an adoptive parent orostepparent ofthe child|oOpercent[72P.S.§9118(a)(12)]. ° The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in F2 P.S.§9116(a)(1)). w The tax rate imposed on the net value of transfers to or for the use of the decedenCs siblings is 12 percent 2PS.§91iG(a)(1.3)).Asibling iodefined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. ' REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: VIRGINIA H . LINHART 21 15 00454 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. DIAMOND ENGAGEMENT STYLE RING 365-00 2 • DIAMOND WEDDING STYLE RING 125 .00 3• RUBY AND DIAMOND FASHION RING 240 .00 4 • DIAMOND ANNIVERSARY STYLE RING 150. 00 5 - 20 INCH 14KT YELLOW GOLD ROPE CHAIN 120.00 6• 14KT YELLOW GOLD WEDDING BAND 80 .00 7• CREEKVIEW ASSISTED LIVING REFUND 21667 . 45 8 • INSURANCE REFUNDS 240 -65 TOTAL(Also enter on Line 5,Recapitulation) $ 31988 -10 If more space is needed, use additional sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: VIRGINIA H . LINHART 21 15 00454 If an asset was made jointly owned within one year of the decedents date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. HOPE L . DOUGHERTY 123 MOUNTAIN VIEW DR . DAUGHTER ETTERS, PA 1?319 B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST t A. 02-09 METRO BANK CHECKING ACCOUNT NUMBER 88,894 .85 50 • 44,44? - 43 538441197 2 • A . 02-09 METRO BANK SAVINGS ACCOUNT NUMBER 3,499 . 47 50 • 11749 .74 627159619 SCHEDULE F ASSETS WERE USED TO PAY ADMINISTRATION EXPENSES TOTAL(Also enter on Line 6,Recapitulation) $ 46,197 - 17 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MSC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER VIRGINIA H. LINHART 21 15 00454 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OFTHE TRANSFEREE,THEIR RELATIONSHIPTO DECEDENTAND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST pr AMICAMQ VALUE �. GIFT OF CASH TO NOPE L- DOUGHERTY, 19,800. 00 100.00 3,500.00 16,300 .00 DAUGHTER, WITHIN FOUR (4) MONTHS OF DATE OF DEATH TOTAL (Also enter on Line 7,Recapitulation) $ 161300-00 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER VIRGINIA H• LINHART 21 15 00454 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS—BUHRIG FUNERAL HOME AND CREMATORY 81??9 . 00 MECHANICSBURG, PA & ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: STONE LAFAVER & SHEKLETSKI 21500.00 3, Family Exemption:(if decedents address is not the same as claimants,attach explanation.) Claimant Street Address City state ZIP Relationship of Claimant to Decedent 4. Probate Fees: LETTERS TESTAMENTARY 120 . 50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7, LEGAL ADVERTISING — THE SENTINEL 190 . 54 8 • LEGAL ADVERTISING — CUMBERLAND LAW JOURNAL ?5. 00 9 • WEIS PHARMACY 27-00 10 . ALERT PHARMACY 63 . 43 11• CAPTAIN HAULING — APARTMENT CLEAN OUT 200 .00 12• MUNNS JEWELERS — APPRAISALS OF PERSONAL PROPERTY 160 . 00 13• UPS — SHIPPING EXPENSE 18 . 28 14 • HOSPICE CARE 750 .00 15. BETHANY TOWERS — CLEANING CHARGE 19 .18 16. ADDITIONAL PROBATE FEE 10.00 SCHEDULE F ASSETS WERE USED TO PAY ADMINISTRATION TOTAL(Also enter on Line 9,Recapitulation) $ 121912-93 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: VIRGINIA H . LINHART 21 15 00454 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include oUtri ht spousal distributions and transfers under r Sec.91�6(a)(1.2).] Schedule E, Items 1, 1. HOPE L . DOUGHERTY Lineal 2, 3 & 4 123 MOUNTAIN VIEW DRIVE Schedule F, Items ETTERSi PA 17319 & 2 Schedule G, Item � of residue 2. WILLIAM R . LINHART Lineal 5117 PULASKI AVENUE PHILADELPHIA PA 19144 Schedule E, Items 5 & 6 1,i of residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A,SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B,CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, j $ If more space is needed,use additional sheets of paper of the same size, X r iqW `✓N iS� +�" k 4 'St Vii"' a.. �;+e{ty-y " x'a,7�w� ,t�! r A!' ' �pR � 2" S+iC"=� � ads �•�Y- �� � � �t f�r LAST WILL AND TESTAMENT OF VIRGINIA H. LINHART I, VIRGINIA H. LINHART, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me . ITEM I : I bequeath my diamond wedding ring, diamond engagement ring, diamond and ruby birthstone ring, and gold band diamond ring to my daughter, HOPE L. DOUGHERTY, if she survives me. ITEM II : I bequeath the wedding ring of my late husband, WILLIAM H. LINHART, and accompanying gold chain to my son, WILLIAM R. LINHART, if he survives me. ITEM III : I bequeath my automobiles., household and personal effects and other tangible personalty of like nature (not including cash or securities) together with any existing insurance thereon to such of my children, HOPE L. DOUGHERTY and WILLIAM R. LINHART, as are then living, to be divided among them by my Executor with due regard for their personal preferences in as nearly equal shares as practical . ITEM IV: I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, in equal shares to such of my children, HOPE L. DOUGHERTY and WILLIAM R. LINHART, as survive me, per capita and not per stirpes. Should both Page 1 of 5 of my children, HOPE L. DOUGHERTY and WILLIAM R. LINHART, predecease me, I devise and bequeath all of my estate, of every nature and wherever situate, in equal shares to those of my grandchildren who survive me. ITEM V: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor' s benefit . Such guardian shall have the power to use principal as well as income from time to time for the minor' s support and education (including college education, both graduate and undergraduate) without regard to his or her parent 's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor' s parent or to any person taking care of the minor. ITEM VI : I appoint my daughter, HOPE L. DOUGHERTY, Executrix of this my last will . Should my daughter, HOPE L. DOUGHERTY,, fail to qualify or cease to act as Executrix, I appoint my son, WILLIAM R. LINHART, Executor of this my last will . Page 2 of 5 ITEM VII : No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, VIRGINIA H. LINHART, have hereunto set my hand and seal this day of ;519 /1✓9�' 2000 . r VVIRGINIA H. LINHART SIGNED, SEALED, PUBLISHED and DECLARED by VIRGINIA H. LINHART, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses . Witness Address qlq /3 �uj Witness Address COMMONWEALTH OF PENNSYLVANIA: . SS . COUNTY OF CUMBERLAND I, VIRGINIA H. .LINHART, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according Page 3 of 5 to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. V GINIA H. LINHART Sworn to or affirmed to and acknowledged before me by VIRGINIA H. LINHART, the Testatrix, this day of 2000 . Notary Public NOTARIAL SEAL CONSTANCE !.. 101111, Plotary Public t4e;a Curr Wni d,PA Cumberland Co. My Commission Expires April 13,2003 COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND -�rl:�' i We, and , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will ; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Page 4 of 5 will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Witness Wit ss Sworn to or affirmed to and acknowledged before me by and A1acze —p, . L4c-k&T witnesses, this P� day of 2000 . Notary Public NOTARIAL SEAL CONSTANCE 1_. KARLi, Notary Public New Cumberland,PA Cumberland Co. My Commission Expires April 13,2003 Page 5 of 5 05/06/2015 12:12 717-920-4666 DEPOSIT SERVICES PAGE 02/02 METRO t 888.937.0004 BANK Har sburg, PA01 Patont 7111 mymet obank.com May 6, 2015 Gerald J Shekletski Stone LaFaver&Shekletski 414 Bridge St PO Box E New Cumberland PA 17070 RE: Estate of: Virginia H. Linhart Tax Identification Number. 193-22-4923 Date of Death: April 9, 2015 To Whom it May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type:Checking Account Number: 538441197 Date Opened: February 25, 2009 Primary Owner: Virginia H. Unhart Secondary Owner: Hope L. Dougherty (Added at opening) Date of Death Balance: $88,894.85 YTD Interest: $2.66 Principal Balance: $88,894.85 Accrued Interest": $1.50 Account Type:Savings Account Number. 627159619 Date Opened: February 25, 2009 Primary Owner: Virginia H. Unhart Secondary Owner: Hope L. Dougherty (Added at opening) Date of Death Balance: $3,499,47 YTD interest: $52.40 Principal Balance: $3,499.47 Accrued Interest": $3.89 ** Please note: The accrued interest will not be paid if the account is closed prior to the date the interest Is scheduled to post. The customer did not have a safe.deposit box at Metro Bank. Please feet free to contact me at (888) 937-0004 if I may be of further assistance. Sincerely, � / z,�� j�� Cindy Stanbery V Support Associate/Deposit Services Metro Bank N'S diamond gallery JEWELRY A.PPRAISAL(S) FOR ESTATE PURPOSES FAIR MARKET VALUE LISTINGS We estimate the value(s)as listed for estate purposes only using fair market value guidelines. The following item(s)have been carefully examined and verified as accurately as possible within the normal and reasonable gemological ranges without the use of gemstone removal or damaging tests. Carat weights are estimated by volumetric formula unless otherwise noted. Prepared For: The Estate of Virginia Linhart Item Description: Diamond engagement style ring consisting of(1)round shape major diamond,*.37ct.SI1 Clarity F-G Color. (4)round shape minor diamonds, *.12cttw,SI2-VS2 Clarity,FGH Color.Mounting is 18K White Gold. finger size 7'/x,Illusion Box setting, 1.5 dwt. Total carat weight*.49ettw Fair Market Value of this Item...............$365.00 Item Description:Diamond Wedding style ring consisting of(5)round shape diamonds,*.16 cttw. SI I-SI2 Clarity, G-H Color,Mounting is 18K White Gold,finger size 7. 1.0 dwt. Fair Market Value of this Item...............$ 125.00 Item Description: Ruby and Diamond Fashion ring consisting of(1)Oval shape Ruby gemstone*.55 ct.AA Red, SI I Clarity,(2)round diamond minor stones*.28 cttw.SI I Clarity,GHI Color.Mounting is 14K Yellow Gold,size 7 14 1.2 dwt. Total carat weight*.83 cttw Fair Market Value of this Item...............$ 240.00 Item Description: Diamond Anniversary style ring consisting of(5)round shape diamonds in a Yellow Gold mounting. Diamond weight*.23cttw, SI I-SI2 Clarity,G-H Color, Mounting is 14K Yellow Gold,Finger size 6 'h. 1.8 dwt. Fair Market Value of this Item................$150.00 1203 Market Street Lemoyne, PA 17043 Date of Appraisal(s): April 29,2015 Total Fair Market Value of All Items...S 880.00 (717)-761-8310 Fax(717)-761-8632 L //Z1-877-DIAMOND C;yfn Ieted by; Christopher C. Munn C; Metal market price and appraised values based on D.O.D.April 9,2015. Gold$1195.00/oz(T) *Carat weights estimated by formula based on measurement.no stone removal. 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