HomeMy WebLinkAbout10-02-78
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RESIDENT DECEDENT
21978
COUNTY OF CUMBERLAND
IMPORTANT:
This return must be completed in detail and riled in duplicate, with all attached, with the Register or Wills or the
County where decedent resided; Return is due within nine months after date or death, unless an extension is granted
by the Secretary or Re'V:cnue. (Section 703 or the Inheritance and Estate Tax Act or 1961.)
Late of
CUMBERLAND
PENNSYLVANIA
} APPIDAVIT OP
EXECU11Ml;RI X
lnJiIAMt!l~
IN THE MATTER OF THE ESTATE OF
JOSEPH KLING, JR.
(STATE FUL.L. NAME OF DECEDENT)
County
County of
CUMBERLAND
} so:
State of
r1DIrn1IlOIIIHJ of tne utate of tne above-named decedent being duly s.....orn, depose S and cay S
Decedent died March 22 , 19~{te.tate leoving a last will, copy of .....hich i. hereto attached. }
(MONTH) (DAY] (YEAR) U~~
} Thomas I. Myers, Myers, Myers, Flower & Johnson
Nam. and addr... of attorney or
other authorized repre.entative to .....hom 4
all can...,ond.nc..hauld be man.d. P. O. Box 125, Lemoyne, Pa. 170 3
DOROTHY ROSE KLING
Exec~ix
That as suchExecutrix deponent is familiar with the affairs of said estate and the property constituting
l EXECUTOR-ADMINlSTRA TOR)
the a;ssets 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
IN WHICH DECEDENT RENTED A S....FE DEPOSIT BOX
None
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
REL.ATIONSHIP OF JOINT
HOL.DERS TO DECEDENT
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception' of the following, for the reasons hereinafter set forth:
of this return,
That Schedul,e 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
giving also separately the accrued interes t 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, treasmy 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 owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, hors~-s', carriages,
automobiles, boats, and any and all other personal chattels of whatsoever, kind or 'natu~e, lett~ 1iy':~~edent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent ';i"tof 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 aDd unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities 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 &s
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 dccedent 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, f'lnancial statements showing the assets and liabilities of" said co-partnership or 'husiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together wi th 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 with 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 propert~r, to whom transf'erred, 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 cony
of the deed, trust agr~ement or other instrument creating the trust. Ther\~ is also set forth in said
schedule a list of all property, real and personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or anJT 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 and addresses of all
persons beneficially interested in this estate at the time of decedent's neath, 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 lire unner 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, ann the relationship of such issue to the beneficiary.
That Schedule 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 vestlture 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 deduction~ 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", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed Bnd sworn to before me this ................................
...._....2ST~1 .. day of~;:L.,.,,..b..vL 19.1K
..........~.........~................
ROTAIlY PUllt:ie ""
)I, ~ I-..&.- Lpire. Dec. 21,1981
l.oIDoJM,l'a. C~b"d Co
,~~;~......__._..._.-
~. iK~ljIo11 Exe r~x
...~r.~~;&;~ ;~;~7?....._..- .--.
Enola..l'ennsylv.ani.a..17Q2.5.............
(City or Tow" and StD.te)
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.
RCC-35
RESIDENT DECEDENT
SCHEDULE "an
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 1n 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 riduciary in said capacity, partnership interests, interest in any undistributed
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 ESTIIlATED DEPARTllENT VALUATION
No. List and describe fully VALUE lIARKET VALUE (Do not write in
this space)
50.00y ~--o ,() 0
1. 1965 Studebaker // SO. 00
2. 1967 Ford Station wagon 150.00y' I- 00. o(J
3. 1971 Volkswagon 200.00."
4. 1968 Chevrolet Van 250.00; ~ )ll. 00
Insert this total opposite "Personal Property", Schedule "B" in X X 650.00 ~ .,0. O()
the "As Reported" column on the last page of this return.
I
.llCC~)7 (12-6))
l'O~IMO:>l\\"EALTIl OF l'E~,;\,SYYL\:>IIA
TRANSFER INHERITA!><CE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
RELA TIONSIIIP ! -
BENEFICIARIES AND ADDRESSES (If step-children or I SURVIVED DATE INTEREST OF
State full names and addresses of all who illegitimate chlc1ren I DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other are lflvolved, set STATE YES IN EST..\ TE
wise in estate) forth this facL) OR NO BIRTH
Dorothy Rose Kling Wife Yes Adult Entire Residue
19 Humer Street I
Enola, Fa. 17025
,
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
. ,
Gross Taxable Estate
$
$
$
$
$
$lQ,Q~O,OO
(1)
(As Reporkd)
16,000.00
650.00
-0-
(2)
(As D..t..rm;llcd)
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Real Property
Personal Property
Transfers
SUMMARY
(Sch. "A")
(Sch. "B")
(Sch. "C")
$
$
$
$
$
$
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~..cc-. '.77)
County, Humber and Home
File Humber
Date of Death rc
File Date
Eltate Home
CUMBERLAND 21-78- 57
SUMMARY
11-16-78
(LAST NAME)
(FIRST NAME) (lNI IAL)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
REPORT OF IHHERITAH E TAX APPRAISER
I, the underligned duly appointed Inheritance Tax Appraiser in and far the County of Cumberland
Petlnlylvania, do relpectfully report that I have appraised the real nd personal property 01 reported in the foregoing return at
tit. value. let forth opposite each item in the last column to the rig t in Schedules. ItAIt, uB", "C", and "E".
Dated: November 16, 1978
J< I
INHERITANCE TAX APPRAISER
REPORT OF THE R GiSlER OF WILLS
I, the undersigned duly elected Regi.ter of Wills in and for
Iu lIy report that I hove allowed deductionl in the amounts cia imed
leller amount II set forth in the last column to the right in Schedul
allowed as 0 deduction.
County, Pennsylvania, do respect-
deponent, except as to those items where a greater or
uFu, which greater or le5ser amount represents the sum
Dated:
REGISTER OF WILLS
VAL E AS APPRAISEO CODE VALUE AS REAPPRAISED
16 000 00 004 00+
10+ +
-0- -0-
-0- -0- 30+
16 650 00
-40.
INVENTORY
Real Prop.rty (Schedule A)
P.r.onol Property (Schedule B)
Jolnt.Held Property (Schedule E)
Tran,f.,. (Schedul.C)
TOTAL GROSS ASSETS
L... D.bt. and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of 11M ..tates or ~
annultl......................._ $
PRINCIPLE
FACTOR
VALUE
ESTATE TAX A~SESSMENTS _ $
1==
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total E.tate
~
COMPUTATION OF TAX
2%
6%
5%
10%
15%
$
$
$
$
$
.
TOTAL TAX
$
(*) A.s evidenced by Charitable
Exemption Certlflcat.. Issued
by the Secretary of Revenue.
Leu tax previously paid
BALANCE
L.u 5% of tax If paid within
3 months after death
$
$
$
~
BALANCE OF INHERITANCE TAX DUE
Add Inte,.st at rote of 6" from
to
AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
BALANCE DUE
Add Interest at rate of 6% from
to
$
$
$
$
l=
$
$
TOT AL TAX BALANCE $
PAID $
Supplemental Cadel: (FOR USE IH HARRISBURG ONLY)
4lI-Adjultment
49+Adjultment
56-Annuity
6O-Life E.tote
92+R_ainder Apprai sol
93-Remainder Deduction
9 3 -Chari ty
94 Remainder Re.idue
96-Success i ve
Life Estate
FOR USE OF REGISTER ONLY
ADJUSTM NTS
NOTE: Where subs~uent adiustments are made to the above com utation of tax by the Register of Wills, for proper reason,
lame Ihould be noted below, with short explanation.
. .
P.
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