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APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, 1956, P,L. 1757, and Act of June 15, 1961.
P. L. 373, os amended)
RCC. 3 (1.69)
COMMQNWEAL TH OF PENNSYLVANIA
DePARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
Application is hereby filed for the approval
of on exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1. Bureau File # 21-78-160
2. Date 01 Death March 21, 1978
3. Date 01 Approval ~4 d)rlq~y
4. Nome of Decedent Lucille B. Sheaffer
5. The Commonwealth's appraised value of the property for which an exemption is claimed is S 5,000.00
(Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the omount of the gift
or bequest represents 0 stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit 0 copy of the document authorizing the transfer, unless
such material has been previously filed.
WILL /l;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II ather, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Carlisle Hospital
224 Parker Street, Carlisle, Pennsylvania 17013
ADDR ESS
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
) )
x7ff c!:,.( /-.J?ttd..v'
BETTY ANN BOWERSOX /
,
Signature 01 Applicant
ROBERT H.
Address 01 Applicant
501 South Hanover Street, Carlisle, Pennsylvania 17013
Official Title Executors of the Estate of Dote 7/",c/7t'
Lucille B. Sheaffer
This form must be completed in triplicote ond all three copies dellyered to the Register of Wills for the County in which the decedent
resided, or In which letters were issued for a non.resident decedent's e.tate. If the decedent was a non.,esldent of Pennsylvania and
letters were not Issued by a Pennsylyania Register of Wills, deliver all three copies to the Director, Bureau of County Collection.,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Pa.
Do not write below this line - Far Official Use Only
Approved: For the Secretary of Revenue
Referred to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
() .4
I
(Signature of Register of wt
1 t ! :;7'l~~J"
Or il;:U3
(County) "'...."""1
(Initials 01 Register 01 Wills)
(Authari .ed Signature)
(County)
(Title)
(Date 01 Approval)
(Date 01 Relerral)
(Date 01 Action)
. See reverse side for reasons
MUST BE FILED IN TRIPLICATE
This section will be compl eted by Bureau Headquarters only when the application for exemption has been denied.
Date:
The application far exemption contained an the face of this farm has been denied because
Nate: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after
the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act 01 May 28, 1956. P.L. 1757, and Act of June 15, 1961,
P.L. 373, as amended)
RCC- 3 (1-691
*
COMM2,NWEAL"'H OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1. Bureau File II 21-78-160
2. Date 01 Death March 21. 1978
3. Date 01 Approval ~c...,:::!.J l~lJ&
4. Nome of Decedent Lucille B. Sheaffer
5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ IS ,000.00
(Note: Where the property is other thon a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously Hied.
WILL !If;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
First United Methodist Church
64 East North Street, Carlisle, Pennsylvania 17013
ADDRESS
8. certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
) 7
. b/tC;:;: /;fl.<''; ,,1/(
BETTY ANN BOWERSOX
Signature 01 APPlicont-rJj{:;t1 .~
Address 01 Applicant 501 South Hanover Street, Carlisle. Pennsylvania 17Q.l3
Date
7/--C/7!-'
,
Official Title Executors of the Estate of
Lucille B. Sheaffer
This form must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were issued for a non.resident decedent's estate. If the decedent was a non.resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harri sburg, Po.
00 not write below this line. For Official Use Onl
Approved: For the Secretary of Revenue
Referred to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
(Signature 01 Register 01 Wills
.Ii'.... t! '~"
1\ (Initials 01 Register 01 Wills)
(Authorized Signature)
.>
(County)
(County)
(Title)
~.'
. Y'
(Date 01 Approval)
(Date 01 Relerral)
(Date 01 Action)
* See reverse sid. for reasonl
MUST BE FILED IN TRIPLICATE
.
~
This section will be campi .ted by Bureau Headquarters onlv when the application for exemption has been denied.
Date:
The application for exemption contained on the face of this form has been denied because
Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days alter
the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acis.
Inventory of the real and personal estote of
LUCILLE B. SHEAFFER
deceased.
House and lot of ground situate in Middlesex Township, 29 Country
Club Road, Cumberland County, Pa.
Cumberland County Deed Book
Value based on appraisal---------------~---------------------
Furniture, etc.---------------------------------------------------
1978 Pontiac Sedan automobile-------------------------------------
The Commonwealth National Bank
Checking Acct. 182-812605-0----------------------------------
Certificate of Deposit 2277----------------------------------
The Farmers Trust Company Certificates of Deposit
#12855-------------------------------------------------------
#10724-------------------------------------------------------
The Cumberland Valley Savings and Loan Association
savings certificate #6686851------------------------------;--.
American Express Travelers Cheques--------------------------------
Demand Note on Letort Warehouses, Inc.----------------------------
121 shares of Dauphin Deposit Bank and Trust Co.------------------
120 common shares American Tel and Tel. Co.-----------------------
162 common shares American Electric Power Co.--------------------- I
56 common shares Penna. Power and Light Co. ----------------------
924 shares Delaware Fund, Inc.------------------------------------
.200 common shares Carlisle Corp.----------------------------------
9 5c.ommo.n shares Bethlehem Steel Corp. ----------------------------
26 common shares Eaton Corp.----------~---------------------------
189 c..ommo.n shares Atlantic City Electric Co. ----------------------
10 common shares Standard Oil Co.---------------------------------
5 common shares Publicker Industries, Inc.------------------------
25 common shares N I C 0 R----------------------------------------
30 common shares Penwalt Corp.------------------------------------
50 common shares GAT X Corp.------------------------------------
80 common shares Ferro Corp.--------------------------------------
460 common shares Windsor Fund Inc.-------------------------------
282 common shares Farmers Trust Co.-------------------------------
10 common shares Ampco--------------------------------------------
8 common shares Frog, Switch and Manufacturing Co. ---------------
810 shares of Wellington Fund, Inc.-------------------------------
338 shares Commonwealth National Bank-----------------------------
109 common shares Commonwealth Edison Co.-------------------------
47 Common shares SCM Corp.----------------------------------------
50 common shares General Motors Corp.-----------------------------
297 shares Sheaffer Bros. Inc.------------------------------------
370 shares Sheaffer Bros. Sporting Goods, Inc.----------------.----
179 shares Letort Warehouses Inc.---------------------------------
40,500.00
1,129.00
5,575.00
10,944.70
10,046.42
10,137.50
10,143.88
10,1651.72
130~OO
5,08~.-43
3,69 .50
7,425.00
3,7761.63
1,214.50
9,831. 35
4,037.50
1,971. 25
898.63
4,039.87
455.62
29.06
751.56
1,020.00
1,184.37
2,970.00
4,489.60
9,024.00
122.50
896.00
6,957.90
10,985.00
2,956.62
722.62
3,028.12
87,208.11
52,691.70
56 103.97
TOTAL----------- 382,337.63
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
1.
j
55:
ROBERT H. BOWERSOX and BETTY ANN BOWERSOX
according to law, deposes and says thatt he yare Executors
of the Estate of Tolle; 11 p R ~hp"f'f'p,...
late of -IDddles.ex-ToNnshilL---_ , Cumberland County, Pa., deceased and that the
within is an inventory made by thp.rn _I the said RYP(,>l1t:nl"~
of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
being duly
sworn
sworn to and subscribed before me,
_.~~Q() 19 7 R
Ann
CAr1;R1p, PA 17013
I. \,.,. '.
CARLI,LE BORO, CUMBERLAND COUNTY
MY COMMISSION EXPIRES DEC. 15, 1980
Member, Pennsylvania Association of Notaries
Address
Date of Death
21
O.Y
1978
Y..r
March
Month
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. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
LUCILLE B. SHEAFFER
deceased.
House and lot of ground situate in Middlesex Township, 29 Country
Club Road, Cumberland County, Pa.
Cumberland County Deed Book
Value based on appraisal--------------------_________________
Furniture, etc.------------------------___________________________
1978 Pontiac Sedan automobile---------------------_____________~__
The COTI@onwealth National Bank
Checking Acct. 182-812605-0-------------------_______________ 10,944.70
Certificate of Deposit 2277-------------------------_________ 10,046.42
The Farmers Trust Company Certificates of Deposit
#12855----------------------------____________________------- 10,137.50
#10724---------------------------____________________________ J 10,143.88
The Cumberland Valley Savings and Loan Association I
savings certificate #6686851-------------------______________! 10,165.72
American Express Travelers Cheques-----------------_______________ f 1301.00
Demand Note on Letort Warehouses, Inc.-------------------_________ i 5,08311.43
121 shares of Dauphin Deposit Bank and Trust Co.----------------__ II 3,690.50
120 cornmon shares American Tel and Tel. Co. ----------------------- II 7,4251.00
162 cornmon shares American Electric Power Co.-------------------__ I 3,776.63
56 common shares Penna. Power and Light Co. ----------------------, 1,214.50
924 shares Delaware Fund, Inc.---------------------_______________ I 9,831.35
200 common shares Carlisle Corp.-------------------_______________ I 4,037.50
95 c..OTI@on shares Bethlehem Steel Corp. ---------------------------- I 1,971. 25
26 co..m. rrron shares Eaton Corp.-------------------___________________ /. 898.63
189 c.ommon shares Atlantic City Electric Co.-------------------___ 4,039.87
10 COTI@on shares Standard Oil Co.--------------------_____________ 455.62
5 common shares Publicker Industries, Inc.-------------------_____ I 29.06
25 common shares N I C 0 R---------------------___________________ 751.56
30 common shares Penwalt Corp.-------------------_________________ 1,020.00
50 co~non shares GAT X Corp.---------------------_______________ 1,184.37
80 common shares Ferro Corp. -------------------------------------- 2,9701.00
460 common shares Windsor Fund Inc.------------------_____________ 4,489.60
282 COlnmon shares Farmers Trust Co.--------------------___________ 9,024.00
10 co~non shares Ampco------------------------____________________ 122.50
8 common shares Frog, Switch and Manufacturing Co. --------------- 896.00
810 shares of Wellington Fund, Inc,--------------------___________ 6,957.90
338 shares Commonwealth National Bank------------------___________ 10,985.00
109 common shares COTI@onwealth Edison Co.--------------------_____ 2,956.62
47 Common shares SCM Corp.-------------------------_______________ 722.62
50 common shares General Motors Corp.----------------------_______ 3,028.12
297 shares Sheaffer Bros. Inc.-----------------------_____________ 87,208.11
370 shares Sheaffer Bros. Sporting Goods, Inc.---------------~.---- 52,691.70
179 shares Letort Warehouses Inc.---------------------____________ 56 103.97
40,500.00
1,129.00
5,575.00
TOTAL----------- 382,337.63