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HomeMy WebLinkAbout11-16-78 RCC-33.,ol-73) " COMMONWEAL TH OF PENNSYLVANIA . OEPARHIENT OF REVENUE BUREAU OF COUNTY COLLECTIONS NOV 1 R 1<n~ COUNTY OF CUMBERLAND RESIDENT DECEDENT IMPORT ANT, 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'.lenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) 11\ TilE ~IATTER OF THE ESTATE OF Lucille E. Dietrich (STATE FUL.L. NAME OF QECEDENTl } AFFIDAVIT OF EXECUTOR ADml\lSTRATOR Late of Cumberland County Stat. of Pennsvl vania }." County of Cumberland ,~>ro:>:>>~w Marian D. Shoap of the ..tot. of the aboy.-nom.d d.cedent b.lng duly .worn, depou and .oy E",ecutor Februarv 28 (MONTH) {DAyl Nome ond oddre.. of ottorn.y or } oth.r authorized ,epr..entotlye to whom 011 correspondence .hould be moJlt.d. , 19~J tutot. leaylng 0 last will, copy of which 1. hereto ottached..} (YEAR) \."'tMfCMOl Decedent died That as such executor deponent is familiar with the affairs of said estate and the property constituting l EXECUTO R-ADMINIST RA TORI the assets thereof and their fair market value. Thilt 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 follo\ving: - NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A S....FE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Qauphin Deposit Bank West ~hnrp Plaz~ Of Lem~ne., p~- t;' t;' That the contents of said safe deposit box or boxes are itemized under Schedules p. with the exception-of the following, for the reasons hereinafter set forth: of this return, That Scheelule 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. II 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 Scheelule 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 interest thereon, if any, down to the last interest day prior to decedenCs death in the case of savings banks, and to the date of decedenl's death in all other cases; all bonds, postal savings, treasury certificates or noles 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 w":d.dng appard, j~wdry, silverware, pictures, 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 nf 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 interesl 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 decedenl; all annuity and endO\\lment contracts the proceeds of which were payable upon the dealh of the decedent; all and the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's death and other investment SeCITI ities owned by Ihe decedent at the time of death, with the-market value there- of a t such time. _.. ~ .... - ~-":",- 1lla.st lLtill anti ffil'.shunl,ltl OF LUCILLE E. DIETRICH I, LUCILLE E. DIETRICH, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and codicils. ITEM I. I.direct that alii my ~ust debts, any expenses that may'have resulted from my last illlless, and my funeral expenses shall be paid from my estate as so"n as practicable after my decease. ITEM I!. I direct that my Executrix, named hereafter, shall convert all the rest, remainder and residue of my estate, whether re'al or personal ty, in to cash ate.. ther public or pri va te sa Ie and under the terms and conditions tha~ my Executrix deems best. I then direct my Executrix to pay on,~-third of the net proceeds from the sale or sales as above to my s.>n, HAROLD E. DIETRICH. If my son, Harold E. Dietrich, does not 'mrvi ve me, bu t leaves issue him surviving, his issue shall take hi:;.share per stirpes. Then, I direct my Executrix to pay over 'the remaining two-thirds of my net estate, in equal shares, to my three daughters whose names I now list: (a) DOROTHY E. MIXELL, who on the date of this testament resides in Fort Lauderdale, Fl~rida; (b) MARIAN D. SHOAP, who on the date of this testament resides in Humrnelstown, Pennsylvania; and (c) ELEANOR V. CONNER, who op the date of this testament resides in youngstown, Ohio. If any of my daughters, named above, do not survive me, but leave issue them surviving, their issue shall take their mother's share per stirpes. ."- ~- .:- ,.- ITEM III. I appoint THE FARMERS BANK AND TRUST COMPANY OF . HUMMELSTOWN, Hummelstown, Dauphin County, Pennsylvania, as guardian of the estate of any minor grandchild of mine who becomes a beneficiary under this Will and with powers to: (a) Receive and hold for such minor or minors all property payable by law tc a guardian appointed by my Will; (b) Invest such property and all accumulated income without restriction to lnvest~ents authorized for fiduciaries; and (c) Use income and principal for the minor's maintenance and education, either'~irectly or by payment to any person having custody of the minor and which person is undertaking the minor's. educa tion and mai [,tenance. payment to such a person and receipt thereof shLll be a complete acquittance of the guardian. All unexpended principal and income shall be paid tci'the minor at his mLjority. Said guardian may, in'dlscharge of all duty hereunder, pay any minor's share deemed imprac ti. :al of admi nis tra tion to the persori standing in place of the m:.nor's parent or deposit it in an interest bearing savings account in the name of the minor. ITEM IV. I appoint my daughter, MARIAN D, SHOAP, as the LXecutrix of my Will. ITEM V. In addition to p'ower.; given them by law, my Executrix and any guardian acting hereunder shall have the fullest power and authority in all matters and 'luestions and to do all acts. which I might or could do if liviag, including, without limitation, complete power and authority to in~est (without restriction to investments permitted ,by law), sell (at public or private sale, for cash or credit, with or without security), mortgage, lease and dispose of and distribute in kind, all property, real and personal , at such times and upon such terms and conditions as they may deem advisable. ITEM VI, All estate, inheritance, transfer, legacy, succession, and other death taxes of any nature, payable by - 2 - ., ...." ... - '. ..... ('cason of my death, which may be as~:essed or imposed upon or wi th respect to property passing under this Will or property not passing under this Will, shall be paid out nf my estate as an expense of administration, and no part of said taxes shall be apportioned or prorated to any legatee or devisee Inder this Will or any person owning or receiving any property not. passing under this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2Y {.'IPI<'\L A.D. 1967. day of ,-y . ~ '-C . .Pro , ,c' . C;-j . ./- , ...-.......-. -,--r-;. ,_ (_ (SEAL) Signed, sealed, published and declared as and for the Last Will and Testament of Lmille E. Ilietrich, the Testatrix, in our presence, who: in her pI' s nce a "in the presence of each other, and at her re<;luel' ave ereJrlto ;'t our hands as subscribing witnesses hereto. .. . :/\j \ j)"1 1.('" I , . U D' hi ['-./\<,-",,3 ~ ",-<.A--.. . f-.. a-m Address J / I' ()~ 1/' I I .'/ M.'~ Name J/ ,~'~l . Address ~., ...::----....1 , . "': " 't:i " . ~ .... '" 0\ c:: Z ~ N: ~ ::l w 8 ::;; ..<:: '" \0: t,': w u: ~ a: w (I) ..... CI :') <( ...: 0 "': co: .... ,0: Z a: .,. ,,: ,,: &: w 0- ....: ,: > 0- A: <( co: W ~. ... x . N: ci "": a: ~ c:: ,: c:: !::'-- <( '0 f'l: .-I: N: Z u.. 'ci' '" '" .... ~ .... .-I: o~ ci ",' 0 '" e ~ '- "" 0 ....: :> ij w l'l :0- " Q) '" 1f d." u '" l'l =~ <;:: ",,' I- [2 '" .~ ~ .... z ';0 .... z &l .3 ~ Q) 0 ",' "- it g> ... <( -'<: w "- '" C' ., .... ~ ~ -'" ::l ~ <l; "- "- .., ~ ... ... "0 I- <l; <l; " ( a: CI '" ~ "0 "- w \1'1 ti a: c:: e "0 ~ :I: ..,- .... 's, l'l <( '" ::l 0 c:: ~ c:: 0 '" z '" '" Q) .... c.. 1'1 ..a <l:: Q) e a::: 0 w 'ci' '" "0 .... CI ~ '" .S ~ '" '" 0 '" ... z .... '" .S c:: '" e '" '" l'l w 0 .;;; " 'm 0 "- 0 "0 0 " '" "- ~ ... ",' 6j ~ Vi '" "- '" ~ Q) <l; ~ ~ '" ~ a::: w ~ ~ k: a: REV-457 (S-78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P,D. BOX 2970 HARRISBURG. PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT 5 February Cumberland 21-78-0170 DATE COUNTY FILE NO. 1979 Whereas, Lucille E. Dietrich late of Borough of Camp Hill in the County of Cumberland Commonwealth of Pennsylvania, having died on the 28 Februarv day of 19 E..., seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fulginiti ,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 expr~sly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any Such future Interest DESCRIPTION OF ASSET UNIT AppraIsement V ALVES Made for Inheritance T ax Purposes . O~ """ "" DM' D~h.~ ,., ,? '''< ?o - ..~-~ .. Tnin>l" 3 283 63 Total ^, ^ "n nr Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 'ith day of 1<'"hr"~.rl', 19 ...19-. I') 1 _' Appraiser (Number and Street) Harrisburg , Penna. (Post Office) , REv-,ta (8-18) COMMONWEAL TH OF PENNSYLV ANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIOHS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPL Y PLEASE REFER TO * Inheritance Tax Division HOTlCE OF FILING OF APPRAISEMENT Ms. Marian D. Shoap 286 Dogwood Drive Hllmmpl!=:rn'WTl, 'PA (Executor or Administrator) In Re: Estate of T.llC'il1p F.. niptr;l"'h Cumberland County - Fi Ie No. 21-78-0170 Dear You are hereby notified that the 'Or:lgi",~l appraisement in the estate of T 11("; 11 p F. ni pt-r; r"n has been filed in the office of the Register of Wills of rnmhprl "n~ County on 5 February , 19~, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total 16 . 000 00 12,835.23 None 3.283.63 $ 5 2-,-l1S, Sf> As to such tax that is paid within three months from date of death, a 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 rate 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. r--, .. - '. () -f-' CJ.0-u '-\...- -c.~'--"--- Date 5 February Signed --.J Title Administrative Officer c ----...... Note: This is not 0 bill. ~ 5j. H1v$rJ"'~ dArt' ignature I Bjl.~. TlTL J ('~. /ub 3/JY/7? COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 RCC-43 (4-71) NOTE: TO BE SUB~rrTTED IN TRIPLICATE REPORTING FINANCIAL INSTITUTION ADDRESS First Federal Savings & Loan [,ssoClatlon 01 Harrisburg -'lW MarKet ",t. Camp Hill, PA ZIP CODE l'lUll Pennsylvania Department of Revenue Bureau of County Collections Gable Building, 3rd, Floor 411 S. Second Street Harrisburg, Pennsylvania 17127 Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: ACCOUNT NO. OF JOINT, TRUST OR INVEST~lliNT DEPOSIT 1-15288 .......- NMlliS ON ACCOUNT OR INVESnlliNT Lucille E. Dietrich or Harold E. Dietrich DATE OF DEATH February 28, 1978 DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR Lucille E. Dietrich ADDRESS 1501 Walnut St. Camp Hill, FA COUNTY Cumberland ZIP CODE 17011 SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR 1501 Walnut St. Harold E. Dietrich ADDRESS Camp Hill, FA 17011 RELATIONSHIP TO DECEDENT Son DATE DEPOSIT OR INVESTHENT WAS ESTABLISHED February 8, 1963 BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ /" S 5.088.28 mj. ~ 1V?J' COMMONWEAL TH OF PENNSYLV ANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTE: TO BE SUBMIITED IN TRIPLICATE REPORTING FINANCIAL INSTITUTION ADDRESS Dauphin Deposit Bank l Trust Co. 21' Marke' ~'ree' Harrlsburg, ~ennlylvanla ZIP CODE ,.,1U::>> Pennsylvania Department of Revenue Bureau of County Collections Gable Building, 3rd, Floor 411 S. Second Street Harrisburg, Pennsylvania 17127 Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT ~ 28 1+8 050 3 NAMES ON ACCOUNT OR INVESTHENT Mrs. Luci1l. E. Dietrich or Hr. Herold E. Di.trich DATE OF DEATH February 28,1978 DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR ADDRESS 1501 Walnut Str..t Camp Hill, Pennsylvania Mra. Lucille E. Diatrlch COUNTY .-1'J' .v IJ. ZIP CODE ~wi1 . SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR Harold E. Diatrlch ADDRESS Unkno1ll1 RELATIONSHIP TO DECEDENT San DATE DEPOSIT OR INVESTHENT WAS ESTABLISHED 10-7-71+ BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ ~ i10l+6.98 \U~~~, ~ Signature TITLE Ja Ann C. Stav.r A.ai.tsnt "-n.g.r Dapoll1 t Account Suvlc.. RC.C.J8 CO\l\10NWE'\LTII OF PEN1>SYL \''\:'o:IA TRANSFER INIIERITANCE TAX RESIDENT DECEDENT SCIIEDULE "E" JOI:'o:TLY OWNED PROPERTY ~ . I~STRlTCTIO;'\lS: Thts Sdll--c!ule must disclose all property, real awl personal, owned by the flececlent Jointly ""ith nnother ur others, incl\ldin~ intangibles, stflnding in the name of' the decedent. liTHI others. List rt"al .-state first.. as pnttrettes. or Joint tenants, giving hrief ctescrlptton, as illdicatt>d limier Schedule ".-\". plus the ltllt.e /tIll! place of' r+"cord of Instrument effecting vestittll'~, but do not include entireties or out 01' statt' rf~/ll estate value in estate vrtluntlon column. Personal property should be listed I:1S in Schetlule "9", plus date of I1c'luisttion, lUll I the name, address anfl relationship (if any) of co-o'ftmers to the llecedl~nt. Description of Property, Date of Acquisition, :'oillme Unit percelltllge Esta.tp. Address and Ilelatlonship of Co-Ol'lners, Ilnd Place Value Share Valuation of nN~orlt of Instrument. where Heal Estate. Dauphin Depo$~t Bank - checking acct. 28-48-050-3,v co-owned with son, Harold E. Dietrich, 4280H Williamsburg Drive, Colonial Crest Apts., Harrisburg, / Pa. 17109 $1,046.98'" 50 First Federal jPvings & Loan - savings acct. 1-15288, co-owned with son, Harold E. Dietrich, 4280H Williamsburg Drive, Colonial Crest Apts., Ha~~ risburg, Pa. 17109 ~40.5~ .s:; ~S' ~., ~ 50 The above accounts were in existence for more than two (2) years Insert this totu] oppo~lle ".Joitltly Owne,1 Property", Schedule In the "As Heported" COlUr.Ul on the lust pa.g(~ of this return. D\<J'ART/.IENT VAWATION CAUTION-Do not Write In This SPA.CP. Value of I<..'ntl re Property $ 523.49 l)otJ(,.~f /' ~l'no.iA 2,520.2~j,O~&'d-Y \-' - - " . '3,043.7 j J. '&.3. W Value of Decedentls Interest 5;;,3, '+1 J 7(PQ, It I ~ ..., 3lfl- :!<- "i;i: c '2 ~ E .- e.J ~ E-o: -0 Co u -;: g, 5u-g --- ~ ~ ~ u ~ 0 ~Efr ~ 0: Rea! Property............. Persona! Property Transfers SUM~IARY ............... ........ ....(Sch. "A") ....... ..... .... ...(Sch. "n") ................................ (Sch. "C") ...........J$<::l1...~'~" ). Gross Taxable Estate. l- .c z u-o u ~ t.l 'n ~ " s.,2 ...l C.> ;.. .... ..... u <( t.l u Vl QlQ :!l - .,-l <( ~ Cl .::= IX :x:: t... S .. 0.- 0.- 0 . "tl i .. !:J ~ !:J t.l t.l. ..... C ;.. <( i= i= I- ....' I1l O! Q t.l ar .,-l ..... c ~ '" -r. .... :c s., ;;; z 1= 0 I- % Vl .... QI c.. ..: t... t.l .,-l. 0. ..Q '0 l- ~ 0 U E E IX ~ ;:l I1l ::L 0 (5 :x:: ...l U U :.. .= :.Ll <; :.Ll " C '0 - IX l::; " '2 ~ c ~. ! .... ~ ~ :;- .:;: - u u ~ (1) (As Reported) $..36, .000 .00. $ ...1.2 ,841. 20 S ...0... S .......3.,.04.3.77. $ ................ $ ....?1.,..8.~4.97. (2) (As Detcrmincd) $ $ ,. ., $ $. $ RCC-'37 (12-63) l'O~DIO:,,\\'tAl.TII OF PE:":-;SYYLA:"IA TIlAr>Sn:R 1lI:IIEIlITA:"CE TAX IlESIllENT DECEDElI:T , " . SCHEDULE "D" BE:\EFICIAHl ES \ h IlENEFlCIAIlIES Ar>D ADDIlESSES RELA TlOr>SlIlP SURVIVED O( step-children or DA.TE Ir>TEREST OF State full nar.les and addresses of all who illegitimate children DECEDENT OF BENEFICIARY ave an interest. vested, cont ingent or other arc involvcd, set STATE YES IN ESTATE y,isc, in estate) forth tpis fact.) 011 NO BIRTH Harold E. Dietrich. 4280H Williamsburo Dr. Colonial Crest Apts.. Harrisburo. p", 1710g son I yes 10/3/21 bne third of estate 1 I Dorothv D. Mixell. 7382 Bioi , I I Cvoress Court Miami Lakes I 1 Fl^~irb "Old dauohter yes 14/17/23 bne third of residue I I Marian Shoap, 286 I I I D. Doowood Dr. HummelstO\~n Pa. 17036 dauohter I I 5/10/24 One third of re,sid)l~. yes I I Eleanor D Conner 34 Mario I n~ O^'~~rl "hi ^ AA '" A rl~..^h"~r vt>" I 7/1q/?<; (lnt> t-hi rn ,,~ rt>sidue.. 1 I 1 I - I I I n~poncnt f\lrlher suys that 1111 tile above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDEr>CE Rc.::-30 ~. f~" COMMO:\I\'EALTII 01" PE:\~SYLVA:\IA TRA:\SFEH I:\HEIUTA:\CE TAX SCHEDULE "c" TRAXSFEJ1.S RESIDE:\T I1ECEDE:iT (1) Did decedent, within two years ornenth, mH.ke any transfer of any material pa.rt of his estate, 'ft'lthout receiving R valuable find adequate conslcleration therefor? (Answer ~'es or no) Nn (~) Did rlece(tent, wI thin two yeaTs of death, transfer propert~. from htmsel f to hlmsel r and another or others (including a spouse) In joint ownership? (Answer yes or no) f-Io (3) If the answer to (1) or (2) above is in the affirmative state: (a.) Age of decedent at t tme of transfer (b) State of decedent' 5 heal th at time of making the transfer. (Note 1). (e) Cause of decedent's death. (~ote 1). (4) Did decedent, in his lifetime, make an~' transfer of property without receiving a valuable or adequate consideration therefor Vo'hlch was to take effect in possession or enjoyment at or after his death? (Answer yes or no) ~U- (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his po....'er of disposition? (Answer yes or no) (b) What was the transfereel s age at time of decedent's death? (5) Oid 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 an)' period which does not in fnct end before his denth: (a) TIle pos!'icssion or enjoyment of_or the right to income from thE' property transferred? (Answer yes or no) T\TO (b) The right to rlesignate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) Hn (0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (7) Did decedent tn hts lifetime make a transfer, the consideration for which .....as transferee's promise to pay income to or for the benefit of care of transferor? (Ansl'ler yes or no) !>'O (8) Did decedent, at nn,)' time, transfer property, the beneficial enjoyment of which was subject to change, becanse of a reserverl power to al ter, amend, or revoke, or which cOllld revert to rtecedent unner terms or transfer or by operation of law? (Answer yes or no) No (0) If the answer to (S) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reservc(l in the decerlent alone or the decedent ann others? (Answer yes or no) SOTE1: The answers to these questions should be supportert by ,arfid.avi t by the utteTllUng physician as well as a copy of the death cent flcate. ~OTE 2: If answer to llny of' the above questions is yes, set forth beloVo' a. description of the property transferred, itls ftlir market value at date of death, dates of transfers and to whom transferre(l, with relationship of transferees to decedent, ir an~'. Submit copy of nn,). trust deed or instrument, if' trans- fers are claimerl to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List appl icable property below in manner in which providelt in Schedules A, il, or E. !TEll DESCRIPTION Il\llKET VALUE (Es tlrns ted) DEPT. VALUATIOS (Dept. Only) NONE \'.lo rJ-L Insert this total opposite "Transfers", Schedule "e" in the "As Itp.ported" column on the last page of this return. w'ClnL Pa.<:l } A?1t:l Z':.,' 1978 Jade and (old pin Costume jewelry Tulip dec. dower ches~ ?ed and green applique quilt Oak 6~'llre ;;tand :;.~"'~ ep\L'l tick Semi spxl ced Jatcd cov~;rlct ',lorn coverlet Ogee mi=or Empire chest Trunk Sewing machine ;tacker .ic~er end table 3 aluminum chairs Slectr:lux Kitchen Cl'pb:;ard Squar2 leg stand 1'001 chest and tools 4 razors 19. print ~. pcrtrai t in frame Appraised by Pe=sonal p=~perty in the estat: of 1':=s, Lucille Dei trich $ 75.00 20.00 1,200.00 100.00 20.CO 15.CO 75.00 200.00 10.CO 20.00 25.00 5.00 1(;.00 30.00 15.00 5.00 5.00 lC .CO 10.CO 10.00 5.00 ,.00 TOTA.L.. . 10.00 ;;;2 J 686. OJ V-- /l J/ /. / --f2-Jb A~~Yb> r Betty Snith ?il[:e 2 . A~:!'il 24; 1978 Fersonal prvperty in the estate c.f Ers. Lucille Deitrich Toothpick h~lder ~ 5.00 5.00 5.00 4.00 15.00 10.00 5.00 ).00 10.00 20.00 10.00 8.00 25.00 5.00 7.00 10.00 4.00 10.00 15.00 5.00 2.00 10.00 100.CO 100.00 150.00 4.00 12.00 2.00 10.00 Chi:1a vase "19['4" souvenier m'J.g Kippon dish J~ccratod pla~~ seat chair VictGrian stand TV trays Pr. lamps Silver plated flataare Household linens Ccntsnts of sidebcare Iris console set Shglish dinner service 5terli:1g salt and peppers f':ajolica pitcher Rug ~:irror 5 pc. chrome breakfast set Sm. appliances Fots and pans Ironer Kitchen glass and china 4 leg drop leaf table Painted shade lamp 4 pc. Fr~nch ?rovincial bedroom suite Pr. l>:Judoir lamps Half spindle plank seat chairs Card table Rug ~. . rn~~~w ~Mil~OO Estate and Insurance Appraising Antiques 114 East Main Street Hummelstown. Pa. 17036 APPRAISAL OF TiB PERSONAL Pi10PEHTY IN THE ESTATE OF I'.ilS. LUCri.].," Dm:T:lICH AT .AU,VT ST., CA:~ HILL, FA. (APRIL 24,1978) 3 pes. upholstered furniture Floor lamp 1>r'oadlool!l rug Table lamp !.jagazine rack Stool Decor'ated cane seat chair 9 pc. dinin5 room suite Oak booy,case Li~oge chop plate 2 flo blue pes., as is 2 wines Flo blue plate Cut glass round bowl Crystal oval bowl Pressed bewl :':arrnalade jar and tray riilk glass plate Jappaned tray Lenox swan Contents of bookcase Sponge edge plate Pressed celery tray Phone 566-2057 ;; 20.00 5.00 10.00 4.00 4.00 4.00 15.00 35.00 20.00 10.00 8.00 5.00 5.00 25.00 10.00 5.00 5.00 4.00 3.00 5.00 25.00 5.00 3.00 RCC -:;5 . Cm~101I'WE.\L11l OF PEllNSYLVAI\IA T~~SFER IllHERITAllCE TAX RESlnE~T DECEDENT SCHEDULE "B" PERSONAL PROPERTY ISSTRVCTIOSS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Propert)' owned by the decedent jointly with another or others must be 11~ted under Schedule "Eft. 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 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. jey,elr)', wearing apparel, household goods, and f\lrnlshlngs, 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 es tate of or income from any propert)' 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. I tern No. !TEll List and describe rully UNIT VALUE ESTIlL~Trn lIARKET V AWE Personal property per attached appraisal Cash found in home . Series "E" Bonds, ($251 denominat1on Feb 1946,./Dec 1944.::..( Dec 1943./ Accrued interest on Bonds Capital Blue Cross - Premium return . Conn. Mutual Life Ins. - Death benefit National Central Bank, Deed of Trust, Nov 7, 1957 Accrued interest on Trust Blue Shield - 65 Special claims ($48.17, $11.80 & $2.001 Medicare - payment on claims ($192.68, $47.20 & $8.001 Miller's Mutual - Refund Homeowners Pol. United Gas Inc. - Refund Riverton Cons. Water Co. - Refund Department of Revenue - Property Tax rebate Sears Roebuck & Co. - Payment Roof Claim ,~ ~ . $ 2,686.001 7.09 ,; 199.16.../ ~~ 9.35 V 4,086.51"V /' 4,494.79_ 218.42./ 61.97' ./ '~ I ; t.J. ~1..,... 247.88~ 9.00' ,.- 13.111- 1.95 I 200.00:/ 600.00" Inser t lilis lotal oppos i te "Personal Proper ly", Scherlul e "8" In the "As Heportell" colunUl on the last page of this return. x X 1f12.841.20l DEPARTlIE~'T VALUATION (Do not write In this space) ~ ~'ij'{,.06 I 7.09 I q '1. I ~ ~.Do C\.~s "*I{)~l... 51 't 1-\9'1.,9 I ~\'?4-~ lDl.'17 ~ ,n'll! 9.DO \3./1 ). '{S ;:)..00.00 \POO.DO .J I d" ~ ~~, U RCC.34 (4..'31 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIOENT DECEDENT SCHEDULE "A" 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 cammon with another or ather, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenants with right of surviarship or tenancy by entireties should be reported an Schedule "E.") Tho ,.01 p,operty located In the Commonwealth of Penn.ylvanla .hould b. ducrlb.d by lot and block numbe,. .t,..t and .t,..t numb.r, tog.th., with o general ducrlptlon of the prope,ty. with 0 r.f.r.nce to the r.cord of the conv.yonc. by which the d.ced.nt took tltl.; If 0 form .tat. number of o. cr..; 01.0 .tat.m.nt of mortgage .ncumbranc.. upon .ach pare. I at d.ath of d.ced.nt. TalC.', a.....m.nt., accru.d Int.re.t on mortgag.., etc"ar. to b" lI.ted on Sc),.dul. "Fu ond mu.t not b. d.duct.d from this .ch.dul.. (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S OEl. TH ~One and one half story frame bungalow known and numbered 1501 Walnut street, Camp Hill. For title see Deed dated Jan. 6, 1945 from Edwin M. Dietrich and Susanna C. Dietrich, his wife, to Mark S. Dietrich and Lucille E. Dietrich, his wife. This Deed is recorded in Cumber- land County Deed Book W Volume 13 page 421. Mark S. Dietrich died Aug. 15, 1957 whereupon full deed to this property vested in Lucille E. Dietrich. Property sold Aug. 10, 1978 for $36,000.00 to Michael L. and Paula H. Bowser IhU1' J-lfA/ J. J PI P _ 7:g1) I.f S't ~ _ ..-----:- 1:/(,,(/ /~) Insert this total apposite "real property", Schedule "A" in the X X X X X "As Reported" column an the last page of this return. (2) (31 OEPARTMENT VALUATION CAUTION (Do not writ. In rid. . pace) ESTIMATED MARKET VALUE !t36, 000. OOY-3l",DOO' no $36,000.00 3l",MO.OO In the case of securities of close or f8Jl1lly 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 Qusiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of tne tlgreement) together with a statement setting forth the character of the business, its location, and such other facts ?ertainlng to the business as may be pertinent to a fair and just appraisal of the decedentts 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, vdthin two ~'ears of decedent's death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or after death, sairl schedule sets forth the nature ami value of such properq." 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 attacherl to the schedule a cony of the deed, trust agreement or other instrument creating the trust. Therl~ 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 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 D attached hereto and made part hereof sets forth the names ann addresses of all perSons beneficiall)' interested in this estate at the time of decedent's rleath, 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 necedent's Will. It also contains a statement showing which of the beneficiaries named In the decerlent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship of such issue to thp beneficiar)'. That S.:/1edule E attached hereto and made a part hereof sets forth all property, real and per- sonal, owned b~" 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 instnunents effecting the vesti ture of real estate and the date of acquisition of personalty, plus the name, a41dress ann relationship, if Rny, of co-owners to the deceden t. That SChedule F attached hereto and made a part hereof sets forth fully and in detaIl all debts and deduc tions cl aimed for and on behal l' 0 f this deceden t' 5 es ta te, i ncl lid i np;, funeral expenses paid; family exemption, where applicable; costs of aclministration of this estate; counsel fees and f\ldiciary'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 ami 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 pledgert 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 therewi tho That t.he totals of the appropriate columns in Scherlules "A", "0", "e", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this t.L .........1.3.............. V' /llcu=.? /J' ,4r .........I:I'9:.:t::.~~!:l.J?~..~J:1?..~E....................._........_.. (E:rectLtor-~ 286.....D.og.wood....Driv.e.................._..._...._.. (Street N tl mber ) .!:I.l,!mfl!e),~.!:Q!'In., ...J'..g,....1.70.Jp.............. (City or Town and State) ...... day of ......N.y..>!.,......... l=-~\ 12~v.~\.s."" FRED R. HARTMAN, Notary Public Hummelstown. DJu)hin Co., Pa, U't.. Comm.~~i.:)O ExpirQS .hn; 28. 1980 .......... 197...~.. SOTE: Before si~ning affidavit make sure tl.l1 blank spaces ill the at'f1davit alld scherlllles nnnexed ure ftlled in with details or the word "Sone", and in case the assets include rure anrl unlisterl securities, secllrities of close or family corporations or an interest In any co-partnership or business, that tile nata and stA.tements required under the parag,raph above relating to Schedule "ll" arf' attacherl. Also make certain that column #1 in the "Surmlary" has been properly completer! as Ilhove-dir~cted.