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HomeMy WebLinkAbout08-07-78 .. i, .'_ ....,..Ii. ,; "i~~~~-3_3 t4-7,.;.) ...- '- , . AUG 0 7 '9'~ COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS "--'--f." .' ..__;.~ .ra " r. 4- RESIDENT DECEDENT COUNTY OF aJMBBREAND IMPORTANT, 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'itenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) Late of Cumberland Permsylvania Cumberland Sarah Dick of the estate "of the abo"o-l"oamec-deeedent being duly sworn, depose } AFFIDAVIT OF EXECUTOR ADMINISTRATOR IN THE MATTER OF THE ESTATE OF Wal ter R. Dick (STATE FULL NAME OF DECEDENT) County County of lss: State of Execut-Or '. XlOOOOOOilt and say Decedent died December 24 (DAY) . 19..:z:l..--1 'estate leaving 0 lost will, copy of which is hereto ottoCh.ed~') (YEAR) ~e (MONTH) Nome andoddress of attorney -or } other authorized representative to whom ~.. 011 correspondl!nce should be moiled. Edward T.. S....hnrpp, f.'lnrti" Ij I'll "C"k 36 South Hanover Street, Carli'sie, PA 1701'1 That as such ~. deponent is familiar with the affairs of said esta'te and the property constituting (EXECUTOR-ADMINIS RATOR\ the assets thereof and their fair marke, value. . That at the time of death ther! was no safe deposit box registered in decedent's individual name, or jointly. with, or as agent or deputy of another, or in;&ecedent'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 THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A $....FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT None . 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 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. 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 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;~ immediate possession, standing to decedent's credit in banks of deposit, ..sayings banks, trust companie.s, or other institutions, whether individually, or in trust for any other pe-~son"';or.pe'r~~n_~ giving also separately the accrued interest thereon, if any, down to the last interest day:--pfior. t~ .de~ederYt;..;:~ death in the case of savings banks, and to the date of decedent's death in all other ca,~~s; a:l(bonds:%_sta1' ~ " " . ~ 4'!:: savings, treasury certificates or notes and other evidence of indebtedness of the United_States-;to the......de- ;: ,cedent; all ob.ligation~,i.whether bYi~ta~ute OF agree~ent they are designated as tax free,~_Jf tl!.:...Uni't;d ~~.~fe~, ~ or any state, or political subdivision thereof, or of any foreign country, which are owned-;.atAtlie tim~.of."'death; - -. ~ .,_, J." all wearing apparel, -jewelry, 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 ;-estima ted market value thereof; all bonds and mortgages held by .deced~nt" ancf of 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 su~h 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 and unpaid as of the date o~ 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. " . I , 'J . '. In the case of securities of close. or family 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 or death. The schedule also sets forth the interest or 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 ,chedule, financial statements showing the assets and liabilities of said co-pa.rtnership or huslness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement) together with 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' 8 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 property, 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 attached to the schedule a co~y 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 passes at decedent1s 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 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 death, 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 f'or life under 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, and the relationship of such issue to the benef'iciary. That SL~edule 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 or the decedent and others, plus the date and place of record of instruments effecting the vestiture 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 deductions 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 Impaid 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, commdssion or debt Is less than the estimated amount claiming and allowed, that the same will be reported to the Register or Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That have the totals of the appropriate columns in Scherlules -A-, -B-, -C-, been carried forward and properly registered in the -E-, and -F- as directed therein, ,yg-L ....._...._....;;e,uJ7~:y;;;~ ..-.................. ...........IlRENDA C'BREHi.i;NotaryPublic' Carlisle, Cumberland Co., Pa. My Commission Expires July 17, 1982 n" ..........19._............ SlDDary. ~C~~ 'Po. J ;J~::.L ...............~Ad;~t;.}-........_........_-- ....G1Q...tmJ.~_.l...DlIdc........M...S.....HlmoDr.M. (Street Number) Carlisle PA 17013 .................................I."................~.........~................"'............................................M... (Citv or Toum 400 StAte) Subseribed and sworn to before me this NOTE: Before signing affidavit make sure all blank spaces in the af~idavit 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 requirerl 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. / ,'. RC C~34 (4~7 3) 1 . ""t COMMONWEALTH OF PENNSYLVANIA bEPART.MENT OF REVENUE 'BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT 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 common with onother or other, 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 lenanls'with right of surviorship or tenancy by entireties should be reported an Schedule "E.") The real property located In the Commonwealth of Pennsylvania should be descrlbed by lot and block number, street and streef number, together with a generol description of the property, with a reference to the record of the conveyance by which the decedent took title; If Q farm atote number of a. ern; also stofement of mOl'tg-age encumbruneea upon each parcel at death of decedent. Taxe., assessments, accrued Interest on mortgages, ete.,ar. to be listed on Schedule HF" and must not' he d~ducted from thl. achedlolle. (1) (2) (31 DEPARTMENT VALUA TION CAUTION (Do not write In thl. apace) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ES TlMA TE D MARKET VALUE 1. All that certa:in tract of land with a dwell:ing house thereon erected situate in North Middleton Township, Cumberland County, Pennsylvania,. as con- veyed to Decedent in Cumberland County Deed Book "N", Volume 20, Page 527. The balance of said tract, after several conveyances by Decedent, consists of 300 feet, more or less, fronting on the Northeast side of Route 74, and extending in depth 370.13 feet, more or less , on the Northern boundary and 560.28 feet, more,or less, on the Southern boundary, and having a width in the rear of 129 feet; known as and numbered 1951 Waggoners Gap Road. , 4,390.00 20,000.00 L- -t#rJ/iJDO.OO AotJr-c fOu'l.J. t~ 4/k- 71/ ~ ~?i' 0 '-110 lj/j"~ 17 5'" t? J . >. .I d, dOO. 00 Insert this total opposite "real property", Schedule" A" in the X X X X X "As Reported" column on the last page of this return. ~ .~--" .' " " , 'RCC-,3S' RESIDENT DECEDENT SCHEDULE "H" 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 "En. Intangible personal property, titled in the name of the decedent, but payable at death to anotner 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 certif'icates,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 lnanyundlstrlbuted 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, shQuld be listed in this schedule. Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No. List and describe fully VALUE MARKEl' VALUE (Do not write in this space) l. Cash 347.00 .:J I..f 7. qQ 1/ ~-OO. 06 2. 1973 Gremlin Automobile, sale price 1,500.00 j'j. . ad 3. Reftmd Check: Medicare 52.00 '.LlC 4. Reftmd Check: Medicare 6.40 /b() 5. Reftmd Check: Medicare 1.60 . 6. MiscellaneoilS Personal Property in Decedent's Home: 'f'J;oa a. 3 drawer dresser 55.00 IOD.06 b. High dresser 100.00 / ~j;' (Jd c. Iron Bed 125.00 d. Marlin .22 rifle 30.00 JO.06 e. Herringer-Richardson .12 gauge shotgun 30.00 '0.06 7. Reftmd Check: Medicare 13.00 / '3, 00 ) 1}--6 rJ, 00 / Insert this total opposite "Personal Property", Schedule "B" in the ~As Reported" column on the last page of this return. x X 2,260.00 " -' '., " 'RCC-'3,6 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "c" TRA.NSFERS *~ RESIDENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material 'Part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) No (2) Did decedent, within two years of death, transfer property from himself to himself' and another or others (including a spouse) 1n joint ownership? (Answer yes or no) No (3) If .the anSWer to (1) or (2) above 1s 1n the aff'irmative state: (e.) Age of decedent at time of transfer (b) State of decedent's heal th at time of making the transfer. (Note 1). (c) Cause of' decedene s death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no)~______ (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) (b) What was the transferee's age at time of decedent's death? (5) Did 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 any period which does not in fB.Ct end before his death: (a) The posseSSion or enjoyment of or the right to income from the property transferred? (Answer yes or no) No (b) The right to designate the persons who shall possess or enjoy th~ property transferred or income therefrom? (Answer yes or no) No . , - (6) 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 in his lifetime make a transfer, the consideration for which was transfereels promise to pay income to or for the benefit of care of transferor? (Answer yes or no) No (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to al tel', amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer yes or no) No (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes,. set forth below a description of the .property transferred, it1s fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, -if trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim 1s based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tirn" ted) DEPT. VALUATION (Dept. Only) None ~ Insert this total opposite ftTransfersft, Schedule ftC" in the ftAs Reportedft column on the last page of this return. .' , " . ~ " WILL I, WALTER R. DICK, 'Of North Middleton Township, Cumberland " County, Pennsylvania, do hereby make, publish and declare the following as and for my Last Will and Testament. FIRST: I give, devise and bequeath my entire estate to my two daughters, Sarah Dick and Beulah Bender, in trust, however, for the follow- 'ing uses and purposes. 1. I direct that my home shall be maintained as a home for my daughter, Sarah, and my daughter, Dorothy, with the provision that so long as they use this property as a home, they shall keep the same in repair and PiLY all of the taxes thereon. 2. At such time as they shall no longer desire to make their home in my residence, or it shall become impossible so to do, then said trustees shall sell the property and hold the proceeds thdreof in trust, using the income therefrom to maintain my daughter, Dorothy, and said trustee shall have the right to use any part of the principal thereof for the necessary care and maintenance of Dorothy. 3. On the death of Sarah and DorothY', all of my estate shall then be divided, share and share alike, to and among all of my grand- children. SECOND: I intentionally make no provlslOn in this will for my son, Harvey L, Dick, or my daughter, Margaret Mackey. THIRD: I hereby appoint my daughters, Sarah Dick and Beulah Bender, as Executors of this will. IN WITNESS WHEREOF, I have hereunto set my hand and seal at Carlisle, Pennsylvania, this 18th day of September, 1962. ()!~ /j. 8~;J Walter -R,' Dick (SEAL) We, the undersigned witnesses, in the presence of Walter R. Dick, did hear him declare the foregoing to be his Last Will and Testament, and did witness the sig~ thereof by him, LAW OFFICES "'DIS AND MciNTOSH lUSLE. PENNSYL.VANIA '\ .~, ~~P-37" '!12~63) (,O~IMO"'WEALTIl OF PE1o;;'\SYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT ' SCHEDULE "D" "r u BENEFICIARIES ., h BENEFICIARIES AND ADDRESSES' RELATIONSHIP SURVIVED DATE (If step-children or INTEREST OF State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY ave an interest, vested. contingent or other are involved, set STATE YES IN ESTATE wise, . in estate) . forth this fact.) OR NO BIRTH ., :;,.." n._1. 'l\n ,,- ,,^,.., , Carlisle, FA 17013 .. , ""'..-..WI' Yes 5/30/21 ' Lifo nstate Dorothy V. SCott 48 West 5 Carlisle, VA 17013 Daughter Yes 9/19/Z9 Life Estate , Deponent further says .that all the above-named benericlaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ~ o _ E~* ijj: c:: 02 ~ e ._.... ::I e~- - 0 '" 0. u 1 g, 5v~ - -- :s :n 1-.0 ~ " 0 ~ S go ~ a: SUMMARY (Sch. "A") .... (Sch. "8") (Sch."C") .....(Sch...!.') Real Property Personal Property Transfers Joillt..Helcl.. F'..,Mty Gross Taxable Estate (2) (A, Dd,'rmin..d) (I) (As Rcpnrlc,]) $10,520.37 $ . ..2,260.00 $......0..... $. ... ..102.51 $ $..12.112.115 $ $ $ $ $ $ r-- '" Z " ~ t.:i w .. ..l " ... " ;.-. ..., " < t.:i " '" '" Q - - < -< '" ll: "" ~ '" '" "" 0 '" '" "" ..:: < "' ..-. "' :I: :I: t.:i :-. l- I- I- ~ Q t.:i S ,0 2:i ... .. ..-: 0:; z - 0 I- -e Z I- '" "" ~ t.:i ~ i- ~ 0 0 ll: c: "" ~ 0 0 '" :.::; t.:i '" ... '" ~ ~ ~ ~ .l; 0 ~ c: ~ -< ~ 0 '" ;::;: 0 ~. E ... E '" s ~ - 15 .~ ... j :::~ u u ,. .' " D Dauphin Deposit Bank and Trust Company MAIN OrF"ICE Zl3 MAR!'".ET StREE1' HA.RRI~eURG. P!N....SYLV..N .... 17105 717 I Z5!5 - elll M.mbor Faa..... D."osil ,nsvr..'Ctt ..or,iXI'"OtlOn July 13, 1978 1..""'0 !, "',,~ 36 ~. hanover ~ t. Carlisle, Pa. 17013 He; ~Hlter K. Dick December 24, 1977 Deceaaed Attn: Edward L. ~chorpp Dear Mr. Schorpp: In r...gards to tbe "bove mentioned, we submit the following information as of the date of death: ...-- 5avings Accnunt If06-6049Q balance $204.65 interest $.51 Account wae opened 12-]5-75 with both namee on it. If we can be of any further Basi.tance, please do not hesitate to contact us. " Very truly your~, CI;t:....~ .zc t"L4_ . . L.{-<- Donald ~. Crowwel1 A~ciAt)Hlt Vier> f'rp~idE"nt DEe/1m. ReC-'38,.:~ .. "~I .COMMONWEALTH OF PENNSYLVANIA . TRAN~FER INHERITANCE TAX , RESIDENT DECEDENT SCHEDULE HE" JOINTLY OWNED PROPERTY .' -~ .. INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly wi t.h another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated under Schedule nAn, plus the date and place of record of instrwnent effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal property should be listed as in Schedule "an, plus date of acquisition, and the name, address and relationship (if any) of co-owners to the de~eli.ent. Description of Property, Date of Acquisitiqn, N~e Address and Relationship of Co-Owners, and Place of Record of Instrwnent, where Real Estate. Unit percentage Value Share Estate Valuation ~ ><X:;x K5<%S<: ><X Q ;0(' 0. ~ ><X o.~~ ><X ><X DEPARTIJENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest 1. Savings Accormt Number 06'. 60499 ~he names of Decedent or Terry. Mackey establishe in Dauphin Deposit Bank & Trust Company,. Carlisle, PA, on December 12,1975 . (205.-11' Orie=Ji.alf -102.58..V ..'. . . Insert this total opposite "Join,tly Owned Property", Schedule "E" 102.58 in the" As Reported" column on the last page of this return. /oJ..rr /tlJ2. J-r '- 2- \ - c.ury,.-,..t..Q.r-J2..~ l'2:>-O\.~\ Date of Death \ '"2 - L-.Lt - -L \ ". . () f . \\ (\ ~ Estate Name ~~ \.A..J o...JLX..JL-.. I j-77) J iou.oty, Number and Name I FiI'e Number '"2- \ " SUMMARY (<... . COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEOENT (L AST NAME) (FIRST NAME) (INITIAL) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and far the County afrJ.~ Pennsylvania, do respectfully report that I have appraised the real and personal property os reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedul es It A", ".BIt I IIC", and liE". Dated: \ C).- L.. "1- --16 ~'- J<, ~ INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WillS I, the undersigned duly "elected Register of Wills in and for County, Pennsylvania, do respect.. fully report thot I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule ifF'., which greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTER OF WILLS ADJUSTMENTS INVENTORY VALUE AS APPRAISED ODE IHARRISBURG USE ONL VI REMAINDER APPRAISEMENT CODE Real Property (Schedule A) $ 00+ -z.O QOO 0.:> 92+ Personal Property (Schedule Bl 10+ "Z 2.("c DO Joint-Held Property (Schedule E) 20+ 107_ 5'0 Transfers (Schedule C) 30+ N iJ0L TOTAL GROSS ASSETS .7.... ?-. 310 2- '5:<e Less Debts and Deductions 4ll- 93- ISCHEDULE FI CLEAR VALUE OF ESTATE Valuation of life estates or ...:&...- PRINCIPLE .FACTOR VALUE (0. annuities.......... ..... ......_ $ t= t=. ESTATE TAX ASSESSMENTS _ $ FOR USE OF REGISTER ONL.Y Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Totol.Estate ~ COMPUTATION OF TAX 2% 6% 15% $ $ $ $ $ TOTAL TAX $ (*) As evidenced by Charitable Exemption Certificates .issued by the Secreti:HY of Revenue. . $ t= Less tax previously paid BALANCE Less 5% of tax if paid within 3 month 5 after death $ $ BALANCE OF INHERITANCE TAX OUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED Estate tax paid BALANCE DUE Add interest at rClte of 6% from to ~ $ $ $ t= $ $ TOTAL TAX BALANCE $ PAID $ Supplement,,1 C"des: (FOR USE IN HARRISBURG ONl Y) 48-Adjustment 49+Adjustment 56-Annuity 6O-life Estate 92+Remainder Appraisal 93-Remainder Deduction 93C-Charity . 94-Remainder Residue 96-Successive life Estate FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above computation of tax by the .Register of Wills, for proper reason, same should be noted below, with short explanation. ~ ~ \ ~ '0 C"- " !i. ~ ~ ~ ~ :i ~ " .. \0 ~ .a 0 ~ .. ~ " .:; ..... ~ '" ~ ~ '" \ ~ a ~ " ~ ~ ~ ~ ~ ~ ~ '0 I>- ~ -5 ~ .... 0 " .. z ~ ~ " ;J ~ '0 % rg '0 ~ .... is .~ ~ ~ ~ " " " u ~ "S .. U '" ..;l 'a '6 ;a-o ~< RC C..2 (2-64) "ECl' .' 2. L- l t3 COMMONWEALTH OF PENNSYLVANIA DATE' ;. .- -' . - " COUNT.;r ,. . O~- 0 0 . '-DEPAR'TMENT OF REVENUE RESIDENT INHERITANCE TAX BURE'Alf OF COUNTY COLLECTIONS . ' HARRISBURG, PENNA, 17127 APPRAISEMENT "L-\.-'1B-C)lCtl FILE NO. Whereas, \ ).... ") (, 0-+0 , Q. D,......ll... late of _N . r'v\ ~J2 o~ in the County of C'~~ c-.k Commonwealth of Pennsylvania, having died on the "L...L\*-'L day of [)..Q...<-~ 19:rJ, seized and possessed of an estate subject to Inheritance Tax under the laws of the Cammonwealth of Pennsylvania; Therefore, I, \ ~'- G 0 0... , 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 CommonwealU1 hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unll Appr.i,ement DucrJpUon of Anot V.tuu Made for Inheritance Tax Putpolel \..z D., (J ~ A ~./), ,,~ . $'"2.-0 ""0 0'0 B ~,'~ .c-h '2.,2.(0 a 00 .~~ 'A.-li . . \ "'-' "t 1l ~~ ~~ -. .~ ta2- 58 > - .-n. " v -..J ~ lJ'f\iL \ ,../\ "- T(~D ~ '2..2, ~(.,""2- Se. . , , , , , , Having been duly sworn according to law, 1 do hereby cer~' y t formity with law on this L.. 7 .~ day of at the above appraisement is made in con- . 19..:::di. '( Appraiser ~~ (POl'lt OftI:eeo). , Penna. f , . . .,; ~\ 0- ~ i" ... ~ '" \ ~ ... ~ ~ -.D <:> ... '" '-> Q I ~ '" ~ :a .... III .<l ~ ;: ~ .. a- -.D " - =- ! 0 ~ " ... 0- +1\ ... ,; .. Ii: I 'i z " ... ~ ~ ~ .:1 .. - 0- r- .; .~ ... ., " r- 0 .. 1 g ~ ... I i" ~ I ;:,.. Il'::. .... .... .... .... ... ... -r ... ... .... IN ... 0 .; S '" oc '-' -;; .... " ., '" - " -.:: -.:: -.:: -1 I ... 1 c- ~ t;; A ... '" "" .. ... .... i !.tJ ." '" t " l ( i" . ." ... " ~ .. .. 1 '" i! Q :s .. ... - ! €Z .... ~ - .. r< '" -;; - '" .. ... -a ... " .. "g " .. <.) := ., .c: .. ~ ... ~ .~ .. l.. 'i ;t. ... ... Q '^ j! c:=a .;: l 0 .. ... '" ;:; ... .; ~ ... .... ~ " -.:: ~ i .. " ~ ~ i" 0- '0 ... ~ .. ~ ;t. a. .; ~ ~ IN " '" '.r. -.:: c:> ;; ... " ';ii Q -.:: tl. ~ , ./ . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 IN YOUR REPLY PLEASE REFER TO Rce-a1 16.73) Inheritance Tax Division NOTICE OF FILING or APPRAISEMENT Sarah Dick 1951 Waggoners Gap Road Carlisle, Pa. 17013 (Executor or Adm ini strater) In Re: Estate of Walter R. Dick Cumberland County - Fi Ie No. 21-78-0191 Dear Miss Dick: You are hereby notified that the original appraisement in the estate af Walter R. Dick has been filed in the affice af the Register af Wills of Cumberland County on October 26 , 19~, Said appraisement reflects the fallowing valuations: . Real Estate Personal Property Transfers Jointly Owned Total $20,000.00 2,260.00 -0- 102.58 $22,362.58 As to such tax that is paid within three months from date of death, a five (S%) 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 accurred prior to December 22, 1965) fram date af death, interest at the rate of six (6%) percent per annum is charged. I Any party in interest wha is aggrieved by this notice may object thereto within sixty days after receipt of said notice os provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2485.1001, P. L. 373. ~~_ J(, Dote October 26, 1978 .J.tfi-- \ Si gned Title Chief Appraiser ~_. Note: This is not a bi II.