HomeMy WebLinkAbout07-01-78
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> -RC'C-33 (4-73)
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'" QQ~MONJY~AL TH OF P~NNSYL VANIA
~. . DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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JUl131978
'" . COUNTY.OF
CUMBERLAND
RESIDENT DECEDENT
IMPORTANT,
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late of
This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the
County where dece:dent resided; Return is due within n(ne months after. date. of death, unless an extension is granted
by the Secretary of Re'lenue. (Section.703. of the Inh.eritnnce and. EsV~te Tax.Act of 1961.)
Cumberland
} AFFIDAVIT OF
, ,
KJU1[QUt1!il{
ADMINISTRATOR
IN THE MATTER OF THE ESTATE OF
Dorothy S.' Toth
(STATE FULL NAME OF DECEDENT]
County
~tQte of
Pennsylvania
) os,
County of
Cumberland
Albert
E.
Toth
.~~l(ll(l
Administrator
I
Decedent d;ed April 1 19~{J\OJ(lJ(tK~lt!K!K~iK~iItIX~~16IC~}eOCUat:<<~..}.
I (MON1"HI \DAY) (YEAR) Intestate .
Name and address of attorney or} James .R. Humer.. ESQ.
oth~r authorized representative to whom . .
ollcorrespol'ldenushouldbem(lded. 1 W<o High S't. " Carl~~le,' PA 17013
I That as .such Administratri&ponent is familiar with the affairs of said estate andthe.property constituting
I . (~;XQtN]{etADM.INIS,T~ATO~J
the ass.ets thereof and their fair market value.. ":' ". . .
I Th,at at the time of death there was no safe deposit box registered in de~ed~nt'.s individual name, or jointly. with, or
as agent or deput~ of another, or in' decedent's individual name, with right of acce~s by:anothe~ as age~tor deputy, with the
ex~eption of the following: -
I
of the estate of the obove.named dece:dent being duly sworn, depose
and soy,
I N....ME ,l,ND ADDRESS OF BANK OR OTHE~ INSTITUTION
IN WHICH CECEDENT RENTED A S.-IFE DEPOSIT BOX
Nnnf":
I
THIS SAF.E DEf:'OSIT,BOX RENTED
IN NAME OR NAMES OF
RELAT10~SHIP OF JOINT
HOLDERS TO DECEDENT
That the contents of said safe deposit box or boxes are i~emii:ed under 8cl1edules
with the exception.of the following, for the reasons hereinafter set forth:
. ,
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the ~eal property
in the Commonwealth of Pennsylvania of which decedent died havi~g .an interest therein~ It also sets forth !he
mortgage encumbrances up~:m each parcel of real property at the date of death, giviI).g the .amount 'stilI due. at
death, naml~ of mortgagee, date, rate of interest, and book _and page 9f ~ecord thereof. "It ~1so' sets fort4 in, the
columns provided therefore the assessed v,aluation of eac~ 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; a.lI moneys left bythe.decedent at the time of
(death, whether in decedent's immediate po~session, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, o~ i!l trust ~or a.ny o.ther person or. persons.
giving also separately the accrued interest thereon, if any,' down to the last interest day prior to de'cedent's
"death in the case of savings banks, and to the d~te of decedent's death in all other cases; ap'bonds, pqstal
. ..., - " ......' -. '~... '",
savings, treasury certifrcates or notes and other evidence of indebtedness of the United~.State-~.Ho';the 'de-
I .. -... ,"'-\ - - ""., eo.
cedent;' all obligations, whether by statute or agreement they are designated as tax free, qC'the.United States,:",..
I .. ... .
or any state, or political 'subdivision thereof, or of any foreign country, which are owne'd ,at the time of de~th;~
I ~- .
all wearing appareJ, jewelry, silverware, pictures, books, works of art, household furniture~;,' hoc,ses, carria:ges, ~
t ~ ~.,. ~__
automobiles, boats, and. any and all other personal chattels of whatsoever, kind or nature-;""leftiby.decedent-,
. ,.' ,~ """ ~''''l' ..''''
together with the fairly. estimated market value thereof; all bonds and mortgages held by decJ'dent~and'.of.all
I ' -. _. .-,...., ._,'......" "
flaims. due and owing decedent at the time. of dea'th, ~nd all promi.ssory,o<<,)tes or other'~nstrumen.ts in writin~
for the payment of money of which decedent died p'ossessed, of w~at~-oever 'nature, 'with interest thereon, If'
~ny, giving the face value and estimated fair market'value thereof, ~i'nd-'if such esti'mated fa'ir:m'a;ket value be
A ""," ",'. .
less than the face value, it sets forth brie(~y the reas~~'s for such de~~ec'iat,io~ as to each it~m; all ~one~s
, . -, " - . - .. ., .
payable to the estate from life insurance policies carried by'decedent; all annuity and endowm'ent 'contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
~ue thereon and unpaid as of the date o~ death, bonds and accrued interest thereon to the date of decedent's
~eath and other investment securities owned by the decedent at the time of death, with the.market value there-
bf at such time.
~
. .
In the case of ..ourltl.. ot clole or fam11y corporations, the value. reported are &1 tar &8
po..ibl. .ub.tanti.t.d by fin.ncial .tatem.nt. of the corporation., .howing the ....t. and liabiliti.a
thereof ..a of the date of death. The Ichedule allO .et. forth the interest of decedent at the t1m. of
death 1n any co-partnership or bUlinssl, and 1n support of the value of such interest there 18 annexed to
la1d 8chedule, financlal statement. lhowtlll the a...ts and liabilities of said co-partnership or Quain....
A copy of the co-partner.hip agr..m.nt, (if oral, a .tat.ment .etting forth the nature of tn. agr..ment)
together with a statement setting forth the character of the business, 1ts 10cat10n, and such other facts
pertaining to the businesl aa may be pertinent to a fair and Just appraisal of the decedent'. interest
th.r.in muat be .ubmitt.d. It .hould al.o ..t forth in it.mized form, togeth.r with the fair market value
th.reof, any oth.r property owned or bequeathed by the d.c.dent at the time of death.
The SCh.du/. C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the cu. of traNlferl otproperty, real or personal, within two years of decedent'l
death, in contemplation ot decedent'l death,-,or intended to take effect in possession or enjoyment at or
after death, said schedule letl forth the nature and value of such property, to whom tranSferred, the
relationship ot the transferee. 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 arter death, there 1s also attached to the schedule a copy
ot the deed, trust agreement or other instrument creating the trust. TherA Is also set forth in said
schedule a list of all property, real and personal,~with its value, which pa6ses 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 Scn.dul. D 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 at
decedent's death at all minor., annuitants and beneficiaries for life under decedent's Will. It also
contains a statement showing which or the beneficiaries named in the decedent's will, it any, died prior
to decedent, the dates ot their death, their issue, and the relationship of such issue to the beneficiary.
That Sch,dul. 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 or record of instruments effecting the vestlture of
real estate and the date or acquisition ot personalty, plus the name, address and relationship, if any,
of co-omers to the decedent.
That S<p,dul, F .tt.ch.d her. to and mad. a part her.of .et. fOrth fully and in detail all debt.
and deductions claimed for and on behalf ot this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs ot &dministration ot this estate; counsel tees and fUdiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence ot the death of the decedent; debts and claims owing anet \mpaid at time of
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
661 of the Inheritanc. and Eetat. Tax Act); tog.th.r with a etatement 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 les8 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", "0", "C", "E", and "F" as directed therein,
have been carried torward and properly registered in the Summary.
Subscribed and 8wom
ore me this ..'::7..fi.....--...
.x....i2d.b...."E:J~....__........_._..__.._____
(E:cecutor-Adm~tor )
..?.....w..,.....M.e.:j,IL._~..t..,....._._..._................._.....................__.
(Street Number)
..N~w.y.ille...P.A_.l.nU.........mm.....mm...m.....
(City cw Toum /1M StAte)
NOTE: Befor~ 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 "0" are attached. Also make
certain ~t column #1 in the .Summary. has been properly completed as above-directed.
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RCC.. 4i4."a)~....'" . .
COMMONWEALTH OF PENNSYLVANIA
DEP>>-RTMENl OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERIl ANCE 1 AX
. RESIDENT DECE~
~
~
.....
._~'.........:........J.'~.:::,;,,~'-"-":
.....__~.T"._
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"
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 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 surviorship or tenancy by entireties should be reported on Schedule "E.")
The r~al property IGcated In the Commonwealth of PennsylvanIa should be
de&cr~bl!ld by lat and block numbor, street and street number, together with
a general description of the property, with a r.ference to the record of the
conv~yanc:e by which the decedent took title; If a farm .tate number of (J.
eres; 01.0 statement of mortgage encumbrances upon each parcel at death
of de eden.. Taxes, assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule uFH and must not be d.educted from this achedule.
LoJ of ground situate in West Pennsboro
To~nship, Cumberland County, Pennsylvania,
along South bank of Conodoguinet Creek; ffi
irnB;oved with ~1...cottage. ~To l.j Lj r !1::r-~f;g
J.. Inl f\ T. l-/ If~ ~ ~~-. . /.~ 0
For chain of t~'see Deed of Mrs. ~ v~
Jeannette Strohm, widow, to Dorothy S. Toth
dat1ed August 11, 1965, recorded in 9..)2..0
Cumberland County Deed Book 21 "R" 948~
,
(1)
(2)
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In thl. .pace)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
2250.00
9000.00
~o.oo
, . !
I
)
.
Insert lhis total opposite "real property", Schedule "A" in the
II As R ported" column on the lost page of this return.
xxxxx
9000.00
$9,000.00
...
RCC-35
ESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*~
OMMONWEALTH OF PENNSYLVANIA
RANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
y the dec~~dent, at the time of his death. Property owned by the decedent jointly wi th another or others
must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but
bayable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
live trust acconnts, 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, househo~d
oods, and fUrnishings, books, paintings, automobiles, boats, etc.)
I Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank,
~tockS, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
kbl e to the es ta te or f'iciuciary in said capaci ty, partnership interests, interes t in any undis tributed
kstate 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.
I
It~ ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No List and describe fully VALUE MARKEr VALUE (Do not write in
this space)
1 1976 Ford Pinto Sdn. , Title A28258511 V
VIN 6 T 11 y 198490 2000.00 ,/ 2,000.00
2 Farmers NationaL Bank of Newville, PA l.---
S/A # 1115~ 103.0Stv' 103.05
"
Inse t this total opposite "Personal Propertyft, Schedule ftB" in X X $2,103.05
the As Repo rtedft column on the last page of this ret~rn. 210 3 . 0 5
~
~
THE FARMERS NATIONAL BANK
No. 9588
OF NEWVILLE, PENNSYLVANIA 17241
CAROLYN H. KOUGH, Asst. Cashier
MARY E. KELSO, Ass!. Cashier
April 20, 1978
Mr. Jrones R. Humer
1 West High Street
Carlisle, Pa. 17013
Dear Mr. Humer:
~
#1115 in the name
$103 .05......-sne had
of Dorothy
no safe
Savings account
Strohm Toth has a balance of
deposit box.
Very truly your&s, .
~t0>~&-f~.;;d, .
Assistant Cashi r
...~ 0'- . _ ,____ __ ,"__'_'__,' ___.,.__.......-....,.._~____.,.. _..,. ~___,_.,. ._~ .
". . , .
--. -....,.~~.. ...- ------~--- - ---- '--.-,-
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FCC - 3&'
COMMOIlWEA.LTH OF PENNSYLVA.NIA
THAIISocR INHERITANCE TAX
SCHEDULE lIell
Tll'cNSFEIlS
*\
RESIDENT DECEDENT
(1) Did decedent, within two years of de 11th, make any transfer of any material part o.t.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) in joint ownership? (Answer yes or no) No
(3) If' the answer to (1) or (2) above is in the "af'fiINtive state:
(a) Age of decedent at time. of transfer 1'IJ{ A
(b) State of decedent's health at time of making the transfer. (Note 1).
(c) Cause of decedent' 5 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) 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) No
(b) What was the transferee's age at time of decedent's death? N/ A
(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 fact 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 the 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 N / A
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for the benefit of care of transf'eror? (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 a1 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) Nn
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as
well as a copy of the death ceM.ificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferred, it's fair market value at date of death, dates of transfers and to whom transf'erred, 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 is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
None
~nsert this total opposite "TranSfers", Schedule new in the
[" '"""'0' oo,~ ,. ". '""' ,~. "' U,," ..,"CO,
None
-
RCC-3? (t2~63)
I
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
*
(
h
~,
SCHEDULE "D" : L!J:. t\
,
BENEFICIARIES
f RELATIONSHIP
BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED DATE INTEREST OF
.statel 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
I wise. in estate) forth this fact.) OR NO BIRTH
Albert E. Toth Hll"h~nrl y",,, T "'~~, , /~ ,,~+~+'"
I
8 11'. Main St.
Ne~vi11e, PA 17241.-
I
EdLn J. Toth Son Yes Lel1a1 2/9 Estate
12~0 Bristol Dr
Mefuphis. Tenn. 38122
I
Wialiam A. Toth Son Y"''' J"'~~' ?/o ,,~+~+'"
4 ~. Main St.
Net.ville. PA 17241 I
I
Ribhard F. Toth Son Yes Leo-a1 ?/Q F"T~T'"
R.b.4. Box 54A
Ca~lis1e, PA 17013
A.I Ernest Toth Jr. Snn V"'~ l.",~~' ?/o ""..+.+
8 W M~; n ST
j ill", PA 17?<1l
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Dep&nent further says that all the above-named beneficiaries are living at this time except below:
,
NAME
DATE OF DEATH
RESIDENCE
~ .
,
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o .
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.. ..
..
~: C
'c 41 E
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-ac.B
< e.
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i: ~ 0
&lee-
- <>:
SUMMARY
Real Property ........ .............. ............ .. ..... .............(SCh. "A")
Personal Property . ......... ........ ........ .......... ...(Sch. "B")
Transfers ............. ........(Sch. "C")
Gross Taxable Estate .
(1)
(As Reported)
$ ..
$...
$...
$.. .
$
$
(2)
(As Determined)
$
$ ..
$
$
$...
$
t- 1
z
!;l 101 .. ..l
.. ~ .. <
:>< 101 !l '"
V') -
- <
~ " DC
lo. 'S ll.
ll. 0 " ll.
ll. ~
~ < '" <
= 101 ;..
l- t- .. Q
101 =
ci Z; :r: ... < = ~
0 t- ..
Z t- V') ll.
lo. 101 - lie
~ 0 0
.<:
= " - ~
0 -;;
." 101 .. 101
" ~ - ~ DC
.b 0 =
.. < ~ ~. 0
'S ;;;: e
'E .!i 5: E
'="="0 j i5 0
::;--t. U U
..1
t ~~
"~:~8- . . -
I
COMMONWEALTH OF PENNSYLVANIA
I
TRANSFER INHERITANCE TAX
,
RESIDENT DECEDENT
I
!INSTRUCTIONS: This schertule must disclose all property, real and personal, owned by the flecedent jointly
~ith another or others, including intangibles, standing in the name of the decedent and others. List
~eal estate first~ as entireties, or joint tenants, giving brief description, as indicated under Schedule
tAli, plus the date and place of record of instrument 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
~chedUle "8", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
--.Jthe decedent.
....
SCHEDULE "E"
JOINTLY OWNED PROPERTY
Description of Property, Date of' Acquisitiqn, Name
Address anrl Relationship of Co-Owners, and Place
of' Record of Instrwnent, where Real Estate.
~:
.)<.
"^
"^ >> ex:: :x
:>< :;:s:%%:sg:~
:x
"^:x
Albert E. Tothand
hu~band and wife
Dorothy S. Toth
1.
Real property, residence,
8 W. Main St., Newville, PA
2.
Real property, 21 Big Spring Ave.,
Newville, PA
3. Real property, 4, 6, 8 E. Main St.
Newville, PA.
4. Real property, 26-E. Main St.,
Newville, PA.
5.
Real property, N. Newton Twp.,
1 acre, unimproved.
Deed dated 9/l3/73and recorded in
Cumbo Co. Deed Book 25 "I" 1044
6.
The First National Bank of Newvill
PA, Ck/Acct #093-476-3
Unit
Value
Yx
:x
B:~
percentage
Share
b(<:Q(:
X><:><
'-.
Es ta te
Valuation
<<~:Q(:
:Q(:
-0-
-0-
-0-
-0-
Insert this total opposite ~Jointly Owned Property", Schedule ~E"
in the ~A5 Reported" column on the last page of this return.
DEPARTMENT
CAUTION-Do
In This
Value of'
I<..ntire
property
None
VALUATION
not Wri te
Spacee
Value of
Decedent's
Interest
None
"
RCC-SI (6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
NOI~1.~:z?l t!Lrotfilr APPRAISEMENT
8 West Main Street',
NetiVille, FA 17241
(Executor or Administrator)
Inheritance Tax Division
\
\
In Re: Estate of
Dorothy S. Toth
Cumberland
County - Fi Ie No. 21-78-0204
\
\
Dear Mr. Toth:
\
You are hereby notified thot the original
appraisement in the estote of Dorothy S. Toth
has been filed in the office of the Register of Wills of Cumberland
County on September 5 ,1978 , Said appraisement reflects the following
valuations:
\
,
Real Estote
Personal Property
T ronsfers
Jointly Owned
Total
9,000.00
2,103.05
None
None
$11,103.05
\,
'\
As to such tax that is paid within three months from date af 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.
Date September 5, 1978 Signed ~A A< 1<, .h~~
1.--
Title
Chief Appraiser
Note: This is not a bi II.
,
I RCCI2 (2-64) . " , September 5, 1978
COMMONWEALTH OF PENNSYLVANIA DATE
PEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX COUNTY Cumberland
BUREAU OF COUNTY COLLECTIONS
I APPRAISEMENT 21-78-0204
HARRISBURG, PENNA, 17127 FILE NO.
Whereas, Dorothy S. Toth late of Borough of NeliV111e
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 1 st day of April 19 78 , seized and possessed of an estate
sJbject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
I Therefore, I, Ira K. Gleim . 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
t~e cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
1 In the event that a.ny future interest In this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the explra.tion of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future Interest.
- I
Unit Appraisement
Description of And Value. Made for Inheritance
Tall. Purpolel
R.kl Property $ 9,000 00
.- ,
I Property 2,103 05
Personal
J~1nt-Held Property None
TJansfers None
TOTAL ASSETS $11,103 05
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formity with law on this 5th day of " September 19.1!L-.
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