HomeMy WebLinkAbout10-19-78
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'-."R'C~~33 "( 4-13)
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I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RESIDENT DECEDENT
COUNTY OF
CUNBERLAND
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'ilenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Late of
Cumberland
} AFFIDAVIT OF
EXECUTOR S
~~X'KOI<<
JANE G. NILLER
{ST.lI.1'E FULl.. NAME OF DECEDENT)
County
S'a'~ 01 Pennsylvania
-"
} ss,
Caun'y 01 Huntinqdon
)l1lm1ll)(lMH>X
Barbara Tracy and Timothy Myers
of the estate of the obove-nClmed decedent being duly sworn, depose
Execut.ors
ond :soy
April
\MONTHI
Nome and address of attorney or }
other authorIzed representative to whom
011 corres.pondence should be moiled.
{DAYl
, 19~{testGte leoving a last will, copy of which is heret~ attached.,}
~YEA.R) M~
Decedent died
16
Newton C. Taylor. Esq.
300 Penn Street. Huntinqdon. PA
"
16652
That as such deponent is familiar with the affairs of said estate and the property constituting
I EXECUTO~:81lK1K{x,NKXOGK
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BA.NK OR OTHER INSTiTUTION
IN WHICH DECEDENT 'RENTED A SAF'E DEPOSIT BOX
Dauphin Deposit Bank & Trust Co.
West Shore Plaza
Lemoyne. PA
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
Jan
G Hiller or
r.
Granddau-hter
That the contents of said safe deposit box or boxes are itemized
with the exception',of the following, for the reasons hereinafter set forth:
under Schedules B
NONE
& E of this return,
That Scheclule 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 hook 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 Scheclule 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 d,eath; 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 dep~t,-;a~ings
banks, trust companies, or other institutions, whether individually, or in trust for any other perso; or persons).
giving also separately the accrued interest thereon, if any, down to the last interest day p~il1JT to de~eaint's/';.
death in the case of savings banks, and to the date of decedent's death in all other case~; all bonds, p~st;J
savings, treasury certificates or notes and other evidence of in4ebtedness of the United States to the.de.
cedent; all obligations, whether by statute or agreement they are designated as tax free, of the~Unit~d States'~
or any state, or political subdiVision thereof, or of any foreign country, which are owned at,the'tiJ!le of death;
all wearing apparel, jewelry. silverware, pictures, books, works of art. household furniture,""borse~,""carr'ia:ges,;-
automobiles, boats, and any and all other personal chattels of whatsoever, kind or nature, left by deced~~t,
together with the fairly.;estimated market value thereof; all bonds and mortgages held by decedent ~arid:Of all
claims due and owing decedent at the time of death, and all promissory notes or otherjnstruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature', with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair'market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to ~ach item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endow~ent contracts
th~ 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.
,
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 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 or said co-partnership or husiness.
A copy of the co-partnership agreement, (ir oral, a statement setting f'orth the nature or the agreement)
together with a statement setting f'orth 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
thereln 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 rorth a true answer to each inquiry
conta:t.ned therein and in the case or transf'ers of property, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to take efrect 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 transrers. In the case of transfers intended to
take I:!frect in possession or enjoyment at or arter death, there is also attached to the schedule a cO'PY
of the deed, trust agreement 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 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 u 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 for life under rlecedent's Will. It also
contains a statement showing which of the benericiaries named in the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, 8I1d the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instruments effecting the 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 expendeJ for burial trusts, tombstones or gravemarkers, and reli-
giomi services, in consequence of the death of the decedent; debts and claims owing arut lmpaid at time of
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the wmount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this
~
................. ........ ../? day of
;;;Jz.,/~.~~;;f~~~~..._~
.;!.Q:p...~1Jp.t~i.'l_.B;2i:!&L.._.._..;UQQA...Market St.
( Street Numb...)
fu'l~~t.,...V.A....;?~Q.122...........~..J!ill.,....rA.17011
(Citv or Toum 4M State)
NOTE: Before signing affidavit make sure all blank spaces in the afridavit and schedules annexed are
filled In with details or the word "Hone", 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
datil and statements requlrerl 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.
.t;EL
....19....1.8.
Q.ERK 01' Oi1PILlNS COURT
~ ~rpire. JaAOU'1 7. 19~-,
i ;;
. RC C-34 (4_' 3)
tOMt.lOtlWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUtlTY 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 another or other, should be identified
as to quantum of interest ond 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 real property located In the Commonwealth of Pennsylvania !iihould be
described by lot and block number. .treet and str6et number, together with
a general description of the property, with a reference to the record of the
con"eyan~e by wh\c" *,e decedant took title; 'I a form state number of a.
cres; also statement of mortgage encumbrances upon eClch parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, ate.,are
to be 115ted~ Schedule "FtI and must not be d_educted from this schedule.
~ that certain tract or parcel of land .
situate in Lower Allen Township, Cumberland
County, Pa., more particularly bounded and
described as follows:
(1)
(2)
(3\
DEPARTMENT
VALUA TION
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
OECEDEHT1S
DEATH
ESTIMATED
MARKET VALUE
BEGINNING at a point on the Southerly line 0
Kent Drive, which point is six hundred
thirty-fiv~ (635) feet East of the East end
of the arc connecting Kent Drive and Letch-
worth Drive; thence along the same South
thirty-six (36) degrees thirty (30) minutes
East one hundred twenty-one and sixty-four
hundredths (121.64) feet to a point on the
Northwesterly line of Lot No. 28 on said
Plan; thence along the same South twenty-
eight (28) degrees twelve (12) minutes West
sixty-six and thirty-six hundredths (66.36)
feet to a point on the Easterly line of Lot
No. 3 on said Plan; thence along the same
North thirty-six (36) degrees thirty (30)
minutes West one hundred fifty (150) feet to
the point of beginning.
BEING Lot No.2, Block "D" on Plan No. 4 of
Highland Estates Development, which Plan is
recorded in the Cumberland County Recorder's
Office in Plan Book 4, page 79, and being
NO._~905 Kent Drive, Samp Hill, Pennsylvania
BEING the same premises which Dennis S.
Deibert and Anne B. Deibert, his wife, by
their deed dated August 21, 1969 and re-
corded on August 22, 1969 in the Recorder's
Office of Cumberland County in Deed Book I,
Volume 22, page 857, granted and conveyed
unto Jane G. Miller
(selling price)
29,500. 00 oi--""'"
'2,q,Soc,oo
1\~u .g~P<\I\-4/ ft 0 b @~,r
ASS Jj'L&o
.~
j]tli
)
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.
29,500.00 '2-"i IS 00 '00
,
. Rec -~Q
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "B"
PERSONAL PROPERTY
*\
RESIDENT DECEDENT
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time o~ his deatlli Property owned by the decedent jointly with another or others
must be listed under Schedule "En. Intangible personal property, titled 1n the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, househo~d
goods, and -furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salar~es or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
estate of or income erom any property held in trust under the will or agreement of another, even though
located outside of the State~ at the time of death, should be listed in this schedule.
Item
No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
DEPARTMENT VALUATION
(Do not write in
this space)
',3o<:>'o~
ITEM UNIT
List and describe fUlly VALUE
ESTIMATED
MARKFr VALUE
197.t.. Plymouth Scamp sedan
CCNB Certificate of Deposit No. 4038,
dated 1/24/73, 5 3/4%
Interest from 1/24/78 - 4/16/78
Dauphin Deposit Bank & Trust Co. Certifi-
cate of Deposit No. 57-2679 dated 5/15/7
6%
Interest from 2/15/78 - 4/16/78
Checking acct. no. 60-54 904 1, Dauphin
Deposit Bank & Trust Co. ~
Savings acct. no. 13-1-0320-2, Dauphin
Deposit Bank & Trust co. (includes
interest to date of death)
Furniture and household goods as follows:
Sofa and chair
Floor lamp
Zenith T.V.
Coffee table
Brown marble top table
Rocker
Green recliner
Two (2) lamp tables
Foot stool
Brass table lamp
Pictures
47" table, four (4) maple chairs
Single chair
AM & FM radio
Knickknack shelf
Westinghouse refrigerator
Miscellaneous dishes
Three (3) odd dishes
Miscellaneous pots and pans
Pantry. miscellaneous items
Three (3) pieces of Corningware
Frying pan
Four (4) pc. bedroom suit
Chair
Oak table
Telephone table
Four (4) pc. maple bedroom suit
Bedroom chair
Night stand
Sewing machine
piano stool
Old upright piano
Clock
Miscellaneous dishes
Rogers silverware
Two (2) card tables
Ironing board
1,000.00
14.38
125. OO.~ .
6.00"/
25.00~......
15.00 /'
50.00
35.00 ;:
5.00 ........
30.00'
/'
3. DO... /
4.00"-
8.00
65.00
6.00 ~
9.00.1 ,
8.00
90.00
5.00
10.00
3.00
5.00
8.00
1. 00
60.00
1. 00
1. 00
1. 00
80.00
4.00
3.00
10.00 ~
10.00 r
25.00 r?
50.00 ;';
It ~~ ~/
.50 '{
x x
Insert this total opposite "Personal Property", Schedule ftBft in
the "As Reported" colWJD1 on the last page of this return.
8,601.12
~,oOO'OO
\'-'-.3'2>
S, 000. () 0
So .00
?-'-l'2>.'OO
\ "2-'5.0->
10.00
""2'5.00
lS.oo
S<>."",
3'5.00
'S _0 C>
'3> 0.00
;'.0'"
'-t.o c:>
<3.0 .::>
<';'S.oo
lo .00
"t,o-'"
<&.00
'1.0.0<'>
S.oo
I..D ,0 0
310Q
S.o':>
e.. 0":>
l\ 0 v
(00.00
\. I..:) Co
,\ ~ v
(,0":>
ceo.co
<...\c.oo
3.<> c>
to .0'::>
\"0.0":>
"2.5.00
So .0 0
<...\c.oo
\0.0<>
5' ,00
, 50
re, 100 ~.l L-
... ReC-3D
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
(CONTINUED)
SCHEDULE "B"
PERSONAL PROPERTY
*
RESIDENT DECEDENT
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 1n the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certU'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 1n said capacity, partnership interests, interest in anyundistributed
estate or or income from any property held 1n trust under the will or agreement or another, even though
located outside of the State, at the time or death, should be listed in this schedule.
/
..-.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. Lis t and describe fully VALUE MA!\KE.T VALUE (Do not write in
this space)
45. Chair no value N -,-J..
46. Clothes tree no value N .--'-
.
.
Insert this total opposite "Personal Property", Schedule "Bit in X X 8,601.12
the nAs Reported" colWlDl on the las t page or thl's return.
RCC-3o
*~
COMMONWEALTH OF PENNSYlNANIA
TRANS}~R INHERITANCE TAX
SCHEDULE "C"
T RA,'; S FEllS
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) Yes
(2) Did decedent, wi thin two years of death, transfer property from himself to himself and another or
others (tnclUfUng a spouse) in joint ownership? (Answer yes or no) ]}To
(3) If the answer to (1) or (2) above Is In the af'firmative state:
(a) Age of' decedent at time of transfer 80
(b) State of decedent's health at time of making the transfer. (Note 1). Poor
(c) Cause of decedent's death. (Note 1). Heart attack caused by severe intestinal problems.
(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)--l[0~
(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?
(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) MO
(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
(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 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 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) No
NOTE 1: The answers to these questions should be sup~orted by arfidavit 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 f'orth below a description of the property
transferred, it's 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 is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
MAIlKET VALUE
(Es tlma ted)
DEPT. VALUATION
(Dept. Only)
DESCRIPTION
Cash gift to Timothy Myers made April 11,
1978
1,000.00 /I..,() () 0.00
Insert this total opposite "TranSfers", Schedule .e. in the
"As Reported" column on the last page of this return.
l\ooo.o\)
1,000.00
.
-."
. .", "'-. l. "'.
Ciin\b~rland CountY',PennsY1.v9-Ilia; my post office' .addressbei,ng 1905
~,' ". ..,' ..~" ' ..'..... <.," '." . ." ., .' \.;.:~~.",
} . '. 'r.' . _ . . ~ , ,"r '.
't<ent-DriV"~!, Camp Hill, l?enii~y1yania,. being of 'S9~d 'mind, memory and
;. j- ,'''''-'\":::.: ,< ;.~l't ", .,,':/....:;'~.<~.\. ~.':... ",;' .'." ",'>..1.. ," '. ,1 :'.',' ",
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.,;.due'oriOlily 'e~tire,'~st'a,t~ ,!;l~;paid'.iDut. of"tl\e ,resi'dug, of"'my" estate, as
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COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT .
,
SCHEDULE "D"
BENEFI CrARIES
.,.'
,
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BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
.S tate full names. and address-es of all who illegitimate" children DECEDENT OF BENEFICIARY
aveo an interest, vested, contingent or other are involved, set STATE YES IN ESTATE
wise,::in estate) forth this facLl OR NO BIRTH -
Barbara Tracy ,
Haymarket, . VA - qrariddauqhte yes adult. 35% of residue
Timothy. MyerS -"" .' . .
. - - .'
Camp Hill, PA grandson yes adult 35% of residue
Karl Myers
Camp Hill, PA grandson yes adult 10% of residue
Scott Myers
I
Camp Hill, PA arandson yes adult 10% of residue
Robert Myers
Camp Hill, PA grandson yes 3/3/61 10% of residue
,
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Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
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Personal Property
Transfers
.J"t....l?rOp~rty
SUMMARY
. (Sch. "A")
..............(SCh. "B")
(Sch. "C")
.. .. .... ... . . .... . ...... .......(Scb.E)
(1)
(As Reported)
$.. ..29,509.00
$ .....a.I:iOl.J2
$ 1,000.00
$ 2.528.00.
$
$H.1:i29.J2
(2)
( As Detcrmincd)
Gross Taxable Estate.
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RCC.3e.
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schenule must disclose all property, real and personal, owned by the rtecedent jointly
with a.not.her or otl~, 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 lmder Schedule
"A", plus the date and place of record of instrument effecting vestlture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Description of Property, Date of AcqUis.:i.tlqn, Name
Address and Relationship of Co-O~nets, and Place
of Recorn of Instrument where Real Estate.
~~~~
Unit
Value
percentage Estate
Share Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
I n This Space.
Value of Value of
Entire Decedent's
___property Inter.es.t
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~Phin Deposit Bank & Trust Co.
Certificate of Deposit No. 55-2674,
dated 8/5/74, 5 3/4%, one year, in
the name of Jane G. Miller or Barbara
Tracy
\
56.001
1/2 2,500.od/ 2,500.0 '"
1/
, 1/2 L.. '6 .0 0
i 28.09
I
5,000.00
Interest from 2/5/78 - 4/16/78
.
Insert
in the
this to tal opposite "Join tly Owned Property", Schedule "En
2,528.0
"As Reported" colunm on the last page of' this return.
'2- ,5'-8 ,DO
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RCC-39 (5--661
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX SUMMARY
RESIDENT DECEDENT
Estate of MILLER. ,lANE G. DATE OF DEATH 4/16/78 FILENO. 21-78-217
(Last Name) (First Name) (Initial)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumber] ann ,
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Dated:
INHERITANCE TAX APPRAISER
- -
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for Cumberland County, Pennsylvania, do respect-
fully report that 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 "F", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:
REGISTER OF WILLS
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
Real Property (Schedule A) $ $ $
Personal Property (Schedule B) 8 60.', , ')
Transfers (Schedule C) 1 000 00
Jnint-Held Property (Schedule E) ? 528 00
TOTAL GROSS ASSETS 41,629 12
Less Debts and Deductions
(SCHEDULE FI
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities. . . . . . . . . . . . . . . . . . . $ t= 1== t=
ESTATE TAX ASSESSMENTS $
FOR USE OF REGISTER ONLY COMPUTATION OF TAX
Tax on $ 2% $
Tax on $ 6% $
Tax on $ 5% $ .
Tax on $ - 10% $
Tax on $ 15% $
Exemptions 0 (0) As evidenced by Charitable
Total Estate Exemption Certificates issued
TOTAL TAX $ by the Secretary of Revenue.
Less tax previously paid $ 1=
BALANCE $
Less 5% of tax if paid within
3 months after death $
BALANCE OF INHERITANCE TAX DUE $ t=
Add interest at rate of 6% from
to $
AMOUNT OF ESTATE TAX ASSESSED $ C
Estate tax paid $ L
BALANCE DUE $
Add interest at rate of 6% from t=
to $
TOTAL TAX BALANCE $
PAID $
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.
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COMMONWEAL TH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Barbara Tracey
2017 Mountain Rd.
Hay Market. Virginia 22069
(Executor or Administrator)
In Re: Estate af
Jane G. Miller
CllIDberland
Caunty - File Na.
21-78-0217
Dear
You are hereby notified that the Original
appraisement in the estate af Jane G. Miller
has b"en filed in the affice af the ReJ1jster of Wills of CllIDberland . .
County on 25. January ,19~, Said appraisement reflects the following
valuations:
.
"
Real Estate
Personal Property
Transfers
Jointly Owned
Total
29,500.00
8,601.12
1,000.00
2,528..0U
41,629.12
As to such tal< that is paid within three months from date af death, a five (5%)
percent discount is allowable. As to any tal< that remains unpaid after nine (9) months
(fifteen manths when death occurred from December 22,1965 to June 16, 1971, inclusive;
and twelve months when death occurred priar to December 22, 1965) from date of death,
interest at the rate of sil< (6%) percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within
si><ly days after receipt af said notice os pravided by Section 1001 af the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373.
25 January 79 \. ~ C. r~ ~
Date Signed ~ \.. '-"-"'d'--"''-''
Title
~dministrative Offieer
, ...-----
t~
Note: This is not a bill.
RCC-2 (2-64) D\-"2.5-1 <t
. . .
. COMMONWEALTH OF PENNSYLVANIA DATE
.. ~- .. ----. ,
'D(~ARTMENT OF RI,VENUE RESIDENT INHERITANCE TAX COUNTY~
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127 APPRAISEMENT FILE NO. L- l I '2, -OL..-lI
Whereas, <)~ G:,. f'v\. l'~ late of L, a J OD "II "'6' .
in the County of . C~,.v-., 0 . ,Q Commonwealth of Pennsylvania, having died on
the \ <O-l~ . ~ 19 -r \1, seized and possessed of an estate
day of
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, L"...." ~(. ~ . an appraiser duly appointed according to law,
having been designated to make a fair a 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 expressly reserves the right to appraise and assess tra.nsfer
Inheritance taxes at the lawful collateral rate on any such future Interest.
Unit Appral&emllnt
Dncrlptlon of Auet. Values Made for Inheritance
Tax PurpOIe&
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Having been duly sworn according to law, I do hereby certify t3t the above appraisement is made in con-
formity with law 011 this '2. C; day of '.~ 19~.
L...e....:, ~~ ,
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