HomeMy WebLinkAbout02-03-78
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.R,SC-S3 (iI-73)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
FE B 0 3
RESIDENT DECEDENT
COUNTY OF
CUMBE RLAi'lD
IMPORTANT:
This return must be completed in detail and filed in duplicate,. with all attached, with the Reg"ister 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 R~ltenue. (Section 703 of the Inheritance and .E;stat~_ Ta~ Act of 1961.)
County of
Cumberland
,..3
} 50',
AFFIDAViT OF
IN THE MATTER OF THE ESTATE OF
G. HAROLD GILBERT
(STATE FULL NAME OF DECEDENTI
EXECUTMX
Lote of
Cumberland
MJml'i'IKCIIllXIiIll{
Stote of
Pennsylvania
>IlllIiKMiXlXiKllf
DOROTHY G..STEffi~ER.
of the estate of the above-named decedent being duly Ilworn, depouS
Executor ix
.and eayS
Decedent died December 10.
(MONTH)
Nome and oddre.lls of. attorney or }
other authorized representative to whom
all eorrespondcnee should be mailed.
(DAY)
., 19:rL-{'.."'o leaYI~. .I..~ will. ;Opy of whl~h I. h....'o .''''hOd..}
lYEARl M~
Gp.orae Ma Honckr -Arr.nrnpy-:::t+--T,;nvl'
National Bank Bllilding. MP,",hrmi,","'hllrg, P".. 170<;<;
That as .such Executrix, deponent is familiar with the affairs of said estate and the property constituting
i EXECUTOR~ADMINISTRA TORI
the assets 'thereof and th~ir fair market value.
That at the time of death there was no safe deposit box registered in.dec.ed~nt's individuaL name, or jointly with, or
as agent or deputy of an'other, or in decedent's individual name, with right.of access.by'another as agtmt or deputy. with. the
exception of the following: -
NAME AND AI?DRESS OF. BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT, BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A S....FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
,
NONE' 1,lf'~m
That the contents of said ~afe deposit box ~r boxes are itemized under'Schedules
wi th the exception' of the following, for the reasons hereinafter set forth: .
of this return,
., < . ',. '. q
That Schedule A attached hereto and made part hereof sets forth' fully' and in detail a\l the real property
in the Commonwealth of P.ennsyl~ania of which decedent died having an interesttherein. It also sets forth the
mortgage encumbrances upon each parcel of real property at th~ . date of death, giving the amount still due at
..' ....
death. name of mortgagee, date,.rate of interest, and boo~ and page of record thereof. I~.a(so sets forth in the
columns provided therefQre the assessed 'valuation of each of. sa~d parcels,' the ~stim'at~d 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; all moneys left by the decedent at the time of
death, whether in decedent's immediate pos ses sion, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust f9r any other perso!1. ?f,perSons
giving also separately the accrued interest thereon, if any, down to the' last interest 'day prior to:'decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; alf ,,;Ods, postl.ll
savings, treasury certificates or notes 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 .tliAe time of death;
an wearing apparel, jewelry, silverware, pictures. books, works of art, household furniture, hor~es', 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 decedint and'of all."
claims due and owip.g deceden~ at the time of dea.th, and all promis sory note"~ 'or other".instr'uments' i~ writing
for the payment of money of which'decedent died possessed, of whatsoever nature; with interest thereon, if
any, giving the fa<;:e value and estimated fair market va~ue' thereof, an,~. if"such' estimated fair'm.arke!'v~)ue be
less than the face value, it sets forth briefly the reasons for such deprepiat~on as to ea.ch .~te'!l; all mone~s
payable to the estate from life insurance policies carried by decedent; ali annuity and endowm'ent 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 of death. bonds and accrued interes t 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.
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In the case or securities of close or family corporations, the values reported are as far as
poslible 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 busine.s, and in support of the value of such interest there is annexed to
said schedule, financial statements showing the assetl 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 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 rorm, together with the fair market value
thereOf, any other property owned or bequeathed by the decedent at the time of death. .
The Sch,dul. 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's
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 or transrers 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 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 pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, orjointly 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 Sch.dul. 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 or 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 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 beneficiary.
That Sch.du/. 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 erfecting the vestiture or
real estate and the date of acquisition of personalty, plus the name, address and relationship, if any,
of co-owners to the deceden t.
That Sch.dul. F attached hereto and made a part hereor sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid;
ramilyexemption, 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 1mpaid at time or
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
63101' 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 amount of tax assessed can be reassessed in accordance therewit~
That the totals of the appropriate columns in Schedules .A., W8-, we., .E., and -F- as directed therein,
have been carried forward and properly registered in the Summary.
Subsen1led and sworn to before me this
..~~-:4i;;;:C~c'utrIx
....ll.8..7....Kin.g.s.l~._.l~&ad.._....................__.__.
(Stren Numb...)
CcgnpJIg!l..}:>.~!1!l:~y':J,y.~i.':l:!}'?9..!l
(CitJI or Tow" 11M St4te)
........_.._.._....zZ/.tL. ... ...... day of.J.a.nua.;r::y,........ 19.I!L..
.........m.... ......,./,:'Z';;:...r.,:t".l::.D...,;...
, NG:~,~\i F,-!;UC
~~y Cljf,1;:rl:'" 'J' '-~ ,.^" i,' ~^,t 11, ]')7
^1(:(.;haiJ.l..:.-LlJll-;, ['ii. GC'.~:::'!...:liJ CJL;',ty
NOTE: Before signing affidavit make sure all blank spaces In the affidavit and schedules annexed are
filled in with details or the word wNone-, and in case the assets include rare and unlisted securities,
securities of close or ramily corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "8" are attached. Also make
certain that column #1 in the .S\llI'Inary. has been properly completed as above-dJ.rected.
"
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RC~34 (4-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT-
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylyonio, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent os tenont)n common with ono'ther or other, should be identified
os to quantum of interest and the estimated yolue should be that of the decedent's interest only. (Property
held os joint tenants with right of suryiorship or tenancy by entireties should be reported on Schedule "E.")
The real property located In the Commonwealth of Pennsylvania should be
described by lot and block number, street and street number, together with
a general description of the property, with a reforence to the record of the
conveyance by which the decedent took title; If 0 farm state number of a.
eres; also statement of mortgage eneumbrances upon each parcel at death
of decedent. Taxes, a.sessment., accrued Interest on mortgages, ote.,ore
to be listed on Schedule IlF" and must nofbe d~ducted from this schedl.lle.
(1)
(2)
(3)
DEPARTMENT
VALUA TION
CAUTION
(Do not write
In this spoce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ES TIMA TE D
MARKET VALUE
NONE
NONE
NONE
I
.
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
NONE
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. RCC-35
RESIDENT DECEDENT
SCHEDULE "B"
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 wi th another or others
must be listed under Schedule nE". 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 f'act that they are not of' the administered estate.
Tangible personal property should be listed f'irst (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 in any undistributed
estate of' or inco~e from any property held in trust under the will or agreemerit of' another, even though
located outside of' the State, at the time of' death, should be listed in this schedule.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
NO. List and describe fully VALUE MARKET VALUE (Do not write in
this space)
1- 1970 Lincoln l>lark III 2-door Coupe, k500.00
Manufacturer's No. OY89A850279: 1,500.00 ~
5':)\lH)
2. Household Goods (See attached Schedule) : aU . n ri:) 563.00
Insert this total opposite npersonal Property", Schedule "B" in X X Q,213.0.,g)
the nAs Reportedn colwrm on the las t page of this return. ~} 0(,,3. DO $2,063.00
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.RCC-36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFERS
*~
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 spo~se) in joint ownership? (Answer yes or no) No
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the transfer. (Note 1).
(c) Cause of decedent'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) 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? No
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which tran~feror 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 d~cedent
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 ye~ 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 alter, amend, or revoke, or which COllld 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 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, 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 prov~ded in Schedules A, B, or E.
ITEM
DESCRIPTION
!lARKET VALUE
(Es time ted)
DEPT. VALUATION
(Dept. Only)
NONE
NONE
NONE
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" colunm on the last page of this return.
NONE
.s.
RCC-37 (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
*....
!', ~
. FIt!,
:<l,.' .'(4.
BENEFICIARIES
(
h
BEN~FICIARlES AND ADDRESSES RELATIONSHIP . SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
a,e an .interest, vested. contingent or other are involved, set STATE YES IN. ESTATE
OR NO ., BIRTH
;wise, in estate) forth this fact.)
Dorothv G. Sterner, . n", .. va", Life Est"...o in ",....101
11Q7 u;~ . R...."" .-'l ~"''''o'''''' r. "'''~u;
r'amn Hi 11 vor intere"'t in ~oin
Pennsylvania 17011 ;,s.,o",,,
Deb,.." T.. S'"
f'\-F-F;~= !'\...." lI,C;;:;
R. n. lid
W""nesboro.
pennsvlvania. 1;.7268 Granddaurrhter Yes Remainder - .L
.
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t
Deponent further says that all the above-named beneCtclaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
. .
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02 Iil e
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SUMMARY
.. ..... ...................................(SCh. "A")
.......... ............ ...(Sch. "B")
.............. .......... .....(Sch. "C")
PJ:9PE!+t,y .. ........J139.l:J.,....~~~..J
Real Property ...
Personal Property
Transfers .. ...............
Jointly..~llecl..
Gross Taxable Estate .
(1 )
(As Reported)
$... No.ne
$ ...:1.,.:1)..3....0..0..
$ ...No.ne
$.~..e.,.na.s.~.
$....
$. ..J.O.,.9.41...5 .;!...
(2)
(As Determined)
$ None
$ 2,01>3.00
$ None
$ 38, ]:36.86
$
$ 40,799.86
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
PCI'E .
~U~' /'(ED
COUt'/",,' f.AU OF '
,J,I"I'I'
v, -e[r-',
D . ,wI ONs
EC ! ~ {
I ",'17 41.1 '71
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RCC-43 (4- 71)
NOTE: TO BE SUBMITTED IN TRIPLICATE
REPORTING FINANCIAL INSTITUTION
ADDRESS
Dauphin Deposit a,anl<, Jl. T1'lJst
,'2~3, ~1arket ,~t1'~t!lt
, HSl;'r.i f>tWl'g. Penn!!yl Van! a
ZIP CODE.,' .1'1,105
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
;,712S~;; a
NAMES ON ACCOUNT OR
INVESTMENT
13. Harald Mltiel.'t 131' "broth". G. Stetner
Dec8mbsS' 10, ,1977
DATE OF DEATH
DECEASED JOINT DEPOSITOR, TRUSTEE
OR INVESTOR
ADDRESS " 103 J4ay od, lie. Apt. 5
,Camp JiU]., ' Pa.
G. Harold Gllbp.l't "
COUNTY
ZIP CODE
17011
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR
Dorathv G. Btsrner
ADDRESS
SGme
~TIONSHIP TO DECEDENT
D~lIJ!1hte%'
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED
4-17-G7
BALANCE, INCLUDING INTEREST
DUE, AT DATE OF DEATH $
$2125.70 ~
~I~C<: J7~,f,,-
S' ~ature TITLE
JD Ann C. Sta~e~
ABeista~tMBnegBr
'Dapol!l1 tAectliJnt S9%'\11 Ces
~CC-3B
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must djsclose all property, real and personal, owned by the decedent jointly
wi th Rnother 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 lmder Schedule
"A", 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
Schedule "B", ]llus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Description of Property, Date of' Acquisi ti()n, Name
Address and Relationship of Co-Owners, and Place
of' Record of Instrument, where Real Estate.
Unit
Value
percentage
Share
Estate
Va.luation
:;o<>~&:)<
X>
xz
)<~9:3<
600.
6<':)<
X> ex
X>
0<:>&
>)x;x<
<X
DEPARTlIENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
All the following items were owned
by the Decedent jointly with his
daughter, Dorothy G. Sterner:
1. Checking Account, established ~
4-17-67, #37-12-323-8, Dauphin_(
Deposit Trust Company: $2,726.70
2. Savings Certificate #4-09-112623
Harris Savings Association, date~
Augus't' 16 , 1974, with sccrued
interest: $5,850.37vr
50%
1,363.3 ~
1,363.35
50%
2,925.1 /
2,925.19
3. Savings Certificate #409-117954,
Harris Savings Association,
dated November 6, 1975, with ~
accrued interest: $7,694.31'
50%
3, 847.1 /
3,847.16
4. Single-payment Savings Certifi-
cates, Class IX, State Capital
Savings & Loan Association, as
follows;
/1. /
#6543f;dated September 4, 197~~
/ '" $4,471.90... /
#7151'jdated December 20, 1974:/
I $15,028.15'
$9272, dated November 6, 1975, /' /
$5,850.37f
50% / , 2,235.95
2,235.95'
50% 7,~14'.08/ 7,514.08
50% 2,925.1 y""" 2,925.19
5. 1668 Shares Common Stock, Decatt~
Income Fund, Delaware Management
Company, r!~c:~~dated July 20,
1970, at~ ~9,573.~
//, '7lfJ fh9J./"1Dj ~(p
The following investment was in the
name of the Decedent, in Trust, for
his, daughter, Dorothy G. Sterner:
50%
9) 11 S;J ~
9,786.9 't 5"'10 ,M.
9,795.33
1108.468 Shares Common Stock, Unitec
Funds, Inc., United Bond Open Pur-
chase Account #08500480, dated May,
1972. Monthly checks on this accour.t
were issued to the Decedent. At
7.335: $8,130.61
100%
~'
8,130.61
8,130.61
Insert this total opposite "Jointly Owned Property~, Schedule "En
in the" As Reported" column on the last page of this return. 38,728. t:; 2
$38,736.86
<
RCC-81 (6~73l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Dorothy G. Sterner
1187 Kingsley Road-
Camp Hill, Fa. 17011
(Executor or Administrator)
In Re: Estate of
G. Harold Gilbert
Cumberland
County - Fi Ie No. 21-78-0011
Dear Mrs. Sterner:
You are hereby notified that the original
appraisement in the estate of G. Harold Gilbert
has been filed in the of/ice of the Register of Wills of Cumberland
County on February 14 , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
$ 2,063.00
None
$38,736.86
$40,799,86
As to such tax that is paid within three months from date of deoth, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death occurred from December 22, 1965 to June 16,1971, inclusive;
ond twelve months when deoth occurred prior to December 22, 1965) from dote of death,
interest at the rate of six (6%) percent per annum is chorged.
Any porty in interest who is oggrieved by this notice moy object thereto within
sixty doys after receipt 01 said notice as provided by Section 1001 01 the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373(\
Date February 14, 1978 Signed ~"" ~ Ie:. /1 h./~
Title Chief Appraiser
~--
Note: This is not a bill.
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R C C-2 l:Z.64.
- February 14, 1978
. . i. COMMONWEALTH OF PENNSYLVANIA DATE
DEPARTMENT OF REVENUE. RESIDENT INHERITANCE TAX COUNTY Cumberland
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127 APPRAISEMENT FILE NO. 21-78-0011
Whereas, G. Harold Gilbert late of Camp Hi 11
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 10th day of December 1912-, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Ira K. Gleim . an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in' this estate is transferred in possession or enjoyment to collateral heirs of the ,de.cedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Aporal$ement
OelcrlpUon 0' Anat Value. Made for InhClrltance
Tu f'urpo.u
REAL PROPERTY NONE $ NOM
PERSONAL PROPERTY $ 2,063.00 2,06 00
TRANSFERS NONE NONE
JOINT-HELD PROPERTY $38,736.86 . 38,73 86
TOTAL ESTATE $40,799.86 $40 , 79 86
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Having been duly SWonl accordin~ to law, I do hereby certify that the above appraisement is made in con-
formity with law on this 14t day of February ~ ~A 19~.
iJxtA_ k, ~
(N\lmber and Strttt)
Harrisburg
(Pat OtIIet)
Appraiser
, Penna,
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RCC'.42 (4-,,) ,
BANK NO.
COMMONWE"'~TH OF PENNSnV...N'...
DEP"'RTMENT OF REVENUE
CATE FILED
NOTICE OF DECEDENT ACCOUNT STATUS 6, 1978
anuary
Submit in truplicate wilhinlO days after knowledge of STATUS OF ,ACCOUNT NO: (JOINT, TRU~T. OR INVESTMENT
!he death. " " , " ' " , r '-'. ~, "~+-. .1.4,1 .,...........t..+. r.{i -..- ........1.,.1;.....
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, RETURN COMPI- ETED NAMES ON ACCOUNT SOCIAL SECURITY NUMeER(sJ
. FORMS TO LeX: AI-COUNTY' G.E. Gil'bert 203-10-2266
INH ERIT AN CE, TAX ,OFFICE Dorothy G'~ . sterner
, ' .,
.ci-.'<:'-.. "su RVIVIIlG'DEPOSITOR ,(aen.flcI...,) lIlF,ORM'" TlOIl'" .. - ..DECEDENT IIlFORM...TIOIl'
NAME RELATIONSHIP . NAME DATE OF DEATH
, Dorothy .9. ,Sterner'- To'oecEDENT. .,A.
.. Dauo:hter G.H. C4-1port .)ec. 10, 1977
ADDRESS ADDRESS
118?'KingoleyRoad' '" .. "
',' 103 Hay DriVe . ,
Camp .Hill, ,Pa... . 17011 . . .~. ..
CITY , '\,,', .' COUNTY
'. ., . .. . . .. , ., ~
Canp Hill ' ." w 'E...--......
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BANKIJNSTlTUTION !,OORESS-> , B",\...o.NCE. OF ,IloCeO\J~T ~T 000 $ ~ ~~
; . . $....' :-:.:; ~J
'. INTEREST ACCRUED AND COLLECTIBLE AT DOD ~O
~ ,<~
TQ..l'Al.
.-.-, ,'a"'NK 'AUTHORIZA TION
THE HARRIS SAVINGS ASSOCIATION I HE f;!:E BY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS A
P. O. BOX 171 1 205 PI NE ST. CORR.ECT REPRESENTATION_OF INFORMATION IN OU'R FIl.ES.IN ACCORD
HARRISBURG, PA. 17105 WITH SECT)ON 742 PI & E TAX ACT OF 1961.
SIGNATURE OF FINANCIAL INVESTIGATOR DATE
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RCC-42 (.77) , BANK NO.
COMMONWEALTH OF P~NN5YLVANIA
DEPARTMENT OF REVENUE
DATE- FILED
NOTICE OF DECEDENT ACCOUNT STATUS January 6, 1978
Submit in truplic.ate ",iihin 10 days ofter,knowledge of STATUS OF-ACCOUNT NO: (JOINT. TRUST, OR INVESTMENT
the death. ' '. ,.<, ........'-. Joint telO.':tntG \ofith rir:ht of Du.rvi vorDhi n
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. . NAMES ON ACCOUNT SOCIAL SECURITY NUMBER(S)
RETURN COMPL ETED
FORMS TO LOC ALCOUNTY G. H. Gilbert, 203-10-2266
. Dorothy.'G. Sterner
'INHmITANCE TAX OFFicE
. . .
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SURVIVilfG DEPOSITOR-(BeneflclClty}':ncfoRMAT.10N.- . >- . DECEDENT INFORMATION
NAME RELATIONSHIP NAME .: -;- /. >-< DATE OF DEATH
.UorothYl:<:i.. S~erner TO DECEOE::"NT,;" G.
.. " 'Daughter' H. Gilb~rt , .. Dec. la, 1977
ADDRESS " , , ,-, ADDRESS 'o, . ,
'1187' Kcings1ey"Road' .. '. .. ,. . 10,3 l:ay ,DriNe
. ,
Camp ',Hin, Pa'. "17011 .. " ..
CITY COU N TY
" .. -., " " ". Hill < 'Vwnocr1and
Ci1rnp ., ZIP CODE 17011
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BAN .K/I NS TI TU TI ON: A D ORE 55 " . " BALANCE QF ACCOUI"fTAT DaD $ 1...,.Ltc:.UY
. , INTEREST ACCRUED AND COLLECTIBL.E AT 000 $ ?'O2.::>2
TOJ.A.L $ ? 11':J~ ':,1
. THE HARRIS SAVINGS ASSOCIATlOi'I ,C<, :- BANK AUTHORIZA TION
tl'.O. BOX 1711 205 PI NE .S!. I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS A
CORR'ECT REPRESENTATION, OF INFORMATION IN OUR FIl.ES IN ACCORD
~&SBUa~,p~ ~~ wiTH SECTION 142 PI&; E TAX ACT OF 1961.
SIGNATURE OF/FINANCIAL INVESTlC:>ATOR DATE
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