HomeMy WebLinkAbout06-07-78
RCC- .3 ('-69)
APPLICATION FOR CHARIT ABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Ac' of May 28, 19S6, P.L. 17S7, ond Act of June lS, 1961,
P.L. 373, as amended)
*'
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECJIONS
Application is hereby filed lor the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on -the transfer o(the property
described below:
\
1. Bureau File # 21-78-0024
2. Dote 01 Deoth .TRn~~:, ]g78
3. Dote 01 Approval 7, Iff'?'!
4. Name of Oeceden t Ri"hRY'n E. Otto
5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ 1,000.00
(Note: Where the property is other than a" specified amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents Q sta~ed fractional or percentage portion of the entire estate- or the e~tire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has b~en prev"i"o"usl{fj,led.~ \.J
WILL u.;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
..'H.
(II ather, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
St. Paul's Evangelical Lutheran Church
ADDRESS
201 West Louther Street, Carlisle. PA 17013
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
~41:e~ ~
Signature 01 Applicant
)(
Address 01 Applicant Rn4 Ti'nll,.,th 'St,.,ppt _ l\Tp,^, r.1Imh"',.,1 <>nn, PJI 17n70
Richard E. OttoD
Official Title RYP('1It,.,;y of' the Rst~te of / ate
~/c?/?t9
x
This farm must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were issued for Q non_resident decedent's estate. If the decedent was a non...resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills, deliver all three copies fa the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po.
00 not write below this line = For Ollicial Use Only
Approved: For the Secretary of Revenue
Referred to Bureau Headquarters
Approved 0
For Secretary of Revtl'nue
Denied* 0
(Signature of Register of
RICHARD E. ~NornsoR4
R GISTER OF WIlLS 1
CUlVltltltl.i!\'iP \iUU\ : ,,j, I
(County
(Initials 01 Register of Wills)
(Authorized Signature)
't1(
(County)
(Title)
(Date of Relerral)
(Date of Action)
* See reverse side for reasons
MUST BE FILED IN TRIPLICATE
t;#.".,..,.,
_ This section will be completed by Bureau Headquarters only when the application for exemption has been denied.
Date:
The applicatian for exemption cantained on the face of this form has been denied because
Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after
the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.