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HomeMy WebLinkAbout06-08-78 . _ ~11. _ _~C.S3 (4.73)' ." ~,' . . i .... COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS I JUN .8 1978 SUPPLEMENTAL COUNTY OF CUMBERLAND I RESIDENT DECEDENT IMPDRTANT: This return must be completed in detail and Ifiled 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'ltenue. (Section 703 df the Inheritance and Estate Tax Act of 1961.) I ARCHIE F. BURK (STATE FULL NAME OF DECEDENT) J,,} EXECUllOR IX IN THE MATTER OF THE ESTATE OF AFFIDAVIT OF SUPPLEMENTAL Lote of CUMBERLAND ADMINISTRATOR Stote of PF.NNSVT.VANTA } ss: Administrator CUMBERLAND DOROTHY McDOWELL Execuj))r ix County of of the estate of the above-named decedent11being duly sworn, depose and -soy : January 8 19 78 { .. } , _ testate leaVing a lost will, copy of which IS hereto attached. lMONTHl {DAY} (YEARl ~~ Name and address or' attorney or } Thomas I. IMye-rS, Myers, Myers, other authorized representative to whom I all corrupondence should be mailed. P. O. Box 125," Lemoyne, Pennsylvania 17043 Th h Executrix d I f .1. . h h ff. f.d d h . . at as suc . eponent IS ami lar Wit t e aalfs 0 sal estate an t e property constltutlOg (EXECUTOR-ADMINISTRA'TOR) I 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 individu~l name, with right of access by" another as agent or deputy, with the exception of the following: - Decedent died Flower & Johnson NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR,NAMES OF HOLDERS TO DECEDENT n;::anphil1 Of> pr", i t Rank " Trnst Co. , ~~ 301 Market Street F M.-.Dowe11 Dauahter Lemoyne. pennsv1vania 17043 That the contents of said safe deposit box or boxes are itemized under Schedules of this return, with the exception.of the following, for the reasonsl hereinafter set forth: That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property in the Commonwealth of Pennsylvania of which debedent died having an interest therein. It also sets forth the mortgage encumbrances upon eacti parcel of real ~rop~rty at the date of death, giving the amount still due at death, name of mortgagee, date, rate of interest, dnd book and page of record thereof. It also sets forth in the columns provided therefore the assessed valuationl of each of said parcels, the estimated market value thereof as of date of death of decedent. I That Schedule B attached hereto and made jart hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at theltime of death;. 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 deposit, savings banks, trust companies, or other institutions, whe~her individually, or in trust for any other person or persons I . :>.."....~.A.IJ giving also separately the accrued interest thereon, if any, down to the last interest day prim! to~de-c~dent's I~~..J~~ I ....'" . " <', death in the case of savings banks, and to the date of decedent's death in all other cases; all."b'onds,~postal ......... savi~gs, treas~y ~ertificates or notes and otherl evidence of indeb~dness of the United St~~~. to the de- l'.;. cedent; all obltgatlOns, whether by statute or agreement they are deSignated as tax free, of the"Umted States, or any state, or political subdivision thereof, or df any foreign country, which are owned at th~ time of death; all wea~ing apparel, jewelry, silverware, Pictures,j books, works of art, househ~ld furniture, ho;t~s( c;:_~rriage~, ~.~. automobiles, boats, and any and all other personal chattels of whatsoever. kmd or nature, left'.by dece~ent;.." together with the fairly. estimated market value ttlereof;" all bonds and mortgages held by decede~han"d~of'~1I ,," claims due and owing decedent at the time of delth, and all promissory notes or other"instruments i<~lwritin'g"'~' I . for the payment of money of which decedent diedpos,sessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair mar~et value thereof, and if such estimated fair-market value be less than the face value, it sets forth briefly th~ reasons for such depreciation as to each item; all moneys payable to the estate from life insurance policieJ carried by decedent; all annuity and endowment contracts I the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends I . 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 th~ 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 8.S 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 of said co-partnership or Qusiness. A copy of the co-partnership agreement, (if oral, a statement setting rorth 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 f'orth 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 fn.cts 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 agrp.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 decedent's death by virtue of the exercise by decedent, either indiVidually, or jointly wi th another, or any power of appoint- ment vested In decedent, ei ther individually or jointly, by the w111, 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 fort.h the names ann addresses of' all persons benHficially interested in this estate at the time of decedene s death, the nature of their res- pective int.erests, their relationship, if' any, to the decedent, together with the ages at the time of decedent's d.eath of" all minors, annuitants and beneficiaries for life under decedent's Will. It also contains a statement showing which of the benef'iciaries 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 S~hedule E attached hereto and made a part hereof sets f"orth 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 deceden t. That Sc/'ledule F attached hereto and made a part hereof" sets forth fully and in detail all debts and deductions claimed f'or and on behalf of this decedent's estate, including runeral expenses paid; f"amilyexemption, where applicable; costs of" administration of this estate; counsel fees and fUdiciary's commissions paid or to be paid; cost expended f'or burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of" the death of" the decedent; debts and claims owing anrl unpa1rl at time of death; taxes accrued chargeable f"or period prior to decedent's death (except those allowed under Section 6~1 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged f'or obliga- tions, if uny. It is agreed that the f'iduciary wl11 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 Ilmount 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", "B", "e", liE", and "F" as directed therein, have been c:arried f'orward and properly registered in the Sunnary. Subscribed and sworn to before me this ... 1'" ...............~....... .... day of . ....19..l..t:. ..~~~~~ Dorothy~~~ell, Executr~x ...4705...N~..Nt&i/llj.y1:eW....Drtve-._. .......c:1l,IIIP.....I;I.,i,!.!..f......R'3..~I.J:.!;;y!.y..~:I.J:,i,.c:I.....!?.g.!.!.. (City .... TOtDft And St4te) ..~. ................O.....~.'-.."~ .. NO,AHY pu'Bn2 ~ 11 _om:.l1is:iion E..r.oir-.:;; Dec. 21, 1981 .u {a"', t.. ....... L .....:..;.,.-1 Co'~l1t.,. NOTE: Before signing af'fidavit make sure all blank spaces in the af"f'idavit and schedules annexed are f"illed in with details or the word IINone", 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 st.atements requirerl under the paragraph above relating to Schedule "BII are attached. Also make certain th~t column #1 in the "Summary" has been properly cQmpleted as above-directed. >iRCC"",""l; ..-=;# ~ .~... RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY , '* CO~WONWEALTH 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. Pr~perty owned by the decedent jointly with another or others must be li&ted under Schedule "E". 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, autompbl1es, boats, etc.) Intangible personal property, such a~ bonds, treasury certificates, 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 capac~ty, partnership interests, interest in any undis tributed estate of or income from any property held in ~rust under the will or agreement of another, even though located outside of the State, at the time of dkath, should be listed 1n this schedule. , '~ Item ITEM UNIT EST! MATED DEPARTMENT VALUATION No. List and describe fully I VALUE lIARKIIT VALUE (Do not write in this space) 1. Grandfather Clock / (purchased new - 1943) 500.00' 500.00 2. Cherry Wood Chest of drawers (plain) lOO.OO~ / 100.00 3. Pennsylvania Railroad Voluntary / Relief Benefit 2,253.60 t 2,253.60 , , I I I I : , , , 2,853.60. 2,853.60 Insert this total opposite npersonal Property", Sch~dule "B" in X X the "As Reported" colwnn on the last page of' thts r:eturn. ~?- .......n: I I I , I COMMONWEALTH OF PENNSYLVANIA DEPARtMENT OF REVENUE , BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 IN YOUR REPLY PLEASE REFER TO RCC-81 [6-73) In Re: I NOTICE OF FILJNG or APPRAISEMENT VoJip.thy McVoweU 47015 N. c.eea/l.v-i.ew VlLive Camp Hili, Pa.. 17011 (Exec~tor or Administrator) Jch-i.e F. BWLk I . Cumb,eJr1.and County - Fde No. Inheritonce Tax Division Estate of 21~78-0028 . Deor M6.. McVoweU, You are hereby notified t~ot theSttppeemen.tal opproisement in the estote of M.ch-i.e. F. BU1l.k hos been filed in the office of the Register of Wi lis of CumbeJr1.a.nd County on June 19. , 1:9~, Soid opproisement reflects the following valuotions: Reol Estate None Personal ~roperty 2.853.60 Transfers I None Jointly Owhed None Total I $ 2.853.60 As to such tox that is pai~ within three months from date of death, a five (5%) percent discount is allowable. As Ito any tax that remains unpaid after nine (9) months (fifteen months when death occurreH from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death ocdrred prior to December 22, 1965) from date of death, interest at the rate of six (6%) perdent per annum is charged. Any porty in interest whJis aggrieved by this notice may obiect thereto within sixty days after receipt of said not'ice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2i85.1001, P. L. 37~ .' Date June 19. 1978 , Signed i':bo.&(- j(, A~ Title CHIEF APPRAISER tr-- - Note: This is not a bi II. RCC-212-64) I I I COMMONW~ALTH OF PENNSYLVANIA I RESIDENT INHERITANCE TAX I APPRAISEMENT I DATE June 19. 1978 .............. ?-DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COUNTY CumboJ1Pn~d FILENO. 21-78-0028 I MdUe F. BWzk ; in the County of CumbeJLta.nd I Commonwealth of Pennsylvania, having died on I the 8th day of Ja.nUiVl.Y 19R, seized and possessed of an estate subject to Inheritance Tax under the la,:,s of thell Commonwealth of Pennsylvania; Therefore, I, IJul K. Gtum , an appraiser duly appointed according to law, having been designated to make a. fair and coAscionable appraisement of the said estate, and to assess and fix . I , the cash value of all annuities and life estates g~owing out of said estate, hereby file the following appraisement: In the event that any future interest In this estate iSI transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Comrrtonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any suchlfuture interest. Whereas, late of Canno H.iU. i I I Unit Appraisement Ducrlption of Anet Value. Made for Inheritance Tall "Purgoaes I Ron,P pJtoneJr.;t1l I $ None I peJL6 0 na..e. PJtO rJeJr.;tU ! 2,853 60 Jo.{.1'I.t Held pJtOprvr.:tu None T 1l.an<\ I. eJL6 None TOTAL ASSETS $ 2 853 60 , . . , " ~ .~ ~ " , . , " .,... . . . . . . . I I I I I I I I I I , I , I I I I Having been duly swo.rn according to law, I: do hereby certify that the above appraisement is made in con- formity with law on this ; ') ..' 19th day of JUne ~ .)fA . 19LL-. }('~ ~~ Appraiser H J. ~mber and Street) aJVlM U/tq , Penna, (PolIt Offlee) .. z i '" ~ f ... .. " \ ~ '" ~ ~ '" '" III '0 ~ '" to ~ ~ ~ t:i "i =:::: " " " i "i '"'"' "" !E " c::> " " .. ~ ~ ,:7 '''' ...... i: ~ ] ,,; ffi ~ ~ ... " <; " ... "" If:, "" "l: 1 ::" 0 ,,; =e i " ... 'l;; S a " ., .. ... " .. ~ "" "t "" - " ~ .,. .. 1 ., ] " " . Q ~ .,. " " i! "" " " .~ Q ... ~ " " <; D::: c:::. '\: ~ .. "" " '!i i! " ~ C4 " " ~ ;;; .., ,. " 0- .. ... * t>:: t ,,; ~ ~ '" '~ "" '" .. .. "" '"- C4 0- " ~ ..:) ~.' . .......