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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RCC:.33 (4'.73)
RESIDENT DECEDENT
COUNTY OF Cumberland
IMPORT ANT:
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~enue, (Section 703 of the Inheritance and Estate Tax Act of 1961.)
late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
~JlS:I:H'XXROR
IN THE MATTER OF THE ESTATE OF
Harry F. McM~llan
(STATE FULL NAME OF DECEDENT)
County
County of
Cumberland
} 55:
State, 01
adroOKMllUQK
Richard McMullan.
of the estate of the above-named decedent being duly sworn, depose S
Executor
and soy S
Decedent died
7
(DAY)
, 19~J testate leaving a last will, copy of which is hereto attached. }
(YEAR) ~iltHl6H
.Tannary
(MONTH)
Name and address of attorney or }
other authorized repres,entative to whom
011 corres.pondence should be moiled.
Michael Johnston. Esquire
301 North Logan Boulevard, Burnham, Penna. 17009
That as such "RY<>C'l1tor deponent is familiar with the affairs of said estate and the property constituting
(EXECU TO R-ADMINI ST RA TO R)
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 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
NONE
That the contents of said safe deposit box or boxes are itemized under Schedules
wi th 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 detai I 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 book 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 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 session, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for any other person or 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; all bond8, postal
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 the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, 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 decedent and of all
claims due and owing decedent at the time of death, and all promis sory notes or other instruments 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 each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment 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 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.
FloC C~34 (4J,' 3)
COMMONWEAL. TH Or , ........., ,.,
DEP4.RTMENT OF REVENUE
BUREAU OF COUNTY COL.L.ECTIONS
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 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 ,eal property lacated In the Commanwealth of Pennsylvania 5hauld be
described by lat and black number, street and street number, tagether with
a general description of the property, with a reference to the record of the
conveyance by which the decedent took title; If a farm state number of a~
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are
ta be listed on Schedule "F" and must nat be deducted Iram this schedule,
(1)
(2)
13\
DEPARTMENT
VAL.UATION
CAUTION
(Do not writ.
in this space)
ASSESSED VAL.UE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VAL.UE
Lot No. 74 on a Plan of Lots known as
Louis Park, recorded in Cumberland County
Plat Book 5, Page 50, known as No. 74
Oliver Road, East Pennsboro Township,
Cumberland County. Subject to unrecorded
Articles of Agreement between deceased and
R. G. Hill Company, Inc. Sold to J.
Maurice Petty. Tax No. 00-002220.
$4,170.00
$27,500.00
~
2'1\ Soo ,DC
/.,l
" '. n
.
I -
-' I / /
( , I
; I
fl'l I s;
, ~ (j t!.. \ .
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.
$27,500.00 21)SoO.00
Rec :-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 with another or others
must be listed under Schedule "E". 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 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 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 capacity, partnership interests, interest in any undistributed
estate 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.
Item
No.
ITEM
List and describe fully
UNIT ESTIMATED DEPARTMENT VALUATION
VALUE MARKEl' VALUE (Do not write in
this space)
$5,036.70 c:; \ D~ 10 . L ()
2,514.16 '2,SoS.\Ll
1,395.00 l ~ 3c\ '? . l) 0
252.00 2, S-z.. . 0 0
250.00 250. 00
345.00 345,00
6.00 <0,00
233.10 2~3 10
32.80 '?JL, ~ 0
1.
Bethlehem Steel Retirement Fund Pension
Plan - payable to estate
Cumberland Valley Savings & Loan
Capital Blue Shield, Camp Hill, Penna.
Medical Insurance Refund.
2.
3.
4.
Bethlehem Steel Corporation
Insurance Interest Payment
5.
1966 Chevrolet Station Wagon
6.
Capital Blue Shield, Camp Hill, Penna.
7.
R. H. Deturck & Son Fire Insurance Rebate
8.
J. Maurice Petty, 74 Oliver Road, Enola.
Rent
9.
Commonwealth of Pennsylvania
State Retirement Fund Payment
10. Personal and Household Items (Furniture,
Sewing Machine, Sweeper, Air Conditioner
Mattress & Springs, and TV
475.00 L\-rS,OO
50.00 50,00
35.00 3S.0~:)
65.00 toS,00
55.00 SS,QO
11. One 38-caliber S&W Revolver
12. One 12-gauge Savage Pump Shotgun
13. One 20-gauge Ithaca Shotgun
14. One 222-caliber Remington Rifle
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
$10,744.76
\ 0) 135.1Y
'RCC~36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFEI1.S
RESIDENT DECEDENT
(i) Did decedent, within two years of death, make any transf'er of any material part of' his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) Nn
(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) Nn
(3) If the answer to (1) or (2) above is in the af'f'irmative state:
(a) Age of decedent at time of' transfer N/~
(b) State of decedent's heal th at time of making the transfer. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transf'er of' property without receiving a valuable or adequate
consideration therefor which was to take ef'fect 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)
(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 bef'ore 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 transf'erred 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/ll.
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or f'or the benefit of care of transferor? (Answer yes or no) Nn
(8) Did decedent, at any time, transf'er property, the beneficial enjoyment of which was subject to change,
because of a reserved power to al ter, amend, or revoke, or which could revert to decedent rmder terms
of transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (8) above is in the aff'irmative, 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 af'fidavit 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 provided in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
N/A
NoM\::-
Insert this total opposite "Transfers", Schedule "CO in the
"As Reported" column on the last page of this return.
RCC-37 (12-63)
COMMO"'WEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFI CIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State 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
wise, in estate) forth this fact.) OR NO BIRTH
Richard McMullan Rnt-;..-."
1790 Orrs Bridae Road Pursuant to Item II
RTlola Penna 17025 Brother Yes Over 21 of Will dated
,Tune ? <; 1974
\
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
RC C-38
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly
wi lh another 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 under 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", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
><><"
"><,,
Description of Property, Date of Acquisition, Name
Address and Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate.
'^' :><:.s.~ ~:5>>;tX ;(<.00 ~ ">< ><"
;t;(< ;(<:&':>< ~ 58::><X;(<~ ">;(< ><" ;>
:><
NONE
N 0 l'0 l::-
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
-0-
..
RCC-81 (6-73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBU RG
17127
IN YOUR REPL Y PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Richard McMullan
1790 Orre Bridge Rd.
Rnnl~, ppnn~
(Executor or Adm in; stratar)
In Re: Estate of
H"rry F M"MI111,,"
Cumberland
Caunty - Fi Ie No.
21-78-0042
Dear
Yau are hereby noti fied that the Original
appraisement in the estate of Harry F. McMullan
has been filed in the office of the Register of Wills of CumlD.erland
County on 27 September ,19-BL, Said appraisement reflects the following
valuations:
Real Estate
Personal Praperty
Transfers
Jointly Owned
Total
27.500.00
10.753.74
None
None
38,253.74
As to such tax that is paid within three months from date of 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 af death,
interest at the rate af 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 27 September 78 Signed ~~ /(~ ~
Title Chief Appraiser L. ~ .
~..~-
Note: This is not a bill.
R C C-~~ (2-64)
'DEPARiMENT OF REVENUE
BUREAU OF COUNTY COLL ECTIONs
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE 0 q - 2. I - 1 3
COUNT..[' j~J../\~
FILE NO. '2- \ -I y, .. 0 () 4 L..
Whereas, \-\n i\ ,'\ ~ i;'. fV\ ( (Y\ ~......:.'-.... late of \.:::::-t>~
in the County of C\, A~.'-." Q....~,.JL Commonwealth of Pennsylvania, having died on
the '1 "t-P_ day of ' ') ~cJ~ 191 '2,;, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwea of Pennsylvama;
Therefore, I, , 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 decedent 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 Appraisement
Delcrlptlon of Allet Valuel Made for I nherltance
TalC. Purpo,es
\< C- _ ~ ~ ..-vo.. .~. ....-;-h $ L..'I SO\) 00
\.JD^" U :--t \u\1S3 l1y
V'--l' J.. V "-' 79-<..,~ .
~. D.. " - N~
. \---- -~ \. \.~ OJ.:. ~J"\....<~,-*, f'J o>--Q...
..J 'V ..J
-"T'" ('r-'t...! ,..\" (J.J:)/~ ~R 2':"" ~
.
-
Having been duly sworn accor~ law, I do hereby c~tify t
formity with law on this '2- day of ::::::,
bove appraisement is made in con-
.R-<.. 19-=La.
\
Appraiser
\. tn... (N\lm~ an... d Str...)
"'VV~I~
(Paot OlIlee)
, Penna.