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HomeMy WebLinkAbout05-08-78 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS :/ / 'co -* i'u4Y 8 1978 COUNTY OF CUMBERLAND "' RCC-33 (4...73) RESIDENT DECEDENT 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'ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF SARA C. BARCLAY Late of (STATE FULL NAME OF DECEDENT) Carlisle, cumberland } AFFIDAVIT OF RICES EXECUT_ ~ County State of PENNSYLVAliIA CUMBERLAND } 55: County of Anna Miller and Betty Adams ~HiHHilI:X Decedent died of the estate of the above-named decedent being duly sworn, depose January 13, 19~{le.,a,e leoving a (MONTH) (DAY) (YEAR) :K;~~ Executjrices and say la.' will, capy of which i. herela altached.} Name and address of attorney or } other authorized repres,entative to whom all corres.pondenc:e should be mailed. 3 George B. Stuart South Hanov~r St., r.arli~l~, Pa 1 7011 Executrices That as such deponent is familiar with the affairs of said estate and the property constituting (EX ECUTO R-ADMtNIST RA TOR) 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 S_...FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Connnonwealth National Bank JJeceoent: 1'lone 1\1 <;:t- ('"...,{~,,,,, D.. . . That the contents of said safe deposit box or boxes are itemized under Schedules e 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 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 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 8 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 possession, 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 bonds, 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 promissory 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 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. RC C-34 (4-73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAl} OF COijNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "Au REAL PROPERTY * Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece. dent. Property held by the decedent os tenant ,in common with another or other, should be identified os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property lacated In the Camma~wealth af Pennsylvania shauld be (I) (2) (3) described by lot and black ~umber, street and street number, together with DEPARTMENT a general description af the praperty, with a reference ta the record af the ASSESSED VALliE VALUATION conveyance by whl ch the decedent taok title; If a farm state number of a. FOR YEAR OF ESTIMA TED CAUTION cres; also statement of mortgage encumbrance. upon each parcel at d.ath DECEDENT'S MARKET VALUE (Do not write of decedent. Taxes, assessments, accrued Inter..t on mortgages, etc.,or. DEA TH In "'I. .pace) ta be listed on Schedule "F" and must not be deducted fram this schedule. None None. I 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. 0.00 RCC -35 COMMONWEALTH OF PENNSYLVANIA TRANSFER iNHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY 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 VALUE MARKET VALUE 1. Blue Cross benefit 309.80 2. Commonwealth National checking account No. 182-132705-1/ 1,743.17 3. Commonwealth Nation~l savings account No. 18-0008814-6~ 4. armers ~st Co. certificate of deposit No. 8262 dated August 9, 1973 Accrued interest 6. 47.94 46.54 46.75 47.16 45.79 46.69 47.88 46.59 47.02 45.91 48.24 48.24 47.45 47.45 47.97 46.69 50.38 49.04 49.04 49.58 39.70 39.89 39.89 38.73 38.82 40.54 40.54 40.90 39.62 39.73 6,000.00 58.67 ifS, Q () 10.00 ~. 5. v one 1881 $10.00 gold piece . S. Series "E" Bonds $25.00 bond dated Feb. 1957 $25.00 bond dated May 1957 $25.00 bond dated June 1957 $25.00 bond dated Aug. 1957 $25.00 bond dated Sept. 1957 $25.00 bond dated March 1956 $25.00 bond dated May 1956 $25.00 bond dated July 1956 $25.00 bond dated Oct. 1956 $25.00 bond dated Dec.1956 $25.00 bond dated Jan. 1955 $25.00 bond dated March 1955 $25.00 bond dated Aug. 1955 $25.00 bond dated June 1955 $25.00 bond dated Oct. 1955 $25.00 bond dated Dec. 1955 $25.00 bond dated April !64 $25.00 bond dated June 1954 $25.00 bond daom Aug. 1954 $25.00 bond dated Nov. 1954 $25.00 bond dated Jan. 1962 $25.00 bond dated March 1962 $25.00 bond dated April 1962 $25.00 bond dated May 1962 $25.00 bond dated July 1962 $25.00 bond dated Jan. 1961 $25.00 bond dated Feb. 1961 $25.00 bond dated Apr. 1961 $25.00 bond dated May 1961 $25.00 bond dated June 1961 Insert this total opposite "Personal Property", Schedule "B" in X X the "As Reported" column on the last page of this return. DEPARTMENT VALUATION (Do not write in this space) 309.80 1,743.17 9,950.10 6,000.00 58.67 45.00 47.94 46.54 46,75 47.16 45.79 46.69 47.88 46.59 47.02 45.91 48.24 48.'2.4 47.45 47.45 47.97 46.69 50.38 49.04 49.04 49.58 39.70 39.89 39.89 38.73 38.82 40.54 40.54 40.90 39.62 39.73 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 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 estat~ 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, mortg~ges, 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION No. List and describe fully VALUE MARKET VALUE (Do not write in this space) $25.00 bond dated Aug. 1961 39.73 39.73 $25.00 bond dated Sept. 1961 40.79 40.79 $25.00 bond dated Oct. 1961 40.79 40.79 $25.00 bond dated Dec. 1961 39.70 39.70 $25.00 bond dated Jan. 1960 42.72 42.72 $25.00 bond dated Feb. 1960 42 . 72 42.72 $25.00 bond dated March 1960 43.10 43.10 $25.00 bond dated Apr. 1960 43.10 43.10 $25.00 bond dated June 1960 41.39 41.39 $25.00 bond dated July 1960 41.39 41.39 $25.00 bond dated Sept. 1960 41. 77 41.77 $25.00 bond dated Oct. 1960 41. 77 41.77 $25.00 bond dated Nov. 1960 40.45 40.45 $25 . 00 bond dated Jan. 1959 44.95 44.95 $25.00 bond dated Mar. 1959 43.10 43.10 $25.00 bond dated Apr. 1959 43.10 43.10 $25.00 bond dated May 1959 43.10 43.10 $25.00 bond dated July 1959 43.52 43.52 $25.00 bond dated Aug. 1959 43.52 43.52 $25.00 bond dated Oct. 1959 43.90 43.90 $25.00 bond dated Nov. 1959 42.62 42.62 $25.00 bond dated Jan. 1958 46.41 46.41 $25.00 bond dated Feb. 1958 46.41 46.41 $25.00 bond dated Apr. 1958 45.06 45.06 $25.00 bond dated May 1958 45.06 45.06 $25.00 bond dated Aug. 1958 45.67 45.67 $25.00 bond dated June 1958 45.,26 45.26 $25.00 bond dated Sept. 1958 44.34 44.34 $25.00 bond dated Nov. 1958 44.34 44.34 $25.00 bond dated Dec. 1958 44.54 44.54 $50.00 bond dated Dec. 1966 66.04 66.04 $50.00 bond dated Dec. 1966 66.04 66.04 $25.00 bond dated Nov. 1957 45.79 45.79 $25.00 bond dated Oct. 1957 45.79 45.79 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X $ 20,975.43 , , RCC- 36 COMMO~WEA'LTIl OF PENNSYLVANIA TI-tANSFFR INHERITANCE TAX SCHEDULE "c" TRc\.NSFEnS l\ES IJ)E~T 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 hi~~elf to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) NO (:I) If the answer to (1) or (2) above is in the af'firmative state: (a) Age of decedent at time of transfer (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 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 sub.1ect to his power of disposition? (Answer yes or no) --1' (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 en.1o~ent 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 en.1oy the property transferred or income therefrom? (Answer yes or no) No (G) 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 en.1oyment of which was sub.1ect to change, because of a reserved power to al ter, amend, or revoke, O'N&hiCh could revert to decedent under terms of transfer or by operation of law? (Answer yes or 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) --- NOTE1: 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 provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) None Non.e Insert this total opposite "Transfers", Schedule "CO in the "As Reported" column on the last page of this return. 0.00 RCC-37 (12-63) COMMONW.EALTII'OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES ( h 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 aye an interest, vested, contingent or other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Grace United Methodist l.nurcn, carl~sle, Pa. $200.00 ~~rine 3AR "r." ~~ Carlis Ie, Pa. ister-in-law $450.00 Ann&! Mi 11 "'or R n "- Box 131, Carlisle. Pa. l\Iiece c:: 1 nnn nn . ~1.. 1/2 of residue Betty Adams, 512 Franklin St. , Carlisle, Pa. l\Iiece $1,000.00 bequest olu 1/2 of residue s s Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE None .~ . RCC-3B RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY COMM,ONWEA,LTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This scherlule must disclose all property, real and personal, owned by the decedent jointly with 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 tmrler Schedule "An, 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 aC'luisi tion, 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, ~d Place or Record of Instrument, where Real Estate. >66;? x,:';>:';> ;? (to X;(- 6 ><X>~ y ~ ~~ 8 ;;> ~X: ~;;> -Q- X>\Y' ::> ;;> v~ >sO X :> Unit Value percentage Sh are ES ta te Valuation :y :>;'<:8>:> Q :X x, x ~ ~~ y >< ~ ~ ~ 8~ :> N ~:> Q >>~ (t \X;? DEPART~ffiNT VALUATION CAUTION-Do not Write In Thi s Space. Value of Value of Entire Decedent's Property Interest None None. Insert this total opposite "Jointly Owned Property", Schedule "E" in the" As Reported" column on the last page of this return. 0.00 Rec-a1 (6.73) COMMONWEAL TH 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 Arr.na C. MUleJt R.D. #4 Box 131 CaJr..U6.te.. Pa.. 17013 (Executor or Administrator) In Re: Estate af Salta. C. Ba/l.ci.a.1! CumbeJri.a.rr.d Caunty - File Na. 21-78-0047 Dear M6. MUleJt, Yau are hereby notified that the OJUa-i..n.ai. appraisement in the estate of Salta. C. Ba/l.ch1.y has been fi led in the office of the Register of Wi lis of CumbeJt.ta.rr.d County on Jwte. 22, , 19K, Said appraisement reflects the following valuatians: Real Estate Personal Property Transfers Jointly Owned Total None. 20.975.43 None. None. 5 20,975.43 As to such tax that is paid within three months from date af death, a five (5%) percent discount is allowable. As to any tax 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 prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereta within sixty days after receipt of said notice as pravided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 37~ Date Jwte. 22. 1978 Signed r 1vu~- N.)J jj;,,--~_"--- Title CHIEF APPRAISER (.-,~ Note: This is not a bill. RC C-2 (2.64) COUNTY Jwte 22, 1978 CumbeJt.ta.nd 21-78-0047 DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURe, PENNA, 17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE FILE NO. Whereas, Sa/l.a. C. Ba/l.ctl1.!f late of Ca.Jl.LU.te in the County of CumbeJt.ta.nd Commonwealth of Pennsylvania, having died on the 13th day of JanuaJLlj 19~, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, !Ita. K. G.te.i.m . 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 Ilfe 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 Description of Anet Values Made for Inheritance Tax Purposes Re.af. PI!.. .k+, $ None PeJtMna1. PI!..OpeJLtl! 20,975 43 Jo~ He.td PI!..OpeJLtl! None T tr..a.n.O M.M None TOTAL ASSETS $ 2~ 975 43 .- . Having been duly swo.rn according to law, I do hereby certify that the above appraisement is made in fgn- formity with law on this 2211d day of \..;Twte ,. 19_. ,,) ',." { . ( ~.L" ;". _/\L..' ;",__ ,_--_ Appraiser (llIlmber lIDd SU..I) HaNtM bU/Lq (Poot Oftl..) , Penna.