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HomeMy WebLinkAbout05-19-78 \.RCC-33 (4-73) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS .. HAY 1 9 1Q7Q couNty OF ~UMBERLAND RESIDENT DECEDENT IMPORTANT: 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'otenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) } AFFIDAVIT OF EXECUOORIX U~KMPOR IN THE MATTER OF THE ESTATE OF MURIEL J. BYERLY {STATE FUL.L NAME OF DECEDENT) Late of Cumberland Pennsylvania County County of Cumberland "} ss: State of _ MARY JANE WRIGHTSTONE ExecuOllL i X x.1!i~~~~~ of the estate of the above-named decedent being duly sworn, depose S and say S (MONTH) Nome and address of attorney or } other authorized representative to whom all correspondence shOed,! :J. (DAY) , 19.-1LJ testate leaving a last will, copy of which is hereto attachedo,} (YEAR) ~~ll(fX Decedent died December 12 Horace A. Johnson, Myers, Myers, Flower & Johnson p n Rny l?S, T~mnynA, PennRy1v~ni~ 17043 Executrix That as sueh deponent is familiar with the affairs of said estate and the property constituting ( EX E CU TO R-ADMIN I ST RA TO R) the as sets thereol and their lair 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 follnwing: - 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 with 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 nf 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 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 interes t thereon, if any, down to the last interest day prim 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; a11 n\.:dl~He dVv'ucl. jtwthy, 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 we' "ayable upon the death of the decedent; all and the corporate stocks and dividends due thereon and unpaid as of tt" date of death, bonds and accrued interest thereon to the date of decedent's death and other in"cslmcnl :',Cl' '::cs owned by the decedent at the time of death, with the market value there- of at such time. RCC.'. ''''73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT 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 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 properly localed In Ihe Commonwealth of Pennsylvania should be (1) (2) (3) described by 101 and block number, street and street number, together with DEPARTMENT a general description of the property, with a reference to Ihe record of Ihe ASSESSED VAL.UE VAL.UATION conveyance by which Ihe decedenllook 1111e; If a farm .Iale number of a. FOR YEAR OF ESTIMA TED CAUTION cr..; also statement of mortgage encumbrances upon each pare. I at death of decedenl. Taxe., a....sm.nts, accrued Inter..t on mortgages, .tc.,are DECEDENT'S MARKET VAL.UE (Do not writ. to be 1I.led on Schedule "F" and mu.t not be deducled from thl. .chedule. DEATH In thl. .poco) NONE None i Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the lost poge of this return. NONE None RCC- 36 COMMO:iVVEALTII OF PENNSYLVANIA TRANSFEil INHFIHTA:iCE TAX SCHEDULE "c" TRANSFERS IlliS mENT 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 spouse) 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 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 subject to his power of disposition? (Answer yes or no) 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 no t 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 (0) 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 enjoyment of which was subject to change, because of a reserverl power to al ter, amend, or revoke, or which could 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 provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) NONE None Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. NONE None RCC':37 (12-63) COMMONWEALTH 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 Benjamin L. Byerly Son Yes Adult Specific Bequest - 707 Breezewood Drive $1,000.00 Mechanicsburq, Pa. 17055 One-fourth residue Richard P. Byerly Son Yes Adult Specific Bequest - R. D. #1 $1,000.00 New Cumberland, Pa. 17070 One-fourth residue John R. Byerly Son Yes Adult Specific Bequest R.D. Dark Hollow Road 51. 000.00 Pipersville, Pa. 18947 One-Fourth residue Mary Jane Wrightstone Daughter Yes Adult One-fourth residue 1509 Carlisle Road Camp Hill, Pa. 17011 Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE RCC-38 RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the (lecedent jointly with another or others, includin~ intangibles, standing in the name ot' the decedent and others. List real estate fi'rst, as enti.reties, or joint tenants, giving brief description, as indicated lmder Schedule "A", plus the date and place of record of instrument effecting vestitllre, but do not include entireties or out of state real estate value in estate vdluation 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 Unit percentage Estate DEPARTMENT VALUATION Address and Relationship of Co~Owners, and Place Value Share Valuation CAUTION-Do not Write of Record of Instrument, where Real Es to. te. In This Space. ')( """"? )< '\l\t,;x :;x :>0 'V' ""~ Value of Value of ~ 5:)< < X ~ ~X ~ ~5: XX X"" IX :;x Decedent's ~ X> X >;;:xx :><~~ Entire ~ x ..>'0 "":;; :> Property Interest 1. cumberland County National Bank & Trust Company Checking Account - No. 1257765 in the name of the decedent and Mary Jane Wrightstone as of 3/12/75. Date of death balance - $1,832.19......./ 50% 916.10J......rg3~,/~ ') 916.10 Insert this total opposite "Jointly Owned Property", Schedule "E" in the" As Reported" column on the last page of this return. $916.10 RCCw81 (6-73) COMMONWEALTH 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 Mary Jane Wrigbtstone 1509 Carlisle Road Camp Bill. PA 17011 (Executor or Administrator) In Re: Estate of Muriel J. Byerly CUlllberland County - Fi Ie No. 21-78-0052 Deor Mrs. Wrigbtstone: You are hereby notified that the Original appraisement in the estote of Muriel J. Byerly hos been filed in the office of the Register of Wills of CUlllberland County on June 29 ,19 78, Soid appraisement reflects the following valuations: Real Estate Personol Property Transfers Jointly Owned Total None 25.175.00 None 916.10 $26,091.10 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 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 thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheri~ance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373. D III ~ L . Date June 29, 1978 Signed (~~ _ j(. ~ Title Chief Appraiser ~---- Note: This is not a bill. RC C-2 (2-64) DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE June 29, 1978 COUNTY Cumberland FILE NO. 21-78-0052 Whereas. Muriel J. Byerly late of Lower Allen Township in the County of Cumberland Commonwealth of Pennsylvania. having died on the 12th day of December 19.12.... 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 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 Ducrlptlon of Asset V.luel Made for Inheritance Tn PUrpOl81 Real Property $ None -I Personal Property 25,175 00 Joint-Held Property 916 10 Transfers None TOTAL ASSETS $26,091 10 Having been duly sworn according to law, I do hereby certify that the above appraisement is made in con- formity with law on this 29th day of !il ~ 19~. ~ d k: Appraiser (IlI1mbeT and Strw) i b Ilarr s urg P . enna. (POItt Oftlce)