HomeMy WebLinkAbout11-13-78
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS.
"
,.
RESIDENT DECEDENT
NOV i 3 1978
COUNTYOF r.T1MRRIH AJilD
IMPORT ANT:
This return must be completed in detail and Jiled in duplicate, with all attached. with the Register of Wills of the
County where decedent resided; Return is due witf1in nine months after.. date of death, unless an extension is granted
by the Secretary of Re'ltenue. (Section 703. of the Inheritance ~nd ~.state Tax Act,of 1961.)
-" ~'.
IN THE MATTER OF THE ESTATE OF
} AF. FlDA VIT.O F .
EXECU:rOR S
".' --
~
DALEJ. MYERS
(STATE FULL NAME OF DECEDENT)
Dickinson Twp.
Lote 01 r.(lMRRRT AND
PENNSYLVANIA
County
County of
CUMBEWND
} ~s:
State of
AllIIKiXlX~
Luther Mountz, Jr. and Amy B. Mountz
of the estate of the above-nomed decedent. being duly sworn, depose
Executor S
and say"
February
(MONTH)
Name and address of attorney or }
other authorized representative to .....hom
all correspondence should bo IToQiled.
Decedent died
1st
, 19~{testat~ .Ieaving a lost will, copy of which is,'hereta,attached..}
(YEAR) K~
(DAY)
George B.
3 S. Hanover
Stuart
St., Carlisle,
Pa.
17013
Executors
That as such. deponent is familiar -:with the affairs of. said estate and the property constituting
IEXECUTOR.ADMINISTRATOR> .
the assets thereof and their fair market value.'
. .
Tha"t 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 irt decedent's i,,!div,idual name,"_with ri.ght o,r acc~ss by another as agent or deputy, with the
exception of the following: ~
NAME AND" ADDRESS OF BANK OR OTHER INSTITUTION THIS SAF~ DEPOSiT BOX REN.TED RELATIONSHIP OF JOINT
" ',. ,
IN WHICH DECEDENT RENTED A S,,,FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Commonwealth National U~n~ -uaJ.e~. -r'lYers. n"'f'edenr
N. Hano'J'er St. , Ga-1._1 n. .
,
That ,'the corite~ts of said safe. depo~it box or boxes are itemized ~nder Sched~les
wi th the e,xcep.tion'~f the f~llowing, for the reasons herein~fter set, forth:.
of this return,
That Sched~/e A attached hereto and made part hereof sets forth fully and in '.detail all the real property
in the Commo~wealth of Pennsylvania of which decedent died, having '~n int~res:~ therein. It" also, ~et~ forth ~he
mortgage et:1cumbrances upon each parcel of real p~operty at the 'date of death, giving' the amount ~till due at
death, name of mo~tgagee, date,. rate of interest, and book and page o~ record t~ereof. it also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the'e.~~~mated market value ther~of
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 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' ifeparately' theaccrueirintec'es f thereon. if any. down to the last intere;( d~y 'prim to 'decedent's
death in the case of savings banks, and to the date of decedent's death in?afl other cases; all bonds, postal
savings. treas~y 'certifiea'tes or ,notes and other evidence' of indebtedness of the Unit~d States to the de.
cedent; all obiigatio~s', 'whether by statut~e or .agreement they are designated as tax free, of the United States,
or any state, or political subdi~ision thereof, or of any foreign Fe.untry. which. axe~'owned at lh~ time of death;
'. ", - ~-" ..... ~~.~
an -",'car~ng apparel., jewelry. ~iJverware, .pi~tures, books,tWorks of'art, household ftirniture.'liorses, carriages,
automobiles, boats', )a~d --~ny ~'n.d <ili. ~ther p'ersonal chattels oCwh'a'"tSo~ver/kiridr:dr"hatur~. l~fi~-by decedent.
together with the fairly estima'ted market value thereof; all bonds amfmo'rtgages held DY~ decedent and'of all
\ .. . ""-
claims due and owing decedent 'at the time of death, and all prorriis"socY"notes or other".ins'tnimeni"s 'in.writing.....
. . " '. ':....""'.". ,,-
for the 'payment of money of which "decedent died pos'sessed, ofwhat~oev~r ~ature, wit~ inter~st' thereon;,if
any, giving the face value and estimated fair market value thereor", a'nd if s'uch.-estimated Jair":'inarket value be
less than the fac:e value, it set~ forth briefly 'the reasons for su~h d~.preciat'i~n:'\s to e.achi,t~m; a~i m~neys
-. ' ....AII ". '," .
payable to the estate from life insurance policies carried by', decedent; all annuity and endowmen{"-contracts-
the proceeds of which wer~ payable upon the death of the de/cedent; all and the corporate stock~. 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 dec~dent,~at the time of de~~h, with the,market value there.
of at such time.
,
.
.
In the case or securities of close or family corporations, the values reported are &s far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets forth the interest of ciecedent 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 aS8ets and liabilities of said co-partnership or huslness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of Uie agreement)
together with a st.atement 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 falr market value
thereof, any other property owned or bequeathed by the decedent at the time of d~~th.
The Schrdvle C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the cue 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 facts 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 agreement 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 pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power or appoint-
ment vested in decedent, elt~r individuall10r Jointly, by the will, deed, or other instrument of another,
with a copy of the instrument creating 8uch power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death, the nature of their res-
pective interests, their relationship, if any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's ~ill, if any, died prior
to decedent, the dates of' their death, their issue, and the relationship of such issue to the beneficiary.
That Scredule E attached hereto and made a part hereof sets forth 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 decedent.
That Sc/'ledul. F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of admdnistration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing anrl lmpaid at time of
death; taxes accrued chargeable for 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 for obliga-
tions, if any. It is agreed that the fiduciary will 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 amount l:laiming 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 wAw, RD", .C", "E", and PFR as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and swom to before me this .................................
................,;z..(,.~ .... . day of Oc.~ ()?!!.mm.. 19.7..8.....
.............-C?/.l?!:K.../..
(':.m d...~ ..... . .....m......
Notary Public - Carlisle, Pa.
My Commission Expires
March 5, 1982
NOTE: Before signing affidavit make sure all blank spaces in the arridavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisted securities,
securities of close or f'amily corporations or an interest in any co-partnershi~ or business, that the
data and statements required under the paragraph above relating to Schedule "BR llre attached. Also make
certain that column #1 in the "SummaryR has been properly completed as above-directed.
'-W~~. ;'"/cr'-'''''
..........{i~-;;;.tMiilJ,;. .. .. ...
D. 7
R.
(StTeet Number)
C/iI~1,t~l~,.P~.J"ZQ13mm..
(City or Tow" and Sto.te)
.,~ ~
':'~'i' T ~'~".'; ,;-....'i-:..:...,'.,.,.~~~:,.:->'..:.':..._.. '-..-
FtCC-3:4..!(~?-a) :. ;,,". :. .
COMMOOWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
S'UREAU OF COUNTY COLLECTIONS
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 interesland 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 real property toe-ated 'n the- Commonwealth of PennsylvanIa shillluld be
descrIbed by lot and block number, street arid street number, together with
a general descrIption of the property, wIth a reference to the record of the'
conveyanc:e by which the decedent took title; If a fc.,m state number of o.
crea; oliO statement of mortgage _encumbrancu upon each parcel at death
of decedent. T~x.e,., al.!e..men~, _acc_rued Interest on mortgages, etc.,are
to .be listed on Schedule II F" and must nOf.be d_educ:ted from this schedule.
/ --
C/l.All that certain property situate in
Dickinson Township, Cumberland County,
Penna., ,co~taining 120 acres, more or less,
improved with a frame house, barn and silo.
P-r. ~S' 11>,,'l.L~ ?:.790
LAP'! '.f30_
IV, 5'4-tJ
i/' ~
2. Minimal fractional interest in 16 acres,
more or less, mountain land situate in
Dickinson Township, Cumberland County,
Penna.
(1)
(2)
13\
DEPARTMENT
VALUA TION
CAUTION
(Do not wrIte
In this apace)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DeATN
ESTIMA TED
MARKET VALUE
"~ /.
183,000.00; \cg3,OOO.00
"-- /
150.00 150,00
r.
.
I
'.
Insert this total opposite "reol property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
183,150.00 \'&'3,150.00
,.
RCC -35
..
_ CO~IONWEALTH OF PENNSYLVANIA
TRANSFER. INHERITANCE TAX
RESIDENT DECEDENT
"SCHEDULE "B"
PERSON AL PROPERTY
*~
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal proper~y owned individually
by the decedent, at the time or his death. Property owned by the decedent jointly with another or others
must be listed under Schedule "En. Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.D.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 f'irst (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 fid~ciary 1n said capacity, partnership interests, interest 1n any undistributed
estate or 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'i~ this schedule.
/'
5. Savings Account No. 159968, Cumberland
Valley Savings & Loan Association
Accrued interest
6. V/~rtificate of Deposit No. 669~,
Cumberland Valley Savings & Loan Assn.
. \
7. 7 shares Production Credit Association
stock 5.00
(Dividend .90 & patronage distributi n
.05
Item
No.
ITEM
List and describe fUlly
1.
Cash
Amounts due decedent for beef
Checking Acoount No. l8l-66l570-0~'
Commonwealth National Bank
4. Certificate of Deposit No. l82496,~
~ommonwealth National Bank
Accrued interest
,2.
3.
. UNIT ESTIMATED
VALUE MARKlIT VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
"-
154.15
\
.. 516.00
151.\.\5
51"'.00
j gogD.01
I
2,880.07
~9.00 v'--
4.47 v~
L>,sq.OD
&.j..Y1
3<40.83
16.72
.3 ,4 O. ~ 3
I
./ IlD'l~
~
5,000.00 Sb!Jo.O()
j
\.... 35.00 .3~. 00
\ \.95 ",/ . ~S
25.00 ,/ .;!.S".OD
" 50.00..../ .,SO. 00
\ 1o~101.'"\S-
6,367.45 I
1,795.18 I (q5.\~
I
~. 84.40 'B'li.'40
a~, 14:1o.~Lf
,17,9l6.30V/ \1 ~,~.'3o
I
8. 1 share Agway common stock 25.00
9. 2 beagle dogs - sale price
10. Cattle, hogs 6< goats - sale proceeds
11. Whea t , corn, sileage and straw - sale pro eeds
12. Sale of coal and posts
13. Sale of farm machinery , auto, truck, etc.
14. Household furnishings, items, etc
Insert th~s total opposite ~Personal Property", Schedule "B" in
the "'As Reportedrt column on the last ,page of thi's return.
x X,
1,\/tC\l.1lD
61,991. 76
RCC-36
.
COMMONWEALTH OF PENNSYLVANIA
TRA:>ISFER. INHERITANCE TAX
SCHEDULE "e"
TRANSFERS
.~.
~'\
~
HESIDE:\T DECEDENT
(1) Dirt 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 h~mself to himself and another or
others (inclw"ling a spouse) In joint ownership? (Answer yes or no) l~O
(3) If the answer to (1) or (2) above is In the affir~~tl~e state:
(a) Age of decedent at time of transfer
(b) State of decedent's health 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 arter his death?
(Answer yes or no) No .
(a) Was there any possibility that the property transrerred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or no)
(b) What was the.transfereets age at time or decedent's death?
(5) Did decedent in his 11f'etime make any transfer without receiving a valuable and adequate consideration
theref'or 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 enjoyment of or the right to income rrom 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
(6) 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 transf'er, the consideration for which was transfereel s promise to
pay income to or for the benefit of care of' transferor? (Answer yes or no) No
(B) Did decedent, at any time, transfer property, the benef'icial enjoyment of which was subject to change,
because of a reserved power to al ter, amend, or revoke, or which could revert to ctecedent under terms
of transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (B) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficl~;y'~~served in the decedent alone or the decedent and others?
(Answer yes or no) -- - '
NOTE 1: The answers to these questions should be su~porterl 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
1\10 r),L
Insert this total opposite nTransfersn, Schedule nen in the
"As Reportedn colunm on the last page of this return.
None
\\lOf'\L
RCC-37 (12-53)
COMMON'\\"EALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RECSIDENT DECEDENT
. SCHEDULE "0"
BENEFICIARIES
"" ~ - .....'
~ '.; I,. .... ,..... "..
A
--
.9;. A_' -::.... -~:,::.. RELA:TIONSHIP
BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED DATE INTEREST OF
(State full names and addresses of all who megitimate~ children DECEDENT OF BENEFICIARY
have an interest._ vested, contingent. or other af~e,.t~nvolved. set STATE YES IN ESTATE
,"'ise. _ in estate). thi~ ,;ct \ OR NO BIRTH
Scotty Davis, R.D. 7,Carlisle ,Pa. Yes $1,000.00
.- ,- -, - -, -
r;".\ .. . t '"_ .~-
Frances Davis. R. D. 5.
Carlisle, Pa. Sister Yes l/j ot residue
my Mountz, R. D. 7,
Carlisle, Pa. Sister Yes 1/3 of residue
-. -
L~uther Mountz Jr. R. D. 7,
Box 294, Car 1:8 le , Pa. Nephew Yes 1/9 of residue
-
Havey Davis, Plainfield, Pa. Nephew Yes - 1/9 of resLdue
.
Bruce Davis.R.D.3. Box 316M
Newville, Pa. " Nephew Yes 1/9 of residue
.
.
.'
,
,
,
.
- ., -
. -
,
~I
-1 .,
.
0'
Deponent further says thut all the above-named benericiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
one
--
.
..
..
o .
-~-
"<"
b. c
'2'" E
.- a> :::s
E-'O
'0 Co"
-< E..
s:..8~
o ..
:;'t;t:
""8,
gE~
SUMMARY
Real Property .......... ....(Sch. "A")
Personal Property .... ... .......(Sch. "B")
Transfers .......... ..... ..... ........ ..(Sch. "C")
Gross Taxable Estate.
(1 )
(As Reported)
183.150.00
61 991.76
..............LO~OO
$
$
$
$...
$". ..... ,.
$245.141.76
(2)
(As Determined)
$. .
$.
$.
$.
$.
$.
CQ
......
Cl'\
M f-o
Z ~
Ii! ~ " ~ ...I
~ - (/l .. 1-1
~ 00(
M ~ ~t ::z:: ell
V) ~c:> (/l -
\C - ~ ~ 00(
I -< ~ " Ill:
<0 ~ ~ Z 'S llo
,... "" 0 ~ ~ " llo
"" . 2:
I ~ -< '" ..,. 00(
,..oj :z: ~ fS' ;.,
.... f-o .. Q
<'l ~ ~. ~ S
0 ~ ::c .. "'- ,..:1 Ul ~ il ~
0 f-o
Z f-o V) ~ Z ""
~ ~ 1-1 ~ f-o
~ 0 ~ U 0 Ill:
U -=
c ~ 1-1 - 0
0 ~ " llo
:c ~ " WI
" t: ~ ~ Ill:
b 0 c
.. -< ~ 0
'S 0 j:' E
'E .... .. S E
- 8
-=="'0 j 0
~~ U
RCC-38
.
-' COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
INSTRUCTIONS: This scherlule must disclose all property, real and personal, owned by the decedent jointly
wi th ano ther 0 r 0 tile rs, inc 1 uding in tangi bIes, standing 1n the name 0 r the deceden t and others~ Lis t
real estate first, as entireties, or joint tenants, giving'brief description, as indicated lUHler 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 "R", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedenta
Description of' Property, Date of' Acquisition, Name
Address and Relationship of' Co-Owners, and Place
of Record of Instnunent, where Real Estate.
ex
Unit percentage Estate
Value Share Valuation
f> 6< VI
6 ex ex
>0 <> )< '^
xX
(
>(>(X>
~:x
)X
None
X>
ex
Insert this total opposite "Jointly Owned Property", Schedule "En
in the" As Reported" column on the last 'Page of' this return.
None
DEPART/.IENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
Nono,
rJl>nt
'"
-
.
IN YOUR REPLY PLEASE
REFER TO
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
RE,v..sta (e.-1St
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Luther Mountz, Jr. Amy Mountz
R. D. 7, Box 294 R. D. 7
Carlisle. FA 17013 CRTli~l~, FA 17013
(Executor or Administrator)
In Re: Estate of
Dale J. Myers
Cumberland
County - File No.
21- 78- 0061
Dear M M
r. ountz, Mrs. Mountz:
You ore hereby notified that the original
appraisement in the estate of Dale J. Myers
has been filed in the office of the Register of Wi lis of Cumberland
County on January 9 , 19-Z.2, Said oppraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
183,150.00
61. 991. 76
None
None
$245,141.76
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 unpoid ofter nine (9) months
(fifteen months when death occurred from December 22, 1965 to June 16, 1971 ,inclusive;
ond twelve months when deoth occurred prior to December 22, 1965) from dote of deoth,
interest at the rote of six (6%) percent per onnum is chorged.
\
Any porty in interest who is aggrieved by this notice mOy object thereto within
sixty days ofter receipt 01 soid notice cis provided by Section 1001 of the Inheritance ond
Estate Tox Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Dote
January 9. 1979
Signed
Title Administrative Officer
L
Note: This is not 0 bill.
RC C-2 12-64)
. COMMONWEALTH OF PENNSYLVANIA DATE January 9, 1979
.
DEPARTMEt-i'r OF REVENUE RESIDENT INHERITANCE TAX COUNTY Cumberland
BUREAIl OF COUNTY COLLECTIONS
~ HARRISBURG, PENNA, 17127 APPRAISEMENT FILE NO. 21-78-0061
Whereas, Dale J. Myers late of Dickinson Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 1st day of February 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, T,po Fnlginit"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 a.ny future interest In this estate Is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration 01 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 Auet Valuel Made for Inheritance
Tall Purpous
Real Property $ 183 150 00
Personal Property 61,991 76
Joint-Held Proper tv None
Transfers None
TOTAL ASSETS 245.141 76
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Having been duly sworn accordin1h to law, I do hereby certify that the above appraisement is made in con.
formity with law on this 9t day of Januarv 19...lL.
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Apprat8e1'
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