HomeMy WebLinkAbout02-22-79
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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RESIDENT DECEDENT
COUNTY OF
ClJI>ffiERLAND
IMPDRT 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 gr6i'lted
by the Secretary of Relotenue, (Section 703 of the Inheritance arid EstAte Tax Act of 1961.) I
Late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
ADMINISTRATOR
IN THE MATTER OF THE ESTATE OF
Ethel B. Holmes
(STATE FULL NAME OF DECEDENT)
County
County of
Cumberland
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State of
~
Charles H. Holmes
Executor
0' the e.tate of the obove.nomecl clecedent being clul)' sworn, depose 5
and so)' S
Decedent died
January
(MONTH)
29
, 19~J toslate leaving 0 los' will. copy of which Is hereto ottochecl..}
{YEAR1 1...UlIIM'lllfi"
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(DAY)
Name ond addres. of attorney or }
other authorized repr.sontative 10 v:-hom
011 correlf)onclenco should be moiled.
Landis & Black, Attorneys . 21.\3
36 S. Hanover Street, Carlisle, PA
172'7
17013
1'1
Thal as such Executor deponent is rami liar with the arrairs or said estate and the property coJtitUting .
(EXECUTOR.AOMINISTRATOR) I
Ihe 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, Jith the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S.4FE DEflOSIT BOX
NONE
THIS SAFE DEPOSIT BOX RENTEO
IN NAME OR NAMES OF
,
REL.ATIONSHIP O~ JOINT
HOLDERS TO DeC:EDENT
under Schedules N/ A or lhis. relurn!
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That Scheelule A attached herelo and made part hereor sets rorth rully and in detail all the real propert~
in the Commonwe'alth of Pennsylvania of which decedent died having an interest therein. It also sets forth thd
mortgage encumbrances upon each parcel of real property at the date of death, givirig the amount still due a~
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in th~
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columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as or date or death or decedent. I
That Scheelule B attached hereto and made part hercor sets rorth rully and in detail all personal properly
,
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"depos.i.t, savingJ
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banks, trust companies, or other institutions, whether individually, or in trust for anYlo,oJ}1~}""p~ls.~_CQ.?"'~!.sons
giving also separately the accrued interest thereon, if any, down to the last intere~t;'~day'-~r.ior5~~-1~~'2f}eJ1t'~
death in the case of savings banks, and to the date of decedenCs death in all othtr....tases"; all bO'n"fls', .p-:og-tai
savings, treasurv certificates or notes and other e\'idcnce of indebtedness of the: Unitgd Stat~s ;~:"lhe ~cL
cedent; all obli~ations, whether by statute or agreement they are designated as ,tax .:free,~of th~ UnitfO 'Stat~sl
""A- ~/ ./ '\ ....
or anv state, or political subdivision thereof, or of any foreign country, which are o'Yn~d aLtheAime oC'death!
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, 'hors~_~', carri~'gesl
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 de'3th, and all promissory notes or other'instruments in writin~
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 bJ
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneyJ
payable to the estate from life insurance policies carried by dece'dent; all annuity and endowment contractJ
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividendJ
due thereon and unpaid as of the da'te of death, bonds and accrued interest thereon to the date of decedent'J
death and other investment securiiics owned by the decedent at the time of death, with the.market value therel
of at such time.
That the contents of sBid safe deposit box or boxes are itemized
the exception'of the following, for the reasons' hereinafter set forth:
with
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In the case of securities of close or family corporations, the values reported are as far u
possible substantiated b)" financial stlltemcnt5 of the corporations, showing t.he usets and liabilities
thereof &15 of the date of death. The schedule also sets forth the interest of decedent at the time ot
deAth In any co-partnership or business, and In support of the value of such interest there il annexed to
said sC'hedule, financial statements showing the assets and. liabilities of said co-partnership or tl,uslne...
A copy or th~ co-partnership a~repment, (if oral, a statement setting forth the nature of t~e agreement)
together with a statement settln~ 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 submttted. It should also set f'orth in itemized forll, together with the fair Ilarltet value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The S,-/ledule 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'.
death, in contemplation of decedent's death, or intended to t&ke erfect in possession or enjoyment at or
a.fter death, sajd schedule sets forth the nature and value of such propertJ., to whom trMsferred, the
relationship of the transferees to the decedent, the proportionate share received by each transferee and
all other facts of a pertinent nature regardin,z: sairl 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 rorth in said
schedule a list of all property, real and personal, with its value, which pa~5es at decedent's death by
virtue of the exercise by decedent, either individually, orjointly with another, or any power of appoint-
ment vested tndecedent, either individually or jointly, by the will, deed, or other instrUlllent of another,
with a copy of the instrument creating such power attached to the schedule.
That 5ch~du'e 0 attached hereto and made part hereof sets forth the names anrt addresses of 811
persons beneficlall~ interested tn this estate at the time of decedent's rleath, the nature of their res-
pective interests, their relationship, if any, to the necedent, together with the ages at the time of
decedent's rteath of all minors, annuitants anrt beneficiaries for life unrter fiecedent's W1l1. It also
contains ti. statemf>nt showing whtch of the beneficiaries named in the rlecedent':lJ w111, if any, died prior
to decedent, the dates of their dellth, their issue, anrt the relationship of such issue to the beneficiary.
That S~~edule E attached hereto and marie a part hereof sets forth all property, real and per-
sonal, owned by thp decedent jointly with another or others, including intangible, standing,in the name
of the decedent and others, plus the date and place of record o( instruments f~ffecting the vestiture of
real estate and the date or acquisi tion of personal ty, plus the name, address and relationship, if any,
of co-owners to the decedent.
That 5c/1~dule F attached hereto and Blade a part hereof sets forth fully and in detail all debts
and deductions claimed for RTllt on behalf of this decedent's estate, inclurlln~ funeral expenses paid;
1./1mily exemption, where appJ tcalllf'; eosts of ac1mlnistration of this estate; counsel fee!lJ and fufliciary'.
connlssions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence or the death of the decedent; debts and claims owing anrl nnpaht at time of
death; taxes accrued chargeahle for period prior to decedent's death (except those allowed under Section
65101' the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obltS'-
tlons, if any. It is agreerl that the fiduciary will present proof' of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, conndssion or debt Is less than the
estimated amount cl aiming Rnd allowed, that the same will be reported to the Register of WHls, and that
the amount of tax assessed can be reassesserl in accordance therewith.
,
Th6t the totals of the appropriate columns in Scherlules "A", "B", "e", "E", and "F" M dtrected theretn,
have been carried forward and properly registered in the Su.mary.
. m. .~_.____
(Encutor-A minlltTlltor) Charles H. Holm
.. ...4~....Ill>.i,li,l)g...~PI,i,ng,s_...RQ!!4._......_............_.___
(Stfea Num&.r)
Carlisle, PA 17013
. .-..-.... ................................ ........~............-...
(Citv or Toum AM St4tA)
SOTE: Befl)re signing arfldavt t mt\ke sure all blank spaces in the affidavit and scherlule~ annexed are
filled 1n with details or the worn "Sone", anrl in C6se the assets include rtirc and unlisted securities,
securl ties of close or f'amlly coq1orations or an interest tn any co-partnership or business, that the
da ta and sta tCfTWnts requi rec1 unrle r the paragraph above relating to Schedule "B" are at tached. Al so 1U.ke
certain that column #1 in the "SUnlllB.rJ'" has been properly completed as above-directed.
Subsc~t\1id and sworn to before me this .-..........................
~~\ . day of R'n,M.~. .... 19ZY
.~All~~N~~/,h
Carlisi,;, C',:"';:y,r' );lU Co" Pa.
My COlllrnis~,ioll fxp:(es July ]7, 1982
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LAST WILL AND TESTAMENT
n.f
I, ETHEL B. HOLMES, of Carlisle, Cumberland County,
Pennsylvania, being of sound mind, memory and u~derstanding,
do make, publish and declare this as and for my Last Will
and Testament, hereby revoking and making void all former
wills by me at any time heretofore made.
FIRST.
I dire,ct all my just debts and funera 1 expenses,
,.' . .'
including any inheritance taxes, be fully paid and satisfied
out of my estate by my executor hereinafter named as soon as
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conveniently may be after my decease.
SECOND. I~ve, devise and bequeath my entire estate, real
and personal, whatsoever and wherever situate, unto my son,
Charles H. Holmes, to be his absolutely.
LASTLY, I hereby nominate, constitute and appoint my said
IN WITNESS WHEREOF,
/.#=~ay of April, A.D.,
I have hereunto
my last will and testament.
set my hand and seal thii
son, Charles H. Holmes, Executor of this
1973.
r.,
Y.. (; ~vJ. 1). )4<~W>.l.lv
(S~)
Signed, sealed, published and d~clared by the above named
Testatrix, Ethel B. HollTles, as and for her last wi'll and testament,
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in the presence of us, who, at her request and in her presence ana
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in the presence of each other, have hereunto subscribed our names
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as witnesses thereto.
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RCC-~4'14-7al
, C COM.tONWEAL TH OP PENNSYLVANIA
- ,DGPARTMENT OP REVENUE
BUREAU OP COUNTY COLLECTIONS
TRANSFER INHERITA"'CE TAX
F.leSIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
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Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of ~ece.
dent. Property held by the decedent as tenant in common with another or ather, should be identified I
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Prop,erty
held as joint tenants with right of surviorship or tenoncy by entireties should be reported on Schedule rE.")
The ,eol property located In the Commonwealth of Pennsylvania should be
ducrlbed by lot and blocle number, .t,eet and IlItreet number, together wi th
o general ducrlptlon of the property, with. a reference to the record of the
conveyance by which the decedent took title; If (I form .tote number of a.
CrlU; olao .tatemont of mortgage encumbrances upon each parcel at death
of docedont. Taxes, oase..ment., accrued Inter.at on mortgages, etc.,are
to be listed on Schedulo 'IF" and must not be deducted from this schedule.
Frame dwelling house located at 433 North 'Vest
Street, Carlisle, PA. Lot 20' x 100'. By deed
dated 9/1/62 property conveyed to William II. Brown
and Ethel B. Holmes. (20 Q 16). William H. Brown
died 4/29/69 and by his-Last Will devised his one-
half interest to Ethel B. Holmes. This property wa
subject to an oral agreement to sell for $9,000.00
prior to decedent's death. The property was subse-
quently sold on ~by 19, 1978, in accordance with
said oral agreement for a gross purchase price of
$9,060.55, "hich included the real estate tax ,,~'
adjustment G,("'/
(1)
ASSESSED VALUE
FOR YEAR OF
aECEDENT'S
DEA TH
2,420.00
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Insert this total opposite "reol properly", Schedule "A" in the X X X X X
"As Reporled" column on the lost page of this return.
(2)
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DEPARTMENT
V~LUA TION
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CAUTION
(Do nof writ.
In #'1. apac.)
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ESTIMA TED
MARKET VALUE
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9,060.5!t"
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9,060.55 q,6bO,S5
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R~SInENT DECEDENT
SCHEDULE lIB"
PERSONAL PHOPERTY
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:RCC-36
COt~IONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangillle and intangible personal property owned ind.ividually
hy the decedent, at the time of his death. Property owned by the decedent jointly with another or others
must be listed under Schedule "Elf. Intangible personal property, titled in ~,he name of the rJecedent, but
payahle nt death to nnother or others, including tHlt not linllted to P.D.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they firc not of the artminlstered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, Hnd furnishings) books, paintings, automobiles, boats, etc.)
Intlmgible _personal property, such as bonds, treasury certificates, cash on hand and In bank,
stOCkS, mortgages, notes, together with accrued interest or rlivl~end5, salaries or wages, insurance pay-
tible to tho e!i>tnte or f'!rluCl-nry in sain capacity, partnership interests, interest in anyundlstributed
es tllt-e 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 listen in this schenule.
I tom
No.
ITEM
List and describe f\llly
UNIT
VALUE
ESTIMATED
MAIIKEf V AUJll
DEPARTMENT VALUATION
(Do no t wrIte In
this spa.,e)
1.
Wearing apparel - given away
Checks: Pennsylvania Blue Shield Medicare and
65 Special Benefits
-0-/
2.
29.60-;;:
2.24/
6.0G"//
.56,....-
7.40
.
I nser t this to tal opposl te "Personal Property", Scheriul e "B" In
,
t.lle nAS lleported" collUl1Jl on the last page of thls return.
x X
45.80
Lt S .80
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>llCC- 36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFH\S
.
RESIDENT DECEDENT
(1) Dirt decedent, within two years ofdeuth, make any tra.nsfer of any material part..Af his estate, without
receiving a valuable and adequdte consideration therefor? (Answer yes or no) ~\lO
(2) Did decedent, within two years of death, transfer property from himself to himself and another or
others (including a spouse) 1n joint ownership? (Answer yes or no) No
(3) If the answer to (1) or (2) above Is In the affirmative state:
(a) Age o~ decedent at time of transfer
(b) State of decedent's heal th at time of making the transfer. (Note 1).
(e) 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 therefo~ which was to take effect in possession or enjoyment at or after his death?
(Answer. yes or no)~______
(a) Was there any possibility that the property transferred might return to t~an9ferer 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
not in fact end before his death:
(a) The posseSSion or enjoyment of or the right to income from th~ 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 incom'e to or for the benefit of care of transferor? (Answer yes or no) No
(B) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserveo power to al ter, amend, or revoke, or which could revert to decedent 1.U1der 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 1n the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions Should be supporte~ by affidavit by the attending phYRician as
well as a copy of the death ceT'tlflcate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferred, it's rafr market VAlue at date of death, dates of transfers and to whom trR.nsferred, with
relationship of transferees to rlecedent, if any. Submit copy of any trust deed or instrumen~, if trans-
fers are claimed to be non-taxable, also submit detailed statemen+ of facts on which said claim 1s based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
lTEId
DESCRIPTION
MARKET VALUE
(Es Urns ted)
DEPT. VALUATION
(Dept. Only)
NONE
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('O~l'M(l:>l\\'EAl.l'Il OF I'EXXSYYL,.\NIA
TRANSFEI( INHERITANCE TAX
RESIDENT DECEDENT ~
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SCIIE\)ULE :€~' 1\
"\)" ~ .tt!f;.
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BENf:FIClAHIES
BENEFICIARIES AND ADDRESSES RELATIONSIIIP SURVIVED
(If step.children or Q,\TE INTEREST OF
,stnte fuJ J namt~S and addresses. of nll who illegitimate childf(~n Df;n~DENT OF BENEFICIARY
:In' tin interest. vested, contingent or other are involved, set STATE YES IN ESTATE
wise. in estate) forth this fact.) OR NO BIRTII
Charles H. Holmes Son Yes 7/20/23 100%
46 Boiling Springs Road
. Carlisle, PA 17013
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j)(!poncnt further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
NONE
)
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(I) (2)
3 SUM~IAllY (As R~p"r"'d) (.~, n",.'rmi'K.d I
0- )w, Heal Property (Seh. "A") $ 9,060.55 $
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;: .~ E Personal Property (Seh, "B") $ 45.80 $
:: t;:I
E-C;
"0 Q, " Transfers ( Seh. "e" ) $ $
~ ~,
~ ".., $ $
~_A.>
::J:l/t:
" ,. 0 $. 5
Go E Q,
~ .:: Gro" Taxahle Estate $ 9,106.35 $
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'COMMONIYEALTH OF PENNSYLVANIA
'TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOlNTL Y OWNED PROPERTY
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INSTRUCTIONS: This scherlule must disclose all property, real ann personal, ownecl 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 hrief rlescription, as indicated unrter Schedule
"A", plus the rlate and place of record of instrument effecting vestiture, but 410 not include entireties
or out of st:1te real estate value In estate vsluation column. Personal property should be listed as In
Schedule "B", plus. date of acquisi tion, ann the name, adrlress anti relationship (if any) of co-owners to
the rleceden t.
Description of Property, Date of Acquisition, Name
, Address and Relationship of Co-Owners, and Place
of' Record of Instrument where Real Estate.
X X>< <<>(x>> x.:
Co<:o< :x 0<: X X
~x><x.: y ()(':
unlt
Value
percentage
Share
<<X
<<
~~
NONE
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Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" .column on the last page of this return.
Estat.e
Valuation
x.:
X
DEPARTMENT VALUATION
CAUTION-Do not WrIte
In This Space.
Value of Value of
EnUre Decedent's
Property Interest
X
:x:
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REV-SI8 (a"7a) -
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PL.EASE
REFER TO
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Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Charles H. Holmes'
46: Boiling Springs Rd.
Carlisle PA 17013
(Executor or Administrator)
In Re: Estate of
I1thel B f10lmes
Cnmherl :::Inn
County - Fi Ie No. ?1-7R-fi?
Deor
You are hereby notified that the Or; gina1
appraisement in the estate of Ethel B. Holmes
has been fi led in the office of the Register of Wi lis of Cnmher1and
County on 28 March ,19--L9, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
$9.060.55
45'.80
None
None
$9.106.35
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 aft...r 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 rote of six (6%) percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within
sixty days alter receipt of said notice as provided oy Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485.1001, P. L.'3.K,8. ~ 0 . l.----
d-Q;v 'C Iv-) :-c../~
Date 2R M"r~h 1 Q7Q Signed 0
Title Administrative Officer
Note: This is not a bi II.
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, ~ , .".~ .. COMMONWEALTH OF PENNSYLVANIA DATE 28 March 1979
REY-457 (8-78)
DEPARTMENT DF REVENUE RESIDENT INHERITANCE TAX . COUNTY Cumberland
BUREAU OF FIELO OPERATIONS
P.O. BOX 2970 APPRAISEMENT FILEtW. 21-78-0062
HARRISBURG, PENNA. 17105
Whereas, 'Rt"hAl R Hnlmp~ late of r.~rl;~lp
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 29th day of January 19 .2!L, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Ton 1<'111 giT'l-i t"; . , 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.
DESCRIPTION OF ASSET UNIT Appraisement
VALUES Made for Inheritance
Tax Purposes
., $ n Mn
D. ...
Personal Pronertv 45 80
.... None
Joint1v Owned None
Total $ 9.106 B5
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Have been duly swOflf tfcording to law, I do hereby ceWft ~at the above apprajsemll.nt is made in conformity
with the law on this t day of -- C r-> (' -J ' 19 _.
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'----' Appraiser
Harrisburg (Number and Street)
, Penna.
(Post Office)
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County, Number and Name
File Number
Date af Death
File Date
Eltate Name Holmes
(l.AST NAME)
Cumberland
Ll-/~-OUbZ
1-LOJ-/1>
SUMMARY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Ethel
(FIRST NAME)
B.
(INITIAL.)
REPORT OF INHERITANCE TAX APPRAISER
I, the undenigned duly appainted Inheritance Tax Appraiser in and for the County of
Pennsylvania, do respectfully report that I have appraised the real and personal property al reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", u.s", "e", Dnd liE".
Cumberland
Dated:
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WillS
I,. the undersigned duly elected Register of Wills in and for County, Pennlylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by depanent, except as to thOle items where a greater or
lesser amount is set forth in the last column to the right in Schedule uFIt, which gr,eater Or leiser amount represents the sum
all ed as a ded cfon .
ow U I
Dated:
REG1STER OF WILLS
.
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED CODE VALUE AS REAPPRAISED CODE
Real Property (Schedule A) $ 9.060 55 $ 004+- 00+
Personal Property (Schedule B) 45 go 10+ 10+
Jolnt.Held Property (Schedule E) .0+
Tran,fers (ScheduleC) 30+
TOTAL GROSS ASSETS OJ,lUb ~
Less Debts and Deductions 10,097 09. 40-
(SCH EDUL E F)
( 990 74)
CLE AR VALUE OF EST ATE
Valuation of life estates or :i..- PRINCIPLE FACTOR VALUE !~
annuities.................... . - $ t= 1=
-
EST A TE TAX A$SESSMENTS -$
FOR USE OF REGISTER ONLY ~ COMPUTATION OF TAX
Tax on $ 2% $
Tax on $ 6% $
Tax on $ 5% $
Tax on $ . 10% $
Tax on $ 15% $
Exemptions * (*) As evidenced by Charitable
Total.Estote Exemption Certificates Issued
TOTAL TAX $ by the Secretary of Revenue.
Less tox prelfl~usly paid $ E
BALANCE $
Leu 5% of tax If paid within
3 months after death $
BALANCE OF INHERITANCE TAX DUE $ I
Add interest at rate of 6% from
.. S
AMOUNT OF ESTATE TAX ASSESSED $ t=
Estate tax paid $
BALANCE DUE $
Add' interest at rate of 6% from
,. $
TOTAL TAX BALANCE $
PAID $
Supplementol Code.: (FOR USE IN HARRISBURG ONl Y)
48-Adj u s tment
49+Adjultment
56-Annuity
6O-life Eltate
92+Remainder Appraisal
93-Remainde. Deduction
93C-Charily
94-.Remainder Relidue
96-SuccessiYf;!
life Estate
FOR USE OF REGISTERONl Y
ADJUSTMENTS
NOTE: Where subsequent odiustments ore made to the above computation of tax by the -Register of Wills, for proper reason,
lame should be noted below, with short explanation.
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