HomeMy WebLinkAbout05-01-78
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RESIDENT DECEDENT
i'1AY 1197S
COUNTY OF Cumberland
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
IMPORTANT,
This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the
~ounty where decedent resided; Return is due within nine months. aftef.date of death, unless an extension is granted
by the Secretary of Re'otenue. (Section 703 of the Inheritance and Esta.te Tax Act of 1961,)
IN THE MATTER OF THE ESTATE OF
} A.. FFIDAVIT OF .
EXECUTOR
~
TIJT'T'R 1<' FMRTr.l(
(STATE FULL NAME OF DECEDENT)
Late of Cumberland
County
County of
011mhprl:=tnCl
} ss,
State of
rCnflS) 1 ,ania
Decedent died
T~nt:) li' n?"I7i r1so-n Trll~t Off; C'pr J r.r.NR R,qnk, N A ,
of the estate of the a"boye-named decedent being duty sworn, depose and say
. 19~{te5tate leavlng"o 1~lSt will, copy of whic~ is hereto attached,,}
(Y EAR) lXNKIlCN
Executor
~XI<O<I:l'lr
T::inll::iry 28
(MONTH)
(D'AY!
Name and address of attorney or }
other authorized ropresentative to whom
all correspondence should be moiled.
Jon F. LaFaver
315 Third Street, New Cumberland,Pa. 17070'
That as such _ F,YP('l1rnT deponent is familiar with the affairs of said estate ,and the property constituting
(EXECUTOR-~~~
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box-registered in deced~nt's indiyidual name, or jointly with,"or
as agent or deputy of another, or in decedent's individual name, with.right of access by-another as ~gent or. deputy. with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S.4.FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
Twite Emrick
RELATIONSHIP OF JOIN,T
HOLDERS to DECEDENT
CCNE BANK. N.A.
Dau hter
~~ Pennsylva
That' the contents of said safe deposit box or boxes are itemized 'under Schedule~ A & Bar th.is return,
with the exception' of the following, for the reasons hereinafter set forth:
. " . - ' . - .
That Schedule A atiached hereto and made part hereof sets forth fully and in. detail' all the real property
in the Commonwealth of Pennsylvania of which dec_edent died having an interest therein. It aiso sets forth the
mortg~ge encumbrances upon each parcel of real property at the date of death, 'givi!1g th~ amount still due at
death. name of mortgagee, date, rate of interest,. and book and p~ge of record thereof. .It also set~ forth in the
columns ,provided therefore the assessed valu~tion of each of said parcels, the estima~ed .mark~t value thereof
as of date of death of decedent.
That Schedule B attached hereto and made parI hereof sels forth fully and in detail all personal property
wherescver situated nwned by the decedent at the time nf death; all moneys. left by the decedenI 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 separatelv the accrued interest thereon, if any, down to the la-st -interest day prim to decedent's
. - ." ...~ fl'
death in the case of savings banks, and to the date of decedent's death in all other cases; all'bon'ds. po.Stalr.
savings, treasury certificates or notes and other evidence of indebtedness of the United Sfates....JQ.I\:the1~;e-_.---=;..
cedent; all obligations, whether by statute or agreement they are designated as tax free, of the Urii(ed'State~J. -
-- ...,....-
or any state, or political subdivision thereof, or of any foreign country, which are owned at the iiine of.~d'eatht,.
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, hor~e-~~ carriagelr' ~'.
automobiles, boats, and any and all other persona.l chattels of whatsoever, kind or nature, left. by:decedent, ::
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together with the faidy; estimated market value thereof; all bonds and mortgages held by dec,edent a~~'df all
claims due and owing decedent at the time of death, and all promissory not~s'or other'instruments 'in writing
for the payment of money of which decede~'t died possessed, of. whatsoev'er n~tu're, ,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 depreciati~n: as to each"item; ati m~neys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contrac'ts
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 ow~ed by the decedent at the time of death, with, the.market value there-
of at such time.
.
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In the case of securities of close or family corporations, the values reported are &s far as
possible substantiated b financial statements of the corporations, showing the assets and liabilities
thereof as of the date 0 death. The schedule also sets forth the interest of decedent at the time of
death in any co-partnersh p or business, and 1n support of the value of such interest there is annexed to
said schedule, financial tatements showing the assets and liabilities of said co-partnership or business.
A copy of the co-partner hip agreement, (if oral, a statement setting forth the nature of tne agreement)
together with a statement setting forth the character of the bUSiness, its location, and such other facts
pertaining to the busine 8 as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted. It should also set forth in itemized form, together with the fair market value
thereof, any other proper yawned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in t e case of transfers of property, real or personal, within two years of decedent's
death, in contemplation 0 decedent's death, ",or intended to take ef'fect in possession or enjoyment at or
after death, said schedu e sets forth the nature and value of' such property, to whom transf'erred, the
relationship of the trans erees to the decedent, the proportionate share received by each transf'eree and
all other facts of' a per inent nature regarding said transf'ers. In the case of transfers intended to
take ef'f'ect in possession or enjoyment at or af'ter death, there is also attached to the schedule a COHY
of the deed, trust agree ent or other instrument creating the trust. Ther~ is also set forth in said
schedule a list of all pr perty, 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 of' appoint-
ment vested in decedent, ether individually or Jointly, by the will, deed, or other instrument of another,
with a copy of the instrl ent creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially inte ested in this estate at the time or 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 or all inors, annuitants and beneficiaries for lire under decedent's Will. It also
contains a statement show ng which of the beneficiaries named in the decedent's Will, if any, died prior
to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That Sctredule
sonal, owned by the deced
of the decedent and other
real estate and the date
of co-owners to the dece
attached hereto and made a part hereof sets forth all property, real and per-
nt jointly with another or others, including intangible, standing in the name
, plus the date and place of record of instruments effecting the vestiture of
l' acquisition of personalty, plus the name, address and relationship, if any,
nt.
That Sctredule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed l' r and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where a plicab1e; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to b paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in conseq ence of the death of the decedent; debts and claims owing and lmpald at time of
death; taxes accrued char eable for period prior to decedent's death (except those allowed under Section
6~1 of the Inheritance a d Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is ag eed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amoun actually paid in settlement of any fee, commission or debt is less than the
estimated amount claimi and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assesse can be reassessed in accordance therewith.
........_.._.~,.::.;;,..k... ..... day of
.....1:~....
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That the totals of the ap ropriate columns 1n Schedules "A", "B", "C", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
CCNB Bank, N.A., Executor of the
Estat 0 Twite E. Emri~k
J!y.;. ........ ....&t.~lk~4t~t-~rrrcer
Subscribed and sworn
ft.1'?/!!.,I!;"
...tf?~
.......192..r.:.
210l
...k,Qt,_.~..t..-..............._......_............_.._.._.__..
(Street Number)
...CaIllp....Hill.~....P.enn.s.y..ly.a.Il.1.."'.....P9JJ.......................
(City Of' Toum and Sto.tc)
. ~l~bli<:
\.';,'jl t:';;, ::1;;.1 ~~d C-:., P.J.
My C.rn;.lLsion L-', J ~s July S; 1981
NOTE: Berore signing af idavit make sure all blank spaces 1n the affidavit and schedules annexed are
filled in with details 0 the word "None", and in case the assets include rare and unlisted securities,
securi~ies of close or f mily corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 i the "Summary" has been properly completed as above-directed.
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..,.RC~C..34("'73', . , '."
COMMONWEAL THOF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDJ;NT,
.... "';'::'':''. ~,'-".~_..::.:;.."'" '(_:'~:::'-~~"""~""""-'''''''''''''~+''''>~''"'---:-
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SCHEDULE "A"
REAL PROPERTY
.
Real property in Pennsylvania, with statement 01 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 identilied
as to quantum of interest and the estimated value should be that 01 the decedent's interest only. (Property
held as ioint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The real p;operty loc:ated (n the Commonw6ohh of PennsylvanIa should 'oe
described by lot and block number, street and street number, together with
a general description of the propert)', with a reference to the record of the
conYeyanc~ by which the decedent took title; If 0 farm .tate number of a.
cres; also statement of mortgage encumbrance. upon each parcel at death
of decedent. Taxes, assessments, accrued Inferest on mortgages, efC.,are
to be listed on Schedule ifF" and must not" be d~duc:ted from this schedule.
(1)
(2)
(3\
OEPARTMENT
VALUATION
CAUTION
(Do not wrIte
In thl. llpace)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
/ W!-rJ..'TO,v' ..
vr Single dwelling located at 241 Walnut Street;
Lemoyne, Pennsylvania. Deed #3476 recorded in
Cumberland County Deed Book V, Volume 9,
Page 468 ~
$3,810,00
$29,000.00
29,000.00
fbll't.L 1. 'J"q cr~o
t-. /lAlJ,. No
::, 91 0
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Insert this total opposite "reol property", Schedule "A" in the X X X X X
"As Reported" column on the lost page 01 this return.
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$29,000)00
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REALTOR.
.~.
4620 FRITCHEY STREET
HARRISBURG, fA 17109
7t7-652-1900
2 PINETREE DRIVE
MECHANICS8URG, PA. 17055
717-697-4691
CERTIFICATE. .
LIMITING
CONDITIONS
1,;
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.JAC~
'~EALTOR
3800 MARKET STREET. P_O. BOX 686
CAMP HILl., PA 17011 .
717-76t-4600
REAL ESTATE
INSURANCE
.-" ;~
1068 HARRISBURG PIKE
CARliSlE. fA 17013
717-24J..80BO
545 W. CHOCOLATE AVE.
HERSHEY. PA 17033
717-634-1302
APPRAISAL OF THE VALUE
For:
Mr. Robert M. Lane, Trus~.Officer
c/o C.C.N.B. Bank, N.A.
21st & Market Sts.
Camp Hill, Pa. 17011
"
I liereby certify that I have personally. examined the property described as
one and one half story bungalow
situate:
241Wal ton Street
Lemoyne, Pennsylvania
Estate of Twite E. Emrich
,.
and it is my opinion that the value of said property as of the 27th day of
February A. D. 1978 is twenty-nine thousand
($29,000) dollars
. The property \-\'as appraised as a whole owned m fee simple and unencumbered
by any indebtedness.
I further certify that I have no present or contemplated future interest III the
property appraised or the result of this appraisal.
,
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/_"'."I;_'!_'-I~;"/ .~__>/I\ ,..-!-'<'-:';'/ll~:Y~_ SEAL
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The opinion of value expressed above is the result of :md is subject to the data and con~
ditions described in' detail in the accompanying report of three pages.
No responsibility is assumed for matters of a legal nature concerning the appraised prop.
erty. nor of qTuestions of surv~y. . . _ _ .
No fractional part of thiS appratsal IS to be used in conjunction with another appralsa1.
Such USe renders'it mvalid. \.., -.
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iMPROVEMENTS
241 Wal ton St. ~ ;Lemoyne
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Type: l~ story single bungalow (asbestos siding)
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Lot size ._._~_~~..__.~:....._.:..X._~E.._~E1?!.9_~.~.Construction; Existing ..m~!:.~......_..._....._.._." ...__...__.. Proposed____________ ",
Living units _..__.~_..___..Construction ....~~.!?.~.~.~.9.~._...~~.':!.~!!.(f....9..Y..::.!...:!!~.~~.......-.--.___.._"__'_"_'" Stories......l!!_--.;.Age_j.?-y rs .
Basemenl __..t.!!!}.....=~",.<!.r.'E.E.<:"t:."'........_....._....._...._....._......................................-............-........--......-.-....--..--....-- .
IsI flaar:.LR.-ili's DR........1li'.,?... K.._..Yg,s..... BR._..._t.%... Clasets...._.tJiQ....._ Balh.Q.[!!;?_..... Other .....t.!.o..r.!..t:. & refg....P2rches
2nd floor: LIL..-__ DlL.........._ K BR.......O"E''''_.. Clasels................._._. Bath..........._....... Other ...-.........-..
3nd floor: lR....~ DR....~__ IL._.._.._ BR.:..._._....._. Clase!;.._..................... Balh._................... Other ---..:...--_."
TYPE OF PLUMBING: (a) Balhraam ___'!E.P..p..'!!.....":....l?E..t.....y."'..F.!:l...O"!9.J.f...lf.t:.<JE'f'!L..............____.
---------.------..-...-.---.---.-............................-........_.--------_...._~-_..__._-_._...__.._-----
. ..____.__.w____...._.P__..__..._.._._.._.___..___...~__--------
. (b) Kilchen _.....E.5!12P."!E..___....?!!.I.:!l....'J..!9...g'!'.'3._.E5'.I2g,e., ample.....cabiIl!!..~'?..__
. . . . .
.-..----.--------------.-.-.-.......-..--...-........--....-.---......-.,---...---.-----.----....--.--..-
INTERIOR: Walls - Plaster ......ye"'_.__...........Dry ...._.__.............__._:............._ Othor ~.......-.._......._-.~..--..-.-.......
Floors __..lZ.i..'2"!_.=._'Y2.._&....!!.O"'Y.E._.....__..___....._.._ Woodwork ...._Pl1.!p.t.."'.d......_..__.... Nalural Firep'ace.~_!':~_._:....__
BASEMENT: .Faundatian ..__.._l>.~()..c...~_........_._....._.._......_.Flaar..........'?"'l!'?.r.:"!.~"!........_.................._.......__Excavated ..~ 00_....___%
. Healing, Type _._!..?E=::.'!...!'..'?.t.....ii.~..J:...._..._:...Fuel...._........().~.~........__........._._...___...Air Canditianing__!!..?.......___
Waler ~ealer ___9..a.!?_......_...........____...._...:....:......._.._......Waler softener _...._....._':'.CJ......__..,.Laundry Irays no..___
ROOF: Type _.'!.!!!p.J:l.'!'J.t:....".0..f..r.!.g:~.,,__ . Candition...._....g:'?e.~...._.................._......_...._.Gutters and dawnspauIL.....---Y_e.&_...._____._
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'MISCELlANEOUS, Ins~lalian ._......_.._.....1.'.".1.'.::............:.........._.........._...._.........................._.,.Slorms __._J.~9.....% Scree~L...~gL_%
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CONDITION, (a) Exterior .._......_....9.:C>."..cl...~.ll".P."..._..............................................................:._......__..__...Rem~ining useful ' life of building,
. . ". . (b) Inleriar' __..:.....ti'!i..Lt>.!.'.?.P.'f'._......._......................................__.._....._.......__._.........._......._......._...__~!f'_iJL,?...--.~.
GARAGE: Construction _...._...._:':'.().:'=...~................._............................:::..............-.-Roof ......_.........~._....::............._...._...._......Na. ~f cars_._.._.....:._.
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OTH:~z~uilDjN.Gs7=.:~::i.:~~::{I!."~~e.t.r....~:=::::::::::.::::::~::.::..:.:::::...::..,.~:i=~.~ay.:=~=~~:~~:=~:::::..._....-=:::=:=_~:......
UTilITIES, . Sewer_._....J!.'1.?.1.J.c:.................... Water _....f''1..1;>~.!'''_._......._.........Gas ......M."'.'3...__........................Electric _..!l.'!ii._.._.__...___.......
Well c,._.c.._..,.........._......_..._..........._._................................................._..............................Seplic tank._.......::_..._..._._...Size ---'_....--.....----~.
. STREET IMPROVEMENTS: Walks .._..?'~.s............._.............Pavi~g....._m.aE.:.......C. and Guller _..?'''!.''..........__...:_..Alley ___...':"?.___._..~
. TAXES: Current general _....!.?B...,,,4..?....._.............._...................... Special assessmenls ..............._.l!?.!:'."'.....J<:r.!.CJ.."':':'__._. -
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. . COMMENT: Neighborhood Irend _....._.'3..~.a..1;>~.Li.."'~<i...
Type slrudures __ sir.!g~~....t..a,.l!!i..l.y.....<iw.."J+..f..!'.gs.....~_........._.Candilian _.J.",}.! t",_.9:e.od_._Age _2.;j.=-4.J....!d.~<y::s
Any area deterimental influences: none known
. 200 .
This property could renl far $....._...................................per month.
The markelability of Ihi, property is __..._g.qQ.~.,.....f...f......!"'..~"'.c:.'2.!."'.t...e..d.....J!lsi.g!!_...._....
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Recommended necessary repairs and possible cost:
1 House needs complete paint job inside.
I . All inside junk and useless items should be cleaned out, including cellar.
I Inside plaster should be repaired where needed.
. . Approximate cost would be less than $1,000
';Plat Plan sketch and/or perimeter drawing of building. ,
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Lot is only' approx.
Legal did not show
exact size
approx. 50'xllO"
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Lot'is flat; with' no apparent draihingproblem. The legal description
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. roes not show ,the exact size of the lot,'but it looks about 50' xlIO' as an educated
guess. There must be off street parking along the 'left side of house, because an,old
car was parked there. This appraiser could not actually see the driveway because of
deep snow. . "
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t~, LAND
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DISTRICT
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,The area is of moderately priced homes, ranging in age from 25 to 45
years". There' is .-no new construction becaus'e it is a very old area' but we~l thought.
'of and houses seem to sell without too much difficulty. It is considered'a good,
well stabilized area. This appraiser saw no other homes for sale, on the street -at "
,this :time.,'
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Comparable Properties
Dole
lol Size,
Sale Price
Sq. Ft.'
No 1 '5835 HL.'II!iide-1<.iYWJ-.l1.>!.r;,11..i!1JiQJ;;1:IJ.}.rg..._.._YJ.Ej7~..-.-.-j~.L~Q9~_-,_
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No. :1 _13_. D.:..2L..J:f!,chani csburq _._,__.___.....:.._...._...lJ,l?ft.LZL....__..:!.:.I!.!!..O
, .,'No. 3 _._2.~~"-~~~?S.J!..d., Ca.fllE....!ilJ.L________._...____~~~.Y-.Z?..__..._._~?..!.~OO ....:......__
.
1
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11
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115x100
72xl59
63xl50
, , ' -- $29 900 $
VALUE BY MARKET APPROACH __,_-"__.___~-
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RCC-135
CO~\ONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
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INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property 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 first (e.g; jewelry, wearing apparel, household
goods, and ftlrnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certU'1cates, cash on hand and 1n bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or rirluciary 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.
I tern
No.
10.
11.
12.
13.
ITEM
List and describe fUlly
UNIT
VALUE
1.
Household Goods
2.
1961 Studebaker Lark
3.
Cash found tn home
4.
...........CCNB Certificate of Deposit 112306
5.
CCNB Certiftcate of Deposit 112313
/CCNB Certificate of Deposit 112325
Accrued Interest on above Certificates of
Deposit
6.
7.
8. ~West Shore Savings & Loan Association.
Savings Certificate #82, 6%
9.
Accrued Interest
~rris Savings Assoctation Account #24208
Accrued Interest
Dauphin Deposit Bank Savings Account
1130001 \
11001-00- )
State Capita~vings & Loan Account
06448"/ 6...- 0 :,:4~
W~?"
Insert this total opposite "Personal Property", Schedule "B" in
the Tl As Reported" column on the last -page of this return.
x X
ESTI MATED
MAIIKET VALUE
DEPARTMENT VALUATION
(Do not wrIte in
this space)
$
1,419.74
742.90
300.00
60.75
3,000.00
3,000.00
3,000.00
72.28
10,000.00
84.74
4,200.00
17.15
1,305.59
@7 ,197 .5])
$27,203.15
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CUMBERLA D COUNTY
" NATIONAL 8ANK AND TRUST COMPANY
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, THJFH:l.AND HU'MMEL
~E:MO:N E, PEN NSY LV"'N I'"
April 21,1078
CC"lB Bnnk NA
". -T~Dst rep~rtment
.. 21st and ~larkE't Strpets
. Carnr )-1;11, Pa. l70ll
'Attention: Miss Jane ~?vidson
J)ear Jane:
This is to advise Y0U thMt Twi tP. ,...
'catp.s of DeDosit w-:i.th 01,..'!T:' Institution on
uary 28.,1972-"
.Emrick had three ~prtifi~
the rlate of his death,- ,Ja,n-
Numb!?!"
Amount
Issue Pate
C/D #2306Q
$3:00()~nO
3/9/69
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$1:0iJo~nn .
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$3,000.00
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Each Certi.ficCltp \\"'215 for Quart.~rly Income check ann issued to
T~ite ~~ Pmrick .
241 Walto~'St~pet
Lemol/De, Pa. 1704'3
If we can he nf Rny further aS~istan~p~ nlease advise.
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Serving the West Shore Since 1923
Telephone: 737.6631
761.7810
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West Shore Savings and Loqn Association
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p, O. BOX 198 . FOURTH and MARKET STREETS
LEMOYNE. PENNSYLVANIA 17043
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THEODORE F. BURD
. , Secretary
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April 24, ' 1978
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Jane E.' Davidson'
CCNB-NA
" ,331 Bridge Street,
New Cumberland FA
17070
RE:
Twite E. Emrick Estate
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'Dear Miss Davidson:
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'At the time of the death of Twite E. Emrick on January 28, 1978;
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" for $10,000 .00 and the interest earned from October 1, 1977 to
'January 28, 1978 was $196.90.
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, ti2-l:;p</;/7/b~)" c~.Iz(t
':Arline'V. Drackley (Mrs.),
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The H A R R I S Savings Association
205 PINE STREET
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HARRISBURG. PENNSYLVANIA 17105
>(- .....:
OfFICES'
Area Code 717/236 - 4041
DOWNTCNVN ' COLONIAL PARK' CAMP HILL ' LEBANON' UNION DEPOSIT
'CAPITAL CITY' NEW CUMBERLAND
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April 25, 1978
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C.C.N.B.
331 Bridge St.
New Cumberland, Pa. 17070
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Attn:
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Twite E. Emrick, Estate
(Miss)JaneE. Dav~dsan
Assistant Vice President
and Trust Officer
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'Dear Miss Davidson:
This is confirmation of the balance in Optional
Savings Account #24208 was $4,200.00 on January 28,
Mr. Emrick, demise. Earning + 16.'34
$4,216'''34 Total of account on date, of death.
"
Passbook'
1978 the
date'of
If you have any further questions plea3e feel free to contact me
at any time.
I remain,
Very truly yours,
...-, Ii C~vo/7,
Cr.=vy_e_~JJ 0 //7a.^~
(Mrs.) ~elyn C. Maile~
'Savings Officer
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COMMONWEALTH OF PENNSYLVANIA
TRANS"~R INHERITANCE TAX
SCHEDULE "c"
TRANSFERS
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RESIDENT DECEDENT
(1) Did decedent, within two years of'denth, make any transf'er of any material part of his estate, without
receiving a valuable and adequate consideration therefo~? (Answer yes or no) No
(2) Did decedent, within two years of death, transfer property f'rom 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 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 w~s to take effect in possession or enjoyment at or after his death?
(Answer yes or no)~n
(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 before his death: I
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) Nn
(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 transfer, the consideration for which w~s transferee's promise to
pay income to or for the benefit of care of transferor? l (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 reserved power to al ter, amend, or revoke, or which cOHld 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) I
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
DESCRIPT ION .
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dep t. OnI y)
NONE
-0-
None
,
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" colunm on the last -page of this return.
None
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LAW OI'TICES
JON F, L",FAVER.
. 317 THIRO STREET.
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LAST WILL AND TESTAMENT
OF
,
TWITE E., EMRICK
I, TWITE E. EMRICK, of the Borough of Lemoyne, County of Cutnber~
land and State of Pennsylvania, being of sound mind, memory and understanding,
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do hereby make; publish and declare this as and for my 'Last Will and Testament
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revoking a;'d making 'void any' and all other willsby'me at, any time
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i(personal or mixed, and wheresoever situate, I hereby give', devise and
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'I' unto my wife, 'HAZEL A~' EMRICK, if she survives me by a period of thirty days~./
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'H If my said wife does not survive me by a period of thirty days;' i:lienthis gift;,'
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';1 to her shalr' be' diyested, and I then give, devise and 'bequeath
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,bequeath J,
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just debts and funeral expenses as soon as conve~e~aY be done/ait~r
II.
All the rest, residue and, remainder of my estate; whether' reai,
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my entire estatel,
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NATIONAt
JOYCE L. SALAPA, TWITE S: EMERICK, and' ALICE ,M.
III.
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I hereby nominate',' constitute and app'oint CUMBERLAND COUNTY
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TRUST COMPANY as Guardian of the estates of any minors who 'may take a I
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BANK AND TRUST COMPANY as Executor of this, my Last Will and Testament~
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under this Will.
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t hereby nominate; constitute and appoint CUMBERLAND COUNTY
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,!i NATIONAL
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,IN WITNESS WHEREOF, I, Twite E. Emrick, the'Testator, have unto
my Las't Will , and Testament, ,set my hand and seal'thi~~3- 'day of
1967. "
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COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
,
BENEFICIARIES
l
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RELATIONSHIP ,
BENEFICIARIES AND ADDRESSES (If step-ehHdren or SURVIVED 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
.
T,.._~ Hp,."hock Daughter yes Le"a1 1/3 Share
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". u Coo, _" Yes Leaa1 1/3 Share
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C1earfie1d. Utah 84016
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Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
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Real Property
Personal Property
T ranslers
Joint1YpOw:ned
SUMMARY
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PPPPPPp..(Sch. "B")
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. ropertYp(Sl:'I1,'~E")
Gross Taxable Esta e
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(1)
(As Reported)
$ 29,000.00
$27,197.57
$.... ...... .::0::.
$ ....1,680,71
$ .p"
$..57,878.28
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(2)
(As Determined)
$
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RC(38..
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COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "E"
JOINTLY OWNED PROPERTY
RESIDENT DECEDENT
\
INSTRUCTIONS: This scherlule must disclose all property, real and persoryal, owned by the decedent jointly
wi"th another or others, including tntangibles, standing;!n the name of' the decedent and others. List
real estate first, as entireties, or Joint tenants, glving'-brief description, as indicated 10lder Schedule
rr A", plus the date and place of record of instrument effecting vest! ture, but do not include entireties
or out of state real estate value in estate valuation colOmn. Personal property should be listed as in
Schedule "B",. ]lIus date of acquisition, and the name, add~ess ann relationship (if any) of' co-owners to
the deced.ent.
Description of Property, Date of Acquisi tion, Name
Address and Relationship of Co-O~ners, and Place
of Record o~ Instrument, where Real Estate.
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"x'\. >00 XX 'X "X
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CCNB Checking Account No. .248-608-2
Balance $3,361.42.
Joint Owner: Joyce E. Hershock,'
Daughter 239 Walton Street
Lemoyne, Pa. 17043.
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Value
percen tage
Share
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Estate
Valuation
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DEPARTllliNT VALUATION
CAUTION-Do not Write
In This Space.
Value of' Value of
Entire Decedent's
Property Interest
1,680.71,/
Insert this total oVposite "Jointly Owned Property", Schedule "Err
in the" As Reported" colunm on the last page of this return.
1,680.71
$1,680.71
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RCC.BI (6-73;
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLi;::ASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Jane E. Davidson, Trust Officer
CCNB Bank, N.A.
2101 Market Street. Camp Hill. FA 17011
(Executor or Administrator)
In Re: Estate 01
Twite E. Emrick
Cumberland
County - File No.
2l-7B-0068
Dear Ms. Davidson:
Yau are hereby notilied that the----"-., ;i'.:l~l Original
appraisement in the estate 01 Twite E. Emrick
has been Ii led in the ol/ice al the Register 01 Wi lis al Cumberland
Cauntyan June 29 ,1978, Soid appraisement rellects the lollawing
valuations:
Real Estate
Personal Property
T ran siers
Jointly Owned
T~tal
29.000.00
27,203.15
None
1,680.71
$57,883.86
As to such tax that is poid within three months Irom dote 01 deoth, a live (5%)
percent discount is ollowoble. As to any tax that remains unpoid alter nine (9) months
(Iilteen months when death occurred Irom December 22,1965 to June 16, 1971, inclusive;
and twelve months when deoth occurred prior to December 22, 1965) /rom date 01 death,
interest ot the rate 01 six (6%) percent per annum is charged.
Any porty in interest who is oggrieved by this notice may object thereto within
sixty doys olter receipt 01 said notice as provided by Section 1001 01 the Inheritonce and
Estate Tox Act al 1961, 72 P. S. 2485-1001, P. L. 373.
Dote June 29,1978 Signed ~a...- k, ~~
Title Chief Appraiser
Note: This is not a bi II.
RC C-2 (2-641
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.
21-78-0068
Whereas,
Twite E. Emrick
late of
Borough of Lemoyne
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 28th day of January 19 78 , 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 Ufe 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.
TOTAL ASSETS
Unit Apprallement
Valuel Made for Inheritance
T.... PUfPOIlll
$ 29,000 0 :
27,203 15 i
None
1 680 71
$57.883 86
Oucrlptlon of Auot
Real Prooertv
Personal Property
Transfers
Joint-Held Prooertv
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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 <:'\. Ju~~ n . 19BL-.
cl.--'"" If', ~-
A.ppralser
(N\lm!x!r and Strfllt)
Harrisburg P
_ , enna.
(Post 0ftI.~)
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