HomeMy WebLinkAbout07-10-78
RCCa33 (4~73)
JW 1019*
COMMONWEAL TH OF PENNSYL VANIA .,
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RESIDENT DECEDENT
COUNTY OF
Cumberland
IMPORT ANT,
This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the
County where decedent resided; Return is due within nine months after date of death, unless an extension is granted
by the Secretary of Re'lenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
X~
County
Carl G. Mortenson
(STATE FULL NAME OF DECEDENT)
County of
Cltmh~,...l.:::lnn
} os,
State of
Raymonn T Cam~ron Vice Pres. National Central Bank
~m:(StX of the estate of the above-nomed decedent being duly sworn, depose and say
Executor
Decedent died T.:::Inl1.:::1,...y
(MONTH)
Name and address of attorney or }
other authorized representative to whom
all correspondence should be mailed.
10
.
I9~{;~~~VI"g c Ic" will, 'cpy cf whl,h I, h""c c''''hed.}
(YEAR)
(DAY)
Robert L. Myers, lIlt-Myers, Flowers & Johnston
3rd Ii. MsrkQt ~trQQt, T.~moyne, PA
17043
That as such ~V~""'l1rn,... deponent is familiar with the affairs of said estate and the property constituting
(EXECU TO R~ADMINIST RA TO R)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A S,->,FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception' of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at
death, name ,of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as 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 separately the accrued interest thereon, if any, down to the last interest day prim to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages,
automobiles, boats, and any and all other personal chattels of whatsoever. kind or nature, h::ft by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the market value there-
of at such time.
RCC -35
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of' his death. Property owned by the decedent jointly wi th another or others
must be listed under Schedule "E". Intangible personal property, titled in the name of' the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of' the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certiricates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in any undistributed
estate or or income rrom any property held in trust under the will or agreement or another, even though
located outside of the State, at the time or death, should be listed in this schedule.
Item
No.
ITEM
List and describe fUlly
UNIT
VALUE
ESTIMATED
MARKEr VALUE
1.
Automobile - 1977 Mercedes Benz 300D
12,000.00
DEPARTMENT VALUATIOI
(Do not write in
this space)
/12,000.00
Stocks:
2. 1,170 shs. AMP, Inc., Common
3. 200 s hs. Ams tar Corp., Common
4. 4 shs. Bell & Howell Co., Common
5. 22 shs. Wadsworth Publishing Co.
25.625
18.375
14.125
30.125
29,981.25/ 29,981.25
3,675.00V 3,675.00
56.50 V- /' 56.50
662.75 V 662.75
Bonds:
6.
$402,000 City of New York Bonds for Rapid
Transit dated 9/15/70, due 3/15/99, 7.25%
~ ~O Q~~~
79.625/330;092.5g)
'-----------~_.
320,092.50
Accrued interest on Item #6 from
9/15/77 to 1/10/78 (117 days)
9,342.37 V 9,342.37
7.
Check from Dean Witter Reynolds, Inc.,
representing dividends paid prior to
death of Carl G. Mortenson
276.24/
276.24
8.
Received from American Airlines, return
deposit due to cancellation of credit
account
425.00/'
425.00
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page or this return.
x X $376,511.61
$376,511.61
.
tiCC'- Ob
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHEIUTAKCE TAX
SCHEDULE "e"
T RAN S FEllS
IlESIDENT DECEDENT
(1) Did decedent, within two years of'deuth, make any transfer of' any material part of his estate, without
receiving a valuable and adequate consideration ther-erar? (Answer yes or no) no
(2) Did decedent, within two years of death, transfer property from himself to himself and another or
others (including Ii spouse) in joint ownership? (Answer yes or no) no
(3) If the answer to (1) or (2) above is in the aff'irmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's heal th at time of making the transf'er. (Note 1).
(e) Cause of' decedent' 5 death. (Note 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration thereror which was to take errect 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 transrerer or his
estate or be subject to his power or 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 transrer without receiving a valuable and adequate consideration
thereror under which transreror expressly or impliedly reserves ror his lire or any period which does
not in fact end berore his death:
(a) The possession or enjoyment or or the right to income from the property transferred?
(Answer yes or no) no
(b) The right to designate the persons who shall possess or enjoy the property transrerred or
income thererrom? (Answer yes or no) no
(6) Ir the answer to (5) (b) above is 1n the afrirmative, state whether the right was reserved 1n decedent
alone or others
(7) Did decedent in his liretime make a transrer, the consideration ror which was transferee's promise to
pay income to or ror the benefit or care or transferor? (Answer yes or no) no
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because or a reserved power to al ter, amend, or revoke, or which could revert to decedent under terms
of' transfer or by operation of' law? (Answer yes or no) no
(9) rr the answer to (8) above is in the arfirmative, was the power to alter, amend, or revoke the inter-
est of' the benericiary reserved in the decedent alone or the decedent and others?
(Answer yes 0 r no) no
NOTE 1: The answers to these questions should be supported by af'fidavit by the attending physician as
well as a copy or the death certificate.
NOTE 2: If' answer to any of the above questions is yes, set rorth below a description of the property
transferred, it's rair market value at date of death, dates or transf'ers and to whom transf'erred, with
relationship of transferees to decedent, if any. Submit copy of' any trust deed or instrument, if' trans-
f'ers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
NONE
Insert this total opposite "Transfers", Schedule "e" in the
"As Reported" column on the last page of this return.
0.00
..
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Eel,;t 3Oi11 Clttb QIt5t&tttetU
OF
CARL G. MORTENSON
I, CARL G. MORTENSON, of the Borough of Camp Hill,
CU!lmerland County, Pennsylvania, make, publish and declare this
to be my Last Will and Testament, hereby revoking all wills and
codicils by me at any time made.
I direct that all my just debts and funeral expenses,
including my gravemarker and all expenses of my last illness,
shall be paid from my residuary estate as soon as practicable
after my decease as a part of the expense of the administration
of my estate.
II .
I bequeath my alltomobiltcs, household dnd personal effec'ts
and other tangible personalty of a like nature (not including
cash or securities), together with a:1Y existing insurance
thpJ:con, to my wife, Mar'y deS. Mortenson, if she survives me by
thirty (30) days.
Should my wife, Mary tieS. Mortenson, not be
living on the th.lrty'-first (31st) day following my death, I
bequeath such tangible personalty and insurance thereon to such
of my children as are living on the thirty-first (31st) day fol-
lowing my death, to be divided between them by my executor with
due regard for their personal preferences in as nearly equal
shareb as practical. If either' of my children shall have prede-
Ct'a ',d'd me, I bequeath the share said deceased chi Id would have
rece1ved to the issue of said deceased child, share and share
alike, and 1n default of issue, I bequeath said share to my sur-
viving child. Any such Jrticle allocated to a minor may. dS my
executor th i Ilks advi Sdble, ei tlwr be del i vered to the millor or
to "ny person to, bol,j for the: !Ill nor or to be sold and the pro-
'.~l:':.li.~ pdid to r:JiC' \iUdHlidl. (l~, "rolH~~j L',' ':list.f'il..u~Jtblt~ to tl~~
. .
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minor as hereinafter provided in Paragraph IV hereof.'
III.
If my wife, Mary deS. Mortenson, survives me (and I direct
for the purpose of this Paragraph III of my will that she shall
be deemed to have survived me unless it appears unmistakably
that she predeceased me), I devise and bequeath the residue of
my estate of every nature and wherever situate, including any
property over which I have any power of appointment, as follows:
A. If the federal. estate tax due because of my death
will be reduced by making this gift for her benefit, I devise
and bequeath to my wife, Mary deS. Mortenson, absolutely an
amount exactly sufficient to reduce such tax to the lowest pos-
sible figure, including full use of the federal estate tax
specific exemption and of any credits available to reduce such
tax. A chief object of this Paragraph III-A is to secure the
full benefit of the marital deduction alldwablc tor federal
estate tax purposes or any similar benefit available under the
federal estate tax law in effect when I die. Accordingly, I
direct that:
1. If the marital deduction or any similar bene-
fit is allowable with respect to any property, including prop-
erty held by entireties, which my wife has received prior to my
death or at my death wi.ll receive otherwise than pursuant to
this Paragraph III-A, the value of such property shall be taken
into consideration in calculating the size of the gift under
this Paragraph III-A.
2. No property ineligible for the marital deduc-
tion or any similar benefit shall be distributed to this gift
for my wife, Ma;r:y deS. Morter;son, pursuant to this Paragraph
III-A.
3. Either cash or investments or both may be
'.
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allocated to the gift under this Paragraph III-A.
4. Any property allocated under this Paragraph
III-A in kind shall be valued at the value at which it is
finally included in my gross estate for federal estate tax pur-
poses, provided that the aggregate market value thereof on the
date of allocation (plus the value as finally determined for
federal estate tax purposes of all other property qualifying for
the marital deduction) is at least equal to the dollar value of
the marital deduction as finally determined for federal estate
tax purposes.
5. If any provision of my will shall result in
depriving my estate of the marital deduction for federal estate
tax purposes for this Paragraph III-A, such provision is hereby
revoked and my will shall be read as if any portion thereof
inconsistent with allowance of the marital deduction for federal
estate tax purposes for this Paragraph III-A is /lull and void.
B. The balance thereof to National Central Bank,
hereinafter called trustee, IN TRUST, for the following uses and
purposes:
1. To pay the net income therefrom to my wife,
Mary deS. Mortenson, for her life in such periodic installments
as trustee shall find convenient, but at least as often as
quarter-annually.
, I
2. As much of the principal of this trust as the
trustee may from time to time think advisable for the support of
my wife to maintain her in the station of life to which she is
accustomed at my death and after taking into consideration her
other readily available assets and sources of income, or for the
support of my children after taking into consideration their
other readily available assets and sources of income or during
illness or emergehcy, shall be either paid to her or them or any
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of them or else be applied directly for her or their or any of
their benefit by the trustee. Any such distributions hereunder
need not be equal.
3. In addition to the above provisions, my wife
shall have the power .to direct trustee to pay to her or to apply
out of principal in each year, including the year of my death,
.'in amount not in excess of the greater of Five Thousand
($5,000.00) Dollars or five (5%) per cent of the then aggregate
value of the trust principal. This power is non-cumulative and
"
can be exercised only by an instrument in writ~hig signed by my
wife, Mary deS. Mortenson, and delivered to trustee.
4. The trustee may apply the net income of this
trust for the support of my wife, Mary deS. Mortenson, should
she by reason of age, illness or any other cause in the opinion
of the trustee be incapable of disbursing it.
5. Upon the death of my wife, Mary deS.
Mortenson, or upon my death if she predeceases me, this trust
shall terminate and the then remaining principal and any accumu-
lated or undistributed income shall be distributed to my then
living issue, per stirpes, without regard to earlier distribu-
tions of principal to children under Paragraph III-B-2.
IV.
I appoint National Central Bank of Harrisburg,
Pennsylvania, guardian of any property which passes either under
this will or otherwise to a minor and with respect to which I am
authorized to appoint a guardian and have not otherwise specif-
ically done so, provided that this appointment of a guardian
shall not apply to property distributable to a minor for whom I
have otherwise made special provision and provided further that
this appointment of a guardian shall not supersede the right of
any fiduciary in its discretion to distribute a share where pos-
sible to the minor or to another [or the minor's benefit. Such
.1
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guardian shall have the power to use principal as well as income
from time to time for the minor's support and education (includ-
ing college education, both graduate and undergraduate) without
regard to his or her parent's ability to provide for such sup-
port and education or to make payment for these purposes, with-
out further responsibility, to the minor or to the minor's
!>arent.or to any person taking care of the minor.
v,
All federal, state and other death taxes payable because of
my death with respect to the'property forming'",y gross estate
for tax purposes, whether or not passing under this will,
including any interest ur penalty imposed in connection with
such tax, shall be considered a part of the expense of the
administration of my estate and shall be paid from my residuary
estate under Paragraph III-C without apportionment or right of
reimbursement. All such taxes on present or future interests
shall be paid at such time or times as my executor or trustee
may think proper regardless of whether such taxes are then due.
VI.
The interests of the beneficiaries hereunder shall not be
subject to anticipation or to voluntary or involuntary aliena-
tion.
VII.
My executrix, executor, trustee and guardian shall have the
following powers in addition to those vested in them by law and
by other provisions of my will applicable to all property,
whether principal or income, including property held for minors,
exercisable without court approval and effective until actual
distribution of all property:
A. To retain any or all of the assets of my estate,
real or personal, including stock of my corporate fiduciary,
without regard to any principle of diversification or risk.
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B. To invest in all forms of property, inclUding
stock, common trust funds and mortgage investment funds, whether
operated by my corporate fiduciary or others, without restric-
tion to investments authorized for Pennsylvania fiduciaries, as
they deem proper, without regard to any principle of diversifi-
cation or risk.
C. To sell at public or private sale, to exchange or
to lease, for any period of time, any real or personal property
and to give options for sales, exchanges or leases, for such
prices and upon sl1ch terms or'conditions as.the;r'deem proper.
D. To allocate receipts and expenses to principal or
income or partly to each as they from time to time think proper.
E, To borrow from or to sell to my trustee even
though such trustee may be my executor.
VIII.
I nominate, constitute and appoint my wife, Mary deS.
Mortenson, Executrix of this, my Last Will and Testament. If my
said wife, Mary deS, Mortenson, is unable or unwilling to serve
<IS Executrix, then I nominate, constitute and appoint National
Central Bank of Harrisburg, Pennsylvania, Executor of this, my
Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this
/ ./".<: day of
y.
.r
1975.
( 1 c;~~"fJL'-_~~-=-~(SEAL)
Carl G. Mortenson
Signed, sealed, published and declared by the above-named
Testator as and for his Last Will and Testament
of us, who, at his request, in his presence and
in the presence
in the presence
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of each other, have hereunto subscribed our names as witnesses.
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RCC-37 (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
(
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST Dr'
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 facL) OR NO BI RTH
Marv deS Mortenson wife yes of a<>e Automobile plus
517 Gale Road ~mmmt- ~~ . mined
Camn Hi 11 PA 17011 for marital deductio
for Federal Estate
Tax
,
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National Central Bank I Amo"nt '''' detarmined
,
'I'~,,~ t-oo -F^~ "ana -F.; t- ^-F i whiC'h px{"ppc1~ M.Qrir.q
Mar" de':: M^r I I n",duction for Feder.a
222 Market Street ! Estate Tax
Harrisburg, PA 17108
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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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SUMMARY
..... (Sch. "A")
.......(Sch. "B")
.(Sch."C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
$ 0.00
$ .....376,511.61
$..0.00
$
$..
$)]6,511.61
(2)
(As Determined)
$
$ 376,511.61
$
$
$
$
376,511.61
00
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"CC.31
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: Thts schedule must disclose all property, real and personal, owned by the decedent .1ointly
with another or others, including intangibles, standing in the name of the decedent and others. List
real estate first, as entireties, or joint tenants, giving brief description, as indicated \.D1der Schedule
IIAII, 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 "BII, plus date of acquisition, and the name, address and relationship (if any) of eo-owners to
the dec8ttent.
~
Description of Property, Date of AcquisitiQn, Name
Address and Relationship of Co-Owners, and Place
of Record of Instrument. where Real Estate.
unit
Value
percentage
Share
Es tate
Valuation
DEPAR'1'IIENT VALUATION
CAIlTION-Do not Write
In This IInce.
Value ot Value ot
Entire Decedent's
property Interest
0<
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List of assets held by tenants
of entireties (jointly as husband
and wife) will be furnished upon
reques t.
NONE
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the liAs Reported" colwm on the last page of this return.
0.00
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RCC-81 l6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBU RG
17127
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tox Division
NOTICE OF FILING or APPRAISEMENT
Raymond T. Cameron, Executor
(Executor or Administrator)
In Re: Estate of
Carl G. ~furtenson
Cumberland
County - Fi Ie No. 21-78-0077
Dear Hr. Cameron:
You are hereby notified that the original
appraisement in the estate of Carl G. Hortenson
has been filed in the office of the Re,ister of Wills of Cumberland
County an September 7 , 19~, Said appraisement reflects the fallowing
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
-0-
$376,511.61
-0-
-0-
$376,511.61
As to such tax that is paid within three months from date of death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death occurred from December 22, 1965 to June 16,1971, inclusive;
and twelve months when death occurred prior to December 22, 1965) from date of death,
interest at the 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 after receipt of said notice as provided by Section 1001 of the Inheritance ond
Estote T ox Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Date September 7, 1978
Signed
.
1\'
,
Title Chief Appraiser
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Nate: This is not a bill.
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RCC-2 {2-641
r
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE September 7, 1978
Cumberland
COUNTY
FILE NO.
21- 78-0077
Whereas,
Carl G. Mortenson
late of Camp Hill
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 10th day of January 19~, 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 consclonable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest,
Unit Appraisement
Description of Anet Valuel Made for Inheritance
Tax, Purpoles
REAL ESTATE OONE $ -0-
I----
EERSONAL PROPERTY $376.511.61 376,51 61
TRANSFERS NCNE -0-
JOINT-HELD PROPERTY OONE -0-
TOTAL ESTATE $376,511.61 $376,51 61
-
-
Having been duly sworn according to law, I do hereby certify that the above appraisement
formity with law on this 7th day of September \ ,
1\, ,I
is made in con-
19~.
Appraiser
(I.,_~~Str..t)
liarrlsburg
(Poat: 0ftI~)
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