HomeMy WebLinkAbout05-30-78
Form No. RCC-62 (6-70) THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER SECTION 701 OF ACT OF JUNE 141, 1.e1,
EF'fECTIVE lANUARY I, 1982, {FILE IN DUPUCATE WITH COpy OF WILL ATTACHEDl
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OFFICE OF'THE REGISTER OF WILLS
C11'>cmVDJ^ND MA'( 0 U 19/8
County of , H Je'V,'"'' n. "...'",.,..
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(Name) (Addreu)
being duly__...__.8WUrll.._________________ according to law, deposes and says that he is the__.__Adro.:i..\l,.Ei.s.j;^~d--Hj;L.m;...s.E----).,--,...--------
xec., m., eptee, cc-
of the estate oL_____Cindy..J....__C.1Quse___.____________ whose last residence was..!<.'...I?"....~.,___!'!~~;L,'.s.:!_,J,)!<!--,.t......---.---,...
Pa. (No,) creet
...~9:'!1:~;r___~.:!-.rf.:L:i:n.__~.,.!.! decoased, and that the whole of the estate of said decedent, who died .J)gQ.....,20.,6).....19.7.7
(City, Borough or Township) ace
consisted of:
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Estimated
Real Estate Value
NONE
Personal Property
1. Checkinl! Account No. 23146028 in Dauphin Deposit Bank And
Trust Company, Carlisle, Pennsylvania. V 4lf.52
2. S~vings Account No. 11-65977 in DauDhin Denosit Bank And
TruSt: lJompany, lJarL1SJ.e, l'ennsYLvanla. /
,/ 11. 53
3. Kinney Shoe Corporation, wage checks. J./ ~ 82.36
4. 1974 Volks\mgen Sedan. v 4:.,525.00
5. Unearned premium. Harlevville Insurance. ...... " 106.00
6. Refund, Federal Incorae Tax. If ./ S4~.40
7. Refund, Pennsylvania Income Tax. /' 1.00
v
'J'OTAL $2,314.81
NOTE: You may expedite the processing of this return by filing with it, and as a part of the return,
letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the
decedent as of the date of death, Such letters must be signed by a responsible officer of the financial
institution 01' mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account, account number and the exact name or names in
which the account is registered. '
!
---1
E~imated
Value
Jointly Held Property
NONE
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___H_ _________
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Transfel'S within TWO YEARS Prior to Death
NONE
L.--
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That at the time of death there was no safe deposit box registered ih 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 dpputy, with the f'x(,f'ption of the following:--
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--~~;~--~-:-~,-~'~;:~~~;c;T ao;=;~-~; f: ;;--- ---=-r~~;~~~-lb-N S~{~~-~;~~-;~~~;--
IN NAME OR NAMES OF ! HOLDERS TO DECEDENT
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
NC'NE
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BENEFICIARIES
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RELATIONSHIP SCRVIVED, ! Jj,GE OF LIFE - ._--~
BENEFICIARIES AND ADDRESSES (r f step-children or TENANTS OR INTEREST OF
(State full names of all and their addresses wilD have illegitimate children DECEDENT ~NNUIT ANTS BENEFICIARY
an interest, vested, contingent or otherwise, in estate.) are involved, set STATE YES AT DEATH OF IN ESTATE
forth this fact.) OR NO DECEDENT
---- -------
Daughter , Entire
Michelle E. Clouse -t~~-l Estate
I ----.--
R. 1;>. 3, Box 274
! -
Newville, Pa. 17241 ! !
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RESIDENT DECEDENT DEBTS AND DEDl'CTIONS CLAIMED
NOT}': List first five items in the spaces so provided, abse'rve. notations thereon, and instructions.
DEBT OR CLAIM NATURE OF SAME
AMOUNT
$
1/
,
Funeral expenses paid
$
Family exemption (will not be alltlwed unless
decedent died residing with a spouse or children.)
Administration Expenses ,.,
Counsel fees ...
Fiduciary
commission ,..
(*) See Note below
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Total
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Note:
The estate agrees to advise the Register of Wills if the amount
01" less than the estimated amount claimed and allowed.
r- r' -'~)"
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actually
Pal: in?lY~l~ of -;t~c~~greatel'
~, .' Keet
l( ." ?'O
, ' "'~ X. , ,tr:t.-f~~,<".""""
(Executor-Administrator)
Subsnibed and SWOl'n to before me this
r( ':- ^
(~ ~~.,-~,"T.daYOrclJ-~j;Sj~>
, " "J'A' N' 'I'C' E"E'."H' E"R' rZL' E"R' ,""OTA'RY PU BUe"
" , "N~i).,J,~. ,Pil., 1724~
Cumberland County Carlisle, Pa. (City or Town and State)
My=COirll 111;-srrrrr-tx-ptr.....;l Jut,d':-') J 27 I 19l.9~~~,--=-=,---O=--=_-c===-=~---"--"-__"-",_-c,_. - .-=--=,=
Havin~ been duly sworn accOl'ding to law, I do hereby certify that the above appraisement is made in ('antOl'mily with law on this
6
,,19,
".~,., .P~" ,~"
,~;l\C,.4i4..,..,
(Street Number)
day of
. ., 19.
Apprllillt'r
In the event that any futul'e intel"est in this estate is transfened in possession 01" enjoyment to collateJ'RI heirs of the decedent after the
expil'ation of any est[:te fOI' life 01' for yeal"S, the Commonwealth hereby expn'ssly reserves the right to appraise and assess transfer-inheri-
tance taxes at the lawful collateral rate on any such future inleH'St.
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for. . County, Pennsylvania, do respectfully
rf..'port that I have allowed debts and deductions In the amounts claimed by deponent, except as to those items where a greater or lesser amount
IS set forth in the last column to the right in said schedule above, which greater or lesser amount represents the sum allowed as a deduction.
:)ated.
Register of Wills
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RCC-Sl (6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
ChalLte6 R. croMe
R.O. 3 Box 274
Newv~e, Pa. 17241
(Executor or Administrator)
In Re: Estate of _
ctndu L. C.e.OM e
CumbeJ!.f.a.nd
County - File No. 21-78-0078
Dear MiL. croMe,
You are hereby notified that the OJr.igi.J11Lf
appraisement in the estate of Ci.ndy L. C.e.oUAP
has been filed in the office of the Rewster of Wi lis of CwnbeJ!.f.a.nd
County on June 8, , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total $
None
2.314.81
None
None
2,314.81
As to such tax that is paid within three months from dote of death, 0 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 dote 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 os provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L.~. .
Dote June 8, 1978 Signed '4; _ J(_L!~~1~=--.
Title _____QHIEF APPlMISEK_ __
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Note: This is not 0 bill.
RC C-2 (2-64)
.
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
June 8, 1978
DEJ'ARTMENT Of REVENUE
BURE"AU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COUNTY
Cu.mbVZ1and
21-78-0078
FILE NO.
Whereas, Ci.ndy L. c.e.ou.oe late of NelWille
in the County of Cumbvc..e.and Commonwealth of Pennsylvania, having died on
the 26:th day of VeeembeJt 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Itta K. Glehn . 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 de-cedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Appraisement
Ducrlptlon of Asset Value. Made for Inheritance
Tilt Purpo'el
ReaR. PltOpeJt:ty $ None
_._~- I---
PeJL6onaR. PltOoeJt:tu 2,314 81
Joint Held PltOpeJt:tq None
T Jta.n6 I. eJL6 None
TOTAL ASSETS ~ 2,314 81
Having been duly sworn according to law, I do hereby certify that the above appraisement is made in ~on-
formity with law on this _ 8:th day of June ~ . ~ ' 19~.
C": .- k. /;/ _..
ApprailJer
(lfumbl!r and St~et)
(PQIt OfIIH)
, Penna.
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