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Home My WebLink About07-13-78 ,RCC...33 (.4""t3) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS *' RESIDENT DECEDENT d)UN;Y3d~ 7ftumber land IMPORTANT, 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 Frederick R. Demain (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUl:D.a r ix ADMINISTRATOR County Edith Demain Lat. of Camp Hill. Cumher] and State of Pe:nnsy' ",,;::In;;::I C t f Cumberland oun y 0 } ss, AGtn+n+~fQ~f- Edith Demain Execu'&Qq: ix of the estate of the above~named decedent being duly sworn, depose and soy Decedent died January (MONTH) Name \lnd address of attorney or } other authorized representative to whom 011 correspondence should be moiled. 1 R (DAY) , 19--1...8-{teltate leaving 0 lost will, copy of which il hereto attached..} (YEAR) intestate Myers, Myers. Flower & Johnson 301 Market Street, Lemoyne, Pennsylvania 17043 That as such executrix deponent is familiar with the affairs of said estate and the property constituting (EX ECUTO R-ADMINISTRA 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 IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Dauphin Deposit Trust Company. W Lemo ne Penns Ivania 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 interes t thereon, if any, down to the last interest day prior 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 furnitp,re, horses, carriages, 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 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 secur:lics owned by the decedent at the time of death, with the market value there- of at such time. .. ~ In the case of' securities of' close or f'amily corporations, the values reported are as f'ar as possible substantiatf'rl by f'inancial statements of' the corporations, showing the assets and liabilities thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business, and in support of' the value of such interest therf~ is annexed to said schedule, financial statements showing the assets and liabilities of' said co-partnership ortlusiness. A copy of thf' co-partnership agreement, (if oral, a statement setting forth the nature of' the agreement) together with a statement setting f'orth the character of' the business, its location, and such other facts pertaini.ng to the business as may be pertinent to Ii f'air and just appraisal of the decedent's interest therein mllst be submtttf'{l. It should also set f'orth in itemized f'orm, together with the fair market value thereof, any other property owned 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 the case of transf'ers of property, real or personal, within two years of decedent's death, in contemplation of decedent's death, or intended to take eff'ect in possession or enJo:'Jo'lllent at or af'ter death, said schedule sets f'orth the nature and value of such property, to whom transf'erred, the relationship of' the transferees to the decedent, the proportionate share received by each transf'eree and all other f'acts of a pertinent nature rep;arding said transf'ers. In the case of transfers intended to take eff'ect in prJssession or enjoyment at or af'ter death, there is also attached to the schedule a cony of' the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said schedule a list of all property, real and personal, with its value, which pa~'ses at decPllent's death by virtue of' the exercise by decedent, either individually, or jointly with another, or any power of' appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereof' sets f'orth the names ann atldresses of all persons bene:ficially interested in this estate at the time of decedent's death, the nature of' their res- pective interests, their relationship, if' any, to the decedent, together with the ages at the time of decedent's death of' all minors, annuitants and beneficiaries for lire under decedent's Will. It also contains a statement showin.'; which of the benef'iciaries 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 benef'iciary. That Schedule E attached hereto and marle a part hereof' sets forth all property, real and per- sonal, owned by the decedent jointly wi th another or others, including intangible, standing in the name of' the decedent and others, plus the date and place of' record of' instruments effecting the vesti ture of real estate and the date of acquisition of' personalty, plus the name, address and relationship, if' any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof' sets forth fully and in detail all debts and deductions claimed for ann on behalf' of' this decedent's estate, inclucUng funeral expenses paid; f'amily exemption, where appl icable; costs of administration of' this estate; counsel fees and f'lldiciary's commissions paid or to be paid; cost expended for burial trusts, tombstones or gruvemarkers, and reli- gious services, in consequence of' the death of the decedent; debts and claims owing and unpaid at time of' death; tuxes accrued chargeable f'or period prior to decedent's death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledgen for obliga- tions, if any. It is agreed that the f'iduciary will present proof' of said claimed obligations upon re- quest, that if' the amount actually paid in settlement of any f'ee, commission or debt is less than the estimated amount cl aiming and allowed, that the same will be reported to the Register of WDIs, and that the amount of' tax assessed can be reassessed in accordance therewith. That the totals of' the appropriate colunms in Scherlules "A", "B", "e", "E", and "F" as directed therein, have been carried forward and properly registered in the Smnmary. Subscribed and sworn to before me this w:3Q:'':' day of .........~.......... ....~.........~.~ NOTARY PUbYO My ColJlll1iOslOD Expires Dec. 21, 1981 Lcmo)'at. Pa.. Cumbedand County ......19)5; /7 C d-ca. ~ ..........................................................~... (E:recutor-Administrator ) (Street Number) (City or Town and State) NOTE: Before signing affidavit make sure all blank spaces in the af'fidavit and schedules annexed are filled in wlth details or the worn "None"_, and. in case the assets include rare and unlisted securities, securi ties of' close or family corporlltions or an interest in any co-partnership or business, that the data and statements reqlli reo under the paragraph above relating to Schedule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. RCC-l66 (8-73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 '* " Re: Estate of File # Domicile . ../,~.' ~/ Dear Kindly give us values as of real estate: an the fallowing .... , ,I ;".,r ..... Assessed Value I; {Nfl ,;() Market Value - This request is in duplicate. Kindly place your value an the carbon copy and return it to us, and keep the original for your file. Very truly yours, Non-resident Inheritonce Tax For Bureau of County Collections ;_ /7- 7Y ~ RC C'_34 (4-73/ COMMONW"AL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY - Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant ,in cammon with another or ather, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenants with right of surviarship or tenancy by entireties should be reported an Schedule "E,") The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a- cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc., are to be listed on Schedule II F" and must not b. deducted from this schedule. (1) (2) (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEA TH ES TlMA TE D MARKET VALUE 1. Undi vided one-half interest in a~f, .e'J;}> House and lot No. 14 South 17th Street Camp Hill, Pennsylvania r i Lot: 50 feet x 142 feet '., , ," Improvements: 2 1/2 story ft'&hie')'.'''', dwelling Deed reference: Deed Book "K", Vol. 11, Page 193 one-third interest passed to Frederick R. Demain and Edith Demain on death of Clara W. Demain Valuation based on appraisal ') ','., , , submitted herewith '1-' "; - $14,500.00 1-f---'$14 ,500.00 2. Unimproved lot on west side of south 17th Street, Camp Hill, Pennsylvania adjacent to No. 14 south 17th Street, item 1. above Dimensions: 50 feet x 142 feet Deed reference same as item 1. above valuation based on appraisal submitted herewith 3,500.00... /' 3,500.00 3. Undivided one-fifth interest in Mountair Lodge in Tuscarora Township, Perry County, Pennsylvania Area: 105 perches Improvements: one story frame Mountain Lodge Deed reference: Perry County Recorders Office - Deed Book 153, Page 117 /' 1,000.00/ 1,000.00 $19,000.00 ~V/ Insert this total opposite "real prape. iy", Schedule "A" in the X X X X X "As Reported" column an the last page of this return, $19,000.00 , RCC -35 *.,'" ~., _'1 CO~~ONWEALTH OF PENNSYLVANIA TRANSF~R INHERITANCE TAX RESI]);';., DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time o~ his death. Property owned by the decedent jointly with another or others must be list.ed 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.O.D. U. S. Savings Bonds and tenta- tive trust accounts, must be listed, despite the f'act that they are not of the administered estate. Tangible personal property shoulrl be listed f'irst (e.g. jewelry, wearing apparel, household goods, and furnishings, hooks, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certi1'icates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or rlividends, salaries or wages, insurance pay- able to the estate or firtuciary in said capacity, partnership interests, interest in any undistributed estate of' or income f'rom any property held in trust under the will or agreement 01' another, even though located outside of the State, at the time of death, should be listed. in this schedule. 4. ~100 shares, P. P. & L. Co. 4 1/2% preferr d stock 52 Savings account No. 11-0000806-7/ Commonwealth National Bank Interest accrued to Jan. 18, 1978 Item No. 1. 2. 3. 5. 6. 7. 8. 9. 10. 11. 12. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE Personal effects and household per appraisal attached goods as 356.00 One-half interest in household good as pe appraisal attached 823.50 $2,000.00 U. S. Series H. Savings Bonds dated 8/8/56, Accrued interest 8/8/77 - 2/8/78 100 2,000.00 51.l, '. f-,7 5,200.00 100 674.58 1.16 Checking account Dauphin Deposit Bank & Trust Company Savings account No. 13-09216,,'DauPhin Deposit Bank & Trust Company Interest accrued to Jan. 18, 1978 ! Savings account No. 13-1-0402-0 / Dauphin Deposit Bank & Trust Company Interest accrued to Jan. 18, 1978 Savings account No. 01-00391 V'" Dauphin Deposit Bank & Trust Company Interest accrued tb Jan. 18, 1978 , S---75 Certificate of Deposit No. 13-03-7259 Dauphin Deposit Bank & Trust Company Interest accrued to Jan. 18, 1978 100 2,718.93 100 5,336.95 100 6,354.43 17.49 100 1,680.30 8.00 100 5,000.00 79.15 ..'--~ Certificate of Deposit No. 13-02-013995 Dauphin Deposit Bank & Trust Company Interest accrued to Jan. 18, 1978 DEPARTMENT VALUATION (Do no t wri te in this space) 356.00 823.50 2,000.00 54.67 5,200.00 67/,.58 1.16 2,718.93 5,336.95 23.35 6,354.43 17.49 1,680.30 8.00 5,000.00 79.15 5,000.00 5,COO.OO 64.50 64.50 V Certificate of Deposit No. 13-07-700926 Dauphin Deposit Bank & Trust Company Interest accrued to Jan. 18, 1978 10,000.00 10,000.00 / 142.44 . 142.44 Insert this total opposite "Personal Property", Schedule "B" in X X the "As Heported" colunm on the last page of' this return. RCC -05 RESIlk\I' DECEDENT SCHEDULE "B" (cant.) 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 with another or others must be listed under Schedule nERo 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 furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certif'icates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or rlividends, salaries or wages, insurance pay- able to the estate or ~irluciary 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. Item No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 14. 13. t~avings account No. 01-04-004876~ First Federal Savings and Loan Assn., HarriSburg, Pennsylvania Interest accrued to Jan. 18, 1978 Savings account No. 002-00-07842~ State Capital Savings Association Interest accrued to Jan. 18, 1978 100 ,)' 3,000.00 ~ 3,000.00 100 l,/ 7.78./ 1,.0' 6,562.86 V 16.29 V' 7.78 0,562.86 16.29 15. Federal Income Tax Refund /' 400.00 II' 400.00 55,522.38 Insert this total opposite "Personal Property", Schedule "8" in the "As Heported" colunm on the last page of' this return. x X $55,522.38 RCC-36' COMMO:iWEi\LTI! OF PENNSYLVA:iT.\ THA'iSFE1\ INHFl\TTi\'iCE TAX SCHEDT:LF TIC" TJ{.\\c:l/j.'llS RES TDE"T DECEDENT (1) Did decedent, .Within two years ofdeuth, make any transfer of' any material part,of his estate, without receiving a valuable and adequate consideration theref'or? (Answer yes or no) NO (2) Did decedent, wi thin two years of death, trans!'er propen.y from himself to himself and another or others (inclutUng a spouse) in joint ownership? (Answer yes or no) (3) If the answer to (1) or (2) above is in the affirmative state: (8) Age of decedent at time of transfer (b) State of decccient's heal th R-t time of making the transfer. (Note 1). (c) Cause of decedent' 5 death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideratlon theref'or which was to take eft'ect in possession or enjoyment at or at'ter his death? (Answer yes or no)~______ (a) Wa~ there any possibility that the property transferred might return to transferer or his estate or be subject to his power ot' disposition? (Answer yes or no) (b) What was the transferee's age at time of decedent's death? (5) Did decedent in his Itfetime ma,ke any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impl iedly reserves for his life or any period which does not in fact end bef'ore his death: (a) The possession or enjoyment ot' or the right to income from the property transf'erred? (Answer yes or no) }.Tn (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) Nn (6) If' the answer to (5) (b) above is tn the af't'irmative, state whether the right was reserved in decedent alone or other!:'> (7) Did decedent in his 1 ire time make Ii transf'er, the consideration for which was transt'eree's promise to pay income to or fur the benet'it at' care of transferor? (Answer yes or no) N() (8) Did decedent. nt. all}" time, transfer property, the beneficial enjoyment of which was subject to change, because ot' a r(~serve;l power to al ter, amend, or revoke, or which could revert to clecedent under terms of' transt'er or by operation of law? (Answer yes or no) No (9) If' the answer to (8) above is in thfl at't'irmative, 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) NOTE 1: The answers t.o these questions should be supporterJ by affidavit hy the attenrting physician as well as a copy of' the death cer-tiricate. NOTE 2: If answer to any of the abuve questions is yes, set forth below a description of the property transferred, it's fair market vlilue at flate of death, dates of transfers and. to whom trttnsferred, 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 detnilerJ. statement of lH.cts on which said claim is based. NOTE 3: List appltcable property below in manner in which providecl in Schedules A, B, or E. ITEM DESCRIPTION MRKET V ALlJE (Es tima ted) DFYT. VALUATION (Dept. Only) None NGNE Insert this total opposite "Trnnsfers", Scherlnle "e" in the "As Reported" colunm on the last p't;.;e of this ret.urn. RCC- 37('12-6 3) COMMONWEALTH OF PEN~SYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDDIT SCHEDULE "0" BENEFICIARIES \ h RELA TIONSIIIP , BENEFICIARIES AND ADDRESSES (II step-chitdren or SURVIVED DATE INTEHEST OF State full names and address es of all who illegitimate children DECEDE1\IT OF BENEFICIARY aye an interest, vested. contingent or other. are involved, set STATE YES IN ESTATE wise. in estate) forth this facL) OR NO BIRTH Edith Demain sister yeS over 18 vr s. Entire Estate m~ -~.._. , ----,--- ~ -t---- I -... .. , I , I ! I -...._- .., I "-_.--,.~._.- -l ! I ---- .. i ! .-.-. __on ! -"- u ---.--.--. I r -_..__."- ! ._-~.._~_.._-- I u - -...-..-.-.-- I 1 =1 _m____.. .--..- .. -. Deponent further says th~lt all the above-named beneficiaries are living at this time except below: . NAME DATE OF DEATH RESIDENCE . ---- ~ '"' .B<n- E<'It: tj= I:::l '2 Il,l S .- ..... :3 S~- "Oc..8 < s. ~3~ .8......& ~ ~ ~ ~ ~ 0 ~ E fr ~ 0: Real Property Personal Property Transfers SUMMARY (Seh. "A") . (Seh. "B") ....... ..... ........(SCh. "e") ........($ch.E) (1 ) (As Reported) $.19,000.0.0 $55.,522.38 $ ...... cOc.. $ 51.0 .n $. $.75,.033.29 ( 2) (As Ddermined) $19,000.00 $ 55,522.38 $ cO.- S 510.n $ S 75,0;33.29 Gross Taxable Estate z 0 E- Ul Z " Z ~ p:: ~ ~ ~ '" - ~ ..l 0 ~ ~ :>< .... ~ < I"J ~ ~ '" VJ >:: 0 - '" - < ..: ..., '" ClI: ~ ~ <1l '0 '" ~ Po. 0; >:: =- w 0 " =- Po. QJ .-l <1l 2: < :E: '" ..: '" :I: :I: ~ c:l .-l .-l ;.. 0 .... ~ .... E- ",-I; "" ~ Q H ~ :I: '" -< . p:: QJ S ~ Ii< ci 0 E- ~ ~ 0:; Z E- VJ P< Po. ~ ~ ~ 0; - i- Ul ~ 0 0 U <1l U -" ClI: ~ c ~ ..., u -=2 0 w .S; "" =- :>< ~ ~ QJ '" .... :;: " E- '0 - ~ ClI: ./:: E- o QJ " , ~ :S - 0 '" "" 0 .c. ~ Ul _2 --. Ii< '" ;: ~ ~ " " W ;........ '"0 " :>< :::~ ..l U U :;: RCc'-3B COMMONWEAL I'll 01' PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY . INSTRUCTIONS: This s('h,~d1l1e must disclose all property, real and personal, owned by the decedent jointly with another or pthers, including intangibles, standing in the name of the decedent and others. List reill es tate fi rs t, liS en tl reties, or join t tenan ts, giving hrief' descri pt1on, as indica ted under Schedule "A", plus the tl~lte and place of record of instrlUnent effecting vestitllre, but rla not include entireties or out of state real estate Vlllue in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisi tion, and the name, address anrl relationshlll (if' any) of co-owners to the der'e.tent. Description of Property, Date of Acquisition, Name Address and Relationship of Co-Owners, and Place of Record. of Instrument, where Real Estate. J< <X <X )0 )0 )00 (> C>< ><< ><:x ~ 6<' X X o'^ X 0 ;0<:2 )O~ 1. $1,000.00 U. S. Series H. Saving Bond dated September 9, 1960 registered in the name of decede or Miss Edith Demain of No. 14 South 17th Street, Camp Hill, Pennsylvania 17011, sister of decedent accrued interest 9/9/77 - 1/18/7 (131 days) . . unit percentage Estate DEPARTMENT VALUATION Value Share Val UB. t ion CAUTION-Do not Write In This Snace. y >0< ><:x )0 Value of' Value of' >9' :)0 6<: Entire Decedent's property Interest 100 t 50% 500.00 IV 500.00 /' 10.91'" 510".91 Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the lu.st page of this return. 10.91 510.91 . RCC-81 (6-73) COMMONWEAL TH 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 Edith Demain 14 S. 17th St. Camp Hill, l2a. 17011 (Executor or Administrator) In Re: Estate of Frederick R. Demain Cumberland County - Fi Ie No. 21-78-0079 Dear Miss Demain: You are hereby notified that the original appraisement in the estate of Frederick R. Demain has been filed in the office of the Register of Wills of Cumberland County an July 27 ,19..lJL, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total $19,000.00 55,522.38 -0- 510.91 $75,033.29 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 rate 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 and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373., _ i V Y/ . Date July 27, 1978 Signed (J,,-uL .- /\ o___..Y/lc', ,~..-- ---------. Title Chief Apprais~_ Nate: This is not a bill. ~CC-2 (2.-64) , COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE July 27, 1978 DEPkRTMENT Of REVENUE ~UREA'U OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COUNTY Cumber lend FILE NO. 21-78-0079 Whereas, Frederick R. Demain late of Camp Hill Cumberland I I'" in the County of Commonwea th of Pennsy vama, havmg died on the 18th 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 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. Unit Appraisement Oelcrlptlon of Auet Values Made for Inheritance Tall. PurpOlel REAL ESTATE $19,000.00 $ 19,000 ~ FERSONAL PROFERTY 55,522.38 55,522 38 TRANSFERS -0- -0- JOINT-HELD PROPERTY 510.91 510 91 TOTAL ESTATE $75,033.29 $75,033 29 - Having been duly swo.rn according to law, I do hereby certify that ,the above appraisement is formity with law on this 27th day of July " i r 'j~ r I /<. /1:,' ",,' .., \ /.'1. V _ _ <-i " , I. ~L -~ ," made i~gon- 19_. Appraiter (N\Jmber and st:l'i'et) Harrisburg (Pod Oftlee) , Penna. ", < ~ @ ~~ ~ u 0., c- I ........ "\\ .. z ~ '" 00 ~ ..; III .. .. ..; ~ ~ '" '"' z ..; .. ~ III '" ::: z ~ .. z '" '" ~ 00 '" III 1; ~ " " " " ~Q ~ w "" - " " Ii ~ l.l.i ~ ~ u H ~ '" "" 1:1 ""' - C " ;; ~ ::l H ~ co r-- , co .... , .... ~ "" ;; " Q .... ~ ~ C - ~ c .5 '" ~ ;; ~ Q '<: o .... <i ::. - " "" " c Q U"'t <:5 :;,; ,,' '" " ll.. o U"'t .... ~ '" ~ N , ,,' " ~ o .., 'to ~ "S, " 'l:: .S ." ~ il; ... ~ := :z: ~ >- ~ c.::: ~ o E- :z: ~ ::e E- ;;! c.. ~ Cl ~' ~ ~ " i! " ~ '<: 1;' " ";; " " 'l:: -,,' " " ~ 'i;: '<: ." ~ " ." " " "j1 ~ l.l.i ~ l: " .., .~ 'i;: 'I: - " "'" " " <; ... ::: ., " l: ::: 'E <>. <>. 'I: l: Q ~ <! " "- <>. '<: .,,' " ~ ~ " l ." ~ " - " l.l.i