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HomeMy WebLinkAbout05-01-78 RCC~33 (4~73) COMMONWEAL TH OF PENNSYLVANIA · ,to. DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS i~ -. RESIDEIH DECEDENT COUNTY OF CUMBERLAND 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'ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) 1,< TilE MATTER OF THE ESTATE OF } AFFIDAVIT OF EXECUTOR ~ Owen W. Baughman (ST/l,TE FUL.L NAME OF DECEDENT) Lat~ of _Cumber'l and State of_Pennsyl vani a Coonty of ~_.Cumbl!r"l arld County } .., = Paul W. Baughman of the estate of the obove.nomed decedent being duly sworn, depose 5 Executor ~_.x and 'lay 5 IMONTHI Nome or'd oddte~s {'of attorney or } other authorized repr~5ento,illc to whom . 011 correspondence she ,If' '.,i. (DAyl , 19~J testate leaving 0 last will, copy of which is hereto attached. } (YEAR) ~~X Decedent died February 2, Jon F. LaFaver 317 Third St., New Cumberland, Pa. 17070 That a~ such_Exe.cutor deponent is familiar with the affairs of said estat~ and the property constituting I ':::XE::U TO R~ADMIN 1ST RA TO R) the as~l'ts tberelll and tlh:ir fair market value. That at tilt: lime of death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agenL qr ueputy 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 .~N C1 t\DDf-<ESS 0 [0 BANK OR OTHER INSTITUTION THIS SAFE DEFOS! T BOX RENTED RELATIONSHiP OF JOINT " WHI CH DE:CEDENT RENTED A SAFE DEPOSI T BOX " NAME OR NAMES OF HOLDERS TO DECEDENT ~ ------ ---~--_._- ~ ~ That the contents of said safe deposit box or boxes are itemized under Schedules wi th I he 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 111 the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the mortgage ~ncumbranccs 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. fhat Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property \vherescver situated O\vned 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 ohligations, 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; U:: '''-.<-lllllt!, <1PVdJLl. jt~\thy, ~ilverware, pictures, books, works of art, household furniture, horses, carriages, automohiles, 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 daims 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 W~'! ')a)'able upon the death of the decedent; all and the corporate stocks and dividends due thereon and ullpaid as nf If,.':, date of death, bonds and accrued interest thereon to the date of decedent's death and other im'eqmcnt ;':l'S owned by the decedent at the time of death, with the market value there- of at sueh lllllt'. .,; C ' ~\ <() _ 0 0~' \ -2-- \ \ \) - \ '-\ \ , ... !lee -35 COMMO~WEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY . 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 "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.Q.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 certificates, 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 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 ESTIMATED VALUE MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 7. 8. 9. Proceeds from Group Life Insurance (Aetna Life Insurance Company Certificate No. 176112) Checking Account No. 14 13 539 6 at Dauphin Deposit Trust Company Savings Account No. 06 61850 at Dauphin Deposit Trust Company $361.83 plus accrued interest of $2.22/ Checking Account No. 4 0222 2 at Farmers Trust Company / Savings Account No.1 11428 3 at Farmers Trust .r Company $6,463.41VPlus accrued interest of $49.40 The following United States Series E Bonds: 25 Q 204 681 563 E Feb. 1944 68.39 25 Q 490 054 969 E Dec. 1944 66.15 25 Q 451 126 607 E June 1944 67.24 25 Q 718 786 832 E Sept 1945 63.20 25 Q 653 461 596 E March 1945 64.22 25 Q 1 136 019 609 E Dec. 1953 51.36 25 Q 544 989 597 E Dec. 1944 66.15 25 Q 442 959 585 E June 1944 67.24 Railroad Retirement for February Nightingale Nursing Home Refund Proceeds from public sale of household furniture and equi pment Cash Property Tax Assistance Refund 245.00// /' 1,145.12.,../ 245.00 1. 2. 1,145.12 3. / 364.05~ 364.05 4. 5. 2,580.21 6,512.81/ 2,580.21 6,512.81 6. 10. 11. '" 513.9V' / 355.4V 1/ 949.00/ V 3,081.00/ 1.00 113.39/ 513.95 355.41 949.00 3,081.00 1.00 113.39 Insert this total opposite npersonal Property", Schedule nBn in the nAs Reported" colunm on the last page of this return. x X 15,860.94 $15,860.94 D Dauphin Deposit Bank and Trust Company MAIN OFFICE: 213 MARKET STREET, HARRISBURG. PENNSYLVANIA 17105 717/255- 2121 Memb81' F.deral Deposit InsuNlne. Corporation March 7, 1978 J oh F. LaFaver .317 Third Street New Cumberland, Pa. 17070 Attn: Jon F. LaFaver ile: Owen W. Baughman February 2, 1978 Deceased Dear Mr. LaFaver: In regards to the above IIlElntioned, we submit the following inf'ol'lll8t1on 88 of the date of death: Checking account nUDIber 14-1.3-539-6. Checking account balance 1,145.12 Savings account number 06-61850. _ Savings account balance .361.8.3.;,.-1nterest 2.22."/- If we can be of any further assistance, please do not hesitate to contact us. . Very truly yours, Y:'U"L""cU~'-''''L'<,d_q' Donald E. CrolllWell Assistant Vice President DID/sau .-1 i. FARMERS TRUST COMPANY CARLISLE, PENNSYLVANIA Date March ,~, 1 97R .Jon F _ LaFaver ~17 Thirrl S1:'rP-P1: Np,,oJ rllmhPTl ~nn, PA 17()70 Re: Estate of Owp-n t.I/_ R::\110hm?n Date of Death Februarv 2, ]978 Dear Mr. L:!FavPT In answer to your request concerning accounts owned, either separately or jointly, by the above referenced decedent and the balance in each account .as of the date of death, we have checked our records and are submitting the following information in duplicate. We suggest that you file one of these letters attached to the Pennsylvania Inven- tory forms (RCCl to substantiate the balance you report, Note that we have shown the correct registration for each account. Also, interest accrued to the date of death, if any, is listed as a separate figure. Very truly yours, @k~Jj1M~ Olive Bolinger or Supervisor Bookkeeping Dept. t~ ---- Bal. in checking ace. #4-0222-2 $2,580.21 V" Bal. in savings ace. #1-11428-3 $6,463.41 V interest $ 49.40 ....-- llCC.-~6 COMMONWEALTH OF PENNSYLVANIA TRANSFER l:'IHEIUTANCE TAX SCHEDUI;r: "c" TRAXSr'FllS ~.."" ~ RESIDEXT DFCEDEXT (1) Did decedent, within two years of'death, make any transf'er of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) (2) Did decedent, within two years of death, transfer property from himself to himself and another or others (including a spouse) 1n joint ownership? (Answer yes or no) (3) If the answer to (1) or (2) above is in the af'f'lrmative state: (a.) Age of decedent at time of transfer (b) State of decedent' 5 heal th at time of making the transfer. (Note 1). (e) Cause of decedent's death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no)__ (a) Was there any possibility that the property transferred might return to 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 wh1.ch transferor expressly or impliedly reserves for his life or any period which does not 1n fact end before his death: (a) The possession or enjoyment of or the right to income from the property transferred? (Answer ~res or no) (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) (6) If the answer to (5) (b) above is in the af'firmative, state whether the right was reserved in decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or f'or the benefit of care of transferor? (Answer yes or no) (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserverl 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) (9) If the answer to (8) above is in the affirmative, was the power to al ter, 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 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 DESCRIPTION MARKET VALUE (Es tlma ted) DEPT. VALUATION (Dept. Only) NONE 00.00 None Insert this total opposite "Transf'ers", Schedule "C" in the "As Reported" colunm on the last page of this return. 00.00 None R.C'C-37 . (12-63) i.'OM~IONWr:ALTH bF PE1{NSYYL\NIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BE"iEFICIARIES BENEFICIARIES AND ADDRESSES \.State full names and addresses of all who have an interest, vested. contingent or other- wise. in estate) RELA TIONSIIIP I (If step-children or I illegitimate children are involved, set I forth this fact.) SURVIVED I DECEDENT STATE YES OR NO DATE OF BIRTH INTEREST Or' BENEFICIARY IN ESTATE Paul W. Bauahman 963 Hummel Avenue Lemoyne, Pennsylvania Fl i n -.- -~ R. D. # 2 MF>chanicsbllrg, Pa. son yes adult 1/5 of Residue dauahter yes adult 1/5 of Residue ~~:n H:~m:~Il~:~:~ L I "'movne Penns.v1 vani a Clair W. Bauahman 113 Rear E Green Street I Mechaniesbura Pennsv1vania Heirs of Claude B. Bau~hman, Dee son yes adult 1/5 of Residue son i ves i adu1 t 1/5 of Residue ni~nn ROast 1010 South Ninth St. Al p~ lfifin? ,l"'~n Rn v ?/lq R n #? Bedford Pa. 15522 Mi, Gene Bauahman Box 249 R. D. # 2 Redford Pa. 15522 J(o,dn I "'''' R~' Rnv ?/lq R D # 2 Redford Pa. 15522 nn..nl ~<< R~lIohm~n Rnv ?/lq R n #? D~ 1 <;<;?? aranddauahter ves I adult i I I 1/10 of Residue great~granddaughter yes I 12/12/60 1/40 of Residue areat~grandson yes 2/19/62 : i i , 1/40 of Res i due great~grandson yes 3/3/63 1/40 of Residue ~nr~n(knn ves 6/2/65 1/40 of Residue Deponent further says that all the above-named beneficiaries are living at this time except below: --_. NAME DATE OF DEATH RESIDENCE - - u_ U ~ --, .301}..... e<'W: tj= s::: '21l S .- Q) ;:::l 5-'0 "0 0. u 1 g, 8t)~ "5t;;t u :> 0 ~sg. ~ 0:: SUMMARY (Sch. "A") ...(Sch. "B") ................ (Sch. "e") (Sch.~'E" ) Real Property Personal Property Transfers Jointly-:-hel d Gross Taxable Estate (2) (As Determined) (1 ) (As Reported) $16,800.00 $ 15.860.94 $..00.00 $ ....836.38 $.. $33,497,}2 $ $ ,. . $ $ $ ,.., "0 Z " ~ W ~ os .. ... " - " ;... .... u <( W " <Il <Il "" - - z "- <( < ~ .f"'": os ~ p::; ~ ..c: '" Q, 0.. 0 ::c '" " Q, 0.. '" <= ..:: '" < '" :::> :;: "Cl <( ~ :t W ;>. ,... l- e( 0 <= ~ Q W c:l I- '" S 0 ~ - "' < ~ " Z .... 0 I- QJ: ... ~ Z I- <Il 3: 0 OJ 0.. ~ W ... ..c ~ I- ~ 0 z <= E 0 ~ UJ 0 ::l ~ C p::; 3: ::E u 0 0 0 " "" :c W "- ... os I- ~ "- ~ b I- 0 ~ c ~ < c .c. 0 '" E 'E ..-. ~ S E >""0 i5 0 ~< ... U U , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HARRISBURG (] C T 1 " 'I C' , . ..;L 0 ~._J RCC>43 (4-6"1) NOTE: TO BE SUBMITTED IN TRIPLICATE c :Y ~>~: - \: Pennsylvania Department af Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania /tl-1 J.../-1f-f/ Dear Sir: Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the fallowing report: NAME OF REPORTING FINANCIAL INSTITUTION ccrlB Bank, U .A. ADDRESS 331 Bridge Street, New Cmnber1and, PA 17070 ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT Savings Account #003-102156-1 NAMES ON ACCOUNT OR INVESTMENT Owen W. Baughman or Paul W. Baughman DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR Owen W. Baughman ADDRESS AND COUNTY 963 HUIllIlle1 Avenue" Lemoyne. PA 17043 County - Cmnber1and DA TE OF DEATH February 2, 1978 SURVI VING DEPOSITOR, BENEFICIARY OR INVESTOR. Paul W. BaUf',hman ADDRESS Unkl)own RELA TIONSHIP TO DECEDENT Unknown DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED November 4, 1977 BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ $836.38 /" R. S. Ste Si gnat~re Deposit Operattons Coordinator TITLE October 13, 1978 ----- RCC-38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTL Y OWNED PROPERTY - INSTRUCTIONS: This schedule must disclose all property, real and personal, owned. by the d.ecedent jointly wi th 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 lmder Schedule "A", 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 "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name Address and Relationship of Co-Owners, and Place of Record of Instrument, where Real Estate. ~i <X 00;>< y (>(X 0< <X <> 0< >0( 00 xx;>< <X 00 (>(X ;>< ~ >(X 1. Savings Account No. 003 102156 1 at CCNB Bank, N. A. in the joint names of Owen W. Baughman and Paul W. Baughman Opened 11/4/77 - Entire Balance included herein. unit percentage Value Share 00 00 ~ 86 Estate Valuation ~~ DEPARTI~NT VALUATION CAUTION-Do not Write In This Spftce. Value of Value of Entire Decedent's property Interest / 836.38 Insert this total opposite "Jointly Owned Property", Schedule "E" in the" As Reported" column on the last page of this return. --- 836.3 836.38 $836.38 CC~[83 CCNe BANK. N.A. MAIN OFFICE 331 BRIDGE STREET NEW CUMBERLAND PENNSYLVANIA 17070 017123B'()B41 April 26, 1978 Jon F. LaFaver 317 Third Street New Cumberland, Pa. 17070 Re: Owen W. Baughman Gentlemen: I am in receipt of your letter dated April 19, 1978, in reference to the Estate of Owen W. Baughman. At the date of death of February 2, 1978 we show a Savings Account #003 102156 1 with a balance of $836.38 and no accrued interest. The account was opened on November 4, 1977 in the names of Owen W. Baughman or Paul W. Baughman.. If I can be of further assistance, do not hesitate to write. Very truly yours, f.:>-, at. ,;;J t'u"~"/>~",,""'" <- Dorothy Morrette Savings Department -! - RCC-61 (6-73) COMMONWEAL TH OF PENNSYL VANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division NOTICE OF FILING or APPRAISEMENT Paul W. Baughman 963 Hummel Avenue Lemoyne. PA 17043 (Executor or Administrator) In Re: Estate of Owen W. Baughman Cumberland County - Fi Ie No. 21-78-0081 Dear Hr. Baughman: You are hereby notified that the Original appraisement in the estate of Owen W. Baughman has been filed in the office of the Register of Wills of Cumberland County on June 29 ,1978, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total lb,800.00 15,860.94 None 836 38 $33,497 32 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 pri or 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. 37~ . '.. ' Date June 29, 1978 __ Signed r /!~_~~ Title .~____ Chi"f Aprr~i.er --."-- ~- -...",,-- \ Note: This is not 0 bi II. ~ RCC-2 (2-64) COUNTY June 29. 1978 Cumberland DEPARTMENT OF REVENUE BUREAU OF .COUNTY COLL ECTIONS HARRISBURG, PENNA, 17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE FILE NO. 21-78-0081 Whereas, Owen W. Baughman late of Borough of Carlisle in the County of Cumberland Commonwealth of Pennsylvania, having died on the 2nd day of February 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 at 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 Deter/pilon of Asset Vatuel Made for Inheritance Tax Purposes Real l:rooertv $ 16,-800 _ RLI Personal lroperty 15,860 4 Joint-Held l:rooertv 836 138 Transfees None TOTAL ASSETS $33,497 1)2 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 a ~X_' 19BL-. _,AU - 1-: __ . Appraiaer (N\Jmber and Strtettv .tlarrisburg, Penna. (Peat otBce) -,; ~I '" ~ i ~ - 0>, ... ~ ... ~ z ~ I " '" --.. :z:; '" ~ '" ~ :s " co N ~ U '" 1::1 '" --.. >- en '" ~ :;l " ..... ~ ..... 0 0: Ul " " t .... N ..... ~ '" '" ..... C 0 "e !E !E ." ., i ... ~ " " '- ... ;0,; .., .., " ><: 8 ~ .. E- o 's '~ ", - D ~ ~ Clo " ., D " ~ i:5 ... ~ ." il ... ... ~ ~ ... t: t: ... " 8 '" .... .0 ... ~ 1 \1l , '" ~ -;; 0 III - 0 ",' == '<: -.;: '<: Uo ..... I '-' 0 <ll -..l 1%0 " .;; E- l ... z ';; o:l .r:: '" .., "e ;: \;:'- III < "-l 0() ~ t ~ " " " 0 ~ " 1 " . " Q -::; ~ "e ... :;: 0 ~ '" " ..!. 0: ... 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