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HomeMy WebLinkAbout08-21-78 \ ~"tC-33 1lf-!3) RESIDENT DECEDENT AUG COUNTY OF __CUMBERLI\Nn COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU or COUNTY COLLECTIONS 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\tcnue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF ~ IW\. M. STroHM Late of Shippensburq 'Ibwllship ,Cumberlan:1caunty Permsylvania State of __-1.. Cumberland Ear1-~?-trQ-,")!o ang Jo!Jp.--.1\" Strohm_ ~ of the estate of the above-named decedent being duly sworn, depose County of Executo!S and say Decedent died November 18 (MONTH) Nome and address of attorney or } other authorized representative to whom 011 correspondence should be mailed. (DAY) 19~{testate leaving a lost will, copy of which is hereto attached. } (YEAR) ~ M::Crea & Davis 24 West King Street, ShippenSburg, Permsvlvania 17257 That as such Exe~to~___deponent is familiar with the affairs of said estate and the property constituting I EX ECU TO R. ADMIN I ST RA TO R) the assets thereof and their fair market value. That at the time or death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agent or deputy or 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 INSTI'UTION 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 -_._- None 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 detai I 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, \vhethcr 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, left by decedent, together with the fairly estimated market value thereof; all bonds and mortgages held by decedent andor 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. In the case of' securities of' close or family corporations, the values reported are as far as possible substantiated by financial 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-pa.rtnership or business, and in support of' the value of' such interest there is annexed to said schedule, financial statements showing the assets and liabilities of said co-partnership or huslness. A copy of' the co-partnership agreement, (if oral, a statement setting; forth the nature of the agreement) together with Ii statement setting forth the character of the business, its location, and such other facts pertaining to the business 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 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 transfers of property, real or personal, within two years of decedent's death, in contemplation of decedent's death, or intended to take ef'fect in possession or enjoyment at or after death, said schedule sets f'orth the nature and value of such property, to whom transferred, the relationship of the transferees to the decedent, the proportlonate share received by each transferee and all other facts of a pertinent nature regarding said transfers. In the case of' transfers intended to take eff'ect in possession or enjoyment at or after death, there is also attachen to the schedule a copy of the deed, trust agreement or other instrument creating the trust. Tl1erl'~ is also set forth in said schedule a list of all property, real and personal, with its value, which passes at decedent's death by virtue of the exercise by decedent, ei ther individually, or jointly wi th another, or any power of appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, wi th a copy of the instrument 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 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 f'or lire nnrter decedent's Will. It also contains a statement showing 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 relationshi.p of such issue to the benef'iciary. That S.:f>edule E attached hereto and mane a part hereof sets forth all property, real and per- sonal, owned by the decedent jointly with 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 tllre of real estate and the date of acquisltion of personalty, plus the name, address and relationship, if any, of co-owners to the decedent. That Scf>edule F attached hereto and made a part hereof sets forth fully and in detail all debts and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid; family exemption, where applicable; costs of administration of this estate; counsel f'ees and fudiciaryts conunissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of the death of the decedent; debts and claims owing and nnpaid at time of' death; taxes accrued chargeable for 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 pledged 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 fee, commission or debt is less than the estimated amount claiming and allowed, that the same will be reported to the Register of' Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "e", nE", and "F" as directed therein, have been carried forward and properly registered in the Summary. , ,/ R. /1,...) h A:hc/L,-,." ..:?/:;.:..f;..::' I-:'~ ....~~L.~....-d.L.'.:;{.~~:,.~:\--....._,.. . (Executor-Administrator) R. #5 and R.R. #l ......................................................................... ........._..._.....~.. (Street Number) SI1iPJ2E!.I1l31:l~.I...l:'~!3,y~\T~<l....~??~?.. (City O'J' Tow" and St4te) Subscribed and sworn to before me this j'1~4c . ltkJ.\e.L ..~, M(),(t<,fIJ'C' Notary Public,~ My Corrm. expires: ~ 1,) 9 f:L NOTE: Bef'ore signing affid~i t ~ake sure all blank spaces in t:he af'f'idavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securi ties of' close or f'amily 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 tn the "Sunnnary" has been properly completed as above-directed. .... day of)\ugl,l,St, . . .... 19....?? RC;\-~34 (4~7-;;'~ COMMONWEALTH OF PENNSYLVANIA DERARTMENT 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 common with another or other, should be identified os 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 surviorship or tenancy by entireties should be reported On Schedule "E.") The real property loeated In the Commonwealth of Pennsylvania should be described by lot and block number, .treet and .treet 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 .tate number of a~ cresi allio stat~ment of mortgage encumbrance. upon each parcel at death of deeedent. Taxe., a....sments, accrued Int.r..t on mortgage., ete.,ar. to be lI.ted on Schedule "F" and must not be deducted from this .chedul.. (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH Real estate situate in Soutfuuipton Township, Cumberland County, Pa. being a tract of unirrp:roved rrountain land containining 25 acres, more or less, having been conveyed to the decedent herein by deed of Mal:y V. Strohm et al by deeddat~:tl!e February 23, 1963 and recorded arrong the deed records of Cumberland County 940 3 ,} (j , Insert this total opposite "reol property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. . (2) (3\ DEPARTMENT VALUATION CAUTION (Do not writ. In this spac.) ESTIMA TED MARKET VALUE 3760.00 ,./ 77 ~ ao< 1376 cJ. o() 3760.00 Rr::c:33b -'Rr COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY Cash In hand, Cash on deposit, Bonds and Mortgages, any interMt In a Copartnership or Unincor- porated Buslneu, Judgments, Royalties, Rights, Shares in Trult Funds, leaseholds, PensIons, Prom is- lory Notes, Claims, Insurance payable to Estate of Decedent; Annuity and Endowment Contracts; Corporate Bonds and Stocks, with Accrued Interest and Dividend, Declared and Unpaid to Date of Death, Acoounts Receivable, Jewelry, Wearing Apparel, Silverware, Houaehold Goods, Automobiles and All Olher Penonal Property of Every Nature Wherever Situate. (Property held jointly by decedent and another mud be listed shOWing names and addresses of other Joint Owners and their relationship 10 decedent.) Unit Values (I) ESTIMATED MARKET VALUE AT DATE OF DEATH (2) DEPARTMENT VALUATION CAUTION (Do not write in this space) 28 Shares Cumberland Valley Cooperative Assn. preferred stock Agway 5% debenture F-6781 dated 12/31/65 49 Shares Pennsylvania Railroad Stock 1.25 280.00 J J-fO. aO 1/ '300.00 300.00 J/ ~ 61. 25 vl/ 6/ ?--J . 696.00 / t. 9'. ,,(J 51.15 ,/ 5""'1. / r 40.00 v-" ~(}.O(j ~j;O 0 25.00 v S-;-OC 5.00 ,/ ' I- ~-: a6 25.00 5.00 ~-O8 1.00 /.e) 10.00 , /t).OO 20.00 ' fJ-().<l~ 50.00' H.4 15.00 / I .)-, D~ 40.00 j,I(}. 0 /}-O' O~ 20.00 10.00 53 Shares Madison F\IDd, Inc. Stock 13 1/8 CUmberland Farm Bureau Cooperative Assn. Revolving Fund certificates Bedroom suite SEWing Machine 2 Straight Chairs China Closet 2 EIrl table lights 1 floor light dishes and <XlOkware Sekverware Refrigerator M:x1el 61 Deep Freezer Washer and Dryer Linens ~ Savings Account No. 93808, Curri:lerland Valley Savings & Loan Assn. Earned Interest on above~unt to 11/18/77 Savings Account No. 93809, Cumberland Valley Savings & Loan Assn Earned interest on above account to 11/18/77 / Savings A=unt No. 93810, CUmberland Valley Savings & Loan Assn. Earned Interest on above account to 11/18/77 ........ 10,000.00 204.86 __ 10,000.00 -' - /0/' 0 ~~. :fJ 204.86 ,. 0 T, (J!.(' (J tJ tJO.olJ 10,000.00 v: 1--1 , ~ tJ'JI?A. 204.86 0/' . la (jOO. 0(1 ~ol./.?~ (J-~xH'ut"r.Adl"iJjj~trauJr mll>;1 ;',1..1 "L~ti"'al,.d "f~rk,.t Valw." (',tI'.lltln S" 1 .mol {'<lrry total t"l {'(,IUrr'll .\'" I ill "Sulllmary" ',11 ,',-v. ..... ~id,. <,f ,...-h~dlll,' U_) I 32,258.98 ~,7 o'.It 5?- '7 [V' Note: This schedule must list all intangible personal property such as, cash in bank, bonds and mortgages, promissory notes, claims.. insur- ance, corpnrat(, bonds and stocks, accounts receivable, interest in partnership, etc., even though physically located outside the Common- weaJth ,H ,hr time of death. As to tangible personal properly (e.g.. jewelry, wearing apparel, silverware, household goods. books., paintinp;.. automobiies, boats, etc,) state where it was actually located on the day of the decedent's death. Tangible personal property which is definite- ly established to have been physically situated outside this Commonwealth other than for a temporary purpose, is not SUbject to ta.." in this Commonwealth. In the absence of a specific declaration as to actual situs, said property will be presumed to have been physically present within this Commonwealth at the time of death. RCC-.36 COMMO:\'WEALTII OF PENNSYLVANIA TflA~~FFH PiliEl\rTANCE TAX SCHEDULE "e" TRc\NSFEI\S *~ I\ES TI1F::n DECEDENT (1) Did decedent, I'!"ithin two years ot'death, make any transfer of' any material part of' his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) NO (2) Did decedent, within two years or death, transrer properLY rrom himseH to himseH and another or others (including a spouse) in ,joint ownership? (Answer yes or no) NO (3) It' the answer to (1) or (2) above is in the affirmative state: (El.) Age of decedent at ti,me of transf'er (b) State of decedent's heal th at time of making the transf'er. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, in his lif'etime, make any transfer of property without receiving a valuable or adequate consideration theref'or which was to take eff'ect in possession or enjoyment at or af'ter his death? (Answer yes or no) YES (a) Was there any possibility that the property trans~erred might return to transferer or his estate or be subJect to his power of' disposition? (Answer y~s or no) NO (b) What was the transf'ereel s age at time of' decedent' 5 death? Sill. Juris (5) Did decedent in his lif'etime make any trans~er without receiving a valuable and adequate consideration theref'or under which transf'eror expressly or impliedly reserves for his lire or any period which does not in f'act end bef'ore his death: (a) The posseSSion or enjoyment of or the right to income f'rom thE.' property transferred? (Answer yes or no) yes 0)) The right to designate the persons who shall possess or enjoy the property trans~erred or income therefrom? (Answer yes or no) yoe (G) If' the answer to (5) (b) above is in the aff'irmative, state whether the right was reserved in decedent alone or others in dPr'e-~t (7) Did decedent in his lifetime ma e a transf'er, the consideration for which was transf'eree's promise to pay income to or ror the benef'it of care of' transferor? (Answer yes or no) no (8) Did decedent, at any time, transf'er property, the beneficial enjoyment of which was subject to change, because of a reservert power to al ter, amend, or revoke, or which c0111d 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 benef'iciary 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 af'f'idavit by the attending physician as well as a copy of the death certif'icate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transrerred, it's rair market value at date of death, dates of transrers and to whom transrerred, with relationship of transf'erees 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 f'acts 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. VAWATION (Dept. Only) Real estate situate at No. aI8 North Prince Street, Shippensburg, Par~meyed by decedent to Mal:y V. Strohm and Helen C. Strohm, her daughterS-by deed dated February 24, 1964 (unrecorded) in which she reserved a life estate (Assessment $5310.00) I ~ /J / n L/O.O() 21,240.00 vV" ,,1/ r &I.J l.J. l)" f' 0 L !~/C/...~ ,:~-; -: ' !, "0 j .~ .) v ;/11. 'i tfl /,., .P e,/ (1. tJ (j Insert this total opposite ~Transfers~, Schedule "eft in the ~ As Reported~ column on the last page of this return. 21,240.00 -- " ' RCC-3? 1.12-63) , - COM~ION\\'EM.TII OF PEN:<<ISYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or 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 Marv V. Strohm - yes sui iuris one.-seventh 218 N. Prince St. ::;hlppenSDUrg, l"a. 17L~7 Helen C. Strohm daughter yes sui juris one-seventh co,,", . r L~'vC ;::_' , .,~~., Earl G. Strohm son yes sui iuris one-seventh R.R.#5, Shippensburg , Pa. John A. Strohm son yes sui juris one-seventh -R; K. lf1- _. , -~-- -~ Mildred L. Chamberlin daughter yes sui juris one-seventh Star Ibute #2 -- , , ---- , . Martha E. Booz dauahter yes sui -;uris one-seventh R. R. #1 I r . 1-1L_JI Melvin B. Strohm son yes sui -;uris one-seventh R.R.#l NewOurg, l"a. u",..u , h Deponent further says that all the above-named benef'iciaries are living at this time except below: None NAME DATE OF DEATH RESIDENCE --- ~ " B<I)...-4 ~<"" 1;;: s::: 02 C1.l e ._...... ::l S ~- "Oc..8 -< S_ ~e;o B......B " 00 ~ ~ " 0 ~ e go ~ 0:: SUMMARY .(Sch, "A") .... (Sch. "B") (Sch."C") Real Property Personal Property Transfers . .:roil'lt:J,y .000er..Property.. Gross Taxable Estate. (2) (As Determined) (1 ) (As Reported) $ 3,760.00 $ 32,258.98 21;240.00 $. $ .3,684.26 $ $. 60,943.24 $ $ $ $ $ $ ... '" Z ~ ~ ~ oS " ..l ~ - ~ ;... .... ~ < ~ ~ ~ '" <JJ - - < -< oS ClIi '" ~ '" p.. "" 0 oS "" p.. ~ '" -< '" < ~ :t ~ ;.. ~ ... ... 00 Q c 0 ~ :t "' -< c ;z: 0 ... '" Z ... <JJ p.. -< ~ ~ ~ i- ~ 0 0 ..c ClIi c '" ~ 0 0 "" '" ~ '" o.l oS !: ~ ~ ClIi b 0 c 00 .,., ~ 0 '" 0 .c' ~ 'E .., '" S ~ 0 0 ;..- "'0 '" :::~ .J U U Rq:.38 RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY - COMMONWEAL TH OF PENNSYL VANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent 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 vestitllre, 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 der:e.lent. . Description of' Property, Date of' Acquisition, Name Address and Relationship of Co-Owners, and Place of Record of Instrument, where Real Estate. X);:>o 0< Unit Value percentage Share Estate Valuation 0< 0< 0< ex ~ DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest ~ <>< 0< ~ 0< ><<~ /' Checking A=unt No. 54-408-6, Peoples National Bank of Shippensburg, created July 1964 in the names of Iva A. Strohm or Mary V. Strohm, Bal. 11/18/77 $2,739.31 ,/ Savings Account No. 054-408-620, Peoples National Bank of Shippensburg, created July, 1965 in names of Iva M. Strohm or Mary V. Strohm, Bal. 11/18/77 $4,629.19! / ;/ .L,369.66 1..1 {, 1: ~J. ~. / 1/ ~,314.60/ J..J It./. ~ (j ,6 ~fI, "- Insert this total opposite "Jointly Owned Property", Schedule "~"684.26 in the "As Reported" column on the last page of this return. *' REV-!5te (8-78' COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.o. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT Earl G. Strohm R.D. II 5 ~hi ppanClhll1'"g ~ Pt::>nn:::l (Executor or Administrator) In Re: Estate of Tu.Q M !=:t-rnhm r:llmhpl"l ;:md County - File No. 2]-78-0094 Dear You are hereby notified that the Oriltinal appraisement in the estate of Iva M. Strohm has been filed in the office of the Register of Wills of Cwnberland County an 12-7 , 19BL.., Said appraisement reflects the fallowing valuations: Real Estate Personal Property Transfers Jointly Owned Total 3.760.00 32,258.98 21,240.00 3,684.26 60,943.24 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 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. 373. 12-7-78 Dote Signed cL ,,~ / - U cl (, ' 1\, .. 'v~ t. ~~, -_ Title. Chief Appraiser l -.--- ~ ~"-- Note: This is not 0 bill. RC,C-Z (2-64,) " DEPARiMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE '\ \ - aG -l \3 COUNTY ( ~.JL.~ FILE NO. ~l -~ '8 -00<:(~ Whereas, \~t~t~ late of S~jj~~ in the County of '0 ' ~ Commonwealth of Pennsylvania, having died on the \ <n -t::JL day of NOI.J. 0 - - ~ 191! seized and possessed of an estate subject to Inheritance Tax under the laws o~ the COIpmonwealth of Pennsylvania; Therefore, I, \ ('-c- l-c>,J.J Q.. , 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 ot any eBtate for life or for Years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inher1tance taxes at the lawful collateral rate on any such future interest. Description of Anet UnIt Value. Appraisement Made for Inheritance Tal( Purpo'el \'----,~ D \?h-\,Q.-erv-~-<"-Si.. ~ -~\.~ '~~\J~~Q.& p~ $ 3160 OL -=-<- '3>"2...:t..5 q~ 2.l 24.01 00 3;684 2.(, .~ ~ Coo '14., 2-~ the above appraisement is made in con- 19~ -" / .{ ,7.. '- 8 Appraieer , Penna. "b ~I '" '-W II ... ~ - ~ ci ::::l z o-t ... " '" :z: ~ " ffi " '-W '--' I~ >- 00 ~ ~ '" ... c.:: \ o:l ~I .. " " .. ~ ~ " " .. <::> li li '" ... 0; ." .,,; ... ~ " " " <-: " ~ ~ ~ ~ ,I ~ Ul - !\ '" E- " "0 .~ '" " c :z: ~ !; fJ' 'I " ~ ... "'- t "'- ... i ~ ~ '-W '"" II " " '" "'- ~ ... <; (:l,. ~ 0 'i == '<: "<: "<: <lo '" " ~ -..l "'I ~ -i; 1 z 1;; ~I "" ~ E- ." 'E t::' '" ~ ~ 1 :;! " " .. " ;; " ... ~ ~ .. .", I ~ ~ .", '" - o:l "15, Q... " " - " ';! ... ... <; ~ c- '-W ."," ~ " := ~ ~ 0:: " "~ ~ " " ~ Q 'E <; '" z Q "',! " "'- ~ C ~ 'C ~ ... "<: ~ - ~ " ~ ~ ... " "" .", ~ " ~ z s.. ,,' ~ 0:: ... '-' '" .;: " <; "- " it: ~ Q '<: Q. 00 ... o:l