HomeMy WebLinkAbout02-23-78
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Form RCC-33
COMMONWEALTH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
"':'J;l.
f} ~'l)
.
RESIDENT DECEDENT
CUMBERLAND
IMPORTANT: This return must be completed in detail and filed 1n duplicate, with will attached, with the
Register of Wills of the County where decedent resided; Return 1s due within one year after
date of death, unless an extension is granted by the Secretary of Revenue. (Section 703 of
the Inheritance and Estate Tax Actor 1961.)
IN THE MATTER OF TIlE ESTATE OF
Ethyl Reddig Mellinger
AFFIDAVIT OF
...................... e......................................................_.m.....'...._h.............,..................,....................h......~.
(State full name of .decedent)
Cumberland /1
Late of .
C t ~~KA~..X
oun 7
State of ....... . ....Pennsylvania
County of
Cumberland..
:}s:
A.4.l\~M
Richard E. Mellinger, heir
of the estate of the above-named decedent being duly sworn, depose 5
and say ,5
~J!!I:x
Decedent dJed
mm/.1ay 1(;,.
(Month)
(JllI.y)
..... 19".,,??.......{' testate leaVing a last
(Y(llr) inte.tste
will. copy of which i. hereto
attached. }
Name and address of attorney
other authorized representative
whom all correspondence should
mailed.
o,}
to
be
David C. Cleaver, Esq., Sharpe and Sharpe, 257 Lincoln Way
East, Chambersburg, Pa.
17201
That as such ...............Heir.......................... deponent is familiar with the affairs of said estate and the property con-
(1';Xl'('utor-AllminiAtratur)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe depo~it bux 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 anotber 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 SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
.
That the contents of said safe deposit box or boxes are itemized under Schedules
return, wi th the exception of the fOllOWing, for the reasons hereinafter set forth:
of this
That Schedule A attached hereto and made part hereof sets f"orth fullv and in detail all the
real property in the Commonweal th of Pennsylvania of" which decedent died having an interest therein. It
also sets forth the mortgage encturlbrances 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 collmms 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 f"orth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death; all moneys lef"t by the decedent
a t the time of death, whethcr in decedent's innnediate possession, standing to decedent's credi t in banks
of" deposit, savings banks, trust companies, or other institutions, whether individually, or in trust f"or
any other person or persons giving also separately the accrued interest 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 in-
debtedness of the Uniterl States to the decedent; all obligations, whether by statute or agreement they
arc designated as tax free, of thc United States, or any state, or political subdivision thereOf, or of
any f'orci.2;fl cOllntry, which are owned at the tll11c of death; all wearing apparel, Jewelry, silverware, pic-
tures, hooks, works of art, hOllSf'ilOld f"urntture, horses, carriaf!;cs, automobiles, bonta, nnd any and all
other personal chattels of whatsoever kind or nature, lef"t by decedent, together witll the ratrly estimated
market value thereof'j all honds and mortgB.~es held by decedent and of" all claims due and owing decedent
at the time of" death, anrl all prom.issory notes or other instrwnents 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 estimatcrl 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 f"rom lif'e insurance polici-es carried by decedent; all annuity and endOWment contracts the
proceeds or which were payable upon the death of" the decedent; and all the corporate stocks and dividends
dlle thereon and unpaid as of the date 'Of death, bonds and accrued interest thereon to the date of dece-
dent's death and oth~r investment securities owned by the decedent at the time of death, with the market
value thereof' at such time.
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III t111~ case 01' st'f:urit.ics of' close or 'family corporations, Uw values rcporterl Ilrc llS far IlS
possible suhstnntintf'd hy fintLnc:lll] stlltcments of' the corpol'ntions, showing the assets flnd. 111lIdllt.i('s
t.hereof fiS of t.he rlflte of rlenth. The schedule also sets forth tIle interest of flccerlcnt at the time of
deat.h in any cO-f'llrtnership or business, and in support of the volue of such interest there is IllUlcXPcl to
said schedule, f'innncinl statements showinp; the assets and liabilities of said co-partnership or business.
A COllY of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together with a 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 mU.':;t 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 intendcrl to tllke effect in possession or enjoyment at or
after death, said schedule sets forth the natur.e ann value of such property, to whom transferred, the
relationship of the transf'erees to the decedent, 'the proportionate share received by each transferee nnd
all other f'acts of a pertinent nature regarding said transf'ers. In the case of transfers intenderl to
take effect in possession or enjoyment at or after rleath, there is also nttacherl to the schedule a COllY
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in sHId
schedule fl list of' all property, real and personal, with its value, which pa!-.:ses Ilt decedent's df"'nt.1l hy
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 instrtunent 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 anti addresses of all
persons beneficially interested in this estate at the time of decerlent' s death, the nature of thetr res-
llcctive interests, their relationship, if any, to the decedent, together wi th the ages at t.he time of
decedent's detlth of till mtnol's, annuitants und beneficiaries for life limIer (leeedent's Wlll. It. Hlso
contains a statement ~;howing which of the benefi'ciaries named in the rlecedent' 5 w:lll, if' ltny, rHed prior
to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made 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
or the decedent and others, plus the date and place of record or instruments effecting the vestiture of
real estate and the date or acquisition or personalty, plus the name, address and relationship, if any,
of co-owners to the decedent.
That Sc/Jedule F attached hereto and made a part hereof sets rorth fully and in detail all debts
and deductions claimed for and on behalr of this decedent's estate, including fUneral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to he paid; cost expended ror burial trusts, tombstones or gravemarkers, and reli-
gious services, in conse'luence of' the death of the decedent; debts and claims owing and unpaid at time of
death; taxes accrued chargeable f'or period prior to decedent's (leath (except those allowed under Section
651 of the Inheritance and Estate Tax Act); toge:ther with a statement of collnteral pledgerl for oblign-
tions, if' any. It is agreed that the fiduciary.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", "E", and "F" as directed theretn,
have been carried rorward and properly registered in the Summary.
Subscribed and sworn to before me this .................................
I'~ d f .70t:/~...1f/. 19?~
.............._....,.:::)l:.~ . ay 0 ..,............,..........,..(~... ..-i..k......
............... ...... .......t::./4.-/?<<~>.:.....~2/(' ~.Z4-::~........
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1004 North West Street
.......................................................................................M....'.........
(Street Number)
Carlisle, Penna. 17013
.............................................................
(City or Town and State)
v ('!'
KOTE: Bef'ore signing affidavit make sure all blank spaces in tl1e affidavit and schedules annexed ure
f'illed in with details or the word "None", and in case the assets tnclude rare and unlisted securities,
securities of close or rnmlly corporations or an interest in any co-partnership or business, that the
data and statements r~~llred 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.
'l-.,.,-.
'RGC-34 ;.-\_,,,)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVeNUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
"'" .~?;. ....
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Real property in Pennsylvania, with statement 01 mortgage encumbrances upon each parcel at death 01 dece-
dent. Property held by the decedent os tenant in common with another or other, should be identilied
os to quantum 01 interest and the estimated value should be that 01 the decedent's interest only. (Property
held os joint tenants with right 01 surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property located In the Commonwealth of Pennsylvania should be
described by lot and blo<.::k number, street and stroot 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 numbor of a-
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,ore
to be listed on Schedule "F" and must not he deducted from this schedule.
Lot with improvements known as 442 East
Washington Street, Chambersburg, Franklin County,
Pa., Deed Reference: Franklin County, Pa., Deed
Book 152, Page 326. Appraised January 30, 1976,
by Robert F. Crider, Realtor, assessed value,
Franklin County Assessor's Office - $2,810.00
(1)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
Insert this total opposite 'j-eal property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
(2)
(31
DEPARTMENT
VALUATION
CAUTION
(Do not write
In tnl. apace)
ESTlMA TED
MARKET VALUE
/-
11,000.00 V / ~ O{){).OO
11,000.00
~/
'/ Oot) OC)
Rec -'35
rrESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
~~~. ~(\
~~
CD1lliONWEALTH OF PENNSYLVANIA
TRANSFErr INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time or 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.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 certificates, cash on hand and 1n bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or riduciary in said capacity, partnership interests, interest in anyundistributed
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 1n this schedule.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. Lis t and describe fully VALUE lIAIlKEr VALUE (Do not write 1n
thi s space)
None .~
Inser't this total opposite "Personal Property", Schedule "Bft in X X fL<f~
the "As Reported" column on the last page of' this reti.rn. None
--
RCC-36
CllMMOXWEALTII lll<' PENNSYLVANIA
THANSFER INHEI\[l'ANCE TAX
SCHEDULE "C"
TRANSP'ErrS
.
Q~JlXO
,.~~~
HESIDE:n DECEDENT
(1) Did decedent, within two years ordeath, make any transrer or any material part or his estate, without
receiving n valuable and adequate consideration there~or? (Answer yes or no) no
(2) Did decedent, within two years of death, transfer property from himself to himself and another or
others (inCluding a spouse) in joint ownership? (Answer yes or no) nn
(3) If' the answer to (1) or (2) above 1s 1n the affirmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the trans:fer. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transf'er of' property without receiving a valuable or adequate
consideration therefor which was to take erfect in possession or enjoyment at or after his death?
(Answer yes or no) 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 lU10er which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a) The possession or enjoyment of 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 transferred or
income therefrom? (Answer yes or no) no
(6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Din decedent in his lif'etime make a transf'er, the consideration Cor which was transferee's promise to
pay income to or f'or the benefit 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 reser\'ect power to al ter, amend, or revoke, or which cOllld revert to rlecedent under terms
of transf'er 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 al ter, amend, or revoke the inter-
est of the beneficiary reserverl in the decerlent 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 cef"tificate.
NOTE 2: If answer to any or the above questions is yes, set f'orth below a description of' the property
transferrerl, it's fair market value at flate of death, dates of" transfers anrl 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 baserl.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPT ION
MARKET VALUE
(Estimated)
DEPT. VALUATION
(Dept. Only)
None
')'kY'fLc
Insert this total opposite wTransfers", Schedule We" in the
"As ReportedW column on the last page of' this return.
None
ftOVt-Z..-
----
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RCC-37 02-H)
CmI\IONII"EALTII OF PENNSYYLANIA
TRA~SFER INIlEHITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
, RELA TIONSIlIP
I;ENEFICIARIES AND ADDRESSES (If step-children or SURVIVED 1 DATE INTEREST OF
tate full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
,ye an interest, vested, cont ill!~ent or other are involved, set STATE YES I BIRTH IN ESTATE
wiso, in estate) forth this fact.) OR NO
Richard E. Mellinger
--
1004 North West 5t. I
Carlisle Pa. . Son yes 1/,
Lester R. Mellinger
4712 Ruth Ann 5t. I ,
__Harrisburg. Pa. o~~ , "M 1/7
---;
i I I
,
Vance C. Mellinger
219 Layfayette St.
Harrisburg, Pa. I son yes I 1/3
,
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'''poner t f'ur thE' (' S<iys t.hat nIl the above-named benef'iciaries are living at this time except below:
NAME
DATE Of' DEATH
RESIDENCE
--_.._-~.._-_._-- .'-~'-'----'
------
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Heal Property
Personal Property
Transfers
SUMMAHY
...(Seh, "A")
,.. ....... ...(Seh, "B")
.........(Seh. "C")
(I)
(As Ikported)
$ .11,000.00
$
$
$..
$....
$11,000.00
(2)
(As DderJJlilll'd)
Cross Taxable Estate
$
$
$
$
$
$
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RCC-38
iWSl DENT DECEDENT
SCHEDULE liE"
,JOINTLY OWNED PJ\OPERTY
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CClMIIONWE:ILTH OF PENNSYLVANIA
TE,\N~fl'J\ [NIIEI\] TANCE TAX
L\SrRl'CTIO~S: This schedule mllst disclose nIl property, real ann persol1fll, owned by the decedent jointly
With another or others, including intangibles, standing in the name of' the decedent and others. List
real estate first, us entireties, or joint tenants, giving brief' description, as indicated Honer Schedule
"A", plus the date and plnce of record of instrwncnt effecting vestiture, but do not include entireties
01' out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule nil", plus date of acquisition, nnd the name, addre~s and relationship (if any) of Co-owners to
the decedent.
Description of' Prop-(:~-ty, l);~-te--Of^cq;l.isJtion, Name! Unit
Address and Relationship of Co-Owners, and Place ,Value
of Record of Instrllment, where Real Estate. !
. ~^X'). >(X:>...~ -
i>c< >Oi:> >>>0<: 8$;00 <>0;00 ~ = ex xx: ;X
~~ ()( ex ex ex V ex v<x;;: )Q 3<x ;X
percentage
Share
Estate
Valuation
::><>;88
ex ex
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5Sgs
DEPARTMENT
CAUTION-Do
In This
Value of'
l!.ntire
Property
VALUATIOr\
not Write
Spnce.
Value of
Decedent's
Interest
None
7L~
Insert this total opposite "JOiiltly Owned Property", Schedule"E"
in the" As Reported" colwnn on the last page of' this return.
None
RCC-8! (6-73)
COMMONWEAL TH OF PENNSYL V ANJA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPL Y PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Richard E. Mellinger
1004 Northwest Street
Carlisle, PA 17013
(Executor or Administrator)
In Re: Estate af
Ethyl Reddig Mellinger
Cumberland
Caunty - Fi Ie No.
21-78-0095
Dear Mr. Mellinger:
You are hereby notified that the Original
appraisement in the estate af Ethyl Reddig Mellinger
has been filed in the office of the Register of Wills of Cumberland
County on March 30 ,19~8, Said appraisement reflects the fallowing
va I uations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
11,000.00
None
None
None
$11 ,000 .00
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 manths 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.
Date March 30. 1978 Signed ~a,.._}r{,-__~L
Title Chief Appraeiser
L_-~."
Note: This is not a bi II.
R C C-2 (2-64)
DEPARTMENT OF REVENUE
BUREAU OF .cOUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
Mal'cli 30; 1978
COUNTY
Cumberland
FILE NO.
21-78-0095
Whereas,
Ethyl Reddig Mellinger
late of
Borough of Carlisle
Cumberland
in the County of Commonwealth of Pennsylvania, having died on
the 16th day of May 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Th f I Ira K. Gleim . d I . t d d' t I
ere ore, , I an appraIser u y appom e accor Ing 0 aw,
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
Ducrlptlon " Aud Values Made ,,, Inheritance
Tn Purposu
Real Property $ 11 ,000 00
--- ------.- .. -. t---
Personal Property None
- .-- -- -r--
Joint-Held Property None
Transfers None
--~---- -. .-- -I
n_ -
TOTAL ASSETS $11,000 pO
- --.----
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.
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Having been duly sworn according to law, I do hereby certify that the above
formity with law on this 30th day of
~.;.
-
appraisement is
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made in con-
,19E-.
Apprai8er
(M:amber and Street)
Harrisburp Penna.
(POft OI'Iee)
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