HomeMy WebLinkAbout09-20-78 (3)
,
.~ I ->} f" 9?
DEDUCTIONS ALLOWED IN
Form RC C-IO
OF Cumberland
DATE APPROVED
$ I 3, Q 9~ 3lf
~ 2hdz )9?y
OFFICE OF T).4E
REGISTER OF WILLS
STATEMENT OF DEBTS
,
AND DEDUCTIONS
THE SUM OF
COUNTY
LATE OF
Borouqh of ShioDf'nRhll'V
AND AGENT OF THE COMMONW..ALTH
ESTATE OF William B. CliooiIVer
e.. -=t I .':l
DATE OF FILING APPRA1SIILMENT A9::;t2st. "
1978
DATi: OF DEATH
October 11, 1977
NO. OF NAM&: OF PAYEE REMARKII AMOUNT
DAT~ VOUCH""
Register of Wills Letters Testarrentarv 35 nn
Register of Wills 6 Short Certificates Ii 00
News Chronicle Advertise Letters 10 00
Cumberland Law Journal Advertise Letters lQ nn
Daniel Hershev Auctioneer for sale of P '" Il?n nn
News Chronicle Advertise R.E. Sale 60 00
Public Opinion Advertise R.E. Sale 3q nn
Hale Real Estate Aporaisal ~n nn
Barl::our Funeral Home Funeral Ac=unt 1297 00
Dr. Donahoe Medical ,,~~,,~.. 174 00
Dr. A. W. Freeman Medical Ac=unt 25 00
Wavnesl::oro Marbel & Granite WJrk Letterim Stone ?~ nn
Chambersbmu Hosnital Ac=unt 1 ~7 17
G. L. Fogelsonger Book A=unt 36 00
;~ f'n Book Ac=unt 29 78
Cumberland Countv Re=rder 1 % Realty Transfer Tax 420 00
flor8u~gshf"'v ""Mrqtor for R. E. Tax ?~ ~n
Borouqh of Shiooensburq Water, sewer & refuse Acct. 129 63
Sarah Cliooinqer Widow's expmntion 2000 00
M. Davison, N. P. Affidavits 15 00
Recrister of Wills Filinq roo. tax "'DD. inventorv 9 00 -
and app. and debts statement
Cunberland County Re=rder Filing Release 10 00
Register of Wills Filing Account and Schedule 50 00
Nomen Michael and Iby Dice Executors' OJrrmission 4028 63
McCrea & Davis Attorney Commission 4028 63
,
COMMONWEAL.TH OF PENNSYL.VANIA
COUNTY OF Cunberland
\t'!, Nomen Michael and Rov Dice
}..,
I ~ u9 P.3'1
HI.IU.V CIlRTIP'Y. THAT. TO THE E;i::aT OF
hlY KNOWLEDGE AND BELIEF, THE ,.OREQOING I. A JUST AND TIltU I: erAT_MENT OF D..T., P'l,lNIRAL EXPINSES AND EXPii:NSa 01"
A"M'NI.TRATION OUBMITU" TO THE EOT"TO o. William ~qe~ ?'JEe"'.E", ". "E"UCTIONE FOR
INHERITANCE TAX PURPO.... ((
_ /l ~ ~~v-... . (L. . I
"AY Of' cutors, Estate of W~ll~am B.
Clippinger, Deceased.
I'. )
SWORN AND _UIISCAIBIO .I:I"ORE Mil THI_ " ,~
,I :~~~~~ir~', ,..1L
My Ccmn. ffiVires;
('
:jjl:
~CC-33 (,\-7.ilJ
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
RUREAU OF COUNTY COLLECTIONS C)"~ \':J j
~t.? 1.0 v
RESIDENT DECEDENT
COUNTY OF __CUMBERLAND_____
IMPORT ANT,
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'.l:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF TilE ESTATE OF
(STATE FULL NAME OF DECEDENT)
} AFFIDAVIT OF
EXECUTOR
AIlMINISTRA TOR
WILLIAM B. CLIPPINGER
Late of
Shippensburq. Curnberlam
PennsylvaIlia
County
State of
~--} s"'
County of
Clunb erland
~
Norman Michael and Roy Dice
of the estate of the obove~named decedent being duly sworn, depose
Executor S
and say
Decedent died
October 11
(MONTH)
Name and address of attorney or }
other authorized representative fa whom
all l;:orrespondence shoold be moiled.
( DAY)
19~
(Y EAR)
testate leaving a last will, copy of which is hereto attached. }
McCrea & Davis
24 West King Street, Shippensburg, Pa. 17257
That as such Exec}!t:ors deponent is familiar with the affairs of said estate and the property constituting
I EX F:Cl) TO H- ADMINI ST RA TO R)
the assets thereof and their fair market value.
That at the time of death there was no safc deposit nux registered in decedent's individual name, or jointly with, or
as agent or deputy of another, ur 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"i'UTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Noru;o
That the contents of said safe deposit box or boxes are itemized under Schedules
wi th 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 primf 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 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 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 securities owned by the decedent at the time of death, with the market value there-
of at sllch 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-partnership or business, and in support of the value of such interest there is annexed to
s aid schedule, financial s ta tements showing the asse ts and 1 iabU i ties of' s aid co-partnership or '!"l.usiness.
A copy of' the co-partnership agreement, (if oral, a statement sett.ing f'orth the nature of' the agreement)
together with a statement setting forth the cnaracter of the business, its location, and such other f'acts
pertaining to the business as may be pertinent to a fair and just appraisal of' the decedentt s interest
therein must be submitted. It should also set forth 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,f s
death, in contemplation of' decedentts death, or intended to take effect 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 proportionate share received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of' transfers intended to
take effect in possession or enjoyment at or after death, t.here is also attached to the schedule a copy
of the deed, trust agreement or other instrument creating the trust. Therl~ is also set forth in said
schedule a list of all property, real and personal, with its value, which paEses at decedentts death by
virtue of' the exercise by decedent, either individually, or jointly wi th another, or any power of appoint-
ment vested in decedent, e\ther individually or jointly, by the wEl, deed, or other instrument of another,
with 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 for life under 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, t.he dates of' their death, their issue, Ill1n the relationship of' such issue to the benef'iciary.
That SLhedule E attached hereto and mane a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or ot.hers, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instrmnents effecting the \iesti 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 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 fees and fudiciary's
commissions 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 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 report.ed 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 therein,
have been carrted forward and properly registered in the Summary.
...19..7.8...
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..... . .. ~tli.pp<=1'lsl:>t1:rgL:I.'E:'!~ly?P;Lll:Ln?I. .
(City OT Town and State)
Subscribed and sworn to bef'1e me this
d'IL'ld'-<-~
....... ...... ..... . day of ;Ii;J._ L
....is'!>I....
... t)Jo~ck{hfLJ,.,~<".
My Conin. expires:' t J ./. I,) ,) J .
!
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisterl securities,
securities of close or family 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 in the "SullB'llary" has been properly completed as above-directed.
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RCC~34 (4-73) ,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
ReClI 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 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 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 block number, stre.t and .treet number, together with
a general description of the property, with a reference to the record of th..
conveyance by which the decedent took title; If a farm .tate number of a.
cres; also .tatement of mortgage encumbrance. upon each parcel at death
of decedent. Taxe., aaa'asments, accrued Int.r..t on mortgage., etc.,are
to b. Ii.ted on Schedule "Fit and must not be deducted from this .chedule.
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not writ.
In thl. spac.)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATN
ESTlMA TED
MARKET VALUE
Real estate situate at No. 109 East Burd
Street, Shippensburg, Pa., conveyed by Harry
Killian and Grace Killian, his wife, by deed
dated November 19, 1951 and recorded in Deed
Book "W", Vol. 14, Page 253, to William B.
and Sadie Jane Clippinger, his wife. Sadie Jane
Clippinger died on July 27, 1969
(Sale Price). ') 3 ") V'-!
MArl1/;1/ /)wIU'P^ I /3 '1 ? t>
)
Real estate situate at No. 113-115 East Burd
Street, Shippensburg, Pa., conveyed by Carrie
B. M:::Caleb and George McCaleb, her husband,
to William B. and Sadie J. Clippinger by deed
dated March 1, 1928 and recorded in Deed Book
"V", Vol. 10, Page 49. Sadie Jane Clippinger
died on July 27, 1969.
(Sale Price)
3370
?>
16,000.00 ...4{,/ (l,,e.. ".h
4720
26,000.00 j.o~"
, 1t"
.
,17
N4" n"",. l)t{,A'/ reJ.. ,-
7?1..U
':I
/; F
)
""
Insert th,s total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
42,000.00
L.I' rJ 00
/r/ ~\/ '
RESIDENT DECEDENT
SCHEDULE "n"
PERSONAL PROPERTY
.
RCC -35 .
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 "Eft. 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 certiricates, 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 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 in this schedule.
I tern
No.
ITEM
List and describe fUlly
UNIT
VALUE
ESTIMATED
MAl\KEJ' V Al,UE
DEPARTMENT VALUATION
(Do not write in
this space)
./
Savings Account, #016-808-4-20, peoples
National Bank of Shippensburg, Bal 10/11/77
24,512.14'" / ;. oil J ,'~, I 't
crecking Ac=unt #16-808-4 ;Peoples National
Bank of Shippensburg, Bal. 10/11/77
14,060.45.1 ! 7,. 1" "'. 1./
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
38,572.59
')~ I) 7}, rj
!lee - 3b
rll\fMO:liWE~LTIl llF PENNSYLVANIA
TK~N8ffR I:liHER[r~NrE TAX
SCHEDULE "ell
Tll\'iSFEnS
+,
~
lIES I nEXT IWClmENT
(1) Dirt decedent, within two years of'death, make any transf'er of' any material part of his estate, without
receiving 11 valuable and adequate consideration therefor? (Answer yes or no) no
(2) Did decedent, within two years of death, transf'er properLY f'rom himself' to himself' and another or
others (including a spouse) in joint ownership? (Answer yes or no) no
(3) If' the answer to (l) or (2) above is in the af'firmative state: not applicable
(a) Age of' decedent at time of transfer
(b) State of decedent 's heal th at time of making the transfer. (Note 1).
(c) Cause of' decedent' 5 death. (Note 1).
(4) Did. decedent, in his li:fetime, make any transf'er of' property without receiving a valuable or adequate
consideration theref'or which was to take ef'f'ect in possession or enjoyment at or af'ter his death?
(Answer )'es or no) no
(a) Was there any possibility that the property transrerred might return to transf'erer or his
estate or be subject to his power of' disposition? (Answer yes or no) no
(b) What was the transf'eree's age at time of decedent's death? no
(5) Did decedent in his lif'etime make any transfer without receiving a valuable and adequate consideration
theref'or under which transferor expressly or impliedly reserves for his lif'e or any period which does
not in f'act end before his death:
(a) The possession or en,joyment of or the right to income from the property transrerred?
(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
(ei) If' the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others not applicable
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for the benef'it of care of transferor? (Answer yes or no) no
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserveti power to al ter, amend, or revoke, or which COllld revert to rlecedent under terms
of' transrer 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 benef'iciary reserved in the decedent alone or the decedent and others? not applicable
(Answer yes or no)
NOTE 1: The answers to these questions should be supported by aff'idavit by the attendi.ng physician as
well as a copy of' the death cer'tif'icate.
NOTE 2: If' answer to any of' the above questions is yes, set forth below a description of the property
transrerred, it's fair market value at date of' death, dates of' transfers and to whom transferred, with
relationship of' transf'erees to rlecedent, ir any. Submit copy of' any trust deed or instrument, if trans-
fers are claimerl 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 Scherlules A, B, or E.
ITEM
DESCRIPT ION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
None
ttON E
.
Insert this total opposite "Transf'ers", Schedule "e" in the
"As Reported" column on the last page of' this return.
None
~
RCC-37 (12-63)
('mIMO~\\'EALTIl OF l'E~~;;YYL\l\:lA
TRANSFER INIlERlTAo\;CE TAX
RESIDENT DEl'EDENT
SCHEDULE "D"
BEKEFIC1ARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED Di\,TE INTEREST OF
(If step-children or
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other. are involved, set STATE YES IN ESTATE
OR NO lHRTH
wise, in estate) forth this fact.)
Sarah Clippinger Widow yes sui juris Elective share to
~v, =,,'- u~u - $:3:3,069.62
<::h' D~ ,.,')~., I
wrnan !'hCha~~" none yes sui -iuris sS 000.00
Shippensburg, Pa. 17257 =+=
Rov ,T. ni~Q
R.R.#S, Shippensburg, Pa. 17257 none yes sui juris 1,000.00
,
Gladys Bender
R.R.fS, Shippensburg,Pa. 17257 none yes sui juris 300.00
Margar~t Wl.uard none yes sui juris 500.00
___' ~a. .
Wilbur Paxton Stepson yes sui 'iuris 500.00
J{.J{.f:" Shl.ppensburg, Pa.
Mrs. Wayne Hann(Hay) none yes sui juris 500.00
,,,.'- ,nn ,n
. .,," , '.", .
David Grush none yes sui -iuris 200.00
R.R.#l, Newburg, Pa.
UJIOUJY 1<llSse.Ll none yes sui juris 500.00
.
Shippensrurg , Pa.
Bobbv Michael none yes sui ;uris 2nn nn
R.R.#4, Shippensburg, Pa. 17257
;r=~l~c;Dl.g~.' ,.,. , .,')~., ~nQ H=~ ~n' ~'w, ~ ')"" ""
Prince St. United Brethren Church 500.00
;:'nJ.ppensourg, l'a.
~SDurg, l'a. .~ 500.00
~~~~n~~~~~~;' ~~~;r~\~;:;f~' ~ , None I Ecd'r 1/7 renainder
D'~;~ent nrrtner s~ystf1at~l Llle auove-,rn.mt'1..! ot'lll:'ficiaries are living at this time except below: no exception
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NAME DATE OF DEATH RESIDENCE
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Personal Property
Transfers
SUMMARY
(Sch. "A")
(Sch. "B")
(Sch. "e")
Gross Taxable Estate
(1 )
(As Reporter!)
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RCC-313
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "E"
JOINTLY OWNED PROPERTY
RESIDENT DECEDENT
INSTRCCTIONS: Th i s schedul emuS t disclose all proper ty, real and personal, owned by the decedent join tly
with another or others, including intangibles, stunding in the name of' the decedent and others. List
re,\l estate first. as entireties, or joint tenants, giving brief' description, as indicated under Schedule
"A", pItiS the date and place of' record of instrument eff'ecting 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 decedent.
Description of' Property, Date of Acquisition, Name
Address and Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate.
C<W<Y88~00gx:)< ^/
OY>Y>~~%%~ ex':'>6Y>:)<
unit
Value
percentage
Share
%R'%
Y>OrxxY>OO
:so<:rxx<x:so<:
0<:)<
None
Estate
Val un t ion
':'>660
>0<:>0<:
None
Insert this total opposi te ",Jointly Owned Property", Schedule "En None
in the" As Report.ed" coluBDl on the last page of' this return.
DEPARTMENT
CAUTION-Do
In This
Value of'
En tire
Property
VAl,UATION
not Write
Space.
Value of'
Deceden t' s
Interest
N_ONF
RCC-81 (6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
*'
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Roy Dice
R.D. 5
~h; ppc>nQ}-\l11'''g~ "Pe-nn::1
(Executor or Administrator)
In Re: Estate of
w;ll;~m R r.lipp;ngpr
Cumberland
County - Fi Ie No.
21-78-0097
Deor
You are hereby notified thot the Original
appraisement in the estate of William B. Clippinger
has been filed in the office of the Register of Wills of Cumberland
County on 12 October , 19.11L, Said approisement reflects the following
valuations:
Real Estate
Persanal Property
Transfers
Jaintly Owned
Total
42.000.00
38.572.59
None
None
80,572.59
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 manths 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. 374n
Date 12 Q",tob"r 7 8 Si gned ~~,.,i, - J<'.
1 "
Yf //_ .
L~~~'-L~_
Title____._
Chie.~_Appraiser
/ -----------.-
Note: This is not a bill.
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
'0 ,-,. .->0
DATE \ -\"c'. (Ll
RC C-2 (2-64)
COUNTyC^-~-0L~
FILE NO. 2\ l'6 - oo<il
Whereas, \}J,O~ b. f.:':.~~ lateofS~I-v-.AJ
in the County of ~,. Commonwealth of Pennsylvania, having died on
the \ \ .{-.fl- day of 0 (~ 19::1J., seized and possessed of an estate
subject to InheritanceTax under th,e laws of ~he Commonwealth of Pennsylvania;
Therefore, I, \ ~~ G.~ . 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 Ufe 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 AppraiUlment
DescrIption of Auet Valuel Made for Inheritance
Tu Purtloles
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Having been duly sworn according tp law, I do hereby ce!:1ify
formity with law on thiB \ l.- -Idi- day of 0 -
at the above appraisement is made in con.
1 19~.
Appraillef
(POlIt OfIIee)
, Penna.
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