HomeMy WebLinkAbout02-02-78
RCC-33 (4-73)
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CO:M6NIWEAL a OF PENNSYLVANIA
DEPARTM~NT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
c.
RESIDENT DECEDENT
COUNTY OF OJMBERLAND
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'tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
IN THE MATTER OF THE ESTATE OF } AFFIDAVIT OF
. TRANSFEREE
BeSSle M. Dunkleberger ~
(STATE FULL NAME OF DECEDENT)
CUmberland (~-" ~'I)ounty ~
Pennsylvania ,} n,
CUmberland
Florence D. Clair
of the estate of the above-named decedent being duly sworn, deposeS
~
State of
County of
~
TRANSFEREE
Decedent died
August
(MONTH)
Name and addr.s. of attorney or }
other authorized repreulntative to whom
all corre.pondence should be moiled.
31
, 1911--1 t..tate leaving a
(YEAR) ~
and say S
la.t will, copy of which I, hereto attached.}
(DAY)
Edward L. Schorpp
Landis & Black, 36 South Hanover Street, Carlisle, PA 17013
That as such Transferee deponent is familiar with the affairs of said estate and the property constituting
~
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION 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
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 detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of
death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons
giving also separately the accrued 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 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 interes t thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the'lll1arket value there-
of at such time.
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In the case of securities of' close or family corporations, the values reported are as far as
poss.ible 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
said schedule, financial statements showing the assets and liabilities of said co-partnership or husiness.
A copy 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 sHch 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 fa.ir 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 effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom transferred, the
relatlons.hip 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, there is also attached to the schedule a copy
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said
schedule a list of all property, real and personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another,
with a copy of the instrument creating such power attached to the schedule.
That Schedule .0 attached hereto hnd 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 beneficiaries named in the necedent's will, if any, died 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, standing1n the name
of the decedent and others, plus the date and place of record of instruments effecting the \estiture of
real estate and the date of acquisition of personalty, plus the name, address ann relationship, if any,
of co-owners to the deceden t.
That Sct>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 fiducia.ry will present proof of said Claimed obligations upon re-
quest, that if the amount actually paid in settlement of any tee, 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 therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this
7 '2,/,!'{
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...........................
... . day of ....";.-,.,T...~:~.{~..?~...<.Q..
'T
....19...]8.
.......~~~R ......,&..~..._......_...
~Transferee
........ .H,P,~.9.,!l.Q~.iiJ9................."".
(Street Number)
. ...q::l:r:~~s.~~!I'1\ 17013
(City CYr Town and State)
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ERl:~m." L nrl:;rrl. Noh17'i Ptiblle
c.;,. '_'.' .:.) c-.... i\,.
Hv C :C'c:.; ';u:"i 17. 19"i3
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NOTE: Before signing aff'idavi.t make sure all blank spaces in tne af'f'idavit a.nd schedules annexed are
f'illed in with details or the word "None", a.nd in case the assets include rare and unlisted securities,
securities of .close or family corporations or a.n interest in any co-partnership or business, that the
data. and statements required under the paragraph above relating to Schedule "B" are attacherl.. Also make
certain that colunm #1 in the "Sllnnnary" has been properly completed as above-directed.
RC C..34 (4~7 3)
COMMON w.E Al TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent as tenant .in common with another or other, should be identified
as to quontum of interest and the estimated value should be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property located In the Commonwealth of Penhsylvanla should be (1) (2) (3)
described by lot and block number, stre.t and street number, tog.ther with DEPARTMENT
a general description of the property, with a reference to the record of the ASSESSED VALUE V ALUA TIDN
conveyance by which the deced.nt took title; If a farm state number of a- FaR YEAR OF ESTIMA TED CAUTION
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Int.r.st on mortgages, etc.,ar. DECEDENT'S MARKET VALUE (Do not writ.
to be listed on Schedule 11Ft! and must not be d.ducted from this schedule. DEATN In this apace)
NONE 7UYw
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
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RCC -35
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
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CO~~ONWEALTH 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 "En. Intangible personal property, titled in the name of' the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the :fact that they are not 01' 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 certit'icates, 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 01' 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. List and describe fully VALUE MARKET VALUE (Do not write in
this space)
NONE hnY1--0
Insert this total opposite "Personal Proper ty" , Schedule "B" in X X JUru.-
the liAs Reported" column on the last page of' this return.
.RCB- 36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "en
TRANSFl':rlS I
.
RESIDENT DECEDENT
(1) Did decedent, within two years of de nth, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration theref'or? (Answer yes or no) Yes
(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) Yes
(3) If the answer to (1) or (2) above is 1n the af'firmatlve state:
(a) Age of decedent at time of transfer 70
(b) State of decedent's health at time of' making the transfer. (Note 1).
(c) 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)-.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) No
(b) What was the transferee's age at time of decedent's death? 76
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under 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 thf.' 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) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or Jor the benefit 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 reserve(l power to al ter, amend, or revoke, or which conId 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 beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no) N .A.
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 transf'erred, 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 time ted)
DEPT. VALUATION
(Dept. Only)
1.
All that certain tract of land situate in Monroe
Township, Cumberland County, PA, containing 0.13
acre fronting on the public road leading from
Churchtown to Boiling Springs and being improved
with a frame dwelling house, more particularly
situate on Water Street in the Village of Allen.
Being the same premises conveyed to Decedent and
Arthur S. Dunkleberger, her husband, (Date of
Death: November 5, 1975) on October 8, 1949, in
Cumberland County Deed Book I, Volume 14, Page 377.
Decedent conveyed a 1/2 interest in said pre-
mises to her daughter, Florence D. Clair, and
William L. Clair, her husband, on December 15,
1975, in Cumberland County Deed Book J, Volume 26,
Page 395.
Decedent conveyed the remaining 1/2 interest to
Florence D. Clair and William L. Clair, her husban ,
on August 10, 1977, in Cumberland County Deed__
Book I, Volume 27, Page 765. r>!ll([' "''':~'LL' '0 L!!
Assessed Valuation(/{$5,150.00 20,600.00
Checking Account #182-312595-8 at Commonwealth
National Bank, Carlisle, PA, was transferred by
decedent on November 26, 1975, into joint names
of decedent and her grandson, Robert Leroy Clair. 960.85
Savings Account #18-0012494-1 at Commonwealth
National Bank, Carlisle, PA, was transferred by
decedent on May 14, 1976, into joint names of
decedent and her grandson, Robert Leroy Clair 1, "72 .12
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"
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2.
qhc) f.5-
3.
Insert this total opposite "Transrers", Schedule "e" in the
II As Reported" colunm on the 1 as t page of this return.
22,632.97
,,~~ (p,"',:).91
J
Commonwealth J~
National Bank ~
February IS, 1978
Mr. Edward L. Schorpp
Landis & Black
Law Offices
Carlisle, Pa. 17013
Re: Bessie M. Dunkleberger
Checking Acct. #182-312595-8
Savings Acct. #18-0012494-1
Dear Mr. Schorpp:
In reply to your recent request, this is to advise that
the above captioned checking account was opened in joint names with
Leroy Clair on 11/26/75 and had a balance of $960.85~ of 8/31/77.
The savings account was opened in joi~-narnes with Leroy Clair on
5/14/76 and had a~ance of $1,065.89 as of 8/31/77 and had accrued
interest of $6.23 as of same date.
Very truly yours,
/
./. . (
Robert A. Talalai
Assistant Vice President
'(I
'-(j.' l-
RAT/dmf
The Commonwealth National Bank, 10 South Market Square, Harrisburg, Pa. 17108 (717) 564-9500
LAST WILL AND TESTAMENf
OF
BESSIE M. DUNKLEBERGER
1, BESSIE M. DUNKLEBERGER, a legal resident of M;)nroe Township,
Cumberland C01mty, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and for my Last Will
and Testament, hereby revoking all other wills and codicils heretofore made by
me.
FIRST: I direct that al I my just debts and funeral expenses,
including my grave marker, shall be paid from the assets of my estate as soon
as practicable after my decease.
SECOND: I devise and bequeath the residue of my estate of every
nature and wherever situate to my daughter, Florence D. Clair, providing she
shall survive me by thirty (30) days. Should my daughter, Florence D. Clair,
predecease me or die on or before the thirtieth day following my death, I
devise and bequeath the residue of my estate to my grandson, Robert L. Clair.
THIRD: I direct that all taxes that may be assessed in conse-
quence of my death of whatever nature and by whatever jurisdiction imposed, sha
be paid from my residuary estate as a part of the expense of the administration
of my estate.
FCUR1H: I nominate, constitute and appoint my grandson, Robert L.
Clair, Executor of this my Last Will and Testament. In the event of the renun-
ciation, death, resignation or inability to act for any reason whatsoever of
the said Robert L. Clair, I nominate, constitute and appoint Florence D. Clair,
Executrix of this my Last Will and Testament. I hereby relieve my Executor or
Executrix from the necessity of posting security in connection with his or her
duties as such in any jurisdiction in which he or she may be called upon to
act insofar as I am able by law to do so.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,' my
Last Will and Testament, consisting of one (1) typewritten page, which bears
my signature for the purpose of identification this /'S-22l'Iay of December, 1975.
dJ ~ 9(G ~q(SEAL)
eSSle M. n. e erg
Signed, sealed, published and declared by the above-named Testatrix,
Bessie M. Dunkleberger, as and for her Last Will and Testament, in the presence
of us, who, at her request, in her sight and presence, and in the sight and
presence of each other, have hereunto subscribed our names as witnesses.
LAW OY"ICI!8
LANDIS a: BLACK
I'tLlSLE. P'ENNSVLVANIA
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RCC-37 h2-63)
COMMONWEALTH OF PENNSYYLANIA
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
lave an interest, vested. contingent or other are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO HI RTH
Florence D. Clair Daup"hter Yes 2/21/24 Life-time transferee of
R.D. #6 Box 516 taxable gift (Real Estat
Carlisle, PA 17013
Robert Leroy Clair Grandson Yes 4/13/52 Joint Tenant (Life-time
40 East Main Street transferee) in bank
Mechanicsburg, PA 17055 accounts
e
Deponent fUrther says that all the above-named bene~iciaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
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SUMMARY
Real Property .... ( Sch. "A")
Personal Property ... (Sch. "B")
Transfers ...... .......................... . ....................................(SCh. "C")
Gross Taxable Estate
$..
$
$
$
$..
$..
(1 )
(As Reported)
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22,632.97
-0-
-0-
(2)
(As Determined)
$
$
$
$
$
$
22,632.97
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RCi;:-38
, .
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
*
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 tmder Schedule
"An, 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 dece,1ent.
Description of Property, Date of Acquisition, Name
Address and Relationship of Co-Owners, and Place
of' Record of Instrument, where Real Estate.
X 5C 5< Xx :& 5<9 SO
Xi ~ Y; OC OC odS
6(; !'X';!'X';
6(;
~xx
X
~8S
c X
1. Checking Account #182-312595-8 at Com-
monwealth National Bank, Carlisle, PA, was
transferred by decedent on November 26,
1975, into joint names of decedent and her
grandson, Robert Leroy Clair.
xx XX X
OCX
2. Savings Account #18-0012494-1 at Com-
monwealth National Bank, Carlisle, PA, was
transferred by decedent on May 14, 1976, int<
joint names of decedent and her grandson,
Robert Leroy Clair. -0-
The above two assets were included in the
taxable estate of decedent under Schedule C
"Transfers".
unit
Value
Xx
X
-0-
percentage Estate
Share Valuation
:s<:
:&:0<: X
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" colUllD'l on the last page of this return.
~ ~
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
-0-
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-0-
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*
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 OF APPRAISEMENT
Florence D. Clair
R.D.6, Box 516
Carlisle, FA 17013
(Executor or Administrator)
In Re: Estate of
Bessie M. Dunkleberger
Cumberland
County - Fi Ie No.
21-78-0106
Dear Mrs. Clair:
You ore hereby notified that the Original - No Letters
appraisement in the estate of Bessie M. Dunkleberger
has been filed in the. office of the Re1:ister of Wills of Cumberland
County on Apnl 20 , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Totol
None
None
22,632.97
None
$22,632.97
As to such tax that is poid within three months from dote of death, 0 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 ~ct of 1961, 72 P. S. 2485.1001, P. L. 37~ 1.
Dote Apr~l 20-"-1978 Signed _ )<, ~ h4/~
Title_ Chi"f Appra.:L_ser
L
Note: This is not 0 bill.
RCC 2 (2-64)
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
April 20, 1978
COUNTY
Cumberland
FILE NO.
21-78-0106
Whereas, Bessie M. Dunkleberger late of Monroe Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 31 st day of August 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 tra.nsferred In possession or enjoyment to collateral heir.s 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
Delcrlptlon 01 Anet Valuel Made I" Inheritance
T" PurpOlfl1
Real Property $ None
----" -
Personal Property None
-
Transfers 22,632 97
Joint-Held Property None
.
--
TOTAL ASSETS $22,632 97
.
----
...
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..-..---..--.-.
..
Having been duly sworn accordim: to law, I do hereby certify that the above appraiseIl!ent is made in con.
formity with law on this 2 h day of ,~/( . A.-J~' 19~.
Appraiaer
(Ifumbe't and Stnet)
Harrisburg
(Poet Me.)
, Penna.
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