HomeMy WebLinkAbout09-08-78
'.RCC-33 (4-73l
COMMONWEALTH OF PENNSYLV~~r 08 1978
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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RESIDENT DECEDENT
COpy Or- \"!HI fJUST
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COUNTY OF CUMBERLAND
IMPORT ANT,
This return must be completed in detail and riled in duplicate, with all attached, with the Register of Wills of the
Countv where decedent resided; Retmn is due within nine months after date of death, unlt"ss an extension is granted
by the- Secretary of Re'J:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
c'nmhE>r] and C01lUt:7
Pennsvlvania
} AFFIDAVIT OF
EXECUTOR
_~R
IN THE MATTER OF THE ESTATE OF
MARY E. HEISEY
(STATE FULL NAME OF DECEDENT)
County
County of
York
J'"
State of
Ald..~
Anna R. Ritchie
of tl,e estate of the Clbove-named decedent being duly sworn, deposes
Executor
and say S
Decedent died
, 19_1 testate leaving a last will, copy of which is hereto attached. }
(YEAR) ~IOXHMXX
Fehruary 11, 1q7R
(MONTH) (DAY)
Name and address of attorney aT }
other authorized representative ,'~ whom
all correspondence should be mailed.
128 East King Street, York, Pa.
J"'-"IP$ R. ~.....l;(y
17403 I',N. ~ii\h~. c:!.r/is/eta.
R1H:u:u~ll 1:;' r..-ri ~9t- J l?9'l']ire
That as such EXECUTOR deponent is familiar with the affairs of said estate and the property constituting
{EX ECUTO R~ADMINI ST RA TO Rl
the assets thereof and their fair market value.
That at thc time of death there was no safe deposit box registcn.:d 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 follO\ving: -
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
Nnn,::t.
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception of the [ollowing, 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; at'l bOl1d~;) 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 ~ime 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 secw ::l~'S 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. 1))' f'inancial statements of the corporations, showing the assets ann liabilities
th~reof' 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, finR.ncial statements showinp.; the assets and liabilities of said co-partnership or "business.
A copy of the co-partnership agreement, (if oral, a statement setting f'orth the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other f'acts
pertaining to the business as mliY be pertinent to a f'air and just appraisal of' the decedent's interest
therein must he submittf'd. It should also se:t f'orth in itemized f'orm, together with the fair market value
thereof', any other propert,Y 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 t8.ke ef'f'ect in possession or en.Joym~nt at or
af'ter death, said schedule sets forth the nature and value of' such property, to whom trlUlsferred, the
relationship of the transferees to the decectent, the proportionate share received by each transf'eree and
all other f'acts of rl. pertinent nature regarding sain transf'ers. In the case of transf'ers intended to
take ef'f'ect in possession or enjoyment at or af'ter neath, there is also attached to the schedule a COllY
of' the d~ed., trust agreement or other instrument creating the trust. Therl~ is also set f'orth in said
schedule a list. of 1;111 property, real and personal, with its value, which passes at dece.hmt's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of' appoint-
m~nt vested in decedent, ei ther individually or jointly, by the will, deed, or other instrwnent of another,
with a copy of the instrument creating such power attached to the schedule.
Thftt Schedule D attached hereto and made part hereof' sets f'orth the names and addresses of' all
persons benefi(~lally interested in this estate at the time of decedent's death, the nature of' their res-
pective intere:->r,s, their relationship, if' any, to the decedent, together with the ages at the time of
decedent's deat.h of' all minors, annuitants and benef'iciaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior
to d8cedent, the dates of' their death, their issue, and the relationship of' such issue to the benef'iciary.
That Scf>edule E attached hereto and made a part hereof sets f'orth all propert;y, 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 eff'ecting the vestiture of
real estate awl the date of' acquisition of personalty, plus the name, address and relationshi.p, if any,
of co-owners to the deceden t.
That Sct>edule F attached hereto and made a part hereof' sets f'orth f'ully and in detail all debts
and deductions claimed for ann on behalf' of this decedent's estate, including f'uneral expenses paid;
f'amilyexemption, where applicaLlej costs of' administration of this estate; counsel f'ees and f'udiciary's
commissions paid or t.o 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 unpaid at time of'
death; taxes accrued chargeable f'or 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 llledgea 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 amollnt 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 therewi tho
That the totals of the appropriate colunms in Scherlules "A", "B", "en, "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
l\,~ (L
Subscribed end S::~}fto btC,2: thiB"'~~'J:i: ... .......~(:E) :..e~.tor' t~~?r~ / :~......,..
::o,b,-,- 'L"Y~"!J1~it'z'\..~"",m ~;;;;;.. ,. ,. ,; ;::.~-,,-----
YORK. YORK COUNTY Mec;h!!!!:i,C;.B.P.\U;,g.,..J?.ennS.ylvania. ...17055.....
My Conunission Expires: MY COMMISSION EXPIRES AUG. 18, 1980 (City or Town and State)
Member, PennsylvaniaAssoci3tlon of Notaries
SOTE: Bef'ore signing affidavit make sure all blank spaces in the af'f'idavit and schedules annexed are
f'illed in with details or the word. "None", and in case the assets include rare and unlisted securities,
securities of close or family corporfltions 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 th~ "Summary" has been properly completed as above-directed.
P.C C.34 (4..73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITAi'lCE TAX
RESIDENT DECEDENI
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 os 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 os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedul" "E.")
The real property located In the Commonwealth of Pennsylvania should be
described by lot and block number, .treet and street number, together with
a general description of the property, with a reference to the record of the
conveyance by which the decedent took thle; If a farm state number of a.
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxe., assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule uFIt and must not be deducted from this schedule.
(1)
(2)
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In thl. space)
ASSESSED VALUE
FOR YEAR OF
DECEOENT'S
DEA TH
ESTIMATED
MARKET VALUE
Real estate situate at 804 West Keller Street,
Mechanicsburg, Pennsylvania, sold
August 17, 1978
20,350.00 j". -----$;0,350.00
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Insert this total opposite "real prope.,,", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
$20,350.00
$20,350.00
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lliast _ill ttnn m~soottel1t
I, MARY E. HEISEY, ot Monroe Township, Curnb", I. . ,.
~::l:;'/J
Pennsylvania. declare tiris to be my la.st will and revoke all wit',,,
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previou.sly' tnade.
1. I give and bequeath my household furniture to ro'" . ,lei",,, t." b.
divided. i\.rnong thern as they shall rnl..1tually agree; any items rem;.d (U""l~; O;Q'h*'l'L b~'
801d by my e:><"c>:ltrix and the proceeds added to my residuary esta'...
{." I give and devise rny farm eituated in Monroe TtNnll:'jh-ip., Cumc';dr).::t,n.d
f::.::<~:d for inheritance tax purposes.
If, after 90 days written notic"" to nim by m.,.
said farm i
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C,~)Wlty, Pennsylvania, to my son,
Charles E. Heisey, at the valuilunn of
ex(:: ('. ut..t" ix., he doee not e:i.ect in writing to accept said offer, I give i'\.nd ci.evis,e sa-.ld
farm to my daughter, Anna R. Ritchie, upon the same terffiH, and if after 90 d,,-y"
wLtte" notice she o<>es not elect in writing to accept said offer, I direct my exec'"-
t .ix to sell sdid farm at either public or private sale and to a.dd the proceeds to my
resHluaryefirate..
3. Ail the re"t, residue and remainder of my eatate I give and be-
Anna R. Ritchie, .Tames D. Heisey and Jacob L. Heisey in equal sh.,res and if any
HeiBeY,
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queath to my six chilaren, Robert A. Heisey, Dorothy H. Mains, Charle~ 1':.
child Hhall prec.ie coa. se n'J.e then to his or ,he r ita- sue pc r stirpe B.
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4. Ii ..ny portion of my ".tate shall boccme <lhtribu~..bl. to a minor \
beneHcial'Y, such share shall be held by surviving parent of the mInor, otherwise b1
The Hdrri.sburg National BarIl<. and Trust Company as testamentary guardian during I
mino:Clty 01 sag: minor, and to use the income and pr\ncipal {or the benefit of said i
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rninc~ dB the gua.rdia.n may deem proper.
5.
I appoint as executrix of this will my daughte r. Anna R. Hitchie.
Ii fOI' il-ny reason s:1.e shall fail to qualiiy or cease to act as s\1ch during the admin..
shall ;aiUo qualify or cease '0 2.ct as such during the administration of my estate,
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iHratlOn of my estate, 1 apP?int as substituted executor my son Jacob L. Heisey,
with the sanle powe r8 ar~d dutie 6 as i~ originally appointed" If for any reaaon he
.
1 appoint as subsbtuted executor The Harrisburg National. Bank and Trust Company,
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y..'\LJl tt,c "'d.ine ;)('wet',;; aca dl..,titJ 2.8 ii :)rlG:-in~tlly ap?ointerl. No bono 6\',ca1) t,:~
_;';~L~l~lr/~d (:;,[ any L_dum ry act.Jng '.lnder this W1U.
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iN WITNESSV'{H~f\.EOF, .1 bave h{~l~e\JDto a~l my hand a.~,~ sea~ this
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Sif?n,~dt HedJe,-:-1/ vublis!lf'd ar1'i dec1."4:r'en
b'\' },1.}-~l ,}<. f->clEe'y'.i- tef~t<:it'_'i}.:: ab0\.-'~
nalJJed.:> d'; ..:iLU;O h'T ~<-;,;;t W_d~ ~Pld_
test.lrncr..t. Il:.:ltten OIl I.W,.) t..i:lee':'S. 01.
~,<:;,'~)e:rl in our p",~I.::tience, w,'---',t"1 ~_t.l-heI'
prf~,"(~ncc~ (t, hf::" r'E'questt 2,~(i ili l,be
i?rt'~'(~l',..:'t:. of e~;.;:h oth~c. L!c'Ve he rennto
Sllb.-.:c r~~br'd O\)_:~. namep af'. atteSl..lng
witne f-'.iJes;
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RCC-37 (12-63)
CO~IMONWEALTH OF PENNSYYL,\NIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
RELATIONSHIP I
BENEFICIARIES AND ADDRESSES (If step-children or SURVIV,ED DATE INTEREST OF
State full names and addresses of all who illegitimate children I DECEDENT OF BENEFICIARY
aye an interest, vested, contingent or other- are involved, set STATE YES BI RTH IN ESTATE
wise. in estate) forth this fact.) : OR NO
Robert A. Heisey
!'no c,
Santa Ana California 92704 Son yes 1/1i ~oo'A,
Doro~hv A
4<; Mon Av "nl1 " ,
Shinnensburl>, Penna 172<;7 A~"~h~o~ .00 , I~ ..A,
'0 "
R. D. 1/2 I
d. Ponn~ 17n" onn , .0. <-
Anna R. Ritchie
R. D. //2 Box 268
Mechanicsburl> . Penna. 17055 daul>hter ves 1 I~ ,. A.
James D. UO'
6351 S. 69th East: P1"r"
Tulsa, Oklahoma 74133 son yes 1 Iii ' '0
T. .L T. U,'
210 I.To~~~ ^.
Mechanicsburg, Penna. 17055 son yes 1/" '0
...
Deponent further says that all the above-named beneficiaries are living at this time except below:
.
NAME DATE OF DEATH RESIDENCE
NON"
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SUMMARY
.. (Sch. "A")
........................ ................... .......(Sch. "R")
............ ........................................(SCh. "C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
$ ..20,350.00
$ 29,5Z6.01
$.. ....... ...0.00
$..
$.. .
$49,926.0:1.
(2)
(As Determined;
$ 20,350.00
$28,950.47
$ -0-
$
$
$ 1<9,300.47
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RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
*'
COMMONWEALTH OF PENNSYLVANIA'
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, ownerl. by the decedent jointly
wi th anot.her or others, including intangibles, standing 1n the name of the decedent and others. List
real estate first, ~s entireties, or joint tenants, giving brief description, as indicated tmder Schedule
"An, plus the da.te and place of record of instrument effecting vestlture, but do not include entireties
or out of state real estate value 1n estate valuation column. Personal property should be listed as 1n
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 Acquisi tion, Name unit percentage Estate DEPARTMENT VALUATION
Address and Relationship or Co-Owners, and Place Value Share Valuation CAUTION-Do not Write
or Record of Instrwnent, where Real Estate. In This Space.
) X;X :<< z: ;Q >Q< y: 06 :<< :<< 0( y & ':XV )< Value of Value of
:>0 ~ )< ')6 ~ 'XX )< :>0 :>0 ~ y: 36 06 ~ >0< >0< Entire Deceden tIs
~ Property Interest
NONE NONE
Insert this to tal opposite ",Jointly Owned Property", Schedule "E"
in the "As Reported" column un the last page of' this return.
:
RCC-39 (5--f.el
COMMONYtS,'L TH OF PENNSYLVANIA
TRANS:""~ INHElllTANCE TAX
RF5WfE1~c PcC~I)F",rT
SUMMARY
DATE OF DEATH ?/11 /78
FILE NO. 21-7R-01nR
-----"'
----~_.
Estate of___. HEISEY
(Last Name)
MARY
(First Name)
E
(Initial)
REPORT OF INHERITANCE TAX APPRAISER
l, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that] have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Dated:
September 25, 1978
I . /
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INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
t. the undersigned duly elected Register of Wills in and for Cumber1 Hnd County, Pennsylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:
VALUE AS REPORTED
$
VALUE AS APPRAISED
$
VALUE AS REAPPRAISED
$
INVENTORY
Real Property (Schedule A)
Personal property (Schedule B)
Transfers (Schedule C)
Joint - Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
REGISTER OF WI LLS
0.00
49 926.01
8 069.50
4
Valuation of life estates or
annuities. . . . . . . . . . . .
ESTATE TAX ASSESSMENTS
$
t=
t=
l=
$
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
TOTAL TAX
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED $
Estate tax paid $
BALANCE DUE
Add interest at rate of 6% from
to
COMPUTATION OF TAX
2%
6%
5%
10%
15%
*
$
$
$
$
$
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
$
$
$
c
$
$
t=
1=$
L
t=
$
$
TOTAL TAX BALANCE $
PAID $
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
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RCC-8\ (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
Anna R. Ritchie, Executrix
(Executor or Adm ini strator)
In Re: Estate of 14..",) F. Heisey
Cumberland
County - File No. 21-78-0108
Deor Mrs. Ritchie:
You ore hereby notified that the or~qinal
appraisement in the estote of Marv E. HeJ.sey
has been filed in the office of the Register of Wills of r.IIIRherland
County on Sopt9IRber :25 19-28-, Said approisement reflects the following
valuations:
Reol Estote
Personol Property
T ronsfers
Jointly Owned
Total
$?n,l'iO.OO
$?P.,9<;0.47
-0-
-0-
stI,,9,300.!o7
As to such tax that is paid within three months from dote of death, a five (5%)
percent discount is allowable. As to any tax thot remoins unpaid after nine (9) months
(fifteen months when deoth 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 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
September 25. 1978
Signed
, E_,
"
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,/ '
Title ~ I\Pllrailler
._---"-.
Note: This is not a bill.
R C C-2 (2~64'
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLL ECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE ~ppt.~mhp~ ?~, 1q7A
COUNTY CUMberlRnd
FILE NO. 21-78-0108
Whereas, M~~y F HRi !U:l\j late of Mnn~nR TnMn.hi r
in the County of CUllberland Commonwealth of Pennsylvania, having died on
the 11th day of February 19 78 , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, IrR K. Gleim . an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration 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 Aggr.isement
Descrlgtlon of Anet V.lues M.de for Inheritance
Till. Purposes
REAL ESTATE $20,350.00 $ 2o,~~~ 00
f---
PERSONAL PROPERTY 28.950.47 28,950 J!L
TRANSFERS NONE -0-
JOINT-HELD PROPERTY NONE -0-
TOTAL ESTATE ~Io9 300 107 4I:I.Q 'Inn 1.'7
Having been duly swo.rn according to law, I do hereby certify that the above appraisement is made in con-
formity with law on this 25tl:1 day of 5BJ;ltSIl/;lBP 197a--.
cL
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Appraieer
(Mlmber and Stnet)
Harril!lbura
(Po.t Oftl~)
, Penna.
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