HomeMy WebLinkAbout08-21-78
RC'l::.~3 (4-Hl
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
coiUJt; 6,19/8 CUMBERLAND
RESIDENT DECEDENT
IMPDRTANT,
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.)
IN THE MATTER OF THE ESTATE OF
NORMAN F. SHUEY
Late of
CUMBERLAND
PENNSYLVANIA
} AFFIDAVIT OF
EXECUTIOR I X
XIllQANIS~~
(STATE FULL NAME OF DECEDENT)
County
State of
County of
CUMBERLAND
} so,
~-
ESTHER M. KEISTER
Execuooix
of the estate of the above-named decedent being duly sworn, depose S
and soy 5
Decedent died Februarv
(MONTH)
Name and address of attorney or }
other authorized representative fo whom
011 correspondence should be mailed.
25
19~1 testate leaving a last will, copy of which is hereto attached. }
(YEAR) ~i{
(DAY)
ROBERT L. MYERS, III, MYERS, MYERS, FLOWER & JOHNSON
P. O. Box 125, Lemoyne, Pennsylvania 17043
That as such Executrix deponent is familiar with the affairs of said estate and the property constituting
(EXECU TO R-ADMIN 1ST RA TOR)
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
T\Tnnp
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception-of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in 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 interest thereon to the date of decedent's
death and other investment secUl<lies owned by the decedent at the time of death, with the market value there-
of at such time.
-----
In the case of securities of close or family corporations, the values reported are as far as
-possible substantiated by financial statements of the corporations, showing the assets and liabili ties
thereof as of the dftte of death. The schedule also sets forth the interest of rlecedent 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 h,usiness.
A copy of the co-partnership agreement, (if oral, a statement setting; forth the nature of' the agreement)
together with a statement setting; f'orth the character of the business, its location, and such otller facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent' 5 interest
theretn must be submttted. It should also set forth in itemized form, 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 transf'ers of'property, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to ta.ke ef'f'ect in possession or enjoyment at or
after death, said schedule sets f'orth the nature ann value of such property, to whom transferred, the
relationship of' the transferees to the decedent, the proportionate share received by each transf'eree and
all other facts of' a pertinent nature regarding said transf'ers. In the case of transf'ers intended to
take effect in -possession or enjoyment at or after death, there is also attached to the scherlule a copy
of' the deed, trust agreement or other instrument creating the trust. Therl~ is also set f'orth in said
schedule a list of all property, real and personal, with its value, which pa:sses 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 instrwnent of' another,
with a copy of the instrwnent creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets f'orth the names anCl addresses of all
persons benef'icially 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 unner decedent' 5 Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, if' any, died prior
to decedent, the dates of their death, their issue, ann the relationship of such issue to the benef'iciary.
That S~~edule 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
of the decedent and others, plus the date and place of record of instrrunents ef'f'ecting: the vesti 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 Sc~edule F attached hereto and made a part hereof' sets forth fully and in detail all debts
and deductions claimed f'or and on behalf of this decedent's estate, inclllrling 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 lmpaid 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 f'or 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 f'ee, commission or debt is less than the
estimated amount cl aimtng and allowed, that the same will be reported to the Register of' Wills, and that
the amount of' tax assessed can be reassessecl in accordance therewith.
That the totals of the apllropriate colunms in Schedules "A", "B", "en, "E", and "F" as directed therein,
have been carried rorward and prollerly registered in the Summary.
Subscribed and sworn to before me this
......~..daY~
NOTARY P'untk: ""
!I.y Cot11rai3~on E.xpiles Doc. 21, 198~
L~D1.::l}"De. 1'0.. Ca:w:;(:dclL:.d. Co:.!:J 1
..... 19...2..J
.........~~~~~;.~.~_...
fj32~S;fJt9fu1fub1b-'tfeet.................
.... .. .\'J()J::'n.t:L.eYE.l.I::>1;1.r:9,?a.,:L.79.t1}...
(City or Town and State)
NOTE: Before signing af'fidavit make sure all blank spaces in the aff'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 corporations or an interest in any co-partnership or business, that the
data anCl statements requi ren 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.
RC C-34 (4~7 3)
COMMONWEAL TH OF PENNSYLVANIA
DEP1.RTMENT 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 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 Schedule "E.")
The real property located In the Commonwealth of Pennsylvania should be (1) (2) (3\
described by lot and block number, street and street number, together with DEPARTMENT
a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title; If a farm state number of a~ FOR VEAR OF ESTIMA TED CAUTION
cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not writ.
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEA TH In this spac.)
to be listed on Schedule "F" and must not h. deducted from this schedule.
NONE
~ ;7/
~
/
Insert this total opposite "real prope,;y", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
~
Page 1
.RCC -35.
COMMONWEALTH OF PENNSYLVANIA
THANS}~R INHERITANCE TAX
REsn';XI DECEDENT
SCHEDULE "B"
PERSONAL PItOPERTY
-~.
..
~.
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time o~ 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 hut not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the f'act that they are not of' the administered estate.
Tangible personal property should be listed f'irst (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certi:ficates, 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.
Item
No.
ITEM
List and describe fully
1. Bonds
~ - $1,000.00 Series E Bonds - dated
12/29/61 - date of death value - $1,588. 0
L - $500.00 - Series E Bond - dated
10/6/65
L - $100.00 - Series E Bond - dated
10/6/65
L - $100.00 Series E Bond - dated 11/8/65
2. Series H Bonds -
2 - $500.00 - 8/30/72
2 - $500.00 - 6/4/74
2 - $500.00 - 3/28/73
2 - $500.00 - 10/18/74
2 - $500.00 - 4/23/75
3 - $500.00 - 7/9/75
3. Bank Accounts
National Central Bank
Certificate Of Deposit #6199055109/"
CCNB Bank, N.A.
I Golden Opp. Account No. 008-700508-8/"
Income Certificate No. 36-15534 V--
Checking Account No. 180-2085-9~
Dauphin Deposit Bank & TRust Company
Checking Account No. 78-24-362-9..........
Savings Account #32-1-01139.........
Certificates of Deposit - No. 2142 ~
No. 1106.......--
First Federal Savings & Loan Assoc.
Account No. 1 11426 ........
Account No. 2-17-700711~
Account No. 2-17-001012
Account No. 2-17-506562 v:
Account No. 2-9-100104./
State Capital Savings
Account No. 002-10-00768~
Account No. 002-00-05361 ~
Account No. 002-20-11612 v'
Account No. 002-20-13698 ~
Account No. 002-20-07409 ~
West Shore Savings & Loan Assoc.
Account #3/3A-647 ~Certificate A258 ~
Harris Savings Association
Certificate #1-02-100499 y'.
Optional Passbook #5-60108""""-
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" cohunn on the last page of' thi's return. Sub-Total
UNIT ESTIMATED
VALUE MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
9,528.00'/ ~ rJ.f: 4d
687.20/ (, f7. ~
137.44.....-' 1,].1/1/
137.44~ I'?~'/
Z 400. 0 ()
1,000.00"//,,()~. 04
1,000.00/ 'J(I~I1'06'
1,000.00~ ~ ()OO. od
1,000.00 -;r. () tiC!. ,,()
1,000.00 /f ~O. 00
1,500.00 ~
1,011.13/ tal/.I.)
3,752.5] v'/J;75!1l
2,007.5E/p.;OD,~ ,-
1,828.3E,,-/i-H'. 'tit
P. t,lJ.. 41-'3
10,242.~;..........lte-7'. 72.-
1,876. 7,~. Ol'i'. r"
2,018.8E 'J '.-
2,018.86 ---J..1 6.1/'. f'..
605.8: ......-- ~()fil"f,
1,004. 4 ~ /00'1, '"
5,022.31 .-r,."J.1.) 0
2 , 0 0 8 . 9, /).; ()(),. 92.-
15,061.7'7;; "II. )f"
297.8 /p,97.IJ
377.1 -- )17.1'0
1,005.0 v1~4()S; 4~
4,020.0 ~()~. IJ~
7,030.4(~O](). t,I'/S
__ /5; t140.dO
15,000.0
5,020.8
527.4
-'-S;" ;tJ. /"1"
...-- 5~7. ~~
98,728.57
tE; 7~f7
. RCC -35.
CO~WONWEALTH OF PENNSYLVANIA
T~\NS"TIR INHERITANCE TAX
*~
PAGE 2
RESIn2~r'DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
Item
No.
4 .
5 .
6 .
7 .
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 wi th 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.D.D. U. S. Savin~s 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 f'irst (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 in bank,
stocks, mortgages, notes, together with accrued interest or nividends, salaries or wages, insurance pay-
able to the estate or f'iduciary in sain capacity, partnership interests, interest in any undistributed
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' neath, should be listed in this schedule.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
SUb-Total-Page 1
~'i 72-f. 57
ta I'd. 41 /
,.~ of2-.) j
98,728.57
3.
Bank Accounts - Cont'd
Cumberland Valley Savings & Loan Assoc.
Certificate No. 6682936__
Certificate No. 6685087~
1,010.4
16,082.39
Stocks
182 shares Dauphin Deposit Trust Company
Stock @ 30.50 p/sh.
525 shares CCNB Corporation Stock
@ 12.50 p/sh
52 shares - Pennsylvania Power & Light
Company 4.50% pfd. @ 51.25 p/sh.
20 shares - Pennsylvania Power & Light
Company 4.40% pfd. @ 50.8437 p/sh.
30 shares - Pennsylvania Power & Light
Company 4.60% pfd @ 50.50 p/sh.
10 shares - Pennsylvania Power & Light
Company 9% pfd. @ 93.50 p/sh
1,016.87
;; j)/. od
I." ~'2.,.nJ
t.~ ,~(: tJ d
~ O/t, ?7
.~ f"/), (J d
9JS":(Jd
1,515.0
33 shares
Conunon @
General Motors
58.4687 p/sh.
Corporation
9:l-9, vF
1,929.48
Demand Note - $19,500.00 at 6% interest
dated December 3, 1977
Balance due at date of death, plus
83 days interest @ 6%
,
19,769.751/1~ 16~7)
w' (}()
Blue Shield & Medicare refunds
84.0
State Capital Savings /
Account No. 002 20-13124~- balance
plus interest
t:) i!~I..Oj,
~Ei,037.61
I. IQO."O
'/
----,.,;
\'-1 Cl. 'i 1
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" colurrm on the last page of this return.
161 887.5
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PA.
17127
f'lCC-43 (4-751
NOTE: TO BE SUBMITTED IN TRIPLICATE
REPORTING FINANCIAL INSTITUTION
ADDRESS
DauJ';hiu DePOUit .J!'~t~ & j1ruBt (;0.
4?~ N _ 1'410111 :tn'HI
t:nolu. Pit.
ZIP CODE
17n;"15
Pennsylvania Department of Revenue
Bureau of County Collections
Gable Building, 3rd, Floor
411 S. Second Street
Harrisburgf Pennsylvania 17127
Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act af 1961, we
herewith submit the following report:
ACCOUNT NO. OF JOINT, TRUST OR
INVESTMENT DEPOSIT
32-1-0113-9
NAMES ON ACCOUNT OR
INVESTMENT ,lorn.U) F.;hue,.
DATE OF DEATH Febrlliu'y ;><;, 1Q?8
DECEASED JOINT DEPOSITOR, TRUSTEE
OR iNVESTOR
NOMn!Ul F. .,huey
ADDRESS 630 N. Front -,t.
''')r:~lft-Yllburrt r~<.
COUNTY Cunb..rl-,n'J
ZIP CODE 17043
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR
nonA
ADDRESS
RELATIONSHIP TO DECEDENT
DATE INVESTMENT WAS ESTABLISHED
WITH THE SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR Novemb..r 29. 1973
BALANCE, INCLUDING INTEREST
PAYABLE, AT DATE OF DEATH $ 1.860.'19
AMOUNT OF PENALTY, IF ANY, FOR
RETIREMENT OF SAVINGS CERTIFICATE
OR CERTIFICATE OF DEPOSIT ON DATE
OF DEA THj
~
'kjl
SIGNAT~~
i.ssit;tsnt ~:'"'el1aUI'er
\.
TI TLE
RpC - 36
COMMONWEALTH OF PE'iNSYLVANIA
TRANSFER I:\HEl\lTANCE TAX
SCHEDVLE 'I e"
TH\"Sr'FllS
*~
l\ESIDEH DECmE'iT
(1) Did decedent, within two years of'deuth, make any transf'er of' any material part of his estate, without
receiving a valuable and adequa,te consideration theref'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) No
(3) If the answer to (1) or (2) above is in the af'f'irmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the transf'er. (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 effect in possession or enjoyment at or after his death?
(Answer yes or 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) Nn
(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 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 hi s 1 i fe Lime make a transt'er, the consideration for which was transferee's promise to
pay income to or f'ur the benef'it of care of transferor? (Answer ,yes or no) Nn
(8) Did decedent, nl any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserved power to al ter, Itmend, or revoke, or which could revert to decedent rmder terms
of transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the benef'iciary reserver! in the decedent alone or the decedent and others?
(Answer yes () r no) No
NOTE 1: The answers to these questions should be supporterl by af'fidavit by the attending physician as
well as a copy of the death cprtificate.
NOTE 2: If answer to any ot' the above questions is yes, set f'orth below a description of' the property
transf'erred, it's f'air market value at date of death, dates of transfers and 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-taxhble, also submit detailed sf,atement of facts on which said claim is based.
NOTE 3: List applicable property below in manner in which provider! in Schedules A, H, or E.
ITEM
DESCHIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
NONE
Insert this total opposite "Transfprs", Schedule "C" in the
"As Reported" colurrm on the Iltst 11'1)..'.;(' of this return.
RCC_ 37 (~2-6 3)
COMMON\\'F.ALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDE1I;T
SCHEDULE "0"
BEJ\EFICIARIES
BENEFICIARIES AND ADDRESSF.S RELA TIONSlllP 1
(If step-children or I Sl[RVIV,ED DATE INTEREST OF
State tull names and addresses of all who illegitimate children I DECEDENT OF BENEFICIAI{Y
aye an interest, vested, contingent or other- are involved set I STATE YES BIRTH IN ESTATE
wise, in estate) forth thIS f~ct.) 01{ NO
Esther M. Keister Sister Yes Adult One-third residue
632 N. Fron t St.
I -.-.
Wormleysburg, Pa. 17043
I
---
Sara M. McGann Sister Yes Adult One-third Residue
4615 South Road
-
Colonial Park. Pa. 17109
Kathryn S. Stewart I Sister Yes Adult One-third residue
"------.
700 N. Front Street I
-----
\
h
Wormleysburg, Pa. 17043
I
j
, I -
i
--.--- -- i I u ---
I I i
,
I --
I I !
,
- -
I
1
! .--.....----..
I
I
--.--_.
!
j --.-.---
1 , -~...-
i
T -----.._-- ----
.------
.--------..
.---
.-----.-,
n
u ,
iJeponent f'urther says thnt all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
._--
u_
-
Gross Taxable Estate
$
$
$
$
$
$161,887,58
(1 )
(As Reported)
-0-
),6)',887,58
-0-
(2)
(As Determined)
~ ,..,
.8 ~
~<,.,
u;: ;::
:5 ~ ~
E~o
'0 Co u
<( s.
s:.8;,
o ~
!it;;t:
u :l 0
~ E go
~ ,,;
Real Property
Personal Property
Transfers
SUMMARY
(Sch. "A")
...(Sch. "B")
... (Sch. "C")
$
$
$
$
$
$
~
0
'"
tJ' ~ C'1
[- ;., ..c ""
z '0 ::l 0 0
~ ..Cl C:l
~ tiI ~ ....
oS - ~ III .. .....
OJ OJ
;... ..-. u ~ -< "'
tiI ~ (j) '"
<fJ Cl - III
- El -< ;., 'M
<f' '0 oS CIl: (j) ~
~ ~ >< ;., ~ 'S '" ~ III
"" 0 [ii 0 III " '" 0 :>
"" p :s: ..... .:: -< ..... .....
'" -< '"
:I: :I: tiI P:l ;., ~, r... ~
~
... tiI ... [- oo <!-l (j) c Q If) '"
ci ~ :I: ,. -< 0 ~ c ~ _N ~
0 [- OJ "'..... ~
Z [- ""
<fJ r... ..c ::l ;., (j)
~ tiI tJ' U - I- (j) ~""
~ 0
0 ~ ::l ..c ~ ~o
c ~ 0 .=: 0 ::E:al -
0 ;., " '" (j)
~ tiI p:; 0 OJ .... ~
" 1: 6 al '0 ~ ~ "'0 ~
.I:l :z: c ;., ~
~ ::; - 0
'S 0 l:' E (j) .
'6 .... OJ :: E ~p.. (j)
~ 0 ::E: H
;?"'lj - 0
:::;~ .::l u u
RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
-
COMMONWEAL TII OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This seherlule must disclose all property, real ann personal, owned by the decedent jointly
with another or others, including intangibles, standing in the name of the decedent and others. List
real f'statf':' first. us entireties, or joint tenants, giving brief' description, as indicated mlrier Schedule
"A", plus the date Ilnrt place of record of' instrrunent 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
Sched.ule "B", plus date of' Iicquisi Uon, and the name, address anrl relationship (if any) of' CO-owners to
the decc(lent.
N I
Description of' Property, Date of' Acquisition, ame
Address and Relationship of' Co-Owners, and Place
of' Recorrt of' Instrument, where Real Estate.
Unit
Value
percentage
Share
Estate
Val ua t ion
QEPART!IENT VALUATION
CAUTION-Do not Write
In This Space.
Value of'
Entire
Property
Value of'
Deceden t' s
Interest
NONE
..--
Insert this to tal oppos i te ",Join tl y Owned Property", Schedule "E"
in the "As Heport,ed" column on the lust page of' this return.
NONE
*'
RCC-Sl (6-73)
COMMONWEAL TH 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
Esther M. Keister
632 N. Front St.
~lvJ..lult;:a;ol".a5' Ft:LULa..
(Executor or A ministrator)
In Re: Estate of
Norman F. Shuev
Cumberland
County - Fi Ie No.
21-78-0119
Dear
You are hereby notified that the Original
oppraisement in the estote of Norman F. Shuey
has been filed in the office of the ReJjister of Wills of Cumberland
County on 29 November ,19~, Said appraisement reflects the following
va I uotions:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
161,849.97
None
None
161,849.97
As to such tax that is paid within three months from date of death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death occurred from December 22,1965 to June 16, 1971, inclusive;
and twelve months when death occurred prior to December 22, 1965) from 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 obiect 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.
29 November 78 \::J I( (l, il '
Date Signed ~ t1 _ L'-t._L~
Title
Chief ^ppraisBr
(
-------
Note:
This is not a bill.
RCC-Z (2-64)
.DEPARTMENT DF REVENUE
BUREAU of COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
\ \ t \..0-( \:?
(' Ii,,' <1
.A..A-v-v~x.....
COUNTY
FILE NO.
2. I -( S . (\ II Ci
Whereas, N c-~'" C c::.., ~ late of W(~Qo~01J..~
in the County of ~l.o,L~,,_ Commonwealth of Pennsylvania, having died on
the -)- <, V- day of ~- ~~ 19_, seized and possessed of an estate
subject to Inheritance ax under thelaws of the 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 de-cedent after
the expiration of any estate for l1fe 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
Delcrlpllon 0' Asset Value. Made for Inheritance
TaltPurpOllli
\., ' \:/L . .-t-. '\ $ N6~
--......~--JL
I----
P c /'v'O---if~,-<.JL 'V/\...-(i -', h \ Co I, '6'-\.''\. ~I
." ~ N 0'---'
\ /\.~/.)j~
.') --+-0 \0-L t-'/L..c -;1-:.. (\) ,-0L
V -
.\ G~J!.. (~ \ I" I '61.\q (\1
Having been duly swo.rn accqrtng to law, I do hereby certify that the above appraisement is made in con-
formity with law on this \ day of \"-J ~.Lk, ~;';~.' 19,8.
Apprailler
\ \ (N\Jln~ and $Cl'nt)
-'1'(J..-/\...."-" '~
(PortOftlC!eI~ '
, Penna.
.,; 00\
r-c: ~
" ....
z., ~ ~ ~, ~
" In :z:
8 '-' .... ~
" '"
c Q '" ~
\.;. '" I
:;a C ....
.... 00 .... Ii Ii
III '" "
.. ~ .... ...... " !:
.. Oll \ ci Q ..,; Ii: " "i
< lI"1 " " ..,
Cl'- ~ '" <:; Eo- " .:2 .~ l:'
i< '" - I ,," \: "
-. < 0- " i '" c '-' ... :z: "'- ~ ... J
..... "' C> ;,. \E, ~ "- ... '-'
11 " 1&0 " ~ a 'i ~ ~ ~
'" <; <; - 1
III '" i ~ ". .., "l ~ "" !:
1:; -'<
^'" r< Z '-' "I; " "
tl < "-l " ~ " " ..
t'-- "' ~ Q -::; 11 "" - ""
"
~ ~ 0 'S, ~ " ~ ...
\ III Ii!' <; 0- 11 ~ "
'" " .~ " Ii
-- ::: " ~ 0:: Q .il C "-
Q "'- "-l
Z ;; ~ ...
~ " " :s ~
~ .~ " '-'
- .., 2 " "-l
"' " '0 ,," ] 0::
Z s.. "
'" " <>> <.t: ~
"- "
'" " Q,
~ Q ~
'"
'"
III