HomeMy WebLinkAbout05-19-78
RCr;:-33"14-73)
,,~
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
'*
RESIDENT DECEDENT
M~y 1 Q rl![ti
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 HIE MATTER OF THE ESTATE OF
Agnes G. Lampe
-"-'-'~~'-
,..J
EXECUTOR
AFFIDAVIT OF
(',lATE F'JLL NAME OF DECEDENT)
Late of____CumQerlancl_"_
Statp. of ___~~nnsy-.!van~a
ADMINISTRATOR
} s",
Trustee
County of _Guillb~~~
~JiilliJl.PLk_._Sanford. Trust Officer Dauphin Deposit Bk & Tr Co "F.xecntm
C'3Hif1fcR of the estote of the above.named decedent being duly sworn, depose and say
Decedent dll~d __~_~_bruary 23,
IMCiNTH)
(DAY)
, 19~{~estate leaving a lost will, copy af which is hereto attached. }
(YEAR) Intestate
Nome 0'1.1 address of attorney or ~ .t.!yers J Myers,
other autho'ized representCl1,ve '0 wh'_'m >
011 correS-jJondence she_ ,I,' J Lemoyne, Penna.
Flower & Johnson
17043
That as such -- _Tx_us..t.pp deponent is familiar with the affairs of said estate and the property constituting
FeX E.:U TO R-A OM1N IS T RA TOR)
the asset:> thcrcoi dud their fair market value.
That at the time uf death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy' or another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
N AM E AN
IN WHIC
--
D ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELAT10NSHIP OFJOINT
~H DE:CEDENT RENTED A SAFE DEPOSI T BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
-
Non~_
--"'-~-------
"----~._._--
,
That the coments of said safe deposit box or boxes are itemized under Schedules Noncof this return,
with the exceptinl1'of the following, for the reasons hereinafter set forth:
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
In the Common,vealth 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 or date or death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
whcre:-;over 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 stale, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
,ill "....<l';IIe, d~'pU'\';;" jl.:',\dlY, ~ilvt:rware, 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 faCt: 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 cslak from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of \\'hich """ 'ayable upon the death of the decedent; all and the corporate stocks and dividends
due thereon aud unra!d {Ie; ,>!' /' date of death, bonds and accrued interest thereon to the date of decedent's
death and olher i;l',.',<';lmvit ".;,-, owned by the decedent at the time of death, with the ,market value there-
or at such lime.
--
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
said schedule, financial statements showing the assets and liabilities of said co-partnership or b,usiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of toe agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of' the decedent's interest
therein must be submitted. It should also set forth in itemized form, together wi th 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 Ii 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 take ef'fect in possession or enjoyment at or
after d~ath, said schedule sets forth the nature and value of such property, to whom transf'erred, the
relationship of the transferees to the _decedent, the proportionate snare received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of' transfers int~rid~d -to--
take effect in possession or enjoyment at or after death, tpere is also att~chedto the schedule a cony
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set f'orth 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 attach.ed to the 'schedule.
That Schedule 0 attached hereto and made part hereof' sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedene 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 lire under 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, and the relationship of such issue to the beneficiary.
That Sc~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 instruments effecting the vestiture 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 for and on behalf of this decedent's estate, including fUneral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel f'ees and f'udiciary'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 anti unpaid at time of
death; taxes accrued chargeable for period prior to decedent's tieath (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of' collateral pledgeti 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 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", "en, "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
..,/,l.;/,L...
Dauphin Deposit Bank & Trust Co.
l/j4~dtrt'.TrUS't'e'e"-."
301 Market St.
.. .......n............................. ............................................~..............
(Street Numbl!T)
Lemoyne, Pa. 17043
..................,..,...........
(City or Town and State)
NOTE: Before signing aff'idavit 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 unlisted securities,
securities of' close or f'amily 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 "Summary" has been properly completed as above-directed.
Subscribed and sworn to before me this
.?h......... d of........
......c~
. .,.. '
.19Z~
RC C-3~ (4-;3) .
COMMONWEAL 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 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 lacoted In the Cammonwealth of Penn-.ylvanla .hould be (1) (2) (3)
described by lot and block number, .tr.et and .tr.et numb.r, tog.ther with DEPARTMENT
a general de.crlptlon of the property, with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title; If Q farm .tate number of a~ FOR YEAR OF ESTIMA TED CAUTION
ere.; 01.0 statement of mortgage encumbrance. upon each parcel at death DECEDENT'S MARKET VALUE (Do not writ.
of decedent. Taxe., a..e..ment., accrued 'ntere.t on mortgage., etc.,are OEA TN In thl. space)
to be lI.ted on Schedule IfF" and mu.t not be deducted from thl. schedule.
/f7rnc
None
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.
/)Znu)
. RCC -35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
*
RESIDENT DECEDENT
SCHEDULE liB!!
PERSONAL PROPERTY
Item
No.
1
2
3
4
5
6
7
8,
9
10
11
12
13
14
15
16
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 li8ted under Schedule fiE". Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e. g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and 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
List and describe fully
UNIT
VALUE
ESTIMATED
MARKEr VALUE
DEPARTMENT VALUATION
(no not write in
this space)
$4,000.00 US 7 3/8% Treas Notes due
2-15-81 9
$1.000.00 US 8% Treas Note due 5-15-82 10
$2.000.00 US 8% Treas Notes due 2-15-83 1
321 shrs American Motors
92 shrs AT&T
28 shrs Delmarva Power & Light
104 shrs Philadelphia Electric
2 shrs S Jersey Industries
6 shrs Studebaker Worthington
45 shrs UGI
150 shrs F. W. Woolworth
2144 Units Fixed Income Collective
Investment Fund
Mortgage Investments Participations
Cash in Trust Fund
Income accrued to 12-23-78
Allor the above items in Trust dated
November 26. 1973 with decedent as
Grantor & Beneficiary
Dauphin Deposit Bank & Trust Co. check-
ing Account 54 14 6240
/
~').. Pb
0.625 $ 3.962.5(~. ,3 '14>.).-50
.5937 1,005.9. ~_~ OC.$. 9'1
0.468 5 2.009.38.....- 02 li{J'/3d
4 3/4 1.524.7~/ ';;",.;;'/7-:;.
! 59 5,428. 0("""'" o. -'(;;(J'. &0
3.9321 390.10.......- IS'f()./{J
8 5/8~ 1.937.0("'-/ / '13;l.{IO
8.062 36.1"'- I 0'("./3
8. ~.~_5 l)oP:.,E'!288. 7 ~ __ .2/,3'. .~-;-
93L4:!1.338.t= / L&/r.d6
7.6871s ~-;653.1' ~~ (~,-53/3
.574 I 20.526.7, "'-~D/5.;I(;,. 73
12.587. 3' ~/;;( 5J.7.37
1.431.7(0-- ~J-I-311(J
598.lC". i!5'9f. /{J
--
3(/::;. () /
369.0
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of' this return.
x X
e!.087""".3..
J" 5.6; 76~'5-: '17
- RCC-:>6
COMMO,WEALTI! OF PENNSYLVANIA
TRANSFER DIHERITAWE TAX
SCHEDULE Tlel!
TfU,Sl'}:ns
*".
. Hi". 1\
i!(). '.,
RESIDE,T DECEDENT
(1) Did decedent, withIn two years of'death, make any transf'er of any material part of his estate, without
receiving a valuable and adequate consideration theref'or? (Answer yes or no) no
(2) Did decerlent, wi thin two years of death, trunsf'er propert.y f'rom himself to himself and another or
others (inCluding a spouse) in joint ownership? (Answer yes or no) nn
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer
(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 lif'etime, make nnJ' transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or arter his death?
(Answer yes or no)--1!Q______
(a) Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or no)
(b) What was the transferee's age at time of decedent's death?
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor 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 transf'erred?
(Answer yes or no) no
(b) The right to rlesignate the persons who shall possess or enjoy the property transferred or
income theref'rom? (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] tretime make a transfer, the consideration for which was transferee's promise to
pay income to or for the benefit of care of transferor? (Answer yes or no) no
(8) Did decedent, nt an;\,' time, transfer property, the beneficial enjoyment of which was subject to change,
because of Ii resel'verl. power to al tel', amend, or revoke, or which conld revert to clecedent under terms
of' transfer or by operatton of' law? (Answer yes or no) no
(9) If the answer to (8) above is in the affirmative, was the power to al tel', amend, or revoke the inter-
est of the beneficiary reserverl in the rtecerl.ent alone or the decedent and others?
(Answer yes or no) no
NOTE 1: The answers to these questions should be supportert 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
transf'erred, it's fair market value at elate 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, lf trans-
f'ers are claimed to be non-taxable, also submit detailed statement of facts on which said claim 1s based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
llESCI\IPT ION
MARKET VALUE
(Es tima ted)
DEPT. VAWATION
(Dept. Only)
tlnn1-'-
None
1/) L./}1-C
Insert this total opposite "Trnnsfers", Schedule "e" in the
"As Reported" colunm on the Inst p:tge of this return.
RCC-37 (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
IJ~_ _ ~t 1\
~
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
s ta te full names and addresses oLaU who illegitimate children DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other are involved, set STATE YES IN ESTATE
wise, in estate) . forth this fact.) OR NO BIRTH
a2e c
William L. Lampe Grandson yes of 50eific Benue"t &
225 Jame~ Court 1/5 Residue
Ai.arlton, New Jersey 08053
Randall L. Lampe r;r~""^n vco ^~ o~c 50ecific Beauest &
1224 West Chester Pike 1/5 Residue
West Chester, Pa 19380
Barbara L Lamoe , . '-~ n~ -- ... .~, _ D ,.
235 N 10th St 'b' I 1/5 Residue ~
Reading, Pa 19601
Richard F Lampe
RD#l Box 447A
M~" a Do 18062 r;~o .A___ VA. n; -__ 1 /, R . _ , A.._,
Julie L Lampe r; ~A" + 5-5-63 5-5-63 1/5 Residue
312 Sumner Ave Grandaughter yes
New Castle, Pa 16103
-
,
h
Deponent fUrther says that all the above-named bene~iciarles are living at this time except below:
NAME DATE OF DEATH RESIDENCE
None
~ --,
SUl.....
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"2 Q) e
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s.......2:l
~ ~ ~
" ~ 0
~ E e
f':! '"
SUMMARY
.(Sch, "A")
... (Sch, "B")
(Sch, "C")
Real Property
Personal Property
Transfers
Cross Taxahle Estate
(2)
(As Determined)
(l)
(As Reported)
$ -Q.-
$ .5.6.,OIl7.34
$ -0-
$ ",0-
$
$56,087.34
$
$
$
$
$.
$
l- '0
Z "
~ lol ~
- ~ ..l
" "" "
:>< " <
lol "
0 <IJ
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<:<:: ~ '2
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0 " =-
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:I: :I: lol ""
.. lol .. E-< ~ Q
l': :r: "' < ;: ~
0 0 E-< 03
Z E-< <fJ ~
~ lol ~ ...
~ 0
0 "
" <:<:: - 0
,52 lol =-
- " ...
'" f-< ~ ~ "
./:: f-< 0 ~
~ ::; ~
'2 0 i:' ~
'2 /, "' 52
-:::"0 " 5 0
~~ ...l U U
RCC-38.
COMMONWEALTH Of PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
INSTRUCTIONS: This schedule must rllsclose all property, real aWl personal, owned by the decedent jointly
with another ur ot.hers, including intangibles, stfinding in the name of the decedent and others. List
real estate first, as entireties, or joint tenants, giving brief description, as indicated Hnrter Schedule
"A", plus the date and place of record of instrument effecting vestitllre, but do not include entireties
or out of state real estate value in estate vd]uution column. Personal property should be listed as in
Schedule "Bit, 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 illld Relationship of Co-Owners, fmd Place
of Record of lnstrmnent, where Real Estate.
~xx:x :x:> ~~~~5( y :;<~X
x:x: 'X Y> :x:> <::0 'X y:X:> 0 *
None
. .
Unit
Value
Y
:X:>y
:x >0
percentage
Share
VV' >V<.
XX36~:x:>
Insert this total opposite ",Jointly Owned Property", Schedule "E"
in the "As ReJorted" colUlTln OIl the lust puge of' this return.
Estate
Valuation
36
>f;x(<
V
DEPARTMENT
CAUTION-Do
In This
Value of
Entire
property
/)IZnu-,
VALUATION
not Write
Space.
Value of
Decedent's
Interest
/)~-m
RCC-81 (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
William S. Sanford, Trust Officer
Dauphin Deposit Bank & Trust Company
301 Market Street, Lemoyne, ~A 17043
(Executor or Adm ini strator)
In Re: Estate of
Agnes G. Lampe
Cumberland
County - Fi Ie No.
21-78-0122
Dear Mr. Sanford:
You ore hereby notified that the Original
oppraisement in the estate of Agnes G. Lampe
has been filed in the office of the Register of Wills of Cumberland
County on July 20 , 19.1lL, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
55.755.47
Nortf~
None:
~755.47
As to such tax that is paid 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 Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Dote July 20, 1978 Signed ~~d ----L(._~
Title___~hief Appra~s~____
--~~-"-
Q, --------...-..-
Note: This is not 0 bill.
RC C-2 (2-64)
DEO'PARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
July 20, 1978
COUNTY
Cumberland
FILE NO.
21-78-0122
Whereas, Agnes G. Lampe late of Borough of Lemoyne
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 23rd day of February 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, T, 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 transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for Years, the CommonwealUl hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Deterltltlon of Auet
Unit
Values
Aptlraisement
Made for Inheritance
Tal{ PUrposes
Real Propwrty
$
None
Personal Iro ert
Joint-Held Iro ert
55 755 4
Transf ers
None
None
TOTAL ASSETS
$55,75547
Having been duly sworn according to law, I do hereby certify that the above appraisement is made in con-
formity with Jaw on this 20th day of ~ ~ ~. 19~.
r- A.... .a /(. ';l __
Apprailt'r
(NUmber and Strteu
Harrisburg., Penna.
(POl!f; OftIee)
~I
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~ Q -.::
<n
'"
~