HomeMy WebLinkAbout09-25-78
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ficc-33 (4-73)
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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RESIDENT DECEDENT
COUNTY OF
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IMPDRT 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'ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Late of
Cumberland
} AFFIDAVIT OF
EXECUTOR
ADMINISTRATOR
County
Mary Ann Shenk
(STATE FULL NAME OF DECEDENTI
State af Pennsylvania
Caunty af Ctnnberland
Jacob S.
) '"
~
of the tiS tote of the above-named decedent being duly sworn, depose
Shenk and Catherine E. Vogelsong
Executor 5
and say
Decedent died
February
8
19~Jtestote leaving CI last will, copy of which is hereto attached. }
(YEAR) ~
(MONTH)
Nome and address of attorney or }
other outhorized representative to whom
all corres'f)ondence should be mailed.
(DAY)
Robert R. Black
36 South Hanover Street, Carlisle, PA
17013
That as such deponent is familiar with the affairs of said estate and the property constituting
(EX ECUTO R-ADM1NIST RA TO R)
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 SAFE 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
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 secur;tics O\vned 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 f'amily corporations, the values reported are as far as
possible substantiated. uy financial statements of' the corporations, showing the assets and liahilities
thereof ~IS of' the date of death. The sehedule also sets forth the interest of decedent at the time of'
death in liny co-partnership or business, and in support of the value of such interest t~erf'~ is annexed to
said schedule, financial statements showing the assets and liabilities of said co-partnership or "!lusiness.
A copy of the co-part.nership 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 such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of ttJe flecedent's interest
therein must he sllhmitted. It should also set forth in itemized form, together with the fair market value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The Schedu/p 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 tJOlke eff'ect in possession or enjoyment at or
after death, said schedule sets f'orth the nature and value of such propert~,., to whom trAnsferred, the
relationship of' the transf'erees to the decedent, the proportlonate share received by each transferee 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 schedule a copy
of the d.eed, trust agreement or other instrument creating the trust. Therl~ is also set forth in said
schedule a list of all property, real and personal, with its value, which passes at decedent's death by
virtue of' the exercise by decedent, either individually, or jointly with another, or any power ot~ appoint-
m~nt vested ill decedent, either 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.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons benef'icidly 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 ht t.he time of
decedent's death of all minors, annuitants anct beneficiaries 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 decedent, the dates of lheir 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, standing in the name
of' the decedent and others, plus the date and place of' record of instrmnents 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/1edule F attached hereto and made a part hereof sets forth fully and in detail aU debts
and deductions claimed f'or and on behalf' of this decedent's estate, including f'uneral expenses paid;
family exemption, where applicablej costs of' administration of this estate; counsel f'ees and f\ldiciaryl s
conunissions 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 unpairl at time of
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Sectton
651 of' the Inheritance anrl Estate Tax Act); together with a statement of collateral pledged -ror obliga-
tions, if' any. It is agreed that the fiduciary will present proof' of' said claimed oblit~ations upon re-
quest, that if the amonnt actually paid in settlement of any fee, commission or debt is less than the
estirnaterl amount cl aiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassesseci in accordance therewith.
That
have
the totals of' the appropriate columns in Scherlules "A", "B", "e",
been carried f'orward and properly registered in the Summary. ,
"E", and "F" as directed therein,
.<2tf!~....
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...':62'c:'"do,,~~/':'-
.. day of
.....19..}~.
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...c:a.:t:l1Err4.1.~I.J,.:v.:9.g~!?9ng.. ............._...........
(Street Numbl!T)
Subscribed and :Jworn to before me this
BRENDA l. BREHM, Notary Public
Carlisle, Cumberland Co., PJ.
My Commission ExpiresJuly 17, 1982
(City M Town and St4te)
NOTE: Bef'ore signing afTidavit make sure all blank spaces in the af'f'idavtt 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 stR.tements requi reel 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_73)
COMMONWEALTH OF PENNSYLVANIA
liEPARTMENT 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 cammon with another or other, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as joint tenants with right of surviarship or tenancy by entireties should be reported an 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 .tat. number of a- FaR YEAR 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 mortgage., etc.,ar. DEATH In this apace)
to be listed on Schedule uF" and must not h. deducted from this schedule.
ND()L
None
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
~
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RCC -35
....
RESID~NT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
.
COMMONWEALTH OF PENNSYLVANIA
TRANSr~;R 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 "E". 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 certif'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 anyundistributed
estate or 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
UNIT
VALUE
ESTIMATED
MARKEr VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1
Checking ACCOilllt -
No. 182-822584-5.
2,228.17 y'"
-'lId-d.';? 17
2
Commonwealth National Bank -
Copy of letter attached.
Savings Accoilllt - First Bank and Trust Company of
Mechanic5burg - No. 507-280-6. Copy of letter
attached.
1,038.23 V---
I O.3i.~ 3
j
3
Balance of Jacob Shenk & Pauline Anderson accoilllt
from the sale of personal property
1,421.27 ",,,...-- 1/.j~\.~1
4
M:>rtgage of David 1. Shenk & Carol Ann Shenk to
Mary Ann Shenk dated September 3, 1975, recorded
in Cumberland COilllty M:>rtgage Book 594, Page 290.
Principal Balance as of February 8, 1978
Medicare Refund
v 14 flid.50
14,982.50 v I '
32.00 VV .3~.OO
5
Insert this total opposite "Personal Property", Schedule "B" 1n
the "As Reported" column on the last page of' this return.
x X
19,702.17
'1~,10~.17
----
Commonwealth J\..
National Bank ~
CAR LISLE. DEPOSIT OFFICE
.Tune 21, 1978
Robert fl. Hlack
Landis r. Hlack
36 South Hanover Street
Carlisle, Pennsylvania 17013
flear ~fr. Hlack:
The balance in 'Iary Ann Shenk I s Checkin~ Account as of 2/8/78 was
S2,228.17. ...-----
us.
If any additional information is needed, please feel free to contact
\' er v t rU,l v vou,r'ils,
^! . . r /?
. '; /u JJfJLl)-z .
,t7w. 'Tcllride,.Tr.'
:\ssistant Branch Manager
The Commonwealth National Bank, One North Hanover Street, Carlisle, Pa. 17013 (717) 249-2414
,
TIIEGj'bYl
'-"!j BANK AND TRUST CO.
MECIIANTCSRURG. PENNSYlVANIA 17055
ESTA,BU!';HED '85~
DAVID B. COOVER
P~ESIOENT
June 27, 1978
Robert R. Black, Esquire
Landis & Black
36 Sou~~ Hanover Street
Carlisle, PA 17013
Re: Estate of Mary Ann Shenk
Date of Death - February 8, 1978
Dear Mr. Black:
We have searched our 'cords and found t'. following
information concerning the above named decedent:
1 . Checking account - None _
2. Savings account #507-280-6,~ the name of Mary
Ann Shenk, opened September 3, 1975.
Date of death balance $1,034.35,...-'
Accrued interest due 3.88 .~'
3. Other savings passbook accounts None
4. Safe deposit box None
5. Capital stock None
6. Time Certificate None
Very tr~ly yours,
/t/;;(i ")/(':"L' l i"
Da'~1 B. toover
President
DBC:c
..............
RCC-36
COMMOll'WEALTH OF PElI'NSYLVANIA
TRANSFER IlI'HERITANCE TAX
SCHEDULE "c"
TRANSFEIlS
.
RESIDENT DECEDElI'T
(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 decedent, within two years of death, transf'er property f'rom himself to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) No
(3) If' the answer to (1) or (2) above is in the arfir~~ttve state:
(a) Age of' decedent at time of' transf'er N/}\
(b) State of decedent's health at time of making the transfer. (Note 1).
(e) Cause of decedent's death. (Note 1).
(4) Did decedent, 1n 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)~_
(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? N/A
(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 berore his death:
(a) The possession or enjoyment of or the right to income from the 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 N/ A
(7) Did decedent in his lif'etime make a transfer, the consideration for which was trans:feree's promise to
pay income to or for the benefit of' care of' transf'eror? (Answer yes or no) No
(8) Did decedent, at any time, transf'er property, the bene:ficial enjoyment of which was subject to change,
because of' a reservert power to al ter, amend, or revoke, or which could revert to decedent under terms
of transf'er or by operation of' law? (Answer yes or no) No
(9) If the answer to (8) above is in the aff'irmative, was the power to alter, amend, or revoke the inter-
est or the benef'iciary 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 cel4;if'icate.
NOTE 2: If answer to any of the above questions 1s yes, set f'orth below a description of the property
transferred, it's fair market value at date of' death, dates of' transf'ers and to whom transferred, with
relationship of' transferees to decedent, if any. Submit copy of' any trust deed or instrument, i:f 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
(Estimated)
DEPT. VALUATION
(Dept. Only)
None
N If'i\L
Insert this total opposite "TranSfers", Schedule "e" in the
"As Reported" colunm on the last page of this return.
t-.l6'1\.-L-
.
RCC- 37 (12-63)
CQ..\lMO:-';WEALTII OF I'E;\;:\SYYL\l\;IA
TRANSFER INHEHlTA:\CE TAX
RESIDENT DECEDENT
SCHEDULE "D"
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''';>''4;;J,..w'.,d,,;'j[
BEI\:EFIClAH1ES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED I
(If step-children or DATF: INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other~ are involved, set STATE YES' IN ESTAn:
wise, in estate) forth this fact.) OR NO lJIRTH
ROY Nelson
P.O. Box 56
Pilot Rock, OR 97868 Son Yes Residue - 1/7 Share
Mary A. Vogelsong
113 Green Street
Mechanicsburg, PA 17055 Daughter Yes Residue - 1/7 Share
Jacob S. Shenk
R.D. #1, Box 520
Mechanicsburg, PA 17055 Son Yes Residue - 1/7 Share
Catherine E. Vogelsong
R.D. #4, Linda Drive
Mechanicsburg, PA 17055 Daughter Yes Residue - 1/7 Share
Charles F. Shenk
511 Terrace Drive
New Cumberland, PA 17070 Son Yes Residue - 1/7 Share
Pauline Anderson
769 Forge Road
Carlisle, PA 17013 Daughter Yes Residue - 1/7 Share
Francis L. Shenk
R.D. #4 Sunset Drive
Mechanicsburg, PA 17055 Son Yes Residue - 1/7 Share
-.
\
h
Deponent further says that all the above-named henef'iciaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
None
.
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SUM~IAHY
(Sch. "A")
(Sch. "B")
( Sch. "C" )
Heal Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As HeporlPtl)
$
$ 19.702.17
$
$
$
$ 19,702.17
(2)
(As f){.t('rmiIH'dl
$
$
$
$
$
$
OJ)
13
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RCC-38
,"
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
'*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
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 under Schedule
"A", plus the date and place of record of instrument effecting vestlture, 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 anrl relationship (if any) of' co-owners to
the decedent.
Name I . ,
Description of' Property, Date of Acquisition, Unit pe rcen tage Esta.te
Address and Relationship of CO-Owners, and PI ace Value Sh are Valuation
o~ Record of Instrument, where Real Es ta te.
~ '^" 0- '^" S? )0 )0 >60
V<) ex ~ X ex
( V<) ::x ~ ~ C>< 0< XX !XC>< 00
Q<
DEPARTAIENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
~ntlre Decedent's
Property Interest
None
N6'/U..,.
Insert this to tal opposl te "Join tly Owned Property", Schedule "E"
in the" As Reported" column on the last page of this return.
N6YU...-
RCC-Sl (6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPL Y PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Jacob S. Shenk & Catherine E. Vogelsong
(Executor or Administrator)
In Re: Estate af Mary Ann Shenk
Cumberland
Caunty - Fi Ie Na. 21-78-0124
Dear Mr. Shenk & Mrs. Vogelsong:
Yau are hereby natified that the original
appraisement in the estate af Mary Ann Shenk
has been filed in the affice of the Register of Wills of Cumberland
County on September 25 , 19 78 , Said appraisement reflects the following
valuations:
Real Estate
Personal Property $19.702.17
Transfers
Jointly Owned
Total $19.702.17
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.
Date
September 25. 1978
Signed
, ,
ii,
I /
, I,
Title
~,~-
Chief Appraiser
(.._--
Note: This is not a bi II.
R C C-2 (2-64)
. DEPARTMENT OF REVENUE
BL1REAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE September 25. 1978
COUNTY Cumberland
FILE NO. 21-78-0124
Whereas, Mary Ann Shenk late of Mechanicsburg
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 8th day of February 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 transferred in possession or enjoyment to collateral heirs of the de.cedent 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 Apprailement
Oucrlptlon of Asset ValueI Made for Inheritance
Tax Purpolel
REAL ESTATE OONE $ -0-
~
PERSONAL PROIERTY $19,702.17 19 702 17
TRANSFERS OONE -0-
JOINT-HELD PROPERTY OONE -0-
TOTAL ESTATE $19,702.17 $19,702 17
.
Having been duly sworn according to law, I do hereby certify that the above
formity with law on this 25th day of September
appraisement is made in con-
19~.
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Appl1Iiaer
(l'fumber and S~"et)
HarriSburg
(.Po.t 0ftI~)
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