HomeMy WebLinkAbout09-13-78
RCC-33 (4~73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
.
RESIDENT DECEDENT
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..a:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
==:TOR
JOSEPH M. MORRISON
IN THE MATTER OF THE ESTATE OF
CHLOE E. ANDREWS
(STATE FULL NAME OF DECEDENT)
County
County of
Cumberland
} so,
State of
Administra tor
JOSEPH M. MORRISON
f/#fcI
of the estate of the above-named decedent being duly sworn, depose
and flay
February 4,
(MONTH)
Name and address of attorney or }
other authorized representative fa whom
all correspondence should be moiled.
(DAY)
, 19~{~e,~~erVing a last will, copy of which is heret~~a_ched.,}
(y EARl '1tfift"/t _
Decedent died
DONALD B. OWEN, Esquire
105 Mt. View Drive, Enola, PA 17025 (717-732-3552)
JOSEPH M. MORRISON " f "I" " h h ff" f"d d h " "
That as such ''i/11r~j' ~deponent IS ami lar Wit tea aus 0 sal estate an t e property constltutmg
({'I IADMINISTRATOR)
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 REL.ATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A S.-\FE DEPOSIT BOX IN NAME OR NAMES OF HOL.DERS TO DECEDENT
FARMERS NATIONAL BANK. Newville PA Chl n'" E Annr"''''~ H/A
That the contents of said safe deposit box or boxes are itemized under Schedules B of this return,
with the exception' 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 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 unpa-id as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment secur:ti,,'s owned by the decedent at the time of death, with the.market value there-
of at such time.
In the case o~ secu~ities of close or family corporations, the values reported are as far as
possible substantiated by t'inancial statements of the corporations, showing the assets and liabilities
thereof as of the date o~ 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, nnancial statements showing the assets and liabilities of said co-partnership or tmsiness.
A copy of' the co-partnership agreement, (if oral, a statement setting forth the nature 'of the agreement)
together with a statement settin~ ~orth the character of the business, its location, and such other ~acts
pertaIning to the business as ma~! be pertinent to a ~air and just appraisal o~ the decedent's interest
therein must be submitted. 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 Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers of property, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to take ert'ect in possession or enjoyment at or
after death, said schedule sets f'orth the nature and value of' such propertr, to whom trAnsferred, the
relationship of the transferees to the decedent, the proportionate 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 deed, trust agriO!ement or other instrument creating the trust. Ther~ is also set forth in said
schedule a list of all property, real and personal, with its value, which passes at decedent's death by
virtue o~ the exercise by decedent, either individually, or jointly with another, or any power of' appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another,
with a copy of' the instrument creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names awl addresses of all
persons benefIcially interested in this estate at the time of decedent's death, the nature o~ their res-
pecti.ve interests, their relationship, if' any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also
contains ft 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 benef'ieiary.
That Schedule E attached hereto and made a part hereof sets f'orth all property, real and per-
sonal, owned by the decedent jotntly with another or others, including intangible, standlng in the name
of the decedent and others, plus the date and place of record of instruments ef'fecting the vesti ture of
real estate amI the date of acquisition of personalty, plus the name, address and relationship, if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deduction':> claimed for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
conunissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in conseqllence of the death of the decedent; debts and claims owing and unpairt at time of
death; taxes accrued chargeable f'or period prior to decedent's death (except those allowerl under Section
651 of' the Inheritance and Estate Tax Act); together with a statement of collateral pledgerl 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 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 Scherlules "A", "B", "C", "E", and "Ff! as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this
,/,rL-
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RD #1, i~lr'4et Number)
.Maryrci~l~l~;;l.[,8t~U;t;;T .
":>C""
NOTE: NlyB~:;,ror;e- ;dgtifng;~frfifav'i\ J~i~e 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,
securi ties of' close or family corporations or an interest in any co-partnership or business, that the
data and statements reqllirert under the pllrap;raph 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)
COMMONW~AL TH SF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
.
Reol property in Pennsylvonio, with stotement of mortgoge encumbronces upon eoch porcel ot deoth of dece-
dent. Property held by the decedent os tenont in common with onother or other, should be identified
os to quontum of interest ond the estimoted volue should be thot of the decedent's interest only. (Property
herd os joint tenonts with right of surviorship or tenoncy by entireties should be reported on Schedule "E.")
The real property locatsd In the Commonwealth of Pennsylvania should be
described by lot and block number, .treet and .treet number, together with
a general description of the property, with 0 reference to the record of the
conveyance by which the decedent took title; If a farm .tat. numb.r of c-
CfIlU; 01.0 statement of mortgage encumbrance. upon each parcel at death
of decedent. Tax.., a.....mant., accrued Int.r..t on mortgage., .fc"ar.
fa b. Ii.ted on Schedul. IIF" and mUlt not b. deducted from this sched"l..
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not writ.
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
1. Decedents residence located in West Pennsboro
Township, Cumberland County, PA as more fully de-
scribed in Deed Book R, Vol. 20, Page 424. No
Mortpage EincumbeI;Q.nce as of date o;f death.
('l Ii to .j II ~. Ce..,,1" ,tl f\ LO<:'k:. Houfl q
(,--4<.t~~.. ~ ." ...r;.-,p f;-NJ.. 1...41 r
, -)
2. 3/4 interest as tenants in Common in a certain
lot located in the Borough of Newville as will more
fully appear in Deed Book Q, Vol. 13, Page 279. No
Mortgage encumberance as of date of death. (see
attached copy of deed into Robert F. Over, et ux.
The recital on said deed traces the decedents ac-
quisition of her 3/4 interest in said property.) ~
SotJ1"i- WI\ r.,.l; "'~w 1I''''l~
)l.jl f3/~ 3PI"At~ AVCI
a \)000.00 - .31..+()Xt>.lov
V
$24,500.00~ ~4500,DO
I
see attached ppraisal)
, .
~,uuu.UUJ
.
'I
750.00*~ ~O. DO
),'J~U'l
//111 t)
)
'~ < . ,,'
\.,--<"<;-"-.
9../0.'''.'''<~' ( t 1. ~l.~ ,:~" ..-:
G' -
';)'~4 Co, II~-<~' _
Insert this totol opposite "reol property", Schedule "A" in the X X X X X
"As Reported" column on the lost poge of this return.
(~f"i 1,", Ill;
$25,250.00
~s ~SO. 00
,
.
....
REALTOR
249.&5&&
36 S. PITT, ST.
CARLISLE, PA. 17013
March 30, 1978
Chloe E. Andrews Estate
Mr. Joseph M. Morrison, Executor
R. D. #1, Box 4
Marysville, Pennsylvania 17053
Re: Subject Property
R. D. #2
Newville, pennsylvania 17241
-
Dear Mr. Morrison:
In accordance with your request, I have personally inspected
the Chloe E. Andrews Estate, R. D. #2, Newville, Pennsylvania, on
March 26, 1978.
The subject property is situated in the Borough of Newville,
Cumberland Counry, Pennsylvania, and fronts along the north side of
Route 641 approximately fifty-one feet more or less and extends at
. an even width to a depth of three hundred eighty-four feet more or
less. It is improved with a cape cod style dwelling being approxi-
mately twenty-five years old. The exterior'is permastone and aluminum
siding, with storm windows and doors and a front and rear concrete
porch. The lot is all in lawn and has several mature trees and
shrubs. Also, there is an asphalt driveway.
The interior offers approximately nine hundred square feet of
living space. There are hardwood floors in the two bedrooms and
living room (carpeted over)~ plastered walls throughout, The kitchen
has a tile floor, wood cabinets, double sink and a small pantry. The
bathroom has a wall-hung sink, commode, tub, no shower, and a built-
in linen closet.
There is a full basement, concrete floor, block wall foundation,
oil hot water baseboard heat, and central air conditioning has been
installed.
The attic is very servicable as a result of being finished with
a tile floor, heat, and painted walls,
'.
Mr. Joseph M. Morrison. Executor
Chloe E. Andrews Estate
Page 2.
March 30. 1978
The overall condition of the subject property is good. How-
ever, it appears that painting the interior would put the subject
property in top condition. My opinion of the market value of the
subject property as of Mar~~~~-19~_8w~s:
TW~NTY-FOUR THO{]~__~~V~~NDRE~ DOLLARS ($24,500.00L
I have no interest of any nature whatsoever in this propprty
now. This opinion is gi~n by me voluntarily and without assuming
any liability on my part.
RLS/ah
.
,.
-
REALTOR
249.&&&5
36 S. PITT, ST.
CARLISLE, PA. 17013
May 2, 1978
Mr. Joseph M. Morrison, Executor
Chloe E. Andrews Estate
R. D. #1, Box 4
Marys~ille, Pennsylvania 17053
Re: Subject Property
R. D. 32, Newville, Pennsylvania 17241
Dear Mr. Morrison:
.
In accordance with your request, I have personally inspected the lot
situate in the Borough of Newville, Cumberland County, Pennsylvania, on
April 28, 1978.
The lot being part of the Chloe E. Andrews Estate, frOnts along the
south side of Big Spring Avenue (see attached legal) and extends to the
center of the Big Spring.
However, the highest and best use of the lot would. be its existing
one, that being a vacant lot due to the amount of fall which certainly
limits building a structure on it. In addition it appears that a sub-
stantial amount of fill has been placed on the lot over the years to fill
'it up.
In my op~n~on this lot would be more desirable to an adjoining
property owner merely for the purpose of enlarging one's property.
opinion_of the market value of the subject property as of April 28,
was: ONE THOUSAND DOLLARS ($1,000).
My
1978,
I have no interest of any nature whatsoever in this property now.
This op~n~on is given by me voluntarily and without assuming any liability
on my part.
Re~~~u~
~ S~mons
RLS/ah
RCC.-35
RESIDENT DECEDENT
SCHEDULE liB"
PERSONAL PROPERTY
*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time oC 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 or the decedent, but
payable at death to another or others, including but not limited to P.D.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the ract that they are not or the administered estate.
Tangible personal property should be listed rirst (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 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 death, should be listed in this schedule.
Item
No.
ITEM
List and describe fUlly
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATIOI
(Do not write in
this space)
1. Household goods and wearing apparel were not
formally inventoried. Decedent was 69 years of
age and notwithstanding the value of her estate
lived in very humble circumstances -- the 3 rooms
of furniture was all extremely old and was donate
to Good Will and/or one or two neighbors.
2. Certificate of Deposit - #AR 3596 - Farmers Nat'l
Bank of Newville, PA.
3. Certificate of Deposit - #AR 4236. - Farmers Nat'l
Bank of Newville, PAt
4. Certificate of Deposit - #AR 3716 - Farmers Nat'l
Bank of Newville, PAt
5. Savings Account # 1789' - Farmers Nat'l Bank of
Newville, PAt
/
$ 11,236.00, \1 d.el".OO
)
10,779.61 \0 11Q. I" I
I
23,326.84 ~~ .3~l...'ilL\
,
27,173.95 ~. ..., Ii~. 'lS
\
11,499.73, II "\"19.1.3
I
'. ~~~:OO . l~.s.Dc
],779.34, ZI, l'ao. \ 5
8,012.95 ~I--/ 8,0 \~,qS
/ - l.\,g5\.j.3~
4,854.39 ;
-0- o.M
6. Checking Account - Farmers Nat'l Bank of Newville
7. Cash
8. v Series E Bonds - see attached list from Safe
Deposit BOK Inventory
9., Wellington Fund - 935 shares @ 8.57 share - See
attached letter
v---
10. v ..tife Insurance Policy - Acacia Mutual #674688-7
11. Life Insurance Policy - see attached letter - all
attempts to obtain dollar amount due under
terms of policy were to NO avail ( see attacl ed
Correspondence) - POLICY SURRENDERED in June 1959
1976 Buick (as per attached appraisal)
v/
2,950.00v
~ qSD.OO
I
12.
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
$103,777.81
\0.3111'8'.L,~
DEATH CLAIM STATEMENT
t DETACH CHECK AND KEEP THIS STATEMENT FOR YOUR RECORDS.
NAME OF INSURED
POLICY NUMAER
DA TF: OF DEATH
CHLOE E. ANDREWS
674688-7
2-4-78
No. 46- 02220f
BENEFITS
DEDUCTIONS
AMOUNT OF INSURANCE ($5,000 minus age adj. $204)
4,796.00
ACCUMULATED DIVIDENDS
PAlO UP ADDITIONAL INSURANCE
ACCIDENTAL DEATH BENEFITS
REFUND OF PREMIUM FROM
TO
NUMBER OF MONTHS REFUNDED
PREMIUM PAYMENT
TO
FROM
NUMAER OF MONTHS PAlO
POLICY INDEBTEDNESS
INTEREST ON POLICY INDEBTEDNESS
STATE
'NTEREST ON PROCEEDS
40
58.39
TOTALS
4,854.39
TOTAL AMOUNT DUE
4,854.39
PROCEEDS HELD UNDER SETTLEMENT OPTION
INSTALLMENT PAYMENT
AMOUNT OF CHECK
4,854.39 '
F.fHl R[V ,.76
Acacia Mutual Life
51 LouIsiana AlRnue, ~h...vcsl, WashngtO'l. DC 2CXJ01
.
If;,.""'" l""!
wr """'" ,........,.......
f""I :. , ).
./ I
(; PM Life Building P.O. Box -1226(1
San Anlonio,Texas 7X2H4 Pl1onl' ,1-11-6161
May 12, 1978
Mr. Joseph M. Morrison
R.D. 1, Box 4
Marysville, Pennsylvania 17053
Re: Policy No. 2970-138
Chloe E. Andrews - Deceased
Dear Mr. Morrison:
We are in receipt of your recent letter informing us of the death of Mrs. Chloe
E. Andrews who was insured under the above mentioned policy.. We certainly
regret to learn of Mrs. Andrews' death and ask that our sympathy be conveyed
to the bereaved family.
An audit of our records disclosed that this policy was not currently active.
A comprehensive search of our older records revealed that the policy had been
surrendered in June 1959.
Mr. Morrison, we certainly regret to have to inform you that there were no
benefits payable on this policy at the time of Mrs. Andrews' death. If you
should have any additional questions regarding this policy, or if we can be
of any further service or assistance, please do feel free to .call on us.
Sincerely,
/"
/ .' -"
.' /..
I
Kenneth P. Jones
Assistant Claims Manager
KPJ:js
enc-
P. S. The certified copy of the Death Certificate is being returned for your
safekeeping.
(r () \' I !{ j'.; '\1' "";
P I I' ','
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"
I ~
\,' ~.
THEVanO'1'a.-dGRouP-----
. ...:> -:'" WELLlN';TON FUr\ID
WINDSOR FUND
IVEST FUND
GEMINI FUND
EXPLORER FUND
TRUSTEf::S' EOUITY FUND
W.L. MORGAN GROWTH FUND
I/I.'r 1.1_,Sl_" 1f'ICO.,~F 1','''Jrl
W[STrv.I",'ST~R 80"10 rllr~n
'NHI,FHAL.L MOI\I[Y 1\,1J\.RKFT 181)<:;'
()UALlFIFO OIVltH=-~,jr) PORTFOUO
OUALlFIFD DIVIDENO PORTFOliO <
FIRST If\JDFX INVESTMFNT TRUST
WAnl/lJlCK MUr'-JICIPAL BO!\IO FUNn
AUG.
2'" lq78
DONALD R. O'./EIIJ
105 MT. VIE~ DRIVE
ENOLA, PA 17025
R~FEREIIJCE:
WELL IN G TON FUND
ACCOUNT H 97536362 NAME or:
ESTtTr or CHLOE [ ~NDRr~s
cIa JOSEPH M MORRISON
RD 1 BOX 4
M~RYSVILLE PA 17053
O~ar Nlr. Owpn:
~!e are in r~cein'" 'of your l,..tter ....~.,rJes":;:l')o information on the
above ref~rcnced ~CCOlJnt.
PLease b~ advised that on February 04, 1978 WeLlinaton Fund soLd
for $8.57vOer ,hare.
If we may be of further a"istance to you, please contact us.
Sincerely,
B~I.S-c-
J~ cI ,~
Sheila Field,
c c:
Post Office Box 1100 I Vnlley Forge, Pennsylvania 1918) ___ .._...____ __________
Telephones: (BOO) 523-7910 (Toll Free) (215) ?c}3-1100 (Cilll Collect in PPtlmy!v;1l1';11
FUND
CODE
21
ACCOUNT
NUMBF.R
97536V,2
COF1~lrSPONDF "Jl
cnn''f'
(:' )111
",",ll
(', \(H-~I ,;
f\.Il)\1ij! I'
506<;22
60'
08/29/78
603
TO INSURE PROMPT ATTENTION, PLEASE DETACH AND RETUR~J THIS PORTlor".
WITH YOUR CORRESPONDENCE, IN THE ENCLOSED WI~IDOW ENVELOPE.
THEVanguardGROUP
DONALD B. OIlEN
105 MT. VIEII ~RIV~
~NOLA, PA 17025
P.O. Box 1100
Valley Forge, PA 19482
,
.
~.~I
FORBES CHEVROLET, Inc.
I
Route 11 & 15 700 No. Statf! Rd. MARYSVILLE, PA. 17053 Telephone (717) 957.2191
Per N.A.D.A. book, as of March 1978, the average loan
value of a 1976 Buick Century Regal is $2950.00.
.
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'RCC - 36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER I~HERITANCE TAX
SCHEDULE "ell
TRANSFEItS
~.."....
~'\
RESIDENT DECEDENT
(1) Did decedent, within two years of'death, make any transf'er of any material part ~ his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) 0
(2) Did decedent, within two years of' death, transfer property from himself to himself' and another or
others (inclurling a spouse) in joint ownership? (Answer yes or no) No
(3) If' the answer to (1) or (2) above is in the arfir~~ve state:
(a) Age of decedent at time of' transf'er fA
(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, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration thereror which was to take errect in possession or enjoyment at or arter his death?
(Answer yes or no)~O______
(a) Was there any possibility that the property transferred might return to tjr.anSferer or his
estate or be subject to his power or disposition? (Answer yes or no) N_A
(b) What was the transferee's age at time of decedent's death? XEX N/A
(5) Did decedent in his lifetime make any transrer without receiving a valuable and adequate consideration
therefor under which transreror expressly or impliedly reserves ror his life or any period which does
not in ract 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 theref'rom? (Answer yes or no) No
(6) Ir the answer to (5) (b) above is i'Nf~e affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in his lifetime make a transf'er, the consideration for which was transferee'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 benef'icial enjoyment of' which was subject to change,
because of' a reserveci power to a1 ter, amend, or revoke, or which could revert to rlecedent under terms
or transf'er 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 or the benericiary reserved in the decedent alone or the decedent and others?
(Answer yes 0 r 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 ceM.ificate.
NOTE 2: If' answer to any of the above questions is yes, set forth below a description of the property
transferred, it's fair market value at date of death, dates of transfers and to whom transrerred, with
relationship of transferees to decedent, ir any. Submit copy of any trust deed or instrument, if trans-
fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPT ION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
f\\ ON.
Insert this total opposite "Transfers", Schedule "e" in the
"As Reported" colunm on the last page of this return.
N.~
WILL
OF
CHLOJ: E. ANDREWS
I. CHLOE E. ANDREWS. of N_oriUe. ClIDlbe..1uIll County.
P_ylY&aia. cs.cla... t1U. to be my Ia.t will aM ...carneat _ct benar,
revoke aoy will pnoriO\Uly ~ tly _.
I_1ft 1 J cU...ct lbat all lilY Juet ubca aM '-ral .xpe....
.hall be paid from my r..idual'y ..taa., a. 'OelD a. pacUcable aft.r my
dec.a... a. a pert 01 the 'XP'D" of the a"-~i.tadoD of my....a..
Ia.m U. I d.vi.. aDd beqlllathdae ....1411111 of my utate of .
every aatur. and wher.v.r .itllla. to my .i.te.., EnNA M, MORRISON.
It.m m. I appaiDt mylzotber-iD-law. RUSSEL MORRISON.
.x.cutor of Chi. my la.t ",,111
ltam IV. I dir.ct that my ""'08&1 ...'....eD.."... or hi.
.ucc...o.. .ball Dot be r.qulrK to live tlGlld for eM faUbflll ,.rformaDC'
of their duti.. ill aoy juri.dicdoD.
.
IN WITNEY WHEREOF. I ba... be..._to ..t my baDd
Chil
,.
day 01. ."
. 1973.
.
',., ." r ({
aloe E ~ AAct~:'. . ,
:ii~d, ...lect. pubU.bed &Dd d.cla...d
by Chloe E. Aaci...... a..tatrb above ..m.d.
a. a.d fo.. h.r la.t .,ill aDd te.taIlMDt.
writteD OD 1 .be.t of peper. iD OlA" pr..enc..
who. in her pr...DC'.. at h.r r.ltl&l.t. &ad
iD the p......c. of .ach other bave b.r'\lDto
.ub.cribed _I' ..m.. a. atte.tiIllI wi......:
\'1/
.~
.
-
I)LI~j,
., ~(,
A._,_~/: C.
_,I lr )1':
.I....~~.
...,
. I
'J--t~ t;.
r_'i~--~.At-,...........
RCC-37 '(12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCIlEDGLE "I)"
BEI'\EFICIARlES
BENEFICIARIES AND ADDRESSES. ,. RELA TlONSHIP I SURVIVED
(If step-children or I DATE INTEREST OF
State full names and addresses of all who illegitimate children I DECEDENT OF BENEFICIARY
aye an interest, vested, cont ingent or other. arc involved, set i STATE YES IN ESTATE
wise, in estate) forth this fact.) , OR NO BIRTH
EDNA M. MORRISON SISTER Y1C8 Sole Heir
-
lln iI 1 , "Rf'lY 4
" , ~ PA
i -~
, ,
f-- -..
I ___._M
I
I --..- -~..-
~
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i ,
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!
I - -~
I I
,
,
, ,
i
--,.-.--. --..-.---.
i ------
i
I I ,
___.u.__
! !
I .
"-------
.---
---.--
DE'ronent further says that all the above-named benef'iciaries are livinp; at this time except below:
... .. I
NAME DATE OF DEATH RESIDENCE
.
- ---~--- --
~ "
.3 -
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~ 0::
SUMMARY
. ....(Sch. "A")
.......... ..... ... ....(Sch. "B")
....... ....................... .......... (Sch. "C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
$25.25.0..0.0
$ J03.777.81
$ -.0-
$
$.
$129.0Z7.81
(2)
(As Determined)
$
$.
$
$
$
$
l- '0
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oj ~ ...:i
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'RCC-38
RESIO'ENT DECEDENT
SCHEDULE "En
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRllCTIONS: This seherl.ule must disclose all property, real ann personal, owned by the decerlent jointly
with another or others, inclurling intangibles, stunding in the name of' the decedent and others. List
rea] estate first.. as entireties, or joint tenants, giving brief' description, as indicated lmder Schedule
"A", plus the date ano. place of record of' instrument eff'ecting vestiture, but do not include entireties
or out of stab' real estate value in estate valuation column. Personal property should be listed as in
Schedule "H", plus date or acquisition, and the name, address and relationship (if' any) of co-owners to
the o.ecedent.
Description of Property, Date of' Acquisition, Name
Address and Relationship of' Co-Owners, and Place
of' Record. of Instrument, where Real Estate.
Unit
Value
percentage
Share
Estate
Valuation
DEPARTMENT VALlJATION
CAUTION-Do not Write
In This Space.
Value of' Value of
Entire Decedent's
property Interest
1. 3/4 interest as tenants in Common in a
certain lot located in the Borough of
Newville as will more fully appear
in Deed Book Q, Vol. 13, Page 279. No
Mortgage encumberance as of date of deat
(See attached copy of deed into Robert F.
Over, et ux; the recital of said deed
traces the decedents acquisition
of her 3/4 share in said property.)
(see attac ed appraisal
;
,.
MoY'L
.-
Insert tbis total opposite "Jointly Owned Property", Scliedule "E"
in the "As HeporLed" column on the lust page of' this return.
** t\\
**Value reported on Sche~ule A
*'
.
REV..~t8 (8-78)
COMMONWEAL TH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REFLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Joseph M. Morrison
RD 1, Box 4
M~ry~vi'lp..l Ph
(Executor or Adm ini strator)
In Re: Estate of _
c.h1np E- AniJrew~
Cumberland
County - Fi Ie No. 71-78-0135
Dear
You are hereby notified that the Origi ~~
oppraisement in the estate of r.h1 np 1'( Andrews
hos been filed in the office of the Register of Wills of r."mhp""a"d
County on ---..a l'phr""ry , 19-19-, Said appraisement reflects the fallowing
valuations:
Reol Estate
Personal Property
T ronsfers
Jointly Owned _
Totol ~_____
7~ 7~{) 00
103:778.62
None
None
$129,028.62
As to such tox that is paid within three months from date af death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death accurred 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 ot the rote of six (6%) percent per onnum is charged.
Any party in interest who is aggrieved by this natice may object thereto within
sixty days after receipt of soid notice as provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373.
~ ~v-~..;:;JL..._'_
Date .----8--Eabr~~79---- Signed ---V'
Title __ Administrative Officer
.~-
v
Note: This is not a bill.
,
,
REV-457 (8-78)
DePARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVt,NIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAI~ J3 Februarv 1979
COUNTyCumberland
FILE No.2l-78-0135
Whereas, Chloe E. Andrews late of Borough of Newville
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 4 th day of Februarv 19 22, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo FlIl "ini ti. ,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
fate on any such future interest.
DESCRIPTION OF ASSET UNIT AppraIsement
VALUES IVlade for Inheritance
Tax Pu r poses
"co, $ ?<; ?<;n nn
Personal Property 103,778 62
Transfers Nnnc
T^<_~'" OT.med None
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