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HomeMy WebLinkAbout05-08-78 RCC-3 (4-73\ APPLICATION FOR CHARITABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX (Act of May 28, 1956, P.L. 1757, and Act of June 15, 1961, P. L. 373, as amended) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS Application is hereby filed for the approval 1. Bureau File # 21-78-136 of an exemption from Pennsylvania Transfer 2. Date of Death March 2, 1978 Inheritance Tax on the transfer of the property -f"r? t4.v described below: 3. Date of Approval 8 Ink' , , 4. Name of Decedent Irene D. Piper 5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ 500.00 (Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or percentage amount above). 6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless such material has been previously filed. WILL IX; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (If other, exploin) 7. Correct Business Name and Address of Charitable Organization receiving property: NAME The First United Presbyterian Church ADDRESS Big Spring Avenue, Newville, PA 17241 o See listing on reverse side for additional charitable organizations covered. 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. Signature of Appl ic ~- ")1 ~, . . \ Address of Apphcant 1 W. Hi h St. Carlisle PA 17013 Officio I Title Attorney Date M"y " 1Q78 This form must be completed in triplicate and all three capies delivered ta the Register of Wills for the County in which the decedent resided, or in which letters were issued for a non~resident decedent's estate. If the decedent was a non~resident of Pennsylvania and letters were not issued by a Pennsylvania Register of Wills, deliver 011 three copies to the Director, Bureau of County Collections, Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po. Do not write below this line. For Official Use Only APPROVED: For the Secretary of Revenue REFERRED to Bureau Headquarters Approved 0 For Secretary of Revenue Denied* 0 (Signature of Register of Wil "';i.i'?j"(gOIl ,\ V.'I f~ (C ,J Co;;:;;I1T ounty) l"7ay of ICht (Date of Approval) (lnitiols of Register of Wills) (Authori zed Signature) (County) (Title) (Dote of Referral) (Dote of Action) * See reverse side for reasons MUST BE FILED IN TRIPLICATE This section will be campi eted by Bureau Headquarters only when the application for exemption has been denied. Dote: The application for exemption contained on the face of this form has been denied because Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable Pennsylvania Inheritance and Estate Tax Acts.