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RCC-33 (4-73)
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COMMONWEALTH OF PENNSYLVANIA _~_
DEPARTMENT OF REVENUE ~
BUREAU OF COUNTY COLLECnONO Cl J (i me'
COUNTY OF CUMBERLAND
M,,~n' '), .\'! TACHED
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
Betty A. Sandberq
(STATE FULL NAME OF DECEDENT)
Late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECU1;IilR IX
~
County
County of
Cumberland
} u,
State of
~l'!i;//~K*'1!
Penelope S. Weltmer
of the estate of the above"named decedont being duly sworn, depo..
Executa:rix
and .oy
(MONTH)
Name and oddress of attorney or }
other authorized representative to whom
all carrespondence should be mailed.
(DAY)
, 19~J t..tate leaving a la.t will, copy af which I. hereta attach.d. }
(YEARl ~
Decedent died
February 27
Thomas I. Myers, Esquire
Post Office Box 125, Lemoyne, Pennsylvania
17043
That as such Executrix deponent is familiar with the affairs of said estate and the property constituting
\ EX ECUTO R~ADMINI ST RA TO Rl
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..I,FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Dauphin Deposit Bank & Trust Co. "~';'~A- 'r~-~
Penelone S. Weltmer dauohter
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 pricrr 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 th::' 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 whatsoeveu kind 9f. ~ature, "left by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by d~ce~nt '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 t~stimated fair market value be
less than the face value, it sets forth briefly the reasons for ~uch depreciation as to each item; all moners
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 securities owned by the decedent at the time of death, \lith the -market value there-
of a t such time.
----
In the case or 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 'business.
A copy of' the co-partnership agreement, (if oral, a statement setting forth the nature of the 1I.greement)
together with a statement setting fo~th 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 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 persona.l, within two years of decedent' 8
death, in contemplation of decedentts death, or intended to take e~fect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom trfu,sferred, the
relationship or the transferees to the deceden t, the proportionate share received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of transfers 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 agreement 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 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 instrmnent 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 rorth the nRmes and addresses of all
persons beneficially 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 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 their death, their issue, and the relationship of such issue to the beneficiary.
That S.:/ledule 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 Schedule 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 fees and ~ldiciary'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 llnpairi 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 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.
Subscribed and sworn to before me this ....
2LS! day of ...~.
...19...7.1.
.,., ....". "
.~~i~~~i%~~~~~~ix
. .. .+(iQ..~9\lt.h..I!'.?t..St.ree.t... ...........................
(Street Numb",.)
.CaIpll~~~':E'~E;y~,,<lI1i."i.17011
(City O'r Tow" and State)
.~........~.
NOTARY p'bm,ia . ~
My Comm!oolClllEopi'''Dec. 21, 19B1
LomD,... Pu. C\UIlber\o."d aoun y
NOTE: Bef'ore signing afridavit make sure all blank spaces in the af'fidavit and schedules annexed are
1'i lIed in wi th details or the word "None", and in case the assets ioc lude rare and unl is ted securities,
securi ties of close or family corporations or an interest in any co-partnership or business, that the
data and statements required under the para~raph above relating to Schedule "B" are attached. Also make
certain that colrunn #1 in the "Sununary" has been properly completed as fibove-directed.
RCC~34 (4~73)
COMMONWEALTH 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 as tenant in common with another or other, should be identified
as to quontum of interest ond the estimated value should be that of the decedent's interest only. (Property
held as 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
described by lot and block number, str..t and .tr.et number, to;ether with
a general description of the property, with a reference to the record of the
conveyance by which the decedent took title; If a farm state number of a.
cres; also statement of mortgage encumbrance. upon each parcel at death
of decedent. Taxes, assessments, accrued Intere.t on mortgages, etc.,are
to be lIsted on Schedule .'F" and must not h. deducted from thIs schedule.
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not write
In thIs space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
Lot fronting 60 feet on south side of
Carol Street, New Cumberland, Penna.
with single one-story frame dwelling,
No. 530 Carol Street (Deed Book l2-S,
Page 185)
Sale Price (,; '7 tI
/.I
~.' ;r.;'>
1'4 b )f
,
11/<' 6170
44,900. oo.~... ?Ol.(}a
LILlI 'd(J. ()~
Insert this total apposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
Rec -36
RESIDENT DECEDENT
SCHEDULE "B"
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 of his death. Property owned by the decedent jointly with another or others
must be li8ted under Schedule "Eft. 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 certiricates, 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 riduciary in said capacity, partnership interests, interest in any undistributed
estate or or income rrom any property held in trust under the will or agreement or another, even though
located outside or the State, at the time or 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)
8
2,093.51
221. 49
100.00
/~ OOO.4.~
~ II .f. "1
J, ","'0.'0
,,", f- .,ro IJ 0......
lJ , C. +' r-r
3'"-" I f<1. 4"tr
1.1 fI'.J. !'" I
~ ,"-I. "'
10'1' '0
1
2
3
4
5
6
7
Household Goods
500 shares - Dual Lite Corp. (OTC)
200 shares Leesona Corp.
100 shares Consol. Edison Co. - common
Harris Savings Assn. OPS Passbook 1040
Harris Savings Assn. CD 4-09-114895~
Dauphin Deposit Bank & Trust Co.
Checking Account
Savings 13-6-0051-6
1963 Corvair automobile - poor repair
14.93 5
17.00
22.75
4
1,000.00
7,468.75
3,400.00
2,275.00
8,066.45
32,180.48
Insert this total opposite "Personal Property", Schedule "B" in
the ItAs Reported" colunm on the last page or this return.
,::1, 90j I. 'Y
c:>
x X
56,805.68
'>- ~ 8'0.); ,r
RCC-jS
C;\MM;\\~l',\1.TI[ IW l'c'\\SYL\MiI A
T1.tA\:-:::FFII T\li;':l:'IT,\'\CF TAX
SCfIF:nULj': !le"
Tl{ \~c.:t'.J':HS
f~
~,f)'~
\hi
IJ ,',Wi, t\
I _:c. """c,_> ',',
,."),.~",,..,c.,.,>..1
~.1:/"',J"'0-~{j>:;'-~;<:
i\ES T DE\T ])I':CF])I':~T
(1) Dirt rteeedent, within two years ot'deat.h, m~tke any tt'll:lsfer' of any material IH.lrt of' Ids pstate~ .....-jthout
receiving :J valuable ur:o ndequfJte considerat.ion t,he~>pfor? (.'\nswer yes 01' no)~~
(::.n Did decedent, 1\'1 t.hin two )'ears of ctf:'atil, transfer properLy from himself to himself imd another Of'
{,then,. (i llclurl i ng it spouse) in ,jo"i nt ownership? (Answer" yes or no) _Q~
(:1) If' the answer to (1) or (2) above is in the at'fJrmaLLve state:
([I) Age of' rleeerlfmt at time of b'uw:;fer
(b) State of decedent.'s health at time of' llIaking t.he transf'er. (Note 1).
(c) Cause or decedent's de:ltb. (~ote 1).
(4) Did ciecedpnt, in hi:.., lif'et.ime, make any t.ransfer of' proy!prty without. receivinp; a valnable or adequate
consideration therfl!.or which was to take ef'fect in possession or enjoynwflt Ht or nfter his rtputh?
(Answer yps or no) no
(it) WilS there any ilossibility that the property transferred might return to transf'erer or his
est.ate or be subject to his power' of' disposition? (Answer yes or no)
(b) What was the transfer'ee's age at time of' decedent's {leath?
(3) Did decedent in his lifetime make any trllnsf'er without receiving a valuable and adequate consideration
theref'or under wldch transf'eror expressly or impliedly reserves f'or his li1'e or <lny period which does
no t in ['ac;t end lJef'ore his death:
(a) The possession or er!joYlllent of or the right to income from Uw property transferred?
(Answer yes or no) no
(b) Tlw right to designate the persons who shall possess cr enjoy th{~ property transferrerl or
income therefrom? (Answer yes or no) no
(fi) If Ow answer to (5) (b) above is in the af'firmative, state whether the right was reservl~d in decedent
alone nr otllers m_.__~_~____.
(7) Did {lecedent in his 1 it'etime make n transfer, the eonsiderntion f'or which was transferee's promise to
pay income to or for the henef'it of care of' tl'IlEsferor? (Answer yes or no) no
(8) Did decedent, at any time, transf'er propcrt.\~ th~ brcmef'icial enjoyment of which was subject to change,
hecause of:t r,~served power to alter, amewl, or revoke, or which cOH]d revert to deeedent under terms
of' transf'er or by operation of law? L\nswer yes or no) no
(9) If' the answer to (8) above 13 in the affi.rmative, was the power tn al tel', amend, or revoke the inter-
e.'it of the belll::-ficiary reserverl in the decedent alone or the decedent and 0 thers?
(Answer yes or no)
NOTE 1: The nnswers to these (!uestions should be supported by affidavit by the attewLing physieian as
well as it copy of the death certificate.
NOTE 2: If' answer to ilny of' thc ahove rJllcstions is yes, set forth below fl description of the property
transferrer), it's f'air market vllluc at date of death, dates of transfers and to I"hom tr.'lnsferre.-l, with
relationship of transferces to decc(lent, if' any. Sllbm-it eopy of any trust deed or instrument, if'trans-
f'ers are claimerl to be non-taxable, also submit detatled statement of' facts on which said claim is based.
~OTE 3: List fll1plicahle property beJow tn marmcr in which provide<i .in Schedules A, il, or E.
ITr:~l
UESCHIPTION
'lARJillT VALliE
(Estimated)
DEPT. VALUAT_':ON
(Dept. Only)
1
Decedent in January, 1978, transferred
to Anna M. Schriefer, her sister,
2 units of Corporate Income Fund
4 th preferred
$2,077.80,/
I
'-I tJ7 7. ~
i
I P-I 1)7 J. n;
Insert thIs tOt:1J opposite "Transf'ers", Schedule "C" in the
"As Heported" eolu1Tm on the last p'lge of this return.
---
'.
RCC-37 (12-63)
l'O~tMO:-i\\'EALTIl OF' I'EI,:":"YYL\:-iL\
THANSFEI, INIlEHITA!\CE TAX
RESIDENT DECEDENT
SCHEDULE "1)"
~G~~~'
Il, t''',c:,'~
..j,/:_',::,;f;':,;/"
BE:-, EFI CIA HI ES
~ B~NEFICJAHIES AND ADDRESSES II (lr~~~~~~~l~~;~Pol' T,-~~;;~iV,Ep"".~I' -- DATE --- INTE~EST (~--
lstate tull na.mes and addresses of all who illl'gitlmate chlrlren DJ.'.,LEVE~r OJ' BENEj'TCiAHY
have an intE'n~.st. vested, contingC'p.t or ot.h(>r- are lllvolved, set STATI<2 rYES _' T IN EST\TE
Wi80, !'1 estatpl +_forth t.his fact.) OR NO I BIRfJ-=r) ____ _____
St. Theresa's Roman 1 i I Specific Bequest
Catholic Church II ~I L_', I -$250.00 -.--
New Cumberland. Pa., ---1
~ -.J 1 I
----~._--
Wpnny Wp 1 t-rner ~, .Yes 5/17/60 Specific Bequ
-
160 S. 31st Street $500.00
Camp Hill, Pa. 17011
Geoffrey Wel tmer Grandson Yes 16/23/61 ._~ecific Bequ
160 S. 31st St. I I
I
est
I 1_ =,
:ronddOUOhtOE'
Dau hter Yes
est
Camp Hill, Pa. 17011
Jodv Weltmer
1 fiO!'; 11 st- !,;t-_
Camp Hill, Pa. 17011
Penelope S.Weltmer
160 S. 31st St.
Camp Hill, Pa. 17011
ath P rk
-+-$500.00
6/22/63
I
I Adult
I
I
--r
~onifin Boquo,t
~~9~_.
I
~ne-half Residue
1 -~----~----
Specific Bequest
191 Andover Road I ~ $500.00
I
Billerica, Massachusetts 01 21 I
~ri~ Park l..Grandson I Yes 9/15/65 Specific Bequest
191 Andover Road I $500.00
I
Billerica, Mass. 01821 I
-
Andrew Park branddaughter Yes 7/19/67 Specific Bequest
191 Andover Road , $500.00
Riller;~a. Mass. 01821 [ l__
,
Linda Anne Park Daughter Yes Adult ~ One-half Residue
191 Andover Road
Billerica, Mass. 01821
I -I
anddauahte+YeS
2 11/64
-.r-~-=i=-l
Deponent f'urther says that all the above-named benef'iciarles are 1 tYing at this time except below:
- ---- -- .---
NAME DATE OF DEATH RESIDENCE
-
"
~
_ ..~, 'Il-
~: r;:
";:: a; E
.:: C::;::l
S......c
-0 "- u
~~ -
3~~
- ~-
::l Of] J-.
U ~ 0
~ E e
~ 0.:;
Heal Property
Personal Property
Transfers
SUM>,lAHY
(Sch. 'X')
(Sch. "B")
(Sch. "e")
$
$
$
S
$
$.1,.0.3.,.783.48
(1)
(As Heportl'd)
44,900.00
56,805.68
2,077.80
(2 )
(As Ddf'rlllill('d)
$ 44,900.00
$ 56,805.58
$ 2,077.80
S
S
$103,783.48
Gross Taxable Estate
'0
C
<0 C
.-l 0
1-4 Ul M
t- Q) C '"
Z -0 ~ .<:: 0
'" 0 r--
M ~ ~
'" " ;; ..l ':> .-l
'" '"
>< '"" " U .0(
~ " '" '" <0
VJ 0 ~ - -..;
:;;: .0(
t9 Q) '0 " =x: 1-4 C
or; ~ p:; Z C '" .. Q) <0
~ 0 r.:I <0 " .. ~ :>
~ CO ..... .-l 2: .0( .-l
'" ~ '"
:I: :I: ~ Cl 0 1-4 ~, .-l :>,
.. .. f- ~ Q) ~ Q Ii< Ul
~ S
c c; ~ "' ~ .<:: ~ ~ Z 1!) c
r: 0 f- u:l 01 ~ 'C'O C
Z '" ;; ;; ~ Ul.-l Q)
~ ~ 0 U ~ '" 1-4 p.,
~ 0
0 .0: 1-4 ~ =x: Q) ~
c: 0 ~ 0 :>'0 .
0 or; >< CO .. :>:co Q)
:.c ~ E-i .~ "" C
'" f- E-i ~ - =x: . . :>,
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:~ ~ CO ~ ~' ~ 1-4
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(5 :>, p., ...:i
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RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTL Y OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TR"'NSFER INHERITANCE TAX
INSTRL'CTIONS: Tllis sehedule must disclose all property, real anrl personal, owned by the rlecedent jointly
with another or others, including intangibles, standing in the name of' the decedent and others. List
real est1it~ first. IlS entireties, or joint tenants, giving brief description, as indicaterl tmrler Schedule
"A", plus the date and place of' record of' instrument ef'f'ecting vestiture, 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 and relationship (if any) of' co-owners to
the decedent.
6
Description of' Property, Date of' Acquisition, Name
Address and Relationship of' Co-Owners, /lnd Place
of Record. of' Instrument, wltere Real Estate.
X> ~ :sx ~YX xx: X>
y :xx. X;<
y>>y :xx
^^ ^^y
X> X> 8:S ~ X> X> xx: :::x
unit percen tage Estate
Value Share Valuation
y 6 X> X> ;sg
X>:::x :)0 ::x ;sg ,x: ><X
:::x y >0
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of
B,ntire
property
Value of
Decedent's
Interest
,
-,..(l..
NONE
~ - ~
- "'"'V ~
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last pag;e of this return.
-----
Reo-so (~77)
County, Number and NameCumber1and 21-78-] 19
File Number ?1-7F1-o139
Date of Death ~'ebrll"'ry?7 1 q7R
File Date 1-?~-7g
Estate Name SANDBERG BETTY A.
SUMMARY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIOENT DECEDENT
(LAST NAME)
(FIRST NAME)
(INITIAL)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", uB", "eu, and liEu.
Dated:
January 25, 1979
Yt/ . 'fi" Li ,,}
. Iv..'" I d /' j (' ,) 'f ,/
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule IIF", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:
REGISTER OF WILLS
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED CODE VALUE AS REAPPRAISED CODE
Reol Property (Schedule A) $ 44,900 00 $ 44 900 00 004+ 00+
Personal Property (Schedule B) 56 805 68 ~F;.Rn~ F;R 10+ 10+
Jolnt.Held Property (Schedule E) -0- -0- 20+
Tran$fers (ScheduleC) 2,077 80 2 077 80 30+
TOTAL GROSS ASSETS 103 783 48 :i~103 783 4R
Less Debts and Deductions 40.
(SCHEDULE F)
TAT
CLE AR V ALUE OF ES E
t=
1-
Valuotlon of life estates or
-"'--
PRINCIPLE
FACTOR
VALUE
annultles....................._ $
1=
ESTATE TAX ASSESSMENTS _ $
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
T oX' on $
Exemptions
Total Estote
~
COMPUTATION OF TAX
$
$
$
$
$
2%
6%
5%
10%
15%
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
.
TOTAL TAX
$
t=
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after deoth
$
$
$
BALANCE OF INHERITANCE TAX DUE
Add interest at rote of 6% from
'0
AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
BALANCE DUE
Add interest at rote of 6% from
to
$
$
t=
$
$
$
$
TOTAL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Adjustment
49+Adju.tment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Chari.ty
94-Remainder Residue
96-Success i ve
life Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsequent adiustments are made to the above computation of tax by the Register of Wills, for proper reason
same should be noted below, with short explanation. '
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REv-eta (6-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Penelope S. Weltmer
(Executor or Administrator)
In Re: Estate of
Bettv A. Sandberq
I.lImhprl rmrl County - File No. ?1-7R-n1,g
Dear Mrs. Weltmer:
You are hereby notified that the original
appraisement in the estate of Getty A. Sandberq
has been filed in the office of the Register of Wills of Cumberland
County an JAnuary 25 , 197~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
is 44,900.00
56.805.68
2,077.80
-0-
$103,783.48
As to such tax that is paid within three months from dote of death, a five (5%)
percent discount is allowable. As to ony tox thot 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 abject 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 Januarv 25. 1979
S. d fi: . 'ff" , ;I /
Igne V.(),"rl,:/,; (' to;., /.- ~
Title Chief ApprAisRr
.... --------
Note: This is not a bill.
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P ,0. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYL V AN IA
RESIDENT INHERITANCE TAX
APPRAISEMENT
D;'.i:: Januarv ?S. 1979
COUNTY CUmbR~]Anrl
FILENO. _21-78-0139
Whereas, F1Rtt\l ". S'mrlhpT'g late of New Cumberland
in the County of Cumber land Commonwealth of Pennsylvania, having died on
the ?7t.h day of !=-ohT" 'OT''' 19 78 ,seized and possessed of an estate
,
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Gloria J. RichClrrt ,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
rate on any such future interest.
DESCRIPTION OF ASSET UNIT Appraisement
VALUES Made for Inheritance
Tax Pu r poses
Real Estate 44 9oo.nn $
r. /,/. nnr nn
,
Personal Prooert\l 56 805.68 56 805 GR
Transfers ?n77.Rn ? n77 Dn
Joint Propertv -o- n
Total Estate "11n,.7R, l..p. ,n~ ,n~ .n
,
.
Have been duly sworn accordin~ to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 'it.h day of l>'1 n,,>'1T' \' 19 ~.
'>>-')"'.0/,'.,).1 .P/~:. .0'.-/0', Ii /
Appraiser
1846 8rookwood St.
(Number and Street)
HarrishllT'Q 171?7
(Post Office)
. Penna.
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