HomeMy WebLinkAbout05-04-78
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
f\CC-33 14-731
RESIDENT DECEDENT
COUNTY OF r.llMRF.RT,ANn
IMPORTANT.
-:fhiS -~eturn 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'lenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Cumber-M.nd )!i
LatE: of ________~~___u._________
~
I J.. / /
" L' I" ounty
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EXECUTOR
:'< THE MATTER OF THE ESTATE OF
Miles G. Stiles
AFFIDA VlT OF
-'--'~;-:-if;Tr' FULL NAME OF DECEDENT)
ADMINISTRATOR
Stat,.. of _ ___.___J?E:!l1n~ylvan.i~a
County 01___C:llIT1!:l.erland
} '"
XdliKiK>KlXilIiK
of the estate of the above-named decedent being duly sworn, depose
Sarah Stiles, survivinq spouse of decedent
:ex~
ond soy
Decedent dH~d
December
~,._-,_.
16
, 19--11-{testate leaving a lost will, copy of which is hereto attached. }
(y EAR) intestote
fMONTH)
NomE' and oddrC5S of (lltc~n('y or }
other authorized repre';<.!illoti'le'o whom
011 correspondence she ',I .
(DAY)
Myers, Myers, Flower & Johnson
301 Market Street, Camp Hill, Pa.
17043
That as SUl:]; __~__sq~yJvor deponent is familiar with the affairs of said estate and the property constituting
, "XE-:CUT"QR-ADMINISTRATORI
the assets thereo] ,11](.1 their fair market value.
Th<ll at tht: time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of anMher, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the fullo\\'ing;
----.
S OF RANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
NT RENTED A S_~FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
it Bank & Trust Co. M;1oc r- and Sarah E. husband & W:L!e
N.; 1o~
----
-.
!'-IAME "ND A['URE::5
IN WHICH DECEDF
n<'lllphin Depos
That tht.: contents of said safe deposit box or boxes are itemized under Schedules
wi th (he excej)t ion, or the follo\ving, for the reasons hereinafter set forth:
of this return,
fhat Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the CommoO\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, namt.: 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 ',nvned 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 prinr to decedent's
death in the case of savings banks, ano to the date of decedent's death in all other cases; all bonds, postal
savings, trt.:asury certificates or notes and other evidence of indebtedness of the United States to the de-
c~denL all obligatiolls, whether by statute or agreement they are designated as tax free, of the United States,
or any state, or political ~;ubdivision thereof, or of any foreign country, which are owned at the time of death;
".:: "'--'-"'ilts "PJ'<.l' 0.;;. iVSL;il)', :-.i iv..:rw arc, pictures, books, works of art, household furniture, horses, carriages,
automobiles, hoats, 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 ov.'jng decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money or which decedent died possessed, of whatsoever nature, with interest thereon, if
any, gi....ng lhe face va[lll: and estimated fair market value thereof, and if such estimated fair,market value be
less than the face value. it sets forth hridly the reasons for such depreciation as to each item; all moneys
pay'able to the cst:lk from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of ',vhich \\.',.. "(1yable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and Iln!,;,~d ,) "date (If death, bonds and accrued interest thereon to the date of decedent's
death and olher 1;;', : InH'1,1 owned by the decedent at the time of death, with the-markct value there-
of at such lil1\1'.
,J,
";
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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-partne:r<ship 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 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 or decedent's
death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, 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 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 cony
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 pa8ses 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 attached 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 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 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 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 fudiciary'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 ami unpaid at time of
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
65101' 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 or 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
...... Lc1.4 day of
1~
~~~:~I~'tt " _i
......m 19]~
_da!U11.e.~.m..""',.,"'_"
(E:recutor-AdministTator )
..J."a...Rigl1g.J;;:d.".RQ,ad.
(Street Number)
M.E1c:l1iil1~c::!Ol:>':l:r9.'.p a . 17 055
(City or Town and State)
!'rm"'JC
" .:, 2J, 197~
Cwnbc.-la;,d "':''ount)
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 family corporations or an interest in any co-partnership or business, that the
data and statements required. under the paragraph above relating to Schedule "Bn are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-directed.
RC C~34 14-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITAI'CE 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 located In the Commonwealth of Pennsylvania should be
described by lot and block number, street and street number, together 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 encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule IlFIJ and must not be deducted from this schedule.
(1)
(2)
(3\
DEPARTMENT
VA LUA TlON
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
Real Property owned by decedent and wife
as tenants by the entireties:
Deed reference:
N(j~
Deed Book "E", Volume
20,Pag-e, 987.
Insert this total opposite "real proped,", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
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 or his death. Property owned by the decedent jointly with another or others
must be li8ted 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.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the ract 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 a.s 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 tully
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
All personal property owned by decedent
and spouse as tenants by the entireties
N~~
Insert this total opposite "Personal Property", Schedule "B" in
the" As Reported" colUJlU1 on the last page of this return.
x X
RCC-36
COMMO\WC:^LTII 01<' PENNSYLVANIA
TllA\SF!<:i\ I\HEI\[TA:>CE TAX
SCHEDULE ue"
TRAN~FEnS
~. . ~t.. t\
~
RESIDE\T m:C!<:I1E'iT
(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)
(2) Did decedent, wi thin two years of death, transfer properLY from himself to himself and another or
ot.hers (including a spouse) in joint ownership? (Answer yes or no)
(:l) If the answer to (1) or (2) above is in the af'f'irmative state:
(a) Age of' decedent at time of transfer
(b) State of decedent IS heal th at time of making the transf'er. (Note 1).
(c) 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 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)
(b) What was the transferee's age at time of decedent's death?
(5) Did decedent in his lifetime make any transf'er without receiving a valuable and adequate consideration
therefor lmder which transf'eror expressly or impliedly reserves for his life or any period which does
not in filet end before his death:
(a) The possession or enjoyment of or the right to income :from thf' property transferred?
(Answer yes or no)
(b) The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no)
(0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in d.ecedent
alone or others
(7) Did decedent in his lif'etime make a transfer, the consideration for which was transferee's promise to
pay income to or for the bene:fi t of care of transf'eror? (Answer yes or no)
(8) Did decedent, at any time, transf'er property, the beneficial enjoyment of' which was subject to change,
because o:f a reservecJ power to alter, amend, or revoke, or which conld revert to flecedent under terms
of transfer or by operation of' law? (Answer yes or no)
(9) If the anSwer to (8) above is in the af'firmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as
well as a copy of the death certU'icate.
NOTE 2: If' answer to any of' the above questions is yes, set :forth below a description of' the property
transf'erred, it's f'air market value at date of' death, dates of' transf'ers and to whom tr~nsf'erred, with
relationship of' transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans-
f'ers are claimed to be non-taxable, also submit detailed statement of f'acts 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
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
See jointly owned property - Schedule E
1'.1
............_X-
"
Insert this total opposite "Transf'ers", Schedule "C" in the
"As Reported" column on the last page of' this return.
RCC-37 (12-63)
COMMONWEALTH OF PENriSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE 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 ESTATE
wise, in estate) forth this fact.) OR NO BIRTH
Sarah Stiles spouse yes of age Property owned
18 Richard Road jointly with spouse
Mechanicsburrr Pa. 17055
"'" ~_ T "'~M' ,,~~ ~-F ~~= iointlv owned
350 North Second Street
Wormleysburg, Pa. 17043
,
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
~ -
o .
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'2 ~~ E
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~ " 0
~E~
f:! 0:
SUMMARY
(Sch. "A")
..(Sch. "B")
(Sch. "C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
$
$
$
$
$
$
(2)
(As Determined)
$
$
$
$
$
$
l-- '"
Z ~
~ W ~
oj ~ ..l
<l> - ~
>-< --. ~ <
W ~ 'Il
'Il 00 '" -
- Q) lJ\ <
-<: " Ill:
>G ~ "" ~ '2 ...
... 0 ..-1 ::$ '0 " ...
... .j.l .Q s:: ..::
OJ -<: OJ Ul 00 rrJ c>. <(
:I: :I: W 0 ...... ~
... W ... l-- a Q
~ :I: .. -<: . -.-I ~ Z
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Z l-- CFJ rrJ ~ ... <(
~ W 00 ,.<1 ~ ,.
0
~ 0 Q) 0 ::$ Ill:
...... Q) U ~ 0
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0 >G ..-1 :0: ...
:c W :0: ;; '"
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.I: 0 "
~ ::: ~ i::. 0
'2 0 2
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-=="'0 " 0 0
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RCC-3B
RESIDENT DECEDENT
SCHEDULE "1'."
JOINTL Y OWNED PROPERTY
*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This scherlule must disclose all property, real and personal, owned by the rlecedent jointly
with 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 Imder Schedule
"A", plus the date and place of record of' instrument effecting vesti ture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "8", plus date of acquisition, and the name, address and relationship (if any) of' co-owners to
the decelient.
Description of' Property, Date of' Acquisition, Name
Address and Relationship of Co-Owners, and Place
of' Record of Instrument, where Real Estate.
% %~)O< % X ><;X~ X:8:8:Q<::)O< ><;XX
0<: ><;X )0< <:X:: ><;X )0< )0< X :Q<:: )0< )0< )0< X
unit percentage
Value Share
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
)O<:><~)O<:x
:x
y~~
1.
Certificate of Deposit No. 16-1604
dated April 4, 1976, issued by
First Federal Savings and Loan
Association in the names of Miles
Stiles, the decedent, and Ellen L.
Dimov, 350 North Second Street,
Worm1eysburg, Pa. 17043. The name
of decedent was removed June 3,
1976. See letter attached.
N/A
III "
I If!}-n.c..-/
2. The following accounts were held
jointly by decedent and Sarah E.
Stiles, his wife, with Dauphin
Deposit Bank and Trust Company:
(1) cheCking account No. 313-0083-
82-01638 opened prior to 2-16-
67 (see cancelled check attach d)
Balance 12-16-77 - $10,269.75
(2) Savings Account No. 12-6-0086-
Opened May 26, 1976, by transf r
of funds from Joint account No
313-0a83-82-01638, Balance 12-
16-77 $10,703.48. Accrued into
$114.43
(3) Certificate of Deposit No.
8292 issued 7-6-76 was renewal
of prior joint certificate No.
8452 issued 1-3-74. Balance
12-16-77 $5,600.00 accrued
interest $60.75.
(4) Certificate of Deposit No.
12201 issued June 7, 1976, wit
joint funds. Balance 12-16-77
$1,000.00 accrued interest $1. 1
See letter attached
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" column on the last page of this return.
-L-~
~lbEB~
Savings & Loan Association
of Harrisburg
February 14, 1978
Hobert L. ~lyers Jr.
r'1yers, Myers t r'lowers, & Johnson
P. o. Box1;~5
Lemoyne, l'a. 170113
He: Estate of Miles Stiles
Dedr I'Jr. ~lyers:
In reply to your letter of February 8, I am forwarding the following
information concerninr, the above named decedent.
A certificate #16-160119 was issued on April 14, 1976 in the names of
~iiles Stiles or El1en L. Dimov, but the name of Miles Stiles was re-
moved on ,Tune 3, 1976.
If we can be of further service, please cOlltact us.
Very truly your~"';A'~
--6d~ X. _ r"""'~~r
Barbara L. Knisley
Savings Department
234 NORTH SECOND STREET. P. O. BOX 1111 . HARRISBURG, PA 17108 . (717) 232-8861
_-m
, , ". ,.,,,. ,~..~ .-
,.
lD
Dauphin Deposit Bank
and Trust Company
MAIN OFFICE 213 MARKET STREET, HARRISBURG, PENNSYLVANIA 17105
717/255- 2121
Member Feder/JI Deposit InsuMnc8 Corporl:ltion
March 7,1978
Myers, Myers, flower and Johnson
Third end Market Streets
P.O. Box 125
Lemoyne, Pennsylvania Re:
Attn: Robert L. Myers, Jr.
Milea G. Stiles
December 16,1977
Dear Mr. Myers:
In regards to the above mentioned, we submit the following
information as of the date of death:
Checking account balance
Opening date
Ssvings account balance
Interest
Date opened
Certificeta of Deposit
Interest
Date opaned
Certificate of deposit
Interest
Date opened
110,269.75
Not available
110,703.98
1114.43
May 26,1976
11,000.00
11.81
Juna 9,1976
15,600.00
160.75
July 6,1976
The above accounta were held in the nemes Miles G. or Sarah Stilas.
If we can be of further sssistancs, please do not hesitate to
contact us.
Very truly yours,
CJJ-~A!..J:~ t~~
Donald E. Cromwell
Assistant Vice President
DEC/pmf
. $ ':0 :i ~ :i"'Ooa ;1:
I'
"",
:',',',- """ ," ..'
',"'~.;.Ji'...eeO 00 l"E, 5'0,"
,..'.'"
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*'
Rce-al (6-73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
Inherifance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Sarah Stiles
18 Richsrd Road
Mechanicsburg, Pa. 17055
(Executor or Adm ini strator)
In Re: Estate of
Miles G. Stiles
Cumberlnnd
County - Fi Ie No. 21-78-0140
Dear Mrs. Stiles:
You are hereby notified that the original
oppraisement in the estate of Miles G. Stiles
has been filed in the office of the Register of Wills of Cumberland
County on May 4 , 19~, Said appraisement reflects the following
valuations:
Real Estate None
Personal Property None
Transfers None
Jointly Owned None
Toto I None
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 object 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.
~-
--
Si gned
k.
~/~-..
Date May 4, 1978
Title
Chief Appraiser
Nate: This is not a bill.
R C C-2 (2-1541
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLL ECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
Hay 4, 1978
COUNTY
Cumberland
FILE NO.
21-78-0140
Whereas,
Hiles G. Stiles
late of Hampden Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 16th day of December 19~, seized and pos.sessed 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 conscionahle 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 Qr enjoyment tQ collateral heirs of the decedent after
the expiration Qt 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 Appraisement
Delerlptlon 0' Ane\ V.I\le5 M9,de ,,, Inheritance
Tu Purpo,e5
REAL ESTATE r~NE $ NONE
-- 1---------- --
PERSONAL PROPERTY NONE t~NE
e-- -
JOINT-HELD PROPERTY NONE NONE
TRANSFERS NONE tXlNE
-- ----- e- --- f-
TOTAL EST ATE NONE I'iJNE
-------- --
--~- e------- ----
...- 1---
-- --
- ---
-- -- ------- !---
-_.~~--- ---- ---
-
- -
-
Having been duly sworn according to law, I do hereby certify that the above appraisement is
formity with law on this 4th day of May "
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made in7Son-
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,
Appraiser
(l'C\Jmber and StUet)
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