HomeMy WebLinkAbout06-22-78
RCC~33 (4~73)
..
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
RESIDENT DECEDENT
COUNTY OF
Cumberland
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
Margaret M. Suver
(STATE FULL NAME OF DECEDENT)
} AFFIDAVIT OF
EXECUTOR
~
County
La'. of Cumberland
S'a'. of Pennsylvania
Cauntyof Cumberland
} ..,
Administrator
Richard L. Foose, Sr.
of the estate of the above-named decedent being duly sworn, depose
Execut.or
and soy
Decedent died
Feb. 28,
(MONTH)
Nome ond address of attorney or }
other outhorized representative to whom
011 correspondence should be moiled.
(DAY)
, 19~{te.tote leaving 0 lo.t will, copy of which I. hereto atklched.,}
(Y EARl .Dt1XiXAliOC
J. Robert Stauffer-Market Square Bldg., Mechanicsburg,
Penna. 17055
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
(EX ECUTO R-ADMINI ST RA TOR)
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
The Commonwealth Nati"nal BAnk Mo~~n~et M - Suver
Main ann Marke t S~
.. ~, n. , '7n~~
That the contents of said safe deposit box or boxes are itemized under Schedules A&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 pos session, 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 hanks, 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 securities owned 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 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 t~ere is annexed to
said schedule, f'inancial statements showing the assets and liabilities of said co-partnershlp or business.
A copy of' the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together with a statement setUng 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 f'orth in itemized f'orm, together with the -rail" 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 ef'f'ect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of' such propert:r, to whom transferred, the
relationship of' the transferees to the decedent, the proportionate, shart; received.by each transferee and
all other facts of' H. pertinent nature regarding said transfers. In the case of transfers intended to
take ef'f'ect in pc.ssessjon 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. Therl~ is ~lso ~et 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 exercis-e.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 t<1 the schedule.
That Schedule 0 attached hereto and made part hereof sets forth the names and addresses of all
persons benef'iciall y 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
decedenes 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, i r any, died prior
to decedent, tile dates of' their death, their issue, and the relationship of such issue to the benef'iciary.
That S~hedule 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 dafe and place of record of instrwnents ef'fecting the vesti ture of
real estlite and the date of' acquisition of personalty, plus the name, address anrt 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 unpaio. 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 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, rold that
the amount of' tax assessed can be reassessed in accordance therewith.
That the totals of the ap-proprlate columns in Schedules "A", "B", "e", "E", and "F" as directed therein,
have been carried forward and properly reglstered in the Summary.
......~
day of /~..
J'A!'['~",.r",.?
.. 197.8.
......J2d~L..LL~..J...Lk....::
(E:recut01'-~
. ...2.16....Wes.t.....Mar.b.1e....St.. ................................_.......
(Street ~utnber)
.J'1e.ch.anic.s.bur.g.....Penna.. ..170.5.5
(City M' Tow" a.nd State)
Subscribed and sworn to before me this
.Y~
'0
-",:' 11, IT1.Jl'
. ~,'__. ~"".;_. ,:_,d'~ CJLC:!Y
NOTE: Before signing af'fidavi t make sure all blank spaces in the af'fidavit and schedules annexed are
f'illed in with details or the worrl "None", and in case the assets include rare and lmlisted securities,
securities of close or famtIy corporatIons or an interest in any co-partnership or business, that the
data ano. statements reqlli red under the paragraph above relating to Schedule "B" are attached. Also make
certain that colunm #1 in the "Su:rmnary" has been properly completed as above-directed.
RCC..34 (4-73)
COMMONWEAL TH 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 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 surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property located In the Commol1wealth of Pennsylvania .hould be
ducrlbed by lot and block number, .treet and .treet 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 stat. number of a~
cres; also statement of mortgage encumbrance. upon each parcel at death
of decedent. Taxe., as.e..ment., accrued Inter..t on mortgages, etc.,ar.
to be lI.ted on Schedule "F" and must not b. deducted from thl. sched",I..
(1)
(2)
(3)
DEPARTMENT
V ALUA TION
CAUTION
(Do not writ.
In this spac.)
ASSESSEO VALUE
FOR YEAR OF
DECEDENT'S
OEATN
ESTIMA TEO
MARKET VALUE
ALL THOSE two certain adjacent Lots of Groun
situate in the Borough of Mechanicsburg, Cou ty
of Cumberland and State of Pennsylvania,
designated and known as Lots numbered 13 and
14, in a certain Plan of Lots made by the
American Realty Company, which is duly recor ed in
the Office of the Recorder of Deeds of Cumbe land
County Pennsylvania, in Plan Book No.1,
page 45, bounded and described as follows:
BEGINNING on said East Keller Street at the
corner of Lot No. 12 on said Plan; thence al ng
Keller Street Eastward, 68.0 feet to the
corner of Race Street; thence along said
Race Street Northward, 129.0 feet to a
public alley; thence along said alley
Westward, 60.55 feet to Lot No. 12 as shown
on said Plan; thence along said Lot no. 12
Southward, 128.8 feet to the place of
BEGINNING. HAVING thereon erected a
single family dwelling house numbered
123 East Keller Street, Mechanicsburg, Pa. 4010.00 v'
Appraised by Ray E. Hutter, Inc., real
estate brokers of 41 West Main St.,
Mechanicsburg, Pa. as having a current
market value of $28,000.00
v
28000.00" 28,000.00
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.
28000.00
$28,000.00
-
RCC -1'5 .
. COMMONWEALTH OF PENNSYLVANIA
TRfu~SFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
.
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 11fsted under Schedule liE". 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 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 riduciary in said capacity, partnership interests, interest in anyundistributed
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.
1
2
3
4
.5
6
7
ITEM
List and describe fUlly
Proceeds from public sale of household
furnishings sold at Haar's Auction,
Dillsburg, Pa. (Sale Sheets submitted
herewith)
Cash located in decedent's safe deposit
Box at Commonwealth National Bank,
Mechanicsburg, Pennsylvania office.
Proceeds from Life Insurance Policy No.
2382038 with The Baltimore Life Insurance
Company, insuring life of decedent.
Proceeds of Savings Account No. 503-074-
7 with The First Bank and Trust Company
of Mechanicsburg, Pa.
Balance as of 2/28/78
Accrued interest to 2/28/78
Proceeds of Savings Account No. 14-0003.551-.5
with The Commonwealth National Bank.
Balance as of 2/28/78
Accrued interest to 2/28/78
Proceeds from sale of Refrigerator and
Gas stove located in decedent's residence
at the time of her death and not included
in public sale noted under item "1"
above, sold to Brady Fultz.
Seven (7) $25.00 u. S. Savings Bonds,
Series E, registered in the names of
Walter Suver or Mrs. Margaret Suver.
Walter Suver, husband of Margaret Suver
predeceased her, having died on December
10, 1977.
Q169535510E dated April 1943
Q246940630E dated August 1943
Q344962309E dated January 1944
Q435365656E dated June 1944
Q501105458E dated November 1944
Q.592412640E dated April 194.5
Q698273526E dated August 1945
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
UNIT ESTIMATED
VALUE MARKEr VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
3008.05 - -
, 1500.00'/
I
107.35 V ~
I
230.54.93 '" /
I 172.91" ./
20924.27 v'
106.88 y
3,008.05
1,500.00
107.35
23,054.93
172.9l
20,924.27
106.88
12.5.00....
125.00
68.64 v
69.53 '
68.39 .
67.24 ..
6.5.28
64.22 .
6.5.09 /
68.64
69.53
68.39
67.24
65.28
64.22
65.09
x X
49467.78
$49,467.78
RCC - 36
COMMO:iWEALTH OF PENNSYLVANIA
TRA:iSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFET\S
*A",
t'.
: '
RESIDENT DECEDENT
(1) Did decedent, within two years of death, make any tra.nsf'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, transfer property from 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 at'firmative state:
(a) Age of decedent at time of transf'er NnnA
(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 lif'etime, 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)~CL----
(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? NnnA
(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 before his death:
(a) The possession or enjo~ent of or the right to income from thE.' property transferred?
(Answer yes or no) ~O
(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 None
(7) Did decedent in his lifetime make a transfer, the consideration for which wa~... transferee's promise to
pay income to or for the benefit of care of transferor? (Answer yes or no) .NO
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserved power to al ter, amend, or revoke, or which COllld revert to decedent under terms
of transfer or by operation or law? (Answer yes or no) Nn
(9) Ir the answer to (8) above is in the arfirmative, was the power to a1 ter, amend, or revoke the inter-
est or the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no) No
NOTE 1: The answers to these questions should be supported by arfidavit by the attending physician as
well as a copy of the death cel"'tificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferred, it's rair market value at date of death, dates or transfers and to whom transf'erred, 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 racts on which said claim 1s based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPT ION
MARKET VALUE
(E. tlma ted)
DEPT. VALUATION
(Dept. Only)
None
None
None
Insert this total opposite "Transrers", Schedule "C" in the
"As Reported" colwrm on the last page or this return.
None
None
~
RCC-37 . (12-63)
('(1MMOilnh:AI.TIl OF PE:-;r-;SYYL\NIA
TRANSFER l1>IlERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BE!\EFICIARIES
BENEFICIARIES AND ADDRESSES
\State full names and addresses of all who
have an interest, vested, contingent or other.
wise, in estate)
RELATIONSHIP
(If step~children or
illegitimate children
are involved, set
forth this fact.)
SURVIVED
DECEDENT
STATE YES
OR NO
DATE
OF
B Ilrm
INTEREST OF
BENEFICIARY
IN ESTATE
Brady Fultz and Mar aret
Fultz, his wire.
200 East Simpson St.
Meohanicsbur Penna.
None
Deceden'e e
estate consisistin
of a house and lot of
Ground known s 2
East Keller St.,
Mechanicebur Pa.
"
Ne hew
Niece
Yes
Val
Entire
Estate
Hesiduar
Richard L. Foose, Sr.
Miriam A. Foose
216 West Marble St.
and
I
- - ----,---
Mechaniosburl<. Pa. 1700:::0::: -.- -j -.--
------- I I I . ....-----
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,
Deponent further says thtlt u] 1 tile above-named benef'iciaries are livin,!.!; at this time except below:
. i
NAME DATE OF DEATH RESIDENCE
-'.-
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o .
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1ii:: =
"2 Cl) E
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~ 8 :0
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u " 0
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SUMMARY
....(Sch. "A")
. ...(Sch. "B")
. (Sch, "C")
Real Property
Personal Property
Transfers
J.o.intlyOwnedProperty(SQh. US"}
Gross Taxable Estate
(1 )
(As Reported)
$. 28000..00
$ ..... 4946.7.18
$0.00
$ .0.00
$..
$ ..77467.78
(2)
(As Determined)
$
$
$
$
$
$
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. RCC-38
. .
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "E"
JOINTLY OWNED PROPERTY
RESIDENT DECEDENT
INSTRUCTIONS: This sched.ule must disclose all property, real ana persona), ownerl by the rlecerlent ,jointly
with another or others, including intangibles, standing in the name of' the decedent and others. List
rl:;'a1 estate first. 11S entireties, or joint tenants, giving brief description, as indicated tmder Schedule
"A", plus the date and place of record of' instrrnnent effecting vestitllre, but do not include entireties
or out of state real estate value in estate va.luation column. Personal property should be listed as in
Schedul e "B", plus rla te of acquisi tion, and the name, address and relationship (i f any) of co-owners to
the decedent.
Description of Property, Date of Acquisition, Name
Address and Relationship or Co-Owners, and Place
or Record of Instrwnent, where Real Estate.
~::9' >0>' ~ XX Xx Xx ~ 8& ./v X-
X! QQ ;XX >0>' %:; <X' ~ >0<; ?<'X' ~ %
None
unit
Value
Estate
Valuation
pe rcen tage
Share
~~
:XXx ;0
>Q >0<;0<) ~ ~;oQ ~
None
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" column on the last page of' this return. Nane
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value or
~ntire
propert;y
None
Value of
Deceden tIs
Interest
None
RCC-81 (6MB)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLt::ASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Richard L. Foose, Sr.
216 West Marble Stre~t
Mechanicsburg, FA 17055
(Executor or Administrator)
In Re: Estate of
Margaret M. Suver
Cumberland
County - Fi Ie No.
21-78-0141
Dear Mr. Foose:
You are hereby notified that the Original
appraisement in the estate of Margaret M. Suver
has been filed in the office of the Register of Wills of Cumberland
County on June 22 , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
28,000.00
49,467.78
None
None
$77,467.78
As to such tax that is paid within three months from dote of death, 0 five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(Ii fteen months when death occurred from December 22, 1965 to June 16, 1971, i nc I usi ve;
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\
J 9 '.( j!/ "
Dote une 22, 1 78 Si gned r. ),.tV~ .' _./'..'00_""'" <? ~,
Title.
Chief Appraiser
c ___""_"_
Note: This is not a bill.
.
RCC-2 (2~64)
. DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
June 22. 1978
Cumberland
COUNTY
FILE NO.
21-78-0141
Whereas, Margaret M. Suver late of Borough of Mechanicsburg
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 28th day of February 19 78 , 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 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.
Unit Appraisement
DelcrlpUon of Auet Values Made for Inheritance
Tax PurpOleli
Real Property $ 28.000~_
Personal Property
49.467 78
1--1
Joint-Held Property None
Transfers None
TCTAL ASSETS $77.467 78
-
Having been duly swo.rn according to law, I do hereby certify that the above appraisement
formity with law on this 22nd day of r.Ld " If". AL.,/:~e.. ..
is made in con-
19~.
ApprailJer
(N\1mber and SWet)
/1Brrisburg
(Post Oftl~)
, Penna.
~
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