HomeMy WebLinkAbout12-14-78
oRce-33 (',73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
RESIDENT DECEDENT
COUNTY OF
CUMBERIAND
IMPORTANT,
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 sranted
by the Secretary of Rev:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Late of
Cwnberland
} AFFIDAVIT OF
EXECUTOR
~
County
ANNTE M r.nNr: "lkh ANNA M T.nNr:
(STATE FULL NAME OF DECEDENT)
State of
Pennsylvania
J os,
County of
X<ilflli~~IIrX
DAVID E. LONG
of the utate of the above-named decedent being duly .warn, depo.. 8
Execut.or
and say8
Decedent died
30
. 19~{te.tate leaving a la.t will, copy of which i. hereto attached.}
(y EAR) ~*,:x.x
.T;:!nl1;:!l'"'Y
(MONTH)
Name and address of attorney or }
other authorized representative 10 whom
all corre.,pondence should be moiled.
(DAY)
SNE LilA KER, McCA LEIl '" E LTCKER
~~ West Main Street. Mechanicsburg. Pennsylvania 17055
That as such F.YP(,>I1Tnl'"' deponent is familiar with the affairs of said estate and the property constituting
I 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 DF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A S.~FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
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 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 aU
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
r9~$tple 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 1J,usiness.
A copy of"the co-partnership agreement, (if oral, a statement setting forth the nature of the 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 mllst be submitted. It should also set forth in itemized f'orm, together with \h~ 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 f'orth 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 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 copy
of' the deed, trust agreement or other instrument creating the trust. TheN~ is also set f'orth in said
schedule a list of all property, real and personal, with its value, which pa!,:ses at decerlent'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 the.ir death, their issue, and the relationship of such issue to the beneficiary.
That Sc~edule 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 "estiture 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 Sc~edule 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 ~tdiciary'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 unpairl 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.
;41
.....//............
:/+#'
(dlif14.u.Ub
day of .,cJ!eC..I24zrARA.! ....
.;f:~<c",<<nY'
... 19...:1..f.
........~gr~............._...
. ..R.,P,J.,,,.!JQ?<o..J).'+.::.lJ.... ......"..........
(Street Number)
...N",,,,PQ.:r:::tL .!:''''IlIl'3.y:J,.Y;;!J:l:i;;!..J.ZQZ.4:...
(City OT Town and St4te)
Subscribed and sworn to before me this
.." f" ? : I ,~\
NOTE: Be~ore signing affidavit make sure all blank spaces in the arfidavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare ami unlisted securities,
securities of close or f'amily corporations or an interest in any co-partnership or business, that the
elata and statements required ~mder the paragraph above relating to Schedule "B" are attachert. Also make
certain that column #1' in the "Sllrrnnary" has been properly completed as above-directed.
RC C~.34 (4_' 3) l
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITA"'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 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 os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property loeated In the Commonwealth of Pennsylvania should be
described by lot and black 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~
cras; 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 uF" and must not h. deducted from this schedule.
(1)
(2)
(3)
DE:PARTMENT
VA LUA TION
CAUTION
(Do not write
in this spoce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMA TED
MARKET VALUE
1.
ALL that certain lot or piece of land situa
in Hampden Township, Cumberland County,
Pennsylvania, having thereon erected a dwel
house known and numbered as 22 Kevin Road,
more particularly described in Cumberland
County Deed Book "0", Volume 23, Page 677.
Sale Price
ed
ing
*/#<l/f" I>fl"..r.4€L
?Pt..o
_7!
J!J~7~
V
$46,500.00;:.-
LIt, 5DO.OO
I
Insert this total opposite "real prope",", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
$46,500.00
~(p 5DO.00
I
,
~ l "..1~o ~)f
C/I'(:;; //~(t). //--;/"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
HARRISBURG
, ~'("'L:' (, ,
:, tI ~I '" r. I~.' t. .,:'/'
, i. ....). , .)
I ",
C I, rlOIY
ClAMP IIJJ.L 0""'"
........., 3, 19ft 9 3 58 f3ftf '78
RCC-43 (5-65)
NOTE: TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue
Bureau of County Collections
26 S. 4th Street
Harrisburg, Pennsylvania
Dear Sir:
,,(/ - '1 f' - iJl 'I 'f
Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith submit the fallowing report:
NAME OF REPORTING
FINANCIAL INSTITUTION
ADDRESS
ACCOUNT NO, OF JOINT,
TRUST OR INVESTMENT DEPOSIT
NAMES ON ACCOUNT
OR INVESTMENT
JInpbla D1tpoeU BeDIt 1& tne\ CoIllflal9
)045 Ha:rket st.. Cup BUl. P e. 1'7OU
14 , 0472-1
-- No l.oItc
DECEASED JOINT DEPOSITOR,
TRUSTEE OR INVESTOR
AnhaM.Loac
DA TE OF DEATH
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR
aa lem 1loacl. ..-~i........ fa. 1'70"
1-30-78
ADDRESS
Uftlr--rua
ADDRESS
RELATIONSHIP TO DECEDENT -
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED .-. 1, 1,."
BALANCE, INCLUDING INTEREST, 76) "
DUE, AT DATE OF DEATH $ ..
~~~~,"nM
RCC-35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
A~~
'~
RESIll";;T DECEDENT
SCHEDUI",E "B"
PERSONAL PROPERTY
Item
No.
1.
2 .
3 .
4.
5.
6
7.
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 listed under Schedule "En. 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 acconnts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed f'irst (e.g. jewelry, wearing apparel, household
goods, and rurnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank,
stocks, mortgag~s, notes, together with accrued interest or diVidends, salaries or wages, insurance pay-
able to the estate or f'iduciary 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
List and describe fUlly
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do no t wri te in
this space)
Checking Account No. 56-15-9617, Dauphin
Deposit Bank and Trust Company, Balance on
Date of Death $
Savings Account No. 14604728, Dauphin Deposit
Bank and Trust Company, Balance on Date of
Death
Accrued interes.
(2) $25.00 United States Savings Bonds, Serie1
"E", registered to Roy S. Long (predeceased
spouse) or Anna M. Long (decedent herein)
lll.68 ",/
\ 1\. \,p'&
..
3,748.34.....y
15.61.....
31"'\"i!.~1j-
I
IS. t. \
ISSUE DATE SERIAL NUMBER DATE OF DEATH VA UE
May 1954 Ql159636064E $ 50.38 ~
June 1954 Ql165911753E 49.04~
TOTAL
(1) $25.00 United States Savings Bond, Series
"E" registered to Roy S. Long (predeceased
spouse) payable on death to Anna M. Long
(decedent herein)
99.42...l---.
q~.~~
ISSUE DATE SERIAL NUMBER DATE OF DEATH VA DE
Jan 1966 Q2161658782E $ 34.47 ~
$750.00 Life paid-up at age 65 Policy, No.
M49819422, Prudential Life Insurance Company,
payable to The Estate of Annie M. Long, Decea1ed,
proceeds of $1,371.01 payable in one sum
Property tax rebate: Commonwealth of Pennsylv,jnia
Net proceeds from public sale of household
contents
34. 47"'" v
3'-\.'-\1
1,371.01.....1-- l,a1\.OI
200.00 ......v. ~O.OO
1,198.50.....1....- \) \"\~. 50
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
/p 'B 5'=\.03
,
$ 6,839.03
RCC-3S
t'tlMM(l\\lVl-~;\T,TII (IF })l':-;\Sl'j,V,'.NIJ\
THA\~F:<:ll t:\I:F!\ITi\\CI" TAX
SClwnUL1<; lTC"
1'1\ \'~I,'I<:IlS
~J~~, ~
:icc~",;','j '"
Ii ,'),'"1,,, (\
'" '.,.i_.:J:,;,."
i_:i..J~<",,~,~?j
:<:'~<":u:.7;t-:
i\ESlIlE\T m:n:lllyr
(1) Dirl di>cedpl1t, within two years of de at 11, makf> any transfer of' {in,\" material part of' his pstutr', WiUIOllt
rec,dving 11 valuable IlEd adeqUllte eonsiderntion theref'or? (iinswer yes or no)--R~_
(2) Did decedent, wi thin 1wo yenrs or deaLh, iranst'er l'rol'eny 1'rom himselt' to himself' and noother or
others (inc1lJ1l"in!{ II spousp) in joint ownership? (Ans.....er yes or I1o)----.N~
(~l) If' the iU1swer to (1) or (::!) abovp is in the aff"irmatlve state:
(a) Af~e 01' fiecedent at timp of' trant;f'er
(b) State or decedent's health lit time of' makin;:!; the trllnsff~r. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in I"ds lifetime, make any transfer of property without reeeiving Ii va.Jwlblc or fulequate
consideraLion theref'or which was to take ef'feet in posseSSion or enJoyment at or af'ter his death?
(Answer yes or no) 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 tr'[insferee's age at time of' decedent's rieath?
(5) Did decedent in ht5 lif'etime make any transfer without receiving a valuable and adequate consideration
theref'or under' which transferor expressly or impliedly reserves for his life or any period which does
not in fact end heC'ore his death:
(<1) The Jlossession or en,joyment of or the right to income f'rom the property transferred?
(Answer yes or no) No
(b) Ttw right to designate the persons who shall possess or enjoy the property t..,illsf'erred or
irlCome therefrom? (Answer yes or no) No
(0) If' the answer to (5) (h) above is in the affirmative, state whether the right was reserved in Iteeedent
alone or others
(7) Did decedent in his lif'etime make a transfer, the consideration for which was transferee's promise to
pay income t.o or ror the lJenef'i t of' care of' transf'eror? (Answer yes oz' no) NQ
(8) Did rlecedent, at any time, transf'er property, the benefieial enjoyment of which was subject to change,
because of' ,-l reserved power to alter, amend, or revoke, or which cOlJ]d rI~vert to (jpcf'dent under terms
of transfer or by operation of' law? (Answer .yes or no) No
(9) If the answer to (H) aLove is in the af'firmative, wns the power to al ter, l1memi, or revoke the inter-
est 01 the lJerwfieil1ry reserved in the decerlent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The anSwers to these questions should be supporteo by af'fldavit fly the attending physician as
wf!ll as a copy of the death certificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of' the property
transf'erred, it's fair market value at date of' death, dates of trlclnsfers anrl to whom trrwsferrw:l, with
rell1tionship of transferees to decerlent, 11' any. Submit copy of' any trust deed or instrument, if' trans-
fers are claimed to be non-taxable, also submit rletrdled statement of facts on whieh SOld claim is based.
NOTE 3: List appl icable pt'operty below in manner in which provided in Schedulps A, il, or E.
ITEM
iJ]<;SCHIPTION
l'\lARlmT VAI,UE
(Estimated)
OE.PT. VAI,lJATIO~
(Dept. Only)
NONE
N.'DrJL,
Insert Uds tot,:d opposite "Transfers", Schedule "C" in the
"As Reported" c(lll..HlII1 on the last. p:tge of this return.
\\1 0 fie..
RCe-37 (~l2-63)
Cml~1()~\\.L\LTII OF PE7':;'>;,YYI .\NJA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE 'TY'
BE:'\EFlCIAHIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP ~
(If step-children or I SURVIVED DATE INTEREST OF
State full names and addresses of all who .11 T t hId I DECEDENT OF BENEFICIARY
1 egl lma eel ren ST.' EYE'
ave an interest, vested. contingent or other are involved. set A r s llIRTH IN ESTATE
wise, in estate) forth this fact.) I OR NO
David E. Long Son Yes One-third (1/3) of
1> n 1 I>~v '''''_I> "esidue
p~
I\nnp C:il,,~ DRI1O'hter Yes One third (1/3) of
8 Clover Lane n~~~ "..~
M~~l..m' p~
nphY'~ Vo,,= T.~n~ DallO'hter Yes One-third (1/3) of
5 <., r';Y'r>lp "es.;rIne
- Camn Hill Pa.
I
,
,
\
h
Deponent further says that all the above-named benef'iciaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
s
- -
,g:.<,'I:'
<I). C
"c: ~ E
"s Cj ~
"Oo..c>
" u
~ ~,
:::: ti~
- ~
:;t;t
u ~ 0
~ E c..
~ ~
Heal Property
Personal Property
Transfers
SUMMARY
(Sch. "A")
. (Sch. "B")
(Sch. "C")
(1 )
(As Heported)
( 2)
(A'i Dl'ti'f!lliIH'c!)
Gross Taxable Estate
$
$
$
$
$
$
$
$
$
$
$
$
\
'\
'"" '"
~ Z "
[iJ ~
'" ~ ..l
~ ~
:>< ..-. u ...:
[iJ " tIJ
en Q -
- ...:
~ '" Ill:
<=<: '" '" ""
'" 0 " ""
'" 1:
w <1'. w ...:
:I: :I: [iJ c..
... [iJ ... f-< ~ Q
C ~ - "' ~ ;:; Z
- 0 f-<
% f-< en '" -I.
'" [iJ - I-
~ 0 0 Ill:
" 0:: 0
0 ""
:c "" ~ ""
" f-< - ~ Ill:
~ f-< 0
~ c
v".. ..r. '0 .c. 0
~ .... ~ ~ ~
0
;.- .:;: -l U (j
....
RCC-38
RESIDENT DECEDENT
SCHEDULE" En
JOINTLY OWNED PROPERTY
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
I:"ISTRlJCTIONS: This scheclule must disclose all property, real and personal, ownerl by the decedent jointly
With anuther or otllers, including intangibles, standing in the name of' the decedent and others. List
real est.at.e first, as entireties, or joint tenants, giving hrief description, as indicated tUHler Schedule
"A", plus the date and place of record of instrument ef'fecting 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' acquisi tion, and the name, address and relationship (ir any) of CO-OWners to
the deceden t.
2
>
'.// <X> 0/ ::x:x: :xx 'VV v. Y:X ^'~, v.
y :>0< /V :xx J( ^,x> x.x> '^^
X> J( X> o<:x :x '^^- '^^- q X>
Description of' Property, Date of' Acquisition, Name
Address and Relationship of Co-Owners, and Place
of' Record of' Instrument, where Real Estate.
V. ex
v.
X>~:x
X> XX
. .
Unit percentage Estate DEPARTllENT VALUATION
Value Share Valuation CAUTION-Do not Write
In This SpR.ce.
9SP :>o<~:x <X> X> Value of Value of
X> e: Entire Deceden tis
"^S :x ::X:X::x property Interest
NONE
NONE
Non.L
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" column on the lust page of' this return.
Ntll'lQ..
. .
*'
REV-518 (8-78)
COMMONWEAL TH 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
David E. Long
RD 1, Box 134-B
N~~nrr, PA 1707fi
(Executor or Administrator)
In Re: Estate of
Ann; p M T.nng
Cumberland
County - Fi Ie No. 21-78-0087
Deor
You are hereby notified that the Original
appraisement in the estate of Annie M. Long
has been filed in the office of the Register of Wills of Cumberland
County on ?R l<'"hrn~ry , 19---19., Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
$4h,~OO.OO
6,839.03
None
None
$53.339.03
As to such tax that is paid within three months from dote 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 rote 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 os provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485.1001, P. L. 37-3.
Dote
28 February 1979
Si gned
Title Administrative Office:r_...___
~-
--------.
"
-----..
Note: This is not 0 bill.
COUNTY
28 February
Cumberland
1979
REV-lt-57 ~8-"8)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATe:.
FILE NO. -2l.=111-00117
Whereas, Anni II=> M T nng late of li' "PonnQh.....rn
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 27th day of August 19.1.1-, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, T.po FlIl llini 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
rate on any such future interest.
DESCRIPTION OF ASSET UNIT Appraisement
VALUES Made for Inheritance
Tax Purposes
Real Estate $ I.< enn on
~ -, ~ QOO 01
'T'r~T1~f,pr~
Joint1" Owned None
"'~~-, I ~51 319 01
I
Have been duly sworn according to law, 1 do hereby cerpfy that th~~.above apppaiseme\lt js made in conformity
with the law on this ~8tR day of F'eb1;tjl"'Y. , j, . . . 19 ~.
Appraiser
(Number and Street)
HarrisburQ:
{Post Office}
. Penna.
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