HomeMy WebLinkAbout06-22-78
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
JUN 221919
COUNTY OF
CUMBERLAND
RC C-33 r4~73)
RESIDEtH DECEDENT
IMPORTANT,
Thi~ return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the
County whme decedent resided; Return is due within nine months after date of death, unless an extension is granted
hy the Secretary of Re-.tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
} AFFIDAVIT OF
1j(:j(1XWlO(1l(~
ADMINISTRATOR
I" THE MATTER OF THE ESTATE OF
AGNES B. SHIPE
("T,~TE FULL NAME OF DECEDENT)
Late of
(;JJmberli!ruL
County
Stole ,,!_ _____1'eIlJlS.Ylyani a
County of _~JlIIIher1 and
__.JQn_J____ LaFaver
) ."'
Administr::tor
of the estate of the obove-nomed decedent being duly sworn, depose S
X:J1fJl.~9'<
end soy 5
iMor,ITH)
NOI11': and oddrc~:; of r,tk,~[1ey N }
other outhO';Il"d repre'cflrOf;ve :0 whom
all correspoftdenc€ sh" "I,_~. _
(DAY)
, 19~{~~tX~)(~~XJW(~1IIs:X~~lI:ll(l.4I<"JQ(;j;~.}
(YEAR) Intestate
Jon F. LaFaver
Dl'ceJcnt dIed
Feb.
14.
317 Third St., New Cumberland, Pa. 17070
That a~ sl~ch _ _~!\~~!rlj_~tr<!..t..9~deponent is familiar with the affairs of said estate and the property constituting
,: E ':UTO R-AOMINI ST RA TO R)
the asset...; thereor ,\l1d their fair market value.
That at the timc of death there was no safc deposit box registered in decedent's individual name, or jointly with, or
as agent 01 deputy Ill' another, or in decedent's individual name, with right of access by another as agent or deputy, with the
cxception of the following:
NAME "'ND AD
IN WHICH DE'
DRESS 0 F' BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OFJOINT
CEDENT RENTED A S.~FE DEPOSI T BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
--
.---
----.
---~._-,. -
That the contcnts 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 Pcnnsylvania 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 dale of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
\\hcrc,>cver situated o\vned by the decedent at the time of death; all moneys left by the decedent at the time of
death. vt'!lCthlT in decedent's immt:diate possession, standing to decedent's credit in banks of deposit, savings
hanks, 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
~avjJ1gs, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
I.::cdcnt: all ohligations, 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;
to:: "'-'";H~ ,~!,p<,,\;L jcweilY, :-,ilvcrware, pictures, books, works of art, household furniture, horses, carriages,
automohilcs, boats, and any and all other personal chattcls 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 ~alue 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 estalt' fro111 life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds Ill' which 'V'.~~ ;1ayable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of tJ,!. dale of death, bonds and accrued interest thereon to the date of decedent's
death and other 11l"!"sl:ncnl ";~1 :~ Ct, o\vned by the decedent at the time of death, with the ,market value there-
or at such tilll~'.
In the case of secUl"ities 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, f'inancial statements showing the assets and liabilities of' said co-partnership or 'b,usiness.
A copy of the co-partnership agreement, (if oral, a statement setting f'orth the nature of tne agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the bustness as may be pertinent to a fair and just appraisal of the decedent's interest
therein mlLst be submttted. It should also set forth in itemized form, together wi th the fair market value
thereof, any other propert:r owned or bequeathed by the decedent at the time of dea.th.
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 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 ef'f'ect in possession or enjoyment at or af'ter rleath, there is also attached to the schedule a COllY
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 rleath 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 rorth the names and addresses of' all
persons beneficially interested in this estate at the time of decedentts death, the nature of their res-
pective interests, their relationship, if' any, to the decedent, together with the ages at the tlme of'
decedentts death of' all minors, annuitants and beneficiaries f'or lire unrler 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 benef'iciary.
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 ef'fecting the vestiture of
real estate and the date of acquisition of' personalty, plus the name, address and relationshlp, if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets f'orth 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 and unpaid 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
have
the totals of the appropriate columns in Scherlules "A", "B",
been carried forward and properly registered in the Summary.
vd
"e" ,
"E", and "F" as directed therein,
Subscribed and sworn to before me th'
S;Jdl~~h:~e- In ..19..??
~W,\q PUBLIC ~L::k
~ r ~ on s Sopt 20. 3 U
New CUffi~ei;: ,-. Cumberland Cu.
......._!t't)t~_______
(Executor-Administrator)
..Ihird..S.t.............................
(Street Number)
NE!\'i....~ulTI~E!T.l..Cl.n..d..pa.:,....1]9?9.
(City or Town and State)
NOTE: Before signing af'fidavit 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 raml1y corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-directed.
R~ C~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 quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as joint tenants with right of surviarship or tenancy by entireties should be reported an 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 Intere.t on mortgages, etc.,ore
to be I isted on Schedule II F" and must not b. deducted from this schedule.
(1)
(2)
(3)
aEPARTMENT
VALUATION
CAUTION
(Do not write
In tnis space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
1. Real estate situate in the Borough of New
Cumberland, Cumberland County, Pennsylvania,
being known as 304 11th Street, New Cumberland,
Pennsyl van i a (See Deed Book "Y", Vo 1 ume 11,
Page 123)
SOLD FOR
,-;~("~' ;,. ",; n .F io/l.,.~;(," 'r "\,
28,500.00.... -p,:ZI;.roo.{)()
12 ~ '
IJ 0 ,.dl.
3 Ii
"' I'
/ ~/
. ,
(,~ ,~....' ",
Insert this total opposite "real property", Schedule "A" .n the X X X X X
"As Reported" column on the last page of this return.
28,500.00
1/01-/1..:'-00,00
/
~,>.~ -?,~,
RESIDENT DECEDENT
SCHEDULE liB!!
PERSONAL PROPERTY
'*
COI~IONWEALTH 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 listed under Schedule "E". 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 rlividends, salaries or wages, insurance pay-
able to the estate or firtuciary in sairl capacity, partnership interests, interest in anyundistributed
estate of or income f'rom 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 f'ully
UNIT
VALUE
ESTHlATEIl
MARKEl' VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1. U. S.SEries "E" Bond dated Feb., 1943
in the face amount of $50 ~ No. L30711136E
3. Property Tax Rebate
141. 38 1...",,/ If/ 3.v
241.20 / :1..1-/. .2-0
/
200.00 .,/ 5tC'c, DO
2. Miscellaneous household furniture and equipment
I
I I
I
I
Inser t this total opposi te "Personal Property", Schedule "B" in
the "As Reportedll column on the last page of this return.
x X
582.58
S- 3:l, 6-8
RCC-36
COMMOll"WEALTH OF PElI"NSYLVANIA
TRAlI"SFER INHERITANCE TAX
SCHEDULE "c"
TRANSFERS
*~
RESIDElI"T DECEDENT
(1) Did decedent, within two years of death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or 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)
(3) If' the answer to (1) or (2) above 1s in the affirmative state:
(a) Age of decedent at time of transfer
(b) State of decedent' 5 heal th at time of making the transf'er. (Note 1).
(c) Cause of decedent' 5 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 enj0yment 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 lif'etime 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 f'act end before his death:
(a) The posseSSion or enjoyment of or the right to income from tht, property transf'erred?
(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)
(6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for the benefit 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 of' a reserved power to al tel', amend, or revoke, or which could revert to decedent under terms
of transf'er or by operation of law? (Answer yes or no)
(9) If the answer to (8) above is in the affirmative, was the power to al ter, 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 affidavi t by the attenrling physician as
well as a copy of the death ceJ"tificate.
NOTE 2: If answer to any of the above questions is yes, set f'orth below a d;scription of the property
transferred, it's f'air market value at date of' death, dates of transf'ers and to whom transf'erred, with
relationship of transferees to decedent, if any. Submit copy of' any trust deed or instrument, if trans-
fers are claimed to be non-taxable, also submit detailed statement of f'acts on which sajd claim is based.
NOTE 3: List applicable property below in manner in which provided in Sc:hedules A, B, or E.
ITEM
llESCRIPTION
MARKET V ALUIl
(Es tima ted)
DF.PT. VALUATION
(Dept. Only)
NONE
00.00
N tYI<.L/
Insert this total opposite "Transfers", Schedule "e" in the
"As Reported" colunm on the last page of this return.
00.00
RCC-37 (12-63)
(,O~lMONWEALTH or' PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE ''IY'
v:!<..
~~~
""II
IJ .~7jI. ,\
,~t.~: i;..r;<~:i~.i!'
BEr\EFIC!\HIES
-
BENEFICIARIES AND ADDRESSES RELATIONSHIP I SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children I DECEDI,NT OF BENEFICIARY
aye an interest, vested. contingent or otherM are involved, set STATE YLS l'I ESTATE
wise, in estate) forth this fact.) ! OR NO BIRTH
~hine I
1 nl ~ ~'hAn"ta St.
A 11 entown. Pa. 18103 . ves adult 1/5 of Residue
r
".-..
7715 Farmda1e Ayenue
I-h....ich....n Pa. 17112 Daunhter yes , adult 1/5 of Residue
Winifred Sturn
lnH; 1.lh,n"b St
A 11 entown. Pa. 18103 Dauqhter yes adult 1/5 of Residue
Th"..esA MII..nhv
8133 Murray Point Road
Baltimore, Maryland 21222 Daughter yes adult 1/5 of Residue
". Fllrh~ i
~n~ l"h'lrnt Sallarp
Baltimore Maryland 21221 Dauahter yes adult 1/5 of Residue
-
I
(
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
-
NAME DATE OF DEATH RESIDENCE
._-~
~ SUMMARY (1 ) (2)
o . (As Reported) (As Determined)
MtIl~
~-<: Real Property .. (Sch. "A") $ 28,500.00 $ 28,500.00
e;;::. ~
'2 dl E Personal Property (Sch. "B") $ ?82,58 $ 582.58
.s v":
"00.8 Transfers . (Sch. "C") $ $
-<: s.
~ e ~ Jointly-held... ..... .3.650.52
..3.....,~ $ $ ~,656.52
~ ~ ~
~ ~ 0
~ E go $ $
f'!. <>: Gross Taxable Estate $.. .32,739.10 $32,739.10
l-
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~ ~
til ~
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::::~ ..l U 0
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
HARRISBURG
I'<CC>43 14~C(li
NOTE: TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Deportment of Revenue
Bureau of County Collections
26 S. 4th Street
Harrisburg, Pennsylvania
J.;-1f-o/lft
Dear Sir:
Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith submit the following report:
NAME OF REPORTING
FINANCIAL INSTITUTION
CC~.13 p',:tnk il.A.
ADDRESS 351 llriJ,ge Street, ~[ew Cu.~.berla"d ?A 170'[0
ACCOUNT NO. OF JOINT,
TRUST OR INVESTMENT DEPOSIT Savings ACC01U:t i'OOl, ')55763..4
NAMES ON ACCOUNT
OR INVESTMENT c\i;nes 13. 8'11}>6 witll ~!ary :;. r;haft'er
DECEASED JOINT DEPOSITOR,
TRUSTEE OR INVESTOR Agnes :So Shipe
ADDRESS
AND COUNTY 304 11th Street. New Cumberlll.ud, T'A 17070 ,~oullty Cumberland
DA TE OF DEATH February ],1" 1978
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR ~~ary E. Cha.ffer
ADDRESS
enk...'1o\t!:
RELATIONSHIP TO DECEDENT
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED
BALANCE, INCLUDING INTEREST
DUE, AT DATE OF DEATH $
Unknown
June 1 'e, 1971
:3,,611).50
" ~ ,-' ....;;U/-.'-, ;' 'De;posit Operations
R. ~. ",l;~CYJ;;., /'", Coordinator
......---:;. .~:--,~"" J./'-'r--
Si gnalure ! TITLE
-----
RCC.38
RESIDENT DECEDENT
SCHEDULE "En
JOINTLY OWNED PROPERTY
CQMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
I~STRVCTIONS: This schedule must disclose all property, real anrl personal, owned by the decedent 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 under Schedule
"A", plus the date and place of record of instrument effecting vestlture, but do not include entireties
or out of state real estate value in estate valuation colunm. 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.
. .
Description of Property, Date of Acquisition, Name Unit percentage Estate DEPARTMENT VALUATION
Address and Relationship of Co-Owners, and Place Value Share Valuation CAUTION-Do not Write
of Recorct of Instrument, where Real Estate. In This Space.
)6 6< 60 ~ ~ X)y 3< X>; 6< 60 Value of' Value of'
~ 6< ~ ~ ~ 3< XX & gg hntire Decedent's
:<< 2 >9> D6 ><X
y IV :)< Property Interest
,/'
l. Savings Account No. 001 055768 4 at I
GGNB Bank, N. A. in the joint names !
of Agnes B. Shipe or Mary E. Sha ffer ! i ,
!
o ened June 18 197 ,
p , 1/
Total Balance $3,610.50 1/2 included
/'
2. Savings Account No. 001 003225 8 at
GGNB Bank, N. A. in the joint names
of Agnes B. Shipe or Winifred Sturn
opened February 28, 1964/
Total Balance $3,702.54~/2 included
, 1,805.25 /'
$1,805.25
I :
Il,85l.27.}/
$1,851. 27
Insert this total opposite ",Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last pagl'! of this return. 3,656e52
$3,656.52
-------
CCCC~[E3
MAIN OFFICE 331 BRIOGE STREET NEW CUMBERLAND PENNSYLVANIA 17070 17171 23B-OB41
CCNS BANK. N.A.
June 14, 1978
Mr. Jon LaFaver
317 Third Street
New Cumberland, Pa. 17070
Dear Mr. LaFaver:
Here is following information regarding the deceased
Savings Account- #001-055768-4
Name- Agnes B. Shipe OR Mary E. Shaffer
Opening Date- June 18, 1971
Balance- $3,610.50 ~
Savings Account- #oOl-003225-8~'
Name- Agnes B. Shipe OR Winifred Sturn
Opening Date- Februar)" 28, 1964
Balance- $3,702.54v'
Agnes
V-
B. Shipe.
We trust this information is satisfactory. If you have any further
questions please feel free to contact us.
SinCerely,. /l
~,,~ X ;h?uL--G
(Mrs.) Candas L. Snell
Assistant Manager
CLS :slb
-
.
RCC-81 (6-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Jon F. LaFaver, Administrator
(Executor or Administrator)
In Re: Estate of Agnes B. Shipe
Cumberland
County - Fi Ie No. 21-78-0146
Dear Mr. LaFaver:
You are hereby notified that the original
appraisement in the estate of Agnes B. Shipe
has been filed in theJlfpce '1 the Re9~ster of Wills of Cumberland
County an u y 1 ,19_, Said appraisement reflects the fallowing
valuations:
Real Estate
Personol Property
Transfers
Jointly Owned
Total
$28,500.00
582.58
-0-
3,656.52
$32,739.10
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 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 July 13,1978 Signed ~ ;'L~
Title Chief AppraJser
l-----~-
Note: This is not a bill.
RC C-2 (2-64)
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
July 13, 1978
COUNTY Cumberland
FILE NO. 21-78-0146
Whereas,
Agnes B. Shipe
Cumberland
late of
New Cumberland
in the County of Commonwealth of Pennsylvania, having died on
the 14th day of February 19~, 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 Apprahement
DucrlptJon of Aud Values Made for Inheritance
Till. PUrpOleli
REAL ESTATE $28,500.00 $ 28,500 00
r--I
FERSONAL PROPERTY 582.58 582 58
JOINT-HELD PROPERTY 3,656.52 3,656 52
TRANSFERS -0- -0-
TOTAL ESTATE $32,739.10 $32,739 10
-
Having been duly sworn according to law, I do hereby certify that the above appraisement is
formity with law on this 13th day of July ;~""-_
X. ..$ .&.. ~
,
made i~g'on-
. 19_.
Apprailt'r
(N'umber and Stnet)
HarrisburQ
(PG.t Oftleel
, Penna.
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