HomeMy WebLinkAbout02-08-79 (2)
RCC-33 (4'-73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
*
RESIDENT DECEDENT
COUNTY OF CUMBERLAND
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 granted
by the Secretary of Re"ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Cumberland
} AFFIDAVIT OF
EXECUTORS
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IN THE MATTER OF THE ESTATE OF
EVELYN E. McELPHATRICK
(STATE FULL NAME OF DECEDENT)
Late of
County
County of
Pennsylvania
Cumberland
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State of
_Kil<ltXllOK
HARRY L. PARSON and GERALDINE M. PARSON
ExecutolS
of the estote of the above-named decedent being duly sworn, depose
and say
Decedent died
27
, 19~J testate leaving a last will, copy of which is hereto attached. }
(y EAR) \:k!X1XNlft
Aoril
(MONTH)
Name and address of attorney or }
other authorized representative Tt:l whom
all correspondence should be mailed.
(DAY)
Charles H. Stone. Esquire
310 Bridge Street, New Cumberland, Penna. 17070
That as such 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 S...FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
D;111ph;n nppnr=:it" R'mk ~no1 ~
1.~.t c:h.....Y"c Pl~'7!3 Bronc"
T,pmnynp r Pp-nn::J .
That the contents of said safe deposit box or boxes are itemized under Schedules B
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 arc 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 sccurjlil's 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 rar as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of'
death in any co-partnership or business, and in support of the value of' such interest there is annexed to
said schedule, financial statements showing the assets and liabilities of' said co-partnership or Qusiness.
A copy of the co-partnership agreement, (it' oral, a statement setting forth the nature of' the agreement)
together with a statempnt setting forth the character of' the business, its location, and such other :facts
pertaini.ng to the business as may be pertinent to a f'air and just appraisal of the decedent's interest
therein mllst he submitted. It should also sc;t forth in itemized form, together wi th the lair market value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The Sc/1edule 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 eft'ect in possession or enjoyment at or
af'ter death, said schedule sets f'orth the nature and value of' such property, to whom transf'erred, 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' transf'ers --intended to
take effect in possession or enjoyment at or af'ter death, there is also attachert to the schedule a copy
of the deed, trust agreement or other instrument creating the trust. Therl~ is also set :forth in said
. schedule a list of all property, real and personal, with its value, which paf.:ses at decedent's death by
virtue of' the exercise by decedent, either individually, or jointly with another, or any power of' appoint-
m~nt 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 D attached hereto and made part hereof' sets forth the names ann 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 ann beneficiaries f'or life under necedent's Will. It also
contains a statement showing which of the beneficiaries named in the decenent'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 Sc/1edule E attached hereto and made a part hereof sets f'orth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent ann others, plus the date and place of record of instruments effecting the vestiture of'
real es ta te Hnll the date of acqui si tion of' personal ty, pI us the name, address ann relationship, if any,
of co-owners to the decedent.
That Sc/1edule 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;
f'amilyexemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
conunissions paid or to be }laid; 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 undf!r Section
651 of' the Inheritance and Estate Tax Act); together with a statement of' collateral pledl!;erl for obliga-
tions, if any. It is agreed that the f'iduciary 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 find 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.
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.....".\"',,(E:~~t~~-'.""'...........................
911 Ohio Avenue
.. ..................................... ..........................."........"....
(Street Numb",,)
..... .I."nloy.":".,...y".":Il.Il.'......;L?()~}
(City or Town and State)
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
t'illed in with details or the word "None", and in case the assets include rare and unlisted securities,
securi ties of close or family corporations or an interest in any co-partnership or business, that the
data and statements requirect under t.he }laragraph above relating to Schedule "B" are attached. Also make
certain that C011l1T1JJ #1 in the "Summary" has been properly completed as above-directed.
RCC-34 (4_73)
COMMONWEALTH OF PENNSYLVANIA
DEP.o\RTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
.'
Real property in Pennsylvonia, 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 ioint tenants with right of surviarship 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 .treet n\lmb.r, 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 encumbrance. upon each parcel at death
of decedent. Taxe., a..essments, accrued Int.rest on mortgages, etc., ore
to be listed on Schedule uF" and must not be deducted from this schedule.
(1)
(2)
(3)
OEPARTMENT
VA LUA TlON
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMA TED
MARKET VALUE
NON E
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Insert this total apposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
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CqM~[ONWEALTII OF PE'INSYLV,\NIA
TIlANSJ<lm INHEllIT:\NCE TAX
jU.'S mENT DECEDENT
SCHEDULE "B'l
PERSONAL 1'1lOPEHTY
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II\STHUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
hy the decedent, at the time of his death. Property owned hy the decedent Jointly wtth another or others
must be listed under Schedule "E". Intanglble persomLl property, titled in the name or the (Ie cedent, but
payable at death to another or others, including but not lirrlited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accotmts, must be listed, despite the f'act that they are not of the administered estate.
Tangible personal property shoulcl be lister! ftrst (e.g. jewelry, wearing apparel, household
!~oods, and furnishings, hooks, paintings, automobUes, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and tn bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
ab:le to the estate or f'trluciary in sairl capacity, partnership interests, interest tn any undistributed
estate of' or income f'rom any property held in trust under the will or agreement of anoth.el', even though
located outside of the State, at the time of' death, should be listed in this schedule.
-
Item ITEM
No. Lis t and descrtbe f'ully
l. 200 shares American Brands, Inc. @
2. 100 ffi ares American Can Co. @
3. 100 shares American Cyanimid Co. @
4. 252.427 shares A. T. & T. @
5. 312 shares Atlantic Richfield - Common @
6. 259 shares Atlantic Richfield - 2.80 pro @
7. 200 shares Baltimore G & E @
8. 100 shares Consolidated Natural Gas @
9. 200 shares Delmarva P & L @
10. 100 shares Duquesne Light Co. @
11. 200 shares General Motors @
12. 10 shares Libby-Dwens-Ford @
13. 150 shares Mobil Oil Corp. @
UNIT
VALUE
48-7/16 $
38-7/16
"6-7/8
b2- 3/4
~9-5/8
D9-l/l6
4-7/8
~9-5/8
3-3/8
17-3/8
64-15/ 6
281,;
65-27/ 2
17-7/8
31~
14.
,
1100 shares Ohio Edison Co. @
18 shares Reynolds Metals Co. @
15.
16.
5 units Pa. Insured Municipal Bond Trust sold for
17.
3 units Municipal Investment Trust Fund sold for
18.
Dauphin Deposit Bank and Trust Co. checking accoun
#58-84-837-1, date of death balance
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19.
Dauphin Deposit Bank and Trust Company savings.~'
account #13-6-0025-7 date of death balance
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20. [ACCrUed interest on above
21. Eampden closed face gold 14 K.
I (see appraisal attached)
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watch with chain
TOTAL
ESTI MATED
MARKEr V AHJE
DEPARTMENT VALUATION
(Do not write in
this space)
/'
9,687.50.
3,843.75. ..~r
./
2,687.50,
,
15,839.79
/
15,483.00
I / /
15,297.18
~
4,975.0Q.
3,962.50
..--
2,675.00'
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l,737.5(}/
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9,876.57' I':.
1,787.50,1/
567.00'.1
5,653.10 I
I 2,235.24.j
2,057.93.i---
360.13 . ~
10.09
100.00 .
$112,106.28
Tnsert tllis total opposite "Personal Propertyl', Schedule \1B" in
the "As Reportedll column on the last page of thts return.
x X $112,106.28
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RCC - v)
C'(lMM(l\1W\Li'll ll!' I'l,'N\f,YLP:ir A
TH_A\:-::FFH r\Ji:'~I\IT!\\'CF TAX
SCIIFDUIJ': lIC!!
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llES I DE\:T ])i':CVDI;:\T
(1) Did (h-'l'edpnt, within t.wo years ot'dei_lt.lt, make all,V tf'ansfer of' any matf~I'jal ]lurt of' l1i<.; estate, without
re('!'i\'lng il valuable H1~d ade4tFlte eonsider.'ltir,n Uwn:.J'or'? (Answer yes or no)~E.___
(2) Did decedent, wi t.hin two years of death, transfer' 11J>('perc:,r fl'om h1msel t' to himsel r a)lO anot.her or
{.thers (ille!llliing: a spouse) ill joint owner'sld!",? (Answer yes or no)~~__
(:1) I C tile answer t.o (1) or (:..n above is in the aff'j rtna t i ve ;.:;ta te:
((1) At2;e of' rlecedent at. time of' trall518r
(b) StKte of decedent's health at t.ime of Irlliking the transfer. (Note 1).
(c) CallSf~ or decedent's de:ith. (Kote 1).
(4) Did rtecedent, in hi:., lifet.ime, llIHke any transf'er of property wIthout receivinp; a valuahle or adequate
consilieratjon therpfor .....hich was t.o take effecL in possession or enjoymet't at or after bts dpath?
(Answer yes 01' no) No
(a) Wu<.; tlwre any possibility that the propert.y transferred might return to transferer or his
estlit.e or be sllhject to his pow~!r of disposition? (Answer yes or no) No
(b) Whitt was the trar:srereel s age at tiw~ of decedent.' s death?
(G) Did d(>cetlent in his lifetime make any transf'er .....ithout receiving a valuable amlarlcfluat.e consideration
therefor tmder whieh transf'eror expressly or impliedly reserves for his -life or any period which does
no tin 1"1U~t end lJel'ore Ids death:
(a) The possession or er~joyment of or tht;! right to income from tlw property transferred?
(Answer yes or no) No
(Il) The right to designate the persons who shall possess er enjoy the property transferred or
income therefrom? (Answer yes or no) No
(0) If the answer to (!'l) (b) above is i.n the af'f'irmative, st.ate whether the right. was reserved in decedent
alone Qr otllPrs
(7) Did decedent in his] if'etime make a transfer, the considerat.ion f'or which WitS transferee's promise to
pay income to or for tlJe benefit of eare of' trar:sferor? (Answer yes or no)
(H) Did rlecertent, at any time, transfer property, the heneficial elljuyrnent of' which W:tS suhjE'ct to change,
hecause of a rpser\,pr! power to alt.er, amE"wl, or revoke, or which cOllld revert to decedent linneI' terms
of t.ransfer or by operat.ion of law? (;\nswer yes or no) Nn
(9) If' the anSwer to (fl) above i.~ in the affirmative, was the power tn al tel', amend, or revoke the inter-
est of the het'efil'lary reservf'(l in OJ(' decedent alone or the decedent ann others?
(Answer yes or no)
NOTE 1: The answers t.o these quest.ions should be SUllportert by af'fidavit hy the attendJng physician as
well as a copy of the (leath cer-t.i Cieate.
r-;OTE 2: If' answer to any of the above qw~stions 1s yes, set forth below fl descr-iption of' the propert,Y
transferrerl, it's fair market vnll\e at date of death, dates of transfers awl to \"hom t.ransf'errerl, with
relat.ionship of' transferees to deeerlent, if any. Sub,nit copy of any trust deerl or instrument, if' trans-
reI's are claimed to be non-t.axlllJle, alsn subndt ctetailerl statement of f'aets on whIch snirl claim is basert.
;-';OTE:J: List flpj1l icahle property below in manner Ln which provided in Schedules A, B, or E.
ITBt
J!ESCRIPTION
_M_ARKET VAlJUE
(Es t tma tcd)
DEPT. VALL"ATTON
(Dept. Only)
NON E
\~ G '-"--.
Insert this totAl opposite "Transf'ers", Schedule "C" in the
"As Reported" eolulTln on the last p!ig;e of this retllrn.
RCC-37 (12-63)
(,O;l~!ll~\\'L\LTll OF rE:-;~,yyl. \~lA
TRANSFER INHERlTA"CE TAX
RESIDENT DEl'EDENT
SCHEDULE "0"
HEi'\EFICIAHIFS
\
h
BENEFICIARIES AND ADDRESSES RELA TIONSllIP SURVIVED I
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT ! OF BENEFICIARY
aye an interest, vested, contingent or other. are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO BIRTH
Geraldine M. Parson Sister Yes Legal Specific Bequests and
911 Ohio Avenue I I one-half of residue
-
T ppnn~ 17043
Violet M. Frame Sister Yes Legal one-half of residue
2800 S. Ocean Blvd.
Boca Raton. Florida
-- -- ,
- I"
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DeI10nent f\lrther says that. all the above-named beneficiaries are livIng at this time except below:
--..-
NAME DATE OF DEATH RESIDENCE
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SUMMARY
(Sch. "K)
(Sch. "B")
( Sch. "C" )
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
NONE
112,106.28
(.~ )
(As Determi!led)
$
$
$
$
$
$
$.
$
$ . ..NONE
$
$
$ .112...106.28
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RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned hy the decedent jointly
with anuther or others, including; intangibles, standing in the name of' the decedent and others. List
real estate first. us entireties, or joint tenants, giving brief' description, as indicated Imrler Schedule
"A", plus the date anrt place of' record of instrwnent efrecting vestiture, but no not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus rtate of acquisition, and the name, address and relationship (ir any) of' co-owners to
the decedent.
Description of' Property, Date of' Acquisi t ion, Name Unit percentage Estate DEI' ARTMENT VALUATION
Address and Relationship of Co-Owners, and PI ace Value Share Valuation CAUTION-Do not Write
of Record of Instrtunent, where Real Estate. In This Space.
> :x Y 'XY'X '" ~~ ~<< <<:QQ:>6 '" 5('>< '" :&: <X :x Value of Value of
~ ~~ =", XX <<& ~~ Entire Deceden tis
<< 'YY :>6 '" N N< :xx'" :xx'" y^~ :>6 :<s<: property Interest
NON E
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Insert this total opposite ",Jointly Owned Property", Schedule "E"
in the liAs Reported" colunUl on the last page of this return.
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RCC-S9 (,..158)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of McELPHATRICK, EVELYN
(Last Name) (First Name)
SUMMARY
E.
(Initial)
DATE OF DEATH 4/27/78
FILE NO. 21-78-242
REPORT OF INHERITANCE TAX APPRAISER
I. the undersigned duly appointed Inheritance Tax Appraiser in and for the County of
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "An, "B", "C", and "E".
Dated:
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for Cumberland County, Pennsylvania. do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "P", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:
REGISTER OF WILLS
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
Joint-Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
VALUE AS REPORTED VALUE AS APPRAISED
$ $
112 lOA 2R
o
"
112 106 28
VALUE AS REAPPRAISED
$
Valuation of life estates or
annuities. . . . . . . . . . . . . . . . . .. $
ESTATE TAX ASSESSMENTS $
t=
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COMPUTATION OF TAX
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
TOTAL TAX
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED $
Estate tax paid $
BALANCE DUE
Add interest at rate of 6% from
to
2%
6%
5%
10%
15%
o
$
$
$
$
$
(0) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
$
$
$
t=
$
$
L=
c$
L
t=
$
$
TOTAL TAX BALANCE $
PAID $
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above cumputation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
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R E V-S 18 (8-7R)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY Pl.EASE:
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Harry L. P"rson and Geraldine M. Parson
911 Ohio Avenue
Lp.moynp., PA -12n4~
(Executor or Administrator)
In Re: Estate of
-rvplyn -E......-. Mf'F.lp'h:::lTro;,-.k
Cumberland
County - File No. 21-78-242
Dear
You ore hereby notified that the OT'i e:;n~l
appraisement in the estate of Evelyn E. M"Elph"TT';"k
has been filed in the office of the Register of Wills of r'l1mhpY>l "nn
County on 28 March , 19.I,'L, Said appraisement reflects the following
valuations:
Real Estate None
Personal Prnpertyl12 ,106.28
Transfers None
Jointly Owned None _
Total __~__ $112.106.28
As to such tax that is paid within three months from date of death, 0 five (5%)
percent discount is allowable. As to any tax that remains unpaid alter nine (9) months
(filteen 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 alter 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. 373.
Date _2JLM"",,,h lQ70,_,____,_ Signed__~
\i~~
-~~~-C)- -----
Title __ Administrative Officer
.
---~
Note: This is not 0 bi II.
.
REV-457" (8-78)
6EPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DA j E:. .., Q P' L1 J? ~ 'h 1 n '7 (')
COUNTY Cumherland
FILE tJO. ? 1 _7 R _? l,?
Whereas, Evelvn E. !1cI:IDhatrick late of Lemovne
in the County of C umb er Ian d Commonwealth of Pennsylvania, having died on
the 27th day of April 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fulginiti ,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 I:state ,,~~O
P"rs~~~l ProD"rtv l? 1 nr; ?R
'T'. "'- None
.T~{ ~+, v Owned Hone
Total 12 106 28
I
I
I
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this :Ie"!;\< day of Haps\< 19....::L9...
\hl(='~~
Appraiser
(Number and Street)
HarrishllTlR"
(Post Office)
. Penna.
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