HomeMy WebLinkAbout08-04-78
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
rXl-7?--v?7f3
*
RCC-33 (4-73)
RESIDENT DECEDENT
t. AUG 04 Wm
COUNTY OF .. t ~;:I-<, ~ <f / 1__
IMPORT ANT,
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'otenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Isabel Hartwick
(STATE FULL NAME OF DECEDENT)
} AFFIDAVIT OF
%:XIillllJlOOlt
ADMINISTRATOR
County
IN THE MATTER OF THE ESTATE OF
Late of
Cumberland
State of
Pennsylvania
Cumberland
} ..,
County of
WilHam S.
Administrator
Sanford, Trust Officer,Dauphin Deposit Bank & Trust Co..
of the estate of the above-nomed decedent being duly sworn, depose and say
Jli:XmlIl>:lO<
Decedent died Aor il
(MONTH)
Nome and address of attorney or }
other authorized representative h'l whom
oil correspondence should be moiled.
23
, 19~{~estote leoving a lost will, capy of which is hereto attached.,}
(YEAR) tntestote
(DAY)
Myers,Myers,Flower and Johnson
301 Market St., Lemoyne, Pa 17043
That as
h Administrator d . f .1. . h h ff.
sue eponent IS ami lar Wit tea aus
(EXECU TO R-ADMIN 1ST RA TOR)
of said estate and the property constituting
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
None .
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
dt?ath, 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 furnitu~e, hors~s, cjlrriages,
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 [or 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 secm .;i~'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 famil;y corporations, the values reported are as far as
possible substantiatt~d b~' financial statements of the corporations, showing the assets and liahilities
thereof as of th€ date of' death. The schedule also sets forth the interest of decedent at the time of
death in an~T co-partnership or business, and in support of the value of such interest t!1ere is annexed to
said schedule, fill/meial statements showing the assets and liabilities of' said co-partnership or business.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the dgreement)
together wj th a statement setting forth the character of' the business, its location, and such other f'acts
pertaining to the business as may be pertinent to a f'air and just appraisal of' the decedent's interest
therein must be submitted. It should also set {'orth in itemized form, together with the fair market value
thereof" any other propert;y owned or bequeathed by the decedent at the time of death.
The Schpdule C attached hereto and made part hereof' sets forth a true answer to each inquiry
contained therein and in the case of' transf'ers of property, real or personal, within two years of' decedent's
death, in contemplation of decedent's death, or intended to take eff'ect in possession or enjoyment at or
a.fter death, said schedule sets forth the nature and value of' such propert~,., to whom transferred, the
relationship o~ .the transferees to the decedent, the proportionat~ share received py each transferee and
all other f'acts of' a pertinent nature regarding said transfers. In the case of' transfers intended to
take eff'ect in possession or enjoyment at or after death, there Is also attached to the scherlule a cony
of' the deed, trust agreement or other instrument creating the trust. Ther\~ is also set forth in said
schedule a list of all property, real and personal, with its value, which pa~:ses at necedent'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 COllY of the instrument creating such' power attach~d to the schedule.
That Schedule D attached hereto and made part hereof' sets forth the names and addresses of all
persons henef'icially interestf~d in this estate at the time of' decedent' 5 death, the nature of' their res-
pecthre interests, their relationship, if any, to the decedent, together with the ages at the time of'
decedenes death of' all minors, annuitants and beneficiaries f'or life under necedent's Will. It also
contains a statement showing which of' the beneficiaries named in the decedent's will, if any, dIed prior
to decenent, the dates of their death, their issue, ann the relationship of such issue to the benef'iciary.
That Schedule E attached hereto and made a part hereof' sets f'orth all property, real and per-
sonal, owned by the decedent jointly wi th another or others, including intangible, standing in the name
of' the decedent and. others, plus the date and place of record of instrmnents eff'ecting the vest! ture of'
real estate and the nate of aC~Jisition of personalty, plus the name, address and relationship, if' any,
of co-owners to the decedent.
I
That Sc~edule F attached hereto and made a part hereof' sets forth fully and in detaIl all debts
and deductiow", claimed 1'01' and. on behalf' of this decedent's estate, including f'uneral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and f'udiciary's
conunissions paid or to be paid; cost expended f'or burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of' the death of the decedent; debts and claims owing ann unpairl at time of'
death; taxes accrued chargeable f'or period prior to decedent's death (except those allowed under Sectlon
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledger! f'or obliga-
tions, if any. It is agreed that the f'iduciary will present proof' of' sain 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 cl aiming; and allowed, that the same will be reported to the Register of' Wills, and that
the amount of' tax assesserl can he reassessed ln accordance therewIth.
That the totals of the appropriate columns in Scherlules "A", "B", "en, "E", and "F" as directed therein,
have been carried forward and properly registered in the Swnmary.
Dauphin Deposit Bank & Trust Co.
Subscribed and sworn to before me this
.......2.lS'~ day of ~~...
~A1l~p~~
My eo...iuiQa Eapiro, Doc. 21, 1981
Le.mope, PQ... Cumhe.rlau.d Cou.n 'J
m 19..2.1;.
d" % ~
/)!j1i;'~~~Ad;;dJ:!f:f~Jf.j............_...
301 Market St.
.........................................
(St:reet Number)
Lemoyne, Pa. 17043
. (City;;:;; To;';;':~;;d State)
SOTE: Before s1gning af'f'jdavi t make sure all blank spaces in the aff'idavit and schedules annexed are
f'illed in with details or the word "None", and in case the assets include rare and unlisted securities,
securj ties of close or family corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that colunm #1 in the "Sunnnary" has been properly completed as above-directed.
RC C-341 (4-731
COMMONWEALTH OF PENNSYLVANIA
DEP'ARTMENT 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 ather, 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 Commol"lwealth of Pennsylvania should be (1) (2) (31
described by lot and block number, str..t and street numb.r, together with DEPARTMENT
a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title; If a farm state number of a_ FaR VEAR OF ESTIMA TED CAUTION
ere.; also statement of mortgage encumbrance. upon each parcel at death DECEDENT'S MARKET VALUE (Do not writ.
of decedent. Taxes, assessments, accrued Inter..t on mortgage., etc., are DEATH In this space)
to be lI.ted on Schedule "F" and must not b. deducted from this schedule.
~
NONE
Insert this total apposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
~
. ,
RCC -35
IlESITk,L' DECEDENT
SCHEDULE "BIl
PERSONAL PROPERTY
.~
~..,
· . t\
CO~WONWEALTH OF PENNSYLVANIA
TRANSf~R 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 wi th 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. V. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the f'act that they are not of' the administered estate.
Tangibl e personal property shoulrl be listed f'irst (e. g. jewelry, wearing apparel, household
goods, ,md f\lrnishings, 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 cUvidends, salaries or wages, insurance pay-
able to the estate or f'iduciary in said capacity, partnership interests, interest in anyundlstributed
estate of or income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time of death, should be listed in this schedule.
Item
No.
ITEM
List and describe fUlly
UNIT
VALUE
ESTIMATED
MARKEr VALUE
DI;:P ARTMENT V ALUAT TO N
(Do not write in
this space)
1
Jewelry (appraisal attached)
$
365.00
,../
,/<
34>5,OD
q(pg'.OO
2
Household Goods (appraisal attached
968.00
3 Commonwealth National Bank
checking account 112 44 21874 V
4
Commonwealth National Bank
Statement Savings Acct 11 0007 2378~
Accrued interest
1,048.75 V I 0'tf.1S
J
1,018.07 t:;, , DI~.o7
I
7.74 7,74f
26,773.59 .;tiP 713.5"l
)
1,875.43 ~- I r1~. 43
)
14.79 1'1.71
81. 29 /' al.~
5 Commonwealth National Bank
Evergreen Passbook Acct. 11 00103 15 7'/
6 Fulton National Bank of Lancaster
Golden Passbook QA 100005-8 '-
Accrued interest
7 Cash
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
$32,152.66 413:1, )-5), {q I.
RCC- '.h
(,il\IMil\WE'II;;'1I tW l'l:\N;;YLI',\'i1 A
"[\{A:-i:-::FFii. I\TFHIT.\\CF TAX
SCflFlHfLI': lie"
]'1{\\'\..;L.'j';HS
~~~
f>~>J
h "-,-",, t\
TJ j""'1.j,'.L.,
~ q)~'.';"\\'~')~1i.;.:>
"'-';::"''''''",,';.:;0'"''''''':'-
IlE~ I I1E\T j)1':CU))'~\T
(1) Did~e:f>dl:'nL. within two years ordeaLh, TIlake Illl'y trllHsfel' of" ilny material purt. oL~i'" esLate, witbout
reet'l\'Ing it valuable ur.d adequf1te eonsidpr;Jj,irm t.hf't'('for? (Answer yes or' no)~~
(2) Did rl("cer!plll" within two yellrs of' rlel1tll, transfer jlrOperLY from Jdmself' t.o himself' and another or
nthers (inclllding a spouse) in joint ownership? (Answer ;yes or HO)--1!Kl-___
(a) If the answer to (1) or (2) ahove is in the aCfirmlltive state:
(a) Ag;e of decerlent at time of transfer
(b) State or decedent's lIC'lilth at. time uf making the transf'er. (Note 1).
(c) CallSP of decedent.' s deftth. (Note 1).
(4) Did decedent, in hi:.; Ii fptime, make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take ef'feet in possession 01' enjoyment at or after h:Ls death?
(Answer yes or no) NO
(a) IYus there any possibility that the property transf'erred might return t.o transf'erer or his
pstate or tw sllbjpct to his power of' dispositlon? (Answer yes or no)
(b) What was the trrmsfereel s age at time of' decerlent's deattJ? ., ~--
(:')) Did decedfmt in his lifetime make any transf'er without receiving a valuable an(ladeql1ate eonsideration
theref'or under whidJ trans1'eror exprrssly or impl iedly reserves f'or hts li1'e or any periori which does
not in fa(~t end hef'ort' his death:
(a) The possessjon or ef'.,joyment of' or the right to income from thf.' property tl'ansferred?
(Answer yes or no) NO
(h) Ttw right to designate the persons who shal] possess cr enjoy the property transferred or
income theref'rolll? (Answer yes or no) NO
(0) If the answer to (!')) (b) ahove is in the af'firmaUve, state whether the right was reserved in decedent
alone I)r others _._~~._______
(7) Did decedent in his I if'etime make a transf'er, the consideration for which W[l.S transf'ereel s promise to
pay income to or for the henef'it of' care of' trar:sferor? (Answer yes or no)
(8) Did decpdent, at an.y time, transfpr property, the beneficial enjoyment of' which was subject to chang;e,
hecause of it l'eserved power to al tel', amend, or revoke, or whi.ch c011]d revert to decedent under terms
of transfer or by operation of law? (,\nswer yes or no)
(!}) If the answer to (H) above i.~ in the ;tf.fi rmative, was the power t,) al tel', amend, or revoke the inter-
est of' the hel1efieiary "psprvpd in the decedent alone or the decedent and others?
(Answer yes or no)
~OTE 1: The answers to these questions sllOu1d he supporteel by af'f'idavit hy the attend.ing physician as
well as a copy of" the Ii,eath ceni ficllte.
NOTE 2: If answer to any of' the ahove 11U\?stions is yes, Sl~t "forth below a description of the property
transt'errerl, it' s f~lir market valllp. at date of death, \I,itcs of transff~rs and to i"hom trllnsf'erre'l, with
relationship of transferees to deceelent, if flny. Submit copy of an,V trust deed or instrur.tent, if" trans-
fers are claimp(l to be non-taxable, 111.S0 submit netail€d st.atement of f'acts on whteh said ela.im is based.
~OTE 3: List Rpp1.icallle property below in manner :in which provide'! in Schedules A, B, or E.
ITE.\!
L'ESCHU'TION
MARKET VALUE
(Es t1ma ted)
OEF'1'. V ALU AT .'::ON
(Dept. On] y)
N (f'/\.L,
None
,
I
i
Insert this totrtl opposjte "Transf'€rs", Schedule "e" in the
"As Reported" cq]umn on the In.st p'ige of this return.
NO"IU-
------
RCC-37 (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BEJ\EFICIARIES
\
h
RELATIONSIIIP !
BENEFICIARIES AND ADDRESSES (If step-children or I SURVIVED DATE INTEREST OF
State full names and addresses of~a1-1 who illegitimate children! D~CEDENT OF m:NEFICIARY
aye an interest, vested, contingent or other- are involved, set r S1ATE YES lJIRTII IN ESTATE
wise. in estate) forth this facL) OR NO
Abram R & Florence Burkho der None Yes of al1:e Specific Bequest
3526 September Dr
--
Camp Hill, Pa. 17011
I
--
NarJ.on H Neidhammer Sister yes of age Specific Bequest
546 H"mmpl A.vP ~/;j KeS10ue
----
Lemoyne, Pa. 17043
-----
I
,
James Acri Jr I Nephe_w yes of al"e 1/6 Residue ---"--
414 Hale St ,
.. -----...,... ------
~
Harrisburl1:. Pa 17104 -~._._- -..-- -....--.-..-
Nancy Acri Motter Niece I yes I of age I 1/6 Hesidue
------- T-- ---.----
"<<ClQ M." ~ <.". ..~I j i Specific Bequest
,
! r--. ----
Harrisburg, Pa 17109
sister-in-laJ I ...
Hartwick of ae:e I 1/3
Mar1an S yes Residue
1901:> Bellevue Rd -.--.
I
Harrisburg, Pa 17104 I
I
I ~~ ,..~~. ".. ro~en~'" "Q~ .~ I ., ~ . . n e.s.t
1617 California Ave i I ~.
-""
Fort Wayne, Ind. 46805 I
-..-.
Marian H AnzOlut Niece yes of age Specific Bequest
n__.
831'/ Chagrin Falls
Chagrin Falls, Ohio 44022
John A Perrill Friend ves of ae:e Snecific Beauest
399111 King St
-.--
Xenia, Ohio
----
Deponent further says thtit all the above-named benef'iciaries are living at this time except below:
-
NAME DATE OF DEATH RESIDENCE
-
None
.
--------------
.
(1 ) (2)
~ " SUMMARY (As Reported) (As Determined)
SrJ'l.....
e<~ Real Property (Sch. "A") $ ,..0- $
ti= c
'2 Q) S Personal Property . (Sch. "B") $ 32,152.66 $
's G) ~
"00.0 Transfers (Sch. "C") $ ,..0- $
-< E_u
~3:o S c.hJL $ $
o ~ 172.35
"5ti~
~ ~ 0 $.. $
~ E g..
~ 0: Gross Taxable Estate $. 32,325.01 $
b '0
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~ .~ ~
'" '" ...l
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;.. ~ ~ <
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- <
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r.... ~ '0 ....
~ 0 =:
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::::~ ...l U U
.
RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEAL TH OF PENNSYLVANIA
TR.\NSFER INHERITANCE TAX
INSTRlJCTIONS: Tllis schc(htle must disclose all property, real and personal, owned by the decedent jointly
with another or others, including intangibles, standing in the name of the decedent and others. List
re;l1 PS ta te fi rs t. !lS en ti reties, or j oint tenants, giving brief' description, as indica ted lUHler Schedule
"A", plr.s the date IUlrt place of' record of instrument efrecting 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 acquisition, and the name, address and relationship (if any") of' co-owners to
the decedent.
Description of Property, Date of' Acquisition, Name
Address and Relationship of' Co-Owners, and Place
of Record of InstrwTlent, where Real Estate.
;~ ~ ~x y >\X:0 %: 60 X:< :)0;00 xx:)o
2::& Y> XX y> ex N ~ % ~ >\X:xx 0:X :x
Unit percentage
Value Share
Estate
Val ua t ion
DEPARTllENT VALUATION
CAUTION-Do not Write
In This Space.
xx;;x:0
o
:)0 :)0
()(:x
:::x
<<~
Value of
h'n tire
Property
Value of
Deceden tIs
Interest
3 Ser1es "E" Bonds in names
Isabel Hartwick or Mrs. Joan N CosIo
$50.00 dated 3/66
100.00 dated 3/66
100.00 dated 3/66
~
$ 68.94V
137.88/
137.88./
~/
$172.3' 54l//7D
..-
11~.~5
$344.70
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the II A.s Reported" coluJTUl on the last page of' this return.
~ 11J.. 35
'*
RCC.81 (6-73)
COMMONWEAL TH 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
william S. Sanford, Trust Officer
Dauphin Deposit Bank & Trust Co.
(Executor or Administrator)
In Re: Estate of Isabel Hartwick
Cumberland
County - Fi Ie No. 21-78-0243
Dear Mr. Sanford:
You are hereby natified that the original
appraisement in the estate of Isabel Hartwick
has been filed in the affice of the Register of Wills of Cumoerland
County on October 12 ,1921L-, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
$32.152.66
None
172.35
$32.325~OI
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 porty 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.
Date OctOber 12, 1978 Signed ~, kJ~~..,-
Title Ghief Appraiser.
;,-----.
Note: This is not a bi II.
~
,RCC-Z (Z-64)
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
October 12, 1978
Cumberland
COUNTY
FILE NO.
21-78-0243
Whereas,
Isabel Hartwick
Cumberland
late of
Camp Hi 11
in the County of Commonwealth of Pennsylvania, having died on
the 23rd day of April 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 de-cedent 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
Description of Asset Values Made for Inheritance
Tu Purposes
REAL ESTATE NONE $ -0-
-.-- ~
PERSClIAL PROPERTY $32,152.66 32,152 66
~
TRANSFERS NOl';'E -0-
JOIllT-HELD PROPERTY 172.3:' 1/2 35
TOTAL ESTATE $32,325.01 $32,325 01
.
Having been duly sworn according to law, I do hereby certify that the above appraisement is made in .egn.
formity with law on this 12th day of October \~ ' , / 19~.
C' "t..4 ~ II , }J:h /L h '
Appraiser
(N'umbcr and Str~t)
Harrisburg
(PMt om(!e)
, Penna.
~I
." 0- ~
~ ~
?, .. ::;
z " N :z:;
8 ~ ~ ~
"
c Q , >-
<..:, '" 0 ~
:! ~ ==
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