HomeMy WebLinkAbout12-05-78
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RI.::C.S3 ("4-7.3)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
.
"
RESIDENT DECEDENT
. f\ ~ ,q71~
COUNTY OF
CIlMBERLAND
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 nin~.months after date of death, unless an extension is granted
by the Secretary or Re'itenue. (Section 703 of the Inheritance and Es.tate Tax Act or 1961,)
IN THE MATTER OF THE ESTATE OF
Late of
Crunbel" 1 and
pennsv Ivan ia
} AFFIDAVIT OF
EXECUTOR
.~
MARY ELLEN CHESTNUT MAY
(STATE FULL NAME OF DECEDENT)
County
County of
Crunberland
} ss,
State of
~ilOltil(
Llovd M. Chestnut
of the estate of the above-named decedent being duly sworn, depose Sand 5ay S
Executor
Decedent died n. r'J"l; 1
(MONTH]
Name and address of attorney or }
other authorized repres.entative to whom
011 correspondence should he mailed,
?fi
(DAY)
, 19~{te~tate leaving a last will, copy of which i. hereto attached..}
< YEA R) ~~)(,ntf)(
SNET.RAKER, McCALEB & ELICKER
44 W€st Main. Street, Mechanicsburg, Pennsylvania 17055
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
IEXECUTOR-AOM1NISTRATOR] .
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 AODRESS OF BANK OR OTHER INSTITU.TION
IN WHICH DECEDENT RENTEO A S....FE OEPOSIT BOX
The Commonwealth National Bank
Mechanicsbur~. Penns Ivania 17055
THIS SAFE OEPOSIT BOX RENTED
IN NAME OR NAMES OF
e
e n
RELATIONSHIP OF JOINT
HOLOERS TO DECEOENT
'ster-in law
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 Scheelule 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.
./v..
r
-tV
That Scheelule 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 posses~ion, standing to decedent's credit in banks of deposit;,sav.jn'gs, :
banks, trust companies, or other institutions, whether individually, or in trust for any other person o'r:'~;tson~'.~: ~/
giving also separately the accrued interest thereon, if any, down to the last interest day prior.to de.ced'en"'s~<~ /
death in the case of savings banks, and'to th'e-.date of decedent's death in all other cases; all b'ondt; postlll .-:, ~~
savings, treasury certificates or notes and other evidence of indebtedness of the United State-; t~...-:.the a,~J_ t;:
cedent; all obligations, whether by, statute. or agreement they are designated as tax free, of the Un-ftea-:8tates,
or any state, or p~liticaI srubdivision - there.of, or of any foreign country, which are owned at the ti~ of .'death;~::~. t:
-all- wearing apparel, jew.elry!, s~-lverware, pictures, books, works of art, household furniture, horses, caITiag~~',
automobiles, boats, and 'any and all other ,personal chattels of whatsoever. kind or nature, left by decedent,
together with the fairly, estimated market va1ue 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 deprec'iation 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 t.he date o~ death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the-market value there-
of at such time.
.
,
.
In the case of securities of close or family corporations, the values reported are as far as
possible substanttaterl by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets Carth the interest of decedent at the time of
death In any co-partnership or business, arid (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 husiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
togethel' with 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 fair and just appraisal of the decedent's interest
therein must be submitted. It should also set forth in itemized form, together with the 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 forth a true answer to each inquiry
contained therein and in the case or transfers o'fproperty, real or personal, within two years of decedent's
death, tn contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after d(~ath, 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 oth(!r 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 a~tached to the schedule a coJty
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 passes at decedent's death by
virtue of the exercise by decedent, either individually, orjointly with another, or any power of appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument or another,
with a copy or the instrument creating such p6wer 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 or 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 l:t. 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 beneficiary.
That S~~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 n8JQe
of the decedent and others, plus the date and place or record of instruments efrectlng the vesti ture of
real estate and the date or 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 deduction~ claimed for and on behalf of this decedent's estate, including funeral expenses paid;
family l~xemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended ror burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence or the death or the decedent; debts and claims owing and unpaid at time of
death; taxes accrued chargeable for period p_rior to decedent's death (except those allowed llllder Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, ir 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 or 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-, -C., -E-, and "F" as directed therein,
have been carried forward and properly registered in the Summary.
. Subscribed and sworn to before me this
;?....d.
,..,.........,..,................
~~i~~---
= day of .Z4?<~~:(.~'!~. 19.1.B......
-~. -. T. A3c-u
........L....&?4~ .....................~
~I\ltl;.~,:.~= E. rc~I;j:;.1, i::,!;RY PUBLIC
~,ECi:,~ ,:=:;~.;~.,G BOrUUGH
CU::[l~!.:Lr\i.;D CCUi\.TY
IJ.Y rn".~" ':'-c~ [-I [1 27.1982
NOTE: Before signing affidavit make sure all blank spaces in the afridavlt and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisted securities,
securities or 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 "8- are attached. Also make
certain that column #1 in the "Stumlary" has been properly completed as above-directed.
............T.irnber...Raad......B._...n.....l...................__.
(Street Number)
....... ..~~9hi:l,!IJ.sl3..J:l1J.r.g~..P.!;!I1n~y:L.y<!J:IJ.<!.lZO'~5
(Citv or Town 11M Sta.te)
.
RC C_34 i 4-131
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDEN1'
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mOTtgage 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 01 the decedent's interest only. (Property
held as joint tenants with right 01 surviorship or tenancy by entireties should be reported onSchedule "E.")
The real property located In the Commonwealth of Pennsy!vanla should be
described by lot and block number, street and street number, together. with
a general description of the pro pert)', with Q reference to the record of the
conveyance by which the decedent took title; If a farm state number of a-
eras; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Inferest on mortgages, efc.,ore
to be listed on Schedule elF" and must not -be d.educted from this schedule.
(1)
(2)
/3\
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this lpace)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMA TED
MARKET VALUE
ALL that certain Lot of ground situate on the
East side of South Washington Street, Borough
of Mechanicsburg, Cumberland County, Pennsyl-
vania, having erected thereon a two and one-hal
story dwelling and outbuildings known and numbe'ed
as 221 South Washington Street,nore particularl
described in Cumberland County Deed Book"B",
Volume 12, Page 397.
(l.1/-A~ P./f.Al....N4. tJ.& I e Sale pr ice
~ <?'~ b
~-
--:3 t., 0
I~
$39 ,500.00... ~q l SOll.Oo
Insert this total opposite "real property", Schedule" A" in the X X X X X
"As Reported" column on the last page of this return.
$39,500.00
Rec -35
*~
CO~MONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "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 1n 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 IlCCOWlts, must be listed, despite the fact that they are not of the administered estate.
T~gible 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, mort.gages, notes., together with accrued interest or nivldends, salaries or wages, insurance pay-
abl e to the es ta te or firluciary in said capaci ty, partner Ship interests, interes t in any undis tributed
estate of 01' income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time or death, should be listed 1n this schedule.
ITEM
List and describe fully
UNIT
VALUE
ESTIMA.TED
MMIKET VALUE
DEPARTMENT VALUA.TION
(Do not write in
this space)
Evergreen Savings Account No. 14-0010536-5,
Commonwealth National Bank, balance on date
of death
$ 9,008.45
35.36
q,OOI?>y.S
3S.3b
Accrued interest
Subordinated Debentures, Agway, Inc.
Certificate.,N'o. Date of Death V91ue
G-1158/ $2,000.00 ~
G-3177 'v: 2,000.00/
J- 75../' 3,500.00,.... /'
~r-,l070 V 2,000.00 ,
J-1958 .,-. 1,900.00 ~
L- 394"-::::- 2,000.00,/"
V-1178 , 2,800.00
TOTAL
16,200.00
\. 10 ,"'2.00.0'"
CCNB Bank, N.A. /
Date of Death ~lue
$2,020.13 ~
2,006.04
~ TOTAL
Optional Account No. 720, The Carlisle
Building and Loan Association, balance on
date of death
IncomE' Certificates,
Certificat~o.
11459 "'/
17116 /
4,026.17
1,863.39
30.49
l.. ~to 33'1
"\
3D ,L{ ~
Accrued interest
Savings Account and
Capital Savings and
Account No. /'
002-00-03766 ~
002-20-11582
002- 25- 03598 ../
Certificates, State
Loan Association
Date of Death Va~ue
$ 202.56"
19,460.00?
1,019.35
TOTAL
20,681.91
Savings Account No. 135084, Cumberland Valley
Savings and Loan Association, Balance on date
of death
2,146.15
36.13
..-
'-- \ '-l\o . l,:>
,
3(., . \3
Accrued interest
Note for $1,000.00; unpaid balance $1,000.00;
given January 11, 1972 by Donald L. Brockway,
617 South Market Street, Mechanicsburg, PA.
to Mary E. May; payable January 11, 1977,
with interest at 8% per year. Accrued
interest to date of death
1,000.00
23.28,
l,OOO.OO
~3-z.,\3
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" column on the last page of this return.
CONTINUED ON PAGE 2
RCC-35
*~
COMMONWEA.:LTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
PAGE 2
SCHEDULE "B"
PERSONAL PROPERTY
RESlm:WT DECEDENT
Item
NO.
8.
9.
10.
11.
12.
13:
14-.
15.
16.
17.
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 1n 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 a.ccounts, 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 f'urnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasUl:y certif'icates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary 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 out:;ide of the State, at the time of death, should be listed in this schedule.
ITEM
List and describe fully
UNIT
VALUE
DEPARTMENT VALUATION
(Do not write 1n
this space)
ESTIMATED
MARKEI' V AWE
Note for $500.00; unpaid balance of $500.00;
given December 12, 1977 by Helen E. Bloom,
25 West Main Street, Newville, PA. to Mary
May; payable on demand; non-interest bearing
500.00
$
Cash in decedent's safe deposit box
2,000.00
Cash in decedent's possession
7.00
-'1.00
Net proceeds from public sale of household
contents
3,4-55.80
Checking Account No. 14-0-233-8, The First
Bank and Trust Company, balance on date of
death
iI~lIe
~
~~
Savings Account No. 502-14-8-0, The First
Bank and Trust Company, balance on.date of
death
753.11
\S~.~\
Certificate of
Bank and Trust
death
Deposit No. 3155~e First
Company, balance on date of
12,300.00
217 .30
~l.....;?,()D .00
'-...It.3 0
'-l,-.'2>S
\~L...S~
l. ~l
Accrued interest
Coins, sale price
4-2.85
Senior Citizens tax refund
112.59
Refund: Bell of Pennsylvania
1.97
x x
"1 L-\., L{ Ll I ' qS
Inser t this total opposite "Personal Property", Schedule "B" in
the "As Reported" colUlJU1 on the last page of this return.
74-,673.28
RCC-36
COMMO:\WEALTH OF PENtI'SYLVANIA
Tl\A\SFFTl INHlmITANCE TAX
SCHEDULE "e"
THANSFEns
11ESIDE:\T nEo:nENT
(1) Din decedent, wit.hin two years of death, make any transfer of any material part of ilis estate, without
receiving a valuable ur.d adequate consirleration therefor? (Answer yes or no) No
(2) Did decedent, within two years of death, transfer property from himself' to himself and another or
others (inclllrling a spouse) in "joint ownership? (Answer yes or no) :No
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer
(b) State of decerlent' 5 heal th at time of' making the transfer. (Note 1).
(e) Cause of' decedent's 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 t~ke ef'fect in possession or enjoyment at or after his dp.ath?
(Answer yes or no) Nn
(a) Was there any possibility that the property transf'erred might return to transf'erer 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 transf'er without receiving a valuable and adequate consideration
theref'or under which transf'eror expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a) The possession or ep.joyment of' or the right to income from the propert;y transf'erred?
(Answer :res or no) No
(0) The right to designate the persons who shall possess cr enjoy the property transferred or
income therefrom? (Answer yes or no) Nn
(6) If the answer to (5) (b) above is 1n the af:firmative, 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 transferor? (Answer yes or no) No
(8) Din clecedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserven power to alter, amend, or revoke, or which cOl1ld revert t.o rlecedent under terms
of' trans fer or by operation of' law? (Answer yes or no) Nn
(9) If the answer to (8) above is in the a:ffirmative, was the power to alter, 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 supportert by affidavit by the attend:i.ng ph;'t'sician as
well as a copy of the death cer-tificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferred, it's fair market value at clate of death, dates of transfers and to I"hom trA.nsferred, with
relationship of' transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans-
fers are cla:lmed to be non-taxable, also submit detailed statement of f'acts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, ll, or E.
ITEM
DESCRIPTION
llAJUCET VALUE
(Es tima ted)
DEPT. VALUAT.mN
(Dept. Only)
None
None
N~
Insert this tntal opposite ~Transfers~, Schedule nen in the
nAs Reportedn col1mID on the last page of this return.
RCC-37 . (12-63)
l'OMMO:>l\\"EALTlI OF PE;I;;I;SYYL\NIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
\
h
BENEFICIARIES AND ADDRESSES' RELATIONSHIP SURVIVED
(If step.chIldren or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
ave an inter~st, vested, contingent or other are involved, set STATE YES IN ESTATE
wise. in estate) forth this fact.) OR NO BIRTH
1'l"11~t-Ppq nr +h~ . . -. ;t." l>e~nest. 5250.00
Methodist Church of Mechanics Tt-em 3 of s,,-ld Will
burO'. MechanicsburO' Pennsvlv nia 00' 0
'I'nn"t-ee" n-F t-he l-lno- t'~~ "... ;+.. Be~uest. 6250.00
~-I' t'nrl T+em lJ. nr s"id Will
Newville, pennsvlvania
R1"'i:=m Bnyil V"ienn Yes Be~uest. 5500.00
Ttem 5 of said Will
Blanche Chestnut Nickel Sister Yes One-eleventh (1/11) of
R. D. 3 the resiilue
Pennsylvania .
Newville.
Reulah Chestnut R;ckaban~h Sister Ves one eleventh (1/11) of
"nn' M~.^' .- . -,. +he ~~<>inI1P
R. D. 3. Newville. Pa.
Helen Chestnut ClevenO'er Sister Yes One-eleventh (1/111 of
"nd Carl Cle"en~en the residue
,
R. D. 2 NewviTh Pa
Harry r. Chp..s.tD.u+- ~nrl ,en Ve" one-ele (1/111 of
r,.,pnp rl1pc:.+T 11+ +he -e,,-lrll1p
75 Big SorinO' Avenue
Newv;lIp, Pa.
.lohn A Chest-nnt ~nrl Brother Yes One-eleventh (1/11) of
M""" C the residue
R. D. 3 Newville Pa.
0
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
0
0
CONTINUED ON PAGE 2
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SUMMARY
. (Sch, "A")
(Sch, "B")
(Sch,"C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Report,.j)
$.
$
$
$
$
$...
(2)
(As rx-t,'rm;,wu)
$
$
$
$
$
$
,
.
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os .. ..
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, '" .0( '" ~
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.... .... '" Q
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RCC-37 ' (12-63)
CO~IMO:>l\l"EALTH OF rE;>;"SYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DEI.'EDENT
PAGE '2
SCHEDULE "0"
JlENEFICIARIES
\
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE INTEREST OF
(If step.children or
S tate full names and addres.ses of a.ll who illegitimate children DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other are involved, set STATE YES IN' ESTATE
wise. in estate) forth this fact.) OR NO BIRTH
Paul S. Chf' "nn "- Vp,,- (\~O _0 1 rl 111\ nf'
Milill"f'il Chf' ....>-.n _ ,;n",'.
R n a f'~~1 ;~10' D~ . . .
D n' ~n" ~ e1" Ve"- (\no_ rl 11 n nf'
M f'he"t-nnt- ....>-.0 -,d nl1P
R. D. 3, Newville Pa.
Llovd M. Chestnut and R1"nthe1" VP" n~n_n 1 pupnt-h (1/1 n nf
Pearl M. Chestnut the residue
Timber Ro"il R. n 1
Mechanicsbw~O' . Pa
Helen Barrick R1nnm 1-11",..." v"" n_n_ ' f1 M'
25 West Main Street n-l' ....>-., 1"",,;nl1p
Newville. Pa
Elverta Barl'ick Thrush Niece Yes (\,.,~- ..,
1237 Franklin Street f1 I??) nf t-h" .."
Carlisle Pa.
Edna Chestnut Gutshall Niece Yes nnp_c,.;vt-u ".;vt-h (1/1'>1'>1
R. D. 3. Box 346 . n-l' .....:. ,n
Newville D~
..
Martha Chestnut Deihl N.;ece Ve" n_o_~ ;vt-u".;vt-h (1 /~I'>)
R.D. 3 of th" .,
Newvi.lle, Pa ..
Sarah Chestnl1t- .b,' Niece Yes One-siXtv sixth n/6 6 )
R. n. U of the resinue
Newvi.l]p, Pa
2
Deponent further says that all the above-named beneficiaries are living at this time except below:
.
NAME DATE OF DEATH RESIDENCE
CONTINUTED ON PAGE 3
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SUMMARY
(Sch. "A")
.(Sch. "B")
. (Sch."C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(1 )
(As Reported)
( 2)
(As Dl"ll'rmined)
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R'CC-37 . (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
PAGE 3
SCHEDULE "D"
~*~
-,
BENEFICIARIES
\
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
ave an interest, vHsted, contingent or other are involved, set STATE YES IN ESTATE
wisn, in estate) forth this fact.) OR NO BIRTH .
r 1 ;:n"pnpp Chest-nUT "e~1,=., Ve~ O~e_~ <v+.. 'd"Th (1/66)
R n ? nT t-hp _n~ 'i nile
Newville Pa. -
Carl Chestn"t I>.Te~hp,,, Vec rlne-c;vt" 'dxth (1/66)
R n 2 nT t-hp ~pc;due
Newville, p~
Walter Chest-n"t- l\Tenhew Vec rlnp_c ;Vhl 'dxth (1166)
1> n 4- - nT t-1,P ~ec"dlle
Newville, p~
Thelma Chest-n"t- "~~hn~e "'<nnn u. rlne_~ -~ -Fourths (114-4-)
901 West Lon+1, o~ nT t-hp ~oco'N"O
Carlisle, Pa
.T"y ChP"'TT1II'I- - "--'--... Voc rlnp_~ -~ -f'olTl"Th", (1 /lJ.lj.)
ann "~_n_~ n+' +-1,0 _n~"rl"p
Carlisle. P~
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A~.. .. ,'1- Mn "Hene Vo~ O~O_~ . -f'OITl"Th", (1 /lJ.lj.)
1> n " - n-l' +1,0 ~e~"rlITP
Carlisle, Pa.
t''-__1__ ,,'-_ I>.Ton1,-.'. Voc rlnp;';~ -~,- -f'olTl"Th", (114-4-)
R. D. 9 of the residue
t'__"_1_ n_
Deponent fUrther 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. "A")
....(SCh. "B")
(Sch. "C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
(I)
(As Reported)
(2)
(As Determined)
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RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
'COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This scherlule must disclose all property, real and personal, ownea by the decedent jointly
with another or others, including intangibles, standing in the name of the decedent and othe'rs. List
real estate first, as entireties, or joint.tenants, giving brief description, as indicated tmder Schedule
"A", plus the date and place of record of instrument eff'ecting 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 elate of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Description of Property, Date of Acquisition, Name
Address ana Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate.
~ ~ ~~XX ~>;;~&5&~ ~ ~~5
~~~ ~ X X X
unit
Value
percentage
Share
Estate
Valuation
DEPART~lENT VALUATION
CAUTION-Do not Write
In This Space.
XXv
:;,
~C)()<<<
>Q0 8& X
9%<S
:x
xx
X>
Value of'
Entire
Proper'ty
Value of
Deceden t' s
Interest
None
None
N~
/'
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
0 " . .
- , > "
RCo.39 (B.77~
County, Number and Nome 21 - Cumberland SUMMARY
File Number 21- 7 8- 248
Date of Death April 26, 1 q7R COMMONWEALTH OF PENNSYLVANIA
Estate Name MAY MARY E TRANSFER INHERITANCE TAX
(L AST NAME) (FI RST NAME) (INITIAL) RESIDENT DECEDENT
REPORT OF INHERITANCE TAX APPRAISER
I, the under~igned 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 "A", liB", "e", and HE".
Dated: I ~-. I}...{J ~ 7'i ~--- J(, )JA~1
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and far County, Pennsylvania, do respect-
fully report thot I have allowed deductions in the amounts claimed by deponent, except as to those items where a ~Ireater or
lesser amount is set forth in the last column to the right in Schedule IIF", which greater or lesser amount represents the sum
allowed as a deduction.
!_ ./ ""':.. "'~'._ -7 .:;.,.~'. 'W<"
Dated: /, ...", ''''"..--LJ
.J ":;r.~~-...,.,~ ' t-....
.- r.-"'c '.'-" .., REGISTER OF WILLS
CODE ADJUSTMENTS
INVENTORY V ALUE AS APPRAISED (HARRISBURG USE ONL YI REMAINDER APPRAISEMENT CODE
Real Property (Schedule AI $ 39 500 00 00+ IJ;<JJ" Rt} tl O() 92+
Personal Property (Schedule B) 74. 673 28 10+ ,,>,;. llu/ I" j
Joint-Held Property (Schedule El -0 20+ -'.I' ~j~
Transfers (Schedule CI :'0 30+ /, f/V'"Vp
TOTAL GROSS ASSETS 114 173 28 71 &Jill 1"* .. -
Less Debts and Deductions 4lJ. 93-
ISCHEOULE FI
CLEAR VALUE OF ESTATE
Valuation1of life estates or % PRINCIPLE FACTOR VAL.UE ~
annuities. ~......... 00.......0 - $ t= I
" - .t=
,:i -
ESTATE TAX ASSESSMENTS -$ . I
.
..
,
FOR USE"OF REGISTER ONLY COC-E COMPUTATION OF TAX
Tax on $ :" 2% $
Toxon$"- 6% $
Tax on $ 15% " $
Tax on $ . $
Tax on $ " $
Exemptions * " (*) As evidenced by Charitable
Total Estate Exemption Cel1ificates issued
TOTAL TAX $ by the Secretary of Revenue.
,
Less tax previously paid $ tE
BALANCE $
Less 5% o-f.tax jf paid within
3 months ~fter death $
BALANCE OF INHERITANCE TAX DUE
Add interest at rote of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED
Estote tax paid
$
$
t=
$
$
BALANCE DUE
$
$
TOT AL T AX BALANCE $
PAID $
Add interest at rote of 6% from
to
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Adj ustment
49+Adjustment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Charity
94-Remainder Residue
96-Successive
Life Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above computation of tax by the .Register of Wills, for proper reason,
same should be noted below, with short explanation.
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RCC-81 (6-7:3)
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
Loyd M. Chestnut
Timber Rd. R.D.I.
M~~h2~icsburg, FQ~~a.
(Executor or Administrator)
In Re: Estate of
Cumberland
Mary E. May
County - Fi Ie No.
21-78-0248
Deor
You are hereby notified thot the
oppraisement in the estate af Mary E. May
has been filed in the affice of the Rejjister of Wills of Cumberland
County on 20 December ,19~, Said appraisement reflects the following
valuations: II-
Original
Real Estate
Personal Property
Transfers
Jointly Owned
Total
39,500.00
74,441. 95
None
None
113,941.95
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 accurred from December 22, 1965 to June 16, 1971, inclusive;
ond twelve months when death occurred prior to December 22, 1965) from date af death,
interest at the rate of six (6%) percent per annum is charged.
Any party in interest wha is aggrieved by this notice may object thereto within
sixty days after receipt of said notice as pravided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485.1001, P. L. 373.
Date 20 December 78 Signed ~ k. .h ~~
Chief Appraiser
Title
Note: This is not a bill.
-
RCC-2 (~-641 . \ '2- "- '\ C( - I 13
"
COMMONWEALTH OF PENNSYLVANIA DATE
., .. -,
DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX COUNTY~)~
BUREAU OF COUNTY COLL ECTIONS
HARRISBURG, PENNA, 17127 APPRAISEMENT FILE NO, '2. \ -I. '0 - cn-"t 8
rn~ G-. ('rI.~ 1Y\.e-.- fJ- .
Whereas, late of t1 -.er~
in the County of CA~O. ~~ Commonwealth of Pennsylvania, having died on
the 'L- Lo Y- day of ~ 19::::r1?, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, \. ~ G-Do, ' , 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 CommonwealtJ1 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 Anel Val un Made for Inheritance
Tax Purpoles
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Having been duly sworn arqding to law, I do hereb~rtifY that the above appraisement is made in c<;>n-
formity with law on this +-lL day of ~..::.._~, .At -It . 191a,
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