HomeMy WebLinkAbout12-08-78
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RCC-33 (4-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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SWJ.?LEMEHT.iu'
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COUNTY OF
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RESIDENT DECEDENT
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\tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
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} AFFIDA VIT OF
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County ADMINISTRATOR
IN THE MATTER OF THE EST A TE OF
. , 5. 12, 5. :J },; t..~. _::.c 'f::~ S
(STATE FULL NAME OF DECEDENT!
State of _ r';';'I~:-;,lv:'1,1
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County o-f ~'L ,h.' rl:t:lcl
Administrator
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Executor
of the estate of the above-named decedent being duly sworn, depose
ond soy
Decedent died
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(DAY) (YEAR) t,ntestate " \ .J
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r'rance:::: .J;::' .J1'.C,-, 1.,~J"
(MONTH)
Nome al1d address of attorney or }
other authol"lzed repres,en1a1ive to whom
all correspe'ndence should be mailed.
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That as such ,J:1 ,jLllstratOl"deponent is familiar with the affairs of said estate and the property constituting
(EXECUTO R-ADMINIST RA TO RI
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 ri ght of access by another as a gen t or deputy, with the
exception of the fullowing: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES 0 F HOLDERS TO DECEDENT
..; 1)'(1 (?
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 111 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 interes t 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 de[;ignated 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 nriefly the reasons for such depreciation as to each item; all moneys
payablle to the estate from life in~urance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were pa yabk upon I he dea th of the decedent; all and the corpora te s tacks and divid ends
due thereon and unpaid a~ nl' \ , tit' death, bonds and accrued interest thereon to the date of decedent's
death and other inveslm ,",-1 I,)' the uecedent at the time of death, with the market value there-
of at such time.
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CotvlMONWEALTH OF PENNSYLVANIA
THANS.8'EH. INHERITANCE TAX
SU'..?PLE11EHTAL
ru':SIDENT DECEDENT
SCHEDULE "B"
PEHSONAL PHOPEHTY
Il\STRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of his death. Property owned lJY the decedent jointly wi tll another or others
must be listed under Schedule "E". Intangible person:,l property, titled in the name of the decedrmt, but
payable at death to another or othel's, 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 ~re not of the administered estate.
Tangibl e personal property shoulrl. 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 dividends, salaries or wages, insurance pay-
able to the estate or fiouciary in saio capacity, partnership interests, interest in any undistributed
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
MAlU\El' VALUE
DEPARTMENT VALUATION
(DQ not write in
this space)
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\ Il"er t this total opposi te "Personal Proper ty", Schedul e "B" in
the "As Reported" column on the last page of this return.
x X
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R E V-5 \8 (8-78)
COMMONWEALTH OF PENNSYLVANiA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Evelyn S. Hess
100 East Willow Street
r.~r1;~1e, PA 17013
(Executor or Administrator)
In Re: Estate of__ WiJ1iam J. Hess
Cumbe!la~~_ County - File No.__ 21-78-0259
Dear Mrs. Hess:
You are hereby notj fied that the Supplemental
appraisement in the estate of_ Wi11i.J;lm J ._li~!2s
has been filed in the office of the Register of Wills of Cumberland
County on February 22 , 19 79_, Said appraisement reflects the following
valuations:
Real Estate__
Personal Property
T ransfers____
Jointly Owned
T ota I ______
None
268.61
None
None
$268.61
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 rote of six (6%) percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within
sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1 DOl, P. ~{:373. ~-:'"
Date _Fel?!uary 22~~97~____ Signed
-> "
Title_Administrative Officer
Note: This is not 0 bi II.
RFV-457 (8,78)
OEPARTME,NT OF REVENUE
BUREAU OF F:'ElO OPERATIONS
P.O. BOX 2970
HARRISBUFIG, PENNA. 17105
SUPPLEMENTAL
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
Dkl-':
February 22, 1979
-...-","..-.
Cumberland
COUNTY
FILE NO, ~_ 21-78:0~,~9
Whereas, William J. Hess late of Carlisle
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the _ 3rd day of May 19l.!L., 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 sLlch future interest.
DESCRIPTION OF ASSET UNIT Appraisement
VALUES Made for Inheritance
Tax, Pu r poses
Real Property $ None
Personal Property 268 61
Joint-Held Property None
I .
Transfers None .
--.J
TOTAL ASSETS 268 61
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. Have been du~y sworn according to law, I do hereby ,c~{tify that !~-E) above appraisement is made in confQrmity
wIth the law on thIS 22nd day of .,'..,. ",' February 19 /2--.
C :.; '.... .......... - '..- ----- '.
Appraiser
(Number and Street)
Harrisburg
(Post Office)
. Penna.
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