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HomeMy WebLinkAbout02-05-79 ... dff2-/ ~ 7 r - _ ;?/ft fEB 05 1979 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 or "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.) IN THE MATTER OF THE ESTATE OF } AFFIDAVIT OF EXECUTOR ADMINISTRATOR ISABEL M. BLACK (STATE FULL NAME OF DECEDENT) Late of r.IIMHERT.AND PENNSYLVANIA CUMBERLAND } ss, JOSEPH W. BLACK n / County State of County of Administra tor of the estate of the above-named decedent being duly sworn, depos"e and soy Decedent died MAY 20, 19~{~estate leaving 0 lost will, copy of which is hereto attached._.} [YEAR) tntestate (MONTH) Name and address of attorney or } other outhorized repres.entative to whom 011 correspondence should be moiled. (DAYl WILLIAM A. DUNCAN, ESQUIRE 17 E. HIGH ST., CARLISLE, PA. 17013 That as such ADMINISTRATOR deponent is [ami liar with the a[[airs nf said estate and Ihe property constituting (EX ECUTO R-ADMIN1ST 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 IN WHICH DECEDENT RENTED A S_.I,FE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT 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 t~erein. It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving the amoul~t still due at death, name of mortgagee, date, rate of interest, and book and page of record ther~of. Ita.1so sets forth in the columns provided therefore the assessed valuation of each of said parcels, the estimated market.valu~ thereof as of date of death of decedent. That Schedule B attached hereto and made part hereof sets forth fully and in detai.I 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 pri?!-,.tQ':i;9S'~~~t"~'"""" dea_~th in the case of savin~s banks, and to '~he date of decedent's deat~ in all other case,s;_<~lp~~?d~;:po-s~a'"ry-""".-' savings, treasury c'ertificates or notes and other evidence of indebtedness of the Unitedi"''--Stft.t~:S:Fl~i'ttfe1't-e.:~~t.-:::~ cedent; all oblig~tions, whether by ~tatute or agreement they are designated as tax free, oJ tht?- iJnite~ State!:..: v -= or any state, or political subdivision thereof, or of any foreign country, which are owned it th-e::t.ime 6-rctJeath;: - .., ~ v~ all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture,:;'h-6rsee;, carriages,"~ 2 automobiles, boats, and any and all other personal chattels of whatsoever. kind or nature~...1e1t....ijJ{dec:dd~~t'0~"~ together with the fairly: estimated market value thereof; all bonds and mortgages held by d;c'~de~t;ana~~f ~li',.~\'~ '_ E~ J _ J. - ~. claims due and owing decedent at the time of death, and all promissory notes -or other'instrume"iils,in~writirig 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 a<He or death, bonds and accrued inte,rest thereon to the date of decedent's death and other investment securities owned by the decedent at the time of death, with the,marker value there~ of at such time. - In the case of securities of close or :family corporations, the values reported are as far as possible substantia.ted. b:r financial statements of the corporations, showing the assets anel liabilities thereof as of the date of death. The schedule also sets forth the interest of' rtecedent at the time of death in any co-partnership or business, and in support of the value of such interest there 1s annexed to 5 aid schertnle, f1 nancial 5 ta tements showing the asse ts and 1 tabU i ties of said co-partnership or "!:l.usiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of tne agreement) together with a statement setting forth the character of the business, its location, and such other facts pertai.ning to the Imsiness 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 propert:r owned or bequeathed by the decedent at the time of death. The Sct>edule 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 cqntell1plation of decedent's death, or, intended to take effect in possession or enjoyment at or after death, said schedule sets forth the nature and value of such property, to whom transf'erred, the relationship of' the transferees to the deceoen.!-, the proportionate share received by each transferee and all other facts of' a pertinent nature regarding said transfers. In the case of transfers Intendect to take effect in possession or enjoyment at or ~fter death, there is also attached ~o the schedule a copy 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 decedent's death by virtue 01' the exercise by decedent, either individually, or jointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrl~ent creating such power attached to the schedule. That Schedule D 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 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 and beneficiaries for life under decedent's Will. It also contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary. That SChedule E attached hereto and made a part hereof sets forth 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 instrwnents effecting the vestiture of real estate and the date of acquisition of personalty, plus the name, address and 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 rlebts and deductions claimed for and on behalf of ~his decedent's estate, including funeral expenses paid; family exemption, where a-pplicable; costs of administration of this estate; counsel fees and f\ldiciary' 5 connnissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of the death of the decedent; debts and claims owing ann. unpalri at time of death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledger! for obliga- tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "en, "E", and "F" as directed therein, have been carried forward and properly registe!"ed in the Sununary. -11. thO It,- 18................................. .... ........ 191..~ ~..... ...~~....~tiJ.,XJaJ~.. , (E:r~gdministTatoT) E. LOUTHER ST. ............................................. (Street Number) GABJ.:r:SLE,J'A.JJOl3. (City or Town and State) ubseribed.and sworn ...~'.-... . "--Ji.:---/ ~~... ... 1(....... v.!;.l_ "..-., ,-... .-.:"'13';-' ~0"IIY of .. ~~ ;..~..:.-,..,. .f.' ../r.. ~ . ~ .:......-.:. ~ . -' '. - :: MAA ORCORAN;:NbtariPublic "ieajis u.mberla.t"Co,;:r;f ~y"COmrrlis:ililii,t-xi>ir~'-<;ejit. 13, 1981 ..:; ~ ~_..' ",- v;;-.... ~.J ;"\.I --;.v~ NOTE:~~~.~efore s_fgning affidavit make sure all blank spaces in the affidavit and schedules annexed are .-- .......... filled in with detaIls or the word "None", anO 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 required under the paragraph above relating to Schedule "B" are fittachen. Also make certllin that column #1 in the "Sununary" has been properly completed as above-directed. . RCC..34 \4-731 COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT 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 qu"antum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenonts with right of surviorship 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 street number, together with Cl general description of the property, with a reference to the record of the conveyance by which the decedent took title; If 0 farm state number of a~ creSi also. sta'ement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must not he d~ducted from this. schedule. (1) (2) , (3\ DgPARTMgNT ASSESSgD VALUg VALUA TION FOR YEAR OF ESTIMA TED CAUTION DECEDENT'S MARKET VALUE (Do nGt write DEATH " In this space) HOUSE AND LOT AT 39 EAST LOUTHER ST., CARLISLE, PA. (FEE SIMPLE) /' 2,330........... $15,000.00" \'5)000 .Ou Insert this totol opposite "real properly", Schedule "A" in the X X X X X "As Reported" column on the last poge of this return. $15,000.00 \ 5, 000 -00 , Rec -35 .- co~nIONWEALTH OF PENNSYLVANIA T~SFER INHERITANCE TAX *' RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY 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 nE". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.D.D. U. S. Savings Bonds and tenta- tive trust accounts, must be listed, despite the fact that they are not of the administered estat~ Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household goods, ~d 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 riduciary in said 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 ESTIMATED MARKEr VALUE UNIT VALUE 1 1973 CHEVROLE~ CAPRICE AUTOMOBILE 2 HOUSEHOLD GOODS 600.0 3 PERSONAL EFFECTS 300.0 4 CHECKING ACCOUNT #182-162582-7 COMMONWEALTH NATIONAL BANK 363.6 5 SAVINGS ACCOUNT #11773 COMMONWEALTH NATIONAL BANK 6 CHRISTMAS CLUB #366 CO~10NWEALTH NATIONAL BANK 7 65.20--""-/ 1978 FEDERAL INCOME TAX REFUND 8 ~ '3> ft,Qd,<.{ '3 b 3,. l?>L{ DEPARTMENT VALUATION (DO not write In this space) ( '\ LO 0 . () i::, Co 0 0 . 00 3,<:>O.o-=> '?:. 10 '3 ' G:, C; \..., 'LlSl. ( ctlo.oo \oS.'20 .,,~-. /"~~ - - :3, ~4~sa4 )L~n'3~ 4,207.34 Insert this total opposite "Personal Property", Schedule "B" in the n As Reported" colunm on the las t page of this return. x X -..., .;. --- ~ .)4 "ii. ~; ,.. I' .; \-~., ~ ..".... -', Y' _. ..- ~-- '.~_> -. --- .---- -:.----:..:.. ' ......_"'~ "'--".... RCC- 36 *~ COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "c" TRANSFERS RESIDENT DECEDENT (1) Did decedent, within two years of de nth, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) NO (2) Did decedent, within two years of dea~h, transfer property from hlmAelf to himself and another or others (inCluding a spouse) in joint ownership? (Answer yes or no) NO (3) If the answer to (1) or (2) above 15 in the affirmative state: (a) Age of decedent at time of transfer (b) State of decedent's health at time of making the transfer. (No:te 1). (0) 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 theref"or9~hich was to take effect in possession or enjoyment at or af"ter his death? (Answer yes or no) ~U_ (a) Was there any possibility that the property transf"erred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) NO (b) What was the transferee's age at time of decedent's death? (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period Which does not in fact end bef"ore his death: (a) The possession or enj~~ent of or the right to income from the property transferred? (Answer yes or no) NO (b) The right to designate the persons who shall possess or enjoy the property transferred or income theref"rom? (Answer yes or no) NO (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (7) Did decedent in his lifetime make a transf"er, the consideration for which was bf6nSf"eree's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) (8) Did decedent, at any time, transf"er property, the beneficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or. revoke, or which could revert to decedent under terms of transf"er or by operation of' law? (Answer yes or nor NO (9) If the answer to (8) above is in the affirmative, 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 supported by af"fidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set f"orth below a description of the property transferred, it's f"air market value at date of death, dates of transfers and to whom transrerred, with relationship of transf"erees to decedent, if any. Submit copy of any trust deed or instrument, if" trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM lIARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) DESCRIPTION NONE N cr-.---L Insert this total opposite "Transfers", Schedule "e" in the "As Reported" colunm on the last page of this return. NONE .~ ~ . RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT ~*~ SCHEDULE "0" ,. BENEFICIARIES 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, vested, contingent or other are involved, set STATE YES IN ESTATE wise. in estate) forth this fact.) OR NO BIRTH JOSEPH W. BLACK SON YES 8-24-50 VESTED. 100% INTERES - . ( h Deponent further says that all the above-named benericiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE T ~ ..., 'sUJ.-I f<* ti: ~ '2 Q,J E .-... =' .E-a'O - 5 " -;: 0' 8~-g "5tit: " ::l 0 ~ S go ~ 0:: SUMMARY . HHHHHHH .(Sch, "A") .H HHHH.HHH.H..(Sch, "B") .H... .H.(Sch, "C") Real Property Personal Property Transfers Gross Taxable Estate. ~ "0 Z u ... ~ .. oS " ..l u :::; u < ;.-. " ~ .u '" '" ,~ - - < -< " CI: ~ t... '" Cl, ~ 0 " Cl, ~ 2: '" -< '" < ~ :I: ~ :-. ... .... .. Q ~ S 0 1', :t .. -< <;; ;Z 0 .... < Z .... '" "" t... ~ ~ .... ~ 0 0 CI: -" c ~ .:: 0 0 " Cl, '.c ~ ~ 0.1 " !::: ~ CI: .b 0 C .. -< ~ .c. 0 "" 0 E _ "E '" ~ S ~ <5 c "~ '"0 " 0 :::~ ....l U U (1 ) (As Reported) $.H. . $.. $. .H $.. $ $H (2) (As Determined) $ $ $. $ $H $. ... -, ". RCC.38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly wi t.h Another or others, including intangibles, standing in the name of' the decedent and others. List real estate first, as entireties, or joint tenants, giving brier description, as indicated under Schedule "A", plus the date and place of record of Instrwnent effecting vestiture, but cia not include entireties or out of state real estate value in estate valuation column. Personal property should be listed as In Schedule "B", plus date of acquisition, and the name, address and~elationshlp (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name Address and Relationship of Co-Owners, and Place of Record of Instrrunent, where Real Estate. :><s<:XXo<: ~'X>(: ~~x:x::OO <>>:xx 0<: ~ vJf; 8: Xl<:X ~ unit Value percentage Share Estate Valuation << :)<X ">69$: << :)< Xl< :&: NONE I Insert this total opposite NJ01ntly OWned Property", Schedule "En in the It As Reported" colllil1Jl on the last page of this return. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedentt 5 Property Interest NONE I'J~ , COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 REV-5tB (8.78) IN YOUR REPLY PL.EASE REFER TO Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT Joseph Black 39 East Louther St. Carlisle, p~ 17013 (Executor or Administrator) In Re: Estate of IsabelM. Black Cumberland 2F-78'-0276 County - Fi Ie No. Dear You are hereby notified that the Original appraisement in the estate of Isabel M. Black, has been filed in the office of the Register of Wills of Cumberland County on 8 March 1979 ,19_, Said appraisement reflects the following voluations: Real Estate Personal Property T ronsfers Jointly Owned Totol $15,000.00 4,207.34 None None $19.207.34 As to such tox thot 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 Junei6, 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 ofter 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 8 March 1979 Signed. _____,__y~~- Title " Administrative Officer ---.. Note: This is nota bill. . REV-457 (8-78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT 8 March 1979 DATE Cumberland COUNTY FILE NO. ?1 iR n,)7~ Whereas, Isabel M. Black late of Carlisle in the County of Cumberland Commonwealth of Pennsylvania, having died on the 20th day of May 19 ...J.!}, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; " Therefore, 1, l,po 1',,1 gi ni H , 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 ali 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 VALUES AppraIsement Made for Inheritance Tax Purposes $ 15 000 00 Personal Pro ert Jointl Owned None Total 19 207 34 ; , Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 8th day of M"rrn . ~', 19 ~; ,,- ~ 0 . ~ ~~ ~O-~ ~ Harrisburg .... (Number and Street) (Post Office) , Penna. :>, ~ s:: :3 o o ~ z w :;; w '" <( a: D.. D.. <( X <( ~ w (,) Z <( !: a: w :I: Z ~ Z w o ;;; w a: '0 '" ~ :g ~ -ci . '" : l(j : ~ 1Q ~ - .... o '" ~ '" >-1 ~ '" -< ~ w ::l \ ~ z "1 w "'"'i > w ~ ~ a: 'N "i .g ~ u.. ~ I: ~ ",- 0 \;li 0 " ~ I- :::> ;;::: z '1l: .... ~ 0 ",- w " '" ~ '"ti -'" :3 2: ... '"0 I- 0 '" ~ a: Q ~ '" <( ~ 's, ~ "5- ~ "'j .... c.. '"Ci" a; '" 0 w '" '" ~ ~ 0:: ~ 0 "" '" s:: '" Q -s :3 " '0 -~ '"0 0 '" '" ~ 0:: ... g; '" 2l 2: -< ~ r.;:: q '::t: '"Ci" 1; o 5. "- '::t: '"0 s:: '" "2 s:: .~ ~ ~- s:: '" ~ '" -Oil 5. ~ ~ :3 o .0 '" 2l ~ .. ~- a; ~ '" .~ ~ ~ <l:: -< ~ "- ~ . . l '" 1i '"0 ~ '"0 ~ 6j