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RCC"33 (4-73)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
"
RESIDENT DECEDENT
jl\~ '2, Cd ,~1~
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 nil)c montbs after date of death, unless an extension is granted
by the Secretary of Re'ltenue. (Section 703' of the ~nheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Lester W. Erb
} AFFIDAVIT OF
EXECUTOR
ABYINI&liIU,EQI1:
(STATE FULL NAME OF DECEDENT)
Late of Cumberland
State of Pennsylvania } ."
County of Cumberland
County
The Fi rst Rank and Trust r.omrany ,Meehan i cshurg
1\.ttmmmmrur of the estate of the above-nomed decedent being duly sworn, depose
Executor
and soy
Decedent died
May
. 19~{testatc leaving 0 lost will, 'copy of which is hereto attoched..}
(y EAR) 1n+e-s4a+Q
22
(MONTH)
Name and address of attorney or }
other authorized representative to whom
all correspondence should ~e moiled.
{DAyl
That as such Executor deponent is familiar with-the affairs of -said estate and the property constituting
(EXECUTO R.ADMINISTR A 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....FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
Commonwealth National Bank
Main and Market Streets
MechanicsburQ, Pa. 17055
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:
B
of this return,
That Schedule A attached hereto and made part hereor sets rorth rully and in detail all the real property
in the Commonwealth of Pennsylvania of which dece,dent died having an interest therein. It als'o ~ets 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 there.of
as or date of death or decedent.
That Schedule B attached hereto and made part here or 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 interes,t day prior to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases~;'~li' bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the UnittE.d States to the..~e-
cedeht; 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 ift the time of death:; ':'
all wearing app~rel, jewelry, silverware, -pictures, books, works of art, household furnitJre. horses, carriages, .
automobiles, boats, and any and all other personal chattels of whatsoever. kind or nat~re,;left by decedent,-
.,. -...
together with the fairly;_estimated market value thereof; all bonds and mortgages held by decedent and'of'~ll
claims due and O\\';ing decedent at the time of death, and all promissory notes or other.instru~e~t~ i~\vriting
for the payment of money of which decedent died possessed, of ~hatsoever nature, with inter;;tth.~-;eon, if.
any, giving the f.ace 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 insura~ce 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 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 thereM
of at such time.
.
.
.~
.
In the case of securities of close or family corporations, the values reported are as far 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 b,uslness.
A copy of the co-partnership agreement, (if oral, a. statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the ousiness 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 of transfers of property, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to tRke effect in possession or enjoyment at or
after death, 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 other facts of a pertinent nat~re regarding said transfers. In the case of transfers intended to
take effect in possession or enjoyment at or after death, there is also attached 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 pa~ses at decedent'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 copy of the instrument 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 Sc~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 name
of the decedent and others, plus the date and place of record of instrwnents effecting the vesti ture 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~edule 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;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions 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 and unpaid 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 pledged 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 registered in the Summary.
The First Bank and Trust Company
Executor\of Lester '
Subscribed and sworn to before me this.. . .....~~~.~.~~.......~ 1\
::::::. ..1t#[~ /P;:'YZ tt.\.. ~ t't;:;r<(f "~~ p ,. B~(~. .~e'''et'~~N''~tl..L. ~b~ro).':?:'.::.::'::::'::::':..'.:."...:.'~..'
~,e'1\"'l?n,oy .,." ,"" ~~, ~,
I" ~.:~.".~ I), :u::-,~rlard County
j., . . .-;,5 J' bD;.'es Oct 22, 1982 . Me(;ha,I]i..(;~s.b.u.rg~...~P~i1.,....l7...
f.,Af'" .~~(. Pennsylvar",ia -ASsociation of Notaries (City or Town and St4te)
NOTE: Before signing affinavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisted securities,
securities 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 column #1 in the "Summary" has been properly completed as above-directed.
Estate
~,.
.RCC~34 (4-73)
COMt.!ONWEA~ TH OF PENNSYLVANIA,
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENl'
'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 common 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 joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E. ")
Th~ fGol property located In the Commonwdolth of Pennsylvania should be (1) (2) (3\
descrIbed by lot and bloc.k numher, street and street number, together with OEPARTMENT
a general description of the property, with a reference to the record of the ASSESSED VALUE VALUA nON
c:onveyance by which the decedent took title; H Q farm s'tate number of o~ FOR YEAR OF ESTIMA TED CAUTION
c:res; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,or. DEATH In this space)
to be listed on Schedule Uflr and must not be d_educted from this schedule.
All that certain lot of ground situate in the
Borough of Mechanicsburg, County of Cumberland, I
State of Pennsylvania, 42 feet by 70 feet, more
fully described in Deed dated 8/14/69, between -
Mary S. Davis and Lester,W. Erb, recorded in -
Cumberland County Deed Book I, Vol. 23, Page 621- / --
5, :500. 00
Sale Price 5,500.00
3 S tory frame dwe 11 i ng, known and numbered
as 50 W. Keller Street, Mechanicsburg, Pennsylvania,
more fully described in Deed dated 2/17/56 between
Paul M. and Rachel M. Spangler and Lester W. and
Sara Jeanne Erb, recorded in Cumberland County / ,/'
Deed Book Z, Vol. 16, Page 132.
I
Sale Price 29,900.00 d.'9I~OD,OO
Insert this totol opposite "reol property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
$35,400.00 UI~IOO ,00
RCC -35
*~
.
'COMMOIlWEALTH OF' PENNSYLVANIA
TRANSFER 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 ftE". 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. U. S. Savings Bonds and tenta-
tive trust accounts, 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 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 firluciary 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 outside of the State, at the time of death, should be listed in this schedule.
Item
No.
ITEM
List and describe fully
UNIT ESTIMATED
VALUE MARKET VALUE
1
First Bank and Trust Co.-Checking Acct. No.
120-506-1 .
Cash found in cash box
2
3
Cash found in wallet
4
Cash found ,i n home
Cash found in safe deposit box
Reimbursement from Medicare
5
6
7
Reimbursement Blue Shield 65 Special
8
Refund on premium,Monarch Life Insurance Co.
9
Refund on Premium, Mutual of Omaha
10
Income Tax refund, Commonwealth of Pa.
11
Refund on Premium Mohlers Insurance Co.
12
State Capital Savings & Loan Assoc. C.D.#13888
Accrued Interest on C.D.#13888
13
14
State Capital Savings & Loan Asso. C.D.#12913
Accrued interest on C.D #12913
15
16 State Capital Sav. & Loan Assoc.CD #8296
17
Accrued interest on C.D.#8296
18
State Capital Sav. & Loan Assoc. C.D.#6270
Accrued Interest on C.D.#6270
State Capital Sav. & Loan Assoc. C.D.#4658
Accrued interest on C.D.#4658
19
20
21
22
Carlisle Building & Loan Assoc.Acc. #6039
Accrued interest on account #6039
23
24
Carlisle Buildin9 & Loan Assoc. Acc #11-2547
Accrued interest on account # 11-2547
(continued)
25
DEPARTMENT VALUATION
(Do not write in
this space)
I ~\ q'il'7.01
gO.~~
I~O.OO
I. '+'1
\)O~tf.OO
'SIt. 'i 0
\~.'-O
0l..1. 0 I
c..'t.l#1
S't.OO
\<=\Q."8'O
\o.~OO.St!.
30*.01..
101000.00
~'1."" .
\~tI.9~
510flO.60
\~<a.'1~
l..,401. 6~
lID S'. D~ .
.3\~(PVt~
1'\. ~S .
5,000.00 .
\~.O~
Inser t this total opposi te "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
I \~,14D.99
x X
Rce-35
'COMMO~WEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "an
PERSONAL PROPERTY
~
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal prOllerty 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 ftE". Intangible personal property, titled in the name o~ 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 accounts, 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 furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal ~roperty, 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 Of' 'fiduciary in said capacity, partnership interests, interest in anyundlstrlbuted
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 ESTIMATED
VALUE MARKEr VALUE
DEPARTMENT VALUATION
(00 not write in
this space)
26
Carlisle Building & Loan Assoc;Aect. #11-3414
Accrued interest on account #11-3414
Carlisle Building & Loan Assoc. Ace. #06-1176
Accrued interest on account #06-1176
Carlisle Building & Loan Assoc. Acc. #06-2412
Accrued interest on account #06-2412
State Capital Savings & Loan Assoc. Acc. #1580
Accrued interest on account #1580
Pontiac Sedan - Sale'Price
27
28
29
30
31
32
33
34
35
Chuck Bricker Auctioneer - Gross sale of personal y
Grandfather clock - appraised value
Assorted cut glass items - appraised value
Blue willow meat platter - appraised value
Picture frame with church scene - appraised value
Boston rocker - appraised value
Plank rocker - appraised value
36
37
38
39
40
,
41
42
43
Demand note dated 1/1/78 between Lester W. Erb and
Lester W. Erb, Inc. 7% interest-balance due
5,000.00
S\DOO. 0 o.
\~i'. 3~
:s', D04. DO
\~r,C\(
.5',000.00)
l__f,'il/
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last pa.ge of' thls return.
x X ~ \81\~H;;t. tt~
128.91
10,251.01 \ OIa.S"i. ~ \
212.96 . O\\~.q/.
/
3,300.00/ 31~O.OO
14,806.00 /'1\'1 i'O(". 00
./' \1~60.00
~O. 00
.
~.Ol)
.~O.OO
40.0
"l0.00
30.00
~,742. 7XJ
;10.00
..3~\3\":'~
3~18'93. Ii
RCC-36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFEfiS
RESIDENT DECEDENT
(1) Did decedent, wi thin two years of' dea th, make any transfer of' any material part .91' his es tate, wi thout
receiving n valuable and adequate consideration therefor? (Answer yes or no) I~O
(2) Did decedent, within two years of death, transfer property from himself' 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 is in the aff'irmative state:
(a) Age of decedent at time of transfer
(b) State of decedent IS heal th at time of making the transfer. (Note 1).
(c) Cause of decedent' 5 death. (Note 1).
(4) Did decedent, in his lifetime, make any transf'er of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no) No
(a) Was there any possibility that the property transferred might return to transferer 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 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 before his death:
(a) The possession or enjoyment 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 therefrom? (Answer yes or no) No
(6) If the answer to (5) (b) above is in 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) Did decedent, at any time, transfer 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 transfer or by operation o:f"law? (Answer yes or no) No
(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 supported by affidavit 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 forth below a description of the property
transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with
relationship of transferees 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 1n manner in which provided in Schedules A, B, or E.
ITEM
MARKET VALUE
(Estimated)
DEPT. VALUATION
(Dept. Only)
DESCRIPTION
None
NDN.
Insert this total opposite "TranSfers", Schedule "en in the
"As Repor.ted" colunm on the last page o:f this return.
N O"t.
Rce-37 ~li-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT .DECEDENT
BENEFICIARIES AND ADDRESSES
(State full names and addresses Df all who
ha~e an interest, vested, contingent or other
wise, in estate)
Marjorie Ann Strasbaugh
W. Allen Street
Mechanicsburg, Pa. 17055
Selwyn B.Walter
67
University Park
Hyattsville Md. 20782
Nevin & Lois Whitcomb
318 W. Lisburn Road
Mechanicsbur Pa. 17055
St. Paul's Lutheran Church
Mounted Route
Enola Pa. 17025
Lutheran Ch r
Odd
999 West Harrisbur Pike
Middletown', Pa. 17057
Mechanicsburg Cemetery Assoc.
101 S. Market Street
Mechanicsbur , Pa. 17055
American Cancer Society
3309 Spring Street
Harrisbur Pa. 17111
SCHEDULE "D"
BENEFICIARIES
RELATIONSHIP
(If step-children or
illegitimate children
are involved, set
forth this fact.)
Cousin
None
SURVIVED
DECEDENT
STATE YES
OR NO
Yes
Yes
Y
DATE
OF
BIRTH
Ad
Adult
INTEREST OF
BENEFICIARY
IN ESTATE
glassware $1,400.00
latter, Picture of Church
two rockers $160.00
Inc. & Note
Erb. Value
I
\
25% of
10% of residuar
10% of residuary estate
Deponent further says tbat all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
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SUMMARY
........(Sch. "A")
.....................................(Sch. "B")
..(Sch, "e")
Real Property
Personal Property
Transfers
Gross Taxable Estate.
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(1 )
(As Reported)
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$ ..................
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(2)
(As Determined)
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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
aye an interest. vested. contingent or other are involved, set STATE YES IN ESTATE
wise. in estate) forth this fact.) OR NO BIRTH
American Heart Association 10% of residuary estate
2915 Wayne Street
,Harrisburg, Pa. 17111
Business Men's League of Mechanic burg
27 E. Main Street 10% of res i ", estate
Mechanicsburg, Pa. 17055
-
,
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"
.
"
,
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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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Real Property. ..............
Personal Property
Transfers ..............
SUMMARY
........ ................. ...............(Sch. "A")
.......... ...............................(Sch. "B")
............. m....(SCh. "C")
Gross Taxable Estate.
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(As Reported)
$..}5.,400.0Q
$.. ..165.720.99
$.. .
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$..201,)20,99
(2)
(As Determined)
$
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C6MMON'I'l'EALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE HE"
JOINTLY OWNED PROPERTY
INSTRUCTIONS: This scherlule must disclose all property, real and personal, owned by the decedent jointly
wi th -anot.her or others, including intangibles, standing in the name of' the decedent and others.. List
real estate first, as entireties, or joint tenants, giving brief description, as indicated under Schedule
"A", plus the date and place of record of instrwnent effecting 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 deced.ent.
Description of Property, Date of Acquisition, Name
Address and Relationship of' Co-Owners, and Place
of Record of Instrument. where Real Estate.
Unit
Value
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
Estate
Valuation
percentage
Share
x
x
3S
:x: 0<
:x
0<: X
:x:
0< :x
:x:
('X)( :x:
t\.l oN-
None
..
Insert this total opposite "Jointly Owned Property", Schedule "En
in the" As Reported" colwm on the last page of this return.
N Of'lL
REV-484 (a"'7B)
County" Num~er and Name
FiI;' Number
Date 01 Death
(21) Cumberland
21-78-280
5/22/78
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate Name
Erb
(LAST NAME)
T.p-~t"p-,...
(FIRST NAME)
w.
(lNITIALI
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of (lnmnpTt1;:tn n
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 uAu, uB", "e", and "E".
Dated:
10 October 1979
~IZLWLJ ~)
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register 01 Wills in and lor 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 IIF", which greater or lesser amount represents the sum
allClwed os a deduction.
Dated:
REGISTER OF WILLS
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
ODE (HARRISBURG USE ONL YI
O()i-
1()i-
2()i-
30+
REMAINDER APPRAISEMENT CODE
Real Prol?erty (Schedule A)
Personal Property (Schedule B)
Joint~Held Property (Schedule EI
Transfers (Schedule C)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE Fl
CLEAR VALUE OF ESTATE
$
40-
Valuation of life estates or
PRINCIPLE
FACTOR
VALUE
1=
.:L-
t=.
onnultles....................._ $
1==
ESTATE TAX ASSESSMENTS _ $
FOR USE OF REGISTER ONLY
Tax on $'
TClx on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
~
COMPUTATION OF TAX
2%
6%
15%
$
$
$
$
$
.
("') As evidenced by Cha,rltable
Exemption Certificates Issued
by the Secretory of Revenue.
TOTAL TAX
$
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
$
$
t=
$
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
~
$
$
$
c
$
$
TOTAL TAX BALANCE $
PAID $
Supplemental Cod':., (FOR USE IN HARRISBURG ONL Y)
48-Adj ustment
49+Adjustment
56.-Annuity
6O-Lile Estate
92+Remainder Appraisal
9.3-Remainder Deductian
9 3C-Charity
94-Remainder Residue
96-Successi ve
Lile Estate
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE: Where subsequent adiustments are made to the above computation 01 tax by the Register 01 Wills, lor proper reason,
same should be nated below, with short explanation.
92+
93-
-
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bruJ
REV-S1B (3-79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P. o. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Investigation Division
NOTICE OF FILING OF APPRAISEMENT
M,I'. Wayne Kautz
T;he First Bank & Trust Co.
:P.:O.Box 350 '
MechiOnic"hll"'g PA 170'55
(Executor or Administratorl
In Re: Estate of
LeSTPc,.., ;W _ F.T1h
.~11mhpT'l.' ;:!nn
County-FileNo.' ::l17Q 280
.
Dear
"
You are hereby notified that the ()",; g;nal
appraisement in the estate of Leste1" :W. F.",h
has been filed in the office of the Register of Wills of Cllrnh"",1 iOn t'I
County on 10 Ootob'eI' ,19....1..9.. Said appraisement reflects the foliowing valuations:
.. J
Real Estate
Personal Property
Transfers
Jointly Owned
Total
~<;'>liO:o.og
1811,31:2.99
Nonp-
None
,$ 2:it9:.::1I2. 99
"
-
~
As to such tax that is paid within three months from dafe 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 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. 2485-1001, P. L. 373.
Title
Appraiser
NOTE: This is not a bill.
REV-451 (8-18) . .
DEPARTMEN'r OF 1l['IIENUE
BUREAU DF FIELD OPERATIDNS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
10 October 1979
DATE
COUNTY
FILE NO.
.r.urnhpT"1 i=lnrl
21-78-0280
Whereas, T.p~t'p"" W F.....'h late of M~Ql-..~13': QCP"rg
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the ? ? ~ ~ day of M ~ J' 19 ..:z.s. , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, \; liR QPil ~tllR 8 ' 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 Estate $ ~. hnn nn
. ~, ~, 184 312 99
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Have been duly sworn according to law, I do here by certify th
with the law on this _ 10tH day of
the above appraisement is made in conformity
19 ~.
Appraiser
(Number and Street)
H.':I""'''''; ~r.~'r'g
(Post Office)
. Penna.
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