HomeMy WebLinkAbout10-05-78
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Form RCC-33
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
'*,
RESIDENT DECEDENT
1-I-1f^~~
COUNTY OF
...qWl!P/:Pf3,1g....~..J~78...
IMPORTANT: This return must be completed in detail and filed in duplicate, with will attached, with the
Register or Wills of the County where decedent resided; Return is due within one year after
date of death, unless an extension is granted 'hy the Secretary of Revenue. '(Section 703 of
the Inheritance and Estate Tax Act ot' 1961.)
IN THE MATTER OF THE ESTATE OF
....!::lc:>l:9.:1;.hLl'!....JC~,~gE?~......
(state full name or decedent)
Late of .......
.G.Wl!9~:r;:I..!!'.I.I4
........................}::::::: OF
IlB:AIJ)l'IS'l'D'TOR
County
Slate of .. .:!?!1!1}:!li1yJygnJ,.!!,.....
Cumberland
County 01
.....}..:
-..-.
....Gr.!1..~g;1.1
--~M"__
of the
$.K!:l,J.g/::r; ... ...m.m.'._'.mm__ .
estate of the above-na.med decedent being dilly. ~worn, depose
_tor
and say
Decedent dJedmP~.C:;f3JJ11:lE?:J:' m .. 25
(Month)
.....--(J.~;.i............ 19..{.~ZX'--'{ =~~B~ing Q last will, copy of which is hereto at~aclied. }
Name and address or attorney or}
other authori~ed representative to
whom all correspondence sho~ld be
mailed.
GeQrge . .fl.... fa.ll.er....
TenW.HighSt .,
CarlisI e,J?a.,17013
That as such ......~~9.),1.:t:.c:>.:r,................. deponent is familiar with the affairs of said estate and the property con-
(I.::t('~llwr-AdminiAhal.or} .
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit bux registered in decedent's individual name, or jointly'
with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent
or deputy, with the exception of the following;- .
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES qF HOLDERS TO DECEDENT
Dauuhin Deuosit Trust Co deceden+ ;n,f . - -!'I-
Carl~sle, Fa. S. Kruger. husband
That the contents of said sare deposit box or boxes are itemized under Schedules
return, with the exception of' the f'ollowing, for the reasons hereinafter set forth:
of' this
That SC,hedu/e A attached hereto and made pa.rt hereof' sets forth fully and in detail all the
real property in the Commonwealth of Pennsylvania or Which decedent died having an interest therein. It
also sets rorth the mortgage encumbrances upon each parcel of real property at the date or death, giving
the amount still due at death, name of, mortgagee, date, rate or interest, and book a.nd page o~ record
thereof'. It also sets forth in the columns .provided theref'ore the assessed valuation of' each of said
parcels, the estimated market value thereof' as of date of' death of decedent.
That Schedule 8 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 lert by the decedent
at the time ot 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 prior to decedent's death in the case of savings banks, and to the date of decederit's'death
in all other cases; all bonds, postal savings, treasury certificates or notes and oth~; evidence of in-
debtedness of the United States to the decedent; all obligations, whether by statute:or. agreement they
are designated as tax free, of the United States, or any state, or political subdivision the~eo~, or ~r
, .... ~ ... <;
. any .roreign country, which are ownen at the time of death; all wearing apparel, jewe~ry, ~ilverwal"e, pic-
tures, books, works of' art, household furni ture, horses, carriages, automobiles, boat~, and any and all'
other personal chattels of' whatsoever kind or nature, left by decedent, together with the ...rafr1 y es timated
market value thereof; all bonds and mortgages held by decedent and of all claims due and owing decedent
at the time of ~eath, and all promissory notes or other instruments in writing for the payment of money
of' which decedent died possessed, of whatsoever nature, wi th interest thereon, if any, giving the face
value and estimaterl fair market value thereo~, and if such estimated fair market value be less. than the
face value, it sets forth brief'ly the reasons for such depreciation as to each 1 tern; all moneys payable
to the estate from li1'e insurance poliei-es carried by decedent; all annuity and endowment contracts the
proceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends
due thereon and unpaid as of the date of' death, bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death, with the market
value thereor at such time.
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.
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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' rlecedent at the time of
death in any co-~artner5hip or business, and In support of' the.value of such interest there Is annexed to
said schedule, finllnclal statements showing the assets and liabilities of' said co-partnership or business.
A copy of thE' co-partnership agreement, (if oral, a statement setting f'arth 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 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 wi th the f'air market value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The Schedl.lle 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 t.wo years of decedent's
death, in contemplation 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 transferred, the
relationship of the transferees to the decedent, the proportlonate share received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the.cas~ 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. Ther~ is also set forth 1n 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, or jointly wi th another, or any power of appoint-
ment vested in decedent) either individually or jointly, by ~he will, deed, or other instrument of another,
with a copy of the instrument creating.su~h power attached to the schedule.
t" t t.
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 ~or 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 with another or others, including intangible, standing in the name
of' the decedent and others, plus the date and place of record of instruments effecting the vestiture of'
real estate and the. date of acquisition .of' personalty, plus the n~e, address and relationship) if any,
of co-ownerS to the decedent.
That Schedule 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, inclurling funeral expenses paid;
family exemption, where applicable; costs of' administration of this estate; counsel fees and fUdiciaryfs
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 ann unpaid at time of'
death; taxes accrued chargeable ror 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 f'idllciary 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 ta~ 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 a.nd properly registered in the Summary.
Subscribed and sworn to before me this ~d..,...,.
~~~-
.,...2.~~.~..~.:......,.............
/Y (~t:reet.ANumberf)
. .,..~;//:;?,./Z4fL..5....
(City or Town and State)
GER
Mv (ommiulon Expires March l. 1980
ClJ,:iilc, PlJ. Cumberland Countv
NOTE: Before signing af"fidavl t make sure all blank spaces in tf1e affidavit and schedules annexed are
filled in with details or the worrl "None", and in case the assets incll1de rare and unlisted securities,
securi ties of close or f'amlly corporations or an interest in any co-partnership or business, that the
data anrl stll.tements requirerl under the "pJlragraph above relating to Scherlule "9" are attllcherl. Also make
certain that column #1 in the "Sununaryrt has been properly completed as above-rlirected.
'. '1
R$C-J4 14-0\3>
COMMONI'!EAL TH OF PENNSYLVANIA
DEPARTMENT 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 common with another or other, should be identified
as ta 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.")
The real property locafed In the Commonwealth of Pennsylvania should be (1) (2) (3\
descrIbed by lot and block number, street and street number, together with aEPARTMENT
a general description of the propert)', with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title; If a farm state number of a- FaR YEAR OF ESTIMA TED CAUTION
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DECEDENT'S MARKET VALUE (Do not write
to be listed on Schedule IIF" and must not be d_educted from this schedule. DEATH lit thl. spoC'tt)
None NONE
,
,
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.
liO_N E~
.
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'RCC -311
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
*'
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of his death. Property owned by the decedent jointly with another or others
must be 11&ted under Schedule "E". Intangible p~rsonal 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 accoWlts, must be listed, despite the f'act that they are not of the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, houBeho~d
goods, and fUrnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certiricates, 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 undis tributed
estate or or income from any property held in trust under the will or agreement or another, even though
located outside of the State, at the time of death, should be listed 1n this schedule.
Item
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKEr VALUE
DEPARTMENT VALUATION
(Do not write 1n
this space)
1.
10 sh. Allenberry Players, Inc. @ 110.
1100.00 ~ /l1(jO. () (j
23236.32 ~ 4.1/1-3'.J 2-
2.
Carlisle Building and Loan Assn.
Savings Cert. #11-1134
.
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" colunm on the last page of' thts return.
x X
24336.32
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COMMONWEALTH OF PENNSYLVANIA
TRANS}~R INHERITANCE TAX
SCHEDULE "c"
TR-<\NSFEllS
RESIDENT DECEDENT
(1) Did decedent, within two years of death, 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 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 af'firmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the transfer. (Note 1).
(c) Cause of decedent's 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 frQrn th~ 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 affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent In his lif'etime make a transfer, the consideration for which was transferee' 5 promise to
pay income to or 'for the benefit of care of transferor? (Answer yes or no) no
(8) Did decedent, at an;)' timet transfer property, the beneficial enjoyment of which was subject to change,
because of a reserved power to alter, amend, or revoke, or which cmtld revert to decedent under terms
of transf'er or by operation of law? (Answer yes or no) 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 benef'iclary 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 transfer~ and to whom transf'erred, 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
DESCRIPT ION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
liONS
Insert this total opposite ftTransfersft, Schedule "e" in the
fI As Reported" colunm on the last page of' this return.
NON8
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RCC-37 . (12-63)
CO~IMO~\rEALTIl OF f'E~,;\,SYYL\N]A
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
.~~
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")" WJ:" It\.
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BENEFICIAHlES
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
(State full names and .addresses of all who illegitimate cr-ilrll'cn 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 BI RTH
Creedin S. Krulrer husband yes entire residue
246 Glendale St. .
Carlisle.Pa.. .17013 . . .
.
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. "n")
. (Sch. "C")
Heal Property... ..........
Personal Property
Transfers
Gross Taxahle Estate
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RCC-38
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
. ,j. ~.. ....
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
re.:\l estate f'irst, liS entireties, or joint tenants, giving brief description, as indicated tmder Schedule
II 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 naine, address and relationship (if any) of co-owners to
the decedent.
Descrtptlon or Proper ty, Date of' Acquisl tio.n, Name
Address and,Relationship of Co-Owners, ~d Place
of Record of Instrument, where Real Estate.
'^ XX:X:>O <X ex
>6':X~ C><; ex::
'\!VAl'
trnit
Value
Estate
Valuation
percentage
Share
~i9:
><X "x
None
Insert this total apposite nJointly Owned Property", Schedule nE"
in the "As Reportedn column on the last page of this return.
DEPARTI.lENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
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NONE-
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RCc;.39 (So-'M')
County, Humber and Home
File Humber
Date of Deatb
File Date
Estate Name
SUMMARY
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
ILAST NAME)
(FI"RST NAMEI
(INITIAL)
REPORT OF INHERITANCE TAX APPRAISER
I, tbe undersigned duly appointed Inheritance Tax Appruiser in and for the County of
Penn.ylvania, do respectfully report that I have appraised the real and personol property a. reported in the foregoing return ot
the values set forth opposite each item in the la$t column to the right in Schedules "All, uB", "C", and liEu.
Dated:
/tP~ Jk 7f
~-'L~ N, ->>~
INHE:RITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in ond lor County, Penn.ylvania, 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 !IF", which greater or lesser amount represents. the sum
ollowed as a deduction.
Doted:
REGISTER OF WILL.S
.
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED CODE VALUE AS REAPPRAISED COOl
Real Property (Schedule A) $ $ 004+ 00+
Personal Property (Schedule B) 24336 32 10+ 10+
Jolnt"Held Property (Schedule E) ~
Tran$fers (Sc:heduleC) 30+
TOTAL GROSS ASSETS :&4336 3:&
Less Debts and Deductions 6447 00 40-
(SCHEDULE F)
17889 32
OF ESTATE
ClE AR VALUE
Valuafton of life estates or ,.~
annuities........ ..............~ $
PRINCIPLE
FAC"tOR.
VALUE
I~
t=
E
ESTATE TAX ASSESSMENTS _ $
,
FOR USE OF REGISTER ONLY
Tax on" $
Tax on $
Tax on $
Tax on $
ToX" on $
Exemptions
Totol Estate
~
COMPUTATION OF TAX
2%
6%
S%
10%
15%
$
$
$
$
$
.
TOTAL TAX
$
.
(*) As evidenced by Charitable
Exemption Certificates isslJec
by the Secretary of Revenue.
$
.t=
Less taJt previously paid
BALANCE
Less 5% of tux if paid within
3 months aEter death
$
$
BALANCE OF INHERITANCE TAX DUE
Add interest at rote of 6% from
..
AMOUNT OF ESTATE TAX ASSESSED
Estate tax pold
~
$
$
$
f=
BAl ANCE DU E
$
$
TOT Al TAX BALANCE $
PAID $
Add interest of rote of 6% from
..
Supplemental Code.: {FOR USE IN HARRISBURG ONLY)
48-Adju.tment
49+Adjuotment
56-Annuity
6O-Lile Edote
92+Remoinder Appraisol
93-Remoinder Deduction
93C-Chority
94-Remainder Re.idue
96-Success i ve
Lile Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsequent odiustments are made to the above computation of tax by the "Register of Wills, for proper reason,
same should be noted below, with short explonation.
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RCC-81 (6-7.9)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
IN YOUR REPL Y PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING or APPRAISEMENT
Cr.eedin S. Kruger
246 Glendale St,
Carlisle. uQuna.
(Executor or Administrator}
"'
In Re: Estate of
Dorotb1 W Kruger
r.rtnlhArltlnn
County - File No.
21-1A-MA4
Dear
You ore hereby notified that the Odg:tn:>l
appraisement inthe estate of Dot'ol'hy l~. J{rugl'\t'
has been fi led in the office of the Register of Wi lis of Cnmh"rland
County on 16 October , 19 78 , Said appraisement reflects the following
voluations:
Real Estote
Personal Property
Transfers
Jointly Owned
Total
None
24,336..'32
None
None
24.336.32
As to such tax that is paid within three months from dote of death, 0 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 dote 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 os provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373,\:\"
Dote 16 O"toher 76 Signed. r12-~t~ J(, ~~
Title
Ghi'"f Appr"i lOP,.
"
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. Note: This is not 0 bill.
F
">f" ..:..
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE \ O-LG,.:.-f'e
COUNTy(l~~~
FILENO. 2\-1.~ -C')'"2..18y_
R C C-2 (2-64)
~
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
Whereas, K. late of'
in the County of (' 1 ~ Commonwealth of Pennsylvania, having died on
the "L-- S~ day of D~ 1911 seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Th f I \ ~ , ~ 0 D. . . . d I ' t d d' t I
ere ore, , ,~"- - . an appraIser u y appom e accor mg 0 aw,
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 CommonwealUl hereby expressly reserves the right to appraise and assess transfer
Inheritance taxes at the lawful collateral rate on any such future interest.
Unit Apprai$ement
Oncrlptlon of Anat Value. Made (or Inheritance
Tall Pur pOle.
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Having been duly sw~ ~rd~o law, I do hereby c~
formity with law on this day of
the above appraisement is made in c9.ll-
. 19~.
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