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Home My WebLink About08-02-78 Form No. RCC.62 (6.70) THIS FOR)! REQVlRED IN ALL ESTATES WITH GROSS ASSETS UNDER .10,000. UNDER SECTION 701 OF ACT OF Jt1NE US. 1"1. ~!'FEC"flVB JANUARY 1, -1982. (FlU IN DUPUCATE WITH COpy OF WILL AITACHED) <";1 L:l.~'/-~ - 63 ClI '1,* OFFICE OF'THE REGISTER OF WILLS to~ \(,-S-~ . . County of .{!Uf.lb.e~L/;!,(1/.a..... AUG 02 1978 .... .Sh.l~.I. try.. .7JC?1.f:S.67................ of ;J.Q~.b.'-:7Nf2,~.<".s:r.<,:~.R<w.4.;.~/:f.j2./.0.LC. (Namel (Addreae) ; being duly..nS..!Y!.tlB./Jl.mn...nm.according to law, deposes and sa)'s that he is them.E_.~~.i/..7..&.l. -,t...mm..n.___.nm (Exce.. Adm., L$tCe, Ere.] of the estate of..Si:zHILE:.L.mG,."Ba.US-E...._ whose last residence was..;;'.~n_u."2LJ,(c:.b~.rZI!i&.L:tia~n__ (No.) (StreC'C) n~.~.~~.&.m.&<<.~<Y.'.mmm.dec<ased, and that the whole of the estate of said decedent, who diedm-:t !.J..9./Z8.___mn (City, Borough Of Township) 7~~ (lfa.~) consisted of: '~ REAL PROPERTY. REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT. WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES. ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. ',< Real Estate Estimated Value . . Personal Property VS85.87 Adult Tricycle with accessories .... CB Radio V63.00 Gold tie clasp (sentimental value) 1/25.00 man's black onyx ring ~ V35.00 3 srroking pipes v V 12.00 assorted articles of clothing v V620 . 00 5 pairs of shoes .. " 35.00 t\T. y,.v. II nnrLlentos (sentiI,"€Iltal value) ..... ,.... 0 '72 Datsun '" --700.00 '76 Chevy Van ",.. / 4.200.00 '. ! - . IdL .;'1-:-f?'1 / NOTE:' You may expedite the processing of this return by filing with it, and as a part of the return, letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the decedent as of the date of death. Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest ih the decedent's accoWlt at the date of death and the type of accoWlt, accoWlt number and the exact name or names in , whi~h thp. ~"''''nllnt iq 1"'pO'iqtp'rpri Jointly Held Property Estimate" Value rb..J."",,1..u1. M., / p ,~ fobr in int names , , 30 Shares Xerox COrp. I~ 1(1'4~:.?~ 1- (712.50 Savings 1\cOOUnt - First Federal Savings & :wan Association 25 Shares A~ican Home Products Corp. Wybro Federal Credit Union 4,167.78 1- Transfers within TWO YEARS Prior to Death I I I 1---- I j I 1- That at the time of death there was no safe deposit box registered ih 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 SAFE DEPOSIT BOX THIS SA.FE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT _HOLDE1!-_~.!.Q~~~DEN~_ BENEFICIARIES P.ELA T10NSHIP SURVIVED AGE OF LIFE BENEFICIARIES AND ADDRESSES (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICJARY an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE forth this fact.) DECEDENT ~..,. '" ..n-Fo "0'" "n f',,11 - I -.- j .i' ESIDENT DECEDENT 'DEBTS AND DEDUCTIONS CLAIMED -N TE: List first five items in the spaces so provided, observe notations thereon, and instructions. DEBT OR CLAIM NATURE OF SAME AMOUNT Funeral expenses paid $ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) OTHER DEBTS AND CLAIMS Administration Expenses. Counsel fees ill Fiduciary commission '" , (') See Note below Total t:ote: The estate agt'ees to advise the Register of Wills if the amount or less than the estimated amount claimed and allowed. :o.....-t...~ ",...0(" 4 :~-:r;'ry.,_ Subscribed an'd--swam to before me this . . . . . .. . ff.-::"{'tY'Yrrr..~{". ~ 39',~~>",//. :;~... day of , , " " , ,IlY.".t.. ~~~-; ~:y;;J~,-~, - ~~// ..... -=s ~,.;;. /" - ~} ". oc.... ~ . ~' d'~ g ,'-"J~ ~;,;:iA1i 'ff"~~LO, No . !Sfk ?-o....{;"" d '0 '40:"~f"""~~ Mechanicsburg, Cumberland Co./ Pa. ~. ...-:"i:'_ . ~ '"Mv Commission Expires Dee; 10.1979 actually paid in settlement of any fee, commission or' debt is greater ..,...,~':;t~..,.."....,. .~$.m~+<.~..,.. (Street Number) ..,. ~ii7:f~~,~~!J;i~70'l" '~:'I"1" '-"' , .'~ .....- Having be-en~-dufy swom according to law, I do hereby certify that the above appraisement is made in conformity with law on this ................ .,;R.,6.ff..L.., day of .... ....... "A~,l~.t':'~d'd"'" d'" Apprtloinr In the event that any future intet'est in this estate is transferred in possession or enjoyment to collateral heirs of the decedent aftel' the expiration of any estate f01" life or for years.. the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for. . .. . . . . . . . . . . . . . . , . . . . . . . . . . . , . .. County, Pennsylvania, do respectfully report that I have allowed debts and 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 said schedule above, which greater or lesser amount represents the sum allowed as a deduction, Dated: .....,...."..,.. d " , d d , .. .., ..' '" ... , .. . Register of Wills " ( r C'l t"' 0 10 ~ C ~ >:E .. :l ~ III 0 ~ 0 e= . :l ..... ~, z tl:J II 0 ~ :l . ~ ..... ~ .r ~ ~ 0 :~ i:~ tl:J ~ n III ~ t III t ~ :w ~, 0 ~, 0: 0 pJ 0 > ..... ::t tl:J 'oJ :l " :1'-. s z ~ UJ ~ --- t:I .. 9i -0 ~ ~ :l f-"f{ > 0 =: Z :l f-" .. > ~ C\ _ '00 :Ci\ ~ .. tl:J ,', .. ~ ;:: :>b 'n- tl:J = > = ~ '<l'CO '" '" .. ;;;- )>:>1 , 0 ~ III :l :bj > ;;' ti~ "l ~ - III UJ ~ t:I'O > > co.. ~:<.:: - t"' \) l-' UJ I-' m :c.-, tl:J >< "" s:: m ~:ft; tl:J ... Z ~. ~ :......- ~ -.---. ""\ . "'" '". +~'" "\. ~- . - f"'" ......-, ....' '\ ~ '..!- .".. '...... ~,~... "'.... ~ ..~. "'-e:":. "r"- ~..?~ ::--.... ;..-- ---= .0:. t .:;::.= _ l::." ~ :; ~ . ~ ~ ,..,'" ~~ ~ €-... \'~. ~ ..." ~ . - "... -: ........, ..,~...... , =t~ \ RCC-Sl (6~73) COMMONWEAL TH 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 Shirley Bouse, Executrix (Executor or Administrator) In Re: Estate of Samuel G. Bouse Cumberland County - File No. 21-78-0301 Dear Mrs. Bouse: You ore hereby notified that the original appraisement in the estate of Samuel G. Bouse has been filed in the office of the Re%ister of Wills of Cumberland County on September 25 ,19~, Said appraisement reflects the following va I uations: Real Estate Personal Property Transfers Jointly Owned Total -0- $6,275.87 -0- -0- :;>6,275.87 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 obiect 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 September 25. 1978 Signed ~t:L- j: > h fp____~ Title Chief Appraiser ,,"-, ~. ~ Note: This is not 0 bi II. RC C-2 (2-641 J' COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE September 25, 1978 DEPARTMENT OF REVENUE a,UREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA, 17127 COUNTY Cumberland FILE NO. 21-78-0301 Whereas, Samuel G. Bouse late of Camp Hill in the County of Cumberland Commonwealth of Pennsylvania, having died on the 29 th day of April 19-Z!L, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Ira K. Gleim , 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 t.he expiration of any estate for Ufe 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. Unit Appraisement Oncrlptlon 0' Allet V.lulI Made (or Inheritance T.x PurpOles REAL PROPERTY NONE $ -0- PERSONAL PROPERTY $6 275.87 6.275 187 TRANSFERS NONE -0- JOINT-HELD PROPERTY NONE -0- TOTAL ESTATE $6.275.87 $6,275 87 - . " '. . . '. , - . . Having been duly BWonl according to law, I do hereby certify that the above appraisement is made in con- formity with law on this 25th day of September ~L A- A. ~ 19-TIL-. AppraiHr (lfumbC!r and Stnet) Harrisburg (PaR om~) , Penna. " 'f ~\ ." 0- ~ " ~ ;;;:) ~ l" ti ~ ;<. " a " " ~ c Q \..) <Jl ~ ~ ... ;; ;; \ " e -D ~ " i iii ~ ;;; !E " -.5 ~ 0 " ~ " <<: (/) " ~ ';; "" -- p Z " ~ ~ '", .. ... ~ ~ '" '"is ... ... ~ l) 0- " .... ... ... 0- :3 ::.. llS ~ I;>. ... ... " rfI l" . " C .; '<<: '<<: '<<: 1 " <; ... " ~ E <') ." i \ -l ::s:: ~ ." S " ~ "' ~ "'t .. <; <:> D.::, ~ ... '" ~ "" - ." -:;; ." " l" ~ " " ~ .. C' ~ :a '6, ..; " .. c " 0' .~ " " ;; l ~ c::;l " It <; '" <Il ~ .\: ... <.tl - ;e ;; " ~ ... 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