Loading...
HomeMy WebLinkAbout12-14-78 , "", .,' ; ~,/._, RCC-23 (4-73) ,; "i '" ! . c2/- 77-3(1 r COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS DEC14197 RESIDENT DECEDENT COUNTY OF Cumberland IMPORT ANT, 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'ltenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF . } AFFIDAVIT OF EXECUTOR County ADMINISTRATOR Harrv T Sloat (STATE FULL. NAME OF DECEDENT) State of .Cumberland Pennsylvania } .., "Late of County of Cumberland William S. Sanford AdI!lm1<liM>>X of the estel"te of the above-named decedent being duly sworn, depose Trust Officer Dauphin Deposit Bk &.Trust Co, and soy I Executor Decedent died June 4 (MONTH) Nome and address of attorney or } other authorized representative to whom 011 correspondence should be mailed. Executor (DAY) 78 '{ , 19_ testate leoying a (YEAR) ~e lost will, copy of which is' hereto attaChed.,} Myers, Myers, Flower and Johnson Lemoyne; Penna. 17043 I Thai as such. deponent is familiar with the affairs of said estate and the property constituting I EXE CUTO R~ADMINISTRA TO R) 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 ., THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A S....FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Nnnp That the contents of said safe deposit box or boxes are itemized under Schedules wi th the exception' of the following, for the reasons hereinafter set forth: of this return, That Scheclule 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 Scheclule B 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 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 ban,ks t tr'!.st .:..cof!1pa~nie,s, or ot~e,r_ ,~~~ti!utions.i: whether individually, or in trust for any other pers,?n .or pers,~p.s giVing also separately the accrued in.terest thereon, if any, down to the last interest day prior to deceden{s~ death iri:..the\case of ~s_avings banks, and to the date of decedent's death in all other case_~.tall bonds. postal ..., savings, treasury ce~t!fi.cat~es or notes and other evidence of indebtedness of the United States to the de- cedent; all obligations, .~heth~r..,iby_~s~atut~, Q~ 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 ~t the time of death; all wearing '!.ppa~~~, j~w~lrY'Jsilve!)Vare,. pic.tures, books, works of art, househoJq furriJfJ:~~',~h;rs'~s;~carriages, \ , 1>-1-..." I.... .-''''"'-1.. 4-"". """";r ~~... . automobiles, boats, and. any and all other personal chattels of whatsoever, kind~'.or".riature. defC'-bWy 'deceaent, - - -,..... "'~'---_~_"...' u... ....-".._, 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 tim'e 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 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 date of 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 dea~h, with the.market value there~ of at such time. '. ~ " . In the cas~ 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 liabili ties 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 llnd liabilities of' said co-partnership or Qusiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of toe 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 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 E~ach inquiry contained therein and in the case of transfers of property, real or personal, within two years of decedent's dea th, in contemplation of deceden t' s dea th, or intended to take effect in possession or enj oyment at or after death, said schedule sets forth the nature and value of such propert~', to whom transferr~d, the relationship of the transferees to the decedent, the proportionate share received by each'transferee a~~ all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to take effect in possession or enjoyment at or after death, th~re is also attached to the. schedule a copy of the deed, trust agreement or other instrument cre~ting the trust~ Ther~ is also set forth in said schedule a list of all property, real and personal, with 1ts value, which pa~ses at decedent1s death by virtue of the exercise by decedent, either individually, qr join~lY ,,1 th .a~other, or any power of appoint- ment vested in decedent, either individually or, joiflt)y,. by the Will, d.eedL or other instrument of another, wi th a copy of the instrument creating such power attached to the schedule. That Schedule D attached hereto and made part hereo~ 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 unner necedent'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 S.:~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 ann others, plus the date and place of record o~ instruments effecting the vestiture of real estate and the date of acquisition of personalty, plus the name, address and relationship, if any, o~ 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 behal~ or this decedent's estate, including funeral expenses paid; family exempti~n, 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 decedent1s death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledgen for obliga- tions, if any. It is agreed that the fiduciary will present proof o~ said claimed obligations upon re- quest, that if the amount actually paid in settlement o~ 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", "e", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. - "Ot\ ........................,s...... . day of ....~....m 19...7....1.. .D...:....,~ ..mm.... NCTAI1Y PU:lbe "'" f-O{y Cor.u1:s:dOn Exptns Dec. 21, 1981 J.o-....oyD.8, PJ.. Cumberb.nd County Daup1r~~..Bank & Trust Co. ( E;ucuto.... 301 Market St. ...................,..,...........-........-.........................~......................._.._..._,,-,- (Street Number) Lemoyne, Penna. 17043 ................-..............................-............................ ..............................~.. (City en' TOlD" and State) Subscribed and sworn to before me this .... NOTE: Before signing affidavit 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 unliste<'l securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements requirerl 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. , ;;"_"<- ._'~.__';!,' '~'_.;.-''';''~._;~-.:~" ..V -....._'.~'--..-,#.-.-,---_....__.__....- RCC_3414..73!" .." COMMONWEALTH 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 os tenant in common wilh another or other, should be identified as to quantum of interest ond the estimoted 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 rGal property located I" the Commonwealth of Penn-sylyanla should be (1) (2) (31 desc:rlbed by lot and block numbor, street and street number, together with DEPARTMENT a general descrlp't\on of 1he property, with a reference to the record of the ASSESSED VALUE VALUA TION conveyance by which the decedent took thle; If a farm state number of a~ FOR YEAR OF ESTIMA TED CAUTIOH eres; also statement of mortgage encumbrances upon each paTee' 01' death DECEDEHT'S MARKET VALUE (Do not write of decedent. Taxes. assessments, accrued Interest on mortgages, etc.,are DEATH In thl. apace) to be lIsted on Schedule IIFu and must not' be d,educ:ted from this schedule. NOl"\L None , Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the lost page of this return. t\\ tl'\I.U Oi' ..' . Rec -35 , . RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY . CO~WONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX I KSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time o~ his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E~. Intangible personal property, titled 1n 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 ~act that they are not or the administered estate. Tangible personal property should be listed ~irst (e. g. jewelry, wearing apparel, household goods, and furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certiCicates, c~sh on hand and 1n bank, stocks, mortgages, notes, together with accrued interest or dividends,. salaries or wages, insurance pay- able to the estate or f'iouciary in said capacity, p(1,rtnership interests, interest in any undistributed estate of or income ~rom any property held in trust under the will or agreement of another, even though located outside or the State, at the time of death, should be listed in this schedule. Item No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 1 GGNB Checking Account 823 3843 ~ CCNB Income Certif. 1607~% due 6-6-81 Interest accrued 9,608.72 q ~DI.1~ I iIOOO.OO t'tl. 19 ;;>'1 ~OO.o() , G\ l't. a l.. '1 t>OO.oo 1lo. 'i'( .;;:lO,lfOO.OO d.\o.3.;l. 2 3 CCNB Income Gertif. Interest accrued ~ 765055 6~% due 7-9- 9 20,800.00 )./0.:. 4 / GCNB In come Certie. 14797 6% due 9-8-78 Interest accrued .,.,.-- CCNB Income Certif. 765046 6!% due 7-9-7 ~t, Declaration of Trust of Dauphin Deposit Bank & Trust Co. #1467 with the follow- ing assets 6-4-78 5 6 Mortgage Participations cash 2064 units Fixed Income Fund accrued income 6,811. 62 182.85 19,286.20 26,280.67 7.09 "~8o.lo '7 . 1.0'\ Insert this total opposite "Personal Property", Schedule "Bft in the "As Reported" column on the last page o~ th!'s return. x X 103,539.43 \o~,S'39. 43 ..:-. 'RCC- ~S COMMO:\WEALTII OF PENNSYLVANIA TRANSFER INHElUTI.NCE TAX SCHEDl.TLE lIell TRJ.Nsrnns llESIDE:iT DECEDENT (1) D.trt decedent, within two years ofcteuth, make any transf'er of /lny mater.ia.l part .of' his estate, l'dthout receiving a valuable ap..d adequa.te consirterntion therefor? (Answer yes or no) no (2) Did decedent, wi thin two years of death, transfer property from himself' to llimself and another or others (inclmUng a spouse) in joint ownershi-p? (Answer yes or no) no (3) If' the answer to (1) or (2) above i,s in the affirmative 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 l)e (4) Did decedent, in his lifetime, make any transfer of property without receiving a va.luable or adequate consideration theref'or wh.tch was to take eff'ect in possession or enjoyment at or after his dp.ath? . (Answer yes or no) no (a.) Was there any possibility that the vro-perty transferred might return to transf'erer or his estate or be subject to his power of' disposition? (Answer yes or no) (b) What was the transf'eree's age at time of' decedent's death? (5) Did decedent in his lif'etime make any transfer without receiving a valuable and adequate consideration theref'or unner which transferor expressly or impliedly reserves fol" his life or any veriod which does not in f'act end before his death: (a) The possession or en,joyment of' or the right to income f'rom the property transf'erred? (Answer yes or no) no (b) The right to designate the persons who shall possess cr enjoy the pro~erty transferred or income theref'rom? (Answer yes or no) no (0) If the answer to (5) (b) above is in the aff'irmative, state whether the right was reserved in decedent alone Qr others (7) Did decedent in tiis lif'etime make a transfer, the consideration for which was transfereet s promise to pay income to or for the lJenef'it of care of' tJ'ansferor? (Answer yes or no) (8) Did decedent, at any time, transfer property, the beneficial enjoyment of' which was subject to change, because of' a reserveil power to al ter, amend, or revoke, or which C01lld revert t.o decedent under terms of' transfer or by operatJon of' law? (Answer yes or no) (9) If' the answer to (8) above is in the af'firmative, was the power to alter, amend, or revoke the inter- est of' the benef'icinry reserved in the decedent alone or the decedent and others? (Answer yes or no) NOm 1: The anSwers to these questions should be SUPpol'terl by affidavit by the attend:i.ng -physician as well as a copy of the death certif'icate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's f(lir market value at date of' death, dates of transf'ers and to .,.,hom transferred, with relationship of transf'erees to decedent, if' any. Submit copy of any trust deed or instrument, if trans- f'ers are claimed to be non-taxable, a.lso submit detailed statement of facts on wh.ich said claim is based. NOTE 3: List applicable property below in ma.nner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARlillT VALUE (Es tima ted) . DEPT. VALUJ\TION (Dept. Only) NCf'lL None Insert this total opposite "Transf'ers", Schedule "e" in the "As Reported" cnlumI1 on the lastpa.ge of this return. t\\Ct'lL If . oJ RCC-37 (12-63) , . COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" *". IJ ~,.t,t. (\ .,.~.., to 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 Janet Hopkins lII;n~o ..o~ ~" ~<> 1I12th Residue 105 S 16th St , Camp. Hill, P\l. ',17011 Isabe11pHoffman Niece ves of a1!e 1/12th Residue 305 Widders Drive Mechanicsburg, Pa 17055 Go~~'d Lefevpr ,~.._... ..0. n~ ""p 1/12th Residue '" 2nd St Di11sburg, Pa 17019 Miriam Sidle niece ves of o"e 1/l2th Residue 1 Kim Acres RD#6 Mechanicsburg, Pa 17055 Helen IHdder Niece yes of age 1/12th Residue 502 E Marble St '.'--"--' -... "" 'Do '''(1"" Harold IHdder Nephew yes of age l/12th Residue 110 N. York St Mechanicsburg, Pa 17055 ;T.~.:. ~_' ,L .. u' ves of "1!e , 11 ?.... 00.'''''0 , 110 l~ Green St Shi rpmans town Pa 17011 ".. _'-._ u_ __~.. Niece yes of age 1/12th Residue Rt 5 Box 346 Covin"ton Kentuckv 41015 1/12th Residue Frances Ev1er Niece ves of af(e 1112 Columbus Ave Lemoyne, Pa 17043 Dr. Robert Lefever Nephew yes of age 1/l2th Residue East Lincoln Ave ~.........h..~" 'Do , .,'>?" Garth S Lefever Nephet./ yes of age 1/12th' Residue 112Mumner Lane . Di11sbur" Pa 17019 h Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE lIInno c' , . ... '"' .8l1)Y""l ~<"t: 1;;: C 'c ~ e .- OJ ::l 6--0 "0 '" U <q, 8r.J~ --- ~ ~ ... U ~ 0 ~ e g._ ~ 0:: Real Property Personal Property Transfers SUMMARY .. ......................(Sch. "A") .. ...(Sch. "B") . .. .... ............... (Sch. "C") (1 ) (As Reported) (2) (As Determined) Gross Taxable Estate $.. $.. . $. $.. . $... . $.. $. $ $ $ $. $ c c .' -.J. ;:)'.J :.., ;:. ~ E- Z ."0 ." ... ~ .~ oj :"(1 " ....l. '" .- " >< "" .U < ~ ." Q '" '" - - < ..-. " i:l: . IX: ~ '8 .. '" 0 " .. '" ..:: '" ..-. '" < - OJ II: II: ~ "" .> - ... ~ ... E- ~ Q ~ :I:: '" "'- ~ ;z: 0 0 E- O; Z E- '" '" < ~ ~ - E- ,-- ~ 0 0 ..<: i:l: " 0' - - 0 IX: ..; .. :c ~ '" ... c '" !: - ~ i:l: b 0 " ~ ""- - 0 '8 0 j;;. ~ -- , _=.:E --. u .:: - J 15 0 .) ~ "0 '" "'- ...l U U ~ ... \-..... R.CC-37 (12-63) COMKION\\'EALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" 1\ "- BENEFICIARIES c . , " - RELATIONSHIP BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED DATE INTEREST OF 'State full names and addresses 61 all who illegitimate children DECEDENT OF BENEFICIARY ave an interest, vested, cant ingenl or. other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH June Baker Niece yeS of aP'e 1/12th Residue 41 Impala Drive,:, . . .. ~. : .... , ~ """"h',r"', Po 17()1(j , - , , ; : . . - " , l h Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE N~"o - ... o . -~- e<~ v;:: C 'a ~ E .- C"l ::I 8--0 '0 '" u <: 8. s:..8:o o ... --- " ~ ... u " 0 ~ E fr.~ ~ <>: SUMMARY . HHHH H.(Sch. "A") ....................................................(&h"~) HHHHHHHHH H'HH(&h. "C") Real Property Personal Property Transfers Gross Taxable Estate f- :'0 Z .... ... ~ ,~ '" ," ..l ... :::E .... >- '" <( ~ ,... rIl '" 0 - - <( -< '" CII: p:: ~ '" llo Po. 0 '" llo Po. 2: '" -< '" <( = = ~ ~, ... ... f- ~ Q ~ S 0 ~ :t "' -< ;:; Z 0 f- Z f- '" Po. <( ~ ~ ~ ... ~ 0 c CII: ..c c p:: .::: 0 0 " llo 'C ~ !" "" '" !: ~ ~ CII: l:: 0 ~ c ~ -< ~ 0 '" 0 .c:' E 'E "" 1: E E "'-0 '" 0 0 :::-< -l U U (1 ) (As Reported) ... ...,.,,0,., 103,539.43 .................. -0- $.. $ $. $.. $H $103.539.43- -0- " (2) (As Determined) $. $ $. $ $.. $ ";:.1 .; '\" ........ R'CC-38 , RESIDENT DECEDENT SCHEDULE "En JOINTLY OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and personal, owneri by the deceden't jointly with another or others, including intangibles, standing in the name of' the decedent an'd others. List real estate first~ as entireties, or joint tenants, giving brief description, as indicated onder Schedule It An, pltis the date anel place of record of instrument ef'fecting vesti ture, but clo not include entireties or out of' state real estate value in estate valuation column. Personal property should be listed as in Schedule "Bit, lllus date of acquisition, and the name, address anrl relationship (if' any) of co-owners to the decedent. Description of Property, Date of Acquisi tion, Name unit percentage Estate DEPART/tENT VALUATION Address and Relationship of Co-Owners, and pi ace Value Share Valuation CAUTION-Do not Write of Record of Instrument, where Real Estate. In This Space. = >0< '0( :x Value of Value of ~ ><,( :x >0<' ~ :x "^ Entire Deceden t's :>0. ><,( Y> Y> >0<: Y> X> :>0. ~ Interest XX 'V Property l\kJnt.- None , . I , Insert this to tal opposi te "Joint! y Owned Property", Schedule "E" t\\flllO 1n the n As He orted" colurrm on the last page of this return. p , -* REv-stB (8"78) COMMONWEAL TH 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 William S. Sanford, Trust Officer. Dauphin Deposit Bank & Trust Company 301 Market Street. Lemovne.PA 17043 (Executor or Administrator) In Re: Estate of Harry J. Sloat Cumberland County - File No. 21~78-0308 Dear Mr. Sanford: You are hereby notified that the original appraisement in the estate of Harry J.. Sloat has been fi led in the office of the Register of Wi lis of Cumberland County on February 14 , 19~, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total None 103,539.43 None None $103,539.43 As to such tax that is paid within three months from date 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 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 moy 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. ~ . ,..} J J- . Date February 14. 1979 Signed (D1.:D Ua,,{J"UAA.- I .- Title Administrat~ e Officer I ~ ~ Note: This is not a bill. REV-457 (8-78) dEPARTlftENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG. PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE February 14. 1979 Cumberland 21-78-0308 COUNTY FILE NO. Whereas, Harrv J. Sloat late of in the County of Cumberland Commonwealth of Pennsylvania, having died on the 4th day of June 19 .llL, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Ful~initi , 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: Carlisle 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 Prooertv $ ,,--. Personal Prooertv 103,539 43 Joint-Held Property , , None TraBsfers . None TOTAL ASSETS 103 539 43 , - M C. . , -, , .c- 0 , ~ :. ~ , " J... . . , " :j . Have been duly sworn according to law, I do hereby certify th t the abov with the law on this 14th' day of appraisement is made in conformity , 19 Z!L-. Appraiser (Number and Street) Harrisburg (Post Office) , Penna. . ~ ;:., ~ 'ci ~~ a> ~ s:: z '" r--: ::s w ~ 0\ 0 :;; '" ~: ~ u w <:> '-.:l~ .....; '" '" Cl "" < !"; ,...f w a:: .....; => "- 00: 00 "l 2 ~ "- .....: ~: <( ",: W "0 X r-l~ > r\) <( ..... ~ ",: ~ w ~ 0 ....: ...::t: a: ~- .s d" ",,: ..... .,: ~ U- s:: s:: w '" 0 ~ to ~ '"" ...: ",: ",- 0 "1:1- '" '" Z :g '" '" ....: B~ <:> ~ ~ ~ ~ ~ k: ;;:: ..,,0 <( ~ '" ~ l- e- m: '" '" ..... ~ '" '" 'ci" OJ' ~ " ....:i u: -'<: 0 ",- 2 o<il o- r j a:: 8 : -'" ::s w 5. ~ ~ w i Cl ~: ~ "" 2' <:t: ~ ~ u: :t: .<::- >: I- -s ~ z ~ 0 '" '" a: "" ~ ~~ os, ~ <l: s:: ~ ~ ~ '" '" ..... '" ::s "" '" E : s:: z Cl 0:: 0 "- "" 0 '" 0 w 'ci" .0 <l:: '" w ~ '" 0 ..... o~ oS s:: 0 ~ s:: '" ~ "" 0 '" ::s oE '" '" '" u; 0" ... '" ... ",- "" 0 ~ '" J'l w ~ n. "" '" ~ <:> '" 0 n. a:: Cl ~ ~ ~ '" 6j ~ ~ Gj t<: 0:: ..'