HomeMy WebLinkAbout11-13-78
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RCC~~ 14-73).
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTION~\c_,,'
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RESIDENT DECEDENT
COUNTY OF CUMBERLAND
IMPORTANT:
This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills 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 Reuenue. <Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cmrber1and
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
ADMINISTRATOR
IN THE MATTER OF THE ESTATE OF
SHARPE P. MELlDIT
(STATE FULL NAME OF DECEDENT)
County
State of
} 55:
Cumberland
Fanners Trust C'.anpany
~
County of
Executot
of the estate of the above-named decedent being duly sworn, depose
and say
(MONTH)
Name and address of attorney or }
other authorized repres.en.tative te whom
all corres.pondence should be mailed.
(DAY)
I9~J testate leaYing a lost will, copy of which is hereto attaChed,,}
(YEAR) ~
Decedent died
June 10
Robert M. Frey, Esquire
5 South Hanover st., Carlisle, Pa. 17013
Executor
That as such deponent is familiar with the affairs of said estate and the property constituting
(EXECU TO R-ADMINISTRA 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 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
None
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception-of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth ful1y and in detail al1 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 Schedule 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; al1 moneys left by the decedent at the time of
death, whether in decedent's immediate pos session, s tanding to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individual1y, or in trust for any other person or persons
giving also separately the accrued interest thereoni if any, down to the last interest day prior to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; 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 at the time;: of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, c'arriages,
automobiles, boats, and any and all other personal chattels of whatsoever. kind or nature, left by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of al1
claims due and owing decedent at the time of death, and all promis sory note s 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 Tair,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; al1 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 secur;ties owned by the decedent at the time of death, with the-market value there-
of at such time.
..
In the case of' securities of' close or f'8Jllily corporations, the values reported are as f'ar as
possible substantiated by f'inancial statements of' the corporations, showing the assets and liabilities
thereof' as of' the date of' death. The schedule also sets f'orth 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, t'inancial statements showing the assets and liabilities of' said co-partnership or b.usiness.
A copy of' the co-partnership agreement, (if' oral, a statement setting f'orth the nature of' tne agreement)
together with a statement setting f'orth the character of' the business, its location, and such other f'acts
pertaining to the business as may be pertinent to a f'air and just appraisal of' the decedent's interest
therein must be submitted. It should also set f'orth in itemized f'orm, together with the f'air market value
thereof', any o~her property owned or bequeathed by the decedent at the time of' death.
The Schedule C attached hereto and made part hereof' sets f'orth a true answer to each inquiry
contained therein and in the case of' transf'ers of'property, real or personal, within two years of' decedent's
death, in contemplation of' decedent's death, or intended to take ef'f'ect in possession or enjoyment at or
af'ter death, said schedule sets f'orth the nature and value of' such property, to whom transf'erred, the
relationship of' the transf'erees to the decedent, the proportionate share received by. each transf'eree and
all other f'acts of' a pertinent nature regarding said transf'ers. In the case of' transf'ers intended to
take ef'f'ect in possession or enjoyment at or af'ter death, there is also attached to the schedule a copy
of' the deed, trust agreement or other instrument creating the trust. Therp. is also set f'orth in 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, orjointly with another, or any power of' appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrrunent of' another,
with a copy of' the instrrunent creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof' sets f'orth the names and addresses of' all
persons benef'icially 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 benef'iciaries f'or lif'e under decedent's Will. It also
contains a statement showing which of' the benef'iciaries named in the decedent's will, if' any, died prior
to decedent, the dates of' their death, their issue, andthe relationship of' such issue to the benef'iciary.
That Schedule E attached hereto and made a part hereof' sets f'orth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the n8Jlle
of' the decedent and others, plus the date and place of' record of' instrrunents ef'f'ecting the vestiture of'
real estate and the date of' acquisition of' personalty, plus the name, address and relationship, if' any,
of' co-owners to the decedent.
That Schedule F attached hereto and made a part hereof' sets f'orth f'ully and in detail all debts
and deductions claimed f'or and on behalf' of' this decedent's estate, including fUneral expenses paid;
f'amilyexemption, where applicable; costs of' administration of' this estate; counsel f'ees and fUdiciary's
commissions paid or to be paid; cost expended f'or 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 f'or 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 f'or obliga-
tions, if' any. It is agreed that the f'iduciary will present proof' of' said claimed obligations upon re-
quest, that if' the amount actually paid in settlement of' any f'ee, commission or debt is less than the
estimated 8JIIount 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",
have been carried f'orward and properly registered in the Summary.
Subseribed and sworn to before me this ...'Zd...............
....~
"CO, "E", and "F" as directed therein,
DOReA A. AlBRIGflT. NOTARY PUBLIC
CARlIS E BORO, CU'lJERLA~m COUNTY
MY COMMISSION EXP:"SS tiUG. 16, 1932
Member, Penllsy!','ania AS~0ciat,on of Notaries
NOTE: Bef'ore signing af'f'idavit make sure all blank spaces in the af'f'idavit and schedules annexed are
f'illed in with details or the word "None", and in case the assets include rare and unlisted securities,
securities of' close or f'amily 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.
m......m....... 19..2.Z..
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IIC c.u l400781
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DEC!DENT
SCHEDULE uAu
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.")
The real property located In the Common_alth of Penuylvonlo .hould be
d..crlbed by lot and block number, .tr..t and .tr.et numb.r, togeth.r with
a g.n.ral d..crlptlan of the property, with a refer.nc. to the r.cord af the
conveyance by whl ch the d.cedent took tltl.; If a farm .tat. numb.r of a.
ere.; 01.0 .tat.m.nt of mortgage .ncumbrance. upon each pare. I at d.ath
of deced.nt. Tax.., a.....m.nts, accru.d Inter..t on mortgage., .tc.,ar.
to be lI.t.d on Schedul. "F" and muat not b. deducted ham thl. ach.dul.,
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not w,lte
In thl. .poce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMATED
MARKET VALUE
House and lDt, 340 G Street, Carlisle,
Currber1and County, Pennsylvania, as appraised
Recorded on October 13, 1950 in Deed Book N,
Vol. 14, Page 286 3l' 0
~-
/'1.5-V'
)
(1/-<,
3,630.00
~
18,000.00 ~ If,OOD.aO
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.
18,000.00
\<61000.M
. '.
ROC -35
RESIDENT DECEDENT
SCHEDULE "BI!
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 listed under Schedule "E", 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 ~Irnishings, 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 fiduciary in said capacity, partnership interests, interest in any undistributed
estate of or income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time of death, should be listed in this schedule.
Item
No.
ITEM
List and describe fUlly
UNIT
VALUE
ESTIMATED
MARKEl' VALUE
1.
2.
3.
4.
5.
6.
Cash
ecking Acct. 4 5136 3, Fa.1:m3rs Trust Co.
Savings Acct. 1 14066 8, Farmers Trust Co.
Proceeds sale of 1971 Ford Sedan
Senior Citizens Tax Refund
Penna. National Mutual Casualty Insurance Co.,
collision damage to 1971 Ford Sedan
Refund , Belvedere Medical Corp.
DEPARTMENT VALUATION
(Do not write in
this space)
7.
a.t)o
(.157. O?J
\0, \~7.'t't
$00.00
.00.00
Q~S. "
!~,Ol'
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return,
x X
19,025.85 I~I O~6.~e;
"
#
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( IN ACCT.
, WITH
WITHDRAWAL
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174-Jt5,-3735
SHARPE MELLOTT
340 G ST.
CARLISLE,PA.
ACCT. NiI.4066
~
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DEPOSIT
BALANCE
DAlE
JUt'. 1'76205.66 ';;,j00.(~::o,;
().T~ "710 210.02 ':1. j10,~""1 ~
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1. /~'~1~.::.:3 ;'J>-'c.:,~
JUr., l'I;:'G2..;).311_'llf::".~'_ "
.JI),.15',v 16:921-,.:" '".4.:'.;..
,)I;., 15' /c,
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t l b n ^ /g191
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TAKE CARE Of' THIS BOOK. IT MUST BE PRESENTED WHEN MONEY 15
DIt~O.ITED OR WITHDRAWN. IF LOST OR STOLEN. NOTIFY COMPANY AT ONC~.
'~~,-
,
FARMERS TRUST COMPANY
Carlisle, Pa.
I .
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.11
RCC-3S
Cl)MMCl\WEALTIl OF PENNSYLVANIA.
TRA\SFFH. I\HFIUTANCF TU
SCHEDULE "c"
THAN"F1~r,S
rillS IDENT DECEDENT
(1) Did decedent, within two years of'death, make any transf'er of' any material part olid'is estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no)
(2) Did decedent, within two years of' death, transfer properLY 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 affirmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's heal th at time of making the transfer. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration 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 f'or 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
(ll) 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 deoedent
alone or others
(7) Did deoedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for thc 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 of law? (Answer yes or no) 00
(9) If the anSwer to (8) above i3 in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions should be supported by 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 ~'hom 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 dettliled 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
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATlON
(Dept. Only)
~O~
NCNE
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
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RCC-37 (i2-63)
CO!\Il\lO"'WEALTH OF PEXiIISYYL\NIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
,
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate c"i1clren DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other are involved, set STATE YES IN EST/\. TE
wise, in estate) forth t.his fact.) OR NO BIRTH
Effie Thumm. sister-in-law yes Over 21 $1. 000.00
R.D. 5 PeinArs Trailer Court
Carlisle, Penna. 17013
Charles Wieland step-son yes Over 21 Residue
~()r.
Carlisle, Penna. 17013
Deponent fUrther says that all the above-named bene~iciaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
(Executor-Administrator
must complete "Ac;
Will ~ Reported .. column #1.)
Administration No. Year
C"l >-l '1:1 ::0
.., .., ell tt
I:'J THE 0 ~ .., e:.
V> :l '"
'" '" 0
(t' :l '1:1
~IA TTER OF THE APPRAISEMENT >-l .... e:.. ...
~ '" 0
>: '1:1 '0
~ ell
0"' .., ...
OF THE ib 0 ~
'0
t<:I l1i
ESTATE OF '" .....
..... '<
III
.....
tt
Sharpe P. Mellott
...
Deceased
Late of Borougll of. CaI-1is1El.
CunDer1and CIl
County of c:
::::
::::
Commonwealth of Pennsylvania >
::ll
W Vl en ><
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P" P" P"
REPORT AND APPRAISAL q ~ ~
-Eo9 -Eo9 ~ -Eo9 -Eo9 -Eo9
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:01 : .. ?1 :- ~--
81 800 8i
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RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
RCC-38
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly
with anot.her or ot.hers, 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 lmder Schedule
"A", plus the date and place of record of instrument 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 decedent.
Description of Property, Date of Acquisition, Name
Address and Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate.
'V ^
:.xV ^^
o
V'
x
V
V
I<V'
Unit percentage Estate
Value Share Valuation
^ ~xxx.> X
^ X'(9:..>
lV"/
1<, 'Y 'VV Xx;-
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
~ OXX)
,
IVVV
N::m:
N bnl
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" colunm on the last page of this return.
t\\'Dn~
REV.8IS IS-78'
COMMONWEALTH 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
Farmers Trust Company
One West High Street
Carlisle. P.f.
(Executor or Administrator)
In Re: Estate of
gharpe P_ Mellott
Cllmherl..nn
County - Fi Ie No. 2l-711 OJ22
Dear
You are hereby notified that the n"igin<>l
appraisement in the estate of Sharpe P M",ll nt-t-
has been filed in the office of the Register of Wills of /"!l1mherland
County on 5 Februarv , 19---12. r Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
18,000.00
19,025.85
None
None
$37.025.85
As to such tax that is paid within three months from date of death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death occurred from December 22r 1965 to June 16, 1971r 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 Inheritll"ce and
Estate Tax Act of 1961, 72 P. S. 2485-1001 r P. L. ~~. ___ ~ (I c~ :/--.._~
,.....----1. (':', .'_""> \_- -
Date 5 February 1979 Signed L/ - - ,--)
Title Administrative Officer
~-..
Note: This is not a bill.
..
5 February 1979
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
COUNTY
FILE NO.
Cumberland
?'-78-0~??
Whereas, Sharpe P. Mellott late of Borough of Carlisle
in the County of rnmhor1 ::mn Commonwealth of Pennsylvania, having died on
the , Of"h day of Jtme 19 A, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Ton 1l'n1 go{ no{ H , an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash
value of 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 $ 1 R non 00
Estate
- .1 - 1 a IV" 0<:
Transfers Mnno
~Tno{nf"'V ~ . "T~~~
Total $37.02" .85
Have been duly sworn according to law, I do hereby certifv that the above appraisement is made in conformity
with the law on this 5th daYOf'~ c~~r~~, r c- : _ ~. 19 !.L.
~ -- Appraiser
'--
(NUmber and Street)
Harrisburg
(Post Office)
. Penna.
--< I ~ ? <P- 34....2,
........................ .eu.becland............... County
RESIDENT INHERITANCE TAX APPRAISEMENT
Esta te of
........... ........ ......Sharpe..!... .11-11 tatt........ ....
Deceased.
Late of
truUs18
.".......................................................................
Date of Death, .............~lQ:o:1.a....................
Appraisement Docket Vol., .........10................
Page,........J~!............... No. ..Jt...~~..........
.........................................................................
Filed in Register's Office, ...~..~~ 19.!~
Amount of tax due, $..:....................................
DEPARTMENT OF REVENUE
;-\
Received, .... ..... ... ........ ..... .... ....... ......... ... ..... ....
.........................................................................
Examined and Approved, .................................
Wrote about Appraisement, .............................
.........................................................................
Appeal from Appraisement, .............................
.........................................................................
Entered and charged, .......................................