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HomeMy WebLinkAbout11-13-78 .. RCC~~ 14-73). COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTION~\c_,,' ',," v2/~ 7f -L3~~ ::^!* 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.. ~....~:..:~::::a,::. ~r ,'~",., '''''. 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; " # . . '. / \ \. ,,~ ,t ,- r .. . . ," --- ( IN ACCT. , WITH WITHDRAWAL . 1,-,,1 =i4,;"-~Jl --"~..~~___ 'J' , I ,,.r ,-.'- ..:;:;:.:::t.:=~,:';;:"~";:'--,.r-;:;::;;-:;:;;;:'::---- -'"- ------ 174-Jt5,-3735 SHARPE MELLOTT 340 G ST. CARLISLE,PA. ACCT. NiI.4066 ~ HL1G~\c - ,\ DEPOSIT BALANCE DAlE JUt'. 1'76205.66 ';;,j00.(~::o,; ().T~ "710 210.02 ':1. j10,~""1 ~ ',", i',"I;Glj..:)S7 :::,,/_;..... 1. /~'~1~.::.:3 ;'J>-'c.:,~ JUr., l'I;:'G2..;).311_'llf::".~'_ " .JI),.15',v 16:921-,.:" '".4.:'.;.. ,)I;., 15' /c, ~'_) .1 '';. ._~_.- ,_-J1I:"._--~,:-"~::'::_4t"~;"'~~~"'=' 41i"'-'~~- f'~"~ :J~ a ~-2q ~ t l b n ^ /g191 ~~. ':,~ \" I OJ ....' ,.,<...-T"----,.____._ .. '--'-.~..........--....., 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 . .... ",' ,,'-. . c \ \ .-'1 i~"C ,.".- - ~ . ~,'... .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. "-\ 1) f\Q.. . ' 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 >< " " P" P" P" REPORT AND APPRAISAL q ~ ~ -Eo9 -Eo9 ~ -Eo9 -Eo9 -Eo9 :t.) i-I I-' ~ :-..:J : m 00> .~ ~ '" .~. ~ ~ ~::: :01 : .. ?1 :- ~-- 81 800 8i . (11 """"""""""... ;.- or. - ~-- S"~ ...~ ~. ,... :i. '.' .. 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, .......................................