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HomeMy WebLinkAbout04-25-79 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS .5-105-- 71 oZ/-1f-"3'1-: * ~ , ~ '!CC-33 (4-73) RESIDENT DECEDENT COUNTY OF CUMBERLAND IMPORT ANT: This reI urn must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the Counly where decedent resided; Return is due within nine months after date of death. unless an extension is granted by the Secretary of Re'enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF HelEm M. Kit:7.mi11pr (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUTOR County ADMINISTRATOR Lo'. of Borough of N~wbuTg State of Pennsylvania } 55: County of Cmmerl >mn Administrator Jack s. Kit7.mi11pr 20d LaQ D Kit~m;llAr of the estate of the above-namecl decedent being duly Iworn, depose ExecutolS and say Deceden' died June 5 , 19~ te.ta'. ~eavlng a last will, copy of which i. hereto attachedo,} (DAY) (~ln'.'Ia'. ?'? 2- _ ['3 'B <e MARK & WEIGLE, Jerry A. tJpi glp,. Attn1"f:l~Y 115 East Kh18 St~wwt . Shippensburg, p", 17~'i7 (MONTH) Nome and address of ottorney or } other authorized representative to whom all corr...pondence should be mailed. That as such Executors deponent is familiar with the affairs of said estate and the property constituting (EXECUTOR-A~) 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 OTHE\R 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 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 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 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; 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 banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interes t 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 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, carriages, 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 all claims due and owing decedent at the time 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 interes t thereon to the date of decedent's death and other inve stment securities owned by the decedent at the time of dea~h, with the market value there- of at such time, " In the case or securities or close or ramily corporations, the values reported are as rar as possible substantiated by rinancial statements or the corporations, showing the assets and liabilities thereor as or the date or death. The schedule also sets rorth the interest or decedent at the time or death in any co-partnership or business, and in support or the value or such interest there is annexed to said schedule, r1nancial statements showing the assets and liabilities or said co-partnership or husiness. A copy of the co-partnership agreement, (if oral, a statement setting rorth 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 rorth 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 hereor sets forth a true answer to each inquiry contained therein and in the case of transfers of property, real or personal, within two years of decedent's death, in contemplation of decedent's death, ,or intended to h.ke effect in possession or enj oyment at or arter death, said schedule sets rorth the nature and value of such property, to whom transrerred, the relationship or the transferees to the decedent, the proportionate share received by.each transferee and all other racts of a pertinent nature regarding said transrers. In the case of transfers intended to take effect in possession or enjoyment at or after death, there is also attaehed to the schedule a copy or the deed, trust agreement or other instrument creating the trust. There is also set forth 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, or jointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the Will, deed, or other instrwnent of another, with a copy or the instrument creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereof sets forth the names and addresses or all persons benericially 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 or all minors, annuitants and beneficiaries ror life under decedent's Will. It also contains a statement showing which of the benericiaries named in the decedent's will, ir any, died prior to decedent, the dates of their death, their issue, and the relationship or such issue to the bener1ciary. That Schedule E attached hereto and made a part hereor 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 or record of instrwnents effecting the vestiture of real estate and the date of acquisition of personalty, plus the name, address and relationship, ir any, or 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, including funeral expenses paid; ramilyexemption, 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 Ilnpaid at time of death; taxes accrued chargeable for 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 fiduciary will present proof or 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 tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "a", "CO, "E", and "F" as directed therein, have been carried rorward and properly registered in the Summary. Subscribed and sworn to before me this ................................. .............;d...9....ti............... day of )]~....... 19..7..8..... /I) t.k^.. J ..............M~~~~~;~:..N~ta~.P;;~......... ..... ... .................................". $~;"-.n'bul1!. PA Cumberland CounlY ("'Tn~s~:on h ';reo; lulV 11. 1982 /J~'4~~~~' )I~~~ . . }.." ,or. /K......~~;;.;ti;;At!=:;;)'...~~............................. Jack s. Kitzmiller Lee....D......fitZiiiil.Ier....................................................................-.. (Street Number) ~......p........IlJ............N~w.b..\1.;!;,g.......!'.i;l........................................................ (City O'l" TOtO" and State) 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 unlisted securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements required under the paragraph above relating to Schedule "a" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. , . ", RS C-34 14-73) S:OMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF,COUNTV COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY *' HELEN M_ KTT7.MTT.T.F.R F.STATF. 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 Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of the property, with a reference to the recard af the canveyance by whl ch the decedent took tltlo; If a farm state number af a- cres; also statement of mortgage encumbrance. upon each parcel at death of decedent. Tax.s, assessments, accrued Interest on mortgage., ete.,ar. to be listed on Schodulo "F" and must not be deducted fram thIs schedule. (I) (2) (3) DEPARTMENT VALUA TION CAUTION (Do not write In this space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMA TED MARKET VALUE All that certain tract of land situate in the Borough of Newburg, Cunberland County, Pennsyl- vania. Sold at Public Sale V $2l,000.0<t' Insert this total opposite "real propei!y", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. $21,000.00 '"2..l1 0 0 () '0 -.) '. Rec -35 RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY *' COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX HF.TRN M KTT7.MTTTRR R~TATF INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time or 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 or 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 ract that they are not or the administered estate. Tangible personal property should be listed rirst (e.g. jewelry, wearing apparel, household 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 undistributed estate or or income rrom any property held in trust under the will or agreement or another, even though located outside or the State, at the time or death, should be listed in this schedule. Item No. ITEM List and describe fUlly UNIT VALUE ESTIMATED MARKI'.'l' VALUE . DEPARTMENT VALUATION (Do not write in this space) Orrstown Bank- Checking Account {!10 126 5 6,389.04 Sale of HouseHold Contents Prorata of Real Estate Taxes Pennsylvania Electric Co. - Refund for over~ payment Erie Insurance- Refund of Premium United Telephone Co. - Reflmd State Employes' D~sab~lity payment (State Employes Retirement /I ~ \ \ D C2,.....-: State Employes Insurance. ~~./-l.. / \ZC\ l (Z..e......."- ) \c< Orrstown Bank -~avings Account #171-2&-4673 Orrstown Bank- Interest on Savings Account 11171-28-4673 1973 Oldsmobile Sedan Distribution from Delbert A. Kitzmiller Estate Erie Insurance - Refund on truck insurance Adams Electric Co. - Refund J. Paul Fogelsanger- Refund of Premium TOTAL ($69 '~;~-8V 50 "LH S.'2-S Insert this total opposite "Personal Property", Schedule "B" in X X the "As Reported" column on the last page or this return. " RCC-36 COMMONWEALTH OF PENNSYLVANIA TRANS}~R INHERITANCE TAX SCHEDULE "c" TRANSFERS RESIDENT DECEDENT HELEN M. KITZMILLER ESTATE (1) Did decedent, within two years of'death, make any transf'er of any material part of' his estate, without receiving a valuable and adequate consideration theref'or? (Answer yes or no) No (2) Did decedent, within two years of' death, transf'er 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 af'f'irmative state: (a) Age of decedent at time of' transf'er (b) State of' decedent's health at time of' making the transf'er. (Note 1). (c) Cause of' decedent's death. (Note 1). (4) Did decedent, in his lif'etime, 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 transf'erer or his estate or be subject to his power of' disposition? (Answer yes or no) No (b) What was the transf'eree's age at time of decedent's death? (5) Did decedent in his lif'etime make any transf'er without receiving a valuable and adequate consideration theref'or under which transf'eror expressly or impliedly reserves f'or his lif'e or any period which does not in fact end before his death: (a) The possession or enjoyment 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 or enjoy the property transf'erred or income theref'rom? (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 transf'er, the consideration f'or which was transf'eree's promise to pay income to or f'or the benefit of' care of' transf'eror? (Answer yes or no) No (8) Did decedent, at any time, transf'er property, the benef'icial 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) 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'iciary reserved in the decedent alone or the decedent and others? (Answer yes or no) No NOTE 1: The anSwers to these questions should be supported by af'f'idavit 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 whom trllnsf'erred, 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, also submit detailed statement of' f'acts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or & ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) NONE N~ Insert this total opposite "TranSfers", Schedule "C" in the "As Reported" column on the last page of this return. 'RCC-J'7 '(12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES HELEN M. IUTZMILLER ESTATE \ h 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 facL) OR NO BIRTH Mar~aret R. Hav D 'r' R. D. il2 Chani>ersburg. Pa Jack S. Kitzmiller Son R. D. III Newburg. Pa _T~~" V-f"~~"a? Son R. D. 111 Orrstown. Pa r.; ndv B P~""~ Daughter 4208 West l75th Place Torrance, California 90504 Deponent fUrther says that all the above-named benericiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE .II1I1I WiJI Administration ~ No.. (Executor-Administrator must complete "As Reported" column #1.) .. Year ............ ....... rn THE C":l ...:j ~ l:C ... ... ~ 0 ~ ... e:. 1Il 1Il 1Il 1Il 0 if :s "tI ...:j e:. a ~ 1Il ~"g ~ r;j" o ... ;- "O.R t"l ~ ., S' ... ~ :\IATIER OF THE APPRAISEMENT OF THE ESTATE OF Hel,eJllM~ Kitzmiller Deceased Late of . . ...Bo.rough..of..Newb.ur.g. County of Cu~ed.ap,4 U) c:: ~ ~ > l:C W U) U) 0< t'l t'l ?'" ?'" ?'" ci ~ ~ . ~ ~ ~ ..... ~ -0 -0 (Xl e- N N f-" f-" > ..: .. .; ~ ~ 0 '" 0'\ 0- 0 l:C~ \0 10 0 ~.... .. f . '8~ (Xl 00 (:) \0 \0 0 ... ... ~ c... ~ Commonwealth of Pennsylvania REPORT AND APPRAISAL """"-&1>""""",, > or. tl ~~ ~t-:) ...~ 3 :i' r.: c... . RC C-38 RESIDENT DECEDENT SCHEDULE HE" JOINTL Y OWNED PROPERTY HELEN M.. KITZMTT.LRR R~TArrR INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly wi th another or others, including intangibles, standing in the name or the decedent and others. List real estate first, as entireties, or joint tenants, giving brier description, as indicated under Schedule "A", plus the date and place or record or instrument errecting vestiture, but do not include entireties or out or state real estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date or acquisition, and the name, address and relationship (ir any) or co-owners to the decedent. '* COMMONWEALTH OF PENNSYLVANIA TRANSF'ER INHERITANCE TAX Description of Property, Date or Acquisition, Name Address and Relationship or Co-Owners, and Place or Record of Instrument, where Real Estate. Unit Value percentage Share Estate Valuation X> >I"> .;v<" -'Xl ..? ~ ^>I' 'So V' ^" ..>v<" v .;v<" .?'~ ^">< "^ DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value or Value of Entire Decedent's Property Interest NONE N~ Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. F";: V-S \8 (8-781 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO - Inheritance Tox Division NOTICE OF FILING OF APPRAISEMENT Jack and Lee Kitzmiller RD #1 If 'i N' ];n,l.J? g. P ^ (Executor or Administrator) In Re: Estate of HeIeR M. Kit~miller CumbeT'l~n" County - File No. ?1-78-n~l.Lq Dear You are hereby notified that the OT' i ~ i n ~ 1 appraisement in the estate of Helen M. KitzmilleT' has been filed in the office of the Register of Wills of Cumberland County on ? 5 ApT'i 1 , 19--'Z..9., Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total $?l,ooo.nn SO.415_?:1 None None 871.4-15.23 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 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 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 Inheritance and Estate Tax Act of 1961, 72 P. S. 2485-1001, P. b.Q373. \~ n . . . .'0 ~- \.-\ \.-+- CJ.~ '0--.. ..c- Vy-.~ju___, Dote 25 ApT'i 1 1 q7q Signed (/) Title. Administrative Officer L------- Note: This is not 0 bill. REV-457 (8-78) DEPARTMENT OF REVENUE BUREAU OF ~IELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DA'TE " a::; Ap-ni 1 , Q7Q COUNTY ~11mhA"Y" .::Inn FILENO. 21-78-0349 Whereas, WQ101l 11 Ki+"m{)]<;/v late of Borough of Newburg in the County of r.llmhpT'l FIn (! Commonwealth of Pennsylvania, having died on the 5 t h day of J un e 19 ..ll!. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, T "''' ~", g; " ; + ; , 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 Po,,' )0",+,,+.- $ 21 000 00 ,,~~~~~~, " . 50,4-15 23 '1'...."'" '" f'P....'" l\T""A T ~ ... ,,, (),.,,, A n Nn"p .,..~... ~, 571 4-15 23 , . / , Have been duly sworn according to law, I do hereby c tify that the above appraisement is made in conformity with the law on this 25th day of '-.~ ,A 1:>1 c ' ' ' 19 -2J. CJ' 0 Appraiser (Numbe( and Street) W:arrisBurg (Post Office) , Penna. ;Z 1-- 18- ; ~9 ............. ...0U~.~B E.}1,I'1H.H3..... ................ County RESIDENT INHERITANCE TAX APPRAISEMENT Esta te of ................. *ea ~n ...M'l'" ~ ,i.t- zm!: .1..3:e 'r.......... Deceased. Late of ...............~ .? ~~ .~fi D... ~.f... ~.~.:1 )?~ '!-:,g,............... Date of Death, ....................6./.5.{.3.8................ Appraisement Docket Vol., ...IQ.................... Page,...l..7..O,................ No. ..9:................'-1 () ......................................................................... Filed in Register's Office, ....25...Ap.r.iJ.. 19..:l.9 Amount of tax due, $....................................... DEPARTMENT OF REVENUE Received, ..... .... ........ ........... ............................. ......................................................................... Examined and Approved,................................. Wrote about Appraisement, ............................. ......................................................................... Appeal from Appraisement, ............................. Entered and charged, .......................................