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HomeMy WebLinkAbout02-28-80 (2) d1-';.?-?C . r !:ICC-33 (4-73) . . ...., '7c: :::. ..,' ~ (-- IO~- '-' c: ~' RESIDENT DECEDENT COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ~UPPLEMENT~ . 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 Re~enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) Late of CUMBE RLAND PENNSYLVANIA } AFFIDAVIT ~F EXECUTOJR lX ~'flmt~j: IN THE MATTER OF THE EST ATE OF ROBERT E. QUIN (STATE FULL NAME OF DECEDENT) County County of CUMBERLAND } .., Supplernen tal State of A1GMAlNWCi)fX FLORENCE P. QUIN .J Execut~rix of the estote of the obove-nomed decedent being duly sworn, depose S and say S Decedent died July 1, (MONTH) Name and oddress of attorney or } other authorized repres,entative to whom all corres.pondence should be mailed. (DAY) , 19~{testate leaving a last will, copy of which is hereto attoched,,} (YEAR) HK~ Myers, Myers, Flower & Johnson P. O. Box 125, Lernoyne, Pennsylvania 17043 That as such deponent is familiar with the affairs of said estate and the property constituting (EX ECU TO R-ADMINI ST RA 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 IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX Dauphin Deposit Bank & Trust Co. Lernoyne, Pennsylvania 17043 THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF Robert ^' Fl nrence Ouin RELATIONSHIP OF JOINT HOLDERS TO DECEDENT Wife 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 Schec/u/e 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 Schec/u/e 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 per~on or persons giving also separately the accrued interest thereon, if any, down to the last interest day pricaT to decedep.t'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 Umted 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 owmg 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 interest thereon to the date of decedent's death and other investment securities owned by the decedent at the time of death, with the market value there- of a t such time. In the case 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 liabilities 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 and liabilities of said co-partnership or 1J,usiness. A copy of the co-partnership agreement, (if oral, a statement setting forth 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 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 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 take effect in possession or enjoyment at or after death, said schedule sets forth the nature and value of such property, to whom transferred, the relationship of the transferees to the decedent, the proportionate share received by each transferee and 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, there is also attached to the schedule a co~y of the deed, trust agreement or other instrument creating the trust. Ther.~ 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, orjointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule D attached hereto and made part hereof 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 under decedent's Will. It also contains a statement showing which of the beneficiaries named in the decedent's will, if arty, died prior to decedent, the dates of their death, their issue, andthe relationship of such issue to the beneficiary. That Schedule 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 and others, plus the date and place of record of instruments effecting 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 forth fully and in detail all debts and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid; family exemption, 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 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 of 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", "B", "e", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this .;;..~................. ............. . .. day.. of ~ ..... 19..~:<::> ""~N ~R;'~"~ . .. .......... Lemoyne, Cumberland Co., Pa. My 'om mission Expires Oct. 25, 1982 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 "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. " ")' . " , 1 . / ") v/L j /1 _)t..{<2-!-:!.."::!;~:.I:::...~U)..-:.;.......:::'_..~.....C.t.d (:Execxtox~ Florence P. Quin Executrix .36.....eo.l-gcrSfi.;~~rJuYn;;;;i.......................................-...........,.. G.glJ~p......a.JJ..;!,.."....)?~.D.IV?Y.J,.Y.@.t?l......1.,.7..Q.JJ......... (City or Town and State) . -. REY-4S1 (8-78) RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY .. SUPPLEMENTAL COMMONWEAL TH 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 liE". 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 tentative trust accounts, must be listed, despite the fact that they are not of the adminis tered estate. Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household goods, and furnishings, 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 payable 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 I1EM UNIT ESTIMA TED DEPARTMENT No. Li st and descri be fully VALUE MARKET V ALUA nON VALUE (Do not write in this space) 1. 4 - Se r ie s "E" Bonds - $25.00 each - in the name of the decedent - POD Florence P. Quin. Date of death value - 101.90 2 . 4 - Series E Bonds - $50.00 each - in the name of the decedent - POD Florence P. Quin. IBte of death vallE - 174.88 3. 4 - Series E Bonds - $100.00 - each in the name of the decedent - POD Florence P. Quin. IBte of death vallE 333.92 Insert thi s total opposite "Personal Property", Schedule "B" in XX 610.70./ the "As Reported" column on the last page of this return. Fi I e Number SUPPLEMENTAL INHERITANCE TAX ~lJMMARY SHEET (BUREAU USE ONLY) 21-78-0368 REY-484 EX+ (3-80) Estate Name QUIN, Robert E. Date of Death 07/01/78 Social Security Number REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the ri ght in Schedules .. A", "8", "C", and ue" Dated: April 10, 1980 P.h~../4.1 #f.b.AfI.A).J INHERITANCE TAX APPRAISER INVENTORY VALUE AS APPRAISED ADJUSTMENTS CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE Real Property (Schedule A) Personal Property (Schedul. B) Jolnt.Held Property (Schedule E) Transfers (Schedule C) $ None 00+ 610 70 10+ None 2lH None 30+ 610 70 40- 92+ TOTAL GROSS ASSETS Less D.bts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE 93- Valuation of life estates or annuities. . . . . . . . . . . . . . RATE FACTOR PRINCIPLE VALUE CODE FOR USE OF REGISTER ONLY CODE COMPUTATION OF TAX $ $ $ $ $ Tax an $ 6% TOTAL TAX INTEREST FROM BALANCE TO $ $ $ Tax on $ 15% T ax on $ Tax on $ Tax on $ Exemptions Total Estate Less Credits DATE OF PAYMENT AMOUNT PAID TAX CREDIT $ $ INTEREST FROM BALANCE DUE . - REV-SIB (3-79) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P. o. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO Investigation Division NOTICE OF FILING OF APPRAISEMENT FloI'ence P. Quin 36 Colgate DI'ive Camp Hill, PA 17011 I Executor or Administrator) In Re: Estate of Robert E. Quin CumbeI'land County - File No. 21-78-0368 Dear MI's. Quin: You are hereby notified that the supplemental appraisement in the estate of Robert E. Quin has been filed in the office of the Register of Wills of CumbeI'land County on ApI'il 10 ,19~. Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total None 610.70 None None $610.70 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. L. 373. Date ApI'il 10, 1980 Signed ~../AA112 / 'dfldlIlJu/) Title Chief AppI'aiseI' NOTE: This is not a bill. R'!'::V-457 ('1-8~) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT INHERITANCE TAX APPRAISEMENT Estate of QUIN, Robert E. File No. 21-78-0368 County Cumberland Date of Death 07/01/78 In the event that any future interest in thil estate il transferred in po_ion or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expr_ly r_rv8I the right to appraise and a_ tral1lfer inheritance taxes at the lawful collateral rate on any such future interest. PROPERTY REPORTED BY THE ESTATE DEPARTMENT'S APPRAISED VALUE 1. TOTAL REAL PROPERTY - SCHEDULE "A" None 2. TOTAL PERSONAL PROPERTY - SCHEDULE "B" 610.70 3. TOTAL TRANSFERS - SCHEDULE "C" . None '... 4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E" None TOTAL REPORTED PROPERTY 610.70 PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH TOTAL UNREPORTED PROPERTY None TOT AL GROSS ASSETS 610.70 LIFE ESTATE OR ANNUITY CALCULATION I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day with the Register of Wills. ~~/tl.JAj~k)fJ ) APPRAISER 04/10/80 DATE