Loading...
HomeMy WebLinkAbout02-22-79 RCQ-33 (4-73) J) C/'- '- / " * r.2. - J..J. -11 COMMONWEALTH OF PENNSYLVANIA DEP ARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF CUMBERIAND IMPORTANT: RESIDENT DECEDENT 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.) IN THE MATTER OF THE EST ATE OF } AFFIDAVIT OF EXECUTOR ~ MAY R. BAER (STATE FULL NAME OF DECEDENT) Late of Cumberland Pennsylvania Cumberland Execut<lf ices County State of } .., County of Doris J. Morrison and Betty M. Hosfelt. AdmllClMKlKOI:X of the estate of the above-named decedent being duly sworn, depose and say Decedent died June 27 , 19~{testate leaving a last will, copy of which is hereto attached._) t YEAR) lliJIJfitU (MON TH) Name and address of attorney or } other authorized repres.entative to whom all corres~ondence should be moiled. (DAY) Sylvia H. Rambo P. O. Box 261. Carlisle, Pa. 17013 That as such executr ices deponent is familiar with the affairs of said estate and the property constituting (EX ECU TO R-ADMINIST RA 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 IN WHICH DECEDENT RENTED A S_~FE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT The Farmers Nati of Newville. That the contents of said safe deposit box or boxes are itemized under SchedulesA &E of this return, with the exception-of the following, for the reasons hereinafter set forth: 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 pos ses sion, s tanding 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 investment securities owned by the decedent at the time of death, 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, rtnancial statements showing the assets and liabilities or said co-partnership or husiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of tne agreement) together with a statement setting forth the character of the business, its location, and such other racts 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 rair market value thereor, any other property owned or bequeathed by the decedent at the time or death. The SChedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case or transrers of property, real or personal, within two years of decedent's death, in contemplation or decedent's death, or intended to take efrect in possession or enjoyment at or after death, said schedule sets rorth the nature and value of such property, to whom transrerred, the relationship of the transrerees to the decedent, the propor~ionate share received by each transreree and all other racts of a pertinent nature regarding said transrers. In the case of'transrers intended to take effect in possession or enjoyment at or after death, there is also attached to the schedule a cony or the deed, trust agreement or other instrument creating the trust. Ther.~ is also set forth in said schedule a list or 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 or another, with a copy of the instrument creating\such power attached to the schedule. That Schedule D attached hereto and made part hereof sets rorth the names and addresses or 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 or decedent's death or all minors, annuitants and benericiaries ror life under decedent's Will. It also contains a statement showing which of the benericiaries named in the decedent's will, if any, died prior to decedent, the dates or their death, their issue, and the relationship or such issue to the benericiary. That Schedule E attached hereto and made a part hereor sets rorth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name or the decedent and others, plus the date and place or record or instruments efrecting the vestiture or real estate and the date of acquisition or personalty, plus the name, address and relationship, ir any, or co-owners to the decedent. That Schedule F attached hereto and made a part hereor sets rorth rully and in detail all debts and deduction~ claimed ror and on behalr or this decedent's estate, including runeral expenses paid; ramilyexemption, where applicable; costs or administration or this estate; counsel rees and fudiciary's commissions paid or to be paid; cost expended ror burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence or the death or the decedent; debts and claims owing and unpaid at time or death; taxes accrued chargeable ror period prior to decedent's death (except those allowed under Section 651 or the Inheritance and Estate Tax Act); together with a statement or collateral pledged ror obliga- tions, ir any. It is agreed that the riduciary will present proor or said claimed obligations upon re- quest, that ir the amount actually paid in settlement or any ree, 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 or the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. LAVANA !.. t,::~'l:J;::'",. !!OTA~Y PUBLIC 80UTHM,:PTOT~ , ':.:,~IC', FflANKLlN CO. MY COMr,,;;,SL)f; EXPIRES AUG. 10. 1981 ~1.)q~..___. (E.re~-~f.II~ """""g"~",,,P...~......~.K......![~W.Y..!..!J.~.t....)?.g..~......!.7...~4J'MM" (Street Number) Subscribed and sworn to before me this ................................. ~ \;".~~m .'\.~.~Fel>~~axymim 19.7.9..... ...........~~\~.,>~:J~..,,,............... .............................................................................................................................. (City or Town and State) NOTE: Berore signing arfidavit make sure all blank spaces in the arridavit and schedules annexed are rilled in with details or the word "None", and in case the assets include rare and unlisted securities, securities or 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. RC C-34' (4-73) , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "Au 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 jn 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 wi th a general description of the property, with a reference to the record of the conveyance by which the decedent toak title; If a farm state number of a. cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must not be deducted from this schedule. (1) (2) (3) DEPARTMENT VALUA nON CAUTION (Do not write In this space) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEA TH ESTIMA TED MARKET VALUE Lower Mifflin Township, Cumberland County, Pa. - Deed Book C, Vol. 22, Page 447 - Sold 9/25/78 // :;>20,400.00/ Insert this total opposite "real property", Schedule "A" in the X X X X X II As Reported" column on the last page of this return. $20,400.00 '20") \.loo.co . . ,RCC -35 RESIDENT DECEDENT SCHEDULE "B" 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 anll 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 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 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 DEPARTMENT VALUATION (Do not write in this space) 1 Checking Account - The Farmers National Bank of Newville, Pa. - Account #209 28 3 Household furnishings sold at public sale 4 Refund United Telephone Company 5 Refund - Medicare 6 Refund Belvedere Medical 7 Refund Adams Electric Coop 8 Refund Pa. Tax 9 Refund - presbyterian Home 4,081.3' 1,701.3 2 Checking Account - The First National Bank of NeWYille, Pa. - Account No. 012 9 4.4 185.6 2.2 67.8 834.00 g ~l L- . \.{ I Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X $ 8,872.47 RCC- % . COMMO\"V'vt:ALTH OF PENNSYLVANIA TRAN~FFH D;HF!tITA~C'F TAX SCHEDULE "c" TR\NSFEltS liES IDEXT DFC'EnEr\T (1) Did decedent, within two years of'death, make any tnmsf'er of' any material part of his estate, without receiving 11 valuable and adequate consideration therefor? (Answer yes or no) No (2) Did decedent, wi thin two years of' death, transf'er property f'rom himsel l' to himsel f and another ot' others (including a spouse) in joint ownership? (Answer yes or 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 transf'er. (Note 1). (c) Cause of' decedent's death. (Note 1). (4) Did decedent, in his lif'etime, make any transf'er 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) (b) What was the transf'eree's age at time of' decedent's death? (5) Did decedent in his lifetime make any transf'er without receiving a valuable and adequate consideration theref'or 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 (11) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) Bo (6) If the answer to (5) (b) above is in the af'firmative, state whether the right was reserved in decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration for which was transf'eree's promise to pay income to or for the benef'it 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 reserverl power to alter, amend, or revoke, or which c01lld 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) 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 f'orth below a description of the property transferred, it's f'air market value at date of death, dates of transfers and to ~'hom transferrHd, 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 slwmit detailed statement of facts on which said claim is based. NOTE 3: List applicable propHrty below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) m~T. VALUATION (Dept. Only) None NG~- Insert this total opposite "Transfers", Schedule "e" in the "As Reported" colUTIm on the last page of this return. ." RCc'-37 (12-63) COMMONWEALTH OF PENNSYYLANIA 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 children DECEDENT OF BENEFICIARY aye an interest, vested, contingent or other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Bettv M. Hosfe1t Daughter yes 12)JB/28 one-half R.D. 3. Newville. Pa. DoriskJ. Morrison Dauqhter yes 7/31/31 R D. 3. Newville. Pa. Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE RC>C-~8 RESIDENT DECEDENT SCHEDULE HE" JOINTLY OWNED PROPERTY '* COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX 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 of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated under 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. unit Value percentage Share Estate Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's property Interest 1. Savings Account - The Farmers National Bank of Newville, Pa. #1457 - jt. w/ Betty M. Hosfe1t & Doris J. Morrison - date of death balance - $23,429.52 1/3 $ 7,809. B4/ 2. CD - AR2754 - The Farmers National Bank of Newville, Pa. - jt. with Betty M. Hosfe1t & Doris J. Morrison - 4/4/74 - $15,000.00 1/3 5,000. ~ 3. Accrued interest on CD AR2754 - $8i3.75 1/3 281. >5 4. CD - AR2755 - The Farmers National Bank of Newville - jt. with Betty M. Hosfe1t & Doris J. Morrison - 4/4/74 - $15,000.00 1/3 5,000. >6' 5. Accrued interest on CD AR2755 - $8~3.75 1/3 281. 5 6. CD 4173 - Peoples National Bank of Shippensburg, Pa. - jt. with Betty M. Hosfe1t & Doris J. Morrison - 12/1/74 - $11,150.00 1/3 3,679.1>/ 7. Accrued interest on CD 4173 - $388~39 1/3 128. 7 8. CD AR 813 - The First National BanK of Newville - jt. with Betty M. Hosfe1t & Doris J. Morrison - 4/15/74 - $11,950.00 1/3 3,943. ~ 9. Accrued interest on CD813 - $143.4) 1/3 47. 0 Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. $26, 171.31 ~i.,/1l.3l SUMMARY Real Property ................. ......................................................... ( Sch. "A") Personal Property ... ........... ....................... ......... .............. ...... (Sch. "B") Transfers ................ ... ......... ............. ... ......... ................ ............. (Sch. "e") ................ .............. ..:r.()J.~:t:JY~ P:~ :1:-.4........................... (~.qh.!'....~). .... o ' -",-< e<'II: ~: c: '2 CII S "- ...., =' SCII- _0.0 ~ S <.I ~ 0: ....<.1"0 o CII --- ;j '" .... <.I ;j 0 ~Sg. ~ Pi:: Gross Taxable Estate ......................... ... cd Q) ~ ~: M , . co: r--. ,. ~ r-f : i= N o ~ z ---- c o :c cd b <Il '2 _ 'E ;;"0 ,,~ ~ Z til ~ til (J) - < rx: ~ ~ < til :r: r-- t.x.. o rx: til ~ < - ..... t.x.. o ~ :I: til !-< r-- ~ < o r-- (J) til ~: lii. "il '" :~ CII .~ ~ . : ~ ) E-t s::: ..-1: r-f : 11-I. 11-I ...1' ::E:: J.l: Cl): ) S 'tl: s::: AS: r-f. J.l: Cl) ~ ~ 0: cd '2 ':U ~ :.>. '" C ,.. V ~ ..:I -< {I.l - -< ac A. A. -< Q ~ ( 1) (As Reported) $.~.O',.4'O'O.OO . $.. ..a.,J3.7.2...4..7.. $......................0.0... $..~.(i.1.)..7J...~ ), $................... ........... $. .S.S.~ .4.4.3."..7.8...... :>1 +J +J < ... i p::; l- ac o A. ~ ac . :Il AS ..-1 :> r-f l>1 (/) (2) (As Determined) $ $.. $ $ $.. $ p::; ~. . .... o QJ .... cd ~ ... o ~. :: -' o U .... o ..c .::: cd QJ ::: c o e ,.. c o U REV-SIB (B-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 Doris J. Morrison Betty M. Hosfel t R. D. 3 R. D. 3 Newville. PA 17241 Newville. PA 17241 (Executor or Adm ini strator) In Re: Estate of MIq R. Baer Cumberland County - Fi Ie No. 21-78-0369 Dear You are hereby notified that the 0riiP-n,,1 appraisement in the estate of ~ R. RAA1' has been filed in the office of the Register of Wi lis of Cumberland County on May 9 , 19..29..., Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total 20,400.00 8,872.47 None 26.171.31 155.4-43.78 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 3n~, -~~ \ (, _ ,- In' ~-l- . c-)~- -::~- .\~-:> \.. \.....} _-".--c-__\~/-",..-,_,.,-j',_^_/ Date May 9. 1979 Signed / U Title Administrative Officer Note: This is not a bill. RE~-457 '(8-~8) 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. May 9. 1979 CUJlberland z'l-?8-0;6.2 Whereas, May R. Baer late of Lower Mifflin Township in the County of CUlll1-~"'J ..",1'1 Commonwealth of Pennsylvania, having died on the 2?th day of June 19 'Z!L., seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fu1ll'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: 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 Pronertv $ .,n hnn 100 Personal Property 8,872 47 Transfers None Joint-Held Property 26,171 31 nv'V'II . T SI)I).44~ ?8 , Have been duly sworn accordineaw I I do hereby c with the law on this qt day of that the above appraisement is made in conformity 19 ~. .j'....... , Appraiser (Number and Street) Harrisburg (Post Office) . Penna.