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Home My WebLink About04-17-79 (2) '"'" I ,I ,- "~ /,/ 1/11/11 1 'T . . " RC<:-3314-7:i) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS '* 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 Re~enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE EST A TE OF } AFFIDAVIT OF EXECUTOR X~lI>>~~i( LULA V. McCOY (STATE FULL NAME OF DECEDENT) Late of Cumberland Pennsylvania County County of Cumberland Ross H. McCoy and Winfield S. }" State of Admini stra tor McCoy, Jr. Execiii~r of the estate of the above-named decedent being duly sworn, depose and soy (MONTH) Name and address of attorney or } other authorized repres..ntative to whom all correspondence should be mailed. , (DAY) , 19~{~estate leaving a lost will, copy of which is hereto ottached. } (y EAR) .ntestote Decedent died June 10 Forest N. Myers 109~ East King Street, Shippensburg, PAs 17257 That as such Exe cutor deponent is familiar with the affairs of said estate and the property constituting (EX E CU TO R-ADMINIST 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 THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT 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 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 interes t, 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 Stat<.>s to the de- cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United State.s. or any state, or political subdivision thereof, or of ~ny 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 interest thereon to the date of decedent's death and other inve stment securities 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 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 husiness. 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. TheN! 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 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 any, 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 Impaid 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", "en, "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this ................................. "CJ~/! 1JJ~~r ...............~~~~~r...................................._.. .......R.........D...........~..2....,.................................................................................... (Street Number) . ...........~.I\.t.P.P..~.!.l..~?~..;:.g,.I.......P..~.n:.!.l..~..~.....)..7..??...7........... (City or Town and State) ...................................~.~~ . .... day of .....p.~..<::.~.~.P..~X.............. 19...7..~.... ....~.\~:~~...\b...:.\~~L. SUSI\N R. MYERS, Notary Public Lemoyne, Cumberland Co., Pa. My Commission Expires Oct. 27, 1990 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. RC ~-34 (4-73), COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" 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 .hould be de.crlbed by lot and block number, .treet and .treet number. together with a general de.crlptlon of the property. with a reference to the record of the conveyance by which the decedent took title; If a farm .tate number of a. ere.; al.o statement of mortgage encumbrance. upon each parcel at death of decedent. Taxe.. a.....ment.. accrued Intere.t on mortgage.. etc.. are to be lI.ted on Schedule "F" and mu.t not be deducted from thl. .chedule. (1 ) (2) (3) DEPARTMENT VALUATION CAUTION (Do not write In thl. .poce) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEI. TH ESTIMA TED MARKET VALUE tenant in common Undivided one-half interest 89 Acres, situate in Southampton Township, Cumberland County, Pennsylvania Brick dwelling house, barn and outbuilding n.,'oe;....o 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. NON E'" '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 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 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. Qousehold goods and furnishings ",,"'- bank account 0" }",~~ <):'1"-"" stock, C-V Cooperative Preferred 6 shares $10.00 ~''<([528'.~ i ~ /"6755.71:" S l4 (,.,L.2-o v $60.00/ jc.2. 3. ~ Y. rwla oJ:, ..},1'i;,+- {\\Q-\I{ ~~ .db 5hfpWJi.K.vK~ . eh.cc\tc~c~ (i~~c\. -\10 :50 R. 4'-\ <( -1 .~ llL-{J. sL/ ) rL \ i \ \'5.:- No.JJ ~1( iJ ~~wr)~"'^ ~ J.. S \I r. /'fc.c:t. r,rL^ G\ (') - --IT lJ Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X C34~?D ")1Q ,. lL{ I... ' 'RCC-3& COMMONWEALTH OF PENNSYLVANIA TRANS~~R INHERITANCE TAX SCHEDULE "c" TRANSFEIlS RESIDENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) TIn (2) Did decedent, within two years of death, transfer property 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 health 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 wi thout receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for 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 (b) 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 decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or 1'0 r the 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) 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 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 whom 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 detailed 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. VALUATION (Dept. Only) Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. NONE" "., . RCC-37 (i2-63) COMMONWEALTH ot PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE uD" 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 BI RTH D",c-c- U u ~ snn yes 1/2 , R.D. #2 2/10/21 Shippensburg, PA 17257 Winfield S. McCoy. Jr. 536 Briar Lane 1/'J'Z./'JA Chambersburl! . PA 17201 . . Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE SUMMARY Real Property ........... ............................................................... (Sch. "A") Personal Property ........... .................. .... ,.......... ...................... (Sch. "B") Transfers ................ ............ ...................................................... (Sch. "C") }qJ.nt.l y.. .Ow.n~.d... .P..+..Qp.~. ~ t.Y. .~....~. ~.~. ...... .'.'.E. .'.'... ...................... ... o . ....."'.... e<'lt ~:: C '2 Qi e .-...... ::s eQi.... "O'ii8 < e_ ~8;;, o Qi ............... ;:l '" ... CJ ;:l 0 ~eg. ~ ~ Gross Taxable Estate ........... .. ( 1) (As Reported) $..4.5.,0.0.0.....0.0. . $. .7,,3.4..3,71-;.. $.............................. $..A.S...J.!?.o..!.o.o. . $.................. ................. $..s..z....~.~~ .J? (2 ) (As Determined) $ $. $ $ $.. $ oci r--< ol .-t E-o Z til ~ til V'l - -< l::l:i t:l.o t:l.o -< til ::c E-< ~ o l::l:i til !: ~ ..... "0 .Qi .'" :la :~ Qi Q P.. .~ ..d Ui t:: ~ o E-< ~ o ~ A- i:! lIS ~ ...... ;::j o Vi ... t1l Qi >< d r--: ~ I': ~ N o Z ~ o ~ E-< -< E-< V'l til t.l ~ ~ t.l :I: ... '" o ~. 0: u: (): ::z .: >: -< .-r ;::>: ....:l. ---.- i J ~~ ..... o Qi .... ~ ~ ~ z: -< ....:l p:; t.U. 1:0. ::t. ;::>. u. (\l 'S (\l ~ ~, ell C C Qi t:l.o ..:l ~ ~ - ~ l:lI: l:l.o l:l.o ~ Q ~ ~ o l:l.o [.I.l l:lI: ..... o .G' :: ... o U ..... o ..c .::: ~ ::: c o E E o U R (;.<:-38 RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY '* COMMONWEALT'H 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 Unit percentage Estate Address and Relationship of Co-Owners, and Place Value Share Valuation of Record of Instrument, where Real Estate. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest 1. 89 Acres,brick dwelling, and barn Southampton Township, Cumberland County 0,,0,0, 1/2 / 45,0,0,0,1/ Ross H. McCoy and Dorothy E. McCOYb his wife R.D. #2, Shippensburg son & daughter-in-law Deed Book Z, Volume 12, page 75 2 . C-V Co-Op, preferred Stock 30, shares @ $10,.0,0, 0,.0,0, 1/2 /' 5 0, . 0, Or'-/ Ross H. McCoy and Winfield S. McCoy, Jr. sons Insert this to tal opposite "Jointly Owned Property", Schedule "E" 45150,. ,I'" li f\ A.l\D in the "As Reported" column on the last page of this return. ..~ , '. REV-SI8 (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 Ross H. McCoy R.D. 2 Shippensburg, PA 17257 Winfield S. McCoy, Jr. 536 Bri al Lane Chambersburg, PA 17201 (Executor or Administrator) In Re: Estate of Lula V. McCoy Cumberl and County - Fi Ie No. 21 -78-0310 Dear Sirs: You are hereby notified that the or i q i na 1 appraisement in the estate of Lul a V. McCoy has been filed in the office of the Register of Wills of Cumberl and County on Auqust 21, , 19a. Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total none 11 .791. 74 none 41),11)0.00 56 .941. 74 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 August 21 , 1979 Signed /~ nAI!f1 J ~~'no Title Admi n i s t rat i ve Offi cer NOTE: This is not a bill. " RCC-39 (ll-&8). COMMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of McCoy. Lula (Last Name) (First Name) (Initial) v. DATE OF DEATH 6/10/78 FILE NO, 21-78-0370 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of r.lImh e,.1 and 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 right in Schedules "A", "B", "C", and "E", ~ndUV kw INHERITANCE TAX APPRAISER Dated: August 21, 1979 REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Cumberland County, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum allowed as a deduction, Dated: INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Join t - Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ ESTATE TAX ASSESSMENTS $ FOR USE OF REGISTER ONLY Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Total Estate TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Estate tax paid $ BALANCE DUE Add interest at rate of 6% from to REGISTER OF WILLS VALUE AS APPRAISED $ VALUE AS REAPPRAISED $ t= t= t= COMPUTATION OF TAX 2% 6% 5% 10% 15% * $ $ $ $ $ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue, $ $ $ t= $ $ c $ 1== L- t= $ $ TOTAL TAX BALANCE $ PAID $ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason, same should be noted below, with short explanation, 00 r-- ~ E-o ~ ." s:i. Z QI .~ '"' tz:I .'" ..cl cU :::E :." ..;l Q) QI ui >< tz:I :~ d -< (J) Q :3i {I} - 0: - 0 -< < r-- : ~ E-i cU all tJ'): ~ ~ '2 A. I: ~ 0 s:; "C cU A. ~: lol < lol 0 s:: > -< ('.I: ~ ::: tz:I .w t'lI >- ~ !-< en tz:I :><: 0.. ~ c Q 0 ~ :I: ~ < 0 S F-l c ~ 0 !-< ~ Z !-< (J) u: at Cl) ~ tz:I u: ..cl ,L:l '- !- ---- ::E:: +.I S 0 0 ;:j ;:j ..c all ~ ~ . 0 u .... 0 tz:I :> u:> '"; A. Q./ loW = !-< eX:: '- ~ all !-< 0 c ~ < ~. '- .c- O :::E ~: 0 e =::8 ~: Q./ 5 e .... .. .- ~ cU 0 0 S:'I< ~ U U REV-457 (8-78) DEPARTMENT OF MVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEM ENT DATi:. Auqust 21. 1979 Cumberland 21-78-0370 COUNTY FILE NO. Whereas, Lula V. McCoy late of Southampton Townc;hip in the County of Cumber 1 and Commonwealth of Pennsylvania, having died on the 10th day of J uen 19 Z!L. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Sandra L. Stone , 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 VALUES AppraIsement Made for Inheritance Tax Purposes Real Estate Personal Property $ TOTAL ASSETS Jointl Held Pro ert Transfers Have been duly sworn according to law, I do hereby certify hat the above appraisement is made in conformity with the law on this 21 s t day of 19 ~. Appraiser (Number and Street) Harri sburq (Post Office) . Penna. en: "0 "': >, I- <!> ~ .... z la d-E' : '"-l s::: \.0; :::s w <!> 0 ::2: tJ ..: W 0 W <!> ~. ::::> CI) Q N; Z <( a.; 00: ...: W 10 a: '-. r--.: VI: > c.. ..c : ~ ~~ N" :3: W ..... ~ c.. VI: en: ....~ s::: ~ c: ~ :3: a: s::: <!> '- 3: ..: <(: '"ti" <!> ~ ('r) X >-: 0; LL ~ ~ '0 0: 0: '0 ~ 0 ~ I I- u: '0 1-; tJ 0 tI.l tI.l { :> l- ..... W u: c: Q): ~ ~ a 'ra ~ -c: .... ~ U .:g ~; .... 0: c: .... ..... z a 0.. c: Z C'll ...: :3: 0 ~ W 0.. ~ ~~ c:( ~ . 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