HomeMy WebLinkAbout04-09-79
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
". " "1~
-:. / -1 c -( ~ '^-'"
10 .-/75 -f-'
_~_ l!'Et) 0 () ~')79
~r 0" 01:7
RCC-3314-73) .
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.)
Late of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
>>EIHI&l1SX'JUaOR
IN THE MATTER OF THE EST Al TE OF
SARAH P. RUSSELL, A/K A
PEARL M. RUSSELL
(STATE FULL NAME OF DECEDENT)
County
County of
Cumberland
} ..,
State of
X~llOD{
Lester Russell,
of the estate af the above-named decedent being duly sworn, depose S
Executor
and say S
(MONTH)
Name and address of attorney or }
other authorized representative to whom
all correspondence should be mailed.
(DAY)
, 19-1LJ testate leaving a last will, copy of which is hereto attached.,}
( YEA R) "bMfiJl(1l(
Decedent died
June
24
Tom H. Bietsch (Bietsch & Morqenthal)
7 Irvine Row, Carlisle, Pa.
17013
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
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
NONE
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent die'd 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 interest 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 estima ted 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.
._.....~,.,."".....:<;,..., ."< ,..,..,....._._,.. .,,-.."'....0 ,.....;.,.."
.
" c..... ."'731
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 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 record of the
conveyance by which the decedent took title; If a farm state number of a.
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, ass'ssments, accrued Interest on mortgages, etc.,are
to be listed on Schedule" F" and must not b. deducted from this schedule.
1.
5.2 acres, more or less, of real
estate situate along the Northern
side of Township Road No. 375 in
Upper Mifflin Township, Cumberland
County, Pennsylvania: improved with
a dwelling house and outbuildings:
and being the greater part of the
property which was conveyed to
decedent and Ervin Lee Russell, her
husband who predeceased her, by deed
dated January 8, 1974, and recorded
in the Office of the Recorder of
Deeds for Cumberland County in
Deed Book "L", Vol. 25, Page 900.
\
(1)
(2)
(3)
DEPARTMENT
VALUA TlON
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
/
3,110.00
V
19,000.0~
~.
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.
19,000.00
\ct 000 .0.;)
\
pee -3s
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
..~.
.. ~.
I ~.: t\
CO~WONWEALTH 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 anyundistributed
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
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1.
Commonwealth of Pennsylvania, Tax
Refund.
(
200.00
2.
"H" Farmall Tractor (old).
200.0-0
3.
Miscellaneous household goods.
150.0,0
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
550.00
5'500'';>
RCC-36
COMMONWEALTH OF PENNSYLVANIA
TRANS}~R INHERITANCE TAX
SCHEDULE "c"
TR.>\NSFEnS
'*
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) No
(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 N/A
(b) State of decedent's heal th at time of making the transfer. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)~______
(a) Was there any possibility that the property transferred might return to transferer or his
estate o.r be subject to his power of disposition? (Answer yes or no) N/A
(b) What was the transferee's age at time of decedent's death? N/A
(5) Did decedent in his lifetime make any transfer without 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 N/A
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for 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) N/A
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)
NONE
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
NONE
N~.
RCC-37" (12-63)
CO~tl\lO:'\lWEALTIl OF rE;\'~SYYL\NrA
TRANSFER INHERITA:'\CE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
\
h
~--~
RELATIONSHIP
~ BENEFIC:IARIES AND ADDRESSES (If step-children or SUJ~~I~ED DATE INTEREST OF
~tate full na.mes and addresses of all who illegitimate chlch"cn DE(~DENT OF BENEFICIARY
ave an interest, vested, contingent or other are Involved, set STALE YES BIRTH TN EST:\ TE
wise, in estate) forth this fact.) OR NO
Roger Russell Grandson Yes "H" Farmall Tractor
R.D. 2, Newville, Pa. 17241
Virginia Bumbaugh Granddauahte Yes Household Goods &
R.D. 2, Newville, Pa. 17241 1/15 of residue
Ernest Russell Grandson Yes $1. 00
114 S. Bedford St.
Carlisle, Pa. 17013
Clyde Russell Grandson Yes $1. 00
411 S. York St.
Mechanicsburg, Pa. 17055
Louise Miller Dauahter Yes 1/5 of residue
R.D. 2 Newville, Pa. 17241
Lester Russell Son Yes 1/5 of residue
R.D. 3, Newville, Pa. 1724]
Raymond Russell Son Yes 1/5 of residue
R.D. 2. Newville, Pa. 1724
Edith Sturn Daughter Yes liS of residue
15 Walnut Street
Newville, Pa. 17241
B .,- 'Rirnpr Granddaughte Yes 1/15 of residue
..
400 S. York St.
Mechanicsburg, Pa. 17055
Gary Russell Grandson Yes 1/15 of residue
R. D. 2, Newville, Pa. 172~ 1
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
NONE
R C C-3B
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly
with 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 tmder Schedule
"A", pltis 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.
uni t
Value
percentage
Share
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
NONE
NONE
Na~
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
REV-518 (8-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIOHS
P.O. BOX ")970
HARRISBURG
17105
IN YOUR REPLY Pl.EASE
REFER TO
..
Inheritance Tax Division
HOTICE OF FILiHG OF APPRAISEMENT
Lester Russell
R. D. 3
Newville, PA 17241
(Executor or Administrator)
In Re: Estate of Sarah P. Russell, a/k/a Pearl M. Russell
Cumberland
County - File No.
21-78-0372
Dear Mr. Russell:
You are hereby notified that the Original
appraisement in the estate of Sarah P. Russell, a/kla Pearl M. Russell
has been filed in the office of the Register of Wills of Cumberland
County on April 9 , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
19.000.00
550.00
None
None
119,5.50.00
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. Lr~73. i: "v,,-,~--,J
(5 '- j .~ "-" :<.. 0
Date April 9. 1979 Signed
Title _ Administrative Officer
/-
~----~
Note: This is not 0 bi II.
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG. PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEM ENT
DATE.
COUNTY
FILE NO.
April 9, 1979
Cl1mhArls:.nn
21-78-0372
Whereas, Sarah P. Russell a/k/a Pearl M. Russell late of Upper Mifflin Township
in the County of Cnmh".,..l Ann Commonwealth of Pennsylvania, having died on
the 24th day of June 19 78 , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Full2: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
RAAl - $ 19,000 00
- " Prnnert.., 550 00
Transfers None
.Tnint-He1d Pronerh' None
TOTA.L ASSETS 110
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 9th day of '- Q\. t::' } Appi1 · _' 19 .2L.
,----.(' ~ \ \.1- ~~'- /~---'<--A~ ,
.. /
C)
Appraiser
Harrisburg
(Number and Street)
(Post Office)
, Penna.