HomeMy WebLinkAbout06-28-79
Form RCC.-33-Rl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COllECTIONS
COUNTY OF
'*
~~F /17
;2 /- 7 Y -3?(:;
RESIDENT DECEDENT
cm.1EERLf.J.m
IMPORTANT: This return must be completed in detail and filed in duplicate, with will attached, with the
Register of Wills of the County where decedent resided; Return is due within one year after
date of death, unless an extension is granted hy the Secretary of Revenue. (Section 703 of
the Inheritance an!! Estate Tax Act of 1961.)
I~~:;::'~:~;.=.~~:::EESTATE ~F...... .....c.. o.qn........t..y...} AAE::DEM:IDN:I:SOTI:RAOT:OR
(State full I1B.me of decedent)
Cumberland
Late of .....
State of ..~e.:nns~l~Ili~ ....
County of . CW!lbe:r::L~AQ.,
.....................................}
ss:
~~tJmi:X
.A.~M~.g}::q,P,dI~.J1cG?,:u.gh~.Y....
of the estate of the above-named decedent being duly sworn, depose
Executor :ll
and say
Decedent died
July
3 ., 19.?~.....5 testate leaving a last will, copy of which is hereto attached. '1
(Jlay) (Vr,ar) L intestate f
(Month)
Name and address of attorney
other authorized representative
whom all correspondence should
mailed.
or}
to
be
llalph A.?h.f3e.~Z.,~~.~.~rney.
798 Valley street, Enola, Ps.. 17025
That as such .ke.cut..It.s....................... deponent is familiar with the affairs of said estate and the property con-
(ExP{'\)tor. Administrator)
stituting 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 THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
None
That the contents of said safe deposit box or boxes are itemized under Schedules
return, with the exception of the following, for the reasons hereinafter set forth:
of this
That Schedule A attached hereto and made part hereof sets forth fullv and in detail all the
real property in the Commonweal th 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 depos:lt, savings banks, trust companies, or other institutions, whether individually, or in trust for
any othel' 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 in-
debtedness of the United States to the decedent; 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, pic-
tures, books, works of a.rt, household furniture, horses, carriages, automobiles, boats, and any and all
other personal chattels of whatsoever kind or nature, left by decedent, together wi th the fairly es timated
market value thereof; all bonds and mortgalres held by decedent and of all claims due and owing decedent
at the time of neath, and all promissory notes or other instruments in writing for the payment of money
of which rtecedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face
value and estimatert 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 polic1'es carried by decedent; all annuity ami endowment contracts the
proceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends
rlue thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of dece-
dent's death anrt other investment securities owned by the decedent at the time of death, with the market
value thereof 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 business.
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 t~ke 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 en,joyment at or after death, there is also attached to the schedule a copy
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 pe~sonal, with its value, which pa~ses at decedent's death by
virtue of the exerci~e 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, and the 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. ~.~E?ed for burial trus~to~ or gravemarkers, and reli-
gious services, in conseque e of the death ~f.the.decedent; dfbts and claims'-oll"iRg..~nd unpaid at time of
,. .'- , \-. .
death; ~xes accrued char e.able for period prior to deCed.e~t .S\.death (except. those al'10weg. under SectlOn
651 of' t~ Inheritance Ind Estate Tax Act); together with ,,-.statement of collateral pledged f'or obliga-
tions, if a~. It is ji:greed that the fiduciary will present 'proof of said claimed obligations upon re-
quest, that i~~m~unt 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 aJllount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "CO, "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this .................................
............................./..31.. '" day of .........~~~............................... 19..?.~..... ...:::b..~...!!.t~...........:..:;..~:z.:~2N~.~:k..i<.~:r;. (
/:J (E:reC'Utor-~_) ,/
......................... ...7lItd:.~../:2t!.,...d.;hA~:.............. ...............1~.4.?....M~.~.....~.;.QA....P..r.tV..~...............................................
NOTARY PU3U':: (Street Number)
My Commission Expires Sep:. ! :'~.:o~......:E.J~.~~,....~~.~.....~.?9.?:?...................
Camp Hill, Pc. Cumberlcnd .~v~". i (City or Town and State)
NOTE: Before signing affidavit make sure all blank spaces in the af'fidavi t 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.
~ '- J4 ll-~"\)
COMMONWEALTH OF PENNSYLVANIA
DEPARTME:NT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
Reali property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Where property held os ioint tenant or tenancy by entireties, report on Schedule "::::". Property b,ld by
the decedent as tenant in common with another or others, should be identified os to quantum of interest and
the l~stimateJ value should be that of the decedent's interest only.
The real prQ'perty located In the Commo(lwealth of Pen,.sylvania should be
described bl' lot and block number, street ond street n"mber. together with
a general de'scription of the property, with a reference to the record of the
conveyance by whi ch the decedent took title; if a farm state number of a-
cres; also s'tatement 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
VALUATION
CAUTION
(Do not write
in this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
;('3- stor~' frame dwelling 2055 Good Hope Road, Hampden
Townshi:p, Cumberland. County, Pa.. See Deed Book "T",
Vol. 9, Pags 152, 3.24 acres
(1.26 aCr€IS wa.s sold to Daniel F. Blust and li'ay Blust,
his wife, on August 2, 1948, said Deed being recoI"ued
on August 3, 1948)
$3, 910.00V / $30,000.00 )//
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As ReportE!d" column on the last page of this return.
~D ()OD,DO
J
RCC-33b -'1<1
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "R"
PERSON AL PROPERTY
Cash In halOd, Cash on deposit, Bonds and Mortgages, any Interest In a Copartnership or Unincor-
porated Business, Judgments, Royalties, Rights, Shares in Trult Funds, Leaseholds, Pensions, Promis-
lory Notes, Cla;ims, Insurance payable to Estate of Decedent; Annuity and Endowment Contracts;
Corporate Bond" and Stocks, with Accrued Interest and Dividends Declared and Unpaid to Date of
Death, Accounts Receivable, Jewelry, Wearing Apparel, Silverware, Houlehold Goods, Automobiles
and All Other PerlGnal Property of Every Nature Wherever Situate. (Property held jointly by
decedent and a"other must be listed showing na.me. and addresses '" Gther Joint Owners and their
relationship to d,ecedent.)
Unit
(1)
ESTIMATED
MARKET VALUE
AT
DATE OF DEATH
(2)
DEPARTMENT
VALUATION
CAUTION
(Do not write in
this space)
Values
Gross proceeds from Public Sale of Personal property
$2,928.00 /
lE.XH;utl,r.A'JffJiniHtraUJr JrIl1ht {(,tal "i"./'Ilimatj.d 'f<Jrkl>t Valtll'" (:.dUIllJI ;\0. 1 .Hld carry total to
('(,IUlfltl .\1) 1 ill "Summary" .)ll ;f'n'~".l' !-lid/> uf ~'heduh~ IJ.)
~2,928.00
~\ qd..~' DD
Note: This schedule mUst list all intangible personal property such as, cash in bank, bonds and mortgages, promissory notes, claims. insur-
ance, corpMat(c bonds and stocks, accounts receivable, interest in partnership, etc., even though physically located outside the Common-
wealth ..t ; hi> ti me of death. As to tangible personal property (e.g., jewelry, wearing apparel, silverware, household goods, books, palnting-s.
au(.omobiles, bo~Lts, etc.) state where it was actually located on the day of the decedent's death. Tangible ~l"'Sonal property which is definite-
ly established to have been physically situated outside this Commonwealth other than for a temporary purpose, is not SUbject to ta-x in
this Commonwealth. In the absence of a. specific declaration as to actual situs, said property will be presumed to have been physically
present within I~his Commonwealth at the time of death.
RCC-3b
CO\1\IO\"I'1<'\LTII OF PFXNSYLVANL\
T1L\\~:FFI\ I:\HE!UTAXC'E TAX
SCHEDULE "e"
TRANSFERS
n.F:~IDE'IT DECEDE'IT
(1) Did decedent, wi thin two years of death, make any transfer of any material part of his estate, wi thout
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
(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) 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) no
(b) What was the transferee's age at time of decedent's death?
(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
(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 reserver! power to alter, amend, or revoj(e, or which conld 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 ~ffirmative, 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 attenll:ing physi cian 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 transferrect, with
relationship of transferees to decedent, if any. Submit copy of anj' 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 VALliE
(Estimated)
DEPT. VAIXATION
(Dept. Only)
Insert this tot'!.l opposite "Transfers", Schedule "e" in the
"As Reported" colu1lU1 on the last page of this return.
NOME
RCC-37 (:2-63)
COI\t!llO:\T\rEALTlI OF PEN7\SYYLANIA
TRANSFER I~HERITANCE TAX
RESIDENT DEL'EDENT
SCHEDULE "D"
BEI\"EFICIARIES
\
h
, RELATIONSHIP T r
BENEFICIARIES AND ADDRESSES (If step-children or SUR\ IVED DATE INTEREST OF
state full names and addresses of all who illegitimate children I DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other- are involved, set STATE YES BIRTH IN ESTATE
wise, in estate) forth this fact.) OR NO
Iva G. NeG'sue.:hey & 128 S. 15 tho St 1 1 _1 () _ 1 J I-
Camp Hill, Pa. 17011 Daughter Yes 1/5 residue
.
Anna 'E. Meek. 4545 II{t . Zion Dr. In_"_~' 2'
Eno1a, Pa. 17025 Daughter Yes 1/5 residue
Bert~ D. Bretz 2305 C loverf ie1<'1 1 r)_()_,?,:,~
lent, Enola, Pa. 17025 Daughter Yes 1/5 residue
Edith V. ':-leek 4800 Woodland tr. l'")_'':":;':_S':!
Eno1a, P.a. 17025 Daughter Yes 1/5 residue
b.udrey .-1. j\ilyers 4.Z:;~C; Mt .Zil'ln Dr
Enola, Pla. 17025 Grandd.aughter Yes rJ_l Q-1'_"7 1/10 :oesidue
Sheila A. :Jia.,.Atnn A.OA i'l KellA"
St. , l.ieehanie s burg, Fa. 17055 granddaughter Yes "! ?_,o_c::') 1/10 residue
I
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
l{CC-~~8
RESIDENT nECEDENT
SCHEDULE "1<:"
.JOINTLY O'VNED PFtOPEHTY
C':'vl~k! \ '\ 1,'\ 1 rH (1 F j'EN\ SYl X \N f\
n \\~:':-:n I \HFltl T\NCE T \\
I\STiUTTTO:\S: TIt.is schedule must disclose all property, real 'lwl personal, owned by the ,lecedent jointly
wi th another or others, including intangibles, standing in the nalTlP of the decedent and others. List
"cll estate Erst, as enUreties, or joint tenants, giving brief rlescription, as indicated under Schedule
"A". plus the date and place of record of instnunent effecting I'estiture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "8", plus date of acquisition, and the name. address and relationship (if any) of co-owners to
the d(~ccdent.
Des c I' i P t to n-'~f~P rop ~r t y, D;~ t~-'~f~-'\~';llli~i t j~~~,N,~~;~r--lj~it
Address Imd Relationship of' Co-Owners, and Place i Value
of Recorrl of Instrument, where Real Estate. ! ,
~~ -~7 r ~ Ar~;.--~~^~-"~~~~-;~~~~~
~( .' J6)r;;~~
!" __.m. _
PE~rcentage
Shllrp
Estate
Valuation
-ex:-:)'--'
,v/'
^'>(--'----
----.----
DEPART}lENT VALUATION
CAUTION-Do not Write
I n This Space.
Value of I Value of
Entire Decedent's
Property I Interest
Savings A(~count #08-0434764, CON::B Ban.lc,
Oct. 23" 1969 5 \ c:
,
I
i
I
openeii
i
i
i
openep.
,
one-half
I
$2,859.~ ./
i
1/
l,095.98f
i
I
I
I
Checking Account #180-19968, CCNB Bank,
Oct. 23, 1969 ::;' J
one-half
I
,
~l ,\56.03
Insert this to tal oppos i te "Join U y Owned Property", Schedule "E"
in the "As Reported" colul'ln on the last page of this return.
REV-5I8 (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
Anna Meck
4545 Mt. Zion Road
Enola, PA 17025
Iva McGaughey
128 South 15th Street
Camp Hill, PA 17011
(Executor or Administratod
In Re: Estate of Frances V. Blust
Cumberland
County - File No. 21-78-0386
Dear Ms. Meck and Ms. McGaughey:
You are hereby notified that the original
appraisement in the estate of Frances V. Blust
has been filed in the office of the Register of Wills of Cumberland
County on August 21 ,19~. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
$30,000.00
2,928.00
none
3,955.03
$36,883.03
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
do/vuL A
-<l'l--c./Vl s:-
Title
Administrative Officer
NOTE: This is not a bill.
., :G-,';)
:::':C':.Inty, N..~mber and Name
21-Cumberland
SUMMARY
file Number 21-78-0386
Dote of Death July 3, 1978
Estate Name Blust
(LAST NAME)
Frances
(FIRST NAME)
v.
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
R~SIDENT DECEDENT
{INITIAL)
,I
REPORT OF INHERIT ANCE TAX APPRAISER
I, thl~ 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 val \les set forth opposite each item in the last column to the right in Schedu\ es .. AIt, "B", "C", and II EIt.
Dated:
August 21, 1979
~
....i,/1
(~ '1 f">- ~~--rc~
iNH E RIT AN CE TAX APP RAiSER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect.
fully report thot 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 "Fit, which greater or lesser amount represents the sum
allowed as .(1 deduction.
Doled:
REGISTER OF WiLLS
r
ADJUSTMENTS
Ir~VENTORV VALUE AS APPRAISED ~ODE (HARRISBURG USE ONL V) REMAINDER APPRAiSEMENT CODE
Real Property (Sl:hedule A) $ 30.000 00 00+ 92+
ersonal Property (Schedule B) 2.928 00 10+
oint-Held Propel'ty (Schedule E) 3.955 03 20+
ransfers (Schedule Cl none 30+
TOTAL GROSS ASSETS 36.883. 03
Less Debts and Deductions 40- 93-
(SCHEDULE F)
GLE.lI,R VA!.UE OF ESTATE
j
T
Valuation of li:ie estates or
~
PRINCIPLE
FACTOR
VALUE
CODE
annuities.................. ..._ $
I-
I
,
l
~
ESTATE TAX ASSESSMENTS _ $
FOR USE OF REGISTER ONLV
CODE
COMPUTATION OF Ti"X:
2%
6%
15%
$
Ta)( on $
T a x on $
r a x on $
Tax on $
Tax on $
Excmpt;ons
fotel Estate
$
$
$
$
*
TOTAL TAX
$
i~) As evidenced by Charitable
Exemption Ce''tifieiltes Issued
by the Secretary of Revenue.
Lass tax previously paid
BALANCE
'-"55 5.% of to" if paid within
.~ ITlonths aite: deatb
$
$
t=
$
BALANCE 0::: INHERITANCE TAX DUE
Add interest ut rate of 6% from
___to
AMOUNT OF ESTATE TAX ASSESSED
$
$
Estate tCiX peid
$
$
$
BALANCE DUE
Add interest 01 rate of 6% from
to
$
TOT AL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Ad!ustrnent
49+Adiu5t~nent
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Chority
94-Remainder Residue
96-SlJccess i ve
life Estate
ADJUSTMENTS
FOR USE OF REGISTER ONLY
NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills for proper reason,
s'(lme should be noted below, with short explanation. '
REV-457 (8-78)
DEPARTMENT OF REVeNUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COrvuvlONlfJEALTH OF PEiJNSYLVANIA I
RESIDENT lI\lHERIT ANCE TAX I
APPRAISEMe~JT ;
i
DATE _
August 21, 1979
____"'~_,.........;c.".."l"I:Jl>
Cumberland
COUNTY
FIL= :;0,
__~J;:Z~-:::9.3~~_
Whereas, Frances V. Blus t _ late of Hamoden Township __..~__~._.,.,_,,_~.~
in the County of Cumberland ~_~_ CcmrnonweJlth of P,n"lS"- Ii '\IT'] -i
the _ 3rd day of July 19 ZlL.., seiz",d and oi I" e.:t:-t~
subject to Inheritance Tax under the laws of the Ccmnwn\vsalth of Penn:cylvanh;
Therefore, I, Sandra L. Stone _~___~_.~ ,m d\;j/:i~ ';"li"ctl C',~>;l
havinq been designated to make a fair and ccnsciOJ],,,ble apPol::;ement the slid ('stat..?, ,.:';:! "
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 tranSTAtred L~; possession or 811JOym,3:1t to coilater2s~ ;kll\':., ut t'tlc"'l ,j'2C,2C>:~:t .11".',
of any estate for Hfe or for years, the Commonwealth hereby expressl)' reserves U~e tight to appra!se and assess trarsf;;;r i(;!'H~ritn-;C~~ t.?lXE'5 ;~.
rate on any such future interest.
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Total Assets J_,___~._~~~lg~b3
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DESCRIPTION OF P'3SE r
Real Estate
Personal Property
Jointly Owned
Transfers
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Have been duly sworn according to law, I do hereby certify that the above appraisement is made in cOi1forrni ty
with the law on this 21st day of ,<f~~':~1'lA1 __ ~7L:.C = 19 7!L-.. ' ..__
,-' /~r;p;',::se-
Harrisburg
._- . .f"p:in,';.
.
(Nltrnber aij,: S,~eet)
(Post Office)