HomeMy WebLinkAbout10-17-79 (3)
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RCC-33 (4-7::;1
RESIDENT DECEDENT
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
j ) /-+-.l
'~/d{VJf'-z{hL"--{ {cC.- 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\tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
Coo"" }
EXECUTOR
AFFIDAVIT OF
GRACE E. HACKETT
{STATE FULL NAME OF DECEDENTI
Late of
Cumberland
ADMINISTRA TOR
State of Pennsylvania
County of Cumber land
}..
Administrator
Dorothy Baez
Executor
of the estote of the above-named decedent being duly sworn, depose
and say
April
(MONTH)
Name and address of attorney or }
other authorized repres,entative to whom
all correspondence should be mailed.
10
(DAY)
, 19-2B--{testate leaving a last will, copy of which is hereto attached. }
(YEAR) lK~
Decedent died
McCREA & DAVIS, John McCrea III
22 South High St., Newville, PA
17241
That as such Executrix deponent is familiar with the affairs of said estate and the property constituting
(EX E CU TO R-ADMI N I ST R A 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 THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
NONF.
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: NONE
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detai I 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
col umns provided therefore the as se s sed 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 pri@f to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, pOSI.aJ
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 mcrtgages 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; ail and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the l'l1arket 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 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 personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly wi th 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 benet'iciary.
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 instrt~ents 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, inclurling funeral expenses paid;
family exemption, where applicable; costs of arlministration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing and unpaid at time of
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules" A", "B", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Ch
..........................(1..........
.... day of . .....Dc:.liJ:ld:0....... 19...Z..!.
~ l> ../A" I ;'
/ ..' j ,""'-7/L--.,{.,-<'i ( , i;. <: .<-
c..-o ~.. ~ . I .
......P.9..~9..t.hy.....~.9:.~..?....(..:......................................~...........................
(Executor-XX:j)U~U)
..~.~.P.~..~..?'.......~.~~...}..?..?...............................................................
(Street Number)
Carlisle, PA 17013
................................................................................ ...... .............,...........
(City or Town and State)
Subscribed and sworn to before me this .................................
j, .~ tJ'
; " J' \,. ,'_I,' I -,;
........ ~'~"""". ,....,. . ./::4i':t-.tli:0..
,/ . ,~
SUSAN J. HOVETTER, ,I!rotary Public
N~wviqa cu:,~',-h.e leo Pa
N~/ C,)~~:s:;;;~..;:;'~;~s s'~:)t. '6, 1982
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
fillerl in with details or the word "None", ann in case the assets include rare and unlisted securities,
securiti.es 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 C.34 (4.73)
COMMONWEALTH OF PENHSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
REVISED
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 os tenant in common with another or other, should beidentiHed
os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held os 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 black number, .treet 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 encumbrance. upon each parcel at death
of decedent, Taxes, as....ment., accrued Interest on mortgages, etc.,are
to be listed on Schedule "F" and must not b. deducted from this schedule.
(1 )
(2)
(3)
DEPARTMENT
VAL.UATION
CAUTION
(Do not write
In th I. .pace)
ASSESSED VAL.UE
FOR YEAR OF
DECEDENT'S
OEA TH
ESTIMATED
MARKET VAL.UE
Proceeds from sale of real estate
with dwelling house erected thereon
situate in Penn TWp., Cumberland Co,
Pennsylvania, sold October ll,19?9
to William W. Dreisbach for and In
consideration of the sum of
$10,500.00
.5; (p r,~,
--
//' )
~, 500. OOJ~:/
-----
..
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.
L_ :~~9_V
( ! ( ) l
Bee -35
CO~~ONWEALTH OF PENNSYLVANIA
TR~NSFBR INHERITANCE TAX
REVISED
SCHEDULE "BI!
PERSONAL PROPERTY
RESIn r DECEDENT
I NSTRl!CTIONS: 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. Savtngs 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 ~lrnishings, 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. List and describe fully VALUE MARKEr VALUE (Do not write in
this space)
Proceeds from life insurance policy
with Ohio National Life Insurance Co. ""
Policy # 337402 $1,502.42 (
\
life insurance policy r
Proceeds from \
with New York Life Insurance Co.
Policy #27-090-877
death claim #607-600 $1,547.90 ,
I /
I
I
./' ''''-
opposite "Personal Property", Schedule "B" in X(X $3,Q50.3~, )\
Insert this total .. -/ ~(;
the "As Reported" column on the last page of this return. -- i,
RCC- V,
Cll\1}.i(),\WE\ L'j[ UF 1'i.:':{\SYL\!\'i I i\,
T{A\~;:/Fi\ I\lT:UTP:\CF TAX
REVISED
SCIIFDULE "e"
1'!, \\'-TlmS
R~
~'~ a.
v: f'-"," , ~..'
~' ;,''''~) I'.l.
r J, _-,y"l):j-~:'~ _~..
!"~;~
'Z.;\~,: ___'r t~i;Y"'=~A~
i,:';:S I lW\T m:n:I1E\T
(1)
Did ~\'~"dent, within two years ot'dp'lth, make "t,y trlit1sfer of any nuitprild ]Joirt of his p"t It'', "jtiltlut
r('('<'1\'ln; a valuable aflfi adequate COIH.,j,jpration tllp!'e['or? (i\n8wpr yes or no)-E~__
Did rlecedent, wi thin two years of death, tI'lIi1SCCi' properLY from himsel f to ilim"elJ' and another at'
(.tlter's Uncluding it spouse) in joint ownership? (Answer yes or no)__nQ__
If the answer to (1) or (2) abovp is in the af'f'irmative state:
(a) Ag;e of decedent at tim.? of transfer
(b) State of decedent's heal th at time of nnking the transfer. (;>late 1).
(c) Cause of decedent's d,,:ttlI. (Note 1).
Did ctecedent, in his lifetime, make any transfer of property without receiving a valuable or ade'luitt~e
consideration therefor which was to take efrect in possession Qr enjoymeI.t ilt or l,fteI' his death?
(Answer yes or no) no
(a) lias there any jlossibility that the property transferred mip;ht return to transferer or his
estilte or be subject to his IJower of disposition? (Answer- y':;s o~ po)
(il) What was Uw transferee's age at time of decedent's rleath?
Did decedent in his I ifetime 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
no t. in filet end before his death:
(il) The possession or er>joyment of or the right to income from tht' property transferred?
(Answer yes or no) no
(tJ) The right to designate the persons who shall possess er enjoy tlJe property transferred or
income therefrom? (Answer yes or no) no
If' tlle answer to (5) (b) above is in the affirmative, state whether the right was reserved in ctecedent
(2)
(:1)
(4)
(5)
(fi)
alone or others
(7) Did decedent in his J if'etime make a transfer, the consideration for whi.ch was transferee's promise to
Jlay income to or for the benefit of care of tl-ar:sferor? (Answer yes or no) no
(8) Did decedent, at any time, transfer property, th0 brcmefi cial enjoyment of which was subject to change,
beciiuse of a reserved power to al tel', amend, or revoke, or which c01Jld revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If the answer to (~ above id in the affirmative, was the power to alter, amend, or revoke the inter-
est of Uw belH~ficiary reserved in th(~ decedent alone or the decedent and others?
(Answer yps 0 r no)
NOTE 1: The rlnswers to these questions shouJd be supporterl by affidavit by the attewUng physician as
well as a copy of tlJe death certificate.
NOTE 2: If answer to any of the above questions 1.s yes, set forth below a description of the property
transferre'l, it's fair market value at date of death, dates of transfers and to y'hom transferreii, with
relationship of transferees to decedent, if any. Svbmit copy of any trust deefi or instrument, if trans-
fers are claimed to be non-taxable, also sublni t ctetailecl statement of facts on which said claim is based.
:'IOTE 3: List aplllicable property below in manner in which provicted in Schedules A, B, or E.
ITEM
lJESCRIPTION
MARKET VALCE
(Estimaterl)
DEPT. VAU'AT~O;>l
(Dept. Only)
I
none
J ,
the )
/
,
Insert this tnl'il opposite "Transfers", ScheduJe "C" in
"As Reported" colunm on the lilst p'J.ge of this return.
LAST WILL AND TESTAMENT
I, Grace E. Hackett, a resident of Penn Township, Cumberland
County, Pennsylvania, being of sound mind and memory, do make,
publish and declare this to be my Last Will and Testament, hereby
revoking any and all Wills by me heretofore made.
FIRST: I direct my Executor hereinafter named to
my just debts and funeral expenses as soon as may be conveniently
done after my decease.
SECOND: I give, devise and bequeath all my estate, be it
real, personal or mixed, to my two children, John Godman and
Dorothy Baez or their heirs, equally, share and share alike, to
their own proper use and behoof forever.
THIRD: I hereby nominate, constitute and appoint John
Godman to be the Executor of this my Last Will and Testament.
In the event he is unable to serve for any reason whatsoever,
then I nominate, constitute and appoint Dorothy Baez to be the
successor Executrix.
IN WITN~SS WHEREOF, I have hereunto set my hand and saalto
this my Last Will and Testament, written on one (1) sheet of
paper, dated this 19!f..-day of ~ , 1974.
~~ ft I/Qe_t,;_lf.
Grace . Hac ett
(SEAL)
This instrument was by the Testatrix, Grace E. Hackett, on
the date hereof, signed, published and declared by her to be her
Last Will and Testament, in our presence, who at her request and
in her presence and in the presence of each other, we believing
her to be of sound mind and memory, have hereunto subscribed our
names as witnesses.
MCCREA & MCCREA
ATTORNEYS AT LAW
lClWYILLI " SHIPP~NBlURl
PENNA.
!tl;/(, If( ,1: ~4 /
, /
jJcnvna- 2/? ~a~
RCC-37 (12-63)
CO~I!\lO:"JWEALTI\ OF F'E0,':\SYYL\NIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
REVI SED
SCHEDULE "0"
BE:\'EFICIARIES
BENEFICIARIES AND ADDRESSES
\State full names and addresses of all who
have an interest, vested, contingent or other-
wise, in estate)
Doroth Baez
R.D.#5, Box 382
Carlisle , PA 17013
John Godman
5120 North Comae st.
Philadelphia, PA 18141
RELA TIONSIu:p--r
(If step-children or i
illegitimate children i
are involved, set I
forth this facL)
SURVIVED
DECEDENT
STA TE YES
OR NO I
DATE
OF
BIRTH
sui uris
sui uris
INTEREST OF
BENEFICIARY
IN ESTATE
one-half
one-half
son
es
Deponent further says that all the above-named beneficiaries are living at this time except below:
-+-
I
---L.
NAME
RESIDENCE
DATE OF DEATH
.... --:
.8rJJ...-l
E<~
t;:= C
02 Q) 6
Os Q) .:
_'ao
v 6 <.J
-:;: 0:
8 '-' ~
--'--,+->
::s ~ f....l
<.J ;:l C
~ 6 fr
f::l. ~
Real Property . . ..................
Personal Property
Transfers .... ....... . .0. .
SUMMARY
(Sch. "A")
... .. (Sch. "B")
( Sch. "e")
( 1 )
(As Reported)
10,500.00
3,050.32
....... .... ....
$
$
$
$
$
$.).), .;l;l Q. :3.2
\
~
(As Dckrrninul)
$
$
$
$
$
$
Gross Taxable Estate
00
f'.;. b
Z 't:l
Q)
.... W .CIl
ell 8 ~ .l
Q) -
;>-< ""- 8 ~ <
W 1'iI. Q) r.I}
(f) ~.Cl ~ -
00 - <
< C) .,...j o:l ClI:
00 ~ ~ ~. ..c: 00
M p., ::I:. Ul '"d Cl..
0 o:l Cl..
I p., Q Q 2:
Iol < ~ <
rl :r: :r: w .: :s: cO ;..,
N ... W ... t-< 1'iI: 0 rl '" Q
c
~ :r: I-l.. .or: 8 lo-l ,.. Z
0 0 t-< I'iI OJ ~
Z t-< if) C) g ~ p., ~
~ W ~ ...... ~
0 OJ ::l 0 ClI:
,..
c ~ t-' A.l C) 'Z: 0
0 ~ 0:: Cl..
'.c Q) ~
ct: E-< ...... ;.. ClI:
1; t-< 0 ...
c
Vl < ...... 0
-0 0 1;:- ~
oE ...... Q) ::
- ...., 0 (3
.-- ~
:::~ -< u u
R C C-18
RESIDENT DECEDENT
REVISED
SCHEDULE" En
JOINTLY OWNED PROPERTY
COMMONWEAL TH 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, incl uding intangibles, standing in the name of the decedent and others. List
real estate first, as entireties, or joint tenants, giving brief description, as indicated lmder Schedule
"A", phis 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. Per90nal 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 DEPARTMENT VALUATION
Address and Relationship of Co-Owners, and PI ace Value Share Valuati on CAUTION-Do not Write
of Record of Instrument, where Real Estate. In This Space.
Value of Value of
l<.ntire Decedent's
Property Interest
none
Insert this to tal opposite "Jointly Owned Property", Schedule "E" l ) lil (
in the " As Repo rted" co 1 wnn on the last page of this return.
.). \6"':; 8}
SUPPLEME~;T AL
Count)', Number and Name
21-78-0388
21 - Cumberland
SUMMARY
FHe Number
Estate Name
04110/78
HACKETT,
Date of Death
(LAST NAME)
(FIRST NAME)
E.
(INITIAL)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Gr<?,ce
REPORT OF INHERIT ANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that I have appraised the rea! and personal property as reported ill the foregoing return at
the values !;et forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Dated:
November 28, 1979
,~//;/ / ,.J / /j' //~,
, .. .c.(., '_/ "--'-c.r; ) c...'
INHERITANCE TAX APPRi\lS,cR
REPORT OF THE REGISTER OF WILLS
i, the undersigned duly elected Register of Wills in and for 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.
Da'led:
REGISTER Or WILLS
Real P
!cODe ADJUSTMENTS
INVENTORY VALUE AS APPRAISED (HARRISBURG USE ONl YI REMAiNDER APPRAiSEMENT CODE
roperty (Sc:hedule AI $ none 00+ 92+
nal Property (Schedule BI None 10+
Held Propelrty (Schedule EI ~lone 20+
ers (Schedule C') !1l'one 30+
TAL GROSS ASSETS None ,
ebts and Deductions 40- 93-
SCHEDULE F}
R VALUE OF ESTATE ! !
?erso
Joint-
Transf
TO
Less D
ClEA
Valuation of life estates or %
:!ilnuities.............~ ........ $
PRINCIPLE
FACTOR
1=
~
VALUE
CODE
ESTATE TAX ASSESSMENTS _ $
f"OR USE OF I~EGISTER ONLY
CODE
COMPUTATION OF TAX
I-
F
I
I
TOTAL TAX
2%
6%
15%
$
I
I
(*) As evidenced by Charitable
Exemption Cettilicales issued
by the Secretary of Revenue.
Tax on $
r 0 x on $
Tax on $
Tax en $
r"x on $
Exemptions
T otol Estate
$
$
$
$
~
*
$
Less tox previously paid
BA LANCE
$
$
t
tes5 5% of rex if paid within
:3 months (lfter declth
$
BALANCE OF INHERITANCE TAX DUE
Add interest at role of 6% from
___ to_
AMOUNT OF ESTATE TAX ASSESSED
Est,'~e tax paid
$
$
$
$
BALANCE DUE
A.dd interest at rote of 6% from
to
$
~
I
I
$
TOT AL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE iN HARRISBURG ONL Y)
48-Adi u stment
49+Adi'ustml~nt
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Rema inder Deduction
93C-Chority
94-Remainder Residue
96-Successive
Life Estate
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.
REV-518 (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 FI LING OF APPRAISEMENT
Dorothy Baez
&. D. I, Box 382
Carlisle, fA 17013
(Executor or Administrator)
In Re: Estate of
Crace I. Hackett
C-.berland
County - File No.
21-78-0388
Dear Mrs. Baez:
You are hereby notified that the 8uppleaenta1
appraisement in the estate of Grace E. Hackett
has been filed in the office of the Register of Wills of CumberlaDd
County on Jov_her., 19 79. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
lone
loDe
lone
lone
IIone
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
Iovember 28, 1979
i
Signed '>/j 77 /\ (I 'L(~ i~,d!-;;J L '-_
/"
Title Appraiser
NOTE: This is not a bill.
SUPPLEMENTAL
REV-457 (8-78)
DEPARTMENT OF REVENUE
BURE.AU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
November .~~~.,
Cumberland
21-78-0388
DATE
COUNT'! ...
FILE NO.
Whereas, Grace E. Hackett ~_ late of Penn Township
in the County of Cumberland Commonwealth of Pennsylvania, h
the 10 th day of Apri 1 19 ~ , seized and possessEd
subject to Inheritance Tax under the laws of the Commonvlealth of Pennsylvania;
Therefore, I, Sandra L. Stone , an appraiser duly appointed acc:)l'~
having been designated to make a fair and conscionable appraisement of the said estate, and to assess ana fl..:
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 0:' E:nj,-:-:,yment to collateral heirs of the decedent afH,~ ~,
of any estate for life or for years, the Commonwealth hereby expressly reserves t[lC r1ght to ilopralse ,and assess transfer inheritance taxes at
rate on any such future interest.
UNIT I. ~,.",
DESCRIPTiON OF ASSET VALUES
i
h
Real Property ~!Y;~"L"
. ~",-.._-~
d
Personal PIloperty II
l!
Joint-Held Property l f,:;",^-'
,- ~
Transfers rI
I; ."n_',.
~ ~
f
- --'- -
"
TOTAL ASSETS I ~t-,,-
t,
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1979
none
Hone
None
None
l{one
Have been duly sworn ~(EfRiding to law, I do hereby certify th t the above appraise
with the law on this - t day of '. . 1
'/2 II (., (
(N41"I)er a.ndI5Street)
narr1.S urg
(Post Office)