HomeMy WebLinkAbout03-30-79 (2)
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RC.'::-33 (4-731
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'.tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE ESTATE OF
} AFFIDAVIT OF
EXECUTOR
County ~~~~
Caroline E. Daniel
(STATE FULL NAME OF DECEDENT)
L f Hampden Twp., Cumberland
ate 0
State of .Pennsylvania
County 01
Cumberl.::md
Ed} t:h .To.qn R.q;r,
of the estate of the above-named decedent being duly sworn, depose
},
Executor
~!Rix\x~
and say
July 4.
(MONTH)
Name and address of attorney or }
other authclrized representative to whom
all correspondence should be mailed.
(DAY)
, 19~{~estate leaving a last will, copy of which is hereto attoched. }
(YEAR) 'X~
Decedent died
William L. Sunday, Esq.
39 West Main Street, Mechanicsburg. Pa. 17055
That as such RXPC'lltri X deponent is familiar with the affairs of said estate and the property constituting
(EX ECU TO R-ADMIN I 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 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
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 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 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 prim 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 oiher 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 persona! chattels of whatsoever. kind or nature, left by decedent,
togt:ther with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interes t thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the market value there-
of at such time.
In the case 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 cnaracter 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 COllY
of the deed, trust agreement or other instrument creating the trust. Therl~ 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 with another, or !iny 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, togetner 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 benericiary.
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 v-estiture 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 ror and on behalf of this decedent's estate, inclurling funeral expenses paid;
family exemption, where applicable; costs of' ac'.ministration 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 unpairl 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
have
the totals or the appropriate columns in Schedules "A", "B",
been carried forward and properly registered in the Summary.
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"E", and "F" as directed therein,
Subscribed and sworn to before me this .................................
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(Street Numbe-r)
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(City or Town and State)
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,:\.'~scL:at;Q1l of NotcHies
NOTE: Before signing afridavit 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 ano unlisterl securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements requirerl under the paragraph above relating to Schedule "B" are attachen. Also make
certrdn that column #1 in the "Summary" has been properly completed as above-oirecterl.
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LAST WILL AND TESTAMENT
I, CAROLINE E. DANIEL, widow, of the Township of Hampden,
County of Cumberland and State of'Pennsylvania, being of sound mind,
memory and understanding, do make, publish and declare this to be my
last Will and Testament, hereby revoking and making void all, former
wills, codicils and other testamentary dispositions by me at any time
heretofore made.
1.
I direct my executrix, hereinafter named, to pay as soon as
practicable after my decease all my just debts and the expenses of
my last illness and burial.
2.
I give, devise and bequeath ill of my estate - real, persdnal
and mixed - unto my daughter, Edith Joan Bair, absolutely.
3.
Should my said daughter predecease me, then and in ~hat event
I give, devise and bequeath all of my said estate unto my grand-
children, C. William Bair and Johanna K. Bair, equally, share and
share alike.
4.
I hereby nominate, constitute and appoint my daughter, Edith
Joan Bair, executrix of this my last Will and Testament. Should my
said daughter fail to qualify or cease to act as executrix, I appoint
my son-in-law, Charles B. Bair, executor of this my last Will.
IN WITNESS WHEREOF, I, CAROLINE E. DANIEL, the testatrix, have
hereunto set my hand and seal to this my last Will and Testament
this
;].5 '" day of
I 1 II .
, 1973.
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(SEAL)
Signed, sealed, published and declared by the above named Caroline
E. Daniel as and for her last Will and Testament in the presence of us,
who, at her request and in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses thereto.
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RCC-:;'4 (1-6'4)
COMMONWEALTH OF PENNSYLVANiA
DEPARTMENT OF REVENUE
BUREAU OF COU~HY COLLECTIONS
TRANSFEf? INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
..
Real property in Pennsylvania, with statement of r:1ortgage encumbrances upon each parcel ot deat;' of dece-
den1'. Where property held as joint tenant or tenancy by entireties, report on Schedule "[:". Property hf'ld by
the Jecedent as tenant in common with another or others, should be identified as to quantum of interest and
the estimated value should be that of the decedent's interest only.
The real prClperty located in the C.,mmor:'lwealth of Pennsylvania shauld be
described b'f lot a.1d block number, street and street number, together with
o general dElscription 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, assessments, accrued Interest on mortgages, etc.,are
to be I isted on Schedule" F" and must not be deducted from this schedule.
ALL those certain five (5) pieces of parcels 0
in the City of Harrisburg, Dauphin County, Pa., sepa
and described as follows, to wit:
1. BEGINNING at a point on the northern line of P
westwardly from the northwest corner of 18th & Paxto
of property No. 1714 Paxton St.; thence northwardly
through the center of a partition wall, 90 ft. to La
westwardly along the line of Lance Alley, 22 ft. to
now or late of John E.Dare; thence southwardly alon
ft. to Paxton St.; thence eastwardly along the north
ton St.,22 ft. to place of Beginning. HAVING thereo
story brick dwelling, No. 1712 Paxton St.
Value based on appraisal, copy attached
Rent due July 1, 1978 but not collected
2. BEGINNING at a point on the northern line of Pa
West of the northwest corner of 18th & Paxton Sts.,at
erty No. 1716 Paxton St.; thence in a northwardly dir
said line through the center of a partition wall 90 f
Alley; thence westwardly along the line of Lance AIle
of property No. 1712 Paxton St.; thence southwardly a
through the center of a partition wall, 90 ft. to Pax
eastwardly along the northern line of Paxton St.,20 f
of Beginning. HAVING thereon erected a 2-1/2 story b
No. 1714 Paxton St.
Value based on appraisal, copy attached
Rent due for June and July but uncollected, 2 m
3. BEGINNING a t a point on the northern line of P
ft. West of the northwest corner of 18th & Paxton Sts
property No. 1718 Paxton St.; thence northwardly alon
through the center of a partition wall, 90 ft. to Lan
westwardly along line of Lance Alley, 20 ft. to line
1714 Paxton St.; thence southwardly along said line t
ter of a partition wall, 90 ft. to Paxton St.; thence
along the northern line of Paxton St.,20 ft. to place
HAVING thereon erected a 2-1/2 story brick dwelling,
Value based on appraisal, copy attached
Rent due for July but uncollected date of death
4. BEGINNING at a point on the northern line of Pa
West of the northwest corner of 18th & Paxton Sts.,at
erty No. 1720 Paxton St.; thence northwardly along sa
the center of a partition wall,90 ft. to Lance Alley;
wardly along line of Lance Alley, 20 ft. to line of p
Paxton St.; thence southwardly along said line throug
a partition wall, 90 ft. to Paxton St.; thence eastwa
northern line of Paxton St.,20 ft. to place of Beginn
thereon erected 2-1/2 story brick dwelling, No. 1718
Value at balance due under Agreement of Sale da
copy attached
Interest due July 3, 1978 but uncollected date
CARRIED FORWARD
I "I " S h d I "A" th
Insert thi s toto opposi te rea property , c e u e in e
"t.s Reported" column on the lost page of this return.
(1)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
land situate
tely bounded
ton St., 291 t.
Sts., at line
ong said line
e Alley; then e
One of propert
said line, 90
n line of Pax
erected a 2-1 2
of death
ton St., 271 t.
line of prop-
ction along
. to Lance
,20 ft. to Ii e
ong said line
on St.; thenc
. to the plac
ick dwelling,
s. @ $125.00
xton St., 251
,at the line f
said line
e Alley; then e
f property No
rough the cen
eastwardly
of Beginning.
o. 1716 Paxto .
ton St. ,231 f .
line of prop-
d line throug
thence west-
operty No. 17
the center 0
dly along the
ng. HAVING
axton St.
ed June 3,1953,
xxxxx
(2)
ESTlMA TED
MARKET VALUE
$14,500.00 ,.,/
125.00
12,500.00
250.00
13,soo.bo
125.00
4,321.49
18.01
$45,339.50
(3\
DEPARTMENT
VALUA TION
CAUTION
(Do not write
In this space)
He C-34 (1-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFEH INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
-REAL PROPERTY
..
Real pr~t~rty in Pennsylvania,' ~ith statement of Qortgage encumbrances upon each parcel at deatn of dece-
dent. '("',ere property held as 10lnt tenant or tenancy by entireties, report on Schedule "~", Property b-Id by
the decedent as tencnt in common with another or others, should be identified as to quantum of interest and
the l~stimateJ value should be that of the decedent's interest only.
The real pre.perty located in the Commo!1wealth of Pennsylvania should be
described by lot and block number, street and street number, together with
a general de,scription 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 s.tatement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, acciued Interest on mortgages etc. are
to be listed on Schedule "F" and must not be deducted from this ~chedule,
(1)
(2)
(3\
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
BROUGHT FORWARD
$45,339.50
5. BEGINNING at a point on the northern line of
Paxton St., 211 feet West of the northwest corner of
18th & Paxton Sts., at line of property No. 1722
Paxton St.; thence northwardly along said line
through the center of a partition wall, 90 feet to
Lance Alley; thence westwardly along the line of
Lance Alley, 20 feet to line of property No. 1718
Paxton St.; thence southwardly along said line throu h
the center of a partition wall, 90 feet to Paxton St ;
thence eastwardly along the northern line of Paxton
St., 20 feet to the place of Beginning. HAVING ther on
erected a 2-1/2 story brick dwelling, No. 1720 Pax-
ton St.
Value at appraisal, copy attached
Rent due for July but uncollected date of deat
13,500.00"....
125.00
Insert this tOI'al opposite "real property", Schedule "A" In the
",t,,$ Reported" column on the last page of this return.
xxxxx
$58,964.50
Bce -~-'5
CQ!vL'vlON\^IE\LTH OF PENNSYLVANIA
TRAJ''iSFE11 nnmRITANCE TAX
SCHEDULE "B"
PEHSONAL PHOPEHTY
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Il"F:SI])rL~\T "j)ECED1~NT
r'SThlJCTION~;: This Schedule must disclose all tangible and intangible personal property f),med individually
by the deced<.mt, at the t.ime of his death. Property owned by the decedent jointly with anotheJ' or others
muse De 1lsLed under Schpdule "E". Intangible personal property, titled In [he name of the decedent, but.
l'ayahle a.t death to another or others, Including but not linlited to P.O.D. U. S. Savings Bonds and tenta-
t.ive ti'US1; accounts, must be listed, despite the fact that they are not of the adminIstered estate.
Tangible personal property shoulrl be listed first (e.g. jewelry, wearing apparel, llousehold
goods" and furnishings, books, paintings, automobiles, boats, etc.)
intangible personal })roperty, such as bonds, treasury certificates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or aividends, salaries or wages, insurance pay-
a.ble to the estate or fiduciary in said capacity, partnership interests, interest in any undistributed
eSUlt,e of or income from any property held in trust under the will or a.greement of another, even though
located oucside of the State, at the time of death, should be listed in this schedule.
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ITEM
List and describe tully
UNIT
VALUE
DEPARTMENT VALUATION
(Do not write in
thi s space)
ESTIMATED
MARKEl' V AWE
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3.1
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5.1
6.1
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7.,
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9.1
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Household Goods and Furnttu~e) I
(see attached appra~sal
Second Mortgage from William F. Rothman ,I
Charles F. Schubert and Samuel L. I
Reed Co-partners t/ d/b/ a Rothman, I
Schubert and Reed, a partnership. I
to Caroline E. Daniel dated Jan. 5,1
1977 and recorded in the Recorder' sl
Office in and for Cumberland count~I'
Pa., in Mortgage Book 615, Page 7581,
in the amount of $20,000.00 tOgeth~~r
with interest thereon at the rate f
7% per annum to be repaid in month y
payments of at least $232.22 each, I'
commencing on the 5th day of Feb- ,
ruary 1977 and continuing thereaftlr
in same amount on same day of each
and every month
Accrued interest June 5, 1978 to July 4
1978 I
I
Claim settlement - Columbia Accident & I
Health Insurance Co. i
Check to Caroline E. Daniel from
Bond Fund Inc., dated June ~~~ 1918
marked sy~tematic Payout received
but not collected on date of death I
July Social Security check I
Accrued dividend on IDS Bond Fund to I
date of death payable to decedent
Refund - True Story magazine
Premium refund - Blue Cross
765.00//
17,941. 01
104.66
364.58
1,500.00
75.50
430.24
39.42
9.35
Premium refund - Loren Rider
16.00
I nser 1:, thi,s to tal opposi te "Personal Proper ty", Schedul e "B" in
~he "As Repori;ed" l~o-lumn on the last page of this return.
x X
21,245.76
l'1CC-3S
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l"~ \\~l:,'i~ I\lW:~IT \\CT;' T\\
SCEFDULE "e"
Tl{ \\;"FrmS
,;'':S 1[1:-:\1' j)l:lF!W\T
(1) Did ,h'cedpnt, within tllO years orde.tth, make 'my transfer of any material part of his estate, without
receiving a valuable and adequllte consi'lpration therefor? (Answer yes or no) Yes
(;2) Did decedent, wi thin two ye.'us of rleath, transfer property from himself to himself and another or
"thers (including a spouse) in joint. ownership? (Answer yes or no) No
(;ll I f the answer to (1) or (2) above is in the affirmative state:
(a) Age of deeedent at time of transfer
(ll) SUite of' decedent's health at. t.ime of making t.he t.ransfer. (Not.e 1).
(c) Cause 0 l' decedent's ,ieath. (No te 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
eonsirleratlon therefor which was to take effect in possession or enjoyment at. or after his death?
(\nswer yes or no) YeH
(a) Was tlH're any possibility that the property transferred might return to transferer or his
estatp or bp subject to his powpr of disposition? (Answer yes or no) YPP,
(il) What was the t.ransferee's age at time of decedent's death? 57
(')) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
thprefor under whietl transferor expressly or impliedly reserves for his life or any period which does
not in fact end tJet'orfe Ids death:
(il) The possession or enjoyment of or the right to income from the property transferred?
L\nswer yes or no) Y p p,
(Il) The l'ig;ht. t.o designate the persons who shall possess or enjoy the property transferred or
income tllPref'rom? (Answer yes or no) Yes
(fj) If the answer to (5) (b) abovp is in the affirmative, state whether the right was reserved in decedent
alone or ot.hers DeC'.pc1e.nt: R] one.
(7) Dirl decedent in Ids] ifetime 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' 't reserved power to al t.er, amend, or revoke, or which cOllld revert. t.o decedent under terms
of transfer or by operation of law? (Answer yes or no) Yes
(!j) If the answer to (H) above is in t.he \if'firmat.ive, was the power to alter, amend, or revoke the inter-
est of' the beneficiary l'eserved in the decerlent alone or the decedent anrl others?
(\nswpr yps or no) _ Decedent alone
~OTE1: The anSwers to these questions should be supported by aff'idavi t by the atten<Ung physician as
we]] as a eopy of the death certi fieate.
~OTE 2: If' answpr 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
reI ationshil' of' trcl!lsf'prees to decedent., if any. Submit copy of any t.rust deed or instrument, if trans-
fers are clnimpd to be non-taxable, also submit detailed st.atement of facts on Which said claim is based.
~OTE a: List al'l'licab]e property below in manner in which provided in Schedules A, B, or E.
lTDl
UJ<;SCRIPT ION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
1.
6195.142 shares of IDS Bond Fund pur-
chased by Caroline E. Daniel as
Trustee for Edith Joan Bair on
January 11, 1977 under Funds
Declaration of Revocable Trust
(copy attached). at $5.57jshare
~4,506.94
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See Item 6, Schedule B, for accrued
dividend
Insert this totJd opposite "Transfers", Schedule lie" in the
"As Repor t.ed" co] llmn on the 1 as t p'J.ge of this return.
34,506.94
REV-4S,j (8-78)
COMMONWEAL TH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELA TI ONSHIP
(State full names and addresses of all who (If step-children or SURVIVED DATE INTEREST OF
ha ve an interest, vested, contingent or other- illegitima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set ST ATE YES BIRTH IN ESTATE
forth this fact.) OR NO
Edith Joan Bair Daughter Yes .y Lt" 21 Entire Estate
I
- -
100 East Locust Street
-
Mechanif"Ch"""p' P::l 17() .J;
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Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
None
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SUMMAR Y
(1)
(As Reported)
(Sch. "A") $ SR, c)64 SO
(Sch. "B") $ ? 1 , ? 4 S 76
(Sch, Ole") $ 14, S06 C)4
(5ch."E")$ 516.22
$
$115,2:13.42
(2)
(As Determined)
$
$
$
$
$
$
Real Property
Personal Property
Transfers
Gross Taxable Estate
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RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
CCMMONWE/\LTH OF PENNSYLVANIA
TnANSF1~H INHERITANCE TAX
niSTRrCTIOliS: 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 I
Address and Relationship of Co-Owners, and Place i
of Record of Instrument, where Rea! Estate. !
unit
Value
percentage
Share
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
1. Checking Account No. 120-271-2
in The First Bank and Trust
Company, of Mechanicsburg, P
. ,
in names of Mrs. W. D. Danie
and Mrs. Joan D. Bair, her
daughter, whose name was
added January 5, 1973
Balance on date of death
11032.4
1/2
l///
516.2z"
: \ \.L
(; \"
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return. $ 516.22
J
R E V-518 (8-78)
COMMONWEALTH OF PENNSYLV ANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
RE"ER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Edith Joan Bair
100 East Locust St.
Mechanicgburg, PA 17055
(E xecutor or Adm ini strator)
In Re: Estate of
Caroljne E. DHnipl
CUTj"jberland
County - File No. 21-77-38CJ
Dear
You are hereby notified that the Original
appraisement in the estate of Caroline E. D;:lTIipl
has been filed in the office of the Register of Wills of Cllmoerl ;:lTIn
County on 25 Apri 1 ,19-1..9, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
;'; Sp',QF,4.c;n
?l,?ltC;.7h
31f,506.94
5J6.??
$115,233.42
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 T ox Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Date
75 April 1979
Si gned
Title. Ac.ministrative Officer>
Note: This is not a bill.
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DA f t: ? r, t, r "Y' ill q 7 ()
COUNTY Cumherland
FI L E rw. .21.::.7 7 - 3J3 9._~__
Whereas, Caroline E. Daniel late of TovmshiD of Hampden
in the County of Cumbe rland Commonwealth of Pennsylvania, having died on
the _ 4th day of Julv 19.1J2..,seizedandpossessedofanestate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, T,€' () F1l1 ~ in it i , 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 coliateral
rate on any such future interest.
DESCRIPTION OF ASSET UNIT Appraisement
VALUES Made for I nt1eritance
Tax Purposes
$
p~~, r'....+"+,, t:; Q 0 h II '"n
Personal PrODertv 2l,2Lt5 76
Transfers 34,50C <) LI
LToirt1v Owned c: 1 h ?'"'
"',,1-:,1 115.233 Li 2
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Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this ?t:;1-1-, day of 'Af"";1 . . . 19.J..:L.
Appraiser
(Number and Street)
Earrisburg
. Penna.
(Post Office)
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