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HomeMy WebLinkAbout02-22-79 RCC-:\-~4-731 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS .tj-1/'-Cfl.t.J '* -<-=-71 RESIDENT DECEDENT COUNTY OF CUMBERLAND IMPORT ANT: This return must be completed in detail and filed in duplicate, with flll 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'ltenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF " THEODORE C. FREDERICK~ (STATE FULL NAME OF DECEDENT) Late of Carlisle, CUMBERLAND } AFFIDAVIT OF JR. EXECUTr/R! R IX ~ County Stote af PRNN'SYT.VANIA } CUMBERLAND . 55: KATHRYN W. FREDERICK Execu~r7x County of ~ of the estate of the above-named decedent being duly sworn, depose S and say S .J Decedent died Jul y (MONTH) Name and address of attorney or } other authorized repres,entotive to whom 011 correspondence should be mailed. 18 t 19~{t.ltate leaving a last will, copy of which i. hereto attaChed.,} (YEAR) I~X George B. Stuart (DAY) 3 Sml~h H~novpr ~treet, CArli~le, Pa. 17013 That as such Executrix deponent is familiar with the affairs of said estate and the property constituting (EXECUTO R-AOMINISTRA 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 Scheau/e 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 Scheau/e B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interes t thereon, if any, down to the last interest day prior to decedent's death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of indebtedness of the United 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 ariy 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. " "10 "... In the case of' securities of' close or f'amily corporations, the values reported are as f'ar as possible substantiated by f'inancial statements of' the corporations, showing the assets and liabilities thereof' as of' the date of' death. The schedule also sets f'orth 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, f'inancial statements showing the assets and liabilities of' said co-partnership or lJ.usiness. A copy of' the co-partnership agreement, (if' oral, a statement setting f'orth the nature of' tne agreement) together with a statement setting f'orth the character of' the business, its location, and such other f'acts pertaining to the business as may be pertinent to a f'air and just apprais~l of' the decedent's int~rest therein must be submitted. It should also set f'orth in itemized rorm, -together with tl'le' f'air 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' transf'ers of'property, real or personal, within two years of' decedent's death, in contemplation of' decedent's death, or intended to take ef'fect in posses'slonor:enjoyment at or a~t~r death, said schedule sets f'orth the nature and value of' such property, to whom transf'erred, the relationship of' the transf'erees to the decedent, the proportionate share peceived by each transf'eree and all other f'acts of' a pertinen't nature regarding said transf'ers. In the case of transf'ers intended to take ef'f'ect in possession or enjoyment at or af'ter 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 f'orth in said schedule a list of' all property, real and personal, with its value, which passes at decedent's death by virtue of' the exercise by decedent, either individually, or jointly with another, or any power of' appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of' another, ,'; 'I ., ' ' " , , ',' " ',' with'a copy of'-the instrumerlt creating such power attached t6 the schedule. That Schedule D attached hereto and made part hereof' sets f'orth the names and addresses of' all persons benef'icially 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 benef'iciaries f'or lif'e under decedent's Will. It also contains a statement showing which of' the benef'iciaries named in the decedent's will, if' any, died prior to decedent, the dates of' their death, their issue, andthe relationship of' such issue to the benef'iciary. That Schedule E attached hereto and made a part hereof' sets f'orth 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 ef'f'ecting th~ 'vesti ture 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 f'orth f'ully and in detail all debts and deductions claimed f'or and on behalf' of' this decedent's estate, including f'uneral expenses paid; f'amilyexemption, where applicable; costs of' administration of' this estate; counsel f'ees and f'udiciary's commissions paid or to be paid; cost expended f'or 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 f'or 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 f'iduciary 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", "CO, "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. p~ --~ tp~~~ . fJ'i:-ms.-="i;;;;er-------- rnr ~~ ~ m~.s Iq~:zCarl(tf~e~...f:;;;:...~;J.~~)"......m...................... NOTE: Before signing af'fidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securities of' close or f'amily 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. Subscribed and sworn to before me this ................................. ",.m day of ..:D~........ 19.....?.~ ~ ...........................5.............. --.~.... ,.__..;- --'-. ~-----;~.--~ .,,.,,- ",,--~-~:_._, . file Col4 jlJ,,1Il COMMONWEALTH OF PENNSYLVANIA DEPARTM,ENT 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 praperty located In the Commonwealth of Pennlylvanla Ihauld be (1) (2) (3\ de.crlbed by lot and block number, Itreet and Itreet number, together with DEPARTMENT o general ducrlptlon af the property, with 0 reference to the recard af the ASSESSED VALUE VALUA TION conveyance by which the decedent taok title; If a farm .tote number of a. FOR YEAR OF ESTIMATED CAUTION cru; ol.a .tatement af mortgoge encumbrancel upon each parcel at death DECEDENT'S MARKET VALUE (Do not write of decedent. Taxe., a.....m.n..., accrued Int.r..t on mortgage., ete.,or. DEI. TH In thl. lpoCO) to be listed on Schedule "F" and must nat be deducted from this Ichedule. NONE I 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. 0.00 N~ RCC 73Fi <,- IlESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '. <.COMMONWEALTH OF PENNSYLVANIA Tr~S'FER INHERITANCE TAX INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta- tive trust accounts, must be listed, despite the fact that they are not of the administered estate. Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household goods, and furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership interests, interest in any undistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of death, should be listed in this schedule. Item No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEl' VALUE DEPARTMENT VALUATION (Do not write in this space) 1. Checking Account No. 4-1325-9, Farmers Trust Co. 26.51 2. Checking Account No. 31161503, Dauphin Deposit Bank and Trust Co. 3,721.65 3. 50 shares Carlisle Corp., common 1,296.88 4. 100 shares Hall's Motor Trasit Co., COIIIDon 1,187.50 5. 200 shares Potomac Electric Power Co., cOIIIDon 3,050.00 6. 125 shares Products Research & Chemical Corp., cOIIIDon 1,539.06 7. 320 shares wnmington Trust 36 11,520.00 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X 22,341.60 2 '-2-<"34l. fa 0 ., . RCC-% P, COMMO\WEALTH OF PE:-INSYLVANI A THA~8FFH. I~HFIUTANCF 'TAX SCHEDULE "c" T It c\N S FE W3 '. rillS IllENT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable ap-d adequate consideration t.herefor? (Answer yes or no) NO (2) Did decedent, within two years of death, transfer property from himself to himself and another or others (inclurling 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 (ll) State of decedent's heal th at time of making the transfer. (Note 1). (c) Cause of decedent's deat.h. (Note 1). (4) Did decedent, in his lifetime, make any transfer of propert.y wi thout receiving a valuable or adequate consideration therefor whi~h was to take effect in possession or enjoyment at or after his death? (Answer yes or no) NU (a) Was there any possibility that the property transferred might return to transferer or his estate or be subj ect to his power of rlisposition? (Answer yes Or no) (b) What was the transferee's age at time of decerlent's death? (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which t.ransferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The possession or ep-joyment of or the right to income from the property transferred? (Answer yes or no) NO (b) The right to rlesignate the persons who sital possess cr enjoy the property transferred or income therefrom? (Answer yes or no) (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone'll' 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 al tel', amend, or revoke, or which conld revert to decedent lmrler terms of transfer or by operation of law? (Answer yes or no) NO (9) If the anSwer to (8) above i3 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 anrl others? (Answer yes or no) NOTE 1: The answers to these questions should be supporterl by affirlavi t 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 rlate of death, dates of transfers and to .'hom transferrerl, with relationship of transferees to rlecerlent, if any. Submit copy of any trust rleed or instrument, if trans- fers are claimed to be non-taxable, also submit detailerl statement of facts on which sairl claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARImT VALUE (Es tima ted) DEPT. VAI,UAT.mN (Dept. Only) NONE Insert this total opposite "TranSfers", Schedule "CO in the "As Reported" column on the last page of this return. 0.00 N If'-1- RCC-Y.7_ (1<1-:-63) CmIMO;\lWEALTIl OF f'E;\,':\,SYYLANIA TR~NSFER INHERITANO: TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY a,e an interest, vested, contingent or other are involved. set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Kathryn W. Frederick, Wife Yes Entire estate 225 S. Hanover St . ,~ c l,;ar .L~s.Le, ra. .L/U.L,j . . \ h Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE n (Executor-Administrator must complete "As Will ~2~~?~~412"" 1978 Reported" column #1.) Administration Year ............ 0 ..., "d ~ >1 >1 C'C C'C DI THE 0 III >1 E.. '" i:l '" '" '" 0 if i:l "tI ~IA TIER OF THE APPRAISEMENT ~ E.. <3 ~ '" "d '0 III ~ 0" >1 OF THE ts" 0 ~ '0 t<l ~ ESTATE OF '" ..... ..... '< III ..... C'C THEODORE C. " :F~OER~CKL JR. Deceased Late of " CARLISLE . .. . - ....... CUMBERLAND en County of c: ::: ::: Commonwealth of Pennsylvania > ~ ~ en en >< I'l I'l ?" ?" REPORT AND APPRAISAL g ~ ~ , '* '* '* '* '* '* :"" : :N :N: :N > :v : '2: .. :Z'" ow: :0 :(A :0 ~ :~: :::1 ,po :::1 "'~ " "0'" :.....: :(1) :.... (1)o~ "0 :. ., ,~: 0\ 8' :0: 0 c... .oo,~ -0 0 ~.oo > '" -, t:l ~-. \'t t.o >1__ :3 :;. r. c... , .~ , ' RCC-:r~~-" . ~ . . 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 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 Address and Relationship of Co-Owners, and Place of Record of Instrument, where Real Estate. .. ^""" ;,.~ .xx unit percentage Estate DEPARTMENT VALUATION Value Share Valuation CAUTION-Do not Write In This Space. Y' Value of Value of '^^' '\ En ti re Decedent's ,;< '\ y Property Interest NONE Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. 0.00 N~ '* REV-SI8 (8-78) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PL.EASE REFER TO Inheritance Tax Divis ion NOTICE OF FILING OF APPRAISEMENT Kathryn W. Frederick 225 S. Hanover St. Carlisle, PA (Executor or Administrator) In Re: Estate of Thpn~n~p r. F~p~p~'~k. ~~. Cumberland County - File No. 21-78-0412 Dear You are hereby notified that the Original appraisement in the estate of Theodore C. Frederick, Jr. has been filed in the office of the Register of Wills of Cumberland County an 2 Q MaTen , 19--f-9.-, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total NORli 2".::l...1.60 Nnn~ N'nnp $22,341.60 As to such tax that is paid within three months from date of deoth, 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. ~~. Q.~ \?\_,J) ~ ~__~(:. Date 2 a Maroh 1979 Signed CJ \ ) Title Administrati vp. Off; ("P~ = I 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 DATE COUNTY FILE NO. ~_?R_7Q Cumberland 21-78-0412 Whereas, Theodore C. Frederick r .11"'. late of Carlisle in the County of Cumberland Commonwealth of Pennsylvania, having died on the 18 t h day of J u 1 v 19 1JL, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, 1~6 F ~ltil.i t 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 collateral rate on any such future interest. DESCRIPTION OF ASSET UNIT Appraisement VALUES Made for Inheritance Tax Purposes $ .... ., ,.. .. -...- None D - _, D__.... .-..... 22 .341 60 - "'--....-+:--- None T . ..., roo -' ". 0- 'I'root-;o' 1522 341 60 , 1 i I . Have been duly sworn according to law, I do hereby cert.~ that the above appraiseme~t is made in conformity withthelawonthis ~it:R day of Mill?~r. r--- ('\ ~ . 19 2.9-. r l.-__ . -'. _. '\.___ ,,---..... .~- . '> '. ','. !. _/ ,,-_."-- ,.___)>......J 1....._' '--..' ...~~ .... ~. '__ J Appraiser (Number and Street) Harl"'i,:;hllT'g (Post Office) , Penna. ;:{ f-.. 7 ~ - Y I :J., ............. ..$;:.l,J.MJ?JiEl>.MLU...... ........... .... County RESIDENT INHERITANCE TAX APPRAISEMENT Esta te of ..................r. h.~.<?~ .9. ~~...~ .!.. .r.r.~ .9-. ~.r.J.!::)$. A...J r . Deceased . Late of ........... .-eaT 3:i.S'3:e..... ........ ........ ....... ......... ..... Date of Death, ........J&..~)J.J.y....;I,~.7.!L........... Appraisement Docket Vol., .J..Q..................... Page,.....L:1.~........... No. ....~.................. Filed in Register's Office, ....f.!L.Mfl..:r.~)). 197.~. Amount of tax due, $..:.................................... DEPARTMENT OF REVENUE Received, ......... ............... ........ ............ ..... ........ ......................................................................... Examined and Approved, ................................. Wrote about Appraisement, ............................. Appeal from Appraisement, ............................. Entered and charged, .......................................