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HomeMy WebLinkAbout01-17-79 . RCt-SS 14-7~ 1 r COMMONWEAL TH OF PENNSYLVANIA'" ", DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS . 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'otenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF } AFFIDAVIT OF MARIE E. KEITER EXECUTOR S SO~~E ;~~;E ;;:C,E~~ERLANn ~ ~~~ -~u~ PENNSYLVANIA County of CUMBERLAND DONALD L. KEITER And MARLIN E. KEITER } 55: State of of the estate of the above...named decedent being duly sworn, depose and cay \ Ex~utors \ ~'X Decedent died July 29 , 19~{'es'ate leaving a laal will, copy of which ia hereto attached.,} -I YEA R) lIilUlKK (MONTH) Name and address of attorney or } other authorized repres.entative to whom all corres.pondence should be mailed. IDAY) George B. Stuart 3 South Hanover St., Carlisle, Pa. 17013 That as such FVPl'l1t"n:rS deponent is familiar with the affairs of said estate and the property constituting (EXECUTO R.ADMINISTRA TOR) 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: - l- RELATIONSHIP OF JOINT HOLDE:RS TO DECEDENT 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 stiJl 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 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, ~iJves:ware, 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 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 interest 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 or securities or close or ramily corporations, the values reported are as rar as possible substantiated by rinancial statements or the corporations, showing the assets and liabilities thereor as or the date or death. The schedule also sets rorth the interest or decedent at the time or death in any co-partnership or business, and in support or the value or such interest there is annexed to said schedule, financial statements showing the assets and liabilities or said co-partnership or Qusiness. A copy or the co-partnership agreement, (ir oral, a statement setting rorth the nature or tne agreement) together with a statement setting rorth the character or the business, its location, and such other facts pertaining to the business as may be pertinent to a rair and just appraisal or the decedent's interest therein must be submitted. It should also set rorth in itemized rorm, together with the fair market'value thereof, any other property owned or beqUeathed by t~e decedent at the time or death. .. -.. ,'.""-' . , The Schedule C attached hereto and made part hereor sets rorth a true answer to each inquiry contained therein and in the case of transfers orproperty, real or personal, within two years or decedent's death, in contemplation or decedent's death, or intended to take errect in possession or enjoyment at or after death, said schedule sets forth the nature and value or such property, to whom transrerred, the relationship or the transrerees to the decedent, the proportionate share' received by.each tr'ansreree and all other racts or a pertinent nature regarding said transrers. In the case or transrers intended 'to take errect in possession or enjoyment at or arter death, there is also attached to the s~hedule a cORY or the deed, trust agreement or other instrumen.t .cres,ting the trust. Ther'~ is also set rorth in said schedule a list of all property, real and personal, with its value, which passes at decedent's death by virtue or the exercise by decedent, either individually,or;jointly with another, or any power of appoint- ment vested in deceden,t, either individually or jointly, by the will, deed" or other instrument of another, with a copy or the instrument creating such p6w~r attached t6 the schedule. That Schedule 0 attached hereto and made part hereor sets rorth the names and' 'addresses or all persons benericially interested in this estate at the time of decedent's death, the nature or their res- pective interests, their relationship, ir any, to the decedent, together with the ages at the time or decedent's death or all minors, annuitants and beneficiaries for life under decedent's Will. It also contains a statement showing which or the benericiaries named in the decedent's will, if any, died prior to decedent, the dates or their death, their issue, andthe relationship or such issue to the beneficiary. That Schedule E attached hereto and made a part hereof sets rorth all property, real and per- sonal, owned by the decedent jointl~ with another or others, i~c1uding jntangible, standi~g in xhe name or the decedent and others, plus the date and place or record of instruments errecting the !estiture or real estate and the date or acquisition of personalty, plus the name, address and relationship, ir any, or co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets rorth rlllly and in detail all debts and deductions claimed ror and on behalr or this decedent's estate, including rllneral expenses paid; ramilyexemption, where applicable; costs or administration or this estate; counsel rees and rlldiciary's commissions paid or to be paid; cost expended ror burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence or the death or the decedent; debts and claims owing and unpaid at time or death; taxes accrued chargeable ror period prior to decedent's death (except those allowed under Section 651 or the Inheritance and Estate Tax Act); together with a statement or collateral pledged for obliga- tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest, that ir the amount actually paid in settlement or any ree, commission or debt is less than the estimated amount claiming and allowed, that the same will be reported to the Register or Wills, and that the amount or tax assessed can be reassessed in accordance therewith. That the totals or the appropriate columns in Schedules "A", "B", "CO, "E", and "F" as directed therein, "..~u::':: :~t:::::::,~:g:~::~~~n. "0 g-,y. Jh14JL U / ..........._........./rtJ..... day of ....~..19.J.a ... ... . . (~..............._._.. ..-IkJ~'1!;;.;!!~!!"!:f;6~ :;i~-=..l~~~,;;~j!'!!~!!q~!..~..L..pa. .........m..............~..~,....p...!.....?,.l....~....~.Z.~A",....N..~w.v..ilJ e , P ~ (City or Town and State) NOTE: Before signing arfidavit make sure all blank spaces in the affidavit and schedules annexed are rilled 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. . lI-Co.i4 I..,a.,' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX . RESIDENT DECEDENT ,_. .,..'..J.,_,..,__~,,.o/,,o,~,,,-,,,,,_,U'"'..,," SCHEDULE "A" REAL PROPERTY *' Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant In common with another or other, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property located In the Commonwealth of Pennaylvanla ahould be deacrlbed by lot and block number, atreet and .treet number, tOllether wi th a lIeneral deacrlptlon of the property. with a reference to rhe record of the conveyance by which the decedent took title; If a farm .tate number of a. cres; olao .tatement of mortllolle encumbrance. upon each parcel at death of decedent. Tax.., a.....m.nts, accrued Int.,.., on mortgag.., etc.,ar. to be II.ted on Schedule "F" ond muat not be deducted from this schedule. (1) (2) (3\ DEPARTMENT VALUA TION CAUTION (Do not write In this spac.) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMATED MARKET VALUE All that certain real property situate in Vi11age~ Walnut Bottom, South Newton Township, Cumberland County, Pa., containil1 g 2 acres, more or less, and improved with a frame house, garage and small barn. 24,280.00 Acquired by Deed 23 Z 417. /'- 30,000.00/ ~IOOt>. 00 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. 30,000.00 ~t>oo. CO Rec -35 RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time or his deatlli Property owned by the decedent jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name or 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 ract that they are not or the administered estate. Tangible personal property should be listed rirst (e.g. jewelry, wearing apparel, household goods, and rurnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certiricates, 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 riduciary in said capacity, partnership interests, interest in anyundistributed estate or or income rrom any property held in trust under the will or agreement or another, even though located outside or the State, at the time or death, should be listed in this schedule. Item No. ITEM List and describe rully UNIT VALUE ESTIMATED DEPARTMENT VALUATION MARKET VALUE (Do not write in /this space) 700.0017 1otJ. ()t) 1. 1968 Ford Torino - sales price 2. Proceeds from 1Il1e of household goods, furnishings, etc. V~ 2,694.95 ~J ~91f. tf..5 3. Checking Account #259-872-7, First Nat1. Bank of Shippensburg 4,624.4~!/~.t,S"~ 1./. "II 4. Savings Account 1140226, Cumberland Valley Savings & Loan Assn. Accrued interest 1,693.13(' 7.08 ~ "9..!. I..S 7 or 5. Savings Account 16689892, Cumberland Valley Savings & Loan Assn. Accrued interest 17,000.00 /-1i tJ~lJ. /)6 91.41 9/. ~/ 6. Trust Fund, Farmers'lrust Co., Trustee u/Agreement 7. 1 share Cumberland Valley Co-op stock 17 ,699.53/" /? ~99 S.3 10.00/" II). ()~ Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page or this return. x X 44,520.51 I../~~~/)..sl RCC-'3S Cl1MMO\WEALTll l1F I'EN~SYLVANIi\ TH.A\:::FFR INHERITANCE TAX SCHEDULE "c" TH.AN~WEIlS rlliS 1DF\T lJECI':J1FNT (1) Did decedent, within two years ofdeuth, make any transfer of any materIal part -p.f hIs estate, wIthout receIving a valuable and adequate consideration therefor? (Answer yes or no) ~o (2) Did decedent, wi thin two years of death, transfer property from himsel f 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 health at time ot' making the transt'er. (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 theret'or which, was to take effect in possession or enjoyment at or after his dpath? (Answer yes or no) No (a) Was there any possibility that the property transferred might return to transferer or his est.ate or be subject to his power of disposition? (Answer yes or no) (b) What was the transt'eree's age at time of decedent's death? (5) Did decedent in his lifetime make any transfer wi thout receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his lit'e or any period which does not in fact end before his death: (a) The possession or enjoyment of or the right to income t'rom the property transt'erred? (Answer yes or no) ~O (b) The right to designate the persons who shall possess cr 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 t'or which was transt'eree's promise to pay income to or for the benet'it of care ot' transferor? (Answer yes or no) No (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to al tel', amend, or revoke, or ,,*bCh could revert t.o rlecedent unrler terms of transfer or by operation of law? (Answer yes or 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 be"et'iciar~ .I:~erverl in the decerlent alone or the decedent and others? (Answer yes or no) NOTE 1: The answers to tbese questions should be supported by aft'idavit by t.he attending physician as well as a copy of the death cel"tificate. NOTE 2: If anSwer to any of the above questions is yes, set forth below a description ot' the property transt'errerl, it.' s fair market value at rlate ot' rleath, dates of transfers anrl to .'hom transt'erred, with relationship of transferees to rlecedent, if any. Submit copy of any trust deed or instrument, if trans- t'ers are claimerl to be non-taxable, also submit detailerl statement ot' facts on which said claim is based. NOTE 3: List applicable property below in manner in which providerl in Scherlules A, B, or E. ITEM llESCRIPTION MARKET VALUE (Estimated) DEPT. VALlJATJON (Dept. Only) NONE ~ Insert this total opposite "Transt'ers", Schedule "CO in the "As Reportpd" column on the last page of this return. 0.00 l'Lnw ROc-37 "(12-63) CmIMO:'<\\'EALTlI OF PEX:\,SYYL\NIA TRANSFER 11IIHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES l h 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 ave an interest, vested, contingent or other- are involved, set STATE YES IN ESTATE wise in estate) forth this fact.) OR NO BIRTH John Thomas Keiter,R.D. 2. Grandson Yes $1.000.00 Box 323A, Newville, Pa. . ~- l(ptt@r.'R n ? Grandson Yes Sl 000.00 Box 323A, Newville, Pa. Scott Edward Keiter. Grandson Yes $1.000.00 Box 95. Walnut Bottom.Pa. Susan Marie Keiter. GranddaughtE rYes $1.000.00 'Rnv Q,\ TJ,. 1 n11t- " n... . . nonald T. l(pit"p.,. Rox 95 Son Yes 1/2 Residue Walnut Bottom. Pa. u_ _.. . - ... - ... '1 ~. 'U'. , 1'1 n. .1..3. ~;-~?~~. , ..~. AJ. -, .......... ..-~ -, 1- n_~ ---- . 11 p Pa Deponent fUrther says that all the above-named benericiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE None Will Administration l 21-78-422 ~ No. r.o.r THE 198 Year ...... MATTER OF THE APPRAISEMENT OF THE EST:\. TE OF Marie E. Keiter Deceased Late ofSouth..Ne.wton..Townsh1p.. County of Cumberland Commonwealth of Pennsylvania REPORT AND APPRAISAL , (Executor-Administrator must complete "As Reported" column #1.) C') .... o '" '" >-l ~ ll> cr (0 t%j '" ..... ll> (b >-l '" :xl .... C1> C1> ~ ~ e?.. ::l 0 ~ ::3 ~ ~ ~ a '0 ~ C1> o .... '0 ~ ~ ..... '< en C ~ ~ > :xl en en en >< I'> I'> I'> ?" ?" ?"' . '1 ~ ~ ~ ~*""""'*'* ~r v. :" \11: ~:' ~n ~,.. \.n l-' . . -. :~.W> :~O'" :.. :.. :xl :V1:0C1l~ : N: O";;l ..... :ooi;~ :. :. (;' .V1:0c... : ..... 0--- '*""""'*"""" > '" ti ;a.~ (': tv ..,~ 3 5' r. c... " . R C C-38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX ." RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY 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 f'irst, as entireties, or joint tenants, giving brief' description, as indicated tmder Schedule "A", plus the date and place of' record of' instrument ef'f'ecting 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 Unit percentage Estate DEPARTMENT VALUATION Address and Relationship of' Co-Owners, and Place Value Share Valuation CAUTION-Do not Write of' Record of Instrument, where Real Estate. In This Space. ~ V' ~ Value VVV v >v<..X. 'J' ^" Value of' of' 'J' v<'X8 N) ^'^' ^'^' "'- En t1 re Deceden t' s 'J' ~ 'VV' property Interest NONE I/u-ruJ Insert this total opposite "Jointly Owned Property", Schedule "E" 0.00 'YLfn~ in the "As Reported" column on the last page of' this return. REV-SI818-78) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY PLEASE REFER TO '* Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT Donald L. Keiter Marlin E. Keiter Box 95 R. D. #2, Box 323A Walnut Bottom. PA Newville, PA (Executor or Admini strator) In Re: Estate of Marie E. Keiter Cumberland County - File No. 21-78-0422 Dear Mr. Keiter: You are hereby notified that the original appraisement in the estate of Marie E. Keiter has been filed in the office of the Register of Wi lis of Cumberl_and County on February 22 r 19~, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total 30,000.00 44~520.51 None None $74,520.51 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. t....373. . . . "Z, Q:u \?v--~ ,~-Ic.'-. Date February 22, 1979 Signed C;7 0 Title Administrative Officer 1----__ ----, -', 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 February 22, 1979 COUNTY FILE NO. Cumberland 21-78-0422 Whereas, Marie E. Keiter late of South Newton Townshio in the County of Cumberland Commonwealth of Pennsylvania, having died on the 29th day of Jill y 19 2!L., seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fulginiti ,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 Real Property $ 30.000 00 Personal Prooertv 44,520 51 Joint-Held Property Nnn.. Transfers None TOTAL ASSETS 74 <;2n <;1 Have been duly sworn according to law, I do hereby cer 'fy that the above appraisement is made in conformity with the law on this 21no day of '-- F rua . 1979_ . ::u c' () Appraiser (Number and Street) Harrisburg (Post Office) , Penna. :.{l -1 a-- -If-~ Cumberland County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ......,..........~~Jij:...I);:...~:J:.+.I);~.......................... Deceased. Late of ....., ,.,. ,~.l?~t~ ,.~~~.l?!}'.. .+.l?~.~):l.:!-P.... ..,. ............. Date of Death, ........:!.~~x...??,..J.n~............... Appraisement Docket Vo1., .....I~..............h%. Page,......!2r................ No. .......r............... Filed in Register's Office, .......y.~y....... 19.?~. Amount of tax due $ . 1 ....................................... DEPARTMENT OF REVENUE Received, ..... ............ .... ............ .... .... .... .... .... .... Examined and Approved, ................................. Wrote about Appraisement, ............................. Appeal from Appraisement, ...........,................. Entered and chargedr ..................,....................