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Home My WebLink About04-25-79 RCC-33 (4-73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ';/.30/11 .'- 'I i-o'tSl 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 Rnenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF Sara Mable Bishop, formerly Sara Mable Brenneman (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUTOR ~ County Late of Cumberland Pennsylvania County of Cumberland } .., State of ~ of the estate of the above-named decedent being duly sworn, deposeS and say S Decedent died July 5, 19~J testate leaving a last will, copy of which Is hereto attached.} (MONTH) (DAY) (YEAR) ~ Name and address af attorney or} James D. Bogar other authorized representative to whom all corrupondence should be mailed. 23WestMainStreet,Shiremanstown,PA170ll William C. Brenneman Executor That as such Executor deponent is familiar with the affairs of said estate and the property constituting (EXECU 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 S....FE 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 wi th the exception. of the following, for the reasons hereinafter set forth: of this return, That Schec/ule 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 Schec/ule 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 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 in!iebtedness 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, housenold 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 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. RC C-34 (4-73) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT 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 liE.") The real property located In the Commonwealth of Pennsylvania should be (1 ) (2) (3) described by lot and block number, street and street number, together with DEPARTMENT a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title; If a farm state number of a. FOR YEAR OF ESTIMA TED CAUTION cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEA TH In thIs spoce) to be listed on Schedule II F" and must not be deducted fram this schedule. None "' N~ 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. RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* RCC -35 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 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 estat~ 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, mortg~ges, 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. Corrnnonwea1th National Bank, Harrisburg, Penna. Checking Account No. 162-107787-2 Titled in the name of Sara M. Bishop. Account Established: September 13, 1977 Balance at Date of Death $ 426.4r' 2. Corrnnonwea1th National Bank, Harrisburg, Penna. Evergreen Savings Account No. 16-0010809-4 Titled in the name of Sara M. Bishop. Account Established: September 13, 1977 Principal Amount: $914.80 Accrued Interest: .69 Balance at Date of Death: $915.49 1"/' 915.49 $1,341.90 \'-~4l.q 0 -\ Insert this total opposite "Personal Property", Schedule "B" in X X the "As Reported" column on the last page of this return. Very truly yours, Commonwealth / \ National Bank /, ~~:.'~.~'~~.:':~ j /1. October 16, 1978 James D. Bogar 23 West Main Street Shiremanstown, Pa. 17011 Re: Estate of Sara M. Bishop Dear Mr. Bogar: In reply to your letter dated September 29, 1978 on the above estate, the following information is listed below as of D.O.D. July 5, 1978: Checking Account - $426.41 In her name only. #162-107787-2 Opened - 9/13/77 Evergreen Savings Account - #16-0010809-4 $914.80 Accrued Interest - $.69 Opened - 9/13/77 In her name only. If you have any questions, please feel free to contact us. ~~-:: ~4 Vice President DSM/cg 7~" Commonwealth National Bank. 10 South Market Square. Harrisburg, Pa. 17108 (717) 664-9500 RCC-36 COMMO~WEA.LTH OF PENNSYLVANIA. THA~SFER I~HERITANCE TAX SCHEDULE "c" TRANSFERS RES IDEXT DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without -receiving a valuable and adequate consideration therefor? (Answer yes or no) Yes (2) Did decedent, within two years of death, transfer properLY from himself to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) No (3) If the answer to (1) or (2) above is in the af'firmative state: (a) Age of decedent at time of transfer 81 (b) State of decedent's heal th at time of making the transfer. (Note 1). Poor (See attachment) (c) Cause of decedent's death. (Note 1). Heart Disease (See attached death certificate) (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no) No (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) (b) What was the transferee's age at time of decedent's death? (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no) No (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) No (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) No (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer yes or no) No (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) NOTE 1: The anSwers to these questions should be supported by affidavit by the 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 date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) Real Estate Property located at 115 West Main Street, Shiremanstown, Cumberland County, Pennsylvania, being the eastern half of a two and one-half story brick dwelling house. Decedent acquired title to the property by deed dated June 4, 1953, said deed recorded in the Cumberland County Recorder's Office in Deed Book "G", Volume 15, Page 530. $34,500.00/ The above premises were transfered by the decedent, Sara M. Bishop, by deed dated October 1, 1977, and recorded in the Cumberland County Recorder's Office in Deed Book ''M', Volume 27, Page 144, to William C. Brenneman and Nancy E. Brenneman, his wife. William C. Brenneman is the son and only heir of the decedent. The above-described property was transfered by William C. Brenneman and Nancy E. Brenneman, his wife, by their deed dated February 24, 1978. The consideration for the transfer was $34,500.00 The consideration of $34,500.00 is deemed to be the fair market value of the property at the date of decedent's death, July 5, 1978. There- fore, no separate appraisal was made. -.:2"") y. "\ $ 0 0 0 \) Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. . . ROBERT W. STAHL. M. D. DAVID S. ZIMMERMAN. M. D. SEIDLE MEMORI...L HOSPIT...L FILBERT AND SIMPSON STREETS MECHANICSBURG, P.... 17055 I~l Iq7g ~ 0, ~I C~ ~3 W~ ~s:t ~, fl(. f?L. ~)'YI. ~ ~ ;::J;~~ wid fl, ~ ~ P' ~ ~~ ~ ,/'t7g.!dJ, ~ tM-o ~Cj · -eN ~ ~ (,0' ~ ~ fv' fA' ev.J ~ J,N.Y ~ . ---ck ~ ~ vY' ~d~;q/l( ~ r .0- ~. ~ ~ ~r--ct- ~ ~ ~ t, /:;,., I..uJt wu<> r:-:. sk~~~~~~ )~. ~ fv j;vt:,J W C-{jAL- ~ ~~, ~~. 'JL!;'~~ ~'1-L ~.(~)~ ~ ~W~' I r~1 ./)~ J I m.O , ('ERTIFI( 'ATE Interval Between Onset and Death WARNING: It is illegal to duplicate this copy by photostat or photograph. ;c.r.' COM~J1C)NVVt:~/':.,L fr-l PEN1\.IS'/ i_V /\0.] I A iJtPf,F\TME',.jT 0" HU\1 TH,VITAl_ STi'\TISTICS N~ 575207 'X)" REGISTRAH 'S CERTIFICATIO~ OF DEATH _JIUkCI--L- _ ____ _ ----24-~ ___ _ ______ ______--.t.:.(, ~. d _./ !...------------- ---- ---,-- ~ r,.,-1 :\,'IG'lIP ~~~)~t r2;L1J._.2LJ~ _~- ~/J.AA4.71~n'"'4 -----~'-- ----/2".----- r'-.j,;r;"l"': Street. I C:tv or TUv'\Jn County State ~~- Co:, City, Eorough or Township 2-~- _____________ D"jp oj' Death____~-/liL--------------" Hace --~ iriho//1</Lf--L2'l.k- BirlhplaCf'_ ,'L2-~~c:I~.-L~-- --- Marital Status___~~~ uric y \i(), d.!?~_,_t2~J"c_L<Lk-.:t,- (kCupation__~--t2/1~, - Vpteran's Sprial ~o, ---,---------'- Registered "10, __~J)pnns:,Tlvania eath \va:-; cau~ed by: Ip ('aUSt' (,1)_ __~~~---.2,~ ,; (1 J.A2 tJ .A.-<l ..I. - .-/ Dup To (h) __.._." _____~_..______._____..___.__~___..~.___._~______m_.__.__,_.__ ...._.._,__.__~___~..,________~.__~ Dup To (eL_ OTHEH SrC'i!FICA\i'T CONDITIONS' contributing to death but no! rpla(f'Cj to the immediaty cause giv,'n in i(" \ ~u_~--~-~-'----------------------------- S\.licide or Homicide _ ____________________________ How did injury occur. NAME DATE OF DEATH RESIDENCE RC9-37 {12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES , I , RELATIONSHIP BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED DATE INTEREST OF State full names and addresses of all who illegitimate children \ DECEDENT OF BENEFICIARY aye an interest, vested. contingent or other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH William C. Brenneman Son Yes .Adul t Entire 220 Walnut Circle Shiremanstown, PA 17011 I I -- -_.._~-- I ~^.._--_.- I --_.- I _u___._...____._ I I I --- --.. -_._------~--- ---. J -- ----..--.-- -- - - , Deponent further says that all the above-named beneficiaries are living at this time except below: f'lCC-38 RESIDENT DECEDENT SCHEDULE" E" JOINTL Y OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERIT ANCE 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 vesti ture, 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. unit Value percentage Share Estate Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Entire property Value of Decedent's Interest None Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. N~ R E V-5t8 (8-78) 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 WilliamC. Brenneman 220 Walnut Circle ShivQmanstown, FA (Executor or Adm ini strator) In Re: Estate of Sar3 Mable Bishop r.llmhp.'Y"1 ;:lnn County - File No. ?J-7R-I.I."1R Dear You are hereby notified that the O'Y"ip)nrl1 appraisement in the estate of SrlY'C'! Mab 1 p. Bi shop has been filed in the office of the Register of Wills of Cumbp.'Y"1 rlnc'l County on 25 April , 19~, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total None 1,3'+1.90 31oh500.00 None $35,8'+1.90 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.,~t3. Signed /'. F ....,.- .--\-.". \...._-, 1.,-1-.... Date 25 April 1979 u Title _ Administrative Officer ~ Note: This is not a bill. 25 April 1979 Cumberland COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEM ENT DATE COUNTY FILE NO. REV-457 (8~78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 ?1_78-458 WhMe~, Sara Mable Bishop ~~of Borough of Shiremanstown in the County of Cumberland Commonwealth of Pennsylvania, having died on the c:; to day of ,r" 1 ~7 19...1.2, 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 c~h 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. APpraIsement Made for Inheritance Tax purposes UNIT VALUES DESCRIPTION OF ASSET $ 34 500 00 None $35 841 90 Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this 251;14 day of $l~;l ~ ,~ . . t ' 191.!l.-. . () ".~-., (-' Appraiser (Number and Street) . Penna. Harrisbur~ (Post Office)