HomeMy WebLinkAbout05-22-79
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
II:
Kenneth R. Kline
being duly sworn ac:c:ording to law, deposes and says that he is the Executor
of the Estate of Orpha C. K1 ine
late of The Borou$thd of Camp Hill. , Cumbertand Cou"ty. Pa., dec:eased and that the
within is an inventory made by him ., the said Ixecutor
of the entire estate of said dec:edent, c:onsisting of all the personal prop.nty and real estate. except real estate outside
the Commonwealth Qf Pennsylvania, and that the figures opposite eac:h item of the Inventory represent it's fair value
as of the date of dec:edent's death.
~c)~n .
and subsc:ribed before me,
.-
ApT il_
19
79
'Jj~~~./J:.~z
.c:utor . Ie ,""M'"
Kenneth R. Kline
Paradise Mobile Home Park
R.D. 11, Lot 134
New Bloomfield, Penna. 17068
Aclclre"
o?7~
~..~~~
. Hotary .Public
-.. L ~
SUSANNE M. BROWN, Notary Public
Lower Allen Twp., Cumberland Co., Pa.
~ Commission Expires Nov. 29,1982
Day
August
Month
1978
Date of Death
22
V..r
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of disc:overy of additional assets.
3. Additional sheets may be attac:hed as to personalty or realty
4. See Artic:l. IV, Fiduc:iaries Ac:t of 1949.
>- .d -a
GI
.... W ::s '"
~ D:: .... 0 iG
W ~ I-l GI
A. U
0\ 0 en ~ 0 GI .
11'\ 0 W w I:Q 0 Ul t"
-:t :I: a:: '" 'II
I .... A. LL .-l .-l A. C
00 Z ... -' ~ .-l iG ..
< 0 A. 0
...... LL -' '" :t
I W 0 < w . ::z:: i-
.-l > Z D:: 0 <
N Z 0 c c
<IS ::I
0 II en Z -& <IS 0
D:: 0
Z w < 0 w
.- ~
, A. -0
C
III
I - I:
0 Gl
..0 -0 ..x
Gl E
\ ... .! 0
I III ::I 0
I -' 0 u: CD
SUPPLEMENTAL
Inventory of the real and personal estate of
Orpha C. Kline,
deceased.
Mortgage Company escrow money from satisfaction of mortgage when real estate
was sold. (200 April Drive, Borough of Camp Hill, County of Cumberland,
Pennsy1vania.)-------------------------------------------------------------------
One Onyx ring with two small diamond chips given by decedent to Kenneth R. Kline,
Executor, beneficiary and co-owner of the safe deposit box where it was deposited
at the time of the decedent's death.---------------------------------------------
One worn engagement ring with small diamon~ given by decedent to Kenneth R. Kline,
Executor, beneficiary and co-owner of the safe deposit box where it was deposited
at the time of the decedent's death.----------------------------------------------
TOTAL
$405 48
125 00
100 00
I
I'
I
I
I
I
I
$630 48
~ - - ----:-.;..;...-~-~.:.:...... --
".-.:- _ ~~~______ ___:--.....r~~~~-;;;;;.;.;;;;.-,~-----.......-__ ~ ~
~~~------
-~
RCC 4 (11/78) COMMONWEALTH OF PENNSYLVANIA
I J003118 .
I NO DEPARTMENT OF REVENUE
i . OFFICIAL RECEIPT · PENNSVLVANIA1NHERITANCEANDESTATETAX
I
-~~ S~~ L 83/l00-~--~---~-~-~--~~~-~~-~~-
RECEIVED ____________________.LD.A.nJ..L- ~V~11 Uli dollars
From:
William A. Yocum, Esq.,
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
. Address
!
f
~
i
: Fil .'-Jo. 21-78-459
~
.
. [' _. of Payment
.
~ Name of Decedent
..
'"
; County
= Remarks:
.
~
~
.
~
I
,
t1
~
.
~f
1525 Cedar Cl1f't Drive
2%Taxon
$
May 22,1979
% Tax on $
Estate Tax, Act of
May 7, 1927
$
$
$
$ ~
$
$ 37.83
Camp Hi1l,Pa.
17011
6% Tax on
$
8-22-1979
Date of Death
15'f" Tax on
$
ORPHA C. KLINE
CUIlberland
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_ % from
to
$
PAm ON ACCOtnrl'.
u 00 ~ [p [L~ @ ill lJT~
SEA L
TOTAL AMOUNT PAID..
37.e3
$ ,~I
/ iJ
-LL/\~
R chard :B,6~g'Whthtraon
Real.tAr of" Wi".
(Title)
$
NOTE: This Triplicate Receipt to be retained for audit purposes.
Received by
NOTE: In accepting the transfer inheritance tax an future estates, prior to the death of the life
tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth shall
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
lile tenant or tenant far years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.