HomeMy WebLinkAbout05-25-79
Form RC C -10
OFFICE OF THE
21-78-462
STATEMENT OF DEBTS
AND DEDUCTIONS
DEDUCTIONS ALLOWED IN r
'LJ
THE SUM OF " . $ f 1;-/1 --
.. $'d~7=J(
REGISTER or WILLS
OF
Cumberland
COUNTY
DATE
AND AGENT OF THE COMMONWIiALTH
. o.A.'l.. J '. Pl C!
?7'1
I I
DATE NO. OF NA"'.. OF PAYEE REMARKS AMOUNT
YOUCHIi'''
~egis ter of Wills trs. Test F. co 1... -... rT-f<:. 41 00
~e~ds ter of Wills Filinu RCC g snn 0 00
The Sentinel Anv Lpttpr<:; 1 10 oS
rumberland Law Journal Adv LpTTPr<:; I 18 100
\1artin L. Myers Funeral Home Services 2.502 80
Spencer T. Videon Funeral Ho ne " 1.248 9 S .
"artledge Cemetery Memorials Monument 97 00
Holv Snirit HosniT::ll f,;:J<:;T illn<=>"" 65 95 .
Stanley M. Wetmore. M.D. Last illness 115 100 "
PP&L Electric Service 79 22
"able TV/Sammons Communic::lti In<:; - Arr('\l1Tl+ 6 68
N. F. Suoon. reimb. for cler I!yman Howard's 'T
I inscription. mobile home am 170 00 "".
William F. Spoon Executor's Commission 1.500 loa"
James R. Hurner, Esq. Attorney Fee 2 SOO 10 n Y'
I ~eserved for Closing Expense 1 C;() I () () ...
Total R c;17 ?c;
-
ESTATE OF Bertha F. Monighan L.ATE OF Hampden Towns}, i r
~'-r 2 )~.- '7Cf DAT~ OF D~ATH July 26. 1978
DATE OF FIL.ING APPRAISEMENT -I- Q.. __
COMMONWEALTH OF PENNSYLVANIA
I,
Cumberland
William F. Spoon
'1
J..'
COUNTY OF
",y KNOWLI!;DGE AND SELIEF, THI!; FOREGOING IS A JUST AND TRU E SrATEMENT OF DESTS, FUNERAL EXPENSES AND EXPENse 01"
ADMINISTRATION SUBMITTED TO THE EST",7E OF Bertha F. Monighan DECU.SED, AS DEDUCTIONli FOR
__IJ1~ I. ~00tf
DAY Of" r
HERESY CERTIFY, THAT. TO THE BEClT OF
INHERITANCE TAX PURPOSES.
USBCR/BED eEFORE ME THIS 7 d
/1 - -'. ; _ '9 7J7
~, /'
(L.5.l
CL.:~be;':Jt:cl (our:t',
-
.
21-78-462
C~MONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
5J1
RCC-33 (4-73!
..
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 Reuenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cumberland
} AFFIDAVIT OF
. EXECUTOR
County ADMINISTRATOR
IN THE MATTER OF THE EST A TE OF
BERTHA F. MONIGHAN
(STATE FULL NAME OF DECEDENT!
State of
Pennsylvania
Cumberland
J."
County of
~NOO~K;KQ{X
William F. Spoon
of the estate of the above-named decedent being duly sworn, depose S
Executor
and say S
July 26.
(MONTH!
Name and address af attorney or }
other outh orized representative to whom
all correspondence should be mailed.
(DAY!
, 19~{testate leaving a last will, copy of which is hereto attached..}
(y EAR! J6JU\1at:i(
Decedent died
James R. Humer, Atty.
1 W. High St., Carlisle, PA 17013
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
( EXECUTOR-ADMINISTRATOR)
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 INN AM E 0 R N AM ES 0 F HOLDERS TO DECEDENT
None
That the contents of said safe deposit box or boxes are itemized under Schedules N/ A of this return,
wi th the exception. of the following, for the reasons hereinafter set forth:
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
where saver situated owned by the decedent at th.'c 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
gi ving al so separately the accrued interes t thereon, if any, down to the las t in teres t day primr 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;
a:: "<-"ling apparel, jewelry, silverware, 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 wer" 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 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 ]),usiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of tne agreement)
together with a statement setting forth the character 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 wi th 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 co~y
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth 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, orjointly with another, or any 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 0 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, together 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 beneficiary.
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 vestiture 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 for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration 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 lmpaid 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 the totals of the appropriate columns in Schedules "A", "B", "en, "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to .before me this .......7..tt:.........
. ;;Of .~m......m 1972
'" .~~ .. ................
~?~: I?"'
~.~ C{; " ~ .,,/ . q1
My (omm;slion hpircs Ju!v I!, 11,.,
Carlisle, PA Cumberland CountY
~~
....~.............................................~...............~................................-...
(Executor-4 .
...~.~..~..~..!...~......~..~J.!..~.~.Y.....P.I.t..Y~........................................._..
(Street Number)
...G:r.~..~.I}.<:.:..9.:.?.t.J.~..,......J..n.g.i.f!,.n.g.......4.6..1.3...5....................
(City or Town and State)
NOTE: Before signing affidavit 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 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.
RC C-34 (4-73)
COMMONWEALTH OF PENl'oiSYLVANIA
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 os tenant in common with another or other, should be identified
os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The feal property located In the Commonwealth of Pennsylvania should be (1) (2) (3)
described by lot and black number, street and street number, together wi th DEPARTMENT
a general descrlptlan of the praperty, with a reference to the record of the ASSESSED VALUE VALUA TION
conveyance by whi ch the decedent took title; If a farm state number of a. FOR YEAR OF ESTIMA TED CAUTION
cres; alsa statement af mortgage encumbrances upon each parcel at death DECEDENT'S . MARKET VALUE (Do not write
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH In this space)
to be listed on Schedule "F" and must not be deducted from this schedule.
None
Insert this total opposite "real property", Schedule "A" In the X X X X X
"As Reported" column on the lost page of this return.
None
Nt~
RCC -35
RESInE~T DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
CO~WONWEALTH 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 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 rlividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
estate of or income f'rom 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.
I tern
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1. 1972 Clarion MH, VIN6B090l66, Pa. Title
No. B25ll0747
2. 1973 Pontiac Bonneville 4-dr. HT VIN
2N39R3P334257, Title A26058ll0 Sale price
8,500.00
1 , 6 5 0 . 00,/
3. Household goods, sale price
4. Coin collection, sale price
5. CCNB S/A #006-703546-9, balance
Interest to 7/26/78
6. CCNB S/A #006-052633-2, balance
Interest to 7/26/78
/
1,432.00,//
315.00
892.22
2.84/
2 5 , 6 2 6 . 14.
107.32
7. CCNB CIA #611-125-6, balance
5,301.326
8. Currency in sale
587.00
9. Colonial Penn Life Ins. Pol. #0C-732097l
5 Penn Center, Phila. 19103 proceeds
,.-
2,020.80<
~~'
10. Six Links Trailer, Dividend & Profit
363.92'
11. Promissory Note, Paul & Carolyn Miller
son-in-law and daughter, w/o interest
/
/'
4,500.00 '
12. 51 Sh. F. W. Woolworth, Com.
y::.
Q' 18.9375
965.81
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of' this return.
x X
52,264.37
'2- 1 '"2- L L{ - ?, 1
Rec - 3S
CliVfMO\WEALTH OF l'E\'\'SYL\~ANI i\
TH.A'i~F~<~l{ I\IiF!UTA\CF TAX
SCHEDCLE "c"
TR\'iSFEllS
~
~;'~ I.!ia
1.'.'.,"',',-::'''
.~.-.!): '.);
\4~.,.i{ "":1\.
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/j[ / ",Y',\'.\~~r), I
'''J;t~';,~?F'
lmSIDE'iT DFCFDF\T
(1) Did (:e~edent, within two years ot'death, make any transfer of any material part~Qf his estate, without
reCe:lVlng a valuable aP.d adequate consideration therefor? (Answer yes or no) l\JO
(2) Did decedent, witld.n two years of death, transfer property from himself to himself and another or
Gthel's (tncludj ng a spouse) in joint ownership? (Answer yes or no)-1-10
(3) I [' the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer N/ A
(b) State of decedent's health at time of making the transfer. (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
considera tion t herefo I' which was to take effec t in possession or enj oyment a t ~ 0 I' after his <teath?
(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) No
(b) What was the transferee's age at time of decedent's death? N/ A
(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 en.i~yment of or the right to income from the property transferred?
(Answer yes or no) No
(b) The right to rlesignate 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 N/ A
(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 11 reserverl 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 t.) at t.er, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent. and others?
(Answer yes or no) No
NOTE 1: The answers t.o these questions should be supporterl by affi<1avi t by the attewling 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 vallIe at date of death, dat.es 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
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
I
I
I
I
I
I
I
~
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last pag;e of this return.
None
N ("\-.L
RE V-453 (8-78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BEN~FICIARIES
BENEFICIARIES AND ADDRESSES RELA TI ONSHIP
(State full names and addresses of all who (H step-chiLdren or SURVIVED DATE INTEREST OF
have an interest, vested, contingent or other- iIlegi tima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set STATE YES BIRTH IN ESTATE
forth this fact.) OR NO
William F. Spoon <::nn Yes N/A 51 <::n F W Wnnl1Arn-r+11
R.#l - Fairway Drive Coins
Greencastle, Indiana 46135 1/3 residue
Lillian V. Flannery Sten-DauuhtP"Y Ypc:, N/A 1/'" r",c:;rlll'"
Six Links Court - R.D.5
Mechanicsburg, PA 17055
Carolyn M. Miller STPn-n~l1unTPr Ypc: 7\T / f), 1/3 rpc;irlllp
P. o. Box 110
Millerstown. PA 17062
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DA TE OF DEATH RESIDENCE
None
.
SUMMAR Y
(Sch. "A") $
(Sch. "B") $
(Sch, "C' ') $
$
$
$
(1)
(As Reported)
(2)
(As Determined)
...
,8oo~
"'< ....
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00 w =
.2 ~ 8
...-.4 11.) :::s
8- -
_0.0
v 8 (J
"10.
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.8 ~ ~
;:l 00 ......
(J ;:l ...
OJ88-
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S Cl::
$
$
$
$
$
$
Real Property
Personal Property
Transfers
Gross Taxable Estate
Eo-< '"
... Z <Ll
~ ~ 00
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>< ~ <Ll
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e 0 D::
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'. #
R C C- 3 e
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
I:-.iSTRUCTIONS: This scl1Pdule must disclose all property, real awl personal, own(>d h,\ tile :_~'.:..:::.:..._l~__ ointly
"tth anotht'r ur others, including intangibles, standing in the namp of the decedent :md 0111(H". List
real estate first, as entireties, or joint tenants, giving hrief description, as indieatp,J IlTl(h~, S,:hedule
"A", plus the date and place oj' record of instnunent effeeLing vestitllrf', but do not include pnt tles
or out of stelte rea] estate value in estate villuation colurrm. Personal property should be liste,: as In
Schedule "B", plus date of acquisition, and the name, address and relattonship (if any) uf co-owners '0
the decedent.
Description of Property, Date of Acquisition, Name unit percentage Estate
Address and Relationship of Co-Owners, and Place Value Share Valuation
of Record of Instrmnent, where Real Estate.
DEPARTMENT VALUATION
CAUTION-Do not Wri te
In This Space.
Value of I Value of
!!,ntire Decedent's
Property Interest
-('
1/2
1/2
5,000.01,/
20.5(
2. First Fed. S & L of Harrisburg
Say. Ctf. #5530 dtd 1/26/73 /
Acct. #9-3456, 6% int., 2 yr. term
$10,000.00
Interest to 7/26/78, $41.18
1/2
1/2
5,000.0('//
20.5(
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the" As Reported" column on the last page of this return.
10,041.18
\O\OL{tl'2J
CL-<-~..;....,:l l--..
t-:- Sc,-C ~,r-
R E V-518 (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
William F. Spoon
R.R.l, Fairway Drive
GpGGncastle, Indiana
(Executor or Adm ini strator)
'I ij 135
In Re: Estate of
Beptha F. Monighan
Cumberland
County - File No. ?1-7R-4f;?
Dear
You are hereby notified that the Original
appraisement in the estate of Bertha F. Monighan
has been filed in the office of the Register of Wills of Cumberland /
County on 25 May , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
852,264.37
None
10,041.18
$62,305.55
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. 373.
Dote 25 May 1979 S;9ned L <2 -0 \~'-~J---==--~
Title Administrative Officer
Note: Thisisnotabill.
. ,..,
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYlVA.NIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAil:. ~ 25 May 1979
COUNTY Cumberland
FILE tWo .,2-.1-78-462
Whereas, Bertha F. Monighan late of Hampden Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the ? nTh day of ,1111 Y 19 ..1Jl, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fulvini ti , 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
$
n , .... ~ u
Personal Property 52,264 37
Transfers u
Jointlv Owned 1" "10' , n
.
Tot al $62.305 55
I
I
I
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this ?I:\tb day of May. 19 ..1..9....
L-(.,<.- ~ L- --l2-0-~"
Appraiser
(Number and Street)
Harri~hllT'f
(Post Office)
, Penna.
01
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