HomeMy WebLinkAbout01-18-79
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RCC-33 (4-73)
RESIDENT DECEDENT
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
O~
COUNTY OF
'*
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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"llenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
(STATE FULL NAME OF DECEDENT)
} AFFIDAVIT OF
EXECUTOR
County ADMINISTRA TOR
IN THE MATTER OF THE ESTATE OF
Richard G. Noaker
Late of Cumberland
State of PA } ".,
County of Cumberland
Doris W. Noaker
~~~~~3t>Xx
Executrn
of the estate of the above-named decedent being duly sworn, depose
and say
Decedent died
January
14
(MONTH)
Name and address of attorney or }
other authorized representative to whom
all correspondence should be mailed.
(DAY)
19~J ~estate leaving a last will, copy of which is hereto attached. }
(YEAR) ~~~~~x
Roger B. Irwin
44 S. Hanover St., Carlisle, PA
17013
That as such Executrix deponent is familiar with the affairs of said estate and the property constituting
( EX E CU TO R-ADMINI 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 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 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 8 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 al so separately the accrued interes t thereon, if any, down to the last interes t 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 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 mcrtgages 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.
;( I - ? C;; - Lf-f-o
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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 llUsiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the 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 with 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 copy
of the deed, trust agreement or other instrument creating the trust. TherR is also set forth in said
schedule a list of all property, real and personal, with its value, which paEses 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 instrl~ent creating such power attached to the schedule.
That Schedule D 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 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 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 unpaid 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 staten~nt 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.
D~ l~...I!fi1;:i/t-l~................_---_...
6 0 8 Devo.nshi.r.e....Dr..;i:y:.e...................................................................
(Street Number)
Carlisle, PA 17013
...................................-.......................... ......................
(City 0'1' Town.. aTtd 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.
Subscribed and sworn to before me this
Cf ~
I
.... day of .........~trf.....
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78
........19..............
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RC C-34 (4-73)
CdMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDEN1"
SCHEDULE leA"
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 wi th 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 DEATH In this spece)
to be listed on Schedule "F" and must not be deducted from this schedule.
None N~'t 1UJ
None
Insert this total opposite "real prope.:/', Schedule "A" in the X X X X X
"As Reported" column on the lost page of this return.
RCC -95
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 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, 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 deseribe fully
UNIT
VALUE
ESTIMATED
MARKEl' VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1
14 American Express Travelers Cheques
20.0C
280.001/
280.00
2
150 Shares of Common Stock of Shippensburg
Mobile Estates, Inc.
Voalue based on Purchase and Sales
agreement 400.00
1975 Datsun Sedan Automobile
Title #B27134391
60,000.00 ~o,ooo.oo
3
1,850. 00 /~1 ,850.00
Total
62,105.00
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
$62,105.00
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PURCHASE AND SALE AGREEMENT
THIS AGREEMENT made on the day of March, 1977
by and between JAMES E. GARDNER, 308 North Morris Street, Shippensburg,
Pennsylvania; FRANK E. HOLLAR,JR., R. D. 1, Shippensburg, Pennsylvania;
GEORGE B. MOHN, 406 North Morris Street, Shippensburg, Pennsylvania;
RICHARD G. NOAKER, 608 Devonshire Drive, Carlisle, Pennsylvania,
hereinafter referred to as the "Stockholders," and SHIPPENSBURG MOBILE
ESTATES, INC., a Pennsylvania corporation having its principal place of
business and registered corporate office at R. D. 5, Shippensburg,
Franklin County, Pennsylvania, hereinafter referred to as the Corporation.
WITNESSES AS FOLLOWS:
WHEREAS it has been found desireable to revoke and rescind the
December 31, 1969 agreement in re the sale of the capital stock of the
"Corporation" and also to revoke and rescind the May 1, 1972 amendment
of said purchase and sale agreement;
WHEREAS th= Stockholders are the Stockholders of the Corporation,
each owning shares of the outstanding capital stock of said Corporation
as set forth in Schedule "A", which is attached hereto and made a part
of this agreement as if set forth herein in full; and
WHEREAS the Corporation and the Stockholders recognize that in the
event of the death of a Stockholder or the sale of ~tock during a
Stockholder's life, the stock of the Corporation owned by such Stockholder
should not pass into the ownership or cont"'ol of a person Vo{ho might not
serve the best interests of the Corporati which would tend to disrupt
the harmonious and successful management Jnd control of thL norporation;
and
WHEREAS the Corporation may desire to acquire stock for reissue to
valuable employees,thereby improving their efficiency and value by
increasing their devotion to the business of the Corporation; and
WHEREAS the Corporation desires to prevent diffusion of holdings
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through bequests, etc. by Stockholders to inactive nonfamily stockholders,
who would contribute nothing in the way of management or development
of the business of the Corporation;
NOW THEREFORE, in consideration of the mutual promises herein
contained, the above parties, for themselves and for their heirs, executor
and administrators, and for itself, its successors and assignes, agree
as follows:
1. PURCHASE AND SALE OF DECEASED STOCKHOLDER'S STOCK
Upon the death of any Stockholder, within ninety (90) days after
issuance of Letters Testamentary to his Executor, or Letters of Adminis-
tration to his Administrator, the estate of such deceased Stockholder
must sell and the Corporation must buy all of the stock in the Corporatior
owned by the decedent at the time of his d8ath, whether acquired before
or after the date of the execution of this Agreement, for the price and
upon the ter~s and conditions hereinafter set forth.
2. DETERMINATION AND PAYMENT OF PURCHASE PRICE IN THE EVENT OF DEATH
In the event of a purchase and sale of stock as the result of
the death of a stockholder, the purchase price for the stock of the
decedent shall be Four Hundred ($~OO. 00) dollars per share of capital stocl<
This purchase price shall be paid in four (~) equal, annual installments
with the first payment due within the ninety ('90) day period provided
in Article No.1.
3. PURCHASE AND SALE OF DISABLED STOCKHOLDER'S STOCK
a. In the event a Stockholder shall suffer total and permanent
disability as hereinafter defined, and such disability has continued
for a period of one year during the lifetime of such Stockholder, then
the disabled Stockholder or his personal representative must sell and
the Corporation must buy all of his stock in the Corporation owned by
the disabled Stockholder, 'Nhether acquired before or after the date of
the execution of this Agreement, for the price and upon the terms and
conditions hereinafter set forth.
b. In the event the disabled Stockholder should die after
becoming disabled but prior to the actual sale of his sto~k, then
Paragraph 1 shall govern and the purc~ase and sale of his stock will be
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treated as a purchase and sale of a dC2e~3ed Stockholder's stock.
c. For the purposes of thi s Paragraph ,nd this Agreement, "total
and permanent disability'! shall mean any physical or mental disability
which wholly and continuously prevents a Stockholder, and apparently
will thereafter, during his entire life, prevent him from performing
his Guties in his normal gainful employment by which he has been earning
his livelihood.
d. In the event the parties fail to agree on whether or not a
Stockholder is tatally and permanently disabled for the purposes hereof,
the disabled party shall desi~nate an Arbitrator and the Corporation
shall designate an Arbitrator, and the two Arbitrators so designated
shall designate a third Arbit~ator to reach this determination. The
arbitrators shall be entitled to receive and rely on any medical advice
or other advice which they shall deem required to enable them to make a
determination, under this Paragraph 3, whether or not a purchase and sale
shall take place, and their d2terminatio'~ o~ evidence so received shall
be final and binding on the p~rties here
If any pa~~v fails to
appoint the Arbitrator wi thin thirty d;,,,,.3 after wri tten lJ ice to do
so, the Arbitrator appointed by the other party, shall be the sole and
exclusive Arbitrator and proceed, etc. as set forth above.
4. D2TERMINATION AND PAYMENT OF PURCHASE PRICE IN THE EVENT OF
DISABILI'l'Y
In the event of a purchase and sale of stock as the result of the
disability of a stockholder, the purchase price for the s~ock of the
decedent shall be Three Hundred Fifty ----($350.00) dollars per share of
capital stock. This purchase price shall be paid in four equal, annual
installments with the first payment due within ninety (90) days after
the occasion for sale and purchase has been determined.
_'?-
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). PUkCHJI.SE J..:JlJ SJiLE OJ, :.."l\:';C1: ~)i'ji::'::, " ~,y rj::.L,~~ON OF DEATH OF; UISAbILI'l'Y
a. In the event a Stockholder desires to sell his stock for any
reason other than disability, then the Stocl.:holder must offer to the
Corporation all of his stock in the Corporation for the price and upon
the terms and conditions hereinafter set forth.
b. The Corporation shall have the option to purchase said stock
at the price and upon the terms and conditions indicated in Paragraph
G or to refuse said tender of stock.
c. If the Corporation refuses a Paragrpah 5 (a) tender of stock,
then the Stockholder shall be entitled to procure any willing third
party purchaser to purchase all of his stock in the Corporation for
:~uch price as they shall agree upon; however, the Corporation shall
;,ave a right of first refusal to purchase said stock for such price
2S shall have been agreed upon in writing between the Shareholder and
the third party purchaser.
d. In the event the Shareholder should die after tendering his
stock but prior to the sale of said stock under Paragraph 5 ~),
t 11.=n Paragraph 1 shall govern an d, the purchase and sale of hi s stock
~hall be treated as a purchase and sale of a deceased Shareholder's
~;tock.
6. DETERMINATION AND PAYMENT OF PURCHASE PRICE OTHER THAN BY REASON
OF DEATH OR DISABILITY.
In the event of a purchase and sale of '1e stock of c, qrty
r.e:"eto pursuant to Paragraph 5 (a), the pL..l chase price to be t >id
ty the Corporation for the tendered Stock shall be Three Hundred
(S300.00) dollars per share of capital stock.
The purchase price under a Paragrpah 5 (a) or 5 (c) purchase
silall be paid in four equal, annual install~ents. The first payment
shall be due within ninety (90) days from the Shareholder's written
:erder of his stock to the Corporat!on, or if two or more Shareholders
~~ll notify the Corporation in writing of their objection to said
":~.'st J=:aY:Tie:-lt, then ~:;e first pay:rlent shall ;;e due ':'hree Hundred
-~: -
..
,C~ixty (360) days from the SharE'holder's \tlritten tender of his stock
to the Corporation.
7. EXCEPTIONS TO REQUIRED PURCHASE AND SALE OF STOCKHOLDER'S STOCK
a. The requirement of sale and purchase upon the death of any
stockholder as contained in Article One (1) shall not apply if said
stock is transferred by the personal representative to the decedent,
either based on provisions in the decedent's Will or otherwise, within
said ninety (90) day period, to any of the following:
Widow of decedent;
Child or children of decedent;
Sons-in-law 01' daughters-in-law of decedent.
,
Step-child or step-children of decedent; or
Grandchildren or step-grandchildren of decedent.
b. The requirement of sale and purch~se upon the disability of a
~;tockholder shall not apply if said stock is transferred, within ninety
(90) days after the Stockholder has been determined to be disabled
according to Article No. Three (3), to any of the class of persons
named in Paragraph A. Above.
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8. DELIVERY OF STOCK
Upon the receipt by the estate of the deceased Stockholder,
or by the Stockholder himself, of the purchase price, then, to the extent
that the amount so received constitutes payment in full for said stock,
the Seller shall deliver the shares of the selling Stockholder so paid
for to the corporate treasurer, after any necessary action and/or
endorsement by the personal representative to a deceased Stockholder or
by selling Stockholder, which endorsement, etc. is agreed to be made
upon request.
9. AFTER-ACQUIRED STOCK
This Agreement shall extend to and cover all capital stock in
the Corporation presently or subsequently owned by the parties hereto.
10. TERlVJ OF THIS AGREEMENT
This Agreement shall terminate upon the occurrence of any of
the following events: Cessation of the Corporation's business and/or
bankruptcy, receivership, or dissolution of the Corporation.
11. BENEFIT
The Agreement shall be binding upon the Corporation, the
Stockholders, and their heirs, legal representatives, successors and
assigns, and each Stockholder, in furtherance hereof, shall execute a
Will directing his executor to perform this Agreement, but the failure
to execute such Will shall not affect-the rights 'of any party nor the
obligations of any estate, as provided for in this Agreement.
12. AUTHORIZATION
The Corporation is authorized to enter into this Agreement
by virtue of a resolution adopted at a special meeting of the Stockholders
and Directors held on the date first mentioned above.
13. ARBITRATION
In the event of any cispute under this Agreem81t not otherwise
provided for, or in the event of any dispute between Arbitrators who may
have been appointed hereunder, such dispute shall be settled by arbitration
in accordance with the rules then obtaining of the American Arbitration
Association, and judgment upon the award ~ay be entered in any court
-6-
having jurisdiction thereof. Any costs of such proceedings shall be
borne by the Corporation.
lij. STOCK SPLITS, ETC.
Appropriate adjustments in the purchase prices may be made
for any stock dividend, stock split, recapitalization, or issuance by
the Corporation of additional outstanding shares occuring after the
signing of this agreement. Said price adjustmentsshallbemade only by
written amendment of this agreement.
15. CORPORATE RESTRICTIONS AFTER PURCHASE
a. So long as any part of the payment of the purchase price
for shares of stock sold in accordance with this Agreement is overdue
andhrin default the Corporation shall not declare or pay dividends on
its capital stock; reorganize its capital structure; merge or
consolidate with any other corporation or sell any of its assets except
in the regular course of business; or increase the salary or bonus of
any officer or executive employee of the Corporation.
b. So long as any part of the purchase price shall remain
unpaid, the selling Stockholder or his personal representative shall
have the right to examine the books and records of the Corporation from
time to time and receive copies of all accounting reports and tax
returns prepared from or on behalf of the Corporation.
16. INVALID PROVISIONS
Invalidity or unenforceability of any particular provision
of this Agreement shall not affect the other provisions hereof, and
. \
the Agreement shall be construed in all respects as if such invalid or
unenforceable provision were omitted. This Agreement shall be construed
under the laws of the Commonwealth of Pennsylvania.
17. AMENDMENT, MODIFICATION OR REVOCATION
This Agreement may be amended, modified or revoked in whole
or in part, but only by a written instrument which specifically refers
to this Agreement and expressly states that it constitutes an amendment,
modification, or revocation hereof, as the case may be.
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". . 'I.
IN WITNESS WHEREOF, the Corporation Las caused this Agreement of
be executed by its President and its corporate seal affixed hereto, and
the Stockholders have hereunto set their hands and seals on the day
and year first above mentioned.
ATTEST:
SHIPPENSBURG MOBILE ESTATES, INC.
By
( SEAL.
Secretary
President
WITNESSED BY:
(SEAL
JAMES E. GARDNER
(SEAL
FRANK E. HOLLAR, JR.
(SEAL
GEORGE B. MOHN
(SEAL
RICHARD G. NOAKER
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SCHEDULE A
SHIPPENSBURG MOBILE ESTATES, INC.
Stockholder Certificate No. No. of Shares Percent
JAMES E. GARDNER 1 150 25
FRANK E. HOLLAR, JR. 2 150 25
GEORGE B. MOHN 4 150 25
RICHARD G. NOAKER 5 150 25
-9-
RCC-'36
CllMMO,\'<<EALTII OF PENNSYLVANIA
TRA'\~FER I'\HERITANCE TAX
SCHEDULE "c"
TRANSrnHS
FtES mE','T DECEDENT
(1) Did decedent, wi thin two years of death, make any transfer of any material part of his estate, without
receiving Ii valuable and adequate consideration therefor? (Answer yes or no) No
(2) Did decedent, within two years of death, transfer property from him~~lf to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) 1\J 0
(3) If the answer to (1) or (2) above is in the affirmattive state:
(a) Age of decedent at time of transfer N/ A
(b) State of decedent's heal th 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
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,$>r. no) N/ A
(b) What was the transferee's age at time of decedent's death? l\Jl 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 enjoyment of or the right to income from the property transferred?
Y (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) l\JO
(G) 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) N n
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserverl power to alter, amend, or revoke, or which c01\ld revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (8) above 1s in the affirmative, was the power to al ter, amend, or revoke the inter-
est of the benefiCiarYNfiserved in the decedent alone or the decedent and others?
(Answer yes or no) A
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 descript10n 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
DESCRIPT ION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
N fvYl.L/
None
Insert this total opposite "Transfers", Schedule "e" in the
"As Reported" column on the last page of this return.
RCC-37 (12-63)
COI\fMON\n~ALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
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
lYe an interest, vested, cont ingent or other- are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO BIRTH
Doris w. Noaker wife yes residue
608 Devonshire Drive
Carlisle, PA 17013
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
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Personal Property .....................................
Transfers . . . . . . . .. . . . . . . . . . . . . . . .
SUMMARY
............. (Sch. "A")
. (Sch. "B")
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Gross Taxable Estate.
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R C C-38
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRllCTIONS: This schedule must disclose all property, real and personal, owneci by the ciecedent jointly
wi th 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 cio 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 anci 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.
uni t
Value
percentage
Share
Estate
Valuation
DEPART1.ffiNT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
None
fl/f11i../
None
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
RCC-39 (5-68)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of Noaker
(Last Name)
Richard G.
(Firs t Name) (!ni ti al)
DATE OF DEATH
1/14/78
FILENO. 21-78-0480
REPORT OF INHERITANCE TAX APPRAISER
Cumberland
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item iill the last column to the right in Schedules "A", "B", "C", and "E".
Dated: Januarv 18, 1979
~ / J Ii Tt/.I' tu /("f)
INHERITAN TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Re:gister of Wills in and forCumberland County, Pennsylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last collumn to the right in Schedule "F", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:
REGISTER OF WILLS
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
Join t - Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
VALUE AS REPORTED
$ IlUIle
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities. . . . . . . . . . . . . . . . . .. $
t=
t=
t=
ESTATE TAX ASSESSMENTS $
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estate
COMPUTATION OF TAX
2%
6%
5%
10%
15%
*
$
$
$
$
$
TOTAL TAX
$
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
Les s tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
$
$
1=
$
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
$
c
AMOUNT OF ESTATE TAX ASSESSED $
Estate tax paid $
BALANCE DUE
Add interest at rate I)f 6% from
to
c$
1-
t=
$
$
TOTAL TAX BALANCE $
PAID $
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above cumputation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
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REV-SI8 (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
Doris w. rJoaker
(Executor or Adm ini strator)
In Re: Estate of Richard G. Noaker
Cumberland
County - Fi Ie No. 21-78-0480
Dear Mrs. r~oaker:
You are hereby notified that the oriQinal
appraisement in the estate of Richard G. Noaker
has been filed in the office of the Register of Wi lis of Cumberland
County on January 18 , 19 79 , Said appraisement reflects the following
valuations:
r~one
$62,105.00
I\Jone
None
;;$62,105.00
Real Estate
Personal Property
Transfers
Jointly Owned
Total
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 11961, 72 P. S. 2485-1001, P. L. 373.
Date Januarlj 18-J.- 1979
l!i " ' ,-' i L'
S i cmed- ,L ,(.Jt -' d A, /. ---!l1,'},3 r /
... .'OfF
,#,>
Title Chief A~aiser
t
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Note; Thisisnotabill.
RCC-2 (2-64)
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA, 17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE January 18, 1979
COUl\"TY CU1~berland
FILE NO. 21-78-01+80
Whereas, Richard G. r'-Joaker late of Carlisle
in the County of i~llr:1hp.T'l ;:mrl Commonwealth of Pennsylvania, having died on
the 14tr- day of .]anuarv 19 78, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Gloria J. Richard , 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 fol' 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.
Unit Approi$ement
Description of An.t VII lie' Mid. for Inheritance
Tax Purposes
Real Ec,tate 0Jone $ -0-
+-.-.----.------ f---
Personal Propertv %2.105.00 62. 1o~ ~
Transfers 0Jone -0-
Joint Propertv None -0-
Total Estate ,il62.105.oo ':'62. 10~ 00
------ .... --'-"-=
-- --.+
-
--
-
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----- -.,..--.------
Having been duly sworn according to law, I do hereby certify that the above
formity with law on this 18th day of Janur:lry
appraisement is made in con-
1979 .
.kP./vodf :1i','ui';'J+,;lj
- ppra ioer
1846 Bro wood st.
(lfumber and Street)
Harrisburg
(Poet OfIlee)
t Penna.
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OF
CUMBERLAND
COUNTY
~ I~~} ~_y,?()
STATEMENT OF DEBTS
AND DEDUCTIONS
Form RC C .10
~ -,
l.ATE OF
DEDUCTIONS ALLOWED IN
. ., f
THE SUM OF ............ i?()~Q<qt--
~~:: A.PPROVED .;0^. n.at'?~?J7?t
]]~l,r Jg,
:'~- \-1-C '~. C_ . J '\1 ,~,t11-.
. Regi.ter of Will., Age.
.....
OFFICE OF TNE
REGISTER OF WILLS
AND AGENT OF THE COMMONW5ALTH
\ ~~ /2 '(Q?} JANUARY 14. 1978
DATE OF FILING APPRAISEMENT DATE OF DEATH
:"
DATe: NO. OF NAME OF PAYEE REMARKS AMOUNT
VOUCM~llt
lL24 J8 Gulf' Oil Cor..Q. _gasoline bill 3...4. 10
1/24 78 United Telephone Co. telephone bill 22. 59
li24 28 P. P. & L. electric bill fl. 42
-L/24 .La D8J.JJ2hin Oil Co. auto r~air 86 2.3
J.L24 _78 Exxon gasoline bill 106 l5L8
.lLll 28 Quali t.....Y Auto Sales auto re~air bill 204 45
lL 1..1 38 ....G..a.r.l.i.l..e A mb--.U 1 an c e ambulance service 40 00
2.1.1 ~8 Frederich & Fair auto service 24 60
U2 78 M. J. Mall Association booth rental 60 00
~ J8 Dau..Qhin Oil Co. zasoline bill 34 l56
flL :zB ile orge ' s Flowers f'uneral f'lowers 42 40
L'l :zB iiull' ~il Cor....l2..1- Kasoline bill 2..3... ..53
Ll3... ~8 Peo-.ple's Nat'l Bank of' Ship 2.. loan repayment 515 00
117 38 Richard Wetzell kerosene bill 100 00
/20 L8 United TeleJ2hone Co. telephone bill 38. 88
'3 78 l'1Y.rtle Thomas SUsquehanna County tax 90. 55
3 J8 Carlisle Hos2ital emerzency room bill 19. 58
.3.- L8 G. Book Roth f'uneral bill 2~050. 00
6 78 Pa. Dept of' Vital Statistic p birth certif'icate 2. 00
1 L8 BorouKh of' Carlisle water bill 26. 64
31 78 Westminster Cemetery burial lot 300. 00
-
7 78 Westminster Cemetery grave marker 235. 00
-
.4 78 Internal Revenue Service 1977 Personal Income Tax 1,750. 00
4 ~8 Pa. Dep t. of' Hevenue Pa. 1977 Personal Income Ta 78. 00
l ~8 Register of' Wills Inventor""'y and qQpraisement 6. 00
I
ESTATE OF RICHARD
Form RC,C .10
DEDUCTIONS ALLOWED IN
OFFICE OF TME
REGISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS
\'/
THE SUM OF .... $ ,~)6^ C;~? u 7
,An ",.,v"J'", } F1 'U
1\: ( li ,L f {"'YJ J c lu \ 1\
\ Regi,ter of Will"
OF
COUNTY
AND AGENT OF THE COMMONWEALTH
,
"
ESTATE OF
LATE OF
DATE OF FILING APPRAISEMENT
OATS OF DEATH
NO. OF NAME OF PAYEE REMARKS AMOUNT
CATE
VOUCHI;Jlt
Roger B. Irwin notary fee 2l. 00
Irwin Irwin & Irwin attorney fee ~.105. 25
Doris W. Noaker family exemption 2,000. 00
Doris W. Noaker executrix fee 3.105. 25
n e National Bank mortg:ag:e "i 78l. 82
RpQ'ister of Wills debts and deductions ~ . 00
Register of Wills filing account 33. 00
--
TOTAL ~20,029 83
COMMONWEALTH OF PENNSYLVANIA
}..:
COUNTY OF (;TTMRF,RT,AND
I. DORIS W. NOAKER
HEREBY CERTln'. THAT. TO THE SEaT OF
MY KNOWLI!:DGE AND SELIEF, THE FOREGOING IS A JUST AND TRU E STATEMENT OF DEBTS. FUNERAL EXPENSES AND EXPENSU OF
RICHARD A. NOAKER
ADMINISTRATION SUBMITTED TO THE ESTATE OF
DECEAsao, AS DEDUCTIONS FOR
INMERITANCE TAX PURPOSES.
// i, ~
(L.5.)
SWORN AND SUSSCR/BIlD BEFORE MI~ THIS
1.~
DAY Of'
DORIS W. NOAKER