HomeMy WebLinkAbout03-13-79
Form RC C.10
.
DEDUCTIONS ALLOWED IN
- OFFICE OF THE
REGISTER OF WILLS
_ -/ 0 ~L.t' Y, -?
"'..~ I {. / () '__
STATEMENT OF DEBTS
AND DEDUCTIONS
ESTATE OF
~
Harry F. Rubert
~
LUEOF Borough of
~~
OF
Cumberland
COUNTY
AND AGENT OF THE COMMONWIIALTH
DATE OF FILING APPRAISEMENT ~,q, (Or 1) 9 DATE 01" DI!ATH 8/6/78
U \
DATE NO. 01' NAME OF PAVEE REMARKS AMOUNT
VOUCHEIt
Aug 2 R-egister of Wills, Cumbo Co. Letters Testamentary &
5 short certs. 50 100
'Sep 1 :umber1and Law Journal Advertise letters
Te ntarv 1~ nn
Sep 2 )etwei1er & Stabingas Funera
Home Tombstone Engraving 20 00
SeD 2 Presbyterian Home Inc. Institutional care 681. 86
Sep 2 James Line, Tax Collector Per Capita Tax 9 90
Sep 2 ~GM Pharmacy Ethical drugs 29 53
SeD 2 ~oth Funeral Home Funeral expenses 1.838 81
SeD 2 ~egister of Wi11s~ Cumb . Co. Two short certificates 2 00
Oct 1 rhe Evening Sentinel Advertise Letters
Testamentary 20 15
Jncashed check. H.P. Lenton.. ~ Professional Services 45 00
Reserves:
~ames D. Flower Attorney's Fee 3,049. 00
Irhe Commonwealth National
Bank Executor's Fee 3,049 . 00
Closing Costs 100 00
8,913 25
We,
COMMONWEALTH OF PENNSYLVANIA 1
J;OUI'i.TY OF Dauphin ss:
ln~ ~ommonweaLth ~at1onal Ban by Robert P. Conway,Vice President & Tax Mgr.
. , H&REBV CERTlI'Y. THAT. TO THE BUT OF
MY J<NOWLEDGE AND BELIEF. THE FOREGOING I. A Jm AND T~ E ~~ENENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF arry. u ert "ECU-SIID. AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES. ~ ' ~ ~
/~ \ ~ ~ (L.S.)
SWORN AND .UBSCRIBED BEl" RE ME THIS V? DAV OP"
1. !t!L-
My Commission Ex~irel Ccl>ber 13. 1980
HarriibwQ. PA Dauphin County
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RCC-33 (4-73)
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
..
RESIDENT DECEDENT
IMPORTANT:
This return must be completed in detail and filed in duplicate, with aU 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.)
COUNTY OF Cumberland
IN THE MATTER OF THE ESTATE OF
Harry F. Rubert
(STATE FULL NAME OF DECEDENT)
Late of
Carlisle, Cumberland
Pennsylvania
} AFFIDAVIT 6F
EXECUTOR
~
County
i -.
State of
C fCumberland
ounty 0
The Commonwealth National
Administrator
)."
Bank b
Robert P. Conwa
Manager
Vice President & Tax Executor
Decedent died
August 6
of the estate of the above-named decedent being duly sworn, depose
and say
(MONTH)
Name and address of attorney or }
other authorized representative to whom
all correspondence should be mailed.
(DAY)
, 19~{testate leaving a last will, copy of which i. heret~ attached.}
(y EAR) :HJUIa&
The Commonwealth National Bank
10 S. Market Square, Harrisburg, PA
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
(EXECUTOR-~X~
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
CODlDonwealtli National Bank Harrv F. Rubert "
Carlisle, Pennsylvania
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:
B
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real Jlroperty
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 stiII 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 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 iDllebtedness of the United States to the de-
cedent; all obligations, whether by statute or agreement they are designa~ed 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, 1(9t -by decedent,
together with the fairly. estimated market value thereof; all bonds and mortgages held by dec'edent and of all
claims due and owing decedent at the time of death, and all promis sory 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 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 liabili ties
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 l),usiness.
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 mlL'5t 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 t.o
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. 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 Ily
virtue of the exercise by decedent, either individually, or jointly with another, or any power of ~ppoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another,
with a copy of the instr\unent 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 "esti ture of
real estate and the date of acquisition of personalty, plus the name, address and relationship, if :i.W,'.
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fu11 y and in d,',.,1il H II <tellt:"
and deductions claimed for and on behalf of this decedent's estate, incluoing funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; eOllnsc~l r,~es f1.ncl t'udiciary'"
commissions paid or to be paid; cost expended for burial trusts, tombstones or gra\,'m,c,]'ker"" ,m,~ re1. i-
giouS services, in consequence of the death of the decedent; debts and claims owing and Ilnpairt 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 coIL :llyral 1'1.,dg..d ~'or obligc,.-
tions, if any. It is agreed that the fiduciary will present proof of said cl,Limed obli~;"ti'ms \1pOIl 1'..-
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", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this "'......,....-"".""........... by: om'ealt~a ional Bank
..................................,...,.{p.~....... day of ............)1U)(..~............... 19",,1.(1... ....yJ.....~,...f.,;.~.~,!~~J~.P.:~....,~,on~.~....~.@~g~;:...._...
(E:recutor-~)
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MV Commission Ex,;ire':(\"~er 13, 1980 ....l:!.l:l,~.;.:L.,~.1:?~g..Lm?.~.~~.~.y.!y~i.:~.........................
Harrisburg. PA Dauphin COWlty (City CYr 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.
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Mc:;.C.~" i....l.J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENt
SCHEDULE "Au
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 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 VALUA TION
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 from this schedule.
None
/;1
Insert this total opposite "real property", Schedule "A" in the
"As Reported" column on the last page of this return.
xxxxx
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None
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FlC C -3F;
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
.
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
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'*
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 dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
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.
Dividend on Item 112 of .50 per share
declared 7/20/78; payable 8/10/78 to
holders of record 8/1/78
139 Shs. Guarantee Bank of Atlantic City,
Common, N.L. 10.37
1.118 Shs. Guarantee Bank of Atlantic Cit
Scrip
Item
No.
ITEM
List and describe fUlly
Intangible Personal Property
1. 58 Shs. Commonwealth National Bank,
Common, OTC
2.
3.
4.
5. Checking Account #182-762613-4 with the
Commonwealth National Bank
6. Evergreen Savings Account #1800100461 wit
the Commonwealth National Bank
7 . Interest accrued on Item 116 to date of
death
8. Optional Account #143858 with the
Cumberland Valley Savings & Loan Assn.
9. Interest accrued on Item I~ to date of
death
I
10. Certificate of Deposit #6688011 with the
Cumberland Valley Savings & Loan
Assn. datec ~2/22/75 at 7\%
11. Interest accrued on Item #10 to date of
death
12. Cettificate of Deposit 116688012 with the
Cumberland Valley Savings & Loan
Assn. dated 2/22/75 at 7\%
13. /Interest accrued on Item #12 to date of
death
14. Certificate of Deposit #18-2326 with the
Commonwealth National Bank
15. Interest accrued on Item #14 to date of
death
16. Claim payment from Medicare
UNIT ESTIMATED
VALUE MARKEr VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
5.50
29.00
,
.9982
1,442.13
1.12
1,826.5
6,613.07
10.72
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" column on the last page of this return.
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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 death. 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 furnishings, 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 fully
UNIT ESTIYATED
VALUE ~ VALUE
17.
laim payment from Penna. Blue Shield
e~d from Capital Blue Cross
DEPARTMENT VALUATIi
(Do not write in
this space)
2.6
18.
19. etropolitan Life Insurance Company
Supplementary Contract #5960llRB
payable on death to William Rubert
and Ruth Rubert
11.0
20.
etropolitan Life Insurance Company
Supplementary Contract #584892RB
payable on death to William Rubert
and Joan Rubert
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page or this return.
x X
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Commonwealth J~
National Bank ~
c
August 30, 1978
Robert K. Reitzel
Commonwealth National Bank
10 South Market Square
Harrisburg, PA 17108
Re: Harry F.Rubert
Dear Mr. Reitzel:
In reply to your letter dated August 21, 1978 on the above estate, the
fOllowing information is listed below, as of August 6, 1978:
Checking Account - 11182-762613-4
Balance - $1,826.56 Opening Date _
Account is joint with Ruth Rubert 4/18/78
'-3.. ..,
Evergreen Savings - #1800100461
Balance - $6,613.07 Accrued Interest _ $36.97
Opening date - Unknown Account is joint with Ruth Rubert 4/18/78
Certificate of Deposits - #18-2326
Principle - $15,000.00 Interest _ $109.13
Account is in his name only.'
If you have any questions, please feel free .to contact us.
Very truly yours,
dJ~Y71~
Daryl f. M;ers [d-M)
Vice President
DSM/ljp
,....The Commonwealth National Bank, 10 South Market Square, Harrisburg, Pa. 17108 (717) 564-9500
,.
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Commonwealth National Bank
Exe~utor of the Estate of Harry F. Rubert
One North Hanover Street
Carlisle, Pennsylvania 17013
RE: Harry F. Rubert Estate
~,
Gentlemen:
This letter will confirm that the Commonwealth National Bank Checking
Account No. 182762613-4 and Evergreen Savings Account No. 1800100461 that were
in :my name and in the name of my father-in-law, Harry F. Rubert, were
convenience accounts only and were not intended to provide survivorship benefits
to me. '
The accounts were established so that I was able to pay medical and other
expenses for the benefit of Harry F. Rubert.
"
"
Very truly yours,
BC51359
Ruth P. Rubert
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aJMBERIAND
II4llEY WING,S
AND LOAN ASSOCII\TION
16 West High Street Carlisle, Pennsylvania 17013 249-2525
Mr. Robert K. Reitzel, Trust Manager
Commonwealth National Bank
North Hanover Street
Carlisle, Pa. 17013
August 25, 1978
RE: Harry F. Rubert Estate
Accounts #143858, #6688012
and #6688011
Dear Mr. Reitzel:
Please be advised that Mr. Rubert had three (3) accounts with
this association at the time of his death.
Optional account #143858 was opened May 3, 1968 in the name of
Harry F. Rubert and power of. attorney was added on April 17, 1978 in the
name of Ruth Rubert. The balance of this account as of August 6, 1978
was $3,588.21 plus accrued interested in the amount of $22.09 for a total
of $3,610.30.
Certificate #6688011 was opened February "22, 1975 in the amount of
$2~eOO.oo for four (4) years at 7%~o. The balance as of August 6, 1978
was $25,000.00 plus accrued interest of $190.77 for a total of $25,190.77.
Certificate #6688012 was opened February 22, 1975 in the amount of
$5,000.00 for four (4) years at 7%%. The balance as of August 6, 1978
was $5,000.00 plus accrued interest of $38.15 for a total of $5,038.15.
If you need additional information cphcerning these accounts please
contact this office.
Very truly yours,
1,,,&<d f ~~
Richard Kuntz
Bookkeeping Department
RK: ym r
CC: James D. Flower, Attorney-at-law
RCC-36
COMMONWEALTH OF PENNSYINANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TR4.NSFEIlS
-~
~
RESIDENT DECEDENT
(1) Did deeedent, within twn yea.. of death, make any teansfee of any mateeial paet o~.his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) ~o
(2) Did deeedeut, within two yeaes of death, teansfee peopee,y from "Jpself to hi.self and auothee oe
others (including a spouse) in Joint ownership? (Answer yes or no) No
(3) If the answer to (1) or (2) above is in the affirm~t~ve 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) Old deeedeut, In hIs lIfetime, make auy teanS,"e of peopeety wlthont eeeelvlng a valnable oe 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 tra~ferer or his
estate or be subject to his power of disposition? (Answer ~~, or no) ~o
(b) What was the transferee's age at time of decedent's death? ~/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 enjo~nt of or the right to income from the property transferred?
(Answer yes or no)
(b) The right to designate the persons who ~all possess or enjoy the property transferred or
income therefrom? (Answer yes or no) ~o
(6) If the answer to (5) ~)'/Aabove 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 wa~dransferee' s promise to
pay income to or for the benefit of care of transferor? (Answer yes or 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 ter, amend, or revoke, or 1l'bich could revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) ~o
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficialf/Aeserved 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
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
None
Insert this total opposite "TranSfers", Schedule "e" in the
"As Reported" column on the last page of this return.
None N ~
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COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFI CIARIES
I RELA TIONSHIP I
BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED 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
William F. Rubert, Sr. Son Yes Legal Specific bequest
259 Baltimore Street Iof $5000.00
Car1is1e-1 PA 17013
William F. Rubert~ Sr. & Yes Leszal ~ecific be~uests of
Ruth Pauline Rubert Dau~hter- In- CUmberland Valley
259 Baltimore Street Law Savings & Loan
Carlisle, PA 17013 optional account
i~ lla.1R'\x or ~3610.30.
.,
A ir conditioning of
~ pme valued at
n...n~~
y ",oJV"',vv
William F. Rubert~ Jr. Grandson YeA LeO's:aJ Specific be~uest of
331 Juniper Street - ~5000.00
Carlisle, PA 17013
.. 2-7-68 Specific bequest
Lisa Diane Rubert Great Grand- Yes of
331 Juniper Street daughter bicycle, $137.20
Carlisle, PA 17013 and $2500.00
Michael Shawn Rubert ~reat Grand- v,cu:! 3-1-71 ~pec ific beJIuests of
331 Juniper Street son l>icyc1e, $98.27 and
Carlisle. PA 17013 ~2500. 00
The Commonwealth National Residue
Bank, Trustee under Will
William F. Rubert, Sr. Son Yes Legal Income & prinCipal
of $250.00
quarterly. Invasion
of prinCipal by
~ fo~.emef:rT~_
- . 1,...L1U'= .
(
h
Deponent fUrther says that all the above named benericiaries are living at this time except below.
NAME DATE OF DEATH RESIDENCE
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SUMMARY
Real Property ................................................ ......... ................. (Sch. "A")
Personal Property. ..................................................................(Sch. "B")
Transfers ............................................. ..................................... (Sch. "C")
...............................................................".......................................................
.........:.............;..................................................................................................
Gross Taxable Estate ................................................................ ................
(1 )
(As Reported)
$.................................
$..................................
$......................................
$......................................
$......................................
$......................................
=
(2)
(As Determined)
$. ..' ......
$......
$ ... ...... .
$. ." .........
$.............
$...
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~ ~: "tj 0= 0-
~ 0 ~: \H : ~ ~ 0-
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~ -< ~ - <
~ ixI: ~ ;"
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c
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6 ~ l=Q' .=: 0
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RCC-37 (12-63)
COMl\IONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
-
SCHEDULE "0"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONS.HIP SURVIVED DATE
(If step-children or 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
Ruth Pauline Rubert Daughter-In- Yes Legal ~t death of her
Law ~usband trust to
. .. ~ontinue under same
conditions for her
lifetime.
William F. Rubert, Jr. Grandson Yes Legal ~ll of Trust residue
and if not liVing
to his heirs.
.
~
..
...
\
h
eponent further says that all the above-named beneftciaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
=-
(1)
(As Reported)
$.....................................
$......................................
$......................................
$........................... .....
$......................................
$......................................
SUMMARY
Real Property .......................................................................... ( Sch. "A")
Personal Property .................................................................. (Sch. "B")
Transfers .................................................................................. (Sch. "e")
s..
o .
...",~
f<""
<;;;: r::
'a QI a
._...... ::s
aQl-
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<au
s:.3~
,S....Q)
=",1::
U = 0
QI a i:lo
g &!
.................................................................................................,......................
.......................................................................................-...................................
GrosS Taxable Estate ...............................................................................
(2)
(As Determined)
$................ . .
$.........................
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$........... ."
$.................... ."
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ro- \1
z Q)
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-r
Fl C C-38
--
.
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
*'
INSTRUCTIONS, Th" 'Oh.dul. =st dtsolos. all P'op..ty, ..., ond p..aonal, own.d hy the deced.nt JOIntly
with on.th.. .. oth..., tn.Iuding intongibl.s, standing in tb. n.... 0' the d...d.nt ond otb.... List
'.al .stat. ,t.st, as .nti..ti.s, o. Joint t.nonts, giving b.i., d.s..iption, as indi.at.d onde. S.h...,.
' A', plus the da t. and pIa.. 0' .....o.d 0' ins t'~.n t ."..tin. v.sti tu.., but do no t inelud. .ntir. ti.s
o. out 0' stst. ..ai .stat. value in .stat. valuatton ,olsam, p..sonal p.op..ty should b. iisted as in
S.h.dul. ' B', pIus da t. 0' a. qut s iti on, ond tb. nam., add..s sand ..le tionsb i p (H any) 0' 'o-own... to
the decedent.
Description of Property, Date of Acquisi tion, Name Uni t percentage Estate
Address and Relationship of Co-Owners, and Place Value Share Valuation
of Record of Instrument, where Real Estate.
:'\
A.
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of' Value of'
Entire Decedent's
Property Interest
1.
u. S. Series H. Bonds
$1000. IAMl1693416H
$1000. 1AM11692451H
$1000. 1AM11693417H
$1000. IAMl1692450H
$1000. IAMl1692452H
Date issued July 1971 in the
names of Harry F. Rubert or
William F. Rubert, Sr.
Total $5000.00 ~7 ~
~c:,/
50%
S 1000.0 I>
-
(mOO~~
~ er.... 't~
L\.~.
Ins..t tbis to t., opposite ' J 0 tn tl y Own.d P.op..ty', S.h.dul. ~ ~ 2500 . 00 D "5, 0 01' , '" p .... , 0 ~
in the "As Reported" column on the last page of' this return. ':>,000
..
-
.
R E VaS 18 (8-78)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PL.EASE
PEFER TO
NOTICE OF FILING OF APPRAISEMENT
RobertP. Conway, Vice President
The Commonwealth National Bank
10 ~- M"",..,k",1- ~'l11""""'" H'hg. p~
(Executor or Administrator) ..
Inheritance Tax Division
In Re: Estate of
H """"""y F. 'R1I'h "',..,1-
Cumberland
County - File No. 2] -7A-04A3
Dear
You are hereby notified that the Ori$!inal
appraisement in the estate of Harry F. Rubert
has been filed in the office of the Register of Wills of Cumberland
County on 9 Apr>il , 19....1.9.., Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
69,252_82
None
5.,000.00
S74,?5?_8?
~
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 ~nd
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. ~~~j-(2_,_> \.. :' "_v_'J-'--'
------- C)
Date
Cl Ap,..,i 1 1 q7q
Signed
Title Administrative Officer
~,
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
COUNTY
FILE NO.
Q AI''''';' 1070
Cumberland
21-78-0483
Whereas, H.~~y t. Rnh.~,. late of Bo~ou.h qF c.~~; ole
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the " · h day of A n g]" · I g .llL, seized and possessed ofan estate
subject to Inheritance Tax under the laws of the Commonwealth of PennSYlvania;
Therefore, I, T.. n Fn l g tot H , 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:
" ". -" '"" '" fu"~ "'~,, " "" "b" .. """"~d " "'W'''o, " 00'"" moo , '0 ""...", ...," ., ". d~",", "", ". ~''''''o"
., '"' ""... ." "" 0' ,,, '-". ,... Commoow_,," ".~., ..,~,,, ,_~, ,.. oJ,", '0 '",,,... ,"d m.., ,.."", ,"""'b~ ..,.... ,... Jow,", ,,".....,
rate on any such future interest.
DESCRIPTION OF ASSET UNIT APpraisement
VALUES Made for Inheritanc
Tax Purposes
$
Real Estate ),1",...""
.... l =>, n ,.....+.. &:.0 -9__~ .R.?
'I''''::ITlJO: -r1'l!Y>JO: .u.
Jointlv Owned r:: nnn nn
.
'I'n1- .:U i~711 ')C:') 'I')
,
.
Have heen duly sworn according to law, I do here by cer . fy that the above appraisement is made in conformity
ith the law on this Q H day of " 19 .12...
-, Q---~\') \:--- \- " r ^V-V--_A_ '--^---'
Appraiser
Harrisburg
(Number and Street)
(Post Office)
-
. Penna.
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