HomeMy WebLinkAbout04-04-79
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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";-/7-77
_ RCr;-33 (4-/3;
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 Re..a:enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Cumberland
} AFFIDAVIT OF
EXECUTOR
XHOONJ6X~
IN THE MATTER OF THE ESTATE OF
CALVIN A. ENSMINGER
(STATE FULL NAME OF DECEDENT)
Late of
County
State of
PENNSYLVANIA
}"
County of
CUMBERLAND
1ffiI~~~
M. Karey Ensminqer
of the estate af the above-named decedent being duly sworn, depose S
Executor
and say S
Auqust
(MONTH)
Name ond address of attorney or }
other authorized representative to whom
011 correspondence should be mailed.
(DAY)
, 19~{~estate leaving 0 last will, copy of which is hereto attached. }
(YEAR) '~~
Decedent died
22
Horace A. Johnson, Esquire
Post Office Box 125, Lemoyne, Pennsylvania 17043
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
(EXECU TO R-ADMIN I ST RA TO R)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS to DECEDENT
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 ~hereof
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
gi ving al so separately the accrued interes t thereon, if any, down to the last in teres 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, po:>tal
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 mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair-market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued 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.
-
P,CC -~.s. l
HFsrDENT DECEDENT
SCHEDULE "B"
PERSON AL PROPEH.TY
CO~~fONWEALTH OF PENNSYLVANI~
TflANS:F'ER INHERITA.NCE 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 wi th 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.
Tangibl e personal property should be listed first (e. g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, sllch 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.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. List and describe fully VALUE MAIUGIT VALUE (Do not write in
this space)
1 Checking Account No. 180-1974-5 1,394.91
( CCNB Bank, N. A. )
2 Savings Account No. 008-074488-1 93S.01(
( CCNB Bank, N. A. ) ~
Interest on above S.8S!
3 1958 Oldsmobile 100.00
4 Furniture, tools and household goods 1,000.00
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(nsert this total opposite "Personal Property", Schedule "B" in X X 3,,435.80 ~,43S.8 0
the "As Reported" column on the last page of this return. .~ ...fJ
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MAIN OFFICE 331 BRIDGE STREET NEW CUMBERLAND, PENNSYLVANIA 17070 (7171774-7000
CCNB BANK. N.A.
Date
October 31, 1978
TO: !-1yers, Myers, FJ ower & Johnson
Third & Market Streets
Lemoyne, PA 17043
RE: Estate uf Calvin A. Ensminger
Name of Decedent
The following is a complete record of the above decedent's accounts
as of
August 22, 1978
Date of Death
ccount No.
'T'ype of Account
Balance on Date of Death
Principal Accrued Int.
Names on Account
(All Owners)
Date of Creation
of Joint
Ownership
L80-1974- 5
008-074488-J
Checking
$1,394.94
$ 935.01
None
Calvin A. Ensminge
Savings
$5.85.
Calvin A. Ensminge
~
R. S. Stephens
Au
)
..
. -;>----
Rec - 36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITAt\CE TAX
S C HED1!IJ: II C II
TFUNC:F'FnS
RESIDE::-.'T DECEDENT
,(I) Did decedent, within two years of death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) no
(2) Did decedent, within two years of death, transfer property from himself to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) no
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer
(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
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or 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? no
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor \fider which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) no
(b) The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no) no
(6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in 111s 1 ifetime 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 ar,) time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserved power to alter, amend, or revoke, or which conld revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If the answer to (8) above is in the affirmative, was the power to al ter, 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 to these questions should be supported by affidavit by the attending physician as
well as a copy of the death certi ficate.
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 valne 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
N~
I nsert this total oppos i te "Trans fers", Schedul e "C" in the
"As Reported" colunm on the last !,'lge of this return.
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1.AST ~'I1LL Ar:u T'STA?:ENT
1, ~al"in A. Ensmineer, 0:' 310 Wertzville Road, Enola,
:.:umbe'land \;ounty, Pennsylvania, make, publish and declare
this Lo be IllY last ':Jill and Testament, hereby revoking and
II akini~ void 8ny and all former Wills by me at any t-ime
heretofore 'lade.
1. I direct the payment of my debts and funeral exp-
3Dses B:J SOOI1 after !:,y death as may be convenient to my Ex-
ecuto~ hereinafter named.
2. I give, devise and bequeath all the rest, residue
and rewaInder of' n,y estate to ~ ~ k{2.n.;Uj A~.n'~'
3. I nominate and appoint M. Karey: ~n8mlnger if 0
to be the ~xecuto~ of this, my Will.
In WITl ~:;S;3 ':li-E:tEC'F, I he~eunto set my hand and seal
thisj'-:qday 0:- October, 1973.
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Signed, sealed, published and declared by the above
named Testator as his Last Will and Testanlent in the pres-
ence of us, who at his request, in his presence and in the
presence of ea~h ot:1er, have hereunto subscribed our names
as witnesses.
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RCC-37 (12"-63'
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BE~EFICIARlES
\
h
BENEFICIARIES AND ADDRESSES RELATIONSHIP I SURVIVED
(If step-children or I DATE INTEREST OF
State full names and addresses of all who illegitimate children I 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 l3I RTH
M. Karey Ensminger
3965 Mountain View Road
- ',-
Mechanicsburg, PA 17055 Son yes of age Entire Estate
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Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DA TE OF DEATH
RESIDENCE
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Real Property
Personal Property
Transfers
Gross Taxable Estate ..
SUMMARY
. (Sch. "A")
............(Sch."B")
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( 1 )
(As Reported)
.35,000.00
3,435.80
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R C C-38
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned hy the decedent 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 tmder Schedule
"A", plus the date and place of record of instrument effecting vestiture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Description of Property, Date of Acquisition, Name
Address and Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate.
Unit
Value
percentage
Share
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
None.
N~
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
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R E V-S18 (8-781
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY Pl.EASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
M. Karey Ensminger
3965 Mountain View
M8chanio~burg p~
(Executor or Administratorf
Road
17055
In Re: Estate of
CRlv;n Aa F.nRminep.~
CumberJand
County - File No.
2l-7~~__
Dear
You are hereby notified that the Orif:')nRl
appraisement in the estate of Cal"in A_ Ensminger
has been filed in the office of the Register of Wills of Cumberland
County on -.-!L Ap~i 1 ,19-29, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total ___
$:l<;~OOO.OO
:l~43l).80
Non P.
Nonp.
838,435a80
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.
Date
4 April 1979
Signed
Title Administrati ve Off; C".P.~
(
Note: This is not a bill.
REV-457 (B-7Bl
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAil:.
~ A:?~il lQ7Q
Cumberland
COUNTY
FILE tw.
~l 7Q-575
Where~, Calvin A. Ensminger l~eof East Pennsboro Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 22 n d day of A ug us t 191.!L, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, r.~ 0 F1l1 fin i t i , 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
$
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P~....~".,.,..., T'> 'U 3 435 80
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Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 4+'h day of Ap'Y";l 19 U-.
Appraiser
(Number and Street)
Hal?l'ilJburg
(Post Office)
, Penna.
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