HomeMy WebLinkAbout04-11-79
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COMMONWEAL TH OF PENNSYLVANIA
DEP AR TMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
~ 1- I f"- S-7!
.
RC(;-33 (4-7S'
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'ltenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cumberland
Pennsylvania
Cumberland
} AFFIDAVIT OF
EXECUTOR
-JfrDMtl'oK~1t'
IN THE MATTER OF THE ESTATE OF
Wilda M. Line
(STATE FULL NAME OF DECEDENT)
County
State of
}"
County of
""llmmmmmrrmo-
Mary L. Sheaffer and Phyllis L. Lackey
of the estate of the above-named decedent being duly sworn, depose
Executor
and say
Decedent died
October
6
, 19~{~estate leaving a last will, copy of which is hereto attached. }
(YEAR) ....._
(MONTH)
Name and address of attorney or }
other authorized repres.entative to whom
all correspondence should be mailed.
(DAY)
George B. Faller
Ten West High St., Carlisle, Pa.
That as such Executors deponent is familiar with the affairs of said estate and the property constituting
lEX E CU 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
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
Farmers Trust Co., Carlisle. Pa.
THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN NAME OR NAMES OF HOLDERS TO DECEDENT
Mrs. David W. L1ne
(a/kla Wilda M. Line)
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 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 pos ses sion, s tanding to decedent's credit in banks of deposit, savings
banks, trust companies, o,r 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 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 anv 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 dea th of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the market value there-
of at such time.
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business, and in support of the value of such interest there is annexed to
said schedule, financial statements showing the assets and liabilities of said co-partnership or lmsiness.
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 tile schedule a cOllY
of the deed, trust agreement or other instrument creating the trust. There is also set forth in said
schedule a list of all property, real and personal, with its value, which passes at decedent's death by
virtue of tllf' exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested ill decedent, either individually or jointly, by the will, deed, or other instrmnent of' another,
with a copy of' the instrument 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' thei I' 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 aml 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 ~lneral 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 statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in BC cordance therewith.
That
have
the totals of the appropriate colUllllls in Schedules "A", "B", "en, "E", and "F" as directed therein,
been carried forward and properly registered in the Summary.
~J:/' ~fI-e-d
Q~t~~:!:~~Ym____m__-
(Executor-Administrator)
Subscribed and sworn to before me this uuuuu,'UUuuu,""'uu
--fJ:. ...... day;'(J;tL19Z9
nuun...n;z{:li{<:Uty........... ,......'l<:U..?~\/..."...u.
..............................................................................................................n.........0'
(Street Number)
(City or Town and State)
NOTE: Before signing affidavi t 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 requirert under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Surrnnary" has been properly completed as above-directed.
RC C.~'4 (4.73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
. TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE uA"
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 loeated In the Commonwealth of Penn.ylvanla .hould be
described by lot and block numb.r, .treet and .treet number, together with
a general de.crlptlon of the prop.rty, with a ref.r.nc. to the r.cord of the
conveyance by which the decedent took tItle; If a farm .tate number of a.
ere.; 01.0 .tatem.nt of mortgage .ncumbrance. upon each parcel at d.ath
of decedent. Taxe., a.....m.nt., accrued Intere.t on mortgage., etc.,are
to be lI.ted on Schedule "F" and mu.t not b. deducted from thl. schedule.
(1 )
(2)
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this spoce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
House and lot known as 207 Second St.,
Boiling Springs, South Middleton
Twp. See deed l2"G"289. David W.
Line predeceased. Sold for
3330.
20000.00 //
..---.
c
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
20000.00
2. 0 ) 000 .0J
pee -3F
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
CO~Th10NWEALTH OF PENNSYLVANIA
THANSFER 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 f'act that they are not of' the administered estate.
Tangible personal property should be listed f'irst (e.g. jewelry, wearing apparel, household
goods, and f'lirnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certif'icates, 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 f'iduciary in said capacity, partnership interests, interest in any undistributed
estate of or income f'rom any property held in trust under the will or agreement of' another, even though
located outside of' the State, at the time of' death, should be listed in this schedule.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No. List and describe fully VALUE MARKET VALUE (Do no t write in
this space)
-
1. Checking account, Farmers Trust Co. ~3t'f6 //
#7-1753-3 cae~.3Y/
2. United Tel. Co. - refund 3.12 /
3. Blue Cross - refund 14.95
4. Metropolitan Edison - refund 6.23
5. Household COD ten ts 1500.00
(nsert this total opposite "Personal Property" , Schedule "B" in X X 1726.67- \ B8 B ,t \0
the "As Reported" column on the last page of' this return. ISfh: I"
FARMERS TRUST COMPANY
CARLISLE, PENNSYLVANIA
Date
March 6, 1979
Geor~e B. faller Esq.
10 We"t Htgh Street
Carlisle, Pa. 17013
Re: Estate of Wilda M. Line
Date of Death October 6, 1978
Dear Geor[;e B Faller
In answer to your request concerning accounts owned, either separately or jointly, by
the above referenced decedent and the balance in each account .as of the date of
death, we have checked our records and are submitting the following information in
duplicate. We suggest that you file one of these letters attached to the Pennsylvania Inven-
tory forms (RCC) to substantiate the balance you report.
Note that we have shown the correct registration for each account. Also, interest accrued to
the date of death, if any, is listed as a separate figure.
Very truly yours, ,
'~'JbCtL 7b~hL
~~l:;N~Jl
Bkp. Dept.
Checking Acct. # 7-1753-3
Balance $363.86
RCC-1S
CllMMO\WEALTII OF I'E:\l\~YLrANI A.
T1{A\~FFit I\I1F1UTAr\CF TAX
SCHEDULE "c"
TIL\\,'~FEIlS
itES I DE ','1' mTFIW\T
(1) Did decedent, within two years of death, m'tkt~ any tl'l.nst'er of any mdterial part of his estate, WjthOllt
rece i v ing a val uaol e and adequr, te consi der" Lif/ll there fo r? (Answer yes 0" no) No
(2) Did decedent, wi thin two years of death, transfer p"operLY from himself to himself and another 01'
(,thers (including a spouse) in joint ownership? (Answer yes or no)~_
(a) I f' the answer to (1) or (2) above is in the affirmat.ive state:
(a) Age of' decedent at time of transfer
(b) State of decedent's health at time of' making the transf'er. (Note 1).
(c) Cause of decedent's de,lth. (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 ef'fect in possession or enjoyment at or after his death?
(/\.nswer yes or no) No
(a) Was there any possibility that the property transferred might return to transf'erer or his
estate or oe subject to his power of disposition? (Answer yes or no)
(b) What was the transf'eree's age at time of' decedent's death?
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which trllnsferor expressly or impliedly reserves for his life or any period which does
not in fllct end before his death:
(a) The possession or enjoyment of or the right to income from thfc' property transferred?
(Answer yes or no) No
(b) The right to designate the persons who shall possess cr enjoy the property transferred or
income UlC,'efrom? (Answer yes or no) No
(0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone qr others ____
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for the Lenefi t of care of t,'ansferor? (Answer yes or no) No
(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\l<1 revert to flecedent under terms
of transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (H) aLove i., in the affirmative, was the power to alter, amend, or revoke the inter-
est of tile beT'eficiary reserved in the decerlent alone or the decedent and others?
(Answer yes 0 r no)
NOTE 1: The anSwers to these questions should be SUllpOl'ted by affidavit by the attemUng physician as
well as a copy of' the death cer-tificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferrer!, it's fair market value at date of death, dates of transfers and to ~'hom trflnsferred, with
relationship of transferees to rlecedent, if any. Submit copy of any trust deerl or instrument, if trans-
fers are claimerl to be non-taxable, also submit detailed statement of' facts on which said claim is based.
NOTE 3: List apl'licable property below in manner in which provided in Schedules A, B, or E.
ITEM
UESCRIPTION
MARKET VALUE
(Es tima ted)
m~PT. VAU,t\Tm:-<
(Dept. Only)
none
Insert this totfll opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
Ree:'J? (J:2-6J)
CO~t]\IO?\l"TALTl! OF PEX:\'SYYL\:'IiIA
TRANSFER INHERITA!\'CE TAX
RESIDENT DECEDENT
SCHEDULE "D"
~~,
~'./J~' t
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Tj /r '11,..:.,,::';',,",__ J
L.~,"'""" ",0
>::~ J/: ',>"";,:,"" ~,::,.~", ";, ;"
BE~;EF]CIAHIES
~ B~NF.FICIARIES AND ADDRESSES ~If~~~~1~~~;~Por I E~~~-~'IV,E~T
\::;tate tull "6,mes and addresse.s of all who 1 illl'g. itimate chlch'en ~E(;l'~~)LNJ I
have an interest, vested, contingent or other- are involved. set STA fL YES
wise, in estate) t-I forth thi" facC) OR NO I
- I
Mary L. Sheaffer dauQ'hter I yes l
321 E. Louther St.. I i
Carlisle. Pa. 1
I
yes I
I
I
-I
n'JTEREST OF
BENEFICTAHY
TN EST,\TE
DATE
OF
BIRTH
1/5 residue
Phyllis L. Lackey
591 "D" St.
daughter
1/5 residue
Carlisle Pa.
Helen E. Ault
4C L nnebrook
Mi11ersvi11e, Pa.. 17551
dau hter
yes
1/5 residue
Arthur A Line
R. D. 4. Carlisle Pa.
son
es
1/5 residue
Robert E. Line
R D 1
Boiling Springs, Pa.
son
yes
1/5 residue
-I --
- I
-
I
i
I
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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Heal Property
Personal Property
Transfers
SUMMARY
(Seh. "A")
. (Seh. "B")
(Seh. "e")
(1)
(A,~ Reported)
(2)
(As n.'tl-rminedl
Gross Taxable Estate
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RCC-38
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by 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 Imder 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 unit Percentage Estate DEPARTMENT VALUATION
Address and Relationship of Co-Owners, and Place Value Sh are Valuation CAUTION-Do not Write
of Record of Instrume nt, where Real Estate. In This Space.
Value of Value of
En ti re Decedent's
Property Interest
DOne
N~
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" co I \llllI1 0 n the last page of this return.
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEAL TH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE April 11, 1979
COUNTY Cumberland
FILE tJO. 21-78-0578
Whereas, 'Wilda M. Line late of South Middleton Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the h+"h day of O('t.n"h~,.. 19 ..:za., seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fulginiti ,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
$ 20 000
0......,1 ~ 00
~ - ~ . 1,888 16
Transfers None
T. . .L_H~ln - None
TOTAL ASSETS it;:> 1 8P,p, It)
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 11 th day of ~ 19 -29..
L-~ ~~. ,
Appraiser
(Number and Street)
Harrisburg
. Penna.
(Post Office)
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R E V-5IB (8-78)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIOHS
P.O. BOX ?970
HARRISBURG
17105
IN YOUR REPLY PL.EASE
REFER TO
Inheritance Tax Division
HOTICE OF FILiHG OF APPRAISEMENT
Mary L. Sheaffer Phyllis L. Lackey
321 E. Louther Street 591 "D" Street
CarliRlp., PA 17013 Carlisle, PA 17013
(Executor or Administrator)
In Re: Estate of _ Wi 1 da M. Li ne
Cumberland
County - Fi Ie No.
21-78-0578
Dear
You are hereby notified that the Original
appraisement in the estate of Wi1da M. Line
has been fi led in the office of the Register of Wi lis of Cumberland
County on April 11 , 19-22., Said appraisement reflects the following
valuations:
Real Estate
Persona! Property
Transfers
Jointly Owned
Total
20.000.00
1.888.16
None
None
$21,888.16
As to such tax that is paid within three months from date of deoth, 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.
Oa'e .l.prilll, 1979 S;gned L€-N 'F~) ~
Title _-.Administrative Officer
~ .--------..
Note: This is not a bill.