HomeMy WebLinkAbout03-20-05
ReC-33 (4-7~J
.
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
,.2 / - 11 f - (I .5~/ .!J
-*
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~enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
EvA M. MEANS
(STATE FULL NAME OF DECEDENT)
} AFFIDAVIT OF
EXECUTORS
A~R
IN THE MATTER OF THE ESTATE OF
Late of
Southarrpton 'Ibwnship, Cumberlanctounty
Pennsylvania
County of
Cumberland
Jacob o. McCurdy and. Richard McCurdy
} ..,
State of
~
Executor S
of the estate of the above-named decedent being duly sworn, depose
and soy
Decedent died
, 19-.-ZL{testate leaving a lost will, copy of which is hereto attached. }
(YEAR) ~
October 1
(MONTH) (DAY)
Name and address of attorney or }
other authorized representative to whom
all correspondence should be moiled.
McCrea & Davis
24 West King Street, Shippensburg, Paw 17257
That as such Executors deponentsisaiJeiliar with the affairs of said estate and the property constituting
(EXECU TO R- ADMINIST 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 S....FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Peoples National Bank
35-37 East King Street Eva M. M2ans or Ibnald S. son-in-law
ShiDDensburq, Perma. 17257 Holtry
That the contents of said safe deposit box or boxes are itemized under Schedules B of this return,
with the exception.of the following, for the reasons hereinafter set forth:
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
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 priIDT 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 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 interes t thereon to the date of decedent's
death and other investment secur.;ics owned by the decedent at the time of death, with the market value there-
of at such time.
In the case o"f securities o"f close or "family corporations, the values reported are as f'ar as
possible substantiated by "financial statements of' the corporations, showing the assets and liabilities
thereo"f as o"f the date o"f death. The schedule also sets f'orth the interest of' decedent at the time of'
death in any co-partnership or business, and in support of the value of such interest t~lere is annexed to
said schedule, "financial statements showing the assets and liabilities of said co-partnership or b.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 must be submitted. It should also set forth in itemized f'orm, 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 transf'erred, 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 COllY
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said
schedule a list of all property, real and personal, with its value, which passes at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested in decedent, either individually or jointly, by the Will, deed, or other instrument of another,
with a copy of the instrument creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof' sets forth the names and addresses o"f 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 ann beneficiaries f'or life unner necedent'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, ann the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instruments effecting the vestiture of
real estate and the date of acquisition of personalty, plus the name, address and relationship, if any,
of' co-owners to the decedent.
That Schedule F attached hereto and made a part hereof' sets forth fully and in detail all debts
and deduction" claimed for and on behalf of this decedent's estate, including funeral expenses paid;
f'amilyexemption, where applicable; costs of administration of this estate; counsel fees and ~ldiciary'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 ann unpain at time of
death; taxes accrued chargeable for period prior to decedent's neath (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of' collateral plenged for obliga-
tions, if any. It is agreen 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.
Hi' (" r, "t':-: r..,....-..v P;J!:-!!C
.. t\1.
t,.i,'I lO;II:ili_~n~"-; [/~;Jirc.:. ::';~piJ!-I-iber 22. 1980
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the wore! "None", and in case the assets include rare and unlisten securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements required unner 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.
Subscri~d and sworn to before me this ... .............................
<J rli~ De~ 78
3;JILI~~a~of (' fkM; .....19...
,
RC C-34 (4-73)
COMMONWEAL nl OF PENNSYLVANIA
DEPARTMENT OF REVEl-WE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent 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 locoted 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 ta 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 space)
to be listed on Schedule "F" and must not b. deducted from this schedule.
None None N Q{\L
None
t\.\ On e..,
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.
RCC -35
~.-
WlI
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSON AL PROPERTY
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 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.
I tern
NO.
ITEM
List and describe fully
UNIT ESTIMATED
VALUE MARKEr VALUE
Checking Acct. #038-803-3, Peoples National Bank
of Shippensburg
5 f 0.53 . 54""
Savings Acct. #038-803-3-20., peoples National
Bank of Shippensburg
Christmas Club, peoFles National Bank
8,174.75:/
A6~2
Cert. of Deposit, Peoples National Bank, as fo11
#3753 dated 3/1/74
#3845 dated 4/1/74
#4813 dated 3/1/76
#1928 dated 11/1/70
#1972 dated 12/1/70.
20.26 dated 2/1/71
#2154 dated 4/1/71
#2597 dated 4/1/72
#3584 dated 12/1/73
#4456 dated 7/1/75
#4488 dated 8/1/75
#4635 dated 12/1/75
#5154 dated 11/1/76
#5220 dated 1/4/77
#5412 dated 6/3/77
#5887 dated 5/4/78
3 ",0.0.0.. alf
3~aQO.Oa
5~ao: Oo.-
~ 00.0.. aQ/,
A,oaa.Q~
/500.. ocr
/
/So.a. 0.0.
/50.0. . acy
/500.. OCY
~,ooo. oiY'
/-500. aQ/..
/50.0.00/.
/-
2,500. .0.0. /
-'50.0..0.0.
/i,aao.aa
A;.aoo.oo
Accumulated interest on al:ove certificates to
date of death 10/1/78
~?
557.0
Savings Account, State Cap. Savings & loan
#032-00-28296
Int. on al:ove acct. to date ad! death
30.0..0.
3.97
112 shs. united Telecommunication Inc. Stock/
19.5
2,184.0.0
410..06'
10..00.
45.00('
25.aCr'
80.00
35.00./
75.0.0/
75.00/
127.5(Y
35.aa
5.00
41 shs. Cumberland Valley Coop. preferred StocJs.
1 share Cumberland Valley Coop. comm::m stock /
Ibcking chair ,maple, ladder back
Maple desk chair
Ibuble door china closet
Linens
Sterling Silver
China
Fostoria Crystal
Crocheted bedspread
Antique cup & saucer
10.00
10..00
Balance of household furnishings
/
3,0.80.25
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
43,532.27
DEPARTMENT VALUATION
(Do not write in
this space)
S.DS3.5*
~ \ 1 'f. 75
.;l.S".~6
.a DDD. Db
)
~OOO.DO
~'IOOO.OO
, 000.0/)
tJ' 0 0 D. ()l:,
0500.00
500. l)1)
5"00.00
500. Db
t Ol>D. DO
:I
.soo. 00
SDO. tdD
~ SUb. DO
soe.DO
I 0 {!) (). 00
)
dODO. SJt:)
I
-S57. D 1
.3bo.o t)
.aQl
~ li~. ()C
,
~\ D. 01:)
IO.DC
lf5. DO
a..s, Do
go. DO
~6.DO
(S. DO
15'.00
\~i. 5C)
a:). Do
5.00
40 ts'o. ~s
&.t3 5 5~. ;:, 1
I
~
To: Pennsylvania Department of Revenue
Bureau of County Collections
Fran: The Peoples National Bank, Shippensburg, Pa.
RE: Estate of E'A M. MEANS, Deceased
Date of Death: October 1, 1978
It is hereby certified that the above-named decedent had, on the above date, the
following accounts with us:
A. aIECKING ACCOUNTS
Account No. Title of Account
038-803-3 Eva M. M3ans
B. SAVINGS ACCOUNI'S
Account NO. Title of Account
038-803-3 20 Eva M. ~ans
c. CERI'IFICATES OF DEPOSIT
Number
Owner or owners Date
Eva M. M9ans 3-1-74
II 4-1-74
" 3-1-76
II 11-1-70
" 12-1-70
" 2-1 -71
" 4-1 -71
" 4-1-72
" 12-1-73
II 7-1-75
" 8-1-75
" 12-1-75
" 11-1576
II 1 -4-77
It 6-3-77
It 5-4-78
3753
3845
4813
1928
1972
2026
2154
2597
3584
4456
4488
4635
5145
,5220
Othe,a12
5887
Date Opened
Prior to 10 years
Balsmce
/ "l5053.54
/
/
Date Opened
Balance (prin. and
into to death date)
$8174.75
Prior to 10 years
Face Value ,Earned interest
/{to date of death)
/
,/'
$3000.00/ $15.55
'3000.00 . .00
5000.00 211.52
1000.00 54.70
1000.00 52.33
500.00 19.79
500.00 14.94
500.00 1/+.94
500.00 24.89
1000.00 16.02
500.00 4.91
500.00 24.89
2500.00 6.76
500.00 22.09
1000.00 21.07
2000.00 52.61
DEe 19 1978
THE PEOPIES NATICNAL BANK of Shippensburg
1 .
per JauJ r ~i
Date:
.....
'~""""'''I' .~" "._'
" .
'lb: permsylvania Depart:Irent of Revenue
Bureau of County Collections
Fn:rn: STATE CAPITAL SAVINGS & LOAN ASSN.
P. O. Ibx 1861
Harrisburg, Pa
RE: Estate of EVA McCURDY MEANS
Deceased
Date of Death:
October 1, 1978
It is hereby certified that the above-named docedent hOO, on the above date, the
following accounts with us:
A. CHECl<IN3 ACCOUNI'S
Acoount No.
Title of Ac<:x:>unt
Date Opened
Balance
B. SAVINGS ACXX>UNTS
Acoount No.
Title of Acoount
Date Opened
Bal. (prin. & In1
032-00-28296
Mrs. Eva McCurdy Means
3-28-77
$300.00-Bal
3.97-Int.
$303.97 D.O.D
Value
This account represents converted Full paid Certificates
C. CERl'IFICATES OF DEPOSIT
Nl:nti:Jer
owners
Date
Face Value
Earned Interl
D. OTHER
Date:
S'mTE CAPITAL SAVINGS & WAN ASSN.
By ..j/~2iq;d... \JlttiSldL4JC
-"{ " /
RCC-30
..;; . .
rmmON'\'K\LTH OF PENNSYLVANIA
Tlt1NSFEH INHEIUTANCE TAX
SCHEDULE "c"
TRANSFERS
'*
RESIDENT DECEDENT
(1) 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) YP~
(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 75
(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) 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?
(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?
no
(Answer yes or no)
(b) The right to designate the persons who shall possess or enjoy the property transferred or
l.ncome 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 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) nn
(8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved 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)
Peal estate situated in Sout.harrpton 'Ibwnship
(Middle Spring) Cmnberland County, Penna.
oontaining approximately 16 acres, being the
same which JaIt)2S Q. Means et ux by their deed
dated April 23, 1970 and recorded in CUmberland
County Deed Book "P", Vol. 23, Page 468 o;>nveyed
to James Q. M2ans and Eva McCUrdy Means. James
G. Means died on August 14, 1974 thereby vesting
the entire fee in Eva ~rdy Means, decedent
herein. Eva McCUrdy Means, by her deed dated
August 4, 1978, conveyed said real estate
to her step-daughters, Marie M. Hal cry ,
Betty M. Ott and Agnes M. Chamberlin
Assessed valuation $4940.00"
\e~. .
D-
V
19,760.00/ \C( lLD 0.00
J
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
19,760.00
\'1 1lo0, 00
)
.... T""'~"'" . '"",h .' """",,.=HllR I) IJUI.IlII11J, ".,
....,'., ,,\IMiIiJtli.illIiIIl8Il~~~II'I'\l-"n_~""
':'-'1 'i'~\ ...
LAST WILL A~m TESTAHENT
I, Eva M. Means. a resident of the Township of Southampton.
County of Cumberland and Commonwealth of ~ennsylvania, beinp of
sound mind and memory, do make, publish and declare this to be
my Last Will and Testament, hereby revokin~ any and all \Vi lIs
me heretofore made.
j llst debts and funeral expenses
done after my decease.
SECOND: r ~ive. devise and bequeath the rockin~ chair in the
dining room to my brother, Jacob O. ~cCurdy, or his heir.
THIRD: I give. devise and bequeath the maple desk c1'lai r to
my brother. Richard McCurdy.
FOURTH: I give, d~vise and bequeath the china closet which
came from the McCurdy family to either of mv brother~ or sisters
who desires it.
FIFTII: I ~ive, devise and bequ~ath mv linens to the four
Ho.1try, Betty :1t't,. A~I)<:t!' ir.hamo(lTlin
"'f~\ ':',
. each cnoosll",' what he OT J,e desire
SIXTH I ~ive. devise and hcqueath the sum of fifty r~so.(10J!
Dollars to each of my three rrandsons on the '1eans sid-.:.
SEVENTH: r give. devise nnd bequeath rry sterliJi.\?silver to
my granddau~hter. Jean Ott Jones.
EIGHTH: 1 give, devise and bequeath my set of ('"hina dishes.
Lamberton Pattern, to my ~randdauphter. Kay C. Fink.
NINTH: I give. devise and beq uea th my f.os tori a c rvs ta 1 to
m~ ~Tanddaurhter, Janice lIe.
TENTH: I give. devise and bequeath TTl" crocheted be(~SnTead
to my niece. N:lRcy \1055.
McCREA & M~CREA !
AtTORNEYS AT I.u I
1'1(,",.,<<[ , I'iHtl'PEN5BURG I,.
fl(NN~ i
ELEVENTH: I give. devise anc bequeath the antique cup and
..
Ii
'j
II
"
ii
~ 1
"
' ~ ....
----__..."''''''...,0 1"111 'll<ll['" 1~ ..rt- '-'J~lr1l11lU1f~ifIIi..~,gl'!.IJI.\tLIUlnjij:~:
saucer with the pink flowered design to my nenhew, Jamt'~ l!andshew
i
I
and wife.
TlvELFTH: I ~ive. devise and bequeath my State Cani.tal Savin~:
and Loan Association Stock to the ~riddle Sprinr United I'TE'sbyteri
Church.
.,:::;JJl9.;h~queath 1aJ":,;'U~.j.,'t,:,ed,. V t i 1 f ti es
;'" .... ,..... ...'. :," "-, . -.' ",'_. ..'. . '. .. . , . 'c. . ','. L. . ,', ,1,.....",..'.:_ :,~,; -'..( '.:', . ""'.' ...< "'; .." ,',' ",. --,;_, ,": . ~" . _' ,
~t the date of ciy death. equally. share and share alike.
FOURTEENTH: '11 the rest. residue and remainder of my estate
be it real. personal or mixed, I ~ive. devise and bequt'ath to
\~arie Holtry. Betty Ott and Agnes Chamberlin. equally, share and
I
share alike, or their heirs.
FIFTEENTH: I hereby nominate, constitute and appoint rnv
brothers. Jacob O. McCurdy and Richard :lcCurdy. to be thf' J:xecuto
of this my Last Will and Testament.
IN lOTNESS WHEREOF. 1 hereunto set :"1y hand and seal to
this
sheets of parer,
I
,",,~ ,'~ ~ ) )J,: J .'"
__~::.: _...!.:-,~__:-..:..:..._ ._..J;"'''-:;;~_LI:.._L_._
(SEAL)
This instrwnent was by the Testatrix. Eva ~'l. '!eans. on
the date hereof. signed. published and declared hv her t:1 be hcr
Last Will and Testament, in our prcsence, sho at her request and
in heT presence and in the presence of each other, we believinp
her to be of sound and disposin? mind and memory. have hereunto
subscribed our nam~s as witnesses.
McCREA & McCREA
ATTO..EYS AT LAW
NeWVILLE , 11I1~~EM5'U.Q
PENN'.
'I
I
I
I
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___ _ ,_:~/:."-~{iL_t_)k ~'f:.. -_______
L'.IJ ' I .J../ '.
-...L.f-J-~L_'____l.L<.i........I...,L.L___ ___
'RCC-37 <1:2-63)
COMMONWEALTH OF l'ENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES
(State full names and addresses of all who
have an interest, vested, contingent or other
wise, in estate)
RELATIONSHIP
(If step-children or
illegitimate children I
are involved, set
forth this fact,)
SURVIVED I
DECEDENT
STATE YES,
OR NO .
DATE
OF
BI RTH
b r
Pa.
ste -son
brother
James Ed ar Chamberlin
P. o. Box #41, Newburg, Pa.
INTEREST OF
BENEFICIARY
IN ESTATE
$1:)0.00
grandson
yes
sui j~i.~.._ ___.____~~o. 09_____.....
R.D. #1, Box 400 A, Carlisle, Pa.
Ibbert R. Means
R.D. #1, Box 400 A., Carlisle, Pa
yes
I sui j~ri~--T'-
I ., . I
-r-s\u-~;hS---r
~ sui juri~
I
I
sui juris I
sui juris l
I
I
.--.- !
I sui juri~
I
sui juris
grandson
R.D.#5, Box 48, Carlisle, Pa.
Ka C. Fink
9348 IDrca Lane, Orangevale, Cali
granddaughter
yes
P. o. Box 124, Newburg, Pa.
Nan M:>ss Silverroan
36 Madison St. ,State College, P
granddaughter
yes
niece
yes
Janes Handsh
7 Stewart Lane,Flemington, ISl.J.
Mary Margaret Brad
564 Benson Ave, Brooklyn , N.Y.
Nephew
yes
Niece
yes
$50.00
sterling sil'ler ..2$:___
dishes
15',
Fostoria crystal'~Z~~
Bedspread JS;
$:
Antique cup & saucer
United Tel. Inc. Stock
J. McCUrdy
St., New Yor' , N. Y.
yes
sui juris
Nephew
236 Madison St. State ColI e Pa Niece
Janes Handshew
eM Nep w
sui uris
es
yes
S\ll ]urlS
es
sui uris
Niece
]
united Tel. Inc. Stock
United Tel. Inc. Stock
Unl ted Te ., Inc. Stoc}
uni ted Tel. . Inc. Stoel
es sui uris United Tel Inc S ck
Yes United Tel Inc. Stock
. ,
~~~ ~~rl~tty Ott and yes sui juris ~~~~~~=~rd
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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SUMMARY
..(Sch. "A")
...(Sch. "B")
.. (Sch. "C")
Real Property
Personal Property
Transfers
Gross Taxable Estate
( 1 )
(As Reported)
$
$...........,....
$
$
$ ...............
$ ........... ..
(2)
(As Determined)
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$
$
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R C C-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 lmder 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
None
\\mv
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" coluIlH1 on the last page of this return. None
\\\ D'M.J
. .
REV-518 (8-781
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
17105
IN YOUR REPL Y PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Jacob O. McCurdy and Richard McCurdy
RD 1/3
ShiPPQusburg, FA 17257
(Executor or Admini strator)
In Re: Estate of
Eva M. Means
ClImherland
County - Fi Ie No. 71-78-0585
Dear
Yau are hereby notified that the Or] gi na1
appraisement in the estate of Eva M. Means
has been filed in the office of the Register of Wi lis of ClImherland
County on 21 March , 19_79, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
None
43.532.27
19,760.00
None
$63,292.27
As to such tax that is paid within three months from date of death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid after nine (9) months
(fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive;
and twelve months when death occurred prior to December 22, 1965) from date of death,
interest at the rate of six (6%) percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within
sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 373.
Dote 21 March 1979 S;gned LeD ~ ~~
Title Administrative Officer
c
-------
'-.
...,...._~
Note: This is not 0 bi II.
REV-457 (8-78) ~
DEPAI'ITMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAii::.
21 March 1979
COUNTY Cumberland
FILE NO. 21-78-0585
Whereas, Eva M. Means late of Southampton Township
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 1st day of October 19 ~, 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:
I n 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
$
Real Estate None
- " - 43,532 27
~- ~ 1 q 7 t:.f1 nn
Jointlv Owned Nnna
Total C::t:.1. ?Q? ?7
Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this ?1 !'If" day of M~rrh 19 7!l-.
\-E'..A.~ '2-~. ~
U Appraiser
(Number and Street)
Harrisburg
(Post Office)
, Penna.
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