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Home My WebLink About04-06-79 ..c Clio. i..'t1l.~.~.' .1./. '7'" d .!J--~ . .~ MAY O. 1 ~'79. [:'N' r ~ r\ ... '- j. "",- A'" . '...- . ..~. " " ~ SUMMARY eou"ty,....urnb... !!,d Mante Ct~rl...nO Fil. Number M., !;T""J~ . ISo.. of Death . lI(01-nh=>T 1.' Q7R FII. Date Eltat. '~me Means Eva O::';ST NAME) (FIRST NAM~ COMMOHWEAL. TH OF PEHNSYL VANIA TRANSFER INHERITANCE TAX RESIDENT DECEDEMT Mlt uN'TIAI.) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland Penltlylvanla, do respectfully report that I have appraised the real and personal property as reported In the foregoing return at the values set forth opPOlite each item In the last column to the right in Schedules "A", "8", "C", and "E", Doted: 21 March 1979 ,,/ \ ~ .' .r .:....... ...--- .. '.-' \::::~ l~-'" , ...:=:::t.:~ INHERITANCE T(~:X ~PPRAlSER .........--'. REPORT OF THE REGISTER OF WILLS ,! t; , ' \ ~ I, the undersigned duly .Iected Register of Wills in and for Curl)ber1pnd Coullty, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, except as to those item!> where a greater or leuer amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum allowed as a deduction. Dated: REmS.TER OF WILL; INVENTORY Reol Prop.rty (Schedule A) Personol Property (Schedule B) JoInt-Held Property (Schedule E) Tron"f.rs (Scheduleq TOT AI.. GAOSS ASSETS L... Debt. and Deductions VALUE AS REPORTED $ VALUE AS APPRAISED $ CODE VALUE AS REAPPRAISED OQ4+ 10+ + 3{l+ CODE. 00+ 0+ 27 i.\, -..,) 40. (SCHEDULE F) CLEAR VALUE OF ESTATE 54,541 59 Voluatlon of life e.tate. or ..:l..- annultl........ It............ It.._ $ PR1NC1P~~ __-= ~~~TO~E VALUE ~ r ESTATE TAX ASSESSMENTS _ $ ------.-.------.--.-- ---_.._--~_.---~---------- FOR USe: OF REGISTER ONLY T eJlC on $ Tax on $ -;;! ,-, /~,I 2. T ax on $ Tax on $ Tax on $. cJ;;\ Exemption. Total Estate ~ COMPUTATION OF "AX ...---....-..--.-..--.------- l._..'f 2% -- 6% .." - 5% 10% 15%:'(.1 i =_ -~-~~ $ --.--'--'---j--- (') $ -----.. -- --' ..---.-. ... . -.. As evidenc..d by Chor.!abje EXflmpf;o~ Certif,cotes iSSt.H!d by th.. Secretory of Revenue, '-*. TOTAL TAX Leu tox previously paid BALANCE Leu 5% of tox if pold within 3 month. ofter deoth $ $ E $ BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Estate tox paid $ t= s -.------t...-........ $ ---.--..-.....-..---.. ....-..._--_. BALANCE DUE $--- $ ---- TOTAL TAX BALANCE $ PAID $ __ Add interest at rote of 6% from to Supplemental Codea: (FOR USE IN HARRISBURG ONl Y) 48-Adjustment 49+Adjustment 56-Annuity 6O-lHe Estate 92+Remoinder Appraisal 93-Remainder Deduction 93C-Chorify 94-Remoinder Ruidue 96-Succe$S j ve life Estafe FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where .ub5~uent adiustments are made to the above computation of tax by the Register of Wills, for proper reason same .hould be noted below, with short explanation. ' REV-51' (8-") COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O~ BOX 2910 HARRISBURG 17105 IN YOUR REP L Y P LE ASS: REFER TO . Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT J.. O. HeC"U".1y "'" lHeh.-r1'!! rr.eC\II'CI1 II) '1 .1. PP;;W;i.'~1ol'~ .~;\ .i.. n.JH (Executor or Administrator) In Re: Estate of ..)~. }1. ~1k)!;)r'~ t_~4I'!d~~, County - Fi Ie No. ~H '" i".~__.__._._ .. . Dear , ~, '.,1 . ~ l t You are hereby notified that the ()r1dl'u!tl. ---.--- ~'.---._---_. appraisement in the estate of ~v~ ,1. ~"I!,t~.____~~__.______._____._ has been filed in the office of the Register of Wi lis of__~:;;Id"',t'!.l ------.--.------ County on %1 MIr'eh ,19_1.', Said appraisement reflects the following valuations: Real Estate__ ~'t ___.___...__.._._____. Personal Property .__4.-..:~5.J.....~.~}-...~. ___..._...........__.___.__. 14 1"'.' . . T rans fers____.__...l~_':!:.!..!: .....-..-.....--..--- --.-- Jointly Owned 'JtGtl-e T ota I ____.___.___.___.__.... . ,.-.. As to such tax that is paid within three months from date of death, 0 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 ot 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-----!~ *.'el~_.!91!______.__m Signed '_. \ Title kt"1{:)!'i'trg,t1h (;(f~', ',- Note: This is not a bi II. ~{;-U (.."", ') /' ,....,/ i/ ,i (-..;; ,.......... "- '- I"~ -C.;>J},,) '* COMMONWEALTH OF PENNSYLV ANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS RESIDENT DECEDENT COUNTY OF cr~~ IMPORTANT: This return must be completed in detail and filed in duplicat,~, 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 Rev;enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) ~ -...--- --_. -~- - Lat. of IN THE MATTER OF THE ESTATE OF } AFFm:VIT 01- ISTATM.~A~Oe:CEOENTi .----- EXECLroRS Southa'rpt.on 'ltlwn."5h1R, OJtrber~ounty ~ Pemsvlvania County of OriJer]w Jaa>b O. McO.u:dy arr:1 Richard ~____. }. ~'\ " t'~' ~ Stat. of ~ ,1 Executor S of the utale of Ihe above-named decedenl being duly sworn, depose # , 19-11L.=.te leaving 0 10.' will, copy of which i;.h~'relo attached. '\ ( YEA R) j alld say ~,.. , 'MONTH) Nome and address of attorney or } olher authorlsed represenlolive to whom all corre.pondence should be moded. Decedent died (DAYi McCrea. , nwis 24 wee~ King Street, ~hi~T.g, Pa. 17257 That as such Executors .__deponentsisatr!eiliar with the allairs of said estate and the property ClJllslllutlng F x ECU TO R...ADM1N1ST RA TO R) the assets thereof and their fair market value. That at the time of death there was lIO safe deposit box registered III decedent's individual name, or Jointly wi Ih, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, \\Ith the exception of the following: - . - -;:':-T-;;;:'::::~~":=-;:;'::;':".:;::;;:::::':::':';;'::;;;':=='_:':::-=:::;;:;'::;":-""'=-~'~=:=-===---:=':'='~';:::::;::::':~;:;;'=~;:~F:-'- - ""::::;;:==:::...-:::..-::::==. NAME AND ADDRESS OF BANK OR OTHER INSTITUTION J THIS SAFF D[~~~()~dT BOX R!7--'::iJlEO I HELAT!O~'JSH1P::'_'::j;c-.JC;)t.j" '-:::' :~:":~~ =~" D'e~"~O~~t~ ~ ':" ^",'''';M~~:~=-~_::1'O' o,~' '2"~":C '=~ 35-37 FAAt King St::reet ______+-..EsuLM..._~..or li':"'In81rl ~. .+SQ.'1-in-la':1 ~. Penna. 17257 ~___..__1101ttY-.-_ .-t-- ---- ~_ - I That the contents of said safe deposit box or boxes are itemized under Schcdulcs_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 furth fully and in detai I all the real property in the Commonwealth of Pennsylvania of which decedent died having all interest therein. It also sets forth ,he mortgage encumbrances upon each parcel of real prot/\?rty at the dale 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 t:ach of said parcels, the estimated market value thereuf as of date of death of decedent. That Schedule 8 attached hereto and made part hereof sets forth fully and in detail all personal property where saver situated owned by the decedent at the time of death; all moneys left by the decedent at the lime of death, whether in decedent's immediate possession, standing to decedent's credit in banks of depOSit, sa\lngs banks, trust companies, or other institutions, whether indivi.dually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down tu 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 hond". pc~tai savings, treasury certificates or notes and other evidence of indebtedness of the United States to Ii' i!t cedent; all obligations, whether by statute or agreement they are designated as fax free, of the United Stale" or anv state, or political subdivision thereof, or of an} foreIgn country, which are owned at the time uf <1<:a1h, all wearing apparel, jewelry, silverware, pictures, books, works of art. household furniture, horses, carriagts, automobiles, boats, and any and all other personal chattels of whalsocva, kind or nature, ldt by decedent, together with the fairly estimated market value thereof; all bonds <lnd mortgages held by decedent and Ul' 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 valut 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 dtcedent:. 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 secur, ,'s owncd hy the decedent at the time of death, with the market value there- of at such time. . '.ow. w.? II COMMONWi'.\L rH OF PEN"SYLVANIA DIPARTMENT 0' REVE!"UE BUREAU OF CO\J"TY COLLECTIONS . TRANSflER INHERIT-ANCE TAX "eSIDEN1 D!C~DENT .. . ..- . .~'f""" !,.,' ~f I fit 'j" I~rf ~: * /..:." SCHEDULE "Au REAL PROPERTY *' Real property in Pel'\nsylvQnio, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant in common with anoth.ror other, should be identified as to quantum of interest and the estimated volue should be that of the decedent's interest only. (Property held as joint te"ants with right of surviorship or tenancy by entireties should be reported on Schedule HE.") Tho ....1 pro,.,.,. located In the Common_alth of Ponnayl'lClnla .hould bo deU"N" by lot Md block nVlllbo" atroot and atr.ot numb.r, tOlothor wIth a tonoral d..e,lptlon of tho .proporty, wIth a roforonco to tho rocord of tho con.,oyol'tCoby which tho "ocedont took tltl.; If a farm .tat. numbor of a. ere.; al.. atotomo"t of mortlao. oncumbranco. upon _ch parcel at doath of doeodont. Ta.xo., a.....lIIOn.., accruod Intor.at on mottoago., .tc.,are to bo Itatod on Schedulo ",,, and muat not bo d.ductod from thla schodulo. (1) (2) (3) DePARTMENT VALUATION CAUTION (Do not wrlto In thla apoco) ASSESSED VALUE FOR YEAR OF DECEDENT'S OUTH ESTIMATED MARKET VALUE ~: .~;! :t~f~ '~~i. None ""'-'<1',0','"'' ~f ~ " ~ .J - " . '~ \ ~ ,.' , 'i-t,t~' ~' t\J N\.U ~, ~,. w~-' ~'1j, ~ ;J~:.' , -"'~ ~:~ '_1,~; ,;~ ",) :,*< lnsert this total opposite "reol property", Schedule "A" in the X X X X X II As Reported" col umn on th e last p age of thi s return. None N tfYH) ~ ~~-:.7';,;~'_f'_:,' . I " . !tee .~15 COMMONWRALTH OF PENNSYLVANIA TIU.N$FER INHERITANCE TAX SCHEDULE.ItB" PERSONAL.PROPERTY RESlnE~T DECEDENT INSTRUCTIONS: Thh SchedulelllUst d~sclo5ean tangible altd intangible personal property owned indiVidually by the decedent, at thetilJl.eof hts death. Property owned b)' the decedent jointly with another or other& llIust be listed under Schedule "!!;". Intangible personal property, titled in the name of the decedent, hut payable tit death to anOther or others, including but not limited to P.O.D. {J. S. Savings Bonds and tenta- tIve trust. at~counts, IIlUlilt be listed, despite the fact that they are not of the tidministered p-stllte. Tangtbl a personal propertyshoul d be lillted tirs t (e. g. jewelry, wearing apparel, househol d good., nnd furnishings, books, paintings, automoblles, boats, etc.) Intangible personal property, such as bonds, treasury certificatell, callh 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 interellts, interest in any undistributed estate of or income f'rom any property held in trust under the w111 or agreement of' another, even though located outside of the State, at the time of death, should be listed in this SCll,~~le. ~;. ,. ~. I<'l.' j~;\ ~",: '" !. ~::~ ~;~i 4;~', .", .; ~.'~", "(I'. .' . ,...., Item NO. ITEW List and describe f'\dly UN xiii" V AX,4lB~ ,~'}, ";.:. ESTtMA#1fE'.. : )I~1', ;. . ..... ., .~"' : ,'.! t' 'i,J fit:' ~'\.,:.;..,:;. ~. '.'1 " /."\ .\Il!; :.~i :'1:: ..,.F. !;;~{ii' #( l": ,'j Checki..rxJ Acct. #038...803-3, Peoples National Bank ofShippensl::m'g Savings Acct. t 038-B03....3-2 0, Peoples National Bank of Shippensl::m'g Christmas Club, ~les National Ba.nk Cert. of Deposit, Peoples National Bank, as foIl . . 5,053.54 8,174.75 256~25 ~'- .'t".?\, '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 2026 dated 2/~71 '2154 dated 4/1/71 '2597 dated 4/1/'2 '3584 dated 12/1/73 14456 dated 7/1/75 '4488 dated 8/1/75 14635 dated 12/1/75 15154 dated 11/1/76 .5220 dated 1/4/77 15412 dated 6/3/77 15887 dated 5/4/78" 3~000.00 I 3 ftPOO. 00 5ftOOO.00 1,000.00 1,000~00 500.00 500,00. 500.00 500.00 1,0.00.00 500.00 500.00 2,500.00 500.00 1,000.00 2,000.00 Acct1nulat.ed interest on aOOve certificates to date of death 10/1/78 557.01 Savi:n<Js Acoount, State Cap, Savings & Loan 1032-00-28296 Int. on atoveacct. to date odl death 112 sha. United Te1eammmication :tne. Stock 300.00 3.97 19.5 2,184.00 "'.i' 41 sha. Currberlanl'Val1ey Coop. preferred Stock 1 share CI.lIrb3rland Valley COOp. ocmron stock 1bcking chair,m:q;>le, ladder back Maple desk chair O:>uble cb:>r china closet Linens Sterling Silver China Fostoria Crystal Crochated bedspread Antique cup & saucer Balance of hau;eh:>ld furnishings 10.00 10.00 410.00 10.00 45.00 25.00 80.00 35.00 75.00 75.00 127.50 35.00 5.00 3,08Q.25 Insert thh total opposite "PElrsonal Property", Sehedule "8" in the 8As Reported" column on the last page of' this return. 43,532.27 x X DEPARTMENT VALUATIO~ (00 not write in this spa.ce) S D63. 51f- t <?,}\74.1S ~s I"". cl S' :::l 0 DD ' 00 -.t, .;3' 000, bO 5 DCI). 00 i i V DO ' DO \)DDO,D6 1566. DO SOD'oo 5-0.0 ,06 SbD.O!) I) Dt,)D.DD SOD,bD 'EDO .(JD ;;; SOD,DC) /500,00 l 000.00 ) ,.... ,., .;J 000. ....'w I 65'7,0 ! 3 .-, I', '0. t\ () c...). L..'_l .3, q 1 \,. ':;z.. h-j.,. D 0 ~l ... 'c.... ro' ~+\0,) \0.00 1.\5.00 d.S; , DO 't:O,OD ":1.,- at} -...>'::::. . 'IS:' DO 1~.DD \ d. "1. 50 ..3.6. OD 5.60 ~ O~D.~~ I l4-~ ,53~. ~ 1 :-.-:,; .. "--""":'~':/";":':";; ":'..,1" /,' ,'/;,;:i-:-5..:;.:. I" . 111 t.. t";; :~;.f; (*~} '~- ~.; f4. l~' .~:: ~ ~<' -,r,. ,,'~ ~i r:. .j, . )....; Tot Pen:nsylvania,Depa:rt:m:mt of Revenue . Bureau of County O:>llections Fran: '!'he Pa::>ples National Bank, Shippensburg, Pa. RE: Estate of EVA. M. MEANS, Deceased Date of Death: October 1, 1978 It is hereby certifi.ed that tOO above-nazred decedent had, on the above date, the followingacx:ounts with us: A. OIECKING ACXXltlNTS Account No. 038...803-3 '1'i tle of, Accx:>unt "',' :.4,-;J Date Opened'~ri i " . . 'l' PriQrCto 10 yeaii\ ,~{,\,;~.~' ,,~" ~,; ,,\ ~.., ,,,' "'J} . ~ 1; '~t}, It" .........-" Balance $5053.54 EvaM. M:lans B. SAVINGS ACCDUNTS Account No. Ti tIe of Account Date ~ned 038-803-3 20 Eva M. ~ans Prior to 10 years Balance (prin. an. into to death da $8174.75 :Of' C. CERTIFICATE'S OF DEPOSIT Number OWner or owners Date Face Value Earned interest (to date of death) 3753 Eva M. ~ans 3-1-74 $3000.00 $15.55 3845 It 4-1-74 1000.00 .00 4813 11 3-1-76 jOOO.OO 211.52 1928 " 11-1-70 :LOOO.OO 54.70 1972 " 12.1-70 1000.00 52.33 2026 It 2-1-71 500.00 19.79 2154 " 4-1 -71 500.00 14.94 2597 It 4-1-72 500.00 1/...94 3584 " 12-1 -73 500.00 24.89 4456 It 7_1-75 1000.00 16.02 4488 II 8-1-75 500.00 4.91 14'635 11 12-:-75 500.00 24.89 5145 II 11-1576 2500.00 6.76 othe~~20 It 1 -4-77 500.00 22.09 112 " 6-3-77 1000.00 21.07 5887 " 5-4-78 2000.00 52.61 Date : THE PEOPLES NATICNAL BANK of Shippensburg . . DEe 1 1978 l, ! .~ t per "..rtL l I..) t 'jju.'. .7;,;~;;T~:J~;~.;fi'~.;i~~:~.~,~~~",~i:~;~~~~;~:t':~'):~f~+;'F:',:,~\"~~~~:Sj!:~~1A~;lfi~'.~i'~~'~;~I-;t1~(:'~'~~\f,!t~~:~'--,< __i'f"":',; -' ~ '.' "i'\:,,: ~~.'-:,;,~,:;~,,;,~"~f:'"r; ;Wr;:,C' >\.,:: ./' , ~f:":,}":~,:"" _~~" ~ Jo,,, :,1.' ',. "dv:1',i'., ~~"" " '. }~.!" i';1',F:,;',:' /~'* ',. t':", ):~:;>/'-~if:~(" . " " ":,,, ~::i"~i"~'~,\" . .'.. . Ii; ...18....~oer:tif;i.edthat theabave-na:ned decedent had, ~" ~;:t":\',y .....,to.U.ardog .~with US I ",';;":'>~?:"'i',:)'{' "';i'!~'?iir,"'_' .' , . " " ~'~'" fil':;!?,' ~?~,"" r" , ",. '1~~" iIIli, ifi~' " '\'1" Deceased "aL r October 1 i 197:~: " on the above date, the '::,:~,~,,',~, ~""ft)'~ '8. SA~ ~ Aac:DUnt NQ.. Title of~t Mrs. ~MecUJ:4YiMean. Date Ope.ned 3-28-17, Bal. {prin. $300.00-Bal 3.97-Int. $303.91 D.O.l Valu! This aCC;O\U'lt repres~t. eonvert.ed Full paid Certificates C.~%o\!BSOF ~rr 0Wl\UW Ilste Face Value Earned' 1 .' ',., o. OTHER STATE CAPITAL SAVINGS & LOAN ASSN'. Oats: By. /;(~-n- )/~A-, \, --));tl(;(t(;~~? - .-',{ ~ F zt :',' ~.:". '.... .; ~{L ~" i':~:', ~~~, ,~', ~,~,' ~.;;w i:" 'I< ~if.~~. ~,."...., " ',4i/'ll J~: ~.~ t;J.,~r,- ,,}",: ','-' i~<" ',"-.-, ,i. i;., "CC-3& -. . .. rn~r\I.)N!m.\I.TH OF PENNSYlNANIA TIL\NSFEH INHBHI1'ANCE 'rAX . SeflSOU:t.E; "e" 'l'R4NSF'EnS RhHm~XT OECEDENT (1) Did dec~dent, wIthin two years of death, l1\a.ke any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) }(P-~ (2) Did decedent. within two years of death, transfer proper~y from himself to himself and another or others C1neludlflg If. spouse) in joint owner.hlp? (Answer yes or no) no (3) If the ansWer to (1) or (2) above is in the affirmative statel (a) Age of decedent at time of transfer 75 ' (b) State of deeedent's health at time of making the tran.fer. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, Innis ltfetime, make any transfer of property Without receiving a valuable 01' adequate consideration therefor which was to take effect in possession or enJo)'1llent at Or atter his death? (Answer yes 01' no) 00 (a) Was there anypossibil1ty that the property transferred might return to transferer 01' 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? (IS) Did decedent tn his lifetime make any transfer without receiving a v&luable~adequ4te consideration therefor under which transferor expressly or impl1edly re..rves#;,4Jrhis.l1fe w:ieny period which does not in fact end before his death: ~..", ' 1'" " (a) The possession orenjo~nt of or the right to ine~4rOl"tht"fr~rtty,~ransferred? (Answer yes or no)" . ~". i.; (b) The right to destgnate the persons who shall posses. or enjoy theW,"operty transferred or income therefrom? '(Answer fe.s or no) no ' ....... (6) It the answer to (5) (b) above is in the atfil'1ll&t1ve, state whether tile right w... reserved in decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration tor 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 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 & ducription 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 Sehedules A, B, or & ITEM DESCRIPTION NUKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) leal estate situated in Southanpton Township (Middle Spring) Ctlltler1arrl County, Perma. c:::ontai.ni.ng approximately 16 acres, being the same which Janes Q. M:mls et ux by their deed dated April 23; 1970 and recorded in CUmber1arrl County Deed Ibok "P", Vol. 23, Page 468 Q9nveyed to Jaxoos Q. ~ arrl Eva ~ ~. James G. Means died on August 14, 1974 thereby vesting the entire fee in Eva M:Orrdy Means, decedent herein. Eva M:Orrdy Means, by her deed dated August 4, 1978, conveyed said real estate to her step-daughters, Marie M. lb1 try , Betty M. ott arrl Agnes M. Chamberlin Assessed valuation $4940.00/' 19,760.00 lq ltc.D.DO J Insertthis total opposite "Tr4nsfers. t Schedule .CII in the liAs Reported- colunn on the 14et page of this retuMh 19,760.00 ICf) ll.c D . Do 1~-c"_".::r:, . , . 'ROC-37 (12..63) COMMONWEALTH OF pt.:NNSYYLANIA TRANSFER INHEIUTANCE TAX RESIDENT DECEDENT ','~ ~~t: ~~.. ~~. fl". .'. ;.;. f;~\"'" ~'.'>.".'..."',"'. .~: ~;.' ~. if':": SCHEDULE "D" BENEFICIARIES BENEFICIAR.1ES AND ADDRESSES \$tate full names and a4dresses of all wllo have an interest, vested, contingent or other w!/'.e in estute) RELA TlONSHIP (If step.c.hildren or illegitimate children!, ate involved, set forth this fact.) R.D.iS, a:>x 48, I<a C. Fink 9348 !.ana Lane, Carlisle, Pa. -u I . '; -~--Lsui.., . . I ----.-------+---.--- . '" j -_.... --r r gral'rlson +y;;- - --r-;uij~.i'~- '" t---- --- "$50-:00 ----W-.-------j---... .f----- .'-' .. ----- I , J' gran1son I-..-~~~--..--t-;tri'j~ris: $50.007 ~_._---_._~_..~-'":-P. , __.___ '..' ...yGS----.. .-, .sw....J~1.s-.s-terl.iRg..silver SURVIVED I DATE INTEREST OF DECEpENT I (IF BENEFICIARY STATE YES: IN' 'L'S1' \'f!'- OR NO i IIIIlTll I ' r.. I . ...---t-..-...-.---...-...r-... --- --..--..-.---.-.--.-. , uria--.i rock] ng eM i r Lj5- ! ;:\ ", ~~>f\ " ~;:. ~ ;. -Jaoob R. R. 13,' Shippensbul::9', Fa. Pa. )..,-';", :_r/, ~~_;:~lf "(!~: ',' ~!.~: , ;; ;': . ~'~'i'>' li'Ii>. ~I~/-' i';' Janes ar rl' P. O. Box #41, Newburg, Pa. .___. $1)0. O~________. R.D. '1, Box 400 A, Carlisle, Pa. Ibbert R. Maans -R.D. il, Box 400 A., Carlisle, Pa -',' i -..- '''-'___'._ ,,___,,___...._,__..__,_~._~ .. - ..~.__...~ .0..... "0 ..__ _+._.. ~_ Orangevale, Cali grarrldaU3'hter yes '--1-'~ --. "--'. - -_...........-... ...... . .... ....--... ! sui juris. dishes ---to --_. .....---......- ...-j-.--.......--........- i : ---.---.-.- -........-_.._,-.._-~-t----_.~_.,-_. ---~-- . I sui juris; Fostoria crystal ---j-~_......_._-_.t----...__. -" ,-_. "-..- .... P. O. Box 124, Newburg, Pa. !-bss Silvexman l.son St. ,State College, P 'granddaugh~er yes niece I' ,./ i sui juris Ba:'lspread I __ _...... __.~.____..____. '''_''-~''_''__ 1---.....-... ....:..__....-__....._....___ yes ! sui juris .__...._..,--~+-:..---._-_.,.._ .... -.----t.. -~.,_., O'.._.._.._,~_,__'_._.._. _..______,___,.~...__,.__... I ' +--.---..____. -..... ....l......__.__........ . .......__.....___._.. sui juris, United Tel. Inc. S Antique cup & sauc( yes 7 Stewart Lane, Flemington, N. J . Nephew yn , N.Y. I Niece I) ~ yes . 40 W. 84th St., NF'!W York, ~. Y_'j--' ~phPw tm1aJ.~y 1. 146 w. 83m St., New York, N. Y. j-Nep . . 1 236 Madison St. ,State ColI e Pa Niece Janes Harxisl'le';l --~........_____r._--._..-._~_.-- -~.- ."-....~-.-.-. I"; es ----f.sui..juris . .+----.llnitedTeL,. Inc.: 15ui juris -I uruf~-TeU",~_S~ sui juris l-.Uni t~g..~.l.!.... In~...!....p~ I sm j uris I i Uni tad Tel. ,- Inc."': .~.ea I') . yes sui iuris United~J.!..!J.Jp~-,: es I sui juris i JJnit.ed.~. ,Inc.~S R ~ N hews Yes -~J-..--.._._---t-...JJl)i-tg9~lLInC::"JS = ~kl~tty' ~t and ..____._..~:_:teP""d.~~~hter... ~~:~=~:_..=~~~j~~.~_..:L:~__:~~~~~g~-thi J)~poflent f'Ur-ther says that all the above-named benefl cla.rles are ll. vlu,!!; It t it! Is ti me p XI'''''' h.,low: yes Niece' NAME -"--'~- _.__._~._--._-_.._---.. '''''--- I DATE OF' DEATH J-- --...... . RE;-,l PI. \, /. ----------------- ) _._-=~I....~-_..=---..~....----...-...-..---. --'-----_.-._._.--.._,~,-----~._-..__.".,..- .._-- --_..~._.~~-. . . .. " ~~..,. eJQMMONWEAL TH OF PENNSYL VANIA TR!\NiFER INHERITANCE TAX RESJDENTpECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY ! I j 1 Ij ~ . INSTR{I('TIONS: Tht~ sehelhde IIIHBt. disclose all property, teal all/I personal, owneq by the rtececlent jointly 11'1 th another or others, ,lnCludtng intangibles, standing in the name of t.he dece~ent llnd ot.hers. I,lst. real pst.atefirst. as entireties, or joint tenants, giving brief descriptton, as indIcated under Schedule "A", plus the date and place of record of' instrument effeeting vestiture, but do not include entireties or out of st:tte real estate value in estate valuation co 1 UlIl1l. Perspnal llroperty should be listed as In Sehedu] e "D", I'lu8 date of acquisl Uon, and the name, address anrlrelat1onshil' (if any) of' co-owners to the rlecedent. ~. t .~;~.\ Unit Value Description of Property, Date of Acquisition, N~me Address and Relattonship of Co-Owners, and Place of RecQrd of Instrlunent, where Real Estate. percentage Share Estate Valuation "iii '!" ; t:l ~, H x~ i ~i/ '~::; ~ i -itl: ~~ i?~; l'~' 1!" None Insert this tllt~l (,pposite ".Jolntly Owned l'roperty", SChl~lluh' "Eft None in the "As Heportt>.d" colullltl Oil t11'J lllSt pap;e of' this rf>.t\lrn. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value or Value of hntlre Decedent's property Interest N SY\V (J ..""".... -~,.",,' ~.~ ROC-87-RI . COMMONWLTH OF PBDSILVANJA ~t or Revenue SAFE DEPOSIT OOX INV.&NTORY October 11, 1978 (Date ot Ent17) 1. Name or decedent. Eva M. Means ~tar Route 2. ShippensburCl. Pa.;/11251; 3. Date ot death. ; J .'i Ii ~/ 4. Name and address or per.on who x-.queat4t4 the opening ot the bo~': '."-:''("''.'./ ,I{'" '{' " ~', .: 1\. " '. ~ 2. Addre.. ot d.cedent. Pt4Qu~t 1, 1?7~ J. Rich~rq "'~Curdv. Box, 17, St. Thomas~ P~. 17252 5. N...", addre...., end relationship, it 8lf1', to decedent. ot pereone present a.t opening or the box. J. Richard McCurdy, Box 17, St. Thomas. Pa. 17252, Brother and co-executor 6. Hame and address ot the tinancial institution wh.re the .ate deposit box i. loca.ted. The Peoples National Bank, 35-39 East King Street, Shippensburg, Pa. 7. Date ot contract to rent box. January 9, 1941 8. Number ot box. 95 9. Title under which box is registered. Eva M. Means or Donald S. Holtry . ' 10. Names and addre.... ot persons having access to box. Eva Means, Star Route 2, Shippensburg, Pa. 17257 Donald S. Holtry, 9 West Burd Street, Shippensburg, Pa. 17257 11. Name and title ot emplo,... charged with the duty or making the inventory. Alan B. Rhinehart. As~istan~ Trust Officer and Assistant Cashier 12. Wu there a wUlin the box? (Yes or No) No 13. It 1'.., state date ot will, name and addre.. ot personal representative, if named in the will, and name and address ot attorney, it any. NLA . . Page 2 .... " " SAFE DEPOSIT OOXINVEm'ORY rn.tructiot!.e: (1)' CASH: Report total only. (2) STOCK: List in detail every common or preferred certiticate, warrant or other rights found in box. Stocks are to 'be designated b)r' name of c~,certiticate number, date of certificate, name in which stock is registered, number of shares and class of stock. (3) OBLlGATlONS of U.S. GOVERNMENT: Number of pieces, dates of issue, face value, names in which registered. (4) BONDS: Designate by nwne, amount, serial number, or otherwise. (5) SAV:mCS BANK or PASS rooKS: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) JEWELRY, corns, STAMPS, MANUSCRIPTS, .B..'TC.: List and describe as fu.ll.y as p08sible. (7) List Deeds, Mortgages, Current ~rance Po11cie,or other evldenxe~ o~ indebtedness. (8) All other contents. 1 . none 2. Cumberl and Valley Co-operati ve Associati on Stock, regi stered to Jarres Q. Means or Eva M. Means Ctf. # 534 Otd 12/10/55 1 share co~mon \<~}~ ~i~: :3i~~ ~i~ 1~j~%~5~.~. ~~:~:~ ~(lJ>) . J Ctf. #5502 Otd 7/25/68?' shares, pf-<J'.; Ctf: #7419 Otd 1011/72 7 sharetIPf~1> Regi s tered to Eva M. Means. " " . Ctf. #9498 Otd 6/1/75 2 shares pfd. United Telecommunications, Inc. Regi stered to Eva M. Means :,/ Ctf. #CU46060/'Dtd 5/29173 112 shares common 3. none 4. none 5. The Peopl€s National Bank, Certificates of Deposit; registered to James Q. or Eva M. Means. Ctf. # 1928 Dtd 11 / 1 /70 $1,000.00 1 year @ 6% Ctf. # 1972 Otd 12/1/70 1,000.00 1 year @ 6% Ctf. # 2026 Otd 2/1/71 500..00 1 year @ 6% Ctf. # 2154 Otd 4/1 /71 500~00 1 year @ 6% Ctf. # 2597 Otd 4/1/72 500.00 1 year @ 6% Ctf. # 3584 Otd 12/1/73 500.00 1 year @ 6% Ctf. # 3753 Dtd \ 3/1/74 /.1,000 .00 2 1/2 years @ 6 1/2% Ctf. # 3845 Otd 4/1/74 /3,000.00 2 1/2 years @ 6 1/2%. Registered to Eva M. Means Ctf. # 4456 Otd 7/1/75 .1,000.00 2 1/2 yea rs @ 6 1/2% Ctf. # 4488 Otd 8/1 /75 ."500.00 1 year @ 6% Ctf. # 4635 Otd 12/1/75 ,/'500.00 1 year @ 6% Ctf. # 4813 Otd 3/1 /76 /5,000.00 4 years @ 7 1/4% Ctf. # 5145 Otd 11/15/76 2,500.00 2 1/2 years @ 6 1/2% Ctf. # 5220 Otd 1/4/77 'SoO.OO 1 year @ 6% Ctf. # 5412 Dtd 6/3/77 /1,000 . 00 2 1 /2 ye a rs @ 6 1/27~ Ctf. # 5887 Otd 5/4/78 / 2,000.00 2 1/2 years @ 6 1 / 2~s 6. none 7. 20-payment life Policy; The Equitable" Life Assurance Society of the United States, Policy # 3-587-667, Otd 12/24/1924, face amount, $1,000.00. Insured; Eva M. Means Beneficiary: Jacob O. McCurdy, brother. Nationwi de Insurance-Hospital Indemni ty Pol i cy-65, Pol icy # AH-0743659, Dtd 8/10/72. Insured: Eva M. Means, $300 Hospital Monthly Indemnity for Maximum of 180 days 8. Power of Attol~ney appointing Marie M. Holtry as POA' for Eva M. Means Dtd. 6/27/78. And now this 11 day of October... , 19 78 , I hereby certi.1.7 under penalty of perjury that the above record is corr~ complete to the best of my knowledge and belief. I . J J , . ~;:'</ ., -~7i::.J --~:;-~/ , ,'/...' . . //,..( '(;'" .."-,, . /c;.."" >/ -j/ "~A.( /'J~ ' , f7"'- . . ;/" ~''''/-. .....,' i,,:.,,"..' /' S~ature Alan B. Rhlnehart Assistant Trust Officer & Assistant Cashier Print Name am Title NOTE: Use separate sheet.s it nElcesaaty. ... .. COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DAle 11 1:'1\'''''-'' 1 rp": H~.v'4n tfll',r, DePARTMENT Of REVENUE 8UIlEAU OF FIELD OPERATIONS P.O. BOX 2"70 HARRISBURG, PENNA. 17105 . . COUNTY FILE NO. ~ "1 ...."nl-:. .'''' yo 1 ":i. I" 1 11 10 ('" ," - 0" ,.,to', ~--- Whereas, ~"'Jl '. 'l:l~'U;l late of ~(';. ,"),"',,:st.t~ T...4'nl'Jhir- in the County of "'.,.1,,'" ~r:;'" Commonwealth of Pennsylvania, havn:c; die;.)], the let day of O~t "~~1" 19lE..... , seized and possessed a Ii t:t<;; subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, t",.) "',.1 ::... - r ,-.' ,an appraiser duly appointed accordi~lq t'J la'..; having been designated to make a fair and conscionable appraisement of the said estate, and to as.c:;ess and fix 1.h", C,t:}, 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 posse~si':"Hl or enjlJyrnent to collateral heirs of the deledent ~l11:'::r' ~t.,~,; t~A,,;!r.)t;u;, of any estate for life or for years, the Conimonwealth nerebY expressly rese-ryes the riqht to appraise and assess- transfer ir;fleritar\cfJ t.;:)',~~s d't th(~ ';(J','J")! c':jP.-q"~r"l rilte on any such future interest. DESCRIPTION OF ASSEl UNiT \/I-'\LUE5 l:.;) p' ,,,:, :~.~ f~'l r;r\ ; t c':: If; ~ :(, '" ce ) '-, ,~, t.~"-::'i ~;.' t" e."'~ ~ ,::.. ,,1 'l> ....:r..'~''\ \', , '" ..vt'-"WJ l'l ~"':' ?7 '1'1... ., (.' ,,, ..,. ",.. . '.-,~~, '/(':~~~'t,,;.l ,. . .' ~ fot :;,1 to,'''' " .~ ..... , - ~ .+--- --.--,,,.._____L__-i I I i --r--------..--....--t--.--.-l I " ., .-------.---.---.-.--4.....------.-4..,..----... .__;___.. i I il- '. ~ =t=-=+~-=~~~~~ ! 'I I i --..---.+---......4 I .'! ! .' "+--1 I I . 1 -----:-.--t-----.-t--'---t--.! ---- ! .-....-.t.....-------t-.-....-i .------..-.,---....----....--...--1..-...---.-.+~--....... . '.......t-..--. .. '. j n I I --+-.------n. .-.....-.-.-. ....,.----;.. I" : .--...-L---....-{L.....-..........-...... ....t."..__...._1 ! d ! I --'----.-- .....+---"....--.-tt.. '...- .........-1--.....' I .: I -----.-.----.....-+....--.-...-........41... ...... ..................+...-----., J n ~ ! " --l----.--1lt.-.-...........-i---- i ,I ;' -~----...,..1""'--.......--...,.-_.....\+'~".. d~..A...'.._.,-..........._,,' . Ii i ...--.-'....-,-----....""'"'.....-i.f.-..-......." '''' ...~"..f-."". i q ! -----...-.---~.~-,+-.~.,,-_.-....,----~"-' ,."-~~f~,, . ,...-. ...~..-.,'+.-.........""#,.. I ~ ! I ------.--....---....--..--...-L-....-......... -"4~"'" .... ........-.....I.-..-..-....-i ! !l I, -.---.---~....,...,.,~--'._--~,,-...-.- ....,.,_.>.~.-_---."....--.;.f-.~ .. .-.......-;----..' ........-'. j I' !: ----------j-...---.-tl.......' ..-.-..t-'''--1 ~-.::-===:',~~:-=-~~,~.,:,'.:::~'~~::::=~:::----,..."~.."'~,' .. Have been duly sworn according to law, I do hereb:1 certify that the above dppraisernent is rnade in ('cIJoemit. with the law on this Zht day of Kin'':'" --- 19 1~ "-.~ f') ....\., ( ~~"'_\;".'''' ,"-"'-'-::'''-._' ...__~_....._........ ~~_~) ~.. :,',p.7,',;,->(:, (NUlntler ann ~.i-!.~~~et) I{13rr5 Bl'lr;~ Penna. (Po~t Or~I,,:e, 'I JJ