HomeMy WebLinkAbout11-07-79
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RCC-33 (4-73)
RESIDENT DECEDENT
COUNTY OF Cumberland
Late af
Cumberland
} AFFIDAVIT OF
EXECUTOR
x~RM~!km.dt~
(
)
IMPORT ANT:
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.)
IN THE MATTER OF THE ESTATE OF
Mary Elizabeth Mader
(STATE FULL NAME OF DECEDENTI
County
State of
Pennsylvania
Cumberland
} ."
County of
~)lJglfXOOKX
Elmer James Slaseman
Executor
of the estate of the above-named decedent being duly swam, depose S
and say S
Decedent died
October
(MONTH)
6th
, 19.-1.li-J testate leaving a last will, copy of which is hereto attached.}
( YEA RI ~iQlexMH!X
(DAY)
Name and address of attorney or }
other authorized repres,entative to whom
all correspondence should be mailed.
Elizabeth P. Quigley, Esquire
26 East Main Street
New Bloomfield, Penna. 17068
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
( EXECUTOR-ADMINISTRATOR)
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
DalJphin Depo~;r R::mk [;, 1',...l1cr Marv E. Mader Q~~"'~~n
301 Market Street RO<':::l F.nnlev
Lemoyne. Penna. 17043
That the contents of said safe deposit box or boxes are itemized under Schedules B&E 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 pos session, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for '~ny other person or persons
giving also separately the accrued interest thereon, if any, down to the last interest day priM 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 promis sory note s 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 r:>ayable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the market value there-
of at such time.
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and 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 tlUsiness.
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 f'orth 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 transf'ers of property, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to take eff'ect 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 transf'erees 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 co~y
of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set f'orth 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, orjointly 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 schedllle.
That Schedule 0 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 benef'iciaries for life under decedent's Will. It also
contains a statement showing which of' the beneficiaries named in the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of' the decedent and others, plus the date and place of record of instruments eff'ecting 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 deductions claimed for and on behalf of this decedent's estate, including funeral 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 accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this ~~
a~ 67
:___::~~ml~::::
.., IMlmbslOn ExWe: Jun-1 t, l'if.','
(.1MCyJ.lt~ fa. Cumberl~i\li Cmn,
NOTE: Before signing af'fidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", ~nd in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-directed.
.RCG-34 (1-641
COMMONWEAL T.H OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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. Where property held as joint tenant or tenancy by entireties, report on Schedule "E". Property hf'ld by
the decedent as tenant in common with another or others, should be identified as to quantum of interest and
the estimated value should be that of the decedent's interest only.
The real property located In the Commo!'lwealth of Pennsylvania should be
described by lot and block number, street and street number, together with
a general description of the property, with a reference to the record of the
conveyance by whi ch the decedent took title; If a farm state number of a.
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule "F" and must not be deducted from this schedule.
(1 )
(2)
(3)
DEPARTMENT
VALUA TlON
CAUTION
(Do not write
In this spoce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMA TED
MARKET VALUE
Residence located at 690 Market Street, Lemoyne, Pa.
(~ of 2 story frame double); described in deed dated
July 9, 1955, recorded in Cumberland County Deed Book
0-16-317, to Simon M. Mader and Mary E. Mader (Simon
M Mader predeceased Mary E. Mader).
~ ~J'I 0,
16,000.00 ,/
16,000.00/
~4.AJJ
~
~
~/t/~I 00
Insert this total opposite "real property", Schedule "A" in the
"As Reported" column on the last page of this return.
xxxxx
,
R E V-45-1 (8-78)'
RESIDENT DECEDENT
SCHEDULE liB"
PERSONAL PROPERTY
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER 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 Sonds and tentative trust accounts, must be listed, despite
the fact that they are not of the adminis tered 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 payable 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.
Item llEM UNIT ESTIMA TED DEPARTMENT
No. List and describe fully VALUE MARKET V ALUA nON
VALUE (Do not write in
thi s space)
Savings Account, The Harris Savings Association,
111-35857 1,345.61
1,345.61
Ins ert thi s total opposite "Personal Property", Schedule "S" in XX / 3 1-j,S- iLl /
the "As Reported" column on the last page of this return. / -
.RCC-3S
t'U\!\10\'\i~\I.I] [ I.lF PF\'\'SYIXA\' 1\
T1U\'~FFlt I\IWltIT\WE 'nx
SCHEDL'LE "C.,
T R\\' c:: FETlS
ilES IDE'.'T m:n:nF\'T
(1) Did dectldent, within two years 01' death, make any transeer 01' any material part 01' his estate, without
receiving Ii valuable and adequate consideration thereeor? (Answer yes or no) no
(:.n Did decedent, within two years 01' rleath, transeer property from himsele to himsele and another or
(,thers (including a spouse) in joint ownership? (Answer yes or no) no
un Ie the answer to (1) or (2) above is in the aff'irmative state:
(a) Age 01' decedent at time 01' transeer
(b) State of decedent's heal th at time 01' making the transeer. (Note 1).
(c) Cause 01' decedent's rleath. (Note 1).
(4) Dirl decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consirlera tion thereeor which was to take et'eect in possession or enj oyment at or aeter his death?
(Answer yes or n~ no
(a) Was there any possibility that the property transferred might return to transeerer or his
estate or be subject to his power 01' disposition? (Answer yes or no)
(b) What was the transeeree's age at time of decedent's death?
(5) Did decedent in his lifetime make any transfer wi thout receiving a valuable and adequate consideration
therefor tmder which transferor expressly or impliedly reserves for his life or any period which does
no t in eitC t end before his death:
(it) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) no
(b) Tbfl right to rlesignate the persons who sh.-,ll ]lnssess or enjoy the property transferred or
income thereerom? (Answer yes or no) nn
(0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Did rlecedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or f'o r the benefit of' care of transferor? (Answer yes or no) no
(8) Did rlecedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
because of 11 reserver! power to alter, amenrl. or revoke, or which could revert to oecedent 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 reserverl in the decerlent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions should be supporter! by affidavi t by the atten.Ung 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 neath, dates of transfers anrl to whom transferred, with
relationship of' transferees to rlecerlent, if' Iiny. Submit copy of' any trust oeerl or instrument, if trans-
fers are claimed to be non-taxable, also submi t rletail ed statement of facts on which said claim is based.
NOTE 3: List applicable property below in manner in whic!1 provirler! in Scherlules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
NON E
Insert this tot.:J1 oppositp "Transfers", Schednlp "en in the
... '\<.:; Pnrl.'!"'tpr!" ~-"nl'l:1Tl "'n ~.l!f) l i1....-t ~.., .~f' ~~\i~ rptl!"!"";~
./Lt1-n.(
,
,we-57 (9.27f.3)
,
COM\101'\\YEALTll OF PF'J~:"YYLA\jrA
TRA;\lSFF:l\ [:'-illFHITANCE T,\X
HESIDENT j)f:CEDE~T
SCHEDULE "0"
BENEFICIARIES
h
B~NEF[~~AR~~-~~~D-~~;~-~F~~SES r(lr~i~~1~~~~~Por I SURVIVED I DATE INTEREST OF
state iull name~ and addresses 01 all Whol illegitimate children DECEDENT OF BENEFICIARY
ave an intel-pst, vested, cont ingent or other- are involved, set STATE YES IN ESTATE
Wl~W, in estate) forth this fact.) OR NO BIRTH
Rosa Epplgy___ ________ Sister Yes Legal 1/4 of Estate
690 Market Street
--
Lemoyne, Penna. 17043
-----"--
-~--------_._"._,.. ---.--
Alice Mader Slaseman Daughter Yes Legal 1/4 of Estate
Lancaster. Penn~_.
------.---
Elmer James Slaseman Grandson Yes Legal 1/4 of Estate
P. O. Box 214
---_._~---
New Cumberland, Penna. 17070
--.---.
Alice Wilt Granddaughter Yes Legal 1/4 of Estate
-----.
Lewisberry, Penna.
-- -.--.-
--
-
-
-----
H_~__ _
Depor:ent further says that all the above-named beneficiaries are living at this time except below:
~---~-"-'~ -.-- - - IDATE OF DEATH
NAME RESIDENCE
.... --:-
3 .....
r:<~
V; ~ c
'2 Q) S
'5 a;.::
'00.8
~ 1L
8'-'"g
"5t;t::
'-' ::l 0
~ S go
~ ~
Real Property
Personal Property
Transfers
SUMMARY
(Sch, "A")
. . . . . . ... ........(Sch. "B")
.. ........... ..(Sch. "e")
( 1 )
(As Reported)
(2)
(As Determined i
Gross Taxable Estate
$
$
$
$
$..
$
$
$
$
$
$
$
t-
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.... W ", ~tr.'1
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Rex -:38
COMMONWF\LTH OF l'EN'lSYLV\NIA
THANSFElt f'iHFBIT\NCE TAX
SCHEDULE "E"
JOINTLY O'NNED PROPERTY
RFsmENT DECEDENT
I~STRrCTIO!\S: This schenule must disclose all property, real ann 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 tmder Schedule
"A", plus the date and place of record of' instrwnent effecting vesti ture, but no not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus nate of' acquisi tion, and the name, address ann relationship (if any) of co-owners to
the decedent.
Description of' Prope;ty, Date of Acquisition, Name I unit
Address and Relationship of Co-Owners, and Place ! Value
of Record. of Instrwnent, where Real Estate. ,
-:,,: .
percentage I \T~,~tate
Share ~ation
---;r
$25.00 Series E Bonds, Mrs. Rosa S. Eppley or
Mary E. Mader I
Sisters; 690 Market St., Lemoyne, Penna.
Q1069450393E Nov. 1952./ b4.59.... 50% I 27 . 30 ./
Q1218202778E June 1955" ,50.34..... 50% 25.17 .....-
Q1208444789E March 1955..... 49.69..... 50% 24.85 ......
Q1199860433E Jan. 1955- 51.18'" 50% 25.59 ...-
Q1963369130E Oct. 1962 ' 40.18~ 50% 20.09......-
Q1955803791E Aug. 1962..... 39.99v 50% 20.00 ....
Q1948355025E June 1962'- ~1. 19/ 50% 20.60....
Q2396759654E Feb. 1969.... 31. 43...... 50% 15. 72 .....-
Q2317315203E Jan. 1968......... 32.67"" 50% 16.34 ....
Q2383443834E Dec. 1968 31.43-' 50% 15. 72 ....
Q2369779907E Oct. 1968 · 32.01/ 50% 16.00......
Q2346207280E July 1968" 32.01./ 50% 16.00 ......-
Q2336690120E May 1968 ... 31. 71.... 50% 15.86.....
Q234395735E March 1968" 32.67- 50% 16.34 ....
Q2301960289E Nov. 1967 ,/ 32.35- 50% I 16.18 ......
$100.00 Series E Bond, Mrs. Mary E. Mader or
Mrs. Rosa S. Eppley, Sisters, 690 Market St.,
Lemoyne, Penna.
C353355971E
Aug. 1958
88.16 V 50%
94.08/
85.84
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
R C C-39 (!5-68)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX SUMMARY
RESIDENT DECEDENT
-
Estate of Mader Mary -- E. DATE OF DEATH10/6/78 FILE NO. 21-78-0587
(Last Name) (First Name) (Initial)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
,
?-:r.:1sylvania, do respectfully report th;>t I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
=-~ated: 7 November 1979 ~Lnd!j}/ xlirru_J
INHERITANCE TAX APPRAISER
__n -- - ---
REPORT OF THE REGISTER OF WILLS
, ~
I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser 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:
REGISTER OF WILLS
- -
INVENTORY VALUE AS REPORTED V ALUE AS APPRAISED V ALUE AS REAPPRAISED
f" al Property (Schedule A) $ 16.000 ~ $ $
Personal Property (Schedule B) 1,345
Transfers (Schedule C) _.>"-
Jr>;n t - Held Property (Schedule E) 385 84
TOTAL GROSS ASSETS 17,731 45
Less Debts and Deductions 4.400 82
(SCHEDULE F)
fT'_EAR VALUE OF ESTATE ---.1l.330 63
Valuation of life estates or
lnnuities . . . . . . . . . . . . . . . . . . . $ t= t= t=
EST A TE ~~ "X ASSESSMENTS $
FOR USE OF REGISTER ONLY COMPUTATION OF TAX
Tax on $ 2% $
Tax on $ 6% $
Tax on $ 5% $
Tax on $ 10% r:; -, --
Tax on $ 15% $ ------ -,
Exemptions * (*) As evidenced by Charitable
Total Estate Exemption Certificates issued
TOTAL TAX $ -.,.---- -.. __L- by the Secretary of Revenue.
Less tax previously paid $ t=
BALANCE $
Less 5% of tax if paid within
3 months after death $
BALANCE OF INHERITANCE TAX DUE $ t=
Add interest at rate of 6% from
to $
AMOUNT OF ESTATE TAX ASSESSED $ C
Estate tax paid $ L-
BALANCE DUE $
Add interest at rate of 6% from t=
to $
TOTAL TAX BALANCE $
PAID $
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
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REV.518 (3-79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P. o. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
I nvestigation Division
NOTICE OF FILING OF APPRAISEMENT
i :t r! - ,. It. v,,'" ~ ;" ~" . .!!',"lA"
P. t. ~.- (~';" *'" 1. 'i
N f- \. " " "' ,..,. ".. 1 ;~ ~- '.. p ^
(Executor or Administrator)
~ 7.1-.0
In Re: Estate of
,. ,t."" 1 -r- ., 1J' -;"'''~ '}..
~t:..' ......" "'- ~
County - File No. ~ 1- 1 "\.. ,.': ,I"
Dear
You are hereby notified that the ());'i ~-' I:'
appraisement in the estate of ",' ~~\~:'
has been filed in the office of the Register of Wills of rl,,'."';"~'" ,
County on "7 1', ,..1 -,", , 191~~. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
,,. .
"'. if ~;, ,. !. .. r ~
It el;t ~-
"\ f' " . r. 'I
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
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Signed
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Title
NOTE: This is not a bill.
. .
REV-457 (B-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT II\IHERITAI\lCE TAX
APPRAISEMENT
DATE 7 Nnv~mh~,... 1 q 7.9....
COUNTY Cumberland
FILE NO. ?.l=2J}...O.2_,~1____~,__
Whereas, Mary E. Mader late of Lemoyne __
in the County of Cumberland Commonwealth of Pennsylvania, havin9 dicrt r'11
the 6th day of October 197~,seizedandpossessedofanestilte
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Sandra Stone ~ ,an appraisHr duly appointed accccdinc; to 16\'1.
having been designated to make a fair and conscionable appraisement of the said estate, a:1d to ,1SS0~S ..wd ii" the r.~;i"h
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 11eirs of th,' decedent after the expiratior:
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 coll.,teral
rate on any such future interest.
DESCRIPTION OF ASSET UN! r I i=\ppr aiSP111ent
VALUES .. rvlc:.de f0r ~nheritance
Tax Purposes
f 'I
P",,~l F.~T;:!TP '" , h Q..Q..Q.. ~ .
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P~r~onal Prooertv I 1,345!~
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Transfers None! j
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Total g17a73l!45
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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 7t-n day of Nnv~;rdl ' 7-.' 19 7...2..-.
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./ Appraiser
(Number and Street)
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(Post Office)
. Penna.
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