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HomeMy WebLinkAbout03-28-79 . RCC-33 (4-73) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ** .,f-,a-7f 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'ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) L fCar1is1e, Cumberland ate a Pennsylvania } AFFIDAVIT OF EXECUTPp.. R IX ~ Caunty IN THE MATTER OF THE ESTATE OF MARGARET RUTH BA ILEY (STATE FULL NAME OF DECEDENT) Caunty of Cumberland }.. Execu~}x State of ~1luC Margaret Ruth Frederick of the estate of the above-named decedent being duly sworn, depose S and say S July 14 ,19~1 testate leaving a last will, copy of which is hereto attached..} (MONTH) (DAY) (YEAR) ~HHlQH Name and address of attorney or} GeOrge B. Stuart ather authorized repres~ntotive to whom 1. 1 P 17013 all correspondence should be mailed. 3 South Hanover St., Car 1S e, a. Executrix That as such deponent is familiar with the affairs of said estate anp the property constituting (EX ECU 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: - Decedent died NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES 0 F HOLDERS TO DECEDENT None That the contents of said safe deposit box or boxes are itemized under Schedules wi th 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 stiJI 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 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 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 whats oever, kind or nature, left by decedent, together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's death and other investment securities owned by the decedent at the time of death, with the market value there- of a t 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 husiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of tne 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.ofth,e .decefililnt' s interest. therein must be submitted. It should also set forth in itemized form, together with the fair market v'alue 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 o~ ~njoyment at or aft~r 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 rec~ivedby each transferee and all other facts of a pertinent nature regarding said transfers. In the case of transfers interided:.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 individual.ly, or jointly wi.th another, or any power of appoint- ment vested in dec~dent, ai ther .indiyidually or. jointly, by the will, deed, or other instrument of another, with a copy of the instrumen't creatln'g' such 'powerattache'Q to the' schedule. '. . That Schedule D attached hereto and made part hereof sets forth the'n'ames' 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 their death, their issue, andthe 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 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", "C", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this ................................. .=.:;.:<<1;, ..' day of go. >~C1fm 19..1.8..... ...~~~c;;~;,;;~~ ~"'_ ~ r~ ~ '\" ~J..t~~.~~;m~~ ?,9..~......~.Q~.~.h....W.~~.~.....~.~.~~.~.~........................................_.. (Street Number) Carlisle Pa. 17013 ..................................s.................................................................................................. (City or Town. and State) NOTE: Before signing affidavit 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 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. r RC c.34 (~7 3) COMMONWEALTH 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. Property held by the decedent as tenant jn 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 located In the Commonwealth of Pennsylvania should be (1) (2) (3) described by lot and block number, street and str.et number, together with DEPARTMENT a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took tltl.; 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, ass.ssments, accrued Interest on mortgages, etc.,ar. DEATH In this space) to be listed on Schedule "F" and must not be deducted from this schedule. NONE l ! 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. 0.00 f\.J o~ . < - RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* RCC-35 COMMONWEALTH 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 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. Item No. ITEM List and describe fully UNIT ESTIMATED DEPARTMENT VALUATION VALUE MARKEl' VALUE (Do not write in --this space) 3,000.0 4,093.5 3,764.6 30.69 1,000.0 1,321.9 10.38 2,615.7 .01 0.0 1. Cash 2. Checking Account No. 5-4473-6, Farmers Trust Company 3. Savings Account No. 2-03199-6, Farmers Trust Company Accrued interest 4. Aetna Life lBurance - proceeds 5. Church of God Home, Inc. - refund 6. 252 shares Puritan Fund, Inc. 7. 1600 shares Idaho Goldfields, Inc. 8. IFC Collateral Corporation subordinated debentures - Corporation in Bankruptcy -roVa1u Series 4/70/81 daed Aug. 19, 1970 Series 8/69/79 dated Oct. 6, 1969 Security No. 2582721 dated May 22, 1972 Series 8/69/79 dated Sept. 30, 1969 Series 11/68/79 dated Feb. 3, 1969 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X ~ 15,842.6 \ S. ~LlL.loL- RCC-}b CLlMMOXW'EA.LTH OF l'E:-.'NSYLVANIA T~ASSFFR ISHERITASCF TAX SCHEDULE "c" TT-t\NSFEJlS ~~~ ~.:~) '~"f"fff\ /j, ',' ~~/J?,l: '" t\, .<~,c:,~>;"l,:){ :~'v~ liES IDE','T DECEDENT (1) Did decedent, within two years of'death, make any transf'er of any material part.!;>f' his estate, without receiving 11 valuable and adequate consideration therefor? (Answer yes ,or no) NO (2) Did decedent, wi thin two years of death, transfer property from h:i,..ijls~l.!" to himsel f and another ot' others (including a spouse) in joint ownership? (Answer yes or no)~_ (3) If' the answer to (1) or (2) above is in the af'firmative state: (a) Age of decedent at time of transfer --- (b) State of' decedent's heal th 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 theref'or which was to take eff'ect 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_t!~nsferer or his estate or be subject to his power of disposition? (Answer yes or 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? (Answer yes or no) No (b) The right to designate the persons who shall possess or enjoy the property transf'erred or income therefrom? (Answer yes or no) No (6) If' the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or f'or 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 reserverl power to al ter, amend, or revoke, or which c011ld revert to decedent under terms of transfer or by operation of' law? (Answer yes or no) No (9) If the answer to (8) above i3 in the af'firmative, 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 ~'hom 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) mA'T. VALUATTON (Dept. Only) NONE Insert this total opposite "Transfers", Schedule "e" in the "As Reported" COlllJTD1 on the last page of this return. N~ 0.00 RCC-37 (12-63) CO!\tl\10~"n:ALTII OF PE;,\;,\SYYL\NIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF \State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY have an interest, vested, contingent or other are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Mar2aret Ruth Frederick Niece Yes One-fifth 503 S. West St. ,Car1i;>le, P~ . 17013 Louise Leatherv. Niece Yes One-fifth 633 Colonial Ave.,York, Pa. 1m3 ...... -. ... ... . Frances Dou2la~tJ..p. o. Box l~~iece Yes One-fifth Zeohvr Cove. Nev. 89448 Jackson Humes Frederick, Nephew Yes One-fifth 213 Kentucky Ave., Lynn Hav en, F la . ~~. "" William Tell Phillipy. Nephew Yes One-fifth 211 Shatto Drive, Car1is 1e, Pa. 17013 Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ~T. ~ ~.. .... o . ...."'.... e~'lt t;: = '2 Q) e .-...., ::s eQ)- '00.8 ~ ~: ....u'O o Q) ............ = en .... u = 0 ~eg. ~ i:l:: Real Property .............. .................................. Personal Property ..... .............................. Transfers ................ ................,.... ............................. SUMMARY . . ( Sch. "K) .........(Sch. "B") . ............(SCh. "C") Gross Taxable Estate ..... ( 1) (As Reported) $ .. .~o- $15..,.8.42..62.. $................~.O~.... $... $.... ................ $.15..842....62.... . .'. . (2) (As Determined) $ $. $ $ $... $ o .... o t'd lI"'l (l) .>- 00 r--. I ..-l N -"--' o z I>l ~ ~ ~ o :c t'd .b '" '0 _ 'S .~ ~ :::--r: [- Z ~ ~ til (,/') ..... <: ~ i:l-o i:l-o <: ~ ::r: [- ~ o ~ ~ ~ <: - "'" ~ o ~ til ~ [- "" <: o [- (,/') ~ ~ J;:t:l: ...:l H <to ~ ::z:: E: ~ f:-I ~ t3 ~ ~: '0 .Q) .Ul :" .Q) :u :Q) :c:::l J;:t:l ...:l: 00: H: ...:l ~: <to: U. ...... o IlJ .... t'd ...:i g <to S J;:t:l ~. U (IS 'S (IS ..:: ;.., '" ~ ,.. Qj i:l-o ...... o ...c:: ~ t'd IlJ .. ., ~ o E ,.. c: o U ...... o .c' :: " u c . ...;l < fI.l - < ClI: Cl. Cl. < Q ;Z < r- " o Cl. ~ ClI: "-. . . RCC-38 RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schedule must disclose all property, real and .personal, owned by the decedent jointly wi th anot.her or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated tmder Schedule "A", plus the date and place of record of instrument effecting vesti ture, 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. N . I I 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 Instrument, where Real Estate. In This Space. Value of Value of En ti re Decedent's property Interest ONE Insert this total opposite "Jointly Owned Property", Schedule "E" N cr--JI..- in the "As Repo rted" column on the last page of this return. 0.00 I REV-SI8 (8-781 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIOHS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY Pl.EASE REFER TO Inheritance Tax Division HOTICE OF FILIHG OF APPRAISEMENT Margaret Ruth Frederick 503 South West Street ('!A,..'; Ql C:) 1 Pll 17013 (Executor or Adm ini strator) In Re: Estate of Margaret Ruth Bailey Cumberland County - File No. 21-78-0.500 Dear Ms. Frederick: You are hereby notified that the Ori"ina] appraisement in the estate of Margaret Ruth Bailey has been filed in the office of the Register of Wills of Cumberland County on Mere" 2R , 1929-, Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total None 15.842.62 None None 115,842.62 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 rote 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. ~ ----:: Date March 28, 1979 Signed ~~~ Title Administrative Officer c---~______ -..--.." Note: This is not a bill. REV-457 (8-78) . DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE COUNTY FILE NO. March 28. 1979 Cumberland 21-78-0500 Whereas, Mar2aret Ruth Bailev late of Carl iRl e in the County of Curnhel'"ll'lnn Commonwealth of Pennsylvania, having died on the 14th day of July 19 .:za. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Len Ful li[initi , 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 Pu r poses 'RAAl .. $ None - ~ .. ".L 15,842 62 Transfers None T. . ''''_Hel n - None I11"\mAT 1115.842 62 I Have been duly sworn acgording to law, I do hereby certify that the above a with the law on this 2 th day of raisement is made in conformity 19 .2!L. Appraiser Harrisburg (Number and Street) (Post Office) . Penna. " . . :::.., I- "ci ~ .... Q) ~ c:: z ~ 0\ ::s w ~ '"""'i 8 :?i Q) t.> W Q) en 0 00: W ;a: (\I: ::> a: ~ ' : Z c.. t'-i ~ w c.. 0: > 0 ~ r-I: W a x ~ C[: ....' ...s ~ 'C 00: ~ c:: ~ I- ~ ..... C'-i ~ U. "U' Q) w ~ 0 ,: Q)' 0 ~ ~ ~ ..:t: t.> u 5 Q) r-I: ~ ~ I- 0 C/) "U' ~'t;l~ Z p;: .... ,: .... ..... C/) ...... ~ ~ ~ ~ ~ Q) 0 Q)' z 5. .ii:l ~ ~ .c--- ~: l- I ..!lo:: W 0.. 5. 0.. ~ 8 ,C/) ::s :2: ~ r-I: a: s..., "U c:::t: ~ ~ ~ w 0 Q) ><: I- "U t.> - ~: ~' .... cc Gl: :I: a ~ .... C/) I1l c:: .... S "U tV ~~ z .... ~ ~. .s, .... <( I1l ::s c:: I1l Q) ..... a.. "U 0 0 I1l Q Q) ~ 0::: 0 "U' ..0 <t:: I- 0 r-I: W Q) "U 0: Z .... C ~ c:: I1l ..-. ~ w ..... C/) c:: c:: ...... Q) I1l ...... ...... ~ Q) c 0 I1l ::s .Q; .... 0.. 5. & "U 0 0 .... c;; Q) t.> ~ ~ ~ .... Q) ~ Q) ~ w ~ ..-. 0::: a: q ~ k: .