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Home My WebLink About09-12-79 Inventory of the real and personal estate of Edward N. Thrush deceased. 1. Tract of mountain land situate on the South Mountain in Southampton Township, Cumberland County, Pennsylvania, having a dwelling house thereon erected. Containing 47 acres, more or less. See Deed of The Red Ribbon Gun Club, Inc. to Edward N. Thrush dated April 8, 1960 and recorded in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed Book "T" Volume 19, Page 454. 30,000 00 2. Lot of ground with auto service building erected thereon, situate in South- ampton Township, Franklin County, Pennsylvania. Containing .99 acre. 3. 4. 5. 6. 7. 8. 9. 10. II. 12. 1.13. 14. 15. 16. 17. 18. 19. 20. 2l. 22. 23. 24. 25. 26. See Deed of C. Eber Miller and Isabelle J. Miller, his wife, to Edward N. Thrush dated April 5, 1972 and recorded in the Office of the Recorder of Deeds of Franklin County, Pennsylvania, in Deed Book Volume 672, Page 613. J Savings Account - No. 1-11384-4 - The First National Bank of Shippensburg, PA Accrued interest on Savings Account No. 1-11384-4 to date of death Checking Account - No. 609-440-5 - The First National Bank of Shippensburg, P Checking Account - No. 609-568-2 - The First National Bank of Shippensburg, P1 1974 Caddilac Coup DeVille 1975 Chevy Impala - four-door sedan I 1974 Chevy El Camino I 1973 Dodge 1/2 ton pick-up truck I 1969 Caddilac - four-door sedan DeVille i 1965 Oldsmobile Convertible - two-door - requires new top I Various old laundry machines (junk or for parts) Desk I Chair Sofa Small safe Miscellaneous tools Davenport Two chairs Hy-Fi Radio set Bench and rocker Refrigerator Miscellaneous kitchen utensils Bedroom suit composed of bed, chest of drawers, dresser and mirror Braided rug TOTAL 20,000 00 218 78 36 4,863 41 73 73 I, 700 I 00 1,450 00 1,650 100 2,800 00 500 00 300 00 15 00 35 00 10 00 25 00 30 00 75 00 25 00 15 00 35 00 25 00 35 00 6 00 100 00 10 00 63,997 28 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND L J 55: Lenore T. Thrush being duly sworn according to law, deposes and says that ~e is AcImini~.,.,..~t1"iX of the Estate of Edward N. Thrnsh late of __Jl();t'ougIL of~ShippeI1sburg~___ , Cumberland County, Pa., deceased and that the within is an inventory made by her the Administratrix-- _, the said Arlministratrix of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. and subscribed before met .~~J~3LJ V ~~XX~~~ Administratrix 208 South Washin2ton Street Shippensburg, Pennsylvania 17257 Address Date of Death 12 Day Op.l"eTQher Month 1978 Yeer INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. 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'" V) ), LU 0 r--- 0:: >- U c c c c 2:' >- x 0 c 0 0 0 0 ::E <( )( )( )( )( -:;; >- 0 0 0 0 >- >- ,- >- ill -' * ~ * * <l: >- N -D '" a >- ~ Q) .- '0 x E V) -f: '0 8 E E ::J - '" C Ql OJ L U J: "- - llJ Q. ,,= '" L > ~ -' <( f- a >- 15 Q) 0 ~ Ql -f: L '0 0 -;;; Ql Q) -0 ~ 15 2 C Q) v> '0 :> -0 Q. o <( Cl. >- Z ::> a ::E <( ~ I ~ \2 "' -0 v> C) 0 -' Cl. .J wi <( '" III e ill o. <f) ~ '" .t: ., '" :l f~ ~ " ~ .g ~<~, G= 't:I .f'" III [:.) ~ c 'iij r> ~ .-:!; 8 1l c=::::J ~ d 0- f.) ~ '(0 " '" H c=::::J a: -r.~ ! 01 B " ,>1 ~ C== :g. .:: III :c t- .f REV-4!5!5 (8-78) ~ (-'I~-bJY? DEDUCTIONS ALLOWED IN OFF ICE OF THE REGISTER OF WILLS STATEMENT OF DEBTS AND DEDUCTIONS OF Cumberland COUNTY AND AGENT OF THE COMMONWEALTH ESTA TE OF Edward N. Thrush DATE OF FILING APPRAISEMENT LATE OF Borough of. Shippensburg DATE OF DEATH December 12. 1978 DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHER Shippensburg Gas Company Gas utility account 1.118 08 -. Adams Electric Comnanv Electric utili TV aCC-Olm't fi5 ?5 Pa. Electric Companv Electric utili tv account 61 60 Glenn W. Dip.hl InSllr::lnc-P. A FiT'P .; ......."""";n,,,,<" fig? 00 Borough of Shippensburg Water rental 37 21 P:l Pl",f''''~';f' ~ Pl- ...-,',.. lI'ti 1 i'tv 1Q~ ~R Adams Electric Company Electric Utility account 75 35 United Telephone Co. Utili tv account 76 13 Jean Downing, Tax Collector, ~ . 'T'wn <: h r r PA ~"'<l1 "'<1 v"'''' 5R RO ~mily Padamonsky, Tax Collector ,... 'T'wn<:h P r. PA T'p.:ll P.~'t::l'tP. 't::lYP.C; 77 ~R Jean Downing, Tax Collector, real estate . '1".......<"1,. r r D^ taxes 229 68 Pague and Fegan Hardware Store Account 46 96 Anson Goodhart Plumbing account 37 50 Oliver Oil Company Gas utility account 226 02 Pa. Electric Company Electric utilitv account 83 30 ShinnensburQ" Gas Comnanv G::l<: nti1i'tv ac-f'Olm't . 205 37 Coca-Cola Bottling Works Account 27 00 Kirbv Oil Burnin17 Sp.rvic-e A ~h 10 Adams Electric Co. Electric utilitv account 119 64 - Ke11v Insulatin2" Co. Accoun t 11 00 Preparatl.on oT-rreceaEmtTs T978 Ruth Craig, Public Accountant Income Tax Returns 48 00 Shippensburg Area School Distri t Decedent's 1978 earned Wage Tax Collector School Income Taxes 20 00 Social Security Taxes due on Internal Revenue Service A of - . 166 00 COMMONWEAL TH OP PENNSYLVANIA} SS: COUNTY OF Cumberland Estate of Edward I Lenore T. Thrush, Administratrix, N. Thrush HEREBY CERTIFY, THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF & Edward N. Thrus~ /lh. 'i /J II DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. . -2 ~ ~ '}V1U.{/ (L.S.) Lenore T. Thrush, Administratrix, Estate of Edward N. Thrush SWORN AND SUBSCRIBED BEFORE ME THIS tZ 'h l",j"Y Public Shirley i'" Sm1t , d.,: . A County ,- '01'1 CUl1,benanLO , Shippensburg "OIOU,,: " ",-', .:g3 ., ' , ~"rdfes ..,ar. lO, ' , My COlf1D1:'~IO,1 -.^", < atio11 oj Notanes n_._~"....I.,~i"'.'~ J.\.S_OCl " OFF ICE OF THE REGISTER OF WILLS STATEMENT OF DEBTS AND DEDUCTIONS THE SUM OF DEDUCTIONS ALLOWED IN $ A 7. ~P:;{. ~ (J REV-4SS (8-781 OF r.nmhp.l" 1 ::Inri COU NTY AND AGENT OF THE COMMONWEALTH CONTINUED ESTA TE OF Edward N. Thrush LATE OF Borough of Shippensburg DATE OF FILING APPRAISEMENT DATE OF DEATH December 12, 1978 DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHER Cumberland Law Journal Advertise Letters of Administrati m 18 00 Np'w<::;_r" . " r.n Advertise Letters of Administrati 10 00 m Robert E. Holtry Account 370 30 ShinnensburQ" Gas Co. Gas utility account 200 72 Pa. Electric Co. Electric utility account 38 19 Adams Electric Co. Electric utility account 146 03 P::l P"p.{' ric Co. Electric utility account 61 33 Mervin Fogelsanger Funeral Home Funeral Expense 1,532 87 ShippensburJ! Gas Co. Final gas utility account 109 25 Cathy Snidle Labor at Decedent's mountain land 6 00 Pa. Electric Co. Electric utility account 131 25 Jean uown1ng, Tax Southampton Twnsh. C.C. PA School real estate taxes 283 81 Em1ly Paaamonsky, Tax CollectoT Southampton Township, F.C. PA School real estate taxes 251 43 Pa. Electric Co. Electric utility account 54 25 Rhinehart's Electric Account 51 65 Kelly RoofinJ! Inc. Labor account ~()9,- eo Pa. Electric Co. Electric utility account 44 28 Edward Goodhart Labor and repairs to water line 26 45 Adams Electric Co. Electric utility account 40 16 Stanley Mooney Decedent's Mountain Real Estate Labor account 37 50 - Emily Padamonsky, Tax Collector County and Township real Southamnton Townshin F.C PA estate taxes 54 92 Jean Downing, Tax Collector County and Township real Southamn'ton Tnwnshin C.C. PA estate taxes 52 50 I Pa. Ele~tric Co. Electric utility account 43 18 I , COMMONWEALTH OF PENNSILVAN1A } SS: COUNTY OF Cumber Ian Estate of Edward I Lenore T. Thrush, Administratrix, N. Thrush HEREBY CERTIFY, THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Edward N. Thrush / DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. P - . j c:2~ ~ __. (L.S.) Lenore T. Thrusq Administratrix, Estate of Edward N. Thrush Shirley f.', Smith, ~:01:;ry Public Shippensburg ,:,;<11;;;;1: c;;mberland Co~nty My Commis~,;li;i L~!res Mar, 26, 1903" Member, Pennsyivania As;:oclatlon of l'MaoeS OF COU NTY AND AGENT OF THE COMMONWEALTH CONTINUED THE SUM OF REV-455 (8-78) OFF ICE OF THE REGISTER OF WIL.L.S STATEMENT OF DEBTS AND DEDUCTIONS ESTA TE OF Edward N. Thrush LATE OF Borough of Shippensburg DATE OF FILING APPRAISEMENT DATE OF DEATH December 12, 1978 DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHER Glenn W. Diehl Insurance AQ'encY Fire insurancp. on D . ,~ 1 and 17;7 100 Eby Granite Works, Newville,PA Monument 1 400 00 Glenn W. Diehl Insurance Agency Insurance on Decedent's vehicle 64 80 Labor at Decedent's momtain Stanley Mooney real g 00 Labor at Decedent's used car John Kelso real estate 6 00 lllenn W. Ulenl Insurance Agency Insurance on Decedent's vehicle 25 ,00 Pa. Electric Co. Electric utility accomt 59 47 Inspectlon of Decedent's '"cn,,' ~ ]::vvn" vehicles ~n 00 The Flrst Natlonal Bank of Balance oWlng on Decedent's Shippensbur~, PA Promissory Note 12.464 74 Glenn W. Diehl Insurance on Decedent's used Insurance Ai!ency carnremi~e~ 364 00 Reglster of Wills of issue Letters of Cumberland Comty. -.PA Administration 34 00 Lenore T. Thrush - Mother of Decedent Famil y exemntion 2 nnn 00 Register of Wills of File Inventory, Statement of Cumberland CUWILV. PA ~n,.1 -. ';n"c ~ . Q 100 Gordon H. Baker, Realtor 1",,,,.1 'co,.. Appraisal 45 100 ~~ Robert J. Yocmn, At.t.oT'np.v - ,1 - . . ? Qnn Inn Jean Downlng, Tax Collector, car lot - school Southampton Townshin. F.C. PA real es'ta'te f"ayp.s ?~~ ~~ Emily Padamonsky, Tax Collector Mom tain Land - schoo 1 Southanmf"on Townchin r. r. PA ",p::I1 t-~voc 287 02 ~igilant Hose Co. Clean spouting, trim pine tree . ...p::I1 pc:f"::If"P 50 )0 Da. Electric Co. Electric Utility Accomt 43 )0 Stanley Mooney uecedent T s r.fumtain real estate 17 :>0 Labor Accomt - Reglster of Wl11s and b~le Accomt1 Record Release and Recorder of Deeds of C.C. ecree AwardlnQ' real estate 100 00 TOTAL :2il.s8~L COMMONWEALTH OP PENNSYLVAN'A } SS: COUNTY OF Cumberland Estate of Edward I Lenore T. Thrusl\ Administratrix. N. Thrush HEREBY CERTIFY, THAT TO THE BEST OF MY K'NOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Edward N. Thrush DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. ,P !J'n! () _ ~A)/ (;L~ (L.S.) \D~ DAY OF Lenore T. Thrusl'\ Administratrix, Estate 79 of Edward N. Thrush SWORN ,)h,rley hI. S:nith, Noler, Public Shippensburg (;orJ~gh~ Clj~berland C~u~\y Mv Cornmiswlil 1:.;(~lres Mar. 26, L8v , "ft~hn' PAnn"'Jivania A~>I1tilltion of Notanes RCC-33 (4-7:8) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS -=<1--') K- "81 '* 9-/~-71 RESIDENT DECEDENT COUNTY OF ClDIlber 1 and 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 Rellenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) Cumberland } AFFIDAVIT OF ~X~X!fim. ADMINISTRA Tiix IN THE MATTER OF THE ESTATE OF Edward N. Thnsh (STATE FULL NAME OF DECEDENT) Late of County State of PennsYlvania County of Cumberland }" Ad .. trix mmlstraKilC of the estate of the above-named decedent being duly sworn, depose S and say S December 12, 19 -ZL{~<K}QXiK~~K~llt.X~J(\OC<<~j()ck~<<~lOX~K} (MONTH) (DAY) (YEAR) .ntestate Name and address of attorney or} Robert J. YOClDIl. Attorney ather authorized repres.entative to whom all correspondence should bemailed.116EastKingStreet.Shippensburg.PA Lenore T. Thrush ~){t)Qx Decedent died 17257 That as such Administratrix deponent is familiar with the affairs of said estate and the property constituting ~nnADMINISTRATU the assets thereof and their fair market vahle~ 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 That the contents of said safe deposit box or boxes are itemized under Schedules with the exception' of the following, for the reasons hereinafter set forth: of this return, That Schec/u/e A attached hereto and made part hereof sets forth fully and in detai I 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 Schec/u/e 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 trus t for any other person or persons giving also separately the accrued interes t thereon, if any, down to the last interes t 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 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 d..\le pI' death, bonds and accrued interest thereon to the date of decedent's death and other investment ~\ ...'cd by the decedent at the time of death, with the market value there- of at such time. "'C;C-84 (4-73) COMM"~L TM OF""MS,lf:"..... DEPARTMENT OF ~eVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "j....' 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 withanO'ther or other, should be identified as to quantum of intere~t 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 C1E.") The real property'lbC1lted In the Commonwealth 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 which 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 VALUATION CAUTION (Do not write In thla apace) ASSESSED VALUE FOR YEAR OF :DECEDENT'S DEI. TH ESTIMA TED MARKET VALUE 1. Tract of mountain land situate on the South Mountain in Southampton Township, Cumberland County, Pennsylvania, having a dwelling house thereon erected. Containing 47 acres, more or less. See Deed of The Red Ribbon Gun Club, Inc. to Edward N. Thrush dated April 8, 1960 and recorded in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed Book "T" Volume 19, Page 454. 5,230.00 V (25% of fair market value) 30,000.0011" 2. Lot of ground with auto service building erected thereon, situate in Southampton Township, Frankli County, Pennsylvania. Containing .99 acre. See Deed of C. Eber Miller and Isabelle J. Miller, his wife, to Edward N. Thrush dated April 5, 1972 and recorded in the Office of the Recorder of Dee s of Franklin County, Pennsylvania, in Deed Book Volume 672, Page 613. 3,500.00 (40% of fair market value) 20,000.00....... 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. 50,000.00 sa tJlJ(J. CD I RCC -35 ...~,.".. ;.\;lIj" !.' t\ COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY Item NO. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. II. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 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 f'irst (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 List and describe fully UNIT VALUE DEPARTMENT VALUATION (Do not write in this space) ESTIMATED MARKET VALUE Savings Account - No. 1-11384-4 - The First National Bank of Shippensburg, PA Accrued interest on Savings Account No. 1-11384-4 to date of death Checking Account - No. 609-440-5 - The First National Bank of Shippensburg, PA Checking Account - No. 609-568-2 - The First National Bank of Shippensburg, PA 1974 Caddilac Coup DeVille 1975 Chevy Impala - four-door sedan 1974 Chevy El Camino 1973 Dodge 1/2 ton pick-up truck 1969 Caddilac - four-door sedan DeVille 1965 Oldsmobile Convertible - two-door - requires new top 218.78 .36 4,863.41 73.73 1,700.00 1,450.00 1,650.00 2,800.00 500.00 300.00 See attached appraisement for following items Various old laundry machines (junk or for parts) Desk Chair Sofa Small safe Miscellaneous tools Davenport Two chairs Hy-Fi Radio set Bench and rocker Re fre gera tor Miscellaneous kitchen utensils Bedroom suit composed of bed, chest of drawers, dresser and mirror Braided rug 15.00 35.00 10.00 25.00 30.00 75.00 25.00 15.00 35.00 25.00 35.00 6.00 100.00 10.00 x x I~ 997. J. r Tnsert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. $13,997.28 RCc-36 COMMO'\WEALTH OF PE~NSYLVANIA TRA'\SFE1{ INHERITANCE TAX SCHEDULE "c" TRANSFErtS H.ESIDENT 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) no (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 (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 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? (Answer yes or no) no (b) The right to designate the persons who shall possess or enjoy the property transferred 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 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 reserveo 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) 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) NONE Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. 00.00 /VUrIU.J RCC-37 (1,{'-63) CO!\tI\10~WEALTll OF PE:''::\'SYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFI CIAHlES , BENEFICIARIES AND ADDRESSES RELATIONSHIP I SURVIVED (If step-children or DATE INTEREST OF State full names and addresses of all who illegitimate crilclren DECEDENT OF BENEFICIARY ave an interest. vested. contingent or other are involved, set STATE YES IN EST:\ TE wise, in estate) forth this fact.) OR NO BIRTH Lenore T. Thrush 208 South Washington Street Shippensburg, Pennsylvania Mother yes Sole Heir \ h Deponent further says that all the above-named beneficiaries are living at this time except below: - NAME DATE OF DEATH RESIDENCE - / ... " .s ." ~ ('a':'; ":It: ... <, 1;) -: ~ .2 Q) E .s " .2 _0.0 ~ E CJ ~ 0: ;CJ~ :;~t CJ ::i 0 ~ E g. ~ ex:: SUMMARY .. (Sch. "A") . . .. . . ..(Sch. "B") ......( Sch. "e") (~c.11.~ "~.'.'J. Real Property ......... ..... ... ............. ........ Personal Property Transfers . ................ Gross Taxable Estate ( 1) (As Reported) ... S(> ~OO() ~..O(>. .13,.9.97.28 00.00 00.00 $ $. $ $. $........... $ .....~;$.,.~~.7.2ft (2) (As Determined) $ $ $ $ $.. $ 00: t- 1'-.: Z "0 QJ b.Q .... ~ .<11 f-l. ~ .<\1 ....;l Q.) - QJ ::l: ,.,-:. :CJ < >< ~ .<1> .0 Cl Vl: ~ CFl s:: - - < 0'1 -< Q) ~ ell: p:;; p.; '2 00: ~ AI "0 =- '" ~ 0 ..c::. -.-I. ~. ~ =- I Iol ~ Iol Vl. ..c:: ~ < r-I :I: -< ::c ~ ::l tI) . ..... ;,., N (/J r- ~ r- E- f-l. f-l c Q ~ ..... ~ .-r: ~: ~: Q) C Z c:i - 0 E- O ,.c Q.) Z E- C/'J ~. ~ ~ . ..c:: ~ ~ Z b/l: U ..... ~ ------ 0 ::l. 0 " 'i:I 0 ...c 0 c ~ f-l f-l ..... .S ~ cO 0 o:l =- ..... ~ a:l Q.) ... ell E- ..... ;.. " .t: 0 ,.,. E- ~. c os -< ..... .c' 0 - 0 ,... I: ~ 'E ..... Q.) 5 ,... ..... 0 ~ ~~ o:l cJ ~ u R C C-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 with 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 under 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 Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. 00.00 AUI-ru.l