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HomeMy WebLinkAbout10-16-78 OC(:- 3 11-F.9; APPUCA TION FOR CHARIT ABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX (Act of May 28,1956, P.L. 1757, and Act of June 15, 1961, P.L. 373, as amended) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS Application is hereby filed for the approval of an exemption from Pennsylvania Transfer Inheritance Tax on the transfer of the property described below: 1. Bureau File # 21-78-596 2. Dote of Death October 16, 1978 3. D.,..f App,.v.1 ~";l? I'r' '? ~ 4.... f D d t Miri Alice Greenawalt . ,,,,orne 0 ece en 5. The Commonwealth's appraised value of the property for which an exemption is claimed is $1,000.00 (Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of the property has been established by appraisal by the Commonwealth, except in those cases where the amount af the gift or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or percenta~ amount above). 6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless such material has been previously filed. WILL N; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (If other, explain) 7. Correct Business Name and Address of Charitable Organization receiving property: NAME St. John's Lutheran Church ADDRESS 5 South Eberly Avenue, Shiremanstown, PA 17011 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. /7 / ---'l'./:/ SI,,,,,,. .f AppI;,.nt ~~ /;;;: >~L Douglas Leber Add fA I. t541 Appalachian Avenue, Mechanicsburg, Par 17055 ress 0 pp Ican President, St. John's Official Title Lutheran Church , Sh i remanstown D /~A8 /C.i''7c-/ ate/:IW~r' ~ -' _/ ~L This form must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent resided, or in which letters were issued for a non-resident decedent's estate. If the decedent was a non.resident of Pennsylvania and letters were not is!'ued by a Pennsylvania Register of Wi lis, deliver all three copies to the Director, Bureau of County Collections, Penna. Deportment of Revenue, 26 S. 4th Street, Harri sburg. Pa. Do not write below this line - For Official Use Only Approved: For the Secretary of Revenue Referred to Bureau Headquarters Approved 0 For Secretory of Revenue Denied* 0 (Initials of Register of Wills) (Authorized Signature) (County) ('~1.- bl? I~?~ (Date of Appr~1) (County) (Title) (Date of Referral) (Date of Action) * See reverse side for reasons MUST BE FILED IN TRIPLICATE This section will be compl eted by Bureau Headquarters only when the appli~~tion for exemption has been denied. Date: The application for exemption contained on the face of this form has been denied because Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable Pennsylvania Inheritance and Estate Tax Acts. Ree- 3 ' l-f9\ APPLICATION FOR CHARITABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX (Act of May 28, 1956, P,L. 1757, and Act of June 15, 1961, P.L. 373, as amended) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS Application is hereby filed for the approval of an exemption from Pennsylvania Transfer Inheritance Tax on the transfer of the property described below: 1. Bureau File # 21-78-596 2. Date of Death October l6--,__197~, 3. Date of Approva I ~-""1 . ~ '7, I q I) ? 4 N f 0 d t Miriam Alice Greenawalt . ame 0 ece en 5. The Commonwealth's appraised value of the property for which on exemption is claimed is $ 2,500.00 (Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or percenta~ amount above). 6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless such material has been previously filed. WILL 0.; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTHER 0; (If other, explain) 7. Correct Business Name and Address of Charitable Organization receiving property: NAME Seid1e Memorial Hospital ADDRESSFilbert & Simpson Streets, Mechanicsburg, PA 17055 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. Signature of Appl icant (O~ ~ aM h ~, Address of Applicant Filbert & Sinlpson Streets, Mech&~icsburg, PA 17055 . Official Title Administrator Dote I.larch 28, 1979 This form must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent resided, or in which letters were issued for 0 non.resident decedent's estate. If the decedent was a non.resident of Pennsylvania and letters were not is~ued by a Pennsylvania Register of Wills, deliver 011 three copies to the Director, Bureau of County Collections, Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po. Do not write below this line. For Official Use Only Approved: For the Secretary of Revenue Referred to Bureau Headquarters Approved 0 For Secretary of Revenue ~ (Signature of Register of Will " "c;',;l4 ,.; 1'-) - V,..!,!i"'f (County) C~ ~7 Iq'7 (Dote of Approva)f , Denied* 0 (Initials of Register of Wills) (Authorized Signature) (County) (Title) (Date of Referral) (Date of Action) * See reverse side for reasons MUST BE FILED IN TRIPLICATE This section will be campi eted by Bureau Headquarters only when the ~kation for exe~ption has been den.,ied. Date: The application for exemption contained on the face of this form has been denied because Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable Pennsylvania Inheritance and Estate Tax Acts. RCC- 3 (1-1)9' APPLICATION FOR CHARITABLE EXEMPTION FROM PENNSYLVANIA TRANSFER INHERITANCE TAX (Act of May 28,1956, P.L. 1757, and Act of June 15, 1961, P.L. 373, as amended) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS 3N?Hl 355 5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ Residue' (Note: Where the property is other than a specified amount of cash, the exemption con not be approved until the value of the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases enter such fractional or perc.nta~ amount above). 1. Bureau File # 21-78-596 2. Date of Death October 16, 1978 3. Date of Approval ~'L A? 19 ~lr 4. Name of Decedent Miriam Alice Greenawalt Application is hereby filed for the approval of an exemption from Pennsylvania Transfer Inheritance Tax on the transfer of the property described below: 6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless such material has been previously filed. WILL [1..; DEED 0; TRUST INDENTURE 0; SURVIVORSHIP 0; OTH ER 0; (If other, explain) 7. Correct Business Name and Address of Charitable Organization receiving property: NAME ADDRESS 5 South Eberly Avenue, Shiremanstown, PA 17011 Trustees of St. John I s Lutheran Church 8. certjfy that the information contained herein is, to the best of my knowledge and belief, true and correct. S;9.otU," of Appl;caot U/'tl ~ / ~ Shader, Sr. Address of Applicant 200 W. Courtland Avenue, Shiremanstown, Pa. 17011 President, Trustees Official Title St. John I s Lutheran Church, Sh ire. Date This form must be completed in triplicate and all three copies delivered to the Register of Wills far the County in which the decedent resided, or in which letters were issued for a non.resident decedent's estate. If the decedent was a non.resident of Pennsylvania and letters were not i s!;ued by a Pennsy I vania Regi ster of Wi II s, del iver a II three copies to the Oi rector, Bureau of County Collections, Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po. Do not write below this line. For Official Use Only Approved: For the Secretary of Revenue Referred to Bureau Headquarters Approved 0 For Secretary of Revenue Denied* 0 (Initials of Register of Wills) (Authori zed Si gnature) i (County) ~ ::J?/9'? (Date of Approv'a ) (County) (Ti tIe) (Date of Referral) (Date of Action) * See reverse side for reasons MUST BE FILED IN TRIPLICATE This section will be compl eted by Bureau Headquarters only when the application for exemption has been denied. Date: The application for exemption contained on the face of this form has been denied because Note: Any party in interest, inciuding the Commonwealth, aggrieved by this action may within sixty (60) days after the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable Pennsylvania Inheritance and Estate Tax Acts.