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Home My WebLink About05-10-79 R C C-3 (4-7'3'. . .' II' COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS 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) 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 # 21-78-599 2. Date of Death July 30, 1978 3. Date of Approval 4. Name of Decedent Elsie A. Sinunons 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 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~; (If other, explain) See attached copy of written docwnent of decedent I s disposition of personal property and personal effects 7. Correct Business Name and Address of Charitable Organization receiving property: NAME World Missions, c/o Brethren in Christ Church ADDRESS Marble and High Streets, Mechanicsburg, PA 17055 D See listing on reverse side for additional charitable organizations covered. 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. Signature of Appl icant ~ (;~' -1~d/ V /fn/].~~ ........., au.L.E. S:unmons Address of Applicant R. D. 2, Box 176, Mechanicsburg, PA 17055 Official Title Informant and an heir-atJRw Date s;' /7f 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 issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, 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, ~evenue REFERRED to Bureau Headquarters ~r (Signature of ~1~$ilis7te! of Will~) (Initials of Register of Wills) l. (County) Approved 0 For Secretary of Revenue Denied* 0 (Authori zed Si gnature) (County) (Title) (Date of Approval) (Date of Referral) (Date of Action) * See reverse s ide for reasons ~-IO-lcr 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, 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. R C C- 3 (4-71,,) .. 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) :I COMMONWEAL TH 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 # 21-78-599 2. Date of Death July 30,1978 3. Date of Approva I 4. Name of Decedent Elsie A. Sinunons 5. The Commonwealth's appraised value of the property for which on 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 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 Xl; (If other, explain) See attached copy of written document of decedent T s disposition of personal property and personal effects 7. Correct Business Name and Address of Charitable Organization receiving property: NAME Mechanicsburg Brethren in Christ Church ADDRESS Marble and High Streets, Mechanicsburg, FA 17055 o See listing on reverse side for additional charitable organizations covered. 8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct. Signature of Appl icant ,;Y~~~. ~ ~~~~~_-'---1/ ~ Fau~ L. Slnunons Address of Applicant R. D. 2, Box 176, Mechanicsburg, FA 17055 Official Title Informant and an Heir- at-Law Date 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 issued by 0 Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections, Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po. APPROVED: F~r the secre\ of ~:venue REFERRED to Bureau Headquarters Approved 0 For Secretary of Revenue ,~~ Oenied* 0 (Signatur,e of Register of Wills) (Initials of Register of Wills) (Authorized Signature) fllCH",im !:. ",~~::'1":':'~ RlG;Sm~ or '/.:U.3 r.;U;..""..:;.:rd (;~j,j I T (County) (County) (Title) (Date of Approval) (Date of Referral) (Date of Action) * See reverse side for reasons -- - 00 not write below this line - For Official Use Only 5 to 1 ~ 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, 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. II!i ...-,.,..--...''''''......--..;.....'''''''""';''''''''''.--..-.., DEDUCTIONS ALLOWED IN ~ 98 THE SUM OF $ _ 7'-6""' 0 ~....... I /~PPROVED' . ~-:--~!tll' \ ..~tC~l)\J ~~/~~. vi \ REGISTER OF WILLS, AGENT, ",~ '~V-45~ (i~~';3) UFf ;CE OF THE REGISTER OF wiLLS ST A TEMENT OF DEBTS AND DEDUCTIONS OF ~UM_~~BL':f\...N~ COUIHY AND AGENT OF {HE COMMONwEALTH / ESTA TE OF ELSIE A. SIMMONS LA TE OF UPPER ALLEN TOWNSHIP DATE OF F lLiNG APPRAISEMEN/~ .c\ IJI'i\ICl DATE OF DEATH July 30, 1978 .. -~. F NAME OF PAYEE REMARKS ER lJyeFs Fune ral Home Funeral expenses $2 3 ----.--- Kunkel Surgical Group Professional services 1 I 0__"___'_ ---.-- ---r- Messiah Village Account 4 .-- ..- "W_. -,---- ___~ Bell of Pennsylvania Account _~SPirit Hosoital Account 3 I Gingrich Memorials Engrav ing monument -..r----------- .._--t-E.ev. Hen.J;Y. Ginder "'ontribution -- ___~ Rev. Earl Lehman Contribution ---i----- -.... I .____ J1gY_L Johl) Bundv Contribution -- _0- ---- Roy Ginder Contribution ---- ----',-- ~ Ma~.Y.J'{ingert Contribution ....__~1.3:othermel T s Greenhouse Flowers I r-- .___~ Els ie Nieslev Funeral luncheon I-l .__~ Rl!th__k!Y..ers Contribution -- 1-- i Mildred Mann Contribution ---1 I--- I __~J~ggister of Wills FilinQ: fees -.-.. --.-->. I I Snelb aker, McCaleb & Elicker Attorneys fee i 2 - ..--.+..--- 1----;- IPauI E. Simmons Executor T s commission --.-.. -4---------'.,- -...---- -+- I i I . --~T-~~-~~--~-~- --t--- I --- --.. j . -- ---.-..--.-..-.--,-- I I BI____ i _._-~_.__._, -~----. ._.~_.'~ I TOTAL $L{..4 I _ _ ._L. __.._ _______._ .- --- . on_ ___..'_'_~'_ __......._.... .~._. - ~~-- r NO. 0 ~_~': H ------. -L------ I ____.___. -l-.---. I I , j----- I _ n___+ _ n_ ___ ! -.---- '-1 .___.._.__n. DATE ---,.--..._~_.- I I I I -----...--...--........--*-.,-----.... I ! I -..-.---.-..--t-..--- -...-- L____.___ ___ I I I --------! ---'--'-- --._------ --i I ; .--t. J I- --- ------- AMOUNT ~5_~_~Q__ i ----1~_ ~-~--P-~-- -' I _::-~:~-~ 42 00 20 60 ----1------ ~Q--p-!L_. -2.5---P-o- !Q_PO_____ _2-fN--- I _~J)~_2____._ I I 12_. P-JL__, i __?__j)o_.__ I _.?__p2-.. _6_~bQ____. ~~-P-Q-._-- Q.~__io.._~ -+- un__ 1------- I i . ---1------' ----1---_..- 58 90 .....,... .1...._..-... .. __.~>O"...~ COM,.(;!~WF.AL TH or PENNSYLVANIA I (ili !, OF __~_~_~~~~~~__, SS: _____.____PAUL E. SIMMONS HEREBY CERTIFY, THAT TO THE BEST uF I, Ml I' LSC::: AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND r::~~TH" OF i,DMINISTRATION SUBMITTED TO THE ESTATE OF ELSIE A. SIMMONS __...__.__ (,i"Cl rl, i-:' ~1".i)l.JCTIONS FOR INHERITANCE TAX PURPOSES,.. -;:2 I ~.l.L f! ~-~~/)---t-~(L.S.) Sl'iORrl ..\tW SUBSCRIBED BEfORE ME THIS 9~ DAY OF -_.~;;:;~?~.~- -~ . ;7 . 19 ~ __L.~..w::.,,-~~ N-.--- CATHARINE r. BOUSUM, NOTARY PUBLIC MECHANICSBURG BOROUGH CUMBERLAND COUNTY I4Y COMMISSIDN FXPlllr~ FEB. 27, 19M