HomeMy WebLinkAbout07-12-79
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.RCC-33 (4-73)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
.
RESIDENT DECEDENT
COUNTY OF CTlMRER rAND
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 Reuenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
Cllmberland
}~
IN THE MATTER OF THE ESTATE OF
ELSTE A_ STMMONS
(STATE FULL NAME OF DECEDENT)
County
State of
Penn1=;ylwmia
} ...
County of
Cumberland
~
Pa1\1 Eo SimWOJ1S, jrr!:orrnan"t ::lnn ::lTI npjl"-::lt--l::H.17
of the estate of the above-named decedent being duly swam, deposeS and say S
~
Decedent died
July
30
, 19-ZL{testate leaving a last will, copy of which is hereto attached. }
(YEAR) Intestate
(MONTH)
Name and address of attorney or }
other authorized repres.entative to whom
all correspondence should be mailed.
{DAYI
Snelbaker, McCaleb & Elicker
~~ West Main Street. Mechanicsburg, Pennsylvania
That as such deponent is familiar with the affairs of said estate and the property constituting
(EX ECUTO R-A DM1Nl ST RA TO R)
the as sets 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 fullowing: -
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
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 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 any other person or persons
gi ving also separately the accrued interes t thereon, if any, down to the las t in teres t 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 de,'ignated 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,
a utomobiles , 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 IL,~ ,1;\ ,,' (If death, bonds and accrued interest thereon to the date of decedent's
death and other investm'."i. J 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 scheoule, financial statements showing the assets and liabilities of said co-partnership or 1msiness.
A coP~/ ,,1' the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
togeilwr with a statement setting forth the cl1aracter of the business, its location, and such other facts
,1erti, rl' i;.i~ to the husiness as may be pertinent to a fair and just appraisal of the decedent's interest
therein JI"ISt l)e submitted. It should also set forth in itemized form, together with the fair market value
then')!" 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 or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom transrerred, the
relationship of the transferees to the decedent, the proportionate share received by each transferee and
all other facts of a pertinent nature regarding sairl 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 cOflY
of the deed, trust agreement or other instrument creating the trust. There is also set forth in said
schedule a list of all property, real and personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly 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 schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
person~ 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, 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 or record of instrl@ents effecting the .estiture 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 clebts
and deductions claimed for and on behalf of this decedent's estate, inclucling nmeral expenses paid;
f'amily exemption, where applicable; costs of administration of this estate; counsel fees ann j\lfliciary'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 dececlent; debts and claims owing and nnpaid 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 pledgerl for obliga-
tions, if' any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that ir 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 Scheclules "A", "B", "en, "E", and "F" as nirecterl therein,
have been carried rorward and properly registe!"ed in the SUlTURary.
Subscriood and sworn to before me this
. u.u.....u.u...uu..7:.~P
.............ed~..
CATHARINE E. BOUSUM, NOTARY PUBLIC
MECHANICSBURG BOROUGH
CUMBERLAND COUNTY
MY I""'MM,sSlnN FXPIRF" FES 27 1982
NOTE: Before signing aff'idavit make sure all blank spaces in the affidavit and schedules annexed are
f'i lIed in wi th de tail s or the word "None", ancl in case the asse ts inc lude rare awl un] is ted securi ties,
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 attachecl. Also make
certain that column #1 in the "Summary" has been properly completed as above-cli.rected.
.. ... day of uPP~~
ur;e~~~....
un" 19...72
t::::il(A.'f.e;.........~.....~~1:Zd2:::~:........"..
(Executor-Administrator)
.. .... .....R. .....D........2....B.ax.....1.7.fi..............................................................
(Street Number)
M~qh9,D.J~.!;?PQ:rg......pq........l7.Qs.s...
(City or Town and State)
RC C-34 (4-;.3)
COMMONWEAL TH 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 in 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 .treet number, together with DEPARTMENT
a general descrIption of the property, with 0 reference to the record of the ASSESSED VALUE VALUA TlON
conveyance by which the decedent took title; If a farm .tate number of a. FOR YEAR OF ESTIMA TED CAUTION
cres; also statement of mortgage encumbrance. upon each parcel at death DECEDENT'S MARKET VALUE (Do not wrIt.
of decedent. Taxe., a..li..ment., accrued Intere.t on mortgage., etc.,are DEA TH In thl. .pac.)
to be Ii.ted on Schedule "F" and must not h. deducted from this .chedul..
NONE NONE
\"\J \. -v~
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.
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
REV-4GI (8-78)
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 uE". 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 tentative 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 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 ITEM UNIT ESTlMA TED DEPARTMENT
No. List and describe fully VALUE MARKET V ALUA nON
VALUE (Do not wri te in
thi s space)
l. Cash $ 6,872 .12.,
2. Proceeds from sale of furniture 583.45/'/
./
3. Medicare refund 25.0Q.,/
Ins ert thi s total opposite "Personal Property", Schedule "B" in XX $ 7 ,480 . 5 7 ~)'-\.~() S1
the "As Reported" column on the last page of this return.
RE V-453 (8-78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
PAGE 1
BENEFICIARIES AND ADDRESSES RELA TI ONSHIP
(State full names and addresses of all who (If step-d1ildren or SURVIVED DATE INTEREST OF
have an interest, vested, contingent or other- illegitima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set ST ATE YES BJRTH IN ESTATE
forth this fact.) OR NO
Mechanicsbur~ Brethern in Charity Cash Bequest:$l.OOO.OO
Christ Church
Marb le and Hi~h Streets
MechanicsburQ: Pa.
World Mis " (,"h- "...... (,~C'"h """.Sl nnn nn
c/o Brethren in Christ Churcl
Marble and HiQ:h Streets
Mechanicsburg, Pa.
Ruth N. Simmons DauQ:hter No
Samuel L ~immnn!': C:nn Vpc. nnp_pilT'h+'h (l/Q) roT
201 Hempt Road t-np ropc. inl1P
MechanicsburQ:. Pa.
Blanche T T.ebn ~ , e-r Yes nnp_picrnt-n fl An n-f'
498 Glenn Street +'hp ....cc::inIlP
Mechanicsburg. Pa.
Helen P. PotteiQ:er DauO"hter Yes ()ne-e"' -,- (l/H) nf'
10 Sherwood Road the -residue
Carlisle Pa.
Dessa M. Diller DauQ:hter Yes nne-eiQ:hth aiR) nf'
231R . "Rn::ln the residue
Mechanicsburg, Pa.
Paul E. Simmons Son Yes ()np- . -,- -,- (l/H) nf'
R. D. 2. Box 176 the -residlle
MechanicsburQ: Pa
Deponent further says that all the above-named beneficiaries are living at this time except below: (CONTINUED ON PAGE 2)
NAME
DATE OF DEATH
RESIDENCE
-
....
.8rJ:J"-'
t':l <: ....
.l:l- :t:I:
(/] - e
'2 ~ E
.,..01 Q.) ::)
E- -
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<: E <.l
I 0 ~
\.olu:CS
..8 +ool 0.)
::l (/] ....
<.l ::l ....
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>< <l.l
e ~
Real Property
Personal Property
Transfers
SUMMAR Y
(Sch. "A") $
(Sch. "8") $
(Sch, "e") $
$
$
$
(1)
(As Reported)
(2)
(As Determined)
$
$
$
$
$
$
Gross Taxable Estate
\
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0 '- .-
t:: 0 CI::
.S ~ .J:: 0
.... .....
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.... Eo-< t':l W
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RE V-453 (8-78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
PAGE 2
BENEFICIARIES AND ADDRESSES RELA TIONSHIP
(State full names and addresses of all who (If step.cbildren or SURVIVED DATE INTEREST OF
have an interest, vested, contingent or other- illegitima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set ST ATE YES BJRTH IN ESTATE
forth this fact,) OR NO
Rhoda L. Lehman n~l1crhTe'Y' Vpr::, Inc_ . , , (l/R) nf'
R. D. 2 ,..ho .
Hopewell, Pa.
Marv J. Bundv Daucrhter Yes nnp_o' _1...L. (l /Wl n f'
33 N. Grant Street rho . ~, ~
Manheim, Pa.
Martha J. Ginder Dau2:hter Yes nne-e i2:hth (1/8) of
21 Grandview Road The Y'er::,jdue
Hummelstown. Pa.
-
Deponent further says that all the above.named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
--
....
Er.J)~
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'8 ~ e
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_ p. 0
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.... U ~
o '"Cl
........ OJ
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;.< p.
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Real Property
Personal Property
Transfers
SUMMAR Y
(Sch. "A") $
(Sch. "B") $
(Sch. "C' ') $
$
$
$
(1)
(As Reported)
=
(2)
(As Determined)
$
$
$
$
$
$
Gross Taxable Estate
\
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-= U.l -=E-< ~ <C
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.... or/] Il)
u.. U.l 0.. <(
tc 0 .... t-
o 0 0::
.... ~ -::: 0
.... u.l a..
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.... Eo-< UJ
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....l W W
E'C C-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEAL TH 0 F PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the rlecedent 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 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", 1)lus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Descript ion of Property, Date of Acquisi tion, Name uni t Percentage Estate
Address rold Relationship of Co-Owners, and Place Value Share Valuation
of Record of Instrwnent, where Real Estate.
DEPARThffiNT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
1. Single Payment Savings Certificate N .
W~196, Class IX, State Capital Savin s
and Loan Association in the amount 0
$10,000.00 issued on August 3, 1973 0
Elsie A. Simmons or Paul E. Simmons
(Son) as joint tenants with right of urvivprship.
One-half taxabl
/"
$ 5,000. C 0 /
2. Single Payment Savings Certificate N .
W4197, Class IX, State Capital Savin s
and Loan Association in the amount 0
$20,000.00 issued on August 3,1973 t
Elsie A. Simmons or Paul E. Simmons
(Son) as joint tenants with right of
survivorship.
.,,/'
One-half taxabl
10.000.CO/
$15 ,000. C 0
'"
'-)
/\.'
,\.1.0 L ~/
, ~y
vJ
"
\"")
v(,
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" colW1lll on the last page of this return.
. ;\
. .
I
RC'C.39 (8.77)' ,
. County, Number and Name 21 Cumberland SUMMARY
-
File Number
Date of Death .Tllly 3D, 1978 j
COMMONWEAL TH OF PENNSYL VANIA
Estate Name Simmons Elsie A. TRANSFER INHERITANCE TAX
(LAST NAME) (FIRST NAME) (INITIAl.) RESIDENT DECEDENT
REPORT OF INHERIT ANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of ,
Pennsylvania, do respectfully report that 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 Schedul es II A", "B", "C", and liE".
Dated:
INHERITANCE TAX APPRAISER
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 a s a deduction.
Dated:
REGISTER OF WIl.LS
ADJUSTMENTS
INVENTORY V ALUE AS APPRAISED !CODE (HARRISBURG USE ONL YI REMAINDER APPRAISEMENT CODE
I Real Property (Schedule A) $ -0_ 00+ 92+
Personal Property (Schedule Bl 7 4-80 57 10+
I Joint-Held Property (Schedule EI 15 000 00 20+
Transfers (Schedule C) -0- 30+
TOTAL GROSS ASSETS :J :J ll~ n c..7
Less Debts and Deductions 40- 93-
'SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
~
PRINCIPLE
FACTOR
VALUE
CODE
annuities............... ......_ $
,=
E
ESTATE TAX ASSESSMENTS _ $
FOR USE OF REGISTER ONLY
Tax on $
Tox on $
Tox on $
Tox on $
Tax on $
Exemptions
Total Estate
~
COMPUTATION OF TAX
2%
6%
15%
$
$
$
$
$
*
TOTAL TAX
$
(*) As evidenced by Chori to ble
Exemption Certificates issued
by the Secretary of Revenue.
$
t=
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
$
$
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
$,
$
$
$
t=
BALANCE DUE
Add interest at rate of 6% from
to
$
$
TOTAL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Adjustment
49+J.djustment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Charity
94-Remainder Residue
96-Succ e ss i ye
Li fe Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsectuent adiustments are made to the above computation of tax by the Register of Wills, for proper reason
same should be noted below, with short explanation. '
\ b ~
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.... 01
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-
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..... b ~
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RE V-4B" IB-' Rl
,
,- County, Number and Name
File Number
21-Cumberland
21-78-0599
30, 1978
SUMMARY
Dote of Death
July
Estate Name
Simmons
Elsie
(FIRST NAME)
(lNI TIAL)
COMMONWEAL TH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
(LAST NAME)
REPORT OF INHERIT ANCE TAX APPRAISER
!, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of r.llmhpr1.::mrl
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregaing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
,--Q
r---.
('-
Do{"d: _
July 12, 1979
'. ~
INHERITAN-CE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
), {'he undersigned duly cl ectcd Regi stcr of Wi I( s in and for County, Pennsyl vania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
less", 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
kODE ADJUSTMENTS
INVENTORY VALUE AS APPRAISED (HARRISBURG USE ONL VI REMAINDER APPRAISEMENT CODE
Real Pronerty (Schedule AI $ nnnp 00+ 92+
Personnl Property (Schedule 81 7.480 57 10+
J'):nt.'~8'd Property (Schedule E) l'i.OOO Ion 20+
Transfors (Schedule C) nnn,:> 30+
TOTil,l GROSS ASSETS 22.480 157
Less Debts and Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valua-:ion of life estates or
~
PRINCIPLE
FACTOR
VALUE
CODE
I
annuities......................__ $
t=
,
E
ESTATE TAX ASSESSMENTS _ $
FORUS~f REGISTER ONLY
Tox on S
Tax on $ _
Tax on $
Tax 0.) S.
Tax on S
Exemptions
Tota! Esta1e
~
COMPUTATION OF TAX
2%
6%
$
$
$
$
$
15%
*
TOTAL TAX
$
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
$-
1=
Less tax previously paid
BALANCE
Less 5% :;f tOY if paid within
3 month" "fter death
$~
$
BJ\UW:::: OF INHERITANCE TAX DUE
Add ',r We I' ot rate of 6% from
____.._..._ to
AMOUiH OF ESTATE TAX ASSESSED
$
$
Estat(. ~Crx paid
$
$
c
BALANCE DUE
Add i"j',ccst "f rote of 6% from
to
$
$
TOTAL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-i\djustment
49+Adju5tment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Chari:fy
94-Remainder Residue
96-Suc:cessive
Life Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsequent adiustments are made to the above computation of tax by the Register of Wills, for proper reason
some should be noted below, with shart explanation. '
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REV-5IB (3-79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FiElD OPERATIONS
P. O. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
Investigation Division
NOTICE OF FILING OF APPRAISEMENT
Paul E. Simmons
R. D. 2, Box 176
Mechanicsburg, PA
17055
(Executor or Administrator)
In Re: Estate of
Elsie Simmons
Cumberland
County - Fi Ie No. 2 1-78- 0 599
Dear
You are hereby notified that the or i 9 i na 1
appraisement in the estate of E 1 s i e Simmon s
has been filed in the office of the Register of Wills of Cumber1 and
County on Ju 1 y 12 ,19~. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
none
$7,480.57
none
$15,000.00
$22,480.57
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.
~,-.c
Date
Ju 1 y 12. 1979
Signed
"'\..-... ".F' '.
\'"~-_.)
Title Administrative Officer
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.
July 12, 19U~._
Cumberland
21-78-0599
Whereas, El s i e Simmons late of Meehan i esburC) "___
in the County of Cumber 1 and Commonwealth of Pennsylvania, having c: r ,)
the 12 th day of Ju 1 y 19 l!l..., seized and possessed of an (sta e
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fu 1 gin it i , an appraiser duly appointed according to ic"' "
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the, ca:.;n
value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
I n the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the ex P''-co
of any estate for life or for years, the Commonwealtn hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful <:"il,'l ral
rate on any such future Interest.
UNIT . F", ;-.' r)~::::7f '
DESCRIPTION OF ASSET VALUES MadO:: id( I f,n
1 -:\'1<: PLrp
Real Es ta te $ ~-I
none I
I
Personal Property 7 480 !
I
Jointly Held Property Ie; nnn ,
Trans fe r none :
TOTAL ASSETS 22,480
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Have been duly sworn according to law, I do hereby certi~ that the ~ove appra~semeI1t is made in confolllll LJ
with the law on this 12th day of '-\ ! \11.11 Y ',. ~ n.. I ' 19 -Z9....
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