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HomeMy WebLinkAbout03-28-79 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ~/-1.f'-CJ~? ()~ tI..-J..J...-77 . ~c'C.3.i- (4~i31 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~enue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF Lote of Cumberland } AFFIDAVIT OF EXECUTOR ~~~ LLOYD R. SALISBURY (STATE FULL NAME OF DECEDENT) County Stote of Pennsylvania Cumbe rland }., County of Clyde Salisbury Xij{jOOAt~X of the estate of the above-named decedent being duly sworn, deposeS Executor and say S September 17 (MONTH) Name and address of attorney or } other authorized repres.entative to whom all correspondence should be mailed. (DAY) , 19~{tutate leaving a last will, copy of which is hereto attached. } ( YEA R) lllfUfatiK Decedent died Edward W. Harker, Esquire, One West High St., Room 203, Farmers Trust Building, Carlisle, Pa. 17013 That as such Executor deponent is familiar with the affairs of said estate and the property constituting ( EX ECU TO R- ADMI NI ST 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: - NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A S.,FE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT 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 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 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, boa ts, 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 interes t 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 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 schedule, financial statements showing the assets and liabilities of said co-partnership or l1,usiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of' HIe 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 of the decedent's interest therein must be submitted. It should also set forth in itemized form, together 'wi th the fair market value thereof, any other property owned or bequeathed by the decedent at the time of death. The Sc~edule 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 transferred, the relationship of the transferees to the decedent, the proportionate share received by each transferee and all other facts of a pertinent nature regarding said 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 copy 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 pa~ses at decedent's death by virtue of the exercise by decedent, either individually, orjointly 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 0 attached hereto and made part hereof sets forth the names 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, 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 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 behal f 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 unpain 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", "en, "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this /l-:..g...m...m r..''',; 1....,.',:.". C:;,-;~<;:, ". ::~~.1 ~~) 1 1"'\1 ' i f~ .....1..;:; ..Ir.(E;;~~i~;:Ad~t;:r....................m................. :I:l.~.....P.~,.....#..??....~.Q~...?'..?,.1................................................-.............. (Street Number) .. ..qCl:.:r..~i.~}.~.'......?~:I?::I?:.~y.1.Y.Cl:~.Cl:.......~.?9.~. ~..... (City or Town and State) .... day of ....Fe.b.r.u~r.y.,................ 19.....7..9... ....4'z12/Z.~.(..i?.011LLl':". (O;\~;.:;.. ? '.'~ ~"-, "..:., .;'.r~ ,~.: ~. ,::',: 'J 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 ann statements required under the paragraph above relating to Schenule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-direcLed. RC CoJ4 (4-73) '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 liE.") The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, tOllether with o 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. ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH ESTIMA TED MARKET VALUE (3) DEPARTMENT VALUATION CAUTION (Do not write J this space) V $15,000.Oo! (1) (2) 2 tracts of land and buildings erected thereon, $2,150.00 situated in West Pennsboro Township, Cumberland County, Pennsylvania. Tract No. 1 contains .264 acres; Tract No.2 contains 9810 square feet A description of Tract No. 1 may be found in Deed Book "X", Volume 22, Page 871, in the Cumberland County Recorder of Deeds Office. A description of Tract No. 2 may be found in the Recorder's Office aforesaid in Deed Book "XII,\~ Volume 15, Page 177. (..- o Said tracts were sold to Doris M. Nickey for the price of $15,000.00 on December 11, 1978. $2,150.00 $15,000.00 l S 1000 ,()::;> 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. RCC -35 RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY '* 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 li8ted 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 VALUE ESTIMATED MARKEl' VALUE DEPARTMENT VALUATION (Do not write in this space) 1. 2. 3. 4. 5. 6. 7. 8. 9. 1971 Buick Opel Station Wagon Dauphin Deposit Checking Account #75-35 969 3 Firewood 1956 GMC Truck Household Furnishings Nationwide Auto Insurance refund Nationwide Truck Insurance refund Refunded 1978 School Taxes - real estate Refunded 1978 County & Twp. Taxes - real esta e 600.00 4,000.3 100.0 400.0 600.00 67.0 46.00 58.3 1. 76 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. x X 5,873.36 51813-56 ,. . J ~!,. ..4 [f(.JJ..lIilqllit~ .J(, 1 ,-I , ., ~,I.J ~ vA....A I j ,'N C...U., r;L;,' i...N.... 11'\"..',l. i- II ;\.':', \.. _ 1'1... ~ i...A A I y...."'..... STATEMENT NO. CHf:CKS THIS STATEMENT o i~-3-" .n.>.... :. LL~~Y,..i 1", :..AL1....lh,,..,y I.... I.} "1 ('AI\Ll~,U Po. livL t 1.' ST ATEMENT :i JY..~ /"f (.; ,.It",vi 1. ""i5A"T-E OF I"REVIOUS NO. o~posrrs-' r aA~~-)M 5T^TEMt':NT THIS Sl'A'rEMEN!J l___~~~.YS SiATEMiXN'r -"--/2"~___~_L__~__L_~~:~=,,-- OAT<; I C''';<';I<$ "NO onl"''' De:"ns l' CHECKS ...HO OT"'." D"6ITS + Gl'if:C~D A"'~~~'':~~~_~_+__O''''os'r~ .0.,..0 eRC",'l''' I I I I I I I I' I : I i I I I i I I I I , I I I I i 1 i I I : I I i I I i I I I I i , i I I I i I I I I i I i I I I I I I L' ___1_____ L-______.___~--------~- ------------ TOTAl. D.lPOl,diS AND ! l.ESS "OTAL CHECI<S ! LESS ACilVTfV I aA~~^NCE ~':"OB CFHi.O'T'; ADDEO ---j AND 01''''<>'' m,91T5 I SERViCE C".'.Af<Gr: I THiS STA,:",,',,'n ------- ---Z-- 1- --~---~-:---:-----1L- --------- . I" L________~_:~____L__~~~~_~~__ ____~~=: \, PLEASE EXAMINE AT ONCE AND REPOiH ALL DIFFERENCES TO Bf\NK CHECKiNG ACCOUNT SERVICE DEPARTMENT. "" 0 Dauphin Deposit Bank KEY C CERTiFl~:D CHECK and Trust Company OD OVERDRAFT E ERROR COHRECTION HARRISBURG, PENNSYLVANIA 17105 5 SERVICE CHARGE B DEBIT MEMO R RETURNED CHECK M CREDIT MEMO CW CASH WiTHDRAWAl.. IN INTEREST ....EMl'\ER FE:tl€AAL DE:POSH INSUnANCL:.: CORPQH-ATlON El,273R \ " RCC-')f, C\l\J1MO'iWEAJiflI OF l'E~NSYLrJ\NI A TI1A'i~FFi\ I'iHFt'..ITi\'iCF TAX SCEEDTJLE "c" T Il\N c: [,1<= TlS i,ES I IW\'T mT IiI)).:\, '1' (1) Did dpcedent, wit.hin two years of'death, make any trallsfer of any materilll part of' his estate, \\ithout receiving a valuable al~d adequAte consider,lt.ioll therefor? (Answer yes or no) No (:.n Did rlecerlent, wiUdn two years of death, trnnsfer- propertv from himself to himself and another or "thers Uncluding a spouse) in joint ownership? (Answer ye; or no) No (:1) If' the answer to (1) or (2) above is in the affirmat.ive state: (a) Age of dpcerlent at time of transfer N lA (h) State of decedent's health at t.ime of making the transfer. (Note 1). (c) Cause of decedent's dectth. (Note 1). (4) Did decedent, in hi:, lifetime, make any transfel' of property without receiving a valuable or adequate consideration therefor which was t.o take effect in possession or enjoymert at or after his dp-ath? (Answer yes or no) No . (a) Wns there any possibility that the property transferred might return to transferer or his estllte 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? N / A (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor tmder wldch transferor expressly or impliedly reserves for his life or any period which does no 1. in filC 1. end hef'ore his de a th: (a) The possession or ep-joyment of or the right to income from tht' property transferred? (~nswer yes or no) r{O (b) The right to designate the persons who shall possess or enjoy the property transf'erre,i or income therefrom? (Answer yes or no) No (G) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone IJr others N / A (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 tl'ap-sferor? (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 reserved power to al tel', amend, or revoke, or which cOllld revert to rlecedent under terms of' transfer or by operation of law? (Answer yes or no) No (9) If the answer to (H) above 1.3 in the affirmative, was the power tIJ al tel', amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent ano others? (Answer yes or no) N / A NOTE 1: The answers to these questions should be SUllporteo by affidavit by the attencUng physician as well as a copy of' the death cer-tificate. 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 anrl to ~'hom transferred, with relationship of transferees to rlecedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also stilimit detailed statement of facts on which said claim is based. NOTE 3: List apl'licable property below in manner in which provider! in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VAL1'ATTON (Dept. Only) None 000 N O>---IL. Insert this totrd opposite "Transfers", Schedule "e" in the "As Reported" column on the last page of this return. i II II I I McCREA & MCL:ilEA 11\ ATTOINUI AT LAW NEWVILLE' SHIPPINIIUIlI I PINHA. I' 'I \ LAST WILL AND ']'ES'.L'AMT';N'l' I, 'Lloyd R. Salisbury, a resident of the Township of West Pennsboro, County of Cumberland and State of Pennsylvania, being of sound mind and memory, do make, publish and declare thi~ to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I hereby direct my Executor, heninafter named, tc pay all my just debts and funeral expenses as may conveniently b~ done after my decease. SECOND: I give, devise and bequeath all my estate, be i1 real, personal or mixed, to Beulah M. Gutshall for and during heJ natural life if she is living with me at the time of my death, and at her death, then I give, devise and bequeath my estate, be it real, personal or mix€d, to my children, to-wit: Florence Clyde Salisbury, Executor of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, dated this I August, 1972. i' I I:) Ul day of .- I / .J ! J I,. ,_,I' ,'. ,'~' 'I. / ,~'I..... I ,\ ,( .l '/ v",, ,( -l " ~ - '. ',/'J '- ':..\..~. ,/'/ _/ , (SEAL This instrument was by the Testator, Lloyd R. Salisbury, on the date hereof, signed, published and declared by him to be his Last Will and Testament, and in our presence, who at his request and in his presence and in the presence of each other, w believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. ",'0 l/)/ ' .' ~ ",:,.~^"";'--."> (j I' r',' /. "'J , ,\ "II ! I ; '. : 'J ~ ~ ~ I /'/)" . n{J .- . ," t '7J'~ . '._.-"~ I,', '. ., p: - I, \/\ ':, I:, i , , -' i ./ ,'1 oJ 1\ Ree:..}? (12-63) <.'O:\Il\lO~"-E:\LTII OF PE:\,:,\SYYL:\Nl..\ TRANSFER lNHERlTA)';"CE TAX RESIDENT DECI<:DENT SCHEDULE "D" BEI\ EFI CIARIES \ h RELATIONSHIP I BENEFICIARIES AND ADDRESSES (If step-children or I SURVIVED I DATE INTEREST OF State full names and addresses of all who illegitimate children I DECEDENT I OF BENEFICIARY aye an interest, vested, contingent or other- are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH Florence Salisbury Daughter Yes 3/12/31 One -quarter interest R. D. #8. Box 385C Carlisle, Pennsylvania 17013 Albert Salisbury Son Yes 12/24/32 One-quarter interest Box 13 6 She rmansdale. P A 17090 C Ivd e Salisbury Son Yes 11/2/35 One-quarter interest R. D. #2, Box 254 Carlisle Pennsylvania 17013 William Salisbury Son Yes 8/9/39 One-quarter interest R. D. # 1, Box 456 New Oxford, PA 17350 Beulah M. Gutshall Life Tenant Yes 9/23/12 Life Tenant-Released fo 43 Fairfield Street $1,000.00 Newville, Pa. 17241 r Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ~ ~ .....eIl..... l.':<"" 1;; -: r:: ';:: <l) E ....... +ol :::J E~- _ p. 0 ~ E <.l ~ 0: "',-,"0 .s~~ ;j '" '" <.l ;j 0 ~ E ~ ~ p;: SUMMARY . (Sch. "A") ...(Sch. "B") .. .. (Sch. "e") Real Property Personal Property Transfers Gross Taxable Estate .. (1 ) (As Reported) $. $ $. . $ $ $.. (2 ) (As Dderrnillct!) $ $ $ $ $ $ r-- '0 Z <l) .... ~ ell ..:l <1l ~ (l) - <l) .( >< ..... <.l ~ <l) ~ (J) Q - .... .( -< ~ CC ~ ~ '2 =-- p... 0 ~ =-- w p... w ~ < :I: -< ::I: ~ ;.., '" Q r- ~ r- t-- S ci ~ ::r: ~ ~ c:; Z 0 b ~ Z b rJl p... ~ ~ ..... 1- 0 ~ 0 CC ..c 0 ::: ..... 0 ~ ~ =-- ',C ~ ~ .... 0:: b ..... ;.. CC 0 ... .t: b c '" -< ..... .c' 0 '2 - 0 E 'E ...... ~ c E ..... ~ ,- .- 0:: 0 0 ~ ~~ ....:l U U R C C-38 RESIDENT DECEDENT SCHEDULE "E" JOlNTL Y OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRUCTIONS: This schenule must disclose all property, real ann 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 Imder Schedule "A", plus the rlate 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. 000 ~ <f"\-L fl E V-5 18 [8-7S) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU.OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG 17105 IN YOUR REPLY Pl.EASE REFER TO inheritance Tax OivisiClr' NOTICE OF FILING OF APPRAISEMENT Clyde Salisbury R. D. #2, Box 254 _.._ CRrHRle, PA17013 (Executor or Administrator) In Re: Estate of _~oyd R. SaliRbury Cumberland County - Fi Ie No. 21-78-0602 Dear Mr. Salisbury: You are hereby notified that the Or; gj l'lfll appraisement in the estate ot TJ o.yd R_ SR1; .ahllry has been filed in the office of the Register of Wi lis of Cumher] Rnd County on Mfl"l"Ch 28-__, 19-29-, Said appraisement reflects the following valuations: Real Estate Persona! Property Transfers Jointly Owned _ T ota I _ _____ ]5,000.00 5,873.36 None None $20.873.36 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 notjc~ as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961, 72 P, S. 2485-' DOl, P. L. 373. Date March 28, 1979 Signed Title Administrative Officer ( -----..... '--- Note: This is not 0 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 DAI.:. March 28. 1979 COUNTY Cumberland FILE NO. _ 21-78-060~ Whereas, Lloyd R. Salisbury late of West Pennsboro Township in the County of ~llmh~,..l Rnn I Commonwealth of Pennsylvania, having died on the 17th day of September 19 ~ , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Leo Fuliiniti ,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 Purposes R.....l - $ ], .000 00 P I 1 Prnn~rt.v 5,873 36 Transfers None .T,,;nf"_R..lrl ~ . None TOTAL ASSETS $20,873 36 . . Have been du!y sworn acc80rding to law, I do hereby cer!ify that the above appraisement is made in conformity wIth the law on thIS 2_th day of ' ( . ~-. ~ch >. 19 ...2.9.... , ..' . . _.~_.. '_'-.0 Appraiser Harrisburg (Number and Street) (Post Office) . Penna. ~ ~ 15 ~: 0\ ;,., Pi ....... I- ~ \0: .... Z -.-I' s::: W <1.l ..Q W ::s ~ t.l ~ :::) 0 <1.l 00: 0 w Q ~: N Z en Si 0: I: W ~ H CO: l'Ij > ..... a:. ~ 0- W ....' s::: 0.. ~ CO: 0: a: s::: <1.l 0.. g r-l: '"0' (l) ~ ~1 ct t'-: ~ u. ~ 1 I: ~ ~ x ~ (l)' 0 tI) <> '0 ~ '0 .. 0 tI) o@ ~ ct <+-. t.l I- a "i\:i ....J; I- 0 I: ~ ~ 'b<i a 2: O'! 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