HomeMy WebLinkAbout08-31-79
~ I - '78- - 603
If/I 7/11
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
-*
RCC-33 (4-73)
RESIDENT DECEDENT
COUNTY OF CUMBERLAND
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 Re-.tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF THE EST ATE OF
} AFFIDAVIT OF
EXECUTOR
ADMINISTRA TOR
GERTRUDE E. SCHMOHL
(STATE FULL NAME OF DECEDENT)
Late of Cumberland
State of Pennsylvania } 55:
County of Cumberland
County
Administrator
Farmers Trust Company
of the estate of the above-named decedent being duly sworn, depose
Executor
and say
(MONTH)
Name and oddress af attorney or }
other authorized repres.entative to whom
all correspondence should be mailed.
(DAY)
, 19~{~~~~J:~~~~~~~Xi1i~~}
(YEAR) Intestate
Decedent died
October 19
James R. Humer, Esq.
One West High St., Carlisle, Pa. 17013
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
( EX E CU TO R- ADMINI 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 fullowing: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
NONE
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 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 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, trus t companies, or other institutions, whether individually, or in trus t for any other person or pers ons
gi ving al so separately the accrued interes t thereon, if any, down to the last 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 Staies to the de-
cedent; all obligations, whether by statute or agreement they are de[dgnated 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 1'" d:,;,' (If death, honds and accrued interest thereon to the date of decedent's
death and other investmci '.' ,d by Ihe 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
1'ossible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof ItS of the date of death. The schedule also sets forth the interest of decedent at the time of
death in any cO-1'artnership 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 lmsiness.
A copy or the co-1'artnershi1' agreement, (if oral, a statement setting forth the nature of the agreement)
togeUli'r.dth a statement setting forth the character of the business, its location, and such other facts
l'erU,-;ni'1.f!, to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein mllst be submitted. It should also set forth in itemized form, together with the fair market value
there0" any other property owned or bequeathed by the decedent at the time of death.
The Scl>edu/e C attached hereto and made part hereof sets forth a true answer to each inquiry
contained Plerein 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 attacherl to the schenule 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 passes 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 Scl>edu/e D attachen 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 Scl>edu/e E attached hereto and mane 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 instrlooents effecting the .estiture of
real estate ann the date of acquisition of personalty, plus the name, address and relationship, if any,
of co-owners to the decedent.
......77)...:.........................
...........L.L~1jylv~
That Scl>edu/e F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for an<l on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudlei /try'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 unpaid 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 pledge(l 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 Reglster of Wills, and that
the amoun t of tax assessed can be reassessed in accordance therewi tho
That the totals of the appropriate columns in Scheaules "A", "B", "en, ~'I" and "F" as directed therein,
have been carried forward and properly registe~ed in the Summary. ~t ~~
Subscribed and sworn to before ma thiB .19fll........ /'F~RS TR~ST · OMPANY
J '- 'I CARLISLE, P . 17013
. ..0...... daYl't~ /1",ll'.. 19JZ . . .iE~~;:,;t;;;:::Ad;;;i;;;;;;;;t,;;:T...... .'
. . .......UJ/ll!1IJ~ ........................................................... ............................................
DORCAS l8RIGHT, NOTARY PUBLIC
CARLISLE BORO, CUMBERLAND COUNT(
MY CO;11MISSiOIJ EXPIRES AUG. 16. 1932
Member, Pennsylvania Association of Notaries
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", ana in case the assets include rare ann unlisted securities,
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 attached. Also make
certain that column #1 in the "Summary" has been properly completed as Ilbove-riirected.
(Street Number)
(City or Town and State)
RC C-34 (4-73) .
COMMONWEALTH 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
described by lot and block number, street and street number, together wi th
o general description of the property, with a reference to the record of the
conveyance by which the decedent took title; If a form stats number of a.
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,ore
to be listed on Schedule" F" and must not b. deducted from this schedule.
(1 )
(2)
(3)
D"PARTMENT
VALUATION
CAUTION
(Do not write
in this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTlMA TED
MARKET VALUE
Real Estate located 31 East North Street,
Carlisle, Pa. Recorded Deed Book #E
Vol. 14, Page 351
/
3,370.00J~ 24,000.00
.'if '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.
24,000.00
~ '4 COO, 00
)
.
RCC -~.5
HESIDEwr lH~CEDENT
SCHEDULE "Bn
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
THANSFER INllERIT,\NCE TAX
I NSTRUC'i'lONS: This Schedule must disclose all tangible and intangible personal property owned individually
by tile decedent, at the time of his death. Property owned by the decedent jointly with anothel" or others
must De 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 tl'ust 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 rlividends, salaries or wages, insurance pay-
able to the estate or f'irluciary in said capacity, partnership interests, interest in anyundistributed
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.
I tern ITEM UNIT ESTIMATED DEPARTMENT VALUATION
NO. Lis t and describe fully VALUE MARKET VALUE (Do not write in
this space)
1. Balance Trust U/Agreement with Farmers Trust Co. 2,650.89
2. Retirement Check, Commonwealth of Penna. 257.64
I
I
.
I
i
I
I
I
[
1 ns er t tbis to tal opposite "Personal Property", Schedule "B" in X X ~\ QOi. 53
the "As Reported" column on the last page of' this return. 2,908.53
RCC - J S
t'\)'A"H)\fi1::i\l.~'1l \1[: 1'E:\\SYLi-,\\iI,\
T,{A\Sr'~"'lZ I\EFIU'P\CF TAX
SCHEDULE "c"
TH \\<';:FEltS
i;ES 11\1-:\'1' m:C]<:rW\T
(1) Dirl rlecedent, wi thin two years of death, make any transfer of any material part of his estate, without
recpiving [! valnallle aEd adequHte consideration therefor? (Answer yes or no) no
(:,l) Did decerlent, wi tldn two yenrs of death, transfer property from himsel f to himsel f and another or
,.thers (inclwling a spouse) in joint ownership? (Answer yes or no) no
(;J) I f the answer to (1) or (2) above is in the affirmative state:
(a) Age of rlecerlent at time of transfer
(b) State of dece,lent'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 ef'fect in possession or enjoyment at or after his death?
(Answer yes or n~ no
(a) Was tllere any possitJility that the property transferred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or 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) TIle possession or enjoyment of or the right to income from th{' property transferred?
(,\nswer 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
(0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Dirl decerlent 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 It reserved power to alter, amend, or revoke, or whicll cOllld revert to necedent under terms
of transfer or by operation of law? (Answer yes or no) no
(9) If the anSwer to (H) above is in the affirmative, was the power to alter, amenrl, or revoke the inter-
est of the beneficiary reserve,l in the ctecerlent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions shoulrl be supported by affidavit hy the attending physician as
well as a copy of the rleath certii'icate.
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 vallie at date of death, dates of transfers and to whom transferred, with
relationship of transferees to rlecerlent, if any. Submit copy of any trust deer! or instrument, if trans-
fers are claimer! to be non-taxable, also slilimit detailerl statement of facts on which said claim is based.
"iOTE:J: List applicable property below in manner in which provided in Scherlules A, B, or E.
ITE~I
lJESCIUPTION
MARKET V AI,UE
(Es tima ted)
DlPT. VALUATION
(Dept. Only)
NONE
Insert this totril opposite HTransfersH, Schedule "CO in the
"As Reported" column on the] liSt p'ige of this return.
l\.\DNE"
REV.453 (8-78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELA TIONSHIP
(State full names and addresses of all who (If ste.p-chiWren or SURVIVED DATE INTEREST OF
ha ve an interest, vested, contingent or other- illegitimate children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set ST ATE YES BIRTH IN ESTATE
forth this fact.) OR NO
Distribution will be made to a1 11 f""'3C'C' R
beneficiaries. Actual shares n ht vet . in",rJ
.
-
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
....
.8oo~
~ ~ -'
.J::/- =l:t
'" - c
'= ~ E
.~ (]) ::j
e- -
"OPoo
~ E '-J
I 0 .
.... '-J .
o "0
.......... <U
::: [/) .....
'-J ::: ....
<U E 8-
x <U
S ~
(Sch. "A") $
(Sch. "B") $
(Sch, "C' ') $
$
$
$
(1)
(As Reported)
24.000.00
2,908.'l3
(2)
(As Determined)
SUMMAR Y
Real Property
Personal Property
Transfers
Gross Taxable Estate
26,908.53
$
$
$
$
$
$
~ "0
.... Z <U
CIS UJ [/)
Il.l ~ o:l
.... <U
UJ ...-I <:.l (l)
VJ Il.l ..J
- .J:: Q ...-I .oc(
~ 0 (/]
S '1-1 VJ
0::: ~
0.. L1.. .J:: ...-I o:l
0 () H .~ a:::
c
c.. CI) ell o:l Q..
Il.l ~ Il.lUJ t.) 'U ;> Q..
..s:: ..c::~ . ~ ~ .oc(
0 ~ UJ ~~ J;J::l 4-/ [/)
::c 0 ...-I s:: 0
Z c ~ ......~ (l) H s:: Z
.... OVJ 'U .J:: (l) Il.l
L1.. c.I.l ;::l b.O ~ 0.. .oc(
0 H ;::l "-' l-
e: .\..I 0 ;::l 0 a:::
.9 0::: H H t.) ..e 0
... (l) 0 ....
t<l UJ c.? 1=Q - Q..
.... ~ ~ w
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.... ~ 0 c
c "-'
.... ~ 0 ;>, 0
- E ..... E
Il.l C
:::=P1:j ..... ::l E
~~ ~ 0 0
..J U U
RC C ~:}8 .
IWSITlENT TJECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
CClM'10\;Wl<:\LTH \)F l'ENNSYLV\NIA
fH,\I\Sl'EH r~m:n.IT,\NCE TAX
r:-iSTRrCTIO,\CS: This schedule must disclose all property, real and personal, owned by the riecerient jointly
with 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 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, N~me I unit
Address and Relationship of Co-Owners, and Place i Value
of Record of Instrument, where Real Estate. 1
perce~tag~l..- Estate
Share 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.
~ () ~U:
I
.1
Cl.lIIFY, Nomber and Name 2l-Cumberl and
Fie l'llumber 21-78-0603
DClre of Death October 19, 1978
II
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SUMMARY
E~tate Name
Schmahl
Gertrude
(FIRST NAME)
E.
(lNI TI A\..l
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
(\..AST NAME)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberl and
Penniylvania, 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 Schedules "A", "B", "C", and "E".
Dated:
August 31, 1979
'~/,~il / ) ri 2 d I;Y!; 6) t(
/ 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 as a deduction.
Dated:
REGISTER OF WILLS
CODE ADJUSTMENTS
INVENTORY VALUE AS APPRAISED (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
Real Property (Schedule A) $ -? ~ (}M (}() 00+ 92+
Personal Property (Schedule B) ? qnR ~~ 10+
Joint-Held Property (Schedule E) nnn,Q 20+
Transfers (Schedule C) nnne 30+
TOTAL GROSS ASSETS ?{.. qnR ~~
Less Debts and Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
.l-
PRINCIPLE
FACTOR
VALUE
~
I
,
annuities............... ..... __ $
t=
F
ESTATE TAX ASSESSMENTS _ $
FOR USE OF REGISTER ONLY
T ax on $
To x on $
To x on $
Tax on $
Tax on $
Exemptions
Toto I E s to te
~
COMPUTATION OF TAX
2%
6%
15%
$
$
$
$
$
TOTAL TAX
$
I
1-
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
*
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 m ooth s after death
$
$
$
t=
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
to
AMOUNT OF ESTATE TAX ASSESSED
Es to te tax po ld
$
$
$
$
c
BALANCE DUE
Add interest at rate of 6% from
to
$
$
TOTAL TAX BALANCE $
PAID $
Supplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Ad! u stment
49+Adjustment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Charity
94-Remainder Residue
96-Success i ve
Life Estate
FOR USE OF REGISTER ONLY
ADJUSTMENTS
NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills for proper reason
same should be noted below, with short explanation. "
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..... "0 <:<:l 0 0
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REV-5I8 (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
Farmers Trust Co.
1 West High Street
Carlisle, PA 17013
(Executor or Administrator)
In Re: Estate of
Gertrude E. Schmohl
Cumberland
County - File No. 21-78-0603
Dear Sir:
You are hereby notified that the original
appraisement in the estate of Gertrude Eo Schmohl
has been filed in the office of the Register of Wills of Cumberl and
County on Augus t 31 . 19-19-. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
24,000.00
2,908.1)'3
none
none
26,908.1)3
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.
Date
August 31, 1979
Signed
"-/~h I>-{'(l~( / J/~.)!. (.
Title Appraiser
NOTE: This is not a bill.
REV-457 (B-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P,O. BOX 2970
HARRISBURG, PENNA. 17105
COMrvl0NWEAL TH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE
August 3l. l~~
Cumberland
,,~~,.L:I8_::.Q_Q,Q3_ "
COUNTY
FILEN0.
Whereas, Gert rude E. Schmoh I late of Ca rJ is 1 e Boro
in the County of Lumbp. r] ;:mrl _ Commonwealth of PonnsylvJnia, hilvinq died nn
the 19th day of Dc tober 19 Z9- I seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Sandra L. Stone ~ I an appraiser duly ar;pointed ac~;'xding to
havinq been designated to make a fair and ccm:cionable appraisement of the said estate, ;:i:1d to d~~se"s dpd lJx the (',"'11
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 i~ possession or enjoyment to collateral lleirs of the decadent ..:lfi~r u~c eX;Jil'dtioli
of any estate for life or for years, the Commonwealth hereby ex.pressly reserves the right to appraise and assess transfer inher~tancf' taxes at the !awful coHatp.ral
rate on any such future interest.
DESCR!PTION OF ASSET
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ApPrai$(-~\n€nt
:\'l~;de for: nheritance
Tax Purposes
TOTAL ASSETS
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$ ?u nnn inn
r 2~::: 153--1
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none i
]6 .J 908 \53
Real Estate
Personal Property
Joint-Held Property
Transfers
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I
Have been duly sworn according to law, I do hereby certi
with the law on this 1] c; t day of
C
that the above appraisement is made in conformity
19 19-.
Appraiser
(Number and Street)
Harrisburg
(Post Office)
. Penna.
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