HomeMy WebLinkAbout03-12-79
DEDUCTIONS ALLOWED IN
Form RC C .10
OFFICE OF THE
REGISTER OF WILLS
~/- 7 f;,,:'v1V
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF ............ $ 1~?2~Jf~,
.~.:(~-u~.rz.9 .
DATE APPROVED ........
OF Cumberland COUNTY
DATE OF FILING APPRAISEMENT
~~-tIJ ' ~/lA'-Z< /-
LATE OF CAMP HILL PENNSYLVANIA
DATE 0,. DEATH DECEMBER 11, 1978
AND AGENT OF THE COMMONWIALTH
ESTATE OF Helen N. Moser
I I
DATE NO. 0" NAME OF PAVEE REMARKS AMOUNT
vOUCHCIt
12/6 78 Patterson Litton ET AL Physi cians - X-Rav !i2 100
11/6 78 Roll ing Green Cemetery Grave Marker - Helen N. Moser 370 00
1111it /78 Quickel-Connor Associates Physicians 17 nn
1 '';. ;( 178
1 ~11 ~ Riverton Water Co. Water bill Re: 489 26 01
11/3C /78 Readers Di!:lest Subscri otions ?J... A~
02/0~ /79 Lorraine Raistrick Cash Anaysis For Tax Returns AR ,00
12/11 /78 Internal Revenue Payroll Taxes RE: Nurse 379 .40
12/11 /78 P A Deot. of Revenue Pavroll Taxes ~I=. ......",..,... L 0..4
12/11 1/78 West Shore Tax Office Payroll Taxes RE: Nurse ~ 1n
12/11 178 Internal Revenue 1978 Federal Income Tax 1 , 008 00
12/11 178 P ADept. of Revenue 1978 Penna. Income Tax ~n ,nn
12/1 = 178 Myers-Hall Funeral Home Funeral Servi ces 1 RQ~ nn
12/1 = il78 Rev. Spencer B. Smith Funeral Serwii:es ''1 nn
92/2~ /79 Wm. J. Daylor Real Estate Aooraiser 100 m
03/01 79 Anne F. KeUler, Tax Collector Boro & Countv RE: Taxes ?AJ... 1?1
02/2C /79 Robert Browand Snow" _ RF. ARQ 70 nn
12/28 /78 Cumberl and Countv Shnrt r....~":t:,..t'lt..... It I .LL. 70 nn
VARll DUS Susauehanna Oil Comoanv Fuel Oil - ~I=. ARQ ,)':;:0 1')1
VARI DUS Bell Teleohone 737-9!il? ~I=. ARQ " IR'1
02/12 /79 Norman Coorney Aooraisina - . , -~~ .'10 nn
01/2-4 /79 Cumberl and d Pub I i shers, Inc. Advertise Estate 20 1!i
01/06 /79 Patriot-News Adv. - ,., . .., A ,m
02/27 179 PP & L ... ~,..;hl ~I=. ARQ '1'1 1A~
02/08 1/79 Truman E. Horner, Inc. T rash Removal RE: 4.89 Q 71:\
VARI( 'US John M. Moser. Executor Executnr Fp.fO!S o Ann nn
VARI( )US Smith. Chamberlain & Hed!:ler PC Leaal Fees 1 .'100 00
COMMONWEAL.TH OF PENNSYLVANIA ($15,669.48)
. ss:
COUNTY OF Dauphin} IS?21.;/g
I. JOHN M. MOSER HEREBV CERTIFY. THAT. TO THE BEaT OF
MY KNOWLEDGE AND BELIEP', THE FOREGOING .S A JUST j!t~ TRU E srATEMENT OF DEBTS. FUNERAL EXPENSES AND EXPENSU OF
ACMINISTRI,TION SUBMlrrED TO THE ESTATE OF LEN N. MOSER DECEASED. AS DEDUCTIONli FOR
\~'W\.~~
DAY 01' 0 John M. Moser, Executor
INHERITANCE TAX PURPOSES.
(L.6.1
SWORN AND 8UBSCRIBli:D BEFORE ME THIS /0 ;;e,l
~ III:z..t-
4~~~~~
HARRISBUItG.D PHIN COUN
MY COMMISSION EXPIRES MAY 17. 198C
Member. Pennsylvania Association of Nlltaries
RC~33 (4-73',
~
t
COMMONWEALTH OF PENNSYL V ANI A
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
021-1 J'- 01, 7 R
3-/;...-71
.. lo-J.()6-f
RESIDENT DECEDENT
COUNTY OF
CUMBERLAND
IMPORTANT:
This retwn 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'ltenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
IN THE MA TTER OF THE EST A TE OF
} AFFIDA VlT OF
EXECUTOR
C XBM~KX~8K
ounty
HELEN N. MOSER
ISTATE FUL.L. NAME OF DECEDENT)
Late of
CUMBERLAND
State of PE N N SYL VAN IA
County of DAUPH IN
~
} ..,
JOHN M. MOSER
Executor
of the estote of the obove-named decedent being duly sworn, depos.
and say
December 11,
(MONTH)
Nome and addre.s of attorney or }
other authorlz.d representative 10 whom
all correspondence should be mailed.
(DAY)
, 19~{le.lat. ~eaving a last will, copy of which Is herelo attached.,}
(YEAR) ~~
Decedent died
JOHN M. MOSE~, EXECUTOR
2917 NORTH FRONT STREET, HARRISBURG, PENNSYLVANIA
That as such EXECUTOR deponent is familiar with the affairs of said estate and the property constituting
( EXECUTOR-ADMINISTRATOR)
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 THIS SAFE DEPOSIT BOX RENTED REL. A T10NSHIP 0 F JOIN T
IN WHICH DECEDENT RENTED A S.~FE DEPOSIT BOX IN NAME OR NAMES OF HOL.DERS 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 ses sion, s tanding 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 prior to decedent's
death in the case of s~vings panks, 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 stattde 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, 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 promis sory 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 interest thereon to the date of decedent's
death and other in\"estment 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 l!usiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the dgreement)
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 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, wi thin two years of decedent's
death, in contemplation of decedent's death, or intended to t~ke 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 co~y
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, 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 schemlle.
That ScheduleD 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, andthe 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 behalf 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 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 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", We", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
SUbscribed?:d8:rnof ~~::-~:-~-:~=~~ -~~ \~,J~~~~!:~\::~___
....--.-..-........... ~. tJ~~t~C1Ltor-Administrator)
-~~~~:€~~-... ------------~~lLi~~~um.m----
HARRISBURG PENNSYLVANIA 17110
MY COMMISSION EXPIRES MAY 17. 1980 .................................-........__._.._.1.__._......._.........__....................__..........._.
Member, Pennsylvania AssociatIOn of Nl.ltaries (City or Town and State)
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", ~nd 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 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 above-directed.
RC C-U (/-.7'1
COMMON'WEAL. TH OF PENhSYL.VANIA
~PARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "Au
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
os 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 Commo"wealth of Pennsylvania should be
described by lot and block number, street and street number, together with
o genernl 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 deced~n'. Taxes, assessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule "F" and must not be deducted from this schedule.
(1)
(2)
(3)
DEPARTMENT
VAL.UATION
CAUTION
(Do not writ.
In this spoce)
ASSESSED VAL.UE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMATED
MARKET VAL.UE
2 Story Brick & Frame Dwell ing located at 489 Country
Club Road, Camp Hill, Penna_ 17011
$8,490/
$67,0~
Account # 01-20-1852-107
Purchased May 13, 1941, Recorded in the office of
the Recorder of Deeds in Deed Book I Volume 12
Page 421
No Mortgage on the Property at date of death
: ,
-'t,...
.\
.
I h. I ." I " S h d I "A'" h
nsert t 's tota oppos, te rea property , c e u e ,n t e
"As Reported" column on the last page of this return.
xxxxx
67,000
to '1 \ 0 00 .0.)
nESlnEXT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
Page 1 of 2
'*
': ... -'::'
rmI.\IOSWE.\LTH OF PENNSYLVANIA
TFU."JSFEn INHERITANCE TAX
I SSTIU:CTlOSS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time o~ his death. Property owned by the decedent jointly with another or others
must be listed under Schedule wEw. Intangible personal property, titled in the name of the decedent, but
pa)'llble 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 o~ 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 certi~icates, 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 ~rom any property held in trust under the will or agreement o~ another, even though
located outside o~ the State, at the time o~ death, should be listed in this schedule.
1 t.t~m
}!iO.
ITa!
List and describe fully
UNIT' ESTIMATED
VALUE MARKE:I' VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
10
Personal Property - Listing attached
1,46/
2,46~'
/.
1 , 096
1 , 48~'
621 //
1, 1 62 /'/
945/"
85~
347/
435/"
36i
50<Y"
1
Personal Property - Listing attached
2
Personal Property - Listi ng attached
3
Personal Property - Listing attached
4
Personal Property - Listing attached
5
Personal Property - Listing attached
6
Personal Property - Listing attached
7
Persona.1 Property - Listing attached
8
Personal Property - Listing attached
9
Personal Property - Listing attached
11
Personal Property - Listing attached
12
Diamond Ring
13
Cash in Bank - CCNB
N j..Y. (:;. ,-:>,~ t.\.
'.J 0'
\A.. " \
19
I US Bonds - SERIES E
i Bond - AT & T - 8.75% Due 5/2/2000
I
50 Shares - U. G.I. $2.75
Preferred
27.250
(~~j/q3g 13
QID Sll. f,,~
cL-.~ 7- \ B(~q " DL\
40,000/
'~"18 ,l '1.-
3,500./
4,000/
377'/
9SY'
"1,363/
/
44, 62.1
14
Savings Account - CCNB
15
Savings Account - Harris Savings
16
Savings Certificates - Harris Savings
~.
17
Notes Receivable - John M. & Elizabeth S. Moser
18
Note Receivable -
Robert J. & Doris S. Moser ~
'.. () < ..J . ...-,. L.\
j....;J ;1... I .
\)0 \.....\ ~ \. 0
.....~
20
21
22
730 Shares - AT&T
Common
61 . 125
BALANCE FORWARD
108,671
.I\!.~rt this total opposite wPersonal Property-, Schedule -B- 1n
.he w'\s Reported- column on the lo.st page of this return.
x X
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Living Room
Schedule B
Poge 1
Description 1/ Value I
Blue Couch I .t, S' I
Nest of Three Tables ,
~
Gateleg Table .~.r
Magazine Rack (7/
Pink Couch . I 2.,!'
Trestle Type Table ( ~ ~) If'
Rocking Chair f tfc
I
Armed Ladder Back Chair : "3!""
Floor Lamp - 6 Way ..5
Antique Cherry Gat.eleg Table (:0,. . r )...,..~
.L
Fan Back Chair ~) I 50
.. j 1[0
RCA 25" Color TV
-
Record Rack With Records . It:)
I
Foot Stool : .J1.
Three-Way Lamp I (t)
Reading Lamp ;z{
I
Lamp Affixed to Wall J I .3
Gold Brackets (with plants attached to wall)1 2 I 5'
. I
Gray Framed Picture I So
I :
White Framed Picture I I So
i
Oval Needlepoint Pictures 12; 30
. I
Gold Framed Picture Kt1,J I : 1.D
,
Medallion - 2" Across (on wall) I ~
i <6
I
Small ones - H" Across (on wall) : 2 i
: . I
Misc. Plants, Ashtrays, Bookends, Flowers ! 1-5 I
I
Mantle Clock ; I
i ; /!is--
(~'-~) I bD
Pieces of China !2
I
Glass Vases (TV) . I
l (0
Electric Clock , I ,
Fireplace Screen I ,
i
Fireplace Grate ,
TV Lamp -
Control Unit for a Motorized TV Antenna ~5
Indoor/Outdoor Thermometer --
Magnovox Stereo' Console 5D
Brass Lamps 2 Q.5
Page Totals l'f"
, ,
--
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Dining Room
Schedule B
Page 2
Description tI Value
Cherry Gateleg Table 350
Centerpiece Balance w/imitation fruit, mirrc r 5
Sideboard/Buffet - ---.,
China Closet l ~o
) /
Two-Door Serving Cabinet
Set of ladder Back Chairs (one with arms) 150
Ornate Carved Wooden Chair .3 r:o.
Three-Table Nest of Tables (veneer chipped) Isl
GE Superline Air Conditioning Unit (DO
Oval Gold Mirror {<6 !
Chairs, Needlepoint Seats ( tAs--r LA /("i) 4 300
Set of Sterling Silver ~l)O
-
. i
KIIr Ht-N
,
Homeade Table 'i-t"
Window Seat r
~
Toastmaster Toaster J-
G E Range .;tc !
GE Refrigerator { 00
Plank Bottom Chairs 2 ?..'t
T wo- Step Ladder 2 I
Breadbox ,
Other Miscellaneous Kitchen Wares ;{l) I
f( ~'>'fAw A(L~ (Do
I
i
4
i
DFN \) ~<;. \< ~W'~, ~J)!
Card Table :1
Small Framed Pi ctures 4
Dad's plaque & cartoon pi cture/I ibrary -
Various books, geographi cs, projector, sl idE S-
HALL CLOSET (DOWNSTAIRS)
Card Table Chairs 4 (0
Card Table ~
Hoover Upright Sweeper 10
Projection Screen ~
Page Totals 7...,1.((3
. ,
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Master Bedroom
;.
~.
-T -- - II . - .. . .... --.......
Description Value
Bedroom Suite ,
Manis Dresser ~ !
ladies' Double Dresser I
Matching Oval Mirror ,
\ ~()()
ladies' Vanity W/Stool > .
---~
Rectangular Mirror
Headboard & Footboard
Mattress and Box Spri ng I
I
Night Stand ~I
Day Bed g'5'
Antique Rocker ~
-.- -_._-- -..-'-...-....- .--- ~of
Antique Arm Chair
Martha Washington Sewing Cabinet - J r:
Magazine Rack - ---.---- ------- - -------;-0 I
Footstool CO!
c-
Gateleg Table J.~ !
,
19" Magnovox Black & White TV w/stand ~O I
Scatter Rugs (not in good shape) 3 (5" I
Reading lamp Ie> I
j
Flower Pi ctures on the wall 2 Yl
Picture of a Mission on the wal I ~ !
Father & Mother Print Pictures -11
Footstool
1. Y1~
Misc. Costume Jewelry, Racks, Trays, I
Perfumes, Photos and the like :L5.1
--"------ - -- f-------.J-.
T obi e Model Radio AM/FM Zen i th IS Ii
$20 Gold Piece ~&O ;~
II
. II
....
r
-- -T
.
Page T otols (,01'
Schedule B
Page 3
r _
-.
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Yellow Bedroom
Schedule B
Page 4
, \
-7
Description fI Value
Lorge Cedar Storage Chest I~O
3/4 Size Four Poster Bed 1~1'
Box Spring and Mattress 1S
Striped Arm Choir ao
White Bookcase ~ tD
Dresser With Mirror (t81c>) Lfoj
- - I ~ 'I
"Three-Drawer Nightstand
Green Carpet sIT
. (
Lamp on the wall
Table w/seven small gloss-knobbed drawen P
Luggage Stand I
Small Dre~~~_~~~~__,,_._____.__ _ . I
-
Gooseneck Lamp I I
!
I
-----.-.- ------,-.- -- --.----- .
BLUE BEDROOM 'I
Twin Beds w/ladder & sideboards '/01
Box Spri ngs & Mattress - z51
Lorge Double Dresser ~ .:tc0:l _~" J 'fDDII
Small Dresser Lamp 'i
Maple Double Dresser w/matching maple .;2 D II
mirror II
Dark Four-Shelf Cabinet toil
Nine Drawer Kneehole Desk :2~1
- --
Queen Anne Type Choir ~Cl
Reddish/Orange Carpet -~.
- - - -- ---
Mapl e Arm Chai r >11
I'
.
I
I
UPSTAIRS HALL I
,
I
Lorge Double Dresser w/matching oval
mirror ~ ~ I 't Y-> ) -- 4 CJD
Small Dresser amp {
Wool Sweater Rock I
AM/FM Portable Radio , II
AM/FM Portable Radio I I
Page Totals { 'f 1'1
,
~
^-
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Front Bedroom
Schedule B
Page 5
~
Description 1/ Value
Pineapple Four Poster Type Bed ') '''6 I v'{"
Box. Spri ng & Mattress I, t) ~ ,
0:......- ,
Tall Dresser With Mirror trfO
Double Dresser With Mirror ,
./ 3~
Emerson AM Table Model Radio I
Small Dresser lamp I
- --- SD i
Victorian Chair
I
Arm Chair ([i
.
Gray Scatter Rug .r
luggage Stand I
Small Table 1-S-
.. - -.... ----- ...-.'
SEWING ROOM
-.,.------. --- .-- --.---.-.
Old Type Six Shelf locker Type Cabinet '5
Old Table ~fl
Readi ng lamp I I
Old Blond Walnut Chair .$
Small Pi cture on the wall I
Singer Sewing Machine I
.(/)'
ATTIC
National Geographies (dating to 1951/50) :~
large Steamer Type Trunk
h _
large Chest (drawers used for Uncle i
i
Shelly's Paints IDD!
--..---- -. -.
Clothing Storage Chests 4 50:
Electric Fan !
I I
Square Window Fan si
Various Other Items, picture frames, etc. (0 :
!
I
I
I
,
PaQe Totals /, ~I ;
--
.0.
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
Downstairs Hall
Schedule
Page 6
.
.
.,.
Description
7r II .
Value
----
- ,
~ I
i
I
12-)
--- - {Lfo
,
:
Small Vase
Pi cture with Moser Medall ion
Rectangular Mirror
Mai I Rack
Incl inator
I I c.. ,r\ h 'f. r IJ fLI:i.
BASEME NT
Frigadare Refrigerator
OIEl Gf Dryer SCQV'r 1)cz...ter
~.
{DD
SearS Washing Machine 1"1..5
Various C~binets __ _ _ ___~__ ___ _ N {
Window Seat -:v ~;
Brackets (match-=-o~_in th-=_~i~c.he~_n__ _ ~_.__fl.." ,
Workbench ~ 117,
Various tools, nails, .Qld paint~, cabinets d ~
rLA~~s ~ clkf5~ ~~ .
Xmas Decorations ^' J I
Step ladder S
Various Storm Windows 5-(/r1 wftt+-
Various Screen Doors $1'It'1 "//11
10
~(
"8''> !
1
Various Mason Jars (with & without lids)
Old Homemade Jelly Cupboard
(~...,.
GARAGE
Spare Tires with Wheels
lawnmower
2
If) .
ID i
S"l
II
,
10 I
5'i
~'
Various Porch Chairs
Hi bach i
Various Garden Tools
Various Other Tools, Vases, Jars, Plants, etc.
P ,"\""'0 "T'~ '0:iJ I hI' n d 1'0 'r
r~~/J l w tD{
/
Page Totals
I, ('''-
..
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
c.o~~ c\J~ao....(\.~
Schedule B
Page 7
..
.
.,
Descriptian
PINK 8. BLUE UMOGE HAVILAND
Coffee Cups
Saucers
Dessert Dishes
-, Valu~---
Dessert PI ates
Salad Plates
lC -(
(
9
9
11
I
31(1
------1\
:\
Hors d'oeuvre
Vegetable Bowl
10" Dinner Plate
Butter Chips
11
-
Footed Candy Dish ?
Gold Guilded Nut Dish (Mfg. Unknown) It S I
_.___.___..________ -4.
Decorator Cookie Plate !; I
Hummel Figures . 4 15 i
: PLAIN PINK lIM<5GE-SEr--.----~--A-- - ----I-
i Saucers 1 ( -- I J
I
I Cups
~etable Dishes
Meat Tray
Covered Vegetable Dish
8~" Dinner Plates
Celery Tray (Marked with II Nil)
Misc. Saucer (doesn't match either set)
Silver Plated Revere Bowls
-..---..
Handled Cookie Dish - Plated
Butter D ish With Cover - SiI ver
7
2
I
~vl
il
II
il
!I
12
2
Cut Glass Jelly Jar With Silver Lid
Japanese Bowl
Japanese Bowl
Glass Plate - 6" Diameter
8" Plate - Cut Glass - (~ G...A)
Salt, Pepper, & Sugar Cluster wi carrier
Gol d Basket
Red Vase (~)<.
~
Cut Glass Jelly Dish
Large Wine Glasses
lC
{-v
?-o
~
YD
tt:> I
5"01
CfI{.C I.
- --
Page Totals
. .
.
,
,.
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
~o ~\..-.. c.'-l ~(l o~~.r
Schedule B
Page 8
.,
Description -7r Value
Small Crystal Goblet ID ,
,
Glass Relish Tray with Spoon or ladle ~ i
I
Glass Bowl 10 ~
Multi-Colored Dish ~ .
Set of Five Cordial Glasses S If()
Set o~ larger Cordial Glasses g tf.o
Sandwich Glass Coasters 24 1'-
Sandwich Glass Dessert Dishes 7 ( > 3".0
Sandwich Glass luncheon Plates 8 \
Footed Sandwich Glass Goblets 10 J
Bud Vase , $
Pink Flowered Vase ~
- ---------'~----
Cut Glass Salts '3 U b {g-
Glass Cream Pitcher 8
-- ------- - - - -v.--'- -- --..-...,.
Glass Barrel Glass ~~ 2 I b
Red Vase (c. ~d A ~) 1'lLJ
Decantur with Stopper ( "l"" At,.. ~. r" -.>. ~ .50
Covered Candy Dish ;{
Amber Footed Goblet '10
Pitcher 1'9
Hurricane Chimney I
Three-Piece Jelly Jar If
Egg Cup ~
Dark Wedgewood 3 /3 0 ~
Piece of light Wedgewood- If l
I
Vase - Wedgewood Color t';
..---
Blue Glass Candlesticks 2 IIfG.LN oti
Blue Gloss Sugar Container "<i~ i
Blue Glass Creamer (l (I.JW. e I
Blue Glass Vase , I
i
I
Small Blue Glass Pitcher J..-
Gold Rimmed Candy Dish ll.,
- --
Glass Bowl -C",+ ~ , Cl..1'.J {IO
Page Totals . i .(',
..
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
c~~~t~ C~.&o~l
t
.f>
Description
LIGHT BLUE GLASS
Plates
c
, on lL
G---.tl~
Saucers
Small Cereal Type Bowls
Casserole Covered Dish
Footed Tumblers
Smoky Glass Vase
Relish Dish
Footed Custard Glasses
Footed Water Glasses
Compote
Small Pansey Glass Vases
- ..._- ---..---.-..------.---- -
Blue Gloss Radish Dish
Chino Flower Arrangement
Glass Bluebird
Gloss Bell
Blue Turquoise Colored Plate
Blue Gloss Cordial Gloss
Various Colors - Wine Glosses
BI ue Glass Vase
Blue Glass Ashtray
Pink Meat Plotter
Green Meat Plotter - cracked
Blue Glass Candle Stick Holders
Pink & Green Soup Tureen With Cover
Green Dinner Plates
Large Round Chino Plotter
Page Totals
Schedule B
Page 9
- ~ .
/I Value
. ~r
8
12
12
Ti
I 1
';<09
I '
5
--.- --- ---
7
7
3
-"-
,
~€ C ~Olll
~
-- .---..-..--?
:S
~
12.
S'
;lq
~
j
;1.~
I III Gl-U9S1>
I(€J-r P,oG:'i
'1
i. ~t- A1r.",
5"0
~
1"I..~I,.r"~
~""f~
I
3'1'7
. ~
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
C ~ ('..rt.... (." ~ Ct 0 AJf..CI r
'J.
...
Description # Value
GREEN CHINA - 1\
Butter Chips f i
Small Bowls ~ I
Round Covered Vegetable Dish !
Gravy Boot With PI ate
Vegetable Dish -- I
Relish Tray 1
Soup Bowls 3 \~ j,/Y{ I
Dinner Plates 3 ?
Bone PI ate
Meat Plotter - Small
Coffee Cups ~
-..-----..-. --.-.-
Vegetable Dish With lid
Luncheon Plates 11
----_.._.._~ -- -.----
Odd Piece - Green Chino
Soup Bowls S 1
Saucers 7 ) I
, I
Pink & Blue Saucers 2 ;z.oi
PINK & BLUE HAVILAND ~ ~~.
Custard Cups 1~
~
Green & Pink Cups 1 6 ~D Ii
Green & Pink Saucers I 6
;1
Plate - White With Blue Stripe \1_ 10 J
!
1
Pink & BI ue Custard Cup Saucers F*~ 8 ,
5i.f AGo ~ .
.
Chino Pink Saucer, Misc. ,
i
- ---._---
SERVICE TABLE . I
Silver Tray I J I
Sil ver Sugar Dish \. ~~l
Silver Pitcher I
,.
Gloss Serv ice Troy S'
Homemacl.e Display Shelf w/various 5
";ArnmlCS- --- .
SiI ver Coffee Pitcher 10
Page Totals ~
Schedule B
Page 10
..
,"
Description
BUFFET
Large Silver Candlestick Holders
Large Silver Serving Tray J'
Large Coffee Pot - Silver
Teapot With Silver Plate
Silver Milk Pitcher
\. GO
Large Sugar Bowl With lid
Small Sugar Bowl
Sal t and Pepper Shaker
Si I ver Nut Trays
Silver Cigarette Holders
.-.
ESTATE OF HELEN N. MOSER
PERSONAL PROPERTY LISTING
C~..~~ <:,,,p~ o~A.AS
Schedule B
Page 11
7T Value
.
2
.301
I
I
I
.
.
i
JJS
2
2
3.0
I~
;k>
ON THE CHINA CLOSET
Silver Candlestic~~older _____._______ __ __._.Ii.
Milkglass Cake Plate ~
Small Flower Arrangement S
SiI ver Gravy Boat (small) (matche~\ SU
large silver tray on buffet) ~ A6D~
, N c.. H- I rv-A- <::...L.c J't.. '7
"'- ~(~ ()('LQ.SJ'~ J ~
Lu (""'/a--e ~.o W""2::_
"
~A-SJ' WI.~I~~~-';M.~~'x)
-~U-S\ 5N~~
c.f.\ t"l'h.. C ~ r t", e.c."-
M Il.-I( ~ (..,,:?S' (?.Irotet"r ~dC v(! 5
Page Totals
is-I
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I
1
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2~
~
Page 2 of 2
.
.
n~'InE~T DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
~~A
,~'
r(l~~IO~WF..\LTH OF PENNSYLVANIA
Tr...t.'\SFER INHERITANCE TAX
I\Sn\rCTI0~S: This Schedule must disclose all tangible and intangible personal property owned individually
hy the decedent, at the time of his death. Property owned by the decedent Jointly with another or others
must b~ listed under Schedule "E". Intangible personal property, titled in the nMJe of the decedent, but
pa~':lble 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 artministered estate.
Tangible personal property should be listed first (e.g. Jewelry, wearing apparel, household
goorls, 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-
atle to the estate or fiduciary 1n said capacity, partnership interests, interest in any undis tributed
e5ttlte of or income from any property held in trust under the will or agreement of another, even though
loeated outside of the State, at the time of death, should be listed in this schedule.
I tt'JIl
~o.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKEl' VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
.- I ,QALANCE BROUGHT FORW ~RD 108,671
100 Shares - Duquesne Ugh t Common 15.875 /'
23 1,587/'"
,/'
24 20 Shares - Fruehauf Corp. Common 26.125 522/'
/
25 20 Shares - International Paper Common 39.500 790../'
:~6 64 Shares - N L Industries Common 1 9. 875 1,272/
27 80 Shares - ST Joe Minerals Common 24.500 1 , 960//
'~8 909.502 Shares - Well ington Fund Common 8.680 8,068/
'"
?9 I Grandfathers Clock 1,000//
I
i 1I!.~rt this total opposite "Personal Property", Schedule "B" in
~lae "\5 l\cportell" column on the last page of this return.
x X
C!23,86.o
\2(""'"S \ t> . S'?
RCC..36
'COMMONWEALTH OF PENNSYLVANIA
TRANSr~R INHERITANCE TAX
SCHEDULE "c"
TRANSFERS
'*
RESIDENT DECEDENT
(1) Did decedent, within two years o1'death, make any trans1'er 01' any material part of' his estate, without
receiving a valuable and adequate consideration there1'or? (Answer yes or no) ~()
(2) Did decedent, within two years 01' death, trans1'er proper~y 1'rom hi~s~1f' to himsel1' and another or
others (including a spouse) in joint ownership? (Answer yes or no) ~()
(3) 11' the answer to (1) or (2) above is in the a1'1'irmative state:
(a) Age of' de~edent at time of' trans1'er
(b) State of' decedent's health at time 01' making the trans1'er. (Note 1).
(c) Cause 01' decedent's death. (Note 1).
(4) Did decedent, in his lif'etime, make any trans1'er 01' property without receiving a valuable or adequate
consideration theref'or which was to take e1'f'ect in possession or enjoyment at or af'ter his death?
(Answer yes or no)___________
(a) Was there any pOSSibility that the property transf'erred might return to transf'erer or his
estate or be subject to his power 01' disposition? (Answer yes or no)
(b) What was the trans1'eree's age at time 01' decedent's death?
(5) Did decedent in his li1'etime make any transf'er without receiving a valuable and adequate consideration
there1'or under which trans1'eror expressly or impliedly reserves f'or his lif'e or any period which does
not in 1'act end be1'ore his death:
(a) The possession or enjoyment of' or the right to income f'rom the property transf'erred?
(Answer yes or no)
(b) The right to designate the persons who shall possess or enjoy the property trans1'erred or
income there1'rom? (Answer yes or no)
(6) 11' the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in his 1 ifetime make a transf'er, the consideration for which was transferee's promise to
pay income to or for the benefit of care 01' trans1'eror? (Answer yes or no)
(8) Did decedent, at any time, trans1'er property, the bene1'icial enjoyment 01' which was subject to change,
because 01' a reserved power to alter, amend, or revoke, or which could revert to decedent under terms
of trans1'er or by operation 01' law? (Answer yes or no)
(9) 11' the answer to (8) above is in the af1'irmative, was the power to alter, amend, or revoke the inter-
est 01' the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The answers to these questions should be supported by a1'fidavit by the attending physician as
well as a copy 01' the death certificate.
NOTE 2: If answer to any 01' the above questions is yes, set 1'orth below a description of the property
trans1'erred, it's 1'air market value at date of death, dates 01' trans1'ers and to whom trans1'erred, with
relationship 01' trans1'erees to decedent, i1' any. Submit-copy 01' any trust deed or instrument, i1' trans-
1'ers are claimed to be non-taxable, also submit detailed statement 01' 1'acts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Es tima ted)
DEPT. VALUATION
(Dept. Only)
NOT APPLICABLE
NONE
N (0-L
Insert this total opposite wTrans1'ersw, Schedule wCw in the
WAs ReportedW column on the last page of' this return.
NONE
"ee-37 (12-6))
OM~IOXWEALTn OF PE:'I:~SYYLANIA
'RANSFER INHERITANCE TAX
ESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
*'
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
ate full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
e an interest, vested, contingent or other are involved, set STATE YES IN ESTATE
wise in estate) forth this fact.) OR NO BIRTH
ROBERT J. MOSER SON YES 7/22/29 ONE THIRD
3152 TOLEDO AVENUE
TULSA. OKLAHOMA 74135
RICHARD A. MOSER SON YES 2/10/32 ONE THIRD
105 WHITMUN ROAD
LONGMEADOW, MASS 01106
JOHN M. MOSER SON YES 8/19/35 ONE THIRD
419 SUSAN ROAD
HARRISBURG, PENNSYLVANIA
17109
leponent fUrther says that all the above-named bene~iciaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
NOT APPLICABLE
.. .....
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....-....
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SUMMARY
Real Property ......... .... .... ..... .......... .......................................... ( Sch. "A")
Personal Property ..................................................................( Sch. "B")
Transfers .......................... ................................................... ..... (Sch. "e")
Gross Taxable Estate ... .... ................. .... ...... ...... ..... .... ... ..... ............. .........
(1)
( As . Reported)
$. ..~!(.q9q............ .........
123 , 869 .
$......................................
$........=........................
$........=..........:......:...
$........~.......................
$. .19.Q~.a6.9.. ....... ............
(2)
(As Detcrminct
. $.....................
$.....................
$...............,......... ..
. $.................
$.................... .
$.....................
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RC C-.JI
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
*'
CoMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly
wi th anot.her or others, including intangibles, standing in the name of' the decedent and others. List
real estate f'irst, as entireties, or joint tenants, giving brief' description, as indicated under Schedule
RAR, plus the date and place of' record of' instrument ef'f'ecting vestiture, but do not include entireties
or out of' st~te real estate value in estate valuatioh column. Personal property should be listed as in
Schedule RBR, plus date of' acquisition, and the name, address and relationship (if' any) of' Co-owners to
the der.~,ient.
I
Description of' Property, Date of' AcquisitiQn, Name
Address and Relationship of' Co-Owners, and Place
of' Record of' Instrument where Real Estate.
.
unit
Value
Percentage Estate
Share Valuation
DEPARTYEHT VALUATION
CAUTION-Do not Write
I n This Space.
Value of' Value of'
Entire Decedent's
Property Interest
All Property owned by Deceased outright (/
The property had been owned jointly as
Joint Tenants with Right of Survivorship
however her spouse died October 6, 1978.
Insert this total opposite -Jointly Owned PropertyR, Schedule -E-
in the -"AS Reported- column on the last page of' this return.
NONE
t~ r-JL