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HomeMy WebLinkAbout12-28-78 Form No, RCC.62 (6.70) THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER tl0.ooo. UNDER SECTION 701 OF ACT OF JUNE 1.. 1.81. EFl"ECTIVJ: JANUARY 1. 1982. (FILE IN OUPUCATE WITH COPY OF WILL ATTACHED) * OFFICE OF' THE REGISTER OF WILLS ,.2/ - /Y',5?/ ~PFP 'J e, ~("'~Q County of . . P~E;Ip;.~P. . . . , . . , . , , . . , ... .., (; !\. /;; /,. ...".",. R&l;U' ,e,. ~,e.s.~.,. ,',.",.,.,.".."." of ., R.,.o, .11.6., Sh.ippensburg.,. .P.a."",.,.."." (Name) (Addr_)' being duly..mm.____..Bw.a.Dl..__mm'huaccording to law, deposes and says that he is the __....Anm; n; l'l tl:ato.r..__mu.m.m__...mm. (Exec., Adm.. Leptft, EtC.) of the estate of.n_m'_~~~~__~.~__~~~~.um.____muu._._ whose last residence was.m_._~Q~Q!!gh._9.t..nm__m__m____mm._mmn_ (No.) (Slreet) m.m-.Shipue.ns.huJ:ghu__m_.__m_.deceased, and that the whole of the estate of said decedent, who died _..!~.~.!'.Ym.?_I~_.l9.?tt (CilY. 90rouBh or" Township) (Dale) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA. WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES. GIVE NAMES. ADDRESSES AlIm RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value All that certain lot of round situate in Southa ton Townshi P S Personal Property Household items sold at P PeQples National R~nk - Chp Prorata of Real Es tate taxes ~fi ,!i'1 H NOTE: You may expedite the processing of this return by filing with it, and as a part of the 'return, letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the decedent as of the date of death. Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account, account number and the exact name or names in which the account is registered. ^ Jointly Held Property Estimated Value , NONE NONE I I i I i I i I I i I ~- I i -L= Tl'ansfel"S within TWO YEARS Prior to Death That at the time of death there was no safe deposit box registered ih 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 SA~'E DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT ..-..---- - . BENEFICIARIES RELA TIONSHIP SURVIVED AGE OF LIFE BENEFICIARIES AND ADDRESSES (I f step-children or DECEDENT TENANTS OR INTEREST OF (State full names of'all and their addresses who have illegitimate children STATE YES ANNUlT ANTS BENEFICIARY an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE forth this fact.) DECEDENT R<llnh A 1)0000 C:nn t..?t.. T '" 'l'nnolr '" t:.t:.t:.n7 J tUn G Reese C:nn 18. V. A. Hospital Lebanon. Pa. 17042 M<lTt-h<l All"'m<ln ~ .- R. D. 116~ Box 199 C:h-f .. p", 171...7 H<lT'rV F l)ooo~ C:nn R. n fjf, 'Rnv ?n 7 Shippensburg. Pa. 17257 l .U_ F Fih", 1 _1.. ~ 17 Clayton Ave. --- L I ancaster, Pa. 17600 I ......._.__._.__._._-_.__.._--_.~ I I I intly Held Propel'ty Ettilllf.t..d Value.. \ ~ , .~ ... .--:'"'.......~~~ -"""'==--.___.. .._....;...__. ___~., .__. ____1 I i i I I ! I-- I i i I l--'--~--- i I ..----...-....-.--------.--.f---------~- ~--- --_._~._._---_. __F__ __....____~_,_....__..___.._,._____ Tr.ntfel" witllin TWO YEARS Prior to Death ;,~ ~..,_.,.... TIt.t at the time of death there was no safe deposit box registered ih decedent's individual name, or jointly with, or ,as agent Ol'\!eputy<oJ another, or in deeedent's individual name, with right of access by another as agent or dpputy, with the eX<."j>pti(lJ) of ihe tollowing;.- B::~~~ ~::.~.~~~~ ~~i:~~~;u;~~.~~~l~~~~'~~.~~:;~~~~~~~~:-.-~;;~:~~~i~ --~---:- r-- -~=----------=t=~--- I j ..=-'="'".=,.-.......___...=""'=-0,.-=-_ .. ,~ ._ _~_"_"' .-,c=--~. ill:;~E~~~~~ I JJf{{rJT5~~k~r----------- forth this fact.) I ". I DECEDENT-l- .. ' I J-~--+----'" I ~t...--------l------ ~~~~~:------~~==-~-=-~~~- ~_---~-n~f---- 1--=--+.-- ----+--------r--- =t G--" "-t ~ f- i -l .. .--.--;--~ -~::=~=:-=.=-:-:t=-=+-~-~ - -~ -==--=~==t::==~:-::=l-==--c- I -- ---+-- I I -+---. ....-----.- --.--. t~-----_._---+- I I' BENEFICIARIES BENEFICIARIES AND ADDRESSES (State full names of .n and their addresses who have an interest, ftsted, contingent or otherwise, in estate.) INTEREST OF BENEFICIARY IN ESTATE on Trailer Court Shippensburg, Pa. 17257 Sandra H"lrm.<ll1 . Cleveland Ave. Chanbersburg, Pa. 17201 r - SIl!M 10 .I~s!Jlaa o 0 , 0 . , 0 0 0 0 , , 0 , , 0 0 . 0 , , 0 , , 0 0 . , . . . . . 0 . 0 0 0 , 0 0 0 0 . 0 : p~'6C OUOllJnpap '6 S'6 pa.....oll'6 wns a\{l sluas.uda.l lunowu .Iassal .10 .IaluaJo8 \{J!\{..... 'aAoqu a(npa\{JS PIUS U! l\{JI!J a\{l Ol uwnlOJ lsul a\{l U! \{lJOj laS S lUnOw'6 .Iassal .10 .Ial'6a.lJl '6 a.la\{..... 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Sl\{l aw a.lolaq Ol U.IONlS PU'6 paq!.IJsqns opaNlolIU PUll paWlUp lunOWll paluwqsa al{l UUl{l sial .10 .I~1Ia.lJl S! lqap.lo UO!SS!WWOJ '&al AU1I 10 luawaln.lS U! p!1Id AllunlJl! lunowll a\{l I! sll!M 10 .lalSlo8a'H al{l as!ApU ol saa.lo8u al1llsa al{.L :a+O./I '. 11Il0.1 / /,/,f' // /' / / SWIV'IJ aNY S.1H3a 'H3H.10 * UO!SS!WWOJ A.l1Ipnp!d * saallasuno::> * sasuadx3 UOll'8.1lS!U!WPV ('ua.lpl!\{J .10 asnods 11 \{l!NI o8U!P!s.u pa!P lUapaJap Isalun pa.....oll'8 aq lOU II!NI) uondwaxaAl!w1!d * p!ud sasuadxa (u.laund .LNfiOKV 3KVS dO 3afi.LVN t- .lllOt13n J"QIII,~,'.."""" ,........., --~- - -- ---- - -- ~- --- -- ~ ---- -"-- .---- ---- ---~.__. --'- - 1_,_-------'--.. =...;..;.... -.____ =-- III RCC 4 (2/77) \1 COMMONWEALTH OF PENNSYLVANIA ,~ NO.;' ~ 063712 DEPARTMENT OF REVENUE = OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX 11 ~ ; RECEIVED ---------------TWO HUNDRED FORTY-EIGHT DOLLARS-------------------dollars II IIIi .. If Il Iii From: II! If II Address ill III! 11 11 i. = n uate of Payment December 21, ~978 ~ Nome of O",d,,' _ ETHEL MAUDE REESE C' County ~', Remarks: = -. ~ " = ~.. ~ ~~z:=..~;.~ ~,.~~~~. =o..~ ~~~~_. Mark & W@ig1@, Attya., representing Pennsylvania Inheritance or Estate Tax due from the following estate: (Harry E. Reese) 2% Tax on $ $ 115 Eaat King Street 6% Tax on s $ Sh1ppensburg,pa. 17257 I 5 % Tax 0 n $ $ No 21-78-509 Dote of Death 1-2-1978 % Tax on $ $ I I i \ TOTAL TAX. CREDIT I \ I Plus interest at the l_%from I I to Estate Tax, Act of May 7, 1927 $ $ 248.00 Cumberland Less five percentum of tax if paid within three months after dote of death $ rote of PAID ON ACCOUNT. $ uW ~ UJ [Lu @@ IJl~ 5 E A L $ \ \ \ .. 248.00 NOTE: This Triplicate Receipt to be retained for audit purposes. , II< : Received by . NOTE: In accepting the tronsler inheritance tax on luture estates. prior to the death of the lile " tenant or tenont for yeors, os evidenced by this receipt, " !s understood that the Cammo~wealth shall U not be precluded or prevented from hereafter ossessing additional inheritance tax at the death of the ., life tenant or tenant lor years whenever it appears that such additional tax may be legally due and ',"'j collectible for ony reason whotsoever. *- --r:=.. ~ m=:IiO.. ~.~ ~vr --'"1. -.ma~-..-.-..~ ~,~ "E:il[ ~.~ ~ .'Y.!::iIi _____ -,O(C"'........ :IE!:lL.' -~:::::::: ..- ---.--. _...~-- _.--~. ------- .. -~- ~- ..---.- -- -- --- - -- ----- -~ -~ -.- --- -_.- ~._--- --- -'.---" -~- ~ - -- -- ~.~. ---- -..- -