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RCC-33 (4-73)
COMMONWEAL TH OF PENNSYLVANIA
DEP ARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
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 Reuenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Late of
ClImherl;:Jnil
} AFFIDAVIT OF
EXECUTOR
~>>')Oi~
IN THE MATTER OF THE ESTATE OF
J. Perry Hoc.ker~mith
(STATE FULL NAME OF DECEDENT)
County
State of
Pennsylv;:Jnia
}.
County of
Cumberland
Robert W. Hockersmith and Ruth H. Mowery
of the estate of the above-named decedent being duly sworn, depose S
Executor S
~~)@tiXrX
and sayS
Decedent died
October
1
, 19~{testate leaving a last will, copy of which is hereto attached. }
( YEA R) :k!X>XNHoX
(MONTH)
Name and address of attorney or }
other authorized repres.entative to whom
all correspondence should be mailed.
(DAY)
Robert J. Yocum, Attorney
116 East King Street
Shippensburg. Pennsylvania 17257
That as such Executors deponent is familiar with the affairs of said estate and the property constituting
( EX E CUT 0 R- KOO.MNOOXKKJ(Q(B\
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 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
with 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 prior to decedent's
death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; all obligations, whether by statute or agreement they are de~'ignated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages,
automobiles, boats, and any and aU 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 aU 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 or tk' ,i;" "I' death, bonds and accrued interest thereon to the date of decedent's
death and other investm.' ,,'.I by the decedent at the time of death, with the market value there-
of a t such time.
In the case of securities of close or family corporations, the values reported are as far as
possible substfmtiated 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 rlecedent at the time of'
death in /iny co-partnership or business, and in support of the value of such interest there is annexed to
said schedlile, financial statements showing the assets and liabilities of said co-partnership or nusiness.
A copy ()f the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
togetlwr with a statement setting forth the character of the business, its location, and such other facts
r>ert ,niL[' to the husiness as may be pertinent to a fair and just appraisal of the decedent's interest
therpin 1J\U-;t be submitted. It should also set forth in itemized form, together with the fair market value
therpr,f', !lny other property owned or bequeathed by the decedent at the time of death.
The Sc/1edule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained tlH',-ein and in the case of transfers of property, real or personal, within two years of decedent's
d,oath, in ccntemplation of decedent's death, or intended to t'ike effect in possession or enjoyment at or
after dea;..h, 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 sain transfers. In the case of transfers intender! to
take effect in possession or enjoyment at or after death, there is also attacher! to the schedule a copy
of the deed, trust agreement or other instrument creating the trust. There is also set forth in said
schedule ri 11st 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,
wi th a copy of the instrument creating such power attached to the schedule.
That Sc/1edule D 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 Ii fe under decedent's Will. I t a] so
contains a statement showing which of the beneficiaries namee! in the decedent's will, if any, died prior
to de.;cdent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That Sc/1edu/e E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly wi th another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instrtooents effecting the vestiture of
real estate and the date of acquisition of personal ty, plus the name, address and relationship, if any,
of co-owners to the decedent.
That Sc/1edule 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, inclue!ing funeral expenses paid;
family exemption, where applicable; costs of ae!ministration of this estate; counsel fees and f'udiciary'.c;
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 e!eath (except those allowed under Section
651 of' the Inheritance and Estate Tax Act); together with a statement of collateral plee!gerl 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 he 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", ann "F" as directed therein,
Summary. ./"'. /,LJ~ '<.1/
dJ t'~/ vI /yI#i#'l4'<1."'" ~
\ '. '~\\\~-'_'>~"-l.Y
Robert W. Hockersfuith
.. ....R1J:t.b.....H.t.....MQw.~.rr.. .............................................................-..............
( ExeC"Utor-A~itIX~lt~~
... :5.4....c;:WI!l>(;)r..~.9.-.n9.....Ay.~D.W~........................................................
(Street Number)
S~~P.E~~~?Y:r:~~....?~~:rl?y.~.'!.a.:!l~a.: 1 72 5 7
(City or Town and State)
NOTE: Before signing affidavit make sure all hlank spaces in the affidavit and schenllles annexed are
fillee! in with details or the word "None", ami in case the assets include rare ann unl isted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data ane! statements required under the paragraph above relating to Schenule "B" are attached. '\l so make
certain that column #1 in the "Summary" has been properly completen as above-directed.
Subscribed and sworn to before me this
26th
...............................,.
have been carried forward and properly registered in the
.....~....
..}~'pll.9.-XY... ................. 19..7.~.......
~
Richard M. Fogelsonger
Shippensourg. Cumbo co.. pa.
Notary Public - Exp, 2-2oS1 ._.J
RC C-34 14-73)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE CIA"
REAL PROPERTY
-
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel. at d~~th of dece-
dent. Property held by the decedent as tenant in common with another or other, ~h~uld be Identdled
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, together wi th
a 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 II F" and must not be deducted from this schedule.
(1)
(2)
(3)
DEPA RTMENT
VALUATION
CAUTION
(Do not write
In thIs spoce)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMA TED
MARKET VALUE
ALL that certain tract of land with improvements
thereon erected situate in the Borough of Shippens-
burg, Cumberland County, Pennsylvania, being Lot
Nos. 24 and 25 of Block "I" of Plan of Hallwood
Heights as recorded in the Office of the Recorder
of Deeds in and for said County, in Plan Book No.3,
Page 113, known as 709 Brenton Street.
It being part of the property conveyed by Hugh B.
Craig and wife to Frank E. Hollar by deed dated
March 20, 1912 and recorded in the above Office in
Deed Book "Y", Volume 7, Page 233; and part of the
property conveyed by the heirs of John Craig to
the said Frank E. Hollar by deed dated March 20,
1912 and recorded in Deed Book "X", Volume 7, Page
282; and the said Frank E. Hollar having died
testate May 22, 1940, by his Last Will and Testament
devised his entire estate to his widow, Rachel B.
Hollar and his son, Frank E. Hollar, Jr., and the
said Rachel B. Hollar having died intestate July 25,
1941, left as sole heir-at-law her son, Frank E.
Hollar, Jr.
BEING the same which Frank E. Hollar, Jr. and Janet M
Hollar, his wife, by their deed dated September 22,
1959 and recorded in the Office of the Recorder of
Deeds, in and for Cumberland County, Pennsylvania,
in Deed Book "Y", Volume 19, Page 1087, conveyed
to J. Perry Hockersmith and Grace W. Hockersmith,
his wife; and the above mentioned Grace W. Hockersmitl
died on June 14, 1973, thereby vesting the entire
fee in J. Perry Hockersmith, now deceased.
Sale Price
,_ I:. /~ /
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\".-'V'
$54,000.00
Insert this total opposite "real propedy", Schedule "A" in the X X X X X
liAs Reported" column on the last page of this return.
$54,000.00 SLf I 000.00
pee -3.=S.
.'~
IJ :;. ... 't\
~, '
CO~Th10NWEALTH OF PENNSYLVANIA
TftANSFEH INHEHITANCE TAX
IlESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
I tern
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
I!\STRUCTIONS: 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 wi th another or others
must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but
payable at death to ano ther or others, including but not 1 1mi ted to P. O. D. U. S. Savings Bonds and ten ta-
tive trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangibl e personal property should be listed f'irst (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
List and describe fully
UNIT
VALUE
ESTIMATED
MARKEr VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
-
'O...~
Checking Account No. 236-064-1, The First Nationa
Bank of Shippensburg, Pennsylvania
Certificate of Deposit No. 6524 - The First
National Bank of Shippensburg, Pennsylvania
Dated: 1-7-76
Accrued Interest on Certificate of Deposit No.
6524 - The First National Bank of Shippensburg,
Pennsylvania
,Certificate of Deposit No. 8452 - The First
National Bank of Shippensburg, Pennsylvania
Dated: 5-8-78
Accrued Interest on Certificate of Deposit No.
8452 - The First National Bank of Shippensburg,
Pennsylvania
Certificate of Deposit No. 6822 - The First
National Bank of Shippensburg, Pennsylvania
Dated: 6-7-76
Accrued Interest on Certificate of Deposit No.
6822 - The First National Bank of Shippensburg,
Pennsylvania
Proceeds public sale of miscellaneous household
items and automobile
Olgaretta K. Witter - Purchaser's share of prorated
real estate taxes
Aetna Insurance Company - Refund insurance
./
7,420.58 ,//
161. 96/
V
6,108.75//
63.90//
...
10,579.19/'
50.22/
/,/
9,133.15
322. 76/
News-Chronicle Company - Refund
New York Life Insurance Company
insurance policy
Erie Insurance Company - refund
insurance
354. 70'
2.20
for subscription
- Proceeds life
1,518.53
.. I
on automobile
46. OO'-~
x x $45,336.11
(nsert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
4S)53~.\t
RCC-'3t,
CllMMll\\>VEi\LTI! OF l'E\\:-;YIXANI A.
TH.A\~F!,'i\ I\HF!\ITi\\CF TAX
SCHEDULE "c"
T R\:-J S l;lmS
J\ESIDE\'T ])j'Ti.:nE\'T
(1) Di<i o.ecedent, within two years of death, make any tnmsfer of any material part of his estate, without
receiving 11 valualJle ar.d adequate considerntion therefor? (.\nswer yes or no) NO
(2) Dio. dccc<lent, within two years of death, transfer properLY Cram himself to himself and another or
others Unclno.i ng a spouse) in joint ownership? (Answer yes or no)--.1!Q_
un It' the answer to (1) or (2) above is in the affirmative staLe:
(a) Age of decedent at time of transfer
(b) State of decedent's health at time of making the transfer. (Note 1).
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lif'etime, make any transfer of property without receiving a valuable or adequate
consio.eration therefor which was to take effect in possession or enjoymept at or after his dpath?
(Answer yes or no) NO
(a) \'las there any possibility that the property transferred might return to transferer or hIs
estate or be subject to his power of disposition? (Answer yes or no) NO
(ll) What was the transf'eree'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 \fio.er which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) NO
(ll) The right to o.esignate 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) Did (lecedent in his lifetime make a transfer, the consideration for whlch was transferee's promise to
pay income to or for the benefit of care of tl'ansferor? (Answer yes or no) NO
(8) Did decedent, at any t.ime, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserverl power to al ter, amend, or revoke, or which cmlld revert to ctecedent under terms
of transfer or by operation of law? (Answer yes or no) NO
(9) If the answer to (8) above i3 in the afflrmative, was the power to al ter, amend, or revoke the inter-
est of the beneficiary. reserved in the decedent alone or the decedent and others?
(Answer yes or no) NO
NOTE 1: The answers to these questions should be supported by affidavlt by the attemling physician as
well as a copy of the death certi ficate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferrect, it's fair market value at date of death, dates of transfers and to whom transferred, with
relationship of transferees to decedent, if any. Submlt copy of any trust deed or instrument, if trans-
fers are claimed to be non-taxable, also ~ilimit detailed statement of facts on which said claim is based.
.'IOTE 3: List aplllicable property below in manner in which providect in Schedules A, B, or E.
ITEM
DESCRIPTION
MARKET VALUE
(Estimated)
DEPT. VALUATWN
(Dept. Only)
NONE
00.00
Insert this totrll opposite "Transfers", Schedule "C" in the
"As Reported" colu1TU1 on the last page of this return.
00.00
N o>--i<-
RCC-37 (12-63)
COI\Il\lONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
BENEFICIARIES AND ADDRESSES
(State full names and addresses of all who
have an interest, vested, contingent or other-
wise, in estate)
r,,+hA-r;nA H T.A:lc.h
37 Montgomery Avenue
Shippensburg, Pennsylvania
Ruth H. Mowery
R. D. 1
Landisburg Pennsylvania 17040
Robert W. Hockersmith
34 Cumberland Avenue
Shippensburg, Pennsylvania
Richard R. Hockersmith
R. D. 3 Box 288-A
Newville, Pennsylvania 17241
SCHEDULE "D"
BEl'\EFICIARIES
RELA TIONSHIP
(If step-children or
illegitimate children
are involved, set
forth this facL)
daughter
daughter
~
i son
son
SURVIVED
DECEDENT
STATE YES
OR NO
yes
yes
yes
yes
DATE
OF
BI RTH
INTEREST OF
BENEFICIARY
IN ESTATE
one-fourth equal share
one-fourth equal share
onA- ~
. Anlla 1 s h:l re
one- fourth equa1__:;.h.l3.r:~_
I
I
i
I
I
!
I
!
NAME
Deponent fUrther says that all the above-named beneficiaries are living at this time except below:
DATE OF DEATH
RESIDENCE
.... -;
..8t1)~
E<~
~: -=
'2 Q) E
's Q) .=
_0.0
~ E <.>
~ 0:
8<'>'g
"ES~t
'-' ::l 0
~E2'
~ 0::
SUMMARY
. . ( Sch. "A")
... ........ .............(Sch. "B")
........................... ............. (Sch. "C")
...... ..... ..J5.cl1.. "E")
Real Property ...............
Personal Property
Transfers
Gross Taxable Estate
( 1 )
(As Reported)
$54,000.00.
$.4.:> x:3:3.6 ....11
$..00.00
$ 00.00
$
$QSj,:3.3().11
(2 )
(As Determined)
$
$
$
$
$
$
f- '0
Z Q)
.... ~ ,..c: ell b.O
rn - ~ ~ H ...;l
0,) Q)
~ ~ .,.-i '-' ;;j 0(
~ S Q) ..0 r.I:J
rJJ U1 Cl U1 -
- H I=: 0(
< Q) <U <1l CII:
~ ~ ..:<: p.. '2 =-
p.. 0 u A. <1l =-
p.. o. .,.-i "'d 2:
~ < ~ ::r:: ..c: @ 0(
:r: :r: ~ ;..,
tI) '"
,... ~ ,... f- >'. .-l ;: Q
~ :r: ~ ...-: H lH H ~
ci 0 E- H 0 Q) Q:j
Z E- rJJ Q) ..0 p..
~ ~ 0... ,..c:: 5 ...... 1-
-^-' b.O 0
0 ;;j. u -5 c:r::
:lie ~ ...., 0 0
j H ,.. Cl.
~ 0- Q./ \.t.l
E- co ...... ;.. CII:
E- o "
c
~ < ...... j::. 0
:e: - 0 E
~:s ",. Q./ 5 E
.... 15
~ 0
~~ ~ U U
.
....
R C C-3B
RESIDENT DECEDENT
SCHEDULE" E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schertule must disclose all property, real and personal, owned by the decedent 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 rtescription, as indicated tmder Schedule
"A", plus the date and place of record of instrument effecting vestiture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", 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
DEPART/lENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
\/'
.,!'
NONE
00.00
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" column on the last page of this return.
00.00
REV-SIB (B-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF F!ELD OPERATIONS
P.O. BOX 7.970
HARRISBURG
17105
IN YOUR REPLY Pl.EASE
REFER TO
Inheritance Tax Division
NOTICE OF FiliNG OF APPRAISEMENT
Robert W. Hockersmith RuthH. Mowery
34 Cumberland Avenue RD 1
Shippensburgt P A T.;:m n; ~'hllrg" P A
(Executor or Adm in i strator)
In Re: Estate of
J_ PArry Hn~kA~~m;T'h
Cumberland
County - File No. 21-7R-0.'1.'1Q
Dear
You are hereby notified that the Original
appraisement in the estate of J. Perry Hockersmith
has been filed in the office of the Register of Wills of Cumberland
County on 9 Apri 1 , 19~, Said appraisement reflects the following
va I uations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
54,000.00
45,336.11
_None
None
$qQ,~~f).Jl
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 _ q Ap~; J 1979
Signed
...... ~'
Title. Administrative Officer
('
.~
Note: This is not a bill.
. .
REV-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE q ApY'i1 1q7q
COUNTY cumberland
FILEtW. 21-78-0559
WhMe~, J. Perry Hockersmith l~eof Shippensburg
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 1 s t day of 0 c t ob er 19 ~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Leo Fulginiti ,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 c~h
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
$
Real Estate <;4 000 00
Personal Property 45,336 11
Transfers None
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Have been duly sworn according to law, I do hereby certify tl)at the above appraisement is made in conforl1}igY
with the law on this 9t:'b day of ',O'or1.1,.... 19 _.
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