HomeMy WebLinkAbout06-07-79
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'RCC:.;3' (4-73;'
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
"-1-17
RESIDENT DECEDENT
COpy OF WiLL MUST
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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.)
COUNTY OF
Cum~erland
IMPORTANT:
IN THE MATTER OF THE ESTATE OF
} AFFIDAVIT OF
EXECUTOR
~XXDl(
County
ELMER C. MYRRS
(STATE FULL NAME OF DECEDENT)
Late of
Cumberland
Stote of Pennsylvania
} '"
County of Y nrk
~
Robert E. Myers
of the estate of the above-named decedent being duly sworn, depose S
Executor
and say S
Decedent died
August 30.
(MONTH)
Name and address of attorney or }
other authorized repres,entative to whom
all correspondence should be mailed.
(DAY)
, 19~J testate lea~ing a last will, copy of which is hereto attached. }
(YEAR) ~
Robert E. Myers
100 York Road. New Cumberland. Pennsylvania
17070
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: -
I
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
I
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 interes t, 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 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 whatso~.~~r:'lfi.V8..,?r""~J1,t\lrt;,1~ft by' ,decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interes t thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the market value there-
of at such time.
RCC-35
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of his death. Property owned by the decedent jointly with another or others
must be 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 trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, and fUrnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in 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.
Item
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1.
Checking account No. 62 59 272 6
Dauphin Deposit Bank and Trust Co.
$312.38
2.
Savings account No. 1-56709
The Harris Savings Assn.
- Principal $916.74
Int. to date
of death 7.95
924.69
3.
Savings Certificate No. 109469
The Harris Savings Assn
6,000.00
4.
One share stock, No. 249, Ski Roundtop, Inc.
10.00
5.
Life insurance from Mass. Mutual Life Ins. Co.
1045.81
6.
Check from William Keller, Jr.
34.40
7.
66 Shares of Common Stock Toys R Us
13 5/8
899.58 /
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
x X
$9,226.86
C:\ ~~\o. ~~
RCC- 36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFEIlS
11ES !DENT DECEDENT
(1) Did decedent, within two years of'death, make any transf'er of' any material part of' his estate, without
receiving a valuable and adequate consideration theref'or? (Answer yes or no) No
(2) Did decedent, within two years of' death, transf'er property f'rom himself' to himself' and another or
others (including a spouse) in joint ownership? (Answer yes or no) No
(3) If' the answer to (1) or (2) above is in the af'f'irmative state:
(a) Age of' decedent at time of' transf'er
(b) State of' decedent's heal th at time of' making the transf'er. (Note 1).
(c) Cause of' decedent's death. (Note 1).
(4) Did decedent, in his lif'etime, make any transf'er of' property without receiving a valuable or adequate
consideration theref'or which was to take ef'f'ect in possession or enjoyment at or af'ter his death?
(Answer yes or no) Nn
(a) Was there any possibility that the property transf'erred might return to transf'erer or his
estate or be subject to his power of' disposition? (Answer yes or no) No
(b) What was the transf'eree's age at time of' decedent's death?
(5) Did decedent in his lif'etime make any transf'er without receiving a valuable and adequate consideration
theref'or under which transf'eror expressly or impliedly reserves f'or his lif'e or any period which does
not in f'act end bef'ore his death:
(a) The possession or enjoyment of' or the right to income f'rom the property transf'erred?
(Answer yes or no) No
(b) The right to designate the persons who shall possess or enjoy the property transf'erred or
income theref'rom? (Answer yes or no) No
(6) If' the answer to (5) (b) above is in the af'f'irmative, state whether the right was reserved in decedent
alone or others
(7) Did decedent in his lif'etime make a transf'er, the consideration f'or which was transf'eree's promise to
pay income to or f'or the benef'it of' care of' transf'eror? (Answer yes or no) No
(8) Did decedent, at any time, transf'er property, the benef'icial enjoyment of' which was subject to change,
because of' a reserved power to alter, amend, or revoke, or which could revert to decedent under terms
of' transf'er or by operation of' law? (Answer yes or no) Nn
(9) If' the answer to (8) above is in the af'f'irmative, was the power to alter, amend, or revoke the inter-
est of' the benef'iciary 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 af'f'idavit by the attending physician as
well as a copy of' the death certif'icate.
NOTE 2: If' answer to any of' the above questions is yes, set f'orth below a description of' the property
transf'erred, it's f'air market value at date of' death, dates of' transf'ers and to whom transf'erred, with
relationship of' transf'erees to decedent, if' any. Submit copy of' any trust deed or instrument, if' trans-
f'ers are claimed to be non-taxable, also submit detailed statement of' f'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
(Estimated)
DEPT. VALUATION
(Dept. Only)
Insert this total opposite "Transf'ers", Schedule "e" in the
"As Reported" column on the last page of' this return.
NDN&.
'Rc'C-37 . (12-63)'
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
~
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
aye an interest, vested, contingent or other are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO BIRTH
n . VAC '::1nn nn
Ann Hartman Granddaughter Yes 100.00
Jennifer Mvers GranddauQ:hter Yes 100.00
Deobrah Lehman Granddaughter Yes 100.00
Evelvn D. Hartman DauQ:hter Yes s':\non nl11c 1/':\ nf' "t"A",-i-l""
Charlotte A. Seward Daughter Yes 1/3 of residuary
Robert E. Mvers Son Yes 1/3 of residuary
"
(
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
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SUMMARY
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( 1 )
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RCC-38" .
RESIDENT DECEDENT
SCHEDULE" E"
JOINTL Y OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERIT ANCE TAX
INSTRUCTIONS: This scherlule must disclose all property, real anrl personal, ownerl by the rlecerlent jointly
wi th another or others, includIng intangIbles, standing in the name of the decedent and others. List
real estate first, as entireties, or joint tenants, givIng brIef description, as indicated lmrler Schedule
"A", plus the date and place of record of instrument effecting vestiture, but rlo not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus rlate of acquISition, and the name, address and relationship (if any) of co-owners to
the de~e,lent.
Description of Property, Date of' Acquisition, Name
Address anrl Relationship of Co-Owners, and Place
of Recorrl of Instrument, where Real Estate.
. .
Unit
Value
percen tage
Share
Estate
Valuation
DEPARTAffiNT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
None
Insert this total opposite "Jointly Ownerl Property", Schedule "E"
in the "As Reported" column on the last page of this return.
NDNE"
REV-5I8 (3-79)
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P. o. BOX 2970
HARRISBURG
17105
IN YOUR REPLY PLEASE
REFER TO
I nvestigation Division
NOTICE OF FILING OF APPRAISEMENT
Robert E. Myers
100 York Road
New Cumberland, PA 17070
(Executor or Administrator)
In Re: Estate of
Elmer C. Myers
Cumberland
County - File No. 21-78-0515
Dear Mr. Myers:
You are hereby notified that the original
appraisement in the estate of Elmer C. Myers
has been filed in the office of the Register of Wills of Cumberland
County on August 21 , 19.zL. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
$ 18,000.00
9,226.86
none
none
27,226.86
As to such tax that is paid with in 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 21, 1979
Signed
~
~~d4/1 4-~-R--
Title Administrative Officer
NOTE: This is not a bill.
C'lUI,ty, Number and Name 21-Cumberland
Fi ie t'lumber 21-78-0515
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REPORT OF INHERITANCE TAX APPRAISER
SUMMARY
[lllte of Death
b,rate Name
August 30 t 1978
Myers
COMMONWEALTH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Elmer
C.
(LAST NAME)
(FI RST NAME)
(INITIAL)
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland
Pennsylvania, do respectfully report that I have appraised the ren! and personal property as reported in the Foregoing return at
the values set forth opposite each item iin the last column to the right in Schedules "A", "B", "C", and "E".
Dated:
August 21, 1979
INHERITANCE TAX APPRAISER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for Cumberland 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.
Da'ted:
REGISTER OF WILLS
ADJUSTMENTS
INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONL YI REMAINDER APPRAiSEMENT CODE
Real Property (Schedule A) $ 18.000 00 00+ 92+
Personal Property (Schedule BI 9.226 86 10+
Joint-Held Property (Schedule EI none 20+
-
Transfers (Schedule CI none 30+
TOTAL GROSS ASSETS ==27,226 86
Less Debts and Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
~
PRINCIPLE
annuitles....................._ $
FACTOR
~
VALUE
CODE
1=
,
ESTATE TAX ASSESSMENTS _ $_
FOR USE OF REGISTER ONLY
~
COMPUTATION OF TAX
Tox on $
Tax on $
Tax on $
Tax an $
Tax on $
Exemptions
Tatal Estate
$
$
$
$
$
2%
6%
15%
*
TOTAL TAX
$
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretory of Revenue.
t=
Less tax previously paid
BA LANCE
Less 5% of tax if paid within
3 month s after death
$
$
$
3ALANCE OF INHERITANCE TAX DUE
'-dd interest at rote of 6% from
to
'-MOUNT OF ESTATE TAX ASSESSED
estate tax paid
$
$
$
1==
$
BALANCE DUE
"dd interest at rote of 6% from
to
$
$
TOTAL TAX BALANCE $
PAID $
I~
;upplemental Codes: (FOR USE IN HARRISBURG ONL Y)
48-Ad! ustment
49+Adjustment
56-Annu ity
6O-Life Estate
92+Remainder Appraisal
93-Rema inder Deduction
93C-Charity
94-Remainder Residue
96-Success i ve
life Estate
FOR USE OF REGISTER ONLY
NOTE: Where subsequent adjustments an! made to the above computation of tax by the Register of Wills for proper reason
same should be noted below, with short explanation. "
ADJUSTMENTS
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R~V-457 (8-78)
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG, PENNA. 17105
COMfV10NVJEAL TH OF PENNSYLVANIA I
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAn:
August 21,
Cumberland
21-78-0515
1979
--
COUNTY
FlU: ~JQ.
'~."'':'''"'~'''''''''-;'''''A~"",""",._",_,,.,_.._~,.,,.,.,.,..,_
Whereas, Elmer C. Myers late of New Cumberland Borough
in the County of Cumberland~_ Commonwealth of P(m~l.,;yl',a.nia. h.winq died 0;1
the 30th _ day of August 19 ~, seized and possessed of an esLJte
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Sandra L. Stone ____ ,a.n appr:.usilf dl~lv "l[;:Jointed according to h\y.
having been designated to make a fair and ccm:cionable appraisement of the said estat8, a:1d to d''.SG~S dnd i)x the ca:i:
value of all annuities and life estates ~Jfowing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred ", possession or enjoyment to collateral l,eirs 01' the decedent af12r tr.c eXPiration
of any estate for life or for years, the Commonwealth hereby expressiy reserves the right to appraise and assess transfer inheritancp taxes at the !awful collateral
rate on any such future interest.
DESCRIPTION OF ASSEr
= =
Real Estate
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, UN'r'
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r-
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~pi'.),$eln€7ii-
ivL.de for lnheritance
Tax Purposes
Personal Property
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r-
18,0?1 00 ~
9,22~.86 !
..~-"""
none I :
&--t
none I
Transfers
Jointly Owned
Total Assets
! .1
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..027,22 .86
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Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity
with the law on this 21st day of ~u~u:t 19 .l.L.
/ 1 -L7 /1 0.-1-0--1/12
Appraiser
Harrisburg
(Number a "i; Street)
(Post Office)
, Penna.
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Inventory of the real and personal estate of
Elmer C. Myers
deceased.
1. Fairview Township, York County, Pennsylvania, being Lots 6, 7 and
8, Plan of Belle Vista, having a frontage of 75 feet on the eastern
line of Ross Avenue and 150 feet deep throughout improved with a
single frame dwelling known as 12 Ross Ave.
17,500
00
2. Residue of tract of land from deed description in Deed Book 435, Page
255, situate on the west side of Old Lewisberry Rd., Silver Lake, York
County, Pennsylvania
9. 66 shares of Common Stock - Toys R us
@ 13 5/8
500 00
312 38
924 69
6,000 00
10 00
1,045 81
34 40
899. 5~
3. Checking account No. 62 59 272 6, Dauphin Deposit Bank and Trust
4. Savings Account No.1 56709 - Principal 916.74
Int. to date of death 7.95
5. Savings Certificate No. 109469, The Harris Savings Assn.
6. One share stock, No. 249, Ski Roundtop, Inc.
7. Life insurance from Mass Mutual Life Ins. Co.
8. Check from William Keller, Jr.
Total
27,226
86
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
t
J
ss:
Robert E. Myers
sworn __~ according to law, deposes and says that he i ~ thF> 'F,xPC'lltnr
of the Estate of Elmer C. Myers
late of ---Boron-ghof uNew Cumberl:and-- - I Cumberland County, Pa., deceased and that the
within is an inventory made by Robert E. Myers, the said Executor
of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
being duly
Sworn
and subscribed before me,
/
If~
~~ /6 197
fh tJ' ~ -II /J Z) -fA,~ 6<-.
Executor - Administrator
100 York Rd.
New Cumberland, PA 17070
r,~,,":""~'~~'" ",":';""'" ~{~,GE
Notary ~L::,:: " r.f;:.:> Tw~.. York Co.
_ Comrnissior, EJq::.;,es Nov. 8. 1982
Address
Day
August
Month
1978
Date of Death
30
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
'd
s:
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Form RC C -10 7'15 5(-# DEDUCTIONS ALLOWED IN
~. b~
.7 . . . . . . . . . . .. $L{'6?9
STATEMENT OF DEBTS --
OFFICE OF THE i Ht ~UM Of
REGISTER OF WILLS DEDUCTIONS ~n .'. l Iq ? f
AND ."I"JJ(V<JZ
OF r.lImhprl::lnn COUNTV
AND AGENT OF THE COMMONWIiALTH ~ t1~ k }YFI ~
", . 'L.t~' . .' . l/ f'N'M '''--
\~-3 --<-;;.~ I , )t.'.~, t "7 /9/'7 ,.)), i\'(/I.Jl\iiReg!tter of Wills, Agent
..
ESTATE OF Elmer C. Myers LATE OF New Cumberland~~CumBIerland County, Pa.
r I q Y'Jq
DATE OF FILING APPRAISEMENT I[ (\.Io ex! DATS: OF DEATH August 30, 1978
~ \
DATE No. OF NAME OF PAVEE REMARKS AMOUNT
VOUCHC"
Nelson Urich Funeral 1960 00
Register of Wills Letters testamentary 27 00
Register of Wills Short Certificates 5 00
Department of Health Death certificates 2 00
Fairview Township Refuse 82 22
Clifford Bailets Taxes 8 79
Law Journal and Evening Sun Advertising Letters 34 65
Eviction Proceedings of tenant CO! ts, sheriff's costs and
filing costs 60 00
Elmer C. Rhem Claim 500 00
Evelyn D. Hartman, daughter Family Exemption 2.000 00
. Total 4,679 66
INHERITANCE TAX STATEMENT
Assets $27,226.86
Debts 4,679.66
Mot- <'::?? "L.7 ?()
Taxes pd. on 22,000.00 October 5, 1978
547.20
Tax at 6% 32.83
-
Penalty 83 Hay 31, 1979 to Nov. 1, 1979
Tax due $33.66
-
COMMONWEALTH OF PENNSYLVANIA
I,
York
Robert t:. Myers
}..:
COUNTY OF
HEREBY CERTIFY, THAT. TO THE BEaT OF
MV KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRU E IHATEM.E:NT OF DEBTS, FUNERAL EXPENSES AND EXPENSU OF
Elmer C. Myers
ADMINISTRATION SUBMITTED TO THE ESTATE OFf ) I ( DECEASED, AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES. : I Y/0vt )A. /\ ~ ~-'
c l ~ (L.S.)
SWO~N AN SUBSCRIBED BEFORE ME THIS :L7 DAV 01" Robert E. Myers
f,/ J ,e
. '. '" '('.),K Oct.
: ~~. ;~"/. 8, 1912
Nv'ii.".' r ..
My COlt,
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