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Home My WebLink About08-02-79 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND L J 55: Grover H. McLaugh1~ being duly sworn according to law, deposes and says that he is the Administrator _ of the Estate of Danny McLaughlin late of the 'Ibwnship of East Pennsboro , Cumberland County, Pa., deceased and that the within is an inventory made by __ __, the said of the entire estate of said decedent, consisting of all the personal propdrty 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. ~ ~/_", ~ -- " f..,. "'- v , I g~~.~:~ J..J -5, (tinf jy-. C/'lt1P 111Lc-, /-4 17tJII Address and subscribed before me, ~'; cle.f I 1l _ ")/[ ({i:: t2h- C;~~_~ - )l.nl-{ ti<' f ' Marilyn Ann Smith. Notary Public My Commission Expires December 15, 1982 HarriJburll, PA Dauphin Counly ,;L k 19 79 Date of Death 3rd Day November Month 1978 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. ~ J C' ::j... C!'-. ~ >- s:: -0 '- Ql I- W ~ '" \ >- 0::: I- III '1 DO w -c( S Q) ~ 0.. l- S' U 0 0 V) .8 Q) c >- t::-. I w 0::: w ~ Ql l- I 0.. CI) c J. z I- ...J u... S III .. Ii u... ...J -c( 0 0.. I-J w 0 -c( w Q) .;.. > 0::: I AI II z ..... Z 0 c: II C .j.J :::J ci I: V) Z CI) 0 1 0::: m U z II w -c( 0.. -0 c: III M il ..... -;: 0 Q) -0 Ii Q) E -0 ..... Ql III :::J ...J U u: Inventory of the real and personal estate of Darmy McLaughlin deceased. Battery Charger Parts Washer Wheel Balancer Tire Changer 2 Jack Stands 2 Floor Jacks Cash Register AVR Tester Snap On Tools & Tool Box Air Conditioner Tools & Cabinet File Cabinet Adding Machine Cabinet & Screws & Bolts Wipers & Hoses Antifreeze, Oil Filters & other miscellaneous 1964 International Scout Jeep CCNB Checking Acoount Belco Credit Union Account Headlight Aimer I II I II II II II I I II 1,550 00 1,060 35 II 5,147 42 II 50 00 I I ,/ I I 75 00 100 00 40 00 600 00 25 00 100 00 200 00 200 00 300 00 45 00 20 00 15 00 20 00 418 99 250 00 Form RC C-J.,p OFFICE OF THE REGISTER OF WILLS ~ l-f)~ - Ltfg/ STATEMENT OF DEBTS AND DEDUCTIONS DEDUCTIONS ALLOWED IN THE SUM OF _ _ . . . . . . . . .. $JJJ1'g3'~ OAT APPROVED .S. _ c.l-'lJ:/rQ'?r ..... - "- I ~ ~. OF ClnnhPr 1 .:=mn COUNTY '+ AND AGENT OF THE COMMONWEALTH ESTATE OF Danny McLa.l ghlin LATE OF as Jeru1S. ro 'Ib'wns. LP, r an County , DATE OF FILING APPRAISliMENT"'" (J 1C2"f::j Q-' }C,'7'? Pennsylvania DATE 01" DEATH November 3, 1978 ~ DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHliJt 12/6 78 Rollinq Green Cemetery Cemetery Bill 391 00 12/7 78 Diarma Steiner - Wages Outstanding Wages OWed 169 60 12/7 78 Linda K. Brooks - Wages Outstanding Wages Owed 127 20 12/7 78 Myers-Hall Funeral Hane Funeral Bill 2,105 50 12/7 78 Grover H. McLaUJhlin Court Fees Reimbursement) riling F~s ~~f ni 19 00 12/11 78 CUmberland Law Journal - Ad Advertising 18 00 1/5 79 Patriot News Agency -Ad Advertising 48 00 5/6 79 r-bbil Oil Corp. Outstanding Bill 2,783 94 3/6 79 r-bbil Oil Corp. - Joe Gardiner Outstanding Bill 5 00 3/20 79 NASa:> - Liability Ins. Premium Outstanding Bill 21 79 3/20 79 Penna. Unerrployment Corrp. Fund Outstanding Bill 28 23 3/20 79 Internal Revenue Service OUtstanding Bill 275 37 3/20 79 Penna. Dept. of Revenue Outstandina Bill .24 29 3/31 79 West Shore Tax Bureau . . . "Rill 10 28 3/20 79 Penna. Dept. of Revenue- 3rd Quart r OUtstanding Bill 178 92 3/20 79 Penna. Dept. of Revenue-4th Quart !I' Outstanding Bill 98 09 3/ 79 Penna. Dept. of Revenue Outstanding Bill 23 12 3/20 79 Penna. Unerrployrnent Carp. Fund (PI malty) Outstanding Bill 6 16 3/22 79 Borouqh of New CUmberland Outstanding Bill 74 15 3/22 79 United Disposal Outstanding Bill 62 50 3/22 79 Gcx:x1ling, Inc. Outstanding Bill 90 29 - 3/22 79 Harrisburg Hospital Outstanding Bill 352 85 3/22 79 PP&L Outstanding Bill 165 55 3/22 79 PP&L Outstanding Bill 93 18 3/22 79 Ri verton Consolidated Water Co. Outstanding Bill 28 53 3/22 79 I Bell Telephone Company of Penna. Outstanding Bill 31 03 Cumbe 1 d COMMONWEALTH I, O~(~;~~~;~L~~NIA }.s: GX;:QY.~J::" tIe McLa"Ugbliu_.. -HEREBY CERTlI"Y. THAT. TO THE BEaT OF COUNTY OF ~Y KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRU E STATEMENT OF DEBTS. FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTIITE OF Dann,y McLau9"hlin DECEASED. AS DEDUCTIONS "'OR INHERITANCE TAX PURPOSES. .:.l(:-/i SWORN AND 8UBSCRI8fll BEFORE "lIE THIS - fl>\... L/ _ . 7 :; - I 5 I e, ...L.L...- // i.t::.' ~C(,J/ { {tL h j~yc..<:~. Ma,IIyn Ann sman, ~obrv lit 81 ~. Cetember 15. 19 ~~" Commilsion EltplreS . , Oauphill CouII!t 1...".\lJ..,;. PA - ~~~ 2/ /}/c4~ OilY OJ" (L.5.) For'll PC C .1Q DEDUCTIONS ALLOWED IN . . STATEMENT OF DEBTS THE SUM OF ............ $g:P~5Z2-. OFFICE OF THE :'jJ;~::V !~At5J~:,~.. REGISTER OF WILLS AND DEDUCTIONS OF CUmberland COUNTY AND AGENT OF THE COhlMONWliALTH '::t\: ~~.~ egllle, of Will., Ag..! "- ESTATE OF Danny Mclaughlin LATE OF East Permsroro To~hi~ Cumberland County, permSYl.VCUlla DATE 01" DEATH November 3, 1978 DATE OF FILING APPRAISEMENT DATI!: I NO. OF I NAME OF PAYEE REMARKS AMOUNT VOUCHEJIt 3/22 79 Samrons Comnunications Inc. Outstanding Bill 12 64 4/9 79 Dept. of Revenue (Penalty) Outstanding Bill 27 40 5/2 79 Internal Revenue Service Outstandinq Bill 75 25 5/2 79 Robert G. Bennett (Snap-an-Tolls) Outstanding Bill 218 00 7/26 79 Marilyn Srni th Notary Fees 5 00 7/26 79 Herschel Lock, Esq. Attorneys Fees 700 00 7/26 79 Grover H. Mclaughlin Administrators Fees S10 R4 Cumberland County Register of wil s Filing Fees 43 00 8,823 70 COMMONWEALTH OF PENNSYLVANIA 1 DAUPHIN S., COUNTY OF Grover H. J.VlCLa ghlin I, MY KNOWL~DGE AND BELIEF, TH~ FOREGOING 18 A JUST AND~.Mc~~h~inDEBTS. FUN~RAL EXP~NSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF DECEASED, AS DEDUCTIONS FOR HEREBY CERTIFY, THAT. TO THE BEaT OF INHERITANCE TAX PURPOSES. ,;J.{" It l SWORN AND SUB~RIBED BEFORE ME THIS . ><::c ,/ 111 7 '/' -/: f;e 'ldf.t~.. (c" ._. .A-.l' ~~ / / M.uilyn Ann Smith, Notary Public MV Commission Expires Oe((lmber 15. 1982 Harrisbufll. PA Dauphin County /k ;V~h'7(l.~~ .,.P<;,J/~~ // / { (L. s.) DAY Of' R C C-39 (5-68) COMMONWEAL TH OF PENNSYL VANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY - DATE OF DEATH 11/3/78 FILE NO. 2 1-78-0648 Estate of Mclaughlin, Danny (Last Name) (First Name) (Initial) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E". Cumberland Dated: V/1ndA/1 j \,/JtJ-lU' ./ INHERITANCE TAX APPRAISER September 18. 1979 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. Dated: REGISTER OF WILLS INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint - Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $ 0 $ $ 5,069 o 5:147~ 10,216 8,823 CLEAR VALUE OF ESTATE /393 C b Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ 1= t= L= ESTATE TAX ASSESSMENTS $ :- FOR USE OF REGISTER ONLY Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Total Estate COMPUTATION OF TAX 2% 6% 5% 10% 15% * $ $ $ $ $ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. TOTAL TAX $ Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death $ $ t= $ BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Es ta te tax paid $ BALANCE DUE Add interest at rate of 6% from to $ c c$ ~ t= $ $ TOTAL TAX BALANCE $ PAID $ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason, same should be noted below, with short explanation. ... ell Q) >< w ~ o ~ z ------ c o :&; ell b Vl '2 - "E "- 'U B::~ E- Z w ~ w CJl ;: lX: A.. A.. ~ w ::I: ~ ~ o lX: W ~ ~ ~ :E ~ o w ::: w !-< ~ 4. ~ o ~ CJl W .~ r--l. .g ::l ~. K '0 ~ .", ca ~ Co> :~ Cl 8 .8 ~ Q) ~ +J. 00 m: rLI. 4-1. 0: 0.. .~. J ~ r--l ~ ..... o .c :; o u ..... o ..c .... C; Q) ~ c o E E o U ell "2 ell :> ;:. Vl C C Q) A.. ~ < fI) - < " Do Do < Q ~ !- " o Do (.r.l " ..... o Q) .... ell ....l REV-5IB (3-79) COMMONWEALTH OF PENNSYLVANIA 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 Grover H. McLaughlin 55 South 19th Street Camp Hill, PA 17011 (Executor or Administrator) In Re: Estate of Danny McLaughlin Cumberland County - File No. 21 -78-0648 Dear Mr. McLaugh 1 in: You are hereby notified that the ori ginal appraisement in the estate of Danny McLaugh 1 in has been filed in the office of the Register of Wills of Cumberl and County on September 18. .19--19-. Said appraisement reflects the following valuations: Real Estate Personal Property Transfers Jointly Owned Total none 5,06(30 34 none 5,147.42 10,216.76 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 Septembe r 18, 1979 Signed V/() n-d .~ 0 J ~Jf) ( ) /' Title Appraiser NOTE: This is not a bill. . REV-457 (8-78) DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMON'V'JEAL TH OF PENNSYLVANIA RESIDENT 11\IHERITANCE TAX APPRAISEMENT September 18, 1979 DATE COUNTY Cumberland Fit E ~J o. 21:L{!:.Q.Q~JL~ _.,._._~...__. -- Whereas, Danny McLauQhl in late of East Pennsboro Townc;bLp _.__~. in the County of Cumber I and ~_ Commonwealth of Pcn!1syl'Jania, l1:1"jn~l died "]1 the 3 rd day of tiovembe r 19 Z8-, seized and possessed elf an esLlte subject to Inheritance Tax under the laws of the Ccmmomvealth of Pennsylvania; Therefore, I, Sand ra L. Stone _ ,an appl'3isi~r du)',' -'It;pointed dc/.crdim; to ~dd. having been designated to make a fair and ccnscionable appraisement of the said estate, cil1d to J'~3(_"'S dLd :JX If\,"\ CiFr. 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;,-, possession or enjoyment to collateral j,ei" of th~ deCe'le'lt ai-,er tI'G eXPiratior. of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inhe,itilncp tilxes .,( the !a'.vful colleteL31 rate on any such future interest. DESCRIPTION OF ASSET '--"--.. Real Estate UN! r I '.,' .'1 ..... v I--"_IJE,, . ;-"\PI:"r'1isP:\nent :\cL.,cte f0r I n~leritance T ax Pur poses t- f t ~ I . no.~-+-i I ....5.,Q69 ~; r I! r7;~;jj I 1" "lIt:. Ll' r Personal Property Tr;:lnc; fprc; Joint-Held Property TOTAl LlC:C:I=TC: I ~ I ! I \ , I I 1- -J. L 1 i Have been duly sw9m ~ccording to law, I do hereby certify that the above appraisement is made in conformity with the law on this t day of seJt~ber '. ~ 19 19-.. '"' (:1 n. d ~ /?t.'V /.-J7)." J . . Anpraiser (Number an,j Street) Harri c;hurg (Post Office) .- . Penna. S' r'"".. ~ :t> , . ~ :] 't ..... ~ ....... 15 ~ ('\) :ITI ~ ~ ('\) 0 1t ~. 0 :01 0 n ~ ~ (') ....., "VI :OJ C ~ s::: 5' cr. :rt 't OJ ~. 8 tJ ::J .3 0 ::J 0 ::l ::J 0- ..... 't ..... ~ ..... ~ :N ('\) :-0 . ~ ('\) ('\) 5" m 0 :0 ('\) OJ 'K .ro OJ OJ ~Q.. cc :::l ..... :ro :, , ('\) '- ('\) -0 ....., '8. :0 ::J-' :~ ~ cr Q.. )> ..... n Q.. ~ N .~ n :01 ~ 0 OJ t/.l OJ 0 s::: OJ :0 ~ ..... t:J :VI r- . .,~ :~ :::s :::s ('\) a :0- 01 ~ ;c.. ::J ..... -I '""l '";> ~ 0... Q.. Q.. () :0 t-< c ~ ~ t/.l~ ~ .,' :t> ~ s::: ::z: " OJ to 8" g. 't m ~('\) 0 ('\) :0 :0 ..... ::r 1J ~ 't:s ..... ('\) N- OJ 2 8i :~ ..- <t '""l ~ OJ ~ -I .""" ~ :-1 0 ..... 0 ~. ~ OJ en" () ~& :0 ....., b en. 0 0 ~('\) ::E ....., ~o... a ~ 2: .~ ~ a 'Tl :ro :VI ~o... 0 :' ('\) ::0 ::T ~ :::s :V'l ~ ..:'" m :ro .- :c ~N- < :u :~ :0 .. :rt m :. - t:J () 2 1..0 C :- :0' h...J ('\) ~ :00 :00 () m '*' ('\) , . '::\ OJ -.. t/.l \<:: : '- 1t \Q N ~ r ~.--....--.:I .......... - -- :.-....:....:.:...-.=.:..-- -~ From: SA/'lOO-----------------------.dQ,J 10 rs . representing Pennsylvania Inheritance or Estate Tax due from the following estate: RECEIVED------------------.IGIfI'Y-'I'R1tR'R &J Address lOA "lftu~ 8~.....1: 2 o/~ Tax on $ Date of Payment AUlfU~ 2.. 1'79 % Tax on $ Estate Tax, Act of May 7, 1927 $ $ $ $ $ $ 8J.51 $ Harriaburv, Pa. 17101 6% Tax on $ F No. 21-78-648 Date of Death 11-1-1'78 15o/~ Tax on $ Name of Decedent D\DY Mc:LAUQRLD County CWlberlaDd · Pam <* ACCOUJl1'1'- TOT AL TAX CREDIT Less five percentum of tax if paid within three months after date of death Plus interest at the rote of _ % from to $ Remarks: uoo ~ [p [L~ @illurn SEA L TOTAL AMOUNT PAID ~. S', $. ~. ,. I , .; "CC.V (Sig,nature) Richarc:a .. Anderson aagiS~~1 f Wills It e 81.S8 NOTE: This Triplicate Receipt to be retained for aullit purposes. - ill Received by NOTE: In accepting the transfer inheritance tax an future estates, prior to the death of the life tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth shall not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the life tenant or tenant for years whenever it appears that such additional tax may be legally due and collectible for any reason whatsoever. &- ------ - -- - -------- ----- -"_._------ ~--- ----- - RCC-33 14-73) . COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ~/c2!71 ;Z {--') f>~GLf( 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 Re'otenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF Danny McLaughlin (STATE FULL NAME OF DECEDENT) Late af Cumber land Pennsylvania Cumterland } AFFIDAVIT OF :=:TOR County State of County of ;." Admini s tra tor Grover H. Mclaughlin of the estate of the above-nomed decedent being duly sworn, depose S ~ Decedent died November and say S 3 19 78 { (y EARl Intestate } (MONTH) Name and address of attorney Or } other authorized repres,entative to whom all Correspondence should be moiled. (DAYI Herschel Lock, Esq. 106 Walnut Street, Harrisburg, PA 17101 That as such Administrator deponent is familiar with the affairs of said estate and the property constituting (~-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 IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT NONE That the contents of said safe deposit box or boxes are itemized under Schedules wi th the exception. of the following, for the reasons hereinafter set forth: of this return, That Schedule A attached hereto and made part hereof sets forth fully and in 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 gi ving also separately the accrued interes t thereon, if any, down to the last interes t day priOT 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 whatsoever. kind or nature, left by decedent, together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair'market value be less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest 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. 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 tJusiness. A copy of' the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement) 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 with 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, within two years of decedent's death, in contemplation of decedent's death, or intended to take ef'fect 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. TherA 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, orjointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule 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 life under decedent's Will. It also contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary. That 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 deceden t. 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 ami 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", "en, "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. ~ (~{t... Subscribed and sworn to before me this ................................. . m day of~"i?fmm 19Zi. .................................... ........22/t2...~.\.t0,:.....(~:,:,....~"..:J;./::{f..< .................... . Marilyn Ann Smith. Notary Public Mv Commission Expi,es December ]5. 1982 Harrisburg, PA Dauphin County .....~L~=:...~..~~.._... (Executor-Administrator) ....... .............,L..c....~~...Lr...c.r.t...J;r.:.:....................................................... (Street Number) ...................C:.1f.('1f.!..;;;4:.~.:...f....&..;...../.?tf.!( ........................ (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", and 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-3.. (4-73) COMW.ONWEAL.:T,H OF peNNSYLVANIA DEPARTMEtH OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY * Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent os 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 os joint tenants wifh right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property located In the Commonwealth of Pennsylvania should be (1 ) (2) (3) described by lot and block number, street and street number, together wi th DEPARTMENT a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title; If a farm state number of a- FOR YEAR OF ESTIMATED CAUTION cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH In this space) to be listed on Schedule "F" and must not be deducted from this schedule. NCNE , Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the lost page of this return. \\JONE:" 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 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION No. Lis t and describe fully VALUE MARKET VALUE (Do not write in this space) Batte:ry Charger $ 75.00 Parts Washer 100.00 Wheel Balancer 40.00 Tire Changer 600.00 2 Jack Stands 25.00 2 Floor Jacks 100.00 Cash Register 200.00 AVR Tester 200.00 Snap On Tools & Tool Box 1,550.00 Air Conditioner Tools & Cabinet 300.00 File Cabinet 45.00 Adding Machine 20.00 Cabinet & Screws & Bolts 15.00 Wipers & Hoses 20.00 Antifreeze, Oil Filters & othe:r Misc. 418.99 1964 International Scout Jeep 250.00 CCNB Checking Account 1,060.35< /' ,. Headlight A.:imer 50.00 Insert this total opposite "Personal Property", Schedule "B" in X X $ 5,069.34 5 D lD~. c "\ the "As Reported" column on the last page of this return. I .. .~ ~ r""-. !"'" I ,--. ') t,. I, ; :~,i' I .,~~""',.) ".~>~ '-~w.I ~ ~~~...' MAIN OFFICE 331 BRIDGE STR EET NEW CUMBER LAND, PENNSYL V AN IA 17070 (717) 774-7000 GGNS SANK. N.A. July 10, 1979 Herschel Lock, Esquire 106 Walnut Street Harrisburg, Pa. 17101 Dan McLaughlints Mobil Account Dear Mr. Lock: This is to advise that account #014-000685-9 for Dan McLaughlin's Mobil was opened on September 1, 1978 in the amount of $1,350.96. The balance in the account at the time of Dan McLaughlints death on November 3, 1978, was $1,060.35. ',- At the time of death the original account was closed, and a new account #001-001768-9 was opened in the name of Grover McLaughlin and Herschel Lock. The balance of $1,060.35 was deposited into this account. We trust this is the information you desire. If we can be of any further assistance, please feel free to contact us. Sincerely, /f' ~~ :;;( ~CL Candas L. Snell Assistant Manager CLS:lms cc: Mr. Grover McLaughlin 55 S. 19th Street Camp Hill, Pa. 17011 Rcc-36. COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE "c" TR1NSFEIlS RESIDENT 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) 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 of' disposition? (Answer yes or 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) Nn (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 al ter, amend, or revoke, or which could revert to decedent under terms of' transf'er or by operation of law? (Answer yes or no) No (9) If' the answer to (8) above is in the af'firmative, 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'fidavit by the attending physician as well as a copy of' the death certificate. 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 transfers and to whom transferred, 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' facts 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. Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. NONE RCC-37 '(12-63') COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFI CIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF State iull 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 BI RTH Megan E. McLaughlin Daughter Yes Hinor 100% by her natural rrother and guardian Julia M. McLaughlin of 501 North Second St. Steelton, Pennsylvania ! I I I I I I i I I I ---- i I ( h I i I i I ! I I ! , - I I - , Deponent further says that all the above-named benericiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE -1 -= I -L--- .... o ' ....."'..... ~<'" tn:: s::: 'a ~ s ,- C1l ;:l s-- _ 0. 0 ~ S u ~ 0: ....u"O o C1l ............... ;:l '" .... u ;:l 0 ~ S ~ ~ p::: Real Property Personal Property Transfers ,Joint~Yh.elc:lp:r:q>eJ::t:yq q . SUMMARY . . (Sch. "A") $ ...q.(Sch. "B") $. ..q........q ...... (Sch. "C") $... (Sch. "E") ....... $.S~147~.2. ( 1 ) (As Reported) - 0 - 5,069.34 - 0 - (2) (As Determined) Gross Taxable Estate $ $ 10,; 216..76q $ $ $ $ $ $ S r.... "0 .8 z tIl C1l ~. .... ~ '" ~ ~ ..;: Q) - C1l >- ..... u ~ ~ C1l P-i Cl r.r.. crJ - - +J ~ -< .~ ~ o:l =: ~ ~ '2 p.. M ril Q" 0 o:l Q" p.. ~. ~ l>l -< l>l 4-l ~ :I: :I: ~ 0 'd ;" ... ~ ... E-< ~ ~ Vl Q t: ~ :r:: ~ -< Ol ,... Z 0 0 E-< :.a M ii) Z E-< crJ i p.. ~ ~ ~ i ! ..... ~ ------- 0 0 ...c =: c ~ u .=: 0 c c:: Q" :c ~ <li ~ ~ E-< ..... ;... =: ./:: E-< 0 ..- c Vl -< ..... 0 '2 - 0 .c. E 'E ,;'. <li :: ~ ..... <5 ,- - c:: :::< .....l U U f' R C C-38 COMMONWEALtH OF PENNSYLVANIA TRANSFER INHERIT ANCE TAX RESIDENT DECEDENT SCHEDULE" E" JOINTLY OWNED PROPERTY INSTRUCTIONS: This schedule 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 description, as indicated lillder 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 Belco Credit Union Account #4678-091 in the narres of Dan McLaughlinjMJbil Oil Co:rp. Account opened 10-25-77. (fubil Oil Co:rp. is Assignee only in this account.) Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" colunm on the last page of this return. Estate Valuation _/ 5,147.42 DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest 5 '1..\ 1. I.\~ p. O. BOX 82 HAR~ISBURG. PA. 17108 Phone 233-8737 CHARTERED Mcrr.k 7, 1939 July 17, 1979 Herschel Lock 106 Walnut Street Ha~risburg, Pa. 17101 Re: Account No. 4678-091 of Dan Mclaughlin, deceased. Dear Mr. Lock: As per request made by Grover Mclaughlin, the fo11ow:~s information is given to you for settlement of the estate of Dan McLaughlin: Amount in account as of March 5, 1979.....~5.2Jl.OJ Amount in account as of November J, 1978..$5,147.42L---~ Dividends paid on account December 31, 1978..$ 3J.61 This account was subject to an agreement between Jan Mclaughlin and Mobil Oil Corporation. A controlling in- terest was vested in Mobil Oil Corporation for futu~G gasoline consignment. If you should have any additional questions, fee: free to contact BELCO at your convenience. Sincerely. LJM/lo I cc: Grover McLaughlin