HomeMy WebLinkAbout04-21-80 (2)
,/--1/
21-78-681
REV-449 (8-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
..) / I r G-,) I
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'ienue. (Section 703 of the Inheritance and Estate Tax Act of 1961.)
Lcte of
Cumberland
Pennsylvania
} AFFIDAVIT OF
EXECUTOR
County ADMINISTRATOR
IN THE MATTER OF THE ESTATE OF
FLORA PAULINE CALAMAN
(STATE FULL NAME OF DECEDENT)
County of
Cumberland
Lester Goodhart and Clarence Goodhart
} '"
State of
K~tXiiX
Executor S
of the estate of the above-named decedent being duly sworn, depose
and soy
Decedent died
November
29
, 19~ ~estate leaving a lost will, copy of which is hereto attached. }
~~~~~
(MONTH)
Name and address of attorney or }
other authorixed representative 10 whom
all correspondence should be mailed.
(DAY)
James R. Humer. Atty.
1 W. High St.. Carlisle. PA 17013
That as such Executors deponent is familiar with the affairs of said estate and the property constituting
(EX ECU TO R-ADMIN I ST RA TO R)
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 OHlER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOL;JERS TO DECEDENT
None
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 tbe 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 whatsoever kind or nr.ture, 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 tht: date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securlities owned by the decedent at the time of death, with the market value there-
of at such time.
FlC C-34 (4.073)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITMICE TAX
RESIDENT DECEDENT
SCHEDULE uA"
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 sliould be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
The real property located In the Commonwealth of Pennsylvania should be
described by lot and block number, street and street number, together with
a general description of the property, with a reference to the record of the
conveyance by which the decedent took title; If a farm .tate 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 "Fit and must not be deducted from this schedule.
(1 )
(2)
(3)
DEPARTMENT
VALUATIOM
CAUTION
(Do not writ.
In this space)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMATED
MARKET VALUE
Tract of land situate ln village of
Plainfield, West Pennsboro Township,
Cumberland County, Pennsylvania, approximate y
3 acres, improved with two story dwelling,
attached 2-car garage, combination barn and
work shop and being remalnlng portion of pre
mises described in deeds recorded in
Cumberland County Deed Books 12 "U" 233
and 13 "F" 23.
Presently under agreement of sale for total
sale price of $37,500.00.
6760.001
37,500.00
Insert this total opposite "real property", Schedule" A" in the X X X X X
"As Reported" column on the last page of this return.
37 ,500. 00 I/.J~ ,5'"00, () 0
-4~1f.
RE V-451 (8-78)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
Item
No.
8
9
10
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 tentative 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 payable 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.
IlEM
Li st and desc ri be fully
UNIT
VALUE
ESTlMA TED
MARKET
VALUE
DEPARTMENT
VALUATION
(Do not write in
this space)
1
Household goods sold at public sale
3/10/79 (Auction sale statement attached)
1971 Chrysler Sdn., Sale price
Electronic organ, sale price
Ceramic figurines, sale price
Farmers Trust Co., Ck. Acct. #4-0634-1
Carlisle B & L, Say. Acct. #5859
Carlisle B & L, Interest to 11/29/78
CVS&L, Say. Acct. #154782
CVS&L, Interest to 11/29/78
C.V.Co-Op. Assn., 3 Sh. pfd.
C.V.Co-OP. Assn., 1 Sh. Com.
C.V.Co-Op. Assn., patronage refund ctf.
10.
10
2
3
4
5
6
4,754.90
1,000.00
1,500.00
300.00
1,599.21
8,087.44
177.56
10,151.57
224.37
30.00
10.00
2.92
7
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
xx
27,837.97 1/.2.~f.J1.17
--fI~1f.
DONALD C. MYERS
/ .' "zJ!
~.,..':<~~.
, . . '" ,fit.f{t-.t '
,-, . '\ ~
\ ~'~~-' .~ /- ^[!-
~..y=~ ",..'( , ., ~
Auctioneer
Box 114 R,D,# 5 Dillsburg, PA 17019
Phone (717) 432,5525
AUCTION SALE STATEMENT
NAME
( .,' -'--
(..:Jfc,(c-
I
(' /"'c': <-L.: 1 L-C
( ',.. ' I
~,( i'~ i I",./'L J'--""
TOTAL SALE RECEIPTS
L: l':.> t/. 7(\
ADVERTISING
.,
f. "<f l {c / J ( / J: i" I I (,. (1.L-I < (, / c.J..
I
ADVERTISING
i ~'; /'1 'i L
,
^ /< [ ( ( ...
)1, c; F
/c. (':(
ADVERTISING
("
c : L.. J ~'- i '-tl
/
.d ~ J iT;: i L
{./.7.2
ADVERTISING
FUMIGATION FEE
AUCTIONEER'S FEE' {'<.J( /uicl. . i{-C-C0.
,:;' ((')
j~% of iJ 7S9~ 'j (3
% of
% of
/ % of
-/ :;; % of .13/. 7,j'
.~31'/.5-
,/
L/ 0. CD
REAL ESTATE FEE
CLERKS FEE
/'j ,r:' ~ /
TOTAL EXPENSES
(; / S 7G
LI/3{, /'-1
TOTAL SALE AFTER EXPENSES
DATE) Ie i 1<;
. ,
\ /' ,
J l~'yV~ / (J >>:1~~ 7 " /'-L r {(':.", /. '/V ./:i/". \
..../1/(' <- ~ (//(v,,;/c,..'- 1\.
t/ AUCTIONEER
~?~-r:~~yd/
OWNER/EXECUTORS
WITNESS
') "
;')...;/ (., (.'-/' \
./)1 .. )
. v /-<./ C ','J ..
~--
----
-------
The Carlisle Building and Loan Association
FOUNDED IN 1868
THE OLDEST IN THE COUNTY
17 WEST HIGH STREET. CARLISLE. PENNA. 17013
Phone 243-2915
December 18, 1978
Dear r"1r. Humer:
We hold optional account #5859 in the individual name of
Pauline Calaman. Optional account #5859 with a balance of
$8,087.44 would have received $177.56 earnings as of November
28, 1978 for a total value of $8,265.00.
I trust this information is satisfactory. If we may be
of further service to you, please feel free to ask.
Sincerel y, ,
-/~ . L ~~;[
f"j~ C. Barnhart
Teller
..
~\ HOAr,
.~
.t( Sl\\
CUMBERlAND
~LLEY ~I~
AND LQLlN ASSCX:I~TION
16 West High Street. Carlisle. Pennsylvania 17013 249-2525
December 18, 1978
James R. Humer
Attorney At Law
Farmers Trust Building
One ~est High St.
Carlisle, PA 17013
RE: Estate of Pauline Calaman
Date of Death--November 29, 1978
Savings Account--#154782
Dear Mr. Humer:
Please find listed below the balance and accrued interest on the only savings
account held by the deceased as of November 29, 1978:
Balance ---------------------------$10,151.57
Accrued Interest -------------------
224.37
Total -----------------------$10,375.94
If additional information is needed, please contact me at this office.
Very truly yours,
j1~t~_L t(..{ !.11l,L<,:J5\
()
Richard L. Kuntz
Bookkeeping Dept.
FARMERS TRUST COMPANY
CARLISLE, PENNSYLVANIA
Date I?ecember 19, 1978
James R. H~er Esq.
1 West High Street
Carlisle, Pa. 17013
Re: Estate of
Flora Pauline Calaman
Date of Death
povember 29, 1978
Dear James R. Rumer Esq.
In answer to your request concerning accounts owned, either separately or jointly, by
the above referenced decedent and the balance in each account .as of the date of
death, we have checked our records and are submitting the following information in
duplicate. We suggest that you file one of these letters attached to the Pennsylvania Inven-
tory forms (RCC) to substantiate the balance you report.
Note that we have shown the correct registration for each account. Also, interest accrued to
the date of death, if any, is listed as a separate figure.
Very truly yours, .
\../.; . /1 ') "1 / .
a(/:{..~ 1/. /..{i..-{Vu.-L
./ .
Beverly A. Nickel
Bkp.
Checking Account #4-0634-1 $1,99.21
REV-452 (8-78)
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCH EDU LE "C"
TRANS!=EliS
RESIDENT DECEDENT
(H Did decedent, within '(wo years of death, make any tnmsfer of any material p3rt of his [stat~. -vithout receiving a valuable and
adequa~e consideration therefor? (Answer yes or no) No
(2) Did decedent, within two years of death, transfer property from himself to himself and another or others (including a spouse)
i in joint ownership? (answer yes or no) No
(3) If the answer to (1) or (2) above is; in the affirmative state:
(a) Age of decedent at time of transfer _iliA..
(b) State of decedent's health at time of making the transfer. (Note 1).
(c) Cause of decedent's dl!ath. (Note 1).
(4) Did decedent, in his lifetime, makl~ any transfer of property without receiving a valuable or adequate consideration therefor
which was to take effect in possesilion or enjoyment at or after his death? (Answer yes or no) No
(a) Was 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
(b) What was the tranSfeTlle'S age at time of decedent's death? N / A
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which
transferor expressly or impliedly reserves for his iife or any period which does not in fact end before his death:
(a) The possession or enjclyment of or the right to income trom the property transferred? (Answer yes or no) No
(b) -l"he right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer yes or no) No
(6; If the answer to (S) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others
N/A
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the
benefit of care of transferor? (Anawer yes or no) No
(8) Did decedent, at any time, transfer property, the beneficial 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 transfer or by operation of law?
(Answer yes or no) No
(9) If tile answer to (8) above is in thl! affirmJtive, was the power to alter, amend"Qf revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer yes or no) j\J 0
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death
certificate.
NOTE 2: If answer to any of the abo1le questions is yes, set forth below a description of the property transferred, it's fair market
value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit
copy of any trust deed or instrument, iT trdnsfers are claimed to be non-taxable, also submit cietailed 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
(Esti mated)
DEPT. VALUATION
(Dept. Only)
None
I
I
I
I
I
I
I
~
I
I
I
I
I
I I
I I
I I
~__J
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
None
N M1...U
~
REV-453 (8-78)
COMMONWEALTH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
I
BENEFICIARIES AND ADDRESSES RELATIONSHIP I
(State full names and addresses of all who (If step-chiUlren or SUR VIV ED DATE I INTEREST OF
have an interest, vested, contingent or other- illegitima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, se t STATE YES BIRTH IN ESTATE
forth this fact.) OR NO
St. Matthew Lutheran rhllrrn - - - - - -- - - - - 2 1/29.; residuary est.
Plainfield, PA 17081
Church of God - - - - - - - - - -- ? 1/?!I: resinll::lrv pc:'t.
Plainfield, PA 17081
Mount Rock Methodist Churc}, - - -- - -- - - - - 2 1/2% residuary est.
R.D.4, Carlisle, PA 17013
Greason Methodist Church - - - - - - - - - -- 2 1/2% resi' est.
R.D.4, Carlisle, PA 17013
Lawrence Paul Sch1ittler Nnt related Ypc: ~11 !1 ~100 00
335 1/2 Bridge St.
Lehighton, PA 18325
Mrs. Vera Brandt Not related Yes MIA $100.00
Plainfield, PA 17081
Robert G. Hippensteel Nenhew Yes N/A 1/10 resinll::lrv pc:'t::l'te
508 Plum Tree Road
Bel Air, MD 21014
Dorothy J. Mohler Niece Yes N/A 1/10 rpsinll::lrv pc:'t::l'te
R.D.l, Box 462, Newvil~PJ 17241
Doris M. West Niece Yes N I A 1/10 resinllarv est::lte
Box 8090, R.D.3
Jonestown, PA 17038
M. Joanne Bernheisel Niece Yes ~11 !1 1/10 resinll::lrv pc:'t::l'te
3231 Blundell Road
Falls Church, VA 22042
Theodore F. Weaver Nephew Yes N/A 1/10 resinll::1rv pc:'t::l'tc
852 E. Louther St.
Carlisle, PA 17013 i
!
Theodore R. Goodhart Nenhew Yes N/A ~/10 residuary estate
1106 Newville Road I
I
Carlisle, PA 17013 I
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
Lawrence Paul Schlittler 12/ /78 334 1/2 Bridge St.
Lehighton. PA 18325
REV-453 (8-78)
COMMONWEAL TH OF PENNSYL VANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP I
(State full names and addresses of all who (If step-children or SUR VIVED DATE INTEREST OF
ha ve an interest, vested, contingent or other- ilIegitima te children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set STATE YES BJRTH IN ESTATE
forth this fact.) OR NO
Charles Dale Goodhart N p.n IH~w Yp.<:; N/A 1/10 residuary estatr
R.D.6, Box 270 B
Carlisle. PA 17013
Lee P. Goodhart Nephew Yes N/A 1/10 residuary estatr
P. O. Box 607
Carlisle, PA 17013
R. Michael Goodhart Nephew Yes N/A 1/10 res iduarv esta tr
301 Hill Crest Dr.
New Cumberland, PA 17070
Edward S. Goodhart Nephew Yes N/A 1/10 residuary estatr
110 E. King St.
Shippensburg, PA 17257
I
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME
DATE OF DEATH
RESIDENCE
R E V-454 (400791
COMMONWEAL TH OF PENNSYLVANIA
BUREAU OF EXAMINATION
INHERITANCE TAX SECTION
SCHEDULE "E"
JOINTLY OWNED PROPERTY
INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly with
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 under 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 colu!TIn. Personal property should be listed as in Schedule HR," 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 Unit Percentage Estate DEPARTMENT VALUATION
A<klress and Relationship of Co-Owners, and Place Val ue Share Valuation (OFFICIAL USE ONLY)
of Record of Instrument, where Real Estate.
~ Value of Value of
m ~ :> Entire Decedent's
Property lnteres t
None
Insert this total opposite "Jointly Owned Property," Schedule "En None I\Jf!I~
in the "As Re orted" column on the last a e of this return.
p
p g
~~
REV-484 EX+ (3-80)
Fi Ie Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-78-0681
Estate Name ______q~, Flora P.
Date of Death
11/29/78
Socia! Security NIJmber
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Approiser in and for the County of Cumberland
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"
Dated: May 1, 1980 ..JI/t~/I2.J 1f.1't.1f~)(d)
INHERITANCE TAX APPRAISER
INVENTORY
Real Property (Schedule A)
Personol Property (Schedule B)
Joint-Held Property (Schedule E)
Transfers (Schedule C)
TOTAL GROSS ASSETS
Less D.bts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annu Hies. . . . . . . . . . . . . .
-
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
VALUE AS APPRAiSED CODE (HARRISBURG USE ONLY)
$ 37 500 00 00+ 92+
27,837 97 10+
None 20+
None 30+
65,337 97
40- 93-
RATE
FACTOR
PRINCIPLE VALUE CODE
--
r
COMPU,TATION OF TAX
$
$
$
$
$ -
FOR USE OF REGISTER ONLY
Tax on $
CODE
6%
T ax on $
15%
T ax on $
Tax on $
T ax on $
Exemptions
Total Estate
TO
$
$
$
TOTAL TAX
INTEREST FROM
BALANCE
Less Credits
DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST
$ + $ $ :;:
+ :;:
BALANCE $
iNTEREST FROM TO ____ $
BALANCE DUE $
TAX CREDIT
$
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
Investigation Division
NOTICE OF FILING OF APPRAISEMENT
Lester Goodhart
R.D. 4, Box 30
Shippensburg, PA 17257
Clarence Goodhart
R.D. 6, Box 270
Carlisle, PA 17013
(Executor or Administrator)
In Re: Estate of
Flora P. Ca1aman
Cumberland County - File No.
21-78-0681
Dear Mr. Goodhart:
You are hereby notified that the original
appraisement in the estate of Flora P. Ca1aman
has been filed in the office of the Register of Wills of Cumberland
County on May 1 ,1980. Said appraisement reflects the following valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
37.500.00
27,837.97
None
None
$65,337.97
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
May 1. 1980
Signed
~/.<v7! II ) #fL~A'4J ~
Title Chief Appraiser
NOTE: This is not a bill.
REV-457 (1-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
Estate of
CALAMAN, Flora P.
File No.
21-78-0681
County
Cumberland
Date of Death
. ._~_1}J~U78
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after theexpirationdofany
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.
f A~::~~~~_~~~~tE
. 1- 3-~5:~Ej)~=----
27,837.97
Nbne
L___Jion~ "
TOTAL REPORTED PROPERTyl 65,;37-~---
PROPERTY REPORTED BY THE ESTATE
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "B"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
---- ----_._-~
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
-
I
I TOTAL UNREPORTED PROPERT;1
1---~-==~cc=c=.c=.=-cc'cc-==-.c-c~4-
----.L. TOTAL GROSS ASSETSj
None
65,337.97
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wi lis.
~,p'fJL/ rJft~;lJLJf.L~
APPRAISER
05/01/80
DATE