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HomeMy WebLinkAbout06-18-79 Form RCC.lO OFFICE OF THE REGISTER OF WILLS _./ I, -7 " /, ,,; -/ _',,\ / / ,I u ' / STATEMENT OF DEBTS AND DEDUCTIONS DEDUCTIONS ALLOWED IN -;tel. 'd . /z.-...,-, / J " OF (":1 ImhRr I cmrl COUNTY AND AGENT OF THE COMMONWSALTH ./ ESTATE OF G. Raymond Fogelsonger LATE OF DATE OF FILING APPRAISEMENT ~ it" ::t (q fJ q OATS OF DEATH November 23, 1978 ~ DATE NO. Of' NAME OF PAYEE REMARKS AMOUNT VOUCH511lt Mervin O. Foqelsanqer Funeral 1,382 00 Morlir-~I ALl '>; 1/1 Forest N. Myers A ttorney fees 2,943 71 M;:,rk ~ r:~..h~... ,Ir ^ fc.c.c- 1nn nn News Chronicle Advertisement 12 00 Cumberland Law Journal Advertisement 18 00 G. Leonard Foqelsonqer Executive Commission 1,471 85 Grace F. All i son Executive Commission 1 471 Rt:) Reaister of Wills Filing fees 36 00 Baker & Russell F ue l 0 i l ')01) Igl Daniel Hershev Aooraisal 30 100 Pennsylvania Electric Co. Elect r i c 107 39 United Teleohone Co. Telephone 85 20 Raloh Dewalt Tree trimming 600 00 McCune Lumber Repairs 79 85 Eby Granite Works Letter i ng 85 00 - $9,571 90 COMMONWEALTH OF PENNSYLVANIA } COUNTY OF CUMBERLAND S.: I. G. Leonard Foqelsonqer and Grace F. Allison MY kNOWLEDGE AND BELIEF, THE FOREGOING 18 A JUST AND TRU E srATEMENT OF DEBTS. ADMINISTRATION SUBMITTED TO THE EST"TE OF G. Leonard Foaelsonqer INHERITANCE TAX PURPOSES, /7 X'" " ~ . .', HEREBY CERTIFY. THAT. TO THE BUT OF FUNERAL EXPENSES "NO EXPENSES OF DECEASED, AS DEDUCTIONS FOR SWORN ANi:> SUBSCRIB!J:D BEFORE ME THIS __Ie~ ,/ .- (L. S.) ;;,.~...;,)(:r/;~e_ CU~!h'_r"d'!,~' 1.~J., r2 My C0mm:ssicr. tx;,;if;;~ G,;r. .7.1, j..dO , REV-449 (8-78) COMMONWEALTH OF PENNSYLV ANrA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS RESIDENT DECEDENT COUNTY OF r1/MRFRLANn 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'llenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) . ell f/l? .:l./ - 'I p~- (.1{!:," IN THE MATTER OF THE ESTATE OF G. Raymond Foqelsonqer (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUTOR ~N~ County Lete of rlJmhAr I i1nrl Stote of PennsyLvania } u, County of Cumberland Administrator G. Leonard of the estate of the above-named decedent being duly sworn, depose and say Decedent died November 23 (MONTH) , 19~ ~estate leaving a last will, copy of which is hereto attached. } (YEAR) ~l't~~ .; ) -2/ - C{ [1 C( G (DAY) Name and address of attorney or } other authorized representative to whom all correspondence should be mailed. Fnr,::>s+ ~I MYEi>rjO, E~q'l i n~ 109 1// Fi1~t King StrAAT Sh i DDensbu.r:o PA. 172rs7. That as such ~xecutors deponertt IS lamtltat witli the affaIrs (EX ECU TO R-ADMIN 1ST RA TO R) Executor S of said estate and the property constituting 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 RELATIONSHII" OF JOINT HOLDERS TO DECEDENT 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 propf:rty 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 thefl~of 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 pos ses sion, s tanding 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 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 nl>ture, left by decedent, together with the fairly estimated market value thereof; all bonds and mortgages held by dec'cdent 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. In the case of securities of close or family corpcrations, 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 "business. 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 t.he 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 effect 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. Therp. 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 the:Lr res- pective interests, the:Lr 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 tha 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 "esti ture of real estate and the date of acquisition of personalty, plus the name, address and relationship, if any, of co-owners to the decedent. 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 con'5equence 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 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 pl'oof of said claimed obligations upon re- quest, that if the amount actually paid in settl ement 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", "C", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary:, J Jir" /. / /./ / y~'- '.'~r~ Subscribed and sworn to before me this ""';""""""''''H''H''''. (: \ ~j,., ........ ... . day of.....May.. In9... .1/fU~d';;~.'2L....._._. ....,9.9.....r;.9.$..t.J$,.Lng,,,,SJ.r..eat.,.,,,,..,,..,,,.,,.,.""""""_""H'_"__" (Street Number) ......s.~~~:~b~~~"~~...1~~r-""""..,,..""."""H.""".. SUSAN It MYERS, Notary Public Lcmoyne, Cumberland Co., PI. My Commission Expires Oct. 27, 1980 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-3j1 (4-73) , . COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RE~DENT DECEDENT SCHEDULE IIAu REAL PROPERTY *' Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant .in common with another or other, should be identified 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 IIE.") 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 wIth 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 ESTlMA TED CAUTION cres; also statoment 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. None f\.J a>-L 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. RC.c -35 RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY . COMMONWEALTH OF PENNSYLVANIA Ta4NSFER 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 li&ted 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 undis tributed 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. List and describe full y VALUE MARKEr VALUE (Do not write in this space) $1,849.50" ~ 1. Furniture, etc. 2. 1976 Lincoln Continental Automob i le 6,000.00- Insert this total opposite "Personal Property", Schedule "B" in X X $7,849.50 -r J f) L\ Cl. S 0 the "As Reported" column on the last page of this return. RCC- 36 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDTJLE "c" TR-'\NSFETlS RESIDE""T DECEDENT (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) no (2) Did decedent, wi thin two years of death, transfer property from 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 affirmative state: (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 lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession 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) (b) What was the transferee'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 under 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 (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) nn (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others (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? (Answer 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 the answer to (8) above is in the affirmative, 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) 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 above 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, if trans- fers 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. Only) None NCl--J- Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. RCC-37 (112-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEHEST OF State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY ave an interest, vested, contingent or other- are involved, set STATE YES IN ESTATE wise, in estate) forth this fact.) OR NO BIRTH , , . c; t Fnic:rnnHI r '1;1 000,00 Shippensburg, PA G. Leonard Foqelsonqer son yes 6-30-1905 1/6 Shippensburg, PA r- F A I I i c;on rlHllnhter ves 6 18 1909 1/6 Shippensburg, PA Ray E. Fogelsonger son yes 4-4-1911 1/6 Shippensburg, PA Berkley R. Fogelsonger son no 5-8-1912 1/6 Shippensburq PA R" .f.. ..J M ~rv..,al c:nn VAC: 11.?F..1Q?? 1 If) Shippensburg, PA Peqqy F. Boinis dauqhter yes 11-27-1930 1/6 WHc:hinntnn n r. , I \ h Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH HESIDENCE .... --:- ..8r.n~ ~<'" ~:: t:: 'j:i ~ s 's Q) .= '00.3 ~ g: 8tJ"g ......... ;:l en .... tJ ;:l 0 ~S2' ~ IX: SUMMARY ......q ......(Sch. "A") ....q..... ...(Sch. "B") ..(Sch. "C") Real Property ........................ Personal Property.............. Transfers Jo i nt pr()P..Eirfy Gross Taxable Estate . r-o '0 Z ~ .... ~ en ell '" ...:l Q) ::E ~ >< tJ < ~ ~ L. Q (/) r- en (1) - - <:(: < L!"\ < OJ \!) C 0...: <lS l:.= I ~ tL. 0: '2 Cl. CD ~ 0 (J): .. <lS Cl. r- ~ ~ ~ -J: rn -0 ..?; < I :I: < :I: ~ (1): L C ~, ... ... f-< Ol ::} co CIl Q N ~ < 0: .D -' S ci ~ ::r: ~ l.L (J) L. [j Z 0 f-< c: <Li ~ Z f-< en u (1): ..0 ~ tL. ~ c. 0:. E ..... ~ -"-' 0 0 0.. :J 0 l:.= E U ....c c ~ >- J:: .::: 0 0 co U): "= Cl. :c ~ n:: Q) w.l 0:: f-< ..... ::: l:.= .tl f-< . 0 c '" < 19 ..... .G' 0 '2 0 E 'E ,;'; Q) :: E ... 0 ~~ 0:: 0 ~ U U ( 1 ) (As Reported) $ ....None $..7.,.849.50 $. $5.)~q?4.~}8. $q.. . .. .. . ......... $?~.,~?~~}8 (2) (As Determined) $ $ $ $ $ $ R C C,38 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX SCHEDULE" E" JOINTLY OWNED PROPERTY RESIDENT DECEDENT INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the rlecedent 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 nnder 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 "8", 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 uni t percentage Estate Address and Relationship of Co-Owners, and Place Value Share Valuation of Record of Instrument, where Real Estate. 1. Common Stock, First National Bank of Shippensburg .- (a)v33 Shares (June 15, 1976) (#3378 Richard M. Fogelsonger (son) 420 Sunset Lane SAippensburg, PA (b) ,i U Shares #2538 1- '. ~~ggy F. Boinis (daughter) Washington, D.C. --(c) 22 Shares #2539 l-H ~. Leonard Foge1songer (son) R.D.#2 _~)' Shippensburg, PA ik'cl) 19 Shares #2540 Ray E. Foge1songer (son) 405 Clifton Road /"Shippensburg, PAl 72 57 UtJ 19 Shares #3576 Ray E. Foge1songer (son) (f)~3 Shares #3577 Richard M. Foge1songer 22 22 22 22 22 22 2. (a) Peoples National Bank A:ertificate of Deposit #3282 $5000.bo (April 1, 1973) II~.~~) H,.-St ate Capi tal Savings & Loan Certificate of Deposit #1522 (December 17, 1970)5000.bo Richard M. Foge1songer (son) 420 Sunset Lane Shippensburg, PA 17257 (b) Peoples National Bank Certificates of Deposit #s 110 & 177 March 1, 1966, Jan. 1, 1966 --~Orrstown Bank Certificate of Deposit #158 December 17, 1965 G. Leonard Foge1songer (son) R.D.#2 Shippensburg, PA 17257 2000.bo ql.'-I 2000.00 ------""'v 3. (a) (1) State Capital Savings & Loan Certificate of Deposit #15275000.00 Certificate of Deposit #15215000.00 Peoples National Bank 11) Certificate of Deposit #32815000.00 August 1, 1973 \ "?" ~) (2) Certificate of Deposit June 1, 1974 (3) Certificate of Deposit June 1, 1976 (b) #3913 500.)0 \ 1.\. ~ '7 #49503000.)0 95. . :l... 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest /' 363.00:' 121.0c( .- /" 242.00. " / 209.00 / 209.00 k 363.0(' ~2500.00.~ 9P · lrDJ- ~ " \U'--? . / l.' '::; 2500.00 I...?' '1"'- 1000.00.... LfZ."I- 1000.00,/ I I 50% 2500.00- 50% 25 0 0 . 0 0.' 50% 2500.00 .::1.0, (~!) 50% 250.0~ 1 . I 50% 1500.00 .j(p,lr\ Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. ~1.024. 78) 50J 504. 4'::~ \ " '. . . Schedule "E" (continued) '. (4) Certificate of Deposit #3280 August 1, 1973 (5) Certificate of Deposit #1782 July 1, 1970 (6) Certificate of Deposit #279 June 1, 1966 (7) Certificate of Deposit #5350 AprilS, 1977 Grace F. Allison (daughter) East Burd Street Shippensburg, PA 17257 (c) Series H Savings Bonds (1) #M15735905H Jan. 1974 (2) #M15735904H Jan. 1974 (~ First National Bank Certificate of Deposit #5624 August 2, 1974 /' v~) Orrstown Bank Certificate of Deposit #304 April 27, 1967 (f) Series E Savings Bond #C2025116028E Apr. 1977 ~~) Captia1 Stock, Orrstown Bank /' 12 Shares / Certificate #3 Aug. 6, 1962 Certificate #437 Jan. 6, 1966 Certificate #731 January 13, 1970 (h) Savings Account-State Capital 25,000.00 Savings & Loan #032-0031329 250.00 50% (i) Checking Account-Peoples Nation.,~". Bank Q 71:I. .5 Z) 50% Grace F. Allison (daughter) :.:l--~1'~,~i{ IS East Burd Street . l Shippensburg, PA 17257 5000.00 \ \ 3. .) 0 1000.00 J-3 ,1\ 30 OJ.) .00,,, ~!" j at 5000.00 'iq, ~ I.{ 1000.00 1000.00 1000.00 i'\ +.. i i..r:' 1000.00 ~ ,?~) 2C L:l?- roo.oo' '.....:-....~._... 102.00 4 . (a) Peoples National Bank Cer~ificate of Deposit ~~016 August 1, 1976 #3283 August 1, 1973 it '; 1. g 1 ..d.1o,~..A ~i~.IIill Orrstc\Iln Bank Certificate of Deposit #1782 April 1, 1974 #2159 October 1, 1975 First National Bank Certificate of Deposit #6836 June 11, 1976 Peggy F. Boinis (daughter) Washington, D.C. ;:!l/, ;;(.'::-. 1000.00 5000.00 r5e~9 (b) : ~ ..',' " 5 0 0 . 0 0 .' 3000.00' (c) ~. ~: 1000.00 5 . Peoples National Bank Certificate of Deposit #3284 August 1, 1973 Susan Boinis (Grandchildren) John Boinis George Boinis Washington, D.C. 1500.00 '~:).l~ 50% 50% 50% 50% 50% 50% 50% 50% t.}(Cl 50% 50% 50% 50% ~g%, 50% 50% 50% {;j ~~LS~ ';,.~~\ 6. Peoples National Bank Certificate of Deposit #364 September 1, 1966 1000.00 50% Series H. Bond \~\ \",:.... D86653090E September 1964 500.00 50% Dl1533185H April 1977 500.00 50% Ned R. Foge1songer (Grandson) R.D.#2, Shippensburg, PA 17257 -2- ,..-' 2500.00 /' 5&., ire 5 0 0 . 0 0 ,~ I\. q I 1500. OQ -' 43.1'1 /' 2500.001/ ~"i, 9j 500.00....... 500.00........- 500.00':" II.O'l ' 500.00'/ \,'1.;L/ yo, .;; I"" S9r 00) 612. OO~--' 12,500.00 125.00 cG.~i:,is \ I ~~1. lp '~ Ii). ;. 500 . 00" 2500.00;: ~_. ~'Y5-6 . (:to S/.;,.l.PO 250.00-- 1500.00 ,-'- J. J.'5- , ... i 500.00 ;,.. I ?-, f,j" " )~ ,.;.;,)." .3 1 :;. CO 750 .00,) ~,SD 500.00"" tc. g \ ~ 2 5 0 . 0 (Y"'" 2 5 0 . 0 0 ,/ Schedule "E" (continued) 7. Series H. Bond Dl1535254H May 1977 500.00 50% Thomas E. Fogelsonger (Grandson ./,/ 250.00...../ 8. Peoples National Bank Certificate of Deposit #5919 May 19, 1978 Berkley George Fogelsonger 1000.00 30, (v'3 (Grandson) 50% 500.00;': IS.3~ 9. Series H. Bond Dl1533l86H April 1977 Patricia A. Rhoden 500.00 50% ,.....-" 250.0cY' 10. Series H. Bond // Dl1335255H May 1977 500.00 50% 250.00,' Ri ch ard E . Fogelsonger (grandson) R.D.#4 Shippensburg, PA 17257 II. Series H. Bond Dl1533l84H April 1977 500.00 50% 250.00 Ray E. Fogelsonger 405 Clifton Road Shippensburg, PA 17257 12. Peoples National Bank Certificate of Deposit # 49 76 1000.00 50% 500.00 ".- "'" July 1 , 1976 ","' , ? I d, . 't d-.. C~h~) . Lt', ......J J . Susan Brownell -3- " ~~ ".. .'0 :)</.,~/"\ ~~~~ COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE UlHIEALJ OF COUNTY COLLECTIONS HAfI~I~UUkG 17 L/7 HCC ., I (. " I) NOTE: TO I,l.:: Slll\i'JITIED IN !'I{Jl'LlCATE HEl'OOTlNC FlNANCJ AL J NSTJ. run ON ADD1{j~SS [,'.irst Nn.tlon'-ll i~nnk 1 dest rtnrr .;t. Shi npensburn; 9 }Ja. ZIP CODE 17257 cij-1f- 06.6-7 l't-'llIlS y I vallI i1 Dc pa n lilt.: n l of Revt.: nut.: Uun~au of CUlIllt y Cui J Cl:l ions Ga u I e tiu i I ding, J I'd, F I uu r 411 S. St.:cund Stn~L't Harrisburg,l'ennsylvania 17127 Pursuant to SCl:l ion 742, Pennsyl vania Inheroi lalKC and ESlate Tax Act of 1961, We herewith submi t the following repon: ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT CertjJ'ieate of i)(n)o[~-jt;L:;C;).~ NAMES ON ACCOUNT OR INVESTMENT G. B. l<'o?el::onrer or Cr,cv;p:.'n J;1,HJl1(;r ,.,'llL-3on DATE OF DEATH hI" o)TPrnhpy. ;:> o'j J 1 q7n DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR G. H. P09'e18Cln'~er ADDRESS 104 N. )';a1'1 St. Shinnensbur~9 Pa. COUNTY ZIP CODE I;nr:,benl':ll! 17?C;7 SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR Grace [<'o":r:;lsiJn:"("r k11i~';()J1 ADDRESS 15 i~. Burd ..'3treet, ShjYmensbl1r'", ['\'1. 1,?')r:'7 RELATIONSHIP TO DECEDENT oaupohter DATE DEPOOIT OR INVESTMENT WAS ESTABLISHED f~ll.c~l.lf; t 2,1 (174 BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ 1 000. O() -'/.If) accruerl J'nt. tn o~ 1 022 . 1 6 ~Y1 ' -/L/' (1 4i"~ J \....~ Signature ~ (i (t :'ol," n ," .1 eaT !' \~ '.-. 000 o. . _: >i~ / ;JI)~: ~iti:~LE . , I .... \.-.' . , . .. ~~~ ,- ~t, -.. ~~i.-~~ ,'.\ COMMONWEAL Hi OF PENNSYL VANIA DEPARTMENT OF REVENUE ULJI-<EAU OF (OUNTY COLLECTIONS HANI-<I~lWRG III ;a j{CC ,,\ l, ,'1) NOI'E: 10 liE SIJEHIll'ED IN l'I<J1'l.JCA'JE REP(){IJNC FtNANeJAL INSn rUT10N ADDt{ESS J.'j rst TTat lonaI i3Clllt~ 1 J\,;st lin'" ~3t. Shi nTWllSb11I'(j'. Pa. ZIP CODE 17?57 ~/- 7f? - O~.!;-, Pl'nn:;y I vani a D~pa rlmenl of Revenue 8ureau of County Collections Gable 8ui Iding, Jrd, Floor />' J I.t 11 S ;--Secnncl8t Feet I 2: 't "" lj;,~-",/.i.<.~ "C III .1-4" _ Harri:;bulg, Penn~ylvania 171~7 Pur~uant to Sect ion 742, Pennsylvania Inheri lance and E~tate Tax Act of lY61, we herewith subllli t the following report: ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT Gcrt i f'j r:n te of' )f: nOELt t .'11_- ( : '.,' ,- .'1' )('))1) NAMES ON ACCOUNT OR INVESTMENT G. lL1YTnC)'tH"'a'"eJ f;ann-cr' or FC>"-,nr Po-; noi ::, DATE OF DEATH rTovpmber' ?3, 1 con DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR (~. ;?:lvrrJond Fo'~eJ f;on'rer ADDRESS 1 (14 N. :~arl Street S11i PDensburn-, P::. COUNTY C v r, I h P. r 'j ;) Wi ZIP CODE 17?h,7 SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR ~'?(~ cr C',r fJoi 11 t n ADDRESS Un >'nm-In RELATIONSHIP TO DECEDENT dau"hter DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED June 11, 1 c)76 BALANCE. INCLUDING INTEREST DUE. AT DATE OF DEATH $ 1ll()() _ ()() ,),- C>~ I _~~ accruec, 1026J;3/?n (' Signature Int. to date ,\ or "lcath TLE .. : l' . . RCC-39 (~68) COMMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT " SUMMARY Estate of Foqelsonqer, G. Raymond (Last Name) (First Name) (Initial) DATE OF DEATH 11/23/78 FILE NO.<< /" 'lS..(){/'5 7 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser 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: a October 1979 xi/L lidl ("l 0(l1l ( ." INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Cumber land 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: 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) CLEAR VALUE OF ESTATE Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ ESTATE TAX ASSESSMENTS $ .;.. FOR USE OF REGISTER ONLY Tax on $ Tax on $ Tax on $ Tax on $ Tax on $ Exemptions Total Estate TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ Estate tax paid $ BALANCE DUE Add interest at rate of 6% from to REGISTER OF WILLS VALUE AS REAPPRAISED $ t= t= t= COMPUTATION OF TAX 2% 6% 5% 10% 15% * $ $ $ $ $ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. $ $ $ l= $ $ c $ C I- E $ $ 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. . . 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 GraceF. AllisonG. Leonard Fogelsonger 15E. Burd St., Apt. #3 66 East King St. Shippcnoburg 11 A. 17257.. ~hippp.n1':hllrg, PA , E"xecutor or Administrator) 17257 In Re: Estate of ~. R~ymond FOfp.1son~er ("l1m'hO'n'~nrl County - File No. ? 1-7 8-06 5 7 Dear You are hereby notified that the Original appraisement in the estate of G. Ravmond Fogelsonger has been filed in the office of the Register of Wills of Cum:ge 1 County on 3 OC1:ohpl'" , 19---2..9 Said appraisement relie~e following valuations: None 7,84QaSO Nona SO,S04.43 SSA,353aQ3 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. Real Estate Personal Property Transfers Jointly Owned Total 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 3 October 1979 r I Signed .\,,10 n ell fA.. ,..JJ Ini ( Title Appraiser NOTE: This is not a bill. REV-4!d (8-78j DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS P.O. BOX 2970 HARRISBURG, PENNA. 17105 COMMONWEALTH OF PENNSYLVJ\:'JiA RESIDENT INHERITANCE TAX APPRAISEMENT c,.... , " 10 -1- '7 9 COUNTY Cumber-land FILum. _.21-78..0657 Whereas, G. Ravmond Fogelsonger late of Shippensburg in the County of Cumberland Commonwealth of Pennsylvania, having died on the 23rd day of November 19 ~, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, Sandra Stone ,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 cash 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 $ .,... " T"_~ ~ 'U~...~ - l::l 1 Pronertv 7.849 50 t" Transfers .. ,,~ .... Jointly Owned ,n t;nl.1 ,~ 'T'ot"i'll n ""." ^ , - , \ I T Have been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with the law on this - ~ p g day of 0 Q t eJ:.r .' , ~. 19 ...2.9.... n ,'i) {I U,rTi,( .--- Appraiser Hbg. (Number and Street) (Post Office) . Penna. r I >, ~ "0 0'1: ..... t--: s::: z (I) ::s w ~ 0\0 0\ 0 ~ (I) (0 ..... CJ w 0 ~; (I) CI) Q ~ <( (I): W 0: bli >i 0 c-.r. -= ::> , C- s::: +'= 04 +J: Z j~j C- O; ~ 00: tl: w <( CI): ~ t--: 0: > ,~. X 04: 0: -....; W ~ <( ...... (I): c.>. (\'): ~ (\'): a:: .....' \ ~ 0 bO N ..... ...... g U- s::: s::: '\\ W (I) 0; 0 '0; -....; (I)' '"Ci (I) (I) .0 u ..... ,.,..t 0 ~ '\.7"\ <ll ~: (I) s::: 0 ~ S ~ z ..... ..... I'll: r-i; ..... S ~. I- (I) ~ <( ~ '0: <ll r+. (I) 0 CIl CIl "0' ...:J 0 Z a. ..... ..... r-i ~ s::: ,~ ..!x: (I)' <ll <ll e- o W a a I ~ 0: 0: (I): 0 ,CIl ::s ~ n, ""', <l% W s: A: Q ... "0 q; n, ~ <ll J: (I) :x: I- q; ..s::: ..G >i s: ..s:::' ..... "0 '~, ..... CIl <ll a:: 0 g Z I'll: ::I; ..... s::: N; 'e, ..... <x: s::: ..... S "0 ::t ~: CJ: <ll (I) 0: ...... <ll ::s ~ (I) s (I) 0.. 0 0 s::: ~ 2 0 N: 0:: 0 w '"Ci "0 ..0 <t:: <ll (I) ..... (I) w 0: ...... CIl s::: s::: 0 ~ .S <ll ".., "0 C t!l; ..... (I) 0 <ll ..... ::s ..... S (I) <ll 1i> Cii .... ~ "0 0 (I) ..... (I) (I) n, ..... n, (I) ~ 0 <ll 0 ..... w q ~ ....... (I) ~ ~ ~ ~ 0: ~ tr:; n::: Inventory of the real and personal estate of G. Raymond FoqeLsonqer deceased. PersonaL Property: Furniture, etc. 1976 LincoLn ContinentaL AutomobiLe JointLy Owned Property: Common Stock, First NationaL Ban~ of ShippensbL'rg, 33 shares #3378 11 shares #2538 22 shares #2539 19 shares #2540 19 shares #3576 33 shares #3577 PeopLes NationaL Bank, Certificate of Deposit, #3282 State CapitaL Savings & Loan, Certificate of Deposit #1522 PeopLes NationaL Bank, Certificates of Deposit #s 110 &177 Orrsotwn Bank, Certificate of Deposit #158 State CapitaL Savings & Loan, Certificate of Deposit #1527 #1521 PeopLes NationaL Bank, Certificate of Deposit #3281 #3913 #4950 #3280 #1782 #279 #5350 $ 1,849.50 6,000.00 Checking Account, PeopLes NationaL Bank Peoples National Bank, Certificate of Deposit, #5016 #3283 #3284 #032-0031329 36~.00 121.00 242.00 209.00 209.00 363.00 2,500.00 2,500.00 1 ,000.00 1 , 000 . 00 2,500.00 2,500.00 2,500100 250.00 1,500 00 2,500100 500100 1 ,500 00 2,500 00 500 00 500 00 500 00 500 00 50 00 612 00 12,500 00 125 00 1,355 78 500 00 2,500 00 750 00 250 00 1,500 00 500 00 750 00 500 00 250 00 250 00 250 00 500 00 250 00 250 00 250 00 500 00 Series H Savings Bonds, #M15735905H #M15735904H First National Bank, Certificate of Deposit, #5624 Orrstmwn Bank, Certificate of Deposit, #304 Series E Savings Bond, #C2025116028E Capital Stock, Orrstown Bank, 12 shares Savings Account, State Capital Savings & Loan Orrstown Bank, Certificate of Deposit, #1782 #2159 First National Bank, Certificate of Deposit, #6836 PeopLes National Bank, Certificate of Deposit, #3284 #364 Series H Bond, #D86653090E #D11533185H Series H Bond, #Dl1535254H Peoples National Bank, Certificate of Deposit #5919 Series H Bond, #Dl1533186H Series H Bond, #Dl1335255H Series H Bond, #D11533184H Peoples National Bank, Certificate of Deposit, #4976 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J 55: G. Leonard f()t)eJ songer ann Grace F. Alllc;nn bei~g duly sworn according to law, deposes and says that they [xecutor~ of the Estate of G. RaymoOO Fogelsonger late of ~ppensbu.f'g.----~-uu- _______~____ , Cumberland County, Pa., deceased and that the within is an inventory made by G. Leonard FogelSOOQer & Grace F. Alll sory the said Ex9Ctltors 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 Inve ry represent it's fair value as of the date of decedent's death. ~ _ ~ Sworn and subscribed before me, , ,f " / ) I t: 19 79 \ ~ ,-),,;>\."~ ,,~-\) ~ \"\ \. ,,- "'\ 66 East King Street. '''-\ SUSAN R. MYERS, Notary Publfc Lemoyne, Cumberland Co., Pa. My Commission Expires O<:t. 27, 1980 Shippensburg, fA 17257 Address Date of Death 23 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. --0 \l >- Q) ''- \..l I- W '- ... ~ 0:: I- 10 'J 1'"'- W oe( Q) U'\ c.. l- e: u "-i 'f 0 0 V'l 0 Q) II ~ W W C 0- >0- J: 0:: en III II .IX) ..... c.. - c.. c r-- Z I- ...J u.. ~ 10 .. Ii II u.. ...J oe( 0 c.. ~~ 0- W 0 oe( w ..,;.. Ni > 0:: ~I .' oe( I z of- II Z 0 c c " ~ " ci I: V'l z ~ 0 \ 0::: U \., z II w oe( - c.. ""0 l( c ~I 10 \ '\ .... -.: 0 Q) .1 ..D lDl Q) E ""0 ~ ! of- ~ II 0 1 10 0 ...J U u: m