HomeMy WebLinkAbout11-09-79
RCC-314-73)
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION FOR CHARIT ABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, 1956, P.L. 1757, and Act of June 15, 1961,
P.L. 373, as amended)
Application is hereby filed for the approval 1. Bureau File # 21-78-657
of an exemption from Pennsylvania Transfer 2. Date of Death 11-23-78
Inheritance Tax on the transfer of the property lilrv (' lq1rr
described below: 3. Date of Approva I 1
4. Name of Decedent G. Raymond Fogelsonger
5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ 1,000.00
(Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percenta~ amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously filed.
WILL B;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Methodist Episcopal Church, now Christ United Methodist Church, of Shippensburg
ADDRESS East King Street, Shippensburg, PA 17257
o See listing on reverse side for additional charitable organizations covered.
8. I certify that the information contained herein is, to the b~st of my knowledge and belief, true and correct.
5;'"""0 .f Appl;,.", ~JJ<6i-T'~I~~
\IO-U
J
Address of Appl icant
hL.. F.:l~t King RtT~pt, Rhipppn~hll"g) PA
17257
Official Title
Executor
Date
October 17. 1979
This form must be completed in triplicate and all three capies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were issued for a non.resident decedent's estate. If the decedent wos a non.resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Pa.
Do not write below this line. For Official Use Only
AP PROVED: For the Secretary of Revenue REFER RED to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied* 0
~. (5;,"]'",:( Rot'O'.f W;lI.J
C~~ 'b~
,
~ (County)
- CO ~ ' 0 tJt
(Date 0 1pproval)
(Initials of Register of Wills)
(Authori zed Si gnatu re)
(County)
(Title)
(Date of Referral)
(Date of Action)
* See reverse side for reasons
MUST BE FfLED IN TRIPI.I<<;~u