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HomeMy WebLinkAbout02-05-79 COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS -< I~?~~ 6~? *..... !,., RCC.33 (4-73) iC 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'tenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IN THE MATTER OF THE ESTATE OF Harold P. Walters (STATE FULL NAME OF DECEDENT) } AFFIDAVIT OF EXECUTORS XIIIMI5lSXK.!rnOJlX Late of Cumberland State of Pennsylvania } ss, County of Cumberland County ll_llliloIllCiK Harold S. Irwin. Jr. and RogRr B. Irwin of the estate of the above-named decedent being duly swom, depose and soy Executor S (MONTH) Name and address of attorney or } other authorized representative to whom 011 corre$i)ondence should be mailed. {DAY} , 19~J testate leaving a last will, copy of which is hereta attaChed.} {~dWilitI Decedent died October 31 Harold S. Irwin. Jr. 44 South Hanover Street. Carlisle. PA 17013 That as such Executors deponent is familiar with the affairs of said estate and the property constituting ( EXECUTO~OOX"'DRX1rdWC 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 THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A S....FE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS 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 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 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 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 or 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 lmslness. 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 ~usiness as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted. It should also set f'orth in itemized f'orm, 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 f'orth 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 f'orth 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 eff'ect in possession or enjoyment at or after death, there is also attached to the schedule a cony of the deed, trust agreement or other instrument creating the trust. Ther~ 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 instrWllent of' another, with a copy of the instrument creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereof' sets f'orth 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 ror lire under decedent's Will. It also contains a statement showing which or the beneficiaries named in the decedent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship or such issue to the benericiary. That Schedule E attached hereto and made a part hereof sets rorth 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 or 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 decedent. That Sc/1edule 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 ann unpain 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 staten~nt 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 have the totals of the appropriate columns in Schedules -A-, -B", -C-, been carried forward and properly registered in the -E-, and -F" as directed therein, "(C,- '-:::,~1C . . J CJUNTY !D:.j LF,iirS LLC.15, 1980 ;::'Y~V~:1;2 !b::ci2 I :')11 oi :" < t~rie~ :.". Sununary. /~j:U/O~dlv~ ....:~ltt~~~..:.:...-irwi] 44 South Hanover Street .....................,.....is;~;t..N~~b;:}.....,......................,.....--.. ...g?:~:l::i::~l.~>...~EO.El~?.y.:J,Y.'3.:n:J:'i... ....JY9U. (City or Tow" and Sto.te) Subscribed and sworn to before me this .......,................' .........3.\" . ~ay of ::S~~ru.,~ 19..73, .....,.' OOZA.(l .m~Y\-". "':~~,~ I' c.: NOTE: Before signing affidavit make sure all blank spaces in the aff'idavit 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 f'amily corporations or an interest in any co-partnership or business, that the data and statements required under the paragraph ab?ve relating to Schedule "B- are attached. Also make certain that column #1 in the -Summary- has been properly completed as above-directed. kl.:C-.J41.._731 COMMOlMfaALTH OF ......'l'l;V.. DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEOe,NT SCHEDULE "A" REAL PROPERTY *' Real property in Pennsylvania, with statement of mortgage encumb.-ances upon each parcel at death of dece- dent. Property held by the decedent as tenant in cammon withanolher or ather, 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 surviarship or tenancy by entireties should be reported an Schedule "E.") The real propertylot;:ated In the Corrnnol'twealth of Pennsylvania should be (1) (2) (3\ described by lot "dnd block numb.r, .tr..t and stre.t number, together with DEPARTMENT a general description of the property, with a r.f.r.nce to the record of the ASSltSSED VALUE VALUA nON conveyance by which the decedent took title; If a farm state numb.r of a- FM YEAR OF ESTlMA TED CAUTION cres; also statement of mortgage encumbrance. upon each parcel at death 'DECEDENT'S MARKET VALUE (Do not writ. of decedent. Taxe., assessments, accrued Int.re.t on mortgag.., .tc.,are DEATH In this space) to be lI.ted on Sch~t;lul. .'F" and mu.t not b. d.ducted from this schedule. NONE NONE N~ Insert this total apposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. 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 tent~ tlve trust accounts, must be listed, despite the fact that they are not of the administered estat~ 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 certiricates, cash on hand and in bank, stocks, mortg4ges, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or riduciary in said capacity, partnership interests, interest in any undistributed estate or or income rrom any property held in trust under the will or agreement or another, even though located outside or the State, at the time or death, should be listed in this schedule. Item No. ITEM List and describe fUlly UNIT VALUE ESTIIlATEIl IIAI\KEr VALUE DEPARTIIENT VALUATION (Do not write in this spsce) 1 Furniture and household items, etc. 109.00 ~ 2 1963 Chevrolet Impala automobile, junked 25.0 ..~.' 3 First National Bank of Shippensburg Checking Account #701-215-6 Savings Account #1-20821-2 11,954.8 2,581.5 4 Monumental Life Insurance Company, benefits payable to Estate under pOlicy #51M5371 2,500.00 returned premiums 20.80 2,520.8 5 Cash on Hand 6 New York Life insurance dividend 17 40 . 2 n L\:OC(.It- Insert this total opposite .Personal Property", Schedule "B" in X X the "As Reported" column on the last page or this return. ROBERT C. CROUSE A..ilt.ont Viee PTuidftt FIRST NATIONAL BANK OF SHIPPENSBURG SHIPPENSBURG, PA. 17257 . PHONE: (717) 532-2151 November 21, 1978 2 i: liEtU Harold S. Irwin, Jr. Irwin, Irwin & Irwin Attorneys at Law 44 South Hanover Street Carlisle, PA 17013 RE: Harold P. Walters Estate Dear Mr. Irwin: Our records indicate that the balance in checking account #701-215-6 in the name of Harold P. Walters was $11,954.84 as of October 31, 1978. The balance in savings account #1-20821-2, also in the name of Harold P. Walters, was $2,560.16 with accrued interest from the date of last pay- ment until the date of death amounting to $21.42. We are unable to locate any other accounts in the decedent's name. Cordially, . (i'dw/! tu~,. Assistant Vice President RCC : pag I RCC - 36 COMMONWEALTH OF PENNRYINANIA TRANRFER INHERITANCE TAX SCHEDULE "c" TRANSFERS + WltJ RERIDENT DECEDENT (1) Did decedent, within two years of'death, make any transf'er of' any material part At. his estate, without receiving a valuable and adequate consideration theref'or? (Answer yes or no) NU (2) Did decedent, within two years or death, transrer property rrom himselr to himselr 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'firm~txe state: (n) Age of' decedent at time of' transf'er N/A (b) State of' decedent's heal th at time of' making the transf'er. (Note 1). (e) 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 theref'or which WaS to take errect in possession or enjoyment at or af'ter his death? (Answer yes or no) NO (a) Was there any pOSSibility that the property transrerred might return to transf'erer or his estate or be subject to his power or disposition? (Answer xes or no) NO (b) What was the transreree's age at time or decedent's death? N/A (5) Did decedent In his lifetime make any transf'er 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 transrerred? (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) MO (6) If the answer to (5) (b) above is in the ar:firmative, 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 f'or the benerit 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 al ter, amend, or revoke, or which could revert to decedent rmder 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 beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) N / A 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 transf'erred, it's rair 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- rers are claimed to be non-taxable, also submit detailed statement of f'acts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) NONE NONE N 0'-'-- I Insert this total opposite "Transf'ers", Schedule "e" in the "As Reported" colwnn on the last page of this return. RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" ~*~ BENEFICIARIES , RELATIONSHIP BENEFICIARIES AND ADDRESSES (If step-children or SURVIVED DATE INTEREST OF State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY aye an interest, vested. contingent or other are involved, set STATE YES IN ESTATE wise. in estate) forth this fact.) OR NO BIRTH G. FRANK WALTERS BROTHER YES 1963 Impala Auto 110 East Orange Street In residue Shippensburg, PA RHEA MESSIMER SISTER YES 1/3 residue Camp Hill Pennsylvania HAZEL WALTERS SISTER I NO _._._--.~---- ..---LlL3_:r~_~;j.2_~e____ - , -- 74 West King Street , I , --------t-----.- --or u._.~.. -- Shippensburg, PA i i I I ----- I I ; i -------- -- j --- I 0- ----'-_..~------------- -- l h -_._~-- ____ n_._~._.__~____~ Deponent further says that all the above-named beneficiaries are living at this time except below: ( NAME DATE OF DEATH RESIDENCE G. FRANK WALTERS 1l/27178 110 East Orange St.Shippensburg (interest to be paid to Estate f Frank Walters) rA HAZEL WALTERS interest lapsed into residue) 3/77 77 West King St. ,ShippensburgPA .. o . -~~ i!<- 't;: C '2 Q.I IS .......... :s S"- "Co.B < S. .:..B;c o " ::;tlt: " " 0 " S c. &l " _ 0:: Real Property Personal Property Transfers SUMMARY ...(Sch. "A") .............. ..(Sch. "8") . ...(Sch. "C") (1) (As Reported) $ ...... 0.00 $.......~.7..~.~.?9.~ .7.2.. $... ..Q.,Q() $ ............. $................... $......1!',499...]? . (2) (As Determined) Gross Taxable Estate. $. $... $.. $. $.. $. CD. t-: 0\: r{ t-- ::r:: Z ." " O. ~ I.:i ~ ~ .. :::>. ..l <l> " ;.-. " o. < I.:i " ~. Z t- <fJ Q fIl (\J 0 - H - < \D <<: (!) ~. oS :s: I ~ ~ ~ 'S IlIl ~ CD Q.. "" O. r:::.. Do H 0 oS Do t- Q.. E-t ~: Z ,?; ~ < '" < I := I.:i H :::>. .0: '" ""'" rl ~ ... t-- .0: ~: H ~ Q ;>, (\J 0 ~ :I: .. <<: :s: (I): ~ S ~ ZQJ t-- 0 t-- Z "" v H>: Z ell "" ~ ""' :S:H ~ ~ p, p, Z ~ ~ ~o ~ 0 p, :::>. 0 HI-' r:::. H CY ..c .p " ~ .:: 0 0 ~ H ::r:. " Do < ., 0 (I)' '" "-l Z .. t: ~ ~ ;: IlIl H ./:l .0: 0 c :s: ~ <<: ~ 0 'S :;:; ::r: 0 j::. E ~ = '5 '" s E H - " .~ "C oS 0 ~~ ....l U U 4 RCC-38 RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY '* COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX 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 lmder Schedule "A", plus the date and place of' record of' instrument ef':fecting 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 acquisitio~, and the name, address and relationship (if any) of Co-owners to the deced.ent. , . . Description of' Property, Date of' Acquisition, Name Unit percentage Estate DEPARTMENT VALUATION Address and Relationship of' Co-Owners, and PI ace Value Sh are Valuation CAUTION-Do not Write of' Record of Instrument, where Real Estate. I n This Space. X? ~~ XXI~ >lYW QO ~>O< :::so Value of' Value of' '9' W Deceden tIs ;(QQQ< Y< ;X ~ Entire X XS X ;X ?< 6 ~o<.x "XX .x '" Property Interest NONE NONE ltllt>---L Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. ~ .()...-o. t~ L, \:"-. RCc.n (&oes) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of WALTERS (Last Name) HAROLD (First Name) P. {Initial} DATE OF DEATH 10/3V78 FILE NO?1-78-627 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", uB", uC", and "E". Dated: INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Cumberland County, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "P", 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) Join t - Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEOULE F) CLEAR VALUE OF ESTATE VALUE AS REPORTED VALUE AS APPRAISED $ $ o 00 o 00 17 409 72 VALUE AS REAPPRAISED $ Valuation of life estates or annuities. . . . . . . . . . . . . . . . . . . $ 1== t= t= 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% o $ $ $ $ $ (0) 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 $ $ 1= $ 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 $ c $ C $ 1- ~ $ 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.