HomeMy WebLinkAbout09-13-06
....J
15056051058
REV-1500 EX (06-05)
PA Department of Revenue *'
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
~\ Olf
File Number
oi1l1
Date of Birth
i(tJ4 -3lP - oo5~
9-c:iI-~003
tJ,5-05- /912tl
Decedent's Last Name
Suffix
Decedent's First Name
MI
Bartoo
Betty
P
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
c.,
1. Original Return
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec~13(A)
between 12-31-91 and 1-1-95) (Attach ~Tp 0) t~ ...,., fR
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX ~NFORMATIJ;S,~LD BE DI~ED T~i~~j E3
NarneDi3yllllle Teleph9n~~~~r ~';J? f9
(717) 802-116.6. :: j <.,.,);\ C3
C., C-:>
REGISTER:9~~~USEQ~Y: \_~ :n
" " -~- Fe; (:"')
~= rn
(j')(J
-n
4. Limited Estate
8. Total Number of Safe Deposit Boxes
Cathy Bartoo
Firm Name (If Applicable)
First line of address
::l~j
r<'
.r:-
240 W. Simpson Street
0"\
Second line of address
City or Post Office
Mechanicsburg
State
ZIP Code
DATE FILED
PA
17055
Correspondent's e-mail address:
DATE
ff-;;2~-6~
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058
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L
15056051058
v
--I
15056052059
REV-1500 EX
Decedent's Name:
RECAPITULATION
Betty
P Bartoo
1. Real estate (Schedule A). ............................................ 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
Decedent's Social Security Number
1(;4 -,B(p -005 c5J-;
59,230.00
500.00
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9.
60,330.00
6,277.50
248.66
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Govemmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .., . . . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_
16. Amount of Line 14 taxable
at lineal rate X.O _ 53,803.84
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
19. TAX DUE. . . ., . . . . . . . . . . ... . . . .......... ., . . . .. . . ... . ... . . ... . . ., . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
L
6,526.16
53,803.84
53,803.84
15.
16.
2,421.17
17.
18.
2,421.17
15056052059
--I
REV-1500 EX Page 3
. Decedent's Complete Address:
DECEDENTS NAME
Betty P Bartoo
STREET ADDRESS
240 W. Simpson Street
DECEDENT'S SOCIAL SECURITY NUMBER
I (g If ~:3tJJ ...
CITY
Mechanicsburg
STATE
PA
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
2,421.17
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
285.43
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
285.43
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(SA)
(58)
2,421.17
285.43
2,706.60
A. Enter the interest on the tax due.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 [iJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [iJ
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [iJ
3. Did decedent own an Hin trust fo(' or payable upon death bank account or security at his or her death? .............. 0 [iJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX. (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Betty Bartoo
All real property owned solely or as a tenant in common must be reported at fair market value. Fair marXet value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
ITEM
NUMBER
1.
DESCRIPTION
240 W. Simpson Street Mechanicsbur, PA; parcel no. 20-23-0587-111;
VALUE AT DATE
OF DEATH
59,830.00
dimensions 66 x 100 x 50 x 106; title conveyed to decedent by right of survivorship in a
concurrent interest of tenancy in the entirety after the death of her spouse Max Bartoo.
TOTAL (Also enteron line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
59,830.00
REV.'503 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Betty Bartoo
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
none
0.00
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
REV-1504 EX+ (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF
Betty Bartoo
FILE NUMBER
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM NUMBER
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. none
0.00
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets 01 the same size)
0.00
REV-l507 EX+ (6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
Betty Bartoo
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
none
0.00
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
REV-l508 EX+("98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Betty Bartoo
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
Upright Piano
300.00
Clothing
200.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
500.00
REV-1509 EX. (6-96*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Betty Bartoo
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. none
B.
c.
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. none
TOTAL (Also enter on line 6, Recapitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV.1510 EX+ (6-..*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Betty Bartoo
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
FILE NUMBER
DESCRIPTION OF PROPERTY DATE OF DEATH
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. none
TOTAL (Also enter on line 7 Recapitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
REV.1511 EX+ ('2-99>*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Betty Bartoo
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Funeral Expenses
6,277.50
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
. State
Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
,Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
6,277.50
REV-l512 EX+ (12-03)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Betty Bartoo
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
FILE NUMBER
1.
utility - water
40.00
2
Utility. electric (PPL)
130.00
3
Utility - garbage & sewer
42.66
4
Utility - telephone
36.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
248.66
.
4\13.
... . J,
_.... a_....._ ,"_._,"_',' .,._.~"_, _..~, _~ .._._.._..... ...___.___....... __"'_"_ 0.:'- ,".. ...'''0 _ _".~.. _. ......._...._.. .. _' .~ ...~ _ _.
..,....'I'-W__ Doot. Bhon "-- Aft If 1__1ftA8OlI fer :n.e.--...
_17 JUlI, I.... J...u.- P..
MADE THE
01 our Lord OM t1Louse~ ni718 Itundretl
~bi~
~ r/'
1!\ttb,
.vol /}/~..
and seventy-two (1972).-
. in tA, year
BETWEEN SOPHIE S. PRETZ, Widow, or Scottsdale, Arizone, party
of the first part,
. Gf:antor .
. and MAX E~ BARTOO and eET'l'Y P. BARTOO, his wite, ot the Borough
of Mechanicsburg, County ot CUmberland and state ot Pennsylvania,
parties ot the second part,
G'I'l1ntce 8:
WITNESSETH, t1ult in COfI8ide'l'l1tion of the SUlll. ot Eighteen Thousand Pi ve
Hundred- -
($18.500.00) Dollan
in MM paid. tAe receipt whereol i8 Aereb71 tJCTmowledged, the aaid grantor do e8 hereby grant
end con1Jty to the .aid grantee s, their heirs and assigns,
ALL that oertaln House and Lot ot Ground situate on the northeast
corner ot South York and West Simpson Streets, in the Fifth Ward
. of the Borough ot Mechanlcsburg, County of Cumberland and State of .
Pennsylvania, bounded and .described as .follows, to wit:
BEGINNING at a point in the curb line at corner of South York and
West Simpson Streets; thence extending eastwardly along the curb 11n~
of said West Simpson Street, sixty-six (66) feet, more or less. to
a point on said curb line at line of lot now or formerly of Lettie
Long; thence northwardly along the line of said lot now or formerly
of Lettie Long, one hundred (100) feet, more or less, to a point in
a public alley; thence extending along said alley in a westwardly
direction fifty (50) feet to a point on the curb line of South York
Street, aforementionedf thence extending along said curb line of South
York Street in a southerly direction one hundred six (106) feet to
the point and piace of BEGINNING.
HAVING thereon erected a two .and one-half story frame dwelling
numbered 240 West Simpson Street, Mechanicsburg, Pennsylvania.
BEING the same premises which Thomas F. Basehore and wite. by
their Deed dated May 1, 1948 and recorded in the Cumberland County
Recorder's Of.fice in Deed Book tiT", Volume 1), Page 557, granted and
conveyed unto John C. Pretz and Sophie S. Pretz, his wife. The said
John C. Pretz died on June 23, 1968, whereupon sole title in said
premises vested in his said wife. Sophie S. Pretz, who is the grantor
herein.
TOGETHER with the rights and privileges granted in and subject to the I
reservati.ons contained in the .following. deeds: Deed of H. K. Spahr i
to Edwin R. Millar, dated Marcy 22, 1921 and recorded in the Cumberland t
. County Recorder's Office in Deed Boo~ "a", Volume 9, Page 367; and Deed
or EdwinR. Millar and wi.fe, to Lettie Long, dated January 14. 1926
and recorded in the Cumberland County Recorder's O.frice in Deed Book I'.
"Ett. Volume 10, Page 288. .. 0
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AND tke Kid gNntor
will warmnt Generally
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IN WITNESS WHEREOF, BlJ.id gNJntOf'
the day aM tfear first above writteL
ka 8 hereunto set
her
Mnd
and selU
~ .
~~.-t~---e
.----.-.---...------..-..e
-...-:..-..-.--.-.-.--..--..-...---.:-. e
.....---...-...-.-.--.---.-...-....-..--..-..e
Jit.t~. Jt.lt~ III. 'tli'm~ .
ba lilt :Ilene.. M
State of
Arizona
},..
do.1Iof /Jl~
County of 'In.(l..~
On this, the . ~ ~~
tllt$ undcr8igned officer, 'PCf'B01l4U,l tl.ppeared
Sophie S. Pretz. Widow
,19 72, before me.
/mown to me (or BO.tiBfactoril,l proven) to be the 'Person whose name is BUb8eribcd to #t,e
within itlStrument, and acknowledged th4t . she ezecuted. stl.tne for the purp081]8.thei"fj6n .
contained. , ....~. '.\)'~ J .;:
. . /..~ ~,"".) I 1 " v".
IN WITNESS WHEREOF, Il&ereuf&to eet m~ lULnd aT 8Cal. . ! ~ /;... "? ~'"
. ~e..~~..:.__._..:.._,:~...;..':;:....~:,~ Co. :~ j
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............NQ.t.(\r~._,.p.y.~11.o......................"..,.._.....~.." ,.' i
JAr. Commission Expires Jan. 3.l9lS Title of OiJileiO \ ,\ ,,'.,
My Co1lllllission Expires: My Commission Expires 1. 3
alT, .l9z:t
I do hereby certiftf that the preciae residence and complete post office address
of tM within Mmed gran".!s 2ij.OWest Simpson St., Meche.nicsburg, Pa.
-~~-
Atton&eJl for _~~tee8
~
&OOK X. 20irACE 131
I'
r
170$$
~((UO(LOOO L~:q(
10461;1,07062006
CLM6U
7/06/2006
.........
30-MECHANXCSDURG ~ORO~GH
21650-MECHANXCSa~ ~EA S.D.
STAWS C
:D,lI..'1'!
01/14./05
01/14/05
01/14105
01l14/0~
ttECEIP'l'
COD~ DESCRIPTION NO
200 CTY-MBCHANIcsnURG 5
2S0 CLB-MSCHAN~CSBu.RG 5
300 MO:lf-MSCRANICSButlG 5
400 SCK-MECHANICS~ORG
01/14/05 201 PILING ~E~
"Cl1/.o3!OS 202 P()8'r.).GE UT & CLAIM
0;1,/18/05 200 CTY-MSCHANICSIURG 5
01/1a/06 250 CLB-MECHANXCSBURG S
01/18/06 300 ~-MBCHANtCSBURG S
01/18/06 400 SCH-MBe~ICSBURG
Ol/~8/06 201 P~LING FEE
o2/oe/o6 202 POSTAG~ R!T & CLAiM
(1 f:Z407835
CUMB CNTY TAX CLAIM
Ct1MBERJAND eOUNT'l TAX o.AtM BW,)!:AU
ON)!: COURTHOUSE SQUAD
~L!SLE P,lI.. 17013
TAX CLAtN INQUIRY
S!TUB-~40 W S~~PSON S~BT
&: $ "l!'ORI{ S'l';IUilIT
PROfERTY.
DBSC - LAND
-Residential B~ildin9
BooX/PAGE 0024X OQ1!O
LMm USE It
ACREAGE .130
W\.Ltl'E ! 9 I B 3 0 VALm!: C &:G
TAX
108.4&
10.~S
123.n
67ti.80
~b'ALTY
10.85
;J..tl]
12.j1
67.n
INTER;a:$'t'
14.58
1.44
16.74
~;J..44
2QOll. TAX TOTJI.L
2004 JrEE TOTAL
~II.R 'X'O'!'ALS & s.u.ANCB
Es~ni.i:Ma DUll: NEXT ft'l0!t1'H
120.02
10.77
133.42
767.62
12.00
1.08
13.34
76.76
5.40
.48
6.00
34.SG
.2005 TAX TOTAL
7. tI OS PHS TOT~
~u T<Y1'AIoS f,. BALANCE
ESTt~C:S: DUE NiJ(T MONTH
- - '. " - - - - - ~ - - - - - . ~ - - - - . ~ - - - - ~ . - - - - ~ .
MIse ReC;EIP'tS
Cr..AIlI/ 'tOTALS
ES'l'IMAT:&:1) ':t'OT~ DUE NBX'1:' MOln'H
OWtGES
133.89
12.72
lS2.76
U5.92
1:l..J5.2J
:1.$.00
5.00
20.00
l1SS .29
In.42
12.33
152.7'
878.94
1181.45
1S.00
5.00
20,00
1.201. 45
.:i!JS6.74
PHONE 717 ~4Q-6366
FAX 717 ~40-6354
REMARKS
CSRT M~tLuR/C 75141
Cl!:RT [If}!.;J:I.-SALB
~ NO 20-23-0567-111
t;lAYMEN'I'S
BlUoANClE
DUE
.oo~
\,.~
PAGE 01/01
flAGE ," 1
Ilol'TADDED
EACH MO
.81
..os
.93
s.,Q~
J:",
6.~C1
.90
;08
1.GO
5.76
.00 G201.;;J 7.74
U09.19
- - - - - - '.
-
.00 2J5G'.74 U.64
2371.3B
~ ~ - - -
~ . ,;.~'
Cumberland County Board of Assessment Appeals
· As of 5 -/Zh- 01
(date), I/we have requested an appeal of our assessment.
· As of the above date. I/we have met with an official assessment representative to discuss my/our
property assessment in question.
· The parcel/account number of the subject property is as follows:
20 -23 -Or;fc7-/I/
Parcell Account Number
· The current Market Value of this property is $ ./ ;jt/ <; 3u
,
· The current Clean and Green value (if applicable) of this property is $
Review Appraiser's Recommendation:
\
;Uev0 l) tAlL.i t='
q-<i; fj 30
~,'- - ;',:' '- ':'. ",' , .
PrCJperlyOwner(.) ~ignatllt8(~}: . .
~..~~.
..11...............,...'..................'....
- . - -- - -" -- . '-,', ,_ - '_' u, ''', _, _ ',_,"";',
. "". "_'.'f"., .
. - - -,- '.-, '-' , ,--", ""-""
. '-', "- - -' - ~ .", '-'.;
~-" - ':',' : - -:'.' ~-<f'_ -' - - -'.' ,-' :,": " ,_:' :-,' _ , _:.
. , " - . . " ~~~" ,.:.,
Property'Ow"er'sD8cision:.'. .'
,':;. .:.~~t~-: J:_:".::-
. < ~
f/we accept the iecOrnrpe"dati()rlo~.t
recommendati(),:""af<:)rmat~pp he
appeal wilrb~\~tfsl:Ctire9'tQ
review appraiser an
'. '. 'win 'not be'scf}
Cfleckin r
o IIwe I8ject the~endat/oo'of the ~"~8e(an'cic;_is
far a farmafhearingby the appea'deadfine. as statedo'.' .'d,
scheduled~' ' . ',. ,
:: -,"- :", - --, '- - 1- '. _ -, _ , :~.. -.:: :' ,':' '. _ ... _ " ,', .- _ . c. _ _ : _ , _ _, _' ".: ," ~_" , "" , _:;", .
'!we ackrJowfedge~ptof~dupb~le ~iQn~d~~i>f~thiSf <
. '- .. '-.-'," -' -, . .
Form 216 (v. 1.2)