Form Et 6.01 - Appraisement Of The Estate For Decedents Dying On Or After July 13, 2001 Page 3

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pArt 4 (continued)
scheDule D: Corporate stock of any kind. See page 3 of the instructions.
closely
number
mArket VAlue
totAl
nAme of the compAny
helD
of shAres
per shAre
mArket VAlue
totAl (enter the total market value on line 4 of PART 3)
ApprAiseD
scheDule e: Money, bank accounts, certificates of deposits, notes, accounts receivable, etc.
Show dates of notes. See page 3 of instructions.
VAlue
totAl (enter the total appraised value on line 5 of PART 3)
ApprAiseD
scheDule f: All other assets, not hereinbefore mentioned, including insurance payable to the estate.
See page 3 of the instructions.
VAlue
totAl (enter the total appraised value on line 6 of PART 3)
Form ET 6.01
West Virginia State Tax Department
Page 3

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