HomeMy WebLinkAbout94-00177
21-94.177
RENUNCIATION
In R~ Bstate of -E_V? ~...J> J.:\ LPn " ~~t-' ~.
deceased,
TOlhe Rcslstcr of Wills of . (' .V\~. '0 ~\ ~.....<::1
County, Pcnnsylvanla,
Thcunderslsned LOYI 14 .~H\lA.\I'\ rlCl.l ljh 1 (v. of
the above decedent, hereby renounce(s) the right to admlnlstcr the cstate and respectfully ask(s) that Lellers
, ,
()( Adrnlf),shCt flo'v\
be Issued 10 ~m~1, A .-IWn1, \,.J , vDn
WITNESS
hand Ihis 'I day of ftl?ruaij ,19il.i,
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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IIV.IIOO!K t 111'''1
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COMMONWEAlHl Of PENNSVlVANIA
olPAI1MEN10f IEVENUE
om 280601
H"IIAI.5IURO.!.!_~ 1'.!.18.p60L
. I . D MICDll! tNI
RtU"';J..,1--l :: (('..it.'::\ L . -';:~l. . c)l')
OCiArmU'I1T,Y NU;;ifiR~---lD'ff6fjjTI\f>f-" -'[bAlE 0' rn..--' ~.
~~.::. .~ '-:>_~..~~~ ~ _"?- '_\.c, ~~ j_~ ~. , ~-\ em',
fjl, 1. Original Relu,n [] 2. supplemenlal Relu,n
o 4. lIml1ed E.lale D 40. Fulure Inlerlll Campraml..
(far dalll of doalh after 12,12,82)
[] 6. Decedenl Olod Tellale [I 7. Decedenl Malnlalned a living Tru'l
(Allach copy a' Willi (Allach copy of T,u.l)
ALL CORRESPONDINCE AND CONPlDINTIAL TAX IN'ORMATlON SHOULD 8E DIRECTED TO.
M - =~l E MAILINOAODRESS
~rtL~L,!<'---0.., '~_~'-J .._._._____ c?> (') .K~~ ~
l PtIONt NUMB!;" . ,_ r
l. "1 ~ ~J .... ~;~-\ -. \\ "';<- l0'--. '~^ p;,>- \ ,D:-, -:,
1. Real Ellale(Schedul. AI ( 1) ..__n...2....___.. ~0
D l(1l
2. Slack. and Band. (Schedule 81 ( 2) ------------. iT'
o ',J'
3. Clo.oly Held SIock/Parlnershlp Inlerell (Schedu'e q (3) ..____._.___ .
(:) L
4. Mo,lgagll and Naill Receivable (Schedule D) I 4) ~n_...___.._~..__..._.._ . .
o '-
5. Ca.h, Bank Oepo.l1. & MI"elloneau. Personal Praperly( 5) ----.--. C
Ischedule EI 0'
6. Jolnlly Owned P,operly (Schedule FI ( 61 _._-%_____..' ;.:
7. Tran,'e" (Schedule G) Ischedule L) ( 71 ______.. L ____ )1n~
8. Tolal G'OIl Allel.llalalllnll 1.7) I....A S~ \.'-\D (81
9. Funeral Expen..., Admlnl'l,ollve Co.I., MI"ellaneou. I 9)
Expen... ISchedule H)
10. Debts, Marlgaoe lIabllltlll, Lien. (Schedule I) 11 D)
11. T alai Deduction. Ilalalllnll 9 & 101
12. Nel Value of E.lole (line 9 mlnu.llne 111
13. Chorllabl. and Governmenlal BequIII' (Schedule JI
14. Nel Value Subjoclla Tax Illne 12 mlnu.llno 13)
15. Amaunl of lino 14 laxable 01 6% role
Ilnclude valulI I,om Schedule K or Schedule M.)
16. Amounl of line 14 laxable 01 15% role
Ilnclude valulI Irom Schedule K or Schedule M.)
17. Principal lax due (Add lax from line 15 and from line 16.)
1 B. C'edlts Spou.ol Poverly Credll Prior Paymenl' Dlscounl Inlerlll
...------..-.....-.. + --..--..---- + .--..-- - ---
19. If line 18 I. grealer Ihen line 17, onler Ihe dllloronce on line 19. Thl.I. Ihe OVERPAVMENT,
mu
20. If line 17 I. grealer Ihon line 18, enler Ihe dlfforonce on line 20. Thl.I.lhe TAX DUE,
A. Enlor Ihe Inlerlll on Ihe balance due an line 20A.
B. Enler Ihe 10101 of line 20 and 20A on line 20B. lhl. l'lhe BALANCE DUE.
Ma~.e. Check Payab,! '01 Reul.ter af Will., Aaont
.. . liE SURI TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RICHKK MATH....
Under penalll.. of perjury, I declnre Inal I have IlCamlned Ihl. relurn, Including acr.ompan~lng Ichll'duhll and Ilaltlmenll, and 10 lh. bill of my knowledge and b.Il,','
1 It I, Irue, corr,cl and complele, I declar. Ihal.all r.al .,Iole ho, been r.ported 01 true market va.llle. Oecloral1on c,i prepare, olher Ih,an lh. penonel fllpr'l.ntall'i' II
ballet on alllnformallon of which preparer hOI any Mnowledge.
!iliflAfiJI(1OfPlf!oN'RmoNsiiif;oRliifNO Rrjij,W---.OollSl-----------..------ ~ I. r~)" OAT!
r I" l't < ,.). (y. ') D.-Uly"Q (~;Il ,-,,,,:) \.." ("',."" _ , "t.J..t ,.: 1 ~ ) u \ ,("/-;' ~.; 2>' ',.. 'l. <::;
!iliWJ'tlArortmTRh -6fff(nti.iNR!PA/ sfNr;':livr- .--... AWlfm""'-"- -- u____..___. oA IE
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(151_
1161
Ch(l{~ Ilr.ll' if you nr. IClluo\linn u refund of your nVl!lpnynwnl.
,)-.. "1 .' i
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'OR DATIl O' DIATH AmR 12/31/91 CHICK Hili
I' A SPOUaAL
POVaRTV CIIDIT IS CLAIMID D
PILI NUMB.I
1/ '/
VEAR
/ 'I /
NUMBER
!, I
COUNTV CODE
M II
f,J,.. 'r-.\. ~JL>-0 \..0.....';.-
~).; c"'"
rh ('L \\0.'-,.,
\_)..L .htt-n.... \().k2...:\
rJ 3. Remainder Relurn
Ifor dalll of dealh prior 10 12.13.821
fJ 5. Fedoral Ellole Tax
Relurn Required
_ B. Tolal Number af Safe D.pa.1I Box..
-0,
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1111
(121
(131____
(14)
x .06 =
x .15 =
(171
(19) .
(19)
120) .
(20AI
(20B) _
UY.UlIU. P.III
...
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COMMONW!ALTH 0' 'INNIYlVANIA
INH!AIIANe! lAI mUtN
1!llo!N! o!C!OItU
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUll EXPENSES
UfATI 0'
€CLuU"\.. l.-, \~"'\-:"'.vv
ITEM
NUMBER
A.
8,
1,
1,
2,
3,
3rc.
d , C{'-V ~'ll
AMOUNT
DESCRIPTION
Funeral bpenle"
,,~~o...., R<::'I\.~ ~"."sl..L ~~.....L
c.D l:rr\.O""'.Jt.I\..\~~.,I C'lr:.....~C.J..1
lS.~~)..\ u....~~" ('~ '-C" ,
cb C'...l>.--l. \(. \~
CD 0..\rlJ\ -\ 1v.J)'"
~~ ~ \ <:'>..v <V- ..."
Administrative Costll
Ponanal Rep,esentatlve Cammllllanl
Social Secu,lty Number of Penanal Repr..entatlvOl _
Year Cammllllonl paid
Allorney Feol
Family Exempllon
Claimant
AddlOIl of Claimant at docodent's death
Streel Addre..
Relallonlhlp
Stato Zip Code
City
4, P,obale Feel
C, Mllcellanloue Explnllll
1.
2.
3,
4,
I'
5,
6,
7,
8,
TOTAL IAllo enter on IIno 9, Rftcapltulollonl
(If mOil Ipace il n..dld, Inllrt addltlonallh.... of lame liae,)
~,~s ~
~D,\ \ ~
C-._ ~'t>
.~"-o,.I--
~~~
s ~ 'S'6 \
\.~
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IIV.UUU+ll.I71
~ .~
(OMMONWIAI1H Of "NNinVANIA
INHIlIfANCI tAX IIfUIN
IUIOIN,DICIDIN'
l
SCHEDULE J
BENEFICIARIES
ISTATE 0'
C-IU...; l:.. ""''';~ \~, ~''':>-J--u
'IU NUMBER
"5:L.
d \~\., . D\'....'\
!TIM
NUMBIR
NAMI AND ADDRlU 0' BENIPICIARY
RILATlONSHI'
AMOUNT OR
SHARI 0' ESTATE
A. T a..ble BoquIIIl,
1. -So.>-,--L~ Q, ~~A......-i S~ D
~or(\ 0..._, ,~,~V 4~~ D
ITIM
NUMBIR
NAMI AND ADDRESS 0' BENEPICIARY
AMOUNT OR
SHARE 0' ESTATE
B. Charltabl. and Goyernmenlal B.quellll
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAha onler an IIno 13, Recapltulallon) S
(If mate .poce I. needed, Intott additional .heet. of lam. .I.e)
14.lq3~1
Ir 'O'3Y'" \ ,f'
REV-1547 EX AFP (12-94.
Co~NWEAl!H OF PENNSYlYlHll
oIPlR1NEN! OF REYENUE
BURIAU OF INDIVIDUAL lAMES
DEPT. 2.0601 ,
tIARRISIUAQ, PA 171ZS'06D1
ISTAn: OF~BROWN FILE NO.
DATE OF DEATH 02-06-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX
PAVHENT TO THE REGISTER OF WILLS, HAKE CHCCK PAVABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ACN
101
U,V;
D ,
v'
DATE 05-01-95
JAMES A BROWN
20 BUTTERNUT LN
MECIIANICSBURG PA 17055-5228
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
E.
A.aunt Re.lttod
-
~
CUT ALONG THIS LINP. .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: iii4'i-ilif - AFP"i i"i: 94T -Ncj'r"i or -6 j;- i: NHEiii rAiioE -i" AX -A P iiiiXisEifiNr; -A i. i:liwAifCE-ijri-- - - -- -.. -- - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF 8ROWN ERNEST L FILE NO. 21 94-0177 ACN 101 DATE 05-01-95
TAX RETURN WAS I I X) ACCEPTED AS FILED I CHANGED
RESERVATION CONCERNING FUTURE INTEREST . Ott REVEnSE (In -n
APPRAISED VALUE OF RETURN BASED ONI ~, (1 \(1 :Tl (0
ORIGINAL li j,l II
1, Rool E.toto ISehodulo A) III .00
.00 ""
2, Steeke ond Bonde ISehodulo al 121 '()
;u
S, Cleeoly Hold Stook/Portnorehlp Interoet ISehedulo C) lSl .00 1"
4, Hortgogoo/Notoe Rooolvoble ISohodule D) (4) ,00 ~J
S, Coeh/aonk Depoelte/Hllo, Perlonol Proplrty ISohodulo El IS) .00
6, JointlY O.nod Praporty ISehedulo FI 161 .00 L/! (',
7, Tronlfore ISehedulo G) 17l :U'" 00 f'.
Totol .\..ote .. ,I 1.[1 ,00
a, laJ
APPROVED DEDUCTIONS AND EXEMPTIONSI
4,381.40
9, FUnorll Expeneu/Ad., Coeto/Hho, Expenlu ISohodule H) 191
10, Debh/Hortgego LloblllUu/Llonl ISohoduh Il 1101 .00
11, TatolDeduetlonl Illl 4.~AI 40
12, Not Volue of Tox Roturn 1121 4,381. 4.!!:
15, ChorUoble/Dovorn.ontol aoquuh ISehedulo J) IlSI' 00
14, Not Voluo of Eototo Subjoot to To. 1141 4,381.4.!!:
NOTEI If In Issassment was issued previously, lines 14, 15 Ind/or 16, 17 Ind 18 will
reflect figures that include the totll of Abh returns Issessed to dlte.
ASSESSMENT OF TAXI
IS, A.ount of Uno 14 ot Spoueol roto 1151
16, Aoount of Llno 14 to.oblo ot Unool/Clo.. A roto (16)
17, Anaunt of Uno 14 to.oblo ot CoUotorol/Ch.. a roto 1171
la, Prlnolpol Tlx Duo
TAX CREDITS I
--
PAVHENT
DATE
,00 X ,00.
,00 x.06.
,OOx.15.
IIBI
,00
,00
,00
,00
RECEIPT
NUHaER
DISCOUNT 1+)
INTEREST I-I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
,00
,00
,00
M IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN fl. NO PAVHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDn" ICRl. VOU KAV aE DUE
A REFUND, SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIDNS.)
R!IEAVATlOHI Estlt.. of dMtdtnh dYing on or blforl Otollblr U, 1912 ..- If .ny future Intlrut In thl ..t.t, I, tr,,".rred
In pa.....lon or enJoYMnt to CI... . (coU.t.r81) beneflel.rl.. of the dMldlnt aft.r thl oplnUon of MY ..t.t. 'or
11'. or for y.,rl, thl C~onw,.1th h.r'bY IMpr...ly r...rvII th. right to Ilppr,lI. and ...... tr.",flr Inhlrltanol T.ICII
.t the law'ul CI... II (colllt,r,1) rat. on any luch future Intlrl,t.
PtJR90U OF
NOTICE I To 'u1fll1 the r.qulre..nh 0' S.ctlon 21"0 of the Inherltlnc. and Eltat. 'alC Act, Aot 22 of 1991. 12 P.I,
S.otlon 2140.
PAVHEHTI DetlCh the top portion 0' thh Notlcl and .ub.1t with your Plv..nt to thl R.ght.r of Willi printed on the rever.. .Id..
..""'. oheck or '''''.V or dol' p.,.bl. to, REGISTER OF MiLLS, AGENT
All p.~ent. rtQllved Ihall first be appllld to Il"tV Intlfllt which IIV bt du. with any r...lndtr I9plltcl to thl tllC.
REFUND (CA)1 A rl'und of . t,1C or.dlt, which WI' not requeltld on the TIIC Rlturn, .IV be rlqu.stld bV coapl.tlng Bn "Applloatlon
for Alfund of Ptnnlvlvenll Inherltenol and Eltlt. TlIC" (REY-UlS), AppllolUonl Iftl IVIUabl1 .t thl OffiCI
of thl AIgllt,r of Nlll1, any of thl U R,".nu. Dlltrlct Offloll, or bv cllllng thl Iplolal Z.-hour
."swtrlng ..rvlc. nulIlIbera for for.. orderlnOI In P'M.vlvanl1 l~aOO-36Z-Z0SD, outside Pem.vlv",11 and
within locII Hlrrhburg If" (117) 187"091\, TOOl (717) 71Z.ZZS2 (H..rlng hlpllred Onlv),
OBJECTlONSI Anv p.rtv In Intlfut not ..Ulfled with thl .pp,.I...."t, l11ow.ncI or dlllllow.ncl of dflcNcUon., or ......tHlnt
of t.~ (Inoludlng dllcount or Int.r..t) I' .hown on thl, Hotlc. au.t obJlet within .I~ty (60) d.v. of r.o.lpt of
thlt Notlel bVI
.~writt." prat..t to thl PA D'Pilrt..nt of A.Venul, loard of APPllll, D.pt. 251021, Harrhburg, PA 1112'.1021, OR
".llotlon to h.v. thl ..tter dltarlJn.d It audit of the Iceount of thl per.an.l rlprlnntlUvl, OR
UIPP..1 to thl Orph.n,' Court.
60"1"
JI1R6T1Yf:
CORRECTlIlIlI.
FlOtuIl Irror. dllcovlr.d on thl. ........nt should be Iddr....d In writing tal PA Dlpart.tnt of AIVenue,
IuralU of Individual TIICII, AllNI Post A......."t RIYI," Unit, DIPt. ZI060I, Hsrr..burg, PA U1ZI~0601
Phon. (1111 717-6505. SII pltgl ;I of thl bookl.t "In.truotlon. for Inherltancl TIIC Rlturn for, R..ldl"t
Dto~tN (REV.1S01) for an IlCplan.tlon of edllnJ,trltlvllv corrlotabl. .rror..
1"1EREI1.
If .nv tllC due J, paid wJthln thr.. (3) cIl.ndlr lonthl .ft.r the d,oldent's delth, . flvl plrolnt (S~) dlloount of
thl t.lC plld 11 IU:JWed.
Interllt II Ilhsrged b.glnnlng with first d.v of dtllnqutncv, or nlnl (9) lIontr't, .nd one 0) dlv fro. tM d.tl of
dllth, to thl dltl of pI~lnt. TIIC.. Mhlch bl(ll.. dllInqylnt b.fora JInUIrV I, 1912 bllr Intll'lIt It tM rat. of
,he (6;() Plrc,"t plr IMUI ollCUlltld It . dilly ratl of .00016,., All tlM" whloh bIGI" dlllnquent on Ind .fter
January 1, 1912 will bllr Interllt It . rata which will VIrV fro. c.llndar vllr to olllndar Vllr with thlt r.t.
announcld bv tlM! PA Dlpart"nt of A.v.nut. Thl I9Pllclbll Intl,.lt r.t.. for 1912 through 1995 Irll
oJICOUIl"
~ ~~ D.Ily Int.r..t Factor !!!! Inttr'lt Aatl D.11v Interllt Fllctor
1912 lOX ,OOOS48 1981 9X ,OOOlll
1981 16X ,00001 1981.1991 IlX ,000501
198. !IX ,OOOSOI 1991 9X ,0001.1
1985 IlX .00OSS6 1991-l~ IX ,000191
1916 lOX .00011l HI9S 9X ,0001.1
--Inta"lIt I. c.lculltld .. follOtlIl
INTEREST' BALANCE OF TAX UN PAlO X NU"BER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
"Anv Hotlc. iliUM Iftlr the t.lC blco... dlllnqutnt will rlfllct In Inttrllt Cllcuhtlon to flft.." US) dlv'
blvond thl d.tl of thl ......Hnt, If PIV""t I. ..dl after thl Intar..t cOlIPutet1on dati .tlotfn on the
MoUcI, additional Intlr..t .u.t b. cIJculatld.