HomeMy WebLinkAbout94-00201
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\ R~~~D~~E~~THEO~ P~:N~Vl~A~?:93~ ikf -,0..j - II ACN 101
OEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAK
OUR':AU "F INDIVIDUAL lAMES APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
::mi3~e:~~lpl 1712'-0601 OF DEDUCTIONS, AND ASSESSHENT OF TAX DATE 06-20-94
ISTATE OF DAVIS -- -L FILE NO. 21 94-0201
DATE OF DEATH 00-10-92 COUNTY CUMOERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX
PAYHENT TO THE REGISTER OF WILLS, HAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
-
HARRY M DAVIS
770 S HANOVER
CARLISLE
STREET
PA 17013
REGISrER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
HOUSE
r
Anount Ronl ttod
-
l
CUT~1.0NO THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
iiEY: i5'4i "Elf" AF p." i i'F 9i T. No'fici niF. "iNti Eifi TAt(cE. 'fAx. APPRii i BEMEiii' ~ -. At rowAN"c E "cili""... - no... . -"..
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DAVIS LESTER FILE NO. 21 94-0201 ACN 101 DATE 06-20-94
TAN RETURN WAS. C X) ACCEPTED AS FILED
C I CHANGED
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. RooI Eltoto ISohldulo Al
2. Stock. ond Bondi ISohodul. BI
5. Clo..l~ Hold stock/Portnor'lhlp Intorut ISchodull C)
~. Hortglgol/Notol Rlcllvlblo ISchldulo 01
5. Co.h/Blnk Popollt./HIIC, Por.cnll Proport~ ISchodulo EI
6. Jolntl~ Ownod Prcport~ ISohodulo FI
7, Tron.foro 13chodulo GI
8, Totol Auots
. ,r'
III
121
151
I~I-
151
161
171
,00
,00
,00
,00
1.177.99
,00
.09
(8)
1.177.99,
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funlrol Exponlol/Adnlnlltrotlvo COlt11
Hhco11onooul Exponul ISohodulo HI
10. Dobh/Hortgogo LhbllltlOl/Llon. ISohodulo II
11, Totol Doduotlonl
12. Not Voluo of TlX Roturn
15. Chlrltoblo/Qovornnlntol aoqUo.tl ISohldulo J)
l~. Hit Voluo of Elllto Subjoot to Tlx
191
1101_
,00
,00
1111
1121
CIS!
11~1
.00
1.177 ,99
,00
1.177 .99
NOTEI
If .n ......ment w.. is.u.d pr.viou.1Y, lin.. 14, 15 and/or 16 and 17 will
r.fl.ot figur.. th.t includ. the total of ~ r.turn. a......d to dat..
ASSESSMENT OF TAXI
IS. Anount of Llno 1~ Ilxoblo ot 6% roto
16. Anount of Llno l~ toxobl. ot 15% r.t.
17. Prlnolpol T.x Duo
TAX CREDITS I
PAYHENT RECEIPT DISCOUNT I + I
DATE NUMBER INTEREST C-I
(15)
(16)
.00 N,06'
1,177.99 N,15'
1171
.00
176.70
176.69
AHOUNT PAID
INTEREST IS CHARGED FROM 05-19-93 TO 07-05-94
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FDRM.M
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
---
TOTAL DUE
,DO
176,69
14.01
190.70
R IF PAID AFTER DATE INOICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REqUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FUR INSTRUCTIONS. I
\
R!SERYATI"H.
PURP"SE OF
N"TicE.
PAVHENT I
REFUN" (CRlI
_I
'~
"
..
, '
"
"
,!
Eat.tl' of d.c.d.~t. dying on or blforl D.o..ber 1Z, 198Z ~. Jf Iny future Intere.t In the ..tlte I. trln.f.rrea
tn po.....lon or InJoy.ent to Clal. a (oollateral) b.neflclsrl'l of thl atoedent aftlr th, IMplratlon of any e.tlt~ far
llfl or for vI.r., thl Co..onwlllth hlrlbv Iwprl..ly rl.lrv.. thl right to appral,. and "'1" tran.flr Inh.rlt,nol Tex..
et the l.wful CI... B (oollltlrll) rftt. on .nv such future Int.r..t,
To fulfill thl r.qulr...nt. of Sletlon Z140 of the Inh.rltane. Ind E.tat. TaK 40t, Aot 22 of 1991, 72 P.S.
SteUon 2140,
D.taeh the tep portion of thl. Hotle. Ind lubelt with your paye.nt to the Rlgllt.r of Will. prlntld on thl r'Vlr'l .Idt,
"Haka .ha.k cr Ion., crdlr pI.obll tCI REGISTER OF HILLS, AGENT
All pay..ntl r.c.lv.d Ihall flrct b, appll.d to any Int.r..t which nay bl due with any rl.llnd.r appll.d to thl tlX.
A refund of . tax cr.dlt, which w" not r.quI.t.d on the Tax Rlturn, nay b. r.qu..ted by co.pl.tlng .n "AppllcatJon
for Rlfund 0' P.nnlvlvania Inh.rlt,nol .nd E.tatl Tax" (REV*1313), Application. ar. av.llabll It the OffJoI
0' the R.gI.t.r of Will., any 0' the 23 R.v.nu. Ol.trlct O"lc.., or by calling the .p.clel 24"hour
.n,wlrlno ..rvlcl nu.b.r. for 'or.. ordlrlnDI In P.nn.ylvanla 1-800-36Z~2050, cut.ldl P.nn'Ylvanl. and
withIn 100al Ilarrllburg aria (717) 787-8094, TOOl (711) 77Z.2Z5Z (Hurlng lIpalnd OnlY),
OBJECTIONS I Any party In Jnt.r..t not .atl.,lld with the appr.i....nt, allcwano. or di.allowance 0' d.ductlon., cr ........nt
0' tax (lnoludlng dllcount or Int.r..t) a. .hown,on thl. Hotlc. IU.t object within .Jxty (60) day. of r,cllpt 0'
thl. NoUe. bYI
ADltIN
ISTRATlYE
CoonECTI"NS,
"ISC"UHT.
INTEREST.
--wrltt.n prct..t to the PA O.partmtnt of Rtvtnu., 80ard 0' App.al., DEPT. 281D21, HarrJ.burg, PA 11IZ8.101.1, OR
.-.I.otlon to have thl .att.r d.ttraln.d at audit of the account of thl p.r.onal r.pr...ntatlv" OR
--app.al to the Orphan.' Court.
FaatUtl .rror. di.oavlrld on thl. a.......nt .hould b. addr....d In writing tal PA OIPartNlnt 0' R,vlnul,
Burleu of lndlvldu.l Taxlt, ATT"1 po.t A.......nt Revll" U'1It, DEPT, 280601, Harrl.burg, PA 17U8-U601
Phon. (717) 187-650&, S.. pagl 3 cf thl bookl.t ''In.tructlon. far InhtrJtanu Tile A.turn for a RnJd.nt
blotd.nt" (REY~1501) for an .~pl.nation 0' ad.lnl.tratlv.lv corr.otabl. .rror.,
If an~ tlX dUI I. p,ld wlthJn thr.. (5) callndar Icnth. aft.r thl dlc.d.nt'. de'th, I flv. p.rotnt 15~) dl.ccunt of
the tax Plld I. allawld.
Int.rl.t I. charg.d big Inning with fir.t day c, d.llnqu.ncy, or nln. (9) aonthl and on. (1) day frol thl dati 0'
d.ath, to th. d.t. c, pay..nt. TaXI' which bloa.. d.IJnquent before J.nulry 1, 1982 b.ar Int.r..t at thl ratl of
.Ix (6~) p.re.nt p.r annul oaloulat.d at a dailY rat. of .000164. All taK" which bloa.. d'llnqu.nt on and a,tlr
Jlnu.r~ 1, 1982 will b..r Int.r..t at a rlt, which will v.ry fro. clllndar ytar to olllnd.r Ylar with that rat.
announe.d by thl PA a.partl,nt 0' R.v.nuI. Th. a~plloabl. Int.re.t rate. 'or 198Z through 1994 Ir.1
!!!! Int.rllt R.tt Dilly Int.rut Factor ~ Int.rut Rat. Dally Int.rllt Factor
1912 lOX .00054' 1916 10~ .000274
I~U 16~ .000431 1917 9% ,000247
1916 III .000101 191'-1991 I1X ,0"0301
un m .000lS6 1992 9% .000247
1991-1994 7~ ,000192
--Intlrllt it ollcultt.d II fOUOWII
INTEREST' BALANCE OF TAN UNPAID N NUMBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
--Any Notlel I,.uld a't.r tht t'M b.eo... dtllnqu.nt will r.fllct tn lnt.r..t oalculatlon to fift..n (IS) dlv,
b.vond the ait. of the a.......nt, If pay..nt I, .ad. aft.r th. Int.r..t cOlputatlon dlt. .hown on the
Notlel, Iddltlon.1 Inttrllt IUlt b. cllculat'd.
PAVHEHT I
REFUN" (CR I.
REPlV
TO.
DISCOUNT.
INTEREST.
,
O.t.ch the top portion of thh NotlCI and tub.1t with your Ply.."t ud, payable to the n... IInd addr... printed
on the reVtr.. .Idt.
All Ply..nt. rlOllVld 'hall flr.t b. applied to any 1I1t,rl,t which ..y bt dul with lIny rl..lnd.r applied to the tllC.
A refund of II tile credit, which Wall not "qUilted on the hue Rlturn, lay bt requlltIld by cOlplttlng In
"Appllcltlon for A,fund of Plnn,ylvanla Inherlt.no. .nd Eltat. TalC" (REV.1SIS), Application, ar. Ivellablt It
the OfficIo' the RIgtat,r 0' Willi. any 0' the 24 R.v.n~. OJ.trlot Offlc,., or by calling the ,plela! Z4-hour
Inllllrlng ..rvlell nuab.r. for for.. orderlngl HEW IN PENNSVLVANIA lM800-36Z-ZDSO, outside Plnn,ylvant,
and within the 100al Harrisburg It,.. (117) 167.8094,
QUlltlent rlqardlng error. cenhlnld on thh netlcl .hould bl addrlltld tal PA DIPut.lnt of Rlvlnu., lur..u
of Indlvldull TalC.., ATTNI Po.t ..........nt Rlvllw Unit, OEPT, 280601, Ilarrhburg, PA 17128-0601, phon.
(717) 7'7-6505.
If Iny tlX due 11 plld within thrll (3) elllndar lonthl aft.r thl d.eldlnt'. dllth, e fly, p.rClnt CSX) dl.count
of thl talC Plid I, allowld.
Int.r..t i. ehltgld hl;JnnJng with flr.t day of dlllnqulncy, or nlnl (91 lonths and onl (1) dlY frol thl date of
dllth, to thl dltt of paVlont, TalC.. which bllca.. dll1nqulnt b,for. Januarv 1, 1982 blDr Intlr..t flt thl rat, of
tilC C6iO Plrclnt PU InnUI calcu1nhd at. dalh rat. of .000164. All tal(lI which blea.1 dlllnqulnt on and after
Jlnu.ry 1, 1932 will blar Int.rl.t at . ratA which will yary frol eallnd.r YI.r to cal.nder Ylar '11th thet ratl
announcld bv thl PA OIPlrtMlnt of RIVlnul. Th. appllcflbl. Int.r..t rat'l for 1982 through 1994 ar'l
!!!! Intltut Ratl Dally IntuI.t foctor :!!!.r Interllt R.l. 0.11'1 Interut Factor
1912 20l ,000541 19.6 10% .000274
1m 16l ,Doom 19.7 9l ,000247
19.\ III ,000301 1911-1991 III .000301
ltI5 III .0003.\6 199Z 9l ,000247
1993-199\ 7l ,000l9Z
..Intlrllt I, aeleulat.d a. followll
INTEREST D BALANCE OF TAX UNPAID X HUMBER OF DUS DELINQUENT X DAILY INTEREST FACTOR
-.lnV NotJcl I..u.d aft.t th, tlM b'DOI', dlllnquent will r.fl.et an lnttrt.t calculatJon to flft,.n (IS) dlV'
blyond the data (If the ........nt. If pav..nt II ..d, after the Intu,.t ao,putltlon dati .hown on thl
Notlo" additional Interllt IU.t b. aeloullttd.
/ (I. j!( II
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
.
REVdlOO Ex + (11"'1
~.~.v
~~':qi;;;..t'
COMMONWEAltH Of PENNSYlVANIA
DEPARTMENT OF REVENUE
DEPT. 28"601
HARRISBURO, PA 17128.0601
mUfimT'S NAME (lAST, FIRST, MiD MIDDLE INITIAll
~ IH If I \, I. I- ~ 7 U~ t>
fil s6wnEcuJtii'(N(JMm----''''~..-lMf{'0/ D!o\TH .TzDAlf Of 'IATH
td "J -'. ,;'_ ,"/\,\-'l/ Y.lfl' (// 'j 'L'/'
__~__ !._~_..~_.___._.=__:..___.__~_'___~_L___ . - .
~ [0] I, Original Rolurn [J 2, Supplomcnlol Rolurn
~~12 [ I 4 lImllcd E.lolc
i5~~ '.
~ [J 6.
Ii
iQ
oz
U2
[] 40, Fuluro Inloro.1 Comp,oml.o
(fo, dolo. 01 doolh ofto, 12.12.821
Docodcnl Dlod Tollalo [I 7. Docodonl Moinlolnod 0 living Tru.1
(Allach copy of Willi (Allach copy 01 Tru'll
ALL CORRESPONDINCE AND CONPlDEilTlAL TAX INFORMATION SHOULD 81 DIRECTED TO.
No\M OMP f/.WlTNliA!iIims
1"IIIi:fi/~( It'l (J/'ovl.1 'I'l,.,~, /111/1/" L/I
TflfPHO'll'NUM8ER-----------'----- < '/1 J ii-I .5 L r /")0
I, Roal EllalO (Schodulo A) ( 11 ____'''..
2. Slock. and Bond. (Schodule BI ( 21 ____,,_
3. Clasoly Hold Sluck/Po'lne"hlp Inlo,o.1 (Schodule q (3)
4. Morlgage. ond Nolo. Recelvobl. (Schodule D) ( 4) _____,_____.___
5. Ca.h, Bank Dopo.il' & MilCellonoou. Pe"onol Proporty( 5) I, I? '7 , V?
(Schedulo E)
6, Jolnlly Owned Proporly (Schedulo F)
7, T,an.fe" (Schodulo GI (Schodulo LI
B, Total Gross All'" (Iolalllno. 1.71
9. Funo,ol Expense., Admlnl.troli,o Co.II, MllCollonoau. ( 91 "
Expon... (Schedulo H)
10. Debll, Morlgage llabllitle., Lien. (Schedule I)
11, Tolal Deduction. (10101 line. 9 & 101
12, Nol Voluo 01 E.lolo (IIno 8 mlnu.llno 11)
13, Charitable and Go,o,nmontal Boquo'I' (Schodule J)
14. Nil Value S~bl.Cllo Tax (line 12 mlnu'.llne 131
15. Amounl of IIno 14 laxable 01 6% rolo
(Include value. from Schodule K or Schedule M.I
16. Amounl 01 line 14 laxable 01 15% role
(Include volue. f,om Schedul. K 0' Schedulo M.)
17. P,inclpallax due (Add lox from IIno 15 ond Irom line 16.)
18, Credlll Spousol Po,orty Crodlt Prior Payments DllCount
....,------ + ----....-. + -------- -
19, II line 18 il 9,color Ihon lino 17, onler tho dlll..once on IIno 19. T"I.I.the OVERPAYMENT.
110
20. IIl1no 17 i. g,oalor Ihon IIno 18, onlor tho dlllerence on IIno 20, Thl.l.lho TAX DUE.
A. Enter the Inlo,o.1 on Ihe bolonco due on line 20A.
1.1/:/_J-/'/~ - 'nil',
z
o
~
E
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fOR DATil O'DIATH AnlR '~'31/91 CHICK HIRI
, A IPOUIAL
POVIRn CRlDIT II CLAIMID 0
PILI NUMB"
c.'J / '
COUNTY CODE YEAR
, PlElE ADDRESS_I
1'/_.'" 11)/ /v,1UU, ';; r
, . If I,'/... J) L (. /'11 __
/ '/" / 1
? t!
,9,,') /
NUM8ER
Co~
[I 3, Remainder Rllu,n
(lor dale. 01 dooln prior 10 12.13.82)
[Is. Foderal E.late Tox
Rllurn Requlrod
_ 8. Tolol Number 01 Safe Depo.1t 80...
f; .1
1'l~/~7
(6)__.
( 71
/; /71. 7 '/
I 81
L)
(101
(111.
(121
(131
(141
"
I 1'/'l.C19
..
(151
____x ,06..
(161
x ,15..
(171_.
Interes'
(181 -___
(191
Check here if you (HO rC'luc-stino (I rofund of your ovcrpnymcnt.
(20)
(20A) _______
(20B)
B. Enter the 10101 of line 20 ond 20A on IIno 20B. This Is Iho BALANCE DUE,
Mako ChICk Payablo to, R181.lor of ~1I1., Aglnl_
.... 81 SURE TO ANSWER ALL QUESTIONS ON REVERSI SIDE AND TO RECHECK MATH....
Unde, penalties 01 perjury, I declare !hall have examined Ihls rolurn, Including accompanying Iche'dules and Slalementl, and 10 the belt of my knowledOI and belief,
it II Irue, correct and complete. I declare thai all real ollale nOI been reported allrue market value, Declaration of preparer olher Ihan the personal reprelentatlve I,
baled on all Information of which preparer has any knowledge.
SfCi'NATUAE OF PE~SON RESPONSIBlE fq~-flllNO RETURN -ADDRESS om-
..N....,!'., /)/..L:.c"',k /("1'" j-IA IV) V,i'/Z Jf 1 ",?_':/L/
!IDNATUAE 0; I'A . RO(HER THAN ffiRESENfMiVI Aob-Ii ss- --- DATE' ,
u_ _._______.______________..__.___
. ,
....
I, ~,
.,
, :
/. "j'
"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING.A CHECK MARK (.,) IN THE
APPROPRIATE BLOCKS. ..'
YES NO
1, Did decedent make a transfer and:
a. retain the use or income of the property transferred, ....""...............;............... _ ~
b. retain the right to designate who shall use the property transferred or Its Income,
v
t. . . t t .
c. re atn a reversionary In eres or .........."......",j"..".................""......"".........
--t
d. receive the promise for life of either payments, benefits or care? .......................
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death
occurred after December 12, 1982, did decedent transfer property within one year of ,/
death without receiving adequate consideration? ...............""............"...""......... ____
./
3, Did decedent own an 'In, trust for' bank account at his or her death?.....................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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