HomeMy WebLinkAbout94-00450
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REV.IlOO EX. 111.01) ~OA D~UO' DIA'HAnII12/31191 CHICK Hili
h::\,y INHERITANCE TAX RETURN :o~:1TY ~:~DIT II CLAIMID 0
Il{\~i:;!, RESIDENT DECEDENT 'Ill NUMUA -
CQMMONWfAl1H 01 PENNSYlVANIA (TO BE FILED IN DUPLICATE 94
DEPARfMHIT Of REVENUE GIS WILL I 21
HARRI!fJ:& ~~O'i'i\20.0601 WITH RE TER OF . S COUNTY CODEm VE"'~_ _
ECE~i~~~~~ IIAI\~{';Sr; ;~;ID~l~ INITIAl! -- -- -------rrC!O~~~.I~,~~I~;~t~DR~~1 r fI t 11 g Home
i -- --'---------l~---f-'--~---.----- 375 Clnremollt Drive
~ IOCiAiS!CuRilVNUMOER DA,EOID!AH DA,EOJOI!,tI CnrlJHle, Ph 17013
~_ _____}_~?-1 8.-)9 7 ~__________-'!:JJ..'?1.94 __2J..13 :2 .~___~~'".'rClIm!lg_r.ll! 11r!
f~ 1. Original Rolu,n [] 2. Supplom.nlal R.lu,n [J 3. R.malndor Rolurn
(for dolo. of d.ath prior 10 12.13.B2)
[J 5. fedoral E.lalo 'ax
Rolurn R.qulrod
Q. B. Talal Number of Solo Dopa.1I Baxo.
~
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:c
Ii
~Q
0%
1.12
~
Llso
NUMBER
z
o
I
[] 40. Fulu,o Inloro.I Campromlso
Ifo, dolo. of doolh ohor 12.12.B2)
[}l 6. Docodonl Dlod To.lalo [J 7. Docodonl Molnlolnod 0 I.1vlng Tru'I
(Allach copy of Willi IAllach copy of Tru'l) __
AU COIRISPONDINCI AND CONPlDINTIAL TAX IN'ORMATION SHOULD III DIRICnD TOI
M -- ~lOMmffMiJl1i1G ADDRESS
~__~-'__ SU.~I\!.1..J!ukc ______________________ 13181 flj L1ex j nr.to[JAl1 SIt r7el (c)9t
TilEPtlONE NUMO,R 1\ r r H)\I r r. I
Ll17..l 652-[ 111!1
1. R.al E.lalo (Schodulo AI ( I) ________.___0____________._____
2. Slack. and Bond. (Schodulo 81 ( 2) ____________0...____
3, Clo.oly Held SIock/Parlno..hlp Inloro,I (Schodulo CI (3) _________._0________
4. Morlgllgo. and Nolo' Rocolvablo lSchodulo D) I 41 ______ ______D_. ..__________
5. Ca.h, Bonk Dopa.lt. & MllCollanoou. Po..anal P,oporlyl 51 __.J 00.00
(Schodulo E)
6. Jolnlly Ownod Proporly ISchodulo FI ( 61 __2._L6-..lUl____
7. Trantlo.. 15chodulo GllSchodulo L) ( 7) ________Q_____
8. Tolal Grall AlloII Ilololllno. 1.7)
9. [unoral Expon.o., Admlnlslratlvo Co.II, Mlscollanoou. ( 9) ------2_..5.U9_. 8 0
Expon.o. ISchodulo H)
10. Dobl., Morlgago Llabllltlol, Lion. ISchodulol1 1101 __0
11. T 0101 Doductlant l'olalllno. 9 & 10)
12. Not Voluo of E.talolllno B mlnu.llno 11)
13. Cha,ltablo and Governmontal Boquo," (Sch.dulo JI
14. No' Valuo SublocI 10 Tax IlIno 12 mlnu. IIno 13)
15. Amounl of IIno 14 loxoblo at 6% ralo
Ilncludo valuo. from Schodulo K or Schodulo M,)
16. Amount of IIno 14 laxoblo 01 15% ralo
(Includo valuo. fram Schodulo K 0' Schodulo M.I
17. Principal 'ax duo IAdd lox from Ilno 15 and !rom Ilno 16.)
1 B. Crodll. Spau.al Povo,ty Crodlt Prior Paymonll OllCount Inloro.t
--------------------- + ---------- +--------.------- - ----
19, IIllno lB It groalo, Ihon IIno 17, ontor Iho dlllo,onco on IIno 19. Thl. 1,lho OVERPAYMENT.
mlf]
20. IIl1no 17 I. groator Ihon Ilno lB. onlor tho dlllo,onco on 11110 20. This I. Iho TAX DUE.
A. Enlo, Iho In'oro.I on Iho balanco due on IIno 20A.
.31tl.RR
[] 4. limited E,'alo
=
( B)
111) 2.569.flO
(12) _---=-0______
113) _ 0
114) ..lliS.OLVENT
115)
x .06..
116) ____________X .15..
z
o
~
S
~
8
g
(17) _
(lB) ________
119)
Clwck hOlo if you uru ,i'fIUC!i.1inO CI refund 01 YOUf OV('Ipuyrncnt.
120) ._____
(2M I .____
(20BI _;TI~ROLV~NT__
B. Enlor Iho lotal of IIno 20 and 2DA on IIno 20B. Thl. I. Iho BALANCE DUE.
M~ke Check Pavable t~1 A.al"er .f Will., Aaent
.... III SUAI TO ANSWIR ALL QUISTlONS ON REVIRSE SIDI AND-TO RECHICK MATH....
Under pinelli" of perjury, I declare thaI I have eKornloed lnll return, Including accompanying Iche'dul.. and Italemenl., anJ to th, bllt of my hnowledg, and b.iiiT,
1111 truI, correel and complete, I declare thol all real I1lale hat been rep"rltd ollruI market value, Declaration of prepare' olher than lh. penonal r'p,...ntallv. I,
based an alllnformallon of which preparer hen any knowledge.
~:~:;~::<<~~;;:;,;;;;Nc=-~i{:~~~~4.:~~ ~zi;f!L II? t~SZ J'j ~v .. Pr..'
,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,,) IN THE
APPROPRIATE BLOCKS.
YES- -Ne)'
1. Old decedent make a transfer al1d:
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,
. . . t t
c. retain a reversionary In eres or .."'.,...................".......,................................
d. receive the promise for life of either payments, benefits or caro? ................,......
2. If death occurred on or before Decembor 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 adequute 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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COMMONWIAl1H Of PENNSVlVANIJ
INHERITANCE TAX RETURN
RISIDENT DECEDE~1 _
iSTATE 0'
R'IV.IIOI EX+I'.oo)
UTTLEY, William F.
SCHEDULE B
STOCKS AND BONDS
L
PILE NUMBER
IAU prap.lly lalntly.awn.d with Right af Survlv~rohlp mUlt, b'..'!!lCla,,<!. an Schldul. ',I
ITEM
NUMBER DESCRIPTION
1.
, ,
..1,
"
.'
, ,
"
,"
..
21-94
VALUE AT DATE
OF DEATH
"I
"
;.." I:
,
, ,
"
,. "
"
"
!
" ,
"
'i, ..
, ,.
,;;
,-
, ,
"
Iii
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TOTAL IAI.a onlor on II~ 2, Roca IIulallon
(II maro 'paco II MOc/Oc/, Inlerl aclclillonal.hloh a' lam I lilt,)
$ -0-
UV,HMUt 1J.W61
COMMOtlWIAI1t1 0' HNNSnVAWA
lHtiUIWICI TAl( mU.N
.,SIOI'" OlelDINT
SCHEDULE F
JOINTLY-OWNED PROPERTY
UTATE 0' UTTLEt I _IH l!_~am F-,--__~_____________~~___=-_-==rLE ~~~~E:~
Joint tonontl')1
NAMI .
ADDRISS
---.
--
RELATIONSHIP TO D~CIDINT _
Daughter
A.
Pamela I. Foc~~y,
(l Robil1 Court
HI~chal1icRb\lrR, PA
'i 70'j5
B.
P. SUIl/1n Duke
381B Lexil1gtol1 Street
Harrisbul'R. PA 1.7109
Daughter
c.
Jolntly.ownod proporty.
ITIM LinER DATI
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBE JOINT MADI DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
I. M.R 10/89 Dauphin nepo.~ 1.t Rllil J~
and Trust Compal1Y-
checking account
I/B7-10067-3 $650.6/1 1/3 $216.88,
"
TOTAL lAlla onlor on Uno 6, Rocapllulallanl
(II maIO .paco II noodod in...' addU/ana' .h.." of .amo .in)
$ 216(88
."
. .
RIV.1l01IX+ 16.161 Jt.., J .
~:.'1\ . SCHEDULE D
COMMONWEAL;~ 0' ~NNSVlVANIA MORTGAGES AND NOTES
lNHlRlTANCI lAX mURN RECEIVABLE
RlSIDENlDECIDINl .
mATI 0'
PILI NUMBIR
21'-9',
UTTLEY, Wi11ttm F. _
(AU proporty ,ol.tly.ow.od with RighI of Survlvo..hlp mull bo dllClo.~d a. Schodulo F)
ITEM
NUMBER DESCRIPTION
1.
VALUE AT DATE
OF DEATH
NONE
,. ,
: '
,.
I.
,.
,
,.
,
" .
"
..1,
"
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I
; I"
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1.1"
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TOTAL AI.o 'ntor on U., 4, Roco Ilulotlon
(1/ marl 'poco I. nHeI,elln,..' aelellllonal ,h"" 0/ lam' 1110.)
$ -0-
I'
,
U~.lSlI IX. 1':"1
UTATI 0'
.'
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cOMMONWIAlTH O. mlNIYlVANIA
INH!RITANCI TAX RUURN
RUIO!NI DlcEDeNT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pllalft Print or Tvp.
e. NUMIIIR
21...'11,
UTTLRY, Williom F.
ITEM
NUMBER
A. Fun"al bplnlll.
B.
2.
3.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
DESCRIPTION
AMOUNT
1.
Musselman Funeral Home Inc.
2,559.80
1.
Admlnlltratlvl COlli.
Perianal Rlprelentollve Com million I
Social Slc~rlty' Number of Penonal Reprllentallve.
Year Comml..lonl paid
Anorney Feol
Family Exempllon
Claimant
Addre.. of Claimant at decedlnt'l death
Street Addre..
Relollonlhlp
City
State
Zip Code
Probate Feel
Register of W11lB-fL1~ Ph Stnte Inh. Tnx Return
MllclllanlOul Explnl..'
10.00
TOTAL lAlla enter on line 9, Rlcopltulollonl S 25 (\9.80
(If mOil IpaCI II n"dld, lnllrt additional Ih"tl of lame 1111.1
.-.... ..
'I
I
I;
~.,-.- -,.......,......... ...'....
~Jd--
(0
RIV-1147 IX AFP (10.93*
CO~ALTH OF PEHHSVLVANIA
OEPARTHENT OF REVENUE
IlMEAU Of' INDIVIDUAL TAXES
DEPI. 110601
HARRllllMQ, PA 17111'0601
NOTICE OF INHERITANCE l'AM
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAM
ACN
DATI 09"13"94
101
FILl NO.
DATI OF DBATH 02-19-94 COUNTY CUMBERLAND
HOTEl TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAVHENT TO THE REaISTER DF WILLS. HAKE CHECK PAVABLE TO "REaISTER OF WILLS, AaENT"
REMIT PAVMENT TOI
P SUSAN DUKE
3818 LEXINGTON ST
HBG PA 17109
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
I Aoount R..IU.d ~
CUT ALONO THIS LINI ... RITAIN LOWIR PDRTION FOR YOUR RECORDS ~
illv: i 54"" " iie "AFjo."r iif: 9iY"NoYi or -ciF"INHiiiii'AifcE" YAX" iiP'PRA"iii iilENi' ~- -A t'i."oWANci-ifri" -".... -.... - - -""
DISALLOWANCE OF DEDUCTIONS AND ASSISSMENT OF TAX
ISTATE OF UTTLEV WILLIAM F FILl NO. 21 94-0450 ACN 101 DATI! 09-13-94
TAM RETURN WAS, I X) ACCEPTED AS FILED I I CHANaED
( )(
RISIRVATION CONCERNING FUTURI INTEREST . SII RIVIRSE
APPRAISED VALUI OF RETURN BASED ONI ORIGINAL RETURN
1. R..l E.toto ISoh.dul. AI
2. Stooke end Bond. ISohodulo B)
S. Clo.ll~ HIld Stook/Plrtnlr.hlp Intlrl.1 ISohldull Cl
4. HortOlgll/Notl. Rlollvlblo ISoh.dull DI
5. Co.h/Benk DIPo.lt./HI.o. Plr.ono1 Proport~ ISohodull El
6. Jolntl~ Ownld Proplrt~ (Sohodull Fl
7. Tron.for. ISohodull a)
e. Totel Alllta
Ul_
(2)
CSl
(41
(5)
161
(71
.00
.00
.00
.00
100.00
216.88
.00
leI
316 . 88
APPROVID DEDUCTIONS AND EXEMPTIONS I
9. Funlrol Expln.o./Ad.lnl.trotl.o Co.t.1
HI,olllonocu. E,pln.o. (Sohodull HI
10. D.bt./HortOlgl LI.bllltlo./Llln. (Soh.dull II
11. Totol Dlduotlon.
12. NIt Volul of Tox R.turn
15. Chorltobll/ao.lrn..ntol Boqul.t. (Sohldull J)
14. Not Volul uf E.toto Subjlot to To.
(9)
UOI
2,569.80
.00
III I
U2)
(11)
U41
2,569.80
2,252.92-
.00
.00
NOTlI
If .n ......m.nt w.. issu.d pr.viDu.ly, lin.. 14, 15 end/Dr 16 .nd 17 will
r.fl.ct figur.. th.t includ. the tDt.l of ALL r.turn. .......d to d.t..
ASSISSHINT OF TAXI ---
15. Aoount of Llnl 14 to.oblo ot 6Yo roto (151
16. A.ount of Llnl 14 to.oblo ot l&Yo rot I (16)__
17. Prlnolpol To. Duo
TAX CREDITS I
PAVHENT
DATE
.00 K.06 .
.00 M.lI .
1171
.00
.00
.00
RECEIPT
NUHBER
DISCOIINT C+)
INTEREST (.1
AHOUNT PAID
TOTAL TAX CRIDIT
BALANCI OF TAX DUE
INTEREST
TOTAL DUI
.00
.00
.00
,00
. IF PAID AFTER DATE INDICATED, SEE REYERSE
'OR CALCULATION DF ADDITIONAL INTEIEIT,
( IF TDTAL DUE IS LESS THAN II, NO PAVHENT IS IEQUIRED.
IP TOTAL DUE IS REFLECTED AS A "CREDIT" ICII, VDII HAV BE DUE
A REFUND. SEE REVERSE IIDE OF THII FORH FDI INSTRUCTIONS.)
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RlIERVATIONI E.toto. 01 d..odont. dYlno on or boloro D.o.obIr 12. 19.2 "- II ony luturo Intor..t In tho ..tot. I. tron.forrld
In po..,ulon or InjoYMf'lt 'to ell.. . (coU.ttr,U beneflol.rl.. of thl dlc.dent ,Uer 'the tllplrlUon of en)' 1I"t, for .
I1f, or for v.trl, 'h. C~llth htrebv IMprll.l~ rl'lrY'. thl right to epprll.1 IMd "'1" trln.f.r InhtrJtenc. T.IlI.
.t the 1ewful C11I. . (ooUlt.r.U retl on en)' .uch futurl Int.rllt. I
P\JllPDIE Of'
NOTICE I To fulfill thl rlqulrl.lnt. of Slctlon 2140 of t~ Inherltancl and E.t,tl TIM Act, Act 22 of 1991. 72 P.'.
SIOUon 2140.
..
Dettch thl top portion of thll Notlcl 1M .ubllt with voyr p.y..nt to thl Rlglttlr of NUIt printed on the rtVlnt .lde.
--"oko o...k or ..no order poy.bl. t., REGISTER OF MILLS, ADEHT .
AU pIV.lnt. nOllvld .htU firet be appllld to anv Intlrllt which OV hi due with fin)' r"llndtr IPpllld to the tlM.
REFUND (CR)I A r.fund of I till credIt, whIch WI' not rlque.tld on the Till R.turn, MlY bl r.que.ted bv cOIP1.~lng In ~Appllo.tlon
for A.fund of P,nn,ylvanla Inherltancl and E.t.t, Tall" (REY-1SIS), Appllcltlon. Irl Iv,lllbl, at the Offlol
of the Rlol.t.r of NII1I, Iny 0' the ZS Revlnue DI.trlot OffiCI., or bv ollllng thl 'PIOIII Z4-hour
an'Wlrlng ..rvlol nutber. 'or for., ordlrlngl In Penn.ylvlnl, 1-100-362-2050, out.ldl P.nn,ylvenll end
within 100.1 H,rrhbyrg er.. (717),787-8094, TDD' (7171 772-Z2SZ'(Httrlna 1IPllred Only).
PAYItENT I
"
OBJECTIONSI Any p.rtv In Intlr..t not .atl.flld with thl IPprll...ent, ellowlnoe or dl'll1owenol of deduction., or ......lInt
of ta. (lnoluc:Ung dltcount or Inttrllt) al .hewn on thlt MoUel tu.t obj.ot within ...tv (601 dan of reo.lpt of
this NoUcl bVI
--wrltt.n protl.t to thl PA Dlplrt..nt of RlvtnUlJ 10lrd of APPIII.; DEPT, 281021, H.rrl.bura, PA 1712'~10tl, OR
--.l.oUon to hlv, the litter det.rtln.d It 8Udlt of thl IOcount 0' thl per.on.l rtprlltntltlv., OR
--appl.l to the Orphan.' Court.
ADHIN
ISTRATlI/!
C_CTlONS,
Flotuel .rror. dl.cov.rld on thl. ......IInt .hould b. addr....d In writing tal PA DIp.rtllnt of RIV~"
,Surtau of Indlvldu.l T'~I', ATTNI Po.t A.......nt Rlvl.w unit, DEPT. 280601, Herrl.burl, PA 11128-0601
Phone (7171 7.7-6505, SI. pig. 3 0' the bookllt "In.truotlon. 'or Inh.rltenc. T'M R,turn for I R.,ldlnt
DtCldent~ (REY-1S01) for In .lIpltnltlon of tdtlnl.trltlv.ly corr.otlbl1 .rror..
INTEREST'
If any t.. due I. Plld within thrlt (5) ell.ndtr IOMth. Ift.r the deoedent'. d.lthJ . flv. Plretnt (SXl dl.oount of"
thl t.~ p.ld II 1110Ntd.
Int.r..t I. chlrttd b.glnnlng with flr.t dlv of Utllnquency, cr nine (9) lanth. and one (11 dlY frOl thldet. of
dtlth, to thl dltl of plV-lnt. TeM" which bee... delinquent b,'orl Janul,Y 1, 1982 bllr Inter..t It thl rltl of,
~IK (6Xl Plro.nt plr InnUl olloul'ttd at I dilly r.tl of .000164. All tIMI. whloh biOI" dellnqulnt on end Ift.r
JlnUlr~ 1, 1982 will b.lr Int.r..t at . r.tl which wIll Vlry frot'o,l.nd.r y..r to elltnUlr y..r with thlt rltl
announotd by the PA Olplrt..nt 0' R,vtnul, The appllcabl. Int.r..t retl' for 1982 thr~ 1994 Ir.1
DISCOUNT'
!!!r Intlrllt R.tl DIllv Intlrl.t Factor :!!!r Inter..t R.t. ,tally Inter'lt flOtor
19U ZOX .000541 1916 lOX .000214
1915 I6X .000411 1981 9X .000241
1984 IIX .000101 I9N-I991 IIX ,00OSOl
1915 ISX ,000116 1992 9X .000241
1995-1994 1X .000192
--Interllt I, ollcul.tld .. folloNII
INT~RE8T . IALANCE OF TAX UNPAID X MUftIER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Notlc' I..utd .ftlr the till bloo... dellnquent,wlll r'fl,ot 1M Ihtlrl.t o.loulltlon to flft"" (11) dlW'
beYond t~ dltl of thl ......lInt. If Plvat"t I. tide .ftlr thl Int.r..t ooaputltlon dlt' .hewn on the
NoUel, IddlUontl Int.,lIt ltU.t b. olloullttd.
:'il'
.,