HomeMy WebLinkAbout94-00495
REV0\5oo EX. 111.011
.'
I Y.. ~/4 - (2..
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH Of PENNSYLVANIA (TO BE FILED IN DUPLICATE 'HJ.""-
DEPARTMENT~' REVENUE ,. ., ~)
HARRlSrJll,. ~ADn:1BD601 . WITH REGISTER OF WILLS I ,COUN.T~.COIlE.p2,L" YEAR 9'2:. NUMBER
!DENT'S NAM! IIAST, 'lRST, AND MIDDLE INlllALI N ' M n!fDR!SS . A
15 T J) \/ M bC'C) c' \vI. S,-. JOe' 3 ( <1/ IA "', h I ({ . V<".
~ OBfITRmt~7mR . ~drDEAHI-'T^fEor;iRIHU-'- {'" ,>r p /I,' II, /1r..
._,~- .JLL:J!..'l::..Lcf.t s:- IJ . 3 l" 'I J ._.J..:.d:':;!.t:._.__ _C.O~_"l ('~_I'.1_h.fLliL~___ / ?('II
~ ~11. Orlglllal Relurn IJ 2. Supplemenlal Relurn [] 3. Remainder Rolurn
l'i~g Ifar dule. of dealh prior 1012.13.92)
lll'" [] 4. lImlled E.lale [J 40. Fuluro Inlore.1 Comproml,o [15. Federal E.lale Tax
02... Ifor dolo' of doalh aftor 12.12.921 Relurn Required
tal [J 6. Decedenl Died Te.lal. [J 7. Decedenl Mainlalned a living Tru,1 _ 9. Tolal Number a' Safe Depo.1t Boxe.
<l: IAttach copy of Willi (Attach copy of Tru'l)
ALL CORRISPONDINCI AND CONPlDENTIAL TAX INfORMATION SHOULD BiDiReCTID TOI
I 15 NAM .. OMPIE!! MAILING ADDRESS
Sa r(v", ~Y(l1^1t J'v). 3c)(-'3('oJ~"'lh((1 Av~
o Z TElEPHONE NUMil-'--- I -------- I I II
v~ (~mr 17' ,
I 7/7) 7 ~ 7',:} t' (/ L
U
'OR DAns O' DIATH AmR 12131191 CHICK HIli.
lP A SPOUSAL
POVIRTY CRlDIY IS CLAIMID 0
.ILI NUMii'R--------------.---
J:?C; ,
I hll/
I 6) ____________
I 71.___...__
(9) J ~I; ~ 7. /~
(10)
(11) -L.2-,--Z.1;--, I t-
(12) .- f",r3-3! ();J.
(13)
(14)
(151__________x .06 =
I)
(161-----._____________x .15 =
6
1. Real f.lale ISchedule AI I 11 _ _______ .________________
2. Slack. and Bond. (Schedule BI ( 21.L'i,_.r.Y.:z....LG......_
3. Clo.ely Held Slock/Parlnershlp Inlere" ISchedule C) I 3} ___~ ___ ___________n________
4. Morlgage. and Nole. Receivable ISchedule D) 1 41 _.____________~___.._____
5. Ca.h. Bank Depo.I" & MI"ollanoou. Pellonal Properly I 5} ._____________
(Schedule EJ
6. Jolnlly Owned Properly (Schedule FI
7. Tran.fers (Schedule G) (Schedule L)
8. TOlal Gro" A"el. (10101 line. 1.71
9. Funeral Expeme,. Admlnl,lrallve Co,I.. iAl"ellaneou. ( 91 JJ....,..i..2_LLf"_
Expen... (Schodule HI
10. Debl', Morlgage lIabllllle.. lIem (Schedule I)
11. Tolal Deducllom (10101 line. 9 & 101
12. Nel Value a' E,'ale (line 0 mlnu.llne 11)
13. Charitable and Governmenlal aeque'I' ISchedule J)
14, Nel Value Sub Ie" 10 Taxlllne 12 mlnu.lloe 13)
15. Amounl of IIno 14 laxable 01 6% role
(Include value, from Schedule K or Schedule M.I
16. Amaunl of line 14 laxabl. 01 15% ralo
Ilnclude valu.. from Schedule K or Schedule M.I
17. Prlndpallax duelAdd lax from line 15 and from line 16.1
19. Credit. Spou.al Poverty Credll Prior Paymen" DI"ounl Inlere,1
------- + ------- +-------------- -- -------.-----.
19. If IIno 19 I. grealer than IIno 17. onler Ihe dlllerence an line 19. Thl. l'lhe OVERPAYMENT.
aD
20. If line 171. grealer Ihan IIno 19. enler Ihe dlllerence on line 20. Thl.I.lhe TAX DUE,
A. Enler Ihe Inlere" on Ihe balance due on line 20A.
9. Enler Ihe 10101 of line 20 and 20A on line 208. This I, Ihe BALANCE DUE,
Mako Chock Payablo to, Rog!!!", of Will., Agont
. ...IURI TO ANSWIR ALL QUIITIONS ON RIVIRSE SIDI AND TO RICtilCK MATH..
TI;;'d;r penclll.. of porlury, I declartthat I halfl .xamlned thl, relurn, Including occomptlnylng Icho'dules and lIetemenh, and 10 Ih, be,l of my Mnowledge and bIU,f,
111. IruI, (orr.ct and compl.te, I declare thai all real tlfale has been reporled 01 true markel volue. Declaratlon of preparer other than Ihs perlonal reprl1,nlatl"l I.
baled on all Informal Ion of which pr.parer hat any knowledge.
SION)AlURE O~PERSON RES~O 18" 'OR ""NO R'lYlfIfN" . ~D.DRESS/;------~-------~-----------./;~~---'-- DAlE ___
J\,'Ltt-I/. -m h ,"{ ~(I, 1(" __.. /" I,:." / i.... ~ (1., . /." I "A.1' I C' I?' (, II
~rytmR(RIY H !ffimIDJwr-"-ADoRI~S-- .-----u~----Wa(-,r-./!!~---T"--___'___LO< -'-- DAIf" _ L..:L.....
Z
o
~
S
'"
B
~
t 'j
!\"'{'{~A
.~'\~fi:;~'
z
o
3
E
~
I
()
(17) _______________
119)________.L__..____
(191 -- -.---0-----..-
(Iwclt .11:,1' If you {III' 1('(IUC\tlll~1 (I 'Pfund of your OvtllpClymtlnl
1201 ----------D-...--___
(20A) _______________.__
(20BI ____________ ________________
--~~._--.._--------_.-._-----~._-----~---
i
-, .'.-..... ...........,...~.. .-. '''''"
IIV.IlDl IX. IH61
'*
CO~~~~fT~L~~IOlJ.I~ml\'tANIA
miDI NT DICIDINT
ISTATIO.
::r R v / 1\1 C'" "Y-J co 1,/,
aOel 3 ('.:.1" ht /" q A y(!.
I
(All property lolntly-ownld with RighI of Su
ITEM
NUMBER
SCHEDULE B
STOCKS AND BONDS
s~.
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
G 8
Shq(t5 ,,-I C'oI"Scl),rla-l(~J Rtl'-) COYf~YQf,'()/'7.
91; oJ'! 7. 1(,
"
".
"
,.
,
TOTAL (Allo Inllr on IInl 2, Rlcapllulollon)
(1/ mOil 'pacI I. n..dld. Inllrt addlllonal,h.." 0/ laml "".)
s
. "
..v.ISl1n.p.UI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
!~
COMMONWeALTH 01 PlNNmVANIA
INHIRITANCI TAX RIlURN
RUIDINT DICIDINT
ISTAff' J: R V I N 0<'<"5"-- w-
JooJ L"o!lll1t b If) A v''.
ITEM
NUMBER
;fr,
0" (>of) 1/./1, /6
,
DESCRIPTION
Pllall Print or T'lI!.!-
I PILE N/U~BIR
L 7 -(}O'19,r
AMOUNT
A. Funlrallxplnlll'
1. fu.(1O'<\( D'-r<!.d--"r'"lcC1Ylle/~'d~,
Q((}. v t' 5
;v1,'1J /5t t' (S'
O('et1'''J of C"'tIVO!.
fVt C\ ( /I 0'
F"" c1 t'.,y "L y 0 f {'I n ~ ,..; I
B. Admlnlltratlvl COI'II
1. Penonal Reprllentotlve Commllllonl
Social Security Number of Perlonal Reprelenlatlvel
Vear Com million I paid
~3Lf~.C'(l
l/tJ/1,(Jco
I
CiO,~CI
J""u(J , ,'C'>
17";-' b' 9
.fJ-,;I. ')
if /p) S'7/f. /?
2, Attorney Fe..
3.
Family Exemption
Claimant . Do (" i A X !II y" v,! II Relatlonlhlp W / f'~ .
Addrell of Claimant at decedent'l death
Street Addrell a 00 3 C, J u .., hi<< ;{ vof
. City Cll:llf II. / /1 l Slate L Zip Code-L1." 1/
.1 t,.(IO, c"o
11'"".
4. Probate Feel
C. . Mllelllanloul Ixpln.."
1,
2,
3,
4,
S.
, 6.
7.
a.
TOTAL (Allo enter on line 9, Recapltulatlonl S . I).. f 1 r I?'
(If mall Ipael II nlldld, Inllft additional Iheetl of lame 11.1.)
.'.i'-~ '/" /
f.~
llEY.1547 EX AFP (08.94*
COHItOHWEAl Tll OF PENNSYLVANIA
DEPART~NT DP nr.ENUE
!URE'U OF INDIVIDUAL TAXES
DEPl, l8D601
HARRt~eURO, PA 11121.0601
,-(1///
NDTICE OF INHERITANCE TAM
APPRAISEH~HT, ALLOWANCE OR OISALLDWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
ACN 101
OAT! 11-07-94
o FILE NO.
DATE OF DEATH 12-31-93 CDUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TD YOUR ACCOUNT, SUBHIT THE UPPER PORTION 0, THIS FORH WITH VDUH TAM
PAYHENT TD THE REOISTER OF WILLS, HAKE CHECK PAVABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT TOI
DOROTHY M IRYIN
3003 COLUMBIA AYE
CAMP HILL PA 1?011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
F
A.ount Ro.Uhd
J
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ili"V: iS47. iif. A iij"" io'S-: 94 T -iloYi c r"o F - "fN'Hiiii f ANtiE "i''Ax. A"piiitA"iiiioiiili'-; -AL l"owANti E. ijli"".".... --.""....
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF IRVIN GEORGE W FILE NO. 21 94-0495 ACN 101 DATI 11-07-94
TAM RETURN WAS I I X J ACCEPTED AS FILED
I J CHAHOEO
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APFRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Rool Eototo ISohodulo AI (II
2, stook I ond Bondi I Sohldulo BI 121
5, Cloloh Hold Staok/Plrtnlrlhlp tnhrut ISohodulo CI ISI
4. Hortgogol/Nat.1 Rooll.oblo (Sohldulo 01 141
S, COlh/Bonk Oopolltl/HIIO, Porlonol Proplrty ISohldulo El (Sl
6. JointlY O.nod Proporty ISohldulo fl 161
7, Tronlforl ISohldulo 01 171
8. Totol AI..to
,00
4.547,16
.00
.00
.00
.00
.00
181
4,547,16
APPROVED DEDUCTIONS AND EXEMPTIONS I
12,878.18
9, Funorol E,plnlol/Ad.. COlto/Hllo. E,plnlu ISohodulo HI (91 __
~O, Dobtl/Hortglgo Liobllitlol/Llonl ISohldulo II 1101 .00
11. Totol OoduoUonl 1111
12. Not Voluo of To. Roturn (12)
15. ChorUoblo/Oavorn.ontol 8oquuto ISohodulo JI (15)
14, Not Voluo of Eltoto Subjl.t to To. 1141
NOTEI If.n ......m.nt w.. i..u.d previDu.1Y, lin.. 14, 15 8nd/Dr 16. 17 .nd 18 will
refl.ct figur.. th.t inDlud. the tot.l Df ~ r.turn. a......d to d.t..
ASSESSMENT OF TAXI
IS. A..unt of Llnl 14 ot SpauIIl roto 11SI
16. A.ount of Lino 14 tl.oblo ot Llnool/Cloll A roto 1161
17, A.ount of Llno 14 tl.oblo ot Collotlrll/Cloll B roto 1171.
18. Prinoipol To. Duo
t'.A7A 18
8,331. 02-
.00
8,331. 02-
,00
,00
,00
K ,00.
M .06.
M .15.
1181
.00
.00
.:1L
.00
TAX CREDnSI
PAYHEHT
DATE
RECEIPT
NUHIER
OISCOUNT 1'1
INTEREST ('1
AHOUNT PAID
rDTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
.00
.00
,00
. IF PAID AFTER OATE 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 "CREDIT" (CR1, YDU HAV IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
'_'ID
RESERVATION I E,t,t.. of dlced.nt. dvlng on or blfor. Olo..b,r 12, 1982 ~~ If any future Int.r..\ In thl ..t.t. I. tran,fltted
In POII.I.lon or .nJoy..nt to ell'l 8 (00111\trll) bln,flcl,rl,. of thl dlfldtnt .,t.r t~. IMplrttJon of any I.t.t. for
llf. ar for y..r., thl Co..onN'llth hlr'bY IMpr...ly rl..rv.. thl right to Ippr,I.. end ...... trant'.r Inhtrltenol 'IXI.
It thl I.wful CII.. . (0011.t.re1) rtt. on tny .uoh future Int.rl.t.
PURPOSE Of
NOTltEl To fulfill thl r.qulr...nt. of Sletlon 2140 of thl Inherlt.ncl end E,tat. 'IX Act, Act 22 of 1991. 72 P.S.
Slotlon l140.
PAYMENT.
Detlch thl top ~ortlon of thl, Notlol and tubelt with your Ply..nt to thl Rlg).t,r 0' Willi printed on thl r.v.r'l .Idt,
--Hike ohlck or Ilon.y ord.r p'Y'bh tal REGISTER OF MILLS, AGENT
All Plv.ent. rlcllved .hlll flrlt be appllld to anv Intlre.t ~hlch .av be due with anv r...lndlr apPlied to the tlX.
REFUND (CAli A refund of . tlK oredlt, which wa. not r.quI.t.d on the Tax Roturn, .av bl rlque.ted bv coaplltlng an "Appl1cltlon
for R,fund of Plnnu1Ya"la Inhlritancl and E.tatl Tile" (REY~1S1S), Application. Irl aVlllIbl, at th,Offlc.
of thl A.gl.tlr of Will., anv of thl 23 Rlvlnu. Ol.trlct Off Ie.., or bv c.ll1ng thl 'Plclal 24~hour
In.w.rlng ..rvlc. nu.blr. fer for.. crd.rlngl In Plnn.vlvanl. 1~aOO'362~2050, out.ldl P.nnlvlvlnl. .nd
within locll Harrl.burg Ir.a (117) 181-8094, TOOl (111) 172-2252 (Ha.rlng I.palrad Onlv),
OBJECTIONS, Anv party In Int.r..t not satl.fled with the appral,a'lnt, allowancl or dll.llowlncl of dlductlon., or ........nt
of tlX (Including dl.count or Intlr..t) a. .hown en thl. Notlc. au.t objlct within IIKtV (60) day. of r.c.lpt of
thlt Notlcl bYI
~~wrltt.n protl.t to the PA D.p,rtllnt of Rlvlnu., Board of A"p.al., DEPT. 281021, Harrltburg, PA 17121-1021, OR
--.I.ctlon to have thl aatter dlteralnld at audit of thl aocount of tha Plr.onal r.prellntltlv., OR
--,pp.al to thl Orphan.' Court.
ADMIN
ISlRAlIVE
CORRECTIONS.
Factu.l arror. dltcov.rld on thl. a..I".lnt .hould bl addr....d In writing tGl PA DIPlrt.,nt of R,venut,
Bur.lU of Individual TaXI', ATTN. Pn,t A.......nt RIVllw Unit, DEPT. 180601, Harrl.burg, PA 11121-0601
Phon' (717) 7U~6S0!i. S.. pig' 3 of thl boakllt "In.tructlo". for Inhlrltancl TII' Alturn for I Allldlnt
Olcldlnt" (REY-1SOI) for an Ixpllnatlon of ad.lnl.tratJvllv corrlctab)1 IrrOrt,
DISCOUNT I
If any tax dUI I. paid within thrl' (~) callnd.r .onthl aftlr thl dacadlnt'. daath, a flVI p.ra.nt (5~) discount of
the t.x pIld I. allaw.d,
lNlEREST.
Intlrllt It charud b.glnnlng with flr.t dlY of dlllnquanlJY, or nlnl (9) .Oflth. arid on. (1) dlV fro. the dltl af
dlath, to thl detl of plV.lnt. 1IM1. which bIC..I dlllnqulnt blfarl JllnulrY 1, 1982 b..r lnter..t at thl rlt, of
.Ix (6XJ Plrclnt p.r annul c.lculatld at e dally rate of .000164. All tax.. which b.ca'l d.llnquent on and Ift,r
Januarv I, 1982 w111 blar Int.rl.t at a rata which will vary fro. callndar Vlar to callnd.r v.ar with thlt rlt,
announcld by the PA D'Plrt..nt of RIVlnu., Thl appllcabll Intlrllt ratll for 1982 through 1994 .r..
!!!.!: Intlrut Alt. Olllv Intlrut Faatar !!!! Intlrllt Rite Dallv Intlrut Factor
1982 20:< ,000S4I 1916 lOX ,000174
1913 16% ,0004311 19.1 9% ,0001~7
191~ 11% ,000101 19be-lool \IX .000101
1915 m ,000356 100! 'X ,000!~7
1993.1994 1% ,000191
--Int.rllt ls calaulatld .. follawll
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINqUENT X DAILY INTEREST FACTOII
'~Any Hotlcl I..~~d .ft.r thl tlX b.ea... dlllnquant will rlfllct In lnt.rl.t calcul.tlon to flft"n (11) dlV'
beyond thl dati of thl u,"..,nt. If p"y..nt It .adl aftlr thl Int.rllt co.putatlon d.t, .hown on thl
HOUCI, Iddlt10nal Intlrllt 'l.l,t b, calcuhtld.
.... " ..
( ) I, '
STATUS REPORT UNDER RULE 6.12 c
",
:1)
Name of Decedent I (~e{~ Y':J P I,)' .r /"y 111 Sr.
I"~
Date of Deathl },o..-i/- '1'.3
Will No, rv~ w: II Admin, No,.:).1 J('/3Y'j
Pursuant to Rule 6, 12 of the Supreme Court Orphans'
Court 'Rules, I report the following with respect to completion of
the administration of the above-captioned estatel
1. State whether administration of the estate is complete I
Yes X No_____
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
3. If the answer to No.1 is Yes, state the followingl
a. Did the personal representative file a final
account with the Court? Yes No K
b, The separate Orphans' Court No, (if any) for
the personal representative's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d, Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report,
Datel /- ,2~ - '-Jc,
iJ~y "7J1tU
Signature'
,po Yo fA ~ M
Name (Pleas type
atJ6 ? (~/ U Y)f b
Address
ctult-':"-
(7}7) '7 ~ 7-.;2 0 Lj 7
Tel. No,
]'YV,'I1.
or print)
" c, A Vc. ,
O:U~ f 1-1,' 10 1'11.
, '7011
CapacitYI ~_personal Representative
Counsel for personal
representative
(MAH I rmfl AM3)
T 7f/u. ;(~ /Yt.-(r Adt" ("~~ . .1!~1'JJ . ~t~ .
~/-Q4.......-l-"^ '{)'o-c/... /l~)..,..L.(4-- / ~ c.z rf.I.J- .. ,r,~..,"<,<--<- ~-('..d....-
,e .A0:r--- rl~~A'- ~tL~.. ~ ./ZJi'~~'. , . .
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Z./. 1/ ''/ .. /,J ./ / 1/ /.... /. y ,
V /u"t-\. \.,.t .;/'t,L"C(~#..~rr; Ck"/ ..-"t~,I...c.... ~k--cl '.VI-'~ "'~'~r/t.-1'1..t...a-C.bc:1--..t
r' ~~; ~~~ h\.. ~~j!~ i :~ ~~/..4' dr ~'_
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cP ~/,J _4'~ 4c.dc~ A"kl. .L" r't /~~...::.->c,
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