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R(V,r,OO'" III vii II!" :; / 1~ ~I fOUAIIIOfDIAfHA"1112131191 CHICK HI"
"\'~~h~~ INHERITANCE TAX RETURN ~Cl~:;fl~~DI! II CLA1M1l1.J:J____
,,'':Wi;. RESIDENT DECEDENT fill NUMIIA 1- __ '-g
COMMONW(&01" '" "''''5YlV''''. (TO BE FILED IN DUPLICATE r ~ / 0, (!),'.:J~
(HPAR1MHlT Of Rlvwur ) ~'>( f
OEPI10060' WITH REGISTER OF WILLS COUNTY COOE YEAR NUMBER
~~":":;"";-'r~~in~~~~ftt~~~OmJWtmUmm;qr .--,_..._-- - -'5 COMPlETE-+AOORE'SS -._-- - +ou, '___n__ ,--
t; nil ;,\' :'\I'~,;I1\1I VII.LAi:\';
lli ,~;'I''\N!;J:JI::LI', \lll:OI'lIY I':, 'Hm.._" ___ 1'.0. Ill); .~IWI
~ 50C'AI 5EC1'~"Y NUM'(R IDAI[ 01 DEAl" jOAlfOriiRl" ;'\1I:Ili\HH ':,llIH(;, I '^, 1711:;';
Q /~;< :<,;J ol'Y3 . /-/t,'/r_ j'-J,;).;(I C""_~JIJli!lUi\JII) co" 1'1\ ________
[ I 1, Suppl.m.nlal R,'uro [J 3.
II 40, Fuluro InlerOlI Campraml.. [J 5,
liar dalOl of d.alh after 12,12,821
U 6, Oo<odonl Dlod ToII",o II 7, Dec.d.nl Malnlaln.d a Living Tru,'
__, . _,~~[~.:~['j~~~I~__'_H ,_"m IAllac~ copy 01 Tru,')
ALL CORRESPONDINCE AND CONPIDINTIAL TAX INPORMATlON SHOULD 81 DIIICTID TOI
NAM~'i11 ;H\ ,~~~-~.-; ~~~I~'---- ------=r:~i'~~l~~R~S'~l
\H""ONE NlIM'IR ' , . .- --- ; 11:\ 01'( II: 1', 1'1\ 171l7'1
I.u 7..17:-} ',(,'7-(,1177 __,~"m ' l'
-Il-
l. Roal E,'a'o ISchodulo AI ( 1) _____,
2, Slack! and Bond. (Sch.dul. BI I 2) ____.._~__
-Il-
J, Clololy H.ld SlocklPurlnollhlp Inl.r.II ISchodulo C) I 31 _____.."...______,,,__
~, MorlgaoOl and Nalu. Ro<oivabl. (Schodul. 0) I 41 n -(l-
5, Cmh. Bank Oopa.11I & MilCollanoau. POllonal Properly( 5) _----dJ~;i:l.2';
ISch.dul. EJ
-0-
6, Jolnlly Owned Propurty ISchodulo FI I 6) -ll-
7, Tron,'oll ISchodulo GIISch.dul. l) I 71,______,
0, T 0101 Grall AII.II IlalallinOl \.71
q, Funoral E'p.n.OI. Admlnlllralivo Co.lI, Mhcollon.ou. I 9) __11 (J(>,J. !H
E'pon.el (Sch.dul. HI
10. O.bll, Morlgao' llabllillol, ll.n. ISchodul. I)
11. T 0101 D.ducllon. (Ialalllno. 9 & 101
12, Nol Valu. of Ellalo IlIn. 8 mlnu.lln. 111
IJ, Charllahl. and Gavernm.nlal B.quo," ISchodul. JI
".____ __, nI4H~,01_ Valu~ Sublo~~o_ ~~~jll_no 1~ ,,,,I~II~,~, 131
15, Amounl of IIno 14 la,ablo 016% ralo
(Includ. valuOl from Schodulo K or Schodul. M,I
16, Amaunl ollln. 14 la,ablo 0115% rolo
Ilnclud. valuOl I,om Schodul. K or Sch.dul. M,)
17, Principal la, duo (Add 10' from lino 15 and Irom IIn. 16,1
10, (rooils Spouial Povnrly Cradil Prior Paymonts
II ( -12
?O, "lIn. 17 is groClIOl Ih[IO IIno 18, onler Ih. dlffer.nce on Iln. 20, Thh I"h. TAX DUE. 1201 ___,__,__,__"~~~,-,,
A. Enler lho inloros' on tho bolooo:o duo on lino 20A, 120A) __.__,._u,
B, Enlor Ih. 10101 0' Ilno 20 (lIId 20A on Iln. 20B, Thh I.,h. BALANCE DUE. (20B) ,_"....,,__u 11;(,. n
Mak.Check Pavabl. 101 R.gl,ter ofWill~,_ Ag.nt _, ___"
---" ----- "u,n'.-.-BESLIRerOANSyiiR ALCaui'STIONS ON RIVIRSI SIDI AND TO RICHICK MATH.... --,--.
Undo;'p;;~'~lti~'~ri;-l1-;j~;y~{doCT;r-;;Ih~~i-i't~{'I''f~';'';~-;;;i~~d thlt rJlurn, including accompanYing Ichll'duhll and .lalemenll, and 10 the bell of my knowledgo and beUefl
It It Iruo, corroel (lnd conlfllolB I decloru tho1 011 ronl 011010 hen hoon roporled 01 true mnrket yalue, Oltlara!ion of pre parer other Ihon Ihe p'honal ropro,onlotl"" II
botod on nil inrnrmotlon of which proporor hll\ Clny lnowlodno,
SiAl '1R\(Hi "",t/'"'' '" 1111110 ""'Of'(.7 MIPR[\\' '---""/fJ~",;I,.t--;? i7~~ 7)/----.-.- bArE n ; n.. '-;',----
\ia~li'",'t7rPA,!fo1I1' '''~''~''Yf rrl.2(,2A /.sX.u~,~i~l5'~I~iJ::ifiFL-n..n..-.._n- OA/!..-2X!Y",
. l,) ~- t.-\ ,~AlLt6\_..IJ!J.~I;~~I~(~~~>_~_~~~"__ou_n__'_..___ ,--.-9/IM'f:--
~
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:.:00
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0..'"
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o Z
u~
f'<1': 1. Orlglnnl R,'urn
R.malnder R,'urn
(far dol.. of d.alh prior 10 12, 13,a2)
F.deral E,'al. To,
RelUtn Requlrod
T 0101 ~\umb" of Safo D.po.1t Bo,..
[ I 4, limllod E.,,,,o
_8,
z
o
3
E
~
01
( 8)
tl,154.25
-{l-
(10)
1,om.Bl
(11) ~_______u______
(12) _-3.JJUd~.4!L___
(13) _,__~~~J.O()'_hh__
2,775.'1/1
114) --'-___,______,,,______
1<>C..52
115) ,
2,775./1/1
K ,06 =
116: _,
-0-
.._K .15..
-Cl-
z
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Discount
Interest
(17) _~,__!.<i(i~~~,_..__
-ll-
(18) __..m,_h_,.n _""on_n_
(19) __,..____::I~::_...,___.
i' + on______,_, '" _,__,___"'._u
19, If lin. 10 I. ureal.r Ih"n line 17, onlor Ih. difforence an lino 19, ThI,I.,he OVERPAYMINT,
IiIU
Chllck hl!'fO il you UIO rcqulu'inu (I le'ulH of youl oVl''1H1ynll'1I1
UYUO'UIIl811
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
. _ , P~,~IO Prlnl,,~~.JJ.eo .
rilE NUMBER
1I~:J~I'~(\
-1IoI..j.U/S,NO
COMMOIlWEAI1II or PUHUVlYMU^
UHIIIIlANCI lAX II1Ulfl
!1110INlOICIOIIH
hiAie OF.'=="=-~~~=
,.,_..,.,;,,~-
,.. _'u ,____ .. .. ,. , .,. ,
_~~. _,'U__ _,..__.,_.h. ......_
H[,N~SFn:lD, IXJHffillY E.
(All pr;P;;~J~~~~..~~~_~~_~I.II; II.,' A,~~_i',I',.~i~l~,',~_!~~;~.i'I~--~~'~.~ ~.'.,~~,_~ioud 011 Scl1l11lulo n
ITEM
NUMBER
DESCRIPTION
_____,_--1",._
VAluE AT \
DATE OF DEATH'
1 ) CllECIUNJ ^CCQIIN'I' (D^UPIIIN DEP.' IlNolK)
2 ) CHECK [.1{a-1 NESSINI (l'ERSONM, C^HI:: FUNI:8)
3) cllEm [i'HON NESSINI (HOUSING FLINI:8)
4) HEi\JJI11 N-umc^ HEFUNIJ CIII,r;I~
U55.9B
" 4%.'17
2,591.~1
210.<19
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,.-.-...,.... ~.-..-t \--.--.--- ,.~.._..,_. ..< .,~,.
P_'d"': .J~!~L (A,h,o,onIOl 011 lillll 5, R~HlpJ!ll.!~non L__4d5'1.2!L._
l"trnd, mlcllUonnl m'l" Kll"'dlonh II mllln \IHlCn i\ ':l',ulrd I,
.(V,I!ll I~ + 1""1
ISlATI OF
,&:J~I}tI
"",..'I1.u.-
COMMONW!MTH 0' PENNsnVANIA
INHERITANCE TAX ME!URN
RESIDENT DECEDEN!
S'I'i\NSFIEf ,1>,
ITEM
NUMBER
A. Funllal hp.n'''1
1.
Imn, l'LNEI~L HONE
2.
l~ SCHEDULE H l '
fUNERAL EXPENSES, .
ADMINISTRATIVE COSTS AND .
MISCELLANEOYS EXPENSES . _ _ ,Pleat. p'rlnl or !yp_~_,_
,____' 11I1l', NUMbeR
IXilKJl1IY E. --!~_
DESCRIPTION
AMOUNT
175.00
SNYIJEl{'g (HI~IJ S'lDNE)
315.00
1.
B. Admlnlltrallv. CO.t'l
2,
3,
4,
c.
1,
2,
3.
3,
4,
5,
6.
7.
Q,
Perlonal Reprelentatlve Commlnlonl
Social Security Number of Personal Representotlvel
Year Commlnlons paid 1994
175 _ 40 _ 6179
544.00
Allorney F~es I ACCOUNl'I~ FEliS
NO QIAHGE
Family Exemption
Claimant . '-' Relationship
Addren ~f Claimant at decodent/s death
Street Addrels
City _
Probate Fees
MIIe.llan.ou. Exp.n'.1I
"
;-
State __ Zip Code
IJN.II~I'ON '1\11' MlB. cum
BElL OF 1'^. . (PHONE CAIJ.S NI' HC1<lE)
A. Z. HI'l'Z~fI\N N3SOC (X-RAYS)
19.10
10.17
. 6.54'
,""
,
,"
T~TAL (Also entDr on line 9, ROCaPltUlatlOn~JS --'lroc,9~;Ji-'--
(If mar. .pac. II n..ded, In..rt additional .h.... of .am. "...1
~IVUIJ I.. P"I
'1~:'~
cm\MOtlwlAlIU 0' ,'rnunVAWA
ItIHUItANU,AIC IlIlU~'1
~1!IP.I~~.~I,(~~_IN1_
SCHEDUU J
BENEFICIARIES
esTATE OF
FILE NUMBER
S'l'N~SFn:r.D, LOhUlllY E.
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATlONSIlIP
AMOUNT OR
SHARE OF ESTATE
1.
A, T o.obl. B.quolls:
Ci\HOLYN OOYEH
HDltl
DUNCANNON, "A. l7020
lYIlXJHI'EH
29;~;
2. SIURLh'Y L LOVE 11\LDHl'EH 25%
RDII 1
NIM!{)H'l', PA. 17074 .
3 NAl{l'Y STANSFII;;LlJ s:JN 2:1i{,
HOII 1
DlJNCANNON, PA 17020
.4
CllIHE S'I'ANSFIl;;LD
DELLVILU\ DAN RD
DUNCANNON, PA 17020
s:JN
25%
ITEM
NUMBER
NAME AND ADDRm OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
'B, Chorlloble and Governmental Boque"l:
1.
\~^,l'rs 'n'iP. lofFSLEYN ClIUHCII
300.00
------- '...----.---
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAho onl.r on IIn. 13, Recapllulollonl
$
3m.oo
(If mort Ipa.. II nuded, In.." addlllonal Ihu..oleam, 111.1
_________4_.___.__________________
, 'J! U
j REV-1S47 EX AFP (08-94.1 '.' I I
CClHHONWhU III or IlF.NNS't'l VANIA " ACN 101
OfP'.IHfHI 01 ''':VI:H'', ~ NOTICE OF INHERITANCE TAK
\ 'U'fAU 01 INDIVIDUAl ''''5 APPRAISEMENT, ALLOWANCE OR DISALLOWANr.E
~i~:isi~:~~I", 1/120.0601 '" OF DEDUCTIONS AND ASSESSMENT OF TAK DATE 11-07-94
EifTATE~O~=~~Sl'7\NsftEtir,~~"'o-=jjlfROlH -~='=~--'-='-~~=----~=-~"---""-~FfL-E=~NO: =~-~2 r~9-4-il"S5'a~=
DATE OF DEATH 01-16-94 COUNTY CUMBERLAND
t
NOTE, TO INSURE PROPER CREDIT TD YDUR ACCOUNT, SUBMIT THE UPPER PORTION OF TNIS FORM WITH YOUR TAK
PAYMENT TO THE REOISTER OF WilLS, MAKE CIIECK PAYABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT TOI
SHIRLEY L LOVF.
RR 1 BOX 151
NEWPORT
PA 17074
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
t---A';~-':j;;T Ra.i t ted----J
-----,._-~.__._----
----._--..---~-
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
it i!V: i sri; - E if -r. j: p- - [Oij:94 Y -No 'fie r -oF - iNH E it-i TAN-C E" 'fA' x - 'A-PPRA"i S Ei.fENT -, - -r. [rOWAN-C E - oR''''''' -"""" -"" - - - -""
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STANSFIELD DOROTHY FILE NO. 21 94-0558 ACN 101 DATE 11-07-94
TAK RET~,IN WAS, I X I ACCEPTED AS FILED
I CIIANOED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BAS~D ONI ORIGINAL
1. Rill Estate (Sohadulo Al 111
2, Stooks .nd Bonds ISohadulo BI 121
3, Closaly lI.ld stook/P.rtnarshlp Into,'..t ISohadulo CI 131
4, l1odg.gu/Not.s Rlt,iv.bI. I Schldl.ll. OJ (4)
5, Cash/B.nk Daposlts/Mlso, Parson.l Proparty ISohadul. EI 151
6, Jointly Ownad P,'op.rty ISoh.dulo FI 161
7. Trlnlhrs {Schedule OJ 171
8, Tot.l Ass.ts
,00
,00
,DO
,00
4,154,25
.00
,00
181
4,154,25
APPROVED DEDUCTIONS AND EXEMPTIONS:
q, Fun.r.l EXPln.../Adn, COlts/Hlsc. Exp.n... (Sch.dul. H) (9)
10, Dabts/Mortg.ga Llabllltlas/Llans ISoh.dul. II 1101
11, Totol Daduotlons
12, N.t Vslu. of T.x Raturn
13. Ch.rit.b1e/Gov.rnm.nt.l A.qulsts (Sch,dul. J)
l~. Not Valua of Est.ta Subj.ot to Tax
1,069,81
,00
III I
112 I
113 )
11~ I
1 .06Q 81
3,084,(,4
309.00
2,77~
NOTEI
If an assessment was issued proviously, lines 14, lS and/or 1&, 17 8nd 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAXI
15, A.ount of Llna 14 st Spoussl rota 1151
16, A.ount of lln. 14 tsxobla ot lln..l/Closs A r.ta 1161
17, A.cunt of Lln. 14 t.xsbla .t Collatarol/Cl.ss Brat. 1171
18. Prinoip.l rlx D~II
TAX CREDITS I
----
PAYMENT
DATE
06-24-94
,OOK'OO,
2.775,4i K .06,
, 00 K' 15,
1181
,00
166,52
,00
166,52
-RECEIPT ~l -DiSCOUNTCtl---
NUMBER INTEREST 1"1
-""':' 1~~___"
AMOUNT PAID
166:'22' -
INTEREST IS CHARGED FROM 10-17-94 TO 11-15-94
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
TOTAL TAX CREDIT 166;2
1"-"'"'' 'AX'" -~ --~'"
INTEREST ,00
----~-------
TOTAL DUE ,30
--,-_ ____n__
I IF TDTAL DUE IS L~SS THAN 11, ND PAVtlENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,I
: ()
RESERVATION I E.tatu of dec.d.nt. dvlng on or before e,o"bl" 12, lflU -. \f any future lnt.rut' In thl utat. II tranlferrod
In POI.llllon or .njoy~.nt to Clall B (oollat.rall b.nlflcla"111 of the d.c.d.nt ~ft'r thl Ixplratlon of any 'It.t. for
Ilfl or for Yler., the Co~~cnwlftlth hlrlby l~prl'llv rl.lrvl. thl right to appral'l and a..... trenlflr Inh,rltencl TaMI'
lit thl lawful Cia.. B (collateral I rlltl on nny .uoh future Interut.
PURPOSE Of
HOTlCEI 10 fulfill the requlrllllntt of S.ctlon Z140 of thl Inhlrltancl and [Itate taM Act, Aot ZZ of 1991. 7Z P,S,
Slctlon ZI(,O,
PAVHENTI Dltach the top portion of thl. Hotlcl IInd 'ub~lt with your paY~lnt to thl RIgl.tlr of Will, printed on thl rlYlr.e Ildl.
-'Hllke chick or laney order IllIYllble tOI REGISTER OF HILLS, ADENT
All paYlllnt. reo..lv.d .hllll first be IIppllotl to liMY Intlr..t which Ilfty b, due with any rellalnd.r appll.d to the tax.
REFUND ICR)I A refund of II ta~ crldlt, which wu. not rlqUI.ted on thl T~~ Return, ~ay be roque.tld by cOMplltlng an "Appllcatlon
for Rlfund of Penn_vlYnnla InherltllncQ and EHatl Tax" (REV-13!!)' Application. al'l IIYftllabh at the Offlc.
cf tht Reglstlr of Wlll., any of thll Z3 Rllv.nue nlltrlct Offlc,., or by call1n,, thl ,plclal Z4-hcur
an.werlng ..rlllc. nUMber I for fOrllS orderlngl In Plnnlylvnnla 1-&00-36Z-Z050, outside PennlvlvlIllla and
within loctll Ilarrl.burg IItlla (1111 1&7-8094, TDO. (117) nZ-ZZfJZ W.arlng l..palr.d Only),
OBJECTIOHSI Any partv In Int.r..t not .atl'fled with the apprnl'...nt, allowance Ot dl.allowlnol of dlductlon., or a""'II.nt
of tax (IncludIng dllcount or Int.rl.t) a. shewn on thl. Hellel Must objlot wtthln ,I~ty (60) day I of rloltpt of
thlt Not Ie. bYI
--wrJtt.n protut to thl PA Oepnrtll.nt of Rllllnul. Board 0' Appul., OEPT, Z810ZI, tlarrt.burg, PA l11za.l0Z1, OR
".llotlon to halll thl "litter d.hrlllnld at lIudlt of thl account of thl p.rsOnlll rtJl"..ntatlllll OR
.-app.al to thl Orphanl' Court.
AOKIK
IS1RATlYE
CORRECTIONS.
rllotual Irror. dl.col/lr.d on thl. 1I1......nt .hould bl nddre'lld In writing tOI PA D.part.lnt of R.I/lnu.,
Rureau of Indll/ldulIl hUI, ATTNI lIolt ......llInt R.I/tlw Unit, DEPT. Z80601, Ilarrllburg, PA 171Z8-0601
Phon. (11) 787-6fJOfJ. S.. png. j of thl hook lit "tnltruetJonl for Inhllrltanc. rllx Rlturn for a Ruld.nt
Olc.dlnt" (REV-lfJ01) for IIn Ixplanatlon of ndlllnl'trntJI/_lv corr.ctabl. .rror..
DISCOUNT I
If anv tex ~UI II pnld within thr.. 151 cnl.ndl)r Ilonth. oftlr thl dlcld.ntl. death, n flvl perc.nt IS%) dltcount of
the tllM paid I. 1I110Wld.
INTEREST,
Interut II chargltl big Inn Ing with fir. t Clay of d.l tnqulncy, or Illn. (91 "onth. and on. (1) dny frol tht dati of
duth, to thl dati of paYlllnt, Taxu which blcnll. d.llnqu.nt b.fore Jonunry 1, 1982 bur Intlrut at the rlt. of
Ibe (6%) percent per annuli calculated at n dally ,."tI of ,000164. All taxu which b.oa.. dlllnqulnt on and after
January I, 198Z will blar lntera.t at a rat. which will vary frail cat.ndllr Ylar to oal.ndar Vlllr with that rat.
announCld by thl PA OIlPartll.nt of Rel/enuII, The IIppllcnbl. Int.r..t rate. for 1982 through 1994 IIrll
'!!!! Interut Ratl Dally Intlr..t fat tor '(Illr lntlr..' Rate Dally Internt Faotor
198Z ZO% ,0005(.8 1986 10% ,000274
1981 16% ,000438 19~1 9% ,000247
1984 11% ,000.501 198a-lqql 11% .ooom
1985 13% ,OOo.sS6 1992 9% ,000247
19Q5-1994 1% ,00019Z
--Inter..t It oaloulntld no followlI
INTEREST . BALANCE OF TAX UNPAID X NUKSER OF OAYB DELINQUENT X DAILY INTEREBT FACTOR
--Any Hotlo, I..u.d nfter the tax hlCOIlII dlltnqu.nt will r.fllct nn lnt.rut caloulatlon to fHt..n ItSI daYI
blyond the dati IIf thl u......nt, If pllYII.nt II Illldl nHlr thl Intlrolt cOllputatlon dati .hown on th.
Hotlc., addltlon.l Intlr..t IIUlt bl calculat.d,