HomeMy WebLinkAbout94-00565
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cOM~m:iI\~\1roJm1JrobMANIA
HARRIS8 5~~, ~2\~\ 11.01"
pJ -,;WI- '1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COUNTVCODE
r,OfDJ.WA~P DEATNAFlER111f' CHiCK HERE
I'Ov!iiTYCRBDIT IS OLAIMED
FILE NUMBeR o? 1- 9 ..... 5(0 S'
No Letters
REV.UOO EX '11Hl)
I
clb
III
DECEDENT'S NAME ILAST, FIROT, AND MIDDLE INITIAL)
SOBOLEWSKI, MARTHA I,
DECEDENT'S COMPLETE ADDRESS
19 SAN JUAN DRIVE
MECHANICSBURG, PA
RCCfAL SECURITY NUMBEA
407.76.4949
X 1, Orlglnll Return
CUMBERLAND
Da.
Os.
o 4. Umlted Eetlle
o 8, Decedonl Died Teollle
(Anach copy 01 Will)
041,
07.
Future Inlerest Compromloe
(for dalos 01 dealh aher 12-12-82)
Dooodent Malnlalnerll Uvlng T,ust
(AlIlch a copy 01 Trust)
o 8,
c P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE llIRECT1!D TOI
o 0 NAME
R N
R D Robert C, Saidia Ea ,
~ ~ TELEPHONE NUMBER
VEAR
NUMBER
17055
Remalndor Return
(lor dsles 01 dealh prior 1012-13-82)
Federal Eelale Tax
Relurn Requlrod
Total Number 01 Sale Dopa sit Boxes
2109
Carn
COMPLETE MAILINQ ADDRESS 0 "-1
Saidis, Guido, Shuff 60 Maa1and'"
o
C
~
I
T
U
L
A
!
N
(1)
(a)
(3)
(4)
(6)
Market Street
Hill PA 170).1
None
None
None
None
17,380,00
71'1 737-3405
1. Real Estlle (Schedule A)
a, Slocks Ind Bonds (Schadule B)
3, Closely Held Slock/PMnerohlp In'er..' (Soh.dulo C)
4, Mortgages and Note. Rooelvable (Schedule D)
6, Cash, Bank Doposllo & Mlscollaneous Personal Property
(Schodule E)
8, Jointly Owned Proporty (Schodule F)
7. Transfers (Schodule G) (Schedule L)
8, Total Groos As.els (10101 lines 1-7)
V, Funeral Expen.e., Admlnlstrallve Cosl., Mlsoollanoous
Expenses (Schedule H)
10, Deble, Mortgage Uabllltleo, Uon. (Schodulo I)
11. Tolal Doductlons (Iolal IInos 0 & 10)
la, Net Vllue 01 Est.IO (II no 0 mlnu. line 11)
13, ChOlltable and Govorn"",ntal Boqueol. (SchDdulo J)
14. Nel Value Subject to Tax (II no 12 mlnu.llno 13)
16, Amount olllno 14taxlblo 016% role
(Include valueslrom Schedule K or Schodulo M,)
lS, Amount olllno 14lax.ble at 16% ralo
(Include values tram Schodulo K or Schodulo M,)
17, PrinCipal lax duo (Add lax Irom IIno 16 and lrom IIna 16,)
18.Credlts/Sp Poverty Prior Payments Discount
+ + 87,52
18. IllIno 181s grealor Ihan IIno 17, enlor the dllloronco on IIno 19. Thl.Is Iho OVERPAVMENT,
lEI 0 IClMok htrt "you lit requtlUng. rtlund QI your OVtrplIymlltt.I
20. "/lne17 Is grealor Ihan IIna 10, onler the dllloronco on IIno 20. Thl.Is Ihe TAX DUI!,
A, Entor Ihe IntorO$t on Iho balanco duo on /lne 20A.
B, Enter Ihe total of IIno ~O and 20A on IIno 20B, Thl. I. Iho BALANCE DUE,
Makl ChllJk Pa abll to: R 'atar 01 Willa A nt
~ ... Be SURE TO ANSWER ALL QUESTIONB ON PAGE 2 AND TO ReCHECK MATH . .
Undtr plnalll.. 01 p"jury, I d.ollre thai j hlv'lIl.mlll,d thl. "lu'", Including accompanying 'llh.dulu .nd 11'llm,ntl, Ind to lhl bul ot my knowl.d." end bIU",III. truCl,
Cotrftl,nd complttt, I dlcl.,. that ,II 'Ullllllll hu bun rtporlld It lIul mark., v.hl', D'o~,.Uon of pr.p.,., olhlt thIn thl ~.r'on.l rlp,...nt_,lv.l. bu.d on .UlnlormaUcn of
whloh prtp.,,' hu Iny knowledge.
(8)
(7)
19,210.90
Ilone
(V)
7,019,54
(10)
398,60
(16)_
29,172,76
~
8
M
C
f
N
(6)
36 , 590.90
(11)
(la)
(13)
(14)
K .06.
7,418,14
29,172,76
None
29,iT2~
1.750.37
,
(16)
0,00 X.16.
0.00
Inloro.1
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
(17)
1,750.37
(18)
(18)
87.52
0.00
(ao)
( aOA)
( aOD)
1,662,85
0,00
1,662,85
'fl.'Jl,H~.(j,~
AOOnE!! ()
...~ .1. A'v.!,~ i;'/ II~vj.. ;~n'; .s. ............ .......
_...~ ?l~: !"J!'~:/~~f.~.. {.:I-'~,4'..." _.. ~~?.... _~ !.(~:r..J..........................
cJI. t./f L/
SIGNATURE OF PREPARE A OTHER THAN REPAESENTATIVE
DATf.
<:::'........-~
Copyrlghl(o)111111 form loHwtll onlyClnl1l Pilei flollwt", Inc.
ADDRESS
Saidis, Guido, Shuff 60 Maa1and
2i"6<i' i-jarko'i' St.teet.............. .......... ......
Co;np' iiii i ':.PA"'i 7(iii'.' ........ ......... .... ....
DATE
,p~;?'/- 7"f
Fo,m lOOoIR", 11-811
..,. ....'~.....f'..........-.. .r.... ("'_ ",
..... ~ ..' --..-..
, REV. 1I0lEX + 11-111
cOM\'/.~lnm~UMllYAN'A
!STATI! OP
MARTHA I. SOBOLEWSKI SS# 407-76-4949
SCHEDULE F
JOINTL V-OWNED PROPERTY
03/31/94
PiLe NUMBER
No Le tters
Jolnttlnant{I):
A.
NAME
Robert E. Sobolewski
ADDRESS
19 San Juan Drive
Mechanicsburg, PA 17055
RELATIONSHIP TO DeCEDENT
Son
B.
c.
Jolnlly-ownad properly:
LETTl!R DATI!
ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECO'S DOLLAR VALUE OF
NUMBER JOINT Of' ASSET '!'INT. PECEDENTINTeRE&T
Tl!NANT JOINT
DAFCU ACCOUNTS
1 A 02/14/8/1 Savings Acct. #36654-00 117.87 50.00% 58.94
2 A 02/14/84 Checking Acct. #36654.11 4,590.73 50.00% 2,295.37
3 A 01/21/92 Savings Acct. #36654-05 33,713.19 50.00% 16,856.60
- TOTAL (Also enter on line e, Reo.ollulatlonl 19.210.90
(II more space Is needed, Insert addltlonalshee!s of sarm size,)
CoPvrlg"'lo) ,,,, torm IOftWI" only Cent" PIIOI So,twlrl, Ino.
Form 1100 Sohldul. P (Rev, n-II)
'. .
COM~l~4\,W~f>>'ANIA
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pleue Print or T
FILE NUMBER
No Letters
'REV-lOll EX. 11-101
MARTHA I. SOBOLEWSKI
ITEM
NUMBER
A. Funl,.ll!xponlu:
SS# 407.76.4949 03 31 94
DESCRIPTION
AMOUNT
1
Myers Funeral Home, Ino.
4,244.54
B. AdmlnlltrllUvl CoI\l:
1. Pel1lOnll Representetlve ConvrlO1llons
8ocl*1 Security Number of Personll Repr81l8nlatlve:
Yell Convrlsslons paid _
2. Anorney Fees 500.00
3. Family exemption 2,000.00
Clllmant Robert E. Sobolewski Relatlonohlp Son
Address of Cla/mant at decedent's death
Street Address 19 San Juan Drive
city Meohaniosbur~ Stale~ Zip Code 17055
4. Probate Fll88
C. MII~II.nlOuI ExpInl":
1 Register of Wills filing fees 25.00
2 Reserved for futuro debts and taxes 250.00
TOTAL Also enler on line 9, Reoa lIulatlon
(II more epace 10 needed, Insert additional sheels of same olle.)
ClIpy"ght(ClI1U1 form leftw." only C'n'.r Pllet 8otlwlte,lno.
. 7 019.54
Form 1100 SC~'dul. H IA,v, 7....'
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ROBERT E. SOBOLEWSKI
}
UI
being duly _ sworn . acco/dlng to 10wI dOpOIOI and IOYI that he
ioint tenant _ 01 tho Elhte 01 Martha
Upper Allen Township
lote 01 -.--..--..-. '------...-,--..-,. I Cumberlond Counly, Po., d.ecfued and Ihot Ihe
him jo nt tenant
within lIon Invonlory modo by ._" Ihe lold .
ollho onllre OIhle oluld deoedonl, conllsllng 01011 the porlonol prop.~rty ond reol OIlole, except roollltolo outsIde
the Commonwealth 01 Ponnlylvonla, and Ihot the IIgurOl oppollte uoh Itom ollhe Invenlory reprolOnt It'l hlr valuo
01 01 tho dolo 01 doc.donl', doalh. '
is the surviving
---
I. Sobolewski
19
(
, id~0'--f..J..~~
e....,o, . Admlnhl,.to,
Sworn
olld lublcrlbod bolore mo,
94
,Tune 28
19 San Juan Drive
NOTARIAL SEAL
THElMA S, McCAUSLIN, NOlary Public
Camp HIli, Cumberland Counly
MYCOmmisslon Expires July 3,1996
---..
110chanicsburg I PA
Add"..
17055
Dolo 01 Oeoth _
March
..'
1994
O.Y
Month
v..,
INSTRUCTIONS
I. An Inventory must bo flied within threo monlhl ollor appolnlment 01 perlonol rep/uenhllvo.
2. A lupplemont Invonlory mUll be IlIod within thIrty deYI 01 dllcovery of oddltlonololllh.
3. Addlllonol Ihoets may be attaohed os to porlonally or really
4. 500 Arllelo IV, Fiduciaries Acl 011949.
p., .
H
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Ul Ul
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0 ..
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~ ffi " H
1 2 ~ z ~ 00
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;!: ~ 0 ~ i ~
<:)-0 ..J U. III
..J jj 0 ~ ~
I W u. 0 ~
- ~ 0 ~ 0<: Ul ;io .
o Q ~ 6 u
- ~ ~ . ~ ~ ~
0 H p., ~
:z; p.,
0.. ~ :::> "ll ~
c ~
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~ 0 1
" "'ll oW
... 0 0
j t3 if 0
II>
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IHVIITORY or THI RIAL AID PIR80lAL 18TATI or
MARTHA I. SOBOLIWSKI, DICIASID
PERSONAL PROPERTYl
Northwestern Mutual Life
Jewelry
TOTAL
H'I
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annuity'
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,$13,170.00
Jd10.00
. $17,380.00
"
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1.1,
).ICI
REV.1S47 EX AFP (01.94*
CO""O~EALIH OF rENNSVLVANIA
DEPARIHENI OF REVENUE
IUREAU OF INDIVIDUAL TAXES
DEPT. 210601
HARRISIURG, PA 11128.0601
C-
AON 101
NOTICE OF INHERITANCE TAM
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
DATI 11-07-94
FILE NO.
DAT! OF DEATH 03-31-9(; OOUNTV CUMBERLAND
HOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAVHENT TO THE REOISTER OF WILLS, HAKE CHECK PAVABLE TO "REDISTER OF WILLS. AOENT"
REMIT PAVMENT TOI
ROBERT C SAlOIS ESQ
SAlOIS ETAL
2109 MARKET ST
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
i-
AMount ROMlttod
OUT ALONO THIS LINE ~ RIlAIN LOWER PORTION FOR YOUR RECORDS ~
iiiV:is4"7"iiCAiijf.rciii:q?ti*ililYicniF.YNHEiiii'AifcE.TAx.'A.piiRAi9EifiilT~..Ai.rciwAifcE.ijRm.....m ......
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF SOBOLEWSKI MARTHA I FILE NO. 21 94-0565 ACN 101 DATE 11-07-94
APPROVED DEDUCTIONS AND EXEMPTIONS I
t 7.019,54
9, Funorol E.pon.../AdM. Co. ./Hllo. E.pon... (Schodulo II) (9)
10, DobtD/Hortgogo Llobllltl../Llon. (Schodulo I) UO)_ 398,60
11, Totol Doduotion. (11 )
12. Not Voluo of TON Roturn (2)
15. Ch.rltobloIOovornMont.l Boquo.t. (Schodul. J) (15)
14, Not Voluo of E.toto Subjoot tc TON (4)
NOTEI If In 1IIIssmlnt WIS iSluld previously. linls 14, 15 Ind/or 16. 17 Ind 11 will
rlflect figurls that includl the total of ~ rlturns ISSllSld to dltl.
ASSESSMENT OF TAXI
15, AMount of L1no 14 .t Spou.ol r.to US)
1., AMount of Llno 14 t...bl. .t Lln..l/Clo.. A r.to (1.)
17, AMount of Llno 14 to..blo .t Coll.tor.l/Cl... R r.t. (17)
18, Prlnolp.l T.. Duo
TAK RETURN WAS I (X) ACCEPTED AS FILED
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED OHI ORIGINAL
1, R..l E.t.t. (Schodulo A)
2, Stock. .nd Bcnd. (Schodulo D)
S. Clo.oly Hold Stock/Portnorohlp Int.r..t (Schodul. C)
4, Hortg.go./Not.o Rooolvoblo (Sohodulo D)
5, C.oh/Donk Dopo.lt./HI.c, Por.onol Proporty (Schodulo E)
.. JointlY Ownod Proporty (S.h.dulo F)
7. Tr.nofor. (Schodulo 0)
B. Tot.l A...t.
TAX CREDITS I
PAVHENT
DATE
06-29-94
RECEIPT
NUHDER
MM886232
DISCOUNT (+)
INTEREST (0)
87,52
( ) CHANOED
U)
(2)
m_
(4)
(5)
(.)
m
, ilL
,DO
.00
,00
17,380,00
19.210,90
.00
(D)
36,590,90
7.41 A 14
29,172.76
.00
29,172.76
,00 K' 0 O.
29,172,76 M' 06.
,00M.15.
(8)
,00
1,750,37
,00
1,750,37
AHOUNT PAID
1,662,85
TOTAL TAX OREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1.750,37
,00
,00
,00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL 1NTEREST,
IF TOTAL DUE IS LESS THAN 81, NO PAVHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAV BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
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RESERVATIONl Eltl'" of dlCtdtnt. dy!nt on or blfar. Dlc.lb.r 12, 19'2 ~~ If 'ny future Int.r..t In thl I.tlt. ,. trln.flrred
In pall,.,lon or .nJoy..nt to Cl,.. B (call,t,r.l) bln,flol,rt.. of the dlCtalnt after thl IMplratlon 0' ,ny I.t.t. 'or
11'. or for v..r., the Co.~nw..lth hereby IMPr...lv r...rve. the rtght to appral.. Ind "'1'1 tran".r Jnn.rlleno. TaMI.
at the llwful el,.. B (col1,t.rel) rtt. on any lueh future Int.r..t.
PURPOSE OF
NOTICE I To fulfl11 Uti requlr...nt. 0' Slotlon lUO 0' the InherltlncI and E,t,t, TalC Act, Act ZZ of 1991. 12 P.S.
SloHon 2140.
PAVNENTI O,tleh the top portion 0' thl, Notloe and lubllt with your pIYI.nt to the Rlgl,',r of Will, printed on the r.v.r.. lid"
--H,ke chick or 'onl~ ard.r P,~.bll tal REGISTER OF' HILLS, AGENT
All p'~"nt. rlcllvld .h'll fJr.t bl appll.d to Bnv Int.rest which .,y b. due wl~h any r"'lndtr appll.d to the tlM.
REFUND ICRJI A r.fund of I tlM credit, which WI' not r,qu.,t.d on the TaM Rlturn, ..y b. rlqul.t'd by calplltlng an "Applloltion
for Rlfund of ~.nnsYIYani. Inh.rltanc. Ind E,t,t. TaM" (REY~1313). AppllcltlanM ar. ovallabl, .t th, Offlc.
of tht Rlgl.tlr of Will., Iny of the 23 Rlvlnul Ol.trlct Off Ie.., or by ollllng the .p.oIRI 24~hour
an,wlrlng ..rvlo. nUtblr, for fori' ordlrlngl In Plnns~lv'nla l~aOO~162.20'0, out.ldl PlnnsYlvanla end
within 100.1 H,rrl'burg ar.. (717) 787~8094j TOOl (717) 772~22S2 (H.arlng I.palr'd Onl~).
OBJECTIONS, Any p.rty In Intlrtlt not s.thfled with the apprllt..,nt, allewlno. or dltallowancl of d.ductlon., or ........nt
of taM (Including discount or Int.r.,t) .. thawn on thl, Notlc. IU.t obJlat within IIMty (60) diY' of rlc.lpt of
thh Notlcl bYI
AIltlIN
UTRATlVE
CORRECTIONS.
"wrlttln protut to the PA O.part..nt of Rlvlnu., Baird of ApPllh, DEPT. 281021, Herrlsburg, PA 1712e~1021, OR
..Itlotlon to hlv. the .att.r d.t.r.lnld at audit of the account of the plrsanal r.pr..lnt.tlv., OR
~.,p~lal to thl Orphan,' Court.
Faotual arrar. dl.covlr.d on thl' ..s.....nt shOuld b. .ddr....d In writing tal PA D.p.rt'.nt of'R,vlnul.
Bur.au of Individual TlMU, ATTNI Po,t A..CI....nt R.vllw Unit, DEPT. 280601, Harrisburg, PA 1712a~0601
Phonl (711) 7'7-6&05. S.I pagl 3 of th. baakllt "In.truotlon. for Inherlt.nce TaM R.turn for. Ruldlnt
D.cld.nt" (REY.1501) for an 'Mplan.tlon of Id.lnlltratlvlly corr.c\,bll Irror..
OISCOUNll
If .ny tlx due It p,ld wlthjn threlll (3) calendlr .cnth. aft". thl d.cldlnt't duth, , flv. perc.nt (Sin dltaou"t of
thl taM paid I. allowld.
INTEREST.
Inter..t It ch.rg.d b.glnnlng with lil,.t day of d.lInqu.ncy, or nln. (9) lIonthl and ani (1) day frol thl date af
duth, to th. d.tl of PlYllnt. fllMU which b.e'.1 dlllnqu.nt blfore January 1, 1982 bltr Illtsrut .. thl rat. of
IlK (6X) p.rc.nt per annot calaulatld .t I dillY r.t. of .OOOI6~. All tax.. which blca.1 d.llnqulnt on and .ftlr
Janulry 1, 1912 will b..r Int.r..t .t I rat, which will v.ry fro. c.l.nd.r Yllr to c.llndlr y.ar with that rat.
Innounc.d by thl pA Dlpart.ent of A.v.nul, Th, .ppllcabl. Intlr..t r.t.. for 1982 through 199~ .r..
!!!!; Inter..t A.t. O.ih Int"tlt Factur !!!r Inter..t Ratl DIlly Intertlt Faator
I'IZ lOX ,000541 I.ao lOX .000Z74
1's! lOX .DOO4U l.a7 'X ,000147
1.14 m ,000501 1'81-1991 m .00010\
1.15 m ,000150 I99Z 9~ .000147
1991-1994 n ,00019Z
ulnter'lt I. calculat.d a. fOllow'l
INTEREST' BALANCE Of' TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Notlc. IlIuld .fter thl t'l( blao.u dlllnqulnt will reU.at an lnt"...t celculItlon to Ultlln (15) diY'
blYond thl d.tl of thl ........nt. If ply..nt I, ..dl Ifter thl Int.r..t co.put.tlon date .hown on thl
HOtlCI, .ddltlonll Intll'ut 'Ult bl aalaul.ted,