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HomeMy WebLinkAbout95-00467 I.f' . (jO' 3 - INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS .\lV. IlOOt:lC .(1-141 Hi II COlA~mr,~m~\(lrorM'IT~~.NI. UAnmIlH5ftb,~'.n~".-. 060' I OECIO!HI" HAue (LAS', ''"81. AND lrAlDOLE INllIAlI Kolr Mar SOCIAL ncunlfVHUUOlln DAlE OF DEATH 217.30.1131 03/16/1995 DAlE OF DlAfH 0/,/19/1912 Coun (IF APPlICAOlf') SURVIVING Elf'OUIII!:'S HAUl! (LASI ,FIRST AND MIDDLE INITIAL) I. O,lglnal ",'uIII 4. L1m1t.d EIIOI. I ~ i N ~ & M C I N SIGNATUnE OF PERSON RESPONSIBLE FOR FILING RETURN FOR OATES OF DEATH AFTER lV~1I9' CHECK HERE IF A SPOUSAL FILE NUMBER 21-95- 4(,.'7 YEAR NUMBER 2. SuppIo""'nlol R.lurn 4.. Futur. IntereSI Compromise liar dOl" 0' d.olh an., 12-12-82) D I, elced,nt DI.d T..tale D 7. O,cldent Maintained a Living Trust IAlloch co 01 Will) IAlloch 0 co 01 Tru't) ALL CORRISPONDINCI AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: HAM I! COUPLETE UAlLlNG ADDRESS Ro Dr II. Irwin IRIIIN, McKNIGHT & HUGHES U~EPHONE NUlAOEn 60 lIest Pomfret Street 717.249.2353 Garlisle PA 17013 I. ROIl EIIOI.15ch.duI0 Al I None Z. Slacks ond Bond.ISch.dul. B) (2) None 3. CIo..ly H.ld SlocklPonn."hlp Inl.,..1 (Sch.dul. CI (3) None 4. Monoao.. and NOI" R.c.I..bl. (Schedule D) (4) None 6. Cnh. Bank D,poln. & Mlac.llaneous P.rsonal Properly (Sch. EI (5) 8 ,347.65 6. Jolnlly Own.d Prop.ny (Sch.dul. F) (6) 14,808.54 7. Tronl"" (Schodul. GlISch.dule L) (7) None I. Total Gro.. A...la (tolal Lln.. 1-71 I. Fun.ral EJlp.nl.l, Admlnlstrallvl COlt.. Miscellaneous E,penl..ISch.dule H) 10. D.btl. MOlIoage Llabllltle.. Lion. (Sch.dul.U It. Tolol D.ducllon. (total Lines 9 & 10) 12. N.I Volu. 01 Ellal. (Line 8 minus Line 11) 13. Charltabl. and GOY'fOrnlnlal B.quests (Schedule J) 14. Nil Value Sub .cllo Tax (line 12 minus line 13) 15. Spousol Tr.nslo" liar dol.. 0' d.ath an.r 6-JO-94) St. Instructions lor Applicablo Percentaee on page 2. IInclud. .alu.. from Sch.dul. K or Sch.dul. M.) 15. Amount 0' Llno 14 t..abl. 016% rala (Include values hom Schedule K or Schedulo M,) 17. Amounl allln. 141axablo allS'/. ,ate (Include values from Schodule K or Sch.dulo M.) 16. Principal la' duelAdd t.. frorn Llno 15. 16 .nd 17.) 18. Credits/Sp Povorty Prior Payments Discount Interest 0.00. 0.00 . Ill, .1/, 0.00 20. II Lln. 191s gr.al" than Lln. 18. .nt.r Ihe dlll.renc. on LIn. 20. Thl,l'lha OVERPAYMENT. [!J 0 IChlck hI" I' you art reque.tlng a refund d. your overpayment.l 21. II L1n. 181. g,ool.r lhan Lln. 19. anle' Iha dlff.r.nca on Line 21. Thlsl,lha TAX DUE. A. Enl., thelnl'fest on the balance due on Line 21A. B. Enlo' th.lolol of Llno 21 and 21A on Lln. 21B. This I.tha BALANCE DUE. Moke Check pe oblolo: Re lale, 01 Willa. A enl ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH . . .,peOl ..0 pelUf)'. ~Ir' I I""'.. t .,.lurn,1'lC nglCCOmplnyngiIC un. .1.1.~nll.' lot. ato"", now ga. 10 I I ,true, ,errKI.OO compl.le, deel.,.Ihalall ,..1..1.11 hi' been r.ported'l In.. 1M'." valUII. Declaration of prepar.' othe, Ihln the personal ,apr.sentatlvels based on alllnfoflNUon of which pt'P"" hlt'"1 knowledOI. R. COUNTY CODE DECEDEHT'S COI.lPLETE ADDRESS 1000 lIest South Street Garlisle, PA 17013 Cumberland SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) 0.00 Remainder Return (10' dOl" 0' d.ath prlo, 10 12-13-82) Federal Estate TaliC Return Required Total Number of Safe Deposit Boxes 05. o 8. (8) 23,156.19 (9) 7,844.50 (10) 93.42 (11) (12) (13) (14) 7,937.92 15,218.27 None 15 218.27 (15)_ 0.00 x 0.00 = (16) (0.00)< .06 = 0.00 (17) 15,218.27 X .15 = 2,282.74 (1 B) 2,282.74 (19) (20) 114.1/, 0.00 (21) (21A) (2IB) 2,168.60 0.00 2,168.60 DATE r,(IV!ftf" DATE ,,!ti!f':f" Form 1500 (Rav. 7-904) ,/ '--. /. , ~. /,. -' . '1~' 2189 Newville Road Ciiriis-ie---PA---i70:cj----------------------------- IRIIIN, McKNIGHT & HUGHES 6Cj - Wes-': - Pc;mfr,;': - S;;r.;et-, - -C~ j.-i i~:C';; - P-A - i -''-6 i j- "" - - (J <h :I)~ ',J ,;;~ IS'\ 'I).. M Co. ~tf :.: '~ 0- \,) ":, -.., '. . ~! e .. '1':' Hr _.' 'E 1..., . 0'51-'" fG~' a: -\0 ~ ._._._~ - -~., .i,' _.'_'l~~> ..::E .!!?::I UU " . j"'~ . '>'1 r., Act 141 011l1M provide. lor the reduction 01 the tax rates Imposed on the net value 01 transfers to or lor the u.e 01 the 'POUII. The ral.. as prescribed by the statute will be: .3% (.03) will be applicable lor estates 01 decedents dying on or alter 7/1/94 and before 1/1/96 .n. (.02) will be applicable lor e.tates of decedents dying on or alter 1/1/96 and belore 1/1/97 .1% (.01) will be applicable lor estales 01 decedents dying on or alter 1/1/97 and before 1/1/98 .Spou.altran.le,. occurring on or alter 1/1/98 will be exempt Irom Inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS. YES NO I. Did doced.n1 make a trlnsle, end: .. t.lllnlho UI.O' Income ollhopropertytrlnsl.rred,. . .. . . .. . ........... . .. . . . . . . ....... ~. ,.laln lhe ,Ight 10 daslgnal. who shon u,. Iho p,operty trenslorred a' Us Income. . . . . . . . . . . . . . . . . . . . . . Co ,etaln. revarsbnary interest; or , , , . , . , . , , . . . . , . , . , , , , , . , , , . , , , , , . . , , . . , . , . , , , d. 'ocllvelho proml.. 10' IU. 01 eltho'peymonts, benofl1So,ca..? .. ....... . . ... ........ . ...... L II duth occurred on 0' bllorl Dlclmile, 12. 1982. did decldont wllhln two YOI... preceding d.ath Irlnal., prop.rty without ,oc.lvlng adoqual' conslde,"llon? II dealh occurred an.r Decemiler 12. 1882. did doc.dlnl t,ans'" property wllhln ana y.a, 01 deeth without ,ecolvlng ed.qulle conlld.rellon? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Dlddlc.dontownen1ntrustfo'.bankaccounlathl.o'ho'doath?............................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. eopy,tghl(c) 1114 formlO,tw.,.ontycpSyalems,lnc. x x X X X X J ~: .~~-Ol'I.......~to.~J:.ti~"''''''.''_."''''' -'-", Form 1500 In... 7.14) REV - 15011!X + (2-17) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or T . FILE NUMBER 21-95- COlAtf.m~gMbY.HI. ESTATE OF Mary R. Keir SS(} 217.30-1131 03/16/1995 (All ro 0 ITEM NUMBER 1 oln owned whh RI hi 01 Survlvorohl mUll be dloeloled on Sehedulo F) DESCRIPTION VALUE AT DATE OF DEATH 6,675.53 Farmers Truet Company, burial truet savings account (}1-421213 2 Gash on hand 5.00 3 AARP Group Health Insurance, prescription refund 16.52 4 Sarah A. Todd Memorial Home, resident refund #237100336 1,650.60 TOTAL (A1,0 onle, on Iino 5. Rece kulatlon) (AUlch addltlonal8 112- x 11' shools H more 'pice Is nood.d.) Copyrfght(c) 1114 form ~ftw.,. Dnty CPSyatMII,Inc:. S 8 347.65 Form 1500 Schod,le E (RoY.Z-17) ~1IfW~~_""""''''''_.',>.ri'''''''''~~~~_~~",,,,"__''',;.m.-.........,....._...: REV -lsOlE)( + 112.111 COlA.~~,WbYANI. ESTATE OP Mary R. Keir SSO 217-30-1131 Joint Itnant{o): SCHEDULE F JOINTLY-OWNED PROPERTY 03/16/1995 FILE NUMBER 21-95- A. NAME Helen F. McDermond ADDRESS 2189 Newville Road Carlisle, PA 17013 RELATIONSHIP TO DECEDENT B lstar B. C. Jointly-owned proporty. ITEM LETTER DATE TOTAL VALUE DECD'S DOLLAR VALUE OF FOR MADE DESCRIPTION OF PROPERTY NUMBER JOINT OF ASSET % INT. PECEDENTINTEREST TENANT JOINT 1 A 01/95 Farmers Trust Gompany, 10,063.38 50.00% 5,031.69 Gartificate of Deposit 0109180 (rollover) 2 A 10/94 Dauphin Deposit Bank & Trus' 7,215.48 50.007: 3,607.74 Gompany, Certificate of Deposit 0810479895 (information notice attached) opened with funds from join accounts held at Farmers Trust Gompany 3 A 08/91 Farmers Trust Gompany, 12,338.21 50.007: 6,169.11 checking account 011-19109 TOTAL (Also onl.. on Iin. &. R.ceo~ulatlon) Is 14 808.54 (If mort 'plcols n..ded.lnson odditlonalsho... 0' some slz..) Copy,lght (c) '"4 'otm so'tw.t. only CPS)'II'mI,lne. Form 1500 S,_.... F (n... 12-11) "'~"'".,_""'~"".#'i. .-.",_.'...,.. '-""~:"i".-k:";'",.".""{,,,:,,: REV.. 1111 EX . (7-&8) SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pl.... P,lnt or . FILE NUMBER 21-95- COlAI111m~g,WbY.NI. ESTATE OF Mar R. ITEM NUMBER A. SS 217-30-1131 03 16 1995 DESCRIPTION AMOUNT Keir Funeral Exp.n...' Ewing Brothers Funeral Home 6,674.50 1 2 Ewing Brothers, hairdreseer fee 25.00 B. Admlnl.tr.tlv. Co.tot I. P.rsonal R.p....ntaUv. Convn/s,lon. 0.00 Social Socu,hy Numb., 0' P.rsonal R'p..51ntaUva: Yae, Convnl..lons p.ld wal ved Z. AIlomoy F... IRWIN MCKNIGHT & HUGHES 1,120.00 3. Family lx.mpUon 0.00 ClallTlllnl none R.I.lIonshlp Add,... 01 ClallTlllnt et d.c.d.nt'. daalh Street Address Chy Stale Zip Cod. 4. Probal. F... 0.00 C. MllceUlnaou. Exp.n"'l 1 Register of lIills, filing 25.00 fees TOTAL IAl.o .nl., on IIn. 9. R.c. hulallonl (II more .p.c. I. needed, In..rt .ddltlonal .hHto 01 10m. .,1..) Copyrlghl (c) 1"" fDlm aoflwar. ani)' CPS)'lltmS,lnc. S 7 844.50 Form lSOO..h...... H(R... '-18) 2 3 Care Apothecary, balance due 30.07 REV.. "'Z EX. (1..IJI COlAl1.\f.~{\'V~"~JbYANIA SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pl.... Prlnl 01 e FILE NUMBER 21-95- ESTATE OP Mary R. Ko1r SSfI 217-30-1131 03/16/1995 ITEM NUMBER 1 DESCRIPTION AMOUNT 42.00 Carlisle Hospital, balance due Carlisle Imaging Asaociates, balance due 21. 35 TOTAL (Also ont.r on line 10, R.ce kulaUon) 1II more 'p.c.is "..d.d, Ins.rt edditlo""lshools 01.."", .Iz..) Cop'frtght Ie) 1114 'Ofmaaftwue only CPSyat..., Inc. $ 93.42 Farm 1l5OO SChedul.I(.....1-I.} REV - 1111 EX. (1.111 CO".~W~""A ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER 21-95- Mar R. Keir ITEM NUMBER ss 217-30-1131 03 16 1995 AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 1 A. TaKAble BaquII\I: Helen F. McDermond 2189 Newville Road Carlisle, PA 17013 aiater 100X. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Chorl1able and Govommenlal Boquests. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also .nto, on line 13. Roca lIula~onl (If more opacols naodod, Inoort additlonaloh.olS of sa"'" 0110.) Copyrlghl (c) 1"4 'ann ICIl1wat. DnIy CPSyst.ms,lnc. $ Fo<m 1500 S.h..... J (ROY. .-an 0.00 . .. " . FARMERS TRUST Ole ~sl High Sired P.Q Box 220 Carlislc,l'clUlsylvania 170U llll~ Data May 11, 1995 Irwin McKnight & HU9hes 60 W. Pomfret St. Carlisle, Ph 17013-3222 RI: Eslatl oC. Oltl oC Death Mary R. Keir 3/16/95 217-30-1131 Olar Rn9"r n. Irwin In answer to your request concerning accounu ownld, Ilthlr IIplratlly or Jointly, by the aboye rererenced decldent and thl ballncl In each account... oC thl dill of death, WI hive chIc kId our records and are submllllng thl CoUowlng InConnatlon In dupUcltl. WI suggest thlt you CUe onl DC these 11111111 IlIlchld to thl Pennsylyanll Inven. tory Corms (RCCl to substantiate the balancl you rlport. Notl that we hlYI shown the correct rlglstratlon Cor each IccounL Also, Intlrnt acoruld to thl dltl DC death, If any, Is IIstld as a "parltl figurl. Vlry truly YOUI1l, ~~~I Doris Goodhart CD/IRII dept. Certificate of deposit 109180 waa opened 1/31/95. Tho value as of 3/16/95 was $10,063.38. The reportable 1099 interest to 000 was $63.38. The certificate is re9istered to Mary R. Keir Dr lIelen F. McDermond. . . .' . FARMERS ~ TRUST ~ May 5, 1995 ROller B. Irwin IrwIn, McKnlllht & HUllhes 60 W. Pomfret Street CarlIsle, PA 17013 Re: EstBte of Mary R. Kelr SSN 217-30-1131 Date of Death: March 16, 1995 Dear Mr. IrwIn: In answer to your request concernlnll accounts owned, eIther separately or JoIntly, by the above referenced decedent and the balance In each account as of the date of death, we have checked our records and are submlttinll the followlnll Information In duplIcate. We sUllllest that you fIle one of these letters attached to the PennsylvanIa Inventory forms (RCC) to substantiate the balance you report. Note that we have shown the correct relllstratlon for each account. Also, Interest accrued to the date of death, if any, Is listed as a separate flllure. Checklnll account 1111-19109 was orlllinally opened 08/26/91. The account is titled Mary R. Keir or Helen F. McDermond. The baiance as of 03/16/95 was $12,309.50 plus accrued interest $28.71 for a total of $12,338.21. The account Is a NOW account and was earnlne 2.10% Interest at the time of her death. Savlnlls account II 1-421213 was orlllinally opened 03/14/95. The account is titled Mary R. Keir Farmers Trust BurIal. The balance as of 03/16/95 was $6,674.50 plus accrued Interest of $1.03 for a total of $6,675.53. The account Is an Irrevocable Burlai Passbook account and was earnlnll 2.80% interest at the time of her death. Sincerely, ~~ Laura Roth Customer ServIce One WL'St High Street P.O. !lox 220 Carlisle, Pennsylvania 17013 (717) 243-3212 QEV-1S43 EX AFP (8094)_ COHHOHWUl TIt Of PtHHSYlYlHlA D[PAATH[HT Of REvtMJE IURUU Of INDIVIDUAL run O(PT. laUD' tfARRlS.URa, Pi l1UI-D6Dl INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE ND.21 95125654 D6-01-95 TYPE OF ACCOUNT ~ SAVINas CHECKINa TRUST CERTIFICATE REHIT PAYHENT AND FDRHS TO, REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17D13 ESTATE OF MARY R KEIR 5.5. NO. 847-00-6123 DATE OF DEATH 03-16-95 COUNTY CUMBERLAND WW HELEN F MCDERMDND 2189 NEWVILLE RD CARLISLE PA 17013 DAUPHIN DEPOSIT UK & T h.. provided ttll;' Deput.'nt with the lnfor..Uon lI.ted balow which h.. b..n u..d In ulcuhtlnll the patentl8. t.. due. Thel,. ,.acord. Indlcet. that at the d..th of the above d'c~nt, YOU ...r. a Joint owner/benaflclary of thl, account. If you '..1 thl. Infor.'tlon I, IncQrract, pl.... obtain wrItten correctIon fro. thl flnancl.. inltltutlon, ,ttech . copy to thl. for. WMI r.twlu Jt te thl .~~w. .ddr.... Thl. 'tf"('N",t h t..abl, 'n eCCOrdNW:8 with the Inh,rltane. TI. ll... of thl COIIRnW..lth of P"""vlvanl., Due.tlons "V ba en.w.rad by calling (711) 787.8527. COMPLETE PART 1 BELOW W . W SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8100479895 Det. 10-24-94 E.t.bU.h.d Account Salanc. P.rc.nt T.xabl. A.ount Subject to rax R.ta Pot.ntial Tax Du. To In.ure propar cradlt to ~our account, two (2) copla. of thl. not lea .u.t 8Ccoapany your paY..nt to the Ragl.tar of Willa. Haka chack p.yable to, "Raglster of Willi, Allent... x 7.215.48 10D.00 7.215.48 .15 I,D82.32 NOTE, If ta. pay..nt. ara .ad. within thr.. ()) .ontha of the decadent.a data of da.th, ~ou .ay daduct . 5X dl.count of the taM du.. Any Inharltanc. taM du. will baca.a dallnquent nlna C,) .onth. .ftar the data of daath. T.. K PART m TAXPAYER RESPONSE FAILUA!i.TO. R!SPOND .WILL . RESULT.. IN AN OFFICIAL TAX ASSESSNENT BASED. ON THIS. NOTIC!. [CHECK ] ONE BLOCK ONLY A. c:J Tha .bov. Infor.atlon and taM due I. corract. I. You .ay choo.a to raalt pay..nt to tha Ralll.tar of WillI with two copla. of thla not Ie. to obt.ln a dl.count or avoid Intar..t, or YOU .ay chack box "A- and r.turn thl. notlc. to the R.gllt.r of WillI and an official .......ant will b. I..uad by the PA Dapart.ent of Ravenu.. I. c:J The above ....t ha. baan or will b. reportad and taM paid with the P.nn.ylvanla Inh.rltanca T.. r.turn to b. fllad by tha dacadent'. rapra.ant.tlva. c. 0 Th. abova Infor..tlon It Incorr.ct and/o~abh and daductlon. war. paid by yOU. You .ult coapl.t. PART [!J and/or PART ~ below. If you indicat. a diff.r.nt tax rat., pl.... .tat. your r.lationship to d.c.d.ntl PART l!l l'AX RI!TURN - CUl'IPU rATION LINE 1. Oat. E.t.bli.h.d 2. Account Salanc. 3. Parcant Tax.bla 4. A.ount Subj.ct to T.x 5. D.bt. and Daduction. 6. ABOunt Taxabl. 7. Tax Rat. 8. Tax Due OFFICIAL USE ONLY DAAF! PA DEPARTMENT OF REVENUE . OF 1 2 3 K 4 5 6 7 X 8 TAX ON ~OINT;T~U~i ACCC~HiS PAD 1 3 4 5 6 7. 8 CLAIMED PART [!] DATE DE8TS AND DEDUCTIONS PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL CEnta... on Lin. 5 of Tax Conput.tJon) I . Und.r p.naltt.. of p.rjury, I d.clare that the fact. I conplat. to the b..t of ny knowledge and balief. haya raportad above are tru., corr.ot and HOME ( WORK ( TELEPHONE TAXPAYER SIGNATURE .. GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with IPPllubla Intarut b.,ed on Infor.atlon .w.lttad bV tM flnMMllal Inltl.ullon. z. l~tltPnC' t.. bec~' delinquent nine ~th. .fta,. the dec~t" dlt. of d.,th. J. A Joint account I. tallMJI. IY'" though tM decadento, ,... .... IKkSIld .1 . ..Ua,. 0' conv."I~.. 4. AccOU"Its UncJuctlna tho.. held bet...." hutbMd wMt ..Ua) which the d.ced..... put In Joint n.... within one 'U'" pdot to ~.th It. fullv 'I..baa .. tten.fa,.l. 5. lecount. .,t.ttUIhed JolnUr bet...." hutbMd end ..U. Hr. ~ OM n.t prlot to d..th at' not 'Iubl_. 6. Account. held by . d4c~t ~In trutt for" ~ther at other. ar. 'lllMlI. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. BLOCK A .. If tM Infor..tlon w.d COllPUtlUon In the notice at. correct end deduction. In not tMilntl clllled, pllce .... ..... In block "'" 0' P.tt 1 of the "'I.plv.r R.,pon,," ..ctlon. Sian two cDPI.. ~ ,ubalt thea with rOUt check for thl .-aunt af tax ta the AIglltl~ af Willi af the county Indlcat.d. The PA a.p.rt-.nt af A.venu. will I..ue en afflcl.1 ......aent CFor. REV~I~1 EXJ upon ~,cllpt of the r.turn froe the A,gllt.~ of Will.. r. BLOCK I _ If the ....t .peclfled on thl, notlc. hi' b.an o~ will b. rlportld .nd t.. p.ld with the P.nn.ylvanl. InhI~ltanc' Tax A.turn flled by tPM; dIcldlnt". rlPrUlnt.Uvl, plac. In .... In block to... of P.rt I of thl "TIll:paVl~ A..pon.... ..oUon. Sign OM copy end r.turn to the PA Daplrt.ant of Rav~, lurlau of Indlvldull Tlxa., Dlpt 210601, Hlrrl.burg, PA 171ZI~06ol In ~ anvllope provided. S. IlOCK C _ If thl noUce Infor..tlon I. Incorrect ancIJo~ d..tuctlona Irl bllng elll.ed, chKk black ..COO end coapllll Plrt. rendS according to thl In.truatlon. bllow. ~Ign two coplal end 1~lt th.. with your check for tho a.ount of tax payabla to the R.gllt.r of Will, of the county Indlc.t.d. Thl PA DIPartaent of R.v~ will la.u. an offlcl.l a,I.II..nt (For. REV~IS~I EXJ upon r.c.lpt of thl r.turn fros the A.gl.tlr of Will.. TAX RETURN - PART Z - TAX COMPUTATION LIIE I. Ent.r thl d.t. the eccount orlglnlllY W'I ..tlblllhld or tltlld In thl .snne~ ..I.tlng .t dlt. of death. NOTEI Fo~' decedent dying Ift.r 121121121 Account. which thl d.c.dent put In Joint n.... within OM (1) v..r of d'lth .r. ts.llbl. fully.. tr....".r.. UOWIV'~, tMn II an 'Il:clullon not to nClld U,ooa pI~ trln"lr.. rlg.~dll" of thl v.lu. of the eccount or the f1UM)e~ of KCounts held. If I daubll l.tl~llk (..J appl.r. blfar. your flr.t n... In thl addr... portion of thl. notlcl, the '5,000 I.clu.lon IlnlMfv h.. bHn deducted fr. the eccount bllanc:1 II nportlMl by thl flnenel.1 In.tltutlon. Z. Entl~ the totll bllanc. of thl ICc~t Includlna Intar.st ItCcrUICI to the dIIt. of delth. S. The percent of thl .ccount thlt I. t.ll:lble for .ach lurvlva~ II det.r.lned .1 followll A. The perclnt ta.abll fo~ Joint 111.t. ..tIb11.h.d .or. then one vI.r prlo~ to the dleldent". dllthl 1 DIVIDED IV TOTAL NUttIER OF JOIKTOWNEAS Ex.-pll' A Joint ....t r.gl.t.r.d DIVIDED IV TOTAl NUttiER OF X 100 . PEACEHT TAXAllE SURVIVING JOINT DWhOS In thl nUl of the d.cedent and tlfO oth.r parlon.. I DIVIDED IV S (JOINT OWHERSJ DIVIDED IY Z (SURVIVORSJ . .167 X IDD . 16.7% CTAXABLE FDA EACH SURVIVOR) I. The parcent taxlbl. fo~ ....t. cr..ted within on. VI., of the dlCed,"t"' dl.th a~ .ecounts owned by thl d.cedent but held In trust fo~ If1Othe~ Indlvldu.HIJ (tru.t ben.Uchrln" 1 DIVIDED IV TOTAL HOHlER OF SURVIVING JOINT OWNERS DR TRUST IENEFICIARIES [.1IP1II Joint .ccount r.gl.t.r.d In the ne.. of the d~.dant and tva ather p.rlon. and a.t.bll~d within one v.a~ of dlath by the d.c.dent. 1 DIVIDED IY Z (SURVIVORSJ . .50 X 100 . soX (TAXABLE FDA EACH SURVIVORJ X 100 . PERCENT TAXABLE I 4. Th. eaount .ubJ~t to taM Cline ~) II dat.r.ln.d by ,ultlplvlng the account balanc. (line Z) by thl p.re.nt tl.lbl. (line 5J. S. Ent.~ the tat.1 of thl debt. and deduction. II.t.d In Part 5. 6. ThI.-aunt tlMabl. (Isne 61 I. d.t.r.lned by .ubtr~tlng the d.bt. and d~tlon. (line 5J fro. thl .-aunt lubJect to t.. (lln. ~I. 7. Ent.r the .pprop~l.t. tlM r.t. (line 7) a. dlt.relned b.low. , I , ., A. For d.t., of d..th occurring .ftlr 6/50/94, the t.M r.t.. for tran.f.re to IpOUII' Ir. II follow.. 1. Dltl' of d.ath on or Ift.r 7/1/94 and b.for. 1/1/96 thl r.t. I. SX. Z. Dlt.. of d..th on or .ft.r 1/1/96 and b.for. 1/1/97 the rlt. II tX. 5. D.t.. of de.th on or .ft.r 1/1/97 and b.for. 1/1/91 thl rlt. II IX. ~. D.t.. of dllth on or .fter 1/1/91 trenlf.r. to lpoull' will b. ...-pt fro. tl.. Notll Far dat.1 of delth prior to 7/1/9~ trenlf.r. to .pOUI.' .r. t..abl. .t 6X. I. Trlnsfer, to Uneal dllcend."t. Including fathlr, .other, .on, daught.~, grandchlldr.", .on~ln~l..., d~t'r~ln-l..., .tepchlld end their I..u. .re taxlbl. .t 11M p.rcent (,XJ. C. Trenlf.r. to .11 other. Including brother, .I.t.~, unci., .unt, n.phew end nlee. .r. taxable .t fifteen p.rclnt (ISXJ. D. If you change the t.M r.t., pl.... IPlClfV your r.l.tlon.hlp to thl dec.dlnt In the ar'l provldld. The aeount of ta. due (line IJ I. d.tarelned by eultlplvlna thl aeount tlll:abl. (line 6J b>> thl tall: r.t. (line 7). .. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dabt. end d.ductlon. .r. det.r.lned ., follow'l A. You 1...llv Ir. rlSPonllbl. for PI,.ent, o~ the .It.t. .ubJect to adllnl.tratlon by I p.rlORlI r.pr.llnt.tlv. I. Insufflolent to p.y the deductlbl. It.... 8. You IKItu.llv p.ld the dabt. Ift.~ d.lth of thl decadlnt end Cln furnllh proof of p.~t. C. Dlbtl b.lng clal.-d IUlt b. It.allld fully In Part 5. If additional Ipee. I. n..d.d, UI. pl.ln PIPI~ I 1/2" . 11~. Proof of p'v-ant uy be requalted bv the PA Departaent of RIVlnu.. ;.....;.'.;.;........ ... .... ... ....... .... TAXPAVER ASSISTANCE ". ...... '.' . . '.. ...... ." . IFVOU NEED FURTHER INFORMATION OR ASSISTANCE;'CONTACTANV/'/ . .' . REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE .'. .. . .OR CALL THE BUREAU OF INDIVIDUAL TAXES,TAXPAVER INQUIRVUNITIN HARRISBURG AT..(717)787~83Z7. TDD' (717). nZ-Z252 (HEARING IMPAIRED ONLY) _ ~. ~.. '.. 4' j:--- - _. - - --- --- -.- .-. -- _..-.--- -- - ---_.- ... .. _ __. ._.__ _._ __ ._.._ ..__ ._.___ n_ __..__ ___ D A A 047891 COMMONWEALTH OF PENNSYLVANIA NO. DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX .,v-lIn tI I','" ... . . " .. RECEIVED FROM, i ACN ASSESSMENT Ii' CONTROL 1:,1 NUMBER AMOUNl IRWIN ROGER B ESD 60 W POMFRET 8T 101 e~,lbB.bO CARLISLE PA 17013 'OlD "Uf ESTATE INFORMATION, I!:'I FILE NUMBER g 21-1995-0467 m NAME OF DECEDENT (LAST) I] DATE OF PAYMENT m POSTMAR E COUNTY saN 217-30-1131 IFIRST) IMII DATE OF DEATH REMARKS m TOTAL AMOUNT PAID ee,168.60 CW ROGER B IRWIN,EGDUIRE SEAL ,. .;; .' CHECK" 305 RECEIVED BY , 5ioN~T~Rf .' ..' .' REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS ;;;-...---- - - - --..- -- - - -- - --. -.----: ~.,.- --:- - -._.-- ~-~.- - -- - - - ,,- --- _..- -"-"-~--- -~....... - ~-" I " , .... " , J ". '. : -.--.- -~ .. 7-~--- _.:-:-....~A. --'~ '1.._ INVENTORY Estate of: Date of Death: County: Msry R. Keir March 16, 1995 Gumberland ........----...-------...-....-----.-......--.--..-...-.-.............--... Csshl 1 Farmsrs Trust Company, burial trust savings account 111-421213 6,675.53 2 Cash on hand 5.00 3 Sarah A. Todd Memorisl Home, resident refund i!237100336 1,650.60 4 AARP Group Health Insurance, prescription refund 16.52 ..---.....------ Subtotal 8,347.65 Total Inventory 8,347.65 ;~.~. . c.___,.~~..._...,." 0"" .c...... ~ '0. ,'.... In ~~~ ,~ ll.' I) !.1I "'0.; "'1 I':::: CL , ^. ') .... , \Q - '-J ~~ ... ~ d ,. Gj () <1> '" .{.} we: ~ :;: E a: .!O!::> UU -1- "'" >. =.... ; ~ fJ... .: .... --= " .... ~a o' C"l '" '" en CD o o ... Jl ;- <>. o c 3 cr .. ~ ;- ~ ... l;l c ~ ~ ... 1" i:i .... :00 ... . - .. o - ... > m Z e: CO :a ~ 0 o ~ ... ." ." ... ... i! III :a m ... 0 > ... ;;l S z o ~ :00 , ... ~ " .... .... <II .... .. - Z < m Z o ~ ..... - I '" v- I a .. n .. . ~ . !'- '61>6110 I'V "1"I.npl~ 'AI al'II'V"S '1> ~1I"a' '0 AII"uoIJad 0' .. pa~OII1" a'l Alw .,..~. l"uo!lIPPV 'E ..1.... l"uoIIIPP" 10 A...oOSIP 10 '~Ip ~"I~I ul~I!'" plJ!l "'1 ,.nw ~'o,u"uI luawI,ddnl V 't 'a.II"lua..,d" l"uoIJ"d 10 ,uaw,uloddl 'alii ,~'uow "'~I ul~I!'" pam ''I I,nw ~JOIU"uI uv '1 SNOIJ.::lnllJ.SNI ""A 5661 ~'a 91 ~I"O 10 '1"0 'IIUOYi IPJOH ".'pp.., ~661 'tl IsnDnv S1~IdX3 NOISSlwnlXl AW Vd "O~ ON'fl~30Wn~ 'HDnOYOO 31SI1w:1 :1Il0nd AYV10N 'HDnvOMVllO '1 3Nl13nlXlVl' 1V3S 1 vIa CIOll Vd 'iJtslt.10~ POOH attl~aN 681Z ~6l 'OI"I'lUIWPV . 'OI""lIli ')-- ....... ''''-'1/1')// "',..~ . fr.... ',....~I r /,i., (. / 'aw aJOla'l po'!!...'!n, PUI UJOMS . ~'"'P ".'UOPO'op 10 O'"P ,~, 10 .. ani I. 'I"I '.IlIUo..,d.. A'OIUO.ul o~'lo wOIl ~'"a all..ddo ..,nflll 0~1 '"~' PUI 'llul.I~.uuad 10 ~1I""'uowwo:> o~, apI.,no "'""01"0' ,da..a 'alo,.. I'" PUI A....ao,d 10uoIJad o~llI" 10 flul'II"UO) ',uapo.op PIli 10 0'"'" a'!Iua '~'Io x,..,II'iJX;I Pi"i '~I ' -. ....'{ ~'I aplw AJO,ua.ul UI "I ul~Il'" '~I'"~I PUI pa..a..p "Id 'A,uno:> pUII'"'Iwn:> ' ---' -';;fsIPii:i ---- -- 10 ""' .1liJ)I 'H h.1DH 10 ""'"3 0~1 10 Kp1nJiJK3 alj1 Sl I~S ,o~, '~II PUI .a.odop ''''"I 01 flulpJO..1 UJOMS ~Inp flulo,! pUOWJaQJH 'j uatan .- I :n { i ~ aN'f'l1l38Wn::l :10 llNnO::l VINV^''''SNN3d ~O HJ.W3MNOWWO::l / /s- '10.-3 ,'," Co REV-lS47 EX AFP 112-94_ COtvtOHWEAlnt OF PENNSYLVANIA DEPARTHfNr OF REVENUE BUREAU OF INDIVIDUAL T"XES DEPT. tII06Dl IIARAISlURC, PI. I71Za.06DI ACN 101 NOTICE OF INIIERITANCE TAM APPRAISEHENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAM DATE 09-25-95 ESTATE OF FILE ND. DATE OF DEATH 03-16-95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT TNE UPPER PORTION OF THIS FORH WITH YOUR TAM PAYHENT TO THE REOISTER OF WILLS. HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AGENT" REMIT PAYMENT TO: ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A.aunt Ra.1U.d CUT ALDNG THIS LINE .. RETAIN LOWER PORTION FDR YDUR RECDRDS ..... iiEV=is4-j-EX-AFP-rrZ-=94Y-iiiificEuO;;-YNHEiiifi,tiCE-YAX-APPRjiisEii€iiT~--ALi."ciwANcE-ijR-mu_m_mm DISALLDWANCE DF DEDUCTIONS AND ASSESSMENT DF TAX ESTATE DF KEIR MARY R FILE NO. 21 95-0467 ACN 101 DATE 09-25-95 TAM RETURN WAS I I X J ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE DF RETURN BASED DN: ORIGINAL RETURN 1. R..l eat.t. (Schedule A) 11) 2. Stock. and Bonda (Schedul. OJ (2) 3. Clo..ly Hald stock/Partnership Int.r..t (Schedule C) (3) 4. "artg.g../Not.. Receivable (Schedul. DJ (4) 5. C..h/Bank Deposita/Hiec. Personal Property (Sch_dul. EJ IS) 6. Jointly Ownad Property (Schedule F) (6) 1. Tranafars (Schedul. OJ (7) 8. Total A...t. J CHANGED .00 .00 .00 .00 8.347.65 14.808.54 .00 18J 23.156.19 APPROVED DEDUCTIONS AND EXEMPTIONS: 7,844.50 9. Fun.r.l Exp.n.../Ada. Co.t./H1.c. Exp.n... ($ch.dul. H) (9) 10. O.bts/Hortg.g. LiabUiUa./Lian. (Schadul. I) UO) 93.42 11. Total OaducUon. (11) 12. Hat Valua of Tax Raturn (12) 13. Charitabl./Govarnllanbl Oaquaat. (Schaduh J) (13) 14. Hat Valua of E.t.ta $ubjact to Tax (14) NDTE: I~ an assessment was issued previously, linas 14, IS and/or 16, 17 and 18 reflect figures that include the total of Ahh returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Un. 14 .t Spou.al rat. US) 16. Aaount of Lina 14 taxabla at Linaal/Cl... A rat. (16) 17. Allount of Lina 14 taxabla at Coll.taral/Cl... Brat. (17) 18. Principal T.x Dua TAX CREDITS: PAYHENT DATE 06-16-95 7.Q~7 q? 15,218.27 .00 15,218.27 will .00 .00 15,218.27 M . DO. K .D6a M .15. lIBJ .00 .00 2,282.74 2,282.74 RECEIPT NUNOER AAD47891 DISCOUNT 1+ J INTEREST I-J 114.14 AHOUNT PAID 2,168.60 TDTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 2,282.74 .00 .DD .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS ~ESS THAN '1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS . "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.J 00 c-r " '.u ,,' REIlIY,nONI Eltat.. of decedwlt, dvlne on or before Dee...,. n, 1912 ..- If MY lulur. Int.rett In tN ....t. Is Inn,f.rtH In pa.....lon or enJD~t to CI... I (coll".r.l) b~'lcl.rl.. 0' tn. dlCHent .ft.,. tN ..plr.llon of env ..t.t. for 11'. or for y..r., tn. C~.lth ner-av ..pr..,lv rll.rv.. thl rIght to appral.. end ...... trent'.r Jnherlt~. T.... at 'M I_ful CI... . (colllt,raU nh on ."., .uch future lnt.,...t. PIlRPOSl OF NOnCEa To 'ulflll tM ,......r..-nt. of Section '141 of the lntMrlt.w:. .1d Elta" ,.. Act, Act ZZ of 1991. 72 P.S. S~UDn 214D. 'AnENT. htllCh the top portion of thb NoUe. _ iUMlt with your pay...,' to tM Aqls',r of WUh ,,,Inted on thII ray.,.,. _Ida. --PWts check or IIOMY ariM,. plylbla tal REGISTER OF MILLS, ADENT All p..,...," nCIlvH wll flr.' bt ...11" to MY lnt.r..t which ..y b, due with MY ,....Ind,,. ItppUMt to thl 'I.. REFLIID (eA) I A nfW'Mt 0' . tn credit, which .... not teetu,,'MI on the Tax R.turn. .ay ~ r....tMl by c.-pl.tlng ., "application for Raft.nd of P...,.YlvMla IntMrltMc. end Eatata Tax" CREV-iSiS). ApplIcatlonl ar. a"an_l. at th.offlc. of thl Reglatar of Willa. any of the 11 Rlvenue Dlatrlct OffiCI'. or by Cllllng the apeelal l~-hour ~___rlna a.rvlca ~rl 'or 'or.a ord.rlngl In P~ayl".,la 1.100-162-2050. outald. Pennayl".,la end within local Harrltburg .r.. (111) 717-1094, TOOl .717) 772-1251 CHe.rlna lapllrMl Only). OIJEClIDHSI Any p.rty In Int.r..t l'WIt a.t"UMI Nlth the eppr......"t, .llowanca or dl..Uowenc. of deductlona, or .....nent of talC Unoludlng d"count or Inttr..U .. Ihown on th" Notlc. lIU.t object N!thln IIxty (60) daya of racalpt 0' th" Hat Ic. by, --Nrlltan proh.t to the PA D.part.ant of Ra"enu., laard of ..pp..... Dapt. ZaIDII, HarrhbUrll, Pi 171Ze-IGZI, OR --.hctlon to hay. the aaU.r dattralnad at audit 0' the .ccount 0' thl p.rsonal npr...ntatl".. OR napp..l to the Orphan.' Court. ..DMIN IITRAlIVE CORRECTIONS, INTEREST I Featual arro,.. dhcoyered on thlt ...........t should ba addn..~ In wrltlna tal PA a.p.rt.....t of R.vanue, lur..u of Individual T.IC", ATTNI Po.t A.....eent R.vl... unit, a.pt. Z10601, H.rrl.burg, Pi 17111-0601 Phon. (717) 787-650S. Sa. pq. 1 of thl booklat "Inatructlon. 'Dr Inherltanc. TIX Alturn 'or a A..ld."t Decadant.. CREV-IS01) 'or an .xpl.natlon of a~lnl.tr.tlv.ly correctabl. .rrora. If any tax ~ II p.ld within thr.. (1) c.lend.r .unthl ,'t.r the decadent'l d..th, . flv. p.rcant (SX) dl,cDUnt 0' the talC paid I. IllUMed. Inter..t .. ch.rg.d beglnnlna with first d.y of delinquency, or nine (9) .ontha and ~ (1) day 'rol thl data of d..th, to the dat. a' payaent. r.x.. which bK-. delinquent before January I, I'll b.ar Inter..t .t the r.ta of alx C6X) parcant p.r ~ calculat.d It . d.lly rat. 0' .000164. All t.... which bee... d.llnquent on and aft.r January 1, 1'112 will baar Int.r..t at . r.t. which will vary froe calandar y..r to c.landar y..r with th.t rat. ....-.oww:MI by thl PA Daplrt...,t of ReVtnl.M. Th. ..,Ucabl. Int.ra.t rat.. 'or I'll through 1995 ar'l DISCOUNT I ~ Inter..t Rat. Dally Int.r..t Factor ~ Intar..t Aat. Dally Inter..t FlGtor 1'82 20X .GaOS4e 1'.7 .. .0001'7 I'll 16. ,aDDU. 1'''.1''1 IlX .000101 1'14 II. .DDUOl 1.92 .. .GOOl" 19I5 ISX .DDU56 1991-1'" '" .GDDln 19" lOX .000l" 1995 ox .GOOl" ulnt.r..t Is calculatlld .. follOttar IHTEIlEST a BALANCE OF TAX UNPAID X HU"BER OF DAYS DELINQUEHT X DAILY INTEREST FACTDR .."'y Notlca Inued .'hr tt. tax bacilli.. delinquent will r.fleet an Intar..t ulculaUon to fUtaan CIS) Mya lMyond thl data of tM ........"t. If p..,....t .. ... aftar the Intar..t cu.put.tlon data thown an the Hotlc., ttddltlanal Intarllt ....t b. calcul.ted.