HomeMy WebLinkAbout96-00119
.
atV,UOO I" 17.9'1
20. If Line 191. greal., thon Line 18, Inl., ,h, diff".ncI an line 20. Thl. i. th. OVERPAYMENT.
ElD
21. If LInt 18 i. greoll' than line 19, tnler ,hI diff".nce on line 21. This II the TAX DUE.
A. Enl.r the inl.r..t on th. balance due on Line 21A.
B, Enlor .holo'ol olllno 21 and 21A on lIno 218, lhi. h ,ho BALANCE DUE.
Mo'" Chell Payable tal R.ghll' of Will., Agent
11. ';'/1'..', ',' ,';, " ~ ~ . Be SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH <lI(
Under penohl" of perlury, I dedor. thai I hovI IlII.omined this ,elurn, including accompanying Sthedulu and ,'ol.menh. and to the bet' of my ~nowl.d9' and b,li.
It It trUI, correct and complet.. I declor. thol 011 real ,,10 It hn. Leen ,eporled ollrue matht \lalue. Declaration of pr.pare, other thon ,h. penonal '.pr...nlo!ivl
bOled on olllnformolion of which pr'pat"r hos any .nowledgt.
'I A UIl O' 'flU N IU'OU$I f '01 flIlt~G IIIUIU AOOI(~$ DAt!
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AU ""''''''AtIYl AO '" 0 fu ' Ii I J 3 f . / ) DAII, /'
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COMMONWfAlUf OF PffHunVANIA
m'Al1MEN' 0' R[VWUE
Of" 2110601
IIAIII5IUII:O.,A 1717.0601
DICIO(NI" HAMlllA". 'Iut. ArlO MIOOU 1111111.11
J5-~3-IL
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
fOR DAtlS Of DEAIH AnlR 12/31/91 CHICK HER'
If A SPOUSAL
povlRn CRlDIIIS CLAIMED 0
fill NUMIIR
0),1 IqqlJ, Ilq
COU~IIY CODE YEAR HUMBf'
UIUDWI"$ c.OMPUIf ADOIIU
&1
lil
hi
..
Cleaver, Lucille R.
lOCIA' $!CU'"' HU.'" 10.1[ 01 DIAIIl UAII 0' "0'"
--'.!l2-2/,-66P __ _lIIlLI.:!,_IJ22, J_'!~0J.L! 92
pi' ,1.I"IC"SIlI 'U'WIWIHO "OU\l '.,.....11',1,\1."." "'lO "'I>lIl'lPllI'.'1 $OCIAl S((Ulln IIUM".
~ Snll Junn DrLve
Hechnnicsburg, PA 17055
(oVIlI Cumberland
AMouiifiRiiVi'Di\Hli~srlu'llo'n,
Cleaver, Forrest J.
~ I. O,iginal Return
208-22-6036
rJ 2. Supplemenlal Relurn
13 201.05
[J J,
~S
D A. limited Eslal. 0 .10. fulure Inleullt Camprami..
(lor dolo. of doalh alre, 12.12,B2)
D 6, Decedent Di.d T"lale [] 7. Oecedent Malnlained a living Trusl
(Allach copy of Will) (Allach copy of Trull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAME (OMrHIl MAtll,lQ ADoins
Romaind.r Relurn
(far dol.. of dealh prior 1012.13.82
federal Eslal. To. Relurn Requirtd
_ 8. Total Number of Saf. D,poIII Bo..,
John H. Eokin, Esquire
illffiiONfiiiiMii" -.
717 766-3172
Horket Squnre Building
~lechanicsburg, PA 17055
z
..
5
~
lil
a:
1. Roal E,'alo IS,hedulo A)
2, S'a,h and Bond'IS,hodule B)
3. Clo..ly Held Stoc./Porlnenhlp Inle,..1 (Schedule q
A. Martgag.. and Nal., Rectivable (Schedule D)
5. Co,h. Ban~ Oeposits & Mi,cellaneau, Penanal Property
(S,hodulo EI
6, Join.ly Ownod P,opo"y IS,hedulo FI
7, t,an.l... (S,hodulo GI (S,hodule II
8. Tolal Gran Aue" (Iololllnll 1.7)
9. Funeral ElI.pen..s, Admlni,ualive Casts. Miscellaneous
bpens." (Schedule H)
10. Debts, Mortgoge llabililill, llens {Schedule II
11. Talal Deductions (Ialallin.. 9 & 10)
12. Net Valut 01 Estoletllne 8 minus line 11)
13. Charitable and Governmenlal BequII" (Schedule J)
IA. Ne' Valul Sublect 10 Tax (line 12 minus line 131
IS, Spou.al t,an.l... (lor dolo. 01 dea.h altor 6.JO,9A)
See Instructions for Af,plicable Plrcenlage an Rever..
Side. (Indude value, rom Schedule K or Schedule M.)
16. Amount olllne U taxable 01 6% role
(Indude valu.. from Schedule K or Schedule M,)
17. Amount of lint 1.1 la.able at 15% role
(Include volu.. from Schedule K or Schedule M.I
18. Prindpal'a. duo (Add 10. from L1no. IS. 16 Dnd 17,)
19. Credits Spoulal Poverly Credil Prior Payments
+
(II
121
(J)
(A I
(51 13,201.05
( 61
171
tB) 13,201.05
(9) ----3_.illl8,.1l8
(101-4,97-b-3"
(III -D.980 1&
(121 (779.09)
(lJ)
(lAI
o
)(.~a
o
(IS)
(16)
(171
)( ,06 a
)( .15 III
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(lBI
o
Discaunl
Inlerll'
+
(191
(20)
o
Check here If you ate tequcsllng a refund of your overpayment.
(211
(21AI
12181
o
., ..........
"
11'#111111+1'.11'
ITEM
NUMBER
A.
B.
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMOUWEAUH 0' PENNSYlVANIA
INHUnANCf lAX '(TU.N
,UIDun DECEDENt
Ploaso Print or Typo
NUMBER
Lucille R. Cleaver
DESCRIPTION
1.
Funoral Expons..,
Hyers Funeral lIome
Rolling Green Cemetery
City He"hanil:Blu.u:g
4. Probolo Foos
C. Mlscollanooul Exponsol'
1. Filing Fees
2.
3,
4.
S.
6.
7,
8,
1.
Admlnlslrallv. CoslI,
Pononal Roprosonlollve Comml..lons
Social Socurlty Numbor of Pononot Roprosonloll.o:
Voor Comml..lons pold
2.
Allornoy Foos
3.
Family Exompllon
Clolmonl Forrest J. Cleaver Rotollonshlp -1u1abnnd
Addro.. 01 Clolmonl 01 docodonl's doolh
S'..ol Addro.. 2 San Juan Drtv..
Slolo PA
Zip Codo 1 7n~~
$15.00
TOTAL (Also onlor on Iino 9, Rocopilulollon)
(II mall IPOC' II no.d.d, Inl.rt addlllonallh..tl 01 lam. lb..)
AMOUNT
$4.998.80
495.00
3.500.00
15.00
S 9,008.80
....~1I...11;;.
COMMOHWIAUH or HNNnLVAHIA
1H".'w.(IWlnU...
II,"",NI DlelDlNI
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
PI.a.. Print or T .
FILE NUMBER
ISTATI OF
Lucille R. Cleaver
ITEM
NUMBER
DESCRIPTION
AMOUNT
I,
Members 1st Federal Credit Union - Personal Loan
$4.971.34
TOTAL (AI.a on'or an lino 10, Rocapitulallanl
(II more spac. ;s n"d.d, ins.rt addi'ional.h..ts of 10m. size.)
$ 4 971.34
/
/:.{",[3 -Id;'
R!V-1547 EX AFP (12-95*
COMHOHW[AlTH Of PENNSYLVANIa
DEPARTMENT Of R[V[NIJE
BUREAU OF INDIVIDUAL TaXES
DUT. 210601
HARRISIURO, Pi 1712a-0'01
,
~
ACN 101
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT DF TAX
DATE 05-13-96
DATI! OF D!ATH 05-13-95
FILE NO.
COUNTY
CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YDUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR T'
PAYMENT TO THE REOISTER OF WILLS. MAXE CHECK PAYABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT TO:
JOHN MEAKIN ESQ
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount Rail! Uad
CUT ALONG THIS LIN! .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifili:is4'j-EX-AFii-n'2:9ifi-iii:i'f'icEuOF-YNHEiiiTANCE-YAX-jippiijiisEilEiiT~uAi:.LoiiANcE-o-Rm___mmum
DISALLOWANC! OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF CLEAVER LUCILLE R FILE NO. 21 96-0119 ACN 101 DATE 05-13-96
If an assassment was issued previOUSlY, lines 14, 15 and/or 16, 17 and 18
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAX:
15. Aoount of Line 14 et Spou.el rete (151
16. A.ount of Line 14 taxabl. .t Lin..I/CI... A rat. (161
17. A.ount of Line 14 taxable .t Coll.t.,.a1/Cl... Brat. (17)
18. Principal Tax Due
TAX RETURN WAS. (X) ACCEPTED AS FILED
R!S!RVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, Reel E.tete (Schedule AI 111
2. Stock. end Bond. (Schedule BI (21
3. Cla..l~ Held stock/Partnership Int.r..t (Schedule C) (5)
4. "ortgeg../Nat.. Receivable (Schedule Dl (4)
5. Caah/lank Depolits'Hi,c. Pa,.lonal Property (Schedul. E) (5)
6. Jointly awned Property (Schedule FI (61
7. Tron,'er. CSchedule 01 (71
8. Tot.l A...t.
APPROVED D!DUCTIONS AND EXEMPTIONS:
9. Fun.r.l Expen.e./Ad.. Co.t./Hi.c. Expen... (Schedule H) (9)
10. Debt./Mortg.ge Llebllltle./Llen. (Schedule II (101
11. Totel Deduction.
12. Net V.lue of T.x Return
15. Charit.bl./Gov.rna.nt.l Beque.t. (Schadul. J)
14. N.t V.lu. of E.t.t. Subj.ct to T.x
NOT!:
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUIIBER
DISCOUNT l+)
INTEREST C-I
) CHANOED
,00
.00
,00
,00
13.201.05
,00
,00
(BI
13.201.05
9,008,88
4.971 .34
(111
n21
CUI
1141
B.QRo 14
779,09-
.00
779.09-
will
,00 X ,00.
.00 X ,06.
,00 X .15.
nOl
.00
,00
.00
.00
.,
AMOUNT PAID
TCTAL TAX CREDIT
B~LANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
.00
.00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
( IF TOTAL DUE IS LESS THAN n, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
PfJ ~ :niP
3:;>,
c:r .. ,p: 8
2- $ . ~. -,
L. c.,
,-) -< ~ ,I,
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C 10 " ,
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0' N
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0\ -
REIOVATlD'" ht,t.. of _edent. dying on or _'or. Dec..., 11, 1912 -- if ."y future Int.r..t In the I..a', II Inn,flrred
In po.....lon or enJoyaent to Cl,.. . (coll."r,l) bene,lo..r... of the deced~t .ft,r the ..plratlon of en, ..t.t. for
11'. or 'or ,..r., the C~.lth heraby ..pr"'I' rl..rVI. the right to ."r,I.. and ...... tren".r Inhtrlt8nC1 ,....
It the i.-Ivl Cll.. . Ceol1_t,r,l) rat. on en, .uch future Int.r..t.
PIIIPOSE OF
NOTICE. To fulfill the '.....r...,\I of Section 21" of the lm-rUMe. and [,tat, fl. let, Act ZZ 0' ."1. 7Z P.S.
Section 2141.
PAvttEHTl Detech the tOIl "rUon of \hit Notice and lutHllt with your P'WMltt to the Rlllhter of Will. prInted on the rIVlr.. .Ide.
........ cMck or ..,., order ,.,Ilbh tOI REGISTER OF MILLS, AOEHT
611 p.~t. received shill fIrst be .,UIId to en, Int.r..t ""lch .., be due ..lth en, r.-I"r 1PP1led to thl tax.
RU\ICD Cah A r.fund of . h. cr~1t, Mhlch .... not r......t~ on the 18M: A.turn, .ay bI r'quI.t~ by c~..t1"' ., "Appllc.tlon
for R.fund of Penn.ylv.,11 Inhlrltenc. end E.t.t. t.... CREY.ISIS). application. Ir. Iv.lllbl. .t thl Offlc.
of ~ R..I.t.r of Will., .,y of the 23 R.venue DI.trlct Offlc... or by c.lllng thl .peclll 14-hour
.,....rlng .arvlc. nuIbIr. for fo~. orderlngl In Penn,.lv.,11 1-loO-S6Z-Zaso, out. Ida Penn,ylv.,l. end
..Ithln locII Harrl.bur. er.. (717) 717-1094, TODI (717) 772-Z2S2 CHI.rlng lap.lred Only).
OIJECTIDNlI Any p.rty In Int.r..t not ..tl.fled ..Ith ~ eppr.....-nt, Illowanc. or dl.allowanc. of deduction., or ......-.nt
of t.. Clncludlng dl.count or Int.r..t) .. ~ on thl, Hotlcl au.t object ..Ithln .I.ty C'O) dey. of rlCIl,t of
thil NotlCI bYI
....rIU., proh.t to ~ PA Dlpart..,t of R.venue, ao.rd of Appe..., Dlpt. lIlOU, Harrilbur., PA l7UI-lOU, OR
"'llCtlon to hevtI ~ ..U.r deteralned at IlUdlt of thl IKcOU'tt of the parsOMI rlPrU.,t.tlvl, OR
.......1 to thl a,.".,.' Court.
ADIIIM
IITIIATlVE
CIllllll:CTlllNS,
INTERrITI
Fectull .rror. dl.cov.red on thi. ........"t Ihould be ackIr...1d In ..rI tine tOI PA Depert..,t of R~,
Bur.au of Indlvlduel ,..... ATTHI Po.t A......."t Revl... unit. DlPt. Zla,ol, H.rrl.burg, PA 17IZ'.0,01
Phone (717) 717.'505. See P'" S of ~ bookl.t -In.tructlon. for Inhlrltancl T.. Return for. R..ldlnt
Decedent- CR[V.ISOI) for., .xplanetlon of ~Inl.trltlv.ly corrlCteble .rror..
If any t.. due II plld withIn thr.. eS) calendar lanth. .ft.r thl decldlnt', d..th, . five parc~t eS~) dl.count of
thl tIX p.ld I, allowed.
Int.r..t I, charged beglml", ..Ith first d.y of delinquency, or nlM e') lanth, end one (l) dey frOll the .t. of
de.th, to thl d.tl of ,,","t. T.... .....Ich bee.. delinquent blfor. January I, I9IZ be.r Int.rut .t thl rat. of
,,, U1U parcent Plr ........ c.lculated It a dlUy rltl of .000164. AU t.... .....Ich bee... dellnquent on and .ft.,.
January 1, 19.2..111 be.r Int.r..t et . lit. which wIll v.ry fr~ cllend.r YI.r to c'land.r ye.r ..Ith that r.t.
announced by thl PA DIp.rt.."t of R.venuI. ThI eppllclbl, Int.rl.t r.t.. for 19.2 through I'" .r'l
DISCOUNT,
'!!!! Int.r..t R.tI 0.1111' Int.re.t F.ctor ~ Intlrl.t R.t. D,Uy Intlrut Fector
1912 ZOX .000541 1917 'X .OOOZ47
1'15 16X .OOOU' 1911-1991 IU ,000SOI
I'" IU ,OOnOl I99Z 'X .00az47
I'as ISX .00as56 1993-1'" 7X .0001t!
I'" lOX .000274 1995-1996 OX .000Z47
.-Inter..t I. cllculated .. fOUOW'1
INTERElT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTERElT FACTOR
--Any Notlc. It.ued Ift,r thl t.. blcOllI delinquent will r.fllCt ~ Int.r..t c.lcul.tlon to fifteen (15) dI,.
beyond the d.t. of ~ .I....eent. If p.yaent I. IIde aft.r the Int.r..t coaput.tlon data shown on thl
Notlc., additional Int.r..t .u.t be c.lcul.t~.