HomeMy WebLinkAbout96-00420
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
Rtv - uoo [II -(,.,,,,
2. Supplomontal Rolurn
4iI. Futuro 1"lorosl COmplDOllSO
(lor dolo. 01 doolh ollor 12-12-62)
08, Docodont Diod TOSlato 07. Decodo"l Moinlllillod 8 UVlIlg Trust
(Mach cop 01 Will) (AMCh a cop 01 Tru,l)
C p ALL CORRESPONDENCE AND CONFIOENTIAL TAX INFORMATION SHOULO BE OIRECTED TO:
2 ~ NAME COMPLETE MA1LINGAOORESS
R 0 Michael R. Rundle Fowler, Addams, ~hart &
~ ~ TELEPHONENUMaE. 28 South Pitt Sl!!''let '6
- T 717 249- 8300 Carlis le PA 17013 <;
1. Roal E.tato (Schodulo A) (1) :..
2. Stock' and Bond, (Schodulo B) (2) 365.00-'
3. Clo'oly Hold Slock/Partnorship Inloro,t (Schodulo C) (3) '"
r'.
4. Mortgagos and Noles Rocoivablo (Schodulo D) (4) I'
5, Ca,h. Bonk Doposits & Miscollaneous Por,onol Proporty (Sch, E) t5) 35,950,86
6. JolnUy Ownod Proporty (Schodulo F) (6)
7, Tron,!olS (Schodulo G) (Schodulo L) (7)
8. Total Gross AssOI' (Iotol Unesl-7)
8, Funeral Expenses, Adminlstrativo Costs, Miscollanoous
Expon..s(SchoduloH)
10. Oobt,. Mortgogo Uobililios. Uon, (Schodulo I)
11, Total Doductions (total Unes 9 & 10)
12, Nol Voluo 01 Estolo (Uno B minus Uno 11)
13, Charilablo and Govornmontal Boquosts (Schodulo J)
14. Not Voluo Sub ocl to Tax (Uno 12 mlnu, Uno 13)
15. Spou'a1 Tronslors (lor dotes of doolh oUor 6-30-94)
Soo InsUllclionslo. Applicobla Porconlogo on pogo 2,
(Includo valuostrom Schodulo K or Schodulo M.)
16. Amount 01 Uno 14 taxable 816% ra10
(Includo values from Schodulo K or Schodulo M,)
17. Amount 01 Uno 141axablo 8115% raiD
(Includo volueslrom Schodulo K o. Schodulo M.)
lB. Principal tax duo (Add tax Irom Uno 15. 16 and 17.)
18. Crodits/Sp Povorty Prior poymonts Oiscounl
o . 00 + +
20, II Uno 191s groolor than Uno lB. onlor Iho dllloronco on Uno 20. This is tho OVERPAYMENT,
~ D Check here If DU are re uestlng a refund of Qur ova aymenl
21, If Uno 1819 groalor than Uno 19, onlor Iho dllforcnco on Uno 21. This Is tho TAX DUE.
A. Entor tho Inlorost on tho balanco duo on Uno 21A.
8, Enlor lho lolal 01 Uno 21 and 21A on Uno 21B, This iSlho BALANCE OUE.
Make Check pa able 10: Re Iste, 01 Wills, A enl
~ ~ BE SURE TO ANSWER ALL OUESTIDNS ON PAGE 2 ANO TO RECH~CK MATH 4 ..
CAS
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KOK
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COM~F,~:tlY~I['~\DJ,PJ/l;'t'\l'b rAN,.
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HARRIS uAG, PA HUI-oeo1
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DEC[DENT'S NA~[ (LASf, fIRM, AND MIDDl[ INITlAll
Mlcholsen lIans Theodore
fall OAT( 5 OF D[A'ti AfTER UIlt/lt1 CU[Ck ti[R[
IF A!iI'OU!iAl
1'01/1 ,nyCllrnu I CLAIM
FILE NUMBER
21-96- 4010
SOCIAL SECURITY NUMBEfl
113-30-3186
DATE or D[Altl
03/22/96
DAT[ or nUntl
03/29//,0
COUNTY com:
V[AR NU~RER
(IF APPllCAOLEI5UAVIVINQ SPOUSE'S NAME ILAST,FIR5T AND ~IODLE INITIAL I
Michelsen Doris W,
X 1, Orlglnol Roturn
4. Umllod Ealelo
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II[C[OlNl'S COMl'l [T[ A()OH(S5
16/, Conodo!;ul net Mobile Estates
Newville, "A 1721.1
County
Cumberland
SOCIAL S[CURlfY NU~B[R
164-2fl-4233
A~OUNT REC[IVEOIS[[ INSTRUCTlONSI
05.
o B.
Romaindor Roturn
(lor dolos 01 doolh pIlar 1012-13-82)
Fodora! Estalo Tax Roturn Roquirod
Total Number 01 Selo Ooposil Boxes
Rundle
.,:1)
1.'4)
. .
.~
I'
", -.
...- ,--
\.oJ
(B)
36,315,86
(9)
12,405.00
(10)
6,764,93
19,169.93
17 ,145,93
(11)
(12)
(13)
(14)
17,145,93
(15)
17 ,145.93 X Q.!..=
0.00
(16)
0,00 X .06 =
0,00
(17)
0.00 X .15 =
0,00
(lB)
0,00
Intorost
t19)
(20)
0.00
0.00
(21)
(21A)
(21B)
0.00
0,00
0.00
nd., p.n..ltl" 0 p"jury,1 d.CIa,. th.t I h...... ...mln.d th.. ,.Iu,n, Includ.ng..ccomp.nYlng sch.dul.. .nd .1.I.mlnlS, .nd 10 thl bllt 0 my knowl.dg' ..nd b.". ,It.. t'UI,
corrlct and compl'l',I dlclarelh..t..lI ,1l1..t..'1 h.. b..n "po,tld at hu. ml,"'t 1I..h.tI. O,c"""llon of p"p.."r olh., Ihl" Ihl p..son..lllpr...nt..h...... b....d on .Ulnlorm"'lon of
whiCh pllp.1I1 has .ny knowl.dgl.
Doris W. Michelsen
!~_'t _ ~?_'!~~?..&~~!'_~~. ~_'!.~~ ~-~ - ~~.,,~~~-'~ - -.. - - - -. - - - --
Newville, PA 17241
Fowler, Addams, Shughart & Rundle
28 South Pitt Street
ciiii ii,ie: - -PA - - -i:io'l:i. -. -.. - -...,.. - - - - - - - - -. - - ---
S)GNATURE OF PERSON RESPONSIBLE FOAFILING RETURN
, I I .
A;',', I, ,<,' I,' rl.<<::/" C:. '. -
SIGNATURE OF PREPAR[ROTHER'HAN R[PRESENTATlvE
\ (\) i
I V\.\ l LlJ.' '. I..... I'"" .,", ,..
.. '--
Copyl'lgh1ICI19!J4 form 10ftw"" only CPSYSllms,lnc,
OAT[
,- lL 'j(.
OAT[
,; ..!..! " (..,
Fo,m 1SOO IR.v. 7-;41
REV. 1IOJ EX + (4.11.
caMII.'l1t,?(~\l,l'.<lf. elill1'ltY~.NI.
''RhiO[Nl'bt"cE'bE'NI
ESTATE OF
SCHEDULE B
STOCKS AND BONDS
FILE NUMBER
21-96-
Hans Theodore Michelsen
SSII 113-30-3186
03/22/96
All
ITEM
NUMBER
1
aln -owned wtth RI hI 01 Survlvollhl mUll be dlaclaaod on Schedule F,
VALUE AT DATE
OF DEATH
365.00
OESCRIPTlON
73 shares Exchsnge Insurance Company
5.00
TOTAL (Also enlOf an line 2, Roc IlullUon
(If mare specel. needod, Insert eddiUonollhoel. of .ome oIze.)
Copyright fe) 1'14 farm .altwIf.anly CPSy.tema,lnc.
S 365.00
Farm 1500 Sch.dull 8 (Rev. 4.11)
"." -., "'.... ......-
BIDELnrACH MOTORS
I. E. Bidul~p~ch
1603 Spring Road
r II l"\ I " I Cl, PA. 170 1 3
r,p, il 2(" 1996
. MR. Mlr.H~F.L H. RUNOl.f::
i.'11 S. PITT ST,
CI~HI I :.l.r::. FA. 17013
Dc.)r 1111 nUN OLE
nE; [lOR ISM I CHEL SEN '11 L/\NDCF,U I SER
, HAVE I NSPECTEO THE ABOVE 11ENT 10NI::D UN I T FOR THE PURPOSE OF
DETERMINING A FAIR AND REASONABLE VALUE OF THF. 1991 TOYDT(\
LANDCRUISER IN QUESTION. TAKING INTO ACCOUNT THE Bl.ACK BOOI;
VALUE ALLOWING FOR THE MODERATE DAMAGE TO THE RIGHT SIDE Or-
fHE CAR AND SEVERAL ~IARKS AND DEEP SCRATCHES ON THE LEFT
S I DE ,AND 11I NDR RUST aE:G I NN I NG TO SHm~ . THE MECHAN I CS AND T I RES
SEEM TO BE IN GOOD WORKING ORDER. THEREFORE A FAIR VALUE
WOULD SEl::M TO BEE APPROXIMATELY ;'18,500.00.
I TRUST THIS WILl. BE 5UI:FICIENT FOR YOUR NEEDS. IF YOU NEE ANV
FUTHER INFORMAHON PLEASE DO NOT HESITATE TO CONTACT 11E AT
YOUR CONVIENcF..
S I NCEREI V
~)-._.-
t... , . (t2..~EL!:iP(\C:H
11 I IlEL.SPIlCH 110TORS
REV. 1111 EX. IF.III
SCHEOULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
cO"lI.'I.'i'llI;'W.l\,,,,,.eWltwANIA
AhIOENl'b~CE'b';'NT
ESTATE OF
Pl.... Print or a
FILE NUMBER
21-96-
Hans Theodore
ITEM
NUMBER
A.
Michelsen
SS# 113-30-3186
03 22 96
B,
c.
DESCRIPTION
AMOUNT
1
FunOflI Expon...:
Egger Funderal Home,
funeral expenses
4,935.00
Newville, PA,
2
Seaman-Wilsey Funeral Home, Inc,
Saugerties, New York, funeral expenses
3,755.00
1,
Admlnlalrativa eo.",:
P....,nal Repr....nl.Uv. Conmlsslons
SocIal Security Number 01 PllfllOnal Repr....nt.tive:
V... Conmlsslons paid
2.
Anornay FOGS
Fowler, Addams, Shughart & Rundle
200.00
3.
Family Ex""1'lion
Ollmanl Doris W. Michelsen
Address 01 Ollm.nl .1 deced.nl'e de.lh
Streel Addr... 184 Condo~uinet
~ Newville
3,500.00
Rel.tionshlp Wi f e
Mobile Estates
51.1. ~ Zip Code 17241
4.
Prob.le FOGS
Mlse.naneou. Exp.ns..:
1
Filing inheritance tax return
15.00
TOTAL (Also enler on line 9. Rae. Ilul.llon)
(II more apac. I. n..ded, Insert.dellllonal .h..'" of ..m. .1...)
CopyrlgM(cl1114 'arm .oflwa,. only CPSYltaml,'nc.
s 12 405.00
Form 1500 Schedul. H IR'v. Fall)
~
REV-1547 EX AFP 112-951.. j
CDHHONW[ALTH Of PENNSVlVANIA
DEPAR'HENT OF REVENUE NOliei' Of tHltfMItAHCI fAM
'UREAU OF INDIVIDUAl 'AKES I ' "." APPRAISEHENI, All OWANel OH 01 SAil OWANel
~~~~iS:~:~~lpA 17128-0601 ~ .m or O[OUCflOHS ANn A$~I$!I"IHf ()f fAM
ESTATE OF MICHillru HANS no ~."T FILE NO,
DATE OF DEATH 03-22-96 COUNTY
ACN 1111
DAT! 09-0~-96
~1~&:04~O
CUMBUll MID
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHII 1111 UI'I'I H I'OHIION 01 'illS 'ORH WI'II YOUR I AR
PAYHENT TO TilE REGISTER OF WILLS. HARE CIIEeR I'AYAII\I 10 "NIDUIIN Ilf WillS, ADIN'"
R~MIT PAYMENT TOI
MICHEAL RUNDLE
FOWLER ADDAMS SHUGART &
28 5 PITT ST
CARLISLE PA 17013
HrOISIlH or WILLS
CUMB[HLA~O CO COUHT HOUSE
CAHLISL[, PA 17013
A.oun!.~~~=~==:J
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REij:iS47 -Eif"Ai=ii-ii'F9ST - iioTicE--aF - "ititi Eit" i i ANc E - TAx- lip PR ii j 5 EM iii T', - -A i. i"awANc E - iili - - - - - - - - - - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MICHELSEN HANS T FILE NO. 21 96-0',20 ACN t 01 DATE 09-02-96
TAX RETURN WAS: I X I ACCEPIED AS IIlED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED. ON: ORIGINAL RETURN
1. R.al Est.t. (Schedule Al 111
2. stocks and Bonds.C$chedule OJ 121
3. Closely Held stock/Partnership lnt.ra.l 'Schedule CI 111
4. Hortg.ges/Nota. Raceivabl. (Schedule 01 1~1
5. CashlBank Deposits/Misc. Parsonal Property C$chadule [) ISI
6. Jointly Owned Property CSch~dule Fl lb.
7. Transfers CSchedule G) 11)
8, Tot.l Assats
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exp.ns.s/Adll, COlh/Hhc. bpen... 15ch.dule tU letl
10, O.bts/Ho~tgag. Liabiliti.s/Li.ns ISchedul. I) (10)
11, Total O.ductions
12, H.t Value of Tax R.turn
13. Charit.ble/Gov.rnM.nt.l Sequ..t. ISch.dul. JI
14, H.t V.lu. of Estat. Subj.ct to Ta.
If an assessment was issued prDviously, lines
reflect figures that include the total of abh
ASSESSMENT OF TAX:
15, Allount of Lin. 14 .t Spou.al
16. Anount of Lin. 14 tawabl. at
11. Anount of line 14 t..abl. .t
18, Princip.l Ta. Due
NOTE:
rat.
lin..l/CI..I A r.te
Coll.t.raI/CI.., h rat.
IISI
llbl
lilt
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHBER
DISCOUNt It I
INIINISI 1,1
m.._,_ _._...__.... _ f
I CItANOED
.00
365.00
.00
.00
35.950.86
.00
.00
181
36'.315.86
12.405,00
6.76'4,93
1111
1121
1131
II~I
Ig.16Q Q3
17.145.93
,00
17.145.93
14, 15 and/or 1&, 17 and 18 will
returns assessed to date.
17.1'.5.93 x,OO,
.00 x' 06,
.00 X .15,
1181
,00
.00
.00
,00
AHOUNI PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
-- --_._---_.~--~------_._.__.- ----
INTEREST AND PEN. .00
-.. ---_.~----- ---.-.
TOTAL DUE .00
. IF PAID AFTER DATE INDICAIID. SEI NLVIRSE
FOR CALCULATION Dr ADDITIONAL INIIHESI.
I lr lOlAL DUE IS LESS III AN $I, NO PAYHENI IS REOUIRED.
II IDIAL DUE IS REFLECTED AS A "CREDI.T" ICRI, YOU HAY BE DUE
A RlrUND. SEE REVERSE SIDE Of Tit IS 10RH FOR INSTRUCTIONS,)
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-"'c;
00
RESERVATION: E,tat.. of docld.nt. dying on or bofor. aec..b., 12. 1982 -- If Bny futuro lnt.rl.t In tho ..tat. I, t,anlf.rrod
In Po....slon or enJoy..nt to Cia.. a (co11atlral) bone'lel.rl.. of the docodont a,t.r the oKplratlon of any o.lalo for
11'. or for Y..". tho Co..onw.allh hareby ..pr..sly ro.erv.. tho right to apprals. and ."0" Iran,f.r Inhoritance Taxe.
at thl llwful ct... B leolla'.ral) rata on any such futuro Int.r..t.
PURPOSE OF
NOfleE:
To fulfill tho requir...nt. of S.ctlon 2140 of tho Inherltancl and [,lat. 'a. lei, Act 22 of 1991. 12 P.S.
Section 1140.
PAYHENT:
Detach Iho lop portIon of thl. Hotlee and sub.lt with your pay.ont to tho Roglstlr of Will. printed on Iho rov.r.. .Ide.
.-Hakl check or .onoy ordor payabl, tot REGISTER OF MILLS, AGENT
All pay..nt. rec.lved shall first b. appll.d to Dny Int.rest which .ay b. due with any r..alnd.r applied to the tax.
AEFUND (CA):
A r.fund of a tax crldlt, which was not rlquest.d on the Tax Aeturn, aay bl requestld by coapletlng an ~Appllcatlon
for Refund of P.n~sYlvanla Inherltanc. and Estale Tax~ (REV-I1I1). .Appllcatlons are available at the OffiCI
of the R.glstlt of Will., any of thl 21 Rev.nue Dislrict Office.. or by calling the sp.clal 24-hour
answlrlng service nu.b.rs for for.s ordering: In PennSYlvania 1-800-362-2050, oulslde Pennsylvania and
within local HarriSburg area (717) 787-8094, TOO_ (7171 772-2252 (Hearing I.pairld Onlyl.'
OBJECTIONS: any party In In\er..t not satl.fled with Ihe appralse.ent. allow~nce or dlsallowlncl of deductlonl, or Iss..s.ent
of taM (Including discount or inter.stl as shown on this Notice aust Object wllhln SIMty (60J days of r.celpt of
thll Notice by;
I
~
--written prote.t to thl PA nepart.ent of Revenue, Board of Appeals, n.pt. 281021, Harrisburg. PA 17128-1021, OR
"election to havI the .atter deler.lned at audit of the account of Ihe personll representative, OR
--applal to the Orphans' Court.
AOHIN
ISTAATlVE
CORRECTIONS I
Factual error. discovered on thl. alse.s.ent should be addressed In writing to: PA Depart.ent of Revenue.
Bur.au.of Individual TIIU., ATTN: Post Auu..ent Review Unit. Oep\. Z8060l, tlarrhburg, PI, 17128-0601
Phonl (1111 7a7-6~05. S.. page 1 of the booklet ~Instructlons for Innetllancl Tax Return for a Resld.nt
Deced.nt~ IREV-1501) for an eMPlanatlon of adalnlstratlvelY corr.ctable errors.
DISCOUJHI
If any taM due i. paid wilhin Ihr.e 131 calendar nonth. afler the deeedlnl's dlath. a flvl plrcent (5~) discount of
the taM peld Is allowed,
PENal TV;
The IS~ tlM a~.sty non-participation penalty I. coapuled on the lotal of the taM and Inter.st assessed, and not
paid b.fore January 18. 1996. Ihe first day efter Ihe end of Ih. laM a~nuty periOd. this non-partlclpalIon
p.nalty is appealable in Ihe saae eanner and in Ihe the sae. tl.e period as you would appeal Ih. laM and intereat
Ihlt has be.n assessed as Indicated on Ihls notlc..
IHTEREST: Inlere.t I. charged beginning wllh flrsl day of d.linquency, or nine (9) nonlh. and on. (II day fro. Ih. dale of
death. 10 the dal. of pey.enl, ta.ls which beca.e delinquent before 'January l. 198Z bear Inter.st at Ihe rale of
slM (6~1 p.reent pet annu. calculated at a dally rale of .000164. All ta.el which b.coMe delinquent on and afler
January I, 1982 will bear Interest al a rale which will vary frON cal.ndar year 10 calendar year with Ihat ral~
. announe.d by Ihe PI, neper'.enl of Revenue. The applicable inlere.1 tales for 19&Z through 1996 are:
'!!!! tnlerest Rale Dally tnternt Faclor ~ Interllst RRtA Dailv Interest Faclor
1982 2Qj( .000S48 IlJ81 .. .000247
19U 16% .000438 IQ88-11}'H Il~ .000301
1984 11% .000l01 1'J9Z Q;( .000241
1985 In .000.556 1995'llJ9to n .000192
1986 10;: .OODZ74 11}QS-llJ96 9% .000Z41
--Inlere.t is celculaled as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hollee Issued afler the laM beeo.ls dellnquenl will reflecl an Inler.st calculation 10 flfleen tiS) days
blyond the dal. of Ihe asses..enl. If paye.nl Is "ad. afler Ihe Inler..1 co~put8110n date shown on Ihe
Hotlc.. addillonal Inllre.t ftust b. calculal.d.