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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEAlTH OF PENNSYlVANIA (TO BE FilED IN DUPLICATE 'J 1--'1
DFPARTMENJ OF HEVENUE I r
>I~'''sfJ:6..J~'I'II?~;~~1 WITH REGISTER OF WILLS). ICOUNTVCODE',., VEAR(r 1. NUMBER
D'~~'~~;;~~':I '~'~'~I:;'D~;' :NIII'" ...~--.. .ljiT(:~~~t~:'~(O~~:~:~O;~~~~~~;-- ---
SOCI.\LSicuNv"NUMiif" -~ jbAIf Of DE AliI lOAf! W 81nltl Moehan iCHburg, PA 17055
16 1- 2 6 :;~,.5 72 .,.. . 09 /02 / 961 07 /0'7 / 'LJ CO"." .'[^MColuj~TII,.b~.,Oc),r,.v...,],..,..I.,j_,_n,_.,.._d"."'.,-I'-,'u'~"I"'O"N-'-' _--.._.... ...~.,._..._._..__ .
II' A"II(.I;i(fisu~~i~ItH' ~;OlJu:St~AI\I..I~\IIIl\1 Atlt> MII'llll UHl'.!1 50CIA( 5H lJRITY IHJM811l ,. ~ ~ ~
Anderson,...~_o^nr1.e ..t"__ _ 203-28-9095
(Xl 1. Orlglno! Refill'" [ ) 2. Supplemental Return [-J 3,
[] 4, Limited Eltate I 40. Future lnlere" Compromlle L.l 5.
(for dales of dealh oller 12.12.82)
[RJ 6, Decedent Dlod 1811010 II 7. Decodent Mainloin~d 0 living Trusl -...Q_'"'8. Total Number of Safe Oeposll 8oll.e~
IAlloch copy 01 Will) IAlloch copy 01 T rV'I)
~LH(lIIl.S;o"DINC:I'AND CON,.DINTlAL TAX INfORMATION SHOIJLD.I DI.lcrIDT01., ,
1fr.~,r~~_::~_~J~-:~_~~~-~_~i~-~ ~~~_ ~_o::,.:I~~}:~',~:~_:~s~~~.~:~ A 17011
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21.
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~eDI Eslote ISch,dvle AI
Slock. and Bonds ISchedvle B)
Clolely Held Slock/Portnershlp Inlefetl (Schedule Cl
Mortgage! and N{'Ihn Recelvuble (Schedule OJ
Cash, Bank Depo!Jh & MIscellaneous Personal Properly
ISchedvle E)
Jolnlly Owned Prop.rly (S"edv'e FI
Transfers ISchedvl. O) ISchedvl. L)
Tolo\ Gron Aueh {Iota I Lines 1.71
Funeral EKpenles, Admlnlstrotlv8 Cosh, Miscellaneous
EKperllln (Schedule HI
O.bts, Morlgoge lloblllll.., lie" ISchedvle I)
Tolo' Oedvclions Ilolollln.. 9 & 10)
Nel Value of Eltote (line 8 minus Une 11)
Charitable and Governmental Bequetll (Schedule J)
Net Value Subjecl10 TaK, (line 12 minus line 131
Spousal Transfers (for dales of death ahe, 6.30.9.41
See Instructions for Applicable Porcentog8 on Reverse
Side, (Include values from Schedule K Of Schedule M,)
Amount of lIne 1.4 taxable at 6% rate
(Include value I from Schedule K or Schedule M,J
Amount of tine 1.4 taKable 01 15% rate
llndude volues from Schedule K or Schedule M.l
Prlnclpallox due (Add lox from litle' 15, 16 and 17.)
CredIts Spousal Poverly Credil Prior Poymenls
+
'OR r.ATlS 0' Df.AIH A"IA 12/31191 C/lICK HIAI
If A SPOUSAL
POVIRn CRIDIIIS CLAIMID [
fill NUMBlR
Remainder Return
liar dolos 01 deolh prior 10 12.13.02)
federal Eliott! Tax Return Required
'/\fj-,;; ,
( 11--
(2) 121,.5_6..
13) _~...__.m__._____
14) ....._.____.___._____.__.
IS) ._.._._.n..2.0.Q....QJL.__
16)__
17)
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135,362.39
157 I 083. ~.~__
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19)
(10)
Ill)
(121
/13)
114)
157 r 083 . 95
157~083.95
(IS) __......J.._5 7....Q1l3 .95
x,Q.!.. ..______..:.9..::...._...
(16)__.___ ,_.____._._._x ,06.
(l7)_..._~
_.__.x ,15.
(101
-0-
DiscClunl
Inler.sl
+
(191
(20)
If Une 19 is greater Ihon line 18, enler Ihe dIfference on !.Ine 20. This Is IIle OVERPAYMENT.
lIe]
Clu"k h~l~ If yrw (He fC(tUestmg (I wfund of YOUI oVUlpnymcnl
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4~)lHl ~i1antJI WdY
_M<.;:<,,;(wn i,c;t.;l.)uru, IJ^
(J1lf] W,'sl ~I,lin St.
~;!Jin:llIctus Lr)WIl. I'^
17055
QSJJ_Q/9]__.._
[lATE
l'7 0.l1
o~nQ ! 9_7. .~...
If linl1l 18 is greater Ihan Une 19, enler Illfl diffl'Jrence on line 21. This is the TAX DUE. (211 .________~____=_Q_::_..._.~,__,
A. Enter the inlero" on the bolo:lcO due on line 21 A (21 AI . ,___.,__..'.~m____._____~.
B, Enler the 10101 of line 2\ Clnd 21 A on line 21 B. ihi\ Is thfl BALANCE OUE. (21B) ....___._..-::,Q..~___..._____
,_ _."M.n.~~,C,~.c_~~yabl. tOI Regl'I.r of WI~I., Agen! _____-._.._.._~._....___...__~
--.----. --~=)> j:'. 81 SURE iO-ANSWEii:~1rQUE5T10NS(fN-iiiVEiisE SIDE ANora RICHICK MATH ...( .<( . ...".....
Under penalties of pflrjury, I declare Ihall hove elwmined Ihi, rOTUrn, including occomrcHlying schurlulel (Inri Ilalementl, and 10 the bell of my knowledge Clnd belief,
it Is Irue, correc;l ancl comrlete, I declare Ihal cIII recll o!lale hcu boon r\lporlecl [1t Irue markot y(due Doclnrution of preparer other than the perlonal reprlllenlallvels
baled on alllnformalion of which preporer hm ony knowlodgo
~:ON("T-~-:E::~:i:~~;~~Z~.,~ :':,~,:f,'::
H ~ flf2.kA/-'Y . ..
~lanes D. Bo~, J.:fiqu.lr'e
Act '41 .f 1994 provld.. for the reduction of the tax rate. Impo.ed on the net value of tranafe,. to or for
the u.. of the .pou... Th. rat.. au pr..crlbed by the .tatut. will bel
e 3~ (.03) will be applicable for e.tate. of decedent. dying on or after 711/94 anti before 111/96
e 2~ (.02) will be applicable for eutate. of decedenla dying on or after 1/1196 ond before 1/1/97
. 1~ (.01) will be oppllcable for e.tale. of dec"denll dying on or after 1/1197 and before 111/98
. 5p.u.al Iranafe,. occurring on or after 111/98 will be exempt from Il!herltancelax.
PLEASE ANSWER UIE FOLLOWING QUESTIONS
IV PLACING A CHECK MARK (v-) IN THE APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a, retain the use or Income of the property transferred, ,....",..,,,..........,,,....,..,,,,.....,..,....,,,,,
b. retain Ihe rlghl to designate who shall use the property Iransferred or lis Income, ,..........,..,
c, reluln a reversionary Interelt; or ,..".."""......,............."".."........,..,..........",,,............,,,
d, receive the promise for life of ellher pay menU, benefits or care' ......................................,
2, If death occurred 0'1 or befote December 12, 1982, did decedent wllhln two years preceding
death Iransfer property without receiving adequate consideration' If death occurred alter
December 12, 1982. did decedent transfer property within one year of death without receiving
adequate consideration' ""',' """..""""""."""" ,.""., , ". ",.""",. "." , ,.",."""""""", ",""'"
3, Did decedent own an 'In trust for' bank account at his or her death"'.."..,,,....,.............,,.......
YES NO_
x
x
x
x
x
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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SCHEDU LE G
TRANSFERS
COMMONWEAlTti or PENNSYLVANIA
lNHUITANCI ,",X InU.N
IIIlOINT DlC_DlNT
PlEASE PRINT OR TYPE
ESTATE OF
James J. Anderson
FILE NUMBER
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWEI TO ANY OF THE QUESTIONS ON THE REVEISE SIDE OP THE COVIA SHEET IS YES.
DECO, DOLLAR VALUE
... Of DECEDENT'S
IIolT, INTEREST
ITEM DESCRIPTlOlol 01 PROPERTY
NUM8ER Include name 01 fh. troOll",.., lheir relolion.hip 10 dennlonf, doh! ,01 froOll.r,
EXCLUSIOlol
TOTAL VALUE
OF ASSET
1- F , 0 Llf., Polley No. 0612560, JoAnne L, ",837,25 100% 7,837,25
Anderlon, apouoe - ourvlvlng benellclery.
2, PSECU IRA'~here 6 Account No. 0161261572, JoAnne 37,270.46 100% 37,270.46
L. Anderlon. lpouoe - aurvlvlng benefloiary,
3, SMith Barney IRA Account No, 746'64314-13, JoAnne 43,749,19 100% 43,749,19
L. Anderlon, opouse - aurvlvlng beneficiary.
4. COMOOnWIalth of PA, Deferred Componaetlon progrem 46,505.49 100% 46,505.49
Ar.cot.l"lt
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TC)T~.IA"o ,"10' onl'.e7,lecopI0l'011,,"J. _~...~13.~.~~~~-"-~9
(II more .pace is ri.edM, Insert addiHonolshee'$ '01 ,'ame Size.,
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BUREAU OF INDIVIDUAL TAXES
IHtlERlJAH{:[ 14)( IJlVHiION
DEPT. 180C.01
11AARIUlIRG, IIA 17128-0601
COMMONW~ALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INIIERITANCE TAX
APPRAISEMENT, AI.LOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATI!
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-29-97
ANDERSON
09"02-96
21 97"0474
CUMBERl.ANo
101
[=-====.~u~~~:.;m~~. --J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WIl.l.S
CUMBERl.ANO CO COURT HOUSE
CARl.ISl.E, PA 11013
CUT ALONG THIS LINE ~ RETAIN LOWER flORTION FOR YOUR RECORDS ...
REv: i 547" E;{' Aj:ii '( 0;;: 97T 'NoYi C E. -OF - "iNliER-if A ifc E" Y AX" A-P PRAY ii E j.fENi'"," -;. i. j:OWAN"C E - iiA - - -" - -"..,," - -",,"-
DISALLOWANCE OF DEDUCTIONS AND ASSESSHEN'r OF TAX
JAMES FILE NO. 21 97-0474 AeN 101
JAMES D BOGARS
ONE WEST MAIN ST
SHIREMANSTOWN
PA 17011
ESTATE OF ANDERSON
TAX RETURN WAS I I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAl. RETURN
I. H.,l EMt.t. (Sohedule A)
2. Stocks and Bondi (Sch.dul. OJ
:$, Clos.ly Held stock/Partnership Inhrut (Schedull C)
4, Hortg.~.s/N~t.s Roceivlbl. (Schedule OJ
S, Cuh/Bank Oapollit5/MilC, Personal Property (Schedull E)
6, Jointly Owned Property (Sch_dule fl
7, Transfers (Sohedull OJ
8. Total Au.hi
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expans.,/Adn. Costs/Misc. Expan... (Schedull Hl
10, Dabts/Hortg8Q8 liGlbilitiu/Liens (Schedule Il
11, Tot.1 OaduClHona
12, Net V.hJe of Tax Return
13. Charit.bla/Govarnnant.l Bequest, (Schedule J)
14, Hat Value of E.t.h Subject to hx
If an assessment 1"8S issued previously, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
1&. Anount of Lina 14
16, AIlOl,lnt of Una 14
17, A~ount of Lina 14
18, PrinclpMl Tax Du.
TAX CREDITS I
--..--------
PAYMENT
DATE
NOTE:
at Spousal
tax.bie at
taxable at
rate
Un..lIChu A r.t.
Coll.ter.l/e1... 8 rat.
RECEIPT
NUHBER
DISCOUNT I>)
INTEREST/PEN PAID 1-)
) CHANGED
(1)
( 2)
13)
I~)
15)
(61
(71
,00
121,56
,00
,00
21.600,l!J!..
,00
135.362,39
(B)
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L
*'
(91
(10)
.00
.JlJ!.
(11 )
(12)
1131
11~1
It~ .1111 II ." 101.91 I
JAMES
DATE
09-29-97
NOTE I To Insure prope,..
credit to your aCClount I
lublllit the upp.r portion
of thh fO,..1Il with YO"lr
hx pallllan t ,
157 ,083.9~
DO
157.083.95
.00
157.083.95
14/ 15 and/or 16, 17 and 18 will
re1:urns .......d to d.te.
051
(6)
(7)
157,083,95 X ,00,
,00 X ,06,
,00X,15,
I1B)
,00
,00
,00
,00
,00
,00
.----------'-----.
,00
-_._-------'-
,00
. IF FAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF AODITIGNAL INTEREST.
IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED,
IF TDTI.I. DUE IS REflECTED AS A "CREDIT" (CRI. YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,)
AMOUNT PAID
TOTAL TAX CRED~
BALANCE OF TAX DUE
INTEREST AND PEN.
.-----.-_._,----
TOTAL DUE
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RESERVATION I E.tat.. of d,cldtnt. dYing on or bafora Oaaa.bar 1t, 1'81 ~. If .ny f~tur. Int.ra.t In thl ..tat. J, trln.f.rr.d
In Po.....Jon or .nJoy.,nt to Cl... a (oollat,rIU bln.flel"rll' of tha d.eft4ent ,ftl!r the Il(rdrat'lon of any I.tate for
IHa or for y..r., the Co..onw..lth her.bv ,"prl..h r...rviI tho tight to Ipprnill atld ..".. tran.far Inh.rUlnoe TaXI'
at the lawful Cia.. B (oallatlral) rlt. on any ,ueh futura Intara.t,
PUAPOSE OF
HOTlCEI To fulfill tha r.qulr..ant. of Saction 2\40 of the lnharltano. and E.tet, hI( Act, Act 21 of 1995. (72 P,S,
510\lon 9140),
PAYHEHTI O.tlch the top portion of thh NoticI and .ube'lt with your pltye.nt to the Rlghtlr of NUl, prlntltd on tM rvv.r.. .Ida,
M-Hake ohlck nr .oney ord.r payable tal REOIBTER OF MILLS, AGENT
REFUND (CR)I A r.fund of a tall or.dlt, whloh wa. 110t r.qullted nn the hx Return, IIY bl requ..tlld by oOMPlItl"9 ..~ "AppUoaUon
for Rafund of Plnnlylvanla Inhlrltanea .nd Eltatl ,Tal(" (REV-nUl. Ap!,Uoation. arl avalhbll at the OffiCI
of the R,gltt.r of Will., any of tho 23 RevenuI OJ.trlot OffiCI., or by calling the .p.oial 24Mhour
an.waring urvlo. nUlllblr. for forll' orderlnSIl In penn'Ylvanla lMaOO-362~2050, ouhldl PennsYlvania and
within 10C81 Harrhburg ern (717\ 181-8094, TOO' (711) 712M22S2 CH.aring Illpalr.d Only).
OBJf.CTtOHSI Any party In lnter..t not .ethfl.d with the appral,,"ent., el1owane. or dlullowancl of d.duotlons, or 1I.......nt
of tax (inoludlng dhcoJOt cr lntarut) a. .hown on thl. HoUcl ML/llt objeot within .Ixty (601 day. of reoelpt of
thlt Notice byI
nwritten protut td thlPA Dapart"nt of RaYlnUI, Board of Appeal., Olpt, 2810211 ttarrhburG, PA \7128-1021, OR
ulhctlon to havll the .attlr detlraJnld at audit of the aocount of tha per.onal rlpre..ntath,e, OR
MMapPlal to thl Orphan.' Court.
ADMIN
ISTRATlYE
CORRECTln~SI
F"ctual errors dlsoovII'.d on thh ",uI.ent .hould b. addra"ld In wrltlng tot PA Oepert.lnt of Rlv.nu.,
fturleu of Individual lIlX.', ATTNI Po.t Allln..nt Rlvlew Unit, Oapt. 2!0601, Harrhburg, PA 1712&-0601
Phonl (717) 187M650S. S.. paae 5 of the bookl.t "In.truoHon. fQ~ lnh.rltanoe Tax R.turn for a Re.id.nt
Dlleedent" (REYMlSOll for an axplanaUon of ed.JnhtratlvliY cOlreotabll error..
DISCOUNT I
11 any tel( due 11 paid within threa (3) lllll.ndar "onthl after thl deoltdlntt. delth, a flvI peroant (5iO dheount of
tha tax PIJd I. allowed,
PENALTVI
The IS% tex ..nuty nonMpertlcJpatlon pinal ty h eo.puted on the total of thl tal( and lnt.rest BUfl.lld, Itnd not
paid b.fore January 18, 1996, the I1r.t day aftlr thlll Ind of thl tax 81lmuty p.rlod, Thit nonMpartlolpaUon
penaltY it appealabl, In the n.e .anner and in thl the Ill" tllIlI per lod a. you would applal thl tall and lnterllt
that ha. be.n a......d .. indleatld on thl. notloe,
INTEREST I
lntar..t h charg.d beginning with flrlt da... of dlllnqu'n~Y, or nln~ (9) lIonth. and one (1) day froll thl dllte of
de.th, to the date of paYllant. TIle.. which beealll dellnqutnt bafora J,nuary I, 1982 b.ar Intera.t It the rata of
.Jle (6;:) perolnt per annu. calculated at a dally rate of ,000164. All tOXI. which benaGI dlllnquent on end .ftar
January I, 1982 will bear Intltrllt at II ratl which will vary frOM calendar yn,- to eal.ndllr YlCor' with that rate
announcld by the PA Oll1ftrtllllnt of RIVlrtUI, Thl applicable lrttlrllt rate. for 1982 thruu;h 1997 arll
'!.!!!: lnter..t Rata ~nt.r..t Factor !!!r lnt.rut Rat. OallY Intlr..t Factor
19'2 20X .00054' 1987 9% ,000247
1983 16% ,000418 19aa.1991 11X ,000301
1984 11% ,000301 1992 9% ,000247
19'" U% ,000556 1993MIil91t 7't. ,000192
1916 10% ,000214 19'5-1997 9~ .000247
~-lnt.r..t J. calculated .. fellow'l
INTEREBT . BAUNCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny Notlce h.ued .fhr thl tax beoo"" dellnqu.nt will r41fhct an Intlrut oalculation to fIft..n urn d.YI
beyond thl datI of the oll",.lnt. If pav..nt It 'lId. aftlr thl Inhrut oo.putatlon dllt. .hown on the
Notloe, additional Int.r..t _Ult b. qaloulated,