HomeMy WebLinkAbout97-00552
r'J C / Yf4)
INHERITANCE TAX ReTURN
RESIDENT DeCEDENT
(TO BE fiLED IN DUPLICATE
WITH REGISTER OF WILLS COURI1CODE
DECEDENT'S NAME ILASI, FIRST, AI.D MIDDLE INITIAl) DECEDERT'S COMPLETE ADORESS
Bohr Racho1 E. 1,1,7. lIalnut Bottom Rond
SOCIALSECURIT1 NUMDER DATE OF OEATH DAlE OF DIRTH Car 1.Islo, PA 17013
203.30.1101 04/03/1997 08/30/1907
Coun'1 Cumberland
\'F Al'PLleA8LEiSuRYMRG SPOUSE'S NAME (LAST ,FIRS! ARO MIODLE IRITI"~"~:::RIT1 NUMDER
X I. Orlgln.1 R.lurn ---rJI. Suppltmonl.1 R.turn
~ , r 4. LI,""d Esllte 0 41. FuMI lnt.,.st Compromls.
! g (Iord.tn01 d..th."ol '2-,2-82) 01,
K ~ []] I. Oocodont Oltd T.st.t. 07, O.ced.nl Mllnlllntd I LI1ing TlUsl --2-1,
(Anl~hcopyoIWIlI) (An.chl:~lust) -
i Op ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION S;IOULD BE DIREC~O;
NAME COMPLETE MAILING ADDRESS
, Geor e A. Vau
TILEPHONE NUMeER 3904 Trind1e Road
_ 717 975.9102 Carn Hill PA 17011
I. Rill E""to (Schodult " I Olle
Z. Stockslnd Bonds (Schedult B) (2) None
3. Cloltly Hold StocklPlrlntrshlp In.o,nt (Schedulo C) (3) NOlie
4, MOrlgogoSlnd Notos R.colvlblt (Schodulo D) (4) None
I. Clsh. Bonk Ooposlls & Mlscolllneous Porsonll Propll1y (Sch, E) (I) Non';
I. Jointly Owntd Propo;1y (Sched"1t F) (I) 13 ,065,39
7. Tr.nsl.rs (Schedult G) (Schedult L) (7) 9,929.99
I. To..' Gross A...ts (to..1 Llnosl-?)
.. Funer.l Expen"., Admnllt,.II.... Costs, Mlsc.lI.ntous
E.pons.s(Schedulo H)
10. D.bts, Morlgogo Lloblllllts, Lltns (Schtdult I)
II. To..1 O.ducllons (totll Lints 9 & 10)
12, N.t Vllu. 01 Es..t. (Lint 8 minus Lint ,,)
13. Choritlblo Ind Gov.rnmentll B.qun" (Schldult J)
14. Nil Vlluo Sub cl to To. (Lint 12 mln"s Lint ,3)
II. Spoultl Trlnsl"s (lor dlt.. of dtlth Iftor 6-30-94)
SH Instrucllons tor Appllclblt porc.nllgo on pig. 2,
(Includo Vlluos Irom SChodult K or Schedul. M,)
II. Amount 01 Lint 14 ....blt 116% rl"
(Includl v.lu" from Schedulo K or Sohtdult M,)
17. Amount 01 Lint 14 tnlblt 1.,5% IItl
(lnclud. v.luts Irom Schedult K or Schedul. M)
II. Prlnclp.I... du.(Add t..lromLlnt 15. 161nd 17,)
It.CrtdkslSp Pov.rty Prior Plymonts Discount
. 925.00. 48.68
ZO. If Lint 191s glllt.r thin Lint 18, .ntlr tho dlttor.nc. on L1n. 20, This Is the OVERPAYMENT.
[!J 0 IChock he.. " you ... ..~_lIng . rotund of you. oV"P.!l!!!!!!!:I
21. It Lint 181s gllll.. thin Lint 19, .nlor the dlttlllnce on Line 21. This Is tho TAX DUE.
A. Enter ,he lnt.r.st on thl bll.ncl due on line 21 A
I. Entorlht tolll 01 lint 211nd 21A on Llnt2'B, This I. the BALANCE ClUE.
Mlk. Chock PI Ibl. to: R 1111. 01 Willi A ...1
. . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH · ·
Unci., pliNltIe. Df JMlflUJY I I d~,.,.lha' I hi.... IllImlr*' 'hit return, tncludlnt .ecllmp.ny1nt tehtdulet "net tlll.menls, .net to thl be..! Q' ff'r'( knowledg' .lId bell.f, 1111 trUll,
COff.' ,nd Camp'-'I. d~I." th'llll ,..1 .,1"1 h.. been '.ported It llue milk., y'I.... o,et."lIon (If p'lpll" othor lhln lhl petlo",,' '.pr...nl.tI....'. bned on ,lIlnfo",...,lon of
whtch pI'pI'" h.. '''1 know~. _
Jane A. Dell is
201 North 2nd Street
Worm i ayahll': 8 " . 'Pi, . . -Uai;j . . - . . . . . . . . . . . . . - . . . . - ..
~1\l,.lI00E' '(1.14)
COMH~'xt.~thI~l!f"MIW~~AHIA
HA~~ISR5~t,~\z8'0e01
I
I
I
Q
8
S1QNATU~1 OF PERSON RESPONSIBLE FOR FIlIRQ RE1URN
,2 .
( - - -t..... L:i-~ ~,-Gh..Lfl..-'
~f
llakATu~1 OF pnEPARER OTHfiR THAR REPRESENT ATlI/E
~ ~.,
'I. I
<. (<", ( Vo....-
, '''hI (el ,,,.irntoftw.,,only Of'S)'I'I"", II'(.
FOR DATES OF DEATHAFlER lZIJII"CHIC~ HI~I
IF A SPOUSAL 0
POVERT't'CRE.DIT IS CLAIMED
FILl NUMIIR
21-97-552
YEAR
NUMBER
AMOURT RECEII/EOISIE INSTRUCTIONS)
0.00
Rlmalnd,r R'lurn
(lor dll" 01 dtlth prior 1012.13.12)
F.dor.1 Estill T.. Rtturn R.qulrld
Totll Numb.r 01 S.I. O.posk Be...
(I)
22 ,995.38
(.)
6,n6.60
(10)_
267.50
~544.10
16 .451.~8
(11)
(12)
(13)-
(14)
16 ,4ill!.
(II).
0.00 X
0.00
,
(II)
16 ,451. 28 X ,06 '
987.08
(17)
0.00X,'5'
0.00
(II)
987.08
Intlrtsl
(It)
(20)
973 .68
0.00
(21)
(21")
(2'1)
13.40
0.00
13.40
DATE
'hi!?
DATI
"?/N'll
Form 'IOOIR", 7.14)
3904 Trlndle Road
Camp' iiiir:'p..: ..i7'oiC..... .-...... -.. ...-. -...-
\
..
- -, ~
I'-< jj-
tie:t:
'tl1 tf~ ';10..
cl) N ,-
\'1\ C\. ,
CI\ 'I
I
.' ;:J \~
, , y-.
,-, r.... ~8
(\IU,: P'"
0:,
,
I
H
, ~!
I'
AIiV .. 1I0U)(. (11-111
'.
SCHEDUL.E F
JOINTLY-OWNED PROPERTY
~1l.~~~AH'A
ISTA 10'
RIlchol E. Bohr 55 203-30-1101
JoIIll _tll)'
A.
NAMI
_.--
Jane A, Davie
I,
c.
JoInllr.ow..... ,.opoftYl
LITTER
FOR
JOINT
TENANT
A
ITEM
NUMIlER
1
DATE
MADE
JOINT
05/19/88
04 03 1997
ADDRESS
201 North 2nd Stroet
Worm1eyoburg, PA 17043
-
DESCRIPTION OF PROPERTY
TOTAL VALUE
OF ASSET
26,130.77
-
ellon Bank . Checking
acccunt #302_109-2667;
balance as of date of death
1_;.
; ~
TOTAL (Also onlll on 111\1 Ii RIOI hu~lIon)
(It moll Spiel Is ","dod, InSllllddhlonolshlolS ot limo 1111,)
Copy'lth' (c) 1114 tOfIn IOt\WI" oNy CPsv""'" Inc.
FILl NUMUR
21-97-552
RELATiONSHIP TO-DICEDINT
Daughter
-
DECO'S
'.<oINT.
50 . 007.
DOLLAR VALUE 0'
ECIDENT INTIRIIT
13 ,065.39
13 065.39
FOIm UOO .._ , (11oo, II-II)
':
, .
.
LAST wm, AND 'l'1~1'AMEN'r
I, RACHEl, E. OOHR, of the Borough of Tower City, County of
Sohuylkill and State of Pennsylvania, do hereby make my last Viill
aM 'ft!starnent and revoke all Willa by mo nt. an.v t.i",,, horo\'ot'oru made.
I give, deviso and bequeath my entire estate, both real am
personal, whatsoever \'ho aarno may be or whoresoavor the samo may be
situate at the time of my dooease, unto my huoband, Oliver A. JJohr.
In ths event that my said husband, Oliver A. Bohr, should
predeoease me, or clie within three months from the date of my death,
then I give, deviBe am bequeath my said entire estate unto my
daughter, Jane A. Davis.
I nom.inate, constitute and appoint my hUSOOM, Oliver A. Bohr,
,Elceautor of this my Last Will am Testament. In the event, however,
that my saicl husbam shoulcl predeceastJ me or that he should die before
the final distribution of my estate, then I nominate, constitute and
appoint my daught.er, Jane A. Davis, F..xecutrix of this my last \'Iill
aM Testament.
I authol'ize and empower my personal representative to sell any
or all of my real estate at publio or private sale as he may deem beat
aM to execute aoo cleliver a deed or deeds therefore, Without any
liability on the part of the purchuser or purchasers to see to the
application of the purohuse money.
In Witnoss Whel'eof, I have hereunto set my hand am seal to this
my Last l'Iill am Testament th:Ls STH day of :r ItAl \J ~ 71:1 ' 1961 .
~---~C~{(E.4!hr ~U
/S-/ ff.~
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
c
..
NOTICE Of INHERITANCE TAM
APPRAISEMENT. ALLOWANCE OR OISALLOWANCE
Of OEOUCTIONS AND ASSESSHENT Of TAM
IUREAU Of INDIVIDUAL TAMES
I~RllAHCE 10M DIYISloN
Dt:P!, m60l
HARRISIURO, PA 17121-0601
m.\U' U If' lit-Hi
10'27-97
BOHR
04'03-97
21 91-0552
CUMBERLAND
101
F- A~ount Ro~lttod :3
MAKE CHECK PAYABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THiS LINE ~ RITAIN LOWER PORTION FOR YOUR RECORDS ~
ii'iv: iS47-ix..APp.C09: i;Y"iloYicr.cjp.i"NHiiiiTANCi .TAX' APPRA iSiiiiilr;.Ai.'i."oWAHCi.OR.... .... -.... ,....
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
RACHEL E FILE NO. 21 91-0552 ACN 101
GEORGE A VAUGHN
3904 TRINDLE RD
CAMP HILL
III
DATE
!STATE OF
DATE OF DEATH
FILE NUMBER
COUNT V
ACN
RACHEL
E
PA 11011
DATE
10-21' 97
ESTATE OF BOHR
) CHANGED
TAM RETURN WAS. I X) ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. Rool E.tato (Scn.dula A)
2. stocke .nd 8o~d. (Schedull 8)
S. ClooalY Hald Stock/Portnaronlp Intara.t (Scn.dula C)
4. "art...../Not.. Receivable ISchedull Dl
5. C.~h/'.nk OIPollt./H1IO. Parlonal Property (Schedull E)
6. JointlY O.n.d Proparty ISchadul. f)
1. Trlnl..'" (Sohedull Q)
I. Totol Au.to
HOTEl To In,ur. prop."
credit to ~our ICCount,
.u.-It tho upp.r portion
O( th18 for.. wUh )four
tax p.yMnt.
.00
.00
.00
~
.00
13;065.39
9.929.99
II)
III
121
(5)
(4)
IS)
(6)
111
22.995.38
6.276.60
267 .50
Ill)
(12)-
I1S)
(14) ~
".Ii'" 10
16.451.28
.00
16 .451. 28
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral EKP.n.../Ad.. Coata/Mllo. EKP.n... (Schedule H)
ID. O.bt./Hortgog. Llabllltla./Llan. ISonadul. 1)
11. Tot.l D.ductlon.
12. Net V.lu. of Tax Return
15. Charitable/Govern..ntal a.qua.tl; Non-elect.d 911S Trult,
14. Not V.lue of E.tat. Subjact to T.x
NOTl:
(9)
I1D)_
IScn.dula J)
If .n ........nt w.. i..ued previou.1Y. lin.' 14. 15 .nd/or 16. 11 .nd 18 will
r.fl.ct figur.. th.t inclUd. the tot.l of ~ r.turn. .......d to dat..
ASSISSMENT OF TAXI
IS. AMount of Lln. 14 at Spou.al rat. (15)
16. Aoount of Lln. 14 t.x.bla .t Lln..l/Cl.a. A rot. (16)
17. Aoount of Lln. 14 ta.obla at Collatarol/C1.'. I r.t. (171
II. Principal T.. Quo
TAX CREDITS:
PAYHENT
DATE
06-30-91
01'08-91
,00 M .00,
16.451.28 M .06.
.00M.15,
UI)
.00
981.08
.00
981.08
RECEIPT
NUHIER
AA211419
AA211513
DISCOUNT It 1
INTEREST/PEN PAID (-)
48.68
.00
AIlOUlT PAID
925.00
13.40
TOTAL TAX CREDIT
---
BALANCE OF TAX DUE
INTEREST AND PIN.
TOTAL DUI
987.08
.00
.00
,DO
---
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN .1. HO PAYHENT IS ~EQUIRED.
If TOTAL DUE IS RtfLECTED AS A "CREDIT" (CRI. YOU HAY IE OUE
A REFUND. SEE ~EVERSE SIDE OF THIS FORM FO~ IHlTRUCTIOHS.1
.
f~ ..~
Ii
.;;
(.)0
ft!URIIAlIOfh ht,t,. of dlio.dtn~. dying on or blfor. Ole"..,bt,. 12, 1912 ~~ If MY futurl Int.r..t 1n the ..t.t. it trenlftrred
1n po.....lon or ",Jo,.."t to ell.. I (ooll1t.nl) lNtneflo1Irl,. of t~ Qc,dMt Iftlr thtt lle.lr.tian of My ..tlte for
lUI or for Y"'" thl Co.-onMIIUt1 h.rlby IMPr...h r...r..,.. the tight to ""rISt. tnd ...... tren.fe,. InhtrltMCI f.N"
It the II",ful el,.. . (OOUltl,.IU r.tl on ,"Y .uck futu"l Int.r..t.
_EOF
NOTlCfl To fulfill the r.qulr...ntl of S..Uon 2140 of the Inh.rltanca tnd E,tata TIle Aot, Aot 21 of 1995. (12 P.S.
leaUon 9140).
PA'tHENfl IMtech tM top porUon of thh Notlcl and tub,1t !11th !lour PIY.lnt to the Realltar of MIU. prlntld on thl rlv.rt. .lde.
--MM' chick or tOtllY ord.r plylbl. tal REGISTER OF MILLI, AGENT
Rf.f~O (CR)I A r"fund of I tile ofldlt, whlClh WI' not r.qu..tld on the filM Rlturn, .IY b. rlqu..tld by ClCtlPllUng In "Applloation
for R.fund of PIM,Ylvanil Inhlrltlnel 4tnd E.tltl Tile" CMEIIMUU). AppllcIUons In IVIUlb11 It the OffiCI
of t~ R_,lItar of ~l1h, .ny of th_ U Mlv.nua Olltrlct OffiCI" or by c.utn. the IPlo111 l4Mh~r
'"....r1n. ..rvlcl nu-b.r. for forll order In.' In Plnntyly,"11 1-laOMS'ZM20S0, out.ldl Penn,Yl"",I, ~
within 10011 Hlrrllbur. ar.. (711) 117-1094, TODt (717J 772..2252 IHllrint! I..,.irltd OnlY).
OIJECTlONSI An~ Plrty In Intere.t not "thfled with thl .ppr.t....nt, .Uow."ce or dluUoWlInC8 of deductiont, or .....Iunt
of tl. (including dltcount or Int.r'lt) .. .hown on thlt Hotlcl .Ult objlct 'lithln .iIcty (60) d.YI of ,'te.tpt of
thit HoUo. b~l
MMwrlUIfl prot..t to the PA Oepart..nt of R.venut, 10lrd of App.III, D.p\. 1.11021, HlrrhtMJrg, Pi 11121~10Z1, OR
M~.IIC1t1on to hlVI the ..ttlr deter.lned It IlUdlt of the ICcount of thl p.rtonlll repr..entatl"., OR
u""ll to thl Orph~" Court.
011I4111
IITAATllIE
C_CTlONII
fMtual errorl dllcov.red on thh ."I..Mnt IhDUld b. ...r....d In writing tOI PA Deplrt""t of RevMUl,
lur.eu of Indlvldu.l fl.lt, AllN, ~Ol' ,t.....tn, R.vl.w unit, nlpt. 210601, Herrllburg, PA 171ZIMO'01
PhOne (717) 711-'501. See "... 1 of the book..t "In.truoUon. for Inh.rltencl TIM R_turn for' R.lldlnt
OIoedlnt" (RfY~lSOll for .n IMpltn1Uon of .m.lnlltraUvah corrlctMle Irrorl.
DISCOUNT I
If any tlM dull I. p.ld ldthln thr.. (5) elltndar IOnthl afUr the Otceden,'1 deeth, I flv. Plrt..,t (5~) dllcrount of
ttMI taM plld 11 .UOMId.
PENALlY I
l.,. lSX tlM IWIItty non~p.rtlelp.tion peMltY 11 cuputld on the totll of thl tlM ."ct Intan.t ......act, and not
paid blfor. Janulry 11, 199', thl firlt d.y a"t.r the .nd of thl tll( '1In"ty Plrlod. Thh non~plrtlclpltlon
pMlttY It ."..llbl1 In thl I" IItnntr end In the the ..... U.. p.rlod .. you would .".al thl tlM and Intar..t
that hit Hen ......ttd a. Indicatld on this notlu.
IIITE,nT,
tntlnlt it ehlr.... be.inning with flr.t dlY of delinquency, or nine (9' ""tht and ana (l) etay frOll thl dlt. of
dIIlth, to thl cStt. of pIy.."t. Till" whioh bee... dlllnquent befor_ Janulry 1, 1..2 blllr Inter..' at thl ratl of
.b ('l() ,.rcent ,.r ..w.. calcul.tld It a dlUv rat. of .0001'''. All tllell whSch bee.. dlllnquent on and after
January 1, 1.IZ will belr Inter..t It . rat. Nhloh will vary fr~ e.lenetlr ~..r to a.landar VI.r with thlt r.tl
IrW"MJftCIH bv the PA o.plrtaent of R.vlnue. f.,. ...1101lb1l1 Int.r..' rat.. for 1912 through 1..1 .rel
'!!!! .nt.r..t R.te O.lly Int.rllt Factor ~ Int.r..t R,t. O.Sh Int.r..t FlGtor
I9IZ lOX .000541 1917 ,~ .0002'"
19n 16~ ,OOOU' 1'''~1"1 11:': .00nJ01
19.. m .000101 I"Z " .000l'"
1911 ISX .000S5' 1995~1991t 7~ .0001tz
19" 10l .00027" 1"5MI"7 9~ .OODZ'"
M-Int.rllt It C.lcIUl.tld II foSIoWl1
INTEIElT . BALANCE OF TAX U"PAIO X "UNBEI OF DAYB DELINQUENT X DAlLY INTElE8T FACTOI
M*Any MottOI i..UId I".r the tllC blleOlMt dllIn.-nt w11i r.fltct In Int.r'lt Clllcullt10n to fHtHtI (15) dlyl
baYond the; cStta of tM '''.''HRt. If PIV'Mnt 11 NdI .ft.r the Intar..t ClHPUtlUon d.t. thOMn on thl
Notte., HctIUonlll Int.r..t Wit be a.leuSltM.