HomeMy WebLinkAbout97-00721
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FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
(10M~~~:t,~ W'~~. r.l\lW~M ANI A
HAR""Rfl~t,'\l~~~',", O{,O'
x 1. O/iginal Return
4. limited Estate
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1.\.9]. 7 OJ../
YliMt
NUMBE~
GOUNfY CODE
05.
o 8,
.------
(B)
21,225.94
oECF.OENT'S NAME (LAnl, Ftn91, AND MIC1DL.E INlllAL) Of.CfOF.NI'S COMPl.fH: AOnHE'I~'j
Ilroom 01'0" I.. 15 North II/J It lmoro Avo.
S~~I~~;~~~;,\N~M"ffi-}~~~~t;~:;~~-i;f;~{(~/:~;;~~~- Mt. Holl y Spr I ng", P^ 1]065
County C\1ll1bcr I Hnd
(IF APPL.ICABLElSURVIVINO srou9E'g NAME (LAST ,FIRST ANO M100l.E 1N';!"1.) ~lOCIAI. SEC~;A;nNC.M'~r~MOUNl RECEIVEO(S~E IN5TRUCTIONS)
L 0.00
--0-;, Romllindor Return
(lor date. 01 death p"or to 1213-82)
Foderal Estate Ta)( Return noquirod
Total Number of Safe Deposit Boxes
2. Supplomental Return
41. Future Interest Compromise
(lor date' 01 death alter 12.12..621
[]] 6. Decedent Died Tostate 01. Decedent Maintained it Living Trust
(Mach copy 01 Will) (Attach a cOPLol Trust)
C P ALL CORRESPONDENCE AND CONFIDENTIAL TA~ INFORMATION SHOULD BE DIRECTED TO:
a 2 NAME , COMPLETE MAILING ADDRESS
R D Ro!\or B. Irwin, Esqulre______.__ IRIIIN, McKNIGHT" HUGHES
~ ~ TELEPHONENuMBEn.- 60 lIost Pomfret Str'eet
T 717..249-2353 Carllslo PA 17013
1. Real Estate (Schedule AI 1) None
2. Stock, and Bond' (Schedule B) (2) None
3, Clo.ely Held Stock/Pannership Interest (Schedule C) (3) None
4, Mongages and Note. Receivable (Schedule 0) (4) None
5. Ca.h, Bank Depo.it. & Mi.cellaneou. Pmonal Propeny (Sch EI (5) None
8, JOlntty Owned Property (Schedule F 1 (6) 21 : 2 2 5 . 9/,
7. Tran,fe" (Schedule 0) (Schedule L) (7) None
8, Total Gross Ami' (total Lino. 1 -71
9. Funeral r;xpenses. Administrative Costs, Miscellaneous
Expen.e. (Schedule H)
10, Debt., Mongageuabilities. Lien. (Schedule I)
n, Total Deductions (total Lines 9 & 101
12. Net Value 01 Estate (Line 8 minus Line 111
13, Charitable end Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
1&. Spousal Transfers (for dates of death after 6-30-94)
See Instructions for Applicable Percentage on page 2.
(Include values from Schedule K or Schedule M)
1.. Amounl of line 14 taxaole at 6% ,ate
(Include valuoslrom Schedule K or Schedule M.)
17. Arnount 01 line 14 taKable at 15'/. rate
(Include values from Schedule K or Schedule M.I
18. Principal ta< due (Add Ia< from Line 15. 16 and 17.)
1'. Crodits/Sp POl/erly Prior Pilyrnanls Discount Interest
0.00. 0.00_ . 77 .12 0.00
20. "Une 19 is greater than Une 18 enler Ihe difference on Line 20. Thl. is the OVERPAYMENT,
~ 0 IChlck herl II you orl roqu",U"i.." rofund of your ovorplyml'!!:l
21. If Une 181s grealer than line 19. enter the dlHerence on line 21. This is the TAX DUE.
A. Enter the Intorest on the balance due on Unu 21 A.
B. Enter the total 01 Une 21 and 21A on Line 21B ThIS Is the BALANCE DUE.
MIke ChIck Po obll t." R lit.. of Willi, A Int
. . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
Undflf penlUllI1l 01 pftl]ury.1 dftclarlllh.l t h,Yllllumlned Ihi~ ,elum. InCluding accomp<lnying schedules and statements, Ind to tne besl 01 my knowledge ind belief, It Is lIUII,
COfrect and complele, I d8CI'III!h,t all Ifill fUltat. hn bfJen ,epoII"d at true mArket ""lUll, Dflclill"llon 01 p,eparer olh,,' than Iha ptllSOMI ,epnlsenlall"e Is based on,lIlnlofma!lon 01
whlcn prepal.f hIS illY knowledgtl
(9)
8,055.90
(10)
30.9/,
(11)
(12)
(13)
(14)
8,086,B4
13,139.10
None
13,139.10
(15)
0.00 X
0.00
(16)
13 , 13 9, 10 X .06 '
788.35
(17)
5,027.~ X15'
75/..1.3
(18)
1,5/,2.47
(19)
(20)
77 .12
0.00
(21)
( 21M
(21B)
1,465.35
0.00
1,465.35
DATE
SIGNATURE OF PERSON Rf- f'ONSIBLE FOR PILING RETURN
/1
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,NV'-
SIGNATURE 0
/}/i'
_J.
Copyr1vht (c) 199
Burry L. Glbb
15 North Bultlmoro Ave,
::,,:~ _ Mt ,il()l! Y sp;'liijs',p~ 170"65
nErARE~,~HE~;LEPnEsENTA"~Eo lIost. pomfro~R~~~~o~CKN.IGHT&..
. Curllslo, PA .17013
fOf liotlwlfllonlyCPSystems.lnc, .
HUGHES
DATE
""
rav ,nux I (7-118)
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pl.... Print or T .
FILE NU BBA
21.97-
COM~1~4\,WjOO~~~ANIA
IST..TIOF
~.!' l..
ITEM
NUMBER
...
Broam 55(1 178. 12: 9~__~/3 !Lt92.L.,~-------_.-
DESCRIPTION
"MOUNT
6,990.90
1
FunOlal Exp.n..a,
Gibaon.Holllnger Funoral
Home
50.00
2
Uriah United Methodist
Church, funeral recoption
B. ..dmlnllt,allv. Cost$>
1. Petsonal Representative CommissIons 0.00
Social Security Number ot Personal Representative: 180-2,6.6415
V.er Commlselone paid WAIVED
2. Attorney Fees 1,000.00
3. .amlly Exempllon 0.00
Claimant NONE Relallonehlp
Address of Claimant at decedent's doath
Street Address -
City Slate Zip Code _
4. Probate Fees 0.00
C. Mla..llanooUs Exp.na."
1 Register of Wills, filing 15.00
fee
TOT"L (Also enter on line 9. Raea It"I.lIonl
(It more IP'.' I. n..d.d, InsOItaddlllon.1 sh..ts ot ..m. .Iz..)
copyright (C) 199" form aoUwire only cpsyslem" Inc.
$ 8,055.90
Form 1100 Schedule HIRe...: 7:-88)
HOTEl To insure proper
aredit to your account,
IUbMit the upper portion
~f thil for_ with your
hM pay.ent,
/S-t;.IX}-- .3
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
.~
(\
IU"EAU Of INDIVIDUAL TAKES
IHHEM"ANCflAM UIY'S'ON
DlPI. I.....
~I.~, ,. Illt'-D'DI
NOTICE OF INHUITANCE TAK
A~~"AISI"INT. ALLOWANCE O~ DISALLOHANCE
Of DEDUCTIONS AND ASSESS"ENT OF TAK
U,'ihl n IU 1"."1
12-15-97
BREAM
05-31-97
21 97,,0721
CUMBERLAND
101
[=~;ount~:~~tt.d"-l
MAKE CHECK PAVAILE AND REMIT PAYMENT TOI
REGISTER OF WIllS
CUMBERLAND CO COURT HOUS~
CARLISLE. PA 17013
CUT ALONG THIS LINE ... RITAIN LOWER PORUON FOR YOUR RECORDS ..
RIV: liW-Ex. AFP" {09': i7Y"NOYiCi"OF -"iNHiiiiT ANci- TAX - APjiRAiiEMENT";" At i."ciwANc i" iili --" -" -" -- --" - - -,,-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
OREN l FILE NO. 21 97-0721 ACN 101
TAK "ETU"N HAS I tX I ACCI~HD AS fiLED I CHANOED SEE
ROGER B IRWIN, ESQ
60 W POMFRET ST
CARLISLE
DAn
ISTAU OF
DATE OF DlATH
FILl NUMIIR
COUNT V
ACN
OREN
PA 17013
ESTATE OF 8REAM
DAn 12-15-97
ArTACHED NOTICE
RISERVATION CONCERNING FUTURE INTEREST " SEE REVERSI
APPRAISED VALUE OF RETURN lASED ONI ORIGINAL RETURN
1. "..1 I.t.t. ISohedul. Al
2. Stooke end lend. I SO_I. II
S. Clo..b Held stoek/~.!'tn.r.hlp Int.r..t ISoh.dul. CI
4. Hart...../Mot.. "...Iyebl. ISoh.dul. 01
I. Cash/lank Oapolita/"lac. Perlonel Property (Schedule E)
.. Jolntl~ OWned ~rop.rt~ ISohadul. f)
7. Tran.f.r. (Sohedul. 01
.. Tot.1 A...h
.00
.00.
,00
.00
.00
21.225.94
.00
III
III
(2)
IS)
(4)
1&1
1.1
171
21, 225,94
APPROVED DEDUCTIONS AND EXEMPTIONS I
.. funeral E.penae./A~, Coats/"lac. EMpen... (Schedule H)
10. Debt./Hort.... Llabllltl../Llon. ISohedul. II
11. Tot.1 Qoduotlon.
12. Mot Value of T.. ~.turn
1S. CharUable/Govlrnllental aequeata, Non-alected nil Trysts
14, Mot V.lue of IIt.t. Subj.ot to T..
8,055.90
191
IlDI
30.94
Ill)
1121
IlSI
tl41
A.nAI. Ata
13,139,10
.00
13,139.10
ISoh.dul. JI
If .n ........nt w.. i..u.d pr.viou.ly, lin'l 14, 15 and/or 16, 17 .nd 18 will
r.fl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t..
ASSISSMENT OF TAXI
11. A.aunt of L I... 14 .t Spou..l r.t. III I
1'. Aoount of LI... 14 t..abl. .t Llne.I/CI... A r.t. 11.1
17. Aoount of LI... 14 t..obl. .t Coll.t.r.I/C1... . r.t. 1171
l't Prlnclp.l T.~ Due
NOTlI
,00
13,139.10
5/027.50
K .00.
x .06.
X .15.
ClIl
.00
788.35
754 . 13
1/542.47
TAX CREDITS I
~AY"ENT
DATE
08-28-97
DISCOUNT 1+1
INTEREST/PEN ~AID I-I
77 .12
ANOUMT ~AlD
1/465.35
"ECEI~T
NUNIU
AA211687
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTERIST AND PEN.
TOTAL DUE
1,542.47
.00
.00
.00
l
" IF ~AID AfTE" DATE INDICATED, jll "IVE"SI
fD" CALCULATION DF ADDITIONAL INTE~IST.
If TOTAL DUE IS LISS THAN tl, NO ~AY"ENT IS REOUI~ED.
IF TOTAL DUE IS REfLECTED AS A "C~EDlT" (CRI, YDU "AY II DUE
A "EfUND. SEE ~EVE~SE SIDE Of TNIS FD"" fO~ INST"UCTIQNS,I
.""'~~
I.U!~VATID'h
_EOI'
NOlltE I
PAV"M1'
REFUMU (CR)I
OIJECTIONSI
ADllIM.
IITRATlIIt
CORtilCTJOMSl
Dl.C0UIl1,
PEMAL'fVI
IM1!IIU1.
f~'
',J
EI"'" of dec~t. dylnl an or blfor. D.c.~.r 12, 1'12 -- If .nv fut~r. Int,r..' In ,ht I.t.t. .. '"en,f.rr.d
In po.....lon or .nJoYHn' to Cl.n . (oolh,....ll b.n.f1c;l.d.. of the dtced.n' eft.r U...Mpa,.U", of MY ..tit. for
Ilf' or for 't..r., thl COIaQ~.lth h.r.by .xp~...lY r...rY" the rltht to IPpr.lt. tnd ...... 'rln'f.r Inherit,nc. "M"
at 'hi laWful Cl." I (lloll~t.r.l) nt. on any lueh future lnt.r..t.
To fulfill tt'le r.qulrIHnt. of Slotton ZI'tG of the Inharltanol IInCI E,t,t. TIM Aot, Aot Zl of 19.5. ()'Z P,I.
Slotlon'lltO)'
o.taoh 'hi toP portlon of 'h" NoUel and tubalt ",lth your plv..nt to thl A.,ht.r of wilh printed (In tha nv.r.. .Ide.
..M_. ohlck or 10n''1 order pIYlbl1 tOI REGISTER OF "ILLS, ADENT
A ,.fund of a tlM cr.alt, Which w.. not r.que.ted on the Tax Rlturn, .ty b. r.que.t.d by coupi.tine an ~Appllo.tlon
for R.f\o!Md of Pennnlvanll InherltlnCle end Elt.t. Tlx~ (MEY-UUl. .ppllcatlon. .ra l"'IUlbl. .t thl Office
of thl R~lhter of Wllh, ."y of tha n Ra""nua Oiltdot OfUCl.., or by ClaUlnll tha .pedtl Zit-hoUr
an....rlne ..,,,,ice nu-b_fI fOf' for.' orderlnll In Ponn,yl".nl. 1.60D-S6l.Z0liO. outtld. PannIYI"."ia end
within 10cIl H.rrllbur, .te. (~11) 711"IO~4, 1001 (711) 77Z-ZZSZ (Ha.tlnl lap.lt.d Only),
Any plrtv in inter..t nett ..U.U.d with the iHtpr.l....nt, .11C1MIInC' or dh.l1owMCl' 0' dec\UCltlonl, or ........nt
of t'M Oneludlnl dhcount or Interl.t) .. .hown on thit NotlCle .u.t obJ.ct within .Ixtv (60) dllY' of rlcllpt of
thll MoUeo bv I
--writt." prot..t '0 the PA Depart..nt of "e"lInue, laIrd 0' i\pp"U, Oapt. 211021, Herrllburl, PA 1112'-toU, OR
--election 10 hl",a tha .atter detlr.lnad .t .udlt of thl account of tl'll p."on.l ,,,,,r..antIUye, DR
--appIII to the Orphll1.' Court.
FHtUIl er,ort dl.oo",.rltd on thh ......Mnt .hOUld b. .ddr....d In fIIrltint tOI PADlp8rt.ant of ".venut,
,ur..u of Indlyldull TIX", AllNI po.t A......."t R.vllw unit, Clpt. Z10601, Harrl.bur., PA 1112'-0'01
PhoM (117) ,,'-'SOS, S.. p... S of the bOOklat ~ln.trucUon. for 'Inh.rltancl hM Return for a ...Idlnt
Dle.dlnt" UtEY-UOl) 'or an l.ltpUnlUon of adlIlnlltraU"llY corrlCltlbl' I,'rort.
If env t.lC .. 11 p.hl within thrH (5) cal.nciar ItOnth. .U" thl cIIcedent's ,ieath, e fI". per-4....t (iX) discount of
the talC p.ld Ie sHoweI.
ThI UiX taM ......tv non"partlcipation pen.lty h ClO....t_ on thtl tote 1 of thl tlX IInd Int.r..t ......"~ and not
paid b.fore JlnYerv 11, 1996, thl Utlt day sft.r the end 0' the \Ix a,,",'ty period, Thh non~partlclp.tlon
p.nelty It .ppa.ltbl. In the .... .lIf\Mr .nd In thl 'hI..... tI.1 p.riod II you would I9p.'l thl 'IIC and Int""t
thlt hll beln .......d .. Indlcltltd on thit notlCl'.
Int.nst I. cMr.... blllnnlnt! wUh flr.t d.y of dellnquencV, or nine (9) IIOnth. tnd ctnI (I) dav frOll thl ute of
dI.th~ to thl date ftf PIYllM"t. TI." NhIClh b~'" delinquent "fore JanuarV I, 1912 Htr Int.,..t .t the rata of
.IIC ('~) p.tolnt plr ~~.Ioul.tld It . d.llv r.te of ,OOOl'~, All tex" which b~c'" dll\nqutnt on and aft.t
JanultY I. 1912 wUi bur Intarllt at a rate which will "'try fro' eallnaar yllr to ell.nd,r ya.r with thlt r.t.
announcld bV ttol. PA n.part.."t of Rev'nue. Th. ,ppUnbl. Interest rat.. 'or 19.1 through I'" a"ll
'!!!!: Interest R.te Oallv Int.rllt f'.~ !!!! Inten.t R.t. DaUv Interllt ractor
I"Z ZOX .0005141 1"" 'X .000247
l.n 16lC .0004" 1"1-1"'1 \IX ,000101
191~ 11:< .000101 1992 'X .000l47
tnS I1X .0003516 1"!o"I"4 IX .0001't2
I'" 10): .000214 1''951"19'1 '9;': .000241
--Int.rut it oatcul.t.d .. folloWII
INTEREST . BALANCE OF TAX UNPAID X NUHSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"~~nv Notlo. ItluItd ,Uer the tax blcot" dlllnquent wUI rlUIClt an Intltllt ClIlcul.Uon to flft..n (U) day.
beyond the d.tl 0' thl ......Mnt. If Plv..nt II ..dl after thl Inhlt..t OOltPUt.tlon dIIt. lhown on the
Hotlc., additional Int.r.st .u.t be c.ltul.ted.