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Home My WebLink About80-00355 -.;1. ,'.' ,::..-' ...... , @3 '( 11". , -',.' .rJ , I .~ '. ,~ '.' a8 ~ I , ,. S:1 rI.I I . >< I ~ " ''': 0 ~ 0 ~ e - 0 ~ 1ll!. - 1.0 . oS 0 u:l z IHSTRUCllOHS ASSElS: ~ lYPE OF ASSEl _Indicate whether the o..et is real estate, personal property, tronsler or jaintly.owned. DESCRIPllOH _ List all assets awned solely by the decedent or awned jointly with another party or parties os tenants in common or os loint tenants with right 01 survivorship at the time 01 death. Include the decedent's percentage of ownership, the name (s) and relationship to the decedent of the surviving joint owners and the estimated market value 01 the decedent's interest as of the dote of death. Include intangible personal property titled in the name of the decedent but payable at death to another party or parties including but not limited to P.O.D. U.S. Savings Bonds and tentative trust accounts. List any property tronslerred by the decedent within two years 01 death lor which he/she did not receive valuable and adequate consideration. Describe oli real estate located in Pennsylvania by lot and block number, street address, number 01 acres and include a general description of the land and buildings.. Also, include the book and pose number in which the deed is recorded and the exact title os indicated on the deed. DEBlS & OEDUClIOHS _ Unsatisfied liabilities incurred by the decedent prior to his/her death ore deductible against his/her taxable estate. In addition to debts incurred by the decedent, other items arc claimable includins the cost 01 administration, attorney Ices, fiduciary fees, lunerol and burial e'penses including the cost 01 a burial lot, tombstone or srave marker. List the dote on which each debt was incurred and/or paid and the names 01 each payee. Provide 0 briel explanation of the nature of each debt claimed and the amount being claimed, Evidence to support the decedent's or the estate's lio~i1ity lor the debts being claimed should be attached to this return A lomily exemption may be claimed by a spouse 01 0 decedent who died domiciled in Pennsylvania. \I there is no spouse, or il the spouse has larfeited his/her rights, then any child 01 the decedent who is 0 member 01 the same household con claim the exemption. In the e'/ent there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the some household as the decedent. .... > z !: ." 0 n > m m S:t. c ~ z > 0 0 0 '" ,.. 0 m Cl n c: 0 .... m ~ '- ;<I m 0 m '" :z ;<I > :z . ." .... m :z :z m .... m .... ? :I: .... '" ~ ? .... -< '" m 0 '" p 0 ? '" :z :z 0 0 ~ 3 ? ." ~ ." m ~ .z ~ . :z .. -< c.... ? "- "- .:-; , \ ,.., ~ ~ " ~ r-;, ; ~ "---, "0 r-.. '-l ~ ; ~ - r ~ ! " ''-1 (,\ . ~i ':: """ ;; . ;, --- ~~ ... " ..... , " " . m l.;:. '" '" ~ "" -< l,J m , .. ~ , :j ... m \..... "-- . -... , > I., . . ~ ;<I t\ \ ~ I t. ~ , 0 ~ I v~ 0 ~ 'j. '" !.' r -t' 0' .~ "- ~ ...... " -<:: . "- V 00J ~ '-J to n ~ a ~ "- ';: ~ '\; ""'. '\ ~ '\' ~ IHFORMAllOH > o ~ = '" .... ;<I > .... o :z ! ,.. :z ,.. o -< m > ;<I PLACE FOR FILIHG _ lhe return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided. liME FOR FILING _ lhe return is due nine months alter the decedent's death, unless on extensian lor filing has been applied tor and granted by the Secretory of Revenue within the nine-month period. FAILURE TO FILE RETURH _ Section 791 of the 1961 Statute provides that" , . .any person who willlully loils to Iile a . return or other report required of him shall be persu,;all', liable. . .ta 0 penalty 01 25% 01 the tax ultimately lound to be d"e or S1,000 whichever is the less to be recovered by the Department of Revenue as debts 01 iike omounr are recov.tobl~ by law." NOTE: Fees paid to an estate repres~ntative; namely, an executor or administrator, for oervices performed in ad. ministering an estate is reportable lor Pennsylvania Income Tax purposes. This taxable income item shoud be reported an lorm PA.40.lndividuallncome Tax Return. INFORMATION To insure proper credit to your account, the name of the estate and file number should be clearly print. ed on the check or money order. This assessment is made in accordance with Section 708 of the Inheritance ond Estate Tax Act of 1961172 P.S. 9 2485.708). To the extent that inheritance tax is paid within three (3) months after the death of the decedent, a discount of five (5) percent is aliowed 172 P.S. 9 2485.716). Inheritance Tax, other than tax on a future interest, is due at the date of the decedent's death and becomes delinquent at the expiration of nine (9) months after the decedent's death (72 P.S. S 2485.711). Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P.S. 9 2485.712), Calculate interest from the delinquent date shown on the face of this form to the date of actual payment using t,he following interest table: ------------ --------- ---------- --- ---- --------- - - - -- - --- -------- -- -- - - - ---- I month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 months .025 8 months .040 11 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .00017 11 days .00186 21 days .00352 2 days .00034 12 days .00203 22 days .00369 3 days .00051 13 days .00220 23 days .00386 4 days .00068 '4 deys .00237 24 deys .00403 5 days .00085 15 days .00250 25 days .00420 6 days .00101 16 deys .00267 26 days .00437 7 deys .00118 1 7 days .00284 27 days .00454 8 deys .001.35 18 days .00301 28 deys .00471 9 days .00152 19 days .00318 29 days .00488 10 deys .00169 20 days .00335 30 days .00500 --------------------- --- ------ --- --- - ---- ----------.- - - - --------- ----..- Any party in interest, including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (60) days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961172 PS. ~ 2485.1001). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: NO. 21.80 355 PETITION FOR LETTERS OF ADMINISTRATION IN THE ESTATE OF ....."~~f.~~S?~,..~.~~f?:-,C;;J$...."..".......",,.... I>ECEAS1~l). To ................... ~~.:; y... .c;.,... .!'~w. ~~.. ....................................................................... Register of Wills f'lI' the Couuty of Cumberlaud, iu the ('ommouII'eallh of I'euu,;ylvania. The Petition of ...............Eli.2:abe th... Z.ubr.ick....... ....... .......... ................................. ..... ........... ...... ........ ..................................................... ..... ,'espeet fully shOll'el h lha t ..~ i'1-m~~.9.p....~).\l;lx:iGJ!;.......... ............. ........... . New Cumberland TOII'uship I WIIS II resident of ..........................................................Borollgh . Cumhel'iaud Coullty, State of Pennsy- vania, and II Citizen of United St.lltes, IInd depart.ed this life iute,;tate in the Couut.y of ..c;.\-!!Jl.R.'?;r;J.~r..g ............... ......................... aud S tll t e 0 I' ...... .1?~ !:l:~.~Y.~ Y. ?!.I}~.~.................................................................................. on .~~.~~!:.4!:\x................ the .........t.~!;....................... da)' of ..........J..u:l-.y.............................. A. D.. 19.7.&...., at the IIgc of .......R....... years. That. the said ........~.~l!!~.:!!?!:...~.~?:.~.c.~.............................. dcccased, left surviviug t.he following named widow or husband, heirs and next. t.o kin, t.o lI'it: Name Relationship Hesidence ....:rn~.~.?!p.!?!;..l:\...~.W?~.~9.l.'i............... ........!1.9.:t;..II!;lx:.................... .....R.2.31...Ho.cker...Dxive.,...HaJ;ri sburg 17111 ................................................................ ............................................ ................................................................ ....~.?.~::.p.~...~.~~.~.~c:.~....................... ............................................ Father .....!,I..P.:\::.,...?-.R.?::'.19.:\....k!J,\l;.t.9.\1......... Detroit, Mich. 48203 ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ ............................................ ..............,................................................. ................................................................ ...............,............................ ................................................................ That those above named include all of the next of kin, so far as known. The said decedent was possessed of personal propel't.)' to the estimate,l value of $..!..?.i.....&.9.jll.~.(~:, &~ and of Real Estat.e, less incumbrance, to the estimated value of $........".0..".................. as near as can be ascertained. That the said Real Estate in so far as is known i,; locat.ed in .......~v.~................................................. ........................................................................................................................................................................................ Therefore, your petitioner!s) respectfully appl)'(ies) for Letters of Administration in the above named estate. l F-oR, Le-G III fTC, T' 0(\;) Dated ........~~y....E........................... A. U., 1!l\l9..... Signature and Addl'c,;,; of Petitionert,;) ................U~.~~~~~.~k............. ........................................................................................ fp'J.3! I!or../(e/? DR, ........................................................................................ ....................1. ~C!..}.. ...Pt!.............!. !/F........ ............ l.l 0/0 COMMONWEALTH OF PF.NNSYLVANIA 1 r ,;s: COUNTY OF CUMBERLAND I ................................................................ ............................f"'I..~(Ift.q,if... ......6.~......i,.1!. iG.~.'.~.t:.. .......... named in the above application being dul)' .....:::?\!!.D..I?:-.l':-l......................... al'conling to law, sa)' that the facts set. forth in the above application are true to the best of ...rJ:~JI:(..... knowledge and belief. .........6w.,(!~~.................................. and subscribed 1 :...tJi?f~....3:...t""~If:............................. before me. \....................................................................................... I ....4r.'.?.....;.....;..~........ A.;'. ,,8.'..... ...........................................................m.....................~.' . ..............'1((1;...l!......1u.h~....~~~.i.~~~~.... .............................................C;;'G1Elis....r.Di~F;e) Filed: ......~.1.a.?......2.~.~.. .....~~.~.~............... ............... A t tot'ne~'.: ....Lit! ~.....f?.2.(J.'./k (!'.?~~~.Cf.- 'f".i '6') (over) 'fie:) li~ tJ!.f\)O ;5/.) /:[ /,:,e/o /['/',2.. tiN, PI/- /I/eft