HomeMy WebLinkAbout80-00421
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BENEFICIARIES
BENEFICIARIES AND ADDRESSES
IStat! full names and addresses of all who have an Intarest
either vMted. contlngont or other interest)
RELATIONSHIP
TO DECEDENT
SURVIVED
DECEDENT
STATE YES
OR NO
AGE OF LIFE
TENANTS OR
ANNUITANTS
AT DEATH OF
DECEDENT
INTEREST OF
BENEFICI4\RY
IN ESTATE
Emma V. Thomas
5 Country Club Place
Camp Hill, Pennsylvania 17011
widow
yes
entire estate
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INFORMATION
PLACE FOR FILING - The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided.
TIME FOR FILING - The return is due nine months after the decedent's death, unless an extension for filing has been applied for and granted
by the Secretary of Revenue within the nine.month period.
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FAII.URE TO FILE RETURN - Section 791 of the 1961 Statute provides that ". , . any person who willfully fails to file a return or
other report required of him, , , shall be personally liable. , . to a penalty of 25% of tile tax ultimately found to be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by law,"
REV.4a4 EX+ (3.aO)
File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-80-0421
Eslale Nome __ A. RALPH THOMAS____
January 20, 1980
Dote of Dealh
S 'I S 'I" b 178-05-3527
OCIO eCllrl y I"um er u...M~.__._____~___.
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritonce Tox Appraiser in and far the County of Cumberland
Pennsylvania, do respectfully report thot I have appraised the real and personal property as reported in the foregoing
return at the values set forth opposite each item in the last column to the right in Schedules "A", uB", "CIf, and "EIf
Dated:
July 23, 1980
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INVENTOR'!
Real Property (Schedule A)
Perlonal Property (Schedul. B)
Jolnt.Held Property (Schedule E)
Transfers (Schedule C)
TOTAL GROSS ASSETS
Less D.bt. and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
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Valuation of life estates or
annultlo.. . . . . . . . . . . . . .
FOR USE OF REGISTER ONLY
Tax on $
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
T oto\ Estate
Less Credits
DATE OF PAYMENT'
.$PMi"J(Il'J"fl", .i}
INHERITANCE TAX APPRAISER
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINOER APPRAISEMENT CODE
$
None 00+
5,104 00 10+
None 2lH
None 30+
5,104 00
40-
92+
93-
RATE
FACTOR
PRINCIPLE VALUE
CODE
~
COMPUTATION OF TAX
$
$
$
$
$
6'.
"
15%
TOTAL TAX
INTEREST FROM
BALANCE
$
$
$
TO
AMOUNT PAID
TAX CREDIT
S
$
INTEREST FROM
BALANCE DUE
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