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. RESIDENT 'CI:DENT DEBTS AND DEDUCTIONS CI.AIMED
NOTE: Lbt rir~ ' It~n'" III thr "11.c~rllllo providrd, C1bHt.rvr l1otaliolUl thereon, and In,,tructloull.
DEB '0 (' ,AiM"~-----"--- NATURE OF SAME
AMOUNT
.--
.',
$
$
Funeral expense!! paid
Family exemption (will not be allowed unlul
decedent died residing with a spouse or children.)
Administration ExpenseJ .
Counsel fees .
Fiduciary
commillion .
(') See Note below
Total
Note: The estate agrees to advise the Register of Wills ilthe amount actually paid in settlement of any fee. commission or debt is greater or !
less than the estimated amount claimed and allowed.
.rI!.~~I,.(,J:;.. ,U~....,....
!l!S_oto,,>td..--1oO )
Subscribed and ,v:orn to belore me this , , '
,..,.....,,,,...,"
,..,..ii.::<... ,..~of ",jW-jt,..,.19,f.fJ,
.,." eidt~,. ,0..,ldc~,<J'(-M~.-<."",.,.""""
WHARINE E. 1l0UStlM, NOIAHY PUBLIC
MEC\iI\;\:ICSSIJI:G !lonOUeli
__ ...ur.roE'Rti\'Nu=tmUNI-Y==--===....;:~-------- --------~---;;..=------
H ~Y COt.lMISSlNI fXI'IR[~, flB, ;u., \982 I I d h b U'f thatth bo . t ' d' I 't 'th I tl'
aVlOg aeen DUlY sworn acco,~ng to aw. 0 ere y cer yea ve appra'semen ,s ma e m con orm' y w, aw on 'IS I
. .. .. ' .. .. .. , . .. .. .. . ' . , . . .. . .. day of . . . , . ' . ' . . . . , . .. ' ... 19.. .. ,
99 Mulberry Drive
"..,..,.."".,,,,...,..,.......,,..
(Stf'u( Number)
,.......'....
Mechanicsburg, Pa. 17055
,..,..,..... ;c'iiv '(J'r' To'';'~'~~d'si~r';)''''''''''''''
Appraiser
In \!Ie event that any luture interest in this estate is transferred in possession or enjoyment to collateral heirs 01 the decedent alter the
expirallon 01 any estate lor lile or lor years, the Commonwealth hereby expressly reserves the right to appraise and assess transler
inheritance taxes at the lawlul collateral rate on any such lulure interest.
,..............,.....,.' ,..,.............
--="' -:=-- ------
---.----
-------
,-------
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly eleeted Register of Wills in and for. . . , . . . , , . , . . County, Pennsylvania, do respectfully report that I have I
allowed debts and deductiona In the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in
the Iutcolwnn to the right in aald schedule above, which greater or lesser amount represents the sum allowed as a deduction. I
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DEDUCTIONS AllOWED IN
OFF ICE OF THE
REGISTER OF WillS
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF
! ! ;.1"/1/
l,>(.',j .
REV-4!!!! (8-78)
OF Cumberland COUNTY
AND AGENT OF TtIE COMMONWEAL TH
OA n i!'PPROYED /.. i/ ','~, /-/.\-"
, :,' .,:' /'/, J
I I L-tl..i.....j_ L.... '" V.l.I~ ,.[ ,}../
REOIST,~R OF WILl.5, AGENT
,/
n
ESTA TE OF John H. Edris
LATE OF
SHvel' Sorin\!: Township
DATE NO. OF NAME OF PAYEE REMARKS AMOUNT
VOUCHER
Mvers Funeral Home. Inc. Fune ra 1 expenses $2 931 71
Luella Edris Family exemption 2 000 00
Register of Wills Filing fees G 00
pierson K. Miller. Inc. Real estate appraisal fee 200 00
Snelbaker, McCaleb & Elicker Attorneys fee 1,SO[ 00
.
'.
TOTAL $6,G37 71
DATE OF FiliNG APPRAISEMENT
v/:'-/" '
v...} , . ~
DATE OF DEATH October LJ, 1979
COMMONWEAL TH OP PENNSYLVANIA l
COUNTY OF Cumberland I SS:
I, Luella Edris HEREBY CERTIFY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF John H. Edris
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES, . ,. , i
ii~<.Jjt?U )1, ~h,{.!J/ _ (L.S.)
"'" ..""""~"~"" " rn'~. ,0' "..< '" " '""' i ,i"" gp'""
t":t;tA/I'~ . Oa ~,j~4":2n~......I
CAltlfllUllE E. [1rl.l~lJM. N01MY PUBLIC
MLCIIAt'ICSlIUnG BOROUGIi
CUMBLIlLAIW caUl'"
I.lIV rllMMISSION fXl'lr.n' f \ H ?7.. 1~8;)
RCC.84
18,771
COMMONWEAlTti OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF
INIiERITANCE TAX
ASSESSMENT
W.
, .
. . . .
.-------------------------------.---..------
TO: ,~,2~'.rt.i' I~'_./-,/.(...J
.-:7. .. '
L' -"<-~> ;;j~.(.J.j..'jrr'>/(.<' ~(~-!-~~~,
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DATE-'l-I' _- '! 1./ /. 1'1(0
! '
" ) i ,II' j . I
ESTATE OF_~~L:--.L:' (, "".-'1.~:...:V
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FILE NO___:L' /IJ':t:: '/ '/
.J-..,..,..,.;.-/.- -'~ ,...--;:- /
(~ ,:;', - /,
COUNTY OF
.1 / I' i~, '" ..I:,-,../~~
For County Information rposcs only
COUNTY rilE NO' ;; I, /. I . Ll d '-' -
r ._-L:-~--/.--.../_---
DATE OF DEATH
i:./: ' .oj
/
/I/9
.
----------------------------- ------- -- - - --- -~ - - -- -- - - - - - -- - ---- - - -~. - ~ - - - --
App-raised Value of Estato:
Real Estate
Personal Property
Jointly Held PropertylTransfers
Amount Taxable @ 6% Rate
$ -------
'>' /., .-,)
,., ;' / I J
I , , ,
$ I " ',/ / /
I,' ',' . j / /
$ / ! " I ..- ~
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~----
l,~ I /
$ ,. "-~
$ ......; ! '/ ! '> (, due
, tax
$ / )")-, ;~ :;/'
Total Gross Estate
Total Approved Deductions
Clear Value of Estate
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
Amount Taxable @ 15% Rate
tax due
TOTAL PENNSYLVANIA iNHERITANCE TAX DUE $
IF;;;/
,-
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
?" '',r
~ ..5 - /, ()
$ "/ .) "7, + $
+
+
$
:; $ /i";- /'/"
,- - "~.-
=
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
~ /' -;)
,J.l; .-
,/".(~
Interest wil! accrue at the rate of six (6) percent per
Inheritance tax from__._._________
annum on the unpaid balance of
to tho date of payment,
SEE REVERSE SIDE FOR INSTRUCTIONS
fIEl3;STER o:~ V1JILL'S COFY
Assesscdby:__~~.// ///;, f. (.:1
Agonllol the Comm6nwoallh
y. ..-
/':C) , ..,1.,' ,j
/ ;/ ( " /"t.,;(J
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.1!,!f,_Tfl.l)_Cl:ION~~
To insure proplH en'lii[ I\) yt"ll'f IlccolH11. the rldlllE: of Ill.: e<;Ic1le ;I[ll.l fdH nurnlwr ~ho(Jld IH~ r:1t'iuly 1.)fIn!.
eti on the ch(;ck Of nlOm~y onJ.:!r
rh;~; H:;SC'$SrlWl1t I:;' lllillJe In ilCCUf i.H1Ci~ willi ~~t~,-::I()fl 'IOU of lIw Inhl'llliH1Cl' ilfHl r~jlillH T,ll( Act of
1961 \72 P.;) I; :~4i3!.i 70H)
To tilt: (!){Ielll IIlOJI illheriliJJll:p t.:-.: I', P;H:J V'Wlllll nil (:t~ (:!) rnonlfh a!lt!1 tIll: ilt'iltl1 of tt~;> dl'cedl'nl, iI
discount of fiVl': (5) pelC'~nt is ullLlwI~d 02 P.S. S 7413S. 71 Gj.
Inhorllilllce Tux, other than tax 011 n fuldt/~ Illl{'rc~~,;, i:; dUll ell tht~ dDlt! Il( 11111 d,'r.r)rlf'nl'~. (i('illh ilnd beromes
delinquent at the expirmion of flint! 191 month:::, ufll~r lh~ c!ecedent'!; tit'dth (72 P.S. tl 2485.711) Inhctl!llnce
TRX on tl futufI.! interest IS payablp. within three l3l months .tlltH Tht! trun5ft~r t;)ke~ effect in posf>t!ssion and
enjoyment Hnd is cJelltlqlJt:nt Ihel'(~altm (72 r.S. Ij 2(1 ('!5. ./121, C"i!c:ulate in!(:reco! horn tile U(~IIfHllH!lll uaW shown
on tile faco of tllis form \0 tile d,:ltiJ 01 uctual puynH~nt uS1nU Ill!: lllliowlnu rmer!.):;! table:
1 rflOnth .005 4 months .020 7 mOqU1S
2 montlls .010 5 months .025 H tnOfllh~'
3 months 015 G months .030 9 ITlOlilh~;
---,..---------.---.-..---
1 days .00017 11 days .OO1et-i
2 days .00034 12 days .00203
3 days .00051 13 dG','s oono
4 days .00068 14 dH~';, 00237
5 days .00085 15 days OD2!iO
6 days 00101 16 di:lYs ,C'02G7
7 days .00118 17 days 00284
8 days .00135 18 anys 00301
9 days .00152 19 dOlYS .00318
10 days .00169 20 dnys .00335
.O3~ 10 rnonths .mjQ
040 11 lHonths .055
0.15 , 2 months .060
21 days ,00352
22 days ,003G9
23 dLlYs ,0038G
24 (!JYs .00403
25 daV!i .00420
2U days .00437
27 duys ,00454
28 days .00471
2.9 days ,00488
30 days .00500
-- --- - ----- --.-------- _.- -- - - --.- - - - ,_. _... _.. - __ - _."_ ,_ ,.._ - ___.~. _n_. _ _ _ _._ _ __~______ ___ __~
Any pClrly in in1cfest, ineludin!} Ihe CornrnOnWl!il!111 illld the persunal n:presenWtivc, nor sutisfwd with
the assessment may object thereto within sixty ((;0) days iJlter receipt uf this Notice uS pfu\lirJcd by Section
, 001 of the lnherltiJncc nnu btalc Tax Act 01 I ~-lG 1 (72 P.S~; :J.48ti" 1 001 ,.
Mi1ke t.:heck or ll'OIWi' Qft!e( paYilble 10'
"Regi:;:er of Will", Agent"
Mallln tliC ddrj(l::;~; 11,.;t,.~u [:"..:Iv:."
.~.;It!~:::-;r;I~M.~~~~.~~,~~".-" ,,:-:"I"
INSTRUCTIONS
To insure proper credit to your occount/ the nome of the estate and file number should be
clearly printed on the check or money order.
i
I
,
I The estate tax imposed by Section 421 is due at the dote of the decedent's death but sholl
r not become delinquent until the expiration of eighteen (18) months afte, decedent's death provided
I that any estate tax occasioned by 0 final change in the Federal return or of the tax due thereon
I sholl not became delinquent until the expiration of ene (1) month after the person liable to pay
, the tax receives final notice of the increase, Calculate interest from the delinquent date shown
! on the face of this form to the dote of payment using the following interest tab'e:
! ----~-rr:;~~----- ~O~~-----'~:~~t~: --- --.~~--- --~-~o~~h~-----~O-~-----~O- ~:n~~:-- -- ~;5; -- ------
I 2 months .010 5 months .025 8 months .040 11 months .055
I 3 months .~15 6 months .030 9 months .045 12 months .060
This determination and assessment is made in accordnnce with Section 421 and Section 732
of the Inheritance and Estate Tax Act of 1961, 72 P,S. 2485-421, 732.
1 day .00017 11 days .00186 21 days .U0352
2 day s .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .00118 17 day s .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00318 79 days .00488
10 days .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 1961 (72 P.S.
~ 2485-1001)
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
REV.483 (8"70)
COI/MONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPE RA TIDNS
INHERITANCE TAX SECTION
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
1/- ,?S-/
DATE, //-1.3-6'0
ESTATE OF, ,hhN II, ,E./",~
FILE NO: ,,:>1- ?tJ-'1rS
COUNTY OF: ---1:. II"" ,~'-I( /"'/0"./
DATE OF DEATH: jtI. '1- 7'1
TO,
------------------------------------------------------------------------------------------
t.. DETERMINATION:
1. Taxable estoto bosed upon:
The United States Estate Tax Return (Form 706)
~ The communication from the Federal Government
confirming the acceptance of or changes to the
Federal Estate Tax Return
2. Amount of credit for State death taxes (as veri lied)
3. Pennsylvania inheritance tax asscssed
(excluding any discount and/or interest)
4. Normal inheritancc tax paid to other States or
Territories of the United Stotes (excluding
any di scount and/or interest)
5. Total inheritance tax credits (line item 3 plus line item 4)
6. Total liability for Pennsylvania estate tax (line item 2
minus line item 5)
NOTE: Complete line items 7 and 8 OtlL Y when determination
is based on Federal Closing Letler
7.
Amount of Pennsylvania estP-te tax assessed on determination
doted /O/2/'iO
Addition (reduction) to Pennsylvania estate tax (line item 6
minus line item 7)
8.
$ 1,2.2.. W. 7, ~i'
$ "0-
$ / 75, gJ'
$ .. 0 -
$ I' 7 ~-. J'i
$ .. 0-
$
$
-0-
-0"
Determination prepared by:
Dote: 1/- 13 -80
)).
~
------------------------------------------------------------------------------------------
B. ASSESSMENT:
1. Pennsylvania Estate Tax reflected on'
line item A (6)
line item A (8)
2. Less credits:
DATE OF PAYMENT AMOUNT PAID
INTEREST
($ )
($ )
($ )
3. Balance of Pennsylvania estate tax due
Interest is due at the rate of six (6) percent per annum from
Assessment prepared by:
Dote:
$
CREDIT
=
=
=
$
to the date of payment.
AOENT FOR THE COMMONWEALTH
SEE REVERSE SIDE FOR INSTRUCTIONS
INSTRUCTIONS
To insure proper credit to your account, the nome of the estate and lile number should be
clearly printed an the check or money order.
This determination and assessment is made in accordance with Section 421 and Section 732
of the Inheritance and Estate Tax Act of 1961, 72 P.S. 2485-421, 732.
----------------------------------------------------------------------------------
1 month .005 4 month s .020 7 months .035 10 month s .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .m 6 months .030 9 months .045 12 months .060
1 day .00017 11 day s .00186 21 days .U0352
2 day s .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 days .00386
4 days .00068 14 days .00237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 day s .00437
7 days .00118 17 day s .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 duys .00318 7!! days .00488
10 days .00169 20 days .00335 30 days .00500
The estate tax imposed by Section 421 is due at the date of the decedent's death but shall
not become delinquent until the expiration of eighteen (18) months after decedent's death provided
that any estate tax occasioned by a linal change in the Federal return or of the tax due thereon
shall not become delinquent until the expiration of one (1) month after the person liable to pay
the tax receives final notice of the increase. Calculate interest from the delinquent date shawn
on the face of this form to the date of payment using the fallowing interest tab'e:
.----------------------------------------------------------------------------------
Any party in interest, including the Commonwealth and the personal representative, not
satislied 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 1961 (72 P.S.
~ 2485-1001)
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: