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Home My WebLink About80-00509 ~~~f';,;",:.~,<: !"".."." {~r-r~'\:'( ,j,". ~:,,~, ',' ~~I ";"~;' - 1~~~>,:; ::,',i ",'r ;;'1: ..'~ ~1{'~." wl'j/" ~f/.'" r. -.Y'.~ :,',' ,,'- -~,{.;':~'." " &/:'. ' ~t ,~#". ~J"',""_' ;~~~;'~:;:, ,. IJ[> ;~~ " t:'\ , .t'''' , I j;.:,( " '6"'.'). \{~;,:,y-'" :~~\ N." -i> ',' "f~ . (J'J C If.l C) .... 00 0 , - t""4 flJ ... . J! 0 .. Z LI.I . > ~ M ~ ~ m i .. I . ti ~ olS ~ i\ , , REVIll" (110) COMMONWEALTH OF PENNSYLVANIA , , DEPARTMENT OF REVENUE . TRANSFER INHERITANCE TAX RESIDENT DECEDENT INHERITANCE TAX RETURN FOR INSOLVENT ESTATES (In.truction. on Reverse Side) COUNTY FILE NO. 1-.11-10 '* BUREA.U NO. Nnrrin~ W PprkinQ of R.D.#4, Box 380, Newville, PA 17241 (NAME) (ADDRESS) being duly sworn according to law, deposes and says thlll he/she is the Executrix (EXEC., ADM., LEGATEE. ETC.) of the estllte of Betsey V. Williams laic of 65 Big Spring Ave., Newville (STREET ADDRESSJ deceBBed and thatlhe whole of the estate of said decedent, who died on Januarv 8. 1980 (DATE) consisted of lhe assets listed below and thllt allowllble dehls and assets and no Pennsylvania Transfer Inheritance Tax is due. HAMilTON C. DAVIS, Notary Public mb.rl.nd Co.. p" My CommissiDn Expires Sepu:m er TYPE OF ASSET ASSETS personal 1972 Chevrolet Nalibu value appraised by Rufe Chevrolet 650.00 personal Apartment furnishings 250.00 i joint Checking account ($161. 81) Farmers National Bank of Newville Betsey V. Williams or Norrine \'l. Perkins 80.90 joint Checking account ($1,362.53) Farmers Trust Company #5-12397 Betsey V. Williams or Norrine W. Perkins 681. 2 7 joint Savings account ($7,463.84) Farmers Trust Company #2-018867 Betsey V. Williams or Norrine W. Perkins 3,731.92 joint Certificate of Deposit ($1,570.18) Farmers Trust Company #17442 (785.09) /5'10, /; Nrs. Betsey V. Williams or Nrs. Norrine Perkins TOTAL $6,179.18 (OFFICIAL USE ONLY) I do hereby certify that the above assels were appraised in accordance wilh PC,i.sylvania law. .J</(l y/" / ';/1'/, ],,'1 ) Sflptllmbflr 4. APPRAISER DATE DEBTS AND DEDUCTIONS NAME OF PAYEE Frank Egger Montrose Nemorial Studio Graham Medical Clinic Carlisle Hospital Carlisle Radiology Assoc. Masland Associates Dr. Fritchey Carlisle Hospital Register of Wills McCrea & Davis Norrine Perkins / /-/{11- c2- lCl80 AMOUNT CLAIMED Funeral Expenses Narker Nedical Expenses Medical Expenses Nedical Expenses Medical Expenses Nedical Expenses Nedical Expenses Filing Fee Counsel Fees Fiduciary Commission 2,070.00 40.00 408.00 5.50 279.00 590.00 500.00 7,000.94 3.00 308.95 308.95 TOTAL $11,514.34 (OFFICIAL USE ONL Y) .I /, ~-/L/. q jL 9-,?:",?o ._ r#l DATE INSTRUCTIONS ASSETS - Describe all Real Estate located in Pennsylvonia ond held solely by decedent or held jointly with another party or parties as tenants in conmon or 05 joint tenants with right of survivorship. Include the decedent's percentage of ownership and the estimated market value. List 011 tangible and intangible personal properly awned individually by the decedent or jointly with another party or parties os joint tenants with right of survivorship at the time of death. Include intangible personal property titled in the name of the decedent, but payable 01 deolh to anolher party or parties including but not limited to P.O.D. U.S. Savings Bonds and tentative trust accounts. List any property transferred by the decedent, within two years of death for which he/she did not receive valuoble and adequate consideration. DEBTS & DEDUCTIONS - Unsatisfied liobilities incurred by the decedent prior 10 his/her death are deductible against his/her taxable estate. In oddition to debts incurred by Ihe decedent, other items are c10imable including the cost of administration, attorney fees, fiduciary fecs, funeral and burial expenscs including the cost of a burial lot, tombstone or grave marker. Evidence to support the decedent's or the Estate's liability for the debts being claimed should be ottached to this return. A fomily exemplion of $2,000.00 may be claimed by a spouse of a decedenf who died domiciled in Pennsylvania, If there is no spouse, or if Ihe spouse has, forfelled his/her righls,,"'en any childaf1he.decedent who is member of the same household can claim the exemption. In the event, there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of Ihe same household os the decedenl. r "'tl C n :?>- m :I>- ~ Z :I>- 0 0 0 VI c r C'l n c: 0 -l Z 3: Z m m ^ z ;:0 :I>- P Z P r z z m -l m -l p -l -< Vl m VI p Vl 0 -l SG Z 0 ;:0 p " " :I>- 0 Z tp -l \'- "T1 n CD t>J 0 :!! c:: :;: ~ z Q ~ <: Ul ~ ..... t>J l> t>J t-' t<: r ~ t-' c: CD <: \ '" ~ . 1'1 -< -< 0 'tl :;: m m ~ 0 :J:' H :I>- :I>- Z t'" ;:0 ;:0 r t'" -< t-' H '-.!;J .., ~ tv .... Ul t-' INFORMATION PLACE FOR FILING - The relurn 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 decedenl's death, unless an exlension for filing has been applied for and granled by the Secretary of Revenue within the nine.monlh period, FAILURE TO FILE RETURN - Section 791 of the 1961 Slatute provides thot ", . ,any person who willfully fails to file a return or other report required of him sholl be personally lioble, . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is Ihe less to be recovered by the Deparlment of Revenue as debts of like amounl are recoverable by law!' ,. . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT -- TO: DATE / '//-> 1 / ,,/ ,I: -' -'',,' 't' , ~.. :. ~ ( ) ESTATE OF ,( ,".:...../ FILE NO, / / ,-,',,:.' . , ,.J I , For County Information purposes only COUNTY FILE NO:~/. '/- COUNTY OF /,~ , / (>." .<- L.~ .~..... -, , / , DATE OF OEA TH .' ,j;':J , .. Appraised Value of Estate: Real Estate Personal Property Jointly Held Property/Transfers $ .., I , " Total Gross Estato $ ./ / Total Approved Deductions / ,../ , Clear Value of Estate $ ---.----- tess: Approved Char itable Exemptions Clear Value of Estate Subject to Tax $ -------- Amount Taxable @ 6% Rate $ tax due ,,:../ / , ,." -.~-------- ,,' +-/ ,I /. ,<.(...$; "A ,', -f J' ///~'-/"" Amount Taxable @ '5% Rate tax due TOTAL PENNSYLVANIA INHERITAN~E/~Di~'~$ . 6 t, ..---- ,,/...., ,- ..; . , (jy Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT $ + $ $ = $ + = + = BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE ,_,I.- .~ . '.. ,; .:":.JI --.--- /'; 1/ /, (/-.1.., P ;'.l.-~' Interest will accrue at the rate of six (61 percent per annum on the unpaid balance of Inheritance lax from to the date of payment. seE REVERSE SIDE FORINSTRucnONS REGISTER OF WILL'S COPY '/' I" Assessed by: _,' I ,I _ . J . AllenIIO~,llte c~m~7eall~ /1 ", , ):/>7'-" v ..' .J"., / '2.-/