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INHERITANCE TAX RETURN
FOR ESTATES WITH GROSS ASSETS
UNDER $10,000.00
~
, CummonWdlltl 0' Plnn.ylvanla
Clpar,mlnt ot Ravlnu.
Trln,f.r Inherltancl Tilt
RMldlnt O.udlnt
Rlv-40. EXt ('.80)
Estate of Harv J. Harlacher
Date of Death July 1. 1980
Social Security # 169-50-7980
Last Address CUnberland County Nursing Hare
Carlisle
PA
17013
Bureau File #
(City)
(Stltll
(Zip)
County File #
,;JI- i)',., - (,-.'.9
,. Decedent died:
aot Intestate (without a willI
o Testate (leaving a last will - copy attached)
2.
o Executor/Executrix
o Administrator/Administratrix
Name
Add ress
(City) (State) (lip)
3. All correspondence should be mailed to Il(I Attorney o Fiduciary,
4. If an attorney is representing the estate, indicate:
Name Jon F. Waver, Esquire
Address 317 Third Street
New Cunberland, PA 17070
(City) (Statel (Zip)
REAL PROPERTY _ Identify real property located in Pennsylvania by lot and block number, street address and I
include a statement of mortgage encumbrances as of the date of death.
NONE
Total
Estimated
Market Value
.""
I Department Valuation
(Official Use Only)
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MAIN OFFice 331 BRIDGE STREET NEW CUMBERLANO. PENNSYLVANIA 17070 17171774.7000
CCNB BANK. N.A.
DATE ..,'".,,;,..."; ~ 25 1980
,)1. ~. 10. _I\. ,
LA\'/ O;,,?ESS
JON F. LAFA\IER
317 THIRD STR2,'!'
Na.J :::tIHBE:ll.A'ID, "A
..,'
17070
RE:
ESTAT': OF HARY J. :JARLI\ ~HE:l
.'
GENTLEMEN:
The following is a list of accounts that we have in our bank,
TYPE OF ACCT.
ACCOUNT NO. OPEN DATE DUE DATE BALANCE
ACCR. INT.
SA'.'
00l-08092L-2 12/13/78
S 2123.59
. 71;,
S .L6
NAMES ON THE ABOVE ACCOUNT
~~RY J. HARLAJHE~
If we can be of further assistance, do not hesitate to write.
Very truly yours,
ceNB, N.A.
,{J {Yl4'<-f} k~
Dorothy Morrette
Savings Department
DEBTS AND DEDUCTIONS
,
"
D.te Name 01 P.ve. Nature of Debt Amount ,
Jesse H. Stone fu1eral Home Funeral C)(!>llmcs paid 1 h~7 nn
Family CJlclTlPlion (will nat be ollomd unless dcctldcnt died
residing with a parent, spouse or chlhhen.J
Administration EICpcnsos
Jon F. LaFaver , Esquire ~FCCS 386.18
Fiduciary Commission
IOther Debts and Claimsl
Register of Wills Filing Fees 6.00
Recorder of Deeds Filing Releases 35.00
Total
2,084.18
Under penalties of perjury. I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct and complete.
~YLO'--~ fY;ffe~, 10-1-80
Signature of~. Joint Date
Ck.Jripr
I do hereby certify that I have appraised the ossets contained herein in conrormity with Pennsylvania law.
):
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2:
0
w Appraiser Oat6 I
III In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expir..tion of any
::l
-' estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance tax.es at the lawful collator..1
<l I1ile on any such future interest.
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ii:
u. ;/, cl Ii' ,; Irf l
g Debts and deductions are allowed in the sum of S at percent.
, >Z:u-c:J
/~~--/j @. /1-.25'-PtJ
'l/itL1.M
\ !egister 01 Wi\.l! Date
BENEFICIARIES
BENEFICIARIES AND ADDRESSES
(Stlte full nemes and .ddreues of all who have an interest
either vested, contingent or other interest)
RELATIONSHIP
TO DECEDENT
SURVIVED
DECEDENT
STATE YES
OR NO
INTEREST OF
BENEFICIARY
IN ESTATE
AGE OF LIFE
TENANTS OR
ANNUITANTS
AT DEATH OF
DECEDENT
FL 32019
1/6 residue
1/6 residue
1/6 residue
1/6 residue
1/6 residue
1/6 residue
Son
Yes
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INFORMATION
PLACE FOR FI LING - The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided.
"
.
TIME FOR FI LING - 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.
FAILURE 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 the 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."
,
RCV0484 CX. (3-80)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
File Humber
21-80-0651,
Estate Harne
Ila ry J. Ila rl acher
Date of Death
7-1-80
Sociol Secur; ty Humber
169 50 7980
REPORT OF INHERITAHCE TAX APPRAISER
I, the undersigned duly oppointed Inheritanca Tax Appraiser in and far the County 01 Cumberland
Pennsylvania, do respectfully report that I have appraised the roo I and personal property as reported in the foregoing
rotum at the values set forth opposite each item in the last column to the right in Schedules "AU, "B", "C", and liE"
Dated: November 26, 1980
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INHERITANCE TAX ^PPRAISER
INVENTORY
VALUE AS APPRAISEO CODE
$ -0- 00+
-0- 10+
2,124 5 20+
5,600 0 30+
$7,724. 5
40-
ADJUSTMENTS
(HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
92+
Real Property (Schedule A)
Perlonal Property (Schedule B)
Joint_Held Property (Schedule E)
Tronlfers (Schedule C)
TOT AL GROSS ASSETS
93-
Leu D.bts and Deductions
(SCHEDULE F)
C~EAR VA~UE OF ESTATE
Valuation of IIf. estates or
annultle.. . . . . . . . . . . . . .
~
FACTOR
PRINCIP~E
VA~UE
CODE
FOR USE OF REGISTER ONLY
Tax an $
CODE
COMPUTATION OF TAX
$
$
$
$_
6"'
"
Tax on S
15%
Tall. on $
Tall. on $
$
Tax on S
Excmvtlons
Total Estate
TOTAL TAX
INTEREST FROM
BALANCE
TO
$
$
$
Less Crodlts
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
5
+ $
S
=
$
+
=
INTEREST FROM
BALANCE DUE
BA~ANCE
TO
S
S
S
,REY"ale FOtCHO)
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Commonwealth of PennsylvanIa
Department of Revenue
BUREAU OF FIELD OPERATIONS
P.O. Box 2970
Horrloburg, PI.. 17105
NOTICE OF FILING OF APPRAISEMENT
IN YOUR REPLY
PLEASE REFER TO
Investigatian Divisian
Jon F. LaFaver, Esquire
317 Third Street
New Cumberland, Fa. 17070
RE: Estate af Hllry J. Harlacher
County of Cumberland
File No. 21-80-0654
Dear Ifr. LaFaver:
You are hereby notified that the Original
appraisement in the estate of Hary J. Harlacher
has been filed in the office of the Register of Wills of Cumberland
County on tlovember 26 ,19 fiQ.., Soid appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Tatal
-0-
-0-
2,124.05
5,600.00
~7,724.05
As to such tax that is paid within three months from date af death, a five (5%) percent
discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months
when death occurred from December 22, 1965 ta June 16, 1971, inclusive; and twelve months when
death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty days
after receipt af said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S, 2485-1001, P.L. 373.
Date November 26, 1980
Signed /f/jJ~.~ffl.I'7f7~4d,r,/)
Title Chief Inheritanc.. Tllx App""i ~p,.
NOTE: This is not a bill.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
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COUNTY FILE NO:
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OATE OF OEATH
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Appraised Value of Estare:
Real Estate
s
Personal Property
+
Jointly Held PropertylTransfers
J '-I -
+ "/ :, f.J.'-'
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s --; "J . .',!
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Total Gross Estate
Total Approved Deductions
Clear Value of Estate
S " " ~ "/ ,/ "'1
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less: Approved Charitable Exemptions
--.-----.
Clear Value of Estate Subject to Tax
S <, (/:"'f, /' /7
Amount Taxable @ 6% Rate
, / ",")
S i., i . ') . _
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tax due
$
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:';2 f....... F) t.-
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Amount Taxable @ '5% Rale
tax due
TOTAL PENNSYLVANIA INHERITANCE TAX ~UE
$ -;~:::5;1. ':;1'1
... .. .. * * .. A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAlO
OISCOUNT
INTEREST
TAX CREDIT
$
+
$
$
=
$
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
BALANCE OF PENNSYLVANIA INHERITANCE TAX ~UE
,;:' ;.; / ;, "~I
$ '"-' _.{" J t...
"'. . /.:,
Assessed by: / I !. f./ ',I- C '
See Information on Reverse Side AgentforthIlCon~'1~)nW8lIth /
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
'*'
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DATE
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ESTATE--'\1'l'- \\
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FILE NO, ~ { ,~^ I c I /
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COUNTY L I.N I J .;j, L;, 'It-L
DATE OF DEAT~~Y~~ ,I .' 0 ,r.l
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COUNTY FILE NO:
TO: C\ p.
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Appraised Value of Estate:
Real Estate
$
Personal Property
+
Jointlv Held PropertylTransfers
+
Total Gross Estate
$
Total Approved Deductions
Cleer Value of Estate
$
less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
s
Amount Taxable @ 6% Rate
$
18X due
$
Amount Taxable @ 15% Rate
talC due
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
33 y -=<'9
I
'* ... '* '* '* '* A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
I::J..LYI)
AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
$3~2 .3( + $ $ = $ ,:z, ;;;.1:>:3/;
I
+ =
+ =
Interest accrues 01 the rate of' six (61 percent por annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$
,
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is
AsIOIIBdby: // /'.' .. I .. "
See Information on Reverse Side Ag.nl'o;lhpCOm w..llh /
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