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Home My WebLink About80-00700 :';'..~, " .:.;-~.~_. ~~.. .~ '..... ';-; ):>~ :~i." D':. ..,: ':f-r~:. I,',t'".' . ~~: , '.-'-; . ~.- ~ .. ~ ~ . rJ) >t e ~ [f '" 15 p.. I H rJ) ii3 z is ~ ..... E-t . j:Q .0: Z ~ I r.:l rJ) ~ rJ) ~ 0 :I: "'" U. " """l.-,"r:.;)~ ",>,-,~::~~~!~~ ;}'!~?itf~ "",,,,,,'ff! :., ,.. ~~.:\~~~~ " ,,,,,,.t;J~ ;;r:1 .;.;~gj , ;,.:~~:i2~;~~~~ ,..,.,-"...,-",,,,,:,--~;;::~ -.... -~: <';(fi{:~~,!. . ""...,_._..~;t~ .'.,,: ::';~t~,~ , ,,',r~J~ '..:' " ,.. .." "".' o o r- d, .. Q ~. . 00 ..... I 0 - N Clt - ~ . J3 \0 0 Z .:1 ,e?',;~i .~r'r:,~ , ,,'~~"~ , ,:: ~;~'h~~ '\"~'I"'f" . :. ~~~~i1~ ~ ." .R> :./....'" , '"_-",JXG ...... :,:~\~~~ "":';'1\ ..f.::~ . ,j} ';::- ;),;~i2f~; ",.;,,;)fi ~.;.~';~~~~~f' INSTRUCTIONS ASSETS _ Descrlbo all Real Estate located In Ponnsylvania and hold solely by docodont or held jointly with another party or parties as tenants in conmon or as ioint tenants with right of survivorship. Include tho decedent's percentage of ownership and the estimated market value. List all tangible and Intangible porsanal property owned individually by the decadent or (aintly with another party or parties as joint tenants with right of survivorship at tho time of death. Include intangible personal property tltlod In the name 01 the decedont, 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 transferred by the decedent, within two yoars of death for which he/she did not receive valuable and adequate consideration. DEBTS & DEDUCTIONS _ Unsatislied liabilities incurred by the decedont prior to his/her death are doductible against his/her to.oble estate. In addition to debts incurred by the decedent, athor items are claimable including the cost el administration, attorney fees, fiduciary fees, funerol and burial expenses including the cas' of a burial lot, tombstone or grave marker. Evid..nc.. to support th.. d..cod..nt's or th.. Estate's liability lor th.. d..bts being claimed should be attached to this return, A lamily e.emption 01 $2.000.00 may be claimed by espouse 01 a decedont who died domiciled in Pennsylvania. 1/ thero is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is member of the same household can claim the exemption_ In the event, there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. t''d:3: r -0 0 n >- m >- !l >- 0 0 0 V1 c r 11l . '< Z G'l n C 0 ~ Z ~ z :l 11l m m '" z ;0 >- 9 Z ? r 00'1 Z m ~ m ~ ,<. (Jl 9 z ~ -< V1 m V1 ::l - 0 V1 0 -i 11l I:ll Z 0 ;0 - 0:3: 9 "T1 "T1 >- 0 x'< ::! 'T1 'd 11l ~ 11l f-''1 :3: (Jl 0 :!! ::l '" Ul 11l ... Z n ::l (Jl- 0 0 ,Ul Ul n ::l' tJ) :to '< ":l C III Ul H r f-' f-' ~ ::l III I:'l C <: 0 fJ. f-' f III III ~ I:'l 0 :l -< -< 111 ::l ~ Ul 0 m m 0 fJ' '1 t1 ::l >- >- Z III ~ ~ ... Z '1 :<l ;0 ;0 r f-' tl 0 :$ ..., Co< III 0 0 0. ... ::l' 'd w ::l III (Jl 0 ::l INFORMATION PLACE FOR FILING _ The roturn is to be Iiled in duplicate with the Register of Wills 01 the county wherein tho decedent resl ded. TIME FOR FILING _ The return is due nine months alter the d..cedent's death, unl..ss an e.tenslon lor Illing has been applied for and granted by the Secretary of Revenue within the nine-month period. FAILURE TO FILE RETURN _ Section 791 01 the 1961 Statute provid..s that" , . .any person who willfully fails to IIle a r..tum or other report required 01 him shall be personally liable. . .to a p..nalty 01 25% 01 the to. ultimatoly lound to be due or $1,000 which..ver is the le~~ t~.~{)~Y~m4rW the Dopartment 01 Rev..nue as debts 01 like amount are recoverable by law." I ';(::, S.!i'IHdl'D- :~~;;lJ ,. L: ~Id Ot 13U OB. .' ;. ~Sm3~ .U ~ J,j.;W ,l30~033~ , .. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' "/ '..o 7 COUNTY FILE NO: /; - ? t) - , /) ~/ /, ,.;- '!' TO: ,,,~/;'-eAA- />.1/.11.'1../ OATE I(UU/,:/;;t-! I ~; II? I ,<" (/,..1 .. ~ ) / f/J,W-'/ /. I /Jt:/,'l/~ ,~rJ ESTATE .-"/ ,- /I,/J' '-1./ __,,-./....d/II- " . / ,', 7 . _, ',.' tI - t'-() / .1 7. It' ~.:,{..t'..'IH-",,^(/dA.--)~ FILE NO, '~,i" /,' I, _j 7" (/ _-<:.dLI'/i//.rJU /tc~{ , COUNTY . J ///j,jA /h.A I ,- 1/ . -/- .".dA"J"i(_l/oJ._ l .,' ..l I' //t;j!J- '(//' I I () , " . DATE OF DEATH" /(-/;1;( ;,,'1 ,.;?' (1 ' / Appraised VBlue of Estate: Reol Estate & + / 1/')-') 3 I Personal Property --- + Joint'v He,d Propeny!Transfers '1'1''-- ,/' $ I ~,~,.t. J I Total Gross Estate '7" '/ - -1 I (I C' - / :.;- (,A' Total Approved Deductions & Clear Value of Estata Less: Approved Charitable Exemptions Clear Value 01 Estata Subject to Tax $ Amount Ta.able @ 6% Rata $ :- , ' /') J..--- tax dur 11-J-rl1/*Jo~ a.v ...//<-f/ Amount Ta.able @ 15% Rate tax due. ---.--/ TOTAL PENNSYLVANIA INHERITANCE TAinniii ",<i!lf/"'.",L tDi/!/ "...? ;' 111 111 111 111 111 111 A five percont discount totaling 8 will be granted if tho Inheritance Tax is paid by Less Credits: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT $ + $ $ = $ + = + = Interest accrues at the rate of six (6) percent per annum on the unpaid balance of Inheritance Tax from to date (if ~ayment. Interest due if paid by is . _ _ ,.' ...' ;. /~-~ BALANCE OF PENNSYLVANIA INHERITANCE TAX Du~N,,;"'il-">/'.i. ,:'/~~.J //I,;J..f --/> , , I / , /'..('.L-ut.4- , /;/ > '.. 1.' Assessed by: / ,-:/._'1_1, (!;;.. See Inlormalion on Reverse Side Agentf~tth.CO'2r~w"l~ ,I), _/ "j' ,., 12,/,,-, / / ./- ,.~..- J / ,J;i~J' r.:', INFORMATION To insuro proper credit to your account, tho name of thu estato and file numbor should be clearly print- ed on the check or money order. This assessment is made in accordance with Section 708 of the Inhcriwncc and Estate Tax Act of 1961 (72 P,S, ~ 2485-7081, To the extent that inheritance tax is paid within throe (31 months aher the death of tho decedent. a discount of fivo (5) percent is allowed (72 P,S, S 2485.716), Inheritance Tax, other than lax on a future interest, is due at tho date of the decedent's denth and becomes delinquent at the expiration of nine (9) months after tho decedent's death (72 P.S. g 2485.711). Inheritance Tax on a future interest is payable within three (3) months after the Hansler takes effect in possession and enjoyment and is delinquent thereafter (72 P.S. ~ 2485.712). Calculate interest from tho delinquent date shown on the face of this form to the date of actual payment using the following interest table: ------------ -------- - - --------- -- - ---- - -------- - - - -- - --- -- - ----- -- -- - - - -- -- 1 monih ,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 montbs ,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 14 days ,00237 24 days ,00403 5 days ,00085 1 5 days .00250 25 days .00420 .00101 , 6 days 16 days ,00267 26 days ,00437 7 days .00118 1 7 days ,00284 27 days .00454 8 days ,00135 1 8 days ,00301 28 days ,00471 9 days ,00152 '9 days .00318 29 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 therelo within sixty (601 days after receipt of thiS Notice as provided by Section 1001 of the inheritanca and Estate Tax Act of 1961 (72 P,S. S 2485.10011, Make check or money order payable to: "Register of Wills. Agent" Mail to the address listed below: "