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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
INHERITANCE TAX RETURN
FOR INSOLVENT ESTATES ONLY
OF RESIDENT DECEDENTS
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COUNTY OF Cumberland
This return mUlt be completed In detail and flied In duplicate, with the Registar of Will, In tho County whore tho docodant rosldad within nino
month. altar dolo of death, unloll on extonslon Is grantod by the Socretary of Ravonue.
Will ~/-go'7/7
Admn. Nil. IQ..8..cL I. Donna E. Mvers
INAMEl
..I' 1 'i Hi veT'vi P\'LD~.-E=~.EA-
\ AOORES51
Misc. she
being duly sworn llccurding 10 law. depuses and SllYS thnl Ji.xis the Supv1 VJ.ne-SjLQ.U.5-e-------- -------
IE)U:C., AUM., LEGAtEE, ETC,\
Ilf Ihe eSlole!lf ...J:lilliam_l1y_~rs_.______~___ laiC ..rJ;~t_P-e-nnsb.Qr.oJo~\~nship-------
(CITY. UOI~OL'GH, OR TOWNSHIP)
consisted of Ihe usselS Iisled helow and that tlllowllhlc dehts .111d deductions e~ceeded the fair 1I1i1rkct value uf the :Isscls tlnd
deceased, and thai the whule of the eslolte nr said del.:edent, whullied on
-- July--;tl;T.~980-.---
no Pennsylvania Trnnsfer Inheritance Tax is due.
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, '.,ONATURE(oLd-
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(,I ( LU".l,I"SlONls,<[N~ ocr. 3. 1934 j
(Attoch addlllo"a~ If neeena,y)'
Ducrlption of Asset
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Sworn Clnd subscribed be foro mo
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'-y,
{ TITLE.!
Type of ..e'
Roal E'tot.i~P' ..
Property, Jointly
Held Prop. Of
Transfors
Estimated
Mor~ot
Value
Depgrlment
Valuation
CAUTION
(Do not wtlte
In this spoco)
Personal
1976 Chevrolet Monte Carlo
1976 C:l?vrole1; Pick-up
1977 Honda XL 175
1977 Hc~da XL 175
1973 Holiday Rambler
1600.00
2775.00
450.00
250.00
4550.00
*All vehicle values based on appraisalS,
copies of which are attached.
TOTALS
$ 9,625.00
'II (,,:/.67.0
.
REPORT OF INHERITANCE TAX APPRAISER
1, the undersigned duly appointed Inheritance Tax Appraiser in and for the above Cnunty do respectfully report that I have
appraised the real and personal properly as reported in the foregoing schedule at tlte values sel forth opposite each item in
the last eolomn to the right. .J?/JJ/I'" I d l-(?f~J{ /J 1(1)
Dated: Fph1"IlR,..Y", ,Q81 tlNHERITANCE TAX APPRAISERI
Name of Payee
DEaTS AND DEDUCTIONS
Nature of Claim
Amount
Claimed
Amount Approyod
by Register
J. W. Richardson
Funeral Home
Funeral Services
4,380.04
First Federal Savings
& Loan Mortgage 1/2 interest
&380.45
TOTALS
$12,760.4
REPORT OF TI\E REGISTER OF WILLS
I, the undersigned duly elel.:led Regisler of Wills in and for Ihe al)()\'c County, do respcctfully rcport that I havc allowed
deductiuns in the amounts set [orth in the above schedulc as claimed, cXl.:ept where I have set forth a grcater nr lesser amount
in Ihe 10Sl column 10 ~hl. which greater or lesser lllllllllllt rerresenls Ihe SID al\owed liS 0 dedlleli!lll
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
tNHERITANCE TAX
ASSESSMENT
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FILE NO.
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COUNTY FILE NO:
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OATE
TO:
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ESTATE
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COUNTY
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DATE OF DEATH
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Appraised Value of Estate:
Real Estate
Personal Property
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$ I /'. /j/, i/()
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Jointly Held PropertylTransfers
Total Gross Estate
Totsl Approved Deductions
Clear Value of Estate
Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
s
Amount Taxable @ 6% Rate
s
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tax dueel; ;;:/-r1v.~8.,"''1. JI :;/jv/ A'/~
Amount Taxable @ 15% Rate
tax due;' .----""
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TOTAL PENNSYLVANIA INHERITANCE TAX:-?,UEuI,..i;0('" t./t-?' J./It.jJ
* ... ... ... ... ... A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
.
s
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=
$
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Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest duo if paid by is'. '.; . __J
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BALANCE OF PENNSYLVANIA INHERITANCE TAX Due-:!</,'-tf;/Y: .1 .' : /")'-1Y...u!/
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See Inlormallon on ReverS8 Side A;lnt10'.'heeommonZ,'lh"::- /1
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INFORMATION
To insure proper credit to your account, tho name of tho estate and hIe number should be clearly print-
ed on lho check or money order.
This assessment is made in accordanct3 with Section 708 of the lnheritancl1 and Estate Tax Act of
1961 (72 P.S, 9 2465,706).
To the extent that inheritance laK is pmd within three 131 months after the death of the decedent, a
discount 01 live 151 percent is allowed (72 P.S. 9 2485.716).
Inheritance Tax, other than tax on a futuro interest, IS due at tho date of the decedent's death and becomes
delinquent at the expiration of nine (9) months after the decedent's death (72 P,S. S 2485-711). Inheritance
Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S. 9 2485- 7121. Calculato interest from the delinquent date shown
on the face of this form to tho date of actual payment using the following interest table:
--------------------- ---------- --- ---- -- ------- - - --- - ---------- - -- -- - - - -- --
I month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 1 1 months .055
3 months .015 6 months .030 9 months .045 12 months .060
I days .00017 I I 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 15 days .00250 25 days .00420
6 days .00101 16 days .00267 26 days .00437
7 days .00118 17 davs .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 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 thereto within sixty (60) days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 196 I (72 P.S. 9 2485.1001 I.
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below: