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HomeMy WebLinkAbout81-00114 R',:V-SIll (1-<<01 COMMONW,J'AL TH OF PENNSYL VANIA OE~ARTMENT OF REVENUE ,TRANSFER INIiERITANCE TAX ;(/-ql-IN INHERITANCE TAX RETURN F'OR INSOLVENT ESTA TES (Instructions on Revers. Side) COUNTY FILE NO, / I -'"i 0 ~.. .~ *' ~-lJ-1'I RESIOENT OECEOENT BUREAU NO, CUI'II I;, ClllllnlJ[!I'LlI III (NAMI:I or 221j I'I'0weLl DI':ive, Cnmp 11:;11, PA 17011 IADDRF.:SS) TOTAL $2,liSO.00 ,..Pi r.., -Q . D (, hein" dilly N\\'Orn nccolllin" loinII', deposes and says Ihal hWshe is lhe sll1'v'iving spouse . (EXEC., ADM.. LEGATEE. ETC,) of Ihe estnte of ,lnmt!H M. Chwuhel'lnin _ laic or 2211 Prowell Drive, Camp Hill, PA 17011 CSTREET ADDRESS) decellRed IInd Ihnl the whole or Ihe eSlale or said decedent, who dicd on .January G, 1981 (DATE. cOllsisted or Ihe nssels Iisled helow and thaI allowable debls;:,' HI deduclions exc.eeded Ihe rair markel vallie of the nssets nnd no Pennsylvania Trunsrer Inherilance Tax is due, '/1A- (1.(.}::, ,L-lA.-Ii:,' .. . ,0 a-- 2"-"4. ~UrVJ.vlng spouse (5IGI>lATlJRE) !TITl..E) TYPE OF ASSET ASSETS ESTIMATED MARKET DEPARTMENT VALUATION VALUE OFFICIAL PEIlSONA IJI'Y: .1, Plymouth sednn, 1977 model, appraised valle $2,liSO.00 (OFFICIAL USE ONL Y) I do hereby certify thatlhe ahove assels were nppraised in accordance with Pennsvlvania law, .-III.!",,,, /" J-;f'/h4dIlJ) APPRAISER MARCH 12, 1981 DATE 1 DATE NAME OF PAYEE DEBTS AND DEDUCTIONS AMOUNT CLAIMED $2, 38'+' 90 2,000.00 3.00 125.00 J. Colvin Neill Funeral lIome Corn E, Chamber 1a in Regl ster of Wills Snelhakel', McCaleb & Elicker Funeral expenses Family exempt ion Filing fee A ttorneys fee TOTAL $li,512.90 (OFFICIAL USE ONL Y) "I In:!. Cj (; ") , ",:' /:';.. JL DATE II'MDI '<9 aI9D.I.MD:);).I 0.10 ~unoWO a~!1 jO s~9ap so ;)nua^;)H jO ~uowpod<)a a~~ A9 pO.la^O:3aJ a9 o~ SS;)I ay~ SJ .la^a~:)!~M OOO'L$.lO anp 09 o~ puno] '</aJDwUln )(D~ aliI jO %S"~ jO .(~IDuad 0 01.. . afqo!f ~r1ouOSJod 039 (fo~s W!~ fO pas!nbas podas .I0~~O.lO wn~;).1 0 .I!! 01 sl!DI ~lInlll!M O~M uo...d ~UD' , . .. ID~I '.p!^a,d .,nID,S L961 .~I la 16L "O!p.S - N~n13~ 31J~ 01 3~n1IV~ 'poJ.lad ~~uow.;)U!U a~~ U!li~!M. anua^oH fO A.lD~aJ:)os a~~ ~9 pa~uDJ6 PUD .I0j pa!lddD u..q 'D~ 6u!!!!.ol UOiSU.,x. uo ".Iun '~ID.p ',IU.p.'.p .~I'.IIo S~IUOW .U!U .np S! UlOI.' .~1 - ~NI1I~ ~O~ 3wiI "pap!seJ 10.p.'.p .~I U!...~M ~Iuno' .~I jO SII!M 10 '.IS!6.~ .~I ~I!M .,D,!!dnp U! p.I!!.q 01 S! UlOI.' .~1 - ~NI11~ ~O~ 3::>V1d NOI1VW~0~NI >- .J a:: a:: z -< -< 0 W W Ul )- )- '" ::l .J <l; U z u: 0 11. i= 0 d -< u.. u.. a:: 0 0 z d l- V> >- I- 0 VI W V> Z I- LU I- W Z ...J 0 ~ 0 -< a:: z ~ W LU ...J Z :=E Z I- 0 :::J U l:l Z 0 VI 0 0 0 -< ~ -< W -< U 0 0.. ..J "~uapa:)ap a~~ so Ploliasno~ awes all~ lO sJoqwaw O.lD oq^' s~ua.lDd .10 ~ua.lDd 0 ,(9 paw!op oq UD:) uOHdwaxo a9~ 'Pl!q3.10 as nods ll3ns ou S! a.lo~~ '~ua^o a~~ ul "uoHdwaxo all~ W!DI:) UD~ Ploqosno~ aWDS oll~ fO J09WOW S! ollM ~uapa;)op all~ jO PI!q3 ,(UD uaqlls.~6JJ JO'i/S!q paHaj.loj SD~ as nods aq~ J!.I0 'osnods ou S! .'.~11I 'D!UD^I~suu.d U! P.I!>!WOP p.!P O~M IUop.'.p 0 jO .snods 0 ~q P.W!DI' .q ~DW OO'OOO'Z$ 10 UO!ldw.x. ~I!WD, V 'u.nl.' s,ql Dl p.~'DllD.q Plno~s P.W!DI' 6u,.q slq.p D~I'Oj 4!!iqD!! ',DIDIS3 .~I'O s,IU.p.'Dp D~II.oddns 01 .,u.P!^3 ".Ia~.IDW a^D.l6 olD auo~sqwo~ '~OIID!.Inq 0 jO ~so:) aq. 6u!pnl:)U! sasuadxa 10!.ln9 PUD IDJOunf 'saaj AJDpnp!j 'sa;)J ,(aU.lOUD 'UOHDJIS!U!WPD fO ISO:) aql 6U!pnl:3U! ;)190W!DP .UD swaH .I"q~o I~uapa:);)p ;)ql,(9 poun:)u! sl9ap 01 UO!HPPD ul "a.DISQ ;)19DXDI Jaq/s!q ISU!D6o Dlq!pnpDp ..0 ~ID.p ..~/s!~ 01 .o!.d I".p.'.p .~I ~q pDll..U! s.!I!!!qD!! p.ijS!IDSUn - SNOI1::>n030 'll 51830 "UO!~DJap!Suo:) alonbapo puo ;)19DnID^ a^!;))a.l IOU PIP a~s/oq q)!qM JOj lllDap fO SJoa,( aMI U!liH^' '.uapa)op aq.,(9 pa.lJOfSUD.l1 '<~JadoJd AUD IS!1 "Sluno:))o ISnJ~ O^HD.ual puo spuog S6U!^DS "SOn .O.O"d 01 paHw!l IOU ~n9 6u!pnpu! sa!pod JO ,(~JDd JaqlouD 01 q~oap ID al9o'<od .n9 '~u;)pa:)ap aql fO awou ;)ql U! pallH ,(IJado.ld IDuos.lad olc:u6uDlu! apnl:Jul "l{loap JO OW!l Ol{IID d!qsJo^!^Jns fO Iq6!.1 l{HM SluDUaIIU!O! so saH.lDd JO ,(4Jod .Iaq~ouo lll!"" ,(I~U!O! olD Iuapo:)op aql'<9 ,(1I0np!^!PU! pauMo '<I.lado.ld IDUOSJad aI9!6uDIU! PUD a19!6uDI 110 IS!1 "..nID^ la~.low palDwHsa aqt PUD d!'1S.laUMO fO Q6DIUQ:).Iad s..uapa:)ap aql apnpul "d!9SJo^!^Jns fO Iq6!J qH^' stUDUaIIU!o! so JO UOU.WO:J !.I! StUDUal so SQ!t.lDd JO ~1'Dd '.~loUD ~I!M ~110!0! PID~'O Iu.p.,ap ~q ~1.loS PI.~ pUD D!UD^J~SUU.d U! P.,D'OI DIOIs3 ID.~ liD Dq'l>S.O - SJ.3SSV SHOIl::>n~lSNI