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HomeMy WebLinkAbout81-00127 i " ",," " " , I, I, " -,' ~' " , .' il,-" " .. H " ' -1,- " " " , " . " -:,'/ '" " " " '. " 'I, 1\ " " " " " ,,'" , r ,,' , , ""I': ! \ ~ '" ",1' d ," I ,'-',:0,:1. , ",I \"I( ~, I " " l , 1,-' j,., -,\,,- ":' _::.!/-:I,', -k',1 'I :'1 1 ',: ~ r} J! It "j!, '1\ I:'" 'I _,: ii 'F _I' r I' f ", I' , , , ' , '" "< I . ~ '!, " ' "1' :i I.' '-q >,0 " 'I I, _,,_'Il '/-' ._,Ii " '. I ~ - , ' " " .. " " " ," /' f :: "I" " " f'_. " " 1 -,'1 " )'j- ," I, '. ,I ,', '", " I' ",-:/' " " , "I " It ~ ' ,/', ,! I ( " " . '" ,,, ,,',,1' . " "8: " J (j, " , ",' 1;- , lI" " ., I, '1'-' J; " " " , " " .' " " " I " , ,I, ~ I 1'" " '" " .' " " " " , '" , " ,,)' -I " '/' ,: 9EN~RAL INI;II!RITANCE TAX II'lFQeMAT~ UnPBtlefled lIabllltlos Inourred by tho dBoodont prior to hl8/hor dBath ore dacluotlble ogoln8t hle/hor to)(oble Getato, In 8ddltlon to dobte Inourrod by th8 dooodont or oetoto, other Itollle aro olulmoblo Inolucllng tho oq,t of odmlnletlutlon, ottornoy IBoe, flduolary IBBe, tunorul unci burluloxpenD08 Inoludh1g tho 006t 01 /I burlBllot, tDmh6tonB or grave morkar, All dobt8 being olelmed egolnst un ostoto oro 8ubloot to thu approval of tho Rogl',\or 01 Wills wIth whom tho Inhorltenoe Tax Roturn 18,f1lod, evldonoo to 8upport tho deoodent's or thl! ostoto'o IIliblll\V fot tho debte baing olBhlled should be ottoohod tothlo sohodulo, . AfBmllY oxemptlon of $2,000 mBY bo OIBllllod by a oPOU8B of 0 dlloedont Who diad domlolled In POl1118vlvBnla, II there 18 no 8pOUSe, or II thB, spouoe 11as.lorleltod his/hot rl~hts, thon any ohlld 01 tho dooedont Who Is a mBmbBr 01 tho same housBhold con olalm tho oxomptlon; In tlw evont thoro 10 no suoh OPOUSB or ohlld, tho Bxemptlol1 can bB olalmed by, a paront or paronte who aro mom bars 01 thB samo houoohold JIS tha dBOBdBnt, Tho lamlly oxemptlon Is alloweble only Bllalnst B88ets whloh p08S by awlll or by the Pai1nsylvl1l1lo Intostoto LoWS, C :'CI @ 8 E; ~ ~ ~ z ~ z z til ~. t:l , ~ ~ 0 p z , z p p < 0 'I 0 0 .., ." ,... , 0 ~ . " ~ , ~ \" .... LJ U l!( Hll;;'>1 r;-. ,1.1 I.' ~->:CI (.. <:"J .-("... ~ (.~l( N 'i"~ i>~ ';j WLI tt Ij:f&:' lt1 (i)" ~~~'~ ~.) .J ~ ut;J ~\~ g W\!'..! SO t" ~ ~..l ~ ~ \ 1.. 1. I~SIRUCTIONSFOR COMPLETING scHeDULE "F" II the fumlly oxomptlon Isbelnll ololmod, Indloote the olBlmont's namo, oddress and his/her rolatlonshlp to the decedont, EntBr "IBmlly oxamptlon" In tl'o tamarks oolumn and the Bmount ololmed In the amount oolumn. A88lgnoonseoutlvo numbBrs to eooh Itam Ilstod, Entet tl]e datQon whloh Baoh dobt woslnourrod and/or paid, Enter the nomos 01 eBol1 flayee, Provldo a brlel oxplanatlonln the rBmarks column fot each dBbt olalmad. EhtBr tho Bmount 01 ftooh dBbt belnll olalmed, " ' The formm\ls~ be signed by the POfson 1'1110 haS aosutt1Bd tho responsibility for. flBylng the ilebts. 2. 3, 4. 6, 6, 7, I, .2 .).() - J'( UgV.440 E~' 13,00) COMMONweAL Tit o~ pemllVLVANIA De~ARTMHHT OP ReVBNue TRANI~IR IHltlRITAHon 'fAX RUloeNT oHolDeHT _.- "l'f~'r'1'~;'f''''~' i..._ F-" ^F~b~~~~~~P' (lnltruotlonl on RIVen. Sid.) * Estate of _~lll!l.\1ltl1.!~!.)lp_o~~,J:.~_~__.__ Lo,t Add rGu'Jlj:;~J\,~._.2. ._.~nO,l\.l L.u...__,.._.,__ .BhipPJluaburg., _1'A_____.l.72!l.7.._ I""(YI 1$""" (ZIP) Dote 01 Death Jutv 5. 19ao Social Seourlty No. la'I-12~(jQ^' Bumau File No. County FileNo. ,;I (-&' J -/,;)'{ 1. Oecedont dl rid 1 (x ) Intoatotfl (without Q will) ( ) r.estato (1llllvlnu Q Inst v.:111--,coIlY attached) 2. Is .tkellllnu of a Fodorol Estato Tax Return roqulted lor thla ulolo? 3. Executor/Exocutrlx ) Admlnlatrator/ Adrnlnlsttatrlx Norno Hnry I~. HamlS ___ Addren ~ SCI\r..,J.iRY~_2 - !lOll U Yu___ NlI ill Jo.int Tenant Witl1 night of survivorship _-Slu."pansbuJ:g.__.EA_ IOITT''" In'T"' 17257 ''IPI ,~g 2! ~~ .0 ..~ ) Fiduciary. I , ~ [;Jf;i; 'n~ ~' ':\. _ "',1 N :J.: .1':'J" Q ',.;.> e-,.I~!:. q-,! n. .oYI 1."/.''1 i!a d ;') '-' ,1\ '!'!~? ,<, . " \ r i 4. All oo.rrearandence should be mailed to (X ) Attorn~y 5,' II an attornoy larorreaontlnujhe oatatol Indlcatol Nome 1I11\1~e E. Hartin 'Addtes& ___239 .~_~~~J~~.L!~~.a.J:.. OhambnrsJ:uu;.!l. FA lolTTI (iT^TIlI J]ZOl , 1~IPI List all safe doposlt bOK~s tenlalered In the qechedoptls/lndlvlduql narnehor lolntly wlthl}lt a~ an agenlor depuly 01 anQt~e!, or,lndocodonl a Indlvlduolnnme wit right 0 accesaby onot or aa ollenlor uepuly. Include the name and qdqtosa 'ollhe bank or otko! Ins II lutlon whore the aa/o doposlt box Is localed, the nam'e (a) In which the box Is reulstorodand'iho rolllllonahlp 01 the lolnt holders to the,decodonl. ' , ' .- -',- NAMe AHPADPRElI OP DANK OR onll~ INSTITUTION INWltlCfI DICSDSNT MAINTAIN~P A S~PE DSPOSIT BOX NAMICR NAMallH WHICH ,IAPI PIPOIITBOX 1& RIOIITBRIIP NONE ___ -----1._ _......---~._----- ~nqer penpltlos o(Plltlury, I doclaro that I hove examlnod thla return, Including accompanying schedules ana statements, and to tho bul 01 my knowlodgo and bailoUt Is truol cOrreat and complete. ' 11- ~D(P - ~ ;>7')' '.'/';2 i' __ / ,$"7"j ~.l-~ ~-,.J t ..;L/....,I.'i::);.LL11 /t,. '/ ,-d" "'/ h , ~ ~.. r"-' ., i' !IONATURH OPPIDUCIARV ,,2 ~-/ ,:I. " ,Y'/ , I DATE w~glo N ~_Q~c c EJ1till!.9.1' HOJ:!U\IY._JJ~~~mJli 1. Old dooodont, wlthlll lwoYIIlHso1ilonlh, IIInlw IIIIY lrllll,lolol noy 111111011111 pilrlol hi!, O'illllli wllhollllOr:olvllll! vnlllohlo ondmloqllolo cOllnlilIHillloll1 (I\Il!iW01 "YIIH" Ilr "Nil",) ,,~.~~,:," 2" 'Old docodolll, wlllllo two YIIOIS III (IOlllh, lrilllslor Plllporly 111111I hllpslIlI' 11IH'.ollll) hilll!,oll/lIorslIlI IlIHlliOolllllr pUll\' or partlos (h\clll(lhlll'(\ 5pOIlSO) III, iollllOWlIlllBlllp'l (1\1ltiWIII "Yo'!;" Iii "No",) ,~~"..'.. 31" I( tho (\1I5WOllOOIIO orlwo ulmols "You" nrilllllO 1i1ll1!,ItWi iIIO elnhlilld 10 110 1I01llnKUlllo, pHlvlilo 1II0lollowlllR Inlotllll\lIolH ' II, I\Ro 01 i1l1co<lollllillllllO 01 lrUllslol. _2:.1-___ h! Copy 01 rloolh oorllflc/llo, e, Allldovll hy Ihollltollr\llll! pllyslr:lulllndlclIlllll! Iho sllllo 01 doolltllllll'!; 1,10111111 III,tllllooIIIUII!illll, d, All olhorlololmolloll 5\1Pllolllnl\ Il\1II1nXllhlllly of Irilll\\ItJl, 4, Olddooorlolll, In his/11m IiIOtllllO, III i1I\O OilY, I Iilllslolof PIOplIlly wlllillllllUeolvlll!l a lJilltlilhlll or'illloqllnlo I;Ollsldlllnlloll Ihorofor which \'IllS 10 tnko oflocllll ponsllsr,iolllJllllljOYilll11llnl O! nllu! Ilis/lllH (Iunlh? (AnHWof "Yds" 01 "N(l",)~. 0, Wns thoro nny IlOuslhlllly lhnllho prol1or1y IFililslorrod IIIllIhl rololll tolliloslnrm 1Illtls!hor 051nto or bo subloct 10 hls/hm pnwqr 01 dlspositlon1 (Answnr "Yns" nl"Nu",) ,.",-~-.- b, Whol WOS lho lrollsfolilo'S ono 01 \1111001 dooodunt'!; doolh'l ----" 5, Did docodontln.hls/hor 1\101111I0 lIIoko OIlY lrunslol wllhoutrocolvillP.iIlJillwlhlll I1nd ildoqUillO cOIIsldorollonlhorolor lIndor which lronslllfpr OKIl[IISsly 01 Irnpllor\ly 10!lorVOS for his/ltm 1110 IIr ilny pllri(HI which (Ioos III fool 011(1 boloro hls/hor doolh: 0, Tho ilOSSOsslon or onioYil\lllll olar lho rlHhlln InGUlno hOllllho Illllporty liilllslollll(l? (Answor "YO!;" or "No",) ~.:!.:,:... 11, Thq rlnhtlo doslnnnlo Iho Ilorl;g~s who shnll jlOSSOss III onjoy \l11l plOporlylli,liIslorlOlI or 1110011I0 lhlllolrolll1 (Answor "Yos" or "No",) _.....:....- G, If Iho onswnl 10 lIvqh, olxlVols "Yos," slolowhllllHlr Iho rlllhl WilS IO!lorvod In duoodont nlonnor olhors, 7, Old.fJocodont In hls!tlOr IHotlllilllllnKu n'lllln!ifor,lho cOllsidornllolllo[ will,~I, was IrlllJsluroo'sprollllso 10 poy IIICOIIIO to or for Iho bonofll 01 (;lIro ollruIIsluror1 (1\lIswm "Yos" O! "No",) ---- ' 8, Old dooodolll, n\,llny 1111)0, Irnnslor proporly, Ihohmofloinl onjoYlllflnlol wllll:h Will; suhjoollo CllOllflO, hnr:ulIso of a rosorvod pqwor to nllor, 1I1111lllil, or [J),yol<ll, O[ which ooold IOVor' Iu docodollllllldor 101lllsof trnnslor 01 by oporolloo 01 low? (Answor "Yos" or "No",.) ~,.~ ',' ,9, I( Iho an5wor to oll1hlllbovo Is "Yos," ViliS tho pownr, [0 nil III , ;111lond or rt1vokotho Inlmosl of llio boooflclnry rosorvod h\ Iho dooodonl nlo110 or U\11 dll(;orlonl1111d olhors'l (Answor"Yos" or "No",) ,-.---'---' ' ~.___.......__~~.-..._.________._,_.~._n________~_______"'r"'-"'~_<-+.~~rm--~; ,,-,-'~~~""""~'---'~'-+-'-'~-----'''''' ! !:l ~ ~ ~ ~ ~ . , 0 N I t ~ f>; ~ ] 'S N a \0 i ~ ~ i ~ i ~ \0 ::l 0 lJl N "" d ..... l:; ~ , ~ z d ~ .,~ d ~ z z ~ ~ ~ ~. ~ ~. ~ ~ ,8 ~ ; , I ~ , , 'i' , , COMMONweALTH OP PENNSVLVANIA DePARTMeNT OP ReVENue BURBAU OP EXAMINATION OPPIOIAL NOTloe OP " INHeRITANOS TAX ASBHSSMSNT *' c:? ) , /( / ) ;),'7 .I'('r)Clvi;;'Y ,,'Yno'c1/vl/tr:" o , ~. VJ~y z';L ,)VvI/ Jl..) '7~1 OATS ~, ~o Ifn"! r~'.~/Yl ~ ~{''Yi>J ("';\ '1.1' ~:1j7)v4t d . - 'I - I.).,.? ESTATE FILe NO, COUNTY DATE OP DeATH - Appralted Vuluo of eltalo: Aool Ellato Porlonal proporty . + JOintly Held Proparly/Tranlforl ,+ Total Oro..Ellate o Tolftl Approved DedUotlonl Cleor Value of Slleto . Leu: Approved ChMII.ble E~emptlonl Cleer Velue of Eltale Subjool 10 TaK . Amount TeKable@ 6% AalO L-. laK due , . Amounl TaKabla @ , 6% Role laK due - , 'j (,~.J. II . TOT~~ PENNSYLVANIA INHeAIT~Nce TAX DUE '5. J~I Z<.; ,(,/. ..;1.,,) ,?'I ) ('lrl~()3) A flva poroent diliooShi"' totatlng '. Inl1orltanoe TOK II paid by . ....if* will be' granlbd If Ihe Lell C,edlll: DATE OF PAYMeNt~ouNT PAID t;. ,..:Q O. [:;I ~ DISCOUNT INTBREST TAX CREDIT _ + . . . . . i./ 0 d.. '7 / " t it! + . Interest accruee 01 tha rete of elK (6) porcenl per ennum on the unpeld balance 0' Inheritance TOK from to date of peymanl, Inter.al due If paid by II sALANoe OP PSNN8YLVANIAINHEAIT",NOe TAX DUI f ~ 81. Inlormallon On nOy.,.a Sid. 11I'tWHI I{I.H vVIlLL