HomeMy WebLinkAbout81-00155
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oATil m' P.:R!lONAI. RI~I'RI~!I.:NT^TIVI~
COMMONWJlAVrH OF rnNNRYl,VANIA 881
COUNTY OF CUMIlURl.ANI)
Ilefore me, tho RealMtor for tho Probllte of Wills IIl\d arlllull\a of l,ottorR of Admll\lsJrllllon In llIId far the county 1)1'
cllmberllll\d, porHol1nlly 0111110 Paul , J, Ourry" Jr,
,j
who, bolna duly sworn ,do ell
of the last WIIIIIl\d Testllmont of
, de~pso I1l1d RIIY thllt liS ExecU tor
Sophia E. Mentzer,
deoellsed
he will wollnnd trllly IIdmlnlster the soods IInd ohllttels, rlshtslIl\d oredlts of slIld dcoellsed lIouordlng \0 IIIW, And
'1I1so will dlllselllly oqmply with the provlslol1s of the law rel,atlns tl) Ttllnsfor Inhe '1(llll~es, a.~" ~"s.ubsorlbe.d before me,
February 25 1\,0.. 19J.L . , ,/' " l;i).,,,. '1
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Bo It remembered that on the 4th
reeorded,thelasl Wlllllnd Testament of
DECREE
Much
day of ~
Sophia E: Mentzer
,A,0:,1981' ,there was probated and
late of'
Camp Hill 13~\1ough
Decellsed, L:otlers Tes tamentary -,-were srlll1tcd to
W1tness my hllnd and offIcial seal the day lInd year ara'resald,
_~, Cumberland County, PonnsylvlInla,
Paul J, CUrl'y, Jr';
~'
?di
(!'r~:J-
Resister
COMMONWIlALTH 01' PINNIYLVANIA
, COUNTY OF CUMBIRLAND
III
Paul J, Gurry, Jr,
_ _" ~ or,,_,'_" ,<__ 'n_
bolng du'ly ,,_U'_''-' __.I3.WOJ:n__. nooordlng to Inw, dOp01U1 nnd InYI thnt, ho ,.ia,._,,,_...~-_,.._._.
_ _ u . ~K.~~~~O:r. 01 tho Eltnlo ol_.~c:lp11,i.a__~..!'l.~I1..t~,(;l.r.,~,u""H'~-~.u-
lato"ol Ca~ Hill Borough ___,..-, Cumborland Oounty, Pn., doo,oOled ~ndt~et tho
within It an Invontory modo by", . n.;\"d.m U _. ," . ,.-" - _...._,tho Inld___~J~.I\\QJ.!.tQ.J;'_u.---
01 tho ontlro elhto of uld dooodont, conllltlng 0,1 all tho porlonnl proll~rty and rool olloto, oxcopt ronl olloto outalde
tho Oommonwoolth 01 Ponnlylvonlol and that tho Ihaurol OppOlltO oooh Itom 01 tho Invontory roprotont It'l hlr value
01 01 tho doto of docodont'l dooth I [/'i) . I
l ~~.rn ,~O,:t. -~.:. and IUblOrlbod boforo mo, J.u ,..._,,'2~lL4,IJI'>)~~_~"_'_'.'-._'" H
7M- .. ,,/' S...ulo .}%Inhlri,ot .
tI~2.~.,~J" ~-:_~l -:;;n::.~~~~ .~.~,_~r~ D.~~~
My (ommllllon lxp~'1 MV \, 19'. -1'9087--" ---.,i.ddt.;;---.-.--...-...-......--.---..
am, HIIo'. CumlNltind Couoly
~- -'r --, ~
Dote of Ooath
23
.....-____.,.~__ ___ on____"_,..
!'~1'1.'\J~~}'..__ __Hh~___ ..___~5!_~~_--.m __._u.____.__~'
Mont" V...
......~_.._-_...._,--_. .~._-~.
O.i'
INSTRUCTIONS
I, An In~ontorY mUlt bo fll~d within tht~o monthl nltar oppolntmont of pononol roprolontntlve,
, A lupploment Invontory mUlt bo 'lIIod within thirty day' 01 dlscovory of additional, olloh,
. Addltlon~1 thoeh' may beatlaohod lis to, ~orlOndlty or roalty ,
, ho Artlolo IV, Flduclarlol Aot of 1949, .
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COMMOMWBAL m OP p~~lmLVAMIA
OOPARTMOMT OP ARVI UK
TRAtllPIR IMHlRlTAMe 'TAX
RIIIOIMT onCloIMT"
. '--
APfllPu~~l~~P
(In .t,vallonto" R.yono Side)
eatat. 01 ____ 80FH.:~_~..:_~E1N~ZF'~______
L.oat Addr... 3522 Jle.e..te,lJ)ber Dd,v.L.__
Camp Hill, FA 17011
-_.~...._... "
Oato 01 Doath F'ebr~a:L33, 1981
Soclnl Socurl,ty No, _~l1.C.ol"l619
Burol1U Fllo No, _______...;
IOITYI
I'TAHI
II,1PI
<;:0\1" ty Fllo No,
21-81~155
,1'"
1. Deoedent dledi
( ) Intntat, (without a will)
(X ) Teltato(leavlng a Illlt wlll--copy attachod)
,
2, ,I_ the IllIng 01 a Foderal Estate Tax Roturn roqulrod lor this ostato?
,3, ( X) eK.outor/l3xeoutrlx ( ) Admlnlltrator/^dmlnlutrotrlx
Namo Paul J. Curry, J:.:.___
, Yos,~No
x
Add!on _ 219 S~to~' Road,
Wayne , ~
IOITYI IDTATHI
Ap t, J?:.l91
:1..2087
IZlPI
4. All oorroapondenoe ahuuld ,bo mailed to Q{X) Attornoy
5, II an allorney I a representing tHe aatpto, Indlcatel
Name J~ K. Arnold,_Esq,
Fiduciary,
Addresa n09 Marl~et S~. , P"O. Box 737
,
Camp ~1i1+ , FA ---11011:-
IOITYI I'TATHI' I~IPI
,L.lat all sale depqalt box~a reQlilhlled In tho dopodo~t'u In'dlvlduql nQlnohor 10lMly with, or 01 an agent OJ deputy
01 another, or In decedent a Indlvlclual name with right 01 access Py ,anot or aa agent or deputy.lnolude ,the MillO
and,addroal 01 the bank or other I~atltutlon whe,ro the Inlo doposlt baxla locotod, tho noma (a) In which thu box
II reglatered ond the relatlonlhlp 01 the lolnt hold,ers to the decedent. '
MAMIAMOAOORUI Op BAM OR OTHSA IMSTITUTIO~
1M WHICH olclol~T MAIMTAIMIO A IAPI oOPOIIT BOX
CCNB BanK I N I!A,
Camp Hil18hoppingCenter
Camp Hill, PA 17011
MAMP OR MAMBIIH WH ctl
SAPO UBPOIIT POX 15 RBOllTOROO
Decedent
-....
Under penal tiel 01 perlury, I deolare thot I hoye examlnod tHla return, Il1cludlng accolnpnnylng schedules and
statementa, and to tho best 01 my knowledge nnd bolla~,I~a,truo, corroct and complete, ,
J 11 'I 4 I" 1) J .-' " "
(iF/ J C(, \_~ \.) {'J'~J/
/I.o)4ATUR"~ ~lf~IARY oATS
e.!;,litiSYkY ANI AJt!lllilllJ]JiQJiJ AX OEN1.B~!J~ 11M A TION
1 PEI1S0NS I1ESPONSII3LEFOR RIiTUI1N
1__......,. .
Soctlon 701 of 1110 11111011 1011 co "nd Eatoto Tnx Acl of 1961 proVldoo t111illllo fOIlOWI!lR'p~rson9 slIollpreparoond fllo
o rolllrn:
0, Tho poroonol rOllrosonllltlvo of Iho 0011110 of tho docmlonl os 10 propOlly of 1110 docodont ndmllllstorodbY 11111I
\11111 slIch nddlllollnl proll(nly wlllch Is or ruoy bo SlIll!ocllo IlIl1orilllnco Tllx of wl1lcl1l1o/sllo sholl IIl1vo or
IIcqlll ro knowl mlRo;
b. Tho Ironoloroo of prO/lorlY lIponlllo In,nsfor of whlcll Inllorilol)co Tox Is or I\IOY boIInposodby 11101961 Slollllo,
IIlGllldlnR 0 trllsloo 0 proporly lrollsfoilod In trllSt, plovidod 111111 nil ,uplltlllorolurn IHlod ilo 1II0do by tho trllnofmeo
of proporly illcllldod In Ihorolllrn Ilf II porsonol roprosonlflllvo,
2, PL.AGE FOlnlLING
Tllo 10111I11.1[\ lobo II10d In dllpllcnlo wllh 1110 Hoglolor of Wills of 1110 eOllnty wllorolnlllo docodenl roslded,
3, TIME FUll FILING
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Tllo lottrrn !!i duo nino 1II0nlllo nUor tho docodonl's dontll, 1I1110S9 1111 oxlonslon fOI filing hns boon applied for and
nronloo by Ihe Socrelmy of Rovonuo within tile nlno-monlll porlod.
4, Ei\lh!LRE.I9 riLE RETU RN
Soollon791 o[lllo 1961 Stnllllo plllvldos tllnll',: ,any porsonwllo Willfully falls te file 0 relurnor other repert
rnqulred or hilil, , ,'shall bo parsorwlly liable", ,10 opellOlty of 25% of Iho tax 1I1t1rnnloly fOllnd lobe dqo,or$I,OOO
whlchovor 1~llIo lossor 10 ho rocovorod hy Ihe Deportmenl of flevonlle flS dobts,of 111(0 nrnount nre recoverable by
Inw," ,
5, JAX RAn;s
Inller"ltonoo Tox Is paynhlo nttlle role of 6% olj(rnnsfor~ to Ilnoal c1oscendnnlo, sllch os fotllor',mothor, husbend, wi fe,
son,daup,hlor, ,p,rnn(lclllldron, p,rnndparenl, son-In-law and dIlUR!lter.ln-low and ot the rolo of 1B% oS to all others,.
6, ,PAYMENT or TAX
Tile ,IIlX ossossod on tile Iron sf 01 of property reported In llle return Is dlle 9 monlhs olier Ihe docedent's death, Interost
ut llie ralo of 6% per onnum nccruos thmollflor lIntll poymentls modo, All payments recolve(1 are first applied teany
Intorest which moy, be due willi any romlllnder oppllod to the tnx, IF TAXISPAID WI,THIN 3 MDNTHS AFTER THE
DECEDENT'S DEATH, A DISCOUNT OF B% OF THE TAX PAYMENT ISALLOW.ED"
All checlls.sllould be modo \IOYllhlo to llie Reglsler o.f Wills of Iho county whorolnlho.decedenl resided and arq
recelvod subjocllo tho 1I11n determination of tlle,Depmtmont of Revenue,
7, WhURE TO. pAy
The taxes Imrosod, (ogolllor wltll any Inturost theroon, are a lien upon real property, wlllch lion, remains In effect until
1110 laxus IInl 1I110100t IIl1vdbeon pold In flll,I," Tho loxes may bEl Sllod for oRalnst ony rool proporty In, lhedecedellt's
estolo or np,olnsl ony Ilroporty belonp,lrlp, to 0 transferee Iloblo for tile taXi .
!,
,,8, FILING or FAI.SE RETURN
....____-. ,,";. _. I
Any porson wllo Willfully mokos 0 fnlse rotllrn or roport roqulred of 111m Shllll, inaccerdohce with Soctlon 7930ftlle
1961 Slnlul.o, be guilty of 0 mlsdomooner and, on conviction thoroof, slloll bo sontenced 10 pay 0 flile nol excoedlng
$1,00001 undergo IrnprlsontIJonlnot oxcaodlng ono yom or holh,
QUESTIONS OONCGRNINO PRortRTY TIl.6~SrERS.
1. Old deoedent,' wllhll\ two yoms of dontll, lillIlHllllly'lrnllslor 01 IIIly III II luiI1II pori 01 Ills oslntu wllllullt locolvlnR
vnlllnblollnd IIdO(lllOlo consldorllllllll? (^"swor 'IYU!i"or "No" ,) ~tl2~'
2, Old tleoodbnl, within lwo yonrsof donlll, Irllllslor proplllty Irolll 11111I\\01(/ IWlsol! to IIll1wolf/llrJlfolll1 nlld OIlOlIlbr putty
or portles (Il1cllldlllp, n spouso) IlIjoilll oWIIOfship? (^"!iWIJ/ flYosfl or fiNo",) ..,Nc_. .
3, IIlho ollswor 10 0110 or two nhovo Is "Yos" nlllltllolrilllshllS nro clallllod 10 ho f1ontnxnblo, provldo Iho 10110wlnl1
lolorlllnlloll:, ,,' , '
0, ARO of docodQnlllt limo of trnllsfor, ___
b,OopyofdonUl'oorllflcnlo, , ' ,
c, Allldovlt ,lWlllo nllolldlnp, pllyslclnJ/ intflcillilll'. fllo stnta 01 docodollt'nllollllh nllllJ10 01 trnllslor.
d, All oUlOr 11I10TII\nlloll slIPporllnnllolltllxllhlllty ollrilllslol, ," ' ',,'
4" Old (looodollt,ln hls/hor 1110111110, 1II11~O nllY lrllllf;fol 01 proplllly wllllo\lt Illt:olvlllH iI vnlilllhlo or IIdoqllnlo cOllsldornllon
thorofor which wns 101111<0011001111 possossloll or olljOYllIlJllt lit 01 1I!l0l ,III !J/llor IIUIIIII'{ (AIISWfH "Yos" or 'INo",) , NO,
a, Wns Ihoro Any posslhlllty Ihottlio propurly trAllllforrod IlIlnhl return 10 trolls!nror or hls/llOr oslnto or ho.suhjool
10 hls/llor pawor of dlsposlllon? (Answor "Yos" or "No".) ~_ '
b, WhnlwltS Iho Ironsloroe', nno lit 11111001 doclldont's lluntll? -_~_
5, Old docodonlln IIls/hor 1110111110 IIInl<o ony trOllSl!)r wllhoutrucolvillH n vlllullhlo/uuf nilllllnllto l:orlsldarollonllluroior
undor Wlllch,lrnnslpror oxprosslY Olllllpllodly rosOIVos for hls/lwr 1110 or nny porioll whir-II doos Inllwt ulld baforo hls/hol
dooth: ' '
0, Tho possosslonor 9njoYlllonlol or Ihqrlnht 10 Inoolllo f[(J1II lllollroporly Irnllslorrod? (Answor "Yos" or "No" ,) No
Il. Tho rlghllo doslflnolo Iho porsons who shollpossossoronjoy Iho Ilroportytrnnsforrolf or Incolllo thorofrolll?
(Answor "yos" or IINo",) No' "
.' e..ll,lho Answor to Ilvo Ii, ollovo Is "Yos," stnta whollHlIlho rlnllt wns rllsorvod Inllocodonl fllono or othors,
, ,
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,7, Old dooodont In hls/hollllolllllo IIloko otrilllslor, Iho consldorllllon lor ~iCII wns lrnhsloroo's promlso to PAY Income
" toor for tho 1l0nolll orcmo 01 tronsfolor? (Answor "Yos" or "No"',) 0,' , , . "
8, Old docodonl, alnrly 1111I0, tronsfor proporlYi \I1ollflloflclol onjoymollt 01 whloll wnssuhlobllochnngo, hocnuso of
n rosorvod powor to nllor, olllolld"or rovollll, or which cOllldrovort 10 dacodonllllldor lerlllsof ,tmnsferor by operAtion of ,
Inw?(Ans.wor "Yos" or,IlNo",).~
'9. If Iha nnswor to olAhl nhovo Is "Yos," wllstho POWfH 10 ollor, olllond or rovokolho Intoroslor Iho henollclmy resorvod
Inlho dococlonll1lono or tho docodolll nndolhors? (Answor "Yos" or "No" ,) ,.-_._
.j, ,
IHC:V.l\lIl EXt (3.001
OOMMONWBAL TH OP PBNN8VLVANIA
D8PARTMBNT OP RUVDNlJD
TRAN8PDR INHDRITANQB TAX
RB81DftNT DBOBllBNT
SCHEDULE "0"
IlRNPPIOIARIIlS
"".twar/O/l$ Oil RIJvor,a S/(Ia)
Estate of
SOPHIA m. MENTzmR
--
'*
SURVIVIlD DATil or ,
BllNBPIOIAR1BS AND AobRBSSllS ' RBI.ATIONeHlp DllOll(l8NT DIFiTH INTIlI1IlST OP IlI1NllPICIAl1V
, .
Paul J, Curry. Jr, Nephew Yea _..JL301. 1~ plus_
_.._...........___._~O-, ...-_......"~..~r~. r'__~_---"_".'"
219 Sugar town Rbad ' " 1/3 of reaidue
........._;-rt____.......__ -_..."._-~ .----.------,- .-
Apt. D-l02
- ___'_"4~__ 1-<----:-- , .-. - -
Wayne, PA 19087 --'
-............-...-.. -- ---
, , , ,
Deborah -'-
Lynn Curry Gt'arldniece Yes 1/3 of residue
--..--- -- -~
2 Colonv Drive . "
- m_'._"_ - -"
Apt, 125-A
.
Wilmington I Del, 19802
.,...-- ......_m
, " 1/3
Sondra Jean Curry Grandniece Yes of residue
, m..........__............._ . .- -.................--...,-..
219 J!uga;:~9~ J~!'a.(L__.. .._~... _,~_....,~__..'T_____..,~...__..,_..._.._ .__,_"_m.. nn_~'."~'_ ,.,..~ --~--~-------.-._.~-...---~-----------
_--.-..."..m_._~_"_~~_.
Apt, D- +.Q~ ...,__._m_.._ ......----..... - ..-
Wayne, PA 19087 .- _.__...-.-.-.~:..- .........--~.-_..---+------
-...-----.
..............-,..--.-~.----'-~ ..~- ,
...--
.
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..------- .._.___....._.___. r..____ ___,.,. ..~~...._n"______'_ _.. -___ ...-,-~..-~_.__._..-~ 'L~~.,~,____""_+r~'_"F_~~'"" . _.__.._m
~-----_..~ _.__.~_," ~...n.'_"'~" ,-,-,------- ._-~-....._...~~---_.. ..---------_...<.'"------~-_. ,--. ----- ....-.,. '..' ---- -.."...----------..
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..---.--~-----.--. ---....---..-...
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--------------- -..-----------
-ri-<--_' ___________~ft_ ----.--... ____m______ .....-~~-~~....... ----.--~------
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-- ------.............-...-....--..-- ....-.-..-.....--.- ------...- --.........----....-r---.-..--.:.;.-
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--- -. ----
, 0.....-.......-.----- ._--- - -
" ,
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The abovll beneflolarles ahlllvlng at this time exoep* for the folloWlngl
NAME
DATa OF DEATH ,
_.....................------------.-.-._~
"
; . t.
~BUqrIONS FOR COMPLETING SCHEDULE HE"
SQh'edule "E" must lI\ollldo 011 proporty~ 1'001 unci r>oruonol, ownadby tho dooodant jointly Wltn enothor
perty or portles os )olnt t/inantu with rluht of survivorship, Both tonglblo and Intonglble proporty ora to be
I~oludod, List 1'001 ostoto first, " "
"
1, Desorlbo al,ll'Ool propurty os Indlootodln tho Il1struotlono for Sohocllilo ,!' A", Dosorlbo \111 porsonol proporty
M I,ndloatod In tho Instruotlons for Sohodulo "(3", Inoludo tho nomo, oddroos oncl rolotlol1shlp,to tho
dooedlint of tho oo'ownor (s) ond tho eloto tl,10 lolnt ownorshlp was ost.llbllol\lld,
2, Indloato the totall'l1arkot VOlllo of thololntly 'ownod PI'ollOl'ty,
3, Indloato tho poroontollo of lho.rlooodont's Intorost.
A. Indlooto tho rTlllrkot voluu of tho dooodont's Intorest,
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CnMIMJlml'M.TII Of' 1'lflfI~;YI.V^'iI^
DI;I'AilTMIOiH Of' IH'Vt:I~11I
TRAN5PHR INHB,RITANCn HX
~RlIDHNT DHCHDelil....~..-..""......:.,
" 1LI0RIGINAI.
INHERITANCE TAX
APPRAISEMENT
-
E.tato o( ___....._..." 901'h111 (1,.. .,N.ontv.or '
21-8J "0155
County _...._.........
ClImbor~nnd
DClto o( Dlloth .,.y~l>r\!nry ~~.,J9.~_L_____
-~ . .rA__~;..'w;....,..)..~.. .'-'~"J'""':t#.'~~'.~l~.l;;UO"'~~__'''~' ,..' -_
In, Ihlt lIy,,,1 thnl a"(. fulurll 111lutft.t I" thl. e_ltllu I, lrull,f"rrolf hi IlouolllolI or fllllflym.,,' fn (.ollulortll h.I,. flf the deaodQl11 nfl.rth.
'.lIlplrutIDn pI n11Y utili" ar IIf. hi for y"rHII, tho CfllIlIlIQIIWonlth htlfltlty nIC,"ouly fif"HVU Ih" rluh' hi 1IIIllfulu 11I1d OUUII !tulI.far
lfih.rlfet" elll t~..!.!! '.J!!..~..ffi'clH.~~.u:.~~1;~~!.!',_~~\~1~1.~ ,~l~~:J~~!.tl!gJ~l,~::zI~':-:'~lr;:',~,~_'-" ~c'~'':~--. ~;'rJ~--:-' ,,,,".;..~t~;::.._ ,:~. ~.: ~.~--:+..~-:::=,~-=,;;.:-- _ ~
PROPERTY NOT IIKLUDED IN RETURN BUT APPRAISED BY THE COMMONWEAL TH
_____~.~__~_.__..u._.......+... _._._ ~"~.m' .c __._.~___n'_".rn'_ . __...w ~_. ._. __ ....._..__........_...._.. .~..._...~.._..__.___~._~__
,
___~...____......_.L ""_'"
-.._._._.....____ .. ____..,r_'__, u.~____..,.
..__..._~.. .. ~~_..-..---_._._-_.-. ~.-..-----
._ .,,,._,,._...~~__. "w_n.._~ ~.. ...___......,._~...__~..4_....
-.-..--- -.._--.......-...-.....-~'.___.. .,-. _ _,_.___..._..___..__.. . ,Hn.~'______'_'_'~~"_._.'_'_.L"__._'__"-
.., ___.. .' >-_..0 .__., ...__ ~._ _.._om. ._..~_,__.__.._.~__._.._~...~.~..__~._._._..__......__..__
.-.____________._,.~_.____.__.... _._.~.._._..~_r _. ......__.....__ ...__.0_.. .._...,.._,_._...__
-..---... .... ,. ...,-._-......~.---...
--=::"==-====-=-'~-=::':".~
ASSET SUMMARY
--
DEPARTMENT'S
APPRAISED VALUE
-------~_..~_..~...._..-.~..-
I., Total R.al Prop.rty - SCH, "A", , , , ., $ .......,.______..nllne..,.,_
2. Total P.rlonal P,op.rty _ seH, "B", '" $ ;.......36,~J._!.7.A___._
3, Tolol Jointly Own.d Proporty - SCH, "8" $ _.___.._._.!1Qnll..__._.
4, Total Tranlf.rl _ SCIi, "C'!, , '" , , " $ ._......___....JlllUq.
-----~..-._.-.-._._.__._~.. _._.._~..... ,.-.~._......
Unroport.d $ ..-_.~~--_.~-- $ ...._~, none
Unr.potto'd $ -_..--~-_._--_....- $ _~.~.!261. 74
Unropllrl.d $ '_'~_4'____"""_'" $ ....--.-- none
Ul1roport.d $ ---.--... - $ .. ......... none
TOT AL GROSS ASSaTS
36.261. 74
.=r:J L.I pa ~STA !~_._~'.~.=:~.:m~U~IY.~._=:.
......:.--.7-:..-.=.."';:==":i:::::.___~===:..;=::::~._=_
REMAINDER
_ _...........__.____._A__...__._._n,.__._..,..~...... 0-_..."..0-._._....._.._.. _. __... .__.._.....""._.~..n.~_ ~ __._...__... ._._____.._._
. .._._o-._.,..~~.w. ~.."."_m -,....__,_.,.~__._.\.......,~.-'_..._.. -.__..,._."....."..,. ....~---~~..~4~..~..__.____r.._
-.-......-----..-..-
"
__........_~.N.. _ ...., . _..._.___..._.._..~n.u._..~..____.....~_...._~__~___-.-;_...._-..._...._.
----_...._-----"'_.~_...~..-_.~_.._...--
- .--_.~.._,._. -.,- .....~.;...~. ._---~....;~._~...-. ....,--_..~.."..~._......_~_.,. ---~
'_............__.____....._.~._._.n._____.__. '__~""_ .,..
"
..._.~_......_.......__....__~_,._O<__.... .
.. ., ...... ,J~., ...._....~..._..__..
I do horehy eortlfy that the Clhove opprnlsol1lol1t Is l1\l1do In con(ormlty with Ponnsylvonlo low and hoahoon IIled thl.
day with Ih" Roglstor of Wills, '
(' 'J , J) ,
..:..---..,---........&:LA..J..i-/'tUI!.It.d.t.a_.:_ t!!!OllJ 1981
AI1f1nAlUldl OATI! I
TOTAL. VALUE
I'
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1.t'I!:.Q1lMAI1.Q.~
To Insuro propor oro\\I\ 10 vour 1I000unl,lhll 11011111 of Iho 0811111I IInd fllo numbllr ehould bo olollrlyprlnl.
od on \1'0 oliook or monoy ardor,
Thlo ononmont Ie modo III oooordlllloo wllh Ooollun 100 of 11'0 IIIhorllonoo IInd Esllllo ro~ Aol 01
1961 (12 p,e, 6 2400.1001,
To 1110 lI~tont \hol InhorllnnoD IQ~ Ie pold wllhln (hllll. 13) Inollllle 011 Dr IhD doolh of Iho dooodonl, 0
, dleDOUnl 01 flvo (81 poroonlle ollowod 172 1',0, 6,2400.1101,
IlIhodlonDO Tox, olhor lI10n tll~ all o'll!IIJro IlIloruel, '0 duo 1111110 dOlO (lllho dooollonl'n (jeml\ on,f hooomos
del(nquonl 01 11'0 oxplrolloll 01 nino 19) monlho oil.., Iho doool/onl'o ,(IIIIlIh 172 ,r,S, !i,2480.7111, Inhorlll\noo
Tn on 0 IUllIIO Intorosl 10 pOYllblo wllllln Ihroo 13) mOlltho ollor 1110 II 11110 lor loko. ullool In pusoonlon and
enJovmonl end Is dollnquenl lI,oroollor 172 P,8, 5 2480.7121, Ooloullllo II1Ioronl from Iho dollnquon1dolo ehown
on Iho'looo of Ihlo fortn 10 Iho <1010 01 001\101 pllymon,luSlnO Iho lollowlno Inlo!or,lllIhlu;
""..._____.._.......... ..._~_......._..... __..... .....__... ..._...... ...__ _ _...__..._ -....._... H" _ _....._ __ __ ..,.. ___.... __ _ _.................... __
1 monlh ,000 4 monlhe .D20 7 I1lrHlI!1B ,030 10 monlhe ,080
2 monlhe .010 o monlho ,026 fI munll\o ,040 11 mrmlho ' ,085
" 3 montho ,016 o months ,030 o rnunll1n ,040 1 2 monlll. ,060
-- -~
1 dove ,00017 11 dnvs ,00185 2 t' d.ve ,00382
2 dove ,00034 12 doye ,00203 22 dnye ,00369
3 dRye ,00051 13 davo ,00220 23 dav. ,00386
4 dRye ,00066 14 dove ,0023'/ 24 dove , 0040~
6 dRYS ,00086 10 doy. ,00260 26, dovo, ,00420
o dRye ,00101. 16 dove ,00207 26 dRVo ,00437
7 doye ;0011~ 17 dovn ,00204 27 dove ,00454
o doye ,00136 10 dove ,00301 20 dove ,00471
8 devs ,00162 19 <lavo ,00318 20 day. ,00400'
10 dnve ,00160 20 days ,00330 30 dnys ,00600 ,
.._ ___ ______ ..._______.. - __.......... _................. - ..... _... - ....__ ........!"'" ..........~____ - .....'-0 _ ......_____.. _..........
Anv pollV In Inlor.el, Inoludlng Iho CommlJllWOllllh IInd 1110 por.onnl roprnsonlollvo, not enllollo<l wllh
Iho 088088mOnl' may obJOOI thorolu wllhln, elKly 1001 doyo nllo! rncolPI of Ihle Nulloo .e provldod by 8001l0n
1001 ollho Inhorllonoo.n<l ~etol"Tn~ Aol 011001112 P,9, ti 2480'100\},
Make Ollook or mohoy ordor paynblo to:
"Rnglstor of Wills, Agonl"
Moll 10 Iho addross IIstud below:
II!:V,,'Db FXt p.hO) ,
COMMONWUA~TH Of fftNN8VLVANIA
DUPAI\TM8NT Op.I\UVRNUR
TI\AN8PUI\ INHUI\ITANOU TAX
I\U8IP8NT PUCUDUNT
SOHEDULE "F"
BTATEMBNT OP Dl!BTB
AND DEDUCTIONB
..
...
Eslate of __~~QE.h~.!LIL..J1.Q.lltzo.F._---~ Dale of D08Ih.-U.PI 8~ ~Flle No," 210810155
WHEN Ol-AIMING THE FAM'iL V eXEMPTION, OOMPLETE THE FClLLOWING,
..~-
.~"",'l'
- *
nillllllol\shlp \0 PlH:(I(j(l111
Clnlll1lllll
- . .- -~- I
I~~~ PATE --, NAM8.Pf PAvee R8MAI1K8 ' AMOUNT
- .'
Plaza Ants. Inc. I Anartment ,.Ani' (MA1"l'h\ ' ?Rq nn
-- n",dAt-er of wn1a ,->:1\ nn
, 1"ett~r8 ,'Tes t""..,,, ,-".."
Holy Spirit Hospital Emergency Hospital Service ..,- 100,00
PP&L Electric bill . 1 A Q'!
B T """mnauy ,T'\",t-t- nf decad,\ID.t. ." R ' 11
Harrisburg Dairy Debt of decedent Q, qf\
-
Janney, Montgonery, Soott StotlK tran~fers ?OM
,Fa, Dept, of Revenue Personal income tax , 5,8,98
,
Interna~ RevenueServiee, 11QAn :'~nn~'" "n~ , AQnn
, Mise, funeral expenses and )Jm.g.\:U;! on "'Io~ 1 ~
;.
~;l:!- Truc\~ 00, TrucK rental 0 moving household 117,84
~llelt RiQhardson Funeral Hot e Funeral expenses 2,798,33
Arnold Slilw fy, Ba\1lev I Att'01"nA\lR , fees , 1-:7Q~ nn
T.
, . Paul J, currv Executor's fee's 1.795,00
, '.
, Register of Wills Additional ,
short certifioates '" 5.00
..-'
.. Register of Wills Filing fees 9.00
, HarriS SaviMS Assooiation outstanding 16an balanoe O/A ,
.., 1-09-111079 2 _ 41\0;. qR
. " .
I Maronetta Millar witness feel 20. On
..
" Jeffrey R. Boswell WitnesS fee 20.00
,.,'
-, -;-
. ,
. ,
~ TOTA~T
, ' 1 n ,007. 2'!L
Cllllmul\\'f) AddrtlSIi ilt limo of Dur;udont'tl pntltll
I,horoby certifY thot 10 thobost,ol my knowledge nnd bellof Ihe ioreg,91ngls a just ond ,true st~tement,ofdebts, funeral
expenses and expenso,s 01 admlnlslrallonsublnllted 10 the eslate as dOJ:lu lions for In orllance Tax purposes.
..; S~,3 iI'l
OA
L
e
DEBTS AND DEDuctIONS ARE AL~OWEO IN THE sUM or-$, ;It)) /J/) 1. d<./r AT
/,;j--
% TAX AATE
;j ,,3-:';>'1
OATU
Q.ENE~AL INHERIT ANCE T AX INFORMATION
Unlatllflod IlabllltlOllrlcurrod by the docedent prior to hla/hor doath aro doductlblo agolnsl hls/hor taxablo
OItate, In addition 10 dobt,s Incurrod by tho.decedent or ntate, ather Ito01S are claimable Including the COlt of
admlnlatratlon, attomey feos, fiduciary feu, funeral and burial expensOl Including tho cost of a burial lot, tombstone
or gravo marker and otheuelated burial expenlOI,
"
All dobts belng'~lalmed against an ostate are lublect to tho approval of the Reglltor ,of Wills wl,th whom tho
Inheritance Tax Retarn 'I filed, Evldence.tnlupport tho decodent'a or tho estate's Ilablllty'for tho debts being
claimed shouldbo attaohedto thl uchedule." '
A family exemption may be claimed by aspoun ora decedent who died domiciled In Ponnsylvanla,H thore Is,
no spouso, or If tholpouso has (or/olted hll/hor tights, ,hen any child of the decedent who II a member ohhe same
hoasehold oan 010101 the,.OKomptlon. In the evont there Is no such .pouse or child, the exlttnptlan can be ,clalm,ed by
a parent or parent. whoQre hHlmher. of,thname household 01 the decedent, The family exemption I. allowable only
agaln.t a,.uts which pan by a will or by the Pennsylvania Intestate Laws, '
NOTEI Compen~atlon paid to an estate reprosentatlve/ namely, an eKOcutor or administrator, ,lor servloOl
performed.!n admlnllterlng.an astate Is reportable for P,ennaylvanla Income Tax purposea. Thla'taxable Income
Itom Ihouldbe reported on form PA.40.lndlvldliallncome Tax Return.
~ ~ ~ 8 ~ ~ ~ ~ ~ ~
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en
INSTRUCTIONS FOR COMPLE'l:!NG SCMEDULE "E"
1, If the family oxemptlon labolng clalmod, Indicate tho clalmant'a name, addrelS and hl./her relationship to
the decedent, Enter "Iamlly ,exemption" In the remarks column and the amount claimed In the amount column.
2, Aaslgri consecutive numbers to oach Itom listed,
3. Enler th,~ da'o on which each debt was Incurrfld and/or paid.
4. Enter the nOmOS of oac~ payeo.
5, Provldo a brief explanation In the remarks oolumn for eachdobt claimed.
6,' Enter the amount 01 each debt bolng claimed, ' " '
7. The lornl muat be .Ignod by the person who has alSumed tho rosponslblllty for paying the debts.
IF ADDITIONAL SP,ACE IS NECESSARY USE aw' x 11" SHEETS.