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HomeMy WebLinkAbout81-00272 'I; ;,t~~::~,:,'i~ i:!\\.!: ,', " ';l~I'\/:; "'.fl_!' i[I/,-- ,i~ iij/1fP~J/.'!i,'~ \,({t~!\:' ~ ; ;~"; Ii ! J,I ,,-~ flit' " !/;'f~1 WH~' tt.'.r , " frrj,;', v~ ',',, -I'! !I,\~I, .' : I ~_ { ," , , ~ -- ,-, )/;/;":, ,~':',~ ',\" li- ~tH-,_:_I,- - ~i~;.'J.'_ !' ~"1,\ ' {:f~:;\ ;-{-~- /, " i, I' , 'I ii ;, " ".j ,,' ,-' I " " " " "" " , I,,, " ;J' " ",I " " 1/, " " ,', j'- IIi " " I' if_, ," " -I," , " " t 1',/ " " II ,', '" 'i ,,., ~.' ,,' ",. ,/, , ..... 92 ..-' (\I' I." I j Ii " ,"~I '10 ,," :", ", I' "" " " " )," ,," " ti " " , ! I , !, . ,~ A I III I & " ~" ,', " J '~ , " ", " " ,,' " " " " " " , " " " '" " " ~, ,. " '" " " " " I, ;' 1-" ,'~ ,", " " /'" " " ',.1 , " '--Ii' , , "~I' ~t>J /, -_,_",,'"J ;'t: )'f'f"j r.!i!~~ "l!- --,",'-1J;, -,:;" ,-- -~':L,~':'~" ~:f;~'~ ", ",i "l I' ,11 J', j , j( ',. '1 I, ,\' '~, 'j(.~~" r;;r ,I' I, I~''-'J),'' w " ' ';j't ,':f,t'H~, " . 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'J I - _- HIt! ,I, ~d~~j~j ;0,",., ,1/.' ;/<' ~'1; t=.~' nE~ATIONaIHP aUnVIVEP AOE Of ~I" TO OEoaoEN'f IlEOaOENT TBNANTa OR , aTATe YES ANNUITANTS on NO AT DeATH Of , OBOBIlBN ---------~-_........- _......._..--....._~ ........------------ f\(l llT'Ounto (1fj t;1I 1:0 , _-"---..____~.....~~~......_.._.,...._u..._._+'...~...~.,~_.__~._.__ ,~.-,-~--....---.--. ----....<~---"""- --.....-"- BBNBFICIARIBS -;- ~ INTBR&aT~OP aBNBflOIMV IN &aT An BENBflOIAnIBa AND ADonBaSBB IS"'" full n.ml..nd llid,..." of oil whll hlYO In IIi"'"1 ihhor Y"t.,I, ~onllnUln' e1' alhor Inl!'"11 -- __..._~-~..r--+--'----'~'---~"---'--'------'7'-""""" __._.~.n'..,..r---"_""'_""- ~...__.....--- _--:-.......---"..~_~~.____~....,...--<_...~-+~._.~_.........._. -'1~_~-.._TT"""'.~~..---- --.-- .--- .u_~_~_~,...__~--------+__~__....____~_ -,-~,-;~''-'-~';~ ----~.-----.... ----- ....;--...___*___->+_..,.~__... ~_._...._,___._..m~_______.~m._____.._ .----.....-~--.----.....- .--------------- _-~..-..~-------~--,...~,',..-r-----.'-----'-'...-...~---... ~ _.-.--...~_..._~--_.,-----,.,.~-- ------------------.~, ~--------.- ....--- ._~_.................-......- -------...~.....,...- -- ______...-----__~,..,~....~m..._~..___~.. ..~-----_._~...- ~.........-- .. "i. 8 c: ~ 0 ~ ~ ~ ! z f,:\ ~ ~ c II: ,. m 'II, 'II' I'" :Jl z' 'II, 'II, ~ ;;I ~ 'II> 0 0 'T1 'T1 :J 6 '. Ii , " \,l. ~. I ':\1' rO"!;..__ ~, II i: H,:' ,'.\,' ,,''', 0' r.> . f~.-; ~ ~ ~ ~b' N i-'" ,.~. B' if;~ 0" "" ~~~~ :Jl i .~~ t'lf:j ~ F ' l<iw ,:.J ., INPORMATION , PLAce FOR PI LING <oi Tho rohlrn 1010 bo iliad In dupllcolo Wllh \110 F1oulOlor of Wills of tho county whoroln Iho do codon I roslded. . ," ' TIM!! FOR FILING _ Tho rotutlll. duo nino monlhs oflor ths (Iooodonts cloolh,unloss IIn o~lonslon for f11lnu has buen applied for end granlod by Iho Baoroll"Y of Rovonuo within 1110 nlno.month porlod, . PAH.URE TO FI LE RETURN ,_ Bootlon ,791 of 11111 ,1901 Stotulo provldos thaI ", , ,any parson who willfully falls 10 fIIo, 0 ruturn or othor rOllo't rOljul'od of him, . , OllUII 1>0 porsol1l1l1y Iloblo , , , 10 n ponolty of 26% of Iho tox ulllmotolv found to bo duo or $1 ,000 wlllohovor In tho lunsor lo.ho rOGovorod by tho Doporl,mol1t of Rovol1liO liB doblS of IIko omount ora rooovoroblo bV loW," , INHERITANCE TAX SUMMARY SHEET A.V.~.f<<Xt ''''01 (!?UREAU USE ONJ.. Yl PII. Numb.r "_..:.c.~~~:l!k:QF-'ZL~_~.mm_'_m_.~_u Eltal. Nam~ ~~-A....Kini-__u_n'_'_~'~'7~_u-'-_,_ Oat. of D.ath' Ootgll!L1!1.J,.J,.2.~____..__" Soalal S.curlty Numb.r _--.!i7.9::~-Q99.1 __,"_ iii Original o Suppl.me~tal o Remainder ,- REPORT OPINHERITANCE TAX APPRAISER 'I, the und.rllun.d duly appolnied, Inherltanc. Tcix Apprclw In and ,for the County of ,0' e ' , . P.nnlylvanla, do r-Ip.ctfully r.port that Ihev. appral..d the r.al and p.nopal ptop.rty a,l r~or' ,n t . or.uo n~ r.tum at the valu.. ..t forth oppollt. .ach It"" I,n th.lolt oolumn to th., rruht In 50h.dul.. "A', "B", "C", and I ,.~II Pot.d., \lI" llT 1 . T 9R1 .-'..i//~.~ I~J J ~~.A tJJt/J .J INHBAIT~NC. T~X'~PPR~".A IHVIHTORY V~LUI AI APPRAISlD coDe ADJUSTMeNT. (HARRIIBUROUU OHLY) ReMAIHDIR APPRAISeMIHT COOl Rlol Proparty (Soh.dijl. A) . P"'onol Prop.rty (lah.Jijl. II) , JolnloH.ld pr~p.rIY (Sah.dijl. I) Trontl... (Soh.dijl. C) TOT ALOROn ASSeTS 00+ 10+ rtJ+ 10+ . __.._.",_,,_~_.!L.J.!l'-llm. .___~ ____ L...O.bll and O.dij.t1on. (SCHIOU~lp) CLIAR VALUe 01' ISTATI o I.lf. eitat. o Annuity 40. u. " W1l pACTOR PRIHCIPLIl VALUI ,. , COOl - J POR un 01' RBOISTER ONLY Tox on $ Tox on $ Tox on $ iox on $ . COMPUTATIOH 01' TAl< $- $ . $ . . 6% IS." Tax 0;'$ __' Bx.mptlon. Tolal Itlolo TOTAl. TAX INTIlRIlST PROM llALAMCE TO $ . $ $ L.u, C"dlll oATH 01' PAYMEMT', AMOUHT PAID DISCOUMT $ + $ ... IMTlRUT . . . $ $ . t, IMTHRilST PROM BALAMCE DUE SALAHCIl TO " , " --~,.-.. " l ,; M $i, ,~ "~ 011 " '0 !, w, j' \ I" , ,YA', '';:I , ;;- :t R it l' 0 u_; '"' ~ 6 \>< 0 ~' .;t. ~l ~ ~ ,~ ~ \ ~' i ~, '& ~ m ~. 8' \101, "' ~ .' '"' -~~~- ~ " ..-,_.....- " i;' , Ii ;i; , I iii H' III V,;HHj 1)( I 13.1101 COMMONWPAL TH ,OF FPNNPVWANIA I)PPAlITMPNT OF IIPVPNUP TlIANPFP" INHURITANCP TAX ' RPRloaNT PPCUPPN'f SCHebUl-a "F" 8TATSMENT OF oeBn AND DGDUCTIONs --- ~.~_. ~.~ - - .-- 'NiliUI- ,.._1_....'" 1 r ..-- Balnloa! m_bm__,JJ!1}:l..1h. 10llg Dnlo of DOPlh_1 011 nino _ Flip No. ,11./;/1:.., ?Z~~H. WHEN CLAIMING T.tlE FAMILY EXEMPTION, COMPLETE THE POLl-OWING I CIIIIIl\i1111 ' I:lnllltlQ lit. lCL Ilr: l1olllll""9I1il> 10 Oll(;OrllIl1l _ 1nl/,111llH.t CIIIllIllllil" Add"","t 111[10 IIf ()lIcodol1l'~ Oootl1, H. D. :':, Dox: n70, ~Cll'lJfll(), PA 1 7013 - -..- . IN~~ OAn NAMa OF FA va 0 R~MARK8 , AMOUNT -. 110 fflltn 11 ~ nnth 2673,05 - ~ ,-. , Gt'lIVc;! },jurkcl' , 320.00 Curlislo llnElJlltlll " ' ,054.04 - , Dl'. Krdtzilll!. lImbulntlco. lllc1101oflV, no 1 VC!dOl'{! Mccl10n 1 - , Oelltor 220.02 lOllS lllAI I'll nor,! l'rdmlJurrlClIIC'llt 130.50 ,-- f-- 00. '12 -- j:-:-.--- , , , Anmuf111 II K 1.!JlL: flllllilv (l' 01111' t;1 011 :.lOOO . 00 (lpn.'"" n.' Fnllol' ~ lltj: 01'11 C Iv 'reo , 150.00 'Be< 1:imo tnd ndc1J.t.LcJnnl oxnor SCB 50.00 - , , - , ,I; "... , - , , , --. " , - , ' , , " - " , - - - - __I , , , , - .. i; .. , , , , " " " , ~ " , -~ ----. ". .,. , ' - , " , , -- TOTALI . ~,__U~ 5DSO.41 , ~H'_ I hereby certify that to tho best of my kl19Wlodgo and b~lIof tho, forogolng Is a Just and truo sla,o!T'ont of dobts" hlnoral oxpensol and exponsos of adm,lnlstratlon submlttod,o the ,estn.lo .~s doductlons for.lnharlt~~c~ Tax purpo,sos. .', 1,)' J . 4~'1q/~'/_ _ A I'm to' It I UCIAIP{ . . ATE . , OFFICIAL USE 0 L 1-,'1.;1 $", i/ / ' ,AT DEllTS AND DEDUCTIONS ARe ALLowed IN THE SUM Oft $ 6 , % TAX RAn 3--';:?1-.?1 ()ATl!. ~L IN~ERITANCE TAX INFORMATION Unlatllliedllabllltlulncurred by tho docodont prior to hll/hor dotlth oro doductlbloagalnlt hll/hor ta~ablo ..tate. In addition to debtllncurrod by tho decedont or ostato, olher IIams lira clalmablo Including the COlt of' admlnlltratlonlattor~,y le"l; liduclary feOl, lunaral and burial a~penlOS Il1cludlng Iho coat of a burial lot, tombltone or grave marker and o,ther rolated burial .xponsOl. All debtl being claimed 'against an IItate are sublect to the approval 01 the Rogllter of Willi with wham Ihe Inheritance Ta~ Return II flied. Evidence >to lupport,lho decedont's or tho OIloto's liability lor tho debtl bolng claimed Ihould be attached to thlslchedule, ' A family e~emptlo~ may be clalmod'by 0 IpOUIO ofa decedont who dlod domiciled In Ponnlylvanla. Illhero Is no spouse, at If the spOUIO has forfelt.d hll/hor rlghtl, then anY child 01 tho decodent who 1&,0 member 01 tho Same household can claim tho e~emptlon. In the ovent thoro Is no such spoule or child, thoeKlIf11ptlon can beclahned by a parent or parenti who are memberl 01 the lomo houloh'cild as tho docedont, Tho lamlly o~omptlon II allawabl,e only agal,nst auotl which pan by a will or ~y tho Ponnsylvanla Inlostato ,",aws, NOTEI Compensation paid to on oatalo repro~ontdtlvoll1Umoly, an o~oculor ar admlnlltrator, for sorvlcOl ' porformed In admlnlatorlng an ei'tate II reportabl. forPenl1sylvanla Income Tax purpose." This taxable II,CO/1\O Itom should be roported on form PA.4p.lndlvldual Income Tax Roturn, , ' I' ~ "0 ~' 8 g ~ i ~ ~ ~ ~ ~ z m @ , Z ~ P c5 , z ~ 0 P 'T1 " .'1 Ii; , '<I' :,;;L.( ~ " .. I,:.n l, 0 C} .'. ~:~ 0, v\4~-, .W t', ~j,r \.;'~ 1.1; ('.1,-' 0' .~'" , N ,~~ C:I;.'" hJf.~j , ~-t:_l ~f: <~a) u ." m~ Il'!Il'! ~ ~ ~ cl \ INSTRUCTIONS FOR COMPLETING SCijEDULE"F" 'I.! If the lamlly oxemptl~n Isbelng claimed, Indicate tho claimant's namo; addres, and hls/har rolatlonshlpto , the docedent, Ente,r "Iamlly exemption" In the romarks column and tho amount ulalmed In the amount column, 2. Aul gn conlOcotl ve numbors to each Item l1ated, ' 3. Enter the do to ,an which oaeh dobt was IncU,rrod and/or paid. 4. Enter tho naf1ies 01 each payoo. S. Pravldo a brlo\ e~plonatlanln tho,romarka catumn loroach debt clalmod. 6. Enter tho amounlo,f each dobl being claimed. 7. Tho form must be slgnod by the person who has auumeqtho,rosponslbllllY lor Roylng Iho dobts. IF ADDITIONAl. SPACE IS NECeSSARY USE aW' x 11" SHEETS,