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HomeMy WebLinkAbout81-00453 . . , ~ ... OATil (W SIJJlSCIUIIINli WJ'J'NI~SS COMMONWIlAI.,TH 9FPUNNSnYANIA I, SSi (;'OUNTY OF C\JMllnI\I,ANl) This 21st. ..dllY (lL__~llly_._...~_~.. A.O.iI981, bel'ufe l1\e, Re81ster for Ihe Probl\tQol' Wills al111 8tllnlln81ellel'S or Admlnlsll'lIll11n In IInd 1'01' slI\d County 01' Cumberland, hI tho CUn\ll1Ullwellltb ul' Pel1l1sylvllnl!l, pel'sul1l1lly CIIIl\C~.. ._~~._- Ad~ S. Perry and William.L. Sunday thc' subsorlbll\8 wltl1esses to thc l'oreguh181nslrumcIII of wrltl1i8 purpol'IIn8 10 be the IlIsI Wlllllnd TcstumelH pf Margar~t L. Smith February 11, 1980 IJllled .._ __. . .., , IlIleol'_ Rn,.n11gl1 nf'. Carli ..1 a, __cumbel'llInd Cuunty Pa., decellsed who belnll duly .l'1worn ,aceurdln8 to Iilw, depusellnd Slly, thlll. they ware ; presenl, and SIIW IIndbellrd the Icslnrix. Marll;aret L, Smith , sl8n, sel\I, publish, prunounce lInd declllre tho sllld Instrument or wrltln8asllnd for It1L-Testall\enl und l.,aslWIII, IInd IIllho Ilmc o(so doln8__ she was ul' suund and disposing mind memury and \Indorslandlng,to Ihe besl of their, and each of their, knowledge, ubsQrvatlol\ IInd belief. Swor.n to .lInd subscrlb.ed before .~,,:'J2;: 0(~.rJ..~&J Reglsler A.'FmAVIT m' m:ATlI ~~~:T~~:!;~:~::~:~:NSYI.YANIA I ss: _.......- 'F"A~k R, RAAAhn~ being duly ~...::ID'Iorn. says thlll liS ncarly as clln be IIsccrlub1Q<I,the sllld decedenl Margaret L, Smith, .'rue.llday j Ihe 30th day of , 11\ PI' aboul 4130 u'clock, ~M. Sworn to IInd subscribed Ihls " 21st dllY 01' July, June, dIed on A,D"I9!!l , .--.J .7 . ) ~(.~.vJ' ~"'/ i1r I-. /bri#.L' . fL<- . ,,81 I 1>. qJft; (1rf~~ Reglstcr 151 ",y""""., 1'1:'1 _ INHliRITANCE TAX RI\TURN . <OMM.a~~t.~!1 ~WI\'l,r,\~'N" , RE8IDPN"T,!'ECliDENT Illil r ~t~iiJA _ File Numbar ~l' 'ii' \ - {) 1.\5 ~ """ ui, "'01 1/ - ,;) J..."l - \,"'1 _. - -~ O~~ Nama (LIII, Flnl, Ind Middle Inllllll Oaoodonl'l Addr.." . ~ \.- .-ffi .Ir \.. 1= "" I<. \\\. ' \-toMl. DPCEASED aOj,II18aou~lvNI;;nbor C;U~~Bth' Q CH"tt,-\- \:1.p l\ \..,~~~"'% _--- ~(;)\~.!..J.~" '& ~._.,-J..ck:.oIL:.'~L_.._, O,x" ~~~~-L- , CHECK 1. Orlgillll ROlurn[g] 2. SUPlllomeOlPl Returo 0 a. Remllnder RetUrll 0 APPRO, PRIATE 4. Llle EllllO [l 6. Fodoral EIlete Tak D ROluro Raqulred. BLOCKS 0, Dacadanl died 10llelo l'Vl 1. Qooodanl molntaloed 0 living 0' 8. Talal Numhor of lafu D (Amch oopy of WIIILW-._____ ' .tnlll (AlIPch eepy of IruII) dOp0111 boxollnvantorlod All corrllpendance Bnd oonfldantlal tak Informallen ,lhoulll ba dlrootad 10i ~~~::eNT Nama\>,), ~ ~ \., ~~^.~ ~~' ~^-"'~ TelephoneNu. ~' "I _ h:l.~IoUf~ PA \"QS~ :ll,QID- g,.H~ __.._.. _.. 'n ~y Stlls. _ Zip RBoapllullllon I. R'IIEltale (Schedule A) 2, Slooka end Pondl (80hudulo 8) 3. Cloluly Hold Sloek/Parlnunhlp Inlolol,l ISohedule CI 4. MonOIDII and NetOl (Schadule 01 6. Calh & MlloellanaouI Ponenal proparty (Scholl'ulo Ii) S. ' Jolnlly Owned Proporty (Sohadula FI 1, Tiaollm (Schadulo 0) S. Total Droll Allel. ltetal IIn" 1.1f 9. Funaral Expen... Admlnlltrsllva Com/Mlleallaneolll Ekpanlel ISchedula HI 10. Oabll/Morlt/ugal/Llenl Isohadllle II \1, TOISI Oaductlon. hOlBlllnal9& 10) \2, Nel Valllo 01 Ellelo Wne B mlnulllne \1) 13. Cherlteblo geqllaill (8ohedulo JI 14, Net Velllo IIlbleellO lek Wne12 mlnullln, 13) REOAPIT. ULATION (1) I 2) ( 3) I 41 ( 6)~~d,4~ I SI ~lA.H...i; (1)__" (8) ~J.\~ I, ~~ AND TAX 191_____ (fO) 111l~, ;).~',"ij'\ (12) ., "i ~ ,,+'21 (13) (14) .Jit~~ ~ CALOU, LATION CompullUon 01 Tak 16. Amount of IIne,14 taklble at ,6% rels (loolllde vlluOI from Sohedulo K) 18. Amount of IIno 14 lIkable al 16% rato (Include YIIUol Item Schedule K) 11. Prlnoll\l\ tex due (Idd tUk frem line 10 plulm from IInu 10) 18, TetelPrlor peymonl" (e) Amounl Paid (hI. PllIIOllcounl (0) Mlnulllllerell ~_. 1e. Bollnee Duelllne 11mlnulllno lB) Meko Check PlYlble 10:' Rogllter of Will., Allenl .. · PLEASE RECHe~K MATH · · · (16) (16) _~~t..6...~~3 k.OB" k,IO- ~.~~ , . ~ 11i9..:1 ~ l\71 lIB) lIef --. ------.. Undor ps"elllol 01 perlury, I doclore Ihall hevu okemlnod Ihll relurl" Inoludlng eocempenylng Ichedlll,lIand Itatemenll, Ind to Ihe bOlt of my knowledge end bellof, IIII tt\le,c Ct, endcompleto, DeolarMlen ef prepersr uthor Ihln th~ porloMI reprelonllllve II b8lOd on elll!1fermallon of whloh,prepmr h" Iny knowl8doe, 4//,.!J / 'l~ AfIVE(~I'~ AODRE~~ 1 """"lOATH __.~~_UT<",.__~~__-,-,--~~~_~~______~_'~'.H..___ StONA TUR E op'PRE'PARlii1C1TH ERmAN 'R E OR e~ e-N"fA':lv"1i \ I \ \ I \ \ "\ " Ii " t' (':'1-,' '.",1 c:,l ,~,:-; 5''> 1;,1,,) DI'" ... .. ". e. ...... ..... '",d 1,1. I (_"1!r.; '(JI,1i -;F- ~~: t~J~n .-),'\ 1, 8. '"" p:! I I 1 I i , I I , I I ,<I \,1'4(01,' q \t'"^')) COMMONWEA~ TH or PENNSV~VANI" DEPARTMENT Of REveNue TRANSFBR INHBRITANce TAX RESIOBNTOEceOSN T SOHEDULE I/BI/ peRBONA~ PROPERTY (llIs/ruor/ll!18 Oil Revwso SIr/D) " Estato of , Ma~garet L, Smith ITBM NO, DeSCRIPTION v~~J e 1, Cash on possession 2. Refund .. "Over Pflyment of insurance diff erence received from Harrisbu g Hospital 3. Refurtd .. P~eabyterian Homes ._ Inc. Medicare Payment .. Belvedere Midica1 Cor . 5, LaPlell diamond engagement ring Valued at appraisal.. copy attached LadY,' s'watdh .. Valued at appraisal .. cop attached CostUme jewelry.. Valued at appraisal copy attached 6, 7, TOTAL Iladdltlc>nallpace Is necessary, use 8%" x ll"sheuts, UIIMATeD M RKBT VALue $ 442.00 24. t.O 29,00 120,00 35,.00 10.00 2.00 662.40 , DePARTMBNT VALUATION IOfFIOIAL USE OIVL yl " "e" . . , . Sohedule "Ii" mUlt Inoludo all proporly, 1'001 nnr1llnrhlll1nl. llWl1urllw tho dOllotlol1llolnlly with IIl10tl1el' perty' or Pertlelellalnt lononll with rlllhl oCBurvlvor,hlll. aoth Inl1l1lhlo omlllllnl1lllblo pruperty ore to be Inoluded, I.I't real ellete, flrB\. ,., 1, Delorlbe ell reel rroporty 01 Imllooled h, tho Il1lt1UOllonl lor Sohadlllo "A", D080rlbo 1111 porlonal propel'ty allndlllated 1111ho InWlIotlonR lor SohO<l\llo "B", ,Inoludo (ho nil 1110 , ocklrosB 011<1 rlllollonRhlp to th,e ,decedent of tho co'ownor (II nnd Iho doto Ihn Il1lnl oWl1orRhl1l woe oBtobllehocl, , 2, Indloate the tCltalmerkol vnlllu oftho IQII1\ly ownod proporly, 3. Indloete tho IlorOont~llo of Iho doom!lIllI',lnlprosl. 4; Indloalo,IM mllrkut valllu nf Iho lIuQutlonl', li,lOI'D.\. - ",_-'E"~"-,"'~~~'~'_"~"" ,---~"~.,',"~,~-~-= -~------.--~._~~.--.---'- _._-"",,,..--~_.--~~"-- !::.: ru ~ 8 l; ITI Z ~ ;!J tTl (j t:l r. r,; ... B ~ ~ ;;i P IJ> . Vl 0 ~ 0 .." .." ~_. , t- I ~ tJ t:.. ~ '" ~ Ld ~ ~Ii If; j;;" n:~, ,"j,i I~ , Po I."'i !::'~: f(J l~id ,._J ~ [,,'I I g. __~,_~"~_'_~Ho_"""""'- :I: ~ z !l d ~ P ~ . ~ N ~ 00 t-' S ~ z w ~ ~ ~ 00 t-' .-. ~ ,,~ (:i [(l o S WIBALJ~HE61J'~I'1I~E XM INFQRMATIQ~ , , , Un..tllflod.llohllltlollnUurrod hy 11\0 uoaodonl prior 10 hll/hor deoth 01'0 doductlblo against hls/hor taKablfl,flstatd, Inndelltlon to tlobtllnourrOl,l by tho duoodonl 01' oIIMO, olhurltlll11l ora olalmablo Inllludlng Iho 00$1 of administration, altorl1llY (oo~, f1dUllhu-y (001, hlllOrul Gild burial oKPon8ollnaludlng Iho OOlt of a burlallQt, tombstohe or gravo m,arker, All debtl bel nO IllolmlKf Doolnlt on 011010 Q,ro lubJoot 10 Iho approval of the Register of Wille with whom tho ' Inhorllan"o TOK Rolul'lllllllrld, I!vldul1oo It) lupport tho daoodonl'l 01' thoellote's liability for the debts being olalmed .1I0uld be etteohotllo thll IIlhodulu, A (.mlly Oll.Oll1lltlon of $2,Qoo I11DY bo olallned by 0 spOUle of e deoedent who dlod domlollod In PenneylVanla, If there 11110 IpOUIO, or If tho lllOUIO hal (or(oltod his/her rlghtl, then any olll1d of the decedent who II a member of the ,"'ne huulohold oDn 010/111 tho OKOI11I)\lol1, In tho' ovonllhoro II no suoh IPOUIIe or ohlld, tho eKemptlon osn be olalmed by. paront nr porenll who uta mOlnbors of the Ilomo household 08 Ihe deaedont, ~ ~ ~ 8 ~ ~ i ~ ~ ~ ,~ ~ ~ ~ l;j . z p p I ~ ~ III ~ N t-' ~ I ~ 00 ! t-' t".- I Z ,p. ~ {' U1 " ~ W t-' ~ " l':ii "Ij ~ \,,1 . P. ~ qf ~: ;<d~; ~ .. If;; ;:~}~ .~t'l ~I" ~ ~ ~ f-Il hI,,,,) _..1" W t-' \0 00 t-' ~TRUOJ'ION8 FOR COMPLI!TING SCHEDULE "E:: I, If. the family eKomptlon Is bolng olslmed, Indlooto the olalmant's namo, llddrase and his/her tslatlonshlp to the daofldent, Enler "family eKemptlon" In ths remarks oolumn and the amount ololmed In the amou,nt oolumn, 2, AIIlgn oon.eoutlve numbers to eaoh Itel11l1ated, 3, antertho dale on whloh each debt was Inourred and/or paid, 4, ' Enter ths,hamea of eaoh payo!!, , Il. Provldo ebrlef oxplahatlon In thorel11srks colUmn for each debt olalmed, G. Enter the smounl of eaoh debt being ololmed, 7, Tho forl11 mutt Ila signed by tho parson who haa a8lumad Ihe responllblllty for peylng thl! dabts. ~ ", ~ r..r" 'o~ i'" . ~ ;11~J \'. Il;~l .'" ,,',11 P ''', ;!I\ " (oJ , '0 ~:. " l.li INPORMA TION Thll doeum.nl I. the Nolie. r.qulred 10 b. ~IY.nund.r S.ollon 709 01 the Inh.rll.no' .nd ell.t. T.x Aol of 1961 (72 P,S, IICllon 24S6), If Ih. I'X I. plld wllhln Ihr.o (3) monlhl .flor Ih. d.o.d.nl'l d..th. . diloounl of 6% of Ih. I.x pild II .1I0w.d, Inherlt.ne. T.x b.oomll dgllnqu.nt nln. (9) monlh. .fler Ih. d.o.d.nl'l, dlllh, Inl.rlll II oh.~g'd .1 Ih. rll. of Ilx 161 p.rc.nt per .nnum on Ih. .mounl of unplld tlX. (See GXAMPle selOWI !, . eXAMPle: If. ballno. of IIX due 01 '2.000,00 II In . d.lI~qu.nl IlilUI 'rom 3-3-S0. .nd' pIym.nl Ii mid. 'on 6-23-BO, the Inlerlll Ii clloulll.d Ii Indloll.d b.low: ITlP , Determln. Ih. rll. of Inl""I from the I.bl. b.low. STlP 2 Mulliply Ih. blllno. 0' IIx dUI by Ih. roll of Inlereil, ITlP 3 Adcj the Inl,,"1 10 Ih. blllno. 01 IIX du.. Int.rlll Irom 3-03-BO 10 6-23-S0 Rllull. In: 2 Monlhl ., .0 I 0 20 D.YI . + .%03U RII. of, Inl.roll ~ . 1338 Slllno. 01 tlX due Rite of Int.r..' INTeRIlST '2,000,00 x .01336 . 26.70 elllno. 01 tlX due PTiii1h1""1 10 ~t f,' Piv~"nl It) .)( an Inler.,1 10 D.1e of Plym.nl '2.~9o,00 'Z6.lQ. '2,026.70 --------------------------------------------------------------------- , ' I monlh .OC6 4 monlhl ,020 7 monlhl .036 10 monthl .060 2 monlhl .010 6 'monlhl ,026 S monlhl .040 I I monlhl ' .065 3 monlh. .016 6 monlhl ,030 9 monlhl .048 I 2 monthl .060 I day .000\7 1 I dlYI .001S6 2 I d.YI .00362 2 dlYI .000~4 12 dlYI .00203 22 d.YI ' .00369 3 d.YI .000 l' 13d.YI .00220 23 d.YI .00396 4 diY' .000611 14 d.y. .00237 24 dlYI .00403 6 d.YI .000B6 16 d.YI ,00260 26 d.YI .00420 6 d'Yi .00101 16 dlYI .00267 26 d.YI .00437 7 d.YI ,001 IS 17 dlYt ,00294 27 d.YI .00464 6 dlYI .00136 IS dlYs ,00301 2 S d.Yi .00411 9 d.YI .00162 19 dlVl ,0031B 29 daYI .004BS 10 diYI .00169 20 dlYI .0033& , 30 d.Yi .00600 --------------------------~-------_._-----~----------~---------------- A~y Olrly In lnl.rell, Inoluding th. CommonwlIUh Ind the o"lon.1 reorellnIlIlY.. nol "".fl,,,d Wllh Ih. IPor'l..m.nl snd ......m.nlm.Y ool.cl within Ilxly 180) dlYs Ifl" reo.lol of Ihil Nolle. is proYldod by S.CIIOn 100 I 01 Ih. Inh,,".noo Ind estill TIX Aol 01 1961 In P.S,' lie. 24S5 - 1001). MAKI' CHICK OR MONey OROIR PAYABLe TOI "ReGISTeR or WILLI. AGeNT" DETACH THe 'fOP PORTION OP THIS FORM AND SUSMIT WITH YOUR PAYMeNT TO THE REQISTeR OF WillS POR THE COUNTY SHOWN ON THE REveRSE, see THE INHERITANce TAX INSTRUCTIONIlOOK FOR ADDRESS. . ' Illlv,uen fiX i IU'~II UUI1HAU UF eXAMINATION FINNIVLVANIA DDrAl1TMINT OF "eveNUe F.D, HUX 8321 HARflIUHURll. PA 11100 ' -. --.....,.- INHllRITANce TAX RIITURN RB81DBNT DBCIIDIINT -1..3 Pile Number n-a1 -4!P_ Oocedont'l Nllno (Lall. l'lrtl, Ind Middle InltllU DEOEA8EIl ...~...amith,....Ma.rga.r. t t" , , SoolllSeoUr1lv Numbol, Olle of DOIlb ~__._._. ___ 201"'1~:~J36 une 30, 1981 _ OHECK " Orl~lIel,Ra'uln D 2. Bupple",onlll RetUrn [iJ 4. Llle Elllle D 6, Pederll Elllte Tex 0 ' Return Required, BLOCK8 O. Dloldell\ died '11l11e W-' 7, Decedenl mllnlllnld I living 0 8. Number of 1111 dlPOIl1 r:1 (Attlch cepv of Willi " " Irult (Alleoh cnpv ef trultl ,boK81lnvlntorlld 1..lLJ or-- ,-- - , All oorrllPondencelnd oonfldln\lel tex lrilormolioa Ibuuld be dlrsolld tOI QORRE. 8PONDENT Neme t-..ACldl-~I,ell , William L,Sunday _~__ rolephone No. nn. 766.9622 Computation 01 TIK 16. ' Ameunl of 11111,14 teKebleat 6% rIte "(16) $ 0, (tllolude vlhl,I from Bohedule K) 16. ' Amount of IIno'14 Imble el U%rltl (18) 1023.00 (Include vllulI Irom SOhedule KI 17. Pllnolpel teK dUI (edd leK from Un. 16 olUI IlK from 110110) 10, TOtl1 Pllorpeymlnll; on supplementaJ. (elAmount Peld ' 157 . 34 (b)' PIUIOllootinl_ , (0) Mlnullnlorllt 3.89 (lB). 153.45 18, 'Olllnoe Oue (11M 17 mlnulllne 181 Meke Chook Plvsbl, 101 heglllsr of WillI, Agohl · · - PLEASE IIECHECK MATH- - - Vhdor ponelt111 of perJury. I dOelero Ihlll hevo m!1llnod Ihll rolurn, Including eccomplnvlng Ichedulollnd lIelimen\l,ond 10 Ihe hell of myknowl,dge Ind bollof, II II true, correo"l,lnd complolo, OeC,leratlOn of plepeler O,ther thin I,he penonlllep,te," ,ntlllve II bl, "d on elllnformellon of,whloh pltpertt h, Bl onv ledge" . 365 Loc1,lst Pq:l.nt ,Road " ' ~.1J.;>- Mach nics 1:'1}:, Pa,17055 'Aultust 3l.l982' SI NATURe l)F paR So A~ RePReseNTATIVS s ADDRess " " nATa APPRO, PRIATE RsCAPIT, ULATION AND TAX CALCU. LATION Dmdlnt'l Addreu For~$t Park Nursing Home Carlisle, Pa, 17013 3, Remllnder neturn 0 ~;or.~; .~~~ .i,. SI:te ~iO~~ . , ". ~U!....- ReCllpltulltlon 1. noel Ellale ISohedulo AI 2, Sloekl end BondI (Schedule B) 3, DlutelV Held Stook/PartnGrehlp Interelt (SOhedule C) 4, Mortgagel end NotellSchedulo 0) 5. Cnlh&MllcollOnGeul petlenel Pr~pertv (Schedule EI 0, Julntly Ownod Proporlv (Schedule P) 7, Trenlfere (Schodulo 0) 0; 'Tetel DrOll Allo\8 hotel IInBl 1-7) 0, ,Funeral EKpenlel Admlnll\tltlve COltl/MllcelleneoUI E~polllll(Sohldulo HI to. OebU/Mol'1DBgBl/Llenl (Sohodule I) 11. Tolsl Deductlonl hotelllnee9 &10) 12. Nt! VOIUDo! EltOI8 Ulno 0 mlnue' line 111 13. Cherll.ble Oeque.,. (8ohedule JI, 14, Net Velue lubleol to IlK (IInol2 mlnulllne 13) (11_ ( 2) ( 31 ( 41 (51 $1023.00 ( 01 ( 71 ( 81 1023.00 ( B) (10) 1023.00 o ] O~3. no (111 (12) (13) (14) K,OO- K,1B- ~53. 45 (17)' 153; 45 (18) 0 39 Wast Main Street Mechanicsburg, Pa.17055 AN RSPRH8SNTATIVS ADbReS8 August 31, 1982 OATS J Rev, 1147ex (l-UI, ,UUR~AU OF e,:AMINAT!ON !, Non~E or INHE~lTANCE TAX , AflSES8MENT I'ENNSII.VANI/\ OEPilRTMeNT OF I1EVeNlJro! APPRAl&eMBNT A~~OWANOE OR OlSA~~OWANC8 CONTRO~ NO. ,101 ' HARRis~u~g~,p~32i7\Of> ! or oeOUCTlO'NS, AND ASSESSMeNT or TAX DAn " ..i _' '-"''''~'''''.H,,,,,,,,__~,_,,,,,,,.~,'''''"'''''-~'_~''.'''Tf'',,,-,,,_'>""..'d''''''=iil''''<~"""",,,,,,""""""-"~_~"'~"~~'~';;C""""'i""',,",'3T'"~T''''''''=''''~',*,,,,'''''''~.",,,,,,~_~_,,,,,~,,.~__!;L,,~,a,,~.,,,,,,,,~~ ISTAn or SHI'l'1l MARGARET t.. PI~e NO. 21 81-0453 llllU,OtJlIaTl'LOG,.JO::EU m_,~,H"m'" "Td,"'''' ",. ._Mu,cOliHTY",QUMllli:RL.[IIlD"-,, ',U'",_,'" NoTe: TO INaURe PRopeR CReDIT TO YOUR ACCOUNT SUBMIT THe uppeR PORTION or THla NOTIOE WITH YOUR TAX PAYMeNT TO THe REOUTER OF WI ~~S OF THe ABOVe COUNTY, MAKE CHecKS PAYAB~e TO "ReOISTeR or WI ~~S, AOeNT, " IF TAX PAYMeNTS ARe MADe WITHIN 3 MONTHS OF THe DEceDeNT'S DATF. or, DeATH. A DISCOUNT OF a% or THe TAX PAID MAYBe DeDUCTED. ' ,Wlt..LlAM L SUNDAY Jll W MAIN aT 'MBCHANICSl)URt;l foil 17055 PLEASE RETURN THIS PORTION TO REGISTER OP WILLS IF PAYMENT DUE ql,J'LA.l-l)~~,'1.'HI~LINe_ . _ -' ,.",. n " , - - . , " p - , - NOTIce or INHeRITANce TAX APPRAIseMeNT, A~~OWANce OR DISA~~OWANce OF DeDUCTIONS AND ASSesSMENT OF TAX __________..___.-.-,-..~_ _ ..... ~.~;'" ..r________L~_.. .__ _._. ,<,___,~___~,_ ~_ ~ ~_ _ _', . u_, .__.____, -,-..n_ _._____.,_~,__. ...." .'- .,__ .._~ ~'O'"<-" -~--~._.. '-.',-'--'" ----~+~---_.~... ISTATe OF SMITH MlIRGl\llET L FIL.e 1'10,21 Bl-0453 ACN 101 DATe 10-12-82 ,__._.._.._..._...1!,-) ,,~i::rLJB..N, Y:!. ~s.:_...U:LI'c:c:~n~p..IlS.,FlI.e.i:>...... !u" )C,f!I\I\JGECl___, APPRAiseD VA~UE OF eSTATe: I. Reel E'''le (Schedule AI 2, Stocks ehd aonda (Schedule 131 3, Glo.e!y Heid S\ock/Penner,hlp Inl.ue51 (Sohedu!e CI 4, 'Mongeon el1d NOlee (Schedu!e 01 E, CUh 8. MieoeOeneoue Pereonel Property (SchedUle EI 5, Jolnlly, Dwned Prcpe~ly (Schedule FI 7, Trene'e" (Schedule Gi 8, Totel GronAuele ( 11 ~_~._....._..'.Q9.~ ( 21. ,~.,_,_...__,_".99..:: ( 31 ,_...__~._,.Q.Q.n: \ 41-'.............._.&9..._ ( 51___1.1.9.~.3.lJ'-Q_' ( 6I,___..___..&Q.... ( 71 .._n."....___..t9Q.." .. (8) ___.._...hQ? 3&9_ AP~Raveo DraucTtoNS AND eXrMPTtoNS: 9. Funerel Expensea/Adminlwe\lye Coelo/Miacelleneoue ExpeI"n (Sohedule HI 10, Deote/Mongeg"/l."ne (Schedule II 1 \. TOI.I Deduclione 12, Nel Velue of Eel." , 3, CherO.ole a"Que.ls (Schedule J) 14, Nel V.lue Suo leol Ie Tax ( 91..____,..,_.......J1L (10,1 "._ .... ,..,_____,-,_QSL.. 1111 (121 1131 114) ___.__.___...J.S!.Q.. ____'-11 023. ~_ -----....\.QQ... __.__,.,.19, 62j,....1.L A"raaMrNT or TAXI , E. Amoun\ 01 Ol1e 14 laxlole .1 S% rele , 6. Amounl of line 14 I..eolo .1 1 E% rete ,'7, prtnCip.! Tax Due TAX ORrDITS, PAyMaNT RECEIPT bATE ,'~ 09-23~Bl 029798 03-30-82 010610 08-31-82 049767 ____..,_I..._,.._~~_,..._.c.., _.____~____..,.._,_~._. THIS AsseSSMENT IS aASED ON: 1 SUPPLJ;:MENTAL' RlilTURN NO INTlRUT U DUE IF PAID IY 08-31-82 ,IF PAID AFTaR DATE INDICA TaD SEE REVERSE FOR INSTRUCTiONS, (16) ,00 x.OS-' 00 II 51 =~._.1.i!&~1-;'4'3"' x IS- ' __? 943021~ 1171 2,943"li.... ..-l-....,---~'-------'1-'-'-.._-:;---------~ DISCOU~IT 1+1 AMOUNT PA"D , INTEREST (-I , ' ' __._ ____~_____~._u,_,'______+____... _~.n. ___.---.--.---______ n__" 127.50 0,00 3.86~ 2,422.60 239.76 157.~4 1.__ "'", . '-,'---'''~ -~" -,,---,-~- ,f-::- TOT A':.!!'..2.2.REDIT. ' 2 ,943.24 .m I .A~ANCB OF TAX DU~__,03CR iiI 'Sal.nce Due ill leU Ihan .',CO he p.Yn'lenl ia,equired) MT AIN THIS POAT!ON FOR VOUI1 RECORDS HErf;','! IIi' I 'A? ill:1 1)1 ill 1 INr-ORMA liON ,_~~ ~< "". n~_",_n_,_ _,~ 1'hlS document in the Notice f(l!QUitI;Jd to bo (H~en undef SocUon' 70~ of the II111enllmCD end estate Ta)' Act 01 I~61 172 'P.S ,~ellon 24(5). If :the lax IS Pllid wHhm \hre. (3) rnonltll~ afl~H Ihe docedent's death, 8 discount of F1% of thO' I,x P.id i$.Uow.d. Inllerilln~e Tlxbeeo,"e. ~ell"qllenl nine (~I ,"onllla llie, lI,e qece~onl'a dUIIl, Inlorell ',a chl'gect al Ihe tile of alx (61 Pe,cent r." Innu," on Ihe Imounl of unplld lax, (SeE EXAMPLE SELOWI , EXAMPLe, if. b.l.nc. olio, due of $2,OOO.Ob la ,n . dohnqu.nl alalua f'om ~-~-80. Ind Plymonl I. mlct. Oh It 23 -SQ: Ih. ,nleroat la c"culall,d.. Indlclted below; STlP 1 Ool.rmln. Ihl tile of Inle'eel from the I.bl. b.low. Into,..' from, 3~03-S0 10 6-n'-SO Re.uit. In' --~-_.~'_.-_.. 2 Montha' ,010 29 O'v. . .L.Jl.Q~a.g RII. of Ihtl,eat ~ .01335 STBP a Mul\lplv Iho b,'.nc. of IIX due bv Ih. tll. of inleresl. alllnc. of tox du. $2.000.00 RlIL9LJnJttUl,.'_n. ..L.Ol.3.;l,IL. , INTeReST $ 26,70 STEP a Add Iho Int.'ee I to Iho bll.no. of tlX du., a.l.nce of tl" ctu. PIUI Inl.'eal 10 :.,gllt.....9.L1'_~.!ll!~1 1+1 I ""AL tlX Ind Inlerlat to Olt. of Plvm.nr $2.000.00 $ ~J.Q.' $2,026,70 .. ~ _,....",... _.. _ M _ ,'0- ~ ~.' _., _.. n ~._ _ _.. _,_ _ _ ~ ~ ~ __ I month 2 mOnlha 3 m6ntha Idov 2 d.va 3clm 4 ctm 6 dM 6 dm 1 d.v. 8 d.VI 9 d.V. I 0 cl'VI - .-; _ _ ~, .. _ ~ ... .. >- _ _ _ _ ',. c. '" _ .. .. _ .. _ _' .006 4 monlha ,020 7 monlha ,035, 10 monlha .050 ,010 ,5 month. ,025 S montha ,040 II monlhl .055 .015 6 mOnlhl ,030 9 montha .045 1 2 montha .060 ,00011 11 dlVI .001S6 21 dlVi .00352 .00034 12 diva ,00203 22 d'vI .00369 .oooal 13 d.v. .00220 23 dlv. .00386 ,00068 14 cllV. .00231 2~ d.VI .00403 .000S5 I 5 diva ,00250 ' 25 dlVI .00420 .00101 16 d'Vi .00267 26 cliVi' .00431 .0011S 11 d.va ,002S4 21 d.vs ,OC454 .00135 I S diva ,00301 28 d'Vi ,00411 ,00152 I (;I dova ,00Gle 29 d.va ,0048S .00169 20 diva .00336 30 dlYI ,00600 .. .. .. i.- .. .. '-0- .. .. .. _ .., _ .. ... n .' .. _ ,. 'n " .. - - .. - .. ... ~ - .. .. .. - - - &- ... _ .- .' _ ~ .' .. .. .. .. . _ ~ -4 ~ .. .. .. ... .. '.. .. .' .. .. " 'Anv PItIV In Inte,..t, Incl~dlng theCommonwolllh Ind the peraohll reprtlent.lly.. not lOUafled Wllh tht .Pprllaem.nl .nd ......m.nl inlV obl,CI wllhln ""tv (601 diva Ifle' r.celPt of,lhli NOllce IS p,oYlcllcl bv Sectioh 1001 Of the Inherlllnce Ihd eitll' T.x ACI of 196 I (72 P.S. ltC, 24$6 - 100 \I. .. MAl<I CHICK Oil MONIV 0110111 PAYABLI TO: "1I1QUTlII D~ WILLI, AGINT" PETACH THa Tap pORTION OF .THIS pOFlM ANO SUSMIT WITH ,vOUR PAvMGN.T TO THe REClISTEFl OF WILLS FOR THE COUN'tv SI10WN ON THE ReveRSE. SEE THe INHERlrANCE TAX INSTRUCTION. SOOK FOR AOORen