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HomeMy WebLinkAbout81-00470 nr.Y.411 EXt (3.eol COMMONWBAL TH Of PBNNaVLVANIA DBPARTMBNT Of RBVBNUe TRANSf8R INH8111TAN08 TAX RBBID8NT D808D8NT SCHllDULE "F" 8TATllMllNT OF DllBTS AND DllDUOTION8 Estate of ~\,.\)~",-,,(\, "",, \Jr..\",~rJ Date of Daath \:l."'\.'io PlleNo,<-1/,.f/-4'7'CJ WHllN CLAIMING THE FAMILY exeMPTION, COMPLETE THE POllOWING, Clelmant Raltlllot1shllJ to ()ocodaht Claimant's Add,oS9 at tlma of OocodarH's 000tl1 I~g~ DArB NAM8 Op PA Vaa R'MARtIS , AMOUNT , , '\,,"\\~, b'... '- " W, ~~"'\,.\.-~ ' 'V... , t<'\\<'.... ... ","I) '" \t.1I, 1'1 I- ~,':\.,,\.!;'. Ub :l.. 15'hl.\" ~u.lool'l~ ~,,,,c.,\l-',,-~ ~~~QA..'l\\- "'''' """'N (,. "" 0 ~',. 'D',' aN e.. \"\$",00 '!. '\ '''-\'/1 " 1;)\;; \"I~'" '\ 1... 0 0 "1:1'1-. '1'>11 \- -.,.l. "I.,'L ~\!I~H/Wfl.. 0'" ...~~ '"' '\,...\.., '.~ a~I-Cll.";'''' '\"-\.-ovJ '1/, Il,) , \~'J.,,\o - l> '>'h\'1\ , , "l.1'L\.1- ' \\'l\-a ~""~'" e- \;'. \ ./f.<> \.' .,... \ '- \"" ;:...~'\ \0 \""\'1.1- \'i\ .".... \>. ,,~ . ,,~'(; v,v<.'IoIl "- v, t.."".....\\- ~ " ~ ....... ~ v N', ;0,.,,\1.\, , , , " , , ,- , " , , ' ' , , , , , , , , " , , , " , , , , , , , " .. " , , , " , , , , '~", , , , , , . , " , .. , " , . " , ..' " , , " , , , ;' ,,' , , , " , " , TOTAL 1 ~I.l)lo.'\~ I hereby certify that ,to thO best o,fmy knowledge and belief the foregoing Is a Just and truestatem.ent of debts, funeral expenses and '1xpenses of admlnlsttatlol'l submitted to the estata a8 doductlons for Il'lherltance Tax purposes. o~~~.~~IMV""~~{' DEBTSANDDEDUOTIONSAA~ALLoweDINTHl!BLlMDF $ d,c,o.,J.rj AT (" %TAXRATI! tJ gENERAl-INHERITANCE TAX INFORMATION Unlqtlllled Ilabllltlos Incu,rod bv tho docodont prior to hls/het dooth aro doductlblo agalnsl hls/hor Iqxablo nlato. In addition to dobtllncurrod I1v tho docodont at ostato, otl,lor Itoms are ,claimable Includlhg the COlt 01 admlnlllratlon, attorn,yleea, IldUclaty leOl, luneral uhd burial eKpenlOS Including the cost bl a burlollot, tambltone or gtave marker end other relqted burial expensOl, All dobll being claimed qgqlnst an eatqto ate subloel to Iho opproval 01 tho Reglslol' 01 Wills with whom the Inherllance TaK Return Is Iiled, Evldoncoto support tho decedent's ot the OItate's liability lot the debts being claimed should be qttached tothll schedule, ' A lomily exemption may be clqlmed\w a spouse ,01 a decodent who died doml,clled In Pennsylvania, 11 there Is no spouse, or If the spouu hql ,fotlelted his/her rlghlS, Ihon any ch,l\d ollhe decedenl who II 0 membetof the sqme household can claim the eKemptlon, In the evont lhere Is no luch spouse or child, the e,lIemPtlon con be claimed bv a parenl or parentawho are memb,ers of the ,.ame houlOhold as the decedent, The Iqmll y exe.m~tlon Is allowable only agalnsl oneil which Po" by '0 will or by the Pennsylvania I,nleatale I.aws. ' ' NOTEI Compensation pqld to on OItate repreaenlotlve/,nomely, ,on oKeculot or admlnllttator, forlOrvlcea porlormed In odmlnl"erlng qn eatol,e Is repo',table IqrPennsylvanllllnoome TqK purposOl. Thll,tqllqble Income Item shQuld bs reportod,an form P A.40.lndl vlduallnc;ome TqK Return. ' i ,~ ~ 8 I ~ ~ z ~' ~ ~ p z ~ i:;j p 0 ~ ~ 'T1 :'0 " , i I (J" ~jJ .... '.-\ lh:,: a: tot: ~::(.~: ~ "'(..... ~t~ ::.c r g~~., j, ~ ,"'ffi VI ~~ ~ t);, ;0 d\.l ~ ~ \ lli~TRUCTIONS FOR ~O~Pl-E'1'Ili9SC~" ' , 1, If the fqmlly eMmptlonlo being clalmsd, Indlcal' th.clalmant's name. qddre" and hll/her relationshiP to ' Ihedeced.nt. lilnter "family ell emption" In Ihe ,remqrks column and lhe amount clqlm.d In the amount column. 2. ~nlgncanaocutlv. numbers to e,gch, Item 11."d. 3, ~nl.Hhedllte on which oqch dellt Was Incurred ,and/or paid. 4. Int., the name. of oach pay... " S.Provlde abrlo! explanation In the "rt,orks column fat each debt claimed, 6,,' Entet Ihe amount of eooh debl belno claimed. ,,' " 7.' The lorm must be a\gn.dby tho peraon who ho, ouumed thetespon,lbllltv for paying the debts. IF ADDITIONAl. SPACE IS NECESSARY USE aWl x 11" SHEETS. COMMONWIlALTH OP PIlNlIIsVLVA,NIA DEPARTMENT OF REVIlNUIl BUREAU OF EXAMINATION OPPICIA~ NOTICE OP INHBRITANOH TAX AS8B8BMHNT '* COUNTY PI~a NOI ./ ..;./. . '~"I ' / '/, 1 '(1- - ~ '~-I' -- 1'< ,. ". DATIl l' . ",I.~ /-' . . -' , !' l..~ '~ //)<"/ .--'(f. JJ-e .._1..1 . ',~ '..' , "2 ' .'- ,-'it' __~,. " ". -', ':.' _ --- -" .,',A.,/, a;, . /1_ .J_'...I.4j'ttI'-'J'\~ t .. ,_ _.' " .,' ." / . aSTATE TOI ' FILE NO, ,0;'1' ....j' ,'/~'J ~~I / -. '_~~" ,.A;I . r. Uf.4(J', ~~V;;:t,~ (;I:~ Apptftl"d Vftlue of &lIale: 11..1 BlIII. Perlonftl, ProperlY /7,) /( . COUNTY (t61/(:;..tU(~</"~' [,lATH OPDEATH ,.(2- /1/ -.J(,J ~._----"'~-"''-~'"-~,''' , .. __-.- ~.~_... H + .,.,..' Jolnlly Hald Propa"ylTtftnlla" + N //164? ,;, '7 / ./f;~ :I'r;; ("(;' '7 o)' -' '/'-' x (~(;> ~ (~) TO\81 QtOIl IIlIlIe To,,1 ApproVftd Dedu(Jtlonl Claat Valua 0' IIftl,t. 11/, ,k'(j;~. '1("/ . . .' / .-.p.......................----.... ~a..: Approvad Charltebla Bxampllonl CllIar Valua,Qf a"8ta SublaOIIO.Tax . /~ x~ ,~ "It/. Amount rax,bla lIP 16'14 Rata . /1 ~;;; i :J 'liJ. lax dUI . " ~</ 'J&, , " (,f" .':- . I , , / lax dua TOTAL PBNNSY~VANIA INHERITANce TAX DUB . I?<J 'J..(p . Amount TaMabl1 @ ,0'14 Rail . .. . ~ . A flvl parOftnl dlloouhl 10lallng , Will ba granted If tha Inharltanco Tax II paid by L....Otadllal /)ATIl OF "AV~I!NT i-ll7n AMDUN'f PAID . :<1/,. ")((7 + DISCOUNT . INTIlRBST rAl< OREDIT . .-;7 //.'(" . ' - . " + .. t .. ,lnlOr..' .OOtu.. ,at II'. rftte of. 1M, ,l6) peroenl por annum on tho unp,ld b~lenoe of Inharllanoo TaM 'tom........... " 10 ,dati' of paymant, Int,.rnt dUI If plid by I, IlAt.AN08 OF PBNN"Y~VANIA INHIlA1TANOll TAl( cUI! ~/:";/</l ~ LfJ , ('rr,I' /, . ~-tJtr:-:/ ' " ,,/) ~' ' AI.....dbyl helnlountll6n on RIVI'" Sid, Ill.(m>! l n elt It'lFORMATIQll., To In,u'B,piopot 0'0""10 yuu, nCCl>IInt, Iho nllmB of Iho ontnlu'lInd fllo num~ol ullQuld ~II'oloolly ptlnl. ad on Iho chock 0, monov o,dor, Thla oll..linonl I. modo In O"OOtllflnQO With Soollon 700 of Iho InllOrltllooll and EIIUIU, ToK Aot 01 10610(72 P,8, 9 2480.7081, To the' exltnl,thBt Inho,llanoo lax 10 pold wllhln Ihrou (3) mon\l11 oft., 1110 doolll of Iho docodonl, 0 dlloount ~I five (8) porolnt II ollowod 172 P,$, ! ~485. 716). Inherllonoo TBx, other Ihln IIIK Oh 0 futuro Interesl, I; due ollho dOlo of 1110 decedonl'a d08\h ond ~ecolT\ol dellnquenl at IhO ,xpltetlon 01 nino 10) monlha eflo' Iho docodonl'ldoolh (72 P,8, 6 2405.711). Inllerlloncl n. on e future Inloroll I, pOyablB within th'oo (3) monlhs 0110' thl \tan,la, tokol offoct In poSGus8Ion and etljoymohl and la dellnqulnt Ihoraolto' 172 P,S, 9 2485.712), Calculoto Inloroll Itomlhe dollnquonl dalo ahown on tho fooe of this fO'M 101110 dolo 01 aClual paymonl uslno lhu lollowlno Inlc'oatleble: ' ""__.........__......_..,_M.........__...... ..........._..___ --- ........_- ......-----.......,-.......- - --........... -----...- .......,....... - -~..- 1 Month .008 4 menths ,020 7 monlha ,030 ' 10 months .060 2 monthl ,010 5 monlhil ,026 ,8 monlha ,040 11 monthl ,OBB ,3 monthl ,015 8 months ,030 9 monlh. ,046 12 monlhs ,060 1 d'yil, ,00017 II doya ,00186 2' days ,00362 2 daya' ,00034 12 day. ,00203 22 doys ,00389 3 daYI .000Bl 13 dava ,00220 23 dOVI .00386 4 d'VI ,00068 '4 dOY. ,00237 24 doy, .00403 8 dlYI ,00005 16 dova ,00260 26 doy, ,00420 8 dlya .00101 16 dovo ,00267 26 daYI ;,00437 7 daYI .00110 ' 17 doy. ,00284 27 day. ,004B4 8,dlY' ,00138 18 dova' ,00301 28 deVI .00471 9 dayl .00152 19 dOVI ,00316 29 daYI ,00406 10 deYI ,00169 20 doye ,00336 30 day. ,00800 ..- -------...-...-----...-........- _ ...----...-......... -~-- ---;... -- ..._.....,-----.. _ -- -....;..---..... -......... Any partv In Inle,oot, 1t1Oludlng the' ComoionWoollh end Iho pO'80nal rep,c.enlollvo, nOI uelleflBd with Ihe 11I1'B'ment rMY obJeot th"alo within elKlY (60) doyaoho, ,ooolpl 01 thl8 Nollee o. pIovlded by Baollli" 1001 of Iho Inhotllanceand hil1to Tox Act 011961 1'12 P,6, 9 2406'1001), " Makl'l Ol,ieok or monoy o,cjor pa'Yableto; "Register of Willa, Agent" Mall to the addrea& IIstodlJelpw; QIlNBPIOIAAIIlB _ _....~~. '=T'--' BpNeFIOIAl\leS AND AOOf\S88aS l\al.ATloNSltll' 8URVIvao AOA dp LIPa INTeRe8T OP ISII" hlllnlmo' on~ I~d""o' nllll Who hovo on In,.,.II TO OacallBNT DacaDaNT T, e,NANTP OR aeNaflolARY , Ilthlly"ttd, uonllt\q,nl 01 olh., 11\11,,"1 OTATe yaa ANN\JITANT8IN aBTAT'U , OR, NO AT DeATH Of E '\)""p, t'.,t)~_c:..~,.!l~ \ ",~.,~_.....:.:,.__n' ._".~2~~___, __~_.__.._ .__.oeO'O_~NT._~ -.,,-'-~- A 0 '!i !> V W ~ '.. '1::n.L- ~_. ---..----'.- ____n___ .------~-- -~-~ \ltall.! ~v",u~J-~__._~~\"1~'"\.\'- ~_. --- - . ~j.,.f~ y IV , 1-\ pI< ~ .____e-...:... ~ l1\V C H"" ('-; :J.1 ,c. u ~~~'1" ~ 1'-', ~"'"'~ \~\I,.'":'l \'lh I'" nj\ " -........-'";....... --- --, ~- - i ~ ~ ,~ , ~ \ J .. , , ill , , , ~ Iil r:~~~ ... ""$ !!)::.,'J -~I' ~1;bi :;t,.-( fi'..oJ d"" i,ld '1<.~1 ~~ ." 'i I .... Ii; f<J ps , INPORMATION, PLAce POI\ fiLING -'Thl relu,n II to be f1lld In dupllcttl with Ihl Rlglm, of Will. of Ihl oountY wtI.rlln, thi ~lCed~1\I 16llded, ,.. . .. TIMi POll PILING _ The return I, dut nlnl monlhl 11\11 Iho ciIO.dlM', dUlhi unl~I' ,n IXllnllon fo, filing h.. been Ippllld for I~d qrlnlld'by Ihl ,_,' ~rlllfV of AeVlnue wllhln Ihe nlnl,rnonth pttlod, . .' .' " , ," .. ,PAtL\JIII TO PI\.eIlITUAN _ Section 19\ of thl 1981 alllute p,nVld.. Ihll " ". Inv pmon v,l10 wlllfullV lell.. tn fill' ,iluro 0' ofhtt tlpcn ", toqulrtd of him, , ,.hlll bl ","o,n1Ilv I\lbll . . ; '10 I ponllty of 25" of tho IIX ultlmlttlv found to bl dUI 0' .1,,000 v,l1lohove' II Ihlllllll \0 be llOoVlttd bV Ihl OIPlrlmonl of AmnuI .1 doh" Of Ilk. Imount 1'1 rlOoverlble bY IIW." jl