Loading...
HomeMy WebLinkAbout81-00674 ,n:y.1S 101 ~. 11 ;'!.Bol COMMONWEA~ TH 01' PENNSHVANIA DEPARTMENT OP REVENUE TIlANSPER INHERITANCE TAX RESilIENT DECEDHNT INHERI1'ANCE T AX RETURN FOR INSOLVENT ESTATES (lnslructlons on Rovorso Sido) cOliN TV NOn;? / ~g 1.6 7 ./~ Ihtato 01 ) fJC(? b T. .J!JIJ1i&dL Lalli aduro," d:? 'l~, AlJti1fl.r,,I[ ',l", r 191 AHh TI /,&11' i;/f/C-._j~t. Ic\'fYI IUTAT"I pat 0 01 Doath -Lit? y -1-4. / ~,I ?! Social Security No. 'pjJ,J... /d ~ (Ftlt.1:....- ;n.,'//"'1 / (, ,) ti'.ltt) T'lPH OP Ann DHSCRIPTION &;,-,~ ~)-8l d.-I t1..''J i -19' .Ill r/~/~ .:.;'.." ;. ,__, t (. j I:JClS ~~ 6 (?c. ,.'..t;) )3/}-r::~/>< J NC<-VI./Nt ,('),"'~.L t!, HATe NO, ~ a z: It ( ) hoc, (~AUIII,,',' O",,',t h.", ,J'),fI-~)'1"f"R J I r JU/" III . Nom. ..:.-li.21,J,l ,:t;,:" aulr'\ r.> A' . ()eVI,., ,"; /'~ 6" Y{j{, Social Security. lola, ->iC.._ I' . L _ ',' L)! ,<, t'l," ,., r,./) Addro.. ~....;i.~-t,"~)\ " ,t/L'(~' - I . . . ... f' ,~!il'HI'bTI -'... ~' /1 ,'-,,' I'" r'?"',/ 'I l_L l/l.li[i"E ~ /""",,..~ ...k.4'........."'-. _.__ . f . . . (C.I'T'O lfilATEI. . \;'.\"'1 Ulldllr'I1Ullll11lillOllHtl'llHY, I c!uolaro thut I haw o~umlnC!d thli retUtll8l1t1 to tho hUll of nw knowlodOIl onll bulhlf h It Hue, corroot and QOllllilatoJ J2 " A' It' t..~ H 1",ey r- . '~OA-' c..' ./ Jl~j _ ./' L ~"..::> ~'t5 SIUiltih.u9 01 r~ldU/;llarv Oit8 HSTIMATHD MARKHT VA~UH ,-:; /-y, 0 1.;1. 1:,' C. I I' " '\~.. r? t{ " . (, {i (:tILl-":') 0 I, ,1119 I Ie;' DHPARTMHNT VALUA TlON (O~PICIAL UU OMLY) " ~ .,.. h'l ;tl~ ;;'" .~ i j> ja; ,bl3 , I, f'I;~J i " '~~ Il:tl 1('1 I ":i .Il . , tl I ,"" ,TOTAL "P..!5.~/,.f3 d. ....~......~.!". ::..~::.... ." /1/;1/4; O"ICIAL U.. ONLY DATE NAMHOF PAVEE ,,... /"! ~~"t I. ,J/', I l"'l}.n /J,(/ ; 'l( 1.1 e (.t1J./ ,r-~~4f3 /, ,]:;''(/11' e.l.p,I /ft1rn I! ~ '7'I/I-$"( fJe,J./JFitIU, tlru'/',Gn,J... ; ~-M.''6/ T"'11J'S/;;i~/(.(I1.'J.5L?/r.;., 'l!.r;.J;....tl No'5!, , f2eoom ~ 7_ /- &' I :/9/l_('~~t:'- ~"c!,'o,JrJ)f'J\i II: I), r..,- '? I l.I, G. t CiJlP-fJ. ?_ ?~ ~'/ P, 11).: {j./.~ild- 07, '7-/-'71 }3o(l.OUa/J ,(I'/I//,,,,!-<L O"ICIAL U.. ()N~Y I 1/. -h/'.-'/; I ....p h 6-;, t/iP NATURE OF CLAIM , '';,,(/ CIO;.;,,: :'F>L.{(./l:'i( '_S Ii' dlljl, J}!'),.L I.~ l3,~j). ):;. All _ i I e/lN./' ,'J!e '/~, !< 14d','O,!-J)f}1 trll"" i8,;M, .,1.. /~/ h t; 13 /,/.,J. , W IJhJl. /3/./. /.. AMOUNT CLAIMBO ,It/(,..-';/., ,(; J .,5'3,00 J6'?,00 JII ( t)O ~,CJO /(.: 1.., .pe> ) .ys~ '? I (oR /110.) ,K5,SA J!~.d>? -=> -././ .J .s ,-, 6,(3 TOTAL COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE BUREAU OF El<AMINATION OFFIOIAL NOTIOE OF INHERITANCE TAX A8SESBMBNT *' _...........~ , COUNTY FILE NO: i:/~ -. ," 'j. ',. '/ ~/ DATI / ) ") i,'.'J"/ J.-,L:: 'r r::',.,' /sl (_I,'" .- .~. / fl..c ( . , ''/ '- i 1/ i" -- d Vi_'I. .> f (,;{'>ll (! ,"/ <+ ., .. ) .-,) /i"/~: ~~,-_.:,~/~ ,. I . ,) ;, t, .1 I .I /; 'i- 1 ./ EBTATB , t:' .)'-1 Jf ('r'('+~ I ) , /"f " ) ,/'t ."I . .';.- t...'" TO: FILE NO, (/ c'( j'~. _'</ _ [~;, ... i:/ .I" . - COUNTY ; /. ",' (,'; '/j' i',,<J. t'>t,-.( ~;~. ,'11I'~'# - .. . ,_. . .. . -, ~ I '_j , i. ,I~' ,,'-'1' .,' . _~ i~.:;~l'':';, (-'{) //'jl-// .' . , DATE OF DEATH. ';////9 / /.. ''I ,/ , ,.- 1>7\"/ /' j ,r I , Appr~ls~d V~luo olesl~I~: Roal est~l~ ,. .~_....-~_......-...--"- Porson~1 Proporly + v'. "-"-j / J/;:'l ~_ _ f.' '..-: ~. J I - i , ~; - , Jolnlly Held PrOporly/Tronslor, t "__..d......_......-....,--. Tolel Approyod Doduollons . ,:~,' 1)--:;/ / ,1/ :"j .' ;. ;~;'/~. I)r/ ,,'/(, ','! TOlol Oro88 Eslolo Clear Valuo 01 Est~t~ . ~ nn'''~'''''. _.H__ Lo,s, Approvod Charitable Ekomptlons - ,....~_..--~....-- Cloor V~luo 01 Est~la Subl~et toTak ~-- A!l1~unt TOksblo @ S% RolO Amount T~k~blo (jjl'15% R~to . ,', 'j' ,j :t: ',' 7 ,'._-, , _ ,.f-'..-. " ttl~'f'~;,,\,)-,.cl(f"'" ~',/,r'/)/I~<.'; IRk due , TOTAL PENNSYLVANIA INHERITANCliTft'~;~I6f'/.tf'Y~:l,-,t if:!,?,);;;;:/".! * * * *,,* * A five peroenl dleoouh! totaling · will bo gr~nled II the Inhorlteno~ T~k Is paid bV L~ss Cf~dlts: OA TE OF PAYMENT AMOUNT PAlO DISCOUNT INTEREST TAX CAEDIT . + . . ~ . +, .. - + .. Inlllrest ecoruol al tbe rele of elk (5) pereont p~r annum on tb~ unpeld balanco 01 Inherltanoo TaK flom_ to dete of pSV!l1~nt, Interest duo A8IUled by: 8.. InformatIOn oh R_Vir.. Blda ' 'I ~'i- .."..,) ; ,