HomeMy WebLinkAbout81-00689
BGNePICIARlea AND ADDAe88ea
lelllt full nlm" IlId Idd,"," 01 III who hi" In Inlll"1
ollhl' '"lid. oonllneolll or olhll In"'"11
BENSFIOIARIES
ne~ATlONeIlIP
TO DeCeDeNT
aunVIVBD
DeCUDeNT
STATe ves
Dn NO
ADe (lP ~IPe
TeNANTS OR
ANNUITAl-jTa
AT DeATH OP
DSC e
INTeReST OP
BeNePICIARV
IN UTATe
natty R. O~~A~
114 S. Fuyotto Stroot
ShippanaPllt'g. PlI. 17257
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INFORMATION
PLAce POR PILlNQ - The retu,n I. to be flied In dupllaole with the Regl.ta, of Wills of the county whoreln tho dlcedent resided,
TIME POR PI LING - The roturn I' duo nino mohlh. eftor the docedonl's dooth. unlO&l on oxtonllon tor filing ha' boon applied for and granled
by the Socrota,y 01 Rovonuo within tho nlno,month period, '
PAILURS TO FILS RETURN - Sootlon 191 of Iho 1061 Stetuto provldos that ", "any person who willfully fell' to file a IIIMn or
other report ,equlred of him, , , sholL bo por.ollolly IIeble , , . to 0 panelty of 26% of the lox ultimately found to lie due or $1,000
whlchaverls the lesser 10 be recovored by the Oepertmont of Ravonue eI debt. 01 like emount ere ,reooverable l1y law,"
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INHERITANCE TAX SUMMARY SHEET
(BUREAU USE: ON\..Y\
Ii) Original
o Supplem.ntal
o Remainder
Pllel'lumber
e.tat. Home
21~81~O~U9
..---
E(\win L. 92o(lhar-\, --'~-~-
Oat. of Death _Mlll'ch 4 t l!HJl
Social Security .l'lu.mber----20f\~?4~3U6A-~
RBPORT OP IHHBRITAl'lCB TAX APPRAISl!R
.' i, th. und".lgnld duly oppolnl.d Inher"on.. TOM Approl,,' In and fOl Ihe County of. Cumbsl'land
Plnn,vlvanlo. do leaplolfully IIp,,I thai I "ave apprahed Ih. loul ond per"nol plllper 08 I~oll'd In Ihe '~r'9olnci
ilIUm 01 Ihl voluea ..I forth oppoeltl eooh It"" In thl \081 oolumn I II hi In $oh ul... "A' , "B", "C' , ond "1"
Dolld, December 16. '1981
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v~~UI ~, ~pp~~\lla COOl ~OJUn"'INTI RI"'A'NOIR ~PPR~l""'INT COOl
IHVIHTORV (H~ R\laURO UII OHLV)
R.al P,opo,ty (Iohodvl' II) e
p.,unQI P,op"'V (Sohodul. II)
JolnltH,ld PIOpllly (Sah.dulo I)
T,anl'''' (Soh.dul' C)
TOT II\. OROII IIUln
I.... Dob,. and D,dultlonl ~. ".
(SCHSOU\.I P) ~
c~I~R V~\.US OP UTATS
0\.11' 8,10" WI rACTOR PRltlCIP\.1 VA\.US COOl
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o Annuity
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COMPUTATION OP TAll
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rORUSIl 0' RIG~ITI!R ONLY.
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".mptionl
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TOT A\. TAX
IHURlST PRO,",'
llA~AtlCe
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DATI! 0" PAVMBH-r
A,",OU~T PAID Ol&COOj!J'
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INTaRUT
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COMMONWaAL Tll Of raNNRVI,VANIA
PEPAIITMENT OF IIEVENUP
TRANBFal1lNllPIIITANOE TAK
IIsalpENT PReSPENT
SCHEDULE lip"
Sl'ATeMIlNT OP DEBTS
AND PIlPUCTION8
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Estllte ol___~edwin.l..-Claodhl1r.t,,____,__.Deto of Dea\h~l
WHEN CLAIMING THE PAMIL V eXEMPTION, COMPLETE THE FOLl-OWINQI
C'\ I' \ Blltty R, Goodhllrt W'I fo
u "'nil nullltlOI1Bhlp,\o DOClldolll . .
Clnlrmmt's AtJdnlful ut lllllll uf Do(:{!(lollt'nDoilth
114 S, Jo'IIYllctO' HtNllt, Sh:LpP\'ll1abllrll, I'll,' 17257
OATE
NAME Of !'AVaE
REMARKB
",MQUNT
__ J1.itWll q', ]lo~d~Qnilor
t!f!\ll!.r a I1l 0 r:LH,~
o
BpdoB lIill haaoe,
O. V. 1I0ao Compuny
Funarnl Harviel\
--Euneru-] flowe~R
f,4QO,OO
Oometery l'lo t '
hmbulllneo a\'lrv:Lc\'l
lrte,
rA"na I'QUA ~3~~nrin[l
Re bter of Willa , Oumb, 00, Bt ....:.-.-. 10.00_
ReBister of \~i11a. Oumb. Co, 25.00
Batty R. Goodhart 2 000,00
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TOT AL . S 6 ,.l21l..ll.lL
I hereb~1 certify that to the best of my knowledge and belief the foregoing Is a Just ahd true statement of dobts, funoral
OKpenSeS and eKpenses of administration submitted to the estate as deductions for Inholltance TeK purposes.
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- Ail/I\l: OII PIDUCIA Y I IJ TE
OF C AL use ONL V
PF-9TS AND DEDUCTiONS ARE ALLOWED IN TH~ SUM OF $ (..,( 'II: '1J
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GENERAL INHERITANCE TAX INFORMATION
Unsatisfied Ilo"llItlos Incurrod hv tho docodon' prior to hls/hor dooth 010 doducliblo against hls/hor to,xohlo
os'u'o.: In uddlllon III dohls Incur,odhy ,ho ,Iocodont at os'oto, o'hol I tOllU uro clull1luhlo Including, the cost 01
administration, nttornov loos, Ilduclarv loos, lunorlll and hurlal oxponlos incladlng tho cOlt 01 0 burial 101, lomb.tono
or grovo marko, Imd o'hot IOlnlod burlol oXllonaos,
All dob,s bOlno clolmod ooolns' on os'n'o aro suhloct to ,he opproval of ,ho Roolltor 01 WllIswllh whom tho
Inheritonco TUK Roturn Is Illod. Evldenco '0 sUllporl ,he docodell"s or ,he ostuto'slloblllty lor the debts belno
clolmod should 110 attached to this schodulo. '
A lomlly oXl/milllon may 110 clollllod hy 0 spouso 010 Ill/codont who died domiciled In Ponnsvlvonlo, II thoro Is
no spouse, or If tho spouso has for/ol'od hls/hor rights, ,hon any child 01 tho docodent who I. 0 momb" of tho some
household con clOltll tho oKemptlon. In tho evont Iho,o Is no such Sllouse or child, tho oXllnpllon con be claimed bv
o poront or Iloronts who oro lIIelllhors of ,ho some housohold os Iho docedon', The lomlly eKomptlon Is allowable onlv
against assets which poss by o,wlll or hy 'ho Pellnsylvonla In'ostato Lows. '
NOTE, COlllponsollon Ilold to on oslota roprosonlotlve; namelv, on eKecutar or administrator, lor urvlclll
perlormed In admlnlsterlno on oslalo Is ropor'llhle lor Ponnsylvanla Income TOK purposes. This taxable Incollle
Item should be roporlod On forl1l PA.40.I"dlvlduallncollle Tax RotulII,
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INSTRUCTIONS FOR COMPLETING SC~"
1. If the lomllv oxomplion I~, holng clolmod, Indlcoto tho claimant's noma, address and his/her relationship to
the docodent. Enter "family eKolllpllon" In .tho remarks colul1ln' and the amount claimed In the amount colul1lll.
2. ASSign consecutlvo numhors to oach 11011I Ilstod.
3. Enter the dato on which each deht was Incurrod and/or paid.
4. Enter tho nalllos 01 ooch poveo,
S. Provldo,o hrio' oxplonolion, In tho rOll1o,ks column for ooch debt claimed.
6, Entor the amount 01 each dobt belno clalmod, '
7. Tho form must bo slgnod bv tho porIon who 1108 assumed tho ,osponKlblllty lor paving the debts,
IF ADDITIONAL SPACE IS NECESSARY USE aWl x 11" SHEETS,