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Pile !'lumber
E.lote !'lame
INHF.:RITANCt:: TAX SUMMARY SHEET
(BUREAU USE: ONLY)
~1-01-07~7
ABV.4.4 aMt 110401
Mildl'ad M. 1'1011'
-------~.---'------..-.-.-~.
IilOrllllnol
D,$upplemonlol
o Remainder
Pol. of P.alh
500101 SeaurllY !'lumb.r
JU~U6.190j.
200-10-4609
REPORT OP I!'lHERITA!'lCE TAX APPRAISER
I, th. underelgn.d duly appalnt.d Inherltano. TOM Appral.., In and far the County af Cumbavl.llnd
Plnntylvanla, do I'tepeotfully r.p." that I have opprolltd tho roo I ond p.rtanol proporty 01 ritpartod I~ tho faregolh~
rettlmat tho valu.. Itl forth oppo.lt. eaoh It om In th~ lut oolull\n to tII. r ht In S dul.. ......., "8 ',"C", and', B"
Dotodl Janu<\PY 4 , 1992
INVINTORY
C
Y~~UI AS APPRAISlD COOl ADJUST""IHTI
(HARRIIIU 0 UII OH~Y)
00+
5 000 00 '0+
Nona ~+
Nona 10+
__0_'_'.-
$ 6,800 00 40.
-
RIMAIIlDIR APPRAISlMIIlT COOl
Rlol Proporty (Iohldull A)
Po,unol P,oPllty (Sohldull B)
Joln..Hlld Propllty (lchldulo I)
T,onl'"1 (Iohldull C)
TOT A~ OROSS AsUTS
~I" Olbtl ond Oldultlonl
(ICH 1l0U~ II 1')
C~IlAR VALUIl 01' "TAU
o Llf. Belale
D "'nnulty
.
--,
e..
BAllI
flACTOR
PRINCIP~I
--
VA~UI
COOl
-
--
h- -
POR 1II$ OP R'9IST~R OH~\'
To. on S
To. on I
To. on S
. To. On S
T.. on S
".mpllon.
Totol Iltoll
wa
COMPUTATION OP1'A)(
S
S
S
S
S
6%
\5%
TOTAL TAX
IHTlRlln PROM,
nA~ANCI
, TO
S
S .
S
~... Crodlll
OATI 01' PAYMINT
AMOUNT PAID DISCOUNT
$ + $
INTeRlST
- $ .
+
.
BAL~HCI
TO
1O " ,
1O
a
~
i ~ ~ :t1 C'l ~
.-; .
~ -'I' i
~ M ] O'l .-;
. 1O
111 ~ O'l,
~. ~ . 'm ::1
<'l J
. 13
,~ ~ ~
. :l
p::
9 ' ,
IS '~ t5 ~ ~
~ .~ ~ cl
z
i ~ "g ~ ~
~ ~ 8
~
IHv..ID!! 1-Xl (;1'"01
COMMONI"/EA~ TH Of PENNRVWANIA
OEI'AIITMENT Of IISVBNUS
TRANSfBR INHERITANCB TAl<
RSRIIJENT IJBCBIlHNT
SOHEDULE "F"
8TATbMHNT OF OHOTS
AND OPPUCTlON8
- ,', r - I r ~_..~ ~ "~~~,,'T'
fatalo of _k1~lc1.!tBd }". _~,2}L_."_C_m-"-___ Pato of Daoth ,7/26/81
WHEN CLJ\IMINO THE FAMII.VEXBMPTION, COMPl.liTE THE FOLLOWING,
I nu
, ,/ :I. ') 'j
Fllo No,,2b.; b Ie<
Clol1l1l0,I c;JBorC'/1ll 13 .Wolf [1"101101181111' 10 D(Ic"ci""1 Husband
CloI1l1l111l" ^dd,,,," "111111" IIf [I,,, ",UII,I'" n",,11I It. D.4~2, BOX 412, Mechaniosburg I Pa. 17055
, '~~~ DAn NAME Of fA V 1ft REMARKS AMOUNT
1 072 ';76J, ueU of 'VonnBYl.vani~ telephone bill 24.99
---"" Ilh6/61 .-..,~~..--."".-,; ,--, " '
2 'ihus ~ldil1oC 01ds~nc. automobile repair " 77.91
'1J;g/~~ "ri"""""'__~~""~_""""~"--"_""_,,,
,I MllIUlis,mg,JJ tall ,'md:l.,.!on Comnan eleot.ric bill 77.11
4 U/4I4a! IUtl4olll.th l\rnold ,school ocouoation tax 147.00
O/a1/u~ IUU.I\bllth 1\.."",1 d 0 48'1 39
~~ school ,real estate tax
6 [1/141.91 .l!.Y~l:1l Eunera1 Home funeral services , 2 I 911.40
'7 0/3/01 'vhll etatBl:lman Group , auto insurance 116.30
'7/29/0J. - - minister ','
fl ,paro~ I<at;jariae 0 50.00
~~ --
9 food and beverages 50.00
-" ,'. ".,' --
..u.. POlo n .D.2.lL ' " transfer title 44.00
11 O/tQL1ll 1-..lU:.\!! Shield & Blue cross health insurance 129.30
12 8/15/13' ~'anun1c;mt g,gmoanv 'inscr~ptio.!!... of name 110.00
13 8/15/8 Qe;orCllil D. Wolf fsmi1v exemotion .. . 2.000.00
I, .
.
--- .
-
.. .
- -
- 0
, '0
0
.
_-......,... - .
..
- -:. -
'0 ,0
0
-
0 .. 0
'""-'--- -... .
0
l-...:_..__,....;...... _~......,......._~.:..:...~ .-.-.---.~.- TOTAL I -. --
6,225.40
-
I hornby co/lilY Ihat Id.lhu bOIl 01 my knuwlodgo and belief tl1elorogolng II a.just and true statement Of debts, funeral
ONIlOlllOI and ON 11011105 of adl11lnlll/atlol1submllled to the oslale as deductions for Inherltanc Tax purposes, ,
A.hlJ, /2,1/11
OATE, f'
SiGN llll~ f 'I ClAll
OFFIOIAL USE.ONLY
UUnl'D AND DIlDUCTIONfl ARE AI.1.0WEO IN THE SUM OF $ . '.~.;f ':<.6-: .l/t> AT
J
"-
J .,(,/"(.4-.-)
TAX RATE
1- ~ -,?.P....
fIATI-
VENERAL INHERITAN~E TAX INFORMATION
Unsot/sfled II~bllltlos Incurred by tho docodont p,lor to hla/her dooth ore deductible ogalnst hls/hor taxable
18tate. In'addlflon to ,d.bts In,;uttod by Iho decedont or os tot., othor Itomlare clalmobl.lnclvdlng'he coat 01
odmlnl.ttatlon, ottorn.Yf.es, flduclorylees, funetal and burial expensos Including tho cost of tf burlollot/tombstone
or groVe morkor and oth.trelat.d burial oxpenses.
Alld.bt. being c:lolmed ogaln.t on ostofe all subject to tho approval of the Rogletet of Wille With, whom the
Inheritance Tax Return" lIIed. !!vldence ,to support tho decedent's or tho estate's liability fot the debtl being
claimed shou,ld be attoch.d to this schedul..
A family .xemPtlon mor b. claimed by a spouse of a dec.dent who dl.d domlcll.d In Pennsylvonlo. If there Is
no IpOUSO, or, If the IPOUse hos forf.ltedhls/het rlghts,thon an(chlld of ,tho d.ced.nt who I e a member of tho lamft
hou.,hold can clolm tho exemption. In tho .ventth.t. Is no luch epouse or child, tho 'l(lII11ptlon can ,be clolm.d by
o parent or Ptltont. who are memb.ts,f the same household as tho deced.nt" The family .xemptlon Is ollowob/e only
agolnst 088.ts which poss,by a will or by tho Pennsylvonla Inteetat. L.aws. .
NOT!!: Comp.nsOtlon paid to an estot. repteuntntlve/ nam.ly, on .xecutor or admlnl.tro'tot, lor servlcee
perfotm.d In adminIstering an eetate la repottablefor Pennsylvania IMom. Tax pUtpaaes. Thlstaxobl. Incom.
Item should be r,pOtt/ld on form PA.40./ndlvlduallneol)1e Tax R.turn.
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INSTRUCTIONS FOR COMPL.!!TI~GSCHEDVL.~ ..!...
1, If tho family exemption II b,'ngt:lolm.d, Indlciate, the c/almant'. nome, addtossarid hls/h..t relotlpnsh Pto
tho decadent. Entot "family oXl/mptlqh" In the rematks column arid tho amount clalmod In the amount olumn.
2. Assign cOnUcutlvenumbers to,ooch 'tern listed. ,
3. Ent.t the date on which each debt Was'lncurred and/or pold.
4. enter the nam.. 01 ~ach ~oy.e, '
S. Provide 0 brief explonallon In the ren.ark. column fat each debt clolmed.
6. Enter the. Omount o/eoch debt belno claimed.
7. The fotm must be signed by the pet.on who has QS,sumed the reeponslblllty' fot poylng the debts.
IF ADDITIONAL SPAC!!ISNECESSARY USE aWl x 11" SHEETS,