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REV-1S.qO EX + (9-81)
..... BUREAU OF EXAMINATION INHERITANCE TAX RETURN
'PENNSYLVANIA DEPARTMENT OF REVENUE RESIDENT DECEDENT
P.O. BOX 8327 File Number 21-78-435
HARRISBURG, PA 17105
Decedent's Name (Last, First, and Middle Initial) Decedent's Address
RUDY, Violet M.
DECEASED Social Security Number I Date of Death 6480 Wertzvi11e Rd.
202-20-1713 6-27-78 Eno1a, PA 17025
CHECK 1. Original Return D 2. Supplemental Return W 3. Remainder Return D
APPR 0-
PRIA TE 4. Life Estate D 5. Federal Estate Tax D
Return Required.
BLOCKS 6. Decedent died testate D 7. Decedent maintained a living D 8. Number of safe deposit D
(Attach copy of Will) trust (Attach copy of trust) boxes inventoried
All correspondence and confidential tax information should be directed to:
CORRE-
SPONDENT Name MURREL R. WALTERS, III, ESQ. Address
105 East Main St.
Telephone No.
(717) 697-4650 City Mechanicsburg State PA 17055 Zip
Recapitulation
1. Real Estate (Schedule A) ( 1)
2. Stocks and Bonds (Schedule B) ( 2)
3. Closely Held Stock/Partnership Interest (Schedule C) ( 3) ,::::0
Mortgages and Notes (Schedule D) ( 4) "
4.
5. Cash & Miscellaneous Personal Property (Schedule E) ( 5)
RECAPIT- 6. Jointlv Owned Property (Schedule F) ( 6)
ULATION 7. Transfers (Schedule G) ( 7)
8. Total Gross Assets hotal lines 1.7) ( 8)
AND Funeral Expenses Administrative Costs/Miscellaneous ,-
9.
Expenses (Schedule H) ( 9)
TAX 10. Debts/Mortgages/Liens (Schedule I) (10)
11. Total Deductions hotallines 9 & 10) (11)
12. Net Value of Estate (!jne 8 minus line 11) (12)
CALCU- 13. Charitable Bequests (Schedule J) (13)
LATION 14. Net Value subject to tax Wne 12 minus line 13) (14)
Computation of Tax
15. Amount of line 14 taxable at 6% rate (15) x.06=
(include values from Schedule K)
16. Amount of line 14 taxable at 15% rate (16) x.15=
(include values from Schedule K)
17. Principal tax due (add tax from line 15 plus tax from line 16) (17)
18. Total Prior payments:
(a) Amount Paid
(b) Plus Discount
(c) Minus Interest (18)
19. Balance Due Wne 17 minus line 18) (19)
Make Check Payable to: Register of Wills, Agent
* * * PLEASE RECHECK MATH * * *
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has
any knowr~ ~, ,;
SIGNATURE OF PERSONA R~;;ESE~IVE(S) ADDRESS
U D. Box 240 Dil1sbur PA 17019
R. Walters, III, Esq.,
105 E. Main St., Mechanicsburg, PA
E OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS
oC5r 1..& I q f' J
DATE
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1llV.1508 v<+ (9"1)
,....
eoMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "E"
CASH AND MISCEllANEOUS
PERSONAL PROPERTY
FILE NUMBER
RUDY, Violet M.
21-78-435
(All propeny JOlntly-owned with the Right of Survivorship must be disclosed on Schedule UFU)
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
2.
Clara J. Cassel - Repayment of personal loan.
$1,660.00
The above item was recorded on Schedule "B"
(personal property) of a supplemental return
which was filed with the Register of Wills of
Cumberland County on January 31, 1980. This
item pertains to an unrecorded agreement for
the purchase of real estate which was situate
at 115 South East Street, Carlisle, Pennsylvania.
Clara J. Cassel, the daughter of the deceased,
made an arrangement with her mother in 1973 to
purchase the property from Jerry J. Pacek and
Mary E. Pacek, husband and wife. Because Clara
J. Cassel was unable to individually finance the
transaction her mother assisted her by contributin~
financially to the purchase. At the time of the
death of decedent, Clara J. Cassel had a balance
due and owing to her mother of $1,660.00, which
was reported in the personal property schedule
of the supplemental return. The estate conveyed
its interest to Clara J. Cassel by deed dated
October 31, 1978, and recorded in Cumberland
County Deed Book 0 , Volume -;1.. 8' , Page 4' s> / .
TOTAL (Also enter on line 5, Recapitulation) $
(If more tp8ce Is needed Inun addltiona' sheets of ume size)