HomeMy WebLinkAbout09-19-96
A ^\ t::H I) E lJ,
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPUCATE
WITH REGISTER OF WILLS
AEV.taoou t(7."41
CAB
H P L
E P 0
CRC
KOK
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cOM~~m~~.:'r'lf",fl1,'i''j)'brANIA
, T,...."
HARRIS U 0, PA 11\21-0101
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DECECENT'SNAME (LAST, FIRST, AND MIDDLE lNlTlAll
Herendeen, Jamea H,
SOCIAL SECURITY NUMBER DATE OF O[ATH
108-10-2173 10/01/1995
DATE OF OIRTH
06/07/1907
FOR QAT[SOF orATH AFTER U131111 CH[CKHEAE
IF A SPOUSAL
P AT'VC TI AIM
FILE NUMBER
21-95-0777
COUNTY CODE
DECEDENTS COMPLETE ADDRESS
50 Circle Drive
East Pennsboro, PA
Calmly
Cumberland
(IF APPllCABLEISURVlVlNG SPOUSE'S NAME (lAST,FIRST AND UIDDLE INITIAL)
Herendeen Eleanor F.
I, Original RoMn
4, Umllod ESlalo
R
E
C
A
P
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A
T
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N
T
A
X
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SOCIAL SECUFUTVNUMBER
165.30-2059
YEAR
NUMOER
AMOUNT RECEIVED(SEE INSTRUCTlONSI
0.00
!Kl5.
...!- 8,
Romalndor Roturn
(for dalos 01 doalh prior 10 12-13-B2)
Fodoral Eslalo Tax RoMn Roqulrod
Total Numbor 0' Saro Doposit 80lCDS
'1.)
, -
,
'J
"J
(8)
(B)
63,461.13
2. Supplomonlal RoMn
X... FuMO Inloros, Compromlso
(lor dalos of doalh anor 12-12-B2)
[ID 8. Oocod.nl Diad Toslal. 0 7. Docodonl Malnlalnod a Uvlng Trus,
Anech co 01 Will Anach a co of Trust
C P ALL CORRESPONDENCE AND CONFIDEtmAL TAX INFORMATION SHOULD BE OIREC'TED TO:
R 2 NAME COMPl.ETE MAIl.ING ADDAESS 0 ()
R 0 Robert L. Keck A. V. P. & T .0. Dauphin Deposit"' B'iink ani! Trus,t,='Company
Ii ~ T'LEPHONENUMBER 213 Market Street ,'.
- T 717 255-2140 Harrisbur PA 17101 .,
1. Roal Eslal. (sChOdulo A) (1) 09. 00.00
2. Slocksand Bonds (Schodule B) (2) 739 .138.13
3. Closoly Held Slock/Portnorshlp Inl.rosl (Schodulo C) (3) 0 , 720.00
4. Mongogoo and Nolos Aocelvoblo (Schodulo D) (4) 25,321.12 <
5. C..h, Bsnk Doposl1o & Mlscellanoous POlSonal Proporty (Sch, E) (5) 51 , 651. Zl
6, JOlnUy Ownod Proporty (Sch.dulo F) (6) Nona"
7. Tlsns!.IS (Schodulo G)(Schodulo L) (7) 0 ,495 . 00
B, TOlal Grosa Assots (Iolal Unool-7)
9. Funeral Expenses, Administrative Costs, MlscoDaneous
Expanses (Schodulo H)
10. DobIS, Mongog. UablllU.s, Uons (Schodulo I)
11. Tolal Doductlons (Iolal Unoo 9 & 10)
12. NOI Valuo 01 ESIOIO (Uno 6 minus Uno 11)
13, Chnrl1ablo ond Govornrnonlal Boqu09ts (Schodulo J)
14. Nol Valuo Sub ocllo Tax Uno 12 minus Uno 13)
15. Spousal Trons!olS (lor dslos 01 doolh anal 6-30-B4)
Soo Instructions for Applicable Percentage on pago 2.
(Include vaJues from Schedule K or SChodule M.)
18. Amount of Une 141oxoble e16% rato
(Include values from Schedulo K or Schedule M.)
17. Amounl or Uno 14 Inxoble e118% ralo
(Includo voluos Irom Schodulo K or Schodulo M,)
lB. Prlnclpallox duo (Add lax Irom Uno 15, lB and 17,)
lB.Crodlls/Sp povorty Prlol Poyrnonls Dlscounl
0.00+..36,117.44 + 1,315.79
20. "Uno 1910 groalor Ihon Uno 16, onlor Iho dllloronco on Uno 20, This Is Iho OVERPAYMENT.
~ ~ ICheck here If you are requesUng a refund of your overpavmentl
21. II Une 1819 gr08tor thon Uno 19, ontor tho dlfforence on Uno 21. ThIs Is the TAX DUE.
A. Enler Ihe Intorost on the balance duo on Uno 21A.
B. Enlor Iho 10lal 01 Uno 21 .nd 21A on Uno 21B, This Is Iho BALANCE DUE.
Make Check pa ble to: Re later of Wills, A ent
~ ~ BE SURE TO ANSWER AlL OUESTlONS ON PAGE 2 AND TO RECHECK MATH ~ ~
Unaerp.naltl" of p"Jury,1 a.el"" thai I hall" ..am.n.a Ih', r.lurn, ,"clUdtngaceompanYlng len,dulu "nd 1I.lIm,n". .nd 10 Ih. tllIl of my II;nowl.d;. and tI,II", nl' trul,
cor'let and compl,t... d,ell.r. lh.t all ,..Iutlt. 1'1.. bun ,.portll!' It Iru. marhl ",.Iu.. O.claratlon of prtpa,., other thlln th. perlonll,.p,..,ntltlll'.l. baud on .lIln'o,matlon of
whlehPr.pa'.'h....nyknowl.dg..
(10)
10,180.74
(11)
(12)
(13)
14
(15)
241 , 788,50 X Q!.._
(16)
621,887.09x ,OB-
(17)
0.00 X .15-
(18)
Intorost
(lB)
(20)
(21)
(21A)
(21B)
SIGNATUAE OF PEASON AESPONS1BLE FOR FIl.INQ AETUAN Dauph in Depos i t Bank and Trus t Company
213 Market Street
'.I~ ii;;rri~.bur- -"PA. Tiior --... - -.. ...... ..---------
Dauphin Deposit Bank and Trust Company
213 Market Street
il;'''rri~.bur~.'- - PA.. i "fioi - - - - -. - - -... - - - - -. - - -. - - - _.
Copyrlllhtlel111S4 farm .oftwa,. onl)' CPS)'llem., Inc.
oR
\
942,325.46
73,649.87
068.675.59
5,000,00
063 675.59
0.00
37 , 313.23
0.00
37,313.23
37,433,23
120.00
0.00
0.00
0.00
OATE
'I/'v( 9 L
DATE
Fo,m 1500 (A,,,,. 1-11"'1
~ .,;.
"IV - taOI EX + IU....)
eO"!I.'1ll)!CMIJN:t1.qr.C'IM':G.YAN'A SCHEDULE A
'illlilb1'N't'bm'b'k'N'f" REAL ESTATE
UTAT1! OF FILl! NUMBER
James H. Herendesn 55. 108.10.2173 10/01/1995 21.95-0777
(fIruperty ,olnUy_ee1 WlIh Rlgh' of Burvlvoralllp mu.'''' doc/OMd on 8choclul. F) All ,..1 ...... Ihould ... ,."..n.d ., "'Ir _, v.lu.
whlclll. delIneel .. th. prl.. ., which property would... ..<h.nged "'lwMn . wllllng buy.r .nd . wllllng Mll.r, n.lth.r ""ng COlIlpIlleello
or MIl both hevln _nabl. knowl of th. "'lVon' "'ell.
ITEM
NUMBER
1
DESCRIFTlON
VALUE AT DATE
OF DEATH
109,000.00
House
Ranch
old.
end Lot, 50 Circle Drive, Camp Hill, Cumberland County, PA,
styla house with brick and aluminum extarior. 35 years
Value based upon appraiaal copy of which ia attached
TOTAL Also onlor on IIno 1, Reel ltullllon
(II moro Ip",is n..dod, In.." Iddl1lonaJ ah..ta 0' lame mo.)
COPyrtghl (c. 11114 'a,m IOflwa,. only CPSYlt,ml, Inc.
. 109 000.00
Fo,," 1500 Schedul. A (A..... n..nl
-~--~_""'J.o;l"-~~,,,,~,,-,~'.;..,,, :"~"'-'-''''-<,-N--'Tt~''_'''"'';tJ::-,<,g>.,.,rn1,.-;::;H_\1t'i<'l_''''"",~;'<~,~",..'-,~,.
REV- 1101 EX + I....'
COM::'\l\lrt't~~'ltc\W~jhY.Nl.
ESTATE OF
SCHEDULE B
STOCKS AND BONDS
James H. Herendeen SS~ 100-10-2173
All
ITI!M
NUMBER
1
9
10
11
12
13
14
15
16
17
10
19
10/01/1995
oln -owned wtth RI ht 01 Survtvo..h must b. disclosed on Schedulo F.
DESCRIPTION
200 share a Amoco Corp
2
200 ahares AT&T Corporation
Accruad Dividend
3
4
109.7512 shares American Water Works Inc
750 shares Be11South Corporation
500 shares Citicorp
733 shares CoreStates Finl Corp
300 shares Co1umbia/HCA Healthcere Corp
4,005.244 shsres Dean Witter Multi St Mun Series Trust
PA Series
5
6
7
o
10,679.003 shares Desn Witter U.S. Government Sec Trust
200 shares Duke Power Co
500 shares Deen Witter Coldwell Benker Tax Exempt
300 sheres IntI Business Machines Corp
400 shares Johnson And Johnson
300 shares Merck & Co Inc
Accrued Dividend
3,320.066 shares Municipal Income Opportunities Shares
of Beneficisl Interest
6,577.445 shares Nuveen Municipal Bond Fund Inc
641 shares Nuveen Tax Exempt Unit Trust Insured PA
Series 143
Accrued Dividend
105.374 shares Nuveen Municipal Bond Fund Inc Class A
000 shares NYNEX Corporation
Total of Continustion Schedule s
TOTAL Also ontor on IIno 2. Roc Il1JIa~on
(II moro .pace ,. noedod. In.on addition'" .hoets 01 .ome slzo.)
Copyrlght(Cl1l14 rotm 10ttW.t. only CP5Yltlm., tnc.
FILE NUMBER
21-95-0777
VALUE AT DATE
OF DEATH
12,825.00
13 ,068.75
66.00
5,050.57
54,937.50
35,671. 88
27,006.47
14,653.13
51,539.32
96,432.12
0,706.25
1.00
20,340.63
29,475.00
16,996.88
102.00
27,040.54
60,052.07
60,266.50
347.74
962.06
30,000.00
140 700.72
S 739 130.13
Fotm 1600 Sch.dul. B IA.v, ._111
Estate of: James H. Herendeen
Soc Sec~: 100-10-2173
Date of Death: 10/01/1995
Continuation of Schedule B
(Stocks and Bonds)
Item Description
~
20 1,000 shares PP&L Resources Inc
21 200 shares Sunrise Hedical Inc
22 000 shares Exxon Corp
23 $10,000 Allegheny County PA Bonds HBIA DTD 07/15/94
5.075% due 09/15/2011-04
Accrued Interest
24 $10,000 Delaware County PA Ind1 Dev Authority
Po11utn Conto1 Revenue Bonds Scott Paper Company
Project DTD 11/01/76 6% due 11/01/2006-95
Accrued Interest
25 $10,000 Hechanicsburg PA Hun Authority Sewer Revenue
Bonds 4% due 06/01/96
Accrued Interest
26 $10,000 Pennsylvania St. Turnpike Commission
Turnpike Revenue Bonds Series L HBIA DTD 06/01/91 6%
due 06/01/2015-01
Accrued Interest
27 $10,000 Phi1sde1phia PA RFDG Series A 5.25% due
05/15/2004
Accrued Interest
20 $10,000 Temple University Commonwealth System High
Fund Commonwealth system of Higher Education PA
Hospital Revenue Series A Bond 7.25' due 08/01/2016
Accrued Interest
--'~~~,I'~",~?'.._,....t\\o<t~~r~~;"~";F!..-.:~-:-'.f',"i"-"""""~''''''''I'.....J'f'~':''-''>f,",'",",-i''''~_'''',''''''VI''''~';W'",,,,.....,,,,!...._:'."..,".._,,~,.".;;<
Unit Value at Date
Value of Death
23,201.25
5,425.00
57,625.00
10,275.40
26.11
10,111.73
250.00
9,906.40
133.33
10,079.40
200.00
10,299.95
190.33
10,775.03
120.03
......-...................
140,700.72
REY-1Ior lEX . cr...)
cO"~\{\l~~~"r.FtW~'N"
ESTATE OF
SCHEDULE D
MORTGAGES AND NOTES
RECEIVABLE
PIIHI Print or 8
FILl! NUMBER
21.95-0777
James H. Herendeen
SS" 108-10-2173
10/01/1995
All
ITI!M
NUMBI!R
1
oln -ownlel wlth tho RI '01 8urvlvorah mUI' be cloolo_ on 8ohodulo F.
DESCRIPTION
Bond and Hortgage for $25,321.12, originally dated July 23, 1986,
Jamea H. Herendeen, Jr. & Nancy Herendeen; premiaea at 309
Blacklatch Lane, Camp Hill, Cumberland County, PA 17011 due July
23, 2003; Current interest payabla at 7.5\ per year on the firat
day of each calendar month recorded in Hortgage book volume B25,
paga 896 unpaid principal balance on date of death.
VALUE AT DATI!
OF DI!ATll
25,321.12
-
TOTAL Also .nl., on IIn. 4. Reel IMlIlon
(If morl .p"ce Is n..dld, In..rt .ddlUonaJ Ih..ta 01 lame Ilz..)
Cop)'flgtlt(c) 11184 form IDftwlllanly CPSYlt''''I, I"c.
S 25 321.12
Farm 1&00 Sch,dule 0 (Ae. 7-111
'_-&.",.,_^~,._{i_,...._...._,.
'~."J.,.'''-'
SCHEDULE E
CAS I'!, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
REV- "01 EX. 11.111
CO":!.Il\;rb\~?\'~t.W~.NI.
eSTATI! OF
Piease Print or .
FIll! NUMBI!R
21.95-0777
James H. Herendeen
SS# 100-10-2173
10/01/1995
oln -ownld with RI hI 01 Survlv.rohl mUll b. dllel.lld on Schodulo
DESCRIPTION
PP&L Resources Inc - Dividend
VALUE AT DATE
OF DEATH
417.50
All
ITEM
NUMBER
I
2
3
Cepitel Blue Cross Security 65
Premium Refund
106.40
Corestates Finl Corp . Dividend
249.22
4
$25,000 Dauphin Deposit Bank Certificate of Deposit #8100914622
7.02\ due 10/20/97
Accrued Interest
25,000.00
936.24
125.00
5
Dean Witter Coldwell Bsnker - Dividend
6
Dean Witter Money Market Fund
22,733.05
7
Ohio Northern University - Check for final quarterly gift annuit
dated September 20, 1995
145.00
o
Household Furnishings . Value per appraisal by George Haar
1,850.00
TOTAL Also .nler on nna s, Roc hulsdon
(An.ch oddlllonal81/'J!' . 11' .h.... d more .plcal. n..d.d.)
Copyrlght(c) 11114 for," .altwatt only CPSy.t,ml,lnc.
S 51 651.21
For," 1500 Schldul. E (Alv. 2-1')
7" '-'~~~'- -, -."- ..-----...,."'.>-"'''',.~,,. -..,~,. ....'....._i:>!A(.co--r
REV.. tlOI EX + 112.11.
cO":I.\l\lffi\"l~~W,WhY'NI'
ESTATI! OF
James H. Herendeen
SCHEDULE F
JOiNTlY-OWNED PROPERTY
SS# 108-10-2173
10/01/1995
FlU! NUMBER
21-95-0777
Jolnttonlnl{I):
NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
B.
c.
Jolnlly-ownod property:
ITEM LETTER DATI! TOTAL VALUE DECO'S DOUAR VALUE OF
FOR MADE DESCRIPTION OF PROPERlY
NUMBER JOINT OF ASSET "INT. DECEDENT INTEREST
TENANT JOINT
TOTAL IAlso .nlor on line 8, ROC.DIMllIonl 0.00
(II more opo.. 10 neodod, Inoart .ddlllonol oheela of ooms 112.,)
Copyrtghtlcl11D4 form laftwat. anlyCPSYltll'lll,lnc.
Farm 1500 Sch.dur. F (R.v. 12.")
REV- 1110 EX + (2-111
cO"If.\{\lfC'E~~~W,Whl"NI.
ESTATl! OF
SCHEDULE G
mANSFERS
PktUG Prtnt or 8
FILE NUMBER
21-95-0777
James H. Herendaen SS# 108-10-2173 10/01/1995
llllS SCHEDULE MUST BE COMPLETED AND FILED IF lllE ANSWER TO ANY OF lllE QUESTIONS ON PAGE 2 IS YES.
ITEM DESCRIP1l0N OF PROPERTY EXCLUSION TOTAL VALUE DECO'S DOLlAR VALUE OF
Inckldl na",. at th. tran,I.,.., th,l' OF ASSET ""NT. DECEDENT INTEREST
NUMBER relatlan,hlatad.c.d.n' ci;i;a'"an,t.r,
I Alice H. Clark - Cash Cift 200.00 200.00 0.00
on 12/15/94
2 Choice in Dying, Inc - Cash 15.00 15.00 0.00
Gift on 11/16/94
3 Chari and Jeol Krenis . 1,000.00 1,000.00 0.00
Cash Gift to Daughter snd
Son-in-law on 12/15/94
4 Chari Briggs-Krenis - Cash 3,000.00 5,125.00 2,125.00
Gift to Daughter on 03/04/95
5 Chari Briggs-Krenis - Cash 4,070.00 4,070.00
Gift to Daughter on 06/12/95
6 Deborah Shapiro - Cash Gift 50.00 50.00 0.00
on 12/15/94
7 Handgun Control - Cash Gift 20.00 20.00 0.00
on 12/03/94
0 Holy Spirit Hospital - Cash 100.00 100.00 0.00
Gift on 12/03/94
9 Marissa K. Briggs - Cash 50.00 50.00 0.00
Gift on 12/15/94
10 Nancy E. Herendeen - Cash 1,000.00 1,000.00 0.00
Gift to Daughter-in-Law on
12/15/94
11 Pamela A. & Gerry Kaskas - 1,000.00 1,000.00 0.00
Cash Gift to Daughter and
Son-in-Law on 11/00/94
12 Project Hope - Cash Gift on 15.00 15.00 0.00
11/16/94
13 Rachael Herendeen - Cash 50.00 50.00 0.00
Gift on 12/15/94
14 Rebecca Herendeen - Cash
Gift on 12/15/94 50.00 50.00 0.00
Total of Continuation Schedule ( ~ \ 1 500.00
TOTAL (Also entor on IIno 7. Rocaollllllllonl IS 8 495.00
(If moro Iplca II noodod, In...n oddldonai ahoots 01 aarno alzo,)
CaPV,lghtlClll11l14 'a,", .otlw", only CPSy.t'"", Inc.
Fa'," 1500 Sch'dul. Q (R.v. 2-111
~-';'-
"'.,....
Estate of: Jemes H. Herendeen
Soc Sec~: 100-10-2173
Dete of Desth: 10/01/1995
Continuation of Schedule G
(Trensfers)
Item Description of Property
~
Exclusion Total Value
of Asset
Decds Dollar Val of
'Int Decds Interest
15 Solange Reoch - Cash Gift
to Granddaughter on
03/10/95
2,000.00
2,000.00
0.00
16 Solange Reoch - Cash Gift
to Granddaughter on
09/05/95
1,000.00
2,000.00
1,000,00
17 Solange Reoch - Cesh Gift
to Granddeughter on
12/10/94
500.00
500,00
10 The Salvation Army - Cash
Gift on 11/14/94
50.00
50.00
0.00
19 Tom O'Donnell - Cash Gift
on 12/17/94
10.00
0.00
10.00
20 United Way of The Capital
Region . Cash Gift on
10/13/94
300.00
0.00
300.00
21 Vania Briggs - Cash Gift on
12/15/94
50.00
50.00
0.00
22 WITF TV 33 Cash Gift on
12/17/94
0,00
75.00
75.00
23 WITF TV 33 . Cash Gift on
01/10/95
100.00
0.00
100.00
1,500.00
.)
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
REV -'It' EX . ('.11)
COM\1.'ll\lf1;\~4\~~WJVhl"NI'
ESTATI! OF
James H.
ITEM
NUMBER
A.
B.
1.
:z.
3.
4.
c.
Pi..... Print or
FILE NUMBER
21-95-0777
Herendeen
SS# 100-18-2173
10 01 1995
DESCRIPTION
I
Fun...ll!llpen...:
Eleanor F. Herendeen
Reimbursement for Internment License Fee
2
Eleanor F. Herendeen
Reimbursement for Wake Expenses
3
Myers-Harner Funeral Home Inc - Funeral Expense
Admlnl.lrIIUv. eo...:
PllI1lOnal R.presen,.Uve Conmlsalona
Social Socurfty Number 01 Pel1lOnal Represen,.Uve:
Ve.. ConmlsaJon. pald 1996
-23-1930033
Attorney Foeo
Wion, Zulli & Seibert
Family exempllon
Clalmanl Eleanor F. Herendeen
Addr... 01 Clalm.nt el decedent. de.'h
Str.., Addr... 50 Circle Drive
C11y Camp Hill
Rel.Uon.hlp
Wife
S'al.~ Z1pCod. 17011-2610
Frob.'. Foeo
Register of Wills
I
Mlao.Ulneoul expen...:
Credit Bureau of Greater Harrisburg
Property Search
2 Cumberland County Register of Wills - Five Short Certificates
3 Cumberland Law Journal - Cost of Advertising and Proof of
Pub 11ca tion
4 East Pennsboro Township - Utility Expense
5 Eleanor F. Herendeen Reimbursement of Lawn Maintenance
6 Eleanor F. Herendeen Reimbursement for Storage end Handling of
Canopy @ GT Watts Inc
7 George Haar, Auctioneer - Appraisal Fee of Personal Property
o Jerry's Sweeter's Sweet'n Grow Snow - Lawn Maintenance
Totel of Continuation Schedule s
TOTAL Also ontor an IIno 9. Reea ltulsdon
(II more aplce I. needed, In.erllddlttonll .he." 01 ...m. .Iz..)
COPVr1li1ht(cl "D"'or," .altw.,. only CPSy.tlml,ln"
AMOUNT
500.00
296.02
1,132.00
20,000.00
20,000.00
3,500.00
390.00
32.00
15.00
40.00
96.53
121.90
62.50
25.00
68.90
1 172.48
s 63 461. 13
'or," 1500 Sell. dull HIA'v, 7....'
"IV - 111:1 EX + 12-.,.
COM::'\ftlrt'E~{\<l,fW,Whl"NI'
ESTATe OF
SCHEDULE J
BENEFICIARIES
James H.
ITEM
NUMBER
ITEM
NUMBER
Herendeen
FiLe NUMBER
21-95-0777
SS# 108-18-2173
10 01 1995
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
RELATIONSHIP
1
A. T..lble SeqUI.":
Dauphin Deposit Bank and Trust Company,
Trustee under Will for Benefit of
Eleanor F. Herendeen
50 Circle Drive
Camp Hill, PA 17011-2610
Net income and
needfull
principal
Wife
2
Nancy Herendeen
(James H. Herendeen, Jr. Predeceased)
309 Blacklatch Lane
Camp Hill, PA 17011-8413
Daughter-in-Law
2/5 Residue
upon death of
widow
3
Chari H. Krenis
210 Vassar Street
Rochester, NY 14607
Daughter
2/5 Residue
upon death of
widow
4
Solange Reach
5344 Nakoma Street
Dallas, TX 75209
Granddaughter
1/5 Residue
upon death of
widow
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
1
B. Chlllftlble end Governmental Bequests:
Dauphin Deposit Bank and Trust Company,
Trustee under Will for Benefit of
Mt. Calvary Episcopal Church
101 N. 25th Street
Camp Hill, PA 17011.3609
5,000.00
upon death
of widow
TOTAL CHARITABLE AND GOVERNMENTAL BEOUESTS AJoo enlot on line 13. Rae Illlllllon
(II more apace I. needld, Inll8f1lddltlonalahee.. oraome 1l.1.)
Capyrlght(clll1l4 far," .aflw'" a"ly CP5y.tlm.,I"Co
S 5 000.00
Fa,," 1500 SChldul. J (Alv. 2-'71
AEV.l....U(l-ll21
SCHEDULE N
SPOUSAL POVERTY CREDIT
COMMONWEALTH OF PENNSYLVANIA
INttERITANCE TAX DIVISION
ESTATE OF
James H.
FiLe NUMBER
Herendeen SS# 108-18-2173 10/01/1995 21-95.0777
This schedule mJst bo cOr1lJleled and nkJd It you checked the spousal povorty Cfodll box on the COySf' sheat.
LA
(AVAILABLe FOR DECEDENTS DYING AFTER 12131/11)
I. Taxable As.Ol0lola1lrom line 0 (cover .h..l) . . . . . . . . . . . . .
............... .
....... I.
942 325.46
2. Inauranco Proceeds an Ufe ot Oecedonl. . . . . . . . . . . . . . . . . . . . , . . . . . . , . . . . . . . . . .. 2.
0.00
3. ROllremenlBenonll................................."..,........... 3.
0.00
4. JolnlAaaallwtlhSpou.o.....................,................ ....... 4.
0.00
5. PALon8IYWlnnlng....,............,........................ . . . . .. 5.
0.00
e.. 01hor Nonlaxoble Asaoll: U'1 (Anoch schedule II -aryl. . . . . . . . . . . ., e..
0.00
lb.
Be.
ed.
e. SUBTOTAL (Unoo 00, b, c, d). . . , . . . . . . . . . . . . . , , . . . , . . . .
,....... .
.......8.
0.00
7. TOla1 Gro.. Aaaell (Add IIn.. l1h'" o~ . . . . . . . . . . . . , . . . . . . . . . . . . . . . . .. ....... 7.
942 325.46
e. Tolal Ac1ual Uobl1llleo . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ....... 8.
D. NOl Valuo 01 Eato'e (Subtroc1l1no 0 from line 7) , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IIl1no Dlo groolor lhon $200,000 _ STOP. The 001010 Is notollglblo 10 claim Iho crodll.1I nol. conUnue 10 Part II. D. 942,325.46
PART II - CALCULATION OF JOINT EXEMPTION INCOME - (Attach copies of Federallndlvlduallncome
. . Tax Relurne for decedent and li ouse. '. .
Income: 1. TAX YEAR: ID 92 2. TAX YEAR: lD 93 3. TAX YEAR: lD 94
I. Spouoo..............,......... I.. 0 . 00 21. 0 . 00 31. 0 . 00
b. Docodonl................,...... lb. 0 . 00 2b. 0 . 00 3b. 0 . 00
o. Jolnl..,.........,..........." Ie. 0.00 2e. 0.00 3e. 0.00
d. Tax Exompllncomo, . . . . . . . . . . . . . . . " Id. 0 . 00 2d. 0 . 00 3d. 0 . 00
.. Olhor Income nOlllOlod obovo. . . . . . , . . . . .. 1.. 0 . 00 2.. 0 . 00 31. 0 . 00
I. TOlo1.......................... n. 0 . 00 21. 0 . 00 31. 0 . 00
4. Average Joint Exomptlon Incomo Calculation
41. Add JoInt Exemption Income from above:
(II) 0.00
0.00
+(21)
0.00 +(31)
0.00
.
0.00
: 3 )
0.00
4b. Avorogo Joint ExompUon Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
II line 4(b) 10 groolor lhon $40,000 - STOP. The os1010 10 nol ollglblo 10 clolm lho crodll. II nOI, conllnuo 10 Part III.
PART III - CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT
ESTATES
.
1. Insort amount at taxable tranatorslo spausD or $100,000, whlchevor Is loss. . . . . . . . , , . , . . . , . . . .. 1.
2. MulUplybycrodllporconloge(ooolnotruCUono)................................... 2-
3. Thlo 101he omounl ollho Rooldonl Spousal Povorty Crodll. Includo lhlo flguro
In tho calculation 01 total crodlts an Ilno 19 at tho cover shoot. . . . . . . . , . . . . . . , . . . . . . . . .. 3.
4. For Nonrosldents, ontor tho ratio at tho docodonfs grass ostalo In PA to tho valuo 01 tho
docodonfsgroaseslalo, . . . . . . , . . . . , . . . . . . . . . . . , . . , . . . . . . , , . . . , . . . .. 4.
5. Mulllply IIno 3 by IIno 4 and onlor Iho 10101 hore. ThloIs lho omounl ollho Nonrooldonl Spousol
Povorty Crodlt. Includo thlo figuro In tho calculation olIOIa! credits an IIno 19 or tho cavar shoot. 5.
COPYflghf(tlllO. 'arm .oft..,. onl)' CP5)'.t.m..lnc.
5th.dull IR.v.l-i21
REV-114I1EX.tIlUI
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
ESTATe OF FlI. Numb.r
James H. Herendeen SS# 108-18-2173 10/01/1995 21-95-0777
PART A: Enlor lh. descripllon and valuo ollillnloro'lI. bolh taxlblo and non-Iaxoblo, rogardl... 0' Iocollon Ind not 01 deductlonl,
whk:h us to Iho decedent's aurvM sousa will, Inlests . a oration a'law, or otherwise.
Doscrt lion olllema
SCHEDULE 0
TRANSFERS TO SURVIVING SPOUSE
110m'
Amount
240,656.44
Pili A To1el: Enlor lhelo1a1 here and In the opou...o "Amounl Recolved" block on Plgo 1 240 , 656.44
Election To SubJect Property To Tex Under Section 2113(A) As A Taxable Transfer By This Decedent.
1I.1nI1t or aImIlor llITangoment moelllhe requlromenl 01 SocUon 2113(A), Ind:
a. Tho fruit or llnilor lITangotnOnt Is lIotod on Schodulo 0, and
b. Tho value 0' lhe fruit or llnilor 1IT0ngemonll0 onlored In wholo or pili .. an ....1 on Schedule O.
lhen lhelrlnoloro~1 poraonal ropro..nllUvo may opoclncally Idonll!y Ihe frual (all or a tracllonal por1lon or porconlogo) 10 be Includod In lho olocUon
10 hovo luch inial or llnilor proporly trootod .. a taxable lronolor In lhlo os1110. If 108S1hon lho onUro valuo 0' the fruit or oImllor proporly Islncludod
as a taxable transfer on Schedule 0, the porsonaJ roprosenlatlvo shall be considered to have mado the election anJy as to a fractlon of the trust or
llnilor llITangomenl. Tho numerolor 01 Ihlo1ractlon 10 oquallo lho amounl ollho truol or slmllor 1IT0ngomonllncludod as a t..oblo 88801 on Schodulo O.
The donomlnolor 10 oquallo lho 101a1 voluo ollho trual or almllor orrongomonl.
ELeCTION:Do you .11" und.r SecUon 21 13(A) 10 trill.. a taxabl.lrlln.'"r In \hll .Ilal. all or I porUon oIl \rual or Ilrnllor Irronglmlnl
cr..ted for the 80le u.e of thl8 decedent's surviving .pOUI. during the surviving lIpOu.e'a enUre IIfeUme?
YES 0 NO 0 Slgnaturl Oall
Note: If the alscUo" applle. to more than on. trust or similar amngemant. then. leparate copy ot Schedule 0 muat be Iluned and nled.
Part B: Entor \ho doscr1pUon and valuo 01 a11lnlorOSlll. bolh laxoblo and non-laxoblo. regordloss a' IocaUon and nel 0' deducllono,
which ...10 lhe decodonrl aurvlvl . ou.. 'or which a Socllon 2113 A olecllon Is bel mado.
lIem . DosctI lion a' llama Amounl
Pili B Total (108 Inolrucllono)
0.00
Capyrlghtlcl till form .aftwarl a"l,. CPS,.111",.,IIlC.
Farm 1600 Schldull 0 (Rlv. 1-1151
AEY..,..7U.(tO-I'"
COM::.\ftlrrril4\~,lYhl"NI'
ESTATl! OF
James H. Herendeen SS# 108-18-2173 10 01 1995
Tl111 achedulall opproprlate only lor I!olllu 01 _II dying liter December 12, IH2.
This schadule I. to be usod lor sIIMure Inlot8811 whore lhe rile 01 tax Which wtll be appllclble when lhe Mure Inloroal V"lIln
OI8IIlon and on nt clnnal be OO1abllshod with cer1s1n .
Tho Inl1rUment aGIUng lhe 1lJlUre InlotOO1lo:
X WIll
SCHEDULE M
FUTURE INTEREST COMPROMISE
FiLe NUMBER
21-95-0777
TNOI
(PI.... Ittach copy 01 InllNmlnl)
Other
I. IIenoftcll~"
NAM!! OF DATe OF AGE TO
BENEFICIARY RELATIONSHIP BIRTH NEAREST BIRTHDAY
I. Nanc Herendeen Deu hter-in-Law 07 25 43 52
2. Chari H. Krenis Dau hter 11 29 38 57
2. Solan e Reoch Granddau hter 09 02 81 14
4.
e.
II. For decedenl8 dytng on or _ July 1, 1994, " a IUrvtvlng .pouse exercised or Inlends to exon:l.. ono 01 lhe lollowlng wt1hln 9
months 01 the decodonrs doo1h, check the appropU.IO box and oupply a copy 01 the docUmenlln w1tlch the surviving spouse
OlCorcl... such wlthdrllWaI rtght
Unllmltad ~ 01 wt1hdrawll Umttad ~ 1 of wtthdmwl
III. EJplanlUon 01 COmpromlaa Olllr: (If moro opsce 10 noodod, enoch Iddlllonal e.s X II" .heelS)
IV. Summery of COmpromlaa Ollar:
1. Amount Dr Future Interest. . . . . . . . . . . , . . . . . . . . . . . . . . . S
621,887.09
2. Value 01 Uno 1 OlCompt from !IX as amount paaslng to charlUes, ole.. . . . . . . . . . . . . . , . . . .
(a1oo Includa as part 01 tola1.hown on Uno 13 01 covor ShOOI)
2. Value 01 Uno 1 paaalng to .pou.. at appropUololax rolo . . . . . . . . . . . . . . . . . . . . . . . .
Chock 1 Block [KJ 8%, 0 3%, 0 0%
(a1oo Include as part 01 tola1.hown on Uno 10 of COvor Sh..l)
4. Value 01 Uno 1 T,,"bIe 11 Uneal Role. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a1oo Include as part 01 101al.hown on Uno 19 of COvor Sh..l)
e. Valuo 01 Unel T..oble 01 COllllotal Rllo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a1oo Include as part 01 tolal.hown on Uno 17 01 COvor Sh..l)
e. Tola1 Value 01 Futuro Inlotost (sum 01 Un.. 21h", 0 mull equal Uno 1) . . . . . . . . . . . . . . . , .
s 5,000.00
s 0.00
S 616,887.09
S 0.00
s 621,887.09
Capyrlghl(c) 111II11 'arm taltw.r. ani)' CPSy.llm..lnCo
Fa,m 1&00 Sch.dutl M IAlv. to-1I4'