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HomeMy WebLinkAbout00-0181NCY. t.IU1 EA ~6 T1 cow+ NTH of Pt ISt'LVANIA ' '!'~'• 0!EPAi'" OF REVENUE utr ~. 280601 ~t ,~ hU1RR1SBURG. PA 11128.0601 H Z w 0 W U W 0 REV-.1500 INHERITANCE TAX RETURN FILE NUMBER ~•~ RESID-ENT DECEDENT ~ ~- QD p.ASr. FrRS~ O ~ ~,I ) I Soc-n~ sECtatlrY DATE OF DEATH vEAR " ~ ~ I ~ ~ y ) oar•oF ~aTH (l~fA1.DO.YEAR) ~ -22-20oc~ p - - c (IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST, FIRST, ANp MIpOLE INITIAL! ~ .~ t. Original Rekrm ~ a Y ~ 4. LinMed EsWe v ~ ~ ~ 6. Daaderrt Oied Testate Nram exy aMrq ~ ~ 9. Proeelds Raoeived ~ THIS SECTION MUST BE COMPLE b TED ~~ ^ 2 SuppNrrrental Retren - 4a. Fulure kMerast Compromise Idr. a auin aer u•uaA 7.Oaeedent i~itainlair>ad a Liwg Tent (A~ aahr a Tnwe 10. Spousal Poverty Credit 1e.r a a.rn exw«n riJrAr aea,.,.esl ALL C THIS RETURN MUST IBl# FILED U1 DUPLICATE MYITH THE REGISTER OF WILLS SOCIAL SECURITY ^ 3.RemairxknRghm{mraara~a~du•r~ ^ 5. Federal Esteta Tax Rearm Required _ 8. Tdel Numtaral Sale peposit Boxes ^ it. Election b tix under Sec. 9113(A) ~~as~ol /^~ CC A~ ~' TAX WF~ORNA-TION ~D EtE DIRECTED TO: Z Tl I i J~ U~ C MAILING ADDRESS _~Z y~3 •>y v Leo N ~ . _MEC~ ~4 N I CS ~, U ~~ _,_P_ A LZ~.~ _ Z O ~_ d W Z O Q H a V X H 1. Real Estate (Sctbdrle A) (1) _ -"' 2. Slodrs and Bonds (Sdredule 8) (Z) 3. Cbsey Held Corporedon, Partnerslrp or Sole-P^oPrietorship (g) - 4. Mortgages ~ Notes Rexivable (Sdxdrle D) (4) - 5. Cash. Bank oepos~ a MisoeAaneorn Personal Property (s) ' 2 Z ~ 2 , 7 5 (Schedule E) 6. ,JoirrBy Owned Property (Sdredde F) ^ ~ (g) ba 7. krter-vivoe Trenalers a Miscehnean Won-Probde Property m - (Schedrrb G ar L) 14. Net Yabe Subject to Tax (Line 12 rrwxn Lure 13} (14) ~ ~ ~ ~ 1_.; r ::7 r ~~ ~ ~ ~-~ ~ - ~_ f ~. y~ , ~ c~1 ~ a. Total Gros Aeeets (~ Lines ,-1} (e} 2 ~ , ~ 2 - 7 9 9. Funeral Expernes a AdmirinOrawe Coen (Schedule H) (9) ~ 7 ~~ . f0. Debts al oecederR, MoApge Lief. a Lies (Sctredrrle q (10) ''7 11. ToW Deductlan (total Lines 9 a 10) ...01) ~ / ©/, Q~ 12 Net Value o/ EslaM (Liao 8 minis Line 11) (12) i I~ 13. Charitable and t'aovenrrr~erNal Begrrestsltiec 9113 Tents for wtdch an ekdlan b fmc has not been (13) made (SdredWe .n SEE BISTRUCTIDtIS Oli REVERSE SIDE FOR APPtJkJtBLE RATES. . t5. Anrourt ai Line 14 taxable at d,e apoueel tax rate, ar trarufers under See. 9118 (axt.~ x .0 _ (15) 18. AmourR o(Line 14 taxable at irreal rate x .0 _ (16) 17. Amount of Line t4 taxabk at sibferg rate 18. Amoret< of Line 14 taxebk at coNaterai rste x .12 19. Tax Due ~. ^ x .15 (17I ~ a (18) {t9) ~~~~-.. - - > > ne: ~ ~ AFL cuESTroNS oN REVERS€ stnE aEV-isnEx . (~~sn' _ SCHEDULE H COMMOMNEALTH OF PENNSYLVANIA FUNERAL EXPENSES St INHERITANCE TAX RETURN ADMINISTRATIVE COSTS R SIDENT DECEDENT "" ^' ` "' FILE NUMBER 2lQ,p ~ d21$/ petits of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: '~ A. Pro~'essl~pnA Servte~s Z.775•a-o 6 , Mt:re~anv~~'s2 rCRsk.e~f & ConC~efP Lr~ner~ 2 I Z8, yC7 ~ . oP~n I~r,9 ~'rra~ve ~Cw~,en-~er~ ~c~u.~P,~-~i f ~ 7 9~, ~ Gf~r~.~ ~onoro-Vt~u~ 8. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commissar Paid: 2, Attorney Fees 3. Fatuity Exemptan: (It decedenCs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant a Decedent 4, I Probate Fees 5, ~ AccountanCs Fees g, Tax Relum Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) I'~, a 5 7 ~ / • 6~CJ ~„ ~„~~~ ~M~.~ ~~ ~~~,~.,, ~~~~~~~ auu~uvnai s~ieats of uia same sizef aBr.rssoc • i,..n caw~oNweuni aF aErarsriv~ r+~+Etar~ rRx r:Ertx:r, ~ES~~~~ ESTATE OF Sohn k ~© FILE Include the proceeds at 66gatan and tl~e date n,e pmoeed3 were received by the estate. AM property l~h~ned with tM right of ITEM NUMBER DESCRIPTION ~-ce ~ ~~ ~ ~/ 2 9~ ~ 2 . S a v i~h~ s ~ c~. a ~- r~ ll ~ ~r-s~ ~~h,~ '~Ce-~ ~~' pp ~~ 3y2 ~9 3651 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY . 2100- 0181 chip mlust be discbsed on Schedule F. VALUE AT DATA OF DEATH ~' ~~i.62 TOTAL (Also enter on line 5, Recapituulatiort) >,~s~ •i~oaraw~u ~ s~e~ .eo.amre~ ~.~__ _ ~~i3z olsa33 ~ l~zz o~o5ao ~~ .a _ ~Tl• . C!#(/~!E DP 990Ct1406b f22b2.79 ~~~ T BANK *" - ; ~ CAbtii 3N _ f2262J9 SBURG, P~ 17101 ~ {~ `". ;- • t~ .ifs..' ~. ~: 50 iOOO~O 3 3~ 9'90 2 i 406 6a' ,~ D11TE ACCOUNT NfJ1~6ER . TYPE OF /1000UI~IT A~&u snt "~/ ~ - ~ : (' , ~ , . ' ~ _ r i ~,F~+ j (~ 0 RETA~ ACCOUNT TITLE /OWNER I ~" V ,.- ~ t r f~ ^ CERT. OF DEP06R Li ~% (`; ~ ~~' 4': i 1 ~ ` :' ^ IRA / FiETIREA~EPff ~j --_ -_ _ _ _`-- L`` ~,.~, ;. t. T!f~ANSACTIOhI FtECEtP AF8137 015033 135 040500 60 ti DR CNECliI1dG 8834936 (1541.17 *.. i BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 INHERITANCE TAX RECORD ADJUSTMENT 1(3INTLY HELD OR TRUST ASSETS -~ ''" ` r,, - ~> ~ _ _ r~ ~ l~~'~- ~ , ~ ~ ~ ~. , _ NAD I A D ~~2 ~" Z N~ J _'~ 1520 CONEWAGO AVE MANCHESTER PA 17345 pennsylvania ~ DEPARTMENT OF REVENUE r~ REV-1b04 EX AFP (12-09) DATE 10-12-2010 ESTATE OF BOSCH JOHN K DATE DF DEATH 02-22-2000 FILE NUMBER 21 00-0181 COUNTY CUMBERLAND SSN/DC 176-26-1261 ACN 00138196 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------------------------------------------------------------------------------ REY-1604 EX AFP C12-09~ ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE: 10-12-2010 ESTATE OF: BOSCH JOHN K DATE OF DEATH: 02-22-2000 COUNTY: CUMBERLAND FILE NO.: 21 00-0181 S.S/D.C. N0.:176-26-12b1 ACN: 00138196 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT NO.: 88342936 TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ) TRUST C 3 TIME CERTIFICATE DATE ESTABLISHED 12-05-1994 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 _ .00 .00 X .15 .00 NOTE: TO ENSURE PROPER CREDIT TO YDUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCDUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 12-18-2009 WRITEOFF .00 185.54 TOTAL TAX PAYMENT 185.54 BALANCE OF TAX DUE 185.54CR INTEREST AND PEN. .DO TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NADIA DOROZNIJ 1520 CONEWAGO AVE MANCHESTER PA 17345 DATE 10-12-2010 ESTATE OF BOSCH JOHN K DATE OF DEATH 02-22-2000 FILE NUMBER 21 00-0181 COUNTY CUMBERLAND SSN/DC 176-2b-1261 ACN 00138197 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS t-- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ REV-1604 EX AFP C12-09~ ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE: 10-12-2010 ESTATE OF: BOSCH JOHN K DATE OF DEATH: 02-22-2000 COUNTY: CUMBERLAND FILE NO.: 21 00-0181 S.S/D.C. N0.:176-26-1261 ACN: 00138197 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE TYPE OF ACCOUNT: CX) SAVINGS C ~ CHECKING C ~ TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 10-23-1985 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 _ .00 .00 X .15 .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. INHERITANCE TAX RECORD ADJUSTMENT pennsylvan~a ~ ~~ JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE REV-1604 EX AFP (12-09? ACCOUNT NU .:8834293651 ~~~ RFV-1a~o EX (oi•io) ® Pennsylvania DEPARTMENT OF REVENUE Bt1REAU OF INDIVIDUAL TAXE5 PO Box 280601 HARRISBURG. PA 17128-0601 DECEDENT'S NAME INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER John K. Bosch 2100-0181 REVIEWED BY ACN Eunice Baker 00138196, 00138197 ITEM SCHEDULE NO, EXPLANATION OF CHANGES The above accounts have been adjusted to zero since they were reported on the probate return. r~ ~ ~ ,- ~ - BUREAU OF INDIVIDUAL TgXES INHERITANCE TAX DIVISION - PO BOX 280601 HARRISBURG PA 17128-0601 i r. b ^ ~ . ~_ ~_) ... ~. a ~--. _. ~ .._ ..- - ,"~'~= NOTICE OF INHERITANCE TAX APP~A~SEMENT, ALLOWANCE OR DISALLOWANCE QF DEDUCTIONS AND ASSESSMENT OF TAX ' . s r ~ __ i r., '- ~: ~ 1 ~ ~ i ~~ ELENA A ZAITSEVA 413 HURON DR MECHANICSBURG PA 17055 cl) .00 c2) .00 c3) .00 c4) .00 c5) 2, 2b2. 79 c6) .00 c7) .00 CUT ALONG THIS LINE _ --~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS 4-- _ ___ ____ ____ _ REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR - - DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: BOSCH JOHN KFILE N0.:21 00-0181 ACN: 101 DATE: 10-19-2010 TAX RETURN wAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) Pennsylvania ~ . . DEPARTMENT OF REVENUE REV-1547 EX AFP (12-09) NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. c8) 2, 262.79 ~9) 5.701.00 clo) .00 11. Total Deductions C11) 5, 701.00 12. Net Value of Tax Return ~ 12) 3, 438 . 21 - 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0 14. Net Value of Estate Subject to Tax (14) 3,438.21- NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 = .0 0 16. Amount of Line 14 taxable at Lineal/Class A rate C16) _0 0 X 0 6 = .0 0 17. Amount of Line 14 at Sibling rate t17) _0 0 X 0 0 = .0 0 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 = .0 0 19. Principal Tax Due (19)= .0 0 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YDU MAY BE DUE FOR CALCULATION OF ADDITIDNAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIDNS. DATE 10-19-2010 ESTATE OF BOSCH JOHN K DATE OF DEATH 02-22-2000 FILE NUMBER 21 00-0181 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 12-18-2010 (See reverse side under Objections Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013