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HomeMy WebLinkAbout05-20-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUTNY, PENSYLVANIA `-_' ORPHANS' COURT DIVISION n ~ - N0.2010-01035 ~ = ~~ ~ -~ ESTATE OF ~ cZis ~ v ROBERT M. BEAUDRY ~; ;J~ .~-- PETITION UNDER SECTION 3102 ~~-~-~ `~`~' OF THE PROBATE, ESTATES AND FIDUCIARIES ~' t~, CODE FOR THE SETTLEMENT OF A SMALL ESTATE TO THE HONORABLE JUDGES OF SAID COURT: 1. Your Petitioner, Paul S. Beaudry, whose address is 4055 West 166`" Street, Cleveland, OH 44135, is an adult individual and son of Robert M. Beaudry, deceased on January 29, 2010, Social Security Number 007-14-9889. 2. Paul S. Beaudry was nominated in Robert M. Beaudry's Last Will and Testament and Codicil as Executor, true and correct copies of which are attached hereto and incorporated as Exhibit "A" and "B". Letters Testamentary were issued to Paul S. Beaudry on October 14, 2010. 2. The Decedent, Robert M. Beaudry, was born on May 12, 1923 and was 86 years of age at the time of death. His residence was Forest Park Health Center located at 700 Walnut Bottom Road, Carlisle, PA 17013. He was a married man at the time of his death. 3. The Decedent's wife, Jacqueline C. Beaudry was the sole heir as set forth in his Last Will and Testament and Codicil. 4. Jacqueline C. Beaudry died March 5, 2010 more than thirty (30) days after Robert M. Beaudry's death. r--- . ,c ~ 7 ,_.; -, ; -: ~•~ G~ -~, ~, ~` 5. Paul S. Beaudry was also nominated in Jacqueline C. Beaudry's Last Will and Testament as Executor. 6. The Decedent's sole assets worth approximately $462.30 are listed as follows: savings account with Members l sc Federal Credit Union (#36295 l) in the amount of $106.94; medical reimbursement in the amount of $45.36 from Guardian LTC; and medical reimbursement in the amount of $310.00 from Forest Park Health Center. 7. The Petitioner filed a Pennsylvania Inheritance Tax Return and has received acceptance of the return. The copy of the return and the response from the Department of Revenue are attached hereto as Exhibits "C" and "D." 8. It is requested that the assets of the Decedent be turned over to the Petitioner to pay the administration expenses and make distribution of the balance to the Estate of Jacqueline C. Beaudry. WHEREFORE, Your Petitioner prays that an Order be made authorizing distribution of the accounts as set forth in the foregoing to Petitioner for him to apply against the expenses of administration and disbursed according to Decedent's Last Will and Testament. Tricia .Naylor, Esc I.D. # 3760 19 West South Street Carlisle, PA 17013 (717)243-7437 Attorney for Petitioner VERIFICATION I verify that the statements made in the foregoing Petition are true and correct. 1 understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. f;. ,ry / ,f~~~' j/f. ` Paul S. Beaudry LAST WILL AND TESTAMENT of ROBERT M. BEAUDRY BE IT REMEMBERED, that I, ROBERT M. BEAUDRY, of SCARBOROUGH in the COUNTY OF CUMBERLAND and STATE OF MAINE, being of sound and disposinc mind and memory, but mindful of the uncertainty of this life, do make, publish and declare this my LAST WILL AND TESTAMENT, hereby revoking all former Wills by me made. After the payment of my legally owing debts, funeral charges and expenses of administration, I dispose of my estate as follows: FIRST: I direct that all costs of administration of my estate be pa_d by my estate, and I hereby authorize and empower my Personal Representative to sell, exchange, convey, transfer, sign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, re-invest or retain investments, of my said estate and to perform all acts and execute all documents which my said Personal Representative may deem necessary, convenient or proper in regard to my property withou*_ fir-~t obtaining any license from Court. My said Personal Repesentative, using his own discretion, has the power to accelerate any payment due or. airy mortgages which may be charged against my estate and such payments may be made at his discretion before the distribution of my estate. SECOND: My wife, JACQUELINE C. BEAUDRY, is living at the time of execution of this will and we have four children born of our marriage; namely, PAUL S. BEAUDRY, JOHN J. BEAUDRY, CATHERINE A. BEAUDRY and MARY E BEAUDRY FIENUP. In the event that we adopt any children in the fu*_ure, thev shall e considered as children of ours for all purposes under this will, it being my intent to provide for any after-adopted children. THIRD: I give, devise and bequea*_h all of my estate, real, personal, and mixed wherever situated and whenever and however acquired to my belr~ed " ~ wife, JACQUELINE C. BEAUDRY, to her rreirs and assigns forever, in. t:~:e event that she survives me. ~~ III', FOURTH: In the event my said beloved wife, JACQUELINE C. BEAUDRY, ~; ~ ~i predeceases me or dies in the course of, or as a direct result of t'r,e same .' -~ ~ accident, epidemic or other calamity which causes my death and her death cuFSOROs ._AW OFFICES i!!r EE"FOR T. MAINE 74032 occurs for these or any other reasons within thirty (30) days after my death, I direct my Will is to be read as though she predeceases me, and I give, bequeath, devise all of the real, personal and mixed proper*_y which ~k~ b ~-I- `, ~,~ I own at the time of my death to my children, namely: PAUL S. BEAUDRi, JOHN J. BEAUDRY, CATHERINE A. BEAUDRY, and MARY E. BEAUDRY FIENUP, eCjUdlly~ share and share alike to be take as absolute owners thereof or per stirpes and not per capita. In the event that any of my children. predecease me and leave any of their children living, I give, bequeath and devise the share of my said deceased child to the children of said deceased child equally, share and share. alike, to take as absolute owners thereof, and not per capita. And ~f i said deceased child does not leave children living, then in that. every I III give, devise, bequeath the deceased child's share to said child's brothers and sisters equally, share and share alike, to take as absolute owners thereof, per stirpes and not per capita. The use of the word child or children shall include in its meaning natural and adopted children. FIFTH: I hereby nominate and appoint my Wife, JAQUELINE C. BEAUDR(, to be I~ the Personal Representative of this my Last Wi11 and Testament, and request that the Court require no security on her bond. In the event that she is unable to serve for any reason whatosever, then in that event. I nominate and appoint WALTER E. HINKLEY, JR. of AUBURN, COUNTY OF ANDROSCOGGIN, STATE OF MAINE to serve in her stead and request that the Court allow him to serve without bond. SIXTH: If any person, legatee or devisee shall directly or indrectly contest or dispute any provision of this Will either before a proba~e court or before any judicial body that this is not my Last Will and Testament or call in question before any court or tribunal the provisions of any legacy, devise or provision herein, then I revoke all provisions in this Will made in his or her behalf and declare the same void and of no effect and give said legacy, devise or share that person would have taken ~ to the remaining beneficiaries in this, my Last will and Testamen . CLIFFOROS' ' LAW OFFIC FS ~ al ~OnNE V S AT LA'N 9~IYM~~ ~YECPOFZ~ V.. ryE OaO~t II~ WITNESS WHEREOF, I have hereunto set my hand and seal this ?gth day of Junk, 1988, in the County of Cumberland, State of Maine. ROBERT M. BEAUDRY I~ ROBERTM. BEAUDRY, testator, sign my name to this instrument this 29th day of June, 1988 and being duly sworn, do declare to the undersigned authority that I sign it willingly, that I execute it as roy free a d voluntary act for the purposes herein expressed, that I am 15 I years ~f age or older, of sound mind and under no constraint or undue I influence. I i I W~, Cheryl Smith and Sherri Brackett , the witnes~es sign our names to this instrument being duly sworn and do hereby declar~ to the', undersigned authority that the testator signs and executes this i strument, his Last Wi11 and Testament and that he signs it caillin ly and that each of us in the presence and hearing of the Testator herebyllsign this Will as witnesses to the Testator signing, and to the best o~ our knowledge the Testator is 18 years of age or older and of sound mind and under no constraint or undue influence. t'~~ ~'i ~ Address Address` Witnes .. I f/_ Witnes ~I ~uFFOr~os~ LAW OFFICES ~~ tEt+,oa T. h.t. ~~Ve oac32 i STATE (~F MAINE i Cumberland, ss. June 2g, 1988 Subscribed, aj~d sworn to and acknowledged before by Robe~t Beaudry 'iTestator, subscribed and sworn to me by Chery~ Smith and Sherr Brackett witnesses, this ~- 29th ~ day of', Jan, 1988. ~ r ;~.. N ary Public/Attor ey At Law ', ~ ;~ I i I I E cuFFOr~os- '..AW UFFIC ES n ' (JR N F_YS a ~ ._.. v. 9~nYMl~1 REEPOR I. !.^niNE 04032 FIRST CODICIL I, ROBERT M. BEAUDRY, a resident of the Town of Scarborough, County of Cumberland and State of Maine, declare that this is the FIRST CODICIL to my LAST WILL AND TESTAMENT, dated June 29, 1988. I hereby amend my Will, dated June 29, 1988, by revoking the following specified provision therein and substituting in its place the following: In PARAGRAPH FIFTH, the last sentence therein is deleted and the following sentence is substituted therefor: in t'r~a event thai Jacqualine is unabla or unwilling to serve as Personai Representative, then in that event I nominate and appoint my son, PAUL S. BEAUDRY of Cleveland, Ohio to serve as Personal Representative and request that he be allowed to serve in said capacity without the giving of any bond. I hereby confirm and republish my Will, dated June 29, 1988, in all respects other than those herein mentioned. I Robert M. Beaudry, the Testator, on this 5th day of December, 1995, first being duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument as the First Codicil to my LAST WILL and TESTAMENT and that I sign it willingly, as my free and voluntary act and that I am eighteen years of age or older, of sound mind and under no constraint or undue influence. ROBERT M. BEAUDRY tie, Kristie C. Cote ,and Cynthia Collard the witnesses, being first duly sworn, do hereby declare to the undersigned authority that the Testator has signed and executed this instrument as the First Codicil to his LAS T WILL and TESTAMENT and that he signed it willingly, and that each of us, in the presence and hearing of the Testator, signs this First Codicil as witness to the Testator's signing, and that, to the best of our knowledge, the Testator is eighteen years of age or older, of sound mind and under no constraint or undue influence. Approved and allowed, ,~ Judge % ~.~ Q STATE OF MAINE YORK, ss Subscribed, sworn to and acknowledged before me by Robert M. Beaudry, the Testator and subscribed and sworn to before me b~ xristie c. cote and Cynthia Collard ,the witnesses, this 5t day of December, 1995. ~~ -~~ Notary,' P blic My Notary Commission \ Expires on: _ ~"~d s-~~c~~ ~~ 1505610101 EX (oi-io) ~ ~~~~ ~ ~ O® ~ OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes ~~~,~,..~E~,o.~E~E,~E County Code Year File Number INHERITANCE TAX RETURN - ---' PO BOX 280601 ~"~'e'~ i ~„~--~ 9'g'g'9' Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 007-14-9889 01 /29/2010 05/12/1923 Decedent's Last Name Suffix Decedents First Name Beaudry , ', Robert (If Applicable} Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Beaudry ', Jacqueline Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ..007-22-0544 ~,~,~'$~~R OF WlZLS FILL IN APPROPRIATE OVALS BELOW MI M MI C C~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82,'. O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number _. _ Tricia D. Naylor, Esq. (717) 249-6873 REGISTER OF WILLS USE ONLY First !ine of address Baric Scherer __ Second line of address 19 West South Street City or Post Office Carlisle State ZIP Code PA 17013 DATE FILED Correspondent's a-mail address: tnaylor@baricscherer, com 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 knowledge. SIGNATU F PER N~sPONSIBLE Fg~ FILING RETURN DATE ~/ 405 West 16(~h Street, C~t~land, OH 44135 SIGN RE OF PREP OTH AN rSENTATIVE 19 West South Street(~Carlisle~PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J 150561025 REV-1500 EX (FI) Decedent's Sociai Security Number Decedent's Name: Robert M. Beaudry ' 007-14-9889 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ~ Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 462.30 6 Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 3. Total Gross Assets (total Lines 1 through 7) ............................. 8. ', 462.30 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 261.50 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. ' 261.50 12. Net Value of Estate (Line 8 minus Line 11) ................. .... . ...... 12. 200.80 13. Charitable and Governmental Bequests(Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................. ...... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .................. ...... 14. 200.80 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 200 80 ' (a)(1.2) x .0 0 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 13. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE........ ............................................ ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610265 1565610205 0.00 0.00 O J REV-1500 EX Paps 3 File Number r1Ar_prlant'c [:mm~lete Address: DECEDENT'S NAME Robert M. Beaudry _ STREET ADDRESS 118 West South Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 8. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. Total Credits (A + B) (2) (3) (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Make check payable to: REGISTER OF WILLS, AGENT. o.oo 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.........................................................................•..........•.••• ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? .............. ^ 4 Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return. are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: ® The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. o The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)]. e The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+!li-io) SCHEDULE E ~ Pennsylvania DEPARTMENT DE REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert M. Beaudry 21-10-1035 Include the proceeds of litigation and the date the proceeds were received by the estate. en nrnnarrv ;ninth owned with right of survivorship must be disclosed on Schedule F. If more space is needed, use aaaiuonai sneeia u. NaN~~ ~~ ~~~_ =a~~~~ ~~« REV-1511 EX' (10-09) ~ ' pennsylvania DEPARTMcNT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Robert M. Beaudry 21-10-1035 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES; 1, 8. 1 ADMINISTRATIVE COSTS; Personal Representative Commissions; Name(s) of Personal Representative(s) Street Address City _ ____-- Year(s) Commission Paid; 2 ', Attorney Fees: 3. ' Family Exemption: (If decedent's address is not the same as claimant's, attach explanation,) Claimant street Address ____ ___ _- City State _ Relationship of Claimant to Decedent _ _-_ 4. Probate Fees: 5. Accountant Fees: 6, Tax Return Preparer Fees: ~~ ~ Inheritance Tax filing fee TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size State ZIP ZI P 150.00 96.50 15.00 261.50 REV-1513 EX+ (01-10) ~'~-~~' Pennsylvania SCHEDULE DEPARTMENT OF REVENUE INHERITANCE TAx RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert M. Beaudry 21-10-1035 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 Estate of Jacqueline C. Beaudry 4055 W. 166th Street, Cleveland, OH wife 200.80 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. NOTICE OF INHERITANCE TAX pennsy~Van~a ~ BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE '~, INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 REV-1547 EX AFP C12-10) HARRISBURG PA 17128-0601 DATE 04-25-2011 ESTATE OF BEAUDRY ROBERT M DATE OF DEATH 01-29-2010 FILE NUMBER 21 10-1035 TRICIA D NAYLOR ESQ COUNTY CUMBERLAND 19 W SOUTH ST ACN 101 APPEAL DATE: 06-24-2011 CAR L I S L E PA 17 013 ( See reverse side under Objections ) Amount Remitted -~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER DF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT AL ------ ONG THIS LINE ---- ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -------------- ------------- REV-15 ------ 47 EX AFP C12-101 NOTICE OF INHERITANCE _ ---- ___ TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: BEAUDRY ROBERT MFILE N0 .:21 10-1035 ACN: 101 DATE: 04-25-2011 TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED $EE ATTACHED NOTICE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 00 C1) 2. Stocks and Bonds (Schedule B) . NOTE: To ensure proper C2) ,00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) of this form with your (4) 00 . tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Sched ule E) C5) .462.30 6. Jointly Owned Property (Schedule F) I6) .00 7. Transfers (Schedule G) I7) .00 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS• c15) 200.$0 x (16) n0 X c17) -nn x cls) .00 x 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Iq) 61 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions C11) 261.50 12. Net Value of Tax Return (12) 200.80 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 200.80 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16 17 18 and 19 reflect figures that include the total of ALL returns asses , , sed to date. will ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) r~ ~, ~ "' -~ 1 F aft, r ~ ~'?,I _..~ ~~~ , J AMOUNT PAID ce) 462.30 00 = .00 045 = .00 12 = .oo 15 = .00 c19)= . 00 TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. 00 ~/{~~ ~~ ~ ~~ `1 ~~~ TOTAL DUE . 00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS ' A "CREDIT' (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.