HomeMy WebLinkAbout03-0769REV-1500 EX (6~0)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
'~,~-~L~' HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
OFFI~I~CSE ONLY
FILE NUMBER
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
I"- SOCIAL SECURITY NUMBER
Z Stoner Frank E. Jr. 204 - 30 - 8634
f't DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-OD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
CD December 20, 2002 March 22, 1931 REGISTER OF WILLS
IAI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ Stoner Catherine
I.--
Z
Z
O
n~
n,
O
J-~'] 1. Original Return
r~4. Limited Estate
~-~6. Decedent Died Testate (Attach copy of Will)
[~9. Litigation Proceeds Received
[~]2. Supplemental Return
[~4a. Future Interest Compromise (date of death after 12-12-82)
---r 7. Decedent Maintained a Living Trust {Attach copy of Trust)
['-~ 10. Spousal Poverty Credit (date of death between 12-31-91 and %1-95)
~]3. Remainder Return (date of death prior to 12-13-82)
['--~ 5. Federal Estate Tax Return Required
6. Total Number of Safe Deposit Boxes
[~11. Election to tax under Sec. 9113(A) (Attach Sch O)
NAME
John M. Eakln
FIRM NAME (IfApplicable)
TELEPHONE NUMBER
(717) 766-3172
COMPLETE MAILING ADDRESS
John M. Eakin
Market Square Building
Mechanicsburg, PA 17055
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
2,867.00
3,500.00
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14)
OFFICIAL USE ONLY
2,867.00
3,500.00
0
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousar tax
rate, or transfers under Sec. 9116 (a)(1.2) x .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)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
20.[-~ · · · ' 'el ,- - ~1 ~ , - i~B · ,3 ·~ ..,,, n
Decedent's Complete Address:
ISTREETADDRESS 705 West Winding Hill Rd.
Mechanicsburg, PA 17055
CITY
ISTATE
IZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3)
if Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT,
Check box on Page '1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX BUE. (5)
A. Enter the interest on the tax due. (5A)
B, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
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 December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ..............................................................................................................
3. Did decedent own an "in trust for" or payable upon death bank account or secudty 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.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of rny knowledge and belief, it is tnJe, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI,~IATU_RE~3F PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS ~ ,, .- , ~
SIGNATUi¥~ OF PRE~,~,~ (~THER' fHAN RE~I~R{::SENTATIVE - / DATE
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. {9116 (a) (1.1)(i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [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 twenty-one 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% [72 P.S. {9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {9116(1.2) [72 P.S. {9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
IIIIII'RII^II!I IA~, RI
IN~IUt:III UI_ tjl ULItl __
SCI IEI)UI_I.~ E
CASIt, LIANK I)l~l'OSIl'S, & MIS(.;.
I'ER$ONAL I'I,IOI'ER'I'¥
rILE tlUMBER
1.
Frank E. StoD~gr~ J~r. ,~/~3 "'7& 9
lu(:lll(le Ih¢. l,m(:r~r,(l~ ~ I Ii i I li-f ,'].,I Ih. d't r, fire I,ro,'~,,d¢ w.r. m( r. lv,.,I I,y rim ~l;~lr, All pr.l,.fly I. Inlly.own.d ~vlfh fh~ ;Iqhl of nufvivm~hlp m,~f I). dlncloned on Scfl.d~l. I
I~1 ~:f:RIl'll~ll VAEUE Af DATE
........ OF DEAftl
Check 939350 from Insurance Company
Return of Premium, See Attached
Check 939349 from Insurance Company
Return of Premium, See Attached
of North America,
of North America,
772.00
2,095.00
10IAL {Al~o e,,ler on line 5, Recapllulalion) $ 2,867. O0
939349
939349
CHECK ON 90 DAYS OF CHECK DATE
. zN~ ~:~ o~.],a3~'~ ,~zzc~ DATE
o3/zW~oo3
BEING IN FULL SE~LEMENT OF ALL C~IMS AGAINST THE ABOVE NAMED COMPANY FOR LOSS AND DAMAGE
STATE
VOID - IF NOT PIlESENTED FOIl PAYMEN)' WITHIN
OCCURRING I .NSUr~ED UNDER POLICY NO, LOSS NO.
~:>- 0~:2831 02-003787
ISSUED AT THE ~ ]~F_a: ~---S~h ~ :Q~ ~-~
PAYABLE AT ,- . ~ ~ [
~STRUSTCOM~ ' ~
DES ~OINES, ~OWA
RAIN AND HAIL L.L.C.
PAY
' TO THE
ORDER OF
AMOUNT
VOID-iFNO'[P~ESENtEDF6RpAyk. JENI:Wii-HjN' f
~0 D~y~ bi: cHiCK DATE :;~30
,'g:~g~)5Ol,' m-'O?:~OOO'&h2i: (3[;, ,q,?,o, O,'
REV 15HEX + (1.9~ ,~_~_.~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER ~/~ ..~ .j~ ~ ?,
Frank g. Stoner Jr.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
5.
6.
7.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name ot Personal Representative (s)
Social Security Number(s) / EIN Number o[ Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Catherine Stoner
Zip
Street Address 705 West Winding Hill Rd.
City Mechanicsburg
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Retum Preparer's Fees
wife
State PA Zip 17055
3,500.00
TOTAL (Also enter on line 9, Recapitulation) $ 3,500. O0
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Frank E. Stoner Jr.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
H.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Catherine Stoner
705 West Winding Hill Rd.
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
wife
AMOUNT OR SHARE
OF ESTATE
Entire Estate
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEI
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART l! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
IN RE: ESTATE OF FRANK E. ·
STONER, JR., LATE OF UPPER ·
ALLEN TOWNSHIP, CUMBERLAND -
COUNTY, PENNSYLVANIA ·
DECEASED ·
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
'ORPHANS' COURT DIVISION
.eq/- o'_g- ',Vog'
ORDER OF COURT
And now, the ~ day of September 2003, upon consideration of the written
petition and on notion of John M. Eakin, attorney for petitioner it is ordered and decreed that
petitioner Catherine Stoner is entitled to receive the assets of Frank E. Stoner Jr., deceased
considering of two checks (Exhibit A ) and this order shall constitute sufficient authority for all
banks, agents or other persons to whom the check s may be presented for payment to recognize
her as the person entitled to receive the same.
IN RE: ESTATE OF FRANK E. :
STONER, JR., LATE OF UPPER :
ALLEN TOWNSHIP, CUMBERLAND :
COUNTY, PENNSYLVANIA :
DECEASED :
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
SMALL ESTATES PETITION
To the Honorable, the judges of the said court:
The petition of Catherine Stoner respectfully represents:
1 .) Your petitioner is Catherine Stoner, a resident of Upper Allen Township,
Cumberland County, Pennsylvania, represented in this matter by her attorney John M. Eakin.
2.) Your petitioner is the widow of Frank E. Stoner, Jr. who died testate'December
30, 2002, a resident of Upper Allen Township, Cumberland County, Pennsylvania. The will is
attached as Exhibit A.
3.) The sole property of the decedent consists of two checks payable to him in the
total amount of $2,867.00 copies of which are attached as Exhibit B.
4.) Your petitionerwas a member of decedent's household at the time of his death and
is entitled to the family exemption of $3,500.00 and in addition she is the sole claimant to estate
proceeds.
5.) All bills of decedent including the funeral bill of Malpezzi Funeral Home of
Mechanicsburg have been paid by your petitioner.
6.) The family exemption exceeds the gross estate of $2,867.00; the estate is
insolvent for Inheritance Tax purposes as shown by the Inheritance Tax Return filed
September ,2003, a copy of which is attached as Exhibit C.
WHEREFORE, your petitioner respectfully prays you Honorable Court to make
an order awarding her the proceeds of the estate consisting of the checks attached as Exhibit B as
provided by Section 3102 of the Probate, Estates and Fiduciaries Code, 20 Pa C.S.A. 3102.
Dated September ) 9.... , 2003 Respectfully submitted
Attor~jy for Petitioner.
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Catherine Stoner, being duly sworn according to law deposes and says the facts set forth
in the within petition are tree and correct to the best of her knowledge, information and belief.
Sworn ,anc~ subscribed before me
this 2 )-~'~lay of September, 2003.
Catherine Stoner
LAST WiLL AND TESTAMENT
8NELB^KE~.
McCALEB & ELICKER
1, I;'RANK 1!;. S'I'()NI!:II, ,IR., ()l! LI:o 'Powl~ship of Upper Allen,
C(.~nl:y of Cumbe~;la~d a~d (~omm(,uwealtt~ of Pennsylvania, heine of
s()ultd a~cl dJSl),~si~q u,i~l, m,,m()~'y a~d t~,dersLa,din%', do make,
[)t~l_,l. ish a~d cl(:-clav(~ II, in as a~tl 17~)r' my l,ask W[I_I. and 'l'es~.amenk,
I~ovel)y .~;evoki.~19 alul makilltl v()id all former wi.lls and codicils bi
u(~ aL al~y k i_me IioI-()L().Foi-o lll;~lo.
FIRST. J_ el:der alid d.ilect: }:[la~ all Iny jush (]ebbs and funeral
expenses be paid by my l~;xecul, l-[x, I~e~:ei. na[Ler named, as soon as
conven[enhJ, y may be done ail_er my decease.
SECOND. i give and I.)eCl,~eaLl~ my cakk].e and farm machinery
tHoLe my w_L.fe, CA'I.'III~!~INI;; A. fq'l't)Nl~lt~, al)solukely, if she survives me.
TIIIRD. ~[ g.ive, devise and 10equeakh all the res[, residue
and remai~tder of my EskaLe, t'eal, personal and mixed, whatsoever
and wl~eresoever sik. uat_ed, _i.~t equal sl~ares un[o my four children,
~amely, RFiBI:lt_'.CA ,I . t?AIItlI~ifi'I'f)CK~ JENNJF'~llt [,. ALI)IS, EI,IZABETtl ~-.
S'I'ONE;R and CINDEREbLA 3. STONER, sl~are and share alike, absolukely
and in fee simple.
If any of my Said children should predecease me and
leave lawfful issue Lo survJ, ve me, 1 order and direc[
sl~are of any such deceased cld_l.d shall be distribuked un[o her
].awful issue per st.i. rpes by represenkakion and no[ per capi[a,
sul0jec[-, however, [o t:he p~;oheckive provisions of I[em Pourkh
hereinbe].ow.
FOURT[I. I order and dj_reck [hak [he share or in[eres[ of an,
be~ef:Lciary under Lt~is, my i,as[ Will and Testamen[ who may be
under: tl~e age of kwe~ty-Lw() (22) years at hl~e [ime for dls[ribu-
hion khereo.[ shall be paid over and delivered un[o TIIE FIRST BANK
AND TRUST COMPANY OF MECIIANICSBURG, PENNSYI,VANIA, as my Teskamen-
Lar-y Trustee, 1N TRUST, NF. VER'I~iII;;I,ESS, -ho hold, manage, inves[ and
~:e:i_~vest: [be same For the use and benefik off said beneficiary
LAW OFFICES
SNELI~AKER,
McCALEB ~¢ ELICKErt
t i,te t. tle ['uust shall I)e /<~l-mi~aLed altd the then I:emaining net :
I)a].a~]ce Lheveo.F sl~aJI I)e i)aLd ()vel7 to 'the beneficiary absolutely.
A. $'I'()NIJ;R, Lo I.,e tte l;'~'tltl .i ,x t~[ Lhis, my Lash Will arid Teshamen[
ol- ~:ease st) t(~ so~'v~, [1~(.1~ altcl ;i. ll [.hal eveli[;, I nominate, con-
hlle Execut't'Jx llot'o(~f'. / I- I~lli oF t:l]e Foregoing [)e.rsons should
Jail [:(') qua l_i Fy ns lily I.;;X('ClII Fix l~et~eunder or cease so to serve,
Lheu a~d Jn Lliat ulL.i_maLe eyelet, 1 ~omina[e, constitute and
npl~() i ill my datt(tlll r,F, I)am~:,l y, I(I];BECCA J. FAHNP:S'.I'OCK, to be the
l!:xecul:['j.x o[ tll_i_~, my l,ast Wi.] I. aud Testament. I order and direct
I~hat none o.[ [~e fouegoing persons shall be required to post bond
ou g.[ve oLheu security as a cond. J.t[on of qualification hereunder.
iN WITNESS WttEREOF, I, FRANK E. STONER, JR., have hereunto
set my hand and seal ~o this, my Last Will and Testament which
consists of two (2) typewritten [)ages to each of which I have
Thousand Nine IIundred Eigll[y-Lhree (1983).
( SEAL!
'l'l~e p.uec:edi~%! JHstt-u,uet~t, co]]sisl:ing of this and one (1) othe
typewrJLteu page, each ~dei)tJ.f.[ed by the signature of the Testator
was o~l the date thereo[ signed, sealed, published and declared by
FRANK E. STONER, JR., Lhe Testator therein named, as and for his
Last Will and Testament, i~ the presence o~_.u~, who, at his
requests, in his Dresence, and iu the pres~[~c~of.-~aqh' okher, have
CO~ONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, FRANK E. STONER, JR., RICHARD C. SNELBAKER and JANET M.
FORRY, the Testator and t_he witnesses, respectively, whose names
are signed [o ~he a~ached or foregoing instrument, being firs~
duly sworn, do hereby declare to ~he undersigned au~horifiy [haft
~he TesLa~or signed and execuhed ~he ins~rumen~ as his Lash Will
and Testament and that he had signed wi]_lingly, and that be
executed ih as hJ.s free anal voluntary act for the purposes therein
exp~-essed, and hi,ah each of tl~e witnesses, in the presence and
~earing of the Testator, signed the Will as witness and that %o
the best of his or ]ler knowledge the Testator was a~ that ~ime
eighteen years o[ age or older, of sound mind aud under no
constrain~ or undue influence.
~ Witness
V~ h'ness
ubscribed, sworn ho and acknowledged before me by FRANK E. STONER
JR., the Testator, and subscribed and sworn to before me by
RICHARD C. SNELBAKER and JANET M. FORRY, witnesses, ~his
day of C-~;'~c_,..~,~,,~',./ , 1983.
Nok~r~ P'Ub llc
939349
9JgJ49 90 DAY§ OF CHECK DATE
BEING IN CULL-SElrLEMENT OF ALL C~IMS AGAINST tHE ABOVE NAMED COMPAN~ FOR LoS~ AND DAMAGE
~CURRINg ; INSuRED UNDER PoLICY NO. ~ o,2~3i Lo~SNO, 02 o03~"7
B~UEDATTHE ' ~ ~z~' :'~; : ' ~ ' -
VoIb- m Noi PRESENfED FOR PA¥~ENf WlfHIN
878 0,"
939350
· ' ' " ' . {,obA'~oi: CHECKDATE
h:i;~Hl~d:keN; h, m~ c~t~'~ Otc ....... "' UAt~ ' ~,"; ' '
bt~[[ k4oiNl~, IOWA
II'q:trt350u' I,"D?]DDD~,i, aI: O~, ,o,?8 Oil'
BUREAU 0-* INDIVIDUAL TAXES
INHERITANC? TAX DIVISION
DEPT ..,Z806~
HAR.R-I~URG, DA 17118-0601
COHHONgEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-164? EX AFP col-03)
JOHN M EAKIN
MARKET SQUARE BLDG
MECHANICSBURG
PA 17055'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
I
11-10-2005
STENER JR
12-20-2002
21 05-0769
CUMBERLAND
101
Aaoun'l: RaeL'l:'ted
FRANK E
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG TH/S LZNE ~.- RETAIN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP [01-03] NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ................. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STENER JR FRANK E FILE NO. 21 05-0769 ACN 101 DATE 11-10-2005
TAX RETURN HAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON:
1. Real Estate (Schedule A)
2.
$.
~+.
6.
7.
B.
ORIGINAL RETURN
(1)
Stocks and Bonds (Schedule B) (2)
Closely Held S*ock/Partnershlp Interest (Schedule C)
Hor~gages/No~as Rece/vabla (Schedule D)
Cash/Bank Deposi~s/HLsc. Personal Property (Schedule E) (5)
JoAntly Owned Property (Schedule F) (6)
Transfers (Schedule G) (7)
Total Assa~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/Hisc. Expanses (Schedule H)
10. Debts/Hot,gage L/eb111*ias/Lians (Schedule 1)
11. Total Daduc~/ons
12. Na~ Value of Tax Ra~urn
15.
lq.
(9)
(10)
Cher/table/Governaan~al Bequests; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Estate Subjac~ ~o Tax
O0
2~867.00
O0
O0
O0 NOTE: To /nsura proper
O0 credA~ *o your account,
O0 suba~ the upper portion
of thLs fora w/th your
~ax payaent.
(8)
2,867.00
.0O
2,867.00
(11) 2.8~7.00
(12) .00
(15) .00
(1~) .00
NOTE:
Zf an assessment Nas ~ssued previously,
refZect ~gures that ~ncZude the totaZ of ALL returns assessed to date.
lines 14, 15 and/or 16, 17, 18 and 19 Nill
(15) .00 x O0 = .00
(16) .00 x 0~.5= .00
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= .00
AHOUNT pATD
ASSESSMENT OF TAX:
16. Aeoun~ of L/ne 1~ a~ Spouse1 rate
16. Amount of Line 1~ taxable a~ L/neel/Class A rate
17. Amount of Line lq at Sibling rate
18. Amount of Line lq taxable at Collateral~Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYHENT RECEIPT D/SCOUNT (+)
DATE NUHBER ZNTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
ZNTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATZON OF ADDITIONAL INTEREST.
.00
.00
.00
.00
( 1F TOTAL DUE *rs LESS THAN $1, NO PAYHENT 'rs REQU'rRED.
TF TOTAL DUE *rS REFLECTED AS A 'CRED.rT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE STDE OF TH.rS FORH FOR 'rNSTRUCT*rONS.)
~EV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'-ILE NUMBER
DECEDEN'FS NAME Stoner, Frank E. Jr. 2103-0769
ACN
REVIEVVED BY Daniel Heck 101
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
Reduced to $2,867.00. Family exemption can only be claimed against assets subject to
H B-3
will or intestacy.
ROW Page 1