HomeMy WebLinkAbout95-0132~~oso~o~
Y
DATE OF BIRTH
10 17 14 c
2. Supplemental Return
EV-7500 EX+(tt-gt)
INHERITANCE TAX RETURN FOR ^AT~E50F DEATH AFTER 1213 CHECK HERE
I~aspousAL
a POVEgTYCRE0IT IS GEMMED
COMMONWEALTH OF PENNSYLy ANIA
DEPARTMENT OF REVENUE RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE FILE NUMBER
~'"' ~=
c2/ ~~3 (~ j~~
HARRISBURG, PA87128-0801
WITH REGISTER OF WILLS ,
couNTYCODE
YEAR NUMBER
D DECEDENT'S NAME(IAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
~ SLIVER, MARGARET L. 442 Walnut Bottom Road
D Carlisle, PA 17013
E SOCIAL SECURITY NUMBER DATE OF DEATH
N
T 162-22-8537 12/01/94
F X 1. Original Return
P
R B
E P O 4. Limited Estate
C R C
K A K
~ 6. Decedent Died Testate
E S (Attach copy of Will)
C P
O O
R N
E E
S N
- T
R
E
C
A
P
I
T
U
L
A
T
I
O
N
T
A
X
C
0
M
P
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T
A
T
1
O
N
Cumberland
4a. Future Interest Compromise
(for dates of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach a copy of Trust)
U 3. Remainder Return
(for dates of death prior to 12-13-82)
5. Federal Estate Tax
Return Required
0 8. Total Number of Safe Deposit Boxes
"""` COMPLETE MAILING ADDRESS
Robert C. Saidis, Es uire Saidis, Guido, Shuff &Masland
TELEPHONE NUMBER 26 West High Str,`ee't`
717 243-6222 Carlisle PA 170131 `''R ~
1. Real Estate (Schedule A) (1) ~ None'
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Stock/Partnership Interest (Schedule C) (3) None
4. Mortgages and Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 433.94
(Schedule E)
6. Jointly Owned Property (Schedule F) (s) 32 , 393.4~i- :-
7. Transfers (Schedule G) (Schedule Lj (7) None
8. Total Gross Assets (total Lines 1-7)
e. Funeral Expenses, Administrative Costs, Miscellaneous (e) 7 468.57
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, Uens (Schedule I) (10) 2 , 107.10
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (line 12 minus line 13)
15. Amount of line 14 taxable at 8% rate (15) 23 , 251.73
(Include values from Schedule K or Schedule M.)
16 Amount f I'
.:
_...~
_ _
~, >4,,
I Y, f
._,
h~+''
- ,--,,
(8) 32, 827.40
(tt) 9, 575.67
(t2) 23 , 251.73
(13) None
(ia) 23,251.73
x.os= 1,395.10
. o Ine 14 taxable at 15/o rate (18) 0.00 X .15 =
(Include values from Schedule K or Schedule M.}
17. Principal tax due (Add tax from line 15 and from line 16.)
18. Credits/Sp Poverty Prior Payments Discount Interest
+ 1,300.00 + 68.42 _
19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT.
,~_ _
A• ~ Check here K; ou are' ail~irt a he?iund of o~ .
,. t
20. If line 17 is greater than line 18, enter the difference on line 20 Thls is the TAX DUE.
A. Enter the interest on the balance due on line 20A.
B. Enter the total of line 20 and 20A on line 206. This is the BALANCE DUE.
0.00
(17) 1,395.10
(is) 1, 368.42
(is) 0.00
(20) 26.68
(~A) 0.00
( 206) 2 6.6 8
- _ _..._- ------.......r ....,~...,....a...t. rnvrc z ryi~u f V Y1Fwt+Tttt+7~,!;f~fATli i~r;-:: ~
Under penalties of penury, I declare that I have examinod this return, including accompanying schedules and statements, and to the best of my knowladg
correctand complete. I declare that all real estate has been reported attrue market value. Declaration of preparer otherthan the personal representative i
which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDR, ESS/ f~ j/
~---444--Sr:z{(~G
20 Houston Drive -----'-
----------------------------------------------------
Mechani PA 17055 -
SIGNATURE OF PREPARER OTHERTHAN REPRESENTATIVE ADD~;~
Saidis,--Gizi-o,- Shuff___& Masland
26 West Hi h Street ---------
-------------g--------------------------------
r.arl ; Gi a va 1 ~nT z -------
!ntl belief, It is true,
based on all Information of
URIC
~ ~"~6 '~~
DATE
PLEASE ANSWER THE FOLLOWING GUESTIONS BY PLACING A MARK ()() IN THE APPROPRIATE BLOCKS.
YES NO
X
X
X
X
X
X
YOU .MUST COMPLE1TE SCH DOLE G AND FILOE T ASEPART OF THESRETURN.
1. Did decedent make a transfer and:
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 I'rfe of either payments, beneftts or care? , .. .. .. .. ... ,
2. If death occurred on or before December 12, 1982, did decedent within two years preceding death
transfer property without receiving adequate consideration? If death occun'ed 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' bank account at his or her death? .. ... ,
1
REV - 1508 EX + (2-87)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETUgN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
ESTATE OF
MARGARET L. SLIVER SS# 162-22-8537 12/01/94
(All property Jolrrtly-owned with Right of 5urvlvorshlp must tie disclosed on Schedule
ITEM
NUMBER DESCRIPTION
1 Thornwald Home - residents fund
2 Medicare reimbursements
3 J. E. Baker Service Award
Print or
VALUE AT DATE
OF DEATH
42.81
116.13
275.00
TOTAL (Also enter on line 5, Rec itulation) $ 433.94
(Attach additional R ~ /9" x ~ 1" rthwwfc 'rf mores cnA~.a is ncwriari 1
Ir
REV- 1511 EX + (g-88)
COMINR S DE ITE ECED TryTLNANIA
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
tJ 1 ATE OF - -
MARGARET L. SLIVER SS# 162-22-8537 12 O1 94
ITEM
NUMBER DESCRIPTION
A• Funeral Expenses;
1 Baumeister, Orcutt & Small Funeral Home
2 Rev. Richard Gordon -honorarium
3 Prospect Hill Cemetery - grave opening
4 Miscellaneous funeral and travel expenses
5 Royer's Flower Shop - funeral spray
6 Funeral Luncheon
B• Adminlstratlve Costs:
t• Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
2• Attorney Fees
or
AMOUNT
5,122.72
125.00
520.00
386.00
106.00
308.85
425.00
3• ~ Family Exemption
Claimant
Address of Claimant at decedents death
Street Address
Ctty
4. Probate Fees
Relationship
State ~p ~~
C• Mlsceilaneous Expenses:
1 Register of Wills - filing fees
2 Reserved for taxes and future expenses
25.00
450.00
TOTAL (Also enter on line 9, Recapitulation) S 7 , 468.57
/lf rrnrc enaro ie nnnrlnri innr~.f ~ddiTinnnl ,.ti,,,,~„ „s ,,,,,,,,,, ,,,~„ ~
REV-1512EX+ (10-88)
SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN DEBTS OF DECEDENT
RESIDENTDECEDENT MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
MARGARET L. SLIVER SS# 162-22-8537 12/01/94
ITENF
NUMBER DESCRIPTION
AMOUNT
1 Thornwald Home - balance due
2 Carlisle Imaging - balance due 1,116.50
3 Dr. Hely 7.15
4 Belvedere Medical 228.25
5 RWC Emergency 10.80
6 Carlisle Imaging 4.27
7 ATS Medical Servi ces 1.94
.8 Carlisle Hospital 25.15
9 Belvedere Medical 707.78
5.26
TOTAL (Also enter on line yo, Recapitulation) $ 2 ,107.10
(If more enA~, is nawrlrari incwrt Arl~lm.,~ol o~M ..s pe...,, ~~.,,, t
i'
REV - 1513 EX + (y-g7~
COMMONWEALTH OF PENNSYLVANIA SCHEDULE J
INHERITANC~TAXEpET_~1RN
RESIDENT EECC EEnnTT BENEF~C~OR~F
MARGARET L. SLIVER SS# 162-22-8537 12 O1 94
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
1 Carl E. Sliver
20 Houston Drive
Mechanicsburg, PA 17055
RELATIONSHIP I AMOUNT OR
! SHARE OF ESTATE
Son 1100$ of residue