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Home My WebLink About95-0150~ ~b This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. AUG ~ 6 2001 Date ? ~_ Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 ~~ ui~ ~~~%S H~os.i~n.~~ECTED {7EP±$; ~3 COMMONWEALTH OF PENNSYLYMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS ,~,~~ ~'EFt FD OJ-TE 4-19-95 dlc CERTIFICATE OF DEATH M YLACK NI LL O 3 2 n~~a~~ C~-~~~ /3 nc.` row uT ,~.,,,t v v v - : ~ ~ .~ ~- INHERITANCE TAX RETURN FOR DATES OF DEATH AFTER 14131191 CHECK HER! ~ p U RESIDENT DECEDENT OVER1 Y CREDIT IS CUIIMED ^ COMMONWEALTH OF PENNSYLVANIA DEP (TO BE FILED IN DUPLICATE FIL! NUMBER ARTMENT OF REVENUE HARRISBURG, PA 1712hi•0601 WITH REGISTER OF WILLS] G ~' /5 ~ /~~ COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS F RIRR, EDITH 5755 WERTZVILLE ROAD SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH ENOL A, PA 17025 8 O 170-23-3118 2/14/95 2/28/19 ~,~~, CUMBERLAND pr APPIICARIFI SURVIVING SPOUSE'S NAME RASL. iIRST AND MIDDLE IN~TIALI SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONSI °' ®1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Relvrn a`e ~ aye FL'~V xo9 ^ d. limited Estate ^ 4a. Future Interest Com romise P (for dates of death prior to 12-13-82' ' ^ 5. Federal Estate Tax Return Required v x m ~ [ , 6. Decedent Died Testole (Attach co f Will) (for doles of death niter 12-12-62 ^ 7. Decedent Maintained a Living Trust _ 8. Tole) Number of Safe De osil Boxes P py o (Attach copy of Trust) ~ COitltl:Sp S ~ ,Cb F ~E t TAX FORMAt 10 tl d f: f: CJ! .- ~ ' .. ~. , . y ~~ ELIZABETH H. DRAYER COMPLETE MAlll G A DR SS 5755 WERTZVILLE ROAD c°a ~ TELEPHONE NUMBER 717 732-3062 ~ 1 ~ "~ ~ ENOLA P PA 1 7 0 2 5 z 0 ~J a W z 0 I- a a I- 1. Real Estate (Schedule A) (1) $ 4 7, 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) (2) 0 3. Closely Held StoclC/Partnership Interest (Schedule C) (3) 0 4. Mortgages and Notes Receivable (Schedule D) (d) 0 5. Cash, Bonk Deposits 8 Miscellaneous Personal Property (5) 0 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 0 7. Transfers (Schedule G) (Schedule L) (7) 0 8. Total Gross Assets (total Lines 1-7) B) 4 7 r 0 0 0. 0 ~ 9. Funeral Expenses, Administrative Costs, Miscellaneous v(9) Expenses (Schedule H) ~ ~~ 7 21 r 0 7 2 • 6 3 10. bebts, Mortgage Liabilities, liens (Schedule I) (1 p) , 0 11. Total Deductions (total dines 9 $ 10) (l 1) _ 2 ~ , 0 7 2 . 6 3 12. Net Valve of Estate (Line 8 minus Line 1 1) 13 Charitable and G l B (12) _ 7 ~i f 9 2 7 _ 3 7 ~ ~ ~ 2 ~ ~ ~ ~ . overnmenta equests (Schedule J) • (13) _ l d. Net Value Subject to Tox (Line 12 minus Line 13) j l4)_~ R~ 2 7 . ~ 7 15. Spousal Transfers (for dotes of death after b-30-94) See Instructions for Applicable Percentage on Reverse (15) X __ `~ ` Side. (Include values from Schedule K or Schedule M.) C.~ , - 1 b. Amount of Line 14 taxable. al 6% rate (16) (Include values from Schedule K or Schedule M.) 7 V -~ - $ 2 !~ r 2 ~ 7 x .06 = 1 .5 5 6.6 4 - 17. Amount of Line lA taxable at 15% rate (17) (Include values from Schedule K or Schedule M.) x .15 = 18. Principal tax due (Add lax From Lines 15, 16 and 17.) (18) _ 1 , 556 .64 19. Credits Spousal Poverty Credit Prior Payments Discount Interest + ~ - (19) _ t0. II Line 19 i3 greater Ikon line 1B, enter the difference on Line 20 . This Is the OVERPAYMENt. (20) _ ^ • tl. If Line 18 is greater than line 19, enter the difference on Line 21 . This is the TAX DUE. (21) A. Enter the interest on the balance due on Line 21A. (Z1A) B. Enter the total of line 21 and 21 A on Line 21 B. This is the BALANCE DUE. (218) 1 5 5 6.6 4 Make Cback Payable tos Register of Wills, Agent , _ nder penalties of perjury, I deck is true, correct and complete. I < Ised on all information of which tv ANSweR Au rr7UESt1oNS bN ~~iIEkSE ~f3 t ~ EC 1 , eve examine t is return, including accompanying schedules. and statements, and to I e est of my knowledge and belie tall rani estate has been reported of true market value. Declaration of prepare, other thou the personal representative has any knowledge. URN ADDRESS - 5755 WERTZVILLE ROAD, ENOLA, PA 17020 DA~3 ~` IVE ADDRESS DATE 352 S. SPORTING HILL RD., MECHANICSBURG, PA 17055 Act #48 of 1994 provides for the reduction of the tax rates. imposed on the neT value of Transfers to or for the i:se of the spouse. The rates as prescribed by the statute will be: e 3% (.03~ will Ise applicable for estates of decedents dying on or after 7h194 and before 1/1/9b ~ 2% (.02~ will be applicable for estates of decedents dying on or after 111 /96 and before 111197 i 1% x.01) will be bppiieable fot estates of decedent: dying on or after 111197 and 'before 111198 • Spousal transfers occurring on or niter 111198 will Ise exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (~ ~ IN THE APPROPRIATE BLOCKS. 1. Did decedent make d transfer and: .................. a. retain the use or income of the property transferre , ..................................... • .... 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 dead: occurred on of bw thoutDe eceb ing adequate onsiderdatio $~t Ifn d athy occurpred eaFtel death transfer proper y December 12, 1982, did deceden- transfer property within one year of death wit out receiving adequate cansideration$ .................................................................................................. 3. Did decedent own an 'in trust For'. bank account at his or her death$ ..................................... IF THE ANSWER TO ANY OF THE ABOi/E QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. REV•1502 E%+ (12-B5) 1, SCHEDULE A COMi~AONWEAITH OF PENNSYLVANIA ~ REAL ESTATE INHERITANCE TAX RFTIIRN RIRR, EDITH (Properly jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estaie should be reported at fair mnrket value which is defined as the price a~ which property would be exchanged between a witt:n., 1............1 .....:u:__ __u__ __~.~__ ~ _._ _ _ .. ~ REV.I311 EXa 17.881 - ' , ~~ SCHEDULE H '~~.~> FUNERAL EXPENSES, COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND IN RESIDENTEDECEDENiRN MISCELLANEOUS EXPENSES please Print or Type TATE OF FILE N M ER RIRR, EDITH ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: ~• NEUMYER FUNERAL HOME $3,554.23 B. Administrative Coats: 1. Personal Representative Commissions ELIZABETH H. DRAYER Social Security Number of Personal Representative: 1 7 2 3 6 - 2.1 19 Year Commissions poid 1 9 9 6 $ 2, 3 5 0.0 0 2. Attorney Fees JAMES M. BACH $2, 820..00 ~ U ~ S''O a 3. Family Exemption _ /.--~ "` Claimant ELIZABETH H.DRAYER Relationship DAUGHTER /f $2, 000.00 Address of Claimant at decedent's death 1, _._ ,. . , _.._._ --- Street Address 5755 WERTZVILL ROAD City ENOLA State PA Zip Code 17 0 2 5 4. Probate Fees $ 1 41 .00 C. Miscellaneous Expenses: ~' REGISTER OF WILLS FILING FEE $ 25.00 2• CITY OF HARRISBURG INSPECTION $ 75.00 g, CUMBERLAND LAW JOURNAL $ 40.00 4 THE PATRIOT NEWS $ 62.71 80YD DILLER TRASH REMOVAL $ 223 00 5. . 6. INTERNISTS OF CENTRAL PENNSYLVANIA $ 100.00 7, LARRY KEEFER $ 30.00 g, CAMERON STORM $ 45.00 TOTAL (Also enter on line 9, Recapitulation) ~f ~ $ 1 1 , 4 6 5 . 9 4 irr more spoce is needed, insert additional sheets of anme size.) .~ ,.- e, ' ESTATE OF EDITH KIRK SCHEDULE H (Continuation) MISCELLANEOUS EXPENSES (continued) Carried forward from Page 1 $ 11 465.94 9. REAL ESTATE COMMISSION 3,290.00 10. BROADVIEW (loan discount) 2,000.00 11. BROADVIEW (Tax service fee) 69.00 12. BROADVIEW (Flood certificate) 19.50 13. BROADWAY (Document preparation) 300.00 14. ALPHA (Notary fee) 5.00 15. ALPHA (Lender's coverage) 8.5.00 16. CENTURY 21 (for City Sheet) 25.00 17. CITY OF HARRISBURG (for Water Term) 25.00 18. STATE TAX STAMPS 470.00 19. ALPHA (Disbursement fee) 35.00 20. ALPHA (Certified copies/various doc uments) 85.00 21. PENN TERMITE 127.20 22. DAUPHIN COUNTY 1996 TAX 160.20 23. TCB OF D/C FOR DELINQUENT 1994-95 TAXES 2,121.77 24. 1996 CITY TAX 367.47 25. CITY OF HARRISBURG UTILITIES 421.55 ---'~ ~ TOTAL MISCELLANEOUS EXPENSES: ~''f $ 21,072.6.3- REV.1513 EX+ t7-B7) t ' .- . SCHEDULE J COMMONWEAITHOFVENN$YlVAN1A BENEFICIARIES INHERITANCE tA% RETURN RESIDENT DECEDENT ESTATE OF RIRR,EDITH FILE B. Choritable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space is needed, insert odditiona) sheets of same size) ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE r n REV-1547 EX AFP (12-951 CONMONIIEALTH OF PENNSYLVANIA ACN 101 DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU DF INDIVIDUAL TAxES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPT. 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 0 5 - 0 6 - 9 6 HARRISBURG, PA 17128-0601 ESTATE OF ED TH FILE N0. 21 95-0150 DATE OF DEATH 02-14-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT'• REMIT PAYMENT TO: ELIZABETH H DRAYER 5755 WERTZVILLE RD ENOLA PA 17025 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Amount Remitted CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS t --------------------------------------------------------------=-------------------------------- REV-1547 EX AFP (12-95) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KIRK EDITH FILE N0. 21 95-0150 ACN 101 DATE 05-06-96 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE A TTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estat• (Schedule A) (1) 47,000.00 2. Stocks and Bonds (Schedule 8) (2) .00 3. Closely Hsld Stock/Partnership Interest (Schsdul• C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 47, 000.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 22,572.63 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 22.572.63 12. Nat Value of Tax Return (12) 24,427.37 13. Charitable/Governmental Bequests (Schedule J) (13) .00 14. Net Value of Estat• Subject to Tax (14) 24,4 27.37 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17 and 18 will reflect figures that include the total of ALL ret urns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) . 00 X . 00_ .00 16. Amount of Lina 14 taxable at lineal/Class A rata (16) 24, 427.37 X . 06. 1 , 465 .64 17. Amount of Lina 14 taxable at Collateral/Class B rate (17) •00 X .15. .00 18. Principal Tax Due (lg) 1 , 465.64 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) AMOUNT PAZD 03-28-96 AA112675 48.87- 1,556.64 04-29-96 REFUND .00 42.13- TOTAL TAX CREDIT 1,465.64 BALANCE OF TAX DUE .00 INTEREST .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. rno /`A~.-n~Arrnu nr ARHTTTn\IAI T\ITrDCCT TC TATAI MIF TC GCFIC/`TFn AC A •YWFnTT° frRl Vnll MAV RF nllF (fEV-id70 E% (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG, PA 1 71 2 8-060 1 DECEDENT'S NAME ~. INHERITANCE TAX EXPLANATION OFCNANGES ACN I i I SCHEDULE STEM EXPLANATION OF CHANGES NO. 1d. G.~ ",_i'~`.'_CrIVc' ..f .:2TlU3r' 3~ 19~i ~ ~1>'>' r _, ' ~ , S far:l:t.l;, ~ ~~a>,L.~on i.ncreGse~:] Lp ..~,,:~(JL'. 1 ~~_ , - ,,r::: :'u TAX EXAMINER: ~y' PAGE