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COMMpNWEALTH OF PENrygyLVANIA
DEPARTMENT OF REVENUE
PT p~0801 .
FI ~NUMIBER
~ I S
OBE FILED NEDUPLICATE
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ARflIS RG, PA 17128-0801 WITH REGISTER OF WILLS. COUNTY CODE YEAR NUMBER
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E DEC~O~NT'SNAME(LAST,FIRST,ANDM ID~EINITIAL~,,. DECEDENT'S COMPLETE ADDRESS
C SNAVELY, MILDRED E. 325 Wesley Drive
E
E
Mechanicsburg, PA 17055
N SOCIAL SECURITYNUMBER DATE O F EATH DATE OF BIRTH
T 162-22-0773 12 7 94 09 23 02 county Cumberland
P X 1. Original rn 2. Supplemental Return 3. Remainder Retum
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4. Limited Estate (for dates of death prior to 12-13-82
~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax
E R ~
K A 3
~ 6. Decedent Died Te;3tate (for dates of death after 12=12-192) Return Required
~ 7. Decedent Maintain
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8. Total Number of Safe Deposit Boxes
E (Attach copy of Wliq (Attach a co~~r~of Trust)
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E E NAME
John E. Slike Es uire COMPLETE MAILIN DRESS
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Said Guido
~S~uff 6t'Masl~~
S N TELEPHONE NUMBER ,
2 Market St~e;~t •'~
T 717 737-3405 am Hill, PA r+-i ~ r,
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2. Stocks and Bonds ( edule B) ~) N¢n!
(2) N
3. Closely Held artnership Interest (Schedule C) (3) ~
4. Mortgages and Notes Receivable (Schedule D) (4) on1
5. Cash, Bank Deposlb & Miscellaneous Personal Property (5) 216.
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 4 83 .3:
7. Transfers {Schedule G) (Schedule L) m 11, 402.9'
s. Total Gross Assets (total lines 1-7)
9. Funeral Expenses, Adminisfrative Costs, Miscellaneous (9) 1 827 . O(
Expenses (Schedule H)
10. Debts, Mortgage Uabilhies, Liens (Schedule I) (10) 2 , 234.4(
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11) /j
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (line 12 minus line 13)
15. Amount of line 14 taxable of 8°h rate (is) 18 , 396.0?
(Include values from Schedule K or Schedule M.)
16. Amount of line 14 taxable at 15% rate (16) 0 . Ot~
(Include values from Schedule K or Schedule M.)
17. Principal tax due (Add tax from line 15 and from line 16.)
18. CreditslSp Poverty Prior Payments Discount Interest
+ + 55.19 -
19. If line 18 is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT
... ... . .
20. If line 17 is greater than line 18, enter the difference on Ilne 20. This 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 20B. This is the BALANCE DUE.
Make Check Pa le to: R ter of Wills A nt
(17)
(18)
(19)
22,457.43
,f~' None
~' 18, 396.03
1,103.76
" 0.0
1, 3.76
55.19
0.00
(~)__" 1,048.57
(~A) 0.00
( 2os)_ 1, 048.57
/ ~ #k Xis' - I~~i,~"
Under penalties of peryury I declare that I have exammsd this return, includmq aecompanyinp achedulss and statements, and to the best of my knowledge and belief, ~t is true,
correct an d complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal repreasntativs is based on all information of
hich preparer has any knowledge.
SI NATURE OF PERSO RESPONSIBLE FO (LING RETURN ADDRESS
DATE
---------------------
~ 2949 North Front Street
~t ----------------------------------------------------- 'z- z~1g.~~
Harrisbur PA 17101
S A RE OF PREPARER OTHERTHAN REP ENTATIVE ADDRESS
DATE
~~~~~, Said_is, -Guid_o,--Shuf_f-_&_ Ma__s_l_a_n__d----------------
2109 Market St_r_eet ~/a 3/~S~
----- --------
Came Hill_ PA 17n1i
r~,
y
=K
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK ()C) IN THE APPROPRIATE BLOCKS-
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 occurred after December 12,
1982, did decedent transfer property wfthin one year of death without receiving adequate
consideration? .. .. .
YES NO
X
X
X
X
X
3. Did decedent own an 'in trust for' bank acxount at his or her death4 X
YOU MUST COMPLE1TE SCHEDULE G AND FIOLE T ASEPART OFT ESRETURN.
f nn unn Ml ] 1Q01 fn.m en H.s... ...6. P,....... o~..~ s.. .~ ,
. c. __ __
REV-150EEX+ (2-87)
COM INHNE RETANCHEOTFgP~EpNETSUYgN ANIA
RESIDENT DECEpEN7
ESTATE OF
tropyright (c) 1 gg1 form software only Center Piece Software, Inc.
SCHEDULE E
CASH,. BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Fnrm ~5(b Crthniiiiln Flq... ~_n~f
MILDRED E. SNAVELY SS# 162-22-0773 12/07/94
REV - 1509EX + (3-88)
01MMONWEALTNOFPENNSYLVANIA SCHEDULE F
IN~~s~b~"~~T~'~N JOINTLY-0WNED PROPERTY
ESTATE ~F
MILDBED E. SNAVELY SS# 162-22-0773 12 07 94 FILE NUMBER
Joint tenant(s):
NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Jack E. Snavely 2949 North Front Street Son
Harrisburg, PA 17110
B.
C.
Jolntiq-owned properly:
ITEM LETTER DATE
NUMBER JOINT MADE
TENANT JOINT
1 A 02/06/85
/ /
DESCRIPTION OF PROPERTY
'NC Bank checking ~ ,
ccount jointly
caned for more than
ne year; transferred
romp viously jointly
can account at CCNB
nk, now merged with
NG Bank
TOTAL VALUE DECD'S DOLLAR VALUE OF
OF ASSET % INT. ECEDENT INTEREST
9,676.61 50.x. 4,838.31
TOTAL (Also enter on line 6, Recapitulation 4, 838 .31
(If more space is needed, insert additional sheets of same size.)
Coovright(c) 1991 form software only Center Pieee Snfiwarw_ Inr..
c__.- 1CM ~_~_.~..~_ G.n _.. .,, ,, .,,
REV- 15 ~ 0 E1+ (2-87)
CON~IONEWEALTCH OF PxERNENSUYRLVANIA
INRESIOENTDECEDETNT N
Prin~~~
FILE
MILDRID E. SNAVELY SS# 162-22-0773 12 07 94
THIS SCHEI ULE MUST BE COMPLETED AND FILED IF THE ANS WER TO ANY OF T HE QUESTIONS ON PAGE 2 IS YES
ITEM
DESCRIPTION .
NUMBER OF PROPERTY
Includsnameofthstransferse,their
EXCLUSION TOTAL VALUE DECD'S DOLLAR VALUE OF
relationahi to decedent date of transfer. OF ASSET °
h INT. DECEDENT INTEREST
1 Transfer of one-half
f 3,000.00 8,701. 00.00$ 5
701
46
o
proceeds of Lord Abbott ,
.
Fund on or about 11/15/94 „,.~°°~~~
to Jack E. Snavely, son ,~?~
of decedent ~
2 Transfer of one-half of f
3, 0.00
8,7 .46
00.00$
5
701
46
proceeds of Lord Abbott ,
.
Fund on or about 11/15/94
to Robert C. Snavely,
son of decedent
TOTAL (Also enter on line 7, Recapitulation)
(If more space is needed, insert additional sheets of same size,)
Copyright (c) 1991 form software only Center Piece Software, Inc.
SCHEDULE G
IS 11,402.92
Form 1500 Schedule G (Rev.2-B7)
+REV- 15'11 a+ (a-asi SCHEDULE H
FUNERAL EXPENSES,
C4IMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
INHERITANCE TAY RFTIIRN
MILDReD E. SNAVELY SS# 162-22-0773 12 07 94
ITEM
NUMBER DESCRIPTION
A• Funeral Expenses:
L Cremation Society
2 New Cumberland Church of God -Memorial Service
3 Funeral flowers
13. Adminlstratlvs Costs:
1. Personal Representative Commissions
Social Security Number of Personal Representative: 182-22-6937
Year Commissions paid
2. Attorney Fees
3. ~ Family Exemption
Claimant
Address of Claimant at decedents death
Street Address
Ciiy
Relationship
4. ~ Probate Fees
State Zip Code
Print or Type
FILE NUMBER
AMOUNT
837.00
350.00
75.00
500,00
C. Miscellaneous Expenses:
1 Landis Jewelers - appraisal 40.00
2 Register of Wills - filing fees 25.00
TOTAL (Also enter on line 9, Recapitulation) S ~°, $27.00
(If more space is needed, insert additional sheets of same size.)
Copyright (c) 1991 form software only Center Piece Software, Inc.
Form 1500 Schedule Ff (Rev. 7-88)
JREV- i5 1 2 Elf (10-88)
SCHEDULE I
COf~y Hry REAALTI EO~Fp P~E~pNg TSUVpN ANIA DEBTS OF DECEDENT
R~slb~ry~roECEDEf~IT MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE
MILDRT~ E. SNAVELY SS# 162-22-0773 12/07/94
ITEM
NUMBER DESCRIPTION AMOUNT
1- Susan Appleby, R.N. - nursing services
2 Alert Pharmacy - medicine 35.00
3 Bethany Village - residence charges 304.30
4 Nova Care 1,465.10
430.00
TOTAL (Also enter on line 10, Rec itulation S 2 234.40
(If more space is needed, Insert additional sheets of same size.)
Copyright (c) 199 form software only Center Plecs Software, Inc.
Form 1500 Schedule I (Rev. 7-88)
FEV-1513EX+ (2_g~l
CDMINQ,ESD NTDTECpbETNTNANIA
SCHEDULE J
~ENEFICIARIE
MILD&ED E. SNAVELY SS# 162-22-0773 12 07 9~
ITEM
NUMBFA NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
L Jack Snavely
2949 North Front Street
Harrisburg, PA 17110
2 Robert C. Snavely
645 Lenker Road
Harrisburg, PA 17111
RELATIONSHIP I AMOUNT OR
` SHARE OF ESTATE
Son I50~ of residue
Son 150$ of residue
_.._ _'...... ~ c. •rwarp. Inf.. __ -~..~ r...v.~