HomeMy WebLinkAbout95-01732~-g5-or~3
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 16 20Q1
Date
H,DS.,q R.v. ?/p
Tr-ERRR,r
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REnMAHE„r HAMS
Buac
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Fr eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSVLN~NIA • DEPARTMENT OF HEALTH • VITAL RECORDS U ~ ~ ~ n
CERTIFICATE OF DEATH iJ 4
« MM.I o.«. Mbd., Lan _ Q.K ~..n
+. Dolores M. Stambaugh
26
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Female 165-
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OR ~OWad~.>WnN.tlpnrWaim'..H9e~_fn my uPMbn.d.rA xcwrM altM t4n..AH.. uW W.e.. mOdu.b M. uu.N.l aM ^ p• ~p)C 0~ Ofi ~-bLtu J7
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REGISTRAR'S SIGNATURE AND NUMBER ~'n ~0 rQ ~ !~
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m. DRE FILED (MmT. D•Y. VBA.I
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INHERITANCE TAX RETURN FOR DATES OF DEATH AFTER 12131!91 CHECK HERE
pOVERTYUCREDIT IS
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MMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENT
TO BE FILE CLAIMED
FILE NUMBER
DEPARTMENT OF REVENUE (
D IN DUPLICATE
DEPT. zaoboi
HARRISBURG, PA 17128-0601 WITH REGISTER'Z7F'~II/ILLS~ 21-95-0173
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (AST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
STAMBAUGH, DELORES MAE 613 "B" St.
W
0 SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH S:ummerdale
PA 17093
W 165-26-5001 .2/23/95 1/30/30 ,
c,°°,
D (IF APPLICABLE( SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL( SOCIAL SECURITY NUMBER SEE INSTRUCTIONS)
DALE C. STAMBAUGH (Husband) 182-22-8601+ ~ % ~~
~ooq r~sl ,,.,~.~
L" ~~. Original Return ^ 2. Supplemental Return ^ 3
Remainder Return
Yay
Lc'asn°C.cY.,
x~~
^ 4. Limited Estate
^ 4a. Future Interest Com romise
P ,
(for dates of death prior to 12-13-82)
^ 5. Federal Estate Tax Return Required
yam
~b. Decedent Died Testate (for dates of death after 12-12-82)
^ 7
D
d
M
d
1
(Attach copy of Will) .
ece
ent
aintaine
a Living Trust
(Attach copy of Trust) - 8. Total Number of Safe Deposit Boxes
~
s°
z
DONALD B. OWEN, C MPLET ADDR
Esq. C~/SSo$ Counselor
At Law
~~ TELEPHONE NUMBER 1O5 Mt. V1eW Dr.
1. Real Estate (Schedule A) (1) - ;- rt ~~ -3 ~;;
~
2. Stocks and Bonds (Schedule B)
(2) _ ~° r3
_ - _
3. Closely Held Stock/Partnership Interest (Schedule C) (3) - ;
4. Mortgages and Notes Receivable (Schedule D) (4) - _ i
5. Cash, Bank Deposits rS Miscellaneous Personal Property (5) ~18.~+73.00
' ~'~
Z (Schedule E) ;
~ ,
b. Jointly Owned Property (Schedule F) (b) -
~ 7. Transfers (Schedule G) (Schedule L) (7) - ~ ~. `.~~ -„
a 8. Total Gross Assets (total Lines 1-7) (g) L~18,1+73.00
9. Funeral Expenses, Administrative Costs, Miscellaneous
Expenses (Schedule H) (9) 8 ,1b 71+.02
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) -
11. Total Deductions (total Lines 9 8 10) (11) 8,~+7~+. 02
12. Net Value of Estate (Line 8 minus Line 11) (12) 9,998.98
13. Charitable and Governmental Bequests (Schedule J) (13) -
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 9,998.98
15. Spousal Transfers (for Pates of death a 9er b-30-94)
See Instructions for Ap licable Percents eon Reverse
Side. (Include values from Schedule K or Schedule M.) (15) $9, 698.98 X.03. 290.97
16. Amount of Line 14 taxable at b% rate
(Include values from Schedule K or Schedule M.) (16) 300.00 x .Ob = 18.00
o 17. Amount of Line 14 taxable at 15% rate
(Include values from Schedule K or Schedule M
) (17) X .15 =
F .
18. Principal fax due (Add tax from Lines 15, 16 and 17.) (18) X08 • 97
~ 19. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ + - (19J -
F 20. If L' 's greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20)
_
21. If L is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) - X08 97
A.'~~, er the interest on the balance due on Line 21A. (21A) -
B. Enter the total of Line 21 and 21A on Line 21B. This is the BALANCE DUE. (216) - $08.97
Make Cheek Payable to: Register of Wills, Agsnt
n er peno tles o perjury, I declare that I have examined this return, including accomponying schedules and statements, and to the best of my knowledge nd belief,
it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the persona r ~nt is
based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ~ . ~- DATE
DALE C. STAMBAUGH, Executor 613 "B" St. ummerdale, PA 17093
SIGNAT REPARER OTHER THAN REPRES IVE ADDRESS
DATE
Es 105 Mt. View Dr., Enola, PA 17025 ~'
...~._ _ ,
~_= ~•
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the use of the spouse. The rates as prescribed by the statute will be:
• 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
• 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
• 1 % (.O1) will be applicable for estate: of decedents dying on or after 1 /1 /97 and before 1 /1 /98
e Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK fir) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and: x
a. retain the use or income of the property transferred, .......................................................
x
b. retain the right to designate who shall use the property transferred or its income, ...............
c. retain a reversionary interest; or ................................................................................... X
d. receive the promise for life of either payments, benefits or care$ ....................................... x
2. If death occurred on or before December 12, 1982, did decedent within two years preceding g
death transfer property without receiving adequate consideration$ If death occurred after
December 12, 1982, did decedent transfer property within one year of death without receiving x
adequate consideration$ ...................................................................................................
x
3. Did decedent own an 'in trust for'. bank account at his or her death$ ......................................
..
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
' s ~~
Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters Testamentary
No. 1995-00173 PA No. 2195-0173
ESTATE OF STAMBAUGH DOLORES M
a/k/a STAMAAitc,H nnr.nn~e nrt~-c~
Late of EAST PENNSBORO TOWNSHIP
Deceased
Social Security No. 165-26-5001
WFIEREAS, on the 7th day of March 1995 an instrument
dated March 13th 1990
was admitted to probate as the last will of STAMBAUGH DOLORES M
a/k/a STAMBAUGH DOLORES MAE
].ate of EAST PENNSBORO TOWNSHIP CUMBERLAND Count
y, who died on the
__23rd day of February 1995 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS Register of Wills in and for
tt~e County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to DALE C STAMBAUGH
wlio has duly qualified as Executor(rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
C1IRLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 7th day of March 1995.
eg s e o s
LAST WILL AND TESTAMENT
I, Dolores Mae Stambaugh, of 613 B Street, (Summerdale,
17093), East Perinsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and
understanding do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all other former wills
and codicils thereto at anytime heretofore made by me.
ITEM I. I direct my Executor, hereinafter named, to pay
from my residuary estate, all my just debts, taxes and other
expenses as soon as may be practicable. I further direct that
my Executor arrarrge for a burial commensurate with my station
in life and that the same be accomplished as economically as
possible. I also direct that I be buried in one of_ two
cemetary lots owned by me in the Rolling Green Cemetary, Camp
Hill, Pennsylvania, more particularly described as Block N,
Veterans Mausoleum, Section 103-D4. ,
ITEM II. I devise and bequeath my only diamond engagement
ring to my daughter, Doretta J. Jac~'bbs,~ of 757 Erford Road,
Camp Hill, Pennsylvania, 17011.
DMS
ITEM III. I devise and bequeath all the rest, residue and
remainder of my estate, both real and personal, whatsoever kind
and nature and wheresoever the same shall be situate, of which
I may die seized or possessed, or to which I may in any way be
entitled, including specifically any property not hereinabove
effectively disposed of, hereinafter sometimes referred to as
my residuary estate, to my husband, Dale Clinton Stambaugh,
providing he shall survive me by thirty (30) days.
ITEM IV. Should my husband, Dale Clinton Stambaugh,
predecease me or die on or before the thirtieth (30th) day
following my death, I devise and bequeath:
A. Unto each of my seven grandchildren hereinafter listed
the sum of One Thousand ($1,000.00) Dollars:
Stephanie A. Williams
William F. Houdeshell, III
Scott D. Houdeshell
Robert L. Jacobs, Jr.
Danielle M. Jacobs
Katrina D. Jacobs
Patrick C. Jacobs M
- of Middletown, PA
- of 806 Charlotte Way,
•Enola, PA
- of 757 Erford Road,
Camp Hill, PA
.L~ - ~I'I. ~.
DMS
Page 2 of 6 pages
B. Unto my two daugt~tE~rs, Doretta J. Jacobs of 757 Erford
Road, Camp Hill, PA and Deborah A. Davis of 806 Charlotte Way,
Gnola, PA, all of my right, title and interest in the real
estate and residence known and numbered as 613 B Street,
Summerdale, East Pennsboro Township, Cumberland County,
Pennsylvania, as follows:
(1) The aforesaid real estate and residence shall be
appraised and Doretta J. Jacobs shall have thirty (30) days
after the date of the appraisal to purchase said real estate
and residence by paying fifty percent (50$) of the appraised
value to Deborah A. Davis, whereupon my Executor shall execute
and deliver to Doretta J. Jacobs a quit claim deed to
effectuate same.
(2) In the event Dorreta J. Jacobs shall refuse to purchase
the aforesaid real estate and residence or shall fail to act
within the prescribed time, Deborah A.. Davis shall have thirty
(30) days after such refusal or expiration of time within to
purchase said real estate and residence by paying fifty percent
(50~) of the appraised value to Dorreta J. Jacobs, wherefore my
Executor shall execute and deliver to Deborah A. Davis a quit
claim deed to effectuate same.
DMS
Page 3 of 6 pages
(3) In the event that Deborah A. Davis shall refuse to
p~irc}iase the aforesaid real estate and residence or shall fail
to act within the prescribed time, the said real estate and
residence shall be disposed of in accordance with item IV C.
hereinafter set forth.
C. All of the rest, residue and remainder of my estate, of
every nature and wherever situate, I devise and bequeath to my
two daug}hers, Doretta J. Jacob:, and Deborah A. Davis, per
stirpes, in equal shares, share and share alike.
ITEM V. In addition to powers granted by law, my Executor
shall. have the powers, without court approval, to compromise
claims, to sell at public or private sale, exchange or lease
for any period of time, any real or personal property and to
give options for sales or leases.
ITEM VI. I appoint my husband, Dale Clinton Stambaugh,
Executor of this my Last Will and Testament. Should my
husband, Dale Clinton Stambaugh, fail to qualify or cease to
act as Executor, I appoint my two daughters, Doretta J. Jacobs
and Deborah A. Davis, alternate Co-Executrices of this my Last
Will and Testament.
~- _
DMS
Page 4 of 6 pages
ITEM VII. I direct that
not be mY personal representatives Shall
required to give bond
for the faithful performance of
their duties 9_n this or in any other jurisdic '
t.ton ,
ITEM VIII. I direct that
Thomas M. Fraticelli, Esquire, of
Upton Drive, Harrisbur
9, PA 17110, shall act as attorney for mY
estate,
IN WITNESS WHEREOF, I have Hereunto set m h
this Last Will and Testament which consists Y and and seal to
(3) other t of this and three
YPewritten pages, each of which bears m
tr1e bottom of the Y initials at
Page, this /3 day of March, 1990.
,t_~ ~ ~ .
--~--------.___- Jl ~ ~-_, r
Dolores --- fj' f~i' ,- ~ ,- - < !.~..
Mae Stambaugh
Page 5 of 6 pages
The preceding instrument, consisting of this and three (3)
other typewritten pages, bearing the initials of the Testatrix
~-~t the bottom of each page, was on the day and date thereof
signed, published and declared by Dolores Mae Stambaugh, the
Testatrix therein named, as and for her Last Will and
Testament, in the presence of us, who at her request, in her
presence, and in the presence of each other have subscribed our
names as witnesses hereto.
residing at l30 ~ ~/~1v,., ,l~X. ~,/rr (~''q
residing at ~< ~ ~- ~ Q~
residing at
~~r11. /J .
DMS
PacrP. (, cif ~ narrate
COMMONWEALTH OF PENNSYLVANIA
, SS
COUNTY OF DAUPHIN
I, Dolores Mae Stambaugh, Testatrix whose name is signed to the
attached .or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will and Testament; that I signed it
willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
~~~ ~ ~~
Dolores Mae Stambaugh
Sworn or affirmed to and act:nowledged before me by Dolores Mae
Stambaugh, the Testatrix, this ~3~ day of March, 1990.
Nota blic
(SEAL) My Commission Expires: 3~~1/9~
MARY J. SFUGHMAN, NOTARY PUBLIC
COMMONWEALTH OF PENNSYLVANIA HARRISBURG, DAUPHINCOUNTY
S S MY COPAMiSSION EXPIRES MARCH 11,1991
COUNTY OF DAUPEITN M:.cibP.~F'pn~srrvsniel~es9eietien~INeferies
We, ~l}c~.~u! s iM - F~tnT~ cetci ~-Qa~..e\a ~S . ~+4o~~a~
the witnesses, whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and say
that we were present and saw Dolores Mae Stambaugh, Testatrix, sign
and execute the instrument as her Last Will and Testament; that
Dolores Mae Stambaugh, signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testatrix signed the Will
as witnesses; and that to the best of our knowledge the Testatrix was
at that time 18 or more years of ale, of sound mind a d under no
constraint or undue influercE.
C~.~-~-
- `.
S~~orn to and subscribed before me
this 3 ~` day o Manc~h, 11990 .
N ary Public
My Commission Expires: ~~~,~J~~
MARY J. SHUGiliviAN, NOTARY PUBLIC
HARRISBURG, DAUPHIN COUNTY
MY COMMISSION EXPIRES MARGH 11,1991
Memb+~r, Pennsylvania Assodation of Notaries
Rrv iSnP Fx ~ h B7i
~`
~s~
COMMONWEAirH OF PENIJSYLVANIA
1N!iERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
ESTATE OF
`.L'l1P~tI3~Li(IH , I ~I?CORES P~IAI?
-- ------- -- - -------- -
All property ---- --
jointly-owned with the Right of Survivorship must be disclosed on Schedule F)
ITEM
NUMBER DESCRIPTION
1. Harris Sa.vinp;s - CD 09-55-2F>01411
Accured. Interest
-'. Harris Sa.v-n~*s - CD 09-56-247035
Accured Interest
3. Harris Sa.vint;s - CD 09-61-255762
Accured Interest
fl • Ila.rris Sav:in~*s - CD 09-63-< 29f169
Accured Interest
5. Itarris ;~a.vin~s - CD Oy-56-237793
Accured :Interest
~~. Harris Savings - Christmas Club - 09-8-00978
Accured Interest
'~• Harris Sa.vin~;s - Checlcin~* Acct !! 0900001769
Accured Interest
`3. Harris Savings - Sav.in~s Acct /# oy-6o-009563
Accured Interest
9. lyy7_I3ui.ck Cent ury - see attached appraisal
10. I Ladies sma.Il. diamond. en~a~;ernent rin~•
Please Print or
LE NUMBER
21-y5-0173
VALUE AT
DATE OF DEATH
500.00
.17
2,030.f111
14.24
1,005.23
8.99
1,099.75
7.98
512. f13
2.y8
400.00
2.02
530.47
.18
5,of-17.19
10.93
7,000.00
300.00
_ ___.______._.___._____._.______________ TOTAL (Also enter on line 5, Recapitulation) $ 18,1+73.00
(Attach additional 8'/x" x 11" sheets if more space is needed.)
(•azls awns }o sjaays ~DUO1jIppD jJasul ~papaau si aaDds aJOw }I)
z0'+1L+1` g $ (uo~;D~n;idDaaa '6 awl uo Ja;ua os~~y) ~br101 •
'8
•L
'9
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•q
00'00 T+10T/T+~ ~d saxes d.z'eTatpn,~ ,~o daad/saa3 ~d0 '£
00'Z~ sdure~.g pine sa~.oN nod xuBus 'Z
z5'z
6~# day ~t.za~oaa sa ~ ~ a
2i ~ ~•-d/ ~Z paz,~t~aaa MdQ 'l
' :sasuadx~ snoauDllaasly~ •,
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OT a~}~ego.zd pT$ T~euoz~tpp~e snTd
00'+18 ~uzT?d 00'ST$ - a~'egoad 00'69$ seal a;DgoJd •y
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00 ' 005 ` E puagsng d~ysuo~;Dteb H`JII~TflY1~S,S , ,~ ~~~Q;UDWID~~
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~~ SCHEDULE J
CO~dM,ONWEAIiN OF PENNSYLVANIA BE N E f l LIAR I ES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
tJ1ATE OF
STAMBAUGH, DELORES MAE
ITE M
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
~" DALE C. STAMBAUGH
613 "B" St., Summerdale, PA 17093
SSN: 182-22-8604
2. DORETTA J. Jacobs
757 Erford Rd., Camp Hill, PA 17011
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequests:
1.
FILE NUMBER
21-95-0173
RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
HUSBAND ~ 100
residue
daughter small diamond
engagement ring
AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $
(If more space is needed, insert additional sheets of same size)
REV-15e7 EX AFP (12-94)
`~OMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
DEPT. 280601
HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX
ACN 101
DATE 08-14-95
DATE OF DEATH 02-23-95 uuLUrtCJ M FILE N0. 9 -0
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OFC HIST ORM WITH YOUR TAX ND
PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO ''REGISTER OF WILLS, AGENT••
REMIT PAYMENT TO:
DONALD B OWEN ESQ
105 MT VIEW DR
ENOLA PA 17025
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Amount Remitted
CUT ALONG THIS LINE _
___________________ RETAIN LOWER PORTION FOR YOUR
REV-1547 EX AFP (12-94) NOTICE
--------
RECORDS
~
----------- __
-------
OF INHERITANCE TAX APPRAISEMENT
-----------------
DI
AL
SA
ESS
ESTATE OF STAMBAUGH
O
E
U
0
D
__
,
LOWANCE OR
MENT OF TAX
DOL
ORES
M FILE
NO
21 95
0173 ACN 101
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) DATE 08-14-95
RESERVATION CONCERNING FUTURE INTEREST - SEE CHANGED SEE ATTACHED NOTICE
REVERSE
APPRAISED VALUE OF RETURN BASED ON:
ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule 8) (1) .00
3. Closely Held Stock/Partnership Interest (Schedule C) (2) .00
4. Mortgages/Notes Receivable (Schedule D) (3) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
(5)
6. Jointly Owned Property (Schedule Fl 1 8,473 00
7. Transfers (Schedule G) (6) .00
B. natal assets (7) .00
APPROVED DEDUCTIONS AND EXEMPTIONS: (s) 18,473.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 8,474.02
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions (10)- 00
12. Net Value of Tax Return (11) - 8-474 0?
13• Charitable/Governmental Bequests (Schedule Jl (12) 9,998.98
14. Nst Value of Estate Subject to Tax (13) •00
NOTE: if an assessment was issued yy
reflect figures that incl
d
p
i
~
i c14) 9,998.98
a
7
u
e
the
total
of
ALL returns
ASSESSMENT OF TAX: date.18 will
assessed~to
15. Amount of Lfne 14 at Spousal rate
(15l 9,
16
Amount
f
698.98
00
.
X .
o
= .00
Line 14 taxable st Lineal/Class A rat
e
17. Amount of Line 14 taxable at Collateral/Cl 300.00 X .06= 18.00
ass 8 rate (17)
18. Principal Tax Due ' 00 X ' 15= . 00
TAX CREDITS: (18) 18.00
PAYMENT RECEIPT DISCOUNT (+)
DATE
NUMBER INTEREST (-) AMOUNT PAID
05-09-95 nen4~~z~
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT
309.87
BALANCE OF TAX DUE 291.87CR
INTEREST .00
TOTAL DUE 291.87CR
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT ZS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), VOU MAY BE DUE
~.,e~o ex ~e.ee :fir i -
1
r' INHERITANCE TAX
COMMONWEALTH OF PENNSYLVANIA EXPLANATION
BUREAU OF IN;.) VIDUAL TAXES OF CHANGES
DEPT. 280601
HARRISBURG, PA 1 7 1 2 8-060 1
DECEDENT'S NAME
i'f•IUTeS I~~,e ~1:"~~;.b311IT1-1 FILE NUMBER
~~~t9~°i7~;.'
ACN
ITEM t t~ I
SCHEDULE NO EXPLANATION OF CHANGES
Act 2.I of 1995 rc~cliic~d tl)~' tax rate on rran.sL~rs to a suz-vz~,fn1 spouse
fr.ozra 3 perc>_nt to C ~€~ree;~t for ~atE~s of :~ear'r? on or ;aft r T3~zu_srv I,
I9~~~» ~iiic C'StB,C° TC:COr~ TYt~S I?C'£'R ACI~liSte'(a 1.i't BCcUrt~ 1;)C~' Nlit}! ~
t,~e c_iian~;c~s.
~1ult2r_alln T<..I Ir;~.iP.
TAX f.iXAMINER: -
PAGE