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HomeMy WebLinkAbout95-0235This is to certify that rhP r~aT?ifino*o L.,...,..._~_ _~._ _, _ ~ I 1 ~ '0~~ death record on file with the Division of Vital Records, and that FrankuYeropoli, whose namleas 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 16 200]' Date H705.1~7 Rev. 2/B7 TYP~vaINr M PER77ANE71T NAME BLACK BNC ,_ 51 r,.. s cauNrv oaDEATH oo, Cumberland ~ DECEDENrsuauALOCCURVwN (C'wNne N•M Ear~Ar.p maul of KMMinp 7N; Eo n•1 r•n6ee.) ,Lasting Room Experti DECEDENT'B MAILNq ADpIE$S IsveI, C•y/TpY 149 Opossum Lake Rd. ? • Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH DA+' DATEovBIRTN rob~m.o,y,y>,rl `• male 7• 168 - 36 sw w.cEOCDE~DH~cn.d,«+,•«»-ee.~w~,.mw,. HOSPIpIL Dec.14,1943 .. ; Perry Co. ,PA ILpMMI.nI^ ERADWp•ure^ ~„^ , • ~ ORO.TwvaFDEQH cACUrYNAMEI7no1rcr7u•on ,gN•ane•I•ronrrle•r) RNB DEDEDENTOF Frankford Tw 149 Opossum Lake Rd I q MM• dw ^ py ID OF BUSMIESSANDUSTRY WAg DECEDENT EVERIN . OECEDENT'9 ~ ~•M1 «rIO R ~ U.S.ARMED FdM.E8? EDUCIP•JN MA,NDLL~ Shoe K•^ ND ~ E Y NT+K+7~• NMfMMriF Dnom.a ~+~+ 1z ro ,~ u ~, a '~oE•) DECEDENT•S . le. ACTUAL n..SW__ PA RESIDENCE DIE 1h.~Ke, E•C•dre Wuyl _ 15r imlruaipy on aNer aEe) n E•c•eMe Min s r...,..... ('.Ilmhorl ~...i bwnMllpT '-. Na Er.Er•w.n DoMtlon^ our. Cr•btlbn^ RrgY•I /tom Sbb^ d rlb F !RUC-?„~ ^ R..w«~• C9 ^ Dwz ~.~~ ,o. White D•Y. rrA•I• +w~v x~ILrsq 1IIl LAST 3 z OERM7 • ~...wx ~ IManm, Dey, Y•eh -.. __... ~^ ~ ~ ..vnrtv DESCRIBE HOW INJURY OCCURRED. NNUr•1 HE•XCie• ^ AoclEne ^ PariOip •neMlpNbn ^ rn ^ No ^ Y°° ^ No~ v.• ^ Nu ~ sw„e. ^ DEUleralaa.I«m,,,e ^ J0 M• •. Toe. RucEOFlwuRr-aMms,Mn,prsx,Iac1E,,;onk• L a. ~~ 7•, b~n0. etc fsa•caYl OCATpN (Sb•eI. Ciy/f . slx•I ICft•~*«eY enN 7a. 'T+~ryn•rbeY•,er1h•x+w~MWbtln K~~~~~~pO"~uncee EeauiWCanWeleEllem 23) SI(iNQURE AND ~ R ••u•~•I.1111 ~nWIMr•bbe .............. - ` ....................................... •RRDMDUNCMGAND CERTIEyy,D RHYSMJAN ais. (PhYecienEM ganpi ewNYinObta~•al Eeetl~) LICENSE R ^~ To Bb MMOinry br•beo.,e..pa•eun•e KIM 11•u, d•b~•neMr•. •ne eu•b1M ~ ~Oo2y ~'Z ~f ~E ~p~I~•DeY. Y'g7~r)c/~~.~ ••~r•I•I•ne brn•rr•I•Ntl .......................... 1C. ii f1 / 714 ••~W ~ / / l 'AI~ICAL E%AMB7ER/CONONER NAME ANDADDRESS OF PERSON WHO COM]LETEO CAUSE OF DEATH/ ~+~+~+•~•++bIR•BOnrw«hvsstlp•Ilon. yl mp OP'"iO^ a+,A •~curne at m•Dm• aue Mq OIem 2~Type«Prin1 Steven L. Hatleberg MD 71 rwt•d.......... Wc•. •ne dV•Ia M•eau•Nq and .............................. "~~"~ """~~'~-• •~•~-•-... ^ BMC,850 Walnut Bottom Rd. ,Carisle, PA ~STRAR'S SIGNATURE AN~NUWj€R • • • • . • • . • 7t. 1 ~~.p ~ ~ (~.p ~ ~ III,-~~) ~ ` ' (~I D/7E FlLED (MOMh, Dey, lbe.) q. ~ O.\t\.O ~_\ 1 C \~e \..7LZT ~~ ~LJ _' I Jan. 20, 1995 "`« Cumberland Valiey - 7j•.Memorial Gardens ~M 010343 L IwwEA"°A°°RES'°`rAC"TV H ~` - - - 5QQ848~2 ~~ ~~~~~~~ '' REV-1 soo ex ~ n 1-?!! FOR DATES OFDEATH AFTER 12f31f91 CHECK E~ ' ;-'~ ~ INHERITANCE TAX RETURN 1F A sPOUSAL '~' "~~'-%-" RESIDENT DECEDENT POVERTY CREDIT IS CLAIMED ^ CCM11MCiNV!`ALT'rt OF PENNSYLVANIA (TO BE FILED IN DUPLICATE FILE NUMBER ~---- DE°AR,r~,EP;T OF REVENUE JEPT.2B0601 WITH REGISTER OF WILLS) HARR153URC. PA 17128-0601 COUNTY CODE YEAR ~ NUMBER ---~ DE~_c~Dfrd ~'~ N.gME (LAST, FIRST, AND MIDDLE INITIALI DECEDENT'S COMPLETE ADDRESS ~.." ~__ Ru~,_ Carl E. 149 Opossum Lake Road ~=U;i :i~:uR!TY NUMBER DATE OF DEATH DATE OF BIRTH ~~~ ~V Carlisle, PA 17013 i~ i 168-36-6688 1/16 12/14/43 Cumberland ca~~tY ~ ~ ' . C. ridinal Return 2. Supplemental Return ^ 3. Remainder Return """ ~;C °~ (for dates of death prior to 12-13-82) `' ~'~.t I ~ .:.. Limited Estate '~ -. -, ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax :C 4. d:e. ~r~.-: I _ (for dates of death after 12-12-82) Return Required ~ '-~ :,. J:rcedent Died Testate ^ 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes "= f~~t!cch copy of Will) (Attach copy of Trust) I hs:~ `'?.kyPd~RIDEIdCE AND CONFIDENfiIAI TAX INFORMATION`SHOULD"BE DIRECTED TO NAA.1E , COMPLETE MAILING ADDRESS u.' ~ ~ F Susan J. Otto Susan J. Otto, Esq. `~~ r~° I 1 Irvine Row (717 t 249- 780 Carlisle, PA 17013 l----- ?, i'•,c.,l f'~;:ato (Schedule A) (1) 0 ('~(~ ^. tcci:s cind Bonds (Schedule B) (2) 0 ~_ ~ t :~9 t ~. C o..sy' Held StocklPartnership Interest (Schedule C) (3) ~ ;-3 . %.i ;~a::ges and Notes Receivable (Schedule D) (4) ~ 5. Cu n ank Deposits & Miscellaneous Personal Pro ert 5 lJl d7 ~ - F= I 5. Jointly Awned Property (Schedule F) (6) N ~ ~ ~` ~.r - ~ i 7. Trcr;sfers (Schedule G) (Schedule L) (7) `~ ~. !'~? °-ri ~- I ~ a- ~ o^^. Tctai Cross Assets (total lines 1-7) (8) Q ?. i ;moral Expenses, Administrative Costs, Miscellaneous (9) 2' ' 48 l~r . L:cnenses (Schedule H) 10. Dr:bts, PAortgage Liabilities, liens (Schedule I) (10) ~ t,,~ ~/ i 1 . i e?ai Deductions (total lines 9 8~ 10) (1 1) 2 8 $ 12. ;~I~t `/clue of Estate (line 8 minus line 11) 891.48 (12J 13. !~;-:^ritn5le and Governmental Bequests (Schedule J) (13) -~ • ` '.; `lr,!u~. Subject to Tax (line 12 minus line 13) --'" (14) ~ Q o i i nl 15. ;>rncunr ct hne 14 taxable at 6% rate (15) x .06 = (!r-'~~de values from Schedule K or Schedule M.) I1G. Ar,ioun7 of line 14 taxable at 15% rate (16) x .15 = {Inci~:r;; values from Schedule K or Schedule M.) 1 ' ~ ~''` , ^n:i 'n>: due {Add tax from line 15 and from line 16.) ,.h (17) j ' I'~ .• ~.. ~ Spousal Poverty Credit Prior Payments Discount Interest I - + + (18) "~. :. ~-.:~ ? ~ is greater than line 17, enter the difference on line 19. This is the OVERPAYMENT. (19) I -~"~.~ - .. ~ ' ? is greater than line 18, enter the difference on line 20• This is the TAX DUE. (20) ~.niar the interest on the balance due on line 20A. (20A) Nnna ~ .:. n`er the total of line 20 and 20A on line 20B. This is the BALANCE DUE. (20B) None !___ ~ __ _.'take Claeck Payable to: Register of Wills, Agent >~ t~ BE.SURE TO' ANSWIER ALL Q1IESTIONS ON REVERSE3IDE AND TO RECIiECK MATH-4t+ -- Jnder , erc a ; r I eciore that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, r is tru c .c c n ~ .~: n, ~ te. i declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is ?esed „n ~~.+ it ,:., c~cr__.i _ ~ ~.~.mich preparer has any knowledge. ~iGr! ii, ~ -.i 15i8L_ FOR FILING RETURN ADDRESS DATE - - - ~ 7 ©/ -771J --- ` - _, r.R ?!? REPRESENTATIVE ADDRESS 3 DATE _ _ _ ~ ~ REV-1u02 EX+ (12-85) /1K.'; ~ ~c COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENi ESTATE OF Carl E. Rudy FILE NUMBER X95-00235 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonoble knowledge of the relevant facts. ITEM ~ NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. NONE SCHEDULE A REAL ESTATE -- TOTAL (Also enter on line 1 Recapitulation) ~ REV-1503 EX+ ,4-86) ~:• 4.~.4J'. , ~„~: COMMONWEALTH OF PENNSYLVANIA ' INHERITANCE TAX RETURN RESIDENT DECEDENT Vt SCHEDULE B STOCKS AND BONDS Carl E. Rudy (Ail property jointly-owned with Right of Survivorship must bs disclosed on Schedule F.) ITEM NUMBER DESCRIPTION 1. NONE FI TOTAL (Also enter on line 2, Recapitulation) 1995-00235 VALUE AT DATE OF DEATH S 7 ~ REV•1508 EX+ (2.87) SCHEDULE E CASH, BANK DEPOSITS AND CCIMMNNERRAN E~TAXERENTURNANIA MISCELLANEOUS ` RESIDENT OECEDEN7 PERSONAL PROPERTY ESTATE OF Please Print or Type Carl E. Rudy FILE NUMBER (All prop~rfy jointly-owne<t wtfh fhe Rtght of Survivorship must be disclosed on Schedule F) 1995-00235 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH NONE TOTAL (Also enter on line 5, Recapitulation) $ (Attach additional 8Yz" x 11" sheets if more space is needed.) ~ , REV-151t f.Xti (7•BB) ~.~~~ EOMMONWEAIiH OF PENNSYLVANIA ' INHERITgNC~ ~qX RETC)RN RESIDrtNT DiCEDENT ESTATE OF Rudy, Car1.E. ITEM NUMBER A• Funeral Expenses: 1. B. 2 3. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCE~~ANEOUS EXPENSES DESCRIPTION Please Print or NUMBER 1995-00235 Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: - Year Commissions paid Attorney Fees Duncan & Otto, P. C, Family Exemption Claimant Edna R. Rudy Relationship spouse Address of Claimant at decedent's death Street Address 149 0 ossum Lake Road City Ca~1 i ~1 a State PA Zip Code 17013 Probate Fees Miscellaneous Expenses: Cumberland Law Journal Evening Sentinel Legal Ad TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of same size.) AMOUNT 750.00 2,0 .00 36.00 40.00 65.48 ~f .- ~~k ~~ 2,891.48 ~ REV.1313'EX* (2•!7~ ' COMMONWEALTH OF FENN ' INMlRIT STLVANIA W, ANCE TAX RETURN iTATE OF Carl E. Rudy ITEM NUMBER SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: Edna R. Rudy FILE NUMBER 195-00235 RELATIONSHIP wife ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) g (If more space is needed, insert additional sheets of same size) AMOUNT OR SHARE OF ESTATE 1007 AMOUNT OR SHARE OF ESTATE { ~- • ~~ Card;, a Q, P v ~b1;C P i ~nmha~,~nri (' ~rti, 1 V~i~ . A ~___~,_ c V W In t+7 >C N I ~.. t REV-1547 EX AFP (12-941 CDMMONNERLTN OF PENNSYLVANIA DEPARTMENT OF REVENUE $UREAU OF INDIVIDUAL .TAXES NOTICE OF INHERITANCE TAX ACN 101 DEPT. 280601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE HAFNtIS8UR6, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DATE 06-12-95 DATE OF DEATH 01-16-95 FILE N0. - NOTE: TO INSURE Penoee .•e~^.~ - COLINT'V f`uYnrn~ ..... ~'~-'-" "^"'+' iu yuuR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX nu PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF MILLS, AGENT^ REMIT PAYMENT TO: SUSAN J OTTO 1 IRVINE ROW CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Aeount Remitted CUT ALONG_ THIS LINE - ----- ETAIN --"-"- - _ LOWER PORTIO REV-1547 EX AFP (12=94j NOTICE OF INHERITANCE TAXNAPPRAISEMENTCOALLOWANCE OR ------"----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RUDY CARL E FILE N0. 21 95=0235 er_N , n, TAX RETURN WAS: ( l ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortyayes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Tranafers (ScMdule G) 8• Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortpaye Liatailitiss/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Nat Value of Estate Subject to Tax NOTE: If --- +rnic ub-1Z-95 ( X) CHANGED SEE ATTACHED NOTICE (1) .00 (2) .00 (3) .00 (4) .00 (5) .00 (6) .00 (7) .00 (8) .00 (q) 891.48 (lo)_ 00 (li) A91 co (12) 891.48- (13) . 00 an assessment was issued y~ ' 14) 891.48- prev oust lines 14 15 and/or 16, 17 and 18 will reiiect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line l4 taxable at Lineal/Class A rata 17. Amount of Line 14 taxable et Collateral/Class B rate 18. Principal Tax Dw TAX CREDITS: PAYMENT RECEIPT DATE NUMBER * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT (+) INTEREST (-) (15) . 00 X .03= (16) . 00 x .06. (17) . 00 X .15= . 00 . 00 .00 (18) . 00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE •00 INTEREST •00 TOTAL DUE •00 .00 ( IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ^CREDIT^ (CR), YOU MAY 8E DUE ,REV-147C•'cX (6.88) ~ ~• . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES , DEPT.:?80601 HARRISBURG. ~A 17t9A_nan~ INHERITANCE iAX EXPLANATION OF GHAN4E5 Carl E. SCHEDULE Reduced to $0.00. F .r FILE NUMBER 2195-{1235 ACN 101 EXPLANATION OF CHANGES ?mption can ,only be claimed against nr~h~t~ TAX EXAMINER: Sohn Rugp PAGE