HomeMy WebLinkAbout95-0328_ n
This is to certify that the certificate hereunto attached is a tine 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._,2001
Date
N,~.,~as>~eTED~s: ~i
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Fran eropoli, ' ectdl~
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMNIONNlEALTH OF PENNSYLIMNIA • DEPARTMENT Of HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH 0 3 6 8 2 9
svaErrE IAILae, _ _
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REGISTRAR'S SgNRURE NUMBE
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INHERITANCE TAX R UR
FOR DATES OF DEATH AFTER 12131191 CHECK HERE
IF A SPOUSAL
~ -~ N
RESIDENT DECEDENT POVERTY CREDIT IS CLAIMED
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT
280601
(TO BE FILED IN DUPLICATE FILE N BER
1,
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HARRISBURG, PA 17128.0601 WITH R.EGiS R OF WILLS) COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
G J S L L ~ ~ C . f ~, ~ ~ DECEDENT'S COMPLETE ADDRESS
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p (IP AP-LICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONSI
>c c h 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return
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^ 4. Limited Estate
^ 4a. Future Interest Com romise
c (for dates of death prior to 12-13-82)
^ 5. Federal Estate Tax Return Required
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a ^ b. Decedent Died Testate
Attach co of Will
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) (for dates of death
fter 12-12-82)
^ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe De osit Boxes
- P
PY (Attach copy of Trust)
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1. Real Estate (Schedule A) (1) __- -- `'^' ~i-t ~j,
2. Stocks and Bonds (Schedule B) (2) -
3. Closely Held Stock/Portnorship Interest (Schedule C) (3 } L.
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4. Mortgages and Notes Receivable (Schedule D) (4) _
5. Cash, Bank Deposits & Miscellaneous Personal Property (5 ~, ~ ~' . b ~ l9.
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e E)
~°-~ b. Jointly Owned Property ($chedule F) (b) `
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f- 7. Transfers (Schedule G) (Schedule L) (7)
- -
6 8. Total Gross Assets (total Lines 1-7)
9
F
~ 8
( ) ~ b I ~p G (p ,
.
uneral Expenses, Administrative Costs, Miscellaneous ~) ~ ~ ~
~„
Expenses (Schedule li)
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) _
11. Total Deductions (total Lines 9 8 10) (11) _ ~~ ~° ~,
12. Net Value of Estate (Line 8 minus Line 11) (12) ro ~ ~ 1 ,
13. Charitable and Governmental Bequests (Schedule J) .---'
14. Net Value Subject to Tax (Line 12 minus Line 13) (y ~~ `'~ `'~ (14) __ '~-
15. Spousal Transfers (for dates of death after b-30-94)
Sss Instructions for Applicable Percentage on Rsvsrse (15)
Side. (Inducts values from Schedule K or Schedule M
)
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16. Amount of Line 14 taxable of 695 rate (16) J~
x (Ob
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(Include values from Schedule K or Schedule M.) ,
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z 17. Amount of Line 14 taxable at 1595 rats (17)
(Include values from Schedule K or Schedule M
) x .15
o .
18. Principal tax due (Add tax from Lines 15, 16 and 17.)
(18) 7
'~"~-~' 1 "'
~ 19. Credits Spousol Poverty Credit Prior Payments Discount Interest
b
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(19)
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F 20. If Line 19 is greater than Line 18, enter the difhrencs on Lins 20. This is the OVERPAYMENT. (20) 3 -T 3 3
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21. If Line 18 is greater than Line 19, enter the difference on Lins 21. This is the TAX DUE. (21) ~ J 3 J
A. Enter the interest on the balance due on Lins 21A. (21A)
8. Enter the total of Lins 21 and 21A on Line 21 B. This is the BALANCE DUE. (21 B) _ 3 ,1 ? 3
Make Cheek Payable to: Realrater of Wtlls, Aoenf
is true, correct and complete. I declare
teed on all information of which orena~
return, including accompar
I been reported at true ma
sots, and to the
preparer other
It of my knowledge and belief,
I the personal representative is
--- _
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GNA RE OF PREP RER OTHER THaN REOCi D sr vo ~ ~ ~ J t G ~ ~ ~~.f) ~r' FTMR ~•'1 ~' l', ~1~T• ~7`~1
DATE
ca- ~ ~_ ~r
DATE
Act #f48 of 1994 provides foe 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% (.03j 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 1/1197
• 1 °J~o (.O1) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98
• 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 (~j 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 life of either payments, benefits 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 within one year of death without receiving
adequate consideration$ ...................................................................................................
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.
r
REV-1508 EX+ (2.87, ~ SCHEDULE E
CASH, BANK DEPOSITS AND
COMMONWEALTH OF PENNSYLVANIA MISCELLANEOUS
'""RE s'~ ENT D~DENTR" PERSONAL PROPERTY
ESTATE OF
F~~~r~~~
Please Print or Typ
ER
SCHEDULE H
FUNERAL EXPENSES,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES
RESIDENT DECEDENT
ESTATE OF
F~~~~N ~~ ~~ G~-~s~ ~~-
lease Print or Type
FILE NUMBER
i~~ ,,~3
ITEM
NUMBER
DESCRIPTION
AMOUNT
A. Funeral Expenses:
~, ~ ~ ~~ ~~ ~tJ c ~ ~,~ ~ ~~ ~~ ~ ~~ ~~~ ~ ~ ~ ~~
~
.
~ ~~- i; ~
,~` ~ ~,.
Administrative Costs: Gz ~ ~ U.,`r,- ~ ~ L )'~Z~~'
1. Personal Representative Commissions
Social Security Number of Person
al Representative: l ~ ~~ - ~ ~ ~~ ~
~ ~ ~j
J J
G
Year Commissions paid ~ 1 ~'.~ '
2. Attorney Fees
3. Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees
1 3 .~ ; ~ ~~
C. Miscellaneous Expenses:
1. CLJ'~' ~~~~
~ ~
~'~
2. .
3.
4.
5.
6.
7.
6.
TOTAL (Also enter on line 9, Recapitulation)
J~
(If more space is needed, insert additional sheets of some size.)
REV-1513 E%a ~2-87)
COMMONWEALTH Of PENN $YIVANIA
INNERRANGE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
c ~ A ~ ~ ~ 7~~',~ ~; ',mil ~) ~~" Z t ~- .
oZ' F `~ ~ ~ ~,r ` ~ ~ Q i N ~ ~ f~+r~,•1
1
~~
FILE NUMBER
I ~ ~ ~~- t~ 0 3 ~
RELATIONSHIP
~~ c'' V~ -r'~ F.
AMOUNT OR
SHARE OF ESTATE
'1C"'
~ i, ~s ~, a ~:~
~ -~-
°~ 1, `~'s ~~ 1
~~t`ti',,~~~'t'
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
1.
r ~ ~ c ~-~ ~
.~ ~ ~ ~ ~ ~
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) ' $ j Q ~ ~ ~y ~ `i
(If more space is needed, insert additional sheets of soma size)
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REV-1547 EX AFP (12-94)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
DEPT. 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX
HARRISBURG, PA 17128-0601
ACN 101
DATE 09-25-95
w ~n~c ~r vui~nt-~L. tLUKtNGt M FILE N0. 2 -0 28
DATE OF DEATH 04-24-95 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:
GEORGE L WEITZEL
534 JOYCE RD
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Anount Remitted
CU~* ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS
----------------------------------------------- ~
----------------------------------------------------------
REV-1547 EX AFP (12-94) NOTICE OF INHERITANCE TAX APPRAISEMENT
ALLOWANCE OR ---
,
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GUTSHALL FLORENCE M FILE N0. 21 95-0328 ACN 101 DATE 09-25-95
TAX RETURN WAS: ( l ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estat• (Schedul• A) (1) .00
2. Stocks and Bonds (Schedule 8) (2) .0 0
3. Closely Held Stock/Partnership Interest (Schedul• C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 76.6 26.00
6. Jointly Owned Property (Schedul• F) (6) .00
7. Transfers (Schedul• G) (7l .0 0
8. Total Assets (81 76,626.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedul• Hl (91 13,649.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)_ .00
11. Total Deductions
(11) );.649.00
12. Net Value of Tax Return (121 62,977.00
13. Charitable/Governmental Bequests (Schedul• J) (131 .00
14. Net Value of Estat• Subject to Tax (141 62,977.00
NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rat' (15) .00 X .00_ .00
16. Amount of Line 14 taxable at Lineal/Class A rat' (16) 62, 977.00 X . 06. 3, 778.00
17. Anount of Line 14 taxable at Collateral/Class B rat' (17) .00 X .1 5. .00
18. Principal Tax Due (1S1 3, 778.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST (-) AMOUNT PAID
06-19-95 AA047893 185.95 3,533.00
PAYMENT MUST BE MADE HY 01-25-96~(.
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 3,718.95
BALANCE OF TAX DUE 59.05
INTEREST .00
TOTAL DUE 59.05
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAV BE DUE
~V-IE70 El( (6-881
COMMONWEALTH OF PENNSYLVANIA
DEPARTMEN" OF REVENUE
BUREAU OP IN!)IVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 2 8-060 1
DECEDENT'S NAME
r~i01'?:1C':? cis
FILE NUMBER
?I_,>~
,-
ACN
ITEM i" r
SCHEDULE NO. EXPLANATION OF CHANGES
,) ~ 7`i1t'"' ~ c~~.%ll2 03: ti1~? 4'Cll~ 1tc,~~,~ att]li.'_'S~ :1~'.,S 'U'4~G1't t~? S<j~ ]O?yi_~a . `-t A7i~ ~f_'C~'f.~ ''lt ~'
' ~ '. z ~~ ? s' nit cont~:,.n a spec i-f is begiiesC to t?~e ctr<^~,-i tv.
INHERITANCE TAX
EXPLANATION
OF CHANGES
TAk' EXAMINER: ~'h -, r ~ €~ ~ ~'~• ~ -~: r
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