HomeMy WebLinkAbout95-0348~~ -g5~D3~1`6
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 1 ~ 200T
Date
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Fran eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH of PENNSYLIMI~A • DEPARTMENT of HEALTH • vrcAL RECORDS ~ 3 6 8 21
CERTIFICATE OF DEATH
NAME OF OECEDENT1Rrt1.MWda,lrq SIX SOCIAL SECURITY NUMBER DREOF DERV pA«ae, Day, Ya6r)
1995
13
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,. Michael Flaherty a. Male a. 197 - 38 - 6059 March
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, Michael J. Flaherty
INFORWWT's NAME RYPrPrIrA Sa-oaMAN7's MAa.IND ADDRESS IS'w,C4yYTS.n.9rs. ZpCodq
Rose Ann Flaherty a 'n ton Dr. Mechanicsbur PA 17055
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'S SKiNRUIE AND NUM DATE FILED (M«ah. 0eY• War)
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~ v v i'---"~"-~ ' -' fOR DATES OF DEATH AFTER 12131!91 CHECK HERE
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° INHE ANCE TAX RETURN ^
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CREDIT IS CLAIMED
OVERT
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SIDENT DECEDENT FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA ~ ~`~^: s ` C~' BE FILED IN DUI:=LICATE 21 95 0348
DEPARTMENT OF REVENUE ~
DEPT. 280601 TH REGISTE ~OF WILLS)
COUNTY CODE YEAR NUMBER
HARRISBURG, PA 17128.0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE tNl L) - DECEDENT'S COMPLETE ADDRESS
Flaherty, Michael D. ~ 6406 Lexington Drive
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w SOCIAL SECURITY NUMBER DATE Of DEATH DATE OF BIRTH Mechanicsburg PA 17055
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197-38-6059
3/13/95
12/30/47
c°u~~ Cumberlan
p (lf APPIICABIEI SURVIVING SPOUSE'S NAME (UST, flRSi AND MIDOIE INITIALI SOCIAL SECURITY NUMBER AMOUNT RECEIVED ISEE INSTRUCTIONSi
Flahert Roseann 170-40-0285
~ ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return
(For dates of death prior to 12-13.82)
cati
c o ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
• (for dates of death after 12-~82)
~ a °' ^ 6. Decedent Died Testate ^ 7. Decedent Maintained a Ing Trust _ 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Tr
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFO TION SHOULD BE DIRECTED TO: .. ~- ~ `
~ NAME COMPLETE MAILING ADDRESS
:;W
'~°~
James E. Reid Jr. Es
uire Connell Reid & S ade
y~ P
~~ TELEPHONE NUMBER
I P. O. BOX 963
( 717 1 238-4776 Harriabur~ PA 17108
r
tate (Schedule A)
R
l E
1 (1) -0
ea
s
.
and Bonds (Schedule B)
St
k
3 (2) -0- T
oc
s
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Interest (Schedule C)
Held Stock/Partnershi
Cl
l
3 (3) -0-
•
p
ose
y
.
es and Notes Receivable (Schedule D)
rt
4
M
a (4) -0-
.
o
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5. Cash, Bank Deposits & Miscellaneous Personal Property (5) '~-
(Schedule E)
Z 6. Jointly Owned Property (Schedule F) (6) -0-
~ 7. Transfers (Schedule G) (Schedule L) (7) -0-
a 8. Total Gross Assets (total Lines 1-7) (8) -0
Miscellaneous
Administrative Costs
enses
Funeral Ex
9 (9) 10, 608' 20
,
,
.
p
Expenses (schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) -0-
s (total Lines 9 $ 10)
l D
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1 1
T
t (1 1) 10 , 608 • 20
uc
on
.
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e of Estate (Line 8 minus Line 11)
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12
N
t V (12) -0-
.
e
a
u
uests (Schedule J)
ble and Governmental Be
13
Ch
it (13) -~-
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ar
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.
lue Subject to Tax (Line 12 minus Line 13)
t V
14
N (14) -0-
.
e
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15. Spousal Transfers (for dates of death after 6-30-94)
N/A N/A
See Instructions for Applicable Percentage on Reverse
Side. (Include values from Schedule K or Schedule M.) (15) x. __
16. Amount of Line 14 taxable of 6°r6 rate (16) -0- x .06 = -0-
(Include values from Schedule K or Schedule M.)
17, Amount of Line 14 taxable at 15% rate (17) N/A x .15 = N/A
z (Include values from Schedule K or Schedule M.)
16 and 17
)
al tax due (Add tax from Lines 15
Princi
18 (18) -0-
.
,
p
.
19. Credits Spousal Poverty Credit Prior Payments Discount Interest
o + + - (19) -0-
a 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) -0-
~- ~ ^
21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) -0-
A. Enter the interest on the balance due on Line 21 A. (21 A) -n-
8. Enter the total of line 21 and 21A on line 218. This is the BALANCE DUE. (218) -0-
Make Cheek Payable to: Register of Wills, Agent
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND; TQ RECHECK MATH ~ ~
~r penalties of perjury, I declare that I have examined this return, including accompanying schedules and state'm'ents, and to the best of my knowledge and belief,
sue, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is
j on all information of which preparer has any knowledge.
.TURF OF PER tJ„RESP,PNSFOR FILING RETURN ADDRESS DATE
~e' an F~..EECG.h~~e..~+rC,,ttt 6406 exin t-en Drive, Mechanicsburg, PA 17055 t< ~ r 2 ~ ~~/.~
.TUBE OF PREPA R T THAN~tt'PRE NTAT ADDRESS GATE
nes E. , ~r~ ~~ P. 0. Box 963, Harrisburg, PA 17108 ((~7. ~ I y/~
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% (.03j will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
'~ 2% (.02j will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
a 1% (.O1j 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.
BY PLACING AS CH CK MARK (r~ IN TH APPROPR ATE BL
OCKS.
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 cared ............
. ...........................
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 considerationi' ...................................................................................................
3. Did decedent own an 'in trust for'. bank account at his or her death ......................................
IF TH~~.ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE. RETURN.
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• REV,S,I EX. reel SCHEDULE H
4:. ;~:
r,~.;~;,:~ FUNERAL EXPENSES,
~~"`"~"} ADMINISTRATIVE COSTS AND
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES
RESIDENT DECEDENT
. Flahert
Please Print or Type
NUMBED
21-95-0348
NUM ER I DESCRIPTION i AMOUNT
A. Funeral Expenses:
t. Neill Funeral Home $6,778.00
B. !Administrative Costs:
1. Personal Representative Commissions _ _
Social Security Number of Personal Representative:
I Year Commissions paid
t. Attorney Fees James E. Reid, Jr. , Esquire $150.00
3. Family Exemption
Claimant Roseann Flaherty Relationship Spouse $3,500.00
Address of Claimant at decedent's death
Street Address 6406 Lexington Drive
City Mechanicsburg State PA Zip Code 17055
4. Probate Fees
Cumberland County Register of Wills $68.00
C. Miscellaneous Expenses:
1. The Sentinel $72.20
2. Cumberland Law Journal $40.00
3.
4.
5.
6.
7.
8.
TOTAL (Also enter on line 9, Recapitulation) S 10,608.20
(If more space is needed, insert additional sheets of same size.)
COMMONWEALTH Of P~NSYIVANIA / •
INHERITANCE TA% RETURN
ESTATE OF
SCHEDULE J
BENEFICIARIES
B. Charitable and Governmental Bequests:
t. N/A
FILE NUMBER
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) IS
(If more space is needed, insert additional sheets of same size)
AMOUNT OR
ITEM NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE
NUMBER
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