HomeMy WebLinkAbout80-00767 COMMONWEALTH OF PENNSYIVANIA REV-1162 EX�11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 020202
HANSON JOHN E
3101 CHESTNUT ST
CAMP HILL, PA 1701 1
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
"'_______ """'_
101 � 5454.55
ESTATE INFORMATION: SSN: � I
FILE NUMBER: 2180-0767 �
�ECE�ErvT rvaME: HANSON EDWIN FRANCIS �
DATE OF PAYMENT: 02/03/201 5 I
POSTMARK DATE: 02/03/201 5 I
couNTv: CUMBERLAND �
DATE OF DEATH: 09/1 2/1 979 I
�
TOTAL AMOUNT PAID: 5454.55
REMARKS:
CHECK# 7142
INITIALS: CJ
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
J '-'i"penn4Ymania L5�56141�5
��ys .,.�,. . ,,, -,c�..c.
REV-1500�� °`�"'"`°s`°"`"
R�reavotln01m0ual laxzs �a^NCodc Ya FIeN�mbe�
vo hox zeoeat INHERI7ANCE TAX RETURN p�
uevsburg. PA nt2s-e6o'. RESIDENT DECEDENT �-I QV � �p�
ENTER DECEDENT INFORMl�TON BELOW
So[Ial Secutity Numbqr De[e of�e2�ii fd41D01^7Y pale of BIRM1 tIA���YVVT
09121979 ON01917
Onceden�'s Les�Nome Sattix �ecetlenls Frs[Name MI
Hanson Etlwin F
Q(Applicabie)En[er Surviving Spouse's Informalion Below
Srouse'sLaslName SURu SpousasFlntNtme MI
TMfS RETURN MUST BE fILED IN DUPL�CA7E YWTH THE
REGISTER OF WILLS
iILL IN APPROPRIATE OVALS BELOW
p '.Originai ReWm � 2 SupU�anerial h'emm O 3- Remainde-Re�cmloate o�tlea�h
prior ro t Z-1�HZ)
p 4.f�gnwlWra�arnpUon Idafe cf � i Futo•e;nle�est Comp�omise(da4�o( p d FatletU Es'lata Tas RnWrn Reqmretl
deBlh nn or aXer]-0-2011J tl'taN aPtz 1J-ffiA9
p Z �er�deol Dlod Tes�ate O B-�ace�eni Mai netl a Lrvin9���s� — e. b�al Nurnoe�of Safa�nposit omes
(AtlecM1 mPY o`wlll.i :H'tach copy o�irusL)
p 10-Liogalbn Pmceetls Rec=ivrs: O 1t Vc��robate Trareteree Remm O i^.� �uterrauEleaJon ol SGouul Tms�s
SSo�eddle P antl G Asse�s Only)
O �3. Bueinass Pssats � 14.3pcvsa is 5 Je Bene9mary
(Na:ms�irnofvetll
CORRESPONDENT- THIS SECTION MOS?6E COMPLETEO.ALL CORRESPON�ENCE AN�CaNFIpENT1AL TA%IHiORWUION SHOULO BE OIRECTEO T0:
Name ./ �JayGmo TrJophooc Numbet
John / �ay SB </ (717)761-0205
!/
Firs�Line otACtlres>
3101 Chestnut st
secona�neorAoaress
Ciry or Post OHice SW�e ZIP Gotle
Camp Hill Pa 17011
CorresOondenPs email aCtlress: tmlfiVCrtat@COmcast.nel �� -� m
c � o
NE EIjSi WIIL�-Y E Otl %;
r ' � � � ' I
... �. .. . Si�3�a:rv�v - - :l
OATEEFlLEp MMDDTYri I i W �.J
I _� I�
� _:,
`�_ _ ��
cn — m f
___ __OATEfREDSTAMF f'
`-'' -n
�
PLEASE USE OMGINAL FORM ONLY
Side 1
i ielll Inli Iii�NIN�lu II�I N�I I�NNI�I��II��
L 15�5614105 15�5614105 J ��,
l�L
U
� 1505614205
FEV-1 hGG EX i Fl7 Decotloet s So6aI 5ecurity Nombor
oeceae�ts r�am=. Edwin F Hanson
REGAPITULATION
I. Real Fs,atz�ScFetlale�2 . .. ... . . ... . .. .. . ... . . ... .... .. . ... i.
1. S�or,ks and eonds lSchedu�e a;� . . . .. .. ... . .. .. . .. .... .. . . .. .. . .. .. . .. . 2. 7.575.87
3. Glwely Held Go�o�ation, Pannersnlp or Sole-PmpnetoisRip (Suhedule G� _..__ .5.
4. MortgagesantlNn�esReceiva�le(Scnetlule��. . . ... . . . ..... . ___. . ._____ 1.
3. Cash, Bank Dep�sits antl Miecellaneous Penonal Property��eheticle E).._. .. 5.
6- Jointly Owne� Pr�petty (SchenWa 5) O Separete B��Iling Requxstetl ._. . . . . 6.
Z Inter-Vws Transfus 8 Mlxcellaneo�u Nor,-Probate Proparry �
(SchetluleG) OSeparateRilbnyHequesled__._.-. �.
N. Total G�oss Asse[s;iolal Lines 1 �hrough ]). .. ...... ... ... ... . . ..... .... 0. 7.575.81
4 FunaralExpansesanAAtlrtJnishat'rveGosts(ScheduleH)___________________ 9.
10. �ebls of DeceAen: Mor�gage�ia�iilties antl Liens(Schedule i)_______ ________ 10-
11. Total OeEuc�ions jminl Lines 5 aM 101. . . .. ... . ... . . .. . . .. . . .. . . . .. . ... 1+. ..
12 Net Value of Estate;Line 8 minue Line it l . ... . . .... .. ... . .. . . ..... ... . 12. 7.575.81
13. Chnri�ble sn0 Govem�,nentnl tleyueyts/Sea 9113 fms�s-fo:whlrn � � � �
an elecUon to 4 z has nol baen na:de(ScieEule JJ ... . ..... .. ... ..... ... .. 13
�4. �le[vaNe3ab]eawiax�i �inat?minus:iaei3) ._. . ..__. . .. .________ ta. 7�575.87
TqX CALCULATION-SEE INSTRUCTIpNS FOR APPLICABLE RATES
S. Amounlol�ne 14 tar�hlo
d(NC S�Oi15dl h.YtA1P OI
transiars underSec. 91�6 �
(a)�1 Z1X 0_ ��.
16 Amouni of Llne 14 tuxaple
euinealra�exo_ 7.575.87 �6_ 454.55
ti. Fmounto(Linet4texablc
a�sihlioq retn X 12 1],
16. Arnoun[efLipe ?4�xa�lz � �
alcnllateralrale X 15 18.
is rwcoue . _ . . _ .. . . . _. . . .. . . . . _ . _. . . _. . . . ._ . . i3. 454.55
2�. FILL IN THE OVAL IF YOIJ ARE REOUESTING A REFUND OP AN OVERPAYMENT p
u�a �sne:or oe� �r� a�+aro�na. �b m.�idn . �:d�emv r=m�v .��r sm�e�n.s � ����em:_a�d�o�re c�i or rry.wo.naeea�re oarei_
. �- I e ecl an� mFle1^. JeJa�a�o f Dreparer�±Ipe, M1a� N_ person responsp@!q [f t!Im elum�s La�M all .orr.a�m o!wE cM1 pe0em M1uv
anY knmNeulqe_
SIG�CR FPERS�F�$ N3IBLEFJ RLINGRETIIFN � ' E
� `�t -l5-
�/ .�r �
no aes / / /� ,c��/ //
�l�� ��,PS'fh`cTc �T L ,!'ic..,� /L// � �7��� � -4 /5
SIGNATl1REOFPREPqREFOiHERiHAFp6F_pNRE5VOA5BLEF� HFlLINGiHEftCTVRN 'JATC
nonaess
IIpNIINNNIN1�N�iII�INNIIN��II��IINB Side2
L 15�5614205 15�5614205 J
evA-15['EX lFi P:,ce L Fie Numbx
Decedent's Complete Address:
oeceoeNrs NFMe
Etlwin F Hanson
S'REE�'ADDRE55 ...... . . .. . .. . � ...��.
3101 Chestnut St
__.___. ___—__. _ -
cir4 �� � Sinie zi�
Camp Hill Pa 17011
Tax Payments and Credits:
i. Tax Due;Page 2.Line 19� �1; _454.55
2. ClEGI:S�Pd4'iT.Pf',�$
A. P�ior Paomen�
B.Di<rnun; _._. . ._.
�See inslrunrianrs-j 1o�al C�etli�s(A f B) �2�_ _
3. In�eie:t
(3;
4. H Line 2 is greaier fhan Line i +Gne 3.anter the tl��fferanm. ilus is't.e OVERPAVMENT.
fill in oval on Page 2.Line 70 to requesi a refund. l4"�
._ It Line� +Lme 3 s greatu than Line 2,enp��he clRerence.This is the TAX DUE i5� _ 454.55
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACiNG AN "X" IN THE APPROPR�ATE BLOCKS
t �iC dece0ent make a Iranster artl'. Yes No
a. retaintl�euseorirwomeotthep�openytranderred._...... ..____ __.._...... .._.._.. ❑ �
b. re m he righl to dacigr�r Hpo shail�se tne F oPe�iy vansfo'roJ or [s Incoria .... __ r] �
c. relain a reversronary nle�eG ___. ._..... _— _- -- ❑ �
tl. recehie[he promiso lo�life of eiNer payments,benefls or care� .___ ...__.._ —_._ ❑ �
2. I(deatn occurtaa zitarC� 12, iy82,die aeaMent harefer orc�-ry wdhin ore yea�of desth
wrho¢rocervlvgatlequaleconsiderel�on% ...._.. __.._ —_ _.__. ❑ �
3. �iCdecedentaxnan'Inirusifor"or0ayahleupoo-death6aak2ccoarts�secuntya�hisorhereeath?...___.... ❑ �
G. �id decedent nrvn aa l�d'rvidual rearemem acmunt.annwN�r oU�er non-pmbata prepertµuuhich
c;ntai� abene5oarytlesg�aoon% .__._ __........ ___... .........._ _.__ ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AN� FILE IT AS PART OF THE RETURN.
Por dates of deat�on orafter July 1, 7994,anA befwe Jan. 1.1995, 1he tex rafe imposed on uhe nel mue ot traosfers to o�for Ihe use of Ihe surviving spouse
Is3 percent[I2 PS§9118(a)(1.1,�i)F
For aates of death on or atter Jan. 1. ?995 the tar ra:e lmposed on �he net value oP'ra�s(ers m or for tha use o!ihe surviving spouse is 0 parcent
p2 P.S.§9116(a)(1.1 j��,ip.The sla�ule dees oa exempt a irensier lo a surviving spouse from ta� an�[ne sien�tory reqoirements for disclosvre o(assets end
filing a�ax ratum are still epWicable eve^Itthe surviving spouse i;the only bene6oiary.
For date3 of deai�on or a5e*Juiy L 2600:
. The iex rate impcued on the net value of transfe;s trom a daceased chiid 21 years of aye or younger at death to or for the use o!e oeNral pareni, an
aeoptNe parent or a ste�parent of the chlld ia 0 perceni[72 P.S.g911fi�aj(L2)].
• Thelazretelmposedmthene;eaueo(iraos(erstoorior�heuseafinetlecede�fsllneal6enefidanesis4.5percent,exceptasnotedln(72P.S.§911fi(al(11I.
. The tax�2te imposed on Ihe ne!value of tansfers to or for�he use ot the decedenYs siblinq�Is 12 percent[72 P�S. §9116(a�(131�.A si6li�g Is def�,ned,
under Sech'on 9102,a�an indlvitlual who has at leastsne parent in mmmon�m�h he Cecetlent whe�her by blootl or atlopuon.
REV-t W3 E%«(6-98)
� scNEou�E s
COMIN'HERRRNCETN(PRENHNVµIA naKS & BONDS
RESIDEM DECEDEN�
ESTATE OF FlLE NUMBEH
��/�7iU � �/i'iiir(jft�
All propxly idmy�awnetl wX�riglil oi surv'rvaahip musl be tlladosatl on ScliMuk F.
ITEM VALUE AT�ATE
NUMBER OESCRIPiION Oi OEATH
� 5"e/l ur r� Ya78'(y(� >Og (i/,e�KJ 75 7S; g'/
(�cinKoff}�.. err`ca CGrec� �"00 /28'0307 (
TOTAL(Also enter on line 2,RecapHulatlon) S 7 ,5 / � o �
(If mOre spac2 is nreGeQ insen aOEAianal sheets af Ine same size)
REV-1513 E%4 (01-10J
-�. pennsylvania SCHEDULE ]
oernxrnex.orxErEx�c
�xxearznxctruanuw+ BENEFICIARIES
RE5I�EMDECEDEM
ESTATE OF. � FlLE NUMBER:
� NG<,5��
RELAT[ONSHIP TO DELEDEM AMOUM OR SHARE
NUMBER NAME AND AODRE55 OF PEPSON(S)RECEIVING PROPE0.TY 00 No[Lirt Tmstee(5J OF E4ATE
i TP%HBIE�ISTRIBIRfONS pnduAe outnghtspouwldistributians and tansfers under
p (' /J Sec.911fi(a)(l.2).] ��n��
1. JO �N G I�GCN.$OH �� Sd✓1
� ,� lbl GG2S�"�u �" �f
�'u�p �; ll f�'< ��o �i
EN(ER DOLLAR AMOUNTS FOR OISTRIBUiI0N5 SHOWN ABOVE ON lJNES 15 THROUGH IB OF 0.EVd500 COVE0.SNEEf,lS APPROPNATE.
�� NON-TPXABLE DISTRIBI/fI0N5 '
A. SVOUS4L�ISiRIBIR10N5 UNDER SECiION 9113 FOR WHICH AN ELEQION TO TA%IS NOT TAKEN:
1.
B. CHANTABLEANDGOVERXMEMAL�ISfRIBU7I0N5:
1.
TOTAL OF PART II- EMER TOTRL NON-TP%ABLE DISTRIBUTIONS ON IINE 13 OF REV-1500 COVER SHEEf. 4
- If more space is needed,use aAAitlOnal Sheets oF paper of Me same SiZe.
NOTICE OF INHERITANCE TAX pennsyLvania
BURE APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
A Vpq4E OF OF DEDUCTIONS AND ASSESSMENT OF TAX
IN HER I 44P PAMAU10 REV-1547 EX AFP (11-14)
PO BOX
HARRISI=21416�_06plf` WILLS
Z015 JUL 27 FM 2 12, DATE 07-20-2015
ESTATE OF HANSON EDWIN F
C L E RK, 0 F DATE OF DEATH 09-12-1979
0 R P H A N S' C 0!J IRT FILE, NUMBER 21 80-0767
COUNTY CUMBERLAND
CORWACLAND krli.'_dbPN E ACN 101
3101 CHESTNUT ST APPEAL DATE: 09-18-2015
CAMP HILL PA 17011-4529 (See reverse side under Objections)
Amount Remitted I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE -0, RETAIN LOWER PORTION FOR YOUR RECORDS 4-
- - - -- ---- -5 ---
Rii:liZ7-Ei-AF�-(Il-i4)-�OTIii-OF-iNHiiITANiE-iiX-APPRAiiEMENi,-A-LOWiNCE-OR
-
--------------
OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HANSON EDWIN FFILE NO. :21 80-0767 ACN: 101 DATE: 07-20-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED CHANGED
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) 7r 575.8 1 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .0 0
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 7,575.81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) .00
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) .00
11. Total Deductions (11) .00
12. Net Value of Tax Return (12) 7,575.81
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . 00
14. Net Value of Estate Subject to Tax (14) 7,102.81
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate (15) .00 X 06 = .00
16. Amount of Line 14 taxable at lineal rate (16) 7.S7yi-81 x 06 = 454.55
17. Amount of Line 14 at sibling rate C17) . 00 X 00 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due C19)= 454.55
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
01-05-1981 XBOOD396 15.43- 18.12
02-03-2015 CD020202 2.69- 454.55
02-03-2015 WRITEOFF .00 919.70
TOTAL TAX PAYMENT 454.55
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.