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HomeMy WebLinkAbout09-04-80 / ()- /Sc:2- . . REV-ISDO EX + 19-81) BUREAU OF EXAMINATION PENNSYLVANIA OEPARTMENT OF REVENUE P.O. BOX 8327 HARRISBURG, PA 17105 INHERITANCE TAX RETURN RESIDENT DECEDENT ;;/--79--/71- File Number DECEASED Decedent's Name (Last, First, and Middle Initiall Stone Charles G. Social Security Number 17'1<;/0' 3:)>~ 1. Original Return 0 3. Remainder Return 0 Oate of Death Decedent's Address 519 Warren Street Lemoyne, PA 17043 CHECK March 28 1978 2. Supplemental Return [i] APPR D. PRIATE 4. Life Estate D 6. Decedent died testate D IAttach copy of Will) 5. Federal Estate Tax 0 Return Required. 7. Decedent maintained a living D 8. Number of safe deposit D trust (Attach copy of trust) boxes inventoried BLOCKS All correspondence and confidential tax information should be directed to: Charles H. Stone CaRRE. SPaN DENT Name Cha r1es H. Stone Telephone No. 717-774-7435 Recapitulation 1. Real Estate ISchedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partn",hip Interest (Schedule C) 4. Mortgages and Notes ISchedule 01 5. Cash & Miscellaneous Personal Property (Schedule E) RECAPIT. 6. Jointly Owned Property (Schedule F) ULATlDN 7. Transf", (Schedule Gl B. Total Gross Assets (total lines 1.7) AND 9. Funeral Expenses Administrative Costs/Miscellaneous Expenses (Schedule HI TAX 10. Debts/Mortgages/Liens (Schedule II 11. Total Deductions (total lines 9 & 101 12. Net Value of Estate Wne 8 minus line 111 CALCU. 13. Charitable Bequests ISchedule JI LATIDN 14. Net Value subject to tax liine 12 minus line 13) Address City State n 0:5 ip ,- ~,.. ......('11 ~:_~ fT1n ~ ~Cl ~? ~ ,:;0 < -0 ,.., .r ':J ,. ::> , :- , - (11 12) $2.17';.00 ( 3) I 4) ( 5) ( 61 ( 71 (8) $2,175.00 ( 9) (10) (111 112) $2.175.00 (13) (141 $2 17'; 00 Computation of Tax 15. Amount of line 14 taxableat 6% rate 115l $2,175.00 x.06=$ 130.50 linclude values from Schedule K) 16. Amount of line 14 taxableat 15% rate (16) x.15= (include values from Schedule K) 17. Principal tax due (add tax from line 15 plus tax from line 161 (17) 18. Total Prior payments: (.1 Amount Paid (b) Plus Discount (e) Minus Interest (18) 19. Balance Due(ljne 17 minus line 18) (19) :. (:), :;- (:) Make Check Payablelo: Register of Wills, Agent J:'",~ n~r~ ~ b ,-' {, "'PLEASE RECHECKMATH'" '1ud..1 I 5" 7. ,-L. Under penalties of perjury,l declare that I ha\le examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has a no e ge. ~ f'/7 / J- L ,~DR (2 DATE I;((').V Vlt.~.......~Q..,\~" I ,~ . C7 G 7 u SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE AODRESS OATE . .' REV.l5O:J EX+ (9.11) SCHEDULE "B" STOCKS AND BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C ~ cvQ,~ )-+ _ ~~C- (All property Jolntly-owned with Right of Survivorship must be dlscloled on Schedule "F") FILE NUMBER ~ J- 7 f-J 7 Y. ITEM NUMBER OESCR IPTION VALUE AT DATE OF DEATH 1. 100 shares, Pennsylvania Power and Light Company, common stock at 21 3/4 $2,175.00 TOTAL (Also enter on line 2, Recapitulation) $? 17~ no (It more .pace II needed In.en additional sheets of I8me Ilze)