HomeMy WebLinkAbout05-27-83
REV-1500 EX + (9-81)
. BUREAU OF EXAMINATION INHERITANCE TAX RETURN
PENNSYLVANIA DEPARTMENT OF REVENUE RESIDENT DECEDENT
P.O. BOX 8327 File Number 21-78-91
HARRISBURG, PA 17105 10-1'I,;}-1
. .
Decedent's Name (Last, First, and Middle Initial) Decedent's Address
Burns , Bruce R. 116 \>lest Neff Avenue
DECEASED Social Security Number o ate of 0 eath Shippensburg, PA 17257
I 11/8/77
J.O...-v I . L. 2. Supplemental Return D 3. Remainder Return [=:J
CHECK 1. Original Return ~
APPR D.
PRIATE 4. Life Estate D 5. Federal Estate Tax D
Return Required.
BLOCKS 6. Decedent died testate [iJ 7. Decedent maintained a living D 8. Number of safe depos!t D
(Attach copy of Will) X trust (Attach copy of trust) boxes inventoried
All correspondence and confidential tax information should be directed to:
CDRRE.
SPDNDENT Name ---Address 28 South Pitt Street
aIm B. Fowler, III, Esq. P. O. Box 208
Telrhone No. . Carlisle PA 17013
71 ) 249-8300 City State lip
Recapitulation
1. Real Estate (Schedule A) ( 1) 8.800.00 cD :':'1
2. Stocks and Bonds (Schedule B) ( 2) ;'\1
3. Closely Held Stock/Partnership Interest (Schedule C) ( 3) ..
-
4. Mortgages and Notes (Schedule D) ( 4)
5. Cash & Miscellaneous Personal Property (Schedule E) ( 5) 725 00
RECAPIT. 6. Jointly Dwned Property (Schedule F) ( 6) 269.48
ULATIDN 7. Transfers (Schedule G) (7) -0-
B. Total Gross Assets (total lines 1.7) ( B) 9.794.48
AND 9. Funeral Expenses Administrative Costs/Miscellaneous
Expenses (Schedule H) ( 9) 3.719.50
TAX 10. Debts/Mortgages/Liens (Schedule I) (10)
11. Total Deductions (total lines 9 & 10) (11) 3.7(.9.50
12. Net Value of Estate Wne B minus line 11) (12) 6.0'14.98
CALCU. 13. Charitable Bequests (Schedule J) (13)
LATlDN 14. Net Value subject to tax (line 12 minu!: line 13) (14) n,014 qR
Computation of Tax
15. Amount of line 14 taxable at ()o1o rate (15) 6,0'14.98 x.06= WL 5"0
(include values from Schedule K)
16. Amount of line 14 taxable at 15% rate (16) x.15=
(include values from Schedule K)
17. Principal tax due (add tax from line 15 plus tax from line 16) (17) 36'iSO
18. Total Prior payments:
(a) Amount Paid
(b) Plus Discount
(c) Minus Interest (1BI 36 tt. S'O
19. Balance Due (ljne 17 minus line 18) (19)
Make Check Payable to: Register of Wills, Agent
. . . PLEASE RECHECK MATH' . .
Under penalties of perjury,l declare that I have 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
any knowl. e. 24 S. Fayette St.
$hi ensbur, PA 17257 5/27/83
ADDRESS 116 H. Neff Averrue DATE
RESENTATlVE
P. O. Box 208
Carlisle, PA 17013
ADDRESS
5/27/83
DATE
~
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Bruce R. Burns
. Rf'.'.I502 EX+ (9.81)
"
SCHEDULE "A:'
REAL ESTATE
ITEM
NUMBER
FILE NUMBER
21-78-91
(All property jOintly-owned with Right of Survivorship must be disclosed on Schedule "F")
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
ASSESSED VALUE
TWo (2) continguous tracts of land, Borough $6,600.00
of Shippensburg, Currherland COlmty, Pennsylvania,
improved with frame dwelling, ","ash house, garage
and stable, having frontage on South Fayette
Street of 105' and on West Orange Street of
96', m.unbered 24 South Fayette Street. Deed
reference: Deed Book "2", Vol. 6, Page 290.
By virtue of intestate law, 1/3 share in said PrE-
mises because vested in Decedent. Harry H.
Burns and Estate of Lulu B. Hilt (date of
death: 3/7/74), each owned a similar 1/3 interest
in said premises at date of Decedent's death.
EstirrEted value of Decedent's 1/3 interest in sai~
premises is based in part on valuation of said
premises in appraiserrent filed to Estate of
Lulu B. Hilt, No. 21-74-688, CurrDerland Cmmty.
$8,800.00
TOTAL (Also enter on line 1, Recapitulation)
$ 8,800.00
-----
(If more space is needed insert additional sheets of s.ame size)
..
RfV.l5Q6 (X+ ,<;-81)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "E"
CASH AND MISCELLANEOUS
PERSONAL PROPERTY
Bruce R. Burns
FILE NUMBER
21-78-91
(All property jointly-owned with the Right of Survivorship must be disclosed on Schedule "F")
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
Refrigerator, stove, bed and dresser, wearing apparel
and other personal effects.
Cadillac, 2-door coupe, 1964 model.
Cash on hand.
$100.00
3<XL 00
325.00
2.
3.
TOTAL {Also enter on line 5, Recapitulation}
$725.00
(If more space is needed insert additional sheats of same size)
REV_l509 EX+ (9-81)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE "F"
JOINTLY OWNED PROPERTY
ESTATE OF
Bruce R. Burns
FILE NUMBER
21-78-91
(This schedule must he completed if the decedent, at the time of his or her death, owned any property 85 e JoInt tenant with the right of survivorship,)
Joint tenant(s):
A.
NAME
Harry D. Burns
RELATIONSHIP TO DECEDENT
Son
B.
C.
ADDRESS
116 West Neff Avenue
Shippensb=g, PA 17257
Jointly owned property:
ENTER
ITEM LETTER FOR
NUMBER JOINT TENANT
1.
A.
2.
A.
----
DESCRIPTION OF PROPERTY
First National Bank of
Shippensb=g, Checking
Account No. 136-160-9,
registered in name of
Harry D. Burns and
Decedent, as joint
tenants with right of
survivorship.
First National Bank of
Shippensb=g, Savings
Account No. 1-16484-2"
registered in names of
Harry D. Burns and
Decedent, as joint
tenants with right of
suvivorship.
Accrued interest to
11/8/77
TOTAL VALUE
OF ASSET
DECEDENT'S DOLLAR VALUE OF
% INTEREST DECEDENT'S INTEREST
$13.48
50%
$
6.74
520.00
50%
260.00
5.47
50%
2.74
TOTAL (Also enter on line 6, Recapitulation)
$
26Q.LV<
<<if more space Is needed in.ert addltlonai sheets of S8me size)
REV.1510EX+ (9-81)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE "G"
TRANSFERS
ESTATE OF
Bruce R. BUITlS
FILE NUMBER
21-78-91
1. Did decedent make any lifetime transfer of property without receiving a valuable and adequate consideration which was
to take effect in possession and enjoyment at or after death, or in which the decedent retained either:
YES NO
a. the possession or enjoyment of or the right to income from the property transferred? or,
b. the right to designate the persons who shall possess or enjoy the property transferred or income; or
c. a reversionary interest?
x
------------ - - - - - - - - - - - -- - -- --~-
x
2. Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to,
or for the benefit or care of, decedent?
------------ - ----------- ------ ---
x
3. Did decedent, at any time, transfer property. the beneficial enjoyment of which was subject to change because of a
reserved power to alter4 amend, or revoke, or which could revert to decedent under terms of transfer or by operation of
law?
----------~-------- ----------
x
4. Did decedent within two years of death transfer a material part of his or her estate without receiving a valuable and
adequate consideration?
--~ -- - - - -- ------- - ----- ----
x
DECEDENT'S DOLLAR VALUE
ITEM ASSESSED TOTAL VALUE % OF DECEDENT'S
NUMBER DESCRIPTION OF PROPERTY VALUE OF ASSET INTEREST INTEREST
A. Real Estate:
1.
B. Personal Property:
1.
TOTAL (Also enter on line 7, Recapitulation) $
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, DESCRIBE THE PROPERTY BELOW.
(If more space Is n_ded insert additional sheets of same size)
,
REV.Ull EX+ (9-81)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "H"
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Bruce R. BUITIS
FILE NUMBER
21-78-91
ITEM
NUMBER
AMOUNT
DESCRIPTION
1.
2.
1.
2.
3.
4.
5.
6.
7.
8.
A. Funeral Expenses:
1.
Fogelsanger F\meral Hoo:e -F\meral Expenses
$1,000.00
B. Administrative Costs:
Personal Representative Commissions
500.00
2,000.00
Attorney Fees - Few ler, Adclarrs & Shughart
C. Miscellaneous Expenses:
Register of Wills - Letters Testamentary _
Cwberland Law Journal - Advertising Letters _
The News-Qrronicle - Advertising Letters _
Register of Wills - Short Certificates _
Recorder of Deeds - Photooopy of Deed -
Register of Wills - Filing Inheritance Tax Return _
Notary Fees -
Register of Wills - Reserve for Filing Accmmt, etc. _
21. 00
18.00
12.00
2.00
1.50
10.00
5.00
150.00
TOTAL (Also enter on line 9. Recapitulation)
$3,719.50
(If more space I, needed Insert additionlll sheets of ume size)
REV-1SI3 EX+ (9-81)
.
. COMMONWEALTH OF PENNSYLVANIA
INHERITANr.E TAX RETURN
RESIDENT DECEDENT
SCHEDULE "J"
BENEFICIARIES
ESTATE OF
Bruce R. BUJ:1rlS
FILE NUMBER
21-78-91
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT
A. Taxable Bequests:
1. Betsy A. Watson Daughter 25%
24 South Fayette Street
Shippensburg, PA 17257
2. Robert R. Burns Son 25%
24 South Fayette Street
Shippensburg, PA 17257
3. Harry D. Burns. Son 25%
116 West Neff Avenue
Shippensburg, PA 17257
4. J~ Ray Koontz Son 25%
R. D. 2
Newville, PA 17241
ITEM
NUMBER
NAME AND ADDRESS OF BENE~ICIARY
AMOUNT
B. Charitable Bequests:
1.
TOTAL CHARITABLE BEQUESTS (Also enter on line 13, Recapitulation) $
(If more spac.is needed insert additional sheets of same size)