HomeMy WebLinkAbout01-0856
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of MI'L V '.N ..:r 'ac,olLl) I ~ fl S,-
also known as
No. 21-01-856
To:
Register of Wills for the .
County of ~()h1berLrlY\J in the
Commonwealth of Pennsylvania
Deceased.
Social Security No. 1. 0 1 .. 0'1 - q 0 J~
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in ~ U .hi) Jo~r L ~ )'\, A County, Pennsylvania, with
h ,~ last family or principal residence at Ie N J.-4 v 1\1 t. r 5+:l ttN 0 L. ~ .
(list street, numoer and municipality)
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d,OO 1 ,
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
~
$
$
$
$
Petitioner_ after a proper search ha-.S-- ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
~
PA
P4
J-.I 0/ I;) PA
/j~ ~J PA
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitione will well a~~ n. 0,- r-"'\ ___
truly administer the estate according to law. Z ~~
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Sworn to or affirmed and subscribed
before me this 17th day of
~PTEMBER ~2001
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No. 21-01-856
Estate of
MELVIN JACOB DICE SR
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW SEPTEMBER 28 ~ 200 \ in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that JAMES RICHARD DICE, aka JAMES R DICE
is! are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to JAMES RICHARD DICE, AKA JAMES R DICE
in the estate of MELVIN JACOB DICE SR
'-7,,/,(7 51f!,r~. ~~<..../ ~ ('...1,0;-..
gister of Wills ~
FEES
Letters of Administration $ 25.00
Short Certificates( ).......... $ 3.00
Renunciation ................ $ 5 . 00
JCP $ ~ 00
TOTAL _ $
Filed..... .~:~7.-:......... A.D. ~-
ATTORNEY (Sup. Ct. J.D. No.)
ADDRESS
PHONE
WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. T 4 9 6 0 214
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<~.., 'MENT ~\ "',;,1.1:
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August 7, 2001
Date of Issue of This Cenlfication
Name of Decedent
Kelrln
21-01-856
J.
Dice, Sr.
~\./ ror'!1:
Last
Male
Sf! X ___.__c____
Social Security No.
March 8, 1918
207 - 07 - 9012
Date of Death
August 5, 2001
Date of Birth
Birthplace
Holy Spirit Hospital
Harrisburg, Dauphin County, Pennsylvania
Place of Death
Cumberland County
, 'l!\
C:tv, Borough 01 "'CC.'J\/115hIP
E. Pennsboro Townshin I .
PBnnsy vania
~- '<r':I!,' ~J;!n';,
Race __ ____~!!_~~~____ Occupation Carpenter I.~aso~____________ Armed Forces? (Yes or No) No
Widowed oe~l~dent's 18 Humer Street Enola PA
Mantal Status ____________._____ Mallng Address _______
"J'il':t,~: ::d(f"'l ellv State
Mr. Melvin J. Dice, Jr.
Informant __________________________ Funeral Director
Name and Address of
Funeral Establishment
Scott D. Brenneman, F.Q
Cocklin Funeral Home,Inc., 30 N. Chestnut Street, Dillsburg, PA
17019
I nterval Between
: Onset and Death
I 20 minutes
1---
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Part I:
Immediate Cause
(a)_~_ar~_~~-pul~~nary arrest
(bl __Diss-=~_~nated._ Metastatic Bon_~_~~n=er
, Median Anal Malignat Tumor
I, c) _________________
2 weeks
2 weeks
Part II:
(d) ._____________________________
Other Significant Conditions
I
I
--r---
Manner of Death
Describe how injury occurred:
Natural
Accident
:~xx Homicide
Pending Investigation
Could not be Determined
o
SUicide
Name ancl Title of Certfier
Ljubisa Stankovic, MD
Address
797 Poplar Church Road, Camp Hill, PA 17011
(M.D., D.O., Coroner, M.E.)
This is to certify that the information here given is correctly copied from an original certificate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vita! Records Office for permanent filing. , tI"%:' .p ~ -
k-~ T ~'7'" 67608
LJ);:..d Re';;lstri:H of Vlldl Recor-ds Distllct No.
August 7, 2001 153 Logan Road, Dillsburg, PA 17019
;, l:drl:"s-;
Cltv. Borough, TO".'\i[1Sh'p
.
RENUNCIATION
21-01-856
In Re Estate of
MELVIN J DICE SR.
deceased.
To the Register of Wills of
CUMBERLAND
County, Pennsylvania.
The undersigned
CHILDREN
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
OF ADMINISTRATION
be issued to
JAMES R DICE
WITNESS
hand this
day of
, 19_.
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Signature)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Me~VI'Y\
J
]) I'e E
Sr:
$.$ArJ /101-D1- ~Ol2-
Date of Death: -A U j \) fr
.;;
J
2001
Will No.
iVon~
Admin. No.
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To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a)
served on or mailed to the following beneficiaries of the above-captioned estate on
Name
Address
)-f.~ 0 /
~:;1
333 _.t)r75t fVe..j ~b(J'J~JPa
/(Y:L&b~ P,"kG l)iltShvr;i VA 1'701~
NeY/ ;'.hi4rshl~ Dc- ~? 1/1.
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: -;IJ e c. 2:J / J.. 00 1
_~~ <O~ I
lY'fture
Name ;;; YY\ ~,,~ _ R 'D I ~:"(--i
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Address /8 N H uW'.(.,.... 3t
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Telephone {j ( lZ 1 3 :J.) t.f f? 1 ~
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Capacity: _ Personal Representative
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BUREAU OF J~DIVIDUAL TAXES
INHER~~t~cE 'rik DIVISION
DEPT. '280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT1 ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-30-2002
DICE
08-05-2001
21 01-0856
CUMBERLAND
101
'I 1 C
JAMES R DICE
18 N HUMER ST
ENOLA
PA 1;7,025
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REV-1547 EX AFP 101-02)
MELVIN
J
Allount Rellitted
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
2,296.00
.00
.00
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4-j-ix--AFP--('oi-:02i--NOY-iCi--OF-i-tiHiifiTAifci-TAic-APPRA-isiifiNT~--Ar.i-oWAtici-ifi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DICE MELVIN J FILE NO. 21 01-0856 ACN 101 DATE 09-30-2002
TAX RETURN WAS: ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
21296.00
NOTE: To insure proper
credit to your accountl
subllit the upper portion
of this forll with your
tax paYllent.
(8)
21296.00
2.032.00
(11)
(12)
(13)
(14)
4.328 00
21032.00-
.00
21032.00-
(15) .00 X 00 =
(16) .00 X 045 =
(17) .00 X 12 =
rate (18) .00 X 15 =
(19)=
. "'. ....... . ru::.",c,u", I+J AHOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED 1 SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)I YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
REV-1470 EX (6-88) -.
. , '*
INHERITANCE TAX
EXPLANA TION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENrS NAME FILE NUMBER
Dice, Melvin J. Jr. 2101-0856
REVIEWED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
H B-3 Reduced to $2,296.00. Family exemption can only be claimed against assets subject to
will or intestacy.
ROW
Page 1
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STATUS REPORT UNDER RULE 6.12
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Name of Decedent: / '/ (. - V ! n
l
Date ofDeath: .A n 5; d 00 I
o 9' .~ ~
Will No.: O-~
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V I ~6 5 r
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State ~ether administration of the estate is complete:
Yes fill No 0
2. lfthe answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal r.9?!esentative file a final account with the Court?
Yes _ No liZl
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal repj'esentative state an account informally to the parties
in interest? Yes g No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
and may be attached to this report. ,/l /
Date: J1-; / 0 3 ~~/}111U' i((Lk1J
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Name
!:J\
Capacity:
fR N. Nu WILt S-f ~b Po
Address J 1 0 d {
1f7 13~-L{1j~
Telephone No.
~ersonal Representative
o Counsel for personal representative
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Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
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Date: 7/01/2003
DICE JAMES RICHARD
AKA
18 N RUMER STREET
ENOLA, PA 17025
RE: Estate of DICE MELVIN JACOB SR
File Number: 2001-00856
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 8/05/2003
Your prompt attention to this matter will be appreciated.
Thank You.
{)~l,; Vffi:taf j)~/~
DONNA M. OTTO "~
DEPUTY REGISTER OF WILLS ~
cc: File
Counsel
Judge
REV-1500 EX 16-00)
REV-1500
(~',
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.___J_J::~__~_=___~_____~__~_
~I N~BER
, O~ __~5(P
NTY CODE - YEAR NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
J) I c.e. /VleLv,"..:r 51
DATE OF DEATH (MM-QD-YEAR)
8 '7 01
8
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II.
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elf 1. Original Return
o 4. Lirnited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
SOCIAL SECURITY NUMBER
;)07-0'7
101'1-
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
/ g tV. j..J vvne r' S 1-
EnoLd Pd l'1oJ-.5'
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OFFICIAL USE ONLY
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TELEPHONE NUMBER
"3 a - q i16"
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(8) Jc:2C\b,-
(11) S'\"32.C
(12) -
(13) ...-.
(14) D
x.O_ (15)
0 (16)
x.O_
x .12 (17)
x .15 (18)
(19)
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(1)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
--
--
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(6)
-
-
(7)
(9)
(10)
.3 ~ DU} .sJ..
1 aJ 0 3~
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Arnount of Line 14 taxable at lineal rate
o
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
20.0
REV-1508 EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
, INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF AA ,~
Q0LYIYl J
7) .
IC(.J
FILE NUMBER
Sr<
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
r:.,^ec:.lc 0.J A t,(.t..roNt 0 ~ 01) 0 ~g 3 'i I
V j 7.Y '} f-J D I;"':t B a}J k.
VALUE AT DATE
OF DEATH
212q~,cc
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ ). :l q lo.. ()0
REV-1511 EX+ (12-99) c
. . ,~..l~'~
~$i~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
it1 eL~n
ITEM
NUMBER
Ac
FUNERAL EXPENSES:
1.
u
D l c::,(j
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
...<) ..
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
Street Address
Social Security Number(s)/EIN Number of Personal Representative(s)
City
Year(s) Commission Paid:
3.
2. Attorney Fees
4.
State _ Zip
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
-
Claimant (] ~ '1 t..S K
Street Address /8 III
.....
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City
P, e,e,;
rJ vmc. r" 5 1-
3 500, \1~
J
Relationship of Claimant to Decedent .s 0 T'\
State 2d- Zip j '1 0;;. .('
Probate Fees
5. Accountant's Fees-
7.
6. Tax Return Pre parer's Fees
TOTAL (Also enter on line 9, Recapitulation) $ 3 5" OOJf '0
(If more space is needed, insert additional sheets of the same size)
.
REV'1512 EX' (1~97) ,
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
/V1 eL V \ '(l
cr Dl~(~ Sr
Include unreimbursed medical expenses.
ITEM
NUMBER
1. OiJA Dm-ft I~~tftllr~
::2
J
t/
5
o
7
tY
q
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lIoiy 5f~;"f f.I~p
, -
~ i1~yJ1:i1Y\ ~M~ I~
I
NtlvYot.. '0) ~yJit1r' Pc:
WM '}) SC-hd~K
E~3-t ?cw/,J.jOo-v-b AMb
~ckr~-rJ ~A5-r
An)JrI~ws Paf~.
pp~L
P(j ~torJ 'P6~ ~ pt$
FILE NUMBER
DESCRIPTION
o)'r' PA
~ y"
v~r I.. <..i
AMOUNT
!I..
~ 3, 1\
8 J } ~ 31
J. 7. 12..
J , 17 )8>
q ~v \)1)
3~.q"L
I U b. J'-L
).D~ /10
LfIoI,ClO
332,~
TOTAL (Also enter on line 10, Recapitulation) $ ;Z OJ :J.. . I 0
(If more space is needed, insert additional sheets of the same size)
.
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF IV{ lC:J.
uLVl'"
NUMBER
I
J LIeu S.
FILE NUMBER
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1.
IV Q 'r'! <-
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)