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OFFICIAL USE ONLY
REV~1500EX +(6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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FILE NUMBER
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (lAST, FIRST,AND MIDDLE INITIAL)
Hau e Minnie L.
DATE OF DEATH (MM-DD-YEAR)
NUMBER
21-01" IOcr')...
CQUNTYCODE YEAR
SOCIAL SECURITY NUMBER
342-03-6100
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
DATE OF BIRTH (MM-OD-YEAR)
06/25/2001 10/24/1908
IF APPLICABLE SURVIVING SPOUSE'S NAME LAST, FIRST, AND MIDDLE INITIAL
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
X 1. Original Return
4. Limited Estate
X 6. Decedent Died Testate
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach copy of Trust)
3. date of death
. Remamder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
B. Total Number of Safe Deposit Boxes
(AttaCh copy of Will)
D 9. Litigation Proceeds Received
D 10. Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A)
(date of death between 12~31-91 and 1-1-95) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & l;OHFIOENTIAL TAX INFORMATION SHOULD BE'DIRECTED TO:.
NAME COMPLETE MAILING ADDRESS
Ro er B. Irwin Es .
FIRM NAME (If Applicable)
IRWIN McKNIGHT & HUGHES
TELEPHONE NUMBER
60 West Pomfret Street
West Pomfret PF~~ssio~a1
Carlisle, PA 1!p~ 9
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1 249-2353
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule 0)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule Gar L)
B. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(8) 9,881.03
(11) 1,905.35
(12) 7,975.68
(13)
(14) 7,975.68
(1)
(2)
(3)
None
None
None
OFFICIAt'1J
tel
-0
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(4)
(5)
NOHI'
None
(6)
9,881.03
None
1,461. 50
443.85
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
o 0
.045
.12
.15
(15)
(16)
(17)
(18)
(19)
x
X
X
X
0.00
358.91
0.00
0.00
358.91
7,975.68
Copyright (c) 2000 form software only The Lackner Group, Inc.
FormREV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
565 Boxwood Lane
CITY T STATE I ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
358.91
Total Credits ( A + B + C) (2)
0.00
3. lnterestIPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 10 requesl a refund (4)
5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
Make Check Payable 10: REGISTER OF WILLS, AGENT
0.00
0.00
358.91
0.00
358.91
''''''''''''':::i~ti~~~:~:'~~~!~~i'yi~~i:~''~tt~!:i~~m~~~~y~~i~~i~~i,~t~~I"~~i~~i
1.
;;'X'ii
l~i~E'APPR'6t~IAT~'BLo~K~ '.'
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 care? .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes No
~~
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Under penalties of perjury, I declare that I ha...e 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 representati...e is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR F1U~ETURN Barbar a V orhes
~ ~.~~. tk Ax<..-7'~~~r~;i:-;()~/~i;-6i3--- ------ - ---- --- --- ----- --
SIGNATURE OF PREPAREROTHER THAN REPRESENTATIVE IRWIN McKN1GHT & HUGHES
60 West Pomfret Street
- --C';'r.fi~ie- --PA--iY6i3- ---- - --- - - ---- -- - -- - - -----
DATE
J/-.J'h?/
DATE
(v/
For dates of death 0 er July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (iill. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0"/" [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1.2)
[72 P.S. 9116(aXll].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX 1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1SOO EX (Re.... 6-00)
..
REV-1509 EX + (1~97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Minnie L. Hauge
SCHEDULE F
JOINTLY-OWNED PROPERTY
SSff 342 - 03 - 6100
06/25/2001
FILE NUMBER
21-01
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
A.
SURVIVING JOINT TENANT'S) NAME
Barbara Vorhes
ADDRESS
RELATIONSHIP TO DECEDENT
565 Boxwood Lane
Carlisle, PA 17013
daughter
B.
c.
JOINTLY-OWNED PROPERTY,
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name 01 financial institution and bank DATE OF DEATH DECO'S VALUE OF
account number or similar identifying number.
NUMBER TENANT JOINT Attach deed for Jointly - held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1 A 10/01/94 M&T Bank, checking account 838.54 50.00% 419.27
2 A 03/01/90 M&T Bank, savings 18,923.52 50.00% 9,461. 76
TOTAL (Also enter on line 6, Recapitulation) $ 9,881.03
T
(If more space is needed insert additional sheets of the same size)
Copyright (e) 199610rm software only CPSystems, Inc.
Form REV-1509 EX (Rev. 1-97)
..
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Minnie L. Hauge
SS!I 342-03-6100
06/25/2001
FILE NUMBER
21-01
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES,
1 Jerry Hauge, food expenses 55.00
2 Peace Chapel Assembly of God, rental fee 50.00
3 UC Davis & Sons Funeral Home 991.50
B. ADMINISTRATIVE COSTS,
,. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
-
Year(s) Commission Paid:
2. Attorney's Fees IRWIN McKNIGHT & HUGHES 350.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State lip
-
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Register of Wills - filing fee 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 1,461.50
(If more space is needed, insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems, Inc.
Form REV-1S11 EX (Rev. 1-97)
-
..
REV-1512 EX + (1-97)
COMMONWEALTH OF PEN NSYL V ANJA
INHEAITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Minnie L. Hauge
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS!! 342-03-6100
06/25/2001
FILE NUMBER
21-01
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Mastercard
DESCRIPTION
AMOUNT
420.61
2
Sprint Telephone
23.24
TOTAL (Also enter on line 10, Recapitulation) $ 443.85
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
-
,.
r;g M&TBank
~~~~UW[~
NOV 05 2001
October 12, 200 I
RE:
Estate Search
The Estate of:
Date of Death (D.O. D.)
MINNIE L HAUGE
6/25/2001
IRWiN, McKNIGHT 8. HUGHES
To Whom It May Concern:
Identified below is the account information requested.
I. M&T Bank accounts in which the decedent's name appears:
Account
Type
Account Number
Account Title
Opening Branch
D.O.D. Accrued Interest
Balances
(Includes AccL
Int.)
$838.54 $.00
CHK
1228323
OPENED 10/94
15004200129250
OPENED 3/90
MINNIE L HAUGE
BARBARA H YORHES
MINNIE L HAUGE
BARBARA H YORHES
4331
SAY
4331
$18,923.52 $19.89
2. Loans, Mortgages, or other obligations titled in the decedent's name
Account Number
Amount Owed
Account Description
NO Safe Deposit Box titled in the Decedent's name existed at our office.
If you have any questions about the information provided, please contact our Records Department at (716) 635-40 I 0 or 1-800-724-
2440 outside of the Buffalo, NY calling area. Thank you.
Sincerely,
M&T BANK CORPORA nON
BY: ~UJ.A:'-L--k~~
Authorized Signature ,
DATE:
10- 12-0\
Manufacturers and Traders Trust Company. 1100 Wehrle Drive, PO. Box 767, Buffalo, NY 14240.0767
/1-dl '-/ -5
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG~ PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ReGorCk...; ot
ReL;::..~'-:~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-21-2002
HAUGE
06-25-2001
21 01-1092
CUMBERLAND
101
"02 JAN 25 P 2 :06
ROGER B IRWIN ESQ
IRWIN ETAL
60 W POMFRET ST
CARLISLE
Clerk..
PA l~bena
PA
*5~
REY-1541 EX AFP U2-DD)
MINNIE
L
Allount Rellitted
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
.00
9,881.03
.00
(8)
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=is4j-Ex--AFP-fi'2=ooi--NO,.-icE--oF-'rNHERiTAifCE-YAi-]rpPR]risEifiNT~--A[i-oWAiicE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HAUGE MINNIE L FILE NO. 21 01-1092 ACN 101 DATE 01-21-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
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. Charitab1e/Governllenta1 Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
(9)
llO)
1,461.50
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
9,881.03
1.905 35
7,975.68
.00
7,975.68
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
358.91
.00
.00
358.91
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
11-29-2001 CDOO0574 .00 358.91
TOTAL TAX CREDIT 358.91
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
443.85
lll)
ll2)
ll3)
ll4)
.00 X 00 =
7,975.68 X 045 =
.00 X 12 =
.00 X 15 =
ll9)=
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
IRWIN ROGER B ESQUIRE
60 WEST POMFRET STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 342-03-6100
FILE NUMBER: 21-2001- 1092
DECEDENT NAME: HAUGE MINNIE L
DATE OF PAYMENT: 11/29/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/25/2001
NO. CD 000574
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $358.91
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: BARBARA H VORHES
C/O ROGER B IRWIN ESQUIRE
CHECK# 924
SEAL
INITIALS: CW
RECEIVED BY:
$358.91
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS