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HomeMy WebLinkAbout02-07-83 (3) . REV-1500 EX + (9-81) BUREAU OF EXAMINATION PENNSYLVANIA DEPARTMENT OF REVENUE P.O. BOX 8327 HARRISBURG. PA 17105 INHERITANCE TAX RETURN RESIDENT DECEDENT -h File Number o:? 1- 7 cf - 4/ t) Decedent's Name (Last, First, and Middle Initiall Decedent's Address CHECK 196-12-5962 1. Original Return C June30,1978 2. Supplemental Raturn W 152 West North Street Carlisle, Pa. 17013 Date of Death APPRO- PRIATE 3. Remainder Ratum 0 BLOCKS 4. Life Estate 0 6. Decedent died testate 0 (Attach copy of WillI 5. Federal Estate Tax 0 Return Required. 7. Decedent maintained a living 0 8. Number of sefe daposit 0 trust (Attach copy of trust) boxes inventoried CORRE- SPONDENT Name All correspondence and confidential tax information should be directed to: George F. Douglas, Jr., Esq. Telephone No. Address 717-243-1790 City State Zip Recapitulation 1. Real Estate (Schedule AI ( 11 2. Stocks and Bonds (Schedule BI ( 21 3. Closely Held Stock/Partnership Interest (Schedule C) ( 31 4. Mortgages and Notes (Schedule 01 ( 41 5. Cash & Miscellaneous Personal Property (Schedule EI ( 51 ----2- 6 7. 00 RECAPIT- 6. Jointlv Owned Property (Schedule FI ( 61 ULATlON 7. Transfers (Schedule GI ( 71 8. Total Gross Assets (total lines 1-71 AND 9. Funeral Expenses Administrative Costs/Miscellaneous Expenses (Schedule H) ( 91 R? nn TAX 10. Debts/Mortgages/Liens (Schedule I) 1101 11. Total Deductions (total lines 9 & 10) 12. Net Value of Estate Wne 8 minus line 111 CALCU- 13. Charitable Bequests (Schedule J) LATlON 14. Net Value subject to tax Wne 12 minus line 13) ( 81 267 . 00 1111 1121 1131 (141 e2 00 185 . oe '25 no Computatioo of Tax 15. Amount of line 14 taxable at 6% rate (15) 1:8500 (include values from Schedule KI 16. Amount of line 14 taxable at 15% rate 1161 (include values from Schedule KI 17. Principal tax due (add tax from line 15 plus tax from line 161 18. Total Prior payments: (el Amount Paid (bl Plus Discount (cl Minus Interest I1BI 19. Balance Due Wne 17 minus line 181 Make Check Payable to: Register of Wills, Agent * * * PLEASE RECHECK MATH * * * x.06= 1 LolL x.15= 1171 11.11 (19) 1] 11 Under penalties of perjury, I declare that I have examined this raturn, including accompanying schedules and statements, and to the best of my knowtedge and belief, it is true, corlllct, and complete. Declaration of preparer other than the personal representative is besed on all information of which preparer has an nOwl~ge:. /, ~ "A~.J e ,(lI'-&' _~... S N TURE Ol-PERSONAL REPRESENTATlVE(S) rA. ADDRESS / / / /6/ J-'3 , 6A TE, ");,1] / !Ir., In DATE REV-I508 EX+ (9-81) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE "E" CASH AND MISCELLANEOUS PERSONAL PROPERTY FILE NUMBER William Coleman (All prop.rtv jolntlv-owned with the RIght of SurvivorshIp must be disclosed on Schedul. "F") ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 2 Eisenhower Uncir. Silver Dollars (1971) 4 Uncirculated coin mint sets value 1.84 (1972) 3.00 cash old bills 1 Uncirc. Mint set 1964 - .91 8.00 Buffalo nickles 4.00 silver halves 14.00 old silver dollars, 7.00 silver halves, .40 old silver dimes, 49 old pennies, 1 foreigncoin 1.60 old silver dimes The coins and bills were appraised by Clarence L. Fauf't, Faust Coins, 19 S.George St.,York, Pa., for $267.00. The entire group of coins and bills were subsequen-tly sold to Clarence L. Faust for the appraisal price $26a.00 TOTAL (Also enter on line 5, Recapitulation) $ 267.00 (If more ,pece I, needed In..rt additional sheets of 18me size) REV-1Sll EX+ (9-81) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE "H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES FILE NUMBER Iv; 11 ; ~m C:n 1 pm-"ln ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: 1. B. Administrative Costs: 1. Personal Representative Commissions 2. Attorney Fees C. Miscellaneous Expenses: 1. Commonwealth Na't. Bank, drilling open safe deposit box G.F. Douglas, Jr., Esquire Filing inventory 47.00 25.00 10.00 TOTAL (Also enter on line 9, Recapitulation) $ 82.00 (If more apace 11 needed Insert additional sheetl of SlIme size)