The URL can be used to link to this page

Home My WebLink About04-23-85 ""1_;;'<+_ *- INHE.(.T1N~~ix~~RN C'.OMMCINww~NSYl.YANIA RESIDENT DECEDENT ='''"lx~=Z= (TO BE FILED IN DUPLICATE ~~ m7105 WITH REGISTER OF WILLS) NAME ,FlUT," ij NT'$ S ELLENBERGER, John Wesley 3310 Trindle Road S IITYNUMlEI ..... OfDEATM Camp "Hill, Pa. 17011 . ~. .. lIIa=w z.cg u~ . c si .z 82 FlU NUMBER ~ / 7 ;?-I, I '1 I 187-16-6331 Oct. 14, 1984 iiI. OrigInol Return Dc, Ufe E-. o 2. Svppll_ntal Return o 4a. Futuro 1_ c-p.ami.. o 3. R_lnder Return o 5. Federal E-. Tax Return Required _ 8. T_I Number cl safe depaoit box.. r.6. o-dent died........ 07, Doadent maintai.... a Hving trust Altach cl WlIQ AttacII af trust) RRESPONDENCE AND CONFIDENTIAL TAX INFORMAnoN SHOULD IE DIRECTED TOI ADORESS 101 North Front Harrisburg, Pa. John A. Roe, Esq, mE E NUMIfR (717) 238-5201 19. If Ii.. 18 i. greator than Ii.. 17. ontlr tho differlnce an Ii.. 19. Thi. i. tho OVERPAYMENT. A. OCheck..... ~ y"" aro ....u...ing a refund 01 your av.rpaymont. 20. H H.. 17 is g_ than II.. 18. entor tho dillerlnce an Ii.. 20. Thi. i. tho BALANCE DUE. A. Entor tho i_ an tho balance dUI an Ii.. 20A. 8. Entor thl t_1 01 Ii.. 20 and 20A an Ii.. 208. Make C...... PayaWe leI "'lder of WHII, "'ent ..BE SURE TO ANSWER AU QUESnONS ON REVERSE SIDE AND TO RECHECK MATH.... Undor penaltie. of perjury. I docIaro that I havl uaminod this rotum. ==: accampany;ng ""'edull' and __. and 10 tho boot of ray knowledge and 1M M is truo. __ and campletl. I docIaro that all ...1 _ has boon at truo mailcot valul. Dedaratian of p<epa_ athor than tho ponanal _- based ~DIlal~ Of ~ ~rw has any btOwl'd~. ~ /}O. ~ 310 Trind1e Road. Camp Hill, Pa. 17011 4/zzJ85 PERSON ItESIONS.lLE POI fiLING .UURN ADDRESS DATE CITY z o 0: j ~ I I. Real E-.(5chedule AI ( I) 2. Stocb and land. (5chedule 8) ( 2) 3. Clasoly Hold StadclPartnenhip Intorest (Schedull q (3) 4. Martgagos and Natos Roceivable (Schedule D) ( 4) 5. Ca~k ~asits & Miscella_u. P_nol Praperty( 5) $ 1 'i b. , 6 n 7 ( Ie E) 6. Jointly Ow.... Praperty (Schedule F) ( 6) 7. Translers (Scfledule G) (Schedule l) ( 7) 8. Tatal Gra.. "-. ~atalli... 1-7) 9. Funeral E_.... Administrative Casts. Miscellaneou. (9) $ Expo.... (Scflodule HI 10. Deb... Mortgagl Uabil_. Uon. (5chedul. i) (10) II. T_I Deductian.(tatal h... 9 & 10) 12. Not Valu. cl Est.... (II.. 8 minus Ii.. II) 13. CharMable and Gavornmontal Beq_ (5chedule J) 14. Not Value.. 'oct 10 tax (Ii.. 12 minu.lin. 131 15. Amount alii.. 14 taxable at 6% rate pndudo values from Schedul. K ar Scfledule M) 16. Amount clli.. 14 taxable at 15'"' rate pndude valu.. fram Schedul. K or Schedul. MI 17. Principal tax due (add tax fram II.. 15 plu. tax fram Iin. 16) "".15. ~n l"l,h?b. Oq - 0 - 1151_ (161 $ 140,976.21 )C .06_ z o S ;:) ... " o u a 18. Tatal Priar paymonl1: Amount Paid Discount Int..,t + . 171Gl 'AI Street 17101 STAff ZI' " c;.r:- "' ("' "-' cO ,-n ",'" r11rT1 ng (-:::;;0 ,!-." r:~ ;:;c:..:: r.... ~. := ..." -0 N ..,'>.... '-....; ( 8) $ 154.607 ':tn (II) 112) (13) (14) 13,624.09 $ 1b.0.Q7R ?1 - 0 - ~ 21,1116.73 (17) (18) (19) (201 (20A) (208) $ 21,146.73 DAn: 4.(> 7J.P.5 1. 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 on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration' 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' bank account at his or her death' 'YEs NO ~ X X x. X 0 X - o- X ---- -0- IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. "...."'..:e~p<"~'__"'".j"~....:.~...."'_"..._' ':;~'X~~{; '" , :;' .' acttEDULE "E" ,;'CtUH. BANK DEPOSITS AND . MISCELLANEOUS JlERSONAL PROPERTY TH OF Pl!NNlYLVANIA ,tNHERITANCE TAX RETURN RESIDENT DECEDENT OFJOBN WESLEY ELLENBERGER , DECEASED i{:~:ER ,.,. ~ t. 2. FILE NUMBER - .... of IaN I .b.1I4- InUIt be ..al . on Schedule "P'") DESCRIPTION 3. 4. Princlpal and 8CCI.IIIJ1ated :I.ncaIe - Dauplrln Deposit Bank & Trust aJc('('''sor Testamentary G.lardian of the Estate of John Wesley Ellenberger, nee.........., as set forth in Will Book "D", Vol. 2, Page 155, Dauplrln County Register of Wills Principal and 8C("IW'lI11..ted :I.ncaIe - Dauplrln Deposit Bank & Trust Co., G.1arc:lian of the Estate of John W. Ellenberger, an Wc<"T'" N:>. 619 Year 1978, Onn..rland County Court of Cnmn1 Pleas New York Life Insurance Company Proceeds Pol. 112212309 (858810) New York Life Insurance Company Proceeds Pol. #12079738 (858810) TOTAL (Also Inter on line 6. Recapltul_ionl fit ~ ~ .. f'tMded InMrt eddttIon" ......... of ..me .... VALUE AT DATE OF DEATH $ 104,762.08 t~ 43,603.75 $ 4,843.94 $ 1,392.53 ,154,602.30 _.1S11.IDC+ CMI) CDIUlMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE"H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ELLENBERGER, John Wesley FILE NUMBER ITEM NUMBER A. 1. B. 1. 2. 3. 4. C. ,. 2. 3. 4. 5. 6. DESCRIPTION AMOUNT Fu__ E_: Myers-Hall Funeral Home (Funeral Expenses) $ 3,614.56 Administrative Costs: Panonal Representative Commissions Social Security Number of Parsonal Representative: Year Commissions peid Attorney Fees - John A. Roe, Esq. $ 7,730.00 Family Examption Claimant Address of Claimant at decedent's death Relationship Pro~F.s - Cumberland County Register of Wills $ 122.00 Miscellaneous Expenses: Cumberland County Register of Wills (3 Short Certific tes) 6.00 Internal Revenue Service (1984 Final Individual Incom Tax Return) 1,776.00 Pa. Dept. of Revenue (1984 Final Individual Income Ta Return) 235.72 Internal Revenue Service (1984 Federal Fiduciary Inco e Tax Return) 92.95 Pa. Dept. of Revenue (1984 State Fiduciary Income Tax Return) 36.86 Cumberland County Register of Wills (Filing fee for Pa. Inheritance Tax Return) 10.00 TOTAL (Also enter on line 9, Recapitulation) ,13,624.09 REV-Ill' EX+ 17"') COIlJ1llflOfmt:ALTH OF PENNSYLVANIA fNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE "J" BENEFICIARIES JOHN WESLEY ELLENBERGER ,DECEASED FILE NUMBER ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE A. Taqble Bequests: 1. Robert M. Ellenberger 3310 Trind1e Road Camp Hill, Pa. 17011 Brother Entire Residue ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests 1. TOTAL CHARITABLE AND GOVERNMENTAL BEOUESTS (Also en.r on line 13, Recapltulationl . 111'1 L > > 0 t'J'-> 1-'-'"0 l;) 00:>:l c ~ I ~ ~ Z ~~ ::l ::ll>> Ct> I>> ~Ct> 1'1 ~ > p.. ::l Ii O'Q On r 1-"- rt rt I-' 1-'- ~ I 1'1 0'-'- I>>::TH I-' 1-'-t'Jrn > > X rnl-' Ct> ::l i rn ~ rt ~ ~ > ~o' o ::T I-' Ct> o 0 ~ Ii ::TrnCt> Ct> Ii 011'11'1 Ct> Ct>~1i ::l > ~ ~ rn o OJ 1-'- tlO " N 1'1 ~ ~ >-'I ?\" rt '"0 '"0 Hl ~ ~ 0 ::T 01>>1-' 1>>0 - ~ ~ 1-'- Hl::l Ct> - OOE: ~ 1'1 ::l 01>> C::I-'- ~ -<J>Ct>rn 1-'2:1-' rtN Ct> .....>-'11-' ~ '< ::TI-'>-'I o"'::rn 0 Ct>- I>>Hl I-' ... ~ 1-'>: 1-'- WOO t:l rn -10- ::l :>:l OHl t:l Hl ~"':>:lp.. Ct> C::Hl t"l 0 - Ct> :>:ll-" tIj Ii .....rtCt> >-'ICil III I-l o w~ ::l Ct> '< Hl IiO t'J ::<: > 0 0 Hl::ll-' rn 0 iO 0 rt c:: ~ 0 III Ii I-' Ii 1-" rn I>> CJ:l 01 ~ [>j ::e 0- 0 ::lCt> rt t'J ~ III Z ~ 0 0 rt p.. Ct> c:: 0 Ii: ... tIj ev, 0 O::Trt Ii i::Trt 0 1-" " 9 ... " i::T Hl I-' i w [>j 'd Ii: [>j I-l =: p.. 01>>1>> '-< N . Z i< N OM ',,-.- Ct> Ii'gj 0'0 0 N Z ~ " (IJ ~ UC-j ~ . 5 ~ l>i L~J Ii o Ii N OJ ~ ~oc 1.0 I>> rt Ct> <: 1-" ~ >< ... Ii: tIj co _J . (.j rt ::T::lCt>O'Q I-' ~ OJ > t'< ... 1-" Ct>rt 1-" OE: '" ... Z ~ t"l > i1>> V1 ~ [>j ~ ~ [>j ~ 1-" Hl Hll-' t'J > ... 1-'- I-' Ct> I-' ~ > ::l 1-" rt Ii I>> I-' ~ Z ~ ::l::TCt> ::l Ct> 0 t:l rt 0'QCt>::lp.. ::l ~ ::T 0 0' to 1-" o '"OCt> 0 Ct> rn Hll>> p..::l Ii > Ct> O'Q ~ OJ rn t'J Ct> tIj I>> ~ Hrn,...., Ii ~ rt ::lrtl-' rt Ct> ::TI>>'-'" Ct> Ct>rt tI Ii Ii Ct> 0 Ct> ~ 1-'-- 0 0 rt '1:l Ct> ~ " 1>>1>>'> ~ 1'1 ~ rn > o 0 000 Ct> :< ~ , Ct>::THl p.. ~I " n 1'1 0 Ct> ;i c >-'IOrt z I>>?\"::T 0 :< . >: Ct> 0 0 " ~ ~ " 1'1 1'1 ~ 1'1 0 Z "'"","'"","'.,.',""';"...',,,,,,, t~lr~f~;;' ' <<" ';. ~~~~:e~:~ESYLVANIA, OFACIAL:REClEIPT !.ft:NNSYlVANIA INHlERITANCE AND ESTATE TAX , RECEIVED FROM: r Lorna Jane Bl1enberqer c/o JOM A. Roe. Bso. 101 M. Fron~ Street Harrisburg, Pa. 17101 L ESTATE INFORMATION: FILE NUMBER NAME' OF DECEDENT DATE OF PAYMENT POSTMARK DATE COUNTY DATE OF DEATH REMARKS SEAL 21-78-619 EI.I.U:B:UGBR .roD ~fil 23 ,Fliiss April 22, 1995 CUllberland O~ober 14, 1984 tl.'BSL MI m ACN , ' . ,., ft. (', , .)SIGNATURE' /' / . G AMOUNT Assessment Control No. 101 -, ~ ~TOTALAMOUNT PAID RECEIVED BY /. I . / "." 1'''' -~ REGISTER OF WIU.S ~ 21.146.73 ..,/ ~ ~ e Ii . = ~l e ---...JJ 21,146.73 / ~- ~ -- REV-1162 EX 2184 ~ .=