HomeMy WebLinkAbout05-02-06 (3)
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1'5056042047
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REV-1500 EX
Decedent's Social Security Number
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Decedent's Name:
RECAPITULATION
8. Total Gross Assets (total Lines 1-7). . . . , . . . . . . . , . . . . . . . . . , . . . . . . . . . , , ., 8.
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1. Real estate (Schedule A). .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) c::::> Separate Billing Requested. . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::::> Separate Billing Requested. . . . . . ,. 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). . . . . . . . . . . . . . . . . . . . .. . . . . . , . . . . . . . 11.
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12. Net Value, of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. f' ~.
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13. Charitable and Governmental Bequests/See 9113 Trusts for which tf '~rN
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. ii"".
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14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. t."
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0 ~
16. Amount of Line 14 taxable
at lineal rate X.o!:iS'
17. Amount of line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
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19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
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20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND 0'
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Side 2
15056042047
15056042047
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
File Number
STREET ADDRESS
E~A"€ STINE
11;1.
/1-.
L/fY€~7t1E
L()CtlS7
wAY
CITY
STATE f//f
C /!,Il..L/S L E
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payment~
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
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--------_. ----------- ------------ --~--~--~--~.- ---
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Total Credits (A + B + C )
3. Interest/Penalty if applicable
D. Interest
E. Penalty
-- -- ~ --~----- --- _.~-_._._-_.._--
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---~-- _~~___u______________ Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
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(2)
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(5A) 0
(5B) Jf 9, 0 Sl{. 90
1. Did decedent make a transfer and: Yes
j~~g:,~ ~.he use or income ~f the property traJnhsferred;..t....t........f.......d.......:t....:........................................................ DO
COlli .. I 'ff 0 c . e roper y rans erre or I S Income; ............................................
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PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
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REV-1502EX + (1-97)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF L ~ ""7"j
rrJl pn IIA r::;- I
Ei'lAl'Esr/A/E A.
FILE NUMBER
~/-oS--6VO
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of
survivorshiD must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
7 Ie. /I t!., ()/: L./lN () / /11 f.J~JI cD PJ/7'# LJUJEZL/"If/' t;
HIJ/,(SE /IT I/:t. LtJCUJT WAy I e/l.I2.t./SLE (At/J)/)Ll:Se'X
7ilU/N'JIt'//J; CuhliJG1iL#-AJLJ Cot/AiTy / ~ElYAI/l~ ~ IS ~Rt
PArl,71(!,LtL.Al2LY j)ESe,e/,g~ /AI TJ./A-T &:::/l.~/AI lJ~
~HI 1>.. ErJH'/f~ j) .Tr J IE r VlX" 72) /fLt! /AE ~.
t./l-J/I:7t72tG AN-tJ ~GS71AlG /I. LA-J/ElLru~ #/S ~/~
~ IS /Jft:>~ r=uay ~GT ,&:I1JA7# /l-T ~ ~
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g-~/L!JEV 1111 7A'~ ~~.(' ~r:-/7CG /AI ~ ~
CU#l~t:=/lL/fAlf) (!,tJU/II ry /A" ,l)ec:b /d~OK lljJl" VeL.. 2/
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;lAVE SS"F. (5/F E: C!f;t.7Y bl: )JECZJ A- -rrA-t!~/b7::>).
FUlL.. /fAIiJ ~/J1j1L.-ErE 7l7Z~ J/E"S7ctJ //1/ ~E-t!if7JI::7I/T
Ivl/I:/II cSl/&- j'l/Rs ,LJ~~e:~EZJ ~y A-'~ $4-/LJ
HtI~/JA-/Vi) ~;Y JA-A/U/J-ILY ~7, :l~~
AfJ/I~A-ISIfL. 6y S. tv, !3I/l,lGTr RG7H. ~TE (.
!I-I1fJlZ/fl.5/fl SETlJ//(!,E$ /~ ~ /rA-t!-JllaJ Nt:7GETZ; <1/ qO) OCCJ,~o
TOTAL (Also enter on line 1 J Recapitulation) $ I 'f 0 I t!)OO. 60
(If more space is needed, insert additional sheets of the same size)
201-CT-Warrant7 Deed-8hort Form-Act 1909-Double Sheet
Henn" Hall. Inc.. Indiana. Pa.
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BOOK~ 2iPAGE 358
MADE THE 25th
of our Lord one thousand nine hundred,
day of
and sixty-'six,
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tt ..: .,q .'dee,,'
f.'\,lfl (~ C) 'rry /":,1 I 1':,'lb
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~. . '. . in.tnil year
April,
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BETWEEN D. EDl,oJARD arT and JEAN S. OTT, his wife, of Middlesex Township,
Cumberland County, Pennsylvania,
Grantor s ,
and ALCIDE A. LAVERTUE and ERNESTINE A. LAVERTUE, his wife, of Hershey,
Dauphin County, Pennsylvania,
Grantee 5 :
WI TNFJiSSETH, that in consideration of Three Thousand ($3,000.00)
in hand paid, the receipt whereof is hereby ackno~vledged, the said g'rantors do
and convey to the said grantee 5, their heirs and assigns,
Dollars,
herebu grant
ALL That certain tract of land situate in the Township of fo.tiddlesex,
County of Cumberland and State of Pennsylvania, and being all of llot No.
21 and the \,oJestern half of Lot No. 22 on the Plan of Evergreen Estates,
Section uA", which Plan is recorded in the Cumberland County Recorder's
Office in Plan Book 8, Page 24, and being more particularly bounded and
described as follows:
BEGINNING at a point on the North side of Locust Lane at line of land
or Garvin, which point is also on the dividing line between Lots Nos. 20
and 21, on the hereinbefore mentioned Plan of Lots; thence along said line
of Garvin on said dividing line North 26 degrees 59 minutes 30 seconds
West, a distance of 150 feet to a point in line of other land of the
Grantors; thence along said other land of the Grantors North 63 degrees
o minutes 30 seconds East, a distance of 150 feet to a point; thence along
a line running through the center of Lot No. 22, on said Plan, South 26
degrees 59 minutes 30 seconds East, a distance of 150 feet to a point on
the North side of Locust Lane; thence along the North side of Locust Lane
South 63 degrees 0 minutes 30 seconds West, a distance of 150 feet to a
point, the place of Beginning.
BEING part of the premises whi8h Fran~is B. Sellers, Jr., and Naomi
L. Sellers, his wife, by Deed dated May 7, 1943, and recorded in the Office
aforesaid in Deed Book "Q", Vol. 12, Page 246, g-ranted and conveyed unto
D. Edward Ott, one or the Grantors herein..
SUBJECT to the restrictions on the Plan o:f Evergreen Estates, Section
"A", and to the restrictions place on said Jots by DO' Edward Ott dated
AND the said grantors , d.o hereby covenant that
t GENERALLY the' property hereby conveyed.
they
will WARRANT
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IN WI~NFJSS..t'ffl.fIJERlg@Ff.;;.J.~~id grantor s ha ve hereunto set their hands
the day and"'year firsl-- above wr~tten.
and sea.l 5
.. (. /.- (', /'.- (' /;-;,...tt:.... ~
.il>igu"il, !!hal"il auillhliu"nil \ ,,__24L-_'J,,_.k~L-;C.--.. _ n____m_____________________n_m ~
. in "Q.::j"ur" of ( ______~Jf.-t!:-?Jj-----d:--n-Q4=-----------m---nm------- e
1~-:---~:~~.-----\> 1// ____________________________________ ~
.----------- ------------ ------ ------ ------ ----- ~
.________n___m_nm___m__n__mm___mm_m__m__________n___ ._.__mmn__________mm_ _____mm_______ m___________nmm_-___nmm e
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~~:~~s~r~~~~~;~;~ce ~f ~L,r4 I
(~lltL:.-.....................--.......-.--..
Attorney
County of CUf-.1 BE RLAND
On this, the
a Notary Public,
the undersigned officer, personally appeared
25th
} SS.
day of
Ap r i 1
, 19 66 , before me,
State of
PENNSYLVANIA
D. EDtIJARD OTT and JEAN S. aTT, his wife,
"",,:;,"";"lrn,oWftto,:me (or satisfactorily proven) to be the persons 'whose nal1'l,eS are subscribed to the
.:::.,...~ \) ..~ ~th~."ti~kr.ument, and acknowledged that the y executed sa1ne "or the purposes therein
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/!;'~ .:'\..' fJt,:'Ifl,r~ESS WHEREOF, I hereu.nto set ,11t~ han~ andJjji(J~l seal.
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r. '.~ ?: ~ '::-', ~
,:;, 'lr ". "." ~ '.,~ :~..';', MILDRED R. BRENNEMAN
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'i-';(:"";t.I~/~ t P'~ ~.. . CARLISLE, CUMBo co., PA. Title of Officer.
'tHlill"~'~il-l,l::,.i My Commiss,'on Ex' M
"..,:;0; , , pires ar. 18, 1970
State of
County of
On this, the
} ss.
day of
, 19
, before rne,
I
do hereby certify that the precise residence and complete post office add1'ess
of the within named grantee is
19
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A ttorney for _______________uu____________________uu________ __nu
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COMMONWEALTH OF PENNSYLVANIA