HomeMy WebLinkAbout10-02-06
REV-l500 EX + (6-00)
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REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
FILE NUMBER
2 1 -0 5 0 2 3 5
""COiOOv'CliliE -YEAR- - - 'N'UMBER- -
SOCIAL SECURITY NUMBER
DECEDENT'S NAME (LAST, RRST, AND MIDDlE INITIAL)
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HORN IRA T.
DATE OF DEATH (MM-DD-Year)
1 88- 1 2 - 5 6 7 8
THIS RETURN ..sr BE RLED IN DUPLICATE WITH THE
REGISTER OF WILLS
DATE OF BIRTH (MM-DD-Year)
03/0512005 02116/1922
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST, RRST, AND MIDDlE INITIAL)
SOCIAL SECURITY NUMBER
D 1. Original Retum
D 4. Limited Estate
00 6. Decedent Died Testate (AIIach copy 01 Will)
D 9. Litigation Proceeds Received
00 2. Supplemental Retum
D 4a. Future Interest Compromise (dale 01 deaIh after 12-12~)
D 7. Decedent Maintained a Living Trust (AIIach copy 01 Trusl)
D 10. Spousal Poverty Credit (dale oIdeaIh between 12-31-91 and 1+95)
D 3. Remainder Retum (dale 01 death prior 10 12-13-82)
o 5. Federal Estate Tax Retum Required
_ 8_ Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AIIach Sell 0)
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NAME
HAROLD S. IRWIN III
FIRM NAME (If Applicable)
IRWIN LAW OFFICE
TELEPHONE NUMBER
717-243-6090
COMPLETE MAILING ADDRESS
64 SOUTH PITT STREET
CARLISLE PA 17013
OFFICIAL USE
i
81,000.00
410.07
0.00
0.00
21,247.84
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)
D 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 Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(1)
(2)
(3)
(4)
(5)
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(7)
102,657.91
(8)
25,581.95
27,968.88
(9)
(10)
53,550.83
49,107.08
0.00
(11)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
49,107.08
(14)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
0.00 X _(15) 0.00
49,107.08 X .045 (16) 2,209.82
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 2,209.82
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
CHECK HERE If' yo:) ARE REOUESTING A REFUrm OF AN OVE:RPAYr.1ENT
REV-1511 EX + (12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HORN IRA T
ITEM
NUMBER
A.
B.
1.
2.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
FILE NUMBER
21 05
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
CARLISLE MEMORIAL SERVICE, INC. - Grave Marker Engraving
HOFFMAN-ROTH FUNERAL HOME, INC.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representatlve(s)
Street Address
UN E ,.-7
A · t. ~
NEW
City
1\J~ 0 \t~[E
CO~\~
fffi~~t\E
11EREYO 4
Zip
Year(s) Commission Paid:
Attomey Fees IRWIN LAW OFFICE
Family Exemption: (If decedenfs address is not the s
Clamant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS
Accountanfs Fees
Tax Return Preparer's Fees
DONEGAL MUTUAL INSURANCE COMPANY - Car Insurance
ROBIN SOLLENBERGER - TAX COLLECTOR - Property Taxes
PHEASANT RUN CONDO ASSOCIATION - Monthly Dues
ERA-NRT, INC. - Real Estate Commission
RECORDER OF DEEDS - PA Real Estate Transfer Tax
OTHER CLOSING COSTS ON REAL ESTATE (See Exhibit "B")
CUMBERLAND COUNTY REGISTER OF WILLS - Filing Costs
CUMBERLAND COUNTY REGISTER OF WILLS - Additional Pre
ADDITIONAL DEATH CERTIFICATES
REAL ESTATE REPAIRS
STOTT AND STOTT: TAX RETURNS
0235
LINt:
B.I'. ~
NEV.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
215.00
7,103.02
6,000.00
272.00
143.00
1,087.93
300.00
4,985.00
810.00
140.59
30.00
50.00
54.00
4,011.41
380.00
25.581.95
Hoffman-Roth Funeral Home, Inc.
219 North Hanover Street
Carlisle, P A 17013
(717)243-4511
March 21, 2005
Darlene E HeberIIig
11 Ridge Ave.
Carlisle, P A 17013-
The Funeral Service for Ira T. Horn
14482-41
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
OUR SERVICE:
Traditional Funeral Service Package. . . . . .
FUNERAL HOME SERVICE CHARGES
$3690.00
$3690.00
SELECTED MERCHANDISE:
Carver Casket. . . . . . . . . . . . . . . . . . . . . . .
Monticello Interment Receptacle. . . . . . . . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . .
$1820.00
$1170.00
$6680.00
Cash Advances
Newspaper Obituary Notice-Sentinel.
Newspaper Obituary Notice-Public Opinion.
Certified Copies of Death Certificates. . .
$212.15
$100.00
$36.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
$348.15
Total
Total Cost .
. . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
$7028.15
History
03/21/2005 Darlene E. heberIig CK # 24458.
03/21/2005 Memorial Guardian Plans
$74.87
$-7103.02
TOTAL AMOUNT DUE .
$0.00
This statement is net and payable in full within 30 days of receipt.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
Please return this portion with your Remittance
$
Amount Enclosed
Service 10 # 14482-41
Ira T. Horn
I~ ~-I(l-(Jb
NAME
ADDRESS
cm ST. ZIP
PHONE
STorr & STOTT
nNANCIAL SERVICES
IS7 s. HANOVER STREET
CARLISLE. PA 17013
Phone: 717-243.8077
€S1ttr~ o~ /1</1 -; 11M A/
/" f./ 5 f?,ff <-r
f:A~l.A5('E jJl} / "7n/q
},t;2'- :070
PREPARER:
~ TAX PREPARATION 0 CONSULTING ~t\ fi(
o ACCOONTJNG 0 PAYROLL N~
o / N bill J DIlI1' 1.tr'J 5' h ;-;::. pilL..
c
AMOUNT
DISCOUNT
TOTAL
PAID
BAL. DUE
,00
1 AaNOWLEDGB mAT1HB ABOVE ~ AMOUNT IS OWED TO S'roTT A: STO'ITFINANCIAL SERVlCBS FOR SERVICBS RENaWID. 1 ALSO ~
Ac:aBB mAT ANY AMOUNT DUB AYlER JO DAYS WILL BE SUBJBCT TO IN11IRIIST IJ 11IE IlA'Dl '" " ....,...",.. ~ 'N A~~ 7\
PAY ANY COlTS ASSOCJATBD WITH nIB COLLECTION OF nus AMOUNI' OR. ANY POImON OF nns AMOUNT DUB TO NONlLATB PA /l}
SIGNATURE DATE
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IDate ~ /(p-O~ I
NAME
ADDRESS
cm ST. ZIP
PHONE
STOTT & STOTT
nNANCIAL SERVICES
IS7 s. HANOVER STREET
CARLISLE, PA 17013
Phone: 717243.8077
/1?11 -:r /-11'1(..; F ~;.~ -:'{"
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7 - :J '1-
'~ TAX PREPARATION
o ACCOUNTING
o
o CONSULTING\",I \t7~
o PAYROLL \ \J'"" \)
AMOUNT
DISCOUNT
TOTAL
PAID
BAL. DUE
1 ACKNOWLEDGB mAT 1HB ABOVE ~ AMOUNT IS OWED TO S'roTT A: STO'IT FINANCIAL SERVlCBS FOR SERVICBS RENaWID. I ALSO
Ac:aBB mAT ANY .u<<>UNT DUB AYlER JO DAYS WILL BE SUBJBCT TO INTIRBST AT nIB RA1'B OF 1.5" M)N'lHLY. I'" ANNUALLY. I AGREB 1'0
PAY ANY COlTS ASSOCJATBD WITH nIB COLLECTION OF nus AMOUNI' OR. ANY POImON OF nns AMOUNT DUB TO NONILATB w.:rJ'r
SIGNATURE DATE ().. - fb- 4J
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISION
PD BOX Za0601
HARRISBURG PA 171Za-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
11-28-2005
HORN
03-05-2005
21 05-0235
CUMBERLAND
101
APPEAL DATE: 01-27-2006
( See reverse side under Objections)
Amount R..ittedl I
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 +-
iE,,:is47-EX-AFP-ioi:osi-NOTicE-OF-iNHEiiTANCE-TAX-APpiAisEitENT:-AiioWANCE-oi---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
IRA T FILE NO. 21 05-0235 ACN 101
DATE
ESTATE OF
DA TE OF DEATH
FILE NUMBER
COUNTY
ACN
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Gover~ntal Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an asses~ent was issued previously, lines 14, 15 and/or 16, 17, 18 and
r~lect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AIIount of Line 14 at Spousal rate (5)
16. A.ount of Line 14 taxable at Lineal/Class A rate (16)
17. Aaount of Line 14 at Sibling rate (17)
18. A.ount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tex Due
HAROLD S IRWIN III
IRWIN LAW OFFICE
64 S PITT ST
CARLISLE
PA 17013
ESTATE OF HORN
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 end Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortpps/Notes Receivable (Schedule D)
5. Cash/BBnk Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Trensfers (Schedule G)
8. Total Assets
NOTE:
DATE
09-20-2005
NUMBER
CD005816
INTEREST/PEN PAID (-)
.00
TAX Hfl5
BEEN ~'D
REt=U.1DCJ. \$
DiE.[wE. \\",~\)y.J
. IF PAID AFTER DATE INDICI _
FOR CALCULATION OF ADDITIONAL INTEREST.
( ) CHANGED
(ll
(2)
(3)
(4)
(5)
(6)
(7)
81.000.00
410.07
.00
.00
21.247.84'
.00
.00
(8)
*'
REY-1547 EX AFP (06-05)
IRA
T
(9)
UO)
.
18.098.93
..
27". 968~88
DATE 11-28-2005
NOTE: To insure proper
credit to your account.
sub.it the upper portion
of this fona with your
tax paYlUlnt.
"
102.657.91
46.067 81
56.590.10
.00
56.590.10
19 will
.00
2.546.55
.00
.00
2.546.55
2.546.55
.00
.00
.00
rOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
(11)
(12)
(3)
(14)
.00 X
56.590.10 X
.00 X
.00 X
00 =
045 =
12 =
15 =
(9)=
AMOUNT PAID
2.5 6.55
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE