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Home My WebLink About01-24-07 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 230601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ENGLE NEVIN E 2708 MILL ROAD BOX 44 GRANTHAM, PA 17027 -------~ kid ESTATE INFORMATION: SSN: 209-28-9632 FILE NUMBER: 2106-0428 DECEDENT NAME: ENGLE MARY ANN DA TE OF PAYMENT: 01/24/2007 POSTMARK DATE: 01/24/2007 COUNTY: CUMBERLAND DA TE OF DEATH: 01/11/2006 NO. CD 007738 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $152.10 I I I I I I I I TOTAL AMOUNT PAID: $152.10 REMARI<S: NEVIN ENGLE CHECK# 894 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS --.J 15056041046 REV-1500 EX (05-04) PA Department of Revenue Bureau of Individual Taxes Dept. 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT .,2/ o~ o ..~ zy Date of Birth ,2?1Y 2-J7 f~3Z ~ / / 12-6JCJ~ I~&/ . /73 .5' Decedent's Last Name Suffix (;:'~M.Ie~~~ Sow";n. Spoo'.', Info~";"" Below Spouse's Last Name Suffix ~~~~I~uritY Number Decedent's First Name MI /lJdrt ;:l/2-~ Spouse's First Name AI e V I .rz...--- MI ~ ;2..cJr Z-y 9' &.5 ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .. 1. Original Return c:::> 2. Supplemental Return c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::> c:::> 4a. Future Interest Compromise (date of death after 12-12-82) c:::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::> 10. Spousal Poverty Credit (date of death c:::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime TelepiqoJle Number "-v r:................. ..~ 7 17!7jr4Jt!~~.~/ REGISTERj)f1-111\lllS LtSt ONLY -'<J 1'\-) 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c:::> 4. Limited Estate c:::> c:::> IVe. V J ....../V.e(lf/ e Firm Name (If Applicable) ..-'.", -t.- First line of address J".", 10 8C;h f( Second line of address ('\.".) .:::- City or Post Office G rd /VI-Ad/Z State ZIP Code DATE FilED 74 / 71/2-7 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct d complete. Declaration parer than th personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041046 15056041046 --.J r I I I I I I -.J 15056042047 REV-1500 EX Decedent's Name: Decedent's Social Security Number ;2cf 2? 7' ~ 3 2- RECAPITULATION 1. Real estate (Schedule A). 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . 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. 8. Total Gross Assets (total Lines 1-7). 9. Funeral Expenses & Administrative Costs (Schedule H). 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . 10. 11. Total Deductions (total Lines 9 & 10).. .... .. . 11. 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) . . . . . . . . . . . 12. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . 14. 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 .OQ.P ,2 ;Z5'5"~ I~ t?2- 15. 16. Amount of Line 14 taxable at lineal rate X .0* .3. 3zf.f? 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT \ \ \ I \ ,v ..\ \. I ,J)J> ~ V.0'0cf DU \:<P1~ ","Ie; ~1" ~ 1\\ ,,\\:)0 \'" 15056042047 Side 2 L . 13. 1. 2. 8 9. :z;zp / c::::> 15056042047 -.J r I REV-1.500 EX P@ge 3 Decedent's Complete Address: DECj)T:~;~t /-J/?/~ 6Z9k STREETA;'g~ /7 / . / / --;;? 'J! J ;2/ ~/j7 //~ // /7Cd/'L ~??7 2?C'X f!- ~ CITY al?i/2?~a-/~J Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payment? A. Spousal Poverty Credit B. Prior Payments C. Discount File Number STATE '7/l I ZIP J -; C} 2- 7 (1) /52,/0 Total Credits ( A + B + C ) (2) o 3. Interest/Penalty 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. Fill in oval on Page 2, Line 20 to request a refund. (4) o B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 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. /~Z., / d Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... D ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or...................................................................................................................... D [2(l. d. receive the promise for life of either payments, benefits or care? .................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D I2Zl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D 1R1 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after 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 three (3) percent [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 zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. 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 zero (0) percent [72 PS. ~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 four and one-half (4.5) percent, except as noted in 72 PS. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116(a)(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. REV-1508 EX + (1-97) ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 21060428 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. Mary Ann Engle ITEM NUMBER 1. DESCRIPTION Members First Certificate VALUE AT DATE OF DEATH $80,547.61 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) $80547.61 REV-1510 EX -(1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary Ann Engle FILE NUMBER 21060428 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST IIF APPliCABLE \ 1. Sovereign Bank IRA# 2478051903 - Spouse beneficiary $20,536.73 100% $20,536.73 Sovereign Bank IRA #0578136954 - Spouse beneficiary 19,102.66 100% 19.102.66 Sovereign Bank IRA #1688217130 - Spouse beneficiary 986.10 100% 986.10 Sovereign Bank IRA #0578225021 - Spouse beneficiary 3,890.23 100% 3,890.23 Sovereign Bank IRA #1688230760 - Spouse beneficiary 7,512.94 100% 7,512.94 Sovereign Bank Keough #1688163276 - Spouse beneficia ry 4,395.24 100% 4,395.24 Fidelity IRA #022-0041730292 - Spouse beneficiary 17.453.01 100% 17,453.01 Janus Funds IRA #202177513 - Spouse beneficiary 84,047.94 100% 84,047.94 Members First IRA #247179 4,506.63 100% 4,506.63 Spouse Y4. children % beneficiary TOTAL (Also enter on line 7, Recapitulation) $ 162,431.48 .. (If more space IS needed, Insert additional sheets of the same size) REV-1511 EX+ (12-99) . .~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. t;ocklin Funeral Home 8,966.60 ~inister, Organist, Church i 300.00 .- 75.00 lowers f,IIonument 1.052.50 amily Exemption 3,500.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent 4. Probate Fees 169.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ $14,063.10 (If more space is needed, insert additional sheets of the same size)