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HomeMy WebLinkAbout01-17-07 ....J 15056051058 REV-1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes , PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death OFFICIAL USE ONLY ~"-~~~e X~llI' INHERITANCE TAX RETURN RESIDENT DECEDENT Rle Number 21 06 ; 1097 Date of Birth 11/16/2006 05/16/1913 Decedent's Last Name Suffix Decedent's First Name MI Jones Doris L (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix First Name MI .~P.?~.~:.s...~~~I.~~~~.~~~,~,~..",... I L.___.........____........___________..._......o...o._o.___.o___..J FILL IN APPROPRIATE OVALS BELOW ca> 1. Original Return c:::> THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C'.:) 4. Umited Estate 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 1!?~~~~~.!!~~P~~-~~~~r.m-.~--.. .m...-',r) i (717)_238=~~____._~._....IJ ;:3 --. -. .'." ,. . -:. _r.:J REGISTER, .. .7 ~ USE .QttLY ~ ., :~ ;~;y?, -: ~J~ :~ -oJ U C:J .. , .-:) c:) ")0 -u ,1 "'11 () .oi1 3: -n C= ("") :0 N (rl '.J--i l> C'.:) ca> 6. Decedent Died Testate (Attach Copy of Will) c) 9. litigation Proceeds Received 8. Total Number of Safe Deposit Boxes First line of address ZIP Code N -.J 1 North Front Street Second line of address or Post Office State DATE FILED 17110-0300 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all infonnatlon of which preparer has any knowledge. URE OF ON R PONSIBLE FOR FILING RETURN DATE .. z- P.O. Box 3200, Harrisburg, PA 17110-0300 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 -.J --.J 15056052059 REV-1500 EX Decedent's Social Decedent's Name: Doris L Jones 430-38-5873 RECAPITULATION 1. Real estate (Schedule A). .............................. . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.! i ,,~ 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. I t-----'--' 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. . . . . " 5. 1,203.00 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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 86,270.68 I 87,473.68 i 17,251.77 ' 449.63 I 17,701.40 I 69,772.28 I 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. i r---- 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I). . . . . . . . . . . . . . . . 10.1 t-----~- I 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . .. . . . . .. . . . . . . . . .. . . . .. . 11.1 12. Net Value of Estate (Line 8 minus Line 11) . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . 12.1 13. Charitable and Governmental Bequests/See 9113 Trusts for which I an election to tax has not been made (Schedule J) .. . . . . . . . . . . . . . . . . . . . . . . 13. I I I 14. Net Value Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14.1 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X.O 45 69,772.28 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. 69,772.28 i 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3,139.75 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT <8> L 15056052059 Side 2 15056052059 ---.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Doris L Jones STREET ADDRESS 151 Lee Ann Court F 0f 061 Number '.~_.~~___m",^,^"1 97 DECEDENTS SOCIAL SECURITY NUMBER 430-38-5873 CITY Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Cred~s1Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,139.75 165.24 Total Credits ( A + B + C ) (2) 165.24 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + 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) B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (5) (5A) (5B) 2,974.51 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. 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 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ D [i] c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i] 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D [i] 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 retum 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 P.S. ~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 P.S. ~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-l508 EX+ (6-98) .. COMMON\l\lEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Jones, Doris, L. FILE NUMBER 21-06-1097 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE OF DEATH ITEM NUMBER 1. HiIIsboro Manor Life Care Center DESCRIPTION 1,203.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,203.00 REV-1509 EX' (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Jones, Doris, L. FILE NUMBER 21-06-1097 If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ronald L. Jones 151 Lee Ann Court, Enola, PA 17025 Son B. C. JOINTLY -OWNED PROPERTY: DATE OF DEATH VAlUE OF ASSET LETTER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAlINSTlTUTlON AND BANK ACCOUNT NUMBER OR SIMIlAR NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOtNTlY-HELD REAL ESTATE. 1. A. 07115104 Commerce Bank Checking Account No. 536713589 2. A. 07115104 Commerce Bank Savings Account No. 626414825 TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 86,270.68 REV-"" EX. (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Jones, Doris, L. FILE NUMBER 21-06-1097 ITEM NUMBER A. Debts of decedent must be reported on Schedule L DESCRIPTION 1. FUNERAL EXPENS.ES: Youngs Funeral Home 508 Champagnolle, EI Dorado, AR 71730 2. Rest Haven Cemetary EI Dorado, AR 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 2. Attomey Fees Year(s) Commission Paid: . State Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant .. Ronald L. Jones StreetAddress 151 Lee AnnCourt City. Enola Relationship of Claimant to Decedent Son 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 8. 7. Metzger, Wickersham, PC - Misc. estate expenses - ovemight mail, photocopies, mileage etc. Cumberland Co. Register of Wills - addional filing fees - inheritance tax return, estate inventory TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 1 30.00 17,215.77 - . . REV-1512 EX+ (12'()3) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILmES, & UENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-06-1097 ESTATE OF Jones, Doris, L. Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. EI Dorado Fire Department Ambulance, EI Dorado, AR 449.63 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 449.63 REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Ronald L. Jones 151 Lee Ann Court, Enola, PA 17025 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-06-1097 AMOUNT OR SHARE OF ESTATE ESTATE OF Jones, Doris, L. Son 50% 2. Cnar1es R. Taylor 1311 South Fort Hood St., Killeen, TX 76542 Son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET n NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed. insert additional sheets of the same size)