HomeMy WebLinkAbout02-09-07 (2)
REV-15oo EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER Y'j
2 1 -0 G 0 l3\
"'CoUNTYCOoE --vE~ - - NuMsER- -
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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WHOLEY FREDITH M.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
2 0 1 - 1 8 - 5 5 1 6
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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12/30/2006 10/29/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
o 3. Remainder Retum (dale 01 death priorlo 12-13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Mach Sch 0)
00 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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THIS.SECTfON MUST$ErCOMPLETEI1: AI..LCOARESPONDENCE.A.NPCONFJO ENTJAl..r.AXINFQAMATION.SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MARCUS A. McKNIGHT III 60 WEST paM FRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
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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 (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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)
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)
OFFICIAL USE ONLY
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0.00 X _(15) 0_00
8,311.61 X .045 (16) 374.02
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 374.02
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a){1.2)
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12,069.01
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16. Amount of Line 14 taxable at lineal rate
(8)
12,069.01
17. Amount of Line 14 taxable at sibling rate
1,960.75
1,796.65
(11)
(12)
(13)
3,757.40
8,311.61
18. Amount of Line 14 taxable at collateral rate
(14)
8,311.61
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> >. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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ecedent's Complete A dress:
STREET ADDRESS
1 LONGSDORF WAY
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
374.02
18.70
Total Credits (A + B + C)
(2)
18.70
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.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check AGENT
0.00
0.00
355.32
355.32
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; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.......................................................................................... .... 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE A
J ~ '07
PA 17324
DATE
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PA 17013
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 3%
[72 P.S. s9116 (a) (1.1) (i)l.
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 0% [72 P.S. s9116 (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 0% [72 P.S. s9116(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 4.5%, except as noted in 72 P .S. s9116(1.2) [72 P .S. 99116(a)(1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. s9116(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-1509 EX + (6-98)
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SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
WHOLEY. FREDITH M.
FILE NUMBER
21
06
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. MICHAEL G. WHOLEY
3943 CARLISLE ROAD
GARDNERS, PA 17324
SON
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JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY ,HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 01/2005 MEMBERS 1 ST FEDERAL CREDIT UNION 577.79 50. 288,90
REGULAR SAVINGS ACCOUNT #257976-00
2. A. 01/2005 MEMBERS 1 ST FEDERAL CREDIT UNION 7,449.20 50. 3,724.60
CHECKING ACCOUNT #257976-11
3. A. 01/2005 MEMBERS 1 ST FEDERAL CREDIT UNION 16,111.02 50. 8,055.51
MONEY MANAGEMENT ACCOUNT #257976-05
TOTAL (Also enter on line 6, Recapitulation) $ 12.069.01
(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
ESTATE OF
WHOLEY. FREDITH M.
FILE NUMBER
21
06
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
2.
3.
FUNERAL EXPENSES:
Ewing Brothers Funeral Home
Wayne Noss Flowers
St. Paul's Evangelica Lutheran Church - Funeral Luncheon
458.40
271.36
100.99
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 Irwin & McKnight 750.00
3. Family Exemption: (If decedent's address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountants Fees
6. Tax Return Preparer's Fees Patricia A. Rosendale, CPA 350.00
7. Register of Wills, Filing Fee 15.00
8. Notary Fees 15.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1.960.75
REV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
WHOLEY. FREDITH M.
FILE NUMBER
21
06
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. Bixler's Rental - Rental Service
31.80
2. Cumberland Crossings - Nursing
1,365.07
3. Continuing Care RX - Medical
399.78
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 796.65
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
WHOI F' TH M 21 OR
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Michael G. Wholey Lineal
3943 Carlisle Road 1/2 Remainder
Gardners, PA 17324
2. Patricia Ann Houck Lineal
22417 Belair Road 1/2 Remainder
Culpeper, VA 22701
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - 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)
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MEMBERS 1st
FEDERAL CREDIT UNION
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REGULAR SAVINGS ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Interest Earned from 1/1/06 to Date of Death
Name of Joint Owner
Date Joint Ownership Established
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HI
257976 -00
01/13/2005
$577.33
$.46
$577.79
$5.21
Michael G. Wholey
01/13/2005
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Interest Earned from 1/1/06 to Date of Death
Name of Joint Owner
Date Joint Ownership Established
257976 -11
01/13/2005
$7,448.29
$.91
$7,449.20
$2.34
Michael G. Wholey
01/13/2005
MONEY MANAGEMENT ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Interest Earned from 1/1/06 to Date of Death
Name of Joint Owner
Date Joint Ownership Established
257976-05
01/13/2005
$16,082.02
$29.00
$16,111.02
$389.27
Michael G. Wholey
01/13/2005
CMBE. RS 1:~J-i=D;RA> CREDIT UNION
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enlse A. Wolfe
Insurance Services upervisor
January 16, 2007
Estate of: FREDITH M. WHOLEY
Date of Death: December 30, 2006
Social Security Number: 201-18-5516
5000 Louise Drive . Po. Box 4() . Mechanicshurg, Pennsylvania 17(JS5 . (717) 6<)7-1161 . "v'N\v.mcmbers lst.org
RESIDENT STATEMENT FROM
CUMg~R ND CROSSINGS
1 LON ,. DORF WAY
CARL SLE, PA 17015
717 -245-99.41
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FREDITH M WHOLEY
clo MICHAEL WHOLEY
3943 CARLISLE RD.
GARDNERS, PA 17324
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r~?1{il;t>.~~te..__..~:~ I~._--'..- .. Oescri pti on
12/30/06 - 12/30106 GAUZE CURITY 2X2 8 PLY STERILE
12/30/06 - 12/31/06 R&B Private Pay
01/02/07 - 01/02/07 Payment Check # 185
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Statement Date Due Date ACCOUNT NUMBER
12/31/2006 Upon Receipt SC000030
$1,365.07
AMOUNT PAID $
Please make check payable to CUMBERLAND CROSSINGS
Remit To:
Diakon Lutheran Social Ministries
PO Box 8500-1131
Philadelphia, PA 19178-1131
Days/1: .
;' Units i,
Chargesl
(Credit)
$0.06
$(382.00)
Payments r
(2)
TOTAL BALANCE DUE:
$6,049.42
Balance
$7,796.49
$7,414.49
$1,365.07
$1,365.07
FACILITY NAME
I CUMBERLAND CROSSINGS
RESIDENT NAME
FREDITH M WHOLEY
ACCOUNT NUMBER
SC000030
JanUarY~07
Michael G. Wholey
3943 Carlisle Road
Gardners, PA 17324
Ewing Brothers Funeral Home, Inc.
630 South Hanover Street
Carlisle, P A 17013-
(717)243-2421
The Funeral Service for Fredith M. Wholey
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
i'eel 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.
1. PROFESSIONAL SERVICES
Services of Funeral Director/StatT. . . . . . .
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Jude 18G Sealed Casket. . . . . . . . . . . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THA T YOU HAVE SELECTED . . . . . . . . . . . , .
Cash Advances
Clergy/Mass OlTering. . . . . . .
Certified Copies of the Death Certificate.
Organist, . . .
Church Custodian
Sentinel Obit. ,
TOTAL CASH ADVANCES AND SPECIAL CHARGES.
Total
Total Cost
. . . . . . . . . . . . . . . . . . . . . . . . .
SUB-TOTAL
INITIAL PAYMENT / DISCOUNT / CREDITS
TOTAL AMOUNT DUE
The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - ] 8.0000 % per annum.
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$3695.00
$3695.00
$2995.00
$6690.00
$125.00
$120.00
$125.00
$50.00
$138.40
$558.40
$7248.40
$7248.40
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$7148.40 ,..-'J. .--/ /
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