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Home My WebLink About02-08-07 (2) .-J 15056051047 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 Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI Spouse's Social Security Number 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) C) 4. Limited Estate 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 Da ime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes ~ Jlr'.a.yk;"Ylqld"l1j ~ ~mc,,":' ."c~ -" 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 and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Correspondent's e-mail address: SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE I 27 /) 7 DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ---I -.J 15056052048 REV-1500 EX Decedent's Name: J ....<13 Decedent's Social Security Number 2+ 3...'1.7+ 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. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) <::) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <::) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . ... .. . .. .... 8. 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. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 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 .0_ . 16. Amount of Line 14 taxable at lineal rate X.O _ · 17. Amount of Line 14 taxable at sibling rate X .12 · 18. Amount of Line 14 taxable at collateral rate X .15 · 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT f\J A Pb Side 2 L 15056052048 . I .q-. 5' 3 P cf;. ) r 7 4- .6'3 't I go' 1.00 1> · Cf I go-J .00 720' .47 ~ . t;. . . rj;. c:::> 15056052048 -.J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Htf"-~t! H.j~i11<iI!-VNf) STREET ADDRESS ~9-6 Cf CHe ST!4l1r sr. CITY STATE fJA- ZIP -" I I ,0 I CdM,o Hlc...l- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) if; Total Credits ( A + B + C ) (2) cp 3. Interest/Penalty if applicable D. Interest E. Penalty 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) (5A) (5B) f 1> cp 1 ~ 4. Total Interest/Penalty ( D + E) 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. 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 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 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 gJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ 0 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. 99116 (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. 99116 (a) (1.1) (ii)]. The statute does not exemot 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 P.S. 99116(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. 99116(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 twelve (12) percent [72 P.S. 99116(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. .._..JI f..l,.,......"'....r-- I, DLIII B. ........., . reIIicIeH or CaIIp Hi.1J., C "lerJ.... County, Pennsylvania, declare that this is .y Last Will and revoke any Wills previously made by me. My Social Security Number is 193-24-3974. ITEM I. I devise and bequeath all of my estate of every nature and wherever situate to my husband, JAMES C. IMGRUND, providing he shall survive me by sixty days. Should my husband, JAMES C. IMGRUND, predecease me or die on or before the sixtieth day following my death, I devise and bequeath the residue of my estate of every nature and wherever situate to my six children: JAIME ANN DEARDORFF - MARK CARL IMGRUND - DAVID ANDREW IMGRUND - JOSEPH JAMES IMGRUND - ANN MARIE BUSSER - MARY JENNIFER IMGRUND - in equal shares. C) Should any of my six children, JAIME, MARK, DAVID, JOSi~, ~~; "'-" --- ";;....::: ANN or M.JENNIFER predecease me, their share of the estate'-::" ...:.;. .-.;:::=-: -.,....., will be divided equally between any of their living children~~~T1 .......j ITEM II. I name my husband, JAMES C. IMGRUND, as pers~~a1 representative (executor) of this Will, to serve without bond. If this person shall for any reason fail to qualifY or cease to act as personal representative, I name JAIME ANN DEARDORFF and ~ <:::> c:::> C' o ("""') ...... w ~ ::-0 --; rT1 ,-"'10 -;C) ..-, J"J ..-:. '--:::J .--.1T1 :,-.:0 .'.::9 ,~ .-, --C) ::::.-n -":.~_l ~:-J -. ...... - .. N -.J MARK C. IMGRUND as personal representative (also without bond), instead. ITEM III. I direct my personal representative to take all actions legally permissible to have the probate of my will done as simply and as free of court supervision as possible under the laws of the state having jurisdiction over this will, including filing a petition in the appropriate court for the independent administration of my estate. IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of May, 1991. ~//~ REV-l508 EX. (1-97) H.e/~ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY /Mjy~",l FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF /-1. 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. ITEM NUMBER 1. DESCRIPTION Re-/u"L tJ./- /(J~..jc,y"", care. i".ru~c_ VALUE AT DATE OF DEATH 1'17-4-.S'S TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) I CJ74. ~S REV.1510 Fj(. (1.97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF flEUN II. /frfCI2II/II{) FILE NUMBER This schedule must be ccmpleted 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 DECO'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST IF APPLICABLE) 1. Mt!fte/C.I U- "-YAlcr( I RA- w/ ~eS' e ./MG/Zvt.J1J 12s-4./ Z4-o IOo~ ( t:<. ) 4> (SfWJ~J p... pelll6.AC--IAIZ y TOTAL (Also enter on line 7, Recapitulation) $ .. (If more space is needed, Insert additional sheets of the same size) REV-1511 EX+ (12-99) _ ~. ...\... ~:'i. '~~ . ,- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF f/€~riN H. //11I G (2.1,1 iVt) FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: flAt'leR-J Fw",~L, If()MIIi ? ~~/..oo 1. 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 I '$() 0 ::J t::) 0 . (') D 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ q I fj" I. b eJ (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Ha.&N H. IMG~I.I/tIf) NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ;{(;,. ~J C . I WI J YWI,( RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 1. -J '~e 9i>~ HIAS lIi1NtJ too ~ 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 4> (If more space is needed, insert additional sheets of the same size) 3:~3: - ~ ~ " ..,.. ~~~ ~ Q) ....., "'::J" ~<IlO ~~.~ < - ~ro3 0\ (Q '" ~ ~ C -l ::J N 0- -l o "" ~V!. . -- ~=.c , . r - ~ ~_........................~