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Home My WebLink About02-21-07 (2) REV - 1101 EX + II.) . . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280801 HARRISBURG, PA 17128-0801 FILE NUMBER 21 06 COUNTY CODE YEAR SOCIAL SECURITY NUMBER __'_______1188-12-3666 I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 00462 NUMBER I- Z W Q W o W Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Gosnell, Helen E DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) ! 09/14/1923 REGISTER OF WILLS 05/14/2006 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 1, Original Return 4. Limited Estate I o 3. Remainder Return (date of death poor to 12-13-82) o 1 W I- lI::~:! l;la.g :z:~~ Oa.lII a. oc( 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes 'I- lI)z Ww D:Q D:z 8li? IRM NAME (It applicable) Ahrens Law Firm, P.C. 52 Gettysburg Pike Mechanicsburg, PA 17055 ELEPHONE NUMBER 717/697-1800 ......., (~~j 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) C,; C]liFFICiAL uSl:6NL Y :_j~~~ ~ 0_._ ':0 N (1) 139,900.00 .~----._._---- ---_._---~~ (2) 30,903.60 or,) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) (4) (5) (6) (7) None z o ~ ::> l- ii: ~ w D: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o 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) 39,448.26 591.19 None -0 ~ -'- 8,249.52 None None (...::J Ul , - i i (8) 179,053.12 (9) (10) 11. Total Deductions (total Lines 9 & 10) (11 ) 40,039.45 139,013.67 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) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 139,013.67 --~---_.~-~-"~--~---- SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x i= i! ::> a. 17.Amount of Line 14 taxable at sibling rate x .12 (17) :. 0 0 S 18. Amount of Line 14 taxable at collateral rate 139,013.67 x .15 (18) 20,852.05 '-- 19. Tax Due (19) 20,852.05 20.0 Copyright 2000 fonn software only The Lackner Group,lnc. Fonn REV-1500 EX (Rev. 6-00) ~ Decedent's Complete Address: STREET ADDRESS 135 E. Winding Hill Road CITY u ------------1STATE -PA------j ZIP 17055 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 20,852.05 19,000.00 1,042.60 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 20,042.60 TotallnteresVPenalty (0 + E) 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 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. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) (4) (5) (SA) (5B) 0.00 809.45 809.45 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;.................................................................................. ~ I ~: ~:::~ ~h~e~~:i~~~~s:~~e~~s~~~..~~~~~.~~~. ~~~.:.~.~.~.~~.t.~~~~~~~~~~. .~.~ .i.t.~. ~~~~~~::::::::: :::::::::::::: :::::::::::::: d. receive the promise for life of either payments, benefits or care?.............................................................. 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. - Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statemants, 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 anyk_nowled~. __. '__,______ _ __, __ ___ ___~, _'____ ________ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Doris J. Schnurbuscb ~ SIGNATURE OF PERSON RESPONSI ,.~ 81~r~~~~~1_~~~9_____~_____..?.:-ll -07 FOR FILING RETURN ADDRESS' DATE DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Thomas J. Ahrens f4 ADDRESS DATE 52 Gettysburg Pike Mechanicsburg, PA 17055 2-20-07 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. 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 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemDt 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. 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 4.5%, 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 12% [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. . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA ~HERrrANCETAXRETURN RESIDENT DECEDENT -~---------_.__._-~._-_..._---._-_.._------------~ ---------- ----- --- ------------------- ----~ I FILE NUMBER 121 - 06 - 00462 ESTATE OF Gosnell, Helen E -------------.---.----------- .----------...----..------..------- --_L-..._n______ All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wimng seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE 0 NUMBER DEATH 1 135 E. Winding Hill Road, Mechanicsburg, PA 139,900.00 TOTAL (Also enter on Line 1, Recapitulation) 139,900.00 F . SCHEDULE B STOCKS & BONDS COMMONWEAl. TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gosnell, Helen E FILE NUMBER 21 - 06 - 00462 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER , . ---------------.".-----.. ---- --- DESCRIPTION -- - -- -- ---------- ---~-------r-------~~---_________r:_ UNIT VALUE i VALUE AT DATE OF DEATH 54.69 13,289.67 1 I First Union Bank (Wachovia) common ~t~ck--- i I I Van Kampen PA Tax Free Income Fund 2 17.17 17,613.93 . '---'~-'_. -------..---------------.--..---. TOTAL (Also enter on line 2, Recapitulation) 30,903.60 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~n_~--___~_____---.l __ ----~---I FILE NUMBER ..121 - 06 - 00462 COMMONWEALTti OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gosnell, Helen E 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Wachovia CAP account # 9620838271 5,540.99 2 Household contents sold by Executrix 150.00 3 Household contents sold at auction 1,249.00 4 1989 Cadillac 1,200.00 Fleetwood 5 Cash in house 109.53 TOTAL (Also enter on Line 5, Recapitulation) 8,249.52 . SCI-EDlLE H FU\BW.EXPENSES& ADNINS1RA11VE COSlS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gosnell, Helen E FILE NUMBER 21 - 06 - 00462 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: A. 1 Funeral home B. DESCRIPTION AMOUNT 4,311.30 2 Casket 1,965.01 3 Funeral luncheon 284.48 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Doris J. Schnurbusch Social Security Number(s) I EIN Number of Personal Representative(s): /3'3-t~- 33J./ Street Address 412 Belvedere Road City Harrisburg State PA Zip 17109 Year(s) Commission paid 2007 Attorney's Fees Ahrens Law Firm, P.C. 6,500.00 5,000.00 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills 310.00 State Zip 5. Accountant's Fees 6. Tax Return Preparer's Fees Estimated 2006 and 2007 income tax returns 250.00 7. Other Administrative Costs 1 Tru Green Chem Lawn - lawn care 51.94 Total of Continuation Schedule(s) 20,775.53 39,448.26 TOTAL (Also enter on line 9, Recapitulation) *' SctleclE H Ft.neraI Expel ~& Am nstraive CostsconlhJed COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 2 Estate Notices 179.36 ESTATE OF Gosnell. Helen E 3 I Inheritance Tax filing fee 15.00 4 Trash removal (stuff the auction house would not take) 350.00 5 I Seller Assistance on house sale (HUD1 attached) 3,922.00 6 Settlement charges to seller on sale of house 10,131.00 7 House fix-up cost to sell 4,356.30 8 House utilities & lawn maintenance 1,665.87 9 PENDOT - duplicate title fee (original not found) 22.50 10 Executrix travel expenses 133.50 Page 2 of Schedule H . SCHEDULE I I i DEBTS OF DECEDENT, MORTGAGE I I LIABILITIES. & LIENS I ~.====,==,===~.._=,=_=c-=c..-.=,=_=_=,=.,=__=_===_"=,===,=,=_~_-==__ i FILE NUMBER 121 - 06 - 00462 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gosnell, Helen E Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Verizon bill 22.59 2 United Water 6.76 3 UGlbill 188.72 4 A T & T bill 46.63 5 West Shore EMS 85.00 6 Sprint 88.54 7 Exxon 6.00 8 Waste Management 46.95 9 Upper Allen Township - Sewer Bill 100.00 TOTAL (Also enter on Line 10, Recapitulation) 591.19 Rd.1513 EX. (9.00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER I FILE NUMBER Gosnell, Helen E I 21 _ 06 _ 00462 ..------.- --'----- -"--r- I RELATIONSHIP TO AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY DECEDENT OF ESTATE ----.--.--------------. ------------ --'-----1--- Do N~Ust Trustee(S)____ TAXABLE DISTRIBUTIONS (include outright spousal distributions) I. 1 Shirley Hanson Albert 909 Manor Drive, Steelton, PA 17113 Friend 100% of Residue 2 Doris J. Schnurbusch 412 Belvedere Road, Harrisburg, PA 17109 Friend Automobile 1,200.00 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropria e, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 10- I --- f--~ =::-- =- - - .......",. - .. - - = - - - .. == =? ::: :::::"" -:::: - .. :::r.: :"'" - - - -- T - lC' ~ ~ ~ t::l ~ c: ~"I V"~: ~. t:J ~ J;,~J ~ C:J ~ ~ - ~ ......, - ~ ". ill ...... ~:@~ ~ ~ ilJ ::: I-< =:l ~2.. ~ ~.- CIJ~~ c:: Q) . '. ~ 0 u- ..c::~~ ~V)~ .... .~~---..r ~ . ..J:.:" ,:..,"1;: ,I;,' , ~.:;r'; '~...'.:'-" ~':.f i'j-. ,"':!,; .~. ~: ,'4'" ~.. ~ ~ >t ~ ,j' "or' , . .jj,;.'.... ~~~ N: ~) < ct. ~&o"~1!i, .~ .~. :j. 'cO: l') ;!~ x 4: J: '" C ( , ~.'~ .:}t~' ''1 JIk" ,. ..... ~~ J ,1 no? FE8 2\ Pln2:: 36 U . 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