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Home My WebLink About03-08-07 (2) --.J 15056041125 .. REV-1500 EX (06-05) PA Department of Revenue. ~~~~~~~~~~~uaITaxes ' INHERITANCE TAX RETURN Harrisbul'Q, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year 2 1 0 6 File Number 112 0 Date of Birth 180389049 1 2 0 8 2 006 o 616 1 9 4 8 Decedent's Last Name Suffix Decedent's First Name L I N E AWE A V E R RUB Y MI L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW IZI 1. Original Return o 4, Limited Estate o o 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 0 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 Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required W ILL I AMP 0 0 U G LAS D 0 U G LAS LAW 0 F F ICE ,) c....., Firm Name (If Applicable) ?= ~... :::l'l First line of address -'J 5 7 W P 0 M F R E T S T I co Second line of address c-) , ) -n ~... -- " City or Post Office State ZIP Code DATE FILE CARLISLE P A 17013 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 and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS 3~/~1 SI~E OF PREPARER OTHER THAN REPRESENTATIVE A ADDRESS ,ftT13 R. ~ 61 W. P~~~~I ~C~\~ ~ J\- IIDt<.. 'PLEASE USE ORIGINAL FORM ONLY ~ DAr S1g 01 Side 1 L 15056041125 15056041125 --.J --.J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Ruby L. Lineaweaver RECAPITULATION 180389049 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) 0 Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . . .. 7. 4815620 8. Total Gross Assets (total Lines 1-7) 8. 4 8 1 5 6 2 0 .......................... . 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 7 5 7 0 5 9 ............... . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 7 5 7 0 5 9 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 0 5 8 5 6 1 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 4 0 5 8 5 6 1 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 (a)(1.2) X.O _ 0 0 15. 0 0 0 16. Amount of Line 14 taxable 4 0 6 8 5 6 1 1 8 3 0 8 at lineal rate X .O~ 16. 5 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X. 15 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1 8 3 0 8 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 L 15056042126 15056042126 --.J REV-1500 EX Page 3 Decedent's Complete Address: File Number 1120 DECEDENT'S NAME Rubv L. Lineaweaver STREET ADDRESS 265 Three Sauare Hollow Road CITY I STATE . ZIP Newburg PA 117240 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 1,830.85 91.54 Total Credits ( A + 8 + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 91.54 T otallnterest/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) 0.00 0.00 1,739.31 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. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 1,739.31 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 00 b. retain the right to designate who shall use the property transferred or its income; ............................... D 00 c. retain a reversionary interest; or ................................................................................................ D 00 d. receive the promise for life of either payments, benefits or care? ....................................................... D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... D 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. D 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. 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. REV-1508 EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruby L. Lineaweaver FILE NUMBER 1120 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinUy-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. DESCRIPTION VALUE AT DATE OF DEATH 5,575.00 1998 Honda 1991 Oldsmobile 500.00 2006 Ramada 28x52 mobile home 21,500.00 Patriot Federal Credit Union, Acct. 0003562120 10,509.48 AAA, refund of dues 54.00 United Health Care, refund 240.00 Nationwide, refund of premium 72.10 Ebuyme, Inc., refund 6.95 AARP, refund 9.10 AARP, health ins. refund 30.22 M& T Bank, checking account 1,000.06 Raymond Fisher, uncashed personal check 20.00 Sentinel refund 12.00 14$50 savings bonds 700.00 Met Life Total Control Account 7,807.44 Refund on vacuum cleaner 119.85 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 48 156.20 REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruby L. Lineaweaver SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 1120 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger-Bricker Funeral Home 3,115.20 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Douglas Law Office 2,300.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 95.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. Sentinel, estate ad 158.81 8. Cumberland Law Journal, estate ad 75.00 9. Shippensburg Family Practice 10.00 10. Orchard Bank 148.42 11. Adams Electric Coop 248.52 12. Juniper Credit Card 321.01 13. Rodale 3.00 14. Embarq 147.14 15. Cingular 386.80 16. Pulmonary Assoc. of Chambersburg 319.74 17. Chambersburg Imaging Assoc. 81.30 18. HSBC 30.00 TOTAL (Also enter on line 9, Recapitulation) $ 7 570.59 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Ruby L. Lineaweaver Decedent's Name Page 1 21 06 1120 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION AMOUNT 19. 20. Country Corner Rental Ctr Register of Wills, filing fees 55.65 75.00 SUBTOTAL SCHEDULE H-B7 130.65 REV"""". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF R b L L' SCHEDULE J BENEFICIARIES FILE NUMBER u)y . Ineaweaver 1120 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS Unclude outright spousal distributions, and transfers under Y1-t~ Sec. 9116 (a) (1.2)] 1. Sherry R. Porter Lineal 257 Three Square Hollow Rd. Newburg, PA 17240 1yo~- 2. John S. Lineaweaver Lineal 2378 W. 2000 North Clinton, Utah 84015 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) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: J8'30%$ Discount: 91.54 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 1988 through 1991 1992 1993 through 1994 1995 throuah 1998 1999 2000 2001 2002 2003 2004 2005 2006 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: