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Home My WebLink About04-05-07 (2) --.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* ~~re:~:~:~~ual Taxes INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death l195-16-9904 ____________J ~~23/200~_________J Decedenfs Last Name Suffix re;t;ri---------------------i r-------1 OFFICIAL USE ONLY County Code Year '---~-- ilrO--:~_ --~ i p\ \ \J File Number r--O-ql1r] Date of Birth l~~/26/192~____________J Decedenfs First Name MI r Jeanne ------------------------1 L~] (If Applicable) Enter Surviving Spouse's Infonnation Below Spouse's Last Name I Suffix II Spouse's First Name MI I [----.--------------------.-...-------------1 O' ___._______________..__...____.______.-1 Spouse's Social Security Number i I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C8:> 1. Original Return c:::l 2. Supplemental Return c:::l 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required c:::l 4a. Future Interest Compromise (date of death after12-12-82) c:::l 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::l 10_ Spousal Poverty Credit (date of death c:::l 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 IJames M. Bach 1(717) 737-2033 Firm Name (If Applicable) I Attorney at Law First line of address 1352 S. Sporting Hill Rd. Second line of address 1 c:::l 4. Limited Estate c:::l 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c:::l c:::l REGISTER OF WJ(,iJ:l USE ONLY , ,n :-=-") : -e-) I c..: =- City or Post Office State ZIP Code fM~~~~b~------------------------.---.-1 rPA _ --I 117050 l'"'<: <",) 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 information of which preparer has any knowledge. SIGNATURE OF P RSON RE ONSIBLE F. FILlN RETURN DATE ADDRESS Jerrold C. DATE -tJ; quire, 352 S. Sporting Hill, Rd, Meehanl burg, PA 17050 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 --.J L 15056051058 --.J 15056052059 REV-1500 EX Decedent's Name: RECAPITULATION Jeanne A Batdorf Decedent's Social Security Number l195-16-9904 I 1. Real estate (Schedule A). ............................................ I 1. i ! 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 3.1 I 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 5.1 ! I 25,120.48 6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . . . . . 6.1 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property i (Schedule G) c::> Separate Billing Requested.. . . . . . . 7.: 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ! 25,120.48 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . .. . . . 9. . 15,972.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. I 11. Total Deductions (total Lines 9 & 10). . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11.1 15,792.00 , 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 9,148.48 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) .... . . . . . . . . . . .. . . . . . . . . 14.1 9,148.48 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 9,148.48 15. 16. 17. 18. 1,372.27 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c::> 15056052059 Side 2 15056052059 .-J L REV-1500 EX Page 3 Decedent's Complete Address: DDr I DECEDENrs NAME DECEDENrs SOCIAL SECURllY NUMBER Jeanne A Batdorf 195-16-9904 STREET ADDRESS Claremont Nursing Home 1000 Claremont Road CITY I STATE I ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 1,372.27 Total Credits (A + 8 + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( D + E ) 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. (3) (4) (5) (5A) (58) 1,372.27 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. 8. 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 [iJ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [iJ c. retain a reversionary interest; or.......................................................................................................................... 0 !il d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [iJ 4. Did decedent own an Individual Retirement Accoun~ annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [iJ 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 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. ~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-1511 EX+ (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Batdorf, Jeanne A. FILE NUMBER Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT Med Services Law Journal & Patriot News 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions r~'--'~'-", State L ....JZip Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Year(s) Commission Paid: 2. Attorney Fees 1, 3. Family Exemption: (If decedenfs address is not the same as daimanfs, attach explanation) Relationship of Claimant to Decedent TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees Account Fee REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Batdorf, Jeanne A. RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under r-'-''.-''-'---'''-"'''----.''''-'---'~.!?:.11IJ!JaJJL2.U~,,~___,__"__"_""_"'_____,__.,_""_"""--""1 "Jerrold C. Roush, 819 N. Front Street, Milton, PA 17847 __~,_"_".".._____~_,__"_.__,_______,_'_'_"'__'~"___,____".___,_,_""_,._",.~_,,___..,_"'_._J of Cousin FILE NUMBER AMOUNT OR SHARE OF ESTATE J. Roush, 819 N. Front Street, Milton, PA 17847 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET U 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) !~'\ f! \ ,,', ! i \ n ........... / \ \ ......... JAMES M. BACH Attorney At Law '~" 1'\ i I \, !' \ it'; ~"\ ii\ ! \ I, ' / i "'-_ ~ 352 S. Sporting Hill Rd., Mechanicsburg, PA 17050, Tel: (717) 737-2033 February 27, 2007 Register Of Wills Cumberland County Court House One Court House Square Carlisle, PA 17013 D \0 - (Jctl0 RE: Estate of Jeanne A. Batdorf SSN: 195-16-9904 Dear Register of Wills: Enclosed herewith please find an original and one copy of Pennsylvania Inheritance Tax Return together with a check in the amount of $15.00 for the filing fee, and a separate check in the amount of $1,372.27, the tax amount. Kindly process in your normal fashion and return to me the official receipt. Respectfully, 1<71 ...~ ') JAMES M. BACH Attorney-at-Law ) -) ! C'l JMB Ilru )':':1 Enclosures: Original and one copy of Inheritance Tax Return Two checks in the amounts of$15.00 and $1,372.27 l"c! ["0 "_ _______ .:....::...-. _..-c.'-": .....-- :5 - - ~ .. - - - - ,~ -=- =:;t;.: .~ -:: .--- ~ .. -.- - ~ .=... ::::- .......... .., - ~ - ~ .::.:: '~~~~ ",-, ~~, ,,:.::.: "~ . '- , ~. r~~