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Home My WebLink About04-04-07 (2) ~ 15056051058 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 Number Date of Death OFFICIAL use ONLY (:()(Jntyg~e Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21 06 1119 10/13/2006 Date of Birth 10/07/1922 Decedent's Last Name Decedent's First Name MI Dill Dorothy E (If Applicable) Enter Surviving Spouse's Information Below Last Name First Name MI ~.P.?':l~~'~..~?~i~I..~~u.~ty.~~mber THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW ca::> 1. Original Return C) 2. Supplemental Return C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 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 Daytime Telephone Number ~ ,...............-........-.......0..............--..........-=-... ,(717) 957-341;~O ;;: ,._._.___......0;.::0_. ..::.u- .. , REGISTER OF~~~~NH .. i : ... '::-11 I ! -.. (;3 ~~ .r:- I _ -o! ::;: ! 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received ...=Q~- 8. Total Number of Safe Deposit Boxes <=> 4. Limited Estate <=> <=> <=> o --n Mary A. Etter Dissinger Firm Name Dissinger and Dissinger 28 North 32nd Street :-::J ,? (..J .. w co or Post Office State ZIP Code DATE FILED 17011 Correspondent's e-mail address:mville@pa.net '~'.'" ADDRESS 28 North 32nd Street, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 .-J -I 15056052059 . Decedent's Name: RECAPITULATION Dorothy E Dill .~~~~~~.~~:S..~.ilil.I...~~~~.~_~~'.fI~~r . 192-14-5091 REV-1500 EX 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0.00 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . . . 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) . . . . - . . . . . . . . . . . . . . . . . . . . . . . . 4. 0.00 ----------.--- 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 5. 131,746.01 6. Jointly Owned Property (Schedule F) c:::J Separate Billing Requested . . . . . . . 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::J Separate Billing Requested. . . . . . . . 7. 0.00 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 131,746.01 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . . . 9. 17,036.11 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 0.00. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . .. . . . . . . .. . . . . . .. .. .. . . 11. i 17,036.11 114,709.90 i 0.00 114,709.90 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 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. '. 0.00 5,161.95 0.00 0.00 5,161.95 114,709.90 16. 0.00 0.00 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c:::J 15056052059 Side 2 15056052059 --.J L REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Dorothy E Dill STREET ADDRESS 30 Argali Lane DECEDENTS SOCIAL SECURITY NUMBER 192-14-5091 CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 5,161.95 0.00 4,902.56 258.03 Total Credits ( A + B + C ) (2) 5,160.59 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnterestJPenalty ( D + 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 0.00 0.00 1.36 0.00 1.36 A. Enter the interest on the tax 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 '. [i] 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 Account, 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. 99116 (a) (1.1) (i)]. v." 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) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Dorothy E. Dill FILE NUMBER ITEM NUMBER Include the proceeds of Utigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION 1. Checking account #304727 with the First National Bank of Marysville 2. Savings account #2072907 with the First National Bank of Marysville 3. Blue Cross refund TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) VALUE AT DATE OF DEATH 113,079.62 18,436.40 229.99 131,746.01 REV.1511 EX+ (12'99>* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Dorothy E, Dill FILE NUMBER ITEM NUMBER A. B. 1. 10. 11. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Michael ShaJonis 4,940.33 ADMINISTRATIVE COSTS: Personal Representative's Commissions 0.00 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 7,904.76 3. Family Exemption: (If decedenrs address is not the same as claimant's. attach explanation) 3.500.00 Claimant Peggy D. Hayman Street Address .30 Argali Lane City Mechanicsburg Relationship of Claimant to Decedent Daughter '. State PA .Zip 17055 4. Probate Fees 306.00 5. Accountant's Fees 0.00 6. Tax Retum Preparer's Fees 0.00 7. Cumberland Law Journal Patriot-News Pastor Floyd Carlen (gratuity) Undertaker, Michael J. Shalonis (gratuity) Marysville Church of God (gift) 75.00 160.02 50.00 50.00 50.00 8. 9. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 17,036.11 . ' . . REV-1513 EX- (9-00) *' COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Dorothy E: Dill NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)1 Peggy D. Hayman, 30 Argali Lane, Mechanicsburg, PA 17055 1. RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter FILE NUMBER AMOUNT OR SHARE OF ESTATE 100% 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 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) -I'-._?/,:- -- . . MAIN OFFICE One Centre Square. P.O. Box B · Marysville, PA 17053 · Phone: 717-957-2196 · Fax: 717-957-4578 January 26, 2007 Dissinger & Dissinger 400 South State Rd Marysville P A 17053 RE: Estate of Dorothy E Dill Here is the information requested per your letter of 1-10-07: Checking 304727 Dorothy E Dill Open: 10-31-80 Int Rate: .60% DOD Bal: $113,079.62 DOD Int: 20.44 Savings 2072907 Dorothy E Dill Open: 11-1-82 Int Rate: .65% DOD Bal: $18,436.40 DOD Int: 24.29 '. Please feel free to contact us if you require any further information. Sincerely, BJ~K~ ""'e- Barbara Recher Manager