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Home My WebLink About05-01-07 REV-1500 EX: (6-00) . ... Z W C W U W C w ~ ~ :!!;Ul ()a:~ w ll.() :E;OO " a:..J ... ll.1D ll. < COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) NOLAN DAVID DATE OF DEATH (MM-DD-Year) L. DATE OF BIRTH (MM-DD-Year) !Xl 1. Original Retum D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy oITrus!) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 083 8 08/11/2006 02107/1978 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) '"COuNTYCci'5E ---y~ - - NUMBER-- SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (date of death prior to 12-13-82) D 5. Federal Estate Tax Retum Required ~ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (AttachSch 0) z o ~ ...J ::) ... 0: <( u W 0::: z o i= <( ... ::) Q. ::E o U ~ ... COMPLETE MAILING ADDRESS NAME MURREL R. WALTERS III FIRM NAME (If Applicable) TELEPHONE NUMBER 717-697-4650 54 EAST MAIN STREET MECHANICSBURG 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental BequeslslSec 9113 Trus1s for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due X _(15) X _(16) X .12 (17) X .15 (18) (19) 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (8) (11) (12) (13) (14) PA 17055 OFFICIAL USE ONLY :) c-:~~ ::1. -<. 2,510.00 :'~ en en 2,510.00 9,988.00 10,937.73 20,925.73 -18,415.73 -18,415.73 0.00 Decedent's ompl ete A ress: STREET ADDRESS 26 UPLAND ROAD CITY I STATE I ZIP NEWVILLE PA 17241 C dd Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterest/Penalty ( D + E ) (3) 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 (4) 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 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 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00 c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for I~e of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 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. ADDRESS PA ADDRESS MURREL R. W TERS III 54 EAST MAIN STREET, MECHANICSBURG PA 17055 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. ~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 0% [72 P.S. ~9116 (a) (1.1) (iill. The statute does not exempt 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. ~9116(a)(1.2)]. The tax rate imposed on the net value oftransfers to or for the use of the decedent's lineal beneficiaries is 4.5%, 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 12% [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-1508 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NOLAN DAVID SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER L. 21 06 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0838 ITEM NUMBER 1. 2. DESCRIPTION 1990 LINCOLN TOWNCAR PROCEEDS OF SALE 2006 FEDERAL INCOME TAX REFUND VALUE AT DATE OF DEATH 300.00 2,210.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2.510.00 REV-151~ EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER NOLAN DAVID L. 21 06 0838 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME 7,000.00 2. CUMBERLAND VALLEY MEMORIAL GARDENS. GRAVE OPENING 1,150.00 3. FLOWERS. ROYER'S FLOWERS 180.00 4. MEMORIAL MARKER. GINGRICH MEMORIALS 1,600.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) DEBORAH L. RYAN - COMMISSION RENOUNCED Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 345 PONDEROSA ROAD .. City CARLISLE State PA Zip 17015 Year(s) Commission Paid: 2. Attomey Fees MURREL R. WALTERS III, ESQUIRE 0.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 58.00 5. Accountanfs Fees 6. Tax Retum Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 9,988.00 (If more space is needed, insert additional sheets of the same size) ~E\f-1512 EX + (6-98) . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NOLAN DAVID L. FILE NUMBER 21 06 0838 Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. CAPITAL TAX COLLECTION BUREAU 2006 LOCAL TAXES 106.90 2. QUANTUM IMAGING MEDICAL 14.60 3. MASLAND ASSOCIATES INC. MEDICAL 38.00 4. WILLIAM PHELAN, MD MEDICAL 302.05 5. BALOGH BECKER L TD SEARS CREDIT CARD 627.98 6. BALOGH BECKER L TD CHRYSLER FINANCIAL 9,467.68 7. LOWES CREDIT CARD 37.48 8. DAUPHIN OIL CO. INC. 343.04 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,937.73