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Home My WebLink About05-02-07 REV-1500 EX (6-00) . OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUNTY CODE ~L 0371___ YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ F Helen ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ 04/22/2006 11/06/1909 ~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I SOCIAL SECURITY NUMBER 179-30-4167 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W t- ~~ ~ ~A-O :z:~ o A-ffi A- ct D 1. Original Return D 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation. Proceeds Received [X] 2. Supplemental Return 0 3. Remainder Retum (date of death prior 1012-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (data of death between 12-31-91 and 1-1-95) 0 11. Election to tax under See. 9113(A) (Attach Soh 0) I- Z W o Z o D- en W a: a: 8 THIS SECTION MUST BE COMPLETED. ALl. CORRESPONDENCEANPCONFIOeNTIAL TAX tNFoRMATION.SHOULD BE DIReCTED TO: NAME COMPLETE MAILING ADDRESS Richard C. Snelbaker 44 West Main Street FIRM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER 717-697-8528 Mechanicsburq, PA 17055 1. Real Estate (Schedule A) (1 ) f-__, OFFICIAL U~Nl y --' 2. Stocks and Bonds (Schedule B) (2) :::~ 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) N z o t= :5 :;) I- 0:: ~ o w 0:: 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) c;? J:". CJl 8. Total Gross Assets (total Lines 1-7) 520.00 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) 0.00 520.00 0.00 12. Net Value of Estate (Line 8 minus Une 11) 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 520.00 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) z o i= ct .... ::::) a.. 2 o o >< ct .... 17. Amount of Line 14 taxable at sibling rate 0.00 520.00 0.00 0.00 x .0 L (15) x .0 45 (16) x .12 (17) x .15 (18) (19) 0.00 23.40 0.00 0.00 23.40 16. Amount of Line 14 taxable at lineal rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [KI CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPA YMENT > >BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 Monroe T Cumberland Count CllY Mechanicsbur STATE PA ZIP 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 23.40 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty (D + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 23.40 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the' total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (5B) 23.40 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes D D D D without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [j 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, induding 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. R F ING RETURN 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . 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 No og []j og og o.g og DATE ~ 6/o? 161 Ryegate Road, Mechanicsburg, Richard C. Snelbaker, Esquire 44 West 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. 9 9916 (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 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. 9 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 4.5%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 9 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. 9 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. 3W4646 1.000 FfEV-1508 EX~ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Helen I. Frv FILE NUMBER 21 06 0371 Include the proceeds of litigation and the date the proceeds were recei\led by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Highmark-Blueshield refund of unused premium 140.22 2 PNC Investment account #1267-1127, cash held in money market fund 379.78 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 520.00 ~EV-15~3 E~+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INt-ERlTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen I. Frv NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Ruth E. Whitman 161 Ryegate Road Mechanicsburg, PA 17055 One Third of Residue: 173.33 2 James M. Fry 524 Silver Spring Road Mechanicsburg, PA 17050 One Third of Residue: 173.33 3 Judy A. Fry 1 West Sherwood Drive Mechanicsburg, PA 17055 16.66 of Residue to Judy A. Fry 1 West Sherwood Drive Mechanicsburg, PA 17055: 86.68 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 06 0371 AMOUNT OR SHARE OF ESTATE Daughter Son Granddaughter 173.33 173.33 86.68 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 3W46AI 1.000 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) $ 0.00 . '. . . Estate of: Helen I. Fry 179-30-4167 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 4 Lori A. Trace 20 West Simpson Street Mechanicsburg, PA 17055 16.67 of Residue to Lori A. Trace 20 West Simpson Street Mechanicsburg, PA 17055: 86.68 Granddaughter 86.68