HomeMy WebLinkAbout05-16-07
.
Rev. 1"eU........ ...
I!!
ll:'12
~~~
Url
,REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
I
COMMClNWEAI. TH OF PENNSYlVANIA
DEPIIIm.lENT OF REVENUE
DEPT._l
HARRISBURG. PA 171211-0II01
FILE NUMBER
21 06
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
192-10-7008
0749
NUMBER
i
w
~
DECEDENrS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Kehew, Sr., James G
DATE OF DEATH (MM-OD-YEAR)
DATE OF BIRTH (MM-OO-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
08/16/2006
09/23/1916
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPUCABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL)
1. Original Retum
2. Supplemental Retum
o 48. Future Interest ~ (date of death after
12-12-82)
o 7. Decedent Maintained a Living Trust (Attach
copy 01 TNSt)
o 10. Spousal Poverty Credit (date 01 death be1ween
1
3. Remainder Return (date 01 death prtorto 12-13-82)
o 4. Urnited Estate
181
o
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Eleclion to lax under Sec. 9113(A) (Attach Sch 0)
6. Decedent Died Testate (A1lach copy
01 WIll)
9. Uligation Proceeds Received
Ii
AM NAME (" appIlc8bIe)
Ahrens Law Firm, P.C.
ELEPHONE NUMBER
717/697-1800
52 Gettysburg Pike
Mechanicsburg, PA 17055
~
~
i
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. JoinUy Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
~CIAlUSE@
~:;'3~ ~
:J~P -<
:;;~"'rrl
.~~;:;~
(_yo
:.:d -Tl
None
None
None
5,300.00
800.00
4,892.17
None
01
-0
-"':-''''
:..;J
'0 --j
~.
-.J
(8)
10,992.17
(9)
(10)
3,791.59
371 .84
(11)
(12)
(13)
(1,4)
12. Net Value of Estate (Line 8 minus Line 11)
4,163.43
6,828.74
13. Charitable and Governmental BequestslSec 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
6,828.74
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z 6,828.74 .045 (16)
0 16. Amount of Line 14 taxable at lineal rate x
~
...
;:)
A. 17.Amount of Line 14 taxable at sibling rate x .12 (17)
:I
8
S 18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
307.00
307.00
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
325 Wesley Drive
CITY
STATE PA
ZIP 17055
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditsIPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
307.00
Total Credits (A + B + C)
(2)
0.00
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Totallnterest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT.
Check box on Page 1 Line 20 to request a refund
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 307.00
(5A)
(5B) 307.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEAsE ANSWER THE FOLLOWING QUESTIONS BV PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves No
a. retain the use or income of the property transferred;.................................................................................. ~ I
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 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 ~
DATE
933 Avila Road
Harrisbur . PA 17109
5' -/l/_ 01
ADDRESS
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
n-;r:
ADDRESS
DATE
52 Gettysburg Pike
Mechanicsburg, PA 17055
5 -I S- 0 7
For dates of de 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 ofthe
surviving spou IS 3% [72 P.S. S9116 (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. S9116 (a) (1.1) (il)]. The statute does not exemDt 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. S9116 (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. S9116
1.2) [72 P.S. S9116 (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. S9116 (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.
,. ~ ..,...,. "'l>:" .~.. ~
*'
SCHEDULE D
MORTGAGES & NOTES RECEIVABLE
CClIIoNONWEALlli OF PENNSYLVANIA
INHERtTANCE TAX REnJIlN
RESIDENT DEOBlENT
FILE NUMBER
21 - 06 - 0749
ESTATE OF Kehew, Sr., James G
All property Jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Loan to J. Gordon Kehew Jr. 5,300.00
TOTAL (Also enter on Une 4, Recapitulation) 5,300.00
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
~TH OFPENN8YlVANIA
INHERITANCE TAllIlETURN
AElllDBIT DECEDBIT
ESTATEOF Kehew, Sr., James G
FILE NUMBER
21 - 06 - 0749
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of
survivorship must be disClosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Royalty rights from Gas/Oil lease on property in West Virginia. Average income for last 3 years 800.00
is $272. Rights cannot be sold outside of the family and revert to other family members if there
are no decendents in this line.
TOTAL (Also enter on Line 5, Recapitulation) 800.00
; .^~l ". -. ,;f;,t.fi
.'
.
SCHEDULE F
JOINTL Y-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kehew, Sr., James G
I FILE NUMBER
21- 06 - 0749
If .n ..... w.s made Joint within one year of the clecedent's dete of cle8th, It must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
J. Gordon Kehew Jr.
ADDRESS
RELATIONSHIP TO DECEDENT
Son
A
933 Avila Road
Harrisburg, PA 171091
JOINTLY OWNED PROPERTY:
ITEM LETTER DATE Include name 0 nan Ilns of a 1)801< acoount number DATE OF DEATH, % O~
NUMBER FOR JOINT MADE r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET I DECO S
TENANT JOINT estate. IINTEREST
1 A 03/1312003 PNC checking account # 50-0321-8366 9,784.341 50%
I
I
I
i
I
I
i
I
DATE OF DEATH
VALUE OF
DECEDENrSINTEREST
4,892.17
TOTAL (Also enter on line 6, Recapitulation)
4,892.17
*'
SCI-EDU.E H
RNRALEXPENSES&
AIl'tWtSTRATNECOSTS
CClMMONWEAI.1I1 OF PENNSYLVANIA
INHERlTANCE TAX RETURN
RESlD8IT DECEDENT
ESTATE OF Kehew, Sr., James G
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 - 06 - 0749
ITEM DESCRIPTION AMOUNT
NUMBER FUNERAL EXPENSES:
A. 1 Cremation Society of Pennsylvania 175.00
2 Clergy $100, Organist $50, Flowers $159 309.00
3 Funeral Luncheon 347.57
4 Clothing for deceased 125.25
I
5 Obituary in newspaper I 304.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
SocIal Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Vear(s) Commission paid
2. Attorney's Fees Ahrens Law Firm, P.C. 2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 72.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees Estimated 150.00
7. Other Administrative Costs
1 Postage 39.00
Total of Continuation Schedule(s) 270.00
TOTAL (Also enter on line 9, Recapitulation)
3,791.59
.
ScheclJe H
R.I1nI Exps 1iOO6&
Ad1*....Castsccnlh&:l
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kehew, Sr., James G
I FILE NUMBER
121 - 06 - 0749
2
Travel & telephone expenses
50.00
3
Estate notice in the Cumberland Law Journal
75.00
4
Estate notice in the Sentinel
130.00
5
PA Inheritance tax filing fee
15.00
Page 2 of Schedule H
.
.
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COUMON~TH OF PENNSYLVANIA
INHERITANCE TAX FlETUAN
RESIDENT DECEDENT
ESTATE OF Kehew, Sr., James G
FILE NUMBER
21 - 06 - 0749
Include unrelmbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Alert Pharmacy 73.00
2 Bethany House 175.00
3 Heritage Medical Group 124.00
TOTAL (Also enter on Line 10, Recapitulation) 372.00
".- ...... ~
REV.1.13 EX+ (MOl
'*
SCHEDULE J
BENEFICIARIES
r
COMMONWEAl:,"", ~VANlA
NtIlIlf1'ANCI TAX IIEnlRN
MIIDENT OICEDINT
ESTATEOF
Kehew, Sr., James G
I FILE NUMBER
I 21 - 06 - 0749
RELATIONSHIP TO AMOUNT OR SHARE
DECEDENT OF ESTATE
Do Hot u.t .
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXMLE DISTAI8UTIONS (Include outrtght IpOUU/ distributions)
1
William O. Kehew
335 Hunter Shet, Woodstock, Ontario, Canada
1/3rd of Residue
2
~ Kehew Cahill
212 - HiD ROIId, Perkinsville, VT
Daughter
1/3rd of Residue
3
James Gordon Kehew, Jr.
I 933 AYiIII Road, Harrisburg, PA
Son
1/3rd of Residue
EnIiIr"'lmOUnIIflrdlllltbuliona shown eove on lines 15lhrough 18, as
, on Rev 1500 cover sheet
D NON-TAXMILE DISTAI8UTIONS:
.
A. ~ DI81"AI8U'r'II UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
-MADE
I. CHAA1TAILE AND GOYERNMeNTAL DISTRIBUTIONS
TOTAl OF PART.. ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
-----------------.------- -----------------------------------------~
! ."..,
.>
:<t
;0,;;
~tf
II~
:I
'ail
'If
-
~,
-- t."
_. "
(!!j ). ,-.
~ ;
::> ,
;'.~,-ft;',!J'
I.....:,:'.........
' .
'~~~~~~
1= .
I. "K:-''...rt
.~; ~ . , ,',- ~'
.. ~ "
. ,<,,:.'
,.~
~';:
:.:.{"..~.t:'..~.l
.iG~~
<fir. . ", ,
~r,
'"
.-
.-
",
.-
",
",
.-
.-
""
r1'
",
..'~..f:2..'...
...... ,,~
~ '.~:
.-
.-
""
'"
~
. t'--
~ -",
~CI)<
~~ ~
E '-.. *'
.- ~ 0Jr
~ on....
!:l ~
~,o~p
~ fJ:l.~
[!l f iii..-t,.,."..:.:
CI) '" ~.. .:t6
~.~7t ..
'-- .
..:.~.a.."
,.~
'~"""
.~
~,
:',~.'.;1~.'.
"-~~
:""J
'1~"
!'.
.t~,,.,.
i 1 ',_
2001HAY 16 Pi"i! I: 17
o EPK (Ie
O ,-. DH' t'i'I':' ..
01 I,' \_\~ \.::
CU","'-:.'I. "1',
IVI. I
RT
. PAc
C1)
00
;:i
~
o
u
.o~
0090
::::::ot--
.- u-
',' ~
" ~]~
M 1:: ...
C1)C1)~
ti .o~ .~
.... -
~ a
~uu
':,: