HomeMy WebLinkAbout06-04-07
REV-1500 EX + (6-00)
,*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128'{)601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
FAILOR URSULA N.
DATE OF DEATH (MM-DD-Year)
OFFICIAL USE ONLY
FILE NUMBER
21 -06 0 8 3 2
""CciUNTY'Co1iE ---vEA~ - - NuMBER- -
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
1 94- 2 8 - 7 6 1 4
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
09/06/2006 10/17/1914
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[Xl 1. Original Retum
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
SOCIAL SECURITY NUMBER
o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Retum (date of death pliortD 12-13-82)
o 5. Federal Estate Tax Return Required
!.. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AtlachSch 0)
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. Jointly 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)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
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NAME
MURREL R WALTERS III
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717-697-4650
COMPLETE MAILING ADDRESS
54 EAST MAIN STREET
MECHANICSBURG
PA 17055
OFFICIAL USE ONLY
(1)
(2)
(3)
(4)
(5)
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9,385.37
(9)
(10)
9,401.00
(11 )
(12)
(13)
9,401.00
-15.63
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 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
(14)
-15.63
X _(15)
X _(16)
X .12 (17)
X .15 (18)
(19)
0.00
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
113 SOUTH ORANGE STREET
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + 8 + C ) (2)
Total Interest/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. (SA)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
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 IX]
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IX]
c. retain a reversionary interest; or ...................................................................................................... 0 IX]
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IX]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.. ........ ... ... ............ ........ ........ .................. ....... ....... .................. 0 IX]
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 IX]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 IX]
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
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ADDRESS
MURREL R. WALTERS III, ESQUIRE
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. 99116 (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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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. 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 4.5%, 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 12% [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)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FAILOR URSULA N.
FILE NUMBER
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.
0832
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
8,787.93
PNC BANK
CHEDCKING ACCOUNT
2.
HERSHEY'S AUCTION
PERSONAL ITEMS. NET SALE PRICE
588.74
3.
STATE FARM
INSURANCE REFUND
8.70
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9,385.37
REV-1511 EX+(12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FAILOR URSULA N.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
06
0832
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. EGGER FUNERAL HOME 7,566.50
2. FLOWERS 132.50
3. MUSIC 100.00
4. FUNERAL LUNCHEON 150.00
5. GRAVE MARKER 745.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) PATIENCE A. ECKMAN (COMMISSION RENOUNCED)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 160 HICKORY ROAD
City CARLISLE State PA Zip 17015
Year(s) Commission Paid:
2. Attomey Fees MURREL R. WALTERS III 600.00
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
SlreetAddress
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 107.00
5. Accountanfs Fees
6. Tax Retum Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 9,401.00
(If more space is needed, insert additional sheets of the same size)
O<EV-,"" '" <'_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
FAILOR URSULA N. 21 06 0832
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distJibutions, and transfers under
Sec. 9116 (a) (1.2)]
1. PATIENCE A. ECKMAN DAUGHTER 1/2
160 HICKORY ROAD
CARLISLE, PA 17015
2. ROBERT F. FAILOR SON 1/2
700 SALEM ROAD, L-15
ETTERS, PA 17319
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - 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)