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Home My WebLink About05-07-07 REV-1500 ESX + (6-00) . COMMONWEALTH OF PENNSYL VANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712~01 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT t- Z W C W () W C w ~ ~~(/) olli:~ W 11.0 ::tOo o 1Ii:...I 8:lD <( DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) BOWERS .JON F. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM.-DD-Year) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 0 4 2 5 ""'COONTYCiiiiE" -YEAR- - - NUMsER- - SOCIAL SECURITY NUMBER 1 72- 5 8 - 4 1 3 2 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (dale of death priorlD 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) (Allach Sch 0) z o ~ ;:) t- o: <( () w a:: X _(15) 8,095.05 X ~(16) 364.28 413.81 X .12 (17) 49.66 X .15 (18) (19) 413.94 05/07/2006 09/23/1972 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (AlIach copy of WlI) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dale of death after 12-12-82) o 7. Decedent Maintained a Living Trust (AlIach copy of Trust) o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) - PA 17055 OFFICIAL USE ONLY ~ ) .,,8 , -,] ) , (., .J .-.J ~ z w c z o 11. (/) W iii: iii: o o NAME MURREL R. WALTERS III FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS -,~,..'" , -_J 19,749.38 "0 f,) --..;. 54 EAST MAIN STREET TELEPHONE NUMBER 717-897-4650 MECHANICSBURG (8) 20,546.85 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mor1gages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly ONned Property (Schedule F) (6) o 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 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 z o ~ :) D.. :E o U ~ 15. Amount of Une 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 20. 0 CHECK HERE IF YOU ARF REQUESTING A REFUND OF AN OVERPAYMENT 4,836.80 7,201.19 (11) (12) (13) 12,037.99 8,508.86 (14) 8,508.86 Decedents ompl ete dress: STREET ADDRESS 21 ANTHONY DRIVE, LOT 3 CITY I STATE I ZIP MARYSVILLE PA 17053 'C Ad Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 413.94 Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty (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 Une 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Une 5 + 5A. This is the BALANCE DUE. (58) 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; ........................................................................... D 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00 c. retain a reversionary interest; or ...................................................................................................... D 00 d. receive the promise for life of either payments, benefits or care? ............................................................. D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. D 00 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 00 0 0.00 413.94 413.94 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 penaties of perjury, I declare that I have ~ned this return, includi~ llCCOffillalying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the persona representative is based on all Information of which preparer has knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~. 5/212007 PA 17055 DATE 5/212007 ADDRESS ADDRESS MU REL ALTERS 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. 99116 (a) (1.1) (i)l. 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)l. 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. ~9116(a)(1.2)J. 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. ~9116(1.2) [72 P.S. ~9116(a)(1)J. 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 t (6-98) 'w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BOWERS JON F. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 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. 0425 ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 6. DESCRIPTION SALE OF 1959 MOBILE HOME 2005 FEDERAL INCOME TAX REFUND 2006 FEDERAL INCOME TAX REFUND 2006 PENNSYLVANIA STATE INCOME TAX REFUND GEICO INSURANCE COMPANY REFUND. CAR INSURANCE 1993 FORD PICKUP TRUCK MEMBERS 1ST FEDERAL CREDIT UNION ROTH IRA. BENEFICIARIES. GERALD P. BOWERS, ,JR. AND MARCIA K. BOWERS MEMBERS 1ST FEDERAL CREDIT UNION ROTH IRA. BENEFICIARY. HANNS BOWERS VALUE AT DATE OF DEATH 5,000.00 306.80 315.00 54.00 146.61 2,000.00 11,512.96 413.81 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheels of the same size) 19,749.38 REV-1509 EX"'; (6-98) 'w COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF BOWERS JON F. FILE NUMBER 21 06 0425 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. GERALD P. BOWERS, .JR. 10 S. BROAD STREET MECHANICSBURG, PA 17055 FATHER B MARCIA K. BOWERS 10 S. BROAD STREET MECHANICSBURG, PA 17055 MOTHER c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A.&B. 1978 MEMBERS 1ST FEDERAL CREDIT UNION 2,394.81 33.3 797.47 TOTAL (Also enter on line 6, Recapitulation) $ 797.47 (II more space is needed. insert additional sheets of the same size) REV-1511 EX,+(12-99) 'w SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BOWERS JON F. 21 06 0425 Debts of decedent must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 3,612.80 2. THE ART CENTER OF MECHANICSBURG . URN 360.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representa1ive (s) GERALD P.BOWERS. JR. (COMMISSION RENOUNCED) Social Security Number(s)JEIN Number of Personal Representative(s) Street Address 10 S. BROAD STREET City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: 2. Attomey Fees MURREL R. WALTERS III, ESQUIRE . 750.00 3. Family Exemption: (If decedenfs address is not the same as daimanrs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS. CUMBERLAND COUNTY 114.00 5. Accountanfs Fees 6. Tax Retum Prepare~s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 4,836.80 (If more space is needed, insert additional sheets of the same size) Continuation of REV.1500 Inheritance Tax Return Resident Decedent BOWERS JON Decedenfs Name F. Page 1 21 06 0425 File Number Schedule H - Funeral Expenses & Administrative Costs - 81 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) MARCIA K. BOWERS (COMMISSION RENOUNCED) Social Security Number(s)/EIN Number of Personal Representative(s} Street Address City State Zip Year(s} Commission Paid: SUBTOTAL SCHEDULE H.B1 REV-15.12 EX + (6-98) . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BOWERS JON F. FILE NUMBER 21 06 0425 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. VISA. MEMBERS 1 ST FEDERAL CREDIT UNION CREDIT CARD 1,359.39 2. REPAIRS TO MOBILE HOME WINDOWS, CARPETING, MINI BLINDS, HOT WATER HEATER 1,972.00 3. COMCAST CABLE TELEVISION 104.41 4. DORIS CAVE TRAILER LOT RENT 1,125.00 5. EAST PENNSBORO TOWNSHIP SEWER/TRASH 46.50 6. PP&L ELECTRIC 327.59 7. SADLER OIL COMPANY FUEL OIL 488.49 8. VERIZON TELEPHONE 85.81 9. NEW JERSEY MOTOR VEHICLE COMMISSION TRANSFER OF PICKUP 92.00 10. REPAIRS TO FORD PICKUP TRUCK 1,600.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7.201.19 "":"'; "'. '- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER JON F. ?1 06 0425 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 s~usal distributions, and transfers under Sec. 9116 (a) (1. )] 1. GERALD P. BOWERS, JR. FATHER 50% OF RESIDUE 10 SOUTH BROAD STREET MECHANICSBURG, PA 17055 2. MARCIA K. BOWERS MOTHER 50% OF RESIDUE 10 SOUTH BROAD STREET MECHANICSBURG, PA 17055 3. HANNS BOWERS BROTHER 413.81 101 BOYLSTON AVENUE, EAST SEATTLE, WA 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) ~