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Home My WebLink About07-12-07 · ---1 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year ~I ala File Number 05S~ Date of Birth 086-18-4215 06/03/2006 09/23/1925 Decedent's Last Name Suffix Decedent's First Name MI PETERS GERALD (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .. 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) __I 10. Spousal Poverty Credit (date of death C~:J 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes GERARD R PETERS (717) 497-2419 Firm Name (If Applicable) City or Post Office State ZIP Code REGISTER Otf"LLS USE o~ = ;:0 ~ "') :IJ C- "...,-0,....... C ~.-'- ::r: '- -' r- .J --- r- '~Zm " . CI) 9? 00 -Qil ::0 D,quFl'iED .J:;. N ; -f"i C) ~') -. ~.~ CJ '(2 '-'~-i r5 rTl First line of address 9 TOMMY LANE Second line of address " :x N -. ..-) ENOLA PA 17025 N Correspondent's e-mail address: Under penalties of pe~ury. I declare that I have examined this return, includin9 accompanying schedules and statements, and to the best of my knowledge and belief, it is tr corr and co plete Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. o PE ON ONSIBLE FOR FILING RETURN DATE OS/23/07 ADDRESS . 106 S BALTIMORE STREET, DILLSBURG, PA 17019 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ...J d-Wj · --1 15056052059 REV-1500 EX Decedent's Name: GERALD PETERS RECAPITULATION 1. Real estate (Schedule A). ...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c.::;; Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C:} Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 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)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .... . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.o.4.... 1,820.51 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 086-18-4215 Decedent's Social Security Number 15056052059 5,500.00 5,455.28 10,955.28 8,443.63 691.14 9,134.77 1,820.51 1,820.51 72.82 72.82 --1 REV-1500 EX Page 3 Decedent's' Complete Address: DECEDENT'S NAME GERALD PETERS STREET ADDRESS cia GERARD R PETERS 9 TOMMY LANE CITY ENOLA ~I File Number O(p oSSq DECEDENT'S SOCIAL SECURITY NUMBER 086-18-4215 STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 72.82 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + 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. Fill in oval on Page 2, 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. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (SB) 72.82 A. Enter the interest on the tax due. 72.82 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;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [i] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [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 zero (0) percent [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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [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 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF GERALD PETERS FILE NUMBER 21 06-0558 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH MOTOR HOME 2 CADILLAC 4,500.00 1,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,500.00 REV-1509 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF GERALD PETERS FILE NUMBER 21 06-0558 If an asset was mad a 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. STEPHANIE J WOLFE 606 WERTZVILLE ROAD ENOLA, PA 17025 DAUGHTER B. C. JOINTLY.QWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEII FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 08/0 1/66 PNC ACCOUNT #5140049394 10,910.56 50 5,455.28 TOTAL (Also enter on line 6, Recapitulation) $ 5,455.28 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF GERALD PETERS FILE NUMBER 21 06-0558 Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: FUNERAL HOME PREMIER CATERING 7,921.00 410.63 2 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attomey Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cily State .Zip Relationship of Claimant to Decedent 4. Probate Fees 62.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 50.00 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,443.63 REV.1512 EX' (12-03) ~. ,~ . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABilITIES, & LIENS ESTATE OF GERALD PETERS FILE NUMBER 21 06-0558 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEDICAL EXPENSES EAST PENN AMBULANCE 35.00 QUANTUM IMAGING 36.00 SOUTH CENTRAL AMBULANCE 600.00 PATHOLOGY ASSOC 12.02 PATHOLOGY ASSOC 8.12 TOTAL (Also enter on line 10, Recapitulation) $ (if more space is needed, insert additional sheets of the same size) 691.14 REV-1513 EX+ (9-00) ,. .. '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF GERALD PETERS FILE NUMBER 21 06-0558 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 [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 GERARD R PETERS 9 TOMMY LANE ENOLA PA 17025 SON 910.26 2 STEPHANIE WOLFE 606 WERTZVILLE ROAD ENOLA PA 17025 DAUGHTER 910.25 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 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) - J un ,\L...1OP\... .JJr~ \ 2 ,PH \~ ~l ')... \ ~ .... g ~ <J'J ..... ~ ~ 0 g~~ '8 aJ g 't-' 00 p..1I)~ N ..... ? ~ ..... o,e-o r- ~ .... .;;; ..... ,:::<+-<;.c)o~ ~ 0 c:'-OI"\. 11).........0.- >~ 0000 ~II)'CN~ eBg~~ e ~ II) t:Q 'B ofr~o~ uot:Qp..P:\ .'" P'"'f'.':"\/ t.."... :i ',1\ \..' N';;CC " - - :? - ==- - -::: - - :::::: - - - -;::; .- - - - - ==- - [,il (j) ;::J o ;:r. E--1 c::e. (j);::J 01 c:i.,;10 ,-I [,il..-:1Uoo ';21-1 (j)r- c:i.SO ,-I ~ u[,il IJ-tIJ-t (j)~ OO;::JO-> ~ ZO oc::e.~;:r.[,il ';2[,ilHt-lH [,ilt-lc:i.c:i.Ul H(j)t.i!;::JI-I 01-1co00 0';8U>J-i (f)t.i!O ~ ';8c:i.u,-IU - - - - - -:::: -:::: -