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Home My WebLink About08-29-07 (2) REV-1500 EX + (6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W (J W C WEIR ALMA H. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 12/16/2006 07/12/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- l!l::!!;1I) (.)1II:l!l: w lL(.) :1;00 " 111:...1 .....lLm lL <( ~ 1. Original Retum o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copyofTrusQ o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAl USE ONLY SOCIAL SECURITY NUMBER 202-05-1054 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (date of death prior \0 12-13-82) o 5. Federal Estate Tax Retum Required !.. 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See. 9113(A) (Attach Sch 0) NAME MURREL R. WALTERS III FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS FILE NUMBER 21 -0 6 1 1 2 7 ""CoUNTY'CoiiE -YEAR- - - NuMBeR- - I- Z W C Z o lL II) W III: III: o (.) 54 EAST MAIN STREET TELEPHONE NUMBER 717-697-4650 MECHANICSBURG z o ~ <( ...I ::) l- ii: <( (J w 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. 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) 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) (1) (2) (3) (4) (5) (6) (7) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I- ::) Q. :E o (J ~ I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) X_(16) X .12 (17) 6,211.61 X .15 (18) 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. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT PA 17055 OFFICIAL USE ONLY o -D ; =-0 -rC) ---p r- '-,I"Tl ~T 142,898.07 : (/:..;< 00 ,(:)'-fl :.....- ,j'55 -I (8) 14,650.60 4,015.28 (11) (12) (13) (14) (19) l':> = = -..l J:- c: G') N 1..0 :Po ~ co .. +:"" -.I 142,898.07 18,665.88 124,232.19 117 ,088.84 7,143.35 931.74 931.74 eel t' C I t Add Dec en s omDle e ress: STREET ADDRESS 5225 WILSON DRIVE CITY I STATE I ZIP MECHANICSBURG PA 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) 931.74 Total Credits (A + B +C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 931.74 931.74 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 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00 c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.......... ............ ..... ..... ... .......... ....... ..... ..... ....... ..... ....... ..... ........ 0 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 0 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 PA ADDRESS MURR R. WALTERS 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. ~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 0% [72 P.S. ~9116 (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 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)]. 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)]. 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. ~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 WEIR ALMA H. 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. 1127 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 10,018.56 SOVEREIGN BANK CERTIFICATE OF DEPOSIT 2. U.M. CONFERENCE LOAN FUND PROCEEDS 53,462.84 3. ERIE INSURANCE TENANTS INSURANCE REFUND 20.00 4. PENNSYLVANIA STATE INCOME TAX REFUND 11.00 5. SOVEREIGN BANK CHECKING ACCOUNT 18,150.04 6. PINNACLE HEALTH REFUND 29.52 7. PEBTF PREMIUM PAYMENT REFUND 179.88 8. CASH ON HAND 1.13 9. PNC BANK INVESTMENT ACCOUNT 61,025.10 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 142,898.07 REV-1511 EX+(12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WEIR ALMA H. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. 21 06 1127 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOOVER FUNERAL HOMES AND CREMATORY INC. 465.60 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) ARTHUR E. DAVIS 7,145.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 58 BURWICK DRIVE City MECHANICSBURG State PA Zip 17050 Year(s) Commission Paid: 2. Attomey Fees MURREL R. WALTERS III, ESQUIRE 6,715.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 325.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 14,650.60 (If more space is needed, insert additional sheets of the same size) REV-1~12 EX + (6-98) *' SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WEIR ALMA H. FILE NUMBER 21 06 1127 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. PENNSYLVANIA DEPT OF REVENUE 450.00 2. PINNACLE HEALTH EMERGENCY MEDICAL 29.52 3. ALERT PHARMACY SVS, INC. MEDICAL 139.25 4. BETHANY VILLAGE RESIDENTIAL CARE 3,396.51 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,015.28 ~:""".(. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER WEIR ~I MA H 21 06 1127 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 distributions, and transfers under Sec. 9116 (a) (1.2)] 1. .JUDY NITTINGER NONE 5% 114 LINDEN DRIVE CAMP HILL, PA 17011 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. UNITED METHODIST STEWARDSHIP FOUNDATION 117,088.84 3030 MULBERRY DRIVE, SUITE 300 MECHANICSBURG, PA 17050 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 117,088.84 (If more space is needed, insert additional sheets of the same size)