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Home My WebLink About10-01-07 ....J 15056041114 REV -1500 EX (06-05) OFFICIAL USE ONLY County Code Year I=ile Number 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 a. \ 'tllD 16~G Date of Birth 499-24-3633 10122006 12031918 Decedent's Last Name Suffix Decedent's First Name MI HAWKINS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix LENORE E 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 W 1. Original Retum 4. Limited Estate D D D D 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 8. Total Number of Safe Deposit Boxes 2. Supplemental Retum D D 1 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required D D D 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT M. FREY Firm Name (If Applicable) 717-243-5838 ~'.~ FREY AND TILEY First line of address REGISTER ILLS USE O!iIIiY "- _ (~ ---J :: :IS Cl ,-") --l I .'1 5 SOUTH HANOVER STREET Second line of address ~~ ZIP Code _,"_J --1 DA1:E FILED (:::;) City or Post Office State ,.'~ - I N CARLISLE PA 17013 Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, n is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF ~O~RESPO~SIBLE FpR FILING RETURN DAJE YUf~- .J.-n"".,~ 1~/I/dl'7 ADDRESS ' , 424 FACTOR STREET, CARLISLE PA 17013 SIGNATURE OF PREf~'3..PTHER_THAN REPRESEN.l8TIVE V V~ ffll P'h4 ADDRESS 5 SOUTH HANOVER STREET, CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY DATE )(J/'/d7 , Side 1 L 15056041114 15056041114 ....J \ ~ .-J 15056042115 REV-1500 EX Decedent's Name: LENORE E HAWKINS RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (ScheduleC) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499-24-3633 Decedent's Social Security Number 1. NONE 2. NONE 3. NONE 4. NONE 5. NONE 6. 7. NONE 8. 9. 990.00 990.00 7250.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . . 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/Sec 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.O L 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042115 15. 16. 17. 18. 15056042115 2395.00 9645.00 -8655.00 0.00 -8655.00 0.00 0.00 0.00 0.00 0.00 o .-J REV-1500 EX Page 3 499-24-3633 Decedent's Complete Address: File Number 21-06-1086 DECEDENTS NAME DECEDENT'S SOCIAL SECURITY NUMBER LENORE E HAWKINS 499-24-3633 STREET ADDRESS CITY II STATE I. ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 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) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. 0 o o o o 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 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. 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? . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . No ~ ~ ~ ~ ~ ~ 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. ~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 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. ~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 four and one-half (4.5) percent, 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 twelve (12) percent [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. 217 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Lenore E Hawkins 21-06-1086 If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. John E. Hawkins 424 Factory Street, Carlisle PA 17013. Son B. Karen L. Hawkins 263 Lincoln Street, Carlisle PA 17013 Daughter-in-Law C. JOINTLY-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 DECO'S VALUE OF TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST NUMBER 1. A. 9/1/06 Members 1 st Federal Credit Union, Savings#189345-00 26 50.00% 13 2. B. 9/17/04 Members 1 st Federal Credit Union, Savings#251147-00 305 50.00% 153 3. A. 9/1/06 Members 1st Federal Credit Union, Checking#189645-11 1,122 50.00% 561 4. B. 9/17/04 Members 1st Federal Credit Union, Checking#251147-11 97 50.00% 49 5. B. 12/16/05 Member 1st Federal Credit Union, Supplement Saving 3/3/1901 50.00% 214 Account#251147-01 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 6 Recaoitulation\ $ 990 (If more space is needed, insert additional sheets of the same size) Primary Owner: REGULAR SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established SUPPLEMENTAL SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established VISA CREDIT CARD ACCOUNT: Account Number Date Account Established Balance at Date of Death Name of Joint Cardholder Estate of: LENORA E. HAWKINS Date of Death: 10/12/2006 Social Security Number: 499-24-3633 MEMBERS 1st FEDERAL CREDIT UNION Lenora E. Hawkins Karen L. Hawkins 189345 -00 11/30/1999 $25.96 $.00 $25.96 John E Hawkins 09/01/2006 251147 -00 09/17/2004 $305.08 $.08 $305.16 Lenora E Hawkins 09/17/2004 189345 -11 01/24/2000 $1,122.08 $.00 $1,122.08 John E Hawkins 09/01/2006 251147 -11 09/17/2004 $96.96 $.00 $96.96 Lenora E Hawkins 09/17/2004 251147 -01 12/16/2005 $428.76 $.08 $428.83 Lenora E Hawkins 12/16/2005 4121449995893455 05/30/2003 $2,394.59 None M"E~S 1STJ-'f~E L CREDIT UNION M~~ t/ It. Denise A. Wolfe Insurance Services S pervisor January 31,2007 5000 Louise Drive · EO. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.members1st.org 217 REV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Lenore E Hawkins Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, Funeral Services 7,198 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I 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 City State Zip Relationship of Claimant to Decedent 4. Probate Fees 48 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Register of Wills, (1) Short Certificate 4 TOTAL (Also enter on line 9 Recapitulation' $ 7250 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12"()3) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE 10 NTD ENT ESTATE OF FILE NUMBER Lenore E Hawkins 21-06-1086 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Members 1st Federal Credit Union, Visa Credit Card Account, #4121449995893455 2,395 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed. insert additional sheets of the same size) 2,395 217 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lenore E Hawkins SCHEDULE J BENEFICIARIES FILE NUMBER 21-06-1086 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 John E. Hawkins Son 1/2 residue of the Estate 424 Factory Street Carlisle PA 17013 2. Larry E. Hawkins Son 1/2 residue of the Estate 615 Mulberry Avenue Jefferson City, MO 65101 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 $ 0 (If more space is needed, insert additional sheets of the same size)