The URL can be used to link to this page

Home My WebLink About11-13-07 'RfV . CIOI EX + I,J tlt w .... ll:CC0 Oii!ll: WlL8 :z:~... OlLlIl lL CC . OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 07 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 0299 NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 .... Z W Q W o W Q DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) Zeigler, Mary C 177-24-5620 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Return (date of death prior to 12-13-82) 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 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 o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes COMPLETE MAILING ADDRESS 52 Gettysburg Pike Mechanicsburg, PA 17055 (1 ) None (2) 2,472.12 (3) None (4) None (5) 10,379.64 (6) None (7) None (8) >~ "1 ~-PF)C1AL USE CiNL! --1"'1 r-,,-,) ~.:- 12,851.76 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) (9) (10) 8,094.12 13,146.06 02/10/2007 03/10/1930 (11 ) 21,240.18 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 1. Original Return 4. Limited Estate 2. Supplemental Return (12) insolvent .... z W Q Z ~ AME Thomas J. Ahrens 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 20.0 Copyright 2000 form software only The Lackner Group, Inc. IRM NAME (If applicable) Ahrens Law Firm, P.C. ELEPHONE NUMBER 717/697-1800 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o 1= :5 ::l .... ii: ~ W a: 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) 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x 1= i! ::l lL 17.Amount of Line 14 taxable at sibling rate x .12 (17) ::Ii 0 0 g 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Form REV-1500 EX (Rev. 6-00) " 'Decedent's Complete Address: STREET ADDRESS 770 Poplar Church Road CITY STATE PA ZIP 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 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;.................................................................................. ~ ~ ~: ~:::~ ~;e~;~i:~:~:~~e~~s~~~..~~~~~ .~~~.~~~.:.~~~~.~..t.~~~~.~~~~~~. ~.~ .i~.~. ~~~~~~~:::::::: :::::::::::::::::::::: :::::: 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?.......................................... ............................................................................ 0 18I 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 18I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... 0 18I 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 penaRies 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, it is true. correct and complete. DeClaration of preparer other than the personal representative is based on all infonn.ation of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Emily L. Re~,olds . DATE 1060 W. Limekiln Road New Cumberland, PA 17070 II /tt If) 7 . DA/'rE ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Tbomas J. AbrenS! ~ L-- J ADDRESS DATE 52 Gettysburg Pike Mechanicsburg, PA 17055 II-f-07 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 exemot 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 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. . , . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zeigler, Mary C J FILE NUMBER 21 - 07 - 0299 All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM I I VALUE AT DATE OF I DESCRIPTION UNIT VALUE NUMBER I DEATH --11 Prudential Financial Inc. common stock I ---~--- 91.561 2,472.12 ! I i I I I I i I I TOTAL (Also enter on line 2, Recapitulation) 2,472.12 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zeigler, Mary C FILE NUMBER 21 - 07 - 0299 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. - ITEM DESCRIPTION VALUE AT DATE 0 NUMBER DEATH 1 Wachovia Money Market account # 1010126443514 33.93 2 Wachovia Burial Reserve account # 3000056137186 7,745.38 3 Wachovia checking account # 1010126443501 2.443.11 4 Continental Life check 157.22 TOTAL (Also enter on Line 5, Recapitulation) 10,379.64 F . . *' SCH3JU..E H I I FlN:RAL.EXPENSES& COMMONWEALTM OF PENNSYLVANIA ADNINSTRA11VE COSlS INHERITANCE TAX RETURN RESIDENT DECEDENT Zeigler, Mary C FILE NUMBER ESTATE OF 21 - 07 - 0299 Debts of decedent must be reported on Schedule I. ITEM I AMOUNT DESCRIPTION I NUMBER FUNERAL EXPENSES: I A. 1 Michael J. Shalonis Funeral Home 3,232.35 2 Minister 120.00 3 Soloist 50.00 4 Grave Marker 221.00 5 Funeral luncheon 300.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Ahrens Law Firm, P.C. 3,500.00 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 Cumberland County Register of Wills 98.00 Inventory filing fee 15.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Estimated final 1 040 and Estate 1041 200.00 7. Other Administrative Costs 1 Estate Notices 204.77 Total of Continuation Schedule(s) 153.00 TOTAL (Also enter on line 9, Recapitulation) 8,094.12 . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SchecUeH F\.IleraI Expel ses & Ad'rW1is1raINe Costsconli'tued ESTATE OF Zeigler, Mary C FILE NUMBER 21 - 07 - 0299 2 PA Inheritance Tax filing fee 15.00 3 Additional short certificate 4 Court Accounting Page 2 of Schedule H 8.00 130.00 .. . *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zeigler, Mary C I FILE NUMBER 21 - 07 - 0299 Include un reimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Golden Ventures nursing home 1,835.37 2 Familyllnternal Medicine Assoc., P.C. 133.05 3 PharMerica 532.06 4 Neighborcare - York 10,470.34 5 West Shore EMS - BLS 175.24 TOTAL (Also enter on Line 10, Recapitulation) 13,146.06 r I 0 I'. ,,) 11::l ex) Z'..') ~ ~ ...,. e, '.: ~ :~~~rl I~o;o 0: r) () I 0 zllc ~~ (~I tF) ((..). ~.,.'I J!! '" n & t~ ;~: Q.. '"J 'j. .,.. 0. ~"j C) ~, ,-',,)~ ""~ "~~ :.r: S031.1N(\ 0 D ;::, II lr) lr) o r--- u o..(!)~ ~~o.. Sil: ~ ...... b1) rT ~I\ 'L-. 1 '-", I::: r;,L,.. l "-,,' I I i _ . ( '. c0 / ~ O? '0( 9;; (!) lZl ;::l o ~ o U c~ lZl30 =:or--- ......u- ~"O< ~ao.. J-4 a:: ... (!)(!)~ ......0 lZl lZl J;'- .~ 91i ~uu