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Home My WebLink About12-03-07 --.J 15056051047 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 OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .... 1. Original Return -c:::;) 2. Supplemental Return c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c;::) c;::) c;::) 4a. Future Interest Compromise (date of death after 12-12-82) c;::) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c;::) 10. Spousal Poverty Credit (date of death c;::) 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 Da time Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes 4. Limited Estate c:) c;::) REGISTER OF WILLS USE ONLY ~ ~ = ..... o rr1 ('""') ( W -0 :3C :rj t" 't-~} n ':::J _..~ C::5 fT'} c..-::J .le) . , "T1 . .~: i~ r --' rT1 (,J--) CJ "1' I +:"' -.J ADDRESS vlf I "CcJI\ . Y1.t.t- DATE '~3J- DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 -.J ~ --1 15056052048 REV-1500 EX Decedent's Name: Jo)~~ A-. j::::-\v1lleqtl.AI RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) <=:) Separate Billing Requested . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <=:) Separate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Decedent's Social Security Number L '1. 3 ~. t. 3 0 7 J-- " _ ,,' ',' _ " _ ,- - - ',~ _, ~_ - ,- ," _ - - ',-i ~ "', ~, 1. 2. 3. 4. 5. 6. 7. 8. H...' 9. 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/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 _ · 17. Amount of Line 14 taxable at sibling rate X .12 3$"" I ? ~ s. 0 t> 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 1\.' \)c.t r\;fl) ~~ "- ''\0 ~'J ~~ (~ Side 2 15056052048 . 351 15. . 16. . 17. 4l- 1 ~ (,~,.o q 18. . 4 1.- I c,.~. 0 r c::::> 15056052048 ...-I REV-1500 EX Page 3 File Number 1.., 0 0 ~ - (:HI '-f j -- Decedent's Complete Address: DECEDENT'S NAME STREETADDR-ESS----~~-\.vv __8- =- _PL(1_ ~e" 4-AI -- ~_________ ___~J~Q_})'l~ili1.-tl-L~ CITY------ -- ____J0~ CJ\t\i\JLLb~ttl-___ ------_.------------ -- ----,--------.---.---..- ------ i STATEr It- ZIP /llJru Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 4 L I{,? ()? I Total Credits ( A + 8 + C ) (2) 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) 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. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (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;.......................................................................................... 0 i ~: ;::::~ ~h~e~;:i:~:~sii~~~::;:~. .~.~.~~~. ~~~. ~~~. ~~~~~.~. .t.~~.~.~.~~~~~~ .~~. it~. i.n.~.~.~.~.;.::::::::::::::::::::::::::::::::::::::: ::::: 8 . d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 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 rp 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. 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. 99116 (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)J. 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. 99116(a)(1.3)J. 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. f'!EV-1502 E(<+ (6-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER JO~N (-\-. F~Y1I)e.~a,.v d.-OO~-dll'f) All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value IS defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 5\'l\~k ~O'l'\ll. (l'+ DESCRIPTION l_p_ C \)G\. ..tHH to \:) r ~ " Q.. M t..Lh.i:lV\. \\.S b l.V'f ) Pi1\. . r 1 ()~-o VALUE AT DATE OF DEATH .:Jt '" r (,11 (,1--0 C \J (\ r. " C r a.,S l:. i "'\ r' \\'....... ~C~\}t.. L\.j). p\l>-(.~'J ~r .s ~ y..... j'J\~ 1.0''\ 1-- TOTAL (Also enter on line 1, Recapitulation) $ ~ s<1 OtJ C/ (If more space is needed, insert additional sheets of the same size) REV.,!!b3 ex.. (1.911 . SCHEDULE B STOCKS & BONDS " COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF jCJ~~ (+. r'\t'p"l.Ll QN All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER FILE NUMBER 2..t)Ou-dll'il ,... 1. f::: "\. '" 4 i t\ v Cl '^ <(, li,"'-... cR. ~""o(J J:<,.Q~ w\ "DJo r .lJ.- DESCRIPTION C .....1/1\ . t~ 0 ~ 'I't\.jI\..;~JLl.Q J; v '^~ ~,^-^j (.9.9.11.>~')-Jfllq.2.'f b4u1.. Fv..lI\J ((p '). y. '-I)lJ 5: -~) - ..f)L "h~j ~ ~.iL- VALUE AT DATE OF DEATH 9.,f..,4LS-r .1 (j ; ;J..(.. 3 . =-i u ~, e, _ ~ vt\.l~ ()J.L cLO H 3} 3;/ l.OO~. rht Cl"~ ~-k. u..1Mt1/\:t. r- ~......L p~r ~ '" '1 So;;. l--c..-l\l /l~ ylo. .(?.A^~ ,-1\ ~ ctI^ ~ hi"tP .e~,.v\CJ cL l- VClIlt\!.i4. 'c/ As 0 1-- J, h I I q -t4 +w" 1..."L c.,w. oft< L.J ill) Cc., 1 L fl..:! : SVV r,,~ Fok",j u.~. '1 B ,. JW, ~ ~ J, q '-II ? ~ W\t'\~iol ir rlA.~ (~&r-.lll !O:~~ ~3( S"' l!j ,1f-/ l' h - 11 k- l">" 1 (Ju '1) ~ - T ~ -t .s:'-"'w. t C \ ~ M (' t- \ ~ b/.,'\J.l ~(/t) ~",.\4! F,^~J) - .1IJO, e3 w\ "'&';cr S 3r, 3} TOTAL (Also enteron line 2, Recapitulation) $ ~.Q I QU4.. q S (If more space is needed, insert additional sheets of the same size) ~'~.".O '*' COMMONWEALTH OF PENNSYLVANIA , INHERITANCE TAX RETURN RESIDENT DECEDENT - SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF. FILE NUMBER I. ~ jo~.v ft. r'flr1e~dA1 '2..00w-Of/'1J 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 NUMBER 1. !)... 5' 1. DESCRIPTION ~OIfe...(~'lq.<t.i I3Gti\~ ~~......i~j ft'H!W\1- a.o rL.f.1f.,...JJ ~ jk'k~ t ~\ l ~y)', /(4 '/0 ft - I Y j.1v lo (i.t. ((,.UW'\ t.,t> ;]. 33lft:~C,jit<-) S . g., t ~~lo'\':l ~\- u ('l}.;I~LLJ M. . j) vs\..:~'^' ~ ~~ n d~' I() IJ)~ ~ I-YJI} 01& lllC.OU,""'+ +4 3 nCe~) l[J) f;n.o Se-tfl,-^-,...J "I- &~~k.-E /!'-<ouP-+- M ",.."h-k d i>A- Shtt (( ~l~\V1 ~ fu.f.dL"ni~ sp,kw... ~ . n I \ ~.} k -t CL L 0 r{ c.A., I;..J 0 IlAv\tp J ~(, t1'\ fa,; rt.i,l1t ~ I).Q. I.....~dll.,v.. I .J k l n ~ b-t " ~ ~ J.. Q, VV1 () l~ '" + 0 f- .9' {),. {3 q q {; 7. '-t J l.w v... ,-Y1-. .. I&U#} -\-t,t 0' ~ -' ~~.J 911, l.~ tM {'\J I 11~J) J ~;r;;WN\-.f (V\ ~ : CLl) ~\- ~ V c.\.l.t/i.L L. r.", " "-l {11;) ~ ~ vii\. b-lr J j 0 h (\J ;4. '-\"'^-tS'a.~J b:eli1..lLu,t4 L't""i.t,,~f-Vi;~ tI-. r~~-lvv~ tA-,1il t.1L ~ P/~ t\~rto, p" s ~ f.~lo}lk fkf.l",~wf .s'tj.k~. ~ W~ -\0 iJ +~:1 I k."" 4)~J ,nf- ~ .Jt 'ia 1'1 Cl pIC (tL1.~ h tau. . Lij\.U''''' I\- 1>'1 CW vl-..l ht11A1tI' I' k r~.v...'I.ol Lt'. . 1\ J _ L, p~~ .~""~~C'i\' {t((\V\L6A}{..Q. ~\.c....JI g e C-IILlh v~.. t1N\ \"\5~\rM'\ft.L bt-+~ (C,-C'~ ~. If loa -0 2..d LJ-:3 VALUE AT DATE OF DEATH .J I Oq:).. i.; 'I I Y U..F, S--,", I 70 ljtJC\. tJ(j I iU;0I18 ~. G- IN "';- ~, u. "'... ,d- 1/" I" ~ ,,{ ". ,,-1-<' k./J 1" 0 1.. d~ I dl> i h l",,! '. A" ,:k,,^1 w{ r IL -e." ~ i (>1\ c..lJi/ tc 6 LVJ u...-. J .t' 1'\ ~ -H-I...b. C'1.. +- ~ ~ UI.J 0 (,C...J. fUd.. J lo(J ~ ~ 0 v.... /....' i" fa. '- -( J \/<< Lu.. eM 1'UlA '~Mf - IU~ waJ t'l, t-h L~ ,) f- g...hJ11tt.k, "If ed eM.... \)~ ct & III LJ- ~ ,'\.tt.-tj.t N'\ TOTAL (Also enter on line 5, Recapitulation) $ q 0 I ~ \ 1. ct (., (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) _~._' \.1~ ~ ;~Q. ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN , RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF 2oo~ - CJ Ii 'f J ITEM NUMBER A. B. J" ~~ Pr. {, t'\ fliq a~ Debts of decedent must be reported on Schedule L FILE NUMBER 1. DESCRIPTION FUNERAL EXPENSES: Pet\! \-c; T"o"",~ J. Gd&.{t'\ FtA/1i...,J i-{o.'Il!- ,"00(1 j).t.I~l.lIO..r{ ~+. D\.l'" r1'\ () rt) PGt. IS n ~ f\,) Pft)CH.sI~ i~.hll~ - ''LrTJO 3) Fu.L.'\.~!; l€t~Cf-.,.J.i.t- ~l'~.- (,) 'frt\M)f.;r h~ ~..., ) c1 ~ La.} tlo.J I ~iJ~(AJ i I (;Q.~ I s- q () -L) ~~~. J t t ~ cf. ':-l 0 C) Ct.;t~")~~~u~~ 1~\~~.~hr\<Atr ADMINISTRATIVE cas,S:' AMOUNT $/~OS- . 1. Personal Representative's Commissions Name of Personal Representative(s) 2. Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees th O+- .~ Ltr ./ 5--P 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) 4. Claimant Street Address City State _ Zip Relationship of Claimant to Decedent Probate Fees 3 '))/ 5. Accountant's Fees I I 6 7. Tax Return Preparer's Fees ~ .-- ltt~J t,\~j I kl ~ ~ PA.\.-rl.'+ fV~\JJ~ C-~~ ~Jrl1: "LvO ~ (lLl ~6r ~ D~ h.L~ --I TOTAL (Also enter on line 9, Recapitulation) $ Y S) U (If more space is needed, insert additional sheets of the same size) REV-1512 EX+' (12-03) '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT , ESTATE OF . FILE NUMBER .\0 ~, J A- Flf' (\.f 5 ,,,,,, 2AJOlr a/lV) .- Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE OF DEATH ITEM NUMBER 1. DESCRIPTION MOl" (t\ -l. rt.v'Y\.A"l ~~ ().; t1 ~ C' lUL. tJ^- f~ lJ 4u> Pt\UJ M~ Dr,.,J... I 1,L1L(>~t\ (hi) b'.v'rl.J At. j 1 () fl' ~ h. I.V~ j I-. ' G).,." Mv... tv',J \-1" "" G w {L 0 tJp. If.: <,-rJ D 7B'( 44JB I t, 'Loq - 83 . TOTAL (Also enter on line 10, Recapitulation) $ 11.., U/ q . g 3 (If more space is needed, insert additional sheets of the same size) AEV-1513 EX+ (9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN , RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Jd ~u A-- ~'I ()1\~'1clAi FILE NUMBER '1./0 DU. ~ 0 If'll 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) ('1.2)] A-"",b !'OJ e.. h (\ neel a. ~ is rc .~ (, I L eCh"N -k a.l fhJ- .~() IoU t\ I f'~ .\0 w;.tJ, Po. ' 1 q:5 3 to" AMOUNT OR SHARE OF ESTATE NUMBER I ,009tJ r Q ~ l'\o ~ J I.lA.l C).J- vn 1 ( lJ 'fa Y\J~ Mu.. r it VI^ fu bfA{.h~ io..d.. ~.tI JU\c-'\'A1U uk-h tlt\cJ lll1y.\JA}Jtl. ctMCfII', {" j.bL"lJ. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET " 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 n - 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) Register of Wills Cumberland County Sir/Madam: I am enclosing Form 1500 concerning my brother's estate. I am not at all sure that I filled out the Form correctly. I spoke to an individual at the Department of Revenue who said complete the form as best I could and the Department would contact me concerning any mistakes made. The person I spoke to, Sandy, was very helpful. I did not complete page 3 because I did not know how to determine the cost of any late fee. I look for your input here. fe? ______ Thank you for your as; ~ - Ambrose Finnegan ..u/ 612 Comstock Ave. '/ Downingtown, Pa 09 484-237-5057 (work) 610-458-4438 (phone) - = --= <I: 0- .r- ;z. 0 3\f).1- OOM';z. .....I-MO:::l .[~~M~ ) ..... :>0: . ;z. 0 -:1 :x z .8 I~' It o c:> o o - ..::::. ::: - =-- -= :: - .... - ....... - j: ::: - - - - - - - - ::: - - ,... - -= -= - .- =- .~ ~ ::::: -- 1--= - ~ --- ~ --- ~ \J1 r=\ rn cO \J1 r=\ ::r tr' ::r Cl Cl Cl Cl tr' ::r r=\ t'" Cl Cl t'"