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Home My WebLink About12-14-07 (2) REV-1500 EX + (6-00) ~- ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w ~ ~ :$(1) ()a:~ w II.() :x: 00 () a:-I 1I.1lI II. < DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W o W o W o Burrell, Carl R. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 7 0 2 7 1 "COUNTY"'COOE ---vE~ - - NliMBER- - SOCIAL SECURITY NUMBER 1 80- 0 1 - 2 044 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (dateofdeathprtorro12.13-82) o 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A} (Attach Sch 0) z o t= <( ..J ::> l- e: <( o w Q:: z o t= <( I- ::> a.. :e o o >< <( I- 08/17/2006 04/08/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ z W Q Z o II. (1) W a: a: o () TELEPHONE NUMBER 717 238-4798 Harrisburg, PA 17101-1609 (8) i I I i i I I I I 5,107.53; ~~ :r2 :3 f ~ c::J r ,'1'1 I P 0 1---_,.1 I l ,:.;) ~ ; I -:' i" -.,-S-2----.---.-t~:;+---{-~~J , ;~~) \~7.i~1:P; -~ ;;5 -- :'5,~7.53 ---I 1,320.00 o 1. Original Return o 4. limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received [K] 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12.12-82) o 7. Decedent Maintained a living Trust (Attach copy ofTrus!) o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY I I I I NAME Lawrence J. Nea , Es FIRM NAME (If Applicable) 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. 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) (1) (2) (3) (4) (5) (6) (7) (9) W N (11) (12) (13) 1,320.00 3,787.53 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a)(1.2) X _(15) 3,787.53 X .045 (16) X .12 (17) X .15 (18) (19) (14) 3,787.53 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 170.44 170.44 Decedent's ComD ete A ress: STREET ADDRESS 4905 E Trindle Road CITYMh'b I STATE PA T ZIP 17055 ee ames urg dd Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 170.44 Total Credits (A + 8 + C) (2) 0.00 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) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 170.44 170.44 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 0 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 0 c. retain a reversionary interest; or ...................................................................................................... 0 0 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 0 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. Under penalties of perjury. I declare that I have examined this return, 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 rsona! representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSO!'tRE ON SIBLE FOR Fill G TURN DATE .j la /3 SIGNATURE OF PREP ADDRESS 108- DATE ADDRESS 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 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell. Carl R REV-1508 EJ( + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 07 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. 0271 ITEM NUMBER 1. 2. DESCRIPTION IRS 2006 Tax Refund - Decedent's final return Holy Spirit Hospital - refund VALUE AT DATE OF DEATH 5,050.00 57.53 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,107.53 REV-1511 EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Burrell Carl R SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 07 0271 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees - Lawrence J. Neary, Esquire 800.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanfs Fees 6. Tax Retum Prepare(s Fees 7. Supplemental Inheritance Tax Return - filing fee 15.00 8. Hamilton & Musser (Income Tax Return preparation) 250.00 9. Hamilton & Musser (Fiduciary Tax Return preparation) 255.00 TOTAL (Also enter on line 9, Recapitulation) $ 1,320.00 (If more space is needed, insert additional sheets of the same size) - - - ...,.. - - ...,.. - -== (') (')-~ e ~g~8~ (j;~~e~ ~~~~> ~ os:a~z ""d e oo~ 0 d >~ e(') - l~J U'1 0 -.lU'1~trle S~O z ~ '-q~ .-j ~~ -< tr1~ ~ ~ > ~,... ~ ~ ~ S ~ en ""0 ~ ~ N ~ ~ ~ ~ Q "'d Z;J>- ~ > Q .... . ,... VJ. t"" Z ~ ~ ~ ~ 'r. m > '~.... ~ - - - - - ...,.. - -- - - - - - - - - - .-j o .'