HomeMy WebLinkAbout01-0594
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
/ b ..c:;!!JK'-/Y
INHERITANCE TAX RETURN FILENUMBER
RESIDENT DECEDENT ~~ - O,J
DECEDENrS NAME (lAST, FIRST, AND MIOOlE INITIAL) LJ
~ S-fon 'e h;res I !(.,
~ DATE OF DEATH ( -OO-YEAR) DATE OF BIRTH (MM-DD-YEAR)
~ :3 00 1..0 IS"
W OF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITlAL)
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G1'f. Original Relum
o 4. Limited Estate
o 6. Decedent Died Testate (Allacllllopyof\Wl)
o 9. Litigation Proceeds Received
o 2. Supplemental Relum
o 48. Future Interest Comprorrise (daIo d deolI1 after 12-12-82)
o 7. Decedent Maintained a Living T RJSt (AIIadl oopy of TIUII)
o 10. Spousal Poverty Credit (dale d d.... ~ 12-31-81 and 1-1-85)
--~~~
NUMBER
SOCIAL SECURITY NUMBER
jfs:,eJ - I&; - 75-30
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (daledt:ledl prforlo 12-1~)
o 5. Federal Estate Tax Reium Required
8. Total NlJT1ber of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AIIacl1 Sell 0)
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10
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COMPLETE MAILING ADDRESS 11 .
7tJ5~yeez.e i../~ (U//J .
/f&dz~ h~ ,111 /70S-S
NAME G ~"QlcI
FIRM NAME (If AppIc:abIe)
~
(8)
f331. 91
TELEPHONE NUMBER
677 lIlIi')
(11)
(12)
(13)
'1' 7o(} , 3 7
/ 3'1. S ;1...
/CJ(),oO
7/7
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or SoIe-Proprietor
4. Mortgages & Notes Receivable (Schedule 0)
5. Cash, Bank Deposits & Miscellaneous Personal Properly
(Schedl.M E)
6. JoirrtIY Owned Property (Schedule F)
o 8epnte Billing Requested
(1)
(2)
(3)
(4)
(5)
t(s-~c:J.~ '1/
fJ- J ., :2 I SO
(14)
3 q , s- ;;1...
(6)
(7)
7. Inter-VIVOS Transfers & MisceIleneous Non-Probate Property
(Schedl.M G or L)
8. ToIII Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Oeceden~ Mortgage Liabities, & Liens (Schedule I)
11. ToIII Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(9)
(10)
S"' 7 trs.O()
3 9'3S-, 39
I. s.r 1-
..". /6dea-r,t . ctJ O~/?
.: If/
14. Net VIIue Subject to Tax (lile 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SI>E FOR APPLICABLE RATES
15. Amount of Line 14 taxable at Ihe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
3n j/
.
x .0 _ (15)
x .0 tiS- (16)
/,5""6
16. Amount of Line 14 taxable allineal rate
3l/.S-~
17. Amount of Une 14 taxable at sibling rate
x .12 (17)
x .15 (18)
(19)
18. Amount of Une 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE W YOU ARE REQUESTI\G A REFUND OF AN OVERPAYMENT
,,"'""" "'''' *'
COMMONW EALTH OF PENNSYLVANIA
JNHERITANCE TAX RETURN
RESIDENT OECEDENT
SCHEDULE E
CASH ,BANK DEPOSzrS,& MlSC.
PERSONAL PROPERTY
ESTATE OF
n rf5f
FlLE NOM BER
'Je
Ihclude 1I1e proceeds ofJili:jation and 1I1e date 1I1e proceeds were receiYed by 1I1e estate.lnplllperll ymtlr-ow ned w iIIl the ri!Jhtofsurriro..h~ a ustbe disclosed 011 Schedule r.
IT E M
NUM BER
~,
(lr5 If t1 /i/ /f,l) jJ /)
r;,30-30 T ~~ I. "D t- 7'00
VALU E AT DATE
OFDEATH
~~}F.Yf
;2 8" I ~~ S-/
/7 3/170
DESCRlPTDN
1.
~5U7~ U~Fcu CC'5 ) (lf7.fJlfl 11//1 fJA
TOTAL (Abo entEron me 5,RecapibJlltbn)
(Ifm ore space E needed, insertadditbnalsheets of1he sam e size)
Lfs-tt;1.. ~/
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COMMONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATEOF {;rf/sf ;2 5ftrnf~
FILE NUMBER
If an asset was made joint within one year d the decedent s date of deatlt, It must be reported on Sc:hedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RElATIONSHIP TO DECEDENT
A. &rtl hi
7-e
70)" /Jr eez{"U/tJtrid 1'.
ficl1-/V117cS h "Lj (b r 76 S-)
~tfN
B.
c.
JOINTl V-OWNED PROPERTY:
LETTER DATE DESCRIPTlON OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include nlllll8 of financial institution and bank a::count nunilar or similar idantifying nunilar. DATE OF DEATH DECO S VPWEOF
NUMBER TENANT JOINT AII8ch dead br joinly-held raaI eslaIe. VALUE OF ASSET INTEREST DECEDENT S INTEREST
1. A. 'ft/9tR :5US!(~-e~4. \Jltl~, fed.Ct-. (jfA,~ 5"2 s. 3r 5/)% I.](,~, &7
C~rt[;'c.a:k 1 ~/()Srr t:i /5t~ -
..- It S-S7. 'I ~
/;, I'll, - )7)%
J.. sv Feu- / II 1./, f~-
Pr. CD tJ OlD) S
3. A. I ~ fa. 8 !l ChPc (<-;' 5~O5', stb s-ot{ t~ 7 s:l.. 7~
-
.... ~ 7/1..r7
A. r;/ flu 3k()(f'1 is 3'1 '39, I r {"cYo
Lf
TOTAL (Also enter on line 6, Recapitulation) $ :);< /':< , 5"'0
(If more space IS needed, insert adc:itionaI sheels of the SlIT1e size)
_.1511EX + [1-e7) II
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATEOF h f'tJS T f S~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESlllENT DECEDENT
RLE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: w~rrUt F~ ~ -Je<rsey~ko~ ~4 L/ 7 35"";"0
1. 7 s: 0(;
rn 'YJ,'~ /(u.f1., .ec-J(lVel(
r.. .~~ Br'{ft"'l' ~t7ospvdlf ~J;lJf'J'<.- 1/# 0' (J
fn(91( 7 s: ~o
j ~d~JJt'r5 (W.el'~
75'- &J()
or:1 cum (s f Ja tU. 'a.J-<-
rod ~ (I.. ft-r Jasey 5"CJ . (f 0
cCt1 ca~lk; h1P~. Wo~ "fJus7.5~ -;). gtJr d"()
Ur~- ~
5 n:w-e ~ ~ C w.e( ra.... 8'tJ. IJ' (j
B. ADMINISTRATIVE COSTS:
1. Personal Representative s Commissions
Name of Personal Representative (s)
Social Security Number(s) J EIN Number of Personal Representative(s)
Street Adaass
City State Lip
Year(s) Commission Paid:
2. AIIorney Fees
3. Fam~y Exemption: (If decedent s adltess is notlhe same as claimant s, attach explanation)
Clamant
Street Address
City State Zp
Relationshp of Claimant 10 Decedent
4. Probate Fees
5. Accountant s Fees
6. Tax Return Preparer s Fees
7.
TOTAL (Also enter on line 9, Recapiulation) $ 5"165'.0&1
(If more space is needed, insert addiional sheets of the same size)
lIEV-1512 EX. 11-17} III
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FIJlA?T R S~
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Include unrelmbursed medical expenses.
ITEM
NUMBER
1.
ESTATE OF
~.
3,
'I.
1:).
RLE NUMBER
DESCRIPTION
AMOUNT
';J.:2.S';;J. l{K
IJ3.:::lh
/', I{ 5-
11?,18
1'Il{8'JJA
7J r SeO IJ E /<...
U.p r (ztrJ
I?/a r',..
()IfJ9 )~ &~r~7
/( ed (Ot1 flot? R /f;r ~ Ie )
TOTAl (Also enteron Iile 10, Recapiulation) $ 3 i 3 5-' 39
(If more space is needed, insert addlional sheets of the same size)
REV-1513 EX+ (9-00)
. -.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Forest ~ S-fo-n1e
FILE NUMBER
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
I TAXABLE DISTRIBUTIONS pnclude outright spousal dislributions, and lransfers under
Sec. 9116 (a) (1.2)]
AMOUNT OR SHARE
OF ESTATE
1.
ENTER DOllAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 1 S, AS APPROPRIATE, ON REV-1500 COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS - J
Jers~,! SA6H! lh~rlc:c..tJ S'oCI-e7ij
~~O
TOTAL OF PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ItJ tJ , 0 (>
(If more space is Fllleded, insert additional sheets oIlhe same size)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
No.AA 496764 REV-1162 EX (11-96)
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
GERALD R STONGE
101
$1.56
705 BREEZEWOOD DRIVE
MECHANICSBURG. PA 17055
FOLD HERE
FOLD HERE --
ESTATE INFORMATION:
FILE NUMBER
21-2001-0594
SSN 160-16-7536
,..
NAME OF DECEDENT (LAST) (FIRST)
STONGE FOREST R
DATE OF PAYMENT
6/25/2001
POSTMARK DATE
6 /2{) /200 1
COUNTY
CUMBERLAND
(MI)
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TOTAL AMOUNT:PAID
DATE OF DEATH
9/03/2000
REMARKS GERALD R STONGE
REGISTER OF WILLS
CHECK# 6062
SEAL
09-05-2005
STONGE
09-03-2000
21 01-0594
CUMBERLAND
101
APPEAL DATE: 11-04-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --. RETAIN LOWER PORTION FOR YOUR RECORDS +-
-------------------------------------------------------------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
FOREST R FILE NO. 21 01-0594 ACN 101
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DCr'l(10nCn nFrlrr n:: NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUNllLtAXE&'I"" "" '_L_ ~" APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~'!"<!' i,', OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601"
HARRISBURG PA 17128-0601
2005 SEP - 2
D'i !0. 10
i liL' ,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
o
GERALD R\STONGE
705 BREEZEWOOD DR
MECHANICSBURG PA
17055
ESTATE OF
STONGE
*
REV-1547 EX AFP (06-05)
FOREST
R
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 09-05-2005
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
_n. K~l,;~.L1"1 l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-20-2001 AA496764 .01- 1.56
TOTAL TAX CREDIT 1.55
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
4.542.41
5,292.50
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
5,765.00
3.935.39
(11)
(12)
(13)
(14)
NOTE:
.00
34.52
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
~
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
9,834.91
9.700 39
134.52
100.00
34.52
(19)=
.00
1.55
.00
.00
1.55
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ( .
IF TOTAL DUE IS REFLECTED AS A "CREDIT'" (CR), YOU MAY BE DUE'; \ \
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) "
RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section Zl40 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S.
Section 9140).
PAYMENT:
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF WILLS, AGENT.
Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the appropriate county,
or the issuance of an Orphan's Court citation.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available
online at www.revenue.state.pa.us. any Register of Wills or Revenue District Office, or from the Department's
Z4-hour answering service for forms orders: 1-800-36Z-Z050; services for taxpayers with special hearing and/or
speaking needs: 1-800-447-30Z0 (TT only).
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Raview Unit, P.O. Box Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions or assessment of tax
(including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at
www.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appaals
P.O. Box Z810Z1, Harrisburg, PA 171Z8-10Z1. Petitions may not be faxed.
B) Election to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court.
OBJECTIONS:
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedant's death, a five percent [570) discount of
the tax paid is allowed.
PENALTY:
The 1570 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnasty period. This non-participation
penalty is appealable in the same manner and in the tha same time period as you would appeal the tax and interest
that has been assassed as indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from tha date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (670) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOS are:
Interest Daily Interest Daily Interest
Rate Factor Year Rate Factor Year Rate
~:1i'i"iim nllll-1991 ~:omn- ~ ~
1670 .000438 199Z 970 .000Z47 ZOOZ 670
1170 .000301 1993-1994 770 .00019Z Z003 570
1370 .000356 1995-1998 970 .000Z47 Z004 470
lOX .000Z74 1999 770 .00019Z ZOOS 570
970 .000Z47 ZOOO 870 .000Z19
Daily
Factor
.~
.000164
.000137
.000110
.000137
Year
mz
1983
1984
1985
1986
1987
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an intarest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interast computation date shown on the
Notice, additional interest must be calculated.
V3