HomeMy WebLinkAbout01-16-08 (3)
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15056041147
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
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 5
0232
Date of Birth
202 20 1164
03 03 2005
02 24 1928
Decedent's Last Name
Suffix
Decedent's First Name
MI
MOWERY
RICHARD
S
(If Applicable) Enter Surviving Spouse's Infonnatlon Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
MOWERY
CAROL
J
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
FILL IN APPROPRIATE OVALS BELOW
D 1. Original Return [!] 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[!] 6. Decedent Died Testate 00 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal Poverty Credit (date of death D 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 Daytime Telephone Number
EDWARD P. SEEBER ESQ. 717 533 3280
Finn Name (if Applicable)
JAMES, SMITH, DIETTERICK ,
REGISTER OF WILLS USE ONLY
SUITE 204, 5020 RITTER ROAD
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First line of address
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Second line of address
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DATerlLED
City or Post OffIce
State
ZIP Code
17055
MECHANICSBURG PA
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Correspondent's e-mail address:eps@jsdc.com
lJ!,der 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,
It IS true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI TURE 0 RSjONj?fX'ONSIBLE FOR FILING RETURN DATE
V vi, Carol J. Mowery 0/ -I 0 -0 g
DATE
Edward P. Seeber Esq.
Ite 204, 5020 Ritter Road, Mechanlcsburg, PA 17055
Side 1
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15056041147
15056041147
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15[]5b[]42148
REV-1500 EX
Decedent'sName: Richard S. Mowery
Decedent's Social Security Number
202 20 1164
RECAPITULATION
1. Real Estate (Schedule A}.......................................................................................... 1.
2. Stocks and Bonds (Schedule B}............................................................................... 2.
3. Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C}.......... 3.
4. Mortgages & Notes Receivable (Schedule D}.......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E}................ 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7}....................................................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H}......................................... 9.
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, of
transfers under Sec. 9116
(a}(1.2)X.00 2,481.86 15.
16. Amount of Line 14 taxable
at lineal rate X .045 0 . 0 0 16.
17. Amount of Line 14 taxable
atsiblingrateX.12 0.00 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 00 18.
19. Tax Due.......................... ............................ ................................... ...................... ...... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15[]5b[]42148
2,511.86
2,511.86
30.00
30.00
2,481.86
2,481.86
0.00
0.00
0.00
0.00
0.00
D
15[]5b[]42148
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-05-0232
DECEDENT'S NAME
Richard S. Mowery
STREET ADDRESS
168 Kerrs Road
CITY I STATE IZIP
Carlisle PA 17013
G
G
(
(
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
(
Total Credits (A + B + C)
(2)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 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.
0.00
0.00 (
Make Check Payable to: REGISTER OF WILLS, AGENT
[
[
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.. ..... ............................ .......................... ......................................... ........ ....... D [!]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;..................................................................................
b. retain the right to designate who shall use the property transferred or its income;....................................
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? ............. ................................................ .......................................... ................
Yes
[!]
[!]
[!]
[!]
No
D
D
D
D
Di
[!]
[!]
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)]. 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 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)]. 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.
Rev-1507 EX+ (8-98)
*'
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mowery, Richard S.
FILE NUMBER
21-05-0232
ESTATE OF
All property Jolntly-owned with right of survivorship must be dIsclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 10/3/07
VALUE AT DATE
OF DEATH
837.29
2 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 12/6/07
837.29
3 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 1/10/08
837.28
TOTAL (Also enter on Line 4, Recapitulation)
2.511.86
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule D (Rev. 6-98)
REV-1161 EX" (12-11'
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mowery, Richard S.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-0232
ESTATE OF
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2.
Attorney's Fees
James, Smith, Dletterlck & Connelly
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Carol J. Mowery
Street Address 168 Kerrs Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent Spouse
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
30.00
TOTAL (Also enter on line 9, Recapitulation)
30.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev. 6-98)
Rev-1602 EX..(8-98)
*'
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery, Richard S.
I FILE NUMBER
21-05-0232
1
DESCRIPTION
Register of Wills, Cumberland County - filing fee for supplemental PA Inheritance
Tax Return & Inventory
AMOUNT
ITEM
NUMBER
30.00
Subtotal
30.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
. . .
REV 1613 EX+ (9.00)
ESTATE OF
NUMBER
I.
1
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mowery, Richard S.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-05-0232
RELATIONSHIP TO
DECEDENT
Do Not List Trustee'.'
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
Carol J. Mowery
168 Kerrs Road
Carlisle, PA 17013
Spouse
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
ll. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Copyright (c) 2002 form software only The Lackner Group, Inc.
TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Form PA.1500 Schedule J (Rev. 6-98)
0.00
2,481.86
2,481.86