HomeMy WebLinkAbout01-16-08
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15056041125
REV -1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes ' . IN RITANCE TAX RETURN
PO BOX 280601 HE
Harrisburg, PA 17128-0601 R[:SIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
o 1 0 1
Date of Birth
182227360
0120200 7
10201928
Decedent's Last Name
Suffix
Decedent's First Name
MI
O'BRIEN
LILLIAN
c
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THrl RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
4a. Future In",rest Compromise (date of
death aftnl 12-12-82)
7. Decedent Maintained a Living Trust
(Attach C'lpy of Trust)
10. Spousal r '<Jverty Credit (date of death 0 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
FILL IN APPROPRIATE OVALS BELOW
[Xl 1. Original Return
o 4. Limited Estate
o
o
2. Supplemplltal Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
STEPEHN
J .
HOG G I E S QUI R E
717 245 2 698
Firm Name (If Applicable)
REGISTER OF WILLS~E ONLY
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1 9
(-
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1
First line of address
j'
S
HANOVER
S '1' . S T E
101
Second line of address
0\
'='
CAR LIS L E
P A
17013
tfATE FILEQ:'?
(..)
0\
City or Post Office
State
ZIP Code
Correspondent's e-mail address:SHOGG@NEXSPOT.Cr )M
Under penalties of perjury, I declare that I have examined this return, includir/) accompany!ng schedules and ~tatements, and to the best of my knowledge and belief,
it IS true, correct and complete. Declaration of preparer other than the person~1 representative IS based on allmformation of which preparer has any knowledge.
SIGNATUR F ~!3SDN REr:ONSIBLE FOR FILING RETURN DATE
.,> / & .-...;::::- I-J L-o'ij-'
6 arrtn 'n CL<K:". h3;
O'J~
REPRESENTATIVE
1/0/ rl
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041125
15056041125
-.J
--I
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: L I LL IAN C. 0' BR I EN
RECAPITULATION
182227360
2. Stocks and Bonds (Schedule B)
........ .. ...... . ......... ........ 2.
142000.00
28.74
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
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.
7747.84
398.13
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested. . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7) 8. 1 5 0 1 7 4 . 7 1
.......................... .
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 6 7 6 4 . 1 7
............... .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .. .. . .. .. . .. 10. 1 1 9 8 0 3 . 7 9
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 3 6 5 6 7 . 9 6
12. Net Value of Estate (Line 8 minus Line 11) 12. 1 3 6 0 6 . 7 5
........................ .
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. 1 3 6 0 6 . 7 5
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.O _ 0 0 0 15. o . 0 0
16. Amount of Line 14 taxable 1 3 6 0 6 . 6 1 0
at lineal rate X .012- 7 5 16. 2 . 3
17. Amount of Line 14 taxable 0 0 0 o . 0 0
at sibling rate X .12 . 17.
18. Amount of Line 14 taxable 0 0 0 o . 0 0
at collateral rate X .15 . 18.
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 6 1 2 . 3 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L
15056042126
15056042126
-1
REV-1500 c" eage 3
File Number
21 07 0101
Oecec;tent's Complete Address:
! rn:CEDENT'S NAME
: LILLIAN C, O'BRIEN
, sTREETADDRESS----------- ------
240 MCALLISTER CHURCH ROAD
_.
CITY
CARLISLE
! STATE
I PA
I ZIP
117015
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
612.30
Total Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
+. 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)
0.00
0.00
612.30
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
612.30
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 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 00
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)]. 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)]. 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-15p2 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
LILLIAN C. O'BRIEN
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 iointly-owned with riaht of survivorship must be disclosed on Schedule F.
FILE NUMBER
21 07 0101
ITEM
NUMBER
1.
DESCRIPTION
REAL ESTATE - 240 MCALLISTER CHURCH ROAD, CUMBERLAND COUNTY,
CARLISLE, PA 17015-
CUMBERLAND COUNTY COURTHOUSE - DEED BOOK V20, PG 619 (DOD DEED)
VALUE AT DATE
OF DEATH
142,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
142 000.00
REV-15?3 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
LILLIAN C. O'BRIEN
FILE NUMBER
21 07 0101
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
28.74
U.S. SAVINGS BOND
L598318366EE
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
28.74
REV-1908'EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
LILLIAN C. O'BRIEN
FILE NUMBER
21 07 0101
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.
ITEM
NUMBER
1.
5
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
DESCRIPTION
AUCTION PROCEEDS FROM SALE OF PERSONAL PROPERTY
VALUE AT DATE
OF DEATH
5,612.40
VET LIFE REFUND
28.72
GERBER LIFE REFUND
16.81
PEOPLES LIFE REFUND
28.62
COMCAST REFUND
0.63
STATE FARM REFUND
31.84
PROPERTY TAX REFUND
500.00
CASH CHRISTMAS GIFTS
325.00
ESTATE CHECKING ACCOUNT # 303172 - MAY 2007 INTEREST
0.89
ESTATE CHECKING ACCOUNT # 303172 JUNE 2007 INTEREST
1.01
ESTATE CHECKING ACCOUNT # 303172 JULY 2007 INTEREST
0.80
ESTATE CHECKING ACCOUNT # 303172 AUGUST 2007 INTEREST
0.97
ESTATE CHECKING ACCOUNT # 303172 SEPTEMBER 2007 INTEREST
14.66
ESTATE CHECKING ACCOUNT # 303172 OCTOBER 2007 INTEREST
15.15
COUNTY TAX REFUND FOR TAXES PD. IN ADVANCE (SETTLEMENT DATE 8/28/07)
$243.58/YR. 8/28/07 TO 1/1/08
84.09
SCHOOL TAX REFUND FOR TAXES PD. IN ADVANCE (SETTLEMENT DATE 8/28/07)
$1,290.80/YR. 8/28/07 TO 1/1/08
1,086.25
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
7747.84
REV-1?09'EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
LILLIAN C, O'BRIEN
FILE NUMBER
21 07 0101
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. MICHAEL O'BRIEN
4600 WARRINGTON AVENUE, APT. 3
MECHANICSBURG PA 17055
SON
B lEILANI BRANDT
832 MOUNTAIN ROAD
NEWVILLE, PA 17241
DAUGHTER
c
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A., B MEMBERS 1ST FEDERAL CREDIT UNION 413.36 137.78
CHECKING ACCOUNT# 49432-11
2. A,B MEMBERS 1 ST FEDERAL CREDIT UNION 779.94 259.98
SAVINGS ACCOUNT # 49432-00
3. A,B MEMBERS 1 ST FEDERAL CREDIT UNION 1.11 0.37
SAVINGS ACCOUNT # 49432-00 - INTEREST
TOTAL (Also enter on line 6, Recapitulation) $ 398.13
(If more space is needed, insert additional sheets of the same size)
,~EV-1511.:X . 1,.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
LILLIAN C. O'BRIEN
FILE NUMBER
21 07 0101
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HETRICK CREMATION SERVICES 1,032.96
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Michael E. O'Brien 7,507.22
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 4600 Warinqton Avenue
City Mechanicsburg State P A Zip 17055
Year(s) Commission Paid:
2. Attorney Fees Stephen J. Hogg, Esquire 7,507.22
3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 302.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Advertising
Cumberland Law Journal 75.00
Carlisle Sentinel 129.77
8. Filing Inheritance Tax Return 30.00
9. Filing Accounting (est) 180.00
TOTAL (Also enter on line 9, Recapitulation) $ 16764.17
(If more space is needed, insert additional sheets of the same size)
'REV-1512'EX + (12-03)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
LILLIAN C. O'BRIEN
FILE NUMBER
21 07 0101
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. COMMISSION FROM SALE OF REAL ESTATE
VALUE AT DATE
OF DEATH
8,520.00
2. BARRETT REAL ESTATE APPRAISAL
325.00
3. SETTLEMENT TRANSACTION FEE
195.00
4. SECURED LAND TRANSFERS - MECHANICSBURG
DEED PREPARATION
75.00
5. NOTARY FEE AT SETTLEMENT
10.00
6. REAL ESTATE TAXES
243.58
7. SECURED LAND TRANSFERS - MECHANICSBURG
PROCESSING/T AX CERTIFICATION
10.00
8. SECURED LAND TRANSFERS - MECHANICSBURG
OVERNIGHT MAIL
25.00
9. REALTY TRANSFER TAX
1,420.00
10. 2007/2008 SCHOOL TAXES
1,290.80
11. SELLER PAID BUYER CLOSING COSTS
4,000.00
12. MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - FEB. 2007
ACCOUNT #49432-02
524.00
13. MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - MARCH 2007
ACCOUNT #49432-02
524.00
14. MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - APRIL 2007
ACCOUNT #49432-02
524.00
15. MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - MAY 2007
ACCOUNT #49432-02
524.00
TOTAL (Also enter on line 10, Recapitulation) $
119.803.79
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LILLIAN C. O'BRIEN
Decedent's Name
Page 1
21 07 0101
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
28.
30.
DESCRIPTION
MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - JUNE 2007
ACCOUNT #49432-02
AMOUNT
524.00
MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - JULY 2007
ACCOUNT #49432-02
524.00
MEMBERS 1ST FED. C.U. - HOME EQUITY LOAN PAYMENT - AUGUST 2007
ACCOUNT #49432-02
524.00
MEMBERS 1ST FEDERAL CREDIT UNION - MORTGAGE LOAN PAYOFF
54,469.89
PEOPLES LIFE INSURANCE COMPANY - PREMIUM JANUARY 2007
14.31
PEOPLES LIFE INSURANCE COMPANY - PREMIUM FEBRUARY 2007
14.31
SEARS - (AGREED TO ACCEPT 60% OF THIS AMT.) $168.90
(NOTICE OF CLAIM FILED FOR FULL AMOUNT)
316.27
AMERICAN EXPRESS (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
9,550.94
FASHION BUG (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
215.32
BON TON (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
1,459.38
KMART (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
367.44
WELLS FARGO
1,292.00
HFC (SETTLEMENT AGREED AT $7239.40)
(NOTICE OF CLAIM FILED FOR FULL AMOUNT)
10,342.00
LOWES (AGREED TO 50% OF BAL. OF $652.83)
326.41
WAL-MART
882.86
SUBTOTAL SCHEDULE I
80,823.13
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LILLIAN C. O'BRIEN
Decedent's Name
Page 2
21 07 0101
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
DESCRIPTION
DISCOVER (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
AMOUNT
14,791.70
BANK OF AMERICA (NOTICE OF CLAIM FILED FOR FULL AMOUNT)
1,455.88
ESTATE CHECKING ACCOUNT #303172 CHECK FEE
10.95
PP&L - JANUARY 2007
342.67
PP&L - FEBRUARY 2007
315.32
PP&L - MARCH 2007
324.45
PP&L - APRIL 2007
160.04
PP&L - MAY 2007
68.74
PP&L - JUNE 2007
33.32
PP&L - JULY 2007
34.28
PP&L - AUGUST 2007
26.76
PP&L - SEPTEMBER FINAL BILL
9.86
EMBARQ - JANUARY 2007
31.15
EMBARQ - FEBRUARY 2007
31.15
EMBARQ - MARCH 2007
31.07
SUBTOTAL SCHEDULE I
17,667.34
. .
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LILLIAN C. O'BRIEN
Decedent's Name
Page 3
21 07 0101
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
46. EMBARQ - APRIL 2007 31.07
47. EMBARQ - MAY 2007 14.15
48. PINNACLE HEALTH - CO-PAY 25.00
49. WALNUT BOTTOM RADIOLOGY - CO-PAY 25.00
50. WALNUT BOTTOM RADIOLOGY - CO-PAY 25.00
51. TUCKEY MECHANICAL SERVICES - HEATING SYSTEM MAINTENANCE 161.82
52. TUCKEY MECHANICAL SERVICES - HEAT PUMP REPLACEMENT 135.32
53. OUTDOOR WORLD - TIMESHARE ANNUAL DUES 102.00
54. TIME SHARE ADVERTISING 399.00
55. STATE FARM INSURANCE 272.46
56. TORY ROCKWELL - ESTATE LAWN MAINTENANCE (7 VISITS @$30.00) 210.00
57. TRACTOR SUPPLY COMPANY - WATER SOFTENER SALT 21.12
58. JEFF SANDERSON - CONTRACTOR - HOME REPAIR ON ESTATE 1,681.00
SUBTOTAL SCHEDULE I 3,102.94
GRAND TOTAL SCHEDULE I $ 119.803.79
RELA TIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a)(1.2)]
1. MICHAEL E. O'BRIEN Lineal 25%
4600 WARRINGTON AVENUE, APT. 3
MECHANICSBURG PA 17055
2. LEILANI J. BRANDT Lineal 25%
832 MOUNTAIN ROAD
NEWVILLE, PA 17241
3. JODY L. GILBERT Lineal 25%
26 CHESTNUT STREET
NEWVILLE, PA 17241
4. RICHARD A. OBRIEN Lineal 25%
2501 PERTH DRIVE
EDMOND, OK 73013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
"'~""'" '"*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LILLIAN C O'BRIEN
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 07 0101
(If more space is needed, insert additional sheets of the same size)