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Home My WebLink About02-06-08 (2) --.J 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 8 00001 Date of Birth 200227769 12222007 09091927 Decedent's Last Name Suffix Decedent's First Name MI ADAMS DONALD L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW a 1. Original Return 0 2. Supplemental Return o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-B2) 0 6. Decedent Died Testate 0 7. Dacedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telep~~ne Number. ._ JAMES M ROBINSON 717245~~8 --:_' Firm Name (If Applicable) TURO LAW OFFICES REGISTER oJ=.'wItl;.S US~:ONL Y j 0-. First line of address 28 SOUTH PITT STREET -;-1' -.",;':':' -- - r I ~--i o Second line of address , ...) C' '.,.. DATE FILED City or Post Office State CARLISLE PA ZIP Code 17013 Correspondent's e-mail address: j rob ins 0 n @ t u r 0 1 a w . com 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 pre parer other than the personal representative is based on all information of which preparer has any knowledge. SI A URE OF PER N SP SIBL FILING RETURN DAT Jonathan N. Adams James M Robinson 17013 Side 1 L 15056041147 15056041147 ~ --I 15056042148 REV-1500 EX Decedent's Name: ADAMS, DONALD L 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) 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. 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/Sec 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 ~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 82,930.23 16. 17. 18. 19. Tax Due......................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Decedent's Social Security Number 200227769 85,378.40 2,400.00 87,778.40 4,848.17 4,848.17 82,930.23 82,930.23 3,731.86 3,731.86 D 15056042148 -1 REV-1500 EX Page 3 Decedent's Complete Address: D ED NT' NAME Adams, Donald l -- ---..---------------- STREET ADDRESS 1700 North Market Street File Number 21 - 08 - 00001 CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,731.86 186.59 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 186.59 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 3,545.27 (5A) (56) 3,545.27 Total Interest/Penalty (D + 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. 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;.................................................................................. x b. retain the right to designate who shall use the property transferred or its income;.................................... x c. retain a reversionary interest; or.. ..................... .................. ...................... ................. .................. ................ x d. receive the promise for life of either payments, benefits or care?............................................................. x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. .................. .................. .... .................... ................ ........... ............ ... ............... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ! x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?......... ............ ... ..................... ................. .................... ...................... ... .......... ! x 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 orfor 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. *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Adams, Donald L ! FILE NUMBER J21 - 08 - 00001 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 DESCRIPTION VALUE AT DATE OF DEATH 85,378.40 Members 1st Federal Credit Union - Aeel. No. 214633 TOTAL (Also enter on Line 5, Recapitulation) 85,378.40 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Adams, Donald L FILE NUMBER 21 - 08 - 00001 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. - -r-- ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION Include the name of the transferee, their relationship to decedent I DECD'S TAXABLE VALUE NUMBER VALUE OF ASSET I INTEREST (IF APPLICABLE) and the date of transfer. Attach a copy of the deed for real estate. ---.-- :- 1 Franklin Templeton Investments Account 2.400.00 100% 0.00 2.400.00 TOTAL (Also enter on line 7, Recapitulation) 2,400.00 *' SCt-EDU.E H FlN:RAl.. EXPENSES & AIlWNSTRA11VE COSlS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Adams, Donald L , FILE NUMBER 21 - 08 - 00001 Debts of decedent must be reported on Schedule I. ~~- ITEM NUMBER FUNERAL EXPENSES: _._~- Auer Memorial Home & Cremation Services, Inc. AMOUNT DESCRIPTION A. 2 Raupp Funeral Home 3 Doris Matt - Organist at Funeral Service 4 Pastor Dennis Beamer 51st Lutheran Church Kitchen Fund - Food at Post-Funeral Luncheon B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Social Security Number(s) I EIN Number of Personal Representative(s): 2. Street Address City Year(s) Commission paid Attorney's Fees Turo Law Offices State Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Register of Wills Cumberland Law Journal The Sentinel - Legal 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Denise Sanders - Flowers TOTAL (Also enter on line 9, Recapitulation) 1,213.00 823.00 75.00 150.00 200.00 1,755.57 288.00 75.00 166.60 102.00 4,848.17