HomeMy WebLinkAbout03-03-08
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15056041125
REV-1500 EX (06-05)
P A Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, FA 17128-0601
ENTEIR DECEDENT INFORMATION BELOW
Social Security Number Date of Death
County Code Year
INHERITANCE TAX RETURN C) \ o?;;
RESIDENT DECEDENT ()\
File Number
0.30 (-j
Date of Birth
14401 3 1 8 7
1 2 1 9 2 0 0 7
04131917
Decedent's Last Name
Suffix
Decedent's First Name
MI
THO M P SON
CAR R I E
t~
(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 DUPUCA TE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[Z) 1. Original Return
o 4. Limited Estate
o
o
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty 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
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
o
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
C H A R L ESE PET R I E
>.-)
352 8 B R I S BAN S T R E E T
() . .'
REGISTER (i)i;~ILLS US~.G.NL y
Firm Name (If Applicable)
First line of address
I
c:;
.: ."'~
Second line of address
....0
City or Post Office
State
ZIP Code
DATE FILEOr.,
H A R R I S BUR G
P A
17111
Correspondent's e-mail address: PetrieLaw@AOLcom
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 tr e, correct and complete. Declaration of pre parer other than the personal representative is based on all information of which preparer has any knowledge.
J OF RSO RES B E OR LING RETURN DA TE
I . 2/15/200@'
MECHANICSBURG
PA 17050
DATE
2/15/200:1
SIG~~E~TH~ REPRESENTATIVE
ADDRESS
3528 BRISBAN STREET HARRISBURG
PLEASE USE ORIGINAL FORM ONLY
PA 17111
Side 1
L
15056041125
15056041125
---I
.-J 15056042126
REV-1500 EX Decedent's Social Security Number
CARRIE 1 4 4 0 1 3 1 8 7
Decedent's Name: M. THOMPSON 1.
REC:APITULA TION
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. 1 8 7 3 4 1 5
o Separate Billing Requested 2 1 0 4 3 8 8
6. Jointly Owned Property (Schedule F) 6. 1.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested . 7
8. Total Gross Assets (total Lines 1-7) 8. 3 9 7 7 8 0 3
9. Funeral Expenses & Administrative Costs (Schedule H) 9 9 3 5 2 2 1
"
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) . . 10.
11. Total Deductions (total lines 9 & 10) . 11. 9 3 5 2 2 1
12. Net Value of Estate (Line 8 minus line 11) 12 3 0 4 2 5 8 2
P Charitable and Govemmental Bequests/See 9113 Trusts for which
-'.
an election to tax has not been made (Schedlile J) 13.
14. Net Value Subject to Tax (Line 12 minus line 13) . . 14. 3 0 4 2 5 8 2
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
1 ~). Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(12) xo _ 0 0 0 15. 0 0 0
16 Amount of Line 14 taxable 3 0 4 2 5 8 2
at lineal rate xo~ 16. 1 3 6 9 1 6
17. Amount of Line 14 taxable 0 0 0
at sibling rate X .12 17. 0 0 0
18. Amount of Line 14 taxable 0 0 0
at collateral rate X .15 18. 0 0 0
19. Tax Due 19. 1 3 6 9 1 6
. .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L_
15056042126
15056042126
.-J
REV-1500 EX PagE! 3
Oecedent'!s Complete Address:
DECEDENTS NAME
CARRIE M. THOMPSON
----- -"-,-- -,.- - -'-'- -.-
STREET ADDRESS
114 MAPLE DRIVE
File Number
CITY
MECHANICSBURG
STATE
PA
ZIP
17050
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
1,369.16
68.46
Total Credits (A + B + C) (2)
68.46
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. 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)
0.00
0.00
1,300.70
5. If Une 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
A. Enter the interest on the tax due.
1,300.70
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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax retum 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 pare!nt, or a stepparent of the child is zero (0) percent [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 four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)J.
The tax rate imposed on the net value of transfers to or for the use at 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-1508 EX + (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHEFtITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARRIE M. THOMPSON
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of sUNivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
CHECKING ACCOUNT AT M & T BANK
VALUE AT DATE
OF DEATH
559.09
2.
HIGHMARK REFUND
191.59
3.
MET LIFE ANNUITY NO. M80-008-01
17,983.47
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
18734.15
REV-1509 EX + (6-98)
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SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARRIE M. THOMPSON
FILE NUMBER
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. NANCY L. BEARD
114 MAPLE DRIVE
MECHANICSBURG, PA 17050
DAUGHTER
B MICKEY M. WEHLER
215 W. SIMPSON STREET
MECHANICSBURG, PA 17055
DAUGHTER
c
JOINTL Y.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 DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'SINTERES
1. A. 12/2004 ORRSTOWN BANK CD #1730047231 22,285.68 33.33 7,427.82
2. A,B 12/2004 ORRSTOWN BANK ACCOUNT NO. 10980628 40,852.26 33.33 13,616.06
TOTAL (Also enter on line 6, Recapitulation) $ 21,043.88
T
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + ('12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHEHITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARRIE M. THOMPSON
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
{
FILE NUMBER
Debts of decedent must be reported on Schedule l.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. NEILL FUNERAL HOME 5,300.86
2. PEALERS FLOWERS 201.35
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) WAIVED
Social Security Numbe~s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Yea~s) Commission Paid:
2. Attorney Fees CHARLES E. PETRIE 350.00
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) 3,500.00
Claimant NANCY L. BEARD
StreetAddress 114 MAPLE DRIVE
City MECHANICSBURG State P A Zip 17050
Relationship of Claimant to Decedent DAUGHTER
4. Probate Fees
5. Accountanfs Fees
6. Tax Retum Preparers Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 9352.21
(If more space is needed, insert additional sheets of the same size)
REV."" '" "*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CARRIE M THOMPSON
SCHEDULE J
BENEFICIARIES
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS ~nclude outright s~sal distributions, and transfers under
Sec. 9116 (a){1. )]
1. MICKEY M. WEHLER lineal 13,649.25
~!15 W. SIMPSON STREET
MECHANICSBURG, PA 17055
2. NANCY L. BEARD Lineal 13,649.25
'114 MAPLE DRIVE
IVIECHANICSBURG, PA 17050
3. ROBERT L. THOMPSON Lineal 3,127.32
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
..
(If more space is needed, Insert additional sheets of the same size)