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Home My WebLink About04-04-08 --.J 15056051047 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT County Code Year File Num ber 2 1 0 7 o 0 9 8 6 Date of Birth 19142 859 2 o 8 3 0 2 007 1 203 1 947 Decedent's Last Name Suffix Decedent's First Name MI DUN CAN S USA N C (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 XX 1 Original Return 4. Limited Estate 2. Supplemental Return 3 Remainder Return (date of death prior to 12-13-82) 4a, Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) 0 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under See. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) 6 Decedent Died Testate (Attach Copy of Will) 9 Litigation Proceeds Received CORRESPONDENT - THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number K E I THO. B R E N N E MAN 8 Firm Name (If Applicable) "J 4 4 W EST M A INS T R E E T I +- S N E L B A K E R & B R E N N E MAN P C First line of address ZIP Code r.,) ) " - J .) ,r! - :.--=-...~ - "~-I Second line of address ,~ n -0 ::0: City or Post Office State (,j.) C> M E C H A N I C S BUR G P A 1 705 5 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanYing schedules and statements, and to the best of my It IS true, correct and complete. Declaration of preparer other than the personal representative IS based on all mformation of which preparer has any and belief, ::6NRA~~~~~J~SI~.:~L~~..::~~R_~__... 232 Stoneh~~ge Lane, Mechanicsburg, s.IG.~~I~A:::o~.:::~~~~.::::::~~A:'V:_ ADDRESS , Administratrix ,_u ,.u.u.", ,.._,.,..,....w.." ~ >mn DATE 11 ttl~': PA 17055 '0?1 e miL_it ~.. ...... 44 West Main Street, Mechanicsburg, PA 17055 m"w...W_~~",w,_,',wmmm_"~_-_'.'~~_am_.__m'''u_''mmmm_' , 'mm~u',","',"'~,."~'" c..c.....~. PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ---1 Ln V ....J 15056052048 REV-1500 EX Decedent's Social Security r~umber Decedent's Name: Susan C. Duncan 191 4 2 8 5 9 2 RECAPITULATION 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. 5,1 8 2- 1 2 6 Jointly Owned Property (Schedule F) Separate Billing Requested 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . 7. 9. Funeral Expenses & Administrative Costs (Schedule H). 9. 2 6,2 6 8- ,- 0 .) 3 1 4 5 0- 6 2 4,4 3 8 _ 6 0 3 7,6 9 1 5 4 2,1 2 9. 7 5 , (1 0,6 7 9 1 3) - 8. Total Gross Assets (total Lines 1-7). ............. 8. 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. 0_ 0 0 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) XO_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X 12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE . . . . . . . . . . . . . . . . 19. 0_ 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 15056052048 ...J REV-1500 EX Page 3 File Number 21-07-00986 Decedent's Complete Address: DECEDENT'S NAME Susan C. Duncan STREET ADDRESS 375 Claremont Drive CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) -0- Total Credits (A + B + C ) (2) 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnterestJPenalty ( D + E ) 4 If Line 2 IS greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in avalon Page 2, Line 20 to request a refund. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) 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- 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: 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? ............................ .......................................... ..................... 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... ................. ............................. ................................................................. [Xl Yes .........0 .................0 ..............0 o No ~~ ~.] ~~ ~ [J 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. S9116 (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 PS. S9116 (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. s9116(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 PS. S9116(1.2) [72 PS. s9116(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 PS s9116(a)(1.3)]. A s:bling IS defined, under Sect:on 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-15G8 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Susan C. Duncan FILE NUMBER 21-07-00986 ESTATE OF 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 DESCRIPTION VALUE AT DATE OF DEATH 1. M&T Bank, checking account No. 523324655 $4,580.48 2. Fry Communications, employment benefit 387.29 3. Claremont Nursing and Rehabilitation Center, Guest Fund Account 4906 214.35 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,182.12 REV-1510 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Susan C. Duncan ITEM NUMBER 1. FILE NUMBER 21-07-00936 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH ACOPY OF THE OEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) Genworth Life and Health Insurance ~4,035.51 100% 14,035.5 Company, policy No. 028-3287-00 Transferee: Frances Stevick, sister of Decedent. Date of transfer: August 30, 2007 (date of death) 2. Western-Southern Life Annuities Transferee/beneficiary: Frances Stevick, sister of Decedent. Date of transfer: August 30, 2007 (date of death) a. Contract No. W0020603008 b. Contract No. W0020696286 110,415.79 5,852.71 100% 100% TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) -0- -0- 26,268.50 TAXABLE VALUE -0- $10,415.79 $15,852.71 REV-1511 EX+ (10-06). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Susan C. Duncan FILE NUMBER 21-07-00986 Debts of decedent must be reported on Schedule 1. ITEM NUMBER A DESCRIPTION ~,MOUNT FUNERAL EXPENSES: Malpezzi Funeral Home - grave marker $ 783.00 B. ADMINISTRATIVE COSTS: Personal Representative's Commissions waived Name of Personal Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attorney Fees to Snelbaker & Brenneman, P.C. 2,200.00 3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent 4 Probate Fees to Register of Wills ($75 and $15 additional probate fee) Accountant's Fees, miscellaneous filing fees and reserve 90.00 5. 1,000.00 6 Tax Return Preparer's Fees l24.00 7 Advertise grant of letters: a. Cumberland Law Journal: b. The Sentinel: $ 75.00 166.60 241.60 TOTAL (Also enter on line 9, Recapitulation) $ 4,1+38.60 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Susan C. Duncan FILE NUMBER. 21-07-00986 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Commonwealth of Pennsylvania, Department of Public Welfare, Estate Recovery Program I 2. Pennsylvania Department of Revenue - 2007 tax liability $37,686.15 5.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 37,691.15 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Susan C. Duncan NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Teresa J. Free 232 Stonehedge Lane Mechanicsburg, PA 17055 Frank Duncan 212 Barley Field Circle Carlisle, PA 17013 Rachel Mellott 6 Meadow Lane Newville, PA 17241 RELATIONSHIP TO DECEDENT Do Not List Trustee(s} Daughter Son Daughter FILE NUMBER 21-07-00986 AMOUNT OR SHARE OF [STATE 1/3 of residue 1/3 of residue 1/3 of residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET " NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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)