HomeMy WebLinkAbout04-10-08~ REV-1500 Ex (OS-o5)
PA DeparUrtenf of Revenue
Bureau of Individual Taxes
Po sox 280601
Harrisburg, PA 17128-0601
15056051058
OFFICU\L USE ONLY
County Code Year File Number
INHERITANCE TAX RETURN ~ I ,+~•~ Ol.l'~~
RESIDENT DECEDENT (.,1 "~
ENTER DECEDENT INFORMATION BELOW
Sociaf Security Number Date of Death
186-34-1121 07/02/2007
Decedent's Last Name
!Dupre
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Spouse's Sodal Security Number
Date of Birth
09/01/1942
Suffix Decedent's First Name MI
Diane E
Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
t~,7 1. Original Return ... ~., 2. Supplemental Return ~x'~`,°r 3. Remainder Return (date of death
prior to 12-13-82)
e.~ `; 4. Limited Estate ; „~: ~ 4a. Future Interest Compromise (date of w'~' 5. Federal Estate Tax Return Required
death after 12-12-82)
C~; 6. Decedent Died Testate =:':") 7. Decedent Mainteirted a Living Trust 0. __ 8. Total Number of Safe DeposR Boxes
(Attach Copy of III) (Attach Copy of Trust)
<'"";~ 9. Litiga8on Proceeds Received r-:'-,; 10. Spousal Poverty Credit (date of death .,......:< 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Stacey Wigton (248) 714-908 ° "~ ~
Finn Name (If Applicable)
__ _ ____. ~ ___~~ _
{:.~~ ~ j
.-
REGfSTER tt~# iNlii¢`ySE O~ ~ _~ `_
=- ~7 O
First line of address = c,r> %'` i c ~` ~-~
1 ` ' ~ r~
r 3
2306 Elkridge Circle - -
c~
Second line of address -=t • • ~ ,
r~ rv .-;.z
- N ii
City or Post Office State ZIP Code DATE FILED
Highland MI 48356
Correspondent's a-mail address: SWIgtOnep nOVI.k12.rn1.US
Under penalties of perjury, l deGare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief
it is true, correct and complete. Dedaretfon of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURE PERSON RESPO SIBLE OR F LING RETURN DATE
03/30/08
ADDRESS
2306 Elkridge Ci cle, Highland, 48356
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
15056052059
REV-1500 FCC
Decedent's Social Security Number
Decedents Nerve: Diane E Dupre
__ .. _._ 186-34-1121
_ _.
RECAPITULATION _ .
__
1. Real estate (ScheduleA) ............................................ . 1. 250,000.00
2. Stocks and Bonds (Schedule B) ...................................... . 2. 0.00
3. Cbsely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. 0.00
4. Mortgages & Notes Receivable (Schedule D) ............................ . 4. 0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 121,571.38
6. Joirrtly Owned Property (Schedule F) <~_ Separate Billing Requested ....... 6. 0.00
7. Inter-Yrvos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ~:w:'~ Separate Billing Requested........ 7. 180,467.46
8. Total Gross Assets (total Lines 1-7) .................................... 8. 552,038.80
9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................... 9. 15,445.92
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) ................ 10. 49,481.55
11. Total Deductions (total Lines 9 8 10) ................................... 11. 64,927.47
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 487,111.40
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ........................ 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 487,111.40
..........,,,, .,. _..~. ._ ,.:...., __.r.. ,~..~. _..... _.._. _
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 .0_ 15.
16. Amount of Line 14 taxable
at Bneai rate X .0 45 487,111.40 16. 21,920.01
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE ......................................................... 19. 21,920.01
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
15056052059
REV 1~i00 EX Page 3
Decedent's Complete Address:
F.IIe. Nurrl¢@G _
EDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER
Diane E Dupre 186-34-1121
S1TtEh_TADDRESS
1032 E. Winding Hill Rd
CITY
Mechanicsburg STATE
PA ZIP
17055
Tax (Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. CreditslPayments
a spousal Poverty credit
B. Prior Paym~rts
C. Discount
Total Credits (A+ B + C) (2)
3. InteresUPenafty'rf applicable
D. Interest
E. Penafly
Total IMerest/Penally (D + E )
4. N Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page Z, Line 20 to request a refund.
5. H 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.
(3)
(4)
(5)
(~)
B. Enter the total of Line 5 + 5a This is the BALANCE DUE. (5g)
Make Check Payable to: REGISTER OF WILLS, AGENT
21, 920.01
21,920.01
0.00
21,920.01
0.00
21,921.01
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 :.......................................................................................... ^
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^
c. retain a reversanary interest; or .......................................................................................................................... ^
d. receive the promise for life of effher 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? .............................................................................................................. ^
3. Did decedent own an "in trust fob' or payable upon death bank account or security at his or her death? .............. ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R 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. §9116 (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. §9116 (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. §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)].
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. §9116(a)(1.3)]. Asibling is defined, under
Section !3102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (8-98)
SCNEOVLE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Diane E Dupre
All nal property owned solely or as a tenant in common must be roported at falr 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 compeged to buy or sell, both having reasonable knowledge of the relevant facts.
(If more space is needed, insert additional sheets of the same size)
REV 1503 EX+ (6-96)
scNEOU~E s
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Diane E Dupre
All property Jolntly~owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
Diane E Dupre
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
(If more space is needed, insert additional sheets of the same size)
RE:V--1507 EX+ (6-98)
SCNEDVLE D
COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES
INHERITANCE TAX RETURN RECENAB~E
RESIDENT DECEDENT
E&TATE OF FILE NUMBER
Diane E Dupre
Ali property Jointly-owned with right ofsurvivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
REV 1508 Ex+ (6-98) SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS 8r. MfSC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Diane E Dupre
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property )oinUy-owned with fight of survivorahlp must be disclosed on Schedule F.
Il'EM VALUE AT DATE
INUMBER DESCRIPTION OF DEATH
1 Members 1st Federal Credit Union, 5000 Louise Dr,Mechanicsburg, PA Checking# 22821 3,573.98
2 Members 1st Federal Credit Union, 5000 Louise Dr,Mechanicsburg, PA Savings# 22821 5.00
3 Wrongful death/Survival Claim settlement - PA Dept of Revenue letter attached 100, 000.00
4 Furniture 3,000.00
5 Jewelry 500.00
6 Household Goods 1,000.00
7 Clothes 200.00
8 Car -totaled in acadent -insurance payout 13,292.40
TOTAL (Also enter on line 5, Recapitulation) s I 121,571.38
(If more space is needed, insert additional sheets of the same size)
REV 1509 EX+ (8-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDI~LE F
JOINTLY OWNED PROPERTY
ESTATE OF FILE NUMBER
Diane E Dupre
If an asset was made joint within one year of the decedenPs date of death, k must be reported on Schedule G.
SURVNING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A• None
B.
C.
JOINTLY-OWNED PROPERTY:
IITEM
NUMBER LETTER
FOR JOINT
TENIWT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME CF FINANCW.INSTITUTIDN ANO BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY+IELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % of
DECO'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENPS INTEREST
1. A. None
TOTAL (Also enter on line 6, Recapitulation) I S 0.00
(If more space is needed, insert additional sheets of the same size)
REV 1510 EX+ (6-88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEpt1LE !~
INTER-VNOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Diane E Dupre
This schedule must be completed and filed N the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITFJd
NUMBE DESCRIPTION OF PROPERTY
INCUIDE T11E NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDEMAND
THEDATEOFTWWSFERATTACHACOPYCFTHEDEEDFCRREALESTATE DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST EXCLUSION
QFAPPLICABL TAXABLE
VALUE
1• Prudential 41,626.01 100 41,626.01
2 RiverSource Funds -Ameriprise Acct#011535798877002 6,156.28 6,156.28
3 Riversource Funds - Atrteriprise Atxi#93104002876 9004 74,524.70 74,524.70
4 Thrift Savings Plan 58,160.47 58,160.47
TOTAL (Also enter on line 7 Recapitulation) S I 180,467.46
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
SCNEDVLE N
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Diane E Dupre
Debts of decedent must be reported on Schedule L
A. FUNERAL EXPENSES:
1' Neill Funeral Home
2 Memory Cards
3 Food
4 Flowers
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(suEIN Number of Personal Representative(s)
Street Address
City .State
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exempfion: (If decedent's address is not the same as daimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
z. Cost to maintain home and pay utilities -see attached
s Short Certs, Death Certs and Courthouse fees
9 House Appraisal
1 o Removal of junk
Zp
Zip
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
6,966.00
156.00
679.00
591.43
75.00
5,860.49
375.00
300.00
443.00
15,445.92
REV 1512 EX+ (12-03)
COMMONWEALTH Of PENNSYLVANIA
MIHERRANCE TAX RETURN
RESDENT DECEDENT
SCNEpVLE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Diane E Dupre
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbureed medical expenses.
(If more space is needed, insert additional sheets of the same size)
RE.V--1513 EX+ (9-00)
SCHEDI~ILE J
COMMONWEALTH OF PENNSriVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Diane E Dupre
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not Llst Trustee(s) OF ESTATE
f TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Stacey M Wigton, 2306 Elkridge Circle, Highland MI 48356 Daughter 50°~
Kelly J Macomber,12529 Day Girls Rd, Bishopville, MD 21813 Daughter 50%
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S
(If more space is needed, insert additional sheets of the same size)
t~ PRESSHARD. YOU ARE MAKING 3 COP/ES.
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