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Home My WebLink About04-14-08 -.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 7 00691 Date of Birth 204038171 07112007 01221918 Decedent's Last Name Suffix Decedent's First Name MI LEBO MELVA M (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 1m 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (date of death prior to 12-13-82) 0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Return Required (date of death after 12-12-82) 0 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 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 JAMES M ROBINSON 7172459688 Finn Name (If Applicable) TURO LAW OFFICES 28 SOUTH PITT STREET REGISTER OF WILLS USE ONLY ,...., = = co ):lot -0 :::u o Go <,. ~IJ . ~ J ..,~., .:,~() 5;~~ ...........) !:",:Q First line of address Sec:ond line of address ~ (:,.) .~r-l "Tl (~ r--- r"...... CARLISLE State PA ZIP Code 17013 ',," 00 ):P DAt€fI~D :x - ---I :g <:) .::- Citlf or Post Office 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 preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERS RESPON ISLE OR FllIN RETURN DATE Barry L. Shughart --i , 4 of' James M Robinson 0(1 treet, Carlisle, PA 17013 Side 1 L 15056041147 15056041147 ---1 -.J 15056042148 REV-1500 EX Decedent's Name: LEBO, MELVA M R.ECAPITULATION 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)................ 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)....................................................................... 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 110. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 111. 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. 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. 16. 17. 18. 156,635.94 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 204038171 117,000.00 5. 57,986.93 8. 174,986.93 13,589.09 4,761.90 18,350.99 156,635.94 156,635.94 23,495.39 23,495.39 D 15056042148 ---.J REV-1S00 EX Page 3 File Number 21 - 07 - 00691 Decedent's Complete Address: D : E Lebo, Melva M -----_....-------- -~-- -~----- .--..--- STREET ADDRESS 740 North College Street Carlisle rUST ATE I PA ZIP I 17013 CITY Tax. Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 23,495.39 Total Credits (A + 8 + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) 4. Ilf 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 S. 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. 8. Enter the total of Line S + SA. This is the BALANCE DUE. (3) (4) (S) (SA) (S8) 0.00 23,495.39 23,495.39 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;.................................................................................. Ll(J b. retain the right to designate who shall use the property transferred or its income;.................................... !xl c. retain a reversionary interest; or.................................................................................................................. ~ d. receive the promise for life of either payments, benefits or care?.............................................................. 'il(. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................. ..... Ix1 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D !xl, 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..... ............................... .............................. ..... ......................... ..................... lUX', 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 nalural 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.S) percent, ex(:ept 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 A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OJ= Lebo, Melva M i FILE NUMBER 121 - 07 - 00691 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 jointly-owned with right of survivorship must be disclosed on schedule F. VALUE AT DATE OF DEATH 117,000.00 ITEM NUMBER DESCRIPTION 1 740 North College Street, Carlisle, PA 17013 TOTAL (Also enter on Line 1, Recapitulation) 117,000.00 I I I I FILE NUMBER 121 - 07 - 00691 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lebo, Melva M 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 VALUE AT DATE OF DEATH --------~----~---- ------ ---------- 14,458.13 DESCRIPTION Citizens Bank Checking Account 610073-550-8 2 Citizens Bank Certificate of Deposit 6246-663651 17,449.84 3 Citizens Bank Certificate of Deposit 6247-706044 10.648.16 4 Citizens Bank Certificate of Deposit 6140-874998 15.000.00 5 Series E - U.S. Savings Bond C75 460 590 E 430.80 ____On TOTAL (Also enter on Line 5, Recapitulation) 57,986.93 . SCI-EDlLE H flt.ERAl... EXPENSES & AIl\IINSTRATIVE COSTS I I I FILE NUMBER I 21 - 07 - 00691 I I _--L_~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lebo, Melva M Debts of decedent must be reported on Schedule I. --~ --._~._---- ~ - ',- ITEM NUMBER I FUNERAL EXPENSES: ~.___ ~...~___u__._~.,___~~_ A. 1 Hoffman-Roth Funeral Home & Crematory Services DESCRIPTION AMOUNT 2 Cumberland Valley Memorial Gardens 3 I St. Matthews United Church of Christ - Post Funeral Reception 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 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills Cumberland Law Journal The Sentinel - Legal State Zip 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs TOTAL (Also enter on line 9, Recapitulation) 7,989.75 1,210.00 300.00 3,499.74 348.00 75.00 166.60 13,589.09 . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _.._~ .__.._-~ --~ -~-~- ! ---'-~"'-"'-----"--~----~-= :~r-----=----':-::::--- --~-====-----=.:::.:_- .1 FILE NUMBER ;21 - 07 - 00691 .....------L_..~.... _~_~_ ...~_.. ESTATE OIF Lebo, Melva M Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Miscellaneous Supplies Needed to Clean and Repair Home 24.70 2 Betra In-Home Care 3 Embarq - Telephone Service 4 PPL Electric Utilities 5 Bora of Carlisle - Water & Sewer service 6 Penns Wood Physical Therapy 7 Carlisle Area School District - School Taxes 8 Richard Farber - Lawn Care and Sidewalks 9 Waste Management - Dumpster 10 Expenses to Sell House 352.00 99.99 815.58 137.82 57.92 1,258.39 300.00 404.00 1,311.50 TOTAL (Also enter on Line 10, Recapitulation) 4,761.90