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Home My WebLink About04-25-08 REV-1500 EX + (6-00) ~- ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W () W C W I- ~~en uo::~ w 15U :I: 0::9 Uo..m 0.. <( DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) NEIBERT, MARGARET R. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 21 -08 0 2 3 2 COuNTYCOoE -YEA~ - - NUMsER- - SOCIAL SECURITY NUMBER 2 43- 1 2 - 4 5 5 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (date 01 deatl1 prior to 12-13-82) D 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTiAl TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS, III FIRM NAME (If Applicable) z o i= <t ..J :J !:: a.. <t () w ~ z o i= <t I- :J a.. :2: o () X <t I- 01/22/2008 09/06/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [Xl 1. Original Retum D 4. Limited Estate [Xl 6. Decedent Died Testate (AttachcopyoIWiII) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit (date oldeatl1 between 12-31-91 and 1-1-95) PA 17055 ~ -u 7:;l N ,--, , --, I- Z W C Z o 0.. en W 0:: 0:: o U 54 EAST MAIN STREET TELEPHONE NUMBER 717-697-4650 MECHANICSBURG J;:\" ::tr.: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Join~y Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X _(15) 13,373.16 X .045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) co .. W N (8) 26,571.24 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < ~ 12,793.49 404.59 (11) (12) (13) 13,198.08 13,373.16 (14) 13,373.16 0.00 601.79 0.00 0.00 601.79 Decedent's Complete Address: STREET ADDRESS 9 PINE HILL AVENUE CITY I STATE I ZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 601.79 30.09 Total Credits (A + B + C) (2) 30.09 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 571.70 571.70 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 IXI b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXI c. retain a reversionary interest; or ...................................................................................................... 0 IXI d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IXI 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 0 IXI 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 IXI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property w~ich contains a beneficiary designation? ....................................................................................................... 0 IXI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 PERSON RESPONSIBLE FOR FILING RETURN l ADDRESS PA ADDRESS MURREL R. WA TERS, III 54 EAST MAIN STREET, MECHANICSBURG PA 17055 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 3% [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 0% [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 0% [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 4.5%, 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 12% [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-150B EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF NEIBERT. MARGARET R. FilE NUMBER 21 08 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. 0232 ITEM NUMBER 1. . DESCRIPTION VALUE AT DATE OF DEATH 61.20 VERIZON REFUND 2. 2007 IRS TAX REFUND 410.00 3. .JANUARY PENSION 1,070.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,541.20 REV-1509 EX + (6-98) . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEIBERT. MARGARET R. FILE NUMBER 21 08 0232 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. KATE E. FEGAN 601 W. MAIN STREET DAUGHTER MECHANICSBURG, PA 17055 B c JOINTL Y.OWNED PROPERTY: LETTE R 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 DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 12/26/07 WACHOVIA 20,364.24 50. 10,182.12 CERTIFICATE OF DEPOSIT OPENED 8/20/07 FROM PRE.EXISTING 2006 CHECKING 2. A. 12/26/06 WACHOVIA 25,116.42 50. 12,558.21 CHECKING 3. A. 3/7/95 WACHOVIA 4,579.41 50. 2,289.71 CHECKING TOTAL (Also enter on line 6, Recapitulation) $ 25,030.04 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEIBERT. MARGARET R. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. 21 08 0232 ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. MYERS FUNERAL HOME 7,400.00 2. CUMBERLAND VALLEY MEMORIAL GARDENS (GRAVE OPENING) 245.00 3. JEFFREY'S FLOWERS (FUNERAL FLOWERS) 380.49 4. ANDREW BURD-HARRIS (MINISTER) 125.00 5. FUNERAL LUNCHEON 200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) KATE E. FEGAN 2,500.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 601 W. MAIN STREET City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: 2. Attorney Fees MURREL R. WALTERS, III 1,800.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 143.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 12,793.49 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEIBERT. MARGARET R. FILE NUMBER 21 08 0232 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. CENTRAL PENNA MRI CENTER MEDICAL 76.44 2. WEST SHORE EMS MEDICAL 98.29 3. VERIZON PHONE 70.86 4. H&R BLOCK 2007 TAX RETURNS 159.00 TOTAL (Also enter on line 10, Recapitulation) $ 404.59 (If more space is needed, insert additional sheets of the same size) RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. RUTH ANDRIONE Lineal 3,200.37 501 ANNESLlE ROAD BALTIMORE, MD 21212 2. MARY McGOWAN Lineal 3,200.37 610 LAKE DRIVE TOWSON, MD 21286-7833 3. KATE E. FEGAN Lineal 3,200.37 601 W. MAIN STREET MECHANICSBURG, PA 17055 4. SMITH NEIBERT Lineal 3,200.37 9 PINE HILL AVENUE MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRI BUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ e"~"" "'. I'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEIBERT MARGARET R SCHEDULE J BENEFICIARIES (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 08 0232