HomeMy WebLinkAbout05-12-08 (2)J 15056041125
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue Coun Code Year File Number
Bureau of Individual Taxes t1'
PO BOX 280601 INHERITANCE TAX RETURN i
Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~~ O ~ ZI~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 2 1 6 2 0 0 8 0 1 1 2 1 9 2 4
Decedent's Last Name
E D D Y
Suffix Decedent's First Name
P R I: S C I L L A
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
O 1. Original Return
4. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
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
between 12-31-91 and 1-1-95)
State ZIP Code
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
K E N D R A A M O H R 7 1 7 9 4 4 1 3 3 3
Firm Name (If Applicable)
P A N N E B A K E R & M O H R P C.
First line of address
4 0 0 0 V I N E S T R E E T
Second line of address
City or Post Office
M I D D L E T O W N
MI
A
MI
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
REGISTER OF WILLS U NL Y
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Correspondent's a-mail address: KENDRA(a~PANNEBAKERLAW.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 allinf ation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN neZC'
ADDRESS
KEVIN M. EDDY AND STEPHEN G. EDDY ~'
SIGNATU EP ER OTHER AN REPRESENTATIVE -- DAT
' a
ADDRESS
4000 VINE STREET MIDDLETOWN --- PA 17057
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056041125 15056041125 J
15056042126
REV-1500 EX
Decedent's Name: PRISCILLA A. EDDY
Decedent's Social Security Number
RE CAPITULATION
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.
~ 0 1 2 3 0 6
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... ... 5. ,
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines 1-7)
........................
... 8. 7 0 1 2 3, 0 6
9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9• 8 3 8 5 , 5 5
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 5 4 7 3 , 5 7
11. Total Deductions (total Lines 9 & 10) ........................ ... 11. 1 3 8 5 9 , 1 2
12. Net Value of Estate (Line 8 minus Line 11) .....
................. . , . 12. 5 6 2 6 3 , 9 4
13. Charitable and Governmental Bequests/Sec 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. 5 6 2 6 3 • 9 4
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 0 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 5 6 2 6 3 9 4 1s
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
0 0
0
at collateral rate X .15 18
19. Tax Due .............. ........................... ..... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 15056042126
0. 0 0
2 5 3 1. 8 8
0. 0 0
0. 0 0
2 5 3 1. 8 8
^X
15056042126 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
0 0
DECEDENT'S NAME
PRISCILLA A. EDDY
STREET ADDRESS
1441 HILLCREST CT, APT 212
CITY ~ STATE ~, ZIP
CAMP HILL PA ~I 17011
Tax Payments and Credits:
1 Tax Due (Page 2 Line 19) (1)
2. Credits(Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount 126.59
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E )
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.
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.
B. Enter the total of Line 5 +5A. This is the BALANCE DUE.
(3)
(4)
2,531.88
126.59
0.00
0.00
(5) 2,405.29
(5A)
(58)
Make Check Payable fo: REGISTER OF WILLS, AGENT
2,405.29
PLEASE ANSV'JER THE 1=0LLOVl1lNG Q!lESTlONS SY PLACING AN "X" !N THE APPRrJPRIATE SLL'CKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred : ...................................................................... ^ ^X
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ X^
c. retain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^ X^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ ^X
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ X^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. ^ 0
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. §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 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)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8c MASC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PRISCILLA A. EDDY 0 0
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
1. WACHOVIA BANK ACCOUNTS # 1000604231805 AND 3060980715452
2. (AUTO INSURANCE REFUND
3. (TOYOTA CAMRY
TOTAL (Also enter on line 5, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
62,740.06
588.00 1
6,795.00 ~
70,123.06
REV-1511 EX + (10-06)
e
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PRISCILLA A. EDDY
ITEM
NUMBER
A.
1.
2.
B.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
PARTHEMORE FUNERAL HOME
FUNERAL MEAL
FILE NUMBER
0 0
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
2.
3.
City State Zip
Year(s) Commission Paid:
Attorney Fees PANNEBAKER & MOHR, P.C.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4.
5.
6.
7.
8.
9.
10
City State Zip
Relationship of Claimant to Decedent
Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS
Accountant's Fees
Tax Return Preparers Fees CHARLES D. KOKOSKI- 2007 PERSONAL INCOME TAX
RETURN
CUMBERLAND COUNTY LEGAL JOURNAL- ESTATE AD
THE SENTINEL- ESTATE AD
COMMONWEALTH OF PA-TITLE TRANSFER
PA AUTO BROKERS- TITLE TRANSFER
AMOUNT
3,982.42 I
200.00
3,506.15
174.00
165.00
75.00
214.48
28.50
40.00
TOTAL (Also enter on line 9, Recapitulation) I $ 8.385.55
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
r
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT f
ESTATE OF FILE NUMBER
PRISCILLA A. EDDY 0 0
Report debts incurred by the decedent prior to death vuhich remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. COUNTRY WALK- APARTMENT RENT 805.00
2. WEST SHORE EMS- AMBULANCE 876.99
3. BONNIE K. MILLER, TREASURER- CAMP HILL TAXES 9.30
4. PP&L 109.50
5. COMCAST 12.81
6. SHEPHERDSTOWN FAMILY PRACTICE 86.30
7. CITIBANK 188.09
8. AT&T 36.50
9. AT&T 50.45
10. COUNTRY WALK- APARTMENT RENT 805.00
11. ERIE INSURANCE- APARTMENT INSURANCE 40.00
12. PHILLIPS AND COHEN ASSOCIATES-CITIBANK BALANCE 25.90
13. IRS- 2007 PERSONAL INCOME TAXES 258.00
14. PP&L 52.84
15. AT&T 36.71
TOTAL (Also enter on line 10, Recapitulation) I S 5 473 57
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PRISCILLA A. EDDY
Decedent's Name
Page 1
File Number
Schedule I -Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. HOLY SPIRIT HOSPITAL 1,032.16
17. HARRISBURG MOVING AND STORAGE 773.02
18. PAUL BAHN- REMOVE TRASH FROM HOME 200.00
19. PP&L 75.00
SUBTOTAL SCHEDULE I 2,080.18
GRAND TOTAL SCHEDULE I $ 5,473.57
REV-1513 EX + (g_00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
PRISCILLA A. EDDY 0 0
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 [include outrightspousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. KEVIN M. EDDY Lineal ~Q `lL
311 WALTON STREET
LEMOYNE, PA 17043
2. STEPHEN G. EDDY Lineal ~(~ ~~~
705 CEDAR RIDGE LANE
MECHANICSBURG, PA 17055
I 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 ~ $
(If more space is needed, insert additional sheets of the same size)
REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death: _ 2,531.88
Discount: __ 126,59
Interest Table
` !Days Delinquent ~ Balance Due ~ Interest
Year i this tim e period this year _ this period
-
__
3efore 1981
_
1982
1983 ______-{-__
I ---
--- ~
-- - _ _
~ _
_
I
_
1984 ~ ~ - j
__ _
1985 ~ __ i
1986 _ _ ---
L _ -----
___
1987
.._, _- --__--
1988 throug h 1991 _-_-__ ,L ___ -~
1992
(993 throug -~
h 1994 1 __- __
--_
~ ---
1995 throug h 1998-
1999
-- ~ --
2000
- --- j
2001 _ _ _ - _ ~
2002
_ __
2003
_,~'
__
2004
--- - -
2005
2006 --
2007
2008
-- -
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17, 1996:
Penalty: _--_____-- -