HomeMy WebLinkAbout06-05-08
15056041169
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
Poaoxzsosol INHERITANCE TAX RETURN ~ 0 ~ [ ~ ~~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~,ic.
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
164541978 02142008 08131919
Decedent's Last Name Suffix Decedent's First Name MI
EURICH VIOLET I")
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE BOXES BELOW
® 1. Original Return
4. Limited Estate
n 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)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number rv
RONALD W EURICH 717-766~~80 co
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Firm Name (If Applicable) REGISTER SUS
First line of address
1114 E COOVER STREET
Second line of address
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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)
City or POSt Office State ZIP Code ~ DATE FILED
MECHANICSBURG PA 17055
Correspondent's a-mail address
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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 DATE ,,eems~
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ADDRESS
1114 E COJO~VER STREET, MECHANICSBURG, PA 17055
SIG--~`L~RER~HA REPRESENTATIVE DATE
43 VEST MAIN STREET, MECHANICSBURG, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041169 15056041169 J
15056~4216~
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: VIOLET M EUR I CH 16 4 5 419 7 8
RECAPITULATION
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) ........ 5. 7 6 , 4 8 4 . 7 7
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 6 , 4 8 4 . 7 7
9. Funeral Expenses & Administrative Costs (Schedule H) ................. .... 9. 8 5 0 . 0 7
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ ... 10. 2 , 6 8 9 . 2 2
11. Total Deductions (total Lines 9 & 10) ............................... ... 11. 3 , 5 3 9 . 2 9
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 7 2 , 9 4 5 . 4 8
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. 7 2 , 94 5 . 4 8
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 lineal rate x .04_5 72 , 94 5 . 4 8 16. 3 , 2 82.55
17. Amount of Line 14 taxable
at sibling rate x .12 17.
18. Amount of Line 14 taxable
at collateral rate x .15 ~u
19. TAX DUE ........................................................ 19.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
3,282.55
Side 2
15~5604216~ 15056042160 J
REV-1500 EX Page 3 File Number
1'hnee~enf'D~ (_mm~lntn ~flrll'P_CC_
Vii Yi-iMV~~i V •~~~..• ~ • .w w. ~~~•
DECEDENT'S NAME
VIOLET M EURICH
STREETADDRESS
1114 EAST COOVER STREET
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (t)
2. Credits(Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greaser 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. (56)
3,282.55
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 : ........................................ . . ^ 0
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? .................................................. .. ^
3. Did decedent own an "intrust for" 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 1S 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.
3,282.55
0.00
0.00
3,282.55
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
VIOLET M EURICH
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.
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
VIOLET M EURICH
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~ COCKLIN FUNERAL HOME 365.07
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State ZIP
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
StreetAddress
City State
Relationship ofClaimant to Decedent
ZIP
4.
5.
6.
~.
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
485.00
TOTAL (Also enter on line 9, Recapitulation) $ 8 5 0 . 0 7
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
VIOLET M EURICH
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
VIOLET M EURICH
RELATIONSHIPTODECEDENT AMOUNT OR SHARE
NUMBER NAMEANDADDRESS 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 RONALD W EURICH SON 100
1114 E COOVER STREET
MECHANICSBURG, PA 17055
ENTER DOLLARAMOUNTS FOR DISTRIBUTIONS SHOWNABOVE ON LINES 15 THROUGH 1 8,AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICHAN 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)
LAS1^ l^IILL AT3D TESTAT•ZET1T OF VIOLET T~~I. EURICH
T, VIOLET I~7. EURICH, of the Borough of I~geehanicsburg,
County of Cumberland and. State of Pennsylvania, being of sound
and disposing mind, riemory and understanding, do make, publish
and declare this my Last ~~Till and Testament! hereby revoking and
making void any and all prior Wills by me at any time heretofore
_ _ ----- mada
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can be conveniently
done .
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever
and V~heresoever the same may be situate, to my son, RUidALD 'v~I.
EURICH, absolutely and unconditionally.
LASTLY, I nominate, constitute and appoint my son, ROT~ALD
W. EURICH, Executor of this my Last dill and Testament, and direct
that he be excused from posting bond or other security for the
faithful performance of his duties in any jurisdiction.
-1-
TI~t i~7ITT~lESS 1~7i3~?EOF, I have hereunto set my hand and seal
,,
this .;L f day oz'' P~ ovember, ~4,. D. , 199LE..
~~LG~ ~~ C ~~%'7tir%~~ ~ (SEAL )
Violet ~i. Euricta:
Signed, sealed, published and declared by the above
named, VIOLET i-i. EUP~IC~I, as and for her Last Mill and Testsanent,
in the presence of us, who have subscribed our names hereto as
witnesses, at the request of said testatrix, in her presence and
in the presence of each other.
-2-
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
I, ~TIOLET 's. TtJRIC~ the testat ri:~
whose name is signed to the attached or foregoing instrument, having
been duly qualified according to Iaw, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary act and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me ~Y -,:
~1'T4I~E~' ~~_ as . T s~I the testatri,X this ,,` >` "
clay- of 1.''OJ~~2~JS~' A. D. s 3c}~1~...
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COMMONWEALTH OF PENNSYLVANIA ) ~~~~~f~ ~
SS. Assocaabonof~
COUNTY OF CUMBERLAND )
We, the undersigned, `~• ~i~~l~~ i~7`i:~]U i'
and -~I?`~ :~. LEVE~t~~~??.GE~t the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the
testat r==X VIOLET .''r.. .~t7RTC~-I sign and exe-
cute the instrument ash/her Last Will and Testament; that the
said testat r ZX , VIOLET '~. !~UR.iC~. executed it as
/her free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testatriX _, signed
the Will as witnesses; and that to the best of our knowledge, `the
testaY~j~X was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
Sworn and subscribed to before`' ~. ~, _.. ~~'
me this -; ~ ~ day of
~Tove~~er 1g~1~ • ~:
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