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Home My WebLink About06-09-082EV-1500 EX (6-OOi OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 - 06 0196 _ _ couNrr cooE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Z Eisenhauer Helen B 180-26-5904 W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W 2/28/2006 11/24/1934 REGISTER OF WILLS W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER D ~ 0 1 inal Retum Ori ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-t3-e2) ¢N U aU g . ~ 4 Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-s2) ~ 5. Federal Estate Tax Return Required U am ~ 6. Decedent Died Testate (Attach copy of will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes a d i d 0 Credit ousal Povert th b t e at st ana t-t- 0 10 t r d ~z S d 11 Election to tax under Sec 9113(A)iAttacn sin o. es ¢ ve s Rece 9. Litigation Procee y e en - . i a e o ea w - p . . l THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z NAME COMPLETE MAILING ADDRE SS w °z Richard C. Snelbaker 44 West Main Street a FIRM NAME (If Applicable) Snelbaker & Brenneman, P .C. Mechanicsburg, PA 17055 O TELEPHONE NUMBER 717-697-8528 1. Real Estate (Schedule A) (1) 0 • 0 U C'? OFFICIAL USE`,t~l-Y - ` ' ~' C_ ~ ~ -~ 2. Storks and Bonds (Schedule B) (2) 967 . 05 - 7 ~ ~ J ~ 3. Closely Held Corporation, Partnership orSole -Proprietorship (3) 0.00 ; n~ ~ ; - 4. Mortgages & Notes Receivable (Schedule D) (4) ~.~ ^O 5. Cash, Bank Deposits & Miscellaneous Person al Property (5) ~ . ~~ -~ n t .'' ~ c (Schedule E) ~ O 6. Jointly Owned Property (Schedule F) (6) 0 ~ 0 0 y` ~ i- Separate Billing Requested Q c r. e:.....ll-... e..~.r I.In.. DrnV~ofu Prn oriv 771 0 •. 00 H a Q U w Z O 4 F a 0 U X a F- 11. Total Deductions (total Lines 9 & 10) (11) 515.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 452.05 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been 0.00 made (Schedule J) (13) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 515.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0 • ~~ 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 452.05 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) 16. Amount of Line 14 taxable at lineal rate ~ • 00 x .0 ~ (15) 452.05 x.o 45 (1s) 17 Amount of Line 14 taxable at sibling rate ~ • ~~ x .12 (17) 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) 19. Tax Due (19) • • a• • 20. 967.05 0.00 20.34 0.00 0.00 20.34 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3 W 4645 1.000 decedent's Complete Address: STREET ADDRESS 43 W. Keller Street, Mechanicsburg Cumberland County CITY STATE ZIP Mechanicsburg PA 17055- Tax Payments and Credits: 1 . Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 2.27 0.00 (1) 20.34 Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty (D + E) (3) 2 • 27 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: REG/STEROFWILLS, AGENT 0.00 22.61 0.00 22.61 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 reversionary interest; or ~ L~ d. receive the promise for life of either payments, benefits or care? ~ 0 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 for" or payable upon death bank account or security at his or her death ? ~ 0 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 7HE ABOVE QUESTIONS 15 YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I tlecl are that 1 have examined this return, inGUding accompanying schedules antl statements, and to the best of my knowledge and i !, it is true, correct and complete. Declaration of prep arer other than the personal representative is based on all information of which preparer has any knowledge ~ Co-Executor R. Eisenhauer, Co-Executor Richard C. Snelbaker, Esquire 44 West Main Street, Mechanicsburg, PA 17055 For dates of death on or after July 1 1994 and befiore 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. § 9916 (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. £ 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 fling 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°fo [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 4.5 % ,except as noted in 72 P:S. ~ 9116(1.2) [72 P.S. F 9116(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. § 9116(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. 3 W 4646 1.000 REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen B. Eisenhauer 21 06 0196 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 3wasss ~ o00 (If more space is needed, insert additional sheets of the same size) REV-?511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen B. Eisenhauer 21 06 0196 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ None B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) 2 3 Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7 1 Register of Wills filing fee for Supplemental Inheritance Tax Return SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 500.00 15.00 TOTAL (Also enter on line 9, Recapitulation) ~ $ 515.00 3W46AG 1.D00 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+(9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Helen B. Eisenhauer 21 06 0196 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 outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Lynn R. Eisenhauer 191 Pinetown Road Leola, PA 17540 One Half of Residue: 226.03 Son 226.03 2 Cindy Lou E. Poorman 2087 South Olathe Street Aurora, CO 80013 One Half of Residue: 226.03 Daughter 226.03 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 11 ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ $ 0.00 (If more space is needed, insert additional sheets of the same size) 3W46AI 1.000