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Home My WebLink About06-13-0815056041,125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 _ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ \ 6 ~ bOld~D ENTER DECEDENT INFORMATION BELOW Soc:ial Security Number Date of Death Date of Birth 2 0 9 1 2 7 3 4 8 0 1 0 2 2 0 0 6 0 8 1 6 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI H I N K L E A N N A 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 QF WILLS FILL IN APPROPR{ATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch, O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number C H A R L E S E P E T R I E 7 1 7 5 6 1 1 9 3 9 Firm Name (If Applicable) _ __ _. _ ~ o REGISTEf~O~IILLS USLEANLY • ',, ~ ~1` First line of address ~ m ~ n-;-y r ~ .: c_u7 3 5 2 8 6 R 1 S B A N S T R E E T ~ ` ~ :. Second line of address ~` ~~'~ ~ ~_' ^, .__ -~' '' City or Post Office State ZlP Code _ DATE FILED ~ H A R R l S B U R G P A 1 7 1 1 1 Correspondent's a-mail address: Petr'ieLaW@AOL.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 a~complete. Declaration of preparer other than the personal representative is based on a8 information of which preparer has any knowledge. SIGNATURE RSON RESPONSA~LE-FOR FILING RETURN nnTC / ~ ADDRESS 125 DILLER ROAD NEW CUMBERLAND PA 17070 SIGN9jUR F PRE R~ OTH~2~N REPRESENTATIVE DATE ADDRE;iS ~C/ 3528 E3R{SBAN STREET HARRISBURG PA 17111 PLEASE USE ORIGINAL FORM ONLY Side 1 15(156[141125 151156041125 15D56D42126 REV-1500 EX Decedent's Social Security Number Decedent's Name: ANNA M. HINKLE 2 0 9 1 2 7 3 4 8 RE CAPITULATION 1. Real estate (Schedule A) ...................................... .. 1. 2. Stocks and Bonds (Schedule B) ................................ .. 2. 3. Closely Held Corporation, Partnership or Sofe-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E} ..... .. 5. 1 4 5 9 2 0 9 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. 1 4 5 9 2 0 9 9. Funeral Expenses & Administrative Costs (Schedule H) ........... ..... 9. 6 0 8 9 5 0 10. Debts of Decedent, Mortgage Liabilities, 8 Liens {Schedule I) ....... ..... 10. 2 4 7 8 2 0 3 11. Total Deductions {total Lines 9& 10) ...................... .... 11. 3 0 8 7 1 5 3 12. Net Value of Estate (Line 8 minus Line 11) .................... ..... 12. - 1 6 2 7 9 4 4 13. Charitable and Governmental BequestsiSec 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. - 1 6 2 7 9 4 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X ~~_ 1g. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1g. 19.1'ax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 15056042126 REV-1500 FJC Page 3 Decedent's Complete Address: File Number DECEDENTS NAME ANNA M. HINKLE _ ___ STREET ADDRESS -- 100 MOUNT ALLEN ROAD _ _ __ _ _` CITY STATE '~-ZIP MECHANICSBURG IPA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B, Prior Payments C. Discount 3, IntexestlPe~rralty if applicable D. Interest E. Penalty 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. tf Line 1 + lane 3 is greater than lane 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (4) (5) (5A) B. Enter tht; total of Line 5 + 5A. This is the BALANCE DUE. (58) 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 : ...................................................................... ^ 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. ff 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" ~ payab4e upon death bank account or security at his or her death? ......... ^ X 4. Did decedent own an Individual Retirement Aocount, annuit)r, or other non-probate propeAy which contains a benefcary designation? .................................................................................................. ^ 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. §911fi (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 (aj (1.1) (ii)j. 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 impaged 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. §911ti(a)(1.2)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is four and one-hall (4.5j percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)). (1) Total Credits (A + B + C) (2) Total InterestlPenalty (D + E) (3) 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)J. Asibling isdefined, 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, $i M~S4. IN RES DENTE E EDEN RN PERSONAL PROPERTY ESTATE OF FILE NUMBER ANNA M. MINKLE include the pnx~eeds of litigation and tiie date the proceeds were received by the estate. AN properly joiMltr~owned widr rktM of survhrorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. IRA AT SOVEREIGN BANK 6.st)5.85 2. (CHECKING ACCOUNT AT SOVEREIGN BANK 7,436.24 3. DIAMOND RING 1 550.00 TOTAL (Also enter on line 5, Recapitulation) ~ ; (If more space is needed, insert additional sheets of the same size) REV-1511 EX +~ (12-99) SCHEDULE H COMAAONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES $c INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA M. HINKLE Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. WIEDEMAN FUNERAL HOME 4,494.50 B. ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative (s) PATRICIA MURRAY 750.00 Soaal Securiy Number(suEIN Number of Personal Representative(s) Street Address 125 DILLER ROAD Cary NEW CUMBERLAND State PA Z;p 17074 Year(s) Commissron Paid: 2006 2. AttomeyFees CHARLES E. PETRIE 750.00 3. Famiy Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant Street Address Chy State Zip Relationship of Cfairnant to Decedent 4. probate Fees 95.00 5 Accountar>Ys Fees 6. Tax Retum Propater's Fees 7 TOTAL (Also enter on line 9, Recapitulation) , S 6,089. (If more space is needed, insert additional sheets of the same size) REV-1512 EX i~ (12-03) COMMONWEALTH OF PENNSYLVANW INHERRANCE TAX RETURN ESTATE SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE L{AB{LIT{ES, 8~ LIENS FILE NUMBER RNNA M. FiINKLE Report debts incurred by the decedent prbr fA death which remained unpaid as of the dabs of loth, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MESSIAH VILLAGE 23,906.48 2. (ALERT PHARMACY ~ 875.55 TOTAL (Also enter on line 10, Recapitulation) I S (If mae space ~ needed, insert additional streets of the same size)