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Home My WebLink About07-11-0815056041169 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PoBox2sosot INHERITANCE TAX RETURN ~ ,. ~; .7 Q ~ 7 Harrisburg,PA17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 201-16-5681 07102007 02131918 Decedent's Last Name Suffix Decedent's First Name MI WHITMOYER JANE S (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 OF WILLS FILL INAPPROPRIATE BOXES 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) E~. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) fi. 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 MURREL WALTERS III, EXEC 717-697-4650 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY First line of address iv 54 EAST MAIN STREET ~O ° _ ~' -, _t~ ~ Second line of address ` ~~ ~ ~ -` '~-,-~ ..~r.1,.i ,_ ° r~-y ._ ; ~7 ~. J City or Post Office State ZIP Code ED - ~ ~ ~ ' ' MECHANICSBURG PA 17055 :-'~ ~~ C ~ ~ ~ , r,a , ,...,_; Correspondent's a-mail address: /f a, ~ Under penalties of perjury, I declare that I ha examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correc nd mpl _ eclaratio of preparer other than the personal representative is based on all information of which preparer as any knowl edge. SIGNATURE P SO ,R PONS LE FOR FILING RETURN i ~ ~E ~ ADDRESS 54 EAST IN STREET, MECHANICSBURG, PA 17055 HF~}.THP~JV REPRESENTATIVE SI ~REPARE D A~ ~ ' ' ~~ ADDR L WHITCOMB EA, 43 WEST MAIN STREET, MECHANICSBURG, PA 17055 Side 1 15056D41169 15056041169 J REV-1500 EX Decedent's Name: JANE S WHITMOYER RECAPITULATION 15056042160 1. Real estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ........................................ 2. Decedent's Social Security Number 201-16-5681 33,813.81 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. 1 , 4 54 , 63 6.02 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .... ... 6. 19 , 7 7 5.13 7. Inter-Vivos Transfers & Misceilaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines 1 - 7) ................................ g, ... 1 , 5 0 8 , 2 2 4 . 9 6 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 7 6 , 7 6 9 . 6 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. .. 10. 16 , 419.3 9 11. Total Deductions (total Lines 9 & 10) ................................ .. 11. 9 3 , 18 9 . 0 7 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 1 , 415 , 0 3 5 . 8 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 9 3 0 2 6 0 7 6 an election to tax has not been made (Schedule J) ...................... .. 13. , . 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 4 8 4 , 7 7 5.13 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 .0 16. 17. Amount of Line 14 taxable at sibling rate x .12 17. 18. Amount of Line 14 taxable 4 8 4 7 7 5.13 at collateral rate x .15 ~ 18. 19. TAX DUE ........................................................ 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 72,716.27 72,716.27 Side 2 15056042160 15056042160 REV-1500 EX Page 3 Decedent's Complete Address: File Number 210 7 0 6 7 8 DECEDENT'S NAME JANE S WHITMOYER STREETADDRESS 10 0 M'I' ALLEN DRIVE CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page Z Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 7 2 8 3 8. 3 4 C. Discount Interest/Penalty if applicable D. Interest E. Penalty 122.07 (1) 72, 716.27 Total Credits (A + B+ C) (2) 7 2, 8 3 8. 3 4 Total Interest/Penalty (D + E) (3) 12 2 . 0 7 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 greater than Line Z, enter the difference. This is the TAX DUE. (5) 0 . 0 0 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 . 0 0 Make Check Payable fo: 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 : .................... 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 "in trust 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 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-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE S WHITMOYER FILE NUMBER 2107 0678 RELATIONSHIP TO DECEDENT 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 THOMAS WHITMOYER NEPHEW 100,000.00 21 LINBERG DRIVE, TRUMBULL, CT 06611 2 MARCY WRIGHT NIECE 90,000.00 PO BOX 647, MORGANTOWN, PA 19543 3 MAGGIE BARKLEY NIECE 90,000.00 371 N MIDDLESEX RD,CARLISLE,PA 17013 4 DAVID SWARTZ GREAT-NEPHEW 30,000.00 3465 TUSCARORA PASS,LOYSVILLE, PA 5 MARK SWARTZ GREAT-NEPHEW 30,000.00 1183 YORK RD,MECHANISBURG,PA 17055 6 LARRY SWARTZ GREAT-NEPHEW 30,000.00 232 N HIGH ST,BIGLERVILLE, PA 17307 ENTER DOLLAR AMOUNTS 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 TAXIS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 AMERICAN HEART FUND 310,086.92 1019 MUMMA ROAD,WORMLEYSBURG, PA 2 AMERICAN CANCER SOCIETY 310,086.92 128 LUCY AVE, HERSHEY, PA 3 ARTHRITIS FOUNDATION 310,086.92 17 SO. 19TH STREET, CAMP HILL, PA TOTAL OF PART [I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 9 3 0 , 2 6 0 . 7 6 (If more space is needed, insert additional sheets of the same size)