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HomeMy WebLinkAbout07-24-08REV-1500 Ex (os-o5> 15056051058 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes ~~ ~ INHERITANCE TAX RETURN County Code rear File Number Po Box zaosol RESIDENT DECEDENT 21 05 0202 Harrishurn Pa ni ~a-nFm ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202-50-8818 -~-~- -~-- -~ March 23, 2005 -J July 14, 1957 ------- Decedent's Last Name Suffix Decedent's First Name MI r---- ~EARD I Beverly (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI --- - _ -- - ----- - ------- --i N/A ~- n Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~__-~- FILL IN APPROPRIATE OVALS BELOW a~ 1. Original Return c~ 2. Supplemental Return c~ 3. Remainder Return (date of death prior to 12-13-82) c~ 4. Limited Estate c~ 4a. Future Interest Compromise (date c~ 5. Federal Estate Tax Return Required of death after 12-12-82) c~ 6. Decedent Died Testate c~ 7. Decedent Maintained a Living Trust g. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) c~ 9. Litigation Proceeds Received c~ 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) _ between 12-31-91 and 1-1-95) c~ (Attach Sch O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name _ Daytime Telephone Number Francis A. Zulli, Esquire _ _ 717-236-9301 Firm Name (If Applicable) IIWIOn Zulll & Seibert REGISTER OF WILLS USE ONLY I~_ __ ------~_._ ___-- -- ___ ___ ___ First line of address ~ r.~ ---- ,_ L109 Locust Street ~ r 4 n _ _ ---- -- ~_~ <-- - -- -- _ ' Second line of address ~ ,.7 cF_ ----------------- - `~ f'"' ,~., r rt N City or Post Office State ZIP Code ' ~-' . . , ~ ~__ _-. .._.-__. __ _._ _ ___ _.. _-._-____- r-- ~ 1 1 ~ (Harrisburg IPA ~ 17101 ~; ~.= i -- -~ L-----~ ~ t , -~ ~ .. r ~ Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, corn t and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU OF RS RE N LE FOR FILING RETURN DATE -- -- --- ------ `--- - -- -_ __ ~ -------- ------------ ?.O~ ADD SS '~~ 609 North T ird Street, Steelto PA 1711 ` _ SIGNATURE F EPARER OTHE AN R PRESEN I E DATES~ '',^~`` ADDRESS 109 Locu~t eet, Harrisburg, P 17101 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 15056052059 REV-1500 EX Decedent's Name: O Gnwn~r~. ~~~.,hri ~ uLN I IVIV 1 . Real estate (Schedule A) 2 . Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages ~ Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) c~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c~ Separate Billing Requested _ 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 1 11. Total Deductions (total Lines 9 & 10) 1 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 1 1 14. Net Value Subject to Tax (Line 12 minus Line 13) TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 14 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X p, 16. Amount of Line 14 taxable 15. at lineal rate X 0. 17. _ Amount of Line 14 taxable 16. at sibling rate X .12 18. Amount of Line 14 taxable 17. at collateral rate X .15 18. 19. TAX DUE 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Social Security Number c.vc-~V-00 I O 1. $ 0.00 2 . $ 0.00 3. $ 0.00 4. $ 0.00 5. $ 3,514.59 6. __ $ 0.00 7. $ 0.00 . $ 0.00 . $5,232.66 0' $3,513.85 ~ $8, 746.51 ' $ 0.00 . $ 0.00 8 9 1 2 3 -$5,231.92 c~ Side 2 15056052059 15056052059 REV-1500 EX Page 3 Decedent's Complgte Address: File Number 21 05 0202 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Beverly Beard 202-50-8818 STREET ADDRESS 1128 Columbus Avenue, Apt. 1 CITY STATE ZIP Lemoyne, PA 17043 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits (A + B + C) (2) 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) (5) (5A) $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 (56) $ 0.00 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; ^ g b. retain the right to designate who shall use the property transferred or its income; ^ x c. retain a reversionary interest; or ^ x 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 ^ x without receiving adequate consideration? ^ x 3• Did decedent own an "in trust 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? ^ x 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 decedents 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 E%+ (6-98) ~~ t COMMONWEALTH OF PENNSYLVANIA SCHEDULE E INRESDENTED~DENTRN CASH, BANK DEPOSITS, ~ flA~SC. PERSONAL PROPERTY ESTATE OF Beverly Beard FILE NUMBER 21- 05-0202 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property joinUyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Citizens Bank savings account # 6100609138 2,382.82 2. Citizens Bank checking account #6206369716 401.24 3. Citizens Bank checking account #6140197686 335.53 4. Household furniture and furnishings -public sale 395.00 TOTAL (Also enter on line 5, Recapitulation) ~ $3,514.59 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) G .~. y1 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Beverly Beard FILE NUMBER 21- 05-0202 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Musselman's Funeral Home 1,500.41 Funeral services B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)1 EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. 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 Register of Wills -Cumberland County 100.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills -filing inventory and inheritance tax return 30.00 8. West Gate Apartments -delinquent rent 2,382.00 9. West Gate Apartments -last month's rent 779.00 10. PPL -electric service 305.25 11. Citizens Bank -safe deposit box drilling and rental 136.00 TOTAL (Also enter on line 9, Recapitulation) ~ $5,232.66 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) ~~y~~ ~ ~.:- COMMONWEALTHOFPENNSVLVANIA SCHEDULE INHERITANCE TAX RETURN DEBTS OF DECEDENT, RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS ESTATE OF Beverly Beard FILE NUMBER 21- 05-0202 Record debts incurred by the decedent prior to death which remained unpaid as of the date of death, include unreimbursed medical expenses. REV-1513 EX+(9-00)) SCHEDULE J ;~: n BENEFICIARIES .;~.~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Beverly Beard NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, al transfers under Sec. 9116 (a) (1.2)] -OS- 0202 RELATIONSHIP TO DECEDENT ~vvlo~rroF Do Not List Trustee(s) sHA>~ OF ESTATE Estate Insolvent II. 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEEP NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Treasury Department -Bureau of Unclaimed Property Finanace Building Vault Estate Commonwealth and North Streets Insolvent Harrisburg, PA 17120 TOTAL OF PART II -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) DAVID A. WION FRANCIS A. ZULLI .LEAN D. SEIBERT SHELLY I.KUNKEL r ~~ LAW OFFICES ;~Qyf P.O. BOx 1121 HARRISeuac, PA 17108-1121 109 LOCUST STREET FIP.RRISBDRG, PA 17101 (717)236-9301 (717)232-1488 FAx (717) 236-6100 EMAIL: WZS@MINDSPRING.COM July 23, 2008 Register of Wills Office Cumberland County Courthouse Carlisle, PA 17013 RE: Estate of Beverly Beard Dear Register of Wills: 1 13 E. MAIN STREET HUMMELSTOWN, PA 17036 (717)566-2501 Enclosed please find two originals and one copy of the Inventory and PA Inheritance Tax Return to be filed in the above-referenced estate, along with a check in the amount of $30.00. Kindly date stamp my copies and return same to me in envelope I have provided. Thank you. FAZ/kd Enclosures I~ ~ © ~~~ ~ ~_ c~ ._ ,-- i i l°1 r~ ~- ~., zJ; _: ,~. . _ ~ ~'i~.J : _ ~ - .E3 .' --i ~. 0 ~ ~ U ~ U 4-i Q ~ M ~--i 3Uo b~ o ~ a ~, a~ ~ .~ ~ .~ ~ .~ °~ ~ ~ ~ U U r N r 00 O r ~ Q W Z T T ~~\) /, ^~ \\ ~ O ~JV/ W U ~ ~ '~ O VV" =Q r a a ~ ~~~ O (j ,~ ~d