HomeMy WebLinkAbout09-04-0815D56041125
REV-1500 Ex (os-o5) INFORMANT'S REPORT OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 ~ \ O~ i1 ~~~
Hanisburg, PA 17128-0601 RESIDENT DECEDENT V
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 8 6 3 0 6 8 3 3 0 4 2 4 2 0 0 8 0 9 0 6 1 9 0 9
Decedent's Last Name Suffix Decedent's First Name MI
G r i f f i t h S u d i e M
(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 OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
O 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}
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 Cred'R (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 ANp CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
J A N E M A L E X A N D E R E S Q 7 1 7 4 3 2 4 5 1 4
Firm Name (If Applicable)
First line of address
1 4 8 S B A L T I M O R E S T R E E T
Second line of address
City or Post Office
D I L L S B U R G
State ZIP Code
REGISTER OF WILLS US Ff,~O~NLY
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Corespondent's a-mail address: jrnalexander.148(c~earthlink.net
Under penalties of perjury, I dedare that I have examined this return, indud'Ing 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 rnpresentative 's based on all information of which preparer has any knowledge.
SIGNATU~ON RESPO~E~R FILING RETURN DATE
~- ' Glr~'-- z 7 -2,r3t7 ~'
ADDRESS
31 Market Street, P.O. Box 172 Lewisberr PA 17339
SIG , TU E OF PREP O R PRESENTAT ~ ~~'~~~ ~~
4-~
1~8 S. Baltimore Street Dillsbur
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125
PA 17019
15056041125
15056042126
REV-1500 EX
Decedent's Social Security Number
Deceae~t'S Name: S udi e M. Griffith 1 8 6 3 0 6 8 3 3
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 8 Motes Receivable (Schedule D) ........................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 3 8 7 7 • 9 1
7. Inter-Yvos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) ........................... 8. 3 8 7 7 • 9 1
9. Funeral Expenses 8~ Administrafrve Costs (Schedule H) ................ 9. 8 3 3 • 7 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule !) ............ 10. 1 4 7 2 • 2 9
11. Total Deductions (total Lines 9 & 10) ........................... 11. 2 3 0 5 . 9 9
12 Net Value of Estate (Line 8 minus Line 11 } 12. 1 5 7 1 • 9 2
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................
14. Net Value Subject to Tax (Line 12 minus Line 13} ................ .. 13.
.. 14.
1 5 7
1 • 9 2
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 1 5 7 1 9 2 7 7 4
0
at lineal rate X -045 16. .
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18•
7 0 . 7 4
19. Tax Due .............................................. .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
~~ ~ 15056042126 15056042126 J
~~
REV-1900 EX Page 3
Decedent's Complete Address:
File Number
00
DECEDENTS NAME
Sudie M. Gdffith
STREET ADDRESS
205 Market Street, P. 0. Box 83
CITY
Lewisberry STATE
PA ZIP
17339
Tax Payments and Credits:
1 • Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InteresUPenalty 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, 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.
(1) $70.74
Total Credits (A + B + C) (2) $0.00
Total InteresUPenalty (D + E) (3) $0.00
(4) $0.00
(5) $70.74
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) $70.74
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 : ...................................................................... ^ ^X
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. 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? ......... ^ ^X
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a benefcary designation? .................................................................................................. ^ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE tT 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
[T2 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 evenrf 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-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Sudie M. Gr"rffith 0 0
Kan asset was made joint within one year of the decedents date of death, it must be reported on Schedule G.
SURVNING JOINT TENANT(S) NAME I ADDRESS (RELATIONSHIP TO DECEDEI
A. Robert E. Griffith
314 Market Street, P. 0. Box 172
Lewisbeny, PA 17339
B
C
JOINTLY-0WNED PROPERTY:
Son
LETTER DATE DESG~IPTION OF PROPERTY % OF DATE OF DEAT-
ITEM FOR JOINT MADE INCLUDE NAME OF FINANGAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLYa-{ELD REAL ESTATE. VALUE OF AS5ET INTEREST DECEDENTS INTER
1. A. 1999 M&T Bank -checking account no. 15706680 $7,755.82 50. $3,877.
TOTAL (Also enter on line 6, Recapitulation) I ;
(If more space is needed, insert additional sheets of the same size) L
p M~s~
ACCC)pNT N0. ACCOUNT TYPE
15706680 M&T CLASSIC CHECKING W/INTEREST
00 0 06108M NM 017
23428
SUDIE M GRIFFITH
ROBERT E GRIFFITH
BOX 83 MARKET ST
LEWISBERRY PA 17339-0083
INTEREST PAID YEAR TO DATE 1.40
A('C''(ITTf~S'T' CTTiVfM~RV
$TA`FEFIENT PER'IOp PAGE
MAR.25-APR.24,2008 1 OF 1
FAIRVIEW
BEGINNING
B~iLANCE DEP9SITS &
OTHER 'ADAITIONS
CHECKS PAID !OTHER
gC38TRAG'I'IC2b115 CURk~ENT
INTEREST PD F,NDZNG
BALA^(CE
NO. AMOUNT NO. AMOUNT NO. AMOUNT
7,550.65 2 902,00 1 697.16 0 0.00 0.33 7,755.82
ACCCITTNT ACTTVTTV
POSTING
uATE
TRANSACTION DESCRIPTSON ^uEPOSITS; INTERE'S'T
& OTHER:ApDITIQNS " CHECKS & -0THER
5UH'I'P.AC'FIC)NS L7A'IiY
HALL.NCE
03-25-OS BEGINNING BALANCE $7,550.65
03-31-08 DEPOSIT 17.00 7,567.65
04-03-08 US TREASURY 303 SOC SEC 885.00 8,452.65
04-10-OB CHECK NUMBER 1197 697.16 7,755.49
,;04.-24-,08 INTEREST PAYMENT 0.33 7,755.82
ENDING BALANCE $7,755.82
- CHECKS PAID SUMMARY'
1197 04-10-08 697.16
ANNUAL PERCENTAGE YIELD EARNED = 0.04 ~
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REV-1511 EX+(10-06)
SCHED~/LE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERrrANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sudie M. Griffith 0 0
Debts of decederrt must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Giant -funeral luncheon $318.
2. Lewisbeny Methodist Church $250,
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Repn~entative (s) None Claimed
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Jane M. Alexander, Esquire
3, Family Exemption: (If decedents address is not the same as daimanYs, attach explanation)
Claimant None claimed
Street Address
City State Zip
Relatxxrship of Claimant to Decedent
4. ~ Probate Fees
5 Accountants Fees
6. Tax Return Preparers Fees
7. { Register of Wills -filing Inheritance Tax Return, Informant's Report
$250.
$15.
TOTAL (Also enter on line 9, Recapitulation) I $
(lf more space is needed, insert add'fional sheets of the same size)
GOMIAQNYYEALTH Of PENNSYLVANIA
DEPARTMENT Of REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280tO1
HARR136VR4, -A 1712l~0001
RECEIVED FROM;
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ALEXANDER JANE M
ALEXANDER LAW OFFICE
148 SOUTH BALT ST P 0 BOX 421
DILLSBURG, PA 1 70 1 9-042 1
ESTATE INFORMATION: SSN: 186-3fl-8833
FILE NUMBER: 6708-1273
DEGEDENT NAME: GRiFFITH SUDIE M
DATE OF PAYMENT: 09/02/2008
POSTMARK DATE: 08/29/2008
couNTY: YORK
DATE OF DEATH: 04/24/2008
REV-1162 EX(11-9d1
NO. YK 015815
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 570.74
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1
C
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TOTAL AMOUNT PAID:
REMARKS: ROBERT E GRIFFITH,INFORMANT
CHECK# 1201
SEAL
INITIALS: AKM
RECEIVED BY:
570.74
BRADLEY C. JACOBS
REGISTER OF WILLS
REGISTER dF WiLLS
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