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HomeMy WebLinkAbout09-16-0815056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year Flle Number Bureau of tndividual Taxes H Po Box zaosol INHERITANCE TA,X RETURN Hanisburg, PA 1712&0601 RESIDENT DECEDENT ~~ b ~ (~~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 200-26-5019 03/13/2008 02/11/1935 Gecedent's Last Name Suffix Decedent's First Name MI IBarrick Barbara A (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 '~: 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 0 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 TO: (Name Daytime Telephone Number Brenda Herren Firm Name (If Applicable) r'`~ REGISTER ~IIILLS USE O~ _ --. ~ ~ i~i7 _, - ~J C~} t~"t , t = First line of address ".~ '` .~ rte- , ~ 371 Comman Road ~ m Second line of address ~ C`? ~.,,, ~_ "~~ _..~ ' D41;DE FILED ~ _ T~ .~ City or Post Office State ZIP Code -l C~ - ,; - ~ Carlisle PA 17013 w z Corespondent's e-mail address: Brenda1228(IDembargmail.com Under penalties of perjury, l declare that i have examined this return, including accompanyk~g schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Dedaretion of preparer other than the personal representable is based on all information of which preparer has any knowledge. SIG TUBE OF PER RESPONSIBLE FOR FI ING RETURN DATE a~ ~~~ 1010 Cranes Gap Road Carlisle, Pa 17013 SI ATURE F PREFAB R ER THAN REPRESENTATIVE i - - DATE v` - - ~.t/~1J.1. ~ 08/27/08 ADDRESS ~ ` 371 Comman Road Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Slde 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Barbara A Garrick 200-26-5019 oe~a~,t,s Nam: RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 0.00 2. Stocks and Sonds(Schedule B) ....................................... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule Ej ........ 5. 41,981.07 6. Jointly Owned Property (Schedule F) A~ Y~ Separate Billing Requested ... , ... 6. 0.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) tw ;=' Separate 8iliing Requested........ 7. 65,822.51 8. Total Gross Assets (total Lines 1-7) .................................... 8. 107,803.58 9. Funeral Expenses & Administrative Costs (Schedule li) ..................... 9. 6,040.50 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 57.48 11. Total Deductions (total Lines 9 & 10) ................................... 11. 6,097.98 12. Net Value of Estate (Line $ minus Line 11) .............................. 12. 101, 705.60 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ - . _ 14. .... 101,705.60 .. ... .... _. _ _.. . _.... __...~. ,.. ..., , ____...._ _,._ ___.._r_,___._......._.. _.. . _..,....n 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 45 15. 101,705.60 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 at collateral rate X .15 18. 19. TAX DUE ......................................................... 19. 4,576.75 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT - 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Flis Number !1_~_J~...ilw f+wr~.~lwiw A.t.lrwww. YCGCYCnI r1 v~mN~~e~ r~uw caa. DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER _ Barbara A Barrack 200-26-5019 STREETADDRESS ~- -~ ---~-'-' 1010 Cranes Gap Road CITY ~ STATE ', ZIP Carlisle ~ PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 4,576.75 2. CreditslPayments A. Spa~sal Poverty Credit ____~~___ _~______. B. Prior Payments C. Discount ----- --- ------- -----___.-_ __._ _. Total Credits (A + B + C j (2) 0.00 3. InkeresUPenalty if applicable D. Interest ---------__-a_~_._.___.-_-_-- E. Penalty -- -_~-~" ~" _~ Total InterestlPenalty (D + E) (3) 0.00 4. If Line 2 is greater than line 1 + Line 3, enter the dii~ence. This is the OYERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the d'rfrerence. This is the TAX DUE. (5) 4, 576.75 A. Enter the interest on the tax due. (5A) B. Enter the tots! of Line 5 + 5A. This is the BALANCE DUE. (56) 4,576.75 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 transfemed or its income : ............................................ ^ c. retain a reversionary interest; or ......................................................................................................................... ^ d. receive the promise for life of either payments, I~er-efits 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 secu-ity at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficary 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 j72 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 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 j72 P.S. §9116(x)(1.2)]. 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-half (4.5) percent, except as noted in 72 P.S. §9116{1.2) [T2 P.S. §9116(x)(1)]. pf tralnsfet5 to or for the use of the decedent's siblings is twelve (i 2) percent [72 P.S. §9116(x)(1.3)]. Asibling is defined, under III II I I~ I~ II ~ ~~ II ~~ ~ ~~! REV-'1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDt~LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sneers of the same slze- REV-15'10 EX+ (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDt~LE G INTER-VIVOS TRANSFERS 8L MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER This schedule must be completed and filed 'rf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY NCI.WETHENAMEOFTHETRANSFEREE.THEIRRELATIONSHIPTODECEDEHTAND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION pF APPLICABLE) TAXABLE VALUE f ~ Equitrust L'Ife Insurance Co Policy # EQ0001062051 F 28,938.80 100 28,938.80 2 Bankers Life Acct # 7787072 12,764.04 100 12,764.04 3 Bankers Life Acct# 7786375 9,817.35 100 9,817.35 4 Bankers Life Acct# 7746025 14,302.32 100 14,302.32 TOTAL (Also enter on line 7 Recapitulation} s I 65,822.51 (If more space is needed, insert additional sheets of the same size} REV-1511 EX+ (12-99) SCNEpt~LE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FlLE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Hollinger Funeral Home 2,023.00 Funeral Reception & Minister 150.00 Georges Flowers 79.50 B. 1 2. 3. city Carlisle state FA .Zip 17013 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City .State Year(s) Commission Paid: Attomey Fees family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Terri Keeney Street Address 1010 Cranes Gap Road Relationship of Claimant to Decedent Daughter 4. Probate fees 5. Accountant's Fees g. Tax Retum Preparer's Fees ~. Attomey Harold Irwin Carlisle TOTAL (Also enter on line 9, Recapitulation) I ~ (If more space is needed, insert additional sheets of the same size) Zip 25.00 3,500.00 263.00 6,040.50 REV~t5t2 EX+ (t2-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDt~LE 1 DEBTS OF DECEDENT, MORTGAGE UABIUTIES, & UENS ESTATE OF FILE NUMBER Report debts incurred by the decedent prior to death which n3mained unpaid as of the date of death, including unreimbursed medical expenses. pf more space is needed, insert additional sheets of the same size) REV•1513 EX+ (9-00) SCHEQULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 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 Karen S Swartz Daughter $24282.21 2 Terri L Keeney Daughter 24282.21 3 Brenda M Harren Daughter 24282.21 4 Nanette B Stewart Daughter 24282.21 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THRO UGH 18, AS APPROPRIATE, ON RE V-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I; (If more space is needed, insert additional sheets of the same size)