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Home My WebLink About09-23-0815056041125 - REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 7 0 8 2 1 Hanisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 9 3 6 1 3 7 9 0 8 2 7 2 0 0 7 1 1 0 6 1 9 5 8 Decedent's Last Name Suffix Decedent's First Name MI S C H M I D T K E N N E T H 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 OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limfted 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 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) `"' REGISTER OF,JI I~It;LS USE ONFY -- ::1 ~ c.'? €~~ .> ~ ~ First line of address ~ u ,-r ~~ C..J 3 5 2 8 B R I S B A N S T R E E T '`'` -- _.,; ~ - . Second line of address ~~~ ~,~ _-+ c? .~ City or Post Office State ZIP Code DATE FILED ~ H A R R I S B U R G Correspondent's a-mail address: PetrieLawCDAOL.COm P A 1 7 1 1 1 Under nafties of perjury, I declare that I have a amined th's return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is :correct and complete. Dedardtion of p rer er than the personal representative is based on all infomlatlon of which preparer has any knowledge. SIG U OF E ON RE ON LE R FI NG RETUR DATE ~___ ___ 9/19/2008 214 ST JAMES COURT MECHANICSBURG PA 17050 SIGNATUIjF,QFf'hEPARER~OTHEfj,SHA1~~EPijj[SENTATfVE DATE 3528 BRISBAN STREET HARRISBURG PA 17111 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 15056041125 15056042126 REV-1500 EX Decedent's Social Security Number Decedents Name: KENNETH M. SCHMI DT 2 0 9 3 6 1 3 7 9 RECAPITULATION 1. Real estate (Schedule A) _ ....... 1. 0 0 0 .............................. 2. Stocks and Bonds {Schedule B) ......................... ~ ........ 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ................. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property {Schedule F) ^ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property (Schedule G) u Separate Billing Requested 8. Total Gross Assets {total Lines 1-7) .................... ..... ..... ..... ..... ..... .. 4. .. 5. .. 6. .. 7. .. 8. 1 1 9 3 9 1 9 3 9 2 2 8 8 2 2 9. Funeral Expenses & Administrative Costs (Schedule H) ......... ..... .. 9. 5 1 0 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ..... .. 10. 11. Total Deductions (total Lines 9 8 10) ................... ..... .. 11. 5 1 0 0 0 12. Net Value of Estate (Line 8 minus Line 11) ................ ..... .. 12. 1 1 8 8 8 2 8 2 13. Charitable and Governmental Bequests/Sec 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 1 8 8 8 2 8 2 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.o _ 1 1 8 8 8 2 8 2 15. 0 0 0 16. Amount of Line 14 taxable 0 0 0 0 0 0 at lineal rate X .0 _ 16 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18 0 0 0 19. Tax Due ......................................... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 15056042126 15056042126 REV-1500 EX Page 3 Decedent's Complete Address: File Number 0821 DECEDENTS NAME KENNETH M._S_C_H__MI_DT ___ __ -_ - -_- ----- --- STREET ADDRESS 214 ST. JAMES COURT -------- ------ ------ CITY -- -. --- - - -- -- STATE -- ZIP MECHANICSBURG ~PA 17050 Tax Payments and Credits: Tax Due (Page 2 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InterestlPenalty ffapplicable D. Interest E. Penalty If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT FII 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. (1) o.oo Total Credits (A + B + C) (2) 0.00 Total InteresUPenalty (D + E) (3) 0.00 (4) 0.00 (5) 0.00 (5A) (5B} 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 : ............................................................... i i ....... ^ ncome; ........................ ts b. retain the right to designate who shall use the property transferred or ....... ^ c. retain a reversionary interest; or ......................................................................................... ' ....... ^ 0 rfe of either payments, benefits or care? ................................................ d. receive the promise for I ....... 2. If death occun~ed after December 12,1982, did derx;dent transfer property within one year of death ^ without receiving adequate consideration? ................................................................................ " ' ....... ^ 0 or payable upon death bank account or security at his or her death? .. intrust fa 3. Did decedent own an ....... 4. Did decedent own an Individual Retirement Account, annuity, or other non~robate property which contains a beneficlary designation? ........................................................................................... ....... ^ 0 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 beneficlary. 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-0ne 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 beneficlaries is four and one-half (4.5} percent, except as noted in 72 P.S. §9116(1.2) i,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 + (8-98) COMMONWEALTH OF PENNSYLVANIA - INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER KENNETH M. SCHMIDT 0821 Indude the proceeds of Ntigation and the date the proceeds were received by the estate. AN oroDerty ioindv~ownad with ripM of wrrivorshb must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2001 TOYOTA CAMRY 2. (ACCOUNTS AT MORGAN STANLEY 4, 000.00 115, 392.82 TOTAL (Also enter on line 5, Recapitulation) I ; (If more space is Headed, ir~rt additional stlcets of the same size) REV-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES St INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER KENNETH M. SCHMIDT Og21 Debts of decederK must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: L B. ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative (s) Soaal Security Number(syEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2, AttomeyFees CHARLES E. PETRIE 250.00 3. Fatuity Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 260.00 5 Accountants Fees 6. Tax Retum Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) S 510.00 (If more space 'rs needed, insert additional sheets of the same size) REV-1513 EX * (9-00) SCHEDULE J - COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES • INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KENNET H M. SCHMIDT voc i 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 [xidude outright spousal distributions. and trartsters under Sec. 9116 (a) (1. )2 1. CATHLEEN E. SCHMIDT Spousal 118,882.82 214 ST JAMES CDURT MECHANICSBURG, PA 17050 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET Ij. 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 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ; (If more space is needed, insert additional sheets of the same size)