HomeMy WebLinkAbout04-0218REV-1500 EX (6-00)
COMMONWEALTH OF
PENNSLYVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
COUNTY CODE
YEAR NUMBER
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
WATT, JAMES W.
DATE OF BIRTH (MM-DD-YEAR)
December 12, 2003 April 18, 1963
DATE OF DEATH (MM-DD-YEAR)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
WATT, BONNIE K.
X 1. Original Return
!!Limited Estate
Decedent Died Testate (Attach copy of Will)
Litigation Proceeds Received
SOCIAL SECURITY NUMBER
211-56-5491
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
290-50-7935
U 2. Supplemental Retum ~---~ ~i Remainder Retum(~:~a,~pn=to~2.~3.~.)
4a. Future Interest Comprise (date of death after 12-12-82) Federal Estate Tax Return Required
7. Decedent Maintained a Living Trust (Attach a copy of Trust) 8. Total Number of Safe Deposit Boxes
10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ~ l~,;,E~l~.c~tino~n to tax under Sec. 9113(A)
THIS SECTION MUST BE COMPLt: H'D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Frances H. Del Duca
J 10 West High Street
ICarlisle, PA 17013
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717-249-1323
1. Real Estate (Schedule A) (1)
2, Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
[ --~ Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property (7)
(Schedule G or L)
9,7oo.ooi
OFFICIAL USE ONLY
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
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
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(8)
2,190.00
26,989.92
(11)
(12)
(13)
(14)
9,700.00
29,179.92
(t g.479.g2t
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x (15)
16. Amount of Line 14 taxable at lineal rate
x (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)
2O. ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address
STREET ADDRESS
35 Slate Lane
STATE
PA
ZIP
17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits (A + B + C) ('2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If line 2 is oreater than line 1 + line 3. enter the difference. This is the OVERPAYMENT
Check box on Page 1 Line 20 to request a refund (4)
5.
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and:
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 revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
Yes
If death occurred after December 12, 1982, did decedent transfer property within on year of death
without receiving adequate consideration? r~
Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death?
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
No
contains a beneficiary designation? ~ ~
IF THE ANSWER TO ~ ~ ~E ~ QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE GAND RLE ITAS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including 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 representative is based on all the information of which preparer has any knowledge.
SIGNATUR,~F PERSON RESPO~ISIBLE FOR FILING RETURN
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
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 3% [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 0% [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 0% [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 4.5%, 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 12% [72 P.S. 9116(a)(1.3)]. A sibling 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 + (1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
ESTATE OF JAMES W. WATTS
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include Ihe proceeds of litJcjalJon and the date Ihe proceeds were received by Ihe estate. All property joinlly.owned with lhe right of survivomhip must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
Utility truck
Harley Davidson
TV
Dell Computer
VALUE AT DATE
OF DEATH
5,500.00
2,000.00
1,000.00
1,200.00
TOTAL (Also enter on line 5, Recapitulation) 9,700.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF James W. Watt
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedenl
ITEM
NUMBER
5.
6.
7.
must be reported on Schedule I.
FUNERAL EXPENSES:
DESCRIPTION
Fogelsanger-Bricker Funderal Home, Inc., Box 336, Shippensburg, PA, 17257
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
State~ Zip
Accountant's Fees
Tax Return Preparer's Fees
AMOUNT
2,190.00
TOTAL (Also enter on line 9, Recapitulation) 2,190.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF James W. Watt FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION AMOUNT
Hershey Medical Center, 500 University Drive, Hershey, PA, 17033
Taylor Rental of Carlisle, 1122 Harrisburg Pike, Carlisle, PA
America Online, Inc., Credit Collection, Two Wells Ave., Newton, MA, 02459
Household RetaiI-QVC2, Household Bank, SB, NA, Box 129, Thorofare, NJ, 08086-0129
Members First FCU Visa Card #4287 5900 0272 9339
Nextel #326235081
R. E. Michel Co., Inc. (Ronald Katz, Esq.), 11403 Cronridge Dr, Ste. 230, Owings, MD 21117-2219
Citizens Bank, 1 Citizens Drive, Riverside, RI, 02915
Certegy Payment Recovery Services, Inc., 11601 Roosevelt Blvd., St. Petersburg, FL 33716
Carlisle All American
Citizens Bank, 1 Citizens Drive, Riverside, RI, 02915
Encore. Dell Financial, P.O. Box 6000, Olathe, KS 66063-0600
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
9,799.08
87.10
115.60
201.77
3,378.31
357.34
4,405.81
6,323.70
660.00
~41
1,214.58
26,989.9?
DATE:
ESTATE NO:
DATE OF DEATH:
March 15, 2004
December 12, 2003
IN THE ESTATE OF JAMES W. WATT
CLAIM AGAINST DECEDENT'S ESTATE
The Claimant certifies that there is due and owing by James W. Watt, deceased, to
Claimant, the sum of $331.83 and costs.
On behalf of the Claimant, I do declare and affirm under the penalties of perjury that the
information and representations made herein are true and correct to the best of my knowledge,
information and belief.
Don Saylor's Market, Inc.
d/b/a Saylor's Market
c/o Zullinger - Davis PC
P.O. Box 40
Shippensburg, PA 17257
717-532-5713
Hamilton C.'lMvis, Esquire tor
Claimant
I hereby certify that on
CERTIFICATE OF SERVICE
2004, I, Hamilton C.
Davis, Esquire for Zullinger - Davis, did serve a copy of the Claim Against Decedent's Estate,
by first class U.S. mail, postage prepaid, to the party listed below, as follows:
Frances H. Del Duca, Esquire
10 West High Street
Carlisle, PA 17013 /
~ I~amilton/C. Davis, Esquire
In the Estate of:
Estate No.
Date L~ -'iS - 0 ~'-
CLAIM AGAINST DECEDENT'S ESTATE
The claimant certifies that there is due and owing by the decedent in accordance
with the attached statement of account or other basis for the claim the sum of
$.
I solemnly affirm under the penalties of perjury that the co_ntents of the foregoing
claim are true to the best of my knowledge, information, and belief.
Phnrmn O,R T'P
Name of Claimant
Signature o! claimant or person authorized to make
verifications on behalf of claimant
Gail Morral, Billing clerk
Name end Title of Person Signing Claim
FILED:
RECORDED:
Claims Docket Liber
Folio
One James Day ~ve
~,s ~
Cumberland, MD 21502~
(301) 777-1773
Telephone Numb~i~fj
Instructions:
1. This form may be flied with the Register of Wills upon payment of the filing fee provided by law. A
copy must also be sent to the personal representative by the claimant.
2. If a claim is not. yet due, indicate the date when it will become due. If a claim is contingent, indicate
the nature of the contingency. If a claim is secured, describe the security.
RW 28
PS-3584
PHARMACARE
ONE JAMES DAY DR.
CUMBERLAND, MD 21502
PHONE: 800-678-1773
A LATE CHARGE OF 1.5% PER MONTH (18.0% ANNUALLY)
WILL BE ADDED TO AMOUNTS 31 DAYS PAST DUE
03/31/2004
30 DAYS. 1.96
60 DAYS. 1.93
90 DAYS. 128.47
AMT DUE.. 134.35
PHARMACARE
WATT, BONNIE
FOR JAMES WATT
647 BRITTON RD
SHIPPENSBURG
ONE JAMES DAY DR.
PA 17257
WATTB
GRP-GS
PAGE
CUMBERLAND, MD 21502
**** PREVIOUS BALANCE
** THIS AMOUNT PAST DUE **
132.36
2.60
YTD MED
DEDUCTION
.00
132.36 .00 1.99 134.35 .00 134.35
BUREAU OF TNDZVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. ZD0601
HARRISBURG, PA 171Z8-0601
CONNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOHANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1G¢7 EX AFP C01-§3)
FRANCES N DEL DUCA
10 N HIGH ST
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
F/LE NUHBER
:;~UNTY
ACN
Oq-19-200q
gATT
12-1Z-2003
210q-0218
CUHBERLAND
101
Amoun"l: Rami 'l:~:ad
JAHES N
HAKE CHECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF WILLS
CUHBERLAND C0 COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTTCE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF gATT dAHES N FILE NO. 21 0q-0218 ACN 101 DATE 0~-19-200~
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Roe1 Es~a~a (Schedule A)
2. S~ocks and Bonds (Schedule B) (2)
3. Closoly Held S~ock/Par~narship Zn~arast (Schedule C)
~. Mor~gagas/No~as Receivable (Schedule D) (~)
5. Cash/Bank Deposi~s/Hisc. Personal Proper~y (Schedule E) (5)
6. Jointly Offnad Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Ada. Cos~s/M~sc. Expanses (Schedule H) (9)
10. Dab~s/Mor~gage L[ab$[[~$as/L[ans (Schedule Z) (10)
1~. To,al Deductions
12. Ne~ Value of Tax Ra~urn
O0
O0
00
O0
9~700 00
O0
00
(8)
2,190.00
NOTE: To ~nsura proper
credi~ ~o your account,
submi~ ~ha upper portion
of ~h~s for. w~h your
~ax payment.
13.
NOTE:
9,700.00
Z6;989.9Z
(11) 29.179.92
(la) 19,¢79.92-
Char~abla/Govornmon~al Bequests; Non-elac~ed 9115 Trusts (Schedule J) (15)
Ne~ Value of Estate Subjec~ ~o Tax (lq)
Zf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun~ of Line 1~ a~ Spousal ra~e
16. Amoun~ of L/ne lq ~axable a~ L~neal/Class A ra~e
17. Amount of L/no lq a~ Sibling ra~a
18. Amoun~ of Line lq ~axable a~ Collateral/Class B ra~a
19. Princlpal Tax Due
TAX CREDITS:
I PAYMENT RECEIPT
DATE NUMBER
.00
19,q79.9Z-
ZF PAID AFTER DATE ZNDICATED, SEE REVERSE
FOR CALCULAT/ON OF ADDITIONAL INTEREST.
18 and 19 will
DISCOUNT (+)
ZNTEREST/PEN PAID (-)
(~5) .00 x 00 = .00
(16) .00 X Oq5 = .00
(17) . O0 x 12 : . O0
(I8), .00 x 15 = .00
(19)= . O0
AMOUNT PAID
TOTAL TAX CREDIT ] .00
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RE~UZRED.
IF TOTAL DUE IS REFLECTED AS A ffCREDZT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.)~,
RESERVATION:
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
[STRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, lgBZ -- if any futura interest in the estate is transferred
in possess[on or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit e[th your payment to the Register of #ills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office
of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-361-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object eithin sixty (60) days af receipt of
this Not[ce by:
--written protest ta the PA Department of Revenue, Beard of Appeals, Dept. 281021, Harrisburg, PA 17128-10Z1,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in writ[ne to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 1712B-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Res[dent
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. Th[s non-participation
penalty is appealable in the same manner and in the the same tiaa period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of o000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which wiXI vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO4 ars:
Tnterest Daily Interest Daily
Year Rate Factor Year Rate Factor
~ ZOZ .000548 1988-1991 111 .000301
1983 162 . 000438 1992 9Z · 000247
1984 112 .000301 1995-1994 7Z .000191
1965 132 · 000356 1995-1998 92 · 000147
1986 101 . 000274 1999 7Z . 000192
1987 102 .000274 ZOO0 72 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rate Factor
2001 91 .000147
2002 62 .000164
2003 52 .000157
ZOO4 42 .000110
X NUNBER OF DAYS DELINQUENT X DAZLY INTEREST FACTOR
--Any Notice issued after tho tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.