HomeMy WebLinkAbout10-23-084 _. _ _ _. __ _ _ - _ /
R` o ~ ~
J 1505607121
REV-1500 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisbur PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 ~1~3
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
8 0 1 2 8 2 0 0 8 1 0 0 5 1 9 5 8
Decedent's Last Name Suffix Decedent's First Name
E N N I S MI
T H E R E S A 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
0 1. Original Return ~ 2. Supplemental Retum
3. Remainder Return (date of death
4. Limited Estate ~
4a. Future Interest Compromise (date of
d prior to 12-13-82)
~ 5. Federal Estate Tax Return Re
uired
^
6. Decedent Died Testate
A
~ eath after 12-12-82)
7. Decedent Maintained a Livin Trust q
0
(
ttach Copy of Will)
9
Liti
ati
P (Attach Copy of Trust) g 8. Total Number of Safe Deposit Boxes
.
g
on
roceeds Received ~ 10. Spousal Poverty Credit date of death
(
bet
1
~ 11. Election to tax under Sec
9113(A
ween
2-31-91 and 1-1-95)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED
ALL .
)
(Attach Sch. O)
Name .
CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
J O H N Daytime Telephone Number r„
B F O
Firm Name (If Applicable) W L E R I I I E S Q
--,
7 1 7 ~c~ 3 ~~ 4-1~ ~'
~ ~ p _~
M A R T S O N L A
W
O F F I C E S REGISTERD S USE'I~NLY
~
First line of address -;
~ ~~~ w
'
1 0 E A S T H I
G H
S T R E E T ~.!-; . -
~ '~
~_- ~-= \f ~ ~ - '
Second line of address ~~ --~-I I"J .'
C1 , ,
City or Post Office
State ZIP Code DATE FILED
C A R L I S L E P A 1 7 0 1 3
Correspondent's e-mail address: j f O W 1 e r a m a r t S O n 1 a W, C O m
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 information of which preparer has any knowledge.
SIG TORE OF PERSC~ESP SIBLE FOR.FILING RETURN
DAT
AD E 18 . 7+~ ~ ~$
110 LINN DRIVE CARLISLE
SIGN U PREP HER T EPRESENTATIVE P A 17 013
~a3 ~ ~
R S
10 AST HIGH STREET CARLISLE
PLEASE USE ORIGINAL FORM ONLY P A 17 013
Side 1
L 1505607121 1505607121
REV-1500 EX
THERESA M. ENNI
1505607221
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,
Decedent's Social
4. Mortgages & Notes Receivable (Schedule D) . , , , •
, , , , . •
4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 1 7 3 8 4
.. , , , , , 5. . 4
0
6. Jointly Owned Properly (Schedule F) ^ Separate Billin
R 3
g
equested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property
(Schedule G) ~ Se
t 4 3 3 8. 4
D
para
e Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) •
........................... s. 5 1 7 2 2. 8 0
9. Funeral Expenses & Administrative Costs (Schedule H) , , ,
••
s
1
7 8
...........
. 8 7. 8 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) , , , , , , , , , 10
1
3 7 8 5. 0 0
11. Total Deductions (total Lines 9 & 10)
...... , . , , , , • , , • , . 11 3 1 6 7 2 • 8 D
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12 2 D D $ D • D D
an election to tax has not been made (Schedule J)
..................13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
2 •
, , , , ,
~~~..........,4.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 0 0 5 0, 0 0
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X• ~ D
D D
.
15.
16. Amount of Line 14 taxable
D . D D
at lineal rate x• 0 4 5 2 0 0 5 0. 0 0
17. Amount of Line 14 taxable 16. 9 D 2 • 2 $
at sibling rate X .12 0 . 0 0
18. Amount of Line 14 taxable 17' 0 • 0 D
at collateral rate X .15 D D D
1 s. 0 . D 0
19. Tax Due
................................................ 1s. 9 0 2. 2 5
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505607221
15O56D7221
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 08
0
THERESA M. ENNIS
STREET ADDaFtc
1108 LINN DRIVE
clrv
CARLISLE
Tax Payments and Credits:
~ • Tax Due (Page 2 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InteresUPenalty ifapplicable
D. Interest
E. Penalty
STATE
PA
ZIP
17013
Total Credits (A + B + C )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.Total Interest/Penalty (D + E )
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) 902.25
(2) 0.0 0
(3) 0.0 0
(4) 0.0 0
(5) 902.25
(5A)
B. Enter the total of Une 5 + 5A. This is the BALANCE DUE.
(5B) 9 0 2.2 5
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:
a. retain the use or income of the property transferred; Yes No
b. retain the right to designate who shall use the property transferred or its income; ............................... ^
c. retain a reversionary interest; or .......................................
d. receive the promise for life of either payments, benefits or care? ~~~~~~~~~~~~~~~~~~~" ^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
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 n~mP 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 decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, 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
ESTATE OF
THERESA M• ENNIS
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Include the roceeds of litigation and the date the proceeds were received by the estate. 0 8 0
All properly ~Oint -owned with fight of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
1• 2004 MERCEDES C320, actual sale price OF DEATH
14,000.00
2• MEMBERS 1ST CHECKING 8 SAVINGS ACCOUNTS, #113155
3,154.40
3• CASH
230.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size) 17 , 3 8 4 • 4
REV-1509 EX + (6-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THERESA M • ENNIS FILE NUMBER
21 08
n an asset was made Joint within one year of the decedents date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
A. JAMES E• ENNIS 1108 LINN DRIVE
CARLISLE, PA 17013
e
c
JOINTLY•OWNED PROPERTY:
ITEM FO JR OINT MADE INCLUDE NAME OF FINANCIAL NS CTITI TI ION AND BANK ACCOUNT NUMBER OR SIMILAR
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
1 • A • prior M&T BANK, PREMIUM ACCT #98121340
t0 1/
28/07
2• A• prior M&T BANK, CHECKING ACCT #30885140
to 1/
28/07
TO DECEDENT
ATHE
DATE OF DEATH ~~ CF
VALUE OF ASSET DECD'S DATE
VALUE OF
INTEREST DECEDENTS INTEREST
66,047.33 50• 33,023.67
2, 629.451 50.1 1, 314.73
TOTAL (Also enter on line 6, Recapitulation) S
(If more space is needed, insert additional sheets of the same size) 3 4 , 3 3 8 • 4 ^
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ESTATE OF
THERESA M. ENN
ITEM
NUMBER
A.
1•
2•
3•
4.
Debts of decedent must be reported on Schedule I.
FILE UN MBER
21 08
DESCRIPTION
FUNERAL EXPENSES:
RONAN FUNERAL HOME, CARLISLE, PA•
CARLISLE MEMORIAL SERVICE, INC•, Monument lettering
LION'S DEN CATERING, Memorial luncheon
AIRLINE TRAVEL for immediate family
AMOUNT
8,993.60
296.00
153.70
1,029.50
B• ADMINISTRATIVE COSTS:
f • Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City
State Zip
Year(s) Commission Paid:
2. AttomeyFees MARTSON LAW OFFICES (ESTIMATED)
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant JAMES E • ENNIS
Street Address 110 8 L I N N D R I V E
city CARLISLE state PA
zip 17013
Relationship of Claimant to Decedent F A T H E R
4 ~ Probate Fees
5 . Accountants Fees
6 ' Tax Return Preparer's Fees
7• REGISTER OF WILLS, FILING FEE, INHERITANCE TAX RET
8• DEATH CERTIFICATES
9• REIMBURSEMENT TO FAMILY FOR TRAVEL-RELATED EXPENSE
(travel, food, lodging, etc.)
TOTAL (Also enter on line 9. Recanlt~ Marl„
(It more space is needed, insert additional sheets of the same size)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
2,500.00
3,500.00
15.00
60.00
1,340.00
~)la
7,887.
REV-1512 EX + (12-03)
SCHEDULEI
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
IN R SIDE TEDE EDENTRN MORTGAGE LIABILITIES, & LIENS
ESTATE OF
THERESA M. ENNIS FILE NUMBER
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, inc uding unreimbursed medical
ITEM expenses,
NUMBER
DESCRIPTION VALUE AT DATE
1• COUNTY OF CUMBERLAND, ACCOUNT PAYABLE OF DEATH
7,000.00
2• JAMES E. ENNIS, ACCOUNT PAYABLE FOR ATTORNEY FEES
TO KARL ROMINGER, ESQUIRE 3,000.00
3• JAMES E. ENNIS, ACCOUNT PAYABLE FOR BAIL BOND
3,785.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size) 13 ' 7 8 5 • 0
REV-1513 EX + (g-00)
S
CHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THERESA M • ENNIS FILE NUMBER
21 p8
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT p
AMOUNT OR SHARE
I_ TAXABLE DISTRIBUTIONS include outri ht Do Not List Trustee(s)
(Sec. 9116 (a~ (12 ]usal distributions, and transfers under OF ESTATE
1• JAMES E• ENNIS
1108 LINN DRIVE Lineal
CARLISLE 20,D50.00
, PA 17D13
EXCESS
OFTASSETSC
Lineal
T
X
N
N (BALANCE OF JOINT
ACCOUNTS (F,1-2))
WERE
PAID
BY
E
JAMES
ENNIS, FROM JOINT FUNDS
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1•
1•
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1•
1•
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S
(If more space is needed, insert additional sheets of the same size)