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HomeMy WebLinkAbout10-23-0815056051058 REV-1500 Ex (D6-D5, PA Departmen! of Revenue ~ OFFICIAL USE ONLY Bureau of Individual Taxes are County Code Year File Number Po Box 2eosot INHERITANCE TAX RETURN - Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 D878 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 342-20-7681 07/28/2008 02/04/1930 Decedent's Last flame Suffix Decedents First NamF; HARTY _ _ MI _ JAMES 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 DUPLI(:ATE WITH THE -- - -- REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ~~:`~ 1. Original Return j 2. Supplemental Return -_; 3. Remainder Return (date of death _,,.,. 4. Limited Estate ~, 4a. Future Interest Compromise (date of prior to 12-13-82) ,-,,,~ 5. Federal Estate Tax Return Required death after 12-12-82) """" 6. Decedent Uied Testate --' `"""" 7. Decedent Maintained a Living Trust (Attach Cop of Will) ~ - - 8. Tctal Number of Safe Deposit Boxes y (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 A . ND CONFIDENTI Name AL TAX INFORMATION SHOULD BE DIRECTED T0: - - - - --.- -_ ___ Daytime Telephone Number ..._ MAS E. FLOWER .............. __ - _ - (717) 737-3405 ....._-._.. _ -. Irm Name (ff Applicable) - _ _ - - - - SAIDIS, FLOWER, LINDSAY .._ REGISTER OF WILDS USE ONLY y -...-. --.. _ ~ j .. First line of address -_ 2109 MARKET ST , ,~ ~: _ Second line of address :-,r; - ,. , - City or Post Office State ZIP Code ~_- DATE FIL -"" _ _...... ~A -; .. CAMP HILL A 17011 - _ -__ -_ - __. .._..........._.-..._.... `' -- ~. Correspondent's a-mail address: tflOWer@Sfl-IaW.COm Under penalties of penury, 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, c ect and co lete Declaration of preparer other than th e personal representative is based on all info SIGNAT O PER N RE , rmation of which preparer has any knowledge. NSIBL R ILIN RETURN D E ~ ADDRESS --- - -- - ____. Q Carol D. Harty, 429 Grubb Street, Middletown PA , 31GNA RE F PREPARER O TH EPRFSFNrnnvr - --- -------__-_-._ ADDRESS -------------- ---- - -- Saidis, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 i ~.. •• ` i 15056052059 REV-1500 EX Decedent's__Nam_e: JAMES RECAPITULATION _.~.~.....~_,m...,. M HARTY Decedent's Social Security Number 342-20-7681 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 & Notes Receivable (Schedule D) ........................... .. 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ...... .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~w~ Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 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) ................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental BequestslSec 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. ..TAX COMPU._ a e ,._ ee_.~,,..~.. ~~~_ m.. ~m....,~,w.,a.~ ,,M®...e _ TATION -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_ 15. 16. Amount of Line l4 taxable - at lineal rate X .0 45 108,497.77 '' 16. 17. Amount of Line 14 taxable - at sibling rate X .12 17 ..._._ 18. Amount of Line 14 taxable at collateral rate X 15 12, 381.51 129,979.66 11,457.10 10, 024.79 21,481.89 '. 108,497.77 108,497.77 ' 18. . __ 19. TAX DUE .........................................................19. '; 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT .««J I_ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Flle Number r.. Decedent's Complete Address: 21 08 ~ -0878 .~ DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER JAMES M HARTY 342-20-_7681 __ _ - - _ STREET ADDRESS - - Bethany Village 325 Wesley Drive - - - _ - - _ STATE _ - --ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 4 2. Credits/Payments ,882.40 A. Spousal Poverty Credit _ __ B. Prior Payments 4,638.29 _ _ C. Discount 244.11 Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable 4,882.40 D. Interest - _._-. .Penalty Total InteresUPenalty (D + E) (3) 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. (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 . (56) 0.00 Make Check Payable to: REGISTER OF W1LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPR IATE 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'? .............. ^ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary 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 exemot 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 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-1503 EX+ (6-98) Y SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JAMES M. HARTY 21-08-0878 All property jointly-owned with right of survivnrshln mucf tie ,~~~.~.,~sa ,.., e,.ti......i_ MET: Historical Prices for METLIFE INC -Yahoo! Finance Page 1 of 3 Yahoo! My Yahoo! Mail More New User? Siyn Up Sign In ~~~„ ~ F ~~ M E _ Search ~..~....~.. WEB SEARCF DOw t' 2.73% Nasdaq '~ 2.49% Thu, Sep 25, 2008, 1:36PM ET - U.S. Markets close ~~~~ +~E7 CUESTES Finance Search MetLife, Inc. (MET) At 1:21PM ET: 55.77 ~ E~kTRR4E.SECURITIE$ LLC ~. No SUt'¢~1"IS@~. '. Historical Prices SET DATE RANGE Get Historical Prices for: ~~ CEO r Daily Start Date: Jul ~ 28 2008 . Eg. Jan 1, 2003 ~'" Weekly End Date: Jul - 29 2008 ~ Monthly C, Dividends Only Get Prices First ~ Prev ~ Next ~ Last PRICES Date Open High Low Close Volume Adj Close" 29-Jul-08 50.57 52.83 50.39 52.81 8,477,900 52.81 28-Jul-08 51.57 52.71 50.27 50.29 5,638,000 50.29 " Close price adjusted for dividends and splits. First ~ Prev ~ Next ~ Last Download To Sp readsheet ADVER'.TISEMENT http://finance.yahoo.com/q/hp?s=MET&a=06&b=28&c=2008&d=06&e=29&f=2008&g=d 9/25/2008 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDIJLE F JOINTLY OWNED PROPERTY ealAlt ur FILE NUMBER JAMES M. HARTY 21-08-0878 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. CAROL D. HARTY 429 GRUBB STREET DAUGHTER MIDDLETOWN, PA 17057 B. C JOINTLY-OWNED PROPERTY: LETTER DATE DES ITEM FOR JOIN T MADE CRIPTfON OH PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR F TH DA O NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE DATE OF DEATH DECD S VAL UE OF ~ A . VALUE OF ASSET INTEREST DECEDENT'S INTEREST ~ . 05/15104 LaSalle Bank checking account #5306425587 7,085.36 .5 3,542.68 2• A. 05115104 LaSalle Bank money market acct. #8603595565 215,959.29 .5 107,979.65 TOTAL (Also enter on line 6, Recapitulation) 13 111,522.33 (If more space is needed, insert additional sheets of the same size) L~S~Ite B ~ k. A 8 ask ref R ri ~, `:35 SouEi) ~.aS~i)~ Si;•~s~r C='}tl:;<t~jU, i3f~ncsir b©6Ct3 bdF.r~t.'.12r F IJiC 3'~} :~i!1-fit%)<; CLIEl~T UPAAT~ - R MaE~rth~.y Sta~e~Eent ufi Your Acc~rr.~t5 E~zth i.a5al2~ S~t~ic ~.A.. 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'h CCSY~4TY ~[a~nr+r sw.. ... iiithds•a~vtr~~~ Qra~aasi~~s ~8~~~~~$ 53(l~~-255~? . ~~~3 812.;'4 .~~ 21~i,~'6?.r1 ~alanca i?~yYff•~~.,~i1 21f,,7~2.67- t1S~ ~i~pi1~IT5 1~1~~ k~' ~#~R C::C4c~~t>>yyN~~~J~:1:~~yWya <YLJ~i"L~ ^~ ~~ a; REV-1510 EX+ (6-98) COMMONWEALThi OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEDULE G INTER-VIVOS TRANSFERS 8 MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JAMES M. HARTY 21-08-0878 This schedule must be completed and filed if the answer to anv of ^uestinns 1 fhrnunh d ,,,, tie .e,,,,..... ~;a_ ,.~.~_ .,~„ .~,... ,.,,,,~.. ,...___. S.' L~tSa~tE~ ~~nk t~.A~t A ~an~Z-~f Amerlcs Con~~any 43a Sat2rk3 L~wa,EE ~Yr~~E '"" f:;fcir,~c~KS, itliitfais B~12z(T.3 Afic:t3be£ Ft3EG Asa)1-~t'rr L:3fi~Y!3+l:e-1~;,~LZ ~?3 .~:.wiit3;iAE 3EiFy'i ~~<~--y2.1:2 MtIf+3T'FlL1t' G3~2E~d~' LIP~A76 £396 ..3.~34E8 M 39ARTY .tF'C~'C£'tIk8I1~ IJ~'~ez Q9~3t1+Qi3 ~2g ~fi~B~i ST Page I cif I ~IC3BLETL!#~~€ PA ~7f35~`-256~ AC~Qi333'~ N~tE#b+2t~ 2~igt3~f#00f34 aj NQNEY i'4Ait(~ET RETI#2EMEMTs: 245~3~C~3~~}£39 ~ta'te33~r ~yc~e; €~ACj~21r~7n2? ~y1~~tr~; ?7. 3fzE.;~4 «2 Onyr ~i3~E;f'2". G 3::Yt'i3E;f~ tt3Ya--4£ci'.-.. Zd:z..~€t 4~~at~~s ARCI f{C3d?i:'!Cc££a: .:- t'.fi..E'fi;-St F83C... , .~jj Yi l t ~tt~t'8vral ~ : ~..s:i.E3Li:. . f3r~ EZ.~'fTiy. ~2F7-ElT3Gf?;- ~#C,~12~s,.~irs Qther i~ithdrawal5 and J)~pasi~5 LYs~tta~ Ariscri~ttitsn ~~/~u~~~ r~~ri:u~~r Y¢zc sea~hrk-zcsra3-` Ctsaas.i.~E$. 5~.~~ II~il Aecaun~ Su~nar D;att~ tt~+/ 3G f`t~& ii1 thctrrawssis IIuc~o~ 3fa 8 aI ~nc~ flS.~~ 32,~2'3.;s II~fPi3RTR1NT IAl~'aRb~1~TIi2N Eittl of stat~mea'i4 EV-1511 EX+ (12-99) SCHEDULE H COMMONWEALrH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ~aiAie ur FILE NUMBER JAMES M. HARTY 21-08-0878 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1' Coble-Reber Funeral Home, professional services, supplies and equipment B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) CAROL D. HARTY Social Security Number(s)/EIN Number of Personal Representative(s) 322-68-3401 _ Street Address 429 GRUBB STREET City MIDDLETOWN .State PA Zip 17057 Year(s) Commission Paid: 2008 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees ~. PUBLISH ESTATE NOTICES, CUMB. LAW JRNL. (75.00); PATRIOT NEWS (162.03 ) TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 2,627.07 5,000.00 3,500.00 93.00 237.03 11,457.10 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCMEDIJLE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER JAMES M. HART1' 21-08-0878 Report debts incurred by the decedent prior to death which remained unpaid as of tha dare „r de~~ti i~,.~..a,..,......_:_~..___~ __,:__. ___ -~--- ~- . __° ,,...,, a,.,,.,~~~~a~ aiicnw ui uie same size) REV-1513 EX+ (g-00) SCNEDVLE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JAMES M. HARTY NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 • SUSAN GUASTELLA, 2131 UNION, LAFAYETTE, IN 47904 2• JAMES R. HARTY, 1609 BUCKINGHAM RD., HARRISBURG, PA 17111 3• CAROL D. HARTY, 429 GRUBS ST., MIDDLETOWN, PA 17057 FILE NUMBER 21-08-0878 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE DAUGHTER SON DAUGHTER 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 M<~DE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1/3 1/3 1/3 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) ~____ __ :3~~~~.LSOd Sfl' :~ ~i ~~ u~ `~ ;.I r- _~ LL ~~ ~ ~ ~ 'd~ ~ a ~I_l ISb'H L '' .,.4,,... ,~,,,~, ~'~~ r ~~~• 1~~ J ••a~ f ,~~ ~~ ~' 'L'~. ~ L 11y"~ ' ~ 7 7 1i~ •:.F - ~': >. ,_ iii: ,fir. t . n W A `~ z ~o ~ ~ vo -~ ~ ~ N v Q a' O U W a . ~ ~ >, ~ 30 ~x n ccn~ ~< o°' u~io°~o ~ w N~ ~U ~ 0 ~ s ~ ~ ~ ~'' A ~ U ~ ~ . ~ ` c c o OUOU O H ~,F~_ it _. ~~ - ~,-~..1 _. _ ~ ~ ~~_