HomeMy WebLinkAbout03-0337I~ZV. 1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
/ 7-
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY~___~,
FILE NUMBER
COUI~CODE YEAR NUMBER
Z
ILl
U.I
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
12, tT'--L4¢ 3 ¼,
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF VVlLLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI'P( NUMBER
1
. Odginal Retum
[] 4. Umited Estate
[] 6. Decedent Died Testate (Attach copy of Will)
[] 9. Utigation Proceeds Received
[] 2. Supplemental Retum
[] 4a. Future Interest Compromise (date of death ~ter 12-12-82)
[] 7. Decedent Maintained a Living Trust (Attach copy of Truat)
[] 10. Spousal Poverty Credit (date of death between 12-31-91 and %1-95)
[] 3. Remainder Return (date of death prior to 12-13-82)
[] 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
THIS SECTION MUST BE COMPL~ I~O, ~L CORRES~NDENCE AND CONFIDENTIAL TAX INF~MATION SHOULD BE DIRECTED TO~
COMPLETE MAILING ADDRESS
FIRM NAME (If ApplicaUe) ~'O~' '~1~{,.) ~L.~
TELEPHONE NUMBER ~¢~p RtL.L. [ lh iq, Oil
1. Real Estate (Schedule A) (1)
2. Stocks aed Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sale-Proprietorship (3)
4. Madgages & Notes Receivable (Schedule D) (4) ~.~
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 4~ ~)~
(Schedule G or L) I
8. Total Gross Assets (total Unes 1 - 7)
9. Funeral Expenses & AdministraUve Costs (Schedule H) (9) "~/-'~
10. Debts of Decedent, Uodgage Liabilities, & Uens (Schedule I) (10)
11. Total Deductions (total Unes 9 & 10)
12. Ne{ Value of Estate (Line 8 minus Une 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (schedule J)
14. Ne{ Value Subject to Tax (Une 12 minus Line 13)
(8)
OFFICIAL USE ONLY
(12) t 57,. 053
(13) t'~ O I'~ IE
<14) 05'3
SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Une 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) X .0 (15)
16. Amount of Une14 taxable at lineal rate J ~"'~.,-
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)
20. [] I CHECK HERE IF YOu ~E REQUESTING A REFUND OF AN OVERPAYME~I
S'rFPA42021F.1
> > BE SURE TO ~S~R ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
JSTREET ORESS eS'
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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.
IsTATE P¢~ Iz'P I~0¢1
!
Total Credits (A + B + C) (2)
(3)
(4)
(5)
(5A)
(5B)
Total Interest/Penalty (D + E)
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 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 alter 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 secudty at his or her death? ..... [] [~]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ANB FILE IT AS PART OF THE RETURN,
Under penalties of perjury, I declare that I have examined this retum, 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.
SIGNATURE OF PERSON RESPONSIBL.E FO~RiFILING RETURN D.A,T~
ADDRESg - ' ~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
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 alter January 1, 1995, the tax rate im posed 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 retum 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 RS. §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 RS. {}9116(1.2) [72 RS. {}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 RS. {}9116(aX1.3)]. 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.
STF PA42021F.2
REV-1,503 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
I
FILE NUMBER
All property jointly-owned with the right of survivo~hip must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 2, Recapitulation)
STF PA42021F.4 (If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (1-97) (I)
COMMONV~TH OF PENNS%VA~A
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Include the proceeds o~ liligalio~ and ~e date the proceeds were received by the estate. NI prOpeli7 Jointly-owned with the fight of suwivo~shlp must be di~osed on Schedule R
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
5,00
'z.:5-'-j
TOT~ (Also enter on mine 5, R~pitulation) $ '1, ~ 0 3,'1 .~
(If mom space is needed, insal additional shee~s o~ the same size)
S3~ PA42021F.9
REV-I,509 EX + (1-97) ( )
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE F
JOINTLY-OWNED PROPERTY
I
FILE NUMBER
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
JOINTLY-OWNED PROPERTY:
U- I I i-i.~ DATE DESCRIPTION OF PROP~-RYY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institulion and bark account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
TOTAL (Also enter on line6, Recapitulation) $ J ~/~'.,,~'~, ,,~----------------~'~.
(If mom space is needed, insert additional sheets of the same s~ze)
STF PA42021F.10
REV-1.510 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 off the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF 11-E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER OF TRANSFER. A~-rACH A COPY OF T~-E DEED FOR REAL ESTATE. VALUE OF A,.e~ET INTEREST (IF APPLICABLE)
TOTAL (AJso enter on line 7, Recapitulation) $ <~ ~C, OC:,, OO
(If more space is needed, insert additional sheets of the same size)
STF PA42021F. 11
REV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
5.
6.
7.
DESCRIPTION
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
S'u'eet Mdress
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Strut Address
city S~ate
Relationship of Claimant to Decedent
Zip
Probate Fees
Accountant's Fees
Tax Retum Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation) $
AMOUNT
~ 00 , O0
gl 0,00
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F. 12
REV-1.,512 EX + (1-97) 0)
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULEI
DEBTSOF DECEDEN~
MORTGAGE LIABILITIES,&LIENS
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
(If more space is needed, insert additional sheets of the same size)
STF PA42021F. 13
REV-l,513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
I
FILE NUMBER
NUMBER
[.
II.
1.
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE~
AMOUNT OR SHARE
OF ESTATE
t oS3,'z..q
15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
a. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS 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 $
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F. 14
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD O02976
RITZIE WALTER C
505 DEUBLER ROAD
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 179-24-7863
FILE NUMBER: 2103-0337
DECEDENT NAME: RITZIE JULIA H
DATE OF PAYMENT: 09/04/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $319.45
TOTAL AMOUNT PAID:
9319.45
REMARKS: WAALTER C RITZIE
SEAL
CHECK# 388
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
, ~EV-1500 EX (r-. ~)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
z
uJ
Z
0
Q.
uJ
r~
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YEA~) DATE OF BIRTH (MM-DD-YEAR)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
II cl - 3..q
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
O1. Original Return
4. Limited Estate
F-J6. Decedent Died Testate (A~ch copy of W~ll)
r~9. Litigation Proceeds Received
j~2. Supplemental Return
O4a. Future Interest Compromise (date of death after 12-12-82)
~]7. Decedent Maintained a Living Trust (Attach copy of Trust)
LF--~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
3. Remainder Return (date of death pdor to 12-13.82)
~'"~ 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[-'~ 11. Election to tax under Sec. 9113(A) (A~c~ Sch O)
FIRM NAME (ffAppli~bie)
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
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 & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
O Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
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
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFF~CIAL USE ONLY
t aa
(11)
(12)
(13)
I
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .g __ (15)
16. Amount of Line 14 taxable at lineal rate I ~ ~ ~ ,~ 0 x .0 I~, ~' (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)
20. 0
Decedent's Complete Address:
STREET ADDRESS
IZIP
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 greater 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. (SA)
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
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 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? .............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................
IF THE ANSWERTO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS 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 represu,tatlve is based on all i~fofmation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE.EI~)R FILING RETURN
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
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)
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
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 paren'
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 n 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 at
individual who has at least one parent in common with the decedent, whether by blood or adoption.
RE¥-1508 EX + ~97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
~/1. Iq, oo
TOTAL (Also enter on line 5, Recapitulation) $ '"~.t ~' (~ (~' ~'O
(If more space is needed, insert additional sheets of the same size)
REV-1511EX + (1,.~.. ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
F..$¥ATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
5.
6.
7.
DESCRIPTION
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Pemonal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative{s)
Street Address
Year(s) Commission Paid:
Attomey Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
State Zip
Street Address
City State ~ Zip
Rela~onship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Prepamr's Fees
TOTAL (Also enter on line 9, Recapitulation)
(If more space ~s needed, insert additional sheets of the same size)
AMOUNT
$ I00,'"[0
- REV-1513 EX+ (9-00~
-~,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
II
!
1.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS 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
(If more space is needed, insert additional sheets of the same size)
~BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DTyTSION
DEPT. 280601
HARRISBURG, PA 17lIB-D601
COMMONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
WALTER C RITZIE
505 DEUBLER RD
CAMP HILL
PA 17011,~
DATE 09-01-2005
ESTATE OF RITZIE
DATE OF DEATH 01-28-2003
FILE NUMBER 21 03-0337
~7:~UNTY CUMBERLAND
ACM 101
Aeount Reei'~ted
RE¥-I;,I7 EX AFP (01-g$)
JULIA H
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF RZTZZE JULIA H FILE NO. 21 03-0337 ACN 101 DATE 09-01-2003
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks end Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
~. Nortgages/Notes Race/robie (Schedule D) (~)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule 6) (7)
8. Tote1 Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Ada. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
803.88
7~503.75
1~9~559.5Z
8~000.00
(B)
7,722.71
.00 NOTE: To insure proper
crad/t to your account,
.00 sube/t the upper port/on
.00 of this fore w/th your
tax payment.
15.
1~.
NOTE:
165,867.13
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TAX CREDITS:
PAYH~NT
DATE
RECEIPT
NUHBER
CD002~5~
DISCOUNT (+1
/NTEREST/PEN PA/D (-)
3~2.12
reflect f/gures that include the total of ALL returns assessed to date.
.00 X 00 = .00
15Z,053.Z~ X 0~5= 6,8~Z.~0
.00 x 12 = .00
· O0 X 15 = . O0
(19)= 6,8qZ.q0
AHOUNT PAID
6,500.28
ASSESSNENT OF TAX:
15. Amount of L/ne lq et Spousal rate (15)
16. Aeount of Line 1~ taxable at Lineal/Class A rata (16)
17. Amount of Line 1~ at S/bl/ng rate (17)
18. Amount of Line lq taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
6,8~2.~0
.00
.00
.00
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT ZS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
Nat Value of Estate Subject to Tax (1~) 152,055.
I~ an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19
6~091.18
(11) 13.813.89
(I2) 15Z,053.2~
RESERVATZON:
Estates of decedents dying on or before December 12, 1981 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or far years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS=
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 1140 of the /nhmritance and Estate Tax Act, Act Z$ of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on tho reverse side.
--Hake check or money order payabXe to: REG/ETER OF NXLLS, AGENT
A refund of a tax credit, ahich was not requested on the Tax Return, may ba requested by completing an "AppXication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office
of the Register of Hills, any of the Z~ Revenue District Offices, or by calling the special Z~-hour
ansaaring service for forms ordering: 1-BO0-56Z-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-BO0-~7-30ZO (TT only).
Any party in interest not satisfied aith the appraisement, allowance, or disalloaanca of deductions, or assessamnt
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--aritten pretest to the PA Dapartamnt of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the dmcedent's death, a five percent (51) discount of
the tax paid is allowed.
The 1SZ 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 and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you ~ould 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 ahich became delinquent before January l, 1981 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after
January l, 1981 Hill bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOO5 ara:
[ntarest DaiZy Interest Daily Znterast Daily
Year Rate Factor Year Rate Factor Yea..~r Rate Factor
1981 ZOX .0005~8 1987 91 .0002~7 1999 71 .O0019Z
1983 162 .000~$8 1988-1991 111 .000501 ZOO0 81 .000219
198q llZ .000301 1991 91 .0001~7 2001 91 .000147
1985 151 .000356 1993-199~ 71 .000191 ZOOZ 61 .00016~
1986 101 .O00Z7q 1995-1998 9Z .OOOZq7 ZOOS 51 .000157
--Interest is calculated as follows:
ZNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DEL/NQUENT X DA/LY /NTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF ZNDZVZDUAL TAXES
INHERXTANCE TAX DIVTSION
DEPT. 280601
HARRZSBURG, PA 17118-0601
WALTER C RITZIE
505 DEUBLER RD
CAMP HILL
PA 17011
COMMONWEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTICE OF ZNHERZTANCE TAX
APPRAZSEMENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
DATE OZ-OZ-ZOOq
ESTATE OF RITZIE
DATE OF DEATH O1-Z8-ZO0$
FZLE NUMBER 21 05-0557
COUNTY CUMBERLAND
ACN 101
Amount Ram:i.t ted
REV-lSd7 EX AFP (01-05)
JULIA H
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF RITZIE JULIA H FZLE NO. 21 05-0557 ACN 101 DATE OZ-OZ-200q
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRATSED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Es*ate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership :]:nterest (Schedule C) (3)
q. Mortgages/Notes Receivable (Schedule D) (q)
$. Cash/Bank DeposLts/Mlsc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7).
8. Total Assets
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Exponses/Adm. Costs/MAsc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Lions (Schedule 1) (10)
11. To,al Deductions
12. Nat Value of Tax Return
NO. 01
.00
7~199.50
.00
NOTE: To Lnsure proper
.00 crodi* to your account,
.00 submit the upper port/on
.00 of this fora with your
tax pay.ant.
.O0
(8)
100.70
7,199.50
.00
(11) 100.70
(12) 7,098.80
15.
NOTE:
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0
Not Value of Estate Subject to Tax (ltl) 159,152.
Zf an assessaent was lssued previously, lines 14, 15 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
(15) .00 x O0 = .00
(16) 159,152.0~ x Oq5 = 7,161.85
(17) .00 X 12 : .00
(18) .00 X 15 = .00
(19)= 7,161.85
ANOUNT PAZD
ASSESSMENT OF TAX:
1.6. Amount of Line lq at Spousal rata
16. Amount of Line lq taxable at LLneal/Class A rata
17. Amount of Line lq at Sibling rata
18. Amount of Line lfl taxable at Collateral/Class B rata
19. Principal Tax Due
TAX CREDZTS:
PAYMENT ' RECETPT DzsCOUNT (+)
DATE NUMBER ZNTEREST/PEN PAXD (-
0q-16-2005 CDOOZq, 5q SqZ. 1Z
09-0q-2005 CD002976 . O0
6,500.28
$19.45
ZF PAZD AFTER DATE ZND/CATED, SEE REVERSE
FOR CALCULATZON OF ADDITZONAL [NTEREST.
TOTAL TAX CREDZT
BALANCE OF TAX DUEI
ZNTEREST AND PEN.
TOTAL DUE
7,161.85
.00
.00
.00
( XF TOTAL DUE IS LESS THAN $1, NO PAYMENT 1S RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE S~DE OF THZS FORM FOR ZNSTRUCTZONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND [CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession ar enjoyment to CLass B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Comeonaealth hereby expressly reserves the right ta appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (TZ P.S.
Section 9140).
Detach the tap portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, 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" (RE¥-1313). Applications are available at the Office
of the Register of Nilis, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-36Z-ZO50; 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 er interest) as shown on this Notice oust object within sixty (60} days of receipt of
this Notice by:
--eritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171ZS-1021,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
198Z ZOZ
1983 16Z
1984 llZ
1985 13Z
1986 IOZ
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oapt. ZBO601, Harrisburg, PA 17LZS-0601
Phone (717) 787-6SOS. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent'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. This non-participation
penalty is appealable in the same canner and in the the same time period as you would 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 (93 months end one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of
six (6Z) percent par annum calculated at a daily rate of .000164. All taxes ehich became delinquent on and after
January 1, 1982 will bear interest at a rate which wiiI vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. Tho applicable interest rates for 198Z through ZOO3 are:
Interest Dally Interest Dally Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
.000548 1987 9Z .000247 1999 7Z .00019Z
.00043B 1988-1991 11Z .000301 ZOO0 8Z .000Z19
.000501 199Z 9Z .000Z47 ZOO1 9Z .000247
.000~56 1993-1994 7Z .O0019Z ZOO2 62 .000164
.000Z74 1995-1998 9Z .000247 ZOO3 5Z .000137
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen ilS) 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.