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Home My WebLink About12-15-08__ __ t ~~ a. `i J 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Vear File Numtrer Bureau of Individual Taxes ~' PO BOX 280661 INHERITANCE TAX RETURN h c~~ Harrisburg, PA t7t28-o6ot RESIDENT DECEDENT oG,~ ~ ~ ~J ENTER DECEDENT INFORMATION BELOW Sodas Security Number Date of Death Date of Birth 11-19-2007 8-29-32 Decedent's Last Name Suffix Decedent's First Name MI (dallagher Roland ,T (N Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW .rra 1. Original Return 2. Supplemental Return 4. Limited Estale 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required deaN 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 SE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX INFORMATION SNOULD BE DIRECTED T0: Name Daytime Telephone Number Michael S. Travis 717-731-9509 ,~, ~ Firm Name (If Applicable) ~ O i Attorney at Law -r, ~.« `~ rTt ~ ~, First line of address ~ - ~_ - ' ' 3904 Trindle Road ~ ~'~ cn " ~ Second line of address ~ ~ ~ ' -' _ o - City or Post Office State ZIP Coda - "~ Camp Hill PA 17011 Correspondent's a-mail address: mSt~fTltfaVIS18W.COm Under penalties of perjury, I declare that I have examined tltis return, including accompanying schedules end statements, and to the best of my knowledge and belief it is true, correct and complete. Declaration of preparar other then Me personal representative is based on all information of which preperer has any knowledge. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS Remainder Return (date of death prior to 12-13-82) SIG~NyA~TURE~ OF PERSON(RESPONSIJBLE FOR FILING RETURN ~nt~ l-A+.uvc.c-f.{-e. ~'. ..~d.J..~Q..L-cyµ„vw 7}wyY Z4 .1.Cn AnnRFa¢ 90 Salem Chu Road, #400, Mechanicsburg, PA 17050 SIGN OF R PARER OTHER THA~LN,REPRESENTATIVE r14'rF) ~~ ! i//_"%~?H-VyS A_T7T. /,'NC%/ N'% GAN - fi'/o~~~ 3904 Trindle Road, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY - 15056051058 Side 1 15056051058 v V J , 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: Roland .T. C,allagher RECAPITULATION t. Real estate (Schedule A).. _ ....................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closel Held Cor oration, Partnershi or Sole-Pro rietorshi Schedule C Y P P P P( )~~~ 3. ~~ 0.00 4. Mortgages $ Notes Receivable (Schedule D) ........................... .. 4. 0'00 5. Cash, Bank Deposits $ Miscellaneous Personal Property (Schedule E) ...... .. 5. 1485.00 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers $ Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 7-7) ................................. ... 8. 1485.00 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 4432.60 10. Debts of Decedent, Mortgage Liabilities, $ Liens (Schedule I) ............. ... 10. 30,1 1 0.1 1 11. Total Deductions (total Lines 9 8 10) ................................ ... 11. 34, 542, 71 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 72. -33 r 057.71 73. Charitable and Governmental Bequests/sec 9773 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. 0.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal taz rate, or transfers und~~ sec. 9116 (a)(1.2) X .D. 15. 16. Amount of Line 14 ~~°`,ble at lineal rate X .0 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. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 ~ 15056052059 ~ REV-7500 EX Paga 3 Fila Number Decedent's Complete Address: DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Roland J. Gallagher _ STREET ADDRESS 90 Salem Church Road, #400 Clrv STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penatty 'rf applicable D. Interest E. Penalty (1) "- Total Credits (A+ B + C) (2) - Total InteresUPenalty (D + E) (3) 4. h 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. ff Line 1 + Line 3 rs greater than Line 2, enter the dffeence. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) 0.00 0,00 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 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 :.................................................................................... ...... ^ 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 I'de 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? ........ ...... ^ ^X 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 AND FILE IT AS PART OF THE RETU 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 s 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 tc or for the use of the surviving spouse is zero (0) p [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 asset filing a tax return are still applicable even 'rf the surviving spouse is the only beneficiary. For dates oT 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 pare adaptive 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 tour and one-haH (4.5) percent, except as nc 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. REV~1506 EX+ (6-98) ti ~"~~ 3. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIU ENT DECEDEN'( SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Rolantl J. Gallagher 21-08-0053 1,485.00 REV-1511 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Roland J. Gallagher 21-08-0053 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Aver Memorial Hone and cremation services, Inc. Cremation 1,415.00 Myers Funeral Home (Services) 1 408.60 e. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) .Charlotte G311ac~her so-eet Address 90 Salem Church Road #4.0.0 _ -__ __ city Mechanicsburg state PA Zip 17050 ---- Year(s) Commission Paid; N/A 0.00 2. Attorney Fees 1 , 500, 00 3. Family Exemption, (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zi Relationship of Claimant to Decedent 4. Probate Fees 109.00 5. Accountant's Fees n. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) I $ 4 432 (If more space is needed, insert additional sheets of the same size) REU 1512 E%+(1203) SCHEDULE 1 commoNwEntTn of aENNSnvnwn DEBTS OF DECEDENT, INMERITANDE Tax RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Roland J. Gallagher 21-08-0053 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) t 1 ~• ~ 6 r 1 7^ Ie ~ ~ m ~__ . a ~i.. - ~ C C~GJ " ) CI ~: U Jr ~ - C.i L,~ 2~-:1 _ ~. C O U N r r F-- z O U O Z 2 Q (.3 W Qm~ _. m~~~~= ~Ud c~_ ~ ~ W M J(nO. oC-fir- ZLL.~Q= QO~..d-_ Q W ~ J Z~U~= J = J W Z Q (.70000= N Q Q ~ a ~ J 0 - ~- Q rc Q . ~ a cn> °~ ~ W J Z - J p i r, W ~ Q 0 v a `~>x _ ~ U_ Q °m a m u :.,,.~ :r .,;.. *,` ,~' MICHAEL S. TRAVIS ATTORNEY AT LAW 3904 TRINDLE ROAD CAMP H4L. PA 17011 TELEPHONE VIJ) J31-9502 FAX VIJ) X31-9511 TOLL FREE 1-877-652-3220 December 10, 2008 Glenda Farner Strasbaugh c~ Register of Wills ~-O ` ; `" '' o - One Courthouse Square c:~ . , ~ ~ = Carlisle, PA 17013 > T -~ _ - r, i1 ~ -- ._. Re: Estate of Roland J. Gallagher, No. 2008-00053 ` _ ;- Inheritance Tax Return „ _ ~ ~ ry ~ _ ~? o ,:.'; Dear Ms. Strasbaugh: tD Enclosed for filing, please find the Inheritance Tax Return in this case. Please return a filed copy in the envelope enclosed for your convenience. The filing fee of $15.00 is also enclosed. There is no tax due. Please contact my office should you have any qu~ions or concerns. Very trily~y_zjurs, Attorney for Administratrix MST/hm pc: Charlotte E. Gallagher, Administratrix