HomeMy WebLinkAbout12-24-08 1505607121
OS
REV-1500 EX
05
(
-
)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 28oso1 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1 0 8 0 7 4 7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 6 4 2 8 D 1 1 0 0 6 1 1 2 0 0 8 0 4 1 3 1 9 3 2
Decedent's Last Name Suffix Decedent's Firs t Name MI
K I R B Y P A T R I C I A A
(If 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
^X 1. Original Return
4. Limited Estate
QX 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust 0
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
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)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
7 1 7 6 9 7 4 6 5 0
Firm Name (If Applicable) REGISTER OF WILLS U~',ONLY 11
M U R R E L R W A L T E R S I I I ~~_ _~' _
_c` ~> - i
First line of address ~, ~? ~ -
k
Second line of address I n-.
-, -,
,_.
5 4 E A S T M A I N S T R E E T -
City or Post Office State ZIP Code ___ ATE FILED h~
. ~ _~
M E C H A N I C S B U R G P A 1 7 D 5 5 ~""'
Correspondent's a-mail address
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.
SI TURE OF PERSO R O I E , R FILING R~TURN
w~ ~~r ~U ~-.._ _ - ~ DATE
~ _. ,
ADDRESS
LEONAR P• I Y &,. E A• ~• WITT MECHANICSBURG PA 17055
SIGNATURE F EP E ER N REPRESENTATIVE
DATE
ADDRESS/~` ' /`/ "~-
MURREL R WALTERS III, 54 E VAIN ST MECHANICSBURG PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 1505607121 J
1,5056077,21,
REV-1500 EX (06-05)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau oflndividualTaxes Coun Code Year
~ File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1, 0 8 0 7 4 7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
~, 6 4 2 8 0 1, 1 0 0 6 1, 1 2 0 0 8 D 4 ], 3 1, 9 3 2
Decedent's Last Name Suffix Decedent's Firs t Name MI
K I R B Y P A T R I C I A A
(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 INAPPROPRIATE OVALS BELOW
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 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 BE COMPLETED. ALL CORRESPONDENCE AND CONFID ENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
7 1, 7 6 9 7 4 6 5 0
Firm Name (If Applicable)
M U R R E L R W A L T E R S I I I
First line of address
Second line of address
5 4 E A S T M A I N S T R E E T
City or Post Office State
~1 E C H A N I C S B U R G P A
Correspondent's e-mail address:
REGISTER OF WILLS USE ONLY
ZIP Code ~
1, 7 0 5 5
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 TURE OF PERSON RES NSI L FOFk'I"'{ILING RETURN pglE ~
~-~~ ~ ~,A~, t 1~ ~~
ADDRESS ~
LEO A •; KI ~ P • 0 • OX 565 ~1ECHANICSBURG PA 7,7055
SIGN ~ O ,PR~~Fy~Or~HER THAN REPRESENTATIVE / ~ DA~ -7 G,
ADgRE3S" ~ ~-
~1URREL R WALTERS III, 54 E MAIN ST f1ECHANICSBURG PA 17055
PLEASE USE ORIGINAL FORM ONLY
DATE FILED
Side 1
1,505607121, 1,505607],21,
1505607121
06
05
REV-1500 EX
(
-
)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
__ Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1 0 8 0 7 4 7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 6 4 2 8 0 1 1 0 0 6 1 1 2 0 0 8 0 4 1 3 1 9 3 2
Decedent's Last Name Suffix Decedent's Firs t Name MI
K I R B Y P A T R I C I A A
(If 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
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
^X 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 BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
7 1 7 6 9 7 4 6 5 0
Firm Name (If Applicable)
M U R R E L
First line of address
Second line of address
5 4 E A S T
City or Post Office
M E C H A N I
R W A L T E R S I I I
M A I N
C S B U R G
Correspondent's a-mail address
S T R E E T
State ZIP Code
- -- -
REGISTER OF WILLS USE ONLY
DATE FILED
~. _ --- -
P A 1 7 0 5 5
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.
SIGNATURE OF PERSON RESPONSIBL~E FOR FILING RETURN DATE
HUUKLSJ
JU IE A ITTn 1 ,S• CHESTNUT ST• MECHANICSBURG PA 17055
SIGNATURE P E T R THAN REPRESENTATIVE
~~'T~
ADDRESS
MURRE R WALTERS III, 54 E MAIN ST MECHANICSBURG PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 1505607121 J
REV-1500 EX
1,505607221,
Decedent's Social Security Number
oecedenYs Name: P A T R I C I A A K I R B Y 1, 6 4 8 8 0 1, 1, 0
RECAPITULATION
1. Real estate (Schedule A)
.................................
.... 1.
... 1 9 0 0 0 0. 0 0
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. 6 6 4 6 9 5 , 8 5
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. ~' ~ 4 8 9 8 , 9 0
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 6 4 4 9 8 3 6
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines 1-7) .......... ..... .. 8. ~ 0 B 7 0 7 9 . 1, I,
9. Funeral Expenses & Administrative Costs (Schedule H) ..... ..... .. 9. 3 7 6 B 9 4 6
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ... .. 10. 7 6 0 8 . 4 6
11. Total Deductions (total Lines 9 & 10) .................. ..... .. 11. 4 5 2 4 1, , 9 8
12. Net Value of Estate (Line 8 minus Line 11) .................. ..... .. 12. 9 9 1, 8 B 7 . 1 9
13. Charitable and Governmental Bequests/Sec 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. 9 9 ~, 8 B 7 , 1r 9
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9115
(a)(1.2) X.o 0 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 9 9 1, 8 3 7. 1 9 16 4 4 6 8 8. 6 7
17. Amount of Line 14 taxable
0 0
0
0
0
a! sibling rate X .12 17. . 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0 18. 0 0 0
19. Tax Due ................................... .... ..19. 4 4 6 8 8. 6 7
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1,505607221,
1,505607821,
REV-15o0 EX Page 3
Decedent's Complete Address:
File Number
21 OS 0747
DECEDENT'S NAtAE
PATRICIA A. KIRBY _ _ _-___ ____-__ _-
STREET ADDRESS
108 SOUTH CHESTNUT STREET
CITY STATE ~ ZIP
MECHANICSBURG ~ PA ' 17055
Tax Payments and Credits:
~. Tax Due (Pace 2 Line 19) l~! 44,632.67
2. Credits/Payments
A. Spousal Poverfy Credit
B. Prior Payments 42,000.00
C. Discount 2
100.00
,
Total Credits (A + B +C) (2) 44,100.00
3. lnterestiPena!y if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This Is the OVERPAYMENT.
Fill in ova! on Page 2, Line 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ 532.67
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 532.67
Make Check Payable fo; 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 : ................................................................
i ......
X
ncome; ........................
b. retain the right to designate who shall use the property transferred or its ......
^
c. retain a reversionary interest; or .......................................................................................... ......
^
d. receive the promise for life of either payments, benefits or care? ................................................. ......
If death occurred after December 12, 1982, did decedent transfer property within one year of death
2
.
without receiving adequate consideration? .................................................................................
h?
d
" ...... ^
^
...
eat
or payable upon death bank account or security at his or her
3. Did decedent own an "in trust for ......
4. Did decedent own an {ndividual 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 fcr the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (i,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 sti!I 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 childtwenty-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)j.
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-ha'f (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)]. 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-1502 EX + (6-98j
`'~::
~~ ~
~:
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
P,ESIDENT DECEDENT
ESTATE OF FILE NUMBER
PATRICIA A. KIRBY 21 08 0747
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts,
Real roe which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 108 SOUTH CHESTNUT STREET, MECHANICSBURG, PA 17055 108,000.00
PER APPRAISAL DATED JUNE 11, 2008
2. 312 EAST LOCUST STREET, MECHAN{CSBURG, PA 17055 85,000.00
PER APPRAISAL DATED JUNE 11, 2008
TOTAL !Also enter on iine 1, P,ecapitulation) ~ $ 193,000.00
(If more space is needed, insert additional sheets of the same size)
REV- i 5G7 EX + (E-SE)
~ ~~
r~:~~~`
COf/~f.~ONVJEALTH OF PENNSY~VP.NIA
INHEP.ITP.NCE TAX RETURN
RESIvENT DECEDENT
-~ ~~-
t~C~'TGAGES & ~C~~~S
~ECCfVA~L~
ESTATE OF
FILE NUt~9BER
KIRBY. PATP.ICIAP,. 21 00 0747
i All property jointly-owned v.ith the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION 0~ DEATH
,, WILLIAM G. SOCKtv1AN, SR. AND SUSAN D. SOCISMAN 664;693.85
5200 TRl!v'DLE ROAD, MECHANICSSURG, PA 17055
TOTAL (Also enter on line 4, P,e~api+.ulation)~ $ 664,693.85
(If more space is ne2d2d, insert additional sheets of the same size;
REV-1508 EX + (6-98)
N:.i'i
~
s-5-+.Y•
~+
CASH
BANK DEPOSITS
& MISC
COMMONWENLTHOFPENNSYLVANIA ,
,
.
INHEP,ITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUh1BER
PATRICIA A. KIRBY 21 08 0747
Include the proceeds of litigation and the date the proceeds were received by the estate.
All propertyjointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. SOVEREIGN BANK 71,730.83
CERTIFICATE OF DEPOSIT
2. PRUDENTIAL FINANCIAL 31,225.08
IRA -BENEFICIARIES JULIA A. WITT AND LEONARD P. KIRBY
3. CAROL E. CLINE 300.00
JULY RENT
4. THE PATRIOT-NEWS 119.15
SUBSCRIPTION REFUND
5. HIGHMARK 197.88
REFUND MEDICAL INSURANCE
6. ERIE INSURANCE 25.00
REFUND
7. PA DEPT. OF REVENUE 68.01
REFUND PERSONAL TAXES
8. HOUSEHOLD CONTENTS 11,000.00
9. J. C. EHRLICH CO., INC. 163.53
SERVICE CONTRACT REFUNDS
10. VERIZON 45.68
REFUND
11. COMCAST CABLE 17.74
REFUND
TOTAL (Also enter on line 5, Recapitulation) ~ $ 1 14 892 90
(If more space is needed, insert additional sheets of the same size)
°, EV- i 50° EX + (5-92j
G~~ _
rrt ~ ~ ~r, ~: ~ ~ ~ a~`~'` ~.. ~..
~>>
COf.":fJIONVvEALTH OF PENNSY~VAfJIA "~~! `~~~~~®~~` ~`~~ ~CO~~~R~~f
INHERITANCE TAX P.E I URN
P.ESIDENT DECEDEfv'T
w iris ~ yr FILE NU~EER
KIRBY. PATRICIA A_ 21 08 0747
If an asset was made joint within one year of the decedent's date of death, it must 6e reported on Schedule G.
suRVivIN~ ~oiN T TENANTIs~ NArv~E
ADDRESS ~RELyTIONSHIP TO DECEDENT
A. JULiE A.. K. VJiTT 100 S. CHESTNUT STREET
MECHANICSBURG, PA 17055
6
C
JOINTLY-OYs'h:'ED PROPEP.TY:
DAUGHTER
I tf:
f~Uly "cER L~ T ~ ~R
FOR JOINT
TEi\ ^,NT DTTE
MADE
JOIti'7 DESCRI IOti OF Pn0°ERTY
~ INC' UD NAME 0~ FINANCIAL INSTI i UTiON ANC 8 NK ACCO=fvT NUM2EP. OR SIVILAR
IDEti i !Fl'ING fJUMSER- A I T,',Cr GEED FOR JO fJ T L Y-SEED REAL ESTA I E.
DATE 0~ DEBT'-
VALUE C=ASSET 9 G=
DECD'S
INT_ZES T G^T C= ~~ ^,T:~;
V„ ~t G
C_C=C-fv i S If. ER'=S;
1. A. 8/30/01 SOVEREIGN BANK 52;253.25 50. 26,126.63
CHECKING
2. A. 2/20/07 SOVEREIGN BANK 76,731.45 50. 38,365.73
MONEY MARKET SAVINGS
TOTAL (Also enier on line E, RecapitelaTion) ~ ~
64,492.36
(It more space is needed, inse~ ~ additional sheets of the same size)
REV-1511 EX + (1 C-06)
Yti ~ ~ --
~~
~~~.vt
COMMONWEALTH OF PENNSYLVANI,4
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
PATRICIA A. KIRBY 21 08 0747
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. ZIMMERMAN AUER FUNERAL HOME -PREPAID
2. ZIMMERMAN AUER FUNERAL HOME -OBITUARY 377.88
3. ZIMMERMAN AUER FUNERAL HOME -MEMORIAL CARDS 116.60
4. PEALERS FLOWERS 112.25
5. ROYERS FLOWERS 242.73
6. KARIN CARROLL -PASTOR 175.00
7. SILVER SPRING PRESBYTERIAN CHURCH -RECEPTION 115.00
8. ORGANIST 75.00
9. GRAVE OPENING 50.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Julie A. Witt & Leonard P. Kirby (RENOUNCED)
Street Address
City State Zip
Year(s) Commission Paid:
2 Attorney Fees MURREL R. WALTERS, III, ESQ. 33,750.00
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 REGISTER OF WILLS -CUMBERLAND COUNTY 775.00
5 Accountant's Fees ALFRED WHITCOMB 1,200.00
6. Tax Return Preparers Fees
7. S. W. BARRETT REAL ESTTE & APPRAISAL SERVICES 650.00
REAL ESTATE APPRAISALS
TOTAL (Also enter on line 9, Recapitulation) I $ 37.639.46
(If more space is needed, insert additional sheets of the same size)
REV-1512 E}: + (12-03)
-~"S~`
d ~.'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
s?5~~~F~E~ i
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
PATRICIA A. KIRBY 21 08 0747
Report debts incurred by the decedent prior to death v/hich remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DA I E
NUMBEP: DESCRIPTION OF DEATH
1. BOROUGH OF MECHANICSBURG 232.64
SEWER/REFUSE
2. BARRY L. HECKARD
SCHOOL REAL ESTATE TAX
3. UNITED WATER
4. COMCAST CABLE
5. PPL
ELECTRIC
6. UGI
GAS SERVICE
7. VERIZON
PHONE
8. WESTFIELD INSURANCE
HOMEOWNERS
g. QUANTUM IMAGING
MEDICAL
10. RECORDER OF DEEDS
RECORD DEEDS
11. PNC BANK
CHECKS
12. SILVER SPRING PRESBYTERIAN CHURCH
CONTRIBUTION
13. KELLY YONTZ
PERSONAL CARE
14. PA DEPT. OF REVENUE
2008 INCOME TAX
15. U.S. TREASURY
2008 INCOME TAX
TOTAL (Also enter on line 10, Recapitulation) ~ $
(If more space is needed, insert additional sheets of the same size]
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PATRICIA A. KIRBY
Decedent's Name
Page 5
21 08 0747
File Number
Schedule I -Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER
DESCRIPTION
A.f/~OUNT
16. AAA FINANCIAL SERVICES
CREDIT CARD 377.88
SUBTOTALSCHEDULEI 377.88
GRAND TOTAL SCHEDULE I $ 7,602.46
REV-1513 EX + (5-00 j
~y~.
,_ SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PATRICIA A. KIRBY 21 08 0747
P,ELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBU I IONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1
JULIA A. WITT Lineal
100 SOUTH CHESTNUT STREET
MECHANICSBURG, PA 17055
LEONARD P. KIRBY Lineal
P.O. BOX 565
MECHANICSBURG, PA 17055
420,652.26
2
II.
1
1
528,652.26
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 15 NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVEP. SHEET I $
(If more space is needed, insert additional sheets of the same size)