The URL can be used to link to this page

Home My WebLink About12-31-0815056041125 REV-1500 EX (06-05} OFFICIAL U5E ONLY RA flar,,~rfmant ~f ~?,c.rP^sta Bureau of Individual Taxes County Code Yeas File Number Po Bax 2eosol INHERITANCE TAX RETURN Harrisburg PA 17128-8641 RESIDENT DECEDENT ~ ~ 0 ~ r a`~~ GraT>=s. L~EGEnEf~r gntFnR,trte-rlnltp 9ELO~n~ Social Security Number Date of Death Date of Birth 1 0 0 8 2 0 0 8 1 1 3 0 1 9 1 4 Decedent's Last iJame M .~ S E E R S Su;iix uerederti's Firsi name M I L D R E D (ff Api;?icabtee ~r3ter c;%; ;ri`.:='.g Spouve~s lt:fvrr~:a:i9;; 'Bei:°a:` Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number PILL INAPPROPRIATE OVAL'S BELOW 0 1. Original Return i~'E G. I :m itFd F.ct~ta 6. Decedent Died Testate (Attach Copy of Will) r"-'t .~. i-iiiyai;on F'rvCec~:z5 ~.BC,c i'vcv lJ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return Aw. F~t~re int,V reet ^wn-r-r~Vr-tica 'Jat~ „„ v ~, n ~~ death after 12-12-82} 7. Decedent Maintained a Living Trust 0 _ (Attach Copy of Trust} iv. vipviiSai YGVe+?'y' ureuit (dat8vf avati"~ between 12-31-91 and 1-1-95) .:.i M! 3. Remainder Return (date of death prior to 12-13-82) 5 Faci~ra! F.,t~tF Tax R~ti.rr 4a _ irar! 8. Total Number of Safe Deposit Boxes .". y.ieGtit~ii i;; tari iii?u~„r .~r~i,. y" i4~~A (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPDNDtNCt Atvu cuNrlutN I IAL I Ax INr~rcmA I tun srluuw at utrctc t to t u: Name Dadime Telephone ~mt;er `._,T .r"1 r=a C H A R L E S E P E T R I E -~' r_'' r_`= =~ Firm Name (If Applicable} = ` r REGISTER OF V4lltLfirt7SE O i~~ --,. First line of address - ~`' -.. _ _ . _ _ , _ CSJ Second line of address City or Post Office State ZIP Code DATE FILED H A R R I S B U R G P~ 3~ 1~ ~- C17 Correspondent's a-mail address: PetrieLaw ,AOL.com 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 a!! information of which preparer has any knowledge. I' ATiSRE O'r` P RSO~,N~ R~EIS_FO Si_6LE FOR FILING RETURN ~ ~~ T_, ~,rv) p p C? c ~' T ,AN F r a r,~ p H z ;_, T; ,., SIGNATUR„~OF PRREI~ OTHER AN REPRESENTATIVE .. J 2 C i~ lT: 1. ~ i-`i?iLJ :~ l~ r, l~, ri~~f:~ ~r,vRG PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 DATE 12/30/x/2008 1~- ~ ~ -! I ~I i DATE 12/3c/2o08 15056041,1,25 ~ ~ J 250560427,26 REV-1500 EX Decedent's Social Sec urity Number Decedent's Name: MILDR.ED O. MASTERS RECAPITULATION 1. Deal estate (Schedule A) ..................... .. 1. 2. Stocks and Bonds (Schedule B) .......................... .. 2. 3. Closely Held Corporation, Partnership or Sofe-Proprietorship (Schedule C} ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) .................. .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 6. Jointly Qwned 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 1-7) ......................... .. 8. ~ 8 4 4 % 3 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. ~ ~ ~ 4 ~ 3 13. Charitable and Govemmentai BequestsJSec 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. 3 ~ ~ ~ ~ ~ TA}: COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 9~. , .~~~.,Ur1t of L;~w lA °.t3x~.:ac, at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.O..~. ~ ~ ~ 15. Q 0 ~ 1r A(1'71It,^~ f1f LtRP 11. tai'a~ilP 3 ~ `~ `~ ~ ~ I ~l ~ U 1 at lineal rate X .045, 16. 17. Amount of Line 14 taxable ~ {~ J at sibling rate X .12 17. 18. Amount of Line 14 taxable ~ ~ ~ ~ ~ ~ at collateral rate X .15 18. 1~ Tax Ds:F 19. 1 7 3 ~ 1 20. FILL IN THE OVAL tF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 7,50560421,26 150560421,26 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAM1E MILDRED O. MASTERS STREET ADDRESS 515 LAMP POST LANE CITY ~ STATE ZIP CAMP FiiLL ~ PA ' 17011 Tax Payments and Credits: t • Tax Due (Pa13e 1 Line 19j 2. CreditslPayments A S I Povert Credit pousa y B, Prior Paarnents _ C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty 8.65 (3) 0.00 (1j 173.01 Total Credits (A + B + C) (2) 8.65 Total InteresUPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fii1 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (4) (5) O.GO 164.36 (5A) (5B) 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 i f d ...... ^ 0 ncome; ......................... or erre ts b. retain the right to designate who shall use the property trans ...... ^ 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? ................................................................................. " " ...... ^ ^ Q or payable upon death bank account or security at his or her death? ... in trust for 3. Did decedent own an ...... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................ ...... ^ 164.36 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 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 if the surviving spouse is the only beneficiary. For dates of deathh 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 p2 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-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ATE OF SCHEDULE F JOINTLY-OWNED PROPERTY FILE NU0.iBER MILDRED O. MASTERS Nan asset was made joint within one year of the decedents date of death, it must be reported on Schedule ~. ADDRESS TIONSHIP TO DECEDENT SURVNING JOINT TENANT(S) NAME A. JAMES R. MASTERS c IOINTLY-OWNED PROPERTY: 515 LAMP POST LANE CAMP HILL, PA 17011 SON ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR 51MIlAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 7/2006 MONEY MARKET ACCOUNT AT PNC BANK 2,542.66 50. 1,271.33 2. A. 7/2006 CHECKING ACCOUNT AT PNC BANK 5,146.79 50. 2,573.40 TOTAL (Also enter on line 6; Recapitulation) ~ S 3, 844.73 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-00) COMMONWEALYH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILDRED O. MASTERS SCHEDULE J BENEFICIARIES FILE NUMBER RELATIONSHIP 70 DECEDENT AMOUNT OR SHARE NUMBER Na,FRE AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTP,TE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. ,LAMES R. MASTERS Lirtea= 3,844.73 515 LAMP POST LANE CAMP HILL, PA 17011 ENTER DOLLAR RMOUNTS FOR DISTRIBUTIONS SWOWN A80VE 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 i. 1. B. CHARITABLE AND GOVERNMENTAt_ DISTRIBUTIONS TOTAL OF PART li -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (Ii more space is needed, insert additional sheets of the same size)