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HomeMy WebLinkAbout01-16-091,5056041,1,25 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 ~~ ~~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 4 1 8 1 6 9 8 1 1 2 8 2 0 0 8 0 4 0 6 1 9 1 6 Decedent's Last Name Suffix Decedent's First Name MI M C G O N I G L E H E L E N E T (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 IN APPROPRIATE OVALS BELOW 0 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) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Gopy 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 T0: Name Daytime Telephone Number C H A R L E S E P E T R I E 7 1 7 5 6 1 1 9 3 9 Firm Name (If Applicable) First Tine of address 3 5 2 8 B R I S B A N S T R E E T Second line of address City or Post Office H A R R I S B U R G REGISTER OF WILLS USE ONLY N C-t ~ 'T_"! _ '_ =: _.ri -~ - .~ ,.._ - r-, ! -; ' i..~ 7 p-- - i :~ State ZIP Code ©ATE~F"t4ED -fir ` ; ~: P A 1 7 1 1 1 _= ~ ~ ^; c.rt .- o Correspondent's a-mail address: PetrleLaW+`a?_AOLCOm 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 RESPQNSIBL~ F R FILIt!1G RETURN DATE ADDRESS 1605 KATHRYN SfiREET NEW CUMBERLAND PA 17070 SIGNATURE OF P ARER THE_R TH EP ESENTATIVE DATE ~~ ~ 1!13/2009 ADDRESS 3528 BRISBAN STREET HARRISBURG PA 17111 PLEASE USE ORIGINAL FORM ONLY Side 1 ],5056041,7,25 7,5056041125 J 15056042],26 REV-1500 EX Decedent's Social Security Number Decedent's Name: HELENE T. MCGONIGLE 2 0 4 1 8 l~~ g RECAPITULATION 1. Reai 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 & Miscellaneous Personal Property (Schedule E) 5. ~ 0 3 2 6 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 1 5 6 7 I 5 3 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property {Schedule G) ^ Separate Billing Requested .... .. 7. 8. Total Gross Assets (total Lines 1-7) ................. ..... .. g. l ~ 1 7 4 7 ~ 8 9. Funeral Expenses & Administrative Costs {Schedule H) 9. / E 5 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens {Schedule I) . ..... .. 10. 0 O 0 11. Total Deductions (total Lines 9 & 10) ...... ..... .. 11. 7 6 5 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............ ..... .. 12. 1 ~ 0 ~ 8 2 ci 8 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. 1 6 0 9 8 2 9 8 TAX COMPUTATION -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.o _ O O O 15. O 0 0 16. Amount of Line 14 taxable at lineal rate X .0 - 0 0 0 16 0 O O 17. Amount of Line 14 taxable 0 O O at sibling rate X .12 17. O 0 0 18. Amount of Line 14 taxable 1 6 0 9 8 2 9 at collateral rate X .15 8 18 2 1 4 7 4 5 19. Tax Due .......................................... .... ..19. 2 4 1 4 i 4 5 20. FILL IN THE OPAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 15056042126 1,5056042126 REV-1500 EX Page 3 Decedent's Complete Address: Fite Number DECEDENTS NAME 'HELENE T. McGONIGLE STREET ADDRESS -- _ __ CITY STATE 'ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit - B. Prior Payments - C. Discount 3. lnterestlPenalty if applicable D, Interest E, Penalty 1.207.37 (1) 24,147.45 Total Credits (A +B +C) (2) 1,207.37 Total InterestlPenalty (D + E ) 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. 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. (3) (4) 0.00 (5) 22,940.08 {5A) (56) 22, 940.08 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 : ................................................................. ..... ^ 0 b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ X c. retain a reversionary interest; or ........................................................................................... ..... ^ 0 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? ................................................................................. " " ...... ^ ^ or payable upon death bank account or security at his or her death? ... intrust 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? ............................................................................................ ...... ^ 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 death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-0ne 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) p2 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. 0.00 REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN REST DENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER HELENE T. McGONIGLE InGude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of surv'nrorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH GOLDEN LIVING CENTER REFUND TOTAL (Also enter on line 5, Recapitulation) ~ $ 5,032.68 032. (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER HELENE T. McGONIGLE Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. 1 2. 3. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Year(s) Commission Paid: Attorney Fees CHARLES E. PETRIE FamBy Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State _ Relationship of Claimant to Decedent 4. Probate Fees 5 Accountant's Fees 6. Tax Return Prepare~'s Fees 7. Zip Zip 750.00 15.00 TOTAL (Also enter on line 9, Recapitulation) ~ E (If more space is needed, insert additional sheets of the same size) REV-1513 EX +(g-pp) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT - -- ESTATE OF FILE NUMBER HELENE T. McGONIGLE RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [ndude outright sppoousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. WILLIAM J. NORK Collateral 160,982.98 1605 KATHRYN STREET NEW CUMBERLAND, PA 17070 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size)