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Home My WebLink About02-23-09 (2)15056051058 REV-1500 Ex (OCr05) OFFICIAL. USE ONLY PA Depar6tterd ~ Revetnie &xeau of ktdividttal Taxes County Code Year File Number Poeox2easol INHERITANCE TAX RETURN tla<risburg, PA nlzs-osol RESIDENT DECEDENT 21 09 000010 ENTER DECEDENT INFORMATION BELOW Sot~al Security Number Date of Death Date ~ Birth 201-07602 01/03/2009 06/29/1918 Decedent's Last Name Suffix Decedent's First Name MI BAIR GRAYCE E (If Applicable) Enter Surviving Spouse's tnformatlon Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW • 1. Original Retum THIS RETURN MUST BE FILED IN DUPLICATE YVITH THE REGISTER OF WILLS 2. Supplemental Retum MI 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) • 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 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 RONALD L. BOWERS (717) 249-7750 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY 1' V First lute of address ~ ~ i"t _ ~ 25 EASTWICK LANE ~~ -TT ~ ~~ ;~. ? . J t`*1 ~ "~~> Second line of address . ~ _? ? rte- Q c.-~ r= ;» m IV City or Post Office State ZIP Code ~AT<~F]I~E~ A ~_ Y CARLISLE PA 17015 '=~ ~ - ;~~ ~`- ~ ---t .. , -~ - - i; y ~ _. ~ Correspondent's e-mail address: ronaldez~embargmail.com CJ'1 Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is truedr ct and complete. Declaration of preparer other than the personal representative is based on all informatbn of which preparer has any knowledge . SIGN OF N R ONSIBLE FOR FILING RETURN DATE /_ _ 25 EASTWICK LANE, CARLISLE, PA. 17015 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: GRAYCE E BAIR 201-07-4602 RECAPITULATION 1. Real estate (Schedule A) . ......................................... ... 1. 2. Stocks and Bonds (Schedule B) .................................... ... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages 8~ Notes Receivable (Schedule D) .......................... ... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 98,679.70 6. Jointly Owned Property (Schedule F) Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 98,679.70 9. Funeral Expenses BAdministrative Costs (Schedule H) .................. ... 9. 2,979.27 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............. ... 10. 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 2,979.27 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 95,700.43 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Sd~edule J) ..................... ... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 95,700.43 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 .0_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 95,700.43 16. 4,306.52 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 g, 19. TAX DUE ...................................................... ...19. 4,306.52 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ 15056052059 Side 2 L. 15056052059 e ~~ \~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 000010 GR_AYCE E BAIR DECEDENTS SOCIAL SECURITY NUMBER STREET ADDRESS - _ _ 201-07-4602 - __ _ FOREST PARK HEALTH CENTER __- __ -_ -__ __ - _ _ 0 WALNUT BOTTOM ROAD _ - clrY - - - - - _ _ _ _ - ___ ___ ____ CARLISLE - _ STATE __ ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments (1) 4,306.52 A. Spousal Poverty Credit B. Prior Payments _ _ _ _ _ _ _ _ _ C. Discount _ _ _ - - - _ 226.65 _ - _ __- _--__ 3. Interest/Penalty if applicable Total Credits (A + g + C) (2) 226 65 D. Interest . E. Penalty __ _ _ _ __ - -- - - - _ tal Interest/Penalty (D + E) (g) 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE 226.65 . (5) A. Enter the interest on the tax due. 4, 306.52 (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 4,306.52 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: a. retain the use or income of the ro P PertY transferred :............................................................................. b r t i th Yes ^ No ............. . e a n e right to designate who shall use the property transferred or its income : ...................................... c retain X ...... . a reversionary interest; or ........... .............................................. d. receive the promise for life of either payments, benefits or care? ............ 2 If d th ^ ^ ^ . ea 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 A t ^ ^ ^X Q ccoun , annuity, or other non-probate property which contains a beneficiary designation? . ........................................................................................ ............................... ^ ^ x 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 (O) percent [72 PS. §9116 (a) (1.1) (ii)]. The statute does n_ of e_ xemot 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-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)]. 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY REV-1548 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT w~nrC ur BAIR, GRAYCE E. FILE NUMBER 000010 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail oroeerrv is--• ~ ...,....~~• -~ - - REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYIVANtA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEDI~LE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER BAIR, GRAYCE E. 000010 Debts of derxderrt must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT a FUNERAL EXPENSES: t' NEILL FUNNERAL HOME, INC. 1,720.00 3401 MARKET STREET, CAMPHILL, PA. 17011-0428 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Sodal Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commissron Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant SVeet Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Zip Zip 1,011.27 248.00 TOTAL (Also enter on line 9, Recapdulation) I a 2,979.27 (If more space is needed, insert additional sheets of the same size) RFV-L13 E ll-08) Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BAIR, GRAYCE E. 000010 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 2116 (a) (1.2).] 1. JAMES E. BOWERS SON One-Half 519 MEADE AVE. Residue HANOVER, PA. 17331 2 RONALD L. BOWERS SON One-Half 25 EASTWICK LANE Residue CARLISLE, PA. 17015 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON L[NES 15 THROUGH I 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TD TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, insert additional sheets of the same size.