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Home My WebLink About03-04-09 (2) 505605104? REV-1500 EX (06-OS) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INSOLUFNI' ESTATE County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN ~ ~ ~ ~ O z p Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6 0 2 8 6 8 4' 0', 9 1 9' 2,0" 0 2' 0 4'2 5 1'9;3 b- Decedent's Last Name Suffix Decedent's First Name MI ,Fi n ;k J e n n e t t=e L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name ~ MI F i n k W i l b u r - . Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate O 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) C:VRRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J A 'N E M A l 'e x a n d e r 7 1 ~n4 3 2 ~; 5 1_ Firm Name (If Applicable) ~.o _~' REGI~ F WILL ~ E ONI;Y' ~n .'~ a t First line of address ~ ~~ I r ! .F- 1 4 8 S o u t h B a 1 t i m o r''e Second line of address City or Post Office State D i 1 1;,s b u r, g P A Correspondent's a-mail address S T t'70~ ~ { ~~ ~ f% c t'tJ ZIP Code DATE FILED 1 7 0 1 9 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~~~Jly~~O RSON R ON IB FOR FILING RETURN DATF~ OD ADDRESS -- r.._...~.._.......y~.~~- - -- intlock Ridge Rd• Mecharticsburg, Pa. 17055 SIG ATURE OF PREPAR ~;OTHER;THA~I~tEPRESENTATIVE~~ ~ ~.~:_..._..-~_._.~ DATE PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 15056051047 15056052048 REV-1500 EX Decedent's Name: RECAPITULATION Decedent's Social Security Number 1. Real estate (Schedule A). ....... . ............................... .... L s 2. Stocks and Bonds (Schedule B) ..... . ,. 3. ........... . ................... Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. .. 2. 4 8 2 .4 ... 3. ` • ~ , 5. 4. Mortgages & Notes Receivable (Schedule D) ... ............. ... ... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule Ej ..... ... 5. 6. Jointly Owned Property (Schedule F) p Separate Billing Requested . 6 7. .... Inter-Vivos Transfers & Miscellaneous Non-Probate Properiy (Schedule G) ... . p Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1-7).... . . .................. ....... ... 8. ~; 9. Funeral Expenses & Administrative Costs (Schedule H)....... 9 ' . .. ....... ... . 9 5 0 8 . S 0 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) 13. ........... ................ Charitable and Governmental Bequests/Sec 9113 Trusts for which ...12. -, an election to tax has not been made (Schedule J) ..................... .. . 13. .: 14. Net Value Subject to Tax (Line 12 minus Line 13} ........... .......... 0 Q .0 ... 14. TAX COMPUTATION -SEE INSTRUC TIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable 15. • at lineal rate X .0 17. _ • Amount of Line 14 taxable 16. at sibling rate X .12 18. •' Amount of Line 14 taxable 17. ~ ' at collateral rate X .15 18. 19. TAX DUE .............. . .. .............................. .........19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056052048 0~0 0 O ],5056052048 REV-1500 EX Rage 3 Oecedent's Complete Address: ~- _ - -- - - __1eru~e~><e.L.__Fink__ _ _ -_. _ _ _ ____ STREETADDRESS 823 Flintlmck Ridge Road __. _____ CITY File Number STATE _ _ - _ PA Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit . Prior Payments C. Discount --___._..----_.-_- _ _..--- 3. InterestlPenalty if applicable Total Credits (A + B + C ) D. Interest E. Penalty ---- --------__---- - --- - _ _ - ___ _ _ ;ZIP _ - - 17055 (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.tal Interest/Penalty (D + E) (3) - 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. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 Make Check Payable to: REGISTER pF WILLS, AGENT .Tr ~~ 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 life of either payments, benefits or care? ............................................ ^ ......................... 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? .............. ^ 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 (al (1.1) (ii)j. The statute does not exemot 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 (O) 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. REV-1503 EX+ (6-98) Y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scH~®u`E ~ STOCKS & BONDS ESTATE OF FILE NUMBER Jeanette L. Fink All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION ~~ 175 Shares John Hancock Securities now Manulife at 27.57 per share VALUE AT DATE OF DEATH 4,824.75 TOTAL (Also enter on line 2 Recapitulation) I $ 4 824 75 (If more space is needed, insert additional sheets of the same size) ~ REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS tJlAlt Uh Jenrette L. Fink FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT t. Myers Funeral Hcme 5723.50 B. 1 2. 3. 4. 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative's Commissions None claimed Name of Personal Representative(s) Wilbur Fink Social Security Number(s)/EIN Number of Personal Representative(sL Street Address City State Zip Year(s) Commission Paid: Attorney Fees Jane M. Alexander 255.00 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant r.r, i'_~~ Street Address 823 Flintlock Ridge Road Mechanicsburg City _ State Zip 3500.00 Relationship of Claimant to Decedent f~ 1 r tU~., Ul7I1LL Probate Fees 30.00 Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9 Recapitulation) I $ 9508 50 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAk RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES t, IAI t Ur Jenrette L. Fink NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)j 1. Wilbur Fink 823 Flintlock Ridge Road N1ec1-tanicsburg, Pa. 17055 2. Jill E. Hoover 1407 Dartmota~ Road Pa. 17404 3. K th F' 398 Bluff View Ihive R~.30736 4. Kevin Fink 1057 New Valley Road Marysville, Pa. 17053 FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not LlstTrustee(s) OF ESTATE Husband 3500.00 Ihughter 0 ~ 0 ~ 0 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET lI NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (It more space is needed, insert additional sheets of the same size)