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Home My WebLink About03-27-0915056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po BOX 280601 21 08 0443 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW :social Security Number Date of Death Date of Birth _ _ . _._ ~D16-62-9772 ! 01/18/2008 Decedent's Last Name Suffix Decedent's First Name Ml 'CHARRON ;DOREEN L (If Applicable) Enter Surviving Spouse's Information Below ;ipouse'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 £•;~ 1. Original Return ms's 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) ?:":: ~ 4. Limited Estate 4a. Future Interest Compromise (date of L~.,3 5. Federal Estate Tax Return Required death after 12-12-82) ~::;;::~ 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust __........... 8. Total Number of Safe Deposit BoxE (Attach Copy of Will) (Attach Copy of Trust) ".~ ~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death f: 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 T Name Daytime Telephone Number THOMAS E. FLOWER ! (717) 737-3405 REGISTER OF WILLS USE ONLY ~ ~ N ` __ ~ I ~r ~ .qtr _ _C ) DATE F14EB I _ ~ ..1...._.. ..,,t CAMP HILL ' PA 17011 _" -;- _ __ _ y .---- .-, n Correspondent's a-mail address: tfloWer@Sfl-12W.COm :J r~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowled~nd 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. SIGNA~~ PER ON RESii~ F`OR FILI„ NSa.F~fURN 3~ ~ /n Glen Charr~ft; 5551 Edsel St., Harrisburg, PA 17109 SI TU OF PREPARE AN REPRESENTATIVE ATEr-- ADD S Saidis, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number __ __ _ ___ Decedent's Name: DOREEN L CHARRON ' 016-62-9772 RECAPITULATION ~~~~~~ ~..~~._ ~. v.._.~._._ ~ ._m 1. Real estate (Schedule A) ............................................. 1. i 2. Stocks and Bonds (Schedule B) ....................................... 2, ', 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3, i 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4, 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 400.00 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, ': 400.00 9. Funeral Expenses 8 Administrative Costs (Schedule H) ................... .. 9. 3,000.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 'i 11, Total Deductions (total Lines 9 & 10) ................................ ... 11. 3,000.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 0.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which _. an election to tax has not been made (Schedule J) ..................... ... 13. '. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 0.00 TAX COMPUTATION -SEE INSTRUCTIONS 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 at lineal rate X .0 _ 16. ': 17. __. _ .. u. ,-_. __ m. Amount of Line 14 taxable ., _~__ ,..~ ..._.. at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE .................................................... ..... 19. 0.00',. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: Fffe Number 21 08 ! 0443 _....., DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER DOREEN L CHARRON 016-62-9772 STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) 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. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 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 :.......................................................................................... ^ 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? ...................................................................... ^ 2. 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? .............. ^ ^x 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 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 (0} percent [72 P.S. §9116(x)(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} p'2 P.S. §9116(x)(1)]. The tax ratq lmPaSed, an~~~ ~e\Va`~e OI~`a~S~~~S~~ O~ ~O~ t~1e 1l$e Ofi ~1e aeC2deR~S SIb~IC1gS lS tWe1Ve (,12} p2rCent ~i2 P.S. ~9116(a)(1.3)~. A sibling'is defined, ender ' ~~IQ~ aSa~~~~~j~~a~a1W110haS atleastone parent'in comm4nwiththe decedent, whether by blood or adoptiwn. S~~lio , REV-1508 EX+ (6-98) (:OMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER DOREEN L. CHARRON 21-08-0443 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) REV-15'11 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES sc INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DOREEN L. CHARRON 21-08-0443 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' NEILL FUNERAL HOME 3,000.00 B. ADMINISTRATIVE COSTS: 1.. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) _ Street Address City .State Zip Year(s) Commission Paid: 2. Attorney Fees 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 3,000.00 (If more space is needed, insert additional sheets of the same size) JOHN E. SLIKE ROBERT :'. SAIDIS JAMES D. FLOWER, JR CAP.OL J. LINDSAY JOHN B. L.9MPI DANIEL L. SULLIVAN DEAN E. REYNOSA THOMAS 1~. FLOWER MARYLOLJ MATAS JASON E. I:ELSO LAW OFFICES SAIDIS, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 EMAIL: tflower~sfl-law.com www.sfl-law.com March 25, 2009 Office of the Register of Wills Cumberland County Courthouse Room 102 One Courthouse Square Carlisle, PA 17013 Re: Estate of Doreen L. Charron File No. 21-08-0443 Dear Sir or Madam: CARLISLE OFFICE: 26 WEST HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL Enclosed are the original and two copies of the Inheritance Tax Return for the above- referenced decedent along with a check in the amount of $15.00 in payment of the filing fee. Please return atime-stamped copy in the enclosed self-addressed stamped envelope. Please contact me if you have any questions regarding this matter. Very truly yours, SAIDIS, FLOWER & LINDSAY Karen Riccardo, Assistant to Thomas E. Flower, Esq. 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