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Home My WebLink About04-20-09 (2)J 15056051058 REV-15 0 0 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 eti. County Code Year File Number INHERITANCE TAX RETURN Hamsburg, PA 17128-0601 RESIDENT DECEDENT 21 08 00377 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 03/04/2008 02/02/1914 Decedent's Lasi Name Suffix Decedent's First Name LOWef MI Marion (If Applicable) Enter Surviving Spouse's R Information Below Spouse's Last Name Suffix Spouse's First Name MI :ipouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH T HE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ;~ 2. Supplemental Return 3. Remainder Return (date of death 4 Limited Estate prior to 12-13-82) 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate (Attach Copy of Will) 7. Decedent Maintained a Livin Trust - (Attach Copy of Trust) 9 8. Total Number of Safe Deposit Boxes 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) CORRESPONDENT - THIS SECTION MUST ~E N COMPLETED. ALL CORRESPONDENCE AND CONFID h ) ame ENTIAL TAX INFORMA710N S 0 ULD BE DIRECTED TO: John C Oszustowicz Daytime Telephone Number Firm Name (If Applicable) (717) 243-7437 Law Office of John C Os i!J.`~ W REGISTER OF WILLS USE CNLY r L: "Z First line of address 104 S Hanover St Second line of address ~ o C ~ j ~ r-; ~ ~. - . City or Post Office = ~ Z? I ~ r'r; Carlisle State ZIP Code DA~I~~ Q ~ - ` " - C~ PA 17013 ' ~~ ~ - -- Correspondent's e-mail address: ~ 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 tree, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE ERSON RES ONSIBLEcF~OyR FILING R TURN C~~l~~'GG~-l~~ / ~ l • ~ DATE ADDRESS L//~/ U~~ 2872 Clearbrook Dr., Marietta, GA 30068 ~ /" SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS ' 104 S Hanover St., Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 _.J J 15056052059 REV-1500 EX Decedent's Name: Marlon R Lower ____. RE CAPITULATIO _._ __ N 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 & Notes Receivable (Schedule D) ......... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 6. Jointly Owned 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) ................... .. .. ..... .. .. g 9. Funeral Expenses & Administrative Costs (Schedule H) ................. . .. g. 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. 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. 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 _ 1 5. 16. Amount of Line 14 taxable at lineal rate x .0 45 15,734.46 16. 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 Decedent's Social Security Number 15, 734.46 15, 734.46 15, 734.46 15, 734.46 708.05 708.05 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 os 00377 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Marion R Lower 167-18-7214 ----------- STREE:TADDRESS 231 Glendale St CITY _ _ STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 708.05 2. CreditslPayments 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. (q) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 708.05 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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? ...................................................................................................... ... ^ Ox 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? .............................................................................................................. ~ 0 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. t~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 ta:x 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. §!x116(1.2) [72 P.S. §9116(x)(1)]. The tax rtte 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(x)(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-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY C~JIAIt Vr Marion R F Lower Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must ha riisrlncnrl ,,., c,.ti„,~„i., FILE NUMBER 21-08-0037 (It more space is needed, insert additional sheets of the same size)