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Home My WebLink About04-27-09 (2)15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes a, ~ County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 09 0218 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth C162-22-0807 02/28/2009 09/19/1927 Decedent's Last Name Suffix Decedent's First Name MI Smith Barbara P (If Applicable) Enter Surviving Spouse's Information Below Sppouse's Last Name Suffx Spouse's First Name MI rl/a 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 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) N 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 1 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 Richard L. Placey, Esq. (717) 236-9577 C` r., , Firm Name (If Applicable) c_('"") v REGISTER OE.V9~LS USE C7AtW ~ .' Placey & Wright ' ~ n First line of address ~ ~ !L~ _, r ! ..1 3621 North Front Street `- ~ '~~ t7 -~, ` Second line of address ~~ = ...E~ --I ~;, ~ City or Post Office State ZIP Code ~ I-larrisburg PA 17110-1533 C:orrespondent's a-mail address: pv'/18W@eplX.net 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 RESPONSIBLE FOR FILI FRET RN DATE / ^ ~ I ~~ - -c--. -. __.__. - ___.. __. _ __.__ _. __-_.. ADD . -, _- Kare ~ ~Gr~ n raig P. it o- cutors, c/o Placey & Wright, 3621 N. Front St., Hbg., PA 17110 ---- SIGNATURE OF PR PARE T ~ THAN RE SENTATIVE ~D/ATE+-~ ADDRESS ~^ _ _ _ __ _ - _ / ~ J--~/~~~ Richard L P~ce'y(, sgyu~e; ~ & ri 621 N. Front Street, Harrisburg, PA 17110 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 REV-1500 EX 15056052059 Barbara P Smith Decedent's Name: 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 & 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) .................................... 8. 9. Funeral Expenses &Administrative Costs (Schedule H) ..................... 9. 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_ 0.00 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 186,438.97 16. 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L_ Decedent's Social Security Number 062-22-0807 0.00 203,887.02 0.00 0.00 2,652.88 0.00 0.00 206,539.90 16,035.79 4,065.14 20,100.93 186,438.97 0.00 186,438.97 0.00 8,389.75 0.00 0.00 8,389.75 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 09 0218 DECEDENT'S NAME DECEDENT'S 50CIAL SECURITY NUMBER Barbara P Smith 062-22-0807 __ -__ STREET ADDRESS 2100 Bent Creek Blvd. CITY _ _ _ _ STATE _ _ ZIP Harrisburg PA 17050 Tax Paylrtents and Credits: 1. Tax Due (Page 2 Line 19) (1) 8,389.75 2. Credits/F~ayments A. Spousal Poverty Credit 0.00 - __ --- - B. Prior Payments 0.00 __ C. Discount 419.49 - _ Total Credits A + B + C 2 ( ) O 7,970.26 3. Interest/F'enalty if applicable D. Interest 0.00 E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 7,970.26 A. Enter'',he interest on the tax due. (5A) 0.00 B. Enter i:he total of Line 5 + 5A. This is the BALANCE DUE. (56) 7,970.26 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................................................................... ....... ^ ^X b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ 0 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? ........................................................................................................ ...... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ 0 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 (O) 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 il~nposed 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. REV-1503 EX+ (6-98) r. _.`~~~~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BARE3ARA P. SMITH 21-09-0218 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-981 i SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE: OF FILE NUMBER BARBARA P. SMITH 21-09-0218 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. ITEM VALUE AT DATE NUMBi=R DESCRIPTION OF DEATH 1. M&T Bank Checking Account 2673022295 2,196.06 2. M&T Bank Savings Account 15004200904074 (Principal-$167.18; Interest-$,02) 167.20 3. Capital Blue Cross -refund unused premium 161.62 4. Miscellaneous Household Goods Small TV w/Stand 10.00 Kitchen Table w/3 Chairs 15.00 Secretary's Desk w/Chair 25.00 Dressers (2) 10.00 Desk 5.00 Display Cabinet 10.00 End Tables (2) w/Lamps and and Coffee Table 8.00 Radio 5.00 Wall Grandfather Clock 25.00 Miniature House w/Furniture 15.00 5. Miscellaneous Personal Effects TOTAL (Also enter on line 5, Recapitulation) $ 2,652.88 (If more space is needed, insert additional sheets of the same size) REV-l fill EX+(12-99) Y r ~ SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER BARI3ARA P. SMITH 21-09-0218 Debts of decedent must be reported on Schedule I. ITEEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Hoffman-Roth Funeral Home 2,889.11 z. Blooms By Vickery -funeral flowers 570.23 3. Funeral Luncheon 915.14 4. Pastor Honorarium 600.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/ElN Number of Personal Representative(s) Street Address City .State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (lf decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal -estate advertising s. The Patriot-News Company -estate advertising s. Reserve for future costs, taxes and expenses Zip Zip 9,000.00 356.00 0.00 0.00 75.00 130.31 1,500.00 TOTAL (Also enter on line 9, Recapitulation) ~ 16,035.79 (If more space is needed, insert additional sheets of the same size) ~~ Pennsylvania SCHEDULE I DEPnan~EraT of aEVENUE DEBTS OF DECEDENT, rNHeRrrANCE-rNxRE-ruRN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER BAREtARA P. SMITH 21-09-0218 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. _ ~ /. pennsylvania SCHEDULE ~ DEPARTMENT GF REVENUE BENEFICIARIES INHERITANCE Tax RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BARE3AR A P. SMITH 21-09-0218 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. Karen S. Burgett, 110 Dorwood Drive, Carlisle, PA 17013 Daughter 1/4 Residue 2. Robert W. Smith, III, 1256 Alma Lane, Mechanicsburg, PA 17055 Son 1!4 Residue 3. Gary S. Smith, 2010 Mountain Pine Drive, Mechanicsburg, PA 17050 Son 1/4 Residue 4. Craig P. Smith, 137 Mt. Airy Road, Coatesville, PA 19320 Son 1 /4 Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. Il NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO 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 $ 00.00 If more space is needed, insert additional sheets of the same size. PLACEY ~ WRIGHT RICHARD L. PLACEY WILLIAM K. WRIGHT (I 943- 1999) ATTORNEYS AT LAW 363 I NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 1 7 110-1 5 3 3 (717) 236-9577 FAX (717) 236-0843 OF COUNSEL CHARLES J.DEHART,III STANLEY J.A. LASKOWSKI Apri124, 2009 Register of Wills CUMBERLAND COUNTY COURTHOUSE One Courthouse Square Carlisle, PA 17013 RE: Estate of Barbara P. Smith Estate File No. 21-09-0218 Dear Madam/Sir: We enclose herewith for filing, in duplicate, Pennsylvania Inheritance Tax Return for the captioned decedent, together with estate check in the amount of $7,970.26 to pay the tax shown due, and our check in the amount of $15.00 to cover the filing fee. Please return your receipt for the same to the undersigned in the enclosed, stamped, addressed envelope, together with aclocked-in copy of the additional first page enclosed. Thank you. Very truly yours, PLACEY WRI /~ - P ~ Ri rd cey .- RLP:hsk ;~ Enclosures ~~~-; - ~ sue' --~ -~ -~ c-~ _' , n~ - , - ..a - __~ - ; c: ~ -- `~~ c~ _~ .. -x? Gtt c~ r~ ~, ;~ ~~ ._ i ? ~.~ C r ~ f; C C' [i .~ ra ,;~.~~~ ,~yf•f4}a, "='~'' ~I ~i °'~'•~:~~ ~. ,~ ": J Q m u~ w 0 -- E., C7 Q W ~ _r ¢ -.~ J Q ~ Z Z j (,~ ry N W ~ 11. 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