Loading...
HomeMy WebLinkAbout05-08-09r :~ 15056051058 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Count Code Year File Number y PO BOx 280601 INHERITANCE TAX RETURN ~ ~ Q ~ O ZS( Hamsburg, PA 17128-0601 o RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW ' 03/03/2008 ' 11/02/1932 Decedent's Last Name Suffix Decedent's First Name MI __ !Baer 'Dolores A _ ___ (If Applicable) Enter Surviving Spouse's Information Below Spouse'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 s~ 1. Original Return _~,, 2. Supplemental Return s:;:~~ 3. Remainder Return (date of death prior to 12-13-82) „~;;; 4. Limited Estate ~;~;;;, 4a. Future Interest Compromise (date of r~-,:~; 5. Federal Estate Tax Return Required death after 12-12-82) °~ 6. Decedent Died Testate ~~ ~~; 7. Decedent Maintained a Living Trust Q,,._ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) C'_ ~ 9. Litigation Proceeds Received „~"°3 10. Spousal Poverty Credit (date of death xw:° 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 T0: Name. _ _ . _ _ _ Daytime Telephone Number ,Louis R. Martin, Esq. (717) 230-9715 __ Firm Name (If Applicable) na ~ _ ~, ,~ ._ REGISTER ~~.LS USE OfV~Y ~ _! ... _~ ~, _ _ T= C7 -,C f ' First line of address T_-. ~ -• -:-rn I - 214 State Street ~ ,~ _, i ? i'7 --rJ ' . Second line of address ~_> -`ri ; r C. ~ rV -.;i _,J .-i a rJ { City or Post Office Code ,y DATE FILED ~,,~ ' State ZIP Harrisburg PA 17101 Correspondent's a-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 true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SISi1+ATURE OF PERSON RESPONSIBLE FOR FILING RETURN ne~r~ ~ Drexel PI., New Cumberland, PA 17070 SIGNATUR~fOF PRE,y ; AR~R~EI/q JHA~ ESQ jTIVE ADDRESS 11 V~%~~J 11Yp~ ~~C~ ©~~ __ 214 State Street, Harrisburg, PA 17101 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 . a J 15056052059 REV-1500 EX Decedent's Name: DOIOreS RECAPITULATION A Baer 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. ! 28,860.00 6. Jointly Owned Property (Schedule F) Separate Billing Requested .... ... 6. ', 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~" (Schedule G) f: ~~~ Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 28,860.00 ', 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. ', 7,870.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. ', 7, 746.00 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. ', 15,616.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 13,244.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which °"" an election to tax has not been made (Schedule J) ..................... ... 13. ! 50.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 13,194.00 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. _._ r..... .,_ ..,... Amount of Line 14 taxable ~ ... .. . ,... _. - at sibling rate X .12 ' 17. 18. Amount of Line 14 taxable 13,194.00 at collateral rate X .15 1 g. ', 1, 979.10 j 19. TAX DUE ....................................................... .. 19. ', 1,979.10 !: 20. FILL IN THE O RPAYMENT 15056052059 Side 2 15056052059 a REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Dolores A Baer 172-26-7590 STREET ADDRESS 103 East Allen St. #201 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable 0.03 D. Interest E. Penalty Total Credits (A + B + C) (2) Total InteresUPenalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1,979.10 0.00 49.50 2,028.50 .i.~ .,.~:µ:r.Y~~A~;ey~^3F'idt'yn i~r:..«~~t~Yvv~""~:wp;;-'H. aYt.-, r,.,.',,r. ..., 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? ........... ... ® ^ 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 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 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 isdefined, 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'S (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Dolores Baer 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. FILE NUMBER (If more space is needed, insert additional sheets of the same size) ReV-1511 EX~ (12-99) SCI~IEDVLE M COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATNE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Dolores Baer a pp~ - pp~.5'l0 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~' Musselmans Funeral Home 4,375.00 2. Catering for Funeral Luncheon 562.50 3. East Penn Ambulance 176.00 a. Manor Care Beauty 69.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City .State Zip Year(s) Commission Paid: 2. Attorney Fees 1, 550.00 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 288.00 5. Accountant's Fees 275.00 6. Tax Return Preparer's Fees ~. Mailing taxes Postal Fee 1.17 s. Cleaning Apt. 540.00 s. Auctioneer 33.00 to. York Daily Record 3.00 TOTAL (Also enter on line 9, Recapitulation) I $ 7,872.67 (If more space is needed, insert additional sheets of the same size) REV-1512 EX, (12-08) i~~~ ` pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Dolores Baer ao©~- ~D-~S~ 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. REy'--1513 EX ~ (11-p8) ~ pennsylvania SCHEDULE ~ ~~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER rr n„o--, o ooas ~ Dolores Baer d ~'~'~ ` 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. Joan Conrad - 6 Drexel PI., New Cumberland PA 17070 Friend 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN ,l . B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Goodwill donation 50.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 50.00 If more space is needed, insert additional sheets of the same size.