HomeMy WebLinkAbout05-18-09
15056041114
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes ~j
Po Box 2sosol INHERITANCE TAX RETURN ~~' D--7 Q~ 1 %~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 11
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
176-50-3424 05212007 05221966
Decedent's Last Name Suffix Decedent's First Name MI
WHEELER ANNETTE M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
WHEELER THOMAS V
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 Q 3. Remainder Return (date of death
prior to 12-13-82)
0 4. Limited Estate 0 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
Q 9. Litigation Proceeds Received 0 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
KARTIC C. DASS CPA, MBA 7177325289
Firm Name (If Applicable)
125 N ENOLA DRIVE
First line of address
Second line of address
City or Post Office State ZIP Code
ENOLA PA 17025
REGISTER OF WILLS USE ONLY
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Correspondent'se-mail address: ROOPADASS@VERIZON.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
SIGN~AT~U E OF PERSON RESP NSI E FOR FILING RETURN DATE
'~ r ~r..w..-~ l~ ~, 0 5 / 15 / 0 9
ADDRESS
405 CENTER STREET ENOL PA 17025
SIGNATURE OF PREPARER OTHER T N REP ENTA IVE DATE
05/15/09
ADDRESS
125 N ENOLA DRIV NOLA PA 7025
PLEASE USE ORIGINAL FORM ONLY
KARTIC C. DASS #23-2237180
CERTIFIED PUBLIC ACCOUNTANT Side 1
L dOLA, PA 17025 1505604111,4
/)
.~ 15056042115
REV-1500 EX
Decedent's Social Security Number
~ecedent'sName: ANNETTE M WHEELER _L76-50-3424
RECAPITULATION
1. Real estate (Schedule A) .......................... . ................ 1. 0 • O 0
2. Stocks and Bonds (Schedule B) ................... . ........ . ......... 2. 0 • 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. O . 0 O
4. Mortgages & Notes Receivable (Schedule D) ............................ 4. O . 0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 14 S O . O O
6. Jointly Owned Property (Schedule F) Separate Billing Requested ........ 6. 110 3 S O . O 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested ........ 7 0 . 0 0
8. Total Gross Assets (total Lines 1-7) .................................. 8. 1118 O O . O O
9. Funeral Expenses & Administrative Costs (Schedule H) .................. .. 9. 13 3 4 9 . O O
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. .. 10. 214 9 O O . O O
11. Total Deductions (total Lines 9& 10) ............................... .. 11. 2 2 8 2 4 9. 0 0
12. Net Value of Estate (Line 8 minus Line 11) ........................... .. 12. -116 4 4 9 . O O
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...................... . 13. O . 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... . 14. -1 1 6 4 4 9 . O O
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 15. O. O O
16. Amount of Line 14 taxable
at lineal rate X .0 4 5 16. 0. 0 0
17. Amount of Line 14
taxable at sibling rate X • 12 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X . 15 18. 0 . 0 0
19. TAX DUE ...................................................... . 19. O . O O
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~
Side 2
L 15056042115 1,5056042115
REV-1500 EX Page 3 176-50-3424
Decedent's Complete Address:
File Number
2007-00545
DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER
ANNETTE M WHEELER 176-50-3424
STREET ADDRESS
05 CENTER STREET
CITY
ENOA STATE
PA ZIP
17025
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C:) (2)
(1) 0.00
0.00
Total InteresUPenalty (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) 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 W1LLS, 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 : ............... . ~ X^
c. retain a reversionary interest; or ..................................................... . ~ 0
d. receive the promise for life of either payments, benefits or care? ................... ........ . ~ a
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 hE~r 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 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)J. 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-1502 EX+ (11-08)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
tr more space Is needed, insert additional sheets of the same size.
z»-
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
NONE ~ NOT APPLICABLE
TOTAL (Also enter on line 2 Reca
(If more space is needed, insert additional sheets of the same size)
0
REV-1504 EX+ (6-98) AT
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the
(If more space is needed, insert additional sheets of the same size)
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` REV-1505 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF FILE NUMBER
WHEELER 2007-00545
1.
2.
3.
4.
Name of Corporation NONE
Address
City
Federal Employer I.D. Number
Type of Business
State
Zip Code
Product/Service
State of Incorporation
Date of Incorporation
Total Number of Shareholders
Business Reporting Year _
STQCI< .: TYPE::::::
:: ~ Tf3;tAL.NUMt3~R QF...:
VALt3E :::
pAR NUMBER OF SHARER
. . : . .:::::::::: .. . ` Vr~LUEOF TktE.:.
. VvtlxtglNan ViGng :SHARI;S.Ot1TSTANbINB .
.'::. ::: ::. ;:. OVUNER8,1!;~l1E:bI~El~i[N~ :#)'i~EDENT'S STOGF
Common $ 0
Preferred $ 0
Provide all rights and restrictions pertaining to each class of stock.
5.
6
7
Was the decedent employed by the Corporation? .^Yes ^No
If yes, Position Annual Salary $ Time Devoted to Business
Was the Corporation indebted to the decedent? .^Yes ^No
If yes, provide amount of indebtedness $
Was there life insurance payable to the corporation upon the death of the decedent?
If yes, Cash Surrender Value $ Net proceeds payable $_,
Owner of the policy
8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years
if the date of death was prior to 12-31-82?
^Yes ^No If yes,^Transfer ^Sale Number of Shares
Transferee or Purchaser Consideration $
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death?
If yes, provide a copy of the agreement.
^Yes ^No
Date
^Yes ^No
10. Was the decedent's stock sold?
If yes, provide a copy of the agreement of sale, etc.
^Yes ^No
11. Was the corporation dissolved or liquidated after the decedent's death? .^Yes ^No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? .^Yes ^No
_ If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
ThiE Ft31»L()UYIN:G.fN>~~F~M}~ ION MUST BE:~IIBMIT`i'~#~ 11ViTM 1'HIS:SCFiI*~3Uf»E.
A. Detailed calculations used In the valuation of the decedent's stock
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If
real estate appraisals have been secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
217
REV-1506 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-2
PARTNERSHIP
INFORMATION REPORT
ESTATE OF FILE NUMBER
WHEELER 2007-00545
1, Name of Partnership ANNETTE M
Address
City
2. Federal Employer I.D. Number
3. Type of Business ProductlService
4. Decedent was a General Limited partner. If decedent was a limited partner, provide initial investment
7. Was the Partnership indebted to the decedent? Yes ~No
If yes, provide amount of indebtedness $
8. Was there life insurance payable to the partnership upon the death of the decedent? Yes ~No
If yes, Cash Surrender Value $ Net proceeds payable $.
Owner of the policy
9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was
prior to 12-31-82?
Yes ~No If yes,^Transfer Sale Percentage transferred/sold
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
10. Was there a written partnership agreement in effect at the time of the decedent's death? Yes ~No
If yes, provide a copy of the agreement.
11. Was the decedent's partnership interest sold? Yes ~No
If yes, provide a copy of the agreement of sale, etc.
12. Was the partnership dissolved or liquidated after the decedent's death? Yes ~No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
13. Was the decedent related to any of the partners? Yes ~No
If yes, explain
14. Did the partnership have an interest in other corporations or partnerships? ^Yes ~No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
' ~- THE: f=aLL(~WIN~ 11~I>~t~i~MA1"It~t~ MUST B;~ SUBMITTEL} Wind THIS'SCHEDUL£ :
A. Detailed calculations used in the valuation of the decedent's partnership interest.
B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the ;year of death and 4 preceding years.
C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals
have been secured, attach copies.
D. Any other information relating to the valuation of the decedent's partnership interest.
ER
Date Business Commenced
Business Reporting Year NA
State Zip Code
6. Value of the decedent's interest $
zn
REV-1507 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
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)
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REV-1508 EX+ (6-98) SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COM N~HERTANCECTAXRE URNANIA PERSONAL PROPERTY
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
Include the proceeds of litigation and the date the proceeds were received ny the estate.
(If more space is needed, insert additional sheets of the same size)
S~Al-E~lEl~1~ ~E ACC®Uf~9TS
Statement Period 05/10/07 TO 06/10/07
1-877-SOV-BANK (1-877-768-2265) WWW.sovereignbank.com TOTALLY FREE PREMIER CHECKING
Account Activity (Cont. for Acct# 921707851)
Date Description Additions Subtractions Balance
05-14 POS PURCHASE 982362 $12.95 $1,165.05
786KTZL 6025CARLISLE
MECHANICSBUR PA _
05-14. .' CHK GARD,PUR 744005 $11.84 $1,153.21
UNIMARTS UNIMARTS#94 `.
ENOLA PA _
05-14 CHECK 1053 $10.00 $1,143.21
05-15 KMART -PAYROLL .. $2,007.81: $3;15'1.02
DIR DEP 070515 ~' ~.. ,, . -
05-15 CHK CARD PUR 855941 ~ $98.10 $3,052.92
CARRABBAS CARRABBAS#
MECHANICSBURGPA
~
-,..-- --- _
05=16 ~ ~=CHECK `. "..'.1054: ~_ $800:00..- .
_ $2,252.92;.
. ,~..
05-16 PUR W/ GSH BK473531 $28.63 $2,224.29
CVS1639105SouthSpor
05`17 ATM CASH WID 005584 -' - .. ~- -~ . ``:, .. ~ =' ._ ~. ' .. _.- < ~...:. $20.DO ~ $2;17791
.. ..,, _ ,. __.. ., , _ t .. -
~'= _' MONEYACC 5000NIVERSI _
~~ ~ 'NERSHE~ ~ :1 PA __
05-17 CHK CARD PUR 130766 $5.00 $2,172.91
CVSPHARM CVSPHARMACY
MECHANICSBURGPA -
05-18
- --
CAPITAL BLUE CRO $885.98
-
- _ -
$3,058.89
.,
..
PR PAYMENT
: ,. _
,
,
o1QO-aaa0o7626
..
._. _
_
05-21 -- -
CHECK 1055 -
$115.00
$2,943.89
05=21 - POS'PURCHASE 899767 $43:60 $2,900:29
EXXONMOBI CARLISLEPI
MECHANIC PA `~
05-23 CHECK 1059 $129.77 $2,770.52
05=23 CC-fECK _ 1Q60 _ $112.62 $2,657.90
05-24 CHECK 1062 $151.51 $2,506.39
page S of 12 921707851
217
REV-1509 EX+(6-98) SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
ESTATE OF FILE NUMBER
ANNETTE M WHEELER .2007-00545
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. THOMAS V. WHEELER
8 BLACK PINE DRIVE
MECHANICSBURG PA 17050
B.
C
nvoor-u~u
JOINTLY-OWNED PROPER TY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE. OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 9/19199 SINGLE UNIT 214,900 50.00% 107,450
0
2. 1993 HONDA ACCORD 1,000 50.00% 500
3. 1993 CHEVY LUMINA 1,000 50.00% 500
4. 1997 GMC JIMMY 3,800 50.00% 1,900
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 6 Recapitulation) $ 110 350
(If more space is needed, insert additional sheets of the same size)
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REV-1510 EX+(6-98) SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA MISC. NON-PROBATE PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ANNETTE M WHEELER 2007-00545
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF
TRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE.
DATE OF DEATH
VALUE OF ASSET
°io OF DECD'S
INTEREST
EXCLUSION
(IFAPPLIGABLE)
TAXABLE
VALUE
1. 0
NONE 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 7 Recapitulation) $ 0
(If more space is needed, insert additional sheets of the same' size)
REV-1511 EX + (10-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. INTERMENT 3,185
2. MEMORIALIZATION 2,466
3. FUNERAL HONE 7,040
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name 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 NA
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees 500
6. Tax Return Preparer's Fees 158
7.
TOTAL (Also enter on line 9, Recapitulation) ~ $ 1
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-OS)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
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.
REV-1513 EX+ (11-08)
ESTATE OF
pennsylvania ~ SCHEDULE J
DEPARTMENT OF REVENUE I BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
n A~AICTfC AA U/LJCCI CD
FILE NUMBER
2007-00545
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).]
NONE NONE NA
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18 OF RE\/-15D0 COVER S HEET, AS APPROPRIATE.
I I. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ Q
If more space is needed, insert additional sheets of the same size.
REV-1514 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
ak Box 4 on REV-1500 Cover Sheet
FILE NUMBER
ANNETTE M WHEELER 200'7-00545
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to
5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
^ Will ^ Intervivos Deed of Trust ^ Other
'.NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS
-0ATE OF DEATH LIFE ESTATE IS FAYAt3LE
NONE ^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
1. Value of fund from which life estate is payable ..................................$
2. Actuarial factor per appropriate table ........................................ .
Interest table rate- ^ 3 1/2% ^6% ^10% ^Variable Rate
0.0000
3. Value of life estate (Line 1 multiplied by Line 2) .............................. $ 0
' NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS
DATE OF DEATH ANNUITY IS PAYABLE
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
1. Value of fund from which annuity is payable ....................................$
2. Check appropriate block below and enter corresponding (number) ................. .
Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12)
^ Quarterly (4) ^Serni-annually (2)^ Annually (1) ^ Other ( ) _
3. Amount of payout per period ................................................$
0
4. Aggregate annual payment, Line 2 multiplied by Line 3 ........................... 0
5. Annuity Factor (see instructions)
Interest table rate - ^ 3 1/2% ^ 6% ^ 10% ^Variable Rate % 0.0000
6. Adjustment Factor (see instructions) ........................................ .
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period
payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 .................. $ 0
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 .......................................... $ 0
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through
G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18.
(If more space is needed, insert additional sheets of the same size)
REV-1644 EX + (3-04)
INHERITANCE TAX
SCHEDULE L
COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT OR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
INVASION OF TRUST PRINCIPAL
FILE NUMBER 2007-00545
I. ESTATE OF
WHEELER ANNETTE M
(Last Name) (First Name) (Middle Initial)
This schedule is appropriate only for estates of decedents dying on or before December 12, 1982.
This schedule is to be used for all remainder returns when an election to prepay ha:; been filed under the provisions of
Section 714 of the Inheritance and Estate Tax Act of 1961 or to re ort thf~ invasion of trust rinci al.
II. REMAINDER PREPAYMENT:
A. Election to prepay filed with the Register of Wills on NONE
(Date)
g. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or Annuitant(s) of election or annuity is payable
C. Assets: Complete Schedule L-1
1. Real Estate ............................$
2. Stocks and Bonds ... . .................. $
3. Closely Held Stock/Partnership ............ $
4. Mortgages and Notes ....................$
5. Cash/Misc. Personal Property ............. $
6. Total from Schedule L-1 .................................................. $ 0
D. Credits: Complete Schedule L-2
1. Unpaid Liabilities ....................... $
2. Unpaid Bequests . . ..................... $
3. Value of Unincludable Assets ..............$
4. Total from Schedule L-2 ... . .............................................. $ 0
E. Total Value of trust assets (Line C-6 minus Line D-4) .............................. $ 0
F. Remainder factor (see Table I or Table II in Instruction Booklet) ................ .... .
G. Taxable Remainder value (Line E x Line F) .......................... . ........... $ 0
(Also enter on Line 7, Recapitulation)
III. INVASION OF CORPUS:
A. Invasion of corpus
(Month, Day, Year)
B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or Annuitant(s) corpus or annuity is payable
consumed
C. Corpus consumed ......................................................... $
D. Remainder factor (see Table I or Table II in Instruction Booklet) ..................... .
E. Taxable value of corpus consumed (Line C x Line D) .............................. $ 0
(Also enter on Line 7, Recapitulation)
R.EV-lbd5 EX+ i7-85)
COMMONVJEALTFi OF PEIvhiSrLVANiA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I. Estate of WiiEELEf~ ANNETTE M
(Last Name) (First Name) (Middle Initial)
I1. Item No. Description dalue
A. Real Estate (please describe)
NONE
-
NOT APPLICA]
Total value of real estate
(include on Section II, Line C-1 on Schedule L) $
B. Stocks and Bonds (please list)
Total value of stocks and bonds
(include on Section II, Line C-2 on Schedule L) $
C. Closely Held Stock/Partnership (attach Schedule C-1 and/or C-: )
(please list)
Total value of Closely Held/Partnership
(include on Section II, Line C-3 on Schedule L) $
D. Mortgages and Notes (please list)
Total value of Mortgages and Notes
(include on Section II, Line C-4 on Schedule L) $
E. Cash and Miscellaneous Personal Property (please list)
Total value of Cash/Misc. Pers. Property
(include on Section II, Line C-5 on Schedule L) $
III. TOTAL (Also enter on Section II, Line C-6 on Schedule L) $
INHERITANCE TAX
SCHEDULE L-1
REMAINDER PREPAYMENT ELECTION
-ASSETS-
FILE NUMBER
2007-00545
3LE
(If more space is needed, attach additional 8'/z x 11 sheets.)
REV-1646 EX+ (3-84)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER 2007-00545
I. Estate Of WHEELER N
(Last Name) (First Name) (Middle Initial)
II. Item NO. ®@SCQI~tI®A Am®unt
A. Unpaid Liabilities Claimed against Original Estate, and payable from assets
reported on Schedule L-1 (please list)
NONE NoT APPLICABL
Total unpaid liabilities $
(include on Section II, Line D-1 on Schedule L)
B. Unpaid Bequests payable from assets reported on Schedule L-1 (please list)
Total unpaid bequests $
(include on Section II, Line D-2 on Schedule L)
C. Value of assets reported on Schedule L-1 (other than unpaid bequests listed under
"B" above) that are not included for tax purposes or that do not form a part
of the trust.
Computation as Follows:
Total unincludable assets $
(include on Section II, Line D-3 on Schedule L)
III. TOTAL (Also enter on Section II, Line D-4 on Schedule L) $
INHERITANCE TAX
cs~u€e~~e e e ~f
~m.e' v a.~ a-`
REMAIN®ER PREPAYMENT ELECTI®N
-CREDIT~-
.E
(If more space is needed, attach additional 8'/z x 11 sheets.)
z»
REV-1647 EX + (g-001
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE M
FUTURE INTEREST COMPROMISE
eck Box 4a on Rev-1500 Cover SI
ESTATE OF FILE NUMBER
ANNETTE M WHEELER 2007-00545
This schedule is appropriate only for estates of decedents dying after December 12, 1982.
This schedule is to be used for all future interests where the rate of tax which will be applicable when the future
interest vests in possession and enjoyment cannot be established with certainty.
Indicate below the type of instrument which created the future interest and attach a copy to the tax return.
^Will ^Trust ^Other
i io,....,.c:..:.,..:..~
NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO
NEAREST BIRTHDAY
1. NONE
2.
3.
4.
5.
II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal
within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the
surviving spouse exercises such withdrawal right.
^Unlimited right of withdrawal ^Limited right of withdrawal
III. Explanation of Compromise Offer:
IV. Summary of Compromise Offer:
1. Amount of Future Interest . $
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet) $
3. Value of Line 1 passin to spouse at appro riate tax rate
Check One ~6%, ^3%, ~0% $
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line 1 taxable at lineal rate
Check One ^6%, ^4.5% $ _
(also include as part of total shown on Line 16 of Cover Sheet)
5. Value of Line 1 taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of Cover Sheet) $ _
6. Value of Line 1 taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet) $ _
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1)
. .$
0
(If more space is needed, insert additional sheets of the same size)
REV-1648 EX (11-99) _ SCHE®t1LE N
~P®USAL P®VERI'~° CAE®IT
CCMMONINEP,LTH OF pErfntcyL\inNln, (AVAILA6LE FOR i3ATE~ v^F D€ATn 3iivifS2 TO 12/31/S+)
INHERITANCE TAX DIVISION
ESTATE OF
WHEELER
ANNETTE
FILE NUMBER
M 2007-00545
This schedule must be completed and filed if you checked the spousal poverty credit t~ox on the cover sheet.
1 . Taxable Assets total from line 8 (cover sheet) ............................................ 1
2. Insurance Proceeds on Life of Decedent ................................................ 2.
....................................................
3. Retirement Benefits • • ~ • • ' ' ' ' ' ' ' 3'
4. Joint Assets with Spouse ............................................................ 4.
5. PA Lottery Winnings •••••••••••••••••""'-~'
6a. Other Nontaxable Assets: List (Attach schedule if necessary).. 6a.
6b.
60.
6d.
6. SUBTOTAL (Lines 6a, b, c, d) ........................................................ 6.
7. Total Gross Assets (Add lines 1 thru 6) ................................................. 7.
8. Total Actual Liabilities .............................................................. 8.
9. Net Value of Estate (Subtract line 8 from line 7) ........................................... 9.
If tine 9 is greater than $200, 000 -STOP. The estate is not eligible to claim the credit. !f not, continue to Part 11.
Income:
Spouse ...........
a ~•
ia. tAx rtAn: is
.
Decedent ..........
b 1 b.
.
Joint .............
c ic.
.
Tax Exempt Income ..
d 1d.
.
e Other Income not
listed above ........
1 e.
f. Total ............. 1 f.
4. Average Joint Exemption Income Calculation
4a. Add Joint Exemption Income from above:
(1 f) + (2f) _
NOT APPLICABLE
2b. 3b.
2c. 3c.
2d. 3d.
2e. 3e.
2f. 3f.__
+ (3f) _ _
(= 3)
4b. Average Joint Exemption Income ..................................................... _
If line 4(b) is Greater than $40,000 -STOP. The estate is not elicltble to claim the credit. !f not, continue to Part
1. Insert amount of taxable transfers to spouse or $100,000, whichever is less ..................... 1
2. Multiply by credit percentage (see instructions) ........................................... 2
3. This is the amount of the Resident Spousal Poverty Credit. Include this figure
in the calculation of total credits on line 18 of the cover sheet . ............................... 3.
4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the 4
decedent's gross estate .............................................................
5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal 5
Poverty Credit .Include this figure in the calculation of total credits on line 18 of the cover sheet...... .
217
REV-1649 EX+ (6-98)
SCHEDULE O
COMMONWEALTH OF PENNSYLVANIA ELECTION UNDER SEC.9113(A)
INHERITANCE TAX RETURN (SPOUSAL DISTRIBUTIONS)
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ANNETTE M WHEELER 2007-00545
Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act.
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust.
This election applies to the
Trust (marital, residual A, B, By-pass, Unified Credit, etc.).
If a trust or similar arrangement meets the requirements of Section 9113(A), and:
a. The trust or similar arrangement is listed on Schedule 0, and
b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O,
then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar
property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative
shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar
arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arranyement.
Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the
decedent's surviving spouse under a Section 9113(A) trust or similar arrangement.
Description Value
NONE
Part A Total ~ $
Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made.
Description Value
Part B Total ~ $
NOT APPLICABLE
0
(If more space is needed, insert additional sheets of the same size)
KARTIC C. DASS
CERTIFIED PUBLIC ACCOUNTANT
P. O. BOx 245
125 N. ENOLA DRIVE
ENOLA, PENNSYLVANIA, 17025-0245
(717) 732-5289
MEMBER
AMERICAN INSTITUTE OF
CERTIFIED PUBLIC ACCOUNTANTS
May 1 s, 2oov
Attn: Glenda F. Strasbaugh
Clerk of the Orphans' Court
One Courthouse Square
Carlisle, PA 17013
In re: Estate of Annette M. Wheeler
#2007-00545
Dear Ms. Strasbaugh:
MEMBER
PENNSYLVANIA INSTITUTE OF
CERTIFIED PUBLIC ACCOUNTANTS
Enclosed, herewith please find the Inheritance Tax Returns of above said Estate, duly
completed, signed and sealed along with the court filing fee of $15.00.
Should there be any question please feel free to call me.
Thank you.
Yours
(%arti
Cc: Estate of Annette M. Wheeler
File
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