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Home My WebLink About05-21-09 (2) 1505607120 --J 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.28oso1 RESIDENT DECEDENT 2 1 0 8 1 1 5 3 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Date of Birth Social Security Number Date of Death 162 07 3154 06 25 2007 09 25 1910 Suffix Decedent's First Name MI Decedent's Last Name G BLANCHE FR~MM (If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~J ~, 4. Limited Estate ~r~, ~_l ( v") s Decedent Died Testate C_~ LJ (Attach Copy of Wilq L ~ 9. Litigation Proceeds Received C-J MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4a. Future Interest Compromise L~ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) ___ 10. ~tvreen1231-91 and~tltll 95jf death `~ 1 L (Attach SchaO) nder Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIALD ~irlNe Telephone NumberBE DIRECTED TO: Name 717 432 9666 DAVID J. LEN~X Firm Name (If Applicable) REGISTER O,F7WILLS USE;QMLY ~ THE WILEY GRGUP , PC ~~ ~`_~ ~-~ ~ ~e `, ~" First line of address c-~ - --~ r _ 1 3 0 W . CHURCH STREET _ ~"fir' r_J Second line of address - = = ~^ -z-. -,-I ~ ; } DATE i~ILED City or Post Office State ZIP Code y ~ ~ PA 17019 ~' DILLSBURG Correspondent'se-mail address: davelenOX@COt11C8St.net Under penalties of perjury, I d rclahation ove exa er o hler than the pelrsoinalaepresentat ve is based on a Intformatfon~of whlchhpreparer has any knowledge.belief, it is true, correct an D9TE Mark D. Meabon 130 Dillsburg, PA 17019 F THAN R ESENTATIVE David J. Lenox 5~~~~Og 130 W. Church Street, Dillsburg, PA 17019 Side 1 1505607120 1505607120 J 1505607220 REV-1500 EX Decedent's Social Security Number 162 07 3154 Blanche G. Fromm DecedenPs Name: _ _ _- ---- RECAPITULATION .............. 1. 1. Real Estate (Schedule A) ............................................................................ ........... 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• Jointly Owned Property (Schedule F) ~~ 'i, Separate Billing Requested ............. 6 6. . 7. Inter-Vivos Transfers & Miscellaneous Non-PS parater Biting Requested ............. 7. (Schedule G) - 0 0 0 ........ ......... g, Total Gross Assets (total Lines 1- ....... ---_ -__ _ _ 8. -- --_- ___ _ _ ------ - 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10• 0 0 0 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 0 0 0 .............................. 12. Net Value of Estate (Line 8 minus Line 11) .............................. ntal Bequests/Sec 9113 Trusts for which . 12. 13. Charitable and Governme an election to tax has not been made (Schedule J) ......................... 13. 0 0 0 • ........ ........ ...... 14. Net Value Subject to Tax (Line 12 minus Lme •~••~ _ __ . 14. _ - _- __-_ -- - - -_ __ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATE 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 0 0 0 15. (a)(1.2) X .00 0 0 0 16 16. Amount of Line 14 taxable 0 0 0 . at lineal rate X .045 0.00 17 17. Amount of Line 14 taxable 0.00 ~ at sibling rate X •12 0 0 0 18 18. Amount of Line 14 taxable 0 0 0 . at collateral rate X .15 0 0 0 .............. 19. 19. Tax Due ................................................................................................... E OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20. FILL IN TH 1505607220 Side 2 1505607220 REV-1500 EX Page 3 nar_adpnt's Cmm~lete Address: File Number 21-08-1153 BENT'S NAME Blanche G. Fromm .T ADDRESS 801 North Hanover Street I CITY Carlisle STATE I ZIP PA I~ 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable 0.00 __ --- Total Credits (A + B + (1) 0.00 (2) 0.00 p. 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. (4) Check box 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. (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. (56) Q . ~ Q 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 :.................................................................................. [J ' x'i ___~, b. retain the right to designate who shall use the property transferred or its income :.................................... j ,', ~x i c. retain a reversionary interest; or ...................... ' x d. receive the promise for life of either payments, benefits or care? .............................................................. ~ z 1, 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without _ i receiving adequate consideration? ....................................................................................................................... ~~ i_X! 3. Did decedent own an "intrust 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? ...................................................................................................................... ~ ~~J 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)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.