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Home My WebLink About07-20-09--~ REV-1500 1505607120 PA Department of Revenue EX (O6-OS) OFFICIAL USE ONLY Bureau of Individual Taxes county cone veer Fee NumSer Po eox.zaosot INHERITANCE TAX RETURN Harrisburg, PA [7128-osol RESIDENT DECEDENT 2 1 0 8 1 0 6 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10172008 11211961 Decedent's Last Name Suffix Decedent's First Name MCGILLVRAY MI JEFF (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 DUPLICAT E WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Retum ^ 3. Remaintler Retum (date of death ^ 4. Limited Estate ^ qa Future Interest Compromise poor to 12-13-g2) (oats or death aver t2-12-e2) ^ 5. Federal Estate Tax Return Required ^ g, Decetlent Died Testate (Attach Copy o/ Will) ^ Decatlent Melntainetl a Living Tmst ~' 0 (gttech Copy or Tmst) __ 8. Total Number 01 Sate DepOSlt BOXES ^ 9. Litigation Proceeds Received ^ 1D Spousal Povedy Cretltl (tlafe of deat h between 121-B1 and id-85) ^ 11. Eiectlon t0 fax under SeC. 9113(A) (Attach Sch. O) HAMILTON C DAVIS Firm Name (If Applicable) ZULLINGER DAVIS, PC First line of address 20 EAST SURD STREET, SUITE 6 Second line of address City or Post Office SHIPPENSBURG State ZIP Code PA 17257 Correspondent's a-mail address: FICD@hamiltOndaviSla W.COm it Istltrueecorrectand completoe DeClehration of prepalrer o[her tfrean the persolnal representaflive s based on elol SIGNATURE OF PERSON RRROnnimoi < <.... ... ..._ ___..._.. B. MCGILLVRAY 120 BUTTERMILK ROAD, NEWVILLE, PA 17241 \DDRESS 20 East Burd Street, L Hamilton C Davis Suite 6, Shippensburg, Pq 17257 Side 1 1505607120 Daytime Telephone Number 7175325713 REGISTER -,p LFn N .c' c!i ~ O t:~C~ ~ ~ N FILED r.~ DATE 7 Ilnl Y .. :=L~ -_ <'3 `v ~_% 4.' ~ ~:~7 n'r'in -s t ;~.3 ~.. ~ . 1 '"i-Ij r .F ,' i'7 1505607120 J 1505607220 REV-1500 EX Decedent's Social Security Number De~'e"r'a"ame MCGILLVRAY, JEFF RECAPITULATION 1. Real Estate (Schedule A) ....................... ............................................................. ...... 1. 2. Stocks and Bonds (Schedule B) .............. ............................................................ ..... 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C)..... ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ....... .............................................. ..... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............ .... 5. 1 , 7 9 2 . 6 9 6. Jointly Owned Properly (Schedule F) ^ Separate Billing Requested ......... .... 6 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property . (Schedule G) ^ Separate Billing Requested ......... .... 7. 0 . 0 0 8. Total Gross Assets (total Lines 1-7) .................................................................... ... g. 1 , 7 9 2 . 6 9 9. Funeral Expenses 8 Administrative Costs (Schedule H) ............... s. 1 3, 4 8 4. 3 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. ... 10. 6 2 5 . 1 0 11. Total Deductions (total Lines 9 8 10) .................................................. 1 4, 1 0 9 4 2 ................. ... 11. . 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12 - 1 2 , 3 1 6 . 7 3 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. - 1 2 , 3 1 6 7 3 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 .00 15, 16. Amount of Line 14 taxable at lineal rate X .045 16 17. Amount of Line 14 taxable at sibling rate X ,12 17 18. Amount of Line 14 taxable at collateral rate X .15 18 19. Tax Due ..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. I_ Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: MCGILLVRAY, JEFF 120 BUTTERMILK ROAD NEWVILLE File Number 21 - 08 - 1060 PA ~ 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) 0.00 A. Spousal Poverty Credit 6. Prior Payments C. Discount 3. InteresVPenalry if applicable Total Credits (A + g + C) (2) 0.00 D. Interest E. Penalty Total lnterest/Penalry (D+E) 4. If Line 2 is greater than Line 1 + Line 3 ente th diff (3) 0.00 , r e erence. This is the OVERPAYMENT . Check box on Page 2 Llne 20 to request a refund (4) 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. (5) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SA) (se) 0.00 Make Check Payable to: REG/STER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transierred :............................................................................ b retai th i Yes No ...... . n e r ght to designate who shall use the property transferred or its income :.................................... c retain a re i g 0 . vers onary interest; or ............... ................................................................................................... d. receive the promise for life of either payments, benefits or care? .................. 2. If death occurred aNer Decemb 12 ~ ( x er , 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 d d ^ ^ . ece ent 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)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)j. The statute does not exemot 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 onor 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 taz 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. CONWI0NWE4.TH OF PENNSYLVFNV INHERITANCE TqX gENRN RESICENT pECEOENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF MCGILLVRAY, JEFF FILE NUMBER 21 - 08 - 1 nFn Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF 1 F&M CHECKING ACCOUNT NO. 35-18051 DEATH 1,245.69 2 PENNSYLVANIA DEPARTMENT OF REVENUE 2008 TAX REFUND 47.00 3 PERSONAL PROPERTY 500.00 TOTAL (Also enter on Line 5, Recapitulation) 1,792.69 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MCGILLVRAY, JEFF INTER-VIVOST RANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 - 08 - 1060 • •••o ~~rr=~~r= fNUSC oe completed antl filed if the answer to any of questions 1 ITEM DESCRIPTION OF PROPERTY NUMBER InGUtle the name of the trenaferee, ihetr relationship la tlecetlant DATE OF DEATH an0 the Eeta of lranafer. Altech a copy of the tleetl fa real estate. VALUE OF ASSET 1 PRUDENTIAL INDIVIDUAL RETIREMENT 38,788.41 ACCOUNT, ANNUITY CONTRACT NUMBER E009590 -PAYABLE TO SISTER AS NAMED BENEFICIARY. THE DECEDANT WAS NOT 59 1/2 AT THE TIME OF DEATH, THUS THE IRA IS NOT TAXABLE. 4 on page 2 is yes. %OF EXCLUSION DECD'S INTEREST QF APPLICABLE) 0% 2 NORTH AMERICAN IDIVIDUAL RETIRMENT 68,062.06 0% ACCOUNT, ANNUITY CONTRACT NO. L011659450, PAYABLE TO SISTER AS NAMED BENEFICIARY. THE DECEDANT WAS NOT 59 1/2 AT THE TIME OF DEATH, THUS THE IRA IS NOT TAXABLE. 3 PRUDENTIAL INDIVIDUAL RETIRMENT ACCOUNT, 38,165.01 0% ANNUITY CONTRACT NUMBER E0142209 - PAYABLE TO SISTER AS NAMED BENEIFICARY. DEATH, THUS THEARANS NOT TAXABLEE TIME OF TOTAL (Also enter on line 7. Recanlrlrfarl....t TAXABLE VALUE 0.00 0.00 0.00 V.VV COMMONWEgITM OF pENNSYIVANIA INNERITgNCE TPX RETURN RE610ENT OECEOENT SCHEDULE H ~F~I~N~~rR~A~L~E~~EN~S/E~S~&~ /~L/n~r`1A 1 IV1~ wJ 1 ~7 ESTATE OF MCGILLVRAY, JEFF ucucs or aeceaent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES• DESCRIPTION /+• 1 EGGER FUNERAL HOME 2 ~ CHURCH 3 ~ HEAD STONE B. 21 08 - 1050 AMOUNT 9,429.57 500.00 2,000.00 ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid z. Attorney's Fees HAMILTON C. DAVIS, ESQUIRE 1,000.00 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 CUMBERLAND COUNTY REGISTER OF WILLS 50.00 5. Accountant's Fees 6. Tax Return Preparer's Fees HOWARD'S ACCOUNTING 325.00 7. Other Administrative Cosls 1 LEGAL ADVERTISING -THE NEWS CHRONICLE 104.75 TOTAL (Also enter on line 9, Recapitulation) 13,484,32 ?ACTH OF PENNSYLVANIA TANCE TAX RETURN ESTATE OF MCGILLVRAY, JEFF ScF~edule H Funeral E~er>ses & Adlnin'str~ative Casts continued LEGAL ADVERTISING -CUMBERLAND COUNTY LEGAL JOURNAL FILE NUMBER 21 - 08 - 1060 Page 2 of Schedule H 75.00 COMMONWEALTH OF PENNSTLVANW INHERRANCE Tq%RETURN RESIDENT DECEDENT ESTATE OF MCGILLVRAY, JEFF SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Include unreimbureed medical expenses. ITEM NUMBER 1 EMBARO 2 ~ EXPRESS SCRIPTS 3 PUBLISHER'S CLEARING HOUSE 4 PA DEPARTMENT OF REVENUE 5 I G.H. HARRISTASSOC., INC. DESCRIPTION FILE NUMBER 21 - 08 - 1060 AMOUNT 267.35 139.90 71.85 117.00 29.00 TOTAL (Also enter on Line 10, Recapitulation) 625.10 REV-161] E%. Ie-0D) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MCGILLVRAY,JEFF SCHEDULE) BENEFICIARIES NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. II. TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X116 (a) (1.2)] BARBARA B. MCGILLVRAY 120 BUTTERMILK ROAD NEWVILLE, PA 17241 Enter dollar amounts for distributions shown above on lines RELATIONSHIP TO DECEDENT Do NM Llst Trus...,.~ MOTHER through 18, as appropriate, on _ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS FILE NUMBER 21-08-1060 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) RESIDUE 1500 cover sheet TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER 0.00 N C O N 1 t N N O 0 N 4 O T O N N 7 0 d . E 5 ° m z m ~o d~ E ° o v iu N U ~ rn r T~orv I m~~~ I I W ~ ~ r F O J ~ U °D~ a N ~ f ~~ LL N `S M Q ~ ' ~' N W ~~ ~ ~.~[ VVV o = ~11N(1 0 °o ~ N N V N L .~ ~.~. ss 6 l \` F w 0 w 0 ,~$ E cn y o ~~ :~ VOoa F~~ ~~ a ~~8~~ ~ ~~~~~ LAW OFFICES OF ZULLINGER - DAMS PROFESSIONAL CORPORATION JOEL R. ZULLINGER 14 North Main Street Suite 200 Chambersburg, PA 17201 717-264-6029 Fax: 717-264-1884 zulnerlaw ,earthlink net Register of Wills Cumberland Courthouse Room No. 102 One Courthouse Squaze Cazlisle, PA 17013 RE: Estate of JeffMcGillvra Est. No. 21-08-1060 Deaz Sir or Madam: Dale F. Shughart Jr HAMILTON C. DAMS , . 20 East Burd Street Suite 6 of counsel , P.O. Box 40 Shippensburg, PA 17257 717-532-5713 Fax:717-530-5222 hamiltondavislaw(a~comcast net July 17, 2009 c~ o CO ~ l_i 'cn~ O is r'j 7 ~ n v ~' c. x. ~ ~~ N ~' 1 .^~i~ w -~ w Enclosed herewith please fmd an inheritance tax return, filed in duplicate. As you can see from the return, the estate is insolvent. A check for filing fee in the amount of $15.00 is also enclosed. Please send a bill to our office for any additional costs due. If there aze any questions or concerns, please contact me at the Shippensburg office. Thank you. Sincerely yours, Hamilton C. Davis for Zullinger -Davis Professional Corporation HCD/njk Enclosures Reply to: Hamilton C. Davis P.O. Box 40 Shippensburg, PA 17257