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Home My WebLink About07-16-09 (2) 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE 7AX RETURN PO BOX 280601 ~ ~ ~ ~ ~ 5~ u,.a~n~~n, on,-rwa.nam - RESIDENT DECEDENT UUU/// ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of B1rth 1 7 3 3 2 6 7 8 2 1 1 1 2 2 0 0 8 0 7 1 9 1 9 4 0 Decedent'sLast Name Suffix Decedent's First Name S t e i n M a r t e ne (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI E. MI FILL 1N APPROPRIATE OVALS BELOW Q7 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-73-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of Q 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Bozes (Attach Copy of Wilf) (Attach Copy of Trust) O 9. litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) behween 1231-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTED T0: Name Daytime Telephone Number ry J:a'•n.e` M. A 1'e x a ',n d e'r 7 1 7' 43 2N4 5 1 4 Firm Name (If Applicable) OF WILLa95E ONhYr ~._ REG ~~ ~ fit.. 4 First line of address ~ ~ r ~ (-- ~ B a l t 1 4 8 S i m o r e S t r e e t ~ c :. , i o~ ~ Z Second line of address ~. C SJ t ' --1 ' < .. ~ ~ DATE FILED Ciry or Post Offce State ZIP Code D i 1 l s b u r g' pa 1 7 0 19 Correspondent's e-mail address: Under penalties of perjury, I declare that I nave examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct antl complete, Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. sir.NAn trlr.M RFaSnN RESP(IFLSIBL FILING RETURN DATE/ ADDRESS 111 _ /I P]aC'-e, liarnsb~g. Pa 17112 SIGNATURE OP P EPARER OTHEF~)~AN~iF~~ENTATIVE - PATE ~ ^ ADDRESS ~ . BaltimD Street, Pa 17019 _T PLEASE USE ORIGINAL FORM ONLY 15056051047 Side 1 15056051047 J ~`.. REV-1500 EX Decedent's Name: RECAPITULATION 15056052048 Decedent's Social Security Number 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 8 Miscellaneous Personal Property (Schedule E) .... .... 5. 3 ~ $ ~ ~ 8 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... .... 7. '; 6. Total Gross Assets (total Lines 1-7) .... ................... ...... ... B. ~ 3 ~ ' $ ~ ~; !) ' $- 9. Funeral Expenses & Administrative Costs (Schedule H) ......... ...... . ... 9. 3 1 0 4; ~ ' Q 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ...... ... 10. ~ 1 9 , 1 9 ; 1 ~ ~' 9 ' 7 11. Total Deductions (total Lines 9 & 10) ... ......... .......... ...... .. t1 = 1 C}; 2 ~ 2 2 7 . 9 =~~ A i3.„, 12. Net Value of Estate (Line 6 minus Line 11) ........ .. .. ...... ..... .. 12 ~ ~ ~ f'~ ~~ ~' 73. Charitable and Governmental Bequests/Sec 9113 Trusts for which '` k,. I= an election to tax has not been made (Schedule J) .. ... .... ....... .. 13 ° _ t ~ r. 4. `_ =,5=. 14. Net Value Subieet to Tax 11 ine 19 minus I ina 131 to ~ ~i ~ 4~ ' TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 ~°" _ ~ ~ ~ " ~ - '^ = (a)(1.2) X .0_ - ~ °. 15. i R 16. Amount of Line 14 taxable at lineal rate X .0 _ ~ t6 n .~ 17. Amount of Line 14 taxable ''~ ; y at sibling rate X .12 y, - t7 ~ n 18. Amount of Line 14 taxable "~`~'~'~ ` r-'~~' at collateral rate X .15 ~~ ~ 1 g ....., .,.c ~,. J;. `,. . ~ ~ - 19. TAX DUE ..... ......... .......... ........ ........ ...... . ... 19 ... . .. ,., ~ ,..eo ~ ~ ~~. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056052048 15056052048 O J S2EV-7500 EX Page 3 File Number Decedent's Complete Address: h}arl~ae E. Stein STREET ADDRESS /r~~~_~~ /~~ 1,~tllgfWit N1IC51i~F FICZSE ~.t11t~r -. 1_~ lxlaL6rklSrt R03(t _ _. __ CITV STATE ~ - ZIP1~13 Tax Payments and Credits: 1. Tax Due (Page 2 Llne t 9) 2. CreditslPayments A. Spousal Poverty Credit - _._ __. __-. B. Prior Payments __ _. - -. _ _ - _ _- C. Discount _- _.__ _____ -- TotalCredits(A+B+C) 3. InleresUPenalty if applicable D. Interest __ E. Penalty -_- ----_- --__-~ - - Total lnteresVPenalty(D+E) 4. If tine 2 is greater than Line 1 + Llne 3, enter [he 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. (1) (2) (3) (4) (5) (5A) (5B) -0- Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Dld decedent make a transfer and: Yes No a. retain the use or income of the property transfemed :.................................................................................... it i ...... ^ ncome :...................................... s b. retain the right to designate who shall use the property transferred or ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... d. receive the promise for life of either payments, benefts or care? ................................................................ ...... If death occurred after December 12, 1982, did decedent transfer property within one year of death 2 . 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. Far 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 ii 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 tc 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) [772 P.S. §9116(a)(1)j. 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. PEV~ISOE E%•11~97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN h~rlate E. Stein SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY Include the proceeds of IiGgation and the date the proceeds were received by the estate. All property jointlyovvned wNll fha right of autvivormhip moat be dbclosed on ScheduN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t' P C A fiord (Harstnnt Nuxsin8 H~ $141.00 2. Reftmd from Olewiler Ftfneial. Hare ~'~ 3. Sovereigt Sedc CSreddn8 lccofmt No}i 278171f?Ci2 (If more space is needed, $3,249.10 TOTAL (Also enter on line 5, Recapitulation) I ~i,7E0.08 sheets of the same slzel REV-1571 EX~ (12-99) SCFIEDIJLE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE CO5T5 RESIDENT DECEDENT ESTATE Of ,late E. Stein FILE NUMBER Debts of decedent must be reported on Schedule 1. A. I FUNERAL EXPENSES: t. R. ADMINISTRATIVE COSTS: 7. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)tEIN Number of Personal Representative(s) Street Address Ciry State Zip Year(s) Commission Paid: 2. AttomeyFees Jane M. Alexander 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ciry State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7 Filing Petition to Settle a arcrll esCate, Inventory, Inheritance tx $265.00 $ 45.00 TOTAL (Also enter on line 9, Recapitulation) I $~iv.w I pl more space is needed, insert additional sheets of the same size) REK~9R E%•IL911 COMMONWEALTH OF PENNSYlVAN1A INHERITANCE TAX RETURN SCHEDULEI DEBTS OF DECEDENT, (GAGE LIABILITIES. & L NUMBER Include unreimbursed medical NUMBER 1. Pa. Department of Welfare Estate Recovery Program Class 3 Claim $33,579.53 Class 51 $158.336,44 DESCRIPTION AMOUNT 917.97 TOTAL (Also enter on line 10, Recapitulation) 5191 more space is needed, iaserl additional sheets of the same size) REV-1513 ENn (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNED~lLE J BENEFICIARIES ESTATE OF ~,~ E. Stein FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sac. 9716 (a) (1.2)] 1 Margo Stun Sister 5()()~ercalt residue 111 Banrv)DOd Place Harrisburg, Pa 17112 2. Morris E. Stein Brother 50 perestt resid7ze 3194 Blue Rock RDed T ~-.~.•cr~_, Pa 17603 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 19, AS APPROPRIATE, O N REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: ' A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. N/A B. CHARITABLE AND GOVERNMENTAL OISTRIRUTIONS 1. NfA TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-151)0 COVER SHEET $ (If more space is needed, insect adtlitional sheets of the same size)