The URL can be used to link to this page

Home My WebLink About07-27-0915056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes ty Po Rox zaosol INHERITANCE TAX RETURN Harrisburo PA 17128-0601 RESIDENT DECEDENT 2" I ~ 9 0 sa~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 1 6 2 9 3 8 7 3 0 6 0 7 2 0 0 9 0 2 2 1 1 9 2 6 Decedent's Last Name P O O L E Suffix Decedent's First Name M A R I E MI K (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 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ it. Election to tax under Sec. 9113(A) between 12-31-91 and 1-i-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number W I L L I A M P D O U G L A S 7 1 7 2 9 3 1 7 9 0 Firm Name (It Applicable) - - -- REGISTER OF WILLS US@QNLY ~, D O U G L A S L A W O F F I C E c7 0 0 ~ r First line of address - _l J'~ ~ r r _-r ~ . ~ , 4 3 W S O U T H S T ' ~z N -.: , ~ ` ~ Second line of address . i, -, `:.:~ ~i ~ C a n 3 _ _I J r >C City or Post Offwe State ZIP Code ~ FILED f V ~' ,-'; C A R L I S L E P A 1 7 0 1 3 co Co«espondent'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 we, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE/pF PnERSON RESPIbAyS,I~BLE F ILING RETURN DATE l X.~t.(~.. a v~/l F.xarn trix ADDRESS 631 W. Old York Rd., Carlisle, PA 17015 July 27, 2009 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056091125 15056091125 J REV-1500 EX Marie K. Poole Decedent's Social Security Number 0 1 6 2 9 3 8 7 3 RECAPITULATION 1. Real estate (Schedule A) .............................. 1. 1 1 2 Q O 0 0 0 2. Stocks and Bonds (Schedule B) ................................ 2, .. 1 7 6 5 9 0 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. 6 Q 2 9 7 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 2 S 6 9 0 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .... .. 7. 8. Total Gross Assets (total Lines 1-7) ......................... .. 8. 1 7 6 5 8 2 8 2 9. Funeral Expenses & Administrative Costs (Schedule H) .............. .. 9. 9 ~ $ 2 9 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .......... .. 10. 11. Total Deductions (total Lines 9 8 10) ........................ .. 11. 9 7 8 2 9 0 12. Net Value of Estate (Line 8 minus Line 11) ....................... .. 12. 1 6 6 8 0 0 4 2 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 6 6 8 0 0 4 2 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(t 2) x.o _ 0 0 0 15 0 0 0 16. Amount of Line 14 taxable at lineal rate x.045 166,800.42 16. 7,506.00 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17 0 0 0 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 18 0 0 0 1 s. Tax Due t s. 7 , 506.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 15056092126 15056092126 J REV-ISOe Ex Page3 Decedent's Complete Address: File Number DECEDENT'S NAME Marie K. Poole - STREETADDRESS - - - - 1030 W. Pomfret SL __ CITY STATE ZIP Carlisle, PA 17013 Tax Payments and Credits: ~ Tax Due (Page 2 Line 19) 2. GreditslPayments A. Spousal Poverty Credit B. Prior Payments _ C. Discount 5375.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestlPenalty (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 2g 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5A) (5B) 7.131.00 Make Check Payable fo: REG/STER OF W/LLS, 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 : .......................................................... . ^ X^ ... ... b. retain the right to designate who shall use the properly transferred or its income : ......................... ..... . . ^ ^X . c. retain a reversionary interest; or ........................................................................................... . .. . ^ d. receive the promise for life of either payments, benefits or care? .................................................. . ... ..... ^ X^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ..... ^ Q 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 properly which containsabeneficiarydesignation?_ ..........................._.............__..........................._......_........ _... ^ Q 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 p2 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 (he 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)]. (1) 7,506.00 TotalCredits(A+g+C) (2) $375.00 (5) 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 defned, 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 ~ I6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Marie K. Poole All real property owned solely or as a tenant in common must be reported al fair market value. Fair market value is deTned as the price at which property would be exchangetl between a willing buyer and a willing seller, neither being wmpelled to buy orsell, both having reasonable knowledge of the relevant facts. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1030 W. Pomfret St., Carlisle, PA 17013 (see attached appraisal) $112,000.00 TOTAL (Also enter on line t Recapitulation) ~ $ 112 000 00 (If more space is needed, insert additional sheets of the same size) REV-7503 EX i (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE SCHEDULE B STOCKS & BONDS All property jointlyowned with right of sunivorshlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. 29 shares Prudential stock @40.10 (06/08/09 value) $1,162.90 shares Bank of America stock @12.06 $603.00 TOTAL (Also enter on line 2, Recapitulation) ~ $ (tl more space is needed, insert additional sheeLS of the same size) REV-1508 E%+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Marie K. Poole Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sovereign Bank, 4 CD's and checking account -see attached dots. $47,829.23 2. M&T Bank, checking #2678075181 $10,771.91 3 Cash $141.69 4. Cumberland County real estate tax rebate $975.00 5. Personal property $500.00 6. Computershare, dividend stock $0.50 7. Comcast refund $16.39 8. Embarq. refund $13.14 TOTAL (Also enter on Tine 5, Recapitulation) I $ Qf more space is needed, insert additional sheets of the same size) REV-1509 EX « 16-981 SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER Marie K. Poole If an asset was made Jolnt within one year of the decedent's date of death, rt must be reported on Schedule G. ADDRESS SURVIVING JOWT TENANT(S) NAME A. Anne M. Cox 1631 W. Old York Road Carlisle. PA 17013 B c JOINTLY-OWNED PROPERTY: TO DECEDENT ITEM NUMBER LETTER FORJOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VAWEOF ASSET %OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST ~. A. 4/23/08 CD/Sovereign Bank $5,138.11 50. $2,569.06 (this was a gift from daughter to Mother) TOTAL (Also enter on line 6, Recapitulation) I $ ~ FRq na (If more space is needed, insert additional sheets of the same size) REV4511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS FILE NUMBER Debts of tlecedeM must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home $3,606.25 2 Friendship Fire Company, celebration of life dinner $250.00 3 Food, tablecloths, beverages for celebration of life dinner $533.31 4. Reverend Terry Albright, funeral $100.00 B. I A6MINISTRATIVECOSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City Year(s) Commission Paid: State Zip 2, Attorney Fees 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. I Probate Fees I $310.00 5. I Accountant's Fees estimate for filing of Fiduciary Return 1041 6. ~ Tax Return Preparers Fees $300.00 7 Live in Care of Pennsylvania $975.00 8 PP&L $51.79 9. Cumberland Goodwill EMC- ambulance from Health South to home $92.75 10 Embarq $33.24 11. Georges Flowers, funeral $223.61 12. S.W. Barrett, real estate appraisal $325.00 13. Cumberland Law Journal, advertising $75.00 14. Evening Sentinel, advertising $208.78 15. Hershey Medical Center, wheelchair transport to Health South 4/8/09 $252.00 16. Carlisle Borough tax account, 2009 school real estate $1,159.53 18. Masland Assoc. $89.53 19. PP&L $37.08 TOTAL (Also enter on line 9, Recapitulation) $ 9 782 40 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Marie K. Poole Decedent's Name Page 1 File Number Schedule H -Funeral Expenses 8 Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 20 ~ Carlisle Borough Tax Account, 2009 school real estate, 1030 W. Pomfret St. ~ $1,159.53 SUBTOTAL SCHEDULE H-67 ~ $1,159.53 NEV-t5i5 EX ~ 19~00i SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Marie K. Poole RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ] TAXABLE DISTRIBUTIONS [include outright spousal distdbutions, and transfers under Sec. 9116 (a) (1.2)] 1/6 1. Anne M. Cox Lineal 631 W. Old York Road Carlisle, PA 17015 1/6 2. Linda J. Dietz Lineal 155 Greenbriar Road Elliottsburg, PA 17024 3. Patricia M. Raymond Lineal 1/6 9 Ridge Ave. Carlisle, PA 17013 4. Marguirite K. Murphy Lineal 1/6 118 Mill St. Mt. Holly Springs, PA 17056 5. David L. Poole Lineal 1/6 1513 Terrace Ave. Carlisle, Pa 17013 6. Dwayne C. Poole Lineal 1/6 1001 Ritner Hwy. Carlisle. Pa 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET Il., NON-TAXABLE DISTRIBUTIONS'. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If mare space is needed, insert additional sheets of the same size) ' REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation To[al Amount Paid within three calendar months of the decedent's date of death: Discount: $375.00 Interest Table _ __ __ _ _ __ Year Days Delinquent Balance Due Interest this time period this year this period _,L_ _ _ TOTALS _ , 7,131.00 Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty