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Home My WebLink About09-18-0915056041125 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 9 0 5 7 8 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 9 0 9 2 5 3 8 0 5 2 4 2 0 0 9 0 8 2 0 1 9 1 3 Decedent's Last Name Suffix Decedent's First Name MI W A T K I N S S R D A V I D O (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name N O N E Spouse's Social Security Number Suffix Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI FILL IN APPROPRIATE OVALS BELOW 0 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) Q 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 ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE GOMPLt I tU. ALL cUKKtSF'UNUtNGt Anu cunrwtn I IAL i Hx mrur<mH i wn anvuw ct umt~ i to i v: Name Daytime Telephone Number C HA R L E S J D E H A R T I I I 7 1 7 2 3 2 7 6 6 1 r.~ Firm Name (If Applicable) - G' REGISTER~INILLS USE ~Y ~ C A L D W E L L & K E A R N S C C=~~~~ ~' " -' ( ' First line of address ~ ~ ~ C ' ~ ~ n i , `i r , 3 6 3 1 N O R T H F R O N T S T R E E T _ -~ -~, Ga ~1. "~ _- C: y-,. Second line of address : ~>' .? -'~ ~ ~ ~ J - .7 ~" -..17 ` ~ ~-~ •• A/1ZSC CII CA ~~ .) ~.~ i -. City or Post Office H A R R I S B U R G State ZIP Code P A 1 7 1 1 0 Correspondent's a-mail address: Cdehart ,caldwellkearns.com 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 i tr e, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledg/e~. SIG TURE OF ~, RS~~ RF~`yLBLE~R FILING RETURN ^J D~E ~ "/ 201 HILLVIEW PLACE ITHACA SIGNATI~R OF P EPARER OTHER THAN REPRESENTATIVE ~ ~ , ~,.~ ~ 3631 N6RTH FRONT STREET HARRISBURG PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 NY 14850 DAT ~ /~~ PA 17110 15056041125 15056042126 REV-1500 EX Decedent's Social Security Number DAVID O. WATKINS SR. Decedent's Name. ~ 1 8 9 0 9 2 5 3 8 RECAPITULATION 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. 2 1 5 1 5 , 9 2 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6• 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 1 4 0 0 4 1 9 1 (Schedule G) ~ Separate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1-7) ......................... .. 8. 1 6 1 5 5 7, 8 3 9. Funeral Expenses & Administrative Costs (Schedule H) .......... ...... 9. 5 5 6 3 2 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...... ...... 10. 11. Total Deductions (total Lines 9 & 10) ..................... ...... 11. 5 5 6 3 , 2 0 12. Net Value of Estate (Line 8 minus Line 11) ................... ...... 12. 1 5 5 9 9 4 6 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 5 5 9 9 4 , 6 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.0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 5 5 9 9 4 6 3 16. 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 18 19. Tax Due ............ ........................... .. ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 0• 0 0 7 0 1 9. 7 6 0. 0 0 0. 0 0 7 0 1 9• 7 6 15056042126 J REV-1600 EX Page 3 Decedent's Complete Address: File Number 21 09 0578 DECEDENT'S NAME DAVID O. WATKINS, SR. __ ___ _ STREET ADDRESS 770 POPLAR CHURCH ROAD CITY ~ STATE T ZIP CAMP HILL PA ' 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 7,019.76 2. CreditslPayments A. Spousal Poverty Credit e. Prior Payments 6,400.00 C. Discount 336.84 Total Credits (A + B + C) (2) 6,736.84 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (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) 282.92 A. Enter the interest on the tax due. (5A) B Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 282.92 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 : ................................................................ ...... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^ 0 c. retain a reversionary interest; or .......................................................................................... ...... ^ 0 d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... ^ X^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death's ... ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation'? ............................................................................................. ..... ^ 0 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 ['2 F.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)(i .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. REV-1508 EX + ('6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER DAVID O. WATKINS, SR. 21 09 0578 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC Bank Accounts: (See attached statement) a. Savings Account #5005300806 -Date-of-death balance 13,167.13 b. Checking Account #5140239032 -Date-of-death balance 5,774.16 2. Bethany Village -Nursing home refund 1,564.52 3. Highmark Insurance -Refund 372.42 4. Bethlehem Steel -Final pension disbursement 637.69 5. Household goods and furnishings -None -Nursing home 0.00 TOTAL (Also enter on line 5, Recapitulation) I $ 21,515.92 (If more space is needed, insert additional sheets of the same size) REV-j509 EX+F6-98} SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DAVID O. WATKINS, SR. ___ 21 09 0578 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 A. None B C JOINTLY-OWNED PROPERTY: ELATIONSHIP TO DECEDENT ITEM NUMBER LETTER FOR JOINT 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 VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV.1510 EX ~(6-95) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER DAVID O. WATKINS, SR. 21 09 0578 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 iNC~u~~rHtNn~s~oFrHerannNSFEREE,rHEiRae~nrioNSr+iProoECEOENrnNO rHEOnr~oFranNSFer nrrncHacoavorrHEOEEOFeRREnrESra1E DATE OF DEATH VALUE OF ASSET %, OFDECD'S INTEREST EXCLUSION r=A~PUCae~El TAXABLE VALUE 1. Ameriprise Annuities: (See attached statement) (a) Account #930071510554004, payable to Thomas Watkins 40,006.78 100. 40,006.78 (son) -Date-of-death value (b) Account #930072544610004, payable to Norman Watkins 100,035.13 100. 100,035.13 and David Watkins, Jr. (sons) Date-of-death value TOTAL (Also enter on line 7 Recapitulation) a 140 041.91 (lf more space is needed, insert additional sheets of the same size) REV 1511 EX+~(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER DAVID O. WATKINS, SR. 21 09 0578 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Neill Funeral Home -Funeral services 379.42 B. ADMINISTRATIVE COSTS: ~ Personal Representative's Commissions Name of Personal Representative (s) David O. Watkins, Jr. Social Security Number(s)/EIN Number of Personal Representative(s) 161-34-1918 Street Address 201 Hillview Place City Ithaca State NY Zip 14850 Year(s) Commission Paid: 2 Attorney Fees Caldwell & Kearns 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 Register of Wills 5 Accountant's Fees 6. Tax Return Preparers Fees 7. I Cumberland Law Journal -Legal advertising 8. Carlisle Sentinel -Legal advertising TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 0.00 4, 500.00 400.00 75.00 208.78 5.563.20 REV-1573 EX + (5-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DAVID O. WATKINS. SR. 21 09 0578 RELATIONSHIP TG 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. 9116 (al (1.2)] 1. David O. Watkins, Jr. Lineal 201 Hillview Place 33.3% residuary Ithaca, NY 14850 2. Norman C. Watkins, III Lineal 33.3% residuary 3. Thomas A. Watkins Lineal 33.3% residuary ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space Is neetled, Insert additional sheets of the same size)