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Home My WebLink About11-20-09 (2) 1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 8 0 6 11 PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 197 28 9424 04 27 2007 09 21 1936 Decedent's Last Name BURKHART Suffix Decedent's First Name KRISTIN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name BURKHART J. Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI N MI P FILL INAPPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) X~ g Decedent Died Testate (Attach Copy of Will) ~ ~ Decedent Maintained a living Trust (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes ~~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death between 12 31-91 and 1 t 95 ~ 11, Election to tax under Sec. 9113(A) - - - ) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JERRY A. WEIGLE ESQ UIRE 717 532 7388 Firm Name (If Applicable) WEIGLE & ASSOCIATES, P.C. First line of address 126 EAST KING STREET Second line of address City or Post Office State ZIP Code SHIPPENSBURG PA 17257 .~.. REGISTER ~ WILLS US~NLY ~~ ~ ~ :; r., ~~ ~ ~ I.__ - ~- -rt ~ <j C .._ - DA' ~ED •• { .-, ,__~ -~ L~ ~7 :~ _z '-^~ - -~ Correspondent'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 true, correct and complete~eGaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. Paul Burkhart II 311 17013 Jerry A. Weigle Esquire ~ ~ -- 126 East DATE Ig Street, Shippensl~tlyF'g, PA 17257 Side 1 1505607120 1505607120 REV-1500 EX Decedent's Name: Kristin Noreen Burkhart 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. 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 (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) .............................__.................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) .............................._.................................. 11. 12. Net Value of Estate (Line 8 minus Line 11) ..............................__........................... 12. 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. Decedent's Social Security Number 197 28 9424 0.00 10,181.42 10,181.42 -10,181.42 -10,181.42 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 0 0 0 15. 16. Amount of Line 14 taxable 0 0 0 16 at lineal rate X .045 . 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 19. Tax Due .............................................................. 19. ................................................. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15D5607220 0.00 0.00 0.00 0.00 0.00 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0611 DECEDENT'S NAME Kristin Noreen Burkhart STREET ADDRESS 311 South Orange Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 0.00 0.00 ~.00 3. Interest/Penalty if applicable p. Interest E. Penalty 0.00 Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (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 theTAX DUE (5) q. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5$) 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 :............................................................................. ^ b. retain the right to designate who shall use the property transferred or its income :................................ ^ [~ c. retain a reversionary interest; or ..............................__............................__............................__................ ^ ^x 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 receivin ade uate consideration ................................ 9 q .................................................................................. X,' 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? ............................... . _ ......... ..................__............................__.................... II I X I 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 Juiy 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 statutedoes not exemota 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. ' REV-1351 EX+10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Burkhart, Kristin Noreen 21-08-0611 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name(s) of Personal Representative(s) 8,910.67 Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Weigle & Associates, P.C. 1,165.75 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, Cumberland County 50.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 55.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 10,181.42 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Burkhart, Kristin Noreen 21-08-0611 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exaenses 1 Hoffman-Roth Funeral Home 8,910.67 Other Administrative Costs 2 Register of Wills, Cumberland County -Exemplified Copy of Letters Testamentary for New York State 3 Register of Wills, Cumberland County -filing PA Inheritance Tax Return H-B7 Subtotal H-A Subtotal 8,910.67 40.00 15.00 55.00 Copyright (c) 2002 farm software only The Lackner Group, Inc. Form PA-15D0 Schedule H (Rev. 6-98) ' REV-1513 EX+111-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER rsurKnalt, rcrlstm Worsen 21-08-06 11 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Llat Trust s I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. ~116(a)(1.2)] Not relevant as estate is insolven . Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 15 00 cover sheet, as app ropriate, II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copynght (c) 2009 form software only The Lackner Group, Inc. Form PA-15010 Schedule J (Rev. 11-08)