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Home My WebLink About01-26-1015056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number Po sox 2sosol 2 1 0 8 0 7 8 9 Harrisbur4, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 7 2 3 2 0 0 8 0 1 0 8 1 9 6 5 Decedent's Last Name Suffix Decedent's First Name MI O H L E R B R E N D A S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 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) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 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 COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL 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 4 3 7 9 0 Firm Name (If Applicable) ~-- c~ - -:',,. E' -~ ~ D O U G L A S L A W O F F I C E REGI WILLS ~ ~ ~~ ~-t~ - ~"' ON ~ ~~ ~ LY ''~ ~::~' - First line of address r - I -~ ~ ' ~ ~ ~ . F-: ; ~: ; - J r~ C~ ' ~ i. ~i 4 3 W E S T S O U T H S T R E E T ' ,.-~ ~ .~ ~. ( -'' '? ~` Second line of address ' ~' ~ ~. - ~ ... ~. City or Post Office State ZIP Code DATE FILE 1LN i C A R L I S L E P A 1 7 0 1 3 Correspondent's a-mail address: dOUQ12SIaWOffIC@.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 is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE 1/26/2010 ADDRESS ~ - -~(~U SIGN URE OF PREPARER TH THAN R RESENTATIVE ~ DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 , 15056041125 15056041125 J . , J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Brenda S. Ohler, 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. 1 0 0 1 2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ S t Billi epara e ng Requested ....... 7. 8. Total Gross Assets (total Lines 1-7) ......... . .. . . ..... . . . . . ... g. 1 0 0 1 2 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 9 3 5 4 1 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .... ........ 10. 11. Total Deductions (total Lines 9 8~ 10) ................... ........ 11. 9 3 5 4 1 9 12. Net Value of Estate (Line 8 minus Line 11) ................. ........ 12. - 9 2 5 4 0 7 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. - 9 2 5 4 0 7 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. 0 0 0 16. Amount of Line 14 taxable at lineal rate X .0 0 0 0 16 0 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17 0 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18 0 0 0 19. Tax Due ......................................... ....... 19. 0 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 15056042126 15056042126 J J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Brenda S. Ohler, 1 6 4 5 2 4 7 6 6 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. 1 O 0 1 2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6• 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ S Billi eparate ng Requested ....... 7. 8. Total Gross Assets (total Lines 1-7) .............. . . ...... . ... . g, 1 0 0 1 2 9. Funeral Expenses 8~ Administrative Costs (Schedule H) ................ 9. 9 3 5 4 1 9 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ..... ....... 10. 11. Total Deductions (total Lines 9 & 10) .................... ....... 11. 9 3 5 4 1 9 12. Net Value of Estate (Line 8 minus Line 11) .................. ....... 12. - 9 2 5 4 0 7 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. - 9 2 5 4 0 7 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. 0 0 0 16. Amount of Line 14 taxable at lineal rate X .0 0 0 0 16 0 0 0 17. Amount of Line 14 taxable 0 0 0 0 O O at sibling rate X .12 17 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18 19. Tax Due ...... . .................................. ....... 19. O O 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 15056042126 15056042126 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 0789 DECEDENT'S NAME Brenda S. Ohler, TREET ADDRESS 2 West Penn Street apartment_105 - - - -- _ _ CITY ~ STATE ZIP Carlisle pa 17013 Tax Payments and Credits: ~~ Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $0.00 Total Credits (A + B + C) (2) $0.00 3. Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty (D + E ) 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. 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. (3) $0.00 (4) $0.00 (5) $0.00 (5A) (5B) $0.00 Make Check Payab/e to.~ REG/STER OF W/LLS, AGE/VT 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 ........................................................................................... ..... ^ 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? .................................................................................. ..... ^ 3. Did decedent own an "intrust 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 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 [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)]. 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. REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Brenda S. Ohler, 0789 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CV Sunguard Association $100.12 TOTAL (Also enter on line 5, Recapitulation) I $ 100 12 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Brenda S. Ohler, 0789 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. John R. Shultz $7,595.50 2. Evans Cemetery Memorials $950.00 3. Death Certificates $35.00 6. 2. 3. 4. City State Zip ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Douglas Law Office Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address Relationship of Claimant to Decedent Probate Fees Register of Wills -Letters 5 Accountant's Fees 6. Tax Return Preparer's Fees $100.00 $62.00 7. Cumberland Law Journal, Estate Ad $75.00 8. Embarq $38 82 9. PP&L $222.44 10. Comcast $100.85 11. The Sentinel, Estate Ad $174.58 TOTAL (Also enter on line 9, Recapitulation) I $ 9, 354 19 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Brenda S. Ohler. mRa RELATIONSHIP TO 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 (a) (1.2)] 1. Bruce E. Ohler Lineal ~I Z Q~ ~2 ~S~ ~v 530 N Delaware Avenue Minersville, PA 17954-1707 2. Andrea Jean Ohler (Werlinger) Lineal y Z v~ ~2 ~ S t +~~ 9802 Emory Road # 37 I Ford Meade, MD 20755 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 needed, insert additional sheets of the same size) REV-1648 EX (11-99) (I) ,, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION ESTATE OF Brenda S. Ohler, SCHEDULE N SPOUSAL POVERTY CREDIT VAILABLE FOR DATES OF DEATH 01/01/92 to 12/31 This schedule must be completed and filed if you checked the 1. Taxable Assets total from line 8 (cover sheet) .......................... 2. Insurance Proceeds on Life of Decedent .................................. 3. Retirement Benefits ................................................................... 4. Joint Assets with Spouse .......................................................... 5. PA Lottery Winnings ................................................................. 6a. Other Nontaxable Assets: List (Attach schedule if necessary) .. credit box on the cover sheet. 6. SUBTOTAL (Lines 6a, b, c, d) ......................................................................................................... 7. Total Gross Assets (Add lines 1 thru 6) ........................................................................................... 8. Total Actual Liabilities ...................................................................................................................... 9. Net Value of Estate (Subtract line 8 from line 7) .............................................................................. If line 9 is greater than $200, 000 -STOP. The estate is not eligible to claim the credit. If not. continue to Part II. Income: 1. TAX YEAR: 1S a. Spouse ............................. 1 a. b. Decedent ......................... 1 b. c. Joint ................................. 1 c. d. Tax Exempt Income ......... 1d. e. Other Income not listed above ..................... 1 e. f. Total ................................. 1 f. 4. Average Joint Exemption Income Calculation 4a. Add Joint Exemption Income from above: (1 fl + (2~ 4b. Average Joint Exemption Income ................................ If line 4(b) is greater then $40, 000 -STOP. The estate is not ~ 2a. 2b. 2c. 2d. 2e. 2f. TAX YEAR: 19 FILE NUMBER 0789 100.12 100.12 9. 3a. 3b. 3c. 3d. 3e. 3f. TAX YEAR: 19 $100.12 + (3~ _ (T3) to claim the credit. If not, continue to Part Ili. 1. Insert amount of taxable transfers to spouse or $100,000, whichever is less ..................................... L7 2. Multi I b credit ercenta a see instructions 2• PY Y P 9 ( ) .................................................................................... 3. This is the amount of the Resident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet .............................................................. 3• 4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate 4. ........................................................................................................................ 5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet .......... 5• 3t~ ~~e ~~ .coo ~Cl `2c~ ~ 00 ~~ ~~ ~ # Zss~{