Loading...
HomeMy WebLinkAbout02-01-10 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death ~~S 30 3g(~5 6~ ~y.aoo9 Decedent's Last Name Suffix ~uSSe~~ M~-s (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth ~ -~a~ t `~3 8 Decedent's First Name ~ ~ ~ -~- ti Spouse's First Name ~b ~h l ~ % _ ~ g ' ~ r I - ~ l ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE `'(w -L REGISTER OF WILLS FILL iN APPROPRIATE OVALS BELOW 1. Original Retum O 2. Supplemental Return O 3. Remainder Retum (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) ! 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (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) between 12-31-91 and 1-1-95) (Attach Sch. O) MI MI ~ufcKtSrvNDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ~~u l a ~L au5~r ~t 5 ~.-3~ o~~~ Finn Name (If Applicable) REGISTER OF~LLS USE ONLQ First line of address ~ ~~ Chi ~c-. Second line of address r e e n Lc.1 ~~ City or Post Office fZ c~ State ZIP Code L r' e ~ ~ L ci In ~ ~P ,4_ ~ g o s y Correspondent's a-mail address: (-~ ~ K '~" r^~ l!-L ~ S ~ h p ~ ~ ~ r Cp M ~"""~ A t7 ~m CX1 77 1 `/' y,~ D ~'~' ~ .. ~;,^} r'y'{ l ~-~ ,~, -, _~~ -t-r `'== ii C.7 G ~rwer penames or pepury, i aecwre 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. DeGaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O ERS RESP N FOR FILING RETU DAT ADDRESS (~ r~~ v SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 15056051047 J 15056051047 REV-1500 Ex (~-os) OFFICIAL U$E ~ PA Departrnerrt of Revenue Bureau of Individual Taxes County Code Year `~ PO Box 280601 INHERITANCE TAX RETURN _ /~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT iX~ ~ J FBI Nun nb~ ~~~ 15056052048 REV-1500 EX Decedent'sGSocial Security N(u/mlber Decedent's Name: ~ ~ <j 3 ~ 3 Tj l~j RECAPITULATION 1. Real estate (Schedule A) ............................................. L ~ ~,` a ~ -~ 2. Stocks and Bonds (Schedule B) ....................................... 2. ~ ~~ 3' -( i • ~ q' 3. Cbsely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. ~5 3, ( 3 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... 7. Inter-V'rvos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... 8. Total Gross Assets (total Lines 1-7) ................................ .... 6. .... 7. .... 8. 9 f 5 Q . 9. Funeral Expenses 8 Administrative Costs (Schedule H) ................. .... 9. 3,5 ! /: f ~ b "7 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............ .... 10. ~ 2 ~ ! • ~ o 11. Total Deductions (total Lines 9 & 10) ............................... .... 11. ~ `~ ~ ~ . ~ 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. ~ ~ ~ ~ 5 ~ 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. ~ ~ 3 ( S ~ ~ S TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .0 _ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable 15. 16. 17. at collateral rate X .15 • 18. 19. TAX DUE .........................................................19. ~ U 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT _ • Side 2 15056052D48 15056052048 J REV-1500 EX Page 3 Flle Number Decedent's Complete Address: ~ ~O ~ - ~ ° ~ ~- ~ DECEDENTS NAME _~_~ _~ ~c _F. ~ ~___ 2 u s STREET ADDRESS ( _ „/ S~ - __ ~ -`- ~- - ~ ~1- --- `-` --- - _ _--- /~ © l~_ - - - -____ _ _ _ K -- __ _--- --_ - CITY ~ / STATE ~ T ZIP ~ ~ O~~ Q~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~ - ~~ 2. CreditslPayments A. Spousal Poverty Credit _ . B. Prior Payments ______~(~ ._ 0 0 C. Discount -- --- Total Credits (A + B + C) (2) ~ ~ ~ f - © v 3. InteresUPenatty if applicable D. Interest E. Penalty ---- -- Total InteresUPenalty (D + E) (3) 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) ~~ ~ (~ d 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable fo: 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 .............................................................................................................. ............ d. receive the promise for Irfe of either payments, benefits or care? .......................................................... ............ ^ ~- 2. If death occurred after December 12,1982, did decedent Vansfer property within one year of death 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, 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 benefiaary. 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)J. The tax rate imposed on the net value of transfers to or for the use of the decedents 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-1502 EX+ (i1-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE s I real property owned solely or as a tenant in common must be re would be exchanged between a willing buyer and a willing seller, neither FILE NUMBER a l - t~ 9 - d aa. ~ d at fair market value. Fair market value is defined as the price at which property compelled to buy or sell, both having reasonable knowledge of the relevant facts. If more space is needed, insert additional sheets of the same size. Settlement Statement ~ ~ P t:ot~tlorr of Nesltetn Few E}a1e Friday, Jtsn 19, 2004 SeNer(s): Estafe of F.,dith Ruesali SetleKs}: Property Type - YeModef: t49D Redman Btylh Attrytt 9uye,(s): lll~age o~ tdeshamin Falls Water 11Aeter Readir~ Buyer(s): Propartp Address: 8 WoodsblulF Rim Propene !ice R ~qp IVOrth Wales PA 19454 Ser~ef Pb.. t220948a Piachssel8ale Price 26,DOD.00 26,OOQ40 Adm~traion Fee . Title Fee Tex CeNilcafion Payable: Pahicxa Tex Cow ~~ PaR,eoeivebte: Other . Other IYGsC D~ebibl ComnramDr+a Payal,le to: KeYaione Proparhes ~.~) C.orrrrr~siorrs Palrable ~ - C.ortrmisaioro PeYabk tx - an Aacdart De~Arnov~ Deposit an Aooastt D Deposit on AaoowR DelefArrrorxrt Olf /10001x11: Date-Amourrk 15 33 33.15 +sp Real Fatale Tex . x.38 4.38 School R+Ni EserAe Tax De osit S m 70QD0 tOD.DO p eo- q/ Comnprrdlq Fee: 163.17 496 70 25 f83.17 28,300.TD Total Proaesds . . 26.3DD-70 Total Reaeired et SsRlemerrt Balaixd Due X ~ $eNef(e 9~ ~' M6 W N~ b ` • b' Ot Cron Paradle tnmissia+ C o ~ f ~ ~ ~ ~ ~y~p . /~~j~ p 3.D0% ~ ~ ~° ~ AMR[ 4 rR14~R. X10 [VC. Ot Days tD ~ Seder. f t _00 CI'edit la 5elBr/Duo Nom trJtryer 183.17 .4=a~5s'1 i.. ~~ a~t~~~7. ~.. +:.. •f-+.. r Cj ~ - 0 i1.~~_!L~i`4~s~~~~ ,«`~ u oi,:t"~s$'n.•~,~','~' k ~,v ~~._-tl {~,~ }. :~Lfz ~3 'd l~s_. a1~`~c. .~y ~- ' ~n• ] y l 25.38.~i.7U Eltete Or F~1 R1lBBeft Pf~eeds; T~` ~,,,,, r°7°r'°~~` - - Qltler: Otter R of Deposit Estate d Edith Rusceil t00.00 Returxt of Seoaq Depasft COttN1{i8510fIB ~ Pribert9ed Plt7partlea 700 CCmF11ie~Orb to: - Cansrrdssiatc PayttlMe i0c - Tttle Fee Paga6te; D AdrrrErOn F of Neshemittli Fad aX C:er011 PiRrfcie t3elfaptlar Tex Cgiec~r 23.06 OverpagmerK - - TOTAL ~ AD1lA NCE ~~ Pt1RCFtASER: 28.300.70 8A PLiRCFtAS ER• Reeoncilfatiwt 26,3A0.7@ 26~3Q0.70 llmckeedc011appsll-Residential Ct~mmunilylNfcKee Group ReattylBSett REV-1503 EX+ (698) SCHED~ILE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF All property Jointly-owned wkh right of survivorship must be disclosed on Schedule F. ITEM - VALUE AT DATE NUMBER ~ DESCRIPTION OF DEATH ,. ~u r ~ . a ~ l~~v w`~ ~e ~ ~ c~ ~ .~~ ~G ss ~ ~ ~ g 7 0 , a~ I ~ ~ . cE g ~ o Slna~rc s 3v`~. 9 r~~ Sh~r~'s ~ ~ S - ~~3a s h~~~- L~ - S c G. l ~ uv. ~~ r ~--J" f ~ 13 s~ 5~6~-s GNM.~ f~~oa~ ~f~ ,~ ~ ~ L-- ~j P - ~y,_ s ~ r-c.~ bcr~-~ ~ %~ c~-~:- c~ ~3,g~~ rJ f 7~ ~.~3 -4~. TOTAL (Also enter on line 2, Recapitulation) I ; (O a ~ 3p~ ~ ~ (If more space is needed, insert additional sheets of the same size) REV-1509 E3(+ fer9~81 ~~~~1 ~ ~~ MN~RfTM[CE TIV( RER1RHf RES~ti QECE'D9V7 scKEOU~ E cases. ~, ~ h~usc. ~~ ~nr ESTATE OF ~ FtLE DER ~~ ~~ C . ~ sue. C ~ .a, - ~~ - ~a~~~-_ IW oiodriv falrMlwawned wkh riaM d wrrriMOnhip ntlwt bs dbCbgd pt 8afnd1lM F. fll mO~E 6p8DE N< nom. miff{ P+aan>an~ m ute sm~~ mrc~ REV-1511 EX+ (10-09) pennsytvania Y,~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE 0~,--~ ~,(~ - `~ FILE NUMBER p Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT a. FUNERAL EXPENSES: ~. 3, 5 ~ G . ~'7 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) 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 ___. _ __ State ZIP Relationship of Claimant to Decedent _ _ _ _ __ ___ 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) I $ ~ 5u ~ , ©`7 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8~ LIENS ` l -- ( l ~i ESTATE OF ~~ l ~"~~ ~ . ~~t CS{> t / _ _ ^~ I LE N~BE~ ~ rU o~ ~ C~ Report debts incurred by the decedeirt prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sneers or the same size. LAST WILL AMID TESTAMENT OF EDITH CANNER RUSSELL I, EDITH CONNEIt RUSSELL being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testamerrt, hereby expressly revoking all other wills, testaments and codicils thereto, heretofore made by me. FIRST: I direct that all my }uclicially enfotreabie debts, funeral e;Kp~ses and the administrative expenses of my estate s soap after my death as practicable, Further, I direct that all estate and inheritance taxes and other taxes in the general nature thereof (together with any interest or penalty thereon}, which shall become payable upon or by reason of my death with respect to any property passing by or under the terms of this Will or any codicil to it homer executed by me, or with respect to the proceeds of any policy or policies of insurance oa my life, or with respect to any other property (includutg property o~+er which I have a taxable power of appointment} included in my gross estate for the purposes of such taxes, shall be paid by my Executrix out of the principal of my residuary estate, and I direct that no part of any such taxes be charged against (or collected from} the person receiving ar in possession of the property taxed, or receiving the benefit thereof, it being my intention that all such persons, legatees, devisees, surviving tenant by the errtirety, appointees and beneficiaries receive full benefits without any diminution vn account of such taxes. S,~'C,~Q~: All the res#, residue and remainder of my estate. of whatsoever nature and wheresoever situate, I give, devise and bequeath to my husband, JOHN CARL RUSSELL of 119 Third Street, Village of West Fairview, Enota, PA 17fl2S, per stirpes. THIRD: In the event that he is not living at the time of my Math, I then give, devise and bequeath alt the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to my sister, LEDA C. JONES, of 4 Woodsbluff Rd, North Water, I94S4, per stirpes. Ft~URTH: In the event that my sister, t.eda C. Jones, pre~~:ceases me, or fails to survive me by a period of thirty (3f}) days, I then give, devise and bequeath all the nest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to Paula- J. Klauger, per stirpes. FIF I notniaate, constitute and appoint ,PAULA J. KLAUGER as Exe~trix of this my Last Will and Testament. I direct that my Frxexutrix , shall not be rewired to post bond. IN WITNESS WHEREQF, I hereunto set my hand and seal this .~ 9 clay of Z two thousand anrt five A.D. (2005}. C' ~~ EDITH CONKER RUSSELL Paee 2 of 4 ~r~ Signed, sealed, published and declared by EDITH CONNEK RUSSELL, the above- named Testatrix, as and for her Last Will and Testamen#, in the presence of us, who. at her request, and in her presence, have hereunto subscribed our names as witnesses. of ~cx~~ S4,,,s 1-!' e~ tZal~ Psue 3 of 4 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF ~ry1,Q~~1P~V~ The foregoing instrument was acknowledged before ine this .~~ aay of five (2405) isy EDITH CONKER RUSSELL, who is personauy knawa to me, or has produced ~ identification, and states that she executed the foregoing document for the purposes contained therein. St$natufe Of pe[~OA taking acknowiadgement Name typed, printed, or stamped. (sue) CoMMUNWEALTN of ~'ENNSrlvnnlA NOTARW. SEAL GAlL P. STRICKLER~ Notary Public Gamp Hf1t Bara, Cumboriand G~aunty My Ca+~~nission Expires feb. 3, 2t}a7 Pose 4 of 4 v~ c ~~ 3 ~"~ 4 ~~ M n • N O O h tO R! O ~s°.° i ~rpd. U ti ? a~~ ~ ` ~ ~ '" i