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Home My WebLink About03-02-10J 15056051058 R~V-150 0 Ex (os-o5, p Department of Revenue Bureau of Individual Taxes OFFlCtAL USE OILY Po sox 2sosol Hamsb~g PA 17128.0601 County Code Year File Number INHERITANCE TAX RETURN j /~ q~ ~ ~ , ENTE RESIDENT DECEDENT I (', 1 ®G Z 7 j 4 R DECEDENT INFORMATbN BELOW Social Security Number Date of Death Date of Birth 204-03-7500 02/10/2009 04/05/1922 Decedent's Last Name Suffix Decedent's First Name Smith MI Ida M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Smith MI ' William B Spouse s Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 1. Original Retum 2. Supplemental Retum 3. Remainder Retum (date of death 4. Limited Estate prior to 12-13-82) 4a. Future Interest Compromise (date of death after 12-12-82) 5. Federal Estate Tax Retum Required 6. Decedent Died Testate (Attach Copy of Will) 7. Decedent Maintained a Livin Trust (Attach Copy of Trust) g 8. Total Number of Safe Deposit Boxes 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 N ame INFORMATION SHOULD BE DIRECTED T0: William B Smith Daytime Telephone Number ~ ~~~-,~ Firm Na me (If Applicable) (717) 532 '~' ~ ~,.:. ,' .-. irst line of address ~ , ~ ~ y ,.:,:s"- REGISTE USE~LY ~ ~ ~':';:: 1 .,~~~ ,.,.I C!1 ~~°- ~~ ~~ , V..ii/// _ Second line of address _ =: ~ --- i._. ~' c.s~ City or Post Office State Zlp Code DATE FILED Shippensburg Pa ~~~-, r Correspondent's a-mail address: Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best of m it is true, correct and complete. Declaration of preparer other than the personal representative is based on all Infomtatbn of which preparer has any kn a and belief, S ATURE F P SON RESP NSIBLE FOR FILING RETURN DATE ADDRESS ~' Q~~-,wt~r~ P 1. ~(n I SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS ~~~ DATE PLEASE USE OR161NAL FORM ONLY 1 505605 1 058 Side 1 L 15056051058 J REV 1500 EX 15056052059 Decedent's Name: ida M Smith 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. Jantiy Owned Property (Schedule F) Separate Billing Requested ....... 6. 7. Inter-vvos 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, 8 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 BequestsJSec 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. 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 ~ b 00.00 15. 16. r Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 g. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 Decedent's Social Security Number 204-03-7500 ~~ ~ ~~ U I 0.00 0.00 0.00 ~L/ N ~ vVI.J ~ V~ 0.00 .~b0o0 . o 0 o.oo 0.00 0.00 15056052059 File Number REV-1500 Ex Page 3 Decedent's Complete Address: Jtl.~v~„' " ' _ ""'- M Smith Ida STREET ADDRESS DECEDENTS SOCIAL SECURITY 204~Q3-7500 STATE Pa cITY TaX payments and Credits: 1. lax Due (Page 2 Line 19) 2• CreditslPayments Credit A. Spousal Poverty - B. Prior Payments - C. Discount ____ Total Credits (A + B + C ) 3. InterestlPenalty if applicable D. Interest Total InteresUPenalty (D + E ) E. Penalty • e 2 is rester than Line 1 + Line 3, enter the differences Tre~ndthe OVERPAYMENT. 4. If Lin 9 Fill in oval on Page 2, Line 20 to reques . 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. ZIP 0.00 (1) lz) (3) (4) (5) (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. ,S AGENT ake Check Payable to: REGISTER OF WALL M BY PLACING AN "X" IN THE APPROPRIATE BLOCKS LLOWING QUESTIONS Yes No PLEASE ANSWER THE FO 1. Did decedent make a transfer and: ......................................... ............................. e of the property transferred;......•••••••••••••• ............ ^ transferred or its income : ................................ a. retain the use or incom ...................................................... retain the right to designate who shall use the prot'~rtY b ^ ......................... . interest; or.. •••••••••••••••'•"" versionary ••••• ""•' c. retain a re benefits or care? .. ...................................................... menu, .............. d, receive the promise for life of either pay within one year of death did decedent transfer property 982 ^ , after December 12,1 2. tf death occurred .................................................. ................... . .......... without receiving adequate consideration ............................. • • at his or her death?...•••••••••• unty th bank account or . • >t „. n dea which 3. Did decedent own an in trust for" or payable upo annuity, or other non- robate property P t Account ^ ^ X , n 4 Did decedent own an Individual Retireme .. ........................... .. . ............. .......................... . contains a beneficiary designation . .. • • • • T COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETUR . ANSWER TO ANY OF THE ABOVE 4UESTIONS IS YES, YOU MUS urvivin spouse IF THE sed on the net value of transfers to or for the use of the s 9 h on or after July 1,1994 and before January 1,1995, the tax rate impo For dates of deat Se is zero (0) percent is three (3) percent [72 P.S. §9'116 (a) (1.1) (i)]. the tax rate imposed on the net value of transfers to or thetst~orY requirem n l~'sdo~re ~ assets and For dates of death on or after January 1, 1995, ~ from tax, and 1 1 n The statute ~~ n~ exempt a transfer to a surviving spou [72 P.S. §9116 (a) (•) C•)l• se is the only benefiaary. filing a tax return are still appli'ca~e even 'rf the surviving spou t death to or for the use of a natural parent, an For dates of death on or after July 1, 2000: of age or younger a The tax rate imposed on the net value of transfers from a~ 2 PS. §9116(ary~ Yew x t as noted ir- rent, or a stepparent of the child Is zero (0) Pe ~ of the decedent's lineal benefiaaries is four and one-half (4.5) percent, a cep adoptive pa The tax rate imposed on the net val 1 of transfers to or for the use is defined, ands 72 P.S. §9116(1.2) [72 P.S. §8116(a)( )] rcent 2 P.S. 9116 a 13 A sibling Is twelve (12) Pe or add • § ()(, )]• rate im on the net value of transfers to or for the use o~ ~ Lenten ~~r by blood The tax per, rent In corn Section 9102, as an Individual who has at least one pa