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Home My WebLink About02-25-10 (2) ~--~ ~.a ~ - - ~p c~ - ' ~ ~ ~ _ J °rn fV - _ .._ ._ ~:: _~ N U'~ ~~ ~~ .:~~. ~ I(1'' ~~~ ~n~ ~~,~(., ~ ~ ~ ~`1,~..i/LC~ '~_v ~- ~~ ~ ` J ~ ~ ~~~~ o G~ U~ ~L~, ~ ~~~ ~ ~~ -~-- ~ti,~: ~~~ - ~z -~~.~: ~~ l ~''~ ~, ~3~~ 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2aofiot 21 09 00648 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 181-18-8768 06/03/2009 07/06/1919 Decedent's Last Name Suffix Decedent's First Name MI GRIMM MRS FAYE W (ff Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 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) • 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 COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number THOMAS A GRIMM Firm Name (If Applicable) First line of address 20 RIDGE DRIVE Second line of address City or Post Office CARLISLE State ZIP Code PA 17015-9721 (717) 241-2637 REGISTER OF WILLS USE ONLY DATE FILED Correspondent's a-mail address: tgrimm@COrT1C2St.rtet 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~ef ~eparer other than the personal representative is based on all informatron of which preparer has any knowledge. SI OF PERSON RES~NSrt E R FILING RETURN DATE i ~ ~, . ~ ~ ', - _ ,. ~ 02/23/10 20 Ridge Drive, Carlisle, PA 17015-9721 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J 15056052059 REV-1500 EX Decedent's Social Security Number FAYE W GRIMM 181-18-8768 Decedent's Name: RECAPITULATION ............................................ 1. Real estate (Schedule A). 1' 2 133,550.00 2. Stocks and Bonds (Schedule B) ....................................... 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. 9,666.50 6. Jointly Owned Property (Schedule F) Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property 7 (Schedule G) Separate Billing Requested....... . . 8 143,216.50 8. Total Gross Assets (total Lines 1-7) ................................... . . 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 23,315.12 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 1,022.33 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 24,337.45 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 118,879.05 13 Charitable and Governmental BequestslSec 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. 118,879.05 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 118,879.05 16. 5,349.55 at lineal rate X .0 _ 17. Amount of Line 14 taxable 17 at sibling rate X .12 18. Amount of Line 14 taxable 18 at collateral rate X .15 5,349.55 19 . TAX DUE ...................................................... ...19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side2 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 09 00648 DECEDENTS SOCIAL SECURITY NUMBER DECEDENTS NAME 181-18-8768 FAYE W GRIMM STREET ADDRESS 16 FOXANNA DRIVE - -- STATE ZIP CITY pA 17015 CARLISLE Tax Payments and Credits: 5,349.55 (1) 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty - Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 5,349.55 5,349.55 Make Check Payable to: REGISTER OF WINS, 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 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 "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 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 decedents 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 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-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY III Iiti~c aNaw ~~ ~~,..... ~ ~'-- - - 1'ILC rvVmocn 2009-00648 ESTATE OF FAYE W. GRIMM Include the proceeds of litigation and the date the proceeds were received by the estate. ..,_ ___~. _~ _.._.:.....~~~....,~~~r ho disclosed on Schedule F. :. 3N n°tn2 r ~ n ~~0~ ~.~ ,~ O ~~- ~ ._.~ ~~,~ ~ ~ m ~ ~ °~~ ~' ~ Q1 ~_ ~ O "' .. `° ~ R V r i\ \ N ~ m C~~ ~ ~ ~ 1~ O 1 f~ ~. ~. m '~ ~ ~ ., ,~ ~_ r ~ ~.. \ ~ ~i i :~j ~ ~+ ~' r ~~~ ~ i ~. n e ' O., ~ ~ °f ~~~ "'~, ~` 3 j = G~ _ ~~; ~ ~ ~ ~ ~ ~ ~~~ 3 ,~ ~ \~ C ~ v ~~ ~~; ~ _, __ o w~ __ A O t