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HomeMy WebLinkAbout04-15-10 (3)15056041158 _,I REV-1500 EX (Oti-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of individual Taxes County Code Year File Number Po aox Zsosot INHERITANCE TAX RETURN 21 10 00205 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 182-12-3912 01222010 05221920 Decedent's Last Name SOULERET Suffix Decedent's First Name EDNA (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITIH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 4 Li i d E . m te state ^X 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 7. Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) MI L MI ^ 3. Remainder f~eturn (date of death prior to 12-1,~-82) ^ 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch.'O) CORRESPONDENT - THIS SECTION MUST l3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION ~HOULI Name Daytime Telephone Numbe VICKY ANN TRIMMER 717-620-21440 Firm Name (If Applicable) PERSON & HEIM, P•C• First line of address PO BOX 659 Second line of address City or Post Office MECHANICSBURG State ZIP Code BE DIRECTED TO: n ~ WILLS U REGIS NLY '~' ~ '' ~ n "d r-; i ti, 7 ~r - ~ c - ~; - , ~ ~ r y D `,~~ ATE FILED tip ~ ~ PA 17055-0659 Correspondent'se-mailaddress: VATRIMMERaPERSUNHEIM • COM Under penalties of pery'ury, I declare that I have examined this return, Including accompanying schedules and statements, and to the pest of my knowledge and belief, it is t orrect and comp) Declaration of preparer other than the personal representative is based on all information of which preparer hps arty knowledge. GNA E O PE RES ILING RETURN DATE ~. RESS 31 GREEN STREET SHIREMANSTOWN, PA 170J55 SIG ~~F PRE~ER O~ER-fiHAN REPS NTATIVE ~ fj J E / U PO BOX 659 MECHANICSBURG, PA 175,5-0659 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041158 8M46473.000 1505604'1158 J C~ 15056042159 REV-1500 EX Decedent's Social Security Number 182-12-3912 Decedent's Names 0 U L E R E T E D N A L RECAPITULATION 1. Real estate (Schedule A) 1. D • 0 0 2. Stocks and Bonds (Schedule B) . 2. 15 4 2 3 • 2 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. 0 . ~ Q 4. Mortgages & Notes Receivable (Schedule D). . 4. ~ , 0 ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 5 4 4 9 • 15 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 8 8 4 6 2 • 8 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 18 0 6 6 8.6 6 8. Total Gross Assets (total Lines 1-7). a. 2 9 0 0 0 3 • 91 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 2 3 2 4 0 • 18 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10. 2158 • 26 11. Total Deductions (total Lines 9 & 10) . 11. 2 5 3 9 8 • 4 4 12. Net Value of Estate (Line 8 minus Line 11) 12. 2 6 4 6 0 5 • 4 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . 13. ~ , ~ 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. 2 6 4 6 0 5 • 4 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 .OO. 0, 0 2 15. 0• D O 16. Amount of Line 14 taxable at lineal ratex.o~l5 264605.48 16• 11907.25 17. Amount of Line 14 taxable at sibling rate X .12 ~ , 00 17. 0 • 00 18. Amount of Line 14 taxable at col lateral rate X .15 ~, ~ ~ 18. ~, ~ ~ 19. TAX DUE 1 s. 119 0 7.2 5 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 8M48482.000 1505604''2159 REV-1500 EX Page 3, Decedent's Complete Address: File Number ai. i.n nnan ~ DECEDENTS NAME SO R T DNA STREET ADDRESS R CITY SHIREMANSTOWN STATE ZJP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) _ 119 0 7 • 2 5 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments 11311.8 9 C. Discount 5 9 5.3 6 Total Credits (A + g + C) (2) _ 119 0 7.2 5 3. InterestlPenalty if applicable D. Interest 0 . 0 0 E. Penalty 0 . 0 0 Total InteresUPenalty (D + E) (3) _ 0 • 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) _ 0 • 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ 0 • 0 0 A. Enter the interest on the tax due. (5A) _ 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) _ 0 • D 0 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: ~ a a. retain the use or income of the property transferred; X b. retain the right to designate who shall use the property transferred or its income; ^ X c. retain a reversionary interest; or . ^ X d. receive the promise for life of either payments, benefits or care? ^ X 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? . X 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 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. 6M4671 1.000 REV-1503 EX + (6.98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ATE OF FILE Edna L. Souleret 21 10'.00205 All property jointly-owned wlth right of survNorship must be disclosed on Schedule F. 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) REV-7508 EX + (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Edna L. Souleret 21 10 00205 3wa6AD t.ooo (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA NVHERfTANCE TAX RETURN RESDBVT DECEDB~ff - - ESTATE OF FILE NUMBEFR Edna L. Souleret 21 10 002Q5 k an asset was made joint wkhin one year of the decedent's date of death, k must be reported on Schedule tx SURVNINGJOMTENANT(S) NAME ADDRESS f~ELATIONSHIPTO DECEDENT A Gallagher, Janet Daughter B Souleret, Judy Daughter C Souleret, Larry Son' JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOIN TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAMEOF FINANCNL INSTRUTpN AND BANKACCOUNT NUMBER OR BIMIL4it IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLV•HELD REAL ESTATE. L1ATE OF DEATH VALUE OF ASSET % OF (xC0'S INTEREST DATE OF DEATH VALUE OF DECEDENTS NTEREST 1 BA 2/3/2007 First Niaqra #649539457 $5,700.60 33.3300 $1,900.20 2 BAC Morgan Stanley #410-054894-003 $154,254.91 25.0000 $38,563.73 3 B 3/2/2007 PSECU #8312 $63,685.44 50.0000 $31,842.72 Interest accrued to 1/22/2010 $72.83 50.0000 $36.41 4 BAC Members First CDS $64,479.21 25.0000 $16,119.80 TOTA (AlcnanlwrnnlinaR RarapitUlatlon) IMP $88,462.86 (M more space is needed, insert addkbnal sheets of the same sae) 3W46AE 1.000 SCHEDULE F JOINTLY OWNED PROPERTY REV•1511 EX+(10.09) 'pennsylvania • DEPARTNIENTOF REVENUE MHERITANCE TAX RETURN RESIDENiDECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Edna L. Souleret 21 10 00205 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. Rocco's Flowers $1,155.00 2 (Frye Funeral Home ~ $11,286.09 Total from continuation schedules . B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State ZIP $2,423.59 2. Attorney Fees: $4,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) $3, 500.00 Claimant Judy Souleret Street Address 313 W Green Street City Shiremanstown State PA ZIP 17011 Relationship of Claimant to Decedent DAUGHER 4. Probate Fees: $125.50 5. Accountant Fees: 6. Tax Return Preparer Fees: $125.00 7. 1 Persun & Heim -Copies, postage, etc $500.00 2 Judy Souleret -postage; telephone; mileage for estate administration $125.00 9W46AG 1.010 TOTAL (Also enter on Line 9, Recapit If more space is needed, add additional sheets of paper of the same size. 3,240.18 Estate of: Edna L. Souleret Schedule H Part 1 (Page 2) 21 10 00205 Item No. Description Amount 3 Food Trays $187.04 4 The Spring House (luncheon) $1,038.63 5 Malpezzi Funeral Home $1,171.43 6 Postage/Thank you cards $26.49 Total (Carry forv~ard to main schedule) $2,423.59 REV-1512 EX i (12-OB) • pennsylvania DEPARTNENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8 LIENS ESTATE OF FILE NUMBER Edna L. Souleret 21 10 00205 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed medical expenses. swaeAH z.ooo If more space is needed, insert additional sheets of the same size. REV-1513 EX-«(11-OS). SCHEDULE J Pennsylvania D~PARINENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT EST FILE NUMBER Edna L. Souleret 21 '0 00205 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).] 1. Judy Souleret USB #VP-75000-AB TOD 3 children Inventory Value: $44,015.43 0~ of Residue: $27,978.94 Daughter $71,994.37 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER. SHEET. S $ 0 .00 ewaeni 2.ooo it mare space is neeaea, insert aeeitional sneers of the same slze. Estate of: Edna L. Souleret Schedule J Part 1 (Page 2) Item No. Description 2 Janet Gallagher Met Life Annuity Janet Gallagher (Daughter) is named beneficiary Inventory Value: $48,622.24 USB #VP-75000-AB TOD 3 children Inventory Value: $44,015.43 0~ of Residue: $27,978.94 3 Larry Souleret USB #VP-75000-AB TOD 3 children Inventory Value: $44,015.56 0~ of Residue: $27,978.94 Relation Daughter Son 21 10 00205 Amount $120,616.61 $71,994.50 A v N D1 g 0 d °o a N a 0 O~ 9 { c C wi i ~' N O ~ ~ W fl/ Q ~ R 'G q S ~. v+ S ~ Oi d r ~ rF ~ W ~ ~ N ,Z7 `~ "1 i>Q o _~ '- ~n - ~ w ~ ~ tQ O ~ N OW ~D ~ N Q- O ~ r ~ O ~ x O in I 0 ar V O 1 O I -t d d, C N r~ ~ C 'j' N a n n d r} I i° ,~ ( Q N l ~ hi ~S ~~'I ~ E ~ ~ ~~~ i p~p ! ! N 4 ~~ i Q ! A o a O I ~ n T j C O ~ ~ D c ~_ m~ R- ~-s m m o, f ~ ~w D O O QQ v Q x {CD I~ CD 1a ! w 1 w ;m`. ! N (D o I n I T. 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