The URL can be used to link to this page

Home My WebLink About05-21-10 1,50561(]11, REV-1500 Ex`°1-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania of .~...w. ~, aE •E,~= County Code Year - File Number -- -- - - Bureau of Individual Taxes INHE RITANCE TAX RETURN ~~ ~~ G3 ~; S ? PO 80X 2806oi RESIDENT DECEDENT Harrisburg, PA 1128-0601 ENTER DECEDENT INFORMATION BELOW Date of Death MMDDYYYY Date of Birth MMDDYYYY _. _. Social Security Number - - - __ - - --- 196-40 4114 02/27/2010 05/31 /1933 - _ - -- _ - - -- -_ Decedent's Last Name -_ _ _ --- - Suffix Decedents irs ame __ ___ -- _ - -- - M _ -_ __ ___ ____ _ ____ - - -- _-- _- onstance Hockley __ _ _ (If Applicable) Enter Surviving Spouse's Information Below ' MI Spouse's Last Name s First Suffix Spouse Name _ _ _ _ _ - _ _ _ _ _ _ _ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 2. Su lemental Return O 3. Remainder Return (date of death Ob 1. Original Return O pp prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O `~. Federal Estate Tax Return Required death after 12-12-62) 7. Decedent Maintained a Living Trust 0 FS. Total Number of Safe Deposit Boxes O 6. Decedent Died Testate O Attach Co of Trust (Attach Copy of'Wil1) ( Py ) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 1 I' Attach Schaounder Sec. 9113(A) between 12-31-91 and 1-1-95) ( ) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number _ __ - _ - _ _ - _ - _ _ _ Ronald E. Johnson, Esq (717) 243-0123 First line of address 78 West Pomfret Street - _ Second line of address _ _- ---_ _. - _ -- - - - -- ------ City or Post Office State Z o e ---- ----- ---- --------- --- - Carlisle PA 170130000 REGISTER OF WILLS U ~ NLY r~ ~-~~ ~, ' ` . xa v ~ ~> ~r r•n rte.) _~l ti^ r -- - r- , -.,-~ i - 'C7 , ~ .,. A DgIFJFILED G~ _~ `~, ~pondent's a-mail address: rejohnson@pa net - penalties of erjury, I d re that I h e examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, ~ correct d c ple ecl~ati of prepare oth~than the personal representafive is based on all information of which preparer has any knowledge. DATE SI Pomfret y~CI~e~Carlisle, PA 'I~/y013 ~RPPARE 1iAN REPRESENTATIVE c/o 78 West Po ret Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1,5056],0101 1,5U561,D101 1505610105 REV-1500 EX Dec:edent's Social Security Number 106-40-4114 Constance W Hockley Decedent's Name 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 and Notes Receivable (Schedule D) ......................... .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 1,952.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 (Schedule G) O Separate Billing Requested..... . ... 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 1,952.00 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 3,645.00 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 3,645.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. -1,693.00 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. -1,693.00 TAX CALCULATION -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_ 15. 16. 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 18 at collateral rate X .15 . 19. TAX DUE .................................................... .....19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 O Side 2 150561D105 1505610105 REV-1500 EX Page 3 .,_ n_.v.~l_L_ w.i..l.......~.. LJCGCYCIIL ~ vvlnM~~~` ~~+~••~~+~• DECEDENT'S NAME Constance W. Hockley STREET ADDRESS 100 Claremont Drive CITY STATE Carlisle i PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 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. File Number (1) Total Credits (A+ B) (2) (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT. o.oo 0.00 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 roe transferred :......................................................................................... ^ P P rtY ^ 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 Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ X^ 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? ........................................................................................................................ ^ 0 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 years of age or younger a~; death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 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 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 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. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Constance W. Hockley Include the proceeds of litigation and the date the proceeds were received by the estate TOTAL (also on line 5, Recapitulation) ~ I,y~Z.UU SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Constance W. Hockley ITEM DESCRIPTION NUMBER p, Funeral Expenses: 1 Hoffman-Roth Funeral Home 2 B, Administrative Costs: 1 Personal Representive Commissions Name of Personal Representative(s) . Social Security Number of Personal Representative: Street Address: City: State: Zip: Year(s) commissions paid: 2 Attorney fees to Andrews & Johnson 3 Family Exemption Claimant Street: City: State & Zip Relationship of Claimant to Decedent: 4 Probate Fees to Register of Wills $ Accountant Fees to Patricia Rosendale, CPA 6 Tax Return Preparer's Fees 7 Clairemont Nursing & Rehab Ctr -final bill g Register of Wills - Pa Inheritance Tax Return -filing fee 9 10 11 12 13 14 15 16 17 18 19 TOTAL (also on line 9, Recapitulation) AMUUN l $2,589.00 $500.00 $541.00 $15.00 $3,645.00 SCHEDULE J BENEFICIARIE S ESTATE OF FILE NUM131/K Constance W. Hockley ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE I TAXABLE D[STI2IDUTIONS [include outright spousal distributions, end transfea under Sec. 9116(ax1.2)] I Cindy Hockley 1 Matthew Court, Carlisle, PA 17015 Daughter 50% 2 Raymond Hockley Son 50% 25 Annendale Drive, Carlisle, PA 17015 II INON-TAXABLE DISTRIBUTfONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter online 13, Recapitulation) $~