The URL can be used to link to this page

Home My WebLink About04-0587REV- 1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28O6O1 HARRISBURG, PA 17128-0601 DECEDENTS N~ME (LAST, FIRST, AND MIDDLE INITIAL) Lebo Jacquellrn DATE CF DEATH (MM-DD-YEAR) I DATE CF BIRTH (MM-DD-YEAR) 5/12/2004 4/4/1961 (IF APPLICABLE)SURV VING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Daniel B. Lebo REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT K C~cFIClAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 2~8-50-9099 THIS RETURN MUST SE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~_ ii X J l Onginal Return I t 2. Supplemental Return E~ 3. Remainder Return (date of death pnor to 12-1::%82) O ~' I L I 4 Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-1242) [~] 5. Federal Estate Tax Return Required t~!E~ 6 Decedent Died Testate (Attach copy of Will) [---'-~ 7 Decedent Maintained a Living TnJst (Attach copy ofTrust) __ 8. Totat Number of Safe Deposit Boxes ~ ![---~ 9 Litigation Proceeds Received E~ 10 Spousal Poverty Credit (date of death betwe.n12-$1-Sl and1_1.95) ~ 11. Election to tax under Sec T NAME tCOMR.k--rE MAILING ADDRESS 44 West Main Street Richard C. Snelbaker FIRM NAME (if Applicable) Snelbaker, Brenneman & Spare, P.O. Mechanicsburg ~PHCNE NUMBER ' 717-697-8528 PA 17055 I Real Estate (Schedule A) (11 2. Stocks and Bonds (Schedule B) (2) 3 Closely Held Corporation, Partnership or Sole-Propnetorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) [~ Separate Billing Requested (6) 7.Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funerai Expenses & Administrative Costs (Schedule H) (9) ! 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1. Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 0.00 O.Oe- 0.00 0.00 0.00 336.36 0.00 (8) OFRCJAL USE ONLY 336.36 (11) 0.00 0.00 0.00 336.36 0.00 (12) (13) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 336.36 Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) Amount of Line 14 taxable at lineal rate Amount of Line 14 taxaDle at s~bling rate Amount of Line 14 taxable at cottateral rate 0.00 x.0 0 (15) 336. 36 x.0 . 45 (16) 0.00 x.12 (17) 0.00 x 15 (18) (19) Tax Due 0.00 15.14 0.00 0.00 15.14 1:2 13. 14 15. 16 17 18. 20 3w46451.000 De~:edent's Complete Address: fSTREET ADORE,SS 885 Hawthorne Avenue Cumberland County - [Mechanicsburg ISTATE PA '['ax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Upper Allen Township Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.76 (1) Total Credits (A + B + C) (2) 0.00 0.00 Total Interest/Penalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. (3) (4) (5) (SA) (SS) 15.14 0.76 0.00 0.00 14.38 A. Enter the interest on the tax due. IZIP 17055- 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 14.38 ::::::::::::::::::::::::::::: ..................................................................... ~k.....e.......C......h,.e.,..~,k.....p...a.?..~(e. ~.o... 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; ......... [----J ~ 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 t~ust 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 benef c ary designation~ I'-'-] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 Decl~f preparer other than the personal repr~entat~e is based on all information of which preparer has any knowledge. ACORESS 885 H~horn Avenue, Mechanicsburg, PA SiG?j/j~,~~ER THAN REPRESENTATIVE 17055 44 West Main Street, Mechanicsburg, PA 17055 DATE DATE 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 3% [72 PS.§ 9916 (a) (1 1)(0] 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 sun4ving spouse is 0% [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 applicabie even ~f the survwlng Spouse ~S the only beneficial/ For dates of death on or after July 1, 2000: The tax rate ~mposed 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 0% [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 45%, except as noted in 72 PS § 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% (72 PS. S 9116(a)(I 3)]. A sibling is defined, under Section 9102 as an individual who has at least one parent in common With the decedent, whether by blood or adoption ~ 3W4646 1.000 REV-1509 EX + (6-98) ODMMONWE_ALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESIDENTDECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY Jacc/~elyn K. :Le~o FILE NUMBER If an asset was made joint within one year of the decedent"s date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME AE:ORESS RELATIONSHIP TO DECEDENT A. :Lebo, Karlee E 885 Hawthorne Avenue, Mechanicsburg, PA 17055 Daughter JOINTLY-OWNED PROPERTY: LE'Fr~ i DATE DESCRIPTION OF PROfi'b,~lY' %OF iTEM FOR JOINT MADE iNCLUDE NAME OF FINA/~CIAL INSTITUlqON AN0 BANK ACCOLIgT i DATE OF DEATH ' F_ATE CF 2EATH NUMBER TENANT JOINT ~MaER OR SIMILAR IDENTIFYING NUMBER A3-~ACH DEED FOR ~--~'~'S j VALUE CF JOiNTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST EECEDENTS INTEREST 1. A. I -A 7 Series EE Savings Bonds with face value of $100.00 jointly owned with Decedent, s Daughter (see attached list) 672.72 50.000 336.36 TOTAL (Also enter on line 6, Recapitulation) $ 336.3 ~ ~nsert additional sheets of the same size) Savings Bond Calculator t,age Iot I [05/2004 i Up datel Savin¢ Series Denomination lEE Bonds ~ $1100 ~ Serial Number # Bonds Total Price Total Interest 7 $350.00 $322.72 Issue SeriaINumber Issue Date Series Denom Price C413194940EE 03/1993/ EE $100 $50.00 C321486040EE 01/1993,'-EE 100 50.00 C321485790EE 12/1992/-EE 100 50.00 C321021254EE 10/1992:/'EE 100 50.00 C320286439EE 08/1992'~ EE !00 50.00 C320286364EE 06/1992~ EE !00 50.00 c271239893ee 04/1992- 'EE 100 50.00 Total Value $672.72 Interest Interest Value Rate $33.36 $83.36 2.41% 45.84 95.84 6.00% 45.84 95.84 6.00% 48.68 98.68 6.00% 48.68 98.68 6.00% 48.68 98.68 6.00% 51.64 101.64 4.00% Issue Date YTD In: $123,~ Next Final Accrual Maturit5 09/2004 03/2023 07/2004 01/2023 06/2004 12/2022 10/2004 10/2022 08/2004 08/2022 06/2004 06/2022 10/2004 04/202£ Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator http://wwws.publicdebt.treas.gov/BC/SBCPrice 6/7/04 REV-1513 EX+ (9430) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Jac=quelyn K. Lebo FILE NUMBER NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTR I BU TIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.:2)] Karlee E. Lebo 885 Hawthorne Avenue Mechanicsburg, PA 17055 100% Residue: 336.36 Daughter 336.36 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART Il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~$ 0.00 3W46AI 1 000 (if more space is needed, insert additional sheets of the same size) C:OMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU QF INDIVIDUAL TAXES DEPT. 280601 E~ARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004075 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 208-50-9099 FILE NUMBER: 2104-0587 DECEDENT NAME: LEBO JACQUELYN DATE OF PAYMENT: 06/22/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/12/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $14.38 REMARKS: TOTAL AMOUNT PAID: 914.38 SEAL CHECK# 2109 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~.~ - ~.%~ BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTS']'ON DEPTo ZB0601 HARRISBURG, PA 17ZZ&-0601 RICHARD C SNELBAKER SNELBAKER ETAL fiq W MAIN ST MECHANICSBURG PA 17055 CUT ALONG THIS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-10~i? EX AFP (01-05) DATE 08-16-200q ESTATE OF LEBO JACQUELYN DATE OF DEATH 05-1Z-ZOOq FILE NUMBER 21 0q-0587 COUNTY CUMBERLAND ACN 101 Aeoun~ RoeJ~od HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAZN LO#ER PORTZON FOR YOUR RECORDS ESTATE OE::'...L:,EBO ~ ,:~j JACQUELYN FZLE NO. 21 0q-0587 ~ . .;~ ~X RETURN HAS: (X) ACCEPTED AS FILED ( RESERVATION CONCERNZN~TURE INTEREST - SEE REVERSE D~ALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ACM 101 APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) ($) ~. Nora:gages/No':es Receivable (Schedule D) (q) 5. Cash/Bank Daposi:~s/Hisc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expanses/Ada. Costs/Misc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gaga L~abili~ias/Lians (Schedule T) (10) 11. 12. 15. 1~. NOTE: DATE 08-16-200q ) CHAN~ED .00 .00 336.36 .00 .00 NOTE: To insure proper .00 credi~ ~o your account, .00 subei~ ~he upper por~ion of ~h~s form w~h your ~ax payment. (8) .00 .00 336.36 To,al Deduc~ions (11) .00 Ne~ Value of Tax Re~urn (12) 336.36 Char/~able/Governman~al Bequests; Non-alac~ad 9115 Trusts (Schedule J) (15) .00 Na~ Value of Es~a~e Subjec~ ~o Tax (1~) 556.36 Zf an assessment ~as issued previously, 11nas 1~, 15 and/or 16, 17, ~8 and 19 ~111 reflect figures that lnclude the total of ALL returns assessed to date. (~s) .00 x O0 : .00 (z6) 336.36 x OqS: 15. lq (IT) . O0 x 12 = . O0 (18) .00 x 15 = .00 (lc)= 15. lq ASSESSMENT OF TAX: 16. Aeoun~ of Line lq a~ Spousal ra~e 16. Aeoun~ of Line lq ~axable a~ Lineal/Class A ra~a 17. Aeoun~ of L2na lq a~ Sibling ra~e 18. Aeoun~ of Line lq ~axable a~ Collateral/Class B ra~e 19. PrincJ)al Tax Due TAX CREDITS PAYMENT RECEZPT DISCOUNT DATE NUMBER INTEREST/PEN PAID (-) 06-22-200q CD00q075 .76 AHOUNT PAID lq.38 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 15.lq .00 .00 .00 ( 'rF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDTT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CA): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) bmneficiarias of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Saction Z140 of the Inheritance and Estate Tax Act, Act Z5 of 2000. (TI P.S. Section Detach the top portion of this Notice and submit with your payment to the Register of Rills printed an the reverse side. --Make check or money order payable to: REG/STER OF NXLLS) AGENT A refund of a tax credit) which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-IS1S). Applications are available at the Office of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-BOO-56Z-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-50Z0 (TT only). Any party in interest not satisfied with the appraisement, alloaance, or disallomance of deductions, or assessment of tax (including discount or interest) as shown on this Noticm must object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZBI021, Harrisburg, PA 171ZS-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phonm (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid mithin three (5) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed es indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of paymmnt. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19az will bear interest at m rate which ail1 vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOX .000548 ~'&- X991 XXZ .OOOSO1 ~ 9Z .000247 1983 162 .000458 1992 92 .000247 200Z 62 .000164 1984 llZ .000501 1995-1994 72 .000192 2005 5Z .000157 1985 152 .000~56 1995-1998 92 .000247 2004 42 .000110 1986 10Z .000274 1999 72 .00019Z 1987 10Z .000Z74 2000 7Z . O0019Z --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated.