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HomeMy WebLinkAbout06-01-10 (2)15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue SUPPLEMENTAL Bureau of Individual Taxes County Code Year File Number Poaox2sosol INHERITANCE TAX RETURN >~r ~ ~~ Harrisburg, PA 1712s-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 209-28-9279 04/17/2009 07/19/1936 Decedent's Last Name Suffix Decedent's First Name MI .McCarthy Barbara A (If 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 FILE D 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 7.__ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) t" 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 DIR JCTED TO: Name Daytime Telephone Number G~ ~.,. ~""; . Heather D. Royer .. G (717) 234-2~ 1p ' `~ , ~ ~ ~ ... ~~ ~ ~ Firm Name (If Applicable) _ __ ° "" ° '"" REGISTERR)~ USE ONLY =~ ~ ~ ~ i Smigel, Anderson &Sacks ~~rnrs ~" __ 4 _. ; ,- _ _ _ _ __ ct~ ~ ._ '-1 First line of address ._, ~.~ ~ ~ ?"° ~~ ~ :=; -y 4431 North Front Street _. ~ ._.. c ~ r ` ..r`7 t~ x Second line of address _. _ "D © ~ x. ~ 'Third Floor City or Post Office State ZIP Code DATE FILED ,Harrisburg PA ' 17110 Correspondent's a-mail address: Hroyer@SaSIIp.COm Under penalties of perjury, 1 declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, co ect and com ete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAFU OF PERS „ RE SIBLE FOR FILING RETURN ATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Barbara A McCarthy ' 209-28-9279 Decedent s Name: ~... __w _... ..~ RECAPITULATION 1. Real estate (Schedule A) ........................................... .. L ', 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. 1,079.00 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property . (Schedule G) 3 Separate Billing Requested...... .. 7. i 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. ' 1,079.00 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. ' 784.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. ` 10,000.00 11. Total Deductions (total Lines 9 & 10) ................................ ... 1 L ': 10,784.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. ' -9,705.00 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxab-e at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X .0 _ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable 15. ': 16. 17. at collateral rate X .15 18. '' 19. TAX DUE .........................................................19.'' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER Barbara A McCarthy 209-28-9279 STREET ADDRESS 11 Hartzdale Drive CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A S sal Poverty Credit you B. Prior Payments 10,272.91 C. Discount 526.32 Total Credits (A + B + C) (2) 10,799.23 436.73 3. Interest/Penalty 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. Fill in oval on Page 2, Line 20 to request a refund. (4) 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. (58) 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: 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 exemot 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 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 isdefined, 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 ESTATE OF FILE NUMBER Barbara Ann McCarthy a/k/a Barbara A. McCarthy 21-09-0398 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) SCIr1EDULE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barbara Ann McCarthy a/k/a Barbara A. McCarthy 21-09-0298 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) _ Street Address City .State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills -Short Certificate s. Register ofWills -Filing fee -Supplemental PA Inheritance Tax Return and Inventory TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 750.00 4.00 30.00 784.00 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Barbara Ann McCarthy a/k/a Barbara A. McCarthy 21-09-0398 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) • ~ ESTATE OF BARBARA ANN McCARTHY 4431 N. FRONT ST. RIVER CHASE OFFICE CENTER, THIRD FLOOR HARRISBURG, PA 17110 os-os 1052 80-184/313 12/31 /09 z3 DATE PAY TO THE Hospice of Central Pennsylvania ~ ~ 10, 00~ . 00 ORDER OF Ten Thousand----------and----------------00/100 ~ 5•~~„ DOLLARS ~ o:+°~~o• ate. 'METRO . BANK Full sat of claims _ _ FOR f\~L.-• NP ~:O3L30L846~: 53 663957 8il' 1D52 ~~ NOTICE OF INHERITANCE TAX Pennsylvania ~ APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP C12-09) INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 a DATE 05-10-2010 S~~ ESTATE OF MCCARTHY BARBARA A /p ~~ DATE OF DEATH 04-17-2009 FILE NUMBER 21 09-0398 COUNTY CUMBERLAND HEATHER D ROYER ACN 101 SMIGEL ANDERSON 8, SACKS APPEAL DATE: 07-09-2010 4 4 31 N F R D N T S T (See reverse side under Objections ) HBG PA 17110 Amount Remitted~- MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALON_6 THIS LINE ~-`1 RETAIN LOWER PORTION_FOR_YOUR_RECORDS_ ~ ___________________ REV-1547 EX AFP (12-09,DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENTAOFOTAXCE OR ESTATE OF: MCCARTHY BARBARA AFILE N0.:21 09-0398 ACN: 1D1 DATE: 05-10-2010 TAX RETURN WAS: (X) ACCEPTED AS FILED t ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN Ci) 139, 176.38 NOTE: To ensure proper 1. Real Estate (Schedule A) 18,619.11 credit to Your account, C2) submit the upper portion 2. Stocks and Bonds (Schedule B) .00 3. Closely Held Stock/Partnership Interest (Schedule C) C3) of this form with your C4) • DO tax payment. 4. Mortgages/Notes Receivable (Schedule D) 18,8 $6.47 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 9,7 72.0 5 (6) 6. Jointly Owned Property (Schedule F) 71 , 190.61 C7) 7. Transfers (Schedule G) ~$) 257.644.62 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) ~y) 2.734.25_ clo)_ 3.094.63_ 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, reflect figures that include the total ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate nl) 25,828.88 cl2) 231,815.74 C13) • DD C14) 231,815.74 lines 14, 15 and/or 16, 17, 18 and 19 will of ALL returns assessed to date. 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: DlscouNr c+) PAYMENT RECEIPT DATE NUMBER INTEREST/PEN PAID C-) 07-02-2009 CD011487 526.32 12-15-2009 CD012103 .00 00 = .00 045 = 10,274.21 12 = .00 15 = 525.00 c19)= 10,799.21 ,000.00 272.91 TOTAL TAX PAYMENT 10,799.23 BALANCE OF TAX DUE .02CR INTEREST AND PEN. .00 TOTAL DUE .02CR C15) .00 X C16) 228.315.74 X C17) . oa x cls) 3,500.00 X AMOUNT PAID * LF PAID AFTER DATE INDICATED, SEE FEVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE ___.. _~ ..,,.rrrnun~ ENTER=cT. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.