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Home My WebLink About97-0995J 1505610101 OFFICIAL USE ONLY REV-1500 °"°'-'°' d~1 PA Departrnertt of Revenue ~ CaatH Code Year File Number Bureau of Individual Taxes INHERRANCE TAX RETURN n PO sox 2$0601 RESIDENT DECEDENT ~ ~ ~ ~ G l Harrisb~~* PA 173x8-o6oi ENTER DECEDENT INFORMATION BELOW Soci~ Security Number Date of Death hMIDDYYYY Date of Birth MI~DYYYY __. 205-09-1290 10/19/1997 07/18/1912 Decedents Last Name Suffix. Decedents First Name.... MI EARNER ,WILSON E (If ApplicabM) Enbar Survivlrrp Spouse's M~rrnation t3slow Spouse's Last Name Suffix Spouse's First Name MI Na .. Spouse's Soaal Security Number TFN.S RETURN MUST 8E QED W DUPLICATE WITH TNE' REGISTER OF WILLS FlLL IN APPROPRIATE OVAL8 BELOW OlD 1. Original Retum O 2. SupplerrterKal Retum O 3. RernaNtder Rehlm (deM of death prior to 12-13-82) O 4. Limited Estate O 4a. Fubxe interest Compromise (date of O 5. Federal Estate TaX Retum Required deaCt.atter 12-1282) OD 6. Decedent Died Testate O 7. Decedent MaY~irted a Livktg Trust 8. Total Number of Strife Deposit Boxes (Attach Copy of WIN) (Attach Copy of Tnist) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Electbn m tax under Sec. 9113(A) bebneen 12-31.81 and 1-1-95) (Attach Sch. O) ', COONDENT - THIS SECTION MUST tIE COMPLETED. ALL COl0lnENCE At0 OOMFiDENTIAI TAX SIFOtZ11AT10N talE Q Name (717) 240-4 ~. ~' ~ ` `~-=' ~~`"} Jane F. Burke ~, - n ~ c. - -~ -- _ `~ ~ z, _._ r Fff(i1STER O~ © ~ First line of address ~ g . `~ = O .-"'-.- ~--- 94 McAllister Church Rd _ ~--i .. .~ G: "'~ Second line of address '~ St t ZIP C d ~~' City or Post Office a e o e __ Carlisle PA ' 17015 Conespardent's einaN address: Under psrrslaas of psr)ury,1 dsdaro that i have eumrNned thin roam, Mdudkrp aooonpartying echsdulss and staterrier-ts, and >p the bset of loawledgs and ballet, a is froe, carrec3 and oompleb. Dedarsuon of preperer other nnn the personal repreeerrteuve Is Dated on au information of aAtich preperer any tawrrledge. SIGNATURE OF FOR FILING RETURW o~rE OBH 5110 94 McAllister' Church Road, Carlisle, PA 17015 SIGNATURE OF PREPARER OTHER THAN SENTATtVE TE ADDRESS PLEBE CtISE ORNi1NAL FORM ONLY ~ Side 1 1505610101 1505610101 J ~~ J 1505610105 REV 1500 EX pecedent's Social Securtly Number __ _ os~ed«rrs rVa~rie: WILSON E. EARNER 205-09-1290 RECAPITULATION 1. Real Estate (Schedule A) ............................................. L 0.00 2. Stocks and Bonds (Sd~eduie B) ....................................... 2. 0.00 3. Closely Held Corporation. Partnership or Sole-ProP~~iP (Schedule C) ..... 3. 0.00 4. Mortgages and Notes Receivable (Sdiedule D) ........................... 4. 0.00 5. Cash, Bank Deposits and Miscell~eous Personal Property (Schedule E)....... 5. 3,800.27 6. Jointly Owned Property (Sd~eduie F) O Separate B~latg Requested ....... 6. 0.00 7. Irk Vivos Transfers 8 MisoeYaneous NoraProbate Property uested t Billin Re O S l G _ 7 _ ...._..._ ,___._. _ __ _. 00 0 ........ epara e g q (Schedu e ) . . 8. ToW Gross Assets (total Lines 1 through 7) ............................. 8. 3,800.27 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 664.20 , 10. Debts of Decedent. Mortgage LreibAitfies, and Liens (Schedule I) .............. 10. 3,136.07 11. Total Deductions (total Lines 9 and 10) ................................. 11. 3,x00.27 12. Net Value of Estab (Line 8 minus line 11) .............................. 12. 0.00 13. Charitable and Governmental BequestslSec 9113 Tnists Tor which __ _ __ ,.. ___ an election m tax has rxR been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject btJ Tax (Line 12 minus Line 13) ........................ 14. 0.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount oT Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (ax1.2) X .0_ 15. 16. Amount of Lme 14 taxable at lineal rate X .0 _ 18. 17. Amount of Line 14 taxable at sibling rate X .12 17. _.__ _... .a_ _._ _.__.... _.._ _ _ _ _.. _ _ _-_ 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ......................................................... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J REV-1500 EX Pape 3 Decedent's Complete Address: FlN Number DECeD~ms t~ WIL30N E. EARNER sTReer,wo~ss c% Jane F. Burke 94 McANister Church Road C ~A~ Carlisle PA 17015 Tax Payments and Clr+edits: 1. Tax Due (Page 2, Lore 19) 2. CreditslPayments A Prior Payments B. Discount (1) 0.00 0.00 3. Interest 4. ff Line 2 is greater than Line 1 + Lme 3, enter the diBerence. This is the OVERPAYMENT. F81 in oval on Page 2, Line 20 to nquaat a rofurrd. 5. H Line 1 + Line 3 is greater than Line 2, enter the diRerence. This is the TAX DUE. Total Credits (A+ B) (2) (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT. ~ _ ... i .. ', f Vii. _ , . ~;_ k PLEASE ANSYMER THE FOLLOWING QUESTK)NS BY PLACING AN "X" IN THE APPROPRUMITE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or noonre of the property transferred :.......................................................................................... ^ b. retain the right b designate who shah use the properly transferred or its income : ............................................ ^ Q c. retain a reversionary interest; or .......................................................................................................................... ^ x^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. B death orx~d after Dec. 12, 1982, did decedent transfer property within one year of d~th without receiving adequate corrsideration? .............................................................................................................. ^ 3. Did decedent own an "in lnet for orpayable-upon-death bank account or security at h~ or her death? .............. ^ 4. Did decedent own an individual retirement account, annuity or other ran-probate properly, which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU ~LS'I' COI~LETE SCHEDIS.E G AND FILE R AS ~1RT OF THE RETURN. -~±t~ fie. .. S r ~~ ~~i '.~~ Y ":~-~'.~ `..~,~ ~ :.~~Fi~~.x.. .. ,. .. .m. -,.~...., ~ ~;,, , r/- 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 tl~e t~se ~ the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dales of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers b or for the use of the surviving spouse is 0 percent (72 P.S. §9116 (a) (1.1) (ii)j. The statute does rat exempt a transfer to a surviving spouse from tax, and the shatrrtory requiremerrls!for discbsure of assets and filing a tax return are stfil app6c~ble even if the surviving spouse is the only benefiaary. For dates d death on or after July 1,2000: The tax rate imposed on the net value of tran~ers from a dec~sed chid 21 years of age or younger at death b or for the use of a natural parerrt, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)j. • The tax rate imposed on the net value ~ transfers to or for the use of the decedentts lineal beneficiaries is 4.5 peroerrt, except as raid in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)j. • The ~x role imposed on the net value of transfers b or for the use of the decedents sibNngs is 12 percent [T2 P.S. §9116(au1.3)]. A siding is defined, under Section 9102, as an individual who has at least one parent in common with the der dent, whether by blood or adoption. ' REV-1508 EX+ (6-98) SCMEpyY~LE E c~~~+• COMMONWEALTH OF PENNSYLVANIA bly.7~7~ DwrK ~wrv~i ~ M~~7\.. INHERITANCE TAX RETURN ~R~` ~~ERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER WILSON E. EARNER 21 97 0995 (If more specs is needed, insert additional sheets of the same size) Financial Tres .' ~' A Kq~one Commtmk~r Sank Deposit Statcolent Navcmbcr 13,1997 to Decomber 13,1997 r11~.~.~ 1...11., b. 1.11..1.1...1..1..1 l d GO JANE F BURKE POA 94 MCALLISTER CHURCH RD CARLISLE PA 17013-9346 ~~ r~rw~ raYrvws ~s NEW LOOK OF YOUR STiti E ~'C~ YOUR ACCOUNT ~~FOi~RI A __ ~- Page 1 of 1 Far intotmttion h8~6 ~ , call: 7I7 243-3212 ~BEITE~R . ...................... ................ .~ : ~l8 ~:~' :......................... .~ ..s.._....._..........~:::.::..:::................ ..:.::........................... ... :.::. Acoo~at Title Wilson E Fmrner Accoant Nxmber 502863 '; ~ .err dde.es 1N~aw6er dwewK Abwiber Abet Fees Ril B~hset t 3,712.86 1 ~ 0.00 0 t 0.00 . _ $ 0.00 ~ 5.34 S 3,718.20 OFFICIAL CHECK I . ~ Fitla(1Cta~ % a ~ 2 ~ ~ 17 ~ ~ ~~~ Issued By Integrated Payment Systems Inc., Englewood, Colorado A Keyslmt Caen Back To C+6bank (New York State): tiuffab, N.Y. 10-E61221~ MEMO ~,'~. 5(3<~~3~ ,~..i~Ji~1' ~L~~ U~J DATE ~~ i.3~ 19 ~~ ;~„ ~' ~~3 ;-,~e .;., ~ ? ~ `z' ,mom ' ~ ~.,~ i PAY --........~ :_::..:.~.....: `.......::::. ~:... ~.......:....., ..... ~ 3 71~ 79 ~ a o~ of ~ "~ATi~ £?~' i3IL9El ~ >~`e~ __ $ , j Drawer Fir~encial 7nisi ~~ =~ - ~. ~- ' REV-1517 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAi EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMB R WILSON E. EARNER 21 97 0995 DeoedeM'e debts mint be rgiorted on 5theduk I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Brethren in Christ Church, funeral service and Luncheon 150.00 2 Georges' Fbwers, funeral spray 215.18 B. ADMINISTRATNE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Z• Attorney Fees: 3• Family Exemption: (If decedent's address is not the same as daimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 33.00 S• Accountant Fees: 6• Tax Return Preparer Fees: ~• Fee for Personal Income Tax preparation and mailing expenses 266.02 TOTAL (Also enter on Line 9, Recapitulation) #''i 664.20 If more space is needed, use additional sheets of paper of the same size. _. _ _ ~ REW15Y2 EX+ (12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES 81t LIENS RESIDENT DEC~ENr ESTATE OF FILE NUMBER WILSON E. EARNER 21 97 0995 Report debt: inturrod by the deudaM prior to death that remained unpdd at the data of death, Ineludiny unraimbursetl medial expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ._ 1 • Commonwealth of PA Dept. of Public Welfare, balance of estate 3,136.07 TOTAL (Also enter on Une 10, Recapitulation) ;, 3,136.07 If more space is needed, insert additlonal sheets of the same size co~wtorlw~u..Tr of PErrlsrLVAtvIA D~ARTAEHT OF PUBLIC 1AIEL.F/WE eu~au of ~Arlcw. oP~tAtloras ESTATE RECOVERY PROGRAM P.O. BOX 8486. HARglSBUAG, PA 7770S84B8 December 08, 2000 JANE F BURKE 94 MCALLISTER CHURCH ROAD CARLISLE PA 17013 Re: WILSON FARNSR CIS #: 590137180 SSN: 205-09-1290 Dear Ms. Burke: This is to acknowledge receipt of payment in the amount of $3.3 6.07. regarding the-.above-referenced estate. This reflects payment up to the value of the estate. If any additional funds become available, please contact me. Your cooperation in resolving this matter is appreciated_ Sincerely, ~~ Edna L. Guido Claims Investigation Agent 717-772-6614 717-705-8150 FA% ~~ NOTICE OF INHERITANCE TAX ~> , ~ n r -, BUREAU OF INDIVIDUAL TARE ~ ~.i' A~R;R1~'74~IENT, ALLOWANCE OR DISALLOWA CE INHERITANCE Tax o1v1s1oN - -- - OF,~~I}~DUCTIONS AND ASSESSMENT OF TAX .. ~ .. i .. PO BOX 280601 I'' _, ~.} Lai '~„'i HARRISBURG PA 17128-0601 ~~1~ SEP ~ 4 ~~ i f ~ 4~ CLERK ~~' o~P~~is ~~u~~ JANE F BURK~'~.~~~~~..~'~rC~ U~ , PA, 94 MCALLISTER CHURCH RD CARLISLE PA 17015 tl) .00 c2) .00 t3) .00 t4) .00 t5) 3,800.27 t6) .00 t7) .00 CUT ALONG THIS LINE _ --~ __RETAIN_LOWER_PORTION_ FOR YOUR RECORDS E-' _ _______________ REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: EARNER WILSON EFILE N0.:21 97-0995 ACN: 101 DATE: 09-06-2010 TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) pennsylvan~a ~ DEPARTMENT OF REVENUE REV-1547 EX AFP (12-09) NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. C8) 3,800.27 t9) 664.20 tlo) 3, 136.07 tll) 3,800.27 11. Total Deductions 0 0 12. Net Value of Tax Return C12) . 0 0 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) . T t14) .0 0 14. ax Net Value of Estate Subject to NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 0 0 = 0 0 .0 0 15. Amount of Line 14 at Spousal rate (15) . X 16. Amount of Line 14 taxable at Lineal/Class A rate C16) .0 0 X 0 6 = .0 0 17. Amount of Line 14 at Sibling rate C17) .0 0 X 0 0 = .0 0 18. Amount of Line 14 taxable at Collateral/Class B rate t18) .0 0 X 15 = .0 0 t19)= .0 0 14. Principal Tax Due TAY f DCTITTC PAYMENT DATE RECEIPT NUMBER DISCOUNT t+) INTEREST/PEN PAID t-) AMOUNT PAID DATE 09-06-2010 ESTATE OF EARNER WILSON E DATE OF DEATH 10-19-1997 FILE NUMBER 21 97-0995 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 11-05-2010 (See reverse side under Objections Amount Remitted -~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.