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Home My WebLink About08-02-10.T _. i-__ 1505610101 REV-1500 Ix t°'-3°' ~ PA Department of Revenue pennsylvanta OFFICIAL USE ONLY Bureau of Individual Taxes o....,w~*«~.wN County Code Year File Number . INHERITANCE TAX RETURN ""~~"`" ~~ ~ PO BOX 28otioi Harrisburg, PA 19128-o6oi u , RESIDENT DECEDENT , ~ f ~ ~ ! ~ d fj ~Ej _ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYW 203-52-3175 ~ ~ 06/11/2009 03/21/1966 Decedent's Last Name Suffix Decedent's First Name MI _____.._.__,.._~.. _.._.~~_._._._.__._._._.._._.__.._.. i Replogle _. .---....T____. _.___-____._., - ~ ~ i Barbara ~ ,.. .~ G i (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name _ Suffix Spouse's First Name MI _ p_ g..__.__..__-_~.~.____.____.____ Re to le ~ _._ _____._ __..___._ _____~ ~ Jr ! ~ ~ Daniel j ~ E ~ _ Spouse's Social Security Number ~ _ . THIS RETURN MUST BE FILED IN DUPLICATE WITH THE :185-56-4487 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW t~ 1. Original Return O 2. Supplemental Retum O 3. Remainder Return (pate of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate'~ax f~etum Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax tlndeY Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O)', CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD ~E DI~tECTED TO: Name Daytime Telephone NUmbler Susan E. Stott . i 1 (717) 243-8077 .,,-~a ~ u ~ rv ~' -. t~v, .. t^ REGISTE~ NYILL., US~ILY _ _,:~ LsJ ~: - "" ~. ~~.- ~ L~ ~ ~ e ~ first lin f add ~ ~~ ~ ~7 S~ano~ '~ _ ~ j ~ r"' '~C ~ w r .w i` ~~' 4 i.:. ` O "ity or P~Office Carlisle l State ZIP Code PA ~ ; 17013 ~T'~~_~ _~ ~.._.._ Correspondent's e-mail address: Under penaltles of perjury, I declare that I have examined this retun it is true ect and complete. Dedaretion of prepare Cher tha SIGNA OF PERSp NS F G RE ADD S 803 Torway Rd GardnersL A 17 4 SIGNATURE ~ P~tF~~HAN REPRESENTATIVE inGuding accompanying schedules and statements, and to the best of e personal representative is based on all Informatbn of which preparE ~" _..r„i.,. C~ • • ' ~ z"1. Ige and belief, 157 S Hanover St Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 150561D101 150561010, REV-1500 EX Decedents Name: Barbara G Replogle 1505610105 Decedent's Social Security Number 203-52-3175 RECAPITULATION 1 . .. ... Real Estate (Schedule A) 1. _~ ~._._...~w _.,.._ . .. . ............... . .................... _ .._... ...... f 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. 6. Jointly Owned Properly (Schedule F) O Separate Billing Requested ....... 6. 198,232.31 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. , 8. Total Gross Assets (total Lines 1 through 7} ............................. 8. 198,232.31 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. i ~.~~.~ 5,676.52 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) .............. 10. f 42,560.29 11. Total Deductions (total Lines 9 and 10) ................................. 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 1'2: 48,236.81 13. Charitable and Govemmantal 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. 149,995.50 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 00 (a)(1.2) X .0, 15. . 16. Amount of Line 14 taxable at lineal rate X .0 _. 16. 17. Amount of Line 14 taxable 18. at sibling rate X .12 Amount of Line 14 taxable 17. ~~ at collateral rate X .15 18. ~~ 19. TAX DUE ......................................................... 19.j 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105.. REV-1500 EX Page 3 File Number ~ I _ ~ (~ , t7 /_ 9 /_ Decedent's Complete Address: v~ I l~ DECEDENT'S NAME Barbara G Replogle STREETADDRESS 803 Torway Rd CITY Gardners STATE PA ZI 17324 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. (1) 0.00 Total Credits (A + B) (2) (3) (4) (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIiAT~ BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :......................................................:............................... .... ^ Q b, retain the right to designate who shalt use the property transferred or its income :........................................ .... ^ c. retain a reversionary interest; or ...................................................................................................................... .... ^ ^x d. receive the promise for life of either payments, benefits or care? .................................................................. .... ^ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......................................................................................................... .... ^ 3. Did decedent own an "intrust 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 R ASI 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 ~f the surviving spouse is 3 percent (/2 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 strviv~ng 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 surv'roing 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 at 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 race 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 decedents siblings is 12 percent [72 P.S. §9116(a)(1.3)]. AIsibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. - _ __ _ ~ _i REV-iso9 EX+ (oi-io) Pennsylvania , SCNEDt~LE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIpENT DECEDENT ESTATE OF: FILE' NIjMBER: Barbara G Replogle 2109+•0696 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Sc edule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELI~TIO~ISHIP TO DECEDENT A• Daniel E Replogle Jr. 803 Tonnray Rd :Spouse Gardners, PA 17324 8. `, ' C. ~ .. :° 70INTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TBIANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCiAI INSTIfUT10N AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OP DEATH VALUE OF ASSET %' of D NT'S I RESr' DATE OF DEATH VALUE OF DECEDENT5INTEREST 1' A' ; 'Metro Bank Checking Acct# 0538205451 _ ~ 28.74 r, 50. ~ 14.37 :., _ 2 A 'Metro Bank Savings Aa,~t# 0627208986 550.31 e 50. ,' 275.16 .~ _. ._ _ ,._ . , ,: . . 3 A 'Soverign Bank Checking Acct# 1671019253 .y ~ 3 415 47 ' S0 ~ ,. .. _ f 1, 707.74 t' 4 A ~ ~ 0 N Equity sales Co Brokerage Acct # 3CG-308746 24,095.08 ~ 50 `' 12,047.54 ~' _ ~,.. 5 A ; ~. _ 'Real Estate _ ... Residence ; _ 178,000.00 ~ ~50, ,. _, _ ,. . ~ ~ 89,000.00 . , y .. _ ~ ~ 6 A 2006 Jayco Greyhawk Motor Home 50,000 v0 ', 50 ~ 25,000.00 7 A , -~ Miscellaneous Personal Propetty - -. .. 4 60000 ~~ 12 ' 50 ~' _ . ~;.'_. ~. ' 62,300.00 8 A ' 2006 Chevy Colorado ; 9,335 00 50 ' 4,667.50 9 A : 2003 Chevy Montecado 4,165.00'' S0 2,082.50 '' 10; A '2000 Dodge Caravan 2,275.00 !i0' ~ 1,137.50 TOTAL (Also enter on Line 6, Recapitulation) I $ 198,232.31 If more space is needed, use additional sheets of paper of the same size, REV-151] EX+ (10-09) SCHEDULE H ~' Pennsylvania ~„`7 DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barbara G Replogle 2109-0696 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Berkebille Funeral Home ~ 5,180.52 ._ . .. .. _ __.. „~ . g. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 460.00 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: 36.00 .. 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) ¢ 5,676.52 , If more space is needed, use additional sheets of paper of the same size, REV-1512 EX+ (12-08) • ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE aF FILE NUMBER Barbara G Replogle 2109-0696 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 • Auto Loan - 2006 Chevy Colorado - 50% x 2,496.79 2 Auto Loan - 2006 Jayco Motorhome 50% 23,323.00 3 Mortgage 50°Jo 16,740.50 ,: _.,. ._. m,~~~.~. .:.. ,. _ ,-. ,+ i i t Y 1 __ ~_ _ .... , a~ ,_. ,.. ,, ~ !' _. .. u. :. j ,.. _ ~ _ , s TdTAL (Also enter on Line 10, Recapitulation) ~ 42,560.29 If more space is needed, insert additlonai sheets of the same size