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Home My WebLink About07-30-101505610101 REV-1500 ~ `O1.1°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania °EP.RrNENT °F AEVEn°E County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 ~ r'~~'~ Harrisburg, PA 1128-0601 RESIDENT DECEDENT ~~ ~ G ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 179-30-8187 06/10/2009 05/28/1937 Decedent's Last Name Suffix Decedent's First Name MI MCHaIe Mary Ann (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW O 1. Original Return ~ O 4. Limited Estate O O 6. Decedent Died Testate O (Attach Copy of Will) O 9. Litigation Proceeds Received O THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return (date of death prior to 12-13-82) O 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) ___ CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Robert D. Katzenmoyer (610) 451-9267 First line of address 2309 Perkiomen Avenue Second line of address City or Post Office State ZIP Code Reading PA 19606 Correspondent's a-mail address: REGISTER OF,`-WILLS USE ON~~' ~ r _, _ t .:. - : ~:.) w ~ ..__.. ~-~ c_..~ .~ ~, -i _~: ~ ---- DATE flL-ED -'T _ ,-_. ~~ ` _ - _~ ~. ~~ -- ~ .., ~ 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT OF PERSON RESPONSIBLE FOR FILING RETURN DATE .~/ .. ADDR 51 adwyn Drive, ading, PA 19606 A OF P ER TER THAN REPRESENTATIVE D TE L~" C~ ADDRESS 2309 Perkiomen Aven ,Reading, PA 19606 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101, J 1505610105 REV-1500 EX ~' Q E ~~/~~` ~~~\ ~~r ~ ~~ ~ ~ ~ ,~ J Decedent's Social Secunt Number y Decedent's Name: 179-30-8187 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. 9,575.47 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 9,575.47 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 988.78 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 9$$.78 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. $,5$6.69 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. 8,5$6.69 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 at collateral rate X .15 18. 19. TAX DUE ...................................................... ...19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 REV-1500 EX Page 3 Decedent's Complete Address: File Number ~, ~d 9 ` ~1_~/~~ DECEDENTS NAME Mary Ann McHale - - - -- -- - -- ----- ----- - -- - - - -- STREET ADDRESS 1128 Columbia Avenue, Apartment #4 CITY Lemoyne STATE r ZIP PA ~ 17043 i 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. (3) (4) (5) 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 :.......................................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ Q c. retain a reversionary interest; or .......................................................................................................................... ^ x^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ x^ 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 "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 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 at death to or far 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. Total Credits (A + B) (2) 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 Mary Ann McHafe 2109-0588 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+ (10-09) ~ pennsylvan~a DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mary Ann McHale 2109-0588 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) John McHale Street Address 51 Gladwyn Drive city Reading state PA zIP 19606 Year(s) Commission Paid: 2010 2• Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State Relationship of Claimant to Decedent 4. 5. 6. 7. ZIP Probate Fees: Accountant Fees: Tax Return Preparer Fees: Register of Wills -Filing Fee Supplemental PA Inheritance Tax Retum TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. 478.78 500.00 10.00 988.78 ~f r REV-1513 EX+ (11-08} ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF FILE NUMBER Mary Ann McHale #2109-0588 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List ?rustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).J 1. JohnM. McHale Brother 100% of residue 2 Virginia McHale (Deceased in 2004) Sister ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. . B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. +$ if more space is needed, insert additional sheets of the same size. ROBERT D. KATZENMOYER 2309 Perkiomen Avenue Reading, PA 19606 610-451-9267 July 20, 2010 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 RE: Estate of Mary Ann McHale File #: 2009-00588 Dear Register, I enclose for you two originals and one copy of the supplemental PA Inheritance Tax Return which I ask you to file, together with a check in the amount of $10.00 for the filing fee. Please time-stamp the copy and return it to my office in the enclosed envelope. I thank you for your attention to this request. Very truly yours, Robert D. 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