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Home My WebLink About08-18-10s 1505610101 REV-1500 °"°`-'°' ~" PA Departrtte,tt of Revenue gFgqAt, lltiE OILY Buneau of Individual Taxes MIHERITANCE TAX RETURN ~~ Code Year ~ ~~ Ps4 i~s~osos REBIDENT DECEDENT ~j 1 0~ O ~ I O ENTER DECEDENT NIFawAAT10II BELOW Sodas Scarily Number Dale of D~Ct MMDDYYYY Date a etrttt MMOOnrw 05&10-3160 06/15/2009 05/10/1917 DeoedenCs Last Name StAlbc Deoadent'a Fltat Name MI ANDREWS DORIS (M Applit:abie) Enter t3urvNNtp Bpotae'e Irtforrrtatlort Below Spouse's Last Name StrRfx Spouse's FMst Name MI Spouse's Sadal SearNy Number THE RETl1iiN MUBT ~ FIL.EDI IN DUPLICATE WIiH THE REGISTER CIF WILLS FILL M APPROPRIATE OVAL>F sELOw ~ 1.Oripiosl Retum O 2. StgplerrtaNel Retum i0 3. Remeirtder Rehan (data of death prior to 12-13-82) O 4. Linihed Estee O 4a. FuWre Inhered Conpronise (date of O 5. Federal Estate Taz Retum Required death afher 12-12-82) O B. Deoedant Dbd Testeee O 7. Decadent Maintained a Livtrrp Trust 8. Total Number d Safe Deposit Boxes (Atterh Copy d t/lflll) (Attach Copy of Trwt) O 9. Lftlgatlon Proceeds Received O 10. Spousal Poverty Credk (date d death O 11. Elecdort i4 tax under Sec. 9113(A) behveen 12-31-91 and 1-1-95) (Attach Sch. O) CO ONDHfT - TiNti tiECTiOp MIMT BE COMPLETED. ALL CORREdPOND'ENCE AND GONFRHrtMI TAX MIRWMIATIDN tiiIDULD ~ DIRECTED TD: Name Daytlme Telephone Number RONALD WATSON ,,,,, Ftrnt Nrle Of address 7 NALRON DRIVE Secard Wre of addre~ City or Pont OfDce LEDGEWOOD Stals ZIP Code NJ 07852 C7 0 .., RE0167EIt C1.. 61lE tJ~' ` • : -; ~.r,~ ~ ~ - C L~ ' it n ~ n t.) .. - ` . ~~ %1 7 _ -~, O -,-r ~ ~, ~ ~ ~,'rr DATE FLED Cornapondertt's s.maU address• Under psrreMbe d perjtsy. I dxare tlrt I hsw exemhied this roWm, 0 axonparyYg schsdAes end and b the best d my Isawbdpe and beNsf. h k true, aonact and mmpMM. Dedratlon d proparer other tl~ the pereonM represerseaNe ie based on inbmmdon d vrhidr pisprer Iw anY krwwMdOe. PERSON RE3PONSIBL~ FOR FILING RETURN DATE JATIUtE OF F+lMpglt68 OTHER THAN N'T """MANE HOWARD PA ~~~~~~ PLiAtNI YtiE ORIGINAL FORM ONLY '. FLANOER8 NJ 07896 EIN-20-'.~1 Z641 Side 1 L 1505610101 1505610101 J ~~ 1 J b5056bOb05 REV 1500 IX Decederrl's Social SeasNy Hksnber OeoederA'a Iv.ma: .056-10-3160 RECAPRULATION 1. Reel Estate (Schedule A) ............................................. 1 2 Stocks and Bonds (Schedr/e B) ....................................... 2. 40,242.00 3. Closely Held Corporation. Parbrerahip or Sole-ProprietorsMp (Schedule C) ..... 3. 4. Mortgages and Notes Reoefvable (ScFredrrle D) ........................... 4. S. Cash, Bank Depastis and Mis~erreorrs Pernond Property (Scfredile E)....... 5. 103,062.00 6. JoFrtly Owned PropeAy (Sdredrrle F) O Separate BMirp Requested ....... 6. __ _. 7. Inter-Vivos Transfers & Misrxirarreous Noo-Prabafe Property (SctredAe G) O Separate BNig Requested........ 7. a. roW Gress Ape/t (total Lines 1 urougn 7) ............................. s. - 143,304.00 9. Frsraral Expenses and Admitis6atlve Coats (Sdredrde H) ................... 9. 7,943.00 10. Debts of Decedent, Mortgage liebi6ties, and Liens (Sdredr4e q .............. 10. 11. ToW DsducUons (total Lines 9 and 10) ................................. 11. 7,943.00 12. Nst Vshrs of Estale (Line 8 micas L.irre 11) .............................. 12. ', 135,361.00 13. Chadtabb aM Govemrtrergal BequestalSec 9113 Tnrats for which an election to fax has rat been made (Sdredule J) ........................ 13. 14. Net Valve SutrJset to Tnr (Line 12 micas Line 13) ........................ 14. 136x361.00 TAX CALCULATION -SEE NtBTRUCTIONB FOR APPLICABLE RATES 15. Amgsd of LLie 14 taxable attire spousal tax ram. or transfers order Sec. 9116 (8x1.2) X .0_ 15. 10. Amorrd of Line 14 taxable at rata x .0~5 135,361.00 ttt. 6,091.00 17. Amarnt d Line 14 taxable __ at slblirg rate X .12 17. _. _. _ 18. Amorsd of Line 14 taxable - at cotiateralrats X .1s 18. 19. TAX DUE ......................................................... 19. 6.091.00 20. FILL IN THE OVAL IF YOU ARE REQUEtiTING A REFUND OF AN OVERPAYMENT O Side 2 b5056bOb05 15056b0105 t3tY-1500 EX Page 3 Decedent's Complete Address: DORIS ANDREWS CEO CUMBERLAND RETIREMENT COMMUNITY sTt~rAt~ss 1LONGSDORF WAY CITY CARLISLE STATB PA Z1P 17015 Tax Payments and Credits: 1. Tax Due (Pape 2, Line 19) (1) 6,091.00 2. CreditslPayrrrents A. Pri« Payments B. Discount Total Credits (A * B) (2) 3. Interest (3) 4. If Line 2 is grea0er than Line 1 + lane 3, enter the difference. This re the OVERPAYMENT. FlN In oval on Pape 2, Line 20 In request a refund. (4) 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This ie the TAX DUE. (~ 6,091.00 Make check payable to: REGISTER OF WILLS, AGENT. t'"k' ?k,:"u~se1'Cs ,F.. 454. fi„~L# d.:~s+:~n .!^. W,h..sn. ~ ~t..:i~i>r`Sai:~'C~'.F~ 'a" >~:i'4~:7s'~` •~3~,~`-x$:#u"•'~ "~C9',,,'A'. «sPxats~"wr>E&i, ~.~l..fw"pMk,,.~4~tt.~nrv~:"(uit~&. "SaY.,.~., .'i PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRUITE BLOCKS 1. Did decedent malts a b'ansfer and: Yeg No a. retain tits use «income of the properly treneferred :.......................................................................................... ^ >r^ b. retain the rind b designate who shaft use the properly trarrsfer-ed « ifs irx;onre : ............................................ ^ fc^ c. retain a reverabrrary intereaX « .......................................................................................................................... ^ 0 d. receive the promise for life d ~tlrer payments, benefits «care? ...................................................................... ^ ^Q 2. If death occurred after Dec. 12, 1982, did decadent trarrefer properly wttl~ one year d death wilharf reoehMg adequate cwnsideration? .............................................................................................................. ^ 3. Did deoederd own an 'in trust far « payable-~orFdeelh baMc aaxxmf «seasity ~ l>s «her de~h? .............. O 4. Did deoederd own ~ irxtividual retirement account, annuity «other ran-probtke property, cor~ins a benefidary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE AB{OVE QUESTIONS B YES, YyOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. ~, ~'rF `' ~ b ~t. ~,,~~ ,yf1 d:'~af~"h''W ~.: '~rAad ui":~tei"I>.~ ~p ~~eS» n,s.~ c~'~~,'~,'~5~(.4*s~i~;k.~z&d''NF'rk~'~~~~'", .,i,`~ r2~'k'~'`~~'~'`~ P'~p~~s, ~~„+r. 4~)(~j 1~ .,~.,1 ~ ., 4 i"uRt' e~4 9c ~ ~ 49 e' .., . x.7~~.k~+ 8t .te .,x .s q~..@4j For dates of death on «after Juty 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers fA or for the use of the surviving spouse is 3 peroerrt [72 P.S. §9116 (a) (1.1) (i)]. For dates of deatlt on « after Jan. 1, 1995, the tax rate imposed an the rtet value of transfers to « for the use of the surviving spouse is 0 percent [T2 P.S. §9116 (a) (1.1) (i)). The statute does not exempt a transfer to a surviving spouse from fax, and the statutory requiretrtettts for disdosure of assets and filing a tax re6um are still appNc~ble even ff the surviving spouse is the only benefiaery. For dales of death on «after July 1,2000: • The tax tale imposed on the net value of bartsfers from a deceased child 21 years of age or younger at death to «for the use of a rt~Ilrel 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 Ute deoedenYs lineal benefiaaries is 4.5 percent, except as Holed in 72 P.S. §9116(1.2) [12 P.S. §9116(aN1)). • The ~c rate imposed on the net value of transfers to «fa' the use of the decedenTs ' ' rs 12 peroer>t [72 P.S. §9116(aX1.3)]. A sibling is detbted, under Section 9102, as an individual who has at least one parerrt trt oommat witlt the decedertt~etlter by blood «adoption. ~, REV-tsoz Ex+ tot-toi penns~-lvania SCHEDULE A DEPARTMENT OF REVENiIE n,N~rnu~ TAx REnRN REAL ESTATE RESmarr o~ ESTATE OF: DORIS ANDREWS FILE NUMtiIER: All real propa~gr owaa0 soltlT or as a tenant in aoarawn moat be raportaa at fair aarirat vawe. Fair market value is defined as the price at which Property would be exchanged between a wiAing buyer and a willing seikr, neRher being compels to buy or sell, both having reasonable knowledge of the relevant facts. I~al t~T tlWt is jointly,owned witlr ri4ht oif survironhtF rmrR tIe 4Ndaed on Sd~dule F. Attadr a mpq of the seltiement sheet if the property has been said. NUM ER indude a copy of the deed showing decedent's interest ff owned as tenant in cannon. VALUE AT DATE OF DEATH DESCRIFiIDN 1• I NOTAPPLJCARI F TOTAL (Also enter on line 1, Recapitulation.) I; ~•~ If more space is needed, use additional sheets of paper of the same size. --.- I cot~e+tornNEUT-I of PEwNSV~wwa I ~«~ 8c B~~ INFIERITAPICE rAx RETURN RESIDENT DECEDENT ESTATE l7f FN.E INIMBER DORIS ANDREWS Aq properly joMMlyowrwd rlilh right of survlro~shlp nwet tM dacload on Sd~sdlde F. ~o more space ~ neeaea, insert aOOltlonel Shears of the same size) REk1504 EX+ (B.ea) COMMAONNIEALTN of PENNSYLVANIA INFfRRANCE TAX RETURN RESIDENT DECEDENT SCNlpYLE C uosE~Y-Hau u~ow~-noN, PARTt~RSFNP OR .~' ESTATE OF FlLE tN1~ER DORIS ANDREWS Sdredule G1 or C-2 (induding aA supporting information) must be attal~ed for each dosely-held corporationlpartr~r&rip i of tl~e decedent, other than a ade~roprietorship. See instructions for the supporting hdorrrmtion to be submitted for sotaprapdetorships. (I1` more space is needed. insert additional sheets of the same size) REV-1507 EX+ (B~tt) SCNt~p~YLE~yp~~ cohwlor+IwEUTH ~ PENNSYLVANIA MOICiGAGES ~ ~~V ~ W INHERITANCE TAX RETURN R[{ENABLE RESIDENT DECEDENT ESTATE OF FILE NUI~ER DORIS ANDREWS All proptAy joittly~awrled YYltll right Of wrvhrorthip mutt be dbclosed on SeMduN F. (If ngre space is needed, insert aiddiNaral sheets of the same size) RE1F1508 IX+ (8-88) c.06f1MONNIEALTH OF pENNSYWANu INHERITANCE TAX RETURN RESIDENT DECEDENT sCNlp11L! CASH, BJWK DEPOSITS, ~ MISC. PERSONAL PROPERTY E8TATE 1JF FILE NUA~ER DORIS ANDREWS IrMiude the proceeds d litigation and the date the proceeds were received ty the estate. All plopMty jointlyovmed with right of survivorship nwst ba disebaad on Sehrrduk F. (If n102 SpaOe i3 deeded, insert edditiorlal Stleeh4 Of the same s¢e) . REV-~SO9 oc+ (oi-io) pennsylvarda nEPAR7MENT OF REVENUE INFIERRAl1~ TA% RENRN RESR)BIr OECEgBif scN~ou~ F ]OINTLY-0WNED PROPERTY ESTATE OF: FILE Ni11MBER: DORIS ANDREWS Jf an aaaat 6eonne Jointly owned wNhin one yak d the detedenCs dMa of death, R moat be raporEed on Sdieduk 6. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECPDENT A. s. c. ]IOINTLY OtiYI~ PI~PER7Y: NOT APPLICABLE nee NuN®e ~ wR ~oorr ~eYwr v~ NAOE mrr orscxlvaoR of vaoreRTV OKLIDE NIWE OF FswNaK o~srtnJrtoN AND BANK ACCO1Mi NUM9t oR ssmAR menn~rw6 M.aEe.,nmoi o®wR nsmr ian Rra~ EsnoE. oarre of DEATH wuuE of ~Er s a DfiLEDBrtS nnessr oarE of oEiaN VAWE of oECt~ems nr~EST I. a NOT APPLICABLE: roT~L (aso e<,re~ on Line s, Recap"ituladon) I; o.oo If more space is needed, use additional sheets ~ paper of the same size. REV-1510 EX+ (08-09) r ~ Pennsylvania : OEPA RTMENT OF REVENUE INHERRANCE TAX RETURN ncc~nvn~r ncrcnamr SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF DORIS ANDREWS FILE NUMBER Thic crhorliila R,iicr hP rnmoleted and filed it the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE ITEM INCWDE THE NAME OF THE TRPNSFEREE, THEIR RELATIONSHIP TO DEOEDENT AND VALUE OF ASSET INTEREST (IfAPRICAELE) VALUE NUMBER THE DATE OFTPANSfER. ATTACHACOPYOfTHEOEEDFORREALESTATE. I. NOT APPLICABLE I TOTAL (Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed, use additional sheets of paper of the same size. ;.. REV'-1511 EX+ (10-09) ~ Pennsylvania DEPFRTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DORIS ANDREWS Decedent's debts must be reported on Schedule I. NUM ER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' FUNERAL EXPENSES 1,865.00 i g, ADMINISTRATIVE COSTS: t, Personal Representative Commissions: Name(s) of Personal Representative(s) RONALD. WATSON _ __.. Street Address 7 NALRON DRIVE __ _. . City LEDGEWOOD __ __ _ ___. _ state N~..... ZIP 07852 Year(s) Commission Paid: 2009 __ _ .. 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 Fees: 6. Tax Return Preparer Fees: 7. POSTAGE a NURSING HOME FINAL BILL 9 MISCEjLLANEOUS I SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS TOTAL (Also enter on Line 9, Recapitulation) I $ If more spate is needed, use additional sheets of paper of the same size. 500.00 393.00 700.00 76.00 4,079.00 330.00 7,943.00 REV-1512 EX+ (12-OS) pennsylvarria DEPMTNENT OF REVENUE DeBtiTAN~ TA7C RE71atN RESm@If DECEOB(f SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES St LIENS ESTATE OF FILE N{NDER DORIS ANDREWS Rapat debts Nrcwred by the deoedart prior to death fJret ramNned ~b rt the ds~e a? dsslb, bKJudNg unreiwbursed wedlal exoerress. If more space is needed, insert addgfon~ sheets d the same size. ~ REV-1513 EX+ (01-301 Pennsylvania SCHEDULE J ~~~ DEPARTMENT DE REVENUE gENEFICIaiRIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE Of: FILE NUMBER: DORIS ANDREWS RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under ' Set. 9116 (a) (1.2).) 1. Bruce A Watson 1355 TresCOtt Dr Westfield IN 46074 Son 43120.00 2 Gail A Frank PO Box 25 Newport PA 17074 Daughter 43120.00 3 Ronald C Watson 7 Nalron Dr Ledgewood NJ 07852 Son 43120.00 4 Darren M Watson 48 Union St Batavia NY 14020 Grandson 1000.00 5 Stephanie L Broere 8428 Silverado Dr Indialapolis IN 45237 Granddaughter 1000.00 6 Sandra L Andrews 13404 Bristow Dawn San Antonio TX 78217 Step-Daughter 1000.00 7 Ca-rie A Rudolph 26118 Hootenanny San Antonio TX 78260 Step-Granddaughter 500.00 8 Christopher C Coker 319 Mountain Echo San Antonio TX 78260 Step-Grandson 500.00 9 Lindsay Watson 7 Nakon Dr Ledgewood NJ 07852 Gr~tddaughter 1000.00 10 Gregory Watson 7 Nalron Dr Ledgewood NJ 07852 Grandson 1000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S 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 DISTRiBlTTI0N5: 1. .v.r.. ne n~nr •r cures trcr~~ unn~ TAVem a nTCTDTRIrRfINS (1N 1 rNF 1i OF RFV-1500 (OVER SHEET. I ~i If more space is needed, use additional sheets of paper of the same size. ~ ~~ L ~r ~ .~~ ~ M ~; i ._ _ 1~~ t yr- rtii 1 1 1 • ~! (~ __ ~ ~~~ ru ___._ ,~ ~ m ~, ti 0 0 0 ~_ .___. ~ ~,~,~ r^ ~~-~ oI 0 ti ^ ~~~;r< Or - CUP . ~~ i pn ~ ~ ~ V ° ~ ~ d M ~ ~ ~ °~ J ~ ~ ~ ~ a ~+ ~ ~ ~ ~ .~ ~ ~ ~ ~ ~ ~ a v ~ °' 3 ~ ~ d ~' ~ 4 a ~ ~ v ~ `' ~ ~ ~ ~ ~ ~ 2 c~ w ' r O ~ •u 2 0 /^~ r- _ W o OOOIf ~ .Z ~ d¢;~~~~ f /"gym ~.i/ o ~au~(72 ~r~ ~ W ([ J