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Home My WebLink About09-29-10' 15~561~14~ REV-1500 EX `°'_'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1, 0 0 7 5 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 7 1, 6 6 6 4 2 0 8 2 8 2 0 0 4 0 9 1 2 1 9 1, 7 Decedent's Last Name Suffix Decedent's First Name Mf R I T T N E R F A Y ~1 (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 FILED 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) Q 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wif1) (Attach Copy of Trust) 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 GUKKt51'UNUtNGt ANU I;UNYIUtN I IAL I AJC mtVKmAI gun anuu~u at uirct~ i to ~ v: Name Daytime Telephone Number f1 U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 0 REGISTER OF WILLS USE ONLY C~ ~ First line of address ~~ `~ CO? - LX ~~._, t~` i ~- - 5 4 E A S T ~1 A I N S T R E E T ~ 3 rte- .~~ ~= .~ t r `_'_ .~~ c:- ~~ ~ ~ ` ~ Second line of address tb -,~= cii ` ' ~1 i~ ~ - ~Dl~~jFILED '~°" - ~ City or Post Office State _- I o e .~ --- ~-- - -- - • . ;"'e e ~1 E C H A N I C S B U R G P A 1, 7 0 5 5 ~~" . '~ ~~` ~=' , , Correspondent's a-mail address: 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. SI OF PERSON SPONSI~L FO ILING RETURN DAy~ PATRICIA A'• S~NEL~ON X512/LEXINGTON A_VE MECHANICSBURG PA 17055 SIGNATURE OF EP ER ER N RESENTATIVE T ~ ~' ' / 2:r ADDRESS MURREL A RS II, S 54 E MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1,505610140 1505610140 J J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: FAY Nl • R I T T N E R 1, 8 7 1, 6 6 6 4 2 RECAPITULATION 1 ~ 6 0 0 • 0 0 1. ........................................... Real Estate (Schedule A) • 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 Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property . (Schedule G) ^ Separate Billing Requested ....... 7. • 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 3 6 0 0 • 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ............ ...... 9. 9 2 • 5 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ...... 10. I, 0 6 2 8 3 . 8 1, 11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 1, 0 6 3 7 6 . 3 1, 12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. - lr 0 2 7 7 6 • 3 1, 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. - 1r 0 2 7 7 6 .3 1 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 1N THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 150561,0240 1,505610240 -I REV-15QO EX PaOe 3 File Number Decedent's Complete Address: 21 10 0759 DECEDENT'S NAME FAY M. RITTNER STREET ADDRESS 1000 CLAREMONT DRIVE CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 7. 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. 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 : ................................................................. ..... ^ ^ 0 b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ 0 c. retain a reversionary interest; or ........................................................................................... ..... ^ 0 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? .................................................................................. ? " " ..... ^ ^ 0 .... or payable-upon-death bank account or security at his or her death in trust for 3. Did decedent own an ..... 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 YE5, YOU MUST COMPLETE SCHEDULE G AND F ILE 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 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 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 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, undE 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) (3) (~) (5) REV-1502 EX+ (01-101 pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN nrcinr_~ir n[rrn[nir ESTATE OF: FILE NUMBER: FAY M. RITTNER 21 10 0759 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointlyowned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. SMALL PORTION OF RECENTLY DISCOVERED REAL ESTATE IN 3,600.00 UPPER ALLEN TOWNSHIP, CUMBERLAND COUNTY SALE PRICE TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 3 600. If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER FAY M. RITTNER 21 10 0759 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B 2 3 4. 5. 6. 7, City State ZIP ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Rlt' h' fCl' tt D d t Year(s) Commission Paid: Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address e a ions ip o aiman o ece en Probate Fees: REGISTER OF WILLS Accountant Fees: Tax Return Preparer Fees: 92.50 TOTAL (Also enter on Line 9, Recapitulation) I $ 92.50 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ X12-08; pennsylvania SCHEDULE 1 DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER FAY M. RITTNER 21 10 0759 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. (COMMONWEALTH OF PENNSYLVANIA ` DEPARTMENT OF PUBLIC WELFARE 106,283.81 TOTAL (Also enter on Line 10, Recapitulation} $ 106,283.81 If more space is needed, insert additional sheets of the same size.