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Home My WebLink About09-27-10 (2) 1505610101 REV-1500 °` ~O1-'°' "'d~ OFFICIAL USE ONLY PA Department of Revenue Pennsylvania u.urcNCn o~ eercMUc Bureau of Individual Taxes ourlty a YeaC Fla Number PO BOx sl3o6oi INHERITANCE TAX RETURN Harrisburg, PA ilTx~zB-o6ot RESIDENT DECEDENT 21 10 366 ENTER DECEDENT INFORMATION BELOW Sodal Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY _. _ __ __ _. .... ' 01/29/2010 Decedent's Last Name.. Suffix Decedent's First Name MI _.. __ __ _. Scott ~ Helen __ (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 t~ 1. Original Return O 2. Supplemental Return O 3. Remaind r Rgtum (date of death prior to 1~-13+82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal E~tat® Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number pf Safa 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 tcy tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach S h. G1) CORRESPONDENT - TNIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTIAL TAX INFORMATION SI Name. _ _ __ _ _ _ _ Daytime Telept _... Robert D. Clark Ld BE DIRECTED T0: s Number .~. c REGISTER 8 USE OI~1' r~i First line of address _ _ ~ ~ ~ :201 N. Market Street ' ~ ~ --~ Second line of address ~ I "~ _ __ ~~ Z W __. City or Post Office _ _ State....... ZIP Code _ _ ~ AILED -- 'New Wilmington, __ 16142 __ , PA ~a x; ; -~, r-ri ~~ 7 ~"~ C`7 ~=~~' ~~ c~~ t'~ - r`t - r°; -rt ~.~ Gn d ~~ Correspondent's e-mail address: Under penalties of perjury, I declare that 1 have examined this return, Including accompanying schedules and statements, and to the my knowledge and belief, ft is true, Correct and complete of preparer other than the personal representatNe is based on all infom~ation of which p r has any knowledge. SIGNATURE OFPERSON RESF~~IBLE FOR FANG RETURN ~ DATE REPRESENTATIVE _... PLEASE USE ORIGINAL FORM ONLY I, ~i Side 1 I~~ 1505610101 1505610~OIb __ _ _- J 1505610105 REV-1500 EX Decedent's Social Security Number _ .. _ ... Decedent's Name: ', RECAPfTULATION ; 1. Real Estate (ScneduleA) ........................................ ..... 1. ~ _. _ 50,000.00 2. Stocks and Bonds (Schedule B) .................................. ..... 2. I 110.62 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ...................... ..... 4. . .....__.. . _..._ , .. _ ~ __w. _ 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. ! 31,605.68 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .. ..... 6. 35,810.71 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. 117,527.01 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. ;.~. 12,941.64 .W. _..~ .~_.~__+ __..~... ~. ._..__...~ 10. Debts of Decedent, Mortgage Liabilities, and liens (Schedule I) ......... ..... 10. 12,111.49 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. ~ 25,053.13 12. Net Value of Estate (Line 8 minus Line 11) ......................... .... 12 92,473.88 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which J ry, V _ ~ '~~ ~~ w "~~°---- an election to tax has not been made (Schedule J) ................... ..... 13. i 14. Net Valw Subject to Tax (Line 12 minus Line 13) ................... ..... 14. ' ', 92,473.88 ~ TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ', transfers under Sec. 9116 _ _ _, I 16. Amount of Line 14 taxable -`,._ _ . ........... .._. . ~_~_ ..~ __.... ~._~ ,......... at lineal rate X .0 4~ 92,473.88 16. ', 4,161.32 17. Amount of Line 14 taxable y°"~ __-.4 ~--~--°---- at sibling rate X .12 17. 18. Amount of Line 14 taxable _.... __..._ _. _. _____.. _ __ ._._... _ . _~__ .. .~ _ . ~ __.. _. __.._ _~~._._ _. . at collateral rate X .15 18. 19. TAX DUE ..................................................... .... 19.' 4,161.32'.: 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610105 ~I 150561005 J ~~~~ ~ Pegg S File Number Decedent's Comalete Address: D N Helen P. Scott ' - - ---_-- STREETADDRESS 5213Terrace Road CITY Mechanicsburg STATE PA tIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 4,161.32 2. CreditslPayments A Prior Payments _---- --------__-- B. Discount Total Credits (A + B) (2) 0.00 3. Interest (3) i 4. If Line 2 is greater than Line 1 +Une 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Une 20 to request a refund. (q) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPR~PaIATE BLOCKS 1. Did decedent make a transfer and: ?Yes No a. retain the use or income of the property transferred :.......................................................................................... b. retain the right to designate who shall use the property transferred or its income : ............................................ X^ c. retain a reversiarary interest; or .......................................................................................................................... d. receive the promise for Iffe of either payments, benefits or care? ...................................................................... xQ 2. If death occurred after Dec, 12, 1982, did decedent Vansfer 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 decxdent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary desi9natan? ........................................................................................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R 4S PART OF THE RETURN. ... ~. N~ mss:, - , 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 f~r the use of the surviving spouse is 3 percent 172 P.S. §9116 (a) (1.1) (i)j. 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 ithe' 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 requi melnts 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 Juty 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 (Or 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)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries 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. §911 ~(a)(11.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-75lYlEX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE All roal property owrrod solely or as a tenant in common must be roported at fair markst valve. Fair market value is dsflned as t price at which property would be exchanged between a wiNkq buyer and a wNlirp seller, neNhsr Doing compelled to buy or sell, both having reasonabb of the rolevaM fads. Real property which b jointly-ovmed with rtght of survlvorohip must be dhulosed on ScheduN ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 129 Mohawk School Road, New Castle, PA 16102 50000 ~ TOTAL (Also enter on line 1 ~tecap (If more space is needed, .Insert addfional sheets of the same size) REV-1503EX + (696) COMMONWEALTH OF PENN3YLVANUI INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS All property Jointly-owned with rlgM of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION ' OF DEATH 1. Savings Bond - $25.00 ~, 110.62 TOTAL (Also enter on line 2 ~tedapitulation) ~ $ 110 62 more space Is needed, Insert adddional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSnVANU1 CASH , INHERITANCE TAX RETURN ,BANK DEPOSITS & M I SC . RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF HELEN SCOTT FILE N MBER 366 Include the proceeds of Ntlgation and the date the proceeds were received lry the estate. All property joirrtly~owned with the right of sunrivorahip must be disclosed on Sctredul~ F. ITEM VALUE AT DATE NUMBER TOTAL (Also enter on I (If more space is needed, insert additional sheets of the same size) 1. MONY 2. First Commonwealth Bank - CD 3. Lincoln Trust 4. Cash DESCRIPTION OF DEATH 6306.24 1545.94 23704.00 49.50 REV-1509 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF HELEN SCOTT FILE MBER 366 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Sylvia P. Shoup 103 Deerfield Dr, Wexford, PA 15090 aauahter B C JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT ~~ MADE JOINT DESCRIPTION OF PROPERTY IWCUIDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR KIENTNMNO NUMBER. ATTACH DEED FOR JOINiLY•HELD REAL ESTATE. DATE OF DEA VALUE OF ASST 96 OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A. 8-25-03 Fint Commonwealth Bank Chedcinp A10440008215 , 10 .90 50% 517.45 2. A 8-25-03 First Commonwealth Bank, savings #0404017443 3 .02 50% 181.51 3. A 8.2003 E-bade 1784.35 50°h 8921.17 4. A 8-2003 AT&T 5238x.18 i i i 50% 28190.58 TOTAL (Also enter on line 6, ecjapitulation) $35,810.71 ..._._ _~_~ ............. ..~~. c.~~nw~~ai o,noow ~~ ins anmtr >3lie) __ __ _ _ _ . ,_ _, „ REV-1511EXr(10.06) SCHEDULE H FUNERAL EXPENSES & cor~oNwEALTHOFPE"NSVI.vANIA ADMINISTRATIVE COSTS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN SCOTT FILE UMBER 366 Debts of decedent must be reported on Schedule I. ITEM .~~ a ..._,...-•--•--• A. B. JMBE 1. 2. 3. 4. 1 2. 3. 4. 5. 6. 7. 8. FUNERAL EXPENSES: Marshall Funeral Home Rev. McCure Westfield Church Giuseppe's Tuscany Grill -dinner ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address AMOUNT 5794.49 100.00 300.00 223.01 CttY State Zip Year(s) Commission Paid: Attorney Fees Famiy Exemption: (If decx3dent's address is not the same as Gaimant's, attach explanation) Claimant Street Address COY State Zip Relationship of Claimant to Decedent -~ Probate Fees Inftial Letters $103.50, Inheritance Tax Return $20.00, Family Settlement Agr} Additional letters (est) $375.00 Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal -legal ad The Sentinel -legal ad more space 5701.08 $50.00 ~ 548.50 75.00 199.56 TOTAL (Also enter on line 9, insert additional sheets of the same size) $12,941.64 _ ____ __ _ r REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS LUMBER 366 Repoli debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Include unreiml~ursed medical expenses. ITEM NUMBER DESCRIPTION ' VALUE AT DATE OF DEATH 1. Gas utility bill 1253.38 2. Penn Power ', 1024.00 3. House sewage 330.00 4. Cleaning 6100.00 5. Comcast 127.88 6. Houselnsurance ' 435.51 7. Verizon 59.41 8. Lawronce County property tax 507.06 9. North Beaver Twp. Sewage 495.00 10. Nationwide Insurance 70 92 11. Ray Eichler-cleaning 500.00 12. Township tax 189.37 13. School tax 953.96 14. Recorder of Deeds 65.00 TOTAL (Also enter on line 10, moro space is needed, insert additional sheets of the same size) i $12,111.49 -_ __ _ L_ i REV-1513 EX + (9.00) col~oNwEnLTM of PENNSYLVANIA INHERITANCE TAx RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES NUMBER I II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [inGude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. Sylvia Shoup, 103 Deerfield Dr., Wexford, PA 15090 2. Jeffrey Paden, 129 Mohawk School Road, New Castle, PA 16102 3. Lana S. May, 2945 N. Dunham, Amelia, OH 45102 4. Judy Shoup, 1940 Rockland, Cincinnati, OH 45230 5. Barry Shoup, 1322 Dorado Court, Amelia, OH 45102 8. Tiffany P. Jones, 129 Mohawk School Road, New Castie, PA 16102 Do Not List Trf Daughter Son Granddaughter Granddaughter Grandson Granddaughter ', I , OF~TATE 1/3 residue 1/3 residue 1/12 residue 1/12 residue 1112 residue 1/12 residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTgNS SHONAV ABOVE ON LINES 15 T1iROUC,1-I 18, AS ONREV--1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE L I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV 1500 COVER SI~IEET (If more space is needed, insert additional sheets of the same size) __ __ -- - _ _ - - __ - - -- _ I __. -.