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HomeMy WebLinkAbout11-04-10 (2)•- ~ 1,50561,01,40 15Q0 EX (°'_'°' REV - OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1, 1, 0 0 3 9 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h MMDDYYYY Date of Birth MMDDYYYY 1, 5 9 2 4 9 5 5 3 0 3 2 6 2 0 1, 0 0 9 2 1, 1, 9 2 8 Decedent's Last Name Suffix Decedent's First Name Ml W H I T E C A T H E R I N E A (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 {N 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) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (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) CORRESPUNDEN I - I HIS 5tc I wN muSl tst cumrLt I tu. ALL GUKKtJt'Unutnl,t HIVU l.VnrlUtn 1 IHL I HR INhVKmH 1 IUn .InVULU CSC UIKtI. 1 CU I V: Name Daytime Telephone Number M 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 REGISTE~F WILLS USILY ~ ~ ~ --,-~ First line of address ~ ~ ,I- _`~ ~` ' ' 5 4 E A S T ~1 A I N S T R E E T c ~ ~ T 1 1 ~>~~a , -~ ~ :i Second line of address r. .... ; ~~ C'? ~~ ~, ~,-....... _ ; r i~~ °W :,. Y-~•J f~igTE*ILED City or Post Office State ZIP Code _ -- - - -- -~ - ~ ~ ~ c_` ^~ '~ M E C H A N I C S B U R G P A L 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. SIG RE OF PERSON R SPONSI FOR FILING RETURN DATE ,,~ /U -- vl - ~;1U/U A RESS KATHLEEN W- LO t R, GREENSPING DRIVE MECHANICSBURG PA 1,7050 SIGNATURE EP Cy7f-IE HAN REPRESENTATIVE DATE ADDRESS /~ ~' MURRE R~• ALTERS III, ESQ • 54 E • MAIN ST • f1ECHANICSBURG PA 1,7055 PLEASE USE ORIGINAL FORM ONLY Side 1 1,50561,01,40 1,505610],40 Continuation of REV-1500 Inheritance Tax Return Resident Decedent CAT'NERINE A. WHITE 21 10 0398 Decedent's Name Page 2 File Number Correspondents Name First line of address Second line of address City or Post Office Correspondent's a-mail address: Daytime Telephone Number State ZIP Code 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 vs based on all information of which preparer has any knowledge. SlG TUR OF PERSON RESP NSIBLE FOR FILING RETURN DATE ADDRESS BARBARA W. BANEY 37 HONEYSUCKLE DRIVE MECHANICSBURG PA 17050 J 1505610240 REV-1500 EX ~ecedent'sName: CATHERINE A • WHITE Decedent's Social Security Number 1, 5 9 2 4 9 5 5 3 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 1 0 8 6 7 3 • 9 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. 5 2 0 0 • 0 0 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. 1, 1 ~ 8 7 3 . 9 Ir 9. Funeral Expenses and Administrative Costs (Schedule H) ......... ......... 9. 1 4 6 4 1, . 4 5 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .... ......... 10. 7 9 8 2 . 0 9 11. Total Deductions (total Lines 9 and 10) ...................... ......... 11. 2 2 6 2 3 . 5 4 12. Net Value of Estate (Line 8 minus Line 11) ................... ......... 12. 9 I, 2 5 0 . 3 7 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. 9 Ir 2 5 0 . ~ ~ 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 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 9 1 2 5 0 3 7 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g. 19. TAX DUE .................... ......................... .. ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 4 1, 0 6. 2 7 0. 0 0 0. 0 0 4 1 0 6. 2 7 Side 2 1505610240 1,50561,0240 J REV-1500 EX Page 3 Decedent's Complete Address: Tax Payments and Credits: ~ ~ 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. File Number 21 10 0398 (1) 4,106.27 Total Credits (A + 8) (2) 0.00 (3) (4) 0.00 (5) 4,106.27 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; .......................... ..... ^ 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? .................................................................................. ..... ^ 3. Did decedent own an "in trust for" orpayable-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? ............................................................................................. ..... ^ 0 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 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. REV-1502 EX+ (01-10) ` pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE Nt1M8ER: CATHERINE A. WHITE 21 10 0398 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 jointly-owned 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. 101 EASTERLY DRIVE 108,673.91 MECHANICSBURG, PA 17050 NET SALES PRICE TOTAL (Also enter on Line 1, Recapitulation.) $ 108.673.91 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOS{TS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUM ER CATHERINE A. WHITE 21 10 0398 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. METRO BANK 5,200.00 CHECKING TOTAL (Also enter on line 5, Recapitulation) I $ 5 200. (If more space is needed, insert additional sheets 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 CATHERINE A. WHITE 21 10 0398 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS FUNERAL HOME, INC. 10,133.00 2. GINGRICH MEMORIALS HEADSTONE ENGRAVING 140.00 3. EMMA JANE THORTON -RECEPTION 50.00 4. PASTOR DEL KEENEY -FUNERAL SERVICE 125.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Persona{ Representative(s) KATHLEEN W. LOSCHER (RENOUNCED) Street Address 39 GREENSPRING DRIVE City MECHANICSBURG State PA ZIP 17050 Year(s) Commission Paid: 2, Attorney Fees: MURREL R. WALTERS, III 3,850.00 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; REGISTER OF WILLS -CUMBERLAND COUNTY 331.50 5 Accountant Fees: 6, Tax Return Preparer Fees: 7. MEMBERS FIRST FEDERAL CREDIT UNION -ESTATE CHECKS 11.95 TOTAL (Also enter on Line 9, Recapitulation) I $ 14,641.45 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent CATHERINE A. WHITE 21 10 0398 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses & Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative Commissions: 2. Names} of Personal Representative(s) BARBARA W. BANEY (RENOUNCED) Street Address 37 HONEYSUCKLE DRIVE City MECHANICSBURG State PA ZIP 17055 Year(s) Commission Paid: SUBTOTAL SCHEDULE H-B1 REV-1512 EX+ (12-08) . ~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT , ESTATE OF FILE NUMBER CATHERINE A. WHITE 21 10 0398 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. SARAH A. TODD MEMORIAL HOME 5,208.99 RESIDENTIAL CARE 2. PPL 308.76 ELECTRIC 3. UNITED WATER 77.05 WATER 4. WESTFIELD CONDOMINIUM ASSOCIATION 400.00 DUES 5. CENTURY LINK 39.26 EMERGENCY PHONE LINE 6. DEBRA BASESHORE WIEST 1,220.83 2010 COUNTYlTOWNSHIP - 2010/2011 SCHOOL TAXES 7. SILVER SPRING TOWNSHIP AUTHORITY 212.00 SEWER 8. HOME DEPOT 52.21 HOME REPAIRS 9. PIERCE-PHILLIPS, INC. 9.19 HEAT PUMP-FILTER 10. DAN WHITE 100.00 HOME REPAIR 11. MILLENIUM PHARMACEUTICAL SYSTEM, INC. 353.80 MEDICAL TOTAL (Also enter on Line 10, Recapitulation) I $ 7,gg2.09 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) . ~pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CATHERI NE A. WHITE ~~ ~ u u~au RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. KATHLEEN W. LOSCHER Lineal 39 GREENSPRING DRIVE MECHANICSBURG, PA 17050 2. BARBARA W. BANEY Lineal 37 HONEYSUCKLE DRIVE MECHANICSBURG, PA 17050 3. WILLIAM B. WHITE Lineal 8560-102 SAN MARCELLO DRIVE MYRTLE BEACH, SC 29579 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1, A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size.