The URL can be used to link to this page

Home My WebLink About10-05-101505610140 REV-1500 EX I°'-'°' OFFICIAL U E Q N Y PA Department of Revenue Bureau of Individual Taxes County Code ,Yea File Number Po sox 26oso1 INHERfTANCE TAX RETURN 2 1 1 0 0 5 2 7 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 6 8 6 0 1 3 7 2 0 5 0 8 2 0 1 0 0 8 1 2 1 9 6 Decedent's Last Name Suffix Decedent's First Name MI G E R H O L D R O B I N A pf 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 DUPLICATEWITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1.Original Return ~ 2. Supplemental Return ~ 3. Remair~der~ Return (date of death prior to 12113-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federail Es{ate Tax Return Required death after 12-12-82) '. 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Ni~m~er of Safe Deposit Boxes (Attach Copy of Wiiq (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit {date of death ~ 11. Election to ~ax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach ~ . ~) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOI Name Daytime Te M U R R E L W A L T E R S I I I E S Q 7 1 7 First line of address 5 4 E A S T M A I N S T R E E T Second line of address i City or Post Office State ZIP Code M E C H A N I C S BU R G P A 1 7 0 5 5 T SHOULD 6E DIREGtED 10: ~on Number ',6 19 7 4 6 5 0 R O WVILLS USE ONLY p I o C'3 .,_ . ~'~ ~ C t I ~,r~ ]~. ~ 2 ~D FILED -c~ Correspondent's e-mail address: Under penalties of perJury, I declare that I have examined this return, including accompanying schedules end statements, and m the t hry knowledge and belief, it is true, ooeecx and complete. Declaration of preparer other than the personal representative is based on aN intormation of which p llas any knowledge. SIG JE OF~~~~~~:3P911~~~rING RETURN I ~~ //~ DONALD W ANNETTE DRIVE ENOLA SIGNATURE OF R AR R N REPRESENTATNE ADDRESS MURREL WAL ERS II ESQ 54 E MAIN__ST.MECHANI PLEASE USE ORIGINAL FORM ONLY Side 1 150561D140 Di4TE d ~ ~ -rfl '~T ~A~17055 i 1505610~L4~0 ~~. i Continuation of REV-1500 Inheritance Tax Return Resident Decedent ROBIN A. GERHOLD 21 10 0527 Decedent's Name Page 2 File Number Correspondents Name First line of address Second line of address City or Post Office Daytime Telephone Number I ~~ State ZIP Code Correspondent's e-mail address: Under penaNiea of perjury, I ded~e ~~ I have examined this return, including accompanying schedules and statements, and to the best of my amd belief, it is true, correct and complete. Declatadion of preparer other Than the pe-saial representative is based on all information of which preparer has any e. SIGNATUREbF PERSON RESPONSIBLE FOR FILING RETURN DAT 1 1505610240 REV-1500 EX Decedent's) Soul Security Number oeceaer~'s Name: ROBIN A• G E R H O L D 1 6$ ''~ 6 D 1 3 7 2 RECAPITULATION ~ '3 I 4 5 4. 2 0 1. Real Estate (Schedule A) ......................................... .. 1. ', ' 2. Stacks and Bonds (Schedule B) .................................... .. 2• 3. Glossy Held Corporation, Partnership or Sole-Proprietorship (Schedule G) ... .. 3. ~ i • 4. Mortgages and Notes Receivable (Schedule D) ........................ . . 4. ~ 9 5 0 . D 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. I 6. Jointly Owned Property (Schedule F) ^ Separate BllNng Requested .... ... 6. • 7. Inter-Vdros Transfers & Miscellaneous N -Probate Property ested Billi R t ~ S 7 .... equ epara ng e (Schedule G) , ... 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 4 D 4 • 2 D 9. Funeral Expenses and Administrative Costs (Schedule H) 9. 4 6 3. 1 5 10. Debts of Deosdent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10. 1 ~ ~ D 1 9 ' 5 2 11. Total Deductions (total Lines 9 and 10) ............................ .. . 11. 1 6~1 ~ I 4 8 2. 6 7 12. ......................... Net Value of Estate (Line 8 minus Line 11) ...12. ~ - ?I D 7 8. 4 7 13. Charitable and Governmental BequestslSec 9113 Trusts for which ', an election to tax has not been made (Schedule J) ................... ... 13• I 14. Net Yalue Subject to Tax (Line 12 minus Line 13) ...................... 14. - 7 ~ D 7 8 • 4 7 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.o _ D. D 0 15. 0. D 0 16. Amount of Line 14 taxable D D D I i D. D D . at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable D D D 17 D. D 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0• D 0 18 0' D 0 at collateral rate X .15 . 19. TAX DUE ................................................... ...19. ', D • D D 20. FILL IN THE OPAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ' ^ I, i I I I Side 2 15O561O24D 15056102~4[~ 1I i REV-1500 FX Page 3 Decedent's Complete Address: File Number 21 10 0527 DECEDENT'S NAME ROBIN A. GERHOLD _ STREET ADDRESS 204 S. ENOLA DRIVE Cry i STATE ;ZIP ENOLA ; PA ' 17025 Tax Payments and Credits: 1 • Tax Due (Page 2, Line 19) 2. CreditslPayments 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. Flli 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. (1), ~ - - Total Credits (A + B) (2) '! (3) {4) I, ~~ (5) ' '~ Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" fN THE APPt~O~RiATE BLOCKS t . Did decedent make a transfer and; III Y s No a. retain the use or incxxne of the transferred : ............. ...., ............................................. I'I b. retain the right to designate who shall use the property transferred or its income: v ions interest• a ............................ ry ................... c. retain a re ers ~~ 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? ........ 0 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a ber-eficiary designation? ..................................... I, 0 IF THE ANSWER TO ANY OF THE At30VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE f~ ~ 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 o~ fob 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 surviv ng ~pouse 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~e nts 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 tf~e se 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 Vineal beneficiaries is 4.5 percent, ~x pt as noted in 72 P.S. §9116{1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9111'~(ab(1.3)]. A sibling is defined, unde Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. II' REV-1502 EX+ (01-10) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RES{DENT DECEDENT ESTATE OF: FILE NUMB R: , ROBIN A GERHOLD 21 10 0~2T~ Aii real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defin as~~ the price at which property would be exchanged between a willing buyer and a willing sailer, neither being compelled to buy or sell, both having rea abfQ knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schad le 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. I VALUE AT DATE NUMBER DESCRIPTION ~ ' OF DEATH i 1. 204 S. ENOLA DRIVE 93,454.20 ENOLA, PA 17025 COUNTY ASSESSED VALUE 74,170 X CLR 1.26 ~, TOTAL (Also enter on Line 1, If more space is needed, use additional st~aets of paper of the same size. REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMB R ROBIN A. GERHOLD 21 10 0~ ~ Indude the proceeds of gtigatbn and the date the proceeds were n~ceived by the estate. Ali property jointlyowned with fight of survivorship must be disclosed on Schedule F. ITEM I ~i VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1995 PONTIAC GRAN PRIX AUTOMOBILE 750.00 CREDIT ON TRADE-IN 2. MEMBER51 ST FEDERAL CREDIT UNION 1,200.00 CHECKING TOTAL (Also enter on line 5, (If more space is needed, insert additional sheets of fhe same size) ~ 1 REV-1511 EX+ (10-09) . pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMB R ROBIN A. GERHOLD 21 10 052' - - -- Decedent's debt must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. RICHARDSON FUNERAL HOME 5,836.00 2. GRAVE OPENING 1,395.00 3. GRAVE MARKER 1,688.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: ', Name(s) of Personal Representative(s) DONALD W. MORGAN (RENOUNCED) 'i ~,,,, Street Address 10 ANNETTE DRIVE City ENOLA State PA ZIP 17025 Year(s) Commissbn Paid: 2, AttomeyFees: MURREL R. WALTERS, IN 1,225.00 3, Family Exemption: (If decedent's address is not the same as daimani's, attach explanation.) ~, Claimant ~~ Street Address City ~ > State ZIP Relationship of Claimant to Decedent d. Proba~ Fees: REGISTER OF WILLS -CUMBERLAND COUNTY 319.15 5. Accountant Fees: 6. Tax Retum Preparer Fees: i 7. TOTAL (Also enter on Line 9, Recapitulation} ~ i If more space ~s needed, use additional sheets of paper of the same size. i I _ _. _ _ _ _ Continuation of REV-1500 Inheritance Tax Return Resident necedent ROBIN A. GERHOLD 21 10 0527 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses 8 Administrative Costs - B1 ITEM NUMBER DESCRIPTION ~ AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative Commissions: 2• Name(s) of Personal Representative(s) LINDA L. MORGAN (RENOUNCED) Street Address 10 ANNETTE DRIVE_ ~ -r- City ENOLA State PA ZIP ~ 7 ~ 2 Year(s) Commission Paid: ~, SUBTOTAL SCHEDULE H•B1 REV-1512 EX+ (12-OS) pennsyivania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHEWTANCETAXRETURN MORTGAGE LIABILITIES, ~ LIENS RESIDENT DECEDENT ESTATE OF FILE NUl41B R ROBIN A. GERHOLD 21 10 0~2~' Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unrei b reed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION ' OF DEATH 1. UGI ~~ 210.00 GAS 2. PP&L 132.00 ELECTRIC i 3. AMERICAN WATER 21.41 WATER ~, 4. MEMBERS 1ST FEDERAL CREDIT UNION ', 1,200.00 VISA 5. MORTGAGE ~, 103,201.36 PENNSYLVANIA HOUSING FINANCE AGENCY, DATE OF DEATH BALANCE i HOUSE SIGNEO OVER TO PHFA IN LIEU OF FORECLOSURE 6. CANCER TREATMENT CENTERS OF AMERICA 5,197.50 MEDICAL T. EASTERN REGIONAL MEDICAL CENTER 45,057.25 MEDICAL I I II ~! I i i I TOTAL Also enter on Line 10 R 'tui ' I S ~ ~ ~ 155 018.52 If more space is needed, Insert eddidonal sheets of Ute same size. !~ i REV-1513 EX+ (Di-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT(~CEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER:, bAb1-1 A /'ICbL1A1 b A• III Ifs!-A ~s RELATIONSHIP TO DECE EN AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustees OF ESTATE I TAXABLE DISTRIBUTIONS [Indude outrigh(sl disMtXrtions and Uansfers under Sec.91ff6 a) 1,2 .] i I 1. SAMANTHA C. GERHOLD Linear ~~ ~ ~ 124 S. ENOLA DRIVE I I ENOLA, PA 17025 ~' '~ 1 i NTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T I it I '~ ! i~ i HROUGH 18 OF REV-1500 COV R EET, AS APPROPRIATE. Q. NON-TAXABLE DISTRf8UTI0NS: ~ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. ~' I it i ~~ ~ i II 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1, i I ~~ ~ I ! I ~! TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. Ir more space is r)eeoea, use aoamonal sneers or paper or the same size. ~