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HomeMy WebLinkAbout12-01-10J REV-1500 EX (01-10) ~ 15 0 5 61014 3 PA De artment of Revenue '~'~ OFFICIAL USE ONLY p Pennsylvania County Code Year Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 0 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT File Number 0499 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 198 10 7640 05 16 2009 Decedent's Last Name Suffix MECKLEY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ^ 1. Original Return ^ 4. Limited Estate ^ 6 Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received Date of Birth 02 23 1919 Decedent's First Name MI MADALENE M Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ® 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 1231-91 and 1-1-95) ^ 3, Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sect 13(A) (Attach Sch. O) d '.~7 CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFO 4~N SHOU E DI -,~ , TO. Name ~ ~~~ ` ~~`• Daytime Tele Numb ~~-, -=~ JEAN D SEIBERT 717 2~~Olt rr~~" First line of address 109 LOCUST STREET Second line of address City or Post Office HARRISBURG State ZIP Code PA 17101 Correspondent's a-mail address: W z s@ m i n d s p r i n g. c o m 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. SIGN OF PERSON E ONSIB E FOR FILIN E RN DATE _., ~ ~ ~;~.~ ~ Edward M. Meckley jl ~~ / C? ADDRESS / ( ' 210 South High Street, Mechanicsburg, PA 17055 SIGNATURE EPAR~R'~OT~1ER THAQI REPRESENTATIVE DATE ~~ Jean D Seibert l 1 ~~ Gtr ~~. -~ ; REGISTER ~'~ US~NLY .._- - ,~... -TJ .•~- G1ry DATE FILED ADDRESS ~ /~ 109 Locust Street, Harrisburg, PA 17101 Side 1 1505610143 1505610143 J ADDITIONAL Personal Representatives Meckley, Madalene M SS# 198-10-7640 5/16/2009 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. /~~ /' 2 Signature ~,, ~ Name Robert M. Meckley Address 6160 Springford Drive Apt. C-6 city, state, zip Harrisburg PA 17111 / /. Date f l r ~~ ~~ / ~ r,~~~i 3 Signature Name Address City, State, Zip Date 4 Signature Name Address: City, State, Zip Date 5 Signature Name Address: City, State, Zip Date 6 Signature Name Address: City, State, Zip Date 150561U243 REV-1500 EX Decedent's Social Security Number Decedents Name: M E C K L E Y, M A D A L E N E M 19 8 10 7 6 4 0 RECAPITULATION 1. Real Estate (Schedule A} .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 7 6 3 . 8 6 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 1-7) ....................................................................... g. 7 6 3 8 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 6 5 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 6 5 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 6 9 8 8 6 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. 6 9 8 8 6 TAX COMPUTATION -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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 6 9 8. 8 6 16. 31.4 5 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. 3 1 . 4 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 150561U243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 0499 DECEDENT'S NAME Meckley, Madalene M _____ STREET ADDRESS 218 South York Street __~ CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 31.45 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 0.00 3. Interest (3) 0.0 0 4, if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box 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. (5) 3'I.4 5 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 :.................................................................................. ^ b. retain the right to designate who shall use the property transferred or its income :.................................... [~] ^x c. retain a reversionary interest; or ................................................................................................................. ^ 0 d. receive the promise for fife of either payments, benefits or care? .............................................................. [] Ox 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" or payable 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? ...................................................................................................................... ^ 1F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. _ - - ,- - -- s s~~: - ~~ ~~~ ~ ~ ~ ~ 1994 and before Jan. 1, 1995,~the tax rate imposed on the net value of transfers to or for the use of the surviving For dates of death on or after July 1, spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 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 retturn 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)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bloodd or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Meckley, Madalene M 21 - 09 - 0499 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 2009 Pennsylvania IncomeTax Refund J 763.86 TOTAL (Also enter on Line 5, Recapitulation) ~ 763.$6 SCHEDULE H ., ' FUNERAL E)CPENSES & COMMONWEALTH OF PENNSYLVANIA ~~p ,c `~'~~ ^c INHERITANCE TAX RETURN h11.J1Y1'Nl~ l f~'1~E C~~ RESIDENT DECEDENT `FILE NUMBER ESTATE OF Meckley, Madalene M I 21 - 09 - 0499 Debts of decedent must be reported on Schedule I. _, ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: __- A. B. ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Years} Commission paid 2. Attorney's Fees Wion, Zulli and Seibert -- Jean D Seibert 50.00 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 Wi11s -filing fee 15.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7, Other Administrative Costs 1 TOTAL (Also enter on line 9, Recapitulation) 65.00 REV-1513 EX+ (11-08) ` SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Meckley, Madalene M 21 - 09 - 0499 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Edward M. Meckley Son 50% of Residue 210 South High Street Mechanicsburg, PA 17055 2 Robert M. Meckley Grandson 50% of Residue 6161 Springford Drive Apt. C-6 Harrisburg, PA 17111 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00