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Home My WebLink About11-15-10 (2),_ __ _ _ _ _T____ _ _ ~ __ ~ _ ~ ~ ~ ~~. • ~ •- ~ 1505610140 REV-1 v00 ~` ~°'-'°' PA Department of Revenue OFFICIAL U~' Y Bureau of Individual Taxes County Code Year Fib Nu~er Po sox 280801 INHERITANCE TAX RETURN 55 Harrbbur~n. PA 17128-0601 RESIDENT DECEDENT ~ ~ C~ ~j b b Date of Birth NMDDYYYY 0 3 0 9 1 9 3 3 Decedent's First Name B r u c e MI A Spouse s Last Name Suffix Spouse's First Name MI Walter Carryl Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE W~'rH THE REGISTER OF WI~.LS FlLL IN APPROPRIATE OVALS BELOW ® t. Orginal Retum ^ 2. Suppbmental Retum ^ 3. Remainder I~e kum (die of ath prime to 1'2-1 ) ^ 4. United Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estae# Tax Rstum R tairsd death afbsr 12-12-82) ^ 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number ~ Sale ' Boxes ( COPY of WNn (Attach Copy of Trust] ^ 9. Litigation Prooseds Received ^ 10. Spousal Poverty CredR (date of death ^ 11. Election to taxi under Sec. 91 3(A) between 12-31-91 and 1-1-95) (Attach ~a CI') ENTER DECEDENT Nt~ORMATIOl1 BELOW Social Security Number Date of Death MYtDDYYYY 2 1 1 2 2 6 5 1 3 0 7 0 4 2 0 0 9 DscedenYs Last Name Suffix Wa I t e r S R (N Applicable) En6sr Surviving Spouse's IMorrnation Below CORRESPONDENT - THIS SECTION MIST BE COLLETED. ALL CORRESPONDENCE AND CONFDENTW. TAX riFORMA BE T0: Name Daytime Teb urnb ar Kar I E. Romi nger 717 2+4'1 60 0 I REGMTEI~t t>sE oNL o First line of address Z ; 155 South Ha nover Street r O c t _ Second line of address DI', C!1 ~ . ~~ --~ City or Post Ofi`ce State ZIP Code FILE D . '~ Car l i s t a P A 1 7 0 1 3 . ^' ~ `~' `~ h , under psrwMke d perjury, I declare that I have ezaminsd this rotum, indudMg parryirq schedubs and arabements, and to the my krawbdps t~eNsr, i< is true. consa and . Decleralbn or prsparor offer Uan the personal is hssW on ~ iMormadon a which any RE OF PER RESPONSMLE FOR FILING RETURN Correspondent's e-rnaN addt+e:s: SIGNATURE OF P~PARER OTHER THAN REPRESENTATNE IRATE mess -- 253 Key West Boulevard, Carlisle P~+ PLEASE USE ORIf31NAL FORM ONLY 1505610140 Side 1 '~ r O~ZOT9SOST __~ ~ I i O~ZOT9SOST I!,~ Z eP!S 0 O 0'0 0 0 '0 O 0 '0 O 0'0 O 0 '0 1N3MUlyd2l3A0 Nr d0 GNt1d3211/ ONLLS3f1D33y 3211r tiOA d11~//r-O 3Hl NI T .61 ...................................................... 3f10 Xt 'el O 0 • 0 sL' ~ Ism ol~si~ L; aun !o iunou [3 O 0 ' 0 ggexsi pilau ~ wnou sl 0 0' O O l "~''0'~ x siw Isauu al4s~s31} l ~au!l ~ iunou SL O O ~ O ~~~ O'X(Z'l)I 9 L l8 '~S ~n wWw~ ~o 'atw Issnods ayi a ; aun ~o iunou S311RI 31911~11dd11 ~ BNOLL~fliil>~N 33S • 11'1f1~T E E • Z b' £ 5 ~ L 'til ...................... (£I aun snulw Zl aun) xsl ~ S MIsA 3 '' '£ l ~ ...... (f SInPs~pS) apew uaaq iou sey x~si W uo!3~ s e y~!yM col S3sNl £ l L6 ~Slsisanba9 IsWaui pus g g iu £ £ ' Z ~ £ S ti L 'zL ............................ (Llaunsnu!weWn)!+~+«~I~n3 5• s ~ O 9 ~ ' L l ............................... (0 t Pus g sau!l Isiai) ~R~Pb Isi • 'OL ............. (I slnP~pS) suan Pus 'sep!I!ge!l e~oNY 'i~ap~~ ~ S3Q b 5• 6 ~ O 9 ~ s .................. (H aInPW~S) siso~ en!~is!wwpy pus las~suadx3 Is~ai L 8'6 9£ L 9 6 L 9.6 Z Z 6 Z O Z'O t- L Z O0.OOO8EI. .S ........................... (L y~ay3 l aeon Is3o3)' ssw~ Isi .~ ....... Pa3sanbaa Bupl!g a3e~edaS ^ (J alnP~ di~edad sis4o~d snoauella~sryp ~ sis~s~e~l sawn-~ .9 ....... paisanbab BugllB a3eiedaS ~ (d alnPa3~S) ~~di PeuMO ~tpu .5 .......(3 aInP~S) ~~d Isuos~ad snoauslla~s!W Pus'sl!s~oda0 Musa `y~ .~ .......................... (0 a1nP~S) algen!aoaa Sai~ pus saBeBi~ .£ ..... (~ aInP~S) d!ys~oiaudad-slog ~o d!ys~au~sd 'uone~o~~ PIaH Ness .Z ...................................... (8 slnPa4~S) ~P4+ae Pus s~ . l ........................................... (d aInP~4pS) ais3s3 is i NOLLV'if11,1 E I. 5 9 Z Z 6 6 Z ~agwnN Iqunaag 161~S s,iuapaoep ~~g •~a~eM .d a~rua ~, ~~ s 'oz '6L '8l 'LI '9l ' 'Sl ~ X111 'fl '£ L 'aL 'll 'Ot '6 e 'L '9 .5 .b '£ 'Z .l X3 00~ 4-N321 i O~ZOT9SOST _, -, '~ i REV-1500 EX Pte' ~ DeCedetk~t ~ ~: __ File Number 0 0 DECEDE NAiE Bnu:e A. Walter Sr. STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0. 2. CreditslPayments A. Prior Payments B. Discount Toth Credits (A + B) (2) 0. 3. Interest 4. ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Fffl M ~ on Pepe 2, Line ZO to request a refund. (4) 0. 5. ff Line 1 + one 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) I~ p, e transfer and. Yek iJo 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; ............................... j c. retain a reversionary interest; or .....................................:.......................................................... d. receive the promise for Ate of either payments, benefits or care? ....................................................... '~ 2. ff death occurred aAer Deoerrrber 12,1982, did decedent transfer property within one year of death without reoeivirig adequate consideration? ....................................................................................... 3. Did decedent own an 'intrust for' or pay~le-upon-0eath bank account a security at his or her death? ......... 4. Did decedent own an irxiividual retirement account, annuity or other non-probate property, which rr--~-~ contains a trerrefiaary deskJr-ation? .................................................................................................. u IF THE ANSMIER TO ANY ~ THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT A1S PART OF TH RETURN. For date of death on or otter July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or fqr the use of the rviving spouse is 3 percent [T2 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan.1,1995, the tax rate imposed on the net v~ue of transfers to or for the use of the survivinngg is 0 [72 P S §9116 (a) (1 1) (ii)] The statute does not exem t tr f t i i f t . . . . p ans a er o a surv v ng spouse rom tax, and the statutory requirer>~i re of assets and ~9 a tax return are still aPPt even if the surviving spouse is the only benefiaary. For dabs of death on or af6er July 1,2000: • The tax robe imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the ~~e of a natural anent, an adoptive parent or a stepp~erit of the child is 0 percertt (72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers b or for the use of the decedent's lineal benefiaaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) I72 P.S. §9116(a)(1)]. • Tire tax rate imposed on the net value of transfers tO or for the use of the der dent's siblings is 12 percent (72 P.S. §91'~16(a)k1.3)]. A siblin is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN TWE APPItO TE BL KS 1. Did decedent mak a REN-1502 F.X+ (01~p~ • . ' p~>th~~ylvan~a SCHEDULE A ~~ ~ REAL ESTATE ~ r~x r ~swENr oECEOEHr ESTATE OF: FEE ISlMBER: Bruce A. Walter Sr. 0 0 AN tpl properly owned solNy or ae a i h common nwet be sported ~ hk marital valve. Fair market value is defined as the price at which would be exchanged between a willing buyer and a wiling seller, neither Being oanpelled to buy or seN, both having reasonadlekndwledge of the avant facts. tial property that b jointly~owned with right of wrvhrorehip moat be ditdoeed on Schsduk F. j Attach a cry of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing dec~denYs interest if owned as tenant in common. VAL EAT DATE NUMBER ' ~ 0 DEATH DESCRIPTION ' 228 Cumberland Drive-Camp Hill, PA -Appraised 2008 i I i 138,000.00 TOTAL (Also enter on Line 1, Recapitulation;) ; 138 000.00 11 IIMO.I~Ia~iO N 1100YOH, Y30 aW111N11fl1 .1110013 W Fli7r70I VI QIO SdR10 SILO. - _. _ _I _ i _ _- ~.. -. REV-1503 EX F fie'^'~ • I corNMO~IweA~TN °F'~""s"tiv^"'" STOCKS ~ BONDS INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE ~ FILE NUA~BER Bruce A. Walter Sr. 0 0 AN lxof~Y joMtly~~ad witll ripM of survh!orsh~ must bs dhtcbsad on ScheduN F. ITEM VALU AT DATE NUMBER DESCRIPTION 0 DEATH 1. Sixteen Savings Bonds-Commerce Bank I 2,140.20 TOTAL (Also enter on line 2, Rec~itulatign) ,~...., 2 140.20 ,.....-~- -r--- ~ .._.._.._, ..~w ..............~. ,,,,`mow ,,. ~~ ~„A ~o~ r r ~ REV-1504 E7(+ j~9',) . ' i SCNED+jJLE C CLO$ELY•HELD CORPORATION, c~TM ~ PARTNERSHIP OR 1NH°Mi i~r ~cE SOLE-PROPRIETORSHIP ESTATE OF FILE ISJMBER Bruce A. Walter Sr. 0 0 Schedule G1 or G2 (including aN supportlng information) must be attached for each cbsey~held corporatioNpaMership iresnest of the decedent, other than sole-prapdeturship. See instructions for tl~e supporlirg infortr~ation to be submitled fa sole-propdebrships. ITEM VALU AT DATE NUMBER DESCRIPTION DEATH L ~'~ TOTAL Also enter on line 3, 'Dion ' f (If more space is needed, insert additional sheets of the same size) _ ___ __ _ _-____- - __ __ __ _ __ __ _ --_ -- _ ___i I. i i i ~__ i - • REV-15Q5 EX + t6*91~j ~ ~ COMMONWEALTH OF PENNSYLVANIA INHERrTANCE TAX RETURN scHiE,ov~s ~~ CLOSELY-HELL CORPORATE STOCK INFORMATION REPORT 1. Name of corporation state of Incorporatiom _ Address Date of Incorporation _ City State Zip Code Total Number of Shareholders 2. Federal F~rlployer I.D. Number Business Reporting Y'e~r _ 3. Type ~ Business Product/Servioe a. I tic ~ .._~ =- ~ _ ~ P~~u~ ~ ~ I~ ~ ~~ common $ '$ Provide all rights and restrictions pertaining to each Bass of stock. 5. Was the decedent employed by the Corporation? ....................................... ^ Yes ^ Nb ff yes, Position Annua• Scary $ Time Devoted to Busineess 6. Was the Corporation indebUed to the decedent? ....................................... ^ Yes ^ Nio ff yes, provide amount ~ indebtedness $ 7. Was ffrere life insurance payable to the corporation upon the death of the decedent? ............... ^ Yes ^ No ff yes, Cash Surrender Value $ Net proceeds payable $ Owrtar of the pdicy 8. Did the decedent seN or transfer stock in this company within one year prior to death or within iwo years ff the date of death was prior to 12-31-827 ^ Yes ^ No If yes, ^ Transfer ^ Sale Number of Shares Transferee or Purchaser Consider~lon $ Date Attach a separate sheet for additional transfers andJor sales. 9. Was there a written sharehakiel's agreertlent in effect at the time of the decedent's death? ............ ^ Yes ^ No ff yes, provide a Dopy of the agreerrlent. 10. was the decedent's stack sold? .... ......... ............................... ^ Yes ^ No ff Yes, provide a copy of the agreement of sale, etc. ° 11. Was the corporation dissolved or liquidated after the decedent's death? ....................... ^ Yes ^ No ff yes, provide a txeakdown of distributions received by the estate, inducting dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? ...................... ^ Yes ^ Nb ff yes, report the necessary information on a separate sheet, inducting a Schedule C-1 or C-2 for each interest. A. Detailrired c~CUlafions used in the valuation of the decedent's stock. ' ', B. Complete copies of 8nandal statements or Federal Corporate Income Tax returns (Forth 1120) for the year of death and 4 ng years. C. If the corporation owned real estate, submit a list showing the complete addresses and estimated fair market values. ff rear appraisals been secured, attach copies. D. List of prindpal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their s~aries, bonuses and any other benefits received from the corporation. F. Statement ~ dividends paid each year. List those dedared and unpaid. ', G. Any ottrer information relating to the valuation of the decedent's stock. ' (If more space is needed, insert addiitiaonal sheets of the same size) r -~ REV-1508.EX+{9-00) • ~ '• COMYIONVVEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCNED~ILE C-Z PARTNERSHIP INFORMATION REPOR' ESTATE OF Bruce A ' lNJ 1. Name of Partnership Date Business Comrrter~ced Address Business Reportirhg Year _ CffY State ~~ Cade 2. Federal Employer LD. Number 3. Type of Business ProductlService 4. Decedent was a ^ General ^ Limited partner. If decedent was a limited partner, provide inifial investment $ 5. tPL~fltf PEIlOt~IT ~ pF PAR'IEtER NAIE f!F NIGBNE t3F C~ OIINT A. B. C. D. _ ' 6. Value of the decedent's interest $ 7. Was the Partnership indebted to the decedent? ................................ ^ Yes ^ No ff yes, Provide amount of indebtedness $ 8. Was there life insurance payable to the partnership upon the death of the decedent? ........ ^ Yes ^ No ff yes, Cash Surrender value $ Net proceeds Payable $ Owner of the policy F T I - 9. Did the decedent sell or transfer an interest in this partnership witllin one year prior to death or within two yearsrf the date of death was' priorto 12-312? ^ Yes ^ No If yes, ^ Transfer ^ Sale Percentage transferredlsokt ~_ Transferee a Purchaser Considera6or- $ 'Date Attach a separate shell for additional transfers arrdlor sales. 10. Was there a written partnership ar~eentent in effect at the time of the decedents death?........ ^ Yes ^ No ff yes, provide a copy of the agreerr>arlt. 11. Was the decedents paMersftip interest sold? .................................. ^ Yes ^ No ff Yom. Provide a copy of the agreement of sale, etc. 12. Was the partnerstrip dissdved ar liquidated after the decedents death? ................. ^ Yes ^ No '' If yes, provide a breakdown of distributions received by the estate, induding dates and amounts received. ' 13. Was the decedent related to any of the paMers? ................................ ^ Yes ^ No ff yes, explain 14. Did the partnerstip have an interest in other corporations or partnerships? ....... ......... ^ Yes ^ No ff yes, report the necessary inforrnatlon on a separate sheet, including a Schedule G1 or C-2 for each interest. A. Detailed ca~ulatlons used in the valuation of the decedents partnership interest. ~ ' B. Complete copies of finandal statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 prfeoe ding years, C. ff the parfierstlip owned red estate, submit a list showing the complete addresses and estimated fair market v~uels. If real efitat~ appraisals have been secured, attach copies. i~ D. Any other information relating to the valuation of the decedents partnership interest. ~! REV-a 507: EX + (8-98) COMMONWEALTH OF PENNSYLVANW INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDlJLE D MORTGAGES ~ NOTES RECEIVABLE ~ ProPMtY johltltlowned IlYltll the dp11t of wrvlvorship must be dlscbsed on SCheduN F. ITEM VALU AT DATE NUMBER DESCRIPTION _ OF EATH 1. TOTAL (Also enter on line (If more space is needed, insert additional sheet of the same siae) .___ .__~ ~. I~~ ~- . . SCHEDt/LE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC. tN RE3 DENT D EDENTRN PERSONAL PROPERTY ESTATE OF FILE IAlN~ER Bruce A. Walter Sr. 0 0 Include the procoeeds of Afjgatbn and tlTe date the proceeds were received by the estate. AM vIINh ~ survivash must bs dkdoad on tidnduls F. ITEM NUMBER DESCRIPTION VALU OF AT DATE DEATH 1. M8T Bank Account 9834711930 1,221.67 State Farm Life Insurance-LF-0216-7442 ' i I 20,000.00 TOTAL (Also enter on line 5, Recapitulatipn) ~!, '! i 21 221.67 ~n ~iMa ayenro ci ~rotlaeu, Insert 800100t1a1 Slle@6 OT IIle Sa1T1e SIZe) T REV-1509 EX+ (01-10) ~ I ~~ . ' . Pennsylvania SCMED~/LE F .DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NU Bruce A. Waiter Sr. 0 0 Nan asset was made jointly owned within one year of the decedent's date of death, n must be ropoRad ion Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS I RELATIONSHI TO DECEDENT A. B. C. .IOIN1'LY-OtIMNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY Xo OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FlNANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH ' DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET ~ JNTEREST D CEDENi'S INTEREST 1. A. I '~ I ', TOTAL (Also enter on Line 6, Recapitulation) s If more space is needed, use additlonal sheets of paper of the same sae. REV-151D EX+~(08-09) ~- . ' . plenr~sylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY l~s~oENT DECEDENT ESTATE OF ~~~ ~ ~, ~..e~s This schedule must be completed and filed if the answrer tb any of questions 1 through 4 on page three of the REV-1500 is yes DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAhE OF THE TRANSFERff, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH 96 OF DECD'S ~, E~(CLUSION TAXABLE NU1116ER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST I~p A~ucAe~.~ VALUE 1. TOTAL Also enter on Line 7, R 'tulation ! ;' H more space is needed, use additional sheets of paper of tli!e same sae. 'I oe~i ~ c~ ~ eve inn nn~ ' . ' , penratsylvania SCHEDULE H ~ . DEPARTMENT OF REVENUE FUNERAL EXPENSES AND ~' INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FIL NUMBER Bruce A. Walter Sr. 0 0 Decedent's debts mgt be sported on ScMduN I. ITEM NUMBER DESCRIPTION A OUNT A. FUNERAL EXPENSES: 1. Malpeai Funeral Home- 6,065.00 Advertising-The Evening Sentinel 187.54 Cumberland Law Journal 75.00 Internment Services-Rolling Green Cemetery 1,345.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address CtiY State ZIP Year(s) Conxnission Paid: y. Athorney Fees: Karl E. Rominger 8,000.00 3. Famlltr Exemption: (If decedenCs address is not Cle same as daimanCs, attach explanatlon.) Claimant Street Address i Cihr State ZIP Relatlorrship of Claimant to Decedent 4• Probate Fees: Cumberland County Register of Wills 347.00 5. Aooounglnt Fees: 6. Tax Refum Preparer Fees: 7. I ~l TOTAL Also enter on Une 9, R tulatron ~ ~ ; 16 019.54 11 I I M O JNa.c p I ICCYOY, Y`Jti auumunai sneer or paper O< ale Same a¢e. REV-15f2 EX~,(12-0a) , ' . ' . Pennsylvania • .DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT _, , r - SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8 LIENS w ~ w~ ~ yr FEE MIMBER Btut:e A. Walter Sr. p p Report debts brcurrod by the decedent prbr to death that remained unpaid at the date of death, Mcluding unreimburlrad mndigl ITEM ' VALU AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on Line 10, Recapitul~tiOri) ~ S If more space ~a needed, ~sert additional sheets of the same size. -T, - _ _ _ __ _- __ _ _ - i _._ _ _ _, i . ' . Pennsylvania SCHEDULE J • QEPARTNIENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBERf Bruce A. Walter Sr. 0 0 RELATIONSHIP TO DECEDE T AMOUN OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustse~s) OF STATE I TAXABLE DISTRIBUTIONS (tndude outri~M spousal dstrfbudons and transfers under S 91 f6 ec. (a) (1.2).] 1. Carry) Walter Lineal 100.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 CO R ~ , AS APPR PRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: L TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ' ~ ~~ _ s •• ,"~~~ ~~ ~~ ~,~~.~ ~~ aw~uv~w~ aiiac~a to NaNv~ to airs se~r~e size. ~- ~ ~~ ~~'~~ ~~'~' • Pennsylvania SCNEDt~iLE K DEPARTMENT of REVENUE LIFE ESTATE ANNUITY ~~" ~'"~~' Tam Po eon 280601 , ~ TERM CERTAIN Himse"~g PA 17128.0601 (CHECK BOX 4 ON REV 1500 COVER SHEET) ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 This schedule should be used for all single-life, joint or successive life estate and term-certain ca~ulations. For dates of death prior to 5- -89 actuarial factors for single-life calculations can be obtained from the Departrnent of Revenu8. , Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99 , and in Alphh Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of k to the tidx rVstpm. ^ Will ^ Intervivos Deed of Trust ^ er NII~ OF tBE l'EIi1Yf- .t?1MTE OF BRIH $! +~ AT - _ fMrR t1f ®Ei1fM ^ Lifts orl, [r Term of Yea ^ Life or ( t]Term of Yea ^ Lifr} or r ^ Term of Yea ^ Lifq or', Term of Ye ^ Litd or' Ci~Term of Yea 1, Value of fund from which life estate is payabb .. . . . . . . . . ............................... $ 2. Actuarial factor per appropriate table .......................... Interest tabb rate - ^ 3.5% ^ 8% ^ 10% ^ Variabb Rate % 3. Value of IHrt estate (Une 1 multlplied by Uns 2) . . . . . . . ................. t .............. NAE OF t~E Alf _ DiR'FE laF BRiH IY~~ ~ ~ ,, _ OF ~. ^Life' or Terra of Yea ^ Lifei,tx ~ Term of Yea ^ Life',or ~ Term of Yea ^ Life or 'Tenn of Yea 1. Value of fund from which annuity ~ PaYabb .......................................... S 2. Check appropriate block below and enter corrosponding number .... .. Frequency of PBYoM - ^ Weekly (52) ^ Bi-weekty (26) ^ Monthty (12) ^ Quarterly (4) ^Seml-annually (2) ^ Annualty (1) ^ Other ( ) 3. Amount of payout Per Period ...................................................... i 4. Aggregate annual Payment, Line 2 multiplied by line 3 ,,, , , , , , , , , , , , , , , , , , ,, , ,,,,, , ,,, , , , 5. Annuity Factor (see instructions) Interest tabb rate - ^ 3.5% ^ 8% ^ 10% ^ Variabb Rate % 6. Adjustment Factor (See instrutxions) . . . . . . . . . . . . . . . . . .............................. . 7. Value of annuNy - H using 3.5%, 6%, 10%, or ff variabb rate and period payout is at end of perrod, caltxdation ia: Lins 4 x Uns 5 x Une 6 ...........................: i~~ , If using variabb rate and period payout is at beginning of period, cakxrlation is (Line 4 x L1ns 5 x Une 8) + Line 3 ................................................. i NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on S~h Ales A through of the tax return. The rasulti IiGs or annuity interest should be reported at the p 'ate tax rate on lines 13 and 15 throw h' 18' the return. If more space is needed, use additional sheets of the same size. REV-1844 E7(i (01-10) ~ , ' . ' .pennsylvania • DEPARTI~NT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT INHERITANCE TAX SCHEDULE L REMAINDER PREPAYMENT OR INVASION OF TRUST CORPUS I. I ESTATE OF FILE NUM Walter, Bruce A., Sr. This schedule is appropriate only for estates of decedents dying on or before Dec This schedule is to be used for all remainder returns when an election to prepay has been filed Section T14 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of ~ R, ( REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of ~Ils on B. Name(s) of Life Tenant(s) or Annuitant(s) Q 0 ~' 12, 1882. ~r the provisi (Date) ', Date of Birth Age on date ' T~r(n of Years of Election or A nulty is P C. Assets: Complete Schedule L-1 ~~ 1. Real Estate .............................. $ 2. Stocks and Bonds ......................... $ '' 3. Closely Held Stoc~c/Partnership ............... S 4. Mortgages and Notes ....................... $ 5. CashMlisc. Personal Property ................ $ 6. Total from Schedule L-1 I $ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities .......................... $ 2. Unpaid Bequests .......................... $ 3. Value of Non Includable Assets ............... $ 4. Total from Schedule L-2 .................... ................................ $ E. Total Value of Trust Assets (Line C-6 minus Line D-4) ~' T F. RemainderFador ........................... ................................ ~--- G. Taxable Remainder Value (Multiply Line E by Line F) .............................. $ i (Also enter on Line 7, Recapitulation) Qj, iNVAS10N OF CORPUS: A. Invasion of Corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on Date 'Te~ of Years or Annuitant(s) Corpus or ~Ahnuity is P Consumed ' C. Corpus Consumed ........................... ................................ ~ ; ~~ D. Remainder Factor ........................... ................................ E. Taxable Value of Corpus Consumed (Multiply Line C by Line D) ........................ S (Also enter on Line 7, Recapitulation) of .pennsylvania INHERITANCE TAX SCHEDULE L-1 4EPARTMENT OF REVENUE INHERITANCE TAX RETURN REMAINDER PREPAYMENT ELECTION '!, RESIOENr oECEOENT -ASSETS- I. ESTATE OF FILE N R Walter, Bruce A., Sr. 0 0 II. ITEM NO. DESCRIPTION VALU A. Real Estate (Please describe.) Total Value of Real Estate a Include on Section II, Line C-1 on Schedule L. B. Stocks and Bonds (Please list.) Total Value of Stocks and Bonds Include on Section II, Line C-2 on Schedule L. C. Closely Held StoddPaMership -Please fist. (Attach Schedule C-1 and/or C-2.) Thal Value of Cbsey Held/Partnership $ Include on Section II, Line G3 on Schedule L. D. Mortgages and Notes (Please list.) Total Value of Mortgages and Notes Include on Section ll, Line C-4 on Sdtledule L. E. Cash and Miscellaneous Personal Property (Please list.) ', i Total Value of Cash/Miscellaneous Personal Properly Include on Section II Line C-5 on Shcedule L. III. TOTAL (Also enter on Section II, Line C-6 on Schedule L.) ~~ _ . . • •-•-•- -,---~. •.. •......... , ..wv.~ cw~nwnm pIIQaW VI F/aF/CI VI UIC Sd1I1C SIL6. REV-18; 8 EX+ (11 09) , ' . Pennsylvania INHERITANCE TAX pEPART'NENTOFREVENUE SCHEDULE L-2 INHERITANCE TAX RETURN REMAINDER PREPAYMENT ELECTION RESIDENT DECEDENT -CREDITS- L ESTATE OF - FILE NUM 4R Walter, Bruce A., Sr. 0 0 II. ITEM NO. DESCRIPTION A UNT A. Unpaid Liabilities Claimed against Original Estate and Payable from Assets Reported on Schedule L-1 (please list) I~ Total Unpaid Liabilities $ indude on Section II, Line D-1 on Schedule L B. Unpaid Bequests Payable from Assets Reported on Schedule L-1 (please list) '', Total Unpaid Bequests ' $ indude on Section II, Line D-2 on Sdradule L C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests list ~ I under "B" above) that are Not Inducted for Tax Purposes or that Do Not Form a Part of the Trust. Ca~ulation as follows: ', Total Non Indudable Assets $ include on Section II, Une D-3 on Schedule L IIL TOTAL (Also enter on Section II, Line D-4 on Schedule L) $ If more space is needed, attach additional sheets of paper of the same size. __ _ -- _ _ __ - -- ---- - - _ _ _ _ _ _ --_ _;_ i I _ _-_---- REV-1647'¢,x(+ (02 `10) r • ~ Pennsylvania ' DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST COMPROMISE (Check Box 4a on REV-1 S00) This schedule is appropriate only for estates of decedents who died after Dec. 12,1182. This schedule is to be used for ~I future interests where the rate of tax which will be applicable when the futurei int~rest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the tajx r$tum. ^ will ^ Trust ^ oa,er I. Benefidarie: NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTHi AGE i NEARESTE t. 2. 3. 4. 5. II. For decedents who died on or after July 1,1994, if a surviving spouse exerdsed or intends to exerdse a ' t N+itlxlrawal with nine months of the decedents death, check the ~propriate block and attach a copy of the document in wh' the surviving spo se exerdses such withdrawal right. ^ Unlimited right of wiNu~rat+lral ^ Umited rig o~ ~rithdrawal III. trxplanation of Compromip Offer: IV. Swnmary of Compromise Offer: 1. Amount of future interest ................................................. . $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ...... $ 3. Value of Line 1 passing to spouse at appropriate tax rate (Also include as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Chedcone. ^ 6%, ^ 4.5% ......................$ (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxat~le at sibling rate (12%) ~ I, (Also include as part of total shown on Line 17 of REV-1500.) ...... $ 6. Value of Line 1 taxable at collateral rate (15%) (Also include as part of total shown on Line 18 of REV-1500.) ...... $ 7. Total value of future interest {sum of Lines 2 thru 6 must equal Line 1) '$ If more space is needed, use additional sheets of paper of the same size. __ _ _ . R~-'sue ~ c~2-os' SCHEDULE N de YWa ' SPOUSAL POVERTY CREDIT ~ • Bureau a Individual Taxes ~ ~ FOR DATES OF DEATH 01/01/92 TO 12/31/94 ESTATE OF FILE NUMBER Bruce A. Walter Sr. 0 0 This schedule must be completed and bleed if you checked the spousal poverty credo box on th e cover 1. Taxable assets total from Line 8 (cover sheet) ...................................................................................... 1 • 161 1.87 2. Insurance proceeds on life of deoedent ................................................................................................ 2• 3. Retirement benefita ............................................................................................................................... 3. 4. Joint assets with spouse ....................................................................................................................... 4• 5. PA Lotbry winnings .............................................................................................................................. 5• 6a. Other nontaxable assets: List and attad- sd-edule if necessary .. 6 a. 6 b. 6 c. 6 d. 6. SUBTOTAL (Lines 6a, b, c, d) .............................................................................................................. 8• 7. Total gross assets (Add Lines 1 thru 6) ................................................................................................ ~• 161 1.87 8. Total actual Nabilides ............................................................................................................................ 8• 9. Net value of sst~e (Subtract Lure 8 from Lins 7) ........................... 9• ....................................................... ~ si O00 -STOP. ~ not b cairn H cainEl-aM Patel. 161, 1.87 Income: 1. TAX :19 2. TAX YEAR:19 3. TAX : ~ 19 a. Spouse ............................. 1 a. 2a. 3a. b. Decedent ......................... 1 b. ?b. 3b c. Joint ................................. 1 c. 2c. 3c. d. Tax-ezampt Income ......... 1d. 2d. 3d, e. Other income not listed above ..................... 1e• 2g. 3e_ 4. Average joint exemption income cakxrlation 4a. Add joint exemption income from above: _~ 4b. Average joint exemption income ............................................................................................................... N1iFN x(611 is P+NtM-Mwn iIQ000 -STOP. TM trshle is not b town Ms CnWt N noG conGbaN ib PaK III. 1. Insert amount of taxabb transfers to spouse or 3100,000, whichever is less .......................................... 2. Multiply by credit percentage (see instructions) ....................................................................................... 3. This is the amount of the Resident Spousal Poverty Credit. Indude this figure in the calculation of total credits on Line 18 of the cover sheet ................................................................ 4. For nonresidents, enter the ratio of the decedents gross estate in PA to the value of the decedents gross estate .......................................................................................................................... 5. Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credft. Indude this fgure in the calculation of total credits on Line 18 of the cover sheet .......... _ _ _ _- .-,. ~ REV-1649. EX +,(g.g6) .. SCHED~/LE O COAM1AbNWEALTH of PENNSYLVANIA ELECTION UNDER SEC. 9113(A) I INHERITANCE TAX RETURN RESIDENT DECEDENT (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE M11Y~ER Bruce A. Walter Sr. ~ U Do not complete this schedule unless ifie estate is making the election to tax asset under Sectlon 9113~A) of tM ti i Estate Tau ff the election applies to more than one trust or similar arrangement, a separate form must be filed for aar~ trust. This elecion ies to the Trust marital residual A B 'B Unified Cred t etc. . fl a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The Dust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in while or in part as ~ asset on Schedule 0, then the trans~or's personal representative may speclfically identify the trust (all or a ftactional portion or percentage) to be included inthelel~ction to have ilarproperty treated as a taxable transfer in this estate. H less than the entire value of the trust or similar property is included as a taxably tran fer on Sched le ch trust or sim- 0 th l s u representative shad be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of t~is ~racdon is equal to , e persona he amount of the trust a similar arrangement included as a taxable asset on Schedule 0. The derwminator is equal to the total value of the trust a si Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, is ~ to the d is survivi s under a Section 9113 A trust or similar a errant. Dea«iption value Part A Toth $ Pact B: Enter the artd of all ' incl in Part A for which the 91 13 A to is bei Descriptlon value Part B Total (If more space is needed, insert additional sheets of the same size) -- - - __ __ ~ _l ', REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: Discount: 0.00 Mterest Table Year Days Delinquent this time period Balance Due this year Interest this period Beforo 1881 1~2 1883 1884 1883 1886 1887 1886 thro h 1881 1882 1883 th h 1884 1895 th h 1898 1998 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 TOTALS Penalty Calculation If the deoEdenYs date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: ~_ I