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HomeMy WebLinkAbout12-13-10J 1,50561,01,01, REV-1500 Ex(ol-lo, enns lvania OFFICIAL USE ONLY PA Department of Revenue p Y County Code Year File Number UI:VAH1MENt 0~ HE Vr NUE Bureau of Individual Taxes fNHERfTANCE TAX RETURN PO BOX 280601 21 09 1197 Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 204-01-1409 12/19/2009 05/18!1918 Decedent's Last Name Suffix Decedent's First Name MI BIERI SUZANNE g (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 FILE D IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return ~ 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-8c') O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe 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 to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MU5T BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD W. STEWART (717) 761-4540 First line of address Johnson Duffle Second line of address 301 Market Street City or Post Office Lemoyne State ZIP Code PA 17043 REGISTER OE~DNILLS USE O ~~ a ~., f' L7 ~ ~- ; ~-.:: . ~ ~ • t'T'i "` ~ ter) mo W .- t ~.. .. ~ . , . ~ U ~ ~ . ~ ,#_, .~._ -~~ --~ ~ : Q~E FILED _~ ' : ~ t-; ..,.:.~ ~; .~ ~ ,,yJ :a .::r-~~ c'~~ Q "+' t Correspondent's a-mail address: rWS@jdSW.COm Under penalties of perjury, I dec{are that 1 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. SIGNATURE,~3F'PER'S6M-•RE,~SPONSIBLE FOR FILING R~TU f ~ 1 DA-f E + , AUUKt55 -` - i 5511 River Road, Harrisburg, PA 17110 ~~. SIGNATURE OF P PA ER OTHER R ENTATIVE DAl'E ~ 2 ((~ ADDRESS Johnson Duffle 301 Market Street, Lemoyne, PA 17043 PLEASE USE ORIGINAL FORM ONLY 150561011 Side 1 150561101 ~,,~-' REV-1500 EX Decedent's Name: Decedent's Social Security Number 204-01-1409 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 and Notes Receivable (Schedule D) ..... . .......... . .......... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... 5. 1 ,770.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested , ...... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 9. Funeral Expenses and Administrative Cosis (Schedule H) ............ ..... . . 9. 15.00 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ....... 10. 11. Total Deductions (total Lines 9 and 10) .......................... ....... 11. 12. Net Value of Estate (Line 8 minus Line 11) ........... . ............ ...... 12. 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. '1,755.OU 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 ~ 1 5. 16. Amount of Line 14 taxable at lineal rate X .0 45 1,755.00 16. 17. Amount of Line 14 taxable at sibling rate X .12 17, 18. Amount of Line 14 taxable at collateral rate X .15 1 g 19. TAX DUE ...................................................... ... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 150561,0],05 1,5056101,05 1,50561,0],05 78.98 O J REV-1500 EX Page 3 File Number tlx+r_PriPnt'~ C~mnlete Address: 'i~ Suzanne B. Bieri ~ STREET ADDRESS Country Meadows 4905 Trindle Road CITY Mechanicsburg, 21-09-1197 __ _ STATE PA _ _ __ _ __. i:IP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Gredits/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, tine 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) (3) (4 ) (5) 78.98 0.71 79.69 Make check payable to: REGISTER OF U~'ILLS, 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 : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. Ifi death occurred after Dec. 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? ........................................................................................................................ ^ 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 is 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 Linea{ beneficiaries is 4.5 percent, e~;cept 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(x)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at {east one parent in common with the decedent, whether by blood or adoption. (1) REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Bieri, Suzanne B. 21-09-1197 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. (If more space is needed, insert additional sheets of the same size) REV-1511 EX;- (1~-09j ~ Pennsylvania DEPARTMENT Of REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Suzanne B. Bieri 21-09-11 ~~7 Decedent's debts must be reported on Schedule I. If more space is needed, use additional sheets of paper of the same size, JF,RIiI' R. DUFFIE. R1C1-AKD 1~~~. ST-:~~~_~~a~ C. RUY ~~'E1UN1:1,. I}~, F.I)11UtiI) G. !~11 ERS n~a~~--) w' t~El~~:r-~ ]UHN A. STATLER IEFFEKSOn~ {. SF--Pti~-A~ JEFFKEY' B. KETTIG '~lARh C. DUFFIE M~~,--A-a. ~. CASS-~~~ 1 D °E December 9, 2010 Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 MELISSA PEEL, GREEVY FADE D. iV1ANLFl' ELIZABETH D. SNOVER A'~DRE'b1' P DOLL1~-A;v~ SAKAH E. HOFFMAN ANDRE~4' J. PETSU, IR. CAROL,YN B. MCCLAIN OF COUNSEL I-IORACE A. JOf{NSON F. LEE SHIPMAN (1965-L006) RE: Estate of Suzanne B. Bieri Date of Death: December 19, 20092, 2010 Your File No.. 21-2009-1197 Our File No. 9957-1 Dear Register: Enclosed for filing, please find the following: 1. 2 Supplemental PA Inheritance Tax Returns. There is tax due in the amount of $79.69. This includes interest in the amount of $0.71 for a filing date of December 10, 2010. 2. One (1 }copy of Pages 1 of the Return, which we ask that you time-stamp and return to us in the enclosed envelope. Should you have any questions, please do not hesitate to contact our office. Thank you for your assistance. Very truly yours, SON FIE, STEWART WEIDNER ~~~ a eman Estate Administration Paralegal Enc. c: Ramsey B. Davenport, Executor :423989 301 MARKET STREET P.O. BOX 109 LEMOYN`E. PENNSYLVANIA 11043-0109 WWW.JDSW.COM 717.761.4540 FAX: 717.761.3015 MAIL @ JDSW.COM ~© +~ V '`3~~r i ~r ~~~~ r ~ ~-i _ ~ -~ `--r ;~ h W -,. .. t4t'+. _r~ T'j.., .-~~. ~; `, ~~ ~> . ~. . ~~=~~ :.:~:-: F -~ ; t= _" ,=-~ _~ ~.:..~ Q JOHNSON, DUFFIE, STEWART & WEIDNER, P.C.