HomeMy WebLinkAbout12-06-10
1505607121
~~ REV-1500 EX (oa_D5>
PA Department of Revenue OFFICIAL USE ONLY
BureauotlndividualTaxes INWERITANCE TAX RETURN County Code Year Filetdumber
PO DOX 280601 2 0 1 0 0 0 6 8 5
Harrisbum. PA 17128-060t RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 4 5 2 8 7 4 3 8 0 6 2 7 2 0 1 0 0 2 1 2 1 9 2 7
Decedent's Last Name Suffix Decedent's First Name MI
C a s n e r J o h n n i e L
(If Applicable) Enter Surviving Spouse's tnfonnation Below
Spouse's Last Name Su~x Spouse's First Name MI
Spouse's Social Security Number
FILL INAPPROPRIATE OVALS BELOW
^X 1. Original Return ^
^ 4. Limned Estate ^
^ 6. Decedent Died Testate ^
(Attach Copy of Will)
^ 9. Litigation Proceeds Received ^
2. Supplemental Return ^
4a. Future Interest Compromise (date of ^
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10, Spousal Poverty Credit (date of death ^
between 12.31-91 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 Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Johanna
Firm Name pt Applicable)
Tur n e r
First line of address
4 7 0 1 N o
Second line of address
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City Of Post OffICB
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ZIP Code O
DATE FILED
H a r r i s b u r g PA 1 7 1 1 0
Correspondents a-mail address:jhr@turnerandoconneil.com
Under penalties of perjury, t declare that 1 have examined this return, rcluding accompanying schedules and statements, and to the hest of my knowledge and oeliel.
it is true, wrrecl and cwny~ele. Declaration of preparer other than th rsonal representative is based on all infomration of which preparer has any knowkdge.
S1Si1iIK1M.1 PE IkESP FOR RETBR ~ . / . ce~w ~ .
1
4
1505607121
THIS RETURN MUST BE FILED tN DUPLICATE WITH THE
REGISTER OF WILLS
Chambersb
PA 17202
TiVE
Harrisbur
PLEASE USE ORIGINAL FORM ONLY
Side 1
17110
150560"117.1
~~
REV-7600 EX Page 3 File Number
nn.•vAnn4'e [_mm~lAtB Address: 20 10 00665
rvv ~~..~. .r--_- - ---_ - - -
DECEDENTSNAME
Johnnie L. Casner -------- ----_--- -_ - __ _ - - _
STREET ADDRESS
28 South Enola Drive _ -_ _ - --- - _ _ ---- _-- - - -
- ----- --
CITY I STATE TZIP
Enola ' PA 117025
Tax Payments and Credits:
1. Tau Due (Page 2 Line 19) (1) 3,003.71
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B +C) (2) 0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E )
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 +Une 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(3)
0.00
(4) 0.00
(5) 3,003.71
(5A)
B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 3,003.71
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 a 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. If death occurred after December 12,1982, did decedent transfer property within one year of death
^
without receiving adequate consideration? ......................................................................................
h?
h
d
" .
^ ^
........
er
eat
or payable upon death bank account or security at his or
3. Did decedent own an 'intrust for .
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
4
.
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 January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (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 zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)j. 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 offer July t, 2000:
The tax rate imposed on the net value of transfers from a deceased child twentyone 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 zero (0) percent [72 P.S. §9116(a)(1.2)j.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
J
1505607221
REV-1500 EX
Decedant'sName: Johnnie L. Casner Decedent's Social Security Number
2 4 5 2 8 7 4 3
8
RECAPITULATION
4 0 6 8 9 5 1
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 8 Notes Receivable (Schedule D) ...................... .. 4.
3 7 4 3 6 ' 4 4
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... ... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6•
7. Inter-Vivos Transfers & Miscellaneous N -Probate Property
(Schedule G) ~ Separate Billing Requested .... ... 7.
B. Total Gross Assets (total Lines 1-7) ....................... ... 8. 7 8 1 2 5. 9 5
9 7 3 9 2. 3 0
9. Funeral Expenses & Administrative Costs (Schedule H) ....... .
...
3 9 8 4 6 4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........ ... 10. •
11. Total Deductions (total Lines 9 & 10) .............. ... 11. 1 1 3 7 6. 9 4
12. Net Value of Estate (Line 8 minus Line 11) ...................... ... 12. 6 6 7 4 9 • 0 1
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............... ... 13.
6 6 7 4 9 0 1
14. Net Value Subject to Tax (Line 12 minus Line 13) . .......... ..... .. 14. ,
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0
0
0
15
0.
0
0
(a)(1.2)x.o _ . .
16. Amount of Line 14 taxable 6 6 7 4 9
0 1 3 0 0 3. 7 1
at lineal rate X •045 . 16.
17. Amount of Line 14 taxable 0 0 0 17 ~ ~ 0
at sibling rate X .12 .
18. Amount of Line 14 taxable
~ ~
~
~'
~
0
at collateral rate X .15 18.
19. Tax Due ................................................19.
20. FILL iN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
3003.71
Side 2
1505607221 1505607221
REV-1502 EX + (6-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OF
FILE
Johnnie L. Canner 20 10 00665
All real property owned solely or u a tenant in common must be reported at (air market value. Fair market value is defined as the price at which property would be
exchanged between a wgfing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads.
a..r nme.nv Which k fointM-owned with right of survivorship must be dleclesed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
t. Net proceeds from sale of 28 South Enola Drive, Enola, PA 40,689.51
TOTAL (Also enter on line 1
pf more space is needed, insert additlonal sl~els of the same size)
REV-1508 EX + (g~98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Johnnie Casner 20 10 00665
Include the s of litigation and the date the proceeds were received by the estate.
en mm~erty bintlvowned witlr right of survivorship must be dkcbsed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Proceeds from PSECU and Members 1st FCU accounts 37,000.00
2. Utility refund 277.05
3. Sewer/refuse refund 115.00
4. Insurance refund 44.39
TOTAL (Also enter on line 5, Recapitulation) I S
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
COMtuIONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ITEM
NUMBER
A.
1.
2.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
Brian C. Musselman Funeral Home (cremation)
Riverview Memorial Gardens
1
AMOUNT
~,sa5.oo
3, 520.20
g, ADMINISTRATIVE COSTS:
~, Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City State ZiP
Year(s) Commission Paid:
1,000.00
2.
AMomeyFees Turner and0'Connell
g. Fatuity Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
Cily State ZIP
Relationship of Claimant to Decedent
327.50
g, P1eba(eF~ Register of Wills
5 Accountants Fees
g, Tax Retum Preparers Fees
294.40
7, Estate advertising 27.40
g, Estate checks 537.80
g. Misc. costs reimbursed to executrix
TOTAL (Also enter on Tine 9, Recapitulation) I S
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN & LIENS
MORTGAGE LIABILITIES
RESIDENT DECEDENT ,
ESTATE OF FILE NUMBER
Johnnie L. Casner 20 10 00665
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
t. Removal of debris from real estate 1,024.00
2. Wells Fargo credit card 583.15
3. East Pennsboro Township sidewalk installation 1,369.00
4. Verizon final bill 55.85
5. PSERS reimbursement June benefit 90.51
6. East Pennsboro Township second quarter sewer 115.00
7. Pennsylvania American Water final bill 74.49
8. PPL Electric Utilities final bill 498.22
9. Heritage Cardiology Associates medical bill 147.00
10. Quantum Imaging & Therapeutic medical bill 8.00
11. Pravin Gadani MD medical bill 19.42
TOTAL (Also enter on line 10, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
REV•1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Johnnie L. Casner 20 10 00665
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
J TAXABLE DISTRIBUTIONS [mdude o ht sppoousal distributions, and transfers under
Sec. 9116 (1.2)]
1. Michelle L. Smedley Lineal 66,749.01
6021 Cumberland Highway
Chambersburg, PA 17202
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
REV-1500 COVER SHEET
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S
(If more space is needed, insert additional sheets of the same size)
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