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HomeMy WebLinkAbout01-14-11 _ I 7_____ 1505610140 REV-1500 ~` ~°'-'°' PA Department of Revenue I Bureau of Individual Taxes County Code Year File Number INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 2 1 1 D D 7 6 D RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 6 5 2 6 7 9 4 0 0 6 2 0 2 0 1 0 0 5 2 2 1 9 1 4 Decedent's Last Name Suffix Decedent's First Name MI B I E B E L V I R G I N I k M (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 FfLED IN DUPLICA'11E MVIIT'H THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^X 1.Original Retum ~ 2. Supplemental Retum ~ 3. Remainder ~etum (date of death prior to 11,2-1~3-182) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal EEst~te Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust D 8. Total Numb@r bf Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to t~x~ under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach ~ch~ ) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX iNFORMA, 10 SHOULD BE DIRECTED T0: Name Daytime Telephony dumber M U R R E L W A L T E R S I I I E S Q 7 1 7 6 '9' 7 4 6 5 0 First line of address 5 4 E A S T M A I N S T R E E T Second line of address City or Post Office State M E C H A N I C S B U R G P A Correspondent's a-mall address: ZIP Code REGIST 1~VILLS US~QNLY . ~' ~!_ C " r ~ ~ ~.. eT . ~ {~- ~._~ n „~~ FILED ~ i - c ~' x 1 7 0 5 5 Under penaltles of penury, I declare that I have examined this return, including accompanying schedules and statements, and to the es a my knowledge and belief, h is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which p pa er!has any knowedge. SI~URPERSON~P IB E FOR f, ILIN~ Ui3N /~ ~~ ATE ~~ ADDRESS MARLENE M• BECKER, 8 W• COOVER ST MECHANICSBURG P 17055 SIGNATURE O~P PA R HER N REPRESENTATIVE pA,TE// j/ ~~ G ADDRESS MURRE T III 54 E MAIN ST MECHANICSBURG ~PIA'17055 PLEASE USE ORIGINAL FORM ONLY Side 1 150561014D 15056101~14b i i J REV-1500 EX IA M• BI 1505610240 Decedent's 1 6 5 Security Number 6 7 9 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 and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 5 ~ 2 8 4 . 7 5 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Probate Property (Schedule G) S t Billi R epara e ng equested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 5 T, ' 2 8 4 • 7 5 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 4 7 0 1 . $ 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 1' !2 9 0 • 1 8 11. Total Deductions (total Lines 9 and 10) ............................... 1 L $' 9 9 1. 6 8 12. Net Value of Estate (Line 8 minus Line 11) ............................ 12. 1 5 11 '2 9 3 . 0 7 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 $ 11 i2 9 3. 0 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate x .045 1 5 1 2 9 3. 0 7 1s. 6', I8 0 8. 1 9 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ......................................................19. bll 8 0 8• 1 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~I Slde 2 III 1505610240 1505610c~410 - - - _ - __ i -- - - ~_' REV-1500 EX Page 3 Decedent's Compete Address: File Number 21 10 0760 DECEDENTS NAME VIRGINIA M. BIEBEL STREET ADDRESS 218 WEST COOVER STREET CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/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, Line 20 to request a refund. (1) ~ 6,808.19 Total Credits (A + B) (2) 0.00 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ 6,808.19 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOW{NG QUESTIONS BY PLAC{NG AN "X" IN THE APPRO{~I~IATE 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 shalt use the property Transferred or its income; ............................... c. retain a reversionary interest; or ................................................................................................ d, receive the promise for Iffe 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? ................................................. .................................... 0 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 r~1 contains a beneficiary designation? .................................................................................................. ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE I? AIS~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 fdr 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 surviuingl'Isppoouse is 0 percent 172 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requnrerrnehts 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 drstr 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)j. • 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. §91760)(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 blood or adoption: REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER'' VIRGINIA M. BIEBEL 21 10 0750 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly~owned with right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. FIRST NIAGARA 3,121.23 CHECKING 2. AMERlCO FEDERAL CREDIT UNION 14,610.35 SHARE ACCOUNT 3 CURIAN CLEARING, LLC 22,215.25 4. LINCOLN FINANCIAL GROUP 21,949.14 ANNUITANTIBENEFICIARY - MARLENE M. BECKER 5. LINCOLN FINANCIAL GROUP 95,388.78 ANNUITANT/BENEFICIARY - MARLENE M. BECKER TOTAL (Also enter on line 5, Recapitula(ion~ I'~ 3 157,284 (It more space is needed, insert additional sheets of the same size) L l l _ __ ___ __. REV-1511 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT w i„~ c yr FILE NUMBED VIRGINIA M. BIEBEL __ 21 10 0760 DecedenCs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. SCOTT FUNERAL HOME 2,817.00 2. WESTMINISTER CHURCH -LUNCH 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) MARLENE M. BECKER (RENOUNCED) Street Address 218 W. COOVER STREET City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: p, AttomeyFees: MURREL R. WALTERS, III 1,400.00 3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation.) Claimant Street Address i City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS ~ 384.50 5 Accountant Fees: 6. Tax Retum Preparer Fees: 7. i TOTAL (Also enter on Line 9, Recapitul~ltiorl) I i 4 701 50 If more space is needed, use addfional sheets of paper of the same size. __ _ __i i l REV-1512 EX+ (12-08) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, ~ LIENS RESIDENT DECEDENT w ~ n ~ ~ yr FILE NUMBER VIRGINIA M. BIEBEL 21 10 0760 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM ~ VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PSERS 1,281.24 REIMBURSEMENT 2. HARRISBURG PHARMACY MEDICAL 8.94 i TOTAL (Also enter on Line 10, Recapitulation) S 1 290.18 If more space is needed, insert additional sheets of the same size. - __ - - _ _ _ -- - i 1 it __ REV-1513 EX* (Ot-t0) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER: VIRGINIA M.131EBEL cr ~~ vi u RELATIONSHIP TO DECEDENT ' AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (Include outs' htspousal distributions and transfers under Sec. 91 T6 (a) (1.2).] 1. MARLENE M. BECKER Lineal 218 W. COOVER STREET MECHANICSBURG, PA 17055 2. TIMOTHY J. BIEBEL Lineal 523 CRESS STREET CARNEGIE, PA15106 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COV R EET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~~ ~ It ~___ _____ ._ -__J_J ..-~ ~JJ:a:......1 .. L.ww~w wf ww..we w! IL.w wn.r.w nisn '~ .......... ..~....... ... ......-..~~ --- -.__..._.._. _..__._ _. r_r_. _. _.._ __..._ _.__.