HomeMy WebLinkAbout02-10-111505610140
REV-1500 ~` ~°'-'°'
PA Department of Revenue oF~iCIaL use c~rv~~
Bureau of Individual Taxes County Code Year ', File Number
Po Box 2sosol INHERITANCE TAX RETURN 2 1 ]~~ 1 2 7 5
HarrisburSt. PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Cnrial Cwnvihi N~~mhar rata of r)aath 6MAnnVWY natty of Rirfh 6A6/nnVWV
5 4 9 2 0 9 1 6 9 1 0 0 8 2 0 1 0 0 9 1 1 1 9 2 1' II
Decedent's Last Name Suffix Decedent's First Name II MI
W A L T E R S J R M U R R E L '' R
(tf Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name ', MI
W A L T E R S P A U L I N E I B
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE I~TH THE
REGISTER OF WILLS
I
FILL INAPPROPRIATE OVALS BELOW '
® 1.Original Retum ~ 2. Supplemental Retum ~ 3. Remain er eltum (date of death
pnor to 2-1 32)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal s t8 Tax Retum Required
death after 12-12-82)
® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Nuhlb~ r of Safe Deposit Boxes
(Attach Copy of Wili) (Attach Copy of Trust)
9. litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election o x under Sec. 9113(A)
between 12-31-91 artd 1-1-95) (Attach ch Ct)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA SHOULD BE DIRECTED T(
Name Daytime Telep on Mumber
M U R R E L W A L T E R S I I I E S Q 7 1 7 ~ 9 7 4 6 5 0
REGISTE O YVILL8 USE ONLY
~.. ,
First line of address ' p `--
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5 4 E A S T M A I N S T R E E T r ~
c7 ~ -
Second line of address ' ~
~ .ry
~
O r
~ ~ xa. ~_
r
Ci or Post Office
ty State ZIP Code
~ ILED ~
!~ ~ `~ ~
M E C R A N I C S B U R G P A 1 7 0 5 5 ~,~,
i,
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Corespondent's e-mail address: ~
Under penaltles of perJury, I declare I have mined this return, Including accompanylrg schedules and statements, and to the be my knowledge and belief
h is true, correct and p of rer other than the personal representative is based on all information of which p has arty knowledge.
SIGNATURE OF P IB OR FILING RETURN ~ D~ E ~ /
r
ADDRESS
MURREL WA TERS, III 130 S RIDGE RD BOILING SPRINGS P A 17007
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1 ~
L 1505610140
- 1505611107
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1505610240
REV-1500 EX
Decedents Spci~l Security Number
Name: MURREL R• WALTERS, JR 5 4 9 ~ 0 9 1 6 9
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.
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Probate Property
(Schedule G) ~ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1 through 7) ........................... 8.
1
0 0 0. 0 0
9. Funeral Expenses and Administrative Costs (Schedule H) ........... ....... 8. 1 ' 1 8 3 6 . 5 0
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ....... 10,
11. Total Deductions (total Lines 9 and 10) ........................ ....... 11. 1 ' 111 8 3 6 . 5 0
12. Net Vales of Estate (Line 8 minus Line 11) ..................... ....... 12. ', 1 6 3 . 5 0
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............... ....... 13.
14. Net Vales Subject to Tax (Line 12 minus Line 13) ...................... 14. 1 6 3. 5 0
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable i
at the spousal tax rate, or ' '~
transfers under Sec. 9116
(ax1.2) x 1 6 3. 5 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .0_ 0. 0 0 16. ' 0. 0 D
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. ! 0. D 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0 18. '
I 0. D 0
19. TAX DUE ............................................... ....... 19. '
i 0 • 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ',
Side 2
L 1505610240 150561040' J
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 10 1275
DECEDENTS NAME
MURREL R. WALTERS JR
STREET ADDRESS
301 BRINDLE ROAD
CITE
MECHANICSBURG STATE
PA ZIP
17055
Tax Payments and Credits:
1 • Tax Due (Page 2, Line 19)
2. CreditslPayments
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.
FIII in oval 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.
(3)
(4)
(5)
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE
1. Did decedent make a transfer and:
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. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate wnsideration? .......................................................................................
3. Did decedent own an "intrust for" or payable-upon~eath 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
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 dr fi
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 survi inc
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requ~grei
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
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 benefiaaries is 4.5 percent, ~exi
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. §91116
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption
(1)
Total Credits (A + B) (2)
TE BLOCKS
No
APART OF THE RETURN.
the use of the surviving spouse is
se is 0 percent
for disclosure of assets and
of a natural parent, an
as noted in
.3)]. A sibling is defined, under
~!
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REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC.
IN RE DAENT DECEDENT N PERSONAL PROPERTY
ESTATE OF FILE NUMBER
MURREL R. WALTERS. JR 21 10 127 II
Indude the proceeds of litigation and Uie date the proceeds were received by the esta~.
All props intly-owned with M of survNorship must be disclosed on &heduk F.
ITEM i VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1993 MERCEDES ' 2,000.00
2. 12003 MERCEDES ~'i ( 10,000.00
TOTAL (Also enter on line 5, Recapitula}ion ~' S
(If more space is needed, insert additional sheets of the same size) IT^
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REV-1511 EX+ 110-091
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER i
MURREL R. WALTERS. JR 21 10 127 '~
Decedent's dells must be sported on Schedule L i
ITEM
NUMBER DESCRIPTION ~' AMOUNT
A. FUNERAL EXPENSES:
1. MYERS-HARNER FUNERAL HOME ', ',
i
I 11,706.00
. I I
I
I
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ADMINISTRATIVE COSTS: ~' ~',
1. I
Personal Representative Commissions:
Name(s) of Personal Representative(s) MURREL R. WALTERS III RENOUNCE
Street Address 130 S. RIDGE ROAD
City BOILING SPRINGS State PA ZIP 17007
i
Year(s) Commission Paid:
2, Attorney Fees: MURREL R. WALTERS, III ' li
i
3. Famiy Exemptbn: (If deoedenYs address is not the same as claimants, attach explanation.) ~,
Claimant
Street Address
City State ZIP ~~
Relationship of Claimant to Decedent ',
4. probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS ! 130.50
5. AcoountantFees:
'
6. i
Tax Return Preparer Fees: ',
7. I
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TOTAL (Also enter on Line 9, Recaptul~tion S ~ ~ 836.50
If more space "s needed, use additional sheets of paper of the same size.
REV-1513 EX+ (01-10)
Pennsylvania ~ SCHEDULE J
DEPARTI~NT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBE : '
MURREI R. WALTERS. JR ~~ ~ n ~ ~~~
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDE T ',
Do Not List Trusteets) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include ou~trigght spousal distributions and transfers under
Sec. 91 T6 (a) (1.2).) i
1. PAULINE B. WALTERS Spousal ~,
301 BRINDLE ROAD
MECHANICSBURG, PA 17050 ',
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 CO ERIS ' EET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: ~', ',
1.
i
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
i
- ~~ i
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
more space is needed, use
of paper of the same
S