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HomeMy WebLinkAbout03-07-111505610101 REV-1500 °`t°'-1O' ~ OFFICIAL UsE ONLY enns lvania PA Department of Revenue P Y County Code Year File Number oE,~.,~,E~,~Fp Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 8 6 • 2 o oi I ~ ~ i ~ Harrisburg, PA i~i28-o601 RESIDENT DECEDENT l/ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY AA ©a i a q5d y oy~ 60,06 0 7~, ~ ga3 Decedent's Last Name Suffix Decedent's First Name MI AI 1 (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI -.~~ T1 KEL L 3 T F,~ NNE Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE r III - ~ ~ ~ z ~ ~ 7 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate ~ 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 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 T0: Name Daytime Telephone Number _p. .a_ ~~ Correspondent's a-mail address: Via. r- 1 ' , ~~ ~ rT7 I , , cn ~ ~.t x C: .i..... -,.<„~_.,_ >Y.~~ DATE FILED State ZIP Code ~ _ ... .. v. ,..a , .d/O[~ ha~/Hai/,coH, Side 1 1505610101 1505610101 J Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: ° `~ ~ D + ~ :~ ~~~. Q ~ ®~ y .~.. RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. ; ~ w `• `: ~.. 2. Stooks 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) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8~ 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 Costs (S~hedule H) ................... 9. 10. Debts of Decedent, Mortgage liabilities, and Liens (Schedule I) .............. 40. 11. Total Deductions (total Lines 9 and 10) ................................. 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Govemmentat Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 14. Net Yalue Subject to Tax (Line 12 minus Line 13) ................... ..... 14. 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_ 45. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 47. 18. Arrrount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING. A REFUND OF AN OVERPAYMENT p Side 2 1505610105 1505610105 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME STREET ADDRESS 5 ~ s ~ don ~c~~A ,~ yr-_ CITY G L~SLC STATE /'~4 ZIP 170 /3 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditsfPayments 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. FiN 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. (5) ~ 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 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 Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate cxmsideration? .............................................................................................................. ^ 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 [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 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 stilt applicable even if the surviving spouse is the only beneficiary. For dates of death on or after Juty 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 lineal beneficiaries is 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 netvalue of transfers to or for the use of the decedent's siblings is 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 bloat or adoption. (1) (~ Total Credits (A + B) (2) (3} (4) REV-1508 EX ~ (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, $c MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. l°/1!G 6h~<< ~ Po B °~ 6° 9~, v errs ~aRGfl, FA /tea s o CjlEcK/NG /~c:Gouiv? ~3 !- Hd/~- 6,S'Og 7, 8 7l0. yz/ ~ _ PNC BANK, Pa e~x sv 9, P1~sduR~'t1, PA i~a3 v ~ERTlflc,~~~' OG DEPas<T 3. ~kc ~4~NK, n. o. ~svx dog, pins,ovR6H, P.4 13a30 ~nav~;' a-.9RXLT ,AccavvT' '~~D-ay76 - 0©/8 `~ T !A A ~ n r F F~il/,~~fi~lq L sER 1/~cf.S, $ ~Qr9 AN01e1%W L/t R/VEGIE G HAk~o7~T~ , /V:C d2 $a `cZ ~ R E?/lC E~E~/? PLAA! lo,a6g.37 ill, 74~ ~s X75',6?s `/y TOTAL (Also enter on line 5, Recapitulation) I $ 3 3 S, 6 ! 6 . ~ D (If more space is needed, insert additional sheets of the same size) AND TESTAMENT KNOW ALL MEN BY THESE ;PRESENTS, that I, Joseph Burns Kelly, married, a legal resident of Carlisle, Cumberland County, Pennsylvania, United States of America, being of sound and disposing mind and memory, do here- by make, publish and declare this instrument as my last WILL and TESTAMENT, in manner and form following, that is to say: ~.~ 1. I hereby cancel, annul and revoke all wills and codicils by me at any time heretofore made; 2. I direct that my just debts and funeral expenses be paid as soon after my decease as may be practicable; 3. I hereby give, devise and bequeath all the rest, residue and remainder of my estate and property, including all property of which I shall die seized and possessed and all property to which I shall be otherwise entitled at the time of my decease, of whatsoever kind of nature and wheresoever situated, be it real, personal or mixed, and all property over which I shall have power of disposition or appointment, ~ to my beloved wife, Jeanne M. Kelly, now .residing in Carlisle, Cumberland . O~ ..... County, Pennsylvania, United States of America, as her sole and absolute property if she shall survive me, being fully confident that she will ~c suitably provide for any children of ours that shall survive me, but not imposing or intending to impose any legal or equitable obligation on my wife, Jeanne M. Kelly, so to do; 4. In the event my said wife, Jeanne M. Kelly, shall not survive me, and for the purpose of this my will she shall be deemed not to survive me if we shall die at or about the same time in a common accident or as the result of a common disaster, I give, devise and bequeath all the rest, residue and remainder~of my said estate and property, absolutely and forever, to Douglas Garties Kelly, my son, Lawrence Joseph Kelly, my son, Jeffrey Steven Kelly, my son, Roger Bruce Kelly, my son, Paul Quinton Kelly, my son~Christopher Martin Kelly, my son, and any child or children that may be born to us or adopted by us hereafter, share and share alike, living at my death: but if neither my said wife, Jeanne M. Kelly, nor any child or adopted child of mine shall survive me, then _~ I give, devise and bequeath all my said estate and property to James Redmond Kelly, of Fort Mitchell, Kentucky, my brother, and Mary Ann Kelly, of 1 Ludlow, Kentucky, my sister,or such of them as shall survive me. 5. I hereby appoint my said wife, Jeanne M. Kelly, as the sole executrix of this my last WILL and TESTAMENT, with full powers of sale, and I request that she be permitted to serve without bond or without. surety thereon and without the intervention of~any court or courts, pro- bate or otherwise, except as required by law. IN WITNESS WHEREOF, I have at Carlisle, Pennsylvania, United States of America, this ~~, day of May, 1975 set my hand and seal to this my last WILL and TESTAMENT consisting of two typewritten pages, this in- eluded, the preceding page hereof. bearing my signature on the lefthand margin. (SEAL) 0 PH BURNS KELLY Signed, sealed, published and declared by the above-named testator,, Joseph Burns Kelly, as his last WILL and TESTAMENT, in the presence of all of us at one time, and at the same time, we, at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses, and we do hereby attest to the sound and dis- posing mind and memory of said testator at the date hereof, and to the performance of the aforesaid acts of execution at Carlisle, Pennsylvania, United States of America, this 1f~ day of May, 1975. Q`~~y~y 313 5- ~/~~ sT~ C~.ac,~~G~ ~Q ~ ~ 2