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HomeMy WebLinkAbout02-22-11 (2)1505610.145 .J REV-1500 x(010) OFFICIAL USE ONLY Pennsylvania County Code Year File Number PA Department of Revenue pFput7MENr OF REVENUE Bureau of Individual Taxes INHERITANCE TAX RETURN ~ ~ U ~ ~ ~iC` Po sox 2aosol RESIDENT DECEDENT Harrisbu PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 175-05-1641 09092005 09111916 Suffix Decedent's First Name MI Decedent's Last Name Adams C. Norman (If Applicable) Enter Surviving Spouse's Information Below MI Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 0 1. Original Retum © 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) t E ~ 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Retum Required e sta 0 4. Limited death after 12-12-82) © 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach COPY of III) i d R d [~ (Attach COPY of Trust) 10. Spousal Poverty Credit (date of death ~] 11. Election to tax under Sec. 9113(A) ve ece s [~ 9. Litigation Procee between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPL BE DIRECTED T0: D ETED. ALL CORRESPONDENCE AND CONFIDENTIAL Te b ephone Num Daytime Name '117~4~5R~8 Robert G. Frey First line of address 5 South Hanover Street Second line of address City or Post Office State ZIP Code Carlisle PA 17013 rk REGISTEICDF WILLS USE'ONLY ~ ~ 3 ~~~ _ ~ ~~~ N -.~ - E FILED D n ~~ .lJ t ,' ~~ __~ ;~ -,-, rCti O "r7 correspondent's e-mail address: r f reyQ f reyt i 1 ey . com Under penalties of perjury, I declare that I have examined this return, including acxompanying schedules and statements, and to the best of my knowledge and belief, it is _ .. .. _ _ _ ______, ~_..._....b.N..e ie h~enA nn III infnrtnafinn of which t1r2Dafer haS anY knoWled9@. FOR FILING RETURN r~v~+ng.~.~ 23 Circle Drive, Carlisle, PA 17013 SIGNATURE OF PR RE O TH/~J RE SENTATIVE Robert Fre ADDRESS 5 South Hanover Street, Ca isle, PA 17013 P SE USE ORIGINAL FORM ONLY L 15175611]145 Side 1 ~~ DATE T'~ ~/~/~ 2.2 ZO DATE ~rd . 2 2, Z a/~ 155610145 .J J 1505610245 REV-1500 EX Decedent's Social Security Number DecedeM'sName: C. Norman Adams 175-05-1641 RECAPITULATION 1. NONE 1. Real Estate (Schedule A) ........................................... 2 2632.11 2. Stocks and Bonds (Schedule B) ................................. . ..... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages and Notes Receivable (Schedule D) ..................... ..... 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) . ..... 5. NONE 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ... ..... 6. NONE 7 Inter-vvos Transfers & Miscellaneous Non-Probate Property . (Schedule G) OSeparate Billing Requested ... ..... 7. NONE a 2632.11 8. ........ Total Gross Assets (total Lines 1 through 7) ............. . . ..... 9. ....... Funeral Expenses and Administrative Costs (Schedule H) .... . ...... s. 115.00 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........ ..... 10. NONE 11 115.00 11. Total Deductions (total Lines 9 and 10) ......................... ...... . 12. Net Value of Estate (Line 8 minus Line 11) ....................... ...... 12. 2517.11 13. or s rus Charitable and Governmental Bequests/Sec 9113 0 . 0 0 an election to tax has not been made (Schedule J) ....................... 13. 14. ............. Net Value Sub'ect to Tax Line 12 minus Line 13 ......... . 14. 2517.11 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or Vansfers under Sec. 9116 0 . 0 0 (a)(1.2) X .0 ~ 15. 16. Amount of Line 14 taxable 2 517.11 at lineal rate X .0 4 5 16. 113.2 7 17. Amount of Line 14 taxable at sibling rate X • 12 17 0 . 0 0 18. Amount of Line 14 taxable 18 0 . 0 0 at collateral rate X . 15 . ....... . 19 113.27 19. TAX DUE ............................................... . which f t T 20, FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (~ Side 2 1505610245 1505610245 ,J Flle Number REV-1500 EX Page 3 Decedent's Complete Address: 21-05-0847 DECEDENTS NAME STREET ADDRESS CITY STATE ~ ZIP 175-05-1641 Tax Payments and Credits: 113.27 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + B) (2) 3. Interest (3) 32.18 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 0.00 Fill in box on Page 2, Line 20 to request a refund. (4) 145.45 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 : ............................................................................. ^ X b. retain the right to designate who shall use the property transferred or its income : ................................ ^ c. retain a reversionary interest; or .................... X 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 consideration? .......................................................................................:......... X 3. Did decedent own an "in trust for' or payable-upon-death bank account or security at his or her death? .... ^ 0 4. Did decedent own an individual retirement account, annuity or other non-probate property, which X 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 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 net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(ax1.3)]. 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. Practitioner Portal Penalty and Interest Calculations CALCULATION DATES- 6/9/06 TO 2/23/2011 TAX DEFICIENCY $ 113.27 CALCULATED INTEREST $ 32.18 BALANCE AS OF 2/23/2011 $ 145.45 Start Over hops:/ /www.doreservices.state.pa.us/ pitservices/Default.aspx 2/18/11 3:10 PM Page 1 of 1 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER C. Norman Adams 21-05-0847 All property jointly-owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM Shares Prudential Stock, 67.49 average price TOTAL (Also enter on line 2, Reca (If more space is needed, insert additional sheets of the same size) OF 2,632 REV-1511 EX + (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF C. Norman Adams 21-05-0847 Decedent's debts must be reported on Schedule I. ITEM A. ~ FUNERAL EXPENSES: 1 B 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2, Attorney Fees: 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Ctty State Relationship of Claimant to Decedent 4, Probate Fees: 5, Accountant Fees: g, Tax Return Preparer Fees: 7. State ZIP ZIP 100 15 TOTAL (Also enter on Line 9, Re If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES FILE NUMBER: ESTATE OF: 21-05-0847 C. Norman Adams RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE NUMBER I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 Ranelte L. Brown 23 Circle Drive, Carlisle, PA 17013 Step Daughter 1 /2 of Residue 2 Stephen C. Adams 816 Golden Eagle Drive, Conway, SC 29527 Son 1/2 of Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. tI NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I ; If more space is needed, use additional sheets of paper of the same size. WSJ.com Stock Charting for PRU prudential Financial Inc (PRU) (NYSE) U.S. Dollar Date Price High Low Volume 9/9/05 67.41 .67.90 67.08 1,221,300 No Splits Get another quote any day after 1/2/1970 1 /2/1970 Symbol: Date: 9/9/~i75'"""""""' Go, 2 Mwrth (Daly) F. c~"-~- Imo 2mo 3mo 6mo 1~ 3~~r 6~ http://www.bigcharts.com/custom /wsjie/wsjbb-historical.asp?symb=pru&close_date=9%2F9%2F05&x=0&y=0 __ Gs ,. _ ..: ~7 6S ~ _ _ S'# 2/11/11 9:06 AM Page 1 of 1 y'~ ~"" nt~ra~v~ data Quotes delayed at least 15 minutes. Market data provided by Interactive Data . Terms & Conditions. Powered and implemented by Interactive Data Managed Solutions.