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Home My WebLink About03-09-11~ Lsos61a1o1 REV-1500 Ex X01.1°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosoi 21 10 0731 Harrisburg, PA s~i28-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 176-64-0351 12/10/2008 06/11/1971 Decedent's Last Name Suffix Decedent's First Name MI Short Christopher L (If Applicable) Enter Surviving Spouse's {nformation Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE R~C~S~'ER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 4. Limited Estate O 4a. Future Interest Compromise (date of death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return {date of death prior to 12-13-82) O 5. Federal Estate lax 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 TO: Name Daytime Telephone Number Mark S. Pinnie, Esquire (610) 565-4055 First line of address 218 West Front Street Second line of address City or Post Office Media State ZIP Code PA 19063 REGISTER O ,~pIk6S USE ONtY' -~ T_- - : ~. ~-; - - ,-, . ~, ,,...} i =~ ... ~ , ;r w~ .. DATLED _.~~ :-:~_.~ - 7". ~. ~'~ ~ ? ;~ Correspondent's a-mail address: i"Tlplnnle@bmplaW.net _ 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, corr d complete. De aration of preparer other than the personal representative is based on all information of which pr par r Ihas any knowledge. SIGNATUR O~ f2SON,RE fySIBL~ FOIE' AILING RETURN ~ DATE ADDRESS 5216 Terrace Road, Mechanicsburg, PA 17050 SIGNATURE OF P RER OTHER REPRESENTATIVE DATE r, - "~ r ADDRESS 218 West Front Street, Media, PA 19063 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J ,~UO' J 1505610105 REV-1500 EX Decedent's Social Security Number t)ecedent's tvame: Christopher L. Short 176-64-0351 RECAPITULATION 1. Real Estate (Schedule A) ........................................ ..... 1. 0.00 2. Stocks and Bonds (Schedule B) .................................. ..... 2. 0.00 3. Closely Held Corporation, Partnership or Svle-Proprietorship (Schedule C) ..... 3. 0.00 4. Mort a es and Notes Receivable Schedule D 9 9 ( ) ...................... 4. ..... 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. 275.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .. ..... 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested... ..... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) ........................ ..... 8. 275.00 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 10,191.57 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... ..... 10. 0.00 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 10,191.57 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. -9,916.57 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. 0.00 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 0 0.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 _ 0.00 1 g, 0.00 17. Amount of Line 14 taxable at sibling rate X .12 0.00. 17. 0.00 18. Amount of Line 14 taxable 00 0 0 00 at collateral rate X .15 . 18 . 19. TAX DUE ................................................ ......... 19. ' 0.00 20. FILL 1N THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 REV-1500 EX Page 3 Decedent's Complete Address: File Number 2110-0731 DECEDENT'S NAME Christopher L. Short ~ '~ STREET ADDRESS ~ ~~ 5216 Terrace Road CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments 0.00 B. Discount 0.00 00 0 Total Credits (A + B) (2) . 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FiA in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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 ......................................................................................................................... ^ 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 0 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? .............. ^ 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 Juiy 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)j. 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(a)(1.3)j. 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. REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Christopher L. Short 2110-0731 Include the proceeds of litigation and the date the proceeds were received by the estate. Afl property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Christopher L. Short 2110-0731 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Neil Funeral Home, Camp Hill, PA 8,503.37 B. 1 2 3 4. 5. 6. 7. a. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State _ Year(s) Commission Paid: Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 1,500.00 Street Address City State - Relationship of Claimant to Decedent ZIP Probate Fees: Accountant Fees: Tax Return Preparer Fees: Estate Advertisement -Cumberland County Law Journal Estate Advertisement -The Sentinel 75.00 113.20 TOTAL (Also enter on Line 9, Recapitulation), $ 10,191.57 If more space is needed, use additional sheets of paper of the same size. ZIP SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS REV-1513 EX+ (01-10) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ] BENEFICIARIES ESTATE OF: FILE NUMBER: Christopher L. Short 2110-0731 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PER50N(S} RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9115 (a} (1.2},] 1. Erin H. Short, 5216 Terrace Road, Mechanicsburg, PA 17050 Wife 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II 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 II -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. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTlFlCATE I , GL ENDA EARNER S TRA SBA UGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certi ~Fy that on the 20th day of July, Two Thousand and Ten, Letters of A:O!~A/l!~/S~RQ ;r~Onf in common form were granted by the Register of said County, on the estate of CHRISTOPHER L SHORT late of HAMPDEN TOWNSH/P (First, Middfe, Last) a/k/a CHRISTOPHER LEE SHORT in said county, deceased, to ERIN H SNORT (First, Midd/e, Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my .hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 20th day o:f July Two Thousand and Ten . File No . 2010- 00731 PA File No. 21- ~0- 0731 Date of Death 12/10/2008 S . S . # 176-d~-035 / NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL '~ ~ eputy