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Home My WebLink About03-22-11 (2) 1,50561,01,40 REV-1500 ~` ~°'-'°' OFFICIAL USE ONLY PA Department of Revenue __ County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETLIRN PO BOX 280601 2 1, 1, 0 0 5 8 0 ' Harrisburg, PA 17128-0601 ____„ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 4 0 1, 4 2 5 6 0 5 0 7 2 0 1, 0 0 6 1. 5 1, 9 2 1, Decedent's Last Name Suffix Decedent:'s First Name Vll S P O T T S M E L V I N L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Ivll N / A Spouse's Social Securit~~~ Number THIS RETURN MUST BE FILED IN DUPLICATE WI'TIH ifHE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return a 2. Supplemental Retum ~ 3. Remainder Re~rurn (date of death prior to 12-13-132) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate lax Return Required death after 12-12-82) 6. Decedent Died ~ estate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of 'hill) (Attach Copy of Trust) Q 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax: under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL. CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SiHOUI.D BE DIRECTED TO: Name Daytime Telephone Number R' M A R K T H O ~{ A S E S Q U I R E: 7 1, 7 7~ h 2 1, 0 0 REGISTER OF W'IL.LS USE ONLY First line of address J, 0 1, S O U T H M A R K E T S T R E E T Second line of address City or Post Office State ZiP Code '---- -~4TE I~II'I"r} M E C H A N :I C S B U R G P A 1, 7 0 5 5 Correspondent's a-mail address: rmarkthomas~gmail.com _~_ Under penalties of perjury, I declare that t have examined this return, including accompanying schedules and statements, and to the best of rn}~ knowledge and bE:lief, it is true, correct and complete.. Declaration of prepares other than the personal representative is based on all information of which prepares 7as any knowledge. TUR OF PERS N ONSIBLE O I I G RETURN PATE: C'fi'f-''~,~ J~ . ~~ ~' - ~ ~ _ ADDRESS f' 576 MAGARO ROAD ENOLA PA 1'7_025 SIGN OF EPA ER T~-IAN REPRESENTATIVE DATE JJ ADDR S 1,01 SOUTH ~1ARKET STREET ~1ECHANICSI9URG PA 1,7155 _ PLEASE USE ORIGINAL FORM ONLY __ Side 1 1,50561,01,40 1,50561,01,40 J 1505610240 REV- ~ 50~:~ EX Decedent's Social Security Number Decedent's Name: Cl E L V I N L• S P O T T S 2 D 4 D~1'_ 4 2 5 6 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1 • • 2. Stocks and BondsiSchedule B) ...................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 1 .5 D 0 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. ' 6. Jointly Owned Prooerty (Schedule F) ^ Separate Biiiing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. ~ :5 O D • 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ................. . 9• 1. S • 0 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............ . 10. ~~ D ~~ 11. Total Deductions (total Lines 9 and 10) .............................. . 11. 1, ~, • 0 ~~ 12. Net Value of Estate (Line 8 minus Line 11) ........................... . 12. L 4 8 5 • O D 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 ~o Tax (Line 12 minus Line 13) ..................... . 14. 1 ~! 8 5 • O C) TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 t~~xable at the spousal tax raie, or transfers under Sec. 9116 (a)(1.2) x.l~ 0 . D O 15. 16. Amount of Line 14 taxable at lineal rate X .04 ~ 1 4 8 5 0 0 16. 17. Amount of Line 14 ?:axable at sibling rate X .12 0 0 0 17. 18. Amount of Line 1-4 tc:xabie at collateral rate .X .' 5 D O O 18. 19. TAX DUE ..................... ........................ .. ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 150561,0240 0. D CI E~ 6. 8 ~' o. o O 0. D 0 Ea 6. 8 5 C] J REV-1500 EX Page 3 nom.-nr~lnnt'c (_mm~lPtP Address: File Wumber 21 10 1)580 ~........,..... ~ .. ....., ... r - - -- - - - -- - - - - - ---- DECEDENT'S NAME MELVIN L. SP_OTTS __ __ --- - ---------- STREETADDRESS 602 1 /2 MAGARO ROAD ------ - ------------- CITY ~ STATE --- Z.IP ENOLA I F'A _ 17025 Tax Payments and Credits: 1. 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 + !_ine 3, enter the difference. This is the DVERPA`o MENT. Fill 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. Total Credits (A + B) (2) (3) (4) (5) 66.83 0.00 ___ 0.00 _____ 66.83 Make check payable to: REGISTER OF W'1LL5, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes IVo a. retain the use or income of the property transferred : ...................................................................... ~,_; X b. retain the rght 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 occurrec, after December 12, 1982, did decedent transfer property within one year of death without receiv+ncj adequate consideration? ....................................................................................... C 3, Did decedent nvm an "in trust for" orpayable-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 bene~iciary designation? .................................................................................................. C.I X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT A5 PAR;T OF THE RETURN. For dates of death on or after July `, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sur•~iving spouse 3 percent [72 P.S. §9116 (a} (1.1) (}] For dates of death on or after Jan. ' , 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 fi)r 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 ' , 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: ~f 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;]. A sibling is defined; undi 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 PENNS`r'LVANIA CASH, BANK DEPOSITS, & MISS. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MELVIN L. SPOTTS 21 10 0580 Include the proceeds of litigation and the date the proceeds were received by the estate. _ All property jointly-owned with right of survivorship must be disclosed on Schedule F. __ ITEM ~ VALUE AT DATE NUMBER DESCRIPTION _ __ OF DEATH 1. 998 Ford Winds~tar passenger minivan 1,500.00 TOTAL (Also enter on line 5, Recapitulation] I ;$ 1.500.00 ~'_~ {If more space is needed, insert additional sheets of the same size) FZEV~1511 E~:+ (10-09) • .pennsylvania EPARTMENT OF REVENU S INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF F1LE NUMBER MELVIN L. SPOTTS ~ 21 10 _0580 _~ Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION _ _ AMOUNT p,, FUNEP~AL EXPENSES: 1. B 2. 3. 4, K J 6 7 City State _ Z1F' ADMINISTRATII/E~ COSTS: Personal Representative Commissions: Name(s1 of Personal Representative(s) Street Address City __ State Year(sl Commission Paid: Attorney Fees: R. Mark Thomas, Esquire Family Exemptiar : (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: LIP 15.00 TOTAL (Also enter on Line 9, Recapitulation} I $~ 15.00 if more space is needed, use additional sheets of paper of the same size.