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Home My WebLink About04-13-11 1505610105 REV-1500 EX (oz-11) {FI) `: PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes """"'"`""" "`°`'"" County Code Year File Number PO BOX 280601. INHERITANCE TAX RETURN Harrisbur , PA 1'7128-0601 RESIDENT DECEDENT ENTER DECEDENT fNFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 342-16-9357 02/16/2011 01/20/1924 Decedent's Last Name Suffix Decedent's First Name MI Hawkins Leonard R (If Applicable} Enter Surviving Spouse's Information 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 REGISTER OF WILLS FELL IN APPROPRIATE OVALS BELOW C~ 1. Original Return p 2. Supplemental Return O 3. Remainder Return (Date of Death O 4. Limited Estate O Prior to 12-13-82) 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O (Attach Copy of Will) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to 'Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THiS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Gregory J. Katshir, Esq (717) 763-8133 First Line of Address 900 Market Street Second Line of Address City or Post Office Lemoyne State ZIP Cads PA 17013 c~ REGISTER OS USE ONL'~ ,, ~:J r.y .... _; ; - t.~, r "; .~- r' _ ~' ~`-~ - ~' ~_ W.. _,.. , ..- :~ ~~ ,' - DATE FILED ,~ _ c.._ _ ,--~ ;~T ~~,, Correspondent's a-mail address: Katshlr(c~aOl.COm Und penalties of perjury, I declare that I ha e e amine this return, including accompanying schedule3 and statements, and to the best of my knowledge and belief, it is ,correct and complete. D ration f p parr they than the personal representative is based on all information of which preparer has any knowledge. SI AT~J~F~E OF PE ON FZES BL O FILIN R TURN _ TE . - -- ADD ~ ~~ SIGNATXIRE OF P ~A OTH R THAN REPRESENTATIVE / ADDRES ~` ~o Q ~ o.-~tc~tcv~' s r~ ~. c~-ti Pte- ~ ~o ~ 3 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 r,~-~;~ J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: Leonard R Hawkins 342-16-9357 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 ... .... . 4,152.99 6 . Jointly Owned Property (Schedule F) Q Separate Billing Requested ... 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property .... . (Schedule G) O Separate Billing Requested.... .... 7. 8. Total Gross Assets (total Lines 1 through 7) .. ...... . ................ .... 8. 4,152.99 9. Funeral Expenses and Administrative Costs (Schedule H} ..... . ......... .... 9. 443.50 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I} ......... . . .... 10. 11. Total Deductions (total Lines 9 and 10} .... . . ...... . . . . . ............ .... 11. 443.50 12. Net Value of Estate (Line 8 minus Line 11) . 13. .... . ..................... Charitable and Governmental Bequests/Sec 9113 Trusts for which ... 12. 3,709.49 an election to tax has not been made (Schedule J) ....... . ............. ...13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 3,709.49 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable 15. at lineal rate X .0 45 3,709.49. 1s 17. Amount of Line 14 taxable . 166.92 at sibling rate X .12 18. Amount of Line 14 taxable 17 at collateral rate X .15 18 19. TAX DUE ....................................... .................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 155610205 166.92 O Side 2 1505610205 REV-15UU EX {FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Leonard R Hawkins STREET ADDRESS 700 Walnut Bottom Road CITY _ STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 166.92 2. CreditslPayments -~---- ---- ----- --- A. Prior Payments B. Discount _ _ 8.34 Total Credits (A + B) (2) 8.34 3. Interest 4. !f Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3} Fill in ova! on Page 2, Line 20 to request a refund. (~} 5. !f Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 158.58 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 .............................................................................................................................. ^ 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? .............................................................................................................. ^ 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 ar 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 far 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(x)(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(x)(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(x)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood ar adoption. REV-15o8 EX+ (zi-iol ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ...v ~ n ~ ~ v~ . __._ FILE NUMBER: Leonard R Hawkins Include the proceeds of litigation and the date the proceeds were received by the estate. All property jaintiy owned with right of survivnrc{,in „,~~C* ~e ..~a..~,...~,, ...~ l+..L_d__1_ w " """ ` ~ru"- " "`-cuc~a, u~~ auui~iuiiai sneers or paper of the same size. ~ Pennsylvania OEPARTMEN7 OF REVENUE INHERITANCE TAX RETURN RESIDENT UECEUENT ESTATE OF Leonard R Hawkins Decedent'c rlahfe n,~~~r he rww..ra...l ~._ !~-L_J__~_ .. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER - - -r--- •~ ~«~....u~ uo~ uuwuunai ~ucc~~ VI ~1d~ef Oi Ifte Sd111E? SIZe. ~zfv-~~~~ ~x+ r;~~-~u; ~ pennsyLvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE BENEFICIARIES GJI/11C Vr': Leonard R Hawkins NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec, 9116 (a) (1,2),] 1 • Lindi Rae Griffiths 375 Hollowbrook Drive Carlisle PA 17013 2 Jo Dassing 12731 Poppy St Newport Richey FL 34654 3 Michael Hawkins 216 E Ridge Road Dillsburg PA 17019 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) daughter daughter son 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. FILE NUMBER: AMOUNT OR SHARE OF ESTATE 113 1/3 1/3 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ 0.00 If more space is needed, use additional sheets of paper of the same size.