The URL can be used to link to this page

Home My WebLink About04-13-111505610140 REV-1500 ~` ~°'-'°) PA Department of Revenue ~ -~~~f~~~~~~~~ i.=s~ :av, Bureau of Individual Taxes County Cade Year File Numlter Po Box z8D6D1 INHERITANCE TAX RETURN Harrisbu PA 17128-0601 RESIDENT DECEDENT 2 1 1 0 0 6 1 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 1 6 6 2 0 5 6 6 1 0 2 1 3 2 0 1 0 1 2 2 3 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name S H U L T Z MI P A U L G (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI S H U L T Z T H E R E S A Spouse's Social Security Number P THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death ^ 4. Limited Estate pnorto 12-13-82) ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Retum Required ® death after 12-12-82) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ^ 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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number T H E R E S A P S H U L T Z REGISTER OF WILLS USE ONLY First line of address 5 0 4 E K E L L E R Second line of address City or Post Office M E C H A N I C S B U R G S T R E E T State ZIP Code P A 1 7 0 5 5 r„~ ~~ z~ r ~C/)~ W :.. ..7 C.:a ILED -~ - Ti --I ~ '~ = rn ~~ ~ Correspondent's e-mail address: Under Penaltles of perjury, I declare that I have examined this return, including accompanying sehedubs and statements, and to the best of my knowledge and belief, it Is true, correct and complete. Deciaretlon of preperer other than the personal representative is based On all infonnatlon of which preparer has any knowledge, SIGNATIJRIyypF PERSON R~ SIf3FjE F„OR FIJ,ING RETURN •,~~®isa.r.c S/ 1/ /S'T' .DATE i - - .--~ HERESA P• SHULTZ, 504 E• KELLER ST MECHANICSBURG PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE U3E ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J a ,J 1505610240 REV-1500 EX Decedent's Social Security Number Decedem's Name; PAUL G• S H U L T Z 1 6 6 2 0 5 6 6 1 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. 8 2 2 4 , 0 0 6. Jointly Owned properly (Schedule F) ^ Separate Billing Requested 7. .... Inter-Vlvos Transfers & Miscellaneous !~ Probate Property (Schedule G) ... 6, ^ Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................ ... 8. 8 2 2 4 , 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ..... ........... .. 9- 1 1 4 3 9. 0 0 10. Debts of Decedent, Mortgage Liabilitles, and Liens (Schedule I) ........... .. 10. 11. Total Deductions (total Lines 9 and 10) .......... . .................. .. 11. 1 1 4 3 9 . 0 0 12. 13 Net Value of Estate (Line 8 minus Line 11) ......... ................. Charitable and G ..12. - 3 2 1 5. 0 0 . overnmental Bequests/Sec 9113 Trusts for which an electlon to tax has not been made (Schedule J) .................... .. 13. 14. Net Value SubJect to Tax (Line 12 minus Line 13) ...... ............. ... 14. - 3 2 1 5. 0 0 TAX CALCULATION SEE - INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 16. Amount of Line 14 taxable at lineal rate x .0 0. 0 0 18, 0 0 0 17. Amount of Line 14 taxable . at sibling rate X .12 0. 0 0 17. 0 0 0 18. Amount of Line 14 taxable . at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ......................................................19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505610240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: G. E. CITY 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 Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. File Number 21 10 0611 STATE ZIP PA 17 (1) 0.00 Total Credits (A + B) (2) 0.00 (3) (4) 0 00 (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 w income of the property transferred : ........................ .............................................. b. retain the right to designate who shall use the propeAy 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 December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......... ................................................................. 3. Did decedent own an 'intrust for' or payable-upon~eath 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 benefiaary 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) p2 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)]. 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 + (8-gg) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ITEM NUMBER SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Indude the ppnxeeds of li6gadon and All orooafir bIMlv.ewnnA ~ ~..~,. NEW CUMBERLAND FEDERAL CREDIT UNION CHECKING 2• 12002 CHEVROLET MALIBU 4 DOOR SEDAN the sere received by the estate. be discbeed on Schedule F. I VALUE AT DATE OF DEATH 4,106.00 4,118.00 TOTAL (Also enter on line 5 Recapitulation) 19 (If more space s needed, insert add~6onal sheets of the same size) REV-1511 FJ(+(10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS Decedents debts must be reported on Schaduk I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: ~• MALPEZZI FUNERAL HOME AMOUNT 11,439.00 B• ADMINISTRATIVE COSTS: ~ • Personal Representative Commissions: Name(s) of Personal Representative(s) THERESA P. 3HULTZ (RENOUNCED) Street Address 504 E. KELLER STREET City MECHANICSBURG State PA ZIP 17055 Year(s) Commission Paid: 2. AttomeyFees: MURREL R. WALTERS, III 3. Family Exemption: (If decedents address is not the same as GaimanYs, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 5• Accountant Fees: s• Tax Retum Preparer Fees: 7 TOTAL (Also enter on Line 9 Recapitulation) I S If more space rs needed, use additional sheets of paper of the same size. 0.00 REV-1513 EX+ (01-10) NUMBER I. 1 Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT OF: SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY E DISTRIBUTIONS [Include outnpht s sal distributions and transfers under Sec. 91 f6 (a (~1.2).] THERESA P. SHULTZ 504 E. KELLER STREET MECHANICSBURG, PA 17055 Do Not List FOR DISTRIBUTIONS LINES 15 THROUGH 18 OF A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II .ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET If more space is needed, use additional sheets of paper of the same size. IUNT OR SH OF ESTATE AS S