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Home My WebLink About04-11-11 1505610105 REV-1500°`t°~u'~"~ OFFICIAL ONLY R4 Department of Revenue ~ Yer Fde Number Bureau of Individual Taxes INHERITANCE TAX RETURN CauKy Code PO BOX 2flOGOi ' O /~Q Harrtsbura. Pi4 i7~28-o6ot. RESIDENT DECEDENT ~~ ~ ' p( 3 ENTER DECEDENT INFORMIATION BELCa1N Social Security Number Date of Death MMOOYYI'Y Date oT Birth MMDDYYYY 198-22-8253 .10/18/2010 09/04/1927 Decadence l.a6t Name SuIBx Decedent's First Name.... MI _ _ _ __ BEAM I MINERVA ' A (N AppllcabN) Eller Survlvhrp Sporrae'a Infornratlon BMcw Spouse's Lest Name Suffix Spouse's First Name MI _ _ _ _ _ __. N!A N/A __ _ _ _ _ Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW OTO 1. Original Return nus tsEEtuRN MusT eE ~ w ouPLlcr-rE wlrll rnE REGISTER OF WILLS O 2. Supplemenml Return O 3. Remainder Return (Date o7 Deam Prior to 12-73-82) QD 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federel Estate Tax Return Required death after 12-12$2) On B. Decedent Died Testate O 7. Decedent Maintained a Living Tnlat 1 8. Trial Nurrlber of Safe Deposit Boxes (Attach Copy o7 WM) (Attach Copy of Trust) O 9. Litlgatbn Proceeds Received O 10. Spousal Poverty Crept (Date of ueam O 1t. Election eo Tax urMer Sec. 8113(A) Between 727-91 and 1-1-95) (Attach Schedule O) CORRE SPONDENT - THN SECTION MUST HE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORYATfON SHOULD BE DETECTED TO: Name Daytime Telephone Number __ Karen Ammerman ; (717) 249-6782 RratlJne 07 Address 4-0u8_Burgner~syRoad SOWIN ~ of Address City or Post OIDoe Carlisle _. State ZIP Code _... Y h=... .... IQ l ? J Ss mi~ / +.~~~ -° r ~ G~ ~~ (~'l -x.7 ~O r ~^ V ~ iI ~ nn~ QATE Fl ~ ~~ LED 7 ~ ra ~iuio CornapondenYs e~all addnsa: Vamplre~pa.rlet under paneltles d par}xy, I dsdare that I treve examkred fns reban, krdudkg aeeomprlyYrg adladulea and at~arnerrts, and b me base oI my Ivxrvledge arrd bafleT, a b bus, cones and complete. Dedaratlorl ae praprsr carer men the peroorrel rcpraserrtetlve Y based an eN krbrrrwdon oT yNlich proprer has srry lcrowledga. SIGNATU PERSON R~ONSIBLE FOR FILING RETURN DATE ~' ter- %/„ ° `_ 04/11 /2001 408 Burgners Road, Carlisle, Pa. 17015 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE pA7E ADDRE33 -._ PLIEASE ufos~ otelalwu. FORM ONLY Side 1 1505610105 1505610105 J l!~^`\ll ~. T~ T7 ~w J 1505610205 RE1h1500 EX (FI) DeoedenYs Soaal Security Number _.__ oecedsrri's ~: Minerva A. Beam 198-22-8253 RECAPITULATtoN 1. RBI Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Sriredde B) ....................................... 2. 3. Gasey Held Corpora8on. Partnership or Sole-Proprietorship {Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash. Bank Deposits and MisoaAaneous Personal Property (Srdredule E)....... 5. ' 7,709.04 ._ _ 6. Jointly Owned Property (Schedule F) O Separate BiNing Requested ....... B. 7. Inter-Vlvos Transfe-s & Misreous Non-Probate Property __. _ (Schredule G) O Separate BlNing Requested........ 7. 8. Total Gross Aaasts (total Lines 1 through 7) ............................. 8. 7,708.04 9. Funeral Expenses and Admin~atlve Costs (Schedule H) ................... 9. '; 8,282.08 10. Debts of Decedent, Mortgage Liabilities and Liens (Sole I) ............... 10. ', 8,981.16; 11. Total Dsductlona (trial Lines 9 and 10) ................................. 11. 17,263.24 12. Nat Valve of Estate (Line 8 minus Line 11) .............................. 12. ! -9,554.20 13. Charitable and Govemmerrfal Bequests/Sec 9113 Tniets for which an ebcUon to tax has not been made (Sdredule J) ........................ 13. 14. Net 1/aN~s eubjsct to Tax (Line 12 nanus Lure 13) ........................ 14. -9,554.20 TAX CALCULATION - 8EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at th spousal tax rate. or trarrefers under Sec. 9116 (ax1.2) X .0_ 15. _. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable _ at sibling rate X .12 17. ' 18. Amount of Line 14 taxable at onNateralrate X .15 18. 19. TAX DUE ...................... ................................... 19.' 20. FILL Mi THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 1505610205 Slde 2 0.00 . O 1505610205 J REV-1500 EX (Fq Page 3 Decedent's Complete Address: S NAME Minerva A. Beam SfREETADDRESS 16 South Enola Drive Apt 305 ~' Ends STATE Pa AP 17015 Tax Payments and Credits: 1. Tax Due (Page 2, Lire 19) 2. CreditslPaymeMs F71• Nmnbsr (1) A. Prior Paymerds B. Dbcount 3. Interest Total Credits (A + B) (2) 4. ti Line 2 is greeter than Line 1 + Line 3, solar the dfierenoe. This is the OVERPAYIENT. FlN In Duel an Papa 2, Lln• 201o request a nrurai. 5. tf Line 1 + Line 3 is greeter than Line 2, enter the dfiererlos. This is the TAX DUE. (3) (4) (5) 0.00 Make check payablee~ to: REGISTER OF WILLS, AGENT. .h t, .; ',+ Y ..~. .:~. ~ e~7 ~~ 1~~~ % ~ dP,:~ # -Nh,s i.,!"T'_.,~.~',_~k,':*i ~~~k„''~"1e3~'$ n~, `~i~'~i x~~+~~ r~X"a"i&r ~ ~ ..~'sc-, # ~" ,.'~k- .. e a* ~. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes Wo a. relafn the use or irxxxne of the properly trarlsferred .......................................................................................... ^ ^ b. retain tits right to designate who shat use the property transferred or ks incolrle ............................................ ^ ^ c. retain a reversarery inierest .............................................................................................................................. ^ ^ d. receive the promise for Nfe of eitiler paymerrffi, benefits or care? ...................................................................... ^ ^ 2. ff death oocumed sitar Dec. 12, 1952, did decedent transfer property within one year of death wdhout receiving adequate consideration? .............................................................................................................. ^ ^ 3. Did decadent own an "intrust for or payable-upon-0eath bank account or seclnihr at Ms or her death? .............. ^ ^ 4. Did decedent own an individual retirement accolmt, annutty or other rxxFprobate properly, which contains a berleiciary desi9natiorl? ........................................................................................................................ ^ ^ IF THE ANSWER TO ANY OF THE ABOVE QI~STIONS IS YES, YOU INlST COiiPLETE SCHEDULE G AND FlLE R AS PART OF THE RETURN. :3 ~ ~+~'u ~~5;'v~f„„*t' ~ ,?:z`" ' ~ M ' `:sa`xit , x~ ~ ~~. '~~ ~ ~ :~~' ,a : r.:sc t wrc 3 , sc.~ :k.s s y„. x,Y; ~ s u ~~ ~ ~ ,~ a xF ~f ~~. }. ~~ .'". ~x+ ; For dates of deatil on or attar July 1,1994, and before Jan. 1, 1995, the fax rata imposed on the net value of transfers to or for the use of the surviving spouse is 3 peroerd [72 P.S. §9116 (a) (1.1) (~]. For dates of death on or attar Jan. 1, 1995, the lax rate imposed on the net value of transfers bo or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (x)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutay regtrirenlertts fa disdosure of assets and filing a tax return are st01 applicable even 'd the surviving spouse is the only benefiaary. For dates of death on a after Juy 1,2000: • The fax rata imposed on the net value d trar~fers fiom 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 tits Chgd i5 0 pen>erd [72 P.S. §9116(aX1.2)]. • The tax rate imposed on the net value of transfers b a for the use of the decederlcs lineal benefidaries's 4.5 percent, except as noted in [!2 P.S. §9116(a)(1)]. • The fax rate imposed on the net value of transfers to or for the use of the decadence sidings Ls 12 percent [l2 P.S. §911ti(a)(1.3)]. A sibling La defined, under Section 9102, as an individual who has at least one parent in common with the decedent, vvhetiter by flood ar adoption. FEK1737->'IX * (609) pennsylvarria sc~a°uu ~ DEPARTMENT OF REVENUE ~~~ ~ ~~~~~/ Moarswaa Lu-s~ur~ss, • INFi91iTANCE TAx f1ETURN NONR6IDBfrOC{®Btr Use Schedule I, Part 2, ONLY far proportionate method of taz computation. ESTATE OF FILE NUMBER Minerva A. Beam 2010-01203 Part 1 must indude mortgage Iiabiliti~, liens and taxes against the Pennsylvania realty that were due and owed es of the date of decedent's death. ComoMb Part 2 ONLY when fha orooortbrrate method ei tidy cemoulftinn ~ .~..t_ .• rtEAI NU96ER nESCR~nON AMOUNT 1 • Departrnent of Public Welfare (dass 5.1) 6,244.76 2. Asoensionpoint Recovery Services LLC (Blair) 1,212.63 3. Ascensionpoint Recevery Services LLC (Haband) 554.08 4. Plnfessional Credk Services (PCS) (Consumer Cellular) 211.87 5. Comcast 8.94 6. Debt Recovery Solutions LLC (DRS) (Sprint) 90.39 7. IC Systems Inc (Verizon) 13.19 8. IC Systems Inc (Verizon) 281.13 TOTAL lM~~ 1 .,. s 8,618.8! rt~t NuMtI~N llE3(X2PTION AMOUNT t• Hartzell Eye MDS 100.00 2. Genzyme 264.17 ~~ M~ _ ; 364.17 TOTAL Also enter an Line 10, RecapilulaUon.) s 8,881.16 trt more space ~ neeaea, use addNiorral sheets of paper of the same size) 'REK1737"jbc+ce-0e1' REVERSE Pennsylvania sCM~01/1iN J DEPARTMENT OF REVENUE s^NiEIpAlI~S DtF19iITANCE TAX REnXOt ESTATE OF FILE NUMBER Minerva A. Beam 2010-01203 When flat rate method is elected, list the beneficiaries of the Pennsylvania property. When proportlonate method is elected, list aN ttenefir~aries. NI11~R I NAME AND ADDRESS OF PERSON(S) RECEMt~ PROPERTY I Do NotELlat s 1 I TESTA I. I TAXABLE DISTRIBUnON3 (Y~chrde ouspM epoued dlaYbutlor~e snd traiaters under Sec. 2118 (aJ(12)J 1. none 6. ENTHt DOLLARAMOlINT3 FOR d3iRiBUnONS Srt04VN ABOVE ON RE\F1737 COVER SHEET OR THE PROPORTWNAIE MIETHOD YiIORICSiEET ON THE REVERSE SIDE OF FAY-1737 COVER SHEET, AS APPROPRUITE. II. NONTAXABLE DISTRIBUTONS: A SPOUSAL DISIRIBUTgN3 UNDER SECTION 2113 FOR WHX;FI AN ELECTION TO TAX 18 NOT BEXiG MADE none B. CHARITABLE AND G01A~IMOiTAL DISTRIBUTIONS ~• none TOUL OF MRT II X0.00 (Enter total non-taxable dlalribulbns on Line 13 of REV-1737 cover sheet.) (If more space is needed, use additional sheets of paper of the same size) NEV~oc+(s~oe) Pennsylvania DEPARTMENT OF REVENUE tNF61ITANCE r~x raTtraw NoNl~smarroEC~Nr sCNSnu~ N I~uNSlew~ oc'^NS~s a AOMINISTRATIY^ COSTS Use Schedule H ONLY for proportionate method of tax computation. ESTATE OF FILE NUMBER Minerva A. Beam 2010-01203 Debts of dsosdsnt must bs nPorbd on Schedule 1. ~~~ ~~ AMOUNT A. FlM1ERAL EXPENSES: 1' Graveside Service 3,660.00 Merchandise (Truman) 1,155.00 Greve liner 935.00 Bronze Plaque on Grenet 800 ~ Notices 300.00 Flowers, Cemetery Fees, 6 Death Cert. 303.30 B. ADMINISTRATNE COSTS: t. Personal Repreeentaure'a Canmi~ion(s) 300.00 Name(s) of Psreonei Rapreserdatire(s)Ksren Ammerman (sutenit requested irbnnatlar fa addWeonel penenel repreeentatlve~s on eddiuond sheets) SoGal Sassily Number(s) or EIN Number(s) d Pereenal RepreaenlaWe(s) ~p~~~)408 Burgners Road ~Y(iee) Carlisle ms(s) Pa ZIP(s) 17015 Year(s) Commiaebn Paid 2011 ?? 2• Attorney Fees 703.78 3• Probeb Fees 125.00 4• Axasdent's Fees 0.00 5• Tau Return Properer's Fees 0.00 ti. ~ Mi6oeManears E~ermea TOTAL (Also enter on Line 9 Recapitulation) ~ ~ 8,282.08 (If more space Is needed, use additional sheets of paper of the same size) REV-1737 EX r (6.08) r Pennsylvania DEPARTMENT OF REVENUE tHr~trraRCE Tax RETtIw+ NorrrFSroatr DECEOErtr ~N~pV~ ~ Use Schedule G, Part 2, ONLY for IN1'tR-YIYO: TIAN~R: O p-oportionate method of tax computation. MIfC. NON-PROSAti ~ROMlTY E8TATE OF FE.E NUMBBt Minerva A. Beam 2010-01203 Part 1 must irtdude aN trensfers of real estate and tangible personal property located in Pennsylvania. CompiaM Part 2 ONLY when the proportiorrata method of tax computation is eled~d. Indude in the description of property the date the transfer' was made artd the name and relationship of the trensferee. This schedule mast be corttpleted and flied if the answer to questions 1 through 4 on the reverse side of the REV 1737 Dover sheet is yes. rrEw I baDde the name d ~ r. ib ~ale~awap_ _ boeo.a~rr a~a rb aab d o~rer. I oaTE of DEATH 1. i-i:• DESCR1Frtott of FROFERrr Nxide the reme d the Yanetree, the n48oidYp b Deoederri and eie deM d hemkr. DATE OF DEATH Attach a ooDV d tlM deed for nrd eemle. VALUE OF A39E'I ExcLUSXxr s EXCLUSION vALt>E o.oo TAXABLE VALUE IMRT s ,rte I s I _ I_; I s 0.00 TOTwL (Also enter on Una 7, Recapitulation.) I: 0.00 (N more space is needed, use additional sheets of paper of the same sae)