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Home My WebLink About06-09-11 1505610105 REV-1500 °` ~°~-11 ' (Ft> OFFtC1AL USE ONLY PA Department of Revenue ~ County Code Year Fle Number Bureau of Individual Taxes PO BOX 28o6oi INHERITANCE TAX RETURN ` CE ENT ~I ~ ~ ' ~~~~( Harrisburg, PAi~i28-o6oi RESIDENT DE D . .,~, ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW 189-09-1716 09/11/2010 04/12/1915 Decedent's Last Name Suffix Decedents First Name MI Bahn Ethel E (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 FILL IN APPROPRIATE OVALS BELOW O 1. Original Retum O 2. Supplemental Retum O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a Future interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) m 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Wili) (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 T0: Name Daytime Telephone Number Russell R. Bahn (717) 732-2692 , n First Line of Address 936 Woodridge Drive Second Line of Address City or Post Office Enola Correspondent's e-mail address: Rbahn@aOLCOm State ZIP Code PA 17022 REGISTER OF~C~ USE ON~Y ~ ~ r t C` rn ~= I .-~~~ to ~ O ~ ~: ~ ~ c~ DATE FILED fV :.~ L~ ;`i 7 - . .~ _.~.~ -:~:~ r-_ rTt L~ Under penalties of perjury, 1 deGare that I have examined this return, including accompanying schedules and statements, and to the hest of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P ON RESPO SIBLE F R RN DAT .~.~- ~ ~ e ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATI DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 ~.--_.~ ii 1505610205 REV-1500 EX (FI) Decedent's Name: Ethel E. Bahn Decedent's Social Security Number 189-09-1716 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 3,071.00 6. Jointly Owned Property (Schedule F) O 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. 3,071.00 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 2,071.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......... ..... 10. 0.00 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 2,071.00 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. 1,000.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. 1,000.00 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 15. 16. 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 collateral rate X .15 18. 19. TAX DUE ......................................................... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J REV 1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENTS NAME Ethel E. Bahn STREET ADDRESS 801 N. Hanover St CITY Carlisle STATE ~p PA 17022 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.00 4. If Line 2 is greater than Line 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. (1) Total Credits (A + B) (2) (3) (4) (5) 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" 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 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 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 benefaary. 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 decedents lineal benefxtiaries is 4.5 percent, except as noted in [12 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedents 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-i5o8 EX+ (u-io) ~~i Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: ETHEL E. BAHN SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY FILE NUMBER: 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 nn schpd~do F Ir more space is needed, use atltlitional sheets of paper of the same size. REV-1511 EX+ (10-09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF ,~ ~ / FILE NUMBER E~i~l=-~ 1,~ ~-~ ~-~ IV . Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Malpezzi Funeral Home 415.00 Malpezzi Funeral Home 748.00 Rolling Green Cemetery 285.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State _ ZIP 2 3 4. 5. 6. 7. s Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Transfer of Funeral Plots Executor expenses Inheritance Tax Return ZIP 71.50 240.00 296.50 15.00 TOTAL (Also enter on Line 9, Reppitulationj I $ 2,071.00 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ETHEL E. BARN RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1~ Russell R. Bahn Son 0 2 Chester H. Bah Son 0 3 Mary A. Bahn Daughter 0 4 Stephen J. Bahn Son 0 5 S. Elizabeth Bajhn Daughter p 6 John M. Bahn Son 0 7 Norma J. Klock Daughter 0 8 Cheri L. Haimowitz Daughter 0 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. First Church of God, 28 E. Main St., Mechanicsburg, PA 1000 First Church of God Community Center, Green Street, Mechanicsburg Pa p Christian Life Assembly, 2645 Lisburn Road„ Camp Hill, PA 0 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I ~ 1Q00 If more space is needed, use additional sheets of paper of the same size.