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HomeMy WebLinkAbout06-14-11 (2) 1505611180 REV-1500 EX (02-1„(Fl) OFFICW. USE ONLY PA Deprhnarrt a Revenue Court Code Year Fits Number 9ar~a a trMividud raxea PO sox 28aeo1 INHERRANCE TAX RETURN n t~ HartiablrrD. PA 17128.0801 V ~) l~V RESIDENT DECEDENT ENTER DECEDENT INFOR~IATiON BELOW Social Security Number Date of D~th MMDDYYYY Date of Bath MMDDYYYY 195-20-6053 02232010 06202028 Decedent's Last Name Sulfa Decedent's First Name MI Clifford L Anthony L (ff Applicable) Enter SurvMnp Spouss's IMormatlon Below Spouse's Last Name Sufix Spouse's First Name MI Spouse's Social Security N1Nnber TE iIWTH THE REGISTER OF WILLS. FlLL IN APPROPRIATE BOXES BELOW ® 1.OripNral Rearrm 0 2. Suppkmerrlal Realm ~ 3. Remainder Retm (Deb a Death Prior b 12-13-a2) 0 4. Umited Estate ~ 4a. Future Inbr~t Compromise (date a Q 5. Federal Esbb Tax Retum Repaired death 8118r 12-12-82) ® 8. Deoederd Died Teateee ~ 7. DeoedeM tAairrtalnad a LNkrg Truat 8. Tool Number a Safe Deposit Bwres (Attach Copy a ~ (Attach Copy a Tnnt) 0 9. Litipedon Proceeds Received (] 10. Spousal Poverty Credit (Dees a Death Q 11. Election to Tax urxf~ Sec. 911a(n) Detvreen 1231-91 and 1-1-lie) (Attecfi Shcedale O) DOl~O1DE1R-TIa6 tN:C110N M1ET Be 001. ALL (X>ONDEIICE AND ©ONFAEMiML TAX iMWarATiON 8110111DBE OREC7ED TD: Name ~ytirrie Telephone Number Suzanne JOnes r~.s 7179752?9 ~, REGISTER O 8E O ~ ~ ~ r~ ~~ FirM Line of Address n C~~"_) 619 Good Hope Road 8 ~ Secant Line of Address _ ~~ ~ o ' c» City or Post Ofice Mechanicsburg State ZIP Code PA 17050 ComopolwMr-t's~a+allsddrws: LISAaHARTMANACCOUNTING. COM under penaltiss a p«jun. 1 declare Q1~ 1 have examined thk ream, aD aooorrgdryinp aciledrllen and >. ~3~!71 1505611180 1505611180 J P.O. BOX 342, GRANTHAM, PA 17027 T PLEASE USE ORIGINAL FORM ONLY 0 ~~,~ '~~ 1505611280 REV-1500 EX (Fp DecaderrYs Social Security Number UeceeenrsWan,e: ANTHONY L CLIFFORD L 195-20-6053 RECAPITULATION ,. Real Estate (sa,eduleA> ................... . . . ................... ,. 410000.00 2. stocks and Bonds (sctredule B) .................................... 2. 10 4 2 8 6.0 0 3. Glossy Held Corporation, Partrrerohip or sole-Prafrietorship (Schedule C) ... 3. N 0 N E 4. Morfgapes and Notes Receivable (schedule D) ........................ 4. NON E 5. Cash, Bank Deposits and Mieoellar>eoua Personal Property (Sctredule E) .... 5. 15 8 5 3 . D 0 - -- -- 8. Jointly Owned Property (Sdredule F) OSeparate Bilang Requested ....... 6. N 0 N E 7. Inter-Vnos Transfers & MieoeNarrfloua Non-Probate Property (Schedule G) OSeparate BiBng Requested ....... ~. N 0 N E 8. Togl Gress Aseeb (total Lines 1 throuoh ~ .......................... s. 5 3 013 9 . D D s. Funeral F~enaes and Administrative Costs (Schedub H) ................ 9. 6 2 6 7 9 . D D t o. Debts of Decedent, Mortgage tJabilities and wens (Sctredule I) ............ 10. 112 9 5.0 D 1 t . Total Deductions (total Lines 9 and 10) . . . .......................... 17 . 7 3 9 7 4.0 0 12. Net valor of Estate (Line 8 minus Line t 1) ........................... 12. 4 5 616 5.0 0 13. Charitable and Govemmerrtal BequesfslSec 9113 Trusts for which an election to tax has not been made (Schedub J) ...................... 13. D . D 0 14. Net value Sutrleet to Tax (Line 12 minus Line 13) ...................... 1a. 4 5 616 5 . D 0 TAX CALCULATION -SEE INSTRUC1ilONS FOR APPLICABLE RATES 15. Amount of Line 14 taxebk at the spousal tax rate. or transfers under Sec. 9116 (a)(7.2>x.o 0 75. D.OD 18. Amount of Line 14 taxable at linealratex.o 45 456165. DO 18. 20527.43 t 7. Amount of Line 14 taxable at sibling rate X . 12 17. D . D 0 18. Amount of Line 74 taxable at collateral rate X .15 , 8. D . D 0 19. TAX DUE ....................................................... 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 20527.43 0 L 1505611280 1505611280 J REV-150Q F~( (F~ Pape 3 Decedents Complete Address: 2110-0373 FNe Number 195-20-6053 DECEDENTS NAME ANTHONY L CLIFFORD L STREET ADDRESS 619 GOOD HOPE ROAD CITY MECHANICSBURG STATE PA ZIP 17050 Tax Paymenffi and Crediffi: 1. Tax Due (Page 2, Line 19) 2. CreditdPayments A. Prior Payments _ B. Discount 3. Interest Total Credits (A + B ) 4. M Line 2 is greater than Lirre 1 + Line 3, enter the difference. This is the OVERPAYMENT. Ffll In box on Pegs 2, Line m to rogrr•st a r•frwrd. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 20527.43 (2) 0.00 (3) (4) 0.00 (5) 20527.43 Makeyy check payable to: REGISTER OF W~A~ILLS, AGENT ~y^#3 ~z ry, e ^a'3"Y iz.rf' ~ ~ -- p"~` q'~~ ~r i u-Y ..~"~" 'YS {'lV ~~.~, n:,., ~i'",~"~s"~S kti~{v~"." e. .~~ '; ..~„~' .Yw'":i~: ~~~~~s,'~.i'Tr±~k-&ys~' ,ps~,~` ' ~k ,_<, c~n~Ye'a, ~ ~, ~ ~ .^w, ~.r' 4. ~.~ .~. ,_. ~:v~'~'a k'ka'~ ~"~f '~~ - ~ «W ~ 5%~ :9''~r'~. M .: PLEASE ANSWER THE FOLLOYYING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer arM: Yes No a. retain the use or income of the property transferred .........................................................................•--. .......... ^ b. retain the right to designate who shall use the Properly transferred or its inc:ome ................................. ......... ^ c. retain a reversionary inberest ................................................................................................................ .......... ^ d. receive the promise for IiFe of eitlrer payments, benefits or care? ......................................................... .......... ^ 2. If death occurred alter Dec. 12, 1962, did decedent transfer propeAy within one year of death without receiving adequate consideration? ................................................................................................. ......... ^ 3. Did decedent own an "in trust foP or payable-uponiJeath baMc axount or aecurily 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 LS YES, YOU MUST COMPLETE SCINcDULE GyAND~flgLE R AS PART OF THE RETURN. g Y ~ ~ .~ %~. ' - ~~ r ~.., „~ ;.1 ~' y~1,~F'`:f .,~'~'' ,`. ,~, rsk r~l~~"'d~,J;,'~,. ('~.~~~ .., ~,~~r'~,~~Y.~'~r~'~"~~Sa.r .~ r~'*.a',:~"~? ni~~ ~~~~""-at~' 5{: ~i~k %r5~v+~r~ +~. F.?.=, For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of trensfera to or for the use of the surviving spouse is 3 percent ]72 P.S. §9116 (a) (1.1) ()]. 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. §9118 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for dLgclosure of assets and fling a tax return are still applicable evend the surviving spouse is the only benefiaary. For dates of death on or after July 1,2000: • The tax Hate imposed on the rret value of transfers from a deceased child 21 years of age or younger at death to or for the rue of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(7.2)]. • The t2oc rate imposed on the net value of transfers to a for the use of the decedents lineal beriefxiaifes is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)]. • The tax rate impoNd 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 cwnmon with the decedent, whether by blood or adoption. REV-1502 EX* (01-10) Pennsylvania SCHEDULE A ~~ ,NHERfTANCE r~x RETi1RN REAL ESTATE RESIDENT DECEDENT OF: FILE NUMBER: AntlwrtY L Clifford 211 Q0373 ~r ~ propwlp owned solNy or as ^ 1nnrR M wmmon nest a nporlsd at ralr nwtwt vaka. Fatr maAcet value a der~bd as u,e price et wmcn property wouM ue e>acirer,ged between a wNNrp Days and a wrong saner. neiarer Deng oanpellea to ~ ar adl, doer havhg reasonable isrowkdgs a the rekvarR rata. ff more apace is needed, ~e additional meets of paper of the same sue. REV-1503IX+(668) co~wroNwEA~TN of rENNSnvANw INNERRANCE TAX RETURN SCHEDULE B STOCKS 8r, BONDS ESTATE OF FEE NUMBER Anthony L Clifford a ~~ ~.^, D 3 `7~ All propxty joNWyowrred nritlr right d survivorship must is di~clos~d on Sclrsduls F. ITEM ings Bonds: Series EE (1920 Share ~ 15.95) ~k of America (1496 shares): inns Bonds: Series E Closing Value 2/23/10= x15.94 per share VALUE AT DATE 39,299 30,624 23,646 10,517 (If more space is needed, insert additional sheets of the same size) rtEV-,soet:x*c"~'°' SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Arrthony L Clifford 211Q0373 Include the proceeds of Atipe<ion and the date the proceeds were received try the estate. ff moro space k needed. use additional sheets of paper of the same sme. REV-1511 EX+(10-09) Pennsylvania DEPARTMENT OF REVElaIE INFERRAtiCE TAX RETURN RESiDENr DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATNE COSTS ESTATE OF FILE NUMBER Anthony L Clifford 2110-0373 Decedent's debts must be nPorbed on Schedule 1. A. FUNERAL EXPENSES: 1. Keisinger Funeral Services 2. B. ADMINISTRATIVE COSTS: 1. Personal RepraaeMetlve Commissions: Name(s) of Personal Represer~Ove(s) Suzanne JOnes Street Address 819 Good Hope Road City tdechanicsburfl Staee PA zlP 17055 Year(s) Commission Paid: 2011 2. 3. 4. 5. 6. 7. AtEorney Fees: Family Exemption: (H decederns address is not the same as dWrrrenrs, attach exp'anstlm.) Cla11r1aM Street Address City Stele Refatiorrahip of Claimant b DeoedeM PmbaEe Fees: AmouMaM Fees: Tax Retum Preperer Fees: Intrestrraent Upkeep F_xpettse (Home) TOTAL (Also enter on Line H more space is needed, use additional sheads of paper of the same size. ZIP 7,805 1,700 39,760 1,000 494 11,293 27 600 REV-1512 EXa (12-08) Pennsylvania OEPARRYENf OF REVENUE INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILRIES 8~ LIENS ESTATE OF FILE NUMBER Anthony L Clifford 2110-0373 R.port a.tie. IRCI.rsa ~y u» a.o.a^e ~ eo aan u~.c ~.Rah.a ~n•~a ~ n~. m~. a a.,m, xy w..l~.~.a n~.,upa~e. REV-1513 EX+ (01-10) penlnsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RES10ENr DECEDENT ESTATE OF: FILE Nl1MBER: Anthon L Clifford 2110-0373 RELATIONSFgP TO OECEDENr AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Nd Lbt Trustss(a) OF ESTATE 1 TAXABLE DISTRIBUTIONS [k~chde outripM detributiaa and Uanarels under Sea 9116 (a) (1.2).) 1 ~ Suzanne T. Jones 619 Good Hope Road, Meclanicsburg, PA 17050 Daughter Twenty-Five % 2' Anthony L. Clifford Son Twerlly-Five % 3040 Arcadia Avenue, Allentown, PA 18103 3. Patrick J. Clifford 4519 Wentworth Avenue, Minneapolis, MN 55419 Son Twenty-Five % 4' Samuel O. Carpenter Grandson Twenty-Five % 713 Peralta Avenue, Berkley, CA 94717 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS S110WN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, AS APPROPRWTE. 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. TOTAL OF PART q -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ 0 M more speoe is needed, use additlond shears of paper of tl~e same size. RE1/-1511 l:X ~ (10.09) Pennsylvania I)EPARThEMr of REVENUE INHERRANCE TAx RETIJFeI RESS~Nr oECEOErrr SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATNE COSTS --- E8TATE OF FILE NUMBER Arltlwrty L Clifford 2110-0373 DeeedsrtCs delNs must be rsttorbed on Schedule I. ITEM A. FUNERAL EXPENSES: 1. Keisittger Funeral Services 2. 2. ~ Albnley Fees: 3. Family Exemption: (tt decedents address is not the Sams ~ daim~lYs, attach axplansdon.) Claimant SVeat Address City State ZIP Reladorlsldp d CfsNnard b Deoadard 4. Probate Fees: 5. AocaxRant Fees: 6. Tax Return Preparer Fees: 7. Investment Upkeep Expense (Home) Also enter on Line 9 7,805 1,700 1,000 494 11,293 27 600 If more space is needed, use additional sheers of paper of the same sig.