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Home My WebLink About08-05-11 (2) 1505610148 '~ REV-1500 Ex t°'-'°' PA Department of Revenue CFFICUU-USE ONLY Buroau of Individual Texas County Cade Year Fila Number PO BOX 29°8°1 INHERITANCE TAX RETURN 21 10 1181 Hartisburg, PA 17129-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 048-16-3158 11062010 08151922 Decedent's Last Name Suffix Decedent's First Name M I WELKER CAROLYN S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRUITE BOXES BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death ^ 4 Li it d E t t ^ prior to 12-13-82) ^ . m e s a e 4a. Future Interest Compromise (dale of 5. Federal Estate Tax Return Required 6 Decedent Died Testate ^ death after 12-12-82) 7 D d t M i t i d Li i T . (Attach Copy of Will) . ece en a n a ne a v ng rust (Attach Copy of Trust) _ 8. Total Number of Safe Deposit Boxes ^ 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 8ECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION 8HWLD BE DIRECTED TO: Name Daytime Telephone Number PETER J• RESSLER, ESQUIRE 717-232-5D00 First line of address 3401 N FRONT STREET Second line of address PO BOX 5950 City or Post Office HARRISBURG State ZIP Code PA 17110 REGISTER OF WILLS USE ONLY ,.,~,y c_ ~~ ~~ ~ ~~r-- c-, r~ ~:, zrn f ,. ' r"~ cr: ' ~ ;i ' , , ,1l~ ILED ~-+ n.) .~ ~? `?~ _~ ~ ~~~ c. cor-eapondencse-manaddroaa: PJRESSLERaMETTE•COM Under penaltlsa of perjury, I declare that I have examined this return, induding accompanying schedules and ahtamenU, and to the beat of my knowledge and belief, it is We, correct and complete. Dedarotion Of proparor other than the pereanal representative is based On all infannation Mwhich proparer has any knowledge. PETER J• RESSLER 3401vN• FRONT STREET, PO BOX 5950 HARRISBURG, PA 17110-0950 SIGNATURE OF PREPARER OTHER THAN REPR TIVE DATE PETER J • RESSLER ~._,,~ /~ _ _ p, ,, _ ~i ~~„ ADDRESS 3401 N• FRONT STREET, PO BOX 5950 HARRISBURG, PA 17110-0950 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610148 aM4a174.000 1505610148 ~ ~~ ~o~u ~ ~~ ~ ~ ~~ J REV-1500 EX 1505610248 Decedent's Social Secudty Number 048-16-3158 __Decedent'sName: WELKER ARO YN Q RECAPITULATION 1. Real Estate (Schedule A) .. .. .. , 2. Stocks and Bonds (Schedule B) . .... ..... .... ......... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , g 4. Mortgages and Nates Receivable (Schedule D) .... .. 4 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5, 8. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .... 7. 8. Total Gross Assets (total Lines 1 through 7) 8 9. Funeral Expenses and Administrative Costs (Schedule H), • 9 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) , 10 11. Total Deductions (total Lines 9 and 10) , .. 11 12. Net Value of Estate (Line 8 minus Line 11) ...... 12 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , 13 14. Nat Value Subjaet to Tax (Line 12 minus Line 13) ... 14 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un er Sec. 9118 ~ (a)(1.2) X .0 o • o 0 15. 18. Amount of Line 1q ~xable at lineal rate X .0 - o • o 0 18. 17. Amount of Line 14 taxable at sibling rate X .12 ~• ~ ~ 1 ~. 18. Amount of Line 14 taxable at collateral rate X .15 4 6, 8 9 4. 6 2 18. 19. TAX DUE .. ... 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 150561U248 Side 2 1505610248 a.oo 5,362.46 0.00 o.oo 20,329.76 o.oo 50,441.82 76,134.04 16,780.33 12,459.10 29,239.43 46,894.61 o•oo 46,894.61 o•oo 0.Oo 0.00 7,034.19 7,034.19 9M4848 4.000 RSV-1500 EX Pape 3 FlI• Number Decedent's Com lete Address: 21 10 1181 DECEDENTS NAME STREET ADDRESS CITY STATE ZIP A Tax Payments and Credits: t. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 5 , 0 0 0.0 0 e. Discount 2 6 3.16 3. Interest (1) 7,034.19 Total Crodila (A + B) (z) 5 , 2 6 3.16 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill In box on Page 2, line 20 to request a refund. (3) _ ~ . ~ ~ (4) 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; ar ...................... ^ d. receive the promise for life of either payments, benefits or care? ........... ^ 2. I} death occurred after Dec. 12, t 982, did decedent transfer property within one year of death without receiving adequate considerationT ............................ . ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account ar security at his or her death? . ^ 4. Did decedent own an individual retirement account, annuity, or other non-probate property which , contains a beneFlciary designatlon? ......... ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN StM a ~ . I~ i t _dE~vk..irv.M Vre .. r For dates of death on or after July 7, 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. §9118 (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 ff the surviving spouse is the only benefiaary. Far 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. §9118(a)(1.2)]. • The tax rate Imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9118(a)(1)]. • The tax rete 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. 9M4a71 2.000 REV-1503 EX ~ (8.OB) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER CarolSS1 S. Welker 21 10 i ~ ai All property jointly-owned with right of survivorship must be d'ucbsed on Schedule F. 3wesss ~.ooo (If more space is needed, insert additional sheets of the same size) REV-7508 EX • (&80] SCHEDULE E COMMONWEALiHOFPENNSYLVANIA CASH, BANK DEPOSITS, F~ MISC. I ~~ E EA~R~EtNRN PERSONAL PROPERTY FILE NUMBER 3Wleno 7.000 pf more space ie needed, insert addiliond sheets of the sane size) REV-1510 EX + (08-0a) Pennsylvania DEPARTMENiOFREVENUE INHERRANCE TAX RETURN RESIDENTDECEDENi SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY VF Carolyn 3. Welker 21 10 1181 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBE DESCRIPTION OF PROPERTY MlC11LIETlENWEOF7IETWVEFEREE,TIEIRREUTIONBNPTODECEDEMAW AE OAIE OFTRMaFHL ATfApiACOP'i OF TiE D[FA FOR REAL ESTATE pATEOFDEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION IF APPL1CABl TAXABLE VANE ~• Jackson National Annuity Contract Number 0059261880 5,000.00 100.0000 0.00 5,000.00 Beneficiary is Peter J. Ressler Interest accrued to 11/6/2010 75.25 100.0000 75.25 2 Genworth Annuity Policy MT069134894 Beneficiaries: Peter J. Ressler, Rutki Grafius and Louise Faust 45,366.57 100.0000 0.00 45,366.57 TOTAL (Also enter on line 7, Retxpitulatlon) E 50 d41 82 Ir more space is needed, use addRional sheela at p~apar at the sme size. BW4ttAF 2.000 REV-1511 EXf'(1o-0B) SCHEDULE H • pennsylvania OEPPRIMEMOF REVENUE FUNERAL EXPENSES AND M1NERfTANCE TNC RETURN ADMINISTRATIVE-COSTS RESOENT DECEDENT • ESTATE OF FILE NUMBER Carolyn S. Welker T Tni~ai Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. Farrow Funeral Directors 9 405.50 B. t ADMINISTRATNE COSTS: Personal Representative Commissbns: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State ZIP 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same es Gaimant's, attach explanation.) Claimant Street Address 4. 5. 6. 7. 1 2 City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Miac Costa (Photocopy, Telephone, Telecopy s Postage) Register of Wills - Filing Fses 7,147.50 106.50 43.83 75.00 _ TOTAL (Also enter on Line 9 Recapitulation) ~ $ ew4snc z.oao If more space is needed, use additional sheets of paper of the same size. REV-1512 EX ~ (12.08) Pennsylvania OEPAR7AEMrOF REVENUE NHERITANCE TAX RETURN ESTATE OF SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE Carolyn 3. Welker 21 10 1181 Report debfa Incurred by the decedent prio- to death that remained unpaid at the date of death, including unreimbursed medical expensaa. ew4sAH z.oac If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) Pennsylvania DEPARTM?lTOF REVENUE INHERRANCE TAX RETURN RESIDENTDECEDENi SCHEDULE J BENEFICIARIES FILE NUMBER: e 21 1 1181 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 disbibutians and transfers under Sec. 9116 (a) (1.2).] 1. Peter J. Ressler 2900 Ancona Road Mechanicsburg, PA 17055 One Third of Residue: 15,631.54 Cousin 15,631.54 2 Ruth R. Grafiua 7501 East Thompson Peak Parkway Apt. #244 Scottsdale, AZ 85255 One Third of Residue: 15,631.54 Cousin 15,631.54 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE515 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. II NONTAXABLE DISTRIBUTIONS A SPOUSAL DLSTWBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 0.00 BW18A12.000 ~~ i~iu~e ayai;c is iioouw, usn aau~uvna sneer m paper Or [ne same size. Estate of: Carolyn S. Welker Schedule J Part 1 (Page 2) Item No. Description 3 Louise R. Faust 6936 Dogleg Way Fort Myera, FL 33919 One Third of Residue: 15,631.54 Cousin Relation 21 10 1181 Amount 15,631.54