Loading...
HomeMy WebLinkAbout08-03-11 (2)• ~ 1505610140 REV-1500 ~` t°'~'°' PA Department of Revenue OFFICUIL USE ONLY Bureau of Individual Taxes County Code Year FNe Number PO BOX 28t~01 INHERITANCE TAX RETURN f1 C Harrisburg, PA 17128-0801 RESIDENT DECEDENT .~ ~ U ~ O ENTER DECEDENT INFORMATN)N BELOW Social Security Number Date of Death MMDDYYYY Date of Birth AMu1DDYYYY 1 8 6 2 8 6 8 6 9 0 7 1 7 2 0 1 0 0 7 1 7 1 9 3 6 Decedent's Last Name Suffix Decedent's First Name MI Cor nman EI ai ne E (N Applicable) Erttsr Surviving Spouse's IrrFormatlon Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1.Original Retum © 4. Limked Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Lkigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 3. Remainder Retum (date of desttt prforto 12-13-82) 5. Federal Estate Tax Return Required 2. Supplemental Retum 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credk (dete of death between 12-31-91 and 1-1-95) 8. Total Number of Safe Deposk Boxes CORRESPONDENT - THIS SECTION MIST BE COM+LETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX NIFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Ri chard Cor nman 717 243 9709 11. Election to tax under Sec. 9113(A) (Attach Sch. O) First line of address 4 1 4 Bur g n e r s R o a d Second line Of address City or Post Office Car l i s t e State ZIP Code L PA 1 7 0 1 3 REGISTER OF IMU.S USE ONLY «. , <y rn- ~tri~ W itl:e~i~ en .s: ~~ r m <~ -~- CJ '~J .,~ `~ ~~ f"i ~'! '- r-+ ::`~ ~~ Correspondent's snail address: Utxfer perrallies of perjury, I declare that I have examined tlris return, including accompanying sdterlWes and etatemeMa, and to the beat of my krpwladpe and trNief, it is inre, coned and complete. Dedaretlon of preparer other then the personal represardative is based on all inTwnratlon of which preparer has any knorledge. 414 Burcmners Road Carlisle PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE pgTE ADDRESS PLEASE USE ORI(31NAL FORM ONLY Bide 1 1505610140 1505610140 J o. ~~ ~- C~ ~ ~~l ~J 1505610240 REV-1500 EX Decedents Social Security Number DacedarH'aWarrie: Elaine E. Comman 1 8 6 2 8 6 8 6 9 RECAPIruunoN 1. Real Estate (Schedule A) ......................................... .. 1. 2 1 8 9 0 0, 0 0 2. Stocks and Bonds (St~edule B) .................................... .. 2. 3. Ckxrely Held Corporation, Partnerahµ~ or Sole-Proprietorsh~ (Sd~edule C) ... .. 3. 4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. 5. Cash, Bank Dapoaits and Miscellaneous Personal Property (Schedule E)..... .. 5. 6. JoinHy Owned Property (Sdreduk F) ^ Separate Billing Requested ..... .. 6. 7. Infar-V~rvos Transfers & MisceNaneous N Probate Property (Schedule G) ~ Separate Billing Requested ..... .. 7. • 8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 2 1 8 9 0 0 , 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. 9. 1 8 0 4 5 . 2 2 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedub 1) ........... .. 10. 4 2 9 9 9. 6 3 11. Total Deductions (total Lines 9 and 10) ............................. .. 11. 6 1 0 4 4 • $ 5 12. Net Value of Estate (Line 8 minus Line 11) .......................... .. 12. 1 5 7 8 5 5. 1 5 13. Charitable end Governmental BequestslSec 9113 Trusts for which an ebdion to tax has not been made (Schedule J) .................... .. 13. • 14. Net Valus Subject to Tax (Line 12 minus Line 13) .................... .. 14. 1 5 7 8 5 5. 1 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount o1 Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)x.o _ 0. 0 0 15. 0. 0 0 1B. Amount of Line 14 taxable at lineal rate x .oas 1 5 7 8 5 5. 1 5 ts. 7 1 0 3. 4 8 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0, 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 1 g. Q• ~ ~ 19. TAX DUE .................................................... ..19. 7 1 0 3. 4 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Slde 2 1505610240 1505610240 J REV-1600 EX Page 3 Fik Number Decedents Complete Address: 0 0 DECEDENrs NAA~ Elaine E. Comman _ STREET ADDRESS CRY STATE ~p Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments g. Discount 3. Interest !1) 7,103.48 Total Credits (A + g) (2) 0.00 4. If Line 2 is grea~r than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. FNI In oval on Pape 2, Une 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) 0.00 (5) 7.103.48 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; or ................................................................................................ d. receive the promise for Ide of either payments, lxmeftts or care? ....................................................... 2. ff death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ 3. Did decedent own an 'in trust for or payable•upon{leath 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 R 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 re(um are still applicable even ff the surviving spouse is the only beneficlary. 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)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefx~aries is 4.5 percx3nt, except as noted in 72 P.S. §9116(1.2) [72 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-f502 EX+ (01-10) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE iNr~wrANCEraxr~ruRN REAL ESTATE RESioENr DecEDErrr `°' ^' ` "~' FILE NUMBER: Elaine E. Comman 0 0 AN nal properly owned solely sx as a tenant In wmmon muss to reported at falr market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willirsg seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads. Real property that la jolntly~olened with rlpht of survivorship must be disclosed on tichsdule F. Attach a copy of the settlement sheetrf the property has been sold. ITEM Include a copy of the deed showing decedent's interest 'rf owned as tenant in carsmon. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 127 Clover Larte-Carlisle, PA 218,900.00 TOTAL (Also enter on Line 1, Recapitulatias.) ~ ; lr mae space is rreeded, use admaor~i af,eas a paper of ase:~e srze. REV-15b3 EX + (8-98) COM~AONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE SCHEDULE B STOCKS ~ BONDS Elaine E. Comman 0 0 AN Properly johllly~owued tAth right of turvhronhip mutt be ditcbted on Seheduk F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 2, Recapitulation) (H more space a needed, ®mert additional sheets of the same size) REV-1504 EX + (6-98) COMiAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OF SCHEDULE C CLOSELY•HELD CORPORATION, PARTNERSHIP OR SOLE•PROPRIETORSHIP Elaine E. Comman 0 0 Schedule C-1 or C-2 (indudirg ati supporting infortnetiron) must be attad~led for each cbselp.hafd ooiporetiadpartnership interest of @~e decedent. otlrer titan a sole-proprietorshgt. See irlshiwtions for the supporting Infonnatbn tD be submitEed forsole-propriehwahlps. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on (If more space is needed, ir~t additional wheels ~ the same sip) REV-1 SOS EX ~ (8.98) COA~MONVYEALTH OF PENNSYLVANIA tNNERRANCE TAX RETURN SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF FILE NUMBER Elaine E. Comman p p 1. Name of Corporation State of Incorporation ~~ Date of Incorporation City State Zip Code Total Number of Sharehdders 2. Feder Empbyar I.D. Number Business Reporting Year 3. Type of Business Produd/Service 4. t ~ ~ ~, Common $ Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? ....................................... ^ Yes ^ No ff Y~~ Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? .............................. . ........ ^ Yes ^ No N yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? ............... ^ Yes ^ No If yes, Cash Surrender Value $ Net proceeds payable $ Oxrttcr of the policy 8. Did the decedent sell or tt'ansfer stock in this rbmpany within one year prior to death or within two year; d the date of death was prior to 12-31.82? ^ Yes ^ No ff yes, ^ Transfer ^ Sale Number of Shares Transferee or Purchaser Consideration $ p~ Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholders agreement In effect at the time of the decedent's death? ............ ^ Yes ^ No If yes, provide a copy of fhe agreement. 10. Was the decedent's stock acid? ................................................. ^ Yes ^ No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissdved or liquidated after the decedent's death? ....................... ^ Yes ^ No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? ...................... ^ Yes ^ No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of finandal statements or Federal Corporate Income Tax returns (Porto 1120) for the year of death and 4 preceding years, C. If the corporation owned real estate, sutxnit a list showing the canplete addresses and estimated fair market values. ff real estate appraisals have been secured, attach copies. D. List of princlpal stodthdders at the date of death, number of shares held and their relationship to the decedent. E. Lisf of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedents stock. (Hmore spacers needed, insertaddltiorb!cheets ofthecarne sme) REV-1608 EX + (8-00) . ` SCHEDI/LE C-Z CON~AOtYWEnt.TH of PErtrtswivww PARTNERSHIP tN RES DENT DECED NTRN INFORMATION REPORT ESTATE OF FILE NUMBER Elaine E. Cornman 0 0 1. Name of Partnership Date Business Commenced Address Business Repatirg Year City State Zip Code 2. Federal Employer I.D. Number 3. Type of Business Produd/Service 4. Decedent was a ^ General ^ Limited partner. If decedent was a limited partner, provide initlal investment $ 5. ~ ~~ _._ !~ ~:~ A. B. C. D. 6. Value of the decedent's interest $ 7. Was the Partrrership indebted to the decedent? ................................ ^ Yes ^ No tt yes, provide amount of indebtedness $ 8. Was ttrere life insurance payade to the partnership upon the death of the decedent? ........ ^ Yes ^ No H yes, Cash Surrender Value $ Net proceeds payade $ Owner of the pdicy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 121-827 ^ Yes ^ No ff yes, ^ Transfer ^ Sale Percentage transferredlsold Transferee or Purchaser Consideration $ Date Attach a separate sheet for addiGonai transfers andJor sales. 10. Was there a written partnership agreement in gifted at the time of the decedent's death?........ ^ Yes ^ No H yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? .................................. ^ Yes ^ No tf Yom. txohde a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated otter the decedent's death? ................. ^ Yes ^ No If yes, provide a txeakdown of distributions received by the estate, induding dates and amounts received. 13. Was the decedent related to any of the partners? ................................ ^ Yes ^ No ff yes. explain 14. Did the paMership have an interest in other corporations or partnerships? ................. ^ Yes ^ No If yes, report the necessary infomration on a separate sheet, induding a Schedule C-1 or G2 for each Interest. A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of finandal statements or Federal Partnership Inrpme Tax returns (Form 1065) for the year of death and 4 preceding years. C. ff the partnership owned real estate, submit a list showing the complete addressJes and estimated fair market values. It real estate appraisals have been seared, attach copies. D. Any other information relating to the valuation of the decedents partnership interest. REV-1507 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN SCHEDULE D MORTGAGES ~ NOTES RECEIVABLE Elaine E. Comman 0 0 Ali properly jolMly-owned wph the right o(survborship must bs dbelo~ed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line (H more speoes needed, insert additional sheets of the same sue) REV-1 b08 EX + tg.ge) SCHEDULE E COMMONWEALTH OF PENNSriVANU1 CASH, BANK DEPOSITS, ~ MISC. IN R S DENT D EDE TRN PERSONAL PROPERTY ESTATE OF FlLE Elaine E. Comman 0 0 Include the gooaeds of Wlgation and the date me p~ooeads srere received M the estate. AN propsrgr johdlYownsd vdlh itNM of sunhors Ih p must bs dbcbssd on Schedule F. ITEM VALUE AT DATE NUMBER DESCWPTION OF DEATH TOTAL (Also enter on line 5, Recapitulation) (If nare space is needed, ira~rt addNlonal ahe~s of the scene alas) REV•1509 EX~ (01-10) Pennsylvania ~ SCHEDULE F DEPARTMENT OF REVENUE I JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ea I /II t ur: Pit.E NUN~BER: Elaine E. Comman 0 0 tl an asset was made Jointly owned wMhin one year of the dec:edeM'a date of death, tl must be rsported on Schedu~ G. SURVMNG JOINT TENANT(S) NAME(S) A. B. C. JOM(iLY-ONMED PROPERTY: TO DECEDENT ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCUU. INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET !6 ~ DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST t. A. TOTAL (Also enter on Line 6, Recapitulation) I S I(ngre apace is needed, uee addldar'ell sheets of paper of the same size. REV-1510 EX+ (08-09) Pennsylvania DEPARTRtEM QF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON•PROBATE PROPERTY Elaine E. Comman 0 0 Ths schedule must be completed and flied iF the answer to arty of questions 1 through 4 on page three of the REV-1500 is yes. REM NUMBER _ DESCRIPTION OF PROPERTY rNCtuoe TfE NNE OF TFE TRAl~ff, TNEit rsa~naNSiPro oECWEM AND nIEOAteaFTRANSA.ATrACNACaProFrrl~~r~rsra:,uESraE. DATE OF DEATH VALUE OF ASSET % OF DECdS INTEREST EXCLUSION nr~uc~a~ TAXABLE VALUE 1. Tlal'AL {ALso enter on Line 7 Recapitulation) ~ s K mare space is needed, use addNbrral aheeb of paper of the same sine. REV-1511 EX+ (10.08) Pennsylvania OEPARTNIENT OF REVENUE INHERITANCE TAX RETURN r~sIDENT DECEOENr SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE ~ FILE IraJ1~R Elaine E. Comman 0 0 Dfadent'f dsMf muff be rsporbd on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. Hoffman Funeral Home 6,486.67 Advertising-The Sentinel 225.05 Adverising- The Cumberland Law Journal 75.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of PeBOnal Representative(s) Street Address City Smte 21P Year(s) Commissiai Paid: 2, Attorney Fees: Karl E. Rominger 3. Family Exemption: (If decedents address is r~ the same as claimants, attach explanatiai.) claimant street Aaarefa Cfty Stale ZIP Relationship of Claimant ~ Decedent 4. p~yq Fees: Cumberland County Register of Wills 5. ~ ApxwMarn Fees: 6. ~ Tax Realm Preparer fees: 7 10,900.00 358.50 TOTAL (Also enter ort line 9, Recapitulation) ~ >< tt more space is nestled, use addtional sheela of paper aFihe same sine. REV-1512 Ex+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHEPoTANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS Elaine E. Comman _ _ 0 0 Report debts intoned by the decedent prior to death that remained unpeld at the dabs of death, including unrelmbunted medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. Bank of America 9,258.26 Lowe's -New Lock Sets ~ 119.69 K-Mart-New Keys ~ 6.33 0 Real Estate Taxes ~ 2,904.01 Ml'3<T Home Equity Loan ~ 17,804.84 Purchase John Deer Lawn Mower ~ 1,000.00 Improvements for Estate Property ~ 1,201.00 to Clifford Comman I 3,1360.33 Reimbursement to Richard Comman ~ 6,845.17 TOTAL (Also enter on Lfne 10, Recapitulation) I : ff more apace is needed, inert addiaonel abeam of the same airs. REV-1513 EX+(01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT is twt r ur: FlLE NUMBER: Elaine E- Comman n n RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Ttustsels) OF ESTATE I TAXABLE DISTRIBUTIONS pnchrde outrioM(spousal dlstr~utlons and transfers under Sec. 91 6 a)) 1.2 .] See Attachment Page(s) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, 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. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. i 11 IIMC sNaun IS tlfiC0tl0, use a00100r1a1 sneers W paper or the same size. Elaine E. Comman DecedehYs Name Page ~ File Number Schedule J -Beneficiaries -1 NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Tnrstes(s) AMOUNT OR SHARE OF ESTATE T TAXABLE DISTRIBUTIONS pndude ouf~ht I distributions and transfers under Sec. 91 6 (a (1.2).] 1. Richard Comman Lineal 0.00 414 Burgners Lane Carlisle, PA-In will but renounced interest to sister 2 Clifford Comman Lineal 0.00 127 Clover Lane Carlisle, PA 3 Mary Wright Lineal 141,855.15 127 Clover Lane Carlisle, PA 4 Angela Blankenship Lineal 2,000.00 22 North High Street Newville, PA 17241 5 Eric Dengler Lineal 2,000.00 22 North High Street Newville, PA 6 Hailey Dengler Lineal 2,000.00 22 North High Street Newville, PA 7 Kathryn Comman Lineal 2,000.00 22 North High Street Newville, PA 8 Seth Comman Lineal 2,000.00 127 Clover Lane Carlisle, PA 9 Ryan Bouder Lineal 2,000.00 127 Clover Lane Carlisle, PA 10 Robert Bouder Lineal 2,000.00 127 Clover Lane Carlisle, PA 11 Nicole Bouder Lineal 2,000.00 11 East Main Street Newville, PA i2EV-1514 Ex+ (4-09) Pennsylvania DEPARTMENT OF REVENUE Bureau d IMiYidual isles PO Banc 280601 Nertisbury PA 1712&0601 SCHEDULE K LIFE ESTATE, ANNUITY 8 TERM CERTAIN .K BOX 4 ON REV•1500 COVER SHE OF FILE Elaine E. Comman 0 0 This schedule should be used for all singb-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calWlations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Alphh Volume for dates of death from 5-1-99 and thereafter. Indicate bekrw the type of instrument that created the future interest and attach a copy of R to the tax return. ^ Will ^ Intervivos Deed of Trust ^ Other ^ Life or ^ Tenn of Years ^ Life or ^Tenn of Years ^ Life or ^ Tenn of Years ^ Life or ^ Tenn of Years ^ Life or ^Term of Years 1, Value of fund from which life estate is payable ......................................... 3 2. Actuarialfadorperappropriatetable,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Interest table rate - ^3.5% ^ 8°~ ^ 10% ^ Variable Rate 3. Value of Iffs estate (Litre 1 multiplied by Line 2) . . . . . . . ............................... E IMq~'Q~'~ '~~~' ^ Life Or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Tenn of Years 1. Value of fund from whichennuityispayable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,: 2. Check appropriate block bekWw and enter corresponding number , , , , , , , , , , , , , , ,, , , , , , , , , , , , Frequency of payout - ^ Weekly (52) ^ Bi-weekly (28) ^ Monthly (12) ^ Quarterty (4) ^Sami-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout Par Period ......................................................5 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate - ^ 3.5% ^ 6°,6 ^ 10% ^ Variable Rate % 8. Adjustment Factor (See instructions) . . . . . . . . . . . . . . . . ............................... . 7. Value of annuky - If using 3.5%, 8%, 10%, orrf variabb rate and period payout is at end of pared, calculation is: Line 4 x Line 5 x Line 8 ...........................s If using variable rate and period payout is at beginning of period, calculation is (Line 4 x Line S x Line 6) + Litre 3 ................................................. i NOTE: The values of the funds that create the atxnre future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the a ppropriate tax rate on Lines 13 and 15 through 18 of the return H more space's needed use addi0arel sheets of the same sine. REV-1844 EX+ (Ot-10) Pennsylvania DEPARTFENT OF ~~ INHERITAtk:ETN(RETURN RESIDENT DECEDENT INHERITANCE TAX SCHEDULE L REMAINDER PREPAYMENT OR INVASION OF TRUST CORPUS nman, Elaine_E. _ _ _ 0 0 _ _ _ This schedule is appropriate only for estates of decedents dying on or before December 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust corpus (princlpaq. IL REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of Wills on (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on date or Annuitant(s) of Elecction C. Assets: Complete Schedule L-1 1. Real Estate .............................. $ 2. Stocks and Bonds .........................$ 3. Closely Held Stodc/Partnership ............... $ 4. Mortgages and Notes ....................... $ 5. CashlMisc. Personal Property ................ $ 6. Totalfrom Schedule L-1 ....................................................$ Term of Years Income or Annuity is Payable D. Credits: Complete Schedule L-2 1. Unpaid Liabilities .......................... $ 2. Unpaid Bequests ............:.............$ 3. Value of Non Includable Assets ............... $ 4. Total from Schedule L-2 ........................................... ....... $ E. Total Value of Trust Assets (Line C-6 minus Line D-4) ............................... $ F. Remainder Factor ........................................................... G. Taxable Remainder Value (Multiply Line E by Line F) .............................. $ (Also enter on Line 7, Recapitulation) III, INVASION OF CORPUS: A. Invasion of Corpus _ (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on Date or Annuitant(s) Corpus Consumed C. Corpus Consumed ...........................................................$ D. Remainder Factor ........................................................... E. Taxable Value of Corpus Consumed (Multiply Line C by Line D) ........................ $ (Also enter on line 7, Recapitulation) Term of Years Income or Annuity is Payable REV-1845 EX+ (11-09) Pennsylvania INHERITANCE TAX SCHEDULE L-7 DEPARTMENT OF REVENUE INHE(dTANCETAxRETUf~! REMAINDER PREPAYMENT ELECTION aESiDENr oECEDENr -ASSETS- I. ESTATE OF FILE NUMBER Comman, Elaine E. 0 0 1Q. ITEM NO. DESCRIPTION VALUE A. Real Estate (Please describe.) Total Value of Real Estate $ Indude on Section II, Line C-1 on Schedule L. B. Stocks and Bonds (Please list.) Total Value of Stocks and Bonds $ (Indude on Section II, Line C-2 on Schedule L. C. Closely Held Stodc/Partnership -Please list. (Attach Schedule C-1 and/or C-2.) Total Value of Closely Held/Partnership $ Indude on Section II, Line C-3 on Schedule L. D. Mortgages and Notes (Pl~se list.) Total Value of Mortgages and Notes $ Indude on Section 11, Line C-4 on Schedule L. E. Cash and Miscellaneous Personal Properly (Please list.) Total Value of CashlMiscellaneous Personal Properly $ Indude on Section II Line G5 on Schedule L. III. TOTAL (Also enter on Section II, Line C-B on Schedule L.) $ If more space is needed, attach additional sheets of paper of the same size. REV-1846 EX+ (11-09) Pennsylvania I INHERITANCE TAX OEPARTMENr OF REVENUE SCHEDULE L-2 ~NNERITANCETAXRETURN I REMAINDER PREPAYMENT ELECTION RESIDENT DECEDENT -CREDITS- I. I ESTATE OF Comman, Elaine E. IL ITEM NO. FILE NUMBER DESCRIPTION A. Unpaid Liabilfies Claimed against Original Estate and Payable from Assets Reported on Schedule L-1 (please list) Total Unpaid Liabilities (indude on Section II. Line D-1 on B. Unpaid Bequests Payable from Assets Reported on Schedule L-1 (please list) Total Unpaid Bequests (indude on Section I I, Line D-2 on Schedule C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are Not Included for Tax Purposes or that Do Not Fonn a Part of the Trust. Calculation as follows: Total Non Includable Assets (include on Section Ii, Line D-3 on TOTAL (Also enter on Section II, Line D-4 on Schedule L) If more space is needed, attach additional sheets of paper of the same size. 0 0 3 3 REV•1807 EXr (Op-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST COMPROMISE (Check Box 4a on REV-1500) ESTATE OF Elaine E. Common 0 0 This schedule is appropriate only for estates of decedents who died aRer Dec. 12, 1982. This sdledule is m be used for ali future interests where the rate of tax which will be applir;able when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that seated the future interest and attach a copy to the tax return. ^ Will ^ Trust ^ Other L 1=^iT,;i ~tTi"7 NAME OF BENEFICIARY ~ RELATIONSHIP ~ DATE OF BIRTH ~ „~,,, AGE TO ^. ~. 2. 3. 4. 5. d For decedents who died on or after July 1,1994, if a survivii nine months of the decedents death, check the appropriate exerdses such withdrawal right. ^ Unlimited right of withdrawal spouse exerdsed or intends to exerdse a right of withdrawal within x~c and attach a copy of the document in which the surviving spouse ^ Limited right of withdrawal Exptsnauon of Compromise Uffer: iv. ~ Summary of 1. Amount of future interest ........................... ....................... $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also indude as part of total shown on Line 13 of REV-1500.) ... ... $ 3. Value of Line 1 passing to spouse at appropriate tax rate (Also indude as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate (Also indude as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxable at sibling rate (12%) (Also indude as part of total shown on Line 17 ofREV-1500.) .... .. $ 6. Value of line 1 taxable at collateral rate (15°k) {Also indude as part of total shown on Line 18 of REV-1500.} .... .. $ 7. Total value of future interest (sum of Lines 2 thru ti must equal Line 1) ..................... $ If more space is rNSeded, use additional sheets of paper of the same size. REV 1848 EX (02-09) Pennsylvania ~oF~va~ Bureau a libividual Takes ~, a...~,~,,, SCHEDULE N SPOUSAL POVERTY CREDIT FOR DATES OF DEATH 01/01/92 TO 1?JS1194 This schedule must be comolebed and filed ff you checked the 1. Taxable assets total from line 8 (cover sheet) ............................ 2. Insurance proceeds on life of decedent ....................................... 3. Retiroment beneftts ...................................................................... 4. Jcnt assets with spouse .............................................................. 5. PA Lottery winnings ..................................................................... Ba. Other nontaxable assets: List and attach schedule if necessary .. 6. SUBTOTAL (Lines 6a, b, c, d) 7. Total gross assets (Add Lines 1 thru 8) ..................... 8. Total actual liabilities ................................................. 9. Net value of estate (Subtract Line 8 from Line 7) ....... n line a u arbaAlr Man SZ00.000 -STOP. The estate b not Income: a. Spouse ............................ b. Decedent ......................... c. Joint ................................. d. Tax~xempt Income ......... e. Other income not listed above ..................... to Galm Me 218,900.00 4. Average joint exemption income calwlation 4a. Add joint exemption income from above: Gedlt bas on the cover sheet. 4b. Average joint exemption income ........................................................................................................... nu,e Nbl is oeare.Men s+aooo - aroP. The estate is rrot sUafbb ro ds6n Me aeare. nrwt continue M ~ertnt 1. Insert amount of taxable transfers to spouse or 5100,000, whichever is less .......................................... 2. Multiply by kxedlt percentage (see instrurdions) ....................................................................................... 3. This is the amount of the Resident Spouse) Poverty Credit. Include this figure in the calculation of total Credits on Line 18 of the cover sheet ................................................................ 4. For nonresiderKs, enter the ratio of the decedent's gross estate in PA to the value of the dseedenYs gross estate .......................................................................................................................... 5. Multiply Line 3 by Line 4 and enter the total here. Thin is the amount of the Nonresident Spousal Poverty Credit. Include this figure in the celwlation of total kxedlts on Line 18 of the cover sheet .......... (+3) REV-1869 EX + (8-88) COAaMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN ESTATE OF scHEOV~E o ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) Elaine E. Comman 0 0 Do not eomplsb ffik scMdule unless the able fs maklnp the election Eo taa assets under t3sction 9113(A) of the hhare~ 8 Fatale Tans Ast. ff the election applies to more than one trust or similar arrangement, a separate form must be tiled for each trust. This election aaaifes to the -Trust (marital, residual A, B, By-pass. Unified Credit, etc.). ff a trust or similar anangatrrlertt meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Sr~edule 0, and b. The value of the trust or similar arrangement is entered in while or in part as an asset on Schedule 0, then the transferor's personal representative may sperzfically identify the trust (all or a fractional portion or percentage) to be induded in the election to have such trust or sim- ilar propauty treated as a taxable transfer in this estate. B less than the entire value of the host or similar property is induded as a taxatlle transfer on Schedule 0, the personal representative shall be oonsi~red to have made the election only as to a traction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the tots value of the trust or similar ~rangement. Part A: Enter the description arb value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. Dea«Ipdon value Part A Total $ Part B: Enter the descri 'nand value of all interests included in Part A for which the Section 91 13 A election to tax is bet made. Deacrip6on Value Part B Total (If more space is needed, ill9ett additional sfals of the same size) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedents date of death: Discount: 0.00 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1981 1982 1983 _ 1984 1985 ----- 1986 -- - ----- --~I 1987 - -- 1988 throw h 1891 - ' - 1992 - - 1993 throw h 1994 1996 through 1998 1999 2000 -~ -- -- 2001 2002 2003 --- 2004 - 2N6 --- -- 2007 - - -- 2008 I - 2009 _ _ 2010 - -- _ 2011 __ _.. - .. ___... _ --------- - ~ -- TOTALS --~ Penaky Calculation If the decedents date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: