HomeMy WebLinkAbout09-01-11 (3)
150561D105
1 EX (oz-u) (FI) ~
REV- i ~OO OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes ~ ` ~ n County Code Year File Number
PO BOX z806oi INHERITANCE TAX RETURN 1
Harrisburg, PA iy128-0601 RESIDENT DECEDENT :~ I ~ ~ ~'
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
161-34-4688 07/05/2011 07/23/1919
Decedent's Last Name Suffix Decedent's First Name MI
LONG E FLORENCE
(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 FILE D IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
r~ 1. Original Return O 2. Supplemental Return 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 Return Required
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (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
PHILLIP E. LONG (717) 921-8617
First Line of Address
719 HUNT MEADOW DRIVE
Second Line of Address
City or Post Office
DAUPHIN
Correspondent's a-mail address:
State ZIP Code
PA 17018
REGISTER SWILLS USE ONLY
r C-) _.
~ .J_i
_ (-]
rT~ ,
_n ___.
- ~.7
~~
DPjIE FLED -'
_~,
;~~
,, ~
~=
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best 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.
SI ATU E O~F RESPONSIB OR FILING RETURN I (~- / Di>TE
.s-1~l~ ?/CI ~luT f-1NA~~~! nt: ;/~Nv1111'll1 ~A I7!/,rSr y- I ~~I
SIGNATURE OF PREtEARERIST R TF{AN REP ENTATIVE DATE
/ '7 ' ~ ~~ , /,. ~, .
ADDt~~~/1V ~~ r ~~/~
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX (FI)
Decedent's Social :iecurity Number
Decedent's Name: FLORENCE E. LONG 161-34-4688
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. Mort a es and Notes Receivable Schedule D
9 9 ( ) ......................... 4.
.. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 62,551.15
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested...... .. 7. 0.00
8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 62,551.15
9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 4,297.06
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. 0.00
11. Total Deductions (total lines 9 and 10) ............................... .. 11. 4,297.6
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 58,254.09
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...................... .. 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 58,254.9
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0
00
.
(a)(1.2) X .o_ 15. 0.00
16. Amount of Line 14 taxable
at lineal rate X .0 45 58,254.09 16. 2,621.43
17. Amount of Line 14 taxable
at sibling rate X .12 0.00 17. 0.00
18. Amount of Line 14 taxable
0
00
0
00
.
at collateral rate X .15 18 .
19. TAX DUE ....................................................... .. 19. 2,621.43
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
FLORENCE E. LONG
STREET ADDRESS _ _. _ _~
1000 CLEREMONT ROAD
CITY. r STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) __ 2,621.43
2. CreditslPayments
A. Prior Payments _ 0.00
_
B. Discount 131.07
Total Credits (A + g) (2) __ 131.07
3. Interest
(3) __ 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. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,490.36
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 "intrust for" or payable-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 FIL E 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 beneficiary.
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 decedent's lineal beneficiaries is 4.5 percent, except as noted in [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(<3)(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-1508 EX+ (11-10)
pennsylvania SCHEDULE E
~.~1 DEPARTMENT or RF~EN~~E CASH, BANK DEPOSITS & MISC.
INHERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
FLORENCE E. LONG 2011-00798
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 on Schedule F.
If more space is needed, use additional sheets of paper of the same size.
TOTAL (Also enter on Line 5, Recapitulation) $ ~ Ei1,b51.15
REV-151: EX~~10-09)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
FLORENCE E LONG 2011-00798
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION __ AMOUNT
A. FUNERAL EXPENSES:
I' RICE MEMORIAL WORKS 135.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) PHILLIP E. LONG
Street Address 719 HUNT MEADOW DRIVE
City .DAUPHIN. __ _ _ _ State PA zIP 17018
Year(s) Commission Paid: 2011
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees;
5. Accountant Fees:
6. Tax Return Preparer Fees:
~~ PAXTON HERALD
TOTAL (Also enter on Line 9, Recapitulation) I ~~
If more space is needed, use additional sheets of paper of the same size.
3,127.56
0.00
0.00
186.50
0.00
800.00
48.00
4,297.06