The URL can be used to link to this page

Home My WebLink About10-31-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXI11-96) N0. CD 015138 BUCHTER RITA E 131 MILKY WAY SHIPPENSBURG, PA 17257 fold ESTATE INFORMATION: SSN: os3-t4-732t FILE NUMBER: 21 1 1 -081 8 DECEDENT NAME: MOORE RITA MARY DATE OF PAYMENT: 10/31 /201 1 POSTMARK DATE: 10/31 /201 1 couNTY: CUMBERLAND DATE OF DEATH: 03/06/201 1 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 189.39 TOTAL AMOUNT PAID: S 189.39 CHECK#1750 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS J 1505610101 REV-1500 t:x~°3.1°> Its PA Department of Revenue pennsylvartia Bureau of Individual Taxes DEE~NTNENT OF ffVEHUE PO BOX 28o6oi INHERITANCE TAX RETURN Harrisbur , PA i~i28-o601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY l03 ~`~ ~3a 030 ~ o ~ I Decedent's Last Name 0 t) R E suffix (If Applicable) Enter Surviving Spouse's Inf orr-tation Below Spouse's Last Name Suffix Spouse's Social Security Number OFFICIAL USE ONLY County Code Year File Number_ Date of Birth MMDDYYYY 09 ~3i9~a Decedent's First Name MI I ~} Spouse's First Name ~"~"1~TTi"TTTrn THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS MI L~ (~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate p 4a. Future Interest Com romise date of Prior to 12-13-82) death after 12-12-82) ( O 5. Federal Estate Tax Return Required O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 11. Election to tax under Sec. 9113(A) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ~ ? 3~~a 63 First line of address Correspondent's a-mail address: p ~~e~Sr -7~ -~ FILED ONLY I .__. ^ } t~.> i- y ..~ -~. C - t ~_ C..l ~"' -' "7 y.-..' _ • • 1. n. ~:, "; l Under penalties of perjury, I deGare 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. SIGNATU OF PERSON RE ONSIBLE FOR FILING RETURN /~~f ~J AT i3~ ~j,~, SIGNATURE OF PREPARER OTH R THAN /7dS~ ~6~/ ~/1 ADDRESS DATE PLEASE USE ORIGINAL FORM ONLY 1505610101 Side 1 REGIST~ OF WILLS ~~ r ti~~~ .j^-~~ .~_ G^ ~. ,~ ~1 ~. ~ ~~ -r7 ..,~ 1505610101 J REV-1500 EX 1505610105 RITA ~N~`~ ~`?oorZ~ .,,me. - RECAPITULATION .................................... 1. 1. Real Estate (Schedule A)......... 2. 2. Stocks andBonds(Schedule6)..••••••••••••••~"""~"~~~~~~~~~ 3. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 4. 4. Mortgages and Notes Receivable (Schedule D) .......................... . 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5• 6. Jointly Owned Property (Schedule F) p Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous NO Sepa aterBileng Requested........ 7• (Schedule G) ................ 8. 8. Total Gross Assets (total Lines 1 through 7) ........... .. ~. 9. Funeral Expenses and Administrative Costs (Schedule H ................ . 10. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. . 11. 11. Total Deductions (total Lines 9 and 10) ................................ . ............12. 12. Net Value of Estate (Line 8 minus Line 11) ................. . 13. Charitable and Governmental BequestslSec 9113 Trusts for which . 13. an election to tax has not been made (Schedule J) ...... . --- ~i :..,. ~~ minnc I ine 131 ........ .......... 14. 15. '' 16. 17. 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 Decedent's Social Secur~ty Number 1505610105 O 1505610105 ~_ _._ __ REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAME ~- I A ~A-~ /~ov rzL STREETADD~ESS is ~ Gtl~+,(~J7 86 rTo~ ~a~~ CITY v~ / I~QE~~ nU2 STATE ~n ZIP ' ~, `~n Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 3. Interest 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. Total Credits (A + B) (2) (3) (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) / ~ 9 • ~ 9 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 :.................................................................................... ...... ^ ~Z] 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 life of either payments, benefits or care? ................................................................ ...... ^ [~C] 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" 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 FILE IT A$ 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(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-1508 EX ~ (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF n / T~ ~ ~ ~ `/ ~ ~ ~ ~ c FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. 6RRsToWnl F~r~~vK. yag,~.ib /Ci~y ~T2~c T oGGiw gc~a ~~T iF ~ ~ 3 d 0~ 8a (, Chcc.ki,~y /~~La~r~t TOTAL (Also enter on line 5, Recapitulation) I ; (If more space is needed, insert additional sheets of the same size) y a9s. ~ ~ :. REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDI~LE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ~ I ~~ M ~ ~ ~ M ~ U ~~ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address 2. 3. 4. 5. 6. 7. City Year(s) Commission Paid: Attorney Fees 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 Probate Fees SET tTZO rJ ~CTj~S TEbT W ail RENu~J~ t A7'~~ •J dX a e..t c~~ Fic J'f~ FEE I9uTa niR~~orl Fe~a., Accountant's Fees Tax Return Preparer's Fees State _ Zip d~~O • S~a TOTAL (Also enter on line 9, Recapitulation) I $ ~~ •~Q (If more space is needed, insert additional sheets of the same size)