HomeMy WebLinkAbout11-15-11 (2)1505611188
~.
REV-1500 EX (02-t1)(FI) ~+
p8nnsylvanfa OFFICIAL USE ONLY
PA Department of Revenue °`""TM`"'°`""""°` County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280801
Harrisburg, PA 17128-0807 RESIDENT DECEDENT ~ ( I ~ ~ c~o2
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
189 07 8721 D8 31 2011 11 16 1918
Decedent's Last Name Suffix Decedent's Frst Name MI
Harrold Luella M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's Frst Name MI
spouse's social security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Retum O 2. Supplemental Retum O 3. Remainder Retum (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required
death after 12-12-82)
~ 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. AlI Correspondence and Confidential Tax Information Should be Directed to:"
Name Daytime Telephone Number
Robert E• Saidis, Esquire 717 243 6222
Frst Line of Address
26 West High Street
Second Line of Address
City or Post Office
Carlisle
State ZIP Code
PA 17013
REGISTER~tt~lLS USE ONLY
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DATE FILED ~. "' ~`~
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correspondent's e-man address: rsaidisCcassr-attornevs.com
Under penalties of perjury, I declarethatl ha examined this return, including accompanying schedules and statements, and tothe best of my knowledgeand belief,
it is true, correctand plate. Declaration o the preparer atherthan personal representative is based on all information of which preparer has any knowledge.
SIGNATUR ESPO R FILIN ETU N DATE
Side 1
1505611188 1505611188
r~enst ust VMI(sINAL FORM ONLY
J 1505611288
Rev-1500 EX (FI)
Decedent's Name: L u e l l a M H e r r o l d
Decedent's Social Security Number
18 9 0 7 8? 21
RECAPITULATION
1. Real Estate (Schedule A) ......................................... 1. 0 • 0 0
2. Stocks and Bonds (Schedule B) .................................... 2. D • D 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ...... 3, 0 • 0 0
4. Mortgages and Notes Receivable (Schedule D) ......................... 4, 0 • 0 0
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ....... 5. D • 0 0
6. Jointly Owned Property (Schedule F) [~ Separate Billing Requested ...... 6. 11, 5 0 9. 2 4
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested ...... 7, D . D 0
8. Total Gross Assets (total Lines 1 through 7) ............................ g. 11, 5 0 9 •2 4
9. Funeral Expenses and Administrative Costs (Schedule H) .................. g, 2 , 9 9 4 •0 8
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ..... . ....... 10. 410 • 6 4
11. Total Deductions (total Lines 9 and 10) .............................. 11. 3 , 4 0 4 • 7 2
12. Net Value of Estate (Line 8 minus Line 11) ............................. 12, 8 ,10 4 • 5 2
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ....................... 13. 0 • D 0
14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... 14. 8 ,10 4 •5 2
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 0 • 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 8 ,10 4.5 2 1 s.
17. Amount of Line 14 taxable
at sibling rate X .12 D • 0 0 17
18. Amount of Line 14 taxable
at collateral rate X .15 0 • 0 0 18
19. TAX DUE ........................... ........................ . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 1505611288 1505611288
0.00
364.7D
0.00
0.00
364.70
f~
Rev-1500 EX (Fl) Page 3
Decedent's Complete Address:
Flle Number
DECEDENTS NAME
Luella M. Herrold
STREEfADDRESS
442 Walnut Bottom Road
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 364.70
2. Credits/Payments
A. Prior Payments 346.47
B. Discount 18.23
Total Credits (A + B) (2) 364.70
3. Interest
(3) 0.00
a. 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. (q)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
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:
a. retain the use or income of the property transferred .................................... Yes
. ^ No
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'in trust tor" orpayable-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 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 peroent [72 P.S. Sect. 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. Sect. 9116(a)(1.1)(ii)]. The statue 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. Sect. 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. Sect. 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. Sect. 9116(a)(1.3)]. A sibling
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-1509 EX+(01-10)
Pennsylvania
DEPARTMENT OF REVENUE
INH ERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
Luella M. Herrold
If an asset became jointly owned wlthln one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. Thomas E. Herrold 4205 Nantucket Drive Son
Mechanicsburg, PA 17050
13.
c.
JOINTLY-OWNED PROPERTY:
ITEM
NUM. LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OFPROPERTY.INCLUDENAMEOFFINANCIAL
INSTITUTION AND BANK ACCT NUMBER OR SIMILAR IDENTIFYING
NUMBER. ATTACH GEED FORJOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET %OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENTSINTEREST
1 A 05/1998 Janney Montgomery Scott account 4195-8108 23,018.47 50.000 11,509.24
joint with Decedent's son, Thomas E. Herrold
consisting of $15,000 General Motors
Acceptance Corp due 12/15/18 $13,201.05 and
$9,817.42 cash
TOTAL (Also enter on Line 6, Recapitulation) I 11,509.24
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+~10-09)
Pennsylvania SCHEDULE H
Of.PARTMENT OF REVENUE
FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Luella M. Herrold
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 David T. Zweier Funeral Home, Inc. 2,175.09
2 Skeeters Pit BBQ, funeral luncheon 203.99
B. ADMINISTRATIVE COSTS:
7. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 600.00
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:
7 Cumberland County Register of Wills, filing fee 15.00
TOTAL (Also enter on Line 9, Recapitulation) I 2,994.08
If more space is needed, use additional sheets of paper of the same size.
REV -1512 EX+(12-08)
Pennsylvania
DEPARTMENT OP REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
Luella M. Herrold
Report debts Incurred by decedent prior to death that remained unpaid at the date of death- Including ~~~~.~n,r,~~~a~ ~~~s~ e,..,e.,Q~
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvainia
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF: FILE NUMBER:
Luella M. Herrold
NUMBE
NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not Ust Tru s AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions
and
,
transfers under Sec. 9116(a)(1.2).j
Thomas E. Herrold Son 8,104.52
4205 Nantucket Drive
Mechanicsburg, PA 17050
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 180E REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 913 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 73 OF REV-1500 COVER SHEET.
It more space is needed, use additional sheets of paper of the same size.
Estate Valuation
Date of Death: 08/31/2011
Valuation Date: 08/31/2011
Processing Date: 10/20/2011
Shares Security
or Par Description High/Ask Low/Bid
1) 15000 GENERAL MOTORS ACCEPTANCE CORP (3704AOEG3)
Financial Times interactive Data
DTD: 12/23/2003 Mat: 12/15/2018 6.25
Estate of: Luella Herrold Estate
Report Type: Date of Death
Number of Securities: 1
File ID: Herrold, Luella M. Estate
Mean and/or Div and Int Security
Adjustments Accruals Value
08/31/2011 86.68750 A/B
86.667500
Int: 06/15/2011 to 08/31/2011
Total Value:
Total Accrual:
Total: $13,201.05
13,003.13
197.92
$13,003.13
$197.92
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.0)
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