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HomeMy WebLinkAbout11-02-11 (3)f --~ REV-~rJ00 E"(01~10) 1505610243 PA De artment of Revenue ~ OFFICIAL USE ONLY p pennsylvania County Code veer File Number Bureau of Individual Taxes oEVnrsr~r~,ov~ruE Po eox.2sosol INHERITANCE TAX RETURN 2 1 11 ~ ` n Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 199 05 7421 09 14 2011 10 06 1918 Decedent's Last Name Suffix Decedent's First Name MI HILER DOROTHY M (If Applicable) Enter Survivitag Spouse's information Below Spouse's Last Name Suffix Spouse's First 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 Return ^ 2. Supplemental Return ^ 4. Limited Estate ^ ¢a, Future Interest Compromise (date of death after 12-t2-92i ^ g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. ~P~~P2ov31 Y9Cr~ (d; t~adeath ^ 3. Remainder Return {date of death prior to 12-13-t32) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ^ t 1. Election to tax under Sec. 9113(A) (Attach Sch. O) 193 SIMMONS RD, MECHANICSBURG. PA 17055 CORRESPONDENT • THIS SEC710N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RAY BUTTERWORTH 610 374 6537 First line of address 1105 BERKSHIRE BLVD Second line of address City or Post Office WYOMISSING State ZIP Code PA 19610 REGISTER OF WILLS USE ONLY ~ r-.y -~. © --- `~~~ ~ ~.~ C~ - [Fr1lTDi~ED ''' _ c.r. `~. Correspondent's a-mail address: ' Under pena"Ities of perjury, I tleGare that 1 have examined this return, inGuding arx:ompany~'ng 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. SIGNAT REOF_PERSON S NSIBLE R FILING RETURN DATE ,~,~~~ ~ ~~~ ~Q9,,, GERALD W. HILER ~ O - ~-- 1505610143 15Q5610143 J ~~ ADDRESS ~ 1105 Berkshire Blvd, Wyomissing, PA 19610 Side 1 f J 1505610243 REV-1500 EX Decedents Name: N I L E R, DOROTHY M RECAPITULATION 1. Real Estate (Schedule A} ..................................................................................... 1. 2. Stocks and Bonds (Schedule B) .......................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ....................................................... 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E.} .............. 5. 6. Jointly Owned Property (Schedule F) Q Separate Bitting Requested ............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested............ 7, 8. Total Gross Assets (total Lines 1-7) ................................................................... 8. 9. Funeral Expenses 8 Administrative Costs (Schedule H) ...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8 liens (Schedule I) ............................... 10. 11. Total Deductions (total Lines 9 8 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. Net Value Subject 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 under Sec. 9116 (a)(1.2} X .00 15. 16. Amount of Line 14 taxable g g $ 5 5 . 0 0 at lineal rate X .045 ~ 16. 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..............................__............................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 199 05 7421 84,058.00 12,245.00 96,303.00 5,153.00 1,295.00 6,448.00 89,855.00 89,855.00 4,043.48 4,043.48 a sae 2 1505610243 1505610243 f REV-1500 EX Page 3 nn.•nrrun4'c rmm~lPte QddreSS: File Number 21 - 1 1 HILER, DOROTHY M '~ STREET ADDRESS 193 SIMMONS RD CITY MECHANlSCBURG Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 202.17 q. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is th~VERPAYMENT. Check box on Page 2 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE TE ZIP PA 17055 (1) 4,043.48 Total Credits (A + B} (2) 202.17 (3) 0.00 (4) (5} 3, 841.31 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 :.............................~.............................................. J ~x i b. retain the right to designate who shalt use the property transferred or its income;.:....::.':....:-..'.:;:....:,': ~ I'i x c. retain a reversionary Interest, or ....................................... ~ =i d. receive the promise for life of either payments, benefits or care? ........................................................... ~ ! ', x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without r--, receiving adequate consideration? .........................................................................................._..................... ~ x i 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.?....... ~ '' x'. 4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............... ................ ^ '~ X tF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR For dates of death on or $fte § uiy 1 ~ 1, (94 ; ~ ]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 1 For dates of death on or fter January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent assets and fie ng a taxlre ~u)rn are stilthl tappl,cable even ,frthet survey ngrspouse s tl~ne only benefciaryx, and the statutory requirements for disclosure of For dates of death on or after July 1, 2000: • The tax rate imposed qn the net value of transfers from a deceased child 21 yyears 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) [7~ 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}j. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bioooatff or adoption. SCHEDULE F coMMOIVwEALTFIOFPENNSrLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT _ _ _ __ _ __ _ ESTATE OF ~ i FILE NUMBER HILER, DOROTHY M I 21 - 11 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Gerald W. Hiler )Cif S~r,r•,o~ s ~ '~ Son NED PROPERTY: W JOINTLY O _ _ LETTER ITEM DA ET C#FfSCR T10N~ PRO R~Y 'Include name o Inanclal Ins to on an ban account number ~ FOR JOINT NUMBER I MADE ' lar identifying number. Attach deed for jointly-held real TENANT ~ JOINT lestate~ 1 A ~ 02/01 /2002 Graystone Bank CD #3000164648 2 A ; 02/01/2002 Wells Fargo CD #247402093398928 3 A 02/01/2002 Capital One #3294773742 4 A ; 02/01/2002 Discover Money Mkt #523-125803-6 5 A ~ 02/01/2002 , Wells Fargo checking #1010059322870 DATE OF DEATH VALUE OF ASSET 50,748.00 14,008.00 83,069.00 13,203.00 7,088.00 % OF DATE of DEATr+ DECD'S VALUE OF INTERES DECEDENTS INTEREST 50% ~ 25,374.00 50% ~ 7,004.00 o 50 /0 41, 534.50 50% 6,601.50 ~i 50% i 3,544.00 TOTAL (Also enter on line 6, Recapitulation) 84,058.00 COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN I INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY __ ESTATE OF HILER, DOROTHII' M FILE NUMBER 21 - 11 This schedule must Fie completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. - - - _--- -- - - -J-------~------ - DE6CRIPTION OF PROPERTY I X OF ~ TAXABLE VALUE ITEM InGude the name qY the Vansferee, their reWtianship to decedent ~ DATE OF DEATH OECO'S EXCLUSION NUMBER VALUE OF ASSET INTEREST (IF APPLICABLE) antl the date of tran,5fer. Attach a copy of the deed for real estate. 1 Metlife stock (META; 40 shares ~ 1,191.00 100% j 1,191.00 2 UGI stock (UGI); 3187 shares ~ 11,054.00 100% ; 11,054.00 TOTAL (Also enter on line 7, Recapitulation) ~ 12,245.00 SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA ` INHERITANCE TAX RETURN ~~'n V L COS' RESIDENT DECEDENT ~ __ __-- I___. _ - -~__ ~_ __.-- ___ _ FILE NUMBER ESTATE OF HILER, DOROTHY M 21 - ~ ~ Debts of decedent must be reported on Schedule i. ----- 1TEM ~ --- -- NUMBER' FUNERAL EXPENSES: DESCRtPT!~:: N AMOUNT A. 1 Matincheck & Datughter, Middletown, PA 4,438,00 i B. ADMINISTRATlVI~ COSTS: 1. Persanat Representative's Commissions Name of Personal iRepresentative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Raymond Butterworth 3. Family Exemptiorh: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Stave Zip Relationshi of Claimant to Decedent a. Probate Fees CCROW 5. Accountants FBes 700.00 7 5.00 6. Tax Return Preparer's Fees ~ 7. Other Administrative Costs 1 TOTAL (Also enter on tine 9, Recapitulation) 5,153.00 i SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF ?ENNSYIVANIA LIABILITIES & LIENS INHERITANCE TA% RETURN ~ RESIDENT DECEDENT FILE NUMBER ESTATE OF HILER, DOROTHY M 21 - 11 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Social Security recapture ~~ 1,295.00 -_-- -- TOTAL (Also enter on Line 10, Recapitulation) 1,295.00