HomeMy WebLinkAbout01-06-12~.
1505610140
REV-1500 ~` ~°'-'°'
PA Department of Revenue ~~~ USE ONLY
Bureau of Individual Taxes County Code Year FBe Number
PO Box 2sosol INHERITANCE TAX RETURN 2 1 1 1 O OSS"?
Harrisburg,, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death iiAMDDYYW Date of Birth f1AMDDYYYY
1 8 6 3 6 6 7 7 7 0 4 1 1 2 0 1 1 0 9 2 0 1 9 1 8
Decedent's Last Name Suffut Decedent's First Name MI
H I K E S A L E X I N E M
(If Appitcable) Ertbsr 8urviving Spouse's IrtMrmatJon Below
Spouse's Last Name Suffer Spouse's First Name MI
N / A
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRWTE OVALS BELOW
1.Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death
pnor to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required
death after 12-12-82)
0
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wili) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRE8PONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFMENTIAL TAX MIFORMATION SHOULD BE DNtECTED TO:
Name Daytime Telephone Number
R I CHARD E. T HRASHER ESQ 7 1 7 3 3 4 2 1 5 9
C7 .~ -z~
First line of address
2 2 0 B A L T I MORE S T R E E T
Second line of address
City or Post Office
G E T T Y S B U R G
Corresponderrt's e-mail address: r thrasher[c7~comcast.net
State ZIP Code
REGISTER O +.. LS USE ONLY
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DATE FILED ~
PA 17325
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Under penaltles of perjury, I declare that 1 have examined this return, including accomparrying schedules and statements, and to the best of my knowledge and belief,
it is true, and complete. De¢laratlon of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG E OF ER N PONSIBLE FOR FILING RETURN DATE
171 S.
REPRESENTATNE
RG PA 17325
1 1 DATE
it
220 BALTIMORE S~'REET GETTYSBURG PA 17325
PLEASE U8E ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140
J 1505610240
REV-1500 EX Decedent's Social Security Number
DecadenrsName: ALEXINE M. HIKES 1 8 6 3 6 6 7 7 7
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 1.
2. Stocks and Bonds (Schedule B) ...................................... 2. 1 0 7 0 5 , 9 2
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. •
4. Mortgages and Notes Receivable (Schedule D) .......................... 4. •
14 6 9 0 8 2
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. •
7. Inter-Vnros Transfers & Miscellaneous -Probate Property
(Schedule G) ~ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 5 3 9 s , 7 4
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• 1 6 $ 2 • 0 1
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 3 4 9 • 2 3
11. Total Deductions (total Lines 9 and 10) ............................... 11. 2 0 3 1 2 4
12. Net value of Estate (Line 8 minus Line 11) ............................ 12. 2 3 3 6 5. 5 0
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 lax (Line 12 minus Line 13) ...................... 14. 2 3 3 6 5. 5 0
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 .o _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 2
3 3 6 5. 5
0
16.
1 0 5 1.
4
5
17. Amount of Line 14 taxable
0
0
0
0
0
0
at sibling rate X .12 . 17. .
18. Amount of Line 14 taxable
at collateral rate X .15
0. 0
0
18.
0.
0
0
19. TAX DUE ...................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610240
1 0 5 1.4 5
0
1505610240 J
T_ _
REV-1500 EX Page 3
Decedent's Complete Address:
F1N Number
21 11 0
DECEDENTS NAME
ALEXINE M. HIKES
STREET ADDRESS
CITY STATE ZIP
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 1,051.45
2. CreditslPayments
A. Prior Payments
B. Discount
Total Credits (A + B) (2) 0.00
3. Interest
(3)
4. ff line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
FNI in oval on Page x, Line 20 to request a refund. (4) p,00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,051.45
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 a its incase; .............................
..
a retain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ Q
3. Did decedent own an 'in trust for' or payable-upon~eath 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 benefiaary designation? .................................................................................................. ^
IF THE ANSWERT~O AyNY OF THE AI30VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
!~`~."~~~:'4'.-:~?~~z~{Yi~, 'r.: ~ - .~-~~ `~ ~~yt+kr4R~:i'S ,~5;~.'t.;q'4'~~:.~ ,~•+' "'R tdi
For dates of death on ar 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 p2 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 disdosure of assets and
filing a tax return are still applicable evert if the surviving spouse is the only benefiaary.
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 valu$ of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent, except as noted in
72 P.S. §9116(1.2) p2 P.S. §9116(a)k1)].
• 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-1503 EX + (8-88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS ~ BONDS
ALEXINE M. HIKES 21 11 0
M propeyr johrtlirowmd rritlr right o(survl+rorship must bu dNclaed on &hrrduN F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 544 shares of Comcast stock at $19.68 per share 10,705.92
TOTAL (Also enter on line 2, Recapitulation) ~ $
(If more space is needed, insert additional sheets of the same sae)
REV-1508 EX + (8-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC.
INHERrrANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ALEXINE M. HIKES 21 11 0
Include the proceeds of litlgafion and the date the proceeds were received by the estate.
M proprarty Jolntl)howrnd wNh right of survNorship nwst bf, dbxk-wd on &hraduM F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, PNC Bank -savings akxount #6309 5,825.17
2. ~ PNC Bank -checking account #8416
3,076.96
3. ~ Chapel Point -refund ~ 5,090.75
4. ~Thrivent Money Market Fund
5. ~ Dreyfus Municipal Bond Fund
645.28
52.66
TOTAL (Also enter on line 5, Recapitulation) ~ ;
(If more space is needed, insert additional sheets of the same s¢e)
REV-1511 EX+ (10-09)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE C03TS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ALEXINE M. HIKES 21 11 0
DsadsM's dsbb must bs nportsd on t3chsduN L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Auer Cremation of PA 247.00
2. Pastor Allwein -funeral service 100,00
3. Oak Lawn Cemetery 300.00
4. Jane's Catering -funeral dinner 393.35
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
Cihr State ZIP
Year(s) Commission Paid:
2, Attorney Fees: Puhl, Eastman & Thrasher 400.00
3. Famiy Exemption: (If decedents address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Register of Wills 130.50
5 Accountant Fees:
6. Tax Return Preparer Fees:
7. Register of Wlls -filing of Inheritance Tax Return 15.00
8. Brokerage commission 96.16
TOTAL (Also enter on Line 9, Recapitulation) I ;
If more space is needed, use additional sheets of paper of the same sae.
REV-1512 EX+ (12-08)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILRIES, ~ LIENS
ESTATE OF FILE NUMBER
ALEXINE M. HIKES 21 11 0
Report debt incurred by the decedent prbr to death that retnalned unpaid at the date of death, Indudbtg unrolmbuniled medical mcpenses,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Chapel Point 196.42
2. Millennium Pharmacy 152.81
TOTAL (Also enter on Line 10, Recapitulation) I ;
H more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10j
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ALEXINE M. HIKES 21 11 0
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lbt Tnr!stes(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include ought usal distributbns and transfers under
Sec. 91 ~6 (a~1.2).)
1. Vance H. Hikes - 171 Hay Street, Gettysburg, PA 17325 Lineal 7,788.50
2. Karen Petyak - 194 Ridge Hill Road, Mechanicsburg, PA 17050 Lineal 7,788.50
3. Dale Hikes - 218 WesYMain Street, Apt. 1, Box 78, Lineal 7,788.50
St. Charles, IA 50240
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-150)0 COVER SHEET, 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 ;
If more space is needed, use additional sheets of paper of the same size.