HomeMy WebLinkAbout01-10-12 (3),+
1505610140
REV
1500 ~` ~°'-'°'
- OFFICIAL USE ONLY
PA Department of Revenue Counly Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO sox 2aosol 2 1 1 1 1 1 0 9
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Sociai Security Number Date of Death MMDDYYYY Date of Birth NNIADDYYW
1 6 8 3 6 9 6 5 9 0 9 0 9 2 0 1 1 0 9 1 7 1 9 4 5
Decedent's Last Name Suffix Decedent's First Name MI
Y o r t y K a y M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Y o r t y S R L e o n a r d E
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
1 6 3 3 0 1 2 0 3 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
pnor to 12-13-82)
4. Lir.:ited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (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)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
S t e p h e n J- H o g g, E s g 7 1 7 2 4 5 2 6 9 8
t.., ;
First line of address
1 9 S H a n o v e r S t r e e t
Second line of address
S t e 1 0 1
City or Post Office
C a r l i s l e
State ZIP Code
REGISTWILLS U>?6~ONLY~
C3J ~~..
Ca r
~~/~ -rr
:~_
ATE FILED
~ ~" ~~
P A 1 7 0 1 3
Correspondent's e-mail address:
Under penalties of pery'ury, i declare that I have examined this return, induding accompanying schedules and statements, and t0 the best of my knowledge and belief,
it is true, co nd complete. DeGaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGI~ATUR PERSON RESPO OR FILIN TURjN ~E
~// ~'/~~
242 9~
SIGNATURE
S• Hanover
REPRESENTATIVE
rlisle
Ste• 101 Carlisl
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140
17013
DATE
PA
1505610140
1505610240
REV-1500 EX Decedent's Social Security Number
Decedent's Name: K a Y M• Y o t^ t v 1 6 8 3 6 9 6 5 9
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 and Notes Receivable (Schedule D) .......................... 4.
6 0 3 5 5 . 9 5
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 1 0 2 • 3 D
7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property
S
h
d
l
G
~ S
t
Billi
R
t
d
7
(
c
e
u
e
) _
epara
e
ng
eques
e
....... .
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 6 0 4 5 8. 2 5
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• 1 2 6 0 9. 4 2
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ....... 10. 2 2 9. 4 3
11. Total Deductions (total Lines 9 and 10) ........................ ....... 11. 1 2 8 3 8 . 8 5
12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12. 4 7 6 1 9 . 4 ^
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. 4 7 6 1 9 • 4 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 _ 2 3 8 0 9.? 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 2 3 8 0 9. 7 0 1s. 1 0 7 1. 4 4
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18, O. D D
19. TAX DUE ............................................... ....... 19. 1 0 ~ 1 • 4 4
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
L 150561024D 1505610240 J
.REV-15001=X Page 3
Decedent's Complete Address:
Flle Number
21 11 1109
DECEDENT'S NAME
Kay M. Yorty -
STREETADDRESS
CITY STATE ZIP
Tax Payments and Credits:
~• Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments -
B. Discount -
700.00
53.57
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.
(1) 1,071.44
(3)
753.57
(4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 317.87
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; 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? ....................................................................................... ^ ^
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 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 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 riot 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 isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Total Credits (A + B) (2)
REV-1508 EX + (8-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BIG~NK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERlSONAL PROPE~2TY
RESIDENT bECEDENT
ESTATE OF rat numatR
Kay M Yorty 21 11 1109
Indude 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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Members 1st Checking Acct#62323-11 437.20
2. Members 1st Savings Acct#62323-00 4,261.92
3. Certificate Account#414943-40 35,085.23
4 Certificate Account#414943-41 20,556.45
5. Interest 9/30/10 Savings Acct 0.88
6. Interest 10/30/11 Savings Acct 0.91
7. Interest 11/29/11 Savings Acct 0.82
8. Share Dividend Certificate 0041 2.70
Accrued Interest to DOD
9. Share Dividend Certificate 0040 4.61
Accrued Interest to DOD
10. Members 1st Savings Acct#414943-00 5.00
11. Interest Accrued to DOD Savings Acct#62323-00 0.23
TOTAL (Also enter on line 5, Recapitulation) ~ $
(If more space is needed, insert additional sheets of the same size)
. REV-1509 EX* (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Kay M. Yorty 21 11 1109
SCHEDULE F
JOINTLY-OWNED PROPERTY
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S)
A. Leonard E. Yorty, Sr.
ADDRESS
Spring Road
ale. PA 17013
TIONSHIP TO DECEDENT
B.
c.
JOINTLY-OWNED PROPERTY:
spouse
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
1. A. 5/13/04 Members 1st Checking Account244756-11 40.58 50. 20.29
2. A. 5/13/04 Members 1st Savings Account244756-00 164.02 50. 82.01
TOTAL (Also enter on Line 6, Recapitulation) I S 102 30
If more space is needed, use additional sheets of paper of the same size.
REV-151`1 EX+ (10-09)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Kay M Yorty 21 11 1109
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Wetzel Funeral Home and Crematory, Inc. 5,009.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) Leonard E. YOrty, Sr.
Street Address 2421 Spring Road
city Carlisle State PA zlP 17013
Year(s) Commission Paid:
2.
3.
AttomeyFees: Stephen J. Hogg, Esquire '
Family Exemption: (If decedents address is not the same as claimants, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5 Accountant Fees:
6. Tax Retum Preparer Fees:
3,000.00
3,000.00
181.50
7. Bond Filing Fee 15.00
8. Advertising: Law Journal 75.00
The Sentinel 178.92
9. Accounting (Est) 200.00
10 Tax Return and Inventory Filing Fee 30.00
11. Personal Representative Bond 920.00
TOTAL (Also enter on Line 9, Recapitulation) I $ , ~ ono „~
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EXt (Ot-10)
ESTATE OF: FILE NUMBER:
k~„ nn v.,fi, 21 11 1109
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not,list Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outn'ght spousal distributions and transfers under
Sec. 91 i6 (a) (1.2).]
1. Dwaine Deatrick Lineal
5735 York Road
New Oxford, PA 17350
2. Darrell Deatrick Lineal
9 S. Peters Street
New Oxford, PA 17350
3. Daniel Deatrick Lineal
5680 York Road
New Oxford, PA 17350
_ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-15n0 COVER S HEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAk;EN:
1. Leonard E. Yort~j, Sr.
2421 Spring Road
Carlisle, PA 17013
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
If mae spaceis needed, use additional sheets of paper of the same size.