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Home My WebLink About01-20-121505611180 -~ REV-1500 EX,OZ_"' IF° Pennsylvania OFFICIAL USE ONLY PA Department of Revenue oeananueNTOFRe~er+ue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 !! ! , '1 r~ ; I Harrisburg, PA 17128-0601 RESIDENT DECEDENT l ~~ ~ ~ .,?L't, ENTER DECEDENT INFORMATION BELOW Socia', Securty Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 161-64-2],16 07022011 011,21944 Decedent's Last Name Suffix Decedent's First Name MI WALTERS NANCY H (If Applicable) Enter Surviving 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 BOXES BELOW ~x 1.Original Return 0 2. Supplemental Return 0 3. Remainder Return (Date of Death Prior to 12-13-82) Q 4. Limited Estate Q 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required death after 12-12-82) Ox 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit (Date of Death Q 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-'I-95) (Attach Schedule 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G. FREY 7172465838 First Line of Address 5 S. HANOVER ST Second Line of Address City er Post Office CARLISLE State ZIP Code PA 17013 Correspondent's a-mail address: R F R E Y a~ F R E Y T I L E Y. C O M REGISTE WILLS USE~IVLY .~ - m ;:L7 '~ ~Kx i ~.~ C7 {. t 7 rn ~, C.~ ~~ ~ J ~; ~-~ ...., ~ ~ w --+ , D+~rE FILED ~ .--: ~', _..~ ~, -'ft Under penalties of perjury, I declare 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. SIGN,QTUfitE OF PERSON RONSIBLE F FILING RF17'URN DATE ~ _ ~~ _ / ADDRESS `-' 2 MILL ROAD CARLISLE PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE 01/13/12 ADDRESS 5 SOUTH HANOVER STREET, CARLISLE. PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1, ..y 1505611180 150561118D J ;~,,,,~;-~ ,~, J 1,505611280 REV-1500 EX (FI) Decedent's Sccial Security Number Decedent's Name: NANCY H WALTERS 161-34-2116 P,ECAPITULATION 1. Real Estate (Schedule A) ............................... ........ . 1. N 0 N E 2. Stocks and Bonds (Schedule B) ........... ....................... . 2. N 0 N E 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . 3. N 0 N E 4. Mortgages and Notes Receivable (Schedule D) .......... ............ . 4. N 0 N E 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ... . 5. 6 6 2 0 . 0 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. NON E 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ..... .. 7. NON E 8. Total Gross Assets (total Lines 1 through 7) ........................ .. 8. 6 6 2 0 . 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) .... . ......... .. 9. N 0 N E 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......... .. 10. NON E 11. fiotal Deductions (total Lines 9 and 10) ........................... .. 11, 0.00 12. Net Value of Estate (Line 8 minus Line 11) ......................... .. 12. 6 6 2 0 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 6 6 2 0 . 0 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.0 0 6620.00 15. 0 • 00 16. Amount of Line 14 taxable at lineal rate x .0 4 5 16, 0. 0 0 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 • 0 0 18. Amount of Line 14 taxable at collateral rate X . 15 18. 0 • 0 0 19. TAX DUE ....... ................................ ............ .. 19. 0 . 0 0 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYME NT 0 Side 2 1505611280 1505611280 P,EV-1500 Ex (FI) Page 3 Decedent's Complete Address: 21-11- File Number (3) DECEDENT'S NAME NANCY H WALTERS STREET ADDRESS CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Pricr Payments B. Discount 3. Interest (1) 0.00 Total Credits (A + B) (2) 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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 the TAX DUE. 161-34-2'16 0.00 (4) 0.00 (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: 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 .................................... ..... ^ Q c. retain a reversionary interest ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or care? ..................:......................................... ..... ^ Q 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................... ....... ^ 0 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 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 (aj (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. §°116(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-'~°8~+`'--'°' SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OP REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER; NANCY H WALTERS 21-11- Include the proceeds of litigation and the date the proceeds were received by the estate. If more space is needed, use additional sheets of paper of the same size. REV-1513 EX* (01-1 O1 pennsylvania SCHEDULE J DEPORTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: NANCY H WALTERS RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] LARRY L. WALTERS ~ 2 MILL ROAD, CARLISLE, PA 17013 SPOUSE ENTIRE REMAINDER ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SHE ET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX !S 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. If more space is needed, use additional sheets of paper of the same size.