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Home My WebLink About02-03-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171 28-0601 RECEIVED FROM: HARRIS PATRICIA M 837 BRIARWOOD LADE CAMP HILL, PA 17011 fold ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: REV-1162 EX(11-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SSN: 165-38-1144 2106-0369 HARRIS RICHARD H JR 0/03/2012 0/03/2012 CUMBERLAND Oil/ 04/ 2006 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK#130 INITIALS: HEA RECEIVED BY: N0. CD 015546 59,299.08 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ACN ASSESSMENT AMOUNT CONTROL NUMBER REV-1500 Ex c°z_~~, cF-> ~' 1505610105 PA Department of Revenue pennsytvanfa Bureau of Indtvidual Taxes °`""`"`"`°`"`"""` PO BOX z8o6ot INHERITANCE TAX RETURN Harrisburg, PA t~t28-0601 RESIDENT DECEDENT ENTER DECEDENT INFOi2MATION BELOW Social Security Number Date of Death MMDDYYYY 165 38 1144 02/04/2006 l _ _ _ _...I ... Decedents Last Name Suffix Harris ~ ~r (If Applicable) Enter Surviving Spouse's Information Below S OFFICIAL USE ONLY County Code Year File Number 21 06 ) 0369 Date of Birth MMDDYYYY 06/18/1945 _........~ MI Decedent's First Name Richard H . pouse s Last Name Suffix Spouse's First Name `Harris __ ..................._................................_..................... : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;Patricia .........._ ................................................................................................................... M_.. Spouse's Social Security Nlumber `-- ......................_......._._............................__... REGISTER OF WILLS FILL IN APPROPRIATE OWALS BELOW O 1. Original Return OD 2. Supplemental Return O 3. Remainder Return (Date of Death O 4. Limited Estate O 4a. Future Interest Compromise (date of prior to 12-13-82) O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate (Attach Co of Wild) O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes py (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 SEC ION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number !Robert L. Knupp, Esgluire ~ ' (717)238-7151.C'7............_........._._..... _.....~~__....._i r~ ~ REGISTER OF ~: U ONLI'T'i t~' ' t~~ r' ~; '~~ First Line of Address _. ~ ri ~ W r `~ r P.O. Box 630 C ~ : " ~. .,Second Line of Address "`""-"'"'~~"' --_____~._ .______~~ ___, ~ ~ _ .~ ~, f, 407 North Front St -t ~ ~ .. ~, rn ~,~ a _...._.__._._..__ ...............__.._......_._.__............__.._.............._..._......._....._...._._......._.._._..............._..................._._..__.........._...._._..._._...._......_.._...... City or Post Office State ZIP Code DATE FILED ~ trt ;..Harrisburg i..._._...._. _..__...._.....__ ..............._._. PA i .17108 ...._...._........__........__...___........._..._.. _..._ j Correspondents a-mau adklress: robert.knupp ~ _velizon.net Under penaftfes of perjury, I dada it Is true, correct and complete. that i have examined this return, induding acxompanying schedules and statements, and to the hest of my knowledge and belief, aretion of preparer other than the personal representative Is based on all i f tf f SI AT FjEOF~pERSON RES n ONSIBLE F~Og FILING RETURN ~ om~a on o which preparer has any know DATES ledge. ~ Patricia M. Hams 837 ~riarwood Lane, Camp Hill, PA 17011 '~/ .fem./ - ~-........ ~~ ~ /J DATE ~isiv /T ADDRESS ~ ' ~ ~ ~ ~~ Flowers & Flowers, CP,~s, 5775 Allentown Blvd., Suite 102, Harrisburg, PA 17112 (717) 652-6564 PLEASE USE ORIGINAL FORM ONLY Side 1 15D56110105 1505610105 J REV-1500 EX (FI) 1505610205 Decedents Name: Richard H. Harris RECAPITULATION 1. Real Estate (Schedule A) ............................................ . 1. 2. Stocks and Bonds (Schedule B) ...................................... . 2. 3. Closely Held Corpbration, Partnership or Sole-Proprietorship (Schedule C) .... , 3. 4. Mortgages and Ndtes Receivable (Schedule D) .......................... . 4. 5. Cash, Bank Depoeits and Miscellaneous Personal Property (Schedule E)...... . 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested....... , 7. 8. Total Gross Asset's (total Lines 1 through 7) ............................ . 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............... 10. 11. Total Deductions dtotal Lines 9 and 10) ................................. 11. 12. Net Value of Estat6 (Line 8 minus Line 11) .................. 12 ............ 13. Charitable and Govlemmental Bequests/Sec 9113 Trusts for which . an election to tax his not been made (Schedule J) ........................ 13. 14. Net Value SubJect to Tax (Line 12 minus Line 13) ..... 14 F . TAX CALCULATION - EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rite, or transfers under Sec, 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 xable at lineal t X ~ ra e .0 17. Amount of Line 14 taxable 16 at sibling rate X .17 17 18. Amount of Line 14 taxable at collateral rate X .15 . _ 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IIF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 150561~02D5 Decedent's Social Security Number 165-38-1144 1505610205 161,336.45 161,336.45 -__ 400.00 160, 936.45 160,936.45 O REV-1500 EX (FI) Page 3 Decedent's Complete Address: Richard H. Harris, Jr. STREET ADDRESS 837 Briarwood Lane clTr Camp Hill Tax Payments and Clredits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII fn oval 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. Flle Number 2106-0369 PA ~ 17011 (1) 7,242.14 Total Credits (A + 6 j (2) (3) 2,056.94 (4) (5) 9,299.08 Make check payable to: REGISTER OF WILLS, AGENT. ~__ PLEASE ANSWER SHE 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 revelrsionary 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 for' orpayable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent oujm an individual retirement acxount, annuity or other non-probate property, which contains a beneficiary designatron? ........................................................................................................ 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 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 19f the child is 0 percent [72 P.S. §9116(a)(1.2)J. • The tax rate imposed on the net vglue 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(a)(1)]. • The tax rate imposed on the net'value of transfers to or for the use of the decedenPs siblings is 12 percent [72 P.S. §9116(a)(1.3)J. 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-15og EX+ (oi-IO) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ca ~ is I c vr: FILE NUMBER: Richard H. Harris, Jr. 2106-0369 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANfi(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT ..... .......... A. Ma M. Harris _. _ .~ _. ry :7165 Chambers Hill Road iMother ?Harrisburg, PA 17111 e. _.. C. _ - ........ ...._ JOINTLY OWNED PROPERTY: LETTER DATE DESC ITEM NUMBER 1 FOR X)IN TENANT A i MADE DINT RIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSTITUTIDN AND BANK ACCDUNT NUMBER OR SIMILAR IDENTIFYING NUMBER, ATTACH DEED FDR )DINttY HELD REAL ESTATE. _, DATE OF DEATH VALUE OF ASSET % OF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST . • :06/30/83 Series EE $75 U.S. Savings Bond #K10863185EE - (copy attached) 134.58 50 67.29 2. A. 06/30!83 Series EE $200 U.S. Savings Bond #R5846039EE - (copy attached) 358.88 50 179.44 3. A. 08/02183 Series EE $100 U.S. Savings Bond #C48900459EE - (copy attached) i 7944 50 89.72 4• A• .Series HH U.S. Savings Bonds - Various issue dates between August 1992 through August 2004, and various denominations. (See schedule and copy of bonds attached) 322,000 00 50 161,000.00 TOTAL (Also enter on Line 6, Recapitulation) I ~ 161,336.45 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~i ' Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS w~n~~ yr -- FILE NUMBER Richard H.Harris 2106-0369 Decedent's debts must be reported on Schedule I. ITEM _ NUMBER DESCRIPTION A• FUNERALEXPEN$ES: AMOUNT i. B. 1 ADMINISTRATIVE !COSTS: Personal Represehtative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State Z1P _. Z• Attorney Fees: 3• Family Exemption:. (If decedent's address is not the same as claimant's, attach explanation,) Claimant Street Addriss City State ZIP _ Relationship) of Gaimant to Decedent 4• Probate Fees: - - 5• Accountant Fees: - 400.00 6• Tax Return Prepareir Fees: 7. _ _ _ _ _ TOTAL (Also enter on Line 9, Recapitulation) $ 400.00 If more space is needed, use additional sheets of paper of the same size. - - - - _ i REV-1513 EX+ (O1-10) '~' Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ] BENEFICIARIES CSIATE OF; FILE NUMBER: Richard H. Harris 2106-0369 NUMBER NAME AryID ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not list Trustee(s) OF ESTATE I TAXABLE DISTRIBUT110NS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).J 1~ Mary M. Hares, 71!65 Chambers Hill Road, Harrisburg, PA 17111 Mother 160,936.45 2. Patricia M. Hams, X837 Briarwood Lane, Camp Hill, PA 17011 Spouse ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIB~IONS A. SPOUSAL DISTRIBliTI0N5 UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: L 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. _ - - Personal Income Tax e-Services Center Penalty and Interest Calculations CALCULATION DATES- 11/04/2006 TO 2/3/2012 TAX DEFICIENCY $ 7,242.14 CALCULATED INTEREST $ 2,056.94 BALANCE AS OF 2/3/2012 $ 9,299,08 https://www.doreservices.state~~pa.us/pitservices/Default.aspx - - Page 1 of 1 1 /3 0/2012