HomeMy WebLinkAbout02-07-12,- ;
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J 1505610105
REY-1500 °``°~u"~
t~- Department of Revenue ~ oFFfaAi. usE ONLY
Bureau of Individual Taxes Counly Code Year ~ We Itumber
INHERITANCE TAX RETURNj . _~.__ ._---.
PO BOX 28o6oi RESIDENT DECEDENT ~1/ 1 ~ ~ _. ,_ ~ ~~~ _
FiarrfsMea. PA i7f28-osoi __- -
MI
~J
Spouse's Last Name SuRbc s ~ Name
$p0"~ $ SO`~ ~""ty " _ THLS RETURN MUST BE FS.ED IN DUPLICATE WITH THE
REGISTER OF WILLS
~ a~ APPROPRIATE ov~LS sELOw
O 1.Originai Rehm ~' 2 Suppl Rshm
O 4. Limited Fatale O 4a Fuhre kMarest Compromise (dale of
death attar 12-12-82)
O 8. Deosderrt Died Testate O 7. Decedent Maintained a Living Tnrst
(Attach Copy of YIfiN) (Attach Capy of Tnist)
O 9. Lidgetion Proceeds Received O 10. Spousal f~ovarty Credit (Dale of Death
Between 12~1~1 and 1-1-95)
MI
O a Remainder Rehm coals of Dee11t
Priarlo 12-13-82)
O 5. Federal Fatale Tax Rehm Requimd
_ 8. Total Number of Safe Deposit Boxes
O 11. Election b Tax under Sec. 9113(A)
(Attach Schedule O)
tXO1tDENf' - 11f15 SECTION MIST 8E t~LEiED. Atl COf~PONOt~IGE Mu WI~DE11iYLL 7wA ~nuw anuuv of oea:~ ~ w ~~:
Name ..~..._ ..._- . _ . _._ .. _ ._ _...._ . _ ..... _. _ _ °aytlrne Teleplwne Number
~:;
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W ~~
s and OsYef,
_. ~ i i ~ ~N~P ~~~ ~ a s/~~P~°~~.~/'~~~ ~~} ` i gas
SIGNATURE OF PREF~ARER OTHER THAN REPRESENTATNE ATE
ADDRESS
PLEAaE tISE ORNiIlUL FO1~ ONLY
Side 1
L 1505610105 1505610105
1505610205
REV 1500 EX (FI) DecederK•s Social ~~ Number
~ ~ MFR T 5 ~~ow,v
~- r~ _~ °i ~ o_~~ a ~._l
Dao~a.rrr$Ne~:
-
RECAPRULATIOit
1. Real Estate (Schedule Aj ............................................. 1. ~., .
2. Stocks and 8onds(Schedule B) ....................................... 2. _ _.. .... ._
3. Closely Held Corporation, PaiP or Sole-Proprietorship (Sdadule C) ..... 3.
4. IlAortgages and Notes Receivable (Schedule D) ........................... 4.. _
5. Cash. BaNc Deposits and MisoeNaneous Personal Property (Sdredrrle E)....... 5.
8. Jointly Owned Properly (Sdredule F) O Separate t3iNin9 Requested ...... 6 a N_ .~ Q ~, y (~ _. D ~ ~ = r~
7. krter-Vives Transfers $ Miaoaaaneous Non-Prot>a6e Properly ~ ~r ~1
8. Total Grote Aseats (total Lines 1 thragh 7) ............................. 8. ; ~ ~ ~. ! ~ ~~
9. Funeral Expenses and Adrttirdstiratlve Costs (Schedule H) ................... 9.
10. Debts of Decedent, Mortgage Liabi~es and Liens (Schedule q ............... 10.
11. Total Dedrrctiorrs (total Lir>es 9 and 10) ................................. 11.
.
12. Net Value of Estate (Line 8 minus line ,,, .............................. _
12. .
~ / ~ ~ / a3
_
.
~
13. CF>arifable and Gonrerrul Bequesffi/Sec 9113 Tn~s for which , ~. .
.
.,..~ . x., ., . , .. _ .. ~ ,
,.,... _ . ~ r_.
en election to tax has rat been made (Schedule J) ........................ 13.
_ . .,
14. Nst Valve Subject to Tax (Line 12 minus Lure 13) ........................
14. C~
/ I ~
TAX CALt:ULATION -SEE INSTRUCTION8 FOR APPLICABLE tiATE8
15. Amount of Llte 14 taxable
at the spousal tax rate, or
__ _ _
__ _
_ __ _ .. __. ...._ . ....
trarra(ers turder Sec. 9118 _ __ _ _
(a)(1.2) X .0. 15.
~
16. Amount of line 14 r~~ble
at tlneal rate x .o~ '
18. /
~~..1~. 7~ .~,3~ ,
.--
17. Amount of Una 14 taxable _ .. __ __ _ _ __
et sibNng rate X .12
. ,. ._.. ..... _,._ .,~ , . 17.
r.G.... .
..r_r. ~a._ x=~-.,, ... ,.~.R ._..
_..
18. Amount of line 14 taxable
at rate X .15 '
- 18.
~.~u...~._
~-,..... ,_n~...,.~a.~,.~.m_._~.,~,.,.._~...,.~~..,~_,
_. __._
19. TAX DUE ......................................................... 19
~j / D 7.33
~_.__.. _
20. FILL Nt THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
' ~ RE1F1500 EX (FI} Pape 3 FNe Nwnber
1'11arJ~t#'rt Celmeiiete Address:
l ~ ~~,R ~ 5 [3R~~v,(~
sT~r"oo ~ r /J ~ S~~ ~,vc f'~ a
~r1Y ~' ~~~~~ ~U~~ ~~~ ~ ~x~ ~
T» Payrnetnts and cl~llt>s:
1. Tax Due (Page 2, Line 19)
2. CreditslPaymerris
A. Prior Payments
B. Distant
3. Ingest
(1) y~ is 7 ~~
Total Credits (A + B) (2)
(3)
(4)
5. ff line 1 + Line 3 is greater than lire 2, order the d'ilferenoe. This is the TAX DUE (5) `'~' . ~ d / J
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
4. M thre 2 n greater than Line 1 + tine 3, errtrser tre digererroe. This is the OYBZPAYIEtf T.
FN In oval oa Pape 1, Line ZO b rogrrest a rNrard.
1. Did deoederd make a transfer' and: Yes
a. retain the use or irrcorrre of the property trar~etred .......................................................................................... ^
b. ratan the right b designate who sireN uee the property trarrsfarred ar its income ............................................
c. r~r a reversior~y interest .............................................................................................................................. ^
d. receive the prarrise for 19e of eitlrer paymerds, berreFts or tare? ...................................................................... ^
2. M deattr ocarrred after Dec. 12,1982, did deoerlent trarsfer property wi>hn one year of death
without receivirg adequate torrsidera6on? .............................................................................................................. ^ I$l
3. Did decedent own an err 1-ust ta' or PaY~e-rrPa- bards acxxxrnt or searrity at his or her death? .............. ^
4. Did deoederrt own an irrdvidrral retierrrerrt account, arrMJily ar otlrer non-prahaee WuP~Y. ~
tontairrs a beneficiary design~on? ........................................................................................................................ ® ^
~ THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART ~ THE. RETURN.
.~"r> ~ n FFi r?" "d - ..y ~ .r.' ~ x1 ~a.vtr ,.~.
'.',
For dates of death on or crier Juy 1,1994, and trefor+e Jan. 1, 1995, the tax rate on the net value of tran~ers b or for the use of the survivptg spouse
is 3 percent [12 P.S. §9116 (a) (1.1) r)~
For dates of death on or after Jan. 1, 1995, the tax rate krrposad on the net vakre of transfers b or for the use of the survivirg spouses 0 perrx3rrt
(72 P.S. §9116 (a) (1.1) (r')J. The statute does trot exempt a transfer b a surviving spouse from ha~c, and the requirements for rre of asks and
fikng a tax rehm are stiff applicwhle even if the srviving spouse is n,e only t>errefirtiary.
For dates of death on or crier .k>fy 1,2000:
• The tax rate imposed an tiro net value of transfers from a deceased chid 21 years of age or yanger at death b ar for the use of a natural parent, an
adoptive parent or a ~ ~ rte chid is 0 paxcertt (72 P.S. §9116(aK12)].
• The tax tale imposed an tiro net value oftrarrsfers b arforlhe use ofihe decedent's Yrteal berteidaries is4.5 percent, aeoceptas rtoiedn [72 P.S. ~116(aX1)~
• The tax rate imposed on the net value of irarsfers b or for the use of the decedents s is 12 perm [7Z P.S. §9116(aK1.3)]. A siring is defined,
rxrder Section 9102, as an individual who has ~ least one parent n carratton with tre decedent, whether by blood ar adoption.
~'
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~nnsylvania
DEPARTMENT OF REVENUE
llNIEkITIINCE TAX RETURN
R oE~r
scN~ou~ F
JOINTLY-0WNED PROPERTY
~~TE ~: ~ ~ ~. g~~ ~ ~ ~ ~ d~~
1? as swR beceen owned rrNirin ene Vaer d the raoereEk's ~s d deatq, k sltwt be neporoei e~ 9ci~aids C.
SURVIVING ]DINT TENANT(S) NAME(S) ADDRESS REL/1TIONSFIID 70 DE(~DErIT
a ~fEl/FiV h' ~d°L!'v~ ~~ / ~3/G ~/° /~'l R 0 S, 7 _ SdN
Sy~iA,o~s~3~~ ~i~ /7~
B.
~.
~on~m Y awN w rY:
IiFll
NuMeER LETIEit
WR
,T3uwr DAIS
ulwE
]DMf oESaI>prTON of PROPERTY
TNCIl10E NAME of fDNNCIAL ARD MINK Aa01Mi M11N1ER oR 9161AR
roErrr>fnt~c Rurleel. ATTACH D®fDR ~DHfiLY HEIR REAL ESDITE.
DaE of DEIDN
VIWROF A56Ef % aF
DBf~BRS
OIfEIIEST DATE of DEATH
wIUIE OF
DE~EIIIS 9f191Bi
i. a /99/ c%s s /~b~ ~
~ 5 ~~ ~~~~~
d/33~ ~>> ~p//
9 SO lay y~d.~
~• ~,.~
s~
~Fs
~vs~P ~SSGG~ ~
8'•~, ~~•
TarAL cnls0 eder on line 6, RecaPituladon)' ~ ,~Ll , '~ ~C . ~'
If more space is needed. use additional streets of paper of the same size.
i
pennsytvania
DEPARTMENT OF REVENUE
BriBQTANI~ TAX RETU(rt
NOlrr~SIDB1rT t1EC~l~rT
s~Niouu a
IN~R-YIYOf lRAMfl~iRf ~ use sdtedt,le c, Pan 2, r~t.Y for
MIfC. NON-lROeAT~ `I~ROltlTY ~ method of tax cornp~or-.
Part 1 rtwst indude all transfers of real estate and tangible personal property located in Pennsylvania.
CompNls Part 2 ONLY when the p-oportlortals matlrod of tax computation b NacMd.
indude in the desrxiotion of orooerty the delta the transfer was made and the name and relationship of the trartsferae.
ESTATE OF
This. schedule
- must be completed and 11Nd ~ the ar>aMrer tD questions 1 throu gh 4 on the_ reverse s tile of the RE1h1737 cower a ltset-;is yes.
.,.
ITEM
ktdude rte nente dtlts t+andetee, rr Y-Det,~edwrand rte dale d aatte(er.
DATE OF DEATH
% OF
NUM~R Asech a d the deed to reel eetrM. VALUE OF ASSET r~tTEREST TAXABLE w1U1E
,QE,Gi~'/~n-B ~~~ ~ ~~ ~~~ ~i3, ~~
>~ rara~>< i i i
.,.
ITEM ttdude the named 4is bane(see~ris nrP to0eoederR and rte dek d taider.
LTATE OF DE11TH
x OF
~~
HUMBER Attach a d the deed to reel eetsM. VALUE of ASSET rrTEr:EST (IF TAXABLE VALUE
~.
Pi11RT = TOTILL S ~ i
~~
TOTAL (aso enter on Line 7, Recapitulation. S d a ~J= 7
(if moos space is needed. use additional sheets of paper of tits same size)