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HomeMy WebLinkAbout03-22-12~__ _ - 1505611185 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box zaoso~ INHERITANCE TAX RETURN 21 11 1352 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 111-18-6362 11122011 02131926 Decedent's Last Name Suffix Decedent's First Name M I GEIGER EUGENE T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI GEIGER BEULAH q Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - -1850 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ Prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) ^ death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust.) 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death Between 12-31-91 and 1-1-95) ^ 11. Election to Tax under Sec. 9113(A) Att ( ach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name D aytime Telephone Number KEITH 0• BRENNEMAN 717-697-8528 First Line of Address 44 WEST MAIN STREET Second Line of Address P•0• BOX 318 City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's a-mail address: REGISTER OF~QtLLS USE ON~i~' _ , s ~ - r ~ ,. r ~-rt N --~1',~ tV _~, .~ r-,.=~7 C~ -'O `j = Y c ~ - + :~ v ...y • • < Dl~E FILED "~ i1~~ ~iiucr penances or penury, i declare that I have examined this return, inGuding 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. SI%G/NJJATUREsO/F PE/~RSO%jyf( RESPONSIBLE FyOR FILING RETURN DATE ~~ V 6L(/i_.C LC~ .U ~f L?O~ /r ~.n ~ . _ ~~ . ~ n ._ BEULAH A• GEIGER, EXECUTRIX y i 'Z~ r- = ~~~ , ,f.-, _..-, t: O ^rt 609 EAST COOVER STREET, MECHANICSBURG, PA ~~..~ l ,y.+r.~ yr rr~crrv~~r< v i r,tht I tiHN KtF'FZESENTATIVE DATE 1~7 55 ADDRESS '3 ~ ~ ~/ ,~~_ KEITH 0• BRENNEMAN, ESQURIE 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA 17055 Side 1 1505611185 1505611185 OM4647 3.000 Ct n~ REV-1500 EX (FI) 1505611285 Decedent's Name GEIGER II~ FNF Decedent's Social Security Number 111-18-6362 RE CAPITULATION T 1. Real Estate (Schedule A) 1. 0 • D 0 2. Stocks and Bonds (Schedule B) . 2 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , , ... 3. D•DO 4. Mortgages and Notes Receivable (Schedule D) . ................ a. 0.OD 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 1, 0 21.7 5 6. 7. Jointly Owned Property (Schedule F) ~ Separate Billing Requested . • Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 6. 7. 0.OD 0 • D D 8. Total Gross Assets (total Lines 1 through 7) 8 1. ~ fl ~ 1. _ 7 ~ 9. Funeral Expenses and Administrative Costs (Schedule H). g. 1, 8 6 6 •8 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) , ........ 10. 0.00 11. Total Deductions (total Lines 9 and 10) , . 11. 1, 866 •86 12. Net Value of Estate (Line 8 minus Line 11) 13. , " " " " Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. (845.11) an election to tax has not been made (Schedule J) , . 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) . ... ..... TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 1a. (845.11) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers untjer Sec. 9116 U (a)(1.2)x.O _ 0.00 16. Amount of Line 14 t xable at lineal rate x .0 4~ 15. 0.00 17. 0. 0 0 Amount of Line 14 taxable 16• 0 • 0 0 at sibling rate X .12 0 • D 0 18. Amount of Line 14 taxable 17. 0 ' D 0 at collateral rate X .15 0 • 0 D 18. 0.00 19. TAX DUE 19. 0 • 0 D 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505611285 1505611285 OM4646 3.000 REV-1500 EX (FI) Page 3 File Number Total Credits (A + B) (2) D , D D 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) D • D D Fill in box on Page 2, Line 20 to request a refund. (4) D • D D 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) D•DD Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN " " X IN THE APPRO PRIAT E 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 . ^ 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" or payable-upon-death bank account or securit at hi h ^ ^ O y s or er 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 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. §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)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. OM4671 2.000 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) D • D D 2. Credits/Payments A. Prior Payments D • D D B. Discount _ D D 0 REV-1508 EX+ (11-10) Pennsylvania DEPARTMENTOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY tJ I A I t 17F: Eugene T . Geiger FILE NUMBER: Include the proceeds of Iltlgatlon and the date the proceeds were received by the estate. 21 11 1352 All propert 'ointl owned with ri ht of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1.I Various refunds due the decedent 1,021.75 TOTAL (Also enter on line 5, Recapitulation) $ 1 021.75 OW46AD 2.000 ~ If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10.09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER Eu ene T. Gei er 21 11 1352 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. TD Bank, N.A credit charges for funeral flowers, cremation services and obituary ad 629.96 B• ADMINISTRATIVE COSTS: 1 Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP _ Year(s) Commission Paid: 2~ Attorney Fees: 3. Family Exemption: (It decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4 • Probate Fees: 5. Accountant Fees: 6• Tax Return Preparer Fees: 7. 1 Cumberland Law Journal Advertise Executrix Notice Total from continuation schedules . TOTAL (Also enter on Line 9, Recapi swasnc z o0o If more space is needed, use additional sheets of paper of the same size. 350.00 75.50 75.00 736.40 $ 1,866.86 Estate of: Eugene T. Geiger Schedule H Part 7 (Page 2) 21 11 1352 2 Register of Wills filing fee for Inheritance Tax Return 15.00 3 The Sentinel advertising Executrix Notice 221.40 4 Reserve for filing fees and other expenses associated with the administration of the Decedent's estate 500.00 Total (Carry forward to main schedule) 736.40 REV-1513 EX+ (01-10) pennsylvania DEPARTMENiOF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: SCHEDULE J BENEFICIARIES 1MBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [InGude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Beulah A. Geiger 609 East Coover Street Mechanicsburg, PA 17055 FILE NUMBER: 21 11 1352 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Surviving Spouse _~ R DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER SHEET AS APPROPRIATE II NON-TAXABLE DISTRIBUTIONS - A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET If mores $ 0.00 9W46AI 2.000 pace is needed, use additional sheets of paper of the same size.