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~'
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Dl~E FILED "~
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~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
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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.