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Home My WebLink About04-02-12 (2) 1505610105 REV 1500 EX (OZ-11) (FI) PA Depa ment of Revenue Pennsylvania OFFICIAL USE ONLY Bureau o Individual Taxes o~P,~.,,~„o, ,~~E~~~ INHERITANCE TAX RETURN Coun Code Year File Number " PO BOX Harrisbu So6oi PA 1 i28-o6oi RESIDENT DECEDENT /~ 1 ~ ~~ ENTER DECEDENT INFO MATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 172-01-1405 '~ 05/28/2011 07/25/1915 Decedent's Last Name ~ Suffix Decedent's First Name MI HUBER JR HENRY S It A licable Enter Survi ( PP ) ring Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Souse's Social Securi N p ty ~mber ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I REGISTER OF WILLS FILL IN APPROPRIATE 01i'ALS BELOW O 1. Original Return Ii t~ 2. Supplemental Return O 3. Remainder Return (Date of Death ', Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Tes ate O 7. Decedent Maintained a living Trust 8. Total Number of Safe Deposit Boxes {Attach Copy of Wil) (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 Sched O) RRESPONDENT - THIS SEC ~ ~ ~ Z;7 ~^f J `~' Name ION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIOW SHOUL , ECTED TO:.~ Daytime Telephone~gt~er zy Marck C. Duffle (717) 761-4544"-'?ern '"~ f" r, ~` _ { REGISTER Of.11V~L~, -U E ONLY ~....} ~ -.m. First Line of Address ~7 ~ . _-y 301 Market Street '' L~ i Second Line of Address ~; P.O. Box 109 City or Post Office I State ZIP Code DATE FILED Lemoyne I, PA .17043 Correspondent's a-mail address: MCD@JDSW.COM Under penalties of perjury, I decl re 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. eclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNF~RE OF PER RES ON LE FOR ING RETURN DATE ADDRESS 523 Ninth Street, New Cumberland, PA 17 0 SIGNATURE OF P R THAN REPRESENTATIVE DATE '} ADDRESS 301 Market Street, P. .Box 109, Lemoyne, PA 17043 PLEASE USE ORIGINAL FORM ONLY Side 1 15D56]~ 0105 1505610105 J r- _~ -T'1 _~ REV-150b EX (FI) Decedent's Name: IiUBER, Henry S. Jr. RECAPITULATION 1. Real Estate (S 2. Stocks and Bonds 3. Closely Held Corp 1505610205 Decedent's Social Security Number 172-01-1405 le A) ............................................. L chedule B) ....................................... 2. 2,282.93 Ilion, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and No es Receivable (Schedule D) .................. 4, 5. Cash, Bank Depos~ s and Miscellaneous Personal Property (Schedule E).... ... 5. 6. Jointly Owned Pro erty (Schedule F) O Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfe & Miscellaneous Non-Probate Property - (Schedule G) i O Separate Billing Requested..... ... 7. 8. Total Gross Asse (total Lines 1 through 7) .......................... ... 8. _. 2,282.93 9. Funeral Expenses nd Administrative Costs (Schedule H) ................ ... 9. 15.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 11. Total Deductions (~ otal Lines 9 and 10) .............................. ... 11. 12. Net Value of Estat (Line 8 minus Line 11) ........................... ... 12. 2,267.93 13. Charitable and Gov rnmental Bequests/Sec 9113 Trusts for which - an election to tax h snot been made (Schedule J) ..................... ... 13. 14. Net Value Subject o Tax (Line 12 minus Line 13) ..................... ... 14. ' 2,267.93 TAX CALCULATION -S EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 t xable at the spousal tax r te, or transfers under Sec. 9116 - (a)(1.2) X .0_ ~ 15. 16. Amount of Line 14 t xable -- - - -- - at lineal rate x .0 4 2,267.93 16. ' 102.06 17. Amount of Line 14 t xable at sibling rate X .12 17 18. Amount of Line 14 t xable ~ at collateral rate X . 5 18 19. TAX DUE ........ I . ............................................... .. 19. ' 102.06 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O I~ Side 2 1505610205 1505610205 I REV-1500 EX (FI) Page 3 Decedent's Complete Address: Henry S. Huber, Jr. ', STREETADDRESS The Woods at Cedar Run Flle Number 824 Lisburn Road, Apt. 31 h CITY ------1-- - - STATE ---' ZI - Camp Hill ' ~ PA 17011 Tax Payments and Cr~dits: 1. Tax Due (Page 2, Line 19) ', (1) 102.06 2. Credits/Payments A. Prior Payments ___ ~ _ B. Discount '~ Total Credits (A + B) (2) 3. Interest ', 4. If Line 2 is greater than Line 1 + ~ine 3, enter the difference. This is the OVERPAYMENT. (3) Fill in oval on Page 2, Line 20 ~o request a refund. (q) 5. If Line 1 + Line 3 is greater than ~ine 2, enter the difference. This is the TAX DUE. (5) 0.25 102.31 PLEASE ANSWER 1. Did decedent i a. retain the b. retain the r c. retain a rev d. receive the 2. If death occurr without receivii 3. Did decedent c 4. Did decedent c contains a ben Make check payable to: REGISTER OF WILLS, AGENT HE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS ke a transfer and: Yes No or income of the property transferred .......................................................................................... ^ t to designate who shall use the property transferred or its income ............................................ ^ ,ionary interest .............................................................................................................................. ^ ~ ~mise for life of either payments, benefits or care? ...................................................................... ^ after Dec. 12,1982, did decedent transfer property within one year of death adequate consideration? .............................................................................................................. ^ I an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ I an individual retirement account, annuity or other non-probate property, which ;iary 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 stat to 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 ven 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 f the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net v lue 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)J. Asibling is defined, under Section 9102, as an indivi ual who has at least one parent in common with the decedent, whether by blood or adoption. Personal Income Tax e-Services Center Penalty and Interest Calculations i CALCULATION DATES- 2/28/2012 TO 3/30/2012 'i TAX DEFICIENCY $ 102.06 ', CALCULATED INTEREST $ 0.25 BALANCE AS OF 3/30/2012 $ 102.31 Start Over https://www.doreservicl~s.state.pa. us/pitservices/Default. aspx I Page 1 of 1 3/26/2012 REV-~5o3 EX+ (7-u) j iZ. Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER James H. Huber. Jr. ~~_~ ~_naae All -- - roperty jointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER ' DESCRIPTION VALUE AT DATE OF DEATH I' 52 Shares ~ M~ettife Inc. Stock Cusip No. 591568108 (Valued using Estatval Valution and is attached to t~is Schedule). I II ~I 2 282 93 TOTAL (Also enter on Line 2, Recapitulation) ; 2,282.93 u more space is neetletl, insert atltlltional sheets of the same size Estate Valuation Date of Death: 05/26/2011 Valuation Date: 05/28/2011 Processing Date: 03/20/2012' Shares Security ' or Par Descriptipn 1) 52 METLIFE IWC (591568108) COM I New York tock Exchange 05/27/201 05/31/201 Total Value: Total Accrual: Total.: $2,282.93 Estate of: Huber, James Estate Report Type: Date of Death Number of Securities: 1 File ID: huber Mean and/or Div and Int Security High/Ask Low/Bid Adjustments Accruals Value 49.10000 93.43000 H/L 99.45000 93.63000 H/L 93.902500 2,262.93 50.00 52,282.93 Page 1 This report 'gas produced wi*_h Estate','a1, a product of Estate valuations & Pricing Systems, Inc. If you have questions, please ontact EvP Systems at ;816) 313-6300 or www.evpsys.com. (Revision 7.1.1) -.