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Home My WebLink About04-16-12 (2)J 1505610140 REV-1500 ~` ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 1 2 9 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYW Decedent's Last Name Suffix Decedent's First Name MI Z I M M E R M A N M A R Y M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return 0 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 Q 6. Decedent Died Testate (Attach Copy of Will) ~ death after 12-12-82) 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes 9 Liti ation Pr d R (Attach Copy of Trust) . g ocee s eceived ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO Name : Daytime Telephone Numbefi .:? H U B E R T X G I L R O Y t -" ~'` x~ c; ~, REGIS ~ LS USE ONLY= +'_ , -. rn ~r~_ r~--. ~ , . First line of address ~ - r~ ~~' - M A R T S O N L A W O F F I C E S ~ , ...,.~ r ' ~ . ~~ _ -n Second line of address , ~-,~ • -+ ~ ~ . • ~- 1 0 E H I G H S T ~~ --~, i City or Post Office C A R L I S L E State ZIP Code L DATE FILED P A 1 7 0 1 3 Correspondent's a-mail address: H G I L R O Y a M A R T S O N L A W- C O M Under penalties of perjury, I declare 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR P RSON RESP S LE FOR FI ING RETURN ~ [ DATE ADDRESS `T I ~?s Il L 1004 LANE CARLISL SIGNA U E OTHER THAN REPRESENTATIVE ADD SS 10 E HIGH TREET CARLISL PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 17 DATE PA 170 1505610140 J~ 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: MARY MACLAY ZIMMERMAN RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 0 . 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. 0 . 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 4 7 4 $ . 0 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 0 . 0 0 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 1 6 0 0 0 . 0 0 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 0 ~ 4 8 . 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ........ ........ .. 9. 0 . 0 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ... ........ .. 10. 8 1 2. 0 0 11. Total Deductions (total Lines 9 and 10) ..................... ......... . 11. 8 1 2 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) .................. ......... . 12. 1 9 9 3 6. 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............ ......... . 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ............ ......... . 14. 1 9 9 3 6 . 0 0 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.o 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 9 9 3 6. 0 0 1 s. 8 9 7. 1 2 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g. 0 0 0 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 1505610240 Side 2 1505610240 8 9 7. 1 2 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 1297 DECEDENT'S NAME MARY MACLAY ZIMMERMAN STREET ADDRESS 1000 WEST SOUTH STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 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. Fill in 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. (1) 897.12 Total Credits (A -~ B) (2) 0.00 (4) (5) Make check payable to: REGISTER OF WILLS, AGENT (3) 0.00 897.12 PLEASE ANSWER THE 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 : ...................................................................... ^ Q b. retain the right to designate who shall use the property transferred or its income; ............................... ^ 0 c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 ^ 3. Did decedent own an 'in trust for" orpayable-upon-death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. 0 ^ 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 i; 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)J. 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(1.2) [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)]. 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-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. fN RESI DENT DECEDEN RN PERSONAL PROPERTY ESTATE OF FILE NUMBER MARY M. ZIMMERMAN 21 11 1297 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with fight of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. U.S. Treasury, 2011 income tax refund 4,748.00 TOTAL (Also enter on line 5, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY M. ZIMMERMAN 2:1 11 1297 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM NUMBER INCLUDE THE NAME OFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATE OF DEATH %OFDE(".D~S EXCLUSION TAXABLE THE DATEOFTRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUE OF ASSET INTEREST (IFAPPDCABLE) VALUE 1. 2011: Cash gift to Nicholas Robison, grandson 5,000.00 100.00 3,000.00 2,000.00 2 2011: Cash gift to Christopher Robison, grandson 5,000.00 100.00 3,000.00 2,000.00 3 2011: Cash gift to Elizabeth Barber, granddaughter 5,000.00 100.00 3,000.00 2,000.00 4 2011: Cash gift to Ann Barber, daughter 13,000.00 100.00 3,000.00 10,000.00 0.00 0.00 0.00 TOTAL (Also enter on Line 7, Recapitulation) ~ $ 16 000.00 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+(12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDEPlT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER MARY M. ZIMMERMAN 21 11 1297 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PA Dept. of Revenue, 2011 income tax due TOTAL (Also enter on Line 10, Recapitulation) I $ If more space is needed, insert additional sheets of the same size. 812.00 REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: MARY M. ZIMMERMAN ? 1 11 1297 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1. Nicholas Robison Lineal 2,000.00 c/o 1004 Shannon Lane Sch. G, Item 1 Carlisle, PA 17013 2 Christopher Robison Lineal 2,000.00 c/o 1004 Shannon Lane Sch G, Item 2 Carlisle, PA 17013 3 Elizabeth Barber Lineal 2,000.00 c/o 18 Aladdin Road Sch G, Item 3 Windham, NH 03087 4 Ann Barber Lineal 10,000.00 18 Aladdin Road Sch G, Item 4 Windham, NH 03087 5 Ann Barber Lineal 1,968.00 18 Aladdin Road 1/2 residue Windham, NH 03087 6. Carol K. Robison Lineal 1,968.00 1004 Shannon Lane 1/2 residue Carlisle, PA 17013 ~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: SHEET. AS APPROPRIATE If more space is needed, use additional sheets of paper of the same,size. 0.00