HomeMy WebLinkAbout03-0998REV-1500 EX (8-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
tm-Ig*o-l(
REV-1500
INHERITANCE TAX RETURN
OFFICIAL USE ONLY
FILE NUMBER
~]1. Original Return
[~4. Limited Estate
]--~ 6. Decedent Died Testate (Attach copy of Will)
--]9. Litigation Proceeds Received
---] 2. Supplemental Return
--] 4a. Future Interest Compromise (date of death after 12-12-82)
--']7. Decedent Maintained a Living Trust (^~c~ copyefmrust)
---]10. Spousal Poverty Credit {date of death bebveen 12-31-91 and %1-95)
NAME
Jerry A. Weigle, Esquire
FIRM NAME (IfAppli~ble)
WEIGLE & ASSOCIATES, P.C.
TELEPHONE NUMBER
717-532-7388
1. Real Estate (Schedule A)
2.
3.
4.
5.
14.
(1)
Stocks and Bonds (Schedule B) (2)
Closely Held Corporation, Partnership or Sole-Proprietorship (3)
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13,
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15)
16. Amount of Line 14 taxable at lineal rate x .0 __ (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
r--~ 3. Remainder Return (date of death pdor to 12-13-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
--']11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
126 East King Street
Shippensburg ,. PA 17257
668.37
OFFICIAL USE ONLY
(8)
1,265.73
(11)
(12)
(13)
(14)
668.37
1,265.73
(597.36)
NONE - INSOLVENT
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R E S I D E N T D E C E D E N T COUN~ CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Russell, Pearl E. 185 - 10 - 2515
f't DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
U.I 07/10/2003 03/19/1914 REGISTER OF WILLS
III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
_ Decedent's Complete Address:
STREET ADDRESS
129 Walnut Bottom Road
CITY
Shippensburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C, Discount
STATE PA J ZIP 17257
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. Th'is is the BALANCE DUE, (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
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; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 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 security at his or her 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.
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~e pemonal representative is based on all information of which preparer has any knowledge.
~,~~ ~- ~ *¢~ La Donna ~
DATE
6 Brookview Drive , PA 17241
SIGNATU~ OTHE
ADDRESS
Darhower
DATE
Jerry A. Weigle, Esquire '/Z--
126 East King Street, Shippensburg, PA 17257
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a)(1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [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 twenty-one 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% [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%, 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 decedenrs siblings is 12% [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.
REV-~JS~8 EX+
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Please Print or Type
FILE NUMBER
Pearl E. Russell
(All property jointly-owned with the Right of Survi~,o~,hJp must be disclosed on Schedule F)
iTEM
NUMBER DESCRIPTION
1. Orrstown Bank Checking Account #600644
2. Highmark Blue Shield - 08/27/03 benefit check
TOTAL (Also enter on line 5, Recapitulation) $
VALUE AT
DATE OF DEATH
584.53
83.84
668.37
(Attach additional 8¥2' x 11" sheets if more space is needed.)
,REV-1511~EX + (7-88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or Type
FILE NUMBER
Pearl E. Russell
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses:
Bo
C.
1.
2.
3.
4.
5.
6.
7.
8.
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney Fees Weigle & Associates, P.C.
Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City
Probate Fees
State __ Zip Code
Miscellaneous Expenses:
Register of Wills, Cumberland County - filing Insolvent PA
Inheritance Tax Return
Choice Critical Care - final pharmacy billing
LeRoy Davis - reimbursement for payment to Outlook Pointe for
July 2003
350.00
10.00
70.91
834.82
TOTAL (Also enter on line 9, Recapitulation) $ 1,265.73
(If more space is needed, insert additional sheets of same size.)
I~E¥-1513 E~+ (2-87)~
COMMONWEALTH OF PI~NNSY~.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Pearl E. Russell
ITEM AMOUNT OR
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE
A. Taxable Bequests:
1. Not relevant as estate is insolvent.
ITEM AMOUNT OR
NUMBER NAME AND ADDRESS OF BENEFICIARY
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) S
(If more space is needed, insert additional sheets of same size)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZVTSTON
DEPT. 180601
HARRTSBURG, PA 17118-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-IS1:/7 EX AFP
JERRY A WEIGLE ESQ
WEIGLE 8 ASSOCS
126 E KING ST
SH[PPENSBURG
PA 17157
DATE 01-Z7-ZOOq
ESTATE OF RUSSELL
DATE OF DEATH 07-10-2005
FILE NUMBER 21 05-0998
COUNTY CUHBERLAND
ACN 10 !
I Amount Remitted
PEARL E
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGTSTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE I~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF RUSSELL PEARL E FILE NO. 21 05-0998 ACN 101 DATE 01-27-200q
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership /nterest (Schedule C) ($)
q. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (E)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Asse~s
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10)
11. To,al Deduct/ons
12. Ne~ Value of Tax Re~urn
15.
lq.
Char/~able/Governean~al Bequests; Non-elected 9115 Trusts (Schedule J)
Net Value of Es~a*a SubSec* *o Tax
.00
668.:57
.00
.00
.00 NOTE: To insure proper
.00 crad/~ ~o your account,
.00 submi~ the upper port/on
of th/s fore wS~h your
~ax payment.
(8)
1,265.75
.00
NOTE:
668.57
(11) 1.2'65.7~
(12) 597.:56-
(15) .00
(14) 597.56-
If an assess;ant was issued previously, lines 14, 15 and/or 16, 17,
reflect flgures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun't of Llne lq at Spouse1 ra~e (15)
16. Amoun~ of L/ne 14 ~axable a~ L/naal/Class A rata (16)
17. Amoun'l: of L/ne 14 at Sibl/ng re~e (17)
18. Aaoun~ of Line 14 ~axable et Colla~:era1/Class B rate (18)
19. Pr/n¢ipal Tax Due
RECEIPT
NUMBER
TAX CREDITS:
PAYMENT I
DATE
18 and 19 will
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PATD
INTEREST AND PEN. .00
TOTAL DUE · O0
( 1F TOTAL DUE ~S LESS THAN $1, NO PAYMENT ZS RE;)U~RED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS.
· O0 x O0 = . O0
· 00 x Oq5= .00
· O0 x 12 = . O0
.00 x 15 = .00
(19)= . O0
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future intarast in the estate is transferred
in possession or enjoyment to Class B (collateral) baneficiarias of tha decedent after the expiration of any estate for
life or for years, the Coaaonaealth hereby axprassly reserves tha right to appraise and assess transfer Inheritance Taxes
at the lemful Class B (collateral) rate on any such future intarest.
To fulfill the raquirements of Section ZlqO of the Inharitanca and Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 91qO).
Detach the top portion of this Notice and submit aith your payment to fha Register of Hills printed on the reverse sida.
--Make check or money order payable to: REGISTER OF #ILLS, AGENT
A rafund of a tax credit, which was not requested on tha Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of tha Register of Nills, any of the 23 Revenue District Offices, or by calling the special 2q-hour
answering service for forms ordering: 1-800-36Z-2050~ services for taxpayers with special hearing and / or
speaking needs: l-8OO-qq?-3OgO (TT only).
Any party in interest not satisfied with fha appraisemant, allowance, or disallowance of daductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 2BIOZ1, Harrisburg, PA 171ZS-lOZl, OR
--election to have the matter datareinad at audit of fha account of the personal rapresentativa, OR
--appeal to the Orphans' Court.
Factual errors discovared on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviaw Unit, Dept. 280601, Harrisburg, PA 171Z6-0601
Phone (717) 787-6505. Sea page 5 of fha booklat "Instructions for Inheritance Tax Return for a Rasidant
Decedent" (REV-IS01) for an axplanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (57.) discount of
tha tax paid is allowed.
Tha 1S7. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, tha first day after the and of tha tax amnesty period. This non-participation
panalty is appaalabla in tha same manner and in tha the soma tima period as you mould appeal the tax and interast
that has been assessed as indicatad on this notice.
Interest is charged beginning with first day of delinquency, or nina (9) months and one (1) day from the date of
death, to the date of payment. Taxes ehich became delinquant bafora January l, 1982 bear interest at fha rate of
six (6X) percent per annum calcuIatad at a daiZy rate of .O0016q. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary free calendar year to colander year ,ith that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO3 ara:
Interest Daily Interest Daily Intarest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ . 0005q8 1987 9Z . OOOZq7 1999 7Z . 00019Z
1983 167. .000q38 1988-1991 117. .000301 ZOO0 87. .000Z19
198q 117. . 000301 199Z 97. . O00Zq7 2001 97. . O00Zq7
1985 137. .000356 1993-199q 77. .000192 ZOO2 67. .00016q
1986 107. . O00ZTq 1995-1998 97. . O00Zq7 2003 57. .000137
--Interast is calculated as follo~s:
TNTBRBST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DBL/NQUENT X DA:ELY TNTEREST FACTOR
--Any Notice issued altar the tax becomes delinquent Rill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after tha interest computation date shown on the
Notice, additional interest must ba calculated.
BUREAU OF INDIVIDUAL TAXES
TNI~RZTANCE TAX DTVISIDN
DEPT. 280601
HARRISBURG, PA 17118-0601
BENJAMIN J BUTLER
BUTLER LAg FIRM
PO BOX lOOq
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTZCE OF INHERITANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENTOF TAX
REV-J,,.r47 EX AFP
~, - 03-29-200q
~ : MILLER ANNA M
10-0q-1995
21 05-0988
'0~ ~t~ 30 CUMBERLAND
~0!
Amoun( Rmmi**ad
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTZCE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF HILLER ANNA NFZLE NO. 21 03-0988 ACN 101 DATE 03-29-200q
TAX RETURN gAS: ( X ) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNZNG FUTURE /NTEREST - SEE REVERSE
:06
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
APPRAISED VALUE OF RETURN BASED ON:
1
2
$
6
7
8.
ORTGTNAL RETURN
Real Estate (Schedule A]
S~ocks and Bonds (Schedule B) (2}
Closely Held Stock/Par~nership Interest (Schedule C)
Nor~wagas/No~as R~cmivab/m (Schedule D} (q)
Cash/Bank Deposi~s/Hisc. Personal Property (Schedule E) (5)
Jo/n~ly O~ned Property (Schedule F) (6)
Transfers (Schedule G) (7)
Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exponsos/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Ltab/li~cies/L/ens (Schedule Z)
11. Total Deduct/OhS
12. Nat Value of Tax Return
1~.
(9)
(10)
Char/~abla/govarnmantal Bequests; Non-elac~ad 911S Trusts (Schedule J)
Nat Value of Estate Subject to Tax
9z500.00
O0
O0
O0
O0
O0
O0
(8)
9,170.25
.00
(11}
(12)
(1:5)
(lq)
NOTE=
Z~ an assessment ~as issued previously; lines 14, 15 and/or 16, 17,
reflect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amoun~ of L/ne 1~ a~ Spousal rate (15)
16. Amount of Line lq ~ax~ble at Lineal~Class A ra~ce (16)
17. Amount of Line lq at Sibl/ng rate (17).
18. Amount of Line lq ~axabla a~ Collateral~Class B ra~a (18).
19. Principal Tax Dun
tAX CREDTT$:
PAYMENT RECETpT Dz$COUNT (+)
· O0 x O0 =
329.75 x 06 =
· O0 x O0 =
. O0 x 15 =
(19)=
NOTE: To /nsura proper
cradi~ ~o your account,
subm/~ ~ha upper por~ion
of th/s fora w/~h your
~ax payment.
DATE
O2-1Z-ZOOq
NUHBER
CD003559
INTEREST/PEN PAZD (-)
.O0
BALANCE OF UNPATD INTEREST/PENALTY AS OF OZ-13-ZOOq
ZF PAID AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
AHOUNT PAID
19.79
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
9,500.00
g.170.2~
329.75
.00
3Z9.75
18 and 19 #ill
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THZS FORM FOR ZNSTRUCTZONS.)
.gO
19.79
.00
19.79
19.79
.00
11.q7
ll.q7
Post Office Box 1004
Harrisburg, PA 17108.1004
Register of Wi~s~
Cumberland C~;t~n~: Courthouse
One Courthouse Square
Carlisle, PA 17013
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