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HomeMy WebLinkAbout05-23-12 1505611186 REV-1500 EX (02-11)(Fq OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Buraeu of Intlividual Taxes Po Box zsosol INHERITANCE TAX RETURN I ,, RESIDENT DECEDENT ~ ~ G O ~ ~ `t' Hercisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW SOCial SCCUfily NUmbef Date Of Death MMDDYVYY Date of Birth MMDDYVVV Decedent's Last Name Suffix Decedent's First Name MI FEEVEY CAROL G (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW X^ 1. Original Return ^ 4. Limited Estate ^ 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 7. Decedent Maintained a Living Trust (Attach Copy of Trust.) ^ 10. Spousal Poverty Credit (Date of Death Between 12-31-91 antl 1-1-95) CORRESPONDENT - THIS 8ECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number CRISTI S. KIRKWOOD 717-486-5693 First Line of Address 1820 PINE ROAD Second Line of Address City or Post Office Slate ZIP Code NEWVILLE PA 17241 Side 1 T T~ m ~:.t ~.= C~ C%'. _L [ ~. _a r-' _~ ~_ fT ~O Q m Correspondent's e-mail address: Untler penalties of perjury, I declare that I have examined this return, inUutling accompanying schetlulea end statements, and to the best of my knovAetl9e and belief, it is true, wrrect and completes Declereti*n of preparer other than the personal representative is based on all inMrmation of which preperer has any knoMedge. 94R S_ HAN_n_ V_ FR RT C:ARI IRI F PA 17013 P EASE USE ORIGINAL FORM ONLY 1505611186 1 W469] 2.000 ^ 3. Remainder Return (Date of Death Prior to 12-13-82) ^ 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes ^ 11. Election to Tax untler Sec. 9113(A) (Attach Schedule O) REGISTER OF ~S USE ONLY ~~ m ~ N =.wr, Sl ~ ~ _~ n. -C N v oc-, "-` w :'10 C~= a ~= DA~FILED 1505611186 J J 1505611286 REV-1500 EJ( (FI) Decedent's Social Security Number D aenrs N CAROL G FEEVEY RECAPITULATION 1. Real Estate (Schedule A) 1 2. Stocks and Bonds (Schedule B) .. ....... ......... ..... 2_ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3, 4. Mortgages and Notes Receivable (Schedule D) q_ 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 8. Jointly Owned Property (Schedule F) ^ Separate Billing Requested g. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Properly (Schedule G) ~ Separate Billing Requested 7. 31,743.72 8. Total Gross Asaem (total Lines 1 through 7) g. 31,743.72 9. Funeral Expenses and Administrative Costs (Schedule H). g, 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 1 p. 11. Total DeducBons (total Lines 9 and 10) , . 11. 12. Net Value of Estate (Line 8 minus Line 11) 12. 31,743.72 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to [ax has not been made (Schedule J) , . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . 14. 31 ,743.72 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 .0 - 15. 16. Amount of Line 14 taxable at lineal rate x .045. 31,743.72 t s. 1,428.47 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 1 g, 19. TAX DUE .. .. .. 19. 1,428.47 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505611286 15[]5611286 twasae z.coo File Number REV-1500 EX (FO Pape 3 Decedent's Comr Tax Payments and Credits: 1. Tex Due (Page 2, Line 19) 2. Credits/Payments A. Pdor Payments _ 8. Discount _ (1> 1 428.47 Total Credits (A + g) (z> 71.42 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the tlifterence. This is the OVERPAYMENT. Fill In box on Page 2, 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) 1 357.5 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl decedent make a transfer and: Yes 0 No a. retain the use or income of the property transferred .. .. ~ J ( ~ b. retain the right to designate who shall use the property transferred or its income ~ L-" ,T -1~ c. retain a reversionary interest .................................. ^ d. receive the promise for life of either payments, benefits or care? 2. It death occurred after Dec. 12, 1982, did decedent transfer property within one year of death X without receiving adequate consideration? . th? h d " " ^ er ea or payable-upon-death bank account or security at his or in trust for 3. Did decedent own an 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 lax 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 velum 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 benenciaries is 4.5 percent, except as noted in [72 P.S. §9176(a)(1)]. • The lax 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. 1 W4871 1.000 REV-1510 EX+(Oa-09) pennsylvania DEPARTMENTOF REVENUE SCHEDULE G INTER-VIV05 TRANSFERS AND MISC. NON-PROBATE PROPERTY CAROL G FEEVEY Thls schedule must be completetl and filed if the answer to any of questions 1 through 4 on page three of the REV-t 500 is yes. ITEM NUMBE DESCRIPTION OF PROPEF2TY VC1ll1ET1ENMICOFTNETRN6FEREE. TIEIR REUTOFHNP TO DECEOENr AtL TIEMTEOFTPNHEItp1TAWpGOPY OF l1E OEEa FOR RFAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION IF pPpUCAeLE TAXABLE VALUE i. MET BANK-CHECKING ACCOUNT (#9855123978) 4, 173.96 50$ 0. UO 9, 173.46 CO OWNERS: CAROL G. FEEVEY CRSSTI S. KIRKWOOD DATE OPENED: 06/27/2011 2 MET BANK-SVGS. ACCOONT(15004226100099) 27,570.26 50$ 0,00 27,570.26 CO. OWNERS: CAROL G. FEEVEY CRISTI S. KIRKWOOD DATE OPENED: 06/27/2011 TOTAL (Also enter on line 7, Recapitulation) $~ 31,743.72 If more space is neeUed, use adtlitional sheets a( paper of the same size. i W46AF 1.000 REV-1513FX.(Oi-10) SCHEDULE J Pennsylvania DEPPRIMEMOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CAROL G FEEVEY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List 7rwtes(s) OF ESTATE TAXABLE DISTRIBUTIONS IlnGude outright spousal tliatdbutions antl transfers under Sec. 9116 (a) (1.2).j 1 CRISTI S. KIRKWOOD DAUGHTER 100.00 1820 PINE ROAD, NEWVILLE, PA 17291 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. II NON-TAXABLE DISTRIBUTIONS A SPWSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 1 W48AI 1000 ~~ nimc space rs nee0ea, use a00l0onal 9nea[5 O[ Paget O1 the Seme Size. ©~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 Mazch 16, 2012 Carol G. Feevey, Curtis S. Kirkwood 1820 Pine Road Newville, PA 17241 Re: Estate of Carol G. Feevev Social Securitk 206-28-4289 Date of Death: February 22, 2012 Dear Sir or Madam: Per your inquiry on March 7, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type ofAccoura Account Number Ownership (Names of) Opening Date Baltutce an Date of Death Accrued Interest Total Checking Account 9855123478 Carol G. Feevey Cristi S.Kirkwood 06272011 $4,173.43 $ .03 _ _ _ $4,173.46 2. Type of Account Savings Account Account Number 15004226100044 Ownership (Names ofl Carol G. Feevey Cristi S. Kirkwood Opening Date 06272011 Balance on Date of Death /" $27,569.87 Accruedlnterest $ ,39 Total - - -_.. _..._ $27 570.26 H tlL NIIf CR iOYn"r LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 17996064 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will he Forwarded to the State Vital /R,~1e/cord:; Opf~fice for perm//anent filing. 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