HomeMy WebLinkAbout95-0193500'70303,~~ ~~ ,~~
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NHERITANCE TAX RETURN FOR DATES OF DEATH AFTER 12131191 CHECK HERE
P
OVERTY CREDIT IS CLAIMED ^
. RESIDENT DECEDENT FILE NUMBER
,
COMMONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE a/ ~~ O/~ ~
DEPARTMENT OF REVENUE
DEPT. 280601
WITH REGISTER OF WILLS)
HARRISBURG, PA 17128-0601 COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
BRINK OLIVE F. 325 WESLEY DRIVE ~"~
c SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH MECHANCISBURG, PA 17055
/
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"' 210-26-5395 12 1 ~
C
c°~~+ CUMBERLAND
p (IF APPLICABLE) SURVIVING SPOUSE'S NAME (UST, FIRST AND MIDDLE 1 y SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTION51
~++ ®1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return
Yarn (for dates of death prior to 12-13-82)
=co ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
~ ~ m (for dates of death after i 2-12-82)
a ^ 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust `8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Trust)
yZ
W W
~o ...__~.._._,___ ~____ _..___.__ _ _. _. __
TELEPHONE NUMBER
717 766-3172 _ COMPLETE MAILING ADDRESS
MARKET SQUARE BUILDING
MECHANICSBUR(~"1($A 17055
~
1. Reol Estate (Schedule A)
(1) _-
- t_ ~ n
'~`~? t~
2. Stocks and Bonds (Schedule B) (2) ~ f r
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages and Notes Receivable (Schedule D) (4) ~ - _
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) NONE ;,. ...~ _
(Schedule E) - ~~= ~, ;
; `'..
6. Jointly Owned Property (Schedule F) (6) 1.319.46
- ~ ~
,,,; ~?,
g 7. Transfers (Schedule G) (Schedule L) . ~(~! 1 `~"
a 8. Total Gross Assets (total lines 1-7) (8) 1, 319.46
u"i 9. Funeral Expenses, Administrative Costs, Miscellaneous (9 )
°C Expenses (Schedule H)
y.
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10 2~ 029 _ 24
~
11. Total Deductions (total Lines 9 & 10) (11) 2 029.24
12. Net Value of Estate (Line 8 minus Line 11) (12) ~
~.
13. Charitable and Governmental Bequests (Schedule J) (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 0
15. Spousal Transfers (for dates of death after 6-30-94)
See Instructions for Applicable Percentage on Reverse
Side. (Include values from Schedule K or Schedule M.) (15) x. ~= 0
16. Amount of Line 14 taxable at 6% rate (16) x .06 =
(Include values from Schedule K or Schedule M.)
17. Amount of Line ld taxable at 15% rate (17) x .15 = 0
z (Include values from Schedule K or Schedule M.)
o
c 18. Principal tax due (Add tax from lines 15, 16 and 17.) (18)
19. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ + - (19)
a 20. If Line 19 is greater than Line 18, enter the difference on line 20. This is the OVERPAYMENT. (20)
r ~ ^
21. If Line 18 is greater than Line i9, enter the difference on Line 21. This is the TAX DUE. (21)
A. Enter the interest on the balance due on Line 21A. (21 A)
B. Enter the total of Line 21 and 21 A on Line 21 B. This is the BALANCE DUE. (21 B)
Make Chick Payable to: Register of Wills, Agent
Under penalties of perjury, I declare that l hove
it is true, correct and complete. I declare that a!
based on all information of which preparer has
SIGNATURE F PERSON RESPONSIBLE FOR FILING RETURN
return, including accompanying
s been reported of true markke~
statements, and to the best of my knowledge and belief,
ion of preparer other than the personal representative is
` ~ , DATE ~` ~~~ ~ ~ ,i
DATE V
r ~ 4} 1r~,- ~s'
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the vse of tl+e spouse. The rates as prescribed by the statute wdl be:
• 346 (.~ wiN be applicable for estates of decedents dying on or after 7/1/94 and before 1/1!96
• 246 (.il-4j wiN be applicable for estates of decedents dying on or after 1/1196 and before 111/97
• 146 (.®1) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98
• Spewsrl transfers ®ccurring on or after 1!1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY Pi.ACING A CHECK MARK (-~~ IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
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 {ife of either payments, benefits or care$ .......................................
2. If death occurred on or before December 12, 19$2, did .decedent within two years preceding
death transfer property without receiving adequate consideration$ 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'. bank account at his or her death$ ......................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE fT AS PART OF THE RETURN.
REV•1509 SX ~ (12.881
COMMONWEAUH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
OLIVE F. BRINK
Joint tanont(s):
NAME ADDRESS RELATIONSHIP TO DECEDENT
A. HELEN F. SCHNEIDER 401 W. MARBLE
MECHANICSBURG, PA 17055 NONE
B.
C.
Jointly-owned property:
ITEM
NUMBS LETTER
FOR
JOINT
TENANT
DATE
JOANT
DESCRIPTION OF PROPERTY
TOTAL VALUE
OF ASSET
DECD'S
961 INT.
DOLLAR VALUE OF
DECEDENT'S INTEREST
1. A ABOUT BANK ACCOUNT 50-7007-7268 $2,738.92 50 $1,319.46
1985 PNC BANK
TOTAL (Also enter on line 6, Recapitulation) I ~ , 319.46
(If more space is needed insert additional sheets of same size)
• '' REV-15124%+ (1-93~
SCHEDULE i
COMMONWEAUM OF PENNSVWANIA DEBTS OF DECEDENT
INHERITANCE TA%RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT Please Print or Type
FILE NUMBER
OLIVE F. BRING