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REV-t500 EX+ (7-94) t'
INHERITANCE TAX RETURN FOR DATES OF DEAT~i AFTER 2131191 CHECK HERE
IF A SPOUSAi
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RESIDENT DECEDE POVERTY CREDIT IS CLAIMED
-~ NT FILE NUM<3E
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT
280601
(TO BE FILI~D IN DUPLICATE
WITH REGI R~
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.
HARRISBURG, PA 17128.0601 STER OF WILLS)
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
PAXTON, Rodney B. (Sr.) 555 Boxwood Lane
W SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Car 1 i s 1 e , PA 1 7013
W 182-22-9311 02-08-95 09-16-31' ~,~~ Cumberland
p (If APILICABIE) SURVIVING SPOUSE'S NAME IUSi, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS)
PAXTON, Fay E. 210-26-5270 $41,919.47
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f- ®1. Original Return ^ 2. Su lemental Return
PP ^ 3. Remainder Return
seat
W icy
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^ 4. Limited Estate (for Mates of death prior to 12-13-82)
^ 4a. Future Interest Com romise
p ^ 5. Federal Estate Tax Return Required
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®b. Decedent Died Testate (for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Trust)
AidCORICESi~QNDEN6"E~iA~pLCOi81 _: A'~: ~,_ ... ;fi ~ .; ~~ ~~°'s
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sQ NAME
Fay E. Paxton COMPLETE MAILING ADDRESS
555 Boxwood L
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TELEPHONE NUMBER ane
717 243-5897 Carlisle, PA 17013
1. Real Esrare (Schedule A) (1 )
2. Stocks and Bonds (Schedule B) (2 )
3. Closely Held Stock/Partnership Interest (Schedule C) (3 )
4. Mortgages and Notes Receivable (Schedule D) (4 )
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (5 )
Z (Schedule E)
b. Jointly Owned Property (Schedule F) (b )
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7. Transfers (Schedule G) (Schedule L)
(7) $ 41 , 919.47
a 8. Total Gross Assets (total Lines 1-7) (g) ~ 41, 919 .4 7
9. Funeral Expenses, Administrative Costs, Miscellaneous (9) $ 9 r 244.00
Expenses (Schedule H)
10. Debts, Mortgage liabilities, Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10) (11) $ 9 , 244.00
12. Net Value of Estate (line 8 minus Line 11) (12) $32 , 675.47
13. Charitable and Governmental Bequests (Schedule J)
~ (13)
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14.-- et Value Shed to T 'ne 12 minus Line 13) 32,675.47
(14) $
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5. f~sal Tran~rs (for,daterof death after b-30-94)
~e nstrudidris-for Applic~~le Percentage on Reverse (15) $ 3 2 , 6 7 5.4 7
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hedule K or Schedule M.)
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7AmGunt of liFb~14 taxable;tlt b% rats (16)
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uesfrom Schedule K or Schedule M.)
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. ;4rpcbnt of Lin~14 taxoble~t 15% rate (17)
x .15 =
~h Yct~de values from Schedule K or Schedule M.)
3.~i:Tupal tax (Add416x~om Lines 15, 16 and 17.) (18) $ 9$0.26
t. Credits Spousal P~~Credit Prior Payments Discount Interest
+ + - (19)
1. If Lins 19 is greater than Line 18, enter the diffsronu on line 20. This is the OVERPAYMENT. (20)
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. If Line 18 is greater than Lins 19, enter the difference on Line 21. This is the TAX DUE. (21) $ 9 8 ~ ' 2 6
A. Enter the interest on the balance due on Line 21A. (21 A) -0-
B. Enter the total of Line 21 and 21 A on Line 21 B. This is the BALANCE DUE. (21 g) $ 9 8 0 . 2 6
Make Cheek Payable to: Register of Wills, Agent
Under penalties of perjury, I declare that I have examined this return, including accompanYing schedules and statements, and to thl
it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other
based on all information of which preparer has any knowledge.
s'f my knowledge and belief,
le personal representative is
DATE
DATE
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the uas of the spouse. The rates as prescribed by the statute will be:
• 3% (.03) will be applicable for estates of decedents dying on or after 7/1 /94 and before 1 /1 /96
• 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
• 1 % (.01) will be applicable for estates of decedents dying on or after 1 /1 /97 and before 1 /1 /98
• Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (r) 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, ............... X
c. retain a reversionary interest; or
d. receive the promise for life of either payments, benefits or care$ .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate conaidsration$ 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$ ......................................
NR
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
r-
REV-1511 EX+ (/-88)
SCHEDULE H
FUNERAL EXPENSES,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISCELLANEOUS EXPENSES
Please Print or Type
ESTATE OF FILE NUMBER
PAXTON, Sr., Rodney B.
ITEM
NUMBER DESCRIPTION AMOUNT
A. Funeral Expenses:
~. Hoffman Roth Funeral Home $6,319.00
Westminster Cemetery 950.00.
Funeral Luncheon 60.00
Grave Marker 1,395.00
B. Administrative Costs:
]. Personal Representative Commissions _ _0_
Social Security Number of Personal Representative:
Year Commissions paid
2. Attorney Fees
- 0-
3. Family Exemption
Claimant
Relationship _0_
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees _ 0 _
C. Miscellaneous Expenses:
~• Death Certificates 20.00
2• Travel Expenses for Grandson from California 500.00
3.
4.
5.
6.
7.
8.
TOTAL (Also enter on line 9, Recapitulation) $ g, 244.00
~~t more space is needed, insert additional sheets of same size.)
' ~eEV-IS~o Ex+ R-~!
1
SCHEDULE G
TRANSFERS
PLEASE PRINT OR TYPE
PAXTON, Sr., Rodney B.
THIS SCHEDULE MUST 8E COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES.
ITS DESCRIPTION OF PROPERTY TOTAL VALUE D~• DOLLAR VALUE
NUMBER Include name of the tronsbrae, flier relationship ro d«edeM, dale oftr~{e~ EXCLUSION OF ASSET °~ OF DECEDENT'S
INT. INTEREST
IRAs -
IDS Extra Income Fund $26,901.0 100 $26,901.07
Fay E. Paxton, Wife,
Beneficiary
Transferred to Beneficia y
after death on 02/24/9
IDS Life Fixed Retirement
Annuity $15,018.4 100
$15,018.40
Fay E. Paxton, Wife,
Beneficiary
Transferred to Beneficia y
after death on 02/23/9
TOTAL W~ .mer on line 7 Reeopihrlmion) I S 41 , 919 4
(li more spool s mseded, rserf add~7ana! sheen of same sin.j
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