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Home My WebLink About09-25-121505610143 REV-1500 ~"°'-'°''~! PA Department of Revenue Pennsylvania OFFIOIAL USE ONLY Bureau of IndWidual Taxes eo~rwR~...-w cour+~r cods veer Fly N„ny,r Po eox.z3osot INHERITANCE TAX RETURN Herrtaburg, PA 17128-0801 21 .,..17r ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT , c - ~- SoUal Security Number Date of Death Date of Birth 12 28 2011 02 19 1938 Decedent's Last Name SufFlx RILEY Decedent's First Name Mi PATRICK (ff 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 INAPPROPRIATE OVALS BELOW 1. Onginal Realm ^ 2. Supplemental Ream ^ 4. Limlled Estate ^ qa. Future lreerea Campanlee (data a desM eaw 72-72-02) ® 8' ( Copy a Wl~1e ^ 7. Pl Ma~ read a uvl Trust A WY ~ru) aY ^ 9. Lttiga9on Proceeds Reoeivetl ^ tC s a „dl ^ 3. Remainder Ratum (date d death prbrto 12-13-92) ^ 5. Federal EstaM Tax Ratum Require0 ~ 8. Total Number of S f D a e eposit Boxes blMree 1P2~- t~a~'1-~5~~~ ^ 11.~A~ Sch. 0) n~ Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD SE DNtECTED TO: Name JESSICA L FISHER Daydme Telephone Number 717 697 3223 Flrat iine of address 555 GETTYSSVRG PIKE Second Iine of address STE C100 City or Post Office MECHANICSBURG smte ZIP Code PA 17055 REGISTER O ICI]3 USE O~gY 1" ~: ~ r. ~.~~ ~ Z~ ~ c.'%C~> O ~ _ :~ -~. ~+' ~ __ -~ DATE S~ED C.) , _ cn Jessica L. Fisher R' 17' I2 1505610143 PA Side 1 1505~61U143 J a v a aid ~, d r~~ is ~h, l e i-~.1,< Qi4 ~ ~G ~ ~ 81GIUTURE AE OREOeocC nm~e..,... .._~____. _. _ J 1505610243 REV-1500 EX Dece°~"''s"ate Riley, Patrick 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 & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6, 7. Inter-Vivos Transfers & Miscellaneous t~nq Probate Property (Schedule G) U Separate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 9. Funeral Expenses & Administrative Costs (Schedule H) .................................... ... g. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ........................... ... 10, 11. Total Deductions (total Lines 9 8 10) ................................................................ ... 11. 12. 13. Net Value of Estate (Line 8 minus Line 11) ........................................................ Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................. .. 12. .. 13, 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................. .. 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or i6. transfers under Sec. 9116 (a)(1.2) X .o0 6 , 4 62 .22 Amount of Line 14 taxable 15. 17. at lineal rate x .045 6 , 4 62.21 Amount of Line 14 taxable 16. 18. at sibling rate X .12 0.00 Amount of Line 14 taxable 17. at collateral rate X .15 0 . 0 0 18. 19. Tax Due ...................................................................................................__.. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 Decedent's Social Security Number 007 34 3113 19,215.13 19,215.13 5,962.36 328.34 6,290.70 12,924.43 12,924.43 0.00 1505610243 290.80 0.00 0.00 290-80 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Riley, Patrick STREET ADDRESS 4 Arlington Drive Carlisle SL4TE ~ ZIP PA ~ 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 410.70 14.54 (t) 290.80 Total Credits (A + B) (2) 425.24 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. Check File Number 21-11 WI (3) (4) 134.44 (5) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and a. retain the use or inwme of the property transferred :............................................................................... Y^es No b. retain the right to designate who shall use the property transferted 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?........... ^ ^ ....................................................................... .............. 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 qND 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) (t.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 u:;e of the surviving spouse is 0 percent [72 P.S. §91 i6 (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 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) (7.3)]. 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-75W EX~ le-ea) COMMONWEALTHOFPENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF SURVIVING JOINT TENANT(S) NAME A. Joan K Riley B. Susan Miller C. yea. ADDRESS (FILE NUMBER _ 21-11 np°rtetl on sehetlula G. RELATIONSHIP TO DECEDENT spouse Daughter JOINTLY OWNED PROPERTY: _I ITEM NUMBER LETTER FOR JOIN DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT % OF DATE OF DEATH TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REA DATE OF CIEATH ALUE OF l4$SE DECD'S VALUE OF DECEDENTS INTEREST L ESTATE. INTEREST 1 AB 11/01/2011 USAA Bank Accounts Jointly Owned with Spouse and Daughter- added daughter within 5,709.59 33.330% 1,903.01 one year of death- Checking Acct 2 AB 11/01/2011 USAA Bank Accounts Jointly Owned with Spouse and Daughter-added daughter within 51,941.56 33.330% 17'312'12 one year of death- Savings Acct TOTAL (Also enter on Line 6, Recapitulation) (If more space is nestled, additlonal pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 19,215.13 I°orm PA-1500 Schedule F (Rev. 6-98) REV-1167 E%~ 110-08) SCHEDULE N ~oM~~~o~ NYLVANIA FUNERAL EXPENSES 8r rJ ADMINISTRATIVE COSTS ESTATE OF Riley Patrick FILE NUMBER 21-11 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Hoffman Roth Funeral Home B. I ADMINISTRATIVE COSTS: t. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State __ Zio Yearlsl Commission paid 2. Attomev's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Joan K. Riley, surviving spouse Street Address 4 Arlington Drive city Carlisle state PA zip 17013 Relationship of Claimant to Decedent SpOUSe 4. Probate Fees 5. Accountant's Fees 5. Tax Return Preparsr's Fees 7. Other Administrative Costs 2,462.36 3,500.00 TOTAL (Also enter on line 9, Recapitulation) 5 962 36 Copyright (c) 2009 form software only The Lackner Group, Inc. I`orm PA-7500 Schedule H (Rev. 10-06) Rev-1512 EX+(12-0E) SCHEDULE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA MORTGAGE LIABILITIES, & LIENS INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF Rile ,Patrick FILE NUMBER 21-11 Report tlsbta incumetl M Me tleeetlem prig ro tleeth Met rsmelnatl unpeitl a<the tlm o/ tlseth, inelutling unrelnnbunetl nrotlicel expames ITEM NUMBER DESCRIPTION VALUE AT DATE 7 Carisle Regional Medical Center- Medical Bill OF DEATH 743.99 2 Carlisle Regional Medical Center- Medical Bill 184.35 TOTAL (Also enter on Line 70, Recapitulation) I 328.34 Copyright (c) 2009 form software only The (LacknerpGreuon Inc additional pages of the same size) Form PA-7500 Schedule I (Rev. 12-08) REV-1610 EX~ (H-09) A1~NT~E q~ f~I$1 i~N COMfAOf~W (DENT DECED~r+~ VANIA ESTATE OF Rile ,Patrick SCl~IEDULE J BENEFICIARIES NUMBER PERSON(Sl RECEIDV NG PROPERTY I TAXABLE DISTRIBUTIONS [inGude outright spo distributions, and tra under Sec. 9116 a 1 Susan Miller PA 2 Joan K Riley PA FILE NUMBER 21-11 ATIONSHIP TO SH,4RE OF ESTATE AMOUNT OF ESTATE DECEDENT Daughter Spouse 6,816.41 9,807.12 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 co~easheet as II• NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS - - ~ .. - ~rv 1 crc 1 V IAL NON-TAXABI Copyright (c) 2009 form software only The Lackner Group, Inc. 16,423.53 Forth pq-1500 Schedule J (Rev. 11-08) ~V~ KEYSTONE ELDER LAW P.C. www.keystoneelderlaw. tom September 24, 2012 Cumberland County Register of Wills I Courthouse Square Carlisle, PA 17013 ~: The Estate of Patrick Riley Cumberland County Estate N~-~ X112 0375 Dear Register of Wills: Please find enclosed a check for the filing fee for the inheritance tax anti three Pennsylvania Inheritance Tax Returns, the 1 st is for the Pennsylvania Department of Revenue which includes all n ~essary documentation, the 2nd return is for the Cumberland County Register of Wills, and the 3 is only the first page of the return. Kindly date stamp this first page of the return and return this document to my office in the self-addressed envelope that I have provided. If you have any questions please feel free to contact my office at the below referenced phone number. Thank you for your prompt attention to this matter. Sincerely, KEYSTONE ELDER LAW P.C. Jessica L. Fisher, Esquire o Enclosures: Inheritance Tax Returns and Check ~~.'; ~ ~, ;~ . ~~ -~ ~,~~ .'i 7 Q~ a 1`. ~,, ~1 ~Y w ~ ~^ 555 Gettysburg Pike, Suite C-100 Mechanicsburg, PA 17055 Phone: 717.697.3223 Fax: 717.691.8070 o , m o q i .r , , > Rrmonrn mm~[ ,~ J ~.. po ;, . i'Iw I ~ w I~` ~ ~ - 0~,~ G ~~ ~ ~~ :,~~ ~ ~ ~~i 2~i2S~EP25 AMIi~ 3! 6 ~ LL. ~ a J W 1 ~ ~sa3txm ~~' ORFFir'~J'; vvURT `~'~~d CUMBERLAND CO., PA 1~"'y v~ 0 ~„~ O (-~ d a N ~Ui /.. rT1 A H W 4. d .~ ~i U ~. v U Iii M Q. O ~ ~ y Q, ~~ o ~ UV