HomeMy WebLinkAbout09-25-12150561
REV-1500 Ex X02-,,, ~F,, 1.18 5
PA Department of Revenue
Bureau of Individual Taxes OFFICIAL USE ONLY
Po Box 28oso, INHERITANCE TAX RETURN C°unty Code Year
Harrisburg, pq 17j28_o601 File Number
ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT 2 ~' ~' 2 0 L 8 7
Social Security Number
Date of Death
1r 8 4 '- 2 6 - MMDDYYYY Date of Birth MMDDYYYY
4907 1,224201,],
Decedent's Last Name 0 9 2 819 3 3
BOOKS Suffix Decedent's First Name
MI
~If Applicable) Enter Survivin s E D G A R
Spouse's Last Name 9 pouse's Information Below F
BOOKS Suffix Spouse's First Name
Spouse's Social Security Number J U L I A M I
1, 6 8 - 2 6 _ 2 6 19 THIS RETURN MUST BE FILED IN DUPLICAT C
FILL IN APPROPRIATE BOXES BELOW REGISTER pF E WITH THE
1. Original Return WILLS
^^ ^ 2• Supplemental Return
4. Limited Estate ^^ ^ 3. Remainder Return (Date of Death
4a. Future Interest Compromise (date of ^^ Pnor to 12-13-82)
^X^ 6. Decedent Died Testate death after 12-12-82) 5. Federal Estate Tax R
^^ (Attach Copy of Will) ^ ~~ ~Ae~ edent Maintained a Living Trust [] eturn Required
9. Litigation Proceeds Received ^^ Copy of Trust.) 8. Total Number of Safe Deposit Boxes
1 ~~ Spousal Poverty Credit (Date of Death ^
CORRESPONDENT - Between 12-31-91 and 1-1-95) 11 ~ Election to Tax under Sec. 9113(A)
(Attach Schedule O)
Name THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFID
ENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
KEITH 0, B R E N N E M A N, Daytime Telephone Number
ESQ.
717-697-8528
REGISTER OF WILLS USE ONLY
First Line of Address
44 WEST MAIN STREET ~~`'
~~ ~ ~,
Second Line of Address ~'
~ -~ ~ r..r,_I
P • 0 • BOX 51,8 ~~._ "ti '~ ~^,
City or Post Office ~ ~~~ ~~ Ci"1 ~~~ ~' ~ r;
C :. _~
MECHANICSBURG state ZIP Code ~~~ ' ~~ ` -~'
~,TE FILED 3C ""
Correspondent's a-mail address:
~ _
Under penalties of
perjury, I declare that I have examined this return, including accompanyin
it is true, correct and complete. Declaration of re
~~ON ,~SPOpISI E
S~ ~ OF P P Parer other than the personal representative Is based onnallsnfoemation of yyh Chhe best of m
~ ~ ~ ,/~j~- R FILIN~ RETURN Y knowledge and belief,
` preparer has any knowledge.
ADD ESS ' -~-~.~(_G~ DATE
JU IA C, ' _
BOOKS, EXECUTRIX ~.~ c/~-„
sl~n~ 3 0 7 S .
r E OF PREPARER OTHER THAN REPRESENTATIVE
WASHINGTON STREET, MECHANICSBU
ADDRESS RG
KEITH 0 . DATE pA 17 05 5
BRENNEMAN, ESQ . 9 is ~2-
44 WEST MAIN STREET, MECHANIC
PLEASE USE ORIGINAL FORM ONLY
SBURG
pA 17055
Side 1
150561,1,1,85
oMnsa~ 3 000 15 0 5 61,118 5
_ -~~
J
1505611285
REV-1500 EX (FI)
RECgpiTULATION Decedent's Social Security Number
184-26-4907
AR
1 ~ Real Estate (Schedule A) F
•
...••
2~ Stocks and Bonds (Schedule B) • 1
3• Closely Held C 0 • ~ ~
orporation, Pa 2.
rtnership or Sole-Proprietorshi
p (Schedule C) •
4. Mortgages and N
0 • 00
otes
Receivable 3•
(Schedule D)
5• Cash, Bank Deposits and
4
Miscellaneous P 0 • 00
ersonal Pro
6. Joint) ~rtY (Schedule E)
Y Gwned Pr 0 • 0 0
operty (Schedule F) 5~
eparate Billie
7• Inter-Vivos Transfers & Miscellaneous Noa
(Schedule G) g Requested
1,3, 926
• 2 9
ro s
^ to Property 6.
Se
parate Billing Requested
8. Total Gross
A 5 ~ 4 8 8 . ~, 6
ssets (total Lines 1 7~
through 7)
9. Funeral Expenses and Ad
8.
ministrative C Q • Q Q
osts
(Schedule H) .
1 ~. Debts of Decedent, Mort a 9• ~' 9 ' 4 ~ 4 • 4 5
9 ge Liabilities, and Liens (Schedule I)
1 1. Total Deducti 7
' 3 4 7' Q 3
ons
(total Lines 9 and 10) 10.
12. Net Value of
Estate (Line 8 mi
11. 1, 4 , 255.2 4
nus Line 11)
13. Charitable and Governmental Be
an election to tax has not quests/Sec 9113 Trusts for which 12•
been 2 ~' , 6 D 2
2 7
made (Schedule J) •
14. Net Value Subject to Tax
13
(Li
(2' ~' 8 7.8 2 )
.
ne 12
TAX CALCULATION _ minus Line 13)
SEE INSTRUCTIONS FOR ' 14.
15. Amount of Line 14 •
A
0 • 00
at the s taxable
PPLICABLE RATES
pousal tax rate, or
transfers u ( 2
' ~' 8 7.8 2 )
n~er Sec. 9116
(a)(1.2) X .0 _
16. Amount of Line 14 t xable 5
0 4 ~ ~ 4 8 8 . ], 6
at -ineal rate X
.
15.
17. Amount of Line 14
at sibling rate X .12 taxable Q• 0 0
Q. Q Q
18. 16.
Amount of Line 14 taxable
at collateral rate X
15 ~ • ~ ~
~ • ~ ~
.
17.
0.00
19. TAX DUE 18. 0.00
••••••..., 0.00
20. FILL IN THE BOX IF YOU ARE R 19.
0 • 0 0
EQUESTING A REFUND OF AN OV
ERP
AYMENT
L 15p56 Side 2
11285
OM4648 3.000
1505611285 J
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
DECEDENT'S NAME
BOOKS
STREET ADDRESS
-~-^L~ A~HrN ,TON c
'UMBERLAND COUNTY
cITY
Tax Payments and Credits:
1 ~ Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
File Number
21, 12 01, 8 7
MECHANICSBURG BOROUGH
B. Discount ~ , 0 0
0.00
3. Interest
STATE
(1)
ZIP
-00
Total Credits (A + g) (2
) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. T '
Fill in box on Page 2, Line 20 to request a refund. his is the OVERPAYMENT. (3)
0.00
5 If Line 1 + Line 3 is greater than Line 2, (4)
enter the difference. This is the TAX DUE. 0 • 0 ~
(5)
0.00
Make check payable to: REGISTER OF
WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING G2DESTION
1. Did decedent make a transfer and: S BY PLACING AN "X" IN THE APPROP
a. retain the use or income of the property transferred RIATE BLOCKS
b. retain the right to designate who shall use the property transferre Yes No
c. retain a reversionary interest ~ ~ ~ 0
d or its income ^ ^
d. receive the promise for life of either ~ X
2. If death occurred after Dec. 12 1982 payments, benefits or care? ~ ~ ~ ^
without receivin did decedent transfer property within one ~ ^
g adequate consideration? . year of death
3. Did decedent own an "in trust for" ~ ~ '
4. Did decedent own an individual retiorem na alccount, an ^ ^
pon-death bank account or security at his or her death?
contains a beneficia nuity, or other non-probate property, which ^ ^
ry designation? 1 .
IF THE ANSWER TO ANY OF THE ABOVE ^
QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND F
For dates of death on or after July 1, 1 ggq ILE IT AS PART
is 3 percent 72 P. and before Jan. 1 OF THE RETURN.
[ S. §91 16 (a) (1,1) (i)]~ 1995, the tax rate im
posed on the net value of transfers to or for the use of the survivin
For dates of death on or after Jan. 1
(72 P.S. §91 16 (a) (1.1 ~ 1995. the tax rate imposed on the net value of transfers t g spouse
filin ) (~~)1~ The statute does not exempt a transfer to a surviving spouse fr
g a tax return are still a licable even if the survivin
PP om tax, and the statutory requirementsrforln'
For dates of death on or after Jul 1 9 spouse is the only beneficiary. 9 spouse is 0 percent
• The tax rate im Y 2000: disclosure of assets and
adoptive Posed on the net value of transfers from a deceased child 21
parent or a stepparent of the child is 0
• percent [72 P.S Years of age or younger at death to or for the use of a natural parent
The tax rate imposed on the net value of transfers to or for the §9116(a)(1.2)).
• The tax rate im an
posed on the net value of transfers to or for the use of the ecedent's lineal beneficiaries is 4.5
under Section 9102, as an individual who has at least one parent in Percent, except as noted in (72 P.S.
decedent's siblings is 12 §9116(a)(1)j.
common with the decedent, whetherebrcent [72 P.S. §g116 a 1.
()( 3)]. A sibling is defined,
y blood or adoption.
OM4671 2.000
REV-1508 EX+ (t 1.10
Pennsylvania
DEPARTMENT OF REVENUE SCHEDULE E
INHERITANCE TAX RETURN A u
RESIDENT DECEDENT C''~~r7, BANK DEPOSITS
EsrarE ol=: PERSONAL PROPERTY CSC.
Ed ar F. Books
OW46AD 2.000
Include the proceeds of litigation and the date the proceeds were received FILE NUMBER:
ITEM All property joint) 21 12 0187
NUMBER by the estate.
y owned with right of survivorship must be disclosed on
Schedule F.
~ ~ 2 0 0 7 DESCRIPTION VALUE AT DATE
Toyota Sienna
auto was OF DEATH
repossessed and sold at auction b
R.BS Citizens y lien holder
13,000.00
2 Members 1 s t
Federal Credit Union
savings account #47212_00
926.29
70TAL (Also enter
If more space is needed, use additional sh On line 5, Recapitulation) $
Bets of paper of the same size. 13 ~ 92 6. 2 9
RE1/-1509 D(+ (01-10)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
~d ar F. Anr,v~.
SCHEDULE F
JOINTLY OWNED pRppERl-1,
If an asset became jointly owned within one year of the FILE NUMBER:
decedent's date of death, it must be re 21 12 018 7
SURVNING JOINT T ported on Schedule G.
ENANT(S) NA~S)
ADDRESS
'A BOO)CS RELATIONSHIPTppED~.
Julia C
307 S. Washin ton
Mechanicsbur g Street,
g~ PA 17055
Surviving Spouse
9
JOINTLY OWNED PROPERTY.
Ir more space is needed, use additional sheets of `C' en Llne 6, Recapitulation) $
paper of the same size. 5 ~ 488 • 16
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
--- FILE NUMBER
Decedent's debts must be reported on Schedule I. 21 12 0187
ITEM
NUMBER
A. FUNERAL EXPENSES: DESCRIPTION
1. Clergy for funeral service AMOUNT
50.00
Total from continuation schedules •
6,264.38
B. ADMINISTRATIVE COSTS:
~ • Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
State __ ZIP
Year(s) Commission Paid:
2~ Attorney Fees:
Snelbaker & Brenneman, p,~,
3• Family Exemption: (If de de is addr ss de oed aS of 3 / 15 / 12) 633.75
e same as claimant's, attach explanation.)
Claimant
Street Address
City
State ~_ ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5~ Accountant Fees: 87.50
6. Tax Return Preparer Fees:
7,
1 Cumberland Law Journal
advertising Executrix Notice
75.00
Total from continuation schedules •
236.40
9wasac z.ooo If more space is needed, use addit oo I sheets of papeoof the sa Recapitulation) $
me size. 7, 347.03
Estate of: Edgar F. Books
Item
No. Description
Schedule H Part 1 (Page 2)
2 Mark Fake
funeral luncheon
3 Malpezzi Funeral Home
funeral services
4 Mechanicsburg Cemetery
cemetery plot and grave opening
Total (Carry forward to main schedule)
21 12 0187
Amount
297.00
5,067.38
900.00
6,264.38
Estate of; Edgar F Books
Schedule H Part 7
2
Register of Wills
filing fee for Inheritance Tax
3 Return
The Sentinel
advertising Executrix Notice
(Page 2)
21 12 0187
15.00
221.40
Total (Carry forward to main s
chedule)
REV-1512 EX + (12-08)
Pennsylvania
~EPARTMENTOF REVENUE SCHEDULE ~
INHERITANCE TAX RETURN DEBTS OF DECEDENT,
RESIDENTDECEnENT i MORTGAGE LIABILITIES
ESTATE OF
~ LIENS
Ed ar F. Books
Report debts incurred b FILE NUMBER
__ y the decedent prior to death that remained un 21 12
ITEM paid at the date of death, includin 0187
NUMBER g unreimbursed medical expenses.
~ ~ DESCRIPTION
RBS Citizens
balance of loan plus repossession
Sienna fees on 2007
Toyota
VALUE AT DATE
OF DEATH
14,255.24
8W46AH 2.000
tf more space is needed, insert ddiAtionallsh enter on Line 10,
Recapitulation) $
eets of the same size.
1455 , 24
REV-1513 EX+(01.j0)
pennsyl~an~a
DEP,4}~7~ENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE pF;
SCHEpU~E .1
BENEFICIARIES
NUMBER NAME AND
~ ADDRESS OF P
TAXABLE DISTRIBUTIONS [Include out 9 0s ou) RECEIVING P
ROPERTY
Sec. g ~ 16 p sal distributions and transfers under
1. Juli (a) (1.2).)
a C• Books
307 S. Washi
MechanicsburnJton Street
g' PA 17055
RELATIONSHIP TO DECEDENT'
Do Not List Trustee(s~
Surviving Spouse
FILE NUMBER:
L2 0187
AMOUNT OR SHARE
OF ESTATE
5,488.16
ENTER ~LLARAMOUNTS FOR DISTRIB~ONS SHOW I
~~ NON-TAXABLE DISTRIBUTIONS N ABOVE ON LINES 15
A. SPOUSAL DIS7RIB THROUGH 18 OF REV-1500
UTIONS UNDER SECTION 9113 F COVER SHEET,
1 OR WHICH AN AS APPROPRIATE.
ELECTION 70 TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II
:sai z o0o ENTER TOTAL NON-T
If mores ABLE DISTRIBUTIONS ON
pace is needed, use additional sheets) of 13 OF REV-
1500 COVER SHEET. $
paper of the same size.
~~
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~~nwealth of Pennsylvania )
County of C~erland (SS:
On this, the 15th da
the undersigned officer y of April ~ 1988 ~ before me a notes
me to be the person whosepnamenally appeared Ed Books rY public
and acl~owled ed t~.t ho is subscribed togas F. ,known to
`~ _ executed- the same for the e within instrum,~t r
conta-zn.ed ,
p~poses therein.
In witness whereof, Thereunto set j .
my nand and official sea~_.
N _~.. ,._.__~..-L..
°~rY Public
f~E~f~A A. ftT7, ~~%TAf?Y Pf~~LiC
~ECyi~B~P~S6kl~~ ~t~~~, Cif„ ra
~f Y ~D~f6~; SSlr,~ EX~f ~~ES Sf t af~D 1 ~g~j.f ~.
14~et~beT. ~°enns;~~4u"Z~12 QSS~wL"i;iQit ng ~!otari~s