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Home My WebLink About10-04-121505611180 -~ REV-1500 EX (02-11)(Fp OFFICIAL USE ONLY PA Department of Revenue ~,un,~ YorY~ a County Cede Year Flle Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 UO PO BOX 280601 a,I Harrisburg. PA 1T72a-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMA71ON BELOW Social Sewdry Number Date of Death MMDDYYYY Date of Birth INMDDYYYY 200-36-4391 ~2112U11 Decedent's Last Name Suffuc SHERIFF (If Applicable) Enter Surviving Spouse's information Below Spouse's Last Name Suffix GARNER-SHERIFF Spouse's Social Sewrlry Number 08271945 Decedent's First Narne MI GEORGE A. Spouse's First Namr: MI NONA THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW Q i. Onginel Retum [~] 2. Supplavnental Retum Q 3. RemairWer Retum (Date of Death Pnor to 12-13-tit) 0 4. Limited Estate Q 4a. Future Interest Compromise (date of Q 5. Feda21 Estate Tax Retum Required deaM alter 12-12.82) ® 6. Decedent Died Testate [] 7. Decedent MalMalned a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) Q 9. Lidgation Proceeds Received Q 10. Spousal Poverty Credit (Date of Death Q 11. Electlon to Tax under Sec. 9113(A) Between 12$i-91 and 1.1-95) (Attach Schedule O) CORRESPONDENT-TMS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFXIENTUL TAX INFORMATION SNOI1iD BE tNRECTED TO: Name Daytiime Telephone Number ROBERT G. FREY 7112435838 Frst Line of Address 5 S. HANOVER ST. Second Line of Address City or Post Office CARLISLE Corraspondent'se-mail address: RFREYaFREYTILE State 2iP Code PA 17013 rv REGISTER WILLS USE Y _ O mS ~ f -~ ~ n 70 ~ ~:, ! ~ :} vi -'.: t' a ~ r c~~` z O ~ N e ~~,77 ~ ~ lYATE FILED c-+ fr1 belle(, ADDRESS 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505611180 1505611180 J J 1505611280 REV-1500 EX {FI) Deicedent's Social Security Number Decedents Name: GEORGE A. SHERIFF 2170-36-4391 RECAPITULATION 1. Real Estate (Schedule A) ........................................ . 1. N 0 N E 2. Stocks and Bonds (Schedule B) ................................... . 2. N 0 N E 3. Cbsely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . 3. NONE 4. Mortgages and Notes Receivable {Schedule D) ....................... . 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ... . 5. 30!]0.00 6. Jointly Owned Property (Schedule F) ~Saparate Billing Requested ..... .. 6. N 0 NE. 7. Inter-Vvos Trensfers & Miscellaneous Non-Probate Property (Schedule G) I~Separate Billing Requested ..... .. 7. NONE. _ 8, Total Gross Assets (total Lines i through 7) 8 3000.0111 9. Funeral Expenses and Administrative Costs (Schedule H) ............... . 9. N O N f: 10. Debts of Decetlent, Mortgage Liabilities and Liens (Schedule I) ........... . 10. NON E 11. Total Deductions (total Lines 9 and 10) ........................... . . 11. 0 , O (1 12. Net Value of Estate (Line 8 minus Line 11) .. . ....................... . 12. 3000.00 13. Charitable and Govemmenfal Bequests/Sec 9113 Trusts for which an election to tax has not been matle (Schedule J) ..................... . 13. (] , [] ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) 14 301111 . (10 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (ax1.2)X.0 I] 30(11J.0(] 15. D.0l1 16. Amount of Line 14 taxable at lineal rate X .0 4 5 18. [] . [] 0 17. Amount of Line 14 taxable at sibling rate X . 12 17. ~ . ~ ~ 16. Amount If Line 14 taxable at collateral rate X . 15 t 8. 0 . D l] 19. TAX DUE ....................................................... . 19. (].(]I] 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 1505611280 1505611280 J REV-7500 Fit (FI) Page 3 nuruelnnY¢ Cmm~lP_1P AddfasS_ 21-11-200 Flle Number 200-36-4391 r DECEDENT'S NAME GEORGE A. SHERIFF STREET ADDRESS 531 CONODOGUINET AVE CITY STATE ZIP CARLISLE PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Pdor Payments B. Discount 3. Interest Total Credits (A + B ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill In lwx on Page 2, Line 20 to requeat a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) o.oo (2) 0.00 (3) (4) 0.00 (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: f d t Yes ^ No ................................................................................. rans erre a. retain the use or income of the property ...... b. retain the right to designate who shall use the property transfeRed or its income .................................... ...... ^ c. retain a reversionary interast .................................................................................................................... ...... ^ d. receive the promise for I"rfe of either payments, benefds or care? ............................................................ ...... ^ 2. If death occurred after Dec. 12, 1982, did decedent Vansfer property within one year of death id ti ? ^ ................................................................................................... era on without receiving adequate cons ....... 3. Did decedent own an "in trust for' or payable-upon-death bank aaount or security at his or hev 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 ABOYE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE C; 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 rote imposed on the net value of transfers to or for the use of the surviving spouse Ls 3 Percent [72 P.S. §9116 (a) (1. t) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposetl on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9176 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and thei 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 fax 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. §91 t6(a)(1.2)]. • The !ax 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 [/2 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)(1.3)]. A sibl(ng 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-1508 EX+(17.f0} SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, 8r MISC. DEPAftiMENT OF REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEOENi ESTATE OF: FILE NUMBER: George A. Sheriff 21-11-200 If more space is needed, use additional sheets of paper of the game size.