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HomeMy WebLinkAbout09-11-12J 1505610105 REV-1500Ex`°'.">IFt, PA Department of Revenue Oennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes """'"`" County Code Year File Number PoaoxzsoeGl INHERITANCE TAX RETURN t Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~~ I ~ o~~g ENTER DECEDENT INFORMATION BELOW Sodal Secudry Number Date of Death MMDDYYYY Date of Birth MMDDYVYY 204-03-7106 01/16/2012 09/29/1921 Decedent's Last Name Suffix Decedent's First Name MI Howard Edna M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Howard George W Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLIOATE WITH THE 217-1z-s21s REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C'~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (tlate of O 5. Federal Estate Tan Return Requiretl death after 12-12-62) l~ 6. Decetlent Died Testate O 7. Decedent Maintained a Living Trust 0 6. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Gate of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETEp. ALL CORRESPONDENCE AND CONFIDENTIAL 7AX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number John C Oszustowicz (717) 243-7437 REGISTER OF WILLS USE ONLY n !_' ~~ n~ ~ S `~ -` First Line of Atldress ~ n7 ~ r C ) 104 S Hanover St ~ ~! ~ ~ ~° - `~ ,~-.. r. ., ri~l Second Line of Address ~ C!) ~': ~ -`D r-, ' ~C-- '°` -rT City or Post Office State ZIP Code dATF, f EO -~ '= P Carlisle PA 17013 n N ~~ I Correspondent's a-mail address: jr7hn0@CafllSlepal8W.C0r0 Under penaltie perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is hue, co t nd complete. DeGaration of preparer other Shan the personal representative rs based on all information of which pr®parer has any knowledge. SIGNATUR O PE N ftES SIBLE F ING RETURN DATE ADDRESS 104 S H o r St., Carlisle, PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L 15D5610105 Side 1 150561D105 J REV-1500 EX (FI) Decedent's Name: Edfla M HOwefd RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schetlule C) ..... 3 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schetlule G) O Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 10. Debts of Decedent, Mortgage Liabilities antl Liens (Schedule I) ............... 10. 11. Total Deductions (total Lines 9 and 10) ................................. 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. Decedent's Social Security Number 204-03-7106 22,445.89 5,031.12 295,054.79 322,531.80 8,445.93 2,130.12 10,578.05 311,955.75 52,867.87 259,087.88 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(t.2) X .0_ 5,031.12 15. i6. Amount of Line 14 taxable at lineal rate X .0 _ 1 g, 17. Amount of Line 14 taxable at sibling rate X .72 134,519.80 17. 78. Amount of Line 14 taxable at collateral rate X .15 119,536.96 18 19. TAX DUE ........................... ............................ .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 1505610205 0.00 16,142.38 17,930.54 34,072.92 O ftEV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Edna M Howard STREET ADDRESS 770 S Hanover St CITY STATE ~ 21P Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 8, 000.00 B. Discount 421.00 3. Interest 4. Ii Line 2 is greater than Line i + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 2Q to request a refund. 5. If Line 1 + Line 3 is greater than Lrne 2, enter the difference. This is the TAX DUE. (1) 34,072.92 Total Credits (A + B) (2) 8,421.00 (3) (4) (5) 25,651.92 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: Yes No a. retain the use or income of the properly transferred .................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income ...................................... ...... ^ c. retain a reversionary interesl ....................................................................__.........._.._..........._................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideretion? ........................................................................................................ ...... ^ 3. Did decedent own an "intrust 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? .................................................................................................................. ...... ~ ^ 1F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dales of death on or otter JDIy 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) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent j72 P.S. §9116 (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 reium are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after Juiy 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 far the use of a natural parent, an adaptive 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(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)]. Asibling 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+(u-~o) pennsylvania SCHEDULE E aEenaTnENT ar "EVENUE CASH, BANK DEPOSITS & MISC. I""EaIT"NCETaxRETUaN PERSONAL PROPERTY 0.ESIDENT DECEDENT ESTATE OF: FILE NUMBER: Edna M Howard 21-12-0248 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. 1. Orrstown Bank Checking Account 108008034 11,368.85 2 Omstown Bank Checking Account 108007009 5,955.28 3 Chapel Pointe at Cadisle refund for nursing care 4,192.94 4 Bridgestone Pension 150.37 5 The Sentinel -newspaper cancellation refund 37.50 6 HMA medical expense refund 9.53 7 Car Insurance refund 18 81 g 2011 Federal Tax Refund 712.00 g Interest on item 1 0.56 1p Interest onitem2 0.05 TOTAL (Also enter on Line 5, Recapitulation) ; I 22,445.89 If mare space is needed, use additional sheets of paper of the same size. REVnSOg E%+(oLno) ~i pennsylvania ei~ pEPAgTMENT OFFEVENUE INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE F ]OINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Edna M Howard 21-12-0248 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• George Howartl 1770 S Hanover St., Carlisle, PA 17013 ~ Spouse e. C. JOINTLY OWNED PROPERTY: ITEM NUMBER IFfTER FOR ]D1Nr TENANT DATE MADE JOIN! DESCRIPTION OF PROPERTY INCLUDE NPME OF FINANCIAL INSTRUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FDR JOINTLY HELD REAL ESTATE DgTE OF DEPTH VALUE DF g58ET %oF DECEDENT'S INTEREST DATE DF DEATH VALUE OF pECEDENT'S INTEREST 1 A . . 02102105 Orrstown Bank Checking Account 106003108 '10,062.23 50 5,031.12 TOTAL (Also enter on Line 6, Recapitulation) I ¢ 5,031.12 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-U9) ~,~`~'," Pennsylvania SCHEDULE G ri~ oernRrMe"TOrReveN"e INTER-VIVOS TRANSFERS AND ~""ER'T""eET"xRETUR" MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Edna M Howard 21-12-0248 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY wauoe rxs nnne av rns raaxsrsaee, ms~a aEUnorvse~r ro oeccocxr nxo we onre orrannsrsa. arrgcnacoar aF me oeeo voa aen~esrnrs. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION ;irnaPl¢nazsl TAXABLE VALVE 1. Members 1st CD #398292-43 transferred to Harvey McCommon (brother) 52,772.74 100 52 772.7 upon death , 2 Members 1st CD #398292-41 transferred to Lois McCommon (sister-in-law) 53,123.36 100 123.31 53 upon death , 3 Members 1st CD #398292-42 transferred to Robert Surfeld (friend) 25,Sa0.07 100 25 540.0 upon death , 4 New York Life Annuity Policy 74202012 Beneficiary Harvey H McCommon 81,747.06 100 81 747.01 (brother). Txfr dale 5/31112 , 5 New York Life Annuity Policy 74202012 Beneficiary Lois McCommon (sister-in-law). Tzfrdate5(31/12 40,873.53 100 40,873.5: 6 New York Life Annuity Policy 74202012 Beneficiary Edna M Howard Trust. Txfr date 712112 40,998.03 100 40,998.0: 70TAL (Also enter on Line 7, Recapitulation) $' 295,054.79 If more space is needed, use additional sheets of paper of the same size. RFV-1511 EX+ (10-09) i±li Pennsylvania SCHEDULE H ~y~ oernatmeNTOraEVervuE FUNERAL EXPENSES AND 1"NERIT"NCE Tnx ReruaN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Edna M Howartl 21-12-0248 Decedent's debts must be reported on Scbedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Ewing Brothers Funeral Home, Carlisle PA 452.23 e. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 7,450.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Sheet Address City State ZIP Aelatlonship of Claimant to Decedent 4. Probate Fees: 158.50 5. Accountant Fees: 6. Tax Return Preparer Fees: ~ The Sentinel -legal advertising 115.20 a Cumberland County Law Journal -legal advertising 75.00 e Cadisle Memorial -tombstone engraving 195.00 i07At (Also enter on Line 9, Recapitulation) I; 8,445.93 If more space is needed, use additional sheets of paper of the same size. R'-V-1512 FR+ (12-06) Pennsylvania SCHEDULE I oEVanTmervT of REVErvuE DEBTS OF DECEDENT, INNERITANCE rAx RETUkN MORTGAGE LIABILITIES & LIENS RESIDENT ~ECEOENi OF FILE NUMBER Edna M Howard 21-12-0248 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If mare space is needed, insert additional sheets of the same size. REV-1513 EX+ (O1-10) Pennsylvania SCHEDULE 7 1NNeR,TAN~E TAX RETl1RN BENEFICIARIES RES[DEM DECEpENT ESTATE OF: Edna M Howard NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PRDPE0.TY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions antl tra 1. 2 3 4 1. Sec. 9116 (a) (1.2).] Harvey McCommon 7 Alliance Dr. Apt 301, Carlisle PA 17013 Lois Mc Common 7 Alliance Dr. Apt 301, Cadisle PA 17013 Robert Surfield 9 Crystal Ln., Carlisle PA 17015 George Howard 770 S Hanover St., Carlisle PA 17013 under List Brother Sister-in-law Fdend Husband OF ESTATE 134519.80 93996.89 25540.07 5031.12 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES ]5 THROUGH 18 OF REV-1500 C'.OVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECRON TO TAX IS NOT TAKEN; 1• Edna M Howard Trust B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS; TOTAL OF PART R -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I; 52867.87 52867.87 if mare space is needed, use additional sheets of paper of the same size.