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Home My WebLink About10-15-12 (2). ~ 1,50561,01,05 REV-1500 EX (02-11) (FI) enns lvania PA Department of Revenue p Y OFFICIAL USE ONLY Bureau of Individual Taxes ~EPaA,MENroFAE~EN~E INHERITANCE TAX RETURN PO BOX 280601 County Code Year ~ J 1 +- File Number F Harrisburg, PA 1128-0601 R ESIDENT DECEDENT >C ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 426-03-3227 01 /16/2012 05/12/1920 Decedent's Last Name Suffix Decedent's First Name MI BURTON ROBERT P (If 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 FILE D IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 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 (date of O 5. Federal Estate Tax Return Required death after 12-12-82) C~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.} O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date 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 COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number r~-~:: _> DAVID P. PERKINS, ESQUIRE (717) 532-95~, '`-' ~ ~ REGISTER ~ ;tS USE ~LY First Line of Address Attorney at Law Second Line of Address 4 James Circle City or Post Office Shippensburg State ZIP Code PA 17257 r---..=y- -." ~.. <J' ~ _~ T ~~' ~ ~~:3 r _~ .. a .F` DATE FILED Correspondent's a-mail address: DPPESQ@GMAIL.COM T1 ~s'7 -;-, ~J; _ -._I ~,,.__ `_~ i_',: - _ i ---i 1 -r=i --L~ rn n Q --n Under penalties of 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 true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG OFD ~~ON R NS t' R FILI RETURN DATE 10/15/2012 ADDRESS 42 est Main Street Walnut Bottom, PA 17266 SIG ATUft OF PRE RE THE AN REPRESENTATIVE DATE l .~--~ ~ 10/15/2012 4 JAMES CIRCLE SHIPPENSBURG, PA 17257 PLEASE USE ORIGINAL FORM ONLY Side 1 1,50561,0],05 150561,01,05 h~~! 1505610205 REV-1500 EX (FI) Decedent's Social Security Number decedent's Name: BURTON, ROBERT P. 426-03-3227 REC APITULATION 1. Real Estate (Schedule A) ............................................ . 1. 0.00 2. Stocks and Bonds (Schedule B) ...................................... . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) .......................... . 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... . 5. 52,011.17 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested....... . 7. 177,599.26 8. Total Gross Assets (total Lines 1 through 7) ............................ . 8. 229,610.43 9. Funeral Expenses and Administrative Costs (Schedule H) .................. . 9. 1 1,215.60 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .............. . 10. 66.68 11. Total Deductions (total Lines 9 and 10) ................................ . 11. 11,282.28 12. Net Value of Estate (Line 8 minus Line 11) ............................. . 12. 218,328.15 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... . 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... . 14. 218,328.15 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 218,328.15 1g, 9,824.77 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ........................................................ . 19. 9,824.77 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME ROBERT P. BURTON STREET ADDRESS 129 Walnut Bottom Road Apt 152 CITY Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. STATE ZIP Total Credits (A + B) (2) (3) (4) (5) 9,824.77 0.00 9,824.77 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 property transferred .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ 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 consideration? .............................................................................................................. ^ 3. 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 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 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 [72 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 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(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-15o8 EX+ (08-12) i ~ pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BURTON, ROBERT P. 21-12-0355 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. REV-1510 EX+ i08-09' ~ ~ pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER BURTON, ROBERT P. 21-12-0355 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. PNC INVESTMENTS Acct# 005-465690 177,599.26 100 0.00 177,599.26 transfer on death 50% to daughter Sheila B. Malone and 50% to son RobertRobert P. Burton, Jr. TOTAL (Also enter on Line 7, Recapitulation) $ I 177,599.26 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ {10-G~j ~ ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER BURTON< ROBERT P. 21-12-0355 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: i' Dugan Funeral Home & Crematory, Inc. cremation 1,280.52 51 Asper Drive Shippensburg, PA 17257 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City __-- -- Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. ~. Street Address City ____ ______ _________ _ State _.___ ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Legal Advertising - $ 75.00 Cumberland Law Journal and $200.16 The Sentinel newspaper State ZIP TOTAL (Also enter an Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. 9,184.42 475.50 275.16 11,215.60 REV-1512 EX+ (12-08) . ~~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER BURTON ROBERT P. 21-12-0355 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. REV-1513 EX+ (01-10) . ~ ~ Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BURTON, ROBERT P. 21-12-0355 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• SHEILA B. MALONE DAUGHTER 50% 421 West Main Street Walnut Bottom, PA 17266 2. ROBERT P. BURTON, JR. SON 50% 121 Uselma Avenue Jefferson, OH 44047 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ $