HomeMy WebLinkAbout12-03-12
J 1505610105
REV-1500 Ex (02_il) (H) •
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
Bureau of Individual Taxes ` County Code Year File Number
PO BOX 280601 QINHERITANCE TAX RETURN ~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT J
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
201-18-2688 12/07/2011 07/27/1925
Decedent's Last Name Suffix Decedent's First Name MI
Showvaker Mary E
(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 FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return p 2. Supplemental Return p 3. Remainder Return (Date of Death
Prior to 12-13-82)
p 4. Limited Estate p 4a. Future Interest Compromise (date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
p 6. Decedent Died Testate p 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 TO:
Name Daytime Telephone Number
Bradley C. Shover (717) 701-2422
RASTER OF WILL USE c%Lij
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First Line of Address ryl :C n ,..j ~
5455 Wer lle Rd rs1 W '
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Second Line of Address
C> a :
City or Post Office State ZIP Code & ATE FILIIW 70 fi l
't7 --t G.J C>
Enola PA 17025 Tr O
Correspondent's e-mail address: taxman415@COmCast.net
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.
S10 ATURE OF P SON PONSIBLE FOR F" G RETURN DATE
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Z 11/30/2012 !
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S RFj~F FjREJ~ARER OT~iER AN REPRESENTATI DATE
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ADDRESS
5455 Wertzville Rd, Enola, PA 17025
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX (Fl)
Decedent's Social Security Number
Decedent's Name: Mary E . Shomaker 201-18-2688
RECAPITULATION
1. Real Estate (Schedule A) 1. 70,000.00
2. Stocks and Bonds (Schedule B) 2. 0.00
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. 8,783.94
6. Jointly Owned Property (Schedule F) O Separate Billing Requested 6. 0.00
7. Inter-Vivos Transfers S Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets total Lines 1 through 7 8. 78,783.94
9. Funeral Expenses and Administrative Costs (Schedule H) 9. 9,711.30
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule 1) 10. 13,744.76
11. Total Deductions (total Lines 9 and 10) 11. 23,456.06
12. Net Value of Estate (Line 8 minus Line 11) 12. 55,327.88
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. 55,327.88
TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.0- 15.
16. Amount of Line 14 taxable
at lineal rate x .0 45 55,327.88 16. 2,489.76
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. 2,489.76
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Mary Elizabeth Showvaker
STREETADDRESS
205 Roxbury Rd
CITY STATE P
Shippensburg PA 17025
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 2,489.76
2. Credits/Payments
A. Prior Payments 0.00
B. Discount 0.00
Total Credits (A+ B) (2) 2,489.76
3. Interest
(3) 17.76
4. 0 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. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,507.52
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? ❑ 0
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?., ❑ 0
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)]. 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-1502 EX+ (11-08)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERNANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary Shomaker
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 205 Roxbury Rd, Shippensburg, PA 17257 70,000.00
TOTAL (Also enter on Line 1, Recapitulation.) $ 70,000.00
If more space is needed, insert additional sheets of the same size.
REV-1509 E(+ (01-10)
j pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE IOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary Showvaker
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. Joyce G. Showvaker 205 Roxbury Rd Daughter
Shippensburg, PA 17257
B.
C.
JOINTLY OWNED PROPERTY:
LErTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 01/01/96 M & T Bank Account #950617717 17,567.88 50 8,783.94
TOTAL (Also enter on Line 6, Recapitulation) $ 8,783.94
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary Showvaker
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. 9,711.30
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State _ ZIP
Year(s) Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant Joyce Showvaker
Street Address 205 Roxbury Rd
city Shippensburg, State PA zip 17257
Relationship of Claimant to Decedent Daughter
4. Probate Fees:
S. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL (Also enter on Line 9, Recapitulation) $ 9,711.30
if more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-GS)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary Showvaker
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• Mortgage with Citizens Bank on 205 Roxbury Rd, Shippensburg, PA 17257 12,064.36
2 Comcast Cable 71.00
3 Penelec 102.00
4 Penelec 83.77
5 Pro Lawn and Landscaping 135.00
6 All State - Homeowners Insurance 2012 388.63
7 M & T Bank Credit Card 900.00
TOTAL (Also enter on Line 10, Recapitulation) $ 13,744.76
If more space is needed, insert additional sheets of the same size.