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HomeMy WebLinkAbout11-28-12 (2) 1505610105 REV-1500 ex t°2-'1> tF" PA Department of Revenue OFFICIAL USE ONLY pennsyivania Bureau of Individual Taxes PO BOx~sobo> ~.~,,,~, "'"" ~ ' County Code Year File Number INHERITANCE TAX RETURN , ` , \ H ri PA b ' 8 6 ~ / ~ RESIDENT DECEDENT / U ar urg, s 1 712 -0 01 ENTER DECEDENT INFORMATION BELOW Social Security Number Daie of Death MMDDYYYY Date of Birth MMDbYYYY 175-10-9627 12/23/2008 12/29/18 Decedent's Last Name Suffix Decedent's First Name MI Bowersox Ralph C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI _ Bowersox Sylvia G '. Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 177-1s-1as9 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 01~ 1. Original Return ~~ 2. Supplemental Return ~~~ 3. Remainder Return (Date of Death Prior to 12-13-82) =~ 4, Limited Estate ,_, 4a. Future Interest Compromise (date of ~^~ 5. Federal Estate Tax Return Required death after 12-12-82) Ci 6. Decedent Died Testate ~_~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ~=~ 9, Litigation Proceeds Received ~~~ 1D. Spousal Poverty Credit (Date of Death ~^~ 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 Tim East, CPA 717-623-8330 First Line of Address 1316 North 17th Street Second Line of Address REGISTER OF WILLS USE ONLY n ~ c ~' n ~ m ~ 'v r^z~, ~ c_~ ~ ~ rn c c x ~ a r nzrn ~ ~ ~ ~ r~ r' ~ ~ `~ ~ o ~ City or Post Office State ZIP Code ~ LED 'L ,.I 'r~ ~rl Harrisburg PA 17103 ~ ~ ~- ~ "= ~ ..~ --7_ pV ~. _ rt'i 1'k C~> U1 O Correspondent's a-mail a s: re ahoo.com ~ '''- Under penalties of perju declare that 1 hav amin is return ' mpanyin a sta merits, and to the best of my knowledge and belief, it is true, rorrect and c plele. Declar ep other the on repr i on a nforma' hich preparer has any knowledge. SIGNATURE 0 SON O ILI R . - DATE c~ ~ ~ /~ t`S~NATURE OF PREPARER OTHER THAN REPRESE~IpiJ ~~ DATE /y ~' //~r/1 // !~ i G/ ADDRES~~ ~~ 1505610105 IRIGIN FORM ONLY Side 1 P~~ ~~~ /~ ~~- 1505610105 J ~~~ 1505610205 REV-1500 EX (FI) Dece~dtent's Social Securit/y~Number Decedent's Name: ~~ L~n C ~~ ~~ ~ ~, ~ ~ I / 5 ~ O ~- "' ~ ~7 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. I •~ ~ i 2 Stocks and 8onds(Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule 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) ,ice Separate Billing Requested ... .... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested.... .... 7. 8. Total Gross Assets (total Lines 1 through 7) ......................... .... 8. ' ~ ~ ~ ~ Q 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. ~ t ~ /~ 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ~ ~ ~ ~ 12. Net Value of Estate (Line 8 minus Line 11) ............. ............. 12 I ~ ~ ~ ~ U 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 1 an election to tax has not been made (Schedule J) ..................... ... 13. ' 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14 _. X CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable lJJ at (meal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X J S 1 g. 19. TAX DUE ................................... ................... 19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~~ Side 2 1505610205 15056102115 , , REV-1500 EX (FIJ Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME ~ - - _ _ ~ tk L ° ~--_.._.~Ga ~J 1E ~5 STREET ADDRESS I a~~ CITY STATE 21P G~M~ N L d 1 I Tax Payments and Credits: i. 2. Tax Due (Page 2, Line 19) CreditslPayments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + t-ine 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) .~_ Total Credits (A+ B) (2) (3) (4) 5. It Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~_~_ .. 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. RfV-1502 EY,+ (ll.-08) 5~ i~ pennsytvania SCHEDULE A i~7 UEFARTM[NT OF RFVfNIIE [NHERRANCE TAx RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Ralph C. Bowersox 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 ar 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. If more space is needed, insert additional sheets of the same size. REV-i5o5 EX. (g-ii) ~ pennsytvania DEPARTMENT OF REVENIIE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Ralph C. Bowersox All property jointly owned with right of survivorship must be disclosed on Schedule F. If more space is needed, insert additional sheets of the same size REV-1504 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Ralph C. Bowersox Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporationlpartnership interest of the decedent, other than a sale-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (6-98) ~ SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES 8c NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Ralph Bowersox All property jointlyowned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX~- (o8-1z) SCHEDULE E ~ ° pennsytvania bEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. rNr+ea~TANCe TAx aETUaN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ralph C. Bowersox Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorsfiip must be disclosed on Schedule F. If more space is needed, use additional sheets of paper of the same size. REV-i5og EX+ (oi-io) i1 pennsylvania SCHEDULE ~ fit D[VAHTMENi DF RFVE NUE INHERITANCE TaxREruRN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: ~? ~~ ~ I~ FILE NUMBER: 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. B. C. JOINTLY OWNED PROPERTY: / ~ ITEM NUMBE0. LETTER FOR JOINT TENANT DATE MADE )DINT DESCRI ON OF PROP INCLUDE NAME OF FIN CIAL INS71 ION AND K ACCOUM NUMBER OR SIMILAR 1DENTIMN UMBER. ATTA H DEED F JOINTLY HELD REAL ESTATE. DATE DF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. TOTAL (Also enter on Line 6, Recapitulation) I $ 0.00 If more space is needed, use additional sheets of paper of the same size. P,FV-151 Ex+ (0£4-09) 5-~ pennsylvania SCHEDULE G DevAaTnENT of REVENUE INTER-VIVOS TRANSFERS AND INFiERiTANCE rpx RETnRN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF -7 ~[ FILE NUMBER ~~FLP~ Jf~L~~SU-?C 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 LNauoE THE rvawE or THe TaarvsFEREE, TnEIR REtanonsnla To oECEOtrvT arvD 1Ht DAZE OF TNANSFtiR. ATTACH A COPY 0'r THE DEED FOR REAL ESTATE, DATE OF DEATH VALUE DF ASSET % OF DECD'S INTEREST EXCLUSION (IF pPPLICABIEI TAXABLE VALE t. TOTAL (Also enter on Line 7, Recapitulation) ~ 0.00 [f more space is needed, use additional sheets of paper of the same size. kev-ISl] ex+ to-oe) ;il pennsylvania ~i UEFAHTM[NT OE REVENl1E INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERA EXPENSES ~~• + e. ADMINISTRATIVE COSTS; i. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Ad s ~~ City x`7/7 _ l Year(s) Commission "Paid: , 2. 3. Claimant /C/ Street Address State ___ ZIP ~~~ff Attorney Fees: Family Exemption: ([f decedent's ad ss is not the same as claimant's, attach explanation.) 4. 5. 6. 7. City Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: State ZIP TOTAL (Also enter on Line 9, Recapitulation) $ ~; ~ ~~ If more space is needed, use additional sheets of paper of the same size. P,EV-15Y2 EX+ 112-OS) s ~ Pennsylvania SCHEDULE I ~~ennTwrNT uF RE~~N,~~ DEBTS OF DECEDENT, INnEalrnNCE rax RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Ralph C. Bowersox Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (p1-10) ~;1 Pennsylvania SCHEDULE J L~l UEFARTMENT OF NEVENUC INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ral h C. Bowersox 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 distrihutions and transfers under Sec. 9116 (a) (1.2).] 1 NONE ~ II ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES IS THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. 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. I$ If more space is needed, use additional sheets of paper of [he same size. REV-1514 EX~ (4-09) SCHEDULE K i~ pennsytvania ijla nE~Aa1ME~r°FAE~EN~E LIFE ESTATE, ANNUITY Bureau o(Individual Taxes PO Box zao6oi & TERM CERTAIN Harrisburg PA 1y1z9-ohm (CHECK BOX q ON REV-1500 COVER SHEET) ESTATE OF FILE NUMBER Ralph C. Bowersox This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. ^ Will ^ Intervivos Deed of Trust ^ Other NAME OF LIFE TENANT DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which life estate is payable .........................................$ 2. Actuarial factor per appropriate table ........................ . ....... . .............. . Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate 3. Value of life estate (Line 1 multiplied by Line 2) ........................... . . .......$ NAME OF LIFE ANNUITANT DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM DF YEARS ANNUITY IS PAYABLE ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which annuity is payable ...........................................$ 2. Check appropriate block below and enter corresponding number ................ . Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^Serni-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period ........................................................$ 4. Aggregate annual payment, Line 2 multiplied by Line 3 .................................. . 5. Annuity Factor (see instructions) Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate 6. Adjustment Factor (See instructions.) ................................................ . 7. Value of annuity - If using 3.5, 6, or 10%, or if variable rate and period payout is at end of period, calculation is Line 4 z Line 5 x Line 6 ................ . ..........$ If using variable rate and period payout is at beginning of period, calculation is (Line 4 x Line 5 x Line 6) + Line 3 ...............................................$ NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. [f more space is needed, use additional sheets of the same size. REV-1644 EX+ (01-10) i~ Pennsylvania INHERITANCE TAX SCHEDULE L ~7 oE~ggTMENT~FRE~E„~~ iNHERtrANCEraxREruRrv .REMAINDER PREPAYMENT aESroErvroecEOENr OR INVASION OF TRUST CORPUS I. ESTATE OF FILE NUMBER Ralph C. Bowersox This schedule is appropriate only for estates of decedents dying on or before Dec. 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust corpus (principal). II. REMAINDER PREPAYMENT: A. Election to Prepay Filed with the Register of Wills on ______ ____ (Date) B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income or Annuitant(s) of Election or Annuity is Payable C. Assets: Complete Schedule L-1 1. Real Estate ................... . .......$ Z. Stocks and Bonds ......................$ 3. Closely Held Stock/Partnership .............$ 4. Mortgages and Notes ....................$ 5. Cash/Misc. Personal Property ..............$ 6. Total from Schedule L-i ..............................................$ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities .......................$ 2. Unpaid Bequests .......................$ 3. Value of Non Includable Assets .............$ 4. Total from Schedule L-2 ..............................................$ E. Total Value of Trust Assets (Line C-6 minus Line D-4) ...........................$ F. Remainder Factor .................................................... G, Taxable Remainder Value (Multiply Line E by Line F) ............................$ (Also enter on Line 7, Recapitulation) [II. INVASION OF CORPUS: A. Invasion of Corpus _ ___ (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income or Annuitant(s) Corpus or Annuity is Payable Consumed C. Corpus Consumed ....................................................$ D. Remainder Factor .................................................... E. Taxable Value of Corpus Consumed (Multiply Line C by Line D) ....................$ ____ _ (Also enter on Line 7, Recapitulation) REV-1647 EX+ (p2-10j Pennsylvania ~ SCHEDULE M pEPARTMENT pE REVENpE I FUTURE INTEREST COMPROMISE INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4a on REV-i5oo) ESTATE OF FILE NUMBER Ralph C. Bowersox This schedule is appropriate only for estates of decedents who died after Dec. 12, 1982. This schedule is to be used for all future interests where the rate of tax that will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the tax return. ^ Will ^ Trust ^ Other I. Beneficiaries I NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY ~~ 1. 1 r 2. ~ 3. i ------ -------------- 4' ___ r s. II. ~ For decedents who died on or after ]uly 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within ~ nine months of the decedent's death, check the appropriate box below and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ^ Unlimited right of withdrawal ^ Limited right of withdrawal III. Explanation of Compromise Offer: I IV. Summary of Compromise Offer: ~ 1. Amount of future interest ......... . ............................. . ............... $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ........ $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check one. ^ 6°10, ^ 3%, ^ 0% .................... $ (Also include as part of total shown on line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Check one. ^ 6%, ^ 4.5% .......................... $ (Also include as part of total shown on Line 16 of REV-1600.) 5. Value of Line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) ........ $ 6. Value of Line 1 taxable at collateral rate (16%) (Also include as part of total shown on Line 18 of REV-1500.) ........ $ 7. Total value of future interest (sum of Lines 2 thru 6 must equal Line 1) ....................... $ If more space is needed, use additional sheets of paper of the same size. REV-1648 EX (02-09) SCHEDULE N ~ pennsylvania ~,FaAH,.,~~,o~~~~E~~~ SPOUSAL POVERTY CREDIT Bureau of lndividual Taxes PO Box zso6ol FOR DATES OF DEATH 01/01/92 TO 12/31/94 Hamsbur PA 17128 ESTATE OF FILE NUMBER Ralph C. Bowersox This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet. 1 . Taxable assets total from Line 8 (cover sheet) .............................................. 1 . 2. Insurance proceeds on life of decedent ... . ............................................... 2, 3. Retirement benefits ................................................................. 3. 4. Joint assets with spouse .............................................................. 4. 5. PA Lottery winnings ................................................................. 5. 6a. Other nontaxable assets: List and attach schedule if necessary .. 6a. 6b. 6c. 6d. ................................................. 6. SUBTOTAL (Lines 6a, b, c, d) • ~ • • 6• 0.00 7. Total gross assets (Add Lines 1 thru 6) ......................... . ..... . .................. . 7. 0.00 8. Total actual Iiabillties ......... . ...................................................... 8. 9. Net value of estate (Subtract Line 6 from Line 7) ............................................ 9. ]f Line 9 is greater than $200,000 -STOP. The estate is not eligible to claim the credit. If not, continue to Part 11. Income: 1. TAX YEAR: 19 a. Spouse ......... . ... la, b. Decedent ....... .... lb. c. Joint .......... .... Ic. d. Tax-exempt income .... ld. e Other income not listed above .. , .. .... le. f. Total .......... .... lf. 4. 4a. Average joint exemption income calculation Add joint exemption income from above: (1f) 0.00 + (zf) _ 2. I TAX YEAR: 19 2d. fie. 0.00 2f 0.00 + (3f) 3. TAX YEAR: 19 3a. 3b. 3[i 3e. 0.00 3f 0.00 0.00 - 0.00 (= 3) 4b. Average joint exemption income ................................. . ... . .................. _ If line 4(b) is greater than $40,000 -STOP. The estate is not eligible to claim the credit. If not, continue to Part 111. 1. Insert amount of taxable transfers to spouse or $100,000, whichever is less ........................ 1, 2. Multiply by credit percentage (see instructions) ............................................. z. 3. This is the amount of the Resident Spousal Poverty Credit. Include this figure in the calculation of total credits on Line 16 of the cover sheet . ................................. 3. 4. For nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate ..................................................... 4. 5. Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Include this figure in the calculation of total credits on Line 18 of the cover sheet......... , . S• REV-1649 EX+ (6-98) SCHEDULE O COMMONWEALTH OF PENNSYLVANIA ELECTION UNDER SEC.9113(A) INHERITANCE TAX RETURN (SPOUSAL DISTRIBUTIONS) RESIDENT DECEDENT ESTATE FILE NUMBER Ralph C. Bowersox Do not complete this schedule unless the estate is making the election to taz assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the _ Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or sim- ilarproperty treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as fo a fraction of the trust or similar arrangement. The numerator of this Traction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made.