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Home My WebLink About01-03-13.~ J 1505610143 REV-1500 E"(02-1' PA Department of Revenue OFFICIAL USE ONLY Pennsylvania County Code Year File Number Bureau of Individual Taxes ~~+*Me~oc~~ Po Box.2soso~ INHERITANCE TAX RETURN 21 11 1022 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 09 10 2011 03 10 1930 Decedent's Last Name Suffix Decedent's First Name MI CALLAWAY WARREN J (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 tN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ^ 1. Original Return ~ 2. Supplemental Retum ^ 3. Remainder Return (Date of Death Prior to 12-13-82) 4. Limited Estate ^ qa. Future Interest Compromise 5. Federal Estate Tax Retum R uired (date of death after 12-12-82) ^ eQ a g. Decedent Died Testate ~ Deceder~ t Maintained a Living Trust (Attach Copy of Will) ^ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ^ 1 p. Spousal PovertyY Creditl(Date of Death 11, Election to tax under Sec. 9113(A) between 12-31 51 and -1-95) ^ (Attach Schedule O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION ~tiHOULD BE~RECTED TO: Name Dayt~e Telephone~li,lmb~ rTt JOEL O SECxRIST ESQ 71~i ~38 3396? ~ First Line of Address 568 OLD YORK ROAD Second Line of Address City .or Post Office State ZIP Code ETTERS PA 17,319 Correspondent's a-mail address: S@ChriStlaW~gntall.COnl Joel O. Sechrist Esq. Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is tru rrect and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNA U Of P SON RESPONSIBLE FOR FILING RETURN DATE ~ - Lori G. Beneyton j-Z ~ Z ~ ' ~-L F. S ~u~z~a avenue, fiellertown, PA 18055 SIG ATU F PREP OTHER HA~1 REPRESENTAT .- i AD 8 Old York Road, Etters, PA L 1505610143 xt ~~ r-- REGIS~RSOF Wlf~ US~~~Y ,:~ U7 v:; ~~ ~~ '. a c :n _r.i ...3 t7 .. _, -._ `_r~n DATE FILED 2Jzl/-v Side 1 1505610143 J 150561243 REV-1500 EX Decedent's Social Security Number °e~ede~rs"ame: Callaway, Warren J. RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... .. 1. 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. . 5. 3 0 , 7 0 0 . 0 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous 1~ Probate Property (Schedule G) u Separate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1 through 7) ....................................................... . g. 3 0, 7 0 0. 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ................................. ... 9. 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. 3 O , 7 0 0 . 0 0 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, 3 O , 7 0 0 . 0 0 TAX COMPUTATION -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 .00 15. 0 . 0 0 16. Amount of Line 14 taxable at linealrateX .045 30,700.00 16. 1,,3$1.50 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. Q_ 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ............................................................................................................... . 19. 1 , 381.50 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505611)243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-1022 DECEDENT'S NAME Callaway, Warren J. STREET ADDRESS 1010 S. Market Street CITY STATE ZIP Mechanicsburg PA 17055 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. Check box on Page 2, Line 20 to request a refund (1) 1,381.50 Total Credits (A + g) (2) (3) (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,381.5U 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 :.................................. ^ X c. retain.a reversionary interest; or..........._ ............................. ^ x d. receive the promise for life of either payments, benefits or care? ..................................................... ^ x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................. ...................................... ^ 0 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)j. For dates of death on or after January 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)j. The statute does not exempt a transferto 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)j. 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-1508 EX+ i11-10) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER /'7~~~ui~~i ~Al.~rw~w. 1 _ . _ _ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ~~~ ~~~.+~.. ~,.aw .a ~iccucu, auumUndl pages OT Ine same SI2e) Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10) REV-1513 EX+(01-10) ` SCHEDULE J COMINHR SIDENTED~CEDENTR"ANIA BENEFICIARIES ESTATE OF FILE NUMBER Callawa ,Warren J. 21-11-1022 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Ronald Kiehl None metal break Mechanicsburg, PA 17055 2 Irina Beneyton Granddaughter one sixth of 1067 2nd Avenue nineteen percent Hellertown, PA 18055 of residue 3 Edi Beneyton Grandson one sixth of 1067 2nd Avenue nineteen percent Hellertown, PA 18055 of residue 4 Lori G Beneyton Daughter 113 of Potter 1067 2nd Avenue County real Hellertown, PA 18055 estate 8 27% of residue 5 Sam Beneyton Grandson one sixth of 1067 2nd Avenue nineteen percent Hellertown, PA 18055 of residue See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet, as a ro riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 01-10) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Warren J. Callaway 09/10!2011 211-22-7246 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Joseph G Callaway 870 Hawthorn Avenue Mechanicsburg, PA 17055 7 Kyle Callaway 870 Hawthorn Avenue Mechanicsburg, PA 17055 8 Wicole Callaway 870 Hawthom Avenue Mechanicsburg, PA 17055 9 Brett Long 875 Hawthorn Avenue Mechanicsburg, PA 17055 10 William M Long 875 Hawthorn Avenue Mechanicsburg, PA 17055 Son 1/3 of Potter County real estate S 27% of residue Grandson one sixth of nineteen percent of residue Granddaughter one sixth of nineteen percent of residue Grandson one sixth of nineteen percent of residue Stepchild 1/3 of Potter County real estate 8 27% of residue 1