HomeMy WebLinkAbout01-03-13 (2)1
1505610140
REV-1500 EX (01-10)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 6 6 5 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY
0 6 2 4 2 0 0 6 0 8 0 8 1 9 2 3
Decedent's Last Name Suffix Decedent's First Name MI
S t a k e R u t h A
(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 Q 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)
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 ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
W a y n e F- S h a d e E s q u i r e 7 1~ 2 4 ~~0 2~ 0
c w ~rn
R S1~R OF WIL_L'~,~USE QII~L
First line of address ~ ~ ~ I-~'j
T~.. -Y•r W :;;0 C:~
.s ~~
5 3 W e s t P o m f r e t S t r e e t QG'
Second line of address ~^+ *~: -,-~ ~ ;- "~
City or Post Office State ZIP Code :.~ _ DATE F~LEb ~ ~ j
C a r l i s l e
P A 1 7 0 1 3
Correspondent's e-mail address: waynefshade(u~comcast.net
under penalties of perjury, I declare that I have examined this return, including acxompanying 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.
SIGNATURE F RSON RESPO IBL~jFOR FILING RETURN DAT
ADDRESS
607 Brad Street Shippensburg PA 17257
SIGNAT E OF PREP R THAN REPRESENTATIVE DATE
ADDRES ' ~- 2 -~ 3
53 West Pomfret Street Carlisle PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140 J
J
1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Ruth A• Stake 2
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 1.
2 1 5 7 6. 0 0
2. Stocks and Bonds (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) ^ Separate Billing Requested ... .... 6. •
7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property
(Schedule G) ~] Separate Billing Requested ... .... 7. •
8. Total Gross Assets (total Lines 1 through 7) ....................... .... 8. 2 1 5 7 6. 0 0
9.
..............
Funeral Expenses and Administrative Costs (Schedule H) 9.
.... 5 1 9. 0 0
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... .... 10.
11. Total Deductions (total Lines 9 and 10) ........................... .... 11. 5 1 9 . 0 0
12. Net Value of Estate (Line 8 minus Line 11) ........ . ............... .... 12• 2 1 0 5 7 . D 0
13. Charitable and Governmental Bequests/Sec9113 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. 2 1 D 5 ~ • D 0
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.o _ D 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
0 0
2 1 0 5 7
9 4
7.
5
7
.
at lineal rate X .045 16.
17. Amount of Line 14 taxable
0
0 D
17
D.
O
D
.
at sibling rate X .12 .
18. Amount of Line 14 taxable
D 0 0
D
0
0
at collateral rate X .15 18. .
19. TAX DUE ......................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
9 4 7. 5 7
Side 2
1505610240 1505610240
REV-1500~X Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Ruth A. Stake __
STREET ADDRESS
100 Mt. Allen Drive __
CITY
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.
0.00
267.72
(4} 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,215.29
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 : ................................................................ .....
^ X
b. retain the right to designate who shall use the property transferred or its income; .......................... ..
...
^ ^
c. retain a reversionary interest; or ........................................................................................... .....
^ X
^
d. receive the promise for life of either payments, benefits or care? .................................................. .....
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
^
without receiving adequate consideration? .................................................................................
h? ......
^
...
3. Did decedent own an "intrust for" or payable-upon~ieath bank account or security at his or her deat ......
4, Did decedent own an individual retirement account, annuity or other non-probate property, which
0
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 i.
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(1.2) [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.
File Number
21 06 656
_ T
'; STATE ZIP
PA 17055
(1)
947.57
Total Credits (A + B) (2)
(3}
REV-1503dEX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS
uwCCITA N!`C TAY RGTI IRN
ESTATE OF FILE NUMBER
Ruth A. Stake 21 06 656
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~, .savings on eves 7 1 ,issue ovem er
2. U.S. Savings bond Series EE, V2372942EE, issued November 1992 5,394.00
3. U.S. Savings bond Series EE, V2372943EE, issued November 1992 5,394.00
4. U.S. Savings bond Series EE, V2372944EE, issued November 1992 5,394.00
TOTAL (Also enter on line 2, Recapitulation) I S 21,576.00
(If more space is needed, insert additional sheets of the same size)
REV-151~t EX+ (10-09)
' pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Ruth A_ Stake 21 06 656
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1,
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
Chy State ZIP
Year(s) Commission Paid:
2, Atromey Fees: Wayne F. Shade, Esquire 500.00
3. Fatuity Exemption: (If decedent's address is not the same as claimants, attach explanation.)
Claimant
SVeet Address _ __
4.
5.
6,
7.
8.
City State ZIP
Relationship of Claimant to Decedent
Probate Fees:
Accountant Fees:
Tax Retum Preparer Fees:
Register of Wills, Short Certificate
Register of Wills, file supplemental inheritance tax return
4.00
15.00
TOTAL (Also enter on Line 9, Recapitulation) I S 519.00
If more space is needed, use additional sheets of paper of the same size.
REV-1513,~RX+ (01-10)
' Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
Ruth A. Stake
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outnght spousal distributions and transfers under
I. Sec. 91 T6 (a) (1.2).)
1, Lynne E. Landi
607 Brad Street
Shippensburg, PA 17257
FILE NUMBER:
21 06 656
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
Lineal
Lineal
Lineal
AMOUNT OR SHARE
OF ESTATE
21,057.00
I 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. I ~
If more space is needed, use additional sheets of paper of the same size,
SCHEDULE J
BENEFICIARIES
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~~~