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Home My WebLink About01-11-131505610105 REV-1500 ex ~oz-11> ~~> enns lvartia OFFICIAL USE ONLY PA Department of Revenue P Y County Code Year File Number Bureau of Individual Taxes ~""pT~`~`~`~`f`~u` Po BOxz8o6oi INHERITANCE TAX RETURN Harrisburg. PA i~1~8-o6oi RESIDENT DECEDENT ~ 1 ~ °~ ~a~ ---- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 06/23/2012 ' 09/29/1914 Decedent's Last Name Suffix Decedent's First Name Bock ' Margaret (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 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) m 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 TO: Name Daytime Telephone Number David E. Bock (717) 7~-0634 ~: ~ ~ w ..., First Line of Address 749 Manor Road Second Line of Address City or Post Office Camp Hill .......State ZIP Code PA '.17011 c... ~ , RE~FiTF~OF WILL E O T:+. ~: ~, :a'~ ~ f"''^4 ~..1 ~ c` ~~~ -tit ~ - ~ c C- y _r ~~ . _ `. ` t..; ~..... f DATE FILEtT„"'~ ~~ Correspondent's a-mail address: Under alties of perjury, I decl hat I have examin this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true rrect and comps eclarat~ prepar~other tj~an the ~rsonal representative is based on all information of which preparer has any knowledge SIGNAIUI~ OF PER$QI~RESe0~i6`I~CE FOR FILI1IG RETURN ~ ~ /~ nnTc i v r - I l~ ADDR y ~ I i l_ ~ ~ ~.~ SIGNATURE OF PREPARER OTHER TH N REPRESE TATI E DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 c~ J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedents Name: Margaret Bock RECAPITULATION 1. Real Estate (Schedule A) .......................................... ... 1. 0.00 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. 6,527.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 9,683.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 16,210.00 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 2,550.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 0.00 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 2,550.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 13,660.00 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. 13,660.00 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. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 0.00 17. Amount of Line 14 taxable at sibling rate X .12 17, 0.00 18. Amount of Line 14 taxable at collateral rate x .15 13,660.00 18 2,049.00 19. TAX DUE ....................................................... ..19. 2,049.00.. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 O REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENTS NAME Margaret A. Bock STREETADDRESS - 150 Kempton Avenue Apartment 1166 CITY Harrisburg STATE Zlp PA 17111 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments __ 0.00 B. Discount 3. Interest 0.00 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. !1) 2,049.00 Total Credits (A + g) (2) 0.00 (3) 0.00 (4) 0.00 (5) 2,049.00 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 properly 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" orpayable-upon-death bank account or security at his or her death? ........ ...... ^ 4. Did decedent awn 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-1507 EX+ (6-98) SCI~IED~ILE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT tsrnre of FILE NUMBER Margaret Bock 179124189 Alt property jointly-owned with right of survivorship must be disclosed en Srhaduln F ~„ ,~,..,.. eNaw ~a nccuw, nisnn auaiaonai snee[s of the same size) REV-1508 EX+ (o8-iz) ~ Pennsylvania SCEIEDVLE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Margaret Bock 179124189 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. 1t more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ i10-0°) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Margaret A. Bock 179124189 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Headstone 450.00 B. 1 State PA ZIp 17011 2. Attorney Fees: 3. Family Exemption: (lf decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. ~. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name{s) of Personal Representative(s) David E. Bock Street Address 749 Manor Road city Camp Hill Year(s) Commission Paid: 2012 Street Address City State Relationship of Claimant to Decedent Probate Fees: Accountant Fees; Tax Return Preparer Fees: ZIP TOTAL (Also enter on Line 9, Recapitulation) ( $ If more space is needed, use additional sheets of paper of the same size. 2,000.00 100.00 0.00 0.00 0.00 2,550.00