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HomeMy WebLinkAbout02-01-131505610143 REV-1500 Ex{02-"' OFFICIAL USE ONLY PA Department of Revenue pennsyivania county code Year File Number Bureau of individual Taxes °~"ei~ PO 80X.280601 INHERITANCE TAX RETURN 21 12 0583 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Soria! Security Number Date of Death Date of Birth 05 06 2012 06 24 1945 Decedent's Last Name KIRWAN Suffix Decedent's First Name J4 ELLEN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Firsi Name Spouse's Social Security Number FILL iN APPROPRIATE OVALS BELOW Q 1.Original Retum 4. Limited Estate D 6. Decederrt Died restate (Attach Copy of Wile 9. Litigation Proceeds Received THfS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ^ 48. Futwe Interest Compromise (date ofr~death~aRa{er 12-12-82) ^ 7' ~Attai Copy of T;u~st)a Living Tn1st ^ 10. tvieen P rt~~redit,~D e a Death 2-3t- and 1- 3_ Remainder Retvm (Date of Death Prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number ~ Safe Deposit Boxes 11.Eledion to fax under Sec. 9113(A) (Attach Schedule O) MI Mi CORRESPONDENT - TNlS SECTION MUST BE COMPLETE(). ALL CORRESPONDENCE AND CONFiDENTtAL TAX INFORMATION SFIOULD BE DIRECTED TO: Name Daytime Telephone Numkter; JESSICA L FISHER 717 6~7 3223 ~' ~ ~ rn First Line of Address 555 GETTYSBURG PIKE Second Line of Address STE C100 City or Post Office MECHANICSBURG State ZIP Code PA 17055 Correspondent's e-mail address: Jessica a~keystoneelderlaw.com __ - -r~ ~-,; ~ ~ _ _ REGISTf~Ot~AI~.S UIa~ONL4f~ ~7 ~„ !""' ~:,1 ~°~1 ~ :~ ~ ~ `~ -~-~ c~ :~ .,:i ,,~ ~ -.~ ~--- .~BATE FlLED F--- ~ -- rtder penalties ~ perjury, I dedare that !have examined this return, including accompanying schedules and statemerrts, and to the best of my knowledge and t~lief, it is true, cared and complete. Declaration of preparer other than the personal representative is based on ail infatuation of which preparer has any knowledge. S RE OF PER6ON RESP ISLE FOR FiLiNG R URAI p f ,t ~ ~ d r~ ,,~ ,,r<. t.~, i~ ~,t~~:.t.~- f ~ra~ ~_ f ^ ,K <$ f-- Ann III Kirwan-4rner ~~-.. ~ ,` 6 ~....~` 1199 W. Trindte Road, Mechanicsburssj. PA 17(355 SIGNATURE OF PREPARER OTHER THAW REPRESENTATNE pA-~ ~,:~ '~ Jessica L Fisher ~ - 6rln F S 555 Gettysburg Pike ,Mechanicsburg, PA Side 1 1505610143 150561D143 J ~~ J 1505610243 REV-1500 EX Decedent's Social Security Number DecedenYsName: Kir'Wan, JO Ellen 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 8~ Notes Receivable (Schedule D} ........................................................ 4. 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ............... 5. 12 9 , 843.51 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous ~ Probate Property Separate Billin Re uested S h l G d g ............ q ( e u e ) c 7. 5 O 611.4 4 r 8. Total Gross Assets (total Lines 1 through 7) ........................................................ 8. 18O , 454.95 9. Funeral Expenses and Administrative Costs (Schedule H) .................................... 9. 22 , 84 9.27 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............................ 10. 7 , 90 6.41 11. Total Deductions (total Lines 9 and 10) ................................................................ 11. 3O , 755.68 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 14 9 , 6 9 9.2 7 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. 14 9 , 6 9 9.2 7 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 . 0 0 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 14 9 6 9 9.2 7 16. 6 , 7 3 6. 4 7 , at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0. 0 0 . at collateral rate X .15 . 19. TAX DUE ................................................................................................................ 19. 6, 7 3 6. 4 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^X Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-12-0583 DECEDENT'S NAME Kirwan, Jo Ellen STREET ADDRESS 1771 Kendall Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 7,479.04 336.82 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 5_ If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make Check Payable to: REGISTER OF WILLS, AGENT. (1) 6,736.47 7,815.86 1,079.39 Total Credits (A + B) (2) (3) (4) (5) 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 :.................................. ^ ^x c. retain a reversionary interest; or ....................................................................................................•---------- ^ 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?....... ^ 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 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)]. 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-1508 EX+(11-10j SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - I FILE NUMBER Kirwan, Jo Ellen 21-12-0583 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. Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10) (If more space is needed, additional pages of the same size) Rev-1510 EX+ (08-09) SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PR BATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kirwan, Jo Ellen FILE NUMBER 21-12-0583 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 THE DATE OF RANSFERSATTACi-I A COP OF TIOHE DEIED FOOREREAL ESTATDE. DATE OF DEATH VALUE OF ASSET °i° OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 SERS Annuity 50,611.44 50,611.44 TOTAL (Also enter on Line 7, Recapitulation} I 50,611.44 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 08-09) REV-1151 EX+ (10-09) ,. COM INOHN ~TAN~ OT~ RET~RN ANIA RE IDEN DE EDEN SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Kirwan, Jo Ellen 21-12-0583 .... ,...,., ...... .. .. wVVw ........~ ,,.. ....,.,.... IVY V.1 VV..VMM.V .. ITEM DESCRIPTION AMOUNT N MBER A, FUNERAL EXPENSES: See continuation schedule(s) attached 1,903.57 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Ann MKirwan-Orner Street Address 1199 W. Trindle Road city Mechanicsburg state PA zio 17055 Year(s) Commission Paid 2013 8,128.20 2. Attorney's Fees Keystone Elder Law P.C. 8,968.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Ann M. Kirwan Street Address 1199 W. Trindle Road city Mechanicsburg State PA ziq 17055 Relationship of Claimant to Decedent Daughter 4. Probate Fees 319.50 5. Accountant's Fees 6. Tax Return Preparet's Fees 7. Other Administrative Costs 30.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 22,849.27 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Kirwan, Jo Ellen 21-12-0583 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex e~nses 1 GingrichTombstone 740.00 2 Hershey Cemetery Company: Foot marker Foundation 187.20 3 Malpezzi Funeral Home 976.37 H-A 1,903.57 Other Administrative Costs 4 Cumberland County Inheritance Tax Return Filing Fee 15.00 5 Cumberland County Register of Wills Inventory Filing Fee 15.00 H-B7 30.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kirwan, Jo Ellen 21-12-0583 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) (If more space is needed, additional pages of the same size) REV-1513 EX+ (01-10j SCHEDULE J COMMNHERITANCE~TF PP RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF (FILE NUMBER Kirwan, Jo Ellen 21-12-0583 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSONISI RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee s I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Ann M. Kirwan Daughter 100,155.35 1771 Kendall Drive Mechanicsburg, PA 17055 2 Joseph A. Kirwan Son 49,543.92 7624 Fort McCord Road Chambersburg, PA 17202 Total 149,699.27 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. 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)