HomeMy WebLinkAbout02-01-131505611185
REV-1500 EX (02-11)(FI)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year File Number
21 11 0350
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY
03072011 1007],939
Decedent's Last Name Suffix Decedent's First Name M I
ARNOLD BARBARA M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
^ 1. Original Return ® 2. Supplemental Return ^ 3. Remainder Return (Date of Death
Prior to 12-13-82)
^ ^ ®
4. Limited Estate 5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
® 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wifl) (Attach Copy of Trust.)
^ ^ ^
9. Litigation Proceeds Received 11. Election to Tax under Sec. 9113(A)
10. Spousal Poverty Credit (Date of Death
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,...;
r~ ~
~
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ELIZABETH P • MULLAUGH 1~5243
717-2
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REC~XE F WILLS ~ ONL~
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First Line of Address D- ~ ~U ~ '~
~" ~ 7'G C~
100 PINE STREET `=' ~ c-a
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Second Line of Address ,~ ~ t__„
P•0• BOX 1166 -~ ~ ~ J ~
City or Post Office
-~ DATE FILED ~
State ZIP Code
HARRISBURG PA 171081166
Correspondent's a-mail address: E M U L L A U G H a9 M W N• C O M
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and comple . De ratio p er other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON ING RETURN DATE
ADDRESS ~
P•0• BOX 262 HARRISBURG, PA 17105
SIGNATURE OF PREPARER OTHER THAN REPRESENTA VE TE
MCNEES WALLACE & NURICK LLC, / /
ADDRESS
100 PINE STREET, P•0• BOX 1166, HA RISBURG PA 17108-1166
side ~
15 0 5 61118 5 OM4647 3.000 15 0 5 61118 5
1505611285
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: ARNOLD BARB ARA M
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 and Notes Receivable (Schedule D) 4 ^ • ^ ^
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. ], ,13 6 • ^ ^
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g ^ , ^ ^
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7. 6 , 5 ^ 6.8 4
8. Total Gross Assets (total Lines 1 through 7) 8 7 , 6 4 2.8 4
9. Funeral Expenses and Administrative Costs (Schedule H). 9. 15 • ^ ^
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 41 • ^ ^
11. Total Deductions (total Lines 9 and 10), . 11 56 • ^^
12. Net Value of Estate (Line 8 minus Line 11) 12 7 , 5 8 6.8 4
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. 7 , 5 8 6.8 4
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers un~er Sec. 9116
16. Amount of Line 14 t xable
o 4~
at linealratex
.
7,586.84 1s. 341.41
17. Amount of Line 14 taxable
at sibling rate X .12 ^ . Q Q 17. ^ • ^ ^
18. Amount of Line 14 taxable
at collateral rate X .15 ^ . ^ ^ 18. ^ • ^ ^
19. TAX DUE 1 s. 3 41.41
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505611285 1505611285
OM4648 3.000
REV-1500 EX (FI) Page 3
DeCedenYc Cmm~latp Orlrlrs.ne•
File Number
'1 1 1 ~ n -~ r n
DECEDENTS NAME
A D ARA
STREET ADDRESS
L 0 NTY
CITY STATE ZIP
M CHAN S PA 70 -
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 3 41.41
2. Credits/Payments
A. Prior Payments ~ . 0 ^
B. Discount ^ , ^ ^
Total Credits (A + 8) (2) ^ • 0 0
3. Interest
(3) 9.6 3
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a refund. (4) 0 • ^
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3 51 • 0 4
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 ^ a
b. retain the right to designate who shall use the property transferred or its income ^ Q
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? . a ^
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)]. 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.
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REV-1508 EX+ (11-10)
pennsylvania
UEPARTtuENT OF REVENUE
INFiERfTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8~ MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Barbara M Arnold 21 11 0350
uwatiAD z.ooo it more space is needed, use additional sheets of paper of the same size.
REV-1510 EX + (OS-09)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Barbara M Arnold 21 11 0350
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
NUMBE DESCRIPTION OF PROPERTY
INCLLDEl}ENNAEOFi}E7RANiFEREE,7}1EIRRElAT10NSFAPTODECEDEMAt~D
7F£DATEOFiwrsFeiATTACHAODPYOFTHEDEEDFORREALESTATE.
DATE OF DEATH
VALUE OF ASSET
%OFDECD'S
INTEREST
EXCLUSION
IF APPLICABLE
TAXABLE
VALUE
1• John A. Arnold QTIP Trust
269.10 common units of AIMCO
Properties, LP 6,506.84 100.0000 0.00 6,506.84
The above asset was not
reported on the original
return.
TOTAL (Also enter on line 7, Recapitulation) $
6,506 84
If more space is needed, use additional sheets of paper of the same size.
9W46AF 2.000
REV-1511 EX+ (10-09)
pennsylVania SCHEDULE H
DEPPRiTyENTOF REVENUE FUNERAL EXPENSES AND
NHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESDENiDECEDENT
to ~ a~ t c~ FILE NUMBER
Barbara M Arnold 21 11 0350
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNER~4L EXPENSES:
~ . None
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City - State ZIP
Year(s) Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
1 Cumberland County Register of Wills
Cost to file supplemental inheritance tax return
15.00
TOTAL (Also enter on Line 9, Recapitulation) I $ 15 00
swasnc s.ooo If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12.08)
Pennsylvania
DEPARTF,£NTOF REVENUE
NHERITANCE TAX RETURN
RESDENiDECEDENT
ESTATE OF FILE NUMBER
Barbara M Arnold 21 11 0350
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ewasArl z.ooo if more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania
DEPARITAENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
tSIATE OF:
FILE NUMBER:
DQi LCaiQ ra eai uc~ia 21 1 1 0350
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. John M. Arnold Son 1/3 share of Trust
P.O. Box 2621
Harrisburg, PA 17105
Lily S. Grace Daughter 1/3 share of Trust
4460 Redwood Highway #16-303
San Rafael, CA 94903
Anna Sophie Stephansen Trust under Will John A. Arnold Granddaughter 1/2 of 1/3 share of Tr
c/o John M. Arnold, Trustee
P.O. Box 2621
Harrisburg, PA 17105
Jahn Otto Stephansen Trust under Will John A. Arnold Grandson 1/2 of 1/3 share of T
c/o John M. Arnold, Trustee
P.O. Box 2621
Harrisburg, PA 17105
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE.
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. $ 0 . 0 0
ust
•ust
9W46AI 2.000 """" ~rw~.. ~~ ~~~~~~ ~~ ~,~~.~~~~a~ ~~~~~~ ui paper or cne same size.
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