HomeMy WebLinkAbout04-1068 COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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REV-1500 I OFF.C,AL.SE O.LY
RESIDENT DECEDENT ~ 0oDE ~. .u~E. --
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
D~E 6F 6EAfH (MM-D-D-fEAR) ' ' DATE OF BIRTH (MM-DD-YEAR)
313/ , ?/1¢/¥
(IF APt~'iCAB~/E} SURVIVIN~ SPOUSE'S NAME (LAST, FIRST, AI~D MIDDLE~NITIAL)
SOCIAL SECURI~' NUMBER
-
TIllS RETURN MUST BE FILED IN DUPLICATE WITN THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. Odginal Return
4. Limited Estate
~]6. Decedent Died Testate (At. ch co~ o~w~)
El9. Litigag~ Proceeds Received
r~2. Supplemental Return
E~] 4a, Futura Interest Compromise (~at* ofde~th dt~r 12-12.82)
[] 5, Federal Estate Tax Return Required
__ 8. Total Number of Safe Deposit Boxes
]11. Election ~o tax under Sec, 9113(A) (~ Sch O)
W
COMPLETE MAILING ADD~RESS
1. Real Estate (Schedule A) (1)
2 Stocks and Bonds (Scheduie B) (2)
3. Closely Held Corporation, Partnership or Soie-Proprletorship (3)
4. Modgages & Nofes Receivable (Schedule D) (4)
5. Cash, Bank Depostis & Miscellaneous Personal Property
(Schedule E)
(5) ~, / ~'
6. Joinlly Owned Properly (Schedule F) (6) .~..~ "'~.~'~'""
E~] Sepemta Billing Requested '
7. mier-Vivos Transfers & Misce,aneous Non-Probate Pmpe~/ (7)
(Schedule G or L)
8. Total Gro~ Assets (tolal Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H) (9)
10,;Deb~ of Decedent, Mortgage Liabilities, & Liens (Schedeie I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 TnJsls for which an election Io tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14)
OF'FICIAL USE oNLY'
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATER
15. Ame~nt of Line 14 taxable at the spousal tax
rafe, or ~ransfers under SEc. 9116 (a)(1.2) x .0 (15)
16. Amount of Line 14 taxable al lineal rate x .0 (16)
17, Amount of Line 14 {axable at sibling rate x .12 (17)
18, Amount of Line 14 taxable al collaleral rate x .15 (18)
19. Tax Due (19)
Decedent's Complete Address:
Tax Payments and Credits:
1, Tax Due (Page 1 Line 19)
2. Credits/Payments
A, Spousal Poverty Credit
B. Pdor Payments
C, Discount
Total Credits ( A * B + C ) (2)
3. Interest/Penalty if applicable
O. Interest
E. Penalty Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. . (5)
A. Enter the interest on the tax due, (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SD)
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; ............................................ []
retain a reversionary interest; or ............................................................................ ; ............................................. ~E~ ~
~i receive the premise for life of either payments, benefits or sam? ...................................................................... [~
2. If death occurred after Oecernber 12, 1982, did decedent transfer property within one year of death r~
without receiving adequate consideration? .............................................................................................................. []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his er her death? .............. []
4. Did decedent own an Individual Retirement Account, annuity, or other non-prubate 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 detes of death ~ ~ a~r Jul~ ~, 19~ and ~fora Janua~ ~, ~5, ~e tax rata im~ ~ ~e net vehie of tr~ns~ra to ~ fer the usa of ~e su~vino s~use ~s
For d~tes of de~th ~ or a~er ~nua~ ~, ~995, the tax rate impo~d on ~e ~et value of ~ansfe~ to or ~r ~e use of ~e su~ivi~ s~u~e i~ 0% F2 P& ~9~6 (a) (t~) (ii)),
The s~tuta d~s not exemDt a ~ansfer to
the s~i~n~ ~se is ~ o~ he.tidal.
For dates of ~a~ ~ or a~er July ~,
~e tax ~te im~ on ~e nel value of transfe~ ~m a debased ~ild ~n~e yea~ of ~e or younger at death to ~ fer ~e use of a netural parent, ~n edoCve parent,
or a s~ar~t of ~ ~ild is 0% F2 P,& ~9~6(a)(t2)].
The ~x rata tm~ on ~ cet value of t~nsfem to er f~ ~e u~ of ~ desert's lin~l ~fidades is 4.5%, ex.pt as ~t~ in ~2 P.& ~9~6(1.2) 172 P.& ~91~6(a)(~)].
~e ~x ~ta im~ on ~e net velne
individnel ~ ~s M ~t one parent in ~m~n ~ ~ de~ ~er by bl~ ~ a~p~.
COM~TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
~E~I~C~NT ~O~NT
ESTATE ~F
SCHEDULEE
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the proceeds of li~gaflon and the date the proceeds were received by Ifle estate. All property Jointly-owned with the ~lght of sur,'ivor~hlp mu~t be disclosed on Schedule
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size}
COMMONWEALTH O¢ PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE F
JOINTLY-OWNED PROPERTY
If an aeeM was made joint within one year of the decedent's date of death, It muat be mpo~ted on Schedule G.
FILE NUMBER
SURVIVING JOINT TENANT{S) NAME
AODRE88
RELATIONSHIP TO DECEDENT
JOINTLY-OWNED PROPERTY:
TOT~ (Also enter ~ line 6, R~pitulatio.) $¢~ ~/~
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Debts of decedent must be reported on Schedule t.
ITEM
NUMBER DESCRiPTiON AMOUNT
5.
6.
7.
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Reprsoentalive's Commissions
Name o! Personal Representative(s)
Social Security Nurnber(s)/EIN Number of Personal Representative(sI
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Streel Address
city
Relationship of Claimant to Decedent
State__Zip
Tax Return Preparer's Fees
TOTAL (Also enter on line 9, RecapituJation)
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
t
1.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
11
1,
RELATIONSHIP TO DECEDENT
TOTAL OF PART !i - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
{If more space is needed, insert additional sheets of the same size)
AMOUNT OR SHARE
OF ESTATE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
TAXABLE DISTRIBUTIONS {include outright spousa~ distributions, and transfers under
Sec. 9116 (a) (1.2)]
A. S~USAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NORENE H. JENKINS
I, NORENE H. JENKINS, of Fairview Township, York County, Pennsylvania,
being of sound mind and memory, do make, ppblish and declare this my Last Will
and Testament, hereby revoking and making void any and all wills by me heretofore
made.
FIRST: I order and direct that all of my just debts and funera{ expenses
be paid by my hereinafter named Executor as soon after my death as may be found
convenient.
SECOND: All the rest, residue and remainder of my estate, real, personal
and mixed, of whatever nature and wheresoever situate, which I may own or
have the right to dispose of at the time of my death I give, devise and bequeath
to my husband, RICHARD C. JENKINS, SR., absolutely, providing he shall survive me
fo~ a period of thirty (30) days.
THIRD: In the event that my said husband, RICHARD C. JENKINS, SR.,
should predecease me, or in the event that he does not survive me for a period of
thirty (30) days, then I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, of whatever nature and
wheresoever situate, which I may own or have the right to dispose of at the time
of my death unto my children, RICHARD C. JENKINS, JR., JEFFREY G. JENKINS
and HARRY L. JENKINS, in equal shares, per stirpes.
FOURTH: I order and direct that my Executor pay all transfer inheritance,
Federal estate, death~ succession and legacy taxes to which my estate or the
transfer of any property thereunder may be subject and to charge such taxes
as a part of the expense of administration and to pay the same from my residuary
estate.
FIFTH: I hereby nominate, constitute and appoint my said husband, RICHARD
C. JENKINS, SR., as Executor of this, my Last Will and Testament~ and I do direct
that no bond shall be required of such Executor. hereunder. My said Executor shall
have full power at his discretion to do any and all things necessary for the
complete administration of my estate, Including the power to sell at public or
private sale and without order of Court, any real or personal property belonging to
my estate, and to compound, compromise or otherwise to settle or adjust any and
all claims, charges~ debts and demands, whatsoever~ against or in favor of my
estate, as fully es I could do if living.
In the event that my husband, RICHARD C. JENKINS~ SR., does not survive
me or fails to qualify, then I nominate~ constitute and appoint my son~ HARRY L.
JENKINS, as the alternate Executor. Said alternate Executor shall have all of the
powers, privileges, duties and immunities as hereinbefore more fully set forth for
my original Executor.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my
'/
Last Will and Testament, this [~ y of u ~ , 1986.
Norene H.
Signed, sealed, published and declared by the above named Testatrix es and
for her Last Will and Testament, in the presence of us, who at her request and in
her presence and in the presence of each other have hereunto subscribed our names
as witnesses.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INOlv~o~Jr~~~
INHERITANCE TAX DIVIS~'
PO BOX 280601 ' .
HARRISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
2005 .II',;.! 2l} IJi g: 18
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-25-2005
JENKINS
03-03-2004
21 04-1068
CUMBERLAND
101
CLEF'i!"
001':'-1"1":
,1 1;"..','..1
HARRY ICUJENKINs T
601 5TH ST
NEW CUMBERLAND PA 17070
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REV-1547EK AFP U2-04l
NORENE
H
Allount Rallifted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE.V' :r!4".EX.,{~"..ca1":tl'~'..Nii'i"i'CE.O'F.i:NHERYf~ilcE.'i!AX.A.PPR'lii'sEWr:lt:.."LL.O'wAN'l:i!.oR'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JENKINS NORENE H FILE NO. 21 04-1068 ACN 101 DATE 01-25-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CWANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Re.l Estate (Schedule AJ
2. stocks and Bonds (Schedule BJ
3. Closely Held stock/Partnership Interest (Schedule C)
4. "ortgages/Notes Receivable (Schedule OJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule GJ
8. Total Assets
[ll
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
6.178.00
1.215.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad... Cosis/Hisc. Expenses (Schedule H)
10. Debis/Horig8ge Liabiliiies/Liens (Schedule I)
11. Toial Deduciions
12. Nei Value of Tax Reiurn
13. Chariiable/Governmenial Bequesis; Non-elecisd 9113 Trusis (Schedule J)
14. Nei Value of Esiaie Subjeci io Tax
(9)
llO)
7,492.00
.00
(11)
(12)
(13)
(14)
NOTE: If an assessment was issued previoUSly, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. A.ouni of Line 14 ai Spousal raie (15)
16. A.ouni of Line 14 iaxable ai Lineal/Class A raie (16)
17. Amouni of Line 14 ai Sibling reie (17)
18. Amouni of Line 14 iaxable ai Collaieral/Class Breis (18)
19. Principal Tax Due
NOTE: To insure proper
credii io your accouni~
submii ihe upper pori ion
of ihis form wiih your
iax pay.eni.
7,393.00
7.49? nn
99.00-
.00
99.00-
14, lS and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
.00 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
.00
.00
.00
.00
.00
TAX CREDITS:
'ATnON .O~OLr '+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A nCREDlp. (CRl ~ YOU HAY BE DUE ....1
A REFUND. SEE REVERSE SIDE OF TWIS FORM FOR INSTRUCTIONS.) ~~~