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Home My WebLink About05-07-13 � 1505610105 REV-15oo Ex�oz_��,��, � OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau oi Individual Taxes �"� M`�� County Code Year File Number INHERITANCE TAX RETURN '� PO BO:K�So6oi � r , �- Harrisburg PA 17i28-o6oi RESIDENT DECEDENT �� :r ' I � � � ENTER DECEDENT INFORMA710N BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 10/08/2012 08/31/1921 DecedenYs Last Name Suffix Decedent's First Name MI Walp WiAiam R (If Applicable) Enter Suiviving Spouse's tnformation 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 W1LLS FiLL IN APPROPRIATE 1�VALS BELOW � 1.Originat fteturn O 2. Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) p 4. Limited Estate O 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required death after 12-12-82) � 6. Decedent Died Te�state O 7.Decedent Maintained a Living Trust ,� 8. Totai Number of Safe Deposit Boxes (Attach Copy of VVill) (Attach Copy of Trust.) O 9. Litigation Proceecis Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(Aj Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SFCTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephnne Number John C Oszustowicz (717)243-7437 - :� RQEGISTER bR�IiNILL��J ONLY � `�' C� �� :,,y ;�^� First Line of Address � -�- f.�',.', � -5 '°� 104 S Hanover St. � � ��' '� °" `'� ='" tl? � � �:.a Second Line of Address — `r �''� � r-� �, _ .�-3 �'� C: � :,� N �" f"n City or Post Office State ZIP Code DATE FILER3"' :i E-� � Carlisle PA 17013 Correspondent°s e-mai�address:johno@carlislepalaw.com Under penatties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of m,y knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on ali information of which preparer has any knowledge. IGN URE F PE N SPONSI E FOR FI G RETURN DATE ;�� .,,,� �,� �� t �3 ADDRESS T 672 Cli Rd., NE tlanta, GA 30307-1789 SIGNRTU E RE , HER THAN REPRESENTATIVE DA7E ADDRESS,` 104 S �anover St., Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1 � 15056:10105 1,505610105 J � � 15056102�5 REV-1500 EX(FI) DecedenYs Social Security Number oecedenes rvame: Wifliam R Walp RECAPITULATfON 1. Real Estate(Schedule A). .... ................ ... ............ ..... . ... 1. 2. Stocks and Bonds(Schedule B} ...... ......... ... ...... ........... ... . 2. 3. Closely Held C�orporation,Partnership or Sole-Proprietorship(Schedule C) ,.. .. 3. 4. Mortgages and Notes Receivable(Schedule D).......... ............. ... . 4. 5. Cash,Bank De{�osits and Miscellaneous Personal Property(Schedule E)....... 5. 9,183.37 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... .. . . 7. 65,191.09 8. Total Gross Assets(total Lines 1 through 7j........... ......... ......... 8. 73,374.46 9. Funeral Expenses and Administrative Costs(Schedule H)... ...... .... ... ... 9. 5,072.74 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I).. ... .... ...... 16. 2,384.85 11. Total Deductions(total Lines 9 and 10).. ...... ............... .... ... ... 11. 7,457.59 12. Net Value of Estate(Line 8 minus Line 11) ........... ......... ....... ... 12. 65,916.87 13. Charitable and Govemmental BequestslSec 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. 65,916.87 ': TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousai tax rate,or transfers under Sec.9116 (a)(1.2)X.0_ 1 5. 16. Amount of Line 14 taxable at Iineal rate x.0 45 65,916.87 16. 2,96626 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ...... ..... ... .... ......... ... ........................ . .. 19. 2,966.26 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OYERPAYMENT � Side 2 � 1505610205 1505610205 � . REV-15Q0 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Wiliiam R Walp - - _ _ _ . _ _ _ _ _ _ . _ STREET ADDRESS _ ____ _ _ 9 Alliance Drive,Apt 1 q6 _ _ _ _ _ _ _ __ - - CITY _ _- _ _ __ _ � STATE I ZIP Carlisle PA I 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 2,966.26 2. Credits/Payments A.Prior Payments 2,873.00 - _ _-- — ------- B.Discount 151.22 _ _ _. _ - - ----- Totai Credits(A+B) (2) 3,024.22 3. Interest (3) 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. (4) 57.96 5. if Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" fN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property 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 occur�ed after Dec.12, 1982,did decedent transfer property within one year of death without receivcng adequate consideration?.............................................................................................................. ❑ � 3. Did decedent��wn 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 FfLE 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 Jari. 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,antl the statutory requirements for disclosure of assets and filing a tax return are stil!applicable even if the surviving spouse is the only beneficiary. For dates of death on or after Jufy 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1 j]. . 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 indivicival who has at least one parent in common with the decedent,whether by blood or adoption. - - _ FiEV-15o8 EX+(OS-iz) � pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS &MISC. INHERITANCE TAX RE(URN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William R Walp 21-12-1109 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 discfosed on Schedule F. ITEM VALUE AT DATE NUMBER QESCRIPTION OF DEATH 1. Chapel Pointe rent refund 364.23 2 Personal Property 5,000.00 3 2012 tax refund 700.00 4 Metro Bank Checking Account#513320119 3,119.14 TOTAL(Also enter on Line 5, Recapitulation) $ 9,183.37 ` If more space is needed,use additional sheets of paper of the same size. _ R�V-1570 EX+ �08-39) � pennsylvania SCHEDULE G DEPARTMENT OI=REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX REfURN MISC. NON-PROBATE PROPERTY RESIDENT DECEiJENT ESTATE OF FILE NUMBER William R. Walp 21-12-1109 This scher7ule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1590 is yes. ITEM DESCRIPTION OF PROPERTY DATE Of DEATH °/a OF DECD'S EXCLUSIOIV TAXABLE INCLUDE THE NAME OF TNE TRANSFEREE,THEIR RELAT[ONSHIP Ta DECEOENT AND NUMBER THE'DATE OF TRANSFER. ATfACH A CODY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST ,7F APPLICABLE) VALUE 1• Janus IRA Account#734239. Transferred 50%each to daughters Susan 65,191,09 100 65,191.09 French and Cathy Askew on 11/22/12 TOTAL(Also enter on Line 7, Recapitulat+on) $ 65,191.09 If more space is needed,use additional sheets of paper of the same size, - R-'J-]Sl' FX+�70-09) �� pennsylvania SCHEDULE H DEPARTMENTOFRl:VENl1E FUNERAL EXPENSES AND INHERITANCE TAX REfURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF PILE NUMBER William R. Walp 21-12-1109 Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIP7ION AMOUNT A. �UNERAL EXPENSES: 1' Ewing B�others Funeral Home,Carlisle,PA 1,582.38 2 Memorial SNroice Food&site rental 446.00 B. ADMINISTRAT]VE COSTS: ].. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City _ __ ___ _____ _ __ State - - - ZIP Year(s)Commission Paid: 2. Attorney Fees: 1,Q12.50 3. Family Exemption:{If decedent's address is not the same as claimanYs,attach explanation.) Claimanl: Street Address City _ __ _ _ _ __ _ . _ _ State _ _ ZIP Relationship of Claimant to Decedent __ __ _ _ . __ 4• Probate Fees: 128.50 5. Accountant Fees: 6. Tax Return Preparer Fees: �• Legal Advertising-�The Sentinel 115.20 s Legal Advertising-Cumberland County Law Joumal 75.00 s Executor travel Fees 1,301.44 to Fee to obtain Federaf Tax ID through service 197.00 �1 Federal Express 8.00 �2 Cleaning of Chapel Pointe room expenses 206.72 TOTAL(Also enter on Line 4, Recapitulation) $ 5,072.74 If more space is needed,use additional sheets of paper of the same size. REV-15]7 .F.X+ �12-t?} ,� � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCE TAX REiURN MORTGAGE LIABILITIES & LIENS RESIDEN7 DECEDENT ESTATE OF fILE NUMBER Wiiliam R. Walp 21-12-1109 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM ! VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• VISA credit c�rd 874.25 2 Dixie Barrick-personal care attendant 1,453.00 3 Centurylink-final phone bill 57.60 TOTAL(Aiso enter on Line 10, Recapituiation) $ 2,384.85 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(O1-10) '��' pennsylvania SCHEDULE � INHERIiANCE TAX RERIRN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William R Walp 21-12-1109 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIHUTIONS[Include outright spousal distributions and transfers under Sec. 9116(a)(1.2).] 1. Gathy Askew C72 Clifton Rd,NE,Atlanta,GA 30307 Daughter 20305.63 2 Susan French 2534 E Palo Verde Place,Paradise Valley,AZ 85253 Daughter 24305.62 3 Ellen Khoshkish 3101 New Mexico Ave NW#855,Washington DC 20016 Daughter 21305.62 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-150U COVER SHEET,AS APPROPRIATE. II NON TAXABLE DISTRIBUTIONS A. SPQUSAL DISTR,IBUTIONS 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. $ If more space is needed,use additional sheets of paper of the same size.