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Home My WebLink About05-24-13 (2) re r� ' � 1sas61o1o� REV-1500 °`�°'-'°' '� �� OFFICIAL USE ONLY C.aniy Code Y� Fie t�mnbe� PO BOX�8060� t Taxes INHERITANCE TAX RETURN �" �' , ;' �"��` �.;� = Har►-�sburg,P�►i7u8-oGo� RESIDENT DECEDENT ��,� � .3� ��`3��„�' ENTER DECEDENT INFORMATION BELOW Social Security Number Date af Death MfdDDYYW Date of B'ath IrN�IDDYYYY �„� .-�- �' � $.,� �� a� �� .��.,.�.��!>��.�`� �,:. DecedenYs La�t Name Sufflx Decedent's First Name MI .r�:.;�� m rz,a� --�ac,. -»��rm:�"�'�'s"'v`Asr� e;sae fiar, ,� ��u. ,aa.r.u^ nra�nnxjarv:e� �rr��a a ,�s r�.;.• �, ;�u; � � �' � u ,�, va � ,: `, f � � :q a b � � � � � � �. � �B �� ,.i �.�ar.� ..�u�' �� .�� ,. ..�. +�' -��,...x*r�r,�9£. r w" . >�..�:�a, . , (If/►PP�icab�e)E�Surviving Spouse's Inforrnation Below Spouse's Last Name Suifix Spouse's First Name MI � �_xk,3�.A�K, �rBS.p{2kgy�'@�,�5 Y �EUYdWP; �R•��. � Z.;y ' § 1NM,. AY 5'�� iR#WS ; � � _� � � � . �. .��. ,�;,� �� :��.s>;� �,_,.�_��.��s$.��. ,. . .�:;� r��.�..�.� ��..� Spouse's Social Security Number THIS REiURN MUST BE FlLED IN DUPLICATE WffH THE _ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Retum O 2.Supplertiental Retum O 3. Rema�der Retum(date of death prior to 12-13-82) p 4.Limited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Retum Required death after 12-12-82j Q 6.Decedent Died Testate O 7.Deoedent Maintained a Living Trust _ 8. Totel Number of Safe Depasit 8oxes (Attach Copy of Will) (Attach Copy of Trust) G 9.Litigadon 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 Sch.O) CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONfIDENTIAI.TAX INFORMATION SHOULD BE DIRECTED T0: Name Daydme Telephone Number ,. � � : .. �. '�� ....�; . . ` � �a._�arera� ��eax-a .a.��u:�va��T..��i. ��:.a��,z.n�•�,�r,y �w,+�.m�#�.�:;, +�'TM� .. �.r a�., .e.� � 7��. REGISTER OF WILLS USE ONLY Fust Ime of address n :. -� — roaa;�,� s s c vu w�,� u z�- r�.� � „� s._w° C � c' ' �° �'€T � o � o � � � i � � ��e� � � ' � ;: � -� � � o �� . r �� , _ .�,.� .��.�,�, , �. F : , �:, second fine of adaress __ �� :aca�', ... _ �+,:«...s: -;.r:y-v .�<�r,.+a�. � ,,,� r' t .. . , . ., TS.. r.... , � , � � 4 ` , . __,__ � � ` � � � � -� •__ � � - > ; _�. �rn'M�a'aa++��,+Ga�.:s2'.� . .. , ,,wrs ae.= ��;d set ,Ru.i.-.«..,�.. Y�,a�.; sN ,v�..�: :, �•� . . • - ��. ... . .,. � .. �Y«'��e Stete ZiP C.ode � � .2�>� x�;� � a . ��n , �- : ,-. .�� . - �T 'T �- �, e �� j � 4 � � . �3 ., -��r �r . � , _ . t� � 3 t 9 - � � ,. , ;� . .. , _ . .� �� _, , . _ �,-� cor�pondenYs e�mail address:__t 4 C�r�l �J 0@ y'G�ha��Ct\ M � rv r" i Under pen�of pery'ury.I declana that i have examined this retum.induding acoompanying srhedules and statemeMS,and to the best of my knowledge and belief. it is itue,oorrect and Complete.Dedaration of preparer other tlian the personel represeniative is besed on aH iniamatfon of which preparer has any knowledge. 31 N RE OF PERSON E9PON316LE FOR FIlINC3 RETURN DATE . S _o��'1 � O/3 �w ss ° SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRES8 � PLEA8E USE ORIGIMAL FORIYI ONLY Side 1 � 1505610101 150561�101 � �,� � �a� � 1505610105 rt�v��oo Ex Decedenrs Sociel Security Number �,�$�: !�-e.�-oy $ � 5�<<sb v r7 � ��„�,�„� - L R�I Estate(Sct�edule A). ....................•--••--................. 1. • • 2. Stocks and BorKis(Sctiedule B) ....................................... 2. • 3. Cbsety Held Corparation,Partr�ership or Sale-Proprieborst�ip(Schedule C) ..... 3. • 4. Mortgages and I�es Receivable(Sdtedute D).................•••-•..... 4. • s. casn.Bank Deposits and Mi�elianeo�u Personal PropeAy(Schedule E).•-••-- 5. ( 3 � 5 b• o � 6. JoiMiY Owned ProPer►Y�S�dule� O S�ate B�lin9 Requested ...._.. 6. . 7. Inter-Vivos Transfers&MFsoeilaneous Non-Proba�e Property (Schedule G) O �rate B�'img Requ�ted........ 7. . $. Totat Grosa Assets(total L.ine,s 1 tlmough�..._.....•................... 8. j �j aZ rj C� • Q O 9. Funeral E�enses and Adminishative Costs(Schedule H)................... 9. 3 � a 3 '� � �o. oe��oe�d�,c.Mor�a9e uan�s.ana�.;�,s�s�ned„�p.............. ,o. q U a � • u a 11. ro�l Dea��ctions(total�ines s and 10)................................. 11. � � � 5 �,f� � )7 12. Net Valus aF�be(L.ine s�t.ine 11).............................. 12. ' Q U Q .�y G 13. Charitable and GovemmeMal Beque�s/Sec 9113 Tnists for which an election to tax has not been macle(Sd�edule J) ..........•••••••••-•... 13. • 14. Net Value Subjsct to Tax(Line 12 minus Line 13) .....................••• 14. ( U U Q •(} O TAX CALCULATION-SEE lNSTRUCTIONS FOR APPLICABLE RATES 15. Amoutrt of Line 14 taxable at ihe spousal tax rate,or transfers under Sec.9116 (ax1.2)X.0_ . 15. . 16. Amount of L'me 14 taxable et lineal rate X.0� � �j.(> !� 16. • 17. Amount of line 14 taxable et sibling rd� X.12 • 17. • 18. Artwunt of L'me 14 taxabie at c�oHateral rabe X.15 s 18. • 19. TAX DUE........••-•-•--.........•-••••--•---.....---••......_... 19_ � S� p � 20. FILL IN THE OVi4�IF YOU ARE REC�UESTING A REFUND OF AN OVfRPAYMENT p Side 2 � 150561D1D5 1505610105 J _ __ . . _ .n m� REV-i5o8 EX+(i1-io) � � pennsylvania SCNlpuLE E �� DEPARTMENT OF REVENUE CASH BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: { � cs��s �� i3 vo3g � _ Include the proc eds of litigation and the date the proceeds were received by the estate. All property jointty owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH / �i...k G� C CC(.�n�` S �" 50 -QGr a �oo S (v�Ss c�.,. -��1�-�s �-uI� i �S,o�� , I.�s -�- s� ��, c, ca TOTAL(Atso enter on Line 5, Recapitulation) ; � 3 � 5�., U C, If more space is needed, use additional sheets of paper of the same size. � _ _ . __ �n� __ , REV-1571 EX1�10.06) � SCNi�LE N coni�rH oF P�sv�vnNU w�UNERAL EXPENSES 8� INHERITANCE TAX RETURN �{y�NIJ I RHI 11 G CO� RESIDENT DECEDENT ESTA OF t l FILE NUIWBER �J'o�l � � S�t\i s b v r-� Debts of decadent must be reportad on Schadulo I. -- ITEM NUMBER DESCRIPTfON AMOUNT A. FUNERAL EXPENSES: –�`�u cJ'c„� ��-�� k�,,,�„�.� G-�� ,. s��s�� }'P'�''r 3 , �� -f�� '� � P�-- °– �r Cr-c.rv.a--�t-� r.,.. .c �� S.u�-vc'�e �.p t zyC,,� S p�'�y �,r-�lo s Q� 't-q� B. ADMINISTRATIVE COSTS: 1. Personal Repres�tative's Commissions Name of Personal RepresentaUve(s) Strcet Address ---- — -- ----- - �Y Syate ZiP - Yea�(s)Commissron Paid: 2• Aflomey Fees 3. Fam�r Exemp6on:(N de�enCs address is not ihe same as daimant's,atfach expFanaUan) Gairtrarrt Street P�ddress _ ---- Cdy Smte Zip Rela4onship of ClaimaM to DecedeM '� a �� 4. Pmba�e Fees `�� / 5• Accountant's Fees 6. Tax Rehim Preparer's Fees 7. TOTAL(Also�ter on line 9,Rer+pituladon) ;3 a � r �'� (N more space is r�eeded,insert additionel sheets of the same size) _._ __ FI�1� ' ,eEV-isiz Ex+(iz-os) �pennsylvania SCHEDULE I DEPARTMENT OF REYENUE DEB7'S OF DECEDENT, INHBl1TMICE TAX RERAtN MORTGAGE LIABILIRES 8F LIENS RFSIDdi'f DECEDBtT ESTA OF FILE NUMdER !�' �� is�ov I 3'Qd �j� RePort aebfs ncumed b�r the de�denc pri�co that r+�atnea nnpa�ia ac the aste af�atn,iodud�g wireimbursea mediea�expe�. � iTEM VALUE AT DATE MUMBER DESCRIPTION OF DEATH i. V.S '�A /"�Cc 5�-tJ— CC� n o w c��. �p l l�.e.�-cz.. c�e� q'� U ,� � , U v � 1�...e g� �s S-�� v�c..c..�,_.�.-a�-�s TOTAL(Also enter on Line 10, Recapitulation) $ � p`� � p d If more space is needed,insert addidonat sheets of the same size. � . _ _ _ �e r� REV-1'S00 EX Pa�e 3 �'de Nmnbar Decedent's Cvmpiete Addresa: t 3 - G� f� � `1 DECEDENj'S NAME t- �.�-C'o��. �. �c�<< S £�J_� —_._ _ STREETADDRESS 11 u ��T�e �c_s� — -_. _ ___ - ---- - cmr �sra� P�- �1 �t.5 v�� S� v r I � Tax Paymentr and Credits: 1. Tax Due(Page 2,Line 19) (1) � �• G 6 2. CreditslPaymenls A.Pri�Payrtients _ B.Discount Total Credits(A+B} (2) 3. Interest (3) 4. If Une 2 is greater ihan Line 1+Line 3,e�er the difference. This is the OVERPAYMENT. FlII in oval on Page 2,Line 20 ta rsquest a�t�d. (4) 5. If Line 1+Line 3 is�ter ri�an L�e 2�e�er tl�e dilFerence.Thi�is tl�e TAX DUE. (5) � 5• �5� Make check payable to: REGISTER OF WILLS,AGENT. : x °i -; ` s°y fd_z�`i.�r�� ' � ��°sM�`-"�� "�`x c .�..�;�.a+�� '*'""� ,,�� +��_ °a ..._-f � _,��"�` -�'"'_r;�,��= I�' ,y.,.:, . �.,,,s.��.'�?'r ....� '�„�..sr .'v.a�_ -. ''�. .: _ .�a�M�_:F�.',�s.,F:�a�2-��-. .._ ;.�� _ . . _ �''~� .- - ° �°'"';� --.. `i.F � �`c . .a�� - '��_..�.��ti . PLEASE ANSWER THE FOLLOINING QUESTlONS BY PLAClNG AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent m�ce a tr�and: Yes No a. ra�in ihe use or�oome�tl�e property 6ar�red:.......................................................................................... ❑ � b. retain the right to designa�who shaN use the property transferred or ils irioome:............................................ ❑ � c. reta�a reversiarary in�or.......................................................................................................................... ❑ � d. receive the prorrii,se for Gte d ei�x paytrierds,benefits or pre?............................. ......................................... 0 2. If death occurred aRer Dec.12,1982,did de�dent transler property within one year of death witt►out receiving adequa�e oonsideration?........................��-•---............................................................................... ❑ m 3. Did deoede�own an�n trust for"or payabie-�on-death bank acoount or security at his or her deafh?.............. ❑ [� 4. Did decedent own an individt�al retiirement account,ar�nuity or other non-probabe properiy,whic� contaios a benefiaary designati�on? ........................................................................................................................ ❑ � IF THE AMSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RfTURN. _ _ , �.� �- _ . i. .� � �� .__� . _ ��f_._ .�. . �� u� �� ,��I��:� For dates of death on or after July ,1994,and be�one Jan. 1,1995,the tax rate imposed on the net w�e of trar�sfers to or for the use of tl�e sunnving spouse is 3 percent[T2 PS.§9116(a)(1.1)(i]. Far dates of death on or af@e� . 1, 19�'i, the tax rate imposed on the net wakie o# lransFers b a for ihe use af ihe s�iving spouse is 0 percent [72 P.S.§9116(a)(1.1)(u)l.The does not exempt a trans�er�O a surviving spouse from tax,�d ttie statu�ay reqtri�for d'�sdosu�e of assets and filing a tax red�m a�e st�a even if the s�aviving spouse is the oNy b�e�iary. For dates af death on or afte�July 1,Z000: • The tax rate imposed on the net v�ue of iransfers irom a dec�d ch�d 21 ye�ars of age or younger at d�th to or for d�e use of a natural pazent, an ado�ive parent or a�r+ent of the du�d is 0 peroent p2 P.S.§9i16(a}(1.2)]. • The tax rate imposed on the net value of tran.sfers to or for the use of tl�e decedem's �ne�al benefia�ies is 4.5 pe�ent, except as noted in 72 P.S.§9116(1.2)[l2 P.S.§9116(aX1j]. • The tax rate imposed an ihe net value af transFerS to or�or th6 t�se af the decederN's siibl�2 peroant[T2 P.S.§9116(ax1.3}].A sibkng is defir�ed,under Section 9102�as an�t�iridual who has at least one parent In common wilh the dec�edent, by blood a a�a►. - _ _ _