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Home My WebLink About06-18-13 � 1505610101 REV-1500 °"°'-°°, � enn lvanta OFFICIAL USE ONLY - PA Department of Revenue P,,,ri Coun Code Year file Number Bureau of Indivfdua!Taxes ' ty Posoxzso6oi INHERITANCETAXRETURN � Harrisburg,PA iyu8-o6oi RESIDENT DECEDENT � � � � D 7� ENTER DECEDENT INFORMATION BELOW Social Security Number Date ot Death MMDDYYYY Date of Birth MMDDYYYY $ 0 / S o � / D 17 /9 !0 / DecedenCs Last Name Suffix DecedenPs First Name MI W nI'C _ _K � �� C � (If Applicable)Enter Surviving Spouse's Information Below � Spouse's Last Name SuHix Spouse's First Name MI � ❑ Spouse's Social Securiry Number THIS RETURN MUST BE FILED IN DUPLICATE WITN THE REGISTER OF WILLS FILI IN APPROPRIATE OVALS BELOW . p 1. Onginal Retum � 2.Supplemental Retum O 3. Remainder Return(date of death ' � • , pnorto 12-13-82) . p 4. Limited Estate O 4a.Future Interest Compromise(date of O 5. FeOeral Estate Tax Retum Required L �5., : death after 12-12-82) O 6. Decedent DieC Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) � O 9.Litigation Proceeds Receive0 O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A) between 1231-91 and 1-1-95) (Atlach Sch.O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIUENTIAL TAl(INFORMATION SHOULD BE DIRECTED T0: � Name Daytime Telephone Number �► � '� 'P � �£ ' � � Q , � �.- J �; .\ `.• .y . 3E�fTEROF�.LS1f�CMLY � m � 7 � � First line ot address � n r r' m rn PP � 1� � nzN o� � o z U? �c o 0 0 3 ',� -� Second line of adCress n O � ' �-� = n •�. ` � I = . � � � . � t' T . � r o City or Post Office State ZIP Code � DATE4� ED N -r� A�t1 v � � P�- 1 7gr .( 1TT1 CorrespondenYs e-mall address:�£ry/y,2 rQ]. .7�fitl.�, �j��_ UrWer naltiesof `•+�T pe pe�ury,I dedare that I have ezamined Ihis retum,indutling acmmpanying schedules antl statemenis,and to ihe best of my knovAedge and belief, , . it is Wa,cortecl end complete.Dedaration of preparer other�han Ihe personal fepresentalive is based on all Infortnation of whlch preparer has any knowledge. SIGNATUR OF PERSON[2ESPONSIBLE FOR FILING RETURN DATE _I 5. �--�.�-� E�e<. (0-17- I ADDRESS � � �qn 6��.�t� � ctiQ A,o..,�,��-< Q.� �� Sa � SIGN URE OF R P ER OTHER TH EPRESENTATIVE � D E ✓ � G � � DD E /f /«/ � � tn 2 �7g Z PLEASE USE ORIGINA FORM ONLY Side 1 � 150561�101 1505610101 � 1 1505610105 , J REV-1500 EX f DecedenCs Social Security Number ' DecedenCS Name: / ..-_�_ / � RECAPITULATION 1. Real Estale(Schedule A). ...... ...... .... ..�. .... ... ........ ... .... .. 1. � •�, 2. Stocks and Bonds(Schedule B) ... .... .... ............. . ... .... .... ... 2. ��.��,�•I� 3. Closely Held Corpo2tion,PaAnership or Sole-Proprietorship(Schedule C) ..... 3. ��•� - - - � 4. Mortgages and Notes Receivable(Schedule D) ... ........ ... ... .... ...... 4. �'.�J��•I 5. Cash, Bank Deposits and Miscellaneous Personal Properry(Schedule E)....... 5. ��7��]•�(0„_I(� - 6. JoinOy Owned Property(Schedule F) p Separete Billing Requested ..... .. 6. ' J��•� Z �nter-�vos Transfers&Miscellaneous Non-Probate Property - -� � -' - (Schedule G) O Separate Billing Requested.. ...... 7. I��J•�J 8. Total Gross Assets(lotal Lines 1 through 7)... .... ... . ....... ... ... .... . 8. � r�`��I Z.g•i�� 9. Funeral Expenses and Administrative Costs(Schedule H)... ... ....... ... ... 9. � ��„O�D 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule p....... ....... 10. �i ��. - - --- - -- 11. Total Deductions(total Lines 9 and 10).... .... ... ....... .......... . .... 11, �''I �_.�,_��_I��_�_�_�, 12. Nel Value of Estate Line 8 minus Line 11 12. ��.�� I ) ....... ...... . ... .... ... ...... 13. Chantable and Govemmental Bequests/Sec 9113 Trvsts for which � � - - - an election to tax has not been made(Schedule J) ....... ....... ....... ... 13. �p�� _�J.� ' ... .... . ,4. I��.�(�� _ '�70� 14. Net Value Subject to Tax(Llne 12 minus Line 13) .. .... ... .. (D 3•i� TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 laxable� al the spousal tax rate,or ._ transfers under Sec.9116 i � � � � (a)(12)X .0_ I .� 15. � . 16. Amount of Line 14 taxable , - �-/��i.� o��I I� b �'I 16. ��3��,�I'��J at lineal rate X.0�� (� `( (O • 17. Amount of Line 14 taxable - at sibling rate X.12 �]•I� 17. ��]•�'J 18. Amount of Line 14 taxable - ` - '- �� -- - � at collateral rate X.15 ` A 18. ' 19. TAX DUE .......... .... ... ... ........... ........ ... .... ............ 19. ) , .� 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1505610105 1505610105 J -�__ ,• REV-1500 EX Page 3 File Num6er . DecedenYs Complete Address: ��—//^ O�"7�o� `; DECEDENT'S NAM . � __�RZG _P. �rN_G_£K STREETADDRESS —/_D_��5 t /'7iQ�it Stre�F cin srn� �A Z1P I 70SS� �s b�.� Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) ��) 3i3 "3(p 2. CreditslPayments A.Prior Payments B.Discount Total Credits(A+B) (2) 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3, Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 i Line 3 is greater than Line 2,enter the difierence.This is the TAX DUE. (5) 3/'� , 3�0 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 trensfer and: Yes N,�o1 � a. retain the use or income of the property transferred�.......................................................................................... ❑ L�7 b. retain Ihe right to designate who shall use the property iransferted or its income:............................................ ❑ Q� c. retain a reversionary interest;or.......................................................................................................................... ❑ Q� ; d. receive ihe promise for life of eilher payments,benefits or care?...................................................................... ❑ [� 2. If death occurred aher Dec. 12,1982,did decedent transfer propeAy within one year of death without receiving adequate considerafion?.............................................................................................................. ❑ � 3. Did decedenl own an°in trust foP or payable-upon�eath bank account or security at his or her death?.............. ❑ [� 4. Did decedent own an individual retirement account,annuity or other non•probate property,which containsa benefidary 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 betore Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for ths use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. t, 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 retum are still applicable even ii the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: . The lax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or tor the use of a natural parent, an adop6ve 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 lhe decedenYs lineal beneficiaries is 4.5 percent, except as noted in 72 P.S.§9116(12)[72 P.S.§9116(a1(1)1• • The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, under Section 9102,as an individuai who has at least one parent in common with the decedent,whether by blood or adoption. , REY-0SOBEX.�1-91� � � . • SCHEDULE E COMMONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS� O{ MISC. � . iNHRESioEn�iTOECeoENTR" PERSONAL PROPERTY ESTATE OF FILE NUMBER c Rrc ? c�rNG�h �-�� - oo��-�r Include ihe proceeds of litigation and ihe date lhe proceeds were received by the esfate.All propertyjointlyowned with the right of survivorship must be disclosed an Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. ��}, �-n!✓�-sr.N��r�rs - �o/ ,e ''�7, 3 Z S . �� S�e� �� ioqq- R� /�10te •. %�";s rxcco��.f- �.v6rs nat- p�iscoae,ce.� �i(,.� fr( Q-f�CCi•p� 1v�f9 �.tJ<S !'C crev�[ �� xecu�o2 . . TOTAL(Also enter on line 5,Recapitulation) $ �32 g. (p�y Qf more space is needed,insert additional sheets of the same size) TN m DWnrHTn oy . o � x�ooz�< r< � 9 Om<ONOm m W3 OrDC7-t m PAtr -IT� q�R � �� D�aO\S = Gt7f2S�-+r� �,�', ar� 2oSOM �i �A-in� C. C -fGfC+im �� N� eK,+W27�f�1 � 9 21"r~i<n 08 . l7i_. fr-r�'NZ-i - r'0�+� �� o k. m O>C m �@ C <Z r m� 0� '0'tl-1 S A DO-i� � " . NY > OEO � t 1�<'9S£. �g p � pA=m r TmN g p - r VO R�1r.Ai � „�, illE-DiNO ^ R N W A n m H • M � � n� � i. z ti �� t� w y� a m g T. p a' O � �1 �1 '17 � � � $ s � � �� s g m � � � A �. � g � 8 �' 3. c . � �'� � � � � � � �� V� g $ w w O yv0� p O$ � Op N O � � O� a O" O� P O � �+ y O O� O� p� 0 m2 p D N �$ Q m 6 £ A g T 0 . � � � � � � O O � � m �' 3 � � 8�. 8 � � ti � E $ � � "� �' � R - � p m 3 � S q q� y^� A� g a O O 3 W s $ � O O O° r O O W � .\° ,2 a' 'a e ' � � � f 3 .R � my � � � � 3 m a o } � � � $ � � ��s � =$m�� „ � �'� g a ;�m>s � � .° � c �K'�� `� �CS3 �� ' O !;� � S N � " �� O �� REV-1511 EX+(10-06) SCNEDIJLE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & � INHERITANCE TAX RETURN ADMINISTRATIVE COSTS � RESIDENTDECEDENT ESTATE OF FILE NUMBER �Q=G �- �.uTNG�K 2/-/l-oo7Gy� Debts ot decedent must be reported on Schedule I. � , ITEM NUMBER DESCRIPTION AMOUNT - a. FUNERALEXPENSES: �. B. ADMINISTRATIVE COSTS: . 1. Personal Representative's Commissions - Name of Personal Representalive(s) � . StreetAddress City � State Zip Year(s)Commission Paid: 2. Attorney Fees JO�Q� J /y.��'�'Q, � �ZOD .QD 3. Family Exemption:(If decedenfs address is nol the same as claimanPs,attach explanation) � Ciaimant Street Address � City State 2ip . Relationship of Claimant to Decedent 4. Probate Fees � . /r0"a 5. Accounfant's Fees � 6. Tax Relurn Preparer's Fees ��K��(�LT2 /�e�p4,rt�rf-N� �. c2o;2 ¢',�Quc�.ctr ��er�( f-Sr:+�.��e�c.-�s, ��0. o 0 � TOTAL(Also enter on line 9, Recapitulation) $ 3�S`• �� Qf more space is needed,insert additional sheets ot the same size) _ �__ .�, ' �REV-1513 EX+(9-0D) sc�e�DU�E r COMMONWEALTH OF PENNSYLVANIA .BENEFICIARIES INHERITANCE TAX RETURN RESIDEM DECEDENT ' ESTATE OF FILE NUMBER Eric P. Winger 21-11 -00764 � RELATIONSHIP TO DECEDENT AMOUM OR SHARE NUMBER NAME AND ADDqESS OF PERSON(S)RECEIVING PROPERTY Do Nol ListTrushe(s) OF ESTATE t TAXABLE DISTRIBUTIONS[nGude oNright spousal dstributions,end transfers under Sec.9N6(a}(12)] �' Priscilla Winger Mother 100$ 100 Mount Allen Drive, Room 333 Mechanicsburg, PA 17055 EMER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 75 THRIXIGH 18,AS APPROPRIATE,ON REV-7500 COVER SHEET �- ll NON-TAXABLE D;�TRIBUTIONS: A. SPOUSAL DISTRIBUTIOPIS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS � 7. TOTdL Of PART II—ENTEFl TOTAI NON-TAXABIE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $