The URL can be used to link to this page

Home My WebLink About07-16-13 . � ---I REV-1500 �`�07�i0� 1505610143 � OFFICIAL USE ONLY PA Department of Revenue pennsylvania cwnrycoae vea� F��e Numeer 8ureau of Individual Taxes ^�^^^��M��h PO BOX280601 INHERITANCE TAX RETURN 2 1 13 0 0 2 6 0 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date ot Death Date o(BiM 02 23 2013 10 12 1929 DecedenPs Last Name Suffiz DecedenPs First Name MI DOIIGHERTY LAS4RENCE J (IF Applfea6le)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI DOUGHERTY FRANCES M Spouse's SoGal Sewrity Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. OriBinal Retum ❑ 2. Supplemental Retum � 3.Remainder Retum(data o1 dealh prlor l012-13�2) � 4. Limlted EsWte � �,FNUre Intares�CompromBe � 5. Federel Estate Tax ReNm Repulred (Eata d Emlh afier 1142A2) � g Deceaent oretl reatete � � Daceoant tdabtehee a uNng rmst 8. Tolal Number ot Sefe Deposit Boxes (nnecncovrotwm) Inaecncwymi�uzp — � 9. LWgationProccedsReceived � 10.SpwsaiaovenvGad�ftlatamaeam �7,EIecUonlotazunderSec.9113(A) Cetween 1231-8+a�a rass� ❑ (Attat�Sch.O) CORRESPONDENT-THIS SECTION MUS7 BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIREC7ED TO: Name Daytime Tele{�ne Numb�f SAMOEL L ANDfiS �D17 76� S�r¢� C p C_ 6> O E��o153'ER OF WILLSL�ONLY Z m � � ° First line of address N � p O - 7� Z, -n 'Yi 525 NORTH 12TH STREET c� o '^ c� a '� � � c� Second Iine of address O � W � m � � �O1 � T D DATt hIIED Ciry or Post Office State ZIP Code LEMOYNF PA 17043 CortespondenYse-mailaddress: �aWa�d65CaeOI.COT Under penallles ot peryury,1 declare Ihat I have eramined Ihis retum,Induding accompanying sc�etlules and SUlements,and to the best of my knrnNetlge an0 beliel, It Is We,cortect and complete.Declaretbn of OreOarer olher than I�e personal representa9ve Is ba5e0 on all Infortnatlon af which preparer has any knowledge. SIGNATIIRE pF PERSON RESPONSIBIEKOR FILING pATE �,a�,,,,,1� hj ��(p�� Frances M. Dougherty / aZp /� ss 532 West Elmwood Avenue, Mechanicsburg, PA 17055 SI�O P MER N EPRESENTATIVE OATE Samuel L Andes � .��Q�� A SS � 525 North 12th Street, Lemoyne, PA 17043 Side 1 � 1505610143 1505610143 �� J 1505610243 REV-7500 EX DecedenPS Social Securiy Number ��sNe�: DOUGHERTY, LAWRENCE JOHN RECAPRUTATION 1. Real Estale(Schedule Aj.......................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. � 4. Mongages&Notes Receivable(Sehedule D).......................................................... 4. 5� Cash,Bank Deposits&Miscellaneous Personal Property(Scheduie E)................ 5. 42 , 3 3 7 . 0 4 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vvos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 1 2 0 , 2 1 2 . 5 5 8. 7otal Gross Aasets(total Lines 1-7)....................................................................... 8. 1 6 2 . 5 4 9 . 5 9 9. Funerei E�enses&AdmiNstretive Costs(Schedule H)......................................... 9. 8 , 2 4 0 . 9 7 10. Debts of Decedent,Mortgage Liabilities,8 Llens(Schedule 1)................................ 10. 2 . 7 B 5 . 2 3 11. Total Deductfons(total Lines 9& 10)...................................................................... 71. 1 S . �2 6 . 2 � �2� Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 S 1 , 5 2 3 . 3 9 13. Charitable and Govemmental Bequests/Sec 9113 Trusts far which an election to tax has not been made(Schedule J)................................................. 13. 74. Net Value Subject to Ta:(Line 12 minus Line 73)................................................. 1a. 1 5 1 , 5 2 3 . 3 9 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 faxable at the spousal tax rate,or hans(ers under Sec.9116 (a)(�z)x.00 151 , 523 . 39 �5 0 . 00 16. Amount of Line 14 taxable at lineal rete X .045 �6� 17. Amount of Llne 14 tazable at sibling rate X .�Z 17. 18. Amount of Line 14 tauabte al collaterel rete X .15 18. 19. Tax Due..................................................................................................................... 19. 0 . 0 0 20. FILL IN THE OVAL IF VOU ARE RE�UESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 � REV-1500 EX Page 3 File Number 21 - 1 3 - 00260 DecedenYs Complete Address: D DENT' NA Dougherty, Lawrence John STREETADDRESS � 532 West Elmwood Avenue CITY . STATE ZIP � Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. CrediL4Payments A. Prior Payments B. Dismunt . TotalCredits(A +B) (2) 0.00 3. Interest (3) 0.00 4. If line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (q� � Check box on Page 2 Line 20 to requesl a refund ' S. If line 1 +Line 3 is grealer than Line 2,enter the diHerence. Thfs is fhe TAX DUE �5) �.Q Q 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 an0: Yes No a. retain the use or income of the property transferted:.....................:............................................................ b. retain the right to designate who shall use the property transferred or its income:.................................... � c. retain a reversionary interest:or.................................................................................................................. d. receive the promfse for life of either payments,benefits or care7.............................................................. 2. If death occurred after December 12, 1982,did decedent transfer property withfn one year of death without� ❑ � receiving adequate consideraUon7....................................................................................................................... 3. Did decedent own an'in lr�st foP or payable upon deaN bank account or security at his or her death?......... � [!7 4. Did decedent own an Individual Retirement Account,annuiry,or other non-probate property which � Q conWins a beneficiary designation7...................................................................................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. � For dates of death on or after July 1,1994 and before Jan.1, 7995,the lax rete imposed on the net value of trensfers to orlor the use of the surviving spouse is 3 pertent[72 P.S.§9116(a)(1.1)(i)). � For dates of death on or after January 1.1995,the tax rate imposed on the nel value af transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The sWtute does not exempt a transfe�to a surviving spouse from tax,and the stalutory requirements kr disGosure of assets and filing a tax re(um are still applicab�e even if the surviving spouse Is the only beneficiary. For dates of death on or after July t,2000: •The tax rate imposed on the net value of trensfers 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 rete imposed on the net value of trensters to or for the use of lhe decedenl's Iineai beneficiaries is 4.5 percent,excepl as noted in nas.gsiis �.z�pzas.gs��s(a)(i)]. •The taz rale imposed on the net value of transfers to or for the use of ihe decedent's siblings is 12 percent(12 P.S.69116(a)(1.311. A sibling is defined under Sectian 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. �°"°"°"'"E^`TM°`"�""�"�^"" PERSONAL PROPERTY NNEFRGNLETAXqETUqN NESOEM OECE�ENT ESTATE OF FILE NUMBER Dougherty, Lawrence John 2� - �s-oo260 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of �I survivorship must be disclosed on schedule F. ITEM DESCRIPTION VAIUE AT DATE OF NUMBER DEATH 1 Citizens Bank checking account No. 6100631702 8,920.37 2 Citizens Bank savings account No. 6233683770 15,195.19 3 Scottrade Investment account No. 2333 5,721.48 4 2006 Honda Accord in fair condition 12,000.00 5 Miscellaneous items of clothing and personal effects 500.00 TOTAL(Also enter on Line 5, Recapitulation) 42,337.04 COMMONWEALTryOFPENNSriVANIA SCHEDULE G INHERITANCETAXRENRN INTER-VIVOS TRANSFERS 8 RESIDENTDECEDEM MISC. NON-PROBATE PROPERTY , ESTATE OF Dougherty, Lawrence John I FILE NUMBER 21 - 13-00260 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTIONOfPROPERTY DPTEOFDEATH %�F EXCLUSION NUMBER �^�etnenm�eormevans�eree,meurewiw�snioroaxeaem yp�UEOFASSEf �cos (�FMPLICqBLE) TAXHBLEVAWE a�a ma e�a w i�sr�. nn�n e owr a ma eaee i«reei�ia�a. wrenesr 1 Individual retirement account with Scottrade izo.z�2.es 100% 0.00 720,212.55 TOTAL(Also enter on line 7, Recapitulation) 120,212.55 � SCHEDULE H COMMONWEALT1pFpENN9YLVANM �� NMERRANCE TNf PEfUFN AM•I�IICT�ATI�IC/YY"}� RESDEM DECEOENT �J��N 1 f W I 11/C WJ 1 J FILE NUMBER ESTATE OF Dougherty, Lawrence John p� - �3 -00260 Debts of decedent must be reported on Schedule 1. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT a 1 Malpeui Funeral Home(funeral expenses) 6,522.47 B. ADMINISTRATIVE COSTS: • 1, Personal Representative's Commissions Name ot Personal Representative(s) SVeet Address Ciry State Zip Year(s)Commission paid z. nnomeysFees Samuel L. Andes 1,500.00 3. Family Exemption: (If OecedenYs address is not the same as Gaimant's,attach explanabon) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of W ills 143.50 5. Accountant's Fees 6. Tax Retum Preparer s Fees 7. Other AdministreUve Costs 1 Cumberland Law Journal (advertising) 75.00 TOTAL(Also enter on line 9, Recapitulation) 8,240.97 Sdiedule H Fir�eral F�er�ses 8, COMMONWEALTH OF PENNSVLVANIA INHERITANCETAXRETURN ��n�� RESI�ENTDECEDENT ESTATE OF Dough2rty, Lawrence John FILE NUMBER 21 - 13-00260 2 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE caeawmEwimovrEHHSnv,wu LIABILITIES 8i LIENS MNERR�NCETNlFENRN f RESDEMOELFAEM FILE NUMBER ESTATE OF Dougherty, Lawrence John z� - �3-,00260 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM ' NUMBER� DESCRIPTION AMOUNT 1 Honda Finance (balance owed on auto loan) 2,785.23 . TOTAL(Also enter on Line 10, Recapitulation) 2,785.23 . . . , NEV451D EX�(H-08) SCHEDULEJ COMMOM4EAlT1 pF PENNSYLVqNIA BEN E FICIARI ES i INHERITANCE TAX REiURN � RESIOEM DECEDEM . ', ESTATE OF . I FILE NUMBER Dougherty, Lawrence John 21 - 13-00260 NAME AND ADDRESS Of PERSON S � RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER RECEIVINGPROPERTY � � DECEDENT � (Words) ($$$) Do Na Liat Trvatee(e) I, TAXABLEDIS7RIBUTIONS[nGudeoutright�spousal � disNbuGOns,and trensfers under Sec.9116(a)(1.2)] � 1 Frances M. Dougherty W ife entire estate 532 West Elmwood Avenue MecFianicsburg, PA 17055 Enter dollar amounts far distributions shovm above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II. NON-TAXABLE DISTRIBUTIONS: � A.SPOUSAI DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS � TOTAL OF PART II-ENTER TOTAL NON-TAW�BLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI O.00