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Home My WebLink About09-23-13 (2) 1 yq'� 1505610105 J REV�iJOOEx(az-vi(FI)�0�� OFFICIAL USE ONLV PA Department of Revenue Pennsylvania Bureau of Individual Taxes `°"�"`" • Counry Cede Year File Number Po eox zao6o� INHERITANCE TAX RETURN Harrisburg,PA i9iz8-o6oi RESIDENT DECEDENT �1 I � q� 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYVYY Date of Birth MMDDYYYY OS/04/2012 12/12/1932 DecedenPs Last Name Suff�x DecedenCS First Name MI Quinn Evelyn (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suff�x Spouse's First Name MI Spouse's Social Securiry Number THIS RETURN MUST BE FILED IN DUPLICATE WITH TtIE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW p 1. Original ReWm � 2 Supplemental Return O 3. R�=mainder ReRim(Date of Death Prior to 1&13-87_) O 4. Limited Estate O 4a. FuNre Interest Compromise(date of O 5. Federal Estate l-ax ReWm Required dea[h aker 12-1&82) O 6. Uecedent Died Testa[e O 7.Decedenl Mainlained a Living l mst � 8. Tolal Number of Safe Deposit Boxes (Altach Copy of Wlll) (Attach Copy ofTmst.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O 1 L Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (P,ttach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE ANO CONFIDENTIALTAX INFORMATION SHOULD EE DIRECTED T0: Name Daytime Telephone Number Michael A. Scherer, Esq (717) 'l_49-6873 RFGISTER OF N�ILLS 115E ONLY i� First Line of Address � � � Baric Scherer LLC Second Line of Address � . � 19 West South Street City or Post Office State ZIP Code � oq7E FiLED' Carlisle PA 17013 �. - � � ' � :� CorrespondenPS e•mail address: I1lSChEfBf�bafiCSChQfBLCOm � � Untler penalties of perjury,I tleclare that I have examinetl this reWrn,inclutling acmmpanying schedules and statements,antl to Ihe best of rny knowiedge and belief, it is Vue,correct and complete.Declaration of preparer other than the personal representalive is basetl on all information ot which preparer has any knowledge. 51 E QF PERSON R P NSIBLE FOR RLING ETURN � ��T� �ADDRESS , ` 0--� 2670 Spring Road, Carlisle, Pennsylvania 17013 SIGNATJJF� F4ftFpA[3�OTHERTHANREPRESE.NTATIVE O E J�/I �1L1 9•i��t•IS A��R 19 st South Street, Carlisle, Pennsylvania 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 15C15610105 J �� J 150561�205 REV-1500 EX(FI) DecedenPs Social Security Number Decedent's Name: EVBIyII QUIIIII RECAPITULATION 1. Real Estate(Schedule A). . .. . .. . . . .. .. . . .. . .. .. . . . .. .. .. .. . . . .. .. . . .. 1. 2. Stocks and Bonds(Schedule B) . . . .. . .. . . . . .. ... .. .. .. . .. .. . .. .. . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . .. . 3. 4. Mortgages and Notes Receivable(Schedule D). . .. . .. . . .. . . . .. . . . . . . . .. . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schetlule E).. . . . . . 5. 3,673.95 6. Jointly Owned Property(Schedule F) O Separete Billing Requested .. . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. .. . . , . 7. 8. Total Gross Assets(total Lines 1 thmugh 7). _ . .. . .. .. .. . .. .. .. ... .. . . .. 8. 3,673.95 9. Funeral Expenses and Administrative Costs(Schedule H). .. . ... . . . . . . .. . .. . 9. 10. Debts o(DecedeM, Mortgage Liabilities and Liens(Schedule I). ... .. . . .. . ... . 10. 11. Total Deductions(bta�Lines 9 and 10).. . . . . . . . .. .. . . . .. . . .. . .. . .. .. . .. 11. 12. Net Value of Estate(Line 8 minus Line 11) . . . . ... . .. . .. .. .. . . . .. .. . .. . .. 12. 3,673.95 13. Charitable and Governmental Bequesis/Sec 9113 Trusts for which an election to tax has not been made(Scheduie J) .. .. . .. .. .. .. . . . . .. . . .. 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) .. .. . _ .. .. . _ _ .. . .. . .. 14. 3,673.95 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount o(Line 14 taxable at ihe spousal tax rate,or Vansfers under Sec.9116 (a)(72)X A_ 15. i6. Amount o(Line 14 taxable at lineal rate X.0 45 3,673.95 �g. 165.33 17. Amount of Line 14 taxable at sibling rete X.12 17. 18. Amount o(Line 14 taxable at collaterel rete X.15 18. is rnxoue . ... .. . . . . .. . ... . . .. . . . . . . . .. .. . .. .. _ . , _ _ . . _ _ . is. 165.33 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 1505610205 150561�205 � REV-�500 E%(FI) Page 3 File Number Decedent's Complete Address: �ECEDENT'S NAME Evelyn Quinn — —__.__. STREETADDRESS - - 2670 Spring Road ...._---- ._--- --._.. CITY STATE TZIP Carhsle PA ' 17013 Tax Payments and Credits: i. Tax Due(Page 2,Llne 19) (t) 165.33 2. CreditslPayments A.Prior Payments _ B.Discount Total Credits(A+B) (2) 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) 5. If Line 1 i 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" IN THE APPROPRIATE BLOCKS 1, Did decedent make a transfer and: Ye:�, No a. retain ihe use or income of the property transferred....................................................._._....._....._................_ ❑ � b. retain ihe right to designa�e who shall use�he propedy�ransferred or its income _..........................._......_..._ ❑ � c. retain a reversionary interest........................................................................................................__....__._.. ❑ � d. receive ihe promise for life of either payments,benefts or care?...._.__.__..__._............._...........__.........,.._. ❑ � 2. If death occurred after Dec.12,1982,did decedent transfer properly within one year of death withoutreceivingadequatewnsideration?.................................................................................._._............._......_ ❑ � 3. Did decedent own an"in trust fof'or payable-upon-death bank account or sewrity at his or her death?.......__._ ❑ � 4. Did decedent own an individual re�irement account,annuiry or other non-probale properly,which wn�ainsabeneficiarydesignation? ..__...................................................._................................_._.._........_._...._ �I � 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 before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of ihe surviving spouse is 3 percenl[72 P.S.§9116(a)(1.1)(i)]. For dales of death on or after Jan. 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 lax,and the statu�ory�requirements for disclosure of assels and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates ot death on or after July 1,2000: . The tax rate imposed on the net value ot 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)(12)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenPs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)j, . The tax rale imposed on the net value of transfers ro or for ihe use of the decedent's siblings is 12 percenl�72 P.S. §9116ia)�1.3)].A sibling is defned, under Section 9102,as an individual who has at leas�one parent in common with�he decedenl,whether by blood or adoption. REV-15o8 EX+(ofl-1z) �i�Jpennsylvania SCHEDULE E ri� oeanaTMeNTOFaeveNUe CASH, BANK DEPOSITS & MISC. irvneairnNCe rnx aEruaN PERSONAL PROPERTY RESiDENT DECEDENT ESTATE OF: FILE NUMBER: Evelyn Quinn 21-12-0919 Indude the proceeds of litiga[ion and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VA W E AT DATE NUMBER DESCRIPTION OF DEATH 1. USAA refund 3,673.95 TOTAL(Also enter on Line 5, Recapitulation) $ 3,673.95 If more spa[e is needed, use additional sheets af paper of the same size.