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Home My WebLink About10-17-13 � _ _ _ _ � J 1505610140 REV-1500 �` �°,_,°, � �epartment of Revenue FlCIAL USE ONLY Bureau of individual Taxes Courriy Code Year Flle Number Po Box 28oso� INHERITANCE TAX RETURN Hamsbu PA 17128-0601 RESIDENT DECEDENT 2 1 1 3 0 0 5 1 ENTER DECEDENT INFORMATIOW BELOW Soda�Sec��rity Number Date of Death NMDDYYYY Date of Bi�th AAAADDYYYY 1 2 1 1 2 0 1 2 � 6 2 5 1 9 1 ? DeoedenYs Last Name Suffix DecedenYs First Name Alll L 0 V E T T E V E L Y N g (If Appllcable)Enter Surviving Spouse's Infonnadon Below Spouse's Last Name Suffix Spouse's First Name M� Spouse's Social Security Number � THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Retum X 2.Supplemental Retum ❑ � 3.Remainder Retum(date of death � prior to 12-13-82) 4.Limited Estate � 4a.Future Interest Compromise(date of � 5.Federal Estate Tax Retum Required � death after 12-12-82) 6•Deoedent Died Testate � 7.Decc�dent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes (Attach Copy of�II) (Attach Copy of Trust) � 9.Litigation Proceeds Reoeived � 10.Spousal Poverty Credit(date of death � 11.Eledion to tax under Sec.9113(A) betvueen 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX MIFORMATION SHOULO BE DIRECTED T0: Name Daytim�Tetephone Ni��er R 0 G E R B • I R W I N , E S Q U I R E 7 �'�b 2 4 �" �n�.�,'�''S 3 � � L��_; �a �, �F WILLS US � ,�:;�, t_'. 1-:--+ � _. f f"� � �";`.� i".r� First line of address : , �� %� �� : � � G„� �'�� ,,i ,.. --m..z I R W I N & M c K N I G H T , P . � . . . ; �:;� �' �r Second line of address � -;=: �= �� .. ,� r �, . �,.�"9 4''J ..�. �,,..,..,. 6 0 W E S T P 0 M F R E T S T R E E T �� µ�w f�s' �' �a � � City or Post Office State ZIP Code DATE FILED C A R L I S L E p A 1 7 � 1 3 Corr'esponcient's e-mail address: Unde�penalNes af perjury,I dec�are that I have examined this retum,including acxomParryi�9 schedules and statemertts,and to the best of my knowledge and belief, it(s true�correec:t end c�mple�e.Dedaration of preparer other than the personal represerrtati�is based on all informafion of which SIGNATURE OF RSON RESPONSIBLE FOR ILING RETURN �Pe��as any knowledge. ��, DA ADDRESS /v fb r3 � 60 WEST PO T STREET CARLISLE PA 17013 SIGNATURE ARER OTFJ�R THAN P ESENTATNE � �� . ADDRE ° � �b (� 6� WEST PO RET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15�5610140 1505610140 � . _ . ,�,J 1505610240 REV-1500 EX Deoedent's Social Securiry Number �nesName: EVELYN 8• LOVETT RecaP�uu►noN 1. Real Estate(Schedule A) .................... ..... .................. 1. . 2. Stocks and Bonds(Schedule B) .................... .................. 2. . 3. Ciosely Held Corporation,Partner�hip or Sole-Proprietorship(Schedule C) .... . 3. . 4. Mortgages and Notes Receivable(Schedule D) ........ ............ ...... 4. . 5. Cash,Bank Deposits and Miscellaneous Pe�sonal Property(Schedule E).. ..... 5. . 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers 8 Miscellaneous N�-Probate Property � (Schedule G) Separate Biliing Requested ....... �. 1 2 5 7 8 ?. 1 3 8. Total Gross Assets(total Lines 1 through 7) ... .......... .............. 8. 1 2 5 ? 8 7, 1 3 9. Funeral Expenses and Administrative Costs(Schedule H) .................. 9. 1 2 6 5. � 0 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) ... ........ .. 10. � . 0 0 11. Totai Deductio�(total Lines 9 and 10) ..... .......... ........ ........ 11. 1 2 6 5. 0 0 12. Net Value of Esta�e(Line S minus Line 11) .......... ......... .... ..... 12. 1 2 4 S 2 2 . 1 3 13. Charitabie and Govemmental Bequests/Sec 9113 Trusts for which an elecc:tion to tax has not been made(Schedule J) .. ...... . ............. 13. . 14. Net Value Subject to Tax(Line 12 minus Line 13) .. .................... 14. 1 2 4 5 2 2 . 1 3 TAX CALCULATION-SEE INSTRUCTfONS FOR APPLICABLE RATES 15. AmouM of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 �a��.2�x.o 0 . 0 0 �s. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X-0 0 . 0 � �g, � . � 0 17• Amount of Lfie 14 taxable at sibling rate x.�2 1 2 4 5 2 2 . 1 3 ��. 1 4 9 4 2 . 6 6 18. Amount of Line 14 taxable at coliateral rate X.15 0 . � 0 �g, 0 . � � �s. TAX DUE .... .................... . ............. .. .............. �s. 1 4 9 4 2 . 6 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 L 1505610240 1505610240 J REV 1500�X Pege 3• _ _ . Flle Number Decedent's Complete Address: 2� �3 0051 DECEDENTS NAME EVELYN B. LOVETT STREET ADDRESS 940 WALNUT BOTTOM ROAD CITY CARLISLE STATE Z�P PA 17013 Tax Paymen�s and Credits: 1. Tax Due(Page 2,Line 19) 2. Credits/Payments �� 14,942.66 A.Prior Payments B.Discount 3. inte�est Total Credits(A+B) (2) 0.00 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. �3� FNI in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. if Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 14,942.66 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X"IN THE APPROPRIATE BLOC KS 1. Did decedent make a tr�ansfer and: Yes No a. retain the use or income of the property transferred• � . ...................................................................... ❑ b. r�tain the right to designate who shaii use the property transferred or its income; ............................... � 0 c. r�tain a reversionary inter�st;or .............................................. � .................................................. ❑ d. reoeive the promise for life of either ments benefits or care? 0 PaY , ....................................................... � 2. If death ocxurred after December 12,1982,did deoedent transfer property within one year of death without receiving adequate consideration? ................................ ❑ � ....................................................... 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ X[� 4. Did dec�dent own an individual retirernent acoount,annuit�r or other non-probate property,which c�ntains a beneficiary 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 before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the survivin s use is 3 pe�cent[72 P.S.§9116(aj(1.1)(i)]. g p° For dates of death on or after Jan.1, 1995,the tax rate imposed on the net value of transfe�s to or for the use of the surviving spouse is 0 peroent [72 P.S.§9116(a)(1.1)(ii)j.The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disdosure of assets and filing a tax retum are sfili applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 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 naturai parent,an adopbve parent or a ste�arent of the child is 0 perc�ent[72 P.S.§9116(a)(1.2)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent,except as noted in 72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]. • 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 individual who has at least one parent in common with the decedent,whether by blood or adoption. REV 1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTIY�NT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER EVELYN B. LOVETT 21 13 0051 This schedule mu,st be c�mpleted and filed if the answer to any of questions 1 thmugh 4 on page th�ee of the REV-1500 is yes. ITEM �SCRIPTION OF PROPERTY �CLUDE 71'IE NM�E OF THE TRANSFERff,TF�IR RQATIONSFpP TO DK�TIT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUIuIBER THE DATE OF TRA�.ATTAqi A COPY OFTF�E DE�FOR RFJ1l.ESTATE VALUE OF ASSET INTEREST nF�q VALUE 1. BANK OF AMERICA NA 125,787.13 100.00 125,787.13 ACCOUNT#68100407262124 IN TRUST FOR JEANNETTE COHICK TOTAL Aiso enter on Line 7,R 'tulation S 125 787.13 If more spaoe is needed,use additional sheets�paper of ihe same size. REV 1511�EX+(1'0-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ' ESTATE OF FILE NUMBER EVELYN B. LOVETT 21 13 0051 Decedent's debts must be reportsd on Scheduls I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. � B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Add�ess ��Y State ZIP Yea�(s)Commission Paid: 2, AttomeyFees: IRWIN&McKNIGHT, P.C. 1,250.00 3. Famihr Exemption:(if decedenYs address i�not the same as daimanYs,attach explanation.) Claimant Street Address ��Y State ZIP Relationship of Claimant fi�Deoedent 4. Probate Fee.s: 5 Aa�untant Fees: 6. Tax Retum Prepa�r Fees: 7. REGISTER OF WILLS-FILING FEE 15.00 TOTAL(Also enter on Line 9,Recapitulation) � 1 265.00 If mo�e space is needed,use additional sheeis of paper of the same size. REV-1513,EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: EVELYN B. LOVETT 21 13 0051 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do N�Ust Trustee(s) OF ESTATE I, TAXABLE DISTRIBUTIONS pndude outri�h�s�ousal distributions and transfers under Sec.91'�6 a) 1.2.] 1. JEANETTE B. COHICK Sibling 124,522.13 490 E. McNAB RD., APT 5 REMAINDER POMPANO BEACH, FL ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SH01NN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS 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 addi�onal sheets of paper of the same size. . , � • . BI�tEAU OF INDIVIDW4L TAXES Penns Ivania lnheritance Tax � enns lvan�a PO BOX 280601 y � y HARRISBUR6 PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response REY-1543 EX DoeEXEt�oa.�Z� FILE NO.2113-0051 ACN 13150402 DATE 09-27-2013 Type of Account Estate of EVELYN B LOVETT Savings SSN 171-28-7425 Checking Date of Death 12-11-2012 X Trust JEANETTTE COHICK County CUMBERLAND Certificate 60 W POMFRET ST CARLISLE PA 17013-3243 BANK OF AMERICA NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.68100407262124 Remit Payment and Forms to: Date Established 04-08-1998 REGISTER OF WILLS Account Balance $125,787.13 1 COURTHOUSE SQUARE Percent Taxable X 100 CARLISLE PA 17013 Amount Subject to Tax $125,787.13 Tax Rate X 0.150 Potential Tax Due ��g�ggg,p� NOTE*: If tax payments are made within three months of the With 5%Discount au x 0.95 decedent s date of death,deduct a 5 percent discount on the tax Cr ) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Ste 1: Please check the a � P ppropriate boxes below. A []No tax is due. I am the spouse of the deceased or I am the parent of a decedent v�rho was , 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not chedc any other boxes and disregard the amount shown above as Potential Tax Due. : _ . _ . � . _ _. _.. B �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part � 1��o I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished.