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Home My WebLink About10-17-13 (2) .J REV-1500 EY(02-1 1505610105 OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes County Code Year File Number PO BOX 28o6oi INHERITANCE TAX RETURN Harrisburg,PA 17128-o6ci RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW [�3�31/2011 1 Suffix Decedent's First Name MI Calhoun J i Hazel (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C=) 1.Original Return CID 2.Supplemental Return C=) 3. Remainder Return(Date of Death Prior to 12-13-82) C=) 4.Limited Estate C=:) 4a-Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) (=D 6,Decedent Died Testate CZD 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) C=:) 9,Litigation Proceeds Received C=5 10.Spousal Poverty Credit(Date of Death C=i 11. Election to Tax under Sec,9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND.CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name I Daytime Telephone kh(m�er Angela Winslow Esquire (412)667-6216, o rt, try li_4 1 r,> C�l REGISTER OF WILLiJOSEONLY�,J (Z, zz� rri ` C:7 < r�) _na --i I FQ First Line of Address lZ:r :"bin .. �t C�, —----- __77— 1500 One Gateway Center Second Line of Address _V7 Fri City, State ZIP Gods DATE FILED 1i `F? Pittsburgh Pa1 15222 _____ .,---j -- '-, ___-____ -J Correspondent's e-mail address:awinSIOW@pionlaw,corn Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGN�rURE OF �-SPOl NSIBLE FOR FILING RETURN g ADDRESS Q 1014 Jenkins Grove, Enola PA 17026 ATRZE ATIV SIGNATU��Fto ji, .SE E ADDRESS U 1500 One Gateway Center, Pittsburgh, PA 15222 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 � `\1 ` � ` ^ .J 1505610205 REV-1 500 EX(FI) RECAPITULATION 3. Closely Held Corporation,Partnership or Sole-Propirretorship(Schedule C) 3. 5, Cash,Bank Deposits and Miscellaneous Personal Property(Schedule Ef.... & 19,781.66 S. Jointly-OwnedProperty(Schedule F). C:) Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C=> Separate Billing Requested.,...... 7, 9- Funeral Expenses and Administrative Costs(Schedule H) .............. 9 2,100.00 10. Debts of Decadent, Mortgage Liabilities and Liens(Schedule 1). .... 10. 13. Charitable and:Govemmental Bequests]Sec 9113 Trusts forwNch an election-to tax has not been made(Schedule J) . 13. TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 1 16. Amount of Line 14 taxable at lineal rate X.0 45 16. 795.67 17. Amount of Line 14 taxable at sibling rate X.12 17. I& A"untofiLine 14 taxable at collateral rate X.15 m 20. FILL IN THEOVAL IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205, ` REV-1500EX(Fp Pages File Number Decedent's Complete.Address: DECEDENT'^i NAME ' Hazel R. Calhoun STREETADDRESS ' 325.Wesley Drive i S CITY STATE ZIP Mechanicsburg Pa 17055 ' Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) - {t) -795.67 2. Credits/Payments A.Prior Payments S.Discount Total Credits(A+g) (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. - Fill In oval on Page 2,Line 28 to request a refund. (4) 5. If line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. {5} - 795.67 Make check payable to: REGISTER OF WILLS,AGENT. PLEASE ANSWER THE FOLLOWING;QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE'BLOCKS . c. 1. Did decedent make a transfer arid: Yes No a. retain the use or income of the propertytransferred.......................................................................................... ❑ b. retain the right to designate who shall use the property transferred or its income............................................ 0 V - c. retain a reversionary interest........................' 0 -0 - d, receive the promise for life of either payments,benefits or care?...................................................................... 0 ■ 2. if death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ - 1 Did decedent own an'in trust for'or payable-upon-death bank account or security at his or her death?.............. 0 0 ' 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ 0 N IFTHE"A AERTOAuYOFTkAk t'QUESTION$- YES;YOU7MUS7COMPLETE-SCHtDULEG:AND:F1LEI TAS•PART,OF.THCPETURN.;�`:`.-'- 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 surviving spouse is 3 percent 172 P.S.§9116(a)(t.t)(i)]. For dates 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)(i.1)(ii)].The statute does not exempt a transfef to a surmving'spouse from tax,and the statutory requirements for disclosure of asset5'and- filing a tax return are still 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 of4ransfers from a.deceased.chiid 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 172 P.S.:§9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5 percent,except as noted in 172 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 F2 RS.-§9116(a)(1.3)]:Asibling is defined, under Section 9102,as an individual who hasat least one parent in common with the decedent,whether by blood or adoption. REV-1508 EX+(08-u) pennsylvania SCHEDULE E to DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERTTANCETAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Hazel R. Calhoun 170-12-983 Include the proceeds of litigation and the date the proceeds were received by the estate. Ali'property jointly owned with right of survivorship must be disclosed on Schedule F. " ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. :Met Life,Annuity,Policy No.: 75611389 19,781.66 y i TOTAL(Also enter on Line S, Recapitulation) $ 19,781.66. .... If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsytvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INMERiTANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Hazel R. Calhoun 21-11-0573 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. r B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State`ZIP Year(s)Commission Paid:_ 2. Attorney Fees: 2,100.00 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State_ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: " 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 4,Recapitulation) ; 2,100.00 If more space is needed,use additional sheets of paper of the same size.