HomeMy WebLinkAbout12-11-13 � r
� 1505610105
REV-i 500��oz_��>���
PA Depa�tment of Revenue P��Y��a� OFFICIAL USE ONLY
��TM�*��N� County Coc� Year Fie Number
Bureau of Individual Taxes INHERITANCE TAX RETURN '"�" J�
� � Po Box z8o6oi � � __�_� ;�_____._.__�. w_.._�
Harrisbu PA 1 �28-060� RESIDENT DECEDENT I f / � V Q i
ENTER DECEDENT INFORMATION BELOW
Sodal Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_....____________ .._._.__ __.__._ _.._
_. __.�___ ___.__
�._ ._ ._ �_ _._...__.___.__._____._._�___._____.___..___.,
_ . _� _
� � 09/11/2012 ! �02/22/1928 ;
�._...._____________.�___..�.___��..._�.�....r _� _.._.� � !_._ _...� __.__....�
DecedenYs Last Name Suffix DecedenYs First Name MI
� �____r_ �, __.___.f
SUTTON ! ; � � PATRICIA � �q;
___._. ___�.€ �___.__._____.�.__ __.._____. ____ _.F___ _.�_._�._�________.___._____.______.� y
(If Applicable)Enter Surviving Spouse's information Below �
Spouse's Last Name Suffix Spouse's First Name MI
�____._____.�_�_.__.._._______ _________.._._ _._.____ _.____._�..____.
.__ ___._.___.___...� _ �. _ __ ___�_
___�__�--� ,
�
E � � �
; � ' ? �
: _ ...___.._ � = i �.,_.
._...._. _..__.__ ._ .____ _--...�. _� �
_. . . _ .._�..... ._._. __ �.
_._ __,
��.___._.,_____- --...� ._.__._w___.__.___.__________._.._.__.
Spouse's Sacc:fai Secur�ty Number
�___.___. _._._____.._____._..____ -� THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
i ___�.._.� REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Retum p 2.Supplemental Retum p 3. Remainder Retum(Date of Death
' Priorto 12-13-82)
O 4.Limited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Retum Required
death after 12-12-82)
� 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Totai Number of Safe Deposit Boxes
(Attach Copy of�II) (Attach Copy of Tn�st.)
O 9.Li�gaation Prooeeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Sd�edule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone N mber
. . . �_____ _�_______._____�.�_,,�...___�.`_.____.__�
_ _� _ �____ �.._ _.,_ _.
i ROBIN ROWE WILLIAMS � (41��'3 1-6467 ,�; � �"
,
f .,...._.____.__._. _____ �._.�.._ � � s
_�.�.__.._.._..� _ __.. �... _ . __ __- - -,___. ___.____ ____.
_--___ �=o�o�_ � _
� � � � � �
First Li�e of Address � � � � t�
__._.________..�______._,. __._.._ .._�_.._ �.__.__.._. __.. ��_. ..�_._ . _ _. _._._ � .___._ w__ _.___._� „
'309 DIXIE DRIVE � � � a --� � ..a'n
Second Line ofAddress �.�__.�._._ ___ .,.�....___�__ .._ _____.___..�..._.�.�____.. � � -r�. � ,,,,,� '�r�
j ...__,..W...__.......,,.,,., . ...__,._,.. . .��_.�..._........w................................... ._.. • � �� wr �
. - .. � � � � � .
;_._..________.__.�__�_.___..�_..�.�_.__ _.__.__.________.,_____.__._..__�._.________._____._ __..___. _.w�.__...______. D I�E
City or Post Office State ZIP Code
��___w__�__.�._____��.__.__.�.�.__...__--, , _� . ._._____ _._.____. ______... :_______�._____._._..,
; �
�TOWSON i � MD � �21204 ,
:. .....,..__ ___�._.__.� ..�.____. __.. �� F � � .
�
; ,
Cornsspondent's e-mail address:rerwilliams@gmail.com
UrKier penalti�of perjury,I dedare fhat I have examined thls return,induding aa�mpanying schedules and statemer�,and to the best of my knawledge and belfef,
ft is true a oomplete. ra�on of preparer other than the personal representative is based on all informatlon of which preparer has any kno�wledge.
StG� SON R SIBLE OR LIN N " DA
. .� �... �
ADDRESS
309 DIXIE DRIVE, TOWSON, MD 21204
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEA8E U8E OR161NAL FORM ONLY
Side 1
� 1505610105 1505610105 J
.
� �
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
t__._____�.___..__._�.._.�_.___...___._.._��.___....._.__�___...__,
'
oecedent's Name: PATRICIA A. SUTTON � ;
RECAPITULATION
,
1. Real Estate(Schedule A). ............................................ 1. 0.00 '
�e w.,��...o.�, .a� - ,...s
2. Stocks and Bonds(Schedule B) ....................................... 2. � 0.00 '
(..�,e.,�.y_�...w�.�.�.....�...�.,,�..�..a.,�..�.,p.,.�....�
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. � 0 00 ;
� �° �
.
4. Mortgages and Notes Receivable(Schedule D)........................... 4.�� ��� 0 00 ;
�..�,.�.,��...��.�..�..�,�.,�,.�...,,.�,.,...._�.�
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 6,732.00 �
�..,.�.�..,..,�.�.,,�.�..�,.. �..
6. Join�y Owned Property(Schedule F) O Separate Billing Requested ....... 6. 0.00 ;
7. Inter-Vivos Transfers 8�Miscellaneous Non-Probate Property ����`�� �""�"`�"�'
(Schedule G) O Separate Billing Requested........ 7. � 0.00 '
{���.�._a.���.�u�..wm�.�.�.�.�.�.,..���.��
8. Total aross Assets(total Lines 1 through 7)............................. 8. � 6,732.00 j
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. � 1,278.00 �
�.�.�.�.,.�.�.,...��.�,.��
� �
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. � 24,431.00 3
11. Total Deductions(total Lines 9 and 10)................................. 11. 25,T09.00 i
,a�:������ ���
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. ���n.��mM1��w��� 0.00 �
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which �
an elec�on to tax has not been made(Schedule J) ........................ 13. � i
�..,,�,� m.�.�....�.�.�..,..
I �q�
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. � 0.00 '
�
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers underSec.9116 _�____. _..__�__.____..__...� _____ _____ . _.�___ ._., �_.___.___�___.._._.______..__..__�__.___.____ .___._ _._____�,
____ - -
�
(a)(1.2)X.0_ � � � ' 15.�
, �
16. Amount of Line 14 taxable ���d.�.,�.�w_���M.�.b�ri�,.v��,��..��,�.�..��.�..�r..�� ; ,�,..��.�M.,.��� _�..�...�,..,�_._���.k - ��
s
� at lineal rate X.0_ � 16.: � ;
��,�..�...,,r,.M��w.w_.,...� ._u�..�,_�� .._..�..___.,.._�.aH_a��... .xi: ;_...�..,.�,�,�..�,�....A.......�,,..�...�.._��..v_�..�...�._.,.u�x..��...r_._.� ,
17. Amount of Line 14 taxable �
at sibling rate X.12 ` 17.i ;
� 18. Amount of Line 14 taxable �~r��,.ti�.. �_,.��,�.. a �......A_..m��. .,a��ro� ,�v...�.�� �..����.��,��.�,.�_.�..��.�.�,.��...�.�...�.__�.�
at coilateral rate X.15 � � � 1&� �
_ .___,..._.....
�,y,�..�,.,_,,�...,�,.�.,...n,....,.,..,.�,.,�.�..�.�...�..�....�..._Y,..,�_.�.�,.�
� ; a
� 19. TAX DUE............�..............�............................... 19.i__--__ ..�__ _._____.. .,____.__ .._.___.__ �._._.__...._ ._...__. ..,
0 00 �
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
� 1505610205 1505610205 �
1 '
REV 1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDE S NAME
PATRICIA A. SUTTON
STREET ADDRESS
THORNWALD HOME
442 WALNUT BOTTOM ROAD
��N STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
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+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
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: Yes No
a. retain the use or income of the property transferred.......................................................................................... ❑ �
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ �
c. retain a reversionary interest.............................................................................................................................. ❑ �
d. rec�ive the promise for life of either payments,benefits or care?...................................................................... ❑ �
2. If death axurred after Dec.12,1982,did decedent 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?.............. ❑ �
4. Did decedent own an individual retirement acoount,annuit�r or other non-probate property,which
contains a benefiaary d+�signation? ........................................................................................................................ ❑ �
IF THE ANSWER TO AHY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE�AND FfLE tT AS PART OF THE RETURN.
For dates of de�ath�or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or f�the use of the surviving spouse
is 3 percent[T2 P.S.§9116(a)(1.1)(i)].
For dates of death on or afiter Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sun�iving spcwse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The stah�te does notexempt a transfer to a surviving spouse from tax,and the statutory requiremeMs for disdosure of asse�and
filing a tax retum are still applicable even if the surviving spouse is the only beneflaary.
For dates of death on a 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 fa 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 rate imposed on the net value of tr�n.sfers to a fa the use of the deoeder�'s lineal beneficiaries is 4.5 peroent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the dec�leM's siblings is 12 peroent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Secction 9102,as an individual who has at least one parent in common with the deoedent,whether by blood or adoption.
a �
REV'150$EXt(08-12)
pennsylvania SCNEp1�LE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS 81c MISC.
INHERITANCE TAX RETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
PATRICIA A. SUTTON 21-12-1012
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joindy owned with right of survivorship muat be disclosed on Schedule F.
�M VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
,.. . ., _. . . .. __
.�. ,.�. � __ _
. ..,�
�.u.� �,�;a. ,._. .
�.€ {MEMBERS 1 ST FEDERAL CREDIT UNION 6,732.00 .
., a � ..0 v .��e , �
.
s -
�_. � � M � � �
_
,
� _ .... _ 4 � . , .
; _. : � .
._ � 1 ,. � �,. .
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,
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, _
, �
�F
9
..v , f. ��.,:.,, .. , - . ,. � .,_ _ . . . ... . ... , , ' {
.:.. . . 'e� .... ��::_ ... .. .... ... .... .... ...... .._ . . . , . . ,,... .. . •^: : . .. ::
.. . . . , J�.. � '='.y.A: . �.
TOTAL(Also enter on Une 5, Recapitulation) $ �` 6,732.00 ''
If moFe space is needed,use additional sheets of paper of the same size. '
� REV-1511 EX+(08-13)
f pennsylvan�a SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DKEDENT
ESTATE OF FILE NUMBER
PATRICIA A. SUTTON 21-12-1012
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. � � FUN�RAL.E�PENSES.� �_. . e .. � _ _. ��.. ���xt�.,
L . _ _
:AUER CREMATION SERVICES 249.00 '
�..._a.___� � ._�,. ,� _.��... ,. �.., �
�GINGERICH MEMORIALS � � �597.00 '
B. ADMINISTRATNE COSTS:
i. Personal Representative Commissions: 335.00
Name(s)of Personal Representative(s) ROBIN R WILLIAMS ' °
Street Address 309 DIXIE DRIVE
City TOWSON State MD ZIp 21204
Year(s)Commission Paid: 2013
2. Attomey Fees:
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
� � � �.�r,., .. .
4. Probate Fees: 97.00.
�. : .�
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. � � _. �
TOTAL(Also enter on Une 9, Recapitulation) $
� 1,278.00
If more space is needed,use additional sheets of paper of the same size.
♦ � •
REV-1512 EX+(12-12)
� pennsylvania SCHEDULE I
D�aAR�rr,EnrrOFREVENUE DEBTS OF DECEDENT,
INHERITIWCE TAX RETURN MORTGAGE LIABILITIES �LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
PATRICIA A. SUTTON 21-12-1012
Report debta incurred by the decedent prior to death that remained unpaid at the date of death,including unreimburaed medical expensa.
�M VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
. _,_ . , . �
. _ v��� � ___...� ,
1.
:THORNWALD NURSING HOME(FINAL RENT) 1,510.00 �
2. �MILLENIUM PHARMACY(FINAL PM� � � 19.00 ���
� �� 3.��� iPA DEPT OF PUBUC WELFARE 22,902.00 �
: .
__ __ ; o ..,
_
; , _ �. .
� . . . -��
; �. �F �: . .�, z.. ���
_ _. . ,
.„ a
� _.. . . � � ,��-
� .
�, �� ���, ��. - ..
�
�-� � :�... �
TOTAL(Also enter on Une 10 Reca itulation 24,431.00 =
►
p ) # �
If more space is needed,insert addiqonal sheets of the same size.