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Home My WebLink About03-03-05 (2) REV_liOOU+lI4CI) *' OFFlCiAI_ liSt: ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 05 c:;QUNTY C_QP,1: ,(!Ol~fL_ SOCIAL SECURITY NUMBER 0013 NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARThlENT OF REVENUE DEPT. 2801101 HARRISBURG, PA 17126-0601 ~ % W o W U W o -rECEDENr5 NAME (LAST, FIRST, AND MIDDLE INITIAL) , Annentrout, Loy C ~A;~~~~~~::M-DD:YEAR) . n nL~;: ~~ ~';;~:MDD-YEARi '(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 232-26-2010 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 4a. Future Interest Compromise (date 01 death aiter 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) 10. Spousal Poverty Credit (date of death between ;",j'll' """,>W:,~-::n, an,9" 1 ;:~:,w('qf'J> o 3. Remainder Return (d-ate 01 deaii,'prior to 12~13:-82) o 5 Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11.Election to tax under Sec. 9113(A) (Attach Sch 0) , I~ ,. Original Return 0 w ~ 0 0 :w::~cn 4, Limited Estate u"'~ w"g ~ 6. Decedent Died Testate (Attach copy 0 ::r:~...I u.... 01 Will) .. < 0 9. Litigation Proceeds Received 0 2. Supplemental Return ,;,~ ~ffi ",0 0% u~ "",-,- COMPLETE MAILING ADDRESS 5521 Carlisle Pike Mechanicsburg, P A 17050 (1) None (2) None (3) None (4) None (5) 111,228.08 (6) None (7) 193,540.00 Oi'I"IC!At USE ONLY r-"" c:;:;) f.'_~:::l Q'1 , FIRM NAME (II applicable) ~~rens~aw Of!ices,-PC. rELEPHONE NUMBER . 717/697-1800 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ ~ ~ ~ < u w '" 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) c~ 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 0:) 304,768.08 (8) (9) (10) 7,478.38 4,222.08 (11) 11,700.46 (12) 293,067.62 (13) , --i 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 293,067.62 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z ,045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ~ ~ .. 17.Amount of Line 14 taxable at sibling rate 4,500.00 x .12 (17) 540.00 '" 0 u ~ 18. Amount of Line 14 taxable at collateral rate 288,567.62 x .15 (18) 43,285.14 119. Tax Due (19) 43,825.14 ! 20. 0 ~~_1l!II__ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 103 W. Keller Street CITY i STATE PA Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 2,191.26 Total Credits (A + B + C) 3. InteresVPenalty if applicable D. Interest E. Penally TotallnteresVPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. S. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ! ZIP 17055 (1) 43,825.14 (2) 2,191.26 (3) 0.00 (4) (5) 41,633.88 (SA) (5B) 41,633.88 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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; or...... ................................ ....................................... ............................ d. receive the promise for life of either payments, benefits or care?.. ............... ........................... 2. If death occurred after December 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 Account, annuity, or other non-probate property which contains a beneficiary designation?. Ves No ~ ~ ~ 0 o ~ o ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. -. --- --.-.- -- -- Under penalties of pe~ury. I declare that \ 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 E!'9parer other t~~n the_perso~~!.-"~PTes~.Q.~a_~~_is__~ased,on _Cl!li"-f~~~tion of whic~_pr_~PCl~r has ant knowledge SIGNATURE OF PERSON RESPO ISLE FOR FILING RETURN ADDRESS Timothy C eag 103 West Keeler Street Mechanicsburg, PA 17055 ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Thomas . hre ADDRESS 5521 Carlisle Pike Mechanicsburg, P A 17050 DATE 3-1-05 DATE DATE 5-/~o5 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets 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 of transfers from a deceased child twenty-one 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% [72 P.S. 99116 (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%, except as noted in 72 P.S. 99116 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% [72 P.S. 99116 (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. '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY CQMMONWCAl,. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT -- ---....---- --, ------ --- ...--- ---, ESTATE OF Annentrout, Loy C FILE NUMBER I 21-05-0013 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinl/y-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 106.883.88 M & T Bank checking account # 8892311864 2 PNC Bank checking account # 50-0360-6705 4,344.20 TOTAL (Also enter on Line 5, Recapitulation) 111,228.08 '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Armentrout, Loy C FILE NUMBER 21-05-0013 ITEM NUMBER u}hls schedule Ill"st be completecl.and Wed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH: % OF Include the name of the transferee, their relal10nshlp 10 decedent and the dale of transfer : DECO'S i EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate VALUE OF ASSET INTEREST I (IF APPLICABLE) 1 i985-Chevr~l~tPUT';;~k transferred within 1 year of death i to Timothy & Elenita Yeager ' 2 1956 Dodge dump truck transferred within 1 year of death to Timothy & Elenita Yeager (not running) i Cash gift to Timothy Yeager within I year of death (3/25/04) 3 4 Cash gift to Elenita Yeager within 1 year of death (3/25/04) 5 ,Transferof633 Old Grove Road, Mechanicsburg, PA, Tax I' Parcel # 42-25-0032-052 to Timothy & Elenita Yeager within 1 year of death 500.ooi 100% 500.00 200.001 100% 200.00 I 80,500.00 100% 3,000.00i 77 ,500.00 I 1 80,500.00 100% 3,000.001 77 ,500.00 37,840.001 100% ! 37,840.00 TOTAL (Also enter on line 7, Recapitulation) 193,540.00 *' SCHEDUI.E H F\.JIIERAL EXPENSES & A[MNSTRA11VE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Armentrout, Lay C 'FILE NUMBER 21-05-0013 Debts of decedent must be reported on Schedule I. ---ITEM-I- DESCRIPTION NUMBER I -- - -----..- ---- A. : FUNERAL EXPENSES: I Additional funeral bill not covered by pre-paid plan 2 Funeral luncheon I Memorial marker ! 3 B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State _ Zip 2. Attorney's Fees Ahrens Law Offices 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zip 4. City Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees Tax preparation 7. 1 Other Administrative Costs Misc. administrative costs 2 Estate notices in The Sentinel and the CC Law Journal Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) AMOUNT i ! ! I I 251.00 336.72 978.38 5,000.00 402.00 130.00 185.92 179.36 15.00 7,478.38 *' Schedule H Fu1eraI E"Jq:lens e s & Adnlinil;balive Cos1s COI'1ti'Uld COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT -- ---..-- ---- --- --- - ESTATE OF Annentrout, Lay C I FILE NUMBER 2]-05-00/3 --r- -"--- -- ..-- 3 . Inheritance tax filing fee 15.00 Page 2 of Schedule H ESTATE OF *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Armentrout, Loy C I FILE NUMBER I 21-05-0013 Include unreimbursed medical expenses. ITEM NUMBER I Quantum Imaging 2 3 4 5 DESCRIPTION Internist of Central P A Ambulance Final Seidle Skilled Nursing bill Federal Income Tax due for 2004 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 410.40 329.06 144.12 3,175.50 163.00 4,222.08 REV.1513 EX. (9.00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _m____ ESTATE OF Annentrout, Lay C I FILE NUMBER 21-05-0013 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Na1List Truatee(s) I Brother AMOUNT OR SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Hannon Annentrout ,3701 N. Point Road, Dundalk, MD 21222 i , 1,000.00 2 Clyde Annentrout I PO Box 849, Franklin, WV 26807 3 1 Shirley Ours I HC 33 Box 2008, Dorcas, WV 16847 ! Brother 1,000.00 4 i Timothy C. Yeager 1103 West Keller Street, Mechanicsburg, PA IS' ! lster I Friend 2,500.00 I , Entire residue of Estate , , , !! I Enter doliar amounts tor distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet' II. NON-TAXABLE DISTRIBUTIONS: IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE lB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500COVER SHEET I i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128.0601 REV- 1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT AHRENS THOMAS J ESQUIRE 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 __n.___ lol~ ESTATE INFORMATION: SSN: 232-26-2010 FILE NUMBER: 2105-0013 DECEDENT NAME: ARMENTROUT LOY C DATE OF PAYMENT: 03/03/2005 POSTMARK DATE: 03/02/2005 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2004 NO. CD 005021 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $41,633.88 I I I I I I I I TOTAL AMOUNT PAID: $41,633.88 REMARKS: CHECK# 110 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS