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Home My WebLink About02-07-14 REV-1500 EX(02-11) 17 1505610143 PA Department of Revenue Pennsylvania USE ONLY p Penns Ivania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 13 0676 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 05 15 2013 02 14 1925 Decedent's Last Name Suffix Decedent's First Name MI SMITH SR LEMAR K (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI SMITH HELEN J Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X❑ 1. Original Return 2. Supplemental Return 3. Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required (date of death after 12-12-82) g Decedent Died Testate 7. (Attach Copy of Tn sd)a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) p V El 9. Litigation Proceeds Received 10.Sgous nPo 3191 r dit(Datte f Death 11.Election to tax under Sec.9113(A) i (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ;a rq EDWARD P SEEBER 71' 33 3280 m cc-5 REG§TEXCPVILLS USE�0,NP1 r. ? 171 -J ;X3 First Line of Address IA r"1 1 SUITE C400 -;:-= C> -r} c7 `= t` ' F Fst Second Line of Address t s f-- Q 555 GETTYSBURG PIKE ti � . DATE FILED City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's e- ad ress: epsajsdc.com Under penalties of jury,I d961are that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct d comple .Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O ERSON R P SIBLE FOR FILING RETURN DATE Lemar K. Smith[Jr. ADDR S tl 25 GrinneoriveDlOarrlp HiIIEPA 17011 SIGNATUR�OREPARER OTHER THAN REPRESENTATIVE DATE Edward P Seeber ADD -40 0❑555 Gettysburg Pike ENIechanicsburg EPA 17055 Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Smith, Lemar K. Sr. 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&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 16, 449 . 56 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�Probate Property (Schedule G) Separate Billing Requested............ 7. 2 ,595 . 00 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 19, 044 . 56 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 8 , 662 . 42 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 3 , 377 . 71 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 12 , 040 . 13 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 7 , 004 . 43 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 7 , 004 . 43 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 .7 , 004 . 43 15. 0 . 00 (a)(1.2)X.00 16. Amount of Line 14 taxable 0 . 00 16. 0 . 00 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE.........................................:...................................................................... 19. 0 . 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-13-0676 Decedent's Complete Address: DECEDENT'S NAME Smith, Lemar K. Sr. STREET ADDRESS 765 Pennsylvania Avenue CITY STATE ZIP Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2CLine 20 to request a refund 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 WILLSOAGENT. 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;.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ ❑x d. receive the promise for life of either payments,benefits or care?...................................:........................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑x ❑ 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.......:.......................................................................................................... ❑ ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESCYOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. A, 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[72 P.S.§9116(a)(1.1)(i)]. , 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 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt 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 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)(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[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-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE p p p INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Lemar K. Sr. 21-13-0676 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank Checking Account No.9856525770-valued per letter dated 712/13 , . 16,449.56 TOTAL(Also enter on Line 5, Recapitulation) 16,449.56 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE ■■ INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Lemar K. Sr. 21-13-0676 This schedule must be completed and filed if the answer to any of questions 1.through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND INTEREST THE DATE OF TRANSFER. ATTACK A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET (IF APPLICABLE) VALUE 1 Auer Cremation Services of PA,Inc.-prepaid funeral 2,595.00 100.000% 0.00 2,595.00 and cremation services TOTAL(Also enter on Line 7, Recapitulation) 2,595.00. (If more space is needed,additional'pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form.PA-1500 Schedule G(Rev.08-09) REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE' FUNERAL EXPENSES AND, RESIDENT DE EDEN TURN ADMINISTRATIVE RA 1 IVE COS 1 S RESIDENT DECEDENT ESTATE OF FILE NUMBER SmithElLemar K. Sr. 2143-0676 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 3[020.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(s)Commission Paid 2., Attorney's Fees JSDC Law Offices 11250.00 3: Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 31500.00 Claimant Helen J..Smith Street Address 765 Pennsylvania Avenue city Lemoyne State PA ZiD 17043 Relationship of Claimant to Decedent _Spouse 4. Probate Fees 138.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 253.92 See continuation schedule(s) attached TOTAL(Also enter on line-9ERecapitulation) 81662.42 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Smith, Lemar K. Sr. 21-13-0676 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exl2enses 1 Auer Cremation Services of PA, Inc. -funeral and cremation services 3,020.00 H-A 3,020.00 Other Administrative Costs 2" Cumberland County Law Journal-estate notice publication fee 75.00 3 The Sentinel-estate notice publication fee 178.92 1-1-137 253.92 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1513 EX+(01-10) pennsylvan.ia SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES p c INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Lemar K. Sr. 21-13-0676 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S)RECEIVING PROPERTY (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Helen J.Smith Spouse 100%of the 7,004.43 765 Pennsylvania Avenue residue Lemoyne, PA 17043 Total 7,004.43 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS,ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)