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Home My WebLink About02-10-14 (2) 1505610140 REV-1500 EX (01.10) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN �I I q I a Harrisburg,PA 17128-0601 RESIDENT DECEDENT CJI ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 0 0 9 2 0 1 3 1 2 1 1 1 9 2 0 Decedent's Last Name Suffix Decedent's First Name MI K R E I S E R J E A N N E (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 ❑ 1.Original Return 2.Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 4. Limited Estate 4a.Future Interest Compromise(date of El 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate 7.Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9.Litigation Proceeds Received 10.Spousal Poverty Credit(date of death 11. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D A V I D D - N O O N E S Q U I R E 5 7 0 2 8 6 7 7 7 7 REGISTER OF WILLS USE ONLY First line of address 2 4 0 - 2 4 6 M A R K E T S T R E E T Second line of address City or Post Office State ZIP Code DATE FILED S U N B U R Y P A 1 7 8 0 1 Correspondent's e-mail address: 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 complet .Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG T E O P ESPONSIBLE FOR FILING RETURN DATE .� �- /y ADDR S 1441 KUHN ROAD BOILING SPRINGS PA 17007 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 240-246 MARKET STREET SUNBURY PA 17801 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 Continuation of REV-1500 Inheritance Tax Return Resident Decedent JEANNE KREISER Decedent's Name Page 2 File Number Correspondents Name Daytime Telephone Number D AV I D D NO ON , E S Q U I RE 5 7 0 2 8 6 7 7 7 7 First line of address 2 40 - 2 46 MARKET STREET Second line of address City or Post Office State ZIP Code S U N B U R Y P A 1 7 8 0 1 Correspondent's e-mail address: 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 a d complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF ERSON RESPONSIBL FO FILIN E N DA � � I ADDRESS 2722 S. ROSEGARDEN BLVD MECHANICSBURG PA 17055 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: J E A N N E K R E I S E R 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 and Notes Receivable(Schedule D) . . . . . . . .. . . . . . .. . . . . . . . .. . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7 2 9 2 . 7 0 7. Inter-Vivos Transfers&Miscellaneous NO-0-Probate Property (Schedule G) Separate Billing Requested . . . . . . . 7. 8 6 1 9 4 . 7 0 8. Total Gross Assets total Lines 1 through 7 8. 9 3 4 8 7 . 4 0 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . .. . . . . . .. . . 9. 5 6 2 2 • 9 2 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) . . . . .. . . . . . . . 10. 11. Total Deductions(total Lines 9 and 10) . . . . . . .. . . . . . . . . . .. . . . ... . . . . . . . 11. 5 6 2 2 . 9 2 12. Net Value of Estate(Line 8 minus Line 11) . . . .. . . . . . . . .. . . . . . . . . . . . . . . 12. 8 7 8 6 4 . 4 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . .. . . . . . . . .. . . . . . 13. 0 . 0 0 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . .. . . . . . .. . . . . . 14. 8 7 8 6 4 . 4 8 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x.045 8 7 8 6 4 . 4 8 16. 3 9 5 3 . 9 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . .. . . . . . .. .. . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . .. . . . . 19. 3 9 5 3 . 9 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 L 1505610240 1505610240 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 0 0 DECEDENT'S NAME JEANNE KREISER STREET ADDRESS 770 SOUTH HANOVER STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1- Tax Due(Page 2,Line 19) (1) 3,953.90 2. Credits/Payments A.Prior Payments B.Discount 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. Fill 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) 3,953.90 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; ...................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ IZI c. retain a reversionary interest;or ................................................................................................ E3 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?.................................................................................................. ❑ 0 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 surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(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)(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(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-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JEANNE KREISER 0 0 If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Susan K. Lehmer 2722 S. Rosegar en Blvd Daughter Mechanisburg, PA 17055 B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 7/28/06 Savings account number ending in 8589 @ Citzens 11,466.68 50. 5,733.34 Bank 2. A 7/28/06 Checking account number ending in 602-8 @ 3,118.71 50. 1,559.36 Citzens Bank TOTAL(Also enter on Line 6,Recapitulation) $ 7,292.70 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JEANNE KREISER 0 0 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. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THETRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Savings account number ending in 712-5 @ Citzens Bank. The account was opened on June 7, 2013 in the name of the decedent and her son, Stephen K. Kreiser 70,194.70 100.00 70,194.70 Principal: $70,180.66 Accrued Interest: $14.04 2. The decedent gifted to her son, Steven K. Kreiser, the 10,000.00 100.00 3,000.00 7,000.00 sum of$10,000.00 on June 7, 2013 3. The decedent gifted to her daughter-in-law, Linda 4,000.00 100.00 3,000.00 1,000.00 Kreiser the sum of$4,000.00 on June 7, 2013 4. The deceden gifted to her daughter, Susan K. Lehmer 5,000.00 100.00 3,000.00 2,000.00 the sum of$5,000.00 on June 7, 2013 5. The decedent gifted to her son-in-law, James Lehmer 5,000.00 100.00 3,000.00 2,000.00 the sum of$5,000.00 on June 7, 2013 6. The decedent gifted to her grandson, Charles Bishop 5,000.00 100.00 3,000.00 2,000.00 Kreiser the sum of$5,000.00 on June 7, 2013 7. The decedent gifted to her grandson, Stephen Bishop 5,000.00 100.00 3,000.00 2,000.00 the sum of$5,000.00 on June 7, 2013 TOTAL (Also enter on Line 7,Recapitulation) $ 86,194.70 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JEANNE KREISER 0 0 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, Myers - Hamer Funeral Home - funeral services 3,853.00 2. Gingrich Memorial -memorial inscription 165.00 3. Mechanicsburg Cemetery- grave opening 409.92 4. Snappers - funeral luncheon 660.00 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: Wiest, Muolo,Noon, Swinehart& Bathgate 500.00 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. Cumberland County Register of Wills - inheritance tax return filing fee 15.00 8. Notary fees 20.00 TOTAL(Also enter on Line 9,Recapitulation) $ 5,622.92 If more space is needed,use additional sheets 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: JEANNE KREISER 0 0 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Susan K. Lehmer Lineal 2722 S. Rosegarden Blvd Schedule F & G Asset Mechanicsburg, PA 17055 2. Stephen K. Kreiser Lineal 1441 Kuhn Road Schedule G assets Boiling Springs, PA 17007 3. James Lehmer Lineal 2722 S. Rosegarden Blvd Schedule G asset Mechanicsburg, PA 17055 4. Linda Kreiser Lineal 1441 Kuhl Road Schedule G asset Boiling Springs, PA 17007 5. Charles Bishop Lineal c/o Susan Lehmer 2722 S. Rosegarden Blvd Schedule G asset Mechanicsburg, PA 17055 Lineal 6. Stephen Bishop Lineal c/o Susan Lehmer Schedule G asset 2722 S. Rosegarden Blvd ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. I.I. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. None 0.00 B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. None 0.00 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, S 0.00 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent JEANNE KREISER Decedent's Name Page 1 File Number Schedule J -Beneficiaries -1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outri ght spousal distributions and transfers under Sec.9116(a)(1.2).] Mechanicsburg, PA 17055 Lineal H105.805 REV(9/11)