HomeMy WebLinkAbout04-01-14 (2) J 1505610105
REV-1500 EX 02-W(F"
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes County Code Code Year File Number
PO BOX28o6D1 INHERITANCE TAX RETURN
Harrisburg PA 17128-0601 RESIDENT DECEDENT a�{
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
02128/2031 08/29/1922
Decedent's Last Name Suffix Decedent's First Name MI
Bell--Revised Mrs Ann M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouses First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE PILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
C=) I.Original Return (AD 2.Supplemental Return C=) 3. Remainder Return(Date of Death
Prior to 1243-82)
O 4.Limited Estate O 4a.Future interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12.12-82)
COD 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Sate Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O S.Litigation Proceeds 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 Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTLo:
Name Daytime Teteptic"Number s M
David J Bell (717)737-67�il(D o
REGISTE0 t Q SE ONLY M
r.. Z
In
U! C>
First Line of Address 'n
O nO � n -n
430 Allendale Ways T m
Second Line of Address ~O O
D CO
City or Post Office State ZIP Code DATE FILED
Camp Hill PA 17011
Correspondent's e-mail address:jefun @aol.COm
Under penalties of perjury,I declare that I have examined this mtum,Including accompanying schedules and statements,and to the best of my knowledge and belle(,
It is We,oa ect and oompmte.Declaration of proparer other than the personal representative is based on all information of which proparor has any knowledge.
SIGNAT E OF PERSQN PO D R Ft iNG RN DATE
S
o �n Af o
SIGNATURE OF PREPARER OTHER THAN REPRE&&AT DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: Ann M. Bell
RECAPITULATION
1. Real Estate(Schedule A). ..... .................. ..................... 1 124,540.00
2. Stocks and Bonds(Schedule B) ........... Z
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)....... S. T 304,899.19
6. Jointly Owned Property(Schedule F) C=) Separate Billing Requested . &
T Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines I through 7) S. 429,439.19
9, Funeral Expenses and Administrative Costs(Schedule H)............. ...... 9. 23,940.00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10.
11, Total Deductions(total Lines 9 and 10)................................. %
12. Not Value of Estate(Una 8 minus Line 11).,.................... ... 12. 405,499.19
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made(Schedule J) ..... .......... .. .... 13.
14. Not Value Subject to Tax(Line 12 minus Line 13) ....... .......... 14. 406,499.19
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under See.9116
(a)(1.2)X,0_
16, Amount of Line 14 taxable
at lineal rate X.0 45 18,247.46 18. 18,247.46
17. Amount of Line 14 taxable
at sibling rate X.12 17,
18, Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE ............ ............... ...... 19. 18,247.46
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=:)
Side 2
1505610205 1505610205
REV-1500 EX(Fl) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Ann M Bell
STREET ADDRESS
1501 Simpson Ferry Rd
CITY STATE ZIP
New Cumberland PA 17070
Tax Payments and Credits:
1. Tax Due(Page 2,Line A) (1) 18,247.46
2. Credits/Payments
A Prior Payments 15,900.00
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) 2,347.46
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income............................................ ❑ E
c. retain a reversionary interest.............................................................................................................................. 11 ■
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ N
2. If death occurred 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 account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑ E
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 dales 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-iSoB EX+(oS-iz)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERrTANCE TAX RErURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: / HUMMER:
Ann MBell
Include the proceeds of litigation and therdate the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, Transfer of funds from her sisters estate—Revision 52,153.19
2 House(see attached) 124,540.00
3 Savings 221,650.00
4 Checking 21,920.00
5 Car 2,601.00
6 Truck 1,575.00
7 Personal property 5,000.00
Ind:Clothes,fumature,Tools yard supplies ect.
TOTAL(Also enter on Line 5, Recapitulation) $ 429,439.19
If more space is needed,use additional sheets of paper of the same size.