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Home My WebLink About03-03-14 � 1505610105 REV-1500 Ex�oz_��>�F�, u OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Count Code Year File Number oEO.w.ME�o�aE�E��E Bureau of Individual Taxes y PO BOX 28o6oi INHERITANCE TAX RETURN � ` /� D f� Harrisburq,PA i�i28-o6oi RESIDENT DECEDENT � � ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ', 12/23/2011 6/13/1990 DecedenYs Last Name Suffix Decedent's First Name MI ' Brouse ' Brian K (If Applicablej 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 DUPUCATE WITH THE _ �cE�iSTER OF Vi/iLLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Return O 2. Supplemental Return p 3. Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. 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 DIRECTED T0: Name Daytime Telephone Number . ...... . . . . . . ._.. . . ..... .. .. . .. . ... . .... . E'.J... Beth G. Cole, Esquire 215-55��99 �' r-- �;�; � REGIS WIILS l�ONL�!'' �3 .�r �' U , �-'`I" � 2:' t°: First Line of Address ��''�- ' w ' � Cl�::- � 1515 Market Street -��- �'. � - �; . . � -� Second Line of Address ��+ � ;.— � Suite 1300 � � �� City or Post Office State ZIP Code DATE FILED Philadelphia PA ' 19102 CorrespondenYs 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 i e,correct and complete. ration of preparer other than the personal representative is based on all information of which preparer has any knowledge. GNA U E OF PERSON R P N IBLE FOR FIL ETURN DAT� � ADDRESS � 5 Queen Avenue Enola PA 17025 I NA U ARER OTHER THAN REPRESENTATIVE DATE . f.. ADDRESS 1515 Market Street, Suite 1300, Philadelphia, PA 19102 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 � , � � � , 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number Decedent's Name: 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. , Q.QQ 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . .. . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. . . . ... 7. ', 8. Total Gross Assets(total Lines 1 through 7). . . .. .. . . . .. . . . .. . . . .. . .. . .. . 8. 9. Funeral Expenses and Administrative Costs(Schedule H). ... .. . .. . . . . . . ... . 9. ' 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). ... .. .... . . ... 10. 'i 11. Total Deductions(total Lines 9 and 10). . ..... .. . .. .. . . .. . . . .. . .. . ... . . . 11. ' 12. Net Value of Estate(Line 8 minus Line 11) . . . .. . .. .. . .. . . . . .. . .. . . . . . .. . 12. 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. ' 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_ 15. " 16. Amount of Line 14 taxable . . . _ at lineal rate X.0_ 16. 17. Amount of Line 14 taxable _ , at sibling rate X.12 17. 'I 18. Amount of Line 14 taxable at collateral rate X.15 18. ' 19. TAX DUE . .. . .. . . . . . . . . . . ... .. . . . . . . .. . . . . .. .. . .. . . . . . . .. . .. . . . .. . 19. i, 0.�� 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1505610205 1505610205 � REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Brian K. Brouse - — --- ----- STREETADDRESS 5_1_6 North 2nd_ Street______ CITY _ _ _ __ __ _ _ _ _ STATE _ _ _ZIP _ . Wormle sbur PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (�) 2. Credits/Payments A.Prior Payments _ B.Discount Total Credits(A+B) (2) 3. inferest (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) Make check payable to: REGISTER OF WILLS, AGENT. ". i� 'i ,.�is' . '�, � .., . �� iv PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE B�OCKS 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. receive the promise for life of either payments,benefits or care?...................................................................... ❑ � 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 individuai retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, � �,jIIRD t "'"°�rv� �im�,��t;�t,� ana az�N .a� r ` v , Q . . �w,�.�ue��`^,t�i�, .. . "�.� tt�' . . . . . , i�i�� .�. . . ,. . .�.� z . ,�j�a ,�Pi ..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 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 antl 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 deceasetl 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. - - _ - Williams Cuker Berezof skv L L C �1515 Market Street C� Woodland Fa11s Mark R.Cuker" Protecting Riglrts for 29 Years Suite 1300 Corporate Center Gerald J.Williams" Philadelphia,PA 210 Lake Drive East Esther E.Berezofsky'i www.wcblegal.com 19102 Suite 101 Beth G.Cole� 215.557.0099 Cherry Hill,NJ Alan H.Sklarsky' 08002-ll63 Andrew F.Erbar;'� 275.557.0673 fnx Sainuel Abloeser� 856.667.0500 Kevin Haverty"' 856.667.5133 fnx Maria C.Janoski�� February 27, 2014 Josepn a.ventit= Christopher Markosf' Michael J.Quirk'=� Attention: Heidi Warner rMemeer,�en„sy,�a,,;a Ba� x Member,New Jersey Bar Cumberland County-Register of Wills �Me,nee�,��.B�r "Membcr,Wash.,D.0 Bar One Courthouse Square Suite 102 Carlisle, PA 17013 RE: Estate of Brian K. Brouse File No. 2012-00613 Dear Ms. Warner: Enclosed herewith please find original and two (2) copies of completed REV-1500 Inheritance Tax Return form as well as check in the amount of$15.00 in the above matter. Kindly file same and return a time-stamped copy to me in the enclosed self-addressed stamped envelope. If you have any questions,please do not hesitate to contact me. ery ly yours, G. ��E BGC/fl Enclosure r.,..y � �� 1 �-L, _ . � � ,C'� �3 � (� � ��`_� ' �� y l` � -. C.J or- �,_ ,. �c; � ' � ; �- �: - � � � r=r i � -� w �� I taJ ,�C,B Y ��5�.�,,f 2 s = � �� ~ � • ..�i • �}e�t�°� *Certified by the Supreme Court of New Jersey as a Civil Trial Attorney �f��f0 A7'��p��, - �93 �w� !�n� � � � � r � x� nN � �. 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