HomeMy WebLinkAbout05-01-14 � �St]567�C!'�Cl�
�i..�"���� �'JS{42•1T;�F[F
psnnsylva�l�► +����c�������v
PA i}et�rtm�e�t ot Re�aar7ua � :w,s,�� Gaantg C�ct� Ya�r F�e ttusaxt�r
8vts�a�Eteda�ridua{Taa�s ����������.r"��i�� �r���� ^ ( � � 1 �I_
��s��easa���a-�t R��MDEC�7't}E��t?�r+IT �.� �
ENTER�E�Et�ENT INft��t�klA'fF�'ft+i�E1.t�W
Sat�t Secuzity t�umlaer Rat�ot t3sath NI�utQpYYY�' O�ate oi B�tth N�A�D1�'Y1'Y
��� tl4aQ3�'�1t2 �r�l���r`��9
t�+�d+�r�t's L�st t+I�me �uf�ix C3�aedent'a�'irst#�tame M�
SH�P}'�AF�'3} l��AIA�.�t
�C#Appll�abte}�nter�urvivtng Spauae's tr�ormatlon Beictw
Spuus+e's t,ast�larrne Sut�x S#�cusa'�Fir�t idams ��
5pouxe's�octi�al Secur'sty htu�tiber
1"�ItS�E'T'U�tP,S Mt,1ST Et��a1.Et7l�J�UP�ICATE WITH'CFti�
REC�tST��t C�F 1RIILL.�
w"1t.L EN A�'F'RL�PRlA"CE BC3XES��Li�W
� t. {�ina#12atum [�X 2. Sup�em�snt�t Rsturn Q 3 R�mafiaarler�ia�rn(C���at Qaarl�
Ptiqe te9 9i-i3$3j
Q 4. limiitl�!E�ke � 4a, �utuce tnti�rost Gorz�rrart�ise(ctipcto ot � 5. Federat Esfat�Tss�R�tuen Reqtwda�xd
daatlti eft,dt 1�-4�•9�)
(� B, neceses,:piea Ye:sa�a � 7'3 che�ant l�6a#�4sin4d a�iuin�Truxs C1 &, Ta�ar ridumkr�r oa'sare c?e�esEt E�m�as
;nstacH Gapy ot vt+�j EAtt�cn csapy o1 rrvst;) •.�_,.
[� 9. LI#pa�assn Pracesds Recexu�! [� �o. 5 P�y Crasic��a�a ot n�a�e 0 t�. ��a,�r�x ur�s�r Sac.s�gs€r�}
6o�ean 1�-91=41 and 4-t-853 t�tt�ds SeheduCd C1) r� .
c
C�RE�"t�+tt�N"Y-'1Ftis SECTK�Ft MlJSt 8E Ct�tvt,�TEO,All CoFiRES�ti�tG�HC�Att�#G�htFltt£Ni�At.7/Ut�Fii&�ATIt�N gt�tt�SLD�tNl�#S7'�itiz --� :*.7 rn
Narr� t��ytirz�g'Ce�h�Numbs� `,`7 c'�
r� `° � `' c°�
R�?�ERT 6. FREY 717—��—;-�9,§� � 'f .�,;
r° �:
REi�tlB ��T_F W�L �4�I�r�! r-
' � r:'a
�y c�:a � ; -rt,
�ir�t Line ofAddress � � ,.t � --�'
5 �. HAN{}VER �T, � —�-► `v f' r`n
Second line ofAddcess �'. G� � 'o
Ci�y or pcst C?�iae Sµ1848 �I�('vOdB DA't°��kLEC
CAF�l,ZSC.E P� �?0�►�
�rrespo��t'�emata�ddres�. R�'��Ya��'i�EYTxLEY.Ctft1
tMaer pans�n�es or�m+�rry.!eiedaKe tl�t f n�,�e e�+ni�ffed�6s re�uum.U�rs�ttinp accamasrsya+g sctteak,M�s�nd*CU+�ar,�C,sMa sa Rho r,�arst ot my r�ad�e gna�e
it i�4tte .carroct artct Cied�ri�ss 4! Atar�t 3h�aise anaf r�'ka�am 3s haaa�ad as�ie! " t�!wtalc,tt rar�ras nr kratr�vtad. .
5� TU��C}F P ��SPC�S�E'FC�R FILI RM CJA3'�
0�' t
AC?q#tESS
st+��ra c����t ,t�t v�� s��a�r�,xtv� ljr- ton /
�a���
� Y
s s���rt� w�;�r�v�� sr�� ����.zs�� �a �����
��as�us�c��z,����.�o�nn o�r�.�
5t�te 1
� �,5��6�CI�,05 �SCf56I��1[l� �
� 1505610205
�
REV-1500 EX(FI) DecedenYs Social Security Number
DecedenYsName: RONALD SHEPPARD
RECAPITULATION
1. Real Estate(Schedule A). .. . . . . . .. . . . . . . .. .. .. .. . . .. .. .. . . .. . . . . . .. 1.
0 . 00
2. Stocks and Bonds(Schedule B). . . . .. . .. .. . . . . . . .. .. .. .. . . . .. .. ... . . 2.
0 . 00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C). . . 3. � • ��
4. MoRgages and Notes Receivable(Schedule D). . . ... . . . . . .. . . . . . . . . . . . . 4. � •��
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). .. . . 5.
4000D.0�
6. Jointly Owned Property(Schedule F) [�Separate Billing Requested. . . . .. . 6.
o . ao
7. Inter-Vvos Transfers&Miscellaneous Non-Probate Property Q.Q O
(Schedule G) 0 Separate Billing Requested.. .. .. . 7,
8. Total Gross Assets total lines 1 throu h 7 .. . . .. . . .. .. .. .
. . . . . .. . .. .. a. 40000.�0
9. Funeral Expenses and Administrative Costs(Schedule H). . . . .. . . . • • •• •• • • 9•
� soo. ao
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . .. . .. .. . . . .10.
o .oa
11. Total Deductions(total Lines 9 and 10). . ... .. .. .. .. .. . .. .. .. .. ... .. . 11.
50� .00
12. Net Value of Estate(Line 8 minus Line 11) 39500 . 00
. .. .. .. .. . . . ... .. .. . . ... .. .. 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which � . 0 0
an election to tax has not been made(Schedule J). . . . . .. . . .. . .. . . .. . . . . 13.
14. Net Value Sub'ect to Tax Line 12 minus Line 13 . . .. .. . . . .
. .. . . . . . . . . . �a. 39500. 00
TAX CALCUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate,or
transfers under Sec.9116 0 . ��
(a)(1.2)X.0 � 15.
16. Amount of Line 14 taxable 17 7 7� 5�
at�inea�rate x.0 4 5 3 9 5 0 0. 0 0 �s.
17. Amount of Line 14 �� �. ��
taxable at sibling rate X . 12
18. Amount of Line 14 taxable �. ��
at collateral rate X • 15 �8'
19. TAX DUE. . . . . ... .. .. . .. . .. .. . . .. . . . .. .. . . . . . . . ... ... .. . .. .. .... . 19.
1777. 50
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
L, 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number 093-40-2332
Decedent's Complete Address: 21-12-0742
DECEDENT'S NAME
RONALD SHEPPARD
STREETADDRESS
CITY STATE ZIP
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1777.50
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 box 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) 1777.50
Make check payable to REGISTER OF WILLS, AGENT.
� � ; ��{� .��#�� � �� � , R..�.�.�;� ..����..t��`
..�.�`�'� °�'� '' -� ���:��� �� �,��.w t� �� . u,�,������.,��. �.�� ,��. ��,��.��r � ���,� f
4�
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............................................ ❑ ❑
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 individual 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.
sFt� ..,. . :a..::. �.�'�r,.�'e.�5,��^��"'�,}� ���..���.x�..G '..�,,'�a,"��`.i:�a�, s'� i xr'�``i`c.�'���'� ^`�2-'�;:�w ��'.�tt r,�?7 ,�'.°�,�S'�.�.`�z'r.'����„.�*".,a,..Y5 "' ��t#'����"`,e,;:,, i,.
� .,.. ... � �� �"�"�a x,�,c �<+,.., , . , a..� ,.r . 6 x ti. ,'�,v.:�r �3.�"��t:* .+�,�.4
.ae.*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 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 decedenYs 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-1508EX+(08-12) SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENTOFREVENUE pERSONAL PROPERTY
iNHERITANCE TAX RETURN
RESIDENTDECEDENT FILE NUMBER:
ESTATE OF: 21-12-0742
Ronald She ard
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER 40,000.00
1. Life Insurance benefits payable at time of death
TOTAL(Also enter on line 5, Recapitulation) $ 40,000.00
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ronald She ard
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
�, Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State Z�P
Year(s)Commission Paid:
2. Attorney Fees: 500.00
3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State Z�P
Relationship of Claimant to Decedent
4, Probate Fees:
5, Accountant Fees:
g, Tax Return PreparerFees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 500.00
If more space is needed,use additional sheets of paper of the same size.
The PrudPniiai lnsurance Gontparsy af Arnerir.a
� �.�",�.��'�.��.+��. Graiap I.;fie("I�im fliv�su n
f'0 f3i;x f3�17 �t7il�jd�l��hi��,PA 1917fi
"!'el(t3UU)?73-3£i'L'1 I�ax(SYt31'1Z7-U76Q
NTarcl� 26,2,Q!��
ft�Ec:'>hc����ard in:�u�•e:d: C'a;yl ShepJ��jT(�
i'O I3ox Z�iU42 C'c���.trc�l Nu3nber: (f-934i5
Oaklar+cl, (:'A ��<�f�04 t,�aJ�"17 INt1iT1I)�t': (.J.��Z{�C)�
T)F;ar 11!I.r. Ryk �be��ard:
�'e h�ve recei��cd a cl�in�tor Grou}� Life T��su.rts�lce; c3n Cary1 Shep�ard issur.d thx�u�h
C�n1il�onwealth Of Ycnns�'1��a�.1ia in klie asnc�t�nt�t-��0,�00.
�1.t the tirrre c�f t17e Ms. She�p�ra's deaitl, the dcsirn�ted be«cfic:iary was Ranaltt
Slaeppat'd. L;e�ause hc/she diecl a#`tcr Ms. Slieppar�j but t�ef.arc rccc;ivin�; th� pracecds
payal�le for this 1�c�licY, t���i,�t��r�t�5 �����,i�r.n����►c�l.d Shc:ppard's e:;tate.
yV�:'cl like lo niake th��?rocessiri��of this Gt�u�� Life Tnsurance c]aiin as pron�pt an�i
co�i��et�ient f"or vc�u �s pc�ssibie. In pt�der tc� �jo s+�, v��c i�ccc�to xeceit�e the fpllc�win�
docunlent(sj:
s A cNrtitied r,c�py o�f a c;c�urt t�rcl�t ap�c�iY�tin�;�i1 e�e�uto7•t�r a�ln�inistrator of Ronalci
Sl�e��ard'� estat�
• 'I'a�ldc�itiiication N�uYnbe��for t�ic cstate of Konalcl Slieppard
Tn.c;la5ec�is �z s�l��ectdt-cssec�.reti:irra c'.Il'V��()�E'..$()I'VOUI'C()t7��ez�ie.nc.e: Piense incluc3e the
clairn riitrn��er��ot�ci�tbcsv�; c�rz all �;t�rrespc�.nd��i�e to etisuxe titnel�hattdli���. We will
�;lvC t�11S CJatY11 Out`tiTTfnCdtatC att�l�tiOri U�Otl T�CCi�t 0'�Z��T1�CCSSAI'y C�OGU1T1CritS. �'�'e
a}�olo;i�e For any i��co;�vr,�riie�ice; this cl�lay may c:ause y�i�.
We a�preciate tl�e cs��p{�rtttr�itv ta ser�e you. It'you laave at�y c��iestio��.S or w��uid lilce
moc•e ic;foccnation,pl�a.se �.ant��t Cristun�er 5�ivice at(S��} 52���-0�42. If.you �xe calling
fram outsic�e thc lJnitcd.St�tes,you can ciial i3s directl..✓ at (2.1.5) 1��-?8'?3. �Nf:a�•e
ifV�]IJ�f�7I�: .iVI�CiC.��iy thrau��l:i l;rici.�y bet�,��E:e;r�B:OQ��.xs�. ar.tcl f3:(�0 p.z7:i. FaSt�r-ri Tirr�G:
S ir�cet•ely.
C`lairns t;oc�rcli�iFat�x
Personal li+�come Tax e-Services Center S/1/14, 1:05 PM
Penalty and Interest Calculations
CALCULATION DATES-
3/3/13 TO 5/1/2014
TAX DEFICIENCY $ 1,777.50
CALCULATED INTEREST $ 61.80
BALANCE AS OF 5/1/2014 $ 1,839.30
i Start Over ;
https://www.doreservices.state.pa.us/pitservices/Default.aspx Page 1 of 2