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Home My WebLink About06-11-14 � 1505610105 REV-1500 EX(oz-ii)(FI) � OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes �INHERITANCE TAX RETURN � PO BOX z8o6oi RESIDENT DECEDENT Harrisbur ,PA i i28-o601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 08/22/2013 03/25/1922 DecedenYs Last Name Suffix DecedenYs First Name MI Slotten Martha C (If Applicable)Enter Surviving Spouse's Information Below MI Spouse's Last Name Suffix Spouse's First Name Spouse's Sociai Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW p 1.Original Return � 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) p 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) � 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.) p 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O ��' Attach Schedule O)r Sec.9113(A) Between 12-31-91 and 1-1-95) � CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Taylor P.Andrews, Esq. (717) 243-0123 REGISTER OF WILLS USE ONLY �> � � � C= G7 � � � First Line of Address �� r,:a � C r-� p 78 W. Pomfret St. � ' =�= `�' '� ` ' "�' - � . ;._ _; ,�� Second Line of Address t ' , �""' � �� ,, �-; C a _ • _ , :s c;) DATEr, 6D) D '�1 �'1 City or Post Office State ZIP Code - �� c�� t:�; ;,..: Carlisle PA 17013 �J � � �;�_ rn ;.�• N tn � O � Correspondent°s e-maii adaress: tpandrews@pa net 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 We,correct and complete.Declaration of preparer other than the personai representative is based on all information of which preparer has any knowledge. � DATE SIGN URE OF PERSO RESPO E F R FILING RETURN DDR � 1337 Ge town Ci le, Car� , PA 17013 HE ENTATIVE � /�} E v S 7 . Pomfret St., Carlisle, PA PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 ,�,� � 15056102D5 REV-1500 EX(FI) DecedenYs Social Security Number 279-12-3657 DecedenYs Name: Martha C. S�Otten RECAPITULATION 0.00 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. 0.00 4. Mortgages and Notes Receivable(Schedule D) . . ... ......... . .. . .... ..... 4. 5,119.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). ..... . 5. 0.00 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . .. ... . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 0.00 (Schedule G) O Separate Billing Requested..... . .. 7. ..... ..... .. . s. 5,119.00 8. Total Gross Assets(total Lines 1 through 7).......... . .. ... . . .... ... . .... . 9. 5,265.00 9. Funeral Expenses and Admmistrative Costs(Schedule H)... ... 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). .. ..... ..... .. 10. 282.00 11. Total Deductions(total Lines 9 and 10). ..... .. . ....... . .. .. . .... . .. ... . ��. 5,547.00 . . ... .... . .. .. . .. 12. -428.00 12. Net Value of Estate(Line 8 minus Line 11) . . ... .... ... . 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which 0.00 an election to tax has not been made(Schedule J) ....... .. . .. . .... . .. .. . . 13. -428.00 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 0.00 15. (a)(1.2)X.0_ 16. Amount of Line 14 taxable -42$.00 16. -19.00 at lineal rete X.0 45 17. Amount of Line 14 taxable 0.00 17. at sibling rate X.12 18. Amount of Line 14 taxable 0.00 �g. at collateral rate x.�5 -19.00 19. TAX DUE ...... ..... ....... ... ........ ........ .. . .. ....... . .... . .. 19. 20. FILL IN THE OVAL�F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � L 15056102�5 15056102�5 File Number REV-1500 EX(FI) Page 3 Decedent's Complete Address: DECEDENT'S NAME Martha C. Slotten STREET ADDRESS 1337 Georgetown Circle STATE ZIP �iTy pq 17013 Carlisle Tax Payments and Credits: �� -19.00 1. Tax Due(Page 2,Line 19) 2. CreditslPayments 0.00 A.Prior Payments B.Discount 0.00 0.00 Total Credits(A+B) (2) 3. Interest �3) 0.00 4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. �4' Fill in oval on Page 2,Line 20 to request a refund. �5) -19.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRsATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred.......................................................................................... � : b. retain the right to designate who shall use the prope�ty 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. 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 �tatut d es not exempt a transfer o a surviv ng spouse from taxe and the statutory requ�ements for ds closure of assets and [72 P.S.§9116(a)(1.1)(n)].The s filing a tax retum 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 f the ch Idr snOfeer enm[72 P.S.§916(a)(1?2)]years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent o P . 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. SCHEDULE E CASH,BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY FILE NUMBER ESTATE OF 21-13-0947 Martha C. Slotten 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 VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1 Federal Income Tax refund received in May 2014 $4,065.00 2 Gross receipts of sale of furnishings from home $1,054.00 liquidator: Rowe's Auction Service received Apri125,2014 TOTAL(also on line 5,Recapitulation) $5,119.00 SCHEDULE H FLJNERAL EXPENSES,ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES FILE NUMBER ESTATE OF 21-13-0947 Martha C. Slotten Debts of decedent must be reported on Schedule I. AMOLTNT ITEM DESCRIPTION NUMBER p. Funeral Expenses: 1 2 g. Administrative Costs: 1 Personal Representive Commissions Name of Personal Representative(s) Social Security Number of Personal Representative: Street Address: City: State: Zip: Year(s)commissions paid: 2 Attorney fees to Andrews&Johnson 3 Family Exemption Claimant Street: City: State&Zip Relationship of Claimant to Decedent: Daughter 4 Probate Fees to Register of Wills 5 Accountant Fees to Patricia Rosendale,CPA ( Tax Return Preparer's Fees '7 $369.00 g Sales Commission to Rowe's Auction Service 9 10 Expenses related to sale of 1337 Georgetwon Circle: $4,125.00 11 A&A Painting $57.60 12 Herman Plumbing repairs $g'7.00 13 Margaret Sebelewski Landscaping $360.00 14 Argent Company-Basement and garage repairs $137.00 15 A&A Company-window and other small repairs $129.00 16 Tuckey's-Furnace cleaning and servicing 17 18 19 $5,264.60 TOTAL(also on line 9,Recapitulation) SCHEDULE I DEBTSOFDECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,including unreimbursed medical expenses. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH Pa Dept of Revenue-Pa 40 for 2013 $282.00 TOTAL(also on line 10,Recapitulation) $282.00