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Home My WebLink About02-0498 o Iv' NO PROBATE REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '. COMMONVVEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-060\ DFrl(:Iti,L liSE ONLY 17-(P5'9 ~ ttev.'__.l'" f ~ Fl..!.NUIfBI!R 21 1/9" COUNTY CODe YEAR SOCIAL SECURITY NUMBER NUMBER OECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) Binningham, Lucy S. 188-14-2714 I ~ DATE OF BIRTH (MU.O[}..YEARf DATE OF DEATH (MM-OD-YEAR) THIS ReTURN IIUST BE FILED IN DUPLICATE WITH THe 09/2111914 02/23/2002 REGISTER OF WILLS -(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER []: 3. Remainder RetUm (date ofdestn priorio 12.13.82) III 1. Original Return Cl 2. Supplemental Return o 4. limited Estate [] 4a. FuMe Interest Compromise (date of death after 12.12.82) o 6. Decedent Died Testate {Attach copy [J. 7. Decedent Maintained a Living Trust (Attach of Witl) copy of Trusl) o 9. Litigation Proceeds Received D. 10. Spousal Poverty Credit (dale of death between 12-31.91 and 1.1-95) c~~~~~.I!IIlE~~,~~~li~~f~~llj~1,I!.~~~1ll3f!,}i{L.. NAME COMPLETE MAILING ADDRESS Dale F Shughart, Jr. Esquire I!! ~U uE" [J: 5. Federal Estate Tax Retum Required o 8. Total Number of Safe Deposit Boxes 0: 11.Election to tax under Sec. 9113{A) (Attach 5ch 0) ...'..0. ... ~_.~ r J 35 E. High Street, Suite 203 Carlisle, P A 17013 (1) None (2) None (3) None (4) None (5) None (6) None (7) 10,756.00 (9) 4,844.00 (10) FIRM NAME (If applicable) TELEPHONE NUMBER 717/241-4311 1. Real Estale (Schedule A) 2. Slocks and Bonds (Schedule B) OffiCiAL U~~E ON!.\' 3. Closely Held Corporation. Partnership or Sole-Proprietorship ,,:0 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o ' Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total G...... AueIa (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) N ~ i 10,756.00 (8) v.; 10. Debls of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) 4,844.00 5,912.00 12. NIIlVslus ofE_ (Line 8 minus Line 11) (12) 13. Charitable and Govemmental BequestsJSec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. NIIl V.lu. SubJect to Tax (Line 12 minus Line 13) (13) (14) 5,912.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate. x .00 (15) or lransfers under Sec. 9116(a)(1.2) ~ 16.Amount of Line 14 taxable at lineal rate 5,912.00 x .045 (16) E 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) 266.04 266.04 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20. 0' "---'-~BE-8URETO ANSWERAU QUi;8i1oN80N REvERaEsfliEAND RECHECKMATH"'- -- __m_._____u Copyright 2000 fonn ...-.. only The 18c:kn11r Group, Inc. Fonn REV-1800 EX (RlIY. WD) Decedent', Complete Addl'llll: STREET ADDRESS ~ 770 Poplar Church Road ;; CITY STATE PA' lIP 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 13.30. Tolal Credits (A + 8 + C) 3. InleresVPenal1y if applicable D. Interest E. Penally TotallnteresVPenal1y (D + E) 4. If Line 2 is greater than Line 1 of- Line 3, enter the difference. This is the OVERPAYMENT. Ch..... box on Pqe 1 Line 20 to '*!uMt. """nd 5. If Line 1 + line 3 is greater than Line 2. enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. S. Enter the total of line 5 + SA. This is the ~CE DUE. (1) 266.04 (2) \3.30 (3) 0.00 (4) (5) 252.74 (SA) (58) 252.74 Make Check Payable 10: REGISTER OF W/U.$, AGENT .~""lI\",a;.-1 11 _..~. ..I'~I tIiF..~1/--;~~..1:' PLEASE ANSWER THE FOLLOWING QUESTIONS BY PlACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: VM No a. retain the use or income of the property transferred:......................................h..................................... 0 JgI b. retain the right to designate who shall use the property transferred or its income:................................ 0 181 c. retain a reversionary interest; or.............................................................h................n..........h............... 0 B d. receive the promise for life of either payments. benefits or care?......................................................... 0 1:8:1 2. If death occurred after December 12. 19B2. did decedent transfer property within one year of death without receiving adequate consideration?..... ...... ....... ........ ....... "'." ..... ...... ..... ...... ........... ...... ....... ............ ...... ........ 0 1:8:1 o IllI o IllI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF. THE RETURN. 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?..... ...... ........ .h.... ....... ...... ..... ...... ..,... ........... "." ...... ....... ...... .................... Under penallies of perjury. I declare that I have examined this relum, jncludin~ accompanying S,Chedules and statements, and to the best of my knowledge and belief. it is true. corred and complefe. Declaration of preparer other than the personal re entative IS based on all Information of whICh pre parer has any knowledge. SIGN~F PERSON ILl G RETURN ADDRESS 5 Cardinal Drive Carlisle, P A 17013 ADDRESS ADDRESS 3 Tanwood Coun CampHill,PA' 17011 35 E. High Street, Suite 203 Carlisle, P A 17013 xi'!< (f& OATE S.-t 1"-0 "'J- cJ;~;l DATE sf; 4/ b 7- For dates of death on or after Jury 1, 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse Is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% {72 P.S. S9116 (a) (1.1) Oi)]. 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 twenty-one 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% [72 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or faf the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .5.99116 1.2)[72 P.S. 99116 (a) (1)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 120/0 172 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 G INTER.VlVOS TRANSFERS & MISC. NON.pROBATE PROPERTY GOMMON'NEAlTH OF PENNSYLVANIA ;:J INHERITANCE TAX ReTURN RESIDENT DECEDENT Birmingham, Lucy S. FILE NUMBER 21 - - ESTATEOF ITEM NUMBER Thle schedule must be completed and tiled If the answer to any of quaatlone 1 through 4 on page 2 Ie yea. DESCRIPTION OF PROPERTY DATE OF DEATH % OF Include the name of the transferee. their relationship 10 decedent and the date of transfer VALUE OF ASSET DECO'S EXCLUSION TAXABLE VALUE A"ach a copy of the deed for fesl estate. INTEREST (IF APPLICABLE) Michael W. Birmingham, son, 5 Cardinal Drive, Carlisle, PA 17013, cash gifts- 61/25/01 - 2,625; 7121101- 2,625; 8/31/01- 2,000. 7,250.00 100% 3,000.00 4,250.00 2 David F. Birmingham, son. 3 Tanwood Court, Camp Hill, PA 17011, cash gifls- 6/25/01 - 2,625; 7/21/01 - 2,625; 8/31101- 2,000. 7,250.00 100% 3,000.00 4,250.00 3 Michael W. Birmingham, son, crealion of one-third survivorship interest in Waypoint Account #100312123, on January 7, 2002, within one year of death. One-half of entire date of death value is therefore taxable. 2,256.00 50% 1,128.00 4 David F. Birmingham, son, creation of one-third survivorship interest in Waypoint Account #1003123, on January 7, 2002, within one year of death. One-half of entire date of death balance is therefore taxable. 2,256.00 50% 1,128.00 TOTAL (A1eo enter on line 7, RecapHulatlon) 10,756.00 ......... ....................... ............ ..o...........................o........ Ac~unt Number 100312123 short Name 3/06/02 14:03:29 BIRMINGHAM, LUCY DDA009LE MINDYAR Waypoint Bank DEMAND - Account Inquiry .. Monetary Activitv . Nbr Debits: 2 Nbr Credits: 2 Bff Date ~ Batch 02/28/02 INT 03/0~/02 ACH 03/0~/02 ACH 03/0~/02 70~ 03/0~/02 70~ Lst Stmt: 2/28/02 Nbr Enclosed: 0 Last Stmt Balance: Current Balance: 2,256.23 2,256.23 Trcd Description Check Nbr 0039 INTEREST PD 0021 US TREASURY 0021 US TREASURY 0060 DEBIT MEMO 0060 DEBIT MEMO Tran Amount ~ ~.11 Y 326.00 215.00 326.00 215.00 Current Bal 2.256.23 2,582.23 2,797.23 2,471.23 2.256.23 F2=Fold/unfold F9_Teller/Memo F3=Exit F4=Field Help FIO=Search/nisplay Opts F7=Non-Monetary Fa=Package Post F12.Previous F13=ACH Inquiry . . .. .. . .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ . . . . . . .. .. .. .. .. .. .. . . ., . . . . .. . . . . . .. . . . . . .. . .. .. . .. VIWayp"ql,pJ Look for us. We.1I get you there. RE:cnPT Acct# TI r# 102 SDDA cioseout TRAN# 4 ON 3/07/2002 3/06/2002 14:12:33 PM Ledger Balance .00 Check and other items rec~i~ed for deposit are Subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays In avalJabllJty according to Bank policy. TEL-DOg (10100) THIS IS YOUR RECEIPT 100312123 2,256.23 Member FDIC /. *' SCIEi1LEH ~ _~~ ..!rITS & ~11\IE\AJD1~ !!" COMMONWEAlTH OF PENNSVlVANI,I, INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF B' . h L S Inmng am, ucy . FILE NUMBER 21 - - Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Parthmore Funeral Home, funeral 3,854.00 2 Greenwood Cemetery, headstone 725.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representalive(s): Street Address City State Year(s) Commission paid Attomey's Fees -- Dale F Shughart, Jr. Esquire Zip 2. 250.00 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Stale Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. 1 Other Administrative Costs Register of Wills, filing Inheritance Tax Return 15.00 TOTAL (Also entsr on line 9, RecepltulsUon) 4,844.00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SHUGHART DALE F JR 35 EAST HIGH STREET SUITE 203 CARLISLE, PA 17013 __nnn fold ESTATE INFORMATION: SSN: 188-14-2714 FILE NUMBER: 2102-0498 DECEDENT NAME: BIRMINGHAM LUCY S DATE OF PAYMENT: OS/21/2002 POSTMARK DATE: 0010010000 COUNTY: CUMBERLAND DATE OF DEATH: 02/23/2002 NO. CD 001197 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $252.74 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DALE F SHUGHART JR CHECK#1749 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $252.74 MARY C. LEWIS REGISTER OF WILLS /"}-66-=- '/ \. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLDHANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER ,': COUNTY ACN 06-24-2002 BIRMINGHAM 02-23-2002 21 02-0498 CUMBERLAND 101 DALE F SHUGHART STE 203 35 E HIGH ST CARLISLE U JR ESQ --1 PA l7.0'J:3 Amount Re..itted '* REV-1547EXAFPC01-021 LUCY S J CHANGED IlJ 12J 13J 14J 15J 16J 17J .00 .00 .00 .00 .00 .00 10.756.00 IBJ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifEV=is4-i-EX-A~:p-foFii2Y-NOT-icE--OF-"fNHEififAifcn:'Ain-PPR1iisEiiEN;:~--ALi-oWAifcE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BIRMINGHAM LUCY S FILE NO. 21 02-0498 ACN 101 DATE 06-24-2002 TAX RETURN WAS: I X J ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate {Schedule AJ 2. Stocks and Bonds {Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable {Schedule OJ 5. Cash/Sank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charltable/Governnental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 19J 1l0J 4,B44.00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 10,756.00 4.844 on 5,912.00 .00 5,912.00 14, lS and/or 16, 17, 18 and 19 will returns assessed to date. .00 266.04 .00 .00 266.04 TAX CREDITS: CH,"<"' l+' AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-J 05-21-2002 CDOO1l97 13.30 252.74 TOTAL TAX CREDIT 266.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 .00 1l1J 1l2J 1l3J 1l4J .00 X 00 = 5,912.00 X 045 = .00 X 12 = .00 X 15 = 1l9J= . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS.J