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Home My WebLink About08-29-14 REV-1500 EX(oz-u)(FT) 1505610105 1,U OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN -' PO BOX 280601 I ryry�� Harrisburg,PA 17128-0601 RESIDENT DECEDENT �I ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 21891 12/09/2013 03/04/1983 Decedent's Last Name Suffix Decedent's First Name MI Erb I James (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C@D 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) r= 4. Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate C=D 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) r= 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 TO: Name - Daytime Telephone Number Mark F. Bayley, Esq. (717)241=446 �_� M REGI 4RQf WILLS IFMONLb, c-J <n 0 n f N T First Line of Address t_" 1 rn 17 West South Street o Second Line of Address n a -1 Z + <:7 C 7 rV F rri i r City or Post Office State ZIP Code DATE FILED W Carlisle PA 17013 Correspondent's 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 is true,correct aV complete.Declaration of reparer other than the personal representative is based on all information of which preparer has any kno letlge. SI P RS FOR FILING RETUR DATE Q DDRESS 662 Walnu Bottom Rd., Shippensburg, PA 17257 IGNATURE OV PR ARER OTHER THAN R RESENTPTIVE DATE cilc �a.�� CSE B -Z�- l � ( AD RESS 17 West South Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J C/� J 1505610205 REV-1500 EX(Fl) Decedent's 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. 881.00 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. 4,492.01 8. Total Gross Assets(total Lines 1 through 7).. . ..... ........ ............. 8. 5,373.01 9. Funeral Expenses and Administrative Costs(Schedule H)....... .. . . .. ...... 9. 13,233.77 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). ......... ... .. 10. 7,114.40 11. Total Deductions(total Lines 9 and 10).. ............ . ....... ........... 11. 20,348.17 12. Net Value of Estate(Line 8 minus Line 11) . ..... ........ .......... .. . .. . 12. -14,975.16 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. 0.00 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 (a)(1.2)X.0_ 15. 0.00 16. Amount of Line 14 taxable at lineal rate X.0_ 0.00 16. 0.00 17. Amount of Line 14 taxable at sibling rate X.12 0.00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X.15 0.00 18 0.00 19. TAX DUE ........... . ....... . .......... ............... ............ 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME James Michael Erb STREETADDRESS 7 Larken Lane CITY STATE ZIP Mount Holly Springs PA 17065 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 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) 0.00 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.......................................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0 c. retain a reversionary interest .............................................................................................................................. ❑ 0 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?.............................................................................................................. ❑ N 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ N 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 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 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-1508 EX+(08-12) 0 pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: James M. Erb 21-14-7 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2000 Saturn S-Series Vehicle(See Kelley Blue Book report attached as"Exhibit 1") 881.00 TOTAL(Also enter on Line S, Recapitulation) $ 881.00 If more space Is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) IRpennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER James M. Erb 21-14-7 This schedule must be completed and riled if the answer to any of questions 1 through 4 on page three of the REV-1500 Is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE INQUDE THE N OF THE. ATTACHA TREI0.ATHE DEED FOR TD DECEDENT MAU ANp NUMBER ME DATE OF TRANSFER.AirAOIACOP10F THE DEED fOR AFAL ESTATE. VALUE OF ASSET INTEREST varvuraelE VALUE I. Blue Beacon 401 k retirement plan(through employment) Non-vested as of date-of-death 4,492.01 100 0.00 TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) _ Iffpennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER James M. Erb 21-14-7 Decedent's debts must be reported on Schedule I. ITEM , NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: __ 1' Hollinger Funeral Home 6,335a 7j' ❑ C- .!._� ice' I —� J1] B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State_ZIP Year(s)Commission Paid: - 0 01 2. Attorney Fees: 3, , 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Frances Erb and Gary Erb Sr. Street Address .7 Larken lane city Mt. HollySrings State PA zip 17065 Relationship of Claimant to Decedent Parents 4. Probate Fees: 253.50' l: 5. Accountant Fees: 145.0011 6. Tax Return Preparer Fees: 7. C] 1__�_.� -- __ - --� ❑ F__ ___ TOTAL(Also enter on Line 9, Recapitulation) $i 13,23. 3.7T� If more space is needed,use additional sheets of paper of the same size. REV-1512 Ex+(12-12) i Jpennsylvania SCHEDULE I I` DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAx RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER James M. Erb 21-14-7 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,Including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sprint(phone bill) 657.03 2. Sprint(Phone bill) 711.00 3. Carlisle Regional Medical Center(medical Bill) 2,548.72 4. Carlisle Physician Services(medical Bill) 1,082.00 5. Capital One(credit card) 1,335.75 6. Cumberland Goodwill Fire Rescue EMS(medical bill) 356.64 7. Quantum Imaging(medical bill) 36.00 8. Cardiology Diagnostics,LLC(medical bill) 35.00 9. Coroners Office(record copying fee) 185.00 10. Carlisle Sentinel 8 Cumbedand Law Journal(advertising) 152.26 11. Mt.Holly Springs Police Department(record copying fee) 15.00 TOTAL(Also enter on Line 10, Recapitulation) ; 7.114.40 If more space is needed,insert additional sheets of the same size. Kelley-Blue Book Pagel of2 l�wRtl Kelley Blue Book The Trusted Resource . : .need I say more? GEICO �- Idwert6emwnt why ads? Sell To Private Party 2000 Saturn S-Series Excellent Condition $7,456 Pricing Report Very Good Condition $1,356 Good Condition S1,281 Style:SL Sedan 4D Mileage:174,000 J✓'-':-- Fav Condition - '-- `vale Party Values valld for your area through - 6/16/2014 Vehicle Highlights Fuel Economy: Max Seating:5 City 25/Hvvy 36/Comb 29 MPG Doors:4 Engine:4-Cy1,1.9 Liter Drivetrain:FWD Transmission:Manual,5-Spd EPA Class:Compact Cars Body Style:Sedan Country of Origin:United States Country of Assembly:United States Your Configured Options Our pre-witted options,based on typical equipment for this or. , /Options that you added while configuring this or. Engine Comfort and Convenience Safety and Security 4-Cyl, 1.9 Liter Air Conditioning Dual Air Bags Transmission Steering Wheels and Tires Manual,5-SPcl Tilt Wheel Steel Wheels Drivetrain Entertainment and Instrumentation FWD AM/FM Stereo Glossary of Terms Tip: Kelley Blue Book®Trade-In Value-This h the amount you on expect to receive when you trade In your or to a dealer.This value Is determined based on the style,condition,mileage and options It's crucial to know your car's Indicated. true condition when you sell it, Trade-[n Range-The Trade-in Range Is Kelley Blue Book's estknate of what you can reasonably expect so that you can price e to reoelve this week based on the style,condition,mileage and options of your vehicle when you trade It appropriately.Consider having In to a dealer.However,every dealer is different and values are not guaranteed, your mechanic give you an objective report. Kelley Blue Book®Private Party Value-This Is the starting point for negotiation of a used- r sale between a private dryer and seller.This Is an'as Is-value that does net Include any warranties.The final prim depends on the ors actual condition and local market factors. EXHIBIT http://www.kbb.com/satum/s-series/2000-satum-s-series/sl-se E - n-sell... 6/23/2014