HomeMy WebLinkAbout09-08-14 � 1505610105
REV-1500 Ex�o=_��,�F�> �
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes U`P p'`�T��`�`"�` County Code Year File Number
PO BOX 28o6oi INHERITANCE TAX RETURN �i
Harrisburq,PA 1'71z8-o6o1 RESIDENT DECEDENT �I �� �i 6 �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01/11/2014 ' 04/12/1945 '
DecedenYs Last Name Suffix DecedenYs First Name MI
LEONARD ' ELLEN M
(If Applicable)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
_ REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Originai Return O 2.Supplemental Retum O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 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 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)
CORRESPONDEN7- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name __ __ _ _ Daytime Telephone Number ,-.� ✓
DENE R. LEONARD III _ (717)609-�52� s , rn �
REGIST�Olt'yVILLS U�NLY"""' �
!:ri %L1
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r-.� _�� � $x�1 r�
First Line of Address t� V� ,;,� � =�� �
..
511 PINEWOOD DR ;-� ,,--., �-� �� �
,_..
� -� —n
Second Line of Address ;, A, , _.,� ,� �
_ _ _ _ . -• � C
" �.':4 r �'TI
O
City or Post Office State ZIP Code
"'�DATE FILED � N �7
RADCLIFF KY ' 40160 ,
CorrespondenYs e-maii adaress:dene.r.leonard.mil@mail.mil
Under penaities of perjury,I declare that 1 have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is t rect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
NATURE F P N RESPONSIBL ILING RETURN � �TE j
/
ADDRESS
511 PINEWOOD DR, RADCLIFF, KY 40160
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056101�5 150561�105 �
_
� 1505610205
REV-1500 EX(FI) DecedenYs Social Security Number
�ecedent's Name: ELLEN M. LEONARD 210�0-1615
RECAPITULATION _
1. Real Estate(Schedule A). ....... ..... .. . .......... .... ... . ... .... ... .
� 0.00
2. Stocks and Bonds(Schedule B) .. .... . .. . ....... ........ ... .......... . 2. _
526.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .... . 3. 0.00
4. Mortgages and Notes Receivable(Schedule D).. .... ... . ....... .. . ....... 4. 0.00 '
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E)... ... . 5. 22,697.00
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... . ... 6.
0.00 '
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 1,847.00
(Schedule G) O Separate Billing Requested..... . .. 7.
8. Total Gross Assets(total Lines 1 throu h 7 ... ....... ... 8. 25,070.00
9 )...... .. ..... ...
9. Funeral Expenses and Administrative Costs(Schedule H)... .......... . .. ... 9. 4,290.00
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)..... . ....... .. 10. 18,403.00
11. Total Deductions(total Lines 9 and 10)...... .. . ....... . ......... ... . ... 11. 22,693.00
12. Net Value of Estate(Line 8 minus Line 11) .. ....... . ....... . .. .. ..... ... 12. 2,377.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0.00
an election to tax has not been made(Schedule J) . ... . ....... . .. ....... . . 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ... .... ............. . ... 14. 2,377.00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousai tax rate,or _ _
transfers under Sec.9116 '
�a)�1.2)X.0- 15. _ _ _
16. Amount of Line 14 taxable 107.00
at lineal rate X.0 45 2,377.00 16.
17. Amount of Line 14 taxable
at sibling rate X.12 17. '
18. Amount of Line 14 taxable
at collateral rate X.15 18. '
_ 107.00
19. TAX DUE . .... . ... .... . .... ... ........ .. . .. .. ... . .. ....... ... ..... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 15�5610205 15D5610205 �
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
ELLEN M. LEONARD
STREETADDRESS
403 D STREET
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 107.00
2. Credits/Payments
A.Prior Payments 15.00
B.Discount
Total Credits(A+g j (2) 15.00
3. Interest
(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) 92.00
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.......................................................................................... ❑ �
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.
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 decedenYs 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.
HEV-i5o3 EX+(8-iz)
;� ., pennsylvania SCI�IEDULE B
� DEPARTMENT OF REVENUE
INHEFITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. LEONARD 2014-00088
All properly jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' HARLEY STOCK
70.00
2 ANCB STOCK 456.00
TOTAL(Also enter on Line 2, Recapitulation) $ 526.00
If more space is needed,insert additional sheets of the same size
REV-i5o8 EX+(o8-iz)
� pennsylvania SCNEDULE E
' DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCETAXREfURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELLEN M. LEONARD 2014-00088
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
�, SAVINGS ACCOUNT AT SANTANDER BANK 18,227.00
2, MISC PERSONAL PROPERTY(BOOKS,COLLECTOR PLATES,ANTIQUES 4,470.00
TOTAL(Also enter on Line 5, Recapitulation) $ 22,697.00
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EXY(08-C9?
` � pennsylvania SCHEDULE G
�'� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
iNHeRnnNCe rnx REruRN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. LEONARD 2014-00088
This schedule must be completed and filed if the answer to any of questions 1 throu9h 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
ITEM INCLUDE THE NAME OF iHE iRAN5F8lff,THEIR REIATIONSHIP TO DECEDBdi AND
NUMBER THE DATE OF TRANSFQi.AITACH A COPY OF iHE DE�FOR REAL ESTAIE. VALUE OF ASSET INTEREST IF APPLICABLE) VALUE
1. HOUSE IN REVOCABLE TRUST(COPY OF DEED INCLUDED) 10,200.00 0 0.00
2 BENEFIT NOW ANNUITY ACCOUNT 1,847.00 1,847.00
TOTAL(Also enter on Line 7, Recapitulation) $ 1,847.00
If more space is needed,use additional sheets of paper of the same size.
R�v-isi� ex+ �as-is7
� pennsylvania SCHEDULE H
" DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
� INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
ELLEN M. LEONARD 2014-00088
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES; 2,811.00
1' HOFFMAN AND ROTH FUNERAL HOME
1,330.00
2. WAKE
g. ADMINISTRATIVE COSTS:
1, Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid;
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
�_� State ZIP
Relationship of Claimant to Decedent
149.00
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $
4,290.00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX�(IZ-12j
r� ` pennsylvania SCHEDULE I
r' DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. LEONARD 2014-00088
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• CREDIT CARD BALANCE(Chase and Bank of America) 7,352.00
2. UTILITIES(ELECTRIC,CELL PHONE,TV,ALARM,ETC.auto withdrawal from Santanders) 1,954.00
3. STORAGE LOCKER(auto withdrawal from Santanders) 822.00
4. HOSPITAL AND AMBULANCE EXPENSES 600.00
5. CATS(7 x upkeep and prepare them for adoption) 1,936.00
6. SNOW REMOVAL AND GRASS CUTTING 615.00
7. PEST REMOVAL(SQUIRREL IN ATTIC) 31.00
8. AUTOMOBILE EXPENSE 1,094.00
9. CAR INSURANCE(auto withdrawal from Santanders) 654.00
10. HOME INSURANCE(auto withdrawal from Santanders) 935.00
11. PROPERTY TAXES 2,081.00
12. HOME REPAIRS 329.00
TOTAL(Also enter on Line S0, Recapitulation) $ 18,403.00
If more space is needed,insert additional sheets of the same size.