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Home My WebLink About10-20-14 J 1505610143 REV-1500 EX`°2_„> �, OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year Fila Number Bureau of Individual Taxes DEPARTMENTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 13 0586 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 04 05 2013 09 28 1920 DecedenYs Last Name Suffix DecedenYs First Name MI 0' HARA ROBERT D (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 DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Originai Return � 2. Supplemental Return � 3. Remainder Return(Date of Death Priorto 12-13-82) � 4. Limited Estate � 4a_Future Interest Compromise � 5. Federal Estate Tax Return Required (date of death after 12-12-82) � g Decedent Died Testate � Decedent Maintained a Living Trust � 8. Total Number of Safe De Osit BOXeS (Attach Copy of Will) ❑ (Attach Copy of Trust) P � 9. Litigation Proceeds Received � 10. Spousal Povert Credit�(�ate of Death 11.Election to tax under Sec.9113 A betweenl2-31�J1 and -t-95) � (Attach Schedule O) � � CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDMUND G MYERS (717) 761 4540 REGISTER OF WILLS USE ONLY First Line of Address c7 �rv� 301 MARKET STREET �": � a r� � Second Line of Address �!� `= r> --i �'� � , ',.': -� ::,> ::sa PO BOX 10 9 �`�� i � :� City or Post Office DATE fILED � State ZIP Code —� LEMOYNE PA 17 0 4 3 � -� .t-� �i r—� � ; �v � m _ �'� cn ca CorrespondenYs e-mail address: egm�jdsw.com p� -� 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 and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ATE Susan Ann Lindsey � ADDRESS 935 O d Quaker Road Etters PA 17319 SIGN E OF PREPARER OTHER THAN REPRESENTATIVE DATE /b Edmund G. Myers l O� ADDRESS 301 MARKET STREET, Lemoyne, PA � Side 1 � 1505610143 1505610143 � 150561�243 REV-1500 EX DecedenYs Social Security Number DecedenYsName: O'HARA� RObe�t D RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 3 7 , 16 6 . 4 0 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3. Ciosely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal PropeRy(Schedule E)............... 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�oq Probate Property (Schedule G) U Separate Billing Requested............ 7. g. Total Gross Assets(total Lines 1 through 7)........................................................ g. 37 , 166 . 40 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 15 . 0 0 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 15 . 00 12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. 37 , 1 'rJl . 40 �3, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Vatue Subject to Tax(Line 12 minus Line 13)............................................... 14. 3 7 , 151 . 4 0 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 �5 O . 0 0 (a)(1.2)X.00 16. Amount of Line 14 taxable 0 . 0 0 16. 0 . �� at lineal rate X .045 17. Amount of Line 14 taxable � . 0 0 at sibling rate X.12 � . 0� 17. 18. Amount of Line 14 taxable 5 572 . 71 at collateral rate X.15 3 7 � 151 . 4 0 18. i 19. TAX DUE................................................................................................................ 19. Jr � r'J 7 2 . 71 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 � 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-13-0586 Decedent's Complete Address: DECEDENT'S NAME O'HARA, Robert D STREET ADDRESS 130 Hummel Avenue STATE Z�P CITY pq 17043 Lemoyne Tax Payments and Credits: �� 5,572.71 1. Tax Due(Page 2,Line 19) 2. Credits/Payments A. Prior Payments B. Discount Total Credits(A +B) (2) �3� 130.23 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 5,702.94 Make Check Payable to: REGISTER OF WILLS, AGENT. _ : _ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" fN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: X . . . . . ......................................... 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:.................................. � a c. retain a reversionary interest;or............................................................................................................... . . ..................................... ❑ � 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?....... ❑ 0 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑ contains a beneficiary designation?............................................... ......... ......... ......... ......... ........ X 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 surviwng spouse is 3 percent[72 P.S.§9116(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 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a suroiving 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 decedenYs siblings is 12 percent[72 P.S.§9116{a)(1.3)]. A sibling is defined, under Section 9102,as an individuat who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1502 EX+(01-70) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'HARA, Robert D 21-13-0586 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-ownedwith right of survivorship mustbe disclosed on schedule F, Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedenYs interest if owned as tenant in common. iTEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Land located at Emanuel Road, Lewisberry,York County, PA-Tax Parcel Id. 37,166.40 270000F0064F000000. Valued using current assessed value of$32,040.00 x CLR of 1.16%_ TOTAL(Also enter on Line 1, Recapitulation) 37,166.40 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10) <Titie> Parcel Key:270000F0064F000000 PercellD: Location:EMANUEL RD Owner.OHARA ROBERT D Land 1/alue:s32040 Buitding 1✓alue:$0 Totai Value:;32040 Deed Book/Page:53A-447 Grantor.OHARA ROBERT D Clean�Green:N Acreage;7.92D Lend Classs 100 Sale Price:a350 Sale Date:AAon Jul 91g62 Homestead Code: Homestead Approv.: Homestead%.: Farmstead Code: Farntstead y.; Copyb Clipboerd �" ��j� i , �y: � �h � � ��A � ��n�.' t ,; � � � � , �, � � �. �a�l� �� , � � � � � � � ��,. �� .�� Q�d �`�� , � �,_ -�LL� hrl�nicipaliti�� R�� SII�� i�� 1�� yr Ftoodpls�n __�_._.__�_, P�r�el� f------Easements) f�] �iis) ?.•Iap:nre uot fi•oiii achial=_tu�cy� 10/15/2014 Scale 1�400 REV-1571 EX+(10_pg) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE F U N E RA L EXPE NS ES A N D INHERITANCE TAX RETURN RESIDENTDECEDENT ADMINISTRATIVE COSTS ESTATE OF O'HARq, Robert D FILE NUMBER 21-13-0586 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT B• ADMINISTRATIVE COSTS: 1� Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4• Probate Fees 5• AccountanYs Fees 6• Tax Return Preparer's Fees 7• OtherAdministrative Costs See continuation schedule(s) attached 15.00 TOTAL(Also enter on line 9, Recapitulation) 15.00 Copyright(c)2009 form software only The Lackner Group, inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF O'HARA, Robert D FILE NUMBER 21-13-0586 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Cost� � Cumberland County Register of Wills Office-Filing Fee for(2nd)Supplemental Return 15.00 H�B� 15.00 Copyright(c)2002 form software only The Lackner Group, Inc. Form Pq-1500 Schedule H(Rev.6-98)