HomeMy WebLinkAbout02-0929
REV-1500EX+(6-00}
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COMMONWEALTH OF
PENNSYLVANIA
OEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-Q601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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Scott Ruth R
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
OFFICIAL USE ONLY
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07/17/2002 06/08/1902
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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FILE NUMBER
lh.L-~~_9- ~ :1..._
COUNTY CODE YEAR ~R
SOCIAL SECURITY NUMBER
5 77- 3 0 - 7 0 1 2
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (AttachSchO)
00 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will}
D 9. litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82}
D 7. Decedent Maintained a living Trust (Attach copy oITrus!)
D 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1-95)
(8)
(11)
(12)
(13)
(14)
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Harrisbur
845 Sir Thomas Court, Suite 12
PA 17109
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81.747.88
81,747.88
8,236.00
8,236.00
73,511.88
73,511.88
3,308.03
3.308.03
NAME
Marielle F Hazen
FIRM NAME (If Applicable)
Jan L Brown & Associates
TELEPHONE NUMBER
717-541-5550
COMPLETE MAILING ADDRESS
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1)
(2)
(3)
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4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a){1.2)
X _(15)
73,511.88 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete ress:
STREET ADDRESS d D .
118 Brookwoo rive
North Middleton Townshio
CITY I STATE I ZIP
Carlisle PA 17013
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
3,308.03
165.40
Total Credits (A +8 +C)
(2)
165.40
3. InteresVPenalty it applicable
D.lnterest
E. Penalty
TotallnteresVPenalty (0 + E) (3)
4. It Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check to: REGISTER OF AGENT
3,142.63
3,142.63
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 IXI
b. retain the right to designate who shall use the property transferred or its income; ................... ................... 0 IXI
c. retain a reversionary interest; or .,. ..................................... ............................... .................... ....... 0 [Xl
d. receive the promise for life of either payments, benefits or care? . .................... ................... ......... 0 IXI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?................... ............... ....................... ............... 0 [X]
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... ..... 0 IXI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................. ............................ ..................... ...................... ..... 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare thai I have examined this return, includinQ accompanying schedules and statements, and to the best of my knowledge 81'ld belief, it is true, correct
and complete.
Declaration of preparer other than the personal representative is based on allmformalion of which preparer has any knowledge.
SIGNATURE OF ~RSON RESPONSIBLE FOR FILING RETURN DATE
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ADDRESS 118 Brookwood Drive
Carlisie PA
SIGNATURE OF PR R OTHER THAN REPRESENT
/
ADDRESS
For dates of death on or after July 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 orlor the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exemDt 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 orlor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S, 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 12% [72 P.S. 99116(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'~m'I""I.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Scott Ruth R
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Anita M Hoaglund
118 Brookwood Drive
Carlisle, PA 17013
daughter
B Scott L Hoaglund
Boiling Springs, PA
grandson
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JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
HEM FOR JOINT MADE Include name of financial inslilul'lon and bank account number or similar identifying number, Attach DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT deed for join~y.held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 8/1990 M&T Bank 44,190.85 50. 22,095.43
Checking 1078496
2 A, B 212002 M& T Bank 17,116.81 100. 17,116.81
Savings 15004202071772
3 A 8/1991 M&T Bank 70,841.78 50. 35,420.89
Certificate of Deposit 31003911159290
4 A 6/2001 M&T Bank 14,229.49 50. 7,114.75
Certificate of Deposit 31003911905809
TOTAL (Also enter on line 6, Recapitulation) $ 81 747.88
(II more space IS needed, Insert additional sheets of the same size)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Scott Ruth R
FilE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home Inc 7,686.00
2 Town Tavern, funeral dinner 50.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
S\reetAtldress
City State Zip
Yea~s) Commission Paid:
2. Attorney Fees Jan L Brown & Associates 500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Prepare(s Fees
7,
TOTAllAlso enter on line 9, Recapitulation) $ 8236.00
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX ,19.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENr
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
1';r:ott R L th R
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustaa(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS linclude outnght spousal distnbutions, and transfers under
Sec. 9116 (al (1.2))
1 Anita M Hoaglund daughter 100% M&T account:
118 Brookwood Drive, Carlisle, PA 17013 Ckg 1078496
CD 31003911159290
CD 31003911905809
50% M& T account:
Svg 15004202071772
2 Scott L Hoaglund
Boiling Springs, PA grandson 50% M&T account:
Svg 15004202071772
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
JAN 1. BROWN & ASSOCIATES
ATTORNEYS AND COUNSELORS AT LAW
OLOE ENGLISH GAl>
845 SIR THOMAS COURT
SUITE 12
HARRISBURG, PA 17109
EMAIL: jlbassoc@pld.nel
JAN L. BROWN'
MARIELLE F. HAZEN"
TELEPHONE (717) 541-5550
FACSIMILE (717) 541-9223
'ADMITTED IN PA AND DlSTAICT OF COLUMBIA
"CERTIFIED ELDER LAW AITORNEY BY
THE NATIONAL ELD~R LAW FOUNDATION
October II, 2002
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 170 I3
Re:
Ruth R, Scott, deceased
Social Security No. 577-30-7012
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Gentlemen or Ladies:
Enclosed please find the following items for filing with the Register of Wills:
I. Estate Information Sheet.
2. An original and one copy of the Inheritance Tax Return together with a check in the
amount of$3,142.63 to cover the tax liability shown to be due and a check in the amoun~
of $15 to cover the filing fee. Make sure the tax payment is marked as received within th~
3 month discount period. I
Please time stamp and return our file copies of these documents. A return envelope is
provided.
If you have any questions, feel free to contact this office.
Sincerely,
\73~t~
Brenda F. Kephart
Legal Assistant
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Enclosure
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTAT
OFFICIAL RECEIPT
MARIELLE F HAZEN ESQUIRE
SUITE 12
845 SIR THOMAS COURT
HARRISBURG, PA 17109
-nn---fold
ESTATE INFORMATION: SSN: 577-30-7012
FILE NUMBER: 2102-0929
DECEDENT NAME: SCOTT RUTH R
DATE OF PAYMENT: 10/15/2002
POSTMARK DATE: 10/11/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 07/17/2002
TOTAL AMOUNT
REMARKS: MARIELLE F HAZEN ESQUIRE
CHECK# 154
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX{ll- ~
E TAX
NO. CD 00173
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
--......-
101 I $3,142.63
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PAID: $3,142.63 I
MARY C. LEWIS
REGISTER OF WILLS
/ "/-? ~ - A;:2/
'\; BUREAU OF INDIVIDUAL TAXES
~tTAMCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR OISALLOWANCE
OF OEDUCTIONS AND ASSESSMENT DF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-02-2002
SCOTT
07-17-2002
21 02-0929
CUMBERLAND
101
Allount R..itt.d
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE"v=is4'-EX--Af'p--niFii2rNoT"icE--OF-YNHEifiTANcrTAic-irpjiRi-isEMENT-,--ALLciiiANcE-bR----------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SCOTT RITH R FILE NO. 21 02-0929 ACN 101 DATE 12-0
MARIELLE F HAZEN
JAN L BROWN & ASSOCS
845 SIR THOMAS CT 12
HBG PA 17109
TAX RETURN WAS: (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al Estate (Schedule AJ
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable [Schedule D)
5. CashlBank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule FJ
7. Transfers (Schedule G)
8. Tot.l Assets
I CHANGED
RITH
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002
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III .00 NDTE: To Insu \ proper
(21 .00 crllCllt to you count,
(31 .00 sub.it the up portion
(41 .00 of this 1'0.... h your
un .00 tax payllent.
(61 81.747.88
(7) .00
(81 81,74 88
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad.. Costs/Misc. Expenses (Schedule HI
10. Debts/"ortgage Liabilities/Liens (Schedule Xl
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and
re~lect ~igures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rat. (IS)
16. AMount of Line 14 taxable .t Lineal/Class A rat. (16)
17. A.OWIt of line 14 at Sibling rate (17)
18. A~unt of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
CR TS:
NOTE:
T
+
DATE
10-11-2002
NUMBER
CD001730
INTEREST/PEN PAID (-I
165.40
191
1101
8,236.00
73,51
3,30
3,30
3,308.
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.!
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YDU HAY E DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTI S.l
.00
1111
1121
113J
1141
.00 X
73,511.88 X
.00 X
.00 X
00 =
045 =
12 =
15 =
1191=
AMOUNT PAID
3,142.63
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE