HomeMy WebLinkAbout03-19-15 J 15�56141�5
� �xY�t IX(03-11)(�)
REV-1500 °`�`""'�"""
Bureau o(InEivitlual Taxes �h� Y� File Nw�Ler
po sox zeoboi INHERITANCE TA7(RETURN f
Mamsbmg,PA ll128-0601 RESIDENT DECEDENT 2� �� � Zr �
ENTER DEGEOEM INFORMI1110N BELOW
Social Securily Number Uale ot DeaN MYDDY'!YY Date of BkN MMWYYrr
/ � �- o �c�s �zoi.� iv � �i��s�
Decetl��,v�Cs Lasl Nanie Sulfix DxceEmCs Firsl Name MI
Sh��k L q rry E
(HAppOcable)EMer SurvHi�g Spousek In/amatlon Bebw
Spouse s Las1 Name Sufiz Spouse's First Name MI
iH15 RETURN NUST BE FILED IN DUPUCA7E WIiH TNE
REGISTER OF WILLS
FlLL IN APPROPRWTE OVALS BELOW
� t.O�gmal ReNm O �-�Fde�^m�ReNm O 3. RemaiMer ReNm(tlale d tleath
pao.w iaiaez>
p 0.Agia�IR�re E�empGm(date d p 5.FUWre Interesl Goenprmese(tlate ol p 6- Fe4eral Esta4 Ta�ReNm Req�ireU
JaaM m w afler]-1-2012) tleaiM1 alter 12-12A2)
p ].De�sEe�rt OieE Te9ale O 8-OeraJeM MairilaFeC a Liv'�T,usi _ 9. Tolal Number ot Safe Deposil Boxes
(anarn mvr ot wai.) Innxn mcr w cust)
p f0.I.in�a�iwi PmrEeEs Recervetl p ti.N«wmsare ra�reree a�m o +2_ oe�e��i�o�or sao��i rNsv�
(SG�eONe F aM G AsseS OnN)
O 13. Bus"viess AseLs O 14.Spause s Sole Benefioary
(!b ttust nvaNeE)
CORRESPONpE1R-1NI5 SEC1qN YVST BE LOYPtElE0.1l1.CORPESPoNOEXtE WID LONFlDENML T/JI NIFONUTpN SNOULU BE�IpEt1E�ttI:
Name Daytime Tel�huie Number
�heodore �- . ShenK , St; , �l �- ��5 y '778
F�rs�u�m aaare�
I� G goX 3 ��' �Isa' Lavina �3ennef-�`
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REGISTENOFWILLSUSEONLY ��O �I,J
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1505614105
J 15�56142�5
REV-1500 E%�FI) p�¢d¢���s Social5ep�nry Number
oe�aenrs xare:
RECMRULAnON /�� J�
1. Real Estale(SdxxlWe A). ._.............................. ........... 1. i CJ V
2 Stotlas antl Bmtls(Schetlule B) ........._................ ............ 2 � � �/
3- Cbseb Held CaPa'a��.ParinershiP w Sdc-ROP�torsNP(Srhetlule C) ..... 3. i C/ V
4. MpkJa9es aM Noles Recervade(SJedule D)..................._..._.. 4. � O �
5. Cash,Bank DeposiLs arM Mis�llarieais Per.^,onal Properiy(Schetlule E�....__. 5. ,� � � �(
V
6. JaMty Owned Roptvty(�ule F) O Separdte Billirg Reques[etl .... ... 6- � G 0
�. i�.-urvos rr�sa a nwsmns��s r�m-v.00�e Property �
(Srlietluk G) O Separele Billirg Requestetl... ..... ]. / n
/ V (�'
8. Tobl Groes Aaceb Qolal Lines 1 Mrotgh l)............................. 8. 7�i ((� r �c9
9. Funeral ExVe^ses aM AOministrative Cos6lSchetlule H)....... ............ 9. � � �� i .5 �
C1
10. Deds ol0ece0ent.Mor�gage LiadlNes aM Liens(5tl�edule I)........._...- 10- � � '
fl. To1a1 DeEuclbns(lotal Lines 9 antl 10)........................ ......... 11. � C �(.i S /
12. NelValceo/Eshte(LireBmnusLineli) ...-_........._ ............. t2 � J l�3/ � 1.�
(
13. Chanbde arM Govemnenta�BeQuesl515ec.9113 T�uSLc fp xfiich ���
an election to taz has�ro[Men matle(Srl'eflule J) ......... ............... 13. /
14. Net Value SuM�ro Tss(Line 12 minus Line 13) ...._..__......_.._.. 14. -- O J •-G / .�� / /
TA%CALCUlAi10N-SEE INSiRUCTION3 FOR MPLICABLE RATES
15. Arnounl of Lire 14�axable
at ihe spousal t�rete.w
translers ueWer Sec.9116
(ag12)X 6_ 15. � / �
16. f�roun[of Lir�e 14 taxable /"�O
al limal rate X 0_ 16. � �/
1L MwM of Lire 14 tmade � �
ats�di�g.ate x.tz ��-
18. MwuM o(Lire 1<taxable / / )
at cdlateral 21e X 15 18. t �/ v
19. TA%DUE ......................................................... 19. � OO
20. FlLL IN THE OVAL IF YW ARE REQUESi1NG A REFUND OF I1N OVERPAYMElR O
UMer V���%d Ge�M�Y.I Jetla�e I lu�e assnwa'1 M¢reWm.'sC1�Nm9�^��Y�5 c ludul�atl Aatenenb.antl b IM1e bast of mY krowbdae arM be6e�.
X e Mc.mnat aM mm0�%�.atldiulnn W pryar¢r dM Man Me pt san r%sG��'k N 4i9 Me 2Wm is L tl M 211 nMmelun W wM1i[M1 qeVam tas
sny bn.Ndge.
�I N OF V I E FOfi FIUNG RENRN DATE
E� .i �iS X ��j",�� �. �, ^ �- 3-i4 -/5
P�;�or '-4: 5 ,
nooaEss 0✓�<v i8tr !, .
p�, /6/0o nfe.ld �"F�7a68� � ) ;rr�'sc%'�:.�>� � e� � � ��2 6 i� -��
SIGNATUREOFPREPMEROtHERTIWNPElt50NRE5PONSIBLEFORFILINGTHERENRN D/TE
AODRE55
L I■�,��������� Side2 �
1505614205
REV-15W E% IF1) Pa]e3 F14HumEn
DecedenYs Complete Address:
oEce�xrs wuE r-
ST��„�� �--�r�y �_. �henk_ _
---
_ z_ C� erc�fL__ ���- , _� _---_ _
— -- __- _ r
qN / ..- _ — . _ _. .. � STATE� q ZIP/��
� ff
Tax Payments and Credits: /�
1. Taz DUe(Page 2,Llne 19� (�) / �/�
2. CreditslPaymenls
A.Prbr Paymen5 _. _ __ _ _. . _.__—
B.UswuM ____.. ._ __—_. . n /-1
(See instruciions.) � Tofal CreMs(A.B 1 (P) I// (/
3. Inte2sl
(3) , (/ �/
4. N Line 2's tyea�r tlan f ine t�lire 3,eMer IM 6Herenoe. 7his is tl�e OVBiPAYIAENf.
Fi11 in ml on Pape 1,LMie 20 m�aqusat a Mund laJ r O �
5. tt Li�1�l.im 3 is greater tliai Line 2,eMer Ne 41R�,vercx.This a�he TA%WE (5) c (/ (/
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X' IN THE APPROPRIATE BLOCKS
1. DiA Oecedenl make a hansfer aM: Yes No
a. relainiheuseaincaneMthepopnlyvansMred..... ......................._........................., ❑ Q�
E. rehain Ihe�1 b Oesi9na�e who Sall ise Ihe P�W�Y Iarsferte0 a ils ircmm ..._................................... ��,/
c. relainareve�siwiarYinte�esl...._.._... ..._....._...........___.._............._._....._......................... ❑ L1
a. �meoro�rorrreaero�r��,o�rnsamre�_................._.._................................._.......... ❑ C3'
z. a e�m omnrea a1�r oec.�z�98z,aa aece�n o-anaer poperry wimm ore r�M a aeam
wiman receivig ad.qw�e mnsidcretim?...................................... ,�� ,/
. ..................___.........._....._....__.........._..... ❑
3. Did Oecedxtl wm an Si trust faf or PaY��Va��a�bank acmunl or seanflY al his a her deaM7.............. ❑ L'�
4. Did daeden�awn an irdiri0ilal retiremenl amJUM.a�muity or otl�er non9���e P�Y.whiCh
canUi�sabenefiria7desig�iation? .........._... ....__..._.............._._._......................_..._..._...__.. ❑ �
IF iHE ANSN�Eft TO ANY OF THE ABOVE QUES110NS IS YES,YOU MUST COIIPLETE SCNEDULE G AND F0.E 1T AS PART OF 1HE RENRN.
ior da�es of deaTh an a aRer Juty 1.1994,and befae 1an.1,7995,tlie tax rate irtposed on ihe riet value of transfers to a for tlie use ol Ne surviving spouse
is 3 pertenl[72 P.S.§911fi(a)(1.1)(��.
For dates of deaM on or afler Jan. i. 1995, tlie �ac rale impose0 ai Ihe net value W hansfers to a�a tlie use of tl�e survivirg spouse is 0 peicen�
[/2 P.S.§9116(a)(7 1)(ii)].The slaWte dces rro�ezempt a transfer b a saviving spouse fian tax,ariA Me slaM1itay requiaments for disdasure d assets and
filing a tac mWm are sfill applica6le even d ihe wrvivirg spouse is ihe only benefitiary.
Frn dates W dealh on a afler Juy 1,ZWO:
. The tac rele imposed on ihe ne[value of bansfers Gmi a deceased child 21 years ot age or youm,�er at deaN lo w fa the use of a nalural parent, an
adop6ve parent a a steppare�l of Me dnld is 0 perceM[/2 P.S.§911G(a)�72)].
. 7he taz rale imposed pi the�cetvalue of transfers to afutlie use o(the decedeM's lineal beriefidanes is 4.5 q.vcent,raccept as noted m�2 P.S.§91161a11�11�
. The t�rate imqsed on the nel value W transfers lo u M tlie use of the decedmPs sblim�s is i2 percenl[l2 P.S.§9116(a)(13)].A sihling is defined,
under Sec6on 9102,az an indrvidual who has at least one parent m canmon wilh the decedent,whelher by Mood or adopuon.