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Home My WebLink About04-16-15 (2) REV-1500 EX(02-11) 1505610143 PA Department of Revenue OFFICIAL USE ONLY p pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN 2 1 15 0 3 1 0 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 01 19 2015 12 26 1919 Decedent's Last Name Suffix Decedent's First Name MI GARLAND MARGUERITE 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 DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 8 Decedent Died Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes ❑ (Attach Copy of Will) ❑ (Attach Copy of Trust) ❑ 9. Litigation Proceeds Received ❑ 10.Spousal Poverty Credit(Date of Death ❑ 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT-THIS.SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DAVID A WION 717 232 7661 n o � REGISTR5 WILLS I2U 044 rn c' First Line of Address <a ►-� r r1rr 3631 NORTH FRONT STREET "� CT) �o Second Line of Address «7 DATt FILED r— City or Post Office State ZIP Code . W -� HARRISBURG PA 17110 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 and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE�ERSONRESPLE!:RF��LINGTURN DATE Susan M. Hofer ADDRESS _. ..32801-Ocean Reach Drive, Lewes, DE 19958 SIGNAT RE F PREPA,AER OTHER THAN EPRESENTATIVE DATE David A Wion ADDRESS Caldwell & Kearns P.C. 3631 North Front Street, Harrisburg, PA 17110 Side 1 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: GARLAND, MARGUERITE M. 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&Notes Receivable(Schedule D).......................................................... 4. 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 6. Jointly Owned Property(Schedule F) Separate Billing Requested............. 6. 18 , 8 2 3 09 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 8, Total Gross Assets(total Lines 1 through 7).......................................................... 8, 18 823 0 9 ' . 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 1 , 392 70 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 3 , 936 . 72 11. Total Deductions total Lines 9 and 10).................................... 5 , 3 2 9 . 42 12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 13 , 493 . 67 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).................. 13 , 4 9 3 67 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable 607 2 2 at lineal rate X .045 1 3 , 4 9 3 . 6 7 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. 19. TAX DUE................................................................................. 607 ..2 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 REV-1500 EX Page 3 File Number 21 - 15 - 0310 Decedent's Complete Address: DEQEDENT'S NAME Garland, Marguerite M. STREET ADDRESS 5225 Wilson Lane, #213 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 607.22 2. Credits/Payments A. Prior Payments B. Discount 30.36 Total Credits(A +B) (2) 30.36 3. Interest (3) 0.00 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) 576.86 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;.................................................................................. E] ❑x b. retain the right to designate who shall use the property transferred or its income;.................................... ncome:.................................... ❑ ❑x c. retain a reversionary interest;or.................................................................................................................. ❑ 0 d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑x 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?......... ❑ ❑x 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 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 surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax reiurn 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)1. 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. REV4609 EX+(01.10) Pennsylvania DEPARTMENT OF REVENUE SCHEDULE F INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Garland, Marguerite M. 21 - 15 - 0310 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT Susan M. Hofer 32801 Ocean Reach Drive Daughter A Lewes, DE 19958 Delbert S. Forker 5082 Carrolton Drive Son B Harrisburg, PA 17112 JOINTLY OWNED PROPERTY: LETTER DATE T'SCRIPT.lO�I�F PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name o Inanclal Ins Itu Ion an bank account numbe DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT or similar identifying number.Attach deed for jointly-held real VALUE OF ASSET estate. INTEREST DECEDENT'S INTEREST 1 AB 10/01/2004 PNC Bank Checking Account No. 56,469.27 33.33% 18,823.09 51-4036-6031 TOTAL (Also enter on line 6, Recapitulation) 18,823.09 REV-1611 EX+(10.09) pennsylvania SCHEDULEH DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVERESIDENT DECEDENT COSTS ESTATE OF Garland, Marguerite M. FILE NUMBER21 - 15-0310 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Geigle Funeral Home 677.20 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 Caldwell & Kearns P.C. -- David A Wion 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 Register of Wills 215.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 TOTAL(Also enter on line 9, Recapitulation) 1,392.70 r pennsylvania SCHEDULE I DEPARTMENT OF AXRET UE RN DEBTS OF DECEDENT MORTGAGE INHERITANCE TAX RETURN T p 7 RESIDENT DECEDENT LIABILITIES IES & LIENS FILE NUMBER ESTATE OF Garland, Marguerite M. 21 - 15- 0310 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Medicine Shoppe 90.77 2 Bethany Village-$6,400.56 minus refund $2,854.40 3,541.16 3 East Pennsboro Ambulance 81.00 4 Medicine Shoppe 7.79 5 PNC Check Image Charge (2 Months x$3.00) 6.00 6 H&R Block-Tax Preparation 210.00 TOTAL(Also enter on Line 10, Recapitulation) 3,936.72