HomeMy WebLinkAbout07-21-15 (2) � isas61v1os
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REV-1500 °`�`�`""°"`"
Bureau ol[ntliNEialTaxes �M� ttm FYervimeer
ro HaX 280601 INHERITANCE TAl(REiURN /� 2
Hamsbum,PP 1]128-0601 RESIDENT DECEDENT L� IN OG� �:J
ENTER OECEDENT INFORMATION BELOW
Soaa�SeaMyNumOer Datea(D�Oi 19A0�1TW pe�ed0trin tilWxrrv
'12072012 07152015
Decetlem's Lest Neme Sulflx Oe[e0anfs Flrsl Name MI
SYevens Donaltl G
(xMVnmda)Enbr SurvHbq 9roWa!IMomistlon Bebw
Spouse's tes�Name Sulflx Spouse's FNs[Neme MI
THIS RETURN MUST BE PILEO IN DUPLICATE N7iH THE
REGISTER OF WILLS
FILI M APPROPR411E OVALS BELOW
� i.W19FeIRaNm O 2.SuPP���am O 3. RemelMa�R¢Nm(aaOaMEeaM
mp pM b f2-13B3)
� 4 UeaN m or aMr]-non(tlel,oi p 5.Uea�afler t2 t2-BR)romise(tlate d � 6. Fede�al Eaie�e Ten ReNrn RWWrM
0
p ].Oe�ent Dretl Teslate O 8.OecetleM Melirtel�rotl a 11Nng Trusl _ B. Tolel NumOer ot Sek Oeposll Bous
(rUlm�mpyOt ll.) (Attac�cePYOIW61.)
� 10.LltlgeWn PraceaJs ReceivM O 11.NomPruYeb Tremferee ReMn O 11. OelemUEktlion of Spousal TeucR
(S�YeOWe F eeM G Asset Only)
O �a.eusiressassms o �a.Spouae�s sob ae�nca�y
(No trust�nvN+m)
CORRERPON�EM-1H16 8EG110t1 YU$t Bf COY%EfF➢.N.ICWdE8VOX0EXLE�IID LOXFIOFNML TAC NFOPMPTION SHWL�BE MlfilEU TO:
Neme Oaytlme Teleplwne NumDer
Karen Stevens Loper (717)737-6764
Flrs�urie anmress
4'12 Candlewyck Rtl
s�a u�mnaere�,
qty or Post Olflce S�ate LP COEe
Camp Hill PA 77071
comapo�e�rs•man amms: k.stevens�compstnet
nEcisreu ov vnus use ox�+o
accls.wrzorwiusu�axv � cn z� m
OAl£FB.EUYYO�YYYY � O L fTl n
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PLF.115E UDE ONIGIIUL iORM ONLY __ � r—
Sitle 1 _ � � o
L I■I�a�����■��, J
1505614105
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� 1505614205
REV-1500 EX(FI) pp�¢p����s Sodel Seantty Numbe�
oa.eaenez rm:
aEcnvtniunox
t. ReveantelscneauleAl. ........_.._......_......._.............. 1. 000
z Smcks a�Bonas lScneaule e) ............_............_. 2. 0.00
3. Clasety Haltl Co�po�etlo�.PaMershlD a�'�Propne�orship(SclieOule C) .._.. 3. 0.00
4. MMga9e%aM Nobs RereNada(SMetlule DI.........._............_. 9. 0.00
5. Cas�.Benk DeposXe aM Miecellerieous Penan&I P�ope�ty(Sc1�eEule E)....... 5. 12 659.00
fi. JOIntIY Ow�O Pmperty(SMeeule FI O Separete 6illMp ReQuaatetl ....... 6. 0.�
]. Inter-Vhros T2nsfine S Mlsmllerea�s NamRoEele RopeMy p�
(Sdietlub G) O SeV�fe BYIm9 ReQuea�eJ........ ].
a. iamiGmasawb(wwu�vtmmu9n�)_._........................ a. 72.868.00
9. Furerat ExP�ea antl ACminlstre0ve Cosis(��uk H)................... 9. 7.758.D0
1o. Dems ot oeceaent�9a9e uaGlnies aM uer�s(scneaub il...-.......... �o. 3,254.00
11. Tobl OetlucWne 0�1 Ll�wa 9 a�b 10)._.............................. H. 71�0'12.00
12. Net Valua oI EahM(L1re 8 minus Lire 11).............................. 12. 1.Fi47.00
13. C�aMade eM GovemmeMel Bequea�NSx.9113 T�us�s fw whic�
an elactlan to qz nas mt Deen maae(SUeeub J) ._._.........._..._- 13_ 0.00
14. Nn Value SuEI��Tu lL'ne 12 minus Li�re 13) ........................ 10. 1.847.00
TA%CpICUlATION-9EE INSTHIICTION3 FOR NPPLICABLE RATES
15- Amwnl M Lire 14 fma�le
at tlre spousal taa Ia4.or
hensfers ur.tler Sec.911fi
(a)I12)X 0- i5.
1fi. Amou�rtatLlrel4�axaDle
elll�elre�e X 0_ �6�
1]. Pnrou�rt of Llne 10 ta�able �98�
et sldln9�� X.12 1 647.00 11.
18. Nnau�rtdLlnal<IavLle
Bltdle�ereltetB X 15 �8'
19. TAl(DUE .................................. 19. 788.00
.......................
20. FILL IN THE OV[�L IF YOII IJtE REOUESIINCa A REFIlNO OF AN OVERPAYNEM O
IMCet P�i IX Galury.l CeGva I M1e�c asamY A Ne reWm,inWMiq tMniP�NM scliMuks aM Nabimb.eM b Me beM o!J�B+aN ENkf
X la We.WIRCL eM mniCb�9.CetlentlOn NY��a dMr NBn Ne C�m�aW'a�tle Iw Po�9 Ua reA�ni M hnssl m all inbnNWn ot xTM MAWn�lus
aMFmMWq.
SIGNANRE OF PEILSON RESPONSIBLE FOR FlLING RETURN ���I IS I�S
nooaess ���. 1 CW �,l'N �� � �ZJ��
SIGNATIIRE OF PNEPMER OTHEft THPN P� ON RE IBLE FOR FILIN THE RN �/�tE
n' euWiS -P�,nw+�
noor�ss �
Side 2
L I��,����Z��� 1505614205 J
REV-0SW IX (Fq Ppe3 FINNmnbw
DecedenPs Complete Address:
oE EOE
Donaltl G. Stavens
Sm�rnooaEss
412 CarMlewyck Rd
CIiV STATE ➢P
Camp Hill PA 17071
Tax Paymenfs and Credits: .
1. TarzOuel�1�^e19) (1) 798.00
2. CredilslPaymenl5
A.PnorPeymenls
B.Discwnl
(Se¢inslructions.) Tdel CreGLs(A�B) (2) 0.00
3. Inlerest
�3� D.00
4. II Llne 2 is qreater Ihen Liire 1 4 Lire 3,eMer Ne dillerence. This is Ne OVEFPAYMENT.
FllinovalonPage7,Lim201orequWaMuM. (d) O.pp
5. II Li�re 1+Line 3 is g�ler ilan tine 2,emer Ne tlilfererm.This is ihe TRX UUE. (� 198.00
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN'X'IN THE APPROPRIATE BIOCKS
1. Oitl tlemdml make e 6emier eM: Yes No
a. re�aintlreusewincomeofihepopetlytrarskrteC.................................................._..........__.................... ❑ �
b. re�ain Ne n9At to tlesgrate wM10 shaN use Ne OmOBM Ire�aferted or Aa inwme.......................................... ❑ �
c. releinareversbiaryimeresl....._.... _.._.. ......._....... ........_...... .._ ❑ �
tl. rearveNepmmisebrlileoleilherpeyments,berefibwmre'+ ............_..__........ ❑ �
2. Ifdealh omirtaE afier Oec.12.198I,Eitl decetlent Irermfer pmpetry wiUin me yeat M EeeM
� wNwN rewiWng atlequata crositlaretion� ❑ �
3- �d tlecedent am en'in buat br a payeble+ipmEeaN bank er.�wnt w saoirRy el his or her EeeM?.............. ❑ �
4. Di0 tle�uCenl own an iMivitlial re�iremenl acmun(anrwity aralher mrt�probale propeiM1/,whiM
con�ainsaberieGoaryCe49retion? .._..._..._.__........._..._.._............................_..._......................_.................__ ❑ �
IF THE ANSWER TO ANY Of THE ABOVE�UESTIONS IS YES,YW MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
Fa dates of deaM on orafierJuy 1,1994,aM 6efore Jan.1,7995,Ne tax iate impose0 m ttie net value of tlansfers to or lor ihe use olthe surviving spouse
is 3 pe2en�[72 P.S.§9N6(a)(1.1)(i)�.
For Oates of death on or aAer Jan. t, 1995, fhe lax rate imposed an the net vaWe of Uarefers lo a for the use ol Ne surriving spouse is 0 percent
[72 PS.§9116(a)(1.1)(i)�.The s�ztule dces not exempl a Vansfer ro a survinng spouse from tmc,and Ne sGWtay requiremenis fw tlisdosure ot assets and
filirg a tae reWm are still apDlicable even'rf the surviviig spouse is ihe only beneficiery.
Fa Oates of Oeath on w aRer Juty 1,2W0:
• The tax aie iniposetl an Ne ret value ol hansfers ham a deceased chdd 21 years of age a yaungn at tl�ih lo or for the use of a nalurel parent,an
ampmre�aram o�a�.y�rem or me cmw�s o oercem�2 Ps.gsiis�aNiz��.
. Thel�raleinposedontl�enetwdlueoftransfersWwfwNeuseofthetlecedenfslinealbenefidanesis4.5peRen4e�asmtetlinp2P.5.§9118(a)(1)].
• The lax 2k impose0 on Ne ne�value W Irans(ers�o a fa ihe u5e M ihe decedenYs siblitgs is 12 percen��/2 P.S.§9116(a�(13j�.A sidirg is def�d,
uMer Seclion 9102,as an intlividual wlw has at least one parent in common wiN Ne decetlmt,wheNer by hbod a edopli�on.