Loading...
HomeMy WebLinkAbout09-17-15 • 1505618403 Pennsylvania OEVARTMENT Of REVE X(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 15 0521 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 03 12 2015 06 06 1946 Decedent's Last Name Suffix Decedent's First Name MI TYSON SR . WILLIAM H (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW R1. Original Return 2.Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) El4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 7. Decedent Died Testate 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 10. Litigation Proceeds Received 0 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) 13. Business Assets 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GEORGE W SWARTZ II 717 398 2205 First Line of Address 18 E MIDDLE STREET Second Line of Address City or Post Office State ZIP Code GETTYSBURG PA 17325 Correspondent's email address: 9ws@_)mooney4law.com REGISTER''F WILLS USE CM4 �Z REGISTER OF WILLS USE ONLY J) DATE FILED MMDDYYYY -70 (,0 J r DATE FI,LED,ST�A.ANP _ CLD — I-r1 Y r... C.J C'O p Side 1 � Illillllllllllllllllllllllllllllllllllllllllllllillllllllll 1505618403 1505618403 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Tyson,,William H. Sr. 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 and Notes Receivable(Schedule D).................................................... 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).......... 5. 341502 - 73 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 34,502 - 7 3 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 10-1559 - 00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 1-7515 -50 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 12-,074 - 50 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 22-,428 - 23 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)............................................... 14. 22-,428 -23 TAX CALCULATION-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 1112 14 -12 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045, 11,214 - 12 16. 504 - 134 17. Amount of Line 14 taxable at sibling rate X.12 0 . 110 17. 0 .00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 504 - 64 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT rul Under penalties of perjury,I declare 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 person responsible for riling the return is based on all information of which preparer has any knowledge. SI ATURE OF PERSON ESP NSIBLE FOR FILING RETURN ,Jaime A Tyson DATE ADDRES 304 E. M.in Street Apt. 1 hiremanstown, PA 17011 ® r F'PREP�ARER OT HAN REPRESENTATIVE George W. Swartz 11 ATE AD ESS $ E„ fiddle treelt, G tysbwrg, PA .17325 i Illlll Illll lilll llll IIII'lull Illll Ill I lull Illll Illi Illi Side 2 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-15-0521 Decedent's Complete Address: DECEDENT'S NAME Tyson,William H. Sr. STREET ADDRESS 304 E. Main Street Apt. 1 <CITY STATE ZIP Shiremanstown PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 504.64 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 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) 504..64 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;.............................................................................. ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 51 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ F 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. w m 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 172 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 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 step-parent 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)]. 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-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Tyson,William H.Sr. 21-15-0521 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Deposit-Money received for van 1.000.00 2 Metro Bank-Estate Account-opening balance 33,502.73 TOTAL(Also enter on Line 5,Recapitulation) 34,502.73 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08=12) REV-1511 Ex+(08.13) pennsylvania SCHE®UL-E H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Tyson,William H. Sr. 21-15-0521 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 7,799.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attorney's Fees Mooney&Associates 2,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City , . State Zio Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 260.00 See continuation schedule(s) attached TOTAL(Also enter on line 9,Recapitulation) 10,559.00 Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEOULEH FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Tyson,William H. Sr. 21-15-0521 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Musselman Funeral Home and Cremation Services-Funeral Bill 7,799.00 H-A 7,799.00 Other Administrative Costs 2 Cumberland Law Journal-Advertise 75.00 3 Register of Wills-Petition Ltrs Adm$90.00 185.00 JCS/Automation Fee$40.50 INH Tax Return$15.00 Inventory$15.00 Renunciation$5.00 Short Cert$20.00 H-B7 260.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX,(12-12) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENTNCETA RETURN MORTGAGE LIABILITIES AND LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Tyson,William H. Sr. 21-15-0521 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Hampden Township EMS-Ambulance Bill for 12/08/2014 757.00 2 Hampden Township EMS-Ambulance Bill for 12/29/2014 758.50 TOTAL(Also enter on Line 10,Recapitulation) 1,515.50 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-12) REV-1513 EX-(01-10) pennsylvania SCHE®ULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Tyson,William H. Sr. 21-15-0521 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S)RECEIVING PROPERTY ($$$) Do Not Lis Trustee 5 (Words) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Lisa A. Bly Daughter 1/4 interest in net 5,607.06 311 Ridge Street distributable Wilkes Barre, PA 18706 estate Jaime A. Tyson Wife 112 share of net 11,214.12 304 E. Main Street distributable Apt. 1 estate Shiremanstown,PA 17011 William H. Tyson,Jr. Son 1/4 interest in net 5,607.06 301 E. Main Street distributable Apt. 1 estate Shiremanstown, PA 17011 Total 22,428.24 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART If -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)