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Home My WebLink About05-17-05 REV-1600 EX + (6-00) *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 ----- - ---- ----- >--r~:D~~~~~:E ~~:~;:~~;6WNITIALl ffi'-OATEOF DEATH (MM-o"iJ.:v-EAR) ----- - I--DATE OF BIRTH(MM~DD-YEAR)-- ~ ~'i?A~;L~C~;L~) ~~R}NING SPOUS"," NAMJU,STO ~;S~~N~ ~~~~'NITIALi-- -11 I'. Original Return ~ " Ol ~ I ! x ) 4. Limited Estate "~i';~m" . f [] 6 ~ L_l 2. Supplemental Retum Decedent Died Testate (Attach copy of Witl) Litigation Proceeds Received 4a. Future Inlerest Compromise (dele of death after 12-12-82) 7. Decedent Maintained a living Trust (AUacl1 copy of Trust) Spousal PovertY Credit (date of deeth between 12-31-91 and 1-1~1 I OFFICIAL USE ONLY IFILE NUM;E;-- 05 I___QQ~NT'(QQQ~ _ YEAR ~-SOC~lSECURITvNUMBE~- I THis RETURN MUST BE FI..ED IN DUPUCATE WITH THE I REGISTER OF WILLS r-SOCIALSECURITY'NUMBER-- ---- - 'l3~ Remainder Retum-(date of death prior to 12-13-82) I . l_J 5. Federal Estate Tax Return Required OLlYl Nl,!MBER ffi NAME e \ Richard L. Webber, Jr. Esquire 2 FIRMNAME (If applicable) - - - i Weigle & Associates, P.C. 8__1 T;L~P;;~E~~~i~~-~c= 1. RBal Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnershlp or Sole-Proprietorship z o 5 " !:: ~ ~ 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) l__': Separate Billing Requested 7.lnlerMVivos Transfers & Miscellaneous Non-Probate Property (Schedule G Dr L) I I Separate Billing Requested 8. Total Gross Assets (total LinBs 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total OBductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 8. Total Number of Safe Deposit Boxes D 11.Election to tax under Sec. 9113(A) (Attacl1 SOOO} 1"L ) 126 East King Street Shippensburg, PA 17257 (1) (2) (3) (4) (5) (6) (7) ~ None None None None 734.35 ('.:: efFICIA13IJSE 9NL.Y :";::J.."J ::If:: .,'1 ';.u;) J ~Pl;" L , :~l': -< ',:-~ ci) -.J :Dill ::il:r: None "-.9 .J;:"" -.0 12,000.00 (9) (10) (8) 12,734.35 7,794.98 ------- - 1,809.09 (11) 9,604.07 3,130.28 0.00 (12) (13) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has , not been made (Schedule J) j 14. Net Value SUbjBCt to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Une 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 0 3,130.28 .045 (16) ~ 16.Amount of Une 14 taxable at lineal rate x >- " 11. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ~ u 18. Amount of Une 14 taxable at collateral rate 0.00 x .15 (18) ~ 19. Tax Due (19) (14) 3,130.28 0.00 140.86 0.00 0.00 140.86 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; Decedent's Complete Address: STREET ADDRESS 487 Centerville Road CITY Newville --(STATE PA IZIP17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 140,86 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty (0 + E) 4. IfUne 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. S. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 140.86 (5A) (5B) 140.86 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 B. retain the use or income of the property transferred;.. I.. I [?tJ b. retain the right to designate who shall use the property transferred or its income; ................. ~_-I fx 1 c. retain a reversionary interest; or. .................. ................. ................ r--: t-;! d. receive the promise for life of either payments, benefits or care?....... D [!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................ Ixl Ix\ 3. Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death?.... LJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ___ contains a beneficiary designation?. l!C: I I-I 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 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 ~~el.~:~a~~Q.!Q~pare~~t!1!!!~~~~rep_~~~iveis~~~?I' allir\!~~~~cf~"-~_!,,~ ~k~~~'!le. __________________ SIGNATURE F PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Vlck' ag . \/) SIG~ATU E OF PERSO&~LE FOR flU AfIDRESS ~/,~ SIGNATURE 6-f PREPAREROTHER THAN REPRES NTA1"IVE Richard L , Webber, Jr, Esquire -DATE 407 Oak Flat Road Newville, PA 17241 r (10/0<;' DATE --A:i5DRESs- Jf/2!ol- DATE 126 East King Street Shippensburg, PA 17257 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 spouso is 3% [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% [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 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. ~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%, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)]. The tax rate imposed an the net value of transfers to or for the use of the decedent's siblings is 12% [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. nRPD .:A. Rev-1608 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COfIMONWEALTt-l OF PENNSYLVANIA ~HERITANCETAXR~URN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship mU8t be dl8Cl081'ld on schedule F. ITEM NUMBER DESCRIPTION 1 1992 Chevrolet Lumina VALUE AT DATE OF DEATH 250.00 2 M&T Bank Checking Account #414-018 484.35 TOTAL (Also enter on Line 5, Recapitulation) 734.35 (If more space is needed, additional pages. of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Fo"" PA-1500 Schedule E (Rev. 6-98) Rev-161G EX. (i--98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMON'NEAL TH OF PENNSYLVANIA INHERITANCE TAX ReTURN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE: NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COPY OFTHE DEED FOR REAL ESTATE 1 Commerce Bank IRA #0000031606 - Transferee - 15.000.00 100.000 3.000.00 12.000.00 Vicki L. Magee, Daughter Date of Transfer 11-12-2003 TOTAL (Also enter on Line 7, Recapitulation) 12.000.00 (If more space is needed, additional pages 01 the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1161 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 7,379.98 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Stale Zip - Year(s) Commission paid 2. Attorney's Fees Weigle & Associates, P.C. 400.00 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 Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 7,794.98 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-16Q2 EX+ (8-98) '* SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Carlisle Memorial 1.073.50 2 Ewing Brothers Funeral Home 5.789.00 3 Hoy's Flowers 138.86 4 Minich's Concrete - Monument 154.23 5 Saylors - Groceries for meal 224.39 Subtotal 7.379.98 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) RIN-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued C~WEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills - Filing fee for inheritance tax return 15.00 Subtotal 15.00 Copyright (e) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1$12 EX+ (e-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COIv'MOfIlWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Black's Water Softener VALUE AT DATE OF DEATH 33.24 2 Bon-Ton - Credit Card 37.19 3 Card member Service - Credit Card 266.78 4 Card member Services. Credit Card 50.00 5 Deborah Piper - Personal Taxes 11.00 6 Exxon Mobile - Credit Card 19.25 7 Holy Spirit Hospital 60.00 8 Holy Spirit Hospital 208.23 9 Kuhn Communication. Cable Television 17.56 10 Kuhn Communications - Cable television 17.56 11 Nationwide Insurance. Auto 76.47 12 PPL - Electric Bill 115.91 13 PPL - Electric Bill 104.51 14 PPL . Electric Bill 187.62 15 PPL . Electric Bill 223.76 16 Sprint - Telephone Bill 24.19 17 Sprint - Telephone 32.37 18 Sprint - Telephone Bill 24.08 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10, Recapitulation) 1,809.09 (If more space is needed, additional pages of the same siz.e) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-U12 EX+ (1.-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued CCWMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETIJRN RESIDENT DECEDENT Gebhart, Charlotte E FILE NUMBER 21-- ESTATE OF ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 19 Wal-Mart - Credit Card 25.00 20 Wal-Mart - Credit Card 33.96 21 West Shore EMS 10.00 22 West Short EMS 130.41 23 West Short EMS 100.00 TOTAL (Also enter on Line 10, Recapitulation) 1.809.09 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV 1613 EX+ (9-00) *' SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gebhart, Charlotte E 21-- NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not LIst Truat~e/.l I. TAXABLE DISTRIBUTIONS [include outright sgousal distributions, and ransfers under Sec. 9116(0)(1.2)] VICKI L MAGEE Daughter One Hundred 3,130.28 407 OAK FLAT ROAD Percent Newville, PA 17241 Total 3,130.28 Enter dollar amounts for distributions shown above on lines 5 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 130F REV-1500COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)