HomeMy WebLinkAbout07-27-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EXI11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005621
STONE DUANE P
PO BOX 696
DILLSBURG, PA 17019
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
---~---- fold
101
$2,395.85
ESTATE INFORMATION: SSN: 185-03-1249
FILE NUMBER: 2105-0211
DECEDENT NAME: GA TES LLOYD C
DATE OF PAYMENT: 07/27/2005
POSTMARK DATE: 07/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/04/2005
TOTAL AMOUNT PAID:
$2,395.85
REMARKS:
CHECK# 104
SEAL
INITIALS: CCP
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV.I500 EX (&40)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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FILE NUMBER
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CO\JN1Y CODE YEAR
DO ~l'
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DEceDENT'S NmE (LAST, FIRST, AND MIOOlE INITIAL)
Gates, Lloyd C.
DATE OF DEATH (MM..oD.YEAR) DATE OF BIRTH (MM-OD-YEARl
0210412005 04/14/1912
(IF APPliCABlE) SURVIVING SPOUSE'S NmE (lAST, FIRST, AND MIDDLE INIT1Al.)
N/A
SOCIAL SECURITY NUMBER
185-03-1249
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
I
NAME
Duane P. Stone, Esquire
FIRM NAME (W~_)
Law Offices of Duane P. Stone, P.C.
TELEPHONE NUMBER
(717) 432-2089
~ 1. OrigInal Retum
o 4. Limited Estata
o 6. Decedent DIed Testate lA*h copy 01 WIll
o 9. Litigation Proceeds Received
o 2. SiJpplemental Retum
o 4a. Futunllnterast Compromise (dlleol_"'" 12.12-62)
o 7. Decedent Malntalned a Living Trust (AlflCIl """,oIT""'1
o 10. Spousal Poverty CredK (dole 01_ _ 12-31'" and 1-1-815)
o 3. Remainder Return (doItol__1012.13-62)
o 5. Federal Estate Tax Relum Required
6. Total Number of Safe DeposIt Boxes
o 11. Election to tax under Sac. 9113(A) 1_ Sell 0)
,. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or SoIe-Proprietorshlp
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & MlsceHaneous Personal Property
(Schedule E)
6. Jointly 0Nned Property (Schedule F)
o Saperate BiRing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probata Property
(Schedule G or L)
8. Total Gross Assets (total Unes 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deducllons (total Lines 9 & 10)
12. Net Value of Eatat, (Line 8 minus Line 11)
13. CharilabIe and Governmental Bequests/Sac 9113 Trusts for wIllch an election to tax has not been
made (Schedule J)
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14. Net Velue Subject 10 Tax (Line 12 minus line 13)
COMPLETE MAILING ADDRESS
Law Offices of Duane P. Stone, P.C.
Duane P. Stone
P.O. Box 696
Dillsburg, PA 17019
(1)
(2)
(3)
(4)
(5)
0.00
0.00
0.00
0.00
66,823.56
C::J
Cl
(6)
0.00
(7)
0.00
(9)
(10)
(8)
12,417.53
1,164.88
(11)
(12)
(13)
66,823.56
13.582.41
53,241.15
0.00
(14)
53,241.15
seE INSTRUCTIONS ON REVERSE SIDE FOR APPL.lCAllLE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0
0.00
2,395.85
0.00
0.00
2.395.85
_!)3J~4 U!i x .0 45
(15)
(16)
(17)
(18)
(19)
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....
;:)
Do
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o
U
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16. Amount of line 14 taxable allineal rate
x .12
17. Amount of line 14 taxable al sibling rate
18. Amount of line 14 taxable at coIalersl rate
19. Tax Due
20.0
x .15
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
REV.1502 EX+ (809.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lloyd C. Gates 2005-00211
All real property owned solely or II a tenant In common must be reported at fair market value. Fair marKet value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts.
Real property which Is jolntly-owned with right of survivorship must be disclosed on Schedule F.
SCHEDULI A
REAL ESTATE
ITEM
NUMBER
,.
DESCRIPTION
VALUE AT DATE
OF DEATH
N/A
0.00
TOTAL (Also enter on line 1, Recapitulation) S
(II more space is needed. insert addKional sheets of the same size)
0.00
REV.1503 EX+ (S-9S*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
leH.DULI .
STOCKS & BONDS
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-00211
All property jointly_eel with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
NJA
0.00
TOTAL (Also enter on line 2. Recapitulation) $
<If more space is needed, insert additional sheets of the same size)
0.00
REV.150.4 EX+ (S.98.
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
IeHIDULI C
CLOSELY.HELD CORPORATION,
PARTNERSHIP OR
SOLE. PROPRIETORSHIP
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-00211 ..
Schedule vI or C-2 (including aU supporting information) must be attached for each closely-held corporation/parlnership interest of !he decedent, other lhan a
sole-proprietorship. See instructions for !he supporting information to be submitted for soleilroPrietorships.
ITEM NUMBER
NUMBER DESCRIPTION
1. N/A
VAlUE AT DATE
OF DEATH
0,00
TOTAL (Also enter on line 3. Recapitulation) $
(If more space is needed, insert additional sheets of !he same size)
0.00
REV-leor EX+ (8-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
leNIDULI D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-002..
All property jolntly-owned wtth right of survivorship musl be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
NJA
0.00
TOTAL (Also enter on Une 4, Recapitulation) $
(If more space is needed, insert add~ional sheets of the same size)
0.00
REV-1508 EX+ (8-98) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
IeNIDULI I
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-00211
Include the proceeds of Ittlgalion and the date the proceeds were received by the estate.
All p1Qp8lty jolnUy~ wItII right of lurvlvorshlp muat be d11cloaed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. Estate account of Uoyd C, Gates. All assets and accounts liquidated and deposited into this account with
Citizens Bank. PNC Invesbnent Account and MT Bank Relationship Checking Account were closed and
the funds from these two accounts were deposited into the Estate Account - 620203-951-9.
VALUE AT DATE
OF DEATH
58,341.00
2. Refund from Quantum Imagaing (Medical Insurance Reimbursement)
3. Prepaid funeral account
382.56
8,100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert addftionaJ sheets of the same Size)
66,823.56
THIS DEED,
@@fP1f
MADE THE /91'-7 day of f<br......7 in the year
of our Lord one thousand nine hundred ninety-.three (1993)
BETWEEN CARL W. HINTZ and DOLORES J. HINTZ, his wife of Hampden Township,
Cumberla~d County, Pennsylvania,
Grantors,
and LLOYD C. GATES, single man, of Mechanicsburg, Cumberland County,
Pennsylvania, Richard C. Gates, a married man, of Camp Hill, Cumberland
County, Pennsylvania, and Ronald L. Gates, a married man, of Mechanicsburg
Cumberland County, Pennsylvania, as joint tenants with r~ghts of survivorsl
Grantee:
WITIESSETH, that in consideration of
-------------------E1ghty-five Thousand ($85.000.00}-------.--------Dollars,
in hand paid, the receipt whereof is hereby acknowledged, the said grantors
,do hereby grant and convey to the said grantee,s, their heirs, successors
and assigns
ALL THAT CERTAIN lot or tract of land situate in Hampden Township, Cumberland
County, Pennsylvania, more particularly bounded and described as follows,
according to survey of D. P. Raffensperger, Registered Surveyor, dated
November 3, 1964, to wit:
BEGINNING at a point on the southerly side of Linden Court which point is at
the division line of Lots Nos. 54 and 55 on the hereinafter mentioned Plan of
Lots; thence south forty-four degrees twenty-nine minutes west S 440 29' W),
along said division line a distance of one hundred forty-one and forty-seven
hundredths (141.4.7) feet to a point; thence north eighty-three degrees
thirty-four minutes west (N 830 34' W), a distance of thirteen and fifteen
hundredths (13.15) feet to a point at line of land of Coppenhaver Nursery;
thence north five degrees twenty..seven minutes west (N 5. 27' Wl, along the
aforementioned land of Coppenhaver Nursery a distance of one hundred thirty-
five (135) feet to a point at the division line of Lots Nos. 53 and 54;
thence north eighty-nine degrees forty-two minutes east (N 890 42 I E),
(erroneously recorded on Plan of Lots south zero degrees eighteen minutes
west (8 000 18' W)), a distance of one hundred ten and sixty-siX hundredths
(110.66) feet to a point on the curve of Linden Court; thence southwardly
along aforementioned Linden Court in an arc to the left with a radius of
fifty (50) feet the arc distance of thirty--nine and twenty-seven hundredths
t",n "'.,.\ .J:__....... -1-_ ._. "__..! ~ ... --,...-..--"",-..--
(Q cQ) [f?) ~
BEING Lot No. 54, ClearvieW Farms on the General Plan of Sect:ions 2 and 3 as
recorded in the Cumberland! County Recorder's Office in Plan Book 9, Page 6.
HAVING thereon erected a singIe dweLling known and numbered as 3 Linden
Court.
BEING the same premises w~ich Carl W. Hintz. single man, by his deed dated
May 10. 1976. and recordeld in the Recorder of Deeds Off ice of Cumberland
County. Pennsylvania, in R.cord Book 026, Page 771, granted and conveyed unto
carl W. Hintz and Dolores !J. Hintz, his wife, the Grantors herein.
Town.hlp of ;.I~-:/.4...,.
Cumbo Co.. PI.
1" ..... ....... 'hi III' 'ale
"-
0... "$- "-f.3 Amt. 1.u;- .?()
Robert P. ZhlgIer
Cumbo Co. DIIt Cot. AIL
c..-.ier-k.^/ 14/t;-
School DIat Cumbo Co.. .
-1" Aul &.bite 'n-anlfllr 1ItlI
Date ':1-'}- 17 Amt. "I~-;. '"""
RCIb8It P. Zlegter
Cumb. Co. DIet. Col. Agt.
c-- ':.OMI,tv~()~,.!V/EALTH OF PtN\'~S..Vt,\I/~,\\,.l\/\ ::::.
-", Df.YlI!1.li'vlE:',!! Of ~~FV!'NU!.: _.
__ _~.., __......~__..'. ,:.f .).~;....,\ r---"'--'~"~"_.""""""'~
;"[ t, :.''(:~' "~."......~,'-_.....,;' /?;),.1.... .1,\ \ ~
""id'\JTIY M~~"93 ~~~~); 8') n n n
r f\, \~ ',) <...,,,.~...'_:,-:~' It,.j/. " .
)~f>.II.:i~~ 1___"",_..",.,
And the said grantors hereby
will warrant specially
covenant and agree that they
the property hereby conveyed.
- D3G PAct10G7
~ @ I~Y\
_/
IN WITlESS WHEREOF, said grantors have hereunto set their hand and seal the
day and year first above written.
Signed, Sealed and Delivered
in the Presence of
".",.....
..__._...._-._------_...._.._~.__..._......--_.._.. ...._...........-.-
~J$" fi"
-J~~..~..~- ............-_....-........_-....-..-
l.4LtV.kl..... -- ~_.----_..-_..-_....-
CARr. W. HINTZ
~~i- ~':7~ .....
State of --Po...
County of -::t:o..u(ln \ n
On this, the
ss.
/ q{.j;day of ~{, 1913, before me,
the undersigned officer, personally appeared Carl W. Hintz and Dolores J.
Hintz,
known to me (or satisfactorily proven) to be the persons whose names
are subscribed to the within instrument, and acknowledged that
they executed same for the purposes therein contained.
-11
IN WITNESS WHEREOF,
I hereunto set my hand and official seal. - .'!1::'
/J . . .,::;.~.~*~; .,
~ ~~ "'.:~l'i,.~.,;J". ,_
'---'---"'--' .-.............._-............. .......---...........--....--..-......-- ._~~~~~;t;;:.::~,~.~. ..
NOTARy'PtJBLic' ...-- "---'-TTt-i e-'o-f-'ojTf':rc:;.-n-~; :?.r: '.. :
'. I:, ~ ..... P'f ' .1
NOT ARlAL SEAL
ELlf N ROSENBl OOM, Notary Public
Harristlurg, Dauphin County
My Commission Expires May 8.1995
State of
SS.
County of
On this, the
day of
, 19
, before me,
the undersigned officer, personally appeared
know to me (or satisfactorily proven) to be the person whose name
subscribed to the within instrument, and acknowledged that
executed same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
--"'-',- "'~-----..,-'- ....."".'_..~,~,.......'"___._...u~..~.,___,__..~__,..,.,...".__........-._.........,w..... ..". _ "."...._~O>',..._.__., ._,__.._._._.".,,'~_~.~H,__'___~.~..""_.~,.
Tit
~oo~ j)36 nCE1068
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~do hereby certify that the precise residence and complete
post office address of the wit.hin named grantee is
3 L~"'"'Of/f.' e(:>C"~7
;? -If-19tj') C A-r>1r )1,/1 <P'" . /?o//
~::::::s:.~:---~-_dlt:~.~':J.-..- ,__.____...
Attorney f 0 r.r;;.!:!cL"'!..1'....:.r:.S...........
COMMONWEALTH OF PENNSYLVANIA
County of .~~.~.-:"":::_~::v:-.~_....~._.._
S5.
RECORDED
on t.his
_._ ~L~_. .___.__. day af_~IJJ~
q~
A. Dtl9_:.....J in the Recorder's office of the said County, in Deed Book
D
Vol.
._._.__...___~'!:r!_...__..______.._....J Page _lQ~_..._
Given under my hand and the seal of the said office, the date
above written.
~ ~ 9d.
.,.........-,...........--......-.......--.................-........_.,~
...........1 Recorder.
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REV-1511 EX+ (12-99>*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-00211
Debt8 of decedent must be reported on Schedule L
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Myers Funeral Home
8,112.30
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Richard C. Gates
Social Security Number(s)/EIN Number of Personal Representative(s) 165-26-5983
Street Address 4607 S. Clearview Drive
0.00
CIty Camp Hili
Year(s) Commission Paid: N/A
State PA Zip 17011
2.
Attorney Fees
4,000.00
3.
Family Exemption: (n decedenrs address is not the same as claimant's, attach explanation)
Claimant
0.00
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4.
Probate Fees
305.23
5.
Accountant's Fees
0.00
6.
Tax Return Preparer's Fees
0.00
7.
TOTAL (Also enter on line 9. Recapitulation) $
(If more space is needed, insert additional sheets of \he same size)
12,417.53
REV.1512 EX. (12-ll3) ..
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABIUTIES, & UENS
ESTATE OF FILE NUMBER
Lloyd C. Gates 2005-00211
Report debts Incurred by thl decedent prior to deelh which I'I/lIlllned unpeid u of the dele of clelth, Including unrelmbureed medical IXpell8II.
ITEM VA~UEATDATE
NUMBER DESCRIPTION OF DEATH
1. Sleep Study 16.43
2. Howard Cohen, MD 259.68
3. Francis Perna. MD 25.96
4. Francis Perna, MD 26.27
5. Holy Spirit Hospitial 58.95
6. Holy Spirit Hospital 18.90
7. EKG Associates 8.83
8. Cardiovascular Surgical Ins!. 7.03
9. Community Vascular Lab and Cardiology 12.87
10. Community Vascular Lab and Cardiology 33.93
11. Mail Boxes Etc. (Retuming Ufe Alert Machine) 19.25
12. VerilOn 14.89
13. Cable Rental 12.00
14. PP&L 32.03
15. Quantum Imaging & Therapeutic 429.84
16. Physicians of Rehabilitation, Industrial & Spine Medicine 148.07
17. Ufe Alert 39.95
TOTAL (Also enter on line 10, Recapnulation) $
(If more space is needed, Insert additional sheets of \he sarna size)
1,164.88
AEV.1513 EX_ ($<00) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
leN.DULI ,
BENEFICIARIES
ESTATE OF
Lloyd C. Gates
FILE NUMBER
2005-00211
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trusl8e(s) OF ESTATE
I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Richard C. Gates 4607 S. Clearview Dr. Camp Hill, PA 17011 Son (per cent) 50.00
2. Ronald L. Gates 2409 Rye Circle Mechanicsburg, PA 17055 Son (per cent) 50.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-I500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
N1A 0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
N1A 0.00
TOTAL OF PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(~more space is needed, insert additional sheets of the same size)
REV.1514 EX+ (12'()3)
*'
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE K
UFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on REV-1500 Cover Sheet
ESTATE OF FILE NUMBER
Lloyd C. Gates 2005-00211
This schedule is to be used for all single life, joint or successive liIe estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be fOund in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate the type of instrument which created the future interest below and attach a copy to the tax retum.
o Will 0 Intervlvos Deed of Trust 0 Other
LIFE ESTATE INTEREST CALCULATION
NAIIIi(S) OF UFE TENANl'(S)
DATE OF BIRTH
NEAREST AGE AT
DATE OF DEATH
TEIUt OF YEARS
LIFE ESTATE IS PAYAIlLE
NJA
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
1. Value of fund from which life estate is payable... . . . ... . . . ... ... . . . . . ... . . . ., ... ., ... . . .$
2. Actuarial factor per appropriate table .................................................
Interest Iable rate - 0 31/2% 06% 0 10% 0 Variable Rate %
3. Value of life estate (Line 1 multiplied by Line 2) ......................................$
ANNUITY INTEREST CALCULATION
twlE(S) OF UFE ANNUrTANT{S)
om OF BIRTH
HEARl!STAGEAT
DATE OF DU11f
TERM OF YEARS
ANNUITY IS MYA&LI
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
1. Value of fund from which annuity is payable... . . . ..... . . ... . .. . . . .... . . . .,. . .., . . ... . ..$
2. Check appropriate block below and enter corresponding (number) ..........................
Frequency of payout - 0 Weekly (52) 0 5i-weekly (26) 0 Monthly (12)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( )
3. Amount of payout per period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .$
4. Aggregate annual payment, Line 2 multiplied by Line 3 ...................................
5. Annuity Factor (see Instructions)
Interest table rate - 0 3 1/2% 06% 010% 0 Variable Rate %
6. Adjustment Factor (see instructions) ..................................................
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period
payout is at end of period, calculation is: Line 4 x Une 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . .$
If using variable rate and period payout is at beginning of period. calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 ..................................................$
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through
G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and t 5 through 18.
(If more space is needed, insert additional sheets of the same size)
REV-1644 EX + (3-04) * INHERITANCE TAX
SCHEDULE L
COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT
INHERITANCE TAX RETURN 2005=00211
RESIDENT DECEDENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER
I. ESTATE OF
Gates Uoyd C
(Last Name) (First Name) (Middle InitiaQ
This schedule is appropriate only for estates of decedents dying on or before December 12, 1982.
This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of
Section 714 of the inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal.
n. REMAINDER PREPAYMENT:
A. Election to prepay filed with the Register of Wills on -
(Date)
B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or Annuitant(s) of election or annuity is payable
N/A - "-
- - ~
- - - ~ -
C. Assets: Complete Schedule L-1
1. Real Estate . . . . . . . . . .. . .. . .. .. .. . . . . . .. . ..$ - -
2. Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . . . . . .$ ~
3. Closely Held Stock/Partnership .. .. .. . .. .. .. ..$ -
4. Mortgages and Notes '" . . . . . . . . . . . . . . . . . . . .$ -
5. Cash/Misc. Personal Property ............... .$ - -
6. Total from Schedule L-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .$ --.-
D. Credits: Complete Schedule L-2
1. Unpaid Liabilities . . . . . . . . . . . . . . . . . . . . . . . . . ..$ " .-
2. Unpaid Bequests. . . . . . . . . . . . . . . . . . . . . . . . . . .$ _ -
3. Value of Unincludable Assets . . . . . . . . . . . . . . . . .$ -
4. Total from Schedule L-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ -
E. Total Value of trust assets (Line C-6 minus Line 0-4) ................................ .$
- --
F. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . .
-
G. Taxable Remainder value (Line E x Line F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
- -
(Also enter on Line 7, Recapitulation)
m. INVASiON OF CORPUS:
A. Invasion of corpus
(Month, Day, Year)
B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or AnnUltant(s) corpus or annuity is payable
consumed
- -- ~ -- -
- ~ - - - -
C. Corpus consumed ........................................................... .$
-
D. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . .
-
E. Taxable value of corpus consumed (Line C x Line D) ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
~
(Also enter on Line 7, Recapitulation)