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Home My WebLink About08-18-05 REV-1500 EX + (6-00) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W (J W C w I- ~s(/) <.>o::~ w&<'> J: o::g <'>&a:J < DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ARMSTRONG MILES CURTIS, JR. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 11/18/2004 09/29/1931 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ARMSTRONG JOAN M. [RJ 1. Original Return D 4. Limited Estate [RJ 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit (date 01 death between 12-31-91 and '-1-95) OFFICIAL USE ONL Y FILE NUMBER 21 -0 5 0 0 6 3 "COuNTY CODE -VEA-;;-- - - NUMBER- - SOCIAL SECURITY NUMBER 1 77- 2 4 - 6 963 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1 59- 2 4 - 8 0 2 8 D 3. Remainder Return (date of death priortc 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 01 THIS SECnON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENnAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS JOHN D. GRIGSBY ESQ. 101 S. MARKET ST. FIRM NAME (If Applicable) z o i= <t ~ :;:) l- ii: <t (J w 0:: z o i= <t I- :;:) Q.. :IE o (J ~ I- I- Z w C Z o a.. (/) w 0:: 0:: o <.> TELEPHONE NUMBER 717-796-6537 MECHANICSBURG 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) PA 17055 ," ., OFFICIAljJSE ONLY g '-J') (1) (2) (3) (4) (5) ALL PROPERTY HELD AT DATE (6) OF DEATH WITH SPOUSE AS TENANCY BY THE ENTIRETIES (7) (9) (10) 14. Net Value Subjectto Tax (Line 12 minus Line 13) l:1=1= INl:TRIlr.T1nN~ nN REVERSE SIDE FOR APPLICABLE RATES Q....\N- Nt7:' ve ,-, ~.\..\. 15. -.J ~,~''''''C~\ \>'-l)\:(:\~ 16. C ~.... k. \J,....:.o~-f:t..... 17. \2...e v ~ <::-"\ YY-. C0-l~ ( , -' 8 IN. 1. 19. ~~.1.~ ~ ~(\ 41.a(11.i't - ---) ~ A.,;ST 20. D X _(15) X _(16) X .12 (17) X .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (8) (11) (12) (13) (14) ! C') - '_J I '::0 I-q C) -:-~ -0 :--) ::1] (:.:) - -1 ; :~~5 /-11 =,::;.-.,. G~) C) -] ,~ 'c~ ". U, Vi _$IDEA'Nt),RECMECKMATH < < DecedQnt's ComDlete Address: STREET ADDRESS 7225 WILSON RD. CITY MECHANICSBURG I STATE PA I ZIP 1 7055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty TotallnterestJPenalty ( D + E) If Line 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 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) 4. (4) (5) (5A) (5B) to: REGISTER OF WILLS, AGENT 5. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check 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; ........................................................................... 0 0 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 0 c. retain a reversionary interest; or ...................................................................................................... 0 0 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 0 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ................. 0 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 0 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 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 OF P RSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 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 spouse 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) (i1)]. 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 on 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. R.".""o:.".- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER 1. SCHEDULE J BENEFICIARIES FILE NUMBER AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 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 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] JOAN M. ARMSTRONG 135 WESLEY DR., APT. 3113 MECHANICSBURG, PA 17055 100 % SPOUSE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)