HomeMy WebLinkAbout10-24-05
REV-l500 EX (6..QO)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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COUNTY CODE YEAR
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NUMB~R
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Layman Karen E.
DATE OF DEATH (MM-DD-YEAR)
01/24/2005
THIS RETURN MUST BE FILED IN DUPI.IFATE WITH THE
REGISTER OF WILlLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
173-42-5927
DATE OF BIRTH (MM-DD-YEAR)
09/25/1949
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Layman Joseph A. Jr.
~ 1. Onginal Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 death after 12-12,82)
o 7. Decedent Maintained a Living Trust (Aftach copy ofTrust)
o 10. Spousal Poverty Credit (dale 01 death between 12-31-91 and 1.1.95)
D 3. Remainder Return (dale of death !i>ribrlo 12.13.82)
D 5. Federal Estate Tax Return Req~ired
JL. a. Total Number of Safe Deposit abxes
o 11. Election to tax under Sec. 911*A) (Allacft Sch 01
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W NAME
fi Joseph A. Layman Jr.
~ FIRM NAME (II Applicable)
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~ TELEPHONE NUMBER
u (717) 249-7193
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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)
(1)
(2)
(3)
(4)
(5)
0.00
0.00
0.00
0.00
19,937.55
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o 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)
991122.57
0.00
0.00
(6)
0.00
(7)
14,882.92
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34,820.47
(9)
(10)
(8)
13,204.00
85,918.57
(11)
(12)
(13)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
0.00 x.O _ (15)
0.00
16. Amount of Line 14 taxable at lineal rate
x .0_ (16)
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
x .15
1 a. Amount of Line 14 taxable at collateral rate
(18)
(19)
0.00
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
. Decedent's Complete Address:
STREET ADDRESS
240 Old Stone House Road
CITY Carlisle I STATEpA I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
0.00
0.00
Total Credits ( A + 8 + C ) (2)
0.00
3. InteresllPenalty if applicable
D. Interest
E. Penalty
0.00
0.00
TotallnteresllPenalty ( 0 + E ) (3)
4. 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 (4)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
0.00
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.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
II
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BlOCIK~
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THa RETURN.
Under penallies of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declarati of preparer other than the personal representative is based on all information of which preparer has any knowledge.
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after January 1, 1995, the tax rate imposed on the net vall
The statute does not exempt a transfer to a surviving spouse from tax, and the stat
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-on
or a stepparent of the child is 0% [72 P.S. s9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's'
The tax rate imposed on the net value of transfers to or for the use of the decedE
individual who has at least one parent in common with the decedent, whether by blood or adoption.
:j. ALIS'
2 P.S. S9116(1.2) [72 P.S.
sibling is defined, under
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
[72 PS. 99116 (a) (1.1) (i)].
NAPD
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","/-1508 EX+ (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Karen E. Layman
FILE NUMBER.
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
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VALUE AT gATE
OF DEATt-l
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2,5[}000
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$~O.OO
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14'~fO.OO
2,2t1.56
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112 99
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ITEM
NUMBER DESCRIPTION
1 Miscellaneous jewelry
2 Miscellaneous clothing
3 2002 Ford Explorer (VIN 1FMZU74E62UA15135)
4 PA State Employees Credit Union - checking account 173425927
5 PA State Employees Credit Union - savings account 173425927
6 cash on hand
7. miscellaneous books
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, IOsert additional sheets of the same size)
19,937.55
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Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
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USE YOUR PSECU CHECK CARD
FOR HORE THAN JUST GROCERIES!
PAY FOR DINING OUT
ONLINE PURCHASES
UTILITY BILLS,AND HORE!
1...111.,. j 11..,...11..11.11111111111111111111111111I111111111
KAREN E LAYMAN
240 N OLD STONEHOUSE RD
CARt ISLE PA 17013-8513
JOINT OWNER
JOSEPH A LAYMAN, JR.
II
,~EV-1510 EX+ 16-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Karen E. Layman
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.
FILE NUMBEiR
ITEM
NUMBER
DESCRIPTION OF PROPERTY
INCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO OECEOENT AND
THE DATE OF TRANSFER ATTACH A COPY OF THE OEEO FOR REAl ESTATE.
DATE OF DEATH % OF DE CD'S EXCLUSION
VALUE OF ASSET INTEREST (IF APPLICABLE)
T BLE
VA UE
American Funds Account No. 64408610 (Individual Retirement Account)-
payable to Joseph A. Layman, Jr., surviving spouse
2. American Funds Account No. 64041349 (Roth Account) - payable to Joseph
A. Layman, Jr., surviving spouse
12,590.69
100
12,59069
2,292.23
100
~,292 23
TOTAL (Also enter on line 7 Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
14,88: .92
II
':',,/,1511 EX, (12'991*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Karen E. Layman
FILE NUMBER
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER
A.
DESCRIPTION
I
AMOUNll
2.
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home Inc. - funeral service package
Casket and interment receptable
Flowers
3169000
3,1040.00
6.
miscellaneous expenses
i
1424.00
488.00
72.00
\405.00
3
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obituary notice - Patriot News
death certificates
4.
B ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2. Attorney Fees
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
<-I. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Carlisle Memorial Service - Grave Marker
2,2f4.00
1 ,8~6.00
8
Westminster Cemetery, Carlisle, PA - cemetery lot
Westminster Cemetery, Carlisle, PA . gravesite preparation
I
1,Ot5.00
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I
9
TOTAL (Also enter on line 9, Recapitulation) $
(If more Space IS needed, Insert additional sheets of the same size)
13,2q4.00
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eX+ (12-03)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Karen E. layman
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DAr~
NUt.mER DESCRIPTION OF DEATH
FILE NUMBER
Ford Credit - payoff Account No. 27777994 - balance due on 2002 Ford Explorer
9,7:t1,1.08
2. Citimortgage Account # 6278508-4, PO Box 9438, Gathersburg, MD 20898-9438 - 50% of mortgage due
on property located at 240 Old Stone House Road, Carlisle, PA held with surviving spouse
74,69b.50
3.
links2Care, Lancaster, PA 17604 - home care services
741.50
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The Bon-Ton, Baltimore, MD 21297 - account balance
71549
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
85,918.$~
""V-1513 EX' (9-001 ~"'~~_
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
1'- - - -
ESTATE OF
Karen E. Layman
: :UlvI8ER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (12)]
1 . Joseph A. Layman, Jr.
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
surviving spouse
FILE NUMBER
AMOUNT OR SH.!\ E
OF ESTATE' '[
34,8\40.47
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- 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)
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