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Home My WebLink About10-24-05 RE'J.l5OQ EX ~J 'I I ! REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT t/ '* COMMONWEAlTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I!:: :.::S12 ufu woo :rCll:~ ulI.lD ~ I I FILE NUMBER 21 05 COUKTY CODE YEAR 0276 I- Z UJ Q UJ o UJ Q DECEDENfS NAME (LAST, FIRST, AND MtDDLE INITIAL) Ireland, Thornton E. DATE OF DEATH (MM-DO-YEAR) 02106/2005 SOCIAL SECURITY NUMBER 246-14-8989 THIS RETURN MUST BE FILED IN REGISTER OF SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DO-YEARI 08/17/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Ireland, Elizabeth A. ~ 1. OIIginal Return o 4. Umited Estate ~ 6. Decedent Died Testate (Alladl oopy of Wl~ o 9. Utigation Proceeds Received o 2. Supplemental Return o 41. Future InteIesl Compromise {dale of daolh _ 12-12-82) o 7. Decedent Maintained a Living Trust (AlladloopyofTIU8t) o 10. Spousal Poverty Credn (dale oIdaalh boIwe8n 12-31-91 ;nj 1-1-$5) NAME John C. Oszustowicz FIRM NAME (n AppIcabIe) Law Office of John C. Oszustowicz TELEPHONE NUMBER (717) 243-7437 COMPLETE MAILING ADDRESS 104 S. Hanover St. Carlisle, PA 17013 z o ~ ::>> l- ii: c( o w a::: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held CoIporalion, Partnership or SoJe..Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposns & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total GroN Assets (total Lines 1-7) 9. Funeral Expenses & Adrninislrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Uabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Unes 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) 14. Net Value Subject to Tax (Line 12 minus Une 13) (14) 371,896.09 2,401.64 (8) 19,625.95 74,297.73 (11) (12) (13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ... ::J Q. ~ o ~ 15. Amount of Line 14 taxable at the spousal tax 2,401.64 x.oL 0.00 rate, or transfers under Sec. 9116 (a)(1.2) (15) 16. Amount of Line 14 taxable at lineal rate 352.270.14 x.o~ (16) 5852.16 17. Amount of Line 14 taxable at sibling rate ___x.12 (17) ! \ ~.852.16 18. Amount of Une 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) CHECK HERE W YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT , I Decedent's Complete Address: STREET ADDRESS _---1 045 Hill Place CITY Carlisle STATE PA Tax Payments and Credits: 1. Tax Due (Page 1 line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 15,852.16 15,800.00 831.58 Tolal Credits ( A + B + C ) (2) 16631.58 3. InterestlPenalty if applicable D. Interest E.Penalty TolallntereslJPenalty ( 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 Une 20 to request a refund (4) 779.42 A. Enter the interest on the tax due. (5) (SA) 5. If Line 1 + Line 3 is greater than Line 2, enter the cfdferen<:e. This is the TAX DUE. B. Enter the tolal of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWiNG QUESTIONS BY PLACING AN ..X" IN THE APPROPRJA TE BlO KS 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 shaH use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; 01'.......................................................................................................................... D [iJ d. mceiVe the promise for life of either payments, benefits or care? ...................................................................... 0 iii 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D 3. Did decedent own an "in lNst 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 conlains a beneficiary designation? ....... .................................................. ........................ .................. ..................... [iJ ~ [iJ o IF THE ANSWER TO ANY OF THE ABOVE QUESnONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF Under plII1lII\le& 01 perjury. I decl8re tIIall haV8 ~ lhilIl8lIlm. ~ ~ sdledules and 1lalllmenlS, and to Ihe best II my lcn<Miedge and belief. ft Is tIU8. conecl end <lOIIlpleIe. cA pf8p8Ier oilier then tie pelfOI18I ~ is '-l on aI inIonnallon cA -MlIcIl prepIlI8r his any lmowledge. F ~NSIBLE FOR FlUNG REl1JRN r'~=-l)- ~Jj. ~L . 104 Hanover St., Car1isle, PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ~- DATE . __~_____,.______.___~___,__~._~____m______ _______._.____.~_.__~.___________.___.__._~__'^~~____.__._.__._<._._,_..__.~..___.__.__._~_._~...____.__..___.__..___._n_____ ADDRESS For dates of death on or after July 1. 1994 and before January " 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse [72 P.S. 99116 (a) (1.1) (ill. For dates of death on or after January 1, 1995, the tax rate imposed on the net N f\~ ~ The statute does not exemot a transfer to a surviving spouse from tax, and thefi r f-/ the surviving spouse is the only beneficiary. For dates of death on or after July " 2000: The tax rate imposed on the net value of transfers from a deceased child twenl1 or a stepparent of the child is 0% 172 P.S. ~9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedei The tax rate imposed on the net value of transfers to Of for the use of the de individual who has at least one parent in common with the decedent, whether by ~~- -. ---. iving spouse is 0% (72 P.S. ~9 16 (8) (1.1) (ii)). and filing a tax relum are still lcable even if J ~US{ I I r the use of a natural parent an ~oplive parent, in 72 P.S. 99116(1.2) 172 P.S. 991~6(a)(1)J. I. A sibling is defined, under sf 9102, as an I \ I ,I REV-1503 EX+ (&-98) *' COMMON\NEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Thornton E. Ireland !~ FILE NUMBER 21~05~0276 All property jolntIy-owlllKl with right of IUI'Vivorshlp must be dIIc1C1111d on ScI1tdule F. ITEM VALUE A DATE NUMBER DESCRIPTION OF DE ATH 1. See attached listing 371,896.09 .: . , , I '. . , , . i \ TOTAL (Also enter on line 2, Recapitulation) $ 371,896.09 (If more space is needed, insert additional sheets of the same sae) , I Sc...he..du \e.. B Ireland, Thornton E. File 21-05-027~ 1 1327.749 shares Scudder GNMA Fund - Class S CUSIP 811158104 15.20 20,181.78 2 231.19 sh Baxter International, Inc. Common Stock CUSIP 71813109 34.88 8,063.86 3400 sh Cisco Systems Common Stock CUSIP 17275R102 17.90 7,160.00 4516.57 sh Exxon Mobil Corp Common Stock CUSIP 30231G102 54.90 28,359.94 5 106.1 sh Emerson Electric Co. Common Stock CUSIP 291011104 68.59 7,277.15 6 335.16 sh General Electric Co. Common Stock CUSIP 369604103 36.18 12,126.09 7 219.28 sh Hershey Foods Corp. Common Stock CUSIP 427866108 60.23 13,207.38 8204.33 sh Intel Corp. Common Stock CUSIP 458140100 22.86 4,671.06 9 149.97 sh JPMorgan Chase & Co. Common Stock CUSIP 481228203 37.70 5,654.02 10 26 sh Medco Health Solutions Inc. Common Stock CUSIP 58405U102 43.35 1,127.10 11 547.52 sh Pepco Holdings Co. Common Stock CUSIP 713291102 12 212.35 sh State Street Corp Common Stock CUSIP 857477103 13 101.87 sh Wal-Mart Stores, Inc. Common Stock CUSIP 931142103 14 1792.932 sh T.Rowe Price International Stock F Acount520033938-5 CUSIP 77956H203 15 40.21 sh Met-Life Co Common Stock CUSIP 59156R108 16 1037.93 sh Fidelity Real Estate Investment CUSIP 316138205 17 1172.573 sh Janus Growth & Income Fund CUSIP 471023200 18 1034.536 sh Janus Fund CUSIP 471023101 19557.398 sh Janus Twenty Fund CUSIP 471023408 20 788.849 sh Evergreen Large Co Growth Fund CUSIP 30023C848 21 762.727 sh Evergreen Utility & Telecommunicat CUSIP 300237849 22 325.54 sh Vanguard 500 Index Growth Fund CUSIP 922908108 22.61 12,379.38 45.33 9,625.91 53.47 5,447.20 12.83 23,003.32 24.00 965.04 28.35 29,425.23 32.05 37,580.96 23.91 24,735.76 41.67 23,226.77 6.25 4,930.31 10.72 8,176.43 110.96 36,121.92 23 199.162 sh Vanguard Growth Index Fund CUSIP 922908504 24 1576.334 sh Vanguard Short-term Investment F CUSIP 922031406 Accrued Dividend on #24 25 1686.207 sh Vanguard Dividend Growth Fund CUSIP 922908604 26211.524 sh Vanguard Total Stock Market Index CUSIP 922908306 Total Assets 25.98 5,174.23 10.63 16,756.43 9.26 12.14 20,470.55 28.55 6.039.01 371,896.09 ,I 11 REV-1510 8<+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE BER Thornton E. Ireland 21-05-b276 I This schedule must be completed and filed If the answer to any of questions 1lhrough 4 on the reverse side oflhe REV-1500 COVER SHEET is~. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH INCLUDE THE NAME Of THE TRANSfEREE. THEIlI RElA110NllHIP TO DECEDENT ANlJ % OF DECO'S EXCLUSION TAXABLE NUMBEIl THE DATE Of TRANSfER. ATTACH A COPY Of THE DEED !'OR REAL ESTATE. VALUE OF ASSET INTEREST Ill' APl'LlCAl!LE) VALUE 1. Evergreen Investments IRA Utility & Telecommunications-A Acct # 2,401.64 100 1007670450 Transferee Elizabeth Anne Bear Ireland - Wife 7/12/05 2,401.64 , , , TOTAL (Also enter on line 7 Recapitulation) $ 2 401.64 (If more space is needed. insert additional sheels of the same size) 'I REV-1511 EX+ (12-99. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT leNIDULI H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Thornton E. Ireland FILE NUMBER 21.05.0276 Debta of decedent must be I'IJIOft8d on Schedule L ITEM NUMBER A. DESCRIPTION AM )UNT 6,802.00 . 195.00 104.48 . . 848.00 . . 0 3 FUNERAL EXPENSES: Ewing Brothers Funeral Home T.A. SulHvan - Headstone engraving Georges Flowers L&D Catering, Inc. . food for memorial service 1. 2 4 B. ADMINISTRATIVE COSTS: 1. Personal Replesentalive's Commissions Name of PelSOl18l Representallve(s) Social Security Number(s)/EIN Number of Personal Representative(s) street Address /0 l.( f J/v I-, ~ ve v (~ v /1.rtL. JOhN (!., () s 2-u...rIo (V l L "2- otJ 'f~ - ff- State I/j-]jp Lfo) ( City /70/3 Year( s) Commission Paid: , 2. AItomey Fees 1,000.00 . 3. Family Exempliol1: (If decedent's address is not the same as claimant's, altach explanation) Claimant Street Address City State . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Legal Advertising 8 Filing Fees 473.00 i i . 168.47 35.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 19625.95 'I REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Thornton E Ireland FILE NUMBER 21-05-0276 \ RELATIONSHIP TO DECEDENT AMOUNT 01 SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lilt Trustee(s) OF ES ATE I TAXABLE DISTRIBUTIONS [Include outrlght spousal distributions, and tlansfers under Sec. 9116 (a}(1.2)] , 1 Elizabeth Anne Bear Ireland. 24 N. Acorn Dr., Baiting Springs, PA 17007 Wife 2,401.64 2 Marilyn !<raja, 104 London Terrace, Evington, VA 24550 Child 8,067.53 3 Thornton Ireland, Jr., 18873 Oakridge Dr., Cleveland, TX 77327 Child 18 ,067.54 , 4 Barbara Mowat, 21443 Ridenour Rd,. Boonsboro, MD 21713 Child fa ,067.53 5 Lois Legere, 10605 Echo Lake Dr., Odessa, FL 33556 Child a 8,067.54 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEIIT n NON-TAXABLE DISTRIBUTIONS: A. SPOUSAl DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE , B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I TOTAL Of PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.1500 COVER SHEET S 0.00 (If IIlOI1I space is needed. insert 8ddltion8I sheets of lhe same size)