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Home My WebLink About11-23-05 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) ANSELL, Donald Merle DATE OF DEATH W I- ~::!cn (.)a:~ wD..(.) ::t:OO (.)a:...J D..a:l D.. < ,I- rnZ Ww a:C a:Z 00 Ua. FILE NO. ,2 I - O~- - / q /3 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 162-20-4836 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS NUMBER I- Z W C w U w C DATE OF BIRTH (MM-DD-YEAR) 05/30/05 12/29/23 SURVIVING SPOUSE'S NAME (IF APPLICABLE) Romaine G. Ansell X 1. Original Return SOCIAL SECURITY NUMBER D 3. Remainder Return (death prior to 12-13-82) D 4a. Future Interest Compromise D 5. Federal Estate Tax (for dates of death after 12-12-82) Return Required X 6. Decedent Died Testate D 7. Decedent maintained a Living Trust 0 8. Total Number of Safe (Attach copy of Will) (Attach copy of Trust) Deposit Boxes 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 12-31-91 and 1-1-95) 9113(A) (Attach Sch 0) ALLCORRESPONOENCI:AND CONFIDI:NTfAl.TAX · INFORMATION StlOULO SI:.DIRECTEDTO: NAME COMPLETE MAILING ADDRESS Charles B. Swi art, Attorne -at-Law 223 Washington Street TELEPHONE NUMBER Huntingdon, PA 16652 814 643-4840 D 2. Supplemental Return 4. Limited Estate 25,833.33 Z o 5 :=l l- ii: <C U w a: 1. Real Estate (Schedule A) [1] 2. Stocks and Bonds (Schedule B) [2] 3. Closely Held Corporation, Partnership or Sole-Proprietorship [3] (Schedule C) 4. Mortgages and Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Pers. Property (Sched. E) 6'1 JOintl1 Owned Property (Schedule F) Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Probate Property (Schedule G or L) 8. Total Gross Assets: (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) [9] 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) [10] 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 has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) [14] 22,333.33 -) ( :) i'l .---) [4] [5] [6] [7] -I 1"'.-) [8] 0 25,833.33 3,500.00 [11] 3,500.00 [12] 22,333.33 [13] Z o ~ I- :=l a. :2 o U >< j! SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aH1.2\ 22,333.33 x 0.00 = 16. Amount of line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate x 0.045 = x 0.12 = x 0.15 = [19] Decedent's Complete Address: 406 Mountain Street Summerdale, PA 17093 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount [1] Total Credits (A+B+C) [2] 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty (D+E) 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 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. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. [3] [4] [5] [SA] [5B] Make Check Payable to: Register of Wills, Agent PLEASE ANSER 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; m b. retain the right to designate who shall use the property transferred or its income; X c. retain the reversionary interest; or X d. receive the promise for life of either payments, benefits or care? X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ~ 4. Did decedent own an individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ~ IF 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 purjury, 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 the preparer has any knnwlp.cinp. S~i ature of Person responsible for filing Return /~tZ:lt~ A ~~ A DRESS 406 Mountain Street Summerdale, PA 17093 Sign r of P epare her rvRepre ntative q~ ~~'-J ------==-'V . ~~~. DATE II -:2./ - Or DATE /// ~ j/ {J-S , For date of death after 7/1/94 and before 1/1/95, tax rate For date of death on or after 1/1/95, tax rate for transfers t The statute does not exempt a transfer to a surviving spou; For dates of death on or after 7/1/2000: Tax rate for transfers from a deceased child 21 years of age stepparent is 0% Tax rate for transfers to or for use of lineal beneficiaries is 4.5' Tax rate for transfers to or for use of decedent's siblings is 120/, with decedent, whether by blood or adoption. ~s'L surviving spouse is 3% 'Jse is 0% be reported. atural parent, adoptive parent or a ~. ~9116 _. ,~f1ciary who has at least one parent in common COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ANSELL, Donald Merle ;J.../- tIS-- /0 13 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair marke value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being comoelled to buv or sell, both havina reasonable knowledae of the relevant facts. ITEM NUMBER 1 SCHEDULE A REAL ESTATE DESCRIPTION 1/6 interest in Clay Township, Huntingdon County real estate (Appraisal for full value of property attached.) Tax Parcel No. 09-09-09.2 VALUE AT DATE OF DEATH 25,833.33 TOTAL (Also enter on line 1. Recaoitulation) (If more space is needed, insert additional sheets of same size.) $25,833.33 Borrower Property Address .0. City Three SDrlnes Legal Description Deed Book 682 .596 Sale Price $ Date of Sale Actual Real Estate Taxes $ 1.143 (yr) Lender/Client Occupant Vacant Census Tract 9512 IFIe No. OIIOlIOllJI, hili .51 AnHII, ClIrleatat, 090909.2 Map Reference 09-09-09.2 LAND APPRAISAL REPORT County Huntlnadon Stale PA Zip Code 17086 Loan Term_ yrs. Loan charges to be paid by seller $ Address Instructions to Appraiser Property RIghts Appraised ~ Fee 0 Leasehold 0 De Minimis PUD Other sales concessions Urban Suburban Rural DOver 75'lr. 0 25" to 75" ~ Under 25" o Fully Dev. 0 Rapid ~ Steady 0 Slow o increasing ~ Stable 0 Declining o Shortage ~ In Balance 0 Oversupply o Under 3 Mos. ~ 4-6 Mos. 0 Over 6 Mos. ~" 1 Family ~" 2-4 Family _" Apts. _" Condo _" Commercial _" Indusb1al---1!" Vacant _" Change In Present Land Use ~ Not Ukely 0 Likely (0) tL From To Predominant Occupancy IZI Owner 0 Tenant _" Vacant Single Family Price Range $ 40.000 to $ 200.000 Predominant Value $ 75.000 Single Family Age --1. yrs. to--1QQ.. yrs. Predominant Age 30 yrs. Location Buitt Up Growth Rate Property Values Demand/Supply Marketing Time Present Land Use Appraiser Tlmothv Schrack o Taking Place (0) Employment StablIlly Convenience to Employment Convenience to Shopping Convenience to Schools Adequacy 01 Public Transportation Recreational Facilities Adequacy of UtilIties Property Compatiblllly Protection from Detrlmental Conditions Police and Are Protection General Appearance of Properties Appeal to Market Good Avg. Fair POOl O~OO OO~O OO~O O~OO O~OO O~OO O~OO O~OO O~OO O~OO O~OO O~OO Comments Including those factors, favorable or unfavorable, affecting marketability (e.g. publiC parks. schools, vfew, nolse): 69 Sq. Ft 01 Acres Comer Lot Present Improvements ~ do 0 do not conform to zoning regulations Elec. Gas Water San. Sewer ~NoOY.. The undersigned has reelled three recent sales of propries most slmIIar and prOJdmale 10 subject and has considered these In the market analysis. The descrfpllon Includes a dollar adJustment renecllng market reacUon 10 those tterns of slgnlncant varl8Uon between the subject and comparable properUes. II a slgnlfleant ttern In Ihe comparable propelty Is superior 10 or more favorable Ihan Ihe subject propel1y, a minus H adJustment is made !hus reducing Ihe Indicated value of subject; If a slgnlfieant ttern In Ihe comparable Is Inferior 10 or 1m favorable than the subject property, a plus (+) adjustment is made thus increaSing the Indicated value of the SUbject ITEM SU P CEO NO Address R.D. RR 1 Box 391 Three S Three S rin s PA 17264 1.78 miles o o +6 458 -13280 6822 158178 09/22 20~ to be $ 155 000 o Old 0 Did Not Physically Inspeel Property Schrack Realty Form LND - 'TOTAL tor Windows' appraisal software by a la mode, inc. - 1-600-ALAMODE SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES, INHERITANCE TAX RETURN ADMINISTRATIVE COSTS AND RESIDENT DECEDENT MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER ANSELL, Donald Merle c:2/- If J-: / (J /-:? ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: 1 2 3 4 B. Administrative Costs: 1 Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2 Attorney Fees: 3 Family Exemption Claimant Romaine G. Ansell Relationship Wife Address of Claimant at Decedent's death Street Address 406 Mountain Street City Summerdale State PA Zip Code 1 7093 3,500.00 4 Probate Fees C. Miscellaneous Expenses: 1 TOTAL (Also enter on line 9, Recapitulation) $3,500.00 (If more space is needed, insert additional sheets of same size) . . REV-1513 EX+ (8-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF: SCHEDULE J BENEFICIARIES FILE NUMBER ANSELL, Donald Merle c2l-o.!~/ () I { ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1 Romaine G. Ansell Wife Entire estate 406 Mountain Street, Summerdale, PA 17093 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS Also enter on line 13, Reca itulation (If more space is needed, insert additional sheets of same size) $0.00