HomeMy WebLinkAbout11-29-05
OFFICIAL USE ONLY
REV.,500 EX l,MOl
~.. . COMMONWEALTH OF
,... . ^ PENNSYLVANIA
...'" .., : .~.. DEPARTMENT OF REVENUE
" ...;~ 'Y. DEPT. 280601
.; . ~ HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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CaUNTY CODE YEAR
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DECEDENrs NAME (LAST. FiRST, AND MIDm.E INITiAL)
Farrell Betty J.
SOCIA:. SECURITY NUMBER
172-24-8081
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
DATE OF DEATH (MM-GD.YEAR)
03/13/05
D,41"E OF 81RrH (MM-DG.YEAR)
12/16/31
SOCl<\L SECURITY NUMBER
(IF APPLiCA8LE) SURVIVING SPOUSE'S f-{,\.ME (LAST, FIRST. AND MIDDLE INITIAL)
II,;
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l~J 1. Original Return
D 4. Limited Estate
l~~~] 6. Decedent Died Testate (Attach copy 01 WIll)
[J 9. Litigation Proceeds Received
[J 2. Supplemental Return
[J 4a. Future Interest Compromise (do1& of d88tt18ft", 12.12-82)
[~.'.1 7. Decedent Maintained a Living Trust (Attach copy ofTrus1)
C! 10. Spousal Poverty Credit (data ofd8at11betwaan 12-31-91800 1-1-95)
CJ 3. Remainder Return (do1& of d8at11 pdorto 12-13-82)
n 5. Federal Estate Tax Return Required
...........
8. Total N umber of Safe Depos~ Boxes
L___j 11. Election to tax under Sec. 9113(A) (Attach SchO)
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NAME COMPLETE MAILING ADDRESS
Brian L. Farrell 19 Fortuna Ln.
FIRM NAME (II AppIc8b18) Enola, P A 17025
TELEPHONE NUMBER
(717) 732-6225
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 Properly
(Schedule E)
6. ~Q~~~Y CAoIned Properly (Schedule F)
U Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probata Properly
(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. Char~ble and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
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14. Net Value Subject to Tax (Line 12 minus Line 13)
115,000.00
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OFFICIAL USE ONLY
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(1)
(2)
(3)
(4)
(5)
688.83
(6)
(7)
(9)
(10)
(8)___.._________________________.._.._______...._...__~_!~~~~_:~.______
..___..__.._____......_______m.....m________......~_~~~~_~:_~.?...._.....
..---_......-----_..._.._--------------...------..--.._.?!?~.?:_~_!.....----_.
(11)
(12)
(13)
16,587.68
99,101.15
(14) ___........____________.._____________..__..______.._._..~~_'_~_~_~.:_~.~..____
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rata, or transfers under See. 9116 (a)(1.2)
x .0_ (15)
99,101.15 x.O ~ (16)
16. Amount of Line 14 taxable at lineal rata
17. Amount of Line 14 taxable at sibling rate
4,459.55
x .12 (17) .....................___________..._._____________.....________....____________...._
x .15 (18) WN_-_-_-_-.-_-_-_w:_-,_-_-'_~_'wmm_-_-'_w_w.w_-_,,,w.-_w_-_-_w_-_-,_w_w~"w_-_-_-_-_w_"
(19) _________..___m_m.._.._m_____..___.....______...m_..~A_~~,_~~_m..
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
CHECK HERE tF YOU ARE REQUESTING A REFUND Of AN OVERPAYMENT
20. L.___]
.............................;i>..:i'.~.'l'QM~Ay,.Q'*.~4~~....~..~~($.~T'...*.(......
Decedent's Complete Address:
STREET ADDRESS
4719-A Charles Rd
CITY M h . b I STATEpA T ZIP 17050
ee ames urg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
4,459.55
Total Credits (A + B + C ) (2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( D + 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)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(5B)
4,459.55
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 lax due.
4,459.55
Make Check Payable to: REGISTER OF WILLS, AGENT
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 [KJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [KJ
c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [KJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [KJ
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? ........................................................................................................................ 0 [KJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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DATE
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ADDRESS
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
E:flJ>LA) PA
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DATE
ADDRESS
For dates of death GIl Gr after Juiy 1, 1994 and befl:re Janliary 1, 1995, the t~x rale impm;ed on the net value of Iransfers tG Gr for the use nf tile surviving !.pouse is 3%
[72 ES. ~9116 (a) (1.'1) (i)].
Fer dales of dmith nn er ailE!r Jamiari 1, 1995, the ta~ ratE; imposed on the roet value of lransfers 10 or for Ihe use nf the surviving spouse :s 0% [72 P.S ~911f) (a) (1.1) (ii)].
The statute does rol:t eXem!l! a lranl.fer io ;~ surviving spouse from tax, and the staiutory requirements ror diseit:sure of assets and filing a tlX return are stili applicable even if
tile surv:ving spouse is the only benericiary.
For cates of death an or after Ju!y 1, 2000
The tax raie imposed on !tie nei vaillE! of transfers fmm a deceased chiid I'N,mty.one YE!ars of agE; or younger at dE!ath 10 or fer the USE! of a natural parent, afl adoptive parent,
or a stepparent of the dliid :s 0% [72 P.S. 991:6(a)(1.2i].
The tax rale ,mposed en the nel value eftransfers 10 or forthe use of tlle decedent's lineal benefiCiaries is 4.5%, except as noleCl in 72 PS. ~9116(12) [72 PS. ~91Hi(a)(1il
TIle taJt rate impC)!;ed cm the net value or h~lllsrers II: or fll!' the use of Ihe (jecedenfs sibl:lvJs is 12% [72 P.S ~911f)(a)(1.3)j. A sibiiflg is defined, under Section 9102, as an
individual who has at least olle parent in corml":ol1 witrl trle decadent. \'\11ell1ar by biood or adop~oll.
REV-1502 EX+ (6-9*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Betty J. Farrell
All real property owned solely or as a tenant in common must be reported at fair merket 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 w1hich is jointly_ned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
ITEM
NUMBER
1.
DESCRIPTION
4719-A Charles Rd. Mechanicsburg, PA 17050
VALUE AT DATE
OF DEATH
115,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets ofthe same size)
115,000.00
RE\i-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Betty J. Farrell
FILE NUMBER
Include the proceeds of I~igation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 Members 1st Federal Credit Union - Savings
51.15
3 Proceeds from sale of personal property at garagelyard sale
437.68
200.00
2 SamErChecking
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
688.83
REV-1511 EX+ (12-99)W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAl EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Betty J. Farrell
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
2
3
FUNERAL EXPENSES:
Sullivan Funeral Home
James R. Gingrich Memorials - engraving of headstone
Karen Waltersdorff - flowers, cake, food, refreshments
Salem United Church - burial
8,126.00
95.00
348.87
650.00
1.
4
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)IEIN Number of Personal Representative(s)
Street Address
City
State
Zip
Yeer(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Add ress
City
State
.Zip
Relationship of Claimant to Decedent
4.
Probate Fees
260.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Intercounty land Transfer - settlement charges
4,570.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
14,049.87
REV:1512 EX+ (12-03)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Betty J. Farrell
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expanses.
ITEM VALUE AT DATE
NUMBER DESCRIPTiON OF DEATH
FILE NUMBER
2
3
Boscov's - charge
306.68
385.67
89.00
311.95
1.
Walmart - charge
Pennsylvania American Water
4
PPL Utilities
St. Mark's Condo Assoc. - association fees
49.42
5
Verizon
6
510.00
7
Hampden Twp. - sewer/trash
230.00
9
Earthlink
440.25
9.95
8
Marie Huber, Tax Collector
10
Comcast
10.54
11
Donegal Mutual Insurance - auto insurance
99.00
12
Carpet Care Solutions - clean carpet for sale of home
95.35
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,537.81
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Betty J. Farrell
FILE NUMBER
NUMBER
[
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
Dennis P. Farrell 52 Hirooka Hosoecho Inasagun Shizoukaken, Japan
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1
Son
24,775.29
2
Karen M. Waltersdorff 727 Sinclair Rd. Mechanicsburg, PA 17055
Daughter
24,775.29
3
Wendy J. Dews 100 Wayne Ave. New Cumberland, PA 17070
Daughter
24,775.29
4
Brian L. Farrell 19 Fortuna Ln. Enola, PA 17025
Son
24,775.28
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET
IT 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 $
0.00
(If more space is needed, insert additional sheets of the same size)
.
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