HomeMy WebLinkAbout12-13-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
lUCY S COOVER
____un fold
ESTATE INFORMATION: SSN: 193-63-3356
FILE NUMBER: 2105-1073
DECEDENT NAME: STONER CHARLOTTE J
DA TE OF PAYMENT: 12/13/2005
POSTMARK DATE: 12/13/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/21/2005
NO. CD 006098
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,321.45
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TOTAL AMOUNT PAID:
REMARKS:
CHECK#145
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
$2,321.45
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
REV-1500 EX ..(6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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STONER CHARLOTTE
DATE OF DEATH (MM-DD-Year)
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DATE OF BIRTH (MM-DD-Year)
10/21/2005 11/10/1905
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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[Xl 1. Original Retum
o 4. Limited Estate
o 6. Decedent Died Testate (AttachcopyofWiR)
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of death aIler 12-12-82)
o 7. Decedent Maintained a Living T rust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICIAL USE ONLY
FILE NUMBER
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COUNTY CODE YEN/. NUMBER
SOCIAL SECURITY NUMBER
1 93- 6 3 - 3 3 5 6
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (date of death prior to 12-13-82)
o 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Eiection to tax under Sec. 9113(A) (Attach Sch 0)
NAME
MURREL R. WALTERS III, ESQUIRE
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
54 EAST MAIN STREET
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TELEPHONE NUMBER
717-697-4650
MECHANICSBURG
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & 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 Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Deceden~ 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 Govemmental 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)
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)
X _(15)
54,302.97 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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(8)
(11)
(12)
(13)
(14)
PA 17055
OFFICIAL USE ONLY
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58,714.38
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58,714.38
3,890.80
520.61
4,411.41
54,302.97
54,302.97
2,443.63
2,443.63
.
Decedent's Complete Address:
STREET ADDRESS
BENT CREEK ROAD, APT. 101
CITY T STATE I ZIP
MECHANICSBURG PA 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
2,443.63
122.18
Total Credits (A + B + C)
(2)
122.18
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
2,321.45
2,321.45
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; ........................................................................... D 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00
c. retain a reversionary interest; or ...................................................................................................... D 00
d. receive the promise for life of either payments, benefits or care? ............................................................. D 1XI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. D 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... D 00
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 pe~ury. 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 PERSON RESPONSIBLE FOR FILING RE,:T~
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ADDRESS LUCY S. COOVER ?I"" DAIlG......ERI..OINT OWNER
142 STATE ROAD, ME AN s,a G ,/ ,. "
SiGNATURE OF PREPARER OTHER THAN S
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ADDRESS MURREL R. WALTERS III, 'ESQUIRE
54 EAST MAIN STREET, MECHANICSBURG
DATE
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PA 17050
DATE
-;J-t;L-J,j'
PA 17055
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. 99116 (a) (1.1) (ii)).
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 oniy 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.{me 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. 99116(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. 99116(1.2) [72 P.S. ~9116(a)(1 )).
The tax rate imposed on the net value of transfers to orfor 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.
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
STONER
FILE NUMBER
CHARLOTTE J.
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. LUCY S. COOVER
142 STATE ROAD
MECHANICSBURG, PA 17050
DAUGHTER
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JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY 0/0 OF DATE OF DEATH
ITEM FOR JOINT MADE INClUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUM8ER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1998 CITIZENS BANK 117,428.75 50. 58,714.38
CHECKING ACCOUNT
TOTAL (Also enter on line 6, Recapitulation) $ 58,714.38
(If more space is needed, insert additional sheets of the same size)
REV-151~ EX + (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STONER
CHARLOTTE
Debts of decedent must be reported on Schedule I.
J.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MYERS FUNERAL HOME. PREPAID
2. ORGANIST. MYERS FUNERAL HOME 100.00
3. FUNERAL LUNCHEON. ST. .fOHNS LUTHERAN CHURCH 89.60
4. FLOWERS - WAYNE NOSS FLORIST 21.20
5. TOMBSTONE - GINGRICH MEMORIALS 2,915.00
B. ADMfNISTRA TlVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Sodal Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees MURREL R. WALTERS III, ESQUIRE 750.00
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY 15.00
5. Accountanfs Fees
6. Tax Return Prepare(s Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 3,890.80
(If more space is needed, insert additional sheets of the same size)
.REV-1512 EX" (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STONER CHARLOTTE
FILE NUMBER
J.
Include unreimbursed medical expenses.
VALUE AT DATE
OF DEATH
ITEM
NUMBER DESCRIPTION
1. LOWER ALLEN TOWNSHIP
PERSONAL TAXES
2. ALERT PHARMACY
MEDICAL
3. ST. .JOHN'S LUTHERAN CHURCH
MONTHLY CONTRIBUTION. PAID OCTOBER 16, 2005 BUT NOT DEDUCTED
FROM CHECKING ACCOUNT UNTIL AFTER DEATH
11.00
209.61
300.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
520.61
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
STONER CHARLOTTE J.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS Dnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. LUCY S. COOVER DAUGHTER. 100%
142 STATE ROAD JOINT SURVIVING HEIR
MECHANICSBURG, PA 17050
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.
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)