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Home My WebLink About12-20-05 REV-l500EXr&-OOl OFFICIAL USE ONl'( REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712~601 FILE NUMBER 21 05 0028 - NUhIlER- - - COUNTY CODE YEAR I- Z W C W (,,) W C DECEDENrS NAME (lAST, FIRST, AND MIDDLE INITIAL) Weaver, Edith M. - - ----------- DATE OF OEATH (MM.DO-YEAR) 12/28/04 SOC~SECURITYNUMBER I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOC~ SECURITY NUMBER DATE OF BIRTH (MM-DO-YEAR) 03/15/09 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) None w .., :.l:~~ U..U woo "'..... u.... ~ o 1. Onginal Return o 4. Limited Estate ~ 6. Decedent Died Testate (AlIachl;O(JYGf'Ml) ~ 9. Litigation Proceeds Received ~ 2. Supplemental Return o 4a. Future Interest Compromise (date of death 8fler 12-12-82) o 7. Decedent Maintained a Living Trust (AIladl copyofTn.ll o 10. Spousal poverty Credit (dOl ofdealh betften 12-31-81111ld 1-1-85) o 3. Remainder Retum(ll&teafdealhprbrk:t12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax underSec. 9113(A) (AllidlSch 01 ... z W Q Z o .. on w .. 1IJ u COMPLETE MAILING ADDRESS Benn Law Firm 103 E. Market Street, P.O. Box 5185, York, PA 17405- 5185 NAME Terence J. Barna, Esquire FIRM NA-ME (If-Applicable) Benn Law Firm TaEPHONENUMBER ._.._._~ (717) 852-7020 r---~ "I 1. Real Estale (Schedule A) 2. Slocks and Bonde (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Noles Reoeivable (Schedule D) (1) (2) (3) (4) (5) 0.00 0.00 0.00 0.00 12,500.00 -':") --) i'_' (~ -.1 z o ~ ~ l- ii: < (,,) w a:: 5. Cash, Bank Deposits & MisceNaneous 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) B. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Uabilitles, & Liens (Schedule I) 11, Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitable and Governmental BequestsJSec9113 Trusts for which an election to tax has not been made (Schedule J) 8,200.00 4,300.00 0.00 ~,) (6) 0.00 0:-- (7) 0.00 (9) (10) (B) 8,200.00 0.00 12,500.00 (11) (12) (13) 14. Net Value Subject to Tax (Une 12 minus line 13) (14) 4,300.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !( I-' ~ D.. ::iE o (,,) ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 4,300.00 X.o 45 (16) 193.50 16. Amount of line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate x .12 (17) x .15 (lB) 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (19) 193.50 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS Messiah Villaae. 100 Mt. Allen Drive .------------------ CITYM h . b ec ames urg I STATEpA ...~---T.zIP--- 17055 Tax Payments and Credits: 1. Tax Due (Page lUne 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 193.50 Total Credits (A + B + C ) (2) 0.00 3. Inte...sUPenalty il applicable D. Interest E. Penaity Totallnte...sUPenalty ( D + E ) (3) 4. If Une 2 is g....ter than Une 1 + Une 3, enter the diffe...nce. This is the OVERPAYMENT, Check box on Page 1 Line 20 to ...quost a refund (4) 0.00 5. If Line 1 + Une 3 is g....terthan Une 2, enter the diffe...noe. This is the TAX DUE. (5) 193.50 A. Enter the interest on the tax due. (SA) B. Enter the total 01 Une 5 + SA. Th~ is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT =-:I~ ~-'III liE PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. ...tain the use or income 01 the property transfe....d;.......................................................................................... 0 ~ b. ...tain the nght to designate who shall use the property transferred or its income;............................................ 0 ~ c. retain a reversionary interest; Of......,................................................................................................................... 0 (iJ d. receive the prom~ for life 01 either payments, benefits or ca...? ...................................................................... 0 ~ 2. II death occu~ aflerDeoember 12,1982, did decedent transfer properly within one year 01 death without receiving adequate consideration? ..........................................................................................."................. D ~ 3. Did decedent own an 'In trust fo~ or payable upon death bank account or seounty at his or her death? .............. 0 ~ 4. Did decedent own an Individual Reti...ment Account, annuity, or other non-probate properly which contains a benefldary designalion? ........................................................................................................................ 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 193.50 Under penaUies of pe~Ufy. I declare !hall have examined this return, including accompanying schedules and slatements, and 10 the besl 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 preparef has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADD~ ~y~-, rI~L,.JT., Doris Anne Young, Executrix, 9445 Cartisle Road, Dillsburg, Pennsylvania 17019 SIGNATU~OT~R THAN REPRESENTATIVE ADDRESS .. ~ Be_nnL."w Firm, 103 .E:.:_Market Street, P.O. Box 5185, York, Pennsylvania 17405-5185 ~___ _____ _1iEr--.mmmn -m: __nilll _~ --_=-a.1 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 PS ~9116 (a) (1.1) (ill. DATE ;.zZ(:?L..<:cvr DAJE L2fI?>/O? For dates 01 death on or after January 1, 1995, the Isx rate imposed on the net vaiue of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~91 16 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from Isx, and the statutory requi...ments for discosu... 01 assets and flling a Isx ...tum a... still applicable even if the surviving spouse is the only beneficiary. For dates 01 death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a steppa...nt 01 the child is 0% [72 P.S. ~9116(a)(1.2)]. The lax rate imposed on the net value of transfers to or for the use 01 the deoedent's lineal beneficianes is 4.5%, exoepl as noted in 72 P.S. ~9116(1.2) [72 P.S. ~911 6(a)(1 1I. The lax rate imposed on the net value 01 transfers to or for the use 01 the deoedent's sibilngs is 12% [72 P.S. ~9116(a)(1.311. 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-150' EX+ ('-981 '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Edith M. Weaver FILE NUMBER 21-05-0028 lndude the proceeds of litigation and the date the proceeds were received by the estate. All property lolntly-owned with right of survfvorshlp must be dllclosed on Schedule F. ITEM NUMBER DESCRIPTIDN 1. The Estate reported $7,500.00 in anticipated settlement proceeds from York County State Court litigation, Weaverv. Donald K. English, et al., No. 87-SU-03093-01 in its return med on September 22,2005. On or about December 6, 2005 the Estate received $20,000.00 from Integrity Insurance Company in Liquidation. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VAlUE AT DATE OF DEATH 12,500.00 12,500.00 REV.1511 EX+ (12.99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAl EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Edith M. Weaver FILE NUMBER 21-05-0028 Debts of decedent must be reported on Schedule L ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: 1. 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 200.00 3. Fam~'j Exemptimr. (If decedent's address is not the same as daimanrs. anach explanauOll) Claimant Street Address City State . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Benn Law Firm. contingency fee on litigation proceeds 8,000.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,200.00 REV-1513 EX-t(9-00) '* COMMONWEAi.JH OF PENNSYLVANiA. INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Edith M. Weaver NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) Doris Anne Young, 9445 Carlisle Road, DiIIsburg, PA 17019 1. 2. Donald E. Weaver, 199 River Isles, BradenlDn, FL 34208 RELATIONSHIP TO DECEDENT Do Not list Trustee(s) daughter son FILE NUMBER 21-05-0028 AMOUNT OR SHARE OF ESTATE 1/2 residue 1/2 residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET U NON.TAXABLE DISTRIBUTIONS: A. SPOUSAL DlSTRI8UTIONS 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)