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HomeMy WebLinkAbout01-24-06 REV-1500 EX (6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 w .., :.:::!;lI) 01:1::':: w!LO J:oo 01:l:..J !LID ~ FILE NUMBER 21 05 0449 COUNTY CODE YEAR NUMBER ~ Z W C W o W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) GRIMES, BARBARA R. SOCIAL SECURITY NUMBER 216-28-5729 DATE OF BIRTH (MM-DD-YEAR) 10/05/1931 DATE OF DEATH (MM-DD-YEAR) 04/'2Ii/2005 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVNlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A [i] 1. Original Return o 4. Lirnited Estate ~ 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of dealh after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (dale of death between 12.31-91 and 1-1-95) o 3. Remainder Return (dale of death prior to 12-13-82) o 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Soh 0) I- ffi o z o !L ~ 1:1: o o ;_~"'~c_1D."'.c_:IU.'~g""'.I._! ...;..~I~_i~'''i.: NAME COMPLETE MAILING ADDRESS GLEN R. GRELL, ESQ. 17 NORTH SECOND STREET, 15TH FLOOR FIRM NAME (If Applicable) HARR SBURG PA 7 1 KLETT ROONEY LIEBER & SCHORLlNG I, 1 10 TELEPHONE NUMBER (717) 903-0179 (717)-231-7700 I"'.~ (1) (2) (3) (4) (5) 165,000.00 71.00 0.00 0.00 74,759.56 z o ~ ...J ::) ~ a: < o w a:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (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. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 15,396.50 266,828.24 0.00 ~-' .-) '-~ ~J 42,394.18 L.~ (6) (7) 0.00 282,224.74 (9) (10) (8) 14,288.20 1,108.30 (11) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 266,828.24 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ a-; ::) 0.. :E o o g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.O_ (15) 266,828.24 x.O~ (16) x .12 (17) x .15 (18) (19) 0.00 12,007.27 0.00 0.00 12,007.27 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.~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT )Jo>_'SUE1'fi.U~D.All.'IQtJErf'''_Rai..c..Ate ~_.~;c: ,\ ',c',' Decedent's Complete Address: STREET ADDRESS 317 WOLF BRIDGE ROAD MIDDLESEX TOWNSHIP erTY CARLISLE I STATEpA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 12,007.27 0.00 13,000.00 600.36 Total Credits ( A + 8 + C ) (2) 13,600.36 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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 Line 20 to request a refund (4) 0.00 1,593.09 A. Enter the interest on the tax due. (5) (SA) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 8. Enter the total 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 APPROPRIATE BLOCKS 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 shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 ~ 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 [i] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. (2 ADORE S 17 NORTH SECOND STREET, 15TH FLOOR, HARRISBURG, PA 17101 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. 99116 (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 exemot 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 only 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-one 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. 99116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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-1502 EX'" (6-9_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF BARBARA R. GRIMES FILE NUMBER 21-05-0449 All real property owned solely or as a tenant in common must be reported at fair market 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 which is jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 317 WOLF BRIDGE ROAD, MIDDLESEX TOWNSHIP, CARLISLE, PA VALUE AT DATE OF DEATH 165,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 165,000.00 REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF BARBARA R. GRIMES FILE NUMBER 21-05-0449 All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION US SAVINGS BOND, WITH ACCRUED INTEREST VALUE AT DATE OF DEATH 71.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 71.00 REV-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BARBARA R. GRIMES FILE NUMBER 21-05-0449 Include the proceeds of litigation 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 CASH DISTRIBUTIONS - MEMBERS 1ST CREDIT UNION -IRA ACCOUNT 2 REFUND - THE SENTINEL 3 REFUND - TV GUIDE 4 REFUND - COMCAST CABLE 5 REFUND - HARTFORD HOMEOWNERS' INSURANCE 6 REFUND - BON-TON 7 REFUND - SPRINT 8 SALE OF MISCELLANEOUS FURNITURE - CARL OCHER, AUCTIONEER 9 PRIVATE SALE OF MISCELLANEOUS FURNITURE 10 MISCELLANEOUS FURNITURE, CLOTHING AND HOUSEHOLD GOODS 11 MEMBERS 1 ST CREDIT UNION - IRA ACCOUNT 12 MEMBERS 1ST CREDIT UNION - SAVINGS ACCOUNT 13 METLlFE TOTAL CONTROL ACCOUNT 14 M & T BANK - CHECKING ACCOUNT 15 2003 BUICK CENTRUY AUTOMOBILE 540.00 96.59 44.16 9.31 26.44 2.85 4.01 445.55 100.00 3,000.00 35,581.17 112.62 16,855.08 5,941.78 12,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 74,759.56 REV-1509 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF BARBARA R. GRIMES FilE NUMBER 21-05-0449 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. DEBORAH A. ANDERSON 108 BIG SPRING TERRACE NEWVillE, PA 17241 DAUGHTER B. C. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 03/11/03 MEMBERS 1ST FEDERAL CREDIT UNION 84,788,35 50% 42,394.18 TOTAL (Also enter on line 6, Recapitulation) $ 42,394.18 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ 112-99>_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF BARBARA R. GRIMES FILE NUMBER 21-05-0449 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 3 FUNERAL EXPENSES: HOFFMAN-ROTH FUNERAL HOME, CARLISLE CUMBERLAND VALLEY MEMORIAL GARDENS BETTY WARNER CATERING LUNCHEON SUPPLIES AND DRINKS 4,299.40 474.00 570.00 217.66 1. 2 4 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) DEBORAH A. ANDERSON 4,000.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 108 BIG SPRING TERRACE City NEVWILLE Year(s) Commission Paid: 2005 11~_~(,-~157 State PA Zip 17241 2. Attorney Fees 4,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 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. REAL ESTATE APPRAISAL - LARRY SLUSSER 8 OFFICE MAX- SUPPLIES 9 US POSTAL SERVICE 380.00 300.00 7.42 39.72 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 14,288.20 REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILlTIES, & LIENS FILE NUMBER 21-05-0449 ESTATE OF BARBARA R. GRIMES Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MASTER CARD - FINAL BILLING COMCAST CABLE - FINAL BILLING 106.33 47.82 2 3 BON-TON - FINAL BILLING YORK WASTE - FINAL BILLING SPRINT - FINAL BILLING CINGULAR - FINAL BILLING PPL UTILITIES - FINAL BILLING HARTFORD - HOMEOWNERS' INSURANCE - FINAL BILLING 161.08 4 435.31 143.71 5 6 20.65 129.96 7 8 63.44 1,108.30 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF BARBARA R. GRIMES FILE NUMBER 21-05-0449 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 [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 DEBORAH A. ANDERSON, DAUGHTER 33.33 108 BIG SPRING TERRACE,NE'MIILLE, PA 17241 2 RICHARD D. GRIMES SON 33.33 1708 BRAEMORE COURT, KERNERSVILLE, NC 27284 3 KATHLEEN A. YEAKLEY DAUGHTER 33.33 118 YELLOW BREECHES DRIVE, CAMP HILL, PA 17011 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 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) KLETT ROONEY LIEBER & SCHORLING A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 17 NORTH SECOND STREET, 15TH FLOOR HARRISBURG, PENNSYLVANIA 17101-1503 TELEPHONE (717) 231-7700 Glen R. Grell (717) 231-7705 Facsimile (717) 231-7712 E-mail: eerell(al.k1ettroonev.com January 20,2006 Cumberland County Register of Wills One Courthouse Square Carlisle, P A 17017 RE: Barbara R. Grimes File Number 21-050449 Enclosed are three copies of form REV -1500, Inheritance Tax Return, for Decedent, Barbara R. Grimes, file Number 21-050449. I also included a check made out to The Register of Wills for $15.00 to cover the filing fee. Please forward a copy to my office using the enclosed self- addressed stamped envelope. Feel free to contact me with any questions. 6]G~ Glen R. Grell For KLETT ROONEY LIEBER & SCHORLING A Professional Corporation GRG/rh ~t Ii i'\ d dJ!!t~.P $) )' L~tl sL e C' P'l /!.-e h 17t hi At:";,,J ,., i '\ \ ~"'\ -j ':" (, \ PENNSYLVANIA DELAWARE NEW JERSEY WASHINGTON. D.C.