HomeMy WebLinkAbout02-03-06 (3)
REV-1500 Ex' + (6-00)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 1 -05 0 54 0
""COuNTYCOOE ---YEA~ - - NUMsER- -
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
1 6 2 - 2 4 - 1 071
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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Schumack Donald D
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
D 3. Remainder Retum (date 01 death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
Q.. 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
5/3/2005 11/27/1930
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Ma A. Schumack
[XJ 1. Original Return
D 4. Limited Estate
[XJ 6. Decedent Died Testate (AttachcopyoIWiII)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum
D 4a. Future Interest Compromise (date 01 death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
D 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-951
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Debra K. Wallet Es . 24 North 32nd Street
FIRM NAME (If Applicable)
Law Offices of Debra K. Wallet
TELEPHONE NUMBER
717 737-1300 eam Hill PA 17011
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
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OFFICIAL USE ONLY
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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)
(6)
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47,708.94 i
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(7)
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(8)
47,708.94
0.00 X ~(15) 0.00
43,236.61 X .045 (16) 1 ,945.65
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 1 ,945.65
2,617.00
1,855.33
(11)
(12)
(13)
4,472.33
43,236.61
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
(14)
43,236.61
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
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSESIDEANDRECHECKMATH <<
Decedent's Complete Address:
STREET ADDRESS
201 East Main Street Rear
CITY
Shiremanstown
STATE
PA
ZIP
17011-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
1 ,945.65
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
TotallnteresUPenalty ( 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)
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)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
1 ,945.65
1 ,945.65
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 !Zl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 !Zl
c. retain a reversionary interest; or ...................................................................................................... 0 !Zl
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 !Zl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 0 !Zl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 !Zl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 !Zl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
Under penalties of perjury, 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 RETURN DATE
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ADDRESS P.O. Box 731,46 Fawn Grove Drive
Albrightsville
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
\.04Mc.1l . WM-ti'
24 North 32nd Street
Camp Hill
PA 18210
DATE
::fAJ. 3'. ~oot.
PA 17011
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)l.
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. ~9116 (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 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. ~9116(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. ~9116(1.2) [72 P.S. ~9116(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. ~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-1508 EX + (6-98)
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SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Schumack Donald D
FILE NUMBER
21 05
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.
0540
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
15000.00
2004 Subaru Forester 2.5 Turbo
2
Allstate Auto Insurance Refund
41 .40
3
M & T Bank Personal Savings Account #15004206021153
10,843.09
4
M & T Bank Checking Account #11793430
1,774.08
5
M & T Bank Premium Interest Account #98084615
19,960.55
6
PP&L Utilities Refund
9.92
7
Vitamin Catalog Refund
79.90
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
47708.94
REV-1511 EX + (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Schumack Donald. D
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
05
0540
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 Malpezzi Funeral Home 560.00
2 St. Gabriels Cemetery 150.00
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 Debra K. Wallet, Esq. 1,500.00
3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 317.00
5. Accountant's Fees
6. Tax Return Preparer's Fees Guy DeAngelis, Inc. 40.00
7. Postage, copies, etc. 50.00
TOTAL (Also enter on line 9, Recapitulation) $ 2617.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Schumack. Donald 0
FILE NUMBER
21
05
0540
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. 2005 Mechanicsburg SO Personal Taxes
19.60
2 HealthSouth
3 Pennsylvania American Water
4 PP&L
5 Skillito Oil Inc.
6 Timothy A. Clark M.D.
7 Verizon
8 West Shore EMS
9 PSECU
10 2004 PA State Tax Return
11 2005 County Real Estate Taxes
10.00
16.75
31.16
641 .08
110.00
50.79
716.95
6.00
40.00
213.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 855.33
REV.1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA L'
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ESTATE OF
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I' FILE NUMBER
21 - -
NUMBER ! - NA~~ND A~~RE~~F PER~:(S) RECEIVING ~OP:RTY-I RE't;b~~~'iJ~ TO -.;..O~i~~T~i~ARE -
TAXABLE DIS~RIBUTIC)Ns(i~c;ude ~utright spousal distrib~tions) ------- illlLNotJ.isUru&IUW---1---------
Mark D. Schumack ! Son 11/3 of residuary estate
P.O. Box 731
Albrightsville, P A 18210
Schumack, Donald D.
I.
2 Donita 1. Schumack
61 1/2 South Pine Street
Hazleton, PA 18201
i Daughter
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i 1/3 of resIduary estate
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3 Lisa A. Schumack
116 South Cedar Street
. Hazleton, P A 18201
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Daughter
i 1/3 of residuary estate
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she t
II. I 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
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L:\S'l' PILL ,.ND T;~ST/:J<il.J'r
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I, L'0lL\LD S::J:-:ILJL,.Ck, Rear 201Sast Hain Street, Shirem~nstoW11,';",
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Penns:,/lvani<3, being of sound mind, memory iJnd understandl.ng;\:doi'~FiWji~
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m;:Jke and publish this to be my L,Jst ',rill ;'md Testament, hereby~"::,: .
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revoking and making void all former vilIs
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made by me at any time
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heretofore.
1. I elect my brother, Robert Sr.:;humack, 706 Northea stern
Building, H2z1eton, Pennsylvania to "1et as Executor of my estate
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and as Guardian for my children until they reach the age of ':2'l~~lE(
2. I direct thatth"~ Guardian for my children shall have the
pO~ITer ui thout reservz1tion to invest these moneys and to spend th~s
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moneys on the maintainence, education and health of my children
until each one of my children reach the age of 21 and then not,' tq
divide the corpus of my est"lte until the youngest reaches the
age of 21.
3 ~ I directtlvJt I should be buried ,c1t the discretion of my
:'''ec:utor accordinq to mv situation ;~nd st.:ltion in life.
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Savings "CCOlm'c 110.
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7. lIy real est'3te is presently loc=lted at Rear 201 East
Street, Shiremanstm..Tn, Pennsylvunia, but there may
est?tc at some future time.
3. My person~l property consists ~s followsr
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Social S2cu.rity Ho. /tfF- 24'- /CJ 7/
9. '111is ~1ill she'll be prob;'1tcd in the Luzerne County Court
f-iouse in \!ilk~s-Barre.
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10. hy Hill shall be kept vTith my impor.tant papers, ancl':a;I;~';C';llV
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signed CO;)y of this Hill shall be kept by my l'.ttorney, , R()~e~~tih:h'!~'i~~:'"
Sclr.unack, ,~squire, anc either cO::Y\7 may be used for I)roh3t~.~:N/ir;\':1~fWj.t:.<,
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