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Home My WebLink About02-09-06 REV-1500 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NUMBER DEPAR6~~~T2~~VENUE RESIDENT DECEDENT 21 05 HARRISBURG. PA 17128-.Cl6O,1~_,_~" .,'~,__,_~~___ ~~~_,_,_, "..Q.Ql.Jt-jIY CODE, .Y);AB "- "----------" - ---.--.------- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER SUNDAY, Mary K. 204-09-9961 ~A:~~:~~;:~ ~MM~DD-YEAR)-"~~-l ~A;~;~~I;;H2(~M-DD-VEARj-'--~--'" I THIS RETUR~;:;:~:;~~~~~~E WITH THE i (IF APPLICABLE) SURVIVING'SPOUSE'S NAME ( LAST, FIRST AI-m MliIDLEINITIAl)~- ___n_____~,_____~ SOCIAL SECURITY NUMBER . Sunday, Harvey _____n_________~ 20~.::g 1-90~_ . '0 .., 1. Origi~~IRetu_;:;;_--' ~ 2. Supplemental Return 0 3. Remainder Return (date of death prior to 12-13-82) o 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 0 5. Federal Estate Tax Retum Required 12-12-82) o 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 12-3t-91 THI$SEC1rI()l!l:M~$1rl!!~~<>MP14e.I),~14c<>.~e$p AME Ivo V. Otto III, Esquire FIRM NAME (If appli.;;3'bie) Martson Deardorff Williams & Otto REV. 1500 EX + ('40) *' 0- Z W C W o w c W 0- ,,~Ul 00<:" wo..g :z:li1.J Oo..m 0.. c( rhO- ~ffi o<:C OZ o~ TELEPHONE NUMBER 717/243-3341 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship Z o 1= j ::> 0- n: ~ w 0<: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous 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) 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) 00524 ,"'IJMB~R 8. Total Number of Safe Deposit Boxes o 11.Election to tax under Sec. 9113(A) (Attach Sch 0) TO: COMPLETE MAILING ADDRESS Ten East High Street Carlisle, P A 17013 (1 ) None (2) 6,401.97 ,-- .._._._~------- (3) None (4) None (5) None ---- --~----- (6) None (7) None (9) ._-~---~-- (10) u.... ", I ~,:) --, ( ',) II --J (8) 6,401.97 (11 ) (12) 6,401.97 (13) 13. Charitable and Governmental 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) (14) 6,401.97 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) -------------- Z 6,401.97 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x 1= ~ ::> (17) 0.. 17. Amount of Line 14 taxable at sibling rate x .12 s 0 0 ~ I 18. Amount of Line 14 taxable at collateral rate x .15 (18) 0- ------ 19. Tax Due (19) 288.09 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 288.09 >> BE SURE TO ANSWER ALL QUESTIONS 011I REVERSE SIDE AND RECHECK MATH << Copyright 2000 form software only The Lackner Group. Inc. Form REV.1500 EX (Rev. 6-00) Rt. Decedent's Complete Address: STREET ADDRESS 33 Strawberry Court I STATE PA I ZIP 17013 CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 288.09 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEDVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (3) (4) (5) (SA) (58) 0.00 288.09 288.09 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;.............................n.............................................. ~ ~ ~: ~::::~ :h~e~;~;i:~~~s:~~;:s~~~. ~~~~I. .~.~~. ~~~. :.~~:.~_~~. .~~~.~.~~~~~~.~. .~.~ .i~. ~~.~.~.~~~.............................. ~~::::::::::: ~~..... d. receive the promise for life of either payments. benefits or care?........................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................n................................................... 0 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................................................................................................ 0 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. ------- -~-------~ - 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 preearer~the'-tha"-!~e personal representative is based on all information of which preparer has any knowledge. SIGNATU~.E OF SIBLE FOR FILING. RETURN ADDRESS R. D~~'. '. er, J J- ~/ /' 3 Southern Cross Drive ,.. ~-e:. .~ ... .~oiling Spri~.s,X~_!7007 ___ SIGNATURE-OF PERSON RESPONSIBLE FOR FILlN~ RETURN ADDRESS T. Randall Adams SI:?:i~~~~~TIVE Ivo v. OttotJ7~~ 537 West Penn Street Carlisle, PA 17013 --ADDRESS ..._~--- DATE 1!/7At DATE _.._~~tb ? I ~ )lX:. Ten East High Street Carlisle, P A 17013 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 statutedoes not exemDta 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. . SCHEDULE B STOCKS & BONDS I _J I FILE NUMBER - 21 - 05 - 00524 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SUNDAY, Mary K. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE 103 shares, Prudential Financial, Inc., Common CUSIP 744320102 TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 6,401.97 6,401.97 REV.1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT -------.----.-. ... --.l ESTATE OF SUNDAY, Mary K. : FILE NUMBER 21 - 05 - 00524 I RELATIONSHIP TO I DECEDENT ______).____ __"D~st Trustes(s) AMOUNT OR SHARE OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) T. Randall Adams 537 West Penn Street Carlisle, PA 17013 Son One half of estate residue 2 R. David Bollinger, Jr. 3 Southern Cross Drive Boiling Springs, P A 17007 Son One half of estate residue B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Estate Valuation Date of Death: 06/06/2005 Valuation Date: 06/06/2005 Processing Date: 01/16/2006 Estate of: Mary K. Sunday Report Type: Date of Death Number of Securities: 1 File ID: 10512.evp Shares or Par Security Description High/Ask Low/Bid Mean and/or Div and Int Adjustments Accruals Security Value 1 ) 103 PRUDENTIAL FINL INC (744320102; PRU) COM New York Stock Exchange 06/0612005 63.20000 61.11000 H/L 62.155000 6,401.97 Total Value Total Accrual Total $6,401.97 $6,401.97 SO.OO Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) ~d~ ;3 - L I