The URL can be used to link to this page

Home My WebLink About02-21-06 -.J 15056051047 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 <I,!f;R - ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT ~I O,~ / / /3 Date of Birth /7? Ii ;l.8'S-3 Decedent's Last Name /2/'I~tJ/l~ p~lllr/7 Suffix Decedent's First Name MI I<UI'tT2 ;11 ~ /l Tit /9 ;r (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return c:::::> 2. Supplemental Return c:::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required c:::l c:::::> 4a. Future Interest Compromise (date of death after 12-12-82) c:::::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::::> 10. Spousal Poverty Credit (date of death c:::::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number c:::::> <::) 4. Limited Estate c:::l 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received B. Total Number of Safe Deposit Boxes :r '11../1/ IJ. /<II/lTZ 7/ "7 '7 7 'I .r c:. -.5- Z- Firm Name (If Applicable) REGISTER QF::WILLS USE tiNt C.'\ .."-1 First line of address / /l7 /~r)/ .rr/l-~Er j'... ~, Second line of address City or Post Office State ZIP Code DATE FILED ~ J IJ!Ch/ Cum/! C/lt/1 d4 r'19 /7//7R 0..;:) Correspondent's e-mail address: DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.J .. .....J 15056052048 REV-1500 EX Decedent's Name: ~/L '7),1 A ~ J( W;Z;r z- RECAPITULATION 1. Real estate (Schedule A). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c:> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:> Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ., . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ . 16. Amount of Line 14 taxable at lineal rate X .O!t}..rfl--/.Xf] 17. Amount of Line 14 taxable at sibling rate X .12. 18. Amount of Line 14 taxable at collateral rate X .15 · 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 Decedent's Social Security Number / TJT / 'I :< f? S-? / / r ;;2 Y 17. p If? . . /'j/?.7.fS- . l~ f' J~ 7. fS- rv?9..,p r t/~f.'t? l:l. 2? '1.f'.?S" .. / J..2? 9 S7. fL . . F y l. / . '/J- c:> 15056052048 ---1 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME File Number STREET CITY If' ~ /l.. (, A .-v',b Tax Payments and Credits: 1. Tax Due (Page 2 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) ->; J;</, YJ- -2'7?_ ';I!J' Total Credits ( A + 8 + C ) (2) ;l 7?., ~p 3. InteresVPenalty if applicable D. Interest E. Penalty 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) !? fi/A 7; 9~~ yJ' C '/, f?~ ~.J ./ TotallnteresVPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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) 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 ~ 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 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [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 zero (0) percent [72 PS. 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 retum 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 PS. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is twelve (12) percent [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 Martha Jane Kurtz FILE NUMBER ~/-t'JJ-IIIJ 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 jointly-owned with right ot survivorship must be disclosed on Schedule F. IT,=~! I \/d~I_I,= AT ~A.T,= NUMBER DESCRIPTION OF DEATH 1. 1?7 Sixteenth Stre"t (fnrmerly 1 ':\116~ ~t) 11.''''\11 I"umberlanrl DA 17070 \.40 . L I..... ...... V It ..... I u; _L, 1',........ _ I . ....., 1 l II VI V Tax Parcel # 26-n0541-017 \ . .. - - -- - - - -- I I I 114,240.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 114,240.00 , ' . REV-1508 EX+ (6-98) . I SCHEDULE E I CASH, BANK DEPOSITS, & MISC. I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY I RESIDENT DECEDENT . . ESTATE OF FILE NUMBER Martha Jane Kurtz ~ I -,p'S--I//:? 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 VALUE AT DATE A.!IIUCCC ncc-rOIDTlnt.,1 ()!= !)=.^.T~ ....-....-...., ,....... 1 M& T Bank, Checking Acct. # 53094972 4,112.69 21 M&T Bank, Certificate of Deposit # 031003914382567 10,015.26 I I I I TOTAL (Also enter on line 5, Recapitulation) $ 14,127.95 I (If more space is needed, insert additional sheets of the same size) .. REV-1511 EX+ (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ES'!'^'!'E OF F!!.E ~!t!M!!E!=! Martha Jane Kurtz 21-05-1113 Debts of decedent must be reported on Schedule L ITEM I~UIYlucn ......,..,..-...........""., ua::ovnlr IIUI.., ...._1........ t\IVluun I A. FUNERAL EXPENSES: 1. Musselman Funeral Home & Cremation Services 1,795.00 B. ADMINISTRATIVE COSTS: 1. Persona! Representative's Commissions 0.00 Name of Personal Representative(s) John D. Kurtz Social Security Number(s)/EIN Number of Personal Representative(s) 202-36-6961 Street Address 127 16th Street City New Cumberland Year(s) Commission Paid: n/a State PA Zip 17070 2. Attorney Fees 0.00 3. Family Exemption: (If decedent's address is notlhe same as claimant's, attach explanation) Claimant John D. Kurtz Street Address 127 16th Street 3,500.00 City New Cumberland Stale PA ,Zip 17070 Relationship of Claimant to Decedent son 4. Probate Fees 302.00 5. Accountant's Fees 6. Tax Return Pre parer's Fees 7. Death certificates (Musselman Funeral Home) 72.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,669.00 ... REV-1513 EX+ (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under ~"r. !l11R (,,\ 11 ?\1 I John D. Kurtz, 127 16th Street, N~~ C~~berland, PA 17070 I RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) FILE NUMBER 21-05-1113 AMOUNT OR SHARE OF ESTATE ESTATE OF Martha Jane Kurtz NUMBER I son 100.00 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 I 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) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KURTZ JOHN 0 127 16TH STREET NEW CUMBERLAND, PA 17070 ~------- fold ESTATE INFORMATION: SSN: 178- 14-2858 FILE NUMBER: 2105-1113 DECEDENT NAME: KURTZ MARTHA JANE DA TE OF PAYMENT: 02/21/2006 POSTMARK DATE: 02/21/2005 COUNTY: CUMBERLAND DATE OF DEATH: 12/14/2005 REMARKS: CHECK# 613 SEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: INITIALS: MW RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 006344 AMOUNT $4/969.45 $4/969.45 GLENDA FARNER STRASBAUGH REGISTER OF WILLS