The URL can be used to link to this page

Home My WebLink About03-15-06 -.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128..()6()1 ENTER DECEDENT INFORMATION BELOW Social Security ~.~.~ber Date of Death OFFICIAL USE ONLY ,9>.~.~~..~e ,X~~r....... INHERITANCE TAX RETURN . . RESIDENT DECEDENT i 1 05 File Number O{P II ; I J Date of Birth i I 210-09-9520 L....... ................................................ Decedent's Last Name 04/19/2005 06/08/1916 Suffix Decedent's First Name MI MILLER EDNA (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix ,~P..~.~~~.:~...~~.~~...~.~.~~..... MI Spouse's Social Security Number r'" ....-__'_._....ny..."...w_."'.._.~~h.'-....,'.w,......,._.~-,...',.v".....~n....".n'_.'........._... .,."_....,~........~'""'.'"'....."......,,.'"',.''^.A.'~h~........^W....~ I ; ! THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW <::::) 1. Original Return <.a> 2. Supplemental Return c:J 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c::> 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 g~.~.~.~~..!.~.~.~P.~.'?I:'~...~.~~.~~~ i r--,~ . j (717) 697-64{:~ ,:':)! ...................................................................................................................................................................................................-..., "-r----RE~iiE.R.~~~~;~~~:i~=.~:=:r~.: I r:~ :'1 I ! i C....,) I'j .s;:'~ I l..__....._..._._.......__...___~.~!.~.!.~.~.~!?.._.._....._..............................1 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C) 4. Limited Estate c:::> e,a, SUSAN A BLASS ~irm Name <,I.~ APP'.I.icable) First line of address 76 BEECHCLlFF DR Second line of address or Post Office State ZIP Code 17013 Correspondent's e-mail 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 pre parer other than the personal representative Is based on all infonnatlon of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN $I :5~(AA-L('I. fL. U~ €k:t{kfr ,'X, ADDRESS 76 Beechcliff Dr, Carlisle, PA 17013 f JURE OF J?R ER 0 AN REPRE DAT5 ~/11a1o DATE~ I ~ - (p -0 l? A DR SS 70 est Main St, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 .....I ...J 15056052059 REV-1500 EX '?~.~.~~.~.~:.~...~~.~.~~.~..~ec..~.~i.~...N.~.'!'~~.~.............., Decedent's Name: RECAPITULATION EDNA MILLER , ! 210-09-9520 1 1. Real estate (Schedule A). ...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.: i 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.! ! i 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . " 3. I , 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. I ! 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. I 1 ! 7,722.87 i ->>---------1 6. Jointly Owned Property (Schedule F) c:;) Separate Billing Requested. . . . . .. 6.! 7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property 1 (Schedule G) c:;) Separate Billing Requested.. . . . . .. 7. 1 i i 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. i 1. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. I ! ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. I 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 7,000.00 I ""~ 14,722.87 I ';I~ 8,045.00 ! 8,045.00 ! j j 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. i 13. Charitable and Govemmental Bequests/See 9113 Trusts for which i an election to tax has not been made (Schedule J) .. . . . . . . . . . . . . . . . . . . . . . . 13. I I I 3,677.87 i 14. Net Value SUbJectto Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . .. 14.1 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 45 3,677.87 17. Amount of Line 14 taxable at sibling rate X. 12 18. Amount of Line 14 taxable at collateral rate X .15 3,677.87 I 15. 16. 165.50 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 165.50 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C'::) L 15056052059 Side 2 15056052059 ---I REV-1500 EX Page 3 File Number De~edent's Complete Address: D~r~ I DECEDENTS NAME DECEDENrs SOCIAL SECURITY NUMBER EDNA I MILLER 210-09-9520 STREET ADDRESS 76 BEECHCLlFF DR CITY I STATE I ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 165.50 Total Credits ( A + B + C ) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) A. Enter the interest on the tax due. 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;.......................................................................................... D [K) b. retain the right to designate who shall use the property transferred or its income; ............................................ D [K) c. retain a reversionary interest; or............... ....... ........................ ........... ...... ......... ............ ............ ..... ....... .............. D [KJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D [K) 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . ....... ........ ................... .............. ...................... ................. ........ .............. D [K) 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... ................ ..................... ........ ....... ..... ..... ................ ...... ..................... ......... D ~ 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)). 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 P.S. ~9116 (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 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 decedenfs lineal beneficiaries is four and one-half (4.5) percent, 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 twelve (12) percent [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. ~EV-1508 EX+ (6-98).- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF EDNA I MILLER FILE NUMBER Include the proceeds of ltigation and the date the proceeds were received by the estate. All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION :Washington Area Teachers Federal Credit Union - account #0009000 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 7,722.87 REV-1509 EX+ (6-98) . *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF EDNA I MILLER FILE NUMBER 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.iSusan A. Blass ;76 Beechcliff Dr, Carlisle, PA 17013 1 Daughter B. JOINTLV-OWNED PROPERTY: ITEM NUMBER 1. LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMIlAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. ~HH Bonds DATE OF DEATH VAlUE OF ASSET "OF DECO'S INTEREST DATE OF DEATH VAlUE OF DECEDENT'S INTEREST A. , 01/21/99 14,000.00 7,000.00 TOTAL (Also enter on line 6, Recapitulation) (If more space Is needed, Insert additional sheets of the same size) 7,000.00 .~EV-1511 EX+ (12-99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF EDNA I MILLER FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL. EXPENSES; Funeral Home City 328.00 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 Year{s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, Insert additional sheets of the same size) 8,045.00 REV-1513 EX+ (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EDNA I MILLER FILE NUMBER NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under . $~c.~Jl1~.(~)O;Z})... !Susan A. Blass. 76 8eechcliff Dr, Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 100.00 n ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE (If more space is needed, insert additional sheets of the same size) 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~..~ I, EDNA: MAE MILLER, also known as EDNA I. MILLER, of the Borough of East Washington, Washington County, pennsylvania, 'do make publish and declare this to be my Last Will and Testament, hereby re voking all wills and Testamentary Writings at any time heretofore made by me. FIRST: I direct that my funeral expenses and the expenses of. my last illness be paid as soon as may be.convenient after'my de- cease. SECOND: All the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, and any policies of insurance thereon, I give, devise arid bequeath to my daughter, SUSAN A. BLASS. THIRD: I nominate, constitute and appoint my daughter, SUSAN A. BLASS, Executrix of this my Last Will and Testament, and I direct that my said Executrix shall not be required to enter securit in any jurisdiction in which she may act. this IN WITNESS WHEREOF, I have hereunto set my hand and seal' J.) U day of ArR.tL , 1987. 17 -z... ""2--, ~ (/d~.~ ,/j--l,U~/iit.- '1/ (Edna Mae Miller //. r? . C-- gi0~ JI. ??!e(,+J Edna I. Mi er (SEAL ) (SEAL) ,- 1 -