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REV-1500 EX (1)-00)
FILE THIS RETURN WITH:
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
Rev-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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FILE NUMBER
21
COUNTY CODE
05 0721
YEAR NUMBER
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DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
DREWETT, MICHAEL A., JR.
DATE OF DEATH (MM-DD-YEAR)
07-03-2005
SOCIAL SECURITY NUMBER
196-58-7142
DATE OF BIRTH (MM-DD-YEAR)
12-03-1961
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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6. Decedent Died Testate (Attach copy of Will)
9. Litigation Proceeds Received
4a. Future Interest Comprise (date 01_ after 12-12-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
011. Election to tax under Sec. 9113(A)
(-.eh Sch 0)
X 1. Original Return
4. Limited Estate
2. Supplemental Return
3. Remainder Returnc_of_....1012-'...21
7. Decedent Maintained a Living Trust (Attach a copy Of Trust)
10. Spousal Poverty Credit (da... Of deatl1belween 12-31-91 and 1.1-96)
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THIS SECTION MUST BE COMPLETED.
NAME
ANTHONY T. MCBETH
FIRM NAME (If Applicable)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
COMPLETE MAILING ADDRESS
407 NORTH FRONT STREET
FIRST FLOOR
HARRISBURG, PA 17101
TELEPHONE NUMBER
(717) 238-3686
1. Real Estate (Schedule A)
(1)
(2)
(3)
(4)
(5)
(6)
$0.00;
$0.001
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$0.001
[
$0.001
$21,149.00 1
OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misc. Personal Property (Schedule E)
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6. Jointly Owned Property (Schedule F)
CJ Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
$0.00
(7)
$0.00 ..... ,., ,;.;\... .... .......;:~~........ ....... '" ..:l... ..j
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(8) $21,149.00
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I)
(9)
(10)
$14,249.00
$4,290.00
17. Amount of line 14 taxable at sibling rate
x
12
(11) 51B 539 00
(12) $2,610.00
(13) $000
(14) $2,610.00
(15) $0.00
(16) $117.00
(17) $0.00
(18) $000
(19) $117.00
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 I1Q\ been
made (Schedule J)
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) x
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16. Amount of line 14 taxable at lineal rate
$2,610.00 x
45
1 B. Amount of line 14 taxable at collateral rate
19. Tax Due
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CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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Decedent's Complete Address:
STREET ADDRESS 6249 STANFORD COURT
CITY I~TATE I~IP
MECHANICSBURG PA 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. CreditS/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
$117.00
Total Credits (A + B + C) (2)
$000
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnterestlPenalty (0 + E) (3)
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)
If line 1 + line 3 is greater than tine 2, enter the difference. This is the TAX DUE. (5)
$0.00
5.
$117.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(5A)
(5B)
A. Enter the interest on the tax due.
$117.00
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS
1.
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income;
c. retain a revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
Yes
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If death occurred after December 12, 1982, did decedent transfer property within on year of death
B
No
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EB
2.
3.
4.
without receiving adequate consideration?
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? [::=J
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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 perjury, I declare that I have examined this retum, including accompanying schedules and statements. and to the best of rny knowledge and belief, it is true, correct, and complete.
Declaration of preparer other than the personal representative is based on all the information of which preparer hall any knowledge.
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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 su . ing spouse is 3% [72 P.S. S9116 (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 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. 99116(a) (1.2)).
I he 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. S9116(1.2) (72 P.S. s9116(a) (1)).
I he tax rate imposed on the net value of transfers to or for the use oHhe decedent's siblings is 12% [72 P.S. S9116(a)(1.3)). A sibling is defined, under Section 9102, as an individual
'me has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 ~. (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF DREWETT, MICHAEL A., JR.
FILE NUMBER
21-05-0721
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
DESCRIPTION
CASH- PNC BANK
RETIREMENT FUND ..VANGUARD
INCOME TAX REFUND RECEIVABLE
SOCIAL SECURITY DISABILITY PAYMENT RECEIVABLE
2000 FORD TAURUS
VALUE AT DATE
OF DEATH
$290.00
$7,709.00
$538.00
$6,812.00
$5,800.00
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$21,149.00
REV-1511 EX +(12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DREWETT, MICHAEL A. I' JR.
FILE NUMBER
21-05-0721
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. PARTHERMOREFUNERAlHOME $4,856.00
2. GINGRICH MEMORIALS - HEADSTONE $1,580.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) NANCY S. DREWETT $2,000.00
Social Security Number(s) I EIN Number of Personal Representative(s) 211-22-6815
Street Address 6249 ST ANDFORD COURT
City MECHANICSBURG State P A Zip 17050
-
Year(s) Commission Paid:
2. Attorney Fees $2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) $3,500.00
Claimant NANCY S. DREWETT
Street Address 6249 ST ANDFORD COURT
City MECHANICSBURG State P A Zip 17050
-
Relationship of Claimant to Decedent MOTHER-DECEDENT LIVED WITH CLAIMANT
4. Probate Fees $108.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. ADVERTISING:
CARLISLE SENTINEL $130.00
CUMBERLAND LAW JOURNAL $75.00
TOTAL (Also enter on line 9, Recapitulation) $14,249.00
Debts of decedent must be reported on Schedule I.
(If more space IS needed, Insert additional sheets of the same size)
REV.'512 eX + ('2~1
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF DREWETT, MICHAEL A., JR.
FILE NUMBER
21-05-0721
Record debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
$1,509.00
$2,781.00
1.
2
VISA CARD - SUSQUEHANNA VALLEY FCU
CAR LOAN - SUSQUEHANNA VALLEY FCU
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$4,290.00
REV,151a EX + (9-00))
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SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DREWETT, MICHAEL A., JR.
FILE NUMBER
21-05-0721
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. NANCY S. DREWETT MOTHER 50%
2. MICHAEL A. DREWETT, SR FATHER 50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
11. 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 II - 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)
Register of Wills Cumberland County, Pennsylvania
INVENTORY
Estate of MICHAEL A. DREWETI, JR.
No. 21-05-0721
also known as
Date of Death JULY 3, 2005
, Deceased
Social Security No. 196-58-7142
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets
wherever situate end all of the real estate in the Commonwealth of Pennsylvania of said, Decedent that the valuation placed opposite each item
of said Inventory represents its fair value as of the date of the Decedent's death, and th Decedent owned no real estate outside of the Commonwealth
of Pennsylvania except that which appears in a memorandum at the end of this Inventory. IflNe verify that the statements made in this inventory
are true and correct. INJe understand that false statements herein are made SUbject to the penalties of 18 Pa. C.S. Section 4904 relating to
unsworn falsification to authorities.
Telephone:
HARRISBURG, PA 17101
(717) 238-3686
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1.0 No.:
ANTHONY T. MCBETH
53729
Attorney
Address
407 NORTH FRONT STREET
Dated
Description
Value
Personal Property:
CASH- PNC BANK
RETIREMENT FUND - VANGUARD
INCOME TAX REFUND RECEIVABLE
SOCIAL SECURITY DISABILITY PAYMENT RECEIVABLE
2000 FORD TAURUS
$290.00
$7,709.00
$538.00
$6,812.00
$5,Boo.00
Total from Continuation Page(s) $0.00
(Attach additional sheets if necessary) Total: $21,149.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal representative, include
the value of
each item, but such figures should not be extended into the total of the Inventory.