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Home My WebLink About03-14-06 , REV-1500 EX + (6.00) * OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER ~~~1CODE ~ l SOCIAL SECURITY NUMBER 203-10-4872 W I- lI::~1/) ull:lI:: wlLU :z:oo ulI:-' ILlD ~ ~ z w c w u w c i DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) McClure, William E. DATE OF DEATH (MM-DD-YEAR) 11-17-2005 06-03-1916 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE DATE OF BIRTH (MM-DD-YEAR) (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) i McClure, Charlotte S. 1103 NUMBER REGISTER OF WILLS SOCIAL SECURITY NUMBER 171-01-9108 r-- 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8, Total Number of Safe Deposit Boxes U 2. Supplemental Return II 4a. Future Interest Compromise (date of death after 12-12-82) X 6. Decedent Died Testate (Attach C 7. Decedent Maintained a Living Trust (Attach copy of Will) copy of Trust) 9. Litigation Proceeds Received D 10. Spousal PovertY Credit (date of death between 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 12-31-91 and 1-1-95) ~ SECTION MUST BE COMPLETED. ALL cORRESPON~f!I_CE fANI) CONFIDENTIAl TAX INFORMATI!~SHOULD BEOIRECTED'TO: NAME I COMPLETE MAILING ADDRESS Neil W. Yahn, Esq. FIRM NAME (If applicable) James, Smith, Dietterick & Connelly, LLP ~ 1. Original Return i 4. Limited Estate I- Z w Q Z o IL I/) w II: II: o U TELEPHONE NUMBER 717/533-3280 None None None None None None None 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o t= :3 :J ~ ii: c( u w 0: 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) C Separate Billing Requested 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) 134 Sipe Avenue Hummelstown, PA 17036 (1 ) (2) (3) (4) (5) (6) -- (7) (9) (10) 11,949.99 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 t= 16. Amount of Line 14 taxable at lineal rate 0.00 x .045 (16) i5 :J a.. 17. Amount of Line 14 taxable at sibling rate 0.00 .12 (17) ::E x 0 u 18. Amount of Line 14 taxable at collateral rate 0.00 (18) ~ x .15 19. Tax Due (19) ('{ OFFICIAf USE ONLY .,;('J ::-;2 1'''''1..) o .z;- (8) 0.00 (11 ) 11,949.99 (12) insolvent (13) 0.00 (14) 0.00 0.00 0.00 0.00 0.00 0.00 >>BE SURE TO ANSweR .ALL-QUESTIoNS ON REVERSE SIDE AND RECHECK ~MATH << Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00 {>J. ; Decedent's Complete Address: STREET ADDRESS 773 Arlington Road I STATE PA I ZIP 1 7011 CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 0.00 0.00 Total Credits (A + 8 + 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 thEOVERPAYMENT. 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. 8. Enter the total of Line 5 + 5A. This is theBAlANCE DUE. (3) (4) -- (5) 0.00 (5A) (58) 0.00 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;............................................................................. ~ b. retain the right to designate who shall use the property transferred or its income;................................ Ix: c. retain a reversionary interest; or.........................................................................................__................ Ixl 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?..... ........ ....... ........ ...... ....... ......... .........__ ...... ....... ....... ................ ............... D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death:?...... C [:!:: 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. 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 personai representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON R~~~SIBL~ILlNG~T~/ _ .." I, ADDRESS Charlotte S. MCC~t~ .)"/ / ' CPU' y- C 773 Arlington Road I (Jy.Pc. Camp Hill, PA 17011 ,x DATE F PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ~&""OG DATE REPARER OTHER THAN REPRESENTATIVE hn, Esq. ADDRESS ~ / It. Je-i. DATE 134 Sipe Avenue Hummelstown, PA 17036 For date tleath 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. 991161.2)[72P.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. , REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClure, William E. FILE NUMBER 21-05-1103 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule{s) attached 10,787.99 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 1,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 132.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 30.00 See continuation schedule{s) attached TOTAL (Also enter on line 9, Recapitulation) 11,949.99 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) II RBV-1502 EX+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEOENT McClure, William E. FILE NUMBER 21.05.1103 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 David M. Myer Funeral Home - funeral services 4.886.50 2 West Shore Country Club. funeral reception 5.901.49 Subtotal 10.787.99 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) . Rev-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWeALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT McClure, William E. IFILE NUMBER 21-05-1103 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills, Cumberland County - filing fee for Return & Inventory 30.00 Subtotal 30.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) . . REV 1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 1 McClure, William E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Charlotte S. McClure 773 Arlington Road Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21.05.1103 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF NUMBER I. Spouse Residue of Estate. life insurance Total 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)