HomeMy WebLinkAbout04-17-06 (2)
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t1'fe.. 4 COMMONWEALTH OF
..16" PENNSYLVANIA
-,,' "Yi" ~ ~ ,., ~'. DEPARTMENT OF REVENUE
. J, DEPT. 280601
, <,; , HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LASr; FIRST, AND MIDDLE INITIAL)
Moyer Robin L.
DATE OF DEATH (MM-DD-YEAR)
01/14/2006
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DATE OF BIRTH (MM-DD-YE/\Rj
I 03/07/1960
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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o 1. Original Return
o 4. limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a living Trust (Attach copy at Trust)
o 10. Spousal Poverty Credit (dale ofdealh between 12-31-91 and 1-1-95)
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FILE NUMBER
21 06
00072
- NUMBER- - -
-- --
COUNTY CODE YEAR
i SOCIAL SECURITY NUMBER
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r THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Gregory R. Reed, Esquire 3120 Parkview Lane
FIRM NAME ("~",",) Harrisburg, PA 17111
TELEPHONE NUMBER
(717) 238-0434
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1 )
(2)
(3)
(4)
(5)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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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)
(7)
(6)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
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)
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)
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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 .0 (15)
-- _J~_~51.28_ x .0 ~__ (16)
16. Amount of line 14 taxable at lineal rate
--------~-------------~-_._-
17 - Amount of Line 14 taxable at sibling rate
x .12 (17)
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
20.0
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
8,651.28
(11 )
(12)
(13)
(14)
(19)
(8)
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8,651.28
8,651.28
8,651.28
389.31
389.31
Decedent's Complete Address:
STREET ADDRESS
___~13 Third Street
-
CITY
Summerdale
I STATE
PA
I ZIP 17093
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
389.31
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total Credits ( A + 8 + C ) (2)
Total Interest/Penalty ( D + E ) (3)
4. 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(5)
(5A)
(58)
A. Enter the interest on the tax due.
389.31
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
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
Under penalties of pe~ury, I dedare that I have examined this retum, 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 personal representative is based on all information of which preparer has any knowledge.
SIGNAT~E OF PERSO~ RESPONSIBLE FOR, FILING RETURN
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ADDRESS ---7 f
DATE
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on th
[72 P.S. 99116 (a) (1.1) (i)1.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transff
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirE
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 a~
or a stepparent of the child is 0% [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 benefici
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings
individual who has at least one parent in common with the decedent, whether by blood or adoption.
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Ie use of the surviving spouse is 3%
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'ing spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)).
nd filing a tax return are still applicable even if
he use of a natural parent, an adoptive parent,
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
, sibling is defined, under Section 9102, as an
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SCHEDULE "E"
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
ESTATE OF:
FILE NO. 21-06-00072
ROBIN L. MOYER
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
300 stock options in Norfolk Southern
Corporation issued in 1997 to the decedent
providing her with the option to purchase
Norfolk Southern Corporation stock at the
price of $33.25 per share. The value of
Norfolk Southern Corporation stock on the
date of death was $50.79 per share. Thus,
the net value of the asset is $17.54 per
share----------_____________________________________________________$ 5,235.00
2.
Combined state, federal and local income
tax refunds for the year 2005-----------_______________________ 3,416.28
Total: $ 8,651.28