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Home My WebLink About05-02-06 f RfV-1S00 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C w o w C Jum er Lester DATE OF DEATH (MM-DD-Year) S. I - OFFICIAL USE ONLY REV -1500 INHERITANCE TAX RETURN RESID NT DECEDENT INr~~~_JL~2~ COUNTY CODE '/EAR NUMBER SOCIAL SECURITY NUMBER DATE OF BIRTH (MM- D- Year) 1 83- 1 6 - 6 506 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS I 08/09/2005 09/16/1923 I (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ :It:-rn (.)~:lt: wCl.(.) :J:oo (.) ~....I tlD <I( o 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (AIlach copy of Will) o 9. Litigation Proceeds Received SOCIAL SECURITY NUMBER I 00 2. Supplemental ~eturn o 4a. F uture Interes~ Compromise (date of death after 12-12-82) o 7. Decedent Maintined a Living Trust (AIlach copy of Trust) o 10. Spousal Pove Credit (date of death lleIween 12-31-91and 1-1-95) D 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I- Z W o Z o Cl. rn w ~ ~ o (.) NAME H. Anthon Adams FIRM NAME (If Applicable) TELEPHONE NUMBER 717-532-3270 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 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) 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) z o ~ ::::) l- e:: ct o w a: - :J 15. Amount of line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a){1.2) .- -- 16. Amount of Line 14 taxable at lineal rate ~ 17. Amount of Line 14 taxable at sibling rate ~ ) 18. Amount of Line 14 taxable at collateral rate A ~ 19. Tax Due COMPLETE MAILING ADDRESS 49 W. Orange Street Suite 3 OFFICIAL USE ONLY PA 17257 :::0 ,'^'-; C'J C) XJ b rTl o C) " ._ --n :::~'~= (~ rn C) ~ --n I ~___._I (1) (2) (3) (4) (5) (6) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec9113 Trusts for which an election to tax has not been made (Schedule J) i \ 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES i \ 25.587.49 (7) (8) (9) (10) 0.00 (11) (12) (13) (14) 0.00 X _ (15) 25,587.49 X .045 (16) 0_00 X .12 (17) 0.00 X .15 (18) (19) ,...." = C:::l CJ'"' :1:"" -< I N -0 :x r:-? 25,587.49 0.00 25,587.49 25,587.49 0.00 1,151.44 0.00 0.00 1,151.44 , o d t' C I t Add ece en s ample e ress: STREET ADDRESS 7 S. Hollar Dr., S.M.E. CITY I STATE I ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 1,151.44 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 : TotallnteresUPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the ~VERPAYMENT. Check box on Page 1 Line 20 to request a refund I (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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payabt to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTION 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; i.......................................................................... 0 00 b. retain the right to designate who shall use the propert~ transferred or its income; ........................................ 0 00 c. retain a reversionary interest; or ...........................;.......................................................................... 0 00 d. receive the promise for life of either payments, benefit~ or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent ~ransfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 00 3. Did decedent own an 'in trust for' or payable upon death ~ank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, ann4ity, or other non-probate property which contains a beneficiary designation? ............................ ~.......................................................................... 0 00 0.00 0.00 1,151.44 1,151.44 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, Y U MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, includi~ accompanying sch les 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 p parer has any knowledge. SIGNATURE ,RSO RES!ONSIB'A FOR FILING RET_~RN ," , DATE j5, \W/1L~ A/\ 4..1 ~ l(l\Olo ADDRESS Pauline R. Martin ~ ~8 McCulloch Road, ShippensburQ SIGNATURE OF PREP~RER N RE IVE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the t rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)J. 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 thp. !,:lIrvivinn !':MIIC:P ic: nOlo 17? P ~ I\Q11f\ fq) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure I 1_ 3 (p tt ~ q'u ;able even if the surviving spouse is the only beneficiary. 1t7, ~ T For dates of death on or after July 1, 2000: .fr;l-& ( c;,.~ ~'" (j The tax rate imposed on the net value of transfers from a deceased child tw~nty-one years of age or younger at deatl or a stepparent of the child is 0% [72 P.S. ~9116(a){1.2)J. : I The tax rate imposed on the net value of transfers to or for the use of the dooedent's lineal beneficiaries is 4.5%, excl 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. ~9116(1 \ individual who has at least one parent in common with the decedent, whether by blood or adoption. ~ \5 lptive parent, t3 ~ 0vJ; 1rJ /'i4# - 4b h-ptl i9116(a)(1)]. 102, as an 0/ R'EV;1508 ~X + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSO ALPROPERTY ESTATE OF FILE NUMBER Indude the proceeds of litigation a d the date the proceeds were received by the estate. All property jointly-owned with rig t of survivorship must be disclosed on Schedule F. VALUE AT DATE OF DEATH 25,587.49 ITEM NUMBER 1. Orrstown Bank Checking Account TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, ins It additional sheets of the same size) 25 587.49 . ",v-'", <X. ". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF SCHEDULE J BENEFICIARIES FILE NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PIROPERTY TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, nd transfers under Sec. 9116 (a) (1.2)] Lester E. Jumper 5049 Orrstown Road Orrstown, PA 17244 Thomas E. Jumper 8496 Newburg Road Newburg, PA 17240 Norma J. Jumper 2167 Lindsay Lot Road Shippensburg, PA 17257 Pauline R. Martin 8 McCulloch Road Shippensburg, PA 17257 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I. Lineal 25% 2. Lineal 25% 3. Lineal 25% 4. Lineal 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABO E 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. I TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTI<!lNS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert dditional sheets of the same size)