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HomeMy WebLinkAbout06-02-06 RE'v-1500 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 -06 0 0 3 """SSij'Nn:-coiSE ~t.~ - - Ni'ill'B'EP- - I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Bohn, Grace L DATE OF DEATH (MM-DD-Year) SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 92- 1 4 - 5 541 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 12/30/2006 04/30/2005 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER W I- :.:: :!lI) uO:::':: W D.u :z:oo UO::....I D.[D D. c( D 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received ~ 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrus!) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 3. Remainder Return (date oldea!h pnor!o 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) (Attaoh Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS John M. Eakin Market Square Building FIRM NAME ill ~ppllcable) I- Z W C Z o D. lI) W 0:: 0:: o U Mechanicsburg, PA 17055 TELEPHONE NUMBER 717 766-3172 z o l- e:( ..J :::> I- a. e:( u w a:: z o l- e:( I- :::> a. :E o U >< e:( I- 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) -'J OFFICIAL USE ONLY ) , (1) (2) (3) (4) (5) ~_.--; 2,659.60 4. Mortgages & Notes Receivable (Schedule D) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 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) (6) (7) (9) (8) 15.00 (11) (12) (13) (14) 2.659.60 9. Funeral Expenses & Administrative Costs (Schedule H) 13. Charitable and Govemmental 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 2,64460 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 19. Tax Due 0_00 X _(15) 0.00 0.00 X _(16) 0.00 396.69 X 12 (17) 47.60 2,247.91 X .15 (18) 337.19 (19) 384.79 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT v~ . -, "..../ > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: \ STREU ADDRESS CITY I STATE I ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2 Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 384.79 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty 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. 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. (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 Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 384.79 384.79 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 [2] b. retain the right to designate who shall use the property transferred or its income; ........................................ D [Xl c. retain a reversionary interest; or ...................................................................................................... D !lJ d. receive the promise for life of either payments, benefits or care? ................................................... ... ....... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. D [s:J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D ILl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... D I2l 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 personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSQN.R)SPONSIBLE FOR FILlNG_~U~N-; DATE .~.~._-~.-....-.....--- ..:;/" (-.........--..-<-7 6/2/2006 ADDRESS 16700 Dougherty Avenue. ' LaureL MD 20707 1~_/ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS . 8306 Beaver Court Chestertown, MD 21620 .I , ! If 6/2/2006 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 3% [72 P.S. S9116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to orfor the use of the surviving spouse is 0% [72 P.S. S9116 (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. s9116(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. S9116(1.2) [72 P.S. s9116(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. s9116(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-1503 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Bohn Grace L. FILE NUMBER 21 06 0013 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 2,659.60 109 shares AT&T @ 24.40 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,659.60 B) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS JNWEALTH OF PENNSYLVANIA ,NHERITANCE TAX RETURN RESIDENT DECEDENT iOF ,In Grace L. FILE NUMBER 21 06 0013 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s)IEIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. Attomey Fees 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountants Fees 6. Tax Retum Prepare(s Fees 7. Filing Fee 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 15.00 DebIs of decedent must be reported on Schedule I. (If more space is needed, insert additional sheels of the same size) ........ ~ ~ .....~ "'~ .".,",,, . jlj;. ~',~.; ;f. ~~ ~... if."'" ~e L. Continuation of REV-1500 Inheritance Tax Return Resident Decedent 21 06 0013 PaQe 1 ~chedule J - Beneficiaries - 1 ~: RELA TlONSHIP 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) f!'euFtd'?lqUt'5~ ;'i)qJ3~3 1. Faye B. Herman Sister 1 % of Residue' 55 Ashford Drive Enola, PA 17025 2. Joanne Casey Niece 15.357% of Residue 16700 Dougherty Avenue Laurel, MD 20707 3. Donna Sue Bird Niece 15.357% of Residue 102 Teal Court Covecreek Club Stevensville, MD 21666 4. Mary Anne Williams Niece 7.857% of Residue 8306 Beaver Court PO Box 774 Chestertown, MD 21620 5. Janet Price Niece 7.857% of Residue 10423 Trail Ridge Ct. Houston, Texas 777064 6. David H. Mitchell Nephew 12.857% of Residue 124 West Phil-ellena Philadelphia, PA 19119 7. Ellen Mitchell Niece 12.857% of Residue 5932 Pulaski Avenue Philadelphia, PA 19144 8. William Mitchell Nephew 203 Prince Street 12.857% of Residue Shippensburg, PA 17257 lJict;tJt ~1lJiII ?:tltV ~Q}~rttcmt~ltt OF GRACE L. BOlIN 1, GRACE L. BOliN, of the East Pennsboro Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made.. I. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this will or otherwise. 3. I give, devise and bequeath my real estate at 57 Ashford Drive, Enola, Pennsylvania, together with the household furnishings therein, to my sister, FAYE B. HERMAN, absolutely and in fee simple if she survives me, but in the event she predeceases me the girt shall not lapse but go instead to her two daughters, MARY - I - ANNE WILLIAMS and JANET PRICE, in equal shares as tenants in common. 4. All the rest, residue and remainder my estate, real, personal and mixed, and wheresoevcr situate, I give, dcvise and bequeath as follows: A.) Fifty-Five (55%) percent of the residue to my following nieces and nephews in equal shares as a class, to wit, JOANNE CASEY, DONNA SUE BIRD, MARY ANNE WILLIAMS, JANET PRICE, DAVID H. MITCHELL, ELLEN L. MITCHELL and WILLIAM M. MITCHELL. In the event a mcmber of the class predeceases me, his or her share shall lapse and be divided equally among the members of the class who survive me. B.) Forty-l<'ive (45%) percent of the residue shall be distributed as follows: 1.) In the event my sisters, FAYE B. HERMAN and JEAN B. MITCHELL, survive me, I give and bequeath one-half (~) thereof to my sister, JEAN B. MITCHELL, and one-fourth (1/4) to JOANNE CASEY and one-fourth (1/4) to DONNA SUE BIRD. 2.) In the event my sister, FAYE B. HERMAN predeceases me and my sister, JEAN B. MITCHELL, survives me, I give and bequeath one- third (1/3) thereof to JEAN D. MITCHELL, one-sixth (1/6) to JOANNE CASEY, one-sixth (1/6) to DONNA SUE BIRD, one-sixth (1/6) to MARY - 2 - ANNE WI LLIAMS, one-sixth (1/6) to JANET PRICE. 3.) In the event my sister, FAYE B. HEnMAN, survives me and my sister, JEAN B. MITCHELL, predeceases me, I give, devise and bequeath one-third (1I3) thereof to FAYE B. liERMAN, one-sixth (1/6) to JOANNE CASEY, one-sixth (1/6) to DONNA SUE BIRD, one-ninth (1/9) to DAVID H. MITCHELL, one-ninth (119) to ELLEN L. MITCHELL and one-ninth (1/9) to WILLIAM M. MITCHELL. 4.) lfmy sisters, FAYE D. HERMAN and .JEAN B. MITCHELL, both predecease me, I give and bequeath one-sixth (1/6) thereof to JOANNE CASEY, one-sixth (1/6) to DONNA SUE BIRD, one-sixth (1/6) to MARY ANNE WILLIAMS, one- sixth (1/6) to JANET PRICE one-ninth (1/9) to DA VID H. MITCHELL, one-ninth (1/9) to ELLEN L. MITCHELL and one-ninth (1/9) to WILLIAM M. MITCHELL. 5. Lastly, I nominate, constitute and appoint my niece, JOANNE CASEY, of Laurel, Maryland, to be Executrix of this my Last Will and Testament. In the event she should for any reason be unable to act as such, I nominate my niece, MARY ANNE WILLIAMS, to be the Executrix in her place and I further direct that no bond or other - 3 - '~--._ ___,,__--..-:.~~~~,.;.:...::;:'!.;/ ~'. \\< L < ..:-_ ,', ,.\. <'" I." '. " ~ . : . . . , .