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Home My WebLink About07-19-06 \ REV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUN1Y CODE -.9~ 0485 ___ YEAR NUMBER I- Z W C W o w C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Hoffman Gloria DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 5/13/2005 6/20/1933 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) J SOCIAL SECURITY NUMBER 202-24-5893 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W l- ll::: ::!;CI) U D::ll::: W a..u :J: 00 u D::....I a..a:l a.. c( D 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received lliJ 2. Supplemental Return D 3. Remainder Retum (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy oITrust) L 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z W C z o 0.. en W a:: a:: o t.) Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER 44 West Main Street Mechanicsburg, PA 17055 717-697-8528 0.00 0.00 0.00 13,000.00 0.00 0.00 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly OlMled Property (Schedule F) (6) 0 D Separate Billing Requested i= :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ;:) (Schedule G or L) l- n: 8 Total Gross Assets (total Lines 1-7) <( 0 W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0::: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (') 0.00 -...J 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) 300.00 12,700.00 0.00 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 0.00 z rate, or transfers under Sec. 9116 (a)(1,2) x .0 0 i= 16. Amou nt of Line 14 taxable at lineal rate 12,700.00 X.O c( I- ::> 0.00 a.. 17. Amount of Line 14 taxable at sibling rate x .12 ::E 0 0.00 U 18. Amount of Line 14 taxable at collateral rate x.1S >< c( T ax Due I- 19. 12,700.00 L(15) 45 (16) 0.00 (17) 571.50 0.00 (19) 0.00 571.50 (18) 20. [K] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W46451.000 I " l . L-. \ Decedent's Complete Address: STREET ADDRESS 61 Hone suckle Drive, Silver Sprin Cumberland Count CITY Mechanicsbur STATE PA ZIP 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 571.50 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 32.18 0.00 Total Interest/Penalty (D + E) (3) 32.18 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 603.68 A. Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + 5A. This is Make (58) 603.68 to: AGENT 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 reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . 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? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " D D 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 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. Yes No D D D D D o D o o o ADDRESS ~ -- OAT 7 {Clio' Administrator, C.T.A N REPRESENTATIVE ,t~<~ ---- 233 W Siddonsburg Rd., Di11sburg, PA 17019 DATE 7!tlf 10 ADORES 44 West Main Street 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. S 9916 (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 The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets anI the surviving spouse is the only beneficiary. 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. S 9116(a)(1.3)]. A s individual who has at least one parent in common with the decedent, whether by blood or adoption. 3W4646 1.000 ~'c;-(). q~~ ;2;~O jJ~ ,~I () (?C l f &; L)() ~ Cv.... 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 tht or a stepparent of the child is 0% [72 P.S. 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 beneficiaries is 4.5%, except as noted il REV-1507 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gloria J. Hoffman SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21 05 0485 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Ronald B. Hoffman note receivable for unpaid balance of outstanding loan 5,000.00 2 Steven P. Hoffman note receivable for unpaid balance of outstanding loan 8,000.00 TOTAL (Also enter on line 4, Recapitulation) $ 13,000.00 3W46AC 1.000 (If more space is needed, insert additional sheets of same size) 8EV-151.1 E"~+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gloria J. Hoffman FILE NUMBER 21 05 0485 ITEM NUMBER A. B. 3W46AG 1.000 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: 1. None 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Snelbaker & Brenneman, P.C. attorney fees for preparation of Supplemental Inheritance Tax Return, Final Account and Inventory TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT 300.00 300.00 'REV-1S13 Ex+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gloria J Hoffman NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERlY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Jeffrey S. Hoffman 9 East Willow Terrace Drive Mechanicsburg, PA 17050 1 33.333333 of Residue: 4,233.33 2 Ronald B. Hoffman 233 West Siddonsburg Road Dillsburg, PA 17019 33.333333 of Residue: 4,233.33 3 Steven P. Hoffman 61 Honeysuckle Drive Mechanicsburg, PA 17055 33.333333 of Residue: 4,233.33 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 05 0485 AMOUNT OR SHARE OF ESTATE Son Son Son 4,233.33 4,233.33 4,233.33 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 3W46AI 1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space IS needed, Insert additional sheets of the same size) $ 0.00