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Home My WebLink About08-03-06 ...J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 05 00914 Date of Birth 167 -22-7453 09/27/2005 04/15/1929 Decedent's Last Name Suffix Decedent's First Name MI Halbert Charles E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW . 1. Original Retum 2. Supplemental Retum 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 4. Limited Estate . 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes Robert M. Baptist Firm Name (If Applicable) (717) 421-6968 REGiSTER OF WILLS USE ONLY First line of address 2600 N. 5th Street Second line of address ,~ City or Post Office Harrisburg State ZIP Code DM E FILED PA 17110-2012 Correspondent's e-mail address:debra.baptist@gmail.com r,) 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. S~~E F P SON RESPONSIBLE FOR F ING R~.~N ... .' . 1 J I. A" DATE 'AOORESS---'-~~ ,__~~l~~~.J ..s:)"J./CI~. . 2600 N. 5th Street, Harrisb.tJ.~~PA 17110 ~___ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 --.J ~ ~ 15056052059 REV-1500 EX Decedent's Name: Charles E Halbert RECAPITULATION 1. Real estate (Schedule A). ............ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .O~ 0.00 16. Amount of Line 14 taxable at lineal rate X.O L 0.00 17. Amount of Line 14 taxable at sibling rate X .12 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 19. TAX DUE. . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L Decedent's Social Security Number 167 -22-7 453 4,500.00 0.00 0.00 0.00 14,939.22 0.00 0.00 19,439.22 7,294.46 18,824.22 26,118.68 -6,679.46 0.00 -6,679.46 0.00 16. 0.00 17. 0.00 18. 0.00 0.00 15056052059 --..J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Charles E Halbert ---...--..- ------ STREET ADDRESS 2510 Rolo Court File Number 21 05 00914 DECEDENT'S SOCIAL SECURITY NUMBER 167-22-7453 CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 0.00 0.00 --. --,---_. - - - --" ---- 0.00 Total Credits ( A + B + C ) (2) 0.00 3. InterestJPenalty if applicable D. Interest E. Penalty 0.00 0.00 4. TotallnterestJPenalty ( 0 + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Fill in oval on Page 2, Line 20 to request a refund. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) (4) (5) (SA) (5B) 0.00 0.00 0.00 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 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; .......................................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 00 c. retain a reversionary interest; or.......................................................................................................................... 0 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i] 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [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 zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)). The statute does not exemot 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in 72 PS. 99116(1.2) [72 P.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 twelve (12) percent [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-1502 EX+ 16-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Charles E. Halbert FILE NUMBER 21-0500914 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 1977 Liberty Mobile Home 4.500.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,500.00 REV-15G8 EX+ (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-0500914 VALUE AT DATE OF DEATH a 28.59 90.34 104.00 29.00 221 .29 172.00 39.00 13,600.00 200.00 a 100.00 50.00 50.00 15.00 50.00 25.00 40.00 50.00 15.00 10.00 10.00 10.00 10.00 20.00 ESTATE OF Charles E. Halbert Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolnlly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Cash in the bank, Members 1st Federal Credit Union, 5000 Louise Dr., Mechanicsburg, PA 17055 Accl. "I" ?n1l:;AQ 2 Final Pay Check - W-2 wages - Wal-Mart 3 Refund of Medical Insurance Premium - Senior Blue 4 Refund from Homeowners Insurance - Travelers Insurance 5 Refund of Security Deposit for Rental of Lot - Rolo Court 6 Refund of Federal Income Tax 7 Refund of Pennsylvania Individual Income Tax 8 2006 Saturn Ion automobile 9 bedroom suite, consisting of a double bed, dresser with mirror, chest of drawers, and 2 bedside tables 10 living room furniture consisting of a sofa, recliner, 2 end tables, coffee table, 2 bookshelves, and an on+o"~inlTlon+ ....on+ol'" 11 17" Zenith color television 12 DVDNCR player 13 Dining room table with 4 chairs and a hutch 14 microwave stand and microwave 15 miscellaneous kitchen items including dishes and pots and pans 16 HP computer, printer, and desk 17 clothing and personal items 18 Dirt Devil vacuum cleaner 19 2 living room lamps 20 small kitchen appliances consisting of a toaster and two coffee makers 21 CD player 22 lawnmower 23 Miscellaneous hand and small power tools TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 14,939.22 REV.1511 EX+ (12'99)_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Charles E. Halbert FILE NUMBER 21-0500914 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Hetrick Funeral Home Food and refreshments 5,798.00 35.65 2 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 000 Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees 0.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 11400 5. Accountant's Fees 000 6. Tax Retum Preparer's Fees 0.00 7. Heating oil to keep the home in selling condition 253.00 8 Advertisement in Patriot News to sell home 144.64 9 PPL - electric service to keep the home in selling condition 55.41 10 Light fixture in small bedroom 13.76 11 Rolo Court - Rent for the lot until the home was sold 880.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,294.46 REV-1512EX+(12-03) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Charles E. Halbert FILE NUMBER 21-0500914 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Lowe's Capital One Credit Card 206.81 2 Traveler's Insurance (automobile insurance) 43.00 3 Verizon telephone service 16.06 4 Comcast cable service 4.62 5 2005 Real Estate tax on 1977 Liberty Mobile Home 48.55 6 2005 Personal Tax 11.00 7 Members 1st Federal Credit Union automobile loan 15,864.12 1,923.45 8 Members 1 st Federal Credit Union unsecured loan 9 Members 1st Federal Credit Union Visa credit card 617.73 10 2004 Local Income Tax 88.88 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 18,824.22