HomeMy WebLinkAbout08-07-06 (2)
REV-1500 EX (6-00:
OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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COUNTY CODE
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YEAR
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
EVANS KENNETH
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
11/8/2005 4/21/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
B
SOCIAL SECURITY NUMBER
269-18-4912
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
EVANS, ROSELLA B.
~ [X] 1. Original Return
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u a:~ 4. Limited Estate
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U a:-l LAJ 6. Decedent Died Testate (Attach copy of 'MIl)
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~ D 9. Litigation Proceeds Received
D 2. Supplemental Return D 3. Remainder Return (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 of Trust) _ 8. Totall Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (d't' of de,th betweeo 12-31-91 ,n(j H-95) D 11. Election to tax under Sec. 9113(A) (Att"h Soh 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
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ELIZABETH P. MULLAUGH, ESQ.
FIRM NAME (If Applicable)
MCNEES WALLACE & NURICK LLC
TELEPHONE NUMBER
100 PINE STREET
PO BOX 1166
717-237-5243
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6. Jointly O'Mled Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
HARRISBURG, PA 17108
0.00
2,456.62
0.00
0.00
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)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(4)
(5)
8,952.00
8. Total Gross Assets (total Lines 1-7)
(8)
11,408.62
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
0.00
0.00
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
(13)
0.00
11,408.62
0.00
11 Total Deductions (total Lines 9 & 10)
(11)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for v.tlich an election to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
11,408.62
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax 2,456.62 L(15)
Z rate, or transfers under Sec. 9116 (a)(l.2) x .0
0
i= 16. Amount of Line 14 taxable at lineal rate 8,952.00 x .0 45 (16)
<(
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:::> 0.00 (17)
Q. 17. Amount of Line 14 taxable at sibling rate x .12
~
0 0.00
U 18. Amount of Line 14 taxable at collateral rate x .15 (18)
><
<( Tax Due (19)
I- 19.
0.00
402.84
0.00
0.00
402.84
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1.000
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Decedent's Complete Address:
SWEET ADDRESS
Messiah Villaqe
100 Mt. Allen Drive
CITY
Mechanicsburq
I STATE
PA
I f7055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
402.84
0.00
0.00
0.00
Total Credits (A + 8 + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty (0 + E) (3)
0.00
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)
402.84
A. Enter the interest on the tax due. (5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check to: REGISTER
402.84
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 []I
b. retain the right to designate who shall use the property transferred or its income; . D []I
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D []I
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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? IKJ 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [XJ 0
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, induding 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.
ERSON RESPONSIBLE FOR FILING RETURN
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DATE
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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.S9 9916 (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 or for the use of the surviving spouse Is 0% [72 P.S. 99116 (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 Lise of a natural parent, an adoptive parent.
or a stepparent of the child is 0% [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 4.5%, except as noted in ;'2 P.S. 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 12% (72 P.S. 9 9116(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.
3W4646 1000
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE 8
STOCKS & BONDS
FILE NUMBER
KENNETH B. EVANS
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.49 Shares
MetLife
DESCRIPTION
VALUE AT DATE
OF DEATH
2,456.62
3W4696 1.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,456.62
REV-1510 EX + (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KENNETH B. EVANS
FILE NUMBER
ITEM
NUMBEF<
1.
This sChedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the HEV-1500 COVER SHEET is yes.
DESCRIP1l0N OF PROPERTY
It\CLLCE TI-E Nd.ME OF TI-E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
TI-E DATE OF T'RAJ\SFER. ATTACH A CQPV OF THE DEED FOR REAL ESTATE
DATE OF DEATH
VALUE OF ASSET
% OF DECO'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE
VALUE
U.S. Savings Bonds, Series EE
Bonds; Bonds payable on death
to Kathy Eurich (daughter); See
attached list and valuation
information
8,952.00 100.0000
0.00
8,952.00
TOT AL (Also enter on line 7, Recapitulation) $
8,952.00
(If more space is needed, insert additional sheets of the same size)
3W46AF 1 000
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KENNETH B. EVANS
NUMBER
J
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Kathy Eurich
23 Impala Drive
Dillsburg, PA 17019-1350
2 Rosella B. Evans
c/o 23 Impala Drive
Dillsburg, PA 17019-1350
100% of Residue: 2,456.62
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Surviving Spouse
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
8,952.00
2,456.62
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
" NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
3W46AI 1000
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
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
ESTATE OF KENNETH B. EVANS
PENNSYLVANIA INHERITANCE TAX RETURN
TABLE OF CONTENTS (EXHIBITS)
A. Miscellaneous Documents
1. Table of Contents - Exhibits
2. Copy of decedent's Will dated September 15, 1965
3. List of savings bonds and November 2005 value
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lliust mill uun <U.eshtmtut
OF
KENNETH B. EVANS
BE IT REMEMBERED, that I, Kenneth B. Evans, of 16 East
Welty Avenue, Dillsburg Borough, York County, Pennsylvania, being
of sound mind, memory and understanding, do na keto publish and
declare this as and for my Last Will and Testament, hereby revoki.ng
and making null and void any and all wills and testaments and
writings in the nature thereof by me at any time heretofore made.
ITEM 1: I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estiite,
of whatsoever nature and wheresoever situated, whether it be real,
personal or mixed, including property over which I have a power of
appointment, I give, devise and bequeath unto my wife, Rosella B.
Evans, absolutely, if she survives me for a periOd of thirty (30)
days.
ITEM 3: In the event that my wife should predecease me
or fail to survive me for a period of thirty (30) days, I then
give, devise and bequeath my entire residuary estate unto my child
now born or children hereafter born to or adopted by myself and
my wife, in equal shares, per stirpes.
LASTLY, I nominate, constitute and appoint my wife,
Rosella B. Evans, as Executrix of this my Last Will and Testament.
In the event that my wife should. predecease me or fail to qualify,
cease to act or renounce probate, I then nominate, constitute and
Witpess:
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(Kenneth B. Evans)
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appoint Kathy J. Eurich as the Executrix of this my Last Will and
Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and
sea1 this (~~~ day of September, 1965.
~LUV4J.~
(Kenneth B. Evans)
(SEAl,)
The preceding instrument, consisting of this and one (1)
other typewritten page, was on the day and date hereof signed,
sealed, published and declared by KENNETH B. EVANS, the testator
herein named, 'as and for his Last Will and Testament, in the
presence of us, who, at his request, in his presence, and in the
presence of each other, have subscribed our names as witnesses hereto.
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Savings Bond Calculator
Page I ofl
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111/2005
13 0 IIlI lilt l)
Series
1~~~~<?n~~_.,J.
Denomination
$11!999.1f
Serial Number
L ..~. ,.
1\1".1111<;
Total Interest
$5,952.00
Total Value
58,952.00
# Bonds
6
Total Price
$3,000.00
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Jute
09/1986 EE $1,000 $500.00 $992.00 $1,492.00 4.00%
09/1986 EE 1,000 500.00 992.00 1,492.00 4,,00%
09/1986 EE 1,000 500.00 992.00 1,492.00 4.00%
09/1986 EE 1,000 500.00 992.00 1,492.00 4.00%
09/1986 EE 1,000 500.00 992.00 1,492.00 4.00%
09/1986 EE 1,000 500.00 992.00 1,492.00 4.00%
Letentl
Note Description
Nl Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
MA Matured and Not Earning Interest
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Issue Date
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$348.
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