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Home My WebLink About06-12-06 REII.1S(lC"x.r6,jJO, w .... ~~l/J UD:" Wo..U xOO UD:..J 0.. CD 0.. <( .* F'id REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2 1 0" COUNTY CODE vEAR SOCIAL SECURITY NUMBER NuMBER Future Inlerest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-J1:91 and 1-1-99) THIS SECTlQ~.~~~T. BE COMPLE!..ED. AJ-l:..CORRE~POt-ll:l~t-I~~~Np ~_O~FIDENTIALT~ 1N.~_Q.RMAT~Q~~HOULDEiE:DII~E:~TED TO: NAME COMPLETE MAILING ADDRESS John B. Fowler, III, Esquire COMMOI\iWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OEPT 280601 HARRISBURG PA 17128-0601 JECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) \-\'ErGLE, LEROY M. .... z w Cl w U w Cl CATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 5,Ci 181-07-6958 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. RemaInder Return (date of death prior 10 12-13.82) o o 5. Federal Estate Tax Return ReqUired 8. Total Number of Safe DepOSit Boxes o 11. Election to lax under Sec 9113(A) (AllaCe Sce 0: Ten East High Street Carlisle, PA 17013 (1 ) None (2) None (3) None (4) None ---- (5) 737.58 -------.--. ..--. (6) 2,168.92 (7) None ) 12; 1 1,2005 12/12/1913 (8) c-:> 2 90650 \.0' . i, 'IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) (9) 9,774.42 ---.-.-----. .._--- -- ----.-.---..- (10) 50,101.70 (11 ) 59,876.12 ~ 1 Original Return o D D 0- 2. Supplemental Return o 4a. D 7. o (12) insolvent 4 Limited Estate 6 Decedent Died Testate (Attach copy of Will) 9 litigation Proceeds Received .... z w Cl z o 0.. FIRM NAME (If applicable) Martson Deardorff Williams & Otto 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 20. D 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x ;:: <( .... :> 0.. 17 Amount of Line 14 taxable at sibling rate x .12 (17) ~ 0 u )( 18 Amount of Line 14 taxable at collateral rate <( x .15 (18) .... 19. Tax Due (19) TELEPHONE NUMBER 717243-3341 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ;:: :5 :> .... a:: <( u w ex: 4_ Mortgages & Notes Receivable (Schedule D) 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) 12. Net Value of Estate (Line 8 minus Line 11) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >>BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) w . Decedent's Complete Address: STREET ADDRESS 770 South Hanover Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) Total Credits (A + B + C) (2) 0.00 3 InterestJPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 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;............................................................................. ~ ; ~. ~::::~ ~h~e~~~;i~~:~s:~~~~s;~~. .~~~~~ .~.~~. .t.~~. ~~~~~.~:. .t.~~.n.s.~~.~~~.~. .~.~ .i.t~. ~~.~.~.~.e~..............................~~.. ~ ~ ~ ~ ~ ,'.' ~ ~ ~ ._...... 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?... ................. ......... ........ ...................... ...................................................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation?................................................................................................................ 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, including accompanYing schedules and statements, and to the best of my knowledge and belief. illS true, correct and complete DeClal allor preparer other than the personal representa!lve IS based on all informa!lon of which prepar~r has any knowled~e. SIGNATURE OF PERSON RESPONSJBLE FOR FILING RETURN ADDRESS .JC)' Williams 899 Good~ear Road SIGyr~('b"'PER~l~o~.~~rtl~G....~ETURN ADDRESS Gardners, A 17324 DATE (~. /-; //1 /.- DAtE' '(. SIGNA TURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE .Joh", Fowler. II~.. s~. ~0 (",Ten East High Street , ~ .- d!' Carlisle, P A 17013 " D~ ("" olde.1h 0: o"fte' Jo', " 1994 ,"d bel"e J,"o"y 1, 1995, Ihe I~ 'ale ,mp",ed 00 'he "o! ,aloe oft'a",le~ 10 0<10< Ihe ",e of 'he ( Z,j",ng spouse IS 3% [72 P,S. ~9116 (a) (1.1) (I)]. For d3tes 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 statutedoes not exemota transfer to a surviving spouse from tax. and the statutory requirements for disclosure of 3ssets 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. ~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 in 72 P,S 99116 12) [72 PS ~9116 (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. ~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. .* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY (':'"lM01>.oWEAi...TH OF PENNSYLVANIA ~hERITANCE TAX RETURN RESICENT DECEDENT ESTATE OF WEIGLE, LEROY M. FILE NUMBER 21 - 05 - Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 499.93 Proceeds from close of Chapel Pointe PCA account 2 Carlisle Area Health and Wellness Foundation, refund of6/19/2000 I03~O 3 Bankers Fidelity Life Insurance Company, refund of premium 133.~5 TOTAL (Also enter on Line 5, Recapitulation) 737.58 .* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WEIGLE, LEROY M. FILE NUMBER 21 - 05 - If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Jean Williams 899 Goodyear Road Gardners, PA 17324 Daughter JOINTLY OWNED PROPERTY: ITEM LETTER NUMBER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY 0 Incl~d~ n~me C?f~nancial institution and bank .a~count number DATE OF DEATH D~C~S DA0~~~ED~:TH or similar Identifying number. Attach deed for JOintly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. A 11/1989 PNC checking account #5140193636 4,337.84 50% 2,168.92 TOTAL (Also enter on line 6, Recapitulation) 2,168.92 . . SCHEDULE H AJNERAL EXPENSES & ADMINISTRATIVE COSTS . ::CMMONWEAL TN OF PENNSYLVANIA NHERI;ANCE ~AX RETURN RESiDENT 8ECEDENT ESTATE OF \VEIGLE, LEROY M. FILE NUMBER 21 .. 05 .. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Hollinger Funeral Home & Crematory Inc. 8,755.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Martson Deardorff Williams & Otto (estimated) 2. 1,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~ I Other Administrative Costs Certified mailing, Department of Public Welfare -L-+2 ~ Filing fee. Inheritance Tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) 9,77 4..t2 . .* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA ,NHERITANCE TAX RETURN RESiDENT DECEDENT ESTATE OF WEIGLE, LEROY M. FILE NUMBER 21 - 05 - Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT PA Department of Public Welfare, CIS Claim No. 810173608 50.101 -0 TOTAL (Also enter on Line 10, Recapitulation) 50,101.70