HomeMy WebLinkAbout07-17-06
REV-15oo 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
21
COUNTY CODE
-9L 0049 ___
YEAR NUMBER
....
Z
W
C
w
o
w
C
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
EYSTER RUTH
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
12/29/2005 6/22/1909
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
162-22-9840
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
W
I-
:.:::=!lI)
00::.::
wD..O
zOO
00:...1
D..lD
D..
<(
01
04
06
09
Limrted Estate
Original Retum
IlLl 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82)
o 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Return Required
o 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposrt Boxes
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
Decedent Died Testate (Attach copy of Will)
Litigation Proceeds Reeeived
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
J-
Z
w
a
z
o
D-
In
W
It:
It:
o
o
JO ANN KEAGLE
FIRM NAME (If Applicable)
113 STRAYER DRIVE
TELEPHONE NUMBER
CARLISLE, PA 17013
717-258-6830
t.."
c.:~:)
1. Real Estate (Schedule A)
(1)
OFFICW! USE ONLY C_.
. .. .. c::
r-'
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 Owned Property (Schedule F) (6)
0 D Separate Billing Requested
i=
:3 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
:) (Schedule G or L)
....
0: 8. Total Gross Assets (total Lines 1-7)
<C
0
W 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
c:::
10. Debts of Decedent, Mortgage Liabilrties, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
-J
~~"1Il
. )
" "j:::1
"T1
C';
~-'n
C)
(.n
w
.J
o
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for Yotlich an election to tax has not been
made (Schedule J)
27,602
(27,602)
o
14. Net Value Subject to Tax (Line 12 minus Line 13)
(27,602)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 9116 (a)(1.2)
0 x .0 ~(15)
0 x .0 ~(16)
0 x .12 (17)
0 x .15 (18)
(19)
o
o
o
z
o
j::
<{
I-
::;)
D..
==
o
o
X
<(
I-
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 laxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
20.
[KJ
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
o
19. Tax Due
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1.000
-
J
Decedent's Complete Address:
STREET ADDRESS
113 STRAYER DRIVE
CI1Y I STATE I ZIP
CARLISLE FA 17013-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
o
o
297
o
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
297
o
o
Total Interest/Penalty (D + E) (3)
o
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)
297
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
o
A. Enter the interest on the tax due.
(5A)
o
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Pa able to: REGIS1EROFWlLLS,AGENT
(58)
o
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 D
b. retain the right to designate who shall use the property transferred or its income; . D D
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D D
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 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 pe~ury, I declare that I have examined this netum, 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 knO'Nledge.
/'lOI3
DATE
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. 99916 (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 0% [72 P.S. S 9116 (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. 9 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. 9 9116(1.2) [72 P.S. 9 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. 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 1.000
--
..
-.I
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REruRN
RESIDENT DECEDENT
ESTATE OF
RUTH EYSTER
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
FILE NUMBER
21 06 0049
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
DEPT OF PUBLIC WELFARE
27,602
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
27,602
--
-1
Due... '\ ~ (l\::)
\=c\ l.\ S UD
N~pD
,"",","",J .-....... 'ifr~ ;& i....".,,,,,....,..,,',...,,..._~.~._""_"'..,~c'"','_-..