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Home My WebLink About06-28-06 REV-1500 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -06 o 343 'CciO'NTYCO'5E ~A~ - - NUMsER- - I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REHFUSS DATE OF DEATH (MM-DD-Year) STEPHANIE H. DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 1 99- 2 8 - 4 782 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~ ~en U or::~ w 15u :I: or::g un.a1 n. < 02/20/2006 01/03/1930 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) !Xl 1. Original Return o 4. Limited Estate !Xl 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Return IdateofdeathpriortoI2-13-82) o 5. Federal Estate Tax Return Required !!- 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THiS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA.TION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURRIEL R. WALTERS III, ESQUIE FIRM NAME (If Applicable) I- Z W o z o n. en w or:: or:: o U 54 EAST MAIN STREET PA 17055 OFFICIAL USE ONLY ~ I 1,336.00 (6) ~, .' - ) -J (7) 106,513.81 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. NletValue of Estate (Line 8 minus Line 11) (8) TELEPHONE NUMBER 717-6!J7-4650 MECHANICSBURG (11) (12) (13) 106,513.81 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (1) (2) (3) (4) (5) (14) 106,513.81 z o i= <( ...J ::> !:: a. <( U W 0:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JO'lntly Owned Property (Schedule F) [J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. TCltal Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0.00 0.00 13. C!naritable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <( I- ::> a. :E o U ~ I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 106,513.81 X ~ (15) 16. Amount of Line 14 taxable at lineal rate X _(16) X12 (17) X .15 (18) (19) 17. Amount of Line 14 taxable at sibling rate 18. ,lI,mount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < o d t' C I t Add ece en s omple e ress: STREET ADDRESS 71 NORTHVIEW DRIVE CITY I STATE I ZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C, Discount (1 ) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable 0, Interest E Penalty Total Interest/Penalty ( 0 + E) (3) 4, If Line 2 is !Jreater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5) A Enter the interest on the tax due, (5A) B, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 PL.EASE 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 [Xl b, retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Xl c, retain a reversionary interest; or ...................................................................................................... 0 [Xl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.. ......... ..... ..... ....... ........ ... ..... .... ..... ..... ....... ............ ................. 0 [Xl J Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS 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 th the personal representative is based on all information of which pre parer has any knowledge, SIGNATURE OF PERSO SPON~IS,L I 0 FJ1rINJtE~~~N",/ 'It: . U! p.(;;V '1??fl/ GEO E . REHFU1S 71 NORTHVIEW DIlIVE, MECHANICSBURG SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~ . , f' MURREL R1WJi. T~;st.(,'~~dtnRE 54 EAST MAIN STREET, MECHANICSBURG DATE /4- " (jlv'L:.' ~:, O~~, ADDRESS PA 17050 ;:.' f.t I li(cr., PA 17055 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 PS, 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 0% [72 PS 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 dE~ath 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. 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 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)j, 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, 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-1503 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF REHFUSS STEPHANIE H. FILE NUMBER 21 06 0343 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 25 SHARES COMMON STOCK. WACHOVIA NET SALE PRICE VALUE AT DATE OF DEATH 1,336.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,336.00 REV-1508 EX + (Ei-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF REHFUSS FILE NUMBER STEPHANIE H. 21 06 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0343 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 105,177.81 MIDLAND NATIONAL ANNUITY TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 105,177.81 REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF REHFUSS FILE NUMBER STEPHANIE H. 21 06 0343 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) GEORGE MARTIN REHFUSS . RENOUNCED Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 71 NORTHVIEW DRIVE City MECHANICSBURG State PA Zip 17050 Year(s) Commission Paid: 2. Attomey Fees MURREL R. WALTERS III, ESQUIRE 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 Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) "'"''''''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF REHFLJSS NUMBER I. SCHEDULE J BENEFICIARIES STEPHANIE H. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. GEORGE M. REHFUSS '71 NORTHVIEW DRIVE MECHANICSBURG, PA 17050 FILE NUMBER 21 06 RELA TIONSHIP TO DECEDENT Do Not List Trustee(s) HUSBAND 0343 AMOUNT OR SHARE OF ESTATE 100% 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - 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)