HomeMy WebLinkAbout08-21-06
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
.
REV-1600 EX + (6-00)
*'
FILE NUMBER
II 2006
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
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NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Gill, Thomas P
DATE OF DEATH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
197-40-5887
DATE OF BIRTH (MM-DD-YEAR)
02-17-2006
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
05-11-2006
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
Gill, Patricia A
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D 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
D
D
D
D
D 3. Remainder Return (date of dealh prior to 12-13-82)
D 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch O)
2. Supplemental Return
4a. Future Inlerest Compromise (date of death afler
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Povertv Credit (date of death between
. 12-31-91 and 1-1-95)
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THiS sEcTioN MUST BE COMPLETED. Al..L.CORRESPONDENCEAND CONFIDEr.rriALtAxINFORMATION
NAME COMPLETE MAILING ADDRESS
EDMUND G. MYERS
FIRM NAME (If applicable)
Johnson Duffie Stewart & Weidner
301 MARKET STREET
POBOX 109
LEMOYNE, PA 17043
(1 ) None
(2) None
(3) None
(4) None
(5) 7,500.00
(6) None
(7) None
(8)
7,500.00
TELEPHONE NUMBER
(717) 761-4540
OFFICIAL liSE ONLY.,
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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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) D Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
6,630.00
7,470.09
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(9)
(10)
11. Total Deductions (total Lines 9 & 10)
(11 )
14,100.09
12. Net Value of Estate (Line 8 minus Line 11)
(12)
insolvent
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
0.00
(14)
0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 X .00 (15) 0.00
or transfers under Sec. 9116(a)(1.2)
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0 (16)
~ 16.Amount of Line 14 taxable at lineal rate 0.00 x .045 0.00
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ll.. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) 0.00
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0
u 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) 0.00
x
~ 19. Tax Due 0.00
(19)
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 <<
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00:
Decedent's Complete Address:
STREET ADDRESS
537 Bedford Court
CITY MechanicsburQ
STATE PA
ZIP 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
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
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
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.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(SA)
(5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "XU IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.................................................................................. D [!]
b. retain the right to designate who shall use the property transferred or its income;.................................... D [!]
c. retain a reversionary interest; or.................................................................................................................. D [!]
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?......... ........... ..... ............................................... .............................................. D [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?...................................................................................................................... l Gd
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 return. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
~mpletec Decl"ration of erep~,~r_other than the personal representalive is based ()n.aIlJnf()fT11"lio.n.lJfIYhich preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
p~iaAGill · h //
Si~SPO~~TURN ADDRESS
DATE
537 Bedford Court
Mechanicsburg, PA 17050
f/;74~
DATE
HAN REPRESENTATIVE
ADDRESS
~_______.. _.__ oft e/q,.
DATE
301 MARKET STREET
LEMOYNE, PA 17043
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. ~9116 (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. ~9116 (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 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.
~9116 1.2) [72 P.S. ~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.
Rev.1608 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gill, Thomas P
FILE NUMBER
21-2006-
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the r1ghl or survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 2000 Dodge Caravan Minivan - Contracted Sales Price
VALUE AT DATE
OF DEATH
7.500.00
TOTAL (Also enter on Line 5, Recapitulation)
7.500.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV.1161 EX+ (12-89)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gill, Thomas P
FILE NUMBER
21-2006-
ESTATE OF
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 6,000.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Johnson Duffie Stewart & Weidner 600.00
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 Preparer's Fees
7. Other Administrative Costs 30.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 6,630.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
RIy-1602 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
Gill, Thomas P
FILE NUMBER
21-2006-
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Musselman Funeral Home and Cremation Services, Inc.
6.000.00
Subtotal
6.000.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rov.1602 EX+ (6-SS)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEOENT
Gill, Thomas P
FILE NUMBER
21-2006-
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Register of Wills Office - Filing Fees: Inheritance Tax Return
$15.00 and Inventory $ 15.00
30.00
Subtotal
30.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1612 EX+ (6-'8)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gill, Thomas P
FILE NUMBER
21-2006-
ESTATE OF
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Chase Visa Platinum Credit Card Account No. 5491 040230304124
VALUE AT DATE
OF DEATH
5.908.96
2 ExxonllMobil Credit Card Account No. 7302 8942 6358 4159
418.83
3 Sunoco Credit Card Account No. 4151-2358064
1.142.30
TOTAL (Also enter on Line 10, Recapitulation)
7,470.09
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
,REV-1613 EX+ (9-00)
ESTATE OF
NUMBER
I.
1
2
3
4
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gill, Thomas P
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-2006-
RELATIONSHIP TO
DECEDENT
Do Not List Trusteelsl
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
Angela Deardorff
3162 Jayne Lane
Dover, PA 17315
Daughter
Jeremy Gill
858 North 25th Street
Philadelphia, PA 19130
Son
Patricia Gill
537 Bedford Court
New Cumberland, PA 17070
Spouse
Stefanie Knaub
201 Norman Road
CampHiII,PA 17011
Daughter
5 Eric Murray Stepchild
2202 A Cedar Run Road
Extended
Camp Hill. PA 17011
See continuation schedule attached Continuation
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
.
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Thomas P Gill 197-40-5887 05/11/2006
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Sandy White Stepchild 0.00
2202 A Cedar Run Road
Extended
Camp Hill, PA 17011
Total
1