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Home My WebLink About08-30-06 (2) REV -1500 EX. r6-00i . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 OS COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00860 IWM8E.~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST. FIRST AND MIDDLE INITIAL) McKEEHAN, James S. f- Z UJ '" UJ U UJ '" DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 08 ]] 2005 08/01/]919 (IF APPliCABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 188-12-5365 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER UJ f- ~~U) u"'''' UJ,,-u IDD u",..J ,,-OJ "- <i o 1 Onglnal Return o o o \:81 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7 Decedent Maintained a liVing Trust (Attach cop i of Trust) o 10. Spousal Poverty Credit (dale of death between 12-31-91 aDd 1-_'-95J THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: __ __ ___ __ ______~___ __m___m______ COMPLETE MAiliNG ADDRESS 4 Limited Estate 6 Decedent Died Testate (Attach copy of Will) 9 Litigation Proceeds Received f- Z UJ Cl z o "- NAME I-Iillary A. Dean, Esquire FIRM N"ME (If applicable) 'v1artson Deardorff Williams & Otto TELEPHONE NUMBER 717243-3341 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) 5 Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o 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) o 3 Remainder Return (date of iJeatn prior io o 5 Federal Estate Tax Return Required 8 Total Number of Safe DepOSit Bexes o 11 Election to tax under See 9113(A) (Mach See 0) 10 East High Street Carlisle, P A 17013 (1 ) None (2) None (3) None (4) None (5) 683.00 (6) None (7) None (8) 68300 (9) 15.00 (10) (11 ) 1 'i. 00 (12) 66K lJ() 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) (14) 668.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec 9116(a)(1.2) z 668.00 .045 (16) 0 16 Amount of Line 14 taxable at lineal rate x >== <i f- ::J (17) "- 17 Amount of line 14 taxable at sibling rate x .12 :;; 0 u >< 18. Amount of Line 14 taxable at collateral rate <i x .15 (18) f- 19 Tax Due (19) "0 0(1 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 3006 - >>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) Decedent's Complete Address: STRLl.T ADDRESS 279 Spring view Road CITY Carlisle STATE P A 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) 30.06 Total Credits (A + B + C) (2) 0.00 3 interest/Penalty if applicable o Interest E Penalty B. Enter the total of Line 5 + 5A This is theBALANCE DUE (3) (JOO (4) (5) 30.06 (5A) (5B) 30.06 Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is thEOVERPA YMENT 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: Yes No a retain the use or income of the property transferred: ............... . ........... . 0 I:8J b. retain the right to designate who shall use the property transferred or its income;... 0 I:8J c. retain a reversionary interest; or.. ..............h.. ............ . 0 I:8J d. receive the promise for life of either payments, benefits or care? 0 I:8J 2 If death occurred after December 12, 1982 did decedent transfer property within one year of death without receiving adequate consideration?.. .......--...... 0 I:8J ...0 I:8J o ~ 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............ .... ................ 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 oenalt:es of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. Ii IS true, correct and cQ1llplete Decla:-atlor pre parer other [har. the personal representative IS based on all Information 0' which preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE \\iehad l;Ienry SIG~;l~~~~\~ ~~R;~ N ~~~PONS)B~E~~~~I:;;~ ~ETURN SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE A. J)e~lI. Esquire 25 Pennw'1 Drive , I r Carlisle, P 17015 " /' 1/ .- ADDRESS DATE ADDRESS DATE 10 East Hlh Street C,! .~ /1 .' Carlisle, P 17013 I' '-.. I ,..,i 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 PS. ~9116 (a) (1.1) (ii)]. The statutedoes 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. ~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 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. *....... .:J!I. ~' - ~ !~ - . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McKEEHAN, James S. FILE NUMBER 21 - - 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 1 DESCRIPTION VALUE AT DATE OF DEATH Nationwide Mutual Fire INsurance Company, refund of homeowners insurance ()~3(1() TOTAL (Also enter on Line 5, Recapitulation) 683.00 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMr\10N\/v'EAL TH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McKEEHAN, James S. FILE NUMBER 21 - - Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Social Security Number(s} / EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2 Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Zip City Relationship of Claimant to Decedent State 4 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7 Other Administrative Costs Register of Wills, filing fee, Supplemental Inheritance Tax return IS.()U TOTAL (Also enter on line 9, Recapitulation) 15.00