HomeMy WebLinkAbout09-15-06 (2)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL)
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Gottshall Jeannette M.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
10/31/2005 10/27/1923
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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00 1. Original Retum
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
o 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICIAL USE ONLY
FILE NUMBER
21 -0 6 006 8
""COuNTv'COoE -YEAR- - - NuMBeR- -
SOCIAL SECURITY NUMBER
1 96- 1 4 - 0 1 9 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (date of death prior to 12-13-82)
D 5. Federal Estate Tax Retum Required
1.. 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under See. 9113(A) (Attach Sch 0)
THI$..$Ee.TION...MO$t..eE...COMptl$TED~...A.l.DteORRE$PONDENCS.IND..CO.IirIDS.III.;!f....,NEORMA.tION.SHOOl.DD...BE.DIRECtED...tO;
NAME COMPLETE MAILING ADDRESS
Ste hen J. Ho Es uire 19 S. Hanover Street, Ste. 101
FIRM NAME (If Applicable)
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TELEPHONE NUMBER
7172452698
Carlisle
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 9116 (a)(1.2)
X _(15)
24,992.42 X .045 (16)
X .12 (17)
X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > . BE. SURE TClJ\NSWER<ALLQUeSTIONSi.ON REVER$E.;SU1E:AND RECHEC KMI\TH.... '<::<
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OFFICIAL USE ONLY
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40,780.80
5,712.71
10,072.67
(11 )
(12)
(13)
15,785.38
24,995.42
(14)
24,995.42
1,124.66
1,124.66
Decedent"s Complete Address:
STREET ADDRESS
7073 Carlisle Pike, Lot 226
CITY T STATE I ZIP
Carlisle PA 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 )
1,124.66
Total Credits (A + 8 + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
~ T otallnterest/Penalty ( D + E )
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
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
.
(4)
(5)
(5A)
(58) '.
to: REGISTER OF WILLS, AGENT
0.00
1.124.66
5.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check
1,124.66
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 IKl
b. retain the right to designate who shall use the property transferred or its income; ........................................ D IKl
c. retain a reversionary interest; or ...................................................................................................... D IKl
d. receive the promise for life of either payments, benefits or care? ............................................................. D IKl
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?.... ........... ........................... ................ .............................. ...... D IKl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D IKl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................... .... .... ................................ D IKl
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
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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.
R~Y-1508 E~ t (6-.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gottshall Jeannette M.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
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.
0068
ITEM
NUMBER DESCRIPTION
1. M& T Checking Account# 604186
2. Pension Check
3. Interest payment 11/21/105
4. Interest payment 12/21/05
5. Interest payment 01/20/06
6. Interest payment 02/07/06
7. Sale of Mobile Home
8. Security Deposit Return
9. Christmas Club close-out transfer
VALUE AT DATE
OF DEATH
33,555.02
417.00
2.83
2.22
2.21
1.25
6,500.00
100.00
200.27
Tt' JlmCl
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/r/l,iJp
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
40,780.80
'R~_1511'~;(1.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gottshall Jeannette M.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
06
0068
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Neill Funeral Home 315.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Sandra B. Dean 2,446.84
Social Security Numbe~s)/EIN Number of Personal Representative(s) 161-34-2085
Street Address 2010 Manada Street
City HarrisburQ State P A Zip 171 04
Year(s) Commission Paid:
2. Attorney Fees Stephen J. Hogg, Esquire 2,446.84
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 132.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7. Advertising:
The Sentinel 137.03
Cumberland Law Journal 75.00
8. Filing Inheritance Tax Return and Inventory 30.00
9. Filing First and Final Accounting (Est.) 130.00
TOTAL (Also enter on line 9, Recapitulation) $ 5712.71
(If more space is needed, insert additional sheets of the same size)
R~V-1512 EX" (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gottshall Jeannette M.
FILE NUMBER
21
06
0068
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Rudolph Kepp, IV - TV
VALUE AT DATE
OF DEATH
500.00
2. Barry Siple - Beneficiary advance payment
2,800.00
3. Leiby MHP - Lot Rent
315.00
4. Chase Card Services - dinner
222.00
5. Comcast
44.32
6. Bank Fee for Check Return Option - November
1.00
7. MBNAlIBA Check Payment
99.00
8. Bank Fee for Check Return Option - December
1.00
9. Bank Fee for Check Return Option - January
1.00
10. Foot and Ankle Center
14.19
11 . Milton S. Hershey Medical Center
10.74
12. The Guide News
39.60
13. Leiby's Parkway
646.02
14. Leiby's MHP Water/Sewer
11.50
15. Milton S. Hershey Medical Center
10.85
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10.072.67
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Gottshall, Jeannette M.
Decedent's Name
Page 1
21 06 0068
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. Milton S. Hershey Medical Center 29.60
17. PP&L February 544.42
18. PP&L March 79.56
19. PP&L April 74.00
20. PP&L May - Final Bill 114.20
21. Milton S. Hershey Medical Center 912.00
22. Milton S. Hershey Medical Center 121.03
23. Health Network Laboratories 5.78
24. Milton S. Hershey Medical Center 221.56
25. M& T Checking Account Fee 18.25
26. M& T Checking Account Service Charge 13.07
27. Leiby's Lot Rent 302.00
28. Property Tax 109.90
29. Personal Tax 24.49
30. Penny MacDonald - Beneficiary Advance Payment 944.14
SUBTOTAL SCHEDULE I
3,514.00
.. Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Gottshall, Jeannette M.
Decedent's Name
Page 2
21 06 0068
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
31. Advance payment to Executrix - Sandra Dean (Sandra paid herself $3000.00 to cover 1,842.45
bills prior to estate account opened. Total bills paid by Sandra $1157.55)
SUBTOTAL SCHEDULE I 1,842.45
GRAND TOTAL SCHEDULE I $ 10,072.67
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
FILE NUMBER
1
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
1. Sandra B. Dean 20% less advance pmt. of Daughter 4049.02
2010 Manada Street $1842.45
Harrisburg, PA 17104
2. Barry Siple 20% less advance pmt. of Son 3091.47
178 Jo-Lee Drive $2800.00
Middletown, PA 17057
3. Penny MacDonald 20% less advance pmt. of $944.14 Daughter 4947.33
1035 Schwanger Road, Apt. 13
Elizabethtown I P A 17022
4. Wayne Gottshall 20% Son 5891.47
7073 Carlisle Pike, Leiby's Parkway, Lot 94
Carlisle, PA 17013
5. Bonnie Basom 20% Daughter 5891.47
479 2nd Avenue
Highspire, PA 17034
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)