HomeMy WebLinkAbout09-22-06
REV-l500 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
F~E N~MB~R 0 6 t) L\ \
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COUNTY CODE YEAR NUMBER
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DECEDENfS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Derr, Minnie Sowers
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
04/06/2005
06/18/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
1 6 1 - 5 4 - 8 828
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
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001. Original Return
o 4. Limited Estate
o 6. DecedentDied Testate (Allach copyo/WiII)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death afIer 12-12-82)
o 7. Decedent Maintained a Living Trust IAllach copy ofTrust)
o 10. Spousal Poverty Credit (daleo/death between 12-31-91 and 1-1-95)
o 3. Remainder Retum ldale of death pJiorto 12-13-821
o 5. Federal Estate Tax Retum Required
.Q.. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Allach SCh 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Wa ne F. Shade, Es uire 53 West Pomfret Street
FIRM NAME (If Applicable)
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TELEPHONE NUMBER
717-243-0220
Carlisle
OFFICiAluSEONLv
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole.proprieto~;hip
4. Mortgages & Notes Receivable (Schedule 0)
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 Prop3rty
(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 Governmental BequestslSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(1)
(2)
(3)
(4)
(5)
PA 17013
(6)
(7)
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1,490.23
(9)
(10)
(8)
9,432.00
1,476.38
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 Sec. 9116 (a)(1.2)
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
X _(15)
X _(16)
X .12 (17)
X .15 (18)
(19)
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFllND (IF AN OVERPAYMENf
(11)
(12)
(13)
10,908.38
-9,418.15
(14)
-9,418.15
> > BE SURE TO ANSYn!R ALL QUESTJONS ON REVERSE SlOE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS 700 Walnut Bottom Road
.
CITY C l' 1
ar IS e
I STATEPA
I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
O. Interest
E. Penalty
TotallnteresVPenalty ( 0 + E) (3)
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)
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. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
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; ........................................................................... 0 00
b. retain the right to designate who shall USE the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ..................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, d d decedent transfer property within one year of death
without receiving adequate consideration?........................................... ..................... ......... ..................... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............. .......................................................................................... D 00
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 peljury. I declare that I have examined this return, including acco npanying schedules and statements, and to the best of rny knowledge and belief, it is true. correct and complete.
Declaration of preparer other than the personal representative is based on all inform3tion of which preparer has any knowledge.
SIGNATUW~SP~~N
ADDRESS 234 Forrest Drive
Gettysburg
SIGNATURE OF PREPARER OT R T AN REPRESENTATIVE
@
ADDRESS 5 West Pomfret Street
Carlisle
DATE
9/8..o/d~
PA 17325
DATE
9/.;2~pb
PA 17013
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 atter 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 u~;e 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 Darent in common with the decedent. whether bv blood or adootion.
REV-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Derr Minnie Sowers
FILE NUMBER
21 06
Include the procee js of litigation and the date the proceeds were received by the estate.
All property joinUy-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
M&T Bank
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
954.23
1,490.23
Pm M&I'Bank
499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
March 20, 2006
Wayne F Sbade
Attorney At Law
53 West Pomfret Street
Carlisle, Pennsylvania 17013
Re: Estate of: Minnie S De"
Social Securitv: 161-54-8828
Date of Death: ADril 6. 2005
Dear Sir or Madam:
Per your inquiry dated March 9, 2006, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1.
Type of Account
Checking Account
Account Number
464821
Ownership (Names oj)
Minnie S /)err *
William Lee Derr, POA *
Opening Date
01/01/69 Closed 03/13/06
Balance on Date of Death
$954.23
Accrued Interest
$ 0.00
Total
$954.23
Please be advised, there was no safe deposit box found for the above decedent.
· For further account information, regarding ownenhip, closures and/or reimbursement of funds, etc., please call
the High Street Carlisle Offke # 717-240-4536.
Sincerely,
~7~~
Nancy Clagett
Records Management
REV-1511 EX+(12-99)
.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Derr Minnie Sowers
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 06
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hollinger Funeral Home & Crematory, Inc. 8,667.00'
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (:>)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attomey Fees Wayne F. Shade, Esquire 750.00
3. Family Exemption: (If decedenfs address is rot the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedeflt
4. Probate Fees
5. Accountanfs Fees
6. Tax Retum Preparer's Fees
7. Register of Wills, file inheritance tax return 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 9,432.00
(If more space is needed, insert additional sheets of the same size)
REV-151.EX+ (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Derr Minnie Sowers
FILE NUMBER
21
06
Include un reimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Forest Park Health Center, patient liability
VALUE AT DATE
OF DEATH
1,476.38
TOTAL (Also enter on line 10. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
1,476.38