HomeMy WebLinkAbout09-27-06
REV-1500 EX + (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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RICHWINE NANCY L.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
01/31/2005 09/15/1961
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
RICHWINE KENNETH
...
~ 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (AIlach copy 01 Will)
D 9. Litigation Proceeds Received
D 2 Supplemental Return
D 4 . Future Interest Compromise (daIeoldeathafler12.12-82)
D 7 Decedent Maintained a Living Trust (AIlach copy 01 Trust)
o 1 . Spousal Poverty Credit (date of death belWeen 12-31.91 and 1.1.95)
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 0 8 4 3
"'COUNTY"'COOE -VEAR- - - NuMBeR- -
SOCIAL SECURITY NUMBER
2 0 6 - 4 8 - 1 347
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death pIiorto 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
NAME
MARK F. BAYLEY ESQ.
FIRM NAME (If Applicable)
tRWt~J At4El BAYLe..-
TELEPHONE NUMBER
717-248 e8S6 Z"-ll.... z. ~ '='
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COMPLETE MAILING ADDRESS
84 saUlt I FIR GTRE!:T
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CARLISLE
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
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)
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)
0.00 X _(15)
0.00 X _(16)
0.00 X .12 (17)
0.00 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
20.0
CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAVf.1ENT
PA 17013
OFFICIAL USE ONLY
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(8)
11 ,564.50
1,711.79
(11)
(12)
(13)
13,276.29
-13,276.29
(14)
-13,276.29
0.00
0.00
0.00
0.00
0.00
Dec;edent's Complete Address:
STREET ADDRESS 765 BAL TIMORE PIKE
CITY I STATE I ZIP
GARDNERS PA 17324
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)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/Penalty ( D + 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 [&]
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [&]
c. retain a reversionary interest; or ...................................................................................................... 0 [&]
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [&]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............ ......... .......... ............... .................. ....................... ... .... 0 [&]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [&]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .. ...... .............. ......... ......... .......... ..... ......... ......... .............. ................ 0 [&]
0.00
0.00
0.00
0.00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
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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 retum 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 .5. ~9116(1.2) [72 P .5. ~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-1511 EX + (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF .
RICHWINE NANCY L
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 05
0843
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. EWING BROTHERS FUNERAL HOME, INC. 7,972.50
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AttomeyFees IRWIN AND BAYLEY
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) 3,500.00
Claimant KENNETH W. RICHWINE
Street Address 765 BALTIMORE PIKE
City GARDNERS State PA Zip 17324
Relationship of Claimantto Decedent HUSBAND
4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS: LETTERS 62.00
5. Accountants Fees
6. Tax Retum Prepare~s Fees
7. CUMBERLAND COUNTY REGISTER OF WILLS: FILING, INVENTORY 30.00
TOTAL (Also enter on line 9, Recapitulation) $ 11.564.50
(If more space is needed, insert additional sheets of the same size)
REV.1512 EX +. (6-98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RICHWINE NANCY L.
FILE NUMBER
21 05
0843
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. MASLAND ASSOCIATES INC.
VALUE AT DATE
OF DEATH
86.85
2. CARLISLE REGIONAL MEDICAL CENTER
163.04
3. CARE MARK
64.90
4. CARLISLE MEMORIAL SERVICE INC.
1,397.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 711.79