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Home My WebLink About10-03-06 REV-1500 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT W I- ~ ~en o O::lII:: W CLo :z: 00 O O::..J CLm CL <t DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U w C HOMER IRMA DATE OF DEATH (MM-DD-Year) M. DATE OF BIRTH (MM-DD-Year) OFFICiAl USE ONLY FILE NUMBER 2 1 -0 6 0 5 9 9 ""'COuNTY"'CoOE ----vEA~ - - NuMsER- - SOCIAL SECURITY NUMBER 1 87- 1 4 - 1 425 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) o 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under See. 9113(A) (Allach Sch 0) z o ~ <( ..J ::J I- 0: <( u w 0:= z o ~ <( I- ::J 0- ::E o (,) ~ 03/29/2006 08/09/1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) PA 17055 OFFICIAL USE ONLY "-> C-~:} "Qo~ 0':'" o C) -i , W (8) : -J~ ~, ---j .........' -~::... "'" -) ._51~830.00 -..-.: .:"j [Xl 1. Original Retum o 4. Limited Estate o 6. Decedent Died Testate (Allach copy of Will) D 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Allach copy ofTrust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0:> '--V 5,309.78 1,104.51 ~ I- Z W C Z o CL en w 0:: 0:: o o NAME MURREL R. WALTERS III FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS (11) (12) (13) 6,414.29 45,415.71 54 EAST MAIN STREET TELEPHONE NUMBER 717-697-4650 MECHANICSBURG (14) 45,415.71 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) D 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 Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) X _(15) 45,415.71 X .045 (16) X .12 (17) X .15 (18) (19) 2,043.71 2,043.71 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 Decedent's Complete Address: STREET .AlDDRESS 410 EAST COOVER STREET CITY I STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 2,043.71 Total Credits ( A + B + 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 (4) 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 (3) 0.00 5. 2,043.71 2,043.71 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 lRl b. retain the right to designate who shall use the property transferred or its income; ........................................ D lRl c. retain a reversionary interest; or ...................................................................................................... D lRl d. receive the promise for life of either payments, benefits or care? ............................................................. D lRl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .... ........... ...... ................. ..... .... .... ............... ..... ....................... D lRl 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D lRl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... .......... .... ...... ......... ............... ...................... ................. .............. D lRl 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 TERS III, ESQUIRE AIN STREET, MECHANICSBURG PA 17055 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 exempt 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. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(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-1509 EX + (6-98) ". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF HOMER IRMA M. FilE NUMBER 21 06 0599 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. ALBERT DISILVERIO 8916 HANNIGAN COURT TAMPA, FL 33626 SON B c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. A IT ACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 8/8/1995 410 EAST COOVER STREET 103,660.00 50. 51,830.00 MECHANICSBURG, PA 17055 .JOINTLY OWNED WITH SON, ALBERT DISILVERIO TOTAL (Also enter on line 6. Recapitulation) $ 51,830.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(12-99) ". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF HOMER IRMA M. Debts of decedent must be reported on Schedule I. 21 06 0599 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 4,458.45 2. PEALERS FLOWERS 236.33 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. Attorney Fees MURREL R. WALTERS III, ESQUIRE 600.00 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 REGISTER OF WILLS. CUMBERLAND COUNTY 15.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 5,309.78 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) "W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF HOMER FILE NUMBER IRMA M. 21 06 0599 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. VISA CREDIT CARD 520.n 2. SHiANNE ..JOHNSON PERSONAL CARE 215.0C 3. ..JANICE BAKER PERSONAL CARE 182.75 4. GRISWOLD SPECIAL CARE PERSONAL CARE 186.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,104.51 REV:15:3~'(* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOMER NUMBER I. SCHEDULE J BENEFICIARIES IRMA M NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. ALBERT DISILVERIO 8916 HANNIGAN COURT TAMPA, FL 33636 FILE NUMBER 21 06 RELATIONSHIP TO DECEDENT Do Not ListTrustee(s) SON 0599 AMOUNT OR SHARE OF ESTATE 100% 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)