HomeMy WebLinkAbout11-01-06
REV.l5QO EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
LOSH
DATE OF DEATH (MM-DD-Yearj
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONL Y
FILE NUMBER .. q
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COUN ~ YEAR NUMBER
SOCIAL SECURITY NUMBER
RHO DELLA
DATE OF BIRTH (MM-DD-Year)
A.
2 0 6 - 3 2 - 2 783
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
10/05/1991 02/18/1907
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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[Xl 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy 01 Will)
o 9. Litigation Proceeds Received
SOCIAL SECURITY NUMBER
o 2. Supplemental Return
o 4a. Future Interest Compromise (date 01 death after 12.12-82)
o 7. Decedent Maintained a Living Trust (Attach copy 01 Trust)
o 10. Spousal Poverty Credit (date 01 death between 12.31-91 and 1-1-95)
D 3. Remainder Return (date of dealh priorto 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)
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THIS SECTION MUST BE COMPLETED; AU.'COR"RESPONDENCE AND CONFIDENTIAL. TAX INFORMATJONSHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MARCUS A. McKNIGHT III 60 WEST POMFRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
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)
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OFFICIAL USE ONLY
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1,934.73:
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f,9S4.73
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5,293.00
(11)
(12)
(13)
5,293.00
-3,358.27
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
-3,358.27
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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
0.00 X _(15) 0.00
0.00 X ~(16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
>- >BESI.JRE TO ANSWER AI.LQI.JESTIONSON REVEFlSE.$IDEAND RECHECK MATH < <
ueceoems \"Omplele Aaaress:
STREET ADDRESS
RD2 BOX 101A
CITY I STATE I ZIP
NEWVILLE PA 17241
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. InterestiPenalty if applicable
D. Interest
E. Penalty
0.00
TotallnterestiPenalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVEAPA YMENT.
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. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check to: REGISTER OF WILLS, AGENT
0.00
0.00
0.00
0.00
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, did decedent transfer property within one year of dealti
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? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .........................................................................:............................. 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
00 fer
ADDRESS
PA
ADDRESS
60 W T paM FRET STREET
CARLISLE
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. 99116 (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. 99116 (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 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. 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 '.ax 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
inrlivirllJ;:j1 who has at least one oarent in common with the decedent, whether by blood or adoption.
REV-1509 EX + (6-98)
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOSH
FILE NUMBER
RHODELLA
A.
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. Kenwood Losh
43 Subdivision Road
Newville, PA 17241
Son
B John G. Moffitt
43 Subdivision Road
Newville, PA 17241
Son
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. ATTACH DEED FOR JOINTLY.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 43 Subdivision Road, Upper Mifflin Township 5,810.00 33.3 1,934.73
Newville, PA 17241
TOTAL (Also enter on line 6, Recapitulation) $ 1 934.73
(If more space is needed, insert additional sheets of the same size)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOSH
FILE NUMBER
RHODELLA
A.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home 4,513.00
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 Irwin & McKnight 750.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7. Register of Wills - Filing Fee 30.00
TOTAL (Also enter on line 9, Recapitulation) $ 5 293.00
(If more space is needed. insert additional sheets of the same size)
"".'''''''.'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
LOSH RHODELLA A.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 00 Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Kenwood W. Losh Lineal
43 Subdivision Road 1/2 Remainder
Newville, PA 17241
2. John G. Moffitt Lineal
43 Subdivision Road 1/2 Remainder
Newville, PA 17241
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. CHAR IT ABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500COVER SHEET $
. .
(If more space is needed, insert addllional sheets of the same size)
FacetWin Screen Print for recdeeds, from "CAMA_Login" 10/3/2006 1:51:jj PM
CUMBERLAND COUNTY ARCHIVE SYSTEM HS:12/21/2004 A
PARCEL: 44 44-06-0037-024.
BILLING HISTORY ----LAND
Last COUNTY Bill AV: 38260
Last SCHOOL Bill AV: 38260
LOSH, KENWOOD & SUSAN
OWNER:
BLDC
109480
109480
TOTAL---,
147740 I
147740 I
I
r1974
IM.v.
I
I
Land:
Bldg:
TOTAL:
50430 l
85680 I
136110 I
I
New 03/01/2004 38260 109480 147740 I
I
I MAIL DATE Why FAV LAND FAV BLDG TOTAL I
I
I 03/01/2004 05 38260 109480 147740 I
I 02/29/2004 50430 85680 136110 I
I 01/05/2004 29 50430 85680 136110 I
I 07/01/2002 40 78200 85680 163880 I
I 07/01/2000 05 78200 .85680 163880 ,
I 06/30/2000 1610 4200 5810 J
'_.__.H'
I
I
CG LAND CG BLDG
TOTAL
5410 85680
5520 85680
91090
91200
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Record: 10601
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Services .............................
Facilities. . . . . . . . . . . . . . . . . . . . . . . . . , . , .
Motor Equipment. . . . . . . . . . . . . . . . . . . . . . .
Casket .,. ~.i.n~. .T;r.i.b.u~.e. .1.8.G~. .G.o.l.d:t.o.n.e. Gold
$ub- Total
Vault . . . . Wilbf-lr:t. MlJnBr.ch. . . . . . . . . . . .
Clothing . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Etc. . . . . . . . . , . . . . . . . . . . . . . . . . . . . , . . .
Total
Cemetery .., . . . . . . . . . . . . . . . . . . . . . . . . .
Certified Copies . . . . . . ? . . . . . . . . . . . . . . . .
Death Notice . . . . . , . . . . . . . . . . . . . . . . . . . .
Flowers ........,....................
Clergy .........,....................
Telephone. . . . . . . , . . . . . . . . . . . . . . . . . . . .
Transportation. . . . . . . . . . . . . . . . . . . . . . . . .
Other Items . . . . . . . . . . . . . . . . . . . . . . . . . . .
3569.00
Brit
3509.. DD
. 640.,00
4209,00
. . . ~ .. . .
.?99:9P
... ~LOO
..50.00
. . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . 254 '. bb
Total . . . . . . .
Additional Items ........,.............. . . . . . . .
cem0kry.. ~V-/(Cy........ ~..........;.. ..fiP...
Totai' . {:?r).. .
GRAND TOTAL ......... . , .
REMARKS
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{!Ock//rl {J. Losh
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