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Home My WebLink About11-03-06 REV-l500 EX + (&00) .* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128~1 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENrs NAME (LAST, FIRST. AND MIDDLE INITIAL) ~ Z W C w U w C WILLIAMS DATE OF DEATH (MM-DD-Year) .JANET v. DATE OF BIRTH (MM-DD-Year) 02123/2006 10/13/1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w .... lI&:: :!!: II) (.)lIII:lI&:: w 0.(.) :z: 00 (.) IE iiI 0. . 001. Original Retum D 4. Limited Estate l&l 6. Decedent Died Testate (Allach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (dale of deaIh alIlIr 12-12-82) D 7. Decedent Maintained a Living Trust (Allach copy of Trust) D 10. Spousal Poverty Credit (daleofdealllbelween 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 0 2 5 5 COiiN'iY"'CoiiE ---vEAR- - - NuMBER- - SOCIAL SECURITY NUMBER 195-16-3966 THIS RETURN lUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (dale of death prior 10 12-13-82) D 5. Federal Estate Tax Retum Required !... 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Allach ~h 0) .... z w c z o 0. II) W 11II: 11II: o (.) NAME MURREL R. WALTERS III ESQUIRE FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 54 EAST MAIN STREET TELEPHONE NUMBER 717-897-4650 MECHANICSBURG z o 5 ::>> ~ ii: -C U w 0:: 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 Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o S ::>> D.. ~ o u ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 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 {au ARE R[OJESTING A REFUND OF AN OVERPAYMENT PA 17055 OFFICIAL USE ONLY :"-...) = = 0-" (8) 1,798.00 18,871.77 (11) (12) (13) (14) -.,.. .,".~ " ~ C) :-n j.', 'I C) (") -:i7 i:j;{ t__-~J C~ :,.~~ .~~~' fil I tJ'") (.....) -=n ~:;::: I W ::t:>>o ~t:- - ex:> +- 9,425.63 20,669.77 -11,244.14 -11 ,244.14 ... Decedents omPle e ress: STREET ADDRESS SARAH TODD MEMORIAL HOME '. 1000 SOUTH WEST STREET CITY I STATE T ZIP CARLISLE PA 17013 IC It Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2, Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 5. TotallnterestlPenalty ( D + E) If Line 2 is greater than Line 1 + Une 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) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT (3) 4. 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 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? ................. 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. Under penaties of perjury, I declare that I have examined this return, includi~ ~ying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete, Declll'lllion of preparer other than the personal representative is based on allmformation of which preparer has any knowledge. SIGNfflF PERSON R:SPONSIBLE FOR FILING RETURN DATE 10 -.;J ~-O(p TIM HY I. MORGAN 434 SAMPLE BRIDGE RD ENOLA PA 17025 DATE d c-r' ~ -,' ~"4 ADDRESS PA 17025 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.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. REV-1508 EX + (6-98) . ... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAMS SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER JANET V 21 06 Include the proceeds 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. 0255 ITEM NUMBER 1. 2. FULTON BANK CHECKING ACCOUNT SOVEREIGN BANK CHECKING ACCOUNT DESCRIPTION VALUE AT DATE OF DEATH 3,974.32 5,451.31 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 9.425.63 REV-1511 EX + (12-99) . -. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAMS JANET ITEM NUMBER A. B. V Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: MALPEZZI FUNERAL HOME. PREPAID FILE NUMBER 21 06 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) FREDERICK L. MORGAN Social Security Numbe~s)IEIN Number of Personal Representative(s) Street Address 6849 WERTZVILLE ROAD City ENOLA State PA Zip 17025 Yea~s) Commission Paid: 2006 Attomey Fees MURREL R. WALTERS III, ESQUIRE Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant 1. 1. 2. 3. Street Address City State Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 5. Accountanfs Fees 6. Tax Retum Prepare(s Fees 7. Zip 0255 AMOUNT 450.00 800.00 98.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,798.00 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Page 1 21 06 0255 File Number WILUJ\MS "Oecedenrs Name JANET v. Schedule H - Funeral Expenses & Administrative Costs - 81 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 2. Name of Personal Representative (s) TIMOTHY I. MORGAN 450.00 Social Security Number(s)/EIN Number of Personal Representative(s) 182408825 Street Address 434 SAMPLE BRIDGE ROAD City ENOLA State PA Zip 17025 Year(s) Commission Paid: 2008 SUBTOTAL SCHEDULE H-B1 450.00 REV-1512 EX + (6-98) . *' SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAMS JANET V Include unreimbursed medical expenses. FILE NUMBER 21 06 0255 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. SARAH TODD NURSING HOME 1,000.60 2. CRMC ANESTHESIA 17.59 3. DEPARTMENT OF TREASURY RECLAMATION OF SOCIAL SECURITY OVERPAYMENT 376.18 4. PENNSYLVANIA DEPARTMENT OF WELFARE 17,477.40 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 18.871.77 ~_15~~.(" COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] FREDERICK L. MORGAN 6849 WERTZVILLE ROAD ENOLA, PA 17025 TIMOTHY I. MORGAN 434 SAMPLE BRIDGE ROAD ENOLA, PA 17025 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I. NEPHEW 1/2 2. NEPHEW 1/2 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET ll. 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 n - 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)