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Home My WebLink About11-16-06 REV-15l1O L'X + fIl-GI) *' PENNSYLVANIA DE=~ DEPT. 280601 . HARRISBURG, PA 17128-0601 OECEDENT'S tWE (lAST, ARST, AND MIDDlE INITIAl) TALLEY KENNETH HAYDEN DATE OF DEATH (IMOO-V_) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT t- Z W Q W (,) W Q DATE OF BIRTH (MM-DO-VelI) 0512512006 11/19/1923 OF APPUCABLE) SURVMNG SPOUSE'S tWE (lAST, ARST, AND MIDDlE INITIAl) FLE NUEER 2 1 -0 6 0 5 9 1 '"C&i1Y"'iXii"" -YEAR- - - iiiiiiiR- - ~SECURITYNUMBER 1 5 9-2 4-9 3 3 0 THIS RETURN MUST BE FI.ED II DUPlICATE WITH THE REGISTER OF WILLS 00 1. Original Return 0 2. Supplehl8l1tal Return o 4. l.imiI9d Estate D 48. FutIn Interest Compromise (Mt eI dIte8lIlBr12-12-82) o 6. Decedent DIed Testate (Allelll:.' elM) 0 7. Decedent Maintained a living Trust (AIIch copy elTrus\) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Cd (_eldeIIl bllIIIIlen 12-31-91 n 1-1-95) ....~~ALL t. COMPLETE MAILING ADDRESS 1 IRVINE ROW ~ :.: J~ :d~8 G f..l 0.11II 0( .... lfi NAME ~ SUSAN J. HARTMAN 2 ARM NAME (If AppIic8bIe) . 01 DUNCAN & HARTMAN P.C. TELEPHONE NUMBER u 717-249-7780 CARLISLE z o t= j =:) t- o: (J w It: 1. Real Estate (Schedule A) (1) 2. Sb:ks and Bonds (Schedule B) (2) 3. Closely Held CorporatIon, ~ or ~ (3) 4. McJrVlges & Notes Receivable (Schedule D) (4) 5. Cash, Bank DepoaiIs & Miscellaneous PensonaI Property (5) (Schedule E) 6. Jointly OWned Property (Schedule F) (6) D Separate BIing Requesaed 7.lnter-VNOS Transfers & Misc:ellalleous NoIH'robatB Property (7) (Schedule G or L) 8. Total Gross A..- (mtaI Lines 1-7) 9. Funeral Expenses & AdlllhlidlclM Costs (Schedule H) (9) 10. Debts of 0eaIdent. Mcqage l.iablIilles, & Liens (Schedule I) (10) 11. T 011I DeductIons (mml Lines 9 & 10) 12. Net Value of e.- (I..ile 8 minus LIle 11) 13. CharitBbIe and GcMmnentaI BequestsISec 9113 Trusts for which an election m tax has not been made (Schedule J) 14. Net Value Subjlctto Ta (Line 12 minus I..ile 13) SEE ItSJRUCTlONS ON REVERSE SI)E FOR APPlICABLE RATES z o t= c t- =:) Q. . o (,) )( C t- 15. Amount of Une 14 taxable at the spousal tax .., or transfers under See. 9116 (aX1.2) 16. Amount of I..ile 14 taxable at IneaI rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of I..ile 14 taxable at coIIalieral.. 19. Ta Due 20.0 AMIJ. RECHeCK mf < < (8) (11) (12) (13) (14) SOCIAl SECURITY NUMBER o 3. Remainder Return (_ eI de8Ih prior m 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to lax under See. 9113(A) (AIIIcIl Sell 0) .. DCRECtED1'O: 3,218.09 o C;o ~'1 ~~ .~~.:~ ~ ~ .-)00 c".") CJ II C)C c. :n :-0-1 :> x _ (15) 14.578.95 X .045 (16) X .12 (17) X .15 (18) (19) 12.733.93 1.119.32 253.75 PA 17013 t-o.) c:;> c;::) 0'" :z:: c:> -< :c- :x \..0 + (Jl :=tJ rTl ,.:-) (-J ~ rn CJ CJ <.::J --I I -;1 --n C) ___ rn (",,') C~ -.,-1 0"'\ 15.952.02 1,373.07 14.578.95 14,578.95 656.05 656.05 Deced r C I te Add en s omp.8 ress: ~~~~21GREENMEAOOWSDR~ CrTY CARLISLE I STATE I ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. CreditslPayments A. Spousal poverty Credit B. Prior Payments C. Discount (1) 656.05 Total Credits (A + B + C) (2) 3. InterestJPenalty if applicable D.lnterest E. Penalty TotaIlnterestlPenalty ( 0 + E) (3) 4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Una 20 to request a refund (4) 5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total dUne 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 656.05 656.05 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 IXl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXl c. retain a reversionary interest; or ............. ........................................ ...... ..... ......... ..... ..... .... ....... ........ 0 IXl d. receive the promise for life of either payments, benefits or caIe? ............................................................. 0 IXl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................. ............ 0 IXl 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 0 IXl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property whk:h contains a beneficiary designation? ..... ....................................................................... ........................... 0 IXl 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 PA 6 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. S9116 (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. S9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure 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 fJeceased 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. S9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(aX1)). 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. S9116(a)(1.3)). A sibling is defined, under Section 9102, as an inrtimll::ll whn Imc; m lP~t nnA MlMt in r:tVnmnn with 1M rfAtwlAnt whAthAr hv hInnrt nr ::winntinn REV-1508 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF TALLEY KENNETH HAYDEN ITEM NUMBER 1. IRS REFUND SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FLE NUMBER 21 06 Indude the ~ of litigation and the date the proceeds were reoeiYed by the estate. AR property will right of IUIVIvorshIp must be dllc:losld on Schedule F. DESCRIPTION 2. UNITED CHURCH OF CHRIST HOMES REFUND 0591 VALUE AT DATE OF DEATH 1,851.00 1,367.09 TOTAL (Also enteron line 5, Recapitulation) S (If more S08C8 is needed. insert additional sheets of the same size) 3.218.09 REV-1509 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FLE NUMBER TALLEY KENNETH HAYDEN 21 06 0591 If.. ...... midi joint wilhln one year of"" decIdent's'" of dIatIt, It must be ...... on Schedule G. SCHEDULE F JOINTLY~WMEDPROPERTY SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. CATHY L. TALLEY 15 E. MAIN STREET, P.O. BOX 139 PLAINFIELD, PA 17081 DAUGHTER B c JOINTL Y-owNED PROPERTY: lETTER IlAJE DESCRIPTION OF PROPERTY "OF DATE OF DEATH ITEM FOR JOINT MADE INClUDE NAME OF RNANCIAl.INSTTTUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NlMlER TENANT JOINT IDENTIFYING NlMER. ATTACH DEED FOR JOINTl V-HELD REAl.. ESTATE. VAlUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 4/5194 CITIZENS BANK ACCOUNT # 6140206758 3,175.88 50. 1,587.94 2. A. 12120/9 CITIZEND BANK ACCOUNT # 6100634515 13,278.93 50. 6,639.47 3. A. 6/11/02 CITIZENS BANK ACCOUNT # 6106439080 4,105.36 50. 2,052.68 4. A. 5/12/93 SOVEREIGN BANK ACCOUNT # 2891034872 4,597.83 50. 2,298.92 5. A. 2/17/04 M& T BANK ACCOUNT # 9836502436 309.83 50. 154.92 TOTAL (Also enter on line 6, Recapitulation) $ 12 733.93 (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 ESTATEOF TALLEY KENNETH HAYDEN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 0IbII of dIcIdent must be NPOrIId on Schedule I. FILE NUMBER 21 06 0591 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. AUER MEMORIAL HOME 202.50 2. FUNERAl RECEPTION 218.82 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)IEIN Number of Personal RepI8S811tative(s) Street Address City State Zip Year(s) Commission Paid: 2. AtklmeyFees DUNCAN & HARTMAN, P.C. 600.00 3. Family Exemption: (If deoedent's address is not the same as claimants. atIach explanation) CIainant Street Address City State Zip Relationship of Claimant m Decedent 4. Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY 98.00 5. Accountanl's Fees 6. Tax Return Pteparer's Fees 7. TOTAL (Also enter on Une 9. Recapitulation) $ 1.119.32 (If more space is needed. insert addillonal sheets of the same size) REV-1512 EX + (6-98) *' SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF TALLEY KENNETH HAYDEN FILE NUMBER 21 06 0591 Include unreimbuned medlcalexpen.... ITEM NUMBER DESCRIPTION 1. PHARMERICA VALUE AT DATE OF DEATH 253.75 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 253.75 __15'3EX.. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF SCHEDULE J BENEFICIARIES FILE NUMBER TALlEV_ . . 21 06 05A1 I t1 nATur.n RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trusf8e(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include =ht r dislrlbulions, and transfers under See. 9116 (a (1. )) 1. CATHY L. TAllEY DAUGHTER 100 15 E. MAIN STREET PLAINFIELD, PA 17081 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 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)