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HomeMy WebLinkAbout11-29-06 REV.,500 EX (6-OOj COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 06 0237 COUNTY CODE YEAR NUMBER t- Z W C W U W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) BANKERT EARL H SOCIAL SECURITY NUMBER 176-26-0666 DATE OF DEATH (MM-DD-YEAR) 03/11/2006 DATE OF BIRTH (MM-DD-YEAR) 11/07/1934 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) w ..., lil::$1I) ull:lil: wa.u ::&:00 ull:..J a.lD a. < [i] 1. Original Retum o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of WiD) o 9. Litigation Proceeds Received o 3. Remainder Retum (dale of death prior 1012-13-82) o 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach senD) o 2. Supplemental Retum o 4a. Future Interest Compromise (dale of death after 12-12-82) o 7. Decedent Maintained a Living Trust (AUach copyofTmsl) o 10. Spousal Poverty Credit (date of dealh between 12-31-91 and 1-1-95) ... z w o z o a. II) w II: II: o U NAME SCOTT A BANKERT FIRM NAME (If Applical>le) COMPLETE MAILING ADDRESS 5 WEST GREEN STREET APTC SHIREMANSTOWN, PA 17011 TELEPHONE NUMBER (717) 303-0103 z o ~ ...J ::) !:: a.. ct u W 0::: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (1) (2) (3) (4) (5) OFFICIALM&E ONLY o ;~::~ ~~~ Q :~~ , , <::) 'C) 1- 'n ~"X] I'.) I...:J 8,068.50 (6) N CO -0 (7) 8,068.50 (9) (10) (8) 2,931.00 1,278.55 (11) (12) (13) 4,209.55 3,858.95 8. Total Gross Assets (lotal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 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) (14) 3,858.95 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ~ ::) a.. ::is o u ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0_ (15) ...______.._._____~L~~?'.!!~_ x .0 1?... (16) 173.65 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate x .12 (17) x .15 (18) (19) 173.65 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C6 Decedent's Complete Address: STREET ADDRESS 820 L1SBURN ROAD APT 711 CITY CAMP HILL I STATE I ZIP PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 173.65 Total Credits ( A + B + C ) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty TotallnterestJPenalty ( 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 differe~ce. This is the TAX DUE. 173.65 (5) (5A) (5B) A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 173.65 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 a. retain the use or income of the property transferred;.......................................................................................... D b. retain the right to designate who shall use the property transferred or its income; ............................................ D c. retain a reversionary interest; or.......................................................................................................................... D d. receive the promise for life of either payments, benefits or care? ...................................................................... D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ......... ................... ............ .... ..... ................ ................... ...... ........... ... ...... D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .... ........ .......... ........... ......... ..... ............................ ....... .............. ....... ............ ..... D No [iJ [iJ [iJ [iJ [iJ ~ [iJ 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 penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaratio of preparer other than the personal representative is based on all information of which preparer has any knowledge. RE OF PERSO~SPO~BLE FOR FILING RETURN RESS ...... ..Y.~jcT~.........._.~.__ ................ 5 WEST GREEN STREET, APT C. SHIREMANSTOWN, PA 17011 __m._._._.___~__.__~____........._..__...._.._ ...._.. ..._m__._mn"n.__. __________..._..__....._......__._.... . ...... ............. .._............___...__........................_n......._mm......_.__ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ....... .......................--..--..!Ll'-?!l~~. ADDRESS DATE 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 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. 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. s9116(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-150B EX+ (6-9B) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF EARL H BANKERT FILE NUMBER 21-06-0237 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION SOVEREIGN BANK (SAVINGS) 2 SOVEREIGN BANK (CHECKING) 3 SALE OF PERSONAL VEHICLE 4 SALE OF PERSONAL HOUSEHOLD ITEMS 5 PRO-RATED RENT FROM MALLARD RUN APARTMENTS 6 PRO-RATED AMOUNT FROM VERI SON 7 RETURN ON SECURITY DEPOSIT FROM MALLARD RUN APARTMENTS 8 PRO-RATED AMOUNT FROM PENNSYLVANIA SCHOOL EMPLOYEE RETIREMENT SYSTEM TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 4,423.07 2,775.47 100.00 100.00 8,068.50 . REV.1511 EX+ (12'99)* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF EARL H BANKERT FILE NUMBER 21-06-0237 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: STONE AND MURRAY FUNERAL HOME 2,766.00 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. Attomey Fees 20.00 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. Accountant's Fees 6. Tax Return Preparer's Fees 7. DEBBIE A. BAIR 95.00 50.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,931.00 REV-1512 EX+ (12-03) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF EARL H BANKERT FILE NUMBER 21-06-0237 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. WEST SHORE EMS 628.41 3 DR. LAWRENCE COX, DO ALL STATE INSURANCE (AUTO INS. APR - AUG) GRANITWERKS MEMORIALS 131.78 2 362.32 4 120.00 5 BONNIE K MILLER 9.80 6 VERISON 25.14 7 PATHOLOGY ASSOCIATES OF CENTRAL PENNSYLVANIA 1.10 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,278.55 , . REV-1513 EX. (9-00) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF EARL H BANKERT NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 SCOTT A BANKERT 2 DEBBIE ABAIR -. RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SON DAUGHTER FILE NUMBER 21-06-0237 AMOUNT OR SHARE OF ESTATE 1,842.65 1,842.65 .. 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYl'/ANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REY-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BANKERT SCOTT A 5 WEST GREEN ST APT C SHIREMANSTOWN, PA 17011 ___~_n_ fold ESTATE INFORMATION: SSN: 172-26-0666 FILE NUMBER: 2106-0237 DECEDENT NAME: BANKERT EARL HENRY DA TE OF PAYMENT: 11/29/2006 POSTMARK DATE: 11/20/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 03/11/2006 NO. CD 007489 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $173.65 I I I I I I I I TOTAL AMOUNT PAID: $173.65 REMARKS: CHECK# 117 INITIALS: CJ RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS UJ a: t.:l c... a: . too I- :z o. (f) :x . 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