HomeMy WebLinkAbout12-01-06
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15056051047
REV-1500 EX (06-05)
PA Deparbnent of Revenue *
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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Date of Birth
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Decedent's Last Name
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Suffix Decedent's First Name
MI
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(If Applicable) Enter Surviving Spouse's Infonnatlon Below
Spouse's Last Name
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Suffix
Spouse's First Name
MI
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Spouse's Social Security Number
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Retum
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4. Umited Estate
;:=:;
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
;:=:;
2. Supplemental Return
'--'
'--'
;:=:; 48. Future Interest Compromise (date of
death after 12-12-82)
~ 7. Decedent Mainlained a Living Trust
(Attach Copy of Trust)
~ 10. Spousal Poverty Credit (date of death '--' 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COIIPlETED. ALl CORRESPONDENCE AND CONFIDENTIAl TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
~
Rrm Name (If Applicable)
REGiSTER OF WILLS USE ONLY
Second line of address
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Correspondenfs e-mail address: :'7 C$)
Under penalties of perjury, I declare that I have examined this relum. including accompanying schedules and slaIemenls. and to the best of my knowledge and belief.
it is true, correct and complete. Declaration of preparer other than the personal representative is based on an information of which prepare< has any knowledge.
SIGN URE OF eERSON RE~~SI8L FOR ILIN RETURN TE d fd
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Rrst line of address
City or Post Office
State
ZIP Code
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051047
15056051047
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15056052048
REV-1500 EX
Decedent's Name:
RECAPITULATION
1. Real estate (Schedule A). ............................................ 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation. Partnership or SoIe-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. 4.
5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::> Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 8.
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). . . .. . .. . . . .. . . . . . . . . . . . . .. . . .. . ... 11.
12. Net Value of Estate (line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . .. .. . . . . .. . . . . . .. . . . . . . 13.
14. Net Value Subject to Tax (Une 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of line 14laxable
at the spousal lax rate, or
transfers under Sec. 9116
(a)(1.2)X .0_
16. Amount of Line 14 taxable
at lineal rate X.O_
17. Amount of line 14 taxable
at sibling rate X .12
18. Amount of line 14 taxable
at collateral rate X .15
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18.
19. TAX DUE.. .. .. . .... ............. .. . . .. ... . .. .. . . .. .. ... ... . . .. .. . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
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15056052048
Decedent's Social Security Number
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15056052048
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
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File Number
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Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
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Total Credits ( A + B + C ) (2)
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3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Une 20 to request a refund.
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(5)
(5A)
(5B)
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5. If Line 1 + line 3 is greater than Line 2. enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN T IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. re1ain the use or income of the property transferred;.......................................................................................... 0 XJ
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d. receive the promise for life or either payments. benefits or care? ...................................................................... 0 ~
2. If death occurred after December 12. 1982. did decedent transfer property within one year of death
3. :m~:~:.~;;.;;;;.;;;;;.;;~.~~.~.;;.~.;.;;;;;?:::::::::::::: 8 ~
4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND ALE IT AS PART OF THE RETURN.
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 three (3) percent [72 P.S. ~116 (a) (1.1) 0)),
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 zero (0) percent
[72 P.S. ~116 (a) (1.1) (ri)). The statute does not exemDt 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 zero (0) percent [72 P.S. ~9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. ~116(1.2) [72 P.S. ~116(a)(1)J.
The tax rate imposed on the net value of transfers to or for the use ofthedecedent's siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)J. 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.
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