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Home My WebLink About12-05-06 REV-1500 EX + (6-00) * COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE , DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ z w c w () w c WALLACE GEORGE DATE OF DEATH (MM-DD-Yea-) H. alkJa GEORGE H. WALLACE, ..R. DATE OF BIRTH (MM-DD-Year) 12/11/2005 01/0411952 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- ~ ~(IJ (.) a:: lil: w a.. (.) %00 (.) a::-, ~ID 0( [&] 1. Original Return o 4. Limited Estate [&] 6. Decedent Died Testate (Allach copy of Will) o 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of deaIh aIIer 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 0 3 0 1 COUN'rY"'COOE -YEAR- - - NuMBeR- - SOCIAL SECURITY NUMBER 1 7 5 - 4 0 - 9 2 1 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (date of death prior1D 12-13-82) o 5. Federal Estate Tax Return Required .!L 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See. 9113(A) (AIlach SchO) NAME MURREL R. WALTERS III ESQUIRE FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 54 EAST MAIN STREET I- Z W C Z o a.. (IJ w a:: a:: o (.) TELEPHONE NUMBER 717-897-4650 MECHANICSBURG (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) z o i= c( -J ;:) ~ ii: c( () 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. JoinUy Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Cosls (Schedule H) 10. Debls 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 Governmental Bequests/See 9113 Trusls 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 i= c( ~ ;:) D.. :::E o () S 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 33,234.26 X ~ (15) X _ (16) X .12 (17) X .15 (18) (19) 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 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT PA 17055 OFFICIAL USE ONLY 564.48 o ~O ro~ 37,490.46 in ~ ~ >4:0 :'.<: (J) ~ ", =J ('") 0 ". )0., C)C . :0 --i ::u t-..,) c::;) c::;:) CI""\ o ,.." n I U1 ::0 ::0 rn ,"'1"1 C') GJO ~~eg "'I IT'l ~oCJ C-:-J C') -n-n ;;;~ ~rn :J:>> :x CD \D -n 38,054.94 4,820.68 (11) (12) (13) 4,820.68 33,234.26 (14) 33,234.26 0.00 0.00 D d t' C I t Add ece en s omple e ress: STREET ADDRESS . 2409 DEERVIEW DRIVE CITY I STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D.lnterest E. Penalty Total Interest/Penalty ( D + 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 Line 20 to request a refund (4) 5. If Une 1 + Line 3 is greater than Une 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. (58) 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 No a. retain the use or income of the property transferre<j; ........................................................................... 0 IX! b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IX! c. retain a reversionary interest; or ......................... ............................................................................. 0 IX! d. receive the promise for life of either payments, benefits or care? ............................................:................ 0 IX! 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........... ...... ..................................... ...... ......... .......................... 0 IX! 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 IX! 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................ ............................. .............. ....................... ......... 0 IX! 0.00 0.00 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. ADDRESS R. RS III, QUIRE MAIN STREET, MECHANICSBURG ADDRESS PA 17055 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 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. ~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-1503 EX + (6-98) . COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF WALLACE GEORGE FilE NUMBER H a/kfa GEORGE H WALLACE JR. 21 06 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0301 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 564.48 u.s. SAVINGS BONDS EIGHT. $100.00 EACH TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 564.48 REV-1508 EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WALLACE GEORGE FILE NUMBER H. a/k1a GEORGE H WALLACE. JR 21 06 Indude 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. 0301 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 35,870.46 WACHOVIA BANK CERTIFICATE OF DEPOSIT 2. TYCO INTERNATIONAL COMMON STOCK 54 @ $30.00 1,620.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 37,490.46 REV-1511 EX+(12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WALLACE GEORGE SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER H. a1k1a GEORGE H. WALLACE. JR. 21 06 0301 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. PARTHEMOREFUNERALHOME 4,242.68 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) SUSAN C. WALLACE . RENOUNCED Social Security Number(s)JEIN Number of Personal Representative(s) Street Address 2409 DEERVII!W DRIVE City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: 2. Attomey Fees MURREL R. WALTERS III, ESQUIRE 450.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY RECORDER OF DEEDS 128.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 4,820.68 (If more space is needed, insert additional sheets of the same size) REVOI51:EXO(. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER H. R. NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 1. SUSAN C. WALLACE 2409 DEERVIEW DRIVE MECHANICSBURG PA 17055 WIFE 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIA TE, 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 II - 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)