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HomeMy WebLinkAbout01-04-07 REV-,500 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w ~ ~-I/l oD::~ wO.o :rOo oD::..J ~Ill c( DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INlTlAL) .- Z W C W o W C PERRY PHYLLIS DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD- Year) OFRCIAL USE ONLY FI,LE NUMBER If '1 \ - D~--0J2.~__ c'fu)rTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER o 6 9 - 4 2 - 3 961 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death pnorto 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) z o ~ -' :J .- ii: c( o w a::: z o i= ~ :J Q" ::! o o S 10/17/2006 09/17/1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) COMPLETE MAILING ADDRESS 9974 MOLLY PITCHER HIGHWAY rEA 17257 ~ 0 OFFIc;m- USE'ONL v: -'i"'.o -:>'>> '1'~~,_(2 ! !"'l';\,-, ~- Ul [Xl 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise ldateofdealh after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy oITrus!) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) -a r::-? w ()'1 NAME SALLY J. WINDER FIRM NAME (If Applicable) ATTORNEY AT LAW TELEPHONE NUMBER 7175329476 SHIPPENSBURG 30,970.00 (8) 30,970.00 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 Governmental 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 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 14,900.62 X .045 (16) X .12 (17) X .15 (18) (19) 14,637.50 1 ,431.88 (11) (12) (13) 16,069.38 14,900.62 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 (14) 14,900.62 670.53 670.53 D d t' C I t Add ece en s amp e e ress: STREET ADDRESS 16 HARDWOOD DRIVE CITY 1 STATE I ZIP DOVER DE 19904 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 670.53 33.53 Total Credits (A + B + C) (2) 33.53 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( 0 + 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 difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 637.00 637.00 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 !Xl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 !Xl c. retain a reversionary interest; or ...................................................................................................... 0 !Xl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 !Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 !Xl 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 !Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 !Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNATURE 16 HARDWOO DOVER PEA ER OTH~t)j~'::~VE 9974 M LLY PITCHER HIGHWAY SHIPPENSBURG I ADDRESS 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 exempt 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. ~,~".,.." .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL V-OWNED PROPERTY ESTATE OF PERRY PHYLLIS FILE NUMBER If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. DOROTHY L. FINKEY 324 EAST ORANGE STREET SHIPPENSBURG, PA 17257 MOTHER B c JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for joinUy-heId real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 10/2001 324 EAST ORANGE STREET, AS SHOWN IN DEED 61,940.00 50. 30,970.00 BK 249, PAGE 260, CUMBERLAND RECORDER OF DEEDS TOTAL (Also enter on line 6, Recapitulation) $ 30,970.00 .. (If more space is' needed, IOsert addlllonal sheets of the same size) / .. 3~7'63 _?l TAX PARCEL NO. 32- 3~ - 24 r;- 057 TillS DEED MADE THE~ day of October. in the year of our Lord Two Thousand One (2001) . BETWEEN DOROTHY L. FINKEY, widow, of324 East Orange Street, Shippensburg, Pennsylvania 17257, hereinafter called GRANTOR AND DOROTHY L. FINKEY, of Shippensburg, Pennsylvania, and PHYLLIS J. PERRY, of Delaware, hereinafter called GRANTEES WITNESSETH. that for and in consideration of the sum of One and 00/100 ($1.00) Dollars consideration, in hand paid, the receipt whereof is hereby acknowledged. the said Grantors does hereby grant and convey. in fee simple. to the said Grantees, their heirs and assigns, as joint tenants with right of survivorship and not as tenants in common. ALL that certain land situate, lying and being in the Borough of Shippensburg, Cumberland County, Pennsylvania and more particularly bounded and described as follows: BEGINNING on the North by East Orange Street; on the East by lot now or formerly of Edward S. Hoyer; on the South by a public alley: on the West by lot now or formerly of Herman Strasberg; having frontage of 32 feet on East Orange Street and a depth of 172 feet and being known as 324 East Orange Street. BEING the same premises which Clyde A. Laughlin. by deed dated May 3. 1950. and recorded in the Recorder of Deeds Office, Cumberland County, Deed Book "W" Volume 14. Page 298. granted and conveyed to J. Craig Finkey and Dorothy L Finkey, Grantor. J. Craig Finkey died December 16. 1967, leaving Dorothy L Finkey to survive him thus vesting full fee simple title in her as surviving spouse. AND the said Grantors covenants and agrees that they will warrant specially the property hereby conveyed. --rA.1s con.vel1~ ',05 ~~ ~ ~J- ~ fAr~ ~~.' . V BOO~ 249 fAGE 260 IN WITNESS WHEREOF. said Grantor has hereunto set her hand and seal the day and year first above wrinen. Signed. sealed and delivered in the presence of: ~<J()J~ COMMONWEALTH OF PENNSYL VANIA 'bLUI_1J~ L ~~ DORoTIfYIJ. FiNkEy ( r Certi fy this to be recorded In Cumberland County P A o' Co ~"......-,4 ~.~ ...... ~., ~ ., ~ ~ . :~.~ I\'; v ~. ,1 . SS'~~:< (SEAL) COUNTY OF CUMBERLAND Recorder of Deeds ON this. the ;;s- day of October. 200 L before me. the undersigned officer. personally appeared Dorothy L Finkey. known to me to be the persons whose names are subscribed to the within insnument. and acknowledged that they executed same for the purposes therein contained. Not8rIaI SeIII a' WInder, ~ PubIlo 8h rg 'lWp-., Cumbli1Ind My million Expl.... F'b,13~ IN WITNESS WHEREOF. I hereunto set my hand and official seal. 4'~~"""."~~"" ~ .~ JW ~...i"""''''''~'''~ -. ...,.~:~;~t';""'~ .~' . "\,.~10... '\.''',''':\ ... . .. I. 1~~~~'i~~~~"1 ~~l9.t;.;A.hr ~'::<i'i~-' . .. ~;;' ~~~t~...~ "~",,--'~~1i Notary IC ~:~:~)Io;~~'i\. )f./~~~;""?~. "4.~~,;'{fi"...'\ . ...., ,,:~ '- ~ ,.... " . ........ ~ """"~"';- ~ ,","L"''''''~~-?''''i''''''' ...~..7:'f:.ni h',5' .:\..; .\IW' ;.',.. ,- ,"'. '11 "li:.~~~~;~'~ .;;o,.>'.,'~j.., ,- ~ I do hereby certify that the precise residence and com~lete post of?ce address of the --1 A within named Grantee(s) is: 3~cf 6. O~ -:>1- '- 2iJ,,'f~~J r/1 17~ 1 .. ~.') ~ ~ ~:;o. ~W '1 :z to 8 ~ c::> CT1 L:l Wl."~ c: ~;; IT, Agent for tee '" !: ~ ~ o :~.~ ~ Date:-# 2 ::n 0 C) t'l ::3 0 -., - c:: 0 r~ :z rn ~ -j f"l1 . -<om Icn:::ti -0 > '-8 ~ (.0 Rnnk' ~&q PAr.~ 9t:-i ~,,,,~.,.., . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF PERRY PHYLLIS FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. TRADER FUNERAL HOME, INC. FUNERAL ACCOUNT 7,365.00 2. SHARON HILLS MEMORIAL PARK, BURIAL VAULT AND BASE, VASE 3,020.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. AttomeyFees SALLY J. WINDER 738.50 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant JAY K. PERRY Street Address 16 HARDWOOD DRIVE City DOVER State DE Zip 19905 Relationship of Claimant to Decedent HUSBAND 4. Probate Fees FILE RETURN 14.00 5. Accountanfs Fees 6. Tax Retum Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 14,637.50 (If more space is needed, insert additional sheets of the same size) ~.'''"''''O .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF PERRY PHYLLIS FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 598.00 1. hACKERMAN-PATZ HOUSE, BALTIMORE, MD., HOSPICE CARE 2. PHARMAQUIP, PRESCRITION MEDICATION 813.88 3. THE JOHNS HOPKINS HOSPITAL, CO-PAY BALANCE DUE 20.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1 431.88