Fillable Beaver County Gov Inheritance Tax Return

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Beaver County Gov Inheritance Tax Return

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FILL IN APPROPRIATE OVALS BELOW
1. Original Return 2. Supplemental Return 3. Remainder Return (date of death
prior to 12-13-82)
4. Agriculture Exemption (date of 5. Future Interest Compromise (date of 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
7. Decedent Died Testate 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
13. Business Assets 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT – THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
1505614105
1505614105
Side 1
REV-1500
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
EX (01-16) (FI)
Social Security Number
Date of Death Date of Birth
Decedent’s Last Name Suffix
Spouse’s Last Name Suffix
Decedent’s First Name
MI
Spouse’s First Name
MI
OFFICIAL USE ONLY
County Code Year File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
(If Applicable) Enter Surviving Spouse’s Information Below
StateCity or Post Office
Correspondent’s email address:
Second Line of Address
First Line of Address
ZIP Code
Daytime Telephone Number
Name
REGISTER OF WILLS USE ONLY
DATE FILED STAMP
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MMDDYYYY
MMDDYYYY
DATE FILED MMDDYYYY
REGISTER OF WILLS USE ONLY
PLEASE USE ORIGINAL FORM ONLY
1505614105
START
➜
Next Page
1505614205
1505614205
Side 2
Decedent’s Name:
Decedent’s Social Security Number
RECAPITULATION
1. Real Estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 3.
4. Mortgages and Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E). . . . . . . 5.
6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . . . 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested. . . . . . . . 7.
8. Total Gross Assets (total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Funeral Expenses and Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . 9.
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I). . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/Sec. 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14.
TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0 15.
16. Amount of Line 14 taxable
at lineal rate X .0 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
REV-1500 EX (FI)
Under penalties of perjury, I declare 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. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADDRESS
1505614205
➜
The PA Department of Revenue does NOT accept electronic signatures. Please sign your return.
The PA Department of Revenue does NOT accept electronic signatures. Please sign your return.
Next Page
PRINT FORM
Decedent’s Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1)
2. Credits/Payments
A. Prior Payments
B. Discount
(See instructions.) Total Credits ( A + B ) (2)
3. Interest
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, 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)
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 transferred ..........................................................................................
b. retain the right to designate who shall use the property transferred or its income ............................................
c. retain a reversionary interest ..............................................................................................................................
d. receive the promise for life of either payments, benefits or care? ......................................................................
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ..............................................................................................................
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death?..............
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[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:
l
The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a step-parent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
l
The tax rate imposed on the net value of transfers to or for the use of the decedent’s lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
l
The tax rate imposed on the net value of transfers to or for the use of the decedent’s siblings is 12 percent [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.
DECEDENT’S NAME
STREET ADDRESS
CITY STATE ZIP
REV-1500 EX (FI) Page 3
File Number
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Beaver County Gov Inheritance Tax Return

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Completed 17 November 2019

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