The URL can be used to link to this page

Home My WebLink About03-08-07 .-J 15056041147 REV-1500 EX (06-05) PA Department 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 INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 6 File Number 00763 Date of Birth 198348985 08042006 04281946 Decedent's Last Name Suffix Decedent's First Name MI VANBUSKIRK STEPHEN J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW o 1. Original Return IBI 2. Supplemental Return o 3. Remainder Return (date of death prior to 12-13-82) 0 4. limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82) 0 6. Decedent Died Testate 0 7. Decedent Maintained a LivinQ Trust (Attach Copy of Will) (Attach Copy of Trust) 0 9. litigation Proceeds Received 0 10 Spousal Poverty Credit {date of death . between 12-31-Q1 and -1-Q5) 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) ~ORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number MARTIN R WILSON 5705231162 Firm Name (If Applicable) WILSON & WILSON r"-:l REGISTER OF :w-'LLS USE Ol'!b'f - ..-J :'-~~J First line of address 222 MARKET STREET I CJ Second line of address " ---' City or Post Office LEWISBURG State PA ZIP Code 17837 -' ~j.-~j DAT~IL-eD ~D f',..) cr', Correspondent's e-mail address: TERRY L. VANBUSKIRK ID~l ~.~ 0'7 SIGNATU / P PARER OTHER ~ REPRESENTATIV; . '/ e:?- t---> ADORE MARTIN R WILSON o DS}r>1 222 MARKET STREET, LEWISBURG, PA 17837 Side 1 L 15056041147 15056041147 .-J ~ --.J 15056042148 REV-1500 EX Decedent's Name: VANBUSKIRK, STEPHEN J. RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D).......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested............. 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)...................................................................... 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 (Line 12 minus Line 13)................................................. 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X ~ 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 2 3 0 , 5 9 0 . 8 7 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. Decedent's Social Security Number 198348985 2. 6.247.40 5. 123.076.44 6. 7. 120 268 68 8. 249 592 52 16.511 16 2 490 49 19 001 65 230 590 87 230.590.87 19. Tax Due.................. ........................................ ................. ................. ............. ............ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 27.670.90 27.670.90 D 15056042148 --.J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 06 - 00763 ~ NAME VANBUSKIRK, STEPHEN J. - _.~._,.,._-,....._~-- STREET ADDRESS 2102 MARKET STREET -- -- APARTMENT 3 CITY _._- .-..------ I STATE IZIP CAMP HILL 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) 27,670.90 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 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 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. (3) 0.00 (4) (5) 27,670.90 (5A) (5B) 27,670.90 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;.................................................................................. 0 ~ b. retain the right to designate who shall use the property transferred or its income;.................................... D [!J c. retain a reversionary interest; or.................................................................................................................. 0 [!J 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?................................................................................... ................................... 0 [!J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D [!J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... [!J D 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 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. ~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 zero (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: 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 .5. ~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 four and one-half (4.5) percent, 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 twelve (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. I i I I I FILE NUMBER 121 - 06 - 00763 '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VANBUSKIRK, STEPHEN J. All properly jointly-owned with right of survivorship must be disclosed on Schedule F. JANUS FUND, ACCOUNT NO. 201693168 25.46 I VALUE AT DATE OF r DEATH 6,247.40 I I I I ITEM NUMBER 1 DESCRIPTION UNIT VALUE TOTAL (Also enter on line 2, Recapitulation) 6,247.40 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT , I I i I I I VANBUSKIRK, STEPHEN J. *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF I I \ FILE NUMBER 21 - 06 - 00763 I Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE 0 NUMBER DEATH 1 M&T BANK, CHECKING ACCOUNT NO. 87206560 23,752.87 2 ACCRUED INTEREST ON CHECKING ACCOUNT NO. 87206560 AT M&T BANK 1.11 3 M&T BANK, CERTIFICATE OF DEPOSIT NO. 031003913465661 10,231.65 4 ACCRUED INTEREST ON CERTIFICATE OF DEPOSIT NO. 031003913465661 AT M&T 95.88 BANK 5 M&T BANK, CERTIFICATE OF DEPOSIT NO. 031003916809577 30,000.00 6 ACCRUED INTEREST ON CERTIFICATE OF DEPOSIT NO. 031003916809577AT M&T BANK 294.21 7 US TREASURY DEPARTMENT, REFUND OF 2006 INDIVIDUAL INCOME TAXES 679.00 8 PSECU, SAVINGS ACCOUNT 51,049.58 9 PSECU, CHECKING ACCOUNT 1,765.40 10 1999 TOYOTA CAMRY 3,500.00 11 JUSTICE CHARLES CLEMENT, JR., REFUND 20.00 12 THE TRAVELLERS, INSURANCE BENEFITS FOR COLLISION DAMAGE TO 1999 TOYOTA 1,252.26 CAMRY 13 THE TRAVELLERS, REFUND OF UNEARNED RENTERS INSURANCE PREMIUM 58.00 14 COMCAST, REFUND 41.46 15 STATE EMPLOYEES RETIREMENT SYSTEM, RETIREMENT BENEFITS 335.02 --- TOTAL (Also enter on Line 5, Recapitulation) 123,076.44 F . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 1 I VANBUSKIRK, STEPHEN J. __~____ I FILE N~~~~~ _ 00763 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. %OF i I DECO'S i EXCLUSION TAXABLE VALUE ,.""'" i I" ~""'''",I I 68,460.55 I I ESTATE OF ITEM NUMBER DESCRIPTION OF PROPERTY Include the name of the transfaree, their relationship to decedent and the date of transfer. Attach a copy of the dead lor real estate. DATE OF DEATH VALUE OF ASSET NATIONWIDE LIFE INSURANCE COMPANY, IRA ACCOUNT NO. 01-5889821 - TERRY L. VANBUSKIRK, 845 ST. LOUIS STREET, LEWISBURG, PA 17837 - BENEFICIARY 68,460.55 2 AIG ANNUITY INSURANCE COMPANY, ANNUITY CONTRACT NO. VP225314 -TERRY L. VANBUSKIRK, 845 ST., LOUIS STREET, LEWISBURG, PA 17837 - BENEFICIARY 51,808.13 51,808.13 TOTAL (Also enter on line 7, Recapitulation) 120,268.68 *' SCt-EDU.E H FlIERAL EXPENSES & Ar6WS1RA11VE COS1S ESTATE OF VANBUSKIRK, STEPHEN J. Debts of decedent must be reported on Schedule I. ITEM i NUMBER! FUNERAL EXPENSES: DESCRIPTION A. 1 l CRONRA TH FUNERAL HOME, FUNERAL EXPENSES I FILE NUMBER i 21 - 06 - 00763 COI.'I.4ONWEAL TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT AMOUNT 3,716.00 B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip 2. Year(s) Commission paid Attorney's Fees WILSON & WILSON -- MARTIN R WILSON 8,200.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS CUMBERLAND COUNTY REGISTYER OF WILLS, SHORT State Zip 80.00 8.00 4. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 i CUMBERLAND LAW JOURNAL, ADVERTISING GRANTING OF LETTERS OF ADMINISTRATION 75.00 TOTAL (Also enter on line 9, Recapitulation) 16,511.16 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I i i I I I I FILE NUMBER 21 - 06 - 00763 THE SENTINEL, ADVERTISING GRANTING OF LETTERS OF ADMINISTRATION *' Schedule H Funeral Expenses & JdlIOb'bClINe CosIs continued ESTATE OF VANBUSKIRK, STEPHEN J. 158.81 2 3 JOHNSON AUTO BODY, REPAIRS TO 1999 TOYOTA CAMRY 1,816.86 4 NORTHRIDGE GROUP, INC., CLEANUP OF APARTMENT RESULTING FROM DECEDENT'S DEATH 2,456.49 Page 2 of Schedule H . *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REruRN RESIDENT DECEDENT I FILE NUMBER \21 - 06 - 00763 ESTATE OF VANBUSKIRK, STEPHEN J. Include unrelmbursed medical expenses. ..-.--- ITEM DESCRIPTION AMOUNT NUMBER 1 VICNIC, INC., RENT 2,039.68 2 JANET L. MILLER. TAX COLLECTOR. 2006 PER CAPITA TAXES 15.00 3 IC SYSTEM, INC., DELINQUENT BILL FOR VERIZON 38.64 4 VERIZON, FINAL BILLING 117.98 5 PPL, ELECTRICITY 183.49 6 COMCAST, CABLE RENTAL 95.70 ---- TOTAL (Also enter on Line 10, Recapitulation) 2,490.49 . . REV.1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ITAXABLE DISTRIBUTIONS [include outright spousal , C1istributions, and transfers under Sec. 9116 (a) (1.2)] 1 i TERRY L. VANBUSKIRK RELATIONSHIP TO DECEDENT 00 Not LIst TrusteeCs) I I FILE NUMBER ! 21 - 06 - 00763 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VANBUSKIRK, STEPHEN J. NUMBER BROTHER ENTIRE ESTATE 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 CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 1 ~ ~ ~ r r- ill 'I 1'"1 I !. .1 i ~" 1 1 1 1 f I ~) ~ ~. " l~ ! I" i; ~ ~ ~'.t:: [ L r' [ l, j C:l L ( ,.........''",< 5~ OJ -'~" t' . :53 / , ~ 3' ~ ~' 3i OJ g" ,,',' ~ / . ,-- . , ~ ~ -.- ~ r- t-<M Zr..w~ O~- CZl[...... -< d[/)O-. :St-<d ~~f3 z-<~ o",:::<[/) [/)~- ~01:S -01u.l :S01~ ~- . ~, , I ., ......) 2D07 i'if":, -8 Hl"i S: 26~ 1"'1 rr;. / r. ,- -' ~",-",'':',' r-- P:; 00 ~ M ~ M t/) I H~M ~~8 p:;or-- Ol...-l .t/) o U~< t/)P-i 00 ZO .. <=~ i--=l~i--=l P:;P:;t/) ~OH ~8~ U...-lU