HomeMy WebLinkAbout03-15-07
REV, 1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
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COUNTY CODE
OFFICIAL USE ONLY
.....QL 0563 ___
YEAR NUMBER
E
SOCIAL SECURITY NUMBER
188-12-4343
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
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W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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REGISTER OF WILLS
SOCIAL SECURITY NUMBER
001
04.
006
o 2. Supplemental Retum 0 3. Remainder Retum (dale of death prior to 12-13-82)
o 4a. Future Interest Compromise (date of death afler 12-12-82) 0 5. Federal Estate Tax Return Required
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) L 8. Total Number of Safe Deposrt Boxes
o 10. Spousal Poverty Credrt (date of death betwean 12-31-91 and 1-1-95) 0 11. Election to tax under Sec. 9113(A) (Attaoh Soh 0)
Original Retum
Limrted Estate
Decedent Died Testate (Attach copy of Will)
o 9. Lrtigation Proceeds Reeeived
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
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44 West Main Street
Richard C. Snelbaker
FIRM NAME (If Applicable)
Snelbaker & Brenneman, P.C.
TELEPHONE NUMBER
Mechanicsburg, PA 17055
OFFICIAL USE ONLY
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717-697-8528
1. Real Estate (Schedule A)
(1)
0.00
0.00
0.00
0.00
3,676.24
0.00
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3,676.24:_1
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2. Stocks and Bonds (Schedule B)
(2)
339,126.86
(335,450.62)
0.00
(335,450.62)
0.00
0.00
0.00
0.00
0.00
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W46451.000
3. Closely Held Corporation. Partnership or Sole-Proprietorship (3)
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4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
6. Jointly O'Mled Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
0.00
8. Total Gross Assets (total Lines 1-7)
(8)
1,099.69
338,027.17
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilrties, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
(11)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for vmich an election to tax has not been
made (Schedule J)
(12)
(13)
14. Net Value Subjectto Tax (Line 12 minus Line 13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under See. 9116 (a)(1.2)
0.00 x .0 L(15)
0.00 X.O 45 (16)
0.00 x .12 (17)
0.00 x .15 (18)
(19)
16. Amou nt 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. 0
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Decedent's Complete Address:
S1REET ADDRESS
Claremont Nursin Home 100
Cumberland Count
CITY
Carlisle
STATE
PA
ZIP
17013-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
0.00
0.00
0.00
Total Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty (D + E) (3)
0.00
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)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
A. Enter the interest on the tax due. (5A)
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE (5B)
Make Check
0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D
b. retain the right to designate who shall use the property transferred or its income; . D
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D
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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 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.
Under penalties of pe~ury, I declare that I have examined this retum, induding 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 personal oopoosentative is based on all information of which pooparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
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ADDRESS
Yes
No
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32 Fie1dcrest Drive, Mechanicsburg, PA 17050
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Richard C. Snelbaker, Esquire
44 West Main Street,
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 PS S 9916 (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. 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. 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. S 9116(1.2) [72 P.S. 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, 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.
3W4646 1.000
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Virqinia E. Bender
FILE NUMBER
21 06 0563
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
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1 Claremont Nursing Home & Rehabilitation Center
refund on resident care
1,717.94
2 Citizens Bank
checking account #6100632466
1,958.30
3W46AD 1.000
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3,676.24
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INI-ERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Virginia E. Bender
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 06 0563
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. None
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 183.00
Name of Personal Representative(s) Robert F. Bender
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 32 Fieldcrest Drive
City Mechanicsburg State PA Zip 17050
Year(s) Commission Paid:
2. Attorney Fees Snelbaker & Brenneman, P.C. 500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 72.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1 Register of Wills
filing fee for Inheritance Tax Return 15.00
2 Cumberland Law Journal
Advertising Executor's Notice 75.00
Total from continuation schedules 254.69
TOTAL (Also enter on line 9. Recapitulation) $ 1 099.69
3W46AG 1.000
(If more space is needed, insert additional sheets of the same size)
Estate of: Virginia E. Bender
188-12-4343
Schedule H Part 7 (Page 2)
3
Patriot News
advertising Executor's Notice
129.69
4
Gingrich Memorials
memorial marker
125.00
Total (Carry forward to main schedule)
254.69
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Virginia E. Bender
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 0563
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Commonwealth of Pennsylvania
Class 3 claim in the amount of $32,001.98 and a class 6
claim in the amount of $306,025.19
338,027.17
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
338,027.17
REV-1513€X+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Vira~n~a E Bender
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Robert F. Bender
32 Fieldcrest Drive
Mechanicsburg, PA 17050
1
21
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Brother
FILE NUMBER
06 0563
AMOUNT OR SHARE
OF ESTATE
0.00
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI 1.000
TOTAL OF PART 11- 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)
$
0.00
LAW OFFICES
SNELBAKER.
McCALEB & ELICKER
U\.ST WILL AND TESTAMENT
I, VIRGINIA E. BENDER, of the Borough of Mechanicsburg, County
of Cumberland and Commonwealth of Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and declare
this as and for my Last Will and Testament, hereby revoking and making
void all former wills and codicils by me at any time heretofore made.
FIRST.
I order and direct that all my just debts and funeral
expenses be paid by my Executrix or Executor, as the case may be,
hereinafter named, as soon as conveniently may be done after my death.
SECOND.
All the rest, residue and remainder of my Estate,
real, personal or mixed, whatsoever and wheresoever situated, I
give, devise and bequeath unto my sister, namely, EVELYN R. BENDER,
absolutely and in fee simple, if she survives me.
THIRD .
If my sister, EVELYN R. BENDER, does not survive me,
then and in that event, I give, devise and bequeath my entire residuary
estate unto my brother, namely, ROBERT F. BENDER, absolutely and
in fee simple.
U\.STLY.
I nominate, constitute and appoint my sister, namely,
EVELYN R. BENDER, to be the Executrix of this, my Last Will and
Testament, but if for any reason she should fail to qualify as such
Executrix or cease so to serve, then and in that event, I nominate,
constitute and appoint my brother, namely, ROBERT F. BENDER, to be
the Executor hereof, each to serve without bond. If both of the
above named individuals should fail to qualify as my personal
representatives or cease so to serve, then and in that ultimate
event, I nominate, constitute and appoint my sister-in-law, namely,
FREDA K. BENDER, to be the Executrix hereof, to serve without bond.
IN WITNESS WHEREOF, I, VIRGINIA E. BENDER, have hereunto set
my hand and seal to this. my Last Will and Testament which consists
of two (2) typewritten
signature this .!2 7t!
pages to each of which I have affixed my
day of ~ A.D., One Thousand Nine
Hundred Eighty (1980).
~1~;AY if!. ~,j
(SEAL)
The preceding instrument, consisting of this and one (1)
other typewritten page. each identified by the signature of the
Testatrix. was on the date thereof signed. sealed. published and
declared by VIRGINIA E. BENDER. the Testatrix therein named, as and
for her Last Will and Testament, in the presence of us. who, at
her request. in her presence. and in the presence of each other. have
subscribed our names as witnesses hereto.
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LAW OFFICES
SNELBAKER.
McCALEB 8: ELICKER