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HomeMy WebLinkAbout05-18-07 (2) .. .. ....J 15056051047 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes . PO BOX 280601 Harrisbur ,PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Securi Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT Decedent's Last Name Suffix MI N/A Suffix MI o THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return C::) 2. Supplemental Return C::) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C:) 4. Limited Estate 1:) <:::) c:::::>> 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) <:::) 10. Spousal Poverty Credit (date of death <:::) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received -.L 8. Total Number of Safe Deposit Boxes ... REGISTER OF WILLS ~ONLY n . (""::0 -J ;g .........~( co Correspondent's e-mail addresS:rmaffettjr@aol.com Under penalties of pe~ury, I declare that I have examined this retum, 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 personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PER RESE'ONSIBI..E FOR Fill G RETU DATE rJ. ADDRESS 1. ar a e, sq . 2201 North Second Street, Harrisburg, PA 17110 SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.J ---I 15056052048 REV-1500 EX Decedent's Name: Dorothy J. Jones 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 & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly OWned Property (Schedule F) c::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::> Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 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, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE.. .. . .. .. . .. .. .. .. ... .. .... .. .... .. .. .. . . .. . . .. ... ... .. .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 Decedent's Social Security Number 15. 16. 17. 18. c:::J 15056052048 --.J REV-15M EX page,3 Decedent's Complete Address: File Number 2006 - 0 1019 DECEDENT'S NAME DOROTHY J. JONES -. STREET ADDRESS 15 Dapp Lane CITY . b I STATE PA 1 ZIP 17050 Mechanl.cs urg Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 23,461. 67 Total Credits ( A + 8 + C ) (2) o 3. Interest/Penalty 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. Fill in oval on Page 2, Line 20 to request a refund. (3) 0 (4) 0 (5) 23,461. 67 (5A) 0 (58) 23,461. 67 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. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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;.......................................................................................... D IXl b. retain the right to designate who shall use the property transferred or its income; ............................................ D !Xl c. retain a reversionary interest; or.......................................................................................................................... D !Xl 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? ........................................................................................................................ 0 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. 99116 (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. 99116 (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.S. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(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. INVENTORY OF REAL AND PERSONAL ESTATE In the Matter of the Estate of DOROTHY J. JONES, late of Silver Springs Township in the County of Cumberland, Commonwealth of Pennsylvania, deceased. Invento~ of the real and personal estate which were of the above-named Dorothy J. Jones, deceased. Taken and appraised the ,UJb day of ~~ ' 2007. (Date of Death: 10/13/06) 1. Sovereign Bank Checking Account No. 571117155 $19,731.56 2. Hershey Trust Company, Revocable Trust, Account No. 2746 415,063.41 3. Hershey Trust Company, IRA, Account No. 800 90,210.26 4. 1997 Nissan Maxima 2,500.00 5. 1999 Mazda Miata 8,000.00 6. Jewelry 500.00 7. Personal Property 200.00 8. Verizon Refund Check 11.30 TOTAL: $536,216.53 . _~~.,uo '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF DOROTHY JUSTICE JONES FILE NUMBER 2006-01019 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 1. DESCRIPTION Sovereign Bank, 3556 Old Gettysburg Road, Camp Hill, PA 17011 Checking Account No. 571117155 VALUE AT DATE OF DEATH $19,731.56 3. 1999 Mazda Miata 2,500.00 8,000.00 2. 1997 Nissan Maxima 4. Jewelry 500.00 5. Personal Property 200.00 6. Verizon Refund Check 11. 30 TOTAL (Also enter on line 5, Recapitulation) $ 30, 942 . 86 (If more space is needed, insert additional sheets of the same size) REV-151o'EX. (1-97) . . SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF DOROTHY JUSTICE JONES FILE NUMBER 2006-01019 ITEM NUMBER 1. 2. This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE . Hershey Trust Company P.O. Box 445, Hershey, PA 17033 Revocable Trust, Account No. 2746: Shares Asset Description 1,648 Connon Trust Fund - Growth Equity 351 Connon Trust Fund - Value Equity 1,442.169 GO Foreign Fund IV 100 Connon Trust Fund - Fixed InCOIre 24,285.56 Temporary Investnent Fund Total Market Value as of 10/13/2006 (See StatazzEnt Attached) Hershey Trust Company P.O. Box 445, Hershey, PA 17033 IRA, Aecount No. 800: Shares Asset Description 126 Connon Trust Fund - Growth Equity 30 Conm::>n Trust Fund - Value Equity 68 Conm::>n Trust Fund - Fixed InCOIre 3,875.62 Temporary Investnent Fund Total Market Value as of 10/13/2006 (See Staterrent Attached) DATE OF DEATH VALUE OF ASSET Market Value $123,167.81 143,692.01 24,452.88 99,465.15 24,285.56 $415,063.41 Market Value $ 9,416.96 12,281.37 67,636.31 3,875.62 $ 93,210.26 %OF DECO'S INTEREST 100% 100% EXCLUSION {IF APPLICABLE \ None $3,000 TAXABLE VALUE $123,167.81 143,692.01 24,452.88 99,465.15 24,285.56 $415,063.41 $ 90,210.26 TOTAL (Also enteron line 7, Recapitulation) $505,273.67 (If more space IS needed, Insert additional sheets of the same size) . REV-1511 EX+ (12-99) . . 'Ckl~.Q_ . '~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF OOROTHY JUSTICE JONES FILE NUMBER 2006-01019 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Ma.lpezzi Funeral Hone, 8 Market Plaza Way, ~hanicsburg, PA For professional services, death certificates, cremation, newspaper notices $2,216.82 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Waived Name of Personal Representative(s) Richard F. Ma.ffett, Jr. & Barbara J. Ma.f ett 0 Social Security Number(s)/EIN Number of Personal Representative(s) 163-44-0197 /182-38-9850 Street Address 15 Dapp Lane City Mechanicsburg State ~ Zip 17030 Year(s) Commission Paid: N/A 2. Attorney Fees Waived 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant N/A Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees Glenda Farner Strasbaugh, Cumberland County Register of Wills Accountant's Fees 480.00 5. 6. Tax Return Preparer's Fees Boyer & Ritter, P.O. Box 8300, Camp Hill, PA, 17001, 2006 Federal & State Incaoo Tax Returns Cumberland County Law Journal-Advertiserrent of Estate Notice Carlisle Sentinel-Advertiserrent of Estate Notice 285.00 75.00 147.01 7. 8. TOTAL (Also enter on line 9, Recapitulation) $3,203.83 (If more space is needed, insert additional sheets of the same size) . REV-1512 EX+ (12-03) . . '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2006-01019 ESTATE OF OOrorHY JUSTICE JONES Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 10. 1. Private Duty Nurse 10/9/06-10/12/06 800.00 $ 2. Messiah Village, Nursing Hone Expenses 5,401.30 3. Reimbursement to Barbara M. Maffett for purchases made on behalf of Decedent before death 230.98 4. Highmark Retirenent Plan - Return of Pension payrrent 260.42 5. Reimburserrent to Barbara M. Maffett for expenses for care of Decedent's dog 199.00 6. PennDot-Miata Registration 36.00 591.58 7. USAA - Auto Insurance for Miata 8. Freysinger Mazda - Inspection & maintenance for Mazda lU.90 9. u.s. Treasury - 2006 Federal Incarre Tax Due 3,298.00 PA Departnent of Revenue - 2006 State Incarre Tax Due 710.00 TOTAL (Also enter on line 10, Recapitulation) $ 11,642.18 (If more space is needed, insert additional sheets of the same size) - R8I-1513 E~.. ,.... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF OORal'HY JUSTICE JONES FILE NUMBER 2006-01019 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY . . Do Not List Truatee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Barbara M. Maffett Daughter 100% 15 Dapp Lane Machanicsburg, PA 17050 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 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)