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Home My WebLink About05-31-07 (2) '-1' 15056051058 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 06 00575 Date of Birth 102-16-2628 06/14/2006 12/09/1925 Decedent's Last Name Suffix Decedent's First Name MI LENTZ HARRY E (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 . 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 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 8. Total Number of Safe Deposit Boxes MARY LENTZ (717) 691-7873 Firm Name (If Applicable) REGISTER 0;'_ !:,ILLS USE GNP' ;~-::-~) -..I First line of address 42 LONGWOOD DRIVE c..., Second line of address ~.. City or Post Office State ZIP Code DATE,F1tJED MECHANICSBURG PA 17050 f"<) ..j... ADDRE1S 106 S BALTIMORE STREE DILLSBURG, PA 17019 PLEASE USE ORIGINAL FORM ONLY Correspondent's e-mail address: Under penalties of perjury, I declare that 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 personal representative is based on all information of which preparer has any knowledge. DATE S"'d.-4-01 .Pa. \ ..,C~ ~ DATE OS/23/07 L 15056051058 Side 1 15056051058 ---1 ~ '~' 15056052059 REV-1500 EX Decedent's Name: HARRY E LENTZ 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) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 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 .0lL 208,861.22 16. Amount of Line 14 taxable at lineal rate X.O L 6,371.70 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 102-16-2628 Decedent's Social Security Number 15056052059 306.48 10,326.53 222,817.71 233,450.72 4,531.80 13,686.00 18,217.80 215,232.92 215,232.92 0.00 254.87 254.87 --1 REV-1500 EX Page 3 Decedent's 'Complete Address: DECEDENT'S NAME HARRY E LENTZ STREET ADDRESS 42 LONGWOOD File Number 21 06 00575 DECEDENT'S SOCIAL SECURITY NUMBER 102-16-2628 CITY MECHANICS BURG I STATE PA I ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 254.87 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) (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) 254.87 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) 254.87 A. Enter the interest on the tax 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;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 iii d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 iii 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 iii 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 ~ 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)J. 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 PS. 99116 (a) (1.1) (ii)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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)J. 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 ofthe decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)J. 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. REV-1503 EX+ (6-98)~~. .,,() I I~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF HARRY E LENTZ FILE NUMBER 21 06-0057 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 4 SHARES IBM 306.48 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 306.48 REV-1503 EX+ (6-98) , '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF HARRY E LENTZ FILE NUMBER 21 06-0057 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH AMERICHOICE ACCOUNT #12580-18 10,326.53 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,32653 RE~-1509 EX+, (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF HARRY E LENTZ FILE NUMBER 21 06-0057 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. MARY LENTZ 42 LONGWOOD DRIVE MECHANICSBURG, PA 17050 SPOUSE 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 DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAl ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. RESIDENCE 185,000.00 50 92,500.00 2 A 2003 NISSAN MURANO 20,545.00 50 10,272.50 3 A 1993 NISSAN MAXIMA 2,975.00 50 1,487.50 4 A AMERICHOICE CHECKING/SAVINGS #12580 (14)(01)(03)(13) 4,762.76 50 2,381.38 5 A AMERICAN FUNDS #5847-7570 (06)(07)(36) 225,980.95 50 112,990.48 6 A FIDELITY INVESTMENT 6,371.70 50 3,185.85 TOTAL (Also enter on line 6, Recapitulation) $ 222,817.71 (If more space is needed, insert additional sheets of the same size) RE~'1511 EX: (12.99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF HARRY E LENTZ FILE NUMBER 21 0600575 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: MALPEZZI FUNERAL HOME 4,370.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attorney Fees 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 91.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 70.00 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,531.80 REV-1512 EX+ (12-03) . '. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF HARRY E LENTZ FILE NUMBER 21 0600575 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 1. 2 MORTGAGE PAYABLE - COMMERCE BANK (50%) NOTE PAYABLE - SOVEREIGN BANK (50%) 9,538.50 4,147.50 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 13,686.00 REV:15:3 EX+ (:-00) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF HARRY E LENTZ FILE NUMBER 21 0600575 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 JULIANNE KALLAS 5338 BERKSHIRE ROAD MILTON NJ 07438 GRANDCHILD 3185.85 2 DANIEL KALLAS 5338 BERKSHIRE ROAD MILTON NJ 07438 GRANDCHILD 3185.85 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 a B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART" - 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) ",.. ,..- -iflI....r~. .".-- ro -- (~ ,1J1 -Iii. .x: ~","" (' .... .' .. ~. :O.,RI, ~~~r :i! ~3Wl';' J :,~: .~ ,~! C\J ~j a~ ~~, r-4 ,...... ..... .~ '0... ~ 0::: :J OJ r.iJ -, cr'! 0::: <t: :c ii N d C) ~ r . ! I .' '.1 -', ~ ~- _ : r : '," "'i",11 ," ". " I',. c., J 8..-UU t \;"1' '...' I H ('I rnJ \.'"';: ,t' [~,:\ ;1 . , \ . r""- OO Q) 1\1 to '- 1 [<) - (J 0 V) (j) r ..-' ~ - ~ '3 ~ c:i vrj .... \J - Q -t"'" '\11 .... ~ - \.,. j \.... Q) 0 c3 ~ c) .... - \{51 \l ~