HomeMy WebLinkAbout06-07-07 (2)
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15056051058
REV-1500.
PA Department of Revenue
Bureau of Individual Taxes .' INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
1.193-12-~13 I Marcl,6.2007
Decedent's Last Name
OFFICIAL USE ONLY
County
Year
File Number
OSto 0
Suffix
[ Jr
Date of Birth
1 February 17, 1925
Decedent's First Name
MI
D
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix First Name MI
I D
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
I REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
-
1. Original Retum
c::>
2. Supplemental Retum
C:J
3. Remainder Retum (date of death
priorto 12-13-82)
5. Federal Estate Tax Retum Required
C:J 4a. Future Interest Compromise (date
of death after 12-12-82)
C:J 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
C:J 10. Spousal Poverty Credit (date of death C:J 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:
C:J
4. Limited Estate
C:J
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
C:J
C:J
Name
Daytime Telephone Number
1717-938-3396
Firm Name (If Applicable)
I Sechrist Law Office
First line of address
REGISTER,Of WILLS USEJiNL Y
. (--? ..
DATE FILED
or Post Office
State
IPA
ZIP Code
I [17319
, I
Correspondent's e-mail address:
/.1-4tJtJ 7
Side 1
L
15056051058
15056051058
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REV-1500 EX
15056052059
Decedent's Name: John Hollerbush
RECAPITULATION
Decedent's Social Security Number
1193-12-9913J
1. Real estate (Schedule A) 1. $0.00
2. Stocks and Bonds (Schedule B) 2. $0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. $0.00
4. Mortgages & Notes Receivable (Schedule D) 4. $0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. $0.00
6. Jointly Owned Property (Schedule F) Cl Separate Billing Requested 6. $20,238.16
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7. $0.00
(Schedule G) co Separate Billing Requested
8. Total Gross Assets (total Lines 1-7) 8. $20,238.16
9. Funeral Expenses & Administrative Costs (Schedule H) 9. $1,528.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10. $9.80
11. Total Deductions (total Lines 9 & 10) 11. $1,537.80
12. Net Value of Estate (Line 8 minus Line 11) 12. $18,700.36
13. Charitable and Governmental Bequests/See 9113 Trusts for which 13. $0.00
an election to tax has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) 14. $18,700.36
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
Amount of Line 14 taxable
15. at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X O.
16. Amount of Line 14 taxable
at lineal rate X 0.045
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
18.
15.
$0.00
$841.52
$0.00
$0.00
16.
17.
19.
$841.52
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
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Side 2
15056052059
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REV-1500 ~ Page 3
Decedent's Complete Address:
File Number
DDI
DECEDENrs NAME DECEDENrS SOCIAL SECURITY NUMBER
John Hollerbush 193-12-9913
STREET ADDRESS
1012 Allen Street
CITY I~Tt~E IZIP
New Cumberland PA 17070
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
$841.52
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C ) (2)
$42.08
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.
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 + SA. This is the BALANCE DUE.
(3) $0.00
(4) $0.00
(5) $799.44
(SA)
(5B) $799.44
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; 0 181
b. retain the right to designate who shall use the property transferred or its income; 0 181
c. retain a reversionary interest; or 0 181
d. receive the promise for life of either payments, benefits or care? 0 181
2. If death occurred after December 12, 1982, did decedent transfer property within one 0 181
year of death without receiving adequate consideration? 0 181
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 181
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate
property which contains a benefiCiary designation? 0 181
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 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. ~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.
REV-1509 EX + (&-98)
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
.
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF John HolJerbush
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINTTENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER
DESCRIPTION OF PROPERTY
Include name of financial institution and bank account number or similar identifying number.
Attach deed for jointly-held real estate.
TOTAL (Also enter on line 6, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$20,238.16
REV-1511 EX. (12-99)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John Hollerbush
FILE NUMBER
ITEM
NUMBER
Debts of decedent must be reported on Schedule I.
A.
1.
2.
3.
4.
5.
6.
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$1,528.00
REV-1512 EX + (12-03)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF John Hollerbush
FILE NUMBER
Record debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$9.80
REV-1513 EX + (9-00))
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
John Holferbush
FILE NUMBER
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)1
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
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
MAY-:.:lU-;&UU'( 10: U4
SUSQ. VAL. }o'(;U '11'(4412U22 P. 02
SUSQUEHANNA
--.............. ~LLEY
FEDERAL CREDIT UNION
May 29,2007
Joel O. Sechrist, Esquire
568 Old York Road
Ett-ers, PA 17319
Re: John Hoflerbush, Jr
Dear Mr. Sechrist:
The following is the information you l'Equested on the account at Susquehanna Valley
FCU held in the name of John HoIlerbush, Jr..1 deceased.
Mr. HolJerbush maintained one account, which induded both a savings and checking
account.
Account #
1103-00 (savings)
1103-40 (checking)
Date of Death (March 6, 2007)
Balance Accrued Interest Total
$68,599.79 $121.55 $68,721.34
$6,065.64 $0.00 $6,065.64
"
The accrued interest listed above is the amount acaued from January I, 2007 through
March 6, 2007.
Mr. Hollerbush opened his account on January 11, 1978. The followIng joint owners
were added at a later date.
-..'
· Feme Hollerbush was added to the savings and checldng accounts on July 8, 2004.
· Mary Lou Jones was added to just the savings account on July 16,2004.
· Bruce l. HoIlerbush was added to just the savings account on August 18, 2004.
Please let me know if you need any additional information.
KInd regards,
'~9~
Kathy Jo Shoaff
Member Servfces~.
@;
3850 HARTZDALE DRIVE · CAMP HILL, PA 17011-7809 ~
LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 ~
Exhibit for Schedule F
TOTAL P.02
Joel O. Sechrist, Esquire
Attorney at Law
568 Old York Road
Etters PA 17319
717 938-3396
Facsimile 717 938-9613
June 5, 2007
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013
Re: John Hollerbush, Jr.
To Whom It May Concern:
Enclosed are two copies of the Inheritance Tax Return for the above individual. No
estate has been opened. Also enclosed is a check for the inheritance tax in the amount of
$799.44 and a check in the amount of$15.00 for the filing fee. Please note that the envelope is
postmarked June 5, 2007.
JOS:lm
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