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HomeMy WebLinkAbout06-07-07 (2) ~ 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 --I SC\. --.J 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 L-. c=:> Side 2 15056052059 ---.J 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 - - - - - - - - - - == -== - - - - - - - - "I ..... ~. , .. \--- -.". -- , \ \ (j ..... (j ::d ~<.i\_ III C CD t; (j E3 \Q .... I-' 0 t1' 1-" 1-'- C CD fJl fJl t; t; rt I-' rt I-' CD 'r CD ::r III t; .. 0 ==' C 0. 0 '" fJl Hl ):01 CD (j 0 :E: CIl C 1-'- ..... ..0 ==' I-' -..J C rt I-' 0 III "< fJl ..... t; W CD (j 0 C t; rt ::r 0 c fJl CD '. c V' >~~ N '"' ...