HomeMy WebLinkAbout07-26-07
REV-1500 EX + (6-00)
.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 -0 7
o 0 2 7 6
COuNTYCOOE ----YEAr- - - NUMsER- -
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
KAPP EUGENE A.
DATE OF DEATH (MM-DD-Year)
SOCIAL SECURITY NUMBER
A1K1A EUGENE ALFRED KAPP
DATE OF BIRTH (MM-DD-Year)
2 0 7 - 0 9 - 1 974
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
02/12/2007 11/17/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
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[Xl 1. Original Return
o 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date of death priorto 12-13-82)
o 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under See. 9113(A) (Attach Sch 0)
,'. tHIs SECTION MUST 8ECOMPLETEt::); ALL-CORRESPONDENCE.AND CONFIDEN'J'IALTAX :INFORMA:ttON SHOULDBEDIRECTED'TO:"....'..
NAME COMPLETE MAILING ADDRESS
MURREL R. WALTERS Ill, ESQ.
FIRM NAME (If Applicable)
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54 EAST MAIN STREET
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
TELEPHONE NUMBER
717-697-4650
MECHANICSBURG
PA 17055
OFFICIAL USE ONLY
(1)
(2)
(3)
(4)
(5)
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21,820.77
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(6)
4,290.91
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(7)
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(8)
26,111.68
(9)
(10)
1,313.00
2,845.47
(11)
(12)
(13)
4,158.47
21,953.21
14. Net Value Subjectto Tax (Line 12 minus Line 13)
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 Sec. 9116 (a)(1.2)
16. Amount 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
(14)
21,953.21
21,953.21 X 0.00 (15)
0.00
X _(16)
X .12 (17)
X .15 (18)
(19)
0.00
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
. .iif>. >i.8E\SltRE-;to:tANsweR.~Ll::\QUES~$(i)NREVERSE:SIDE AND RECHECKMATH..,< .c:: >;<'t .'
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'Decedent's Complete Address:
STREET ADDRESS
20 N. 12TH STREET
CITY I STATE I ZIP
LEMOYNE PA 17043
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
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.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
0.00
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 lZl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 lZl
c. retain a reversionary interest; or ...................................................................................................... 0 lZl
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 lZl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................... 0 lZl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 lZl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 lZl
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, 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.
SIGNATURj OF PERSON RESPONSIBLE '~L1NG RETUR I ~~:h 'il~,
ADDRESS
PA 17043
DATE /
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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 P.S. S9116 (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. S9116 (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. s9116(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. S9116(1.2) [72 P.S. s9116(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. s9116(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-1508 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
KAPP EUGENE A.
FILE NUMBER
NKlA EUGENE ALFRED KAPP 21 07
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
00276
ITEM
NUMBER
1.
DESCRIPTION
DISTRIBUTION OF SHARE OFALBERT W. KAPP
REVOCABLE LIVING TRUST
LEBANON COUNTY, 2005-602
VALUE AT DATE
OF DEATH
21,820.77
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
21,820.77
REV-1509 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
KAPP EUGENE A. A/K/A EUGENE ALFRED KAPP
FILE NUMBER
21
07
00276
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. CATHERINE D. KAPP
20 N. 12TH STREET
LEMOYNE, PA 17043
WIFE
B
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JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 3/16/96 SOVEREIGN BANK 8,581.81 50. 4,290.91
CHECKING ACCOUNT
TOTAL (Also enter on line 6, Recapitulation) $ 4,290.91
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+(12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
KAPP EUGENE A. NK/A EUGENE ALFRED KAPP
FILE NUMBER
21
07
00276
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. NEUMYER FUNERAL HOME - PREPAID $7,459.00
B. ADMINISTRA TIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) CATHERINE D. KAPP (COMMISSION RENOUNCED)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 20 N. 12TH STREET
City LEMOYNE State PA Zip 17043
Year(s) Commission Paid:
2. Attomey Fees MURREL R. WALTERS III 1,200.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS - CUMBERLAND COUNTY 113.00
5. Accountanfs Fees
6. Tax Return Pre parer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 1,313.00
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KAPP EUGENE A. NKJA EUGENE ALFRED KAPP
FILE NUMBER
21
07
00276
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. HCR MANOR CARE
NURSING HOME CARE
2,739.11
2. EAST PENNSBORO AMBULANCE SERVICE
55.00
3. NEIGHBORCARE
PHARMACY
51.36
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,845.47
""":"'>*
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KAPP EUGENE A. A/K/A EUGENE ALFRED KAPP
SCHEDULE J
BENEFICIARIES
NUMBER
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
FILE NUMBER
21 07
RELA TIONSHIP TO DECEDENT
Do Not List Trustee(s)
00276
AMOUNT OR SHARE
OF ESTATE
1.
CATHERINE D. KAPP
20 NORTH 12TH STREET
LEMOYNE, PA 17043
WIFE
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
ll. 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 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)