The URL can be used to link to this page

Home My WebLink About08-14-07 RF. 1Std f:X:' (1-00, . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 __ HARRISBURG, PA 17128-0601 .... Z W C W () W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Bomgardner, H. Kenneth Sr. r~~;;~~;;~;;M-DD-YEAR)---U1==::DD-YEAR)~_ (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o 3 ::> .... ii: c( () w ..: 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) }FILE NUMBER 21 06 01009 COUNTY CODE. . YEAR ____ NUMBER. r SOCIALSECURITv NUMBER , 204-28-1218 Hills RETURN MUSTI'lE FILED IN DUPLICATE WITH THE OFFICIAL USE ONLY REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (date of death prior t()12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) (1 ) (2) (3) (4) (5) (6) (7) None None None None 19,789.03 None None ,jhn~.~~f,t:;H;-;:'ijj OFFICIAL USE ONLY (") *0 -."":0 m-o 1=l:r(") ~c-'- )::> r- 1~.Zrn :_'= (J) ~ '.JOQ ;.:Q-n , .:) c= I"-v = <= --.. :7:>- c:: G") i I ~~. Originat-Retum.---- . 0 2. Supplemental Return ----- . w :.: ~ In 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after lil f ~ 12-12-82) 13 ~ g 181 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach 8: III of Will) copy of Trust) c( 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (data of death between ___~__ 12-31-91 and 1-1-95) ,.i,.nON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BEDIREeT.''te!); ME COMPLETE MAILING ADDRESS ~ ~ ~1~r~~E~;a~~~~e)-'---- '-- -~---'-----I 8~ ~E~E::o~f~~~:E~fCraigA. Diehl._____.____ __I b~~pT~Wt~:~~ill-4436 .~LZL7/76~~~ 13 ____ __ ~l-cc_==_=___=________=_==____=__=____________'c.=._ (9) (10) 8,789.03 - ~._--_._._-_.- 20,480.30 :- :x;... J': (~-' ~12, 7~9.!t~ (11 ) 29,269.33 (12) insolvent 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subjectto Tax(Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES x .00 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) z o ;: c( .... ::> ll. ::E o () ~ .... 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 x .045 x .12 x .15 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPA YMENT. >> BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< (15) (16) (17) (18) (19) Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00\ . Decedent's Complete Address: STREET ADDRESS 124 Woods Drive, Lot 23A --. CITY I STATE PA I ZIP 17050-2799 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) Total Credits (A + 8 + C) (2) 0.00 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 theOVERPA YMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (3) (4) (5) (5A) (58) 0.00 0.00 0.00 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;..............................,............................n................ ~ ~ ~: ~::::~ ~h~e~~~:i~~:~s:~~~=s~~~. ~~~I.I. .~~~. ~~~. :.~~:.~~~. .~~~~.~~.e.r.~~.~. .o.~ .i~~. ~~.~.~~~.'.'.'.'...'.'...'.'.'.'.'.'.'~~::::::::::: .'.'..... d. receive the promise for life of either payments, benefits or care?.............................n............................ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..............................no........................... ,"'........................... n..................... 0 ~ 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?.............................. n............................ n............................ --.................... 0 ~ IF THE ANSWER TO ANY OF THE A80VE 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 return, including accompanying schedules and statements. and to the best of my knowledge and belief. it is true. correct and complete. Declaration preparer other than the perso~al representative is based on all information of which preparer has any knowledge. __ ._~._ . ____ . ______ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS iller, Susan ADDRESS 124 Woods Drive, Lot 23A Mechanicsburg, P A 17050-2799 ZTE I (J1o/OTI DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE--- ADDRE~ ..~- -- Craig A. Diehl c 3464 Trindle Road Camp Hill, PA 17011-4436 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. ~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 0% [72 P.S. ~9116 (a) (1.1) (Ii)). The statutedoes not exemDta 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 ofthe child is 0% [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 4.5%, except as noted in 72 P .5. 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 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 bv blood or adoDtion. *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER ~_________~ - 06 - Ol009 ESTATE OF Bomgardner, H. Kenneth Sr. Include the proceeds of litigation and the date the proceeds were received by the estat~1I property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 558.25 Proceeds from Public Auction held on February 2, 2007 Proceeds from Public Auction held on January 23,2007 2,816.00 2 International Union of Operating Engineers of Eastern Pennsylvania and Delaware Benefit Plans 5,000.00 3 M&T Bank - Checking Account - #87034510 414.78 4 2000 Ford Truck Ranger (Repossessed) 11,000.00 TOTAL (Also enter on Line 5, Recapitulation) 19,789.03 ~~~,~" 1 INHERITANCE TAX RETURN RESIDENT DECEDENT ---_._----_..._--~--- -----_.._~-_... --...-- SCI-EDlI.E H RXERALEXPENSES& AIl\INS1RA11VECOSTS ESTATE OF Bomgardner, H. Kenneth Sr. Debts of decedent must be reported on Schedule J. ITEM NUMBER A. DESCRIPTION FILE NUMBER 21 - 06 - 01009 AMOUNT FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Miller, Susan Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 124 Woods Drive, Lot 23A City Mechanicsburg State P A Zip 17050-2799 Year(s) Commission paid 2007 Attorney's Fees Law Offices of Craig A. Diehl -- Craig A. Diehl 1. 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 3,455.07 3,455.07 State 4. City Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Zip 5. Accountant's Fees Law Offices of Craig A. Diehl - 2006 Income Tax Preparation 6. Tax Return Preparer's Fees 7. Other Administrative Costs The Sentinel - Legal Advertisement Cumberland Law Journal - Legal Advertisement Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 98.00 I I I I i I I 1 I ! I I I I -I I 200.00 151.55 75.00 1,354.34 8,789.03 SchedUe H FLnnI Expenses & ~cdWeCostscontinued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bomgardner, H. Kenneth Sr. Haar's Auction Service - Auctioneer Commission Haar's Auction Service - Auctioneer Commission I FILE NUMBER _L 21 - 06 - 01009 Law Offices of Craig A. Diehl - Reimbursement of certified mail fees for DPW letter Page 2 of Schedule H 223.30 1,126.40 4.64 .~. SCHEDULE I ~ DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS IN~~~~';,N~~~"2r:~~~lfN _.~_____~._______-1_____ ---- -IF'LE NUMBER- ---. ___.______ _ ......_ L 2~_..06.. OJ.Q09 ESTATE OF Bomgardner, H. Kenneth Sr. Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Gettysburg Road Animal Hospital.. Veteranarian bill Camp Hill Emergency Physicians.. Doctor bill HSBC Auto Finance.. Balance owed on 2000 Ford Truck Ranger Internal Revenue Service.. Personal income taxes TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 200.00 19.07 14,033.65 6,227.58 20,480.30