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HomeMy WebLinkAbout08-31-07 -.J 15056041147 REV-1500 EX (06-0S) 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 OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 File Number 0508 Date of Birth 201059186 05032007 05241921 Decedent's Last Name Suffix Decedent's First Name MI HENNE RICHARD H (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 a 1. Original Retum 0 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) 0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Retum Required (date of death after 12-1 H12) a 6. Decedent Died Testate 0 7. Decedent Meintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 1 0 Spousal Poverty Cred~ ~ date of death 0 11. Election to tax under Sec. 9113(A) . between 12-31-91 and -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 THOMAS S BECKLEY 7172337691 Firm Name (If Applicable) BECKLEY & MADDEN 212 NORTH THIRD STREET REGIST~ 8j WILLS lISE ONLY -','1 ;:.... -'--<J '-~_. 1 C:-) " (.J , ' '-,"" First line of address , >',; Second line of address -0 City or Post Office HARRISBURG, State PA ZIP Code 17101 :~J N :~T1 FILED .. -.J Correspondent's e-mail address:becks@pa.net 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. SIGNATURE OF PERSON RESPONSI8LE FOR FILING RETURN Manufacturers Traders and Trust DATE d ~ / J; CJ.-U-I2~ COmpany ~/~ 7 /07 ADDRESS ---r- / I Thomas S Beckley ADDRESS 212 North Third Street, Harrisburg" PA 17101 Side 1 L 15056041147 15056041147 -.J REV-1500 EX Page 3 Decedent's Complete Address: '::sNAME Henne, Richard H. STREET ADDRESS Bethany Village West Nursing Home File Number 21 - 07 - 0508 5225 Wilson Lane Mechanicsburg I STATE PA IZIP I 17055 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 45,068.07 42,750.00 2,250.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 45,000.00 Total Interest/Penalty (0 + E) 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 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) (5) 68.07 (SA) (5B) 68.07 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;.................................................................................O [!] b. retain the right to designate who shall use the property transferred or its income;....................................D [!] c. retain a reversionary interest; or...............................................................................................................0 [!] d. receive the promise for life of either payments, benefits or care?............................................................. 0 [!] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.... ......... ......... ................ ....... .......................................................,....... .........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?.... ........... .......................,......... ................................................ ..... .............J;!] 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR 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)]. 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. 99116 (a) (1.1) (ii)]. The statute does not exemDB 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 zero (0) percent [72 P,S. 99116 (a) (1.2)]. I 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 of the decedent's Siblings IS twelve (12) percent [72 P .S. 99116 (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. -.J 15056042148 REV-1500 EX Decedent's Name: HENNE, RICHARD H. 201059186 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) 0 Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 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, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of line 14 taxable at lineal rate X .045 17. Amount of line 14 taxable at sibling rate X .12 18. Amount of line 14 taxable at collateral rate X .15 15. 1,001,512.76 16. 17. 18. 19. Tax Due.............. .............. .................. ............ .................................... ............... ..... .1'9. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Decedent's Social Security Number 760,970.28 103,919.13 196,081.23 1,060,970.64 56,283.92 2,673.96 58,957.88 1,002,012.76 500.00 1,001,512.76 45,068.07 45,068.07 D 15056042148 -.J . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. FILE NUMBER 21 - 07 - 0508 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE 0 NUMBER DEATH 1 12,000 shares of Allied Irish Bank stock 62.15 745,800.00 2 Allied Irish Bank - accrued dividend 15.170.28 TOTAL (Also enter on line 2, Recapitulation) 760,970.28 F '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYl VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. FILE NUMBER 21 - 07 - 0508 Include the proceeds of litigation and the date the proceeds were received by the estatEAII property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE 0 NUMBER DEATH 1 M& T checking account 5,097.25 2 Refund - Carefirst - Blue Cross/Blue Shield 2,356.00 3 Refund - West Shore A.L.S. 634.30 4 Refund - State Farm Fire and Casualty Co. 53.40 5 Refund - State Farm Mutual Automobile Insurance Co. 4.45 6 Dividend - State Farm Insurance 13.60 7 M&T Individual Retirement Account 94,362.48 8 M&T Individual Retirement Account 1,397.65 (accrued interest) TOTAL (Also enter on Line 5, Recapitulation) 103,919.13 F . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. FILE NUMBER 21 - 07 - 0508 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE NUMBER Include the neme of the transferee, their relationship to decedent VAlUE OF ASSET DECO'S (IF APPLICABLE) and the date of trensfer. Allach a copy of the deed for real estate. INTEREST 1 Vanguard Money Market Account 195,998,94 100% 195,998.94 2 Vanguard Money Market Account 82,29 100% 82,29 (accrued interest) I This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. TOTAL (Also enter on line 7, Recapitulation) 196,081.23 . SCHEDU.E H FUNERAL EXPENSES & ADNINSTRATlVECOSTS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: A. 1 Lynn Beres (reimbursement for funeral expenses) DESCRIPTION B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Manufacturers Traders and Trust Company Social Security Number(s) I EIN Number of Personal Representative(s): Street Address P.O. Box 2961 City Harrisburg Year(s) Commission paid Attorney's Fees Beckley & Madden 1. State PA Zip 17105 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. City Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Zip State 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland County Law Journal (legal advertising) TOTAL (Also enter on line 9, Recapitulation) FILE NUMBER 21 - 07 - 0508 AMOUNT 434.38 27,402.00 27,402.00 664.00 75.00 56,283.92 . SchedUe H FlIleraI ExpeIISeS & AaTi1istraINe Costs c::a1inued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. FILE NUMBER 21 - 07 - 0508 2 The Patriot-News (legal advertising) 306.54 Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE T />J( RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. FILE NUMBER 21 - 07 - 0508 Include unreimbursed medical expenses. ITEM DESCRIPTION NUMBER AMOUNT 1 Bonnie K. Miller, Treasurer 10.00 (2007 County and Township personal tax) 2 Millenium Pharmacy System, Inc. 849.93 3 Bethany Village (balance due) 1.708.75 4 Lower Allen Township 64.70 5 PA Department of Revenue (2006 tax liability) 40.58 TOTAL (Also enter on Line 10, Recapitulation) 2,673.96 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henne, Richard H. I FILE NUMBER 21 - 07 - 0508 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS{include outright sgousal aistributionsg and ransfers under Sec. 116 (a) (1.2)] 1 Lynn Beres Daughter Residue 1,001.512.76 55 Black Walnut Drive Etters, PA 17319 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Shriner's Hospitals for Crippled Children 500.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEI T 500.00 MAY. 11. 2007 1 0 : 47 AM M T TRUST ......,Uo.~ x .,., ........-...vu.aw., A~".AT~W a:'" ....'(S"VaGl, PJII\l1ll8YL..,.AmA, .1 nos NO. 5505 p, 2 ~ , - ;; I, RICHAlU) H. lIBNNE, or Camp Hill, Cumberland County, pennsylVania, do hereby make my last rill and testament. re- voking all testamentary dispositions her.tofo~e made by me. 1. I desire tha. t my burial. be on the taJni.ly buri&l plot in Hains Churcb Cemetery, Wern.rsville, Barks County, Pennsyl- vania. ': 2. If my wite, Virginia J. Henne, survives Ille tor a period of ninety (90) days. I give to ber all my estate. I:eal and personal and wberesoever situate. If Idy said wife sw:vives IDe. but dies within 'the said period of ninety (PO) days, I direct that any part of my estate that .ba.ll be required sha.ll be used for ber comfort. maintenance and support and to pay any medioal bills pertaiD1.ng to ber and her funeral expenses. i :.~ . " 3. If my said wife predecease. me or dies wi thin the 8aid ninety (90) day period, I disposQ of all of my estate, real and peraoD&! and wberesoever situate. except that autborized to be disbursed under. the foregOing paragraph, as :follows: (a> I give to 'J:be Shriner's Hospitals for Crippled Chilc:h"liln, a corporation, the SWIl of FiVe Hundred ($500.00) Dollars. for the USQ and benefit of the hospitals owned, operated and main..; tained by said corporation. (b) Xf my daugbter, Lyrm Ann Henne, has attained the age of thirty-five (35) years at the tiJae of my death, I give to her eLll my estate. real and personal and wheresoever situate. If my said daughter h&s not attained tbe age of thirty-.five (3S) years at the time of m.y death. I give to her the SWII o.f Five Thousand ($5,000.00) Dollars. (c) All the rest, residue and remainder of my estate, real and personal and wheres.oever situate, I give to Daupbin Deposit l:f:. ~; ,;:~ ,_J~ 0'; ~;,r '::---~~:', ":-,, - ::,", - ", : "::>..~.) ~ :~:', "'~';' ~~?;;: '}~j .," t'l MAY, 11. 2007 10:48AM M T TRUST NO. 5505 P. 3 ~ i' ... ~ ~ i. '. ;'-(1 Bank and Trust Company, HArrisburg, Pennsylvania, ion trust, to invQst and reinvest and to iLdd the net incOIle therefrom to prin- cipal, the resulting fund to be hereinafter referred to as the "trust ~uadn. I a.u'thori~e lIlY Trustee at aD,. time and frolll time to t~e When in ita sole and uncontrolled discretion it deems it ~ expedient, to expend any part of the trust ~uDd ~or the comfort, maintenance, support, education and to meet an,. emergency per- taining to my said daughter, Lynn Ann lienoe. I authorize my Trustee to make the said expenditure. either directly to my said daughter, Or to Uly other person for her bene~it, and the receipt of the party so selected by my Trus'tee to be 'the recipient thereof shall be a sufficient acq1dttance. I further authoX'ue my daughter, Lyrm Ann Henne, beginning one (1) year from the date o~ lilY death, to withdraw, annually from the trust fund, the sum of Five Thousand ($5,000.00) Dollars, by delive.ring to the Trustee a written request for the said SWII. My said daughter shall have the right to withdraw only the sum of Five Thousand ($5,000.00) Dollars in anyone year and failare to reque6t payment in any year shall b. deemed to be a waiver o~ her right to wi thdra.w. When my daughter, Lynn AnD Henne, attains the age of eighteen (18) years, my Trustee shall pay to her all the net income frOlll the trust fund instead of adding the said net income to principal. My Trustee shall continue to haw discretion- ary authority to disburlie principal of the trust for the benefit o~ the said Lynn Ann Henne <md she shall continue to have the righ1: to withdra.w the sum of Five Thousand ($5,000.00) Dollars per yea.r as bereinbe:fo.I:e provided. When my l!Ia.id daughter a.ttains the a.ge of thirty- , l' ~ Q. ~ '" r; 2. ~}i;.:~1;i;'. ~'i:\';:. · .... ".';, ..:.:.... . ........ " ': .... 7.'., ~'~-"; - .-- .~'.~~'." i~~;;:{. ;~~ ~, "" , , t MAY. 11. 2007 10:48AM M t TRUST NO. 5505 P. 4 five (35) years, 'this trust sbaJ.l terminate and IllY' TJ;ustee shall pay to her the enti~e trust fund and any accumulated income, free and clear o~ the trust. If lII)" said daughter shOUld die before receiving the entire trust f\1Dd but leave issue surviri.ng Iter, this trust shall continue for the bene!! t of her issue, each of the said issue to have an equal share in the tund. The fund shall be held, administered and dilibursed under the sarae terms and con- di tiODS a.s hereinbefore set forth for the trust held for the bene- fi t of my said da119hter. If Illy said daughter shall die before receiviDg the entire trus't fund, leaving DO issue surviving ber, I give the balance Of the trust fund, together with any aCCUlllula'ted income therefrOUl, to The Shriner's Hospitals for Crippled Children, a corporation, for the Wie and benefit of the hospitals owned, operatwd and maintained by said corporation. 4. I direct that all inherit&Qce taxes and estate taxes impo.ed because of my death shall be paid frOlll the residue of my es~te to the same effect as if they were expense. of administration, S, I direct that all legacies, shares or in'terests in my estate, wbe'ther principa.l or income, while in the hands of my Bxecutor or Trustee, shall DOt be subject to execution, a.ttaohment Sur jUdgment, sequestration or any o'ther process for any debt, contract, or enga.gaent of any beneficiary, and shall not be sub- ject to pledge, a.ssignment, conveyance or anticipation, and the personal receipt ot 'the benefieia.ry, except as otherwise provided in this Will, shall be the sufficient and only diScharge of my Executor or 'fr\;ujte. for pa.ymen1: ot prinCipal or income. (). I nOlllinate, constitute and a.ppoint my Wife, Virginia J. Henne, to be the Execu.trix of tbis my last will and testaDaent. If lII)" said wife is unable oX" unwilli.ng to so act, I appoint 3. '.,.". ',1. , ,:. ',,' .' ~.~. .....', \l.~ .- '" " :. ~ .- '- ,::~'l. ,~;' , < .. ,~ .J1 ~:~~~ >", ...,~:' ('~'. ">", :1. "'.:" "~t .~ -:.~' ;:1.'~ !',~ " ol,'., ",I$' \ ~1;. '1,'1:' ~! ',',: ';,:.;;; ~~~~ rl~, "'4: ~7. ,..~ '!"'. ~:'Y'" ." 1r\~: f.~: ~/.; r,'" J" ~. , ~~', k, ~f'.' ./,', ~(: ~~:' I..., R';':t: ~;';" t.., ~'". '{ ~,': ~~.. ~,. ." ~~r;.;;.r ..;!r.~.. '...."1'ii1;,.., ,~.'~, ~l ~.:,,;", i">l' ~:; I'~.~ ;,,\:'%J)-, MAY, 11. 2007 10: 48AM M T TRUST NO, 5505 P 5 , ~ Dauphin Deposit Bank and trast Company, HArrisburg, pennsylvania., to be my Executor. IN WItNESS WHERBoF, I have hereuato set my hand and .eal to this Illy lut will and testament this 1.5"' . day of January, 1981. Signed, sealed, published and declared by the above-named Richard H. lienne, as and. for hb laat "Ul aod testaJllent ~~ ~2IL in the preSCIIlCe ot us Who, at: his reqaest and in his presence. /~ ' 'U (SEAl and in the pre..oee of each other, have here1ilDto sabscribed oar Dallies as witn.sses 'this .is:..- day of .1anuary, 1981. ~~ '-14' {/ .J. ll.. /L WIlLIAM .1. MADDEN, J~., BSQUIRE 240 North 'J:hird Street HArrisbarg, Pennsylvania 4.