HomeMy WebLinkAbout11-30-07 (2)15056041125
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 7 0 5 2 9
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 8 3 1 2 8 7 1 4 0 3 1 6 2 0 0 7 1 1 0 4 1 9 1 7
Decedent's Last Name Suffix Decedent's First Name MI
N u s s A r t i e G
(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
0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
J o h n C Z e p p I I I 7 1 7~~5 2 8~ 9 0-:9
Firm Name (If Applicable)
A t t o r n e y A t L a w
First tine of address
P O B o x 2 0 4
Second line of address
City or Post Office
Y o r k S p r i n g s
State 21P Code
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REGIS
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DATE FILED
P A 1 7 3 7 2
Correspondent's a-mail address:
Under penalties of pery'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 of prepan:r other than the personal representative is based on all information of which oreaarer has anv knowledge.
DATE
11/14/07
429~VSought High Street, Mechanicsbur PA 17055
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
11/14/07
ADDRESS
P_O Box 204 York Sprin s PA 17372
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 15056041125 J
15056D42126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Artie G. N u s s 2 8 3 1 2 8 7 1 4
RECAPITULATION
1. Real estate (Schedule A) ................................... ..... 1
1 1 9 3 2 0 8
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.
1 7 2 1 0 1 7
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. ..... 5. •
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .. ..... 6•
7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property
(Schedule G) ~ Separate Billing Requested .. ..... 7.
8. Total Gross Assets (total Lines 1-7) ...................... ..... 8. 2 9 1 4 2. 2 5
9. Funeral Expenses & Administrative Costs (Schedule H) ........... ..... 9. 1 2 1 6 3 • 7 4
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ....... ..... 10. 4 6 7 5 0
11.
......................
Total Deductions (total Lines 9& 10)
.....11. 1 2 6 3 1, 2 4
12. Net Value of Estate (Line 8 minus Line 11) .................... ..... 12. 1 6 5 1 1 • 0 1
13. Charitable and Governmental Bequests/Sec 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. 1 6 5 1 1 • 0 1
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X.0 _ 0 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 1 6 5 1 1 0 1 1s
17. Amount of Line 14 taxable
0
0
0
at sibling rate X .12 17
18. Amount of Line 14 taxable
0
0
0
at collateral rate X .15 18
19. Tax Due .............. ......................... ... .... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 15056042126
Side 2
0. 0 0
7 4 3. 0 0
0. 0 0
0. 0 0
7 4 3. 0 0
15056042126
,REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 07 0529
DECEDENT'S NAME
Artie G. Nuss
STREET ADDRESS
3 ] 1 West Green Street
CITY
Mechanicsburg STATE
PA ZIP
17019
Tax Payments and Credits:
1• Tax Due (Page 2 Line 19) (1) 743.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
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 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.
0.00
(3) 0.00
(4) 0.00
(5) 743.00
(5A)
(5B) 743.00
Make Check Payable fo: 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 : ...................................................................... ^ ^X
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X
c. retain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ ^X
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. ^ 0
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 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. §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)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
s'2EV-1503 EX + (6-9a)
SCHEDULE B
' COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Artie G. Nuss 21 07 .0529
Ali property jointty-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PIMCO Funds & Allianz Funds 11,932.08
1,140.73 Shares @ 10.46
TOTAL (Also enter on line 2, Recapitulation) I ~ 11 932 08
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Artie G. Nuss 21 07 0529
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointty-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Adams County National Bank 12,806.35
Checking Acct. #1761056
2. LPL Financial Services Refund Check 2,767.40
3. B1ueCross B1ueShield Refund Check 289.67
4. Blair Refund Check 99.97
5. Adams County National Bank 1,179.31
Savings Acct. #9672427
6. Lou Gehrig's Disease Refund 67.47
TOTAL (Also enter on line 5, Recapitulation) E 17,210.17
(If more space is needed, insert additional sheets of the same size)
• REV-1511 EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES Sr
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Artie G. Nuss 21 07 0529
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES;
1. Monahan Funeral Home 10,230.00
B.
1
2.
3.
4.
5.
6.
7.
S.
9.
10.
11.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)lEIN Number of Personal Representative(s)
Street Address
City State _
Year(s) Commission Paid:
Attorney Fees John C. Zepp, III
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
Accountants Fees
Tax Return Preparer's Fees
Cumberland Law Journal
Carlisle Sentinnal
Inventory
Inheritance Tax Return
Family Agreement
Zip
Zip
1,500.00
142.14
75.00
166.60
15.00
15.00
20.00
TOTAL (Also enter on line 9, Recapitulation) I S 12 163 74
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (~2-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Artie G. Nuss 21 07 0529
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Michelle Krewson 15.00
2. Michelle Krewson
Gas -Check written Nov. 30, 2006
3. Michelle Krewson
Food -Check written Jan. 18, 2007
4. Michelle Krewson
Christmas Gifts - Check written Dec. 1, 2006
5. Pinnacle Health
6. ~ Spirit Physicians Services
TOTAL (Also enter on line 10, Recapitulation) I ~
(If more space is needed, insert additional sheets of the same size)
30.00
50.00
150.00
128.57
93.93
467.50
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Artie G. N uss 21 07 0529
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Rhonda Renee Summers Lineal 0.50
1575 Town Hill Road
York Springs, PA 17372
2. Michelle Denis Krewson Lineal 0.50
429 S. High St.
Mechanicsburg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 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
1.
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S
(It more space is needed, insert additional sheets of the same size)
vvL1V1L 1 V 111L' VV1LL VP NI[11L'. l1. 1VUJ~7
Be it remembered, that I, ARTYE G. NUSS, 398 Latimore Valley Road, York Springs, Latimore
Township, Adams Country, Pennsylvania, being of sound mind, memory and understanding, do
make, publish and declare this as and for my Last Will and Testament, hereby revoking and making
null and void any and all Wills and Testaments and writings in the nature thereof by me at any time
heretofore made.
ITEM 2: All the rest, residue, and remainder of my estate of whatsoever nature and
wheresoever situated, whether it be real, personal or mixed, including property over which I have a
power of appointment, I give, devise and bequeath unto my beloved husband, KENNETH E. NUSS,
absolutely, providing he survives me for a period of thirty (30) days.
ITEM 3: Item 3 has been deleted and revised to read: In the event that my husband should
predecease me or fail to survive me for a period of thirty (30) days, I then give, devise and bequeath
my entire residuary estate unto my beloved children, RHONDA R. BUPP, MICHELLE D.
KREWSON in equal shares.
WITNESS:
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ARTIE G. NUSS
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ITEM ~: This has been deleted and revised to read. I direct my hereinafter named Executor
to sell all of my property, both personal and real and either public or private sale, and reduce the
same to cash, to be added to the residue of my estate and disbursed according to this my Last Will
and Testament.
Lastly, I nominate, constitute and appoint my husband, KENNETH E. NUSS, as Executor of
this my Last Will and Testament. In the event that my husband should predecease me or fail to
quaiiry, cease to Pict or renotuice probate, I then nominate, constitute and appoint, R. RENEE RUPP,
1-'IICHELLE D. KREWS®N, as executors of this my Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this -~ftc~., ~-~~ day
of ~ ~r ~ ~ ~ ~ , 1992.
~~c, ~~?. ~~ ! ~-~-~-~'~' (seal)
ARTIE G. NUSS
The preceding instrument, consisting of this and one other typeset page, was on the day and
date thereof signed, sealed, published and declared by AR.TIE. G. NUSS, the Testator herein named,
as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence
and in the presence of each other, have subscribed our names as witnesses hereunto.
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