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Home My WebLink About01-24-08 ~EV~ 500 E\"I6-00; OFFICIAL USE ONLY COMMONWEI>.L ,h OF PENNSYL VANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESI DENT DECEDENT I "" '"'00" : ~L COUNTY CODE -9L 0563 ___ YiOAR NUMBER I DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) Bender Vir inia DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 02/02/1919 E SOCIAL SECURITY NUMBER 188-12-4343 THIS RETURN MUST 8E FILED IN D UPLlCA TE WITH THE f- Z W Cl ~ ! 6/11/2006 W (IF APPLICABLE; SURVIVING SPOUSE'S NAME (LAST, FiRST, AND MIDDLE INITIAL) ~I 0 , 0';,;,,, "'"m ~~rnl- u O:::~ . U 4 limited "state ~ ~S I D 6 Decedent Died Testate (Attach :opy of 'Mil) ~a:l II <l: ''----1 9. Litigation Proceeds Received THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENT/ALIAX INFORMATION SHOULD BE DIRECTED TO: I NAME COMPLETE r<tAILlNG ~.oDRESS , Richard C. Snelbaker 44 West Main Street FIRM NAME (If Applicable) KXJ 2_ Supplemental Retum ~ Remainder Return (date of deal" pflor 10 12-13-62, D 4a. Future Inlerest Compromise (dale of death after 12-12-82) D ~ederal Estate Tax Return Required D 7 Decedent Mai~tained a Living Trust (A:tach copy of Trust) _ 8 Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit idat, 0' death belwee- 12-31.91 ond 1-1.901 D 11. Election to tax under Sec. 9113(A) (A'<8'h So" 0) REGISTER OF VIIILLS SOCIAL SECURITY NUMBER I I- Z w o z o 0- If) ~ . Snelbaker & Brenneman, ~ """"0", NUMe" 717-697-8528 1 Real Estate (Schedcle A) P.C. Mechanicsburg, PA 17055 (1) OFFiCIAL U SE ?}'!.~ Y r::"':") 2. Stocks and Bonds (Schedule B) (2) (- 3 Closely Held Co'poration, Parlnership oc Sole-Proprietorship (3) 4 r'/Grtgages & Notes Receivable (Scheduie D) (4) 5 Cash. Bank DepOSits & Miscei:aneous Personal Property (Sched;";le E} (5) Z 6. Jointly O\Wled Property (Schedule F) (6) 0 D Separate Billing Requested 1= :3 7 1.11er-Vivos Transfers & Miscellaneous Non-Probate Property (7) ::::> (Schedule G or L) C: c.. 8 Total Gross Assets (total Lines 1.7) <x: 0 W 9. Funeral Expenses & Administrative Costs (Schedule HI (9) e::: 10. Debts of Decedent. Morlgage liabilities. & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) c' . 11 r,) :l-.-"" -f , ;)1: , , .- , it ~ ] .-; -J ":'-t )-- co ..- .... .r- 495.00 495.00 13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 0.00 0.00 14 Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 , 15_ Amount of Line 14 taxable at the spousal tax z rate, or transfers under Sec. 9116 (a)(1.2) o ~ 16. Amount of Line 14 taxable at lineal rate I- :::) ~ '7 Amount of Line 14 taxable at sibling rate o , U 1'8 A.moum of Line 14 taxable at collateral rate ~ :,9 Tax Due ~ 20. 0 ~'-,-j=l;l:(~tlj=!-lil~ > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 0.00 x .0 ~(15) 0.00 x .0 ~(1B) 0.00 x 12 (17) 0.00 x 15 (18) (19) 0.00 0.00 0.00 0.00 0.00 3W4645 : 000 Decedent's Complete Address: S1REET ADDRESS Claremont Nursin Home, 100 Clar Cumberland County CITY Carlisle STATE PA ZIP 17013- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A Spousal Poverty Credit 8. Prior Payments C. Discount (1) 0.00 0.00 0.00 0.00 3. Interest/Penalty if applicab/e D. Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 0.00 0.00 Tota/lnterest/Penalty (0 + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + 5A This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the prom ise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . " D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " D ~ 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 perjury, I declare that I have examined this ralum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete Deel aration of preparer other than the personal representative is based on all information of which preparer has any knowledge Yes No D D D D ~ ~ ~ ~ ~ [Jg I 32 Fie1dcrest Drive,Mechanicsburg, PA 17050 t~%? Richard C. Snelbaker, Esquire 44 West Main Street,Mechanicsburg, PA 17055 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 PS 89916 (a) (1 1) (i)l. 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. 89116 (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 stili 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 PS 89116(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 PS. 9 9116(1.2) [72 PS 9 9116(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 PS. 9 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. 3W4646 1 000 REV-15GB EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Virqinia E. Bender Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 06 0563 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Monumental Life Insurance Company Iproceeds from life insurance policy on life of Evelyn R. . Bender, Decedent's sister who died 10/13/2001. 495.00 3W46AD 1000 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 495.00 'REI1-1511 E':< + (12.99) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Virginia E. Bender ITEM NUMBER A B. 1. 2. Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: None ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Robert F. Bender Social Security Number(s) I EIN Number of Personal Representative(s) 179-12-4005 Street Address 32 Fieldcrest Drive City Mechanicsburg State PA Zip 17050 Year(s) Commission Paid: Attorney Fees Snelbaker & Brenneman, p.e. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Ciaimant Street Address City State Zip 4. Probate Fees Relationship of Claimant to Decedent 5. Accountant's Fees 7. 6. Tax Return Preparer's Fees 1 3W46AG 1.000 Register of Wills filing fee for Supplemental Inheritance Tax Return TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 06 0563 AMOUNT 24.75 225.00 15.00 $ 264.75 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Virginia E. Bender SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 06 0563 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Commonwealth of Pennsylvania Class 3 claim in the amount of $32,001.98 and a class 6 claim in the amount of $306,025.19 230.25 3W46AH 2000 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 230.25 . REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Virainia E. Bender 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J Robert F. Bender 32 Fieldcrest Drive Mechanicsburg, PA 17050 FILE NUMBER 21 06 0563 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I Brother 0.00 I I ! ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 LROUGH 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 3W46AI 1.000 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