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HomeMy WebLinkAbout01-30-08 (2) -.J 15056051058 REV-1500 EX (06-05) PA Department of Reveooe '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFACIAL USE ONLY CoI.rlty Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT 21 07 File Number 00553 Date of Birth 186-16-2740 05/01/2007 04/11/1918 Decedent's Last Name Suffix Decedenfs First Name MI Dodson John T (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name Suffix Dodson Spouse's First Name Jean MI F Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVAlS BELOW . 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required . 4. Umited Estate 48. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date 01 death 11. EJection to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTlOH MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIOEN11AL TAX INFORIIATlON SHOULD BE OIRECTEO TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Win) 9. Utigation Proceeds Received o 8. Total Number of Safe Deposit Boxes John DeLorenzo, Esq. FIf1Tl Name (If Applicable) 982-0460 FllSt line of address 1118 Pine Road " -,..-: REGIS~OF WILLS U~NLY C C~ ~-O -:3? (... . :"~ -"'-. <..oJ o :'~.: '..j) Second line of address , ..~-.. ~ J:;,-' ::J{; ")-:-:-= City or Post Office Carlisle State ZIP Code 17015 f~~FILED N PA Conespondenfs &-mail address: Under penalties of peljury, I declare thaI I haw examined ... return. including 8CCOIr1pIII1yin 8CheduIes and stal8menls. and to the best of my knowledge and belief. II is true. correct and CXll\1lI8le. Declaration of preperer olher then the pensonaJ repI-utIve Is based on III information of which preperer has 8I'I'f knowledge. OF P ON UNG RETURN 0,6; 15 OTHER THAN REPRESENTATIVE PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 --.J --.J 15056052059 REV-1500 EX Decedenrs Name: John T Dodson RECAPITULATION 1. Real estate (Schedule A). ...... . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . .. . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or SoIe-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) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 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 BequeslslSec 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 APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .oJL 380,429.00 15. 16. Amount of Line 14 taxable at lineal rate X.O 45 852,796.40 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable 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 15056052059 Side 2 186-16-2740 Decedent's Social Security Number 163,980.00 886,745.85 178,096.57 69,787.87 1,298,610.10 60,013.15 5,371.61 65,384.76 1,233,225.40 1,233,225.40 0.00 38,375.84 . 15056052059 --.J REV-1500 EX Page 3 Decedent's Complete Address: 21 FHe Number 07 00553 DECEDENT'S NAME DECEDENrS SOCIAL SECURITY NUMBER John T Dodson 186-16-2740 STREET ADDRESS 22 Ridge Lane CITY I STATE , ZIP Newville PA 17241 Tax Payments and Credits: 1. Tax Due (Page 2 line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 38,375.84 40,000.00 1,918.79 Total Credits ( A + B + C ) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty 41,918.79 TotallnterestlPenalty ( D + E ) (3) 4. If line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. FHI in oval on Page 2, Une 20 to request a refund. (4) 3,542.95 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. (5) (SA) (58) B. Enter the total of line 5 + 5A. This is the BAlANCE DUE. 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; .......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [KI c. retain a reversionary interest or.......................................................................................................................... 0 IiJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [KI 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [KI 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? ........................................................................................................................ 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) Oi)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fi6ng a tax retum 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 decedenfs 6neal beneficiaries is four and one-halt (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)J. The tax rate imposed on the net value of transfers to or for the use of the decedenfs sib6ngs 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. REV-;"" EX' (~"'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF John T. Dodson FILE NUMBER 21-07 -0553 AU real property owned solely or IS a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Property located at 1060 Roxbury Road, Newburg, PA 17240 (valued per county assmt.) VALUE AT DATE OF DEATH 163,980.00 TOTAL (Also enter on 6ne 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 163,980.00 REV:'." ex. ''''',* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF John T. Dodson FILE NUMBER 21-07-0553 All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE OF DEATH 2 3 4 5 6 7 8 DESCRIPTION Ferris Baker Watts Acct. #2675-9696 (valued per attached Exhibit) Oppenheimer Acct. #A09-OO14315 (valued per Stmt) Sixteen $1,000 Series EE Bonds Nos: M16734412-27 (valued per Bank) 1342 Shrs. ACM Managed Dollar Income Fund at $8.12 per share per Dow Jones 1434 Shrs. Alliance World Dollar Govt Fund at $12.76 per share per Cow Jones 315,187.60 137,617.00 25,328.00 10,897.04 18,297.84 146,306.08 2888 Shrs. American Electric Power Co. at $50.66 per share per Dow Jones 879 Shrs, MFS Muni High Income Fund at 8.51 per share per Cow Jones 5128 Shrs. PPL Corp. at $44.00 per share per Dow Jones 7,480.29 225,632.00 886,745.85 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REv-150B EX+ (6-9B) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF John T. Dodson FILE NUMBER 21-07-0553 ITEM NUMBER Indude the proceeds of litigation and the date the proceeds were received by the estate. All property joinUy-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION VAlUE AT DATE OF DEATH 1 ACNB Checking Acct. # 221627 (valued per attached letter from Bank) 2 ACNB five Cert. of Deposits Nos.:172513-17 (valued per attached Bank Itr.) 101,737.72 76,358.85 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 178,096.57 REV-l50S EX+ (6-S8* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLy-oWNED PROPERTY ESTATE OF FILE NUMBER If an asset was made joint within one yeaf of the dec:edent's date of death, it must be reported on Sc:hedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Jean F. Dodson 22 Ridge Lane, Newville, PA 17241 Spouse B. c. JOINTLY-OWNED PROPERTY: LETTER DAlE DESCRIPTION OF PROPERTY %OF DAlE OF DEATH IlEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER DR SIMIlAR DATE OF DEATH DECO'S VAlUE OF NUMBER lENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOtNTlY-HELD REAL ESTAlE. VALUE OF ASSET IN1EREST DECEDENT'S IN1EREST 1. A. 06117/95 Bank of New York Accts. 361443 & 2616694 12,486.44 50 6,243.22 2 A 05119/05 ACBN Acct. 2263424 5,683.51 50 2,841.81 3 A 05/19/05 ACNB C/O #165245 26,082.00 50 13,041.00 4 A 01101/00 Ferris Baker Acct. 2676-3228 47,865.68 50 23,932.84 5 A 01/01/05 Oppenheimer Acct. A09~023928 43,958.00 50 21,979.00 6 A 10/05/97 1998 Buick Century (valued per Kelly Blue Book) 3,500.00 50 1,750.00 TOTAL (Also enter on line 6, Recapitulation) $ 69,787.87 (If more space is needed, insert additional sheets oUlle same size) REV-l0511 EX+ (12-99* COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF John T. Dodson FILE NUMBER 21-07-0553 Debts of decedent must be reported on Schedule L ITEM NUMBER A. AMOUNT B. 1. 2. 3. 4. 5. DESCRIPTION 1. FUNERAL EXPENSES: Egger Funeral Home, Inc. - funeral Carlisle Memorial Service, Inc. - engraving Memorial Service Expenses 6,938.75 194.00 306.35 2 3 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Elizabeth Worley Social Security Number(s)/ElN Number of Personal Representatiye(s) StreetAddress 31 Church Road City Carlisle Slate PA Zip 17015 Year(s) Comnission Paid: 2007 35,000.00 Attorney Fees 10,000.00 Famiy Ex~: (If decedenfs address is nollhe same as claimant's, attach explanation) Claimant Jean F. Dodson Street Address 22 Ridge lane City Newville 3,500.00 Slate PA .Zip 17241 Relationship of Claimant In Decedent spouse Probate Fees 450.00 Accountant's Fees 450.00 6. Tax Reun Preparer's Fees 7. Erie Insurance - home insurance TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert adcitional sheets of the same size) 380.00 2,280.98 158.91 40.00 16.70 297.46 $ 60,013.15 8. Frances Oiler - Tax CoUector (prop. taxes) 9. Storage Units for Estate Property 10. Cumberland County Recorder of Deeds 11. US Post Office - certified mailing 12. legal Publications (SentieJ and Cumberland law Journal) REV:1512 EX. (12-m) . COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABlunES, & UENS ESTATE OF John T. Dodson FILE NUMBER 21-07-0553 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. US Treasury - income taxes (est.) 3,827.00 2. PA Dept. of Revenue - income taxes (est.) 700.00 3. Presbyterian Homes, Inc. - medical expenses 154.78 4. Continuing Care Rx - medications 1.95 5. Swaim Health Care Center - medical expenses 211.58 6. The Clock Doctor - dock repairs 376.30 7. Green Ridge Village - care expense 100.00 TOTAL (Also enter on Una 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,371.61 . ' REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John T. Dodson FILE NUMBER 21-07-0553 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trus1Ile(s) OF ESTATE I TAXABLE DISTRIBUTIONS PncIude oulright spousal distributions. and transfers under Sec. 9116 (a) (1.2)) 1. Jean F. Dodson Spouse 380,429.00 2. John H. Dodson, Sr. Son 385,403.20 3. Jeanne C. Dodson Daughter in Law 40,995.00 4. John H. Dodson, Jr. Grandson 40,995.00 5. Jessica A. Dodson Granddaughter 40,995.00 6. Elizabeth Worley Daughter 344,408.20 ENTER DOUAR 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 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) REV~1514 EX+ (12-03) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K UFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on REV-1500 Cover Sheet ESTATE OF John T. Dodson RLE NUMBER 21-07-0553 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. IBI Will 0 Intervlvos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF UFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TEAll OF YEARS DATE OF DEATH UFE ESTATE IS PAYABLE Jean F. Dodson (spouse) 10/08/1924 83 BI Life or 0 Term of Years o Life or 0 Term of Years o Life or 0 Term of Years o Life or 0 Term of Years o Life or 0 Term of Years 1. Value of fund from which life estate is payable . . . 00 . . . . . . . . . . . . . . . . 00 . . . . . . . . . . 00 . . . . . 00$ 2. Actuarial factor per appropriate table ................................................. Interest table rate - 0 3 1/2% i16% 0 100/0 0 Variable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) ......................................$ 999,475.00 0.31081 310,641.00 ANi.JUITY INTEREST CALCULATION NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUn'Y IS PAYABLE o Life or 0 Term of Years - o Life or 0 Term of Years o Life or 0 Term of Years o Life or 0 Term of Years - 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Check appropriate block below and enter corresponding (number) ....... . . . . . . . . . . . . . . . . . . . Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) 0 Monthly (12) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( ) 3. Amount of payout per period . . .. . . . . . . . . . . 00 . . . . . . .. . . .. . .. .. . . . .. . 00 . . . . . . . . . . . . . . .$ 4. Aggregate annual payment, Line 2 multiplied by Une 3 ................................... 5. Annuity Factor (see instructions) Interest table rate - 031/2% 06% 0 10% 0 Variable Rate % 6. Adjustment Factor (see instructions) .................................................. 7. Value of annuIty - If using 31/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . .$ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 ..................................................$ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, insert additional sheets of the same size)