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HomeMy WebLinkAbout02-14-08 (2) l .~ REV . ,... Ell . (I.IOJ . OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 08 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 171-28-7007 COMMONWEAL Tli OF PENNSYlVNlIA DEPARTMENT OF REVENUE DEPT. 2eoeo1 HARRISBURG. PA 17128-0801 0028 NUMBER ... Z lU Q lU hl Q ECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Stone, Roy Harold DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 11/18/2007 06/22/1914 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) Stone, Jean E. 204-01-2043 o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ~ 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 1. Original Return 0 I! 0 4. Limited Estate 181 :.:~~ fdD.8 181 6. Decedent Died Testate (Attach copy ISI :z:i-J (JD.III of Will) ~ 0 9. LitigationPr~sR~ed 0 .... cnz lUlU D:Q D:z 8~ 2. Supplemental Return 4a. 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 of death between 19 9 --~~~-~~~~--'-' -~--- _ ___m.~_... ~-----~ _ -- --- _ -- - .:~--~- -~--'----~' -- _..-~-., ----=:~- .' '." " ~>>. ., , :i:, ~ . ME Thomas J. Ahrens IRM NAME (If applicable) Ahrens Law Firm, P .C. COMPLETE MAILING ADDRESS 52 Gettysburg Pike Mechanicsburg, PA 17055 (1 ) None (2) 49,556.48 (3) None (4) None (5) None (6) None (7) 616,599.80 (8) (9) 26,798.66 (10) 198.00 666,156.28 ELEPHONE NUMBER 717/697-1800 f',,) z o 5 ~ ~ 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 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) ~":OE:PAL USE @ ...~ ~~t ~~ g --- ":"'':7 r-n ,.r~., , ;.;.-..... ,J:;- "''', ~::l e N (11 ) 26,996.66 639,159.62 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 639,159.62 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 134,769.38 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 504,390.24 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ~ ~ -~--~~-"--- ::;) lL 17. Amount of Line 14 taxable at sibling rate x .12 (17) s 0 (J ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 22,697.56 22.697.56 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Form REV-1500 EX (Rev. 6-(0) Copyright 2000 form software only The Lackner Group, Inc. .l'^ . Decedent's Complete Address: STREET ADDRESS 7 N. Railroad Avenue CITY I STATE PA JZIP 17055 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 1,134.88 Total Credits (A + B + C) 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty (D + 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 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) 22,697.56 (2) 1,134.88 (3) 0.00 (4) (5) 21,562.68 (5A) (5B) 21,562.68 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS y~ I 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 promise 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?...................................................................................................................... 3. Did decedent own an "in trust 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?..................................................................................................................... D ~ ~ ~ D 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 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 aU infonnalion of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Jeaa E. Stoat 7 N. Railroad Avenue Mechanicsburg, PA 17055 ADDRESS DATE 2-11-1/1 DATE ADDRESS DATE '- .---- 52 Gettysburg Pike Mechanicsburg, PA 17055 .z-- 11/0/ 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% [12 P.S. ~9116 (a) (1.1) (i}J. 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) (iin. The statute does not exemDt 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 0% [72 P.S. 99116 (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. ~9116 1.2) [12 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 12% [12 P .5. ~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. . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold ~L~ ~UMBER 21 - 08 - 0028 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 I DESCRIPTION I Dryfus Premier State Muni BdFd PA-Class A I UNIT VALUE VALUE AT DATE OF DEATH 15.89 49,556.48 TOTAL (Also enter on line 2, Recapitulation) 49,556.48 . SCHEDULE G ~ l_ INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY I FILE NUMBER Stone, Roy Harold . 21 - 08 - 0028 This schedule must be completed and flied If the answer to any of questions 1 through 4 on page 2 Is yes. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ITEM NUMBER DESCRIPTION OF PROPERTY Indude the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed for real estate. 1 7 N. Railroad Avenue property in the Roy Harold Stone: Living Trust dated November 2, 1999 . DATE OF DEATH I VALUE OF ASSET I %OF DECO'S INTEREST EXCLUSION (IF APPLICABLE) 84.912.00 84,912.001 100% , i I i ! i 18.507.401 100% I I i 11,904.011 100% I i ! ! 379,074.431 100% i 20,000.001 100% f 19,978.861 50% 2 17 E. Strawberry Avenue property in the Roy Harold Stone Living Trust dated November 2, 1999 f I i i I I 671.991 I 38,720.131 100% 100% 3 PNC Bank CD # 31600213634 in the Roy Harold Stone Living Trust dated November 2, 1999 I 52,820.411 100% I I TAXABLE VALUE 18,507.40 11,904.01 379,074.43 20,000.00 9,989.43 671.99 38,720.13 52,820.41 TOTAL (Also enter on line 7, Recapitulation) 616,599.80 4 USB Financial Services, Inc. investment account # AH 00084 38 in the Roy Harold Stone Living Trust dated 11/2/1999 5 Thrivent Annuity Contract # LC3347849, spouse is the : beneficiary , 6 AIG Sun America Annuity # A634050528D, spouse is the beneficiary 7 Citizens Bank IRA # 6140-169704, spouse is the beneficiary 8 Citizens Bank Checking account # 610070-686-9 in thei, Roy Harold Stone Living Trust dated November 2, 1999 9 Citizens Bank Money Market account # 620116-689-4 i in the Roy Harold Stone Living Trust dated Novenber 2, 1999 . SCtEDlI.E H RN:RAL EXPENSES & AIlVNSTRA11VE COSTS COMMONWEALTH OF PENNSYWANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold Debts of decedent must be reported on Schedule I. ITEM ! NUMBER I FUNERAL EXPENSES: I A. 1! Funeral Home I FILE NUMBER 21 - 08 - 0028 DESCRIPTION AMOUNT 6,025.00 2 Funeral luncheon 259.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip 2. Year(s) Commission paid Attorney's Fees Ahrens Law Firm, P.C. 16,650.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Jean E. Stone Street Address 7 N. Railroad Avenue City Mechanicsburg Relationship of Claimant to Decedent 3,500.00 State P A Spouse Zip 17055 132.00 4. Probate Fees Register of Wills 5. Accountant's Fees 6. Tax Return Prepare(s Fees 7. Other Administrative Costs 1 Estate notices 217.66 Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 15.00 26,798.66 . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold 2 PA Inheritance Tax filing fee SchecUe H FtnIaI Elcpensss & Amnshc4NeCosisconli'uJd _I ~~E NUMBER 21 - 08 - 0028 I I I I I I I I 15.00 Page 2 of Schedule H '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX REnJRN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold I FILE NUMBER 21 - 08 - 0028 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Quantium Imaging 198.00 TOTAL (Also enter on Line 10, Recapitulation) 198.00 REV.1513 EX. (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold I FILE NUMBER 21 - 08 - 0028 ! RELATIONSHIP TO I ; AMOUNT OR SHARE I i NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT i OF ESTATE I Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) i i 1 I Jean E Stone Spouse 30,661.42 I i 7 N. Railroad Avenue, Mechanicsburg, PA 17055 ; i 2 I Roy Harold Stone Beneficiary Trust Trust 608,498.20 I 7 N. Railroad Avenue, Mechanicsburg, PA 17055 I I ! I I ! j ; r I i ; I Enter dollar amounts for distributions shown above on lines 15 through 18, as appropria e, 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 REV.1514 EX+ (9.00) . SCI-EDll.EK J LFE ESTAlE, AtftJTY & 1ERNI CERTAIN (Check Box 4 on Rev-1500 CouerSheel) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 08 - 0028 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 on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. o Will ~ Intervivos Deed of Trust 0 Other ESTATE OF Stone, Roy Harold NAME(S) OF LIFE TENANT(S) G TERM OF YEARS LIFE ESTATE IS Jean E. Stone 09/27/1915 NEAREST A EAT DATE OF DEATH PAYABLE 92 ~ Life or o Term of Years o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years DATE OF BIRTH 1. Value of fund from which life estate is payable $ 608,498.20 .17109 2. Actuarial factor per appropriate table Interesttable rate - 031/2% 06% D 10% D Variable Ratt Value of life estate (Line 1 multiplied by Line 2) 5.2% $ 104.107.96 ._--~ o Life or o Life or o Life or o Life or TERM OF YEARS ANNUITY IS PAYABLE o Term of Years o Term of Years o Term of Years o Term of Years NAME(S) OF ANNUITANTS NEAREST AGE AT DATE OF BIRTH DATE OF DEATH 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 Hi-weekly (26) 0 Monthly (12) 0 Quarterly (4) o Semi-annually (2) 0 Annually (1) 0 Other 3. Amount of payout per period 4. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interesttable rate - 031/2% 06% 010% 0 Variable Rat<< 6. Adjustment Factor (see instructions) 0.00 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 HOlE: 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, 15, 16, 17 and 18. REV.1647 EX+ (9-00) . SCI-EDULE M FlITl.R:... ~TCCM=ROMSE (Check Box4a on Rev-1500 CowrSheel) COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold I FILE NUMBER 21 - 08 - 0028 This schedule Is appropriate only for Estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and 11 enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return o Will 181 Trust 0 Other I. Beneficiaries NAME OF BENEFICIARY 1. Jean E. Stone 2. Rickie J. Cook 3. 4. 5. II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal ri~. U Unlimited right of withdrawal 181 Limited right of withdrawal III. Explanation of Compromise Offer: Spouse will withdraw $104,107.96 for her future needs, balance will go to the daughter upon the death of the spouse. RELATIONSHIP Spouse Daughter ---- DATE OF BIRTH 09/27/1915 04/18/1945 ta:ro NEARESTBRTH:lAY 92 63 Cl IV. Summary of Compromise Offer: 1 . Amount of Future Interest: 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 0 6% 0 3% 181 0% (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate 06% 1814.5% (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) 608,498.20 104,107.96 504.390.24 608,498.20 . ~~~9113(A) (SPOUSAl.. DIS1RBJT1ONS) COMMONWEAllli OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER 21 - 08 - 0028 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Roy Harold Stone Beneficiary Trust Trust (marital, residual A, B, By-pass, Unified Credit, etc.). Stone, Roy Harold If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. 1 DESCRIPTION 7 N. Railroad Avenue, Mechanicsburg VALUE 84,912.00 2 17 E. Strawberry Avenue, Mechanicsburg 18,507.40 3 PNC Bank CD # 31600213634 11,904.01 4 USB Financial Services, Inc. account # AH 00084 38 379,074.43 5 Citizens Bank Money Market account # 620116-689-4 52,820.41 6 3,118.721 shares of Dryfus Premier Muni BdFd PA-Class A 49,556.48 Total of Continuation Schedule(s) Part A Total 11,723.47 608,498.20 Part B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. DESCRIPTION VALUE 1 7 N. Railroad Avenue, Mechanicsburg 84,912.00 2 17 E. Strawberry Avenue, Mechanicsburg 18,507.40 3 PNC Bank CD # 31600213634 11,904.01 4 USB Financial Services, Inc. account # AH 00084 38 379,074.43 5 Items # 5, 6 and 7 I Part B Tot;Il (If more space is needed, insert additional sheets of the same size) 114,100.36 608,498.20 . SCI-EDlI..E 0 8..ECTION IN:ERSEC. 9113(A) (SPOUSAL CIS1RBJT1ONS) conIi1ued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Stone, Roy Harold FILE NUMBER 21 - 08 - 0028 Part A, Continued: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. 7 DESCRIPTION Balance of Citizens Bank checking account # 610070-686-9 after estate deductions/expenses VALUE 11,723.47 Page 2 of Schedule 0 Part A ESTATE OF 5 6 7 SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) Part B continued Stone, Roy Harold FILE NUMBER 21-08-0028 Citizens Bank Money Market account # 620116-689-4 All shares of Dryfus Premier Muni BdFd PA-Class A Balance of Citizens Bank checking account 52,820.41 49,556.48 11,723.47 Ahrens Law Firm, P .C. I"~ "<<ii Gettysburg Pike ]i i;# :i ~chanicsburg, PA 1705i- .. · ..a ... 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