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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 07
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
00603
NUMBER
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Beebe, Douglas T.
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
06/01/2007
02/02/1939
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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~ 1 Original Return
D 4. Limited Estate
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NAME
Debra K. Wallet
6, Decedent Died Testate (Attach ccpy
of Will)
9. Litigation Proceeds Received
D 2,
D 4a.
D 7,
D
Supplemental Return
274-34-3010
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Future Interest Compromise (date of death after
12-12-82)
Decedent Maintained a Living Trust (Attach
copy of Trust)
10, Spousal Poverty Credit (date of death between
1-1-95)
D 3, Remainder Retum (date of death prior to 12.13-82)
D 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11, Election to tax under Sec. 9113(A) (Attach Sch 0)
FIRM NAME (If applicable)
, Law Offices of Debra K. Wallet
rfELEPHONE NUMBER
717/737-1300
1, Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3, Closely Held Corporation, Partnership or Sole-Proprietorship
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4, Mortgages & Notes Receivable (Schedule D)
5, Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
D 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)
12, Net Value of Estate (Line 8 minus Line 11)
COMPLETE MAILING ADDRESS
I
I 24 North 32nd Street
I Camp Hill, PA 17011
i
I
(1 ) None
(2) 233,755.06
(3) None
(4) None
(5) 72,266.73
(6) None
(7) 346,017.18
(8)
(9) 13,651.01 -- I
(10) 7,328.75
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(11 )
20,979.76
631,059.21
(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)
631,059.21
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
28,397.66
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
28,397.66
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Copyright 2000 form software only The Lackner Group, Inc.
15, Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under See, 9116(a)(1 ,2)
z 631,059.21 .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
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19. Tax Due (19)
Form REV-1500 EX (Rev. 6-00)
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Beebe, Douglas T.
FILE NUMBER
21 - 07 - 00603
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
1 Columbia Acorn Int'l Fund 45.89 67,783.52
2 Vanguard Health Care Fund 156.65 41,370.48
3 Mairs & Power Gr. Fund 84.30 46,842.56
4 150 shares BP 67.61 10,141.50
5 400 shares Eagle Bulk Shipping 22.44 8,976.00
6 500 shares General Electric 37.45 ! 18,725.00
7 1000 shares Knight Transport 19.06 19,060.00
8 600 shares Commerce Bancp. 34.76 20,856.00
TOTAL (Also enter on line 2, Recapitulation)
233,755.06
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Beebe, Douglas T.
FILE NUMBER
21 - 07 - 00603
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.
ITEM
NUMBER
I 1996 BMW 528Si
DESCRIPTION
VALUE AT DATE OF
DEATH
5,000.00
2
Dell Laptop
300.00
3
Household items (including books, stereo, LPs and CDs, clothing, bedroom furniture, desk, Queen Anne
side table and chairs, dining room set, microwave - many items donated to Salvation Army and Shining
Light Thrift Shop)
300.00
4 Wedding ring 25.00
5 Power tools 25.00
6 HP B/W laser printer 100.00
7 PSECU checking account - Share 04 82.82
8 PSECU savings account - Share 0 I 44.31
9 Vanguard Money Market Prime 53,069.00
10 TD Bk. Money Market Account 12,672.00
11 Cash in possession of Decedent 100.00
12 PNC checking account #50-7001-1744 255.86
13 Com cast refund 6.15
14 State Farm refunds 107.94
15 EZ Pass refund 16.79
16 Columbia Acorn class action settlement proceeds 161.86
TOTAL (Also enter on Line 5, Recapitulation)
72,266.73
.
SCHEDULE G I uu
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Beebe, Douglas T.
FILE NUMBER
21 - 07 - 00603
ITEM
NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY I % OF I
. DATE OF DEATH EXCLUSION
i Include the name of the transferee. their relationship to decedent and the date of transfer. VALUE OF ASSET DECD'S TAXABLE VALUE
. Attach a copy of the deed for real estate I NTEREST (IF APPLICABLE)
Fidelity Traditional IRA #2AJ-469696 58,221.00 100% I 58,221.00
I
2 TDAmeritrade Roth IRA #885-024759 106,987.00 100% 106,987.00
3 Great-West Retirement Services Deferred Comp Plan 180,809.18 100% 180,80918
#78978-01
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TOTAL (Also enter on line 7, Recapitulation)
346,017.18
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Beebe, Douglas T.
SCHEDULE H
FUN:RAl.. EXPENSES &
ADMINISlRATIVE COSTS
FILE NUMBER
21 - 07 - 00603
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
2.
FUNERAL EXPENSES:
Neill Funeral Home
2
Pealers Flowers
DESCRIPTION
AMOUNT
Social Security Number(s) / EIN Number of Personal Representative(s):
City
Relationship of Claimant to Decedent
Probate Fees
5. Accountant's Fees
3
Patriot News (obituary)
4
JDK Catering (memorial service)
State
Zip
5
Staples (supplies for memorial service)
Attorney's Fees
Debra K. Wallet, Esq.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
4.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Street Address
City
Year(s) Commission paid
State
Zip
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Smart Move Makers (moving & cleanup services)
2
Christian Baker Co. (Administrator's bond)
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
470.00
94.29
169.49
986.81
24.12
7,500.00
462.00
695.00
3,000.00
249.30
13,651.01
ESTATE OF
4
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Beebe, Douglas T.
3
Schedule H
Funeral Expenses &
Administrative Cos1s continued
Cumberland Law Journal (advertisement of grant ofletters)
5
Postage, photocopies, mileage, etc.
Patriot News (advertisement of grant ofletters)
FILE NUMBER
21 - 07 - 00603
Page 2 of Schedule H
75.00
114.30
60.00
ESTATE OF
*'
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Beebe, Douglas T.
FILE NUMBER
21 - 07 - 00603
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Loyalton of Creek view (June rent)
DESCRIPTION
AMOUNT
593.00
2
State Farm Insurance (car and renters insurance)
334.20
3
West Shore Ambulance
642.11
4
Pinnacle Health
111.30
5
Omnicare Pharmacy
129.79
6
Chase Credit Card
40.00
7
Lincare (oxygen)
15.00
8
Pinnacle Health Hospitals (medication)
15.00
9
Verizon Wireless
21.03
]0
Verizon
9.03
I]
DCM Services (collection agent for Citibank and AT&T credit cards)
],739.67
12
US Treasury (2006 federal income taxes)
3,152.90
13
P A Department of Revenue (2006 state income taxes)
525.72
TOTAL (Also enter on Line 10, Recapitulation)
7,328.75
REV-1513 EX+ (9-00)
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Beebe, Douglas T.
FILE NUMBER
21 - 07 - 00603
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT
Do Not L.ist Trusteejs)
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Lisa C. Jennings
60 Main Street
Exeter, NH 03833
Daughter
/2 of residuary Estate
2 Jonathan G. Beebe
100 Overlook Road
Montclair, NJ 07043
Son
1/2 of residuary Estate
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
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Decedent's Complete Address:
STREET ADDRESS
CITY
Mechanicsburg
STATE PA
()rl'y~ \ S j91\Q4<,r-~
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1100 Grandon Way, Apt. 620
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
24,000.00
1,263.16
Total Credits (A + B + C)
(2)
25,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penally (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 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 3,134.50
(5A)
(5B) 3,134.50
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;.......................................... .............................. D ~
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d. receive the promise for life of either payments, benefits or care?............. ....................... ........................ D IOiI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?................ ........................ ................. .......... ..................... ................... ........... D ~
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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?................. ........................ ................. ........... ..................... .................. .........
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 accompany,ng 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 RESPONSIBLE FOR FILING RETURN ADDRESS DATE
Lisa C. Jeu iugs "
60 Main Street 2("bio! 0 '(
Exeter, NH 03833
ADDRESS DATE
100 Overlook Road Z/zq lor
Montclair, NJ 07043
ADDRESS DATE
24 North 32nd Street ~I '-l/ ~oop'
Camp Hill, PA 17011
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 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 0%
[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 0% [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 4.5%, 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 12% [72 P.S. ~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.