HomeMy WebLinkAbout10-01-08-~ REV-1500 15056041147
EX (O6-OS) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO 80X.280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 0 0 0 9 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
151200994 01052008 04251925
Decedent's Last Name Suffix Decedent's First Name MI
DENSHAM WILLIAM E
(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
® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death aker 12-12-82)
® g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
^ 9. Litigation Proceeds Received ^ 1 p, 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 TO:
Name Daytime Telephone Number
DEBRA K. WALLET 7177371300
:~,
Firm Name (If Applicable)
LAW OFFICES OF DEBRA K. WALLET
First line of address
24 NORTH 32ND STREET
Second line of address
City or Post Office
CAMP HILL
State ZIP Code
PA 17011
REGISTER O~S USE ~Y
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DATE~FILED '-
Correspondent'se-mailaddress: Walletdeb~aol.COm
Under penalties of perjury, 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 preparer other than the personal representative rs based on all information of which preparer has arty knowledge.
ADDRESS
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844 Kiehl Drive, Lemoyne, PA 17043
William J. Densham
~~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
L.O~.tkIC . t,Jc~,u..,t- Debra K. Wallet ~. 3nT ocY
ADDRESS
24 North 32nd Street, Camp Hill, PA 17011
Side 1
15056041147 15056041147
15056042148
REV-1500 EX
o~ede~eSName: DENSHAM, WILLIAM EDWARD
Decedent's Social Security Number
1512 0 0 9 9 4
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... . 1.
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.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .................. .. 5. 1 3 6 , 5 1 7 . 0 1
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .............. 7, 31 , 4 4 9 . 3 6
8. Total Gross Assets (total Lines 1-7) ....................................................................... . 8. 1 F 7, 9 6 6. 3 7
9. Funeral Expenses & Administrative Costs (Schedule H) ........................................... . 9. 1 2, 5 9 4 6 9
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .................................. . 10. 3 , 2 9 7 . 4 2
11. Total Deductions (total Lines 9 & 10) ...................................................................... . t1. 1 5 , 8 9 2 . 1 1
12. Net Value of Estate (Line 8 minus Line 11) ............................................................. . 12. 1 5 2 , 0 7 4 . 2 6
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. 15 2 , 0 7 4 . 2 6
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 .00 15.
16. Amount of Line 14 taxable
at lineal rate x .045 15 2, 0 7 4. 2 6 16. 6, 8 4 3. 3 4
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. 6, 8 4 3. 3 4
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
15056042148 15056042148 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 08 - 00090
DECEDENT'S NAME
Densham, William Edward
STREET ADDRESS
8 Riddle Road
CITY
Camp Hill STATE
PA ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1} 6,843.34
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 6 , 0 0 0.0 0
C. Discount 315.79
Total Credits (A + g + C) (2) 6, 31 5.79
3. InterestlPenalty if applicable
p, Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box 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. (5) 527.55
A. Enter the interest on the tax due. (5A)
g, Enter the total of Line 5 + SA. This is the BALANCE DUE. (56) 5 2 7 . rJ RJ
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 :...........................................:....:.................................... ^ ^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 "in trust for' or payable upon death bank account or security at his or her death? ............... ^ ^x
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.
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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)]. 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 E
CASH, BANK DEPOSITS, & MISC.
'
COMMONWEALTH OF PENNSYLVANIA
.. PERSONAL PROPERTY
'
I NHERITANCE TAX RETURN
.
RESIDENT DECEDENT
I
FILE NUMBER
ESTATE OF Densham, William Edward 21 - 08 - 00090
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
DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 PNC Checking Account #51-4001-5792 37,827.82
2 PNC Money Market Account #50-503-4624 86,896.40
3 PNC Burial Certificate of Deposit #21001028253 8,004.29
4 Pistol 125.00
5 Rifle 115.00
6 Pocket watch 125.00
7 Furniture 200.00
8 Clothing 200.00
9 Cash in possession of Decedent 52.50
10 PPL Utilities refund 104.41
11 PA American Water refund 5.50
12 Verizon refund 11.98
13 Utility refund 52.90
14 PA Treasury -retirement 1,351.21
15 2007 Federal income tax refund 541.00
16 Economic Stimulus Rebate from US Treasury 600.00
TOTAL (Also enter on Line 5, Recapitulation) ~ 136,517.01
'' SCHEDULE E
', CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSVWANIA PERSONAL PROPERTY '~
INHERITANCE TAX RETURN i '
RESIDENT DECEDENT II COIItI PIUeC~
__ ____ _.
FILE NUMBER
ESTATE OF Densham, William Edward ~, 21 - 08 - 00090
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 DESCRIPTION .VALUE AT DATE OF
NUMBER DEATH
17 Firemans Fund Insurance refund 304.00
Page 2 of Schedule E
' SCHEDULE G
COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS ~
INHERITANCE TAX RETURN ~+
RESIDENT DECEDENT IIAI~C. NON-PROBATE PROPERTY
ESTATE OF Densham, William Edward FILE NUMBER
21 - 08 - 00090
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY
NUMBER Include the name of the transferee, their relationship to decedent
and the date of transfer. Attach a copy of the deed for real estate.
DATE OF DEATH ~ % OF
VALUE OF ASSET j DECD'S
i INTEREST
EXCLUSION TAXABLE VALUE
(IF APPLICABLE)
1 MetLife Invs USA fixed annuity
31,449.36 i 100%
31,449.36
TOTAL (Also enter on line 7, Recapitulation) ~ 31,449.36
CHmIA_E H
FUNERAL EXPENSES & ~~
COMMONWEALTH OP PENNSYLVANIA ~/~ n /~ ~+
INHERITANCE TAx RETURN ~~T IV'1T1 Y C ~~ 1 J
RESIDENT DECEDENT ~,
ESTATE OF Densham, William Edward FILE NUMBER
21 - 08 - 00090
_. --_
Debts of decedent must be reported on Schedule I.
-- -
ITEM I~
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 'David K. Dahlgren Funeral Home 7,633.94
228 N. Centre St., Philipsburg, PA 16866
2 Philipsburg Marble and Granite -Burial marker 1,080.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
William J. Densham
375.00
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 844 Kiehl Drive ~
city Lemoyne State PA zip 17043 ~i
Year(s) Commission paid 2008 ',
2. 'i Attorney's Fees Debra K. Wallet, Esq. 2,500.00
3. ~I Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
~I Claimant
4.
5.
s.
7.
1
Street Address
~' City State Zip
Relationship of Claimant to Decedent
~~ Probate Fees
Accountant's Fees
Tax Return Preparer's Fees Jackson-Hewitt (2007 tax prep)
Other Administrative Costs
Photocopies, postage, mileage, etc.
TOTAL (Also enter on line 9, Recapitulation)
'~ 341.00
178.95
50.00
12,594.69
Schedule H ~
COMMONWEALTH OF PENNSYLVANIA ', A,,~,~: {:~~^~
INHERITANCE TAX RETURN ~, /'~F.Y I tln~Y~ ~.~.7~ '~,
RESIDENT DECEDENT
------
ESTATE OF Densham, William Edward ,FILE NUMBER
21 - 08 - 00090
2 ,Mileage of William J. Densham, Co-Executor (73 miles at $0.505/mile) 36.87
3 Mileage of Alan J. Densham, Co-Executor (764 miles at $0.505/mile) ~ 385.82
4 Postage and photocopy expenses of Co-Executors 13.11
Page 2 of Schedule H
SCHEDULEI
DEBTS OF DECEDENpT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA '. LIABILITIES O LIENS
INHERITANCE TAX RETURN 7
RESIDENT DECEDENT
"FILE NUMBER
ESTATE OF Densham, William Edward 21 - 08 - 00090
Include unreimbursed medical expenses.
- _ - - -- -_
ITEM DESCRIPTION
NUMBER
1 Health Network Labs
2 Pulmonary and Critical Care Assoc.
3 Heartland Pharmacy
4 Manor Care Nursing Home
5 State Employees Retirement System
6 PPL Electric Utilities
7 Nephrology Assoc. of PA
AMOUNT
403.50
187.90
238.88
1,204.00
1,127.67
95.52
39.95
TOTAL (Also enter on Line 10, Recapitulation) 3,297.42
REV-1573 EX+ (9.00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
William Edward
Densham
, 21 - 08 - 00090
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I~ TAXABLE DISTRIBUTIONS[include outright spousal
distributions, and transfers
under Sec. 9116 (a) (1.2)]
1 William Jeremiah Densham Son 50% of Residuary
844 Kiehl Drive Estate
Lemoyne, PA 17043
2 Alan J. Densham Son 50% of residuary
288 Rainprint Lane Estate
Murrysville, PA 15668
Enter dollar amounts for distributions shown above on lines 15 t hrough 18, as appropriate, on Re v 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
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I, WILLIAM EDWARD DENSHAM, of Camp Hill, Cumberland County,
Pennsyivania, being of sound and disposing mind, memory, and understanding, do hereby
make, publish, and declare this to be my Last Will and Testament and hereby revoke all other
Wills and Codicils that I have made, including the Will dated February 23, 1984.
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~ FIRST: It is my wish, and I direct, that after my death, my body be buried in
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.; Allport Cemetery in Clearfield County. I further direct that the funeral arrangements be made
through Dahlgren - Gilham Funeral Home, in Philipsburg, Centre County, Pennsylvania.
c SECOND: I give, devise, and bequeath all of my Estate, of whatever nature and
:~
wherever situate, in equal shares, to my sons, WILLIAM JEREMIAH DENSHAM, of
~~
Harrisburg, Pennsylvania, and ALAN J. DENSHAM, of Greensburg, Pennsylvania, so long
as they each shall survive me by thirty (30) days. Should either of my -sons fail to survive me
N
by thirty (30) days, but be represented by children then living, these children shall take, per
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-~ J stirpes, the share to which my son would have been entitled if then living.
~' THIRD: Should neither of my sons nor any of my grandchildren survive me by
thirty (30) days, I give, devise, and bequeath all of my Estate, of whatever nature and
wherever situate, in equal shares, to my sister, DORIS ANN ROBERTS, of Greenbelt,
Maryland, and to my other sister, MARLENE KAY DIVINEY, of Morrisdale, Pennsylvania.
Should either of my sisters fail to survive me by thirty (30) days, but be represented by
children then living, these children shall take, per stirpes, the share to which that sister would
have been entitled if then living.
FOURTH: All interests of any beneficiary in the income or principal of this Estate,
while undistributed and in the possession of my Executor, even though vested and
distributable, shall not be subject to attachment, execution or sequestration for any debt,
contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to
pledge, assignment, conveyance, or anticipation.
FIFTH: All inheritance, estate, and succession taxes (including interest and any
penalties thereon) payable by reason of my death shall be paid out of and be charged generally
against the principal of my residuary estate without reimbursement from any person.
~~~ SIXTH: In addition to all rights and powers conferred by law, I authorize and
J
_ ~ empower my Executor and his successors, in his absolute discretion and without necessity of
obtaining court approval:
~,
A. To buy investments at a premium or discount.
b
~„ B. To hold property unregistered or in the name of a nominee.
C. To give proxies, both ministerial and discretionary.
~ D. To compromise claims.
E. To join any merger, consolidation, reorganization, voting trust
plan, or any other concerted action of security holders and to delegate discretionary duties
with respect thereto.
F. To lend to, and buy from, my estate.
G. To borrow and to pledge real and personal property as security therefor.
H. To sell at public or private sale for cash or credit or partly for each, to
exchange, or to lease for any period of time, any real or personal property, and to give options
for sales, exchanges, or leases.
I. To exercise any option permitted by law which he believes to be
1
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advantageous from the viewpoint of overall tax reductions, including, without limitation of the
foregoing, power and authority to claim administration or other expenses either as income tax
deductions or inheritance or estate tax deductions, without regard to whether they were paid
from principal or income and without requiring adjustments between principal and income for
any resulting effect on income or estate taxes, and a deduction of such expenses for income tax
purposes shall be given effect in computing the respective shares of all persons interested in
my estate set forth herein, even though the effect is to increase the share of one beneficiary or
class of beneficiaries hereunder at the expense of another; and to make such adjustments, if
any, between beneficiaries with respect thereto as he shall deem appropriate in view of the
nature of the transaction and the amounts involved.
J. To distribute in cash or in kind or partly. in each.
The powers granted hereunder shall be exercisable with respect to all real and personal
property, including, but not limited to, income and principal held for minors or disabled
beneficiaries at any time, until the actual distribution of all property. All powers, authorities
and discretion granted here shall be in addition to those granted by law and shall be
exercisable without leave of court. However, nothing herein shall be interpreted or construed
to encourage, authorize, empower, or permit the Executor to act or cause anyone to act in a
manner contrary to or inconsistent with accepted standards of portfolio diversification and risk
management.
SEVENTH: I nominate, constitute, and appoint my sons, WILLIAM JEREMIAH
DENSHAM and ALAN J. DENSHAM, as Co-Executors of this, my Last Will and Testament.
In the event of the renunciation, death, resignation, or inability of either of my sons to act for
whatever reason in this capacity, then I nominate, constitute, and appoint the other son to act
as sole Executor. In the event of the renunciation, death, resignation, or inability of both of
my sons to act for whatever reason in this capacity, then I nominate, constitute, and appoint
my sister, MARLENE KAY DIVINEY, as Executrix of this, my Last Will and Testament.
I direct that no representative named above shall be required to post security for the
faithful performance of his/her duties in any jurisdiction insofar as I am able by law to relieve
him/her of such obligation. Any of my representatives shall be entitled to reasonable
compensation for the performance of the duties set forth here.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this a ati`` day of
~~,~,~~ , 2000 , on this, the fourth of four typewritten pages. I have also signed the
left-hand margin of the first three of these pages for purposes of identification only.
~~9-f~-
- M
WILLIAM EDWARD DENSHAM
SIGNED, PUBLISHED, and DECLARED by the Testator, WILLIAM EDWARD
DENSHAM, as his Last Will and Testament, in the presence of us, who at his request, in his
presence, and in the presence of each other, have hereunto subscribed our names as witnesses.
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ACKNOWLEDGMEN
Commonwealth of Pennsylvania
County of Cumberland
I, WILLIAM EDWARD DENSHAM, Testator, whose name is signed to the attached
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will and Testament; that I signed it willingly; and that
I signed it as my free and voluntary act for the purposes therein expressed.
. ,
`,qq,~, ~}
Bt%~^*~- ~" .lac ~ -~siy..--
WILLIAM EDWARD DENSHAM
Sworn or affirmed to and subscribed before me by WILLIAM EDWARD DENSHAM,
the Testator, this ~~ day of S(~ ~ , 2000.
Notary Pu is
Notarial Seal
Marryy M. Loper, Notary Public
Camp HIII Boro, CumbeAand County
My Commission Expires Oct. 27, 2003
Member, Pennsylvania Association of Notaries
AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
We, Debra K. Wallet and hCn~~,"7, ~~~v ,the witnesses whose
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names are signed to the attached instrument, being duly qualified according to law, depose and
say that we were present and saw the Testator, WILLIAM EDWARD DENSHAM, sign and
execute the instrument as his Last Will and Testament; that he executed it as his free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testator signed the Will as witnesses; and that, to the best of our knowledge, the Testator was
at that time 18 years of age or older, of sound mind, and under no constraint or undue
influence.
l.Q.yln~. 'I'
Sworn or affirmed to and subscribed to before me by ~~,bt'~ K. L1~ 11~.
and ~~,,;,~,~~n ''~,'~uc1~ ,witnesses, this ~C>~ day of ~Ur-~ , 2000.
Notary Publi(~
Notarial Seal
Mary M. Loper, Notary Public
Camp Full Boro, Cumberland Coun
My Commission Expires Oct. 27, 20 3
Member, Pennsylvania 0.ssociation of Notaries