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HomeMy WebLinkAbout01-23-0915056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Count Code Year File Number Bureau of Individual Taxes y PO BOX 280601 INHERITANCE TAX RETURN Hanisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 0649 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 183-20-4320 03/12/2002 08/09/1926 Decedent's Last Name Suffix Decedent's First Name MI Arndt .Robert E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Arndt Barbara C Spouse's Social Security Number 578-22-0661 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return , :_ 2. Supplemental Retum ':. 3. Ramainder Return (date of death prior to 12-13-82) 4. Limited Estate ___ , 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required death after 12-12-82) <1 6. Decedent Died Testate ;~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received _. 10. Spousal Poverty Credit (date of death C:~ 11. Elaction 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 Jennifer Denchak Wetrel (717) 232-5000 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY METTE, EVANS & WOODSIDE n ~=' First line of address `-~ C~ `° -~ 3401 North Front Street ' ~ '° ~ ' , ;, r^ N , , r r Second line of address ~ -; , W PO Box 5950 `- = , - ~ -~ `- _.~-7 ~_ _ City or Post Office State ZIP Code DATE FIC6Q~ ~-"' = - Harrisbur - ~~ --t '-' _ . 9 PA 17110-0950 ~ _... N Correspondent's a-mail address: IjknOde@mette.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 is based on all information of which preparer has any knowledge. SIGNA-~ PERS~P,AN6R FILING RETURN ~_ DATE ADDRE 108 Autumnwood Drive, Middletown, PA 17057 IG TURE OF PREPARER OTHER THAN REPRESEN ATIVE .DATE t ~~ t ; /, ,~- jn A DRESS ~~ 401 N. Front Street, PO Box 5950, Harrisburg, PA 17110-0950 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 1;056051058 15056052059 REV-1500 EX Dece~jent's Social Security Number Decedents Name Robert E Arndt 183-20-4320 ~. _~__ ~__~_ _ . _ _ ~ __ ~ ~~ -- .__.___ n e _____ ~ _ -- 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. 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. 30,223.77 17, 710.63 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 11. Total Deductions (total Lines 9 8 10) ................................... 11. 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) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. ~~m ..._ an .m . ~_ .. _ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES _ _ - ___ e. 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 0 121,287.68 15. 16. Amount of Line 14 taxable at lineal rate X .045 168,993.29 18. 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 258,217.16 306,151.56 15, 340.00 530.59 15,870.59 290,280.97 290, 280.97 0.00 7,604.70 7,604.70 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 ' 0649 __ ~__ DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Robert E Arndt 183-20-4320 STREET ADDRESS 30 Westfields Drive Cumberland County CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total InteresUPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (56) 7,604.70 7,604.70 2,789.58 10,394.28 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 :......................................................................................... ~ ^ 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? .............. ^ ^Q 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) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutor)~ 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)]. 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-1503 ~X+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Robert E. Arndt 21 08 0649 All property jointly-owned with right of survivorship must he disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCR4PTlON OF DEATH 1.184 Shares Hartford Financial Services, Inc. common stock CUSIP: TCKR: HIG 11,976.56 184 shares common stock at $65.09 per share 2. 217.3255 Shares ITT Corporation common stock CUSIP: TCKR: ITT 13,365.52 217.3255 shares common stock at $61.50 ger share 3. 94.0776 Shares Rayonier, Inc. common stock CUSIP: TCKR: RYN 4,881.69 94.0776 shares common stock at $51.89 per share TOTAL (Also enter on line 2, Recapitulation) , $ 30 , 223.77 3wasss ~.ooo (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (g.g8) COMMONNlEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF FILE NUMBER Robert E. Arndt 21080649 Include the proceeds of litigation and the date the proceeds were received by the estate. SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY 3wasn~ 1.000 (If more space is needed, inseR additional sheets of the same size) REV•1510 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE: NUMBER Robert E. Arndt 21. 08 0649 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of thle REV-1500 COVER SHEET is yes. ITEM NUMBS DESCRIPTION OF PROPERTY INCLLOE THE NOME OF TFE TRANSFEREE, THEIR RELATIONSHIP TO DECEDEM AND TFE DATE OF TRANSFER ATTACHACOPY OF THE DEED FOR REAL ESTATE DATE OF DEATH VALUE OF ASSET °lo OF DECD'S INTEREST EXCLUSION IF AP'LICABLE TAXABLE VALUE ~ Allianz Annuity Policy #1001236103; beneficiary is spouse 20,690.45 100.0000 0.00 20,690.45 2 Allianz Annuity Policy #1001220308; beneficiary is spouse 5,352.71 100.0000 0.00 5,352.71 3 Jackson National Life Insurance Annuity Policy #33604710; beneficiary is Arndt Family Trust 41,174.00 100.0000 0.00 41,174.00 4 Real property situate in Silver Spring Township, Cumberland County, Pennsylvania, known and numbered as 30 Westfields Drive; further identified as Tax Parcel Number 38-23-0571-212. 191,000.00 100.0000 0.00 191,000.00 Held in the Robert and Barbara Arndt Family Living Trust, as acquired by Deed dated October 23, 2000, and recorded in Cumberland County Deed Book 278, Page 4303. Valuation is based on sales price; see attached settlement sheet. TOTAL (Also enter on line 7, Recapitulation} $ 258,217.16 (If more space is needed, insert addRional sheets of the same size) 3W46AF 1.000 REV-1511 ~X+(12-99) ~ SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert E Arndt 21 08 0649 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t E~neral Expenses Myers Funeral Home, flowers, funeral luncheon B. 1 2 3 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State PA Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Barbara C. Arndt 7,000.00 4,000.00 3,500.00 Street Address 30 Westfields Drive City Mechanicsburg State PA Zip 17050 Relationship of Claimant to Decedent SPOUSE 4. Probate Fees 190.00 5. Accountant's Fees 150 .00 6. Tax Return Preparer's Fees 7. 1 Diane C. Reeser Reimbursement for expenses to administer estate and clean out residence, including travel, telephone, postage 500.00 3W46AG 1.000 TOTAL (Also enter on line 9, R~ (If more space is needed, insert additional sheets of the same size) 15,34 REV-1512 EX + (12.03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHREERSIDENTEDECEDENTRN MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Robert E. Arndt 21 08 0649 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, includinl3 unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' Bank of America - Credit Card #4313-5100-1767-9004 Credit card 530.59 TOTAL (Also enter on line 10, Recapitulation) $ I 530.59 3wasa,H z.ooo (If more space is needed, insert additional sheets of the same size) REV-;.513 EX+ (11-08} iii Pennsylvania !.~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF FILE NUMBER Robert E. Arndt 21 08-0649 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS jInclude outright spousal distributions and transfers under Sec. 2116 (a) (1.2).] 1. Barbara C. Arndt Spouse 121,287.68 Allianz Annuity Policy #1001236103 - $20,690.45 Allianz Annuity Policy #1001220308 - $5,352.71 Life Estate in Credit Trust - $95,244.52 2. Arndt Credit Trust 168,993.29 Remainder Interest in Credit Trust ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON l1NES 15 THROUGH 18 OF REV-1500 COVEF, SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX i5 NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -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 LIFE ESTATE, ANNUITY & TERM CERTAIN heck Box 4 on REV-1500 Cover SheE ESTATE OF FILE NUMBER Robert E. Arndt 21 08 0649 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 fife calculations can be obtained from the Department of Reveinue, 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. ^ Will D Intervivos Deed of Trust ^ Other • NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Barbara C. Arndt 03/1011924 78 ®Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which life estate is payable ..........................................$ 2. Actuarial factor per appropriate table ................................................ . Interest table rate - ^ 3 1/2% ^ 6% ^ 10% ®Variable Rate 5.4000 264,237.81 0.36045 3. Value of life estate (Line 1 multiplied by Line 2) ......................................$ 95,244.52 NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH • NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which annuity is payable ............................................$ 2. Check appropriate block below and enter corresponding (number) ......................... . Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^Serni-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period ........................................................$ 4. Aggregate annual payment, Line 2 multiplied by Line 3 .................................. . 5. Annuity Factor (see instructions) Interest table rate - ^ 3 1/2% ^ 6% ^ 10% ^Variable Rate 6. Adjustment Factor (see instructions) ................................................. . 7. Value of annuity - If using 3 1/2%, 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 z 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) REV-1649 EX+ (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE NUMBER Robert E Arndt 21 OB 0649 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance 8 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 Arndt Credit Trust Trust (marital, re:,idual, A, B, By-pass, Unified Credit, etc.) If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed in Schedule O, and b, The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O, 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 sim- ilar 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 0. The denominator is equal to the total value of the trust or similar artangement. 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. (If more space is needed, insert additional sheets of the same size) 3W46E2 2.000 Annuity, Life Estate, and Remainder Factors Transfer Date: 3/2002 §7520 Rate: 5.40% Calculation Type: Life Principal: $264,238 Lives: 1 Ages: 78 Life Estate Rerainder Factor: 0.36045 0.63955 Value: $95,244.52 $168,993.29