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HomeMy WebLinkAbout02-24-091505607121 -'~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 0 8 0 6 2 3 Harrisbu , PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Date of Birth Social Security Number Date of Death 1 9 9 1 4 1 6 6 1 0 5 2 6 2 0 0 8 0 3 1 8 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI T S C H O P S A M U E L C (If Applicable) Enter Surviving Spouse's Information Below MI Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^X 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) h O h S between 12-31-91 and 1-1-95) . ) c (Attac CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Daytime Telephone Number Name A L I C E J T I L L G E R E S Q 2 1 5 2 3 0 9 6 0 0 Firm Name (If Applicable) First line of address 6 4 5 E B U T L E R Second line of address A V E N U E City or Post Office N E W B R I T A I N State ZIP Code _ , REGI~R OF WILLS~E ONLY 'T'1 f i ?J ~ "_ Y ~~ ~ r_' N i ~~: ~ ~ ~ , ~ ;~~ v ` J,•/ ~- E FILED - `(~A P A 1 8 9 0 1 w Correspondent's a-mail address:ATILLGER VERIZON NET 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. Declar tion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR EPERSDN RES SIBLE FO~tLIN/~G~ETUf<2N DATE C/0 645 E• ~fLER AVENUEv NEW BRIT, PA 18901 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 645 E• BUTLER AVENUE NEW BRIT,PA 18901 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 , 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: SAMUEL C• T S C H O P 1 9 9 1 4 1 6 6 1 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. 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) ... . .. . . . . .. . ..... 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) ........... . ..... ..... 12. .. 13. .. 14. 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 .0 _ D ~ D 15. 16. Amount of Line 14 taxable at lineal rate X .045 6 6 8 4 8. 1 6 16. 17. Amount of Line 14 taxable at sibling rate X .12 D D D 1 ~. 18. Amount of Line 14 taxable at collateral rate X .15 0 D D 18 19. Tax Due ................................................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 9 1 5 8. 4 6 7 5 0 3 0. 1 7 8 4 1 8 8. 6 3 1 2 3 7 0. 4 7 4 9 7 0. 0 0 1 7 3 4 0. 4 7 6 6 8 4 8. 1 6 6 6 8 4 8. 1 6 D. 0 0 3 0 0 8. 1 7 0. 0 0 0. 0 0 3 0 0 8. 1 7 1505607221 J ;4EV-1500 EX Page 3. , Decedent's Complete Address: File Number 21 08 0623 DECEDENT'S NAME SAMUEL C. TSCHOP STREET ADDRESS --- - -- - --- 1000 CLAREMOND ROAD _ CLAREMONT NURSING & REHAB CENTER CITY STATE zip CARLISLE PA 17013 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 ifapplicable D. Interest E. Penalty 3.008.17 Total Credits (A + B + C) (2) 0.00 _ 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. (3) 0.00 (4) 0.00 (5) (5A) 3,008.17 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 3, 008.17 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; ............................... ^ X^ c. retain a reversionary interest; or ................................................................................................ ^ d, receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 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 "intrust 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 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)]. 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-1508 EX + (6-98,) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MSC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER SAMUEL C. TSCHOP 21 08 0623 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. WAYNE BANK -CHECKING ACCOUNT # ~ ~~ , •~ ~ ~ 416.32 2. MEMBERS FIRST -ACCOUNT # ~~~ ~7Q ~ 11.51 3. COUNTRY HOME -REFUND 1,200.00 4. CITIGROUP -FINANCIAL MANAGEMENT ACCOUNT #315-19123-12 788 6,983.63 5. IPA DEPARTMENT OF REVENUE - 2007 PERSONAL INCOME TAX REUND I 547.00 TOTAL (Also enter on line 5 Recapitulation) I $ 9 15 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-~8) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER SAMUEL C. TSCHOP 21 08 0623 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1 DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIRRELPTIONSHIPTODECEDENTAND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. CITIGROUP -IRA ACCOUNT # DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION (IFaPPUCABLE) TAXABLE VALUE . 315-19123-12788 PAYABLE TO SANDRA TSCHOP RICKARDS WYCKOFF 75,030.17 100. 75,030.17 & DAVID TSCHOP TOTAL (Also enter on line 7 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-Q6) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER SAMUEL C. TSCHOP 21 08 0623 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. TEETERS FUNERAL HOME -FUNERAL SERVICES 10,547.75 2. FUNERAL FLOWERS 542.72 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Year(s) Commission Paid: 2. AttomeyFees ALICE J. TILLGER, ESQUIRE 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4 5. 6. 7. Street Address City State Zip Relationship of Claimant to Decedent Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY Accountant's Fees Tax Retum Preparers Fees Zip 1,000.00 280.00 TOTAL (Also enter on line 9, Recapitulation) I $ 12 370 47 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER SAMUEL C. TSCHOP 21 08 0623 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 -BALANCE OWED FOR 2007 PERSONAL INCOME TAX 4,970.00 TOTAL (Also enter on line 10, Recapitulation) I $ 4 970 (If more space is needed, insert additional sheets of the same size) • REV-1513 EX + (g_00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER SAMUEL C. TSCHOP 21 08 0623 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 [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. SANDRA TSCHOP RICKARDS WYCKOFF Lineal 33 424 08 114 PEARL DRIVE , . CARLISLE, PA 17013 2. DAVID TSCHOP Lineal 33 424 08 HCR 67 BOX 416P , . DINGMANS FERRY, PA 18328 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, Insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 9th day of June, Two Thousand and Eight, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of SAMUEL C TSCHOP late of M/DDLESEX TOWNSH/P (First, Midd/e, LasU a/k/a SAMUEL CHARLES TSCHOP in said county, deceased, to SANDRA TSCHOP R/CKARDS WYCKOFF (First, Middle, Lastl and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said c>fri ce a t CARLISLE, PENNSYLVANIA, this 9th day of June Two Thousand and Eight. File No. 2008-00623 PA File No . 21- 08- 0623 Date of Death 5/26/2008 S . S . # 199-14-1661 r NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL LAST WILL AND TESTAMENT OF SAMUEL C. TSCHOP I, SAMUEL C. TSCHOP, of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as my last will and testament, hereby revoking any and all wills by me at any time heretofore made. FIRST: I direct payment out of my estate of the expenses of my illness and funeral SECOND: All the rest, residue and remainder of my estate, real and personal, I give, devise and bequeath in equal shares to my children SANDRA T. RICKARDS-WYCKOFF and DAVID B. TSCHOP. Provided further that if either child predeceases me, their share shall pass to their issue per stirpes. I intentionally make no provision for DOROTHY WILLIAMS TSCHOP as we are separated and in the process of a divorce. THIRD: I direct that the legacy or share of real or personal property falling to any person under the age of twenty five years under the provisions of this my will, shall be paid to and retained by my trustee hereinafter named, in Trust, to invest and reinvest the same, to collect the income and after paying all expenses incident to the management of the trust, to use and apply as much of the net income and principal as may be necessary in the sole discretion of my trustee for such person's support, well-being and education, and that the balance of principal and any accumulation of income remaining in the hands of the trustee be paid to such person upon attaining the age of twenty five years. I direct that such payments shall be made without the intervention of a guardian and the receipt of such person as may be selected by my trustee to disburse the same shall be a sufficient acquittance. I further direct that any property, including but not limited to insurance, which passes to a minor otherwise than under the provisions of this will and with respect to which I am authorized. by law to appoint a guardian or trustee and have not done so, shall likewise be paid to and retained by my said Trustee who shall also be guardian of such non-testamentary assets with the same rights and powers as set forth in this paragraph. The trust shall terminate upon the twenty fifth birthday or the death of the child for whom it is held, whichever event shall first occur. Upon termination because such child has attained the age of 25 years, the principal and any accrued or undistributed income shall be paid over to such child, absolutely and free of further trust. Upon termination as a result of the death of such child before attaining the .age of 25 years, the principal any accrued or undistributed income shall be distributed to his or her estate. FOURTH: The interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation until distribution is actually made. FIFTH: In addition to the powers granted by law, my Executors and Trustees shall have the following powers, exercisable at their discretion from time to time without court approval, with respect to both principal and accumulated income, and such powers shall continue until distribution is actually made. (a) To sell at public or private sale, exchange or lease for any period of time any real or personal property and to give options for sales or leases. (b) To compromise .claims, and to disclaim any interest which I may have in an estate or trust. (c) To accept. in .kind, retain and invest in any form of property without regard to any principle of diversification as to any property owned by me at my death. (d) To make distribution in cash or in kind. SIXTH: I appoint SANDRA T. RICKARDS-WYCKOFF as Trustee of any trust created herein for the benefit of DAVID B. TSCHOP'S children. Should SANDRA predecease me or be unable or unwilling to act as Trustee, then I appoint KATHLEEN TSCHOP as successor Trustee. I appoint DAVID B. TSCHOP as Trustee of any trust created herein for the benefit of SANDRA T. RICKARDS-WYCKOFF'S children. Should DAVID predecease me or be unable or unwilling to act as Trustee, then I appoint CHARLES WYCKOFF as successor Trustee. 2 LASTLY: I appoint my daughter, SANDRA T. RICKARDS-WYCKOFF of this my last will and testament. I direct that she shall not be required to file any. bond to qualify or serve as Executor in any jurisdiction. In the event my said daughter shall predecease me, or should fail or be unable to qualify or having qualified should resign or die, then I appoint my son, DAVID B. TSCHOP as alternate Executor in her place and stead, with all of the rights and powers as though originally named herein. IN 'WITNESS WHEREOF, I have hereunto set my hand and seat at the end hereof this day of ~-~A. D. 2006. (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testator as and for his Last Will and Testament in the presence of us, who in his presence and in the presence of each other, all being present at the same time and at his request have subscribed our names as witnesses thereto. ,~ ~-' < u~ ',~ ~.~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF `~j~Ci')~ ~?%"tu r I, SAMUEL C. TSCHOP, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my last Will; that I signed it willingly; and that I signed it as my free and voluntary act. for the purposes therein expressed. SWORN TO AND SUBSCRIBED Befor a this ~ ~~ day of '~ ~~~~2006. ~ ~, , Q. No ry Public COMMpFlyyt-~LTM OF PEIV1Y81'LV NOTARIAL SEAL ~A ~ANEt.IE L. PITCHER, Worcester Twp., ~~a~try ~ ~ Comrrnss~un ~ fires Au ust 5, 20pg 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF ~```~~ ~'~ e.~ We, f1~'' cr =~ ~~~ and ~~~~`'~~ ~ "'~~~ the witnPCCac ~nihnca namcc are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his last will; that the said Testator, SAMUEL C. TSCHOP, signed willingly and that the Testator 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 eighteen or more years of age, of sound mind and under no constraint or undue in en'ce. ~~~ ti~,o~r SWORN TO AND SUBSCRIBED `~~ J Before me this ~ ~r day of % / ~L~t~ 2006. Ngtarv Public JANEtLE ~ _ ..,, •~~~ ~t PfTCHER. Notary Pups Worcester T wP•, Montgcxnery Coun Commission expires August 5, 200 5 N r O v rn R a ~ ~ ~ O N yr ~- '' ^-r~^+ M V/ ~ C CC~ G G 1 ~ ` CC~^ G C7 S ? ~ YQ ~ W •! x F- .p Q ~ /`~ ~ a 8 0 QQM O N N N ~ ~ ~ pl ~ !~ C .~ H ~ ~ N M ~ ~ t y ~ ~o O ~ M 'D y p () S = .~ ` ~ a~j ~ ~ ~ m `{./ ~ C ~ O ~ O ~ aL o U (J t O V Q Q c t ~ LL m E 0 u U a~ ~' Z c cC Y E J a a ~' N ~~ O .'n ~ O vi O 0 j ~ U 3 y ¢ z ~ a c c ~~ m ~JaBoM Z l.L } ~ 4 N V ~ L ~ N .. 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