HomeMy WebLinkAbout02-25-091556041158
REV-1500 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Inliividual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 21 0 8 0 9 6 2
Harrisburg, !'A 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
087,82U08 0824],927 •-•6
Decedent's Last Name
HOLLINGER
Suffix Decedent's First Name
GWEN
(If Applicable) Enter Surviving Spouse's Information Below
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 BOXES BELOW
u~ 1. Original Return
4 Limited Estate
6 Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
2. Supplemental Return
^ 4a. Future Interest Compromise (date of
~~ 7. death after 12-12-82)
Decedent Maintained a Living Trust
(Attach Copy of Trust)
I
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
MI
D
Mf
3. Remainder Return (date of death
f prior to 12-13-82)
L ~' 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposil Boxes
I~ 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
v.vrcrc~arvrvu~rv I - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
KEITH 0 - BRENNE~1AN 71,7-697-8528
Firm Name (If Applicable)
SNELBAKER & BRENNEf1AN, P•C•
First line of address
44 WEST MAIN STREET
Second line of address
P•0• BOX 318
City or Post Office
IECHAiVICJt:iLIR(~
REGISTER OF WILLS USE C~N~Y
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State ZIP Code pAi'g~LED '-- `r
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P A 17 t9
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Correspondent's e-mail address:
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 oeiief.
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.
CIr`AIATI IC]C lli- n~nn~r.i r~rr.nn.,..~~~ ~ ~...~. ~.. ..._ ___. _.
KIV
ERIC L- HOLrLINGER, EXECUTOR 318 HEISERS LANE, CARLISLE, PA 17015
SIGNA~U~E OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
KEITH 0- BRENNEMAN, ESQUIRE 44 WEST MAIN STREET, f1ECHANICSBURG
PLEASE USE ORIGINAL FORM ONLY
PA 17055
Side 1
15tJ56041158 15056041158
6M4647 3.000
~~
REV-1500 EX
15056042159
RECAPITULATION ~
1. Real estate (Schedule A) .
....31.
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
7. Inter-Vivos Transfers & Miscellaneous Non-Probate P op m,~ng Requested 6.
(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 12
an election to tax ha;> not been made (Schedule J) . .
. 13 .
14. Net Value Subject to Tax (Line 12 minus Line 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 .OIL D , D D 15.
16. Amount of Line 14 taxable
at lineal rate X .04,5
17. Amount of Line 14 ta:aable o • D D 16.
at sibling rate X .12
D • DD 17.
18. Amount of Line 14 taxable
at collateral rate X .15
n.nn 18.
19. TAX DUE
. 19.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15D56042159
6M4648 2.000
o•oo
0.Oo
o.oD
D•00
3953.77
o•DO
0•DO
J 1 J J
15804.77
641.94
16446.71
-12492.94
0.00
0.00
a.oD
G•op
D•OD
C•DO
15D56D42159
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
STREET ADDRESS
MECHANICSBURG BOROUGH
CITY
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit O • O O
B. Prior Payments O • 0 Q
C. Discount O • O Q
3. Interest/Penalty if applicable
D. Interest 0 • ~ 0
E. Penalty O • Q Q
File Number
62
STATE
(1)
Total Credits (A + g + C) (2) ~ ~ 0
Total InterestlPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. ~ ~ ~
Fill in box on Page 2, Line 20 to request a refund.
(4) 0 00
5 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5) 0 •0 0
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
0•
0•
(5B> 0.00
Make Check Payable to: REGISTER OF W/LLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred; Yes No
b. retain the right to designate who shall use the property transferred or its income. h X
c. retain a reversionaryinterest; or
d. receive the promise for life of either payments, benefits or care? ~ I v
2. If death occurred after December 12. 1982, did decedent transfer property within one year of death J L."J
without receiving adequate consideration? . ~,
~,
3 Did decedent own a~ "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? --,
~i
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 (3j percent [72 P.S. §9116 (al (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 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
72 P.S. 9116(1.2) [72 P.S. ~9116(a)(1)]. ( )percent, except as noted in
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve 12
under Section 9102, as an individual ~aho has at least one parent in common with the decedent, whether by bloodtor adoptio §9116(a)(1.3)]. A sibling is defined,
6M467~ 1.000
ZIP
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
_ Gwen D . Hn l i ; ,,.tee,..
SCHEDULE E
CASH, BANK DEPOSITS, 8~ MISC.
PERSONAL PROPERTY
i~iuue ine 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
DESCRIPTION
1 M&T Bank
(checking account #3740104132
I
I
I
3W46AD 1.000
TOTAL (Also enter on line 5 Recapi
(If more space is needed, insert additional sheets of the same size)
FILE NUMBER
VALUE AT DATE
OF DEATH
3,953.77
3,953.77
R'c V-'511 EY+(10.06)
SCHEDULE H
COMMONWEALTH OF PENNS`(LVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE (1C
Gwen D. Hollinger FILE NUMBER
21 oa o962 _
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES: AMOUNT
t. (Hollinger Funeral Home & Crematory, Inc.
funeral services
B.
1
I
ADMINISTRATIVE COSTS:
~ Personal Representative's Commissions
~ Name of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State __ Zip
2. i Attorney Fees Snelbaker & Brenneman, P.C.
3. ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
I
Claimant
j Street Address
City
State Zip
' Relationship of Claimant to Decedent
~ ~ Probate Fees
i
5. Accountant's Fees
,
6. Tax Return Preparer's Fees
,
7.
1 (Certified mail costs
2 (Cumberland Law Journal
advertising Executor's Notice
Total from continuation schedules .
TOTAL (Also entar nn r~A a
~wasAC ~ ooe (If more space is needed, insert additional sheets of the same size)
13,331.62
I
1,156.25
62.00
,
5.32
75.00
1,174.58
$ 15,804.77
Estate of: Gwen D. Hollinger
21 08 0962
Schedule H Part 7 (Page 2)
3 The Sentinel ,,e
advertising Executor's Notice
174.58
4 Reserve
for filing fees, accountant fees and other
miscellaneous costs associated with the
administration of the Decedent's estate
1,000.00
Total (Carry forward to main schedule)
1,174.58
REV-1512 EX + (12.08)
Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT
RESIDENT DEC ENETURN ,
MORTGAGE LIABILITIES 8c LIENS
ESTATE OF
Gwen D . Hollinger FILE NUMBER
21 OS 0962
Report debts incurred by the decedent pr ior to death that remained unpaid at the date of death, including unreimbursed
di
ITEM me
cal expenses.
NUMBER
...~ DESCRIPTION VALUE AT DATE
~ iDiscover Card OF DEATH
credit card debt
460.44
2 UGI
gas service
103.00
3 ( United Water of Pennsylvania
water service
24.49
4 Verizon
phone service
54.01
TOTAL (Alsn entar nn I ono ~n
8W46AH 2.000 If more space is needed, insert additional sheets of the same size.
$ 641.94
RE'J-1513 EX+ (11-OS)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETUf2N
RESIDENT DECEDENT
ESTATE nF =
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY
[ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
,e Sec. 2116 (a) (1.2).]
1. Lizabeth J. Hipple
300 Adams Street
(Steelton, PA 17113
8 W46A1 2.000
FILE NUMBER
21 08 0962
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Daughter
j
ENTER DOLLAR AM I
OUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE
nlnnl ~r~.. ,, .,~ .-
C.00
u~u I IVIVJ-
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1 j
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1
TOTAL OF PART If - E=NTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET.
If more space is needed, insert additional sheets of the same size.
0.00
,AST WILL AIv'D TES'I'Ar1ENT OIL' CxW.~N ,p, I-IOLTJIZdGl~,'F
-~, Gt-~JEN D. ~0;,~,INGE~; of the fox°ougri of T~lacl2aniesbur~,
County of Gumberla.nd a.nd= State of ~enx'sylvania, beixlg of sound
a.nd disposing mind, rnempry and understanding do malse, publish
and declare this my ,Last Wi~.l and m,estament, hereby revokinrr and
mA~xng void any and aIi r- b
prior t~ llls by one at any tin.; heretofore
made.
1,
l direct the payment of all my Just debts and -~'unsra~,
expenses as soon after my decease ati: thF~ s~.r-~V carp be C~,l~Verli~tY]'~~V"
done.
2.
Inasmuch as i hsvF
alt, ead r made
3 adec~ur~te provisions ~'or
my ° ara, :ERIC ... t~OLIJII~~G.~t~
s duz'~.,nG rr~y Iifetime T ;T
~ ~ g~ ~e, dev se
a.r~d. bE.nu~:atr.~ pry e
c_ wh~tsoevelw ~~ature anct whgresoPver
the same ~zr
mG, be situate, to my d _
au~llter, ui~~;.tiJ~S`1'H J , ri ~'.~
an.~ unco.nditional?y.
n ~mr r
J/']
_1:~,
'C)1P.lr!u tS ~
C().CIo^ t, .:L uLi'~E Ai~C~
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n
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3
~' '
~~. .r0.~,,~I~~~,
T r k~~
, :~.~~e cuto,
~' 1
V
Y
•
- l T~
tl ~
won, .Ertl~.~,
~ p '~L'1e o trip; 'p~~r Ln.Sr U:ri~,i. ax1Ci ~~^
`~.~u1.,amP.nt3 An C2
~
every ,~,
what m~,r said
;on should ~~rsdecease
m
be unable or
u.n~.;iliir
~ tc
s e, or should he
then i
n such , erve
in stzci-i capacit~l
for r
a.n~ reason
, eve.r~t, r noma ,rzate
cons ti~ute a.nd appoint
T ~ZAFETg J. I,r
l apL,E EY
,
' m
y daughter,
,
>.ecutr- ~,x off
this my Last t~Jil? ar?d `i'eStament
,
-l~
i.r_ h;~s p~,ace and stead, and in either instance, ~ direct that
my said personal represen'tata.ves be excusad from fi~.ing bond dr
othar security ~'ar> the faithful. p~;rforms.nae of. their diztics.
lIv' ~l'~Tl~t.c~,SS lIF-i~FOF, i have her>etz.nte set my ha.n~ and 5ea~
this ~ ~ day of August, A. :I)., 1.91.
~~ .~,~-~.,.~ ~ , l~'~ ~.~.~-,,,. ~-~ ~, ;SCAT, }
GwE.n D. Hollinge:~-
~~-fined sealeG ~.' ,
pub~.ished and decyared bar the move na~r!Ed,
G~;lc,7~` ~. T-TOLLING~, as and for> ri~:r past, ti;~i.11 and. Testament, in the
presence of us, wha ha.~re subscribed oux> raa.tr3es hEretc, as wit.nesse::,
a`~ the request of said: testatrih, ~n hex> presence a.nd wn the
presence o~ e3e1'i other>.
~ ~ . ~ ,~~
!~ l~ ~~
~, ~,. ~ ~.
,~_
COMMON'FJEALTH OF PENNSy'LVANZA )
SS.
COUNTY OF CUhISETZLANU )
I, G4tifEN D. HQLLING~1~ the teatat rix
whose name is signed to the attached or foregoing instrument, hav~,ng
been. duly qualified according to 7.aw, do hereby acknowledge that T
signed and executed the instrument as my Last Wi11 and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary a~tt and deer, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me by
GTnr='PJ .~. HOLLTNGER __ the testa~T, this ~/3a4
da}~ of -- A ii,fr~ia - _ , A.TD. ~ ~ 99~ .
,Gv
}'rr~ a'.a? ~ ~,~tl
~~#f2~,o-.,~~ ., ~riycl:'
COMMONWEALTH OF PENNSYLVANIA ~~?~1w'; ~~ `' "' b
S S . t~M~,E~r, Fern ;~Narti~.;i~M c;~~•~r~c`iVoiM;ies
COUNTY OF CU?~1BERLAND )
We, the undersigned, ~ Rp~ERT S?'AT7FFk1~
and Trni~ ,~~.
FtL ~_i_A iYi~ ~JT,~'v'~,DEr~ the witnesses whose names are
signed to the attached or foregoing instrument, being dul}r qualified
acccrding to law, depose and say that we were present and saw the
ix ~~'~i~ T si r. and exe-
t e s t a e Y> __ r i -' '_ ~? ~.,~,.?..u..r.~I.C~,.~.._.._ 7 g
cute the instrument as ~,,. her Last Wi1,:1 and Testament; that the
said testatr.~,- > ui;TEi`~ U HOT,T,TNr„~, e~cecuted i*_ as
Sher free and voiuntarv act for the purposes therein expressed;
that esch of us, in ttie hearing and eight of the testat~-, signed
the G?ili as witnesses; and. that tc the hest of our ~~nowledge, the
testat?-~~, was, at the time, eighteen !;Lo) or mare years of age,
of scone mine, anc Lander n;~ constraint, dlress or undue influence.
Sworn and subscribed to befor
me this ~~~"~ da}' of
August ~99~~
~Y.~3Y(FS1'!~•r_i ~.~~J`.~.~7 ~-:.~ •i.y~ 1".T~., i.1f ~ `I,: J '•