HomeMy WebLinkAbout06-25-09 (3)15056051058
REV 1500 ~ (~)
PA Department of Revenue
,, Bureau of IndMdual Taxes INHERITANCE TAX RETURN
Po BOx 280601 RESIDENT DECEDENT
PA 17128-0601
IAL USE ONLY
OIL
County Code Year File Number
~ I C~ ~ ~~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
396-~46-7930 3!26!09 6113!47
Decedent's Last Name Suffix Decedent's First Name MI
STROM NEIL L
(if Appitcable) Enter Surviving Spouse'e 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 INAPPROPRIATE 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 (date of 5. Federal Estate Tax Return Required
death after 12-12-82)
6. peoedent D'~ed Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wilq (Attach Copy of Trust)
9. L'~igation Proceeds Received 10. 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 COliFIDENI'IAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytbrte Telephone Number
JOSEPH J. D1XON 717-233-8757 ~~
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Firm Name (If Applicable) REGISTER OF WIFE ONLY C... _
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JOSEPH J. DIXON, ESQ. ~"~ ~"
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First line of address 9~y ~ ~
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126 STATE STREET c:~7 ~ ~ ?a•
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Second line of address '-~ G_ " .. ' a'~ z
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State ZIP COde
City or Post Office
DATE FILED ~rJ
HARRISBURG PA 17101
Correspondent's e-mail address: ~.--•••~•~--•~-~--~~+rina r~+m
Under penalties of perjury. I declare that 1 have examined this return, including aocompar>ying schedules and atatemer>ts, and to the best of my knwwledge and belief,
ft is true, correct and complete. Dedaretfon of preparer other than the personal representative ~ based on a8 inbrrnation of which preparer has any knowledge.
SIGNATURE OF PE ON RE N318LE FOR FILING RETURN DATE
to ~1 ~ ~y ~Tz,~~ ~5~''! ~~/I
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
~.EwaE usE oru~w~ Fotall oN~Y
Side 1
15056051058 15056051058
J
REV 1500 EX
Dec~denYs Social Security Number
Decedent's Name: NEIL L STROM 39f-46-?930...
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 8 Notes Receivable (Schedule D) ............................. 4.
5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ........ 5.
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6.
7. Inter-vvos Transfers 8~ Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1-7) .................................... 8.
9. Funeral Expenses 8~ Administrative Costs (Schedule N) ..................... 9.
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................ 10.
11. Total Deductlona~ (total Lines 9 8~ 10) ................................... 11.
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12.
13. Charitable and Governmental BequestslSec 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.
TAX COMPUTATION -SEE iNSTRUCTiON3 FOR APPLICABLE RATES
15. Amount of Une 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0~ 16.
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
15056052059 Side 2
15056052059
$63,720.00
0.00
0.00
0.00
$134,379.00
6198,089.00
$26,227.40
$4,376.81
630,604.21
$167,494.79
6167,494.29
$7,537.26
67,s37.zs
15056052059
REV-1500 EX Page 3
Decedent's Complete Address:
ciTY
FlN Numbtr
DECEDENT'S SOCIAL SECURRY NUMBER
STATE I nP
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) ~'7~537 ~6
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Cred'~is (A + B + C) (2) _ _, ~7 RR
3. InteresUPenaNy if appNcable
D. Interest
E. Penalty Total Ir>terestlPenaNy (D + E) (3)
4. ff Line 2 is greater than Line 1 + tine 3, enter the differ+erxe. This is the OVERPAYMENT.
FiN th oval on P~ 2, line 20 to request a refund. (4)
5. If Une 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (~)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (~) 57,16Q.40
Make Check Payable to: REGISTER ~F WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent malts a transfer and: Yes No
a. retain the use or income of the property transfemed :.......................................................................................... ^
b. retain the right to desigr-ate who shall use the property transferred or its income; ........................................... ^
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for Me of either payrrrents, benefits or c~e? ...................................................................... ^
2. If death oaxirred after Decen>ber 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an "intrust for• or payable upon death bank account or secx~rily at his or her death? .............. ^
4. Did der~dent own an Individual Retirement Acootmt, annuity, or other non-probate properly which
contains a ben~Ciary designaaon? ........................................................................................................................ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FlLE R AS PART OF THE RETURN.
For dates of death on or aflBr 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 th a for the use of the surviving spouse ~ 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 requir+errrer~s for dist~osure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For defies 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 th or for the use of a natural parent, an
adoptive par~erlt, or a stepparent of the child is zero (0) percent (72 P.S. §9116(a}(1.2)].
The tax retie 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 th or for the use of the decredenYs siblings is iwehre (12) perCer>t [72 P.S. §9116(aX1.3)]. A sibNng is defined, under
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REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDI~LE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FlLE NUMBER
Indude the proceeds of 1'digation and the date ttte proceeas were recetvea oy me e~~.
w~ .. wnthr.nrned Wilk rfaht of survivoreldD !IMl~ l1e disclosed 011 Schedule F.
June 23 2009
JEWELRY LIQUIDATORS
319 South Third Street
Lemoyne PA. 17043
- 717-730-9677
Coin appraisal for Daniel Strom
One 1 oz. American Eagle silver bullion coin.
Two 1982 commemorative proof half dollars, Washington birthplace. One is circulated.
Six (5) mint coin state quarter sets,
Twenty (2) mint coin state quarter sets.
Thirty-one single state quarters, Unc.
Twenty-five wheat cents and asst. foreign coins.
Six foreign. notes.
Total value $48.00
- Arthur Bleiweiss
.. ~ Owner Jewelry Liquidators
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REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDI~LE F
JOINTLY-OWNED PROPERTY
FlLE NUMBER
ESTATE OF
ff an easel was made joint within one year of the decedents dale of deeth, R mgt be reported on SchsduNe G.
SURVIVING JOINT TENANT(S) NAME
A.TATYANNA V. STROM
B.
C.
in~u'r~ v_rtiwN~n PRAPERTY~
ADDRESS
504 HUMMEL AVENUE
LEMOYNE, PA 17043
RELATIONSHIP TO DECEDENT
EX-WIFE
F DATE OF DEATH
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTRUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % O
DECD'S
INTEREST VALUE OF
DECEDENT'S INTEREST
~ . A.
1218195 REAL ESTATE
1800 HUNTERS DRIVE , MECHANICSBURG, PA 17050
$127,444.00
50%
$63,720.00
~ ~,_. ~ A _, ..
~ pennsylvan~a SCHEDULE ~
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~~.
ESTATE OF
NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY
I TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Daniel M. Strom, 1800 Hunters Drive Mec:han'~csburq, PA 17050
Svetiana A. Thayer, 32101 Palm Street Lawrenceville, NJ 08648
Martin A. Strom, 65 W Loather Street Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
Son
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
1/3
113
1/3
1.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES 8E LIENS
pennsylvan~a
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
incurred by the decedent prior to death that remained unpaid at the date of - indudin9 unreimbursed maa~UEexpenses.
ITEM
1.
FINAL TRASH BILL
FINAL VISA BILL
FINALAMBULANCE BILL
FINAL HOSPITAL BILL (HOLY SPIRIT HOSPITAL)
FINAL PP&L BILL
FINAL HOMEOWNER'S INSURANCE BILL
APPRAISAL FEE (JEWELRY LIQUIDATORS)
TOTAL
$44.25
$272.72
$862.32
$2,622.00
$63.72
$480.00
$31.80
$4,376.81
EV-1511 EX+ (12-99)
SCMEp1~L~ N
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
Debts of decedent must be reporMd an Schedule L
1TEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
$2,440.78
~ ~ PARTHEMORE FUNERAL HOME & CREMATION SERVICES, INC.
g. ADMINISTRATIVE COSTS:
~ , Personal Representative's Commissions $ 9 , 9 0 4.9 5
Name of Personal Representative(s) Q~~.xi'r=r ne cTr~O~A
Social Security Number(s)IEIN Number of Personal Representative(s)
Street Address
City MECHANICSBURG _State pA .ZP 17050
Year(s) Commission Paid:
Z• Attorney Fees $9,904.95
3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation)
Claimant DANIEL M. STROM
street Address 1800 HUNTERS DRIVE
CityMECHANICSBURG _State pA _ZiP 17050
Relationship of Claimant to Decedent SON
4. Probate Fees $331.00
5. Accountant's Fees
g. Tax Return Preparer's Fees
~• ESTATE PUBLICATION -CARLISLE SENTINAL $70'72
CUMBERLAND COUNTY LAW JOURNAL $75.00
TOTAL ~ $26,227.40