HomeMy WebLinkAbout07-15-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 01 1488
BRUCE CHARLES SR
1 MISTY LANE
MIDDLETOWN, PA 17057
°------ fold
ESTATE INFORMATION: ssly: 202-20-5o9s
FILE NUMBER: 2108-1 162
DECEDENT NAME: BRUCE ENOCH D JR
DATE OF PAYMENT: 07/ 15/2009
POSTMARK DATE: 07/ 15/2009
COUNTY: CUMBERLAND
DATE OF DEATH : 10/ 01 / 2008
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 51,924.44
TOTAL AMOUNT PAID:
REMARKS: RECEIPT PUT IN ATTY PROTHY
BOX
CHECK# 1007
SEAL
INITIALS: JN
REV-1162 EX~ 1 1-96)
51, 924.44
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
' .1
1505607121
REV-1500 ~ (os-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 8 0 1 1 6 2
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 0 2 2 0 5 0 9 6 1 0 0 1 2 0 0 9 0 9 2 3 1 9 2 7
Decedent's Last Name Suffix Decedent's First Name MI
BRUCE J R E N O C H D
(If Applicable) Enter Survi`ing 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
^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)
~
^X 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 ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
GVKKtSF'VNUtN 1 - ~ Fill ,tl: ~ run MU51 tst GVMrLt ~ tU. ALL I.VKKC.~rV1YUtnGC AnU ~-VI~It Wtl~l l IAL 1 AA IntVKNW l ivn .~nVULU est UIKtV 1 tU 1 V:
Name Daytime Telephone Number
H ANTHONY ADAMS
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY
First line of address n ~
~ ~'
4 9 WEST ORANGE STREET ~ ~~j~~~
Second line of address ~-~--~ .'~~^]. r`- ~ , -, ..~:~;;~
S U I T E 3
~
r ~ ~'
Ci or Post Office ~ State ZIP Code
tY ~
Ca ti: {`-:4'
~ ~ ~
S H I P P E N S B UR G PA 1 7 2 5 7 ~~ v =~~~:
Correspondent's a-mail address:
Under penalties of pery'ury, 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 representable is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
~Q
ADDRESS
1 MISTY LANE, MIDDLETOWN
PA 17057
SIGNATUR~ PREP HER THAN REP TATIVE TE
S-
-
ADDR
~~ ~ ~ ~
b
.
EASE USE ORIGIN FORM ONLY ~"7~
Side 1
1505607121 1505607121 J
J 1505607221
REV-1500 EX Decedent's Social Security Number
Decedents Name: ENOCH D. BRUCE, J R. 2 0 2 2 0 5 0 9 6
RECAPITULATION
4 6 9 0 0
0 0
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. •
2 ~ 2 7
8 ~
5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ....... 5. •
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6• •
7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property
Billi
R
~ S
d
7
eparate
ng
.......
(Schedule G)
equeste . •
8. Total Gross Assets (total Lines 1-7) ........................... 8. 4 9 0 2 7. 8 ~
9. Funeral Ex enses & Administrative Costs Schedule H
P ( ) ..
.......
..... 9.
.. 3 0 0 8 • ~ 2
2 9 9 8 2 7 0
10. Debts of Decedent, Mort a e Liabilities, 8 Liens Schedule I
9 9 ( ) ..... 10.
....... .
11. Total Deductions (total Lines 9 8~ 10) ............. ....... ....... 11. 3 2 9 9 0. 8 2
12. Net Value of Estate (Line 8 minus Line 11) ........... ....... ....... 12. ~ 6 0 3 6. 9 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) .... ....... ..... .. 13. •
~ 6 0 3 6 9 9
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
0
0
0
15
0
0
0
(a)(1.2> x .0 . . .
16. Amount of Line 14 taxable
0
0
0
0
0
0
at lineal rate x .0 . 1 g .
17. Amount of Line 14 taxable 1 6 0 3 6. 9 9 17 1 9 2 4. 4 4
at sibling rate X .12 .
18. Amount of Line 14 taxable
0
0
0
0
0
0
at collateral rate X .15 . 1 g• .
~ 9 2 4. 4 4
19. Tax Due .................................. ....... .... ...19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
1505607221 1505607221
REV-1500 EX Page 3
Decedent's Complete Address:
(1) 1, 924.44
DECEDENTS NAME
ENOCH' D. BRUCE, JR.
STREET ADDRESS
11 NORTH MORRIS STREET
CITY
SHIPPENSBURG STATE
PA ZIP
17257
Tax Payments and Crediits:
~ • Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InterestlPenalty if applicable
D. Interest
E. Penalty
File Number
21 08 01162
Total Credits (A + B + C) (2) 0.00
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.
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.
(4) 0.00
(5) 1,924.44
(5A)
(5B) 1, 924.44
Make Check Payable fo: 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? .................................................................................. ..... ^ 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? ............................................................................................. ..... ^ 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
[7'? 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 childtwenty-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-1502 EX + (8-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ENOCH D. BRUCE JR. 21 OS 01162
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real ro which is in -owned with ri ht of survivorshi must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. DWELLING AT 11 NORTH MORRIS STREET, SHIPPENSBURG, BOROUGH, 46,900.00
CUMBERLAND COUNTY, PENNSYLVANIA (HUD ATTACHED)
TOTAL (Also enter on line 1, Recapitulation) ~ ~ 46, 900.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ENOCH D. BRUCE, JR. 21 08 01162
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. TREFZ & BOWSER FUNERAL HOME, INC. 2,258.12
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City
Year(s) Commission Paid:
State Zip
2. Attorney Fees
3, Family Exemption: (If decedents address is not the same as claimant's, attach explanation)
Claimant
Street Addn~s
City State Zip
Relationship of Claimant to Decedent
4. I Probate Fees
5 Ac;oountant's Fees
6. Tax Return Preparers Fees
7
TOTAL (Also enter on line 9, Recapitulation) I ~
(If more space is needed, insert additional sheets of the same size)
750.00
3,008.12
REV-1512 EX + (12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ENOCH D. BRUCE, JR. 21 08 01162
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. CENTRAL PENN GAS (UGI) 397.42
2. HOSPITALIST OF FRANKLIN COUNTY 61.92
3. KEYSONTE HEALTH CENTER 139.43
4. CMC COLLECTION 261.13
5. BOROUGH OF SHIPPENSBURG (UTILITY) 239.66
6. REALTOR'S COMMISSION ON SALE OF REAL PROPERTY 2,814.00
7. REALTOR'S SETTLELMENT FEE ON SALE OF REAL PROPERTY 250.00
8. TRANSFER TAX ON SALE OF REAL PROPERTY 469.00
9. PENELEC 36.55
10. HERSHEY MEDICAL CENTER 169.17
11. SHIPPENSBURG EMS 117.77
12. SUMMIT CANCER & HEMATOLOGY 44.96
13. CUMBERLAND VALLEY MEDICAL 96.06
14. HOUSEHOLD FINANCIAL CORP. MORTGAGE PAYOFF 24,685.63
15. CENTRAL PA REHABILITATION 200.00
TOTAL (Also enter on line 10, Recapitulation) I S 29,982 70
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
ENOCH D. BRUCE JR. 21 08 01162
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [indude outri~ ~ spousal distributions, and transfers under
Sec. 9116 a 1.2
1. CHARLES BRUCE, SR. Sibling 16,036.99
1 MISTY LANE
MIDDLETOWN, PA 17057
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
jj, 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 I ~
(If more space is needed, insert additional sheets of the same size)
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
ar zsoz-ozesi tExa-e, ~
1.[ ]FHA 2.[ ] FmHA 3.[ ]Conv. Unins.
4.[ ] VA 5.[ ]Conv. Ins. I8. Fik Number. I 7. Loan Number. 8. Mortgage Insurance Case Number.
C. NOTE: This form furnishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
"(p.o.c.)' were paid outside the dosing; they are shown for informational purposes and are not included in the totals.
D. Name 8 Address of Borrower.
Cumberland Non•Profit Housing
Shippensburg, PA 17257 E. Name, Address 8 TIN of Seller.
Estate of Enoch D. Bnrce, Jr.
Charles Bruce, Sr. Executor F. Name 8 Address of Lender.
,
G. Property Location: TIN of Seller. H. Settlement Agent:
11 North Moms Street
Shippensburg, PA 17257 Place of Settlement H. Anthony Adams, Esquire
Boro. of Shippensburg, I. Settlement Date: November 21, 2008
J. Summary of Borrower's Transaction K. Summary of Seller's Transactlon
100_ Greve Amount Due from 9errower I00_ Greve Amount Due fo Seller_
101. Contract sales price 48,900.00 401. Contred sales price 48,900.00
102. Personal Property 402. Personal Property
103. Borrowers settlement charges (line 1400) $1,051.50 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
108. City/town taxes to 28.80 408. Cityftown taxes to 26.80
107. County taxes to 407. County taxes to
108. Assessments to 408. Assessments to
109. School taxes to 382.44 409.School taxes to 362.44
110. 410.
111. 411.
112. 412.
113. 413.
120. Gross Amount Due from Borrower $48,340.74 420. Gross Amount Due to Seller $47,289.24
200. Amounts Paid by or in Behalf of Borrower: 500. Rsductlons In Amount Due to Seller.
201. Deposits or earnest money 2,500.00 501. Excess deposit (see instrudions)
202. Prncpal amount of new loan(s) 502. Settlement charges to seller (line 1400) $3,533.00
203. Existing loan(s) taken subject to 503. Existlng loan(s) taken subject to
204. 504. Payoff of first mortgage to HFC 24,500.00
205. 505. Payoff of second mortgage
206. 508.
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for Items unpaid by seller
210. CityRown taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
213. School taxes to 513.Schod taxes to
214. 514.
215. 515.
216. 51B. Borough of Shippensburg 239.88
217. 517.
218. 518.
219. 519.
220. Total Paid ByHor Borrower $2,500.00 520. Total Reduction Amount Due Seller $28,272.66
300. Cash at Settlement Fromlto Borrower
301. Gross amount due from borrower (line 120) $48,340.74
302. Less amounts paid by/for borrower (line 220) $2,500.00 600. Cash at Settlement To/from Seller
801. Gross amount due to seller (line 420)
802. Less reductlons in amount due seller (line 5zo)
$47,289.24
$28,272.88
303. Cash X from to Borrower $45,840.74 803. Cash X to from Seller $19,018.58
Substltute Form 1099 Seller Statement
The information in Blocks E, G, H, 18 line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax infomration and is being
furnished to the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required to be
reported and the IRS detemtines that it has not been reported. If this real estate is your prindpal residence, file Fonn 2119, Sale or
Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable pans of Form
4797, Form 6252 and/or Schedule D (Form 1040). You are required to provide the Settlement Agent (named above) with your correct
taxpayer identification number. H you do not provide the Settlement Agent with your taxpayer identification number, you may be subject to
civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct
taxpayer identification number.
(Seller) (Selby)
L_ SetHerrent Charnel
700. Total SalsslBroksrs Commission: based on rice $48,900.00 X Paid from Pafd from
Division of Commission line 700 as folkrws: Borrowers Sellers
701.ReMax real Select $1 382.000 Funds at Funds at
702.ReMax First Advanta a $1 432.00 Settlement Settlement
703. Commission id at Settlement 2 814.00
704.
800. Items Pa able in Connsctlon with Loan
801. Loan O ' inatlon Fee
802. Loan Discount
803. isal Fee
804. Credit Re rt
805. Lenders Ins action Fee
808. Mat a Inaurarxxi ication Fee
807.
808.
809.ReMax Advanta a Transaction Fee 250.00
810.
811.
812.
813.
814.
900. Items Re wired b Lender to ee Paid in Advance
901. Interest from to $ er da
902. Mort a e Insurance Premium for
903. Hazard Insurance Premium for
904.
905.
1000. Reserves De itsd with Lender
1001. Hazard insurance months er month
1002. Mat a insurance months $ r month
1003. C ro taxes months $ er month
1004. Coon ro taxes months $ er month
1005. Annual assessments months $ r month
1006. School taxes months $ er month
1007.
1008.
1009. A ate Accounts Ad ustment
1100. Title Cha es
1101. SettlemenUclosi fee
1102. AbstracUtitle searoh to A8A Abstradin Settlement Services ~•~
1103. Title examination
1104. Title insurance binder
1105. Document r aratlon
1106. Note fees
1107. Attome s fees to H. Anthon Adams Es wire 5~•~
indudes above item numbers
1108. Title insurance to Bankers Settlement Services Ca ftal R ion
indudes above item numbers
1109. Lenders covers e
1110. Owners covers e
1111.
1112.
1113.
1200. Government Recordin and Transfer Cha
1201. Rtscordin fees: Deed 38.50 Mort a e Release $ 38.50
1202. Ci /coon tax/stam s: Deed 469.00 Mort a e
1203. State tax/stam s: Deed 489.00 Mort a a $ 469.00
$ 469.00
1204 UPI 10.00
1205.
1206.
1300. Additional Settlement Cha es
1301. Surve
1302. Pest Ins action
1303.
1304.
1305.
1306.
1307.
1308. c-~___~~ rtie.,,.~ rrtir. N..~Mer Transfers to Lines 103 8602 Above) $1,051.50 $3 533.00
'••~. • •,•`.. __---°•---- ----- - - CERTIFICATION
I have carefuly reviewed the HUD-1 Settbment Statement and to the beat of my knowledge and belief, R is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement.
Seller Borrower
Seller Borrower
To the best of knowledge the HUD- ettlement Statement which I have prepared is true end atxurate account of the nds which were received and
have been or i e ib e u rs gn part of the settlement of this transaction. Date
- " Settlement Agent
WMNING: It b a . ro WwwhgiY mNre false atalemsrds to the lNtilad States on This a any oMar aMdlar farm. PenNUsa Won eonvictiort end ImpriforaraaN. Fa details ass: Title 18 U.S.
Cods Ssctiwr 1(71)1 and Sadion 1010.