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HomeMy WebLinkAbout07-10-09 (2)' 15056041046 REV-1500 EX (05-04) ~~ ~~ ~~ ' PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Dept. 280601 INHERITANCE TAX RETURN Q Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ~ D ! ~ ~ ~, ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 4 0 5 .2 4 2 6 0 2 2 6 2 0 0 9 1 Q 0 9`7 9 1 7 Decedent's Last Name Suffix Decedent's First Name MI K u h n G l a d y s E (If Applicable) Enter Surviving 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 i 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate O 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number A n t h o n y L D e L u c a E s q 7 1 7 2 5 8 6' 8 4 4 tbar. Firm Name (If Applicable) First line of address P.O. B o x 3 5 8 Second line of address 1 1 3 F r o n t City or Post Office S t r e e t B o i l i n g S p r'i n g s Correspondent's a-mail address: State ZIP Code REGISTER QE ~LS USE SLY , >~p+~ ~C+_~ r 't.l d - i l ~ ~ ~ ~~~ ~~~ r ~ --- j ' © ~. ~' ,"' k~.F ~ V / -~ ~-_' . `~ ~ -~ ^~ ~ , •• ~ ~ DATE FILED P A 1 7 0 0 7 r, j ~~ ,,`,^,+ ~'" ""~ .Y~ 1 ~~._ '."> ~.. +~ r'3 r `p Side 1 L 15056041046 15056041046 J 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, 15056042047 REV-1500 EX ~ ' Decedent's Social Security Numbe r Decedent's Name: ~ .rt _ ~ ~ ~. . ~.. ~~ ~ ~~ RECAPITULATION 1. Real estate (Schedule A) . ............................................ 1. 0 . 0 0 2. Stocks and Bonds (Schedule B) ....................................... 2. 0 , 0 0 3. Closely Held Corporation, Partnership or Sole-ProprJetArship .(Schedule C) ..... 3. . ; 0 • 0 0 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 0 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 1 ~ 1 1 2 , 4 7 6. Jointly Owned Property (Schedule F) C Separate Billing Requested ....... 6. 4 5 , 2 4 2 . 1 8 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C Separate Billing Requested........ 7. 5 ~ 7 9 2 „ 5 , 7 , 8. Total Gross Assets (total Lines 1-7) .................................... 8. 5 2 1 4 7 2 2 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 1 0 ~ 6 1 8 • 0 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 7 3 6 4' 11. Total Deductions (total Lines 9 & 10) ................................... 11. 1 0 ~ 6 9 1 • 7 2 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12 4 1 ~ 4 5 5 5 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 0 0 an election to tax has not been made (Schedule J) ........................ 13. ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 4 1 ~ 4 5 5 i 5 0 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 ~5 4' 1 4 5 5 .5 0 1 s. 1, 8 6 5. 5 0 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. 1 ~8 6 5 5 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056042047 15056042047 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME S~~a C~_y_5-~s-__I~u~1I1 - ---- - ------- -- - STREETADDRESS 16 Rear Mountain Street ___ _ _._ CITY Mount Holly Springs STATE PA ziP 17065 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit _-_ B. Prior Payments _ _ _ C. Discount - ~ Total Credits (A + 6 + C) (2) - 0 - 3. InterestlPenalty if applicable D. Interest - 0 - --- - - - E. Penalty _ 0 _ _ - - -- - -- -- --~- Total Interest/Penalty (D + E) (3) - 0 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. (4) --- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $1 , 8 6 5.5 0 A. Enter the interest on the tax due. (5A) - 0 - B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~1 .8 6 5.5 0 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? .............. ^ 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. (1) $1,865.50 -v- -0- REV•1508 EX. (1.87) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY -zGCinGtir nGr~nGtir ESTATE OF FILE NUMBER Gladys E. Kuhn Indude the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER _ DESCRIPTION OF DEATH ~• I Certificate of Deposit, #31000298957, at PNC Bank ( $1,112.47 TOTAL (Also enter on line 5, Recapitulation) I ~ 1 , 1 1 2 . 4 7 (if more space is needed, insert additional sheets of the same size) REV-1509 EX ~ (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Glayds E. Kuhn If an asset was made joint within one year of the decedent's date of death, h must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Audrey L . Jury 41 Mountain Street Mount Holly Springs, PA 17065 B. Paul C. Kuhn C JOINTLY-OWNED PROPERTY: 16 Rear Mountain Street Mount Holly Springs, PA 17065 Daughter Son ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial instltution and bank account number or similar identifying number. Attach deed for jointly-held real estate. ~ DATE OF DEATH VALUE OF ASSET °k OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 0/1 / 2 Checking Account $1 01 .37 50~ $ 52.18 #5140399036 at PNC Bank 2 B /21/ 7 Residence at 16 Rear Mountain St $90,380.00 50~ 45,190.00 TOTAL (Also enter on line 6, Recapitulation) ~ 4 5 , 2 4 2. 1 8 (If more space is needed, insert additional sheets of the same size) ~vtsto Ex • n-sn COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF Glayds E. Kuhn SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 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 DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE of TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE 1. MetLife Investors Insurance Company $ 5,792.57 100 -0- $5,792.57 Contract A2064423 TOTAL (Also enter on line 7, Recapitulation) I a 5 , 7 9 2. 5 7 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEDULE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Glayds E. Kuhn Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~~ Hollinger Funeral Home & Crematory, Inc. $10,203.08 501 North Baltimore Avenue Mount Holly Springs, PA 17065 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. Attorney Fees Anthony L. DeLuca, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 400.00 4 5 6 7 City State _ Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Filing Fee - Inheritance Tax Return Zip State Zip 15.00 TOTAL (Also enter on line 9, Recapitulation) I $ 10 , 618.0 8 (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 SCHEDI~LE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Glayds E. Kuhn Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Glayds E. Kuhn FILE NUMBER 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. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 1 S, 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. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ - 0 - (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: ANTHONY DELUCA PO BOX 358 BOILING SPRINGS, PA 17007 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 184-05-2426 FILE NUMBER: 2100-0000 DECEDENT NAME: KUHN GLADYS E DATE OF PAYMENT: 07/ 10/2009 POSTMARK DATE: 07/ 10/2009 COUNTY: CUMBERLAND DATE OF DEATH: 00/00/0000 REV-1162 EX111-96) NO. CD 01 1472 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $1,865.50 TOTAL AMOUNT PAID: REMARKS: CHECK# 805 SEAL INITIALS: MW $1, 865.50 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS a . 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