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Home My WebLink About09-22-09t ADLER &ADLER ATTORNEYS AT LAW 125 LOCUST STREET P.O. BOX 11933 HARRISBURG, PENNSYLVANIA 17108-1933 TELEPHONE (717) 234-3289 FAX (717) 234-1670 WILLIAM L. ADLER CRAIG I. ADLER* *ALSO ADMITTED TO PRACTICE IN NJ OVERNIGHT MAIL ADDRESS: 125 LOCUST STREET HARRISBURG, PENNSYLVANIA 17101 LEWIS F. ADLER (1934-1984) DAVID S. KOHN (1934-1985) LOUIS J. ADLER (1959-1999) KOHN AND ADLER (1934-1960) KOHN, ADLER &ADLER (1960-1981) September 16, 2009 Cumberland County Courthouse Register of Wills One Courthouse Square Carlisle, PA 17013 Dear Register: RE: Estate of John W. Davis 21-08-0657 Enclosed please find a check for $5.00 so that the supplemental inheritance tax return for the above estate can be processed. Thank you. Very truly yours William L. Adler 4 'cYa ..... .. ~~ 3C ~:j+ -.~;.j ._ .. ~'J`M.} y4 1 505605 1 05f3 REV-1 ~OO Ex iGa-G5! OFFICIAL USE ONLY PA Department of Reven;s2 Bureau ofi Individual Taxes ~ ~ ~ ~ INHERITANCE TAX RETURN minty Code Year Fide Number ~o sox 28~G6g, 21 08 0657 Hamsburg. PA t7t2e-osot -~ ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Soci,`~i Security Number Date of Death Date of Birth 184-09-1733 05/2312008 08111/1916 Ueceae^t s t.ast ~aame Suffix Decedent`s First Name MI Davis John ~ (If Applicable) Enter Surviving Spouse's Infarmatian Below Spouse s last Name Suffix Spouse's First Name MI Spouse s Sliciai Security Nurntser THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW , Qrig~nal Return ~ 2 Supplemental Return 3. Remainder Retum {date of death prior to 12-13-$2} •t ~im;ted Estate 4a Future Interest Compromise idate of 5. Federal Estate Tax Return Required death after 12-12-82) r Decedent Died Testate ? Decedent Futaintained a Living Trust 00 8 Tatat Number of Safe Deposit Boxes ~ Attars: Oapy of Vtit,i, t (Attach Copy of Trust} '± '~+r baton ?roceeds Received '. ~. Spoaisal Poverty Credit (data cf death 11. Election to tax under Sec. gi13(,A} between 12-3?-9t and i-,-try (Attach Sch. Q} CORRESPONDENT - THIS SECTION MUST tiE COMPLETE0. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO' Name Daytime Telephone Number VNiI)am L. Adler (717) 234-3289 Firm Name (If Applicable) t*a _t"7 ADLER S ADLER '~ .a .... -~t-' ' - -' r r~ ~ ) First rune of adaress ~ rte" `fl ~T~~;, ; c7 125 Locust Street y ~ tv r ' ~' }-~~ Second fine of address ~C S~~ ~.,~~. r C.~ -~-t Z - °`~ ~ e9ty or Post Office State SIP Code •' .C' - `=~ '~_.~> Harristaurg PA 17101 , t Correspondent s e-mail address. Uruser Utralties or pery'ury, l declare that (have examined this return, including accompanying schedules and statements, arxi to the best of my knowled ge and betel, ~t ~s true, correct and complete. DeCiaratlfln of preparer other than the personal rearesentative is basod on all information of which preparer has any knowledge. SIGNATU OF PERSON RESPONSIBLE F FILING RE !RN DATE '~ `~~- - ~' 8- 0 9 ADC? ~ ~ ~ ~ o~~~-e- __ . ,~ i ?3 3 9 ~~ SIGrJ T~ "' PREP R p R "PRESE~iTA'rG,IE /r~~~ ,utn F, s O 1 Z '.S L o live ~ ~ f'7~'~ ~ ~~ LEASE USE ORIGINAL FORM ONLY Side 1 15050() ~ 1058 150;iEC):~~ 1058 J 15056052059 REV 1500 EX Decedent's Social Security Number oece.nrs ~~: John W Davis 184-09-1733 RECAPITULATION 1. Real estate (Schedule A)........................ ........... . . - ....... 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 11,678.00 3. Cbsely Held Corporation. PaMership or Sole-Pmprktorship {Schedule C) ..... 3. 4. Mortgages ~ Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits b Miscellaneous Personal Property (Schedule E) .... , . , . 5. 6. Jointly Owned Property (Schedule F) Separate Bating Requested ....... 8. T. Inter:Vivos Transfers S Miscellaneous Non-Probate Property (Sdtedule GI Separate B~NNng Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. 9. Funeral Expenses b Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent. MoAgage Liabilities. 8~ Liens (Schedule 1) ........ . ....... 10. 11. Total Deductions (total Lines 9 S 10) ................................... 11. 12. Net Value of Estate (Llee 8 minus Line 11) ............................. 12. 13. Charitable and Govenwnental Bequests/Sec 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 INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 16. Amount of line 14 taxable at Gnesl rate x .0 45 11,678.00 16, 525.51 1 ~. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 tR 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ 15056052059 Side 2 15056052059 RE\h1500 t?X Pige 3 Decedent's Complete Address: File Number 21 08 0657 CEDENTS NAME DECEDENTS SOCIAL SECURITY t~lMBER John W Davis 184-09-1733 STREET ADDRESS - -' - - - - 5225 Wilson Lane CITY ~ ~ - i STATE --- ZIP _ _ _ Mechanicsburg ~ PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 525.51 2. CreditslPayments A. Spousal Poveliy Credit _ _-- 8. Prior Payrrlerits C. Discount -~ ~ - - - - ---- Tmal Credits (A + 8 + C) (2) 8.909.04 3. InleresflPenalry if applicable 0. Interest E. Penalty - Total InterestlPer>aHy (D + E) (3) 4. if Line 2 is greater than Line 1 + Line 3, enter the ~ference. Ttas is the OVERPAYMENT. Fill in oval on Page 2, Une 20 to request a refund. (4) 8,383.53 5. H Une 1 + Line 3 is greater than Line 2, enter the d'llferenrce. This is the TAX DUE (5) A Ereer the interest on the tax due. ~~) B. Enter the total of Line 5 + 5A. Tlas is the BALANCE DUE i5g) 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 ~ a. retain the use or income of the property transferred~ ...............-_.................................................................... ^ b. retain the right to designate who shall use the properly trar~femed or its income : ........................................... ^ c. retain a reversionary interest: or .......................................................................................................................... ^ d. receive the promise for bfe of either payments, benef~s or care? ...................................................................... ^ 2. tf death oowrred after December 12,1962, did decedent transfer property within one year of death without receivgig adequate aonsiderauon? .............................................................................................................. ^ 3. Did decedent own an 'rn bust for or payable upon death bank account or searnity at his or her death? .............. ^ Q 4. Did decedent own an trldividual 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 ttie net value of transfers to or for the use of the sunrirring spouse is tht+ee (3) percent [T2 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 ~ transfers to or for the use of the surviving spouse is zero (0) percent X72 P.S. §9116 (a) (1.1) ('adj. The statute does not exempt a transfer to a surviving spouse from tax, and the statu~y regt~rements for disclosure of assets aI>d f6ing a tax return are still applicable even if the surviving spouse is the Drily 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 a young 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 ~ or for the use of the decedent's meal beneficiaries is form and one-h~f (4.5) percent, except as noted in T2 P.S. §9116(1.2) (72 P.S. §9116(a)(1)i. The tax rate imposed on the net value of transfers to or for the use of the decedents slings is twehre (12) percent 172 P.S. §9116(a)(1.3)j. Asibling isdefined, under Section 9102, as an individual who has at Least one parent in common wiUi the decedent, whether by bbod or adoption, SCHEDULE "B" STOCKS AND BONDS Estate of John W. Davis File Number 21-08-0657 ~TErI NUMBER DESCRIPTION VALUE AT DEATH Ikon Office Solutions, Inc. 988 shares common stock CIK 21676 11.82/share $11,678.00 TOTAL STOCKS AND BONDS $11,678.00 --~.~ .3 ~ o ..~ '~AP~ RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County -Register Of Wills One Courthouse Square Carlisle, PA 17613 DAVIS JOHN W Receipt Date: 9/22/2009 Receipt Time: 12:28:42 Receipt No.: 1058332 Estate File No.: 2008-00657 Paid By Remarks:W~ILLIAM L ADLER ESQ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 5.00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 1263 $5.00 Total Received......... $5.00