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HomeMy WebLinkAbout11-13-091505607121 REV-1500 ~ (06-05> PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes ~' Po sox 2sosol INHERITANCE TAX RETURN 2 1 0 9 0 8 4 8 _ Harrisburg, PA 17128-0fi0i RESIDENT DECEDENT ENTER DECEDENT fNFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 1 2 4 4 0 0 1 0 7 2 1 2 0 0 9 0 4 0 3 1 9 3 2 Decedent's Last Name SutTix Decedent's First Name MI WI CKENHEi SER PAUL I NE H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 1. Original Return 4. Limited Estate QX 6. Decedent Died Testate (Attach Copy of Wilt) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum 4a. Future Interest Compromise (date of death after 12-12-82) 1 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number SHAWN M. P I E R S O N 7 1 7 5~ 0 4 ~6 6 Firm Name (If Applicable} ~= q w '?'~ First line of address 1 0 5 E A S T Second-line of address City or Post Office L I T( T Z State ZIP Code P A 1 7 5 4 3 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Totaf Number of Safe Deposit Boxes 11. Election to tax under Sec. 8113(A) (Attach Sch. O) REGISTER pF1II1D.LS USE (',~Y r ~~. ~{~ DATE FILED ~ ~ _rx Correspondent's a-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 belief, it is true, correct and complete. Declaration o reparer other than the personal representative rs based on all information of which preparer has any knowledge. SI TU OF PERS R PO F F!L G TU /~~ - ////,~ ©~~T ~O~ Loo g ADDRESS 1020 TUNBRID E LA E MECAHNICSBURG PA 17050 SIGNATURE OF TH HAN REPRESENTATIVE DATE /vr'SG; ~Cy 105 EAST OREGON ROAD LITiTZ PA 17543 PLEASE USE ORIGINAL FORM ONLY OREGON ROAD Side 1 .1505607121 1505607121 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: PAULINE H. WICKENHEISER 2 0 1 2 4 4 0 0 1 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. 4 6 1 7 0. 7 4 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... .... 5. 6. Jointly Owned Property {Schedule F) ^ Separate Billing Requested ... .... 6. • 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property uested arate Billin Re ~ Se l G 7 1 7 ~ 8 7 rJ • $ 2 ... g q p (Schedu e ) . .... 8 2 2 6 0 4 6. 5 6 8. ................ Total Gross Assets (total Lines 1-7) _ . , ... ..... . 9 1 4 4 6 7 • 5 0 9. Funeral Expenses i3< Administrative Costs (Schedule H) ........... . ..... 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) ....... ..... 10. 11. Total Deductions (total Lines 9 8 10) ...................... ..... 11. 1 4 4 6 7, 5 0 12. Net Value of Estate (Line 8 minus Line 11) .................. ..... .. 12- • 2 1 1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........... ..... .. 13. 2 1 1 5 7 9 0 6 ..... 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.o _ . 16. Amount of Line 14 taxable 2 1 1 5 7 9 0 6 9 5 2 1 0 6 . at lineal rate X -045 16. 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17. . 18. Amount of Line 14 taxable 0 0 0 0• 0 0 at collateral rate X .15 1 g 5 7 9 0 6 19. 'Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 9 5 2 1. 0 6 Side 2 1505607221 1505607221 REV-1500 EX Page 3 n......a~.,~~~ (`mm~lnte Oriri~ncca ~..~~~.~..~. -----r---- - - DECEDENTSNAME LINE H.'INICKENHEISER --- PAU _ STREETADDRESS 1020 TUNBRIDGE LANE ----- CITY STATE 'ZIP ~ 17050 MECHANICSBURG PA File Number 21 09 0848 Tax Payments and Credits: (1) 9,521.06 t. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal PoveRy Credit B. Prior Payments 9,000.00 C. Discount 473.67 Total Credits (A +B +C) (2) 9,473.67 3. Interest/Penalty if applicable D. Interest 0.00 E, Penalty 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. {4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 47.39 A. Enter the interest on the tax due. (5A) B. Enter the total of line 5 +5A. This is the BALANCE DUE. (56) 47.39 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 : ................................................................. ..... Q Q 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 occurced after December 12,1982, did decedent transfer property within one year of death ^ 0 without receiving adequate consideration? .................................................................................. a ..... ^ 0 or payable upon death bank account or security at his or her death? ... 3. Did decedent own an "intrust for ...... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which centains 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 [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 'rf 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-0ne 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)j. 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)j. A sibling 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-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER PAULINE H. WICKENHEISER 21 09 0848 Include the proceeds of litigation and the date the proceeds were received by the estate. Atl property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Susquehanna Bank Checking Account #236823401 (Includes Accrued Interest) 40,654.68 (See attached DOD value) 2. Susquehanna Money Market Account #10001849594 (Includes Accrued interest} 4,619.28 (See attached DOD value} 3. Refund from Country Meadows Associates ggg.7g TOTAL (Also enter on fine 5, Recapitulation) ~ $ _ 46,170.74 {If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-~8) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON•PROBATE PROPERTY FILE NUMBER PAULINE H. WICKENHEISER 21 09 0848 This schedule must be completed and tiled if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. fT.EM NUMBER DESCRIPTION OF PROPERTY MCLODETHENAMEOFIHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTf~YD THE DATE OF TRANSFER ATTACHACOPYOFTHEDEEDFORREALESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD~S INTEREST EXCLUSION (IFAPPLICASLE) TAXABLE VALUE ~. Sunlife Financial Annuity Contract KA12672343-01 96,759.16 100. 96,759.16 (Beneficiaries =children, Michael Wickenheiser, Paula Deck and Steven Wickenheiser) 2. Western National Annuity Contract W215647 83,116.66 100. 83,116.66 (Beneficiaries =children, Michael Wickenheiser, Paula Deck and Steven Wickenheiser) l TOTAL (Also enter on line 7 Recapitulation) I $ 179 875 82 (!f more space is needed, insert addfional 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 PAULaNE H. W(CKENHEISER 21 09 0848 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Kearney A. Snyder Funeral Home -Professional Services, Facilities, Equipment, 10,055.00 Casket, etc. ) 6. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City STate Zip Year(s) Commission Paid: 2. Attorney Fees Shawn M. Pierson 3. Family Exemption: (If decedents address is notthe same as Gaimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills ~ Accountant's Fees Reserve for 2009 Personal Taxes 6. Tax Return Preparers Fees 7. Cumberland Bar Association -Estate Advertising 8. Sentinel -Cumberland Newspaper -Estate Advertising 9. Copies, Toll Calls, Faxes 3,632.71 350.00 75.00 75.04 54.79 225.00 TOTAL {Also enter on line 9, Recapituiation} + $ 14,467.50 (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 FILE NUMBER PAllLINE H. WiCKENHEISER 2~ n9 nRaR 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 [nGude outright spousal distributions, and transfers under Sec. 9116 {aj (1.2)i 1. Paula M. Deck Lineal 1/3 of residuary estate, 617 S. Broad St 1/3 of assets listed Lititz, PA 17543 on Sch G 2. Steven M. Wickenheiser Lineal 113 of residuary estate, 1020 Tunbridge Lane 1/3 of assets listed Mechanicsburg, PA 17050 on Sch G 3. Michael D. Wickenheiser Linea( 1/3 of residuary estate, 1313 Willow Creek Drive 1/3 of assets fisted Mount Joy, PA 17552 on Sch G ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX !SNOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space is needed, insert additional sheets of the same size) a air _'~`'~. ., Z C ~ ~ M ~' ~° ~ N ~~ ~ N 4 (7 ~N_ r~y N H ~ sa O l+'~ {' i` t `.. ~! 209 ~4Y ~ 3 ~~ t2~ 39 I f _ ~~ f~Y ~~~ ;. ~. "'?'' J ~ ~ _l _. 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