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Home My WebLink About11-20-09 (2)7,5056071~.L i REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 0 9 0 7 3 2 Harrisbu , PA 17128-0601 RESIDENT DECEDENT ENTEIR DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 7 0 7 9 9 1 2 0 6 2 2 2 0 0 9 0 3 1 5 1 9 1 9 Decedent's Last Name Suffix Decedent's First Name MI B E H R E N S R I C H A R D (If Apiplicable) 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 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) Q 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) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number C H A R L E S E P E T R I E 7 1 7 5 6 1 1 9 3 9 Firm Name (If Applicable) First. line of address 3 5 2 8 B R I S B A N SeGOnd line of address City or Post Office H A R R I S B U R G S T R E E T Correspondent's a-mail address: Petr18L8W Q~OL.C01T1 State ZIP Code P A 1 7 1 1 REGISTER OF WILLS USE ONLY cv '`~ ~:~ t:~7 _: ^ La ~J ~~ _ -- - ~: . o _~ -~ x=~ i ~ UALED t --I '-' - 1 ~ ~ cn Under penalties of perjury, I declare that I have examined this return, including acxompanying schedules and statements, and to the best of my knowledge and belief, it is tr ,correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. 7ATUREqF PER N 1~E SQL O ylLt G RETURN DATE i.~1i r/'` ~ / `~.. 11' i~l, ,l''~' 1 10/27/2009 812, ACRI ROAD MECHANICSBURG PA 17 SIGPJAT OFPREPARER OTH NAN REPRESENTATIVE DATE ~~a~ . ~ r ~. 10/27/2009 3528 BRiSBAN STREET HARRISBURG PA 17111 PLEASE USE ORIGINAL FORM ONLY 1505627121 Side 1 1505607121 J 1505607221 REV-1500 EX Decedent's Name RICHARD BEHRENS Decedent's Social Security Number 2 0 7 0 7 9 9 1 2 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 & Notes Receivable (Schedule D) ~ ~ - ~ ~ ~ ~ ~ ~ ~ 4. • 1 0 0. 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 4 9 0 7 7. 4 9 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property . (Schedule G) ~ Separate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1-7) ........................ ... 8. 4 9 1 7 7 4 9 9 Funeral Expenses & Administrative Costs (Schedule H) 9. 1 0 0 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........... 10. • 11. Total Deductions (total Lines 9 & 10) ................... 11. 1 0 0 0 0 1c:. Net Value of Estate (Line 8 minus Line 11) ........................ 12. 4 9 0 7 7 4 9 1:1. Charitable and Governmental 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. 4 9 0 7 7 4 9 T~4X COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 1,`i. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 (a)(1.2) X.0 _ . 16. Amount of Line 14 taxable at lineal rate X .045 4 9 0 7 7 4 9 16. 17. Amount of Line 14 taxable 0 0 0 17 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 at collateral rate X .15 . 19 Tax Due ....... ............................ ..... ..19. 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505627221 Side 2 0. 0 0 2 2 0 8. 4 9 0. 0 0 0. 0 0 2 2 0 8. 4 9 0 1505627221 REV-1500 EX Page 3 rlnrprlpnt's Cemulete Address: File Number 21 09 0732 DECEDENT'S NAME RICHARD BEHRENS STREET ADDRESS 812 ACRI ROAD CITY _ - _ - _.. STATE ZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 2,300.00 C. Discount 110.42 Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (1) 2,208.49 Total Credits (A + B + C) (2) 2, 410.42 Total Interest/Penalty (D + E ) 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. 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) 201.93 (5) 0.00 (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: 1 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? .................................................................................. h? h d ..... ^ ^ ^ ... er eat 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or ...... Did decedent own an Individual Retirement Account, annuity, or other non-probate property which 4 . 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) pen;ent [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 SPC:tion 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) COMMON~NEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER RICHARD E3EHRENS 21 09 0732 Include the proceeds of litigation and the date the proceeds were received by the estate. All property iointN-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. REFUND FROM PMI 100.00 TOTAL (Also enter on line 5, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) COMMON~NEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER RIr.HARn RFHRFNS 21 09 0732 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVI\/ING JOINT TENANT(S) NAME A. LINDA 61=HRENS JOINTLY-OWNED PROPERTY: ADDRESS 812 ACRI ROAD MECHANICSBURG, PA 17050 ELATIONSHIP TO DECEDENT DAUGHTER ITEM NUMBER LETT=R FOR JOINT TENPNT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. .7/17/04 ACCOUNTS AT BELCO COMMUNITY CREDIT UNION 98,154.97 50. 49,077.49 TOTAL (Also enter on line 6, Recapitulation) I $ 49,077.49 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + 110-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES Sr INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER RICHARD E3EHRENS 21 09 0732 Debts of decedent must be reported on Schedule f. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. PARTHEMORE FUNERAL HOME 100.00 B. 1 2. 3. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedents address is not the same as claimants, attach explanation) (claimant SVeet Address City State _ Relationship of Claimant to Decedent 4. I Probate Fees 5 Accountants Fees 6. Tax Rekum Preparers Fees 7 TOTAL (Also enter on line 9, Recapitulation) I $ 100.00 State Zip Zip (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER RICHARD E3EHRENS 21 09 0732 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 DEATN TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) Kt V-1613 tX + (y-l Uj COMMONIPo'EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE:iIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RICHARD E3EHRENS 21 09 0732 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 [inGude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Il. 1 1 L1NDA BEHRENS 8.12 ACRI ROAD AIIECHANICSBURG, PA 17050 Lineal 49,077.49 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET fJON-TAXABLE DISTRIBUTIONS: ~~. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 13. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more soace is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT I, RICHARD BEHRENS, of 521 Bedford Court, Mechanicsburg, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be m~ LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pa~~ all of m~- jt.ist debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I give and bequeath the sum of One Dollar ($1.00) to my son, RICHARD W. BEHRENS. THIRD, that I give and bequeath the vehicle that I own at the time of my death to my daughter, LINDA D. BEHRENS. FOURTH, that I give, devise and bequeath all of the rest, residue, and remainder of my property, real, personal, and mixed, to be divided equally between my daughters, DELORES J. SHELLENBERGER and LINDA D. I/~EHRENS FIFTH, that if my daughter, LINDA D. BEHRENS, has predeceased me, or has failed to survive me for a period of at least ninety (90) days, then I give, devise, and bequeath her share of my estate to be divided equally bet~x~en _, . L)elores J. Shellenberger's daughters, Sherie and Lori. SIXTH, that if my daughter, DELORES J. SHELLENBERGER, has ,~ predeceased me, or have failed to survive me for a period of at least ninety (9~~, days, then I give, devise and bequeath her share of my estate to her survi~ ing cl'iild or children. SIXTH, that I hereby appoint my daughter, LINDA D. BEHRENS, as the E;~ecutrix of my Estate. If she is unable or unwilling to perform in this capacity, then I appoint my daughter, DELORES J. SHELLENGERGER, as the Executrix of my Estate. I direct that my Personal Representative shall not be r~=~quireu to post i~ond in chis or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 23~~ day of August, 2005. ,- r. ,. . :_ ; RICHARD BEHRENS WITNESS WITNESS' ACKINOWLEpGMENT C:OMMONWEAL'I H OF PENNSYLVANIA COUNTY OF DAUPHIN I, RICHARD BEHRENS, testator, whose name is signed to the attached ~~r foregoing instrument, havi-ng been duly qualified accordir_g to lavT, do hereby ackno~~~ledge that I have signed and executed the instrument ~~s m~ I_,ast WII ~~--:d T.~st-~me-~` that I signF~d !' SvilLrgly and that signed it as rr.~ rF,~: and eollzntar<Y~ act for the puzposes therein expressed. Sv-orn cr affi-rmed to and ackr,oc~Tledged before ine by RICHARD F3Ef-l~?~:-N`~, the testator, this 23r~ day of August, 200. ~; ,. --- - hICHARD }3F,HRENS ,ilf „ , f I~('ITAP.Y~'U B LI L ,~ - , ~~:^ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and ASHLEY L. COLESTOCIi, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and sa_y that we were present. and sa«~ testawr sign and execute "the instrument as his LAST WILL AND 'I'ESTA?~IENT; that RICHARD BEHRENS signed willingly and that he executed it as his free ~~nd voluntary act for the purposes therein expressed; that each of us in the Izearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of ;pound mind and under no constraint or undue influence. S~~orn or affirmed to and subscribed before me by CHARLES E. PETRIE and ASHLEY L. COLESTOCK, witnesses, this 231~d day of August, 2005. ` .' _. WITNESS ^ e ' ''' '`' Ln~ ~~NES ;~ f ~ ,~ ~` TARY BLIC ;~ :~;,,