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HomeMy WebLinkAbout01-13-10 (4)1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 PO 60X.280601 Harrisburg, PA 17128-0601 - RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 161 32 3161 10 13 2009 Decedent's Last Name RODGERS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Decedent's First Name MI THOMAS J 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 ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 5 Decedent Died Testate {Attach Copy of Will) ~ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 1 p. Spousal Poverty Credn (date or death 11. Election to tax under Sec. 9113(A) between 12-31-91 and i-1-95) ~ (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MARK C DUFFIE Finn Name (If Applicable) JOHNSON DUFFIE STEWART & WEIDNER First line of address 301 MARKET STREET Second line of address City or Post Office LEMOYNE Correspondent's a-mail address: State ZIP Code PA 17043 REGISTER OF WILLS USE ONLY n r.~ ° C O cs ;=:-; r~~ ~ ~ \5 TTO /\^~l Y r i -`- -,m, _ _ ,- _ -, -- f DATE-~ ~ c - - . - - ~~ tV 7 ~ .~- ~ -~r w , 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 of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~'JsQ~!~i(p~L ~~p_,dp Maureen Palese J I d (~U 1856 Hol SIGNATURE OF Hill, PA 17011 REPRESENTATIVE Mark C Duffie DATE ADDRESS /I • ~ 301 Market Street, emoyne, PA 17043 Side 1 1505607120 1505607120 ~1 REV-1500 EX 1505607220 Decedent's Name: T it 0 (I1 a S J R O d g@ rS 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. 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 (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12. Net Value of Estate (line 8 minus Line 11) ............................................................. 12. 13. Charitable and Governmental BequestslSec 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 APP LICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable 2 1 5 5 0 0. 0 0 16 at lineal rate X .045 , . 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. Decedent's Social Security Number 161 32 3161 1,200.00 215,500.00 216,700.00 11,585.52 11,585.52 205,114.48 205,114.48 0.00 9,697.50 0.00 0.00 9,697.50 Side 2 L,,, 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09- DECEDENT'S NAME Thomas J Rodgers STREET ADDRESS 24 Center Drive CITY Camp Hill STATE PA ----- -_ ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable p, Interest E. Penalty 484.88 Total Credits (A + B + C) Total InteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. Make Check Payable to: REGISTER OF WILLS, AGENT (1> 9,697.50 (2) 484.88 (3) (4) (5) 9,212.62 (5A) (5B) 9,212.62 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 :.................................... ^ ^x 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? ...................................................................................................................... 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)J. 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 exemot 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)). 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. Rav1808 EX~ (8.98) SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY CONNAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rodgers, Thomas J 21-09- InGude the proceeds of litigation and the date the proceeds were received by the estate. All property Jointlyowned with the rlpht oT survivorship must bs dlsciossd on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1810 EX+ (8-88) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rodgers, Thomas J 21-09- 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 INCLUDE NAME OF 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 Noll Financial Services -IRA Account No. 111,700.00 111,700.00 2453040970 2 Noll Financial Services -IRA Account No. 103,800.00 103,800.00 2453134520 TOTAL (Also enter on Line 7, Recapitulation) I 215,500.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV•11b1 Ex+ItOAb) COMMNHER TANCE~ AxERETURNANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Rodgers, Thomas J 21-09- ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name(s) of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Johnson Duffie Stewart 8c Weidner 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip _ Relationship of Claimant to Decedent 11,012.02 500.00 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 73.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 11,585.52 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Rodgers, Thomas J 21-09- ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Funeral Services 11,012.02 H-A Subtotal 11,012.02 Other Administrative Costs 2 Cumberland County Register of Wills Office -Filing Fees for Inhertiance Tax and 30.00 Inventory 3 Cumberland County Register of Wills Office -Filing Fees for Petition for Small 43.50 Estate H-e~ Subtotal 73.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Rodgers, Thomas J 21-09- NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not Liet Truetse e (Words) ($$$) I • TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. ~116(a)(1.2)] Katrina Law Daughter 68,371.49 Camp Hill, PA 17011 Maureen Palese Daughter 68,371.49 Camp Hill, PA 17011 Michael Rodgers Son 68,371.49 Camp Hill, PA 17011 Total 205,114.47 Enter dollar amounts for distributions shown above on lines 5 through 18 on Rev 150 0 cover sheet, as appro priate, II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ 0.00 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ESTATE OF THOMAS J. RODGERS, JR. SCHEDULE OF EXHIBITS EXHIBITA NOLL FINANCIAL SERVICES Date of Death Valuation of Decedent's IRA Accounts 388229 Experience Reputation Service Thomas C. '"I7m" Noll, CLU Chartered Financial Consultant Tami Noll Russo CPA-CFP®-CLU PHONE: (717) 939-0968 FAX: (717) 939-4344 OFFICE ADDRESS: 1420 Farmhouse Lane Middletown, PA 17057 MAILING ADDRESS: P.O. Box 205 Highspire, PA 17034 WEB ADDRESS: nollfinancialservices.com E-MAIL: nonfinancial@comcast.net Registered Representatlves of andsecuritles offered through OneAmerica Securities, Inc., MemberFlNRA, SIPC, ARegistered Investment Advisor, OneAmerican Square, Indianapolis, IN 46206, (317) 285-1877. Noll Financial Services is not an affiliate of OrfeAmelica Securities. d ~ ~ a~ ._ O o ~ ~ Z ~ ~ ~ (U N C O d .i C aC.r C r r"' (O RT C L L (0 Y Y Y U U o N ~ N . ~~~ ~ ~U N C ~ N N ~. m w ~~ m ~ ~ ~ ~ Omn - L O O O O 0 ~ ~ ~ ~ a D 4 'f t i`: ~ CO n d y G C r r M O ~ r '.' d d C ~ r aO n lr) y H m r r to N y d m W ~ ~ ~ ~ ~ as ~ ~ °o ~ ~ cNO rn o u°~ u°~ i°n "- ~ y ~ ~ r` v M w ,C O to (~ tCy co e- ~ N M ~ Z ~ d0' ~ ~ ~ ~ P a O ~ ~ ~ ~ ~ ~ ~ ~ ~ e» p ~ ~ N N 'O Q M r l0 ~ ~ ~ ~ ~ ~ t. ~ Ch M M CO 0 ~ J ~ ~ ~ ' ~ ~ m N N l0 ~ M ~ N N N ( 0 ~ ~ a ~ `' -a ° ~ ~ r- 3 E E E E O ri co c~ of YI "' r ~5.+ r ~ ~ .C L t E N a l0 o ~ ~ o s ~ ~ ~ i-- i- - w - ~ ~ ~ ~ ~ _ ~ O 1- N ~' ~ O O .a V Ch M M (/) ~ r (C) O O `~ ~ ly0 N N ~ l0 N ~ O N O N O N r N Y I ~ L L d K ~ ~ C t U_ U r H ~ la W ~ EA EH Efl H 2 ~ LL ff? fA Ei? M M Q Q N J y w J J ~ to C M M M M > > N N N ~ E O~ C O C D~ ~ L L .~ N ti ~ ~ ~ ~ ~ ~ M d'! !9 rn rn °~ ~ ~ rn O O , ~ O O O N ~ ~ ~ ~ ~ ~ (~O ~ d l0 d N O ~ a 7 ~ r ~ ~ i ,C t ~ H CO > > V ~ Y ~ K ~o ~ C ti N Nit O O ~ C - C d O ~ C C COO ~- a00 Q N O ~ 7~ r ~ ~ ~ N (~ ~ C) V N ~ tp N V r C D ~- r I q N Q > C d' N ~ N C Q t0 CO CO > C JERRY R. DUFFIE RICHARD W. STEWART C. ROY WEIDNER, JR. EDMUND G. MY$RS DAVID W. DELUGE JOHN A. STATLER JEFFERSON J. SHIPMAN JEFFREY B. RETT[G KEVIN E. OSBORNE RALPH H. WRIGHT, JR. MARK C. DUFFIE JOHN R. NINOSKY MICHAEL J. CASSIDY CHRISTOPHER S. LUCAS Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 ATTN: Jackie Dear Jackie: MELISSA PEEL GREEVY WADE D. MANLEY ELIZABETH D. SNOVER ANDREW P. DOLLMAN L A W O F F I C E S SARAH E. HOFFMAN ~ O ~O O J l \ . u \ HORACE AF JOHNSON UFFIE F. LEE SHIPMAN (1965-2006) January 12, 2010 c~ N °- ::., C© o -~_, _,_, ~ - ? Z ~ ~ C ?7 , s~ ` RE: Estate of Thomas J. Rodgers, Jr. ~~ ~-' w . Date of Death: October 13, 2009 ,` ~: ~ ` -" Social Security No. 161-32-3161 ==~ Our File No. 16126-1 ~---I ~, ?_,~ ~, N ~} 0 We are assisting the beneficiaries of the Estate of Thomas J. Rodgers, Jr, in the administration of his Estate. We are filing the Petition for small estate in lieu of probate so at this time, there is no estate number issued to this Estate. Enclosed you will find the following documents: 1, Petition for Small Estate. Our check in the amount of $43.50 for the filing fee. We have enclosed one original and two copies of the Petition and Order. Please time stamp the enclosed copies and return to us in the enclosed self addressed stamped envelope. A return envelope for the Order is also enclosed. 2. Inheritance Tax Return. We are filing the Return and making prepayment in order to qualify for the 3 month discount for the above referenced Decedent, who died on October 13, 2009. There is tax due in the amount of $9,212.62. 3. Inventory. Enclosed you will find our check in the amount of $30.00 representing the filing fee for the Inheritance Tax and Inventory. Please contact me if there is any problem with the above documents. Filing a Petition for Small Estate is new to our firm so we hope that we have handled it correctly. 301 MARKET STREET P.O. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109 WWW.JDSW.COM 717.761.4540 FAX: 717.761.3015 MAILC~JDSW.COM JOHNSON, DUFFIE, STEWART &WEIDNER, P.C. Thank you for your assistance in this matter. Should you have any questions, or require any additional information, please feel free to contact me. Very truly yours, HNSON, UyFF~E, S~R~~EIDNER ana L. ieseman Estate Administration Paralegal Enc. c: Maureen Palese :376714 r ~p Q ~ j r iV ~ • ~y ~~ ~~ ~ 2at~ JAN ! 3 FM 2~ 43 { ~~K; n~ C_a- ~ ~~.~ N N V ~~ L .... /l~d' U ~ 3. p ~ C M ~ ~ ~ ~ '~' C ~ ~ ~ N N S ~ P, ~, ~ -I Q '~ U ~ cYt ~ ~ ~~ ~ U1 O ~ ~ ~Y ~ CU Owx W w 0 ~ ~ ~ ~ /~ ~ w VJ~r ~ w F'r~ ~ p~jC~j~ .o ~ ~ ~ ~ ~ ~ ~ ~ 3 4 a ~ \ O ~--'