HomeMy WebLinkAbout01-15-10 (2)15056041125
-' REV-1500 EX (06-05)
OFFICIAL USE ONLY
PA Department of Revenue Coun Code Year File Number
Bureau of Individual Taxes ty
PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 9 0 4 7 1
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 8 4 4 6 0 2 6 5 0 5 0 4 2 0 0 9 0 2 0 7 1 9 5 6
Decedent's Last Name Suffix Decedent's First Name MI
S N Y D E R DAV I D 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
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)
^ 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 0 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 TO:
Name Daytime Telephone Number
R O B A K R U G E S Q U I R E 7 1 7 2 9 2 5 6 1 5
Firm Name (If Applicable)
First line of address
5 3 E A S T C A N A L S T R E E T
Second line of address
P O B O X 1 5 5
City or Post Office State
D O V E R PA
Correspondent's a-mail address:
ZIP Code
REGISTE~ WILLS US E L Y
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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.
SIGN TUR O PERSON RESPONSIBLE FOR FILING RETURN
DATE
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ADDRESS
4650 EY STREET Dover PA
SI ATU F R RER ER THAN REPRESENTATIVE DATE
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ADDRE S
PO Box 155 Dover pA
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125
15056041125
J
J
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: DAVID E. S N Y D E R 1 8 4 4 6 0 2 6 5
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.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 1 2 3 5 0 4 9
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 3 2 5 6 5
7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 2 6 7 6 1 4
9. Funeral Expenses & Administrative Costs (Schedule H) ........ . ...... . 9. 8 0 8 2 2 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .... ....... . 10. 2 2 9 2 1 6 1
11. Total Deductions (total Lines 9& 10) ................... ....... . 11. 3 1 0 0 3 8 1
12. Net Value of Estate (Line 8 minus Line 11) ................. ....... . 12. - 1 8 3 2 7 6 7
13. 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. - 1 8 3 2 7 6 7
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 0 0 0 15. 0 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 O O O 16 O O O
17. Amount of Line 14 taxable
0 0
0
at sibling rate X .12 17 0 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0 18 ~ 0 0 0
19. Tax Due ......................................... ...... .19. O O 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042126 15056042126 J
RSV-1500 EX Page 3
Decedent's Complete Address:
File Number
0471
DECEDENT'S NAME
DAVID E. SNYDER _ _ _ _
STREET ADDRESS
1A RICHLAND LANE _ _ __
CITYSTATE ZIP-- ----
CAMP HILL PA 17011
Tax Payments and Credits:
~. Tax Due (Page 2 Line 19) (1) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
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) 0.00
A. Enter the interest on the tax due. (5A)
6. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) '-' Sot, v ~.yw,-~ 0.00
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
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q
c. retain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ ^X
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ Q
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)].
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.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DAVID E. SNYDER
FILE NUMBER
0471
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
OF DEATH
1. Final paycheck from Highmark dated 5/22/09 1,808.59
2. Members 1st Federal Credit Union account 1,627.90
3. 2007 Dodge Caliber SX7 vehicle 8,500.00
Blue Book value
4. Federal Income Tax refund 414.00
TOTAL (Also enter on line 5, Recapitulation) I $ 12,350 49
(If more space is needed, insert additional sheets of the same size)
REV-1.509 ~X'+ (6-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DAVID E. SNYDER 0471
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Terence V. Grady
B
c
JOINTLY-OWNED PROPERTY:
RELATIONSHIP TO DECEDENT
none
ITEM
NUMBER LETTER
FOR JOINT
TENANT 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 INTERESI
1. A. Members 1st Credit Union acct # 048-11 651.29 50. 325.65
TOTAL (Also enter on line 6, Recapitulation) I $ 325 65
(If more space is needed, insert additional sheets of the same size)
REV-1,511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
__
ESTATE OF FILE NUMBER
DAVID E. SNYDER 0471
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Emig Funeral Home 7,220.20
B.
2
3
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees Rob A. Krug, Esquire
Family Exemption: (If decedent's address is not the same as claimants, attach explanation)
Claimant
Zip
500.00
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills of Cumberland County 72.00
5 Accountants Fees
6. Tax Return Preparers Fees Flickinger and Assoc. 175.00
7. Debts and deductions 10.00
8. Releases filing fees 5.00
9. Reserve for future filings 100.00
TOTAL (Also enter on line 9, Recapitulation) I $ 8,082 20
(If more space is needed, insert additional sheets of the same size)
REV-1'512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DAVID E. SNYDER
SCHEDULE /
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
0471
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medi cal expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1. West Shore EMS 892 70
2. Payoff to Chrysler Credit on automobile loan 10,905.00
3. CitiFinancial Services 5,718.51
4. Chase Credit Card 1,547.97
5. Visa 951.70
6. East Pennsboro Ambulance Service 380.00
7. Harrisburg Gastroenterology 505.25
8. Central PA Oral Surgeons 195.00
9. Physicians of Rehabilitation & Spine Medicine 50.00
10. Pinnacle Health Hospital 330.00
11. MasterCard Services 1,196.41
12. AT & T Wireless 249.07
TOTAL (Also enter on line 10, Recapitulation) I $ 22,921 61
(If more space is needed, insert additional sheets of the same size)
REV'-151 ~ EX + (g-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DAVID E. SNYDER na~~
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. F. Shirley Kunkel Lineal
Lineal
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 IS NOT 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 $
iii more space Is neeaea, insert aoaltlonal sheets of the same size)