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Home My WebLink About03-19-10---~ REV-1500 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box.28oso~ INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT 2 1 0 9 0 6 5 4 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 188626086 06222009 07231966 Decedent's Last Name Suffix Decedent's First Name ERNST MI DENNIS A (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 death after 12-12-82) ^ 5. Federal Estate Tax Return Required ^ g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust (Attach Copy of Wilp (Attach Copy of Trust) _. _ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 O Spousal Poverty Credit (date of death between 12-31-si and 1-1-ss) ^ 11.Election to tax under Sec. 9113(A) (Attach Sch. O) Name CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: N O R A F. B L A I R Daytime Telephone Number 717541:1428 Firm Name (If Applicable) First line of address 5440 JONESTOWN ROAD Second line of address PO BOX 6216 City or Post Office HARRISBURG State PA ZIP Code t_ 17112-0216 CJ ILY _ ~ ~, - 'i `, Correspondent'se-mail address: NFBLAW@comcast.net Under penalties of perjury, I declare that 1 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. SIG TURE OF PERSON RESP(ngSIBLE FOR FILING RETURN """``~"'~"`"" Dagmar Ernst ~DDRESSr ,~ ~ ~ r Q 1400 esta Drive, Harrisburg, PA 17,.2 IGN E OF PREPARER OTHER T EP NTATIVE t' ~ ~~ DATE ` Nora F. Blair n RESS ~ ~.:~~/'Ga 5440 Jonestown Road, Harrisburg, PA 17112-0216 I._. Side 1 1505607120 1505607120 <~ REGISTER~F~IA~ILLS USQ v ~a r> ~~ ~7 ri T? -' w r--. i ~ -~' '- -~ _ "n '.J ~., - SATE FILED '~ 1505607220 REV-1500 EX Decedent's Social Security Number oecadent~s Name: E R N S T, D E N N I S A. 18 8 6 2 6 0 8 6 __ 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. 1 6 , 2 7 4.51 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested......... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested......... ... 7. 8. Total Gross Assets (total Lines 1-7) ................................................................. .. 8. 1 6 , 2 7 4.51 9. Funeral Expenses & Administrative Costs (Schedule H) .............................._.... ... 9. 8 , 3 8 6 . 3 0 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ........................... .... 10. 9 , 7 17.9 9 11. Total Deductions (total Lines 9 i~ 10} .............................................................. ... 11. 1 8 , 1 0 4 . 2 9 12. Net Value of Estate (Line 8 minus Line 11) ....................................................... .... 12. - 1 , 8 2 9 . 7 8 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 2 9 . 7 8 _ -- 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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 - 1, 7 5 4 8 9 17. - 2 10.5 9 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ............................................................. . _ ................ .. 19. - 2 1 0 5 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. a Side 2 1505607220 1505607220 REV-1500 EX Page 3 File Number 21 - 09 - 0654 Decedent's Complete Address: Ernst, Dennis A. STREETADDRESS 107 October Drive -- -- - - CITY Camp Hill STATE ZIP PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 __ __ Total Credits (A + g + C) (2) 0.00 3. InteresUPenalty if applicable p. Interest E. Penalty Total InteresUPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT (4) Check box on Page 2 Line 20 to request arefund - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (56) O.0 0 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 :............................................................................. X b. retain the right to designate who shall use the property transferred or its income :................................ x c. retain a reversionary interest; or ............................................................................................................ x d. receive the promise for life of either payments, benefits or care? .............................__............................ x 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 "in trust for" or payable upon death bank account or security at his or her death.?....... x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................. .................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR 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 statutedoes 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)]. 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. SCHEDULE E CASH, BANK DEPOSITS, &vMISC. COMMONWEALTH OF PENNSYLVANIA PE~SOtLI /~ L PROPERT i INHERITANCE TAX RETURN G ~7 ~~YY!'1 Il RESIDENT DECEDENT I, ESTATE OF FILE NUMBER Ernst, Dennis A. 21 - 09 - 0654 Include the proceeds of litigation and the date the proceeds were received by the estateAll property jointly-owned with the right of survivorship must be disclosed on schedule F. ------ ITEM NUMBER DESCRIPTION -- _ _ - --- -_ ___ _---- 1 Cash 2 Konica Check 800.02+1912.54 3 Unemployment 2,010.00+125.00+3843.50 4 Sale of Truck 5 Erie Insurnce Refund 6 Unclaimed Property 7 Wachovia Checking 8 Prudential 401(k) 9 2009 Federal tax refund VALUE AT DATE OF DEATH __ 2,500.00 2,712.56 5,975.50 800.00 44.00 84.85 1, 798.94 1, 542.66 816.00 TOTAL Also enter on Line 5, Reca itulation _ ~ P~ ) 16,274.51 ', ^~ ~~,~T~SCHmULE H COMMONWEALTH OF PENNSYLVANIA '~~ -" ~' ~-~+~ INHERITANCE TAX RETURN ! /~r1~A~wrCTp/~T7~/~~/'~ RESIDENT DECEDENT ~' ~yL/1rY~\1~7 ~ IW' 1YG VVJ 1 J ESTATE OF Ernst, Dennis A. - _ -- _. - --- Debts of decedent must be reported on Schedule I. __ _ --- - ITEM _ - NUMBER', FUNERAL EXPENSES: DESCRIPTION _ -_ - - - - - - __ _ A. 1 ,Zimmerman Auer 2 !Newspaper 3 !Resurrection Cemetary 600.00+130.00 i 4 Funeral Luncheon 5 Brachendorf Memorial B. ~, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Dagmar Ernst l __ -- - __ __ _ __ ;FILE NUMBER 21 - 09 - 0654 AMOUNT 1, 584.72 - 75.00 730.00 70.80 480.00 Street Address 1400 Vesta Drive 1,250.00 city Harrisburg state PA zip .17112. Year(s) Commission paid 2010 2. Attorney's Fees Nora F. Blair 1,250.00 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 4. Probate Fees Cumberland County Register of Wills 117 + 30 147.00 Cumberland County Bar Journal 75.00 Paxton Herald 48.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Camp Hill Plaza (rent ,fees for utilities and cost to paint and clean rugs in apartment) 909.37 __ __ - -- _ _ _ TOTAL (Also enter on line 9, Recapitulation) 8,386.30 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ', RESIDENT DECEDENT ESTATE OF Ernst, Dennis A. __ 2 PP&L Schedule H w ~. Ftneral Ex^p~en~ses & 3 Notary Fee 4 Cleaning out apartment 5 Hoffman Ford (repairs to truck) 6 Trash removal 7 Executor's expenses (mileage, telephone charges, postage) 8 Erie car insurance 9 Local Income Tax __ _. --- FILE NUMBER 21 - 09 - 0654 135.17 5.00 720.00 549.35 75.00 84.00 123.00 74.89 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT '. __ ESTATE OF Ernst, DennlS A. FILE NUMBER 21 - 09 - 0654 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. Citibank Bank of America Camp Hill Plaza PP&L Comcast Pinnacle Health DESCRIPTION __- TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 5,718.63 3,909.40 10.00 61.00 3.96 15.00 9,717.99 KtV-1513 EX+ (11.08) ~ ' pSCHEDU/LpE J COMMONWEALTH OF PENNSYLVANIA ~. BENEFICIARIES INHERITANCE TAX RETURN ' RESIDENT DECEDENT __ - __ _ - - - -- - ESTATE OF Ernst, Dennis A. - -- NAME AND ADDRESS OF PERSONS RELATIONSHIP TO NUMBER O DECEDENT RECEIVING PROPERTY Do Not List Trustee(s) I~ TAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 William B. Ernst 221-M Evens Avenue Harrisburg, PA 17109 2 Gerda S. Matzen 1528 Great Creek Drive LaCrosse, VA 23950 FILE NUMBER _ 21 - 09 - 0654 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Brother One-third of the net estate. Sister One-third of the net estate. 3 ' Dagmar Ernst Sister 'One-third of the net 1400 Vesta Drive 'estate. Harrisburg, PA 17112 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00