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HomeMy WebLinkAbout05-06-1015056051058 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 sox 2aosol 21 09 0948 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 200-36-9370 10/01 /2009 06/26/1950 Decedent"s Last Name Suffix Decedent's First Name MI Becker Robert T (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 __ 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 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Lisa Marie Coyne, Esq. (717) 737-0464 Firm Name (If Applicable) REGISTER {~F,i~/ILLS USE OI~ --7 Coyne & Coyne, P.C. ' ~~ ~ f t --; ~ C First line of address ~ ~ ,t ~ ~ ~~ 3901 Market Street t ~~~ >~ ' ' ' `~ } Second line of address ; t"y© ~- C~ c ; ~ ~ Q ^r1 C ?r# t'_"~ _ DA I~ "~D +. rn City or Post Office t ,~ State ZIP Code ~ Camp Hill PA .17011 '~ Correspondent's a-mail address: Under penalties of perjury, 1 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. SIGf~TURts OF PERSON RESP SIBLE R FILI G RETURN ~ DAT -- - _- ADDRESS Dorothy A. Becke 57 Derbyshire Drive, Carlisle, PA 17015 - --- - - - SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE _. _ __ __ ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Robert T Becker 200-36-9370 Decedents Nam 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 & 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 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. 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 4 22,472.22 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 39,500.32 273.26 1,086.44 40,860.02 10,606.90 7,780.90 18,387.80 22,472.22 22,472.22 0.00 0.00 15056052059 REV-1500 EX Page 3 File Number rlcrcrlon4'c f _mm~lnfn Arlrirocc• 21 09 :0948 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Robert T Becker _ _ 200-36-9370 - _ _ _ -- STREETADDRESS 57 Derbyshire Drive CITY STATE ,ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total InterestlPenalty (D + E) (3) 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) 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. (1) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 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 properly 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? ................................................................................................. ............. ^ 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? ........................................................................................................... ............. ^ 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 B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA '~. INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BECKER, ROBERT T All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER ---- 1 82 Shares of Principal Financial Group, Inc. 2 ' 70.922 Shares of Bond Fund of America (Class A) 3 ', 223.081 Shares Capital Income Fuilder Fund (Class A) 4 175.337 Shares of Capital World Grwth & Income 5 122.389 Shares of Goldman Sachs Real Estate Secs. 6 124.394 Shares Income Fund of America Fund 7 385.828 Shares of Lord Abbott Affil. Fund (Class A) 8 202.376 Shares MFS Bond Fund 9 1007.867 Shares MFS Income Fund 10 177.254 Shares MFS Total Return Fund ] 1 8.609 Shares New World Fund (Class A) 12 337.051 Shares Putnam Conv. Income Growth Fund 13 3.52 Shares Putnam Conv. Income Growth Fd. Class B '~ I ~_-. -- _-- - I FILE NUMBER 21 - 2009 - 0948 UNIT VALUE ' VALUE AT DATE OF ; - - - -~- DEATH _ 25.46 2,087.72 11.77' 834.75 46.96 10,475.88 ~I 33.12 ' 5,807.16 ' 6.42 ' 785.74 14.90'', 1,853.47 9.55 3,684.66 II 12.56 2,541.84 I 3.13'', 3,154.62 12.96' 2,297.21 46.42 399.63 I 16.38 5,520.90 16.12' ~~ 56.74 --- - - -- TOTAL (Also enter on line 2, Recapitulation) 39,500.32 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA ~. PERSONAL PROPErtTI '. INHERITANCE TAX RETURN ~'. ~. RESIDENT DECEDENT '. '~. _.. _.._ _ _ ____._ ..__.____. _ _ ___-._._ _.-____-_--_ _ _- _._.__a- _ __.. ______.. ___.. ESTATE OF BECKER, ROBERT T FILE NUMBER 21 - 2009 - 0948 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Metro Bank-- Checking Acct. 24.20 2 Members 1st FCU-- Savings Acct. 25.00 3 Members 1st FCU-- Investment Savings 224.06 -- - -- TOTAL (Also enter on Line 5, Recapitulation) 273.26 r ~ETRO BANK 3801 Paxton Street Harrisburg • PA • 17111 mymetrobank.com 888.937.0004 March 9, 2010 Coyne & Coyne 3901 Market St Camp Hill, PA 17011 RE: Estate of: Robert T. Becker Tax Identification Number: 200-36-9370 Date of Death: October 1, 2009 To Whom It May Concern: ~~~~on~ MAR 1 0 2010 This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account. Number: 513263038 Date Opened: 03/14/2001 Primary Owner: Robert T. Becker Date of Death Balance: $24.20 Account Type: Checking Account Number: 513321075 Date Opened: 05/26/2001 Primary Owner: Robert T. Becker Secondary Owner: Dorothy A. Becker Date of Death Balance: $1457.53 Account Type: Savings Account Number: 616237478 Date Opened: 05/26/2001 Primary Owner: Robert T. Becker Secondary Owner: Dorothy A. Becker Date of Death Balance: $484.28 f ,. ~ ~ ~~, ~. ~' ~ ETRO BANK 3801 Paxton Street Harrisburg • PA • 17111 mymetrobank.com 888.937.0004 Account Type: Savings Account Number: 626147664 Date Opened: 05/22/2003 Primary Owner: Robert T. Becker Secondary Owner: Dorothy A. Becker Date of Death Balance: $196.03 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, -~ Diana Reynolds Metro Bank Research Associate/Deposit Services SCHEDULE F 11 COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN '~, RESIDENT DECEDENT -----_. .~..- - _ - _ . I ESTATE OF FILE NUMBER BECKER, ROBERT T 'I 21 - 2009 - 0948 __ __ 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 ADDRESS RELATIONSHIP TO DECEDENT --__ -- A. Dorothy A. Becker 57 DERBYSHIRE DRIVE Wife CARLISLE, PA 17015 JOINTLY OWNED PROPERTY: _ _ __ MADE T DESCRIPTION OF PROPER 1Y, Y ITEM LETTER DATE jlnclude name of financial institution and bank account number DATE OF DEATH ' % OF DATE OF DEATH FOR JOINT, or similar identi In number. Attach deed for anti -held real (VALUE OF ASSET DECD'S VALUE OF NUMBER TENANT JOINT I ~ 9 INTEREST( DECEDENT'S INTEREST estate. _ - Metro Bank Checking 1,457.53] 50%~ 728.77 1 A. 05/26/2001 i _- - I No. XXXXXX075 2 A. 05/26/2001 Metro Bank Savings 484.281 50%'% 242.14 ' ' No. XXXXXX478 j j 3 A. 05/22/2003 ,Metro Bank Savings No. XXXXXX664 4 A. 04/01/1995 'Members 1st FCU Savings No. XXXXXX856 196.031 50%, 35.01' S0%'~ 98.02 17.51 SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner LOAN ACCOUNT: Account Number/Suffix Date Loan Established Principal Balance at Date of Death Loan Type Collateral Secured Interest Rate Name of Co-Borrower LOAN ACCOUNT: Account Number/Suffix Date Loan Established Principal Balance at Date of Death Loan Type Collateral Secured Interest Rate Name of Co-Borrower 'Loan does not have life coverage. MEMBERS 1St FEDERAL CREDIT UNION 150847-00 04/13/1995 $25.00 $.00 $25.00 None 150847-05 05/19/1996 $224.06 $.00 $224.06 None G //i`. ~ ~~ ~ i \\ u <~' ` f;. 150847-02 03/31/2004 $.00 Home Equity Line of Credit/Contractual Pledge of Shares 57 Derbyshire Drive, Carlisle, PA 17015 3.25% Dorothy Becker 150847-03 09/11 /2007 $15,542.16 Home Equity/Contractual Pledge of Shares 57 Derbyshire Drive, Carlisle, PA 17015 6.24% Dorothy Becker ME B RS 1sT FEDERAL REDIT~~tIO~N • `~~, Danielle A. Kline Lending Insurance Support Specialist March 2, 2010 Estate of: ROBERT BECKER Date of Death: 10/01/2009 Social Security Number: 200-36-9370 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 800 283-2328 • ~ ) wwwmemberslst.or~ St MEMBERS 1St FEDERAL CREDIT UNION SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established VISA ACCOUNT: Account Number Date Account Established Balance on Date of Death Joint Cardholder 150856-00 04/13/1995 $35.01 $.00 $35.01 Dorothy Becker 04/13/1995 4672090000187542 12/18/1995 $19.90 Dorothy Becker M M S 1sT F/~ ~(R~AL ~REDI ION ~51I ~ "~c4 •~~~ Danielle A. Kline Lending Insurance Support Specialist March 2, 2010 Estate of: ROBERT BECKER Date of Death: 10/01/2009 Social Security Number: 200-36-9370 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org SCHEDULE H COMMONWEALTH OF PENNSYLVANIA ~~ -" `~ ~+~/ ~ ~ INHERITANCE TAX RETURN /~ry~~ ~~~~~~/~T ~/~ -_ RESIDENT DECEDENT ~ /`YJIYIIIrh71IV~11~Vr-C~S i ESTATE OF -- - - -- - ---- --- - -- - - BECKER ROBERT T FILE NUMBER -------- - - _ _- - -- ' 21 - 2_0.09 - 0948_ _- Debts of decedent must be reported on Schedule I. ITEM ---- - _ _ _ _ _ _ NUMBER ' DESCRIPTION _ _-- - - A. 'FUNERAL EXPENSES: ----- --------- 1. Funeral Home 2. Flowers 3. Obituaries 4. Reception Costs i '~, B. ADMINISTRATIVE COSTS: 9. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Coyne & Coyne, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Dorothy Becker Street Address 57 Derbyshire Drive City Carlisle State PA Zip 17015 Relationship of Claimant to Decedent Wife 4. Probate Fees Cumberland County Register of Wills i 5. Accountant's Fees 6. ' Tax Return Preparer's Fees 7. Other Administrative Costs 1 Postage 2 Cumberland Law Journal-- Legal Advertisement Total of Continuation Schedule(s) AMOUNT 3,401.10 174.90 200.00 979.59 1,500.00 3,500.00 83.00 44.00 75.00 - - -- _ ~ - _ I 649.31 TOTAL (Also enter on line 9, Recapitulation) 10,606.90 Sd~edule H COMMONWEALTH OF PENNSYLVANIA it r EXS INHERITANCE TAX RETURN RESIDENT DECEDENT I ~ CO6'15 _ _ --- _. -- - _ _ _ ---- -_ _ - -- ESTATE OF - - -_- -------- ------ __ BECKER, ROBERT T FILE NUMBER -_ ---- I - 2009 - 0948 3 Patriot News-- Legal Advertisement -- -- -1_' - - - - - - -- -- 134.31 4 Reserves 500.00 5 Inheritance Tax filing fee 15.00 i SCHEDULE DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA ' LIABILITIES INHERITANCE TAX RETURN , & LIENS I RESIDENT DECEDENT -- ESTATE OF - _ - _ --- -- - - - - - _ BECKER, ROBERT T ,FILE NUMBER _ _ _ _ __ -- --- 21 - 2009 - 0948 ___- _- Include unreimbursed medical expenses. ___ __ ---- - ITEM NUMBER 1 Home Equity Loan 2 Visa _ - DESCRIPTION AMOUNT __ __ _ --- 7,771.00 9.90 -- _r -_-- - - - - - TAL (Also enter on Line 10, Recapitulation) 7,780.90 LAST WILL AND TESTAMENT OF ROBERT THOMAS BECKER I~ I, ROBERT THOMAS BECKER, of Perry County, Pennsylvania, bein of sound mind, memory and understanding, do make and publish this my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. ITEM I. I direct that all m y just debts and funeral expenses be fully paid and satisfied as soon as conveniently may be after my decease. ITEM II. I give all of the rest, residue and remainder of my estate unto my wife, Dorothy Adams Becker, provided that she is living on the thirtieth day after th date of my death. ITEM III. In the event my wife, Dorothy does not survive me or does not survive me by said period of thirty days, I then give all the rest, residue and remainder of n estate unto the Dauphin Deposit Bank and Trust Company of Harrisburg, Pennsylvania, in trust, however, to act as Trustee upon the following terms and conditions: A. To divide my entire estate into equal shares one for the Benefit of each of my then living children. B. To create with these equal shares separate trust account one for the benefit of each such child. C. To pay the income and so much of the principal as may, i the sole discretion of my Trustee, be necessary for the mainte- nance, support, medical expenses and education of each of my children, each payment being made according to the need of said child from his or her individual, designated trust account. The payments may be made by my Trustee directly to each of the chil- dren, or to such of them, as may be, in the sole opinion of my Trustee, of such age and ability to handle properly the funds so paid to the child, or may be made by my Trustee directly to the person having the custody and care of my children. D. To distribute the accumulated income and principal then remaining in each designated account to each child in the follow- my manner: one quarter of the account balance when he or she attains the age of eighteen (18) years; one third of the account balance when he or she attains the age of twenty-one (21) years; one half of the account balance when he or she attains the age of twenty-four (24) years; and the remaining balance in his or her designated account when he or she attains the age of twenty-six (26) years. ~I ~~~ E. If any of my children should die prior to attaining the age of twenty-six (26) years, the remaining balance in his or her designated account shall first pass equally to the issue of such deceased child, if any, and if no such issue then to my surviving children subject to any trust restrictions as are then in existence. ITEM IV. In the event my wife should predecease me and I should die without children to survive, I givE all the rest, residue and remainder of my estate to those heirs who would have taken had I died intestate under the laws of the Commonwealth of Pennsylvania. ITEM V. In addition to the powers conferred by law, I authorize my Executor or Trustee, in absolute discretion: A. To retain in the form received, and to sell either at public or private sale any real or personal property. B. To manage real estate. C. To invest and reinvest only in forms of property defined ~s legal investments according to the laws of the Commonwealth of Pennsylvania. D. To exercise any optional rights arising from ownership o nvestments. i~ E. To compromise claims without court approval, and without the consent of any beneficiary. ITEM VI. All principal and income shall b free from anticipation, assignment, pledge or obligations of beneficiaries, and shall not be subject to attachment, execution or other legal process. ITEM VII. In the event m wife Y predeceases me, I appoint Barbara Lee Nickel and Walter F. Nickel, III, to be and act as guardians of the person of any of my children who may be minors at the time of my death. ITEM VIII. It is hereby directed that my executor, hereinafter named, shall pay all inheritance, state, succession and legacy taxes to which my estate or the transfer of any property hereunder may be subject and to charge such tax as part of the administration, payable out of my residuary estate. ITEM IX. I nominate, constitute and appoint my wife, Dorothy, to be and act as my sole Executor of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of my wife, I nominate, constitute and appoint Robert M. Becker, as Executor of this my Last Will and Testament. As a final v/ ~~ alternative, I appoint Robert C. Adams as my sole Executor of thi my Last will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal thi -.--~~ day of ~~~ ,` _, 1985. _ -~-`" l~p~ _~ ( SEAL ) Robert Thomas Bec er The preceding instrument, consisting of this, and four (4) other typewritten pages, was on the date thereof signed, publishe and declared by Robert Thomas Becker, the Testator therein named, as and for his Last Will, in the presence of us, who at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. ~~ . '~.~ 7 Residing at