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HomeMy WebLinkAbout00-0160' J 1505607121 REV-1500 EX 0 ( 6-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number Hamsbu , PA 17128-0601 RESIDENT DECEDENT 2 1 0 0 0 1 6 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth ? 1 1 0 7 6 8 1 8 0 1 2 5 1 9 9 9 0 6 2 6 1 9 2 2 Decedent's Last Name Suffix Decedent's First Name MI S T O U F F E R W I L L I A M W (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI S T O U F F E R E D I T H D Spouse's Social Security Number 1 8 8 2 0 6 6 7 4 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ prior to 12-13-82) 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required 0 6. Decedent Died Testate (Attach Copy of WII) death after 12-12-82) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ (Attach Copy of Trust) 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 R M A R K T H O M A S E S Q U I R E 7 1 7 7 9 6 2 1 0 0 Firm Name (If Applicable) First line of address 1 0 1 S O U T H M A R K E T Second line of address City or Post Office M E C R A N I C S B U R G S T R E E T State ZIP Code REGISTE FJNILLS US LY f_y 1 ~ "Tr ~ , I..i _TlJ r'^~ ...., It ~-~ r-r~ ny J 1l .J ~~ ~ - ~ 1, . J r 7 \ .~ ._ ~._~ \ + ~ _ ~ ... ~i "-DATE FILED • ~ • + .,,,,,. • 1!1 .~ ,-, - - y ":" P A 1 7 0 5 5 Correspondent's a-mail address: rmarkthomasCcDQmail.com 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 FO FILING RETURN ' DATE] ADDRESS ~-'/~~ ~-~~~~ 547 BRIGHTON PLACE SIGNAT Pbt>~RFR R REPRESENTATIVE MECHANICSBURG PA 17055 DATE ~"/ar~/a©~~ 101 SOUTH MARKET STREET ~ MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121, 1505607121 l :: .y .; J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: WILLIAM W• STOUFFER 7 1 1 0 7 6 8 1 B RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. ], 7 2 0 0 0 ~ 0 0 2. Stocks and Bonds (Schedule B) ,,,,,,,,,,,, 2 ,,,,, 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0 . 0 0 4. Mortgages 8 Notes Receivable (Schedule D) ... . . . . . . . . . ....... 4 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5, 4 7 7 2 . 5 0 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 Lines1-7) ,,,,,,,,,,,, g 1 7 6 7 7 2 5 0 . ,,,,,,, . 9. Funeral Expenses & Administrative Costs (Schedule H) ,,, , , , , , , , , , ,,, , g, 4 4 6 0 ~ 6 5 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............ 10. 11. Total Deductions (total Lines 9 8 10) ............ 11 4 4 6 0 6 ............... . . 5 12. Net Value of Estate (Line 8 minus Line 11) ,,, , , , , , , , , , , , ,,, , 12. 1 ? 2 3 1 1 8 5 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 7 2 3 1 1 . 8 5 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 .o0 1 7 2 3 1 1. 8 5 15. 0 0 0 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. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 00 olso DECEDENT'S NAME WILLIAM W. STOUFFER STREET ADDRESS 547 BRIGHTON PLACE CITY STATE MECHANICSBURG ZIP PA 17055 Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) (1) 2. Credits/Payments 0.00 A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable 0.00 D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Total Interest/Penalty (D + E) (3) 0.00 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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE . (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN " " X IN THE APP ROPR IATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; .................................................. Yes ^ No ^ X .................... b. retain the right to designate who shall use the property transferred or its income; ............................... ^ 0 c. retain a reversionary interest; or ....... ..................................................................... ^ ^ .................... 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 ear of death y 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? ..... ^ Q .... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. ^ a 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 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)j. 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)j. 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. REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE WILLIAM W. STOUFFER FIL F NI IMR~R 21 00 0160 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real ro which is ' in -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1 • ondominium at 547 Brighton Place, Mechanicsburg, PA 17055; This ro e p p rty was owned with the ecedent as joint tenants by the entireties on decedent's date of death. An appraisal was not done, but the roperty is currently listed for sale at $172,000.00, VALUE AT DATE OF DEATH 172,000.00 TOTAL (Also enter on line 1, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E ~• COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN R S~ DENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER WILLIAM W. STOUFFER 21 00 0160 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~• ettropolitan Life Insurance Company 1,400.00 2• ~4C and S, Inc. 3• !Garlock, Inc. 4. 5• M K Porter Personal Injury Trust 6. 7• r'NC Bank 300.00 800.00 400.00 172.50 100.00 1,600.00 TOTAL (Also enter on Tine 5, Recapitulation) I ~ 4 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & IN RES DENTEDECEDENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER WILLIAM W. STOUFFER 21 00 0160 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: ~ • Musselman's Funeral Home (no receipt available) AMOUNT 3,000.00 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees R. Mark Thomas, Esquire 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4• Probate Fees 5. I Acxountant's Fees 6• I Tax Retum Preparer's Fees ~• Attomey fee for Met-Life settlement 8• Attomey fee for AC and S, Inc., settlement 9• Attomey fee for Garlock, Inc., settlement 10. Attorney fee for Flintkote settlement 11. Attorney fee for H K Porter settlement 12. Attorney fee for CSR settlement 100.00 76.50 560.00 100.00 266.66 133.33 57.50 166.66 TOTAL (Also enter on line 9, Recapitulation) I a (If more space is needed, insert additional sheets of the same size) ~~ ~ a3s . G~ '~ i~ ~ c~ ~~q3 ~I DICE OF INHERITANCE TAX '~Ci`'!~'r~'~~14P~'PfR~~~$r~1NNT, ALLOWANCE OR DISALLOWANCE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION -• ", OF ',p~~OCTI ONS AND ASSESSMENT OF TAX PO BOX 280601 ,_.ti.-;i4 i~~,,..1..1 ,~i ~:L;. _ HARRISBURG PA 17128-0601 ~~10 JUL ~ 6 ~'E~ 42~ 48 4RPN,A~~'S `~-~~~~-~~T R THOMAS v , . ~•~. _:._~ . 101 S MARKET ST MECHANICSBURG PA 17055 pennsylvania ~ ~` DEPARTMENT OF REVENUE ~ REV-1547 EX AFP (12-09) DATE 07-13-2010 ESTATE OF STOUFFER WILLIAM W DATE OF DEATH 01-25-1999 FILE NUMBER 21 00-0160 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 09-11-2010 (See reverse side under Objections ) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE _ ~ R_ETA_IN LOWER POR_TION FOR YOUR RECORDS F- _ _ REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE ___________ OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: STOUFFER WILLIAM WFILE N0.:21 00-0160 ACN: 101 DATE: 07-13-2010 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 172, 000.00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) .0 0 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) •0 0 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 4,7 7 2.5 0 6. Jointly Owned Property (Schedule F) (6) .0 0 7. Transfers (Schedule G) (7) .0 0 8. Total Assets c8) 17b , 772.50 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4,4 6 0.6 5 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0 11. Total Deductions (11) 4,460.65 12. Net Value of Tax Return (12) 172, 311 .85 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0 14. Net Value of Estate Subject to Tax (14) 172,311.85 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 , 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) 172, 311 .85 X 00 = . 00 c16) _ 00 x 06 = . 00 (18) .00 X 15 = .00 (19)= nn PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.