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HomeMy WebLinkAbout06-09-10' 150561U145 REV-1500 ~``°'-'°' OFFICIAL USE ONLY pennsylvania PA Department of Revenue DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg PA 17128-0601 RESIDENT DECEDENT a ~ -' - ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 093-05-6915 07012008 12191928 Decedent's Last Name Suffix Decedent's First Name MI Burdick William H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW © 1. Original Return 0 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum 0 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G FREY 7172435838 First line of address 5 SOUTH HANOVER STREET Second line of address City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent's a-mail address: r f rey@ f reyt i 1 ey . COm REGISTER OF WILLS USE O~I Y C ~ ca r~~~~ ~: t ~- ` ~ "' ". ~ ~T"i wF0 ~ ! ~ ' Cl; i~: DATEE~ ED ' - ~` ~+ L7 '.,~ 4::, .J r . e .. /: `) ~_~ w .~.-'i r~ Under penalties of perjury, I declare that I have examined this return, including acx:ompanying 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~F~ P ARSON RESPON F~,R`FILING RE R~1~ ~ ~ ~ T~ < ADDRESS 11LL''~,~~ ,~•L SIGNA ADDRESS PLEASE US Side 1 L 1505610145 1505610145 J ~~ J REV-1500 EX Decedent's Name: W 1111 am H B u r d i c k Decedent's Social Security Number 093-05-6915 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) ...................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ...... 5. 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. NONE 7. Inter-vvos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ........ 7 NONE 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 89180.00 89180.00 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 116 6 9 . O O 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. NONE 11. Total Deductions (total Lines 9 and 10) ............................... 11. 116 6 9 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................. 12. 7 7 511.0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 0 . 0 0 14. Net Value Subiect to Tax (Line 12 minus Line 13) ....................... 14. 7 7 511 . O 0 TAX CALCULATION -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 15. O. 0 0 16. Amount of Line 14 taxable at linealratex.o 45 77511.00 16. 3488.00 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X , 15 18. 0 . 0 0 19. TAX DUE ....................................................... 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610245 3488.00 L 1505610245 1505610245 J REV-1500 EX Page 3 File Number 093-05-6915 Decedent's Complete Address: 21-08-00761 DECEDENT'S NAME William H Burdick STREET ADDRESS CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest (1) Total Credits (A + B) (2) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (3) (4) 3488.00 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3488.00 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 : ............................................................................. ^ a 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 Dec. 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 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-1508 EX+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MSC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER William H Burdick Sr. 21-08-00761 Include the proceeds of litigation and the date the proceeds were received by the estate. ~ ~ ~ ~ ~ ivy c aua~c w neeoea, Insert aoalnonai sheets of the same size) REV-1511 EX + (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER William H Burdick, Sr. Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. I FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: 2,000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 3,500 Claimant Tanya Greiman street Address _3286 Spring Road city Carlisle state PA zIP 17013 Relationship of Claimant to Decedent Daughter 4. Probate Fees: 377 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. West Shore EMS 1,508 8. Southeast Alabama Medical Center 4,096 9. Dothan Hematology 8~ Oncology 188 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 11 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) pennsylvania SCWEI~ULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William H Burdick Sr. 21-08-0761 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 ~ Tanya M. Greiman 3286 Spring Road, Carlisle, PA 17013 Daughter 33.33% 2 Charles E. Burdick 270 Green Hill Road, Newville, PA 17241 Son 33.33% 3 William H. Burdick, II 197 Big Spring Terrace, Newville, PA 17241 Son 33.33% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SHE ET, 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: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ O If more space is needed, use additional sheets of paper of the same size. ~ Fax Transmission 8/8/2008 12:58 ~~ 1~A~E 1/002 Fax Server Reference ID: 2530666 Wachovia Bank: N.A. Balance Confirmation Scrviccs P O Box 40028 Roanoke, VA 24022-7313 August 8, 2008 FREY & TII,EY ATTORNEYS AT LAW 5 SOUTH HANOVER STREET CARLISLE, PA 17013 SUBJECT: Verification /Confirmation of Account and Balance Information provided for: Customer: WILLIAM H BURDICK SR (SSN# XXX-XX-6784) Date of Death: July 1, 2008 Deposit Account Information Account Account Date of Death Average Date Maturity Interest Acctued YTD Date Type Number Balance Balance* Opened Date Rate Interest Interest Paid Closed CERTIFICATE OF 731 517,860.72 4/6/1987 53.54 5319.50 7/18/2008 DEPOSIT LEGAL TITLE: WII.LdAM H BURDICK CLOSING BALANCE: 517892.63 CHECKING XXXXXXXXX8241 58,417.72 12/10/1986 50.01 54.96 7/18/2008 LEGAL TITLE: WII.LIAM H BURDICK CLOSING BALANCE: 51781.69 Fax Transmisslon 8/8/2008 12:58 pM PAGE 2/002 Fax Server Reference ID: 2530666 No Safe Deposit Box found for customer. * Datc of death balance dots not include accrued intcrest. * I f date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were made during that time period. A Jennifer Straub Servicenter Associate Phone: (540)563-7323 tc; js Sovereign Bank Court Ordered Processing \ Decedents - MA 1-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 September 23, 2008 Robert G. Frey Frey & Tiley 5 South Hanover St. Carlisle, PA 17013 RE: Estate of William H Burdick Sr. Date of Death : 7/1 /08 Dear Robert G. Frey: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, ~~.~~ cc~ ~ ~ -~-ti~~~~ Laurie DiGiando nico Team Leader 617-533-1789 Sovereign Bank ESTATE OF William H. Burdick, Sr. SOCIAL SECURITY #: 201-10-0174 DATE OF DEATH: July 1, 2008 Account #: 2895400170 Type: CD Open date: 7/29/1998 In the name of: William H. Burdick Sr. ITF William H. Burdick II and Tonya M. Greiman and Charles E. Burdick Date of Death Balance: $8,643.25 Int.(YTD) from 1/1/2008 to 6/30/2008 $160.80 Accrued interest to date of death: $1.79 Other Info: Closed 7/3/08 Page 1 of 1 Sov~ G~~la Barnc September 24, 2008 Attorneys-At-Law 5 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of William H. Burdick, Sr. Dear Mr. Frey: I have researched our records and find that Mr. Burdick, Sr. one had one account with us. This account was a certificate of deposit. The account number was 200914734 in the amount of $10,000.00 purchased August 25, 1995. The certificate was closed by William H Burdick, II July 9, 2008 in the amount of $18,321.72. I am enclosing copies of the certificate, history for the past year, and the CIF file for Mr. Burdick showing that this was the only account he had. If you have any further questions, please call me at 229-873-3788. Sincerely, ~G! U ~ U ~v~// Peggy Y. Tyson Assistant Vice President Enc: 4 items Post Office Box 3488 Moultrie, GA 31776-3488 (229) 985-1120 Fax (229) 985-0251 This Is Not ACheck -Customer Copy -This Is Not A Check ~~ AMERICAN HOME BANK. We Aelp build vou~ /utu~e. September 5, 2008 Frey & Tiley Attorneys-at-Law 5 South Hanover Street Carlisle, PA 17013-6929 RE: Estate of William H. Burdick Acct. No. 290002385 SS# 067-20-6784 In regards to the above mentioned estate, we have the following accounts on record for William H. Burdick: Account Number 7/1/08 Balance Accrued Interest Opened date 290002385 $14,570.13 $25.70 11 / 17/2005 As of September 5, 2008, the account is still open and accruing interest. Should you need any further information, please feel free to contact me directly at (717) 285-6574. Respectfully yours, Brett E. Miller Assistant Vice President __ __ - ___ __ 3840 Hempland Road /American Way Corporate Center / Mountville PA 17554 • Phone 717/285-6400 or 877/BANK-AHB • www.bankahb.com