HomeMy WebLinkAbout06-14-10.,
15056051047
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 BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT i r ~ ~ ~~~' >
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
~I ~ 4~9 ~99'~ o~~.~oo~ ~~ao ~ ~l ~'
Decedent's Last Name Suffix Deceduent's First Name MI
(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 OVALS BELOW
® 1. Original Return
O 4. Limited Estate
O 6. Decedent Died Testate
(Attach Copy of Will)
O 9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
O 2. Supplemental Return
O 4a. Future Interest Compromise (date of
death after 12-12-82)
O 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
O . 3. Remainder Return (date of death
prior to 12-13-82)
O 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
O 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 TO:
Name Daytime Telephone Number
Firm Name (If Applicable)
First line of address
Second line of address
City or Post Office
State ZIP Code
REGISTER OF 1NILLS USE ONLY
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Correspondent's a-mail address:
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;OF Q~RSON RF~POIVSI~,iFO~ F~LtNG RETURN / yM Q~E _ ~^ t/~;~
ADDR~ ~ ~ A~ty .~1/..!~ w~ ~ ! /~~~LJJ~ ~IL ~`r /I ~J,-'/~'I'~~~:Il ~! ~'7I~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
],5056051047 15056051047 J
J
15056052048
REV-1500 EX
Decedent's Social Security Number
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Decedent's Name: ~"~_ ~ ~ .._:..~. ~ ,' 5.
RECAPITULATION
1. Real estate (Schedule A) . .......................................... .. 1. •
2. Stocks and Bonds (Schedule B) ..................................... .. 2. •
3. Closely Held Corporation, Partnership or Sale-Proprietorship (Schedule C) ... .. 3. •
4.
5. Mortgages & Notes Receivable (Schedule D) ...........................
Cash, Bank Deposits & Miscellaneous Personal Property (Schedule ~ ..... .. 4.
.. 5. •
~Q~ ~ ~ (~•
6.
7.
8. Jointly Owned Property (Schedule F) O Separate Billing Requested .....
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule O Separate Billing Requested......
Total Gross Assets (total Lines 1-7} .................................. .. 6.
.. 7.
.. 8. •
~ `"~ ~ ~ ~ •
f ~ ~ ~ ~• /
9.
10.
11. Funeral Expenses & Administrative Costs (Schedul~ ..................
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule,... ...........
................
Total Deductions (total Lines 9 & 10} ................. .. 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_ .
5.
~16. `Amount of Line 14 taxable /~
at lineal rate X .0 ~ ~ (y ~~ ~ • ~ ~
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
O
Side 2
15056052D48 15056052048
} + '
REV-1500 EX Page 3
Decedent's Complete Address:
STREET ADDRESS
~~~
CITY ,. - , --_
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments __
C. Discount ~~___
File Number
STATE ~., _ i ZIP
1,
Total Credits (A + B + C) (2)
3. InterestlPenalty if applicable
D. Interest ,_ _
E. Penalty
--- Total Interest/Penalty (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. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
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 :.................................................................................... ......
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 "intrust 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? ................................................................................................................. rrte~,,
....... lL~•
^
1F 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 b{ood or adoption.
REV-1508 EX + (7.97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE E
CASH,_ BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER _
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
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TOTAL (Also enter on line 5, Recapitulation} ` $ ~~ ~ ~ g ~ `-~
of mare spaca is nPP.r1Pd, insert additional sheets of the same size)
00 0 06117M NM I17
1921
ESTATE OF CHARLES J GRAMS
CLETA E HULL, EXEC
236 INDIAN CREEK DR
MECHANICSBURG PA 17050
INTEREST PAID YEAR TO DATE 2.67 MECHANICSBURG
errniiu-r ciiMMwnv
SEG~NNING, , ..
~ALANIE :::::.....:... ,.: ~1EP~4 TTY ~ .:
.. :~OTHER< ~ADDTTtONS ...... ;.
:......, . ~~HE~K~::::pAt~ ....::... .:0~'HEi~ ....:..:.....:.
...:.. '<SUB'r'RACTTONS..... .:.. ...:CURR~IT.....:
. IMT:E~ESt.. PD . ..... `ENp~NG.........
: .. ;, ..$AI:ANCE... ; ::
N0. AMOUNT N0. AMOUNT N0. AMOUNT
18,775.18 3 13,843.88 1 73.66 0 0.00 1.06 32,546.46
Af`f`f111A1T Af`TT~ITTV
POSTING.,
DATE - - - - - -
-
TRANSACTION DESCRIPTION - -
D~POSTTS, INTEREST
~ OTHER ADDITIONS
CHECKS 8 ~OTHER~ ~
SUBTRACTIONS
.. 1XAI~1~
BALaANCE
08-03-09 BEGINNING BALANCE 518,775.18
OS-13-09 DEPOSIT 5,175.00
08-13-09 DEPOSIT 3,668.88 27,619.06
08-19-09 CHECK NUMBER 0096 73.66 27,545.40
OS-28-09 DEPOSIT 5,000.00 32,545.40
09-02-09 INTEREST PAYMENT 1.06 32,546.46
ENDING BALANCE 532,546.46
~~
...
.... CHECKS PI4TD 'SUMMARY .: - ::..
96 OS-19-09 73.66
ANNUAL PERCENTAGE YIELD EARNED = 0.04
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~ r108A (6/D7)
REV-1510 EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF r~tt numrstrc
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
ATTACHACOPYOFTHEDEEDFORREALESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST
EXCLUSION
IFAPPLICABLE
TAXABLE VALUE
~. ~.~. ~ ~ ~l3 ~S 1' ~ 1 ~ y3~1 r 1 E
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TOTAL (Also enter on line 7, Recapitulation) ~ $ , Gf 3 $''~~
(If more space is needed, insert additional sheets of the same size) ~'
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TALC lE! NitM~E€! :-: ftET~#~EME~sET'~t~ @1Q " ':
220-34-0198 0214092994
INDIVIDUAL RETIREMENT ACCOUNT
MSiT BANK AS TRUSTEE FOR
6117 43,080
CLETA E HULL
ABF CHARLES J GRAMS
236 INDIAN CREEK DRIVE
MECHANICSBURG PA 17050
~k~.~_...,:.; ........`~ ! 16-0538020
~TAT~t~Q+tT'R~R~#7 PAGE ._
01-01-09 to 12-31-09 1
M8~T
TELEPHONE BANKING CTR
PO BOX 767
BUFFALO, NY 14240
800-829-1924
5~
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.:4 Y a - MRS I'._ .. ,~ ...:'. ..... ..-. . .^F .... ..~~' . ~ , ~~/i iX JI~ ~ ~~ h W.C ~ &3„ ~~~
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ACCOUNT NO 35-004201777470 ACCOUNT TYPE MBiT MKT ADV
01-01-09 BEGINNING BALANCE .00
06-09-09
06-09-09 TRANSFER IN TO BENEFICIARY
DEATH WITHDRAWAL 14,381.15
14,381.15- 14,381.15
.00
06-09-09 TAX WITHHELD-DEATH WITHDRAWAL .00 .00
06-09-09 STATE TX W/H-DEATH WITHDRAWAL .00 .00
PLAN SUMMARY
BEGIN PLAN BAL .00 DISBURSEMENTS 14,381.15
PLUS DEPOSITS 14,381.15 FED TAX WITHHELD .00
NET INTEREST .00 ST TAX WITHHELD .00
LESS DEDUCTIONS 14,381.15
TOTAL PLAN VALUE .00
2009 IRA CONTRIBUTION INFORMATION
THE FOLLOWING IS YOUR FORM 5498 TOTALS. BECAUSE THE
AMOUNTS ARE ZERO, NO REPORTING TO THE I.R.S HAS OCCURRED
BOX 1 - IRA CONTRIBUTIONS IN 2009 OR 2010 FOR 2009 0.00
BOX 2 - 2009 ROLLOVER CONTRIBUTIONS 0.00
BOX 5 - FAIR MARKET VALUE OF PLAN AT END OF 2009 0.00
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REV-1511 EX+ (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
- ~ - - -
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNE A• L~XPENSES: C~ ~ ' ~' .~` ~ `L,"~
1. ,/,'~~ ~~tJ
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees ~/~"'
3. Family Exemption: (If decedent's address is not the same a,S,claimant's, attach explanation)
-- --
Claimant - - - -"~~--
~~ ~~
Street Address ~" ~ ~ ~ ~ s '
i~
City r,. _ , ..~ _...:.~.:_.~.- ---~ State Zip _ ..
Relationship of Claimant to Decedent -t~ - -~ ;~ °'" ` ~ `~~
4. Probate Fees .-----~
5. Accountant's Fees ~~'
6. Tax Retum Preparer's Fees. ~ ~- ~ _
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TOTAL (Also enter on line 9, Recapitulation) ($ ~, f `~~ y~, ioy
(If more space is needed, insert additional sheets of the same size}
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF ~ / q FILE NUMBER
Report ebts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
(If more space is needed, insert additional sheets of the same size)
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
No . 2009- 00512
Estate Of : CHARLES J GRAMS
CERTIFICATE OF
GRANT OF LETTERS
PA No . 21- 09 - 0512
(First, Middle, Last1
Late Of : HAMPDEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : 214-09-2994
WHEREAS, on the 2nd day of Tune 2 0 09 an instrument dated
June 13th 2003 was admitted to probate as the last will of
CHARLES J GRAMS
(First, Midd/e, Last)
late of HAMPDEN TOWNSHIP, CUMBERLAND County,
who died on the 15th day of May 2 0 09 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
CLETA E HULL
who has duly qualified as EXECUTOR(R/XJ
and has agreed to administer the estate according to law, all of which
fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 2nd day of June 2009.
egister of Will
eputy
* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
~ II
LAST WILL AND TESTAMENT
I, CHARLES J. GRAMS, of the Borough of Mechanicsburg, County of
Cumberland and Commonwealth of Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making void all former Wills and
Codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be
paid by my Executrix, hereinafter named, as soon as conveniently may be done
after my decease.
SECOND. I give, devise and bequeath all the rest, residue and remainder
of my estate, real, personal and mixed, whatsoever and wheresoever situate, unto
my wife, RHODA C. GRAMS, absolutely and in fee simple, if she survives me.
THIRD. If, however, my wife, RHODA C. GRAMS, shall not survive me,
then and in that event I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever and wheresoever
situate, in equal shares unto my daughter, CLETA E. HULL, my son, RANDALL L.
GRAMS, and my daughter-in-law; SHIRLEY J. GRAMS, if she has not remarried,
share and share alike, absolutely and in fee simple.
Provided, however, that if either of my said children shall predecease me
leaving lawful issue to survive me, then I order and direct that the share provided
above for such deceased child shall be paid over and distributed unto his or her
lAW OFFICES
,MARLIN R. McCALE6
said lawful issue per stirpes, said issue to take the ancestor's share by
representation and not per capita.
Provided further, however, that if my daughter-in-law, SHIRLEY J. GRAMS,
shall predecease me or if she has remarried, then and in that event, {order and
direct that the share provided herein for her shall instead be paid over and
distributed in equa{ shares unto her children, namely: TIMOTHY WAYNE GRAMS
and CRYSTAL LEIGH TURNER, share and share alike, absolutely and in fee
simple.
LASTLY. I nominate, constitute and appoint my wife, RHODA C. GRAMS,
Executrix of this, my Last Will and Testament, but if for any reason she shall fail to
qualify as such Executrix or cease so to serve, then I nominate, constitute and
appoint my daughter, CLETA E. HULL, to serve in her place and stead, each to
serve without bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I, CHARLES J. GRAMS, have hereunto set my
hand and seal to this, my Last Will and Testament which consists of three (3)
typewritten pages to each of which I have affixed my signature this day of
~~ ~~T , A.D., Two Thousand Three (2003).
-~~`)
,- ~-
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The preceding instrument, consisting of this and two (2) other typewritten
pages, each identified by the signature of the Testator, was on the date thereof
LAW OFFICES II
v1ARLIN R. McCALE6 _2_
signed, sealed, published and declared by CHARLES J. GRAMS, the Testator
therein named, as and for his Last Will and Testament, 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.
~~~~~
~~
;-
LAW OFF{CES
MARLIN R_ McCALE6 -3-
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