Loading...
HomeMy WebLinkAbout06-21-1015056041158 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes Po aox 2soso~ INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 09 0439 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 159-60-4150 05022009 01191963 Decedent's Last Name Suffix Decedent's First Name MACKEY JEFFREY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW a 1. Original Return ^ 4. Limited Estate ^ 6. Decedent Died Testate ^ (Attach Copy of Will) 9. Litigation Proceeds Received ^ 2. Supplemental Return ^ 4a. ^ 7. ^ 10. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) MI W MI ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return 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 TO: Name Daytime Telephone Number DAVID F• SPANG, ESQUIRE 717-262-2185 Firm Name (If Applicable) WALKER, CONNOR & SPANG, LLC First line of address 247 LINCOLN WAY EAST Second line of address City or Post Office CHAMBERSBURG State ZIP Code PA 17201 REGISTER OF WILLS USE ONLY ~ ~ (4 ~ ~ ~ ~ to ~ ^~ F `"' 4 ~ ~-., r.... f^-r ~YL . ~' c.~ _ ~ ,~.., . -1 ~ HAILED ~. _ -_ __ r~r-; ~~7. Correspondent's a-mail address: D F S a9 W C S L A W O F F I C E• C O M 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. ~~~ ~~ C/0 WALKER;' CONNO~ & SPANG, LLC 24__7 LWE, CHAM_BERSBURG, P_A_ 17 SwIVATyI~~ OF PREPARER OTJ'9ER A~I91V REPRESENTATIVE nn-rG 247 LINCOLN WAY EAST CHAMBERSBURG, PA 17201 PLEASE USE ORIGINAL FORM ONLY 15056041158 Side 1 6M4647 3.000 15056041158 15056042159 REV 1500 EX Decedent's Social Security Number 159-60-4150 Decedent's -yame~'1 A C K E Y JEFFREY W RECAPITULATION 1. Real estate (Schedule A) 1. 0 • O O 2. Stocks and Bonds (Schedule B) . 2. 0 • 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. 0 . 0 0 4. Mortgages & Notes Receivable (Schedule D). . 4. O • 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 2 310 6 • 0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. O.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. O • 0 0 8. Total Gross Assets (total Lines 1-7). 8. ~ 0 6 • 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 5 0 8 0 • 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10. 0 . 0 0 11. Total Deductions (total Lines 9 8~ 10) . 11. 5 0 8 0 • 0 0 12. Net Value of Estate (Line 8 minus Line 11) 12. 18 0 2 6 • 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 Subject to Tax (Line 12 minus Line 13) 14. 8 0 2 6 • 0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~ef Sec. 9116 1 2 (a)( . ) X .0 0.O O 15• O.O O 16. Amount of Line 14 taxable at lineal rate x .oli5 18 0 2 6.0 0 16. 811.0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0.O O 18• 0 • 0 0 19. TAX DUE 19. 811 • 0 0 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 6M46482.000 15056042159 REV-1500 EX Page 3 Aw wJw Mj~A ~A•M MIA~'A A~~~A!•C• File Number ai. nq nt,aq r vvvM V.. - - - DECEDENTS NAME MA K Y FFR Y STREET ADDRESS M R A CITY V STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments • C. Discount 0.0 0 (1) 811.00 Total Credits (A + B + C) (2) 0 • 0 3. Interest/Penalty if applicable D. Interest 12 • 0 0 E. Penalty 0.0 0 Total InteresUPenalty (D + E) (3) 12.0 0 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. (4) 0 - 0 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8 2 3 • 0 0 A. Enter the interest on the tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 8 2 3 • 0 0 Make Check Payable to: FaEG1STER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a X a. retain the use or income of the property transferred; erty transferred or its income; ro the ll s h h i t p p u o s a e e w gna b. retain the right to des 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 ^ L J without receiving adequate consideration? . ^ a 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 exemot 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 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. 6M4671 1.000 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Jeffrey W Mackey _ 21 09 0439 Include the proceeds of litigation and the date the proceeds were received by the estate. A!I property jointly-owned with the right of survivorship must be disclosed on Schedule F. {TEM~ I VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Distribution from Estate of Ethel M. Henry 22,986 2 Citizens Bank Checking Account #6201118091 20 3 Uncashed check payable to Jeffrey Mackey 100 3W46AD 1.000 TOTAL (Also enter on line 5, Recapi~ (If more space is needed, insert additional sheets of the same size) 23,106 ~, ~ ., .3 8, ~+' ~ ;; ~~~ , ~ / Trackl~our Expenses.: 13 ~: ~.~ . ~~' O AutolTravel ^ Education ^ MedicaVbental ;; d Business ^ Entertainment p Savings ~ a ~ ~ g Q Charities Q Food Q Taxes .. ~ e~ _, ~ Q Clothing ^ Home ~ Utilities gAL. ependent Car ^ Insurance ^ Other ~ ~ ~ FORD - - ~ # - ~ F _ ~ ~ ~ ~5 .. // ' ITEM. - . AMOUNT _ ,,, a ~ ~'::~ L . _ _~ y LI ~,, ~ - DEPOSfT ` y ~ ` r FOf enhanced SeCUrlty yOUr aCCOUnt FORD ~= ~`;.;{ ~. . number has been"blocked out on this copy ~ +~ ." #~, ~ ~ ~ ~ ~r ~ ..~ ~ ' ~ ~ ~~ ~ _ ~ e v`` r Sr Gf '~ ~ ~ .: t~f ~ rll''~~, Memo _ ., ~1 n w / TrackYour Expenses... L ,'~" ~ 2 ^ Auto/TraveF D Education ^ MedicaVDental ^ Business ^ Entertainment ^ Savings ~~,r ^'Charities ^ Food ^ Taxes ~ ~. ~ ~ L `-1 ^ Clothing ^ Home ^ Utilities gA~, ~B~pendent are ^ Insurance ^ Other FoR~D ~~ r t .,:~ Gi' C. /~~._ ITEM f '~ Cr} G' _ ~i.., L~ AMOUNT F: C.r ;, G o l' .2~ ! ~ __.. DEPOSIT For enhanced security your account FDR`D number has been blocked out on this copy ,. / 'r .. Memo . irCL-1 ! ~. ~ ' S ~; l~i.t.~~ -~,`~ ~' • M M _ _ NOT NEGOTIABLE Scott Mackey is one of three surviving children of the Jeffrey MatRey Estate. ESTATE OF ETHEL M. HEMRY 1368 HEARTHSIDE DR. CHAMBERSBURG, PA_ 17202 ~'- ~ t. ~0-,039 131 313 109 /~' ~~"~ A j f ~ z~ ORRSTOWNBANK d Tiadi 'oa ofExulles ~~~:03 L3 L5036~: L09 0046 2 II' 0 L3 L Payment to the funeral home was advanced on behalf of the Jeffrey Mackey Estate from the Estate of Ethel M. Henry. f ESTATE OF ETHEL M. HENRY 1368 HEARTHSIDE DR. CHAMBERSBURG, PA 17202 ~-1~9 14 4 313 109004620 ~~ ~ ~ ~j ~~~•~T ,,[ 3~ boo ,pp ' v"~~ P..r ! U ~ v ORRSTOWNBANg ~ _/ -x:03 13 15036: 109 0046 20u' 0 144 Tyler Mackey is one of three surviving children of the Jeffrey Macke~Zy Estate. i • ESTATE OF ETHEL M. HENRY 60319 14 0 1368 HEARTH5IDE DR. 109U04620 CHAMBERSBURG, PA 17202 ~~, ~,, ~ ~31~ a ~ ( ~. ~- ~s $ 5, 0 7~. 3~ odder of s` j ~ ! ~ ~ ~ ~ ` /` n~ ' ~G ~} ~ ~C,S ~ ~.St. V ..^C~ li/ ~ ~ ~ t ~ '~~ ~ LtJ ow me.e~ s 0 ORRSTOWNBANg ~ z ~~~ x:03 L3 L5036~: L09 0046 20u' 0 L~,O • so-1503 13 9 `~ ESTATE OF ETHEL M. HENRY 313 9 1368 HEARTHSiDE DR. 109004620 CHAMBERSBURG, PA 17202 ~ Q ~ Q a ~--a ~C.O ~ • C -~ odder of ~ ~ .'~ ~ 8. c~ dO ~. «~..~ ORRSTOWNBANS ~ z ~t~ / i~CL~'t c ~°. cif J's'~r Fa r.~ 3rd n~ x:03 i3 i5036~: i09 0046 20u' 0 i39 . 60-15039 15 0 ESTATE OF ETHEL M. HENRY 313 1368 HEARTHSIDE DR. 109004620 CHAMBERSBURG, PA 17202 S ~. ~,~ ~ ~} a orfde of ve ~ • ~ ~ a ~ ~~c, , 3 3 Oiutsl'owlvB~ A Tradition ofEzullence NP ~:0 3 L 3 L 50 3 6~: LO 9 00 4 6 200' 0 L 50 Final-distribution to the Jeffrey E. Mackey Estate from the Ethel M. Henry Estate +~ + w.. »« ~Ar~::; ~ O~t~~ : X009 ~ ~ : ~ M ~ ~~ 16 3 4 49 f} 8 ~ ~ sz-is .. 0083 09 CH - ECKNo ~3©~r~G.~~~~ -: ::.. t ..`> :::: ':;:_._;= ;; ::.;::<:<•~ :.:: 311 :.. :~:. ::.: . ,, <::;>~ O~ #iurrdtect'~~nt#`fl0/100 Dollars ~ ~.~ ~~ • ...: ~F~l~~~~1.Ii~1ll'11"'1 ~~11~II~~~Xblf:~~I~. ~ 1 ~~ . 00 >.:::. ...: 03~6.{Q9~35 :: .. ~Ir ~k .PAY TO THE ORDER OF ~IEFFREY E MAC ,:. / '. ::.:. :. .:.. :. `:.'~' :..~. :i::.~' .: JR~tNtlhgan , Sys NY '` 5BOt E Taft Road .... .: .; North Syracuse NY 1212-A~t0 .:: ::.. :. ; . ' _.~.._._.~.._._.... MP : `~~{nt~~~l~~~ll~~~~~~sr~,~~~t~•~~~an~~~~1[IE~'~~,'1~~~.~I~tJt~. ~COt~lif~AtRR: ~IC~~~RESjb~NET',TflEASURER :. ON ~~'0 30 6 50 9 9 3 5~~' ~:0 3 ~ X00 2 6 7~: 6 30 i 5008 3 5 50 9~~' REV-1511 EX+ (1~-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER f r W 21 0 Debts of decedent must be reported on Schedule I. ITEM I - NUMBER DESCRIPTION A. FUNERAL EXPENSES: ~. Fogelsanger-Bricker Funeral Home funeral services B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) •T~ ~ i n Conyers and Scott E . Mackey Street Address see attached City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant none Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 The News-Chronicle Co. - legal advertising 2 Cumberland Law Journal - legal advertising AMOUNT 3,265 1,500 87 138 75 TOTAL (Also enter on line 9, Recapitulation) ~ $ 5 , 0 65 ~was,ac 1.000 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (11-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Jeffre W. Macke 21 09 0439 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. 2116 (a) (1.2).] 1. Jill n . Conyers Daughter 1 / ~ of residu 10352 Rowe Run Road Orrstown, PA 17244 2 scott E . Mackey Son 1 / 3 of residu 640 Mickey Inn Road Chambersburg, PA 17202 3 Tyler Mackey Son 1 / 3 of residu 10303 Muddy Run Road Orrstown, PA 17244 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. [[ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 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. Z 0 swasA~ 2.000 if more space is needed, insert additional sheets of the same size. e .e ~~e 1/state or ~ezrrey w. i~lacxey Estate of Jeffrey W. Mackey Executors (Page 1) Name Jill D. Conyers Address 10352 Rowe Run Road Orrstown, PA 17244- Tax ID 191-70-9797 Name Jeffrey E. Mackey Address 640 Mickey Inn Road Chambersburg, PA 17202- Tax ID 203-62-7951 159-60-4150 Martha B. Walker, Esquire mbw@wcslawoffice.com Michael J. Connor, Esquire mjc@wcslawoffice.com David F. Spang, Esquire dfs@wcslawoffice.com Cumberland County Courthouse Register of Wills 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Jeffrey E. Mackey File Number: 2109 0439 Dear Register of Wills: 247 Lincoln Way East Chambersburg, PA 17201 (717 262-2185 Fax (717 262-2187 Stacey A. Shank Paralegal Julie M. Metz Estate Paralegal Enclosed for filing please find two copies of the REV-1500 in the above- referenced matter. I have also enclosed an extra copy of page one of the return for you to time stamp and return to me in the enclosed envelope. Our check for the tax owed in the amount of $823.00 is enclosed, as well as our check in the amount of $15.00 for the filing fee. If you have any questions, please feel free to call me. Very truly yours, ~~~Y- ` J 1' M. Metz ~G ~ ___ E fate Paralegal t-~, ~' ~-- r, ~ ~ , ::~~ , . ,_~ - ~~ Enclosures w' ~~ ~' ~ '~ ~` ~~~.~ __ - _-~ C'.~ t3 -.. i ~ 4 ....~ ~ '77 +~ '1 `~ 7 C~ '~'"~ ~~~ ~ N ~ ~ r.., ~,,, ,~.- ,e-~ t~- Gl) ~' ~ :~ .r,: ~~ ~~ ~ C? ~ ~ as b'~~~~~~Ca ~' .~ ~ ~ ~ * ~~ ,p N r 'r l%~- <.~ ~ . -, ~~ _~ .~ ;~ ~ ~_ ~, :.. . ''~"~ ;~~ ~~`.- -~ ,. .~~_ ~.~__ ~~ ~~ C..a ~'. r.~ c °••;, t....- ~ ~1'" C~ ~~ c.. ~~ ~~ U ~4. 0 ~ r.~ r ti ~ ~ ~ tC per., ~ N ~N N O t] N L r ~ "~ ~r=ti ¢~ N ,~ v F"r"y F~ o~ o~ ~~ v ~. :~ ~- `~- .T J t ~..J ~ ._.i.- ~ ~ ~ ~ ~ ~ ~ C~.. J 4 ~ `, ,~ ~~~ ~~-`