Loading...
HomeMy WebLinkAbout07-01-10 (2)1505610143 REV-1500 Ex(o,_,o, PA Department of Revenue nns Ivania OFFICIAL U3E ONLY ~ y County Code Year File Number Bureau of Individual Taxes oE.M.rerrtaFrrcvrxue Po Box.2soso~ INHERITANCE TAX RETURN 21 p19 1020 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 158 16 2246 10 05 2009 09 12 1925 Decedent's Last Name Suffix Decedent's First Name ', MI DANDY DANIEL A (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 DUPLIC~T~ WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW I X^ 1. Original Return ^ 2, Supplemental Return ^ 3 Remainder R~etum (date of death pnorto 12-1 2) ^ 4. Limited Estate ^ ~ Future Interest Compromise (date of death aRer,2-,z-a2) ^ 5. Federal Esta`;e Tax Return Required 6. DeCe~nt Drsd T-tee Mei ned a Livin Trust 0 (Attach Copyofwn) ^ 7• Att ropy "ot~n,st) ® 8, Total Numt>e~ of Safe DeposR Boxes ^ 9. Litigation Proceeds Received ^ 10• s~a,eal P~t ~i-d~Of death ^ 71. Election to' under Sec. 9113(A) )) (Attadl SCh. ) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA ON SHOULD BE DIRECTED TO: Name Daytime TAleph Number MARCI S MILLER 717 540. 4332 N 0 REGtST6ILLS U~ONL1(°~ ;" 7~ C :aa First line of address ~ I* r ; ~ ~- I s~r'i 2000 LINGLESTO~iN ROAD ~ -~ "- -`= ~' 7 rJ -t7 ~;.-; Second line of address c"~ -n -~ SUITE 202 r~,,, .~ rv r~~ . -..~, D FILED '~ ~ x City or Post Office State ZIP Code ~ '"' HARRISBURG PA 17110 Correspondent's e-mail address: mmiller~hazenelderlaw.com '~ Under penalties of pery' i declare that I have examined this return, includ'ing accompanying Schedules and statements, and to the of my knowledge and belief, d Is true, Correa and plate. Declaration Of preperer other than the personal representative Is based on ail information Of which pre r has any knowledge. SIGNATURE OF PER~'N R LE FOR FILING RETURN ATE G%~•~ Daniel J Dand oZ g ~ U ADDRESS 2000 Linglestown Road, Harnlsburg, PA 17110 -~ Side 1 L 1505610143 1505610~r43 J 1505610243 REV-1500 EX Os0e0""'' "~""°~ Dandy, Daniel A RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedu~ C)......... 3 4. Mortgages 8 Notes Receivable (Schedule D) ............. ......................................... .. 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .............. . 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ 7. Inter-Vivos Transfers 8 Miscellaneous Ikon-Probate Property (Schedule G) u S g, eparate Bitting Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ............. ........................................................ 8. 9. Funeral Expenses & Administrative Costs (Schedule H) .... .......................... ......... s. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 11. Total Deductions (total Lines 9 & 10) ............ 10. ....................................................... 11. 12. Net Value of Espite (line 8 minus Line 11) .............. .......... . 13. Charitable and Governmental • ' ............................... Bequests/Sec 9113 Trusts for which 12. an election to tax has not been made (Schedule J) ...... ......................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ........................ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE 14 RATES 15. Amount of Line 14 taxable at the spousal tax rate or , transfers under Sec. 9116 (a)(1.2) X .00 16. Amount of Line 14 taxabb 15. at lineal rate x .045 19 , 985.07 16 17. Amount of Line 14 taxable . at sibling rate X .12 0.00 17 18. Amount of Line 14 taxable . at collateral rate X .15 n n n _ _ 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 158 16 2246 Side 2 1505610243 150561024 365.50 45,058.15 45,423.65 20,610.21 4,828.37 25,438.58 19,985.07 19,985.07 0.00 899.33 0.00 0.00 899.33 REV 1500 EX page 3 Decedent's Complete Address; DECEDENT'S 111MAE Dandy, Daniel A STREET ADDRESS 1000 West Sotrth St. CITY Carlisle Tax Payments and Credits 1. Tax Due (Page 2, Line 19) 2• Credita/Payments A. Prior Payments B. Discount 3. Interest 4.300.00 44 97 File Number 21-09-1020 4. If Line 2 is greater than Line 1 + une 3, enter the difference. This is the OVERPAYMENT. Check box on Pape 2 Lino TO to requsst a refund 5. If Line 1 + Li 3 STATE ZIP PA 17013 ~', (1) 899.33 Total Credits (A + B) !(2) 4.344.97 (3) (4) 3,445.64 ne s greater than Une 2, enter the difference. This is the TAX DUE. (~) Make Check Pa able to: REGISTER OF WILLS AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACIN G AN "X" IN THE APPROPF~~~ 1. Did decedent make a transfer and: a• retain the use or income of the property transferred :.................... b• retab the right to designate who shall use the Property trensfe ................... • retain a reversbnary intermit; or ................ rred or its inc•,orr~e;,,,,,.,.•,.,•••... d. rooeive ........................ ................ the Promise for life of either ....................................................................... 2. H death ocarmsd albr December 12, Payments, benefits or care?......... 1982, did decedent transfer ........................... ^~~q adequate conaideratbn? Property within one ........................ TE BLOCKS No Yes ........... . .. .......... ................................... 3. Did decedent own an "in trust for or payable upon death bank account or security at his or of death without. ^ 4. Did decedent own an Individual Retirement Account, annu ^ contains a her death?......, IF THE AN3INER TO ~°~ry designatbn? .................... ~'~ or other non-probate property which ANY OF THE ..................................... EVE QUESTIONS 13 YES, YOU MUST COMPLETES ~ ^ CHEDULE G AND FILE IT AS ART OF©E RETURN. FaP use ~ 3 death on or afEer Juty 1, 1994 and before Jan. 1, 1995, the tax rate im Percent 172 P.S. §9118 (a) (1.1) (i)]. Posed on the net value of transfers to or for For dates of death on or after January 1, 1995, the tax rate im ~ use ~ the surviving [72 P.S. §9118 (a) (1.1) (ii)]. The eta Posed on the net value of transfers to or for the use of the aunvivi assets and Gin9 a tax return aro stiW tote does ~ e~Pt a transfer to a surviving spouse from tax, and the statuto ~ spouse is 0 percent For dates of death on or aPPlkabb even if the surviving spouse is the only beneficiary after Ju 1, ry requirements for discbsure of • The tax rate hrrr b .2000: pa~posed on the net value of transfers from a deceased child 21 are of a e or younger at death . The tax rate irn McPParent of the child is 0 percent [72 P.S. §9118 (a) (1.2)]• 9 72 P.S. §9118 1.2)172 P.S. §9118 (a) (1)]. Posed on ~ net value of transfers to or for the use of the decedent's lineal beneficiaries is 4 5 to or for the use'of a natural parent, an • ~ ~ rote imposed on the net value of transfers to or for Percent, except ~s noted in iblirg ~ defined under Section 9102, as an individual who ~ at~bast oned pa~re~nt ~n summon w~ ~ d ~ Percent (72 P.S. §9118 (a} ( 3) . A ecedent, whether bY, b,ood or adoption. I i Rw-1603 p(+ (~) ~~ ~~ REeaeHro ESTATE OF Dand ,Daniel A a~ r JoMtly.oM,,,.d +MU~ ~pht a surWP must b. dbclw~d an scn.dw. F. ITEM CUSIP NUMBER NUMBER DESCRIPTION 1 10 shams ~ MetLlfe Insurance Company FILE UNIT VALE VALUE AT DATE OF DEATH 3 •~ 365.50 TOTAL (Also enter on Line 2. Recapitulation) (K mar 6prce is ,, ~~~ 365.50 C0PYn9ht (c) 2002 form sofirvare on Pr9es of the aame size) ly The Lackner Group, Inc. Forrn PA-1501D ~chedule B (Rev. 6-98) __ _- I SCHEDULE B STOCKS & BONDS Rw-160! E7Cr (~) r ~~ ~~ ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY iel A FILE N~f11ABER 21-0 -1020 ~ Prop«ty 1a -own.a ~ ~ o ~"~,~o„hinm~nt w 6'° she. ~F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 Cash on hand '~ pF pEATM 2 Refund from CenturyTel Inc. - ov 140.80 erpayment of telephone utility 3 Members 1st F 19.78 ederal Credit Union -checking acct. #32740 4 Members 1st Federal Credit Union - 10.408.52 savings acct. #32740 5 MldPenn Bank Acct. #30082700 -Money market account 12.874.74 21,614.30 TOTAL (Also enter on Une 5, Recapitulation) (ff mae ePe~ce b needed. addNionai 45.058.15 ~PYrigM (c) 2002 form eoilware only The Lackner Group, Inc. peae8 of the same size) Form PA-1600 s~hedule E (Rev. 6-98) - _ _ __ I REV-1151 EX+ (10.og) c°~AAII ~`Li:'F~avw N~~D ESTATE OF Daniel A SCHEDULE H FUNERAL EXPENSES ~ -DMINISTRATIVE COSTS ITEM ~~ A. FUNERAL EXPENSES: Debts of decedent must be reported on Schedule 1. DESCRIPTION See continuation schedule(s) attached ~ILE', NUMBE 21-f;1t~-1020 AMOUNT 11,131.81 B• ADMINISTRATIVE COSTS: 1 • Personal RePreserltative's Commissions Name of Personal Representative(s) Daniel J Dan street address 333 North Mountain Rd. City Net+wiile state PA zip 1 T241 Yearfs) Commission paid 2010 - 2011 2. Attomev's Fees Hazen Eider Law 3. Family Exemption. (tf decedent's address is not the same as claimant's, attach explanation) Cla&nant Street Address Cdy State Relationship of Claimant to Decedent Zip 4• Probate Fees Register of Wills 5• Accountant's Fees Mark J. Wetzel, CPA _ preparation of personal and fiduciary II i 6• Tax Retum Preparer's Fees ~• Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 8, Recanituiarton) .. _ ,_, ___„ ,~,,,, ,~,111ero onry the Lackner Group, Inc. Form PA-1'b00 3,100.00 5,250.00 106.00 350.00 672.40 20,610.21 H (Rev. 10-06) ESTATE OF FILE NUMBER 21-0!8-1020 ITEM NUMBER DESCRIPTION Funeral EYnnn=~. AMOUNT 1 American Monument Co. -lettering for tombstone 2 Bartlett Greenhouses 8 Florist -funeral flowers 425.00 3 Edible Ar'r'angements -funeral luncheon 374.50 4 Mario's Restaurant -funeral meal 278.78 5 Quinlan Funeral Home 553.53 6 St. Mary -church for funeral serWces 8.000.00 1.500.00 H-A ~~.Afltive Cflst~s 11,131.81 7 Cumberland Law Journal -estate notice 8 NJMJ News paper -obituary for decedent 75.00 9 Sentinel -estate notice 378.00 219.40 H-B7 672.40 Copyright (c) 2ppy form Software only The Lackner Group, Inc. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued Form PA-150b ~5chedub H (Rev. 6-98) Rw-pats Ex+ (1z-oal ~~ ~~ o ESTATE OF Daniel A scN~ou~E ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 27-0 ~ a.pts tnc,.~.e ey m. d.c.au,~ aior to a.m awt nnWnW wyiyd ae m. a.a a w.u,, a,a„s„o ,,,,,w„~ ~ ITEM NUMBER DESCRIPTION 1 Carlisle HMA Physician -medical expense 2 Cumberland-Goodwill FireRescue -ambulance services 3 Embarq Teiephone -final phone bill 4 Millennium Pharmacy Systems East 5 Sarah Todd Memorial Home -final nursing home bill 6 Special Event ER Medical Services _ medical expense 7 West Shore EMS -ambulance coats TOTAL (Also enter on Line 10, Recapitulation) Copyright (c) 2009 form so („ "~° ~e is needed, ada~uon.l p~ of the same size) Rware only The Lackner Group, Inc. VALUE AT DATE of DEATH 10.00 58.94 58.50 12.90 3,182.95 61.61 1.446.47 4,828.37 Forth PA-1500 Schedule I (Rev. 12-08) REV-1673 EX~ (11-0!) C~~«~4~~~~/ANIA ESTATE OF C SCHEDULE J BENEFICIARIES nand ,Daniel A NUMBER PERSON S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spo • distributions, and tra under Sec. 9116 a 1 Gina Dandy 42216 Terrazzo Ter. Apt 405 Stone Ridge, VA 20105 2 Daniel J Dandy 333 North Mountain Rd. Newville, PA 17241 FILE NUMBER RELATIONSHIP TO 21-019-1020 DECEDENT SHARE OF E9Ta4TE AMOUNT OF ESTATE Daughter 50~. of the residue Son 15016 of the residue toter dollar amounts for distributions shown above on lines 15th h 18 on Rev 1500 coyer sheet a a II. NON-TAXABLE D1STR~UTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAbEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS • ^", •~ - rn ~ ttc 1 vTAL NON-TAXAB Copyright (c) 2009 form soflvvare only The Lackner Group, Inc. Form PA-1<SOO~ S~Chedule J (Rev. 11-08) o 0 O ~ ~ O O O r O O T O I [~~ `~' _~ ~f~e v _d } O M ~ o ~ C3 _ R c O O r = a ~ 0 ~~ IC 0 Q 41 O O O ~ O M y ; O ~ r ~ m ~ ~ N ~ N ~ O O o ~"~ O co Q V O ~ et - to e cD Q N N N .~ Q ~ d po ° o C ~+ N ~ m G ~ A "L7 C 0 a c3 Q m to c~ .~ c •- :c ~ n s H . Q U ~UQ m R K ~ W ie > .'. : ,~ ~ W m ~ To ~ O FO- t C1 V ~ ~ C7 f# O O O t ~ M M r ~ ~ (~ V V N j Q MEMBERS 1~ FEDERAL CREDIT UNION SAI/INGB 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 CHECKNG AGCOUNT•_ 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 Estate of: Dp-NIEL A. DANDY Date of Death; 10/12/2009 Social Security Number; 158-16-2246 327240-00 04/07/2008 $12,874.74 $2.12 $12,876.86 None 327240-11 04/07/2008 $10,408.52 $.51 $10,409.03 None MBERS 1ST FEDERAL CR~biT UNION DanieNe .Kline Insurance Services Specialist November 24, 2009 ~~'~ I'~~ 0 1009 ........-~:.~.~?u 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwuPmembersl st.org " "~`'"' i"'~~~ ~W An Estate Planning; Elder Law and S recrtl Needs Manning Law ~rrrr 2000 Linglestown Road, Suite 202 Harrisburg, PA 17110 www.HazenElderLaw.com 'nti. (71'T) 540.4332 11~u'ielle F. Hazen, CFI.A* Fax: (717) 540-4313 MJard S. Miller, Associate June 30, 2010 ra ~ ~' ~' l c-,. ~ ~~,,_ CERTIFIED MAIL x~ ~ `^' US~ ' - ~~' :-i~ ~ ~_,~ t ~x~ ~, J : Register of Wills JI ~ ~ . . c Cumberland County Courthouse ~~ ~ - ~``' One Courthouse Square I ~~' ~ "~= ~'^ ~ Carlisle, PA 17013-3387 r ~; `~ ~+ Re: Estate of Daniel J. Dandy File No.: 21-09-1020 Social Security No.: 158-16-2246 Inheritance Taa Return To: The Register of Wills: Enclosed for filing please find the original and one copy of the shave}-referenced Inheritance Tax Return and Inventory, along with a copy of the first pja~e of the Inheritance Tax Return. Please date stamp the first page of the return and a ~Capy of the Inventory and return them to my office in the enclosed self-addressed envelgp~. Also enclosed is a check for the filing fee in the amount of $30.00. If you have any questions or require any additional information, please do not hesitate to contact me. Sincerely, C 0 ~c*X~"°ris~' Corinne Eggers Woodhouse Enclosures Paralegal cc: Daniel A. Dandy, Ex. "Certified Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Suprenrre Court