HomeMy WebLinkAbout09-03-10 (3)---~ REV-1500 EX (01-10) 1505610143
~~ OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO Box.2soso~ INHERITANCE TAX RETURN 21 i li ~ ~~
Harrisburg, PA 1712s-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
208 24 0094 04 25 2010
Decedent's Last Name Suffix
BRANDY
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
Date of Birth
11 03 1924
Decedent's First Name MI
DONALD R
Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WVITH THE
REClST~R CAF ~1~d1 ~l~S
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ^ 2. Supplemental Return
^ 4. Limited Estate ^ 4a. Future Interest Compromise
(date of death after 12-12-82)
® g Decedent Died Testate ^ 7 Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust)
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
^ 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
ROBERT P KLINE 717 770 2540
First line of address
714 BRIDGE STREET
Second line of address
PO BOX 461
City or Post Office State ZIP Code
NEW CUMBERLAND PA 37070
Correspondent's a-mail address:
REGISTER OF V111LLS USE ONLY
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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 RENSIBLE FILING R URN DATE
~ Nancy L. Steinberger 9- ~ - !~ ~'
ADDRE S ~
1014 Dogwood Lane, Enola, PA 17025
S NATURE OF EP ER ER T N EPRESENTATIVE DATE
Robert P Kline ~',~~~¢~- ~~,-y
ADDRE
714 Bridge Street, New Cumberland, PA 17070
Side 1
L 1505610143
1505610143
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1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: B R A N D T, D O N A L D R 2 0 8 2 4 0 0 9 4
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RECAPITULATION _ _ __ - -
1. Real Estate (Schedule A) ....................................................................................... ... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) ......................................................... . 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7l 5 , 1 6 0 4 4
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7. 3 5, 0 8 1 1 0
8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. ~i O , 2 41.5 4
9. Funeral Expenses & Administrative Costs (Schedule H) ........................................ . 9. 7 , 7 5 5 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 3 8 2 3 8
11. Total Deductions (total Lines 9& 10) .................................................................... ..11. 8, 1 3 7 3 8
12. Net Value of Estate (Line 8 minus Line 11) ........................................................... ..12. ~E 2 , 1 0 4 1 6
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. L~ 2 , 1 0 4 1 6
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 .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 4 2, 10 4.16 1 s. 1, 8 9 4 6 9
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. 1, 8 9 4 6 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 1,894.69
Total Credits (A + g) (2) 0.0 0
(3) 0.00
(4)
(5) 1,894.69
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 :.................................................................................r ~x'
i.
b. retain the right to designate who shall use the property transferred or its income :.................................... ~~ _,, `x
c. retain a reversionary interest; or ...............................................................................................................~__•--' ~x
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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 year of death vvithout
receiving adequate consideration? ............................................................................................................. r-.
........~• ~ ' x ~~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which -
contains a beneficiary designation? ................................................................................................................... X~ ~-.
.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR
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 Janua 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 sta~ute 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)].
• 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 )].
• 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) . A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bloo~or adoption.
` ', SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ~ FILE NUMBER
Brandt, Donald R 21
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedulE: G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIOINSHIP TO DECEDENT
Nancy L. Steinberger 1014 Dogwood Lane Daughter
A Enola, PA 17025
_ __ SCRIPT.ION----F PROPERTY __ _ - _- __ _ of _ --
LETTER DATE - _ ~~' 9 t ~ d 1 y - - - _- -
ITEM Include name o financial Ins Itu Ion an bank account number DATE OF DEATH ~> OF I DATE OF DEATH
NUMBER FOR JOINT MADE or similar identi m number. Attach deed for ointl -held real VALUE OF ASSET DE;CD'S~ vALUE of
ENANT ..JOINT- INTE-RES _ _ _-
-- -estate. ---- - _ - _ _ - -- + -- - --- - _ -'~ 0 DECEDENT'S INTEREST
1
1 ~ A 1st National Bank of Marysville #3063653-T 30,320.88 ~0 /0 15,160.44
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COMMONWEALTH OF PENNSYLVANIA S^HEDULE V i~
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT ~ MISC. NON-PROBATE PROPERTY
ESTATE OF Brandt, Donald R FILE NUMBER
21
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
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ITEM I DESCRIPTION OF PROPERTY II
p DATE OF DEATH % OF EXCLUSION I' TAXABLE VALUE
Include the name of the transferee, their relationshi to decedent ~ DECD'S (IF APPLICAEILE)
NUMBER VALUE OF ASSET
and the date of transfer. Attach a copy of the deed for real estate. INTEREST I~
- -- { _ _ -___ --_- - - --- -- --- - ---- 1111
1 ,First National Bank of Mifflintown IRA #6404132 10,566.36 100% 10,566.36
2 !, MetLife Investors USA Annuity #A2056036 24,514.74 ~, 100% ~ 24,514.74
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SCHEDULE H
. FUNS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN er~~N~C'rp/~TI~ /C ~P1C~T@
RESIDENT DECEDENT i /"Y~~n N ~ ~ V'\ ~ ~YG ~IV~7 ~ ~7
FILE NUMBER
ESTATE OF Brandt, Donald R 21
Debts of decedent must be reported on Schedule I.
-- __
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NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 ,Sullivan Funeral Home, 51 N. Enola Dr, Enola, PA 17025 6,740.00
B. 'ADMINISTRATIVE COSTS:
~ . ~i Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
I' Year(s) Commission paid
2. ' Attorney's Fees Kline Law Office
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
'~ Relationship of Claimant to Decedent
4. Probate Fees Register of Wills
5. Accountant's Fees
6. '~,, Tax Return Preparer's Fees
7. ~ Other Administrative Costs
1
TOTAL (Also enter on line 9, Recapitulation)
i 1, 000.00
15.00
7,755.00
SCHEDULEI
DEBTS OF DECEDENQT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES {.if: ~ICNS i
INHERITANCE TAX RETURN ~ G
RESIDENT DECEDENT
i
- ---. _---- _ --_ - _ _ _- -- --- -- ----- _-- - - j
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FILE NUMBER
ESTATE OF Brandt, Donald R 21
_ - _
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimk~ursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
__ _ --
1 State Employees Retirement System 186.88
2 Debbie Lupold, East Pennsboro Treasurer 5.50
3 Andrews & Patel Associates, P.C. 73.00
4 Pinnacle Health Hospital 50.00
5 Mobile X-Ray Imaging, Inc. 16.49
6 Holy Spirit Hospital 50.51
TOTAL (Also enter on Line 10, Recapitulation) 382.38
REV-1513 EX+ (11-08)
SCHEDULE J~+
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN G R
RESIDENT DECEDENT '
--- __ _ __ _ ___ __ - _ _ _ _ - II - _ _ _ __
----
ESTATE OF FILE NUMBERR
Brandt, Donald R
- - - ___ 21
__
- - --- _-- -_ -- - --- -- _ _ ----_--- ------------ _ I_ --- _ - __ ---
RELATIONSHIP TO ~ SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER ~ NAME AND ADDRESS OF PERSON(S) ~ DECEDENT (Words) i ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS[mclude outright spousal ~I
distributions, and transfers ',
~ under Sec. 9116 (a) (1.2)] I ', '
1 ~ Nancy L. Steinberger j Daughter ', ALL
1014 Dogwood Lane 'I ~
~ Enola, PA 17025
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Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate.
II. ~ NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
', B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T 0.00
___ _- --- _ - - ____ - __ _ - - - - --_ __ _ - --- -- _--. _ _ _ -_ __ _ i
LAST WILL AND TESTAMENT
OF
DONALD R. BRANDY
1, DONALD R. BRANDY, of East Pennsboro Township, Cumberland County,
Pennsylvania 17011, being of sound and disposing mind and memory, do
hereby make, publish and declare this for and as my Last Will and Testament
hereby revoki~~c~,, any and a!I Wills or Codicils by me at any time heretofore
made.
1 hereby declare that I am a widower who is unmarried. I have one child,
my daughter, Nancy L. Steinberger.
My fate wife STELLA M. BRANDY, died September 17, 2004.
ITEM 1- 1 direct my Executor hereinafter named, to pay ali my just and
lawful debts and funeral expenses out of my personal estate as soon after my
decease as is convenient.
Initialsl.~~
Page 1 of 6
ITEM 11 - 1 specifically give and devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed, wheresoever situate, to
my daughter, NANCY L. STEINBERGER.
ITEM I11 - If my daughter, should predecease me then, l give devise and
bequeath all the rest, residue and remainder of my Estate, real ,personal and
mixed, wheresoever situate, to my granddaughter, JAMIE L. STEINBERGER, per
stirpes.
ITEM 1V - 1 hereby nominate and appoint my daughter, NANCY L.
STEINBERGER, ns the Executrix of this my Last Will and Testament.
ITEM V - tf my daughter, NANCY L. STEINBERGER, should predecease me
or should be unable to serve as my Executrix then 1 appoint m~y grand-
daughter, JAMIE L. STEINBERGER, as my successor - Executrix for this my Last
Will and Testament.
ITEM VI - My Executrix appointed under this Will shall have the following
powers:
Initials
Page 2 of
A. To retain any or all assets of my estate, real or persanal,
without regard to any principle of diversification, risk, or
productivity.
B. To invest in all forms of property, including stocks, common trust
funds and mortgage investment funds, without restriction to investment
authorized for Pennsylvania fiduciaries as she deems proper, without
regard to any principle of diversification, risk, or productivity„
C. To sell at public or private sale, to exchange or to lease, for any
period of time, any real or personal property and to give options for
sales, exchanges or leases, for such prices and upon such terms and
conditions as she deems proper.
D. To borrow money from any person or institution including my
Fiduciaries and to mortgage or pledge any or all real or personal
property as my Fiduciaries in their sole discretion shall choose, without
regard for the dispositive provisions of this instrument.
E. To compromise any claim or controversy.
Initials -
Page 3 0
F. To exercise any option, right or privilege granted in insurance
policies or in other investments.
ITEM V 11- My Executrix is authorized and empowered to retain, for
such period of time as my Executrix may determine, any assets, including the
capital stock of any closely held corporation, which at any time shall come
into the possession of my Executrix, whether such assets are or are riot of the
character approved or authorized by law for investment by fiduciaries and
whether such assets do or do not represent an overconcentration in one
investment.
ITEM VI11 - No interest of any beneficiary under this Will or any Codicil
hereto, shall be subject to anticipation or to voluntary or involuntary
alienation.
ITEM IX - All estate, inheritance, succession and other death taxes
imposed or payable by reason of my death and interest and penalties
thereon with respect to all property comprising my gross estate for death tax
purposes, whether or not such property passes under this Will, shalt be paid
out of the residue of my estate, as if such taxes were expenses of
administration, without apportionment or right of reimbursement.
Initials
Page4of 6
I authorize my Executrix to pay all such taxes at such time or times cis
deemed advisable.
WITNESSES:
ITEM X- Wherever the context requires, singular and plural, and
masculine, feminine and neuter, shall be interchangeable.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~g
day of ~ G~-l ~~ 2007. 7
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~~~9~N~ oRDR, ~~Li..'~'1M~ OE IP@R99M~iYd..~~l~-$b~
NOTAf~IAL sly --~, tSEAL~
CABMEN ~1ALD0~!~:~~. ~lu~~- Public
Camp Hill ~orc ;A;~~.~~~~~~lar~~ Coun4y
M~ ~omr~i~:~io~; ~:~~~;~u .:~-~~uary 19, 2010
~~+~.~ !?
DONALD R. BRANDY
1 ' residing at /cr/ y o -~ c ~~ v~:~~p,.~.
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residing at ~~~"`~ ~ (/~- ~
Initials ~~
Page 5 of 6
/~ p ~~Y ~'
WE DONALD R. BRANDY ~ ,.J l ~ ~ /U D ~ and
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~~(~ 1 G 1~l ~'1~-a° ~- ~ '' ~'~ ,the TESTATOR and WITNESSES whose
names are signed to the attached or foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testator
signed and executed the instrument as his Last Will and Testament and that
he had signed willingly for willingly directed another to sign for him, and
that he executed it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and hearing of
the Testator, signed the Will as witness and to the best of his or her
knowledge the Testator was at that time eighteen ~18~ years of age nor older,
of sound mind, and under no constraint or undue influence.
~ n
DONALD R. BRANDY, Testator
WITNESSES:
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Subscribed, sworn to, and acknowledged before me by DONALD R.
BRANDY, the Testator, and subscribed and sworn to before me by
~/} N~ ~ S ~t N ~ ~'~tG~2 and ~ ~ ~-~~-n c 2 /~,~ ,witnesses, this
day of 2007.
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CARME~f ~r ~.;nf~ary P~bNc
Camp l~i;~ ~. _~~,~;~ Cau~~+
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~SEAL~ F.. _ .... _.. .~ .~..
G~Y~2,uU ~a.QaO ~
Notary Public
Page 6 of 6