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HomeMy WebLinkAbout09-07-10.~ REV-1500 Ex (01-10> ~ 15 0 5 61014 3 OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2sosol INHERITANCE TAX RETURN 21 10 ~4~" ~~~ ~ ~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~' "~ </' '~~ ENTER DECEDENT {NFORMATION BELOW Social Security Number Date of Death Date of Birth 205 07 0258 06 16 2010 09 07 1916 Decedent's Last Name Suffix Decedent's First Name M1 KAPP SELMA E (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 ^ 4. Limited Estate ® g Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received ^ 3. Remainder Return jdate 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 5ch. O) THIS RETURN MUST BE FILED IN DUPLICATE: WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ qa. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GERALD J BRINSER 717 838 6348 First line of address 6 E MAIN STREET Second line of address PO BOX 323 City or Post Office State ZIP Code PALMYRA PA 17078 Correspondent's a-mail address: j e r ry @ b w z l a w. 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, Corr t and complete. Declaration of preparer oth r than the personal representative Is based on all information of which preparer has any knowledge. S NAT E O ERSON RESPONSLBLE FO G RET DATE Eu ene E. Ka r 9 PP ~"/~~ .~i_~ 561 wood Drive, Mechanicsburg, PA 17055 SIGNA OF PREPARER E AN REPRESENTATIVE DATE ~,L„~ Gerald J Brinser ~~~~,~~ 6 E. Main Street, Palmyra, PA 17078 Side 1 1505610143 REGISTER `OF~'~ILLS USE=ONLY -i '~ ~~ , :~ .. ,,, ' •' -.._1 . ,., - ;; .:- DATE FILED ~.., 150561U143 J ~~` E~o`s~~ ~ ~'' ~~~~ ` 1. Rem ~ (hil~loM~ A)....... ......... .. .., .. .......... 1. 2. ~ arnl Bonds (tea ~ ..........::..............•........... ,.................................... 2. 3. ~M~Id Coepa~atk~n, Partnet~tip or Sr,~r-PrQpri~crrip ~~wdub C ?• •• 3. 4. Nr~Dr~M!'!~ hk ~Mlcsiva~le (Sthde Q) ..... ........... ................ ........ ' 4. .. S. Cs t 8 Mk.n+rau; Parsor~i Pcap~tY (Stub E) .......... 5. ~~ ~"~ • 8. ~ ~ (duce h) ~ S-eparato e~tt~ l~at~u~ed~ed .:........... 6: ~ $ , ~ ~ 1 . ~ '~. 7. !rte 1Awss Tione~ne~ i liAtlsn~us N~rrNPa1s . atPer ~~ rd R 9 G T .......... .. p eque ( ~ahs~ub ) D r . a. Tout ~rt~s ~ ( LMea 1-~ ....................................................................... 8. ~ $ , ~' 8 ~3 . ~ 3 9. Funer~ E~xp~eu~es d pious Costs (~chedWe :..................................... 9. 85.17 10. DW~s of E~sdsro, t~ttxgr~e uobes, 8 lbns (,`: ~teduUt°y ............................ 10. ~.~~ , ~ 3 ~ „, 7 11 . T+a41 M~6t~lls (tom fl 810)........ ........................................................... -' 11. 1 ~. 1'~ ~ . 9 3 ~ tit • .i~Nrt ~ ~f ~ (~ 8 ~itrt~s t.be 11 }...... '~, . f ~ 7 ~, ~r ~ ~ ', 13. ~tst'~bwt t+itrtt E~v~ene~er;R~Mqus~W t1~! ? for which =an than b titx Ras not i~w- n ~k ~........... ......... ........................ , 14. t~t 161~ar !t- Tait {tom 12 mintta L;~e .1 Sj. ... ....., .. .,...,t,..... ~ . _ 1© ~ ? ' ~~ ~ ~ ~ _ ~~ TaAX t'l~Tt~N •NttlZ"f~NS ~ ~~~.M~ ~ ~ __ _ - _ _ ~, 18. ~ of Line 14 tare at t#rir tart rals, of ~ ; Vic. $1'16 ~ (aj(1.~ X .t'~I 1~. 1a. ~IrrtQtmt of W ~ 14~ 17. Atr~ount of tine 14 tote 1$. M of Liihs 14 at rlKe X .15 1~. 19. Tsx Qrs ..................... ........... .............. ................ ,.. 1P l , 8 9 ~ . ~ 6i' Zo. ~1~a. Mi'1'!~ o~ilt. ~`'~!' alk" 4~ 1A~1 ~rR't~~: N, ''I ~h ('r""~ LJ '~ J M d R u, j ~! w i ,, ;, F- • . ;,,. ,. REV-1500 EX Page 3 File Number 21 - 10 Decedent's Complete Address: NT' NAME Kapp, Selma E. STREET ADDRESS 222 Messiah Circle, Rm 416 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 84.82 Total Credits (A + B) (1} 1,696.46 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. (2> 84.82 (3) 0.00 (4) (5} 1, 611.6 4 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 :.................................................................................. _ x b. retain the right to designate who shall use the property transferred or its income :................................... x c. retain a reversionary interest; or .................................................................................................................. _.X- . __ 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 without receiving adequate consideration? ...................................................................................................................... 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 bene iciary designation? ........................................................................... ........................................... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE I'~~ 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)j. 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 0 percent [72 P.S. §9116 (a) (1.1) (ii)j. 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 re urn 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 they 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, e~:cept 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. §911E~ (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether y blood or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT __ FILE NUMBER ESTATE OF Kapp, Selma E. 21 - 10 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Verizon -Refund 13.52 2 Donegal Insurance -Refund 23.00 TOTAL (Also enter on Line 5, Recapitulation) ~ 36.52 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kapp, Selma E. FILE NUMBIER 21 - 10 If an asset was made joint within one year ~f the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Eugene E. Kapp 561 Dogwood Drive Son q Mechanicsburg, PA 17055 JOINTLY OWNED PROPERTY: ~, LETTER ITEM DATE DESCRIPTION OF PROPERTY _ i DATE OF DEATH ' ~% OF ~ DATE of DEATH ~ FOR JOINT NUMBER ; ! MADE Include name of financial institution and bank account number or ~ ~ DECD'S VALUE OF ASSET VALUE OF TENANT I JOINT similar identi In number. Attach deed for olntl held real estate 9 J fY Y- .; INTERESTi DECEDENTS INTEREST 1 A 07/26/2008 Fidelity Investments -Account No. X24635430, 82,867.73 50% i 41,433.87 held JOINT WROS with Son ~ 2 ! A 2008 PNC Bank -Account #5005957218 14,835.27 i 50°l0 7,417.64 SCHEDULE F JOINTLY-OWNED PROPERTY TOTAL (Also enter on line 6, Recapitulation) 48,851.51 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kapp, Selma E. SCI-EDIJL.F H FU(~EAARA~~L DAA~~~F~~~VSES & ~,~II~IIVG~~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: A. 1 Musselman Funeral Home B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) FILE NUMBER 21-10 AMOUNT 179.17 Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Brinser, Wagner & Zimmerman 645.00 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 ~ Register of Wills -Inheritance Tax Return Filing Fee 15.00 TOTAL (Also enter on line 9, Recapitulation) 854.17 Sched~e H ' Funeral E & COMMONWEALTH OF PENNSYLVANIA /~~ ~M ~~, INHERITANCE TAX RETURN Adrr~n~sU~ative ~~ (-VI lYn~ RESIDENT DECEDENT __ _ _ ._ -__ _ - - - ESTATE OF Kapp, Selma E. FILE NUMBER 21 - 10 2 Register of Wills -Inventory Filing Fee Note: The above expenses and those on Schedule I were paid out of the joint funds on Schedule F. 15.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN ~ RESIDENT DECEDENT FILE NUMBER ESTATE OF Kapp, Selma E. 21 - 10 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Messiah Village (7056.00 + 3193.80) 2 ~ Alert Pharmacy 3 Holy Spirit Hospital Note: The above expenses and those on Schedule H were paid out of the joint funds o Schedule F. AMOUNT 10,249.80 55.56 29.40 TOTAL (Also enter on Line 10, Recapitulation) 10,334.76 REV-1513 EX+ (11-08) I SCHEDULE) COMMONWEALTH OF PENNSYLVANIA ~ BENEFICIARfES INHERITANCE TAX RETURN i ~ RESIDENT DECEDENT ESTATE OF ~ FILE NUMEiER Kapp, Selma E. ~ 21 - 10 RELATIONSHIP TO I SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSONS} DECEDENT I (Words) ($$$) RECEIVING PROPERTY ~ Do Not List Trustee(s) ~ ___, I ( ~- TAXABLE DISTRIBUTIONS[include outright spousal ~ I~~ distributions, and transfers under Sec. 9116 (a) (12}] ~ ~ ~ 1 Eugene E. Kapp '~ Son I Entire Residue 37,699.10 561 Dogwood Drive ' j I ~ Mechanicsburg, PA 17055 ~ ~ I f I I i I ~ i i ~, Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. II NON-TAXABLE DISTRIBUTIONS: I I 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 SHEET~~ 0.00 ~~f~~ Last Will and Testament OF SELMA E. KAPP I, SELMA E. KAPP, of Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Wili and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my son, EUGENE E. KAPP, provided he survives me. While this bequest is absolute, it is my wish that any Memorandum I may leave addressed to my Personal Representative indicating my desire with respect to the disposition of any item of my tangible personal property shall be regarded. ARTICLE III REST, RESIDUE AND REMAINDER I give, devise and bequeath all the rest, residue and remainder of my :Estate, of whatsoever nature and wheresoever situate, unto my son, EUGENE E. KAPP, or his then-living issue, per stirpes, should he predecease me. ARTICLE IV DISTRIBUTION TO BENEFICIARIES UNDER THE AGE OF 25 /INCAPACITATED PERSONS Whenever my Personal Representative is directed to distribute property to or for the benefit of any beneficiary who is under (a) twenty-five years of age, or (b) a legal disability or otherwise suffers from an illness or mental or physical disability that would make distribution directly to such beneficiary inappropriate (as determined in my Personal Representative's sole discretion exercised in good faith), my Personal Representative may distribute such property to the person who has custody of such beneficiary, may apply such property for the benefit of such beneficiiary, may distribute such property to a custodian for such beneficiary, whether then serving or selected and appointed by my Personal Representative (including my Personal Representative), under any applicable Uniform Transfers to Minors Act - or Uniform Gifts to Minors Act, or may distribute such property directly to such beneficiary without liability on the part of my Personal Representative to see to the application of such property. This provision shall not in any way operate to suspend such beneficiary's absolute ownership of such property or to prf;vent the absolute vesting thereof in such beneficiary. 2 ARTICLE V POWERS OF PERSONAL REPRESENTATIVE My Personal Representatives} shall have the following powers in addition. to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. D, 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 or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. 3 G. To make such elections, decisions, concessions and settlements in c;onnection with all income, estate, inheritance, gift, generation skipping or other tax refunds and the payment of such taxes as my Personal Representative and/or Trustee shall deem aI>propriate, without obligation to adjust the distributive share of any person thereby affected. ARTICLE VI TAXES I direct that estate, inheritance, transfer and other taxes of similar nature payable by reason of my death, together with any interest or penalties thereon, and imposed with :respect to any property, whether or not disposed by this Will, shall be paid out of the residue of my Estate and shall be considered a part of the expense of the administration of my Estate. I further direct that my Personal Representative shall have the absolute power in his or its discretion to pay the same at once whether or not the law under which they are imposed permits the postponement of all or part to a later date ARTICLE VII PERSONAL REPRESENTATIVE I name, constitute and appoint my son, EUGENE E. KAPP, Executor of this my ]Last Will and Testament. If he fails to qualify or ceases to so act, I name, constitute and appoint my daughter-in-law, KAREN J. KAPP, Alternate Executrix to complete the administration of my Estate, and if she also fails to qualify or ceases to so act, I name, constitute and appoint my grandson, LIONEL E. KAPP, Alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed hereunder shall be required to post bond for the faithful administration of the duties required in any jurisdiction. 4 IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~'~ day of ~ , 2008. / S - SEAL ,~ ) SELMA E. KA.PP Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in th~,e presence of each other, have hereunto subscribed our names as witnesses. /sl ISM ;~ ~2u- ~ Witness d ~. ~~L Witness ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, SELMA E. KAPP, ~J~? ~~~ ~ ~ /~ f G~~...5 and ~I/C/ ~-~L ~ - i~SS/~ ,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. S ~ c~ ELMA . KAPP , Witness / ~~ ~ / - Witness Subscribed, sworn to and acknowledged before me by SELMA E. KAPP, Testatrix, and _ ~~ Y~ ~ ~~ ~- ~ YE~ S and /~ ~ lC ~-G~ ~- ~ ~'~- ~S / ~ ~/ ,witnesses, this ~ ~ day of ~~ , 2008. ;~ n s ~ ~.,~' ~~ Gum Not Public ~' :332903v2 6