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Home My WebLink About09-15-10~ REV-1500 Ex(°'-'°' ~ 1505610143 PA De artment of Revenue ~ OFFICIAL USE ONLY P Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 2 1 10 /~ Q Harrisburg, PA 17128-0601 RESIDENT DECEDENT V tJ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202 10 7744 07 13 2010 03 14 1918 Decedent's Last Name PAUL Suffix Decedent's First Name JOHN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® t. Original Return ^ 4. Limited Estate ® g Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ t1dat e ,fdeath 10' e P 3rt9 g s b tween 2 1 and ^ 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) MI J MI CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GREGORY M KERWIN 717 362 3215 First line of address 4245 ROUTE 209 Second line of address City or Post Office ELIZABETHVILLE State ZIP Code PA 17023 REGISTER OFC~WILLS USE ~LY C1 ° - x_:, f ~ ~i ~~~~ rnv <. " ,; a~r m T~ .,~~ ~ ~ L~~-~~ ~ 7 rJ -t't -'-} r- ~ 3 - w ~~. a `~~ ;~ «_~ c:.-3 ,:, t J t _7 <7 t- :"7 G •~ Correspondent'se-mail address: gmkerwin@hotmail.com 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. 209, Elizabethville, PA 17023 Side 1 1505610143 1505610143 J 5 ross Driv ,Mechanicsburg, PA 17050 IGN OF PR ARE OT ER TH PRESENTATIVE DATE Gregory M Kerwin CJ.,g..~~ ~~ REV-1500 EX 1505610243 ~ecedenes Name: PAUL , JOHN J 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. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ......... .... 7. 8. Total Gross Assets (total Lines 1-7) ................................................................... ... g. 9. Funeral Expenses & Administrative Costs (Schedule H) ..................................... .... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. 11. Total Deductions (total Lines 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 .00 15. 16. Amount of Line 14 taxable 5 5 0 2 8 3 3 , at lineal rate X .045 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. Side 2 1505610243 Decedent's Social Security Number 202 10 7744 65,995.39 65,995.39 9,051.50 1,915.56 10,967.06 55,028.33 55,028.33 2,476.27 2,476.27 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 10 Paul, John J STREET ADDRESS 1225 Gross Drive CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 123.81 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> 2,476.27 Total Credits (A + B) (2) 123.81 (3) 0.00 (4) (5) 2,352.46 ''S5[[)) Make Check Payable to: REGISTER OF WILLS, AGENT. r.~."1_urr, k~~.~ ..1';'s ~ =x.;7 ° j_' •~' ' "~ 7 ? ~'.; ~M~..,~ti~ - _ J >: ~. j` ~r +•-„ 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 :.................................... ^ ^x c. retain a reversionary interest; or .................................................................................................................. ^ ^x 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? ....................................................................................................................... ^ 0 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? ...................................................................................................................... ^ IF THE ANSWER TO ANY OF THE ABOVE 4UESTIONS 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 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 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) (n)]. 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 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)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 Paul, John J 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 Checking account #1150911 at Mid Penn Bank, 349 Union Street, Millersburg, PA 17061 8,884.50 2 Savings Account #2040534 at Mid Penn Bank, Millesburg, PA 17061 46,964.40 3 ~ Certificate of Deposit #302074266 (Burial Reserve) at Mid Penn Bank, Millersburg, PA 4 I Teamsters Pension Check for June 9, 926.49 220.00 TOTAL (Also enter on Line 5, Recapitulation) ~ 65,995.39 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H ~ F ~ Uy N~FJ ~~ A~ Lp Ems) CAPE ~ I V / S- / EIS ~&~ /'1LArw1\1~711V~\ I IYG VW 1 ~7 FILE NUMBER ESTATE OF Paul, John J 21 - 10 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 'i Hoover-Boyer Funeral Home, Elizabethville, PA, funeral I 7,880.50 B. 1 2. 3. 4. 5. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip ~', Year(s) Commission paid i ' Attorney's Fees Kerwin & Kerwin -- Gregory M Kerwin 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 ' ~, Probate Fees Register of Wills ', Accountant's Fees 6. I Tax Return Preparer's Fees 7. I Other Administrative Costs 1 j Notary fee on Oath of Subscribing Witness 850.00 186.00 5.00 TOTAL (Also enter on line 9, Recapitulation) 9,051.50 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H ~~,~,„Funeral E~er~ses 8~ /"YLaA 1 wl l VWR ~~ FILE NUMBER ESTATE OF Paul, John J 21 - 10 2 Register of Wills, filing Inheritance Tax Return and Inventory 30.00 3 ', Reserved for closing costs 100.00 I Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMO ERITANTCEO AX RETURNANIA LIABILITIES, & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF Paul, John J 21 - 10 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Pharmica, account payable for medication 41.00 2 East Pennsboro ambulance, account payable 50.00 3 ~ Golden Living Center, account payable ~ 366.26 4 ~ Hospice of Central PA ~ 1,458.30 TOTAL (Also enter on Line 10, Recapitulation) ~ 1,915.56 REV-1615 E%+ (11-08) ~, SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Paul, John J 21 - 10 RELATIONSHIP TO SHARE OF ESTATE I AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trusteeis) ~ I~ TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers - - i under Sec. 9116 (a) (1.2)] 1 John Paul, Jr. ~I Son Entire Estate 1225 Gross Drive Mechanicsburg, PA 17050 I ~, Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover I 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 SHEET 0.00 KERWIN &KERWIN ATTORNEYS AT LAW 4245 STATE ROUTE 209 GOVERNORS' ROW ELIZABETHVILLE, PA 17023 27 NORTH FRONT STREET (717) 362-3215 HARRISBURG, PA 17101 (717)896-9089 (717)238-4765 FAX (717) 362-4459 FAX (717) 238-8455 Please Reply To: 0 ELIZABETHVILLE OFFICE ~ HARRISBURG OFFICE September 14, 2010 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: The Estate of John J. Paul Date of Death -July 13, 2010 SS#: 202-10-7744 Dear Sir or Madam: rv 4 ':?~7 C O .Z, t- r ~ cn _~, ~-~ ~ ~ ~ c_ ~ :~ ~:~ n ~0-z-- Z _ r 7C ~ ~ a ^- O Please find enclosed herewith the Certification of Notice Under Pa. O.C. Rule 5.6(a) along with the Inheritance Tax Return and Inventory with respect to the above-captioned estate for filing in your office. I have included a check payable to Register of Wills, Agent in the amount of $2,352.46 for the tax that is due. I have also enclosed a second check in the amount of 30.00 for the filing fee. Would you kindly time stamp the enclosed file copies and return them to me in the enclosed, stamped, self-addressed envelope? Thank you for your help. Very truly yours, ~~~~~ GREGORY M. KERWIN PATRICK E. KERWIN (1913-1987) GREGORY M. KERWIN- GMKerwin@Hotmail.com TERRENCE J. KERWIN - TJK@Kerwinlawfirm.com JOSEPH D. KERWIN - JDK@Kerwiolawfirm.com HOLLY McCLURE KERWIN - HMK@I{erwinlawfirm.com GMK:bmk Enclosures t- .~