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Home My WebLink About08-11-104 1 J REV-1500 ~`(°'-'°' PA Department of Revenue pennsyWania Bureau of Individual Taxes e@"'m'~ROr"~'-a PO 80X.280601 INH Harrisburg, PA 17128-0601 F 1505610143 OFFICIAL USE ONLY County Code Vear File Number 121 Iy a g~9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 186 24 8713 04 21 2010 Decedent's Last Name Suffix GONTZ SR. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix GONTZ SDOUSe's Social Security Number Date of Birth 12 02 1930 Decedent's First Name MI RALPH R Spouse's First Name MI MARY C THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Retum ^ 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future IMereat Compranise (date of death after 2-1282) ^ 8. (Ad~aUeCopy of will) to ^ 7, (Anade[;opy i~ine$ )a Living Trust ^ 9. Litigation Proceeds Received ^ 10. b6otvre~enl2-31-7 a~ndt{d~5~fdeath 3, Remainder Retum (date of death pdorto 12-13-82) ^ 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes ^ t t. 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 JERRY A WEIGLE ESQUIRE 717 532 7388 First line of address 126 EAST KING STREET Second Tine of address City or Post Office State ZIP Code SHIPPENSBURG PA REGISTEf~F WILLS U~ONLY •-r,, ~ .l , , .;.,~ n ~ C _ - ~ - _ , - _. --cfj -,t ~ ~ .. J ~.._i7 ~ t n ~ ~ t ~ -~. _ - ~W7EtFILED N t.-..: ~ ~~ ;r Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including aecompanying schedules and statements, and ro 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. ADDRESS C. Gontz Side 1 1505610143 1505610143 J S ~ J REV-1500 EX Decedent's Name: GOilltt`Z, Ralph R. Sr. Decedent's Social Security Number 186 24 8713 RECAPITULATION 1. Real Estate (Schedule A)........... 2. Stocks and Bonds (Schedule B). 1505610243 ........................................ 1. ........................................ 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 I~oq-Probate Property (Schedule G) LJ Separate Billing Requested............ 7, 8. Total Gross Assets (total Lines 1-7) ..................................................................... g, 7,054.50 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ..................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ..................... 10. 11. Total Deductions (total Lines 9 8 10) .............................................. ..................... 19. 7 , 054.50 12. Net Value of Estate (Line 8 minus line 11) ..................................... ..................... 12. - 7 , 0 5 4 . 5 0 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) .......................... ..................... 13. 14. Net Value SubJaet to Tax (Line 12 minus Line 13) .......................... ..................... 14. _ 7 r 054 .50 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0 0 0 (a)(1.2) X .00 . . . 16. Amount of Line 14 taxable 0 00 16 0 OO at lineal rate X .045 • . . 17. Amount of Line 14 taxable 0 0 0 17 O 0 0 at sibling rate X .12 . . . 18. Amount of Line 14 taxable 0 O 0 18 0 0 0 at collateral rate X .15 . . . 19. Tax Due ............................................................................................ ...................... 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 1505610243 Side 2 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 DECEDENT'S NAME Gontz, Ralph R. Sr. STREET ADDRESS 7 Roxbury Road CITY Shippensburg STATE PA ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + g) (2) 0.00 3. Interest (3) q, If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (q) 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. (5) ~,~0 Make Check Pa able 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 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 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 i , 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 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)]. 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. ~ REV X1161 EXt (10-06) coMr~tF~~ANin SCHEDULE H FUNERAL EXPENSES & 1DMINISTRATIVE COSTS ESTATE OF FILE NUMBER Gontz, Ralph R. Sr. 21 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT q. FUNERAL EXPENSES: See continuation schedule(s) attached B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 6,969.50 Street Address City State Zio Year(sl Commission paid 2. Attorney's Fees Weigle 8~ Associates, P.C. 75.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 10.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 7,054.50 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Gontz, Ralph R. Sr. 21 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Fogelsanger-Bricker Funeral Home H-A Other Administrative Costs 2 Register of Wills, Cumberland County -filing Insolvent PA Inheritance Tax Return H-B7 Copyright (c) 2002 form software only The Lackner Group, Inc. 6,969.50 6,969.50 10.00 10.00 Form PA-1500 Schedule H (Rev. 6-98) REV~1513 EX+ (11-08) SCHEDULE J °O""hF°~~'~~drY""'^ BENEFICIARIES ESTATE OF I FILE NUMBER Gontz. Raluh R. Sr. 21 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distrbutions, and transfers under Sec. 9116 a 1.2 Not relevant as estate is insolve t. Total Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1bOD Schedule J (Rev. 11-08) I »O o^ I W r ~ (mNN~ Y W ~~ 0 p l~i~ad N ~ ~~ ~~~ v'~n ~ o~ LL ~.~o ~- N 111 NOQ O O ~ L (tea O U b p N e-i H d 7 W V H M ctl 'r w ,y O N O' n rl V] .-r 7i N 3 N w0 ,~ P' +.1 w S-i H N d N ~ O '-I +i O .-r fA m U •rl wi aD N O N P4 ~ 0°4 ~ U a ~ v~ °; W ~-' .~ F" 3 ~ v~'i ~ a ~ ~ _ ~ O d o d ~ ~ X ~ s~, ~ o "' W ~ V ~ W ~ ~ d 4 W ~ 3 r- v^, -, ~~- TLl ~ .+.; _ ~. ,, 2.. _ j yw ` '`;