HomeMy WebLinkAbout10-13-10 (2)1505610101
REV-1500 Ex to~_~o>
PA Department of Revenue pennsytvania OFFICIAL USE ONLY
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Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box 280601 21 10 0110
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
202-20-7017 01/1412010 11!01/1927
Decedent's Last Name Suffix Decedent's First Name MI
Gingerich Shirley A
(If Applicable) Enter Surviving Spouse's Information Befow
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OPALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Bradford Dorrance, Esq. (717) 255-8014 ~t._.
First line of address
210 Walnut St.
Second line of address
P.O. Box 11963
City or Post Office State ZIP Code
Harrisburg PA 17108
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Correspondent's a-mail address:
Under penalties of perjury, 1 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.
SIGNAT E OF P RSON RESPON BLE F R FILING RETURN DATE
1Y rojr ~a
ADDRESS
Sandra K. Seckinger, 1302 Strafford Rd., Camp Hitl, PA 17011
SIGNATU OF PRE RER HER THAN REPRESENTATIVE ` DATEi
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P
ADDR
Bradford Dorrance, 210 Walnut St., P.O. Box 11963, Harrisburg, PA 17108
PLEASE USE ORIGINAL FORM ONLY
Side 1
150561,0101 15056],0101,
1505610105
REV-1500 EX
Decedents Social Security Number
decedents Name: Gingerich, Shirley A. 202-20-7017
RECAPITULATION
1. Real Estate (Schedule A} .......... . .................................. 1.
2. Stocks and Bonds (Schedule S) ....................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D) ........................... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 192,660.12
6. Joint{y Owned Property (Schedule F} C1 Separate Billing Requested ....... 6.
7. Enter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested..... 7.
8. Total Gross Assets (total Lines 1 through 7} ..... . ....................... 8. 192,660.12
9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 17,617.58
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... . . ...... 10. 13,778.28
11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 31,395.86
12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 161,264.26
13. Charitable and Governmental BequestslSec 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. 161,264.26
TAX CALCULATION -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 .0! 15.
16. Amount of Line 14 taxable
at lineal rate x .0 45 129,011.41 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 32,252.85 1 s
19. TAX DUE ....................................................... .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056],0105 15056101,05
5,805.51
4,837.93
'! 0,643.44
O
J
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 10,643.44
2. Credits/Payments
A. Prior Payments _ _ 9,750.00
-__
- ----- ----
B. Discount
Total Credits (A + B } (2) ,75 .00
3. Interest +"
(3)
~. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in ova! on Page 2, tine 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5} 893.44
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 :......................................................................................... . ^
b. retain the right to designate who shall use the property transferred or its income : ........................................... . ^
c, retain a reversionary interest; or ......................................................................................................................... . ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate cansideration? ............................................................................................................. . ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^
4. Did decedent awn an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................ ^ 0
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 Jan. 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 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 stilt 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}]. ,~ 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-1508 EX+ (6-98)
~=~~ ~ SCHEDULE E
CASH
BANK DEPOSITS
& MISC
COMMONWEALTH OF PENNSYLVANIA ,
,
.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FfLE NUMBER
Gingerich, Shirley A. 21-10-0110
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Checking Account No. 5140023485
3,121.28
2. Members 1st Federal Credit Union Savings Account No. 24541-00 571.69
3. Members 1st Federal Credit Union Investment Savings Account No. 24541-05 2 751.40
4. Members 1st CD No. 24541-60 85,687.47
5. Members 1st CD No. 24541-61 8,307.12
6. Members 1st CD No. 24541-62 34,488.31
7. Members 1st CD No. 24541-63
55,130.85
8. Coins (sale price) 312.00
9. Two Burial Plots 2,080.00
10. Ring (sale price) 210.00
TOTAL (Also enter on line 5, Recapitulation) $ I 192,660.12
(If more space is needed, insert additional sheets of the same size)
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~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Gingerich, Shirley A. 21-10-0110
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Parthemore Funeral Home
6,824.27
B.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s) NOne
Street Address
2.
3.
City _ State
Year(s) Commission Paid:
Attorney Fees: Keefer Wood Allen & Rahal, LLP
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
4,
5,
6,
7.
s.
9.
City ___ State
Relationship of Claimant to Decedent
ZIP
Probate Fees;
Accountant Fees;
Tax Return Preparer Fees:
Keefer Wood Allen & Rahal Out-of-Pocket Expenses: advertising, telephone, postage
Funeral Reception
Harrisburg Cemetery - Footstone Moved/Engraved
ZIP
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
9,500.00
323.50
301.05
121.64
547.12
17,617.58
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pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Gingerich, Shirley A. 21-10-0110
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses,
If more space is needed, insert additional sheets of the same size,
REV-1513 EX+ {01-14)
~ Pennsylvania SCHEDULE J
DE4'ARIMENI OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Gingerich, Shirley A. 21-10-0110
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a} (1.2).]
1 • Erin Lynn Parthemore, 429 N. 2nd St., Wormleysburg, PA 17043 Granddaughter 70%
2. Sharon Parthemore, 429 N. 2nd St., Wormleysburg, PA 17043 Daughter 10%
3. Sandra K. Seckinger, 1302 Strafford Rd., Camp Hill, PA 17011 Niece 10%
4. Deborah L. Haley, 2315 Green St., Harrisburg, PA 17110 Niece 10%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $
If more space is needed, use additional sheets of paper of the same size.