Loading...
HomeMy WebLinkAbout10-28-10 (3)' 1505610140 REV-1500 EX (°'-'°' PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 0 0 6 0 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h MMDDYYYY Date of Birth MMDDYYYY 1 8 3 1 2 3 6 2 8 0 5 1 4 2 0 ], 0 0 9 0 8 2 0 2 3 Decedent's Last Name Suffix Decedent's Firs t Name MI W E N G E R G E R A L D L (lf Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Ml Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Rei;urn (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) OX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 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 J O H N C Z E P P I I I 7 1 7 5 2 8 8 9 0 0 First line of address P O B O X 2 0 4 Second line of address City or Post Office Y O R K S P R I N G S Correspondent's a-mail address: State P A ZIP Code ~ 1 7 3 ? 2 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 other than the personal representative is based on all information of which preparer has any knowledge. SIGNA OF ERS N RE PONSIBLE FOR FILING RETURN DATE ADDRES 916 WILLIAMS GROVE ROAD MEC NICSBUR PA 17055 SIGNATU F PREPA RESENTATIVE DP~TE annRFC ---_ PO BOX 2~4 YORK SPRINGS PA :17372 PLEASE USE ORIGINAL FORM ONLY Side 1 15056101,40 1,50561,01,40 J 1,505610240 REV-1500 EX ~ecedent'sName: GERALD L WENGER Decedent's Social Security Number 1 8 3 1, 2 3 6 2 8 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 and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Persona! Property (Schedule E)....... 5. 1, 8 4 6 1 . 1 2 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. Totat Gross Assets (total Lines 1 through 7) ........................... 8. 1, 8 4 6 1, . 1 2 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• ~ 6 1 3 6 . 2 8 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 9 3 ^ . 5 4 11. Total Deductions (total Lines 9 and 10) ............................... 11. 1 7 0 6 6 . 8 2 12. Net Value of Estate (Line 8 minus Line 11) ............................ 12• 1 ~ 9 4 . 3 0 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. 1 ~ 9 4 3 D 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 D D D 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 3 9 4 3 D 16. 17. Amount of Line 14 taxable D D D 17 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 D ^ at collateral rate X .15 18. 19. TAX DUE ..................... ....................... ... ..... .. 19. 20. FILL 1N THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 150561024U Side 2 D. 0 0 6 2. 7 4 D. D 0 D. 0 0 6 2. 7 4 1505610240 REV-1500 EX .Page 3 Decedent's Complete Address: DECEDENT'S NAME GERALD L. WENGER _ STREET ADDRESS ~^ 916 WILLIAMS GROVE ROAD CITY MECHANICSBURG STATE ____ PA ZIP 17055 Tax Payments and Credits: ~ ~ 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. l=ilt in oval 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. File Number 21 10 0607 Total Credits (A + B) (2) (3) (4) (5) Make check payable to: REGISTER OF W1LLS, AGENT 62.74 0.00 0.00 62.74 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 : ...................................................................... ^ CXQ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X c. retain a reversionary interest; or ................................................................................................ ^ 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? ........................ ................... ............................................ ^ ^X 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ......... ^ 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 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 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 o1` 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 fhe 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)]. Asibling 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 COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER GERALD L. WENGER 21 10 0607 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 ~ 5 212.41 Acct. #5070076206 2. Brethern in Christ Foundation 9,601.28 3. Westfield Insurance Refund 8.00 4. Cash on Person at time of death 105.90 5. Television 400.00 6. 2004 Saturn 3,000.00 7. Ameriprise Financial 133.53 TOTAL (Also enter on line 5, Recapitulation) ($ 18,461.12 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER GERALD L. WENGER 21 10 0607 ITEM NUMBER A. 1. 2. FUNERAL EXPENSES: Conklin Funeral Home Lunch after funeral Decedent's debts must be reported on Schedule I. DESCRIPTION AMOUNT 10,716.25 240.53 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: John C. Zepp, III 1,500.00 3, Family Exemption: (If decedent's address is not the same as claimants, attach explanation.) 3,500.00 Claimant Stephen L. Wenger Street Address 916 Willaism Grove Road City Mechanisburg State PA ZIP 17055 Relationship of Claimant to Decedent 4• Probate Fees: Cumberland County Register of Wills 120.50 5 Accountant Fees: 6. Tax Return PreparerFees: 7. Cumberland County Register of Wills, Inventory 15.00 8. Cumberland County Register of Wills, Inheritance Tax Return 24.00 9. Cumberland County Register of Wills, Family Agreement 20.00 TOTAL (Also enter on Line 9, Recapitulation) I $ 16,136.28 If more space is needed, use additional sheets of paper of the same size. REV-1512 E,~(+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE i DEBTS OF DECEDENT, MORTGAGE LIABiLiTIES, & LIENS ESTATE OF FILE NUMBER GERALD L. WENGER 21 10 0607 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Long Term Care Pharmacy 23.71 2. Donald Shank (Care Provider Prior to Death) 600.00 3. I Verizon Wireless 4. I Verizon Wireless 5 . ~ Holy Spirit Hospital TOTAL (Also enter on Line 10, Recapitulation) I 9s If more space is needed, insert additional sheets of the same size. 48.33 30.31 228.19 930.54 REV-1513 EX+ (01-1 D) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: (~rF.R A T .n T, WRNCTRR ~ t t o n~n~ 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).J 1, Henry E. Wenger Lineal Q.20 987 Knepper Drive Mechanicsburg, PA 17055 2. Charles E. Wenger Lineal 0.20 44 Foxanna Drive Carlisle, PA 17013 3. Stephen L. Wenger Lineal 0.20 916 Williams Grove Road Mechanicsburg, PA 17055 4. Rebecca Arai Shenk Lineal 0.20 101 Pear Lane Shippensburg, PA 17257 5. Deena Brown Lineal 0.66 50 Impala Drive Dillsburg, PA 17019 6. Krista Dollman Lineal 0.66 112 S. George St. Mechanicsburg, PA 17055 7. Carla Apple Lineal 0.66 897 Emily Drive Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. 70TAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ Ir more space Is neeaea, use aaaltlonal sheets of paper of the same size. ~. LAST ~~JILL A~1D TEST~~.T~'1ET1T OF GERALD L. ~~~JET3GER 1', GL~'R1~.LD L. WE~IGER, of the To~~r,nship of T~~~onroe, County of Cumberland .and. State of Pennsylvania, beinf~ of sound and dispos i n~ mind, memory and understand ita~;, do make, publish and declare this x-Zy Last Will_ and Testament, hereby revoking and making void any and all prior ti^Jillg by rr~e at any time heretofore made . 1. Z direct the payment of all xrly dust debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. Z dive, devise and bequeath. all the rest, residue and remainder of my estate, real, ,personal and mixed, whatsoever and wheresoever the saxae zi~ay be situate, to my dear wife, AT~Ti~TA I~~?AE ti~JEr1GF~;., absolutely and unconditionally. ~• In the event that my wife, AP1TdA T~TA.E WENGER, should. predecease me, or should she die within thirty (30} days from th.e date of xny death, then in either of such ©vents, I give, devise and bequeath m.y entire estate, of t~ahatsoever nature and wheresoever the same -1-- may be situate, to my five (5) children, to irit, ]:3ET~1RY E. ti~JENGER, CT~.P~LES E. ti~iENGER, STEPHEN L. ti°IENGER, JEP]-~HEY A. t~JET~dGER and TZ.EBECCA AIJT~t SHENI~, share ar~d share alike, per stirpes . LASTLY, I nominate, constitute a.nd appoint my ti,rife, Ar~1T~lA T~~~.E ti^JEl`1GER, ExecLttrix of this xr~y Last ti^lill and Testament, and in the event that my said trife should predecease xne, or should she be unable or un~~rillin~; to serve .in such capac~Lty for any mason, then i,n such event, Z nominate, constitutE; and appoint my son, TiENRY E. b~IET~TCrL'R, and rriy son, ST_EPEHT~1 L. ti^IET~IGE~R, Co- Executors of this my Last Mill and Z'estatnent, in k,~er place and stead, and in all instances, T direct that my said personal representatives b© excused from posting bond or other security for tale faithful performance of their duties in arty jurisdiction. ZT~1 ti~~TITT~7ESS ti^1IiEI~EOr, T have hereunto set my hared and seal. this __...__!.._ day of T~'Ia y , 1~.. D . , 19 9 7 • / - / I~t .~.~.. ~ (~LAr~ ) Gerald L. ~^Ten~;er _Z~ Silted, sealed, published anc~ declared by the above nam©d, G'~~.AT~D T~. ti~dT~I~?G1J ~, as and for his T,ast l~lill ~;~nd Testament, a.n the presence of us, ti,Tllo have subscribed our nar.~.es hereto as wittlesses, at the request of said testator, in his presence and i.n the presence of each other, - 3- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, G1i~P~AL~ L, ?~°TI;1`jCrLP- , the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for ttie purposes therein contained. Sworn and affirmed to and acknowledged before me by, CT.I±;R:!~LD L, 1.~~T~I`7G~R the testat ox' , this ~/~`"`~' _ day of T'~Za~T A. D. 1997 . ..R.~'~ ,. Gerald L. Ten ; C~ r~~ -. . N tary Public COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ) ~y Eekk~.l~u~ery f'1~~ • 'Mona, S ~ C~~ ~ 191 P ~,~ ~r~. We, the undersigned, J. ROBL'RrL' ST~~UFI~ER and S~1S_AT~l ~~.. I'~IcCO~'_' the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testator C~?~'T~~~.LI~ L. ~~T~?'7G~~R sign and exe- cute the instrument as tiis~~Ci~ Last Will and Testament; that the . said testator G~R~~LD L, ti~dEl~rG~~'R executed it as his~~X free and voluntary act for the purposes therein expressed; that each of us, in the hearing acid sight of tl~.e testat Or , signed the Wi11 as witnesses; and~that to the best of our knowledge, the testatoX' was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and ~b.~c^ribed to before me is ~ /" day of vt ~' ' ~ .~ -.~..... A~! _ MYC~in~on ~~- Mb~c a ro~v q~n .° __-,_