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HomeMy WebLinkAbout11-04-10 (2)1505607121 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number Po sox 2a~o1 Harrisburg, PA 17128-0601 2 1 1 0 0 1 1 8 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6 2 2 2 5 6 7 8 0 1 0 6 2 0 1 0 0 4 1 9 1 9 2 8 Decedent's Last Name Suffix Decedent's First Name MI I c k e s W i l l i a m F (If Applicable) Enter Surviving Spouse's Information Below 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 OVALS BELOW Q 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) 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 S t e p h e n J H o g g E s q u i r 7 1 7 2 4 5 2 6 9 8 F' N If A I' bl e irm ame ( pp rca ) First line of address 1 9 S H a n o v e r S t r e e t Second line of address S t e 1 0 1 City or Post Office C a r l i s l e State ZIP Code REGIS ~ OF WILLS U~ONLY C ~~ o _T; a i-r; , Z7 ~~~ ~~ Q ~:~~ . "~ ~'_ Z rn .F~ CI? ~ 1 ~=~ .~ ..;t_.f ~ ~-~ © ~ L.. F > ~E FILED iV . C.T'i . P A 1 7 0 1 3 Correspondent's a-mail address: ShOgg12@Centuryllnk.net Under penalties of perjury, I declare that I have examined this return, including acx:ompanying schedules and statements, and to the best of my knowledge and belief, it is Vue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 19 S. Hanover Street, Ste• 1D1 Carlisle PA 17013 S~(JATUi PRE OTHERN REPRESENTATIVE DATE f~\\ // ~/i~-/C/~// 1280 Mud Run Road York Springs PA 17372 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 ~'~ ~. _~ 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: W i 11 i a m F• I c k e s 1 6 2 2 2 5 6 7 8 RECAPITULATION 1. Real estate (Schedule A) ...................................... 1. .. 4 5 0 0 0. 0 D 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. r 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ..... .. 5. 1 1 7 9 6 6 . 4 4 ~, 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) ......................... .. 8. 1 6 2 9 6 6. 4 4 9. Funeral Ex enses 8 Administrative Costs Schedule H 9. 1 7 9 9 9. 9 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... .... ... 10. 1 4 7 4 4 . 1 9 11. Total Deductions (total Lines 9 & 10) ............. ....... .... ... 11. 3 2 7 4 4 . 1 5 12. Net Value of Estate (Line 8 minus Line 11) ........... ....... .... ... 12. 1 3 0 2 2 2 . 2 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for wh ich an election to tax has not been made (Schedule J) .... ....... .... ... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .... ....... .... ... 14. 1 3 D 2 2 2 . 2 9 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.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 1 3 0 2 2 2. 2 9 16. 5 8 6 0. 0 0 17. Amount of Line 14 taxable 0 D D 0 0 0 at sibling rate X .12 . 17, . 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 . 18. . 19. Tax Due .................................. ....... .... ...19. 5 8 6 0. 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 r• REV-1500 ~X Page 3 t~ecedent's Complete Address: File Number 21 10 0118 DECEDENTS NAME William F. Ickes STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 5,860.00 Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill 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. A. Enter the interest on the tax due. (3) 0.00 (4) 0.00 (5) 5, 860.00 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 5,860.00 Make Check Payable fo: 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 December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ..... ^ ^ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (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 zero (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 twenty-one 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 zero (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 four and one-half (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 twelve (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. F3EV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER William F. Ickes 21 10 0118 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real roe which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Single family home located 104 Mohawk Road, Newville, Cumberland County 45,000.00 Pennsylvania Settlement on July 1, 2010 to David F. Line and Brenda K. Line Recorded in the Cumberland County Recorder of Deeds on July 6, 2010 Instrument Number: 201018037 TOTAL (Also enter on line 1, Recapitulation) ~ $ 45.000.00 (If more space is needed, insert additional sheets of the same size) REV-9508 ~X + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER William F. Ickes 21 10 0118 Include the proceeds of litgation and the date the proceeds were received by the estate. All property jointly-owned with right of sunirvorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1. County Tax Refund 1,570.00 2. The Sentinel refund 41.59 3. Bob Baish Glass & Body Shop, Inc. 4. Failor-Wagner Post 421 Home Association, Inc. refund 5. Clerk of Court of Cumberland County 6. Orrstown Checking Account#108005631 7. Interest Deposit 2/10 8. The Dreyfus Fund 9. Monumental Life Insurance Company check#1401128372 10. Monumental Life Insurance Company check#1401128373 11. Monumental Life Insurance Company check#1401128374 12. Monumental Life Insurance Company check#1401128375 13. Monumental Life Insurance Company check#1401128376 14. Monumental Life Insurance Company check#1401128377 15. Monumental Life Insurance Company check#1401128378 16. Prospect Used Auto Parts of Gettysburg TOTAL (Also enter on line 5, Recapitulation) S ~ ., ~ oaa „,, (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent William F. Ickes 21 10 0118 Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, 8 Misc. Personal Property ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 17. Adams Electric Coop., Inc. 323.90 18. Adams Electric Coop. Inc. 98 39 19. 1997 Chevrolet Monte Carlo LS Coupe - VIN# 2G11NW12M2V9150325 1 330.00 Kelly Blue Book Value , SUBTOTAL SCHEDULE E 1,752.29 GRAND TOTAL SCHEDULE E S 117, 966.44 REV~1511 ~X + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER William F. Ickes 21 10 0118 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, Inc. 1,503.60 2. Auer Cremation Services of Pennsylvania, Inc. 1,495.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) David A. Ickes Street Address 1280 Mud Run Road C;~, York Springs State PA zip 17372 Year(s) Commission Paid: 8,148.32 2, Attorney Fees Stephen J. Hogg, Esquire 6,000.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4• Probate Fees 360.50 5 Acc~untanYs Fees 6. Tax Return Preparer's Fees 7. Advertising: Law Journal 75.00 The Sentinel 187.54 8. Accounting (Est.) 200.00 9. Tax Return and Inventory Filing Fee 30.00 TOTAL (Also enter on line 9, Recapitulation) I S ~ ~ (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER William F. Ickes ~ 21 10 0118 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Adams Electric 85.03 2. Allegany Optical 27.10 4. Galbraith's Accounting & Tax Service 185.00 5. Pa. Department bf Revenue 2.00 6. Cumberland County Tax Claim Bureau -Property Taxes 2,143.24 7. Cardiology Diagnostic LLC 140.00 8. Shelby Winter, Tax Collector g 80 9. Shelby Winter, Tax Collector 149.42 10. G.H. Harris Associates, Inc. 2009 School Per Capita tax 29.00 11. Barrett Appraisal- Services 350.00 12. Newville Cummunity Ambulance 837.50 13. Kinetic Imaging ` 290.00 14. Alexander Springs Emergency Physicians 1,027.00 15. Adams Electric 25.75 16. Adams Electric 75.59 TOTAL (Also enter on line 10, Recapitulation) I S 14 744 19 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent William F. Ickes 21 10 0118 Decedent's Name Page 2 File Number Schedule 1-Debts of Decedent, Mortgage Liabilities, 8 Liens ITEM NUMBER DESCRIPTION AMOUNT 17. Carlisle Regional Medical Center 1,100.00 18. Lung Asthma Sleep Associates 584.00 19. Moffitt Heart & Vascular Group 400.00 20. West Shore EMS 1,022.37 21. Deluxe Checks 19.20 22. Mutual Life Insurance Premium 102.80 23. Adams Electric Final Bill 7.88 24. David Ickes, Executor refund for out of pocket payments for funeral expenses, cremation 3,383.27 services, filing fees 25. David Ickes, Executor refund for payment of the Estate property taxes 2,143.24 26. Real Estate closing costs 605.00 SUBTOTAL SCHEDULE I 9,367.76 GRAND TOTAL SCHEDULE I E 14, 744.19 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. David A. Ickes 1280 Mud Run Road York Springs, PA 17372 2. Lisa A. Finkenbinder 196 Mountain View Road Mt. Holly Springs, PA 17065 3. Roger Ickes 2509 5th Avenue Pueblo, CO 81003 FILE NUMBER 21 10 011. RELATIONSHIP TO DECEDENT Do Not List Trustep~c- Lineal Lineal Lineal AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. II. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space Is needed, Insert additional sheets of the same size)