HomeMy WebLinkAbout03-0986 EV-1500 EX ~6-00)
COMMONWEAl_IH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
FILE NUMBER
W
n,
0
0
X
I'--~I. Original Return
[~]4. Limited Estate
[~]6. Decedent Died Testate (Attach copy of Will)
~19. Litigation Proceeds Received
[~2. Supplemental Return
~--] 4a. Future Interest Compromise (date of death after 12-12-82)
E~7. Decedent Maintained a Living Trust (^ttach copyof Trust)
----] 10. Spousal Poverty Credit (date of death bekveen 12-31-91 and 1-1-95)
NAME
Jerry A. Weigle, Esquire
FIRM NAME (ifApplicab~elgle
· & Associates, ?.C.
TELEPHONE NUMBER
(717) 532-7388
COMPLETEMAILINGADDRESS
126 East King
Shippensburg,
14.
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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)
12. Net Value of Estate (Line 8 minus Line 11)
13.
1,677.96
5,986.80
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14) (4,308.84)
~]3. Remainder Return (date of death prior to 12-13-82)
i---1. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
r'-i 11. Election to tax under Sec. 9113(A) (A,ach Sch O)
Street
PA 17257
1,677.96
5,986.80
(4,308.84)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
x .12
x .15
(15)
(16)
(17)
(18)
(19) NONE - INSOLVENT
> > BE sURETOA~SWER ALL QUESTioNS ONREVERSE SIDE AND RECHECK MATH < <
Z
UJ
Z
O
u~
UJ
O
LU
_ _
R E S I D E N T D E C E D E N T c0u. co0,
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Gardner, James U. 187 -- 16 - 4357
~ DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-OD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE YVITH THE
UJ 06/17/2003 07/09/1920 REGISTER OF WILLS
III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Gardner, Cladys A.
Decedent's Complete Address:
STREET ADDRESS
232 Big Pond Road,j
CITY
STATE PA
Shippensbur~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
(4)
(5)
(5A)
(5B)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
JZIP 17257
NONE - INSOLVENT
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 premise 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.
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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
.~f~z~' ~.~' .~:~'~7~/..~-~: Gladys A. Gardner f f -- Z f//
ADDRESS
232 Big Pond Road, Shippensburg, PA 17257
SIGNATU PREPARER O ERTHAN PR E
Jerry A. Weigle tl--z~/
ADDRE,t~.~.// v \ ! t/v ilJ
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 3%
[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% [72 P.S. §9116 (a) (1.1)
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
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 paren
or a stepparent of the child is 0% [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%, 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 decedenrs siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as ar
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-I,~a EX * (?7)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER James U. Gardner
Include the proceeds of litigatJon and the date the proceeds were received by bhe estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Prudential Financial - liquidation of 59 shares Common Stock
received as demutualization shares
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
1,677.96
$ 1,677.96
REV'.I$11 EX+
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT Please Print or Type
ESTATE OF FILE NUMBER
James g. Gardner
ITEM
NUMBER DESCRIPTION AMOUNT
ko
Bo
C.
1.
2.
3.
4.
5.
6.
7.
8.
Funeral Expenses:
Fogelsanger-Bricker Funeral Home
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney Fees Weigle & Associates, P.C.
Family Exemption
Claimant
Address of Claimant at decedent's death
Street Address
Relationship
City
Probate Fees
Miscellaneous Expenses:
Register of Wills, Cumberland
Inheritance Tax Return
State __ Zip Code
County - filing Insolvent PA
5,626.80
350.00
10.00
TOTAL (Also enter on line 9, Recapitulation) $ 5,986.80
(If more space is needed, insert additional sheets of same size.)
RE',/-1513 EX * (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER James U. Gardner
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
H.
Not relevant as estate is insolvent.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART il! . 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)
ON REV 1500 COVER SHEET
REGISTER OF WILLS, CUMBERLAND COUNTY
STATUS RE, OR= UNDER RULE 6.12
.~ame of Decedent:
3ames U. Gardner
Date of Death: 06/17/2003
Will No. %1-o3- ~q~G
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No__ Insolvent PA Inheritance Tax Return was
filed and accepted as filed.
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
co Did, the personal,representative state an
-~-- ...... nt formally t:~o the ~ ..... ~=~ '
p-~_~o zh'-intereSt? Yes ~ No
appro~al's Of ~formal
Cerk~of abe O~phans'
Date: I-%g-o¥
Copies O.f..:receipts', releases, joinders and
°~- i'nfozmal accounts may be filed'with
~S'~gna ~ure k
Jerry A. Weigle, Esquire
Name (Please type or print)
WEIGLE .& ASSOCIATES, _ P. C.
12-6' East King Street
Address
Shippensburg, PA 17257
(717) 532-7388
Tel. No.
Capacity:
Personal Representative
(M~H:rmf/TLM3)
X
Counsel for personal
representative
BUREAU OF INDIVIDUAL TAXES
/NHERZTANCE TAX DTVZSXON
DEPT. 180601
HARRISBURG, PA 17118-060!
COMMONHEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT) ALLO#ANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-15¢i7 EX &FP [01-05)
JERRY A WEZGLE ESQ
WEIGLE & ASSOCIATES
116 E KING ST
SHIPPENSBURG
CUT ALONG THIS LINE
PA 17257
DATE 01-19-ZOOq
ESTATE OF GARDNER
DATE OF DEATH 06-17-Z005
FILE NUMBER 21 03-0986
COUNTY CUMBERLAND
ACN 101
I Amoun~ RecLined
RETAIN LO#ER PORTION FOR YOUR RECORDS
JAMES
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
U
DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GARDNER JAMES U FILE NO. 21 03-0986 ACN 101 DATE 01-19-200q
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) ($)
q. Mortgages/No,es Receivable (Schedule D) (q)
S. Cash/Bank Deposits~Misc. Personal Proper~y (Schedule E) (S)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Cos~s/Misc. Expanses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
11. To,al Deductions
12. Ne~Valua of Tax Re~urn
1~677.96 · 010
· O0
.0!0 NOTE: To insure proper
.OiO credi~ ~o your account,
.0!0 subei~ ~he upper portion
.OiO of ~his form wi~h your
~ax payment.
(a) 1,677.96
5,986.80
(11)
S.9R& .80
q,308.8q-
13.
lq.
NOTE:
ASSESSMENT OF TAX:
15. Amoun~ of Line lq e~ Spousal ra~e
16. Amoun~ of Line lq ~axabla a~ Lineal/Class A ra~e
17. Amoun~ of Line lq a~ Sibling ra~e
18. Amoun~ of Line lq ~axable a~ Collateral/Class B ra~e
19. Princi=el Tax Due
TAX CREDITS
PAYMENT RECEIPT
DATE NUMBER
Charitable/Governmental Bequests; Non-elec~ed 9115 Trusts (Schedule J) (15)
Ne~ Value of Es~a~e Sub~ac~ ~o Tax
Zf an assessment was issued previously, lines lq, 15 and/ar 16, 17,
reflect figures that /nclude the total of ALL returns assessed to date.
.00
q,308.8q-
18 and 19 w'ill
(15) .00 x O0 : .00
(16) .00 x ~Oq5= .00
(17) .00 x 1Z = .00
(18) .00 x 15 = .00
(19)= . O0
DISCOUNT (+1
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE O; TAX DUEil
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER DATE INDICATED) SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1., NO PAYMENT XS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR)) YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
RESERVATION:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration of any estate for
life or for years, the Common#aalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
iNTEREST:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF RILLS, AGENT
A refund of a tax credit, which ~as not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania [nheritance and Estate Tax" (REV-15LS). Applications are available at the Office
of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour
ans#aring service for forms ordering: 1-800-562-2050; services for taxpayers ~ith special hearing and ! or
speaking needs: 1-800-4~7-5020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as sho~n on this Notice oust object ~ithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17128-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in lariting to: PA Department of Revenue,
Bureau of Lndividual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (S) calendar months after the decedent's death, a five percent (52) discount of
the tax paid is allowed.
The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January [8, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (62) percent per annum calcuIatad at a daily rate of .000L64. Al1 taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are:
Interest Daily Interest Daily [ntarast Daily
Year Rate Factor Yea__r Rote Factor Yea__r Rate Factor
1982 ZOZ .000548 1987 91 .000247 1999 77. .000192
1983 16X .000458 1988-1991 111 .000501 2000 81 .O001L9
1984 111 .000301 1991 9Z .000147 ZOO 1 9X . OOO 247
1965 1SI .000356 1993-1994 72 .000192 2002 62 .000164
1986 IOZ .000274 1995-1998 92 .000247 2003 52 .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond tho date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest oust be calculated.