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HomeMy WebLinkAbout12-07-10i` ~,.~- ', 1505610101 REV-1500 Ex col -lo' PA Department of Revenue enns lvania OFFICIAL USE ONLY P Y Bureau of Individual Taxes PO BOX 28o6oi ~`~~~,-,';~r~~~~:,-:~~~~ County Code Year File Number INHERITANCE TAX RETURN ~ r A ' RESIDENT DECEDENT / Harrisbur , P 7128-0601 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 419-52-8791 05/11/2008 01/27/1941 Decedent's Last Name Suffix Decedent's First Name MI Gandy Harry C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Gandy Sara Jane Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 161-34-4168 REGISTER OF WILLS FILL IN APPROPRIATE OVALS 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 John H. Broujos (717) 243-4574 First line of address 4 North Hanover Street Second line of address City or Post Office Carlisle Correspondent's a-mail address: State ZIP Code PA 17013 REGISTER O~-VSlILLS USE ONS~ C.. _ ~ ~ 1 --r- ("~ ._ ~~ ~, i.._ ~ r...T'l 1 I-=' iai ~ J ~. ` ~ L _i ~ ` -~ ..._._ ...1 ...~ DAZ.E,r-ftED -~~-- ~ti .-- . t. F _ _ s "' r-_' ,. '':~ '"% ~,. i .,fi 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 mplete. claration of prepay T other than the personal representative is based on all information of which preparer has any knowledge. S G URE O~ P ON SPONSIBLE FO LIbtG 'TURN DATE A DRESS ~ ~ ~.~ 55 Cavalry Road ~" Carlisle, PA 17013 SIGNATURE OF P EPA OT N REPRESENTATIVE DATE . ~. ~~ I 1u ADDRESS 4 North Hanove Street Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY 1505610101 Side 1 1505610101 ~'~' ~~ J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: Harry C. Gandy 419-52-8791 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 83,000.00 2. Stocks and Bonds (Schedule B) ..................................... 2. .. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) .... . .................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E}..... .. 5. 0.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 1,098.13 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1 through 7) . . ......................... .. 8. 84,098.13 9. Funeral Expenses and Administrative Costs (Schedule H) . . ............ ..... 9. 7,151.08 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... ..... 10. 67,940.67 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 75,091.75 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. 9,006.38 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...... . ............ ..... 14. 9,006.38 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. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 __ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17, 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE .................................................... ..... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 1505610105 150561,0105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Harry C. Gandy 21 09 0107 STREET ADDRESS 55 Cavalry Road North Middleton Township CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19} (1j 0.00 2. Credits/Payments -- A. Prior Payments B. Discount Total Credits (A + B } (2) 0.00 3. Interest - -- (3} 0.00 --------------------- - I Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, tine 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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 .................................................................................................................... ...... ^ l~ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ _ ...... (^ 3. Did decedent own an "in trust for" orpayable-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 A5 PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed an 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 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)]. 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. ~FV-tsc~z. Ex+ col-~.~; pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: Harry C. Gandy 21 09 0107 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 property that is jointly-owned with right of survivorship must be disclosed on Schedule F. If more space is needed, use additional sheets of paper of the same size. REV-i5og EX+ (oi-io) i pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Harry C. Gandy 21 09 0107 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR ]DINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A . , 1987 Chevrolet CP VIN: 1G1FP21F4HN185326 100.00 100 100.00 2. A M & T Bank Joint Checking Account #: 9833000350 998.13 100 998.13 TOTAL (Also enter on Line 6, Recapitulation} I $ 1,098.13 If more space is needed, use additional sheets of paper of the same size. If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. ~ pennsylvania SCHEDULE H oEPARTMCNr of REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Harry C. Gandy 21 09 0107 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION _ _ AMOUNT A. FUNERAL EXPENSES: 1' Ronan Funeral Home 5,588.58 255 York Road, Carlis{e, PA 17013 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 0.00 Name(s) of Personal P.epresentative(s) Sara Jane Gandy Street Address 55 Cavalry Road city Carlisle state PA zIP 17013 Year(s) Commission Paid: 1,000.00 2. Attorney Fees: 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 262.50 5, Accountant Fees: 6, Tax Return Preparer Fees: ~~ Wolfe & Shearer Appraisal Service 300.00 33 South Pitt Street, Carlisle, PA 17013 TOTAL (Also enter on Line 9, Recapitulation) $ 7,151.08 If more space is needed, use additional sheets of paper of the same size. ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Harry C. Gandy 21 09 0107 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-1.51 EX+ 101-1.~) i pennsylvania SCHEDULE J DEPARTMEN70FREVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Harry C. Gandy 21 09 0107 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 la) (1.2).] 1. Sara Jane Gandy Spouse 100°!° 55 Cavalry Road, North Middleton Township, Carlisle, PA 17013 2. Weslia C. Gandy Daughter 0% Pine Ridge Estates, Mt. Holly Springs Borough, PA 17065 3. Christopher J. Gandy Son 0% 1003 Rockledge Drive, Carlisle Borough, PA 17013 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 SHEETJ$ 0.00 If mare space is needed, use additional sheets of paper of the same size.