HomeMy WebLinkAbout12-10-10J 1505610101
REV-1500 °`t01-1°'
PA Department of Revenue Pennsylvania OFFICIAL USE ~NLI~
wrunwr or wwxw l.+Otln
Bureau of Individual Taxes ty Code Year File Number
PO BOX28o6o1 INHERITANCE TAX RETURN - - '--,
HaMsbum PA 17128-0601 RESIDENT DECEDENT Z' ~ ~ Gf ~ ' (> [~ 7 /
ENTER DECEDENT INFORMATION BELOW i ---
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY '
165-16-2846 08/13/2010 07/03/1917 ~!
Decedent's Last Name Suffix - Decedent's First Name ~' pal
DeHart !Charles I,
Ii Applicable) Enter Surviving Spouse's Information Below ~ ----
Spouse's Last Name Suffix Spouse's First Name MI
I
_ _
Spouse's Social Security Number--------------- '-------- '------------------------+---- - --,
------- - - - THIS RETURN MUST BE FILED IN DUPLICATE WItH ~FiE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Retum O 2. Supplemental Retum O 3. Remaindej' R turn (date of death
prior to 12+13- ~)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal E9tat T}ax Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number f Safe Deposit Boxes
(Attach Copy'of WNI) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election toltaxurhder Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sdh. a1
GvKFiESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION 8HC
Name _ - __-.-__.--__ _ Daytime Telephc
Ronald E. Johnson, Esq _ (717) 243-01
REGISTER
First line of address
78 West Pomfret Strete
Second line of address
City or Post Office
Carlisle
State ZIP Code D
PA !17013
DIRECTED T0:
USE
t'r'1 C""~
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n~ f"`f1
O ~~
~~'~,' ~,
_ ~ s'r`t
~~
Corrosponderrt's e-mail address: re'ohnson a.nt=t
Under penattles of perjury, I dedOre that I have examined this rotum, inducting accompanying schedules and statements, and to the bea of knowledge and belief,
it h true, correct and complete. CYedarotbn of preparer other then the personal rePresentatlve is based on all Infannation of which p aro h s any knowledge,
TU~~ O SI FOR FILING ~ RN ~ A I AtE
- ~~
PA 17013
q!/o 78 West Pomfr~~treet, Carlisle, PA 17013 V
Side 1
L,~, 1505610101
15056101I,0]~
III ~
i
15D5610105
REV 1500 EX
Decedent's'
oec~d~,rs Name: Charles E. DeHart ! 165-16-~
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 Personal Property (Schedule E)....... 5.
6. Jointly Owned Property (Schedule F O Se Grate Billin Re nested ....... 6. !~
P 9 q ~ ;
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.
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9.
10. Debts of Decedent, t4lortgage Llabilfties, and Liens (Schedule l) .............. .10.
11. Total Deductions (total Lines 9 and 10) ................................. 11.
12. NatValue_of Estate_(Line B. minus Line 11) .............................. 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which °
an election to tax has not been made (Schedule J) ........................ 13.
14. Net Value Subjset to Tax (Line 12 minus Line 13) ........................ 14. i
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 ""`°~ - - ""-"°°'°- ---
v....,,w
at lineal rate X .0 4~ 12,648.79 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.! .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1505610105
Side 2
1505610,0
II
~i
Number
31,537.68
31,537.68
10,456.37
10,456.37
21,081.31
8,432.52
12,648.79
569.20
569.20
O
REV 1500 EX Page 3
Decedent's Complete Address:
Charles E. DeHart
134 Homers Road
Fila Number
PA
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
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.
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.
Total Credits (A + B) (2)
1
17013
569.20
(3)
(4)
(5) 569.20
Make check payable to: REGISTER OF WILLS, AGENT.
P 1~. Did dec~de~R. eHE FOLLO1KtNG. QUESTIONS BY PLACING AN "X" IN .THE APPRIQ RUATE BLOCKS
transfer and. No
Ye
a. retain the use or income of.tt-e~property:trarisferred :................... a
b. retain the right to des)gnate who shall use the properly Vansfened or Its. income : ............................................
c. retain a reversionary interest; or .......................................................................................................................... ^ 0
d. receive the promise for life of either payments, benefits or care? . x
2. If death occurred after Dec. 12, 1982,. did decedent transfer property within one year of death
without receiving adequate consideration? .................... ' O
........................................ri............................................., j^ x
4. Did decedent own an ind dual rettrement~account, annuityaor other non-probate propertyowhich eath? ^ ^
contains a benefcary designaflonl .......................................... ~ ^
..............................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE! IT $ 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 fpr t e~use of the surviving spouse is
3 percent p2 RS. §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 s~unriving 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 requirQm ntjs 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 Uansfers from a deceased child 21 years of age or younger at death to or for h~ 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)( .~)]. A 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.
LAST WILL AND TESTAMENT
OF
CHARLES DeHART
I, CHARLES DeHART, ofMiddlesex Township, Cumberland County, P
of sound and disposing mind,. memory and understanding, .do hereby make, publi h
as and for my Last Will and Testament, hereby revoking all other wills and codici~s
by me.
FIRST: I direct that all my just debts and funeral expenses, i~cl ding my grave
marker, shall be paid from the assets of my estate as soon as practicable after my~ d cease.
SECOND: I give, devise and bequeath 40% of the residue of ffiy state, of every
nature and wherever situate to the Tree of Life Church to be administered by Pastor ave Herr as he
deems appropriate to help the poor of the church.
'~
T~tn~ I give, devise'and bequeath 60% of the residue of may skate, of every
nature and wherever situate, to my three daughters, equally, namely, JUDY'I . MOTTER,
SHIRLEY L. BOGGS and EVELYN E. FIELDS
,~ ,provided that should any to ~y daughters
predecease me, their shall be distributed tb the'ir' issue, per stirpes, living at the tide ofmy death.
FOURTH: I direct that all taxes that may be assessed in copse
of whatever nature and by whatever jurisdiction imposed, shall be paid from my
part of the expense of the administration ofmy estate.
FIFTH: I nominate, constitute and appoint my
MOTTER and SHIRLEY L. BOGGS, or the survivor of them, Co-Ex
Will and Testament.
vania, being
declare this
tofore made
ofmy death,
ry estate as a
~r , JUDY M.
o this my Last
SIXTH: I direct my Executrix and her successors shall not be!,
bond for the faithful performance of their duties in this or any other jurisdiction.
to give
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,, m ,Last Will and
Testament consisting of two (2) typewritten pages, each identi-fled by my signature, 's
day of ~y'LC1Zl~~°~ , 2009.
(~. . ~~'~"~ '! SEAL
Chazles DeHart ( )
Signed, sealed, published and declazed by the above-named Testator, Chalrl sl DeHart, as
and:for his .L~ Will and Testament, in the presence of us;-v~ho, at his-request, yin his sight and
presence, and in the sight and presence of each other, have hereunto subscrib~'d ~hr names as
.. witnesses. .
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND -~- )
I, Charles DeHart, Testator, whose name is signed to the attached or ford
having been duly qualified according to law, do hereby acknowledge that I signed
instrument as my Last Will and Testament; that I signed it willingly; and that I sib
and voluntary act for the purposes therein expressed.
Sworn or ~ to.and aekx~owledged .before me by Charles DeHart,l
c~ , day of ~~~. ;-~... ~-~-- , 2009.
CO~pNyyEALrtH OF PENNSYLVANIA
NOTARIAL SEAL
SHELLY SEXTON, Notary Public
Carlisle Boro, Cumberland l ~u 2011
MY Commission Expires. Agri
3 instrument,
executed the
it as my free
Testator, this
Charles DeHart, Testato
/ l ~ ~//
i ~~•~~ ~~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, RONALD E: TOHNSON and ~,/~ayy~ ~, ~~~,~~,~ ',
whose names are signed to the attached or foregoing instrument, being duly quali~e
law, do depose and say that we were present and saw Testator sign and execute the ilns
Last Will and Testament; that Charles DeHart, signed willingly and that he execi}te
and voluntary act for the purpose therein expressed; that each of us in the hearing'I a~
Testator signed the Will as witnesses; and that to the. best of our knowledge the Testa
time 18 or more years of age, of sound mind and under no constraint or undue in~luE
Sworn or affirmed to and subscribed to before me by RONALD E
an ~ ` witnesses, this ~ _~_'
--.~ ,,~ ~ r' , 2009. _ _ ~
E.
kb.e witnesses
.~ccordingto
riiment as his
i tit as his free
d~ sight of the
or was at that
JOHNSON
day of
SHELLY SEXTON, Notary Public
Carlisle Boro, Cumberland County
~ Commission Expires April 26, 2011
SCHEDULE E
CASK BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF FII',E IrT[JMBER
Charles E. DeHart '~ 1!-10-0871
Include the proceeds of litigation and the date the proceeds were received by the estate
Ali ro nY 'ointl -owned with ht of Snrvivorahi must be disclosed on Schedule F
ITEM DESCRIPTION V ',AT DATE
NUMBER MEATH
1 Cash ' $900.00
2 Checking account no: 161239-11 -Members 1st FCU I~
(see letter attached) $7,891.16
3 Savings account no: 161239-00 -Members 1st FCU
(see letter attached) II 22,746.52
TOTAL (atso on line 5, Rxapitulation) $31' 537.68
. St
MEMBERS 1't
FEDERAL CREDIT l7NION
REGULAR SAVINGS ACCOUNT:
Account Number/ Suffix 161239-00
Date Account Established 08/17/1996
Principal Balance at Date of Death $22,744 29 ''
Accrued Interest to Date of Death $2 23
Total Principal and Accrued interest $22,746.52
Name of Joint Owner None
CHECKING ACCOUNT•
Account. Number/Suffix ., 161239-11
Date Account Established 03/09/2010
Principal Balance at Date of Death $7,890.90
Accrued Interest to Date of Death $.26
Total Principal and Accrued Interest $7,891.16
Name of Joint Owner None
MEMBERS 1ST FEDERAL
C/ ~
Leigh- a Stallings
Lending Insurance Support
September 3, 2010
Estate of: Charles E. Dehart
Date of Death: 08/13/2010
Social Security Number: 165-16-2846
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 '
- _
_ i
1st.org
SCHEDULE H
FUNERAL EXPENSES, ADMIIVISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
1/a 1 F11 ~ OF
Chalres E. DeHart
Debts of decedent most be remrr.a .,., c_~._a-._ .
11 rm DESCRIPTION
NUMBER
A• Funeral Ezpenses:
1 Hofiinan-Roth Funeral Home
2
B• Administrative Costs:
1 Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address: -
City: State: Zip:
Year(s) commissions paid:
2 Attorney fees to Andrews & Johnson
3 Family Exemption
Claimant
Street:
City: State & Zip
Relationship of Claimant to Decedent: _
4 Probate Fees to Register of Wills
S Accountant Fees to Patricia Rosendale, CPA
6 Tax Return Preparer's Fees
7 ACH Deluxe Check
8 Cumberland-Goodwill EMS
9 Register of Wills - PA Inheritance Tax Return filing fee
l0 Reserve for Closing
11
12
13
14
15
16
17
18
19
TOTAL (also online 9, Rxapitulation)
110-0871
I I AMOUNT
8,378.17
$ ,350.00
~ 49.50
$13.95
$49.75
$15.00
500.00
$10, $6.37
SCHEDULE J
BENEFICIARIES
ESTATE OF
Chazles E. DeHazt
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP
NUMBER
rAx~E ns~txffivrmNS tea. Do Not List Trustee(s)
I r •P0°~V ~, ~d mmrm. radar sw. 9116(.x1.2>]
1 Judy M. Molter
33 Stoney Run Road, #3, Dillsburg, PA 17019 daughter
2 Shirley L. Boggs
241 South West Street, Cazlisle, PA 17013 daughter
3 Evelyn E. Fields
12300 Sandy Mountain Road, Orrstown, PA 17244 daughter
II NUN-TAXABLE DSTRIDUIIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEWG MADE
B. Charitable .cd Gavanmmtd B.quem:
1 Tree of Life Church, 50 K Street, Cazlisle, PA 17013
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (atso enter online 13, Recanitulationl
I~I~,E NUMBER
21-10-0871
iJINT OR SHARE
', 0~' ESTATE
li 20%
20%
~I
20%
~I
40%
$0