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HomeMy WebLinkAbout12-27-101505610143 REV-1500 Ex `°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 10 ~ ~~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 184 12 3210 10 05 2010 10 10 1918 Decedent's Last Name Suffix Decedent's First Name MI NAFTZINGER CHARLES W (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 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required 6 Decedent Died Testate (Attach Copy of Will) ~ 7• (AttacheCoMaionta~~~st)a Living Trust py ff 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Povert Creditl(date of death between 12-31 ~J1 and -1-95) 11, Election to tax under Sec. 9113(A) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number RICHARD W S TEWART (717) 7 ~, 4 5 4 0; C7 <:: ~ REGISTER OF ~E OPY ~7 t"- °~ ~,.,%? ~3 First line of address ;..~ ~~ `'"~ ~~~~ `-~ 301 rZi~iRKET ST ~~~ -+~ ~•~' ~ Second line of address --© ---~ ~;°;~ ~.~:~ PO BOX 10 9 ~~ ~~" ~~ DATE FILED City or Post Office State ZIP Code LEMOYNE PA Correspondent's a-mail address: RWS@JDSW.COM 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 PE LE FOR FILING RETURN DATE ~---~- David J Naftzinger ~~(2' ~ ~~I (,~ ADDRE 274 Javcox Road. Avon Lake. OH 44012 SIGNATURE OF PREP RE OTHER THAN REPRESENTATIVE DATE /~/~- RICHARD W. STEWART jt- '°~ 3 ~i0 ADDRESS 301 Market St., Lemoyne, PA Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX DecedenYsName: NAFTZINGER, Charles W Decedent's Social Security Number 184 12 3210 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 & Notes Receivable (Schedule D) ........................................................ 4. 11,317.76 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous moo; Probate Property uested te Billin Re r S 7 ............ g q epa a (Schedule G) U . g. ........................................ Total Gross Assets (total Lines 1-7) ............................. g. 11 , 317.7 6 11,469.49 9. Funeral Expenses 8~ Administrative Costs (Schedule H) ....................................... 9. 2 7 , 7 2 7 . 8 8 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10. 39,197.37 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. -27,879.61 12. Net Value of Estate (Line 8 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. -27,879.61 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 0 . 0 0 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 . at collateral rate X .15 . 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 0.00 0.00 0.00 0.00 Side 2 1505610243 1505610243 REV-1500 EX Page 3 rlor-orlont'c C_mm~l~atEa OrlcirP_~~_ File Number 21-10 DECEDENT'S NAME NAFTZINGER, Charles W STREET ADDRESS 223 Haldeman Avenue CITY New Cumberland STATE PA ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box 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. (5) 0,0~ Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: a. retain the use or income of the property transferred :............................................................................... ^ ^x 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? ............................................................ ^ ^x 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?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ^ ^x 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 January 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)]. 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. Rev-1608 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER NAFTZINGER, Charles W ___ 21-10 Include the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly-owned with the right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (10-06) SCHEDULE H COMM(,n ~q11~ (;Fq~ RL~ANIA FUNERAL EXPENSES & NHR, `ICE~CECE~~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER NAFTZINGER, Charles W 21-10 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached 11,395.99 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 73.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 11,469.49 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER NAFTZINGER, Charles W 21-10 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Funeral Expenses 11,395.99 H-A 11,395.99 Other Administrative Costs 2 Cumberland County Register of Wills Office -Filing fees for Inheritance Tax Return (15.00), 73.50 Inventory (15.00) ,Petition for Small Estate (15.00) and Cumberland County JCP Fees (28.50) H-B7 73.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAFTZINGER, Charles W 21-10 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 Bank of America 1,279.49 2 Capital One Services, Inc. - c/o Weltman, Weinberg & Reis Co. LPA 3,212.44 3 HFC 8,497.33 4 Sears Card 3,359.30 5 Sears MasterCard 3,964.16 6 US Bank Card Member Services 6.278.74 7 US Bank Card Member Services -Card Payment 130.00 8 West Shore EMS~ALS 1.006.42 TOTAL (Also enter on Line 10, Recapitulation) I 27,727.88 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1 (Rev. 12-08) 4 - c-~ a--=-.,,~ ~---~ LAST y`~ILL ~~ T.~STAI'a~NT of CHARLES Z'tIZS©Td ~~AFTZIiVGk:R I , CHARDS 4'~ IZ~SON. 11AFTZ~'dGER , r e s i d ing at - ~vE'r+v ~v.yB~'~c~~v0 223 Haldeman Avenue in the City of ~, County CVM BE,QL A~/d of and State of Pennsylvania, being of sound and disposing mind and memory, do hereby declare this to be my Last Y~ill and Testament, hereby revoking any and all vrills and testaaents, or ~~rritings in the nature thereof, by ne at any time heretofore made, thus dis- posing of all my estate: IT~a`,~g I: I give, devise and bequeath all my - estate, wheresoever and whatsoever, both real and per- sonal, to which I may be entitled or which I may have power to dispose of at my death, unto my vrife, Eliza- beth Ann Naftzinger, absolutely, if she shall be living at my death. - IT~i II: In the event that my wife, Eliza- beth Ann Naftzinger does not survive me, then I give, devise and bequeath all of my estate, both real and personal, to my children in equal shares; but in the event that any of them shall have died in my lifetime leaving issue at my death,~sueh issue shall stand in their place and take the share such deceased child would have taken if such child had survived me. -1- i,:7 ~~1 '''.3 IT~~2 III: In the event that my vrife, Elizabeth Ann Naftzinger, shall predecease rue, I appoint riy father- i n-lati°;r, John B. Bruns, of 1829 Bridge Street, Neva Cumber- land, Pennsylvania, as guardian of the persons of any of my children who shall be minors. ITEM IV: I do hereby nominate, constitute and appoint John B. Bruns of PJev~r Cumberland, Pennsylvania, as Executor of this ny Last 'dill and Testament. L~ tiITi~TE'SS ~`T~-T..B?~EOF, I, Charles ~'~tilson Naftzinger, have hereunto set my ha_ad and seal to this my Last ~~dill and Testament, consisting of two (2) typewritten pages, this / ,~ day of ~.~ , 1950 . ~~ ~~ /~~~~`"'f SEAL ) 3 ~. Signed, sealed, published and declared by the said Charles y"~ilson Naftzinger to be his Last ~"rill and Testament in our presence, v~tho, at his request and in his presence and in the presence of each other, vie believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. ~,~~.~c~~.~-~ //~~~~e~'r e s i d ing a t ,~c'! ~ ~~-~w~.-~, G~ G `~ ~~ G~~.~s ,!f pesiding at l~kS~ -2- ~A~ ~~ c=* ~`~ ~~_ k ~. s ~' ~ r=" ~ ~ $,~ I i ,~~, ~_, :; 3 ,~ _„ '~ S y - tl ~--~