HomeMy WebLinkAbout02-28-11 (2)1505610101
OFFICIAL USE ONLY
""~ REV-1500 ~"°'-'°'
PA Department of Revenue Pennsylvania
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Bureau of Individual Taxes
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INHERITANCE TAX RETURN
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RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date
_ _ of Death MMDDYYYY Date of 81rth MMDDYYYY
178-10-6260 03/18/2008 ', 09/11/1919
Decedent's Last Name Suffix Decedent s First Name MI
-_ __.
~
Anderson A
Mary
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix Souse's First Name
__. , F
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
O 1. Original Return Ctp 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 Sefe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
(~ 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 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number r
_ _„
Stephanie Kleinfelter CO ~' ~~'
REGISTER /5~~~t~1SE OM"R7! c
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r-=urn n$ i., . -
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First line of address
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635 N. 12th Street _ ~ -
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Second line of address ._ ..... _. -
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Suite 400
State ZIP Code DATE FILED
City or Post Office _
Lemoyne PA 17043
Correspondent's a-mall address:
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.
SIG TUBE 06.PERSON RESPONSIBLE FOR FILING RETURN DATE ~
Adams Road, Breingsvilie, PA 18031
TORE OF PREPAR,ER THiitf2 TH f2EPRESENTATIVE DATE
635 N."12th Street, Suite A00, Lemoyne, PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 J
J 1505610105
REV-1500 EX Decedent's Social Security Number
178-10-6260
Decedent's Name:
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. MoAgages and Notes Receivable (Schedule D) .......................... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5 58,844.49 ,
s. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
p rtY , _ ... _.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Pro e
(Schedule G) O Separate Billing Requested. , ...... 7.
~ _--. .. _.._ _ ._..,T- „_~..._._. -
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ''
9. Funeral Expenses and Administrative Costs (Schedule H) ................ . .. 9. ' 600.00
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) . ............. 10. '
11. Total Deductions (total Lines 9 and 10) ................................. 11. ,
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. ,
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............. ........ 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 58,244.49 .
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
16. Amount of Line 14 taxable 58,244.49
at lineal rate X .0 45
17. Amount of Line 14 taxable
at sibling rate X .12
.. __. _
18. Amount of Line 14 taxable
15.'
1s. 2,621.00 '',
17. ',
at collateral rate X .15 18.
19, TAX DUE ......................................................... 19. _- _..
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610105 1505610105
REV-1500 EX Page 3
DPr_Pdent's Comulete Address:
File Number
'~ l M t2 f7Cn /~~
DECEDENT'S NAME
Mary A. Anderson
STREET ADDRESS
7 Nicholas Drive
CITY
Carlisle STATEPA zIP17015
Tax Payments and Credits:
1. lax 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.
(1) 2,621.00
Total Credits (A+ B) (2)
(3)
(4)
(5) 2,621.00
Make check payable to: REGISTER OF WILLS, AGENT.
• n ~~ x ={ ~ ~~ h
a ,x v b _~ s ~.... . .. -..
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 :......................................... ... ^ Q
c. retain a reversionary interest; or ....................................................................................................................... ... ^
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 "intrust 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? ..................................................................................................................... ... 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 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 fax 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 race 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.
REV-i5o8 EX+ (u-io)
~ Pennsylvania SCI~IEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDEM DECEDENT
ESTATE OF:
PILE NUMBER:
Mary A. Anderson a J p g d (p ~~
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property 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-1511 EX+ (10-09)
~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAx RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Mary A. Anderson o~ ~ b g ~~
Decedent's debts must be reported on Schedule I.
A.
1.
B.
1.
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State Z1P
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State
Relationship of Claimant to Decedent __
4• Probate Fees:
5. Accountant Fees:
6, Tax Return Preparer Fees:
7.
ZIP
600.00
TOTAL (Also enter on Line 9, Recapitulation) I ~ 600.00
IF more space is needed, use additional sheets of paper of the same size,
REV-1513 EX+ (O1-10)
~ pennsylvania SCHEDULE J
DEPARTMENT OE REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary A. Anderson o~ ( O ~ bCp / "'~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Suzanne K. Hickes Daughter 19414.83
7 Nicholas Drive, Carlisle, PA 17105
2. James L. Anderson Son
275 Adams Road
Breingsville, PA 18031
3. T. Michael Anderson Son
1798 Los Cosas Road
Boca Raton, FL 33486
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.
19414.83
19414.83
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV•i50D COVER SHEET I ~
If more space is needed, use additional sheets of paper of the same size.
178-10-6064 LAW OFFICES OF PETER G. ANGELOS - S
BKLY39825 SETTLEMENT AND DISTRIBUTION SHEET
39.09°k WD
Check No.: 52499
JAMES L. ANDERSON ,Personal RepreserMatNe of The Estate of MARY
ANDERSON, Surviving Spouse of ROBERT L. ANDERSON
SFTTI FMFNT~
Wallace & Gale BS
TOTAL:
ATTORNEY'S FEE: (33.33% of Settlement)
MEDICAL 81LLS:
TOTAL:
CASE EXPENSES:
TOTAL:
TOTAL DEDUCTIONS:
$ 11.674.88
BALANCE TO: JAMES L. ANDERSON . Penonai Representative of The Estate of MARY ANDERSON $ 23.349.78
Surviving Sgousa of ROBERT L. A DERSON
AND NOW, this / S:l day of ~e/;~up-~ , ,SOH , i / We do hereby declare that this Settlement and
Distribution Sheet has been read and is understood and approved and that the deductions for expenses and other items shown hereon
are -ai correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged.
WITNESS JA L. ANDERSON, Personal Representative of Tha Estate of MARY ANDERSON,
Su ing Spouse of ROBERT L. ANDERSON
WITNESS
WITNESS
WITNESS
$ 11,674.88
$ 0.00
$ ` 0.00 $ 0.00
v. Wallace 8 Gale BS
$ 35,024.64
$ 35.024.64 $ 35.024.64
S
$
0.00
S 0.00 $ 0.00
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01f01f1996 00:00 6103917442 ANDERSON INV INC ! PAGE 02
IN THE ORPHAN'S COURT
(OR)
BEFORE THE REGISTER OF WILLS
FOR
ANNE ARUNDEL COUNTY, MARYLAND
IN ?HE ESTATE
*
OF
ROBERT L. ANDERSON '~
DECEASED
*
ESTATE N0.40973
i ~F 7Y +F
FOURTH AND FINAL ADMINISTRATION ACCOUNT OF
JAMES L. ANDERSON, PERSONAL REPRESENTATIVE
OF THE ESTATE OF ROBERT L. ANDERSON, DECEASED
THIS ACCOUNTANT CHARGES HIMSELF WITH THE
AMOUNT STATED ON THE SUPPLEMENTAL INVENTORY
FILED HERE'wITH:
AND PROPOSES TO DISTRIBUTE THOSE FUNDS
TO THE ESTATE OF MARY A. ANDERSON,
SPOUSE OF THE DECEDENT:
ONE PERCENT IIVHERTTANCE TAX PAYABLE TO
REGISTER OP WILLS ($363.84)
COUNSEL FEES PAID TO WHARTON LEVIN
EHRMANTRAUT & KLBIN, P.A. PER THE
ATTACHED PETITION: ($525.00)
BALANCE TO BE DISTRIBUTED TO THE
ESTATfi OF MARY A. ANDERSON, SPOUSE OF
DECEASED, ESTATE NO: 2008-0067,5
PA NO: 2108-0615
BEFORE, THE REGISTER OF WILLS,
CUMBERLAND COUNTY, PENNSYLVANIA
$36,383.57
NET TO SPOUSE: 5 494.73
0101/1996 00:00 6103917442 ANDERSON INV INC ! PAGE 03
178-10-8064
BKLY39825
80,81 % E
Chedk No.: 52498
LAW OFFICES OF PETER G. ANGELOS
SETTLEMENT AND DISTRIBUTION SHEET
S
JAMES L •ANDERSON ,Personal RepresertYatlve of The Estate of ROBERT L. v. Wallace 8 Gale BS
ANDER~N
SETTLEMENT:
Wallace & Odle BS
S 54.575.36
S
s
s
TOTAL:
S 54.575.36 S 54.575.36
ATTORNEY'S FEE: (33.33% of Settlement)
S 16,191.79
MEDICAL BILLS:
S D.00
S
TOTAL: S 0.00 S 0.00
CASE EXPENSES:
S 0.00
S
S
TOTAL• S 0.00 S 0.00
TOTAL DEDUCTIONS: S 16.191.79
BALANCE TO: JAMES L ANDERSON .Personal Rakaassntativs of Tier Ealam of ROB L. ANDERSON $ 36.363.57
AND NOW, this ~ Sr day of Z3~2L. z-l. ' t, - I / We do hereby declare that this Settlemenrt and
Distribution Sheet has been read and is understood.and ap roved and that the deductions for expenses and other items shown hereon
are lrue nd correct and receipt of a copy of this Settlement and Distribution Sheet is acknowledged.
WITNESS J L ANDERSON, Personal Reprossmstive of The F.atats of ROBERT L ANDERSON
wlTNess
WITNESS
WITNESS
WITNESS
' ~ 6101/1996 00:00 6103917442 ANDERSON INV INC ! PAGE 04
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