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HomeMy WebLinkAbout02-22-111505610101 REV-1500 E" t01-1O' ul OFFICIAL USE ONLY PA Department of Revenue pennsylvarria Coun Code Year File Number Bureau of Individual Taxes OEP,PiMFXT ,aE,~„~E ~, PO BOX 28o6oi ~ INHERITANCE TAX RETURN Hamsbur PAi 128-0601 RESIDENT DECEDENT ~' U~~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 174-20-6986 11/22/2010 10/02/1928 Decedent's Last Name Suffix Decedent's First Name MI Brandt (If Applicable) Enter Surviving Spouse's Information Below Paul S' Spouse's Last Name Suffix Spouse's First Name MI Brandt 'Grace E Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 177-24-72ss. REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q1d 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate GID 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 Grace E. Brandt ' (717) 766-8165 First line of address 591 Locust Lane Second line of address State PA ZIP Code ..17055 ~+?f City or Post Office Mechanicsburg Correspondent's e-mail address: REGISTER OF WILLS US~~NLY ~ ~ 0 ~~~ ~~~ ~ ~~ 2~ 7t C7 {{--~~ ID 3 UII FILED .. r -~-~ ~' r' _ ~• ~.;~? °r•t ~ rn ~n C~ Under penalties of perjury. I dedare that I have examined this return, induding 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 URE OF PE SON FjESPONSIBLE FOR FILING RETURN DATE ,_" Ih ~~~ ~ L7 _,GaGr~.~¢ 02/22/11 ~i , ~Q- /r~'~S' SIGNATURE OF PREPARER OTHER THAN DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J REV-1500 EX Decedent's Name: PaUi S. Bfandt 1505610105 Decedent's Social Security Number 174-20-6986 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 0.00 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. 112,546.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 97,042.53 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 209,588.53 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 5,276.12 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............ .. 10. 0.00 11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 5,276.12 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 204,312.41 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. 204,312.41 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 at lineal rate X .0 45 204,312.41 16. 9,194.06 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18 19. TAX DUE ....................................................... .. 19. 9,194.06 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Paul S. Brandt STREET ADDRESS 591 Locust Lane CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0.00 B. Discount ~ , n5 26`3 483.88 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. (~ ) Total Credits (A + B) (2) (3) 9,194.06 483.88 0.00 8,710.18 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 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 :.......................................................................................... ^ 0 b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ X^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 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? ........................................................................................................................ 0 ^ 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 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. REV-i5og EX+ (oi-io) pennsylvania DEPARTMENT OFREVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Paul S. Brandt If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Grace Brandt 591 Locust lane Mechanicsburg, PA 17055 Wife B. C. JOINTLY OWNED PROPERTY: REM NUMBER LETTER FOR JOINT 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. I ~ I ~ ~ y Belco Savings Account # ©?, ~ 2 6 0 - S 1 149.00 50 74.50 2 A I1 1 I5y Belco Checking Account# p~~Z„G o - ~y 28,016.00 50 14,008.00 3 A i ~ t ~Q`i Belco Savers Club # 07 12 60 - S7 4,902.00 50 2,451.00 4 A ~ ! ~ ~~,~ CD # '3 S ~ p° (~ ~co~ 1,171.00 50 585.50 5 A ~ l I ~$g Delaware Investments High Yeild Opp Fund A #5046439171 43,149.00 50 21,574.50 6 A 111 ~~d8 Invest #5HT-104031 147,705.00 50 73,852.50 TOTAL (Also enter on Line 6, Recapitulation) I ~ 112,546.00 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) ~ pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Paul S. Brandt This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. IRA Delaware #5245309850 Transferee: Grace E. Brandt (wife) 41,929.60 100 41,929.60 Rollover IRA Delaware #4000025497 Transferee: Grace E. Brandt (wife) 11 212 93 100 11 212 93 2 , . , . Verizon Pension Benefit# ~'7~iy'-286Transferee: Grace E. Brandt (wife) 43,900.00 100 43,900.00 97,042.53 TOTAL (Also enter on Line 7, Recapitulation) ~ 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 Paul S. Brandt Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Irrevocable Burial Reserve 4,809.12 2 Additionslchanges to funeral 467.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Chraat ~r1~irPCc 4. 5. 6. 7. City State _ Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: State ZIP ZIP TOTAL (Also enter on Line 9, Recapitulation) I $ 5,276.12 If more space is needed, use additional sheets of paper of the same size.