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HomeMy WebLinkAbout03-21-11 (2)J 1505610101 EX (oi-io) ~ REV-1500 ~ PA Department of Revenue OFFIC:IAL USE ONLY Pennsylvania Bureau of Individual Taxes ~~>~a* ~ * ~< < < ~E County Code Year File Number INHERITANCE TAX RETURN PO BOX 280601 Zj / ~ ~1 ~ ~ r~ / Harrisburg, PA i~iz8-o6o> RESIDENT DECEDENT I ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth PAMDDYYYY 202-36-6753 12/30/2009 12/25/1945 Decedent's Last Name Suffix Decedent's First Narcie MI Marcum Diana K (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 Q)d 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 U 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 TO: Name Daytime Telephone Number Heather D. Royer, Esq. First line of address 4431 N. Front St. Second line of address Third Floor City or Post Office Harrisburg State PA ZIP Code '17110 REGISTER OF WILLS USE ONLY C-7 T C ~ -- - y ~~ ~~ -- - - _a~ _.. - ;13 - '`, r- _~_ ~_~ DATE-FILED - ,- _, "D `-'- _~ '~ ~ i.. __ r` i O _~~ Correspondent's a-mail 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. /~ SIGNATURE F PE ON R~PO I LE F R FIL~G F/~ RN DATE (J,JI a i a ,~ / 1/ ADDRESS ~ ~ ' ' 301 Luther,Road, Harq, PA 17105 ADDRESS ~/ / / ' 4431 North Front St., Third Floor, Harrisburg, PA 17110 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: 202-36-6753 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. 2,119.02 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 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.. 2,119.02 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. ' 3,001.22 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10, 23,683.59 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ' 26,684.81 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 0.00 13. Charitable and Governmental Bequests/Sec 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. 0.00 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 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 O Side 2 1505610105 1:505610105 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Diana Kay Marcum . -- - STREETADDRESS 315 Walnut Lane CITY Carlisle STATE ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments 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) (3) (4) (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 :.................................................................................... ...... ^ Q 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? ................................................................ ...... ^ 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 "intrust 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 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 benE;ficiaries 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-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Diana Kay Marcum 2010-00099 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, insert additional sheets of the same size) REV-1511 EX+ (10-04) ~i`1 pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Diana Kay Marcum 2010-00099 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Auer Cremation Services of Pennsylvania, Inc. 1,792.69 2. Remembrance Cards and Photo Enlargement 184.91 s. Funeral Luncheon 492.96 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 Street Address City .__.....___ _...------ ---------- State _ Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: ~• Register of Wills -Short Certificates 8. The Sentinel -Advertising s. Cumberland Law Journal -Advertising ~ o Death Certificates i ~ . Mileage and messenger fees iz. Filing fee-PA Inheritance Tax Return and Inventory State ZIP ZIP 80.50 4.00 198.16 75.00 120.00 23.00 30.00 TOTAL (Also enter on Line 9, Recapitulation) I $ 3,001.22 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX± (12-G8) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Diana Kay Marcum 2010-00099 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 ~ RN V' ' ' A I 88 00 Helen Jones, (isitmg nge s) 2. Visiting Angels Referral Fee 27.00 3. Capital Mgt. Services, LP Re: JC Penney Credit Card 1,206.31 4. Northland Group, Inc., Citibank-Sears Credit Card 1,471.08 5. American Credit & Collections, LLC-Chase Credit Card 8,507.03 6. Asset Acceptance, LLC-Dress Barn Credit Card 371.48 7. Asset Acceptance, LLC-Avenue Credit Card 1,436.73 8. Atlantic Credit & Finance, Inc.-Household Bank Gold Mastercard 3,518.44 9. Kohl's Credit Card 770.92 10. Sarah A. Todd Memorial Home (incidentals) 62.50 11. Pinnacle Health #09111486 250.00 12. Holy Spirit Hospital 445.50 13. Carlisle HMA Physician Mgmt. #733481 25.00 14. Carlisle Regional Medical Center 229.33 15. Estate Information Services, LLC-Discover Card Credit Card 5,274.27 TOTAL (Also enter on Line 10, Recapitulation) $ 23,683.59 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. ~ Pennsylvania SCHEDULE ] DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Diana Kay Marcum 2010_-000_99 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• Aaron Michael Marcum, minor clo Debbie M. Thompson, 315 Walnut Lane Grandson 100 Carlisle, PA 17015 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 SHEET. $ If more space is needed, use additional sheets of paper of the same size. r MEMBERS i't FEDERALCREDCr UNION • 3~o3-~a a-~-s~ SAVINCzS ACCOUNT: Account NumbedSutfix 258618-00 Date Account Established 01!26/2005 Principal Balance at Date of Death $5.00 Accrued Interest to Date of Death $.00 Total Principal and Accrued Interest $5.00 Name of Joint Owner None M ERS 1sT FEDERA . CRE~DI~jNION -v--~ Danielle A. Kline Lending Insurance Support Specialist March 2, 2010 Estate of: DIANA MARCUM Date of Death: 12/30/2009 Social Security Number: 202-36-6753 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 7.83-2328 wwwmemberslst.org ~~ BIi,~~~ LISTENING IS JUST THE BEGINNING.SM March 12, 2010 Smigel, Anderson & Sacks, LLP 4431 North Front Street Hamsburg, Pennsylvania 17110 Dear Ms. Bradley: RE: Diana Kay Marcum, deceased December 30, 2009 !i A ~-I~' /d In response to your recent inquiry concerning the accounts maintair.~ed in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 2219-20948, open 12/29/1994, date of death. balance $2,114.02, in her name only. Non-interest bearing account. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly youurs, ~v~. ~} Karen D. Hillegas Credit Inquiry Processor . ~, . , ,.: 1.800.FULTON.4 fultonbank.com Fulton Bank, N.A. Member FDIC. Member of the Fulton Financial Family.