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HomeMy WebLinkAbout03-23-11~50~610~4~ ~~~-~ ~~~ EX (01-10) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 ',~,r~ j ~~ ~'~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT -- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 176 32 6417 07 23 2010 Decedent's Last Name Suffix SINGER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth 05 12 1932 Decedent's First Name MI LLGYD G Spouse's First Name MI 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 ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 6 Decedent Died Testate (Attach Copy of Will) ~ ~• AttacheCo a~of Trust a Living Trust PY ) ~ 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 12-31=91 and 1-1-95) ~ 11, Election to tax under Sec. 9113(A) (Attach SCh. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES L) HUGHES ESQ 717 249 6333 ~-~, First line of address 354 ALEiNDEE. BERING R.O Second line of address City or Post Office State ZIP Code CARLISLE PA REGISTER OF WILtrS; FJSE ONLY ._ ..~ .+ -; - .. DATE FILED _ _ .- -~ ~~ ~ Correspondent's a-mail address: jhughes c~sal~mannhughes.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. Declar ion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG E OF PERSON RESP N IBLE FOR FILIN~ RETURN DATE _,..'~ -------- Janet LSinger - j AD S 1135 Gree in ewville PA 17241 SIGNATURE O REPAR 0 R REPRESENTATIVE DATE James D. Hughes Esq. ~ Z j ADDRE S 3 4 Alexan er S ring Road, Suite 1. Carlisle. PA Side 1 ~~~1505610143 1505610143 J ~5D561D243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Slinger,: Lloyd G 1 "7 ~ 32 641' RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. ~ , r.~ 5 ~ . ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. ~. 9 ~ . 50 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous -Probate Property ~ Se arate Billin Re uested h l S d G p g q ............ c ( e u e ) 7. 11.9 , 5 9 6. 4 5 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 1.2 9 , ~ ~ ~ , ~~ 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. ~ 1. , ~ ~ f~ , Q Q 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 ~ 10) ................................................................... 11. ~, r ~ tj ~ . a ~} 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 1. Q $ ~ ~ ~ ~ , ~;,~ 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. 1., Q $ r ,~ ~ ~ , ~ ~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or to n1 2rXu00erSec. 9116 1..~$, ~Q(} . ,~~ ()( ) 15. Q . C1t} 16. Amount of Line 14 taxable a ~'~ 16 ~} ~ a - at lineal rate X .045 . . 17. Amount of Line 14 taxable at sibling rate X .12 ~ - ~ ~ 17. Q • C1 Q 18. Amount of Line 14 taxable at collateral rate X .15 d - ~ ~ 18. Q - ~ ~ 19. Tax Due .................................................................................................................. 19. ©. ~ ~ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 15fl56~®243 Z5O5b~Q24~ J REV-1500 EX Page 3 Decedent's Complete Address: File Number 2110 DECEDENT'S NAME Singer, Lloyd G STREET ADDRESS 1135 Green Spring Rd. CITY Newville STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.0© 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. Make Check Payable to: REGISTER OF WILLS, AGENT. (1) 0.0£I (}.DO Q.Q~ Total Credits (A + B) (2) (3) (4) (5) 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 :.................................. ^ c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ a 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?....... ^ 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-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Sin er, Llo d G 21-10 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 174 shares of Prudential Financial Inc. 54.905 9,553.47 TOTAL (Also enter on Line 2, Recapitulation) 9,553.47 ~n civic aNa~.c ~~ ~icCUeu, auunional pages or tine same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) - .; COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT VV~~i~~~~w iwr CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Singer, Lloyd G 21-10 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ~~~ ~nvic aNat,c W ~iCCU CU, dualuonal pages or cne same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) .,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT V'~/i i~~~~~rw INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Singer, Lloyd G 21-10 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY NUMBER THE DATE OF TRANSFERSATTACFi A COPY OF TI HOE DEIED FOOREREAL ESTATDE. DATE OF DEATH VALUE OF ASSET °i° OF DECD'S INTEREST EXCLUSION IF ( APPLICABLE) TAXABLE VALUE 1 Midland National Life Insurance Company -Annuity 102,135.78 100.000% 102,135.78 Policy No. 8000051579 -Beneficiary is Janet Singer, wife 2 Prudential Annuities -Annuity Contract No. E0208244, 17,460.67 100.000% 17,460.67 Beneficiary is Janet L. Singer, wife TOTAL (Also enter on Line 7, Recapitulation) I 119,596.45 (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 G (Rev. 6-98) REV-1151 EX+ (10-06) .~ COMMNHERITANCE~ ~ RETURN ANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Singer, Lloyd G 21-10 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 10, 000.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zia Year(sl Commission raid 2. Attorney's Fees 7,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Janet L. Singer Street Address 1135 Green Spring Rd. City Newville State PA Zip 17241 Relationship of Claimant to Decedent Spouse 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 46.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 21,046.00 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 Singer, Lloyd G 21-10 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Fogelsanger-Bricker Funeral home -funeral services 10,000.00 H-A 10,000.00 Other Administrative Costs 2 Register of Wills -filing fee 3 Salzmann Hughes, P.C. -reimbursement for two FedEx mailings H-B7 15.00 31.00 46.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-08) SCHEDU~.E J COMMNHERITANCEOT~ RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF I FILE NUMBER Sinaer_ Llovd G ~~ _~ n NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(Sl RECEIVING PROPERTY (Words) $$$ Do Not List Trustee s ( ) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Janet L. Singer Wife Entire Estate 108,300.42 1135 Green Spring Rd. Newville, PA 17241 Total 108,300.42 Enter dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet, as a r o riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 209 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ~aistorical Q~:~_•tes: Chartinb Tools i~?r Lookinb Up a Secu~~ity's L~~ct Closin~T ~' .,~e - ~~.~~~~••• ~~'a~~ i ~_~~r 1 Enter Keyword(s) 'SEARCH 1 More a j~ ~ , ~ ~ ?~:I~~ ETF SCREENERS •~~~ ~fiE~t. ~ µ V`Pr Build yaK own a>stomiad saeerts with over 70 aiceria in pat a few ~ r Charts' it ~ tom. • t a ,n .: r • ar Ennketlhfitd+ Investors should consider csrotully lisfortnetlon contained In the prospectus, including investrnerrt ~ __ , _______.. "_.______. Ertar 5wnbab1fsyPVardt . `~' ~ ~'~ . Nome Quotes Novvs ;Industries. Msrksts w Hlstorlcsl Quotos t3lpti~torts ®Advarte:~dToob Prsr!nium Products This Historical Quotes tool allows you to look up a security's exact closing price. Simply type in the symbol and a historical dale to view a quote and mini chart for that security. (>' Enter Symbol: pru Prudential Financial Inc Friday. July 23, 2010 Enter Date: 7/23/2010 Cfosiny Pace. Open: r--~ (-~' ~- ,, l , I ~ .~ H!~h Low ~ -_-~ `~ t ~L jScot~rade DNLINE 1'f7fi0E5 Scottrade: $7 Trades, Fast Executions 55.42 54.58 55.64 ____ A ~ 54.17 2,545,479 Go To Charting ~~~ Sponsored Links Hot Stock Pick - GSLO All American Solar Energy. Trading, Investment, Stocks. www GcSolarUSA com Refinance Rates at 2.87% $160,000 mortgage for $434/mo. No Hidden Fees - No SSN Req-Free Quotes Lendgo com mortgage Mortgage Rates Hit 3.25%! If you owe less than $729k you probably qualify for govt Refi Programs www SeeRefinanceRates com Turn $5K into $1,057,887 In next 24 months Trading Stock Options! FREE Book Show You How! www.TheluveslorC!ty com Find a broker E~TRADE Trade Free for 60 Days. E•TRADE Securities. A.x Trade Now at Fidelity No Splits 2-Month Daily Chart of Prudential Financial Inc ?I FREE $5dK Why Pay Morel Switch Trade Currencies Online to OptionsHouse. Home i About i Job Opportunities i Contact Us i Feedback i Help Copyright ®2010 MarketWatch, Inc. All rights reserved. By using this site, you agree to the Terms. of Use. and Privacy. Policy (updated 4!3!03). Intraday Daia provided by Thomson Reuters and subject to terms of use, Historical and current end-of-day data provided by Thomson Reuters. Intraday data delayed per exchange requirements. Dow Jones Indexes (SM) from Dow Jones 8 Company, Inc. All quotes are in local exchange lime. Real lime last sale data provided by NASDAQ. More information on NA$[)AQ traded. symbols and their current financial status. Intraday data delayed 15 minutes for Nasdaq, and 20 minutes for other exchanges. Dow Jones IndexesSM from Dow Jones & Company, Inc. SEHK intraday data is provided by Comstock and is at least 60-minutes delayed. All quotes are in local exchange time. - - , P t r _t~ ____`~..1„t,,..~-1 Q,r.~rmhnl-r,rnRrrlncP ('~At ~ ~~y~Z~lU V MIDLAND NATIONAL /Life insurance Ccm an • Annuli Division P Y Y SEPTEMBER 20, 2010 SALZMANN HUGHES PC ATTORNEYS AT LAW 354 ALEXANDER SPRING RD STE 1 CARLISLE PA 17015 Re: Lloyd C1 Singer, deceased Policy: 8000051579 Beneficiary: Janet Singer Dear Mr. Hughes: A~Yinitities a~t their Best **712 Letter'~* This contract is an Annuity. Below is the information that is needed to complete the estate tas return. Decedent: Lloyd G Singer Social Security Number: 176-32-6417 Date of Issue: 06/04/2006 Type of Contract: Non-Qualifed Annuity Date of Death Value (as of 7/23/2010): $102,135.78 If you have questions, please call us toll-tree at 877-880-6367. We are available Monday through Thursday from 7:30 am to 5:00 pm (CST) and Friday from 7:30 am to 12:30 pm (CST). A service professional within the Claims and Benefit Department will be happy to take your important call. Sincerely, Donna Scharlau FLMI, AAPA Claims and Benefit Specialist Claims and Benefit Department cc: File RightFa-z ~,-I24; 2Gi ~ 4 : C4 : 26 r=M P';uE ~/ Ju~~ Fa.{ ::~. r~~~~ Prudential Arrnuitles ~~~ ~~~ ~~j A Business of ?rudenlial Financial, Inc. ~. P.O. Box 7960 Philadelphia, PA 19176 1833) 778-2888 TTY: (300} 654-7637 ww~.pnrdentiaLcom Salzmann & Hughes Attorneys at Law Re: Lloyd G Singer Contract. Number: E0208244 September 24, 2010 Dear Sir or l~Tadam: Thank you for your inquiry on the above contract. The contract value as of 7/23/2010 was $17,460.67. Beneficiary is Janet L. Singer. If you have any questions, please call the Prudential Annuity Service Center at (888) 778-2888. The Service Center is open l~~Ionday through Thursday between 8:00 a.m. and 7:00 p.m. and Friday between 8:00 a.m. and 6:00 a.m. Eastern time. If you are using a telecommunications device for the hearing impaired, you may call (800) 654-7637, I~~londay tlu-ough Friday between 8:00 a.m. and 8:00 p.m. Eastern time. Sincerely, I~im ~'aviston Annuity Claims Variable annuities are issued by Pruco Life Ursurance Company (in New York, by Pruco Life Insurance Company of New Jersey). Both companies are located in Newark, NJ. Variable aruiuities are distributed by Pnrdential Annuities Distributors, Uic., Shelton, CT. Fixed aruruities are issued by The Prudential Insurance Company of America. All are Prudential Financial companies and each is solely responsible for its owrr financial condition and contractual obligations. [Page 1 of 1)