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HomeMy WebLinkAbout03-31-11~ 1505610105 REV-1500 Ex ~oz-~~, ~~, enns lvania OFFICIAL USE ONLY PA Department of Revenue P Y County Code Year File Number (]f P~R'Mf YL pf' R~?/~.Nl;f Bureau of IndividuaiTaxes INHERITANCE TAX RETURN PO BOX 28o6oi + + ,~; ~ ~ ~--° Harrisburg, PA 1128-0601 RESIDENT DECEDENT ~' 1 C' ~° ~!r...~ ~~.~, ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 105-44-7841 10/16/2004 12/12/1953 Decedent's Last Name Suffix Decedent's First Name MI BROTHERS Jr. Clark W (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI n/a 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 ~ 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 Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) Cl~ 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 Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:., ..~ Name_ _ Daytime Telephone N~jtber _ _-_ -~ _. Daryl Christopher (717) 238-6791 '~ -~'~-~ .ri .. First Line of Address Angino & Rovner, P.C. Second Line of Address 4503 North Front Stre City or Post Office State ZIP Code Harrisburg PA 17025 Correspondent's a-mail address: DATE FILED _;_ , ;~ _ ._~ .. -~~ G 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 ERSON R PONSI FOR ILING RETURN DATE ~r ~ ~ ~~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L 1505610105 Side 1 1505610105 J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: 105-44-7$41 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. ', 7,200.00 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. ' 7,200.00 9. Funeral Expenses and Administrative Costs (Schedule H) ............ ....... 9. 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........ ....... 10. 11. Total Deductions (total Lines 9 and 10) .......................... ....... 11. 12. Net Value of Estate (Line 8 minus Line 11) ....................... ....... 12. 7,200.00 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. 7,200.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 7,200.00 16. 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 324.00 0.00 0.00 324.00 O Side 2 1505610205 1505610205 REV-1500 EX (FI) Page 3 Flle Number Decedent's Complete Address: DECEDENT'S NAME BROTHERS Clark William Jr. - - - STREETADDRESS Seven West Locust Street _ __ ___ CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 324.00 2. Credits/Payments A. Prior Payments _____ B. Discount __ _ _ ___ _ Total Credits (A + B) (2) 3. Interest (3) 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 324.00 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 .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dee. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" orpayable-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? ........................................................................................................................ ^ 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(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+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BROTHERS Clark ~Iliam Jr. 21-06-0052 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-1513 EX+ (01-10) . ` pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BROTHERS Clark William Jr. 21-06-0052 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. ~ Clark William Brothers, Ilt Son 7200. 660 Front Street Enola, PA 17025 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. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I$ 7200. If more space is needed, use additional sheets of paper of the same size. -_: ~ - -' enns lvan~a ~ y DEPARTMENT OF REVENUE October 26, 2010 Daryl Edwin Christopher, Esquire Angino & Rovner, PC 4503 North Front Street Hamsburg, PA 17110 Re: Estate of Clark Brothers, Jr. File Number 2106-0052 Court of Common Pieas Perry County Dear Mr. Christopher: ~1~ ~) The Department of Revenue has. received the Petition for: Approval of Settlement. Claim to be• ' ~ . ~- ~ - . _ - -.. - .filed on behal£.of the above-referenced-Estate.in regard to a:wrongful death~and survival action.: It has- . - ~`.~ ~ ~ _ ... - . . .been forwarded to'-.this Bureau foF..the -Commonwealth's appraval of the allocation of the proceedsPa.d to . ~ • . _ settle the actions. `~~ - ~:Pu~`suant to the :Petition, the Decedent died as a result of a construction accident. Decedent is.: ~ . _ _~~.~ ~_~ ~° - . ~~~ ~ . ~. _~. . survived. by his son.: ~ .. ~ . ~ - ~ . , +•. -~_ - - ~ _ Rlease~ b.e°advisedahat,_based upoxi.these.facts.and.for-inheritance tax purposes. only, this 1..-- ~ : ~ -. ~~ . :.~`~~ -~ Department has no objection to the .proposed :allocation of the net proceeds of this action, $10,800.00 to - .-- ~:~~ e ~ '- the wrongful death claim and $ 7,200.00 to the survival claim- Proceeds of a survival action are an asset included in. the .decedont'.s .estate and are subject to the imposition of Pennsylvania inheritance tax.: i 42. :. :.~~~r~ . _ Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as the .. proceedss are allocated. In re 'Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995). . _. I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hiaring regarding it. Please contact me if you or the Court has any questions or requ;res anything additional from this Bureau. S ~ cerely, annon E. Baker Trust Valuation Specialist Inheritance Tax Division _ _ .. ~~b~~- Bureau of Individual Taxes ~ PO Box 280601 ~ Harrisburg, PA 17128 ~ 717.783.5824 ~ sF~abaker@state.Ga.us .~ ., - . ~~ :, -.