Loading...
HomeMy WebLinkAbout05-18-11' 1505610140 REV-1500 EX (°'-'°' OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 28oso1 INHERITANCE TAX RETURN 2 1 1 :L 0 2 5 7 Harrisburg, PA 17128-OS01 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 1 1 2 2 6 3 6 9 0 2 0 7 2 0 1 1 0 5 0 7 1 9 2 4 Decedent's Last Name Suffix Decedent's First Name MI W A G N E R G E R A L D I N E: M (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 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) GVKKt,I'VIVUtIV 1 - i hip ~t~ i ivn mu, i tit ~umr~C i cu. ALL V VRRCJrVPINCPIVC APIU VVI~rIL/Cl~ 1 wL 1 An II~rVR1rIR11V1~ ~7nVYLY DG YIRGV ~ Gv ~ v. Name Daytime Telephone Number R O G E R B- I R W I N 7 1 7~, 2 4 9 ~ 3__.~ ..- . -, First line of address 6 0 W E S T Second line of address City or Post Office C A R L I S L E Correspondent's a-mail address: State P A ZIP Code ~ 1 7 0 1 3 5?'E~t taF WILLS~U$E ONLY , _;, --- - ;~ .:` __.., -, r i _- ~:_. .- r .. J ~ .. f _ ~.._j ~. J . ~- ;- DATE FILED 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. A URE OF PERSO E P NSIBLE OR FILING RETURN DATE / ~ a O, • ~ ADDRESS 3041 WAGGONERS GAP ROAD CARLISLE PA 17015 SIGNATURE OF P EPARER OTHER THA REPRESENTATIVE DA E ~ ij n ADDRESS 60 WEST P FRET STREET CARLISLE__ PA 17013 PLEASE USE ORIGINAL FORM ONLY 155610140 P O M F R E T S T R E E T Side 1 1505610140 J J 1505610240 REV-1500 EX Decedent's Social Security Number ~ecedent'sName: GERALDINE M- WAGNER 2 1 1 2 2 6 3 6 9 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. 1 3 9 1 5 9 . 4 1 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous N~,p~Probate Property (Schedule G) S a eparate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 3 9 1 5 9 , 4 1 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 9 3 0 5 . 1 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ....... 10. 4 3 7 1 . 5 6 11. Total Deductions (total Lines 9 and 10) ........................ ....... 11. 1 3 6 7 6 . 7 2 12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12. 1 2 5 4 8 2 . 6 9 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 2 5 4 8 2 . 6 9 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 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X 0. 0 0 16, 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 1 2 5 4 8 2. 6 9 18. 1 8 8 2 2. 4 0 19. TAX DUE ................................................ ...... 19. 1 8 8 2 2• 4 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 0257 DECEDENT'S NAME GERALDINE M. WAGNER STREET ADDRESS 770 S. HANOVER STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1 • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 941.12 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) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ 17,881.28 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 : ...................................................................... ^ ^X 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? ....................................................... ^ Q 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 "intrust for" or payable-upon-death bank account or security at his or her death? ......... ^ Q 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 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, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. (1) 18,822.40 941..12 (3) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RES DENT D EDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER GERALDINE M. WAGNER 21 11 0257 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. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. PERSONAL PROPERTY -SUMMARY ATTACHED 827.00 2. CASH 517.78 3. M&T BANK -CHECKING ACCOUNT #88119505 14,772.20 4. M&T BANK -SAVINGS ACCOUNT #15004213067695 26,463.28 5. MEMBERS 1ST FEDERAL CREDIT UNION -SAVINGS ACCOUNT #211306-00 414.30 6. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-41 10,573.14 7. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-49 12,093.03 8. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-69 10,592.29 9. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-70 10,995.60 10. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-71 13,078.38 11. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-7~'. 12,263.01 12. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-7~i 11,217.47 13. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-67 5,102.47 14. MEMBERS 1ST FEDERAL CREDIT UNION -CERTIFICATE OF DEPOSIT #211306-68 10,249.46 TOTAL (Also enter on line 5, Recapitulation) $ 139,159.41 (If more space is needed, insert additional sheets 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 GERALDINE M. WAGNER 21 11 0257 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MUSSELMAN FUNERAL HOME 2. ROLLING GREEN CEMETERY 471.12 285.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State _ ZIP Year(s) Commission Paid: 2. Attorney Fees: IRWIN & McKNIGHT, P.C. 7,500.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: REGISTER OF WILLS 261.50 5 Accountant Fees: 6. Tax Return Prepared=ees: PATRICIA A. ROSENDALE, CPA 495.00 INCOME TAX RETURNS & FIDUCIARY RETURN 7. REGISTER OF WILLS -FILING FEE 30.00 8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 9. THE SENTINEL -ESTATE NOTICE 187.54 TOTAL (Also enter on Line 9, Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. 9.305.16 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF GERALDINE M. WAGNER FILE NUMBER 21 11 0257 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. CARLISLE BOROUGH TAX ACCOUNT -TAXES 4.90 2. ALERT PHARMACY -MEDICAL 112.66 3. OUTSTANDING CHECK #0116 (M&T BANK) 4,254.00 TOTAL (Also enter on Line 10, Recapitulation) I $ 4, 371 56 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: GERALD INE M. WAGNER 21 11 0257 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. PATRICIA G. WICKARD Collateral 31,370.68 3041 WAGGONERS GAP ROAD 1/4TH REMAINDER CARLISLE, PA 17015 2. RICHARD E. CRISMORE, JR. Collateral 31,370.67 821 STRATFORD WAY, APT H 1/4TH REMAINDER FREDERICK MD 21701 3. NEIL U. CRISAMORE Collateral 31,370.67 1015 RED ROAD 1/4TH REMAINDER HARRISBURG, PA 17110 4. HARRY B. DANNER Collateral 31,370.67 2101 FOXFIRE DRIVE 1/4TH REMAINDER MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS 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. $ it mare space is neeaea, use aoaiuonai sneers or paper or the same size. Kevin M. Wickard 140 Pleasant Hall Road Carlisle, PA 17013 (717) 241-5341 February 14, 2011 Geraldine Wagner 770 S. Hanover St. PC 234 Carlisle, PA 17013-4105 I, the undersigned appraiser, have personally inspected the articles listed on the attached summary. To the best of my knowledge, the values stated are true and correct as of February 14, 2011. I have found most items to be in good condition and have taken into account both physical and functional depreciation in arriving at conclusion of value. I further certify that I have no personal interest in the property and that neither my employment nor compensation is contingent upon the valuation of this property. In my opinion the fair market value of the items contained in the estate of Geraldine Wagner as of February 14, 2011 is $827.00 Respectfully submitted, ~~tu-~ Kevin M. Wickard SECRETARY 125.00 MANAVOX TV 75.00 TV STAND 5.00 LOVE SEAT 150.00 SMALL SHOW CASE 50.00 DISHES AND COLLECTIABLES 25.00 RADIO 1.00 PHONE STAND 5.00 FLOOR LIGHT 5.00 OLD STOOL 5.00 RECLINER 10.00 SEWING BASKET 5.00 WALL CLOCK 20.00 WOODEN STORAGE CABINET 10.00 MISC. IN CABINET, BASKETS ETC. 30.00 CEDAR CHEST 25.00 AFGANS AND BLANKETS 25.00 3 PC. BEDROOM SUITE 225.00 ROOM LIGHTS 5.00 PICTURES 5.00 BLACK RADIO 1.00 QUILT 20.00 TOTAL APPRAISED VALUE--- ~ $827.00 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Irwin and McKnight PC 60 West Pomfret Street Carlisle, PA 17013 Re: Estate of Geraldine Wa er Social Security: 211-22-6369 Date of Death: February 07, 2011 Phone 888-502-4349 F ax (302) 934-2955 March 3, 2011 Dear Sir or Madam: Per your inquiry on February 25, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names o, fl Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Ownership (Names o, fl Opening Date Balance on Date of Death Accrued Interest Total Checking Account 88119505 S Earl IWagner Jr - (~ Q ~ ~-~ d~ Geraldine M Wagner Patricia G Wickard (POA) 0828/64 $14,772.19 $ .01 $14,772.20 Savings Account 15004213067695 Geraldine M Wagner Patricia G Wickard (POA) 07/Z8/OS $26,463.06 $ .22 $26, 463.28 1 MEMBERS 1st FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 211306-00 Date Account Established 11/16/2001 Principal Balance at Date of Death $414.28 Accrued Interest to Date of Death $,p2 Total Principal and Accrued Interest $414.30 Name of Joint Owner None CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-41 Date Account Established 01 /11 /2011 * Principal Balance at Date of Death $10,571.23 Accrued Interest to Date of Death $1.91 Total Principal and Accrued Interest $10,573.14 Name of Joint Owner None *Rollover from certificate 211306-40, originally established 02/08/2010. CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-49 Date Account Established 01/11/2011* Principal Balance at Date of Death $12,089.87 Accrued Interest to Date of Death $3.16 Total Principal and Accrued Interest $12,093.03 Name of Joint Owner None *Rollover from certificate 211306-43, originally established 02/08/2010. CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-67 Date Account Established 05/12/2010* Principal Balance at Date of Death $5,101.22 Accrued Interest to Date of Death $1.25 Total Principal and Accrued Interest $5,102.47 Name of Jainl=Owner' Patricia Wickard Date Joint Ownership Established 05/12/2010 *Rollover from certificate 211306-63, originally established 10/09/2009. CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-68 Date Account Established 07/08/2010* Principal Balance at Date of Death $10,249.09 Accrued Interest to Date of Death $.37 Total Principal and Accrued Interest $10,249.46 Name of Joint Owner 4gP~.u 3.~. .- Patricia Wickard . Date Joint Ownership Established 07/08/2010 *Rollover from certificate 211306-62, originally established 08/03/2009 CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-69 Date Account Established 09/21/2010* Principal Balance at Date of Death $10,589.96 Accrued Interest to Date of Death $2.33 Total Principal and Accrued Interest $10,592.29 Name of Joint Owner None *Purchased by transfer of shares from 211306-00. 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-70 Date Account Established 09/21/2010* Principal Balance at Date of Death $10,993.18 Accrued Interest to Date of Death $2.42 Total Principal and Accrued Interest $10,995.60 Name of Joint Owner None *Purchased by transfer of shares from 211306-00 . CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-71 Date Account Established 09/28/2010* Principal Balance at Date of Death $13,075.50 Accrued Interest to Date of Death $2,88 Total Principal and Accrued Interest $13,078.38 Name of Joint Owner None *Rollover from certificate 211306-48, originally established 02/27/2010. CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-72 Date Account Established 10/07/2010* Principal Balance at Date of Death $12,260.31 Accrued Interest to Date of Death $2,70 Total Principal and Accrued Interest $12,263.01 Name of Joint Owner None *Purchased by transfer of shares from 211306-00. CERTIFICATES OF DEPOSIT: Account Number/Suffix 211306-73 Date Account Established 10/20/2010* Principal Balance at Date of Death $11,215.00 Accrued Interest to Date of Death $2.47 otal Principal and Accrued Interest $11,217.47 Name of Joint Owner None *Rollover from certificate 211306-65, originally established 11/20/2009 BERS 1ST~yFrE1DE^RA CREDI NION Danielle A. Kline Lending Insurance Support Specialist February 28, 2011 Estate of: GERALDINE WAGNER Date of Death: 02/07/2011 Social Security Number: 211-22-6369 ' ` `JVelcome to l0/lc~.}.. Unline Banking Page 1 of 1 ACCOUNT SUMMARY > SAVINGS DETAIL M&T Market Advantage Related Links: Transfers &.Loan Payments: View: Statements &:Checks~ Export Dafa ~-order New Chg~ks ~ ~~~ account Mrkt Advantage 7695 ~ ~Totai.B~i~~ $22,2o9.os available Balance $22,209:06 ~.__._ . View Gales dar View Calendar show Last 10 Transactions ~ , or _ .View From , To :4~Q , t~Post,'Date Tran_sactlon Desch : ; Cr its/pebits Totai,Balance 02/10/2011 CHECK NUMBER 0116. - _: <. . 02/04/2011 INTEREST PAYMENT -$4,254.00 $22,209.06 01/07/2011 CHECK NUMBER 0115 $2.28 $26,463.06 -$4,740.16 $26,460.78 01/04/2011 INTEREST PAYMENT $2.76 $31,200.94 12/06/2010 CHECK NUMBER 0114 -$4,553.00. $31,198.18 Depending on when your statement generates, you may not see a full 90 days of history. If your statement has just been generated, you may get a message indicating that no transactions are available from 61 - 90 days. Customer Service e~rr~ P~ tail s~rr ~i~- p~hwne~. Q ~~' ©2011 Manufacturers and Traders Trust Company. Users of this web site agree to be bound by the provisions of the M&T Web Banking Terms and Conditions. View the Terms and Conditions, Privacy Policy or Security Information. https://onlinebanking.mandtbank.com/history/HistorySavings.aspx?Id=2 2/15/2011