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HomeMy WebLinkAbout06-07-11J 1505610140 REV-1500 ~` (°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Po sox 28osot County Cade Year File Number INHERITANCE TAX RETURN Harrisbu PA 17128-Ot301 2 1 1 1 0 2 9 6 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date Of Death MMDDYYW Date Of Birth MMDDYYW 2 0 2 2 0 1 8 9 4 0 1 2 8 2 0 1 1 0 7 3 1 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name SWE I TZER DOROTHY M (If Applicable) Errter Surviving Spouse's Irtformatlon Below Spouse's Last Name Suffnt Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death ^ 4. Limited Estate ^ prior to 72-13-82) 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required ® 6. Decedent Died Testate ^ (Attach Copy of Willj death after 12-12-82) 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe DeposR Boxes ^ 9. Litigation Proceeds Received ^ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 12-37-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO N ame : Daytime Telephone Number J OE L R. ZUL L I NGER 71 7 2~4 6~2 9 ~ REGISTER LS USE Y First line of address 1 r C1) '~! 1 4 NORTH M A I S N STREET ~~~ ~ i-r econd line of address SUI TE 2 00 ~ ~'~ tv N '~ City or Post Office State ZIP Code S L'~ DATE FILED C H A M B E R S B U R G P A 1 7 2 0 1 Correspondent's e-mail address: Under penalges of pariury, I deGere that I have examined this return, InGuding accompanying schedules and laments, and to the hest of my knowledge and belief, it fa true, correct and complete. Dedareeon of preparor other than the personal representative is based on all information of which preperer has any knowledge. SIGNATUgI: OF PERESPONSIBLE FQgFIL111G.gE7yRl~b i ~Gj~ ~C~-v. ~ C!/ S~-~ DATE ~ ~~` J/ ADDRESS 110 STEWART PLACE E OF PREPARER~THE~S PA 17257 DATE PLEASE USE ORIGINAL FORM ONLY L 1505610140 Side 1 1505610240 1505610140 J~ REwtSOO Ex DsosdenCs Socal Sscurky Number Deoedent'sNmre: DOROTHY M. SWEITZER 2 0 2 2 0 1 8 9 4 RECAPITULATN)N 1. Real Estate (Schedub A) ........................................... 1. 2. Stocks and Bonds (Schedub B) ...................................... 2. 3. CkJesly Hskt Corporetbn, Partnsrehip or Sole-Proprietorship (Sr:hedub C) ..... 3. 4. Mortgages and Notes Recelv~k (Schedub D) .......................... 4. . 1720 ~~ p~ J~ ~` .. 5 ~ ~~ ~. J 1505610240 REV-1500 EX Decedent's Social Security Number Decedents Name: DOROTHY M. SWEITZER 2 0 2 2 0 1 8 9 4 RECAPITULATION 1. Real Estate (Schedule A) ....................................... .... 1. 2. Stocks and Bonds (Schedule B) .................................. .... 2. 3. Closely Held Corporation, Partnership orSob-Proprietorship (Schedule C) . .... 3. 4. Mortgages and Notes Receivable (Schedule D) ...................... .... 4. 5. Cash, Bank Deposits and Mis~ilaneous Personal Property (Schedule E)... .... 5. 5 7 5 3 , 7 9 8. Jointy Owned Property (Schedule F) ^ Separate Billing Requested ... .... 6. 7. Inter-Vwos Transfers & Miscellaneous N -Probate Property (Schedub G) ~] S eparate Billing Requested ... .... 7. 8. Total Gross Assets (total Lines 1 through 7) ....................... .... 8. 5 7 5 3 , 7 9 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .... 9. 5 0 4 3 . 0 0 10. Debts of Decedent, Mortgage Liabilitbs, and Liens (Schedub I) ......... .... 10. 5 5 8 . 9 3 11. Total Deductlona (total Lines 9 and 10) ........................... .... 11. 5 B O 1 9 3 12. Net value of Estate (Line 8 minus Line 11) ........................ .... 12. 1 5 1 8 6 13. Charitable and Governmental 13equests/Sec 9113 Trusts for which an election to tax has not been made (Schedub J) .................. .... 13. 14. Nst Valrx Sub)ect to Tax (Line 12 minus Line 13) .................. .... 14. 1 5 1 8 6 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.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at Ilneal rate X .0 _ 0 0 0 1 t3. 0. 0 0 17. Amount of Line 14 taxable at sibling rate x. t 2 1 5 1. 8 6 17. 1 8, 2 2 18. Amount of Line 14 taxable at collateral rate X .15 0 Q 0 18. 0. 0 0 19. TAX DUE ................................................... ...19. 1 8 . 2 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505610240 1505610240 REV-1500 EX Pape 3 Decedent's I ADDRESS Address: File Number 21 11 0296 CITY Shippensburg STATE PA ZIP 17257 Tax Payments and Credits: 1~ Tax Due (Page 2, Line 19) (1) 2. Credits/Payments 18 22 A. Prior Payments B. Discount Total Credits (A + B) (2) 3. Interest 0.00 4. If Line 2 is greater than Line 1 + one 3, enter the difference. This is the OVERPAYMENT. (3) Fill In oval on Pape 2, Lina 20 to roqueat a refund. (4) 0 00 5. If Line 1 + Line 3 Is greater than Line 2, enter the difference. This is the TAX DUE. (5) 18.22 Make check payable to REGISTER OF WILLS, AGENT ' ,'~8. r_ p Iv d r °k ;', sr gNs Ifis C s '`la'siAyqy"W 15~ 4v v :~.ekk CeII~' II PR°s a^ak((:'~uvi 77 [[ I's.'r uyIpp*~,,., n i i ~ •p.+, ~ "J. .4i 'p:p~4. ppyyWr p, ~w ..:N, sw P ~ ~,a. ,y.gti pw II avoe Slk $Vl~:.= aline. _ntl.l.C ,.,, €s. PR, ..F~b4S nl~ 4aaCU Y i iv,~iR¢~pl,{plllk r~k~W li .li~gEWlisal'~ll of lliafi~i Ik'„ dl lit t4l :qh4~yg.C qy~ daE.iq ... • y,,,~y~ ;h Ia+ l blfl a l p ~Ri i{•" u i u~"a t,l;' u a k~. ~I:.aI~ESb ,.~9k ~iu.llmYM4k~~HtltlC...~il~~~u NiC34l?gg°ilaslBB~.~kfwXPluu~,tlL arrh,'~l'u~1~7~~11i " 11 ^ K~C~ I r " St: ".'q t"a~d~CdG l , p ( ~ !'Iii'I~ C~1~C~'~~' alq I ~ ~7 ~' t~ ~~I~ ~~~ ~ . N : i i ! : .: l ll 1 ~ ~ .. a, .*I'havl~h4~,. 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 a 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 ............................................................................................... . ^ d. receive the promise for life of either payments, benefits or care? .................. . 2. If death occurred after December 12,1982, did decedent transfer property within one ear of death y without receiving adequate consideration? ............................. 3. Did decedent own an 'in trust for ar 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 benefiaary 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. .i aOd~Nel!tkt~~~dui ~^ ~ k~ aNilYl~ybw':k I I~gllly dGhik C IiIrvCi ° I!ii i. ~ ~ .,,:! ~J 7) ai{{R1~ J,}~"'N~'7f ~ ^e-Errr (F6 € ° 6 N `S l r.:.~N RhNkW4'"g'N : 7 .. i ::'- € a A h 4CI5~~I94~r, r&~ ..iF, 4 .... n,~~YilR 6E i ~fiJ1r. t,I~~i° ii r`"'. 7!le l.~i Ili a I!iit Ili i.)hkl::G~Ji~NiaGJ!!v4Iy~EBN Ills lg9d) A a pi,g'e Ila r °sIRI~'i rR 'Silllli BR'Y, iX 84 Rif Nifl 'I'yn SlS°"I raS i!ei''a 89S+aGl N ....., ~` "N I I k~ai.i.~i~~li,,.,')~.~i~~~~NNr7k~,)d ,~[ ,±nilw:~~f4~1:,~;~]"~=~~(~rR~~~,~iw~"~~.l~i))Jl~~h~tl~i~:~~,InG~Jh~,Gi~l 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 p2 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 ff the surviving spouse is the only beneficlary. 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 decedents 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•+ (8-98) SCHEDULE E COMMONWEALTH OF PENN3YLVANw CASH, BANK DEPOSITS, ~ MISC. IN RES DE T DE EDENT N PERSONAL PROPERTY ESTATE OF FILE NUMBER DOROTHY M. SWEITZER 21 11 0296 Include the s of Iltlgatlon and the date the prooaeds were recehred by the estate. All Pro In .owned with rlpM of survhorehip must be dbclosed on SehsduN F. ITEM NUMBER ~. Checking Account #6825, 2. Refund, Skvatlcas Tab Graphics 3. Refund, Comcast Cable 4. (Refund, State Farm Insurance renter's insurance policy TOTAL (Also enter on line 5 Recapitulation) I s (If more space e: needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 5,658.72 70.00 14.44 10.63 REV-1511 EXt (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER DOROTHY M. SWEITZER 21 11 0296 Decedent's debt must be reported on Schedule I. ITEM -- NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger-Bricker Funeral Home, funeral services 3,416.50 2. Shull-Koontz, gravemaker 765.00 B. ADMINISTRATIVE COSTS: Personal Representative Commissions: Neme(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Pafd: 2, Attorney Fees: Joel R. Zullinger 750.00 3. Family Exemptbn: (If decedents address le not the same as claimants, attach explanatbn.) Claimant Street Address D~' State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Letters - 30.00; will -15.00; short certificates 5.00; JCS fee 23.50; 111.50 automation 5.00; filing return -15.00; additional probate fee - 15.00 5 Accountant Fees: 6. I Tax Return Preparer Fees: 7 TOTAL (Also enteron Line 9, Recapitulation) ~ s If nare space is needed, use addhbnal sheets of paper of the same size. 00 RPV-1512 EXw (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS DOROTHY M. SWEITZER 21 11 0296 Report dells Incurred by the decedent prior to death that remained unpaid at the date of death, including unroimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Century Link, balance due on account 12.84 2. Penelec, balance due on account 41.59 3. Chambersburg Hospital, balance due on account 61.40 4. Shippensburg Area EMS, balance due for transport services 443.10 TOTAL (Also enter on Line 10, Recapitulation) I S It oars space is needed, insert additional sheets of fhe same size. REY-1573 EX+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DOROTHY M. SWEITZER 21 11 0296 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trusted/s) OF ESTATE I TAXABLE DISTRIBUTIONS [Indude ou~pht s I distributions and transfers under Sec. 91 f6 (a (12).] 1. William C. Porter Sibling 110 Stewart Place residue Shippensburg, PA 17257 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS ~ R. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TE. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I ; If more space Is needed, use additional sheets of paper of the same size. ~ _ JRZ - 5.1 sweitzer.2 March 16, 2010 !,p -_ _~ _.,, _. -~ ~_ ~ ~7 r~ try • LAST w2LL AND TESTAMENT '. ~ c I, Dorothy M. Sweitzer, of 101 Prince Street, Room 212, Shippensburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any and all former wills and codicils thereto by mP heretofore made. 2. I direct that all my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I give, devise and bequeath the residue of my estate of every nature and wherever situate to my brother, William C. Porter, providing he shall survive me by thirty days. III. Should my brother predecease me or die on or before the thirtieth day following my death I give, devise and bequeath the ~ n T' •"-1 _~ , <.; ~ c~ -i residue of my estate of every nature and wherever situate to my niece, Grace E. Commerer. IV . ~" Any fiduciary under this will shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property whether principal or income, including property held for minors, exercisable without Court approval, and effective until actual distribution of all property: A. To retain any and all of the assets of my estate, real or personal, without regard to any principle of diversification of risk. B. To invest in all forms of property including stock, common trust funds and mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification of risk. C. To sell at public or private sale, to exchange or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly in each. Page 2 3 3 ~" G. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. v. I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed, shall be paid. from my residuary estate as a part of the expense of the administration of my estate. v=. I appoint my brother, William C. Porter, as executor of this I~ my will. Should my brother predecease me, fail to qualify or cease to act, 2 appoint my niece, Grace E. Commerer, as executrix of this my will. V22. No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, 2 hereunto set my hand and seal to this my last will and testament, consisting of five typewritten pages, the first three of which bear my signature in the margin for the Page 3 purpose of identification this _IQ ~~ day of r '(SEAL) Signed, sealed, published and declared by the above-named testatrix as and for her last will and testament in our presence, who in her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses. .~ ~ ~'lf~~o/1 (low ~~a C~~ ~ - N~- ~~- ~~~ IC • ~Gl l~~/2~P~ and testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and testament and that she executed it as her free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testatrix, signed the will as witnesses and to the best of their knowledge, said signer was at that time eighteen years of age Page 4 We, Dorothy M. Sweitzer, ~1~c~d/P ~J• I(e/% , the or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledge before me by the above-named signer and subscribed and sworn to before ~ne by the above-named witnesses this ~ day of 4r h_ ~N, zoo . ~/w~ Notar Public CQMMONWEALTH OF PENNSYLVANIA Notarial Seal Angela M. Schaeffer, Notary Pubik Shlppensburg Boro, Cumberland County My Commission Expires May 15, 2011 Member, Pennsylvania Association of Notaries Page 5 Q ~s~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Law Offices of Zullinger-Davis 14 North Main Street Suite200 Chambersburg, PA 17201 Phone 888-502349 F ax (302)934-2955 Apri128,2011 Re: Estate of Dorothy M Sweiter Social Security: 202-20-1894 Date of Death• January 28 2011 Dear Sir or Madam: Per your inquiry on Malch 9, 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 Checking Account 87118772 Dorothy M Sweitzer 02/O1i99 $5,65872 $ .00 $5,65872 For any additional udormation ou the above aceounts, including ownership and any changes, closures and/or reimbursement of funds, piewe cell the Wahmt Bottom 0)16oe at11717-532-TA14. We weft unable to locate any safe depot box for the above-mm8oned decedent. This triter does not hxiude any aarounts io which fbe deceased may have been listed as Power of Attorney, C~Stadian of Uniform Traa~'ers, Repreaentatlve Payee, ar Trosfee uuda a Written Agresment Sincerely, Tammy Spencer Adjustment Services ;~~ V r a d N ~ +, ~ /A Y~ ~ T f+ ^~ •... ~ ~ ,~1 ~ Qp ~ c C ~~+ ~ N ~, id ~ ~-~1 1.1 ~ 1~ L ~ .~ ~ ~ p o'er ON '" ~ ~ N i dd c , m a ~ Z ~ ,.~ ob c ~ i .~ a v N ~ °y p~ U r-1 V •• O I~w o~ICES of ZULLINGER-DAMS rxo~ox,~.coRro~ox -- JOEL RZULLINGER SUZANNE M. TRINH HAMILTON C. DAMS strinhn~~llinQer-davis.com hdavisna zullineer-davis.com izullineerCn~zullineer-davis.com 14 North Main Street, Suite 200 20 East Burd Street, P.O. Box 40 Shippeesburg, PA 17257 Chsetbersburg,PA 17201 717-532-5713 717-264-6029 717-530-5222 (FAX) 717-264-1884 (FAX) June 1, 2011 N Qt r.. Register of Wills ouse Cumberland County Courth ~ 1 Courthouse Square ~ , Carlisle, PA 17013 ~° ~' a~ z Dear Register: ~ ^' 4'? RE: Estate of Dorothy M. Sweitzer Enclosed for filing in your office axe an original and one copy of the PA Inheritance Tax Return for the above estate. Also enclosed is check payable to Register of Wills, Agent in the amount of $18.22 for inheritance tax due and check payable to Register of Wills in the amount of $83.00 for costs and filing fee. If you have any questions, please contact my Chambersburg office. 'Thank you. Very telly~yQours, . /` oe R. Z er Encls.