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Home My WebLink About06-17-11150 561,0105 .. REV-1500 ~X Paz-~~, ~Ft> enns lvania OFFICIAL USE ONLY PA Department of Revenue P Y oEPppTMENTOFRE~EN~E County Code Year File Number Bureau of Individual Taxr~s INHERITAI~ICE TAX RETURN PO BOX 280601 ~' ~~ Harrisburg, PA i~128-0601 RESIDE~I~IT DECEDENT I `~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDY"YYY Date of Birth MMDDYYYY 174-05-0104 06/13/2010 04/02/1917 Decedent's Last Name Suffix Decedent's First Name MI SENTZ MRS ANNA C (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 q~EGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-'13-F32) O 4. Limited Estate O 4a. Future Interest Cornapromise (date of O 5. Federal Estate Tax Return Required death after 12-12-8~) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total NumbE:r of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Tru:st.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to lax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schr=_dule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD IBE DIRECTED T0: Name Daytime Telephone Number RICHARD S. HOCKLEY (717) 249-5629 ~ti, First Line of Address 206 ACRE DRIVE Second .Line of Address City or Post Office State CARLISLE p,,A ZIP Code ,,~ ~, REGISTER~II~ILLS USE"rgiVLY `T`ll-j?~ ~ `~~ .1 e;:.. ~: ~ c~ _ r ~ ~ , $ ~~ ~ ~7i ATE FILED I•`.J ~'~ -~_ 17013 ~~ ~~1 ~- ::- '~:.-i ,..I m Correspondent's a-mail address: rSh01 @COmCaSt.tl@t 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. SIGN O ERSON BEFr~131~IBL R FILI ~ TARN rv~-rc SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ,~ ~ DATE ADDRESS P PLEASE USE ORIGINdo1L FORM ONLY Side 't 1,50561,0105 15056101,05 J J 1,505610205 REV-1500 EX (FI) Decedent's Social Security Number decedent's Nacre: ANNA C. SENTZ :174-05-0'104 RECAPITULATION - 1. Real Estate (Schedule A) .......................................... ... 1. 172,500.00 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. 68,752.18 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. 241,252.18 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. ', 4,859.08 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. 125,834.01 11. Total Deductions (total Lines 9 and 10) ...:........................... .. 11. ' 130,693.09 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 110 559.09 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. 110,559.09 TAX CALCU LATION -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. i 16. Amount of Line 14 taxable at lineal rate X .0 e 15. 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 16,583.86: 18. 16,853.86 19. TAX DUE ........................ ................... .............. . 19. 16,853.86 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056117205 15056102CI5 REV-1500 EX (FI) Page 3 Decedent's Complete Address: DECEDENT'S NAME ANNA C. SENTZ STREET ADDRESS 221 GARLAND DRIVE CITY CARLISLE Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments _____ _ B. Discount 3. Interest 14,000.00 700.00 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. File Number STATE PA ZIP 17013 (T) 16,853.86 Total Credits (A + B) (2) 14, 700.00 (~) (4) (6) 2,153.86 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? .......... . ........................................................... C~ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................. [ 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? ........................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT,4S 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. LL6~-ZZi~-LTL :TTa~ ~~ REV-1.5o2 E:X+ (Q?.-]Oj ~ Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTA~'E RESIDENT DECEDENT ESTATE 0~: FILE NUMIBER: ANNA C_ SENTZ All real property owned solely or as a tenant in common must be reported at fair Market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property that is jointly-owned with right of surviv®rship must be disclosed on Schedule F. 1t more space is needed, use additional sheets of paper of the same size. REV-i5o8 EX+ (li-io) ~ Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSgTS & MISC. INHERITANCE TAX RETURN PERSONAL PRaPERTY RESIDENT DECEDENT ESTATE OF: FILE NI;~MBER: ANNA C. SENTZ 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. Ir more space is needed, use additional sheets of paper of the same size. REV-1.51.1 EX .- (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ANNA C. SENTZ Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A• FUNERAL EXPENSES: 1' EWING BROTHERS FUNERAL HOME INC 3,199.08 2. CHURCH FUNERAL: Minister, Organist, Housekeeping, Mead 865.00 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: 200.00 3. Family Exemption: (If decedent's address is not the same as claimant`, attach explanation.) Claimant 4. 5. 6. ~. Street Address City __ State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: SCHEDI~LE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ZIP TOTAL (Also enter on Line 9, Recapitulation) I $ If more space is needed, use additional sheets of paper of the same size. 385.00 210.00 4,859.08 REV-1.512 EX ~- (12-o8j ~ pennsylvan~a SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NIJMBER ANNA C. SENTZ Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimb~ursed medical expenses. ITEM NUMBER DESCR}i~TION VALUE AT DATE OF DEATH 1' WELLS FARGO REVERSE MORTGAGE 103,364.27 2. BOROUGH OF CARLISLE 3,508.61 3. HOUSE CLEANING: PREPARE TO SELL 221 GARLAND DR. CARLISLE, PA 17013: 2,415.00 4. HOME REPAIR: PREPARE TO SELL 221 GARLAND DR., CARLISLE, PA 17013 3,236.08 5. MONTHLY HOME EXPENSES: S/W BORO CARLISLE, PP&L POWER, H. 0. INSURANCE 1,310.05 6. FOR FIVE (5) YEAR PERIOD WAS PRIMARY CAREGIVER TO DECEDENT TO INCLUDE THE 12,000.00 FOLLOWING ACTIVITIES: - Power of Attorney (POA) responsiblities - Plan weekly schedules for personal care and manage payroll; incl. draw down on funds - Maintain and give directions on daily drugs - Scheduling medical appointments, and taking to medical appointments - 11 p.m. check and overnite with decedent or prepare an overnite schedule w/ care givers - Meal and grocery planning and shopping - other TOTAL (Also enter on Line 10, Recapitulation) I $ 125,834.01 If more space is needed, insert additional sheets of the same size.