The URL can be used to link to this page

Home My WebLink About06-24-11 (2)15056051058 '~ REV-1500 EX (06-05) PA Department of Revenue Bureau oflndividualTaxes ~ INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 .~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW OFFICIAL USE ONLY County Code Year File Number 21 09 0763 Social Security Number Date of Death Date of Birth 187-16-4406 08/04/2009 02/18/1921 Decedent's Last Name Suffix Decedent's First Name MI Winn Dorothy L (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 INAPPROPRIATE 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) • 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) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Lisa Marie Coyne, Esq. (717) 737-0464 Firm Name (If Applicable) REGISTER OF WILLS USE QIV1=Y C ~~ Coyne & Coyne, P.C. ? ~ 4 First line of address ' 1 J'J .~ 1"t_n 3901 Market Street _ ~~ ~ .~- %~ r Second line of address i ,--~, ~-, City or Post Office Camp Hill ,r-.. -. State ZIP Code DATE FILLS -p C~- PA 17011-4227 ~~, .''' , =:j t_ rTj ~`.~ ~ -4 i Correspondent's a-mail address: IISa@COyneandCOyne.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, ~. ,,...,, .. ...............a ~,,.,,..ioro no~iarar~nn of nranarar n}her than tha nersnnal representative is based on alt information of which oreoarer has anv knowledge. URE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADD ESS f Renl~,e ~. Wewer, 312 48th Street, Harrisburg, PA 17111 and ordon E. Winn, Jr., 401 McCormick St. West Fai SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 t ~, J 15056052059 REV-1500 EX Decedent's Social Security Number Dorothy L Winn 187-16-4406 Decedent's Name. 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 & Notes Receivable (Schedule D) ............................ . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 16,060.05 6. Jointly Owned Property (Schedule F) Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) • Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 16,060.05 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 3,155.00 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 3,155.00 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 12,905.05 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. 12,905.05 TAX COMPUTATION -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 1 5. 16. Amount of Line 14 taxable at lineal rate x .045 12,905.05 1g. 580.73 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 580.73 19 ....................................... TAX DUE .. ... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side2 15056052059 r~EV-1500 EX Fage 3 nPCPdent's Complete Address: File Number 21 09 0763 Dorothy L Winn STREET ADDRESS 208 Fourth Street CITY West Fairview DECEDENT'S SOCIAL SECURITY NUMBER 187-16-4406 STATE ZIP PA 17025 Tax Payments and Credits: 1 Tax Due PPage 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C ) 3. InterestlPenalty if applicable D. Interest E Penalty 580.73 (2) Total InterestlPenalty (D + E) (3) 4 If Line 2 s 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 0.00 0.00 0.00 580.73 580.73 1 Did decedent make a transfer and: Yes No P P Y t l s -_ `- who shall use the property transferred or its income : ...................................... desmnate ht to b. retain the ri g g ...... ~~ c. retain a reversionary interest; or .................................................................................................................... ...... ~_ ~- [~ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... If death occurred after December 12, 1982, did decedent transfer property within one year of death 2 . without receiving adequate consideration? ....................................................................................................... ....... ~i L 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ....... ....... Did decedent own an Individual Retirement Account, annuity, or other non-probate property which 4 _ . 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (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 zero (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 twenty-one 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 zero (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 four and one-half (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 twelve (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-i5o8 EX+ (ii-io) ~ pennsylvania SCHEDULE E DEPARTMENT of REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAx RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DOROTHY L. WINN 21-09-0763 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 addiuonai sneers or paper or uIe same site. _. _ _ i___~ennsyCvania DEPARTMENT OF REVENUE May 6, 2011 Michael J. Navitsky, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road, Suite 303 Harrisburg, PA 171 ] 0 Re: Estate of Dorothy L. Winn File Number 2109-0763 Court of Common Pleas Cumberland County Dear Mr. Navitsky: The Department of Revenue has received your correspondence on April 29, 2011. Attached was the petition to approve a compromise settlement to be filed on behalf of the above-referenced estate in regard to a wrongful death and survival action. It was sent to this office for the Commonwealth's approval of the allocation to the proceeds paid to settle the actions. According to the Petition, the 88 year old decedent died as a result of medical negligence. Decedent is survived by her to adult children, who are the only individuals eligible to receive funds under the wrongful death allocation. Pursuant-to the Supreme Court of Pennsylvania, before there can be any recovery in damages by one in family -elation for negligent death of another in the same relation, there must be a pecuniary 1oss.Mannin~ ~ . Capelli, 4I 1 A.Zd 252, 270 Pa:Super. 207, Super.-1,979. Family relation required to maintain action under Wrongful Death Act is defined to require showing of pecuniary loss ~byrelatives seeking damages as result of wrongful death of decedent; there must be occuniary loss by one in family relation.before there is any recovery in damages. Hodge v. Loveland, 690 A?d 243. 4~6 ?a:Super. 188, Super.1997, reargument denied,appeal denied 723 A.2d 672, 555 Pa. 701.. Occasiona'. gifts and services are not sufficient on which to ground 'a pecuniary loss. Gavdos,Supra; 301 PA at 530, 152 A- and ~ ~ 2. However as the proceeds in this matter are a minimal net of $80,290.25, this Off ce has no cbjection to the allocation that you have requested. Please be advised that, based upon these facts and for inheritance tax purposes only, this Department has no objection to the proposed allocation of the net proceeds of this action, $64,240.20 to the wrongful death claim and S 16,060.05 to the survival claim. Proceeds of a survival action are an asset included ir. the decedent'sestate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 19y5). 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 hearing regarding it. Please contact me if you or the Court has any questions or requires anything additional from this L-3ureau. $~fn erely, ~~ _. ; , - anrion E: Baker '(• Trust 'Valuation Specialist _ Inheritance Tax Drvisioli ~- - _ _ . Bureau of Individual Taxes ~ PO Box 280601 ~ Harrisburg, PA 17128 ~ 717.783.5824 ~ shabaker@state.pa.us REV-1511 =X+ (12-99) ~, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Dorothy L. Winn 21-09-0763 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. I 2. 3. I B ; ADMINISTRATIVE COSTS 1. ~ Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Pearls) Commission Paid: I 2 i Attorney Fees 3. I Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) i Claimant Street Address City State Relationship of Claimant to Decedent 4 Probate Fees 5 Accountant's Fees 6. Tax Return Preparer's Fees ~. Inheritance Tax Filing Fee ~. ~ Postage ~~. ~I Reserves Zip Zip TOTAL (Also enter on line 9, Recapitulation) I $ (It more space is needed, insert additional sheets of the same size) 1,800.00 30.00 300.00 15.00 10.00 1,000.00 3,155.00 REV-1513 =X~+ (1.1-08) Pennsylvania SCHEDULE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy L. Winn 21-09-0763 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.Z).] 1. ~ Gordon E. Winn son ~ 1/3 2. Renee Wewer daughter ~ 1 /3 3. Geofrey Cambell grandson 1/3 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 WHICN 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, $ If more space is needed, insert additional sheets of the same size. C OYNE & C OYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Li4a Marie Coyne Jaime L. High 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 www.coyneandcoyne.com June 23, 2010 Office of Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Dorothy L. Winn, Deceased No. 21-09-0763 Dear Sir or Madam: Enclosed please find the original and two (2) copies of the Second Supplemental Inheritance Tax Return for the above-referenced Estate related solely to litigation proceeds on a survival claim. Please docket the original and return to this office a "clocked-in" copy with the enclosed stamped envelope. A fifteen dollar ($15.00) filing fee is also enclosed for this Supplemental Inheritance Tax Return per check no. 105. Additionally, enclosed please find an estate check no. 104 in the amount of $580.73 as the inheritance tax return due per this Return. If you have any questions, please call me. Very truly yours, COYNE & COYNE, P.C. a Marie Coyne LMC/cmc Encls. n Cc: Renee J. Wewer, Co-Ext. _> ~ ~-- _?.' Gordon E. Winn, Co-Ext. -`' -z ~-~ ~~~ ~t_' _ ~- ~ _ r - _ ~ rn tU ~_~ ~ C~ -,-? ~~ C _.> _~ -~- - ~ : V r-fi , ~•:~ c -ri RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumbe=land County - Register Of Wills One Courthouse Square Carlisle, PA 17613 /~INN DOROTHY L Estate File No.: 2009-00763 Paid By Remarks: CORDON WINN ------------------------ Fee/Tax Description INH TAX RETURN Check# 105 Tota_ Received......... Receipt Date: 6/24/2011 Receipt Time: 11:18:56 Receipt No.: 1066072 Receipt Distribution -------------------- Payment Amount Payee Name 15.00 CUMBERLAND COUNTY GENERAL FUN ---------------- $15.00 $15.00 F" 5 ' ,tea . ~. r a ,:y~ .~ M-' ~~ t~l-. Q~ -.>, a r, , ''mow. ~. ' ~ ~. , .G" a-~ ~ ~~ ~ ~~~ C ? ~"-~_ -. ~T`t f ~ ~ ~._ r.r.. a ,Q ~^: 1 , v/ /Q ~! U n d ~wv ~ O ~ Z go c o ~ Q~r ~ }Y~ ~ V ~~' ~ Q J ~ Q ~ O W per= U o Z Boa 3'~~,d V M ~ ~ ~ o ~ U ~ ~ ~ c~UOCJ O