HomeMy WebLinkAbout07-08-11
1505607121
REV-1500 EX (os-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
Po Box zsosol INHERITANCE TAX RETURN 2 1 1 0 1 0 8 8
Harrisbum, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Binh
1 0 2 6 2 0 1 0 0 9 0 7 1 9 8 4
Decedent's Last Name Suffer Decedent's First Name MI
B o b b D a v i d 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
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
Q 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (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 0 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 CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
W a y n e F S h a d e 7 1 7 2 4 3 0 2 2 0
Firm Name (If Applicable)
REGISTE FF WILLS US~ILY
First line of address ~ ~ C
r.,. t..
5 3 W e s t P o m f r e t S t r e e t ~
Secondhneofaddress ~~~ '' `-~
C70~i ~" r', ~--,
OCR ~ ....+
City or Post Office State ZIP Code ~ FILED
,
C a r l i s l e P A 1 7 0 1 3 `'
Correspondent's a-mail address: waynefshade(a,comcast.net
Under penalties of perjury, I dedare that I have examined this return, Induding accompanyirg sdredules and statements, and to the best of m know
it is true correct and complete. Dedarelion of preperer other than the rsonal re Y ledge and belief,
pe presentative is based on all informati er has any knowledge.
SI UR F PE SON R€SPON BL OR FILING RETURN TE
A SS ~ ~~~~
153 Ri land Road Carlisle PA 17015
SIG T RE OF PREPA T}IA~REPRESENTATIVE
~~~ ~ / TE
ADDRESS/ r~~~(
53 West Pomfret Street Carlisle PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 10 1088
DECEDENTS NAME
David C. Bobb
STREET ADDRESS
153 Richland Road
Y
CIT
Carlisle STATE ZIP
PA 17015
Tax Paymenffi and Credits:
1• Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Diswunt
Total Credits (A + B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Total InteresUPenalty (D + E) (3)
Flit 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.
(5e> 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
'.' .k`~., sw s....
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; ..........
...................................................
........
^
O
b. retain the right to designate who shall use the property transferred or its income : ....................... ....
.. ^
: ^X
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 year of death
without receiving adequate consideration? ......................
. ........................................................ ^
....... X^
3. Did decedent own an'in trust for' or payable upon death bank acxount 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.
~~~t, ,.~~ ,, ,, ., ~, .
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)j.
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 (O) 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 ff 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 childtwenty-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 [/2 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)]. Asibling isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-15p8 EX + (8-98)
COMMONWEALTH OF PENNSYLVANW
INHERITANCE TA% RETURN
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
David C. Bobb 21 10 1088
Include the roceeds of litigation and the date the proceeds were received by the estate.
All properly ~ohrtly-owned with r1gM of survivorship must bs disclosed on Schedule F.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1 rretnaam .ClnO arrnnnt 1 I 7.
2. 2000 Pontiac Sunfire SE coupe, valued on the basis of the sale to an unrelated
third party
3. TDAmeritrade, account # 862064417
4• (Capital Blue Cross, health insurance premium refund
5. (Erie Insurance Group, refund of automobile insurance premium
1,000.00
2,491.50
193.00
31.00
TOTAL (Also enter on line 5 Recapitulation) I ;
(If nwre space a needed. insert addidonal streets of the same size)
URRSTQWN
Box
d Tit~rort of F,xciellenc~
Wayne F, Shade, Esq.
53 West Pomfret Street
Carlisle, PA 17013
Fax 249-0017
November 5, 2010
Re: Estate of David C. Bobb
Social Security Number 195-64-5369
Date of Death October 26, 2010
~ ~ FTF_AF.TtFtY CL~I2TIFIED THAT THE ABOVE NAMED DECEDENT HA.D THE
FOLLOWING ACCOUNTS WITH ORR,Sr1bYd~N BANK
CHECKING ACCOUNT
Account No. --
Account Type -
Date Opened -
Joint Account (mane/date) -
Balance -
Accrued Interest -
106005624
Reward Checking
8/5/10
None
$229.88
$.10
Best Regards,
Vicki I.. Gullixon
Customer Service Specialist
77 East Kin® Strool
P.O. t3aoc 25C
Shippcnsburg, PA 17257
1.8se.ORRSTOWN
www.orrstawrn.com
11/05/2010 11:13AH [Job No. 54147 f~j0001
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REV-1509 EX + (8-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE F
JOINTLY-OWNED PROPERTY
David C. Bobb FILE NUMBER
21 10 1088
M an asset was made john wRhin one year of the decedents dab of death, it must be reported on Schedub G.
SURVMNG JOINT TENANT(S) NAME ADDRESS
A. a v rame O ,,. .,.. .._
PA 17015
B Kathy Craine Bobb
c Kathy Craine Bobb
JOINTLY-OWNED PROPERTY:
153 Richland Road
Cazlisle, PA 17015
153 Richland Road
Carlisle, PA 17015
TO DECEDENT
LETTER DATE OESCPoFTION OF PROPERT
ITEM
NUMBER
FOR JOINT
TENANT
MADE
JOINT Y
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
DECD'S
INTEREST
D VAL~ DOEFATH
DECEDENTS IN
~
12/84 TEREST
. A. United States Savings Bond Series EE # 065204296 193.00 50. 96.50
2. B. 12/85 United States Savings Bond Series EE # 092265740 185.48 50. 92.74
3. C. 09/85 United States Savings Bond Series EE #L188006110 94.60 50. 47.30
4. ID. 109/86 (United States Savings Bond Series EE #L261874971 I 90.941 SO.I 45.47
TOTAL (Also enter on line 6, Regpitulation) I ;
nnn n.
IT RIDfe ~-~~..v a
apace is needed, insert additional sheets of the same size)
Calculated Value of Your Paper Savings Bond(s)
/" ' Page 1 of 1
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 10/3010
Total Price Total Value Total Interest
_$150.00 $56402 YTD Interest
$414.02 e., . ~.,
Bonds: i-4 of 4
aeria~ at Series Denom +ssue Next Final
C65204296EE EE
C92265740EE EE
L188006110EE EE
L261874971EE EE
Date Accrual Maturity
$100 12/1984 12/2010 12/2014
$100 12/1985 12/2010 12/2015
$50 09/1985.03/2011.09/2015
$50 09/1986 03/2011 09/2016
Totals for 4 Benda
Notes
NI Not Issued
NE Not eligible for payment
P5 Includes 3 month interest penalty
MA .Matured and not earnin interest
http://www.treasurYdirect.gov/BC/SBCPrice
Issue Interest Interest
Price Rate Value
$50.00 $143.00 4.00% $193.00
$50.00 $135.48 4.00% $185.48
$25.00 $69.60 4.00% $94.60.
$25.00 $65.94 4.00% $90.94
L50.OO 6414.02 tcaw n,
11 /8/2010
REV-1511 EX+(10-OB)
Ct)MMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
C.
SCHEDULE H
FUNERAL EXPENSES S
ADMINISTRATIVE COSTS
71 In inoo
Ostler of decedent must be reported on schedule I.
ITEM
NUMBER
A
DESCRIPTION
•
~. FUNERAL EXPENSES:
Auer Cremation Services of Pennsylvania
Inc
2•
3• ,
.
Osiris Holding of Pennsylvania, Inc., grave opening and mazker
Kathy's Deli, LLC, funeral food
4•
5• Cumberland County Historical Society, Two Mile House
Robert Marsh, pastor
6•
7 George's Flowers, funeral flowers
•
8• Carlisle Special Police, security
Supplies
B• ADMINISTRATIVE COSTS;
~ • Personal Representative's Commissions
Name of personal Representative (s)
Street Address
City
State Zip
Year(s) Commission Paid:
2. Attorney Fees Wayne F. Shade, Esquire
3. Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation)
Claimant Kathy Craine Bobh
Street Address 153 Richland Road
city Carlisle say PA 17015
Relationship of claimant to Decedent Mother Zrp
4• Probate Fees Register of Wills of Cumberland County, PA
5• Accountant's Fees Smith Elliott Kearns, 2010 income tax returns
6• Tax Return Preparers Fees
~• Cumberland Law Journal, advertise Letters Testamentary
8• The Sentinel, advertise Letters Testamentary
9• Register of Wills, filing inheritance tax return
TOTAL (Also enter on line 9. Raranin~lntr~„i
(If more space is needed. insert additional sheets of the same size)
AMOUNT
2,076.31
3,000.01
1,175.96
350.00
200.00
190.80
125.00
31.87
750.00
3,500.00
83.50
250.00
75.00
198.16
15.00
i
1