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Home My WebLink About08-22-11RE Ex c01-1o) 1505610143 V-1500 PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes DEPARTMENT OF REVENUE County Code Year PO 80X.280601 File Number Harrisburg, PA 17128-0601 INHERITANCE TAX RETURN 2 1 1 0 12 4 2 ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT Social Security Number Date of Death 1 5 0 12 4 g g g Date of Birth 12 11 2010 O1 05 1926 Decedent's Last Name K U C H A R Suffix Decedent's First Name. ROBERT MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death ^ 4. Limited Estate prior to 12-13-82) ^ qa, Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required ® g. Decedent Died Testate ~ Decedent Maintained a Livin Trust (Attach Copy of Will) ^ (Attach Copy of Trust) 9 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ^ 11. Election to tax under Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXAttach Sch. O) Name NFORMATION SHOULD BE DIRECTED TO: CRAIG A D I E H L ESQUIRE CPA "Daytime Telephone Number 717 763 7613 First line of address 3464 TRINDLE ROAD Second line of address City or Post Office CAMP HILL Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS REGISTER WILLS USE ONLY ~~ _ -• r - ~' ~ r0.., '+~ ~~ ~ ,,~.~_: ~ I ~ J ~ ./ .- -.. .-- ~~ LEp r:,,y State DAT ZIP Code -,-= ~~`~ PA 170114436 ~ ~~~ ~.:~ Correspondent's a-mail address: c d i e h l@ c a d i e h l l a w, c o m Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of m kno it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has an SIGN~U~ O~PEFjS~N RESPONSIBLE FOR FILING RETURN Y wledge and belief, ~~// // ~ y knowledge. ""-" ~~ Richard Kuchar ADDRESS 6426 Terrace Court, Harrisburg, PA 17111 IGNATURE OF PRFCeoro nrur., ~, ,. Z ~~ _ ~ -~ •••~ '~~~rRWtNIAIIVE Craig A Diehl E DA ADDRESS ~ squire CPA 3464 Trindle Road, Camp Hill, PA 170114436 Side 1 L 1505610143 1505610143 J C_~ 1505610243 REV-1500 EX Decedent's Social Security Number Decedents -vame: K U C H A R, ROBERT 1 5 0 12 4 9 8 9 RECAPITULATION 1. Real Estate (Schedule A) ................ ......................................................................... . 1. 2. Stocks and Bonds (Schedule B) .................................................. ............................. 2. 1. 7 5 8, 6 8 4 6 4 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, 7 6 9 , 2 2 2 . 2 2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .......... 6 ... 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property . (Schedule G) ^ Separate Billing Requested ............. 7• 8 4 7, 0 4 5. 3 1 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 3 , 3 7 4 , 9 5 2.17 9. Funeral Expenses & Administrative Costs (Schedule H) ....................... .................. 9. 1 0 6 , 4 0 4 . 7 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...............................,, 10. 1 8 , 5 8 2 12 11. Total Deductions (total Lines 9& 10) ............:................................ ......................... 11. 1 2 4, 9 8 6. 8 2 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12 3 , 2 4 9 , 9 6 5 . 3 5 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. 3 2 4 9 , 9 6 5 . 3 5 ~ 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 .00 15. 16. Amount of Line 14 taxable at linealrateX .045 3, 249, 965.35 16. 146, 248 44 17. Amount of Line 14 taxable . at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18 19. Tax Due ........................................................................ ............................................. 19. 146, 248.44 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 ~,~,~, 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: Kuchar, Robert STREET ADDRESS 6426 Terrace Ct. File Number 21 - 10 - 1242 cITY Harrisburg STATE ZIP ---- PA 17111 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 146,248.44 A. Prior Payments 110 , 0 0 0.0 0 B. Discount 5,789.47 Total Credits (A + B) (2) 115 , 7 8 9.4 7 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. c5) 30,458.97 Make Check Payable to: REGISTER OF WILLS, AGENT. ~. a k 15 ~.. !- ~ - ~ Y ~~~.I i .r I ~~1 ~r 5 ..1 k~l' ~{yp -~~~ ~ ; ~~ ~I - _ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN T HE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;....... Yes No ........................................................................... ^ a b. retain the right to designate who shall use the property transferred or its income :.................................... c. retain a reversionary interest; or........... payments, benefits or care~ .............................................................. ^ ^ d. receive the promise for life of either x ........ 2. If death occurred after December 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?......... x 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 Jul 1 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin spouse is 3 percent [72 P.S. 91 ~6 a 1.1 i g 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 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 discl assets and filing a tax reffurn are still applicable even if the surviving spouse is the only beneficiary. osure of 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 ears 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) (j.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)J. • 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) . A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w§ether by bloo~ or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Kuchar, RObert FILE NUMBER 21 - 10 - 1242 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF 1 T. Rowe Price -Tax-Free Short-Intermediate Fund DEATH Account #2785889570-9 5.56 51, 905.10 9335.449 shs 2 Verizon Acct #00013538964 34.04 30, 363.68 892 shs 3 Northrop Grumman Corp. Acct #00000226823 64.16 17,836.48 278 shs 4 Marathon Oil Corp. Acct #00001459481 35.15 20, 554.85 584.775284 shs 5 American Electric Power Acct #00000914665 35.64 8,186.88 229.710516 shs 6 Whirlpool Acct #00000729540 85.74 11,403.42 133 shs 7 Pfizer, Inc. Acct #00005612748 17.02 629.74 37 shs 8 Frontier Communications, Corp. Acct #00000347337 9.37 2, 005.18 214 shs TOTAL (Also enter on line 2, Recapitulation) 1,758,684.64 SCHEDULE B COMMUNWFJ-LTHOFPENNSYLVANw STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Kuchar, Robert FILE NUMBER 21-10-1242 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE. VALUE AT DATE OF 9 PacTiv Corporation DEATH 9,600.21 10 Exxon Mobil Corporation Acct #00006039821 72.18 156, 583.17 2169.342866 shs 11 Legacy Treasury Direct (see attached listing) 215,000.00 12 MGE, Energy, Inc. Acct #0000063624 42.18 10, 701.10 253.7007 shs 13 Duke Energy Acct #106172 17.59 18,327.23 851.9119 Plan shs 190 DRS shs 14 Valley National Bancorp Acct #0011278000 13.86 42,002.66 3030.495 shs 15 Bob Evans Farms, Inc. Acct #9000074658 34.28 13,643.44 398 shs 16 Dreyfus NJ Municipal Bond Fund -Class A Acct #0758-xxxx8020 12.36 98,431.23 7963.692 shs Page 2 of Schedule B COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS continued ESTATE OF Kuchar, Robert All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 17 Dreyfus NJ Municipal Money Market Fund Acct #0758-xxxx8020 11,992.750 shs 18 Copley Fund Acct #111680 305.798 shs 19 Federated Securities Corp. Acct #3758399 1581.0270 shs 20 Fidelity NJ Municipal Money Mkt Fund Acct #X43-624555 11, 985.61 shs 21 Vanguard PA Tax-Exempt Money Mkt Acct #0063-88044754305 12,723.920 shs 22 Vanguard PA LT Tax-Exempt Admiral Acct #0577-88044754305 9, 918.236 shs 23 Merrill Lynch Acct #5F3-78T18 24 DTE Energy Acct #3402045093 406 shs FILE NUMBER 21 - 10 - 1242 UNIT VALUE VALUE AT DATE OF DEATH 1.00 11, 992.75 44.03 ~ 13,464.29 8.98 ~ 14,197.62 1.00 ~ 11, 985.61 1.00 ~ 12, 723.92 10.82 ~ 107, 315.31 20, 762.95 46.32 18,805.92 Page 3 of Schedule B SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT CO nti n u ed ESTATE OF Kuchar, Robert All property jointly-owned with right of survi vorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 25 Great Northern Iron Ore Acct #4000077852 66 shs 26 Johnson Controls Acct #4000077852 939 shs 27 Moneygram Acct #3402045093 511 shs 28 Tenneco Acct#3700032049 309 shs 29 Viad Acct #4000077852 127 shs 30 Wells Fargo Acct #3402045093 352 shs 31 Fairpoint Communications 16 shs 32 McGraw Hill Acct#125094830811 39.50 shs FILE NUMBER 21 - 10 - 1242 UNIT VALUE VALUE AT DATE OF DEATH 150.00 9, 900.00 38.10 ~ 35, 775.90 2.68 ~ 1, 369.48 40.61 ~ 12, 548.49 26.96 ~ 3,423.92 30.49 ~ 10, 732.48 .03 0.48 36.10 1,425.95 Page 4 of Schedule B SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Kuchar, Robert I FILE NUMBER 21 - 10 - 1242 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM ' NUMBER DESCRIPTION 33 Public Service Enterprise Group Acct #125094830811 282.41 shs 34 Spectra Acct #125094830811 520 shs 35 Energy Arkansas Acct #125094830811 17 shs 36 U.S. Savings Bonds EE Bonds (See Attachment) UNIT VALUE VALUE AT DATE OF DEATH 31.37 8,859.20 24.90 ~ 12, 948.00 99.00 ~ 1,683.00 741, 595.00 Page 5 of Schedule B COMAAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Kuchar, Robert FILE NUMBER 21 - 10 - 1242 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joint) -owned ' survivorship must be disclosed on schedule F. Y with the right of ITEM NUMBER DESCRIPTION 1 United States Treasury - 2010 Federal Income Tax Refund 2 State of New Jersey - 2010 State Income Tax Refund 3 Hudson City Savings Bank Acct #5500001562 4 Hudson City Savings Bank Acct#5500618963 5 Hudson City Savings Bank Acct#5500619181 6 Hudson City Savings Bank Acct #5500619233 7 Hudson City Savings Bank Acct#5500619256 8 Hudson City Savings Bank Acct #5500619568 9 Hudson City Savings Bank Acct #5500619587 10 Metro Bank Acct #0833168537 11 JP Morgan Chase Bank, N.A. Checking Acct #xxx6768 TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 23,291.00 952.00 619.56 11,446.00 517.71 11,856.18 20,600.59 636.36 24,491.23 246, 878.28 252, 718.82 769,222.22 SCHEDULE E ,CASH, BANK DEPOSITS, & MISC. CO"MAONWEI+LTHOFPENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Kuchar, Robert FILE NUMBER 21 - 10 - 1242 Include the proceeds of litigation and the date the proceeds were received by the estate. All grope 'ointl -own survivorship must be disclosed on schedule F. rtY J Y ed with the right of ITEM NUMBER DESCRIPTION VALUE AT DATE OF 12 JP Morgan Chase Bank, N.A. DEATH Savings Acct #xxx2007 50,329.87 13 Bank of America Savings Acct #xxxx4223 36,185.19 14 Capital One Bank Certificate of Deposit #1244307257 20,927.42 15 Capital One Bank Certificate of Deposit #1242522971 10,455.50 16 Capital One Bank Certificate of Deposit #1241799563 30,958.41 17 Capital One Bank Certificate of Deposit #1243534156 1,006.17 18 Hennion & Walsh Acct #3760-8239 9,253.69 19 U SAA Acct #11238197 16,087.44 20 New Jersey Manufacturers Insurance Company -Insurance Refund 10.80 Page 2 of Schedule E COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Kuchar, Robert FILE NUMBER 21 - 10 - 1242 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY NUMBER InGude the name of the transferee, their relationship to decedent DATE OF DEATH ~~ OF EXCLUSION and the date of transfer. Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S TAXABLE VALUE INTEREST (IF APPLICABLE) 1 Hudson City Savings Bank -IRA Acct #50606 48, 846.76 100% 48, 846.76 2 Wachovia Bank Certificate of Deposit #xxx5552 11,191.29 100% 11,191.29 3 Wachovia Bank Certificate of Deposit #xxx9018 12,512.54 100% 12,512.54 4 Wachovia Bank Certificate of Deposit #xxx0397 12,012.13 100% 12,012.13 5 Metro Bank Trust Accounts 751,090.59 100% 751,090.59 6 Vanguard -IRA Short Term investment Grade Fund 11,392.00 100% 11,392.00 TOTAL (Also enter on line 7, Recapitulation) I 847,045.31 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H /~F~UN~EnR~A~LpDCPENSES & /yLJlYlllrk7 1 ~W 1 IYG ESTATE OF Kuchar, Robert FILE NUMBER 21 - 10 - 1242 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION A• 1 Neill Funeral Home -Transport Services B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Richard Kuchar AMOUNT 2,061.42 60,000.00 Street Address 6426 Terrace Court city Harrisburg state PA zip 17111 Year(s) Commission paid 2011 2. Attorney's Fees Law Offices of Craig A. Diehl 42,186.90 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 1 593.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal -Estate Advertisement 75.00 TOTAL (Also enter on line 9, Recapitulation) 106,404.70 Schedule H C COMMONWEALTH OF PENNSYLVANIA Funeral INHERITANCE TAX RETURN ~ll'n1n15~'abVe C06'lS COl'1~nued RESIDENT DECEDENT FILE NUMBER ESTATE OF Kuchar, Robert 21 - 10 - 1242 2 Sentinel -Estate Advertisement 198.16 3 Register of Wills -Additional Short Certificates 40.00 4 Richard Kuchar -Reimburse Postage/Overnight Charges 189.18 5 Law Offices of Craig A. Diehl -Reimbursement for Certified Mail Costs for DPW Letter 5.54 6 Law Offices of Craig A. Diehl -Reimbursement for Bank of America Research Fee 20.00 7 Register of Wills, Cumberland County -Filing Fee for Inheritance Tax Return 15.00 8 Register of Wills, Cumberland County -Filing Fee for Family Settlement 20.00 Agreement Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMOERTI nNCETnxRETURN~'~ LIABILITIES, & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF Kuchar, Robert 21 - 10 - 1242 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Messiah Village -Nursing Home Bill (November) 8,532.87 2 Alert Pharmacy Service -Pharmacy Bill 260.12 3 United States Treasury -Fourth Quarter Federal Estimated Tax Payment 6,505.00 4 Messiah Village -Final Nursing Home Bill (December -Partial) 2,940.41 5 Capital Area Health Associates -Physician Bill 268.72 6 Messiah Village -Transport Charge 75.00 TOTAL (Also enter on Line 10, Recapitulation) I 18,582.1.2 REV-1513 EX+ (11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Kuchar, Robert FILE NUMBER 21 - 10 - 1242 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not Llst Trustee(s) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Richard Kuchar Son 1/3 Residue 6426 Terrace Court Harrisburg, PA 17111 2 Ralph Kuchar Son 1/3 Residue 4310 Hogmire Road Avon, NY 14414 3 Karen Kuchar Daughter 1/3 Residue 2418 State Street, Apt. 9 Harrisburg, PA 17103 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00