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HomeMy WebLinkAbout09-06-111505610143 REV-1500 Ex(°'_'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2aosol INHERITANCE TAX RETURN 21 11 0067 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 721 18 4828 12 07 2010 06 22 1913 Decedent's Last Name LYNCH Suffix Decedent's First Name MARY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Return 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) X^ 8 Decedent Died Testate (Attach Copy of Will) ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal PovertyY Credit (dale ~f death between 12-31 51 and T-1-95 3, Remainder Return (date of death MI L MI prlorto 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11,Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDWARD P SEEBER 717 533n3280 ~:.- -~~ First line of address SUITE C400 Second line of address 555 GETTYSBURG PIKE City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's a-mail address: ePSt'O7jSdC.COnI rCJ r -~, REGISTER OFypr~S-RISE ONtLY ~ _~_ Zr rn I -' c:n -, < - --f • i cry DATE FILED ~-, i ~' ~_; c° :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. SICiNAIUKt Uh YtKJVN Kt JYUNJItiLt YVK hILI N(.U Kt1UKN VAIC .,-~CL; c~~ ~7. ~' G-~~ , . ~i~C_ Sarah M. Lynch ~I ~ ~/ l ADDRESS SIGN URE EPARER OTHER THAN REPRESENTATIVE DATE ~`~-----'~~- Edward P Seeber ~~~, ~ ~ j Suite C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 Side 1 1505610143 1505610143 J REV-1500 EX Decedent's Social Security Number oeceeenrsName: Lynch, Mary LOUiSe 721 18 4828 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. 2 3 , 912.2 9 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 17 , 921.53 7. Inter-Vivos Transfers 8. Miscellaneous N ,nq Probate Property (Schedule G) ^ Separate Billing Requested............ 7. 3 , 680.00 8. Total Gross Assets (total Lines 1-7) ................................................................... .. 8. 45 , 513.82 9. Funeral Expenses & Administrative Costs (Schedule H) ............................... ........ 9. 2 6 , 02 6.52 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 10. 2 , 901.8 9 11. Total Deductions (total Lines 9 & 10) ........................................................... ........ 11. 2 8 , 92 8.41 12. Net Value of Estate (L.ine 8 minus Line 11) .................................................. ........ 12. 16 , 585.41 13. Charitable and Governmental BequestslSec 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. 16 , 585.41 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 16 5 8 5.41 16. at lineal rate X .045 , 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ................................................... .............................................................. . 19. 1505610243 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 1505610243 Side 2 1505610243 0.00 746.34 0.00 0.00 746.34 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0067 DECEDENT'S NAME Lynch, Mary Louise STREET ADDRESS 3821 Leyland Drive CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 757.23 37.32 (1) 746.34 794.55 48.21 Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box 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. (5) 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 :............................................................................... ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................. ^ 0 c. retain a reversionary interest; or .............................................................................................................. ^ ^x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 0 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? .................................................................................................. ^ ^ ............ x 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 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 fa) (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 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 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 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-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY COMMONW EALTH OF PENNSVLVANI/\ INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Lynch, Mary Louise 21-11-0067 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Miscellaneous personal property -valued per Executrix 500.00 2 Estate of Alice M. Anderson - 2.5% residuary interest valued per amount received 22,681.39 3 PA Department of Revenue - 2010 individual income tax refund 440.00 4 United American Insurance Company -refund of insurance premium 237.94 5 MONY Policy No. SL80277A -beneficiary is the Estate; valued per check received 52.96 TOTAL (Also enter on Line 5, Recapitulation) I 23,912.29 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Lynch, Mary Louise 21-11-0067 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Sarah M Lynch B. C 3821 Leyland Drive Daughter Mechanicsburg, PA 17050 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY 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 ASSE % OF INTERD ST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 12/29/1981 Bank of America Checking Account No. 0005 12,262.10 50.000% 6,131.05 0408 6771 -valued per bank letter dated 4125111 2 A 02/01/1971 Bank of America Checking Account No. 0010 6,288.00 50.000% 3,144.00 0651 7376 -valued per letter dated 4125/11 3 A 1 2131 /1 997 BlackRock High Yield Bond Inv A held in 13,251.54 50.000% 6,625.77 Merrill Lynch Account No. 898-66583 -valued per public listing & letter dated 3/24/11 4 A 12!31/1997 Cash held in Merrill Lynch Account No. 898 258.61 50.000% 129.31 -66583 -valued per letter dated 3/24111 5 A 12/31/1997 Delaware High Yield Opportunities A held in 3,782.79 50.000% 1,891.40 Merrill Lynch Account No. 898-66583 -valued per public listing & letter dated 3124111 TOTAL (Also enter on Line 6, Recapitulation) I 17,921.53 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 E7(+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Lynch, Mary Louise 21-11-0067 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSERSATfACN A CO Y OF T~E DEED FOR REAEESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Toale Brothers -prepaid funeral account 3,680.00 100.000% 0.00 3,680.00 TOTAL (Also enter on Line 7, Recapitulation) I 3,680.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 Ex+t10-06) EE EETT C~I INH RI A E T T RN COMMORESIDENT DEC DEN~YLVANIA SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Lynch, Mary Louise 21-11-0067 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N M R q, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 17, 225.34 Street Address City State Zip Year(sl Commission Daid 2. Attorney's Fees James, Smith, Dietterick 8 Connelly, LLP 4,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Street Address City State Zia Relationship of Claimant to Decedent 4. Probate Fees 137.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,163.68 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 26,026.52 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Lynch, Mary Louise 21-11-0067 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Good Shepherd Church -honorarium 300.00 2 Manasota Memorial Park -funeral services -opening & closing of grave 1,520.00 3 Miscellaneous travel expenses for Executrix to attend Florida funeral services 1,842.69 4 Neill Funeral Home -funeral services in PA 8,184.68 5 Sarasota Paper -obituary publication 382.16 6 St. Mary Star of the Sea -honorarium 250.00 7 Toale Brothers -funeral services in Florida 4,080.00 8 West Shore Country Club -funeral reception in Pennsylvania 665.81 H-A 17,225.34 Other Administrative Costs 9 James, Smith, Dietterick 8 Connelly, LLP -reservation for estate administration closing 250.00 10 Jean Burns -cleaning services 60.00 11 Register of Wills, Cumberland County -filing fee for Return & Inventory 30.00 12 Register of Wills, Cumberland County -short certificate 8.00 13 Sarah M. Lynch -reimbursement for mileage 815.68 H-B7 1,163.68 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER L nch, Ma Louise 21-11-0067 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 AAA Financial Services -credit card 86.94 2 Griswold Special Care - unreimbursed homecare services 817.30 3 Janet Sweitzer -caregiver 126.87 4 JoAnn Talginiti -caregiver 111.62 5 Lisa Saksek -caregiver 47.00 6 Mechanicsburg Area Meals on Wheels -meal services 77.00 7 Sarah M. Lynch -reimbursement for 2010 purchases 1,340.03 8 Sarah M. Lynch DMD - unreimbursed dental bill 189.38 9 Sue Sohn -caregiver 105.75 TOTAL (Also enter on Line 10, Recapitulation) I 2,901.89 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-0e) SCHEDULE J COMMNHNRIEDENTEDEC DEN~RNANIA BENEFICIARIES ESTATE OF I FILE NUMBER Lynch, Mary Louise 21-11-0067 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 1 Sarah M. Lynch Daughter Residue 8~ joint 16,585.41 3821 Leyland Drive accounts Mechanicsburg, PA 17050 Total 16,585.41 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. 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 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)