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HomeMy WebLinkAbout10-31-11--~ REV-1500 Ex (01-10) ~ 1505610143 PA Department of Revenue y OFFICIAL USE ONLY Penns Ivania Bureau of Individual Taxes OEVARTMENTOFREVENUE County Code YBar File Number PO BOX.280601 INHERITANCE TAX RETURN 2 1 1 1 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ~ ~ ~ (P ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204 28 2475 02 04 2011 11 17 1912 Decedent's Last Name Suffix SPENCER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required ^ g, Decedent Died Testate ~ Decedent Maintained a Living Trust 0 (Attach Copy of WII) ^ (Attach Copy oT Trust) 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (date of death between 12-31-91 end 1-1-95) ^ 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 HAMILTON C D A V I S Daytime Telephone Number 717 532 5713 First line of address 20 EAST BURD STREET Second line of address SUITE 6 City or Post Office SHIPPENSBURG State ZIP Code PA 17257 REGISTER QF~IVILLS USEILY ~'~ ~ ~I _ ~ ~ '_ -a ~ . ~~ ~ - r~ ,-~ 3 1 -- , O ~:i )'rt DATLED ~~ -> C,.:r -~~ 1 ,, ., i,..r =r; Correspondent'se-mailaddress: hdavis@Zullinger-DaViS.cOm Under penalties of perjury, I decla that I have examined this return, inGuding accompanying schedules and statements, and to the best of m knowled a and belief, it is true, correct arJc(corrplete~ De~aration yf preparer other than the Y g personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF P N E SIBLGno r iun f-.~~~ 1l DOUGLAS L SPENCER ADDRESS ~~~ 107 S SIGNATUF SLY DRIVE, MECHANICSBURG, PA 17055 DACOe oco nru~e r. _ _ _ Decedent's First Name MI GERTRUDE M Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS Hamilton C Davis DATE 20 East Burd Street, Shippensburg, PA 17257 Side 1 L 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: SPENCER, GERTRUDE M. 2 0 4 2 8 2 4 7 5 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5. 1 , 3 7 1 . 4 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ 7. Inter-Vivos Transfers & Miscella . g, 2 7 , 3 1 1 . 9 4 neous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............ . 7. 58,612.00 8. Total Gross Assets (total Lines 1-7) ........ ............................................................... g. 8 7, 2 9 5. 3 9 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... g, 3 , 2 7 5 . 0 9 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................ 10. 1,138.76 11. Total Deductions (total Lines 9 & 10) .... .................................................................. 11. 4,413.85 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 13. Charitable and Governmental Bequests/S 91 12. 8 2 ' 8 8 1 5 4 ec 13 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) .......................... ....................... TAX COMPUTATION 14. 8 2, 8 8 1. 5 4 -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 16. Amount of Line 14 taxable 15. at lineal rate X .045 8 2, 8 8 1. 5 4 17. Amount of Line 14 taxable 16 3, 7 2 9. 6 7 at sibling rate X .12 18. Amount of Line 14 taxable 17. at collateral rate X .15 18. 19. Tax Due ........................ ............................................................................................. 19. 3, 7 2 9. 6 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 11 SPENCER, GERTRUDE M. 107 BROLLY DRIVE MECHANICSBURG STATE ZIP PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 3,729.67 A• Prior Payments B. Discount Total Credits (A + g) (2) 0.00 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) 3,729.67 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: a. retain the use or income of the property transferred :............... Yes No .......................... b. retain the right to designate who shall use the property transferred or its income :.................................. ~ O c. retain a reversionary interest; or ................................. x 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 x 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 AS PART OF THLJE 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 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 feast one parent in common with the decedent, w&ether by bloo~ or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMdDNwEA~TN OF aENNSnvANw PERSONAL PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPENCER, GERTRUDE M. FILE NUMBER 21-11 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 NUMBER DESCRIPTION VALUE AT DATE OF 1 RENT REFUND DEATH 489.00 2 COMCAST REFUND 2.14 3 HAAR'S AUCTION - PROCEEDS FROM CONTENTS OF APARTMENT 534.05 4 PENSION REFUND 284.26 5 ERIE INSURANCE REFUND 62.00 TOTAL (Also enter on Llne 5, Recapitulation) 1,371.45 COMMONWEALTH OF PENNSYLVANIA SCHEDULE F INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT CCTwrr •.~ -~..~.~ yr SPENCER, GERTRUDE M. I FILE NUMBER 21-11 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 DOUGLAS L. SPENCER 107 SHOLLY DRIVE A MECHANICSBURG, PA 17055 Son ~~~~. ~ ~ r vvvrvtu F'FZ~PERTY: ITEM LETTER DATE NUMBER FOR JOINT MADE TENANT JOINT 1 A TATet iw~__ __.__ DATE OF DEATH VALUE OF DECEf]FNT'.C IAITCO ~cr 24, 994.19 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPENCER, GERTRUDE M. This crhe.l..r...r FILE NUMBER 21 - 11 ----_ •••~°• ~~ wrr~p~ezea 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 and the date of transfer. Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE 1 SOLOMON SMITH BARNEY TOD ACCOUNT, INTEREST (~FAPPLICABLE) PAYABLE TO CHILDREN AS NAMED sa,s~2.oo 58,612.00 BENEFICIARIES INTER-VIVOST RANSFERS & MISC. NON-PROBATE PROPERTY TOTAL (Also enter on line 7, Recapitulation) 58,612.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPENCER, GERTRUDE M. ~UI.E H er~T-p~Tw /E~I~ES ~ ^~•~~ 11Vi I IYC ~~ Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION A• 1 TOLL GATE RESTAURANT -FUNERAL RECEPTION 2 PASTOR AND MUSIC FOR FUNERAL FILE NUMBER _ 21-11 AMOUNT 720.09 400.00 B• ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2• Attorney's Fees HAMILTON C. DAVIS, ESQUIRE 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 5. Accountant's Fees CRYSTAL RACKETY 6• Tax Return PreparePs Fees 7. Other Administrative Costs 1 TOTAL (Also enter on line 9, Recapitulation) 1, 975.00 180.00 3.271; no SCHEDULEI DEBTS OF DECEDENT, MORTGAGE C~NWEALTH OF PENNSYLVANIA LIABILITIES, ~ LIENS INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SPENCER, GERTRUDE M. FILE NUMBER 21 - 11 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 PPL AMOUNT 186.95 2 STORAGE DEPOT 291.50 3 HOLY SPIRIT - DEDUCTABLE 85.00 4 WEST SHORE EMS 229.51 5 2010 IRS -UNITED STATES TREASURY -TAX LIABILITY 336.00 6 BARRY HECKARD, TAX COLLECTOR 9.80 TOTAL (Also enter on Line 10, Recapitulation) 1,138.76 REV-1819 EX+ (11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES SPENCER, GERTRUDE M. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 DOUGLAS L. SPENCER 107 BROLLY DRIVE MECHANICSBURG, PA 17055 2 SARAH S. BECK P.O. BOX 2504 SAG HARBOR, NY 11963 3 JUDITH S. BILLOW 160 BILLOW LANE MILLERSBURG, PA 17061 I FILE NUMBER 21-11 RELATIONSHIP TO SHARE OF ESTATE DECEDENT (Words) AMOUNT OF ESTATE Do Not Llst Trustee(s) ($$$) Son 1/3 OF SALOMON, SMITH BARNEY 24,269.54 TOD ACCOUNT Daughter 1/3 OF SALOMON, SMITH BARNEY TOD ACCOUNT Daughter 1/3 OF SALOMON, SMITH BARNEY TOD ACCOUNT Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 coverlsheet, as appropriate. II. 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 For ~~ P.riod 07/20/2011 to 02/10/2011 ~_.. ,. 001068 GERTRUDE M SPENCER Df1UGLAS L SPENCER 107 BROLLY Di? MECHANICSBURG PA 17055-5842 Primary account number: b0-0395-5155 Page 1 of 4 Numtier of enclosurdse0 ........ • ' For3~4-hourbaniting;"ar1!d•traltsactionor intt3~r't~ r'att~ informatta~n si+~n'o~h'to ' . PNC•B~~rikt3nline Banking atpnc:com. •~" Po~'+~U~tcs'me'r s~rrvice cail 1-888=PNC=BANK Mi~irlday = Friday: 7 AM - 10 PM'ET Saturday: & Sunday: a AM - 5. PM. ET Para servicio en espaPiol, 1-866-HOLA-PNC MoringT ,Please contact 41;s.,at 1-888-PNC-BANK.., ----~~-.: _ ~ Write=to:Cust -~-.---~_..__._~.. ...1,n„r.:; Omer Service Pittsburgh PA 15230-9738 ~~~ . ,~, ~ s~v~... y Visit us at pnc.com ,. ; ,,,, , ~•,,. , .,.~, , .....,.. .;`•'~"d~'terminaL• 9-edo 531-1~'~"8..;.,.... .. . . „ 144Faa~hbat`"hif~isiY~ede'Ti~ita~"oily Qescriptlon Interest Checking ~ . ;.~... .. Performance Monep Market Tote11)ets ......:..... ..... .~ Account Number - 500395.5355 50.0448-2786 Deposit Balance.. 4;634.50 ...49;988:37. , 5~ 622 87 -' , . ,. ..v.avr rrpl~if PIED .... . ~. ~D~S>t ~ti ~~~ ~~ ~ ~g ~C~~t ~iA1M8iry A Gertrude ~M Spencer Do l ccount number, 5Q-0395-5.155 ug as L Spencer Overdraft Protection P,roxided. By: XX)C)(~(2786 Ralanc~" Sumter . . Be~Fnninp balance Deposits and otheraddltlons Checks and other dedulogi: Ending 4,862.14 ~_:..~~_ ...____ ,.._~._ .. _. _ 20845 . 1 936 09 batanca. ,. . . -._ , . 4,684.50 .. Averape~rhtsrltfi iY . ,.,. .. ~lian~~~.. - _ ,, ransaclion Sum ~~'Y ,. 4,940.80 '~ Checks paid/ withdrawals Check Card POS signed transactions Check Card/Bankcard POS PIN transactions 3 1 0. . Total ATM transactions PNC Bank ATM transactions Other Bank ATM transactions ' ; ... 0 0 0 s~~st..$4nitit~taS.r , :. Annual Pereerdaye Yfeid Earned (APYE) Number or d in interest rod Re J 1 Average collected Intaresf Paid As of 02/16, a total of $AT in interest was paid this year. O.OlY balance forAPYE this peryod . 28 4,940.80 .04 PNDMLT01-JOB69969-N40-NNNNNN-002-001829 g Statement For 24hour information, sign on to PNC Bank Online Bankin ®~I V~~~~ 1~ on pnc:com, g FOf tlN (iwriod 01/20/Z011 to 0?J1s/Z011 GERTRUDE M SPENCER Account number; 50-0443-2786 -continued Primary account number: 50-0395-5155 AntlYit~ DOtai~ . Page 3 of 4 ..W....,. _. _. _ ..~.._ Deposits and ~ _........ Other Additions ... .. . Date ......... . ... _,... . ,..._..,.............,.,..__.......,., ..., ..... amount Description There was:1 Deposit or.OfherAddition 02/16 7.75 Interest Payment totaling x7.75. Ohl Balance Dsira:~ Date Balance 01/20 49,980.62 Date Balance 02/16 49,988.37 DhIf1~I1 Tnw Innnnnrn ~Iww •~~~. ~. ~. ~.~ ...........~~~ ~J ~~ v TOD1Designation of Beneficiary(iesj SALOMONSMTTHBiAR1LVE'Y aooount Number Ind, no~unt r tc Fc Amemberotclttgreu~?' The Account Owner(s) whose signawre(s) appears hereon, hereby designates transfer on death (TOD) benefiCiary(ies) for the Salomon Smith Bamey Inc. accamt currently carried under the account number stated above, This TOD Beneficiary Designation re+rokes all prior TOD Beneficiary Designations made in relation to this account. This TOD Beneficiary Designation Form is a part of the Transfer on Death Agreement executed by Account Owner(s) and by this reference is specifipliy incorporated into said Agreement. A percentage must be entered for each beneficiary named, and the total MUST equal 10096. ~[ ^ r i ~ Slate 21P Code tf arry eerttficrary listed above is not Imng at the death of the Last survtving Account Owner, that 8eneficiiary's share shall revel to the Mate of the asst surviving Account owner. V a sole Ibcotlnt Owra Is married. aM the spouse is rat designated as ifte sole beneficiary, the spouse must mist sign the following coruent ai theprasenre d a Alotaryiwdfk: cONSE1rt1' OF SPOl15E: Being tlw Aonoutt Oemer's spouse, t Isoreby consent ro the above designation, and release any s-aoutory a other tnberest I may have in the AaoraN. ttitrSnrousN Ca~eeertmwtbe afpaadbrsaapmsroa asAbrarr q~bNc. signed itr ntypre~naB this Spouses Signature O~ - ~P ~ 199 Note Public STOP HERE! This document must be signed ~~ Gfie presence of a Notary Public. Prim Name of arxa, Ow->ar der ~ucle 1~. Print Namo or Aaeun nWner NOTARlAt. 8EAL .LAMES E. aREEM. 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