HomeMy WebLinkAbout04-0820 COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~- Durff, Leroy A. 206 32 1030
Z --
UJ
/~1 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST SE FILED IN DUPLICATE WITH THE
LU 03-22-2004 10-08-1942 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Durff, Frances C.
UJ
SOCIAL SECURITY NUMBER
199. - 34 - 7738
E~l. Original Return
[~4. Limited Estate
[~]6, Decedent Died Testate (Altac, h copy ol W~ilt
r~9 Litigation Proceeds Received
~]2. Supplemental Return
[~4a. Future Intarest Compromise (da~e of death after 12-12-~2)
[~7, Decedent Maintained a Living Trust (AUa~h copy of Trust)
[~10, Spousal Poverty Credit (date of death between 12-31-91 a~d 1-1-9§)
NAME
Jerry A. Wetgle~ Esquire
FIRM NAME (~i~
~i~le & Associates~ P.C.
TELEPHONE NUMBER
717-532-7388
E~]5. Federal Estate Tax Return Required
__ 8. Total Number of Safe Deposit Boxes
E~l 1, Elec6en to tax under Sec. 9113(A) (AUach SCh O)
COMPLETEMAILINGADDRESS
126 East King Street
Shippensburg, PA 17257
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Scheduta E)
6. Jointly Owned Property (Schedule F) (6)
~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 13 ~ 6 9 8.03
10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11, Total Deductions (total Lines 9 & 10) (11)
12, Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
13,698.03
(13,698.03)
NONE - INSOLVENT
15.
SEE INSTRUCTIONS ON REVERSE SLOE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .o_ (15)
16. Amount of Line 14 taxable at lineal rate
x .0_ (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x ~15 (19)
19. Tax Due (19) mos!~
Deced~nt's Complete Address:
ISTREETADDRESS 194 Horsekiller Road
cIr,' Shippensbur~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spoesal Poverty Credit
B. Prior Payments
C. Discount
I STATE
PA I ziP 17257
3. Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE,
Make Check Payab/e to: REGISTER OF WILLS, AGENT
(3)
(4)
(5) NONE
(5A)
(5B) NONE
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; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
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? .............................................................................................................. [] []
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 THE RETURN.
Under penalties of perjury, I declare that I have examined this return, includMg accompanying schedules and statements, and ~o the best of my knowledge and belief, it is true, correct add cornpleth.
Declaration of preparer other than the personal representative is based on all [nforrnation of which preparer has any knowledge
.,j,,,,,,,,,,,,,,,,~GNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DA~
~/~/~''~2 (3',,/~-'L~' ~ Frances C. Durff
ADDRESS -- F r~
194 Horsekiller Road, Ship~ensburs, PA 17257
SiGN/~:UR~ OF PREPARER OTHER TH/~N REPJf, RSE~I]'ATJ~E DATE
~/~.,,~ ~ "" iA/~ Jerry A. Weigle '~ __"~ /,_.~Z./
. v,.I/ /
/weig~e & Assoct 6 Ea~st King Street, Ship~ensb~rg, PA 17257
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 3%
[72 'AS. {}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% [72 'AS, §9116 (a) (1.1) (ii)
The statute does not exemat a transfer o a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
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 paten
or a stepparent of the child is 0% [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%, except as noted in 72 'AS, {}9116(1.2) [72 ,AS. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenrs siblings is 12% [72 'AS. {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as
individual who has at least one parent in coramon with lhe decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INMERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Please Print or Type
FILE NUMBER
Leroy A. Durff
(All ~y jaintly-owned with the Rigkt of Survivorship must be disclosed on Schedule F)
iTEM
NUMBER DESCRIPTION
ALL ASSETS JOINTLY OWNED WITH SPOUSE.
TOTAL (Also enter on line 5, Recapitulation)
(Attach additional 8~' x 11' sheets if more space is needed.)
VALUE AT
DATE OF DEATH
~-,~,, ~ I~-,,I ~ SCHEDULE H
FUNERAL EXPENSES,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
iNHERITANCE TAX RETURN MISCELLANEOUS EXPENSES
RESIDENT DECEDENT Please Print or Type
ESTATE OF FILE NUMBER
Lero¥ A. Durff
ITEM
NUMBER DESCRIPTION AMOUNT
A. Funeral Expenses:
1. Fogelsanger-Bricker Funeral HOme 8,1 ! 2.32
2. Rehobeth Cemetery Association 400.00
3. Flowers 137.27
4. Thanks You notes postage 43.29
5. Use of church for reception 100.00
6. Luncheon reception 414.15
7. Memorial Stone 4,406.00
B. Administrative Costs:
1. Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
2. Attorney Fees Weigle & Associates, P.C. 75.00
3. Family Exemption
Claimant Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees
C. Miscellaneous Expenses:
1. Register of Wills, Cumberland County - filing Insolvent PA 10.00
Inheritance Tax Return
2.
3.
4.
5.
6.
7.
8.
TOTAL (Also enter on line 9, Recapitulation) $ 13,698.03
(If more space is needed, insert additional sheets of same size.)
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Leroy A. Durff
ITEM AMOUNT OR
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE
A. Taxable Bequests:
1. Not relevant as estate is insolvent.
ITEM AMOUNT OR
NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation)
(If more space is needed, insert additional sheets of same size)
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Off'ice for permanent filing.
Fee for this certificate, $2.00
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~'"'~cal ~.¢gistra'r
P 9913767
No.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL elEOORDS
CERTIFICATE OF DEATH
(Coroner)
A. Durff z. ~az~ "206-~-10~0 .. ~rch 22, 2~4
D~phin ~. ~ry ~. ~. Hershey ~ ~ter ~'~"~'"* ,0. white
Frances C. Durff
TIME OF DE,IH ] D~TE PRONOUNCED DF~kD !MoPlh, Dey ~eer}
2,. 11:37 a.~.l '~. March 22 2004
Gunshot: wound 'co h~ad
~,, 194 Horsekiller Rd., Shippensburq, PA 17257
~'"~ South Newton T6wnshtp
~. Rehobeth Cemetery ~.. Cumberland County, PA
I~ ~-~icker F.H. I~o., P.O. ~ 336, ~ PA ~7257
~ ..~ [2 Mar. 22, '04 9:59 a.m.
[] ,~a ~' [] "° [] [~ c0~.~,~,~ []~=~',~. ~°~farsek~_ller' Road
self-inflicted gunshot
wound to head
2004
S. Hetrick, Coroner
1271 S. 28thSt., Harrisburg, PA 17111
BUREAU OF ZNDTVZDUAL TAXES
TNHERTTANCE TAX DTVZSZON
PO BOX 180601
HARRISBURG, PA 17118-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-154? EX AFP
JERRY A WEIGLE ESQ
WEZGLE & ASSOCS
126 E KING ST
SHIPPENSBURG
PA 17257
DATE 11-15-2004
ESTATE OF DURFF
DATE OF DEATH 05-22-Z004
FILE NUHBER 21 04-0820
COUNTY CUHBERLAND
ACN 101
Amount Remitted I
LEROY A
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGTSTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~,~
REV-15&7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF DURFF LEROY A FILE NO. 21 04-0820 ACN 101 DATE 11-15-2004
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
4. Nortgagas/Notas Receivable (Schedule D) (4)
S. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funeral Expanses/Adm. Costs/Hisc. Expanses (Schedule H) (9)
10. Dabts/Hortgaga Liabilities/Liens (Schedule I) (10)
11. Tote1 Deductions
12. Nat Value of Tax Return
15.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Nat Value of Estate Subject to Tax
O0 NOTE: To insure proper
O0 credit to your account,
O0 submit the upper portion
of this form with your
tax payment.
O0
O0
O0
O0
(8)
15,698.05
.00
NOTE:
.00
1~ .198.05
15,698.
.00
15,698.
If an assessment was issued previously, 11nas 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
18 and 19 will
--RECEIP1
'~?NUHBER.
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
DISCOUNT (+)
INTEREST/PEN PAID (-)
ANOUNT PAID
TOTAL TAX CREDIT I
I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( IF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
TAX CREDITS:
PAYHENT
DATE
ASSESSHENT OF TAX:
15. Amount of Line lq at SpousaX rata (IS)
16. Amount of Line lq taxable at Lineal/Class A rata (16)
17. Amount of Line 14 mt Sibling rata (17)
18. Amount of Line 14 taxable at Collateral/Class B rata (18)
19. Principal Tax Due
· O0 x 00 = . O0
· 00 x 045= .00
· O0 x 12 = . O0
· O0 x 15 = .00
(19)= . O0
RESERVATIDN: Estates of decedents dying on or before December 1Z, 19aZ -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S.
Section 9140).
PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Hake check or money order payable to: REGZSTER OF N[LLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l~15). Applications ara available
online at www.ravenue.stete.~a.us, any Register of Wills or Revenue District Office, or from the Department's
Z4-hour answering service for fores orders: 1-8OO-)6Z-ZOBO; services for taxpayers with special hearing and/or
speaking needs: 1-BOO-447-50ZO (TT onlY).
OBJECTIONS: Any party in interest not satisfied with the appraiseent, allowance or disallowance of deductions or assessment of tax
(including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice
by filing Dna of the following:
A] Protest to the PA Department of Revenue~ Board of Appeals. You may object by filing a protest online at
www.boardofappeals.state.pa.us on or before the expiration of the sixty-daY appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box ZS10Zl, Harrisburg, PA 17128-1021. Petitions may not be foxed.
B) Election to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box ZB0601, Harrisburg, PA 171ZB-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (BX) discount of
the tax paid is allowed.
PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January l, 198Z will hear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are:
Interest
Interest Daily Interest Daily Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .O0054B ~"~)"~6-1991 IIX .000301 ~ 9X .OOOZ~7
1983 16Z .000438 1992 9Z .000247 ZOOZ 6Z .000164
1984 llZ .000301 1993-1994 7Z .O0019Z ZOO3 5Z .000137
1985 13Z .000356 1995-1998 9Z .000247 2004 42 .000110
1986 lOX .000274 1999 7X .00019Z
1987 102 .000274 ZOO0 72 .O0019Z
--Interest is calculated es follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELTNQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15] days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.