HomeMy WebLinkAbout01-24-12--~ REV-1500 Ex (01-10) u- 1505610143
PA De artment of Revenue ~A OFFICIAL USE ONLY
P pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 80X.280601 INHERITANCE TAX RETURN 2 1 1 1 0 0 3 7 5
Harrisburg, PA 17128-t)601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
199 34 7688 03 04 2011 12 04 1943
Decedent's Last Name
KUHNS
(If Applicable) Enter Surviving Spouse's Information Below
Suffix Decedent's First Name
JAMES
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
MI
B
MI
® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise
(dale of death after 12-12-82) ^ 5. Federal Estate Tax Return Re uired
4
0
^ g Decedent Died Testate ^
(Attach Copy of WII) ~ Decedent Maintained a Living Trust
(Attach Copy of Trust) 8. Total Number of Safe De
p°Slt BOX2S
^ 9. Litigation Proceeds Received ^ 10. 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 DIRECTE
Name D TO:
HAMILTON C DAVIS Daytime Telephone Number
717 532 5713
ra
REGISTER OF USE O~L11'
First line of address x
20 EAST BURD STREET ~ '~
Second line of address ~~ .
SUITE 6 --~
~
_ ~
City or Post Office State
ZIP Code DATE FILED ~.
SHIPPENSBURG PA 17257
Correspondent'se-mail address: hdaVlS@ZUllinger-DaVIS.COm
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 prepargr has any knowledge.
JILL I. KUHNS
467 OAK FLAT ROAD. NEWVILLE. PA 17241
OTHER THAN REPRESENTATIVE
r
Hamilton C Davis
ADDRESS ._~
20 East Burd Street, Shippensburg, PA 17257
Side 1
1505610143
1505610143 J
ADDITIONAL Personal Representatives
KUHNS, JAMES B. SS# 199-34-7688.` 3/4/2011
Under penalties of perjury, the undersigned declare that they have examined this return,
including accompanying schedules and statements, and to the best of their knowledge and
belief, it is true, correct and complete.
2 Signature
Name
Address
City, State, Zip SHIPP NSBURG PA 17257
Date
3 Signature
Name
Address
City, State, Zip
Date
4 Signature
Name
Address:
City, State, Zip
Date
5 Signature
Name
Address:
City, State, Zip
Date
6 Signature
Name
Address:
City, State, Zip
Date
151 GOODHART ROAD
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedents name: K U H N S, JAMES B. 19 9 3 4 7 6 8 8
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)
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .............
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .............
8. Total Gross Assets (total Lines 1-7) .......................................................................
27,774.26
5.
6 58,872.25
7 438,082.00
$ 524,728.51
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
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 made (Schedule J) ................................................. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... .. 14.
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 .o0 5 19 , 4 6 9 5 1 15.
16. Amount of Line 14 taxable
at lineal rate X .045 16.
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.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
5,259.00
5,259.00
519,469.51
519,469.51
0.00
0.00
Side 2
1505610243 150561243
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 11 - 00375
DECEDENT'S NAME
KUHNS, JAMES B.
STREET ADDRESS
304 NEALY ROAD
CITY
NEWVILLE STATE
PA ZIP
17241
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A• Prior Payments
B. Discount
3. Interest
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Total Credits (A + B)
(1) 0.00
(2) 0.00
(3) 0.00
(4)
(5> 0.00
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 :.................................................................................. ^
b. retain the right to designate who shall use the property transferred or its income :.................................... n
c. retain a reversionary interest; or .................................................................................................................. r~~-1 ^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
receiving adequate consideration? ............................................................................................. ^ ^
.......................... x
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? ...................................................................................................................... ^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. §9196 (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 refturn 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 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) (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. 69116 (a) (1.3)1. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether y blood or adoption.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.'
COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF KUHNS, JAMES B. 21 - 11 - 00375
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 ORRSTOWN BANK STATEMENT SAVINGS ACCOUNT NO. 787132 (SEE ATTACHED 16,131.11
VALUATION)
2 ACCRUED INTEREST ON 1 4.18
3 I MEMBERS 1ST FEDERAL CREDIT UNION SAVINGS ACCOUNT NO. 138903-00 (SEE
ATTACHED VALUATION)
4 I MEMBERS 1ST FEDERAL CREDIT UNION SAVINGS ACCOUNT NO. 138903-05 (SEE
ATTACHED VALUATION)
4,831.61
6,807.36
TOTAL (Also enter on Line 5, Recapitulation) ~ 27,774.26
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF KUHNS, JAMES B. FILE NUMBER
21 - 11 - 00375
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
KAY I. KUHNS 304 NEALY ROAD Spouse
q NEWVILLE, PA 17241
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT L~FfSCRIPT.l0~11t C~F PRO~ERTY
Include name o Inanaal Ins I u Ion an bank account numbe
or similar identifying number. Attach deed for jointly-held real
estate.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1 A More than 1 304 NEALY ROAD, N. NEWTON TOWNSHIP, s5,ooo.o0 50% 32,500.00
year CUMBERLAND COUNTY, NEWVILLE, PA
17241
2 A More than 1 PNC CHECKING ACCOUNT NO. 22,468.37 50% 11,234.19
year 51-4040-9695
3 A More than 1 PNC SAVINGS ACCOUNT NO. 51-3034-4111 s,s7s.25 50% 4,839.13
year
4 A More than 1 PNC INVESTMENTS, ACCOUNT NO. 20,597.85 50% 10,298.93
year 004-745278
TOTAL (Also enter on line 6, Recapitulation) 58,872.25
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF KUHNS, JAMES B.
FILE NUMBER
21 - 11 - 00375
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
InGude the name of the transferee, their relationship to decedent
and the date of transfer. Attach a copy of the deed for real estate. DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
1 PACIFIC LIFE ANNUITY CONTRACT NO. 311,5os.s2 100% 311,506.62
VR04047532, PASSING TO SURVIVING SPOUSE,
KAY I. KUHNS, AS NAMED BENEFICIARY
2 JOHN HANCOCK LIFE INSURANCE COMPANY, 126,575.38 100% 126,575.38
ANNUITY CONTRACT NO. 2673583, PASSING TO
SURVIVING SPOUSE, KAY I. KUHNS, AS NAMED
BENEFICIARY
TOTAL (Also enter on line 7, Recapitulation) 438,082.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
~ F ryU ~ I ~ ~~ p R ~ + A~ LpD (APE ~ N S ^ES - ~& +
FILJIYI~I V1~7 1 f W I I V G CW 1 ~7
FILE NUMBER
ESTATE OF KUHNS, JAMES B. 21 - 11 - 00375
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER FUNERAL EXPENSES:
A. 1 PRE-PAID
B. ADMINISTRATIVE COSTS:
~. 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 5,000.00
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 CUMBERLAND COUNTY REGISTER OF WILLS 82.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 CUMBERLAND COUNTY LEGAL JOURNAL 75.00
TOTAL (Also enter on line 9, Recapitulation) 5,259.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
Funeral E~cnses &
Adminis6ative Costs continued
FILE NUMBER
ESTATE OF KUHNS, JAMES B. 21 - 11 - 00375
2 I THE NEWS CHRONICLE
101.50
Page 2 of Schedule H
REV-181 FX+ (11-08) a ~' a
SCHEDULE)
COMMNHERTA CE TAXRETURNANIA BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF KUHNS, JAMES B. FILE NUMBER
21 - 11 - 00375
NUMBER RELATIONSHIP TO
NAME AND ADDRESS OF PERSON(S) ~ DECEDENT
R SHARE OF ESTATE
(Woros) AMOUNT OF ESTATE
($$$)
ECEIVING PROPERTY I Do Not lJSt Trwtes(s)
I~ TAXABLE DISTRIBUTIONS [inGude outright spousal
distributions and transfers
under Sec. X116 (a) (1.2)]
1 KAY I. KUHNS ~ Spouse RESIDUE 519
469
5
304 NEALY ROAD ; ,
.
NEWVILLE, PA 17241
i
i
i
3
1
i
I
I
~ 7
I
I
J
I
{k
3
i
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover
eet, 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
v~sTOwly
Ba~vx
A Tradition of Lxcelle~rce
November 3, 2011
Law Offices of Zullinger-Davis
Hamilton C. Davis, Esquire
20 East Burd Street
PO Box•40 •
Shippensburg, PA 17257
Fax: 530-5222
Rs: Estate of James B. Kuhns
Social Security Number 199-347688
Date of Death 3/4/11
IT IS HEREBY CERTIFIED THAT.THE ABOVE NAMED DECEDENT HAD THE
FgLLOWING ACCOUNT WITH ORRSTOWN BANK:
SAVINGS ACCOUNT
Account No.-
Account Type-
Date Opened-
Date Closed-
Joint Account'(name/date)-
Balance-
Accrued Interest-
787132
Statement Savings
10/12/93
3/31/11 _
No
$16,131.11
$4.18
Best Regards., 1
~~ (~
~~~~~
Jill R. Worthington
Deposit Processing Clerk
:!k
• 2695 Philadelphia Avenue
Charnbersburg, PA 97201
•' 1.888.ORRSTOWN
. VE-t4U"UI~«a36"~'S$t3trti9'BsC9~II1rt
MEMBERS 1St
FEDERAL CREDIT UNION
Nav f ~~ 2ot ~
SAVINGS ACCOUNT:
Account Number/Suffix 138903-00
Date Account Established 03/30/1994
Principal Balance at Date of Death $4,831.61
Accrued Interest to Date of Death $.10
Total Principal and Accrued Interest $4,831.71
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 138903-05
Date Account Established 07/12/2008
Principal Balance at Date of Death $6,807.36
Accrued Interest to Date of Death $.20
Total Principal and Accrued Interest $6,807.56
Name of Joint Owner None
M M RS 1ST FEDERAL RED T NION
4 t
Danielle A. Kline
Lending Insurance Support Specialist
November 8, 2011
Estate of: JAMES B. KUHNS
Date of Death: 03/04/2011
Social Security Number: 199-34-7688
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslstorg
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Pacific Life 11/8/2011 2:33;:.11 PM PAGE 2/002 Fax Server
X1.1
t
~'.J~
November 8, 201 1
HAMILTON C DAMS
LAW OFFICES OF ZULLINGER-DAMS
ATTN: NICHOLE
FAX: 717-530-5222
Re: Accumulated Cash Value
Contract: VR04047532
Annuitant: JAMES B KUHNS
Owner: JAMES B KUHNS
Dear Nichole;
We are writing in response to information requested on the above-referenced contract.
The Accumulated Cash Value as of March 4, 2011 is $311,506.62.
If you have any questions, you may contact an Annuity Information Specialist at (800) 722-4448, Monday
through Friday from 6 a.rn. to 5 p.m., Pacific Time. You may also contact your registered representative
with questions. Neither Pacific Life nor its representatives give tax or legal advice.
Sincerely,
G~Q ~ - ~~
Lorene C Gordon
Vice President, Operations
Retirement Solutions Division
Pacific Life Insurance Company
Retirement Solutions Division
P.O. Box 2378, Omaha, NE 68103-2378 www.PacificLife.com
Securities Distributed by Pacific Select Distributors, Inc., Member, FINRA & SIPC
NOV ' ~: 2011
John Hancock Life Insurance Company (U.S.A.)
John Hancock Annuities Service Center
164 Corporate Drive, Portsmouth, NH 03801-6815
Mailing Address: PO Box 9505, Portsmouth, NH 03802-9505
(877)543-2363
www.jhannuitles.com
November 8, 2011
HAMILTON C DAMS, ESQUIRE
PO BOX 40
SHIPPENSBURG, PA 17257
Dear Mr. DAMS:
Re: CONTRACT/CERTIFICATE # 2673583
iG~~t~CCTIG1p.
the future is yours~''~
This letter is in response to the inquiry recently submitted for the annuity contract referenced above. The date of
death value as of 03/04/2011 was $126,575.38.
If you have any questions or concerns about this letter, please call us at 877-543-2363. Our Claims Service
Representatives are available on weekdays from 9:00 a.m. to 5:00 p.m. EST.
Sincerely,
John Hancock Annuities
Life insurance annuities, includin® group annuities, are products issued by John Hancock Life Insurance Company (U.S.A.)•, Bloomfield Hills, MI "not licensed in New York
LAW OFFICES OF
ZULLIlVGER-DAMS
PROFESSIONAL CORPORATION
JOEL R ZULLINGER SUZANNE M. TRINH gA1VIILTON C. DAMS
strinh(c~zullin¢er-davis.com hdavisna zullinger-davis.com
'zullin er zullin er-davis.com
14 North Main Street, Suite 200 20 East Burd Street, P.O. Box 40
Shippensburg, PA 17257
Chambersburg, PA 17201 717-532-5713
717-264-6029 717-530-5222 (FAX)
717-264-1884 (FAX)
January 19, 2012 ~ ~
Register of Wills rte-
Cumberland County Courthouse t ~ ~?
-+~ -,-,
Room No 102 ~' N ~ ,
One Courthouse Square .,.,, ~,
Carlisle, PA 17013 ~ ~`"
c•:
RE: Estate of James B. Kuhns
Est. No. 21 11 00375
Dear Sir or Madam:
Enclosed herewith please find an inheritance tax return, filed in duplicate.
A check for filing fee in the amount of $15.00 is also enclosed. Please send a bill to our
Shippensburg office for any additional costs due.
If there are any questions or concerns, please contact me at the Shippensburg office. Thank
you.
Sincerely yours,
~..~ ~ .
~~~..~~ .
Hamilton C. Davis
for Zullinger -Davis
Professional Corporation
HCD/njk
Enclosures
Reply to: Hamilton C. Davis, Esquire
P.O. Box 40
Shippensburg, PA 17257
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