HomeMy WebLinkAbout03-16-121505610140
REV-1500 ~` (°'-'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
Po sox 28oso1 2 1 1 1 0 3 1 3
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 6 4 3 4 8 5 5 2 1 1 2 7 2 0 1 0 1 2 2 7 1 9 4 1
Decedent's Last Name Suffix Decedent's First Name MI
K U T Z J R D O N A L D E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
K U T Z B A R B A R A L
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
^X 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORR ESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
E - R A L P H G O D F R E Y E S Q 7 1 7 9 7 5 9 6 0 0
First line of address
1 0 1 1 M U M M A
Second line of address
S U I T E 2 0 1
City or Post Office
L E M O Y N E
R 0 A D
State
P A
ZIP Code
REGISTEgOF WILLS USE~NLY ~ -
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Correspondent's a-mail address: RGODFREY(c~C-WLAW.COM
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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.
SIGNATU }RE OF PERSON RE,$PONSINLEFLING RETURN ~~ i A~ j
ADDRESS
41 LTIMORE STREET MT. HOLLY SPRINGS PA 17065
SI A RE O REPARER OT R H EPR ENTATIVE DAT
DR
1011 MUMMA ROAD UITE 01 LEMOYNE PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140 J
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i
REV-1500 EX
1505610240
Decedent's Social Security Number
Decedent's Name: D O N A L D E• K U T Z, J R• 1 6 4 3 4 8 5 5 2
RECAPITULATION
1. Real Estate (Schedule A) ......................................... .. 1. 9 2 0 0 0 0 0
2. Stocks and Bonds (Schedule B) .................................... .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3.
4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 5 7 1 8 4 8
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ..... .. 7. •
8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 9 7 7 1 8 . 4 8
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9.
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10.
11. Total Deductions (total Lines 9 and 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 CALCULATION -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.o _ 3 5 5 0 7. 8 6 15.
16. Amount of Line 14 taxable
at lineal rate X .045 3 5 5 0 7. 8 5 16.
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 18.
19. TAX DUE ....................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610240
2 2 8 2 5. 8 0
3 8 7 6. 9 7
2 6 7 0 2. 7 7
7 1 0 1 5. 7 1
7 1 0 1 5. 7 1
0. 0 0
1 5 9 7. 8 5
O. o 0
0. 0 0
1 5 9 7. 8 5
1505610240 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 11 0313
DECEDENT'S NAME
DONALD E. KU_T_Z, JR. __ _
STREET ADDRESS
415 North Baltimore Street
CITY STATE 'ZIP
Mt. Holly Spring PA 17065
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount _
0.00
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
Total Credits (A + B) (2)
(4)
(1) 1,597.85
(3)
0.00
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,597.85
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^
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..
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.
.
.
b. retain the right to designate who shall use the property transferred or its income; .
..
:
::
::
:
::
::
:
:
::
:
c. retain a reversionary interest; or .......................................................... . :
:
^ O
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 "intrust for" orpayable-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.
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 i~
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 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)J. 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)j.
• 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)]. Asibling 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-1502 EX+ (01-10)
pennsylvania I SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
FILE NUMBER:
DONALD E. KUTZ, JR. 21 11 0313
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
415 North Baltimore Avenue I 92,000.00
Mt. Holly Spring, PA 17065 (2010 tax assessment attached hereto)
TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 92,000.00
If more space is needed, use additional sheets of paper of the same size.
Cumberlartl~ C~l~s~t~ 13~ar~ ®f Assessmel~t Appeals
®Id Courthouse, First Floor
®ne Courthouse Square
~ariisle, PA 1703
2300004.2-?a~-19890
deAellleoallleortlla~olrleaeallall'rlloaoilelrnrllelilnillal
29351
KUTZ, DONALD EDWARD JR T83 P1
415 NORTH BALTIMORE AVENUE
MOUNT FIOLLI' SPRINGS, PA 17065-1605
Deadline for Scheduling an Informal Review
Appointment: June 14, 2010
For details, please see the reverse side.
NOTICE OF CHANGE OF ASSESSMENT
The Cumberland County Board of Assessment Appeals is providing you with notice of the value on this property,
determined as a result of the Cumberland County countywide reassessment completed this year. The countywide
reassessment values each property at current Fair Market Value, as of January 1, 2010, equalizing and establishing a
uniform tax base so that properties of like characteristics and the same actual Fair Market Value will be taxed the same.
VALUE NOTIFICATION
MAILING DATE; May 3, 2010
Munic.: 23 - MT HOLLY SPRINGS SORO
School: 3 •- CARLISLE AREA SD
Location;
/S 15 AT EALTIMORE AVENUE
LAND LESS THAN 1 ACRE
Tazcable Property
Land Size: .25 acres
Property Type: R
Residential (Under 10 Acres)
Homestead Approved
Parcel Identifier:
23-31-2187-0190
FORMAL APPEAL DEADLINE:
_ _June 14 , 2 010
2010 Base Year Assessed Value Old Assessed Value
Fair Market Value (2010 Market x 100%) (2004 Market)
Land 42, 000 42, 000 20, 000
Buildings 50, 200 50, 200 52, 280
TOTAL 92,200 92,200 72,280
2010 Clean and Green Values
Land NOT NOT NOT
Buildings APPLICABLE APPLICABLE .APPLICABLE
TOTAL
Clean and Green values apply to qualified farm and forest land and become effective
only upon application and approval. Clean and Green applications must be received
by the Assessment Office no later than 4:30 p.m. on October 15, 2u10. i hose
previously approved for Clean and Green do not need to re-apply.
The ESTIMATED impact statement printed below is our best estimate of change, based on 2010 COUNTY tax figures.
THIS ESTIMATE DOES NOT INCLUDE ANY BOROUGH, TOWNSHIP, OR SCHOOL DISTRICT IMPACT.
Current 2010 County mills = 2.579
Adjusted 2010 County mills 2.074
$ 186 0 2010 COUNTY Tax BEFORE Reassessment.
$ 191 m 2010 COUNTY Tax AFTER Reassessment.
(see reverse side)
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
DONALD E. KUTZ, JR. 21 11 0313
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2
1986 Volkswagen Sirocco
1988 Toyota Truck 4wd
1,200.00
1,600.00
TOTAL (Also enter on line 5, Recapitulation) I $ 5 718.48
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
DONALD E. KUTZ, JR. 21 11 0313
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S)
A.
c.
JOINTLY-OWNED PROPERTY:
ADDRESS
Mt. Holly Spring PA 17065
RELATIONSHIP TO DECEDENT
pouse
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 ASSET % OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
~. A. ALL OTHER PROPERTY NOT LISTED IN THIS
RETURN IS JOINT WITH SPOUSE
TOTAL (Also enter on Line 6, Recapitulation)
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DONALD E. KUTZ, JR.
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
FILE NUMBER
21 11 0313
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES
~. :
Hollinger Funeral Home
10,140.00
B• ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) Barbara L. Kutz 3,908.00
street address 415 North Baltimore Avenue
pity Mt. Holly Springs state PA zIP 17065
Year(s) Commission Paid:
2. Attorney Fees: Cipriani & Werner
P.C.
, 4,500.00
3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation.) 3
500
00
Claimant Barbara L. Kutz ,
.
street Address 415 North Baltimore Avenue
c;ty Mt. Holly Springs state PA zIP 17065
Relationship of Claimant to Decedent Spouse
4. Probate Fees: 269.50
5 Accountant Fees:
6. Tax Return Preparer Fees: 250.00
~. Advertisement for Estate -Cumberland County Law Journal
8.
Advertisement for Estate -Sentinel Newspaper 75.00
9.
Inheritance Tax filing fee -Cumberland County Register of Wills 168.30
15.00
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
22,825.80
REV-1512 EX+ 112-08)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, S~ LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DONALD E. KUTZ, JR. 21 11 0313
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~ . Mable R. Stratton -Tax Collector Real Estate 345.41
2 Mable R. Stratton -Tax Collector Per Capita Tax 11.00
3 Mable R. Stratton -Tax Collector Per Capita Tax 11.00
4. Silver Spring Dental Associates -Dental Treatment 177.46
5 Commonwealth of Pennsylvania 20.00
6 Leonard Magazine payment for item 72.87
7 Shipley Oil -heating 558.84
8. payment to Barbara Kutz 100.00
9. Tax payment 174.13
10. Car payment -Jamie Sheaffer 250.00
11 Century Link -Telephone 178.02
12. Dish Network -Television 101.75
13. Met-Ed Electric -Electric Bill 194.10
14. Americredit 306.39
15. Reserve 2010 Personal Taxes 1,376.00
TOTAL (Also enter on Line 10, Recapitulation) I $ 3,876.97
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10;
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DONALD E. KUTZ, JR. 21 11 0313
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1 Barbara L. Kutz -Spouse spouses 50.00
, 415 North Baltimore Street
Mt. Holly Springs, Pa 17065
2. Melissa Miller -Daughter Lineal 16.67
1005 Pheasant Drive -North
Carlisle PA 17013
3. John D. Kutz -Son Lineal 16.67
272 Pine Road
Pikeville, TN 37367 16.67
4. Ronald Kutz -Son Lineal
364 Fernwood Drive
Waco TX 76712
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $
If more space is needed, use additional sheets of paper of the same size.