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HomeMy WebLinkAbout03-26-121505610143 PA Department of Revenue OFFICIAL USE ONLY Buroau of Individual Taxes oowrr~avaw~.: county Cods rear Flle Number PO 80X.280601 INHERITANCE TAX RETURN 21 11 1314 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER;taECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth Decedent's Last Name Suffoc Decedent's First Name MI PETERSON C8RI3TINE (If Applicable] Enter Surviving Spouse's Information Below Spouse's Last Name Suffer Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE 1MTH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Oripirral Rstum ~ 2. Supplsmerttal Rstum ~ 3. Remainder Retum (date of loth prior to 12-13.82) 4. Limited Estete ~ 4a. ~~ dI aRsr i2 72i~) ~ 5. Federal Estate Tax Rstum Required ® 8. Decedent Dfsd TeNaN (Attach Copy d wuq ® T, ~PNY f)e Living Trust ~ 8. Total Number of Safe Deposit Boxes 9. Litlpatbn Proceeds Received ~ 10. ~i1~T a~r~i-5~dsetli ~ 11.~Attech Seh. OI ndsr Sse. 9113(A) CORRE3A~[AFIDENT -THIS aECTION MUST t3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORtIAAT10N aHOULD sE DIRECTED TO: Name Daytime TNsphone Number EDNA>it13'~ P 3EEBER 717 533280. First line of addross 3IIITE C400 Second iir-+a of address 555 GETTYSBURG PIRE City or Post Office r~c~iNlcssvRG arrtali address: Stets ZIP Code PA 17055 r.~ -- RECa13TER OF+~~ K SE E~Y rn _.~ U .. ~ ~ ~. c» ~ ~ rQ ~Q ~ -i O ~ ~ - - rk ~~ a ~ .C` U"b°"hui, a ~~aw°~"''~mpl 1aDecMd~ru'or,~d P-s~pa"ro~r'daRM~r the ~igxw in I 'vi ': into 'of wl, ~prepar~.ar tw anyk~'d°a1r~wN~ .bN1°'' Peterson SIGNATURE bF Tt4W IO:PRESENTATNE DATE ~~~~i,,~----~`-" Edward P Seeber ~ 19 i I L- PA 17055 Side 1 L 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number '•~»~ Peterson, Christine 198 40 1610 "' RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Cbsely 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. 2 6 , 95 9.52 s. Jointty Owned Property (Schedule F) ^ Separate Billing Requested............ s. 7. Inter-Vivos Transfers 8 Miscellaneous I~nu; 3epera a Bing Re uested h l 7 10 996 7 65 ............ q edu e G) ~,J (Sc . , . 8. Total Ores Assets (total Lines 1-7) ..................................................................... 8. 1, 023 , 724.62 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 71 , 02 8.43 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. 10. 25 , 916.0 9 11. Total Deductions (total lines 9 & 10) ................................................................... 11. 96 , 944.52 12. Net Value of Estate (Una 8 minus Line 11) .......................................................... 12. 92 6 , 7 8 0.10 13. Charitable and Govemmentai Bequests/Sec 9113 Trusts for which an elsdion to tax has not been made (Schedule J) ............................................... 13. 14. Net Value 8ubJsct to Tax (Line 12 minus Line 13) ............................................... 14. 92 6 , 7 8 0.10 TAX CQMPUTATION -SEE INSTRUCTION8 FOR APPLICABLE RATES 15. Amount of Line 14 taxabb . at the spousal tax rate, or transfers under Sec. 911 s 15 0 . 0 0 . (a)(1.2) X .00 1s. Amount of Lino 14 taxable 92 6 , 7 8 0.10 1 s. 41, 7 05.10 at Nnsal rate X .045 17. Amount of Une 14 taxable 0 0 0 17 0. 0 0 at styling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 0. 0 0 at collateral rate X .15 . . 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 41,705.10 Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Ccimplete Address: File Number 21-11-1314 DECEDENTS NAME Peterson, Christine STREET ADDRESS •- 815 wellington Drive CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 40,000.00 2,085.26 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Pags 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. (1) 41,705.10 Total Credits (A + B) (2) 42,085.26 (3) (4) 380.16 (5) Make Check Pa able to: REGISTER QF 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 trensferred :............................................................................... • b. .retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... d. roceive the promise for life of either payments, benefits or care? ............................................................ 2. H death occurrod after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 3. Did decadent 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 6 AND FILE IT A8 PART OF THE RETURN. For dates of death on or after Juy 1,1994 and beforo Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse i8 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 surivrving spouse from tax, and the statutory requirements for disclosuro of assets and filing a tax return are still applicable even ff the surviving spouse is the ony beneficiary. For dates of death on or after Juy 1, 2000: • The tax rate imposed on the net value of,trensfers 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. §9118 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 fa deftned under Section 9102, as an individual who has at least one parent in cmnmon with the decedent, whether by bloo~ or adoption. Rw-1t+OS EX+ (6-ss) r~, cowoNwEan~ of vEwasrwAreA NNINtlTANCE TAX RETURN R1T t1ECE0EH- SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE ~F (FILE NUMBER Peterson, Christine 21-11-1314 trxdues n,.~roc~ a INi~idon and a» data E,s procssds wen. rooNrw by a,. same. al propwey joimly.owned tM rbne a1 survivorship must bs asd on schsek~s F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2011 Subaru Outback -valued by dealer;hip 25.000.00 2 John Hancock -long-term cane insurance premium 696.43 3 Mory -rotund of premium 43.93 4 Refund of school roal estate taxes -per HUD 1 884.41 S `8tate-Fenn -vehicle insurance promium 334.75 TOTAL (Also enter on Line 5, Recapitulation) I 26,859.52 (If mtxe space is needed additional pages of the same size) Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedub E (Rev. 6-98) Rw-7610 EX+ (a-fa) SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY corw.nt of ve~sr~viva~, IPlrLIVMPICE TNf NETIINN IIEgOENT DECEDEM ESTATE OF (FILE NUMBER Peterson, Christine 21-11-1314 This schedule m~ut bs completed and filed h fhs answer to any of questions 1 through 4 on the rsvsrw aids or tM REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY ~-~"~'"ErR wsF~""ERS. ~r~,~t~o~ ~nT~~F~o ~ ~EEST~T°E. DATE OF DEATH VALUE OF ASSET %OF DECD'8 lr~lrEREST ( Arai s~~E) TAXAUE 1 AXA Equitable Contract No. 307617376 -beneficiaries 170,387.24 100.000% 0•~ 170.387.24 are the children -valued per value as of 8/9/11 2 TD Ameritrade IRA No. 901991228 -beneficiaries are 453,233.89 100.000% 0.00 453,233.99 the children -valued per value as of 9/9/11 3 Cash held in TD Ameritrade Account No. 901079388 - 22.694.58 100.000% 0.00 22,694.59 titisd M the Christine Peesrson Living Trust -valued per valve as of 8/9H 1 4 2,943.688 shares of Franklin Income A held in TD 5,975.68 100.000X o•~ 5,975.68 Ameritrstde Account No. 901079388 - tltlsd in the Christine Peesrson Living Trust -valued per value as of 9/9H 1 5 542.199 shares of Manning 8 Napier Pro Blend 7,016.06 100.000% 0•~ 7,016.06 Conservatlve Class S held in TD Ameritrade Account No. 901079388 - tltlsd in the Christine Peterson Living Trust -valued per value as of 819/11 6 357.929 shares of MFS Ser Tr X EmergMg Market Debt 5,325.98 100.000% _ 0.00 5,325.88 A held In TD Amettrade Account No. 801079388 - tltled in the Christine Pebreon Living Trust -valued per value as of 8/9H 1 7 100 shares of Microsoft Corp Com held in TD 2,584.00 100.000% 0•ro 2,584.00 Amsritrade Account No. 901079388 -titled in the Christlne Pebreon Living Trust -valued per value as ot9/8111 8 Mballaneous pereonal property - tttled ~n the 5.000.00 100.000% 0.00 5,000.00 Christine Pebreon Living Tnrst -valued per Trustee Tobl of Contlnuatlon Schedule eo attached page TOTAL (Also enbr on Line 7, Recapitulatlon) ~ 896,763.10 (If more apace is needed, additional pages of the same size) Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedule O (Rev. 6-98) Ibv-1610 EX~ (N!) SCHEDULE Q INTER VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY ccworowe~rnoFVE~nv~ ~T~ continued aoE ESTATE QF FILE NUMBER Peterson, Christine 21-11-1314 ITEM NUMBER DESCRIPTION OF PROPERTY ~~~~~ A ~p~Py ~'~F ~ oE~ ~~ Esr ~. DATE OF DEATH VALUE OF ASSET %OF DECD'8 ~"~~sT °CC~uswN (~ ~.~c~s~e) TAXABLE VALUE 8 1,272.481 shams of PIMCO Total Retum A held in TD 14,035.58 100.000% 0.00 14,035.58 Ameripade Account No. 801079388 -titled in the Christine Petsraon Living Trust -valued per value as of 8/9H 1 10 PNC Bank Checking Account No. 50-0581.8154 -titled ~ 14.511.97 100.000°ti 0•~ 14,511.87 in the Christine Peterson Living Trust -valued per statement 11 RBI estate located at 815 Wellington Drive, Carlisle, 284,000.00 100.000°k 0•~ 294,000.00 PA`- tftisd in the Christine Peterson Living Trust - valued per safes price TOTAL (Also enter on Line 7, Recapitulation) I 886,765.10 Copyright (c) 2002 form software ony The Lackner Group; Inc. Fonn PA-1500 Schedule G (Rev. 6-98) REV-1767 EX~ (70-06) c ~I€~i~iwu- SCHEDULE H FUNERAL EXPENSES 8~ ESTATI: CF FILE NUMBER . Peterson, Christine 21-11-1314 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Reprosentative(s) Street Address City State Zio Year(s) Commission paid 2. Attomev's Fees James, Smith, Dietterick 8i Connelly, LLP 3. Family Exemption: (If decedent's addross is not the same as claimant's, attach explanation) Claimant Street Address - City State Zip Relationshio of Claimant to Decedent 8,529.73 34,200.00 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Proparor's Fees 7. Other Administrative Costs 28,298.70 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 71,028.43 Copyright.(c) 2009 form softwaro ony The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Peterson, Christine 21-11-1314 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral Exoenses Carlisle Beverage -beverages for immediate family memorial gathering 34.84 2 Comfort Suites -memorial gathering 2,511.07 3 Ewing Brothers Funeral Home -memorial gathering 5,835.88 4 Nelis -food for Immediate family memorial gathering 62.16 5 Staples -thank you notes 11.65 6 VYins 8< Spirits -beverages for immediate family memorial gathering 74.13 Other Administrative Costs 7 AAA -vehicle title transfer fees ' 8 Alfredo Pizza -food for helpere cleaning house 9 Bemis Campanella -house cleaning services 10 Bemis Campanella -house cleaning services 11 Borough of Carlisle -sewer 8 water service for residence 12 Borough of Carlisle - sewer b water service for residence 13 Borough of Carlisle -sewer 8 water service for resldence 14 ~ Chris Reifsteck -house repairs H-A 8,529.73 36.50 22.58 110.00 250.00 148.80 72.90 33.21 75.00 Copyright (c) 2002 form software ony The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE QF FILE NUMBER Paterson, Christine 21-11-1314 ITEM NUMBER DESCRIPTION AMOUNT 1 S Fairfield Inn 8 Sultss -room rental for movers 666.88 16 Fine Line Realty - naaltor commission 8,520.00 17 Jeffrey Peterson -reimbursement for mileage 8~ tolls 1,508.70 18 Jessica S Mark Brewbaker -seller's assistance for sale of real estate 10,000.00 19 Lowes -packing supplies 375.18 20 Oiler Landscaping -lawn care prior to death 161.12 21 Oiler Landscaping -lawn care prior to death 80.00 • ~ ' 22 Oiler Landscaping -lawn care prior to death 161.12 23 Oiler Landscaping -lawn care prior to death 144.16 24 PPL - electric service for residence 225.79 25 PPL -electric service for residence 223.00 26 PPL -electric service for residence 98.95 27 PPL -electric service for residence 222.00 28 PPL -electric service for residence 222.00 28 Recorder of Deeds, Cumberland County -realty transfer tax 2.840.00 30 Regbter of Wlils, Cumberland County -filing fee for Return 15.00 31 UHaul -trailer rental 8 moving boxes 171.62 Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Peterson, Christine LE NUMBER 21-11-1314 ITEM NUMBER DESCRIPTION AMOUNT 32 UHaul -truck rentals & gas 1,600.00 33 LISPS -address change verification 8 box rental 53.00 34 Walmart -supplies for cleaning house 135.60 35 Wendy's -food for helpers cleaning house 23.59 H-87 28,298.70 Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1614 EX+(1Z-0a~ scNEau~s ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Cq,M10NN1EALT11 OP PENNSYLVANIA INHERITANCE TA%RE7VRN RE8IDENT DECEDENT ESTATE OF FILE NUMBER Peterson, Christine _ _21-11-1314 Report dabb incurred by tM daeadant prior to daafh that ramdrlad unpaid ~ tM dab of daatlr, inch~na unrNmblxasd rrla~cal axpanatrs. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Apple Store -credit account 14.98 2 Chase Credit Card -credit card 2,441.59 .- 3 Chase Credit Card -credit card 3,258.21 4 Comcast -cable service for residence 176.26 5 Dean Bange -check written prior to death 8 cashed in after death; house washing 325.00 6 Glady McAlsvy -check written prior to death & cashed in after death 150.00 7 Oiler Landscaping -lawn care prior to death 120.84 8 PNC Bank Line of Credit No. 40 03 048113528484 -titled in the Christine Peterson Living 17,154.20 Trust -valued per statement 9 PPL -electric service for residence 223.00 10 United States Treasury - 2011 individual income tax 1,641.00 11 Visitlng Angels -care prior to death 110.00 12 Vital Records -check written prior to death 8 cashed in after death; death certificates for 300.00 husband TOTAL (Also enter on Line 10, Recapitulatlon) I 25,816.08 (N more spaDe is needed, additional pages of the same size) Copyright (c) 2009 form software ony The Lackner Group, Inc. Fonn PA-1500 Schedule I (Rev. 12-08) REV.161,i1[+ 111.1 SCHEDULE J C0t~1~ ~ ~~~-E'Y""'^ BENEFICIARIES ESTATE OF FILE NUMBER Peterson, Christine 21-11-1314 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE MOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY (Words) (SSS) I TAXABLE DISTRIBUTIONS [include outright spousal • d~stnbutions, and transfers under Sec. 9116 a 1.2 . Jeffrey R. Peterson Son 112 of IRA 8 463,390.05 344 Village Drive Rssidue ' Mars, PA 16048 Zachary T. Petereon Son 112 of IRA 8 463,390.OS 36134 Shade Tree Trail Residue Avon, OH 44011 Total 926,780.10 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet as a 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 it -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI Copyright (c) 2009 form software ony The Lackner Group, inc. Forth PA-1500 Schedule J (Rev. 11-08) JAMES SMITH DIETTIIUC:K & CONNELLY LLP Cheryl L. Baker, CP Certified Paralegal clb@jsdc.com March 23, 2012 Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Trust Estate of Christine Peterson File No. 21-11-1314 Dear Ms. Farner Strasbaugh: Enclosed are an original and two (2) copies of the Pennsylvania Inheritance Tax Return to be filed in the above-referenced Estate. I have also enclosed a check for $15.00 representing the filing fee. Please time-stamp the copy and return it to me in the enclosed self-addressed, stamped envelope. If you have any questions, please feel free to contact me. Sincerely, DIETTERICK & CONNELLY, LLP Paralegal Enclosures cc: Jeffrey R. Peterson, Trustee Zachary T. Peterson Reply to: Suite C-400 555 Gettysburg Pike Mechanicsburg, PA 17055 Direct Dial: 717-298-2094 Direct Faz: 717-298-2095 ~~ m `nom boo v ~-, ~. P.O. BOX 650 HERSHEY, PA 17033 Courier Address: 134 SIPE AVENUE HUMMELSTOWN, PA 17036 TEL. 717.533.3280 WWW.JSDC.COM GARY L. JAMES MAX J. SMITH, JR. JOHN J. CONNELLY, JR. SCOTT A. DIETTERICK JAMES F. SPADE MATTHEW CHABAL, III NEIL W. YAHN EDWARD P. SEEBER SUSAN M.KADEL JARAD W. HANDELMAN COURTNEY K. POWELL KIMBERLY A. BONNER JEFFREY M. MCCORMICK KAREN N. CONNELLY JOHN M. HYAMS CHRISTINE T. BRANN OF COUNSEL: GREGORY K. RICHARDS BERNARD A. RYAN, JR. ~~ + ti p '~?;~ tV ~,. -` o, r x,,, t.._. ,~ .. ~~= m ~~ ~ ~ n " ~ ~ ~ O ~n~ ~C rr'' ~ ~~ ~~ ~~ r ~~ b~ b~ --, 0 .~ ..,~ ..~~<. ~ nC~:~ Q r ~ tri t=i ~o~ ~~ ono ~~ r W~ 0 ~, _~ t ,.~:. i f_~ ___ ~. ~, Cl~ ~ ~~ ~~TQ CJ 0 r ;.., ,.. °~'i ,C` 7fli1'74 .. I-IASLER ~ o ~ ~ ~ ~ 3 ~ W