HomeMy WebLinkAbout03-0965--[tFV 15~ EX (6~'0)~
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
][:FICIAt. USE ONLY
FILE NUMBER
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Tarner, Dick F. 208 - 28 - 6963
~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE W~TH THE
UJ 04/12/2003 09/02/1933 REGISTER OF WILLS
UJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Tamer, Janet L. -- -
z
z
0
uJ
0
(J
W
n~l. Original Return
E~4. Limited Estate
r~6. Decedent Died Testate (Attach copy of Will)
---]9. Litigation Proceeds Received
[-~2. Supplemental Return
E~4a. Future Interest Compromise (date of death after 12-12-82)
--"]7. Decedent Maintained a Living Trust (Aftach copy of Trusl)
E~10. Spousal Poverty Credit (date of death between t2-31-91 and 1-1-95)
~-~3. Remainder Return (date of death prior to 12-13-82)
--"]5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
E~] 11. Election to tax under Sec. 9113(A) (Aftach Sch O)
NAME
Jerry A. Weigle, Esquire
FIRM NAME(IfApplicable) WEIGLE & ASSOCIATES, P.C.
TELEPHONE NUMBER
(717) 532-7388
COMPLETE MAILING ADDRESS
126 East King
Shippensburg,
Street
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 B) (4)
5. Cash, Bank Beposits& Miscellaneous Personal Property (5}
(Schedule 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)
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)
12. Net Value of Estate (Line 8 minus Line 11)
13,
14.
680.00
7,903.20
1,497.59
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13)
(14)
OFFICIAL USE ONLY
680.00
9,400.79
(8,720.79)
NONE - INSOLVENT
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (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 (18)
19. Tax Due (19)
De(~edent's Complete Address:
STREET ADDRESS
105 West Burd Street
CITY
Shippensburg
STATE
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
ZIP
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. 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 (4)
(5)
(5A)
(SB)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
17257
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
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 dght 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, 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.
105 West Burd Street
Sl~
ADDRE
Janet L. Tarner
~nsburg, PA 17257
Jerry A. Weigle
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 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% [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 twenty-one 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% [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 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% [72 RS. §9116(a)(1.3)]. A sibling 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-1508 EX +~l-g?} j~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Dick F. Tarner
Include the proceeds of litigation and the date the proceeds were received by the estate. All pmpen'y jointly.owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Illinois Pocket Watch circa 1884
Bulova Wrist Watch
1985 Pontiac Parisienne
300.00
80.00
300.00
TOTAL (Also enter on line 5, Recapitulation) $ 680. O0
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (7-88)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or Type
ESTATE OF FILE NUMBER
Dick F. Tarner
ITEM DESCRIPTION AMOUNT
NUMBER
Bo
C.
1.
2.
3.
4.
5.
6.
7.
8.
FuneralExpenses:
Fogelsanger-Bricker Funeral Home
Beedle's Flowers
Funeral Reception
Innovative Graphics
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney Fees Weigle & Associates, P.C.
Family Exemption
Claimant Janet L. Tarner Relationship
Address of Claimant at decedent's death
Street Address 105 West Burd Street
Spouse
City Shippensburg State PA Zip Code 17257
Probate Fees
Miscellaneous Expenses:
Register of Wills, Cumberland County - filing Insolvent PA
Inheritance Tax Return
3,443.50
42.40
310.05
22.25
575.00
3,500.00
10.00
TOTAL (Also enter on line 9, Recapitulation) S 7,903.20
(If more space is needed, insert additional sheets of same size.)
REV-1512 EX+ (1-93) A , ~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or Type
ESTATE OF FiLE NUMBER
AMOUNT
ITEM
NUMBER
2.
3.
4.
5.
6.
7.
8.
DESCRIPTION
Lisa L. Helm, Tax Collector - real estate taxes
Branch Creek Physicians
Chambersburg ALS - West Shore
Chambersburg Hospital
Allfirst Bank - safe deposit box rental
Comcast Cable
Sprint
Penelec
TOTAL (Also enter on line 10, Recapitulation)
776.97
98.06
448.24
11.00
14.95
18.00
32.66
97.71
$ 1,497.59
(If more space is needed, insert additional sheets of same size.)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE T,~X RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER Dick F. Tarner
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS (include outdght spousal distributions)
II.
1.
Not relevant as estate is insolvent.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
~.~,., HRB COLLECTIBLES ~
~,.~ Henry & Rowena Betz
717-263-3165 email: hvbetz@earthlink.net
Buying THE FAYETTEVlLLEANTIQUE MALL Selling
Route 30 Fayettevtlle, PA t7201 7'17-352~8485
Building No. 1 Booths 119 & 145
Watches, Fobs, Clocks, Postcards, Covers, Sterling Souvenir
Spoons, Royal Doulton, Stangl Birds and various Smalls
Pa Sales Tax No. 28-061823 NAWCC
R. E. MILLER, Inc.
Chambersburg~ P) _
Address
I Account
Reg. No. Clerk Forward
5
7
8
9
10
11
12
13
14
~.~dams a^ Your ^ccount Statod tO Dato - If [~r is Found, ~eturn at On~
ROLLBACK SERVICE
INSPECTION STATION
24 HOUR TOWING
REPAIR SERVICE
STOUFFER'S AUTO SERVICE
1270 ORRSTOWN ROAD
SHIPPENSBURG, PA 17257
(717) 532-8425
PLEASE DETACH AND RETURN THIS STUB WITH YOUR REMITrANCE AMOUNT ENCLOSED $
'~:~ .............................. CUT HERE ................................... ~__
DATE
PAY ~ST ~OUNT IN BA~NCE COLUMN
STATEMENT -- STOUFFER'S AUTO SERVICE, SHIPPENSBURG, PA 17257
BUREAU OF TNDZVZDUAL TAXES
TNHERZTANCE TAX DZVZSZON
DEPT., 18060] ~
HARR~.~,~RG, PA 171Z8-0601
JERRY A WEIGLE ESQ
WEISLE & ASSOCS
126 E KING ST
SHIPPENSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHERTTANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
.~ ~i5.~ of DATE
' ~'~'/i]tS ESTATE OF
DATE OF DEATH
FILE NUHBER
FEB 25 ;~ 8:2~OUNTY
ACN
01-12-2004
TARNER
04-12-2005
21 05-0965
CUMBERLAND
101
Aaoun'l: Roa'; 'H:od
REV-i~i? EX AFP
DICK F
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGISTER OF gILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF TARNER DICK F FILE NO. 21 05-0965 ACH 101 DATE 01-12-2004
TAX RETURN gAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORTGTNAL RETURN
1. Real Es~a~a (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely held Stock/Partnership In~aras~ (Schedule C) ($)
~. Mor:kgeges/No~cas Recelvabla (Schedule D) (q)
S. Cash/Bank Deposi~s/Misc. Personal Propar~y (Schedule E) (5)
6. Jointly O~ned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~cs
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Ada. Cos~:s/Misc. Expenses (Schedule H) (9)
10. Dab,s/Mortgage Liebili~ias/Lians (Schedule 1) (10)
11. To,al Deduc~Lons
12. Net VaZua of Tax Re~urn
680 O0
O0
O0
.00 NOTE: To insure proper
O0 cradi~ ~o your account,
O0 subai~ ~he upper portion
O0 of ~hLs form ~i~h your
~ax payment.
(8)
5,085.20
15.
1~.
NOTE:
ASSESSMENT OF TAX:
15. Aaoun~ of Line 1~ a~ Spousal ra~e
16. Aaoun~ of L/ne lq ~axabla a~ L~neal/Class A ra~a
17. Aaoun'~ of Line lq a~ Sibling re~e
18. A.oun~ of Line 1~ ~axabZe a~ ColZa~eral/Class B ra~e
19. P~nc~pal Tax Due
TAX CREgZTS:
PAYNENT RECEIPT DISCOUNT (+)
BATE NUHBER INTEREST/PEN PAID (-)
680. O0
1,497.59
(11) &.680.79
(12) 5,900.79-
Chari~abla/govarnaen~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
Ne~ Value of Es~e~e Subjec~ ~o Tax (lq) 5,900.79-
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(15) .00 x O0 = .00
(16) .00 x 045= .00
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= . O0
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT XS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOT[CE:
PAYHENT:
REFUND [CR):
OBJECT/OHS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December IZ, 19BZ -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer [nheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZI40 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TZ P.S.
Section g140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available mt the Office
of the Register of Hills, any of ':he Z5 Revenue District Offices, or by calling the special Z~-hour
answering service for fores etd, ring: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: l-BOO-~q7-5OZO ('eT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 2BlOZ1) Harrisburg, PA 171ZB-IOZ1) OR
--election to have the matter determined at audit of the account of the personal representative) OR
--appeal to the Orphans' Court.
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, Dept. ZB06Ol) Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death) a five percent (BZ) discount of
the tax paid is allowed.
The 1SZ 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 and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period es you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became daXinquent before January 1) 198Z bear interest at the rate of
six (BI) percent par annum calculated at a daily rate of .00016q. AIl taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate whlch will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 lOX .000548 1987 9Z .O00Z~7 1999 7Z .00019Z
1983 16Z .000~38 1988-1991 llZ .000501 ZOO0 8Z .000Z19
1984 llZ .000301 1992 9Z .0002~7 ZOOl 9Z .000Z~7
1985 132 .000556 1995-199~ 72 .00019Z 200Z 62 .00016~
1986 XOZ .000274 1995-1998 9Z .0002~7 2003 5Z .000137
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPAID
X NUNBER OF DAYS DBLINI~UENT 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.
~EV-1470 EX (6-88)
EXPLANATION
COMMONWF_ALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Dick F. Tarner 2103-0965
REVIEWED BY ACN
John Kuchinski 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
H B3 Reduced to $680.00. Family exemption can only be claimed against assets subject to
will or intestacy.
ROW Page 1