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HomeMy WebLinkAbout03-28-121 1505610105 ~I REV-1500 °`t~-~"t~~' OFFICIAL USE WILY PA Department of Revenue ~~~ County Code Year Fla Number Bureau of Individual Taxes ~""""`"`°`"`~"~` PO BDx~8o6oi INHERITANCE TAX RETURN ~1 ~ I O C~ Harrisburg, PA i~u8-o60i RESIDENT' DECEDENT o ENTER DECEDENT INFORMATION BELOW Soaal Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 476-56-3934 08/08/2011 07/31/1951 Decedent's Last Name Suffix Decedent's First Name MI Hammel Susan R (If Applicable) Enter SurvNing Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Benjamin Jeffrey H Spouse's Soaal Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 1o9-as-sos3 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW t>p 1. Original Retum O 2. Supplemental Retum O 3. Remainder Retum (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Sete Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTNIN MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHWLD BE DIRECTED T0: Name Daytime Telephone Number Jeffrey H Benjamin (717) 249-6934 First Line of Address 435 West South Street Second Line of Address City or Poet Office Carlisle Correspondent's e•mall address: State ZIP Code PA 17013 REGISTER USE t~ ~ A ~ ~~ ~ ~~ ~ ~ ~ 2~ "'r fV DATE FILED C,] ,, r ~' C n Under penalties of perjury, I declare that I have examined this relum, including eccompertying schedules and statements, and to the best of my knowledge and belief, it is true, co a complete. Dada of preparer olirer than the personal representatlve is based on all information of which preperer has any knowledge. SI ON I RN rr DATE 3~28/2D/ Z 435~W}Qlt So1rtKStre>r5t /Carlisle, k/# 17013 SIGNAT RE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE UsE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 *~7 n i J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedents Name: Susan Ridgway Hammel 476-56-3934 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 and Notes Receivable (Schedule D) ......................... .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 25,090.00 6. Jointly Ovmed Property (Schedule F) O Separate Billing Requested ..... .. 6. 6,182.00 7. Inter-Vvos Transfers 8 Miscellaneous Non-Probate Property h l O S S d G t Billi R t d 7 609 87 333 u epara ( c e e ) e ng e ...... eques . .. , . 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 640,$05.$7 9. Funeral Expenses and Administrative Costs (Schedule H) ............... .... 9. 6,731.76 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........... .... 10. 11. Total Deductions (total Lines 9 and 10) ............................. .... 11. 6,731.78 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. 633,874.11 13. Chadtable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .... 13. 14. Net Value Sub)ect to Tax (Line 12 minus Line 13) .................... .... 14. 633,$74.11 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 633,874.11 (a)(1.2) X .OQ 15. 0.00 16. Amount of Line 14 taxable at lineal rate x .0 45 0.00 1 g, 0.00 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 REFUNb OF AN OVERPAYIdENt Side 2 L 1505610205 1505610205 0.00 ~~ REV-1500 EX (FI) 'Page 3 Decedent's Complete Address: Flle Number DECEDENTS NAME Susan Ridgway Hammel STREET ADDRESS 435 West South Street CITE Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 2. Tax Due (Page 2, Line 19) Credits/Payments A. Prior Payments B. Discount 3. Interest (1) 0.00 Totai Credits (A + B) (2) (3) 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 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 ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise for life of either payments, benefits or pre? ................................................................ ...... ^ 2. If death occurred after Dec. 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ~ ^ 3. Did decedent own an "in Vast fora 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 designatian? .................................................................................................................. ...... ~ ^ 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 io or for the use of the surviving spouse is 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 benefidary. 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 p2 P.S. §9116(x)(1.2)). • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is 4.5 percent, except as noted in [72 P.S. §9116(x)(1)]. • The iax 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)j. Asibling is defined, under Section 9102, as an individual who has at least one paren# in common with the decedent, whether by blood or adoption. REV-i5o8 EX+ (u-io) ~ pennsytvania SCMEpYLE E DEPARTMENT OF REVENUE CASHr BANK DEPOSITS ~t MISC. 1NHERRANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Susan Ridgway Hammel 2011-00875 Include the proceeds of litigation and the date the proceeds were received by the estate. All Droperty 1olMly owned with right of survivorship must be discbsed on Schedule F. If more space is needed, use additional sheets of paper of the same size. LV 1 S 11VA1LL4 V). V SG LA JGUL311 TL 11RUG 111 Y 41 UGJS 1\\. V 1G W.) - 11G11G~' 1J1LLG LV VA 1 4~'G 1 Vl J ~,: ~ B~Y4 ~/V•JA 7NE 7RUEEEU IESOUR[E F!r ~~'g! 4yl,e: ?; tp3Rtt E^ _..... t-.C.-'r-;a ~ ~- '9!'!~'S ( .:,": alt ;B',_ ~ ,. ;, c. 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What H my Cledit 5 nOt pGffeCt? .._ .: ", c ,c..: , ~ ..._~ 1 ; C: ,c.s.• ,,et N#4, 2,a i 5: ! -ez ~ 1 wam to list my car for sate '~ Top lOs b News Used Cars for Sate near Carlisle 2002 Volkswagen Jetta , - ~~~,, :. x,.~r ~,.~t~ ,_..... http://www.kbb.com/voikswagen/jetta/2002-volkswagen jetta/gl-wagon-4d/?Vehicleid=49... 8/22/2011 REV-igpg EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RE9DENT DECEDENT !`iCN~dYLE ~ JOINTLY-OWNED PROPERTY Susan Rid gway Hammel 2011-00875 If an asset tTawme jolntlp owned wltldn one year of the decedents date of deatly it must be repart+od on Schsduk 6. SURVMNG JOINT TENANT(S) NAME(Sj ADDRESS RELATIONSHIP TO DECEDENT A• Jeffrey Herbert Benjamin 435 West South Street, Carlisle, PA 17013 spouse B. C. 70INTLY OMAMED PROPERTY: ITEM NUMBER LFRE0. FOR IOINT TENANT DATE MADE ]DINT DE,SCRIPnON OF PROPERTY INCLUDE NAME OF FlNANCIAL INSRRITION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOBVTLY NEID REAL ESTATE. DATE OF DEATH VALUE OF ASSET % DF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A . 08/01/11 100 shares Johnson & Johnson 6,182.00 100 6,182.00 TOTAL (Also enter on Line 6 Recapitulation) I; 6,182.00 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TA%RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF fiLE NUMBER Susan Ridgway Hammel 2011-00875 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY IRr1U0E THE NM1E oT Tlff TRANSfH~, tNEm RaArmNSRiP To DEC~ENf ANO Tr~E DaTE oFTrsnNSFEa. aTrACR A coEr oETNE o®wR ~ ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION tFAPPLICAaLE TAXABLE VALUE I• Carlisle Area Shcool District Retirement Savings Plan [403(b)j administered by'The Standard' Benefiaary - Jeffrey H Benjamin 100% 113,731.26 100 112,731.2E 2 ~ an Stanley Smith Bamey -cash Benefiaary - Jeffrey H Benjamin 1 2,74 100 2.7e 3 Morgan Stanley Smith Bamey - Pruco Life Insurance Company Benefiaary - Jeffrey H Benjamin 100% 15988011 100 159,880.11 4 Askar Corp. -Hartford Life - MFS Total Retum Benefiaary - Jeffrey H Benjamin 100% 23,499.01 100 23,499.01 5 Askar Corp. - Paafic Life -Port Opt Growth Beneficiary - Jeffrey H 128,051.99 100 128 051 99 Benjamin 100% , . 6 Askar Corp. - Amefic~ Funds -American Funds Inc Fnd of Amr A Benef~iary - Jeffrey H Benjamin 100% 54,868.79 100 54,Sfi8.79 7 Askar Corp. - Paafic Life -Port Opt Growth Beneficiary - Jeffrey H Benjamin 100% 111,605.79 100 111,605.79 8 Series EE United States Savings Bonds POD Jeffrey H Benjamin 18,623.00 100 18,623.00 9 Series EE United States Savings Bonds POD Brin H Benjamin 71.18 100 71.18 TOTAL (Also enter on Line 7, Recapitulation) ; I 609,333.87 If more space is needed, use additional sheets of paper of the same size. 274 Senate Ave 7d~ FSoor Camp Hill, PA 170ll cct ?l7 730 1800 direct 7]' 730 1878 fax 7t7730 tA94 toll free 800 237 1700 Ptovember 16, 2091 Jeffrey H. Benjamin 435 W. South Street Carlisle PA 17013 Re: Date of death values for Susan R. Hamme! DOD: 818111 MorganStanley SmithBarney Dear Jeff: As requested here are the date of death values for one half of the securities held in the joint account by us: .Inint arrttunt Amount Descri tion Price Value 4442.29 American Balanced Fund 16.89 75,030.28 1.506.39 Ca itlaP income Builder Fund 46.85 70,574.38 4711.51 Income Fund of America 15.98 75 289.93 50 Johnson and Johnson 61.82 3,091.00 TOTAL 223,985.59 IRA account Amoun# Desert tion Price Value 2.74 Cash in a/c 2.74 159886.11 Prueo Li#e Insurance 159,880..11 TOTAL 159,882.85 Should you require additional information please let me know. Sin rely, '`~...._ De a Koons Registered Marketing Associate The Keystone Group /dak The information herein hae been obtained from sources we believe to he reliable, but we do n~ guarantee its accuracy or compMtsnsss. Morgan Stanley Smirk Barney LLC. Member SIPC. Holdin~ts by irnestor Susan R Hammel 6mrrurrld B Sklar Susan Hammel as.:na aov~soas caoue a+c 435 W South Stna3t A[~jr /~ j'~ Carlisle, PA 17013 AskarAdvisora Group Ina Date: 08/()8/'1011 AskarCorp. Greeted: 10/13/2011 1/ ` J1,( ' { 6101 -34th Ave S, Suite 3W ~ i 1 L C ~ !~ P. Bloomington, MN 55425 852-864-8463 Susan R Mammal Acct Name:Susan Hammel No_BENEF(LW Hammel); HarttordReaders Access; stretch pmts Acct Mo:00712833331 AcctType:Ber~flciary Non-Q1~8fied Aassf Name T)dter Awtfi~ MDL tlsrns 6uuldly prio~,(i} 11YIw (i) AAF&T~TALREIIJRN E41UffY ti~ita0R0 1.725.58 13.82... 29,49BA'1 AccounlTotat $23.499.01 _ Acct Name:Susan Hammel NQ BENEF(LW Hamlr-el); Padfic Life/Selet~ One; stretch pmts Acct No:VR10004758 Acct Type:Beneticiary Non-OuasBed Asset Name ikkv Aesetiype Ypt, Name 9uan8ly Pdee+(iI Vakw (i)' PORT OPf OROWfH WON-CLA98~IE0 pylCfflc LA=E 15,986.08 ..8.49 126,p51.ti9 Awounl Total: 5128,051.99 Acct Name: Susan Hammel O_BENEF IRA (LW Hammel); American Funds: stretch pmts Acct No:00085158815 AcctType:C88T IRA Beneficiary Asset Name Ticker Assst~rpe ' ` MgL NanK 6uardKY '' Prke (!7 VbNn (i) AN~tAICAN FUNDS its FND OF AMECX EQUITY ~ 8,524.01... 15.57 54.888.79 Accaunt'[61ek $54,868.79 Acct Name:Susan Hammel O_BENEF_IRA (LW Hemmelj; Pacific Ufellloyages/GIA+/stretch pmts; issued 6/11/2010 Acct No:VR10009186 AcctType:BerreBdary IRA Asst None TidAr AsseNype IApt, Nsop~ HuenNty Pries (~ ilelw 15) PORE OPT OflOYVfH NON-CLASSIFI~ p ~E 19.12719 8.50 111,88b.79 ACCWSrt Total: s1 ~ 1.tw5.79 InvestorTotal: 5318,025.58 Ineamplele M presented watwul aaanpeaying tlbcWsue papas Pape 1 of 2 Calculated Value of Your Paper Savings Bond(s) ~al~iuiated Yali'Je Qf YeLr Pager ~Yinga E~Qnd(s) Calculator Results for Redemption Date 08/2011 Page 1 of 1 Total Price Total Value Total Interest YTD Interest $25.00 $71.18 $46.18 $2.78 Bonds: 1-i of i Issue Next Finale Issue Interest Serial # Series Denom Date Accrual Maturity Price Interest Rate Value Note _477062505EE EE $50 02{1991.02/2012 02{2021, $25.00; $46.18_. 4.00% $71.181 _Totals for i Bonds' $25.00 X95.18' _ _ #71.18: Notes NI Not Issued _ _. NE Net eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest ~„ P~~' ~'`~ http://www.treasurydirect.govBC/SBCPrice 9/6/2011 REV-1511 EX+ (10-09) i pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETU0.N RESIDENT DECEDENT SCHEDULE H FUNERAL. EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Susan Ridgway Hammel 2011-00875 Decedent's debts must be reported on Schedule I. A• FUNERAL EXPENSES: 1' Memorial Service, R ecepfion z Funeral Home (cremation, Abituaries, ...) B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City _ Year(s) Commission Paid: State _ ZIP Z• Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.} Claimant Street Address City __ _._ State Relationship of Claimant to Decedent 4• Probate Fees: S• Accountant Fees: 6• Tax Return Preparer Fees: ~~ Title transfer fees 8 Inheritance filing fee 2, 381.33 2, 789:43 134.50 201.00 15.00 TOTAL (Also enter on Line 9, Recapitulation) I ~ 6,731.76 If more space is needed, use additional sheets of paper of the same size. ZIP REV-1513 EX+ (O1-10) ~ Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDEM oECmeNr ESTATE OF: tZLE NUMBER: Susan Rid way Hammel 2011-00875 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List TrusMe(c) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).j 1. Jeffrey Herbert Benjamin 435 West South Street, Carlisle, PA 11013 spouse 640534.69 2 Brin Hammel Benjamin 435 West South Street, Carlisle, PA 17013 daughter 71.18 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 SECRON 9113 FOR WHICH AN ELECRON TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. `I TCTAI OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, $ If more space is needed, use additional sheets of paper of the same size.