The URL can be used to link to this page

Home My WebLink About05-05-121505610143 REV-1500 EX(°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes UEFnRTMENT OF REVENUE PO 80x.280601 INHERITANCE TAX RETURN 21 11 1309 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 035 38 3219 09 20 2011 03 07 1928 Decedent's Last Name Suffix Decedent's First Name MI GREENSMITH PHYLLIS M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 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 death aker 12-12-82) ~ 5. Federal Estate Tax Return Required g Decedent Died Testate (Attach Copy of Will) ~ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 0 8. Total Number of Safe De osit Boxes P 9. Litigation Proceeds Received ~ 1 p. Spousal Povert credit (date of death between 12-31 ~Jt and T-t-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 DIRECTED TO: Name Daytime Telephone Number EDWARD P SEEBER 717 533 3280 First line of address SUITE C400 Second line of address 555 GETTYSBURG PIKE City or Post Office MECHANICSBURG State ZIP Code PA 17055 REGISTER OF LS USE O~',Y Cv7 ~p t'rt ~ ~ ~' ~cnc~' Q ~ = - -b ~ ~ ~ DATE Eb tV CJ m ~+ c. ; .-__ ~_T7 C""! r -~; ~ .t.1 i`C'- ~- ~~ Correspondent's a-mail address: epS~SdC.COtYI 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, cored complete. Declaration of preparer other than the personal representative Is based on all information of which oreoarer has anv knowledae_ Edward P. Seeber G ~. Suite C-400 555 Gett sbur Pike Mechanicsbur PA 17055 SIGNATURE PREPA R O R THAN REPRESENTATIVE DATE Edward P Seeber C> ~~~~ ~ ~~ Suite C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 Side 1 1505610143 1505610143 J ~- 1505610243 REV-1500 EX Decedent's Social Security Number oe~ede"rsName: Greensmith, Phyllis M. 035 38 3219 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) .............. . 5. 17 9.71 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. 519 , 12 3 . 4 4 8. Total Gross Assets (total Lines 1-7) .................................................................... . g. 519 , 303.15 9. Funeral Expenses & Administrative Costs (Schedule H) .............................. ......... 9. 23 , 935.30 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..................... ......... 10. 952.7 6 11. Total Deductions (total Lines 9 & 10) .......................................................... ......... 11 2 4 , 8 8 8 . 0 6 12. Net Value of Estate (Line 8 minus Line 11) ................................................. ......... 12. 4 94 , 415.0 9 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_ 4 94 , 415.0 9 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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 4 94 415.0 9 ~ 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 0 . 0 0 18. 19. Tax Due ................................................. ................................................................ . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 22,248.68 0.00 0.00 22,248.68 Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-1309 DECEDENT'S NAME Greensmith, Phyllis M. STREET ADDRESS 127 Laurel Drive CITY Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 21,000.00 (1) 22,248.68 22,105.26 __ 143.42 1,105.26 Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (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 :............................................................................. ^x ^ b. retain the right to designate who shall use the property transferred or its income :.................................. ~ ^ c. retain a reversionary interest; or .............................................................................................................. 0 ^ 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? ................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^x ^ 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. §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 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)]. . 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)]. 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+t6-98) COMMONW EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Greensmith, Phyllis M. 21-11-1309 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. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phyllis M. FILE NUMBER 21-11-1309 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFERSATfACFl A COPY OF THE DEIED ~OR REAL ESTATE. DATE OF DEATH VALUE OF ASSET h OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 New York Life Annuity held in Wells Fargo Brokerage 84,598.27 100.000% 0.00 84,598.27 IRA No. 38643574 -beneficiaries are Caroline Greensmith (50%) & Gail Greensmith (50%), daughters - valued per letter dated 5/2111 2 TransAmerica Life Ins Co. Annuity held in Wells Fargo 76,937.38 100.000% 0.00 76,937.38 Brokerage Account No. 38643576 -beneficiaries are Caroline Greensmith (65%) 8 Gail Greensmith (35%), daughters -valued per letter dated 10/24/11 3 Miscellaneous personal property -valued per Trustee 500.00 100.000% 0.00 500.00 8~ beneficiaries 4 Real estate located at 127 Laurel Drive, East 216,800.00 100.000% 0.00 216,800.00 Pennsboro Township, Cumberland County, PA -titled in the Phyllis Greensmith Living Trust -valued per tax assessed value * common level ratio (216,800 * 1) 5 Wells Fargo Bank Certificate of Deposit No. x1079 - 22,947.31 100.000% 0.00 22,947.31 titled in the Phyllis Greensmith Living Trust -valued per letter dated 12/19/11 6 Wells Fargo Bank Certificate of Deposit No. x1268 - 11,572.04 100.000% 0.00 11,572.04 titled in the Phyllis Greensmith Living Trust -valued per letter dated 12/19/11 7 Wells Fargo Bank Certificate of Deposit No. x9893 - 8,371.89 100.000% 0.00 8,371.89 beneficiary is Caroline Greensmith, daughter -valued per bank statement 8 Wells Fargo Bank Checking Account No. x9064 -titled 27,049.13 100.000% 0.00 27,049.13 in the Phyllis Greensmith Living Trust -valued per letter dated 12/19/11 Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 7, Recapitulation) I 519,123.44 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1570 EX+ (6-88) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Greensmith, Ph Ilis M. 21-11-1309 ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF ROANSFER.SATTACN ACOPY OF TIOHE DEED OR REAL ESTATE. DATE OF DEATH VALUE OF ASSET k OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 9 Wells Fargo Bank Savings Account No. x2710 -titled 70,347.42 100.000% 0.00 70,347.42 in the Phyllis Greensmith Living Trust -valued per letter dated 12/19/11 TOTAL (Also enter on Line 7, Recapitulation) I 519,123.44 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV•1151 EX+(10-r16) COM IN RIDAENT D CEDEN~RN ANIA SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Greensmith, Ph Ilis M. 21-11-1309 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION R AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 1,177.00 Street Address City State Ziq Year(sl Commission paid 2. Attorney's Fees James, Smith, Dietterick 8~ Connelly, LLP 19,000.00 3. Family Exemption: {If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Street Address City State Ziq Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 258.30 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 23,935.30 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Greensmith, Phyllis M. 21-11-1309 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Myers Funeral Home -funeral services 1,177.00 H-A 1,177.00 Other Administrative Costs 2 Cumberland Law Journal -trust administration notice publication 75.00 3 Register of Wills, Cumberland County -filing fee for Return 15.00 4 The Sentinel -trust administration notice publication 168.30 H-B7 258.30 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Greensmith, Ph Ilis M. 21-11-1309 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Associated Otolaryngologists of PA Inc. -unreimbursed medical bill 9.82 2 Crystal Springs -water delivery service for residence 53.17 3 Cumberland Valley Endo Center -unreimbursed medical bill 14.18 4 Discover -credit card balance 295.01 5 PAWC -water service for residence 43.12 6 PPL Electric -electric service for residence 223.00 7 Quantum Imaging -check written prior to death; cashed in after death (No. 5202) 5,2g 8 Tun` Care -check written prior to death; cashed in after death (No. 5206) 42.39 9 Verizon -telephone/cable service for residence 168.31 10 Vickery Neurodiagnositics Group -unreimbursed medical bill 98.48 TOTAL (Also enter on Line 10, Recapitulation) I 952.76 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+111-08) COMMNHRES~IDENTEDECEDEN~RNVANIA SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER vrC~nsrnun, rn ins m• 21-11-1 309 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(Sl RECEIVING PROPERTY (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Caroline L. Greensmith Daughter 65% Trans ann 8 279,090.24 127 Laurel Drive residue; 50% real Enola, PA 17025 estate 8~ NY ann; CD 2 Gail L. Greensmith Daughter 35% Trans ann & 215,324.85 623 Colfax Road residue; 50% real Wayne, NJ 07470 estate 8~ NY ann Tota I 494,415.09 Enter dollar amounts for distributions shown above on lines 1 5 throu h 18 on Rev 150 0 cover sheet, as a r o riate. II 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 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)