HomeMy WebLinkAbout05-02-12 1505610140
REV-1500 EX ~°'-'°'
P OFFICIAL USE ONLY
A Department of Revenue
Bureau of Individual Taxes County Code Year file Number
PO Box 28oso1 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1 1 1 1 3 8 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 8 6 2 4 9 2 1 2 1 2 2 0 2 0 1 1 0 6 1 3 1 9 2 9
Decedent's Last Name Suffix Decedent's First Name MI
R E E D C U R T I S G
(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
1. Original Return
4. Limited Estate
^X 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust 0
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
S T R E E T
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
D A V I D W R E A L E R 7 1 7 7 6 3 1.3 8 3
First line of address
2 3 3 1 M A R K E T
Second line of address
City or Post Office
C A M P H I L L
State ZIP Code
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
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Correspondent's a-mail address: DWREAGERaREAGERADLERPC • COM
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.
SIGN URE OF PERSON RE3PON B .OR FILING RETURN ~ ~ DATE
<< ~ Z. ~
A DRESS
24 NORTH 23 STREET CAMP HILL PA 17011
SIGNATURE F PREP HER THAN REPRESENTATIVE ~ b TE _
ADDRESS
2331 MA T STREET CAMP HILL A 17011
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: C U R T I S G• REED 1 8 6 2 4 9 2 1 2
RECAPITULATION
1. Real Estate (Schedule A) ......................................... .. 1.
2. Stocks and Bonds (Schedule B) .................................... .. 2. 3 9 6 8 0 , 9 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. 8 6 9 8 8 . 6 0
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .....
.. 7.
1 8
1
8
3
9,
4
4
8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 3 0 8 5 0 8 , 9 6
9. Funeral Expenses and Administrative Costs (Schedule H) .... ..... ....... .. 9• 6 9 2 3 . 4 2
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .... ....... .. 10. 1 9 6 . 2 0
11. Total Deductions (total Lines 9 and 10) ................. ..... ....... .. 11. 7 1 1 9 . 6 2
12. Net Value of Estate (Line 8 minus Line 11) .............. ..... ....... .. 12. 3 0 1 3 8 9 . 3 4
13. Charitable and Governmental Bequests/Sec 9113 Trusts for wh ich
an election to tax has not been made (Schedule J) ........ ..... ....... .. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........ ..... ....... .. 14. 3 0 1 3 8 9 . 3 4
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 _ O D 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 3 0 1 3 8 9. 3 4 16. 1 3 5 6 2. 5 2
17. Amount of Line 14 taxable
at sibling rate X .12 0 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
0
0 0
0
0
0
at collateral rate X .15 18. .
19. TAX DUE ........................................ ..... ....... ..19. 1 3 5 6 2. 5 2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q
Side 2
1505610240 1505610240
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S'JAME
C U R T I S G• REED
__
__ __ ____ ________
STREET ADDRESS
2100 BENT CREEK DRIVE
CITY
MECHANICSBURG STATE
PA ZIP
17050
Tax Payments and Credits:
t. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments
B. Discount 678.11
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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
File Number
21 11 1380
(1) 13, 562.52
Total Credits (A + B) (2) 678.11
(3)
(4) 0.0 0
(5) 12 , 8 8 4 • 41
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; ^ 0
::::::::::::::::::::::::::
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? .................................................................................. ..... ^ X^
3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? .... ..... ^ 0
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 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)]. 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)]. 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-1503 EX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CURTIS G• REED 21 11 1380
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. UNITED STATES SERIES EE SAVINGS BONDS - 250 TOTAL BONDS 39,680.92
TOTAL (Also enter on line 2, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX+ (11-10)
Pennsylvania SCHEDULE E
tSEPARTMENT OF REVENUE
CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
CURTIS G• REED 21 11 1380
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
1. WELLS FARGEO - CHECKING/SAVINGS 86,888.60
PO BOX 6995
PORTLAND, OR 97228-6995
2• PERSONAL PROPERTY 100.00
TOTAL (Also enter on Line 5, Recapitulation) I $ 8 6 , 9 8 8.6 0
If more space is needed, insert additional sheets of paper of the same size
REV-1510 EX+ (08-09)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
CURTIS G• REED 21 11 1380
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
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE
VALUE
1. AMERIPRISE ANNUITIES AND IRA 148,592.10 50.00 74,296.05
SUZANNE L• MILLER - DAUGHTER
2• AMERIPRISE ANNUITIES AND IRA 148,592.10 50.00 74,296.05
BRADLEY S• REED - SON
3• THRIVENT FINANCIAL FOR LUTHERANS - ANNUITY 33,247.34 50.00 16,623.67
SUZANNE L• MILLER - DAUGHTER
4• THRIVENT FINANCIAL FOR LUTHERANS - ANNUITY 33,247.34 50.00 16,623.67
BRADLEY S• REED - SON
TOTAL (Also enter on Line 7, Recapitulation) I $ 181, 8 3 9.4 4
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
~pennsylvania
6EPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
CURTIS G• REED 21 11 1380
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. FUNERAL - HOOVER FUNERAL HOME 2,507.00
2• WOODLAWN CEMETARY 1,230.00
3• ROMBERGER MEMORIALS 350.00
4• PASTOR - WILLIAM STICLEY 125.00
5• FUNERAL LUNCHEON - SOPHIA'S ON MARKET 1,146.92
6• FUNERAL FLOWERS 75.00
7• ORGANIST - S• DANIELS 125.00
B
2.
3.
4.
5.
6.
7
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State _
Year(s) Commission Paid:
AttomeyFees: REAGER & ADLER, PC
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
Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS
Accountant Fees: H & R BLOC K
Tax Retum Preparer Fees:
1,000.00
293.50
71.00
TOTAL (Also enter on Line 9, Recapitulation) I $ 6 , 9 2 3. 4 2
ZIP
ZIP
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-OS)
'pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
CURTIS G• REED 21 11 1380
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
1. MEDICAL - YOUNGS MEDICAL EQUIPMENT 7.76
2• MEDICAL - HERITAGE MEDICAL GROUP 40.00
3• MEDICAL - ALERT PHARMACY 115.58
4• PHONE - VERIZON WIRELESS 32.86
TOTAL (Also enter on Line 10, Recapitulation) I $ 196
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:
CLIRTIS G. REED ~l. 1.1. 1.aAfl
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 outs' ht spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. SUZANNE L• MILLER Lineal 150,694.67
24 NORTH 23RD STREET
CAMP HILL, PA 17011
2• BRADLEY S• REED Lineal 150,694.67
28 CRESTWOOD LANE
MILFORD, NH 03055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
1. 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, $
If more space is needed, use additional sheets of paper of the same size.
W I L L
I, CURTIS G. REED, of Lower Paxton Township, Dauphin
County, Pennsylvania, being of sound and disposing mind, do
make-and publish this my last will and testament.
ITEM I. PRIOR WILLS. I revoke all prior wills and
codicils.
ITEM II. .DEBTS. I direct that alY 'my jus~L"tl~'bC's
funeral expenses including, if any., my grave marker and the
cyst of perpetual care of my burial plot, and all expenses of
my last illness, shall be paid from my residuary estate as soon
as practicable after my death as a part of the. expense of the
administration of my estate.
ITEM III. TAXES. I direct that all estate, inheri-'
tance, transfer, legacy or succession taxes which may be as-
sensed or levied with respect to my estate or any part of my es-
tate, whether or not passing under my will, shall be paid from
my residuary estate as soon as practicable after my death as
part of the expenses 'of the administration of my estate.
ITEM IV. PERSONAL AND HOUSEHOLD EFFECTS. I-give
and bequeath my automobiles, household furnishings, personal
effects and other tangible personalty of like nature (.not in-
ciuding cash or securities), together with any existing insur-
ance thereon to my wife, AUDREY M. REED, provided she survives
me by thirty C30) days.
In the alternative, if my wife does not
survive me, I give and bequeath-this property equally to my
chi.ldren,.SUZANNE L. REED and BRADLEY S. REED.
ITEPQ V. RESIDUARY ESTATE. I give, devise and be-
(~ queath all the rest, residue and remainder of es~tat_e~of ever
w r
,
nature whether .real, personal or mixed, and wherever situated,
including any property over which I may now have or hereafter
acquire a power of appointment to'my wife, AUDREY M. REED, pro-
vided she survives me by thirty (30) days.
In the alternative, if my wife does not su
vive me, I give, devise and bequeath all of such property equally)
to my Children, SUZANNE L. REED and BRADLEY S. REED, it
ITEM VI. APPOINTMENT OF EXECUTRIX. I appoint
my wife, AUDREY M: REED, Executrix of this my last will and test-
ament. Should my wife fail to qualify, or cease to act as
Executrix, I appoint SUZANNE L. REED and. BRADLEY S. REED to be
Co-Executors.
ITEM VI'I'. FIDUCIARIES - BONDING. No fiduciary
or alternate named in this my last will and testament, shall be
required to post bond for the faithful performance of his. duties
in this or any other jurisdiction.
IN WITNESS WHEREOF, I-have hereunto set my hand
this day of , 1977.
~ ~~~LL..~~
---„G~~GaLil_'_'9_~- - "e~d----
The preceeding instrument consisting of this and
one other typewritten page signed at the bottom for security pur-
poses, was on the date thereof signed, published and declared
by CURTIS G. REED, the Testator herein named, as and for his
last will in the presence, of us who, at his request, in his
presence, and in the presence of each other, have subscribed our
names as witnesses thereto.
-2-
• '•
CONIMONwEALTH OF PENNSYLVANIA )
ss:
COUNTY OF DAUPHIN ) ,
I, CURTIS G. REED, Testator, whose name is
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to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my last will; that i signed it will-
ingly, and that I signed it as my free and voluntary act for
,the purpose therein expressed.
j Testator
Sworn or affirmed to and acknQwled d before me,
by CURTIS G. REED, the Testator, this~b~ day o
~° ~ -- -Nota y Publ
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~~~ -<
Rt . ~ BEf1Y p pLIAN, Notary Public
~~"~, .' Harrisburg, Dauphin County
~k~~,` .~ My Commission Expires Aug. 5,1978
N 'i ` ,
COMMONWEALTH OF PENNSYLVANIA )
ss:
COUNTY OF DAUPHIN. )
We, the undersigned witnesses whose names are
signed to' the attached or foregoing instrument, being duly quali
fied according to law, do depose and sag that we were present
and saw the Testator sign and execute the instrument as his last
will; that he signed .willingly and.. executed 'it as'~a free and
voluntary act for the purposes therein expressed; that each of u
in the hearing and sight of the Testator signed the will as
witnesses; and that to the best of our knowledge .the. Testator
.. . .
was at that time 18 or more years of age, of sound. mind and
under no constraint or undue inf uence.
- --- - Wi Hess - - -~'-------------
r-- Witness
Sworn or affirmed to and subscribed to before
me by H. JOSEPH HEPFORD and F CES HAMAKER ,
witnesses, this day of ~ 1977.
Notary
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BETTY D OUAN, Nobry Prbrie
Harrisburg, Dauphin Courrty
kly Commission Expires Aug 5,1978
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