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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) n; = c-~ -_ G° CJ~ ~: .__. ~~ ~+ _. :~~ ~~ ~ .. C.~ DATE FILED C `~' :~ -~ ~. _,.; r,-'~ ~~ -r~t P A 1 7 0 1 1 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 ~j'"•" F M1~ e ~, ~ ra ;.~ ~ff~ r7 ~~, LvF r "~<, 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 ~ ~~ , ~~~ -< 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 ~~ ~ ~ i f ,~ f .~rf ~ y ~'' { ~'~ l~. , ~.:. . Y ~~ ~ ~.~ ~~ ,~ ~ ~, ,a ~, ~~ ~~ g~T., -4- ~, ---- BETTY D OUAN, Nobry Prbrie Harrisburg, Dauphin Courrty kly Commission Expires Aug 5,1978 ~~a,~a9, I,~v ~v~ ~ ~~ C ~~ u. ~, ~~` fie. ~a~s~.. ~ (5..~,~.. ~vh'~ o..~ ~'-~ ~, w ~,~ =~~, 4 c~ ~-~ ~. n.,~,a ~` l ~~~ s ~~~ ~~~ ~~~~