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HomeMy WebLinkAbout06-29-12rrrrrrrJ 1505610105 REV-1500 ~rtoz-"'I~' PA Department of Revenue Pennsylvania OFFICUIL USE ONLY Bureau of Individual Taxes "`°`"~` County Code Year File Number PD BOx 280607 INHERITANCE TAX RETURN Harrisburg, PA 19728-0607 RESIDENT DECEDENT ~ I I~ a~~~-- INTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 12/25/2011 Decedent's Last Name Hummel MMDDriW Date Of Birth MMDDriri 07/27/1926 Suffix Decedent's First Name Leah (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI L MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (~ 1. Original Retum O 2. Supplemental Return O 3. Remainder Retum (Date of Death Prior to 12-1382) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) m 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe 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 lax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Ronald P Sieg (717) 564-1808 First Line of Address 3737 Sharon Street Second Line of Address City or Post Otfice Harrisburg REGISTER f7F WILLS l1~ONLV , ~ r.s ~ ~? C ~ -r cn.:( c' Cj l ~ ~'y} State ZIP Code A ILED PA 17111 y O '~ Correslwndent's e-mau address: rpsieg@verizon.net Under panalbes of per)ury, 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, coned and complete. Declaration of preperer other then the personal representative is based on all information of which preparer has any knowledge. SIGNATURE PERSON RESPONj~BLEhFOR FILING RETURN .DATE 3737 Sharon Street, Harrisburg, PA 17111 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1517561011]5 J J REV-1500 EX (FI) Decetlent's Name: Decedent's Social Security Number 182-22-5907 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporatlon, Partnership or Sde-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 180,815.57 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Yvos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 180,815.57 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 6,081.69 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 232.70 11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 8,314.39 12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 174,501.18 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. 174,501.18 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 .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 t 7. 18. Amount of Line 14 taxable at collateral rate x .15 174,501.18 t8 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 1505610205 26,175.18 26,175.18 REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENPS NAME Ms. Leah Louella Hummel STREET ADDRESS 128 S 15th Street CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Pdor Payments _ 26,250.00 e. Discount 1.308.76 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 ZO to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the diference. This is the TAX DUE. (1) 26,175.18 Total Credits (A+ 8) (2) 27,558.76 (3) (4) 1, 383.58 (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 Vansfer and: Yes No a. retain the use or income of the property transferred .................................................................................... ...... ^ b. retain the right to designate who shall use the property iransfemed or its income ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 2. It death occurred after Dec. 12, 1962, did decedent transfer property within one year of death without receiving adequate censideration? ........................................................................................................ ...... ^ 3. Did decedent own an "in tmsl for" or payable-upon-death bank acceunt 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 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 [!2 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 disdosure of assets and filing a tax return are still applicable even 'rf 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 far 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 benefidaries is 4.5 percent, except as noted in [/2 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-gob EX+(u-io) ~ Pennsylvania SCNEpULE E DEPARTMENT OF flEVENUE CASHr BANK DEPOSITS Ft MISC. INHERRANCE TAX 0.ETURN PERSONAL PROPERTY 0.ESIDEM DECEDENT ESTATE OF: FILE NUMBER: Leah Louella Hummel 2012-00242 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 diccbsed on Schedub F. ITEM VALUE AT DATE 1. Checking Acct 1051074029 at Sovereign Bank, 1300 Camp Hill Mall, Camp Hill, PA 17011 167,407.67 2, CD Acct 31003913918719 at M & T Bank, 3805 Trindle Road, Camp Hill, PA 17011 10,197.66 3, Refund from HighMark-health insurance 299.42 4_ Refund from Verizon- phone service 2.35 5_ Cash on hand 460.46 6. Sale price of car-1996 Chevy Cavalier 800.00 7, Refund from Claremont Nursing Home 1,641.00 g. Refund from AAA member insurance 7.01 g. All of Leah's personal goods were disposed of while she was in the nursing home. 0.00 TOTAL (Also enter on Line 5, Recapitulation) ; I 180,815.57 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (1U-09) ~~~ pennsylvania DEPAflTMENT OF REVENUE INHERRANCE TAX RETURN 0.ESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Leah Louella Hummel 2012-00242 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPRON AMOUNT A. FUNERAL EXPENSES: t' Michael J Shalonis Funeral Home (check 102) 2,050.25 Frank Snyder and Sons Monuments (check 105 for $1000.00 and check 109 for $969.00) 1,969.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) ROnald P Sieg , ExeCUtor street address 3737 Sharon Street qty Harrisburg state PA ZIp 17111 Year(s) Commission Paid: 2012 Only 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address _ City State ZIP Relationship of Claimant to Decedent 4. ~ Probate Fees: S. ~ Accountant Fees: 6. Tax Return Preparer Fees: ~~ Miscellaneous Expenses of settling the estate Cumberland Law Journal-Estate Nofice (check 104) The Sentinel (Cadisle) -Estate Notices (check 107) Repay Executor for direct out-of-pocket expenses (chedts 107 and 114) 500.00 600.00 332.50 0.00 0.00 75.00 157.68 397.26 TOTAL (Also enter on Line 9, Recapitulation) I $ 6,081.69 If more space is needed, use additional sheets of paper of the same size REV-1512 E%+ (12-08) SCHEDULE I ~;` pennsytvania DEPARTMENT Of REVENUE DEBTS OF DECEDENT, INHERRANCE TAX RETURN MORTGAGE LIABILITIES 8t LIENS RESIDEM DECEDENT ESTATE OF FILE NUMBER Leah Louella Hummel 2012-00242 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimburoed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• D AI H ff de b'll check 101 r. an u , nUst i ( ) 20.00 2. Bank fee for a returned Social Security check 15.00 3. Alert Pharmacy-final pharmacy bill (check 103) 70.00 a. Sovereign Bank charge for printing checks for estate account 27.70 5. Donation to Cumberland County Office of Aging for miscellaneous assistance (check 110) 100.00 TOTAL (Also enter on Line 10, Recapitulation) I; 232.70 if more space is needed, insert additional sheets of the same size. REV-1513 EX+ (OS-10) '~ pennsylvania DEPARTMENT OF REVENUE INMERRANCE TAX 0.ETURN 0.ESIDENi DECEDEM SCHEDULE 7 BENEFICIARIES ESTATE OF: FILE NUMBER: Leah Louella Hummel 2012-00242 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 outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] i. Mr. John H Hummel 1881 N. Nash Street, Unit 1910, Adington, VA 22209 Nephew 1/8-of-residual 2. Ms. Marcia Dunlap 101 Avingnon Way, P 0 Box 846, Daniels, WV 25832 Niece 1/8-of-residual 3. Ms. Debbie Crow 505 Cypress Dr., Canyon Lake, TX 78133 Niece 1/8-of-residual 4. Mr. Harry H. Sieg 30 North 15th Street, Camp Hill, PA 17011 Nephew 1/8-of-residual 5. Mr. Donald C. Sieg 34 Junction Road, Dillsburg, PA 17019 Nephew 2000.00-and-1/8-res 6. Mr. Ronald P. Sieg 3737 Sharon Street, Harrisburg, PA 17111 Nephew 5000.00-and-1/8-res 7. Mr. Dennis J. Sieg 105 NW Cody Drive, Lees Summit, MO 64081 Nephew 2000.00-and-1 /8-res 8. Mr. David L. Sieg 1787103rd Street, Clive, 10 50325 Nephew 2000.00-and-1l8-res 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 SECTION 9113 FOR WHICH AN ELECRON TO TAX IS NOT TAKEN: 1. B. CHARRABLE 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 sheers of paper of the same size,. ~-~~,~ Account# 1051074029 Interest ........___.... fl.u<,~:L ~:., and the irrkreat paid may drflx e~ on when irearaM is aedted ro your acmu Checks Posted Check 0 Dacs Pakf Mrourd Reference _ 974' 1223 561.59 986602365 Chock / Data Paid Amorad Reference ~,. .`;~ {312'1 `;,";'3fdfi5 _< 8f05 976 12/22 575.53 993642795 v~~ Was i~.~z~~ ~~ 1~~~-e: N® (~erts~,aro, c6iwe~c~ d~~r-G- y,~~l~• Na~2'prsl~ima9(y C ~a~vl~ rr,~,,~~1'r~-~ ot~v-ec-~ DAP®sr-1- • N~~ ~. tsv c'~ec~C 22C • ~ o~i1'ftKQrl,' ~ ~ ~ sv~a~ 1. 1 w A C ~C ~ uvy~ i55i~PO~ ~ ~ ~~ ~~ ~ ~ ~ T~ ~~ (`F PRA z °f ° rosro7anzv 4 Chaegs) Posted = 519,604.27 M asterisk (~ krdica~s a skip in sequentlal Gleck raanbeB. M (E) indkates dreck was nWlVeded tc en ek•cfronic Bem. Account Activity Date °°A Addrnone swrtraarons ealarwx 12-15 Beginrdng Balance sta6.ess.77 ©Oee MBa Highland Park March 2,2012 306 L LOUELLA RUNNEL 128 S 15TH ST CAMP HILL PA 17011-5501 (~ , V~+~a v~alZ.r~.., wap~~vll..~~ eti c.7` r~~~cDT~i ~.Qxvnv-• Re: CD Account Closing Notice -- Account~31~039139i87Y9-_---__-_ Deaz L Louella Hummel, We are writing to confirm that on 02/27/12„~+6ur CD account was closed or transferred. At that time, the balance was $10,197.66. ~ We'd like to remind you that M&T Bank is committed to providing you with solutions to all your financial needs. To find out more about the many ways we can help you with those needs, simply stop by any MdtT Bank office or call the M&T Telephone Banking Center at 716-626-1900 or 1-800-724-3222. Or if you'd like, visit the MdtT website at www.mandtbank.com. Thank you for banking with MdtT Bank. Sincerely, Fkchael N. Tnadyeh Michael N. Tradyer SNACCL AZR61 COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENVE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS6URG, PA 1 ] 126-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1182 EX111-98) N0. CD 015737 SIEG RONALD P 3737 SHARON ST HARRISBURG, PA 17111 ACN ASSESSMENT AMOUNT CONTROL NUMBER ,ea ESTATE INFORMATION: SsN: 1sz-zz-sso~ FILE NUMBER: 2112-0242 DECEDENT NAME: HUMMEL LEAH LOUELLA DATE OF PAYMENT: 03/22/2012 POSTMARK DATE: 03/22/2012 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2011 REMARKS: SEAL CHECK#108 101 ~ 526,250.00 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: 526,250.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER /a .g.~~~,~-/~ -- _ G ~' ~7d1~ -- - - ~ __ sg[.ll.~ 373 ,P-..~ ~y~ _- L - ~.__... _.. A%A. ~/%/ i ~ s2,~2g_ Goa _ __ _-- O __ _ ___ _ ____ __