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HomeMy WebLinkAbout04-0931 0E.T."0'0' INHERITANCE TAX RETURN ~/ 0 RESIDENT DECEDENT county Code Year Number DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~OCIAL SECURITY NUMBER 179-32-7521 NELSON, OARRYL, L ,ATE OF DEATH (MM-CD-YEAR) DATE OF BIRTH (MM-DO-YEAR) /18/04 4/10/1940 REGISTER OF WILLS F APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 4ELSON, SONORA L, ~1 Original Return I I~ H2 Supplemental Return ~_~3 Remainder ReturnI I 0 8 Total Number of Safe Deposit Boxes 6 Decedent Died Testate (Attach copy of Will) 117 Decedent Maintained a L~wn9 Trust (Altech a copy of Tn~st) 11 Election to tax under Sec 9113(A) fills SECTION MUST BE COMPLETED. 'ALL CORRESP. ONDENCE/~ID CONEIDENT .Al. T~ INFORMATION SNOULD BE DIRECTED TO: ROBERTgAME C. RPITTER. FRQ ICOMPLETE MAILING ADDRESS 2401 N. FRONT STREET, P O BOX 12087, HARRISBURG, PA 17108-2087 FIRM NAME (if Applicable) ROBERT C. SPITZER, P C TELEPHONE NUMBER 717-231-7600 1 Real Estate (Schedule A) (1) $000 ! OFFICIAL USE ONLY $0 00 Stocks and Bonds (Schedule B) (2) $0 00 Closely Held Corporation, Partnership or Sole-Propdetershlp (3) Mortgages & Notes Receivable (Schedule D) (4) $000 !. 5 Cash, Bank Deposits &Misc Personal Property (Schedule E) (5) Separate Billing Requested 7 inter-Vivos Transfers &Misc Non-Probate Properb/ (7) $528 5 9 90 ~......_j ~ ................................................. (Schedule G or L) $533,51990 (8) 8 Total Gross Assets (total Lines t-7) 9 Funecal Expenses & Administrative Costs (Schedule R) (9) $11,101 85 10 Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (10) $0.00 ~1 TotalDeductions(totalLinesg& 10) (11) $~1 101 85 (12) $522,418 05 ~ 2 Net Value of Estate (Line 8 minus Line 11 ) 13 Charitable and Governmenta~ Bequests/Sec 9113 Trusta for which an election to tax has not been (13) $0 00 made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) (14) $522,41805 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15 Amount of line 14 taxable at the spousal tax $00o rate, or transfers under Sec 9116 (a)(1 $522,418 O5 0 (15) 0 -- d6) $ooo IZ x .12 (17) $000 ~-~. 17 Amount of line t 4 taxable at sibling rata ~ x .15 (18) $000 0 18 Amount of line 14 taxable at collateral rate 19 Tax Due (19) $000 Decedent's Complete Address: ISTREET ADDRESS 117 N 17TM STREET STATE ZIP C~TY PA 70 CAMP HILL Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) (1) $000 2. Credits/Payments A. Spousal Poverty Credit B Prior Payments C Discount Total Credits (A + B + C) (2) S0.00 3. Interest/Penalty if applicable D Interest E. Penalty Total InteresVPenalty (D + E) (3) $000 4 If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page f 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) A Enter the interest on the tax due. (5A) B Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) S0.00 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 properly transferred; ~ ~ b retain the right to designate who shall use the property transferred or its income; c retain a rewsionary interest; or d receive the promise for life of either payments, benefits or care? 2 g death occurred after December 12, 1982, did decedent transfer property within on year of death without receiving adequate consideration? ~ 3. Did decedent own an "ia trust for" 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 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. ~)e I.~-3t~crl of preparer other than [he personal representative is based on all the in formation of which preparer has any knowJedge S!GNA,~URE OF PERSON RESP©N~SIBLE FOR FILING RETURN DATE / S:O~JATURE OF PRE?/,C~f~/~ OTH,~2 THAN RE?~.S E'NTA~..~;~ ~' ¢~D~,ESS . -- "~. / . /' "' ... // .,7 . For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (11) (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% [72 PS {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 bventy-one 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% [72 P.S. §9116(a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, 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 decedenrs siblings is 12% [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. SCHEDULE E CO~ONWE^LTH OF PENNSYLV^"~A CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RES~aENT DECE~E"T PERSONAL PROPERTY ESTATE OF NELSON, DARRYL L. FILE NUMBER ,r~g~de the proceeds o~ IdL§ation and the date the proceeds were received by the estate All property }ointly-owned with the ri~h~ of survivorship must be disclosed on Schedule F VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION 1. VARIOUS ITEMS OF TANGIBLE PERSONAL PROPERTY, USED CLOTHING, FURNISHINGS, AND THE LIKE-SEE A~I-ACHED VALUATION. $5,000.00 TOTAL (Also enter on line 5, Recapitulation) $5,000 00 (If more space is needed, insert additional sheets of the same size) Augas-~l 1, 2004 TO WHOM IT MAY CONCERN: The purpose of this is to document and support the nature and value of items of tangible personal property - not investments - owned by DARRYL L. NELSON. After reasonable investigation, the undersigned has determined that all of the miscellaneous tangible personal property of DARRYL L. NELSON consisted of used clothing, personal items, items of personal adornment - watch, ring-all of which, taken together, had a fair market value at the date of his death, January 18, 2004, of approximately $ 55 ,el C~i:. 7 SONDRA L. NELSON, WIDOW SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA ~NHER[TANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF NELSON, DARRYL L. FILE NUMBER Yhis 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 DESCRIPTION OF PROPERTY % OF DECD'S TAXABLE 1. NDIVIDUAL RETIREMENT ACCOUNT WITH MORGAN STANLEY, ACCOUNT #028552, SEE VALUATION ATTACHED. $528,519.90 100.0% 0 $528,519.90 TOTAL (Aisc enter on line 7, Recapitulation) $528519 9( (If more space is needed, insert additional shec'~ ~' ~"~ same size) Darryl Nelson Morgan Stanley Account 410-045320~002 CIo~lng Val~le on DOD (1-18- # Share~ De~ri~tion S~tbol 04) Total 158 ~Jere Sys Inc CI B AGR'B $3.7C $584.6~ 6 ~,gere Systems C~ass A AGR'A $3.g~ $23.8~ 50 ~.va,~a Inc AV $16.42 $821.0( 500 FE~EX Co~p FDX $69.94 $3,4,970.0( , 500 ~ewlett Packa/d HPQ $25.52 $12~760.0( 1000 Im~ Corp. INTC $32.8S $32,890.0( 300 JLG lnds Inc. JLG $16.0~ $4,800.0( 600 Lucent Technok:~es LU $4.61 $2,766.0( 300 =enn National Gaming PENN $23.01 $6~903.0( 1000. F~ite Aid Corp. RAD S5.7~ $5.770.0( 100 Nal Mart Stores, Inc. WMT $53.4E $6,348.0( 400 NEBMD Cor~. HLTH $10.04 $4,016.0( MS Mural Fund~ 4865.485 Limited Dural[on ~ MSLDX $9.52 $46,368.0; 4613.909 Smaa-Mid Spec Vai Fd B JBJBX $12.83 $59,196.4! 702.845 ,~vidend Grit/th Secur B ~IVBX ~p41.52 $2%182.1; 30(38.279 Van Kampen Comstock B ACSWX $16.3~ $4g,155.21 2'340.147 Ve~ Kampe~ Globa Franchise B VGFBX $19.7~ ~,46,288.11 Liquid Asset Fund (DOD value) $133,291.25 Total $528,51 g.9o JUL-J4-2004 NED 02:[0 P~ FRX NO, P, Ot Terri Shl(uda 4~' & Walnut Stree~ Strawberry ~e, ~ H~sbu~, PA 17101 717 255-~ 717 255-~1 (f~) '1'~, RobeH:Spitz~ Fmm~ Terri Shkuda Iaaa 231-7602 I~ 2 incl cover ~ ~ 7/13//04 am Dan~ N¢Iso~ (DOD value) c~ Please find enclosed a sprea<tsheet showing the ~ of death value of Dar~ Nelson's Morgan Stanley accoullt. Thank you, Tefri ~ku~ SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF NELSON, DARRYL U :ILE NUMBER Debts of decedent must be reported on Schedule L iTEM AMOUNT NUMBER DESCRIPTION ' FUNERAL EXPENSES: 1. V~YERS HARNER FUNERAL HOME, CAMP HILL, PA S3,367 85 2. ;INGRICH MEMORIALS, MECHANICSBURG, PA $4,234,00 ~ ~DMINISTRATIVE COSTS: 1 Personal Representative's Commissions WAIVED Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2 Attorney Fees ROBERT C. SPtTZER, PC $3,500.00 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 5. Accountant's Fees 6 Tax Return Preparer's Fees 7 TOTAL (Also enter on line 9, Recapitulation) $11,101 85 (If more space is needed, insert additional sheets of the same size) · .. ~,,~ MYERS-HARNER FUNERAL HOME, INC.  ~ 1905 MARKET STREET P.O. BOX291 ROEI~RTH HARNER i CAMP HILL. PENNSYLVANIA 17011 SUPERVISOR ~ ~'~'" LOCALLY OWNED AND TELEPHONE February 7, 2004 Mrs. Sondra L. Nelson 117 North 17th Street Camp Hill PA 17011 Services for Darryl Lee Nelson January 24, 2004 Charges for Services Selected $ 3,775.00 Professional Services Use of Facilities Automotive Equi~rnent$ 3,775.00 Charges for Merchandise Selected Casket $ 2,590.00 Vault 980.00 $ 3,570.00 Cash Advanced Newspaper Notice/Local $ 81.00 New~paper Not ice/Out -of-Town 143.00 Clergy 100.00 Certified Copies 40.00 Flowers 212.00 $ 576.00 Total due within thirty days, please: $ 7,921.00 Received check from Prudential Insurance Co (03/04/2004) - .4~553.15 ORDER FORM O,d,r 28435 ~.~~ Supplier ' ,~ee R. Ack. # MEMORIALS Date Rec'd "A Tribu~ to L~e' Found. ordered Complete 5234 Simp~n Fe~ R~d, ~echa~burg, PA 17050 · [717) 76~22 Position verified SOLDTO: H¢5. S~aCa ~XB,~ Date of Order H~ I:,~c~H Center Over ~ Graves Lot ~ Phone (H) ~ ~ - I~ ~ (W) Approx. Date of Completion ~- ~,-~ ~[~ Le~ering " NELSO Base~- O X I'g X O.? Finish I,n°l' f f. ' ' Misc. Location: Agreement: A 50% deposit is required pdor to commencement o[ wo~ Price $ Agree~pays1atedba~anceup~ner~ti~nre~ard~ess~f~a~rtr~ub~es~rshipments~ra"y~ther~reasons This orderorconta~cannotbecancelled Foundation ,$ ~, Dy customer unless agreed by ~th pallas. ~e a~icle herein mentioned shall remain the pro. Ay o[ James R, Gingrlch Memorlel~ until paid in lull and i agr~ to carefully proofread all names and ~tes ~or accuracy and a~ept full res~nsibil{ty fo~ any e~om or ~issions THERE WILL BE AN ADDITIONAL TOTAL that ~nterest ~all ...... Hhe ~ate og ..... d on.half percent (1 ~%) ~r mo~th ~ the U.~ ba~ .... ~ to James R. Gi~gdch Memonals ~ot paid DEPOSIT Upon Completion $ (~her agree that t~e above names, sperling, and dates are correct) Salesman Type of Sale Date Entered 3ames R. Gingrich Memorials 5243 Simoson Ferry Road Mechanicsbura, PA 170SS ,..f,~/?c~F.,~- ¢717~ 766-5622 S2r~._ ra Nelson J voice 7~27~2004 117 N. 17th Street Camp Hill, PA 17011 28435 5/12/2004 Darryl - Sondra Nelson Ron Colvin 1 Double Heart 2 Vase 1 Foundation 1 Sand Blast Order Total: $4,234.00 Payments: $4,000.00 Balance Due: $234.00 SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES ESTATE OF NELSON, DARRYL L. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do NOl List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and I transfers under Sec. 9116 (a) (1.2)] SONDRA L NELSON, 117 N 17TM STREET, CAMP HILL, PA 17011 WIDOW 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTLONS SHOWN ABOVE ON LINES ~5 THROUGH 18, AS APPROPRIATE, ON REV ~500 COVER SHEET II NON-TAXABLE DISTRtBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S0.00 (if more space is needed, insert additional sheets of the same size) BUREAU OF ZNDTVZDUAL TAXES INHER/TANCE TAX DZVZSTON PO BOX 180601 HARRTSBURG, PA 171ZB-D601 COHNONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX REV-lEvi? EX AFP COg-0gl) ROBERT C SPTTZER ESQ PA 17108 DATE 12-20-2004 ESTATE OF NELSON DATE OF DEATH 01-18-2004 FZLE NUNBER 21 04-0951 COUNTY CUHBERLAND ACN 101 J Amoun~ Reei~ad DARRYL L HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGZSTER OF NZLLS CUHBERLAND CO COURT HOUSE c,'=, c.~ CARLISLE, PA 1701:5 C~.~..NG~'rs L:[NL~:~ ~ RETAZN LONER PORTTON FOR YOUR RECORDS ~ c~ DZSALLO#ANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF NELSON DARRYL L FZLE NO. 21 04-0951 ACN 101 DATE 12-20-2004 TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVAT/ON CONCERNZNO FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORZGZNAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Znterest (Schedule C) ($) q. Nortgages/Notes Receivable (Schedule D) (fi) .00 $. Cash/Bank Daposits/N/sc. Personal Property (Schedule E) (5) 5;000.00 6. Jo/ntly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) 5~8;519.90 8. Total Assets (8) APPROVED DEDUCTZONS AND EXENPTZONS: 11,101.85 9. Funeral Expenses/Adm. Costs/H/sc. Expenses (Schedule H) (9) 10. Debts/Hortgage L/ab/lit/as/L/ens (Schedule 1) (10) 11. Total Deduct/ons 12. Nat Value of Tax Return 15. lq. Char/table/Governaental Bequests; Non-elected 9115 Trusts (Schedule J) Not Value of Estate Subject to Tax .00 NOTE: To /nsure proper .00 crad/t to your account, .00 sub./t tho upper port/on of thls form w/th your tax payment. .00 53:3,519.90 (11) 11 .'101.85 (12) 522,418.05 (15) . O0 (1¢) 522,418.05 NOTE: Zf an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 N111 reflect figures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amount of L/no 1~ at Spousal rate (1.6) 16. Amount of L/ne 1~ taxable at L/neal/Class A rate (16) 17. Aeount of LAne 1~ et S/bllng rote (17) 18. Amount of Line lq taxable et Collateral/Class B rate (18) )al Tax Due 19. Pr/nc/ TAX CREDZTS PAYIIENT DATE 522,q18.05 X O0 = .00 · 00 x 045= .00 · O0 x 12 = . O0 · O0 x 15 = . O0 (19)= . O0 RECE/PT NUNBER 1F PAID AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULAT/ON OF ADDZTZONAL ZNTEREST· DZSCOUNT (+) ZNTEREST/PEN PAZD (-) ANOUNT PAZD TOTAL TAX CRED]:T I .00 BALANCE OF TAX DUEl .00 ~NTEREST AND PEN. .00 TOTAL DUE . O0 ( ZF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REi~UIRED. 1F TOTAL DUE TS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR TNSTRUCTIONS.