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HomeMy WebLinkAbout08-07-12,J 1505607121 REV-1500 EX (os:DS, PA Deparbnent of Revenue Bureau of Individual Taxes PO BOX 2ti0601 INHERITANCE TAX RETURN County Code Year File Number Hanisbu PA 1712&0601 RESIDENT DECEDENT 2 1 1 ~.. 0 0 0 0 8 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 9 2 5 0 9 5 3 6 1 1 2 1 2 0 1 1 0 8 0 6 1 9 5 9 Decedent's Last Name Suffix Decedent's First Name P I T T E N G E R Ml D A V I D A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS © 1.Original Retum ^ 2. Su pplemental Retum ^ 3 Re i ^ 4. Limited Estate ^ 4a F t . ma nder Retum (date of death ^ 6 D , u ure Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Retum Required . ecedent Died Testate (A~~ ~Py ~ WAl) ^ 9 Liti ti ^ 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe De Posit Boxes . ga on proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ Ele ti 11 between 12-31-91 and 1-1-95) c on to tax under Sec. 9113(A) ' CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND C N ame ONFI DENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: H A R O L D S I R Daytime Telephone Number Firm Name (ff Appligble) W I N, I I I 7 1 7 ~~- ~~ 3 6 ~ 9 D I R W I N A W O F F I C E r'tr7 REGISTER Oe LS USE Y ~~ r- - - Rirst line of address ~ z_ r ; ~~ , ~ _~:.: ,- ~3 P I T T S T R E E T ~~:, ~. -~~~~ -~ . c..l Second line of address C'? ~~ ~ ~' ~ ~ -~:-~ C `~ _.:- _~ ~ C-'s v'-"r ~ i~i-1 City or Post Office ~+ r~ -~ State ZIP Code DATE FILED ~"''~ C A R L I S L E P A 1 7 0 1 3 Correspondent's e-ma~ address: INVinIaWOffIC@tt77g111aII.COfi'1 Under penalties of perjury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and belie{, it is true, corned and complete. Dedaration of preparer other than the personal representative is based on all Mfonnation of which preparer has any knowledge. ~IQ~1~4TA1RE OF~E~RSON ,i~~LFieFOR FIL,iNC~ RETURN E~yNIPER STREET UTH PITT STREET L 1505607121 CARLISLE CARLISI PLEASE USE ORIGINAL FORM ONLY Side 1 PA 17D13 _._.-~~~ T~/ ~ PA 17013 1505607121 J 1505607221 REV-1500 EX Decedents Name: DAVID A. P I T T E N G E R Decedent's Social Security Number RECAPITULATION 1 9 2 5 0 9 5 3 6 1. Real estate (Schedule A) . , • • . , . • ................................ 1. 0. 0 0 2. Stocks and Bonds (Schedule B) , • • . . , • .............. 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) 3 0. 0 0 ..... . 4. Mortgages $ Notes Receivable (Schedule D) • • , 0. D 0 .. . ........ a. 5. Cash, Bank Deposits $ Miscellaneous Personal Property (Schedule E) 5 0. 1 7 4 4 0 0 • • • • , • . . 0 8 1 8. Jointly Owned property (Schedule F) ^ Separate Billing Re quested ....... 6. 7. Inter-Vivos Transfers $ Miscellaneous N Probate Property (Schedule G) ~ Se ar t B 5 8 5 D D , D D p a e illing Requested .:..... 7. 1 1 0 3 5 , 0 ? 8. Total Grams Assets (total Lines 1-7) ..... ••~~ $. 8 6 9 7 5. 8 8 9. Funeral Expenses $ Administrative Costs (Schedule H) .............. .. s. 2 0 8 2 4. 0 0 10. Debts of Decedent, Mortgage Liabilities, $ Liens Schedule I l ) .......... .. 10. 0. 0 D 11. Total Deductions (total Lines 9& 10) ......................... .. 11. 2 0 8 2 4 0 0 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental ~ ~ ~ ~ ~ ~ • • • ' ' ' • • ' Bequests/Sec 9113 Trusts for which ~ • 12. 6 6 1 5 1, 8 8 an election to tax has not been made (Schedule J) ................. 14. Net Value Subject to Tax (Line 12 minus Line 13 . 13. 0. 0 0 • TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE 1 ~ 14. 6 6 1 5 1. 8 8 RATES 5. Amount of Line 14 taxable at the spousal tax rate or , transfers under Sec. 9118 (a)(1.2) x .045 6 6 1 5 1. 8 8 16. Amount of Line 14 taxable 15. 2 9 7 6. 8 3 at lineal rate X .0 0 . 0 0 17. Amount of Line 14 taxable 16• O . D 0 at sibling rate X .12 0 0 0 18. Amount of Line 14 taxable 17. 0 , 0 0 at collateral rate X .15 0 . 0 0 18 0. 0 0 19. Tax Due .. ...............................:.............. 19. 2 9 7 6. 8 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REk 1500 EX Pape 3 Deceden;Ns Complete Address: File Number 21 11 00008 DAVID A. PITTENGER STREET ADDRESS 316 JUNIPER ~Tr~~cT an CARLISLE Tax Payments and Credits: t• Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty STATE PA Total Credits (A + B + C ) ZIP 17013 (1) 2 976.83 (2) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.Total Interest/Penalty (D + E) (3) Fill in oval on Page 2, Line 20 to 0.00 request a refund. 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due, (4) 0.00 (5) 2 976.83 (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 2 976.83 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: a. retain the use or inoome of the Yes No prOPertY transferred; .......... b. ratan the right to designate who shall use the ............................................................ ^ c. retain a reversionary interest; or ...... ~°~' transferred ~ its income; ............................... ^ ...... d. receive the .................................................................................. ^ pr~nise for life of either payments, benefits or care? ............. ............................. 2. If death oocerred after December 12 1982 did ........... . ~thcet reoeivin ~ decedent transfer property within one year of death 9 adequate consideration? ................ ............................ 3. Did decedent own ~ 'in Dust for' or Pce ..................... payable u death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Aoceunt, annuity, or other non ~ ~ ~ ~ ~ ~ ~ ~ ~ ^ contains a beneficlarydesignation? .................... -Probate property which IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. For dates of death on or affer July 1,1994 and before January 1,1995, the tax rate im is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. Pad on the net value of transfers to or for the use of the surviving spouse 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 survivin s use i [72 P.S. §9116 (a) (1.1) (ii)]. The statute does no____ t exempt a transfer to a surviving spouse from tax, and the statut g ~ s ~ (0) ~~t filing a tax return are still applicable even ff the surviving spouse is the only beneficiary. ~ requirements for disclosure of assets and For dates of death on or after July 1,2000: The tax rate imposed on the net value of tr~sfers from a deceased child twenty-one years of adoptive parent, or a stepparent of the child is zero 0 age or younger at deathto or for the use of a natural parent ~ ( ) Percent p2 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to ~ for the use of the decedent's lineal beneficlaries is four andone-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(aK1)], The tax rate imposed on the net vaue of transfers to or for the use of the decedent's siblings is twelve 12 Section 9102, as an individual who has at least one parent in common with the ( ) Percent (72 P.S. §9116(aX1.3)]. A sibling is defined, under decedent, whether by blood or adoption. REV--1503 EX + (8-98) C~ONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ITEM NUMBER ~~ NONE SCHEDULE B STOCKS & BONDS 21 11 All propeRy jointly-owned wffh right of survivorship must be disclosed on Scbeduk F. DESCRIPTION TOTAL (Also enter on line 2, Recapitulation) s (If more space is needed. inseR additional sheets of the same size) VALUE AT DATE OF DEATH 0.00 0. REV-1504 EX + (8.88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT tbTATE OF DAVID A. PITTENGER FILE NUMBER Schedule C-1 or G2 (including all supporting information) must be attached for each 21 11 00008 sole-proprietorship. See instructions for the su rti in ~Sey-held co~~PaMnership interest of the decedent, other than a ITEM ppo n9 formation to be submitted for sole-proprietorships. NUMBER ~~ NONE DESCRIPTION VALUE AT DATE OF DEATH 0.00 SCI~IEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP TOTAL Also enter ~ line (If more spa0e is needed, insert additional sheets of the same sip) RED/-1507 EX + (~98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT e~T~~~ .. • ~ v~ ITEM NUMBER -.__ 1. SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER nw L I 1 1 UUUO$ All property jointly-owned with the right of survivorship must be dlecbsed on Schedule F. DESCRIPTION VALUE AT DATE NONE OF DEATH 0.00 TOTAL Also enter on line (If more space is deeded, insert additional sheets of the same size) REV-1508 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN )AVID / ITEM NUMBER 1. 2. 3 4. ir~uae the All property. of litigation and the date the 21 11 med with right of surv'nrorshipmust bye di~~b ~ on Schedule F. 2006 HONDA ACCORD DESCRIPTION 32,000 Miles /Fair Condition Value based on Kelly Blue Book Trade-in Value as shown on Exhibit "A" M~TBANK Checking Account No. 3740133081 Value as shown on Exhibit "B" M~TBANK Savings Account No. 15004216209343 Value as shown on Exhibit "C" CHIMNEY SWEEP SYSTEMS, INC. Final Uncashed Paycheck from Employment , SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY VALUE AT DATE OF DEATH 11,034.00 2,959.10 2,512.38 935.33 TOTAL (Also enter on line 5, Recapitulation) s (If mae space is needed, insert additional sheets of tits same size) 17 REV-1509 EX + (6-98) COAiMAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN FILE NUMBER .,. ~ ~ ~ i VUUUt3 ff an asset was made joint within one year of the decederd's date of death, d must be reported on Schedule G. SCHEDULE F JOINTLY-OWNED PROPERTY SURVMNG JOINT TENANT(S) NAME A. JOHN PITTENGER B C JOINTLY-OWNED PROPERTY: ITEM FOR JOINT MADE CUMBER TENANT JOINT 1 527 Thomwood Lane Carlisle, PA 17013 ADDRESS INCLUDE NAME OF FINANCIAL I~NS~UTTI~ AND B~AN~K ACNCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HEIR REAL ESTATE. House and lot at 316 Juniper Street, Carlisle, PA 17013 DATE OF DEATH VALUE OF ASSET 117,000.00 TOTAL (Also enter on line 6, Regpitulation) (If more spaces needed, insert additional sheets of the same size) S RELATIONSHIP TO DECEDENT Father % OF DATE OF DEATH DECD'S VALUE OF INTEREST DECEDENTSINTERES7 50. 58, 500.00 RSV-1510 EX + (6.98) COMMONWEALTH OF PENNSYLVANW INHERrrANCE TAX RETURN RESIDENT DECEDENT tSTATE OF SCHEDULE G INTER-VIVOS TRANSFERS $ MISC. NON-PROBATE PROPERTY urwlu A. f'ITTENGER FILE NUMBER 21 11 00008 This schedule must be completed and filedd the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY u+cxunF n~ wu~ oFn~ naATarrerw ro oECEOartAND NUMBER t~oA~oFrnA-~r~tArrACHACOProFn+eofforaRHFxesrAh. DATE OF DEATH %OFDECD'S EXCLUSION 1. 401(k)PLAN VALUE OF ASSET INTEREST aFAe Named Beneficiary -Melissa Pittenger (Daughter) 11,035.07 100. Value as shown on Exhibit "D" .TOTAL Also enter on line 7 Recapitulation j (If more space is needed, insert additional sheets of the same size) 1 TAXABLE VALUE 11,035.07 REV-1511 EX+(1C-OB) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCNED~ILlE N FUNERAL EXRENSES & ADMINISTRATIVE COSTS FILE ITEM NUMBER A. 1. B. Debts of dacederh must be reported on 11 DESCRIPTION FUNERAL EXPENSES: EWING BROTHERS FUNERAL HOME, INC. -Funeral, burial and related services ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commissan Paid: 2. AttomeyFees IRWIN LAW OFFICE 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanatan) Claimant MELISSA PITTENGER street Address 316 JUNIPER STREET City CARLISLE state PA zip 17013 Relationship of Claimant to Decadent DAUGHTER 4• Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 5, Accountant's Fees s• Tax Retum Preparer's Fees ~• CUMBERLAND COUNTY REGISTER OF WILLS -File Inventory and Appraisement 8• PP&L -Electric Bill 9• Mold Remediation at Real Estate TOTAL (Also enter on line 9. Reranit~ d~finn~ I (If more space is needed, insert additional sheets of the same size) S AMOUNT 11,000.00 5,000.00 3, 500.00 30.00 300.00 994.00 REV-1512 EX ~ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES,. $ LIENS ESTATE OF DAVID A. PITTENGER FILE NUMBER Report deals incurred by tl~e decedent prior to death which remained unpaid as of the date of death, in lud ng u nreimbursed medical ITEM expenses. NUMBER DESCRIPTION VALUE AT DATE 1• NONE OF DEATH 0.00 TOTAL (Also enter on line 10, Recapitulation) I S (If more space ~ needed ~rt additional sheets of Uie same s¢e) REy-1513 EX + (g..pp) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT eeTwTr n~ SCHEDULE J BENEFICIARIES DAVID A. PITTENGER NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j. TAXABLE DISTRIBUTIONS (include o ht spousal distributions, and transfers under Sec. 9116 (~a (1.2)] 1. MELISSA PITTENGER 316 Juniper Street Carlisle, PA 17013 AMOUNT OR SH OF ESTATE 100% Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET s (if more space is needed, insert additional sheets of the same size) 0.00 FILE NUMBER 21 11 0001 ~TIONSHIP TO DECEDENT Do Not Llst Trustee(s) Lineal 2006 Honda Accord SE Sedan 4D Trade In Values -Kelley Blue Book Page 1 of 1 D o©I~ I ZIP CODE:17013 iSign in (or Sign up) home car values ~ cars for sale ~ car reviews I khf~ +.,...,:_~._ Your Blue Book® Value Show Used Car Prices i Price Your Next Car 2006 Honda Accord _ ~. 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