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HomeMy WebLinkAbout08-14-12 (2) 1505610140 REV-1500 EX (°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 28oso1 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ~ ~ ~~ ~~~° ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 5 9 2 4 9 3 3 7 0 6 0 1 2 0 1 2 0 3 0 2 1 9 3 0 Decedent's Last Name Suffix Decedent's First Name MI S P E R T Z E L A N N A 6 (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 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number M A T T H E W A M c K N I G H T 7 1 7 2 4 9 2 ~~5 0 REGISTER S USE OI~X ~~ r-T i r ~ "C7 Cw ' " to ~ '.., f 1 ~ , C ~ ~- , First line of address ~-'':= i ~--- ~ ~- r.., ., ._~._ ~ ~ ~ G' ~ ' ~ _.. I R W I N & M c K N I G H T P C ~'~~- -- _. ; -~. :- :, ~ ~ Q ~ '~ _ ~ , Second line of address y~1 - 6 0 W E S T P O M F R E T S T R E E T _ ~~ ~~ ~ - '~'T i ~-~ C~ City or Post Office State ZIP Code DATE FILED O C A R L I S L E P A 170 13 Correspondent's a-mail address: 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. SIGNATU P RSON R PON$IB O F tVG R " ATE 1~ ADDRESS ~ K• 4347 GRAPEWOOD DRIVE WARRENTON VA 20187 SIGNATURE OF PREPARE~OTH~R.fi~'1AN REPRESENTATIVE DATE ADDRESS ~~ ~ f 60 WEST P0~1FR~ STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 150561,0140 J hrJ J 1505610240 REV-1500 EX Decedent's Name: ANNA B • SPERTZEL Decedent's Social Security Number 1 5 9 2 4 9 3 B 7 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. • 2. Stocks and Bonds (Schedule B) ...................................... 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. 1 0 1 2 0 • 7 9 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 ~ 1 2 0 • 7 9 9. Funeral Expenses and Administrative Costs (Schedule H) ............ ...... 9. 2 6 7 9 • 0 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ...... 10. • 11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 2 6 7 9 . 0 7 12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. ? 4 4 ], . ? 2 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. 7 4 4 1, . ? 2 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 0 ~ Q 15. 16. Amount of Line 14 taxable at lineal rate X .045 ~ 4 4 L 7 2 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 ~ ~ 0 18. 19. TAX DUE ..................... ....................... ... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 0. 0 0 3 3 4. 8 8 0. 0 0 0. 0 0 3 3 4. 8 8 1505610240 J ',qEV-1500 f'~X Page 3 Decedent's Complete Address: File Number 00 DECEDENT'S NAME ANNA B. SPERTZEL STREET ADDRESS 515 PEACH GLEN IDAVILLE ROAD CITY STATE ZIP GARDNERS PA 17324 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 16.74 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. 334.88 Total Credits (A + B) (2) 16.74 (3) (4) 0.00 (5) 318.14 Make check payable to: REGISTER OF WILLS, AGENT _ .: j n 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 : ................................................................. ..... ^ Q b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ X^ 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? .................................................................................. ..... ^ Q 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? .... ..... ^ X^ 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. ~, -~ ,..: ._ ; .7I~ ~ ter..'-' 'k ..- -, l'." .s ~la.-. '.-_: :_:.. ~ .. _.,, __-~~~_.~._ .1 ~1~ .~......~~u.a.u-~..~~._...._~...._ ~_._. _~..._..~ _ ._~_-.--.~~ ___ _ _ ..F ~-~Ja... _. _. __. _-..--e-~ 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-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: ANNA B. SPERTZEL 0 0 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. PNC BANK -CHECKING ACCOUNT #51-8004-0888 3,911.05 2. ITHRIVENT FINANCIAL FOR LUTHERANS I 6,209.74 IRA CONTRACT #3811872 BENEFI IARY: THE ESTATE OF ANNA B. SPERTZEL TOTAL (Also enter on Line 5, Recapitulation) I $ 10,120 79 If more space is needed, insert additional sheets of paper of the same size REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ANNA B. SPERTZEL FILE NUMBER 0 0 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME 270.84 2. DIANE BALTAEFF -MUSIC FOR MEMORIAL EVENT 200.00 3. KITCHEN SUPPORT -GIFT CARDS 110.00 4. JOAN SPROUL -PIANIST 100.00 5. KAREN KENNEDY -SOLOIST 100.00 6. MT. ZION CHURCH -DONATION 100.00 7. FLOWERS FOR CHURCH 243.05 8. BULLETINS FOR MEMORIAL 196.68 9. FIESTA SUPPLY -TENTS/CHAIRS 250.00 f c. CONNIE TATE -FOOD COST 150.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attomeyl=ees: IRWIN & McKNIGHT, P.C. 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address 4 5. 6. 7. 8 9 City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Retum Preparer Fees: REGISTER OF WILLS -FILING FEE -INHERITANCE TAX RETURN REGISTER OF WILLS -FILING FEE -PETITION TO SETTLE SMALL ESTATE NOTARY FEES 750.00 30.00 43.50 15.00 TOTAL (Also enter on Line 9, Recapitulation) $ 2,679.07 SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS If more space is needed, use additiohal sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ANNA B. SPERTZEL Decedent's Name Page 1 File Number Schedule H -Funeral Expenses ~ Administrative Costs - A. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 11. BRETHERAN CHURCH IDAVILLE -DONATION 100.00 12. tCE - GARDNER MARKET 20.00 SUBTOTAL SCHEDULE H-A ~ 120.00 REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ANNA B. SPERTZEL - ,., ., 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 transfer; under Sec. 9116 (a) (1.2).] 1. JAMES D. SPERTZEL Lineal 2,480.57 PO BOX 293 1/3 REMAINDER BIGLERVILLE, PA 17307 2. ROBERT G. SPERTZEL Lineal 2,480.57 104 SCHOFIELD DRIVE 1/3 REMAINDER EAST BERLIN, PA 17316 3. BEVERLY RUDISILL Lineal 2,480.58 4347 GRAPEWOOD DRIVE 1/3 REMAINDER WARRENTON, VA 20187 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS; TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ It more space is needed, use additlona- sheets of paper of the same size. ~ ~ ;~ ~ ~ ~,: . ;i i' LAST WILL AND TESTAMENT OF ANN B. SPERTZEL I, ANN B. SPERTZEL, of 515 Peach Glen-Idaville Road, Gardners, Adams County, Pennsylvania 17324, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking my prior wills dated December 16, 1986, February 7, 2002, and any and all other wills or other testamentary dispositions that I may have previously made. ITEM I I direct my Executor, hereinafter named, to pay all lawful debts and the expenses of my last illness and burial without an Order of Court approving them. ITEM II All estate, inheritance, legacy, succession and transfer taxes (including any interest and any penalties thereon) lawfully payable with respect to all property includable in my gross estate or taxable in consequence of my death by any State or territory of the United States or by any other taxing authority, whether such taxes are payable by my estate or, in the absence of this provision, by any recipient of any such property (including, but only in the discretion of my Executor, any inheritance taxes 1 ~: which may, but need not, be prepaid) shall to the extent possible be paid by my Executor out of my residuary estate. ITEM III I give, devise and bequeath all of my estate, both real and personal property, and wheresoever situate, to my husband, ROBERT B~ SPERTZEL, if he survives me by thirty (30) days. In the event my husband, ROBERT B. SPERTZEL, does not so survive me by thirty (30) days, then in that event, I give, devise and bequeath my entire estate as follows: A. I give, devise and bequeath the china cupboard, Westmoreland dishes, and Fenton dishes to my daughter, BEVERLY ANN RUDISILL; B. I give, devise and bequeath my husband's .35 caliber Marlin rifle, .22 caliber revolver, gun cabinet, and John Deere tractor to my son, ROBERT G. SPERTZEL; C. I give, devise and bequeath my dining room table and chairs and Lenker restored breakfast set to my son, JAMES D. SPERTZEL; D. I give, devise and bequeath any remaining mortgage proceeds from the sale of my farm to BEVERLY ANN RUDISILL, 2 o 6 ROBERT G. SPERTZEL, and JAMES D. SPERTZEL, in equal shares, or to their issue, per stirpes; and E. I give, devise and bequeath all the rest, residue and remainder of my estate to my children, BEVERLY ANN RUDISILL, ROBERT G. SPERTZEL, and JAMES D. SPERTZEL, in equal shares, or to their issues, per stirpes. ITEM IV In addition to all powers, authorities and discretions granted to them by law, statute, or under any rules of court, I hereby expressly authorize and empower the Executor and any Substitute or Successor Executor the absolute and sole discretion: 1. To invest and reinvest in such government secured stocks and bonds, or other secured property, real or personal, as they may deem advisable or proper without application to, or the approval of, any court and without being otherwise restricted as to the character of any investment by any statute or rule or law of court governing the investment of estate funds. 2. To use administrative or other expenses as income or estate tax deductions and to value my estate for tax purposes by any method permitted by law. 3 m e 3. To make division or distribution of the assets of the estate in money or in kind, or partly in each, and to cause any part thereof to be composed of property different in kind from any other part. Their judgment and any determination in connection therewith, including values assigned to various assets, shall be binding and conclusive on all persons interested therein. 4. To pay, compromise, compound, extend, modify, renew, adjust, submit to arbitration, sell or release any claims or demands of the estate against others, or of others against the estate, as they shall deem advisable, and make any payments in connection therewith. 5. To execute, acknowledge, and deliver any and all instruments in writing which they may deem advisable to carry out any of the foregoing powers, including the power to indicate any division or distribution of the estate by deeds or other writings or instruments recorded among the public records of any jurisdiction where any such property may be located. 6. To deal conclusively with all matters and questions regarding the estate including both real and personal property. 4 4 C presence of us, who at her request, in her presence and in the presence of each other, believing her to be of sound mind, memory and understanding, hereunto subscribe our names as witnesses, the day and year last above written. et air ~ uV,~r~ ~.e~~~~~ i~~~ ~. ~ of a rso=~k /U R~~„ ~ k ~~3ar 6 ' ~ ~ 'COMMONWEALTH OF PENNSYLVANIA COUNTY OF ADAMS ss: We, ANN B. SPERTZEL, and ,. Y1/Y) G~,~, the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the foregoing instrument as her Last Will and she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witness and that to the best of their knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~~ B. SPER E Witness Ti~it es- Subscribed, sworn to and acknowl- edged before me by ANN B. SPERTZEL, ~,.. t'he Testatrix, an su scr' edf~.a~d b e f r e me b U~- '1~- to y and ~,(a, witnesses, this IcS~- day of _. 2003. .~ Notary Public My commission expires: Noaariel Seal Tracy L Peters, No4`ary PubNc Menegen Twp., AcYarr~s Cotariy My Gorrunisslon E~ires July 1 t, 2006 Member, Fennaywanta Aasociatlon of trdades Senior Cheddng Flan A~vount S-ta~ement For 24hour icionnationSgn on to ANC BenkOnrme Banking ANNA B SPERTZEL °B ~Q0R1 Primary atxount number. AcoountNumber: 51-8004-0888 -eorrtinued Page2oF3 e ~~~ 5i-8004-0888 Online and Electronic Banlting`~Deducdons Date Amount .Description 05!22 431.29 Web Pmt Single -Transfer Pncbank xtransfr 399349091 05124 302.38 Direct Payment - ACH Firstenergy Opco. XX~OUCX;9C~/5~ 05/25 120.92 Direct Payment -Gettysburg Comcast Gettysbu 13377901 06105 167.50 Direct Payment -Premium Unitedhealthcare X?ODUUC842~ 06!05 36.60 Direct Paymen# -Premium Uhc Medicare X)UCX)0C2191 Daily Balance Detail There were 5 Online or Elecir©r~ic Banking Deductions totaling ~1,arva,e~. Date Balance oats Balance Date Balance Date Balance 05/09 4,144.39 05!22 3,193.10 05/31 2,677.05 O6/05 3,706.95 05/11 3,884.39 05/24 2,890.72 Q6l01 3,911.05 06/07 3,891.03 05/21 3,624.39 05125 2,769.80 PNC CHECK READY GIVES YOU THE POWER OF A CASH BUYER You're in control because we put the financing in place and the check in your h~d.* At PNC Bank, you'll get a decision on your auto loan in as little as '" 15 minutes for most applications.* If approved, leave the bank with a 'blank' Check Ready check, or receive a check in the mail the next business day.* Plus, now through July 20, get $100 for your new _ Check Ready Auto Loan. ** * Credit is subject to approval. 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Use of the Mobile Deposit feature requires a supported camera-equipped device and you must download a PNC mobile banking app_ Eligible PNC Bank account and PNC Bank Online Banking required. Certain other restrictions apply. Sign on to Online Banking today bo: Check Balances > Transfer Funds > Pay Bills l•~ .; :r.- r'1.'i r" Th~lve~~ Flna~cia! for ~utherans® June 5, 2012 Estate of Anna B Spertzel 515 Peach Glen Idaville Rd Gardners PA 17324-9627 Subject :Estate of Anna B Spertzel IRA Contract 3811872 To Whom It May Concern: Thrivent Financial for Lutherans is required by the Internal Revenue (IRS) to report the contract value as of the date of death to the estate of Anna B Spertzel. The IRS form 5498 will be sent to the above address in January of next year. Form 5498 will report the fair market value of the IRA plan to Anna B Spertzel's estate. This letter should be retained for income tax purposes when filing the decedent'_s income tax return. Date of Death: 06/01/2012 Contract Value as of Date of Death: $6,209.74 If you have any questions regarding the above information, please contact your Financial Associate, MICHAEL P SMITH, whose telephone number is 717-502-1100. You are also welcome to call Thrivent Financial for Lutherans at 800-847-4836: Sincerely, Death Claims Death Claims & Services Product Services Department, FSO Cc : MICHAEL P SMITH 0165 24784 00 Anna B Spertzel ,deceased, Contract # 3811872, CIF # 502032684 Deceased's Customer ID: 502032684