Loading...
HomeMy WebLinkAbout08-17-12 (3) 155610105 REV-1500 Ex t°2_li'tF`' PA Department of Revenue pennsyLvania OFFICIAL USE ONLY Bureau of Individual Taxes ~E~,.,~E,+f u INHERITANCE TAX RETURN County Code Year File Number PO BOX 280603 Harrisburg PA 1'7328-0601 RESIDENT DECEDENT ~ ~ l ~ ~' ~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 11 /20/2011 08/24/ 1917 Decedent's Last Name Suffix Decedent's First Name MI Yetter John S (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 REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW (~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-821 O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate (Attach Co of Will) O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes py (Attach Copy of Trust.} O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) ,.~rcrctsrunutNT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Gary Yetter (717) 645-4275 REGISTER OF WILLS USE ONLY First Line of Address r..., ~ ` 813 Shuler Street r-,a p "- ;~1 ~~ r. Z~f ~ ~i~ t ~ ~ Second Line of Address C ry -t - = ' , j L7~ r = G ~ ~ rv L ~ G ~ _, I ti_f ~ City or Post Office State ZIP Code D~~FiLE©; i-._' ; -'1 Mechanicsburg PA 17055 0`- rT ~ Correspondent's a-mail address: D ~ ~r:'~ .7 ~ -~~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowiedge and belief, it is true, correct and complete. Declaration of preparer other than th l e persona representative is based on all information of which preparer has any knowledge. SIGNATUR F PERSON RESP B, F ING RETURN DA TE ~/ ~~ ~ 2iD ~ Z' ADDRESS 813 S hul Street Mec a sburg Pa SIGNA P P ER OTHER THAN REPRESENTATIVE ~ ~ il6L~11 ~~~ DATE ADDRESS P O Box 303 Hershey Pa 17033 PLEASE USE ORIGINAL FORM ONLY Side 1 15U56101,B5 1505610105 ~ ~ 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: John S. Yetter RECAPITULATION 1 . Real Estate (Schedule A) .......................................... ... 1. 83,000.00 2 . Stocks and Bonds (Schedule B) .................................... ... 2. 23,000.00 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. 2,000.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 74,295.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Pro ert p y (Schedule G) O Separate Billing Requested..... ... 7. 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 182,295.00 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 10,999.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 941.00 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 11,940.00 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 170,355.00 13. Charitable and Governmental BequestslSec 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. 170,355.00 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 45 16. 7,666.00 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 18 19. TAX DUE ....................................................... ..19. 7,666.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 J REV-1500 EX (FI) Page 3 Decedent's Complete Address: John S Yetter - __ _ _ -- STREETADDRESS 813 Shuler Street __ _--_ - --_ _. - __- cITY Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments ___ B. Discount 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 -_ --- - - - -ZIP - STATE PA 17055 (1) Total Credits (A + B) (2) (3) (4) (5) 7,666.00 7,666.00 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 property transferred ................................................................................... ....... ^ . b. retain the right to designate who shall use the property transferred or its income ..................................... ....... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "in trust for" orpayable-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 PA RT 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(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. RFV-I502 Ex± (Oi-10) pennsylvania SCHEDULE A ~„~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT t~iAlt OF: FILE NUMBER: John S Yetter 2011-01287 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buv or sell. hnrh havi~n raacnn~hlu ~~,...,~aa,.,...~ ~~,....~_..__. ~__._ _~ ~~~~~~ ~Na« ~~ nceaeu, use aooinonai sneers or paper of the same size. ~. REV-i5o3 EX+ (7-v) ~`~i pennsylvania DEA4RTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER John S Yetter 2011-01287 All property jointly owned with right of survivorship must he disclosed ~n s~tiod~ae c ~~ niuie space is neeaea, insert aaoitional sheets of the same size REV-15o& EX+ (ii-io) Pennsylvania DEPARTMENT OF HEV[NUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: John S Yetter 2011-01287 Include the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly owned with right of survivorship must be dicdnsad „n Grhaduln c ~~ inure space is neeaea, use aaaitionai sheets of paper of the same size. REV-LSOg EX+ (oL-to) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEpENT scNE~u~ F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: John S Yetter 2011-01287 If an asset became jointly owned witl~in one year of the decedent's date of d~th, it must be reported on Srlmdule G. SURVMNG JOINT TENANT(S) NAME(5) ADDRESS RELATIONSHIP TO DECEDENT A• Gayle L Smith 1755 Pennecam Drive Daughter The villages FL 32162 B' Gary Yetter 813 Shiner Street Son Mechanicsburg Pa 17055 C. JOINTLY OWNED PROPERTY: mat NUMBFJt LEITBt FOR ]OBR TENANT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL DESTITUTION AND BANK ACCOUNT NUMBBt qt SIMILAR JOINT IIJB~InFYRIG NUMBBL ATTACH D® FOR JOINTLY HEIR REAL ESTATE. 1. A• 01101106 PNC Bank 01101106 PNC Bank 01/01/81 Citiztal Bank Of101181 Citizen Bank B 01!01106 PSECU DATE ~OFATH w of D DATE of DEATH VALUE OF /ALUE OF ASSET INTEREST DF~ENTS INTEREST 38,448.00 50 19,224.00 19,136.00 50 9, 568.00 36,181.00 50 18,091.00 ~.~•~ 50 22,603.00 9,618.00 50 4,809.00 TOTAI. (Also enter on Line 6, Recapitulation) ~ ~ If more space is needed, use additional sheets of paper of the same size. 74,295.00 REV-7 `] 7 £X t ( 0-0~)) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John S Yetter ITEM NUMBER A• FUNERAL EXPENSES: 1' Brown Funeral Home Funeral Meal and Flowers SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS AMOUNT 5,974.00 635.00 4• Probate Fees: 294.00 S• Accountant Fees: 6• Tax Return Preparer Fees: ~• Jones & Henninger Deed Prep 338.00 Notices, Newspapers 258.00 FILE NUMBER 2011-01287 Decedent's debts must be reported on Schedule I. DESCRIPTION B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City ________ _____ State ZIP Year(s) Commission Paid: z• Attorney Fees: 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation,) Claimant Gary T. Yetter Street Address 813 Shuler Street _ _ city Mechanicsbur state PA ZIP 17055 Relationship of Claimant to Decedent SOn TOTAL (Also enter on Line 9, Recapitulation) I $ 7 499.00 If more space is needed, use additional sheets of paper of the same size. ~`~i pennsylvania e.~l DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS tJlAlt VF FILE NUMBER John S Yetter 2011-n~2~~ Report debts incurred by the decedent prior to death that remained unpaid at the darn of Anarh h~i~~ah~ ~~...e:M~.,.._..., __~:__~ _._____ _ .~ ~~~~~~ ~Na~C ~~ rieeuea, mser[ aaailionai meets of the same size. / 'REV-1513 EX+ (O1-10) ~i~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE BENEFICIARIES r~iarr oi=: John S Yetter NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 ~ Gayle L Smith Gary Yetter RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Son ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. FILE NUMBER: 2011-01287 AMOUNT OR SHARE OF ESTATE 86927 86928 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I # If more space is needed, use additional sheets of paper of the same size.