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Home My WebLink About09-10-12J 1505611188 REV-1500 Ex(02-22)(Fp pennsytvania OFFICIAL USE ONLY PA Department of Revenue °""^m°'""""q` County Coda Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280801 Harrisburg, PA 1712 8-08 0 7 RESIDENT DECEDENT 21 12 0 4 21 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 191264047 02 27 2017E 08 191914 Decedent's Last Name Suffix Decedent's Rrst Name MI Bretton Gertrude C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Frst Name 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 Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O aa. Future Irnerest Compromise (date of O 5. Federal F~tate Tax Return Required death after 12-12-82) [~ 6. Decedern Dled Testate O 7. Decedent Mairnained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) p 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death p 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT -This section must be completed. All Correspondence and Confldentlal Tax Information Should be Directed to: Name Daytime Telephone Number Elyse E• Rogers 717 612 801 fV ~ REGISTEI® LLS USE ~Y ' ~ ~1 ( "t7 !3t ~ _ Frst Line of Address -' cn `` ` ~ ~~rf 1 ~If"Tl ~ 'I C7 r i Saidis, Sullivan & Rogers ~~ a `_-`~- Second Line of Address 7 ~^'] ` 635 North 12th Street, Suite 400 ~ ~ t City Or POSt Office State ZIP Code DATE FILED Lemoyne PA 17043 correspondent's e-mail address: erogers@ssr-attorneys.com Under penalties of perjury, I declare that I have examined this return, inelud ing accompanying schedules and statements, and to the beat of my knowledge and belief, it is true, correct and complete. Declaration of the preparer other than personal representative is based on all information of which preparer has any knowledge. SIGNATUR~ PERS~SPQNSIBLE FOR NG RETJ,(RN DATE ~ ~ ADDRESS SIGNATUREO PAREROT THA EPRESENTATIVE DATE .1v L /6~iZ ADDRESS 635 N rth 12th Stre , Su 400 Lemo ne, PA 7043 PLEASE USE ORIGINAL FORM ONLY Side 1 n .I - L 1505611188 1505611188 ~ • /~) 1505611288 Rev-1500 D( (Fl) Decedern's Social Security Number 191264047 Decedern'sName: Gertrude C Bretton RECAPITULATION 0 • ~ ~ 1. Rea! Estate (Schedule A) ......................................... 1. 2. Stocks and Bonds (Schedule B) .................................... 2. S , O 7 8.4 8 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ...... 3. ~ • ~ ~ a. Mortgages and Notes Receivable (Schedule D) ......................... 4. 0 • 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ....... 5. 5 , 2 91.0 3 6. Jointly Owned Property (Schedule F) O Sepazate Billing Requested ...... 6. 8 7 0 ' 7 0 7. Inter-~vos Transfers & Miscellaneous Non-Probate Property 0 • 0 0 (Schedule G) O Sepazate Billing Requested • • • • • • 7. 8. Total Gross Assets (total Lines 1 through 7) ............................ 8. 11 , 2 4 0 • 21 9. P ( ) .................. Funeral Ex enses and Administrative Costs Schedule H 9. 8 , 6 5 5.0 4 3 2 , 0 3 4 •0 3 10. 9 9e ( ) ............. Debts of Decedent, Mort a Liabilities, and Liens Schedule I 10. 11. Total Deduetlons (total Lines 9 and 10) .............................. 11. 4 0 , 6 8 9.0 7 ~ • ~ ~ 12. ............................. Net Value of Estate (Line 8 minus Line 11) 12. 13. Charitable and Govemmernal Bequests/Sec 9113 Trusts for which 0'00 an election to tax has not been made(Schedule ))•••••••••••••.•••••.••• 13. ~ ' ~ ~ 14. Net Value SubJeet to Tax (Line 12 minus Line 13) ....................... 14. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0.00 0.00 (a)(1.2)x.oo is, 16. Amount of Line 14 taxable 0. 0 0 0. 0 0 at lineal rate X .045 16. 17. Amourn of Line 14 taxable 0. 0 0 0. 0 0 at sibling rate X .1 z 17. 18. Amourn of Line 14 taxable ~ ' ~ ~ at collateral rate X .15 18 0 • 0 0 19. .................................................... TAX DUE 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 1505611288 1505611288 J Rev-1500 EX (FI) Page 3 Decedent's Complete Address: File Number 21 12 0421 DE ENTS NAME Gertrude C. Bretton STREET ADDRESS 1700 Market Street cITY Cam Hill srATE PA zIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Prior Paymerns B. Discount (1) 0.00 0.00 ~~~~ Total Credits (A+ B) (2) 0.00 3. Interest 4. If lane 2 is greater than Line 1 + Line 3, erner the difference. This is the OVERPAYMENT. FIII In oval on Page 2, Llne 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) 0.00 (4) (5) 0.00 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. retainareversionaryirnerest •••••••••••••••••••• ............................... ^ 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 decedern own an in tmst 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 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 peroern [72 P.S. Sect. 911s(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 peroern [72 P.S. Sect. 9116(a)(1.1)(ii)]. The statue does not exempt a trar~fer 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 parern, an adoptive parent or a stepparent of the child is 0 peroern [72 P.S. Sect. 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. Sect. 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. Sect. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parern in common with the decedent, whether by blood or adoption. REV -1503 EX+ (8-88 SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INH ERITANCE TA% RETURN RESIDENTDECEDENT ESTATE OF FILE NUMBER Gertrude C. Bratton 21 12 0421 (If more space is needed, insert additional sheets of the same size) REV-1508 EX4 (11-10) Pennsylvania SCHEDULE E bRPARIMf.'N'r di'NtYk'NGt CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENTDECEDENT ESTATE OF: FILE NUMBER: Gertrude C. Bratton 21 12 0421 Include the proceeds of litigation and the date the proceeds were received by the estate. All property lolntly owned with right of survivorship must be disclosed on Schedule F. If more space is needed, Insert additional sheets of the same size REV-1508 E%+(Ot-10) "' ' pennsylvania SCHEDULE F tlERARI'Mk NT Oi'RkYE'NUE INHERITANCETAX RETURN JOINTLY-OWNED PROPERTY RESIDENTDECEDENT ESTATE OF: FILE NUMBER: Gertrude C. Bretton 21 12 0421 If an asset became Jointly owned within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Charlotte L. Malick 916 North Spring Street Sister Middletown, PA 17057 B. c. JOINTLY-OWNED PROPERTY: ITEM NUM. LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY. INCLUDE NAMEOF FINANCIAL INSTITUTION AND BANK ACCTNUMBER OR SIMILARIDENTI FI'ING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST DATE OFDEATH VALUE OF DECED EN7'S INTEREST 1 A Keystone Federal Credit Union 1,048.87 0.000 524.44 2 A 24 shs PPL stock 692.52 0.000 346.26 TOTAL (Also enter on Line 6, Recapitulation) I 870.70 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(t0-09) Pennsylvania UEVpR1M~Nt OK REYtNlik' INHERITANCE TAX RETURN RESInENTOECEOENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Gertrude C. Bratton 21 12 0421 Decedent's debts must be reported on Schedule I. A. FUNERAL EXPENSES: 1 Jerre Wirt Blank Funeral Home 2 C. Elizabeth Klein -additional funeral costs B. ADMINISTRATIVE COSTS: 1. Personal Represernative Commissions: Name(s) of Personal Represernatlve(s) Street Address City State Zip Year(s) Commission Pald: 2. Attorney Fees 3. Family Exemption: (If decedern's address is not the same as claimant's, attach explanation.) gaimarn Street Address 4. s. 6. 7 8 9 10 City State Zip Relationship of paimarn to Decedent Probate Fees: Accournant Fees: Tax Return Preparer Fees: Register of Wills of Cumberland County -probate costs Saidis, Sullivan & Rogers -out-of-pocket expenses The Sentinel -legal advertising Cumberland Law Journal -legal advertising 5,764.40 956.84 800.00 800.00 90.50 0.00 168.30 75.00 TOTAL (Also enter on Line 9, Recapitulation) ( 8,655.04 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+(12-08) ~ Pennsylvania UfiPhhiMEN'f Oi h~'VkNUE INHERITANCE TAX RETURN RESIDENTDECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Gertrude C. Bretton 21 12 0421 Report debts Incurred by decedent prior to death that remained unpaid at the date of death, Ineludlnp unrelmbursed medical expenses. I DESCRIPTION 1 C. Elizabeth Klein - to compensate for time expended in acting as agent under Power of Attorney including but not limited to paying bills, preparing income tax returns, and otherwise handling all of decedent's personal affairs for period 3/2009 through 2/27/2012 2 C. Elizabeth Klein -reimbursement for mileage expense incurred while acting as agent for decedent 3 C. Elizabeth Klein -reimbursement for clothes and toiletries purchased for decedent 4 I Verizon -balance due 5 I Manor Care -balance due 6 I PSERS -reimbursement 7 ~ Pennsylvania Department of Public Welfare DEATH 1, 000.00 2,345.71 535.41 9.20 4.00 24.22 28,115.49 TOTAL (Also enter on Line 10, Recapitulation) I 32,034.03 If more space is needed, insert additional sheets of the same size. REV-1513 EXr(Ot-10) Pennsylvania SCHEDULE J OEPARiMk N'f pF'AkVkNUE INHERITANCETAX RETURN BENEFICIARIES RESIDENTDECEOENT ESTATE OF: FILE NUMBER: Gertrude C. Bratton 21 12 0421 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBE NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY Do Not Ust Trus s OF ESTATE T TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec. 9115(a)(1.2).] Charlotte L. Malick Sister 0.00 916 North Spring Street Middletown, PA 17057 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE515 THROUG H 180E 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: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-'1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. Attachment to Pennsylvania Inheritance Tax Return Estate of Gertrude C. Bratton Date of Death: 02/27/2012 File No: 21-12-0421 Non-probate assets will be used to pay certain debts and administrative expenses for which the probate estate is insuf#"icient. ~ OI f~ ~ O Mo (~`(l~j] O ~ N J T r ~_ O ni _~ LL ~ O A 0 U ~ ~ p C ~ v ~ a~ n p'~ "' ~ „~ H ~ U n°6" ~ ~ ~ ~ a ~ O C N ~ ry} ~ Y. r+ ri V1 0 ~ o ~ a z ~ a~"i o ,~ U ~ ~ ~OU O N~ r ~ ~ ~ C ~ k = o =~ Law Offices of SAIDIS, SULLIVAN & ROGERS A PROFESSIONAL CORPORATION ROBERT C. SAIDIS DANIEL L. SULLIVAN ELYSE E. ROGERS JOHN A. FEICHTEL DEAN E. REYNOSA TODD F. TRUNTZ MARYLOU MATAS SEAN M. SHULTZ ROBERT B. HAMILTON HANNAH WHITE-GIBSON 635 NORTH 12~ STREET, SUITE 400 LEMOYNE, PENNSYLVANIA 17043 TELEPHONE: (717) 612-5800 - FACSIMILIE (717) 612-5805 EMAIL: attorney~ssr-attorneys.com www.ssr-attornevs.com September 6, 2012 REPLY TO LEMOYNE 717-612-5801 eroeerssa jssr-attorneva.com Register of Wills of Cumberland County One Courthouse Square Carlisle, PA 17013 i- r; Re: Estate of Gertrude C. Bratton ~''' o~,;. File No: 2012-00421 ~ Dear Madam: ~.~ Enclosed for filing with your office are the following: 1. Original and one copy of the Pennsylvania Inheritance Tax Return. Please note there is no tax due. 2. Inventory; and 3. Check in the amount of $30 representing your filing fees. Please time stamp and return a copy of this letter. A return envelope is enclosed for your use. If you have any questions or require additional information, please do not hesitate to contact me. cjr Enclosures cc: C. ElizaBeth Klein Sincerely yours, ~~ S Elyse .Rogers CARLISLE OFFICE: 26 WEST HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 Of Counsel JOHN E. SLIKE STEPHEN L. GROSE ~. rn ~~ -v c.^ =~ r'~rr7 p '~) r~ ~;-"' <:~ ~ ~,__ -n ~n o~