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HomeMy WebLinkAbout09-27-121505610140 REV-1500 Ex (°'-'°) OFFICIAL USE ONLY PA DeparMent of Revenue County Cade Year Flle Number Bureau of IndiNdual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 1 2 0 1 1 1 Hemisb re PA 1712&0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal 3ewrlry Number Data of Death MMDDYYW Date of Birth MMDOYYVY 0 2 0 1 1 1 1 2 8 1 `9 2 6 Decedent's Last Name Suffix Decedent's Firet Name MI B A Y E R R I C H A R D C (If Applicable) EMer Surviving Spouse'e Information Below Spouse's Last Name Suffix Spouse's First Name~~ Spouse's Saclal Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI © 1.Original Return ~ 2. Supplemental Return ~ i!. Remainder Retum (date of death prior to 12-13.82) 4. Limited Esfate ~ 4a. Future Interest Compromise (tlate of ~ ti. Federal Estate Tax Retum Required death after 12.12-82) ® 8. Decedent Died Testate ~ 7. Decedent Malntalned a Living Tmst 1 B. Total Number of Safe Deposit Boxes (Attach Copy of WIII) (Attach Copy of Trust) 9. LI9ga9on Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 1'I. 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 MFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 0 First Ilne of address 5 4 E A S T M A I N Seand line of address city or Post OtOCe M E C H A N I C S B U R G S T R E E T State ZIP Code REGISTER OF WILLS USE ONLY ho r~ N ( `' f*t r'- '~ ~Ci,;, N O ~" ~C:_ ~ B ~ OATE'F]LED D .. P A 1 7 0 5 5 c~ -~ ~'! r~ ~' .c: i^, _o F,. z~ ,~~ r--~ r", .. -~ -ri :` f3 `~ rn Corcesponde e-mail address: Under peria r)ury, I dedare Ihel I have eyamined tp~ return, induding accompanying schedule and aletemeMa, and to the beat of my knowledge end belle(, Il la tnn, ro a complete. Decleradon of rer r then the pereorml representative Is based on all Infonnadon of which praparer has any knowledge. D SIGNATURE A ~P~ER~T}~HAN REPRESENTATIVE ~ /y 4_// ~ L Side 1 1505610140 'L505610140 J J 1505610240 REV-1500 EX Decedem's Rame: RICHARD C• BAYER Decedent's Social Secudry Number 5 RECAPITULATION 1 8 0 7 0 0. 0 0 1. Real Estate (Schedule A) ......................................... .. t 1 4 5 2 6. 2 8 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. 2 7 1 9 9 4 , 3 7 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. 8. Total Gross Assets (total Lines t through 7) ........................ ... 8. 4 6 7 2 2 D . 6 5 9. ............... Funeral Expenses and Administrative Costs (Schedule H) 9. ... 1 4 1 2 3 . D 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10. 5 9 3 0 . 9 0 11. Total Deductions (total Lines 9 and 10) ............................ ... t t. 2 D D 5 3. 9 0 12. Net Value of Estate (Line 8 minus Line 11) ......................... ... 12. 4 4 7 1 6 6 . 7 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to taz has not been made (Schedule J) ................... ... 13. 14. Net Value Subject to lax (Line 12 minus Line 13) .. ........... .. ..... .. 14. 4 4 7 1 6 6 . 7 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 D 0 is 0. 0 0 (a)(t.2)x.o- . . 16. Amount of Line 14 taxable 4 4 7 1 6 6 7 5 ts 2 0 1 2 2. 5 0 at lineal rate x .045 . . 17. Amount of Line 14 taxable O D D 17 0. 0 0 at sibling rate X .t2 . . 18. Amount of Line 14 taxable D D D D • D D at collateral rate X .15 t8. 19. TAX DUE ...................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 2 0 1 2 2. 5 0 Slde 2 1505610240 1505610240 J REV-1500 EX Page 3 e~___J~.~a~~ f~....,...l..e.. Add~ncc• Flle Number 21 12 0111 DECEDENT'S NAME RICHARD C. BAYER STREET ADDRESS 8 BIGHORN AVENUE CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Pdor Payments 19.200.00 B. Discount 960.00 3. Interest 4. If Line 2 is greater than Line 1 +Une 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) 20.122.50 Total Credits (A+EI) (2) 20.150.00 (3) (4) 37.50 5. If Line i +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (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 : ................................................................. i f d i ...:. ^^ ncome : ......................... erre or ts b. retain the right to designate who shall use the property trans ... ^ c. retain a reversionary interests or .......................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................. ...... 2. If death occurred aNer December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... 3. Did decedent own an 'intrust fart' 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 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 ~i.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 bloods or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMEM OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RICHARD C. BAYER 21 12 0111 All nut 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 buy or sell, both having reasonable knowledge of the relevant facts. Real property that Is jainty~owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. IS BIGHORN AVENUE I 180,700.00 MECHANICSBURG, PA 17055 COUNTY ASSESSED VALUE Line 1, Recapitulation.) ~ S If more space is needed, use addiM1Onal sheets of paper of the same size. REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE 7AX RETURN RESIDENT DECEDENT ESTATE SCHEDULE B STOCKS & BONDS FILE NUMBER RICHARD C. BAYER 21 12 0111 All propeAy jointry•owned whh right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PPL '14,526.28 STOCK (526 SHARES -NET SALE PRICE) TOTAL (Also enter on line 2, Recapitulation) ~ ; (If more space is needed, insert additional shee5 of the same size) REV-1508 EX+ (11-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, S MISC. PERSONAL PROPERTY Include the proceeds of litigation and the date the proceeds were received by the estate. All property olntty owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION 5,332.91 SAVINGS 2. M&T BANK 33,624.07 SAVINGS 3. SANTANDER 2,714.00 SAVINGS 4. CHEVROLET 13,616.00 2009 IMPALA VALUE FROM MOTOR TREND WEBSITE 5. INHERITANCE 2,949.46 JOSEPH A. BAYER ESTATE 6. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION 8,198.64 CHECKING 7. M&T BANK 3,717.66 CHECKING 8. PNC 12,544.07 CHECKING 9. CITIZENS 937.88 CHECKING 10. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION 27.102.78 CD 11. M&T BANK 19,739.85 CD 13. CITIZENS 12,346.77 CD 12. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION 129,170.28 MONEY MARKET TOTAL (Also enter on Line 5, Recapitulation) I ; If more space is needed, insert additional sheets of paper of the same size REV-1571 FCC+(10-09) pennsylvania SCHEDULE H DEPARTMEM OF REVENUE FUNERAL EXPENSES AND INHERITANCE TA%RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT RICHARD C. BAYER 21 12 0111 Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: . 1. NEILL FUNERAL HOME, CAMP HILL, PENNSYLVANIA 8,575.50 2. GRAVESTONE 247.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) DAVID A. BAYER Street Address 33 MURRAY HILL CIRCLE City BALTIMORE State MD ZIP 21212 Year(s) Commission Paid: (RENOUNCED) p Ahomey Fees: MURREL R. WALTERS, III 4,800.00 3, Family Exemption: (If decedent's address is not the same as claimants, adach explanatba) Claimant Street Address Cdy State ZIP _ Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 500.50 6 Accountant Fees: 6. Tax Retum Preparer Fees: 7 TOTAL (Also enter on Line 9, Recapitulation) 15 „ ,„ ,,,, If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8r LIENS ESTATE OF FILE NUMBER RICHARD C. BAYER 21 12 0111 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbureed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. HERSHEY KIDNEY SPECIALISTS, INC. 299.00 MEDICAL 2. UPPER ALLEN TOWNSHIP, DENNIS ZERBE 2,677.98 2012 COUNTY/TOWNSHIP TAXES - 620.46 2012/2013 SCHOOL TAXES - 2,057.52 3. COMCAST 100.20 CABLE 4. UPPER ALLEN TOWNSHIP 112.00 SEWER 5. USAA 150.21 INSURANCE 6. A SWEEP ABOVE MAINTENANCE, INC. 2,300.00 CHIMNEY REPAIR 7. CHARLES INNERS, M.D. 291.51 MEDICAL TOTAL (Also enter on Line 10, Recapitulation) I S If more space is needed, insen additional sheets of the same size. REV-1513 E%~(Ot-1 n) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER NAME AND ADDRESS OF PEI I TAXABLE DISTRIBUTIONS [Include om Sec.9 1. DAVID A. BAYER 33 MURRAY HILL CIRCLE BALTIMORE, MD 21212 2. CHARLES D. BAYER 8 BIGHORN AVENUE MECHANICSBURG, PA 17055 SCHEDULE) BENEFICIARIES RECEIVING PROPERTY ~ Do Not gal distributions and hansfers under Lineal Lineal ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER 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. AMOUNT OR SH. OF ESTATE 50.00 50.00 TOTAL DEPART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed, use additional sheets of paper of the same: size.