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Home My WebLink About10-01-121505610101 REV-1500 exi°1-'°' ~ PA Department of Revenue per~nsylvania OFFICIAL USE ONLY Bureau of Individual Taxes "`"~°""`"'"°° County Code Year INHERITANCE TAX RETURN I i PO BOX 280601 I Harrisburg, PA iyi28-0601 RESIDENT DECEDENT ~ ~ I ~ p~ j ile Number ~ ~1 // ~~ I ~ LX ~ ~ ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY __~ _.05/27/2012 __ __ J 07/24/1915__. ___ -~ _ Decedent's Last Name Suffix Decedent's First Name MI Kennedy ~-- Mary _ __ 1 _ L1 (if Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ---- 1 ~ - ---- - --- ---- - -- -- -J ~ _~ ~----- -__ __ _ I~ I~----I1 _1 L--J Spouse's Social Security Number -- - - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE __ __________~ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return OD 2. Supplemental Retum O 3. Remainder Return (date of death O 4. Limited Estate O 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number - -- - - - - - _- _ -- -- _ ------ - --- i 1 ~ Attorney James M. Bach First line of address 352 S. Sporting Hiil Ro Second line of address ~ --- - _ _ __ _ --- ---- -- _ _ l I- - --- - ---- - ---- -----.. ---- REGISTER OF WILLS USE ONLY rv n ~~ ~ - rn ~ ~~i ' --t ,Z'' t _G- ..; -~, ~~~` ~ City or Post_Office State ZIP Code I ""'~"`~ ~ Me he a In csburg 1 ~ PA ~ ' 17050 ~ ---_-- - ------ 1 Correspondent's a-mail address: w Lh 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. SIGNATSI~OF~PyEGRSON RESP~IBLN~ E~yG~_ _ _ g7E~j ~'/ ADDRESS S; } ~n ._ ~ ~~~ C _~ c~ 15056101D1 Side 1 1505610101 J ~~~ 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: i RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 2. Stocks and Bonds (Schedule B) ..................................... .. 2. ~ ~ ______,__. ___.._.__._ j ___.__ ~._.___._. _~ 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. ___ .._ 152,375.34 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property i (Schedule G) O Separate Billing Requested...... .. 7. ~ _~.r--- ---_ 8. Total Gross Assets (total Lines 1 through 7) ........................... I .. 8. ~ 152,375.34 ~ 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. j i 11. Total Deductions (total Lines 9 and 10) ................................. 11. j 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. F 14. Net Value Subject 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 - _ - (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable -"" at lineal rate X .0 _ 16. 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 30,735.82 _ __ _ _ I ~~ __ 30,73 85 2 121,639.52 _ _ __ _ _~ i ___.___ ..~--5,473.77 5,473.77 Side 2 L 1505610105 1505610105 REV-1500 EX Page 3 Decedent's Complete Address: 5,848.31 DECEDENT'S NAME Mary R. Kennedy STREETADDRESS - 628 Thrush Court CITY Mechanicsburg STATE PA ZIP 17055 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 5,473.77 Total Credits (A + B) (2) 5,848.31 (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT. 374.54 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 :.......................................................................................... ^ x^ b. retain the right to designate who shall use the property transferred or its income :............................................ ^ x^ c. retain a reversionary interest; or .......................................................................................................................... ^ X^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ x^ 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 "intrust for" orpayable-upon-death bank account or security at his or her death? .............. ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ........................................................................................................................ ^ 0 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 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-1737.4 EX i (6.08) ~ Pennsylvania SCNEpYLE E, PART 1 DEPARTMENT OF REVENUE MISCELLANEOYS INHERirANCE TAX RETURN PERSONAL PROPERTY NONRESIDENT DECEDENT ESTATE OF FILE NUMBER Mary R. Kennedy Part 1 must include all tangible personal property having its situs in Pennsylvania. Examples of tangible personal property are jewelry, furniture, paintings, etc. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. Complete Part 2 on reverse side ONLY when the proportionate method of tax computation is elected. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH _ __ t ~ 1994 Oldsmobile (99,000 miles) 500.00 2 '2004 Dutch Wintergreen Mobile Home, Mechanicsburg, PA 28,000.00 ::' 3 John Hancock Life Insurance Payable to Estate 3,148.77 !. 4 *Citizens Bank Checking Account (see Exhibits A & B) 109,066.13 5 *Citizens Bank Checking Account (see Exhibit C) 6 PSECU Savings & Checking Accounts (see Exhibit D) 11,660.44 ! *See Exhibits A, B, C __ __ , *NOTE: Citizens Bank provided incorrect information which I attached to original Retum. This Supplemental Retum has the REVISED correct information marked as Exhibits A, B, & C PART 7 TOTAL 152,375.34 PART s Torw~ _, :: ~,Yx~,T:..:~,;- (From reverse side.) $~_ y_.~,__, 4„,, , - ~,._. ~. TOTAL (Also enter on Line 5, Recapitulation.) $ 152,375.34 (If more space is needed, use additional sheets of paper of the same size) JCS, LD, LU I L 0. ~~HIVI HI,~VUIV l JCI(Y 1~CJ ~ZS ~l" IYU ICU r, 4/~h Account Number 6100900118 Account Title M R T~enned Date encd 3/20/1995 Account a pieckin Princi al Balance as of DOA $106719.26 Interest from Last Postin to DOb $2.24 Account Balance as o~DOA $106721.50 YTD Interest to DOb $15.78 ~ /OG~ 7 3 7 z Sl .~ X f} Jtl', LD. LUIL ~:77HIVI Ht,WUIUI JtItV1l.CJ ~1~U, I,U !', 1/~ Account Number 6100678415 Account Title ~ ~~~ Date ened 6/6/1980 .A,ccount T e Checlcin Princi a1 Balance as of DOD $2328A1 laaterest from Last Postin. to DOD $ ,02 Account Balance as of DOD $2328.03 YTD Tuterest to DOb $ ,82 ~,~ 232.8,$sr ~~ ~ StN, lh, 1011 g;yyAM AGI;UUNI 5tHV1Ct5 ~~~ ~~~ September 25, 2012 Howard D Kennedy 628 Thn~,sh Ct Mechanicsburg 1'A 17050 Estate of MARX R KENNED'Y' Date of Beath: May 27, 2102 S SN: 207-07-7348 Deaf Sir/Madam: 11~V. ~ j'~ ~, L/4 One Citizens Drive ROP112 ltivezside, RI 02915 In accordance with your request, the attac]~ed information sheet has been provided in the above decedent's nauae as of his/her date of death. For InstaIlment 7~oa~ or Line of Credit accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-877-579-2667. Decedent Account REF#: 549256 ~~ ~~~ Howard Kennedy, Executor 20 W. Pine St. Enola, PA 17025 Re: MARY R KENNEDY, Deceased. PSECU Reference # 4569229889916 Dear Mr. Kennedy: 06/14/2012 The above referenced person has an account with PSECU which was opened on June 1, 1999. The Share accounts were individually held by MARY R KENNEDY. The following are the Date of Death Balances for MARY R KENNEDY'S account with PSECU: Account Date of Death Balances Interest -May 1-27 {S1) Savings $2,634.68 $0.29 (S4) Checking $9,024.80 $0.67 The account has been closed per your request. ~~~=~ l~ ~Gd~ ~~ If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237- ~ ~~' °7328, press 6, extension 3120. Sincerely, ~~ Sandy Fagey ~~ Member Service Representative PSECU ~,.!~ ~~ Pennsyivania State tmptoyees Credit Union P.O. Box 67013, Harrisburg, PA 17106-7013 • 717.234.8484 • 800.237.7328 • » psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION. EQUAL OPPORTUNITY LENDER. i r , , REV-1511 EX+ (10-09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY R. KENNEDY Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Gingrich Funeral Home (Headstone) 970.00 z. Sentinel Newspaper 221.40 3. Cumberland Law Journal 75.00 a. Probate Fees Register of Wills 550.00 5. Messiah Village 7,415.04 s. Village Association Fee 55.00 ~. Diane Kennedy (funeral lunch) 350.00 e. ADMINISTRATIVE COSTS: i. Personal Representative Commissions: 8,035.00 Name(s) of Personal Representative(s) Howard D. Kennedy, Sr. Street Address 20 West Pine Street C;ty Enola State PA ZIP 17025 Year(s) Commission Paid: 2013 9,642.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant N/A Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees; 7. SEE ATTACHMENT FOR CONTINUATION OF SCHEDULE H SUB TOTAL ~ 27,313.44 TOTAL (Also enter on Line 9, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. a ~ SCHEDULE H (continued) For the Estate of Mary R. Kennedy ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 8. Maureen Gunther (cleaning of residence) 9. Alberto Luther (exterior washing of residence) 10. Clyde Leach (replaced rear steps to residence) 11. Brian Luther (replaced carpet in residence) 12. Howard Kennedy Sr. (postage) 13. Village Association lot (rent for mobile home) 14. PPL Electric 15. Tony Garrick (lawn maintenance) Second sub total GRANDTOTAL 500.00 280.00 155.32 571.83 15.00 1,400.00 180.23 320.00 3,422.38 30,735.82 AME ~ J S M. BACH Attorney At Law 352 S. Sporting Hill Rd., Mechanicsburg, PA 17050, Tel: (717) 737-2033 September 28, 2012 Register of Wills 1 Courthouse Square, Room 102 Carlisle, PA 17013 Re: Estate of Mary R. Kennedy Dear Register of Wills, Enclosed herewith please find a Supplemental Tax Return regarding the Estate of Mary. R. Kennedy. We ask that you process this in your normal fashion. Lastly, you will find enclosed a Fifteen Dollar ($15.00) check payable to the Register of Wills which represents a filing fee. Respectfully, James M. Bach Attorney at Ilru~ Encl. 1($15.00 Check) (Filing Fees) ~,~~n 0 d~'~m ~,Ul~ y ao y3 ~~''a ao ~_ d ~a 0 cn f-- Ani x1 i-+ ~ `'o o~ .. ~ ~ y. aN° o N y ~ V ~ O (/~ C; N .p y W C' fD