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HomeMy WebLinkAbout10-25-12 1505610140 REV-1500 ~` t°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year FNe Number PO BOX 280601 2 1 1 2 1 1 1 9 Harrisburg, PA 17128.0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 1 4 3 4 0 4 0 7 0 9 1 8 2 0 1 2 0 7 1 1 1 9 3 4 Decedents Last Name Suffix Decedents First Name MI D U N K L E B E R G E R M I R D Z A H (H Applipble) Enter Surviving Spouse's Infomtatton Below Spouse's Last Name Suffer Spouse's First Neme MI D U N K L E B E R G E R H A R R Y E Spouse's Social Security Number 2 0 0 2 2 5 0 6 9 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return 4. Limited Esfa~ ® 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credk (date of death txiMieen 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THI8 SECTION MUSE BE COMPLETED. ALL CORRESPONDENCE AND CONF®ENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number R O G E R B- I R W I N E S Q U I R E 7 1 7 2 4 9 2 3 5 3 REGISTER OF WILL8 USE ONLY First line of address -v ,r' =;, C A R L I S L E P A 1 7 0 1 3 - 6 2~c`y a ~--~ a~ w ~~ CorrospondsM's e-mail address: N rn UrWer psnelfbs of peryury, l declare that I have examined this return, rnduding accompanying schedules and statements, and to the best d my krxnxledge and tblief, it is true, caned and complete. Dedaratlon of p~pa(er other then the personal repreaentaflve Is based on all information d which preparer has arty knowledge. I R W I N & M c K N I G H T P C Second line of address ~„~ b ~ ~ ~ 6 0 W E S T P O M F R E T S T R E E T rn ~~' n N ~~ O - ' - City or Post Office State ZIP Code o66ar,~iL-~a ~ •- ~ c~ V 753 W• LOUT.iIER STREET CARLISLE P SIGNATURE OF PREpARj=R OTHER THAN REPI~ASENTATNE T POMF PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 70 J 1505610240 REV-1500 EX Decedents Social Security Number Dseedenrsrlsme: MIRDZA H• DUNKLEBERGER 2 1 4 3 4 0 4 0 7 RECAPITULATION 1. Real Estate (Schedule A) ........................................ ... 1. 2. Stocks and Bonds (Schedule B) ................................... ... 2. 3. Closely Hekl Corporation, Partnership orSole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages and Notes Receivable (Schedule D) ....................... ... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 8. Jointly Owned Property (Schedule F) ^ Separate BUlirg Requested .... ... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Probate Property (Schedule G) u Separate BNNng Requested .... ... 7. 8. Thal Grog Asssta (total Lines 1 through 7) ........................ ... 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10. 11. Total Deductions (total Lines 9 and 10) ............................ ... 11. 12. Net Value of Estsbs (Line 8 minus Line 11) ......................... ... 12. 13. Charitable and Governmental Baquests/5ec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ... 13. 9 3 8 5. 7 7 9 3 8 5. 7 7 8 5 7. 5 0 8 5 7. 5 0 8 5 2 8. 2 7 14. Nst Value Subject to Tax (Line 12 minus Line 13) .. ........... .. ..... .. 14. 8 5 2 8. 2 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (a)(t.2)x.o _ 8 5 2 8. 2 7 15. 0. 0 0 18. Amount of Line 14 taxable at lineal rate X .0 0. 0 0 18. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTINf3 A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1505610240 0. 0 0 ~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 12 1119 DECEDENTS NAME MIRDZA H. DUNKLEBERGER STREET ADDRESS 753 W. LOUTHER STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. CredNs/Payments A. Prior Payments B. Discaint 0.00 3. Interest 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIN M oval on Paps 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. (~) 0.00 Thal Credits (A + g) (2) 0.00 (3) (4) 0.00 (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 properly trarisferred : ......................................... ............................: b. retain the right to designate who shall use the property transferred or its income : ............................. ^ c. retain a reversionary interest; or ....................................................................... ^ ......................... d. receive the promise for life of either payments, benefits or care7 ....................................................... ^ Q 2. If death occurred after December 12,1962, 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 arxount 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 benefiaary designation? .................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTION5 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)I. 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 decedents lineal benefidaries 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-t 508 EX+ (1 t-50) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY Intilde U1e of titi8atlon and the dale the proceeds were received by the estab. All owned vvNh right of survivorahi moat be ~aclosed on SchMuN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS 1ST FEDERAL CREDIT UNION -CHECKING ACCOUNT #452313 9,380.77 2. MEMBERS 1ST FEDERAL CREDIT UNION -SAVINGS ACCOUNT #452313 5.00 TOTAL (Also enter on Une 5, Recapitulation) I S 9, 385 If more space is needed, Insert additional sheets of paper of the same size REV-'f 511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS MIRDZA H. DUNKLEBERGER 21 12 1119 Decedent's dsbls must be reporled on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Canmissions: Name(s) of Personal Rapresentativets) SfreetAddress City Staff ZIP Year(s) Commiesion Paid: p, AttomeyFees: IRWIN 8 McICNIGHT, P.C. 750.00 3. Family Exemption: (If deosderlPs address is not the same as daimanYs, attadr explanation.) Claimant Street Address City State ZIP Re~tionship of Claimant fA DeosdeM 4. Probate Fees: REGISTER OF WILLS 92.50 5. AccouMaM Fees: 6. Tax Retum Preparer Fees: 7. REGISTER OF WILLS 15.00 TOTAL (Also enteral Line 9, RecaQitulaation) I S If more space is needed, use addltlonal sheets of paper of the same size. REV-1513 EX+ (Ot-10) enns Ivania P Y SCHEDULE) DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT OF: FILE MIRD2:A H. DUNKLEBERGER 21 12 1118 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lbt Trusis~s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude outriaM spouse~distri6utions and hansfers under Sec.91f6 alliil.2)). ~. HARVEY E. DUNKLEBERGER Spousal 8,528.27 753 W. LOUTHER STREET CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S It mare space is r~eedea, use addltanal sru~s of paper a the same size. ~c~t~f tII ~.es~r~ I, MIRDZA H. DUNKLEBERGER, oP the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and i Testament, hereby expressly revoking all Wills and Codicils hereto- fore made by me. 1. I authorize and empower IIlV executor to sell any realty owned by me at my death, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. ley executor is authorized and empowered to continue to engage in any business in which I may be engaged at tqy death, for such period as seems expedient to said executor. 2. I devise and bequeath all of my estate of every nature and wherever situate to ~ husband Harvey E. Dunkleberger, providing he shall survive me by sixty days. 3. Should the gift in Paragraph No. 2 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. Should any child be under the age of twenty-one years at my death, then all of 14Y property given in Paragraph No. 3 shall be held in trust by The Commonwealth National Bank of the Borough of Carlisle, Pennsylvania. The trustee, as well as ~1+ executor, is hereby authorized to retain unconverted, any property, real or personal, that I may own at my death, and shall be under no duty to convert the same into legal investments. The trustee shall have the power and authority to hold, manage, invest and reinvest and to pay over the net income of the trust property to or for the use and benefit of such of my children as may be under the age of twenty-one years, or to accumulate the same in the sole discretion of the trustee. The trustee shall be under no duty to distribute or use the income equally for .each of my children under twenty-one years, but may distribute or use it unequally in its discretion. The trustee is also authorized and empowered to pay over to, or for the. use and benefit of, any of IRY children whether under or over twenty-one years, such portion of or all of the principal of the trust estate as in its sole -1- discretion seems proper, for the maintenance, education or setting up of a child in business or in a profession or for similar purposes. The Trustee shall be under no duty to distribute or use the principal equally for each of my children, but may distribute or use principal unequally in its discretion. My primary object is the support, main- tenance, and education of such children as may be under twenty-one years of age. When the youngest of my children reaches the age of twenty-one years, then whatever remains of income or principal of the trust estate shall be distributed equally to my children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living, and subject to the same trust provisions if he, she or they are under twenty-one years of age. 5. I nominate and appoint Harvey E. Dunkleberger, to be the executor of this my Last Will and Testament, he is to serve as such without bond. Should he die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Vij:a Strazdina, as sCbstitute executrix with the same powers as are given herein to my executor, and also without the Filing of any bond. 6. Should the gift in Paragraph No. 3 take effect, I hereby direct that Vida Straz:dina shall be the guardian of the person of any of my children who shall be under the age of eighteen years at my death. 7. I hereby suggest that my personal representative retain the services of Irwin, Irwin & Irwin as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~C day of November, 1977• ~i'~~I ~/ e~Ede6.~..~1~~i./i J(SEAL) MIRD'~A H. DUNKLEBERQEdC -- Signed, sealed, published and decla//r//ed by Mirdza H. Dunkelberger, the testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the pr ence oP each they have subscribe(d~ou-r, na(Jme~,s/~as witnesses hereto. ~Kd~ f6.6~i~s - ~ s,.. -z- ACKNOWLEDGEMENT AND AFFIDAVIT We, MIRDZA H. DUNKLEBERGER , J. MARIE JONES , and BETH E. HEMMINGER , the testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that 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 testat rix , signed the Will as a witness and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND . Subscribed, sworn to and acknowledged before me by MIRDZA H. DUNKLEBERGER , the testatrix and subscribed and sworn to before me by J. MARIE JONES , and BETH E. HEMMINGER , witnesses, this ~~ day of November , 19 77 . ~- ~. ROGE RWIR, RcraRV rueuc CARLISLE BOROUGH, CUMBERIAryO pppryTM YY COMAIISSIpry FIRES OCT. S. 1980 St Send Inquires to: 5000 Louise Drive PO Boz 40 Meehanlcstwrg, PA 17055 www.memberslst.org Main Swhchboard: (8pp) 283-2328 EZ Call: (717) 697-4372 or (800) 283-4372 TDD: (717) 697-5312 or (800) 283-2326 exl. 5312 ® TelaBranch: (800)237-7288 MEMBERS 1st FEDERAL CREDIT UNION 4410 1 AV 0.350 4410-4410 * ~ IInIIIrulllrnurllullu~Irlnlr~Inlllrnlrlrln~llrlnlrl ~ MIRDZA H DUNKLEBERGER ~~ 753 W LOUTHER ST CARLISLE PA 17013 W_ o~ w~ Statement of Accounts Aug 25, 2012 thru Sep 24, 2012 Account Number: 452313 Balances at a Glance: Checking: g,38p.77 Savings: 5.00 Certificates: 0.00 Loans: 0.00 Money Management: 0.00 Swipe 5 YTD Reward : 0.00 Page: 1 of 1 Your aggregate balance as of September 1st is 59,197.32. An aggregate balance of 52,500 and having 3 products will place you in the Silver MLR level. Go mobile with our mobile banking apps! See the enclosed insert for more details. CHECKING ACCOUNTS 0011 -CHECKING Date Transaction DescxiDtion Aug 25 6+elance FonvarD~ Additions Subtractions Balarwe Aug 31 Deposit ACH XXSOC SEC 1,268.00 7.923.65 9 191 65 ID: 3031036030 CO: XXSOC SEC , . Aug 31 Deposit Dividend 0.100% 0.B7 9 192 32 Annual Penaanlage YAe/d Earned 0. >OOJb from 08/01/2012 dhrouglh AB/31/2012 , . Based on -Average Dewy Balance of 7, 882.75 Sep 04 Deposit ACH AETNA INC 188.45 g 380 77 TYPE: BENFT PYMT ID: 9949371001 CO: AETNA INC Sao 24 Ending Balance .. .. s,36o.n SAVINGS ACCOUNTS 0000 -REGULAR SAVINGS Aug ZS Balance Fonvaid O°"'r"~' S~v 24 Ending Ba/anos 5.00 5.00 YTD SUMMARIES TOTAL DNIDENDS PAID 0000 REGULAR SAVINGS 0011 CHECKING 0.00 1.91 Total Year To Date Dividends Paid NOTE: Total includes closed shares