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HomeMy WebLinkAbout11-13-1215U561U101 REV-1500 ex `°'-'°' OFI=ICU\L USE ONLY PA Department of Revenue Pennsylvarda ,µ«.~, Bureau of Individual Taxes `~""" County Code Year File Number PDBOxz8o5ol INHERITANCE TAX RETURN~~ 1 ~ ~ I~ Harrisburg. PA 17128-0601 RESIDENT DECEDENT t Social Security Number Date of Death MMDDYYYV Date of Birth MMDDYYYY s' 9 ~'a ~~9~ p ~ oa <~o~a o'7/~ 19~~ Decedent's Last Name Suffix Decedent's Firs t Name MI ~~s+I~~ Kelly ~'a (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First ame rr11 MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW tll~ t. Original Retum O 4. Limited Estate O 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Receivetl THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF 1MILLS O 2. Supplemental Return O 4a. Future Interest Compromise (date of death after t2-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of TmsQ O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder ReWrn (date of death prior to 12-13-82) O 5. Fetleral 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 Mark W. Allshouse, Esq. (717) 582-4006 First line of address 4833 Spring Road Second line of address City or Post Office Shermans Dale State ZIP Code PA ,17090 REGISTEl~F WILLS USE,rOdLY 1 ~ ~~ ' r t ..1 ~ ~- ~ J~1~ _ r ~~ _ r _ _ ` ( ... ~ .TI ~. ,- r~r' -17 ~ _:_: CL r - -• -T"1 ' ATB FILED ~ i? - W ,..+> ~ ~..I ~, correspondent's a-mail address: mark~christianlawyersolutions.com Under penalties of perjury, i declare that I have examined this return, indudirg accompanying scnedules and statements, and to the best of my knowledge antl belief, it is true, correct and mmple[e. DeGaration of preparer other Man the personal repre58ntallVe is based on all in(orrniation of which preparer has any knowledge. OF PERSON RESPONSIBLE FOR FILING RETURN DATE Huurceaa IZ f~~ (S Nar..A l~lirJ~ ~I-~~c-.4r f~a, l1UZj SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 4833 Spring Road, Shermans Dale, PA 17090 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1505610101 J REV-1500 EX Decedent's Name: RECAPITULATION 1505610105 Decedent's Social Security Number i59-sa-sy9y i. Real Estate (Schedule A) ....................... ..................... 1. 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. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5, ~S! i j s-y ~ U.. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... .. , 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 8. Total Gross AsseLS (total Lines 1 through 7) .................. ....... ... 8. ~ S j~~S ~~ 9. Funeral Expenses and Administrative Costs (Schedule H) ....... ....... ... 9. ~, ~ 6 R - 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... .. 10. 11. Total Deductions (total Lines 9 and 10) ......... .................... ... it r7 7~ ~ , Q 12. Net Value of Estate (Line S minus Line 11) ...... ......... ........ ... 12. +'7 ~7 9 9 Q3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which - / OL 1_ ...... an election to tax has not been made (Schedule J) ..................... ... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. ~ ~ -/ ~ , ~ 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(12) X .OQ 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 l4 taxable at collateral rate X .15 18. 19. TAX DUE . ................... .......... .......... ......... ... 19. (n.. _. `I y" 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 150561015 1505610105 REV-1500 EX Page; 3 Decedent's Complete Address: Flie Number DECEGEN~S (DAME ~O ~, 1~ ~~ STREETADDRE , " ~ -~ /1/0,2 r I~IO /w- ~ r /-~ CITY STATE //r~-/ I/ ~-f ZIP / ~o a.s- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreddslPayments A. Prior Payments .__ B. Discount _-- Total credits (A+ B) (2) 3. Interest 4. If line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Pill in oval on Page 2, Line 20 to request a refund. (q) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (6) Make check payable to: REGISTER OF WILLS, AGENT. (1) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN 1fHE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transfemed :.................................................................................... ...... ^ b. retain the right to designate who shall use the property Gansferted or its income : ...................................... ...... ^ c. retain a reversionary interest; or ......................................................................................................... . ^ k^ . ......... 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 "intrust 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 Uansfers 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: e 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 o(the child is 0 percent [72 P.S. §9116(a)(1.2)]. e The tax role 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)]. e 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. Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNT`', PENNSYLVANIA Name of Decedent: Kelly Jo Kistler O Date of Death: June 2, 2012 File Number:_~11- ~ a - O 9 ~ 3 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ~ Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ....... ©Yes b. The separate Orphans' Court No. (if any) for the personal representative's account is: ®No c. Did the personal representative state an account informally to the parties in interest? ............................... ®Yes ©No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signa[ure of Person Fi/irsg This Faim Capacity: ®PersonallRepresentative Counsel Richard J. Kistler, Jr. Name of Person Filing [his Form 12 North Enola Drive Address Enola. PA 17025 (717)732-1671 re(ephone Form RW-l0 rev. 10.13.06 REV-1508 EX+ (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCE1ED11LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ___... _.. _. _......., .,~ ...o aanm sire/ __ ~( t' I N `~0 1% _ , l l ~L FILE NUMBER --LL fln`Gude the .proceeds of litigation and the date the nmraon~ wero .e,.e~,.e..., .._ _~_._ ~~~ - D o ~/ REV-1511 Ex+ (10-05j • ~~ "pennsylvania SCHEDULE H DEPANTME"' DE REVENl1E FUNERAL EXPENSES AND rNNERITANCE TAX RETU"" ADMINISTRATIVE COSTS RESIDENT DECEDENT 'STATE OF ~~ I I ,~ ~a K s l' ~- FILE NUh ao Decedent's debts must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION 1. B. ADMINISTRATIVE COSTS: 1~ Personal Representative Commissions: Name(s) of Personal Representative(s) __ Street Address City - 2. 3. 4. 5, 6. 7. 77G~,~7 - State_Zlp_ Year(s) Commission Paid: r'' Attorney fees: Family Exemption: (7f decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City _ _ State _ ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Taz Return Preparer Fees: County Register of Wills -filing fee for inheritance tax return _3 ^ l 7 -~ ` YT1 ~ _ 'v );~ Z' _: r- 7 W , . . ~; ~,. ~ r-._ _ .7 ~. ~ - 3 -n T ao ~" O _ L7 TOTAL (Also enter on Line 9, Recapitulation) I; 77G d b If more space is needed, use additional sheets of paper of the same size. SULLIVAN FUNERAL HOME tigh f i rtg ,YOttr a!av Sunday, June 3, 2012 Richard Kistler 12 N. Enola Dr. Enola, PA 17025 Ju6n L. Sullivan, i)imcmr 51 N. 8nala 6r. Enola. RA 17025 Phum¢: 17171732.5400 Fax: (7171-'f 3L21ti2 Dear Richard, Thank you for placing your trust in our services. We hope that we have met your expectations and made [his difficult 6me a little easier. Below are the charges that your family has incun•ed. Please make payment within 30 days of [he above date. ~L O PROFESSIONAL SERVICE, FA TI S a@ AUTOMOTIVE OTHEER MERCHANDISE SELECTED Ambra Rental Aclpnowledgement Cards Re@is[er Book $inc Memorial Folders $inc Urn /Vase Nary Companion $inc TOTAL OTHER MERCHANDISE SELECTED CAS1IADVANCES C 'tied Copies of Death Certificate Clergy Honorarium Rev. Larry Hale Newlspaper Notice patriot News Corgner's Authorization Fee Small Spray of Daisies and Seasonal TOTAL OF SERVICES $6,755.00 $416.00 $ 60.00 $ 100.00 $ 276.07 $ inc CASH ADVANCE TOTAL $561.07 $7,762.07 BALANCE DUE If there are any questions or concerns that remain unanswered, please call me. Sincerely, r- Mario A. Billow Funeral Director ~~~ ~~ ~~~e~,~ $7,762.07 -' I Kelley Blue Book The Trusted Resource' r http://www.kbb.com/honda/accord/201 Q-honda-accord/ex-sedan~d/7i Dter Your Blue Book® Value i ~ ,~ re®, 2010n Honda Accord Mllmge: 21142 Trade-In Value ~. Excellent ~ ~.-~I, $15,855 Very Good ~, ~,$15,555~ Good $14,855 Fair $13,155 Maz Seadnd: 5 Engine: 4-0yl, VTEC, 2.4 Ltter Transmission: Automatic, 5-Spd w/Overdrive Body Style: Sedan Country of Assembly: United States Your Configured Options Our pre-sekch;d optiprs; based on rypral equipment for this rar. J Optlons gret you added while mnflgudrg this rar. Engine Canrat and CAmerilence 4Cyl, VIEC, 2.4 liter Keyless Entry Trarremissbn Air Contlebnirg AutptWBC, 5-Spd w/Overdrive lower Windows DHrehain power Dgor l.edcs FWD Cruise ContrM &aldrq and Trxtlwr Sing Tractlat Contrd Power Ong StadAry Cgnird rtt wheel AB$ (4Wheel) Enbrtainment end [nstromenfatlon AM/FM Shvea MP3 (MUItl Dkt) SaFeIY and SeauHly Dual Air Bags Side Air Bags FBR Flead Curtain Air Bags loft Vehicle Highlights MPG: Ciry 21/Hwy 31 DOOrs: 4 onvetraln: Fwo EPA Class: Midsize Cars Country of Odgin: Japan Sesb Pourer Seat Rao! aM 61au Ma1x1 ROOf liglrtlrq Daygme RunrYrg Lghts wlMaiF ana tires AIWy Wheels 10/t/1210:20F