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HomeMy WebLinkAbout11-30-12 (2)J 1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Coun Code Year tY File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 2 0 3 4 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h MMDDYYYY Date of Birth MMDDYYW 1 7 1 5 4 8 8 2 4 0 3 0 1 2 0 1 2 0 7 2 5 1 9 5 9 Decedent's Last Name Suffix Decedent's Firs t Name MI P A R T H E M O R E L I N D A Z (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI P A R T H E M OR E J E F F R E Y D Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. 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 INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MURREL WALTERS I I I ESQ 71 7 697 4650 First line of address 54 EAST MAI N STREET Second line of address City or Post Office State M E C H A N I C S B U R G P A Correspondent's a-mail address: ZIP Code ~2EGISTER OF ~LS l~ 04~LY rv ~ C © fti'i ~ ~ ~ ~ ~ ~ c.-~> ..~, .~. ~ ~,.. r c.,:j ; ~ I v-~ ~ ~ ~ ~w~ `~ ~~ ~~ r~ ~ ~ ~? -mow '_~7 - : ~_~ ~ ~ _. e @ 1 7 0 5 5 '`~.., i,~ ~~' ~ 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. SIGNA U O PE SPONSIBLE FOR FILING RETURN ,h ~~E ,~, '~ ~ ADDR~xSS JEFFREY D PARTHEMO E 116 YORKSHIRE DR MECHANICSBURG PA 17055 SIGNATURE OF P A R O HE HAN REPRESENTATIVE DA~ ~_ / ADDRESS ,~ ` MURREL ~. AL RS, III, 54 E. MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY L 1505610140 Side 1 1505610140 J h~J J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: LINDA Z. PARTHEMORE 1 7 1 5 4 8 8 2 4 RECAPITULATION 7 9 0 0 0 0 0 1. Real Estate (Schedule A) ........................................... 1. ' 1 7 3 8 3 3 3 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. • 1 6 9 5 2 9 6 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 Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. • 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 1 3 3 3 6. 2 9 9. .................. Funeral Expenses and Administrative Costs (Schedule H) 9. 2 3 1 1 7. 9 9 9 7 3 2 1 5 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 9 9 ( ) ...... ....... 10. • 11. Total Deductions (total Lines 9 and 10) ........................ ....... 11. 3 2 8 5 0 . 1 4 12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12• 8 0 4 8 6 . 1 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............... ....... 13. • 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... 14. 8 0 4 8 6 . 1 5 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.o 5 5 2 4 3 0 7 15. 0. 0 0 16. Amount of Line 14 taxable 2 5 2 4 3 0 8 1 1 3 5 9 4 at lineal rate X .045 16. • 17. Amount of Line 14 taxable ~ ~ ~ 17 ~ • 0 at sibling rate X .12 • 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 1 g, . 19. ............................................... TAX DUE ....... 19. 1 1 3 5. 9 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 12 0344 DECEDENT'S NAME LINDA Z. PARTHEMORE STREET ADDRESS 116 YORKSHIRE DRIVE CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) (~) 1,135.94 2, Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 0.00 3. Interest (3) 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. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,135.94 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. retain a reversionary interest; or ........................................................................................... ..... ^ 0 d. receive the promise for life of either payments, benefits or care? .................................................. ..... ^ ^X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ..... ^ ^X 3, Ditl decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? .... ..... ^ 0 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-1502 EX+ (01-10) pennsylvania ~ SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LINDA Z. PARTHEMORE 21 12 0344 All real 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 jointly-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. 1074-15 LANCASTER BOULEVARD 79,000.00 MECHANICSBURG, PA 17055 ADJUSTED SALE PRICE PRE-VALUATION BY REMAX REALTY ASSESSMENT TOTAL (Also enter on Line 1, Recapitulation.) I $ 79,000.00 If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LINDA Z. PARTHEMORE 21 12 0344 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. HEINZ STOCK 1,589.10 30 SHARES 2. PROCTOR & GAMBLE 6,666.00 100 SHARES 3. WALT DISNEY 6,354.00 150 SHARES 4. AT&T 139.24 4 SHARES NET SALE PRICE 5. SMUCKERS STOCK 66.93 1 SHARE NET SALE PRICE 6. COMCAST 396.74 13 SHARES NET SALE PRICE 7. PPL STOCK 2,171.32 76 S HARES TOTAL (Also enter on line 2, Recapitulation) I $ 17,383.33 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: LINDA Z. PARTHEMORE 21 12 0344 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PINNACLE HEALTH HOSPITALS 1,781.32 PTO PAYOUT 2. SOCIAL SECURITY 255.00 DEATH BENEFIT 3. METLIFE 12,101.64 INSURANCE AND ANNUITY 4. 1998 HONDA ACCORD 1,057.00 BLUE BOOK VALUE 5. 1998 CHEVROLET MAILBU 1,758.00 BLUE BOOK VALUE TOTAL (Also enter on Line 5, Recapitulation) I $ 16,952.96 If more space is needed, insert additional sheets of paper of the same size REV-1511 EX+ (10-09) pennsylVania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LINDA Z. PARTHEMORE 21 12 0344 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. PARTHEMORE FUNERAL HOME, NEW CUMBERLAND 12,408.70 2. FUNERAL LUNCHEON, ST. MARK LUTHERAN CHURCH 650.79 3. MECHANICSBURG CEMETERY ASSOCIATION -OPENING & CLOSING FEE 1,050.00 4. GINGRICH MEMORIALS 5,875.00 B. 2 3 4 5. 6. 7 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) JEFFREY D. PARTHEMORE Street Address 116 YORKSHIRE DRIVE City MECHANICSBURG State PA Year(s) Commission Paid: (RENOUNCED) Attorney Fees: MURREL R. WALTERS, III Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS Accountant Fees: Tax Return Preparer Fees: 333.50 TOTAL (Also enter on Line 9, Recapitulation) $ 23,117.99 SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ZIP 17055 2,800.00 ZIP If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER LINDA Z. PARTHEMORE 21 12 0344 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. UPPER ALLEN TOWNSHIP 336.00 SEWER 2. PPL 424.96 ELECTRIC 3. UPPER ALLEN TOWNSHIP 400.07 COUNTY/TOWNSHIPTRXES 4. UPPER ALLEN TOW NSHIP 1,427.12 SCHOOL TAXES 5. SUNGUILD CONDO ASSOCIATION 3,051.00 HOMEOWNERS' DUES 6. ERIE INSURANCE 114.00 HOME 7. PAINTING-JOHN O'LEARY 1,080.00 PAINTING 8. KITCHEN & BATH DISCOUNTERS 1,344.00 BATHROOM REPAIR 9. GLASSMASTERS 125.00 MIRROR REPAIR 10. R&T HOME SERVICES 430.00 RESTORATION WORK 11. HOME DEPOT 500.00 NEW TOILET 12. SELECT PROPERTY MANAGEMENT 500.00 PAYMENT TO SUNGUILD WATER DAMAGE REPAIR TOTAL (Also enter on Line 10, Recapitulation) I $ 9,732.1 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LINDA Z. PARTHEMORE ~~ ~ ~ n~aa RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. JEFFREY D. PARTHEMORE Spousal 55,243.07 116 YORKSHIRE DRIVE MECHANICSBURG, PA 17055 2. EDWARD J. ZEISLOFT Lineal 12,621.54 680-16 GENEVA DRIVE MECHANICSBURG, PA 17055 3. SHIRLEY M. ZEISLOFT Lineal 12,621.54 680-16 GENEVA DRIVE MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE, II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ SCHEDULE J BENEFICIARIES If more space is needed, use additional sheets of paper of the same size.