HomeMy WebLinkAbout11-21-12
1505610140
OFFlC{AL U8E ONLY
REV-154 °` `°'-'°'
PA Department of Revenue ~~ Code Y~ ~ ~~
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box 2sosol 2 1 1 2 0 3 6 9
Harrisb PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
SOCial Severity Number Date of Death ii~lDDYYYY Date of Birth NtMDDYYYY
1 8 4 1 2 4 5 3 2 0 3 1 5 2 0 1 2 0 6 0 5 1 9 1 9
Decedent`s Last Name Suffer Decedent's First Name MI
GR I S S I N G E R R E N A ~
{If Appiicabtej Eater Survlvtag Spouse's Lr-fon~natlon Below
Spouse's Last Name Suffer Spouse's F'ust Name
Spouse`s Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MI
FILL IN APPROPRIATE OVALS BELOW
® 1.Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death
prior to 12.13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Retum 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 1Niln
^ 9. Litigation Proceeds Reserved
^ {Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
^
11. Election to tax under Sec. 9113(A}
h
4
S
between 12.31.91 and 1-1-95) }
.
c
(Attach
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL. TAX INFORMATION SHOULD BE DIRECTED T0:
Daytime Telephone Number
Name
S U S A N J- N A R T M A N 7 1? 2 4 9 7 ~_ 8 0 ~.~
..~-,
First line of address
1 I R V I N E R 4 W
Second Une of address
City or Post Uffice
C A R L I S L E
State 21P Code
~~
REtilBTER ~ tt~JLlB U8E ONLY
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P A 1? 0 1 3
Correspondents e-mail address: s u s a n a d u n c a n h a r t m a n l a w• c o m
Under penaiae9 of perjury t declare that 1 have examined this tetum, inducting aocornpanying schedules and statements. and to the !~ at my knowledge artd brief,
it is true. oomxt and complete lion of preparer other n the personal representative is based on aq iMorrnaUon of which preparer has any knowledge.
SIGNATURE OF PERSON NSIBLE F L RN OATS ,
ADDRESS
100 KENT CIRCLE
SIGNATURE OF PR,~ARER OTHER THAN
1505610140
LADS4N
:NTATNE
PLEASE USE ORIGINAL FORM ONLY
Side 7
2945
oATE
1505610140
~~
`'~~'~
J
REV-1500 EX
~~NamP RENA V • GRISSINGER
Decedent's Social Security Number
1 8 4 1 2 4 5 3 2
RECAPITULATION
...........................................
1. 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.
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.
5 8 1, 0 L. 7 7
9 8 8 5. 8 5
3 L 5 3 9. 1 D
9 9 5 2 6. 7 2
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 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.
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 D D D
15.
(a)(1.2) X ~0
16. Amount of Line 14 taxable
7 8 5 2 9
2 0
16
at lineal rate X .045 .
17. Amount of Line 14 taxable D D D 17.
at sibling rate X .12
18. Amount of Line 14 taxable D D D 18
at collateral rate X .15 .
19. TAX DUE ............................................ ........ .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1505610240
150561,0240
Side 2
L 2 3 9 1,. 7 6
8 6 0 5. 7 6
2 0 9 9 7. 5 2
? 8 5 2 9. 2 0
7 8 5 2 9. 2 0
0. D 0
3 5 3 3. 8 1
o. 0 0
0. D 0
3 5 3 3. 8 1,
155610240
File Number
REV-1500 EX Page 3 21, ]., 2 0 3 6 9
>ecedent's Complete Address:
DECEDENT'S NAME _
~ENA V • GRISSINGER __ --- -- - - --
STREET ADDRESS
1,00 KENT CIRCLE
_ -- - -- ----- ;STATE ZIP
CITY S~ 29456
~ADSON
Tax Payments and Credits: (1) 3, 533.81,
~. Tax Due (Page 2, Line 19)
2. CreditslPayments 4, 0 0 0. 0 0
A. Prior Payments ], 7 6 . 6 9
B. Discount Total Credits (A + B) (2) 4 ,1, 7 6 • 6 9
3. Interest (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 6 4 2 • 8 8
Fill in oval on Page 2, Line 20 to request a refund.
(5) 0 •0 0
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Make check payable to: REGISTER OF WILLS, AGENT
~~ SASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
" Yes No
1. Did decedent make a transfer and: D
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; ... • • • • • • • ~ ~ • • • • • • • • ~ ~ • ~ • ~
.... ~ • ~ • ~
..... ^ X
.......................................................................................
c. retain a reversionary interest; or
^
X
.............................................
receive the promise for life of either payments, benefits or care? .....
d
.....
.
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
...... ^
0
.................................
without receiving adequate consideration? ................................................
edent own an "intrust for" or payable-upon-death bank account or security at his or her death? ...
Did d
....•• ^
ec
3.
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
.........
...... ^
^
tarns a beneficiar designation? ...................................................................................
con Y
E ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
IF TH
eath 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
For dates of d
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 f and the stat toe requirements forldisOcposuee of assets and
Y
X72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax,
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:
• he tax rate im osed 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 paren , an
T p
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]• eal beneficiaries is 4.5 percent, except as noted in
= The tax rate imposed on the net value of transfers to or for the use of the decedent's Iln
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9n16(a)(1.3)]. Asibling is defined, under
• The tax rate Imposed
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoptio
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
ESTATE OF 2 ], 12 0 3 6 9
RENA V• GRISSINGER
All nropertv jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION
NUMBER
~, M&T SECURITIES - ACCT• # 0000342206
ESEE ATTACHED
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
58,101.77
58 ,101.77
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
occin~niT f1F(`Ff1FNT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMB
ESTATE OF
RENA V• GRISSINGER 21, 12 0369
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.
VALUE AT DATE
ITEM OF DEATH
NUMBER DESCRIPTION
~, 2007 CHEVROLET COLBALT 9,000.00
2. ITHE SENTINEL - REFUND I 32.25
3• IKEMPER PREFERRED REFUND CHECK I 8.34
4• (SECURITY DEPOSIT RETURNED I 312.50
5• (PERSONAL PROPERTY I 500.00
32.76
6. BANK OF AMERICA REFUND
TOTAL (Also enter on line 5, Recapitulation) I $ 9 , 8 8 5.8 5
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
RENA V• GRISSINGER 21 12 0369
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
100 KENT CIRCLE
LADSON, SC 29456
RELATIONSHIP TO DECEDENT
DAUGHTER
ADDRESS
SURVIVING JOINT TENANT(S) NAME(S)
a. ~1ARY GRUBER
e
c
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
~, A. 9/10 MB~T CHECKING ACCT • #41,5774
ESEE DOD LETTER ATTACHED3
2 • A 9/1,0 WELLS FARGO ACCT • #101,0296344501,
ESEE ATTACHED3
3 . A 9/1,0 ~1&T SAVINGS ACCT • #15004201,561,550
ESEE DODO LETTER ATTACHED3
OF DATE OF DEATH
DATE OF DEATH DECEDENT'S VALUE OF
VALUE OF ASSET INTEREST DECEDENT'S INTEREST
5, 985.82 50 • 2, 992 •91,
6,785. 54~ 50 • ~ 3,392.77
50,306.84 50•~ 25,153.42
TOTAL (Also enter on Line 6, Recapitulation) I ~ 31 , 5 3 9 • 10
If more space is needed, use additional sheets of paper of the same size.
iZEV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF
RENA V• GRISSINGER 21, L2 0369
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER
A 1.
2•
4•
5-
6
3
2.
3.
4
5
6
7,
8-
DESCRIPTION AMOUNT
FUNERAL EXPENSES: 3, 7 0 3. 1, 2
HOLLINGER FUNERAL HOf1E 5,195.60
B-P•0• ELKS #578 - WAKE 150.00
f1INISTER 1,50 •00
RICK LE BLANC - FUNERAL 221.54
GEORGE'S FLOWERS 1,95.00
CARLISLE f1Ef10RIAL SERVICES
State ZIP
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Adtlress
State ZIP
City
Year(s) Commission Paitl:
Attorney Fees: DUNCAN & HARTf1AN PC
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Adtlress
City
Relationship of Claimant to Decedent
Probate Fees: REGISTER OF WILLS
Accountant Fees:
Tax Return Preparer Fees:
FILING FEE
HELD IN RESERVE
2, 000.00
261, • 50
1,5.00
500.00
TOTAL (Also enter on Line 9, Recapitulation) I $ 12 , 3 91 • 7 6
If more space is needed, use additional sheets of paper of the same size.
;LV-1512 EX+ (12-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
INGER 21, 12 0369
~ENA V- GRISS
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
VALUE AT DATE
ITEM
NUMBER DESCRIPTION OF DEATH
1, MIKE f1C CORKEL - RENT PAYf1ENT 1,015.00
907.42
2. SEARS
114 • 31,
3 . STOKEN OPHTHAL~10LOGY
3 41, • 31,
4. PPL
1, 635.09
5 . BANK OF A~1ERICA
472.83
6. CAPITAL BLUE CROSS
7. ~1IDDLESEX TOWNSHIP f1UNICIPAL AUTHORITY - W&S 78.75
71,•00
8. COf1CAST
9. TARGET - STORAGE CONTAINERS 53.14
10. KEMPER INSURANCE COf1PANY - CAR INSURANCE 154.68
63.59
1.,1. CENTURYLINK
12- f1ILT STACKFIELD - TRASH REMOVAL 1,00.00
13. ANGELA WHITE - CONDO CLEANING 450-D0
3 41, • 31,
1.,4. PPL - FINAL BILL
907.42
15• SEARS CREDIT CARD
TOTAL (Also enter on Line 10, Recapitulation) I $ 8 , 6 0 5 • 7 6
If more space is needed, insert additional sheets of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
21 12 0369
.ANA V. GRISSINGER Page 1 File Number
~~cedent's Name
~rhprl~~IP_ I - Debts of Decedent, Mortgage Liabilities, & Liens
i i civi DESCRIPTION
NUMBER
16. (hIDDLESEX TOWNSHIP - WATER BILL
17. COf1CAST - CABLE BILL
18• STOKEN OPTHA~10LOGY
19. BANK OF Af1ERICA CREDIT CARD
20• THREE SPRINGS FAf1ILY PRACTICE
~ti . C0~1~10NWEALTH OF PA - CAR TITLE
AMOUNT
78.75
23.66
1,14 .31
1„ 635.00
25.69
22.50
SUBTOTAL SCHEDULE I 1, , 8 9 9 • 91,
GRAND TOTAL SCHEDULE I ~ 8,605.76
REV-1513 EX+ (01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
RENA V• GRISSINGER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Incl Sec. 9196 (a) (~ ~jl]distributions and transfers under
1, MARY GRUBER
100 KENT CIRCLE
LADSON, SC 29456
FILE NUMBER:
21, 12
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
0369
AMOUNT OR SHARE
OF ESTATE
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, 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:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, use additional sheets of paper of the same size.
LAST WILL
~c
TESTAMENT
I, RENA V. GRISSINGER, of 40 Melron Court, Carlisle, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and declare
this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils
heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred beside my husband Ted in our burial plot
located at Westminister Cemetery.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath all of my estate of whatever nature, be it real,
personal or mixed, and wherever situate unto my daughter, MARY F. GRUBER, provided she
survives me by thirty (30) days. In the event she fails to survive me by thirty (30) days, I give,
devise and bequeath all of my estate unto SAFE HARBOUR of Carlisle, Pennsylvania..
FIFTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my
estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
SIXTH I hereby nominate, constitute and appoint MARY F. GRUBER as Executrix of
this my Last Will and Testament. In the event of renunciation, death, resignation or inability to
act for any reason whatsoever of MARY F. GRUBER, I nominate, constitute and appoint
SUSAN J. HARTMAN as Executrix of this my Last Will and Testament. I hereby relieve my
Executrix from the necessity of posting security in connection with her duties, as such, in any
jurisdiction in which she may be called upon to act insofar as I am able by law to do so. In
addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to
retain in the form received, and to sell either at public or private sale any real or personal
property owned by me at the time of my death.
IN WITNESS WHEREOF, I have hereunto set my~hand and seal to this, my Last Will and
Testament, consisting of one typewritten page this ~ day of 'yyl a~
201 1.
NA V. GRISSINGER
Signed, sealed published and declared by the above named Testatrix RENA V. GRISSINGER as
and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF CUMBERLAND
~~~
SS.
I, RENA V. GRISSINGER, Testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and
acknowledged before me, by
RENA V. GRISSINGER this ~n~ day
of ~ ~ /'G~ , 201 I .
~-~r/~ D, GI~L~~
Notary Pu lic
CQ ONWEALTH OF PENNSYL-VANIA
NOTARIAL SEAL
JDAN D. ADAMS, Notary Public
Carlisle Boro., Cumberland County
Commission Ex ices March 7, 2 11
~( osr~-V SYJiu-o A-~
RENA V. GRISSINGER
COMMONWEAL TH OF PENNS YL VANIA
COUNTY OF CUMBERLAND
:SS.
We, ~~~l1~ ~ ~~ ~/~~"~fil A N and G ,1,~v~s~
~,~v~/mar L
the witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw RENA V.
GRISSINGER sign and execute the instrument as her Last Will; that she signed willingly and
that she executed as her free and voluntary act for the purposes therein expressed; that each of us
in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our
knowledge, the Testatrix was at that time eighteen (1 S) or more years of age, of sound mind and
under no constraint or undue influence.
Sworn or affirmed to and
subscri~ ~ ~ r~~ b~_ ~~
~ t~ ~" N L___ and
tG ~ (,01~' 6~`J ~ ,witnesses,
this ;~~J(/~ day of , 201 1.
~(J •
Notary P lic
COMMONWEALTH O~ pENNSYLYANlA
NOTARIAL SEAL r~ublic
JOAN D. ADAMS, Notary
Carlisle Boro., Cumberland Coun
M Commission Expires Tvlarch 7, 2 11
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Me~TSank
499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302) 934-2955
August 23, 2012
Duncan & Hartman, P.C.
Susan J. Hartman
Qne Irvine Row
Carlisle, PA 17013
Re: E_ state of Rena V Grissin~er
Social Security' 184-12-4532
Date of Death: March 15, 2012
Dear Sir or Madam:
Per your inquiry on March 31, 2012, please be advised that at the time of death, the above-named decedent had
on deposit with this bank the following:
1. Type of Account Checking Account
Account Number 415774
Ownership (Names o, fl Rena V. Grissinger
Mary Gruber
Opening Date 07/01/1973
Balance on Date of Death $5, 985.82
Accrued Interest $ .00
Total $S, 985.82
2. Type of Account Savings Account
Account Number 15004201561550
Ownership (Names o~ Rena V. Grissinger
Marv Gn~ber
Operlirrg Date 11/17/1999
Balance on Date of Deat{t $50,306.10
Accnied Interest $ ~ 74
Total _.
$50,30b.84
REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death: 4 , 0 0 0 • 0 0
Discount: 2 1, 0 - 5 2
Interest Table
Year Days Delinquent Balance Due
this time period this year Interest
this period
Before 1981
.1982
1983
1984
1985
1986
1987
1988 throw h 1991
1992
1993 throw h 1994 _ x-
1995 throw h 1998
1999
r
2000
2001
,2002
_2003
2004
2005
2006
2007
2008
2009
2010
TOTALS
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17, 1996:
Penalty