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Home My WebLink About01-11-13 (2)EX (02-11) (FI) REV-1500 PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 1 7 1 28-0601 1505611185 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN 21, 1, 2 0 2 3 5 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 1,74-20-61,44 Decedent's Last Name 1,200201,1, MMDDYYYY Date of Birth MMDDYYYY 1,1,1,41,926 Suffix Decedent's First Name RICHWINE CHESTER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name RICHWINE MARILYN Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 200-22-51,33 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW MI L MI H 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 0 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 ^ 1 1. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number KEITH 0- BRENNEMAN, ESQ- 71,7-697-8528 First Line of Address 44 WEST MAIN STREET Second Line of Address City or Post Office State ZIP Code f1ECHANICSBURG PA 1,7055 RESTER OF WILLS~LISE ONLY ~~ ~ f ~' ~ .~ I g"~ ',~ ~ ~ ~ ~' i "n ~ f t' + 't ,. ~ --~x i ,_ ~.~ DATE ~D . ..... '° •~ /,k.3 ....rte e,b~ ~'~ ~, ~,~ Correspondent's a-mail address: 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN D TE ADDRESS ~1ARILYN H • RICHWINE, EXECUTRIX 5 f1ELW00D LANE, ~1ECHANICSBURG, PA17050 SIG ( . OF PREPARER OTHER THAN REPRESENTATIVE t D ~~~ ADDRESS KEITH 0 • BRENNE~1AN, ESQUIRE 44 WEST f1AIN STREET, ['1ECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA 17055 1505611185 Side 1 OM4647 3.000 1505611185 ~ h~c~ J 1505611285 REV-1500 EX (FI) Decedent's Social Security Number 1,74-20-61,44 Decedents Name RI~HWINE CHESTER ~- RECAPITULATION 1. Real Estate (Schedule A) 1. 0 • 0 0 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 g. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1 through 7) g. 0.00 0.00 0.00 56, 226 • 31, 0.00 0.00 56, 226.31, 9. Funeral Expenses and Administrative Costs (Schedule H). g. 2 , 9 0 7 • 6 5 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 1 p_ 0 • 0 0 1 1. Total Deductions (total Lines 9 and 10) , 1 1. 2 , 907 • 6 5 12. Net Value of Estate (Line 8 minus Line 11) 12. 5 3 , 318.6 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , . 13. 0 - 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) . 14. 5 ~ , 51, 8 - 6 6 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- 53,31,8 •66 15. 16. Amount of Line 14 t xable 4 ~ at lineal rate X .0 0 - 0 0 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 OM4648 3.000 0.00 0.00 0.00 0.00 0.00 J Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0 ' ~ ~ B. Discount ~ ' ~ ~ 3. Interest (1) 0 •00 Total Credits (A + B) (2) ~ ' ~ ~ (3) 0 •0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 0.00 (5) 0 •0 0 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: ^ 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 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? . ^ X 3. Did decedent own an "in trust for" or payable-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 transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §91 16 (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(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)j. 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. onnas~i z.ooo File Number REV-1500 EX (FI) Page 3 REV-1508 EX+ (11-10) pennsylvania SCHEDULE E ++ DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, ~ M~St+. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT FILE NUMBER: ESTATE OF: Chester L. Richwine 21 12 0235 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 1. Mony Life Insurance Company of America death benefit from contract #BL14380 & BL14381 TOTAL (Also enter on line 5, Recapitulation) $ owasAD 2.000 If more space is needed, use additional sheets of paper of the same size. 56,226.31 56,226.31 REV-1510 EX + (08-09} SCHEDULE G pennsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 12 0235 Chester L. Richwine This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY o EXCLUSION TAXABLE ITEM INCLIAE TFE NOME OF TFETRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH /o OF DECD'S IF APPLICABLE VALUE NUMBS THE DATE OF TRANSFER ATTACHACOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST 0 • 0 0 ~ 63,311.67 0 0.00 Prudential Life Insurance Life insurance policies as follows: a. #B1 108 639 - $10,802.42 b. #20 743 589 - $27,639.62 c. #25 330 225 - $11,816.67 d. #73 255 112 - $13,052.96 Decedent's spouse Marilyn H. Richwine was the designated beneficiary. These items are listed for informational purposes only and are not taxable. TOTAL (Also enter on line 7, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 0.00 9W46AF 2.000 REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OFREVENUE INHERITANCE TAX RETURN EDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS RESIDENT DEC FILE NUMBER ESTATE OF Chester L. Richwine 21 12 0235 Decedent's debts must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. I None B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address ~itv State ZIP Year(s) Commission Paid: AMOUNT 2. Attorney Fees: Snelbaker & Brenneman, P. C. (Estimated) 2 , 500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant C+roe+ ~rirlrocc 4. 5. 6. 7. 1 9W46AG 2.000 City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Cumberland Law Journal advertise Executrix Notice Total from continuation schedules . DESCRIPTION TOTAL (Also enter on Line 9, Recapitulation) ~ $ If more space is needed, use additional sheets of paper of the same size. 75.50 75.00 257.15 2.907.65 Estate of: Chester L. Richwine Schedule H Part 7 (Page 2) 2 Register of Wills Filing fee for Inheritance Tax Reurn and Inventory 3 Snelbaker & Brenneman, P.C. certified mail costs 4 The Sentinel advertising Executrix Notice Total (Carry forward to main schedule) 21 12 0235 30.00 5.75 221.40 257.15 REV-1513 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: L. Rich SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ TAXABLE DISTRIBUTIONS [InSeCe91t16h(a)p(1 2)~ istributions and transfers under 1. Marilyn H. Richwine 5 Melwood Lane Mechanicsburg, PA 17050 All of Residue: 53,318.66 FILE NUMBER: 21 12 0235 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Surviving Spouse I 53,318.66 _.__._.._......,.. ~+ ~1,+„~~~ non~ic nnl I INFO 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II IIIVIC a~a~.c +.a ++.+...... + ---- --- 9W46AI 2.000 _ ,~ ~'~ - a ~! _~_~ T ~~°~~ILL gTiD TESTriT~iEP1T OE' Ci7E`~TER L. RICHWINE I, C1lE~TER L. RIC~TWII~3E; of the Township of Silver Spring, County of Cunlberland_ and State of Pennsylvania, being a~ sound~=~ ~~ and dit pos irig mind, memory and. understandinT, do make , ~shr>~ ->_ =~? ,'1 T' ~ _ _ -.~ jr_ . -9 ~T'q rv i 1 and declare this i~ny Lest ti~~ill and Testament . ~~~~_~ rti _. - -~'~^~ __ .~ J ~.l J."',y - "t-~ --~ ~~ -,-q _~_ _ ,-' --t :..~ ~' ~ C~ ~:. I direct ti?e payment of all my just debts and funeral expenses as soon lifter my decease as the san7e can conveniently be done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate . of whatsoever nature and i~rheresoever situate, to my wife; 1~Iaril~n H~ Richwine, absolutely and unconditionally. 3• In ,he event tll~at my wife , Marilyn H . Richwine , should prede- cease 1Tie , or should she die at about tl~ie same time as I do, such as in a1~ accident com~~on to both of us, ti~en in ouch event, I give, devise a.nd bequeath ray entire estate, real, personal and mixed, whatsoever and wheresoever the same may be situated, to my two children, to wit, Robert E. Richwine and Betsy flnn Richwine, share and share alzl~e LASTLY, 1 nornin~~.te, constitute a.nd appoint my wife, Marilyn H. Richwine. Executrix of this my Last V~ill and mestament, and in the event tll~~at my raid. wife should predecease me, or should she be unable or unwilling, to serve in such capacity for any reason, then in such event, I nom~~ate, constitute and appoint my two children, to 1,v it, Robert E. Richwine and Betsy Ann Richwine,. -1- I~r ~ .?i ~4 V3n~+''~ '. ,~ ~ y11~ T - ~ 1 , M1 ~~~t~ R~~~ 1 T ~ i ~ 7 b t ~~~ { A ~ r+ N r '~' ~f 74 r ~ f ~+ .+ 7~.L.'r r ~ 5 l ~~, i,.~i ~ .J Y k ' ° ~ *° i~~ r~' ~ ° ;~i; ~Z ,. , .. ~ ~ _~a°~_ ~' . afm.6Ys~VnY . n . tP • . ~ n- Ci0-~'~1-eCi,ltOl_~ C' t~]-~ ~ Ii'1f T ~.s 1, ~~V~~ ~ ~ and ~ e~;t-~.iii'~.S1Z _i rl i~er ~~iciCe a:~d stead. rl~l ~~~il~ j\i"~~=~`_~ I~`,1Flr',rs~,`?j' I '"1~.V~ iLer'8L1:C'it,0 s~. ~ '.Tiy` huna and se-~.1 t1_'11~ ~.. d_~y ~~f July ~ rL . D . 1x`76 . (SEAL) Chester L. Richwine Si~'n~c1 _~~led, pug, ~ is'_~ied a. rid declared Chester L. .Richwine , .as and ~'or his Last ~~,ri the presence ;~' us~ who have subscribed our witnesses; at the request of said testator? in the preser_~~~° ~,~~' eacn other, ~, by t1_~>e above named ~ 11 and Testament , in n ;rues hereto as in his presence and --- r' ~,, . - ,~ ,~ ~s ,. ,r _ ;' - _.,, .:nM G~, ~~ ~' k'A'a ". `' `~; -: r ~; _2_