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HomeMy WebLinkAbout01-10-13 (3)1505610140 REV-1500 EX `°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN _ /~ j /~ C'~~ )CI Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ t .7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date Of Birth MMDDYYYY 2 0 1 0 7 4 8 7 1 0 3 2 6 2 0 1 2 0 5 1 9 1 9 1 6 Decedent's Last Name Suffix Decedent's First Name MI J U L I U S E D WI N A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI J U L I U S MARGARET S Spouse's Social Security Number 1 6 4 3 4 ~ 4 7 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4 Limited Esta[e ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after l2-12-82) 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 CONFIDE NTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Narne Daytime Telephone Number KENT H PA T T ERSON 7 1 7 2 3:~; 4 1;,;~0 0 ~' ~; ~ ~ I~iGI~ER OF WILLS US6Df~' ~ it =~ ~ J7 - I n r n -- ... ~ ; ;, t--' i Y'E t ~'1 ~~' r First line of address i n ~~~ 2 2 1 P I N E S T R E E T ="` ~'"` ,, ~ ` ~.z ~ ~ Second line of address ' ` ^ "-, ; - - ca; ~ :x ` City or Post Office State ZIP Code g y DATE fD~"7 D H A R R I S B U R G P A 1 7 1 0 1 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 belie!. 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. J Susan J. Wible, executrix, 662 Diane Drive _ Etters __ PA 17319 SIGNATU E OF EPA R OTHER THAN REPRESENTATIVE DA E `--" ,ADDRESS Sara J. ongy. ecut , 5 Victoria Way Camp Hill PA 17011 _ PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 15056101.40 ~ ~~ 1505610240 REV-1500 EX Decedent's Social Security Number ~ecedenrsNeme: EDWIN A. JULIUS 2 0 1 0 7 4 8 7 1 RECAPITULATION 1. Real Estate {Schedule A) 1. 2. Stocks and Bonds (Schedule B) 2 2 9 3 5 0 3, 3 7 ...................................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ................... ..... .. 4. 6 6 8 9 4 7 5. Cash, Bank De osits and Miscellaneous Personal Pro ert Schedule E P P Y( ) ..... .. 5. , 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 1 9 7 1 9 1 6 (Schedule G) ^ Separate Billing Requested ..... .. 7. , 8. Total Gross Assets (total Lines 1 through 7) .................. ..... .. 8. 3 1 9 9 1 2 , 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ........... ..... .. 9. 2 1 0 1 0 7 1 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ..... .. 10. 4 9 2 3 . 6 4 11 Total Deductions (total Lines 9 and 10) .... .. 11. 2 5 9 3 4 . 3 5 12. Net Value of Estate (Line 8 minus Line 11) ....... ..... .. 12. 2 9 3 9 7 7 . 6 5 13 Charitable and Governmental BequestslSec 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. 2 9 3 9 7 7 . 6 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal Cax rate, or transfers under Sec. 9116 (a)(1.2>x.o _ 1 0 2 6 2. 7 5 15. 0. 0 0 16. Amount of Line 14 taxable 2 8 3 7 1 4 9 0 1 2 7 6 7 1 7 . at lineal rate X .045 1s. . 17 Amount of Line 14 taxable 0 0 0 17 0 0 0 at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate x .15 18. 19 TAX DUE .............. ..... .. 19. 1 2 7 6 7. 1 7 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 + 0 0 DECEOENrsNAME EDWIN A. JULIUS STREET ADDRESS 3 Victoria Way CITY ,STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: ~ Tax Due (Page 2, Line 19) (1) 12,767.17 2 CreditslPayments A. Prior Payments B. Discount Total Credits (A + g) (2) 0.00 3. Interest (3) 7.33 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 + Llne 3 Is greater than Line 2, enter the difference. This is the TAX DUE. (5) 12,774.50 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 : ................................................................. ..... ^ Q 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? .................................................. ..... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ..... ^ Q 3. Did 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? ............................................................................................. ..... ~ ^ 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 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, are 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, undf Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. RF V-~ 503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER EDWIN A. JULIUS + 0 0 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VAUUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Oppenheimer & Co., Inc. -Account #A09-0014018 1. Alcatel-Lucent common stock - 7 shares 17.01 2. ATST common stock - 500 shares 15,895.00 3. Bank of America common stock - 200 shares 1,986.00 4. Comcast Corp common stock - 48 shares 1,456.80 5. Fairpoint Communications common stock - 15 shares 0.00 6. FNB Corp common stock - 628 shares 7,749.52 7 Ford Motor Company common stock - 100 shares 1,248.00 8. Frontier Communications common stock - 791 shares 3,298.47 9. Hersha Hospitality Trust (REIT) - 730 shares 3,978.50 10. Hospitality Properties Trust (REIT) - 630 shares 16,411.50 11. Idearc Inc. common stock - 39 shares 0.00 12. ING Groep NV preferred stock - 400 shares 8,792.00 13. Medical Properties Trust (REIT) - 350 shares 3,374.00 14. Pepco Holdings common stock - 775 shares 14,763.75 15. Verizon Communications common stock - 796 shares 31.306.68 TOTAL (Also enter on line 2, Recapitulation) $ 293.503.37 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent EDWIN A. JULIUS + DecedenPs Name Page 1 File Number Schedule B -Stocks 8 Bonds ITEfv9 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 16. Windstream Corp common stock - 800 shares 9,544.00 17. John Hancock Preferred Income Fund - 350 shares 7,605.50 18. Income Fund of America stock - 3,597.363 shares 63,205.67 19. Nuveen Preferred Income Fund - 1400 shares 12,404.00 20 Advantage Government Liquidity Fund - 90,466.97 shares 90,466.97 SUBTOTAL SCHEDULE B 183,226.14 GRAND TOTAL SCHEDULE B $ 293,5(13.37 RFV-1508 EX~ (11-10) pennsylvania SCHEDULE E DEr ARTMENI OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESioENTOECEOENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: EDWIN A. JULIUS + 0 0 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 ~ Metro Bank Account #05125089590 3,9.55.83 2. Highmark Insurance refund 241.09 3. Ohio Casualty refund 583.70 4. Fidelity Mutual Distributing Trust 22.85 5. Social Security Administration payment 1,65'7.00 6. Maguire Ford lease refund 189.00 TOTAL (Also enter on Line 5, Recapitulation) I $ 6 689.47 If more space is needed, insert additional sheets of paper of the same size REV-1510 EX+ (08 09) pennsylvania OEPARTMENI OF REVENUE INHERITANCE TAX RETl1RN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER EDWIN A. JULIUS + 0 0 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. ITEM NUMBER DESCRIPTION OF PROPERTY ir;auoE -11E N,~r~E of rHF rRnNSFEREE rHnR RE~nTioNSr+la ro oecEOENT nNO rHeonTEOFrRnNSrER.~,rrncHacoPVaFTHEOeeoFOF,RFn~ESTnrE DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION pFnavucne~el TAXABLE VALUE 1. The Income Fund of America - A 19,719.16 100.00 19,719.16 CB&T Custodial IRA Account#6003-8901-06 Beneficiaries upon death of decedent -Susan J. Wible and Sara J. Songy -daughters of decedent TOTAL (Also enter on Line 7, Recapitulation) I $ 19,719.16 If more space is needed, use additional sheets of paper of the same size. RFV-1511 EX~ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF EDWIN A. JULIUS Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION A FUNERAL EXPENSES: 1 Shalonis Funeral Home 2. Duke's Riverside Restaurant -funeral reception FILE NUMBER + 0 0 AMOUNT 9,560.90 1,077.81 B 1 2 3 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Attorney Fees: Kent H. Patterson Family Exemption (If decedent's address is not the same as claimant's, attach explanation,) Claimant Margaret S. JUIIUS ,500.00 3,500.00 street Address 3 Victoria Way c;ty Camp Hill state PA ZIP 17011 Relationship of Claimant to Decedent S~JOUSe 4. Probate Fees: Register of Wills 382.00 5 Accountant Fees: 6 Tax Return Preparer Fees. 7. Cumberland Law Journal 75.00 8. Central Penn Business Journal 150.00 9. Reserve for costs 1,500.00 10. Register of Wills -filing fees 30.00 11. Boreman & Babb Accountants 235.00 TOTAL (Also enter on Line 9, Recapitulation) $ 21,010.71 If more space is needed, use additional sheets of paper of the same size REV-~ 512 EX+ (12-08) pennsylvania SCHEDULE °E~aRTME"T °F RE~E""` DEBTS OF DECEDENT, wHERirnNCE Tax REruRN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER EDWIN A. JULIUS + 0 0 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 DESCRIPTfON OF DEATH 1 Minna Pulgar -personal care 192.00 2. Genevieve Wilson -personal care 888.00 3. Senior Helpers -personal care 300.00 4. Cumberland Apothecary 144.57 5. Visiting Angels -personal care 897.00 6. Ohio Casualty 559.38 7. Minna Pulgar -personal care 54.00 8. Genevieve Wilson -personal care 144.00 9. Ford Credit 327.20 10. Debbie Lupold, Tax Collector 721.08 11. PPL 52,12 12. Senior Helpers -personal care 20.00 13 PA American Water 19.25 14. Pinnacle Health 36.75 15. UGI 26.28 TOTAL (Also enter on Line 10, Recapitulation) I $ If more space is needed, insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent EDWIN A. JULIUS + Decedent's Name Page 2 Schedule 1 -Debts of Decedent, Mortgage Liabilities, & Liens File Number ITEf~~ NUMBER DESCRIPTION AMOUNT 16. Social Security Administration -partial refund of benefits 542.00 SUBTOTALSCHEDULEI 542.00 GRAND TOTAL SCHEDULE I $ 4,923.64 REV~151:; EX+f01_10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ff~1A/IN A .II II II IS + n n 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) (12).] 1 Susan J. Wible Lineal 141,857.45 662 Diane Drive Etters, PA 17319 2. Sara J. Songy Lineal 141,857.45 5 Victoria Way Camp Hill, PA 17011 3. Margaret S. Julius Spousal 10,262.75 3 Victoria Way Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. I I. 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. $ lr more space Is neeoea, use aaolnonal sneers or paper or me same size. ATTACHMENT TO SCHEDULE J Person Receiving Relationship Share of Estate Property to Decedent 1. Susan J. Wible daughter =~ of Item 1 of Schedule G; ~ of remainder interest of residual trust 2. Sara J. Songy daughter =~ of Item 1 of Schedule G; '~ of remainder interest of residual trust 3. Margaret S. Julius wife life estate in residual trust Amount of Estate $141,857.45 $141,857.45 $ 10,262.75 REV-1514 EX+ (4-09) pennsylvania DEPARTMENT Uh REVENUE Bureau of Individual Taxes PO Box 280601 Hauisburg PA 17128-0601 SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (CHECK BOX 4 ON REV-1500 COVER SHEET) ESTATE OF FILE NUMBER EDWIN A. JULIUS + 0 0 This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. ^ Will ®Intervivos Deed of Trust ^ Other NAME OF LIFE TENANT DATE OF BIRTH • NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Mar aret S. Julius 9/1/1915 97 ®Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1 Value of fund from which life estate is payable , , , , , , , , , , , , , ,,, $ 274,258.49 2. Actuarial factor per appropriate table , ..... , , , . , , .03742 Interest table rate - ^ 3.5% ^ 6% ^ 10% ^X Variable Rate 1.4 3. Value of life estate (Line 1 multiplied by Line 2) $ 10,262.75 NAME OF LIFE ANNUITANT DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE ^ Life or ^Term of Years ^ Life or ^ Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which annuity is payable , , , , , , , , , , ,,,, , , 2 Check appropriate block below and enter corresponding number ...... , , , ........... Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^ Semi-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period 4 Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . ........ . . 5 Annuity Factor (see instructions) Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate 6. Adjustment Factor (See instructions) 7. Value of annuity - If using 3.5%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ...........................$ If using variable rate and period payout is at beginning of period, calculation is (Line 4 x Line 5 x Line 6) + Line 3 .. . ... . ...... . c NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. Ii more space is needed, use additional sheets of the same size. REV-1649 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE NUMBER EDWIN A. JULIUS + 0 0 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. tf the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital residual A B By-pass Unified Credit etc ) If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or sim- ilarproperty treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. Residual trust dated 11/4/1995 for benefit of Margaret S. Julius 274,258.49 Part A Total I $ 274 258 49 Part B: Enter the descri tion and value of all interests included in Part A for which the Section 9113 A election to tax is bein made. Description Value Residual trust dated 11/4/1995 for benefit of Margaret S. Julius 274.258.49 (If more space is needed, insert additional sheets of the same size) 274.258.4