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Home My WebLink About02-04-13 1505610143 REV-1500 Ex (a2_,,, PA De artment of Revenue P OFFICIAL USE ONLY pennsylvania Bureau of Individual Taxes County Code Year File Number oEVnnrMENTOF NEVENUE PO 80X.280601 Harrisburg PA 17128-0601 INHERITANCE TAX RETURN 21 13 t 2 , ~ ~ RESIDENT DECEDENT J ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 09 07 2012 O1 28 1948 Decedent's Last Name Suffix Decedent's First Name MI GUISE DONALD =, (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI GUISE LINDA A Spouse's Social Security Number 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 Estate ^ qa Future Interest Compromise 5. Federal Estate Tax Return Re wired (date of death after 12-12-82) ^ q g Decedent Died Testate ~ (Attach Copy of Will) ~ Decadept Maintained a Living Trust 0 (Attach Copy of trust) 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (Date of Deatn 11. Election to tax under Sec. 9113(A) between 12-31 91 and T-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 EDWARD P SEEBER 7~7 533 8~ ~ M First Line of Address SUITE C400 Second Line of Address 555 GETTYSBURG PIKE City or Post Office MECHANICSBURG State ZIP Code PA 17055 R~I~ER OF V~LS ~ ~ILY " rnx~ -~~ ~~'~ '..~ ~ ~ ''~ ]y ~t7 ~ ~ ~ ~~~ ~ ~ ~~~ _.~ ro t--- ~ DATE Ff D -rt Correspondent's a-mail address: ePs~l'SdC.COm 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. SIGNATUR~IF PERSON RESPpNSI~I.E FOR FILING RETURN ner~ ~~- Linda A. Guise / ~2S /3 RER OTHER THAN REPRESEN"~IIVE-"""- ~~ DATE Edward P Seeber ~~}3 // ~ 555 Gettysburg Pike^Suite C-400dVlechanicsburgCPA 17055 Side 1 L 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: C7UISe~ Donald L. 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 & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 713.10 7. Inter-Vivos Transfers & Miscellaneous ion; Probate Property (Schedule G) u Separate Billing Requested............ 7. 178 , 302.21 8. Total Gross Assets (total Lines 1 through 7) ........................................................ 8. 17 9 , 015.31 9. Funeral Expenses and Administrative Costs (Schedule H) .................................... 9. 14 , 085.08 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............................ 10. 11. Total Deductions (total Lines 9 and 10) ................................................................ 11. 14 , 085.08 12. Net Value of Estate (Line 8 minus Line 11) ................................. . ........................ 12. 164 , 930.23 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. 164 , 930 .23 TAX COMPUTATION -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 .o0 164 , 217.13 15. O. 00 16. Amount of Line 14 taxable at lineal rate X ..045 713.10 1s. 32.0 9 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ................................................................................................................ 19. 32.0 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Guise, Donald L. STREET ADDRESS 4283 Carlisle Road CITY Gardners Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0..00 File Number 21-13 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2~~ine 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. STATE ZIP PA- 17324 (1) 32.09 Total Credits (A + B) (2) 0.00 (3) (4) (5> 32.09 Make Check Payable to' REGISTER OF WILLS~AGENT. ~ ~ h iFv a rk' st'.' k 8u k 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 :.................................. ~ a c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? .................... . ....................................... x 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 neficiary designation? .................. ~ ^ ................. . IF THE ANSWER TO ANY OF arns a THE ABOVE QUESTIONS IS YES~YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r , . ., ~, , 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 January 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)]. A sibling 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-1509 EX+ (01-10) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Donald L. 21-13 ff an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Rebecca or Grace Sangmeister 35 East Woodland Avenue Granddaughter Penndel, PA 19047 B. Veronica ~ Chad Guise 106 North Middlesex Road Granddaughter 8t Son Carlisle, PA 17013 C. Violet ~ Chad Guise 106 North Middlesex Road Granddaughter & Son Carlisle, PA 17013 JOINTLY OWNED PROPERTY: ITEM LETTER FOR JOIN DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT % OF E OF TH DAVA~ NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR DATE OF DEATH VALUE OF ASSE DECD'S U DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. INTEREST 1 A 05/19/999 Members 1st Federal Credit Union Savings 495 42 50 000% Account No. 183762 -valued per bank letter . . 247.71 dated 1/16/13 2 A 04/09/2002 Members 1st Federal Credit Union Savings 441 11 50 000% Account No. 216156 -valued per bank letter . . 220.56 dated 1116/13 3 C 03/17/2006 Members 1st Federal Credit Union Savings 648 76 33 333°/ Account No. 270762 -valued per bank letter . . a 216.25 dated 1/16113 4 B 04/09/2007 Members 1st Federal Credit Union Savin s 9 85 75 o 33 333 / Account No. 303983 -valued per bank letter . . 0 28.58 dated 1 /16/13 TOTAL (Also enter on Line 6, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2010 form software only The Lackner Group, Inc. SCHEDULE F JOINTLY-OWNED PROPERTY 713.10 Form PA-1500 Schedule F (Rev. 01-10) Rev-1510 EX+ (08-08) SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Guise, Donald L. 21-13 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 1 DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. TD Ameritrade IRA No. 913-908091 -valued per statement ending 8/31/12; beneficiary is spouse DATE OF DEATH VALUE OF ASSET 178,302.21 % OF DECD'S INTEREST 100.000% EXCLUSION (IF APPLICABLE) 0.00 TAXABLE VALUE 178,302.21 2 Cash gift to Grace Sangmesiter, granddaughter on 12/8/11 125.00 100.000% 125.00 0.00 3 Cash gift to Grace Sangmesiter, granddaughter on 3/29/12 125.00 100.000% 125.00 0.00 4 Cash gift to Rebecca Sangmesiter, granddaughter on 1 /3/12 125.00 100.000% 125.00 0.00 5 Cash gift to Rebecca Sangmesiter, granddaughter on 3/1 /12 125.00 100.000% 125.00 0.00 6 Cash gift to Veronica Guise, granddaughter on 113/12 125.00 100.000% 125.00 0.00 7 Cash gift to Veronica Guise, granddaughter on 311/12 125.00 100.000% 125.00 0.00 8 Cash gift to Veronica Guise, granddaughter on 8/1/12 125.00 100.000% 125.00 0.00 9 Cash gift to Violet Guise, granddaughter on 1/3/12 125.00 100.000% 125.00 0.00 10 Cash gift to Violet Guise, granddaughter on 7/19112 125.00 100.000% 125.00 0.00 TOTAL (Also enter on Line 7, Recapitulation) 178,302.21 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 08-09) REV-1151 Ex+ (10-09) COMMONW~4LTtl O ,Fq~PENN~YLVANIA INFjER IDEN44~iEDTECEDEN RN ESTATE OF Guise[~onald L. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER 21-13 ITEM NUMBE A. FUNERAL EXPENSES: See continuation schedule(s) attached Decedent's debts must be reported on Schedule I. DESCRIPTION AMOUNT 13 X320.08 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid 2. Attorney's Fees James^Smithmietterick & ConnellyCLLP 750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zlp Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7• Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL (Also enter on line 9rRecapitulation) 14m85.08 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ~•~ ~ t+~ ~ vr• IFILE NUMBER Guise, Donald L. 21-13 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exn ns _c 1 Hollinger Funeral Home & Crematory -funeral services 13,320.08 H-A 13,320.08 Other Administrativ Gostc 2 Register of Wills, Cumberland County -filing fee for Return 15.00 H-B7 15.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) , ~ ~ 1 REV-1513 EX+ (01-10) COMMOry R IDEN~EDECEDEN~RN ANIA SCHEDULE J BENEFICIARIES ESTATE OF Guise Donald L FILE NUMBER , . 21-13 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOU I TAXABLE DISTRIBUTIONS [include outright spousal (Vllords) distributions, and transfers under Sec. 9116 a 1.2 1 Ch d 8 a Veronica Guise 106 North Middlesex Road Son 8 Joint account Carlisle, PA 17013 Grandaughter 2 Chad 8 Violet Guise 106 North Middlesex Road Son & Joint account Carlisle, PA 17013 Grandaughter 3 Linda Guise 4283 Carlisle Road Spouse IRA Gardners, PA 17324 4 Grace Sangmeister 35 East Woodland Avenue Granddaughter Joint account Penndel, PA 19047 5 Rebecca Sangmeister 35 East Woodland Avenue Granddaughter Joint account Penndel, PA 19047 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 ov~easheet, as a I i II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS VT OF ESTATE ($$$) 28.58 216.25 164,217.13 247.71 220.56 164,930.23 ~ ~ ~ a~ OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 01-10)