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HomeMy WebLinkAbout02-28-13J 1505610143 REV-1500 Ex(o2_„> m ~~~, PA De artment of Revenue OFFICIAL USE ONLY p Pennsylvania County Code Year File Number Bureau of Individual Taxes oevnaTMarrornevenue Po Box.2sosot INHERITANCE TAX RETURN 21 12 1288 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 12 05 2012 03 28 1932 Decedent's Last Name Suffix Decedent's First Name MI ENGLE SHIRLEY S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 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) L) q g Decedent Died Testate (Attach Copy of will) ~~ ~ Decedent Maint ned a Living Trust 0 (Attach Copyrust) _ 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~~ 1 D, spousal Poverty Creditl(Date of Death 11. Election to tax under Sec. 9113 A between 12-31 91 and -1-95) ~ ( ) (Attach Schedule O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXI RMATION SFII3IJLD BF~I~CTED TO: Name Daytimel8phone Number ~ rTi GREGORY M KERWIN 717 ~ b°o2 32~ ~ ~ First Line of Address 4245 STATE ROUTE 209 Second Line of Address City or Post Office State ZIP Code ELIZABETHVILLE PA 17023 ~, ~ REG~T DWI LE~USE~CINI;7' V '~ ~ c:a s c~ c ~W ,,~, - ~.i f_.. ~ ~~ I:..~ ~ ; _ :s> C~ iri 4 'Ti DATE FILED Correspondent's a-mail address: gmkerWln~hOtnlall.COrTI Under penalties of pery'ury, I deGare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, cprrect and corog+lete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG • RE OF PERSO CPr1NCl F.cno c SIGNATURE OF ADDRESS Gregory M Kerwin DATE ~ ~i -/s 4245 State Route 209, Elizabethville, PA Side 1 ~..~ 1505610143 1505610143 J PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF Engle, Shirley S FILE NUMBER 21-12-1288 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 IsrJowledge. Signature #2 Name Addressl Addressl City, State, Zip 4245 State Route 209 Elizabethville PA 17023 Date 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Engle, Shirley S 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. 1 Q , 9 91.0 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested.......... .. 6. 1 Q 6 , Q 51.68 7. Inter-Vivos Transfers 8 Miscellaneous I~nq Probate Property (Schedule G) LJ Separate Billing Requested.......... .. 7. 8. Total Gross Assets (total Lines 1 through 7) ..................................................... ... g. 117 , Q42 . 68 9. Funeral Expenses and Administrative Costs (Schedule H) ................................. ... 9. 17 , 455.13 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......................... .. 10. $ 5 6 , Q Q 11. Total Deductions (total Lines 9 and 10) ............................................................. ... 11. 18 , 311.13 12. Net Value of Estate (Line 8 minus Line 11) ................................. .. ..................... .. 12. 98 , 731.55 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. 98 , 7 31 . $ 5 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 .00 15. 0 . Q 0 16. Amount of Line 14 taxable at lineal rate x .045 98 , 731 .55 16. 4 , 442.92 17. Amount of Line 14 taxable at sibling rate X .12 O. O Q 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 O. O Q 18. 0. 0 0 19. TAX DUE ............................................................................................................... . 19. 4 , 442.92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 I..~ 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Engle, Shirley S STREET ADDRESS 453 Pawnee Drive CITY Mechanics Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4,580.44 222.15 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2, Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make Check Pa r~a ~, ,_~~,~~~-~:. ~: ~Y,r::~ ble to: REGISTER OF WILLS, AGENT. 4,802.59 359.67 (3) (4) (5) 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? ............................................................ [ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................ 3. Did decedent own an "in trust for" or payable 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 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. File Number 21-12-1288 STATE ZIP PA 17050 (1) 4,442.92 Total Credits (A + g) (2) Rev-1508 EX+111.10) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER En le, Shirle S 21-12-1288 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jotntlyowned with the right of survivorship must be disclosed on schedule F. - -~ - - ~ ~.unwi ici payer yr me same size) Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10) Rev-1509 EX+101.10) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER En le, Shirley S 21-12-1288 n an asset was made joint within one year of the decedenPS date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Karen L Shillings B. C. 766 Corwood Drive Daughter Sarasota, FL 34234 JOINTLY OWNED PROPERTY: ITEM LETTER FOR JOINT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH ° /o OF DATE OF DEATH NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSE DECD'S INTEREST DECEDENT'S NTEREST 1 A 07/09/2007 Premises situate at 453 Pawnee Drive, 171,000.00 50.000% 85 500 00 Mechanicsburg, PA -Value based on selling , . price -see settlement sheets attached hereto 2 A 11/02/2004 Members 1st, 5000 Louise Drive, PO Box 40, 3,308.45 50.000% 1 654 23 Mechanicsburg, PA -Regular Savings , . Account #139656-00 3 A 11/02/2004 Members 1st, 5000 Louise Drive, PO Box 40, 9,493.42 50.000% 4 746 71 Mechanicsburg, PA -Checking Account , . #139656-11 4 A 11/02/2004 Members 1st, 5000 Louise Drive, PO Box 40, 27,565.55 50.000% 13 782 78 Mechanicsburg, PA -Saving Account , . #139656-11 5 A 07/09/2007 Reimbursement of real estate taxes on sale 735.91 50.000°/a 367 96 of premises . TOTAL (Also enter on Line 6, Recapitulation) I 106,051.68 (If more space is needed, additional pages of the same size) ~ Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 01-10) REV-1151 EX+~10A9) COMM~WF~I,T~OF p Dyryg RLVANIA SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Engle, Shirley S 21-12-1288 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Hetrick-Bitner, Harrisburg, PA -Funeral 2,245.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s) Commission Paid 2. Attorney's Fees Kerwin & Kerwin, LLP 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 115.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 11,594.63 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 17 455.13 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 ESTATE OF FILE NUMBER Engle, Shirley S 21 12 1288 ITEM NUMBER DESCRIPTION AMOUNT 1 Other Administrative Gosh Notary fee on Oath of Subscribing Witness 5.00 2 Notary fee on car title 5.00 3 1/2 of Settlement Charges on sale of Real Estate 6,767.19 4 Airline Flights to and from Florida -For Funeral, to prepare premise for sale, to settle on 2 188 30 property , . 5 Hotel -While staying in PA 1,076.93 6 Hertz -Car rental while in Pennsylvania 341.41 7 Moving furniture to Florida 915.00 8 Moving expenses in Pennsylvania 75.00 9 Maid service -Cleaning house prior to sale 190.80 10 Register of Wills -Filing Inheritance Tax Return and Invento ry 30.00 H-67 11,594.63 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA MORTGAGE LIABILITIES AND LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER En le, Shirle S 21-12-1288 Report debts incurred by tfie decedent prior to death that remained unpaid at the date of death, including unreimbureed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 PPL Electric Utilities Company -Account payable for electric 658.55 2 Comcast -Account payable for TV cable 70.00 S Water Bill 127.45 TOTAL (Also enter on Line 10, Recapitulation) I 856.00 (If more space is needed, additional pages of the same size) Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+101-10) COMM_QI~ H pF~DNNg RLVANIA SCHEDULE J BENEFICIARIES ESTATE OF En le, Shirle S NUMBER NAME AND ADDRESS OF PERSON(Sl RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(al(1.211 Karen L Shillings Corwood Drive Sarasota, FL 34234 FILE NUMBER 21-12-1288 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) Daughter ~ Entire Estate Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 co~easheet as a NON-TAXABLE DISTRIBUTIONS: II• A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS • -- • --~ ~~ r-nrt ~ n - ~rv 1 CK I v I AL rvoN-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)